Tocilizumab is useful for coronavirus disease 2019 patients: the key point is timing

SUMMARY OBJECTIVE: In coronavirus disease 2019, a rapidly progressive inflammatory process is considered to be the main cause of organ damage and mortality. Therefore, the importance of anti-inflammatory treatments such as tocilizumab is increasing. METHODS: A total of 107 patients who received tocilizumab between March 2020 and March 2021 were included in the study. The primary termination point was mortality. We compared surviving and deceased patients by the stage of the disease and where the drug was given (service or intensive care unit). RESULTS: The mean age was 60.8±14.6 years (minimum 29 years, maximum 96 years). According to the WHO staging system, 16 (15%) patients had moderate, 47 (43.9%) patients had severe, 44 (41.1%) patients had a critical illness. Although all patients were admitted to the service, 26 (24.3%) patients received tocilizumab in the intensive care unit. Of 107 patients, 80 (74.7%) survived and 27 (25.2%) died. Mortality was found to be significantly higher in critical patients (96.3%), severe patients (3.7%), and moderate patients (0%) (p<0.001). Peripheral oxygen saturation measured at admission was found to be significantly lower in patients who died. The initial saturations (p=0.008) were found to have independent effects on mortality. CONCLUSION: The results showed that tocilizumab is an effective treatment option for coronavirus disease 2019 disease and reduces mortality, but the key point is timing.

The Effect of an Aerobic Exercise Programme on Blood Glucose Level, Cardiovascular Parameters, Peripheral Oxygen Saturation, and Body Mass Index among Southern Nigerians with Type 2 Diabetes Mellitus, Undergoing Concurrent Sulfonylurea and Metformin Treatment

@#Background: Diabetes mellitus increases the risk of cardiovascular diseases and allcause mortality. The present study investigated the effect of an eight-week aerobics programme on fasting blood sugar (FBS), cardiovascular parameters, peripheral oxygen saturation (SpO2), and body mass index (BMI) among subjects with type-2 diabetes mellitus (T2DM). Methods: A pretest-posttest experimental design was employed. Fifty subjects, diagnosed with T2DM, attending the Diabetes Clinic of the University of Nigeria Teaching Hospital, Enugu, were conveniently recruited, gender and age-matched, and randomised into exercise and control groups. The intervention included an eight-week aerobic exercise at 60%–79% HRmax for 45 min– 60 min, 3-days per week. The FBS, SpO2, BMI, resting heart rate (RHR), and systolic (SBP) and diastolic blood pressure (DBP) of the subjects were measured before and after the intervention. The paired and independent t-test(s) were used for the analyses within and between the groups, respectively (P ≤ 0.05). Results: The exercise group had a significantly lower SBP (15.0 mmHg, P = 0.001), DBP (7.9 mmHg, P = 0.001), RHR (4.8 bpm, P = 0.001), FBS (34.9 mg/dl, P = 0.001), and BMI (2.3, P = 0.001), while the SpO2 improved by 3.9% with P = 0.001, relative to the control group.Conclusion: Aerobics is an efficacious adjunct therapy in controlling the FBS level, blood pressure, BMI, and improving SpO2 among T2DM subjects

A survey on the implementation of the early goal-directed therapy after cardio-pulmonary resuscitation in Suzhou area / 中华急诊医学杂志

Objective To evaluate the implementation of the early goal-directed therapy after cardiopulmonary resuscitation in Suzhou area,in order to provide clinical data for standardized post resuscitation care.Methods This retrospective study included comatose survivors of CA,admitted into intensive care units (ICU) of 10 hospitals in Suzhou area between January 2009 and December 2010.the parameters,mean arterial pressure (MAP),peripheral oxygen saturation (SpO2),partial pressure of carbon dioxide (PaCO2),blood glucose (Glu) and body temperature (T),were collected for 48 h after CA.The percentage of parameters achieving recommended goals was compared.Results A total of 101 CA patients were enrolled in this study.Among the parameters of GDT,the percentage of achieving recommended goals for SpO2 and MAP was 90.1％ and 81.4％ ; the percentage of achieving recommended goals for Glu and PaCO2 was 55.4％ and 32.8％ ; however,mild therapeutic hypothermia (MTH) reached the lowest percentage,only 10％ ; there were significant differences in the percentage of achieving recommended goals for these parameters,P ＜0.01.Conclusions The quality of early goal-directed therapy in the CA patients should be improved,especially in the management of body temperature and partial pressure of carbon dioxide.