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Objective To investigate the physical and mental condition and medicine consumption of medical staff of shelter hospitals in Shanghai during the fight against the epidemic of coronavirus disease 2019 (COVID-19). Methods A total of 144 frontline medical staff who fighting against the COVID-19 epidemic from a tertiary first-class hospital from Apr. 4 to May 12, 2022 were surveyed by questionnaires online. Their physical condition including body weight change before the medical work and one month later, sleep quality and the medicine consumption during the medical work were collected and analyzed. Results The mean body weight of frontline doctors before the medical work and one month later were (69.80+/-8.35) kg and (68.60+/-7.37) kg, while those of nurses were (55.36+/-8.27) kg and (53.80+/-7.38) kg, both showing a decreasing trend but without significant difference (all P>0.05). A total of 63.89% (92/144) frontline medical staff suffered from insomnia, of which 27.08% (39/144) needed drug intervention. The top 5 common diseases among frontline medical staff were sleep disorder (63.89%, 92/144), skin injury (25.69%, 37/144), body pain (23.61%, 34/144), oral ulcer (13.19%, 19/144), and acute upper respiratory tract infection (9.72%, 14/144). A total of 155 medical staff used drugs, and the top 5 common drugs were skin application (16.77%, 26/155), Ganmao'an granule (12.26%, 19/155), zolpidem tartrate tablets (11.61%, 18/155), Kangfuxin liquid (11.61%, 18/155), and celecoxib capsules (8.39%, 13/155). Conclusion Frontline medical staff in shelter hospitals are prone to have body weight change, sleep disorder, skin injury, body pain, oral ulcer, acute upper respiratory tract infection and so on, which suggests that in future similar large-scale medical support, it is necessary to pay sufficient attention to the physical condition of frontline medical staff and provide them sufficient medicine.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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Background: COVID-19 is caused by SARS-CoV-2 and has is responsible for over 619 million infections and over 6.5 million deaths globally since identification in 2019. Infection during pregnancy is associated with increased adversity including increased risks of admission to intensive care, increased ventilatory support, preeclampsia, preterm birth and maternal death. Vaccination remains the best protection against severe disease. The majority of trials for novel or repurposed COVID-19 therapies including mRNA vaccinations have excluded pregnant or lactating women despite being an at-risk population. Broccoli sprout extract contains a naturally occurring phytonutrient sulforaphane which upregulates the Nrf2 transcription factor resulting in expression of antioxidant proteins, anti-inflammatory effects and has demonstrated anti-viral effects in-vitro . Severe COVID-19 results in excessive cytokine production resulting in a proinflammatory state with significant oxidative stress and multi-organ dysfunction with evidence of placental abnormalities in almost half of infected mothers. Method(s): CO-Sprout is a pilot, double blinded, placebo controlled randomised trial that is recruiting pregnant women ( n = 60) between 20 and 36 weeks completed gestation with COVID-19 diagnosed within 5 days. Participants are randomised to either broccoli sprout capsules (containing 21 mg sulforaphane) or identical placebo (microcrystalline cellulose) twice daily for 14 days. The primary outcome will be duration (days) of COVID-19 related symptoms and other exploratory outcomes including unplanned hospital admissions, birth outcomes, inflammatory markers, microbiome and placental changes. Patients are recruited through maternity departments at Monash Health and Jessie McPherson Private Hospital. Result(s): Trial in progress. Conclusion(s): Trial results to be published after trial completion.
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Background: Treatment of iron deficiency anaemia (IDA) involves replenishing body iron stores either intravenously (IV) or orally. Previous studies of IV iron in pregnancy have been unblinded, which creates potential for bias measuring primary outcomes. We aimed to determine the feasibility of blinding pregnant women with IDA to IV iron (brown solution) compared to oral iron. Method(s): Two-arm, placebo-controlled randomised trial, with blinding of patients, clinicians and outcome assessors, at 2 Sydney maternity hospitals, 2021.2022. Pregnant women, .18 years of age, 26.32 + 6 weeks' gestation, with mildmoderate IDA (Haemoglobin 80.104 g/L and Ferritin <30 mug/ L), planning to give birth at one of the study hospitals were included. Women were randomised to either (1) a single IV ferric carboxymaltose 1000 mg infusion plus daily placebo oral capsules, or (2) oral capsules 80 mg elemental iron daily and a single placebo intravenous saline infusion, from treatment allocation to birth. Result(s): The study closed after recruiting 16/50 (32%) planned women, at a median gestation of 30 weeks. The baseline median haemoglobin was 101.5 g/L [interquartile range (IQR) 99.0-103.75 g/L] and baseline median ferritin was 11.5 mug/L [IQR 8.0-17.5 mug/L]. Two thirds of women (69%) correctly determined their treatment allocation on the infusion day, increasing to 87% at 4 weeks post infusion (100% of women IV iron). Median,[IQR] haemoglobin increased to 116 g/L, [113-120] and 110 g/L, [104-114] at 4 weeks in IV and oral iron groups respectively. Compliance, acceptability and side effects were measured. Conclusion(s): Blinding of women to IV iron was not successful at 4 weeks post-infusion. Trial recruitment was delayed and interrupted by COVID.
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A wide range of polymer-based drug delivery systems have been reported for the treatment of various diseases. However, the dosing regimen of many drugs, such as stimulator of interferon genes agonists, programmed cell death protein-1 antibodies, and coronavirus disease 2019 vaccines, consists of repeated intratumoral or intramuscular injections. These repeated administrations may lead to poor adherence, thus resulting in compromised therapeutic outcomes and increased financial burden. Here, we devel-oped a multidose drug delivery platform by engineering polylactic-co-glycolic acid (PLGA) with different molecular weights into self-healing single-cavity microcapsules (SSM). This approach showed a flexible collocation strategy to achieve customized pulsatile drug release and was fully degradable with good safety. Notably, this single-injection delivery system contains only PLGA, holding great promise for clinical translation.(c) 2022 Chinese Society of Particuology and Institute of Process Engineering, Chinese Academy of Sciences. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
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Background and aim: Gastrointestinal (GI) bleeding is deemed "obscure" when upper and lower GI endoscopy reveal no bleeding site. While the term "overt" is used in cases where visible blood passage is observed or reported, cases without macroscopic bleeding stigmata are defined "occult". Although small bowel origin accounts for only about 5% of all GI bleedings, it makes up the majority of obscure GI bleedings. Diagnostic work-up and treatment of small bowel GI bleedings can be challenging, especially when overt bleeding symptoms are absent. Material(s) and Method(s): We report the case of a frail patient with multiple comorbidities and evidence of bleeding small bowel angiodysplastic lesions on videocapsule assisted enteroscopy (VCE). Device assisted enteroscopy (DAE), planned in order to treat the bleeding lesions, was delayed after the patient contracted SARSCoV- 2 infection. Eight weeks after, in the absence of clinical signs of bleeding, a device for real time luminal blood detection (HemoPillR acute, Ovesco) was applied to guide timing of enteroscopy. Result(s): The 71 year old male patient was on dual anti platelet therapy and had persistent clinical features of iron deficiency anemia (Hemoglobin 8,0g/dl). Upper and lower GI endoscopy were negative for potential bleeding sources. VCE showed three small lesions suspect for angiodysplasia within 1 to 13 minutes after pylorus passage. Upon recovery from SARS-CoV-2 infection and congestive heart failure with respiratory insufficiency, we administered HemoPillRacute orally, without previous bowel preparation. The measurement showed a peak HemoPillR-Index (HI max) at 1h 47min after capsule administration (Fig. 1) and was therefore indicative of a small bowel bleeding site, best approachable by antegrade oral route, in keeping with the prior VCE findings. On subsequent DAE, performed through spiral enteroscopy, the small bowel angiodysplastic lesions were successfully treated. [Figure presented] Conclusion(s): Our case report illustrates how a novel telemetric blood detection measurement was able to confirm luminal blood presence and successfully guide timing of therapeutic DAE in a patient with obscure-occult GI bleeding, without the need for repetition of VCE.Copyright © 2023. Editrice Gastroenterologica Italiana S.r.l.
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Introduction: Atrial fibrillation (AF) is one of the most common forms of arrhythmia in the clinic. There are about 10 million AF patients in China, of which 1/3 are paroxysmal AF, and the remaining 2/3 are persistent or permanent AF. Long-term AF impairs cardiac function and leads to heart failure and thromboembolism. Moreover, AF increases the risk of mortality and ischemic stroke. Drug therapy and radiofrequency catheter ablation (RFCA) are still the mainstream treatment for AF patients. However, drug therapy has its drawbacks because of the high recurrence rate and side effects. Therefore, the current antiarrhythmic drugs could not meet all the clinical needs of patients with AF. RFCA is superior to antiarrhythmic drugs in maintaining sinus rhythm, improving symptoms and exercise tolerance, and improving quality of life. The role of RFCA in the treatment of persistent AF has gradually been recognized and affirmed. Although RFCA has been progressively used in the treatment of AF, there is still a high recurrence rate of AF after RFCA, especially in patients with persistent AF. Hence, it is meant to solve the high recurrence rate of AF after RFCA. Shensong Yangxin (SSYX) capsule has been proven to treat arrhythmia both in animal studies and clinical research. SSYX capsule could regulate multi-ion channels, improve cardiomyocyte metabolism and regulate autonomic nervous function. In addition, randomized, double-blind, multicenter clinical research indicated that the SSYX capsule exhibited good clinical efficacy in treating ventricular premature beats and paroxysmal AF. However, the effect of SSYX on recurrence after RFCA for patients with persistent AF remains unclear. High-level randomized controlled trials (RCTs) could offer clinicians high-quality evidence regarding the usage of SSYX capsule, especially in persistent AF patients who received RFCA. Hence, the RCTs aim to evaluate the effect of SSYX capsules on the prognosis in patients with persistent AF after RFCA through multicenter, double-blind RCTs. Method(s): This trial will be conducted with a total of 920 participants diagnosed with persistent AF who received RFCA. The participants will be randomized (1:1) into groups receiving either SSYX or Placebo for 1 year. The primary endpoint includes the recurrence of AF within 1 year after RFCA. The secondary outcome measures include changes of AF load at 3 months, 6 months, 9 months, and 1 year after treatment, the time of first atrial flutter/AF, the incidence of cardioversion 1 year after treatment, changes of transthoracic echocardiographic parameters 1 year after treatment, the incidence of stroke and thromboembolism at 6 months and 1 year after treatment, the score of SF-36 within 1 year after treatment. Application: The trial is ongoing. The trial started in September 2019 and recruiting patients. Data collection will be completed after all participants have completed the treatment course and follow-up assessments (expected in 2022, pending COVID-19). Next Steps/Future: The SS-ADJUST study is a randomized control study of TCM in persistent AF after RFCA. It will determine the place of SSYX capsule as a new treatment approach and provide additional and innovative information regarding TCM and the specific use of SSYX in persistent AF after RFCA.
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Background/Aims Effective symptom management may require the use of medications. Medication adherence may be hindered by formulation aspects, such as poor taste. Paediatric studies indicate, that despite concerns of swallowing solid dose forms, children prefer these to liquid forms. They find the solid dose forms more palatable. However, swallowing numerous solid dose forms, may present a significant 'pill' burden to patients and their care-givers. Filling empty gelatine capsules with requisite medications is seen and used as a way to address palatability, decrease pill burden and thereby increase compliance. Yet there is little evidence on the impact this practise may have on the effectiveness of over-encapsulated medicines. This study explored the effect of over-encapsulation on in vitro disintegration and dissolution, of some commonly used medicines in paediatric palliative care. Method Immediate release (Cyclizine Hydrochloride, Gabapentin, Paracetamol) and modified release preparations (Omeprazole, Diclofenac sodium) were over-encapsulated in size 00 gelatin and HPMC capsules (n=6). Dissolution and disintegration were tested according to Pharmacopeia standards. Statistical analyses, using Student's T-test and f1 and f2 tests (respectively) were applied to determine similarities or differences in disintegration or dissolution. Results Disintegration and dissolution was prolonged for all over-encapsulated immediate release preparations, especially when using HPMC capsules. However, percentage of drug dissolved met the acceptance criteria for immediate-release solid oral dosage. Over-encapsulation of modified release preparations did not lead to significant dissolution or disintegration changes. Conclusion Over-encapsulation, may delay medication release, especially for immediate release medicines however, medicine effectiveness may not be. Further studies are required before we can safely recommend use of over-encapsulation as an administration compliance aid.
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Molnupiravir is one of the drugs for the etiotropic therapy of a new coronavirus infection COVID-19. It has confirmed its clinical efficacy in the treatment of patients with mild and moderate COVID-19, including those who are at high risk of progressing to severe disease. The aim of the study was to evaluate bioequivalence of the generic drug molnupiravir ALARIO-TL and the original drug Lagevrio with a single oral administration in healthy volunteers. Materials and methods. This bioequivalence study was an open, randomized, two-period crossover study. In each of the two periods, volunteers received a single dose of the test drug, or reference drug molnupiravir, in the form of capsules at the dose of 200 mg. The washout period between the doses was 3 days. To determine pharmacokinetic (PK) parameters and bioequivalence, the concentration the concentration of N-hydrozycytidine (NHC), the main molnupiravir metabolit in the blood plasma of volunteers was evaluated. The blood plasma sampling was carried out in the range from 0 to 16 hours in each of the study periods. Bioequivalence was assessed by comparing 90% confidence intervals (CIs) for the ratio of geometric means of AUC(0-16) and Cmax of the test drug and reference drugs with the established equivalence limits of 80.00 - 125.00%. Results. A total of 28 healthy male volunteers were included in the study. According to the results of the statistical analysis, after the administration of the test and reference drugs, the 90% CIs for the ratio of the geometric means of AUC (0-16) and Cmax were 96.31% - 113.64% and 91.37% - 114.8%, respectively. These intervals fit within the established limits of 80.00-125.00%, which confirms the bioequivalence of the drugs. When comparing the frequency of the individual adverse events registration, no significant differences were found out after the administration of the test and reference drugs. Conclusion. Based on the results of this study, it can be concluded that the test and reference drugs of molnupiravir are bioequivalent. In addition, the data obtained indicate that the drugs have similar safety profiles.Copyright © 2022 Volgograd State Medical University, Pyatigorsk Medical and Pharmaceutical Institute. All rights reserved.
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Stress during Coronavirus disease-2019 (COVID-19) pandemic affects the physiological and immunological response to women's reproductive health. Meanwhile, Apium graveolens and Eucalyptus globulus are immunomodulators related to women's reproductive health. This investigation had a goal to examine the effectiveness of A. graveolens and E. globulus towards the expression of Heat Shock Protein-70 (HSP70) as the primary biomarker of stress, Tumor Necrosis Factor-Alpha (TNF-alpha) as a pro-inflammatory protein, along with Luteinizing Hormone (LH) and Growth Differentiation Factor 9 (GDF-9) as folliculogenesis markers. An experimental randomized controlled trial was utilized by using a pre-test and post-test control group design. Sixty women, who had stress based on DASS-21 questionnaire, were divided into two groups in Nusukan Health Center, Indonesia. The intervention group was orally administered with 300 mg A. graveolens capsules and E. globulus essential oil for 14 days, while the control group was given a placebo. Blood samples and stress levels were then evaluated before and after the intervention. No significant difference was found in the stress levels of the control and treatment groups at the pre-test. Meanwhile, the intervention group had the decreased HSP70, TNF-alpha, and stress levels (p<0.001). In contrast, increased LH and GDF-9 levels were displayed in the intervention group compared to the control group (p<0.001). These findings revealed that A. graveolens supplementation and E. globulus essential oil have the ability to decrease stress and are able to protect folliculogenesis markers on women's reproductive health due to stressful conditions during pandemic COVID-19. Copyright © 2022 by Indonesian Journal of Pharmacy (IJP).
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A wide range of polymer-based drug delivery systems have been reported for the treatment of various diseases. However, the dosing regimen of many drugs, such as stimulator of interferon genes agonists, programmed cell death protein-1 antibodies, and coronavirus disease 2019 vaccines, consists of repeated intratumoral or intramuscular injections. These repeated administrations may lead to poor adherence, thus resulting in compromised therapeutic outcomes and increased financial burden. Here, we developed a multidose drug delivery platform by engineering polylactic-co-glycolic acid (PLGA) with different molecular weights into self-healing single-cavity microcapsules (SSM). This approach showed a flexible collocation strategy to achieve customized pulsatile drug release and was fully degradable with good safety. Notably, this single-injection delivery system contains only PLGA, holding great promise for clinical translation. © 2022 Chinese Society of Particuology and Institute of Process Engineering, Chinese Academy of Sciences
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Even after a year, the COVID-19 pandemic produced by the SARS-CoV-2 remains a major source of concerns for scientists. Surprisingly, the primary protease is a key target because of its role in viral propagation. No significant data is available regarding the off-label indications of pharmaceutical adjuvants so far. CAP stands for "Cellulose Acetate Phthalate", an industrial polymer utilized in the enteric coating of tablets and capsules. CAP has been shown in certain trials to have anti-HIV properties by using the co-receptor location. Thus, in the present work, CAP was used to test against SAR-primary CoV-2's protease Mpro using in-silico method. Auto Dock was used to evaluate selected CAP molecules against SAR-CoV-2, and Discovery studio visualizer was used to create 3D and 2D interaction photos. CAP's binding energies were-3.05kcal/mol,-3.78kcal/mol and-3.01kcal/mol during blind docking, site specific docking, and docking in presence of N3 inhibitor, respectively. Additionally, the discovery studio visualizer was utilized to observe the interacting amino acids with CAP structure. Interestingly, the data from the discovery studio visualizer showed that it established H-bonds with Mpro residues, TYR37, TYR101, and LYS100 during blind docking and LYS88, TYR101, and LYS100 during site specific docking. The findings indicated that CAP binds non-competitively to allosteric sites and that it may have synergistic effects with other anti-viral agents. Moreover, further research is required to justify its synergistic activity as anti-viral agent. Copyright © 2022, Anka Publishers. All rights reserved.
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Introduction UCLH has developed a modified 'At Home' Capsule endoscopy (ACE) service for patients undergoing capsule endoscopy where the entire procedure is completed at home through remote (telemedicine) assistance. This aimed to improve access to endoscopy services during the covid-19 pandemic. This a preliminary review of the ACE focusing on procedure safety, success rates and patient satisfaction. Methods Data on all ACE procedures at UCLH was looked at prospectively. Demographics, completion rates, and complication rates were recorded. All patients were asked to complete patient satisfaction questionnaires relating to the at home process (experience of the process, support from staff, expectations, tolerance of procedure, satisfaction, and preference for future investigations). Results 34 ACE procedures were looked at for this study. 13 were colon capsule endoscopies (CCE) and 21 small bowel capsule endoscopies (SBCE). Mean age of participants was 38 years and 17 (50%) were males. Indications were FIT positive (2.9%), iron-deficiency anaemia (14.7%), inflammatory bowel disease (61.7%) or investigation of other symptoms (20.6%). 31 (91.1%) procedures were successful- defined as a complete procedure with adequate bowel preparation. There were 3 failed ACEs (2= poor prep, 1= capsule not excreted). There were no complications and no need to convert the remote test to 'in-hospital'. 16 (47%) patient satisfaction questionnaires were returned. No patients found the procedure painful or embarrassing and 12 (75%) patients were not anxious prior to their procedure. On a satisfaction scale of 1-10, 12 patients (75%) scored ACE as ≥8. 13 (81.3%) patients would choose to have ACE vs inhospital CE. 12 (75%) patients would choose ACE as their preferred colonic investigation over CE in-hospital, colonoscopy, and CT colonography. Importantly, 87.5% of those patients had previously undergone a colonoscopy. Conclusions This is preliminary data on ACE, which shows a similar safety and success rate to standard practice in-hospital capsule endoscopy. 75% of patients preferred ACE over any other colonic investigation, suggesting potential increased acceptance by the public as a colorectal cancer screening test.
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The novel coronavirus disorder 2019 (COVID-19) outbreak commenced in early December 2019 in the capital metropolis of Wuhan, Hubei province, People‟s Republic of China and precipitated a world pandemic on march 11, 2020. Though some the international locations have succeeded in slowing down the price of the unfold of this pandemic, most the international locations throughout the globe are nevertheless persevering with To journey and growing vogue in the increase and unfold of this lethal disease. Hence, in the present day scenario, it has grown to be necessary to manipulate and eventually irradicate this lethal sickness using a nice vaccine. An RNA-based vaccine would possibly be greater superb than ordinary as vaccines to deal with a pandemic treatment. However, administration of acute seizures in sufferers with COVID19 as properly as administration of PWE and COVID19 wishes to think about doable drug-drug interactions between antiseizure capsules and candidate tablets presently assessed as therapeutic preferences for COVID-19. In this paper, we look at moral troubles and public conversation challenges associated with the improvement of cell-based therapeutics for COVID19.
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Introduction: The lack of a history of the course of a new coronavirus infection and the lack of data from randomised trials makes it difficult to choose the right treatment tactics and prescribe adequate prophylaxis in patients who have suffered from COVID-19. Comorbid patients with cardiovascular diseases and endothelial dysfunction have a high risk of a severe course of COVID-19 and subsequent thrombotic complications, which manifest clinically as cardiomyopathy;venous thrombo-embolism (deep vein thrombosis and pulmonary embolism);pulmonary thrombosis in situ;stroke;arterial thrombangiitis;rarely, arterial peripheral thrombosis and microvascular thrombosis, in the lungs, liver, kidneys, brain, etc.;and mild disseminated intravascular coagulation syndrome. The role of endothelial dysfunction in the development of severe complications is underestimated. In the pathogenesis of COVID-19, the defeat of the microcirculatory bed plays a crucial role. The SARS-CoV-2 virus causes associated endotheliitis damage to the endothelium due to virus entry and cytokine storm. Endotheliitis leads to the release of tissue factor, which leads to the formation of an excess of thrombin and fibrin;the body tries to cover the virus with these and prevent its spread, which entails negative side effect such as thrombosis Methods: Sixty-six patients who had COVID-19 were examined (42 women and 24 men;mean age 48 years [range 20 – 80 years]). Patients complained of a feeling of paraesthesia, mainly in the lower extremities, a feeling of heaviness, stiffness in the popliteal region, an increased vascular pattern on the entire surface of the skin, a burning sensation in all vessels, and a feeling of weakness. Ultrasound colour duplex scanning showed no signs of thrombosis in the large vessels. Using a high frequency ultrasound Doppler and a 25 MHz sensor, the nailbed of the first finger of the upper limb was examined. The microcirculatory images were analysed by the shape and spectrum of the curves. Twenty patients received prophylaxis with rivaroxaban 10 mg daily (group 1) and 46 patients did not (group 2). The control examination was carried out four weeks after the start of therapy: sulodexide one capsule twice daily. The coagulogram parameters were also studied. Results: A depletion in spectral characteristics was seen in patients after COVID-19 disease, in comparison to microcirculatory images recorded in healthy individuals. Predominantly, the red part of the spectrum was recorded in patients after COVID-19, the lighter part of the spectrum was not recorded. Group 1 patients had higher amplitude parameters than group 2, but they also registered a depletion in spectral characteristics. Soluble fibrin monomer complexes were increased 4 – 5 times, D-dimer 2 – 2.5 times, and antithrombin III 1.5 times. The international normalised ratio, activated partial thromboplastin time, fibrinogen, prothrombin according to Quick, prothrombin time, clotting time, and bleeding time were within the reference intervals both before and after treatment. Upon repeat examination four weeks after the course of sulodexide therapy, the spectral characteristics were normalised, and the coagulogram parameters were also normalised. Conclusion: The red part of the spectrum, according to the Doppler criteria, corresponds to the fastest particles moving in the middle of the stream. The lighter part of the spectrum corresponds to particles moving more slowly. The reduction in spectral characteristics in patients after COVID-19 disease corresponds to parietal stasis and readiness for thrombosis, which was confirmed by the coagulogram data. Examination of the nailbed using high frequency ultrasound Doppler in patients who have COVID-19 allows the identification of stasis of the parietal blood flow, which corresponds to a prethrombotic state. The prescription of sulodexide allows for an improvement in the condition of patients and normalisation of microcirculation indicators
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Background: Antiviral vaccine is not effective, synthetic antiviral drugs are highly toxic, leading to increased interest in herbal medicines as promising antiviral drugs. Recently, Vipdervir has been developed from medicinal herbs with the aim to support and treat diseases caused by viruses such as H5N1 and SARSCoV- 2. In the present study, we assessed Vipdervir's antiviral activity against H5N1 and SARS-CoV-2. In addition, we also evaluated the acute toxicity and repeated dose toxicity of Vipdervir in mice and rabbits, respectively. Methods: H5N1 inhibitory effect of Vipdervir was assessed using hemagglutination inhibition assay. Vipdervir's SARS-CoV-2 inhibitory effect was evaluated by Plaque Reduction Neutralization assay. Acute and repeated dose oral toxicities of Vipdervir were determined according to OECD 423 and OECD 407 guidelines, respectively. Results: Data show that Vipdervir is effective against both H5N1 and SARSCoV- 2. At concentrations of 3 mg/mL and 5 mg/mL Vipdervir completely inhibits H5N1. At a concentration of 50 μg/mL Vipdervir showed an inhibitory effect on SARS-CoV-2. Acute toxicity data revealed that the LD50 of Vipdervir is greater than 35200 mg/kg, b.wt. in mice. Repeated toxicity data indicated that Vipdervir did not induce significant differences in body weight gain, hematology and clinical biochemistry in compared to the control group. The No Observed Adverse Effect Level of Vipdervir is greater than 613.8 mg/kg b.wt./day in rabbits. No delayed toxicity effects of Vipdervir were observed. Conclusion: Vipdervir capsules were found to be antiviral effective and relatively safe in the tested doses and experimental conditions.
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BACKGROUND AND AIMS: COVID can affect many organs including kidneys involving various possible pathophysiological mechanisms [1]. Post-COVID conditions require focused approach for diagnosis, personalized treatments and rehabilitation. Ultrasonography (US) can provide accurate information for detecting kidney disease [2]. Shear wave elastography (SWE) is a recognized ultrasound method, still having a limited use in nephrology, yet can be used for early detections of kidney abnormalities. The aim of this study was to evaluate semiotics and the added diagnostic value of US for post-COVID kidney disease. METHOD: We included 20 cases to the study (23-68 years;8 women) who underwent COVID-19 during last 3 months with signs of kidney disease (proteinuria, increased levels of creatinine, uric acid in blood, hypertension) and other clinical, laboratory symptoms of nephropathy after COVID-19 without specific data of previous history of kidney disease. The control group included 20 healthy individuals (9 women), with mean age 37 ± 7 years without clinical, laboratory signs of nephropathy according to disease history. All patients underwent general clinical, lab tests;abdominal US including precise multiparameter US of kidneys as in [2] measuring renal resistive index (RI), did SWE, and sensitive Doppler (B-flow and similar) in parenchyma and vessels using curved abdominal transducer of US systems: LOGIQ 9 (GE Healthcare), Toshiba Aplio and Hitachi Arietta. RESULTS: We detected US changes in all age groups, both in females and males. Severe kidney disease signs included thinning, increasing echogenicity of kidney parenchyma (P < .05), detection of fibrotic changes and small hyperechoic inclusions, hilly margins, anaechoic strips under the capsule, RI increasing in segmental arteries over 0.75, and decreasing velocities under 25 cm/s. SWE showed increased parenchyma stiffness to 10 ± 1.7 kPa (6-13 kPa) versus 4.2 ± 1.2 kPa (P < .05). Moderate changes included mild decrease of kidney medullary differentiation, RI increasing in segmental arteries over 0.7;parenchyma stiffness increased to 7.2 ± 1.5 kPa (5-10 kPa), P < .05. In 16 patients we diagnosed hypertension;all patients had increased RI over 0.75;pyelonephritis was in 2 patients. Three patients had the following abnormalities: amyloid kidney after COVID-19 was in two patients (male 62 years and female 58 years) manifesting on US with increased echogenicity small kidney, decreased blood flow and increasing RI (Figure 1). One patient had collapsing glomerulopathy [3] manifesting with proteinuria;kidney biopsy with immunohistochemistry performed 1 month after beginning of COVID-19 showed collapsing focal segmental glomerulosclerosis;US symptoms were unspecific (Figure 2). CONCLUSION: Multiparameter ultrasound is an effective method for early detection of various types of kidney disease in patients after coronavirus disease, potentially effective to distinguish signs of nephropathy associated to COVID-19. Evaluation of renal RI and increased stiffness of kidney parenchyma are reliable markers.
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Increasing lung diseases, mutating coronaviruses, and the development of new compounds urgently require biomimetic in vitro lung models for lung pathology, toxicology, and pharmacology. The current construction strategies for lung models mainly include animal models, 2D cell culture, lung-on-a-chip, and lung organoids. However, current models face difficulties in reproducing in vivo-like alveolar size and vesicle-like structures, and are unable to contain multiple cell types. In this study, a strategy for constructing alveolar models based on degradable hydrogel microspheres is proposed. Hydrogel microspheres, 200–250 μm in diameter, were prepared using a self-developed printing technique driven by alternating viscous and inertial forces. Microcapsules were further constructed using a coacervation-based layer-by-layer technique and core liquefaction. Three types of cells were inoculated and co-cultured on hydrogel capsules based on optimized microcapsule surface treatment strategies. Finally, an in vitro three-dimensional endothelial alveolar model with a multicellular composition and vesicle-like structure with a diameter of approximately 230 μm was successfully constructed. Cells in the constructed alveolar model maintained a high survival rate. The LD50 values of glutaraldehyde based on the constructed models were in good agreement with the reference values, validating the potential of the model for future toxicant and drug detection.
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DDW 2022 Author Disclosures: Ryosuke Kobayashi: NO financial relationship with a commercial interest ;Natalia C. Calo: NO financial relationship with a commercial interest ;Bong Sik Kim: NO financial relationship with a commercial interest ;Christopher Teshima: NO financial relationship with a commercial interest Aims: Push enteroscopy (PE) is commonly used in patients with obscure GI bleeding after a negative esophagogastroduodenoscopy and colonoscopy to investigate for a bleeding source within the proximal small bowel. However, there is almost no literature that has measured the anticipated proportion of the small intestine that can be evaluated by using the PE technique. The primary aim of this study was to quantify the percentage of small bowel examined by PE by using capsule endoscopy (CE). Methods: Prospective patients referred for small bowel investigation of obscure GI bleeding were offered single session PE followed by CE. PE was performed using a pediatric colonoscope fitted with a distal attachment cap that was advanced as far as possible into the small intestine using a water immersion method and aided by multiple reduction maneuvers. Two endoscopic clips were placed to denote the maximal insertion point reached by PE. Potential bleeding sources identified during PE were treated during careful endoscope withdrawal. CE was then performed with direct endoscopic placement of the capsule into the duodenum by use of a gastroscope fitted with a capsule delivery device. CE was then performed as per usual standard-of-care. The clips were identified during CE and the small bowel insertion depth of PE was quantified by the percentage of small bowel transit time (SBTT) and of small bowel progress (SBP) from the CE examination. The study was approved by our center’s IRB. Results: Fifty-six patients were enrolled between August 2019 and November 2021;mean age 62 years;59% male. Study recruitment was hindered by our institution’s pausing of clinical research recruitment in the first year of the Covid-19 pandemic. Five cases were excluded due to incomplete small bowel examination by CE and 1 case in which PE could not be performed;leaving 50 cases for the analysis. The median CE SBTT was 4h 55m. The median SBP and SBTT percentage as determined by the location of the endoscopic clips placed during PE were 14% (IQR 5-26) and 11% (IQR 4-21), respectively. Bleeding lesions were detected by PE in the stomach in 10 cases and in the duodenum/jejunum in 20 cases. CE identified potential bleeding lesions within the segments of small bowel examined by PE in 12 cases and distal to the clips in 22 cases. CE detected only 69% of angioectasias that had been treated by PE and did not visualize 2 cases of submucosal tumor that were discovered during PE. Conclusions: PE achieves an average examination of the proximal 14% of the small bowel. This should inform appropriate selection of PE vs. DBE when a bleeding lesion is detected by CE. However, notable lesions may be missed by both PE and CE examinations.
ABSTRACT
Shufeng Jiedu Capsules are composed of eight traditional Chinese medicines, including Huzhang (Polygoni Cuspidati Rhizoma et Radix), Lianqiao (Forsythiae Fructus), Baijiangcao (Herba Patriniae), Chaihu (Bupleuri Radix), etc. Shufeng Jiedu Capsules has exactly effects such as dispelling wind and clearing heat, removing toxin and relieving sore-throat, which had been used in treatment of respiratory infectious diseases with symptom like fever, intolerating wind in clinic for a long time. Shufeng Jiedu Capsules are the recommended drugs for the "Influenza Diagnosis and Treatment Plan" (2020 version)issued by National Health Commission and "Diagnosis and Treatment of Pneumonia in COVID-19"(version 4, 5, 6, 7, 8 and 9). Pharmacological mechanism and clinical application of Shufeng Jiedu Capsules weresummarized in this paper, in order to summarize characteristic and the post-marketing research path of Shufeng Jiedu Capsules, and provide ideas for more post-marketing traditional Chinese medicine products.