Treatment Of Severe Forms Research Articles

Protective Effect of Resveratrol Against Non-Small Cell Lung Cancer: In-Vitro and In-Silico Studies

Resveratrol, a non-flavone polyphenol molecule, has been shown to be both chemotherapeutic and chemopreventive in the treatment of several forms of cancer, including lung cancer. 80% of cancers of the lungs are non-small cell lung cancers. The study was carried out to see the effects of Resveratrol in non-small cell lung cancer cells (A549) and to observe its binding as an inhibitor to Akt protein using in-vitro and in-silico studies, respectively. As per the results of Cell viability assay, which used Doxorubicin and Dexamethasone as standard drugs, Resveratrol (p = 0.01, p = 0.0051) could significantly stop lung cancer cells from growing, with IC50 values of 37.32 ± 0.8 μM. It was discovered that Resveratrol was about six times more effective than Dexamethasone, suggesting that it has a significantly higher anti-proliferative potential than this standard drug. During the Wound-closure assay, the rate of migration in the Resveratrol treatment group showed a lower migration rate at a higher concentration of 500 μM together with a change in the shape of the cell, demonstrating the concentration-dependent behavior of A549 cell growth. In the current study, it was demonstrated using Cell viability assay and Wound closure assay that Resveratrol exhibits anti-proliferative activity on A549 lung cancer cells and inhibits cancer cell proliferation in a concentration and time-dependent manner. It was also observed that Resveratrol binds to Akt protein and it inhibits the activity of Akt by interacting with the ATP-binding region of Akt protein. However, the molecular mechanism behind resveratrol’s anti-cancer benefits remains unknown. Finally, the current study may lay the groundwork for future research into the tumor suppressor resveratrol.

Exploring the effect of epigallocatechin gallate on non small cell lung cancer.

Human epidemiological studies have shown that diets rich in plant polyphenols have beneficial effects on various diseases including cancer. Epigallocatechin Gallate, a flavonoid polyphenol molecule, has been shown to be both chemotherapeutic and chemo-preventive in the treatment of several forms of cancer, including lung cancer. 80% of cancers of the lungs are non-small cell lung cancers. The study was carried out to see the effects of Epigallocatechin Gallate in non-small cell lung cancer cells (A549) using in-vitro studies. Cell Viability Assay was performed using MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay. Wound Healing assay was also performed at different concentrations of the compound. Dexamethasone and Doxorubicin, the drugs with anti-cancer properties served as control. A549 cell lines were used. In the current study, it was demonstrated using Cell viability assay and Wound Healing assay that Epigallocatechin gallate exhibits anti-proliferative activity on A549 lung cancer cells and inhibits cancer cell proliferation in a concentration and time-dependent manner. It was observed that Epigallocatechin gallate (P = 0.0016, P = 0.0018) could significantly inhibit the growth of lung cancer cells with IC50 values 60.55 ± 1.0 μM. The result of wound Healing assay suggests that Epigallocatechin gallate can inhibit the proliferation and migration of A549 cells with concentrations near or higher to 50 μM. Epigallocatechin gallate's protective effect has been shown in A549 lung adenocarcinoma cells in a time and dose-dependent manner. This suggests the implication of Epigallocatechin gallate for the prevention and therapy for lung cancer.

Anti-cancer potentials of aervine validated through in silico molecular docking, dynamics simulations, pharmacokinetic prediction and in vitro assessment of caspase – 3 in SW480 cell line

ABSTRACT Colon cancer is the third most lethal type of cancer in the world. Resistance to chemotherapy remains a serious barrier in the treatment of several forms of cancer, particularly colon cancer. Therefore, it is essential to develop alternative treatment methods. The docking score study of the aervine produced a low dock score for the 2BDF target compared to the 1IKN and 4OAR targets. Comparing the aervine to the reference compounds Capecitabine for 2BDF, Topotecan Hydrochloride for 1IKN and Tamoxifen for 4OAR, the binding affinity of the aervine was found to be higher. Further molecular dynamic simulation results for aervine and reference standard drugs for each cancer types reveals that aervine possess good binding affinity simulation trajectories towards all three cancer targets. The MTT assay revealed that aervine has a highest cytotoxic impact against a colorectal cancer cell line, with an IC50 value of 122.12 ± 1.26µg/ ml. Aervine produces reactive oxygen species, induces caspase-3 pathway in SW480 cells, and promotes apoptosis. This research shows that aervine can be developed as a new 2BDF target inhibitor against colorectal cancer.

Appraising reconsolidation theory and its empirical validation.

Re-exposure to elements of prior experiences can create opportunities for inducing amnesia for those events. The dominant theoretical framework posits that such re-exposure can result in memory destabilization, making the memory representation temporarily sensitive to disruption while it awaits reconsolidation. If true, such a mechanism that allows for memories to be permanently changed could have important implications for the treatment of several forms of psychopathology. However, there have been contradictory findings and elusive occurrences of replication failures within the "reconsolidation" field. Considering its potential relevance for clinical applications, the fact that this "hot" research area is being dominated by a single mechanistic theory, and the presence of unexplainable contradictory findings, we believe that it is both useful and timely to critically evaluate the reconsolidation framework. We discuss potential issues that may arise from how reconsolidation interference has typically been deducted from behavioral observations, and provide a principled assessment of reconsolidation theory that illustrates that the theory and its proposed boundary conditions are vaguely defined, which has made it close to impossible to refute reconsolidation theory. We advocate for caution, encouraging researchers not to blindly assume that a reconsolidation process must underlie their findings, and pointing out the risks of doing so. Finally, we suggest concrete theoretical and methodological advances that can promote a fruitful translation of reminder-dependent amnesia into clinical treatment.

Relation between Hematological and Biochemical Parameters per Days of Symptoms in Hospitalized Patients with flu-like syndrome and COVID-19

Beside the acute respiratory syndrome caused by COVID-19, the exacerbated inflammatory process leads to systemic coagulation disorders, acute cardiovascular disorders, acute renal failure, metabolic changes and other clinical manifestations, increasing the mortality of patients with severe forms of the disease. The development of effective vaccines and drugs for the adequate treatment of severe forms of the disease has become a priority for the scientific and medical community. Likewise, the discovery of possible predictors for the early identification of severe cases with a high risk of death are constantly being sought. Laboratory tests, such as blood count, coagulation tests, hormonal and biochemical tests, are performed on a daily basis in the hospital environment and have proved to be very useful in the search for these indicators. In our study, we evaluated the laboratory tests of 398 positive and negative patients for COVID-19 admitted to hospitals in Uberaba, from the Macroregion of Triângulo Sul, state of Minas Gerais, with a population of 800,000 inhabitants. In our results, it was observed that the patients who died presented anemia, neutrophilic leukocytosis, increased CRP, urea and creatinine from the 5th, 6th day of symptoms, and with lymphopenia on the 1st day. In blood gas analysis, pH, SaO2 and PO2 were reduced since the 1st day of symptoms in patients who died, and the pH remained reduced until the clinical outcome. Changes were also found in the dosage of LDH, aPTT, albumin and electrolytes. Given these results, laboratory tests can be useful as predictive signs of severity in the early days of symptoms.

Non-COVID-19 respiratory viral infection.

To summarise the knowledge on the spectrum of disease that respiratory viral infections can cause and recognise how often they overlap.To learn the most common causes of respiratory viral infections and acknowledge other less frequent agents that may target certain key populations (e.g. immunocompromised patients).To improve awareness of the recent advances in diagnostic methods, including molecular assays and helpful features in imaging techniques.To identify supportive care strategies pivotal in the management of severe respiratory viral infections.

Phytochemical analysis and thrombolytic profiling of Costus afer stem fractions

BackgroundThe most commonly occurring mechanism driving ischemic heart disease, ischemic stroke, and myocardial infarction is thrombosis. It is normally characterized by platelet activation and aggregation. Thrombolytics have been used in the treatment of several forms of thrombosis, but their adverse effects have limited their usefulness. Thus, there is a need to develop alternatives from medicinal plants known to possess antithrombotic activity such as Costus afer.ResultsThe phytochemical evaluations indicated the presence of flavonoids, alkaloids, cardiac glycosides, tannins, terpenoids, and saponins. The antithrombotic profiling showed that streptokinase had the highest percentage clot lysis, followed by ethylacetate fraction of the extract, which was higher than aspirin and other fractions of the extract.ConclusionThe present findings show that C. afer stem extract and various fractions possess antithrombotic activities. However, further studies are needed to characterize the antithrombotic bioactive compounds present in the different fractions that are responsible for the activities.

ПРИМЕНЕНИЕ БИОТЕХНОЛОГИЧЕСКИХ ЛЕКАРСТВЕННЫХ СРЕДСТВ В ПЕДИАТРИЧЕСКОЙ ПРАКТИКЕ РЕСПУБЛИКИ БЕЛАРУСЬ

The article deals with the use of biotechnological drugs (BTLG) in the treatment of children of the Republic of Belarus, mainly suffering from rheumatoid arthritis. This group of drugs is a new, very promising and insufficiently studied group in the world pediatric practice. The work assessed the effectiveness of the use of BTLG, taking into account the indications in pediatric practice. The results of studying the structure of patients receiving BTLG depending on the nosological unit of the disease, age, sex, place of residence of patients are presented; analyzes the effectiveness of de-escalation of therapy, switching to another drug, “escape” of the effect when using BTLG. The authors substantiate the need for a further differentiated approach to the use of the BTLG group in the treatment of severe forms of rheumatoid arthritis in children, the need to take into account the effects of the therapy.

ARGONOPLASMIC COAGULATION IN THE TREATMENT OF EXTERNAL GENITAL ENDOMETRIOSIS IN WOMEN

Aim: to evaluate the effectiveness of the argonoplasmic coagulation method in the treatment of external genital endometriosis (GE) in women. Materials and methods. An open, prospective, controlled, clinical and experimental study was conducted. 50 women with genital endometriosis aged 20 to 50 years and older were examined (the average age was 35±15 years). The following forms of GE were identified: peritoneal endometriosis - in 21 (42%) patients; extraperitoneal endometriosis - in 15 (30%); uterine body endometriosis - in 9 (18%); retrocervical endometriosis - in 5 (10%) patients. Clinical, laboratory (blood test, urinalysis, biochemical studies, hemostasiogram, bacteriological and microscopic studies of the cervical canal and vagina, cytological studies); instrumental and special research methods were used. By the method of enzyme immunoassay (ELISA), studies were conducted for the presence of infections: toxoplasmosis, herpes and cytomegalovirus, chlamydia, mycoplasma, ureaplasma infections, rubella. Results. For the treatment of external genital endometriosis, a combined treatment regimen was applied: argonoplasmic coagulation of endometrioid heteropathies using the FOTEK EA 141M apparatus, followed by the prescription of a course of hormone therapy including dienogest (visanna), which contributed to improving the general condition and quality of life, relieving clinical symptoms, reducing the frequency of relapses, improving the hormonal status of the women. With a mild form of external genital endometriosis, argonoplasmic coagulation of endometrioid heteropathies was carried out in the "spray" mode at a power of 37-42 W, at a depth of 0.1-1 mm with a time interval of exposure of 2-4 seconds. In the moderate-severe form of external genital endometriosis, argonoplasmic coagulation of endometrioid foci located at a depth of 1-2 mm was carried out in the "spray" mode at a given power of 42-50W, with a time interval of exposure to an argon torch of 3-5 seconds. In severe external genital endometriosis, argonoplasmic coagulation was performed in the "filgur" mode at a given power of 57-64 watts with a time interval of exposure of 4-7 seconds, at a distance of no more than 2.5-3.0 mm. Conclusions. The use of APC using the FOTEK EA 141M device ensures the effectiveness of treatment that enables to avoid the formation of rough scars, adverse reactions and / or complications, shortening of the time interval, absence of pain syndrome, microbial contamination, risk of massive bleeding. The use of dienogest group is effective in preventing relapses after surgical treatment of severe forms of genital endometriosis.

Statins for Graves' orbitopathy: a new tool for prevention and treatment?

Graves' orbitopathy, which affects about 25–30% of newly diagnosed patients with hyperthyroidism due to Graves' disease, 1 Tanda ML Piantanida E Liparulo L et al. Prevalence and natural history of Graves' orbitopathy in a large series of patients with newly diagnosed Graves' hyperthyroidism seen at a single center. J Clin Endocrinol Metab. 2013; 98: 1443-1449 Crossref PubMed Scopus (146) Google Scholar is a multifactorial autoimmune disease causing inflammation and remodelling of orbital tissues, with relevant clinical manifestations heavily effecting the quality of life of affected individuals. 2 Neag EJ Smith TJ A 2021 update on thyroid-associated ophthalmopathy. J Endocrinol Invest. 2021; (published online Aug 20.)https://doi.org/10.1007/s40618-021-01663-9 Crossref PubMed Scopus (1) Google Scholar Considerable progress has been made in our understanding of pathogenesis of the disease 2 Neag EJ Smith TJ A 2021 update on thyroid-associated ophthalmopathy. J Endocrinol Invest. 2021; (published online Aug 20.)https://doi.org/10.1007/s40618-021-01663-9 Crossref PubMed Scopus (1) Google Scholar and in the treatment of severe forms using combination therapies (eg, intravenous glucocorticoids and mycophenolate or orbital irradiation) or novel drugs (teprotumumab, tocilizumab, and rituximab). 3 Bartalena L Kahaly GJ Baldeschi L et al. The 2021 European Group on Graves' orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves' orbitopathy. Eur J Endocrinol. 2021; 185: G43-G67 Crossref PubMed Scopus (24) Google Scholar Statins for Graves' orbitopathy (STAGO): a phase 2, open-label, adaptive, single centre, randomised clinical trialAddition of oral atorvastatin to an ivGC regimen improved Graves' orbitopathy outcomes in patients with moderate-to-severe, active eye disease who were hypercholesterolaemic. Future phase 3 studies, which could potentially recruit patients regardless of low-density lipoprotein cholesterol concentration, are required to confirm this association. Full-Text PDF

Первый опыт применения ингибитора фактора роста эндотелия сосудов ранибизумаб в комплексной терапии ретинопатии недоношенных в УРФО в ГАУЗ СО МКМЦ «Бонум»

Material and methods. The study included 16 patients (31 eyes). Types and terms of treatment. Stage I in the treatment of ROP, laser coagulation of the avascular areas of the retina was performed in three patients with aggressive posterior ROP (4 eyes, 12.9%). In all patients, the progression of the disease was noted. Intravitreal injection of ranibizumab was performed in the period from 8 to 16 weeks (10.5±2.0 weeks), PCV from 32.3 to 39.6 weeks (37.0±1.8 weeks). Result. After laser treatment and IVI of ranibizumab, 11 patients (31 eyes, 81.6%) showed regression of the disease. In 5 patients (6 eyes, 19.4%) - progression. If the ROP progressed, a 25G or 27G lenssparing vitrectomy was performed. Complete regression of ROP was achieved in one patient (1 eye, 16.7%). Partial regression was observed in two patients (2 eyes, 33.3%). In two patients (3 eyes, 50%), the disease progressed to stage 5 with the development of total retinal detachment. Conclusion. As a result of the complex treatment of severe forms of the active stage of retinopathy of prematurity in the regional children's ophthalmological center MKMC "Bonum" in Yekaterinburg, the following data were obtained: complete regression with retinal adhesion is observed in 12 patients (26 eyes, 83.4%), of which in one patient (1 eye, 3.2%) regression was achieved after vitrectomy. Partial regression with the formation of a peripheral retinal detachment after vitrectomy was achieved in two patients (two eyes - 6.5%). Progression of retinopathy of prematurity to stage V with the development of total retinal detachment in two patients (3 eyes, 9.6%). Complex treatment of severe stages of active ROP using laser treatment, IVI and vitrectomy allows to preserve vision in 90.4% of patients. Key words: retinopathy of prematurity; intravitreal injection; laser coagulation of the retina; vitrectomy.

Bone Marrow Transfer in Relapsing-Remitting EAE Ameliorates Disease at First Remission, with No Synergistic Effect upon Co-Transplantation with Mesenchymal Stem Cells.

Multiple sclerosis (MS) is a neurological disorder characterized by an autoimmune response, demyelinating plaques and axonal damage. Intense immunosuppression (II) followed by autologous hematopoietic stem cell transplantation has been proposed as a treatment in severe forms of MS. We have used murine relapsing-remitting (RR) experimental autoimmune encephalomyelitis (RR-EAE) to evaluate the transplantation of syngeneic bone marrow cells (BMC) after II, in combination with mesenchymal stem cells (MSCs) as a new therapeutic adjunct capable of improving immune reconstitution. In EAE-affected mice treated with BMC alone, we observed a drastic reduction in the clinical course only during the early RR phase of the disease. There was no difference in the RR-EAE clinical course between mice treated with BMC alone and co-transplanted mice. To analyze the immune reconstitution, we quantified the circulating immune cells in naïve and RR-EAE-affected mice after II, with BMC alone or in combination with MSC. Although II resulted in reduced numbers of circulating immune cells, reconstitution did not differ in co-transplanted mice. During the early phase of the disease, IL-4 was significantly elevated in co-transplanted mice, as compared to those treated with BMC alone. These data suggest that BMC transplantation after II transiently ameliorates the clinical symptoms of RR-EAE, but that co-transplantation with MSC has no synergistic effect.

Assessment of quality of life in patients with severe acne

Acne vulgaris is a common disease affecting up to 85 % of adolescents. Localization of dermatosis in cosmetically signifiant areas, the duration of the therapy and the formation of post-acne symptoms have a high psycho-emotional load and negatively affect the quality of life. Due to the fact that acne affects the most vulnerable and socially sensitive age group, it is imperative not to overlook psychological abnormalities such as anxiety, depression and suicidal thoughts. This review presents the types of diagnostic scales for assessing the quality of life of patients with acne, pathogenesis and risk factors for scar formation – the main factor affecting the self-esteem of patients with acne vulgaris, and also proposed new methods of combination therapy with the use of corticosteroids and isotretinoin in the treatment of severe forms.

Rosacea — modern features of pathogenesis and the possibility of drug correction in the era of growing antibiotic resistance

The pathophysiology of rosacea is a complex process in which the following factors are important: vascular disorders, changes in the connective tissue of the dermis, microorganisms, dysfunction of the gastrointestinal tract, immune disorders, changes in the sebaceous hair apparatus, oxidative stress, climatic factors, psycho-vegetative disorders, constitutional angiopathy, emotional stress, hormonal imbalance, exposure to chemical agents. Therapy for rosacea can be difficult for specialists and cause patient dissatisfaction due to a recurrent course. The treatment of severe forms of the disease is especially difficult. Traditional antibiotic therapy and correction of hormonal levels in women give a positive, but often temporary effect. Objective — to study the efficacy and tolerability of systemic isotretinoin in the treatment of papulopustular forms of rosacea. Materials and methods. The study involved 30 patients (21 women and 9 men) aged 39 to 56 years who had papulopustular rosacea. Evaluation of the effectiveness of therapy was carried out using the scale of diagnostic assessment of rosacea before and after 6 months from the start of treatment. All patients were prescribed systemic isotretinoin as monotherapy — the drug Roaccutane (F. Hoffmann-La Roche Ltd, Switzerland) in the following dose: during the 1st month — 0.3 mg/kg, during the 2th—6th months — 0.2 mg/kg once a day along with fatty foods. Results and dicsussion. Before treatment, the rosacea diagnostic scale score was (10.8 ± 0.9) points. After 6 months of therapy, it decreased 6 times and equaled to (1.8 ± 0.4) points. Conclusions. The analysis of the data obtained indicates a high efficiency of Roaccutane in the treatment of papulopustular forms of rosacea. Side effects in the form of dry skin and mucous membranes when taking Roaccutane were minor due to the low dose of the drug and were corrected with appropriate moisturizers.

Yoga and its impact on chronic inflammatory autoimmune arthritis.

Rheumatoid arthritis (RA) is one of the most common chronic inflammatory autoimmune diseases, which adversely affects the quality of life. RA is a disease of unknown etiology, however, both genetic and environmental factors appear to contribute to the susceptibility to this disease. The severity and progression of the disease are attributable to the release of a host of inflammatory cytokines, cytotoxic and immune regulatory factors. The treatments of RA are primarily limited to symptomatic alleviation of pain or other symptoms or to the use of cytotoxic drug treatment in severe forms of the disease which is commonly associated with significant side effects. Despite lack of a cure, the disease may be controlled by mind-body interventions. Holistic treatments such as Yoga significantly improve and reduce the psycho-somatic symptoms, pain perception, disability quotient, joint flexibility, range of motion, posture, muscle strength, coordination, and disease activity. Here, we discuss the features of RA and address how Yoga can be used as a therapeutic regimen to improve the quality of life of patients with RA.

An SPR investigation into the therapeutic drug monitoring of the anticancer drug imatinib with selective aptamers operating in human plasma.

The anticancer drug imatinib is often involved in therapeutic drug monitoring (TDM) studies aimed at improving the treatment of several forms of leukemia and gastrointestinal stromal tumors (GIST). To further implement the TDM of imatinib in clinical practice, we developed a detection assay by using an ssDNA aptamer, which demonstrated excellent selectivity and was not affected by interference from the components of human plasma samples. The efficient binding of imatinib to the aptamer was demonstrated by means of surface plasmon resonance (SPR) analysis, which allowed the development of a quantitative assay in the concentration range between 400 and 6000 ng mL-1 (0.7-10 μM), where a lower limit of quantification (LLOQ) of 400 ng mL-1 was achieved. The precision of the assay was found to be within 12.0%, whereas the accuracy was in a range between 97.1 and 101.5%. The sample preparation procedure displayed a recovery in the range of 48.8-52.8%. Solid validation data were collected according to the regulatory guidelines and the method was compared with standard analytical techniques, leading to the development of a feasible aptasensor for the TDM of patients administered with imatinib.

Бариатрический пациент: основные аспекты подготовки к хирургическому лечению ожирения и ведения после него. Лекция для практических врачей

Over the past years and decades, in the world in general and particularly in Russia, bariatric surgery is becoming more widespread for the treatment of severe forms of obesity. There is an increase in the number of operations performed along with the effectiveness and minimising risks of the operations held due to the improvement of surgical techniques. In this lecture, there are clearly stated indications and contraindications for the surgical treatment of obesity. Here are presented various types of bariatric surgeries and their pathophysiological mechanisms which affect on body weight, carbohydrate and lipid metabolism. There is also presented their effectiveness in comorbid obesity pathology, primarily among patients with type 2 diabetes. Here was held an analysis of possible negative effects after surgical treatment for obesity, including secondary hyperparathyroidism, post-bariatric hypoglycemia, etc., as well as predictors of postoperative prognosis in relation on metabolic control among patients with obesity and type 2 diabetes.

Risk factors for methicillin-resistant Staphylococcus aureus and extended-spectrum ß-lactamase producing Enterobacterales in patients with diabetic foot infections requiring hospital admission.

ABSTRACTPurposeMethicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) may complicate the treatment of diabetic foot infections (DFIs). The aim of this study was to determine the risk factors for these pathogens in DFIs.Material and methodsThis was a prospective observational study of 167 consecutive adult patients with DFIs. The diagnosis and severity of DFIs were based on the Infectious Disease Society of America (IDSA) classification system. Multivariate analyses were performed in order to identify risk factors for MRSA and ESBL-E infections.ResultsS. aureus was the most isolated pathogen (n= 82, 37.9 %) followed by Escherichia coli (n= 40, 18.5%). MRSA accounted for 57.3% of all S. aureus and 70% of Klebsiella pneumoniae and 25% of E. coli were ESBL producers, respectively. Deep ulcer [OR 8,563; 95% CI (1,068-4,727)], previous use of fluoroquinolones [OR 2,78; 95% CI (1,156-6,685)] and peripheral vasculopathy [OR 2,47; 95% CI (1.068-4.727)] were the independent predictors for MRSA infections; and osteomyelitis [OR 6,351; 95% CI (1,609-25,068)] and previous use of cephalosporins [OR 5,824; 95% CI (1,517-22,361)] for ESBL-E infections.ConclusionsMRSA and ESBL-E have adquired a great clinical relevance in DFIs. The availability of their risk factors is very convenient to choose the empirical treatment in severe forms.

ANTIMICROBIAL PEPTIDES AND UBIQUITIN PROTEIN LIGASE E3 IN DESTRUCTIVE FORMS OF PANCREATITIS

The development of methods for predicting and pre-venting the development of infectious destructive forms of acute pancreatitis for clinical practice is one of the important problems of pancreatology, the solu-tion of which would reduce post-operative mortality in severe acute pancreatitis, reaching 30-80%. To date, traditional laboratory and instrumental methods of diagnosis do not fully satisfy clinicians, since they do not always allow timely and reliable determination of the probability and time of microbial contamina-tion of pancreatic and parapancreatic tissue in pa-tients with destructive pancreatitis. In this regard, it is of interest to search for new methods for predicting and timely diagnosis of infected forms of pancreatic necrosis, which would significantly improve the re-sults of treatment of severe forms of acute pancreatitis. The use of changes in the dynamics of levels of antimi-crobial peptides - α-defensins and Ubiquitin Protein Ligase E3 in the blood serum of patients for diagnos-tic purposes makes it possible to predict and deter-mine earlier the transformation of sterile pancreone-crosis into infected and can be used as markers of the development of contamination of destructive forms of acute pancreatitis.

Role of markers of inflammation, severity and infusion therapy in COVID-19-defined pneumonia

Background. Coronavirus disease (COVID-19) is likely to remain an important differential diagnosis in the next 2 years for anyone seeing a doctor with a flu-like condition, lymphopenia and/or a change in smell (anosmia) or taste.
 Objective. To consider by what markers of inflammation it is possible to diagnose the severity of COVID-19-defined pneumonia with the possibility of its infusion correction.
 Materials and methods. The clinical manifestations of the disease by severity can be classified into five forms: asymptomatic, but rather presymptomatic, according to clinical manifestations, infectious process can be attributed to persons with a positive PCR-test result for SARS-CoV-2 and normal C-reactive protein (CRP), interleukin-6 (IL-6) and ferritin. Lymphopenia is a negative prognostic factor. A mild course of the disease is characterized by any of the different signs and symptoms (eg, fever, cough, sore throat, malaise, headache, muscle pain) without shortness of breath or with shortness of breath, or with atypical images on chest radiographs and within 10-15 % lesion and still normal CRP, IL-6 and ferritin (~70-80 %). Moderate disease occurs in patients who have evidence of lower respiratory disease on clinical assessment or imaging, oxygen saturation (SpO2) ≥94 % and an increase in CRP, IL-6, ferritin, and D-dimer less than 50 % of normal. The severe course of the disease includes patients with a respiratory rate >30 per minute, SpO2 <94 %, the ratio of the partial pressure of oxygen in arterial blood to the fraction of inhaled oxygen (PaO2/FiO2) <300 mm Hg, infiltrates affecting >50 % of the lung parenchyma and a possible increase in CRP, ferritin, IL-6 and D-dimer more than 2-3 times (~20 %). The critical course of the disease is respiratory failure, septic shock and/or multiple organ failure, subtotal lesions of the parenchyma of both lungs (1-5 %).
 Because the disease manifests itself as pneumonia, radiological imaging plays a fundamental role in the diagnostic process, treatment, and follow-up. Standard X-ray examination of chest has low sensitivity in detecting early changes in the lungs and in the initial stages of the disease. At this stage, it can be completely negative. In later stages of infection, chest X-ray usually reveals bilateral multifocal alveolar opacities, which tend to coalesce until the lung is completely opaque. Pleural effusion may occur. Given the high sensitivity of the method, computed tomography (CT) of the chest, in particular high-resolution CT, is the method of choice in the study of COVID-19 pneumonia, even in the initial stages.
 There is no specific antiviral treatment recommended for COVID-19, and there is currently no vaccine. Treatment is symptomatic, and oxygen and fluid therapy represent the first step towards resolving respiratory distress and intoxication. Non-invasive and invasive mechanical ventilation may be required in cases of respiratory failure that is resistant to oxygen therapy. For the treatment of severe forms of the disease (>50 % of the lesion of the lung parenchyma), antioxidant therapy is necessary. The key requirement is to influence mitochondrial permeability, that is, to pass through the membrane of cells and mitochondria and accumulate in mitochondria (inactivation of ROS), as well as block the signals of pathways that transmit instructions from the surface to the nucleus to start inflammation (IL-1, -6, -18) in order to ensure the survival of cells as long as possible. With this pathogenetic purpose, to stop the “cytokine shtrom” we use edaravon (Xavron) 30 mg and Tivorel 100.0 ml.
 Conclusions. We have shown that in patients with moderate, severe and critical COVID-19-defined pneumonia (CRP ≥100 mg/l, ferritin ≥900 ng/ml, IL-6 >202.3 pg/ml) Xavron and Tivorel as an intravenous infusion caused clinical improvement in 71 % of patients.