ACTIV-3/TICO Study Group* Background: Ensovibep (MP0420) is a designed ankyrin repeat protein, a novel class of engineered proteins, under investigation as a treatment of SARS-CoV-2 infection.Objective: To investigate if ensovibep, in addition to remdesivir and other standard care, improves clinical outcomes among patients hospitalized with COVID-19 compared with standard care alone.
Aim: To improve treatment effectiveness for patients with previous myocardial infarction (MI) while studying clinical pathogenetic features of decompensated heart failure (HF) in the postinfarction period with the focus of using succinic acid. Materials and Methods: The work is based on the results of an examination of 60 patients with previous MI, who got registered decompensated II А-B CHF. The patients with previous STEMI complicated by decompensated HF were divided into groups: the I group included the patients with previous STEMI, who were getting standard treatment according to the guidelines of the MoH of Ukraine (beta-blockers, ACE inhibitors, dual antiplatelet therapy (acetylsalicylic acid+clopidogrel), nitrates, statins) (n=30); the II group included the patients with previous STEMI, who were getting succinic acid into the therapy complex beside the standard treatment. Results: We determined insignificant improvements in such symptoms, as angina, dyspnea, dizziness, and tiredness in the group of patients receiving standard treatment. Herewith using succinic acid reduced clinical signs of inadequate response to physical exercise significantly. Disregarding the one-sidedness of the probable dynamics of the aforementioned 6MWD characteristics, the positive dynamic was less significant in the case of standard treatment. all examined groups presented positive dynamics concerning decreasing the number of points in the patients with decompensated HF after STEMI during the therapy according to Borg’s scale. Conclusions: The use of succinic acid for patients with decompensated heart failure that occurred after STEMI is accompanied by positive clinical effects, and antiischemic and cytoprotective influence.
The aim: To study the relationship between the concentration of copeptin, NT-proBNP, ST2 and indicators of myocardial remodeling, the dynamics of these indicators in order to predict the occurrence of decompensated heart failure (HF) in patients with acute myocardial infarction (AMI). Materials and methods: The study is based on the results of the examination of 160 patients with MI, including 120 patients with decompensated CHF II A-B stage according to Vasylenko-Strazhesko classification of (FC) III-IV (according to NYHA) and 40 patients with MI without signs of decompensated CHF, as well as 20 medically healthy individuals. The level of copeptin, NT-proBNP, ST2 were determined. Results: In patients with signs of decompensated HF there were significantly higher levels of NT-proBNP in the blood serum that amounted to (950.38±3.15) pg/ml, in patients without decompensated HF after MI (580.15±3.03) pg/ml compared to healthy individuals (111.20±3.47) pg/ml (p<0.05). The mean value of copeptin concentration in patients with decompensated CHF was recorded (18.11±0.12) pg/ml, compared to (12.03±0.14) pg/ml in patients with MI without signs of CHF decompensation. Conclusions: The most significant for clinical and prognostic assessment of the post-infarction period complicated by decompensated HF is the response of the patient’s body to dosed physical exertion and the levels of NT-prpBNP, copeptin and ST2.
The aim of the study was to increase the efficiency of diagnostic methods to find means to improve the treatment of patients with decompensated heart failure in the post-infarction period. Materials and methods. This study is based on an examination of 120 patients with decompensated HF (60 patients with STEMI and 60 with non-STEMI). Patients with previous STEMI complicated by decompensated heart failure were divided into groups, depending on their treatment. The studied groups were homogeneous in terms of age, sex, the severity of the course of the disease, duration of the post-infarction period, and the presence of clinical manifestations of decompensation. The patients were observed on the first day after hospitalization, after 1 and 2 months after treatment. Copeptin serum levels were assayed using the EK 065-32, EIA Copeptine kit (RayBiotech, Inc., USA). ST-2 in blood serum was determined with the help of the Presage ST-2 kit (Critical Diagnostics, USA). The level of ST2 was determined in ng/ml. Results. We analysed the effect of therapy on the level of ST2 in the blood serum of examined patients with STEMI and non-STEMI complicated by decompensated heart failure. All the treatment regimens we proposed led to a significant decrease in the level of this peptide in blood serum after the end of the treatment. In patients of group I who received basic therapy drugs, the average ST2 concentration was (49.47±1.77) ng/ml before treatment. After 1 and 2 months of therapy, it was (44.92±1.22) ng/ml and (41.67±1.18) ng/ml, respectively (p˂0.05). The patients with decompensated heart failure after non-STEMI from group I had a copeptin level of (18.13±0.10) pg/ml before treatment and probably decreased to levels of (16.29±0.15) pg/ml and (15.09±0.14) pg/ml after 1 and 2 months under the influence standard therapy. Conclusions. We found the dependence of copeptin and ST2 levels on decompensated HF in the early and late post-infarction periods. It was established that the use of the therapy with a combination of the studied drugs led to a more intense decrease in serum copeptin, compared to therapy with succinic acid, arginine drugs, and standard therapy (p˂0.05). Using a differentiated treatment algorithm for patients with decompensated heart failure in the post-infarction period, copeptin and ST2 in blood serum increases the effectiveness of treatment and prevents complications.
This article highlights the main components of the curriculum of the elective discipline "Urgent issues of cardiology" of the Ivano-Frankivsk National Medical University for students of the 6th year of the medical faculty. The results of students' mastery of integral, general, professional competencies according to the educational and professional program "Medicine", second (master's) level are provided. The importance of using innovative technologies in independent extracurricular work to ensure a high level of the educational process is highlighted. The purpose of teaching the academic discipline "Urgent issues of cardiology", the method of organizing practical classes using all types of teaching methods recommended for higher education, the basic knowledge and skills that a student acquires when learning the materials of the discipline are clarified. The article emphasizes the importance of using various teaching methods recommended for higher education (explanatory and illustrative, reproductive, problem presentation, heuristic, research) when conducting practical classes, according to the approved thematic plan. The discipline is aimed at students achieving the corresponding learning outcomes reflected in this article. The optimal combination of modern technologies, work in educational and practical centers of the university, the development of clinical thinking focused on deepening knowledge and skills in the study of the pathology of the cardiovascular system are the main goals of studying the elective discipline "Urgent issues of cardiology". Aim. Establish new opportunities and analyze the main provisions of the discipline "Urgent issues of cardiology" to improve the assimilation and further use of the acquired knowledge and skills by students. Materials and methods. According to the curriculum, teaching of the discipline "Urgent issues of cardiology" is carried out in the 6th year of the medical faculty during the XI-XII semester. The program on "Urgent issues of cardiology" in the 6th year involves the study of the basics of cardiology, while the emphasis is on the study of etiology, pathogenesis, clinic, diagnosis, treatment and prevention of the main and the most common diseases of the cardiovascular system. The subject of study of the academic discipline is the improvement and expansion of knowledge about diseases of the circulatory system. Results. The teaching of the elective discipline "Urgent issues of cardiology" is carried out in accordance with the provisions of the educational and professional program "Medicine" of the second (master's) level of higher education, work and training programs of the elective discipline. When studying the discipline "Urgent issues of cardiology", all types of teaching methods recommended for higher education are used. The discipline is aimed at students achieving appropriate learning outcomes. Conclusions. Taking into account the specifics of a doctor's professional activity, the need to improve and optimize the educational process of the selective discipline "Urgent issues of cardiology" is aimed at the formation of a competent person who is able to solve professional problems in non-standard circumstances. This discipline provides the future doctor with the knowledge and skills to suspect, diagnose and prescribe individual treatment, according to modern guidelines and recommendations, for the treatment of the main diseases of the cardiovascular system.
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