Background: In the current proposal, we used the intralipid in standard therapy against COVID / 19 as an energy carrier for parenteral nutrition in critically ill patients. In patients receiving intralipid, there was an accelerated recovery of the lungs, a decrease in markers of endogenous intoxication (EI), tissue hypoxia and an improvement in general condition. In the absence of Intralipid in the intensive care unit, there was a slow recovery of the lungs and a more prolonged improvement in the general condition with the preservation of EI markers (cytolytic enzymes, C-reactive protein, platelets) and tissue hypoxia (pCO2 AV> 6 mm Hg). Collectively, Intralipid has been seen in the targeted LPO treatment plan for oxidative and nitro-galogenic stress in SARS-Cov2 / COVID / 19 patients.
Objective: to study the structure of medical prescriptions for antibacterial drugs used in patients with various types of infection of the bronchopulmonary system in the conditions of typical practice in Kursk (Russian Federation) and Chisinau (Republic of Moldova). Materials and methods. In order to assess the structure of prescribing various classes of antibacterial agents used to treat patients with infections of the respiratory system, a survey of doctors from medical organizations in Kursk and Chisinau was conducted in the period from October 2019. to January 2020 as a one-time descriptive study. As model diseases are taken: acute bronchitis with purulent sputum, exacerbation of chronic obstructive pulmonary disease with purulent sputum, non-severe community-acquired pneumonia. Results. The leaders in prescription for acute bronchitis with purulent sputum were cephalosporins: in Kursk, their share was 24% (cefixime was most often prescribed), and in Chisinau, 26.8% (leaders were cefixime and ceftriaxone). In patients with exacerbation of chronic obstructive pulmonary disease and purulent sputum, doctors from both cohorts also more often recommended cephalosporins: 29.4% and 36.1% for Kursk and Chisinau, respectively; among them, cefixime, ceftriaxone and cefotaxime were leaders in Kursk, while ceftriaxone, cefotaxime and cefuroxime axetil were the priorities in Chisinau. For non-severe community-acquired pneumonia, doctors in Kursk preferred macrolides (more often - azithromycin and clarithromycin), inhibitor-protected penicillins (more often - amoxicillin/clavulanate) and cephalosporins (mainly of the 3rd generation), in Chisinau, cephalosporins (mainly of the 3rd generation) and penicillins (including inhibitor-protected) were more often prescribed, the proportion of macrolides was significantly less. Conclusion. Doctors from Chisinau and Kursk implement pharmacotherapy for this group of patients in accordance with modern clinical guidelines; at the same time, cases of irrational use of certain medicines are recorded.
Tuberculosis is an infectious disease that affects practically all organs, including the thyroid gland. In the same time, the hypofunction of the thyroid gland may increase susceptibility to infection with Mycobacterium tuberculosis. Antituberculosis treatment, especially with second-line drugs, can lead to hypothyroidism. It has been found that rifampicin, ethionamide, prothionamide and para-aminosalicylic acid are among the most common antituberculosis drugs responsible for the development of hypothyroidism. These preparations/agents can cause thyroid dysfunction by increasing the metabolism and clearance of thyroid hormones by inducing cytochrome P-450 enzymes, deregulating/ iodine uptake and synthesis of thyroid hormones, altering hormone receptor action and intracellular signal transduction. The treatment with these medications requires the monitoring of the function of the thyroid gland during the treatment, especially in the first 3 months, but also in the post-treatment period. The installation of clinical and/or subclinical hypothyroidism will require the use of appropriate doses of levothyroxine during antituberculosis treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.