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An Ephemeral Review on Pulmonary Arterial Hypertension
Akshima Gupta,
Kanaparthi Sushrutha,
Nikhil Kumar Vanjari
Issue:
Volume 7, Issue 4, July 2019
Pages:
81-85
Received:
23 May 2019
Accepted:
25 June 2019
Published:
9 July 2019
Abstract: Pulmonary arterial hypertension [PAH] is a rare and potentially fatal disease whose management is usually restricted to a few specialized centers. The crucial vascular modifications in pulmonary arterial hypertension are endothelial-cell proliferation, vasoconstriction, thrombosis and smooth-muscle cell. As patients don’t essentially board in the neighborhood to those centers, daily care and emergencies ought to be delegated to the primary and second lines. Reduced contractility of mycardium, decreased venous return and abnormal rate of exchange of gases leads to deprivation of oxygen to cell and death. Diagnosing and management of pulmonary arterial hypertension is critical. There is no cure for PAH. Modern developments regarding cell biology, molecular genetics and of idiopathic pulmonary arterial hypertension create new insights and therapeutic targets in the management. However, there are several treatment options that aim to reduce symptoms, improve the quality of life, and slow disease progression. This short review provides an outline of our therapeutic protocols supported out there information. Based on the analysis of the reasons for death in the PAH population, a review of the main emergencies is provided. Drugs include vasodilators, anticoagulants, antiplatelet agents, antiinflammatory therapies, and vascular-remodeling therapies. Most of the drugs have pleiotropic effects.
Abstract: Pulmonary arterial hypertension [PAH] is a rare and potentially fatal disease whose management is usually restricted to a few specialized centers. The crucial vascular modifications in pulmonary arterial hypertension are endothelial-cell proliferation, vasoconstriction, thrombosis and smooth-muscle cell. As patients don’t essentially board in the n...
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Modern Possibilities of Metabolic Therapy in Improving the Quality of Life in Patients with Postinfarction Cardiosclerosis
Vasilieva Irina,
Rezvan Vladimir,
Dvoretskiy Leonid
Issue:
Volume 7, Issue 4, July 2019
Pages:
86-92
Received:
24 June 2019
Accepted:
16 July 2019
Published:
26 July 2019
Abstract: 95 patients with postinfarction cardiosclerosis and angina pectoris II and III functional classes were examined. The study included patients who refused intervention revascularization. The main group included 48 patients who were added taurine (Dibikor 750 mg / day) to enhance the effect of basic therapy, and the comparison group included 47 patients who received standard therapy and placebo. The duration of treatment was 3 months. The study demonstrated positive effects of taurine that was confirmed by significant improvements in the following indicators: subjective status, indicators of the Seattle questionnaire, echocardiographic parameters, cardiac arrhythmias. There was a decrease in the severity of fatigue by 2 times, a decrease in the intensity of complaints of palpitations by 72.3%, a decrease in the severity of dyspnea by 30.0% and a severity of pain in the heart area by 50%. Indicators of most scales of the Seattle questionnaire in patients of the main group at the end of the study significantly exceeded (p <0.05) the corresponding values in patients of the comparison group. In patients whose treatment was used taurine, a significant improvement in inotropic function was noted (the ejection fraction is significantly higher than in the comparison group, respectively 56.0 ± 1.8 and 53.5 ± 1.1%, p <0,05), the bathmotropic and chronotropic myocardial functions improved, which was shown by a 45% decrease in the number of ventricular extrasystoles, a 57% decrease in the frequency of supraventricular heart rhythm disturbances, a decrease in the incidence rate of ST segment depression (in the main group the number of episodes was significantly lower than p <0,05 than in the comparison group). The use of taurine in the complex treatment of patients with exertional angina, after suffering a myocardial infarction, is safe and not accompanied by side effects. Taurine is advisable to include in the complex treatment of patients with exertional angina pectoris, who have had a myocardial infarction in order to improve the myocardial inotropic function, enhance the antiarrhythmic and lipid-lowering effects of the basic therapy. The recommended dose of Taurine is 750 mg per day as a supplement to standard therapy with a duration of therapy of at least 3 months.
Abstract: 95 patients with postinfarction cardiosclerosis and angina pectoris II and III functional classes were examined. The study included patients who refused intervention revascularization. The main group included 48 patients who were added taurine (Dibikor 750 mg / day) to enhance the effect of basic therapy, and the comparison group included 47 patien...
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Evaluation of Topical Dispenser Systems for Vaginal Delivery of Feminine Medications
Chanelle Toerien-Hayes,
Quy Nguyen,
Joy Woods,
Qiang Liu,
Thomas Kupiec,
Nicole Vu
Issue:
Volume 7, Issue 4, July 2019
Pages:
93-101
Received:
17 May 2019
Accepted:
25 June 2019
Published:
5 August 2019
Abstract: The vaginal route of administration has a large surface area with a rich blood supply demonstrating capacity for local absorption and systemic bioavailability of drugs. However, there are problems associated with current vaginal delivery method in terms of dosing precision and accuracy. In this report, the potential utility of the metered-dose Topi-CLICK® Perl™ system for vaginal delivery of feminine medication is presented. The aim was to evaluate the efficiency of Topi-CLICK® Perl™ for dosing accuracy, precision, and residual waste of medicaments relative to currently available dispensing systems. The results showed Topi-CLICK® Perl™ system to have the highest accuracy for a dose being correctly delivered more than 88% of the time. Whereas other commonly used dispenser systems, such as plastic or metal (aluminum) ointment tubes with smooth or ribbed applicators, exhibited not more than 10% of doses being within acceptable limits for accuracy. Medication waste was significantly minimized using Topi-CLICK® Perl™, which has an estimated overfill volume less than 6%. This required overfill volume ranged from 39% to 88% respectively, for the plastic and metal ointment tubes. Qualitatively, operators of Topi-CLICK® Perl™ found the metered-dose system the easiest to use with little mess. Based on these results, Topi-CLICK® Perl™ outperformed other traditional dispensing systems for vaginal drug delivery in accuracy and precision, with the least amount of residual medication waste.
Abstract: The vaginal route of administration has a large surface area with a rich blood supply demonstrating capacity for local absorption and systemic bioavailability of drugs. However, there are problems associated with current vaginal delivery method in terms of dosing precision and accuracy. In this report, the potential utility of the metered-dose Topi...
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Impact of Integrated Whole Body 68Ga PET/MR Imaging in Comparison with 68Ga PET/CT in Lesions Detection and Diagnosis of Suspected Neuroendocrine Tumours
Alshaima Alshammari,
Michael Masoomi,
Rizwan Syed,
Evangelia Skoura,
Sofia Michopoulou,
Fulvio Zaccagna,
Jamshed Bomanji,
Francesco Fraioli
Issue:
Volume 7, Issue 4, July 2019
Pages:
102-111
Received:
26 June 2019
Accepted:
26 July 2019
Published:
10 August 2019
Abstract: Combined PET/MR is a relatively new technique and so far there has been a very limited report of the potential simultaneous PET/MR and PET/CT application in the evaluation of neuroendocrine tumours. The present study aimed to compare "Ga-DOTATATE PET/CT and PET/MR imaging in patients with known neuroendocrine tumours (NET) and assess the confidence in anatomic lesion detection and localization. We analysed the data of 37 NET patients who underwent both 68Ga-DOTATATE PET/CT and PET/MR using the same injected activity. Visual findings by two observers of the two modalities were recorded. SUV max of both primary tumour and liver lesions for both modalities and PET/MR derived apparent diffusion coefficient (ADC) values were measured. To study the value of additional MRI sequences, the differences in performance between PET with T1+T2w, PET with DWI reads, and PET with post contrast was assessed. No significant differences between the two modalities were seen regarding the number of patients affected by primary or metastatic disease. However, counting the number of lesions per patient, both observers were able to recognize more liver lesions in MRI T1 and T2. The interclass correlation coefficient (ICC) demonstrated a strong correlation between SUV max derived from PET/CT and PET/MR in both primary lesions (ICC = 0.92; p = 0.001) and liver (ICC = 0.882; p = 0.001). In the evaluation of lesion per patient, PET+ contrast and DWI detected more metastasis than the evaluation of PET +T1 and T2 alone. There was no significant correlation between ADC values and PET/MR SUV max of the tumour (respectively: p = 0.43, p 0.88 and p = 0.295). PET/MRI has comparable accuracy in localization and staging to PET/CT, and has a potential to become a valid alternative to PET/CT in staging and follow up of NET patients, with advantages in the characterization of liver lesions. In our study DWI and contrast helped to detect more lesions.
Abstract: Combined PET/MR is a relatively new technique and so far there has been a very limited report of the potential simultaneous PET/MR and PET/CT application in the evaluation of neuroendocrine tumours. The present study aimed to compare "Ga-DOTATATE PET/CT and PET/MR imaging in patients with known neuroendocrine tumours (NET) and assess the confidence...
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