RESUMO
Ð ost-COVID-19 syndrome (PS) is one of the medical and social problem. According to WHO, 10-20% of COVID-19 patients suffer from PS. The use of medical gases - inhaled nitric oxide (iNO) and molecular hydrogen (iH2) - may influence on the mechanisms of development PC. AIM: To evaluate the safety and efficacy of the combined inhalation of NO and H2 (iNO/iH2) in patients with respiratory manifestations of PS. MATERIALS AND METHODS: 34 patients with PS (11 men/23 women, 60.0±11.7 years) were included in the prospective open-label controlled study in parallel groups: the main group (n=17) received iNO/iH2 for 90 minutes once a day for 10 days (concentration of NO 60 ppm, H2<4% in the gas mixture), the control group (n=17) didn't receive inhalations. The period from the confirmation of COVID-19 to the start of the study was 641.8±230.5 days. The groups did not differ in the baseline parameters. The clinical symptoms (from the self-observation diary and mMRC questionnaires, "dyspnea language"), FAS, HADS, SF-36 scores, 6-minute walk test, the blood serum parameters of oxidative stress, the dynamics of the microcirculation in the eye bulbar conjunctiva were evaluated. The individual dose of iNO has chosen during a 15-minute test (the positive dynamics of the microcirculation have indicated that the dose was selected correctly). RESULTS: The decrease the symptoms severity, such as dyspnea, cough, fatigue and palpitations (p<0.005), the increase in SF-36 questionnaire scores (p=0.006) and a reducing of FAS score (p=0.001), as well as the anxiety component of HADS (p=0.02) were revealed at the end of treatment in the main group compared to the control group. We observed an improvement in distance walked (p=0.01) and the values SpO2 (p=0.04) in 6-minute walk test, the increase in the volumetric blood flow velocity in venules (p<0.001), and the date in oxidative damage (p<0.001) and antioxidant activity (p=0.03) parameters in the blood serum. CONCLUSION: The results of the study demonstrate clinical efficacy iNO/iH2 on clinical indicators, parameters of oxidative stress and microcirculation in patients with PS.
Assuntos
COVID-19 , Hidrogênio , Óxido Nítrico , Humanos , Feminino , Masculino , Óxido Nítrico/administração & dosagem , COVID-19/complicações , Hidrogênio/administração & dosagem , Pessoa de Meia-Idade , Administração por Inalação , Estudos Prospectivos , SARS-CoV-2 , Síndrome de COVID-19 Pós-Aguda , Resultado do Tratamento , IdosoRESUMO
UNLABELLED: Aim - to develop an algorithm to guide neuroprotective therapy in railway workers undergoing long-term follow-up for primary open-angle glaucoma (POAG) judging from the efficacy of sequential administration of intravenous dosage form of Mexidol and oral tablets. MATERIAL AND METHODS: All sorts of JSC Russian Railways employees with stage I-III POAG and well-controlled intraocular pressure were enrolled. Mexidol was first to be administered intravenously by a dropper in a day hospital (250 mg daily for 5 days) and then taken orally at home (125 mg t.i.d. for 3 months). A comprehensive ophthalmic examination with high-technology control was performed in all patients at their first, second, and third follow-up visits. RESULTS: Data from 58 patients (96 eyes) were analyzed. Statistically significant improvements in perimetry and optical coherence tomography results were only obtained at a third visit, i.e. at the end of the course of Mexidol tablets. The treatment effect was most pronounced in stage I-II patients. CONCLUSION: The results suggest that combination therapy with intravenous and oral Mexidol received sequentially as well as long-term (3-month) administration of Mexidol tablets can both be recommended in POAG patients. It has been also found that neuroprotective therapy with Mexidol performs best for early stages of the disease.