Infections from temporary catheters in hemodialysis patients in Kosovo.

The objective of this study is to evaluate the frequency of infections from central venous temporary catheters and the type of a microorganism caused, from January 2017 up to December 2019. This study was performed on patients who were on hemodialysis (HD) through the central temporary venous catheter, right and left femoral vein, right jugular vein, and right subclavian vein.The patients in the HD center in Pristina, Kosovo, were used as a clinical sample. In this study, 1902 patients with temporarily central venous catheters (CVCs) were involved, while the control group consisted of 642 patients. Both groups were matched for age and gender. In all patients and the subjects of the control group, following data were obtained: Anamnesis, medical examination, as well as biochemical and hematological laboratory tests, CVC swab and antibiogram and hemoculture. Data analysis was performed using the descriptive statistical methods and the Chi-square test comparing the laboratory results of a HD patients treated through the central temporary venous catheter. Based on the results of this research, higher incidence of infections occurred with femoral vein access, compared to other CVCs accesses. The most common microorganisms responsible were Staphylococus epidermidis, while the 2019 had the highest incidence of infection.

Comparison of Effect of Leukotriene Biosynthesis Blockers and Inhibitors of Phosphodiesterase Enzyme in Patients with Bronchial Hyperreactivity.

AIM: Blocking effect of leukotriene biosynthesis-zileuton and blocking the effect of phosphodiesterase enzyme-diprophylline in the treatment of patients with bronchial asthma and bronchial increased reactivity, and tiotropium bromide as an antagonist of the muscarinic receptor studied in this work. METHODS: Parameters of the lung function are determined with Body plethysmography. The resistance of the airways (Raw) was registered and measured was intrathoracic gas volume (ITGV), and specific resistance (SRaw) was also calculated. For the research, administered was zileuton (tabl. 600 mg) and diprophylline (tabl. 150 mg). RESULTS: Two days after in-house administration of leukotriene biosynthesis blocker-zileuton (4 x 600 mg orally), on the day 3 initial values of patients measured and afterwards administered 1 tablet of zileuton, and again measured was Raw and ITGV, after 60, 90 and 120 min. and calculated was SRaw; (p < 0.01). Diprophylline administered 7 days at home in a dose of (2 x 150 mg orally), on the day 8 to same patients administered 1 tablet of diprophylline, and performed measurements of Raw, ITGV, after 60, 90 and 120 min, and calculated the SRaw (p < 0.05). Treatment of the control group with tiotropium bromide - antagonist of the muscarinic receptor (2 inh. x 0.18 mcg), is effective in removal of the increased bronchomotor tonus, by also causing the significant decrease of the resistance (Raw), respectively of the specific resistance (SRaw), (p < 0.05). CONCLUSION: Effect of zileuton in blocking of leukotriene biosynthesis is not immediate after oral administration, but the effect seen on the third day of cys-LTs' inhibition, and leukotriene B4 (LTB4) and A4 (LTA4) in patients with bronchial reactivity and bronchial asthma, which is expressed with a high significance, (p < 0.01). Blockage of phosphodiesterase enzyme-diprophylline decreases the bronchial reactivity, which is expressed with a moderate significance, (p < 0.05).

Maximum Time of the Effect of Antileukotriene - Zileuton in Treatment of Patients with Bronchial Asthma.

OBJECTIVE: Maximum time of the effect of antileukotriene substances - Zileuton in the treatment of patients with bronchial asthma and increased bronchial reactivity and of the salbutamol as agonist of the beta2 adrenergic receptor studied in this work. METHODS: Parameters of the lung function are determined with Body plethysmography. Raw and ITGV were registered and specific resistance (SRaw) was calculated. Zileuton (Zyflo, tbl. 600 mg), producer Cornerstone Therapeutics, USA was used in the research. RESULTS: Results of this research, in patients with bronchial asthma, indicate that antileukotriene substances-Zileuton administered in a dose of 600 mg first day (oral route of administration 4 × 1 tbl.) has not caused significant decrease of the specific resistance of the airways (SRaw) (p value 0.1 > Alpha 0.05), whereas Zileuton administered two days in a row, in a dose of 600 mg (4 × 1 tbl. a day), has caused significant decrease of the specific resistance of the airways (SRaw) (P value 0.03 < Alpha 0.05). Effect of the control with salbutamol (beta2-adrenergic receptor agonist) is efficient in the removal of the increased bronchomotor tone, causing significant decrease of the resistance (Raw), respectively of the specific resistance (SRaw), (p value 0.05 = Alpha 0.05). CONCLUSION: Formation of leukotrienes depends on the lypoxygenation of the arachidonic acid by 5-lypoxygenase. Zileuton is an active and powerful inhibitor of the activity of 5- lypoxygenase and as such inhibits generation of its products. Consequently, besides inhibition of cys-LTs', zileuton also inhibits the formation of leukotriene B4 (LTB4), which is a powerful chemotactic of other eicosanoids too, which depend on the synthesis of lekotriene A4 (LTA4). This suggests that the effect of antileukotrienes (Zileuton) is not immediate after oral administration, but the powerful effect of the Zileuton seen only after two days of inhibition of cys-LTs', and inhibition of leukotriene B4 (LTB4) and A4 (LTA4).

Importance of the adrenergic nerve system in the response of gases in the arterial blood following the provoked bronchospasm.

INTRODUCTION: This work, partial pressure of the respiratory gases in the capillary blood (pH, PaO2, PaCO2) was studied, following the protective action of the beta2-drenergic stimulator-Hexoprenaline and alpha2-adrenergic blocker-Tolazoline in the bronchoconstriction caused by a beta-blocker-Propranolol. MATERIAL AND METHODS: in patients with increased bronchial reactibility. pH, oxygen partial pressure (PaO2), dioxide carbon partial pressure (PaCO2) in the arterial blood, with the assistance of the analyzer IL, following some minutes of sample taking were defined in all patients. As a standard to verify the accuracy of the measurement, ampoule solutions of pH, PaO2 and PaCO2 were utilized (Acidobasel, Berlin). RESULTS AND DISCUSSION: Following the inhalation of the beta-blocker-Propranolol (20 mg/ml-aerosol), there was an evident decrease (p < 0.05) of pO2 and a non-significant increase (p > 0.1) of pCO2. Beta2-adrenergcic stimulator-Hexoprenaline (2 inh x 0.2 mg), shows an protective effect in the decrease of pO2 (p < 0.05) following the bronchoconstriction being provoked by Propranolol. Alpha2-adrenergic blocker-Tolazoline (20 mg/ml-aerosol), has not shown a protective action in the bronchoconstriction caused with propranolol, therefore significant decrease (p < 0.05) of pO2 and a non-significant increase (p > 0.1) of pCO2 appeared. This shows that stimulation of beta2-adrenergic receptor has protective action in changes of the respiratory gases. Meantime, blocker of the alpha2-adrenergic receptor (Tolazoline) has not shown a protective action in changes of the respiratory gases.

Study of formulation of mild pharmaceutical forms of paracetamol in medical practice.

INTRODUCTION: Paracetamol is one of the most used antipyretic- analgesic preparation, which can be found in different pharmaceutical forms and in different doses. Due to its wide utilization in the clinical practice, determination of paracetamol in pharmaceutical formulation is of a great importance since that over dosage with paracetamol may cause the hepatic fulminant necroses and other toxic effects. MATERIAL AND METHODS: Study has included two formulations of paracetamol suppositories with doses of 125 mg widely used in the paediatric practice. Suppositories prepared according to these two formulations by the melting method and spilling into forms was subject to the quality control by implementing a series of trials and analyses for that aim, such are: reactions of identification, average mass, disintegration time, and homogeneity whilst quantitative determination was performed by applying two methods of instrumental analyze: spectrophotometry in UV zone and cromatography in liquid phase with high pressure. RESULTS AND DISCUSSION: Results of these analyses, performed immediately following the preparation and 3 months after the preparation, showed that content of paracetamol in both of two formulations is within the norms of Pharmacopoeia. Suppositories of paracetamol in doses of 125 mg prepared as per formulation 1 are to be considered as more appropriate because it contains semi synthetic glycerides as excipient which has better features than other suppository excipients.