Reduction in the COVID-19 pneumonia case fatality rate by silver nanoparticles: A randomized case study.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has devastated mankind. To date, no approved treatment is available to completely combat this disease. Although many studies reported the potential of silver nanoparticles' (AgNPs) action mechanism and effect against SARS-CoV-2, this is the first clinical trial that aimed to prove this effect. This open-label, randomized, parallel-group, investigator-initiated study (IIS) was conducted in India from 2021 to 2022 and included 40 patients diagnosed with moderately-severe to severe COVID-19 pneumonia. This study proved a significantly higher survival rates (p < 0.05) and significantly lower number of days until supplemental oxygenation was required (p < 0.0001) for patients receiving intravenous AgNPs in form of AgSept® in addition to the standard COVID-19 treatment. This study highlights the importance of intravenous AgNPs administration in the treatment of virus-induced pneumonia.

Lipoprotein-associated phospholipase A2 (Lp-PLA2): a review of its role and significance as a cardiovascular biomarker.

OBJECTIVE: To conduct a comprehensive, systematic review of studies assessing the significance of lipoprotein-associated phospholipase A2 in cardiovascular diseases (CVDs). MATERIAL AND METHODS: A review of the literature was performed using the search term "Lipoprotein-associated phospholipase A2 (Lp-PLA2)" and each of the following terms: "cardiovascular risk," "cardiovascular death," "atherosclerotic disease," "coronary events," "transient ischemic attack (TIA)," "stroke," and "heart failure." The searches were performed on Medline, Google Scholar and ClinicalTrials.gov. RESULTS: The majority of published studies showed a significant association between Lp-PLA2 levels and cardiovascular events after multivariate adjustment. The association was consistent across a wide variety of subjects of both sexes and different ethnic backgrounds. CONCLUSIONS: The role of Lp-PLA2 as a significant biomarker of vascular inflammation was confirmed, and Lp-PLA2 seems to be closely correlated to cardiovascular events. It may be an important therapeutic target and may have an important role in prevention, risk stratification and personalised medicine.

Assessment of Symptoms Control, Pulmonary Function and Related Quality of Life in Asthmatic Patients Treated with Extrafine Beclomethasone Dipropionate/Formoterol Fumarate 100/6 µg pMDI: Results of a Multicenter Observational Study in Romania (ALFRESCO Study).

Introduction: Asthma treatment guidelines advocate the use of long-acting beta2-agonists (LABA) in addition to inhaled corticosteroids (ICS) in patients whose asthma is uncontrolled by ICS alone. This is the first study done in Romania, which collected the real-world data on the effects of Foster® (extrafine beclomethasone dipropionate/formoterol fumarate BDP/FF in a pressurized metered-dose inhaler pMDI 100/6 µg formulation) in adult asthmatic population. Objective: We aimed to assess the asthma symptoms control, pulmonary function and quality of life parameters in a heterogeneous Romanian asthmatic adult outpatient population, treated with extrafine BDP/FF 100/6 µg pMDI. Methods: This was a prospective, multicenter, observational study involving 30 pulmonologists randomly selected from the Romanian healthcare system, which did not declare any competing interests. Recruitment period was Oct 2018 - Feb 2019, while the patients' observational period was 24 weeks. The study included poorly controlled and uncontrolled adult asthma outpatients treated with non-extrafine formulations medication, for which the treatment indication, according to Global Initiative for Asthma (GINA) 2018, was the use of an ICS-LABA combination. The study collected demographic data, smoking habits, comorbidities, data regarding asthma diagnosis, the evolution of asthma symptoms, spirometry, Asthma Control Questionnaire (ACQ-7) scoring test, current and concomitant treatment. Results: Of 302 included patients, 290 completed the study. Pulmonary function parameters assessed during the trial (forced expiratory volume in one second - FEV1 and forced vital capacity - FVC) showed a significant improvement versus baseline (p<0.001). ACQ-7 score decreased significantly from 3.09±0.83 (visit 1) to 1.56±0.89 (visit 2) and to 1.09±0.81 (visit 3) (p<0.001). At the end of the study, 127 (43.79%) patients were well controlled (ACQ-7 score < 0.75). Conclusion: This observational study demonstrates the effectiveness and safety of extrafine fixed combination of BDP/FF (100/6 µg) pMDI in Romanian adult asthma patients uncontrolled with non-extrafine medication in a real-world setting, leading to clinically and statistically improvements in asthma control and pulmonary function.

Impact of chronic venous disease on quality of life: Results of vein alarm study.

Chronic venous disease (CVD) affects millions of people and negatively impacting the patient's quality of life (QoL) and most of the patients are diagnosed with CVD in advanced stages. The impact of newly diagnosed CVD on QoL has not been evaluated by other studies in Romania. The aim of this study was to assess the QoL for adult patients newly diagnosed with CVD addressing to the General Practitioner's (GP) office in Romania between June to August 2016. Patients included in the study were adult, signing the inform consent form, newly diagnosed with CVD or patients diagnosed with CVD, without CVD treatment the past 6 months. Data on demographic distribution, risk factors, clinical profiles, CVD symptomatology, QoL parameters, as well as pharmacological management practice were collected. The study included 1,893 patients (79.08% females) with 50.4% of patients in the age group 51-70 years. The most frequent CVD symptoms reported, were heavy leg sensation (85.74%), swelling of the feet (77.28%) and pain (73.11%). The most frequent CVD signs were telangiectasia and reticular veins (79.19%), varicose veins (65.77%) and edema (53.35%). The clinical, aetiological, anatomical and pathophysiological (CEAP) classification placed most of the patients in C3 class (31.85%), followed by C2 class (28.00%), C1 class (21.02%) and C4a (8.87%). Most of the patients reported 'low' or 'moderate' intensity of the CVD symptoms. QoL was affected for most of the patients at 'a mild' or 'moderate' degree, being noticed as a significant negative impact on physical, psychological, and social functioning components of QoL, correlated with CEAP class (P<0.001). Data regarding correlation of CEAP class, CVD symptoms and impact on QoL identified a significant correlation between all analyzed components (P<0.001). Study results prove that CVD diagnosis was established with relative delay and CVD is negatively affecting patients' QoL. Additional research will be needed to identify the long-term impact of CVD on QoL of the affected patients and their families.

Epidemiology and clinical characteristics of chronic venous disease in Romania.

Chronic venous disorder (CVD) is a complex disease, that affects millions of people worldwide, and due to the fact that in its early stages is often overlooked by healthcare providers and ignored by the patient, the assessment of incidence and prevalence of CVD is difficult to be made. The aim of this project was to assess the CVD prevalence, risk factors and clinical characteristics in the adult population in Romania. A cross-sectional survey was carried out in Romania from June 2015 to July 2015, including 185 general practitioners (GPs). Data regarding patient characteristics, risk factors, family medical history, CVD signs and symptoms, C-classification, and pharmacological management of CVD were collected. The study included 7,210 patients, predominantly female (71.0%), with the mean age of 58.2 years. Within the study population, 2,271 (31.5%) patients had already the CVD diagnosis established prior to the study visit, while for 2,664 (36.9%) patients, CVD was diagnosed during the visit, while for the rest of the patients, 2,275 (31.6%), CVD diagnosis was not established prior or during the study visit. Age, female, sex and previous pregnancies were major risk factors for developing CVD. The newly diagnosed CVD rate was 36.9% and the directly calculated CVD prevalence in June-July 2015 was 68.4%, while the indirectly calculated CVD prevalence was 80.7%. CVD is a very common disease, with a prevalence of CVD within the study population in June-July 2015 of 68.4%. The newly diagnosed CVD cases represent 36.9% of patients included in this study, nevertheless both parameters could be underestimated, as long as a significant percentage of patients presenting symptoms, but no CVD signs, were not considered by GPs as CVD cases.