Rolul celulelor stem în tratamentul pacienților cu COVID-19

Background. Covid-19 is a new strain of coronavirus that manifests itself with acute respiratory failure and ARDS that can progress to multiple organ failure. Objective of the study. Presentation of the role of treatment, in patients with Covid-19, with stem cells in the acute phase and recovery. Material and Methods. Review of 20 articles from Pubmed. gov, Stem Cells journals, The Regenerative Stem Cells Institute, BMC, ERS, Journal of Translational Medicine, American Lung Association. Results. The pathogenesis of Covid-19 is based on the presence of cytokine storm-the therapeutic target in the acute phase, while in the recovery phase the therapeutic targets-the decrease of pulmonary fibrosis and facilitation of pulmonary vascularization. The role of stem cells in the treatment of covid-19 is represented by: Immunomodulatory role-inhibiting the activity and proliferation of B, T cells and natural killer, inhibiting the maturation and antigenic presentation of dendritic cells, activating macrophages. Anti-inflammatory role-release of chemokines, secretion of lipoxin A4, TGF-beta, nitric oxide, prostaglandin E2, secretion of IL-10, reduction of IL6, reduction of TNFalpha, decrease of neutrophils. Secretion of repair factors-of vascular endothelial growth, platelet-derived growth factor, IGF1 and HGF-activation of angiogenesis. Antifibrotic role reducing the expression of pro-fibrotic ligate TGF-p1. Conclusion. Stem cells with their significant immunomodulatory functionality can suppress the predominant cytokine storm in the acute phase of the disease. At the same time, stem cell transplantation has been shown to be effective in activating endogenous mechanisms of repair, tissue regeneration and decreased pulmonary fibrosis. Result in attenuation of multiple persistent organ dysfunctions.Introducere. Covid-19 este o nouă tulpină a coronavirusurilor ce se manifestă cu IRA și SDRA care poate evolua până la insuficiență multiplă de organe. Scopul. Prezentarea rolului tratamentului, pacienților cu Covid-19,cu celule stem în faza acută și de recuperare. Material și metode. Analiza a 20 articole din Pubmed.gov, StemCells journals, The Regenerative Stem Cells Institute, BMC, ERS, Journal of Translational Medicine, American Lung Association. Rezultate. Patogenia Covid-19 este bazată pe prezența furtunii citokinice-ținta terapeutică în faza acută, în faza de recuperare-scăderea fibrozei pulmonare și facilitarea vascularizării pulmonare. Rolul celulelor stem în tratamentul covid-19 este reprezentat de: Rol imunomodulator – inhibarea activității și proliferării celulelor B, T și natural killer, inhibarea maturării și prezentării antigenice a celulelor dendritice, activării macrofagelor. Rol antiinflamator – eliberarea chemokinelor, secreția lipoxină A4, TGF-beta, oxiduluinitric, prostaglandineiE2, secreția IL-10,reducerea IL6, reducerea TNF-alfa, scăderea neutrofilelor. Rol reparativ – secreția factorilor de creștere endotelial vascular, factorul de creștere derivat din trombocite, IGF1 și HGF - activarea angiogenezei. Rol antifibrotic – reducerea expresiei ligatului pro-fibrotic TGF-p1. Concluzii. Celulele stem datorită funcției lor imunomodulatoare semnificative pot suprima furtuna de citokine predominantă în faza acută a maladiei. În același timp transplantul de celule stem s-a dovedit a fi eficient în activarea mecanismelor endogene de reparare, regenerare a țesuturilor și scăderea fibrozei pulmonare. Rezultat cu atenuarea disfuncție multiple de organe persistentă

Paracetamol - benefits and damages

Departament of Pharmacology and Clinical Pharmacology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. Paracetamol and the combined drugs, which belong to the OTC list that are released without a prescription, are most commonly used in the symptomatic treatment or selftreatment of acute respiratory infections. The diversity of trade names often misleads patients who resort to their administration without consulting a doctor. For these reasons, there is an increase in the incidence of acute intoxication and fatal adverse reactions (fulminant hepatic necrosis, etc.). Aim of the study. The aim of the study consisted in analyzing the presence on the pharmaceutical market of mono- and combined drugs containing paracetamol and estimating possible risk of side effects in self-treatment with them. Materials and methods. Based on the study of the State Drug Nomenclature, were selected drugs containing paracetamol with analysis of single dose and combination diversity. Results. In the Republic of Moldova there are 95 mono- or combined drugs containing paracetamol (acetaminophen), including producers from: Moldova - 22, Romania - 20, Ukraine 13, Belarus - 12, Turcia - 5, Russia - 5, Slovenia - 6, Georgia - 4, India - 4, Bosnia and Herzegovina - 2, United Kingdom -1, Germany - 1. The presence of single-dose mono drugs containing paracetamol of 50-250 mg for children and 500-600 mg for adults was found. There is a wide range of combined drugs including: paracetamol + decongestant adrenomimetics (phenylephrine, pseudoephedrine), paracetamol + H1-antihistamines (pheniramine, chlorophenamine), paracetamol + adrenomimetics + H1-anehistamine +, paracetamol + opacimetamine ), paracetamol + H1-anihistamines + opioid analgesics (codeine, promethazine), paracetamol + non-inflammatory anti-inflammatory drugs (propifenazone), paracetamol + antitussive opioid analgesics (codeine, dextromethorphan), which in some cases may have caffeine and / or ascorbic acid added. In accordance with the recommendations of the European Medicines Association the dose of paracetamol in adults for 24 hours is 3.2 g, and in the case of people with pre-existing hepatitis and those who suffer from alcohol abuse, of 2g / 24 hours. The presence of the H1-antihistamine component can result in diminished attention with tragic consequences for drivers, people who do machinery work, as well as the development of dry mucous membranes, including the tracheo-bronchial mucosa, which can enhance the dry cough and decrease the bronchial drainage creating the feeling of ineffectiveness of said drugs. The effect of improved breathing, through the decongestant adrenomimetics, is of short duration (1-2 hours), especially in the first 24-48 hours, which stimulates the more frequent use of drugs with systemic effects, including increased blood pressure, palpitations, tremor. Conclusions. The number and variety of drug combinations of paracetamol impose caution for their use, in order to avoid overdose and the possibility of developing hepatotoxicity

Treatment patients COVID-19 with stem cells

Introduction. COVID-19 is a disease that has spread worldwide and was first detected in Wuhan-China in December 2019. The virus has spread rapidly across different geographical areas. SARS-CoV-2 affects many systems and organs, but it mainly affects the respiratory system causing pulmonary distress, severe respiratory failure. Aim of study. To study the effect of cell therapy on the treatment of COVID-19 patients with severe respiratory failure. Methods and materials. The study was performed based on literature review: Cells therapy in patients with COVID-19 using different sources of stem cells. Results. According to the studies analyzed for the treatment of patients with covid-19, stem cells were used from: bone marrow, dental pulp, amniotic membrane, umbilical cord, human embryonic stem cells, fat stem cells and stromal fraction. Methods of administration: by inhalations and intravenous. Human amniotic epithelial cells and human mesenchymal stromal cells are found in the amniotic membrane of the placenta. Amniotic cells have an immunoregulatory, regenerative and anti-inflammatory role with a regenerating effect on pulmonary architecture in vivo. Stromal amniotic cells facilitate the adhesion of the key transcription factor Nrf2 to the antioxidant protein in HAMSCs. They were administered by inhalation, by nebulizer, facilitating the administration and amplifying the degree of pulmonary spread. Patients' recovery was only 6 days compared to standard-treated patients, who recovered within 22 days. Human amniotic epithelial stem cells in clinical trials were administered intravenously at a dose of 1 million cells kg; they improved the inflammatory and fibrotic response by removing lung damage. Allogeneic human umbilical cord mesenchymal stem cells were used to treat SARS-CoV-2 positive patients by introducing them in different doses: 5x107 3-day dose, 3 intravenous doses, 1x106 MSC/kg, single intravenous infusion;3x107/dose, intravenous infusion in 3 doses. Conclusion. Stem cells in the treatment of Covid-19 patients are used in the acute phase and in the recovery period. They have the ability to inhibit cytokine storms, neoangiogenesis, increase vascular permeability and an immunomodulatory effect for better protection of alveolar tissue. Very important is the antiviral and antibacterial role that facilitates the recovery of lung function. Thus, stem cell covid-19 therapy offers the possibility of treating acute processes and facilitates post-COVID-19 recovery

THE ROLE OF STEM CELLS IN TREATMENT PATIENTS WITH COVID-19

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Covid-19 este o nouă tulpină a coronavirusurilor ce se manifestă cu IRA și SDRA care poate evolua până la insuficiență multiplă de organe. Scopul. Prezentarea rolului tratamentului, pacienților cu Covid-19,cu celule stem în faza acută și de recuperare. Material și metode. Analiza a 20 articole din Pubmed.gov, StemCells journals, The Regenerative Stem Cells Institute, BMC, ERS, Journal of Translational Medicine, American Lung Association. Rezultate. Patogenia Covid-19 este bazată pe prezența furtunii citokinice-ținta terapeutică în faza acută, în faza de recuperare-scăderea fibrozei pulmonare și facilitarea vascularizării pulmonare. Rolul celulelor stem în tratamentul covid-19 este reprezentat de: Rol imunomodulator – inhibarea activității și proliferării celulelor B, T și natural killer, inhibarea maturării și prezentării antigenice a celulelor dendritice, activării macrofagelor. Rol antiinflamator – eliberarea chemokinelor, secreția lipoxină A4, TGF-beta, oxiduluinitric, prostaglandineiE2, secreția IL-10,reducerea IL6, reducerea TNF-alfa, scăderea neutrofilelor. Rol reparativ – secreția factorilor de creștere endotelial vascular, factorul de creștere derivat din trombocite, IGF1 și HGF - activarea angiogenezei. Rol antifibrotic – reducerea expresiei ligatului pro-fibrotic TGF-p1. Concluzii. Celulele stem datorită funcției lor imunomodulatoare semnificative pot suprima furtuna de citokine predominantă în faza acută a maladiei. În același timp transplantul de celule stem s-a dovedit a fi eficient în activarea mecanismelor endogene de reparare, regenerare a țesuturilor și scăderea fibrozei pulmonare. Rezultat cu atenuarea disfuncție multiple de organe persistentă.Background. Covid-19 is a new strain of coronavirus that manifests itself with acute respiratory failure and ARDS that can progress to multiple organ failure. Objective of the study. Presentation of the role of treatment, in patients with Covid-19, with stem cells in the acute phase and recovery. Material and Methods. Review of 20 articles from Pubmed. gov, Stem Cells journals, The Regenerative Stem Cells Institute, BMC, ERS, Journal of Translational Medicine, American Lung Association. Results. The pathogenesis of Covid-19 is based on the presence of cytokine storm-the therapeutic target in the acute phase, while in the recovery phase the therapeutic targets-the decrease of pulmonary fibrosis and facilitation of pulmonary vascularization. The role of stem cells in the treatment of covid-19 is represented by: Immunomodulatory role-inhibiting the activity and proliferation of B, T cells and natural killer, inhibiting the maturation and antigenic presentation of dendritic cells, activating macrophages. Anti-inflammatory role-release of chemokines, secretion of lipoxin A4, TGF-beta, nitric oxide, prostaglandin E2, secretion of IL-10, reduction of IL6, reduction of TNFalpha, decrease of neutrophils. Secretion of repair factors-of vascular endothelial growth, platelet-derived growth factor, IGF1 and HGF-activation of angiogenesis. Antifibrotic role reducing the expression of pro-fibrotic ligate TGF-p1. Conclusion. Stem cells with their significant immunomodulatory functionality can suppress the predominant cytokine storm in the acute phase of the disease. At the same time, stem cell transplantation has been shown to be effective in activating endogenous mechanisms of repair, tissue regeneration and decreased pulmonary fibrosis. Result in attenuation of multiple persistent organ dysfunctions

Objective audiometry for early diagnosis of hearing loss in children

Catedra de Otorinolaringologie USMF,, Nicolae Testemiţanu,, Centrul Republican Functional de Audiologie, Protezare auditiva si Reabilitare medicopedagogicaThe early and precise diagnosis of hearing impairment is undoubtedly very important for the successful rehabilitation of children with this pathology, and their further integration into the society. We analyzed and revealed the particularities of the auditory evoked potentials of the brain stem (BERA) and otoacoustic emissions (OAE) in children with hearing loss and other different associated pathologies. Our data includes the results of examination of 110 children with hearing l oss, and of 110 healthy children. We confirm the practical usefulness of OAE and BERA examination in early diagnosis of hearing impairment in children. Depistarea precoce şi diagnosticul exact al surdităţii la copii sunt indispensabile în reuşita reabilitării acestora şi pentru integrarea ulterioară în societate. Au fost analizate şi elucidate particularităţile potenţialelor evocate auditiv ale trunchiului cerebral şi a otoemisiilor acustice la copiii cu surditate şi diferite patologii asociate. Au fost analizate rezultate a 110 copii cu surditate şi a 30 copii sănătoşi. S-a confirmat utilitatea practică şi valoarea diagnostică a otoemisiilor acustice şi a potenţialelor evovate auditiv în diagnosticul precoce al surdităţii la copii

Características de los niveles de comprensión lectora de los alumnos del segundo grado de educación primaria de la Institución Educativa Walt Whitman, Vipol de Naranjal, San Martín de Porres, 2015

La presente investigación titulada Características de los niveles de comprensión lectora de los alumnos del segundo grado de educación primaria de la institución educativa Walt Whitman, Vipol de Naranjal, San Martín de Porres, 2015, tuvo como objetivo determinar las características de los niveles de comprensión lectora de los alumnos del segundo grado de la mencionada institución. Este propósito guarda relación con el problema planteado de conocer las características de los niveles de comprensión lectora de los alumnos del segundo grado de educación primaria de la institución educativa particular Walt Whitman, Vipol de Naranjal, San Martín de Porres, 2015. Esta investigación se realizó dentro del enfoque cuantitativo y utilizó el diseño descriptivo simple. La muestra estuvo conformada por 20 estudiantes del segundo grado de primaria. La técnica que se empleó fue la observación y como instrumento se utilizó la lista de cotejo en escala dicotómica, el cual fue adaptado y validado mediante juicio de expertos. Su confiabilidad fue probada a través del estadístico KR-20. Luego de la evaluación en sus distintas dimensiones, los resultados se presentan de manera gráfica y lingüística. La investigación concluye que el 55.0% de los alumnos del segundo grado de educación primaria de la institución educativa particular Walt Whitman, Vipol de Naranjal, San Martín de Porres, 2015, logró el nivel B (Nivel en proceso), seguidos con el 40,0% en el nivel A (Logro previsto) y solo el 5,0% en el nivel C (Nivel en Inicio)

Post Covid-19 respiratory complications treatment by stem cells

Background. Covid-19 is a new type of coronavirus that manifests itself with acute respiratory failure and acute respiratory distress syndrome that can progress to multiple organ failure. Despite the therapeutic advances, there are challenges in the treatment of this disease, thus directing attention to stem cells. Objective of the study. Presentation of the role of treatment, in patients with post Covid-19 respiratory complications with stem cells. Material and Methods. Review of 25 articles from Pubmed.gov; StemCells journals; The Regenerative Stem Cells Institute; BMC; ERS; Journal of Translational Medicine; American Lung Association. Results. The primary disorder in the pathogenesis of Covid-19 is at the level of the immune system, by acting on the ACE2 receptor in pneumocytes and the production of the cytokine storm, the increase of C-reactive protein levels and the inability to transform pneumocytes type II into type I while maintaining the transition phase of pneumocytes type II. The role of stem cells in the treatment of covid-19 is represented by: Immunomodulatory role - inhibiting the activity and proliferation of B cells, T cells and natural kiler, inhibiting the maturation and antigenic presentation of dendritic cells, activating macrophages. Anti-inflammatory role - release of chemokines (CCL5, CXCL9,10,11), secretion of lipoxin A4, TGF- beta, nitric oxide, prostaglandin E2, secretion of IL-10, reduction of IL6, reduction of TNF- alpha, decrease of neutrophils-secretion of repair factors of vascular endothelial growth, platelet-derived growth factor, IGF1 and HGF - activation of angiogenesis. Antifibrotic role- reducing the expression of pro-fibrotic ligate TGF-p1. Conclusions. Stem cells with their significant immunomodulatory functionality can suppress the predominant cytokine storm in the acute phase of the disease. At the same time, stem cell transplantation has been shown to be effective in activating endogenous mechanisms of repair, tissue regeneration and decreased pulmonary fibrosis with increasing pulmonary vascularization and improving oxygen saturation. It has been proven that stem cells do not have receptors for ACE2 and thus they cannot be infected by the SARS-Cov-2 virus

Estrategias metodológicas de clima escolar con estudiantes de una institución educativa secundaria - Querecotillo; 2019

La investigación desarrollada tuvo como propósito mejorar el clima escolar en los educandos de segundo grado del nivel secundaria de la Institución Educativa Pública \\"San Francisco de Chocán\\" perteneciente al distrito de Querecotillo. La metodología obedece al diseño cuasi experimental de tipo Pre y post test. Los instrumentos empleados para el acopio de datos son de estructuración del autor y están definidos por la técnica de la encuesta. Se utilizó dos cuestionarios: uno dirigido a docentes y otro a estudiantes, cuya muestra fue de 50 estudiantes. Para procesar los datos se hizo uso del sistema Microsoft Excel y Microsoft Word, presentándose los siguientes resultados: los docentes manifiestan que el 69% de los estudiantes muestran conductas agresivas, lo que afecta de forma considerable el clima escolar. Por otro lado, el 76% de estudiantes encuestados perciben un entorno áulico no favorable, manifestándose que el clima escolar no es adecuado para el aprendizaje. La aplicación de estrategias metodológicas mejoró el clima escolar de los estudiantes de 2°grado y esto queda demostrado en la variación de la media obtenida, siendo la media del pre test 9,76 que ubica el nivel de conocimiento sobre las habilidades sociales y comunicativas en el nivel de logro \\"inicio\\". Con la posterior aplicación de las estrategias metodológicas a través de talleres y la respectiva evaluación final el post test nos arroja una media de 14,40; lo que ubica a los estudiantes en el nivel ?logrado?. Esta variación de las medias determina la comprobación de la hipótesis.Tesi

Otitele medii exsudative şi recidivante la copii

Se efectuează o analiza comparativă a manifestărilor clinice şi a modificărilor locale stabilite intraoperator la copiii cu otită medie exsudativă şi recidivantă. Aceste forme reprezintă diferite sta-dii de otită medie şi au multe particularităţi comune. Diagnosticul se bazează pe datele anamnezei minuţioase şi impedansmetriei în dinamică. Datele otoscopiei nu sunt clare. Modificările locale în majoritatea cazurilor sunt, practic, identice