The efficacy of direct antiviral therapy in HCV cirrhotic patients

Spitalul Clinic Republican de Boli Infecţioase „Toma Ciorbă“, Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“The study involved 65 patients with HCV genotype 1b Child Pugh A and B cirrhosis treated with Ledipasvir / Daclatasvir + Sofosbuvir with/without Ribavirin for 12 weeks in Clinical Hospital for Infectious Diseases “Toma Ciorba”. We studied the evolution of clinical and haematological, biochemical parameters and also of the viral load. The most common adverse effect of antiviral therapy with ribavirin in the treatment of HCV infection is anemia. The efficacy of DAA therapy in compensated cirrhosis was not influenced by the dose reduction or discontinuation of ribavirin. After the completion of antiviral therapy 64 (98,4%) patients presented undetectable viral load, 1 patient died, was diagnosed with hepatocarcinoma. The results obtained showed the efficacy of this treatment. В исследовании участвовали 65 пациентов с циррозом печени HCV-этиологии, с генотипом 1b, классы А и B по классификации Чайлд-Пью. Пациенты принимали лечение препаратами прямого противовирусного действия по одной из схем: Ledipasvir / Daclatasvir + Sofosbuvir с/без Рибавирина в течение 12 недель в Клинической больнице инфекционных заболеваний «Тома Чорбэ». Мы изучили эволюцию клинических, гематологических и биохимических параметров, а также вирусную нагрузку. Наиболее распространенным побочным эффектом противовирусной терапии с Рибавирином в лечении инфекции HCV является анемия. Эффективность терапии препаратами прямого противовирусного действия при компенсированном циррозе не зависит от снижения дозы или отмены Рибавирина. После завершения противовирусной терапии, 64 пациента (98,4%) представили отрицательную вирусную нагрузку, 1 пациент умер (диагностирована гепатокарцинома). Полученные результаты исследований указывают на эффективность лечения препаратами прямого противовирусного действия

Some clinical, epidemiological and laboratory aspects of botulism B in adults in Republic of Moldova

Catedra Boli infecţioase, tropicale şi parazitologie medicală USMF “ Nicolae Testemiţanu”, SCBI “T. Ciorbă”This article highlights some clinical, epidemiological and laboratory aspects of botulism B in 74 adults hospitalized in different diseases departments of Republic of Moldova. The illness evolved mostly after the consumption of different products hermetically packed in domestic conditions. Only the cases of botulism B were selected, botulotoxina was achieved by biologic tests on mice. În articol sunt prezente aspectele clinice, epidemiologice şi de laborator la 74 bolnavi adulţi cu botulism de tip B, spitalizaţi în secţiile de boli infecţioase din Republica Moldova. Maladia s-a dezvoltat după consumul în hrană a diferitor produse alimentare împachetate ermetic în condiţii de casă. Noi am selectat numai bolnavii cu botulism de tip B prin decelarea acestui agent în rezultatul testării pe şoareci

The clinical and evolutionary characteristics of mumps meningitis in teenagers and adults

Catedra Boli infecţioase, tropicale şi parazitologie medicală USMF „N.Testemiţanu”, Spitalul Clinic de Boli infecţioase „T.Ciorbă”Out of 40 patient with mumps meningitis admitted to the T.Ciorba Clinical Hospital of the Infectious Diseases between November 2007-February 2008 most frequently were affected the men (98%), their age being between 14-29 years old, presented by students pupils. Meningitis, as a rule, appeared at the 6-9 day. The combinated form (parotiditis +orhitis +pancreatitis + meningitis) has been revealed in 72% of cases. Meningitis symptoms have been diagnosed in 58% of cases. The lumbar punction has revealed hypertensive transparent liquor, limphocitozis and insignificant modifications of the glucose and chloride levels. Au fost examinaţi 40 de bolnavi cu oreion la care s-a dezvoltat tabloul clinic de meningită urliană, spitalizaţi în SCBI ”T. Ciorbă” pe parcursul a 4 luni (noembrie 2007 – februarie 2008). Vîrsta pacienţilor a variat între 14 – 29 ani, majoritatea fiind elevi şi studenţi din diferite colectivităţi, printre care predominau bărbaţi (98%). Meningita s-a declanşat, de regulă, la a 6-9 zi de boală. La majoritatea (72%) pacienţilor s-a stabilit forma combinată a maladiei (oreion + meningită + pancreatită +orhită). Semnele meningiene s-au depistat la doar 25 (58%) pacienţi. LCR s-a caracterizat printr-o pleiocitoză limfocitară şi modificări neesenţiale a glucozei şi hlorizilor

Doză redusă de Tocilizumab 200 mg, comparativ cu 400 mg, la pacienții cu forme severe de infecție COVID-19

Introduction. Excessive, deregulated pro-inflammatory cytokine secretion has a detrimental impact on the evolution of COVID-19, aggregating the tissue impairment, organ failure, and an increased risk of death. Several studies have demonstrated the beneficial effect of Tocilizumab (TCZ) in reducing hyperimmune response in severe forms of COVID-19. Material and methods. This is an experimental controlled clinical trial, consisting of 66 patients hospitalized with severe COVID-19. Results. On overage, the decision to administer TCZ was made on average on the 11.34±0.31 day of the disease, when the beginning of Cytokine Storm was suspected in the patients already on dexamethasone treatment. The clinical and paraclinical parameters, including fever, asthenia and dyspnea duration, SpO2 level, oxygen therapy need, improvement of the radiological picture, and duration of hospitalization were more favorable in patients treated with TCZ 400 mg compared to those treated with TCZ 200 mg (p<0.0001). The relative risk of rapid worsening after TCZ (RR=0.88), the relative risk of decreasing blood pressure (RR=0.29) and the relative risk of transfer to intensive care units for invasive or non-invasive ventilation (RR=0.8) was lower in patients treated with TCZ 200 mg compared to the 400 mg TCZ lot. Conclusions. The dose of TCZ had a significant impacton the duration of clinical manifestations, the duration of oxygen therapy and the duration of patient hospitalization, with better results for TCZ 400 mg compared to TCZ 200mg. Although the risk of worsening after TCZ and the risk of transfer to intensive care were lower in patients treated with TCZ 200 mg. So, the 200 mg fixed dose of TCZ can be a life-saving option for severely ill patients with COVID-19 in the context of IL-6 inhibitor supply shortages.Introducere. Eliberarea excesivă a citokinelor proinflamatorii are un impact negativ asupra evoluției infecției COVID-19, sporind afectarea tisulară, insuficiența organică și riscul de deces. Mai multe studii au demonstrat efectul benefic al preparatului Tocilizumab (TCZ) în reducerea răspunsului hiperimun în formele severe de infecție COVID-19. Material și metode. Este un studiu experimental, clinic controlat, care include 66 pacienți, internați cu forme severe de infecție COVID-19. Rezultate. Decizia privind administrarea de TCZ a fost luată în medie în ziua a 11,34±0,31 de boală, când a fost suspectat debutul furtunii de citokine la pacienții aflați deja în tratament cu dexametazonă. Parametri clinici și paraclinici, precum durata febrei, asteniei și a dispneei, nivelul SpO2, necesitatea în terapie cu oxigen, ameliora-rea tabloului imagistic radiologic, și durata spitalizării au fost mai favorabili la pacienții tratați cu TCZ 400 mg față de cei tratați cu TCZ 200 mg (p<0.0001). Riscul relativ de agravare rapidă după administrarea TCZ (RR=0,88), riscul relativ de diminuare a tensiunii arteriale (RR=0,29) și riscul relativ de transfer în secțiile de terapie intensivă pentru ventilație invazivă sau non-invazivă (RR=0,8) a fost mai scăzut la pacienții tratați cu TCZ 200 mg, comparativ cu lotul TCZ 400 mg. Concluzii. Doza de TCZ a influențat durata manifestărilor clinice, durata terapiei cu oxigen și durata spitalizării pacienților, cu rezultate mai bune pentru TCZ 400 mg față de TCZ 200 mg, deși riscul de agravare după TCZ și riscul de transfer în terapie intensivă au fost mai joase la pacienții tratați cu TCZ 200 mg. Deci, doza de TCZ de 200 mg poate fi o opțiune de salvare a vieții pacienților gravi cu infecție COVID-19, în contextul deficitului de aprovizionare cu inhibitori de IL-6

Сравнительная характеристика ботулизма у лиц молодого и старшего возраста

USMF N. Testemiţanu, ISMP SCBI Toma CiorbăSummary. There were examined 2 groups of patients: I – young patients (19-44 years old); II – aged patients (45-71 years old). The disease developed mostly after the consumption of products like meat or mushrooms hermetically wrapped in domestic conditions – at young patients, and products like fish and fruits and vegetables – at aged patients. There was a light and medium evolution at young patients, and medium and hard evolution – at aged patients. There could not be defined big differences between the groups, but at patients’ guidance a wrong diagnosis was suspected in 54,1% cases of the young group, against 41,4% cases of the aged group. In both groups more frequently was determined botulotoxinum B apart or in association with botulotoxinum A and C. 5 patients (3,3%) died in the young group, and 1 patient (2,1%) dies in the aged group. Only 82,4% patients were cured with antibotulinic serum.Резюме. Были обследованы 2 группы больных ботулизмом: I – лица молодого возраста (19-44) и II – лица старшего возраста (45-71). Болезнь развивалась после употребления в пищу мясных продуктов и грибов, консервированных в домашних условиях, почти одинаково часто в обеих группах, в то время как после употребления рыбных и фруктово-овощных консервов домашней заготовки диагноз ботулизма ставился чаще в I группе. В клиническом течении болезни среди больных обеих групп разницы не отмечалось, однако диагноз направления был ошибочным у 54,1% лиц в I группе и в 41,4% – во II. В обеих группах диагноз был подтвержден выделением ботулотоксина типа В самостоятельно или в сочетании с типами А или С. Умерло 5 (3,3%) больных ботулизмом в I группе и 1 (2,1%) во II. Лечение противоботулинической сывороткой было проведено у 82,4% больных

Сравнительная характеристика ветряной оспы у взрослых и детей

Catedra Boli Infecţioase FECMF, USMF N. Testemiţanu, Catedra Boli Infecţioase Tropicale şi Parazitologie Medicală, USMF N. Testemiţanu, IMSP SCBI T. CiorbăSummary. The clinical study shous epidemiological, laboratory results, indicated în 2 groups of sick people (65 – adults and 66 – children). The majority of patients were about 19- 25 years, and including a group of children aged 15-18. A part of people were hospitalized in stationary with the correct established diagnosis (adults – 98,4%, children – 95,4). All the patients had eruptions when they were hospitalized. Besides the affectation of teguments, was affected the conjuctiva (adults – 9,2%, children – 13,6%), buсcal mucosa (adults – 3,2, children – 10,6%), genital impaired mucosa (adults – 16,9, children – 10,6). All the patients were discharged on the second day of hospitalization.Резюме. Изучены клинические, эпидемиологические и лабораторные показатели у 2-х групп больных: 1 – 65 взрослых, 2 – 66 детей. Большинство больных были в возрасте 19- 25 лет среди взрослых и 15-18 лет среди детей. Большинство больных поступили в стационар с правильно установленным диагнозом (у взрослых – в 98,4% и у детей – в 95,4% случаев). При поступлении у всех больных была сыпь. Кроме кожных покровов были поражены коньюнктивы (у 9,2% взрослых и у 13,6% детей), слизистая полости рта (у 32,2% взрослых и у 10,6% детей) и слизистая генитальной сферы (у взрослых – в 16,9% и у детей – в 10,6%). Все больные были выписаны в среднем на 7-ой день госпитализации

Некоторые клинические и лабораторные аспекты у пациентов с инфекционным мононуклеозом

IMSP SCBI Toma Ciorbă, Catedra de Boli Infecţioase, Tropicale şi Parazitologie Medicală, USMF N. TestemiţanuSummary. The research comprises clinical, evolutive and laboratory aspects regarding 45 patients with infectious mononucleosis disease hospitalized between 2006-2012 in SCBI “Toma Ciorba”. The age of the affected patients varied from 2 to 32 years old. The most of them were children and teenagers. When comparing symptoms in adults and teenagers there were no differences. Teenagers and adults have had the same. Infection in children is characterized by polymorph symptoms and syndromes. There were changes in general blood test in 93,3% of patients. Heterofile antibodies were present in the entire allotment of patients. Antibodies antiinfectious mononucleosis of type Ig M and Ig G were also positive in 50% of patients examined. The evolution of the disease has been benign.Резюме. Мы иследовали клинические данные 45 больных инфекционным мононуклеозом различных возрастных групп. В сравнительном аспекте течение заболевания у подростков и у взрослых показало идентичность симптоматики. Отличительным от подростковой группы у детей отмечалось значительное разнообразие симптомов и синдромов, т.е. клинический полиморфизм. Изменения со стороны лейкоформулы были выявлены у 93,3% пациентов. Гетерофильные антитела были положительными у всех пациентов. У 50% больных были выявлены антитела IgM и IgG к антигенaм вируса. Течение заболевания в целом было благоприятным, осложнений не наблюдалось

Clinical, epidemiological, laboratory and treatment characteristics of anthrax

Catedra Boli infecţioase, tropicale şi parazitologie medicală USMF ,,Nicolae Testemiţanu”, IMSP Spitalul Clinic de Boli Infeciooase ,,Toma Ciorbă”This article reveals some clinical, epidemiological, laboratory and treatment peculiarities in 9 patients with cutaneous anthrax of carbuncular form. The diagnosis was confirmed by the bacteriological method in 8 patients. The disease has a classic evolution with the prevalence of mild and moderate forms. One patient with severe carbuncular form developed a secondary septicemia. 8 patients were treated with Penicillin, and one with Ciprofloxacin. All the patients with anthrax recovered. În articol sunt prezentate unele particularităţi clinice, epidemiologice şi de laborator la 9 bolnavi cu antrax cutanat , forma carbunculoasă. La 8 dintre ei diagnosticul a fost confirmat bacteriologic. Boala a evoluat caracteristic cu prevalarea formelor uşoare şi medii. La un pacient cu forma gravă s-a dezvoltat septicemia cărbunoasă secundară. 8 pacienţi s-au tratat cu Penicilină, iar unul (cu alergie la Penicilină în antecedente) a fost tratat cu Ciprofloxacină. Toţi bolnavii s-au însănăoşit