11 research outputs found
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Impact of extended-course oral nirmatrelvir/ritonavir (Paxlovid) in established Long COVID: Case series and research considerations
BACKGROUND: Prior case series suggest that a 5-day course of oral Paxlovid (nirmatrelvir/ritonavir) benefits some people with Long COVID, within and/or outside of the context of an acute reinfection. To the best of our knowledge, there have been no prior case series of people with Long COVID who have attempted longer courses of nirmatrelvir/ritonavir. METHODS: We documented a case series of 13 individuals with Long COVID who initiated extended courses (>5 days; range: 7.5-30 days) of oral nirmatrelvir/ritonavir outside (n=11) of and within (n=2) the context of an acute SARS-CoV-2 infection. Participants reported on symptoms and health experiences before, during, and after their use of nirmatrelvir/ritonavir. RESULTS: Among those who took a long course of nirmatrelvir/ritonavir outside of the context of an acute infection, some experienced a meaningful reduction in symptoms, although not all benefits persisted; others experienced no effect on symptoms. One participant reported intense stomach pain that precluded her from continuing her course. Among the two participants who took a long course of nirmatrelvir/ritonavir within the context of an acute reinfection, both eventually returned to their pre-re-infection baseline. DISCUSSION: Long courses of nirmatrelvir/ritonavir may have meaningful benefits for some people with Long COVID but not others. We encourage researchers to study who, how, and why nirmatrelvir/ritonavir benefits some and what course length is most effective, with the goal of informing clinical recommendations for using nirmatrelvir/ritonavir and/or other antivirals as a potential treatment for Long COVID
Nikolay Ivanovich Pirogov (1810–1881): Anatomical research to develop surgery
The 19th century Russian surgeon Nikolay Ivanovich Pirogov believed passionately
in the importance of anatomy for surgeons. His interest in anatomy began as a
medical student in Moscow. After graduating in 1828 Pirogov entered the postgraduate German-Baltic University of Dorpat (now Tartu in the Republic of Estonia)
where he studied anatomy and surgery. After completing his study, he remained to
research the consequences of ligation of the aorta in a series of animal experiments, which formed the core of his doctoral thesis. He wanted to determine the
feasibility of aortic ligation as a treatment for patients with an aneurysm of the aorta
or iliac artery. He discovered that success was only likely when the aorta was ligated
between the two mesenteric arteries and the ligature gradually tightened, an
approach surgically difficult in humans. Pirogov then spent 2 years at the Charité
Hospital in Berlin before returning to Russia. In 1841, he was appointed Professor
of Applied Anatomy and Surgery at the Imperial Medico-Surgical Academy in Saint
Petersburg. He instituted the teaching of microscopy and histology to the medical
curriculum and in 1846 formed the Institute for Applied Anatomy within the academy, where in addition to teaching medical students future teachers of anatomy in
Russia were trained. Pirogov published extensively on anatomy, including several
anatomical atlases, the most notable his three-dimensional atlas of topographical
anatomy published in four volumes between 1852 and 1859. Today Pirogov’s contributions to anatomy are remembered in a number of anatomical structures named
after him. Stem cells & developmental biolog