The recognition of the presence of ST-segment elevation in the context of ACS （acute coronary syndrome） is fundamental for the good outcome of the case. However, some electrocardiographic patterns have been highligh...The recognition of the presence of ST-segment elevation in the context of ACS （acute coronary syndrome） is fundamental for the good outcome of the case. However, some electrocardiographic patterns have been highlighted by the fact that there is no elevation, but they represent a severity similar to ACS with ST elevation. Hence, it is necessary that doctors who do the first service recognize these standards promptly.The electrocardiographic pattern of association between the ST-segment depression and the hyperacute T waves representing myocardial infarction in the anterior wall, localizing more specifically in the anterior descending artery, now known as the De Winter pattern, was first described by Dressler, and then described by Winter six years later. Winter observed that, out of a series of 1,452 cases, 2% of patients with anterior wall infarction had the pattern of ST-segment depression, positive and symmetrical T waves, and occasionally mild ST-segment elevation at AVR derivation. Those patients are admitted to the emergency room with a typical chest pain. However, because the electrocardiographic findings of this syndrome are not known to many health professionals, in many cases the patients do not receive adequate care and have fatal outcome, since mortality is relevant in these cases. Thus, the rapid recognition of this pattern is extremely necessary for the correct and effective intervention.展开更多
We present a 48-year-old male patient with a history of classic precordialgia, ST-segment elevation in inferior leads （II, III and aVF）, with t：oponin m：d CK-MB （creatine kinase-MB） elevated on the day of admiss...We present a 48-year-old male patient with a history of classic precordialgia, ST-segment elevation in inferior leads （II, III and aVF）, with t：oponin m：d CK-MB （creatine kinase-MB） elevated on the day of admission that received conventional anti-ischemic treatment. Hemodynamically stable, symptom-free, is referred to cardiac catheterization. In the selective catheterization of the left coronary artery, a moderate lesion was observed in the middle third of the anterior descending coronary artery; in the right coronary artery, a subocclusive proximal lesion with TIMI （thrombolysis in myocardial infarction） II. We performed a single projection m：d opted for angioplasty. Before, it was decided to re-evaluate the left coronary artery, m：d it was observed in the contrast test that anterior descending artery was occluded. Intra-coronary nitroglycerin and new contrast injection were performed, which showed totally open descending artery with TIMI III, without obstructive lesions as initially suggested, and improvement of pain. It was a severe coronary vasospasm. When a new contrast injection was performed in the right coronary, with a therapeutic catheter, the disappeaxance of the subocclusive lesion and the presence of a normal coronary flow were observed, although there was a moderate plaque in its proximal third, which motivated the maintenance of angioplasty with stent placement in a proxhnal third of right coronary artery. During the passage of the intracoronary guidewire it was once again evident that diffuse coronary artery vasoreactivity was present; the procedure was successfully completed.展开更多
It is considered that renewal of growth in serotoninergic caudal fibers their sprouting to injury site and formation ofoutgrowth net is factor for locomotion recovery. The aim of our work was to study the influence of...It is considered that renewal of growth in serotoninergic caudal fibers their sprouting to injury site and formation ofoutgrowth net is factor for locomotion recovery. The aim of our work was to study the influence of rat fetal neural cells enriched withserotonin-producing cells, on morphogenesis, gene expression of serotogenesis （Pet1, Nk2.2, Lmxlb, Tphl, Tph2, Sert） andserotonin level in organotypic n. raphe cultures in injury of neurite-glial fibers in vitro. Injury was modeled by the way of crossingneurite-glial fibers after their formation under long-term culture. The cell accumulation was observed in the injury zone when fetal n.raphe cells, previously enriched with serotonin-producing cells were added into organotypic culture of n. raphe with crossing fibersunder the culture conditions. As a result, crossing site was filled with these cells after 14 days of culture. The activation of expressionin cascade of regulatory genes-regulators of serotogenesis Pet1, Lmxlb, Tphl, Tph2, Sert and increased serotonin content in theculture material were also observed. The activation of gene expression of serotogenesis Pet1 and Sert, and increased serotonincontent by 1.7 times were revealed when conditioned medium from culture of fetal rat cells was used. An eviction of single cells wasobserved in control samples of organotypic n. raphe culture after injury. Crossing site was remained without signs of cell filling inthese samples at day 14 after culture. The activation of regulatory gene expression of serotogenesis Pet1, Nkx2.2, Lmxlb, Tphl,Tph2, Sert and restoration of serotonin content were also absent in the culture material.展开更多
Adenoid hypertrophy associated with high morbidity in children. However, in severe cases surgery recommended, some medical treatments are effective too. This study is based on effect of nasal steroid spray, mometasone...Adenoid hypertrophy associated with high morbidity in children. However, in severe cases surgery recommended, some medical treatments are effective too. This study is based on effect of nasal steroid spray, mometasone, in decreasing upper airway obstruction and other symptoms of adenoid hypertrophy. In a clinical trial study 51 children with adenoid hypertrophy divided in two groups： 2-4 years old and 5-11 years old. Each patient receive nasal momethasone （one puff each nostril twice a day） for 3 months and their symptoms evaluated before treatment, 3 months after treatment initiation and 3 months after stop it with questionnaire and lateral neck radiography. Decreasing in all symptoms score and upper airway obstruction was statistically significant in both groups 3 months after treatment and its effect maybe stable for next 3 months. Nasal momethasone spray is effective in decreasing adenoid size and severity of symptoms of adenoid hypertrophy and this response is more obvious in 2-4 years old children.展开更多
The increased incidence ofNHL(non-Hodgkin's lymphoma),along with its high mortality rate and pronounced resistance to therapy pose an enormous challenge.Both traditional therapeutic strategies and recently develop...The increased incidence ofNHL(non-Hodgkin's lymphoma),along with its high mortality rate and pronounced resistance to therapy pose an enormous challenge.Both traditional therapeutic strategies and recently developed therapeutic strategies against NHL such as chemoimmunotherapy and targeted therapy have drawbacks.Therefore,novel therapeutic approaches for NHL are urgently needed.Maytansine-loaded PLA-TPGS(polyethylene glycol 1000 succinate-polylactide)nanoparticles were synthesized.And then,rituximab targeting NHL was conjugated together by using EDC(1-ethyl-3-(3-dimethylaminopropyl)carbodiimide)as a coupling agent.The in vitro/vivo antitumor activity was evaluated by Raji cell proliferation inhibition and nude mice xenograft tumor models for NHL.Both the rituximab-conjugated and maytansine-loaded PLA-TPGS nanoparticles(maytansine-NPs(Nanoparticles)-rituximab)and maytansine-loaded PLA-TPGS nanoparticles(maytansine-NPs)presented significant inhibition effect on Raji cell proliferation in a concentration-dependent manner.Compared with conventional maytansine and maytansine-NPs,maytansine-NPs-rituximab showed significantly enhanced cytotoxicity and increased cell apoptosis in Raji cells.The maytansine-NPs-rituximab described in this paper might be a potential formulation for targeting chemotherapy and immunotherapy to CD20+B cell malignancies.展开更多
Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic inflammatory disease that is often mistaken for gallbladder (GB) cancer. Differential diagnosis based on clinical features or imaging scan is virtually...Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic inflammatory disease that is often mistaken for gallbladder (GB) cancer. Differential diagnosis based on clinical features or imaging scan is virtually impossible and pathological confirmation is crucial for diagnosis. A 72-year-old man was referred to an oncologist for suspicion of unresectable GB cancer with liver metastasis. He was admitted and underwent three percutaneous needle biopsies. However, all specimens showed non-neoplastic hepatic parenchyma with the third biopsy indicating xanthogranulomatous inflammation with abscess formation. The final biopsy changed the diagnosis from GB cancer to XGC. He was prescribed oral antibiotics and discharged after multiple ERBD stenting because of benign biliary stricture. He regularly visited an outpatient clinic and a follow-up CT scan showed a decrease of gallbladder mass. In conclusion, xanthogranulomatous cholecystitis should be considered in the differential diagnoses of GB mass and clinical suspicion is very important for a precise diagnosis.展开更多
Global warming is an irreversible process resulting in the deterioration of living conditions for various organisms, including the most important agricultural species. So-called ζ^32 factor of Escherichia coli is emb...Global warming is an irreversible process resulting in the deterioration of living conditions for various organisms, including the most important agricultural species. So-called ζ^32 factor of Escherichia coli is embedded into the RNA-thermosensor in the λ cIII gene and plays an important role in the regulation of bacterial response to hightened temperatures. Expression of heat/cold-shock genes and some virulence genes in response to temperature changes is coordinated by the genome. There are some known RNA-thermosensors with different structures that provide a functional control of the diversity of cellular processes. The most common RNA-thermosensor is the ROSE-element suppressing expression of heat-shock genes. A common feature is functionally important and it is elimination that makes the RNA-thermosensor insensitive to high temperatures. In this paper we describe molecular sequences (RNA-thermosensor) whose chemical compounds influence on the homeostatic temperature regulation, namely, on the corresponding enzymes. Though the data on RNA-thermosensors we obtained for microorganisms it is maybe possible in the long run to change the animal genome at the molecular level by the insertion of these sequences or cultivation of symbiotic microorganisms, which may be used for production of biologically active compounds. In addition, such insertions would probably be able to reduce the negative effect of high environmental temperatures on living organisms.展开更多
Myiasis is considered a serious medical condition in animals and humans that occurs predominantly in tropical countries.Cochliomyia hominivorax is one of the main fly species that causes myiasis and the actual geograp...Myiasis is considered a serious medical condition in animals and humans that occurs predominantly in tropical countries.Cochliomyia hominivorax is one of the main fly species that causes myiasis and the actual geographic distribution includes the Caribbean and all of South America,except Chile.The use of synthetic insecticides and endectocides in livestock for the myiasis treatment has resulted in insect resistance,while also causing residuals in the environment and contamination of animal food products.Biologically active compounds are considered an alternative for the sustainable management of insects,as they are biodegradable and less damaging to the environment.This study developed a nanoemulsion containing the essential oil of Baccharis dracunculifolia and evaluated its in vitro effects on C.hominivorax larvae.High pressure homogenization was used to develop the nanoemulsion.Larvicidal tests were carried out with the tested products using 15 larvae/repetition,for a total of 150 larvae per treatment.Five different concentrations of the nanoemulsion were tested shortly after preparation and after 120 days of storage.For the fresh formulation,at concentrations of 5,7.5,10,13.5,and 15%(w/v)we found mortality of 28,48,70,84,and 97%,respectively,while for the stored formulation,we found mortality of 17,36,51,81,and 92%.The larvicidal effect was similar,except for the concentrations of 5 and 10%(w/v)(p<0.05).Our results show that the natural based B.dracunculifolia nanoemulsion can be considered a promising alternative for the treatment and control of myiasis caused by C.hominivorax.展开更多
Purpose： To evaluate the effect of adipose derived mesenchymal stem cell （ADSC） on the regeneration of irradiated mandible submitted to distraction osteogenesis on adult rabbits. Methods： Ten adult rabbits were se...Purpose： To evaluate the effect of adipose derived mesenchymal stem cell （ADSC） on the regeneration of irradiated mandible submitted to distraction osteogenesis on adult rabbits. Methods： Ten adult rabbits were selected and the dorsal fat was harvested for isolation, dissociation and culture of adipose derived adult mesenchymal stem cells. The mandibles were irradiated on a single dose of 20 Gy. After 30 days the animals underwent mandibular lengthening by distraction osteogenesis. After 10 mm of lengthening, the animals were distributed into two groups. Saline solution （1 mL） was injected the control group, and supplemented with ADSC, on the study group. After 4 weeks the mandibles were removed and evaluated by tomography and histomorphometric analysis. Histomorphometric was obtained and statistical analysis done by Mann-Withney test （p 〉 0.05）. Results： The tomography shows a significant improvement on the Hounsfield scale for lateral fibrovascular zone （114.5±9.7 control group to 148 ± 24, p = 0.0045） and central fibrovascular zone （37 ± 13.4 control group to 96 ±41.8 on study groupp = 0.0045）. The Histomorphometric analysis demonstrated an increase area of new bone formation. The mineralized area was of 61.2 ± 9.9% in the study group and 31.3 ± 10.6% in the control group （p = 0.0045） for the central fibrovascular zone, 79.± 9.1% in the study group and 39.1 ± 14.7 on control group for anterior fibrovascular zone （p = 0.0001） and 67.7± 12.9% in the study group and 38.4 ± 12.9% in control group for posterior fibrovascular zone （p = 0.0001）. Conclusions： The injection of adipose derived mesenchymal stem cell was effective to improve bone regeneration distraction callus on the irradiated mandible.展开更多
The scientific concept of probiotics has been widely accepted throughout the last decades; consequently, its industrial production and commercialization have been increased. This is only the beginning since a recent g...The scientific concept of probiotics has been widely accepted throughout the last decades; consequently, its industrial production and commercialization have been increased. This is only the beginning since a recent global probiotic market analysis estimated an annual growth, boosted mainly by a rising request from the Asian and European consumer in the next 5 years. So the pharmaceutical industry needs to develop new dosage forms containing probiotic microorganisms in order to offer consumers a variety of products. Different kinds of matrix tablets with Lactobacillus coryniformis CECT 5711 were designed to protect this strain from the technological process and harsh gastrointestinal conditions up until their arrival in the gut, as well as environmental conditions during their storage. With this aim, various retarding polymers were combined so as to get controlled release tablets. All formulations were evaluated in terms of technological processability, bacterial viability and stability. Finally, an optimal formulation with Methocel K-15 M EP, Eudragit L-100 and alginate sodium, which contain Lactobacillus coryniformis CECT 5711, was selected due to the fact that it assured an excellent survival of the microorganisms after their exposition to all conditions mentioned above, besides it will be able to improve human＇s health.展开更多
Early efforts at mandibular reconstruction are described from ancient China and the Etruscans to even Hippocrates, involving wooden, terracotta and metal prostheses attached to bone or teeth. Since then, modem surgery...Early efforts at mandibular reconstruction are described from ancient China and the Etruscans to even Hippocrates, involving wooden, terracotta and metal prostheses attached to bone or teeth. Since then, modem surgery has developed more effective techniques, including no vascularized bone grafts, better alloplastic materials, vascularized loco regional grafts, soft and hard tissue compounds, bone fixation and stretching materials, and mechanisms for study models. These components have become indispensable in the surgeon＇s arsenal with regard to reconstructive surgery. A gold standard for mandibular bone reconstruction is the use of autogenous grafts. The objective of this study was to describe a clinical case of mandibular reconstruction with autogenous graft associated with adjuvant hyperbaric oxygen therapy. The clinical case presented shows the treatment performed for after-effects correction due to the non-consolidation of sagittal mandibular osteotomy performed for correction of standard III dentofacial deformity, resulting in a pseudoarthrosis with bite deviation and facial asymmetry. As a treatment plan, mandibular reconstruction was instituted with autogenous graft of anterior iliac crest associated with the use prototyping biomodel and hyperbaric oxygen therapy. After a control of 1 year and 6 months, no signs of recurrence were identified and the radiographic image showed excellent positioning, good volume and maintenance of the mandibular contour.展开更多
Human secretin is responsible for carrying a number of physiological functions including energy and water homeostasis, thus making secretin receptor a promising target for drug development. For GPCRs （G protein-coupl...Human secretin is responsible for carrying a number of physiological functions including energy and water homeostasis, thus making secretin receptor a promising target for drug development. For GPCRs （G protein-coupled receptors）, radioactive ligands are usually used in conventional binding assays to characterize the binding affinities of the ligands. An alternative non-hazardous fluorescence based binding assay is lucrative over the radio-ligand assays. Here, we have developed a FRET （fluorescence resonance energy transfer） competitive binding assay for human secretin receptor. The receptor gene sequence is cloned in the SNAP （single nucleotide amplified polymorphisms） tag-plasmid and expressed in CHO （chinese hamster ovary）-K1 cells. Its expression and function is confirmed with immunofluorescence localization and receptor activation. The receptor and the ligand are labeled with fluorescent donor （Tb） and acceptor （Alexa488）. FRET signals are produced when the labeled ligand is bound to the receptor and the same drop when it is displaced by the test compounds. The saturation concentration of the receptor labeling is 100 nM, and the ligand Kd value is 500 nM. At these concentrations, the IC50 of unlabeled secretin is 1.63 4- 3.55 nM. Additionally, few class-B ligands are screened and hold good correlation with traditional radio-ligand assay. Henceforth, this FRET binding assay can be efficiently used as a primary screening tool for peptide analogs.展开更多
The direct acting antivirals(DAAs)are now the standard of care for hepatitis C virus(HCV)treatment with high and effective sustained virologic responserate(SVR)and great safety profile,including solid organ transplant...The direct acting antivirals(DAAs)are now the standard of care for hepatitis C virus(HCV)treatment with high and effective sustained virologic responserate(SVR)and great safety profile,including solid organ transplant patients.There are increasing reports showing DAAs are effective with high SVR rates and safety profile in kidney transplant recipients.There are reports on drug-drug interaction(DDI)between tacrolimus with DAAs.However,data remain lacking on potential DDIs between tacrolimus and DAA regimens and the management process.This case series reports three kidney transplant patients on tacrolimus who were successfully treated for HCV with multidisciplinary approach,although there was DDI between tacrolimus with sofosbuvir/velpatasvir and glecaprevir/pibrentasvir,which required tacrolimus dose adjustment to maintain therapeutic level during and after DAA treatment.Such DDIs should be aware of and closely monitored by pharmacist and physicians with tacrolimus dose adjustment as needed during and right after DAA treatment in post-kidney transplant patients.展开更多
Based on bibliographic research, the article examines how pharmaceuticals address people‟s sexual needs and desires,stimulated by creative economy. The main argument indicates that pharmaceuticals create conditions fo...Based on bibliographic research, the article examines how pharmaceuticals address people‟s sexual needs and desires,stimulated by creative economy. The main argument indicates that pharmaceuticals create conditions for do-it-yourself sexualities,based on bodily stereotypes disseminated by creative industries, which reflect dominant heteronormative discourses. People shapetheir bodies, enhance sexual experiences, and foster sexual hygiene and prevention of sexually transmitted infections.展开更多
Objective： To develop a highly sensitive LC-MS/MS （liquid chromatography-mass spectxometry/mass spectrometry） method applied to the detection and quantitation of UDCA （ursodeoxycholic acid） related substances suc...Objective： To develop a highly sensitive LC-MS/MS （liquid chromatography-mass spectxometry/mass spectrometry） method applied to the detection and quantitation of UDCA （ursodeoxycholic acid） related substances such as CA （cholic acid）, DCA （deoxycholic acid）, CDCA （chenodeoxycholic acid） and LCA （lithocholic acid） in raw material and pharmaceutical formulation. Methods： The method was validated for specificity, linearity, accuracy, precision, robustness. A triple quadrupole mass detector was employed, equipped with an ESI （electrospray ionization） source operated in the negative ion mode. The chromatographic system consisted of a Symmetry C 18 column （150 mm × 4.6 mm, id; particle size 5 μm） and methanol-acetonitrile-ammonium acetate （pH 7.6; 10 mM） （40：40：20, v/v/v） as the mobile phase. The chromatographic conditions were 25 uL injection volume, flow rate of 0.4 mL/min and column temperature set at 35℃. Key tindings： The method requires a minimum sample amount and presents very low LOD （limits of detection） for CA （0.29 ng/mL）, DCA （0.59 ng/mL）, CDCA （0.13 ng/mL） and LCA （0.44 ng/mL） in comparison to LC methods coupled to different detectors like UV （ultraviolet）, fluorescence and refractive index. Conclusions： The developed and validated LC-MS/MS method for the determination of UDCA and related substances in raw material and in a suspension was advantageous since it required a minimum sample amount. In turn, it could be used as a stability indicating method.展开更多
One of the most significant health issues is the disorders of mood according to the fact that they have a significant effect on the quality of life of the patients, their families, their working and wider social surro...One of the most significant health issues is the disorders of mood according to the fact that they have a significant effect on the quality of life of the patients, their families, their working and wider social surroundings. According to the World Health Organization, mood disorders are the fourth cause of morbidity and mortality with a tendency to move to the second place by the 2020. The prediction of higher number of patients diagnosed with depression in the future comes from the facts that the main factor of risk, like stress, is in constant rise. Furthermore, the demographic image （ageing of the population） is changing, associated with the effect of comorbidity of depression, also attributed with increase of the number of genetically predisposed patients with this mood disorder. The aim of this study is to define, describe and question the role of pharmacists in the treatment of patients suffering from depression. Therefore, we measured the impact of pharmaceutical care on significant parameters in treatment of depression due to the selection of appropriate therapy according to the guidelines, adherence of the patient, quality of life, work capability, anxiety, side effects and interactions with other medicines.展开更多
Patient safety has become a priority for the health system, including dentistry. Several studies showed that health care meant to improve people＇s health is an important source of disease. Good clinical practices aim...Patient safety has become a priority for the health system, including dentistry. Several studies showed that health care meant to improve people＇s health is an important source of disease. Good clinical practices aim to maximize effectiveness and therapeutic compliance, minimize risks and costs, respecting the patient＇s choice from generic drugs, also from the moment of prescribing, the supervision of drug-related events must be taken into account, not only on the patient but also in the environment. Pharmacovigilance and pharmacoecovigilance have to be conceived as a clinical practice in dentistry. There is no established culture of drug induced reaction reports by dentists in Uruguay, and awareness of environmental care is incipient. The pharmacy of faculty of dentistry, （Universidad de la Repfiblica）, an institutional project that has been developed since 2006, is in a transformation process. The pharmacovigilance dentistry Node is in full development. The toxicovigilance and pharmacoecovigilance activities are recent. The general aim of this project was to establish the pbarmacovigilance, toxicovigilance and pharmacoecovigilance clinical practice in dentistry. The widespread use of cosmetic as toothpastes, or mouth rinses, drugs and dental materials, as well as exposure to chemical contaminants through the population＇s living habits and the environmental damage caused by drug wastes requires comprehensive and up-to-date information to establish rational strategies.展开更多
ACC （adrenocortical carcinoma） is an uncommon and aggressive malignancy with an overall five year survival rate from less than 50%. The majority of cases are accidentally diagnosed by imaging studies done for other ...ACC （adrenocortical carcinoma） is an uncommon and aggressive malignancy with an overall five year survival rate from less than 50%. The majority of cases are accidentally diagnosed by imaging studies done for other reasons, so they are often diagnosed in the later stages. Due to the rarity of both neoplasms, the synchronous presentation and the lack of effective therapeutic options; we report a case concerning about a female patient with adrenal cancer with a low grade solitary fibrous tumor who underwent surgery, adjuvant radiotherapy and chemotherapy with good response.展开更多
Abstract： Long bone septic non-union by MRSA （methicillin-resistant Staphylococcus aureus） is always a challenge for the orthopaedic society. Traditional treatment options include distraction osteogenesis methods a...Abstract： Long bone septic non-union by MRSA （methicillin-resistant Staphylococcus aureus） is always a challenge for the orthopaedic society. Traditional treatment options include distraction osteogenesis methods and vascularised bone grafting. These techniques require a high level of expertise and are frequently involved with a variety of side effects or complications. We present a rare case of ulnar fracture complicated by MRSA infection that led to septic non-union. We treated the septic non union with the technique of induced membrane formation （Masquelet technique）. A 33 year old male presented to the outpatient clinic, 2 months after internal fixation of a Gustillo I fracture of the left forearm. There was pus discharge from the operative wound and specimen culture was positive for MRSA. Initially the patient received conservative treatment with antibiotics for a period of one month. However, the patient returned with the same clinical presentation. The patient was then treated with hardware removal of the ulna and debridement of the septic non-union. The formed 5 cm bone defect was filled with cement spacer and the ulnar bone was fixed with external fixation. Eight weeks later, the spacer was removed and the bone gap was filled with autologous cancellous bone graft from iliac crest. Five months after grafting, the patient was reviewed. No clinical or functional problems were noted and osseous consolidation of the ulnar bone was confirmed in plain x-rays. The Masquelet technique is a promising alternative treatment for the management of infected long bone non-unions of the upper extremity.展开更多
Background:The emergence of Coronavirus SARS-CoV-2 evoked an unprecedented threat globally.Ever since the spread of this pandemic research and clinical trials have concentrated on the repurposing of already exciting F...Background:The emergence of Coronavirus SARS-CoV-2 evoked an unprecedented threat globally.Ever since the spread of this pandemic research and clinical trials have concentrated on the repurposing of already exciting FDA drugs to find a successful candidate to combat Covid-19.Objective:The objective of this study is to propose a therapeutic protocol that may have a potential solution to treat the severe infections associated with coronavirus.The clinical application of this protocol(Al-Akidi Therapeutic Protocol,A-TP)is highly recommended,as there are several scientific evidences that support this trusted protocol to be of great potential.Methods and Materials:This A-TP includes the use of one of the respiratory Fluoroquinolones(Levofloxacin or Moxifloxacin)in doses of 500 mg twice daily for 7-10 days,together with high doses of Vitamin D3(10000 IU/day)and Zinc(50 mg daily)for few weeks.This protocol is based on the previous antiviral activity of those Fluoroquinolones towards few viruses,the potent antibacterial activity on respiratory infections and high available concentrations in the lungs.It is also based on molecular docking of Levofloxacin and Moxifloxacin on various viral enzymes.Results:Molecular docking showed encouraging and very interesting docking scores and binding affinity of Levofloxacin and Moxifloxacin to certain viral enzymes,such as,RNA dependent RNA polymerase(RdRp),3-Cysteine-Like protease,Neuraminidase,Replicase polyproteins and Trans-Membrane Protease Serine 2 inhibitor(TMPRSS2).The highly expected clinical results of using this protocol are:reduce infection,control of temperature,improve breathing with less dependent on supplemented oxygen,and remarkable reduction of the pro-inflammatory cytokine storm,and hence,reduce hospitalization and mortality.Conclusion:Levofloxacin is highly recommended in managing the severe infections associated with Corona virus and has a remarkable reduction of pro-inflammatory cytokine storm as an immuomodulating agent.Levofloxacin is superior in this protocol over Moxifloxacin,due to its high excretion(≤83%)as unchanged through the kidneys,while Moxifloxacin is only 20%is excreted unchanged.It is an extra advantage of Levofloxacin to manage coronavirus in the kidneys.High doses of Vitamin D3 and Zinc are very useful to provide additional effective measures to combat Corona virus.Therefore,the use of this A-TP is highly and strongly recommended,as it serves the full requirements for excellent and potential therapy for the severe infections associated with Covid-19.展开更多
文摘The recognition of the presence of ST-segment elevation in the context of ACS （acute coronary syndrome） is fundamental for the good outcome of the case. However, some electrocardiographic patterns have been highlighted by the fact that there is no elevation, but they represent a severity similar to ACS with ST elevation. Hence, it is necessary that doctors who do the first service recognize these standards promptly.The electrocardiographic pattern of association between the ST-segment depression and the hyperacute T waves representing myocardial infarction in the anterior wall, localizing more specifically in the anterior descending artery, now known as the De Winter pattern, was first described by Dressler, and then described by Winter six years later. Winter observed that, out of a series of 1,452 cases, 2% of patients with anterior wall infarction had the pattern of ST-segment depression, positive and symmetrical T waves, and occasionally mild ST-segment elevation at AVR derivation. Those patients are admitted to the emergency room with a typical chest pain. However, because the electrocardiographic findings of this syndrome are not known to many health professionals, in many cases the patients do not receive adequate care and have fatal outcome, since mortality is relevant in these cases. Thus, the rapid recognition of this pattern is extremely necessary for the correct and effective intervention.
文摘We present a 48-year-old male patient with a history of classic precordialgia, ST-segment elevation in inferior leads （II, III and aVF）, with t：oponin m：d CK-MB （creatine kinase-MB） elevated on the day of admission that received conventional anti-ischemic treatment. Hemodynamically stable, symptom-free, is referred to cardiac catheterization. In the selective catheterization of the left coronary artery, a moderate lesion was observed in the middle third of the anterior descending coronary artery; in the right coronary artery, a subocclusive proximal lesion with TIMI （thrombolysis in myocardial infarction） II. We performed a single projection m：d opted for angioplasty. Before, it was decided to re-evaluate the left coronary artery, m：d it was observed in the contrast test that anterior descending artery was occluded. Intra-coronary nitroglycerin and new contrast injection were performed, which showed totally open descending artery with TIMI III, without obstructive lesions as initially suggested, and improvement of pain. It was a severe coronary vasospasm. When a new contrast injection was performed in the right coronary, with a therapeutic catheter, the disappeaxance of the subocclusive lesion and the presence of a normal coronary flow were observed, although there was a moderate plaque in its proximal third, which motivated the maintenance of angioplasty with stent placement in a proxhnal third of right coronary artery. During the passage of the intracoronary guidewire it was once again evident that diffuse coronary artery vasoreactivity was present; the procedure was successfully completed.
文摘It is considered that renewal of growth in serotoninergic caudal fibers their sprouting to injury site and formation ofoutgrowth net is factor for locomotion recovery. The aim of our work was to study the influence of rat fetal neural cells enriched withserotonin-producing cells, on morphogenesis, gene expression of serotogenesis （Pet1, Nk2.2, Lmxlb, Tphl, Tph2, Sert） andserotonin level in organotypic n. raphe cultures in injury of neurite-glial fibers in vitro. Injury was modeled by the way of crossingneurite-glial fibers after their formation under long-term culture. The cell accumulation was observed in the injury zone when fetal n.raphe cells, previously enriched with serotonin-producing cells were added into organotypic culture of n. raphe with crossing fibersunder the culture conditions. As a result, crossing site was filled with these cells after 14 days of culture. The activation of expressionin cascade of regulatory genes-regulators of serotogenesis Pet1, Lmxlb, Tphl, Tph2, Sert and increased serotonin content in theculture material were also observed. The activation of gene expression of serotogenesis Pet1 and Sert, and increased serotonincontent by 1.7 times were revealed when conditioned medium from culture of fetal rat cells was used. An eviction of single cells wasobserved in control samples of organotypic n. raphe culture after injury. Crossing site was remained without signs of cell filling inthese samples at day 14 after culture. The activation of regulatory gene expression of serotogenesis Pet1, Nkx2.2, Lmxlb, Tphl,Tph2, Sert and restoration of serotonin content were also absent in the culture material.
文摘Adenoid hypertrophy associated with high morbidity in children. However, in severe cases surgery recommended, some medical treatments are effective too. This study is based on effect of nasal steroid spray, mometasone, in decreasing upper airway obstruction and other symptoms of adenoid hypertrophy. In a clinical trial study 51 children with adenoid hypertrophy divided in two groups： 2-4 years old and 5-11 years old. Each patient receive nasal momethasone （one puff each nostril twice a day） for 3 months and their symptoms evaluated before treatment, 3 months after treatment initiation and 3 months after stop it with questionnaire and lateral neck radiography. Decreasing in all symptoms score and upper airway obstruction was statistically significant in both groups 3 months after treatment and its effect maybe stable for next 3 months. Nasal momethasone spray is effective in decreasing adenoid size and severity of symptoms of adenoid hypertrophy and this response is more obvious in 2-4 years old children.
文摘The increased incidence ofNHL(non-Hodgkin's lymphoma),along with its high mortality rate and pronounced resistance to therapy pose an enormous challenge.Both traditional therapeutic strategies and recently developed therapeutic strategies against NHL such as chemoimmunotherapy and targeted therapy have drawbacks.Therefore,novel therapeutic approaches for NHL are urgently needed.Maytansine-loaded PLA-TPGS(polyethylene glycol 1000 succinate-polylactide)nanoparticles were synthesized.And then,rituximab targeting NHL was conjugated together by using EDC(1-ethyl-3-(3-dimethylaminopropyl)carbodiimide)as a coupling agent.The in vitro/vivo antitumor activity was evaluated by Raji cell proliferation inhibition and nude mice xenograft tumor models for NHL.Both the rituximab-conjugated and maytansine-loaded PLA-TPGS nanoparticles(maytansine-NPs(Nanoparticles)-rituximab)and maytansine-loaded PLA-TPGS nanoparticles(maytansine-NPs)presented significant inhibition effect on Raji cell proliferation in a concentration-dependent manner.Compared with conventional maytansine and maytansine-NPs,maytansine-NPs-rituximab showed significantly enhanced cytotoxicity and increased cell apoptosis in Raji cells.The maytansine-NPs-rituximab described in this paper might be a potential formulation for targeting chemotherapy and immunotherapy to CD20+B cell malignancies.
文摘Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic inflammatory disease that is often mistaken for gallbladder (GB) cancer. Differential diagnosis based on clinical features or imaging scan is virtually impossible and pathological confirmation is crucial for diagnosis. A 72-year-old man was referred to an oncologist for suspicion of unresectable GB cancer with liver metastasis. He was admitted and underwent three percutaneous needle biopsies. However, all specimens showed non-neoplastic hepatic parenchyma with the third biopsy indicating xanthogranulomatous inflammation with abscess formation. The final biopsy changed the diagnosis from GB cancer to XGC. He was prescribed oral antibiotics and discharged after multiple ERBD stenting because of benign biliary stricture. He regularly visited an outpatient clinic and a follow-up CT scan showed a decrease of gallbladder mass. In conclusion, xanthogranulomatous cholecystitis should be considered in the differential diagnoses of GB mass and clinical suspicion is very important for a precise diagnosis.
文摘Global warming is an irreversible process resulting in the deterioration of living conditions for various organisms, including the most important agricultural species. So-called ζ^32 factor of Escherichia coli is embedded into the RNA-thermosensor in the λ cIII gene and plays an important role in the regulation of bacterial response to hightened temperatures. Expression of heat/cold-shock genes and some virulence genes in response to temperature changes is coordinated by the genome. There are some known RNA-thermosensors with different structures that provide a functional control of the diversity of cellular processes. The most common RNA-thermosensor is the ROSE-element suppressing expression of heat-shock genes. A common feature is functionally important and it is elimination that makes the RNA-thermosensor insensitive to high temperatures. In this paper we describe molecular sequences (RNA-thermosensor) whose chemical compounds influence on the homeostatic temperature regulation, namely, on the corresponding enzymes. Though the data on RNA-thermosensors we obtained for microorganisms it is maybe possible in the long run to change the animal genome at the molecular level by the insertion of these sequences or cultivation of symbiotic microorganisms, which may be used for production of biologically active compounds. In addition, such insertions would probably be able to reduce the negative effect of high environmental temperatures on living organisms.
文摘Myiasis is considered a serious medical condition in animals and humans that occurs predominantly in tropical countries.Cochliomyia hominivorax is one of the main fly species that causes myiasis and the actual geographic distribution includes the Caribbean and all of South America,except Chile.The use of synthetic insecticides and endectocides in livestock for the myiasis treatment has resulted in insect resistance,while also causing residuals in the environment and contamination of animal food products.Biologically active compounds are considered an alternative for the sustainable management of insects,as they are biodegradable and less damaging to the environment.This study developed a nanoemulsion containing the essential oil of Baccharis dracunculifolia and evaluated its in vitro effects on C.hominivorax larvae.High pressure homogenization was used to develop the nanoemulsion.Larvicidal tests were carried out with the tested products using 15 larvae/repetition,for a total of 150 larvae per treatment.Five different concentrations of the nanoemulsion were tested shortly after preparation and after 120 days of storage.For the fresh formulation,at concentrations of 5,7.5,10,13.5,and 15%(w/v)we found mortality of 28,48,70,84,and 97%,respectively,while for the stored formulation,we found mortality of 17,36,51,81,and 92%.The larvicidal effect was similar,except for the concentrations of 5 and 10%(w/v)(p<0.05).Our results show that the natural based B.dracunculifolia nanoemulsion can be considered a promising alternative for the treatment and control of myiasis caused by C.hominivorax.
文摘Purpose： To evaluate the effect of adipose derived mesenchymal stem cell （ADSC） on the regeneration of irradiated mandible submitted to distraction osteogenesis on adult rabbits. Methods： Ten adult rabbits were selected and the dorsal fat was harvested for isolation, dissociation and culture of adipose derived adult mesenchymal stem cells. The mandibles were irradiated on a single dose of 20 Gy. After 30 days the animals underwent mandibular lengthening by distraction osteogenesis. After 10 mm of lengthening, the animals were distributed into two groups. Saline solution （1 mL） was injected the control group, and supplemented with ADSC, on the study group. After 4 weeks the mandibles were removed and evaluated by tomography and histomorphometric analysis. Histomorphometric was obtained and statistical analysis done by Mann-Withney test （p 〉 0.05）. Results： The tomography shows a significant improvement on the Hounsfield scale for lateral fibrovascular zone （114.5±9.7 control group to 148 ± 24, p = 0.0045） and central fibrovascular zone （37 ± 13.4 control group to 96 ±41.8 on study groupp = 0.0045）. The Histomorphometric analysis demonstrated an increase area of new bone formation. The mineralized area was of 61.2 ± 9.9% in the study group and 31.3 ± 10.6% in the control group （p = 0.0045） for the central fibrovascular zone, 79.± 9.1% in the study group and 39.1 ± 14.7 on control group for anterior fibrovascular zone （p = 0.0001） and 67.7± 12.9% in the study group and 38.4 ± 12.9% in control group for posterior fibrovascular zone （p = 0.0001）. Conclusions： The injection of adipose derived mesenchymal stem cell was effective to improve bone regeneration distraction callus on the irradiated mandible.
文摘The scientific concept of probiotics has been widely accepted throughout the last decades; consequently, its industrial production and commercialization have been increased. This is only the beginning since a recent global probiotic market analysis estimated an annual growth, boosted mainly by a rising request from the Asian and European consumer in the next 5 years. So the pharmaceutical industry needs to develop new dosage forms containing probiotic microorganisms in order to offer consumers a variety of products. Different kinds of matrix tablets with Lactobacillus coryniformis CECT 5711 were designed to protect this strain from the technological process and harsh gastrointestinal conditions up until their arrival in the gut, as well as environmental conditions during their storage. With this aim, various retarding polymers were combined so as to get controlled release tablets. All formulations were evaluated in terms of technological processability, bacterial viability and stability. Finally, an optimal formulation with Methocel K-15 M EP, Eudragit L-100 and alginate sodium, which contain Lactobacillus coryniformis CECT 5711, was selected due to the fact that it assured an excellent survival of the microorganisms after their exposition to all conditions mentioned above, besides it will be able to improve human＇s health.
文摘Early efforts at mandibular reconstruction are described from ancient China and the Etruscans to even Hippocrates, involving wooden, terracotta and metal prostheses attached to bone or teeth. Since then, modem surgery has developed more effective techniques, including no vascularized bone grafts, better alloplastic materials, vascularized loco regional grafts, soft and hard tissue compounds, bone fixation and stretching materials, and mechanisms for study models. These components have become indispensable in the surgeon＇s arsenal with regard to reconstructive surgery. A gold standard for mandibular bone reconstruction is the use of autogenous grafts. The objective of this study was to describe a clinical case of mandibular reconstruction with autogenous graft associated with adjuvant hyperbaric oxygen therapy. The clinical case presented shows the treatment performed for after-effects correction due to the non-consolidation of sagittal mandibular osteotomy performed for correction of standard III dentofacial deformity, resulting in a pseudoarthrosis with bite deviation and facial asymmetry. As a treatment plan, mandibular reconstruction was instituted with autogenous graft of anterior iliac crest associated with the use prototyping biomodel and hyperbaric oxygen therapy. After a control of 1 year and 6 months, no signs of recurrence were identified and the radiographic image showed excellent positioning, good volume and maintenance of the mandibular contour.
文摘Human secretin is responsible for carrying a number of physiological functions including energy and water homeostasis, thus making secretin receptor a promising target for drug development. For GPCRs （G protein-coupled receptors）, radioactive ligands are usually used in conventional binding assays to characterize the binding affinities of the ligands. An alternative non-hazardous fluorescence based binding assay is lucrative over the radio-ligand assays. Here, we have developed a FRET （fluorescence resonance energy transfer） competitive binding assay for human secretin receptor. The receptor gene sequence is cloned in the SNAP （single nucleotide amplified polymorphisms） tag-plasmid and expressed in CHO （chinese hamster ovary）-K1 cells. Its expression and function is confirmed with immunofluorescence localization and receptor activation. The receptor and the ligand are labeled with fluorescent donor （Tb） and acceptor （Alexa488）. FRET signals are produced when the labeled ligand is bound to the receptor and the same drop when it is displaced by the test compounds. The saturation concentration of the receptor labeling is 100 nM, and the ligand Kd value is 500 nM. At these concentrations, the IC50 of unlabeled secretin is 1.63 4- 3.55 nM. Additionally, few class-B ligands are screened and hold good correlation with traditional radio-ligand assay. Henceforth, this FRET binding assay can be efficiently used as a primary screening tool for peptide analogs.
文摘The direct acting antivirals(DAAs)are now the standard of care for hepatitis C virus(HCV)treatment with high and effective sustained virologic responserate(SVR)and great safety profile,including solid organ transplant patients.There are increasing reports showing DAAs are effective with high SVR rates and safety profile in kidney transplant recipients.There are reports on drug-drug interaction(DDI)between tacrolimus with DAAs.However,data remain lacking on potential DDIs between tacrolimus and DAA regimens and the management process.This case series reports three kidney transplant patients on tacrolimus who were successfully treated for HCV with multidisciplinary approach,although there was DDI between tacrolimus with sofosbuvir/velpatasvir and glecaprevir/pibrentasvir,which required tacrolimus dose adjustment to maintain therapeutic level during and after DAA treatment.Such DDIs should be aware of and closely monitored by pharmacist and physicians with tacrolimus dose adjustment as needed during and right after DAA treatment in post-kidney transplant patients.
文摘Based on bibliographic research, the article examines how pharmaceuticals address people‟s sexual needs and desires,stimulated by creative economy. The main argument indicates that pharmaceuticals create conditions for do-it-yourself sexualities,based on bodily stereotypes disseminated by creative industries, which reflect dominant heteronormative discourses. People shapetheir bodies, enhance sexual experiences, and foster sexual hygiene and prevention of sexually transmitted infections.
文摘Objective： To develop a highly sensitive LC-MS/MS （liquid chromatography-mass spectxometry/mass spectrometry） method applied to the detection and quantitation of UDCA （ursodeoxycholic acid） related substances such as CA （cholic acid）, DCA （deoxycholic acid）, CDCA （chenodeoxycholic acid） and LCA （lithocholic acid） in raw material and pharmaceutical formulation. Methods： The method was validated for specificity, linearity, accuracy, precision, robustness. A triple quadrupole mass detector was employed, equipped with an ESI （electrospray ionization） source operated in the negative ion mode. The chromatographic system consisted of a Symmetry C 18 column （150 mm × 4.6 mm, id; particle size 5 μm） and methanol-acetonitrile-ammonium acetate （pH 7.6; 10 mM） （40：40：20, v/v/v） as the mobile phase. The chromatographic conditions were 25 uL injection volume, flow rate of 0.4 mL/min and column temperature set at 35℃. Key tindings： The method requires a minimum sample amount and presents very low LOD （limits of detection） for CA （0.29 ng/mL）, DCA （0.59 ng/mL）, CDCA （0.13 ng/mL） and LCA （0.44 ng/mL） in comparison to LC methods coupled to different detectors like UV （ultraviolet）, fluorescence and refractive index. Conclusions： The developed and validated LC-MS/MS method for the determination of UDCA and related substances in raw material and in a suspension was advantageous since it required a minimum sample amount. In turn, it could be used as a stability indicating method.
文摘One of the most significant health issues is the disorders of mood according to the fact that they have a significant effect on the quality of life of the patients, their families, their working and wider social surroundings. According to the World Health Organization, mood disorders are the fourth cause of morbidity and mortality with a tendency to move to the second place by the 2020. The prediction of higher number of patients diagnosed with depression in the future comes from the facts that the main factor of risk, like stress, is in constant rise. Furthermore, the demographic image （ageing of the population） is changing, associated with the effect of comorbidity of depression, also attributed with increase of the number of genetically predisposed patients with this mood disorder. The aim of this study is to define, describe and question the role of pharmacists in the treatment of patients suffering from depression. Therefore, we measured the impact of pharmaceutical care on significant parameters in treatment of depression due to the selection of appropriate therapy according to the guidelines, adherence of the patient, quality of life, work capability, anxiety, side effects and interactions with other medicines.
文摘Patient safety has become a priority for the health system, including dentistry. Several studies showed that health care meant to improve people＇s health is an important source of disease. Good clinical practices aim to maximize effectiveness and therapeutic compliance, minimize risks and costs, respecting the patient＇s choice from generic drugs, also from the moment of prescribing, the supervision of drug-related events must be taken into account, not only on the patient but also in the environment. Pharmacovigilance and pharmacoecovigilance have to be conceived as a clinical practice in dentistry. There is no established culture of drug induced reaction reports by dentists in Uruguay, and awareness of environmental care is incipient. The pharmacy of faculty of dentistry, （Universidad de la Repfiblica）, an institutional project that has been developed since 2006, is in a transformation process. The pharmacovigilance dentistry Node is in full development. The toxicovigilance and pharmacoecovigilance activities are recent. The general aim of this project was to establish the pbarmacovigilance, toxicovigilance and pharmacoecovigilance clinical practice in dentistry. The widespread use of cosmetic as toothpastes, or mouth rinses, drugs and dental materials, as well as exposure to chemical contaminants through the population＇s living habits and the environmental damage caused by drug wastes requires comprehensive and up-to-date information to establish rational strategies.
文摘ACC （adrenocortical carcinoma） is an uncommon and aggressive malignancy with an overall five year survival rate from less than 50%. The majority of cases are accidentally diagnosed by imaging studies done for other reasons, so they are often diagnosed in the later stages. Due to the rarity of both neoplasms, the synchronous presentation and the lack of effective therapeutic options; we report a case concerning about a female patient with adrenal cancer with a low grade solitary fibrous tumor who underwent surgery, adjuvant radiotherapy and chemotherapy with good response.
文摘Abstract： Long bone septic non-union by MRSA （methicillin-resistant Staphylococcus aureus） is always a challenge for the orthopaedic society. Traditional treatment options include distraction osteogenesis methods and vascularised bone grafting. These techniques require a high level of expertise and are frequently involved with a variety of side effects or complications. We present a rare case of ulnar fracture complicated by MRSA infection that led to septic non-union. We treated the septic non union with the technique of induced membrane formation （Masquelet technique）. A 33 year old male presented to the outpatient clinic, 2 months after internal fixation of a Gustillo I fracture of the left forearm. There was pus discharge from the operative wound and specimen culture was positive for MRSA. Initially the patient received conservative treatment with antibiotics for a period of one month. However, the patient returned with the same clinical presentation. The patient was then treated with hardware removal of the ulna and debridement of the septic non-union. The formed 5 cm bone defect was filled with cement spacer and the ulnar bone was fixed with external fixation. Eight weeks later, the spacer was removed and the bone gap was filled with autologous cancellous bone graft from iliac crest. Five months after grafting, the patient was reviewed. No clinical or functional problems were noted and osseous consolidation of the ulnar bone was confirmed in plain x-rays. The Masquelet technique is a promising alternative treatment for the management of infected long bone non-unions of the upper extremity.
基金The author acknowledges the help and support of Dr.Sabah J.Saleh(The National Center for Quality Control and Research,Ministry of Health(Iraq))and Ameer H.Khadem(Department of Pharmaceutical Chemistry,College of Pharmacy,Al-Bayan University).
文摘Background:The emergence of Coronavirus SARS-CoV-2 evoked an unprecedented threat globally.Ever since the spread of this pandemic research and clinical trials have concentrated on the repurposing of already exciting FDA drugs to find a successful candidate to combat Covid-19.Objective:The objective of this study is to propose a therapeutic protocol that may have a potential solution to treat the severe infections associated with coronavirus.The clinical application of this protocol(Al-Akidi Therapeutic Protocol,A-TP)is highly recommended,as there are several scientific evidences that support this trusted protocol to be of great potential.Methods and Materials:This A-TP includes the use of one of the respiratory Fluoroquinolones(Levofloxacin or Moxifloxacin)in doses of 500 mg twice daily for 7-10 days,together with high doses of Vitamin D3(10000 IU/day)and Zinc(50 mg daily)for few weeks.This protocol is based on the previous antiviral activity of those Fluoroquinolones towards few viruses,the potent antibacterial activity on respiratory infections and high available concentrations in the lungs.It is also based on molecular docking of Levofloxacin and Moxifloxacin on various viral enzymes.Results:Molecular docking showed encouraging and very interesting docking scores and binding affinity of Levofloxacin and Moxifloxacin to certain viral enzymes,such as,RNA dependent RNA polymerase(RdRp),3-Cysteine-Like protease,Neuraminidase,Replicase polyproteins and Trans-Membrane Protease Serine 2 inhibitor(TMPRSS2).The highly expected clinical results of using this protocol are:reduce infection,control of temperature,improve breathing with less dependent on supplemented oxygen,and remarkable reduction of the pro-inflammatory cytokine storm,and hence,reduce hospitalization and mortality.Conclusion:Levofloxacin is highly recommended in managing the severe infections associated with Corona virus and has a remarkable reduction of pro-inflammatory cytokine storm as an immuomodulating agent.Levofloxacin is superior in this protocol over Moxifloxacin,due to its high excretion(≤83%)as unchanged through the kidneys,while Moxifloxacin is only 20%is excreted unchanged.It is an extra advantage of Levofloxacin to manage coronavirus in the kidneys.High doses of Vitamin D3 and Zinc are very useful to provide additional effective measures to combat Corona virus.Therefore,the use of this A-TP is highly and strongly recommended,as it serves the full requirements for excellent and potential therapy for the severe infections associated with Covid-19.
