RESUMO
The narrow range of choice and virus resistance to the most common drugs require search and introduction of new drugs with proven efficacy and safety for the treatment of influenza. Ergoferon is a new combined medicine containing release active antibodies to interferon-gamma (anti-IFNgamma), CD4-coreceptor and histamine. The formulation influences various links of antiviral defense and provides antiinflammatory effect. The efficacy of the drug is related to its production process during which multiple reduction of the initial concentration of every component leads to release of special release activity. Previous experimental studies showed that anti-IFNgamma had antiviral activity against pandemic influenza virus A (H1N1) 2009 comparable to that ofoseltamivir (suppression of virus replication in the lung tissue, increase of the lifespan and reduction of the laboratory animals mortality). The aim of the multicentre randomized clinical trial was to compare (versus oseltamivir) the efficacy and safety of ergoferon in the treatment of influenza in adults. 213 patients with flu-like symptoms were examined in 8 medical centres of Russia during two epidemiological seasons (2010-11 and 2011-12). The inclusion criteria were: the first 48 hours after the onset; fever > or =37.8 degrees C, at least one common symptom and at least one respiratory symptom. Influenza was confirmed in 52 patients by QuickVue rapid diagnosis. 23 patients received ergoferon according to the treatment scheme and 29 received oseltamivir (daily dose 150 mg). Duration of the treatment was 5 days. The patients were followed up for 7 days. The primary endpoint was the percentage of the patients with the body temperature normalization for 2-5 days of the treatment. The maximum efficacy of ergoferon was observed on the second day of the treatment: almost half (48%) of the initially febrile patients had normal body temperature (versus 28% in the patients treated with oseltamivir). The comparison of the two groups of the patients by the morning and evening measurements of the body temperature every five days of the treatment by Cochran-Mantel-Haenszel revealed a significant difference between the two groups (chi2 = 7.1; p = 0.008). The average duration of the fever in the group of ergoferon was 2.3 +/- 1.2 days, in the group of oseltamivir--2.6 +/- 1.3 days (the efficacy of oseltamivir in the present study was comparable with the previously published data). The percentage of the patients treated with antipyretics because of hyperthermia on the second day of the treatment lowered 3 times and amounted to 17% (versus 41% in the oseltamivir group). The severity of common and respiratory symptoms (nose/throat/chest) significantly decreased on the third day of the treatment in both groups, the majority of the patients had either minimum severity or no signs of influenza. The clinical improvement was associated with positive changes in the life quality. No cases of the disease aggravation were recorded. Complications requiring antibiotic treatment or hospitalization were not observed during the followup. There were no adverse events recorded due to the drug use. No deviations in the laboratory indices were stated. Ergoferon is a new safe drug for the treatment of influenza. Its clinical efficacy was comparable to that of oseltamivir. The therapeutic effects of the drug were evident from: significant reduction of the disease severity, duration of febricity and general toxicity and respiratory flu symptoms, lower percentage of the patients with fever for 2 days. The febrile period in most of the patients did not exceed 2 days.
Assuntos
Antivirais/uso terapêutico , Influenza Humana/tratamento farmacológico , Oseltamivir/uso terapêutico , Adolescente , Adulto , Antipiréticos/uso terapêutico , Temperatura Corporal , Antígenos CD4/imunologia , Feminino , Febre/tratamento farmacológico , Histamina/imunologia , Humanos , Influenza Humana/etiologia , Interferon gama/imunologia , Masculino , Pessoa de Meia-Idade , Federação Russa , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
Intracranial event-related potentials (ERPs) were recorded in neurological patients to infrequent higher-pitch 'deviant' tones and to frequent 'standard' tones when they occurred, in random order in a mixed sequence of standard and deviant tones and when they occurred in separate sequences, that is, infrequent tones alone with intervals similar to inter-deviant intervals of the mixed sequence and frequent tones alone with intervals similar to those between the standard tones of the mixed sequence. When the tones were ignored, ERPs showed three types of responses revealing three different processes involved in stimulus discrimination in the superior temporal cortex: (1) a pitch-dependent response in the primary auditory cortex; (2) an interstimulus-interval dependent response in the secondary auditory cortex; and (3) a change-detection ('mismatch') response in the auditory association cortex. When the tones were attended, ERPs to deviant and standard tones showed differences also in the basal ganglia-thalamic circuits and in the hippocampus, indicating their involvement in attentive processing of auditory stimulus changes.
Assuntos
Atenção/fisiologia , Córtex Auditivo/fisiopatologia , Discriminação da Altura Tonal/fisiologia , Percepção da Altura Sonora/fisiologia , Estimulação Acústica , Adolescente , Adulto , Eletroencefalografia , Epilepsia/fisiopatologia , Potenciais Evocados Auditivos , Potenciais Somatossensoriais Evocados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Localização de SomRESUMO
Recent studies of a group of researchers from the Institute of Human Brain (St.-Petersburg), concerning the role of the distributed brain systems in different kinds of perceptual and cognitive acts, are reviewed in this paper. Principally different approaches were used, i. e., electrophysiological (multi-unit record with implanted electrodes) and positron emission tomography (PET). Possibility and benefit of application of the combined analysis of these different sets of data in order to obtain more detailed information on the work of the brain systems are discussed. On the basis of some examples of such a combined analysis the authors conclude that such a combined approach is the optimal way to reach a deeper insight into the anatomical-functional organization of the human brain.
Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Pensamento/fisiologia , Tomografia Computadorizada de Emissão , Adolescente , Adulto , Circulação Cerebrovascular/fisiologia , Eletrodos Implantados , Eletrofisiologia , Atividade Nervosa Superior/fisiologia , Humanos , Pessoa de Meia-Idade , Neurônios/fisiologia , Radioisótopos de Oxigênio , Doença de Parkinson/fisiopatologia , Doença de Parkinson/psicologia , Psicofisiologia , Tomografia Computadorizada de Emissão/instrumentação , Tomografia Computadorizada de Emissão/métodosRESUMO
In 16 Parkinson patients treated with implanted electrodes, the multiunit impulse activity of 165 neuronal populations was recorded as a part of the diagnostic procedures during the performance of a set of verbal psychological tests. 10 neuronal populations in the thalamus revealed selective responses to visual presentation of the target words remembered prior to the test or to the presentation of both the target words and of the words closely resembling the targets graphically.
Assuntos
Memória/fisiologia , Neurônios/fisiologia , Doença de Parkinson/fisiopatologia , Núcleos Talâmicos/fisiopatologia , Aprendizagem Verbal/fisiologia , Humanos , Doença de Parkinson/psicologia , Percepção Visual/fisiologiaRESUMO
Evoked discharge rate variations in the populations of subcortical (mainly striopallidal and thalamic) neurons in man during lexical processing were studied. The neuronal activity of 165 populations was recorded as a part of the diagnostic procedures in 16 parkinsonian patients treated with implanted electrodes. The patients were performing a set of psychological test involving perception and simple operations with visually presented words and pictures. A class of neuronal reactions is described which reflect endogenous brain processes associated with inner speech.