Clinical benefits with oseltamivir in treating influenza in adult populations : results of a pooled and subgroup analysis.

BACKGROUND: Influenza is a potentially life-threatening illness that affects approximately 10% of the population annually, with resulting personal misery and societal disruption. Oseltamivir is a novel influenza treatment that has been extensively investigated. We describe a series of retrospective analyses investigating various measures of clinical efficacy across different populations of influenza-infected patients enrolled in studies of oseltamivir (Tamiflu((R))) that were conducted within the clinical development programme. METHODS: Adolescents and adults (13-97 years, n = 4015) presenting within 36 hours of onset of influenza symptoms were randomised to receive oseltamivir 75mg or placebo twice daily for 5 days during local influenza outbreaks. Of these patients, 2413 had laboratory-confirmed influenza and are included in the analysis. Approximately 30% (n = 739) of patients were 'high risk'; 20% were healthy elderly subjects (n = 488) and 10% (n = 251) were patients with chronic respiratory and/or cardiac conditions. The primary endpoint was time to alleviation of a seven-symptom cluster in influenza-infected patients. Supplementary analyses were conducted using a variety of illness definitions and symptom clusters to investigate the sensitivity of the assessment of overall efficacy to differing disease definitions and also to explore efficacy in important subpopulations. RESULTS: A total of 2413 patients had confirmed influenza infection (placebo: n = 1063; oseltamivir: n = 1350). Across all populations, the time to alleviation of illness was reduced by 19% (median duration 100.6 hours [95% CI 94.8-104.7]) compared with placebo (124.5 hours [95% CI 117.7-132.3], p < 0.0001). Oseltamivir recipients returned to normal health status, regained ability to perform usual activities and regained normal sleep patterns significantly faster than placebo recipients. The median duration of troublesome influenza symptoms was significantly reduced by oseltamivir treatment, e.g. fatigue by 29% and myalgia by 26% (both p < 0.0001). After 48 hours of treatment, 57% more placebo than oseltamivir recipients remained febrile, despite greater use of acetaminophen by placebo recipients. In addition, the median duration of acute febrile illness was significantly shortened by oseltamivir treatment compared with placebo in patients with cardiac disease (44.0 hours vs 64.7 hours, p = 0.026) or chronic obstructive airways disease (37.9 hours vs 53.8 hours, p = 0.004).Efficacy was similar among influenza A- and influenza B-infected patients. Oseltamivir was well tolerated, with transient gastrointestinal effects (observed in one in seven oseltamivir-treated patients compared with one in 12 patients on placebo) that only rarely resulted in study discontinuation. CONCLUSIONS: Oral oseltamivir is a well tolerated and effective treatment for influenza in adolescents and adults, including the elderly and patients with chronic cardiac and/or respiratory disease.

[Isolation and some properties of polynucleotide phosphorylase from E. coli]. / Vydelenie polinukleotidfosforilazy iz E. coli i nekotorye ee svoistba.

A new method for isolation of polynucleotide phosphorylase from E. coli, including ion-exchange chromatography and gel-filtration has been developed. The method results in 300-fold purification of the enzyme, which being devoid of nuclease and phosphatase activities can further be utilized for oligonucleotide synthesis. It was shown that upon storage the enzyme loses the primer-independent activity and in the absence of NaCl can be used for further syntheses. An addition of NaCl stimulates the elongation of the oligonucleotide chain. Some advantages of polynucleotide phosphorylase from E. coli in comparison with the M. luteus enzyme are discussed.

[Relationship between recognition asymmetry and the interval between the stimuli of a dichoptic complex]. / Zabisimost' asimmetrii raspoznavaniia ot dlitel'nosti intervala mezhdu stimulami dikhopticheskogo kompleksa.

Recognition of optic stimuli (contour drawings, words and word combinations) was studied in conditions of binocular, monocular and dichoptic presentation. The interval between stimuli of the dichoptic complex (ISI) was: 0, 10, 20, 50, 100, 200, 400, 600, and 1000 ms. In all the cases "the effect of the right eye" was revealed. The mean values of the asymmetry index (A) are: high probabilistic monocular dichoptic presentation--45%. With a longer ISI, the percentage of correct recognitions of the second stimulus presented to the left eye, increases, while the A parameter decreases. This dependence is less pronounced in the recognition of the first terms of the stimuli pair. Dependence between the recognition level of the first and second stimuli, presented to the right eye and the ISI, is monotonous. The following A values for the three kinds of stimuli have been obtained: drawings--37%, word combinations--38% and words 59%. The results are discussed in the aspects of functional asymmetry, psychologic refractoriness and attention.

[A study of the phases of audiovisual interaction]. / Issledovanie faz audiovizual'nogo vzaimodeistviia

A study was made of the dependence of errors in recognizing visual and discriminating acoustic stimuli and of the reaction time (RT), on the duration of intersignal intervals (ISI) (10, 20, 50, 100, 200, 400, 600 and 1000 msec). With longer ISI a decrease in RT has been found, particularly pronounced in responses to the second stimuli of the pair. RT to the visual (acoustic) stimulus increases not only when an acoustic (photic) signal is present in the complex, but also in the case of its anticipation. The level of errors in recognizing visual and discriminating acoustic stimuli does not depend on ISI duration. The results so obtained are discussed as related to psychological refractory period and to interaction of sensorimotor channels of the human brain.