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1.
Zh Nevrol Psikhiatr Im S S Korsakova ; 121(3. Vyp. 2): 29-32, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33908229

RESUMO

A variety of structural and functional post-stroke disturbances demands an integrated clinical/diagnostic approach. Persistent hypoxemia due to disturbance of a saturation of blood oxygen in sleep can decrease the effectiveness of neurorehabilitation. In some cases of sleep apnea, the efficiency of continuous positive airway pressure therapy is insufficient and it should be combined with course neuroprotective therapy. Modern approaches to neuroprotective and neuroreparative therapy are considered as the independent direction for treatment of the central sleep apnea syndromes in patients with stroke consequences that is obviously important aspect of secondary prevention of a stroke.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Síndromes da Apneia do Sono , Apneia do Sono Tipo Central , Acidente Vascular Cerebral , Isquemia Encefálica/complicações , Isquemia Encefálica/tratamento farmacológico , Humanos , Apneia do Sono Tipo Central/etiologia , Apneia do Sono Tipo Central/terapia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico
2.
Artigo em Russo | MEDLINE | ID: mdl-32490618

RESUMO

OBJECTIVE: To study the efficacy and safety of the complex metabolic neuroprotective medicine cytoflavin in tablet form in patients with vertigo and dizziness in a distant period of mild traumatic brain injury. MATERIAL AND METHODS: Forty patients, aged 20-55 years, with a mild traumatic brain injury were studied for 3 months to 1 year. Cytoflavin was used as monotherapy in a dose of 2 tablets 2 times a day for 25 days. Otoneurological and stabilometric examinations were performed before and after treatment. The Dizziness Handicap Inventory, a visual-analogous scale and HADS were administered. RESULTS AND CONCLUSION: Cytoflavin decreases the severity of vertigo and dizziness, improves stabilometric indicators and reduces emotional disorders in patients with vertigo in the distant period of mild traumatic brain injury. No significant adverse reactions are observed.


Assuntos
Concussão Encefálica , Inosina Difosfato , Adulto , Tontura , Combinação de Medicamentos , Mononucleotídeo de Flavina , Humanos , Pessoa de Meia-Idade , Niacinamida , Succinatos , Vertigem , Adulto Jovem
3.
Artigo em Russo | MEDLINE | ID: mdl-27845313

RESUMO

AIM: To study the efficacy and safety of the complex metabolic neuroprotector cytoflavin in children with the consequences of perinatal hypoxic brain damages. MATERIAL AND METHODS: Patients, aged 4-8 years, were stratified into three groups: 35 with infant cerebral palsy, 64 with the minimal brain dysfunction and 47 with sensorineural hearing loss. The control group consisted of 30 children. Monotherapy with cytoflavin was carried out in the dose of one tablet twice a day for 25 days. Neurologic status, neurophysiological examination andneuropsychophysiological testing were performed before and after treatment. RESULTS AND CONCLUSION: The efficacy of cytoflavin in children of preschool and early school agewas demonstrated. A complex neuroprotective action, including vasoactive, nootropic and antiasthenic effects, was revealed. Side-effects of cytoflavin were not observed.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Lesões Encefálicas/tratamento farmacológico , Paralisia Cerebral/tratamento farmacológico , Mononucleotídeo de Flavina/uso terapêutico , Perda Auditiva Neurossensorial/tratamento farmacológico , Hipóxia Encefálica/complicações , Inosina Difosfato/uso terapêutico , Niacinamida/uso terapêutico , Succinatos/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Lesões Encefálicas/etiologia , Paralisia Cerebral/etiologia , Criança , Combinação de Medicamentos , Feminino , Perda Auditiva Neurossensorial/etiologia , Humanos , Nootrópicos , Parto , Gravidez , Resultado do Tratamento
4.
Int J Tuberc Lung Dis ; 17(12): 1531-7, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24200264

RESUMO

SETTING: A large randomized controlled trial recently showed that for treating latent tuberculous infection (LTBI) in persons at high risk of progression to tuberculosis (TB) disease, a 12-dose regimen of weekly rifapentine plus isoniazid (3HP) administered as directly observed treatment (DOT) can be as effective as 9 months of daily self-administered isoniazid (9H). OBJECTIVES: To assess the cost-effectiveness of 3HP compared to 9H. DESIGN: A computational model was designed to simulate individuals with LTBI treated with 9H or 3HP. Costs and health outcomes were estimated to determine the incremental costs per active TB case prevented and per quality-adjusted life year (QALY) gained by 3HP compared to 9H. RESULTS: Over a 20-year period, treatment of LTBI with 3HP rather than 9H resulted in 5.2 fewer cases of TB and 25 fewer lost QALYs per 1000 individuals treated. From the health system and societal perspectives, 3HP would cost respectively US$21,525 and $4294 more per TB case prevented, and respectively $4565 and $911 more per QALY gained. CONCLUSIONS: 3HP may be a cost-effective alternative to 9H, particularly if the cost of rifapentine decreases, the effectiveness of 3HP can be maintained without DOT, and 3HP treatment is limited to those with a high risk of progression to TB disease.


Assuntos
Antituberculosos/administração & dosagem , Antituberculosos/economia , Custos de Medicamentos , Isoniazida/administração & dosagem , Isoniazida/economia , Tuberculose Latente/tratamento farmacológico , Tuberculose Latente/economia , Rifampina/análogos & derivados , Antituberculosos/efeitos adversos , Simulação por Computador , Análise Custo-Benefício , Terapia Diretamente Observada/economia , Esquema de Medicação , Quimioterapia Combinada , Custos Hospitalares , Humanos , Isoniazida/efeitos adversos , Tuberculose Latente/diagnóstico , Modelos Econômicos , Anos de Vida Ajustados por Qualidade de Vida , Rifampina/administração & dosagem , Rifampina/efeitos adversos , Rifampina/economia , Fatores de Tempo , Resultado do Tratamento , Estados Unidos
5.
Mol Psychiatry ; 15(5): 535-47, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-18521089

RESUMO

Interferon (IFN)-alpha has been used to investigate pathways by which innate immune cytokines influence the brain and behavior. Accordingly, the impact of IFN-alpha on diurnal secretion of hypothalamic-pituitary-adrenal (HPA) axis hormones was assessed in 33 patients eligible for treatment with IFN-alpha plus ribavirin for hepatitis C. In addition, the relationship between IFN-alpha-induced HPA axis changes and proinflammatory cytokines and behavior was examined. Plasma ACTH and cortisol as well as tumor necrosis factor (TNF)-alpha, interleukin-6 and their soluble receptors, were measured hourly between 0900 and 2100 hours at baseline and following approximately 12 weeks of either no treatment (n=13) or treatment with IFN-alpha/ribavirin (n=20). Plasma IFN-alpha was also measured at each visit. Depression and fatigue were assessed using the Montgomery-Asberg depression rating scale and the multidimensional fatigue inventory. Compared to no treatment, IFN-alpha/ribavirin administration was associated with significant flattening of the diurnal ACTH and cortisol slope and increased evening plasma ACTH and cortisol concentrations. Flattening of the cortisol slope and increases in evening cortisol were correlated with increases in depression (r=0.38, P<0.05 and r=0.36, P<0.05, respectively) and fatigue (r=0.43, P<0.05 and r=0.49, P<0.01, respectively). No relationship was found between immune and HPA axis measures, although increases in plasma IFN-alpha, TNF-alpha and soluble TNF-alpha receptor2 were independently correlated with behavioral endpoints. These data indicate that chronic exposure to innate immune cytokines may contribute to the altered diurnal HPA axis activity and behavior found in medically ill individuals. However, given the lack of correlation between HPA axis and immune measures, the mechanism by which chronic cytokine exposure influences HPA axis function remains to be determined.


Assuntos
Antivirais/farmacologia , Ritmo Circadiano/efeitos dos fármacos , Citocinas/sangue , Hepatite C/patologia , Hepatite C/fisiopatologia , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Interferon-alfa/farmacologia , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Hormônio Adrenocorticotrópico/sangue , Adulto , Antivirais/uso terapêutico , Ritmo Circadiano/fisiologia , Depressão/tratamento farmacológico , Depressão/etiologia , Ensaio de Imunoadsorção Enzimática , Fadiga/tratamento farmacológico , Fadiga/etiologia , Feminino , Hepatite C/tratamento farmacológico , Humanos , Hidrocortisona/sangue , Interferon-alfa/efeitos dos fármacos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Ribavirina/farmacologia , Ribavirina/uso terapêutico , Estatística como Assunto , Estatísticas não Paramétricas
6.
Aliment Pharmacol Ther ; 25(10): 1163-74, 2007 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-17451562

RESUMO

BACKGROUND: Whether antidepressants prevent depression during interferon-alpha/ribavirin treatment for hepatitis C virus infection has yet to be established. AIM: To investigate the use of paroxetine in a prospective, double-blind, placebo-controlled study for this indication. METHODS: Sixty-one hepatitis C virus-infected patients were randomly assigned to the antidepressant, paroxetine (n = 28), or placebo (n = 33), begun 2 weeks before and continued for 24 weeks during interferon-alpha/ribavirin treatment. Primary endpoints included development of major depression and severity of depressive symptoms measured by the Montgomery Asberg Depression Rating Scale (MADRS). RESULTS: Rates of major depression during the study were low (17%) and did not differ between groups. Nevertheless, using published MADRS cut-off scores, the percent of subjects who met criteria for mild, moderate or severe depression during interferon-alpha/ribavirin therapy was significantly lower in paroxetine- vs. placebo-treated subjects (P = 0.02, Fisher's exact test). Assignment to paroxetine was also associated with significantly reduced depressive symptom severity. This effect was largely accounted for by participants with depression scores above the median (MADRS > 3) at baseline in whom paroxetine was associated with a maximal reduction in MADRS scores of 10.3 (95% CI: 2.1-18.5) compared with placebo at 20 weeks (P < 0.01). Study limitations included a small sample size and high drop-out rate. CONCLUSION: This double-blind, placebo-controlled trial provides preliminary data in support of antidepressant pre-treatment in hepatitis C virus patients with elevated depressive symptoms at baseline.


Assuntos
Antivirais/uso terapêutico , Transtorno Depressivo Maior/prevenção & controle , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Ribavirina/uso terapêutico , Adolescente , Adulto , Idoso , Antivirais/farmacocinética , Transtorno Depressivo Maior/virologia , Método Duplo-Cego , Feminino , Hepatite C Crônica/psicologia , Humanos , Interferon-alfa/farmacocinética , Masculino , Pessoa de Meia-Idade , Paroxetina/uso terapêutico , Ribavirina/farmacocinética
7.
Anesteziol Reanimatol ; (2): 53-8, 2005.
Artigo em Russo | MEDLINE | ID: mdl-15938099

RESUMO

The aim of the study was to evaluate the influence of different predictors on the outcomes of acute renal failure (ARF) in cardiosurgical patients. A hundred and five cases of ARF in January 1995 to August 2004 were retrospectively analyzed. Sixty-one patients received continuous renal replacement therapy (CRRT) and 44 patients had intermittent RRT (IRRT). Eighteen preoperative, perioperative, and postoperative risk factors were assessed. The overall hospital mortality was found to be 42%: 48.4% in the CRRT group and 33.3% in the IRRT group. A statistical analysis revealed 8 significant predictors of fatal outcomes: (1) the severity according to the APACHE II scale (25 +/- 1 scores); (2) the number of organ dysfunctions (3.6 +/- 0.2); (3) large-dose inotropic support; (4) artificial ventilation; (5) oliguria; (6) severe concomitant hepatic failure; (7) moderate-to-severe concomitant posthypoxic encephalopathy. CRRT improved survival in AFR associated with severe cardiorespiratory failure, oliguria, and cerebral dysfunctions. The paper discusses criteria for choosing the modes of renal replacement therapy.


Assuntos
Injúria Renal Aguda/terapia , Terapia de Substituição Renal , APACHE , Adolescente , Adulto , Idoso , Procedimentos Cirúrgicos Cardíacos , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Resultado do Tratamento
8.
Anesteziol Reanimatol ; (2): 54-7, 2002.
Artigo em Russo | MEDLINE | ID: mdl-12227001

RESUMO

The efficiency of plasmapheresis in the treatment of infectious complications and multiple organ dysfunctions was evaluated in 66 patients after heart surgery. Early plasmapheresis attenuated the cytokine-related systemic inflammatory response and organ damage. The optimal use of plasmapheresis modifications (membrane plasma filtration, plasma carboperfusion, cryoapheresis) improved the clinical outcomes.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Insuficiência de Múltiplos Órgãos/terapia , Plasmaferese , Complicações Pós-Operatórias/terapia , Adolescente , Adulto , Interpretação Estatística de Dados , Endotoxinas/sangue , Humanos , Pessoa de Meia-Idade , Plasmaferese/métodos , Resultado do Tratamento
11.
Zh Mikrobiol Epidemiol Immunobiol ; (3): 87-91, 1976 Apr.
Artigo em Russo | MEDLINE | ID: mdl-60858

RESUMO

The authors analyzed epidemiological and clinical peculiarities of infectious hepatitis in children aged under 11 years in conditions of mass-gamma-globulin prophylaxis in microdoses the last 5 years in Voronezh. It appeared that the incidence of the disease fell and that its clinical course became milder. In connection with reduction of the incidence of infectious hepatitis in the age group of under 10 years, the incidence of the disease was relatively higher in children aged from 10 to 14 years, with a tendency to levelling-out the periodic autumno-winter elevations among preschool children. Introduction of decreased gamma-globulin dose for hepatitis prophylaxis led to a lesser expenditure of the preparation and thus permitted to vaccinate more children.


Assuntos
Hepatite A/prevenção & controle , gama-Globulinas/administração & dosagem , Adolescente , Fatores Etários , Criança , Pré-Escolar , Surtos de Doenças/prevenção & controle , Hepatite A/epidemiologia , Humanos , Lactente , Federação Russa , Estações do Ano
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