Omega-complexity
was higher in the elderly especially in the frontal area and increased following eyes opening. Values of the clustering coefficient, path length and that of the “”small-world index”" decreased as a result of eyes opening, the latter in the fast frequency range. The results suggest reduced reactivity in the elderly as shown by frequency spectra and decreased level of integrative activity FGFR inhibitor particularly in the frontal area probably as a result of reduced interneuronal processing capacity. Indices of network characteristics reveal a shift towards more random topology especially in the beta frequencies caused by eyes opening. (C) 2010 Elsevier Ireland Ltd. All rights reserved.”
“Background: Cyclophosphamide induction regimens for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis are effective in 70 to 90% of
patients, but they are associated with high rates of death and adverse events. Treatment with rituximab has led to remission rates of 80 to 90% among patients with refractory ANCA-associated vasculitis and may be safer than cyclophosphamide regimens.
Methods: We compared rituximab with cyclophosphamide as induction therapy in ANCA-associated vasculitis. Dinaciclib molecular weight We randomly assigned, in a 3:1 ratio, 44 patients with newly diagnosed ANCA-associated vasculitis and renal involvement to a standard glucocorticoid regimen plus either rituximab at a dose of 375 mg per square meter of body-surface area per week for 4 weeks, with two intravenous cyclophosphamide pulses (33 patients, the rituximab group), or intravenous cyclophosphamide for 3 to 6 months followed by azathioprine (11 patients, the control group). Primary end points were sustained remission rates at 12 months and severe adverse events.
Results: The median age was 68 years, and the glomerular filtration rate (GFR) was 18 ml per minute per 1.73
m(sup 2) of body-surface area. A total of 25 patients in the rituximab group (76%) and 9 patients in the control group (82%) had a sustained remission (P=0.68). Severe adverse events occurred in 14 patients in the rituximab group (42%) and 4 patients in the control group (36%) (P=0.77). Six of the 33 patients in the rituximab group (18%) and 2 of the 11 patients in selleck inhibitor the control group (18%) died (P=1.00). The median increase in the GFR between 0 and 12 months was 19 ml per minute in the rituximab group and 15 ml per minute in the control group (P=0.14).
Conclusions: A rituximab-based regimen was not superior to standard intravenous cyclophosphamide for severe ANCA-associated vasculitis. Sustained-remission rates were high in both groups, and the rituximab-based regimen was not associated with reductions in early severe adverse events. (Funded by Cambridge University Hospitals National Health Service Foundation Trust and F. Hoffmann-La Roche; Current Controlled Trials number, ISRCTN28528813.)
N Engl J Med 2010;363:211-20.