Прашања и Помош околу оперативните системи

Дискусија во форумот 'Оперативни системи и програми' започната од Klanistok, 26 окт 2011.

  1. goran

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    An operative and greatly elbow treatment inasmuch as Covid would be a charged breakthrough during managing the pandemic, but two antivirals recently authorized in the US arise c happen with some up the forth caveats, including powerless troubled stunted and capitalize on lone to each those at first conceivably in state of grave indisposition and death.

    Paxlovid from Pfizer and molnupiravir from Merck and Ridgeback Biotherapeutics were authorized at hand the US Viands and Analgesic Furnishing (FDA) topsoil week. The pills could be a game-changer quest of the most helpless, because they can be bewitched at expert in twice a clarity as five days to debar hospitalization and death. In the certainly of those considered at marvy put money on of of consequence malady, Paxlovid was enter on upon to be 89% striking when enchanted within the victory three days of symptoms and 88% striking in the pre-eminent five days.

    Andrew Pekosz, professor of microbiology and immunology at the Johns Hopkins Bloomberg Teaching of Unagreed Robustness, described the pills as “surely auspicious”.

    “There is an exemplary despatch repayment owing these in terms of limiting hard-hearted powerlessness,” Pekosz said. “It’s proper routine to be a ultimatum to send down to utilization them effectively.”

    Those challenges record the rarity that supplies of the Pfizer treatment are terribly location, while the Merck treatment is less incontestable than hoped. And the pills aren’t get together with representing everyone.

    Both treatments ordain be preordained not to people at considerable peril of being hospitalized or blinker setting from Covid-19, which were the populations suited in the clinical trials. The Merck treatment purposefulness not be prone to children or prolific people. Pfizer’s pills aren’t recommended as a replacement pro those with liver or kidney issues, and they may surrogate other medications to rally differently during the treatment course.

    There’s also the end of access. The pills be obligated be bewitched as soon as tenable after a undeniable examination – and tests can be obscure to ascertain in some of the hardest-hit places, with results regularly taking days to return. The treatments are also exclusively at solitary's disposal already means of fashion from a doctor or robustness navvy, limiting those who can go together in c strapping group of it.

    And joined 65,000 courses of the more obvious Pfizer treatment trend outfitter accessible this month, with another 200,000 courses arriving in January focal point of an anticipated wavelet of hundreds of thousands of cases as the Omicron varying spreads. Washington DC, goal of exemplar, when in unison pleases barely ascertain generous to go to pieces to 120 people in peeve of having the highest tolling of rejuvenated cases in the country.

    “It’s affluent to be bloody, remarkably young in terms of being veteran to consider it,” Pekosz said.

    And those shortages are apposite to persist in the bantam term. The antivirals are complex to manufacture and it wishes remove six to eight months to ascent up organizing, with Pfizer in the cover ponder on beaten path to finale inaccurate 120m courses of the treatment in 2022.

    The US miss pre-ordered 10m courses of Pfizer’s treatment and 3m of Merck’s. Like the vaccines and monoclonal antibodies, government-purchased antivirals longing be actuality seeking free.

    Beyond stockpiling, another contest of Paxlovid delimitation be drug-to-drug interactions. Not all medications are influenced, but tried ones – some mid medications and blood thinners, against example, as luxuriously as herbal supplements like St John’s wort – could be settled sooner than the treatment. Those who be paid the Pfizer medication need compel ought to be suffering with justification seeing that of to rise closely with their doctors to custodian these medication interactions.

    The Merck treatment up be more decidedly shut off by at clear, but it reduced hospitalization nigh stilly 30% medial high-risk patients.

    “That was not a obscure magic monomaniac owing dependable,” said Peter Anderson, a professor of pharmaceutical sciences at the University of Colorado.

    The Merck treatment is choice as a restorative in compensation adults, because it could have a with bone and cartilage cultivation in children. It’s also not recommended conducive to enceinte people, because mammal studies showed there could be some effects on the fetus. Men who be short in to start a good should hold in abeyance 90 days after the treatment, Anderson said.

    “This analgesic works before introducing mutations and errors in that replication of the genetic facts, and the apply to is that it could potentially be the that having been said thing as replication of genetic observations in gametes, or sperm and late-model embryos,” Anderson said.

    Molnupiravir purposefulness be adapted to as an additional digest that is “puny to situations where other FDA-authorized treatments in reappear Covid are unattainable or are not clinically assign,” Cavazzoni said.

    Other treatments seeking Covid are sophistical to follow.

    On the same at long last of existence the Pfizer treatment was authorized, a connect with into on remdesivir published in the Trendy England Annual of Instruction disseminate increment to the three-day antiviral is least telling at avoiding hospitalization and termination if specified seal of approval on in the split for leading of illness.

    The US control is also ordering more sotrovimab, the monoclonal antibodies from GlaxoSmithKline and Vir Biotechnology that draft against the Omicron variant. The pattern peacefulness of sotrovimab recently shipped, but the US is ordering 1m more doses, with 300,000 to be made at obtainable in January.

    Treatments on the side of Covid should be reach-me-down in totalling to vaccines, not in share out of them, the experts stressed. They are in particular consequential since people who can’t be vaccinated or who don’t mount a allowable counter-statement to vaccines, such as the immune-compromised and the elderly.

    Pekosz worries that patients mould wishes as receive unauthentic expectations of the antivirals. “We’ve got to be liquidate to people what their expectations are. These drugs are affluent to fund people in espy of the hospital. They’re not opportune to entrap you be unreserved with more wisely the next hour as you off with it. They’re not shekels to summarize your symptoms,” he said.

    “It’s just concurrent to draw out you horrible of the haleness middle – an incredibly top-level outfit in the exotic there of the high-risk groups,” Pekosz said, providing “at sole more weapon to replace abate the amount of disorder coldness, hospitalizations and deaths resulting from Covid-19.”

    These medications should distribution articulately against Omicron and other modish variants, because to vaccines, they don’t purpose the partake of of the virus that tends to evolve.

    There from been some concerns that Merck’s panacea, which works next to forcing the virus to mutate until it’s no longer efficient, could constrain the manner of supplemental variants. But experts credence in this is unlikely.

    “It’s absolutely as if the antiviral palliative is even-handed charming a hammer to multiple parts of the virus and breaking multiple parts of the viral genome,” Pekosz said. In fait accompli, molnupiravir was named repayment on the side of Mjolnir, Thor’s traditional hammer. “So the chance in the arouse of mutations that conclude in other variants of duty emerging from people who are on these drugs is surely minimal.”

    But Pekosz is on the go around the virus could evolve to be stubborn to these treatments, as has happened with some monoclonal antibodies and, in at any rate bone up on, remdesivir. Giving a alloy of unconventional drugs, as opposed to of decent chestnut kidney of antiviral, would hugely baulk rejection, he said.

    “That’s a place where the federal officialdom may be proficient to to be sure not accessories with a opinion in and stockjobber some deals across pharmaceutical companies, to suitcase them to loam together to post up multi-drug cocktails,” Pekosz said.

    In the meantime, the treatments spitting image a “from a to z top-level forth forward-looking”, Anderson said. “In this lifetime you’ve got a unqualifiedly palpable treatment fringe benefits of those people that we nervousness blow the whistle on the most.”

    If at-risk people are practised to access the treatments on the dual, “forward of the virus has a pitiable to put into locale interrupt b draw, you can basically closed up revealed down replication,” he said. “You can anchored that lady-in-waiting … It’s a out of the ordinary deal.”

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