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1.
J Intern Med ; 289(5): 738-746, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33511686

RESUMEN

BACKGROUND: Published reports on tocilizumab in COVID-19 pneumonitis show conflicting results due to weak designs or heterogeneity in critical methodological issues. METHODS: This open-label trial, structured according to Simon's optimal design, aims to identify factors predicting which patients could benefit from anti-IL6 strategies and to enhance the design of unequivocal and reliable future randomized trials. A total of 46 patients with COVID-19 pneumonia needing of oxygen therapy to maintain SO2 > 93% and with recent worsening of lung function received a single infusion of tocilizumab. Clinical and biological markers were measured to test their predictive values. Primary end point was early and sustained clinical response. RESULTS: Twenty-one patients fulfilled pre-defined response criteria. Lower levels of IL-6 at 24 h after tocilizumab infusion (P = 0.049) and higher baseline values of PaO2/FiO2 (P = 0.008) predicted a favourable response. CONCLUSIONS: Objective clinical response rate overcame the pre-defined threshold of 30%. Efficacy of tocilizumab to improve respiratory function in patients selected according to our inclusion criteria warrants investigations in randomized trials.


Asunto(s)
Anticuerpos Monoclonales Humanizados , Biomarcadores Farmacológicos/análisis , COVID-19 , Monitoreo de Drogas/métodos , Interleucina-6 , Neumonía Viral , Anciano , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/farmacocinética , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/fisiopatología , COVID-19/terapia , Femenino , Humanos , Factores Inmunológicos/administración & dosificación , Factores Inmunológicos/farmacocinética , Infusiones Intravenosas , Interleucina-6/antagonistas & inhibidores , Interleucina-6/sangre , Italia/epidemiología , Masculino , Oximetría/métodos , Terapia por Inhalación de Oxígeno/métodos , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/epidemiología , Neumonía Viral/etiología , Valor Predictivo de las Pruebas , Pruebas de Función Respiratoria/métodos , SARS-CoV-2/aislamiento & purificación , Resultado del Tratamiento
2.
Neurosci Lett ; 358(1): 37-40, 2004 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-15016429

RESUMEN

Riluzole is a presynaptic inhibitor of glutamate release with neuroprotective properties. In order to evaluate the effects of riluzole on motor activity in post-traumatic peripheral neuropathy (PTPN), the sciatic nerve of Wistar male rats was exposed monolaterally and subjected to crushing for one min by a surgical forceps. Animals received an intraperitoneal treatment with riluzole (2, 4 or 8 mg/kg per day), diclofenac (5, 10 or 20 mg/kg) or with vehicle for 3 days. Motor activity and coordination was evaluated in a circular open field and in the rotorod test. The treatment with riluzole stimulated ambulation in PTPN rats and improved their motor performance and coordination. The effect of treatment with riluzole on locomotor activity was greater than that of treatment with diclofenac and was dose-dependent. Furthermore, in contrast to vehicle- and diclofenac-treated rats, animals treated with riluzole showed a long-lasting improvement of locomotor activity as it was assessed 7 days after the end of treatment. These findings suggest that riluzole may improve motor performance in PTPN, and this does not depend on its antinociceptive activity. Its neuroprotective properties are possibly involved in this effect.


Asunto(s)
Actividad Motora/efectos de los fármacos , Enfermedades del Sistema Nervioso Periférico/tratamiento farmacológico , Riluzol/uso terapéutico , Neuropatía Ciática/tratamiento farmacológico , Animales , Masculino , Actividad Motora/fisiología , Enfermedades del Sistema Nervioso Periférico/etiología , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Ratas , Ratas Wistar , Riluzol/farmacología , Neuropatía Ciática/complicaciones , Neuropatía Ciática/fisiopatología
3.
Urol Int ; 70(3): 227-31, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12660463

RESUMEN

A 43-year-old Albanian man is presented who underwent nephrectomy for a huge right spontaneous perirenal hematoma. The diagnosis of polyarteritis nodosa as the etiology of the hematoma has been made only by histological examination, because of the quick and unforeseeable onset of this complication and the nonspecificity of symptoms. We hypothesize a relationship between reactivation of polyarteritis nodosa and treatment with rifampicin and isoniazid.


Asunto(s)
Hematoma/etiología , Hipertensión Renal/etiología , Enfermedades Renales/etiología , Poliarteritis Nudosa/complicaciones , Adulto , Antituberculosos/uso terapéutico , Humanos , Isoniazida/uso terapéutico , Riñón/patología , Masculino , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Nefrectomía , Rifampin/uso terapéutico
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