The relationship between regional microstructural abnormalities of the corpus callosum and physical and cognitive disability in relapsing–remitting multiple sclerosis

Significant corpus callosum (CC) involvement has been found in relapsing–remitting multiple sclerosis (RRMS), even if conventional magnetic resonance imaging measures have shown poor correlation with clinical disability measures. In this work, we tested the potential of multimodal imaging of the entire CC to explain physical and cognitive disability in 47 patients with RRMS. Values of thickness, fractional anisotropy (FA) and mean diffusivity (MD) were extracted from 50 regions of interest (ROIs) sampled along the bundle. The relationships between clinical, neuropsychological and imaging variables were assessed by using Spearman's correlation. Multiple linear regression analysis was employed in order to identify the relative importance of imaging metrics in modeling different clinical variables. Regional fiber composition of the CC differentially explained the response variables (Expanded Disability Status Scale [EDSS], cognitive impairment). Increases in EDSS were explained by reductions in CC thickness and MD. Cognitive impairment was mainly explained by FA reductions in the genu and splenium. Regional CC imaging properties differentially explained disability within RRMS patients revealing strong, distinct patterns of correlation with clinical and cognitive status of patients affected by this specific clinical phenotype

Pharmacare 2019

[Italiano]: Questo volume intende offrire una sintesi efficace ed esaustiva dei dati relativi ai consumi e alla spesa dei farmaci erogati a carico del Servizio Sanitario Regionale (SSR) della Campania in regime di assistenza convenzionata per l’anno 2019. Sulla base delle informazioni fornite da una banca dati che copre una popolazione assistibile di circa sei milioni di abitanti rappresentativa del 10% circa della popolazione nazionale, è stata tracciata una correlazione tra la prevalenza delle patologie presenti nel territorio e il corrispondente utilizzo dei farmaci, suggerendo al contempo valide interpretazioni sui principali fattori che influenzano la variabilità nelle prescrizioni. È stata inoltre dedicata un’accurata analisi ai profili prescrittivi delle principali categorie terapeutiche, con particolare attenzione ai regimi di politerapia negli over 65, alle differenze di genere nell’utilizzo dei farmaci e ai profili di utilizzo dei farmaci nei pazienti con COVID-19. È stata così realizzata una dettagliata panoramica sull’uso dei farmaci in termini di spesa, volumi e tipologia all’interno dell’ambito territoriale, che vuole candidarsi quale strumento di monitoraggio a supporto dei decisori, utile sia per la pianificazione di interventi di sanità pubblica, sia per l’identificazione di potenziali aree di miglioramento ./[English]: This volume aims to offer an effective and comprehensive summary of the data on consumption and expenditure of drugs dispensed by the Regional Health Service (SSR) of Campania region under health care agreements during the year 2019. By using information supplied by a database covering a population of about six million inhabitants, a correlation has been drawn between the prevalence of diseases in the area and the corresponding use of drugs, suggesting at the same time useful interpretations of the main factors influencing the variability in prescriptions. A thorough analysis was then conducted on the prescribing profiles of the main therapeutic categories, particularly focused on polypharmacy regimens in the over-65s, gender differences in medication use, and medication use profiles in patients with COVID-19. A detailed overview of medication use in terms of expenditure, volume and type within the region has thus been created, which aims to be a monitoring tool to support decision-makers, useful both for the planning of public health interventions, and for the identification of potential areas of improvement in these contexts

Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial

BackgroundTocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients.MethodsA multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days (co-primary endpoints, a priori expected rates being 20 and 35%, respectively). A further prospective cohort of patients, consecutively enrolled after the first cohort was accomplished, was used as a secondary validation dataset. The two cohorts were evaluated jointly in an exploratory multivariable logistic regression model to assess prognostic variables on survival.ResultsIn the primary intention-to-treat (ITT) phase 2 population, 180/301 (59.8%) subjects received tocilizumab, and 67 deaths were observed overall. Lethality rates were equal to 18.4% (97.5% CI: 13.6-24.0, P=0.52) and 22.4% (97.5% CI: 17.2-28.3, P<0.001) at 14 and 30 days, respectively. Lethality rates were lower in the validation dataset, that included 920 patients. No signal of specific drug toxicity was reported. In the exploratory multivariable logistic regression analysis, older age and lower PaO2/FiO2 ratio negatively affected survival, while the concurrent use of steroids was associated with greater survival. A statistically significant interaction was found between tocilizumab and respiratory support, suggesting that tocilizumab might be more effective in patients not requiring mechanical respiratory support at baseline.ConclusionsTocilizumab reduced lethality rate at 30 days compared with null hypothesis, without significant toxicity. Possibly, this effect could be limited to patients not requiring mechanical respiratory support at baseline.Registration EudraCT (2020-001110-38); clinicaltrials.gov (NCT04317092)

Correction to: Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial (Journal of Translational Medicine, (2020), 18, 1, (405), 10.1186/s12967-020-02573-9)

Following publication of the original article [1] the authors identified that the collaborators of the TOCIVID-19 investigators, Italy were only available in the supplementary file. The original article has been updated so that the collaborators are correctly acknowledged. For clarity, all collaborators are listed in this correction article