A Study of Starch-Sucrose blends by solid state NMR spectroscopy

Biopolymer-based systems are today encountered in a wide variety of possible applications, since they are usually low-cost materials and respond to the actual eco-sustainable requirements of renewability and biodegradability. On the other hand, these systems are sometimes related to low chemical and mechanical stability, and the research for new formulations with higher performances is continuously growing. To this aim the investigation of the phase, structural and dynamic properties on a nanometric and subnanometric scale and of their correlations with the final macroscopic behaviour is of fundamental importance. In this field, Solid-State NMR (SSNMR)can givean important contribution since it offers a large variety of tools for the investigation of both structural and dynamic properties, on large spatial (0.1-100 nm) and frequency ranges, of amorphous polymeric materials. In this work we studied hydrophobically-modified starch/sucrose spray dried amorphous blends by means of SSNMR techniques

Short article: Safety of targeted prophylaxis strategy in patients with resolved hepatitis B virus infection receiving rituximab for immune-mediated diseases

OBJECTIVES: Rituximab (RTX) is a monoclonal antibody that is widely used in hematologic malignancies and immune-mediated diseases (IMID) and has been associated with the risk of hepatitis B virus reactivation (HBVr). Thus, antiviral prophylaxis is recommended before RTX treatment in all patients with chronic hepatitis B virus (HBV) infection and those with resolved infection affected by onco-hematological conditions. By contrast, the correct management of HBsAg-negative/HbcAb-positive patients candidates for RTX-containing regimens for IMID is still debated, owing to few data currently available in this setting. PATIENTS AND METHODS: We retrospectively evaluated the risk of HBVr in patients with IMID with resolved HBV infection, referred to the Infectious and Tropical Diseases Unit Outpatients Service, Careggi Hospital, Florence, Italy, between September 2013 and September 2017, undergoing RTX without antiviral prophylaxis and followed up by serial serum HBV-DNA monitoring. RESULTS: Overall, 20 patients with IMID were identified (70% female, with median age of 57 years) and followed up for a median period of 19 months (range: 2-36 months). A single HBVr case, detected in preclinical stage, was observed (1/20, 5%), and targeted prophylaxis was promptly introduced. CONCLUSION: The results supported the low to moderate risk of HBVr in HBsAg-negative/HBcAb-positive patients with IMID undergoing RTX, in contrast to what is observed in onco-hematological settings. The targeted prophylaxis strategy, based on serum HBV-DNA serial monitoring, seems a safe option in these patients

Recovery from Triple Infection with SARS-CoV-2, RSV and Influenza virus: A case report

The overall probability of infection with RSV, influenza virus, or SARS-CoV-2 in the general population is assessed as high by the ECDC. A high level of respiratory virus circulation increases hospitalizations and places significant pressure on healthcare systems. Here we describe the case of a 52-year-old woman who recovered from pneumonia with a triple infection with SARS-CoV-2, RSV, and Influenza virus. We suggest searching for antigenic or molecular detection of VSR and influenza viruses, together with SARS-CoV-2, in patients with respiratory symptoms during this epidemic period, whereas all three viruses are present right now

Phase separation in amorphous hydrophobically modified starch–sucrose blends: Glass transition, matrix dynamics and phase behavior

The phase behavior and matrix dynamics of amorphous blends of octenyl succinic anhydride (OSA) modified starch and sucrose was studied as function of blend composition and water content. Phase separation into two amorphous phases, one enriched in OSA starch and the other in sucrose, was confirmed by differential scanning calorimetry (DSC). DSC and 1H solid-state NMR show that the phase separation is only partial. The glass transition temperature (Tg) of the OSA starch-rich phase was found to be ∼30–100 K higher than the Tg of the sucrose-rich phase, depending on blend composition and water content. A novel type of coupling between changes in physical state of the sucrose-rich phase and plasticizer redistribution is proposed, leading to an unexpected increase of the glass transition temperature of the modified starch-rich phase at higher matrix water contents. A quantitative model for the phase separation of the anhydrous blends into two amorphous phases is presented. The model predicts that, with increasing blend sucrose content, the weight fraction of the sucrose-rich phase decreases, while the sucrose content of both the OSA starch-rich phase and the sucrose-rich phase increases. This novel phenomenon is relevant in the understanding of the stability and performance of multiphase food and pharmaceutical components

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)