Dacryocystography with computed tomography: A preliminary study | [DACRIOCISTOGRAFIA CON TC: STUDIO PRELIMINARE]

Gli Autori h a nno co ndott o uno studio TC d ell e vie lacrima!i escre tri ci normali dopo irrigazi one co n iohexol. Il lume del sacco e del dotto naso-lacrimale ris ulta ben dimostrato, soprattutto n ell e proiezioni co ronali ed assiali così com e i rapporti di tali s trutture con gli altri tessuti molli, fisiologici e patologi ci. La limita z ion e rappresent a ta dalla maggior e do se di radiazioni per il pazient e, rispetto alla dacriocistografia convenzion al e, r e nde elettiva l'indagine dac riocis tografica re nei casi di os truzion e non chiaram en te flogistica (sospett e l esioni neoplas ti ch e o traumati che d elle v i e escretrici o delle strutture limitrofe) , in c ui ris ulta di notevole interesse la possibilit à di a nalizzare sezioni assiali

Fluoroangiography of glaucomatous optic papilla

Authors describe the fluoroangiography of the optic pupil in 15 patients who were suffering from chronic open-angle glaucoma and found a lessening of the fluorescence of the optic disk. It can be attributed to a hypoperfusion of the optic nerve. The results obtained and that is an constant ipofluorescein, even with different levels in relation to the type of glaucoma damage noticed, they look to support this etiopathogenetic hypothesi

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)