Tocilizumab in COVID-19 interstitial pneumonia

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.

Subchorionic placental cyst: histopathological and clinical aspects in two cases

Authors report here two cases of subchorionic placental cysts with diameters of 5 x 6 cm and 10 x 12 cm, respectively, diagnosed by ultrasound in pregnancy. Subsequent histological and biochemical examinations seem to prove their origin from the trophoblastic "X-cells" and confirm their frequent benign nature.

Some considerations about the "Fibrolipocalcareous myopathy" (Mattioli-Foggia and Raso disease)

Fibrolipocalcareous myopathy also known as Mattioli-Foggia and Raso Disease was observed first time in 1945. They described clinical, anatomopathologic and radiological Bigliardi aspects. At present the published cases are more than forty. We have pointed out our attention on the published cases. We believe, regard to histopathological and whole clinical data, that this disease could be considered as a) the outcome of a vascular hamartoma; or b) the consequence of a "mesoblastic phacomatosis".

Bateman's disease

Bateman's disease is characterized by the presence of purpuric eruptions involving the extremities. Semi-thin sections and morphological pictures evidence the damage this illness can cause to the elastic fibres. After passing in review the various pathogenetic theories, the Authors consider this disease an expression of discrasic alterations of an amyloidosic character of all the vessel structures, of severe senile elastosis and of the lack of fibrin-like material.

[A clinical and anatomical-histological contribution to the study of lipofibrocalcareous myopathy. Mattioli-Foggia and Raso disease]

The paper reports the clinical and histological biopsy data of a patient suffering from lipo-fibro-calcareous myopathy (Mattioli-Foggia and Raso's disease). It affirms that this pathology may be attributed to the group of phacomatosis and that in this instance this is a case of neurovascular phacomatosis (neuroblastodermosis).

[Gingival hyperplasia associated with the therapeutic use of nifedipine: review of clinical cases]

The AA., starting point for some clinical cases occurred to their observation, deal with gingival hyperplasia by calcium-antagonists, showing that, not with standing the unlike aetiology, the clinical and histological picture is like the anticonvulsive or immunedepressor gingivitis.

[Cementoma of the jaw. Clinical case]

The A.A. describe a case of cementoma come to their observation, reporting considerations resulting from an attentive analysis of the literature on the subject.