Use of amantadine in a patient with SARS‐CoV‐2 Aranda‐Abreu, Gonzalo Emiliano; Aranda‐Martínez, José Dolores; Araújo, Ramiro
Journal of medical virology,
January 2021, Letnik:
93, Številka:
1
Journal Article
Background and purpose
Chronic migraine is a highly disabling primary headache disorder that is the most common diagnosis of patients seen at tertiary headache centres. Typical oral preventive ...therapies are associated with many limitations that impact their therapeutic utility. Erenumab was the first available calcitonin gene‐related peptide monoclonal antibody in the UK. It had proven efficacy in migraine prevention in clinical trials and limited real‐world data in tertiary settings.
Methods
We audited our first 92 patients (n = 73 females) with severely disabling chronic migraine who were given monthly erenumab 70 mg sc for 6 months between December 2018 and December 2019.
Results
At 3 months, monthly migraine days were significantly reduced by a median of 4 days, and all other variables also showed significant improvement. The improvement was not affected by baseline analgesic use status. More than half of our patients experienced a clinically meaningful improvement in migraine days. No serious adverse events were reported.
Conclusions
Our real‐world data with erenumab demonstrate it is effective and well tolerated in managing patients with chronic migraine in a tertiary care setting.
Our real‐world data on the efficacy of erenumab for difficult‐to‐treat chronic migraine confirm a significant reduction in monthly migraine days at 3 months which go hand‐in‐hand with previously published reports.
Background
Indomethacin is a nonsteroidal anti‐inflammatory drug whose mechanism of action in certain types of headache disorders remains unknown. The so‐called indomethacin‐responsive headache ...disorders consist of a group of conditions with a very different presentation that have a particularly good response to indomethacin. The response is so distinct as to be used in the definition of two: hemicrania continua and paroxysmal hemicrania.
Methods
This is a narrative literature review. PubMed and the Cochrane databases were used for the literature search.
Results
We review the main pharmacokinetic and pharmacodynamics properties of indomethacin useful for daily practice. The proposed mechanisms of action of indomethacin in the responsive headache disorders, including its effect on cerebral blood flow and intracranial pressure, with special attention to nitrergic mechanisms, are covered. The current evidence for its use in primary headache disorders, such as some trigeminal autonomic cephalalgias, cough, hypnic, exertional or sexual headache, and migraine will be covered, as well as its indication for secondary headaches, such as those of posttraumatic origin.
Conclusion
Increasing understanding of the mechanism(s) of action of indomethacin will enhance our understanding of the complex pathophysiology that might be shared by indomethacin‐sensitive headache disorders.
Objective
To review and highlight current literature on emerging acute migraine treatments, focusing on CGRP receptor antagonists, gepants, and 5‐HT1F receptor agonists (ditans).
Background
Current ...acute migraine therapy consists of nonspecific analgesia and triptans. Limitations to these medicines, including lack of efficacy in many patients, side effects and the contraindication of triptans in patients with cardiovascular disease, suggest that there is an unmet need for new treatments. Studies of serotonin pharmacology led to the development of triptans, 5‐HT1B/1D receptor agonists, some of which have actions at the 5‐HT1F receptor. Exploration of the role of calcitonin gene‐related peptide (CGRP) has resulted in the development of CGRP receptor antagonists.
Method
The authors performed a literature search of Pubmed and Cochrane databases as well as reviewed s presented at meetings: American Headache Society, American Academy of Neurology, European Headache Federation and the Migraine Trust International Symposium, as well as on‐line sources. The authors briefly detail the relevant migraine pathophysiology pertaining to 5‐HT1F receptor and the CGRP pathway relevant to acute therapies. Recent clinical trials of acute therapies in which 5‐HT1F receptor agonists or CGRP receptor antagonists were studied are summarized.
Results
Two 5‐HT1F receptor agonists have reached phase II clinical trials. One, lasmiditan, has completed 2 phase III clinical trials, demonstrating a significant effect for pain freedom and most bothersome symptom at 2 hours. Among the 6 gepants tested for the acute treatment of migraine to date, after issues for some of hepatic safety or efficacy, 2 CGRP receptor antagonists, rimegepant and ubrogepant, have completed phase III trials showing efficacy and safety.
Conclusion
Current available therapies have either been nonspecific or had important limitations, including in patients with cardiovascular risk factors. Phase III clinical trials of lasmiditan, rimegepant and ubrogepant all met their primary endpoints, so the options for migraine‐targeted acute therapy will likely soon increase.
Since students and teachers spend much of their time in educational buildings, it is critical to provide good levels of indoor environmental quality (IEQ). The current COVID-19 pandemic has shown ...that maintaining a good indoor air quality level is an effective measure to control the transmission of the SARS-CoV-2 virus. This study used sensors to monitor key IEQ factors and assess several natural ventilation scenarios in a classroom of the University of Granada. Subsequently, the IEQ factors (temperature, relative humidity, CO2 concentration, acoustic environment, and air velocity) were evaluated for the selected ventilation scenarios in the occupied classroom, and the field monitoring was carried out in two different assessment periods, winter and summer. The obtained results show that the CO2 concentration levels were well below the recommended limits. However, the maintenance of the recommended thermal and acoustic IEQ factors was significantly affected by the natural ventilation strategies (temperature and relative humidity values were very close to the outside values, and the background sound pressure level was over 35 dBA during the entire assessment). The proper measurements and careful selection of the appropriate ventilation scenarios become of utmost importance to ensure that the ventilation rates required by the health authorities are achieved.
Replicative stress during embryonic development influences ageing and predisposition to disease in adults. A protective mechanism against replicative stress is provided by the licensing of thousands ...of origins in G1 that are not necessarily activated in the subsequent S-phase. These 'dormant' origins provide a backup in the presence of stalled forks and may confer flexibility to the replication program in specific cell types during differentiation, a role that has remained unexplored. Here we show, using a mouse strain with hypomorphic expression of the origin licensing factor mini-chromosome maintenance (MCM)3 that limiting origin licensing in vivo affects the functionality of hematopoietic stem cells and the differentiation of rapidly-dividing erythrocyte precursors. Mcm3-deficient erythroblasts display aberrant DNA replication patterns and fail to complete maturation, causing lethal anemia. Our results indicate that hematopoietic progenitors are particularly sensitive to replication stress, and full origin licensing ensures their correct differentiation and functionality.
La Unión Europea afronta la cuarta revolución industrial y el mercado único digital con la unificación del régimen jurídico sobre protección de datos personales pretendida por el Reglamento (UE) ...2016/679 General de protección de datos. Esta unificación es más teórica que real, toda vez que aspectos formales del reglamento y los materiales del contenido del derecho fundamental a la protección de datos dificultan este proceso. La entrada en vigor del Reglamento en mayo de 2018 proporcionará el primer marco legal de referencia para la implementación en las empresas de una verdadera cultura de la privacidad, de la protección de datos personales y el cumplimiento normativo en la UE.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Triphenylphosphine stabilized Pd, Cu and PdCu nanocatalysts supported on carbon nanotubes (CNTs) or phosphorus functionalised silica (P−SiO2) were prepared via a one‐pot methodology. The series of ...P−SiO2 supported catalysts evidenced metal particle sizes of metallic nanoparticles (M‐NPs) between 1 and 2.4 nm, smaller than their equivalents on CNTs (2.4–2.6 nm). Such a difference in particle size as a function of the support and the metallic composition indicated the more pronounced mediation of the CNTs support during the formation of the M‐NPs when compared to the P−SiO2 support. The series of supported catalysts were tested in the semi‐hydrogenation of alkynes providing differences in reactivity which might be correlated with the size and composition of the M‐NPs and the nature of corresponding support. The carbon supported catalysts displayed in general higher activities than those supported on silica and the bimetallic catalyst PdCu/CNTs were the most selective for the case of alkyl substituted alkynes. This catalyst could moreover be recycled several times without loss of activity nor selectivity.
A one pot methodology for the preparation for triphenylphosphine stabilized Pd, Cu and PdCu nanocatalyst supported on carabon nanotubes and phosphorus functionalised silica is presented here. The catalysts were tested in the semi‐hydrogenation of alkynes. Differences in reactivity were correlated with the particle size and composition of the nanoparticles and the nature of the support.
Migraine is a debilitating disease whose clinical and social impact is out of debate. Tolerability issues, interactions, contraindications, and inefficacy of the available medications make new ...options necessary. The calcitonin-gene-related peptide (CGRP) pathway has shown its importance in migraine pathophysiology and specific medications targeting this have become available. The first-generation CGRP receptor antagonists or gepants, have undergone clinical trials but their development was stopped because of hepatotoxicity. The new generation of gepants, however, are efficacious, safe, and well tolerated as per recent clinical trials. This led to the FDA-approval of rimegepant, ubrogepant, and atogepant. The clinical trials of the available gepants and some of the newer CGRP-antagonists are reviewed in this article.
Background
No data are available about whether Coronavirus disease 2019 (COVID‐19) pandemic have led to changes in clinical profiles or results of exercise testing once the usual activity was ...reassumed, as well as if wearing a facemask has any impact on the tests. The aim of this study is to evaluate differences in the patients referred to exercise stress testing in the context of COVID‐19 pandemic and analyse the feasibility and results of these tests wearing a facemask.
Methods
We included all patients referred for an exercise test from 1 June to 30 September 2020 and compared them with the patients attended within the same period in 2019 before and after propensity score matching. All patients referred in 2020 wore a facemask.
Results
A total of 854 patients were included: 398 in the 2020 group and 456 in 2019. No significant differences in baseline characteristics of the patients were observed, with the exception of dyspnoea, which was nearly twice as high in 2020 as compared with 2019. Regarding the results of the tests, no differences were observed, with almost 80% of maximal tests, similar functional capacity and over a 20% of positive exercise tests in both groups. These results remained after propensity score matching.
Conclusion
COVID‐19 pandemic has not changed the clinical profile of patients referred to exercise testing. In addition, performing exercise testing wearing a facemask is feasible, with no influence in functional capacity and clinical results.
PDF
