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Article ; Online: Interleukin-1 and interleukin-6 inhibition in patients with COVID-19 and hyperinflammation.

Salvatierra, Juan / Aomar-Millán, Ismael Francisco / Hernández-Quero, José

The Lancet. Rheumatology

2021 Volume 3, Issue 4, Page(s) e248

Language	English
Publishing date	2021-03-08
Publishing country	England
Document type	Journal Article
ISSN	2665-9913
ISSN (online)	2665-9913
DOI	10.1016/S2665-9913(21)00064-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Anakinra, una alternativa potencial en el tratamiento de la infección respiratoria grave por SARS-CoV-2 refractaria a tocilizumab: comentario.

Aomar-Millán, Ismael Francisco / Salvatierra, Juan / Callejas-Rubio, José Luis / Raya-Álvarez, Enrique

Reumatologia clinica

2022 Volume 19, Issue 2, Page(s) 120–121

Title translation	Anakinra as a potential alternative in the treatment of severe acute respiratory infection associated with SARS-CoV-2 refractory to tocilizumab: coment.
Language	Spanish
Publishing date	2022-02-10
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2231357-6
ISSN	1885-1398 ; 1699-258X
ISSN (online)	1885-1398
ISSN	1699-258X
DOI	10.1016/j.reuma.2022.01.003
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Article ; Online: Anakinra as a potential alternative in the treatment of severe acute respiratory infection associated with SARS-CoV-2 refractory to tocilizumab: comment.

Aomar-Millán, Ismael Francisco / Salvatierra, Juan / Callejas-Rubio, José Luis / Raya-Álvarez, Enrique

Reumatologia clinica

2022 Volume 19, Issue 2, Page(s) 120–121

MeSH term(s)	Humans ; SARS-CoV-2 ; Interleukin 1 Receptor Antagonist Protein/therapeutic use ; COVID-19/complications ; COVID-19 Drug Treatment
Chemical Substances	Interleukin 1 Receptor Antagonist Protein ; tocilizumab (I031V2H011)
Language	English
Publishing date	2022-06-22
Publishing country	Spain
Document type	Letter
ISSN	2173-5743
ISSN (online)	2173-5743
DOI	10.1016/j.reumae.2022.06.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Anakinra after treatment with corticosteroids alone or with tocilizumab in patients with severe COVID‑19 pneumonia and moderate hyperinflammation. A retrospective cohort study: reply.

Aomar-Millán, Ismael Francisco / Salvatierra, Juan / Hernández-Quero, José

Internal and emergency medicine

2021 Volume 16, Issue 4, Page(s) 1105–1106

MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Antibodies, Monoclonal, Humanized ; COVID-19/drug therapy ; Humans ; Interleukin 1 Receptor Antagonist Protein/therapeutic use ; Pneumonia/drug therapy ; Retrospective Studies ; SARS-CoV-2
Chemical Substances	Adrenal Cortex Hormones ; Antibodies, Monoclonal, Humanized ; Interleukin 1 Receptor Antagonist Protein ; tocilizumab (I031V2H011)
Language	English
Publishing date	2021-03-10
Publishing country	Italy
Document type	Letter ; Comment
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-021-02690-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Glucocorticoides solos versus tocilizumab solo o glucocorticoides más tocilizumab en pacientes con neumonía grave por SARS-CoV-2 e inflamación moderada.

Aomar-Millán, Ismael Francisco / Salvatierra, Juan / Torres-Parejo, Úrsula / Nuñez-Nuñez, María / Hernández-Quero, José / Anguita-Santos, Francisco

Medicina clinica

2021 Volume 156, Issue 12, Page(s) 602–605

Abstract: Aim: To assess clinical outcomes according to the immunosuppressive treatment administered to patients with severe SARS-CoV-2 pneumonia and moderate inflammation.: Methods: A retrospective observational cohort study involving 142 patients with severe ...

Title translation	Glucocorticoids alone versus tocilizumab alone or glucocorticoids plus tocilizumab in patients with severe SARS-CoV-2 pneumonia and mild inflammation.
Abstract	Aim: To assess clinical outcomes according to the immunosuppressive treatment administered to patients with severe SARS-CoV-2 pneumonia and moderate inflammation. Methods: A retrospective observational cohort study involving 142 patients with severe COVID-19 pneumonia and moderate inflammation divided into three treatment groups (pulses of methylprednisolone alone [groupI], tocilizumab alone [groupII] and methylprednisolone plus tocilizumab [groupIII]). The aim was to assess intergroups differences in the clinical course with a 60-day follow-up and related analytical factors. Results: 14 patients (9,8%) died: 8 (10%) in groupI and 6 (9,5%) in groupsII andIII. 15 (10,6%) were admitted to ICU: 2 (2,5%) from groupI, 4 (28,5%) from groupII and 9 (18,4%) from groupIII. The mean hospital stay was longer in groupII and clinical outcome was not associated with treatment. Conclusions: Tocilizumab seems to be not associated with better clinical outcomes and should be reserved for clinical trial scenario, since its widespread use may result in higher rate of ICU admission and longer mean hospital stay without differences in mortality rate and potentially adverse events.
MeSH term(s)	Antibodies, Monoclonal, Humanized ; COVID-19/drug therapy ; Glucocorticoids/therapeutic use ; Humans ; Inflammation ; Retrospective Studies ; SARS-CoV-2 ; Treatment Outcome
Chemical Substances	Antibodies, Monoclonal, Humanized ; Glucocorticoids ; tocilizumab (I031V2H011)
Language	Spanish
Publishing date	2021-01-28
Publishing country	Spain
Document type	Case Reports ; Observational Study
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2021.01.006
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Article ; Online: Glucocorticoids alone versus tocilizumab alone or glucocorticoids plus tocilizumab in patients with severe SARS-CoV-2 pneumonia and mild inflammation.

Aomar-Millán, Ismael Francisco / Salvatierra, Juan / Torres-Parejo, Úrsula / Nuñez-Nuñez, María / Hernández-Quero, José / Anguita-Santos, Francisco

Medicina clinica (English ed.)

2021 Volume 156, Issue 12, Page(s) 602–605

Abstract	Aim: To assess clinical outcomes according to the immunosuppressive treatment administered to patients with severe SARS-CoV-2 pneumonia and moderate inflammation. Methods: A retrospective observational cohort study involving 142 patients with severe COVID-19 pneumonia and moderate inflammation divided into three treatment groups (pulses of methylprednisolone alone [group I], tocilizumab alone [group II] and methylprednisolone plus tocilizumab [group III]). The aim was to assess intergroups differences in the clinical course with a 60-day follow-up and related analytical factors. Results: 14 patients (9,8%) died: 8 (10%) in group I and 6 (9,5%) in groups II and III. 15 (10,6%) were admitted to ICU: 2 (2,5%) from group I, 4 (28,5%) from group II and 9 (18,4%) from group III. The mean hospital stay was longer in group II and clinical outcome was not associated with treatment. Conclusions: Tocilizumab seems to be not associated with better clinical outcomes and should be reserved for clinical trial scenario, since its widespread use may result in higher rate of ICU admission and longer mean hospital stay without differences in mortality rate and potentially adverse events.
Language	English
Publishing date	2021-05-24
Publishing country	Spain
Document type	Case Reports
ISSN	2387-0206
ISSN (online)	2387-0206
DOI	10.1016/j.medcle.2021.01.004
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Characteristics and clinical outcome in 312 patients with moderate to severe pneumonia due to SARS-COV-2 and hyperinflammation treated with anakinra and corticosteroids: A retrospective cohort study.

Aomar-Millán, Ismael Francisco / de Victoria-Carazo, Javier Martínez / Fernández Reyes, Daniel / Torres-Parejo, Úrsula / Pérez Fernández, Laura / Martínez-Diz, Silvia / Ceballos Torres, Angel / López Gómez, Jairo / Bizzarri, Francesco / Raya Álvarez, Enrique / Salvatierra, Juan

PloS one

2023 Volume 18, Issue 3, Page(s) e0283529

Abstract: Objective: To assess the clinical outcome (death and/or Intensive Care Unit (ICU) admission) based on the time from hospital admission to the administration of anakinra and the possible usefulness of a "simplified" SCOPE score to stratify the risk of ... ...

Abstract	Objective: To assess the clinical outcome (death and/or Intensive Care Unit (ICU) admission) based on the time from hospital admission to the administration of anakinra and the possible usefulness of a "simplified" SCOPE score to stratify the risk of worse prognosis in our cohort of patients with moderate/severe SARS-CoV-2 pneumonia, both vaccinated and unvaccinated, that received anakinra and corticosteroids. In addition, the clinical, analytical, and imaging characteristics of patients at admission are described. Methods: Retrospective cohort study of 312 patients admitted to Hospital Clínico San Cecilio in Granada for moderate/severe pneumonia caused by SARS-CoV-2 that received anakinra and corticosteroids between March 2020 and January 2022. Clinical and analytical data were collected as well as the patient outcome at 30 and 60 days after admission. Three treatment groups were established according to the time from hospital admission to administration of anakinra: early (1st-2nd day), intermediate (3rd-5th day), and late (after the 5th day). Results: The median age was 67.4 years (IQR 22-97 years) and 204 (65.4%) were male. The most common comorbidity was hypertension (58%). The median time from the start of symptoms to anakinra administration was 6 days (IQR 5-10) and the SaFi (SaO2/FiO2) was 228 (IQR 71-471). The cure rate was higher in the early-onset anakinra group versus the late-onset group (73% vs 56.6%). The latter had a higher percentage of deaths (27.4%) and a greater number of patients remained hospitalized for a month (16%). On admission, the patients had elevated C-reactive protein (CRP), ferritin, and D-dimer values and decreased total lymphocytes. Analytical improvement was observed at both 72 hours and one month after treatment. 42 (13.5%) required ICU admission, and 23 (7.3%) orotracheal intubation. At 60 days, 221 (70.8%) were discharged, 87 (27.8%) had died and 4 (1.4%) remained hospitalized. The mean dose of anakinra was 1000 mg (100-2600 mg) with differences found between the dose administered and the clinical outcome. There were no differences in the primary outcome based on vaccination. A simplified SCOPE score at the start of anakinra administration was lower in patients with better clinical evolution. Conclusions: Early treatment with anakinra and corticosteroids was associated with a better outcome regardless of vaccination status. A simplified SCOPE was found to be a good prognostic tool.
MeSH term(s)	Humans ; Male ; Aged ; Female ; SARS-CoV-2 ; COVID-19 ; Interleukin 1 Receptor Antagonist Protein/therapeutic use ; Retrospective Studies ; Adrenal Cortex Hormones/therapeutic use ; Treatment Outcome
Chemical Substances	Interleukin 1 Receptor Antagonist Protein ; Adrenal Cortex Hormones
Language	English
Publishing date	2023-03-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0283529
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Anakinra after treatment with corticosteroids alone or with tocilizumab in patients with severe COVID-19 pneumonia and moderate hyperinflammation. A retrospective cohort study.

Aomar-Millán, Ismael Francisco / Salvatierra, Juan / Torres-Parejo, Úrsula / Faro-Miguez, Naya / Callejas-Rubio, José Luis / Ceballos-Torres, Ángel / Cruces-Moreno, María Teresa / Gómez-Jiménez, Francisco Javier / Hernández-Quero, José / Anguita-Santos, Francisco

Internal and emergency medicine

2021 Volume 16, Issue 4, Page(s) 843–852

Abstract: Introduction: Little evidence appears to exist for the use of anakinra, a recombinant interleukin-1 receptor antagonist, after non-response to treatment with corticosteroids alone or combined with tocilizumab in patients with severe COVID-19 pneumonia ... ...

Abstract	Introduction: Little evidence appears to exist for the use of anakinra, a recombinant interleukin-1 receptor antagonist, after non-response to treatment with corticosteroids alone or combined with tocilizumab in patients with severe COVID-19 pneumonia and moderate hyperinflammatory state. Patients and methods: A retrospective observational cohort study was carried out involving 143 patients with severe COVID-19 pneumonia and moderate hyperinflammation. They received standard therapy along with pulses of methylprednisolone (group 1) or methylprednisolone plus tocilizumab (group 2), with the possibility of receiving anakinra (group 3) according to protocol. The aim of this study was to assess the role of anakinra in the clinical course (death, admission to the intensive care ward) during the first 60 days after the first corticosteroid pulse. Clinical, laboratory, and imaging characteristics as well as infectious complications were also analyzed. Results: 74 patients (51.7%) in group 1, 59 (41.3%) patients in group 2, and 10 patients (7%) in group 3 were included. 8 patients (10.8%) in group 1 died, 6 (10.2%) in group 2, and 0 (0%) in group 3. After adjustment for age and clinical severity indices, treatment with anakinra was associated with a reduced risk of mortality (adjusted hazard ratio 0.518, 95% CI 0.265-0.910; p = 0.0437). Patients in group 3 had a lower mean CD4 count after 3 days of treatment. No patients in this group presented infectious complications. Conclusions: In patients with moderate hyperinflammatory state associated with severe COVID-19 pneumonia, treatment with anakinra after non-response to corticosteroids or corticosteroids plus tocilizumab therapy may be an option for the management of these patients and may improve their prognosis.
MeSH term(s)	Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Humanized/administration & dosage ; Antirheumatic Agents/administration & dosage ; COVID-19/complications ; COVID-19/mortality ; Drug Therapy, Combination ; Female ; Glucocorticoids/administration & dosage ; Humans ; Interleukin 1 Receptor Antagonist Protein/administration & dosage ; Male ; Methylprednisolone/administration & dosage ; Middle Aged ; Retrospective Studies ; Spain ; Survival Rate ; Treatment Outcome ; COVID-19 Drug Treatment
Chemical Substances	Antibodies, Monoclonal, Humanized ; Antirheumatic Agents ; Glucocorticoids ; Interleukin 1 Receptor Antagonist Protein ; tocilizumab (I031V2H011) ; Methylprednisolone (X4W7ZR7023)
Language	English
Publishing date	2021-01-05
Publishing country	Italy
Document type	Journal Article ; Observational Study
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-020-02600-z
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Article ; Online: Characteristics and clinical outcome in 312 patients with moderate to severe pneumonia due to SARS-COV-2 and hyperinflammation treated with anakinra and corticosteroids

Ismael Francisco Aomar-Millán / Javier Martínez de Victoria-Carazo / Daniel Fernández Reyes / Úrsula Torres-Parejo / Laura Pérez Fernández / Silvia Martínez-Diz / Angel Ceballos Torres / Jairo López Gómez / Francesco Bizzarri / Enrique Raya Álvarez / Juan Salvatierra

PLoS ONE, Vol 18, Iss 3, p e

A retrospective cohort study.

2023 Volume 0283529

Abstract: Objective To assess the clinical outcome (death and/or Intensive Care Unit (ICU) admission) based on the time from hospital admission to the administration of anakinra and the possible usefulness of a "simplified" SCOPE score to stratify the risk of ... ...

Abstract	Objective To assess the clinical outcome (death and/or Intensive Care Unit (ICU) admission) based on the time from hospital admission to the administration of anakinra and the possible usefulness of a "simplified" SCOPE score to stratify the risk of worse prognosis in our cohort of patients with moderate/severe SARS-CoV-2 pneumonia, both vaccinated and unvaccinated, that received anakinra and corticosteroids. In addition, the clinical, analytical, and imaging characteristics of patients at admission are described. Methods Retrospective cohort study of 312 patients admitted to Hospital Clínico San Cecilio in Granada for moderate/severe pneumonia caused by SARS-CoV-2 that received anakinra and corticosteroids between March 2020 and January 2022. Clinical and analytical data were collected as well as the patient outcome at 30 and 60 days after admission. Three treatment groups were established according to the time from hospital admission to administration of anakinra: early (1st-2nd day), intermediate (3rd-5th day), and late (after the 5th day). Results The median age was 67.4 years (IQR 22-97 years) and 204 (65.4%) were male. The most common comorbidity was hypertension (58%). The median time from the start of symptoms to anakinra administration was 6 days (IQR 5-10) and the SaFi (SaO2/FiO2) was 228 (IQR 71-471). The cure rate was higher in the early-onset anakinra group versus the late-onset group (73% vs 56.6%). The latter had a higher percentage of deaths (27.4%) and a greater number of patients remained hospitalized for a month (16%). On admission, the patients had elevated C-reactive protein (CRP), ferritin, and D-dimer values and decreased total lymphocytes. Analytical improvement was observed at both 72 hours and one month after treatment. 42 (13.5%) required ICU admission, and 23 (7.3%) orotracheal intubation. At 60 days, 221 (70.8%) were discharged, 87 (27.8%) had died and 4 (1.4%) remained hospitalized. The mean dose of anakinra was 1000 mg (100-2600 mg) with differences found between the dose ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Hepatitis aguda por citomegalovirus como causa de trombosis portal y mesentérica.

Aomar Millán, Ismael Francisco / Pérez Fernández, Laura / Parejo Sánchez, María Isabel / Hernández Quero, José

Medicina clinica

2010 Volume 135, Issue 7, Page(s) 338–339

Title translation	Portal and mesenteric vein thrombosis secondary to cytomegalovirus hepatitis.
MeSH term(s)	Adult ; Cytomegalovirus Infections/complications ; Hepatitis, Viral, Human/complications ; Humans ; Male ; Mesenteric Veins ; Portal Vein ; Thrombosis/virology
Language	Spanish
Publishing date	2010-09-04
Publishing country	Spain
Document type	Case Reports ; Letter
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2009.06.003
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