ABSTRACT
A previous report on 814 patients who were coronavirus disease 2019 (COVID-19) positive provided preliminary therapeutic efficacy evidence with interferon-α2b (IFN-α2b) in Cuba, from March 11 to April 14, 2020. This study re-evaluates the effectiveness of IFN-α2b during the period from March 11 to June 17, 2020. Patients received a combination of oral antivirals (lopinavir/ritonavir and chloroquine) with intramuscular or subcutaneous administration of IFN-α2b. The primary endpoint was the proportion of patients discharged from the hospital; the secondary endpoint was the case fatality rate, and several outcomes related to time variables were also evaluated. From March 11 to June 17, 2,295 patients had been confirmed to be severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive in Cuba, 2,165 were treated with Heberon® Alpha R, and 130 received the approved protocol without IFN. The proportion of fully recovered patients was higher in the IFN-treated compared with the non-IFN-treated group. Prior IFN treatment decreases the likelihood of intensive care and increases the survival after severe or critical diseases. Benefits of IFN were significantly supported by time variables analyzed. This second report confirmed our preliminary evidence about the therapeutic effectiveness of IFN-α2b in SARS-CoV-2 infection and postulated Heberon Alpha R as the main component within antiviral drugs used in the Cuban protocol COVID-19.
Subject(s)
COVID-19/therapy , Interferon alpha-2/therapeutic use , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Chloroquine/administration & dosage , Comorbidity , Critical Care , Cuba/epidemiology , Drug Therapy, Combination , Female , Humans , Infant , Infant, Newborn , Kaplan-Meier Estimate , Lopinavir/administration & dosage , Male , Middle Aged , Retrospective Studies , Ritonavir/administration & dosage , Treatment Outcome , Young AdultABSTRACT
A prospective observational study was conducted for assessing the therapeutic efficacy of interferon (IFN)-α2b in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the first month after the coronavirus disease 2019 (COVID-19) outbreak began in Cuba. From March 11th to April 14th, 814 patients were confirmed SARS-CoV-2 positive in Cuba. Seven hundred sixty-one (93.4%) were treated with a combination of oral antivirals (lopinavir/ritonavir and chloroquine) with intramuscular administration of IFN-α2b (Heberon® Alpha R, Center for Genetic Engineering and Biotechnology, Havana, Cuba), 3 times per week, for 2 weeks. Fifty-three patients received the approved COVID protocol without IFN treatment. The proportion of patients discharged from hospital (without clinical and radiological symptoms and nondetectable virus by real-time polymerase chain reaction) was higher in the IFN-treated compared with the non-IFN treated group (95.4% vs. 26.1%, P < 0.01). The case fatality rate (CFR) for all patients was 2.95%, and for those patients who received IFN-α2b the CFR was reduced to 0.92. Intensive care was required for 82 patients (10.1%), 42 (5.5%) had been treated with IFN. This report provides preliminary evidence for the therapeutic effectiveness of IFN-α2b for COVID-19 and suggests that the use of Heberon Alpha R may contribute to complete recovery of patients.
Subject(s)
Antiviral Agents/therapeutic use , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Interferon-alpha/therapeutic use , Pneumonia, Viral/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , Child, Preschool , Chloroquine/therapeutic use , Coronavirus Infections/mortality , Cuba , Drug Therapy, Combination , Female , Humans , Infant , Interferon alpha-2 , Lopinavir/therapeutic use , Male , Middle Aged , Pandemics , Pneumonia, Viral/mortality , Prospective Studies , Ritonavir/therapeutic use , SARS-CoV-2 , Young AdultABSTRACT
Se expone el caso de una mujer de 46 años, que acude a la consulta por asimetría mamaria y masa palpable a la exploración. Se realizó mamografía, ecografía, PAAF/BAG, que se complementó con resonancia magnética (RM) (secuencias turbo-spin eco potenciadas en T2 y estudio dinámico 3D con secuencia SPGE potenciada en T1 con contraste paramagnético extracelular). En la RM el tumor presentó una estructura heterogénea muy aproximada al aspecto macroscópico de la lesión, y la RM aportó información sobre el comportamiento funcional. Se presentan las características morfológicas y el estudio funcional de la lesión, así como la correlación entre las distintas técnicas de imagen y el estudio anatomopatológico
We present the case of a 46 year old woman who comes to the consultation due to mammary asymmetry and palpable mass on examination. We performed a mammography, ultrasonography, FNAP/core biopsy, completing it with magnetic resonance imaging (MRI) (T2 weighted turbo-spin sequences and 3D dynamic study with a T1 weighted SPGE sequence with extracellular paramagnetic contrast). In the MRI, the tumor showed a heterogeneous structure that was close to the macroscopic aspect of the lesion, the MRI supplying information on the functional behavior. We present the morphological characteristics and functional study of the lesion and the correlation between the different imaging techniques and the pathology study
Subject(s)
Female , Middle Aged , Humans , Hemangiosarcoma/diagnosis , Breast Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Magnetic Resonance Spectroscopy/methods , Mammography/methods , Ultrasonography, Mammary/methodsABSTRACT
Proponemos un protocolo de estudio de resonancia magnética (RM) que optimiza la valoración de los injertos de Ligamento Cruzado Anterior (LCA) de la rodilla. Se estudiaron 12 rodillas con una plastia de tendón rotuliano hueso-tendón-hueso, al protocolo habitual se añadieron planos oblicuos siguiendo la dirección del injerto, planos coronales y secuencias tras la adminsitración de gadolinio. En ocho pacientes se mejoró la visualización del injerto en los planos oblicuos. Se observó un realce periférico del injerto en ocho casos, favoreciendo la visualización de su límite en cuatro de ellos, y en dos pacientes con exploración anormal se constató un tejido vascularizado hipertrófico. En los planos coronales se demostró en un caso el espacio intercondíleo estrecho. Existen diferencias morfológicas entre una ligamentoplastía y un LCA nativo que dificultan su estudio mediante RM. La introducción de secuencias oblicuas y con gadolinio puede favorecer su visualización. Es necesario complementarlo con planos coronales para estudiar su relaciones con estructuras laterales
