Introduction: Neuromyelitis optica is an inflammatory and usually relapsing demyelinating autoimmune disease of the central nervous system that targets the optic nerves and spinal cord. Rituximab has been used for different neurological diseases that are probably immunemediated or involving humoral immunity. The objective of this study is to evaluate the efficacy and safety of rituximab as treatment for neuromyelitis optica in a tertiary hospital. Methods:Retrospective study of patients with neuromyelitis optica treated with rituximab 1000 mg on days 1 and 15, repeated every 6-8 months. We recorded EDSS score, relapse rate, overall condition, CD19+ count, presence of anti-NMO antibodies, and possible adverse reactions.Results: Six patients were treated; all were women with a median age of 46 years (range 38-58). Anti-NMO antibodies were detected in 3 patients (50%). Baseline EDSS was 4 (range 2.0-5.5). Two patients had previously been treated with an immunomodulatory drug. Median time from the first rituximab infusion to first relapse was 3.7 years (range 1.7-6.9). Two patients had infusion reactions after the first dose of rituximab. Four patients remained relapse-free and their EDSS score did not progress during rituximab treatment, one patient showed no clinical improvement, and one patient could not be evaluated.Conclusion: Rituximab can be considered an attractive therapeutic alternative for patients with neuromyelitis optica as there are no approved treatments for this disease. Further studies with rituximab are needed to establish the role of this drug in treating neuromyelitis optica. Evaluación del uso de rituximab en la neuromielitis óptica ResumenIntroducción: La neuromielitis óptica es un trastorno autoinmune, inflamatorio y desmielinizante del sistema nervioso central que afecta a la médula espinal y al nervio óptico, de carácter recurrente. Rituximab ha sido utilizado en el tratamiento de varias enfermedades neurológicas de probable naturaleza autoinmune o donde la inmunidad humoral estaba implicada. El objetivo de este estudio es evaluar la eficacia y seguridad de rituximab en el tratamiento de la neuromielitis óptica en un hospital terciario.Métodos: Estudio retrospectivo de pacientes con neuromielitis óptica tratadas con 2 infusiones de rituximab 1.000 mg separadas por 15 días, cada 6-8 meses. Se evaluó la puntuación EDSS, la existencia de brotes, el estado general, el recuento de CD19+, la presencia de anticuerpos anti-NMO y las reacciones adversas.Resultados: Se trataron 6 pacientes, todas mujeres (mediana de edad 46 años; rango 38-58).En 3 de ellas (50%) se detectó la presencia de anticuerpos anti-NMO. La EDSS basal fue de 4 (rango 2-5,5). Dos pacientes recibieron previamente algún fármaco inmumodulador. La mediana desde el primer brote hasta el tratamiento con rituximab fue de 3,7 años (rango 1,7-6,9); 2 pacientes presentaron alguna reacción adversa tras la primera infusión del fármaco. En cuanto a la respuesta, 4 pacientes no volvieron a tener brotes y su EDSS no progresó, en una paciente no...

reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. carbon dioxide 30 [27][28][29][30][31][32][33][34][35] mmHg and median temperature 37.1 [36.8-37.3]°C. After removal of artefacts, the mean monitoring time was 22 h08 (8 h54). All patients had impaired cerebral autoregulation during their monitoring time. The mean IAR index was 17 (9.5) %. During H 0 H 6 and H 18 H 24 , the majority of our patients; respectively 53 and 71 % had an IAR index > 10 %. Conclusion According to our data, patients with septic shock had impaired cerebral autoregulation within the first 24 hours of their admission in the ICU. In our patients, we described a variability of distribution of impaired autoregulation according to time. ReferencesSchramm P, Klein KU, Falkenberg L, et al. Impaired cerebrovascular autoregulation in patients with severe sepsis and sepsis-associated delirium. Crit Care 2012; 16: R181. Aries MJH, Czosnyka M, Budohoski KP, et al. Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury. Crit. Care Med. 2012.

Haemodialysis reduces serum levetiracetam concentration and can lead to subtherapeutic levels. Close monitoring is necessary when dialysis is used on patients receiving anticonvulsant drugs that are extensively eliminated by the procedure.

Taking into account that joint administration of oral iron and cyclosporine modified can generate a physicochemical interaction that involves a decrease in the absorption of cyclosporine modified, we believe that it is necessary to recommend spacing administrations of both drugs as well as monitoring levels of cyclosporine in order to ensure optimal levels of immunosuppression.

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