What is known and objective Tocilizumab is an IL‐6 receptor inhibitor agent which has been proposed as a candidate to stop the inflammatory phase of infection by the severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2). However, safety data of tocilizumab in pregnant women and their newborn are scarce. We aimed to describe maternal and neonatal safety outcomes associated with tocilizumab treatment in pregnant women with severe COVID‐19. Methods This is a retrospective study of severe COVID‐19 pregnant women, treated with tocilizumab in two Spanish hospitals between 1 March and 31 April 2020. Demographics, medical history, clinical and radiologic findings, treatment information and laboratory data of mothers and their newborns were collected from electronic medical records. Results and discussion A total of 12 pregnant women were identified to have received tocilizumab during pregnancy in the two hospitals. Median gestational age at admission was 27.7 weeks (interquartile range, 18.0–36.4). Most of them received lopinavir/ritonavir, azithromycin and hydroxychloroquine, two patients received corticosteroids and one received interferon beta 1B. All 12 pregnancies resulted in live births. Somatometric values were normal for all newborns, and evolution at 14 and 28 days was favourable for all of them. Hepatotoxicity was observed in 2 patients, which improved or resolved at discharge. Cytomegalovirus reactivation was detected in another patient who had also received corticosteroids for 15 days, causing a congenital infection in her newborn. Both hepatotoxicity and viral reactivation adverse events were classified as possibly related to tocilizumab administration according to Naranjo's causality algorithm. What is new and conclusions It does not appear that tocilizumab has detrimental effects for the mother and newborn. Close monitoring of infections should be considered, especially if other immunosuppressive agents are used.

Experiments were conducted to investigate vaccination and dietary modification as possible prophylactic measures to minimize bacterial kidney disease (BKD) infection occurrence and severity in Atlantic Salmon. In the nutritional modification studies, a commercial diet and six diets containing various levels of calcium, magnesium, zinc, iron, copper, maganese, cobalt, iodine, and fluorine were fed to post-yearling Atlantic salmon. After administration of different diets, the fish fed the diet high in iodine (4.5 mg/kg feed) and fluorine (4.5 mg/kg) had a lower prevalence of clinical BKD (3.6%) as compared to fish fed the other experimental diets (15-24% BKD prevalence) and the commercial feed (34%). In vaccination trials, post-yearling Atlantic salmon parr administered a 0.1 ml intraperitoneal injection of formalin killed BKD cells emulsified in Freund's complete adjuvant, showed an elevated agglutinating antibody response, and almost complete absence of BKD lesion formation in kidneys.Prevention of furunculosis was achieved in salmon and trout by vaccination. Injection adminis tration of Aqua Health's "Furogen" a commercial furunculosis bacterin reduced losses from 75-83% in control animals to 2.2-10% in vaccinated fish during laboratory trials. Field evaluation of this bacterin in brook trout demonstrated reduced mortality from 36.1% in controls to 9.7% in vaccinated animals.

These figures resemble those from, similar studies carried out in other European hospitals. This is therefore a common practice resulting from the need to treat. Health authorities should encourage clinical trials so that drug therapies for children become evidence-based.

CaseA child with Niemann-Pick disease type C was started on miglustat therapy at the age of 2 years. Intrathecal administration of hydroxypropyl-β-cyclodextrin was added 5 months later. The initial dose of 175 mg was gradually increased over the first 6 months to reach 325 mg. The drug was administered every 15 days, and the patient received 43 doses. A slight delay in progression of the disease was seen during the first year of intrathecal hydroxypropyl-β-cyclodextrin. However, additional symptoms have emerged since that time, suggesting a lack of effectiveness of the drug. Our patient has shown no drug-related adverse events.ConclusionsIntrathecal hydroxypropyl-β-cyclodextrin therapy is safe, but its efficacy seems questionable in a patient with the severe infantile form of Niemann-Pick disease type C.

Knowledge of osmolality of oral liquid dosage forms in the division of neonatology enables the risk of intestinal aggression caused by enteral administration of the medication to be assessed.