Valutazione dell'efficacia e della sicurezza dell'Infliximab e della Ciclosporina Orale Microemulsione (Neoral) nei pazienti con colite ulcerosa severa refrattari agli steroidi per via endovenosa. Risultati preliminari di uno studio randomizzato controllato

Background. Intravenous steroids represent the mainstay of therapy for severe attacks of Ulcerative Colitis (UC). In steroid refractory patients, both iv cyclosporine (CsA) and infliximab (IFX) are valid rescue therapies. Several studies have shown that oral microemulsion CsA (Neoral) is equivalent to iv CsA in term of safety and efficacy in UC patients. Aim. To investigate the efficacy and safety of oral microemulsion CsA vs IFX in patients with severe attack of UC, refractory to iv steroids. Material and methods. From May 2006, all consecutive pts admitted for severe UC were considered eligible. Pts were treated with iv steroid, according to the Oxford regime. After 1 week of intensive treatment, pts non responder to the therapy and not candidate to the surgery, were asked to participate to the trial. They were randomised to receive IFX 5 mg/kg or oral CsA 5 mg/kg. Results. A total of 30 patients were randomised, 17 in the IFX group and 13 in the CsA group. One month after study inclusion, 9 patients of the IFX group (53%) and 7 pts of the CsA group (54%) were in clinical remission (p=0.96), with a Powell-Tuck index ≤ 3. At the end of the follow-up, 7 pts in the IFX group (41%) vs 4 in the CsA group (31%) (p=0.35) underwent colectomy. The total cost of the IFX therapy with IFX was 8.052,84 € versus 1.106,82 €, for each patient. Conclusions. Oral microemulsion CsA and IFX seem to be equivalent in term of efficacy and safety in severe UC patients refractory to iv steroids. In patients treated with IFX the cost of therapy were significantly higher.

Catalysts and processes for next-generation H2 production

The present study is focused on the development of new VIII group metal on CeO2 – ZrO2 (CZO) catalyst to be used in reforming reaction for syngas production. The catalyst are tested in the oxyreforming process, extensively studied by Barbera [44] in a new multistep process configuration, with intermediate H2 membrane separation, that can be carried out at lower temperature (750°C) with respect the reforming processes (900 – 1000°C). In spite of the milder temperatures, the oxy-reforming conditions (S/C = 0.7; O2/C = 0.21) remain critical regarding the deactivation problems mainly deriving from thermal sintering and carbon formation phenomena. The combination of the high thermal stability characterizing the ZrO2, with the CeO2 redox properties, allows the formation of stable mixed oxide system with high oxygen mobility. This feature can be exploited in order to contrast the carbon deposition on the active metal surface through the oxidation of the carbon by means of the mobile oxygen atoms available at the surface of the CZO support. Ce0.5Zr0.5O2 is the phase claimed to have the highest oxygen mobility but its formation is difficult through classical synthesis (co-precipitation), hence a water-in-oil microemulsion method is, widely studied and characterized. Two methods (IWI and bulk) for the insertion of the active metal (Rh, Ru, Ni) are followed and their effects, mainly related to the metal stability and dispersion on the support, are discussed, correlating the characterization with the catalytic activity. Different parameters (calcination and reduction temperatures) are tuned to obtain the best catalytic system both in terms of activity and stability. Interesting results are obtained with impregnated and bulk catalysts, the latter representing a new class of catalysts. The best catalysts are also tested in a low temperature (350 – 500°C) steam reforming process and preliminary tests with H2 membrane separation have been also carried out.