Tenascin Expression in Human Placentas during FGR Affected Pregnancies and Umbilical Doppler Velocimetry Correlation

Objective: The aim of this study was to evaluate the expression of some non collagenous extracellular matrix proteins, in particular tenascin, in human placentas of intrauterine growth restricted fetuses with abnormal umbilical Doppler velocimetry. Study Design: Study group (group A) consisted of 23 pregnant women with intrauterine growth restricted fetuses, with or without preeclampsia. Control group (group B) consisted of 10 pregnant women with appropriate fetal weight for gestational age. Placental specimens were collected from biopsies obtained after cesarean delivery. Umbilical artery Doppler velocimetry was performed within four hours from delivery in all patients. Tenascin expression was studied by immunohistochemistry and western blot techniques. Results: A difference in birth weight and placental weight was found in the two groups, being lower in the study group. Umbilical artery Doppler velocimetry showed abnormal patterns in the study group and normal findings in the control one. Tenascin was strongly expressed in placentas from growth restricted fetuses, as shown by immunohistochemistry and by RT-PCR, while it was almost absent in placentas from group B. Conclusion: A relationship between abnormal Doppler patterns and tenascin distribution in growth restricted fetuses has been observed. The presence of tenascin might be considered as a placental compensatory mechanism in FGR fetuses with abnormal umbilical artery Doppler velocimetry

RAST: Clinical applications

Allergic diseases are multifactorial, heterogeneous disorders caused by the interaction of environmental and genetic factors. Over 25% of the world's population suffer from allergic diseases including asthma, allergic rhinitis, eczema, and drug reactions. In recent years, the prevalence of allergic diseases has increased annually throughout the world seriously affecting the quality of life of the patients, and creating a serious burden on both health and society. Such conditions constitute a challenge for both public health organizations and healthcare providers. The pathogenesis of allergic diseases has generally been considered to be driven by immunity, including IgE overproduction, IgE receptor abnormality, and Th2-skewed Th cell differentiation. The present review aims to critically analyze the potential and the applicability of the radioallergosorbent test (RAST) in the diagnostic process of allergic skin diseases. This is a very intricate and complex process which should has to be founded on patients' medical history. However, the patient and family's own perceptions and knowledge may influence history so laboratory studies represent a very informative tool in the diagnosis of allergic skin diseases. In particular, in vivo methods, such as prick test, often represent the first choice because they are not expensive, immediate and not invasive. Therefore, alternative in vitro methods like RAST are preferred in particular conditions, including severe eczema or when there is persistent dermatographism

RAST: Clinical applications

Allergic diseases are multifactorial, heterogeneous disorders caused by the interaction of environmental and genetic factors. Over 25% of the world's population suffer from allergic diseases including asthma, allergic rhinitis, eczema, and drug reactions. In recent years, the prevalence of allergic diseases has increased annually throughout the world seriously affecting the quality of life of the patients, and creating a serious burden on both health and society. Such conditions constitute a challenge for both public health organizations and healthcare providers. The pathogenesis of allergic diseases has generally been considered to be driven by immunity, including IgE overproduction, IgE receptor abnormality, and Th2-skewed Th cell differentiation. The present review aims to critically analyze the potential and the applicability of the radioallergosorbent test (RAST) in the diagnostic process of allergic skin diseases. This is a very intricate and complex process which should has to be founded on patients' medical history. However, the patient and family's own perceptions and knowledge may influence history so laboratory studies represent a very informative tool in the diagnosis of allergic skin diseases. In particular, in vivo methods, such as prick test, often represent the first choice because they are not expensive, immediate and not invasive. Therefore, alternative in vitro methods like RAST are preferred in particular conditions, including severe eczema or when there is persistent dermatographism

Managing Moderate-to-Severe Psoriasis in the Elderly.

Managing psoriasis in the elderly can be difficult for physicians, who must consider comorbidities, the resulting polypharmacy, and progressive functional impairment of several organs. Indeed, topical agents are the first-line treatment for limited disease. Phototherapy is recommended if topical drugs are not sufficient and the patient has multiple comorbidities and risk factors that make them a poor candidate for an oral or injectable systemic agent. The most important pharmacokinetic alteration in the elderly population is the decreased excretory capacity of the kidney; thus, cyclosporine should be considered a last resort treatment, and the administered dose of methotrexate should be lowered according to the reduction in estimated creatinine clearance. Acitretin can be used in the absence of severe renal insufficiency, paying attention to lipid profile, treating eventual hyperlipidemia, and closely monitoring liver enzymes. Available data on biological drugs in the elderly are limited. Biologics are associated with a small but significant overall risk of infections. However, there is no convincing evidence that the relative risk of infection with anti-tumor necrosis factor (TNF)-α therapy increases with age. Nevertheless, the package inserts for biologics recommend caution when administering these medications to the geriatric population, due to the high baseline risk of infection in such patients. Etanercept seems to be well tolerated, possibly because of its lower immunosuppressive characteristics compared with other biologics. However, studies with larger sample sizes are needed to confirm its safety