Sclerodermia

Il classico termine sclerodermia, che etimologicamente-ed erroneamente-richiama l'attenzione soltanto sulle manifestazioni cutanee della malattia

Digital ischemic necrosis in a patient with systemic sclerosis: The role of laser Doppler perfusion imaging

The impairment of microcirculation is a cardinal feature of systemic sclerosis (SSc). Raynaud's phenomenon and SSc can cause painful digital ulcers on the fi ngers or toes, with resulting complications such as serious infections, gangrene or possible amputation. This case report shows the possible role laser Doppler perfusion imaging (LDPI) could play in diagnosis and follow-up of digital arterial obstructions in SSc patients. LDPI is a non-invasive microvascular imaging technique able to provide maps of the cutaneous blood flow (CBF). We describe here the case of a woman affected by SSc who suddenly presented with pallor and pain; afterwards an area of necrosis became clearly visible at the distal phalanx of the third right fi nger. The LDPI of the dorsal surface of that fi nger showed a reduction of CBF. Selective arteriography was performed in order to assess the degree and location of the obstruction before proceeding with adventitiectomy. Following this procedure LDPI showed a normal CBF in the distal phalanx and complete healing of the necrotic area. Consequently, we can state that LDPI alone provides an indirect functional estimation of possible digital artery obstruction. Further, we can assert that the overall effect of the adventitiectomy resulted in an increase of the CBF. © 2009 by Verlag Hans Huber, Hogrefe AG, Bern

Rhinovirus-induced type I interferon responses and viral load in primary nasal epithelial cells of subjects with & without atopic rhinitis and asthma

Background: Defective type I interferon (IFN) production and consequent enhanced viral load have already been described in the bronchial epithelium of atopic asthmatic patients. The aim of the present study was to evaluate rhinovirus (RV) mediated IFN-β expression and RV load in upper airway epithelial cells of individuals with or without allergic rhinitis and asthma. Methods: Primary nasal epithelial cells were collected with the use of a curette from adults with allergic rhinitis (n=7), allergic rhinitis (n=7) and asthma and from non-allergic, healthy volunteers (n=7). Cells were exposed to 1 multiplicity of infection of RV1b or control medium. Culture supernatants and total RNA were harvested after incubation for 6-72h. RV-induced cytotoxicity was evaluated by a crystal violet colorimetric assay and by measuring lactate dehydrogenase (LDH) release in cell supernatants. RV-mediated RANTES release in cell supernatants was determined with the use of ELISA. In order to investigate viral load we evaluated the intracellular RV RNA levels by real-time PCR. RV-induced IFN-β expression was also measured by real-time PCR

Conception via in vitro fertilization and delivery by Caesarean section are associated with paediatric asthma incidence

Background: The association between perinatal factors and asthma inception is under rigorous investigation. Nevertheless, evidence of a correlation between asthma, conception via in vitro fertilization (IVF) and delivery through Caesarean section (C-section) is inconclusive. Objective: We aimed to assess the relation of asthma incidence with IVF and C-section, after controlling for several potential confounding factors. Methods: Parent-reported wheeze in the last 12 months (current), wheeze ever, physician-diagnosed asthma, method of conception, and type of delivery were recorded from questionnaires filled in by the parents of 2016 Greek children aged 9-13, (the Healthy Growth Study population). Some perinatal data were recorded from children's medical records and others were reported by parents; anthropometric measurements were also conducted in children. Results: IVF was correlated with physician-diagnosed asthma (OR = 2.25; 95% CI = 1.11-4.56), but not with current/ever wheeze after adjustment for potential confounding factors. After adjustment, C-section was also associated with asthma (OR = 1.39; 95% CI = 1.04-1.87), but not with current/ever wheeze. When the association of both IVF and C-section with asthma was examined in the same multivariate logistic regression model, it was weakened to borderline significance (OR = 2.04; 95% CI = 1-4.15 and OR = 1.34; 95% CI = 1-1.81 respectively). Conclusions and Clinical Relevance: Conception via IVF and delivery by C-section may predispose children to future asthma development. Either variable could also exert a confounding effect on the link of the other to asthma; this may partially be accountable for inconsistencies in the findings of pertinent studies. © 2013 John Wiley & Sons Ltd