Certolizumab for the treatment of psoriasis and psoriatic arthritis: a real-world multicentre Italian study.

BACKGROUND: Certolizumab, a pegylated tumour necrosis factor-α inhibitor, reduced disease activity in randomized trials of patients with psoriasis and psoriatic arthritis. Real-life data are missing. OBJECTIVE: To confirm the effectiveness and safety of certolizumab in patients with psoriasis and psoriatic arthritis in routine clinical practice. METHODS: In this retrospective study involving 11 Italian sites, patients with psoriasis and psoriatic arthritis received subcutaneous certolizumab (400 mg loading dose at 0, 2 and 4 weeks, followed by 200 mg every 2 weeks) for up to 52 weeks. Primary outcomes included mean change from baseline in Psoriasis Area and Severity Index (PASI) and modified Nail Psoriasis Severity Index (mNAPSI) scores, and the proportion of patients achieving a 75%, 90% or 100% reduction in PASI score. Other endpoints included Disease Activity Score computed on 44 joints correlated with the erythrocyte sedimentation rate during the first hour (DAS44-ESR), Tender Joint Count (TJC), Swollen Joint Count (SJC), pain [visual analogue scale (VAS) score], inflammatory markers and quality of life (QOL). RESULTS: In the study were enrolled 153 patients (mean age: 55 years). Certolizumab reduced the mean PASI score from baseline by 4.45, 6.30 and 7.58 at weeks 12, 24 and 52, respectively (P < 0.001 for all). At weeks 24 and 52, 69.6% and 83.3% of patients had a PASI score ≤3. DAS44-ESR, TJC, SJC and mNAPSI scores, and pain VAS were also all significantly improved from baseline at each time point. C-reactive protein levels decreased during treatment, being significant at week 24. On multivariate analysis, psoriasis duration, baseline PASI, mNAPSI and pain VAS scores were found to be predictive of the improvement in PASI score at week 12. CONCLUSION: Certolizumab displayed also in the real-life encouraging results in both psoriasis and psoriatic arthritis patients.

Vascular patterns in basal cell carcinoma.

BACKGROUND: Dermoscopy has been proved to increase the diagnostic accuracy of basal cell carcinoma (BCC). OBJECTIVE: To characterize the type and frequency of vascular patterns in superficial and nodular BCCs. METHODS: We retrospectively analysed the dermoscopic images of 504 histopathologically proven BCCs. RESULTS: The most common vascular pattern was represented by arborizing vessels (306/504; 60.7%), which were significantly more frequent in nodular BCCs (nBCCs) compared with superficial BCCs (sBCCs), and in pigmented sBCCs vs. non-pigmented sBCCs (P<0.0001). Short fine telangectasias (SFTs) were found in 33.1% (167/504) of cases and were significantly more frequent in sBCCs compared with nBCCs (P<0.0001). Hairpin vessels were detected in 52/504 (10.3%) BCCs. Minor vascular patterns included glomerular vessels (41/504; 8.1%), dotted (21/504; 4.2%), comma vessels (5/504; 1.0%) and polymorphous pattern (9/504; 1.8%). CONCLUSIONS: Arborizing vessels are prototypic of nBCCs, whereas SFTs are characteristics of sBCCs. Differential diagnosis with squamous cell carcinoma or melanoma is mandatory when a polymorphous pattern is detected.

Comparison of methods for thiamin and riboflavin nutriture in man.

Thiamin and riboflavin nutriture were assessed in 127 apparently healthy individuals aged between 20 and 82 yr, living in small villages near the town of Gubbio. The methods of erythrocyte transketolase activity and HPLC determination of thiamin pyrophosphate (TPP) for thiamin and erythrocyte glutathione reductase and HPLC determination of flavin adenine dinucleotide (FAD) for riboflavin were used. A significant correlation between enzymatic and HPLC methods was found. This was not the case for the correlation between status test and vitamin intake, particularly for thiamin. The vitamer determination in blood by HPLC can be considered a reliable, fast and reasonably accurate method for long-term thiamin and riboflavin nutritional status assessment.

A nutrition study involving a group of pregnant women in Assisi, Italy. Part 1: Anthropometry, dietary intake and nutrition knowledge, practices and attitudes.

A study was conducted on a group of full term pregnant women in the gynaecology and obstetrics ward of the Assisi Hospital. The study included the anthropometric evaluation and a survey including information on eating habits, life styles, nutrition knowledge, food preferences and aversions during pregnancy, use of oral contraceptives, and cigarette smoking. A subset of 20 pregnant women was examined periodically from the beginning of the 2nd trimester until the end of pregnancy to ascertain anthropometric status and food consumption. In the same hospital the anthropometric measurements of 83 newborns were taken. In some cases there was a relatively small weight gain and therefore gain in body fat during pregnancy (6.3 kg), with obvious effects on the weight of their respective newborns. Eating habits showed notable quantitative and qualitative irrationalities and nutrition knowledge was poor. Oral contraceptives were not widely used.