Immunomodulating treatment with low dose interleukin-4, interleukin-10 and interleukin-11 in psoriasis vulgaris.

Psoriasis is a chronic inflammatory skin disease affecting approximately 2-3 percent of the world population; it is characterised by hyperproliferation and hyperplasia of the superficial layers of the epidermis. Inappropriate signals released by the immune system determine an altered keratinocyte differentiation, resulting in the formation of desquamating, thickened, inflamed and erythematous plaques. The aim of this investigation was to study the pharmacological activity and safety of three low dose cytokines, Guna-Interleukin 4, Guna-Interleukin 10 and Guna-Interleukin 11 at the concentration of 10 fg/ml in patients affected by moderate to slight psoriasis vulgaris. The multicenter, double-blind, randomized, placebo-controlled clinical trial involved 48 patients who were enrolled and followed up according to a 8-month experimental project. All patients received, according to a cross-over model, either the experimental treatment or placebo, alternatively. Globally, in the 41 evaluated patients it was observed a PASI significant reduction (Friedman test: p=0.00960). The DLQI too decreased significantly in all subjects compared to baseline (Friedman test: p=0.00007). The safety of the treatment with three low dose cytokines administered simultaneously was proved; no adverse event was reported during the whole trial.

Neonatal screening for congenital cytomegalovirus infection in preterm and small for gestational age infants.

Congenital cytomegalovirus (CMV) infection affects many organs: reticuloendothelial and central nervous system are particularly involved. Congenital CMV infection is the leading cause of non-genetic sensorineural hearing loss. Hearing impairment can be present at birth or it can occur months or even years after birth. It is as well an important risk factor for antenatal stillbirth, preterm birth and small for gestational age (SGA) condition. For these reasons we should early identify congenital CMV infection investigating at least at risk newborns such as preterm or SGA babies given that a simple and standardized method for a large scale screening program is lacking. In our study, we found an association between congenital CMV infection and preterm births (3.03%) and with SGA condition (3.7%). Consequently, routine CMV urine detection should be performed at least in all babies born before 37 weeks of gestational age and in term SGA newborns.

VEP and EEG in cortical blindness: a case with a complicated course.

We report a case of cortical blindness secondary to an extensive bilateral occipital ischemic infarct and complicated by the onset of bilateral optic nerve ischemia. We discuss the behavior of the VEP, present--an unusual finding--in the first phase of the occipital ischemic lesion, and the value of the alpha band rhythm in the EEG record.

Protection against sudden coronary occlusion by induced mild chronic volume hypertrophy in dogs.

A model of mild chronic volume hypertrophy in the dog has been described which consists of establishing a small arteriovenous (A-V) shunt. The model was utilized to evaluate the protection afforded by mild chronic volume hypertrophy against sudden coronary occlusion. Eight animals were studied, 4 with a single shunt (mean estimated 25% increase in cardiac output) and 4 with a double shunt (mean estimated 57% increase in cardiac output). The A-V shunt resulted in the expected volume hypertrophy by roentgenographic and cardiac weight criteria, but was small enough to produce no signs of exercise intolerance, cardiac failure, or definite electrocardiographic changes. After 6 months, the A-V fistulae were surgically closed and 2 weeks later, under normal hemodynamic conditions, the heart was challenged by sudden, permanent ligation of the left circumflex coronary artery at its origin. The time from ligation to death was measured and compared with 10 control animals without such fistulae. Death occurred in 2 to 13 min in the control animals; in contrast, 5 of the 8 animals with mild chronic volume hypertrophy survived longer than any control animal, and 2 were long-term survivors. The actuarial estimate of the difference in survival was significant (p=0.007) and indicated that the fistulae reduced the hazard of coronary ligation by a factor of 6. A single small shunt afforded protection similar to a double one. Therefore, mild chronic volume hypertrophy induced by a small A-V fistula in the normal dog protects against sudden coronary occlusion. We speculate that the procedure may have a role in the multifactorial prophylactic management of coronary artery disease in asymptomatic high risk subjects, instead of an inapplicable exercise program.