Omalizumab and allergen immunotherapy for respiratory allergies: A mini-review from the Allergen-Immunotherapy Committee of the Italian Society of Pediatric Allergy and Immunology (SIAIP)

Although currently approved to treat severe asthma and chronic spontaneous urticaria, omalizumab has also been an effective and safe add-on treatment for other allergic diseases. Namely, omalizumab has been proposed to be used as add-on therapy in patients with allergic rhinitis and asthma and undergoing specific allergen immunotherapy (AIT). AIT is the only treatment that modifies the natural history of IgE-mediated diseases. This brief review summarizes the available evidence and controversies on the efficacy and safety of omalizumab combined with specific AIT (AU)

True and false contraindications to vaccines

Nowadays, the awareness of risks related to infectious diseases has decreased, whereas THE perception of risks related to vaccination is growing. Therefore, it may be difficult for health care providers to convince people of the importance of vaccination and adherence to the immunisation schedule. Selected situations that might raise uncertainties about vaccine recommendations are discussed in order to help health care providers to identify real and perceived contraindications to vaccines, and cases to be referred to specialised pre-vaccination consultation due to an increased risk of adverse events to vaccines (AU)

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True and false contraindications to vaccines.

Nowadays, the awareness of risks related to infectious diseases has decreased, whereas THE perception of risks related to vaccination is growing. Therefore, it may be difficult for health care providers to convince people of the importance of vaccination and adherence to the immunisation schedule. Selected situations that might raise uncertainties about vaccine recommendations are discussed in order to help health care providers to identify real and perceived contraindications to vaccines, and cases to be referred to specialised pre-vaccination consultation due to an increased risk of adverse events to vaccines.

[Ultrasonographic evaluation of timing in emergency cervical cerclage]. / Valutazione ecografica del timing nel cerchiaggio cervicale d'emergenza.

The aim of the present paper is to utilise endovaginal ultrasonography as an instrument for establishing the most appropriate moment for carrying out cervical cerclage after interrupting uterine contractions in a situation of near miscarriage. A patient at 20 weeks and 4 days of gestation, with contractions, integral membranes and complete dilatation, was laid in the Trendelemburg position, keeping the bladder moderately full, and given tocolytic therapy. After 14 days cerclage was carried out on a reconstituted neck. At 37 weeks and 1 day, the patient delivered a female newborn weighing 3.100 g. The Trendelemburg position, the moderately full bladder and tocolytic therapy with endovaginal ultrasonographic monitoring can move the timing of surgery forward so as to render it safer and more useful for prognostic purposes.

[Physical training and low-dose heparin-calcium in patients suffering from chronic obliterating arteriopathy of the lower limbs with intermittent claudication]. / Training fisico ed eparina calcica a basse dosi in pazienti affetti da arteriopatia obliterante cronica degli arti inferiori con claudicatio intermittens.

In the treatment of peripheral obliterating arteriopathy (POA) physical training provides clear results in terms of increased walking autonomy; it is still not fully clear whether the positive effects of physical training can be further improved by concomitant back-up drug therapy. For this purpose 374 patients of both sexes, with a mean age of 64 years, suffering from chronic peripheral obliterating arteriopathy of the lower limbs were enrolled in a controlled open clinical trial, instructed to follow a programme of physical training and randomly allocated to low dose treatment with heparin calcium (12,500 IU/day) for 6 months. An improvement in the claudicometric parameters (free gait interval, absolute gait interval and recovery time) measured at constant speed and in the resting Winsor ankle/arm index of the most severely damaged limb were observed in both groups. These improvements were significantly greater in the group receiving pharmacological treatment (p < 0.01) and efficacy increased in line with basal deambulatory impairment. The results obtained and the good tolerance of the drug underline the clinical efficacy of heparin calcium at low doses in association with a physical training programme in patients suffering from Fontaine's stage II peripheral obliterating arteriopathy.