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Background: The aim of the study was to give guidelines for the management of a pulmonary rehabilitation program in patients affected by COPD., Materials and Methods: 52 patients affected by COPD with chronic respiratory failure and hypoxemia have been evaluated. All patients underwent a personalized rehabilitation program joining traditional technics of rehabilitation and an exercise training. The study was divided into three different phases: traditional pulmonary rehabilitation; exercise training by treadmill; home care rehabilitation. In order to follow-up the outcome of the patients, the 12 minutes walking test and the pulmonary function tests were used., Results: The study showed clearly an improvement of fitness of the patients after exercise training These results were confirmed after one year follow-up., Conclusions: In conclusion, in the light of these results, the exercise training and, overall, the home care rehabilitation, acquire an important role in the management of patients affected by COPD.

A case of a pregnant woman suffering from centronuclear myopathy is described. The patient has successfully carried out the pregnancy and delivery.

The ovarian renin-angiotensin-aldosterone system (OVRAS), although not fully known, appears to play an important role in ovarian physiology (steroidogenesis, follicular stage, ovulation). The possibility of manipulating ovarian function by means of the pharmacological modulation of OVRAS opens new horizons for the control of human reproduction.

Since it is now recognized that asthma is an inflammatory disease of the airways, the powerful antiasthmatic effects of corticosteroids are believed to be largely dependent on their broad anti-inflammatory activity. These drugs are the most effective asthma treatment currently available but, although they have been used for a long time, only recently the molecular mechanisms underlying their pharmacological actions are becoming clear. Corticosteroids bind to intracellular receptors which, upon ligand-dependent activation, interact with specific genomic DNA sequences thus leading to an increase or a decrease in the transcription rate of several target genes. Modulation of gene transcription by glucocorticoids underlies complex interactions involving their receptors, genomic DNA, nuclear chromatin, and other transcription factors. Furthermore, steroid hormones can also modulate gene expression at the post-transcriptional level. The anti-inflammatory and antiasthmatic effects of corticosteroids are mediated by down- or up-regulation of specific target genes. Down-regulation of gene expression leads to a reduced synthesis of several cytokines and adhesion molecules. Up-regulation results in increased production of lipocortins and beta 2-adrenergic receptors. A small minority of asthmatic patients do not respond to corticosteroids, and the mechanism underlying this steroid resistance is still under investigation.

The Authors describe in detail the complex immunological mechanisms thanks to which the maternal organism does not reject the embryo, constituting an allogenic transplant. They examine the modifications, referring to both natural and adoptive immunity, occurring in the pregnant without ignoring the important contribution the foetus itself and adnexa make to the gestation positive termination. In the second part of the paper all the pregnancy pathologies, originating from an imbalance proper to the immunity system, are considered. The following pathologies are particularly described: a) the spontaneous recurrent abortion, both primary and secondary; b) the gestosis; c) the maternal-foetal isoimmunization towards transferable antigens present on red corpuscles, white corpuscles and blood platelets. At last Authors describe all the autoimmune illnesses in pregnancy and their influence on the foetus. Such illnesses may be: a) organ-specifics (immunological thrombocytopenic purpura, thyrotoxicosis, myxedema, serious myasthenia); b) systemics (rheumatoid arthritis, lupus erythematous). The course of each pathology, its influence on the embryo and, the present therapeutic protocols are examined.

The Authors consider the etiology postmenopause osteoporosis and the drugs for a modern therapy of this disease. They also analyse the effectiveness and the unfavourable effects of these drugs and suggest a personal treatment for osteoporosis.

Mean levels of maternal blood magnesium in a group of pathological pregnancies were compared to levels found in a group of physiological pregnancies. The paper concludes that low levels of blood magnesium are an improbable condition in pregnancy due to the existence of protective mechanisms, and that they are therefore rarely the cause of the most common obstetric pathologies.

The pathogenetic, diagnostic and therapeutic aspects of vulvar dystrophies are reviewed, special attention being paid to a comparison of therapeutic tendencies past and present. The advantages of topical treatment with corticosteroids and testosterone and those of the most recent surgical techniques are compared respectively with the results obtained in past years using estrogenic topical treatment and demolition surgery.