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Background and Aim: There are few clinical data on Adalimumab (ADA) biosimilars in inflammatory bowel disease. We aimed to perform a multicenter, observational, prospective study on safety and effectiveness of ADA biosimilar ABP 501 in patients with inflammatory bowel disease. Methods: All consecutive patients from the cohort of the Sicilian Network for Inflammatory Bowel Disease treated with ADA biosimilar ABP 501 from February 2019 to February 2020 were enrolled. Patients were divided into three groups: group A, naïve to ADA and naïve to anti‐tumor necrosis factors; group B, naïve to ADA and previously exposed to anti‐tumor necrosis factors; and group C: switched from ADA originator to ABP 501. Results: A total of 559 patients (median age 39 years; Crohn's disease 88.0%, ulcerative colitis 12.0%) were included, with a follow‐up time of 403.4 patient‐years. Thirty‐six serious adverse events occurred in 36 patients (6.4%; incidence rate [IR]: 8.9 per 100 person‐years [PY]). The IR of serious adverse events was higher among patients in group A compared with group C (17.4 vs 4.8 per 100 PY; IR ratio = 3.61; P < 0.001) and among patients in group B compared with group C (16.4 vs 4.8 per 100 PY; IR ratio = 3.42; P = 0.041). Among ADA‐naïve patients (group A + B), 188 (85.8%) had a clinical response after 12 weeks, including 165 (75.3%) who achieved steroid‐free remission. Higher treatment persistence estimates were reported for patients in group C compared with groups A and B (log–rank P < 0.001). Conclusions: Safety and effectiveness of ABP 501 seem to be overall similar to those reported for ADA originator. Switching from originator to ABP 501 was safe and effective. [ABSTRACT FROM AUTHOR]

Abstract Asthma and rhinitis are often co-morbid conditions. As rhinitis often precedes asthma it is possible that effective treatment of allergic rhinitis may reduce asthma progression. The aim of our study is to investigate history of allergic rhinitis as a risk factor for asthma and the potential effect of allergen immunotherapy in attenuating the incidence of asthma. Hospital-referred non-asthmatic adults, aged 18–40 years between 1990 and 1991, were retrospectively followed up until January and April 2000. At the end of follow up, available subjects were clinically examined for asthma diagnosis and history of allergen specific immunotherapy, second-hand smoking and the presence of pets in the household. A total of 436 non-asthmatic adults (332 subjects with allergic rhinitis and 104 with no allergic rhinitis nor history of atopy) were available for final analyses. The highest OR (odds ratio) associated with a diagnosis of asthma at the end of follow-up was for the diagnosis of allergic rhinitis at baseline (OR, 7.8; 95%CI, 3.1–20.0 in the model containing the covariates of rhinitis diagnosis, sex, second-hand smoke exposure, presence of pets at home, family history of allergic disorders, sensitization to Parietaria judaica; grass pollen; house dust mites; Olea europea: orchard; perennial rye; and cat allergens). Female sex, sensitization to Parietaria judaica and the presence of pets in the home were also significantly predictive of new onset asthma in the same model. Treatment with allergen immunotherapy was significantly and inversely related to the development of new onset asthma (OR, 0.53; 95%CI, 0.32–0.86). In the present study we found that allergic rhinitis is an important independent risk factor for asthma. Moreover, treatment with allergen immunotherapy lowers the risk of the development of new asthma cases in adults with allergic rhinitis.

BACKGROUND: The need for more effective smoking-cessation interventions is firmly established. However, access to these services can be problematic in real life. E-mail messages may be a convenient alternative to deliver smoking-cessation interventions. The aim of this pilot study was to assess the effectiveness of incorporating tailored e-mail consultation messages in a smoking-cessation program for smokers willing to quit. METHODS: This pilot study examined the feasibility of integrating e-mail consultation messages in a smoking-cessation program for smokers willing to quit and with Internet access. At baseline, demographic data, smoking history and expired carbon monoxide (CO) levels were collected at a clinic visit. The subjects were provided with the specialist's e-mail address and instructed to prepare e-mail messages containing simple and clear information about their quitting progress. The counselor offered e-mail counseling throughout the smoking-cessation program. A 6-month follow-up visit was arranged, at which abstinence was reviewed. RESULTS: Of the 30 participants initially enrolled in the study, 21 (70%) attended the follow-up 6-month visit. E-mail counseling was more frequently offered (4-8 times) to the participants who completed the study, compared to those lost to follow-up (1-4 times). Comparisons with baseline exhaled CO values showed a significant within-group reduction at 6 months after smoking-cessation (P < .001) in the quitters, compared to smoking-cessation failures. Sustained smoking abstinence at 6 months was 37%. CONCLUSIONS: The integration of e-mail consultation counseling in a smoking- cessation intervention is feasible and effective. E-mail counseling as part of a smoking-cessation program warrants further evaluation. [ABSTRACT FROM AUTHOR]

We describe the clinical cases of two male subjects, respectively 73 and 41 years old, affected with insulinoma, misdiagnosed for many years as psychiatric subjects and scarcely responsive to therapy with benzodiazepins, antidepressants and antiepileptics. Although Whipple's triad was satisfied in both subjects since the onset of symptoms, they had to wait a long time for the correct diagnosis and appropriate treatment. Once the surgical therapy was carried out, our subjects recovered totally and ended the psycho-drugs.

We describe the case of a 70-year-old male with the catastrophic antiphospholipid syndrome admitted for skin gangrene of the fingers. The initial diagnosis was antiphospholipid antibody syndrome in a patient with rheumatoid arthritis and a history of deep vein thrombosis of the lower limbs. Liver involvement, the characteristic skin gangrene, pneumonia and worsening severe renal failure were determinant to make the final diagnosis of catastrophic antiphospholipid syndrome that led the patient to death.