Previous studies have reported the mean depth buy inhibitor to the epidural space as ranging from 4.8 to 5.6cm in obstetric populations with variable BMI [29�C31]. In Balki et al.’s [20] study, the mean depth to the epidural space in an obese obstetric population was reported as 6.6cm (range 4.5�C8.5cm), which is the same mean calculated in our study, 6.6cm (range 4.4�C9.8cm). The depth to the epidural space was more than 8cm in 4.3% of the patients in our study, less than the 14% reported by Balki et al. [20]. Nine parturients received multiple epidural catheter placements due to inadequate relief (no more than 2 placements), but 7 of these were defined as ��late�� failures, which are more likely due to dislodgement of the catheter rather than improper placement.

This suggests that the use of EDE prior to prepuncture US can provide more accurate prediction of depth to the epidural space.5. ConclusionThe use of the epidural depth equation (EDE) prior to ultrasound visualization in the longitudinal and transverse US views results in better clinical correlation than with the use of ultrasound alone.Conflict of InterestsThe authors declare that they have no conflict of interests.AcknowledgmentThis study was funded by the Department of Anesthesiology, University of Pittsburgh, USA.
Psoriasis is a chronic inflammatory immunomediated disease of unknown aetiology, which is significantly associated with psychological distress and impaired quality of life [1�C3]. Treatment of this condition is not curative but is aimed at inducing a temporary control of clinical manifestations and improving the impact of the disease on quality of life and the level of acceptance of the disease.

The management of a chronic disease like psoriasis is complex and is conditioned by multiple factors, including, but not limited to, the objective severity and distribution of skin lesions, the influence on psychosocial aspects, the response to previous therapies, and the presence Batimastat of concomitant psoriatic arthritis (PsA) and comorbidities. Therapeutic management of psoriasis usually requires a patient-tailored approach in which combination and sequential therapies are often considered over time in order to augment response, to optimize the safety profile, and/or to meet specific clinical needs. There is a wide armamentarium of therapeutic tools available for the treatment of psoriasis which includes topical medications, phototherapy, and systemic nonbiological and biological drugs. It is estimated that moderate-to-severe psoriasis accounts for about 25% of psoriasis patients [1], most of whom are likely to require systemic drugs or phototherapy.