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[Clinical manifestations correlated with anticardiolipin antibodies in systemic lupus erythematosus: preliminary results of a prospective study]. 系统性红斑狼疮的临床表现与抗心磷脂抗体相关:一项前瞻性研究的初步结果。
Medicina (Florence, Italy) Pub Date : 1990-10-01
M Galeazzi, G D Sebastiani, G Passiu, A M Bellucci, F Porzio
{"title":"[Clinical manifestations correlated with anticardiolipin antibodies in systemic lupus erythematosus: preliminary results of a prospective study].","authors":"M Galeazzi,&nbsp;G D Sebastiani,&nbsp;G Passiu,&nbsp;A M Bellucci,&nbsp;F Porzio","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Antiphospholipid antibodies (aPL) have been linked to various clinical manifestations in systemic lupus erythematosus (SLE), mainly thrombosis, repeated abortions and thrombocytopenia. Despite the large number of studies which have been published in the recent years, there is still some debate on this matter, and no firm conclusion has been reached as yet. Among the various aPL, anticardiolipin antibodies (aCL) have received more attention, mostly because they can be easily detected by means of immunoenzymatic assays. The main objective of the present study was to determine the prevalence of IgG and IgM aCL isotypes in SLE in order to compare their possible association with the clinical manifestations of the disease. Clinical features of 40 consecutive and unselected SLE patients (35 female and 5 male) were prospectively studied. Sera from the same patients were tested for the presence of aCL, using a standardised ELISA assay, and the presence of aCL was correlated with the various clinical events. Results showed that the prevalence of aCL was 42.5% for the IgG isotype and 10% for the IgM isotype. Regarding the clinical associations of aCL, we found a strong linkage between the presence of these antibodies and the occurrence of both thrombosis and abortions; a weaker association with neurological events was also demonstrated. These results, if confirmed on larger series, suggest that aCL should be searched in patients with SLE in order to identify those who are at greater risk of developing some severe clinical problems and could benefit by prophylactic treatment.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"403-5"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Decrease in notifications of AIDS dementia complex in 1989-1990 in Italy: possible role of the early treatment with zidovudine]. [1989-1990年意大利艾滋病痴呆复发率的下降:齐多夫定早期治疗的可能作用]。
Medicina (Florence, Italy) Pub Date : 1990-10-01
A Chiesi, M G Agresti, L G Dally, M Zaccarelli, C Tomino, M Floridia, S Vella
{"title":"[Decrease in notifications of AIDS dementia complex in 1989-1990 in Italy: possible role of the early treatment with zidovudine].","authors":"A Chiesi,&nbsp;M G Agresti,&nbsp;L G Dally,&nbsp;M Zaccarelli,&nbsp;C Tomino,&nbsp;M Floridia,&nbsp;S Vella","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We evaluated the incidence of AIDS dementia complex (ADC) in groups of patients who acquired infection through different risk behaviours, and attempted to evaluate the possible role of zidovudine (AZT) treatment in preventing or delaying the onset of ADC. The Italian National AIDS Registry was used to study patients with AIDS for whom ADC was reported as an index disease. Relative risk of presenting ADC between different patient categories has been determined. Logistic regression was used to analyse temporal trends in the proportion of AIDS cases presenting with ADC. Of the 6466 cases reported between August '87 and August '90, ADC was seen in 640 (9.9%). I. V. drug addicts had twice the risk (estimated odds ratio: 1.9; 95% confidence interval: 1.5-2.6, p less than 0.001), compared to homo/bisexuals, of presenting with ADC. There is significant evidence (p less than 0.0001) that after a progressive increase in the period '87-'89, it began a definite decrease in the monthly proportion of ADC cases, starting August '89. AZT was introduced in Italy in July 1987 for patients with AIDS or advanced ARC. The incidence of AIDS dementia complex at the moment of AIDS diagnosis in our population of patients, began to decline 24 months after the introduction of systematic AZT treatment in Italy. This could have been due to inhibition of HIV replication in the Central Nervous System among patients who initiated AZT-treatment before developing full-blown AIDS.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"415-6"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Infective endocarditis: a changing disease]. 感染性心内膜炎:一种变化中的疾病。
Medicina (Florence, Italy) Pub Date : 1990-10-01
M Venditti, P Martino
{"title":"[Infective endocarditis: a changing disease].","authors":"M Venditti,&nbsp;P Martino","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Infective endocarditis is best characterized as a disease in evolution. The list of patients at risk, which formerly included almost exclusively patients with rheumatic heart disease, is being continuously modified and expanded. Nowadays, patients with prosthetic heart valves, users of illicit intravenous drugs, and patients with mitral valve prolapse rather than patients with rheumatic heart disease account for the majority of cases of infective endocarditis. Moreover, due to the widespread use of indwelling atrial catheters for parenteral nutrition as well as for intensive cytotoxic therapy, catheter-related right-sided endocarditis is emerging among nosocomial infections. With the advent of successful antimicrobial therapy, complications rather than endocardial infection pose the major therapeutic problems. In addition to progressive heart failure, myocardial abscesses, fungal endocarditis, relapsing infection, and major systemic emboli in the presence of large protuberant vegetations constitute indications for replacement of the valve. Despite progresses in diagnosis and therapy, infective endocarditis will most likely continue to challenge physicians even in the next future.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"373-85"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Macrophages from healthy adults release TNF-alpha after exposure to Pneumocystis carinii of murine origin. Preliminary study]. 健康成人的巨噬细胞暴露于鼠源卡氏肺囊虫后释放tnf - α。初步研究。
Medicina (Florence, Italy) Pub Date : 1990-10-01
E Tamburrini, A De Luca, G Ventura, G Maiuro, A Siracusano, E Ortona, A Antinori
{"title":"[Macrophages from healthy adults release TNF-alpha after exposure to Pneumocystis carinii of murine origin. Preliminary study].","authors":"E Tamburrini,&nbsp;A De Luca,&nbsp;G Ventura,&nbsp;G Maiuro,&nbsp;A Siracusano,&nbsp;E Ortona,&nbsp;A Antinori","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The ability of Pneumocystis carinii to induce TNF-alpha release by macrophages from adult healthy humans was investigated. Monocytes and monocytes derived macrophages produced an high amount of TNF-alpha when exposed to P. carinii cysts obtained from rats with steroid induced pneumocystosis. TNF-alpha release was P. carinii specific as shown by the inhibition exerted by the anti-P. carinii hyperimmune serum and it was not mediated by putative traces of endotoxin.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"393-4"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Skin disease in Basedow's disease]. [Basedow氏病中的皮肤病]。
Medicina (Florence, Italy) Pub Date : 1990-10-01
S Leoni, G Proto, I Torossi, F Grimaldi, A Mazzolini
{"title":"[Skin disease in Basedow's disease].","authors":"S Leoni,&nbsp;G Proto,&nbsp;I Torossi,&nbsp;F Grimaldi,&nbsp;A Mazzolini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Two cases of Graves' (Basedow) dermopathy are reported. In one case pretibial myxoedema was localized on the external surface of the legs down to insteps. In the second case a diffuse form involved both legs and was characterized by wrinkles and peau d'orange appearance at the ankles. In both cases a biopsy confirmed the diagnosis of Graves' dermopathy, showing diffuse areas of amorphus substance infiltrating the derma and fragmentation of collagen fibers. According to the literature, the skin lesions were associated with ophtalmopathy. Thyrostatic therapy affected ophtalmopathy in one of the patients, while pretibial myxoedema regressed in both. The pathogenesis of pretibial myxoedema is not completely clear yet, although dermopathy, along with ophtalmopathy and acropachy, is considered to be an extrathyroidal manifestation of Graves' disease related to bioassayble antibodies anti-TSH receptor. A class of dermopathy-associated antibodies (DAAb) has been identified. It seems to be a reliable biological marker for pretibial myxoedema since it is nearly absent in patients with ophtalmopathy and without dermopathy. Since DAAb does not stimulate human fibroblasts in culture, the role of DAAb in the development of Graves' dermopathy is still to be found.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"408-11"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Clinical usefulness of a new echocardiographic window: the transesophageal approach]. 一种新的超声心动图窗口的临床应用:经食管入路。
Medicina (Florence, Italy) Pub Date : 1990-10-01
R Gentile
{"title":"[Clinical usefulness of a new echocardiographic window: the transesophageal approach].","authors":"R Gentile","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The image quality of standard echocardiograms can be unsatisfactory for various reasons such as pulmonary disease, obesity, chest deformities. The introduction of transesophageal echocardiography has solved these problems and provided a new acoustic window to the heart and mediastinum. Its superior imaging resolution and increased sensitivity allow cardiac structure and function to be visualized in great detail. The procedure has proven to be a valuable means of intraoperative and perioperative monitoring of left ventricular performance and in the evaluation of surgical results. In critically ill patients, diagnoses missed at surface echocardiography, including aortic dissection, left atrial masses, native or prosthetic valve vegetations, have clearly been identified by transesophageal window. In awake patients, the procedure is well accepted and associated with no major complications. On the basis of our initial experience, we conclude that esophageal approach complements standard two-dimensional, Doppler, and color flow examinations, and is a major advance in the care of patients with cardiovascular disease.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"411-5"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Macroglobulin alpha-2 in synovial fluid: relationship with reactants of the acute phase of rheumatoid arthritis]. [滑液中巨球蛋白α -2:与类风湿关节炎急性期反应物的关系]。
Medicina (Florence, Italy) Pub Date : 1990-10-01
B Seriolo, M Cutolo, F De Cesari, S Accardo
{"title":"[Macroglobulin alpha-2 in synovial fluid: relationship with reactants of the acute phase of rheumatoid arthritis].","authors":"B Seriolo,&nbsp;M Cutolo,&nbsp;F De Cesari,&nbsp;S Accardo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Metalloproteinases (e.g. collagenase, elastase, stromelysin) are present in large amount in synovial fluid (SF) during rheumatoid arthritis (RA) and are actively involved in articular tissue damage. alpha 2-Macroglobulin (alpha 2M) functions as a \"molecular trap\" for proteinases and is considered the major inhibitor of metalloproteinases. We found increased concentrations of alpha 2M in SF of RA patients, significantly related to acute phase reactants, local inflammatory parameters and joint damage. The alpha 2M ratio between, RA SF and control SF, was found higher than between RA serum and control serum, indicating a selective localization and activity of alpha 2M in inflamed joint. The relationship between alpha 2M and the inflammatory parameters, including IL-6, is discussed.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"401-2"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12876995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Diagnosis and course of small hepatocarcinoma in cirrhosis. 6 years' experience]. 肝硬化小肝癌的诊断和病程。6年的工作经验]。
Medicina (Florence, Italy) Pub Date : 1990-10-01
A Salmi, G Rangoni
{"title":"[Diagnosis and course of small hepatocarcinoma in cirrhosis. 6 years' experience].","authors":"A Salmi,&nbsp;G Rangoni","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diagnosis of hepatocellular carcinoma smaller than 3 cm in diameter was possible in 64 (27.7%) of 231 consecutive cases. Ultrasonography provided the highest diagnostic sensitivity which was further increased by combining this methodology with laparoscopy. Evolution of nodules was more often multicentric but sometimes unicentric with slow growth. Surgical treatment in selected patients (small resections) was associated with high operative mortality (37.5%). Survival of patients (Child C excluded) after percutaneous ethanol injection under ultrasound guidance was 100% at three years.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"407-8"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13124656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[The human genome project: reflections of an expert]. [人类基因组计划:一位专家的思考]。
Medicina (Florence, Italy) Pub Date : 1990-10-01
M Siniscalco
{"title":"[The human genome project: reflections of an expert].","authors":"M Siniscalco","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Just about five years have elapsed since a handful of leading scientists began to discuss the opportunity to launch the Human Genoma Program, an international organized effort to characterise all the genetic material--DNA--of the human organism. Today, the project is well under way with the participation of tens of thousands investigators from all over the world and the direct involvement of major sponsoring bodies such as the United States Department of Energy and the National Institutes of Health, the European Economic Council, the USSR Academy of Sciences and the Governments of France, Great Britain, Italy, Japan and Spain. Yet, the reactions of the general public to the Project is, to say the least, very diverse. Some are sure of its positive impact on the prevention and cure of inherited diseases, some fear its infringence on individual privacy, but the majority remains totally indifferent. Since the lack of adequate information is the common denominator at the root such different reactions, this Editorial will try to summarise the major issues of the Project and their impact on Society.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"417-20"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13254987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[High-dose immunoglobulins for the treatment of rheumatoid arthritis: pilot study of 7 cases]. 【大剂量免疫球蛋白治疗类风湿性关节炎:7例中试研究】。
Medicina (Florence, Italy) Pub Date : 1990-10-01
B Tumiati, M Veneziani, G Castellini, A Belelli
{"title":"[High-dose immunoglobulins for the treatment of rheumatoid arthritis: pilot study of 7 cases].","authors":"B Tumiati,&nbsp;M Veneziani,&nbsp;G Castellini,&nbsp;A Belelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>High intravenous doses (400 mg/kg) of gammaglobulin (IVIG) were administered monthly for six months to 7 patients with severe rheumatoid arthritis (RA). In all cases, previous treatment with NSAIDs and corticosteroids and in 3 of them with gold and/or methotrexate had been ineffective. A 50 per cent improvement of Ritchie index was obtained in 6/7 patients, morning stiffness was reduced from greater than 2 hours to less than 30 minutes in 6/7 patients. Swollen joints and Lee index improved in all patients. ESR did not show any change but RCP improved in 6/7 patients. The study of lymphocyte subpopulation showed no substantial changes in CD20+, CD3+, CD4 and CD8 cells as well as in CD4/CD8 ratio and a significant increase in 2H4+T cells without changes in 4B4+ subpopulation. IVIG improved the clinical and laboratory features of patients with severe RA. The major problem raised by IVIG therapy is its high cost suggesting that this therapy should only be applied in well selected patients with RA.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"398-401"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12876993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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