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Biomedical subjects

A Baruffo

Publications and source records attributed to A Baruffo.

7 recordsLinked to original sources
PubMed2001

Assessment of pituitary gonadotropin release to gonadotropin releasing hormone/thyroid-stimulating hormone stimulation in women with systemic sclerosis.

OBJECTIVE: To evaluate basal and dynamic levels of pituitary gonadotropin release in female systemic sclerosis (SSc) patients of childbearing age and in post-menopausal SSc patients. METHODS: We performed stimulation tests for gonadotropin-releasing hormone (GnRH) and thyroid-stimulating hormone (TRH) during the early follicular phase in 12 women of childbearing age [mean age (S.E.M.) 34.8 (2.4) yr] with SSc to determine serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin. Blood samples were also obtained from six post-menopausal women with SSc [mean age 46.8 (2.4) yr], after TRH stimulation; only serum prolactin concentration was determined, because elevated basal concentrations of FSH and LH were expected. Hormone concentrations were estimated by radioimmunoassay. Comparisons were made with healthy control women matched for age and reproductive status. RESULTS: In SSc patients of childbearing age, basal FSH, LH and oestradiol (E(2)) levels were not significantly different from those in controls, whereas basal prolactin concentration was significantly higher than in controls (P=0.0001). After the stimulation test, the peak concentrations of FSH (P=0.0001) and prolactin (P<0.0001) were significantly higher than in controls. The net integrated response curves [net area under the curve (AUC)] for FSH and LH did not differ significantly between SSc patients and controls. On the contrary, the net AUC for prolactin in response to TRH stimulation was significantly higher than in controls (P=0.001). In post-menopausal patients, basal E(2), FSH, LH and prolactin levels were not significantly different between women with SSc and controls. However, after TRH stimulation, peak levels and net AUC for prolactin were not significantly higher in patients than those in controls. No significant correlations were found between basal and stimulated FSH, LH and prolactin levels and the severity of involvement of various organ systems. Multiple regression analysis showed that basal and stimulated prolactin concentrations were associated with skin sclerosis and peripheral vascular and lung involvement. CONCLUSION: Our results suggest that subclinical primary hypogonadism can occur in SSc patients. They also confirm an alteration in the mechanism for prolactin secretion and release, which may not only contribute to further disturbance of the reproductive axis but may also have an influence on the disease.

Adult↗
PubMed2000

The predictive value of attributes of pain to classify rheumatoid arthritis.

Out of 2300 patients with rheumatic diseases 1627 were analysed to develop a classification of rheumatoid arthritis based on clinical attributes of pain. Of these, 641 patients had the disease and 986 were controls with other rheumatic conditions. For traditional format classification, six of eight variables were selected: pain at a fixed joint; symmetrical pain; continuous pain; pain mainly present at night or in the morning; pain following joint pressure; and pain decreased by load/movement. The occurrence of four or more of these features was associated with a 72.1% sensitivity and a 79.1% specificity. A classification tree constructed on four features that showed the greatest diagnostic power (symmetrical pain, pain mainly present at night or in the morning, pain at joint pressure, continuous pain), was associated with a 75.8% sensitivity and a 77.0% specificity.

Adult↗
PubMedDate not supplied

Dehydroepiandrosterone sulphate serum levels in systemic sclerosis.

OBJECTIVE: To evaluate in a cohort of women with systemic sclerosis (SSc) the dehydroepiandrosterone sulphate (DHEAS) serum levels and their relationship with disease severity. METHODS: DHEAS serum concentrations were measured by radioimmunoassay in 40 SSc patients and compared with those in 40 controls matched for sex and reproductive status. IL-2 sR alpha was evaluated as a disease activity index. A preliminary organ/system severity scale proposed by Medsger et al. in 1999 was used to evaluate disease severity. RESULTS: Mean serum levels of DHEAS in SSc women of childbearing age were significantly lower than in controls (0.87 +/- 0.85 microgram/ml versus 2.75 +/- 0.42 micrograms/ml; p < 0.001). On the contrary, no difference was found between postmenopausal women and controls. A reduction below the 95% confidence limits was found in 10 out of 11 patients of childbearing age and in 8 out of 29 postmenopausal women, respectively. In 5 out of 11 patients of childbearing age taking steroids for their SSc (< 10 mg/daily) DHEAS levels were significantly lower than in patients not taking steroids (p = 0.01). On the contrary, 16 out of 29 postmenopausal women using steroids had lower DHEAS concentrations than in patients not taking steroids, although the difference was not statistically significant. There was no statistically significant difference in DHEAS levels between patients with diffuse or limited SSc, or between those with or without organ system involvement. No correlations were found either in pre- and post-menopausal steroid nonusers, or in limited and diffuse subsets, between DHEAS levels and age, postmenopausal years, disease duration, IL-2 sR alpha, disease organ/system severity scale. CONCLUSION: Our data show that, as in other autoimmune diseases, low serum DHEAS is a feature of premenopausal SSc patients. More extensive prospective studies are needed to define the exact role of DHEAS dysregulation in SSc.

Adolescent↗
PubMedDate not supplied

Clinical pattern of pain in rheumatoid arthritis.

OBJECTIVE: To evaluate whether rheumatoid arthritis (RA) is associated with a characteristic clinical pattern of pain which may be useful as a criterion to differentiate RA from other rheumatic diseases. METHODS: 2300 patients from the ReumaLink data bank project with definite rheumatic diseases were studied. Of these 907 patients (39.5%) fulfilled the ARA/ACR revised criteria for RA, while 1393 had rheumatic diseases other than RA. The following diagnostic attributes of pain were considered: localization, symmetry, continuity, modulation, relationship with time and with loads/movements, tenderness. RESULTS: After a descriptive analysis, some pain characteristics were selected individually and others were combined. Only 8 variables were considered for a predictive analysis. Univariate analysis showed that symmetric pain is the most potent discriminating item, with 82.2% sensitivity, 69.2% specificity, a 61% positive predictive value and a 83.3% negative predictive value. A higher probability of RA was present in patients with symmetric pain than in those with asymmetric pain (odds ratio = 7.8). A multivariate analysis performed on 1627 patients showed that a specific clinical pattern of pain (symmetrical pain, pain following joint pressure, mainly present at night or in the morning, continuous) could predict RA patients with a 68.9% likelihood. The lack of these symptoms excluded RA with 92% probability. CONCLUSION: The clinical pattern of pain defined by us can predict RA with a 70% probability. This value reaches 86% when the variables "pain in a fixed joint" and "pain decreased by load/movements" are added. These results indicate that determining the clinical pattern of pain is a useful screening tool for suspected RA, in particular early in the disease course.

Adult↗