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A Mathieu

Publications and source records attributed to A Mathieu.

126 records · Page 7Linked to original sources
PubMedDate not supplied

[The role of HLA-B27 molecules in the pathogenesis of ankylosing spondylitis].

Ankylosing Spondylitis (AS) is characterised by the strongest association with an HLA antigen ever described for any disease. It represents therefore the ideal model for the understanding of the link between immune-mediated diseases and the HLA system. The role of HLA-B27 in the pathogenesis of AS will be discussed focusing on the recently described higher expression of these molecules in patients with AS compared with healthy controls.

Amino Acid Substitution↗
PubMedDate not supplied

Takayasu's arteritis overlapping with systemic sclerosis.

We describe an unusual case of overlap between Takayasu's arteritis (TA) and systemic sclerosis (SSc). TA has been found in association with several diseases, but not with SSc. To our knowledge this is the first case report of TA associated with SSc in the literature. It is possible that the expression of the two diseases in our patient was influenced by the presence of genetic factors predisposing to both TA and SSc.

Adult↗
PubMedDate not supplied

Anti-cardiolipin antibody from a patient with antiphospholipid syndrome (APS) recognizes only an epitope expressed by cardiolipin/beta 2-glycoprotein-I (beta 2GPI) complex and induces APS.

OBJECTIVE: As the antiphospholipid syndrome (APS) is characterized by antibodies which bind negatively charged phospholipids either directly or mainly through different target epitopes located on the beta-2-glycoprotein-I (beta 2GPI) molecule, the aim of this study is to describe an additional target epitope for anti-cardiolipin binding. METHODS: The binding characteristics of affinity purified anti-cardiolipin antibodies from a patient with monoclonal gammopathy associated with clinically overt APS were studied; inhibition studies were also carried out. These antibodies were used for the active induction of experimental APS. RESULTS: The affinity purified anti-cardiolipin antibodies were found to bind a target epitope created by the complex of cardiolipin/beta 2GPI, while not reacting with a complex composed by another phospholipid (phosphatidylserine/beta 2GPI), as confirmed by direct binding and competition assays. Immunization of naive mice with this unique affinity purified anti-cardiolipin antibody resulted in the induction of experimental APS (thrombocytopenia, prolonged coagulation timed and fetal resorptions). The anti-cardiolipin/beta 2GPI injected mice developed high titers of mouse anti-cardiolipin/beta 2GPI antibodies with the same binding characteristics as the human antibody which was used for disease induction. CONCLUSION: APS is a unique syndrome that is characterized by a diversity of pathogenic anti-phospholipid antibodies which may explain the diversity of clinical manifestations reported in patients.

Aged↗
PubMedDate not supplied

[Diagnosis of post-operative jaundice (author's transl)].

The typical factors responsible for post operative jaundice are: 1) increased pigment load; 2) hypoperfusion; 3) sepsis and 4) drugs. In the patient evaluation, one should carefully review the patients chart for hypotensive episode during surgery, the drugs being administerd and the evolution of the illness which will facilitate the identification of the causal factors. Aside the aminotransferase, alkaline phosphatase and bilirubin levels, the risk of hemolysis, of sepsis, the synthetic function of the liver and the integrity of the biliary tree must be established. Post-operative jaundices appear quite often in a context of multiple etiology. However, it is very important to know when surgery is hazardous and when it is mandatory and lifesaving.

Biliary Tract Surgical Procedures↗
PubMedDate not supplied

Correlations among capillaroscopic abnormalities, digital flow and immunologic findings in patients with isolated Raynaud's phenomenon. Can laser Doppler flowmetry help identify a secondary Raynaud phenomenon?

Thirty subjects with a diagnosis of isolated Raynaud's phenomenon, according to anamnestic and objective criteria, were cross-evaluated by various methods: laser Doppler flowmetry (LDF) during a standardized cold and rewarming test, nailfold capillaroscopy, immunological and other laboratory parameters, to assess the diagnostic and prognostic significance of each method. Correlations were also assessed among disease duration, capillaroscopic pattern score, quantitative digital flow values and laboratory parameters. Nearly 30% of patients showed immunologic abnormalities (ANA positivity at variable titres, ENA, hypocomplementemia, immunocomplexes); 16% of patients had a pathologic capillaroscopic pattern, not well correlated with immunologic findings; a characteristic cold stop reaction of digital flow (partial or total) was detected in 86% of the subjects; in ANA+ pts., ANA titers were positively correlated with the intensity and length of stop reaction (Trec). A significant correlation between digital flow parameters and the capillaroscopic score was also found in each considered group. Our results outline the relevance of LDF, during a standardized thermic test, to evaluate apparently primary RP, because even if a definite scleroderma-like capillaroscopic pattern is absent, this flowmetric method may detect potentially secondary RP patients.

Adult↗
PubMedDate not supplied

Critical review in the surgical pathology of carcinoma of the stomach.

Further to a thorough analysis of the management of the surgical specimen for gastric carcinomas, guidelines were defined following several recommendations including informative gross and microscopic descriptions associated to a final correct staging of the tumour, according to the TNM classification and must at least include tumour penetration, nodal or distant metastases. The Belgian working party for GI cancer debate on these data and present a check-list that would help pathologists.

Adenocarcinoma↗
PubMedDate not supplied

[Sulfasalazine in rheumatology].

Sulphasalazine (SLZ) has proved to be a drug effective in inducing clinical improvement or remission in chronic inflammatory rheumatic diseases (other than inflammatory bowel diseases) such as rheumatoid arthritis (RA) and some seronegative spondyloarthropathies, in a fashion similar to that of long-acting, second-line drugs in RA. Several clinical studies agree upon the efficacy of the compound employed at a dose of 2-3 g/day and upon the incidence of side effects, which appear to be equivalent to or lower than those related to traditional disease-modifying drugs employed in RA. The following points should be clarified and developed with regard to the use of SLZ in chronic rheumatic diseases: main mechanism(s) of action, improvement of therapeutic strategy (i.e.: combined treatments, maintenance therapy), prevention and control of main side effects, and its preferential use or limits in the management of a larger number of inflammatory rheumatic diseases.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Cytotoxic drugs in systemic autoimmune diseases.

Inhibition of cell proliferation, together with the depression of synthesis of non-specific and specific cellular products, are the modes of action of cytotoxic drugs. In systemic autoimmune diseases these actions result in immunosuppressive and anti-inflammatory effects. The adoption of cytotoxic treatment, as well as the choice of the cytotoxic agent and therapeutic strategy in individual patients, depend on the disease status, on the patient's tolerance to previously administered drugs and on the theoretical risk of major side effects. The oncogenic risk and its relationship with the cumulative dose or the duration of traditional administration schedules must be taken into account, even if this is not constant for all cytotoxic drugs. Both in life-threatening and in seriously disabling systemic autoimmune diseases cytotoxic drugs are employed, according to general guidelines, to induce complete or partial remission of active disease in patients intolerant or refractory to corticosteroids and/or to other disease-modifying drugs. Combinations of cytotoxic drugs and other non-specific immunosuppressive agents as well as innovative therapeutic regimens (pulse therapy, alternation of treatments) have been used with encouraging results: in the future cytotoxic drugs may perhaps be used in association with specific immunosuppressive agents in a complementary combination to halt pathologic processes in systemic autoimmune diseases.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Long-term follow-up of technetium articular index in rheumatoid arthritis patients during oral chrysotherapy: evidence of paradoxical behaviour.

The Technetium Articular Index (TcAI) is regarded as a parameter of local inflammation in rheumatoid arthritis (RA). We studied TcAI behaviour during 1-year chrysotherapy in a group of fifteen RA patients. In non-responders TcAI showed a gradual decrease up to the 6th month and a return to baseline values within the second semester of the follow-up; conversely, in response patients TcAI remained unchanged during the entire period of the study, thus showing a paradoxical behaviour probably depending on the recovery of normal physical ability and articular activity.

Administration, Oral↗
PubMedDate not supplied

Nerve growth factor and mast cell distribution in the skin of patients with systemic sclerosis.

Nerve growth factor (NGF), a well-characterized neurotrophic factor, induces an increase in the number of mast cells (MCs) in the peripheral tissues of developing rats, as well as histamine release in fully differentiated MCs. Since MCs increase in the dermis of patients with early systemic sclerosis (SSc), we examined the distribution of NGF in the skin of patients affected by SSc. Immunohistochemical studies showed that NGF distribution was more intense in the dermis of patients with SSc than in the skin of controls. A possible correlation between MCs and NGF in disease activity is hypothesized.

Adult↗
PubMedDate not supplied

The Italian version of the Functional Disability Index of the Health Assessment Questionnaire. A reliable instrument for multicenter studies on rheumatoid arthritis.

A working group of ten rheumatology institutes (UNIREUM) was formed in Italy to promote multicenter therapeutic studies on rheumatoid arthritis. The Functional Disability Index (FDI) of the Health Assessment Questionnaire (HAQ) was chosen as a measure of disability. This paper reports the results of a multicenter study to validate an Italian translation of the instrument and to assess its reliability and validity. Two questions were modified to achieve cross-cultural equivalence. Back-translation into English showed agreement with the American instrument. Reproducibility was high: the test-retest correlation coefficient was 0.989 and ranged from 0.81 to 0.99 for the centers taken separately. Validity was confirmed by a correlation coefficient of 0.95 between the patient self-attributed and the physician-attributed FDI scores. We conclude that our Italian version of the HAQ FDI is a reliable and valid self-administered instrument.

Adult↗
PubMedDate not supplied

Anti-neutrophil cytoplasmic antibodies in 566 European patients with systemic lupus erythematosus: prevalence, clinical associations and correlation with other autoantibodies. European Concerted Action on the Immunogenetics of SLE.

OBJECTIVES: To evaluate, in a cohort of 566 patients with systemic lupus erythematosus (SLE) drawn from 11 European centres: (i) the prevalence of ANCAs and their subspecificities in a large series of European SLE patients; (ii) the possible associations of ANCA with the most common clinical manifestations of the disease; and (iii) whether ANCAs correlate with some of the autoantibodies commonly found in SLE. METHODS: ANCA detection was performed by indirect immunofluorescence (IIF), and by ELISA for lactoferrin (LF), myeloperoxydase (MPO), proteinase3 (PR3) and lysozyme (LZ) subspecificities. RESULTS: The prevalence of ANCA was 16.4% (IIF). The prevalence of LF was 14.3%, LZ 4.6%, MPO 9.3%, and PR3 1.7%. Our results show that ANCA is associated with certain clinical manifestations of SLE. In particular, positive correlations were found between IIF ANCA and serositis (p = 0.026), livedo reticularis (p = 0.01), venous thrombosis (p = 0.03) and arthritis (p = 0.04), while anti-LF antibodies were associated with serositis (p = 0.05) and livedo reticularis (p < 10(-3). Nevertheless, multivariate analysis demonstrated that other autoantibodies, such as aCL and SSA/Ro, are more closely correlated than ANCA with some of the aforementioned clinical features. CONCLUSION: Our results demonstrate that ANCA are detectable in SLE sera and that some of them are associated with particular clinical manifestations. Whether ANCA plays a direct pathogenetic role in the vascular damage of SLE or only represents an epiphenomenon or a marker of disease activity remains to be elucidated.

Adolescent↗