Since a striking association between hepatitis C virus (HCV) infection and mixed cryoglobulinemia has been demonstrated, the aim of this study is to investigate the effect of alpha-interferon (alpha-IFN) on HCV viraemia and clinico-serological manifestations of 15 patients (ten female and five male, mean [+/- SD] age 53 +/- 7 years). In 14/15 patients pre-study steroid dosage remained unchanged during treatment. alpha-IFN was administered at a dose of 2 x 10(6) IU daily for a month, then every other day for five months. On the whole, a statistically significant improvement of purpura (p < 0.001), serum transaminases (p < 0.001), and cryocrit (p < 0.01) was observed after alpha-IFN treatment. HCV viraemia was detected by polymerase chain reaction technique in 13/15 patients with mixed cryoglobulinemia and anti-GOR antibodies, expression of HCV-related autoimmunity, were present in 8/15. After alpha-IFN treatment, HCV RNA levels showed a clear-cut reduction in five persons and disappeared in another, while anti-HCV antibodies (Chiron ELISA and RIBA II) did not change after the six-month period of therapy. These data further support the possible etiopathogenetic role of HCV in patients with mixed cryoglobulinemia and suggest that alpha-IFN may be regarded as the elective treatment in this disease.

Chronic Disease↗

PubMedDate not supplied

Antibodies against hepatitis C virus in mixed cryoglobulinemia patients.

The prevalence of antibodies against hepatitis C virus (anti-HCV) in an unselected series of 45 mixed cryoglobulinemia patients was assessed by an enzyme linked immunosorbent assay (Chiron ELISA HCV, Second Generation). The anti-HCV specificity was evaluated by a recombinant based immunoblot assay (Chiron RIBA HCV, Second Generation Assay). HBV-related markers and HIVAb were detected in the same samples. The prevalence of anti-HCV observed in mixed cryoglobulinemia was compared with 80 patients with other immunological systemic diseases. Anti-HCV were found in 91% of mixed cryoglobulinemia patients, and confirmed by RIBA in all cases; on the other hand, anti-HCV were practically absent in other control diseases. HBV markers were recorded in 49% of mixed cryoglobulinemia subjects; while HIVAb were constantly absent. These data give us new insights into the etiopathogenesis of mixed cryoglobulinemia.

Adult↗

PubMedDate not supplied

[Bullosis in diabetics. Apropos of a new case].

Idiopathic bullae occurring in diabetics constitute an uncommon condition which may reveal the diabetes, announce its decompensation or represent a mere epiphenomenon. The authors report the case of a woman who experienced two episodes of idiopathic bullae: the first one disclosed the diabetes, the second one heralded its decompensation. Both episodes were preceded by painful paraesthesia. The bullae contained a clear and serous fluid and the separation was intradermal. Direct immunofluorescence with anti-fibrin serum only showed fluorescence in the lumen of the bulla and in subjacent dermal areas. Electron microscopy demonstrated that the tissue separation was at the base of the stratum corneum. Other clinical cases and pathogenetic theories found in the literature are reported. In contrast with other bullous diseases occurring in diabetics and often of poor prognosis, idiopathic bullae is a benign condition requiring no more than a symptomatic treatment.

Adult↗

PubMedDate not supplied

Growth-plate cartilage metabolic response to mechanical stress.

An in vitro study assessing the metabolic response of growth-plate cartilage explants to mechanical stress was performed. Cultured explants were exposed to two types of stress: (a) single high-compressive force (SHC), and (b) multiple intermittent low-compressive force (MILC). Proliferative activity and matrix synthesis were determined with liquid scintillation counting after explants were labeled with [3H]thymidine and [35S]-sulfate. Our in vitro findings suggest that too high a force, even acting for a short time, may result in permanent injury of growth plate cartilage. Hence, we hypothesized that there might be an unknown pathogenetic mechanism of Salter's fifth-type epiphyseal injury. We report the results of our study.

Animals↗

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The effects of patellar taping on patellofemoral incongruence. A computed tomography study.

Patellar taping for the purpose of patellar medialization is a nonoperative rehabilitation technique used in the treatment of patellofemoral pain. Despite early reports of excellent success rates, the indications for this treatment and its efficacy on patellofemoral pain are unclear. The present computed tomography study was undertaken to evaluate the effect of patellar taping on patellofemoral incongruence. Sixteen female patients (age range, 16 to 25 years) with anterior knee pain related to patellofemoral incongruence underwent computed tomography examination with their quadriceps muscles relaxed and contracted both before and after patellar taping. Patellar lateralization was measured as lateral patellar displacement, and patellar tilt was measured as lateral patellar angle. Patellar taping did not significantly affect patellofemoral lateralization or tilt. The results of this study do not support the use of this method for passive correction of patellofemoral incongruence. Although patellar taping may well be effective in controlling anterior knee pain during physical therapy, it does not do so by medializing the patella.

Adolescent↗

PubMedDate not supplied

[Peutz-Jeghers syndrome. Report of a family].

The Authors report on the clinical and instrumental findings of a 11 years old patient affected with Peutz-Jeghers syndrome, several component of her family were also affected. The Authors confirm clinical heterogeneity of the disease and the importance of a early diagnosis.

Age Factors↗

PubMedDate not supplied

Changes of elastic fibers in musculoskeletal tissues of Marfan syndrome: a possible mechanism of joint laxity and skeletal overgrowth.

The aim of the study was to analyze by histochemical, ultrastructural, and morphometric methods the musculoskeletal tissues in three humans affected with Marfan syndrome. Histochemical and morphometric data demonstrated that the content of elastic fibers in the perichondrium, periosteum, and knee capsule of the individuals with Marfan syndrome was dramatically reduced in comparison with control tissues. Ultrastructurally the elastic fibers appeared fragmented and indented, because of the presence of discontinuous aggregates of elastin among randomly dispersed filaments. These abnormalities of the articular capsule argue that these fibers could be functionally incompetent to resist normal stress, predisposing to joint laxity. Moreover, alterations in both perichondrium and periosteum seems to support our previous hypotheses about the control of long-bone growth exerted by elastic fibers.

Adolescent↗

PubMedDate not supplied

[Results of a survey on knowledge and habits among hospital doctors concerning primary prevention of venous thromboembolism].

BACKGROUND: The purpose of this study was to analyse the attitudes towards and knowledge of primary prevention of venous thromboembolism (VTE) among hospital doctors in Calabria. METHODS: The survey was based on theoretical knowledge and practical management of hortopedics, surgeons, gynecologists and internists working in 14 hospitals. RESULTS: Out of a total of 340 physicians contacted, 154 (45%) agreed to take part in the survey. 82% of those who responded used VTE prophylaxis on a routine basis. Unfractioned heparin (71%) was the most frequently used methods; early deambulation (55%), low molecular weight heparin (49%) and elastic stocking (49%) were less frequently employed. Surprisingly, one third used aspirin. 75% of those contacted had modified their approach to prevention during the last few years, in particular owing to improvements in pharmacological therapy and increased awareness of the problem. In the survey of clinical practice, 80% of those who took part correctly identified the VTE risk, 86% suggested the best treatment, but only 27% assessed the exact frequency rate of deep venous thrombosis (DVT) and pulmonary embolism (PE) in the absence of prophylaxis. CONCLUSIONS: Most of the doctors contacted showed scant interest in the primary prevention of VTE. The 45% who agreed to be interviewed revealed a good practical approach but were not sufficiently aware of the real incidence of DVT and PE in a clinical risk context without prophylaxis. Although they must be interpreted with caution, these findings allow the real behaviour of hospital physicians in this region to be assessed with regard to the primary prevention of VTE and suggest the need for more correct information about this aspect of venous thromboembolic disease which is not yet sufficiently well known.

Data Collection↗

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[Early relapse of herpes simplex encephalitis. Clinical and therapeutic implications].

A case of Herpes simplex virus encephalitis (HSVE) is reported in a 5 year old boy, who relapsed twice during the acute phase of the disease. The second relapse was completely cured by increasing the daily treatment with acyclovir to a dosage of 60 mg/kg intravenously for two weeks and 30 mg/kg by mouth for a further week. The full disappearance of the symptoms and the regression of cerebral lesions could be correlated to a prompt diagnosis and to the dosage of acyclovir employed, higher than that suggested for diseases caused that was by other members of the Herpes virus family.

Brain↗

PubMedDate not supplied

Bone marrow hypoplasia associated with acute viral hepatitis in four children.

Four cases of children, aged 2 to 11 years, with acute viral hepatitis and bone marrow hypoplasia are reported. Three patients presented only jaundice and hepatomegaly; one also had liver failure. All the four patients underwent bone marrow aspiration which showed bone marrow aplasia. In two of the four patients a liver biopsy revealed patchy necrosis with inflammatory mononuclear cell infiltrate. Half of the patients received a bone marrow transplantation; the remaining patients were treated by intravenous infusion of immunoglobulins, growth factors and steroids. The main epidemiological and etiological features of such association are also reported.

Biopsy↗