Biomedical subjects
Publications and source records attributed to G Letizia.
The authors report an aneurysm in the popliteal artery surgically treated with success. The operation consisted on the installation of one tubular prosthesis femoro-poplitea with a termino-terminal anastomosis. The follow-up to 3 and 6 months from the operation showed good functional recovery.
Forty-eight patients were subdivided into three groups according to the stage of their rheumatoid arthritis and to whether or not they received glucocorticoids; they were compared to healthy volunteers of similar sex, age, and body weight. Before calcitonin treatment, bone mineral content (BMC) of RA patients was significantly lowered, especially in patients with 3rd and 4th Steinbroker degree and in those taking glucocorticoids. Synthetic eel calcitonin was administered in three 60-day cycles separated by 40-day intervals with daily dosage 40 U.M.R.C. (1 vial). This treatment did not result in a increase of BMC compared to baseline. A further decrease of BMC observed at the end of treatment was not statistically significant. No appreciable variation was found in parameters of phospho-calcic metabolism.
Recently it has been demonstrated that ipriflavone (IP), an isoflavone derivative, is able to increase bone mass in patients with established postmenopausal osteoporosis (PMO). Here we present a preliminary report of a 2-year multicenter, double-blind, placebo-controlled clinical study performed in order to evaluate the efficacy and tolerability of IP in PMO. A large number of patients with PMO, referred to 12 Italian centers, was randomly divided into 2 groups and treated with oral IP (600 mg/day) or placebo (Pl). All patients received an oral Ca supplement (1 g/day). One hundred and twenty six patients completed 1 year of the study. Bone mineral density (BMD) of the distal radius, measured by DPA, serum osteocalcin (BGP), and urinary hydroxyproline excretion (HOP/Cr), were measured before and after 12 months. After 12 months, a significant increase in BMD was observed in the IP-treated group (P < 0.05). IP determined a reduction of HOP/Cr, while in Pl-treated patients a significant increase of this index, as well as of BGP, was observed. After 12 months the difference between the two groups resulted significant (P < 0.05) for BGP. The drug was well tolerated and the patients' compliance to the oral treatment resulted excellent. The results of this study indicate that IP is able to increase bone mass in patients with PMO.
In vitro studies on the effects of dexamethasone on human synovial cells have shown that with high concentrations of the steroid in the culture medium cellular activity was completely blocked whereas with low concentrations (10(-6)M), cellular density decreased but there was an increase in the synthesis of RNA, DNA, protein and hyaluronic acid. These data, coupled with clinical experience of using intra-articular hyaluronic acid to treat patients with osteoarthritis of the knee, prompted the investigators to carry out an open, randomized study of the use of very small doses of dexamethasone in association with hyaluronic acid in 40 osteoarthritic patients. Twenty patients received a weekly intra-articular injection of 20 mg sodium hyaluronate in 2 ml phosphate buffer for 5 weeks; the other 20 patients followed a similar treatment regimen, the only difference being the addition of 0.4 mg dexamethasone phosphate to the first injection. Clinical examination of the knee was made before each injection, 7 days after the fifth injection and 60 days after the start of the trial. Rating scale assessments were made at each visit of spontaneous pain, pain during the day, at night, weight bearing and whilst walking. The results showed that whilst a progressive decrease in all pain parameters was evident and persisted after the end of treatment in both patient groups, pain intensity decreased more rapidly and to lower levels in all but weight-bearing pain, as did improvement in joint mobility, in the combined treatment group. Local tolerance was good with both treatment regimens, with no untoward signs or symptoms at any time.(ABSTRACT TRUNCATED AT 250 WORDS)
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Using the electron transmission microscope, the writers studied the ultrastructural appearances of the synovial membrane obtained during acute haemarthrosis, with the aim of elucidating the morphological basis of he mechanism of reabsorption of the various components of the blood. It was observed that all the elements of the synovial intima showed substantial modifications of the cytoplasm and of the plasmalemma. The cytoplasm showed: (a) marked abundance of lysosomes and lysophagosomes; (b) the presence of conspicuous cavities crammed with erythrocytic fragments; (c) marked reduction of normal cytoplasmic organelles. The plasmalemma, on the surface bordering the joint cavity, showed numerous philopods and lamellipods. These modifications, which affected all the cellular elements of the intimal stratum, demonstrate that they are macrophagically differentiated.
The writers used the electron transmission microscope to study the ultrastructure of the synovial membrane in joints or synovial areas that varied in their exposure to weight bearing or other mechanical stresses. They used fragments of synovial membrane obtained surgically from the knee and from the elbow joints. In the joints or synovial areas little exposed to weight bearing or traction, the three strata of which the synovial membrane is composed were well differentiated from the fibrous capsule. The intima contained abundant cells with a trophic function (chiefly A cells); the subintima was intensely vascularised and had numerous fat cells but few fibres; the subsynovia was predominantly fibrous. On the other hand, in joints or synovial areas notably exposed to weight bearing or traction stresses, the synovial membrane was thinner, with few cellular elements (mostly resembling fibroblasts) and few blood vessels, while the fibrillar component was particularly marked. These differences in the ultrastructure confirm Franceschini's hypothesis that the synovial fluid is produced in those areas of the synovia that are less exposed to mechanical stress.
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OBJECTIVES: The objective of this double-blind randomised, placebo-controlled study was to examine the efficacy and safety intramuscular vitamin B12 (Tricortin 1000) in the treatment of low back pain in patients with mechanical or irritative lumbago. METHODS: 60 patients aged between 18 and 65 years with lumbago or sciatic neuritis of mechanical origin without need for surgical procedures were enrolled. Patients had to present with a proven medical history for back pain (lasting from 6 months to 5 years) and a pain intensity [as evaluated with a Visual Analogic Scale (VAS)] equal or greater than 60 mm. Efficacy primary end-point was evaluated by means of a visual analogic scale (VAS) and a Disability Questionnaire (DQ). Consumption of paracetamol during the study period was the secondary efficacy end-point. RESULTS: Both treatment groups experienced a sharp decrease in pain and disability. However, comparison between groups at the end of the treatment period showed a statistically significant difference in favour of the active treatment both for VAS and DQ (p < 0.0001 and p < 0.0002, respectively). Consumption of paracetamol proved significantly higher in the placebo group than in the active treatment (p < 0.0001). CONCLUSIONS: The efficacy and safety of parenteral Vitamin B12 in alleviating low back pain and related disability and in decreasing the consumption of paracetamol was confirmed in patients with no signs of nutritional deficiency.
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