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Biomedical subjects

L Sallì

Publications and source records attributed to L Sallì.

At least 19 recordsLinked to original sources

[Magnetic resonance imaging of seronegative sacroiliitis].

INTRODUCTION: The inflammatory involvement of the sacroiliac joint is frequent during seronegative spondylarthritis. The clinical diagnosis of sacroiliitis may be very difficult, especially in the early stage, because joint motion cannot be assessed directly and the clinical picture is very similar to that of lumbar pain. Conventional radiography is negative as long as the structural change in the joint is limited to the synovial membrane and the cartilage (early stage). Computed Tomography (CT) also has many drawbacks, and thus the changes can be shown only when chondritis and enthesitis have already damaged the bone. The disease onset is usually preceded by a long latency; early diagnosis is needed for a proper and timely treatment, which can be made only with a highly sensitive and specific technique. We investigated the diagnostic accuracy of MRI in the early detection of sacroiliitis during seronegative spondylarthritis. MATERIAL AND METHODS: Forty patients with suspected sacroiliitis and negative radiographic findings were submitted to MRI; thirty-seven of them were HLA B27 positive. MRI was performed with a .5 T superconducting unit; T1-weighted SE, T2-weighted FSE, T2* GE, and STIR images were acquired on the oblique coronal plane parallel to the anterior sacrum. Ten asymptomatic volunteers were also examined as a control group. RESULTS: An irregular sacral border and marrow changes at the insertion of the sacroiliac ligaments were seen in 3/10 asymptomatic volunteers. MRI was negative in 7/40 patients, while the synovial compartment was replaced by some tissue with low signal intensity of T1 and high signal on T2 in the other 33 patients; this finding was referred to synovial pannus. Persisting low-signal foci were seen in the synovial compartment in 16/33 patients, which were referred to spared cartilage. High-signal regions were depicted at the bone periphery in 9/33 patients, which areas were consistent with bone erosion; the subchondral bone was markedly hypointense in 5 of these patients, indicating sclerosis. Finally, diffuse high signal intensity was found in the bone marrow in 3/33 patients and referred to infectious sacroiliitis. CONCLUSIONS: MRI appears the method of choice for the early detection of seronegative sacroiliitis because it can show the early changes in cartilage and subchondral bone, filling the gap between the onset of symptoms and radiographic evidence. Moreover, MRI uses no ionizing radiations and makes therefore a precious tool for the diagnosis and follow-up of young patients, hopefully decreasing the use of CT which however provides better detailing of bone and bone degeneration.

Arthritis↗

Echo-Doppler left ventricular filling abnormalities in patients with rheumatoid arthritis without clinically evident cardiovascular disease.

Our investigation aimed at verifying diastolic abnormalities in rheumatoid patients, without clinically evident cardiovascular disease and other confounding complaints, by using pulsed Doppler examination of transmitral blood flow. We selected 40 patients fulfilling revised American Rheumatism Association (ARA) criteria for the diagnosis of rheumatoid arthritis having no symptoms of cardiac disease or clinical findings of other extracardiac diseases. We also studied 40 rheumatoid-matched healthy volunteers as a control group. An echocardiographic examination was carried out on each subject. Left ventricular structural and functional measurements were obtained. Interventricular, septal thickness and left ventricular mass index were significantly higher in rheumatoid patients than in the control group. We also found in rheumatoid patients higher mean values of peak A velocity and A/E ratio. When multiple linear regression analysis was performed on the data of rheumatoid patients we found an independent relationship only between A/E ratio and left ventricular mass. In conclusion, our results confirm diastolic abnormalities in rheumatoid patients and point out that these abnormalities also affect echo-Doppler parameters of left ventricular filling. Moreover, further analysis of our data may suggest the possibility that structural left ventricle changes could be responsible for left ventricular filling impairment.

Arthritis, Rheumatoid↗

[Exfoliative conjunctival cytology in Sjögren's syndrome].

The study has been performed in order to give a contribution to the knowledge of the conjunctival cytology in Sjögren's syndrome. Exfoliated cells were obtained by a tampon from the inferior conjunctival sac of 11 patients affected by primary or secondary Sjögren's syndrome; the material was placed onto a microscope slide and it was stained with May-Grumwald-Giemsa, after the ferning test had been performed. Tear production had been previously assessed in all patients by Schirmer's I test and basic secretion test that showed an evident tear fluid hyposecretion. Cytoanalysis of tear fluid showed, in all patients, a marked lymphocytosis, presence of epithelial cells (sometimes cell-adhesion) and a number of "snake-cells", with a nucleus-cytoplasm ratio in favour of cytoplasm. Some of those cells have a thicker cytoplasmic membrane and/or a spindle-shaped peripheral nucleus, characteristic finding of keratoconjunctivitis sicca. In all cases we found mucus and fibrin (sometimes with included cells), organic debris and big crystals, some of which aggregated.

Aged↗

Cardiac involvement in rheumatoid arthritis: evidence of silent heart disease.

BACKGROUND: Rheumatoid arthritis (RA) is a systemic disease involving many organ systems and is frequently accompanied by cardiac alterations. However, there is considerable disagreement concerning the cardiac abnormalities found in patients with RA. The purpose of our investigation was to determine, by a non-invasive method such as echocardiography, the nature and extent of cardiac involvement in RA patients with no symptoms of cardiac disease, in comparison with a control sample. METHODS: We selected 35 patients affected by rheumatoid arthritis (five men, 30 women), aged 51 +/- 11 years. No patient had either symptoms of cardiac disease or extra cardiac complaint. As a control group we studied 52 volunteers, aged 51 +/- 12 years, randomly selected among a larger group of subjects with no symptoms, signs and/or clinical findings of extra cardiac diseases. All were in sinus rhythm and without any cardiac symptom. Standard two-dimensional, M-mode and Doppler echocardiographic examination was carried out on each subject. RESULTS: In RA patients we found a higher prevalence of several abnormalities. We found no statistically significant differences between the groups of RA patients based on the stage and duration of disease. We found no correlation between cardiac abnormalities and inflammatory indices or drug therapy. DISCUSSION: At least three alterations seem to be typical of RA patients in the absence of any symptom of cardiac disease: (1) posterior pericardial effusion, (2) aortic root alterations and (3) valvular thickening. The prevalence of MVP is controversial and needs further investigation. These alterations are variously combined in each patient, and for this reason we think that it is possible to represent such a heart involvement as 'silent rheumatoid heart disease'. Moreover the knowledge of the presence of unrecognised cardiac abnormalities can be very important for the correct assessment and management of the RA patient.

Arthritis, Rheumatoid↗

[Reflexions on the Tietze syndrome. Clinical contribution].

The authors report 4 cases of Tietze's syndrome. In 3 of them the syndrome onset during a rheumatic disease (psoriatic arthritis, sternoclavicular hyperostosis). It is thus necessary to distinguish between the idiopathic of unknown ethiology and the secondary form due to, a well defined disease, in 3 cases observed.

Adult↗

Two-site ELISA for quantification of the terminal C5b-9 complement complex in plasma. Use of monoclonal and polyclonal antibodies against a neoantigen of the complex.

A quantitative ELISA procedure using monoclonal and polyclonal antibodies against neoantigens of the terminal C5b-9 complement complex has been developed. The ELISA was demonstrated to be both sensitive and reproducible. The normal range for C5b-9 determinations, defined as 2.5-97.5% interval of the values obtained in 76 healthy blood donors, was 3.12-10.3 AU/ml. The presence of rheumatoid factor did not affect the determination of C5b-9 as demonstrated by immunoabsorption studies.

Antibodies, Monoclonal↗

[Efficacy and tolerability of ketoprofene administered through iontophoresis in rheumatoid arthritis. Results from a multicentric study].

Three-hundred and twelve patients with osteoarthritic diseases were admitted to a multicenter clinical trial. The patients were given 100 mg Ketoprofen twice-a-day by iontophoresis for 10 consecutive days. Pain relief was almost complete in 94.6% of the patients, improvement of active motility in 83.6%, disappearance of swelling in more than half of the patients and functional improvement in about all the cases. Two allergic skin reactions of a mild degree (0.6%) were registered. Therefore, Ketoprofen administered by iontophoresis showed to be efficacious and safe in the treatment of acute osteoarthritic diseases also in high risk patients.

Acute Disease↗

[Relapsing polychondritis. A case report].

The authors describe a case of "relapsing polychondritis" showing that the characteristic manifestation of the disease on nasal and ear cartilage took place at a later stage than in the eye vessels, the inner ear and the trunk and valves of the aorta. The authors therefore consider the term "relapsing polychondritis" to be somewhat restrictive and claim that owing to the systemic diffusion of the disease in all vessels, R.P. should be included among systemic vasculitis diseases.

Adult↗

[Cardiovascular response to sympathetic stimulation in normal subjects with or without familial hypertension].

UNLABELLED: The aim of our study was to seek out a possible different reactiveness to cardiovascular stimulation tests among normotensives with and without positive family history of essential hypertension. We have studied about 200 inhabitants of Ustica and 49 medicine students, all normotensives according to the World Health Organization and the Joint National Committee criteria. In an isolated room and in a supine position, blood pressure (BP) and heart rate were measured every 30 s for 15 min with an automatic sphygmomanometer. Averages of last 4 measurements were considered baseline values. Then we have carried out mental stress (MS), handgrip and active orthostatism test (AO) in the inhabitants of Ustica; cold pressor test and AO in students. Patients were divided in 2 groups, genetics and controls, on the basis of a positive family history of essential hypertension. The 2 groups, in every sample, were similar for sex, age, body mass index and alimentary and life habits. RESULTS: a preliminary estimation of Ustica sample showed a different prevalence of positive history between hypertensives and normotensives (63.9% vs 46.61%; p less than 0.05) and no difference between hypertensive and borderline patients (63.9% vs 64.2%); BP and heart rate were slightly higher in controls; there was no statistical difference between genetics and controls. CONCLUSIONS: our results can be explained in various ways: pressor dysregulation in candidates for hypertension may be masked in a large group of normotensives; exaggerated pressor response do not exist in genetics or this pressor dysregulation is impossible to find out with the cardiovascular stimulation tests we have used; other mechanisms are responsible for genetic hypertension.

Adult↗

[Telethermographic evaluation of the intra-articular administration of thymopentin in rheumatoid arthritis of the knee].

Fifteen subjects with rheumatoid arthritis defined as "classical" or "definite" according to A.R.A. criteria and classified according to Steinbrocker as stages I to III were submitted to knee joint infiltration (bilateral where both knees were involved) with 50 mg thymopentin in 1 ml, once a week for five weeks. Telethermographic examination was performed in all cases in order to evaluate the thermal inflammatory component before the first and 48 hours after the last infiltration. In none of the patients with the exception of only one case, did the drug lead to a significant change of the thermal index. This evaluation does not take into account any other objective and subjective parameters the study of which was beyond the scope of the above research.

Adjuvants, Immunologic↗

[Different prevalence of some indices of cardiac and vascular impairment in normal weight and obese patients with essential arterial hypertension].

Certain physiopathological features that differentiate essential arterial hypertension in normal weight and obese patients are recalled. The results of a retrospective study carried out in 293 hypertensive patients admitted to the Clinic in recent years are reported with a view to evaluating the prevalence of certain parameters (ischaemic cardiopathy, left ventricular hypertrophy, renal, vasculo-cerebral and retinal impairment) in patients subdivided into two groups: normal weight and obese. The study showed in the first group a higher prevalence of signs of ischaemic cardiopathy; in the second a higher prevalence of left ventricular hypertrophy. This difference is accentuated in the subgroup of smokers as regards ischaemic cardiopathy and in non-smokers as regards left ventricular hypertrophy. The possible explanations for this different behaviour are discussed.

Adult↗

[Monoclonal antibody assessment of lymphocyte subpopulations in rheumatoid arthritis in adult patients in relation to stage and treatment].

Twenty patients with various stages of RA were examined. They included: 1) 7 cases in Steinbroker stage 1 (onset); 2) 13 cases in Steinbroker stage 2-3 (chronic). The group was divided into 16 treated and 4 untreated cases. Monoclonal antibodies were used to assay T3, T4, T8 and T4/T8 ratio and the results were compared with those in a control group. The results showed a T8 deficit and a consequent change in the T4/T8 ratio in untreated subjects with "onset" RA. The immune situation of the chronic and treated cases was very similar to that in the control group probably as a result of treatment.

Adult↗

[Audio-vestibular changes in patients with rheumatoid arthritis].

A functional audio-vestibular investigation based on impedance metric techniques and electronystagmography was carried out in a group of patients with "classical" rheumatoid arthritis (RA) and with treated or untreated "definite" RA in various stages. Data obtained from these patients were compared with those obtained from a control group. Significant hypoacusis of the transmissive type was found in initial stages of RA while sensorineural or mixed type hypoacusis was found in later stages of RA. Significant vestibular alterations of the central type suggesting supratentorial involvement were found in several cases independently of the stage of RA and of the age of the patients.

Acoustic Impedance Tests↗

[Behavior of the turnover of I131-fibrinogen in various diseases of the connective tissue].

It is generally admitted that alteration to the blood coagulation system, particularly the creation of fibrin from fibrinogen may play a pathogenetic role in the complex mechanism that characterises rheumatic diseases of the connective tissue. A study was therefore conducted to see whether accelerated fibrinogen turnover could be demonstrated in such patients. To this end the clearance of fibrinogen marked with I131 was assessed in 25 patients in various stages of connectivitis and 10 controls was measured. The results showed a distinct acceleration in fibrinogen turnover only in patients with highly active rheumatoid arthritis. In contrast patients with rheumatoid arthritis in the regressive phase or with stable progressive systemic sclerosis showed values similar to the control subjects. Finally the possible explanations for this behaviour are examined and the clinical interest of the technique employed is assessed.

Arthritis, Rheumatoid↗