Biomedical subjects
M Mosca
Publications and source records attributed to M Mosca.
Investigation of microelement content of bulk milk from different regions of Italy.
Samples of bulk milk were analyzed for their lead, cadmium, zinc, chromium and copper contents in relationship to the production zone and at various periods of the year. The results obtained showed that the milk samples examined would be considered free from peaks of metal contamination. The metal contents of milk analysed were not related to the different degrees of pollution in the various zones or the type of the animals' diet, but mainly to chance.
Specific and non-specific parameters of the host defence system in patients with superficial fungal infections.
Some measures of systemic host defences, i.e. white cell counts, lymphocyte subsets, delayed-type hypersensitivity and polymorphonuclear leucocyte functions, were evaluated in 42 patients suffering from cutaneous superficial mycoses and in 35 healthy volunteers. Patients were divided according to the extent of their lesions into two groups: group A (30 patients) with skin involvement > or = 30% and group B (12 patients) with skin involvement < or = 1%. No significant abnormalities in systemic defence mechanisms were observed in group B patients, whereas multiple alterations of polymorphonuclear phagocyte activities, i.e. chemotaxis, phagocytosis, mitogen-induced superoxide anion production, were observed in patients with extensive lesions. The values of these phagocytic functions remained significantly reduced (P < 0.01) in these patients after recovery and during a 6-month follow-up period.
Pityriasis versicolor in a newborn.
Pityriasis versicolor is a superficial mycosis that rarely afflicts children. We present a case in a 2-month-old male baby in good health, with hyper- and hypopigmented macules located in the cervical region and on the scalp, face and chest. Moreover, we report our record of cases in infancy and the predisposing factors.
Predicting visual assessment of allergic patch test reactions by non-invasive measurements.
The quantification of allergic patch test reactions to several compounds was evaluated on patients using laser Doppler velocimetry (LDV), transepidermal water loss and colorimetry. The correlation between visual scores and instrumental measurements was investigated by the implementation of a modern statistical method: a classification tree. The LDV showed the highest correlation with the severity of the reaction. The best prediction model was obtained when the data of the three instruments were considered together. Using the classification tree methodology, a model of classification, independent of human observation, was developed. The technique can not only predict an allergic reaction for a new patient, but can also give a measure of how reliable its predictions are. This new method, when entirely standardised and approved, could help in the harmonisation of patch test reactions in different laboratories, thus allowing a more homogenous interpretation of these reactions.
Neutrophil recruitment in the reperfused-injured rat liver was effectively attenuated by repertaxin, a novel allosteric noncompetitive inhibitor of CXCL8 receptors: a therapeutic approach for the treatment of post-ischemic hepatic syndromes.
Hepatic reperfusion injury represents a crucial problem in several clinical situations including liver transplantation, extensive hepatectomy and hypovolemic shock with resuscitation. Repertaxin is a new non-competitive allosteric blocker of interleukin-8 (CXCL8) receptors, which by locking CXCR1/R2 in an inactive conformation, prevents receptor signaling and polymorphonuclear leukocyte (PMN) chemotaxis. The present study shows that repertaxin dramatically prevents rat post-ischemic hepatocellular necrosis (80% of inhibition) and PMN infiltration (96% of inhibition) at a clinically-relevant time (24 h) of reperfusion. Treatment with repertaxin by continuous infusion is demonstrated to be the optimal route of administration of the compound especially in view of its clinical therapeutic use. Because repertaxin has proven to be safe and well tolerated in different animal studies and in phase I studies in human volunteers, it is in fact a candidate novel therapeutic agent for the prevention and treatment of hepatic post-ischemic injury.
[Chronic inflammation and endothelial dysfunction: analysis of a cohort of patients with SLE and UCTD].
OBJECTIVE: Cardiovascular complications, mainly caused by an accelerated atherosclerosis, are one of the leading causes of death and disability in patients with systemic autoimmune diseases. Endothelial dysfunction is considered the earliest and reversible step of atherogenesis. Aim of the present study is to investigate endothelial function (EF) in patients with systemic lupus erythematosus (SLE), undifferentiated connective tissue diseases (UCTD) and correlate the results with clinical and laboratory variables. METHODS: EF was assessed on the peripheral microcirculation by the perfused forearm technique that can estimate both endothelium- dependent and endothelium- independent vasodilatation. The same evaluation has been repeated in two patients after the administration of 20 mg of 6-metilprednisolone. RESULTS: Twenty-three female patients with SLE or UCTD, with a follow up of at least 1 year have been studied and compared with 8 healthy controls matched for epidemiological variables and traditional risk factors for cardiovascular disease. A significant reduction both in endothelium dependent than endothelium independent vasodilatation was observed in both patients groups compared with controls. In addition, UCTD patients demonstrated a significant reduction in the nitric oxide pathway compared with controls and SLE patients. Finally, steroid administration induced an improvement of vascular reactivity. CONCLUSIONS: Despite the well documented side effects of chronic corticosteroid therapy, our data might suggest a role for antinflammatory and immunosuppressive therapy in the prevention of premature atherosclerosis in patients with systemic autoimmune diseases.
Undifferentiated connective tissue diseases (UCTD): a review of the literature and a proposal for preliminary classification criteria.
The connective tissue diseases include a heterogeneous group of conditions characterized by a wide variety of signs and symptoms. There also exists, however, a group of systemic autoimmune disorders with signs and symptoms not sufficiently evolved to fulfill any of the accepted classification criteria for the defined connective tissue diseases. These conditions have been defined as undifferentiated connective tissue syndromes, latent lupus, incomplete lupus, and undifferentiated connective tissue diseases. After an analysis of the existing literature, we discuss the possible significance of the undifferentiated diseases among the already defined connective tissue diseases and make a proposal for preliminary classification criteria for these conditions.
Treatment of the idiopathic inflammatory myopathies: a retrospective analysis of 63 Caucasian patients longitudinally followed at a single center.
OBJECTIVE: To analyze the therapies used over the past 20 years at a single center to treat patients with idiopathic inflammatory myopathies (IIM), and to compare their effectiveness. METHODS: Sixty-three Caucasian IIM patients were selected for this study based on the following parameters: (i) a definite diagnosis of IIM; (ii) a follow-up period of at least one year; and (iii) a complete record of clinical and serological data for the course of the follow-up. The following data were collected from the patients' records: the first choice and subsequent therapies, the patient's response to these treatments, the outcome at the end of the follow-up. RESULTS: Two therapeutic approaches were identified: steroids alone and the combination of steroids with immunosuppressive drugs. Of the 63 patients studied, 36 received steroids alone and 27 received steroids plus immunosuppressors. Sixteen patients did not respond to the initial therapy, 33 showed a stable response, and 14 experienced a relapse in disease activity during the follow-up. No statistically significant differences among these 3 groups of patients were observed with respect to sex, age at disease onset, diagnosis, CPK levels at disease onset, and therapeutic approach. CONCLUSION: Corticosteroids represent the mainstay of IIM therapy, both as the first choice treatment and as maintenance therapy. The use of immunosuppressive agents should be restricted to those patients with severe contraindications to steroid treatment.
[Preliminary study on the effects of various environmental pollutants in a group of newspaper sellers].
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Undifferentiated connective tissue diseases in 2004.
The existence of patients with signs and symptoms suggestive of a systemic autoimmune disease but not fulfilling the classification criteria for defined diseases is a common experience in clinical practice. The first description of these diseases dates back to 1980, when LeRoy proposed the term "Undifferentiated Connective Tissue Syndromes" (UCTS) to define the early phases of connective tissue diseases that at their onset are undefined, as opposed to mixed or overlapping syndromes in which the disease appears well defined. LeRoy also raised the fundamental question as to whether a proportion of patients with an undifferentiated profile may see their condition remain undifferentiated or even experience a remission of all pathologic features, rather than evolving to a definite connective tissue disease (CTD). Many studies conducted on undifferentiated diseases have shown that up to 75% of patients will not develop a defined CTD and that these conditions exhibit typical clinical and serological manifestations and a good prognosis. We and others have defined these conditions as Undifferentiated Connective Tissue Diseases (UCTD) and it is our opinion that the UCTD represent distinct clinical entites. UCTD could offer an ideal clinical model for the study of single autoantibody specificities, the effects of various factors (such as pregnancy) on the disease course, and the general pathogenesis of autoimmune conditions. Before they can be so used, more must be discovered about their nature and characteristics, and studies will be necessary to improve the sensitivity and specificity of the existing preliminary classification criteria.
Lupus erythematosus and the skin.
Cutaneous manifestations of patients with lupus erythematosus (LE) are very frequent, show a great variety and can occur at any stage of the disease. The most consistent environmental trigger factors so far recognized are exposure to ultraviolet light and certain drug classes known to be capable of inducing LE in otherwise healthy individuals. A classification system has been established including clinical, histologic, photobiologic, serologic, and immunogenetic findings to better define the different cutaneous subtypes of LE. During their clinical evolution, the cutaneous manifestations vary considerably, and, therefore, the diseases which should be considered in differential diagnosis are different, according to the stages of disease development. Furthermore, 25 years of experience worldwide have revealed that individuals whose disease presentation is dominated by subacute cutaneous LE skin lesions and the presence of circulating anti-Ro/SS-A antibodies represent a rather homogeneous immunogenetic subphenotype of LE that enjoys a good prognosis over time. Treatment should be individualized according to disease severity. The majority of patients with cutaneous manifestations of LE do not require systemic immuno-suppressive/ immunomodulatory therapy and the advent of recombinant biologicals has given hope to the small percentage of patients that suffer from particularly severe skin disease activity.
Assessing remission in systemic lupus erythematosus.
The past few decades have witnessed development and validation of indices to assess activity, damage, and quality of life (QoL) in patients with systemic lupus erythematosus (SLE). These indices are widely used in clinical research and randomised controlled clinical trials, but not in usual clinical care. Definitions of flares and response to therapy have been proposed on the basis of indices. However, criteria for disease remission have not been clearly established for these indices, except for the SLE Disease Activity Index (SLEDAI). Defining remission in SLE in an objective manner depends on reaching agreement on the relative importance of systemic activity, damage, QoL, and laboratory tests, as well as activity and damage of specific organs.
[Double-blind comparison of a betamethasone dipropionate-iodochloroxyquinoline combination and a flumethasone pivalate-iodochloroxyquinoline combination in the therapy of steroid-sensitive dermatoses with superinfection].
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[The therapeutic activity of an anti-mycotic preparation (Vancide 89 RE-BTC 2125 M 50%)].
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Guidelines for the management of essential mixed cryoglobulinemia.
The principal therapeutic procedures and when they are clinically indicated in the management of essential mixed cryoglobulinemia (EMC) have been the subject of much debate. This paper reviews current knowledge and our experience in the treatment of this complex disease. It is generally agreed that patients with purpura, the primary symptom of EMC, should avoid long periods of sitting or standing in the same position. Non-steroidal antiinflammatory drugs can be used for the management of arthralgias and/ or arthritis. Low dose steroids (0.5-0.3 mg/kg/die) are usually sufficient to control the purpura, arthralgias, arthritis and weakness, while larger doses (0.5-1.5 mg/kg/die) are needed to treat the renal involvement, peripheral neuropathy and serositis. Since the discovery of the association between EMC and viral infections, the appropriateness of cytotoxic drugs has been re-evaluated and they are no longer used. With the low antigen content diet, a regimen designed to restore a saturated mononuclear phagocytic system, good results have been obtained in the treatment of purpura, arthralgias, weakness and peripheral neuropathy. Furthermore, this dietary regimen may play a steroid sparing role. Plasma exchange is widely used in the management of severe renal involvement, hyperviscosity syndrome, sensory motor neuropathy and liver involvement in EMC.
Surviving catastrophic gastrointestinal involvement due to Churg-Strauss syndrome: report of a case.
Gastrointestinal (GI) involvement is not rarely encountered in Churg-Strauss syndrome (CSS). We describe the case of a young white woman presenting with acute acalculous cholecystitis, who subsequently developed, despite prompt administration of immunosuppressive therapy, life threatening GI involvement, requiring multiple operations. Over a 7-month period the patient eventually recovered from her disease. Forty-two months later she is free from symptoms, with low daily doses (6 mg) of oral methylprednisolone. Although medical and surgical complications of CSS may develop while the patient is undergoing therapy, early diagnosis with joint surgical and medical management is essential to bring the disease under control.