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R Marcolongo

Publications and source records attributed to R Marcolongo.

At least 91 records · Page 5Linked to original sources
PubMed1996

Antineutrophil cytoplasmic antibodies in synovial fluid and in serum of patients with rheumatoid arthritis and other types of synovitis.

OBJECTIVE: Antineutrophil cytoplasmic antibodies (ANCA) are present in several vasculitides and in other immunomediated diseases. The reported prevalence of ANCA in rheumatoid arthritis (RA) is variable. In addition, the presence of such autoantibodies has been poorly investigated in synovial fluid (SF). The objectives of this study were (1) to investigate the presence of ANCA both in the serum and in SF from patients with RA and other forms of synovitis (OS); (2) to analyze the reactivity of ANCA against isolated antigens proteinase 3 (PR3), myeloperoxidase (MPO) and lactoferrin (LF); and (3) to evaluate the clinical relevance of these autoantibodies. METHODS: Twenty-eight patients with RA, 13 with OS, and 17 with osteoarthritis (OA) of the knee joint were studied. No patient had clinical manifestations of vasculitis. SF and serum samples were investigated for the presence of ANCA by indirect immunofluorescence (IIF); the reactivity against PR3, MPO and LF was assessed by ELISA. RESULTS: ANCA were detected by IIF in SF of 39.3% patients with RA, 38.5% with OS, and 5.9% with OA. With 2 exceptions, patients who had ANCA in SF showed positivity also in serum. The presence of both anti-MPO and anti-LF antibodies was found in 3 patients with RA and 1 with OA; a patient with RA showed antibodies only against LF and another one with RA only against MPO. No reactivity was found against PR3. In patients with RA ANCA were not associated with disease activity. CONCLUSION: We found an increased incidence of ANCA both in SF and serum from patients with RA and OS. The pathogenic role and the clinical relevance of such autoantibodies in these diseases remain to be established.

Adult↗
PubMed1995

Immunosuppressive therapy prevents recurrent pericarditis.

OBJECTIVES: This study reviews the clinical outcome of a series of patients with recurrent pericarditis before and after immunosuppressive therapy. BACKGROUND: Despite anti-inflammatory treatment, some patients with acute pericarditis experience repeated relapses of the disease. The use of steroids for the treatment of recurrent pericarditis remains controversial. METHODS: Twelve patients (4 women, 8 men; mean [+/- SD] age 35.9 +/- 17.2 years, range 15 to 65) with recurrent pericarditis unrelated to any systemic disease were selected. All 12 patients previously received ineffective short-term courses of low dose steroids and had a total of 39 relapses during a mean follow-up period of 14.2 months (range 4 to 50). A 3-month course of treatment with prednisone, at an immunosuppressive dosage, was started (1 to 1.5 mg/kg body weight per day for 4 weeks, then gradually withdrawn). When prednisone reduction was undertaken, all patients started a 5-month course of treatment with aspirin (1.6 g/day until steroid suspension, then reduced to 0.8 g/day). RESULTS: During a mean follow-up period of 41.6 months (range 7 to 104), immunosuppressive treatment with high dose prednisone resulted in stable remission in all except one patient, who experienced one relapse. In this patient, the addition of azathioprine to prednisone induced a persistent remission, which remained after 1-year follow-up. During treatment, three patients had severe steroid-related adverse effects that in two patients required replacement of prednisone with azathioprine and cyclophosphamide, respectively. This variation in the immunosuppressive regimen did not modify the favorable clinical outcome. CONCLUSIONS: The dose and duration of steroid treatment are critical factors in preventing recurrent pericarditis. High dose prednisone with aspirin should be considered in the treatment of recurrent pericarditis resistant to anti-inflammatory therapy. Cyclophosphamide or azathioprine should be reserved for patients who do not respond to high dose prednisone or who experience severe complications related to steroid therapy.

Adolescent↗
PubMed1995

A comparative study of tenidap, a cytokine-modulating anti-rheumatic drug, and diclofenac in rheumatoid arthritis: a 24-week analysis of a 1-year clinical trial.

Tenidap is a novel anti-rheumatic drug that combines cytokine modulation with cyclo-oxygenase inhibition. This 24-week, multicentre, double-blind, randomized study compared the clinical efficacy, biochemical effects and safety of tenidap 120 mg/day (once daily) with diclofenac 150 mg/day (50 mg t.i.d) in the treatment of 384 patients with active rheumatoid arthritis. After 24 weeks, improvement with tenidap was significantly greater than with diclofenac for all five primary efficacy parameters, two of the four secondary efficacy parameters and 11 of the 13 Arthritis Impact Measurement Scales assessments. The superior efficacy of tenidap was apparent after 4 weeks of treatment with further improvements observed by 24 weeks. The probability of discontinuation due to lack of efficacy was significantly greater in the diclofenac group. Tenidap but not diclofenac was associated with significant, rapid and sustained reductions in C-reactive protein and serum amyloid A levels and with a significant reduction in plasma interleukin-6. The nature and frequency of side-effects were similar in the two groups as was the discontinuation rate for treatment-related safety reasons. Tenidap was associated with an equal incidence of elevated transaminases, but a higher incidence of mild (> or = 500 mg/24 h < 1500 mg/24 h) non-progressive, proteinuria of proximal tubular origin compared with diclofenac.

Acute-Phase Proteins↗
PubMed1995

Childhood onset cyclic neutropenia: G-CSF therapy restores neutrophil count but does not influence superoxide anion and cytokine release by neutrophils.

In this paper we describe the case of a 16-year-old boy with childhood onset cyclic neutropenia (CN) with a 21 d cycle who was successfully treated with recombinant granulocyte-colony stimulating factor (G-CSF). Cyclic therapy with G-CSF (5 micrograms/kg/d s.c. for 1 week every 21 d) maintained peripheral neutrophil count above the normal range, reduced the incidence of severe infections and significantly improved the patient's performance status throughout an 18-month follow-up. Phenotypic analysis of circulating lymphocytes demonstrated that G-CSF treatment does not modify the phenotypic profile of circulating B, T and NK cell populations. Circulating neutrophils released normal amounts of cytokines (including IL-1 beta, IL-8, TNF alpha) and superoxide anion during G-CSF therapy.

Adolescent↗
PubMed1995

A multi-centre, double-blind comparative study of the efficacy and safety of aceclofenac and diclofenac in the treatment of rheumatoid arthritis.

A long term multi-centre, double-blind, parallel group study was undertaken to investigate the efficacy and safety of aceclofenac (170 patients, 100 mg b.i.d. and placebo once daily) in comparison to diclofenac (173 patients, 50 mg t.i.d.) given for 6 months to patients of both sexes with active rheumatoid arthritis. Efficacy was evaluated in 131 aceclofenac and 130 diclofenac patients at 15 days, 1, 2, 4 and 6 months. Although both treatment groups showed significant improvement in all evaluations of pain and inflammation (assessed by a Visual Analogue Scale and the Ritchie Index) and a progressive reduction in morning stiffness, there were no significant differences between the groups. There was, however, a trend towards greater improvement in hand grip strength with aceclofenac (22% improvement) than diclofenac (17% improvement). Adverse events in both groups were minor, predominantly gastro-intestinal, and fewer patients tended to experience gastro-intestinal events on aceclofenac (13%) than on diclofenac (17%). The overall assessment of tolerance, however, did not differ significantly between groups. In summary, this study supports a therapeutic role for aceclofenac in the treatment of rheumatoid arthritis, and suggests it is an effective and safe NSAID for the treatment of this disease.

Adult↗
PubMed1995

Somatostatin 14 and joint inflammation: evidence for intraarticular efficacy of prolonged administration in rheumatoid arthritis.

Previous studies with intraarticular administration of somatostatin (SST14) in rheumatoid arthritis showed an antiinflammatory and analgesic effect. The aim of the present study was to demonstrate the efficacy and tolerability of SST14 in rheumatoid arthritis (RA) patients for a longer period of treatment than previously scheduled. Forty-one patients with RA of the knee were treated with a cycle of intraarticular injection of 750 micrograms of SST14, every 15 days. The efficacy of SST14 was evaluated by determining acute phase parameters (erythrocyte sedimentation rate, C-reactive protein [CRP]) and by clinical assessment (pain at rest and on movement, joint tenderness, morning stiffness, spontaneous pain). Additionally, telethermography was performed to evaluate the intensity of the joint inflammation. The tolerability of the treatment was also assessed both by patients and physicians. SST14 produced a reduction in all parameters; this was already statistically significant after the second injection in terms of pain at rest and on movement, and after the third injection for all other symptoms. The treatment showed an excellent tolerability, both local and systemic. Our results indicate the analgesic property of SST14 and demonstrate its capacity to reduce progressively joint inflammation confirmed by thermography and by reduction of pain, after a month of therapy.

Acute-Phase Proteins↗
PubMed1995

[Laboratory and instrumental clinical study of 150 patients with psoriatic arthritis].

The study included a 5-year-follow-up. We noticed that our data did not agree with the data in literature as regards the distribution percentage of the various articular subsets. It was pointed out that the distribution percentage of some particular clinical subsets of the disease (for example the symmetrical polyarticular subset and the spondylitic and/or sacro-iliac subset) were linked to sex. The study of the bio-humoral parameters showed that the most significant data was the particular clinical and radiological severity of PA in the patients with high IgA levels. Radiological findings showed the involvement of the sterno-clavicular and manubriosternal joints by osteoproduction and/or erosive manifestations, which was associated with a particular clinical severity of the disease. Eventually, our study revealed a significant relationship between psycho-physical stress and articular and/or cutaneous manifestations of the disease. This data seems to confirm the recent neuro-immunological studies hypothesizing a likely role of stress and subsequent depression in the ethiopathogenesis of rheumatic diseases caused by an immune imbalance.

Adult↗
PubMed1995

[Estrogens and cartilage: an ex vivo ultrastructural study].

The ultrastructural change brought about by administration of oestrogens on articular cartilage were evaluated in the course of the present study. To this end 3 stabilized postmenopausal patients were selected who were to undergo bilateral hip prosthesis. After the first operation the patients were started on continuous estriol treatment by oral route for 6 months. For study purposes a cartilage fragment was obtained during the first (baseline time) operation and the second operation (final time, after 6 months of oestrogen therapy). The results of histologic examination of the semifine sections as well as the submicroscopic patterns of the various cell elements showed great similarity in all cases considered. Ultrastructure examination had evidenced signs of marked cell damage in the 3 initial samples. After treatment with oestrogens, chondrocyte metabolic activity was resumed, evidenced by the presence of extensive granular endoplasmic reticulum with hypertrophic cisternae, finely dispersed nuclear chromatin and more regular nuclear membrane. These findings would appear to support metabolic stimulation of articular cartilage by the oestrogens.

Cartilage, Articular↗
PubMed1995

[Usefulness of the determination of C reactive protein and other acute phase proteins in rheumatoid arthritis].

The acute phase response is defined as a large number of diverse reactions which attempt to adjust the organism to the effects of stress/injury. It is now clear that there is a complex interaction between the cytokines with interleukin-6 predominant, but also involving interleukin-1, tumor necrosis factor and a group of recently described cytokines including as well interleukin-11, leukaemia inhibitory factor and oncostatin M all of which influence the levels of acute phase proteins. In clinical practice, C reactive protein (CRP) is frequently used as marker of the acute-phase response. It has a short half-life and consequently it is a sensitive measure of cytokine-induced protein synthesis. In rheumatoid arthritis (RA) the rate appearance of bony erosions in the early phase of the disease correlated with the mean serum concentration of CRP in some studies. A recent study examining the rate of spinal trabecular bone loss in the first year of rheumatoid disease found a strong correlation between bone loss and serum CRP concentrations. It appears that CRP concentrations reflect the level of "systemic osteoclast-activating factor" and are, therefore, a good measure of the general catabolic state of the patient. Many would now consider that persistently elevated serum CRP in patients with RA is in itself an indication for immunosuppressive therapy.

Acute-Phase Proteins↗
PubMed1994

Involvement of atlanto-axial joint in rheumatoid arthritis: rare or frequent?

The authors studied the incidence of atlanto-axial joint involvement by conventional radiography and CT in 183 patients with classical or definite rheumatoid arthritis (RA). In determining lesions the significance of factors such as age, sex, duration and severity of the disease was evaluated. Atlanto-axial subluxations turned out to be quite frequent (30%) in the series of patients examined and were directly correlated with age, duration and stage of the disease, and extraarticular manifestations. Clinical symptoms were evident in only 70.9% of cases, confirming the correlation reported by other authors between clinical manifestations and radiologically observed lesions. Traditional radiography performed in the dynamic position revealed a prevalence of anterior subluxation, whereas CT gave a precise indication of the entity and type of atlanto-axial lesion. In conclusion, the authors confirm the importance of such investigations in all patients with RA, even those without evident clinical manifestations. They also emphasize the necessity of periodic monitoring in view of the possible risk of mortality in these patients.

Adult↗
PubMed1994

Lymphoedema of the limbs in rheumatoid arthritis.

The lymphoedema of the extremities is a rare complication of rheumatoid arthritis (RA); it does not appear to be correlated with positivity for rheumatoid factor nor with the clinical activity of the disease. The authors describe 6 cases of lymphoedema in patients affected by RA; in 3 of them the lymphoedema was localized in the upper and in the remaining cases in the lower limbs. Four patients, (one of whom has been subjected to a lymphoangiography which demonstrates an obstruction of the deep lymphatics), presented an increase of the plasma fibrinogen degradation products (FDP). This could confirm the hypothesis according to which the lymphoedema could be attributable to an obstruction of the lymphatics caused by fibrin and other degradation products of the coagulation system. In one case the authors underscore the therapeutic effectiveness of lymphodrainage associated with administration of diuretics.

Adult↗
PubMed1994

Fibromyalgic syndrome: depression and abnormal illness behavior. Multicenter investigation.

This study reports psychological symptoms assessed in 327 patients with fibromyalgia (FS) in a multicenter investigation. Two self-report scales, in their validated Italian translations, were used for screening: the CES-D (the Center of Epidemiologic Studies-Depression) developed at the NIMH for measuring depression and the Illness Behavior Questionnaire (IBQ) developed by Pilowsky and Spence. The cutoff point of 23 in the CES-D scores revealed about 49% of the fibromyalgic patients as depressed. In analyzing patterns of illness behavior patients with FS showed a high score on IBQ scales of disease conviction, psychological versus somatic focusing and denial. CES-D scores showed significant correlations with illness behavior scales. These results and their implications for the treatment of fibromyalgic patients are discussed.

Adult↗
PubMed1994

[The role computerized telethermography in the diagnosis of fibromyalgia syndrome].

Fibromyalgia syndrome is a form of extraarticular rheumatism of unknown origin; its diagnosis is fundamentally based on clinical and anamnestic findings, on characteristics of pain and on number and sites of tender points, very painful areas to palpation. At present there is no laboratory or instrumental test available for a more objective diagnosis. The Authors verified the utility of telethermography for fibromyalgia syndrome diagnosis to point out a possible specific pattern; in particular the tender points were studied, even to find some analogy to myofascial syndromes trigger points, which appear as hot spot to telethermography. The telethermographic patterns of 156 patients with fibromyalgia syndrome have been compared with tender point maps obtained from same subjects and with telethermographic data of patients affected by spine osteoarthritis and normal controls. The patients with fibromyalgia syndrome showed a non specific hyperthermic pattern, corresponding to painful muscular areas, comparable with pattern of osteoarthritic patients. This phenomenon can be interpreted as a greater thermic emission by hypertonic muscles. Therefore, telethermography in fibromyalgia syndrome cannot represent a basic diagnostic tool but can support the clinical diagnosis and play an important role in the follow-up of patients.

Adult↗
PubMed1994

[Fast-dissolving sublingual tablets of piroxicam versus naproxen in the treatment of recurrent acute osteoarthrosis. Multicenter clinical trial].

An open comparative study was carried out to evaluate the efficacy and safety of piroxicam FDDF, for sublingual administration, versus naproxen in the treatment of osteoarthritis. Sixty-one patients with acute-phase osteoarthritis involving various joints are reported. They were treated with 20 mg/day piroxicam FDDF or with 1000 mg/day naproxen for a total of 4 weeks. Drug efficacy was evaluated on the base of the variation of spontaneous pain, pain on motion, functional limitation and capacity to perform a specific activity. The intensity of spontaneous pain on the first day showed a statistically significant improvement with both drugs, but the onset of analgesia was only after 15 minutes with piroxicam and after 1 hour with naproxen. The improvement in pain intensity increased on the first day and until the 7th day with both drugs, but the comparative analysis between the analgesic efficacy of the two treatments proved to be favourable to piroxicam. On the 7th day, pain on motion and the capacity to perform a specific activity showed a statistically significant improvement with both drugs, but the comparative analysis between the two treatments proved to be favourable to piroxicam. The two drugs showed the same efficacy in functional restriction. The local and systemic tolerability of piroxicam was good. Only 5 patients experienced 6 systemic side-effects, and 1 patients showed local side-effects, but 11 patients of the naproxen group showed 12 systemic side-effects. Thus piroxicam showed a better analgesic and anti-inflammatory efficacy than naproxen. Piroxicam proved to have a better systemic tolerability than naproxen. The local tolerability of piroxicam FDDF was good.

Acute Disease↗
PubMed1993

Expression and functional role of tumor necrosis factor receptors on leukemic cells from patients with type B chronic lymphoproliferative disorders.

Two receptors for tumor necrosis factor (TNF) with different molecular weight (75-Kd and 55-Kd) and binding affinity have been recently discovered. To investigate the distribution and the functional role of these receptors on leukemic B cells from hairy cell leukemia (HCL) and B-cell chronic lymphocytic leukemia (B-CLL) patients, we evaluated: (1) the cytofluorimetric pattern of uncultured and cultured leukemic B cells incubated with utr-1 and htr-9 monoclonal antibodies (MoAbs), which specifically recognize the 75-Kd and 55-Kd TNF receptors (TNFR), respectively; (2) the effect of TNF-alpha and TNF-beta on leukemic B cells in an in vitro proliferation assay; (3) the role of anti-TNFR MoAbs on TNF-alpha and TNF-beta-driven B-cell growth; and (4) the proliferative effect of utr-1 and htr-9 MoAbs on in vitro cultured leukemic cells. Our study shows that the high affinity (75-Kd) but not the low affinity (55-Kd) TNFR molecules are expressed on freshly isolated leukemic B cells recovered from HCL and B-CLL patients. The expression of these receptors was neither upregulated nor downregulated by different stimuli, including TNF-alpha, TNF-beta, B-cell growth factor, and interleukin-2. TNF-alpha efficiently triggers the proliferation of HC and, to a lesser extent, the growth of B-CLL cells. TNF-beta was also able to transduce the proliferative signal in HCL, but not in B-CLL patients. TNF-alpha- and TNF-beta-driven B-cell proliferation was inhibited by the preincubation of leukemic B cells with utr-1 but not htr-9 MoAb. Moreover, anti-75-Kd, but not anti-55-Kd TNFR MoAb, was able to trigger the proliferation of leukemic B cells, and in particular of HC. These results show that leukemic B cells from patients with HCL and B-CLL are equipped with a fully functional high affinity TNFR.

Aged↗
PubMed1993

Systemic sclerosis following anti-androgenic treatment for prostatic adenocarcinoma.

We describe a male patient who developed systemic sclerosis following orchiectomy, radiotherapy and anti-androgenic treatment for prostatic adenocarcinoma. This case appears interesting as it further supports the possibility of a relationship between neoplasia and systemic sclerosis. The concurrence of scleroderma and iatrogenic hypoandrogenism suggests that hormonal influences may also play a role in the pathogenesis of this connective tissue disorder.

Adenocarcinoma↗