PubMed Health⌕ Search

Biomedical subjects

R Marcolongo

Publications and source records attributed to R Marcolongo.

At least 109 records · Page 6Linked to original sources

[Evaluation of the efficacy of intra-articular administration of somatostatin in rheumatoid arthritis].

The above study was undertaken in order to evaluate the efficacy of intra-articular somatostatin in rheumatoid arthritis. Twelve patients were enrolled and all of them concluded the experiment of three consecutive intra-articular somatostatin injections of 750 mcg at two-weekly intervals. All patients reported a statistically significant reduction in painful symptomatology, particularly of pain during active movement, pain at climbing stairs, and morning stiffness. In one patient, telethermography revealed complete subsidence of articular inflammation. There were neither local nor systemic side effects.

Adolescent↗

A placebo-controlled study of the efficacy and tolerability of a nonsteroidal anti-inflammatory drug, DHEP plaster, in inflammatory peri- and extra-articular rheumatological diseases.

A double-blind, randomized, placebo-controlled study has been carried out in order to assess the effects of the new topical cutaneous formulation, diclofenac hydroxyethylpyrrolidine (DHEP) plaster. Sixty patients (10 M + 50 F, mean age 56.6 yrs) suffering from local inflammatory processes in peri-articular/tendinous and/or extra-articular sites were involved in this study and randomly given either DHEP plaster or placebo plaster. Plasters were applied and left on the site of inflammation b.i.d. (at 8 a.m. and 8 p.m.) for 14 days. Patients under stabilized systemic treatment with NSAIDs, glucocorticoids and/or basic therapy for over 2 months, maintained this treatment unchanged during the course of the study. Patients were examined on days 3, 5, 7 and 14. The effects of the treatments were assessed using subjective, semi-quantitative (provoked pain, peri-articular swelling, doctor-patient judgement, telethermographic index) and quantitative variables (spontaneous pain measured using a visual analogical scale). In the peri-articular pathologies, spontaneous and provoked pain decreased faster and in a clinically relevant manner in the group treated with DHEP plaster compared to the control group (p < 0.01). Local inflammation, objectively evaluated using the telethermographic index, showed consistent reduction during the study which was statistically significant from day 3 onwards and significantly different compared to the control group. Global assessment of efficacy, expressed by the investigator and the patients, was significantly better (good to excellent after only 7 days in 70% of the cases) in the DHEP group compared to the placebo group. In the extra-articular pathologies, results similar to those reported earlier were obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗

Pharmacokinetics of diclofenac hydroxyethylpyrrolidine (DHEP) plasters in patients with monolateral knee joint effusion.

The aim of this study was the assessment of blood and synovial levels of diclofenac after repeated epicutaneous dosing with DHEP plasters in patients with joint effusion. To eight volunteers suffering from monolateral knee joint effusion, DHEP plasters containing 180 mg DHEP each, were applied on the affected knee b.i.d. (at 8 a.m. and 8 p.m.) for 4 consecutive days (8 doses) and only at 8 a.m. of the 5th day (9th dose). Plasters were left on the affected area until the following application or for 12h the 5th day. Venous blood samples were collected immediately before the first dosis and 1, 4 and 8 hours after the 9th application, while synovial fluid (SF) from the affected knee joint was collected at the beginning of the study and at 4 hours after the 9th DHEP plaster application. Unchanged diclofenac was measured in plasma and SF by means of a GLC-mass spectrometry technique. Low but durable levels of diclofenac were obtained at each collection after dosing in plasma. Detectable SF concentrations of diclofenac at the 4th hour of the 9th application were obtained, thus indicating the diffusion of diclofenac into the synovial liquid. The authors conclude that the topical application of DHEP plaster b.i.d. for 4 days allows measurable levels of diclofenac to be obtained in the underlying affected joint, without producing elevated circulating blood concentrations of diclofenac, thus greatly reducing the risk of possible systemic side effects.

Administration, Cutaneous↗

[Long-term treatment with i.v. immunoglobulin in the therapy of systemic lupus erythematosus].

BACKGROUND: Treatment of several autoimmune diseases with intravenous gammaglobulins (IvIg) has been demonstrated to be safe and effective in determining clinical improvement and decreasing autoantibody titer. We tested the hypothesis that IvIg would be effective in patients with Systemic Lupus Erythematosus (SLE). METHODS: We conducted an open trial involving 12 patients with SLE refractory to conventional treatments with monthly infusion of IvIg at a dosage of 400 mg/kg/day for 5 consecutive days. The duration of the therapy with the same dose every 4 weeks was from 16 to 24 months. RESULTS: A progressive clinical improvement was observed in 11 patients during IvIg therapy, and it persisted during the all period of treatment. The clinical improvement was associated with an increase of haemoglobin, albumin levels, total serum complement and C3 and C4 components, platelets count in 2 thrombocytopenic patients, and a progressive reduction of ESR, plasma immunocomplexes and antinuclear antibodies. A marked improvement in serum urea, creatinine clearance and proteinuria was also observed in the patients with renal involvement. We have not observed any adverse effects with the long-term use of this treatment. Several mechanisms have been postulated to explain the effect of IVIg in the treatment of autoimmune diseases. Many experimental and clinical data support the interesting hypothesis that IVIg may be effective in some autoimmune diseases by restoring a normal function or the physiological immune network through the same regulatory mechanisms leading to a suppression of autoimmune disorders in normal individuals. The presence of a wide spectrum of anti-idiotypic antibodies in IVIg could regulate T and B-cell activities preventing the emergence of B-cell clones with specificity for autoantigens epitopes and down-regulating autoantibodies production. CONCLUSION: The results obtained suggest that IvIg therapy seems to be a promising and beneficial approach in the treatment of SLE. However, double-blind studies are necessary to confirm the results obtained particularly to ascertain the optimal dosage, the schedule of infusion and the duration of maintenance therapy with IVIg, and to determine their long-term effectiveness, the reduction in late morbidity and mortality and the effect on the quality of life of patients with SLE. Moreover, because of the high cost of IVIg, their use seems to be especially indicated for patients non responders to conventional treatments and for these with infectious complications.

Acute Disease↗

[Anti-ENA antibody determination in various connective tissue diseases: comparison of 2 detection techniques].

The authors compared two different techniques for the detection of anti-ENA antibodies (anti-Sm, anti-RNP, anti-SSA, anti-SSB) in several different connective tissue diseases, using double immunodiffusion (ID) and a new membrane-based enzyme immunoassay. The aim of the work was to research the assay sensibility and specificity of the results obtained with the two different methods. Notwithstanding the fact that the two techniques are equivalent in their performance, the recombinant DNA appears to have greater sensibility and less specificity compared to ID. The former requires less time of execution although it presents difficulty in interpreting low scale positive results. Although the number of sera examined was low, the authors assert that the recombinant DNA technique will require further development.

Adolescent↗

[The utility of a classification scale of lumbar pain for the diagnosis of the fibromyalgia syndrome].

To help fibromyalgia syndrome's diagnosis, the authors propose the use of Back Pain Classification Scale (BPCS), verbal test for pain analysis, able to distinguish between organic and functional disease. Two-hundred patients suspected for fibromyalgia and forty controls completed the questionnaire and so it was possible correctly to distinguish patients with organic disease from those affected by fibromyalgia. The authors conclude that BPCS can represent a useful tool for fibromyalgia diagnosis.

Adult↗

Analysis of HLA DP, DQ, and DR alleles in adult Italian rheumatoid arthritis patients.

We analyzed the distribution of DRB1, DQA1, DQB1, and DPB1 allelic variants in 48 rheumatoid arthritis (RA) patients, compared with 109 Italian random controls, using PCR amplification and hybridization with specific oligonucleotides. We confirm the previously reported increase of DR4 specificity, in comparison with healthy Italian individuals. In particular, we find a statistically significant positive association of DRB1*0401 and DRB1*0404 alleles with RA. However, when we compare the DR4+ groups, none of the DRB1*04 alleles is increased in the RA group. By sequence analysis, performed on 10 patients, we demonstrate that the DRB1*04 genes of RA show no difference from the DRB1*04 sequences previously published. From the molecular analysis of the other DRB1 polymorphic variants, we find a trend of positive association of DRB1*0101 in DR4-negative patients versus DR4-negative healthy controls and, in the group of DR4-negative and/or DR1-negative patients, a similar increase of DRB1*06. Also, we observe in RA patients a statistically significant increase of DQA1*0301 and DQB1*0302 accompanied by a significant decrease of DQA1*0201, DQA1*0501 and DQB1*0201. Finally, from the analysis of DPB1 gene, it can be assessed that the distribution of DPB1 alleles does not differ significantly between RA patients and healthy controls.

Adult↗

[Efficacy and tolerability of iloprost in the treatment of digital vasculitis secondary to connective tissue diseases].

The authors have evaluated the effects of long-term treatment of digital vasculitis secondary to various types of connective tissue disease, Systemic Lupus Erythematosus (SLE), Progressive Systemic Sclerosis (PSS), Sjögren's Syndrome (SS), using iloprost. The drug has proven to be effective both in reducing pain and clinical symptoms induced by vasospastic phenomena, as well as in promoting the healing of serious acral ischemic lesions. In the patient with LES, clinical modifications of the local vasculitic phenomena have been associated with a contemporaneous remission of the disease. The persistence of the drug's clinical effects even after suspension of treatment, instrumental and biohumoral changes and concomitant systemic effects on the disease lead to the conclusion that the drug's effect, is not merely due its vasodilating action and its ability to interfere with the coagulative process, but rather must be sought within the context of a morpho-structural repair of the microcirculation.

Adult↗

[Ketoprofen efficacy and tolerance in simple painful shoulder].

Thirty patients presenting with painful shoulder syndrome were treated with i.m. ketoprofen 100 mg b.d. for 8 days to assess the efficacy and tolerance of the above treatment regime. The patients' condition was monitored by clinical, instrumental and laboratory examinations. Ketoprofen was found to be significantly effective in all cases of non calcific rotator cuff tendinitis while no improvement was noted in calcific tendinitis. The above data confirm the efficacy and tolerance of ketoprofen in the treatment of painful shoulder syndrome as an alternative to local steroid therapy.

Adult↗

[Evaluation of the use of thymopentin in patients with progressive systemic sclerosis].

Although the exact etiology of progressive systemic sclerosis (SSP) is still unknown, it is felt that immunologic disorders may be implicated in its pathogenesis. On the basis of these considerations, an open study with an immunomodulating drug, thymopentin, was performed in 20 SSP outpatients. These subjects were initially treated with thymopentin three times a week for three consecutive months (phase I); during a second study phase lasting three months, 10 patients continued to receive thymopentin and the remaining 10 placebo (phase II). A significant improvement in various clinical, laboratory and instrumental findings was seen following thymopentin treatment. During phase II, those on placebo regressed to basal conditions, while an added improvement was noted in those who continued with thymopentin.

Female↗

[Clinical report of a case of CREST syndrome].

A case of CREST syndrome presenting with marked diffuse calcinosis and prevailing joint involvement is presented by the authors. Diffractometry revealed the presence of calcified hydroxy-apatite crystals within subcutaneous nodules. Scleroderma-like microcirculatory changes with blood flow alterations typical of Raynaud's syndrome were present on capillaroscopy. The authors feel the case to be of interest not only in view of the rare occurrence of the condition but also of the particular extent and severity of the signs and symptoms presented by this patient.

Female↗

[Clinical experiences with tenoxicam. Preliminary results of a multicenter study].

Preliminary data concerning the efficacy and tolerability of tenoxicam in a large, multicenter Italian study are presented. In many centres 625 patients (31% of the total) have been evaluated: 283 patients with osteoarthrosis and 342 with extra-articular rheumatism completed the study. Efficacy of tenoxicam (20 mg/die) was stated as equivalent or superior to reference drugs (diclofenac 100 R, piroxicam 20 mg). Tolerability profile has been generally good; tenoxicam, in particular showed the lowest incidence of side effects (7.4%).

Adult↗

Clinical efficacy and tolerance of galactosoaminoglucuronoglycan sulfate in the treatment of osteoarthritis.

An open design has been carried out by the authors comparing the efficacy and the tolerance of galactosoaminoglucuronoglycan sulfates (GAGs) with those of ibuprofen lysine in patients affected by osteoarthritis (OA). The experimental group included forty patients of both sexes, aged from 35 to 67 years, with diffuse OA. Ten patients were treated with GAGs administered orally (600-1200 mg/die) and ten patients with GAGs administered intramuscularly (50-100 mg/die); likewise for the ibuprofen therapy two subgroups were formed, such that ten patients were given the drug orally (1500-2500 mg/die) and ten patients had intramuscular therapy (400-800 mg/die). The treatment lasted 40 days. The parameters considered were: pain at rest, pain on pressure, pain on active movement and pain on passive movement. Tolerance was considered by carrying out some routinary laboratory tests and a careful clinical and anamnestic examination. At the end of the study, an improvement in all the clinical variables considered was found in both groups of patients, with no significant differences between the oral and the intramuscular administrations. With regard to tolerance, it must be noted that 10% of the patients in each of the two considered groups patients suffered from gastro-intestinal diseases (pain, nausea, pyrosis). The results achieved, therefore, confirm the efficacy and above all the good tolerance of GAGs in the treatment of OA, characteristics of particular importance for a drug designed for the therapy of a chronic pathology such as OA.

Adult↗

Electrophysiologic evaluation of local steroid injection in carpal tunnel syndrome.

Extensive sensory and motor nerve conduction studies were performed in a series of patients with electrophysiologically proven, idiopathic carpal tunnel syndrome who were treated by a single steroid injection (40 mg of triamcinolone acetonide). Electrophysiologic studies, which included evaluation of median, ulnar, and radial orthodromic sensory action potentials, median and ulnar motor action potentials, and electromyography of two intrinsic muscles of the hand, were done before and at 45 days and six months after the treatment. By the end of the follow-up period, the symptoms had remitted completely in 11 hands (35%), 18 (58%) benefitted from partial relief, and two did not improve. In addition to the relief of symptoms, abnormalities of motor nerve conduction improved in 65% of cases, and abnormalities of sensory nerve conduction improved in 73% of all the individual digital branches of the median nerve examined. Recovery of function of the median nerve continued for a long period, even after the pharmacologic effect of the steroid agent had presumably ceased.

Action Potentials↗

[Analgesic activity of cinnoxicam. Findings of clinical sensimetry].

The antalgic activity of a newly characterized NSAID (cinnoxicam) was evaluated by cutaneous sensimetry. A precocious and significant increase in pain threshold was demonstrated by the algometric data observed after oral administration of one tablet of the drug under examination in both healthy volunteers and in rheumatic patients.

Administration, Oral↗