PubMed Health⌕ Search

Biomedical subjects

S Accardo

Publications and source records attributed to S Accardo.

At least 55 records · Page 3Linked to original sources

The epidemiology of Lyme borreliosis in Italy.

Erythema migrans was described in Italy only in 1971 although Italian dermatologists were familiar with it a long time before. In 1983, the first case of Lyme borreliosis with multisystem involvement was identified. The endemic areas in Italy are the Ligurian coast, the province of Friuli Venezia Giulia, and the region surrounding the town of Bologna. In Liguria, the incidence of Lyme disease is about 17/100,000 inhabitants per year. Serosurveys of the general population and of sentinel animals were useless in determining the diffusion of Lyme borreliosis whereas evaluation of people at risk of tick bites and patients with suggestive signs or symptoms was more effective. Among the clinical manifestations of Lyme borreliosis, cutaneous involvement is four times more frequent than neuroborreliosis and arthritis is less frequent in Italy than in the USA.

Humans↗

Androgen replacement therapy in male patients with rheumatoid arthritis.

A hypogonadic condition characterized by low serum testosterone levels has been identified in male patients with rheumatoid arthritis (RA). Seven men with active RA were treated daily for 6 months with oral testosterone undecanoate plus a nonsteroidal antiinflammatory drug in an attempt to evaluate the immunologic response, the overall clinical response, and the sex hormone response to such replacement therapy. At the end of the 6 months, there was a significant increase in serum testosterone levels (P less than 0.05), an increase in the number of CD8+ T cells, and a decrease in the CD4+:CD8+ T cell ratio. The IgM rheumatoid factor concentration decreased significantly (P less than 0.05). There was a concurrent significant reduction in the number of affected joints (P less than 0.05) and in the daily intake of nonsteroidal antiinflammatory drugs (P less than 0.01). The well-known immunosuppressive action of androgens probably contributed to our findings in these RA patients.

Administration, Oral↗

Adult-onset Still's disease associated to toxoplasma gondii infection.

Adult-onset Still's disease is characterized by high spiking fever, evanescent maculopapular rash and arthritis. Several recent reports have associated its development with a variety of infectious agents. We describe the case of a 25-year old woman presenting high fever, maculopapular rash and seronegative polyarthritis associated with lymphoadenopathy, splenomegaly and neutrophil leucocytosis together with acute acquired toxoplasmosis. Other causes of systemic illness were excluded by appropriate laboratory, radiological and histological investigations. Clinical, radiological and laboratory findings as well as possible etiopathogenetic correlations among both pathological conditions are discussed. Toxoplasma gondii should be considered as a further possible triggering agent associated with the development of adult-onset Still's disease.

Adult↗

Nail involvement in osteoarthritis.

Two cases of nail involvement associated with primary interphalangeal osteoarthritis of the hand, including leukonychia and longitudinal nail ridge, are reported. Osteoarthritic changes of the distal interphalangeal joints may cause nail lesions by exerting direct pressure on the nail matrix or by interfering with local blood flow. Moreover, inflammation of the Heberden's nodes is often present and seems to participate in the development of nail alteration. In our patients, leukonychia disappeared after local steroidal anti-inflammatory treatment of the osteoarthritic node and longitudinal nail ridge disappeared after treatment with nonsteroidal anti-inflammatory agents.

Aged↗

Sex hormone status of male patients with rheumatoid arthritis: evidence of low serum concentrations of testosterone at baseline and after human chorionic gonadotropin stimulation.

Serum concentrations of luteinizing hormone, follicle-stimulating hormone, prolactin, 17 beta-estradiol, testosterone, androstenedione, dehydrotestosterone, dehydroepiandrosterone sulfate, and cortisol were examined in 14 men with rheumatoid arthritis (RA) and in age-matched osteoarthritis controls. Hypophyseal, adrenal, and testicular responses to stimulation with luteinizing hormone-releasing hormone, adrenocorticotropin, and human chorionic gonadotropin, respectively, were evaluated in 8 RA patients and in 8 age-matched healthy volunteers. Basal serum testosterone concentrations were significantly lower in male RA patients than in the osteoarthritis control subjects (P less than 0.01). After human chorionic gonadotropin stimulation, serum concentrations of testosterone were also lower in the RA patients than in normal healthy controls (P less than 0.05). These findings suggest that diminished testicular steroid biosynthesis might contribute to the serum testosterone deficiency observed in male RA patients.

Adult↗

Sex hormone status in women suffering from rheumatoid arthritis.

We studied the sex hormone status of 21 seropositive (IgM-RF) women with rheumatoid arthritis (RA), who were subdivided according to their premenopausal and postmenopausal status. Age matched women with secondary osteoarthritis were used as controls. The hormones evaluated were luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), 17-beta-estradiol (E2), progesterone (Pg), testosterone (T), delta 4-androstenedione (A), dehydrotestosterone (DHT), dehydroepiandrosterone sulphate (DHEAS) and cortisol (C). Normal concentrations of all the hormones considered were found in premenopausal women with RA. Statistically higher concentrations of T (p less than 0.05), A (p less than 0.05) and DHEAS (p less than 0.01) were observed in postmenopausal women with RA when compared to controls, whereas no differences were found for all other hormones studied. Although the significance of observed relative hyperandrogenism in postmenopausal women with RA is not clear, our data seem to indicate that sex hormone levels are altered in patients with RA.

Adolescent↗

Different fibronectin concentrations in plasma samples drawn from the affected and unaffected arms of a pagetic patient.

Plasma fibronectin concentrations in blood drawn from both arms of a pagetic patient affected only at the humerus, ulna and radius of the right arm were studied. Significantly higher levels were observed in the affected arm compared to the nonpagetic arm. Results suggest that in vivo synthesis of soluble fibronectin is associated with increased bone turnover and demonstrate the value of bilateral blood sample collection when localized bone disease is present.

Aged↗

Plasma fibronectin in psoriatic arthritis subgroups.

Plasma from 38 patients suffering from one of the five broad clinical subgroups of Psoriatic Arthritis (PA) were studied for soluble plasma Fibronectin (pFn). The mean total concentration of pFn was 453.03 micrograms/ml +/- 142.83 SD, with a significant statistical difference (p less than 0.01) versus a healthy control group matched with respect to sex and age. In order to evaluate the biological role that pFn might play in this pathological condition, observed concentrations were correlated with the degree and duration of the psoriasis and arthritis. In addition, pFn was correlated to some biohumoral parameters that are modified during inflammatory processes (ESR, CRP, sCu, sFe, Hb) and to uric acid levels. Tissue typing (HLA) was done where possible. From our observations, we suggest that pFn most likely is not an acute phase protein and rather than having specificity for a particularly disease, might, in widespread and severe cases be, a general and useful marker of the connective-tissue organizing and repairing response, following its injury.

Arthritis↗

Short-term treatment of osteoarthritis: a comparison of sodium meclofenamate and ibuprofen.

A double-blind crossover study compared sodium meclofenamate (300 mg daily) and ibuprofen (900 mg daily) in thirty patients with osteoarthritis. Each treatment period was of 3 weeks duration. Both drugs were effective in reducing the severity of joint symptoms and in improving the range of motion, with the exception of spine movement which did not show any changes from the baseline. Tolerance was good.

Aged↗

Indoprofen in rheumatic patients with acute episodes: a multicentre trial.

The results are reported of an open multicentre trial in 228 rheumatic patients with flare-ups. Fourteen centres adopting the same investigational protocol collaborated in the study. Indoprofen was administered for 1 week at a daily dosage of 1000 mg according to a treatment schedule used with success in acute gouty arthritis: a 400 mg i.v. bolus was followed by 200 mg (1 tablet) t.i.d. Subjective (pain) and objective variables were used for reliable assessment of activity. Marked reduction of pain intensity was already noticeable on day 1 of treatment and was followed by progressive improvement in subjective and objective variables for all the diagnoses considered. According to the patients' own overall assessments, results were good or very good in more than 50% of cases. The best outcomes were obtained in low back pain, acute gout and psoriatic arthritis. At the end of treatment only 7.4% of patients experienced no change or deterioration of symptoms. Adverse reactions, consisting mostly of mild and reversible gastrointestinal disturbances, were reported by 9.2% of patients, but only in 1.8% was treatment discontinued. Indoprofen administered according to the above schedule is an appropriate treatment for acute episodes of rheumatic diseases.

Adolescent↗