[Scleroderma (progressive systemic sclerosis)].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
S Zeni
Publications and source records attributed to S Zeni.
Protective effect of zinc against spontaneous malformations and lethality in Bufo arenarum embryos.
Explore the source record for details and available documents.
Animals↗
[Interrelationship between vitamin D intake and absorption and retention of calcium during nutritional recovery].
We have previously reported that, in the first stages of nutritional recovery, the needs of undernourished infants, in terms of protein-calories percentage (P%) are higher than normal, producing an accelerated catch-up. Consequently, calcium (Ca) and phosphorus (P) balances increase proportionally to weight gain rate (WGR) in order to attain a normal body composition. As for the control of Ca metabolism by vitamin D, the question is whether vitamin D intake must also be increased during this accelerated catch-up growth period. In this report we have analysed retrospectively previous results in order to clarify the interrelationship between Ca absorption, Ca retention and vitamin D intake. A total of 29 undernourished infants, from 2 to 18 months of age, were fed Ad libitum with one of two proprietary milk formulas containing, per 100 g.: Ca, 0.50 and 1.17 g.; P, 0.37 and 0.50 g.; vitamin D, 350 and 400 UI (8.7 and 10 micrograms); proteins, 11.34 and 17.00 kcal/100 kcal of total diet, respectively. Recommended Dietary Allowances (RDA) of Ca and vitamin D, according to FAO/OMS and NRC, were calculated with reference to normal infants body weight and to 1000 kcal of recommended dietary energy intake. Ca intake was higher than the RDA and ranged between 60 and 413 mg/kg/day; intake of vitamin D increased proportionally to food intake; calcium absorption ranged between 40.0 and 92.0% (mean = 69.8 +/- 14.6) and CaB correlated with Ca intake (r = 0.97), being higher than normal.(ABSTRACT TRUNCATED AT 250 WORDS)
Calcium↗
The effect of tiaprofenic acid on uric acid excretion in man.
The uricosuric effect of tiaprofenic acid was evaluated in a group of normouricaemic inpatients with various rheumatic disorders. Six patients aged 26 to 60 years were maintained on a standardised low-purine diet and, after a washout period of 72 hours, tiaprofenic acid was administered in 3 oral doses of 300 mg 12-hourly. A normal renal function, as assessed by serum creatinine and creatinine clearance determinations, was considered mandatory for entry into the study. The following parameters were evaluated before and after treatment: haematological values, blood urea nitrogen (BUN), serum and urinary creatine concentrations, serum uric acid concentration and the fractional excretion rate of uric acid. Our preliminary results showed a substantial increase of urinary uric acid excretion in the samples collected after treatment, especially in the first 4 hours.
Adult↗
[Iron-creatinine ratio in basal urine. Its usefulness as a nutritional status indicator with relation to iron].
Explore the source record for details and available documents.
Child, Preschool↗
Theory about interrelationships between macromineral nutrients and growth rate during recovery from undernutrition.
Previous papers of our group have reported that, in the first stages of nutritional recovery, the needs of undernourished infants, in terms of Protein Calories percentage (P%) were higher than normal, and similar to those of other mammals which double their birth weight faster than man. During this period, a high dietary P% produces an accelerated catch-up growth. Therefore, Calcium and Phosphorus balances increase proportionally to weight gain rate (WGR), and Calcium retention per gram of new tissue is dependent on dietary Calcium/Protein ratio. On the other hand, Bernhart demonstrated that there was a direct correlation between the growth rate of the sucklings of several species, including humans, and the percentage of protein and ash in the fluid milk. As a consequence of these facts, we assume that during catch-up growth, in order to attain a normal body composition, dietary level of essential minerals must be related to factors affecting weight gain. These relationships suggest the hypothesis that, during the recovery from undernutrition, in order to meet the needs of the catch-up growth allowed by the Protein/Calories ratio, Calcium and Phosphorus milk concentrations would be in relation to the Protein/Calorie concentration. In this way, Calcium and Phosphorus concentrations might be the limiting factors for attaining a normal body composition. This hypothesis might also be generalized to other minerals in order to prevent them from becoming the limiting factors for attaining a normal body composition.
Calcium↗
[Calcium-creatinine in basal urine in relation to calcium intake and nutritional status in children under 3].
The calcium/creatinine ratio (Ca/Creat.) as an indicator of calcium nutritional status was evaluated in "basal urine" from 24 children comprised within the ages of three to 36 months during a 60-day period. The children were divided in normal or undernourished, according to Waterlow's classification. Children under 12 months of age were fed ad libitum with one of two commercial milk formulas, assigned according exclusively to the pediatric criterium. Children older than 12 months received milk besides the habitual hospital diet. In all cases the food intake was controlled and the calcium intake calculated. At the end of the study, basal urine was collected and calcium and creatinine determined. The results revealed that: a) In the normal children the Ca/Creat. ratio gradually decreased with age tending to a low value of 0.2 at the age of 36 months. The relationship between the Ca/Creat. ratio and the calcium intake showed a change in the slope when the requirements were met according to RNC (60 mg/kg/day); b) In undernourished children, the Ca/Creat. ratio was nearly constant whatever their age or calcium intake. The trend to approach the value of 0.2 for calcium intake (about 250 mg/kg/day), however, and the absence of the inflexion point, would suggest that the requirements of these children are far higher than the NRC recommendation, and that the change of the slope would be found for intakes over those obtained in our study. According to these findings, we conclude that the Ca/Creat. ratio in basal urine does not reflect calcium intake, but would depend on the bone calcium turnover. Consequently, it would be a simple and useful indicator of calcium nutritional status.
Calcium↗
[Use of the urinary calcium/creatinine ratio as an indicator of the nutritional status of calcium].
The relationship between calcium and creatinine in basal urine for evaluating its usefulness as an indicator of calcium nutritional status was evaluated. Samples of basal urine were collected form a group of 5 to 12-year-old school children who followed a three-month program of dietary complementation. The calcium to creatinine ratio showed no correlation with daily total calcium intake. However, a correlation was found when intake was expressed in mg per kg of body weight (r = 0.67) and increased significantly when data were grouped according to growth rate (r = 0.85). On this basis, the Ca/Creat. ratio was analyzed as a function of weight gain (g/kg) for calcium intake: higher and lower than 10 mg/kg/day (4 = 0.82 and 0.89, respectively), the intercept of each line with the Y axis (null weight gain) being 0.096 and 0.068, respectively. These findings indicate the possibility of using the Ca/Creat. ratio in field studies as an indicator of nutritional status of the population in regard to calcium.
Body Weight↗
Vascular impairment in patients with primary biliary cirrhosis.
Experimental and clinical observation suggest that patients with primary biliary cirrhosis (PBC) have endothelial dysfunction. Postischemic digital blood flow, nailfold capillaroscopy, von Willebrand factor (vWf) and tissue-type plasminogen activator (t-PA) plasma levels were examined in 59 PBC patients. Forty-six subjects (15 with liver diseases other than PBC, 11 hypercholesterolemics, 20 healthy subjects) served as controls. PBC versus healthy controls (209.8 +/- 1.4% and 16.54 +/- 1.44 ng/ml vs. 120.2 +/- 1.4% and 9.91 +/- 1.49 ng/ml; p<0.001) and related to bilirubin (r = 0.38, p<0.02; r = 0.47, p<0.0005, respectively). vWf was also increased in other liver diseases (249.9 +/- 1.7%; p<0.001) and related to bilirubin (r = 0.59, p<0.05). Postischemic finger blood flow negatively correlated with vWf(p<0.05 or less). Our data indicate that PBC patients have microvascular disease. Whether vessels other than those of the fingers were involved remained unclear. vWf and t-PA might reflect a dysfunction of teh hepatic vascular endothelium.
Aged↗
[Evaluation of quality of life in patients with systemic sclerosis by administering the SF-36 questionnaire].
AIMS: To evaluate the quality of life of patients affected by systemic sclerosis (SSc) through the application of the Medical Outcome Survey Short-Form 36 (SF-36) questionnaire and to correlate the results with the disability index of the health assessment questionnaire (HAQ-DI) and the systemic involvement. METHODS: We studied 95 (3 M, 91 F) patients affected by SSc (mean age 60 years, range 39-83, mean duration of disease 6 years, range 1-34). The organ system involvement was evaluated by skin score, chest High Resolution Computed Tomography (HRCT), electrocardiography according to Holter, Doppler-echocardiography and esophagogram. RESULTS: Considering the values of the 8 question groups of the SF-36 the most different between the patients and the control population are the values relevant to the physical dimension. The general health values estimating the physical and social dimension are significantly lower in the patients than in the control population (t=9,324; p<0,0001). A very good correlation was found between the DI (r = -0,7903; p <0.0001) and all the scores of SF-36. The skin involvement showed a statistically significant correlation with the DI (r=0.3709; p=0.0002) and the PA score of the SF- 36 (r =0.2853; p=0.0051). No other statistically significant correlation was found between any of the SF-36 dimensions and involvement of a specific organ. CONCLUSION: SF-36 showed to be a valid instrument to evaluate the quality of life and the disability of patients with SSc and it seems to correlate with extent of skin involvement.
Activities of Daily Living↗
[Cost-of-illness in systemic sclerosis: a retrospective study of an Italian cohort of 106 patients].
AIMS: It is increasingly important to determine the economic consequences of diseases considering the policy of limited health-care budgets. In this study we evaluated the annual direct and indirect costs of Systemic Sclerosis (SSc) and we tried also to identify any cost predictors. METHODS: We studied 106 patients (103 female, 3 male), 57 affected by Limited Systemic Sclerosis (LSSc) and 49 affected by Diffuse Systemic Sclerosis (DSSc). Mean age was 57 years (SD +/- 13.8) and mean disease duration was 8,9 years (SD +/- 7.2). Direct Costs: data were calculated referring to DRG (Disease Related Group) expenses for the in-patients. We referred to national pharmacopoeia to calculate the pharmaceutical cost for the out-patients. Indirect costs: we estimated the expense comparing our cases to literature data. Intangible costs: these are attributable to pain and psychological suffering. It is very difficult to express the intangible costs in monetary terms and they are often conveyed as disability and poorer quality-of-life. We used the Health Assessment Questionnaire "HAQ" and the Short Form-36 "SF-36" to evaluate this issues. RESULTS: Our study confirms, the extremely high costs caused by Systemic Sclerosis (total cost's 2001 year is 1,173,842.93 Euro, and average yearly patient cost is 11,073.99 Euro). Considering an estimated prevalence of 375 cases/106, the total yearly economic impact of SSc in Italy should be 249 million euro. Intangible costs were calculated as modifications of the health status. Average value of the HAQ was significantly higher than the control population (0.94 +/- 0.72), average values in the SF-36 were significantly lower than the control population (49.99 +/- 19.16 for physical dimension and 58.42 +/- 27.71 for mental dimension). The diffuse form of SSc, anti-Scl 70 antibodies, high skin score and a poor health status (HAQ and SF-36) were found to be cost predictors. CONCLUSIONS: As reported in the literature, our study confirms, the extremely high costs for total and single patients caused by Systemic Sclerosis. The DSSc are more expensive than the LSSc approximately 11% (p=0.0067). The direct costs are 30% higher in the DSSc than the LSSc (p < 0.001). The indirect and intangible costs are not significantly different. Moreover, our study shows also the possibility of identifying different cost predictors.
Aged↗
[Raynaud's phenomenon].
Raynaud's phenomenon (RP) is a vasospastic disorder characterized by episodic color changes of blanching, cyanosis, and hyperemia in response to cold and/or emotional stress. Although most typically noted in the fingers, the circulation of the toes, ears, nose and tongue is also frequently affected. Population studies have shown that RP in adults is more common in women than men, with prevalence estimates ranging from 4% to 30%. Geographic variations in the prevalence reflect differences in climate. RP may be a primary or a secondary process. LeRoy and Medsger suggested criteria for primary RP: symmetric attacks, the absence of tissue necrosis, ulceration or gangrene, the absence of a secondary cause, negative antinuclear antibodies, normal nailfold capillaroscopy and a normal erythrocyte sedimentation rate. Secondary RP is characterized by an age of onset of more than 30 years, painful and asymmetric attacks, ischemic skin lesions, positive autoantibodies, capillaroscopic abnormalities and/or clinical features suggestive of connective tissue diseases (CTDs). Among the CTDs, systemic sclerosis has the highest frequency of RP. Finding a cause for RP requires a knowledge of the patient's occupational, smoking, drug history, physical examination, nailfold capillaroscopy, routine laboratory tests and autoantibodies. Furthermore, RP should be distinguished from acrocyanosis, a condition characterized by continuous cyanosis of the hands or feet that is aggravated by cold temperature. The most important instruction to the patient is abstinence from any smoking, offending drugs should be discontinued, and abrupt changes in temperature. If these measures are inadequate, calcium-channel blockers are the most widely used (nifedipine 30 mg up to 90 mg daily). Alternatively, sympatholytic agent (prazosin), angiotensin II -receptor type I antagonist (losartan), selective sertonin-reuptake inhibitor (fluoxetine) may be useful. In the severe cases the role of prostaglandins is well established, but standard therapeutic protocols are not jet available.
Adolescent↗
Capillaroscopic observations in childhood rheumatic diseases and healthy controls.
OBJECTIVE: To describe, by using video nailfold capillaroscopy (NFC), microvascular abnormalities in children with rheumatic diseases and to evaluate the capillary changes over a follow up period. METHODS: 118 children suffering from rheumatic diseases: 55 juvenile idiopathic arthritis (JIA), 7 mixed connective tissue disease (MCTD), 6 primary Raynaud's phenomenon (PRP), 34 systemic lupus erythematosus (SLE), 8 juvenile systemic sclerosis (JSSc) and 8 juvenile dermatomyositis (JDM) were included in the study. Patients with major capillaries abnormalities or scleroderma pattern were followed up for at least 12 months. 70 age- and sex-matched healthy controls (HC) were also examined. RESULTS: In HC there was a significant correlation between age and capillary length (p = 0.001). JIA patients showed capillary number, size, shape and arrangement similar to HC. Minor abnormalities were frequently observed. The percentage of major abnormalities were significantly increased compared to HC in MCTD (p = 0.008), SLE (p = 0.0002) and JDM patients (p < 0.0001). 5/8 of JSSc had a scleroderma pattern from the onset of the disease. The serial observations in connective tissue diseases also showed that the evolution of capillaroscopic pattern was not unidirectional. In fact, in some nailfolds there was an increase in capillary loss and in avascular areas, whereas sometimes it remained stable on repeated examination. CONCLUSION: NFC can be used as a simple, inexpensive, non-invasive method to evaluate the microvascular abnormalities in childhood rheumatic conditions, and it may be useful in early recognition and monitoring scleroderma spectrum disorders.
Adult↗