[Role of pre-orthodontic information].
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Child↗
Biomedical subjects
A Martini
Publications and source records attributed to A Martini.
[Study of torsion defects of the lower limbs using computerized tomography].
January, 1990, to July, 1993, the torsional defects of the lower limbs were studied at the Department of Radiology of the Istituto Ortopedico Rizzoli, Bologna. Ninety-three patients were examined, all of them affected with congenital or acquired (posttraumatic and/or iatrogenic) torsional defects. The torsional angles, i.e., the anteversion acetabulum angle, the anteversion femoral neck angle and the tibial torsion angle, were measured as follows: the patients were laid supine with their limbs either in intrarotation with the patella perpendicular to the table (62 patients) or in neutral rotation with the feet in the pace position (31 patients). The images were always analyzed at the console by two different radiologists in the following days. The electronic lines for measuring torsional angles were drawn by the two radiologists ex novo on the previously acquired CT images. No statistically significant differences were observed between the two groups of patients. The measures were independent of limbs position and the interobserver differences were bigger in children and in the measurement of femoral neck anteversion angle; however, these differences decreased by about 50% with better console use. CT, thanks to its feasibility, has replaced conventional (direct or indirect) radiology to study the torsional defects of the lower limbs. Moreover, CT is extremely useful not only for early disease diagnosis (location, rotation degree and associated joint deformities), but also for treatment planning, be it surgical or conservative.
Adolescent↗
Frequency and clinical significance of anti-RNP antibodies in Italian SLE patients.
The frequency and clinical significance of anti-RNP antibodies in patients with systemic lupus erythematosus (SLE) are still a matter of debate. In this study we report our experience with a series of 123 unselected Italian patients (93 adults and 30 children) suffering from SLE according to the ARA criteria. Anti-RNP were detected by counterimmunoelectrophoresis in 25 patients (20%), 19 of whom did not show other antibodies to extractable antigens (isolated RNP). Our study shows a striking association between anti-RNP and arthritis as well as between anti-RNP and Raynaud's phenomenon. In addition, we found an association between anti-RNP and lack of renal involvement. This association was limited to those patients with isolated RNP and was independent of the presence of anti-dsDNA antibodies. These data were confirmed by a 50 month follow-up study.
Adolescent↗
Anti-double stranded DNA, anti-histone, and anti-nucleosome IgG reactivities in children with systemic lupus erythematosus.
In this study we evaluated the presence of anti-nucleosome reactivity in children with systemic lupus erythematosus (SLE), and assessed its clinical correlations in comparison with anti-dsDNA and anti-histone IgG levels. Reactivities to nuclear substrates were determined by enzymatic immunoassays in 80 sera from 22 children with SLE, and solid phase adsorption experiments were performed. In children with active SLE, the anti-dsDNA, anti-histone, and anti-nucleosome IgG levels were elevated, and were significantly correlated with disease severity; during remission anti-histone (but not anti-dsDNA and anti-nucleosome) antibodies, although reduced, were still significantly elevated. The results of adsorption studies showed that anti-dsDNA antibodies contributed to anti-nucleosome reactivity, while anti-histone antibodies did not. The recognition of the H3H4-DNA nucleosome subparticle, rather than H2AH2B-DNA, may be related to the nucleosome reactivity. In children with SLE anti-nucleosome reactivity is present; it is in part due to anti-dsDNA antibodies and in part to antibodies recognizing conformational epitopes that may be related to the H3H4-DNA nucleosome subparticle. Its clinical significance for diagnosis is not greater than that of the anti-dsDNA antibodies.
Adolescent↗
Lumbosacral fusion with pedicular osteosynthesis.
A total of 40 patients affected with lumbosacral degenerative pathology and submitted to pedicular synthesis and laminectomy were followed-up. There was an 86% success rate after an average of 2 years. The authors conclude by recognizing the effectiveness of pedicular fixation, and the need to associate laminectomy with fusion because of the frequent association of instability and stenosis in degenerative low back pain.
Adolescent↗
Circulating levels of interleukin 1 beta and of interleukin 1 receptor antagonist in systemic juvenile chronic arthritis.
OBJECTIVE: To measure circulating interleukin 1 beta (IL-1 beta) and IL-1 receptor antagonist (IL-1Ra) levels in patients with systemic juvenile chronic arthritis (JCA) and to evaluate their correlation with disease activity. METHODS: IL-1 beta and IL-1Ra levels were measured by ELISA in 45 patients with JCA (20 systemic, 10 polyarticular and 15 pauciarticular) and in 15 healthy controls. RESULTS: Plasma IL-1 beta levels were undetectable in the majority of patients with systemic JCA, and detectable levels were not associated with different treatments or with parameters of disease severity. Serum IL-1Ra levels were markedly increased in patients with systemic JCA and significantly correlated with the persistence of systemic features, the extent and severity of joint involvement, and with C-reactive protein concentrations. Serum IL-1Ra levels were also significantly correlated with IL-6 levels. CONCLUSION: These results argue against a relevant role of IL-1 in systemic JCA. The increase in IL-1Ra levels does not appear to reflect an increase in IL-1 production, but may rather be induced by IL-6.
Adolescent↗
The surgical treatment of vertebral deformities in achondroplastic dwarfism.
The authors analyzed 15 patients affected with achondroplastic dwarfism with vertebral deformity treated surgically between 1976 and 1994. The forms represented were: achondroplasia; diastrophic dwarfism; spondyloepiphyseal achondroplasia. The types of vertebral deformity were: kyphosis: 12 (angular: 6; regular: 6); scoliosis: 1; kyphoscoliosis: 2. Neurological symptoms were present in 10 patients. Treatment was as follows: laminectomy: 8; posterior fusion with instrumentation: 2; anterior fusion: 2; anterior fusion with laminectomy and posterior fusion: 3. There were postoperative neurological complications in 4 cases (27%). Fusion must be performed early in angular kyphosis in the adult in order to prevent neurological symptoms. Wide laminectomies do not require associated fusion because they do not cause late vertebral instability.
Achondroplasia↗
Out-patient arthroscopy.
The results and complications of knee arthroscopy performed using local (982) and truncular anesthesia (523) at the out-patient arthroscopy clinic of the Rizzoli Orthopaedic Institute between 1982 and 1994 were analyzed. Furthermore, the literature on technique and surgical indications for the use of out-patient arthroscopy with a 3 in 1 block was reviewed.
Ambulatory Surgical Procedures↗
Use of subambient differential scanning calorimetry to monitor the frozen-state behavior of blends of excipients for freeze-drying.
The purpose of this study was evaluation of mannitol and its blends with other excipients commonly used as freeze-drying cryoprotectants or bulking agents in simulated lyophilization conditions. Subambient differential scanning calorimetry (DSC) has been used as an analytical tool to evaluate the phenomena from both a qualitative and a quantitative point of view. The DSC scans were performed at rates comparable to those generally practicable in industrial lyophilizators. During a simulated freeze-drying process, three crystallization events have been observed on mannitol solutions: the first two on freezing, and the last one on heating. The phenomena are dependent on each other. The addition of other excipients can significantly influence this behavior by specifying the crystallization of mannitol in freezing or by inhibiting it fully. This means that the final physical state of the freeze-dried product (amorphous, crystalline, or partially amorphous/partially crystalline) can be tailored by accurately choosing not only the freeze-drying conditions but also the composition of the solution to be lyophilized. The results point out how the physical state of freeze-dried products can be controlled by an accurate choice of both excipients and their relative ratios, with the possibility of reducing the number of preformulation activities required to design the most appropriate formulation for each new drug candidate.
2-Hydroxypropyl-beta-cyclodextrin↗
IgG autoantibodies to complement C1q in pediatric-onset systemic lupus erythematosus.
OBJECTIVE: Antibodies to C1q (aC1q) have been found in up to 50% of adult patients with systemic lupus erythematosus (SLE) and have been associated with proliferative glomerulonephritis. We investigated the prevalence and clinical significance of aC1q in pediatric SLE. METHODS: Antibodies to C1q, measured by an ELISA method, were evaluated in 29 patients with childhood-onset SLE, 26 females and 3 males, aged 7.5 to 19.6 years. RESULTS: Seventeen (59%) of the 29 patients were initially positive for aC1q. No correlation was found between either the presence or titer of aC1q and any of the clinical manifestations, including nephritis. However, a significant correlation was observed between aC1q levels and anti-double-stranded DNA antibodies and C3 values. Serial determinations of aC1q in 23 patients showed a progressive decline in the titers with few significant fluctuations. Antibodies to C1q were not a reliable predictor of increased SLE activity, since they increased or became detectable in only 50% of the pre-flare sera. CONCLUSION: Antibodies to C1q were frequently positive in our patients with pediatric SLE and were correlated with laboratory variables of disease activity. However, unlike in adults with SLE, a high correlation between aC1q and glomerulonephritis was not found in these pediatric patients.
Adolescent↗
Oral versus intramuscular methotrexate in juvenile chronic arthritis. Italian Pediatric Rheumatology Study Group.
OBJECTIVE: To compare the efficacy and safety of methotrexate (MTX) after oral and intramuscular administration in children with juvenile chronic arthritis (JCA). METHODS: Pediatric rheumatology centers in Italy participated in this short-term, prospective, open trial. Each investigator was allowed to choose the oral or intramuscular route of administration according to his personal preference in everyday clinical practice. Patients enrolled by each center were given MTX through the same method of administration. All patients received 10 mg/m2 of MTX each week for six months. RESULTS: A total of 257 patients with JCA (127 treated orally and 130 intramuscularly) were enrolled in the trial by 11 Italian centers. The response rate after 6 months of MTX therapy was 58% in the oral and 61% in the intramuscular cohort. The frequency of adverse side effects did not differ significantly between the two treatment groups. CONCLUSION: The results of this study suggest that MTX at the conventional dose regimen is equally effective and has a similar safety profile in children with JCA when administered orally or by intramuscular injections.
Administration, Oral↗
Serum soluble CD23 levels and CD23 expression on peripheral blood mononuclear cells in juvenile chronic arthritis.
OBJECTIVE: To assess the CD23 status in patients with juvenile chronic arthritis (JCA), as defined by serum soluble CD23 (sCD23) and the expression of CD23 on peripheral blood mononuclear cells. METHODS: Serum sCD23 levels were measured by ELISA in 22 patients with systemic JCA (s-JCA), in 40 patients with antinuclear antibody positive pauciarticular JCA (ANA+ p-JCA), and in 38 healthy controls. CD23 expression on T cells, B cells, and monocytes was determined by flow cytometry analysis of double fluorescence staining. RESULTS: Serum sCD23 levels were increased in both ANA+ p-JCA and s-JCA; no relation with disease activity or severity was found. In patients with ANA+ p-JCA, serum sCD23 levels were correlated with an increased percentage of B cells expressing CD23, while in patients with s-JCA the serum sCD23 levels were correlated with an increased percentage of monocytes expressing CD23. CONCLUSION: Serum sCD23 levels are elevated both in systemic and ANA+ pauciarticular JCA: different cell subset CD23 expression in s-JCA and ANA+ p-JCA (i.e. monocyte or B cell, respectively) suggests that in pauciarticular JCA CD23 may be implicated in B cell activation and autoantibody production, while in systemic JCA may be involved in monocyte activation and in the release of inflammatory mediators.
Adolescent↗