Biomedical subjects
C Gennari
Publications and source records attributed to C Gennari.
Paget's disease of bone: diagnosis and management.
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Practical guide for the use of bone mineral measurements in the assessment of treatment of osteoporosis: a position paper of the European foundation for osteoporosis and bone disease. The Scientific Advisory Board and the Board of National Societies.
Bone mineral assessments provide a tool for the diagnosis, assessment and monitoring of individuals with osteoporosis. The correct application of this methodology and the interpretation of assessment will improve the direction of treatments to those most at need.
Ultrasound parameters in osteoporotic patients treated with salmon calcitonin: a longitudinal study.
Speed of sound (SOS) and broadband ultrasound attenuation (BUA) of ultrasound (US) in bone have been proposed as alternatives to radiation-based methods for the quantitative assessment of osteoporosis. However, the usefulness of US in monitoring response to treatment in osteoporotic patients has yet to be defined. To compare US with bone mineral density (BMD), we studied 112 osteoporotic women (age range 50-64 years). Seventy-eight of them were treated with salmon calcitonin nasal spray (CT; 200 IU/day, 1 month on and 1 month off) and calcium (500 mg/day); 34 patients were given only calcium. One hundred and four women complied with treatment throughout the 2-year study period. At baseline and after 1 and 2 years we measured BMD at lumbar spine by dual-energy X-ray absorptiometry (DXA), and SOS, BUA and Stiffness index, by an Achilles ultrasound unit. Moreover, biochemical markers of bone turnover (alkaline phosphatase, osteocalcin and hydroxyproline) were also measured at baseline and after 6, 12 and 24 months. In the calcitonin-treated group at the end of the study period BMD had increased by 1.99%, SOS by 0.20%, BUA by 0.88% and Stiffness by 2.12%. By contrast in the calcium-treated group all parameters had decreased (BMD, -2.66%; SOS, -0.55%; BUA, -3.30%; Stiffness, -6.0%) by the end of the study period. The differences between groups were significant for BMD, SOS and Stiffness. At baseline a significant, but weak correlation was found between BMD and US parameters. The correlation coefficients between percentage changes at the end of the study period, in BMD and in SOS, BUA and Stiffness, were all significant (p < 0.001), being 0.41, 0.53 and 0.57 respectively. In conclusion, ultrasound measurements carried out in conjunction with BMD measurements will yield a more comprehensive assessment of skeletal status and may be helpful in monitoring the response to treatment in osteoporotic patients.
Reactive arthritis by staphylococcus epidermidis: report of an unusual case.
In the literature many cases of Staphylococcus epidermidis (SE) complications are reported, but we have not found any reference about reactive arthritis secondary to SE. We report an unusual case of a patient with SE bacteriaemia, who developed elbow arthritis, asymmetrical sacroiliitis, keratoderma and restrictive cardiomyopathy. The clinical pictures, the instrumental and biochemical findings, in particular the positivity of HLA B27, allow us to set this case in the complex and heterogeneous chapter of reactive arthritis.
A problematic case of chlamydia pericarditis and sicca syndrome.
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The International Federation of Societies on Skeletal Diseases (IFSSD): a new interdisciplinary world organization on musculo-skeletal disorders.
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Effect of calcium supplementation as a high-calcium mineral water on bone loss in early postmenopausal women.
It is generally agreed that an adequate calcium intake is necessary for the maintenance of bone health and that calcium supplementation reduces the rate of bone loss in postmenopausal women. Mineral waters are calorie free, and some, with relatively high calcium levels, might be significant sources of calcium. We studied the effect of mineral water in 45 early postmenopausal women randomly assigned to receive a high-calcium (Ferrarelle, Italy) or a low-calcium mineral water. On the basis of the dietary regimen, women were divided in two clusters (A = 23 subjects, B = 22 subjects) significantly different only for calcium intake (CI) and for dietary consumption of calories (energy). At the end of the study period (13 +/- 1 months), bone mineral density at the distal radius showed a significant decrease (P < 0.001) only in cluster with low CI. The difference between the clusters was significant (P < 0.05). Furthermore, the cluster with high CI showed a significant (P < 0.05) reduction in osteocalcin serum levels after 3 months. This study provides further evidence to support the use of a high calcium mineral water as an effective prophylaxis against postmenopausal bone loss.
Recommendations for the registration of agents used in the prevention and treatment of glucocorticoid-induced osteoporosis.
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Clinical utility of bone mass measurements in adults: consensus of an international panel. The Society for Clinical Densitometry.
Low bone mass predicts future fracture risk as well as high cholesterol or high blood pressure can predict the risk of heart disease or stroke. Prevention of the first fracture should be a clinical goal. In patients without fractures, osteopenia and osteoporosis can be diagnosed based on the extent of reduction in bone mass below mean peak bone mass of young healthy individuals. As bone mass decreases, fracture risk increases exponentially. Clinical situations in which an assessment of bone mass and fracture risk affects therapeutic decisions include estrogen deficiency, vertebral abnormalities, radiographic osteopenia, asymptomatic primary hyperparathyroidism, and long-term corticosteroid therapy. Serial measurements can also be used to monitor the effects of osteoporosis treatments. The appropriate technique and skeletal site for bone mass measurements should be chosen based on the patient's circumstances and the precision of measurement. A clinical interpretation can enhance the value of computer-generated bone mass measurement reports and improve decision making.
Bone alkaline phosphatase measured with a new immunoradiometric assay in patients with metabolic bone diseases.
We have investigated the clinical utility of a new quantitative two-site radioimmunometric assay specific for bone alkaline phosphatase (B-ALP) in 219 healthy control subjects and in 264 patients with various metabolic bone diseases. B-ALP was compared with total alkaline phosphatase (T-ALP) and with osteocalcin (BGP). B-ALP increased linearly with age in both sexes. In postmenopausal normal women B-ALP increased by 82% compared with premenopausal normal women, whereas the differences between pre- and postmenopausal women for T-ALP and BGP were 18% and 30% respectively. As assessed by Z-score, the highest values of B-ALP were found in patients with Paget's disease of bone, bone metastases or hyperparathyroidism and in patients on maintenance haemodialysis. In osteoporotic patients, B-ALP< but not T-ALP, showed a slight but significant (P < 0.05) difference compared with normal women. On the basis of bone turnover, osteoporotic patients were divided into two groups: high turnover and low turnover; B-ALP, like BGP, was significantly (P < 0.01) higher in patients with high turnover. In conclusion, B-ALP, measured by this new method, can be considered a sensitive marker of bone turnover and could be especially useful in identifying women at risk of developing osteoporosis.
An unusual case of restrictive cardiomyopathy in a patient with reactive arthritis caused by Staphylococcus epidermidis.
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[Various personality traits of patients with psoriatic arthropathy].
It is well known that patients affected by rheumatic diseases may present specific pathological trends in personality structure, as has been extensively reported in literature. Our study was aimed at investigating several aspects of the personality traits of 20 patients with psoriatic arthropathy, compared with a group of 20 patients with rheumatoid arthritis. All patients were evaluated with appropriate rating scales assigned in auto and hetero-administration. The study results points to a personality trait disturbance in psoriatic arthritis patients, which can be clearly differentiated from the anxious habitus and/or reactive-depressive state observed in patients with rheumatoid arthritis.
[Heart involvement in Behcet's disease: a personal caseload en review of the literature].
BACKGROUNDS: Various cardiac abnormalities have been described in patients with Behçet's disease. The number of reports remains small, but increasing awareness have widened the spectrum of manifestations. We report our evaluation of cardiac involvement in 15 patients affected by Behçet's disease, diagnosed according to the criteria for the International Study Group for Behçet's Disease. PATIENTS AND METHODS: All the patients have been examined by a clinical, biochemical and instrumental point of view. Six patients resulted to be affected by heart diseases, in particular by mitral valve prolapse; moreover one of them presented an unexpected dilatative cardiomyopathy. CONCLUSIONS: The authors affirm that the pathological heart features are not so uncommon as previously reported in literature, emphasizing the necessity of a constant evaluation for the cardiovascular system also in the asymptomatic patients.