Biomedical subjects

F Fantini

Publications and source records attributed to F Fantini.

At least 289 records · Page 16Linked to original sources

PubMedDate not supplied

Evaluation by dual-photon absorptiometry of bone mineral loss in rheumatic children on long-term treatment with corticosteroids.

The introduction of reliable and non-invasive methods of measuring bone mass has allowed investigators to study the bone mass loss (ostopenia) related to rheumatic diseases and corticosteroid therapy. Serial measurements of lumbar bone mineral density (BMD) by dual-photon absorptiometry (DPA) is an effective method of checking bone mineralisation. In children, however, the bone mass is not constant over time, so bone densitometric measurements must take into account not only the net loss but also the missing increase in BMD. In order to study the effects of both chronic rheumatic disease and the long-term administration of corticosteroids in children, as a first step the reference curves of bone mineralisation (mean BMD values and annual % BMD growth rates) were calculated from a control population of 79 children (32 males and 47 females) aged 3 to 20 years. All the subjects involved in the study underwent DPA utilising a Norland Bonestar instrument provided with a 153 Gadolinium source and the average BMD (g/cm2) of the lumbar spine was calculated. As a second step, a transverse study was carried out on a series of 157 children and young adults affected by chronic rheumatic diseases with juvenile onset. As a third step, a longitudinal study on the adverse effect of the chronic administration of corticosteroids on bone mineralisation was carried out on a series of 58 patients affected by chronic rheumatic diseases with juvenile onset who were being treated with long-term corticosteroids. Serial measurements of bone mass should help us to improve our strategies in preventing and counteracting osteopenia due to the chronic administration of corticosteroids also in children.

Absorptiometry, Photon↗

PubMedDate not supplied

[Rheumatic fever].

While rheumatic fever (RF) remains a major problem in underdeveloped countries, in continental United States and Western Europe the incidence of this disease declined markedly in the sixties and reached a nadir during the seventies. However in the last eighties a resurgence of RF has been documented in some areas of the United States with an eightfold increase of incidence over the prior 15 year average. Although a true outbreak of RF has not been documented in Italy, a trend towards an increased number of new cases per year has been observed at the Centre for Rheumatic Children at the Gaetano Pini Institute in Milan. Most of these children presented a mild disease with clinical features rather different from those described in classical textbooks. Most of them satisfied the revised Jones' criteria, in some cases the objective signs of arthritis could not be noticed, but the joint involvement presented as marked arthralgia while other features supported the diagnosis of RF. Rheumatic carditis was observed in more than 1/3 of cases with a high rate of residual valvular heart disease of a mild degree of severity in most cases. In conclusion RF has not completely disappeared in Italy and remains as a possible cause of permanent valvular heart damage in children. It is possible that the increasing morbidity observed in the last eighties may be related to the reduced primary prophylaxis against streptococcal infections due to the wrong conviction that RF is no more a risk in developed countries.

Adolescent↗

PubMedDate not supplied

[Reactive arthritis].

The term reactive arthritis was introduced to describe an acute non-purulent arthritis complicating an infection elsewhere in the body. Reactive arthritis can also be classified into HLA-B27 associated and non-associated forms. Rheumatic fever is an example of the HLA-B27 non-associated forms with genetic factors other than HLA-B27 involved. HLA-B27 associated reactive arthritis includes enteric, urogenic and idiopathic arthritides. The bacteria known to trigger post-enteritic reactive arthritis are: Yersinia, Salmonella, Shigella, Campylobacter, Clostridium difficile and Brucella; those known to trigger post-urethritic reactive arthritis are Chlamydia trachomatis and Ureaplasma urealyticum, but often the germ remains unidentified. Mechanisms through which susceptibility to reactive arthritis is linked to HLA-B27 antigen are still incompletely understood, but a clue could be cross-reactivity between B27 and a surface antigen of pathogenic germs. The clinical profile of the disease is characterized by an asymmetrical oligoarthritis with involvement particularly of the peripheral joints of the lower limbs. The arthritis generally recovers without sequelae within a few weeks or months. Accompanying features can be the involvement of enthesis and tendon sheets in form of a talalgia or dactylitis. In some cases the arthritis can relapse and chronicize. In some cases, in addition, involvement of the axial skeleton can occur (spondylitis and/or sacroiliitis). Another feature of the disease is the frequent association with typical extra-articular manifestations such as uveitis and muco-cutaneous lesions.

Arthritis↗

PubMedDate not supplied

[Mortality study of workers employed in the construction of railway cars in Collefero].

The mortality of 276 workers employed in a facility for the manufacturing and maintenance of railroad equipment has been studied in the town of Colleferro (province of Rome). The cohort was based on the 1968 payrolls, and follow-up was conducted up to 1988. Exposure to asbestos took place both during insulation (performed by specialized companies in the same workplaces where study subjects were operating) and during repair work. Mortality for all causes was lower than expected (45 observed, SMR: 71), while mortality from all neoplasms was consistent with expected figures (21 observed, SMR: 107). An increase for respiratory neoplasms was observed (10 observed, SMR: 138); the increase was statistically significant allowing for 20-30 years of latency (7 observed, SMR: 337).

Aged↗

PubMedDate not supplied

Is onset type evaluated during the first 3 months of disease satisfactory for defining the sub-groups of juvenile chronic arthritis? A EULAR Cooperative Study (1983-1986).

This study represents an attempt to collect observations from co-operating countries to evaluate the previously suggested criteria for juvenile chronic arthritis during the onset periods 0-3 and 3-6 months, preferably studied prospectively. Only 267 of 378 forms returned were satisfactory for inclusion because of failure to observe exclusion criteria or insufficient information. Despite this it was possible to conclude that systemic disease represented 25% of the group and that these features tended to decline during the 6 month period. Gut inflammation was seen in 4.5% and the frequency of chronic iridocyclitis increased during the observation period to 4.5%. Variation in joint state during this period suggests that course classification may be important, as 23 of 118 who were pauciarticular at 3 months became polyarticular by six months, but only 46 of 76 who were polyarticular at 3 months remained in this state at six months.

Adolescent↗

PubMedDate not supplied