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Biomedical subjects

F Trotta

Publications and source records attributed to F Trotta.

At least 91 records · Page 5Linked to original sources

[Radiological picture of the hand and foot in systemic lupus erythematosus].

A detailed examination of the hands and feet was performed in a group of 34 patients affected by systemic lupus erythematosus (SLE), using low-dose mammographic film and Rank Xerox selenium plate, according to current diagnostic techniques. All patients presented articular symptoms (pain and arthralgia). The high incidence (38,8%) of patients with no radiographic evidence of bone damage-even though articular symptoms are present-is emphasized. In such cases, it is very difficult to distinguish SLE from rheumatoid arthritis, especially as far as therapeutic management and prognosis are concerned. The lack of any "pathognomonic" radiological sign of the lupus arthritis, in the hands as well as in the feet, is then stressed. Nevertheless, arthropathy in SLE is defined as a deforming non-erosive arthritis, with a typical symmetric distribution, affecting most commonly-according to incidence-the proximal interphalangeal and metacarpophalangeal joints. In the hand, arthropathy is referred to as Jaccoud's type arthritis, because it is characterized by joint deformities which can be corrected. In the foot, the main abnormalities include hallux valgus, subluxation of the metatarsophalangeal joints and widening of the forefoot.

Adult↗

[Prevalence and occurrence of infections caused by hepatitis B virus in the dialysis units in the Apulia region].

Sera of 803 hemodialysis patients and 413 staff members were tested to evaluate the relationship between infectivity markers and spread of HBV infection in dialysis units. HBsAg was detected in 13.8% patients undergoing chronic hemodialysis and 3.9% staff members. High prevalence of HBeAg and DNA polymerase activity was observed only in HBsAg positive patients. The highest titers of HBsAg and anti-HBc were detected in hemodialysis patients, whereas asymptomatic carriers showed low titers of these markers. A highly significant correlation was recorded between detection of HBeAg in patients and presence of serum DNA activity. These data suggest that in HBsAg hemodialysis patients a more active viral replication occurs and a higher contagiousness of these subjects.

Adolescent↗

[The hyperostotic knee].

Diffuse idiopathic skeletal hyperostosis (DISH) is a disorder characterized by bone proliferation of spinal and extraspinal structures. Frequently, extraspinal manifestations may occur before the involvement of the spine. These alterations are so common and characteristic that they should be included in the diagnostic criteria for DISH. The patella is one of the most commonly involved sites. The knee of 48 patients affected by DISH, according to Resnick's diagnostic criteria, were subjected to systematic, radiographic and xerographic studies. The most characteristic radiographic patterns are: thickening of the anterior margin of the patella (81.1%); ossifying enthesopathy of supero-anterior margin of patella (68.7%); periosteal new bone formation on the tibial insertion of the cruciate ligaments (47.8%); presence of fabella (41.%); presence of megafabella (22.9%), which may come near the posterior profile of the femur. Changes are usually symmetrical in DISH: entheseal abnormalities mostly involve the antero-superior margin of the patella, whereas in osteoarthritis, osteophytes are found on the postero-superior margin. In the lateral view enthesophytes at the bone attachment of the cruciate ligaments are oriented inside the joint space; on the contrary, osteophytes are always oriented outside the joint space. Radiographic manifestations of the fabella are similar to those observed in osteoarthritis, and so they cannot be utilized in the differential diagnosis of these diseases.

Aged↗

[Value and limitations of scintigraphy of the hand in rheumatoid arthritis].

99mTc-polyphosphate joint imaging of the hand has been performed in 18 patients, with evidence of inflammatory joint disease, but without any significant radiographic lesions, which might be related to rheumatoid arthritis. The hand scans were compared to clinical and radiographic data. An year after, the same subjects were re-examined, with both the radionuclide imaging and radiography. Scintigraphy has been shown to be significantly more sensitive for detecting inflammatory joint disease than x-ray, especially in the early stage of rheumatoid arthritis. Although radionuclide imaging is non specific (activity is increased also in osteoarthritis, trauma, metabolic bone disease, infarction, etc.). Radiography is highly specific but relatively non sensitive.

Adult↗

Serum IgA anti-hepatitis A virus as detected by enzyme-linked immunosorbent assay. Diagnostic significance in patients with acute and protracted hepatitis A.

A capture enzyme-linked immunosorbent assay for the detection of serum IgA against hepatitis A virus has been developed. The test was highly specific, and the time course of detectability of IgA anti-HAV was longer than six months in 42/42 patients with acute or protracted hepatitis A followed prospectively, but shorter than two years in 14/14 patients tested 21-24 months after diagnosis of acute hepatitis A. IgM anti-HAV were at detectable levels in only 1/42 cases tested six months after the clinical onset. The detection of serum IgA anti-HAV is a simple and specific method to differentiate protracted cases of hepatitis A from non-A, non-B hepatitis.

Enzyme-Linked Immunosorbent Assay↗

Monophasic and polyphasic pattern of alanine aminotransferase in acute non-A, non-B hepatitis. Clinical and prognostic implications.

One-hundred-and-two out of 788 consecutive patients (12.9%) hospitalized for an attack of acute hepatitis fulfilled criteria for non-A, non-B (NANB) hepatitis, and were followed prospectively for 8 to 70 months. Forty-one out of 97 patients showed a monophasic pattern of alanine aminotransferase (ALT), and all recovered completely. In contrast, 22 of 56 (39.2%) subjects with a polyphasic pattern of ALT exhibited persistent hypertransaminasemia for more than 14-18 months, and all of them developed chronic hepatitis. Thus, a polyphasic pattern of ALT seems to characterize one of two forms of NANB hepatitis, more frequently associated with parenteral exposure, absence of jaundice and a high tendency for the development of chronic hepatitis. This suggests distinct immunopathogenetic mechanisms from two unrelated NANB agents. Benign, non-progressive chronic persistent hepatitis is the prevalent form of chronic sequela of NANB hepatitis observed in our patients. Although many of these patients show a tendency to spontaneous remission of the disease, there is the possibility in some of a deterioration of inflammatory activity of the liver that has need of immunosuppressive therapy.

Acute Disease↗

[The elbow exposed to vibrating instruments and idiopathic diffuse skeletal hyperostosis: association or pure coincidence?].

A group of 11 patients with chronic enthesopathy of the elbow caused by vibrating instruments was systematically examined for spinal signs of diffuse idiopathic skeletal hyperostosis (DISH). Nine patients revealed spinal involvement, the two exceptions probably relating to the patients' youth. The findings support the hypothesis that DISH is not a disease but rather a tendency to excessive ossification of ligamentous structures in response to stimuli that generally produce only modest new bone formation. Those suffering from such ossifying diathesis should be directed towards work unlikely to damage the enthesis.

Adult↗

[Evaluation of an immunoenzyme test (ELISA) for the determination of an Ag/Ab system correlated to non-A, non-B post-transfusion hepatitis].

An ELISA for the detection of a Ag/Ab system related to non-A, non-B post-transfusion hepatitis (NANB-PTH) has been developed. A convalescent serum from a patient suffering, 14 month before, of NANB-PTH was used both as capture and detector antibody in a "sandwich" type immunoassay to detect an Ag (Ag-NANB). A "blocking" immunoassay was used, in the same test, to detect the corresponding antibody (Ab-NANB). All patients with NANB-PTH were positive, alternately, for Ag-NANB or Ab-NANB. The Ag was found in the acute phase sera of 3 out of 22 cases of NANB-PTH (13,6%), but in none of 29 acute hepatitis type B,26 acute hepatitis type A,14 NANB sporadic hepatitis, 5 infectious mononucleosis and 8 healthy subjects. 2/3 Ag-NANB positive subjects became chronic carriers of this Ag, whereas the third seroconverted for Ab-NANB after the first two months of their disease. Furthermore, a significant increase of the Ab-NANB titer was observed in the convalescent phase of the disease in 18/20 NANB-PTH. As expected, a relatively high prevalence for Ab-NANB was found in the other groups of patients, suggesting the high diffusion of the agent, but none of these subjects showed a progressive increase of the antibody titer during the course of their disease.

Antigens, Viral↗

[Immunoenzyme determination of IgA specific anti-HAV in the serological diagnosis of hepatitis A].

A capture enzyme immuno assay for the detection in the serum of specific IgA antibodies to HAV is described. A total of 203 sera from patients and controls were tested. IgA anti-HAV were present only in sera from patients with recent hepatitis A. 23 patients were followed prospectively and IgA anti-HAV were at detectable levels for at least six months after the onset. The detection of IgA anti-HAV is proposed as an important test to differentiate hepatitis A with persistent hypertransaminasemia from non-A, non-B patients.

Antibodies, Viral↗

Thiopronine-induced pemphigus vulgaris in rheumatoid arthritis.

Thiopronine, a D-penicillamine-like agent, is being prescribed increasingly for RA. Among side effects, only benign skin reactions have been mentioned to date. A single case of pemphigus erythematosus induced by this drug was recently reported. We describe here 3 other patients who developed pemphigus vulgaris during long-term thiopronine therapy and who improved after the drug was stopped.

Aged↗

Role of PGE2 in the modulation of the adrenergic response in man.

The influence of sympathetic stimulation (SS) (achieved by 2 min cold application) on the plasma concentration of PGE2, PGF2 alpha (radioimmunoassay), noradrenaline (NA) and adrenaline (A) (radioenzymatic assay) and on forearm vascular resistance (indirect measurement, FVR) was studied in 16 healthy volunteers before and after cyclooxygenase inhibition by indomethacin (200 mg per day orally for 3 days) and lysine acetylsalicylate (corresponding to 10 mg X kg-1 of acetylsalicylic acid -ASA- iv). SS induced a sharp increase in PGE2 (from 8.1 +/- 4.3 pg X ml-1 before SS to 23.9 +/- 6.5, P less than 0.001 2 min after the beginning of SS and then to 18.9 +/- 10.2, P less than 0.001 to 8.4 +/- 3.9, NS, 4 and 12 min respectively after the beginning of SS). Plasma levels of PGF2 alpha remained undetectable both before and after SS. The increase in PGE2 was associated with a simultaneous increase in NA (from 13.4 +/- 24.2 to 204.1 +/- 67.2 pg X ml-1, P less than 0.001 during SS and 140.6 +/- 39.5, NS at the end of the experiment), whereas A did not vary significantly. FVR increased significantly only during SS. ASA did not affect PGE2 and NA plasma levels at rest or after SS. No PGE2 was detected during IND administration either before or after SS. IND significantly increased NA plasma concentration at the observation made 12 min after the beginning of SS (185.2 +/- 64.3 pg X ml-1 vs basal values of 135.9 +/- 46.2 pg X ml-1, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Folic acid deficiency in beta-thalassaemia heterozygotes.

Plasma and red cell folate mean contents have been found to be significantly lower in 41 symptom-free beta-thalassaemia heterozygotes than in 21 controls. Such decreases must be considered as effects of an increased folate utilization caused by the enhanced total, both effective and ineffective, erythropoiesis. Since no close correlation has been found between packed cell volume and plasma or red blood cell folate levels, it seems that in 'healthy' beta-thalassaemia subjects, the degree of anaemia is not influenced by folate body reserves. However, the frequent finding of reduced red cell folate contents suggests that further folate imbalance might lead to clinically significant degrees of folate deficiency.

Adolescent↗