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Biomedical subjects

G Danieli

Publications and source records attributed to G Danieli.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Interleukin-2, soluble interleukin-2 receptor and tumor necrosis factor in sera from patients with rheumatoid arthritis.

Interleukin-2 (IL-2), soluble interleukin-2 receptor (IL-2R) and tumor necrosis factor (TNF) have been measured in sera from 47 patients affected by classic rheumatoid arthritis (RA) using an enzyme-linked immunosorbent assay. The patients were divided into 4 groups as follows: group A, 18 patients with inactive disease; group B, 19 patients with active disease under treatment with non-steroidal antiinflammatory drugs (NSAID) and second-line drugs; group C, 5 patients with active disease under treatment with NSAID and cyclosporine A (CSA) for at least 4 months; group D, 5 patients in the same condition as patients of group C, but treated with azathioprine (AZA) instead of CSA. IL-2 was undetectable in all patients except two, both characterized by active disease. Soluble IL-2R levels were above the upper limit of the normal range in most of the patients studied, but the mean value ( +/- 1 SD) was significantly higher in patients of group B (1,288 +/- 421 U/ml) than in patients of group A (686 +/- 205 U/ml) and group C (842 +/- 414 U/ml). In two patients affected by active RA treated with pulse methylprednisolone therapy (1 g/day for 3 alternate days) the values of soluble IL-2R dropped from 948 to 662 U/ml and from 660 to 518 U/ml, respectively. No statistically significant correlation was observed between the serum level of IL-2R and the RF titre or percentage of C1q-binding activity, respectively. TNF was found within the normal range in all patients except one, who was characterized by active arthritis, high number of rheumatoid skin nodules and extremely high RF titre.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Essential cryoglobulinemia: a therapeutic dilemma.

Our data confirm those already reported in the literature. There is no univocal therapy for essential cryoglobulinemia. Several therapeutic strategies may be employed according to severity of the clinical picture. Skin and articular involvement may benefit from the administration of non-steroidal antiinflammatory drugs. The presence of visceral involvement requires steroids and/or immunosuppressive drugs. Plasma-exchange should be used in patients with severe progressive disease. However, data showing that anyone of the proposed treatment could irreversibly stop the clinical course of the disease are lacking. Immunological parameters except serum viscosity cannot help in the decision to initiate a plasma-exchange program and in monitoring its efficacy.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Five-year follow-up of 165 Italian patients with undifferentiated connective tissue diseases.

OBJECTIVE: To study those conditions with a proven or hypothesised immunologic pathogenesis and denominated under a working definition of undifferentiated connective tissue diseases (UCTD). METHODS: A multicentre prospective study was organised involving 10 tertiary referral centers of internal medicine in Italy, with the aim of describing the natural history of UCTD and the prevalence of its different clinical and immunological manifestations. RESULTS: After a five-year follow-up period, data on 165 patients were available for analysis. UCTDs occur mainly in females in their fourth decade of life. Articular and mucocutaneous features and Raynaud's phenomenon represent the most common findings. Nevertheless, we also detected a relatively high incidence of permanent major organ damage. Regarding the immunologic parameters, we documented some conflicting results in the correlation between serologic abnormalities and clinical features. In 10 patients UCTD evolved to a major disease, generally systemic lupus erythematosus or Sjögren's syndrome. CONCLUSION: A low rate of evolution to a defined autoimmune disease, the limited use of steroid or immunosuppressive therapy, and a favourable course in the majority of cases are the main characteristics of patients with UCTDs.

Adolescent↗
PubMedDate not supplied

[Research and evaluation of Internet resources for the practice and teaching of nursing].

Recent changes in the Italian health care system are causing a complex redefinition of the traditional principles of nursing. Among the new principles that are being proposed, the implementation of a clinical practice based on the evidence generated by the medical research community appears to be prominent. However, objective time constraints in finding and evaluating the available information have often hampered the achievement of this highly desirable goal. In this perspective, exploitation of the intrinsic quickness of the internet-based information retrieval systems has the potential to effectively circumvent the problem. To provide nurses with a proper training in a timely search and evaluation of on-line data, we have designed and developed a guide to those websites providing clinical information. This guide consists of (1) reviews of existing websites, and (2) proposal of a standardized model for selection, evaluation, and description of existing and newly appearing websites. We believe that this guide might increase the capability of nurses to effectively exploit the medical and scientific information resources available on the net.

Education, Nursing↗
PubMedDate not supplied

Coagulative modifications in patients with systemic sclerosis treated with iloprost or nifedipine.

This study compared iloprost and nifedipine to ascertain whether they could improve parameters of endothelial and platelet functions in the treatment of Raynaud's phenomenon secondary to systemic sclerosis. Thirteen patients affected by systemic sclerosis were treated with intravenous infusion of iloprost, and 7 patients were treated with oral nifedipine. Blood samples were taken at baseline and after 6 and 12 months of therapy to assess main serological indexes of endothelial damage, thrombin activation, fibrinolysis, as well as natural inhibitors of coagulation. After 12 months of therapy, the patients treated with iloprost had a significant decrease in thrombomodulin levels (p = 0.02) and a significant increase in tissue-plasminogen activator levels (p = 0.007), in comparison with the patients taking nifedipine (p = 0.007). Moreover, patients treated with nifedipine showed increased levels of thrombin-antithrombin complex after 12 months of therapy in comparison with baseline values (p = 0.03) and in comparison with the values of the patients treated with iloprost over the same period (p = 0.05). These preliminary results thus seem to indicate that iloprost plays an important, if at least partial, role in the protection and restoration of endothelial integrity in patients with systemic sclerosis.

Blood Coagulation↗
PubMedDate not supplied

Are behaviour and motor performances of rheumatoid arthritis patients influenced by subclinical cognitive impairments? A clinical and neuroimaging study.

OBJECTIVE: To determine whether some behavioural manifestations and poor motor performances in patients affected by rheumatoid arthritis (RA) are due to subclinical cognitive defects. METHODS: We performed a psychometric assessment of 30 patients affected by RA exploring several cognitive domains such as memory, visual-spatial integration, motor planning, mental flexibility, relating performances with morphological and functional neuroimaging (MRI and SPECT). We also related the cognitive data with the Ritchie and Lee indexes and other clinical parameters. RESULTS: We found an impairment in visual-spatial tasks in 71% of patients with a high correlation to activity and disease severity as expressed by the Ritchie and Lee indexes (p < 0.005; p < 0.01). Furthermore, we detected in 38% of patients some difficulties in mental flexibility related to the Lee Index (p < 0.05). These poor performances are related to hypoperfusion of the frontal and parietal lobes as detected by brain SPECT; this finding is more evident in patients with brain white matter alterations on MRI. CONCLUSIONS: Our data allow us to hypothesize that manual dexterity could be due to a disconnection between subcortical white matter and parietal-frontal lobes because of microangiopathy; furthermore, a chronic reduction in sensorial stimuli by impaired joints could lead to produce an alteration in motor planning cognitive processes.

Adult↗
PubMedDate not supplied

Antibodies against terminal galactosyl (alpha 1-3) galactose epitopes in systemic sclerosis (scleroderma).

Sera from 224 patients with systemic sclerosis (scleroderma) were analyzed for circulating antibodies against an antigenic determinant characterized by two molecules of galactose in alpha 1-3 linkage. About 45% of the patients were found to have values above the normal range. The mean antibody level was significantly higher than that found in normal subjects (p less than 0.001) or in patients with primary Raynaud's phenomenon who were included as controls. The mean level of anti-Gal antibodies correlated with the degree of skin and internal organ involvement, as well as with the presence of progression or inflammation. Furthermore, when patients with early onset disease were analyzed, high levels of anti-Gal antibodies were present in the subgroups characterized by evidence of progression or inflammation, whereas patients with stable disease did not differ from the controls. We conclude that humoral immunity against Gal alpha 1-3 Gal is an early feature of scleroderma, may be important for its pathogenesis, and may provide a more sensitive tool to detect disease activity.

Adolescent↗
PubMedDate not supplied

Use of high-dose intravenous immunoglobulin in systemic lupus erythematosus: report of three cases.

Three patients with life-threatening manifestations of systemic lupus erythematosus (SLE), unresponsive to conventional high-dose corticosteroid and/or immunosuppressive therapy were treated with intravenous polyspecific IgG (IVIG). Following IVIG infusion, lupus encephalitis in the first patient quickly resolved and the impressive improvement of the clinical status was associated with a transient increase in C1q-binding activity. The daily infusion of IgG had to be suspended after three days in the second patient with encephalitis and nephritis, because the renal function rapidly deteriorated; subsequently, six plasma exchanges led to an almost complete recovery. Finally, leukocyte and platelet counts increased and remained within normal range following IgG therapy in the third patient having SLE-associated leuko- and thrombocytopenia. In all three patients a decrease in anti-DNA antibody levels and an increase in total complement hemolytic activity were detected after therapy.

Adolescent↗
PubMedDate not supplied

[Vasculitis].

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

Rheumatoid lung disease. (A clinical, physiological and histological study in 33 patients).

Clinical, physiological and histological investigations on lung involvement are reported in 33 rheumatoid patients. The clinico-pathological patterns of rheumatoid lung disease observed in 19/27 non-smoking female patients were characterized radiologically by diffuse interstitial opacities, functionally by V/Q inequality and microscopically by peribronchiolar and/or alveolar fibrosis. Emphasis is placed on the ventilation/perfusion relationship as well as histopathological studies for a more accurate diagnosis of lung disease in RA. Patients with pulmonary nodules and pleural opacities were also observed. A possible immunological aetiology is suggested on the basis of the simultaneous finding of IgG, complement and fibrinogen in the pulmonary tissue.

Adult↗
PubMedDate not supplied

Fish-oil fatty acid supplementation in mixed cryoglobulinemia: a preliminary report.

OBJECTIVE: Since fish oils seem to play a potential role in the treatment of inflammatory disorders by inhibiting arachidonic acid metabolism, the purpose of this study was to determine their therapeutic efficacy in mixed cryoglobulinemia (MC), an inflammatory condition caused by the deposition of immune complexes in vessel walls. METHODS: In an 8-week double-blind randomized trial, ten MC patients received a daily dietary supplement of 3 gm of eicosapentaenoic acid (EPA) and 2 gm of docosahexenoic acid (DHA), while 10 other MC patients received placebo (olive oil). The severity of purpura, arthralgias, paresthesias, asthenia and Raynaud's phenomenon were monitored daily, and serological assays were performed at the beginning of the study, at the end of the treatment period, and after 4 weeks of wash-out. RESULTS: No significant differences were found between the two groups with regard to the clinical symptoms, although the percentage of patients who reported a clinical improvement was higher in the group treated with fish oils. As for the serological parameters, no variation was found in the placebo group, while in the group receiving fish oils a significant decrease in cryocrit and rheumatoid factor levels was observed, which in the case of rheumatoid factor persisted at the end of the wash-out period. CONCLUSIONS: Under the experimental conditions employed in this study, we could not demonstrate a significant improvement in clinical symptoms in patients with mixed cryoglobulinemia treated with fish oils. However, since our results indicated some improvement in the serological parameters potentially involved in the pathogenesis of the disorder, further studies are warranted to establish the optimal dose and duration of fish oil supplementation in the treatment of MC.

Adult↗