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Biomedical subjects

W Mantovani

Publications and source records attributed to W Mantovani.

30 records · Page 2Linked to original sources

The cervical spine in patients with psoriatic arthritis: a clinical, radiological and immunogenetic study.

The radiological changes of the cervical spine were evaluated in 57 patients with psoriatic arthritis and were correlated with clinical, radiological, and immunogenetic features of the disease. Forty patients (70%) showed radiological evidence of the cervical spine being affected by the disease. Two patterns of cervical spine abnormalities were noted. Fifteen patients (26%) had erosive and/or subluxing cervical rheumatoid like lesions; 25 patients (44%) had a more frequently reported pattern similar to ankylosing spondylitis. Although subaxial subluxations were the most frequently observed cervical abnormalities (53%) in the inflammatory subgroup, none of the patients studied had cord compression. Ankylosing cervical spine disease was the only form of axial involvement in nine (36%) of 25 patients with the ankylosing form of psoriatic arthritis. All of these patients had peripheral disease and were B27 negative. Predictors of cervical spine disease patterns were considered using clinical, demographic, and radiological features and HLA antigens. The results of a multivariate analysis showed that the best predictors of inflammatory cervical spine disease are the presence of HLA-B39 and HLA-DR4 antigens, radiocarpal erosions, and the absence of the HLA-DR5 antigen.

Arthritis, Psoriatic↗

Extraarticular manifestations of rheumatoid arthritis and HLA antigens in northern Italy.

We performed retrospective analysis of 141 Northern Italian patients with rheumatoid arthritis (RA). This series represents all the patients seen as in and/or outpatients at the rheumatologic unit of Reggio Emilia Hospital during a 2 year period (1987-88). We observed a low frequency of nodules (16%) and vasculitis (2.1%). Thus, RA seems to be milder in our population compared to Caucasian patients with RA originating from North America or England. We observed a weak association with DR4 (RR = 2.4) in the total group of patients with RA. A low frequency of DR4 was observed in patients and controls (29 vs 14.5%, p = 0.001). When compared with controls the frequency of DR4 was significantly higher in seropositive (p = 0.001), but not in seronegative patients. We found that DR4 was significantly associated with nodules (RR = 6.4), with extraarticular features (EAF) (RR = 4) and with erosions (RR = 3) compared with controls. The subgroups with nodules and EAF had a DR4 frequency (respectively, of 52 and 40%) which was significantly higher than that observed in remaining patients (respectively, 25 and 24%). No significant difference was observed in the DR4 frequency between the patients with erosions and those without (34 vs 18%). Thus, DR4 in our population seems to be predominantly associated with a subgroup of patients characterized by seropositivity and EAF.

Aged↗

Epidemiologic and immunogenetic aspects of polymyalgia rheumatica and giant cell arteritis in northern Italy.

We studied the epidemiology of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in a Mediterranean population. Ninety-nine patients with PMR and/or GCA were identified over a 9-year period (1980-1988) in Reggio Emilia, Italy. The average annual incidence of PMR and GCA was 12.7/100,000 and 6.9/100,000, respectively, in a population aged 50 years or older. Frequencies of HLA antigens were determined in 49 patients with PMR and/or GCA who were followed by staff at our rheumatology unit during the 1980-1988 period. When compared with HLA findings in 242 healthy controls, DR4 was not found to be significantly associated with PMR (24% in PMR patients versus 14% in controls). Patients with GCA also showed an increased frequency of DR4 compared with controls (36% versus 14%), but this difference was also not statistically significant. The immunogenetic features of PMR and GCA and the relationship between the immunogenetic and epidemiologic patterns in different populations are discussed.

Aged↗

Reassessment of HLA association with celiac disease in special reference to the DP association.

Patients with the late-onset form of celiac disease have been studied for HLA association by conventional serology (DR and DQ typing) and by oligonucleotide probing with gene amplification (DP typing). Patients and controls were sampled in the Bologna area of northern Italy. Almost all patients were positive for DQw2 (94%), being DR3 positive (72%) and/or DR7 positive (65%). The proportion of DR3/7 heterozygotes in the patients was significantly increased over that expected from the Hardy-Weinberg equilibrium. No positive association with DR5 and no significant increase of DR5/7 heterozygotes were observed. Among the DP alleles reported to exhibit an association with celiac disease in other populations, only DPB3 showed a moderate increase of a borderline significance, not attributable to a linkage disequilibrium with DQw2.

Alleles↗

Microalbuminuria in diabetic children and adolescents. Relationship with puberty and growth hormone.

Urinary albumin excretion (UAE) was determined by radioimmunoassay in two 24 h urine collections from 125 diabetic children and adolescents and from 71 normal children matched for age and sex. Thirteen patients (10.4%) aged greater than 12 years had microalbuminuria, i.e. log transformed UAE levels above the upper normal range (24.5 mg/24 h). UAE values were positively correlated with age, GH secretion, but not with duration of disease, glycosylated hemoglobin, renal size or N-acetyl-beta-glucosaminidase excretion. Diabetic normoalbuminuric children aged 10 years and older had significantly higher UAE than controls and than younger diabetic patients matched for duration of disease. HLA DR3/DR4 heterozygosity frequency was significantly higher (p less than 0.01) in the microalbuminuric group than in the normoalbuminuric. All microalbuminuric subjects (n = 8) with short duration of disease (3.92 +/- 3.43 yr) developed diabetes at puberty. In conclusion, our cross-sectional study suggests: if a number of factors are combined, i.e. HLA DR3/DR4 heterozygosity, onset of disease at puberty and higher GH values, the probability of developing abnormal levels of UAE will increase.

Adolescent↗

Clinical response to auranofin in patients with psoriatic arthritis.

Fifty-two patients with psoriatic arthritis (PA), treated with auranofin (AF), were entered into a one year prospective, open study. The total group showed a significant increase in frequency of HLA antigens A1 and B38, and a reduction of B5 when compared to healthy controls. There was a remission or an important improvement of disease in the 51% of 45 patients who completed the study. The rate of withdrawal due to side effects was low (8.8%) and the toxicity was mild in nature (diarrhoea and mucocutaneous rash). We prospectively sought predictors of response using HLA antigens, and clinical and laboratory parameters at the beginning of therapy. The only 3 factors found to be related to outcome were duration of psoriasis, physician and patient assessment of disease activity. No laboratory data or HLA specificities could be associated with substantial response to AF therapy.

Arthritis↗

Immunological markers in non-Hodgkin's lymphomas.

Membrane markers of lymphomatous cells were studied in 33 patients with non Hodgkin's lymphoma and correlated with morphological diagnosis according to Rappaport's classification. Nodular lymphomas and the majority of lymphocytic lymphomas showed B cell characteristics, whereas only 6 out of 23 with diffuse pattern were B. None of the histiocytic lymphomas were B, 3 were T, and 4 non T-non B. Mixed lymphocytic/histiocytic lymphomas showed different immunological patterns (B, T, non T-non B, B and T). These results confirm the importance of functional classification, which can clarify the pathogenesis of lymphoma.

Adult↗

Chromosome radiation-induced aberrations in patients with Hodgkin's disease. Possible correlation with second malignancy?

The karyotype of peripheral blood lymphocytes has been studied in a group of patients with Hodgkin's disease. Before any therapy, the karyotype was either normal or aneuploid. A few months after radiotherapy (total nodal irradiation) a conspicuous amount of structural chromosome aberrations was found. Three to six years after completion of radiotherapy, the lymphocyte karyotype was almost normal, even if stable ionizing radiation-induced aberrations were still detectable. This is consistent with the normal behaviour of these patients and with the long-lasting effect of radiations on nuclear D.N.A. Owing to the close relationship between ionizing raditions and chromosome aberrations on one hand, and abnormal karyotypes and tumors on the other, it cannot be overlooked that these aberrations may play an important role, together with other carcinogenic factors, in the development of second malignancies in these patients.

Adolescent↗

T lymphocyte subsets and colony growth in hairy-cell leukemia.

The distribution of T cell subsets and the T colony-forming capacity were assessed in 22 patients with hairy-cell leukemia. An overall increase in the proportion of T gamma cells (31 +/- 15%) and a decrease in Tmu cells (38 +/- 11%) were observed if compared with normal controls (16 +/- 6% for T gamma and 51 +/- 13% for Tmu). In half of the patients, however, these values were normal. T gamma cells were highest in the splenectomized patients and in the 15 non-splenectomized patients T gamma cells were higher in those with active disease. Patients with stable disease or in remission had values close to normal. The T colony-forming capacity of unseparated and enriched T lymphocytes was normal regardless of the T cell subset distribution and clinical stage of the disease. These findings suggest that in HCL, unlike B cell chronic lymphocytic leukemia, the imbalance in Tmu/T gamma ratio does not result in an impairment of the in vitro T colony-forming capacity.

Animals↗

[Intermediate resection and distal pancreatectomy for benign neoplasms of the pancreas: comparison of postoperative complications and costs].

The middle pancreatic resection for benign pathology of the pancreas has been proposed as an advantageous alternative to the distal pancreatectomy, even though the risk of complications is greater. The purpose of the present study is to compare the cost and intra and perioperative impact for the 2 procedures. All patients with benign neoplasia of the body and tail of the pancreas operated on from 1990-1999 were selected from our computer archives, 21 patients underwent an intermediate resection and 64 a distal pancreatectomy. Operative time, units transfused, perioperative complications, post-operative stay and cost were compared. Statistical analysis revealed that the 2 operations are not significantly different in the intra-operative period. Comparing serious complications, the percentage of pancreatic fistulas (33% vs. 11%; P < 0.03) and average hospital stay (21.2 +/- 11.7 days vs. 15.5 +/- 7.1 days; p = 0.009) are greater for the middle than distal resection, respectively. In cases with post-operative complications the hospital stay is even more significant (middle 31.8 +/- 10.3 days vs. 19.1 +/- 7.6 days; p = 0.0002). The economic margin of residual costs, calculated by using the difference of DRG (no 192) and average post-operative costs, is similar for the 2 procedures in cases with normal post-operative courses, (intermediate Euro 2890.02; distal Euro 3181.9), while in cases with complications (DRG no 191), the difference increases (intermediate Euro 8670.11; distal Euro 12788.94). The middle pancreatic resection in respect to the distal pancreatectomy presents a greater technical difficulty when you take into account the longer post-operative course, the increased difficulty in treating complications and the increased costs.

Adolescent↗

Clinical subgroups and HLA antigens in Italian patients with psoriatic arthritis.

The frequencies of HLA antigens were studied in 101 Italian patients with psoriatic arthritis. The total group showed a significant increase in frequency of A1 and B38, and a reduction of B5 when compared to healthy controls. No association between DR and/or DQw antigens and PA were demonstrated. The comparisons between the clinical subgroups and normal controls revealed a significant association of B38 with asymmetric peripheral arthritis, B27 and B39 with spondylitis (with or without peripheral involvement). When intergroup comparison were made, the patients with spondylitis had an increase in frequency of B27 and DQw3 as compared to those with symmetric and asymmetric peripheral disease. DR4 and DRw53 were associated with earlier age of onset of arthritis. There were also significant associations between DQw3 and severe disease, and between A9, B5 and presence of erosions and joint space narrowing. No association with DR4 was showed in a subgroup of patients with symmetric polyarthritis without DIP involvement.

Adult↗