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Ruperto N, Ozen S, Pistorio A, Dolezalova P, Brogan P, Cabral DA, Cuttica R, Khubchandani R, Lovell DJ, O'Neil KM, Quartier P, Ravelli A, Iusan SM, Filocamo G, Magalhaes CS, Unsal E, Oliveira S, Bracaglia C, Bagga A, Stanevicha V, Manzoni SM, Pratsidou P, Lepore L, Espada G, Paut IK, Zulian F, Barone P, Bircan Z, Maldonado MDR, Russo R, Vilca I, Tullus K, Cimaz R, Horneff G, Anton J, Garay S, Nielsen S, Barbano G, Martini A. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: Overall methodology and clinical characterisation. Ann Rheum Dis 2010; 69:790-7. [DOI: 10.1136/ard.2009.116624] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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102
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Majorana A, Bardellini E, Ravelli A, Plebani A, Polimeni A, Campus G. Implications of gluten exposure period, CD clinical forms, and HLA typing in the association between celiac disease and dental enamel defects in children. A case-control study. Int J Paediatr Dent 2010; 20:119-24. [PMID: 20384826 DOI: 10.1111/j.1365-263x.2009.01028.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The association between coeliac disease (CD) and dental enamel defects (DED) is well known. AIM The aim of this study was to investigate the prevalence of DED in children with CD and to specifically find the association of DED and gluten exposure period, CD clinical forms, HLA class II haplotype. DESIGN This study was designed as a matched case-control study: 250 children were enrolled (125 coeliac children - 79 female and 46 male, 7.2 +/- 2.8 years and 125 healthy children). Data about age at CD diagnosis, CD clinical form, and HLA haplotype were recorded. RESULTS Dental enamel defects were detected in 58 coeliac subjects (46.4%) against seven (5.6%) controls (P < 0.005). We found an association between DED and gluten exposure period, as among CD subjects the mean age at CD diagnosis was significantly (P = 0.0004) higher in the group with DED (3.41 +/- 1.27) than without DED (1.26 +/- 0.7). DED resulted more frequent (100%) in atypical and silent CD forms than in the typical one (30.93%). The presence of HLA DR 52-53 and DQ7antigens significantly increased the risk of DED (P = 0.0017) in coeliac children. CONCLUSIONS Our results confirmed a possible correlation between HLA antigens and DED.
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Ravelli A. Zur Deutung und Benennung überzähliger Karpalelemente: (Bemerkungen zur Arbeit von E. de Cuveland, Fortschr. Röntgenstr. 84 [1955]:847). ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1212894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ravelli A. Appendixstumpf im Zökum. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1231816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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107
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Ravelli A. Eine seltene Ossifikationsanomalie an den Grundphalangen der Zehen (Zapfenepiphysen). ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1232346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ravelli A. Über eine eigenartige Form des sternalen Schlüsselbeinendes („Fischmaulform”). ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1212633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Meiorin S, Filocamo G, Pistorio A, Magni-Manzoni S, Sztajnbok F, Cespedes-Cruz A, Magnani A, Ruperto N, Martini A, Ravelli A. Impact of involvement of individual joint groups on subdimensions of functional ability scales in juvenile idiopathic arthritis. Clin Exp Rheumatol 2009; 27:527-533. [PMID: 19604450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To investigate the influence of arthritis in individual joint groups on subdimensions of functional ability questionnaires in children with juvenile idiopathic arthritis (JIA). METHODS 206 patients were included who had the Childhood Health Assessment Questionnaire (C-HAQ) and the Juvenile Arthritis Functionality Scale (JAFS) completed simultaneously by a parent and received a detailed joint assessment. In each patient, joint involvement (defined as presence of swelling, pain on motion/tenderness and/or restricted motion) was classified in 3 topographic patterns: Pattern 1 (hip, knee, ankle, subtalar and foot joints); Pattern 2 (wrist and hand joints); Pattern 3 (elbow, shoulder, cervical spine and temporomandibular joints). Frequency of reported disability in each instrument subdimension was evaluated for each joint pattern, present either isolatedly or in mixed form. RESULTS Among patients with Pattern 1, the JAFS revealed the greatest ability to capture and discriminate functional limitation, whereas impairment in the C-HAQ was more diluted across several subdimensions. Both C-HAQ and JAFS appeared to be less reliable in detecting functional impairment in the hand and wrist (Pattern 2) than in other body areas. Overall, the JAFS revealed a superior ability to discriminate the relative functional impact of impairment in individual joint groups among patients with mixed joint patterns. CONCLUSION In children with JIA, a functional measure focused to assess the function of individual joint groups (the JAFS) may detect with greater precision the functional impact of arthritis in specific body areas than does a standard questionnaire based on the assessment of activities of daily living (the C-HAQ).
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Saad-Magalhães C, Pistorio A, Ravelli A, Filocamo G, Viola S, Brik R, Mihaylova D, Cate RT, Andersson-Gare B, Ferriani V, Minden K, Hashkes P, Rygg M, Sauvain MJ, Venning H, Martini A, Ruperto N. Does removal of aids/devices and help make a difference in the Childhood Health Assessment Questionnaire disability index? Ann Rheum Dis 2009; 69:82-7. [DOI: 10.1136/ard.2008.097592] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective:To assess whether the removal of aids/devices and/or help from another person in the Childhood Health Assessment Questionnaire (C-HAQ) leads to a significant change in the disability index (DI) score and responsiveness in juvenile idiopathic arthritis (JIA).Methods:Changes in the C-HAQ DI score in a cross-sectional sample of 2663 children with JIA and in 530 active patients with JIA in a trial of methotrexate (MTX) were compared.Results:Patients in the MTX trial had higher disease activity and disability than the cross-sectional sample. The frequency of aids/devices (range 1.2–10.2%) was similar between the two samples, while help (range 5.3–38.1%) was more frequently used in the MTX group. Correlation between disease severity variables and the two different C-HAQ DI scoring methods did not change substantially. There was a decrease in the C-HAQ DI score for both the cross-sectional (mean score from 0.64 with the original method to 0.54 without aids/devices and help, p<0.0001) and the MTX sample (mean score from 1.23 to 1.07, p<0.0001). A linear regression analysis of the original C-HAQ DI score versus the score without aids/devices and help demonstrated the substantial overlap of the different scoring methods. Responsiveness in the responders to MTX treatment did not change with the different C-HAQ DI scoring methods (range 0.86–0.82).Conclusion:The removal of aids/devices and help from the C-HAQ does not alter the interpretation of disability at a group level. The simplified C-HAQ is a more feasible and valid alternative for the evaluation of disability in patients with JIA.
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Carroccio A, Iacono G, Di Prima L, Ravelli A, Pirrone G, Cefalù AB, Florena AM, Rini GB, Di Fede G. Food hypersensitivity as a cause of rectal bleeding in adults. Clin Gastroenterol Hepatol 2009; 7:120-2. [PMID: 19124116 DOI: 10.1016/j.cgh.2008.07.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 07/20/2008] [Accepted: 07/27/2008] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Rectal bleeding and lymphonodular hyperplasia (LNH) in children can be caused by food hypersensitivity (FH). Our aim was to verify whether similar clinical and endoscopy presentations in adults can be due to FH. METHODS Consecutive adult patients with rectal bleeding were enrolled. All underwent routine assays, colonoscopy, and histology study. RESULTS Ten of 64 (15%) patients showed LNH as the unique sign at colonoscopy. An oligoantigenic diet resolved the rectal bleeding in 9 patients, and the reintroduction of several foods caused symptom reappearance. Double-blind placebo-controlled challenges with cow's milk and wheat protein confirmed the FH; symptoms reappeared 1-96 hours after the challenge. None of the patients were positive for IgE-mediated assays. In patients with LNH and FH, histology of the ileum and colon mucosa showed a higher number of lymphoid follicles and intraepithelial and lamina propria eosinophils compared with the other patients with rectal bleeding. CONCLUSIONS Recurrent rectal bleeding can be caused by FH in adult patients. Endoscopic evidence of LNH characterizes these cases.
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Ravelli A, Villanacci V, Chiappa S, Bolognini S, Manenti S, Fuoti M. Dietary protein-induced proctocolitis in childhood. Am J Gastroenterol 2008; 103:2605-12. [PMID: 18684195 DOI: 10.1111/j.1572-0241.2008.02035.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cow's milk protein-induced proctocolitis presents with overt rectal bleeding in otherwise healthy infants and is characterized by an eosinophilic infiltrate of the left colonic mucosa. Although it is the most common cause of proctocolitis in infancy, dietary protein-induced proctocolitis had hardly ever been reported in childhood so far. We hereby report 16 otherwise healthy children aged 2-14 yr, who presented over a 6-yr period with persistent or recurrent rectal bleeding related to a mild form of left-sided colitis characterized by a prominent eosinophilic infiltration, focal lymphoid follicle hyperplasia, and a prompt clinical and histological response to a cow's milk-free diet. No patient had a history of food-induced proctocolitis during infancy, and most patients did not show an IgE-mediated response to cow's milk protein. Half of the patients did have other gastrointestinal symptoms, but no systemic symptoms were present and other causes of colitis were excluded by appropriate investigation. Tolerance to cow's milk protein developed in half of the patients within a year. Dietary protein-induced proctocolitis is a relatively common cause of overt rectal bleeding in childhood, and its features are remarkably similar to those of dietary protein-induced proctocolitis of infancy.
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Saad-Magalhães C, Pistorio A, Ravelli A, Brik R, Mihaylova D, Ten Cate R, Andersson-Gare B, Ferriani V, Minden K, Hashkes P, Rygge M, Sauvain MJ, Venning H, Martini A. Does incorporation of aids/devices and help, make a difference in the childhood health assessment questionnaire disability index? Analysis from the printo juvenile idiopathic arthritis database. Pediatr Rheumatol Online J 2008; 6. [PMCID: PMC3333903 DOI: 10.1186/1546-0096-6-s1-p108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Manzoni SM, Ravelli A, Klersy C, Visconti C, Lanni S, Borali E, Muratore V, Montecucco C, Epis O. A comparison of clinical vs ultrasound determined synovitis in juvenile idiopathic arthritis (JIA). Pediatr Rheumatol Online J 2008. [PMCID: PMC3333896 DOI: 10.1186/1546-0096-6-s1-p101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Filocamo G, Schiappapietra B, Manzoni SM, Lanni S, Solari N, Viola S, Pistorio A, Ruperto N, Tani D, Martini A, Ravelli A. Development and initial validation of the parent acceptable symptom state in juvenile idiopathic arthritis (JIA). Pediatr Rheumatol Online J 2008. [PMCID: PMC3333913 DOI: 10.1186/1546-0096-6-s1-p117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Malattia C, Damasio MB, Magnaguagno F, Pistorio A, Valle M, Martinoli C, Viola S, Buoncompagni A, Loy A, Ravelli A, Tomà P, Martini A. 2.4 Magnetic resonance imaging, ultrasonography and conventional radiography in the assessment of bone erosions in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2008. [PMCID: PMC3334193 DOI: 10.1186/1546-0096-6-s1-s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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