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Rueda F, Maqueda L, Domínguez V, Rodriguez E, Alonso D, Núñez C, Vallory J, Poitevin Y, Fantini F. An update on the latest and most relevant improvements achieved in the European helium-cooled ceramic breeder TBM design. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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Recalcati S, Tonolo S, Meroni E, Fantini F. SARS-CoV-2 in the sweat of COVID-19-positive patients: a possible route of transmission? J Eur Acad Dermatol Venereol 2021; 35:e865-e866. [PMID: 34416062 PMCID: PMC8656368 DOI: 10.1111/jdv.17607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/24/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Affiliation(s)
- S Recalcati
- Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - S Tonolo
- Microbiology and Virology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - E Meroni
- Microbiology and Virology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - F Fantini
- Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
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Cammisa L, Pacifici S, Fegatelli DA, Calderoni D, Fantini F, Ferrara M, Terrinoni A. Non-suicidal self-injury and suicide attempt: A continuum or separated identities? Eur Psychiatry 2021. [PMCID: PMC9471579 DOI: 10.1192/j.eurpsy.2021.463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction Non-suicidal self-injury (NSSI) has been proposed as diagnostic entity and was added in the section 3 of the DSM 5. However, little is known about the long-term course of the disorder: NSSI and suicide attempt (SA) often lie on a continuum of self-harm, but it’s still unclear if they represent two different nosografical entities. Both these groups are commonly enclosed in the term of Deliberate self-harm (DSH), also including self-harm with suicidal intent conditions. Objectives This study aims to explore differences between two clinical samples (NSSI and SA) to highlight the possible connection between these two categories, to better understand the risk of progression from NNSI into suicidal intent conditions. Methods 102 inpatients with DSH (62 NNSI; 40 SA; age range: 12 to 18 years) were assessed by self-report questionnaires: the Deliberate Self-Harm Inventory (DSHI) and the Repetitive Non-suicidal Self-Injury Questionnaire (R-NSSI-Q) to explore the severity and repetitiveness of self-injurious behaviors and by the Beck Hopelessness Scale (BHS) and Multi-Attitude Suicide Tendency scale (MAST), as indirect measures of suicidal risk. Results Preliminary results showed that inpatients with NSSI (62) presented high scores of indirect suicide risk, similar to SA sample (40). Conclusions This result highlights the possibility to consider NSSI and SA in a continuum of psychopathology and that repetitive self-harm even in the absence of clear suicidal intentions represent a significant risk factor in the development of suicidality in adolescence. Disclosure No significant relationships.
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Recalcati S, Barbagallo T, Tonolo S, Milani M, Fantini F. Relapse of chilblain-like lesions during the second wave of coronavirus disease 19. J Eur Acad Dermatol Venereol 2021; 35:e315-e316. [PMID: 33586154 PMCID: PMC8014539 DOI: 10.1111/jdv.17168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/19/2021] [Accepted: 02/02/2021] [Indexed: 11/29/2022]
Affiliation(s)
- S Recalcati
- Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - T Barbagallo
- Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - S Tonolo
- Microbiology and Virology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - M Milani
- Surgical Pathology Division, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - F Fantini
- Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
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Recalcati S, Tonolo S, Luzzaro F, Fantini F. Response to 'No evidence of SARS-CoV-2 infection by polymerase chain reaction or serology in children with pseudo-chilblain'. Br J Dermatol 2020; 183:1154-1156. [PMID: 32880906 PMCID: PMC7461372 DOI: 10.1111/bjd.19493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 11/30/2022]
Abstract
Linked Article: Caselli et al. Br J Dermatol 2020; 183:784–785.
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Affiliation(s)
- S Recalcati
- Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - S Tonolo
- Microbiology and Virology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - F Luzzaro
- Microbiology and Virology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - F Fantini
- Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
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Recalcati S, Barbagallo T, Frasin LA, Prestinari F, Cogliardi A, Provero MC, Dainese E, Vanzati A, Fantini F. Acral cutaneous lesions in the time of COVID-19. J Eur Acad Dermatol Venereol 2020; 34:e346-e347. [PMID: 32330324 PMCID: PMC7267354 DOI: 10.1111/jdv.16533] [Citation(s) in RCA: 179] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- S Recalcati
- Dermatology Unit, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - T Barbagallo
- Dermatology Unit, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - L A Frasin
- Dermatology Unit, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - F Prestinari
- Dermatology Unit, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - A Cogliardi
- Pediatric Unit, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - M C Provero
- Pediatric Unit, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - E Dainese
- Surgical Pathology Division, Department of Oncology, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - A Vanzati
- Surgical Pathology Division, Department of Oncology, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - F Fantini
- Dermatology Unit, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy
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Narduzzi S, Fantini F, Blasetti F, Rantakokko P, Kiviranta H, Forastiere F, Michelozzi P, Porta D. Predictors of Beta-Hexachlorocyclohexane blood levels among people living close to a chemical plant and an illegal dumping site. Environ Health 2020; 19:9. [PMID: 31969154 PMCID: PMC6977344 DOI: 10.1186/s12940-020-0562-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 01/07/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Hexachlorocyclohexane is a synthetic chemical with several isomers, including β-Hexachlorocyclohexane (β-HCH). In 2005, a large contamination of crude milk from some bovine farms along the Sacco River (Central Italy) was detected; it was related to the illegal disposal of large quantities of processing waste by a chemical industry of the area. A biomonitoring study, conducted in 2007 on a sample of the residing population, found high values of β-HCH in people living close to the river. These results led to the establishment of a clinical and epidemiological surveillance program on all the exposed population. The aim of the study was to evaluate the determinants of β-HCH blood levels in people living within 1 Km of the Sacco River, focusing on the role of specific foods, body mass index and risk factors not yet identified. METHODS The program involved all people living within 1 km of the river. A descriptive analysis of β-HCH blood levels was done in relation to the potential determinants including specific foods. Regression analysis was used to study the association between potential determinants and (natural log) β-HCH haematic concentration. The results were expressed as geometric mean ratios (GMR). To take into account similarities within the families we adjusted for family clustering. RESULTS A total of 602 subjects (87.2%) agreed to participate in the surveillance. The β-HCH geometric mean serum concentration was 72 ng/g lipid. The regression analysis showed that being female (GMR: 1.32, 95%CI: 1.14-1.53), elderly (GMR> 70yy: 10.04, 95%CI: 6.65-15.15), obese (GMR: 1.63, 95%CI: 1.28-2.08), eating food of local/own production (GMR 1.47, 95%CI: 1.15-1.88) and using water from private wells (GMRdrink:1.47, 95%CI: 1.00-2.14 and GMRwash: 1.48, 95%CI: 1.17-1.87) were associated with higher β-HCH values. There was inverse association with breastfeeding (GMR: 0.64, 95%CI: 0.47-0.86). The focus on specific foods showed that the most important factors were eggs and beef. CONCLUSIONS The study indicated a greater contamination for older people, and those drinking and washing with water from private wells and consuming locally produced food, especially eggs and beef.
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Affiliation(s)
- S. Narduzzi
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - F. Fantini
- Department of Prevention, Local Health Unit Roma 5, Colleferro, Italy
| | - F. Blasetti
- Department of Prevention, Local Health Unit Roma 5, Colleferro, Italy
| | - P. Rantakokko
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - H. Kiviranta
- Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - F. Forastiere
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - P. Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - D. Porta
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
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Damiani G, Calzavara‐Pinton P, Stingeni L, Hansel K, Cusano F, Pigatto PD, Agostinelli D, Albertazzi D, Angelini G, Angerosa F, Arigliano P, Assalve D, Ayala F, Barbagallo T, Belloni‐Fortina A, Berta M, Biale C, Bianchi L, Biasini I, Boccaletti V, Bonamonte D, Borghi A, Bragazzi N, Brambilla L, Bressan M, Brunasso A, Bruni F, Bruni P, Caccavale S, Calogiuri G, Cannavò S, Carugno A, Cataldi I, Chiarelli G, Cirla A, Corazza M, Cossutta M, Cova L, Cristaudo A, Cusano F, Danese P, Dal Canton M, De Pità O, De Salvo P, Donini M, Fantini F, Ferrucci S, Flori M, Fontana E, Foti C, Francalci S, Frasin L, Gallo R, Gasparini G, Gola M, Gravante M, Guarnieri F, Guastaferro D, Ingordo V, Lauriola M, Leghissa P, Lisi P, Lombardi P, Lorenzini M, Malara G, Magrini L, Marone G, Martina E, Mascagni P, Matteini Chiari M, Meligeni L, Melino M, Miccio L, Milanesi N, Molinu A, Monfrecola G, Morelli P, Motolese A, Musumeci M, Naldi L, Napolitano M, Nasca M, Pacifico A, Paganini P, Papini M, Pasolini G, Patruno C, Pellegrino M, Peroni A, Peserico A, Piras V, Pugliese A, Raponi F, Raviolo P, Rebora A, Recchia G, Riva F, Romita P, Rossi M, Ruggieri M, Saggiorato F, Sartorelli P, Schena D, Schettino A, Spanò G, Stinchi C, Tasin L, Tramontana M, Taddei L, Valsecchi R, Russo F, Vascellaro A, Venturini M, Vincenzi C, Virgili A, Zucca M. Italian guidelines for therapy of atopic dermatitis—Adapted from consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis). Dermatol Ther 2019; 32:e13121. [DOI: 10.1111/dth.13121] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 10/04/2019] [Accepted: 10/11/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Giovanni Damiani
- Department of Biomedical, Surgical, and Dental Sciences Unit of DermatologyUniversity of Milan Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Young Dermatologists Italian NetworkGISED Bergamo Italy
- Department of DermatologyCase Western Reserve University Cleveland Ohio
| | | | - Luca Stingeni
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | - Katharina Hansel
- Section of Dermatology, Department of MedicineUniversity of Perugia Perugia Italy
| | | | - Paolo D.M. Pigatto
- Department of Biomedical, Surgical, and Dental Sciences Unit of DermatologyUniversity of Milan Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
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Nasuelli N, Cecchin M, Onorato S, Savoini G, Marino S, Fantini F, Diana C, Godi L. 48. Cranial nerve involvement as a unusual presentation of multifocal motor neuropathy. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.10.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bettoli V, Pasquinucci S, Caracciolo S, Piccolo D, Cazzaniga S, Fantini F, Binello L, Pintori G, Naldi L. The Hidradenitis suppurativa patient journey in Italy: current status, unmet needs and opportunities. J Eur Acad Dermatol Venereol 2016; 30:1965-1970. [DOI: 10.1111/jdv.13687] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 03/11/2016] [Indexed: 12/31/2022]
Affiliation(s)
- V. Bettoli
- Department of Medical Sciences; Section of Dermatology; University of Ferrara; Ferrara Italy
| | - S. Pasquinucci
- Operative Unit of Dermatology; SS. Giovanni e Paolo Hospital; Venice Italy
| | - S. Caracciolo
- Department of Medical Sciences; Section of Neurological, Psychiatric and Psychological Sciences; University of Ferrara; Ferrara Italy
| | - D. Piccolo
- Department of Dermatology; University of L'Aquila; L'Aquila Italy
- Italian Association Outpatient Dermatologists (AIDA); Rome Italy
| | | | - F. Fantini
- Dermatology Unit; A. Manzoni Hospital; Lecco Italy
| | - L. Binello
- Azienda Sanitaria Locale ASL AT; Asti Italy
| | - G. Pintori
- Inversa Onlus; Patient Association; Selargius Italy
| | - L. Naldi
- Centro Studi GISED; Bergamo Italy
- Department of Dermatology; Azienda Ospedaliera Papa Giovanni XXIII; Bergamo Italy
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Fava P, Astrua C, Chiarugi A, Crocetti E, Pimpinelli N, Fargnoli MC, Maurichi A, Rubegni P, Manganoni AM, Bottoni U, Catricalà C, Cavicchini S, Santinami M, Alaibac M, Annetta A, Borghi A, Calzavara Pinton P, Capizzi R, Clerico R, Colombo E, Corradin MT, De Simone P, Fantini F, Ferreli C, Filosa G, Girgenti V, Giulioni E, Guarneri C, Lamberti A, Lisi P, Nardini P, Papini M, Peris K, Pizzichetta MA, Salvini C, Savoia P, Strippoli D, Tolomio E, Tomassini MA, Vena GA, Zichichi L, Patrizi A, Argenziano G, Simonacci M, Quaglino P. Differences in clinicopathological features and distribution of risk factors in Italian melanoma patients. Dermatology 2015; 230:256-62. [PMID: 25659983 DOI: 10.1159/000368775] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 09/29/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND No studies are available in the literature on the distribution of different melanoma features and risk factors in the Italian geographical areas. OBJECTIVE To identify the differences in clinical-pathological features of melanoma, the distribution of risk factors and sun exposure in various Italian macro-areas. METHODS Multicentric-observational study involving 1,472 melanoma cases (713 north, 345 centre, 414 south) from 26 referral centres belonging to the Italian Multidisciplinary Group for Melanoma. RESULTS Melanoma patients in northern regions are younger, with thinner melanoma, multiple primaries, lower-intermediate phototype and higher counts of naevi with respect to southern patients; detection of a primary was mostly connected with a physician examination, while relatives were more involved in the south. Northern patients reported a more frequent use of sunbeds and occurrence of sunburns before melanoma despite sunscreen use and a lower sun exposure during the central hours of the day. CONCLUSIONS The understanding of differences in risk factors distribution could represent the basis for tailored prevention programmes.
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Affiliation(s)
- P Fava
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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Gualdi G, Monari P, Crotti S, Damiani G, Facchetti F, Calzavara‐Pinton P, Fantini F. Matter of margins. J Eur Acad Dermatol Venereol 2014; 29:255-261. [DOI: 10.1111/jdv.12504] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 03/05/2014] [Indexed: 11/30/2022]
Affiliation(s)
- G. Gualdi
- Department of Dermatology Spedali Civili‐University of Brescia Brescia Italy
| | - P. Monari
- Department of Dermatology Spedali Civili‐University of Brescia Brescia Italy
| | - S. Crotti
- Department of Dermatology Spedali Civili‐University of Brescia Brescia Italy
| | - G. Damiani
- Department of Dermatology Spedali Civili‐University of Brescia Brescia Italy
| | - F. Facchetti
- Department of Pathology I and II Spedali Civili‐University of Brescia Brescia Italy
| | - P. Calzavara‐Pinton
- Department of Dermatology Spedali Civili‐University of Brescia Brescia Italy
| | - F. Fantini
- Department of Dermatology Ospedale ‘A.Manzoni’ Lecco Italy
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Massafra U, Migliaccio S, Bancheri C, Chiacchiararelli F, Fantini F, Leoni F, Martin LS, Migliore A, Muccifora B, Napolitano C, Pastore R, Ragno A, Ronzoni S, Rotondi M, Tibaldi M, Villa P, Vinicola V, D'Erasmo E, Falaschi P, Minisola G. Approach in glucocorticoid-induced osteoporosis prevention: results from the Italian multicenter observational EGEO study. J Endocrinol Invest 2013; 36:92-6. [PMID: 22398397 DOI: 10.3275/8288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Glucocorticoid-induced osteoporosis (GIO) is the most frequent cause of secondary osteoporosis. GIO is linked to glucocorticoids (GC) daily assumption with maximum effect within first months of treatment and decreasing to basal levels as the therapy is discontinued. In Italy, primary prevention of GIO is suggested when GC therapy (prednisone >5 mg/day or equivalent) is taken for longer than 3 months. Lazio GISMO (Italian Group for Study and Diagnosis of Bone Metabolism Diseases) group organized the GC and Osteoporosis Epidemiology study (EGEO) to evaluate physician's approach in preventing GIO. The study involved 19 osteoporosis centers. Patients taking long-term GC therapy were recruited and information collected: medical history and anthropometric data, GC therapy, primary disease, physician's specialty, osteopororosis screening, and pharmacological intervention. The study included 1334 patients. Mean age was 63 ± 13 yr; 243 (18%) patients had a history of falls from standing position in the previous 12 months, 78 (35%) vertebral fractures, 91 (41%) fractures other than vertebral, 27 (12%) femoral fractures, and 27 (12%) multiple sites fractures. The molecules of GC more often prescribed were prednisone and 6-metil prednisolone. One thousand and forty patients (78%) were taking GC for more than 6 months. GC therapy was prescribed more frequently by rheumatologists (62%). Antiosteoporotic drugs for GIO prevention were prescribed in 431 patients (32%). Among the patients, only 27% (360) received calcium and vitamin D supplements, and 39% (319) treated by rheumatologists received anti-resorptive drugs. In conclusion, our data show that in Italy, as already described elsewhere, only a small subpopulation of GC-treated patients was supported by an anti-osteoporotic therapy, indicating the need to further stimulate awareness of both patients and specialists, prescribing GC therapy, to an appropriate and prompt GIO prevention.
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Affiliation(s)
- U Massafra
- Unità Operativa Semplice Reumatologia, Ospedale S. Pietro Fatebenefratelli, Rome, Italy
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Biasini A, Fantini F, Neri E, Stella M, Arcangeli T. Communication in the neonatal intensive care unit: a continuous challenge. J Matern Fetal Neonatal Med 2012; 25:2126-9. [DOI: 10.3109/14767058.2011.648241] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Fantini F, Apolloni L, Dal Bello S, Fellin F, Grando L, Pavei M. New cooling system with dielectric fluid for magnetizing winding in RFX-mod experiment. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Agostinetti P, Palma MD, Fantini F, Fellin F, Pasqualotto R. PCCE—A Predictive Code for Calorimetric Estimates in actively cooled components affected by pulsed power loads. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2010.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
The author commemorates, in the 20th year since his death, Camillo Benso Ballabio, unforgettable figure of rheumatologist, renowned clinician, man of great culture. The most important stages of his life are described, by adding to the biographical sketches some quotations that confirm the intellectual depth of such a protagonist of the history of the Italian rheumatology.
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Affiliation(s)
- F Fantini
- Cattedra di Reumatologia, Università di Milano, U.O. di Reumatologia, A.O. Istituto Ortopedico Gaetano Pini, Milan.
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Lurati A, Cimaz R, Gattinara M, Gerloni V, Teruzzi B, Salmaso A, Fantini F. Relationship between delayed menarche and bone density in patients affected by juvenile. Reumatismo 2011. [DOI: 10.4081/reumatismo.2008.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Fantini F, Greco A, Del Giovane C, Cesinaro A, Venturini M, Zane C, Surrenti T, Peris K, Calzavara-Pinton P. Photodynamic therapy for basal cell carcinoma: clinical and pathological determinants of response. J Eur Acad Dermatol Venereol 2010; 25:896-901. [DOI: 10.1111/j.1468-3083.2010.03877.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ingegnoli F, Fantini F, Griffini S, Soldi A, Meroni PL, Cugno M. Anti-tumor necrosis factor alpha therapy normalizes fibrinolysis impairment in patients with active rheumatoid arthritis. Clin Exp Rheumatol 2010; 28:254-257. [PMID: 20483049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Accepted: 12/10/2009] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Rheumatoid arthritis (RA) is associated with increased cardiovascular risk and involvement of inflammation, coagulation and fibrinolysis. Treatment with infliximab, a tumour necrosis factor-alpha (TNF-alpha) blocking chimeric monoclonal antibody, induces a long-term reduction of inflammation and coagulation, but its effect on fibrinolysis is still unknown. We carried out an observational study investigating plasma biomarkers of inflammation and fibrinolysis in RA patients before and after 14 weeks of infliximab treatment given according to the therapeutic guidelines for RA. METHODS We studied 20 selected patients with active RA and without any other atherosclerosis risk factor as well as 40 healthy controls. Patients, treated with a stable dose of methotrexate, received infliximab (3 mg/kg) at week 0, 2, 6 and 14. At week 0 and 14, we assessed clinical, inflammatory and fibrinolyitic parameters. RESULTS At baseline, plasminogen activator inhibitor (PAI-1) antigen, PAI-1 activity and tissue-type plasminogen activator (t-PA) antigen were significantly higher in RA patients than in controls (p=0.01, p=0.001 and p=0.0001 respectively). After 14 weeks of infliximab treatment, the levels of PAI-1 antigen, PAI-1 activity and t-PA antigen significantly decreased till normalization (p=0.0001). Plasma levels of C reactive protein (CRP) and interleukin-6 (IL-6) were directly correlated with levels of PAI-1 antigen (p=0.011 and p=0.0001), PAI-1 activity (p=0.013 and p=0.027) and t-PA antigen (p=0.017 and p=0.040). CONCLUSIONS This study provides evidence that TNF-alpha blockade by infliximab not only decreases inflammation, but also reduces the inhibition of fibrinolysis. Such a combined effect may be pivotal in reducing the whole thrombotic risk in these patients.
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Affiliation(s)
- F Ingegnoli
- Department of Rheumatology, University of Milan, Istituto Gaetano Pini, Milan, Italy
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Gualdi G, Monari P, Fantini F, Cesinaro AM, Cimitan A. Electrochemotherapy-induced virus disappearance in HHV-8-positive skin nodules of Kaposi sarcoma: first histological and immunohistochemical demonstration of efficacy. J Eur Acad Dermatol Venereol 2010; 24:239-41. [DOI: 10.1111/j.1468-3083.2009.03395.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sonato P, Agostinetti P, Anaclerio G, Antoni V, Barana O, Bigi M, Boldrin M, Cavenago M, Dal Bello S, Palma MD, Daniele A, D’Arienzo M, De Lorenzi A, Ferro A, Fiorentin A, Gaio E, Gazza E, Grando L, Fantini F, Fellin F, Luchetta A, Manduchi G, Milani F, Marcuzzi D, Novello L, Pasqualotto R, Pavei M, Pengo R, Peruzzo S, Pesce A, Pilan N, Piovan R, Pomaro N, Recchia M, Rigato W, Rizzolo A, Serianni G, Spolaore M, Spolaore P, Sandri S, Taliercio C, Toigo V, Valisa M, Veltri P, Zaccaria P, Zamengo A, Zanotto L. The ITER full size plasma source device design. Fusion Engineering and Design 2009. [DOI: 10.1016/j.fusengdes.2008.11.095] [Citation(s) in RCA: 165] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lubatti C, Ingegnoli F, Gualtierotti R, Boracchi P, Zahalkova L, Zeni S, Soldi A, Fantini F. [Nailfold capillaroscopic report: qualitative and quantitative methods]. Reumatismo 2009; 60:249-53. [PMID: 19132148 DOI: 10.4081/reumatismo.2008.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Nailfold capillaroscopy (NVC) is a simple and non-invasive method used for the assessment of patients with Raynaud's phenomenon (RP) and in the differential diagnosis of various connective tissue diseases. The scleroderma pattern abnormalities (giant capillaries, haemorrages and/or avascular areas) have a positive predictive value for the development of scleroderma spectrum disorders. Thus, an analytical approach to nailfold capillaroscopy can be useful in quantitatively and reproducibly recording various parameters. We developed a new method to assess patients with RP that is capable of predicting the 5-year transition from isolated RP to RP secondary to scleroderma spectrum disorders. This model is a weighted combination of different capillaroscopic parameters (giant capillaries, microhaemorrages, number of capillaries) that allows physicians to stratify RP patients easily using a relatively simple diagram to deduce prognosis.
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Affiliation(s)
- C Lubatti
- Dipartimento e Cattedra di Reumatologia, Istituto Gaetano Pini, 20122 Milano, Italia.
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Ingegnoli F, Sciascera A, D'Ingianna E, Fantini F. Systemic sclerosis, capillary leak syndrome and nasopharyngeal carcinoma: an unusual association or paraneoplastic manifestations? Rheumatology (Oxford) 2008; 48:201-2. [DOI: 10.1093/rheumatology/ken422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Teruzzi B, Salmaso A, Gerloni V, Gattinara M, Pontikaki I, Fantini F. Chronic Recurrent Multifocal Osteomyelitis (CRMO): four cases treated with aminobisphosphonate (pamidronate). Pediatr Rheumatol Online J 2008. [PMCID: PMC3333991 DOI: 10.1186/1546-0096-6-s1-p189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Fantini F, Salmaso A, Gerloni V, Gattinara M, Teruzzi B, Pontikaki I, Lurati A. Accuracy of preliminary remission criteria some JIA category. Pediatr Rheumatol Online J 2008. [PMCID: PMC3333900 DOI: 10.1186/1546-0096-6-s1-p105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Lurati A, Salmaso A, Teruzzi B, Gerloni V, Gattinara M, Fantini F. Relationship between delayed menarche and bone density in patients affected by juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2008. [PMCID: PMC3334105 DOI: 10.1186/1546-0096-6-s1-p45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Salmaso A, Lurati A, Pontikaki I, Gerloni V, Gattinara M, Teruzzi B, Fantini F. Efficacy of a second TNF blocker, when the first one failed, in patients with juvenile idiopathic arthritis (JIA). Pediatr Rheumatol Online J 2008. [PMCID: PMC3334104 DOI: 10.1186/1546-0096-6-s1-p44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Gerloni V, Pontikaki I, Gattinara M, Fantini F. Focus on adverse events of tumour necrosis factor blockade in juvenile idiopathic arthritis in an open monocentric long-term prospective study of 163 patients. Ann Rheum Dis 2008; 67:1145-52. [DOI: 10.1136/ard.2007.069484] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lurati A, Cimaz R, Gattinara M, Gerloni V, Teruzzi B, Salmaso A, Fantini F. [Skeletal mineralization in a prepubertal female population affected by juvenile idiopathic arthritis]. Reumatismo 2008; 60:224-229. [PMID: 18854886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Puberty is an essential step in bone mass accrual. Growth failure and impairment of sexual maturation are frequent manifestations of chronic illnesses in the paediatric population, and chronic rheumatologic disorders such as juvenile idiopathic arthritis (JIA) are no exception to this. METHODS The aim of our study was to prospectively evaluate bone density in adolescent females with JIA, and to correlate the results with clinical variables, in particular with age at menarche. Lumbar spine (L2-L4) area bone mineral density (aBMD) (assessed by Dual X-ray Absorbiometry, DXA) was monitored every 6-12 months in a group of 38 girls with JIA. The evaluated bone density accrual during the peripubertal time as well as absolute and relative (Z-score) aBMD in relationship with age at menarche, JIA subset, disease activity (as evaluated by ESR and Hgb), corticosteroid and methotrexate treatment (mean pro kg daily dose, cumulative dose) was assessed. Height, body mass index (BMI), bone mass content (BMC) values were also collected. Volumetric BMD (vBMD) evaluated with a geometric correction formula has been calculated and compared to aBMD. RESULTS Patients were divided into two groups: - group I included girls with menarche age within normal limits for Italian standards; - group II included girls with delayed menarche. The BMD values and Z scores in group I were not significantly different to normal population. The BMD values and Z scores in group II were significantly decreased when compared to the normal population (p<0.001). With a multivariate analysis only age at menarche seemed independently related to peripubertal mineralization (p=0.025, r between -0.65 and -0.75). With a binary logistic analysis only disease activity (ESR and Hgb values) seems independently related to a menarche delay (1.24+/-0.4 for each mm/h). CONCLUSION Our data show a critical role for disease activity in determination of a regular pubertal onset and an optimal bone density achievement.
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Affiliation(s)
- A Lurati
- Ospedale Fornaroli, Unità di Reumatologia, Magenta, Milano.
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Gerloni V, Pontikaki I, Gattinara M, Fantini F. [Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the literature and personal experience]. Reumatismo 2008; 59:244-61. [PMID: 17898886 DOI: 10.4081/reumatismo.2007.244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The therapeutic approach to JIA is sometimes very troublesome and progression to erosive polyarthritis may occur in all JIA categories. Only Methotrexate has shown efficacy and safety in a large controlled trial. Nevertheless, in many cases, drug resistance or intolerance has led to try other therapeutic options, with still debatable results. Therefore, there has been space, in the last few years, for new therapies as the TNF-inhibitors. This therapeutic approach has shown a dramatic clinical benefit in active polyarticular refractory JIA: the rate and rapidity of response have exceeded those of all other studied DMARDs. Preliminary data show that they are efficacious also for other pediatric rheumatic disease (spondyloarthropathies, autoimmune uveitis, dermatomyositis, Kawasaki syndrome and some autoinflammatory diseases). TNF-inhibitors in JIA have demonstrated a favourable benefit-to-risk profile. However, as their use has increased worldwide, some unusual, usually not serious, adverse events have emerged. Severe infections, including TB, and deaths have been reported. Long-lasting active disease, systemic disease, concurrent and previous immunosuppressive therapies, all contribute to risk of infection and other serious AEs. Given the evidence that TNF has a primary role in the pathogenesis of JIA, particularly in joint destruction, neutralizing this cytokine early, within the window of opportunity, could halt or delay progression of joint damage and debilitating consequences of the disease. Thus, for JIA patients whose disease is not quickly controlled with MTX, TNF blockers may be considered as first-line treatment, although long-term safety data still need to be established.
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Affiliation(s)
- V Gerloni
- UOS di Reumatologia Infantile, Istituto Ortopedico Gaetano Pini, Milano, Italia.
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De Marco G, Gerloni V, Pontikaki I, Luriati A, Teruzzi B, Salmaso A, Valcamonica E, Gattinara M, Fantini F. [Long-term evaluation of infliximab in the treatment of persistently active juvenile idiopathic arthritis refractory to conventional therapy]. Reumatismo 2007; 59:50-6. [PMID: 17435842 DOI: 10.4081/reumatismo.2007.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate, in long-term open label prospective study, infliximab as therapeutic choice for Juvenile Idiopathic Arthritis (JIA) non responsive to conventional therapy. METHODS We enrolled to treat with infliximab 78 JIA patients (66 females, 12 males): the mean age was 20.7+/-7.1 years (median 20.9, range 5.4-34.9); mean JIA duration was 13.6+/-7.6 years (median 13.5, range 0.4-31.4). Infliximab, at dose of 3-10 mg/kg/infusion added to weekly subcutaneous Methotrexate or other previous DMARDs, was administered by intravenous infusions at weeks 0, 2, 6 and every 8 weeks thereafter. Chest X-ray, Mantoux's test, electrocardiogram were performed at baseline; laboratory tests and clinical evaluation were performed at each infusion. Response was evaluated according to ACR improvement criteria. RESULTS Mean treatment period was 21.6 months+/-18.8 (median 14.7, range 1.4-72.4). Just after first infusion most of patients reported significant improvement in pain, fatigue, morning stiffness. Infliximab is still successfully administered to 23 patients (29.5%); 55 (70.5%) patients suspended because of: inefficacy (7), infusion reactions (17), adverse events (9), disease flare-up after a period of effectiveness on synovitis, pain, and morning stiffness (19), remission (2), lack of compliance to treatment (1). Infusion reactions, like dyspnea, flushing, chills, headache, hypotension, anxiety, throat oedema, were observed in 29 patients (34.5%). Anti-DNA antibodies were present in 7 patients (none developed Systemic Lupus Erythematous). CONCLUSIONS Infliximab showed impressive effectiveness treating refractory JIA, although most of patients had to discontinue treatment because of disease flare-up or adverse events. Infliximab may represent a good therapeutic choice in patients non-responders to Methotrexate.
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Affiliation(s)
- G De Marco
- Ist. Ortopedico Gaetano Pini, U.O. di Reumatologia e U.O.S. Reumatologia Infantile, Cattedra di Reumatologia, Università di Milano.
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De Lucia O, Paresce E, Murgo A, Epis O, Pisoni L, Schito E, Valcamonica E, Piana C, Fantini F. [Simultaneous ultrasonography and arthroscopy for the study of the joint environment: indications and limits]. Reumatismo 2007; 59:146-52. [PMID: 17603695 DOI: 10.4081/reumatismo.2007.146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Arthroscopy is a mini-invasive technique that allows the direct observation of the joint cavity and the execution of diagnostic and therapeutic procedures; arthroscopy needs a very long learning-time curve as well as dedicated spaces and instruments. Ultrasonography is an imaging technique that enables to perform an immediate extension of the standard physical examination. The opportunity to visualize soft tissues, to obtain multiplanar and dynamic images in real time makes this practice easy repeatable at low costs. Ultrasonography allows to detect a variety of changes during inflammatory processes. The wide experience in arthroscopy of rheumatic patients acquired through the years by our team at the G. Pini Institute led us to study in vivo, during arthroscopy, the correspondence between arthroscopic and ultrasonographic images. Up to now three knee arthroscopies have been conducted with the double equipment (ultrasonographic and arthroscopic devices) in operating room. In our experience, the combination of the two methods in operating room may improve the validation of ultrasonography with arthroscopy as gold standard, helps to train the ultrasonographer to give immediate answers in order to clear the doubts aroused by ultrasonographic images; it also allows the arthroscopist to visualize the deeper layers of the synovial membrane making double guided targeted biopsies possible. Limits are the complexity of the procedure (instruments, operators, spaces, training of the doctors), the loose of power-doppler signal with the blood tourniquet and the always difficult evaluation of cartilage.
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Affiliation(s)
- O De Lucia
- U.O. e Cattedra di Reumatologia, Istituto Ortopedico G. Pini, Milano, Italia.
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Pisoni L, Murgo A, Paresce E, Zeni S, Fantini F. Effectiveness and safety of leflunomide in the clinical practice. A different experience. Clin Exp Rheumatol 2007; 25:115; author reply 116. [PMID: 17418002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Fano V, DʼOvidio M, DellʼOrco V, Forastiere F, Porta D, Blasetti F, Fantini F, Corbo A, Perucci CA. Morbidity, Mortality and Reproductive Health in an Area Contaminated by Persistent Organic Pollutants. Epidemiology 2006. [DOI: 10.1097/00001648-200611001-00922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
OBJECTIVE To study the sequence of atrial activation and the interatrial electromechanical delay (IEmD) noninvasively in healthy subjects during sinus rhythm (SR). METHODS AND RESULTS In 66 SR healthy subjects P-wave activation was analyzed by means of vectorcardiography. The timing of atrial contractions was measured as the intervals between the P-wave and the A-wave of the Doppler right and left ventricular inflows (P-A(t) and P-A(m)), and IEmD was calculated as the algebraic difference P-A(m)- P-A(t). In the horizontal plane the vectorcardiographic P-loop was anteroposterior ("typical", 41 subjects), anterior (18), or posterior (7). IEmD (mean +/- SE 17 +/- 8 ms) was directly related to R-R and P-R intervals. IEmD was significantly shorter in anterior and posterior P loops than in the typical (6.5 +/- 5.3 and 8.1 +/- 10.1, respectively, vs 24.2 +/- 3.1 ms). In the posterior P-loop group, who exhibited longer P-A(t), mitral E-wave velocity and E/A ratio were reduced, and left atrial booster function was increased. CONCLUSION IEmD was widely variable in SR, reflecting the origin site of sinus impulse, which independently influenced ventricular filling dynamics.
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Affiliation(s)
- G Barletta
- Department of Cardiology, Careggi Hospital, University of Florence, Italy.
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Abstract
It has been widely accepted that the antiphospholipid syndrome (APS) is an autoimmune hypercoagulability syndrome in which a variety of venous and arterial thrombotic events may occur. Peripheral obliterating arterial disease characterized by aortoiliac steno-occlusion occurring in young women, is reported in the literature under the name of Small Aorta Syndrome (SAS). Although it remains unclear whether SAS represents a separate entity, the small size of the distal aorta increases the risk for aortoiliac occlusive disease. A 41-year old white woman was admitted with acute digital ischemia of the left foot. She had positive lupus anticoagulant and IgG anti-cardiolipin antibodies (61 UI/mL), but antinuclear antibodies and anti-ds-DNA antibodies were negative. She previously had two deep venous thromboses of the legs and, despite the oral anticoagulant therapy, pulmonary embolism occurred. Shortly thereafter, abdominal angio-magnetic resonance imaging suggested that the infra-renal aorta was narrowed more than 50%, without thrombotic occlusion of the terminal aorta and common iliac arteries. These findings were compatible with the features of SAS. There were no atherosclerotic changes in the artery wall and no other prediposing risk factors such as smoking, oral contraceptive or hyperlipidemia. After adequate anticoagulation and intravenous prostacyclin treatment the patient's symptoms and the ischemic lesions improved markedly. To our knowledge this is the first report of the association of SAS and primary APS. The occurrence of SAS in patients with APS may dramatically increase the risk of trombothic events.
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Affiliation(s)
- F Ingegnoli
- Department of Rheumatology, Istituto Gaetano Pini, Milano, Italy.
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Lurati A, Pontikaki I, Teruzzi B, Desiati F, Gerloni V, Gattinara M, Cimaz R, Fantini F. A comparison of response criteria to evaluate therapeutic response in patients with juvenile idiopathic arthritis treated with methotrexate and/or anti-tumor necrosis factor alpha agents. ACTA ACUST UNITED AC 2006; 54:1602-7. [PMID: 16646003 DOI: 10.1002/art.21784] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE There are no validated criteria to evaluate clinical response in juvenile idiopathic arthritis (JIA). The purpose of this study was to compare 4 sets of criteria (2 from the American College of Rheumatology [ACR] and 2 from the European League Against Rheumatism [EULAR]) for clinical response evaluation in JIA patients treated with methotrexate and/or anti-tumor necrosis factor alpha drugs. METHODS Seventy-five patients with JIA were evaluated at baseline and after 6 months of therapy with second-line drugs. Mean age at study onset was 12.8 years (range 2-32.9 years). Diagnoses were systemic JIA (n = 16), rheumatoid factor-positive JIA (n = 5), rheumatoid factor-negative JIA (n = 9), persistent oligoarticular JIA (n = 10), extended oligoarticular JIA (n = 33), and psoriatic arthritis (n = 2). Clinical response was evaluated with the ACR Pediatric 30 criteria and the ACR 20% response criteria (ACR20), and with the EULAR Disease Activity Score (DAS) and 28-joint DAS (DAS28). Patients with EULAR criteria responses of "good" or "moderate" were classified as responders. Responders and nonresponders according to the different criteria were then compared. RESULTS For patients younger than 16 years, Cohen's kappa varied between 0.51 and 0.72, with a good-to-excellent reproducibility index for all comparisons, except for the DAS28/ACR20 comparison. The best agreement was obtained by comparing the DAS and the ACR Pediatric 30. For patients older than 16 years, the reproducibility index was good or excellent in only 2 cases, i.e., comparing the DAS and the ACR Pediatric 30 and comparing the DAS and the DAS28 (as expected). CONCLUSION Our study shows a good agreement overall for the different criteria tested. The highest concordance was observed between the DAS and the ACR Pediatric 30, the lowest between the DAS28 and the ACR20. Our data suggest that the ACR Pediatric 30 criteria can be used also in adult patients affected by JIA, and that the original DAS can be an alternative to the ACR Pediatric 30 in both children and young adults with JIA.
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Affiliation(s)
- A Lurati
- Gaetano Pini Institute, Milan, Italy.
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Bellintani C, Ghiringhelli P, Gerloni V, Gattinara M, Farronato G, Fantini F. [Temporomandibular joint involvement in juvenile idiopathic arthritis: treatment with an orthodontic appliance]. Reumatismo 2006; 57:201-7. [PMID: 16258606 DOI: 10.4081/reumatismo.2005.201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE About 65% of children suffering from juvenile idiopathic arthritis (JIA) shows a more or less marked involvement of temporo-mandibular joint (TMJ) with altered mandibular growth, resorption of the condyles, occlusary instability, reduced chewing ability and facial dysmorphia. The purpose of our study is to prevent and to treat the progressive evolution of JIA on craniofacial growth and morphology with a functional appliance; surgery should be considered only in so far as the adequacy of TMJ movement is concerned. METHODS From 1992 until now 72 children with proved JIA and TMJ involvement have been treated (50 females, 22 males, aged 6 to 16 years old). TMJ involvement was bilateral in 61% and unilateral in 39% of patients. A diagnostic workup was carried out involving tomograms of TMJ and cephalometric radiograph and analysis. The authors used a bimaxillary activator in the attempt to modify the unfavourable growth pattern and provide a gradual ante-rotation of the jaw. RESULTS Almost all JIA patients showed satisfactory long term results, easing of pain, reduced skeletal discrepancy, increased function and good facial profile. CONCLUSIONS The long term results of this study indicate that orthopaedic therapy might control the vicious circle of the malocclusion in children with JIA, preventing exacerbation of mandibular clockwise rotation. Surgical intervention for the improvement of TMJ function should be considered only if a severe restricted state is imminent.
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Affiliation(s)
- C Bellintani
- Cattedra e Reparto di Ortognatodonzia, Clinica Odontoiatrica, Università degli Studi di Milano.
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Del Papa N, Cortiana M, Comina DP, Maglione W, Silvestri I, Maronetti Mazzeo L, Fracchiolla N, Fantini F, Cortelezzi A. [Endothelial progenitor cells in systemic sclerosis: their possible role in angiogenesis]. Reumatismo 2006; 57:174-9. [PMID: 16258601 DOI: 10.4081/reumatismo.2005.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recently, several studies have demonstrated the presence of circulating endothelial progenitors (CEPs) responsible for angiogenesis. Notably, these cells are able to migrate to ischemic tissues and differentiate in situ in mature endothelial cells. Aim of this study was to assess the presence of CEPs in the peripheral blood of patients with Sistemic Sclerosis (SSc) and evaluate their significance as an attempt of re-vascularization MATERIAL AND METHODS Samples of peripheral blood from 40 healthy subjects and 56 patients with SSc were studied. Five-parameter, 3-color flow cytometry was performed with a FACScan. CEPs were defined as CD45 negative, CD34 and CD133 positive. In addition, plasma levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were detected by commercial ELISA (R&D Systems). RESULTS Levels of CEPs (CD133+/CD34+/CD45-) were significantly higher in patients with SSc in comparison to HC (P = 0.01). No correlation was found between CEPs and any clinical parameter of disease neither activity score. CEPs were significantly higher in the group of patients with early disease, while their number decreased in the late phases of disease. Plasma levels of VEGF, but not bFGF, were significantly higher in SSc in comparison to HC (P<0.001) but no correlation was found between VEGF concentrations and CEP number. CONCLUSIONS The presence of CEPs in patients with SSc suggest that sclerodermic hypoxic tissues could induce the mobilization of bone-marrow derived cells in an attempt to provided new vessels, in the early phase of the disease, at least.
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Affiliation(s)
- N Del Papa
- Dipartimento di Reumatologia, Istituto Ortopedico G. Pini, Via Pini, 9 - 20122 Milano. .
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Ingegnoli F, Zeni S, Gerloni V, Fantini F. Capillaroscopic observations in childhood rheumatic diseases and healthy controls. Clin Exp Rheumatol 2005; 23:905-11. [PMID: 16396714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To describe, by using video nailfold capillaroscopy (NFC), microvascular abnormalities in children with rheumatic diseases and to evaluate the capillary changes over a follow up period. METHODS 118 children suffering from rheumatic diseases: 55 juvenile idiopathic arthritis (JIA), 7 mixed connective tissue disease (MCTD), 6 primary Raynaud's phenomenon (PRP), 34 systemic lupus erythematosus (SLE), 8 juvenile systemic sclerosis (JSSc) and 8 juvenile dermatomyositis (JDM) were included in the study. Patients with major capillaries abnormalities or scleroderma pattern were followed up for at least 12 months. 70 age- and sex-matched healthy controls (HC) were also examined. RESULTS In HC there was a significant correlation between age and capillary length (p = 0.001). JIA patients showed capillary number, size, shape and arrangement similar to HC. Minor abnormalities were frequently observed. The percentage of major abnormalities were significantly increased compared to HC in MCTD (p = 0.008), SLE (p = 0.0002) and JDM patients (p < 0.0001). 5/8 of JSSc had a scleroderma pattern from the onset of the disease. The serial observations in connective tissue diseases also showed that the evolution of capillaroscopic pattern was not unidirectional. In fact, in some nailfolds there was an increase in capillary loss and in avascular areas, whereas sometimes it remained stable on repeated examination. CONCLUSION NFC can be used as a simple, inexpensive, non-invasive method to evaluate the microvascular abnormalities in childhood rheumatic conditions, and it may be useful in early recognition and monitoring scleroderma spectrum disorders.
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Affiliation(s)
- F Ingegnoli
- Department of Rheumatology, Istituto Gaetano Pini, University of Milan, Italy.
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DiDonato M, Toso A, Dor V, Sabatier M, Menicanti L, Fantini F, Buckberg G. Mechanical Synchrony: Role of Surgical Ventricular Restoration in Correcting LV Dyssynchrony During Chamber Rebuilding. Heart Fail Rev 2005; 9:307-15. [PMID: 15886976 DOI: 10.1007/s10741-005-6807-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cardiac failure is frequently complicated by intra and or interventricular conduction delay that results in dyssynchronized cardiac contraction and relaxation. In contrast to an electrical intervention by biventricular pacing, this study tests the capacity of geometric rebuilding by surgical ventricular restoration (SVR) to restore a more synchronous contractile pattern through mechanical reconstruction without exogenous pacing input. Thirty patients (58 +/- 8 years) undergoing SVR at the Cardiothoracic Center of Monaco were prospectively evaluated with a protocol which uses simultaneous measurements of ventricular volumes and pressure to construct pressure/volume (P/V) and pressure/length (P/L) loops. Mean QRS duration was within normal limits (100 +/- 17 ms) preoperatively. Preoperative LV contraction was highly asynchronous. Endocardial time motion was either early or delayed at the end-systolic phase, yielding P/L loops with abnormal in size, shape, and orientation. Postoperatively, SVR resulted in leftward shifting of P/V loops and increased area; endocardial time motion and P/L loops almost normalized. The hemodynamic consequences of SVR included improved ejection fraction; reduced end-diastolic and end-systolic volume index; more rapid peak filling rate; peak ejection rate and mechanical efficiency resulting in mechanical intraventricular resynchronization that improves LV performance.
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Del Papa N, Cortiana M, Maglione W, Comina DP, Silvestris I, Moronetti Mazzeo L, Fracchiolla N, Fantini F, Cortelezzi A. [Raised levels of circulating endothelial cells in systemic sclerosis]. Reumatismo 2005; 57:29-35. [PMID: 15776144 DOI: 10.4081/reumatismo.2005.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Circulating endothelial cells (CECs) have been described in different conditions with vascular injury. Vascular abnormalities play a key role in the pathogenesis of Systemic Sclerosis (SSc). The aim of our study was to look for the presence of CECs in SSc patients and to evaluate their clinical significance. METHODS We studied 52 SSc patients and 40 healthy controls (HC). Five-parameter, 3-color flow cytometry was performed with a FACScan. CECs were defined as CD45 negative, CD31 and P1H12 positive, and activated CECs as CD45 negative and P1H12, CD62, or CD106 positive. RESULTS Total and activated CEC counts were significantly higher in SSc patients when compared with HC and positively correlated with disease activity score. We found a significant association between CECs and disease activity; as regard with organ involvement, CEC number correlate with the severity of pulmonary hypertension. CONCLUSIONS Raised counts of CECs may represent direct evidence of active vascular disease in SSc as regard as visceral involvement, the association between CECs and pulmonary hypertension suggest a relevant role for CECs as a marker of prominent endothelial involvement.
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Affiliation(s)
- N Del Papa
- Dipartimento di Reumatologia, Ospedale G. Pini, Via Pini 9, 20122 Milan.
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Mastaglio C, Fantini F. About the difficulty in interpreting ultrasonographic images of temporomandibular joint. Rheumatology (Oxford) 2005; 44:413-6; author reply 416-7. [PMID: 15637035 DOI: 10.1093/rheumatology/keh472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ingegnoli F, Del Papa N, Comina DP, Maglione W, Lupi E, Gerloni V, Fantini F. Autoantibodies to chromatin: prevalence and clinical significance in juvenile rheumatoid arthritis. Clin Exp Rheumatol 2004; 22:499-501. [PMID: 15301253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To determine the prevalence of anti-chromatin antibodies (Abs) in juvenile rheumatoid arthritis (JRA) and to assess any association between the presence of anti-chromatin Abs and clinical subsets of the disease. METHODS IgG anti-chromatin Abs and anti-extractable nuclear antigens (ENA) Abs were detected by an enzyme-linked immunosorbent assay (ELISA), and antinuclear Abs (ANA) by indirect immunofluorescence in sera of 89 children with JRA. Ten children with systemic, 32 with polyarticular and 47 with pauciarticular disease onset (uveitis occurred in 17/47 children) were studied. As a control group, 12 sera of patients suffering from idiopathic uveitis and 31 age- and-sex-matched healthy children (HC) were examined. RESULTS Abs to chromatin were detected in 14/47 (29.8%) of children suffering from pauciarticular onset JRA and in this group the higher prevalence of anti-chromatin Abs has been found in children with chronic uveitis (p = 0.002). Anti-chromatin positivity was observed in 2/10 (20%) of systemic and in 3/32 (9.3%) of polyarticular onset JRA. Furthermore, none of the patients with idiopathic uveitis and HC had Abs to chromatin. anti-chromatin Abs titers remained relatively stable over a 6-month control period. CONCLUSION Our results confirm previous data about the presence of circulating anti-chromatin Abs in juvenile arthritis. Interestingly, anti-chromatin Abs were significantly higher in the group of patients with pauciarticular onset with past or present history of uveitis, than in patients without ocular involvement. A long-term follow-up study could be useful to demonstrate the potential utility of these autoantibodies in diagnosing, classifying and treating children affected.
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Affiliation(s)
- F Ingegnoli
- Department of Rheumatology, University of Milan, Istituto Ortopedico Gaetano Pini, Milan, Italy.
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Belotti Masserini A, Zeni S, Cossutta R, Soldi A, Fantini F. [Cost-of-illness in systemic sclerosis: a retrospective study of an Italian cohort of 106 patients]. Reumatismo 2004; 55:245-55. [PMID: 14872224 DOI: 10.4081/reumatismo.2003.245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIMS It is increasingly important to determine the economic consequences of diseases considering the policy of limited health-care budgets. In this study we evaluated the annual direct and indirect costs of Systemic Sclerosis (SSc) and we tried also to identify any cost predictors. METHODS We studied 106 patients (103 female, 3 male), 57 affected by Limited Systemic Sclerosis (LSSc) and 49 affected by Diffuse Systemic Sclerosis (DSSc). Mean age was 57 years (SD +/- 13.8) and mean disease duration was 8,9 years (SD +/- 7.2). Direct Costs: data were calculated referring to DRG (Disease Related Group) expenses for the in-patients. We referred to national pharmacopoeia to calculate the pharmaceutical cost for the out-patients. Indirect costs: we estimated the expense comparing our cases to literature data. Intangible costs: these are attributable to pain and psychological suffering. It is very difficult to express the intangible costs in monetary terms and they are often conveyed as disability and poorer quality-of-life. We used the Health Assessment Questionnaire "HAQ" and the Short Form-36 "SF-36" to evaluate this issues. RESULTS Our study confirms, the extremely high costs caused by Systemic Sclerosis (total cost's 2001 year is 1,173,842.93 Euro, and average yearly patient cost is 11,073.99 Euro). Considering an estimated prevalence of 375 cases/106, the total yearly economic impact of SSc in Italy should be 249 million euro. Intangible costs were calculated as modifications of the health status. Average value of the HAQ was significantly higher than the control population (0.94 +/- 0.72), average values in the SF-36 were significantly lower than the control population (49.99 +/- 19.16 for physical dimension and 58.42 +/- 27.71 for mental dimension). The diffuse form of SSc, anti-Scl 70 antibodies, high skin score and a poor health status (HAQ and SF-36) were found to be cost predictors. CONCLUSIONS As reported in the literature, our study confirms, the extremely high costs for total and single patients caused by Systemic Sclerosis. The DSSc are more expensive than the LSSc approximately 11% (p=0.0067). The direct costs are 30% higher in the DSSc than the LSSc (p < 0.001). The indirect and intangible costs are not significantly different. Moreover, our study shows also the possibility of identifying different cost predictors.
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Affiliation(s)
- A Belotti Masserini
- Dipartimento e Cattedra di Reumatologia dell' Universitá degli Studi di Milano, Milano, Italia
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Ingegnoli F, Del Papa N, Lupi E, Comina DP, Maglione W, Gerloni V, Fantini F. [Anti-chromatin antibodies in juvenile rheumatoid arthritis]. Reumatismo 2004; 55:240-4. [PMID: 14872223 DOI: 10.4081/reumatismo.2003.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE to evaluate the prevalence and clinical significance of anti-chromatin antibodies (Abs) in juvenile rheumatoid arthritis (JRA). METHODS IgG anti-chromatin Abs were detected by an enzyme-linked immunosorbent assay (ELISA), in sera of 94 children with JRA (10 children with systemic, 38 with polyarticular and 46 with oligoarticular disease onset). As control group, 33 age- and-sex-matched healthy children (HC) were also examined. RESULTS Abs to chromatin were detected in 24/94 (25.5%) of children suffering from JRA. Particularly, the higher prevalence of anti-chromatin Abs has been found in children with oligoarticular (30,4%) and polyarticular (23.7%) onset JRA. In these groups Abs titers were significantly higher compared to systemic JRA and HC (p=0.003). Anti-chromatin Abs were observed more frequently in patients with oligoarticular disease and chronic uveitis (21.7%). Furthermore, higher levels of anti-chromatin Abs has been found in all the patients treated with anti-TNF-alpha therapy (p< 0.0001). CONCLUSIONS our results confirm previous data about the prevalence of anti-chromatin Abs in JRA. These Abs were significantly higher in the group of patients with oligoarticular onset with past or present history of ocular involvement and in the group with polyarticular JRA treated with biologic therapy. A long-term follow-up study could be useful to evaluate the potential utility of these autoantibodies.
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Affiliation(s)
- F Ingegnoli
- Cattedra di Reumatologia, Istituto Gaetano Pini, Milano, Italia.
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Fantini F, Cimaz R. A fatal case of systemic lupus erythematosus complicated by acute pancreatitis, invasive aspergillosis and features of thrombotic thrombocytopenic purpura. Lupus 2004; 12:418-21. [PMID: 12765308 DOI: 10.1191/0961203303lu375cr] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We describe the case of a 23-year-old woman with a mild form of systemic lupus erythematosus who presented a febrile illness rapidly followed by general worsening, neurologic involvement, renal failure and coma. While hospitalized in the intensive care unit she also suffered from acute pancreatitis, microangiopathic hemolitic anemia, thrombocytopenia and prolongation of clotting times. Despite aggressive treatment the patient died at day 17 of hospitalization in the intensive care unit. At autopsy necrotico-hemorragic pancreatitis, diffuse pneumonia, peritonitis and cerebral edema were present. Most striking was the presence of invasive aspergillosis, which was detected in all organs examined. In this case thrombotic thrombocytopenic purpura, invasive aspergillosis and multiorgan failure including acute pancreatitis were present. The relationship between the three entities is complex, and it is difficult to establish which of the different events took place first and triggered the others.
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Affiliation(s)
- F Fantini
- Department of Rheumatology, University of Milan, Gaetano Pini Institute, Milano, Italy
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