1,721,060 research outputs found
Treatment strategies for apatient with rheumatoid arthritis and hepatitis C
No full textBACKGROUND: The poor prognosis of rheumatoid arthritis (RA) can be aggravated by the concomitant presence of chronic hepatitis C virus (HCV) infection and there are no guidelines for the treatment of patients affected by both conditions.
OBJECTIVE: To propose new therapeutic strategies for patient affected by RA and concomitant HCV chronic infection.
METHODS: Review of the literature on the usage of cyclosporine-A (CsA) and anti-tumour-necrosis-factor (TNF)-alpha agents for the treatment of patients affected by RA and HCV.
RESULTS/CONCLUSION: CsA exerts an inhibitory effect on HCV replication and it is safe in patients affected by RA and HCV. Anti-TNF-alpha agents are safe and efficacious in patient with RA and HCV. Anti-TNF-alpha and CsA can be safely given in combination in RA patients with HCV infection
Therapeutic indications for high dose intravenous immunoglobulin in autoimmune or immunomediated diseases in pediatrics [Indicazioni terapeutiche con Ig e.v. ad alte dosi in patologie autoimmuni o immunomediate in eta pediatrica]
No full text[Viral genotype and HLA class II alleles influence on extra-hepatic manifestations of chronic HCV infection]
No full textSclerodermic lesions after liposuction in a patient with Raynaud's phenomenon and anti-centromeric antibodies
No full textViral genotype and HLA class II alleles influence on extra-hepatic manifestations of chronic HCV infection
No full textOBJECTIVE: To test whether an association between HCV genotype, HLA class II alleles distribution and extra-hepatic manifestations (EHM ) can be demonstrated in a group of Italian patients with chronic HCV infection .
METHODS: Sixty patients affected by HCV infection with EHM were consecutively enrolled. 163 HCV patients without EHM were tested as controls for the prevalence of HCV genotypes, while we referred to literature as to the controls for HLA distribution. HCV-RNA was quantified by a RT-PCR. HLA class II alleles typing was performed using a standard microlymphocytotoxicity assay. We used chi-square or Fisher test (p<0.05 significant). Odds Ratio (OR) was performed by 2X2 contingency table.
RESULTS: HCV 2c genotype was found in 63.46% of patients compared to 19.63% of controls (p<0.0001; OR=7.11). Furthermore, it correlated with carpal tunnel syndrome (p=0.03; OR=4.5) and autoimmune thyroiditis (p=0.02; OR=9.2). On the contrary, 1b genotype protected from EHM in toto (p=0.0004; OR=0.21) and particularly from carpal tunnel syndrome (p=0.0014; OR=0.07). Moreover, 3a genotype prevented HCV people from having cryoglobulinemia (p=0.05; OR=0.11). As to HLA, DR6 seemed to facilitate EHM in HCV patients (p=0.041; OR=1.61), while DQ2 (p=0.03; OR=0.5) and DQ3 (p=0.002; OR= 0.5) may play a protective role. In addition, HLA DR3 was associated with cryoglobulinemia (p=0.02; OR=9.5).
CONCLUSIONS: According to our findings, 2c genotype can be considered as a major risk factor for developing HCVrelated EHM, while 1b genotype seems to prevent their onset; there are also evidences suggesting that HLA might play a role in chronic HCV infected patients
Pregnancy in Wegener's granulomatosis: successful treatment with intravenous immunoglobulin
No full textWe present the case of a women diagnosed with Wegener's disease at the age of 26 years, refractory to corticosteroid and cyclophosphamide therapy. Treatment with intravenous immunoglobulin (IVIg) was started, leading to partial clinical remission of disease. During IVIg treatment she became pregnant. IVIg therapy was continued, the disease went into remission, and after 40 weeks the patient delivered a healthy boy. After 6 months from the delivery, the patient became pregnant again. Now she is at the 22nd week of pregnancy and she is doing very well. This case supports the beneficial effect of IVIg in Wegener's granulomatosis and illustrates its safety and efficacy during pregnancy
Combination therapy with cyclosporine A and anti-TNF-alpha agents in the treatment of rheumatoid arthritis and concomitant hepatitis C virus infection
No full textWe describe two cases of rheumatoid arthritis (RA) patients and concomitant hepatitis C virus infection (HCV), treated with cyclosporine A (CsA) and anti-TNF-alpha agents. SGOT/SGPT and HCV-RNA serum levels remained unchanged longer than 1 year of treatment. No side effects were registered. We suggest that combination therapy with CsA and TNF-alpha blockers should be considered safe and well-tolerated in the treatment of HCV-positive RA patients
Absence of anti-cyclic citrullinated peptide antibodies in erosive osteoarthritis: further serological evidence of the disease as a subset of osteoarthritis
No full textErosive osteoarthritis (EOA) is considered to be a rare subset of osteoarthritis (OA) characterised by destructive changes involving the proximal interphalangeal and distal interphalangeal joints.1–3 Laboratory findings are usually negative even though a slight increase of erythrocyte sedimentation rate may occur.2,3 Radiologically, central erosions and the “gull wing” deformity characterise the disorder.4 Synovial pathology shows changes consistent with both rheumatoid arthritis (RA) and OA.1,2 Histological examination of synovium from patients with EOA joints shows lining cell hyperplasia, lymphocytic infiltration, and pannus formation, features indistinguishable from those of RA.1
The relationship between EOA and classical OA is controversial, as some authors consider it to be a separate disease entity, some regard it as one end of the spectrum of OA, and some regard it as an interface between OA and RA.1,4 A relationship between EOA and RA was first suggested by Ehrlich,5 who noted the superimposition of clinical, laboratory, and imaging findings of RA in 62 of 170 patients initially diagnosed with EOA. Moreover, in the early stages of the disease, the differential diagnosis between EOA and other arthritis, such as RA or psoriatic arthritis, may pose a challenge, requiring a number of laboratory tests and investigations.3,6–8 It is well known that anti-cyclic citrullinated peptide antibodies (anti-CCP) are highly specific for RA and good predictors of radiographic joint damage9; for that reason this study aimed at detecting these autoantibodies in serum samples of patients with EOA, in order to ascertain their clinical usefulness and, possibly, to contribute to the clarification of the relationship of EOA with classical OA and RA. On the one hand, positive results may support the hypothesis that EOA is an interface between OA and RA, but, on the other hand, negative results may support the hypothesis that EOA is one end of the spectrum of OA.
We evaluated 32 patients with EOA showing typical EOA radiographic findings.6 The control group included 35 patients affected by nodal OA of the hands (NOA) fulfilling American College of Rheumatology criteria10 and 50 healthy subjects. All the patients were examined for exclusion of psoriatic arthritis, RA, undifferentiated spondyloarthropathies, gout, and pseudogout. In addition, 45 patients with RA were examined to test the sensitivity and specificity of our anti-CCP enzyme linked immunosorbent assay (ELISA) kit (table 1)
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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