The game theory in thoracic surgery: from the intuitions of Luca Pacioli to the operating rooms management.

Game theory is a formal way to analyze the interactions among groups of subjects who behave each other. It has historically been of great interest in the economic fields in which decisions are made in a competitive environment. Game theory has fascinating potential if applied in the medical science.

Frequency of musculoskeletal conditions among patients referred to Italian tertiary rheumatological centers.

Objective: To describe the occurrence of different rheumatic diseases and to examine the characteristics of patients referred to six Italian rheumatological units. To compare these data with those from other countries.

Methods: Six Italian rheumatological tertiary referral centers participated in the study.

Comorbid conditions in the AMICA study patients: effects on the quality of life and drug prescriptions by general practitioners and specialists.

Objective: Osteoarthritis (OA) has been identified as the disease with the highest rate of comorbidities, which may increase the likelihood of disability. The AMICA study evaluated how the presence of a coexistent disease and/or its chronic pharmacological treatment influenced the prescription of pharmacological and nonpharmacological therapy in patients with OA.

Patients And Methods: The 2764 general practitioners (GPs) and 316 specialists (98 rheumatologists, 166 orthopedic surgeons, 52 physical medicine specialists) participating in the study were asked to enroll 10 consecutive patients with OA diagnosed according to the American College of Rheumatology clinical criteria.

The characteristics of symptomatic osteoarthritis in general and specialist practice in Italy: design and methods of the AMICA Study.

Objective: The diagnostic and clinical approach to osteoarthritis (OA) of the hand, knee, and hip in general practice and specialist practice in Italy as determined by the AMICA project.

Methods: Eligible subjects were identified among patients aged > or =50 years consecutively observed by their general practitioner (GP) or a specialist during the study period for diagnosis or treatment of symptomatic OA of the hand, knee, or hip. OA was diagnosed according to the American College of Rheumatology clinical criteria.

[Sodium gold thiosulfate therapy: an open, viewed, multicenter trial in rheumatoid arthritis patients followed for two years].

Objective: To evaluate if parenteral gold-therapy with Sodium gold thiosulfate is effective and safe for the treatment of rheumatoid arthritis we began an open, multicenter trial.

Methods: 126 rheumatoid arthritis patients were treated with Sodium gold thiosulfate for two years. Efficacy, quality of life, progression of joint damage, inflammatory parameters and side effects were evaluated.

[Rheumatoid arthritis: frequency of hospitalization and evaluation of economic burden].

About 10% of the Italian general population is affected by rheumatic diseases (RD). Due to their chronic and disabling nature, RD are cause of an annual economic burden evaluated in about 17,000 billions italian lire. In Italy, rheumatoid arthritis (RA) affects nearly 400,000 people.

Study of peripheral bone mineral density in patients with diffuse idiopathic skeletal hyperostosis.

Diffuse idiopathic skeletal hyperostosis (DISH) is an ossifying systemic enthesopathy which involves not only the spine but which may also appear in other sites. Degenerative, inflammatory and metabolic factors have been reported for a possible pathogenic role in the new bone growth that characterises DISH. In the present study peripheral bone mineral density (BMD) has been measured in patients affected by DISH and the results compared to those of a control group.

Relationship of rheumatoid factor isotype levels with joint lesions detected by magnetic resonance imaging in early rheumatoid arthritis.

Objective: To evaluate the relationship between rheumatoid factor isotypes and articular damage detected by magnetic resonance imaging and plain radiography in early rheumatoid arthritis.

Methods: 20 consecutive patients with early active rheumatoid arthritis underwent determinations of serum IgM, IgA, and IgG rheumatoid factors by enzyme-linked immunosorbent assay (ELISA). Plain radiographs of the hands and wrists were obtained, and the wrist, metacarpophalangeal joints, and proximal interphalangeal (PIP) joints on the more severely affected side were investigated by magnetic resonance imaging before and after gadolinium-DTPA injection.

Circulating levels of soluble CD30 are increased in patients with systemic sclerosis (SSc) and correlate with serological and clinical features of the disease.

Activated Th2 lymphocytes express the surface molecule CD30 and release a soluble form of the same molecule which can be detected both in vivo and in vitro. In the present study, high levels of soluble CD30 were found in the peripheral blood of patients with SSc, and a significant correlation with skin score and erythrocyte sedimentation rate (ESR) was detected. Furthermore, we observed a higher spontaneous release of soluble CD30 in the supernatants of unstimulated cultures of peripheral blood mononuclear cells from our patients compared with healthy controls.

Time course of radiologic lesions in spinal hyperostosis: an osteoradiometric study.

The purpose of this study was to evaluate changes over time in the flowing spinal ossification characteristic of spinal hyperostosis. Thirty-two patients were studied. A QR-ORM osteoradiometry apparatus was used to measure variations in the surface area of the ossification on radiographs obtained after three, ten, and 20 years.

Somatostatin 14 and joint inflammation: evidence for intraarticular efficacy of prolonged administration in rheumatoid arthritis.

Previous studies with intraarticular administration of somatostatin (SST14) in rheumatoid arthritis showed an antiinflammatory and analgesic effect. The aim of the present study was to demonstrate the efficacy and tolerability of SST14 in rheumatoid arthritis (RA) patients for a longer period of treatment than previously scheduled. Forty-one patients with RA of the knee were treated with a cycle of intraarticular injection of 750 micrograms of SST14, every 15 days.

Intra-articular somatostatin 14 reduces synovial thickness in rheumatoid arthritis: an ultrasonographic study.

Sixteen patients with RA (3 males, 13 females), diagnosed according to RA revised criteria, were selected and entered the study. They underwent six intra-articular injections of 750 mcg of SST14 at 15-day intervals. The thickness of the synovial membrane (SM) was measured with a 5-MHz linear sound with longitudinal and transversal scanning carried out on the upper patellar cavity.

[Intra-articular treatment with somatostatin 14 in rheumatoid arthritis].

19 patients with RA underwent six intraarticular injections of 750 micrograms of Somatostatin 14 in one knee at 15-day intervals. In all patients some clinical parameters were evaluated: articular function, pain on pressure, spontaneous pain, pain on movement, duration of morning stiffness. Also some laboratory parameters were examined: complete blood cell count, ESR and CRP.

Efficacy and tolerability of etodolac in the treatment of osteoarthritis.

An open clinical trial was carried out in 57 patients with osteoarthritis of the knee, hip or spine to assess the effectiveness and tolerability of etodolac. Patients received 200 mg etodolac twice daily for a period of 2 weeks. The results of clinical and patient assessments made at baseline and at the end of the study period showed that there was significant improvement in pain at rest and on active and passive movement, local tenderness, pain on climbing stairs, joint swelling and functional status.

Diffuse idiopathic skeletal hyperostosis (DISH) and situs viscerum inversus. Report of a single case.

An uncommon case of diffuse idiopathic skeletal hyperostosis (DISH) is described in a patient with situs viscerum inversus. The radiographic features typical of DISH are present only on the left side of the thoracic spine. This finding confirms the role of the descending thoracic aorta in preventing the location of DISH on the left side.

[Vertebral hyperostosis and hyperostosis frontalis interna].

Routine roentgenographic examination of the spine was performed in 690 patients with rheumatologic disorders. Ankylosing hyperostosis was discovered in 124 patients (18 percent). Roentgenograms of the skull revealed hyperostosis frontalis interna in 63 percent of cases, especially in female patients.