Extra-articular manifestations in 587 Italian patients with rheumatoid arthritis.

The aim of the study was to evaluate the frequency of extra-articular manifestations (EAMs) of rheumatoid arthritis (RA) in a series of patients from nine Italian rheumatology clinics. A total of 587 patients underwent direct questioning, complete physical evaluation, and review of medical records and laboratory data. The relationships between EAMs and the eosinophilic count, IgM rheumatoid factor (RF), and antinuclear antibodies (ANA) were studied.

Isolated sternoclavicular joint arthritis in heroin addicts and/or HIV positive patients: three cases.

The authors describe three patients in whom septic arthritis of the sternoclavicular joint (SCJ) occurred, drug addiction and human immunodeficiency virus (HIV) infection representing the predisposing conditions. Infectious arthritis is well known in intravenous drug users, but it is rare in HIV positive patients, who are prone to bacterial infections from usual or unusual microorganisms. In one case, staphylococcus aureus methicillin sensitive was responsible for septic arthritis.

Incidence of Yersinia enterocolitica antibodies in patients with inflammatory joint diseases.

Agglutinating antibodies against Yersinia enterocolitica serotypes 0:3, 0:8 and, to a minor extent, 0:6 were found in 18 out of 93 patients with inflammatory joint diseases. Patients with undifferentiated arthritis showed the highest prevalence of antibodies against Yersinia enterocolitica. The possibility that serotypes other than 0:3 may be involved in triggering arthritis is discussed.

Anti-enterobacteria antibodies in psoriatic arthritis.

The occurrence of certain antibacterial antibodies was studied in the sera of 22 healthy donors (HD) and 66 patients with different diseases. The cases investigated included 22 rheumatoid arthritis (RA), 22 non-arthritic-psoriasis (NAP), and 22 psoriatic arthritis (PA) patients. A complement fixation test was used with Yersinia enterocolitica 0:3 type (YEC), Yersinia pseudotuberculosis (YPT), Campylobacter jejuni (CJ), and Campylobacter fetus (CF) antigens; the detection of anti-Chlamydia trachomatis (CT) antibodies was carried out using an immunoperoxidase colorimetric slide test that allowed the detection of isotypes of specific antibodies.

Prevention of NSAID-induced ulcers by the coadministration of misoprostol: implications in clinical practice.

The guiding principle of ulcer therapy for many years has been "No acid, no ulcer" and many still adhere to it. Nonsteroidal anti-inflammatory drugs (NSAIDs) appear to cause ulcers primarily through prostaglandin depletion rather than through an acid-based mechanism. These ulcers affect a large number of patients and give few warning signs, often none, until it is too late.

Iliolumbar ligament ossification as a radiologic feature of reactive arthritis.

We describe the case of a 21-year-old woman with the clinical picture of HLA-B27+ reactive arthritis (ReA) in whom the ossification of the left iliolumbar ligament was detected. Our case proves that ligament calcifications, which have so far been ascribed to diffuse idiopathic skeletal hyperostosis may also occur in young patients with ReA not primarily affected by metabolic osteoarticular diseases with negative family history.

Multicentre double-blind study of the efficacy, safety and tolerance of pirazolac compared with sulindac in patients with rheumatoid arthritis.

Of the 160 patients (80 pirazolac/80 sulindac) who entered the study through 14 investigators, three-quarters completed a 12-weeks therapy and three-fifths completed the entire 24-weeks therapy. In the pirazolac group 15% of the patients and in the sulindac group 11% dropped out from the study due to adverse clinical experience. The drop-out rates due to unsatisfactory therapeutic response were respectively 15% and 16% in the pirazolac and the sulindac groups.

Antibacterial antibody pattern in seronegative spondyloarthropathies (SNSA).

The occurrence of some anti-bacterial antibodies was studied in sera from 31 healthy donors (HD) and 101 patients with different rheumatic diseases. The cases investigated included 7 Psoriatic Arthritis (PA), 35 Rheumatoid Arthritis (RA), 17 Undifferentiated Seronegative Spondyloarthritis (U-SNSA), 13 Behçet's syndrome, 18 Enteric Arthropathies (EA), 7 Ankylosing Spondylitis (AS) and 4 Reiter's syndrome. A complement fixation test was carried out to detect the presence and to evaluate the titer of the specific antibodies against the relative bacterial antigens.

[Immunoenzymatic test for the study of anti-cardiolipin antibodies. Evaluation of a commercial kit].

ELISA is a sensitive method extensively used to detect anticardiolipin antibodies, but up to now there is no standardization of the assay to make a reliable comparison in the results obtained from various laboratories. For that it appears more useful to use a commercial kit for detecting these antibodies. The authors have carried out a comparison between this commercial kit and an ELISA prepared in laboratory in order to evaluate its usefulness.

Present status and new perspectives in non-steroidal anti-inflammatory drugs therapy.

The mere mechanism of inhibition of synthesis of prostaglandins (PGs) is unable to account for the whole anti-inflammatory activity of non-steroidal anti-inflammatory drugs (NSAIDs). In fact most of them have been found to inhibit, to a varying degree from drug to drug, some polymorphonuclear (PMN) functions, namely their aggregation, superoxide anion generation, lysosomal enzyme release and, in addition the production of leukotriene B4, which induces an intense inflammatory response. The observation that some patients with chronic inflammatory arthropathies on treatment with NSAIDs undergo an impressive clinical remission together with the reduction of inflammation indices in plasma is sustained by many in vitro and in vivo experiences, where different NSAIDs have been found able to influence the behaviour of the immune system cells and of the para-immune one (PMNs and macrophages).

The acute phase protein profile in inflammatory arthropathies.

A quantitative evaluation of the changes of the levels of acute phase reactants (APRs) during inflammatory phenomena is a useful tool both in monitoring the course of some inflammatory diseases and the efficacy of the anti-inflammatory therapy. Nonetheless, the information collected through the various indices appears unable to provide either an overall digital evaluation of the phenomenon or an easy correlation with the clinical state findings. In fact, APRs appear to have different sensitivities in detecting an inflammatory state: some proteins rise immediately to high or very high levels when an inflammatory process flares up and their plasma concentrations are strictly related to the inflammation activity, whilst some others have longer latency times and less sensitivity to small variations in the inflammatory condition.

[Evaluation of the efficacy of orgotein in a series of patients with hydrarthrosis of the knee].

A study was carried out to verify the efficacy of intra-articular orgotein in patients with different forms of hydrarthrosis of the knee. The results confirm the value of orgotein for the local treatment of osteoarthritic joint swellings. However in the presence of marked exudative synovitis processes (chronic primary polyarthritis), the use of orgotein is of limited value.

Monoclonal antibody investigation in rheumatoid arthritis: presence of a T cell subpopulation bearing a double marker.

Using a double marking technique of peripheral blood lymphocyte (PBL) from 23 patients suffering from rheumatoid arthritis (RA) and 12 normal healthy subjects (NHS), the authors were able to demonstrate that there was no alteration in the OKT8 + ve population of RA patients, when compared with NHS. On the contrary, an increased percentage of the subpopulation of lymphocytes OKT4 + ve was detected. Finally, the presence of a subpopulation of T cells carrying both the receptors for monoclonal antibodies OKT4 and OKT8 has been detected.

Flurbiprofen in rheumatoid arthritis therapy.

Preliminary findings are reported from an open study of 300 mg flurbiprofen daily in 24 patients and from 6 out of 30 patients treated so far in a double-blind crossover comparison of 300 mg flurbiprofen daily and 150 mg indomethacin daily in the treatment of rheumatoid arthritis. The results indicate that flurbiprofen is effective in relieving symptoms and is better tolerated than indomethacin. Using an experimental model in rats to assess the anti-inflammatory activity of flurbiprofen, data suggest that flurbiprofen is unable to prevent an immunological type of inflammation but is capable of modifying the type and extent of cellular infiltration.