A clinical prediction rule for lymphoma development in primary Sjögren's syndrome.

Objective: To develop and validate a practical prediction rule for the progression from primary Sjögren's syndrome (pSS) to B cell non-Hodgkin's lymphoma (B cell NHL) based on the combination of routinely available clinical and serological disease variables.

Methods: The case records of 563 patients with pSS were reviewed, and their demographic, clinical, and immunologic features were collected. Multivariate logistic regression analysis was performed to identify independent risk factors for lymphoma development and to create a propensity score for discrimination between patients at risk of B cell NHL and those patients not at risk.

Adverse events during longterm low-dose glucocorticoid treatment of polymyalgia rheumatica: a retrospective study.

Objective: To assess the occurrence of adverse events in a cohort of patients with polymyalgia rheumatica (PMR), treated with low-dose glucocorticoids (GC).

Methods: This was a retrospective study by review of medical records.

Results: We identified 222 patients who had a mean duration of followup of 60 ± 22 months and a mean duration of GC therapy of 46 ± 22 months.

Classification criteria for Sjogren's syndrome: a critical review.

Over the years, several different criteria sets have been proposed for the classification of Sjögren's syndrome (SS), but none of them has been widely adopted by the scientific community until the publication of the 1993 Preliminary European Classification criteria. These Classification criteria have been largely employed both in clinical practice and in observational and interventional studies for many years. In 2002 the Preliminary European Criteria were re-examined by a joint American and European Committee.

Coupled plasma filtration adsorption for the treatment of a patient with acute respiratory distress syndrome and acute kidney injury: a case report.

Coupled plasma filtration adsorption (CPFA) is an extracorporeal blood purification therapy based on non-specific pro- and anti-inflammatory mediator adsorption on a special resin cartridge coupled with continuous veno-venous haemofiltration or continuous veno-venous haemodiafiltration and is one of the emerging treatments for septic patients. However, in the literature, there are limited data about its efficacy in treating patients with acute diseases but without the traditional criteria for sepsis. We describe the case of a 43-year-old male who developed acute respiratory distress syndrome secondary to pneumonia and acute kidney injury, whose clinical conditions rapidly improved after early CPFA therapy.

"To be or not to be," ten years after: evidence for mixed connective tissue disease as a distinct entity.

Objectives: To determine if mixed connective tissue disease (MCTD) can be considered an independent clinical entity, to compare 3 different classification criteria for MCTD (Kasukawa, Alarcón-Segovia, and Sharp), and to define predictors (clinical features and autoantibodies) of potential evolution toward other connective tissue diseases (CTDs).

Methods: One hundred sixty-one MCTD patients were evaluated retrospectively at the diagnosis and in 2008. They were classified, at the diagnosis, according to the 3 classification criteria of MCTD (Sharp, Alarcón-Segovia, and Kasukawa) and reclassified in 2008 according to their evolution.

The radiographic fate of the syndesmosis after trans-syndesmotic screw removal in displaced ankle fractures.

The purpose of this study was to evaluate the radiographic changes of the tibiofibular position and the ankle mortise after removal of trans-syndesmotic fixation to determine if there is loss or maintenance of correction. In addition, the effect of the type of rotational injury, early weight bearing, and the number of trans-syndesmotic screws used on the integrity of the inferior tibiofibular articulation or ankle mortise after screw removal were evaluated. An analysis was conducted of 86 patients, with an unstable rotational ankle fracture requiring open reduction with syndesmosis screw stabilization.

[Adherence to cervical cancer screening in an Italian SLE cohort].

Objective: Papanicolau (Pap) smear abnormalities are more frequently observed in systemic lupus erythematosus (SLE) respect to the general population. The primary objective of the present study was to evaluate the adherence to cervical cancer (CC) screening in an Italian cohort of SLE patients and, secondly, to evaluate the disease-related factors possibly influencing the patients' behavior.

Methods: Consecutive 25 to 64 year old SLE patients and aged- matched healthy women were enrolled for the study.

Development of quality indicators to evaluate the monitoring of SLE patients in routine clinical practice.

The assessment of systemic lupus erythematosus (SLE) patients in routine clinical practice is mainly based on the experience of the treating physician. This carries the risk of unwanted variability. Variability may have an impact on the quality of care offered to SLE patients, thereby affecting outcomes.

Undifferentiated connective tissue diseases (UCTD): simplified systemic autoimmune diseases.

Conditions characterized by the presence of clinical and serological manifestations suggestive of systemic autoimmune diseases but not fulfilling the classification criteria for defined connective tissue disease (CTD) are common in clinical practice and are indicated as undifferentiated (U) CTDs. Although epidemiological data are not available in the literature, up to 50% of the patients with an undifferentiated CTD of less than one year of duration were reported. The majority of patients suffering from UCTDs are young females, do not evolve into full blown CTD and are stable over time displaying mild clinical manifestations and single autoantibody profile.

Incident comorbidity among patients with rheumatoid arthritis treated or not with low-dose glucocorticoids: a retrospective study.

Objective: To assess the prevalence of comorbidity in a cohort of patients with rheumatoid arthritis (RA), treated or not with low-dose glucocorticoids (GC) and who have been followed for at least 10 years.

Methods: This was a retrospective study by review of medical records.

Results: We identified 365 patients: 297 (81.

Clinical manifestations and treatment of Churg-Strauss syndrome.

Churg-Strauss syndrome (CSS) is a systemic necrotizing vasculitis affecting small to medium-sized vessels, and characterized by asthma, blood hypereosinophilia, and eosinophil-rich granulomatous inflammation of the respiratory tract. In the past few years the pathogenesis of the disease and its clinical manifestations have been clarified, fostering important advances in the treatment of CSS. Systemic corticosteroids are still considered the cornerstone of treatment.

European League Against Rheumatism recommendations for monitoring patients with systemic lupus erythematosus in clinical practice and in observational studies.

Objectives: To develop recommendations for monitoring patients with systemic lupus erythematosus (SLE) in clinical practice and observational studies and to develop a standardised core set of variables to monitor SLE.

Methods: We followed the European League Against Rheumatism (EULAR) standardised procedures for guideline development. The following techniques were applied: nominal groups, Delphi surveys for prioritisation, small group discussion, systematic literature review and two Delphi rounds to obtain agreement.

Diagnosis and referral of rheumatoid arthritis by primary care physician: results of a pilot study on the city of Pisa, Italy.

The aims of the present study were to evaluate, in the city of Pisa: (1) the prevalence of rheumatoid arthritis; (2) the reliability of the prevalence estimated by primary care physicians, using the rheumatologist's diagnosis as the "gold standard" and (3) the economic impact of the disease. The Tuscany registry of primary care physicians constituted the framework from which a sample of subjects was selected. The rheumatoid arthritis (RA) subjects >18 years followed by each primary care physician constituted the population studied.

[Churg-Strauss syndrome: outcome and long-term follow-up of 38 patients from a single Italian centre].

Objective: This study was aimed at verifying any potential correlation between anti-myeloperoxidase antineutrophil cytoplasmic antibodies (ANCA-MPO) and clinical features and outcome indices in Churg-Strauss Syndrome (CSS).

Methods: Thirty-eight Churg-Strauss syndrome patients were selected from the medical records of all vasculitis patients attending the Rheumatology and Immunology Unit at the Department of Internal Medicine of the University of Pisa in the decades between 1989 and 2008. Data were analysed retrospectively.

Minimally invasive arthroscopic-assisted reduction with percutaneous fixation in the management of intra-articular calcaneal fractures: a review of 24 cases.

Unlabelled: A retrospective analysis of 24 cases of minimally invasive, open reduction, and internal fixation of intra-articular calcaneal fractures is presented. Collected data included articular step-off, medial wall displacement, and Boehler's angle, in addition to other descriptive characteristics of the fracture and case series. The operative technique is described in detail including the optimal screw constructs.

Occurrence of organ-specific and systemic autoimmune diseases among the first- and second-degree relatives of Caucasian patients with connective tissue diseases: report of data obtained through direct patient interviews.

Studies have demonstrated a familial aggregation of systemic and organ-specific autoimmune diseases. The aim of the present survey was to obtain, by patient interviews, a preliminary estimate of the prevalence of systemic and organ-specific autoimmune diseases among the first- and second-degree relatives of Caucasian patients with connective tissue diseases (CTD) or inflammatory arthritis followed at our unit. Between June 2007 and January 2008, 626 patients and 85 controls (patients with osteoarthritis, osteoporosis, or fibromyalgia) were interviewed.

[Analysis of the evolution to defined connective tissue diseases of patients with "early unidifferentiated connective tissue diseases (UCTD)"].

The term undifferentiated connective tissue diseases (UCTD) is used to identify systemic autoimmune diseases not fulfilling classificative criteria for defined connective tissue diseases (CTD). Aim of the present study was to evaluate the evolution to defined CTD of an historical cohort of 91 UCTD patients followed at our Unit and to describe clinical and serological characteristics of stable UCTD patients with a disease duration of more than 5 years. Patients, previously described, were selected for having an undifferentiated profile after 1 year of follow up.

Fracture dislocations of the tarsometatarsal joints: Analysis of interrater reliability in using the modified Hardcastle classification system.

Fracture dislocations/subluxations of the tarsometatarsal joint are complex injuries that are often misdiagnosed. Prompt recognition and treatment of Lisfranc injuries decrease the likelihood of long-term sequelae. The original (1909) classification system was modified in 1982 and again in 1986.

Awareness, treatment and control of hyperlipidaemia, hypertension and diabetes mellitus in a selected population of southern Italy.

The purpose of the present study was to assess the degree of awareness, treatment and control of hyperlipidaemia compared with hypertension and diabetes mellitus in a selected population of southern Italy. All participants to a cardiovascular disease prevention campaign examined between April 1994 and July 1995 were screened for hyperlipidaemia, hypertension and diabetes mellitus. Subjects received also ECG, echo-Doppler of carotid arteries and filled in a questionnaire concerning personal and familial cardiovascular diseases, smoking habit and drug consumption.

[Relationship between lipid profile and blood viscosity in a sample of Calabrian population].

Plasma viscosity is increased in subjects with risk factors for ischemic heart disease whereas the role of blood viscosity is controversial. Aim of the present study is to evaluate the relationship between blood lipids and blood viscosity. One hundred seventy eight male subjects have been enrolled, aged 35-70 years, participating in an atherosclerosis prevention campaign held in Catanzaro between September 1994 and April 1995.

[Serum pancreatic enzymes in the diagnosis of carcinoma of the pancreas].

Serum levels of amylase, pancreatic isoamylase, lipase, trypsinogen, and elastase 1 were determined in 41 patients with pancreatic carcinoma and compared with those 71 patients with chronic pancreatitis and 17 patients with digestive non-pancreatic carcinoma, in an attempt to evaluate their relative values in the diagnosis of pancreatic cancer. Trypsinogen and elastase 1 levels were the most frequently abnormal (56%), followed by pancreatic isoamylase (39%), lipase (34%), and amylase (27%). In 4 patients with resectable cancer levels of all serum enzymes were within normal limits, with the single exception of a low trypsinogen level in one patient.