138 results on '"E. Bruschi"'
Search Results
52. [Blood acetoacetate, 3-hydroxybutyrate, lactate, pyruvate and alpha-ketoglutarate behavior in chronic uremia during a single hemodialysis]
- Author
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G F, Guarnieri, L, Faccini, E, Bruschi, and L, Campanacci
- Subjects
Adult ,Male ,Renal Dialysis ,Chronic Disease ,Lactates ,Humans ,Hydroxybutyrates ,Ketoglutaric Acids ,Female ,Middle Aged ,Pyruvates ,Acetoacetates ,Uremia - Published
- 1969
53. [Designing and testing an electronic monitor for hemodialysis]
- Author
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E, Bruschi and A, Muolo
- Subjects
Renal Dialysis ,Electronics, Medical ,Monitoring, Physiologic - Published
- 1971
54. [Recent progress in the technic of periodic hemodialysis]
- Author
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P, Confortini, G, Galanti, G, Ancona, E, Bruschi, C, Dalla Rosa, and D, Corà
- Subjects
Kidney Diseases ,Kidneys, Artificial - Published
- 1965
55. [Changes in the content of water, electrolytes, glycogen and protein and nonprotein nitrogen in the skeletal muscle of uremic patients in intermittent hemodialytic treatment]
- Author
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G, Maschio, G, Mioni, G, Bazzato, E, Bruschi, G F, Guarnieri, B, Blasina, and E, Bertaglia
- Subjects
Adult ,Male ,Electrolytes ,Adolescent ,Nitrogen ,Renal Dialysis ,Muscles ,Potassium ,Humans ,Water ,Female ,Glycogen ,Uremia - Published
- 1968
56. [Anesthesia problems in bilateral nephrectomy]
- Author
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U, Melella, M, Zambello, E, Bruschi, and A, Giongo
- Subjects
Adult ,Polycystic Kidney Diseases ,Sodium ,Succinylcholine ,Anesthesia, General ,Nephrectomy ,Kidney Neoplasms ,Hypertension, Malignant ,Chlorides ,Renal Dialysis ,Preoperative Care ,Potassium ,Humans ,Calcium ,Kidney Diseases ,Preanesthetic Medication ,Anesthetics - Published
- 1970
57. [Our experience in the treatment of postoperative acute renal failure]
- Author
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E, Bruschi, A, Muolo, G, Gianfranceschi, and E, Galvani
- Subjects
Arteriovenous Shunt, Surgical ,Postoperative Complications ,Renal Dialysis ,Humans ,Mannitol ,Acute Kidney Injury ,Prognosis ,Diuresis ,Uremia - Published
- 1970
58. [Anesthesia in patients treated by repeated hemodialysis]
- Author
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U, Melella, M, Zambello, G, Ancona, and E, Bruschi
- Subjects
Sodium ,Anemia ,Phosphorus ,Acute Kidney Injury ,Anesthesia, General ,Metabolic Diseases ,Renal Dialysis ,Humans ,Kidney Failure, Chronic ,Anesthesia ,Calcium ,Anesthesia, Inhalation ,Erythropoietin ,Anesthesia, Local ,Anesthetics ,Uremia - Published
- 1970
59. [Reflections on the electrocardiogram in periodic treatment with the artificial kidney]
- Author
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C, Dal Palù, C, Dalla Rosa, A, Bonadonna, G, Ancona, and E, Bruschi
- Subjects
Adult ,Male ,Electrocardiography ,Humans ,Kidney Diseases ,Kidneys, Artificial - Published
- 1967
60. [Hemodynamic changes in the reinfusion phase at the end of dialysis. Evaluation of some parameters]
- Author
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G, Galanti, A, Pasqualicchio, G, Gianfranceschi, C, Pasoli, E, Bruschi, and A, Franzoni
- Subjects
Male ,Renal Dialysis ,Chronic Disease ,Hemodynamics ,Humans ,Heart ,Kidney Diseases ,Uremia - Published
- 1967
61. [On infections of the external arteriovenous shunt for hemodialysis]
- Author
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A, Muolo, E, Bruschi, E, Galvani, and G, Ancona
- Subjects
Arteriovenous Shunt, Surgical ,Postoperative Complications ,Renal Dialysis ,Humans ,Pseudomonas Infections ,Acute Kidney Injury ,Staphylococcal Infections ,Anti-Bacterial Agents - Published
- 1969
62. Subject Index, Vol. 6, 1986
- Author
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R.-D. Hesch, Hermann Haller, Luigi Minetti, P. Madeddu, Andreas Hvarfner, Helmut Geiger, Leif Wide, Michael A. Kirschenbaum, Grazia Covi, Filippo Quarto di Palo, Marco Boscaro, Louis V. Avioli, Barbara Lucani, M.J. Atkinson, N. Glorioso, Lorenzo Malatino, Enrico Valvo, F.M. Pala, Carmelo Erio Fiore, Michael Thiede, Emilio Nardi, Vito M. Campese, Enrico Arosio, Peter Weidmann, Sverker Ljunghall, A. Elli, Giorgio Bazzato, Roberto Pedrinelli, Silvana Favaro, Luigi Corea, R. Ziegler, Franco Mantero, Agostino Fracasso, Carlo Gennari, Maurizio Giuseppe Abrignani, M.A. Spanu, Mihaela Lüdersdorf, Antonio Dal Canton, Armando Magagna, Giacomo Bruschi, Salvatore Cantaro, Alessandro Lechi, A. Rappelli, Hans Vetter, D. Scherling, Rosangela Genchi, Armin Distler, Lenz T, Maurizio Bentivoglio, D. D'Agostino, Bernward Garthoff, Uwe Heckmann, Paolo Verdecchia, Patrizia Veniero, Adele Nardecchia, Anna Filomena Perrone, K.-H. Graefe, R. Foti, Michele Stornello, Giacomo Tamburino, Flavio Scanferla, Gerhard Schmid, Werner Schmidt, August Heidland, Giulio Romano, Aurelio Rapado, Anshumali Chaudhari, Giuseppe Maschio, David A. McCarron, Alberto Vianello, E. Benazzi, G. Greco, Pablo Cosci, Luigi Scapellato, Salvatore Novo, Gerard A. Charbon, Ketty Savino, S. Rubattu, Thomas Philipp, Wolfgang Haecker, Udo Bahner, Mario Passeri, Heinz Losse, A.D. Perris, Antonio Salvetti, C. Mörlin, Paolo Bonino, S. Rocco, Antonia Fabris, Roberto Polignano, Maria E. Bruschi, Giovanni Bonadonna, Shaul G. Massry, Heinrich Ohnmeiss, Vittorio E. Andreucci, Hugo Kesteloot, Rosario Modica, E. Niutta, Giuseppe Bianchi, Ugo Coli, G. Herrmann, Gaetano Crepaldi, Maresa Altomonte, Paola Corradini, Anna Pirrelli, Concetta Fargetta, Alberico Borghetti, Ernesto Carafoli, Paolo Morachiello, Marco Nazzari, Maurizio Surian, Miklos Palkovits, Domenico Galati, Giuseppe Donia, Clara Lechi, B. Corradi, Giovanni Pavese, Massimo Sabbatini, Antonio Pinto, Silvano Landini, Kunitoshi Iseki, Palummeri E, Vittorio Nicita-Mauro, Ciro Esposito, J. Sommer, Peter Baumgart, Flavio Righetto, Arturo Borsatti, Fabio Malberti, Gianfranco Cervellin, P. Dessi-Fulgheri, F. Fallo, Stanislav Kazda, Claudio Bianchini, Giuseppe Vezzoli, Cynthia D. Morris, Giacomo Colussi, Marina Del Turco, Renato Nami, Angelo Cavatorta, Lorenzo A. Calò, Claudio Marone, Riccardo Pieri, Francesco Uccello, Georg Luckhaus, Angela D'Angelo, Walter Zidek, Giuseppe Opocher, Antonio Strano, and K.-D. Rämsch
- Subjects
Gerontology ,Index (economics) ,Nephrology ,business.industry ,Medicine ,Subject (documents) ,business - Published
- 1986
- Full Text
- View/download PDF
63. Zinner's Syndrome: Case report of a Developmental Anomaly of the Mesonephric Duct.
- Author
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Cleva M, Montaldo L, Graziani G, Bruschi E, and Valentino M
- Subjects
- Male, Humans, Middle Aged, Dysuria, Seminal Vesicles diagnostic imaging, Seminal Vesicles abnormalities, Wolffian Ducts diagnostic imaging, Wolffian Ducts abnormalities, Syndrome, Kidney diagnostic imaging, Kidney abnormalities, Genital Diseases, Male
- Abstract
Zinner's syndrome is a rare congenital malformation characterized by the association of unilateral renal agenesis with ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. Most patients are asymptomatic until the third or fourth decade of life when the syndrome is associated with dysuria, perineal pain, infertility, and painful ejaculation. In this report, we present the common imaging findings of this rare developmental anomaly involving the mesonephric duct in a 48-year-old male patient experiencing pelvic pain, recurrent dysuria, and pollakiuria., (Copyright Journal of Radiology Case Reports.)
- Published
- 2023
- Full Text
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64. Experimental Characterization, Modeling, and Numerical Evaluation of a Novel Friction Damper for the Seismic Upgrade of Existing Buildings.
- Author
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Bruschi E, Zoccolini L, Cattaneo S, and Quaglini V
- Abstract
The paper presents the experimental characterization, the formulation of a numerical model, and the evaluation, by means of non-linear analyses, of a new friction damper conceived for the seismic upgrade of existing building frames. The damper dissipates seismic energy through the friction force triggered between a steel shaft and a lead core prestressed within a rigid steel chamber. The friction force is adjusted by controlling the prestress of the core, allowing the achievement of high forces with small dimensions, and reducing the architectural invasiveness of the device. The damper has no mechanical parts subjected to cyclic strain above their yield limit, thereby avoiding any risk of low-cycle fatigue. The constitutive behavior of the damper was assessed experimentally, demonstrating a rectangular hysteresis loop with an equivalent damping ratio of more than 55%, a stable behavior over repeated cycles, and a low dependency of the axial force on the rate of displacement. A numerical model of the damper was formulated in the OpenSees software by means of a rheological model comprising an in-parallel system of a non-linear spring element and a Maxwell element, and the model was calibrated on the experimental data. To assess the viability of the damper for the seismic rehabilitation of buildings, a numerical investigation was conducted by performing non-linear dynamic analyses on two case-study structures. The results highlight the benefits of the PS-LED in dissipating the largest part of seismic energy, limiting the lateral deformation of the frames, and controlling the increase in structural accelerations and internal forces at the same time.
- Published
- 2023
- Full Text
- View/download PDF
65. BENIGN FOVEAL DEPIGMENTATION: A MULTIMODAL IMAGING INVESTIGATION.
- Author
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Parodi MB, Arrigo A, Bruschi E, Manitto MP, Martina E, and Bandello F
- Subjects
- Humans, Fluorescein Angiography methods, Electroretinography, Multimodal Imaging, Vision Disorders, Tomography, Optical Coherence methods, Retinal Pigment Epithelium
- Abstract
Purpose: To describe the multimodal imaging characteristics of benign foveal depigmentation., Methods: The study was designed as prospective observational case series. Patients with benign foveal depigmentation were prospectively investigated by means of multimodal imaging, including blue-light and near-infrared fundus autofluorescence, optical coherence tomography (OCT), OCT angiography, color testing, microperimetry, and electrophysiology. The main outcome measures were vessel density and retinal pigment epithelium (RPE)/photoreceptor complex OCT reflectivity., Results: Overall, 4 patients were identified, with bilateral and unilateral involvement in 1 case and 3 cases, respectively. Fundus autofluorescence provided variable results, showing more impairment on near-infrared fundus autofluorescence. Structural OCT revealed slight attenuation of the outer retinal bands in the area affected by benign foveal depigmentation, associated with choroidal hypertransmission, whereas enface OCT better delineated the attenuation of the reflectivity signal. The mean reflectivity intensity of RPE/photoreceptor complex was statistically significantly reduced in patients with respect to control subjects in the benign foveal depigmentation area. Optical coherence tomography angiography, color testing, microperimetry, electrooculogram, and electroretinogram findings were normal., Conclusion: Benign foveal depigmentation may represent a focal RPE disease. The limited alterations within the RPE band, as visualized on enface OCT and confirmed on near-infrared fundus autofluorescence, suggest an impairment in melanin production or distribution within the RPE cells.
- Published
- 2023
- Full Text
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66. Volumetric Evaluations of Full-Arch Implant Supported Restorations and Their Role on Patients' Quality of Life: A Mixed-Model Analysis.
- Author
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Bruschi E, De Angelis P, Papetti L, Rella E, Gasparini G, D'addona A, and Manicone PF
- Subjects
- Dental Implantation, Endosseous, Dental Restoration Failure, Follow-Up Studies, Humans, Middle Aged, Prostheses and Implants, Quality of Life, Retrospective Studies, Treatment Outcome, Alveolar Bone Loss diagnostic imaging, Dental Implants, Immediate Dental Implant Loading methods, Mouth, Edentulous surgery
- Abstract
Introduction: Full-arch, implant-supported hybrid restorations, employing tilted implants, can offer an efficient way of treating edentulous patients. Several factors, such as the timing of implant placement and the inclination of the fixture, can have a detrimental effect on their stability. This retrospective study is aimed at discerning the role played by those factors., Materials and Methods: Patients treated with full-arch, implant supported restorations were selected for this study; cone-beam computed tomography (CBCT) images, taken 3 months and 3 years after delivery of the final restoration, as well as peri-implant values, were obtained and compared; bone loss was measured on four sites for each implant and then averaged. These patients were recalled, and the OHIP-5 questionnaire was administered., Results: 21 patients, with a mean age of 53 years, were included in the present analysis. 108 implants were placed, and 25 Toronto prostheses were delivered. According to a mixed-model analysis, tilted implants (0.51, p < 0.001) had a higher rate of bone loss, while implants placed in a healed ridge suffered less bone loss than immediate implants (-0.21, p < 0.001). Patient-level variables have a significant effect on this variable, as implants coming from the same subject share a similar risk of bone loss. The mean response to the self-administered OHIP-5 questionnaire was 1.53 ± 0.29; other variables did not have a statistically significant effect on this outcome. Discussion/Conclusions . The results of the present study show that Toronto bridges prostheses are an efficient procedure for treating edentulous patients, as their oral-related quality of life is reported as satisfactory even 7 years after delivery of the restoration. Tilted and immediate implants are more at risk of bone loss. Implants coming from the same subject share a similar risk of bone loss., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2022 Ernesto Bruschi et al.)
- Published
- 2022
- Full Text
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67. Flapless Localised Management of Sinus Floor (LMSF) for trans-crestal sinus floor augmentation and simultaneous implant placement. A retrospective non-randomized study: 5-year of follow-up.
- Author
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Bruschi GB, Bruschi E, and Papetti L
- Abstract
Background: Trans-crestal sinus lift procedures are well established., Purpose: to retrospectively analyse the efficacy of a flapless trans-crestal maxillary sinus floor elevation and simultaneous dental implant placement based on the Localised Management of Sinus Floor (LMSF) technique suitable for cases with sufficient width of keratinized tissue and of crestal bone but insufficient vertical dimensions of the bone below the sinus., Materials and Methods: 71 sinus elevations with simultaneous implant placement were performed on 52 consecutive patients. Following an initial pilot bur transmucosal perforation, the Magnetic Mallet was used with progressively larger osteotomes. The mallet osteotomes are initially directed palatally, towards the cortex of the medial wall of the sinus, below the palato-nasal recess (PNR) and then redirected in a more vertical direction to create the final osteotomy for implant placement., Results: No significant complications were reported in the post-operative phase. The cumulative success rate during the observation period was 95%. All successful implants were successfully loaded with metal-ceramic or monolithic zirconia crowns and bridges and remained in function during the observation period., Conclusions: Flapless Localised Management of Sinus Floor (LMSF) is a safe and effective surgical technique with minimal risks and with the advantage of low morbidity. Also, only native bone is used for augmentation and there is no need for additional grafting., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. Published by Elsevier Ltd.)
- Published
- 2021
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68. Bilateral detachment of the neurosensory retina in an apparently asymptomatic woman.
- Author
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Brambati M, Borrelli E, Trevisani F, Bruschi E, Bandello F, and Querques G
- Subjects
- Female, Humans, Middle Aged, Retina, Retinal Detachment diagnosis, Retinal Detachment etiology
- Abstract
Systemic hypertension is related to a variety of retinal manifestations. Reported herein is a case of malignant hypertension associated with bilateral foveal neurosensory detachment in a middle age woman with stenosis of the left renal artery. The present case outlines the importance of recognizing ocular manifestations as a possible consequence of life-threatening systemic disease., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
- Full Text
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69. Efficacy and safety of baricitinib in 446 patients with rheumatoid arthritis: a real-life multicentre study.
- Author
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Guidelli GM, Viapiana O, Luciano N, De Santis M, Boffini N, Quartuccio L, Birra D, Conticini E, Chimenti MS, Bazzani C, Bruschi E, Riva M, Canziani LM, Bianchi G, Pozzi MR, Limonta M, Gorla R, Perricone R, Frediani B, Moscato P, De Vita S, Dagna L, Rossini M, and Selmi C
- Subjects
- Drug Therapy, Combination, Humans, Methotrexate adverse effects, Purines, Pyrazoles, Sulfonamides adverse effects, Treatment Outcome, Antirheumatic Agents adverse effects, Arthritis, Rheumatoid diagnosis, Arthritis, Rheumatoid drug therapy, Azetidines adverse effects
- Abstract
Objectives: Baricitinib, an oral Janus kinase (JAK) 1-2 inhibitor, is currently used along biologic DMARDs (bDMARDs) after the failure of methotrexate (MTX) in rheumatoid arthritis (RA). We investigated the efficacy and safety of baricitinib in real life., Methods: We prospectively enrolled 446 RA patients treated with baricitinib from 11 Italian centres. Patients were evaluated at baseline and after 3, 6, and 12 months. They were arrayed based on previous treatments as bDMARD-naïve and bDMARD-insufficient responders (IR) after the failure or intolerance to bDMARDs. A sub-analysis differentiated the effects of methotrexate (MTX) and the use of oral glucocorticoids (OGC)., Results: Our cohort included 150 (34%) bDMARD-naïve and 296 (66%) bDMARD-IR patients, with 217 (49%) using baricitinib as monotherapy. Considering DAS-28-CRP as the primary outcome, at 3 and 6 months, 114/314 (36%) and 149/289 (51.6%) patients achieved remission, while those in low disease activity (LDA) were 62/314 (20%) and 46/289 (15.9%), respectively; finally at 12 months 81/126 (64%) were in remission and 21/126 (17%) in LDA. At all-timepoints up to 12 months, bDMARDs-naïve patients demonstrated a better clinical response, independently of MTX. A significant reduction in the OGC dose was observed at 3 and 12 months in all groups. The serum positivity for both rheumatoid factors (RF) and anti-citrullinated protein antibodies (ACPA) conferred a lower risk of stopping baricitinib due to inefficacy. Fifty-eight (13%) patients discontinued baricitinib due to adverse events, including thrombotic events and herpes zoster reactivation., Conclusions: Real-life data confirm the efficacy and safety profiles of baricitinib in patients with RA and provide evidence that drug survival is higher in bDMARDs-naïve and seropositive patients.
- Published
- 2021
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70. Widefield OCT angiography and ultra-widefield multimodal imaging of Susac syndrome.
- Author
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Giuffrè C, Miserocchi E, Marchese A, Cicinelli MV, Bruschi E, Querques G, Bandello FM, and Modorati GM
- Subjects
- Adult, Female, Fundus Oculi, Humans, Magnetic Resonance Imaging, Multimodal Imaging, Scotoma diagnosis, Visual Field Tests, Visual Fields, Fluorescein Angiography, Ischemia diagnosis, Retinal Artery Occlusion diagnosis, Susac Syndrome diagnosis, Tomography, Optical Coherence
- Abstract
The aim is to present the changes in ultra-widefield and widefield multimodal imaging, including optical coherence tomography angiography of a 33-year-old woman diagnosed with Susac syndrome, over 1 year of follow-up. Fundus examination and multimodal imaging revealed bilateral arterial occlusion of multiple vascular branches with retinal ischemia. Over 1 year follow-up, best-corrected visual acuity improved while retinal ischemia gradually resolved. Widefield optical coherence tomography angiography showed reperfusion of macular large vessels, but not of the small capillaries. Despite anatomical improvement, functional defects of the visual field persisted. In conclusion, widefield and ultra-widefield imaging provided high-resolution details of the central and peripheral damages in Susac syndrome.
- Published
- 2020
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71. Comparison of Marginal Bone Loss Around Axial and Tilted Implants: A Retrospective CBCT Analysis of Up to 24 Months.
- Author
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Bruschi E, Manicone PF, De Angelis P, Papetti L, Pastorino R, and D'Addona A
- Subjects
- Dental Implantation, Endosseous, Dental Prosthesis Design, Dental Prosthesis, Implant-Supported, Follow-Up Studies, Humans, Maxilla, Retrospective Studies, Treatment Outcome, Alveolar Bone Loss, Dental Implants, Spiral Cone-Beam Computed Tomography
- Abstract
This clinical study retrospectively analyzed cone beam computed tomography (CBCT) images to determine the potential influence of implant inclination on peri-implant marginal bone loss after 18 to 24 months of functional loading. Twenty-five consecutive patients presenting with an edentulous or partially edentulous maxilla or mandible and an adequate bone volume for receiving oral implants were selected for analysis of the marginal bone loss around tilted and/or axial implants. The study population included patients rehabilitated with Toronto bridges (TBs), fixed partial dentures (FPDs), or single crowns (SCs) on axial and/or tilted implants. The primary outcome was the CBCT analysis of peri-implant marginal bone level change, depending on inclination of implants and type of prostheses. The secondary outcome was analysis of survival and success rates of tilted and axial implants. A significant difference was observed for peri-implant buccal bone loss (mean of axials 0.42 ± 0.06; mean of tilted 0.70 ± 0.09) (P = .009). The difference in peri-implant lingual/palatal/mesial/distal bone loss was not significant between axial and tilted implants (P > .05). No significant difference was observed between the marginal bone level and the type of prostheses for both tilted and axial implants in all the assessed sites (P > .05). The success rate for both tilted and axial implants was 100%, and no complications were observed for all the prosthetic rehabilitations, with a 100% survival rate. Compared to axial implants, tilted implants showed a significant statistical difference for peri-implant buccal bone loss, but no other differences were observed for peri-implant bone loss or for implant survival and success rate. Fixed partial or total rehabilitation using tilted or axial implants, or with tilted and axial implants, could be a reliable technique with advantages to patients and operators.
- Published
- 2019
- Full Text
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72. Ultrasound characterization of insulin induced lipohypertrophy in type 1 diabetes mellitus.
- Author
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Bertuzzi F, Meneghini E, Bruschi E, Luzi L, Nichelatti M, and Epis O
- Subjects
- Adolescent, Adult, Aged, Biomarkers analysis, Blood Glucose analysis, Diabetes Mellitus, Type 1 drug therapy, Female, Follow-Up Studies, Glycated Hemoglobin analysis, Humans, Injections, Subcutaneous, Lipodystrophy chemically induced, Lipodystrophy diagnostic imaging, Male, Middle Aged, Pilot Projects, Prognosis, Retrospective Studies, Young Adult, Diabetes Mellitus, Type 1 complications, Hypoglycemic Agents adverse effects, Insulin adverse effects, Lipodystrophy diagnosis
- Abstract
Objective: Subcutaneous insulin absorption is one of the key factors affecting glycemic control in patients with diabetes mellitus under insulin therapy. Insulin-induced subcutaneous lipohypertrophy has been reported to impair insulin regular absorption and hence glycemic control. So far, lipohypertrophy diagnosis has only been clinical. This study aims at evaluating the possible role of ultrasound scan in the assessment of subcutaneous lipohypertrophy in patients affected by type 1 diabetes mellitus., Methods: A pilot observational retrospective study was performed in 20 patients affected by type 1 diabetes mellitus. In these patients the areas with clinical evidence of lipohypertrophy dependent on the insulin injections were characterized by the presence of tissues that at the ultrasound scan resulted similar to fibrotic tissues (hyperechogenic) or to an interstitial edema or to fat tissues (hypoechogenic). It was utilized a multi frequency linear probe (6-18 MHz). The patients were advised to avoid insulin injections on the areas with lipohypertrophy scanned by the ultrasound and the HbA1c changes were evaluated 3 months later., Results: The lipohypertrophic areas presented at least three different aspects upon ultrasound assessment: the iso-hyperechogenic one, with a predominant fibrotic component; the isoechogenic one, with "large tangles" fibrotic elements and the iso-hypoechogenic aspect with no fibrotic elements. When patients were advised to avoid insulin injections on areas with lipohypertrophy defined by ultrasound scan, 3 months after the first evaluation HbA1c had significantly improved (basal HbA1c 7.87 ± 0.56 versus 7.67 ± 0.52 3 months later, p = 0.029). No significant improvements of the HbA1c were found in the control matched group in which lipohypertrophy was only clinically valued through inspection and palpation., Conclusions: Ultrasound scan can help identify and characterize the lipohypertrophic areas and this might be useful to improve glycemic control.
- Published
- 2017
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73. Feasibility, acceptability and construct validity of EQ-5D in systemic sclerosis.
- Author
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Gualtierotti R, Ingegnoli F, Scalone L, Cortesi P, Bruschi E, Gerosa M, and Meroni PL
- Subjects
- Diagnostic Self Evaluation, Feasibility Studies, Female, Humans, Male, Psychometrics, Reproducibility of Results, Surveys and Questionnaires, Disability Evaluation, Patient Acceptance of Health Care statistics & numerical data, Quality of Life, Scleroderma, Systemic psychology, Severity of Illness Index
- Abstract
Background: Systemic sclerosis is a chronic disabling disease that is often associated with severe physical and psychological impairment. Nonetheless, health-related quality of life (HRQoL) in patients with systemic sclerosis is often left behind in clinical practice and research. One of the reasons for this lack of evaluation is the current use of tools, such as the short form-36 (SF-36) questionnaire, that are complete but complicated to use in everyday routine. Other self-reported outcome measures such as the health assessment questionnaire (HAQ) are simple, but specifically designed for physical disability., Study Aims and Methods: Our aim was to evaluate the feasibility, acceptability and construct validity of EQ-5D, a simple and quick self-assessment tool, and to compare its performance with SF-36 and HAQ. We investigated 119 consecutive patients with systemic sclerosis (94% female; age: median 63 years, interquartile range 53-70 years) at three different rheumatology centres. Acceptability was evaluated from comments made by the patients and feasibility on the basis of the number of patients needing assistance or not answering questions (missing data). Construct validity was based on both convergent and divergent validity between conceptually similar and dissimilar domains, respectively, of the compared instruments., Results: EQ-5D was well accepted by patients. The percentage of patients missing data in at least one EQ-5D domain was 2.5%. Spearman's correlation coefficients between similar dimensions of EQ-5D vs SF-36 and vs HAQ were moderate (≥0.30) to strong (≥0.50); in contrast, correlation coefficients between less comparable dimensions were weak. As expected, the EQ-5D anxiety/depression domain did not correlate with any of the HAQ domains. The EQ-5D visual analogue scale (VAS) concordance with SF-36 general health domain and HAQ total score was strong (≥0.50 for both). Median value for the EQ-5D index (interquartile range) was 0.81 (0.75-0.86). The EQ-5D index had correlation coefficients >0.40 with all SF-36 domains and with all HAQ domains, HAQ total and HAQ VAS., Conclusions: Our data demonstrate good acceptability, feasibility and construct validity of EQ-5D in patients with systemic sclerosis. We suggest the use of EQ-5D in systemic sclerosis patients as an HRQoL measure in clinical practice, in randomised clinical trials and/or in pharmacoeconomic evaluations.
- Published
- 2016
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74. Pixel or Paper? Validation of a Mobile Technology for Collecting Patient-Reported Outcomes in Rheumatoid Arthritis.
- Author
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Epis OM, Casu C, Belloli L, Schito E, Filippini D, Muscarà M, Gentile MG, Perez Cagnone PC, Venerelli C, Sonnati M, Schiavetti I, and Bruschi E
- Abstract
Background: In the management of chronic disease, new models for telemonitoring of patients combined with the choice of electronic patient-reported outcomes (ePRO) are being encouraged, with a clear improvement of both patients' and parents' quality of life. An Italian study demonstrated that ePRO were welcome in patients with rheumatoid arthritis (RA), with excellent matching data., Objective: The aim of this study is to evaluate the level of agreement between electronic and paper-and-pencil questionnaire responses., Methods: This is an observational prospective study. Patients were randomly assigned to first complete the questionnaire by paper and pencil and then by tablet or in the opposite order. The questionnaire consisted of 3 independent self-assessment visual rating scales (Visual Analog Scale, Global Health score, Patient Global Assessment of Disease Activity) commonly used in different adult patients, including those with rheumatic diseases., Results: A total of 185 consecutive RA patients were admitted to hospital and were enrolled and completed the questionnaire both on paper and on electronic versions. For all the evaluated items, the intrarater degree of agreement between 2 approaches was found to be excellent (intraclass correlation coefficient>0.75, P<.001)., Conclusions: An electronic questionnaire is uploaded in a dedicated Web-based tool that could implement a telemonitoring system aimed at improving the follow-up of RA patients. High intrarater reliability between paper and electronic methods of data collection encourage the use of a new digital app with consequent benefit for the overall health care system., Competing Interests: Conflicts of Interest: None declared., (©Oscar Massimiliano Epis, Cinzia Casu, Laura Belloli, Emanuela Schito, Davide Filippini, Marina Muscarà, Maria Giovanna Gentile, Paula Carina Perez Cagnone, Chiara Venerelli, Massimo Sonnati, Irene Schiavetti, Eleonora Bruschi. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 16.11.2016.)
- Published
- 2016
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75. Use of ultrasound in treatment decisions for patients with rheumatoid arthritis: an observational study in Italy.
- Author
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Epis O, Scioscia C, Locaputo A, Cappelli A, Maier A, Rocchetta PA, Tomietto P, Perin A, Rigon C, Santo L, Casilli O, Lapadula G, and Bruschi E
- Subjects
- Adult, Aged, Aged, 80 and over, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Arthritis, Rheumatoid drug therapy, Comorbidity, Female, Hand diagnostic imaging, Humans, Italy, Logistic Models, Male, Middle Aged, Prospective Studies, Severity of Illness Index, Steroids therapeutic use, Wrist Joint diagnostic imaging, Young Adult, Arthritis, Rheumatoid diagnostic imaging, Decision Making, Ultrasonography, Doppler
- Abstract
In rheumatoid arthritis (RA), treatment response is generally assessed using standard clinical disease activity measures. However, ultrasound has become increasingly popular among rheumatologists to monitor disease activity and response. The purpose of this analysis of ECOgraphic evaluation for STaging ARthritis (ECOSTAR) study data was to determine how ultrasound affects clinicians' decisions about changing treatment in RA. ECOSTAR was an observational, cohort study conducted between March 2010 and December 2012 at nine clinical centers in Italy in RA patients being considered for treatment change. After clinical evaluation of each patient, patients underwent diagnostic ultrasound (US) investigations and each patient was given a total echography score using a combination of scores for joint effusion, synovial hypertrophy, and power Doppler. The US results were provided to the clinicians and the influence of US on the clinicians' treatment choices were recorded. Ninety-five patients screened for study inclusion had confirmed RA (mean age 53.9 years; mean disease duration 8.9 years). Therapy changes were made by clinicians according to the hand and wrist joint US scores: score 0 appeared to have no influence on clinicians' decision to modify treatment, scores >0-3 were associated with a numerically higher estimated probability of not changing therapy than changing therapy, and scores >3 had a greater influence on the clinician to modify therapy and an increased probability of the clinician changing therapy versus not changing therapy. Ultrasonography scores appear to influence treatment decisions in patients with RA, with clinicians appearing less likely to alter treatment regimens in patients with low ultrasound scores and more likely to change treatment regimens when higher scores are obtained. Further research is warranted.
- Published
- 2016
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76. Safety of Abatacept in Rheumatoid Arthritis With Serologic Evidence of Past or Present Hepatitis B Virus Infection.
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Padovan M, Filippini M, Tincani A, Lanciano E, Bruschi E, Epis O, Garau P, Mathieu A, Celletti E, Giani L, Tomietto P, Atzeni F, Sarzi Puttini P, Zuliani F, De Vita S, Trotta F, Grilli A, Puoti M, and Govoni M
- Subjects
- Adult, Aged, Aged, 80 and over, Arthritis, Rheumatoid complications, Female, Humans, Male, Middle Aged, Retrospective Studies, Virus Activation drug effects, Abatacept therapeutic use, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid drug therapy, Hepatitis B complications
- Abstract
Objective: Rheumatoid arthritis (RA) with concomitant hepatitis B virus (HBV) infection represents a therapeutic challenge due to the risk of HBV reactivation under immunosuppressive treatment. To date there are few data coming from anecdotal case reports that concern HBV reactivation following treatment with abatacept. This observational retrospective study was aimed to assess the safety profile of abatacept in this particular clinical setting., Methods: Eleven Italian rheumatologic centers provided data from patients with RA and positive HBV serology treated with intravenous abatacept. HBV markers and clinical and laboratory data were checked at followup visits every 3 months., Results: In total, 72 patients were included in the study: 47 inactive carriers, 21 occult carriers, and 4 chronic active carriers for HBV. At baseline all of the patients had normal liver function tests and low or undetectable HBV DNA levels, except for those with chronic active hepatitis. Thirteen patients received prophylaxis with lamivudine, and 4 received treatment with adefovir or tenofovir. At the end of the 24-month followup period, 49 patients were being treated. Data from 316 followup visits showed that abatacept was safe. No patients experienced reactivation of hepatitis B. Treatment withdrawals (23 patients) were due to lack of efficacy, subject decision/lost at followup, or adverse events not related to HBV infection., Conclusion: Our study provides reassuring data about the safety profile of abatacept in RA with concomitant HBV infection without universal antiviral prophylaxis. Further prospective studies are needed to confirm these preliminary results., (© 2016, American College of Rheumatology.)
- Published
- 2016
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77. Adherence to current recommendations on the use of methotrexate in rheumatoid arthritis in Italy: results from the MARI study.
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Manara M, Bianchi G, Bruschi E, Azzolini V, Belai Beyene N, Corbanese S, De Gennaro F, Martin-Martin LS, Molica Colella AB, Pozzi MR, Romeo N, Rossini T, Severino A, and Sinigaglia L
- Subjects
- Adult, Aged, Antirheumatic Agents therapeutic use, Cross-Sectional Studies, Female, Humans, Italy epidemiology, Male, Medication Therapy Management statistics & numerical data, Middle Aged, Practice Guidelines as Topic, Practice Patterns, Physicians' statistics & numerical data, Retrospective Studies, Time-to-Treatment, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid epidemiology, Guideline Adherence statistics & numerical data, Methotrexate therapeutic use
- Abstract
Objectives: The aim of this study was to assess how the management of rheumatoid arthritis (RA) with methotrexate (MTX) in Italy is adherent to current national recommendations., Methods: We performed a cross-sectional and retrospective analysis of data collected from the MARI study, a multicentre survey on Italian patients with RA on treatment with MTX for at least 12 months. Retrospective data included patient's clinical history, previous treatment with MTX, screening tests performed before MTX prescription. Cross-sectional data were collected about current treatment with MTX, concomitant medications, and disease activity. Each proposition of the 2013 Italian recommendations on the use of MTX in RA was reformulated in terms of audit criteria, and adherence to provided indications was evaluated for every patient., Results: Among the 1336 included patients, less than 40% had started treatment with MTX within 3-6 months from the diagnosis and nearly 30% of them were prescribed with an initial dose of MTX between 12.5 and 15 mg/week. Screening for HBV and HCV infection as well as chest x-ray was performed in a proportion of patients around 60% and more than 90% of them underwent lab tests before MTX prescription and regularly throughout the treatment. Folic acid supplementation was given at recommended dosages in a high proportion of patients., Conclusions: Our survey showed a good adherence of Italian rheumatologists to recommendations regarding safety issues with MTX in RA, but a suboptimal approach in terms of time and dosage of the treatment in the early phases of the disease.
- Published
- 2016
78. Reduced dose of tocilizumab for the maintenance of remission in patients with rheumatoid arthritis: a clinical experience.
- Author
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Epis O, Casu C, Belloli L, Schito E, Filippini D, Muscarà M, and Bruschi E
- Subjects
- Antibodies, Monoclonal, Humanized therapeutic use, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid diagnosis, Humans, Remission Induction, Severity of Illness Index, Treatment Outcome, Antibodies, Monoclonal, Humanized administration & dosage, Antirheumatic Agents administration & dosage, Arthritis, Rheumatoid drug therapy
- Published
- 2015
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79. Efficacy and safety of rituximab with and without methotrexate in the treatment of rheumatoid arthritis patients: results from the GISEA register.
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Sebastiani M, Anelli MG, Atzeni F, Bazzani C, Farina I, Fedele AL, Favalli EG, Fineschi I, Cino N, Dal Forno I, Gasparini S, Cassarà E, Giardina R, Bruschi E, Addimanda O, Cassone G, Lopriore S, Sarzi-Puttini P, Filippini M, Pignatti F, Gremese E, Biggioggero M, Manganelli S, Amato G, Caimmi C, Salaffi F, Iannone F, Ferri C, Sandri G, Lapadula G, Gorla R, Govoni M, Ferraccioli G, Marchesoni A, Galeazzi M, Foti R, Carletto A, Cantini F, Triolo G, Epis OM, and Salvarani C
- Subjects
- Adult, Aged, Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal, Murine-Derived adverse effects, Drug Therapy, Combination, Female, Humans, Male, Methotrexate adverse effects, Middle Aged, Rituximab, Treatment Outcome, Antibodies, Monoclonal, Murine-Derived therapeutic use, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid drug therapy, Methotrexate therapeutic use, Registries
- Abstract
Introduction: Rituximab (RTX) is a monoclonal anti-CD20 antibody approved for the treatment of rheumatoid arthritis (RA) in association with methotrexate (MTX)., Objectives: To evaluate the efficacy and safety of RTX-MTX combination therapy compared with RTX alone in the treatment of RA., Methods: We analyzed data from a prospective cohort study, the Italian biologic register GISEA, to investigate the efficacy and safety of rituximab. Moreover, the adverse events (AE) and the causes of discontinuation therapy were analyzed., Results: We identified 338 RA patients, 162 treated with RTX and 176 with RTX-MTX. After 52 and 104 weeks of therapy the disease activity score in 28 joints and the Health Assessment Questionnaire Score were available in 168 patients (78 with RTX-MTX and 60 with RTX alone), showing significant reduction without differences among the two groups. AE were reported in 142 patients (42%), for a total of 368 recorded side effects. The majority (90.5%) of AE were mild to moderate in severity. Comparable percentages of severe AE were reported in the 2 groups (9.9% for RTX alone and 9.3% for RTX+MTX). A poor disease control was observed in 14.2% and 13.5% of patients treated with RTX+MTX and RTX, respectively; while 12 patients (4.5% in RTX+MTX, and 2.5% in RTX group) suspended therapy for AE., Conclusions: RTX showed a good efficacy and safety profile in the real-life management of RA patients regardless of the association with MTX., (Copyright © 2014 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.)
- Published
- 2014
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80. Clinical and ultrasound evaluation of the response to tocilizumab treatment in patients with rheumatoid arthritis: a case series.
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Epis O, Filippucci E, Delle Sedie A, De Matthaeis A, and Bruschi E
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- Arthritis, Rheumatoid blood, Biomarkers blood, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Severity of Illness Index, Time Factors, Treatment Outcome, Antibodies, Monoclonal, Humanized therapeutic use, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid diagnostic imaging, Arthritis, Rheumatoid drug therapy, Joints diagnostic imaging, Joints drug effects, Ultrasonography, Doppler
- Abstract
This case series evaluates the clinical and ultrasound response to tocilizumab treatment in patients with rheumatoid arthritis (RA). Six patients with active RA (DAS28 ≥ 3.2) for ≥6 months, refractory to conventional DMARDs or anti-TNF agents, received tocilizumab 8 mg/kg every 4 weeks, as monotherapy or in combination with DMARDs, for 6 months. The following clinical parameters were assessed monthly: number of tender joints (28 and 44 joints), number of swollen joints (28 and 44 joints), DAS28-ESR, DAS28-CRP, VAS score, global health status, health assessment questionnaire, patient global assessment of disease activity, physician global assessment of disease activity, functional assessment of chronic illness therapy (FACIT), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). All patients also underwent a gray-scale ultrasonography (US) assessment with power Doppler evaluation at each visit. All clinical parameters improved during the study, versus baseline. This improvement was statistically significant for most parameters 2 months following tocilizumab initiation and was sustained to the end of the observation period. The number of tender joints (44-joint evaluation), the FACIT score, and ESR and CRP concentrations were significantly improved versus baseline values after the first month of tocilizumab treatment. The course of US evaluations mirrored that of clinical parameters; a faster and more evident response was observed for foot joints, with respect to hand joints. This case series suggested the rapid clinical benefit of tocilizumab. Ultrasound assessment showed that the onset of this effect was faster in the foot joints than in the hand joints.
- Published
- 2014
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81. Radiographic evaluation of crestal bone levels of delayed implants at medium-term follow-up.
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Bruschi GB, Crespi R, Capparè P, Grande N, Bruschi E, and Gherlone E
- Subjects
- Adult, Aged, Alveolar Bone Loss physiopathology, Dental Implants adverse effects, Female, Follow-Up Studies, Humans, Jaw, Edentulous, Partially diagnostic imaging, Jaw, Edentulous, Partially physiopathology, Male, Middle Aged, Radiography, Retrospective Studies, Surgical Flaps, Time Factors, Alveolar Bone Loss diagnostic imaging, Bone Regeneration, Dental Implantation, Endosseous, Jaw, Edentulous, Partially surgery
- Abstract
Purpose: The aim of this study was to evaluate the radiographic bone level changes after delayed implant placement at medium-term follow-up, with three elements kept constant: keratinized gingiva thickness, implant axes perpendicular to the opposing occlusal surface, and implants with a collar of 2 mm., Materials and Methods: Patients treated in a private practice setting were retrospectively enrolled in the study. They underwent delayed placement (4 to 8 weeks after extraction) of dental implants in edentulous premolar or molar regions. Implants followed a delayed loading protocol. Crestal bone levels were measured at baseline; at provisional prosthesis placement; at 1, 3, and 5 years; and at medium-term follow-up of healing from implant placement., Results: One hundred twenty patients received 135 implants (one or two implants per patient); 3 implants were lost. After a mean follow-up period of 9.71 ± 4.88 years, a survival rate of 97.76% was reported. At 1 year after implant placement, mean bone loss of -1.5 ± 0.62 mm was found. At almost 3 years post-implant placement, a mean bone gain of +1.20 ± 0.49 mm was seen, which was statistically significantly different compared with 1 year. After this point, the bone levels remained stable; similar values were reported over time, with no significant differences., Conclusions: The mean vertical bone gain of +1.20 ± 0.49 mm seen at almost 3 years after implant placement in this study may be supported by both clinical parameters as presence of sufficiently thick keratinized gingiva (3 mm), implants with a 2-mm collar, and the axis of implant insertion perpendicular to the opposing occlusal surface.
- Published
- 2014
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82. High rate of disease remission in moderate rheumatoid arthritis on etanercept therapy: data from GISEA, the Italian biologics register.
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Iannone F, Gremese E, Gallo G, Sarzi-Puttini P, Botsios C, Trotta F, Gasperini S, Galeazzi M, Adami S, Cantini F, Sebastiani M, Gorla R, Marchesoni A, Giardina A, Foti R, Mele A, Bruschi E, Bagnato G, Erre GL, and Lapadula G
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Drug Therapy, Combination, Etanercept, Female, Glucocorticoids administration & dosage, Humans, Italy, Male, Methotrexate administration & dosage, Middle Aged, Prospective Studies, Registries, Severity of Illness Index, Surveys and Questionnaires, Treatment Outcome, Tumor Necrosis Factor-alpha antagonists & inhibitors, Young Adult, Antirheumatic Agents administration & dosage, Arthritis, Rheumatoid drug therapy, Biological Products administration & dosage, Immunoglobulin G administration & dosage, Receptors, Tumor Necrosis Factor administration & dosage, Remission Induction
- Abstract
The aim of this study was to evaluate the clinical outcomes of etanercept in rheumatoid arthritis (RA) patients with moderate or severe disease activity. We analyzed data from the Italian biologics register Gruppo Italiano Studio Early Arthritides (GISEA) to investigate the rate of disease remission and functional improvement, based on the 28-Joint Disease Activity Score (DAS28) and the (Health Assessment Questionnaire (HAQ) score in RA patients with moderate or severe disease activity beginning etanercept therapy. Disease was defined as severe (H-RA) with DAS28 ≥5.1 and moderate (M-RA) with DAS28 ≥3.2 to 5.1 at baseline. Patients were considered in remission if DAS28 was ≤2.6, and HAQ ≤0.5 defined normal function. We enrolled 953 RA patients, 320 with M-RA and 633 H-RA. Age and disease duration were similar in the two cohorts, but H-RA patients had significantly more comorbidities (p < 0.01) and took significantly more disease-modifying antirheumatic drugs (p < 0.001) than M-RA patients. After 1 year, the percentage of patients achieving disease remission and normal function (DAS28 ≤2.6 plus HAQ ≤0.5) was higher in M-RA (21.4 %) than in H-RA patients (14.8 %, p = 0.007), regardless of the disease duration. Additionally, female gender (p = 0.006) and H-RA class (p = 0.002) negatively predicted disease remission at 1 year. However, the drug survival rate did not differ between the two subsets. This study confirms that etanercept was effective in the treatment of active RA, but best response, in terms of disease remission and normal function ability, was greater and easier to attain in M-RA patients. These findings may aid clinicians to choose the best strategy to treat RA.
- Published
- 2014
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83. Interventional ultrasound: a critical overview on ultrasound-guided injections and biopsies.
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Epis O and Bruschi E
- Subjects
- Humans, Injections, Intra-Articular, Joints diagnostic imaging, Joints pathology, Predictive Value of Tests, Rheumatic Diseases diagnostic imaging, Rheumatic Diseases pathology, Treatment Outcome, Antirheumatic Agents administration & dosage, Image-Guided Biopsy methods, Joints drug effects, Rheumatic Diseases diagnosis, Rheumatic Diseases drug therapy, Rheumatology methods, Ultrasonography, Interventional
- Abstract
Over the last decades ultrasound-guided procedures have become increasingly diffused in rheumatology, mainly thanks to the technical advances achieved in the ultrasound (US) field, combined with the greater availability, good portability and reduced cost of US devices, compared to other imaging techniques already used in rheumatology units. The direct visualisation of the tissue under analysis and the real-time imaging performance enabled by US-guidance account for an improved accuracy and directness in needle placement in a number of rheumatology interventions such as tendon and intra-articular injections. Compared with blind procedures, US-guided injections are more accurate and safe and they result in better clinical outcome in terms of joints improvement in function and decreased risk of damages caused by needle misplacement. The accuracy in needle placement of US-guided injections has proven to be important not only in common intra-articular injections, but especially in case of complex anatomical areas like the hip, facet and atlanto-occipital joints, where blinded injections are deemed poorly accurate and thus highly risky. Moreover US guidance can be successfully employed in more complex procedures such as synovial biopsy, portal establishment or arthroscopy, where US can also be combined with other imaging techniques. Overall the employment of US-guided procedures is considered to be safe and well-tolerated, and increases the accuracy and therapeutic effectiveness of the interventions performed. This may pave the way for a more widespread employment of US-guidance in rheumatology units, and new studies could further explore the therapeutic advantages of these procedures.
- Published
- 2014
84. Response to letter to the editor by Rui Baptista, M.D., Rogério Teixeira, M.D.
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Gargani L, Agoston G, Pignone AM, Moreo A, Badano LP, Bazzichi L, Costantino MF, Pieri F, Epis O, Bruschi E, De Chiara B, Mori F, Bombardieri S, Cerinic MM, Bossone E, and Picano E
- Subjects
- Female, Humans, Male, Echocardiography, Doppler methods, Exercise physiology, Exercise Test adverse effects, Hypertension, Pulmonary etiology, Pulmonary Wedge Pressure, Scleroderma, Systemic complications
- Published
- 2013
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85. Imaging in rheumatology: ultrasafe + ultrasure = ultrasound.
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Epis O, Giacomelli L, and Bruschi E
- Subjects
- Bibliometrics, Humans, Image Interpretation, Computer-Assisted, Image-Guided Biopsy, Imaging, Three-Dimensional, Injections, Predictive Value of Tests, Rheumatic Diseases diagnostic imaging, Rheumatic Diseases therapy, Rheumatology methods, Ultrasonography, Doppler, Ultrasonography, Interventional
- Abstract
Technological advances in ultrasonography (US) in recent years has allowed for improvements to the imaging quality of gray-scale ultrasound and the development of more advanced forms of this imaging technique such as 3D and Doppler US. These improvements mean that US now has an accepted place in rheumatology not only in diagnosis, but also in the determination of disease progression and pathology and in facilitating guidance of interventional therapies. The increasing use of US-guided intervention by rheumatologists in the last 20 years is evidenced by the almost exponential increase in the number of publications in the relevant subjects.
- Published
- 2013
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86. Improving diagnosis of early inflammatory arthritis : results of a novel triage system.
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Bruschi E, Casu C, Filippini D, Pisoni L, Schito E, Zahalkova L, Muscarà M, Gentile MG, Livio V, Marceglia S, Giacomelli L, and Epis O
- Subjects
- Adult, Aged, Ambulatory Care methods, Early Diagnosis, Female, Humans, Male, Middle Aged, Telephone, Arthritis diagnosis, Arthritis immunology, Health Care Surveys, Mass Screening methods, Surveys and Questionnaires, Triage methods
- Abstract
Objectives: Early treatment of inflammatory arthritis (IA) leads to reduced disease activity, reduced joint damage, decreased functional impairment and increased chance of remission. However, delay often occurs from referral to rheumatology appointment. This survey evaluated whether a preliminary triage carried out by healthcare workers without formal medical training could be effective in identifying patients with or without early IA., Methods: Patients were recruited during their first call to our centre, before their first visit. A simple questionnaire, including three questions and aimed at investigating the presence of sign and symptoms of IA was developed. The same survey was administered twice: the first time, during patient's first call to our centre (telephone survey), and the second time, during their first visit with the rheumatologist (Ambulatory visit survey). We compared the outcomes of the survey with the actual diagnosis made by the rheumatologist following standard medical examination., Results: In total 484 patients were included in the study, and 34/484 (7.02%) were confirmed to have early IA. The telephone survey was able to detect the non-early IA patients in 99.5% of cases; the same result was reported for the ambulatory visit survey. The median time required to complete the questionnaire was 1 minute in both surveys., Conclusions: The adoption of a simple survey, also administered by non-medical personnel, may effectively contribute to the early detection of IA.
- Published
- 2013
87. Use of ultrasound-assisted arthroscopy in rheumatology: an experience in 11 patients with different rheumatic diseases.
- Author
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Paresce E, De Lucia O, Bruschi E, Giacomelli L, and Epis OM
- Subjects
- Adult, Arthroscopy, Female, Humans, Male, Middle Aged, Surgery, Computer-Assisted, Ultrasonography, Rheumatic Diseases diagnostic imaging, Rheumatic Diseases surgery
- Abstract
The 'real time' capability of ultrasound (US) allows dynamic assessment of joint and tendon movements, which can often aid in the detection of structural abnormalities. The simultaneous use of arthroscopy (AS) and US is therefore a logical progression. Here the results of a series of 11 patients with different rheumatic diseases in whom a combined use of US and AS was adopted are reported.
- Published
- 2013
- Full Text
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88. Tight control applied to the biological therapy of rheumatoid arthritis.
- Author
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Epis OM, Giacomelli L, Deidda S, and Bruschi E
- Subjects
- Arthritis, Rheumatoid drug therapy, Biological Therapy, Humans, Practice Guidelines as Topic, Precision Medicine, Antibodies, Monoclonal therapeutic use, Antirheumatic Agents therapeutic use
- Abstract
In the last decade, treatment strategies for rheumatoid arthritis (RA) have included the early use of disease-modifying anti-rheumatic drugs, since prompt suppression of disease activity is associated with a reduction in radiological damage. This strategy has now been incorporated into the broader concept of "tight control", defined as a treatment strategy tailored to each patient with RA, which aims to achieve a predefined level of low disease activity or remission within a certain period of time. To pursue this goal, tight control should include careful and continuous monitoring of disease activity, and early therapeutic adjustments or switches should be considered as necessary. It is noteworthy that the key role of tight control of RA has been stressed by the recent EULAR Guidelines. This review discusses the most recent evidence concerning the role of a tight control strategy in the treatment of RA, and on how this strategy should be pursued., (Copyright © 2012 Elsevier B.V. All rights reserved.)
- Published
- 2013
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89. Localized management of sinus floor technique for implant placement in fresh molar sockets.
- Author
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Bruschi GB, Crespi R, Capparè P, Bravi F, Bruschi E, and Gherlone E
- Subjects
- Adult, Aged, Alveolar Bone Loss diagnostic imaging, Alveolar Bone Loss surgery, Alveolar Process diagnostic imaging, Dental Implantation, Endosseous instrumentation, Dental Implants, Dental Prosthesis Design, Dental Prosthesis, Implant-Supported, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Maxillary Sinus diagnostic imaging, Maxillary Sinus surgery, Middle Aged, Minimally Invasive Surgical Procedures methods, Osteotomy instrumentation, Radiography, Bitewing methods, Surgical Flaps surgery, Survival Analysis, Tooth Extraction, Tooth Socket diagnostic imaging, Dental Implantation, Endosseous methods, Molar, Sinus Floor Augmentation methods, Tooth Socket surgery
- Abstract
Background: The use of osteotome for vertical bone augmentation and localized sinus elevation with minimal surgical trauma represents a suitable procedure to increase the vertical dimension of available bone for implant placement., Purpose: The aim of this study was to report clinical and radiographic results of localized management of sinus floor (LMSF) in fresh molar sockets at 13-year follow-up., Materials and Methods: Fifty-three patients, needing one or two maxillary molar extraction, were enrolled in this study. LMFS procedure was performed and 68 implants were positioned. A presurgical distance from the alveolar crest to the floor of the maxillary sinus and the amount of new radiopacity between the sinus floor and alveolar crest were measured from the mesial and distal surfaces of each dental implant surface., Results: After a mean follow-up period of 9.76 ± 5.27 years (ranged from 4 to 17 years) a survival rate of 100% was reported. Mean bone height at temporary prosthesis placement was 7.99 ± 1.16 mm. They were stable over time, reporting a mean value of 8.01 ± 1.46 mm at 13-year follow-up., Conclusions: The results of this study demonstrated that LMSF procedure in fresh molar sockets allowed to expand the dimensions of resorbed posterior maxillary alveolar bone both vertically and horizontally with a success rate of 100% of implant osseointegration over time., (© 2011 Wiley Periodicals, Inc.)
- Published
- 2013
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90. Clinical and echocardiographic correlations of exercise-induced pulmonary hypertension in systemic sclerosis: a multicenter study.
- Author
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Gargani L, Pignone A, Agoston G, Moreo A, Capati E, Badano LP, Doveri M, Bazzichi L, Costantino MF, Pavellini A, Pieri F, Musca F, Muraru D, Epis O, Bruschi E, De Chiara B, Perfetto F, Mori F, Parodi O, Sicari R, Bombardieri S, Varga A, Cerinic MM, Bossone E, and Picano E
- Subjects
- Female, Follow-Up Studies, Humans, Hypertension, Pulmonary diagnostic imaging, Hypertension, Pulmonary physiopathology, Male, Middle Aged, Retrospective Studies, Scleroderma, Systemic physiopathology, Vascular Resistance, Echocardiography, Doppler methods, Exercise physiology, Exercise Test adverse effects, Hypertension, Pulmonary etiology, Pulmonary Wedge Pressure, Scleroderma, Systemic complications
- Abstract
Background: Patients with systemic sclerosis (SSc) are at risk for developing pulmonary hypertension, which is associated with a poor prognosis. Exercise Doppler echocardiography enables the identification of exercise-induced increase in pulmonary artery systolic pressure (PASP) and may provide a thorough noninvasive hemodynamic evaluation., Aim: The aim of this study was to evaluate the clinical and echocardiographic determinants of exercise-induced increase in PASP in a large population of patients with SSc., Methods: We selected 164 patients with SSc (age 58 ± 13 years, 91% female) with normal resting PASP (<40 mm Hg) who underwent a comprehensive 2-dimensional and Doppler echocardiography and graded bicycle semisupine exercise Doppler echocardiography. Pulmonary artery systolic pressure, cardiac output, and pulmonary vascular resistance (PVR) were estimated noninvasively. Cutoff values of PASP ≥50 mm Hg and PVR ≥3.0 Wood Units at peak exercise were considered a significant exercise-induced increase in PASP and PVR, respectively., Results: Sixty-nine (42%) patients showed a significant exercise-induced increase in PASP. Among them, peak PVR ≥3 Wood Units was present only in 11% of patients, about 5% of the total population. Univariate analysis showed that age, presence of interstitial lung disease, and both right and left diastolic dysfunction are predictors of peak PASP ≥50 mm Hg, but none of these parameters predict elevated peak PVR., Conclusions: Exercise-induced increase in PASP occurs in almost one-half of patients with SSc with normal resting PASP. Peak exercise PASP is affected by age, interstitial lung disease, and right and left ventricular diastolic dysfunction and, only in 5% of the patients, is associated with an increase in PVR during exercise, suggesting heterogeneity of the mechanisms underlying exercise-induced pulmonary hypertension in SSc., (Copyright © 2013 Mosby, Inc. All rights reserved.)
- Published
- 2013
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91. Computer touch screen-based technology: a promising tool for the management of rheumatoid arthritis.
- Author
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Epis OM, Canesi B, Bruschi E, and Sonnati M
- Subjects
- Humans, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Computers, Handheld, Rheumatology instrumentation, Software, User-Computer Interface
- Published
- 2011
92. Efficacy of tidal irrigation in Milwaukee shoulder syndrome.
- Author
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Epis O, Caporali R, Scirè CA, Bruschi E, Bonacci E, and Montecucco C
- Subjects
- Calcium Phosphates metabolism, Chondrocalcinosis metabolism, Chondrocalcinosis pathology, Combined Modality Therapy, Crystallization, Drug Therapy, Combination, Humans, Joint Diseases metabolism, Joint Diseases pathology, Methylprednisolone therapeutic use, Syndrome, Therapeutic Irrigation methods, Tranexamic Acid therapeutic use, Treatment Outcome, Ultrasonography, Chondrocalcinosis therapy, Joint Diseases therapy, Shoulder Joint diagnostic imaging
- Abstract
Objective: To assess the efficacy of tidal irrigation in patients with Milwaukee shoulder syndrome (MSS)., Methods: Ten patients with clinical diagnosis of MSS underwent ultrasound examination and tidal irrigation followed by instillation of methylprednisolone and tranexamic acid. A single shoulder was treated in 9 cases; in one patient with bilateral shoulder involvement, both shoulders were treated at different times. Six patients had longlasting disease (Group A) unsuccessfully treated with repeated joint fluid aspirations and intraarticular corticosteroid injections. Four patients had recent-onset illness without radiologic damage but with clinical findings similar to classic MSS (Group B), not previously treated with corticosteroid injections with symptoms dating from 3 months or less. Clinical examination including evaluation of adverse events, range of motion, and pain score by a 100 mm horizontal visual analog scale was scheduled just before tidal irrigation and after 2 and 6 months following the procedure in all cases., Results: Short- and longterm safety was excellent in all patients. Group A patients experienced short-lived improvement so that tidal irrigation had to be repeated within 6 to 10 months. No further therapy was necessary in any of the Group B patients during a mean followup of 16.5 months (range 12-24) due to a persistent clinical improvement without clinically detectable joint effusion., Conclusion: Closed-needle joint irrigation is a minimally invasive procedure, which led to a significant improvement in both pain and active motion in patients with longstanding symptoms. Patients with recent-onset disease recovered completely.
- Published
- 2007
93. Ultrasonographic analysis in vitro of parietal thickness of lower limb varicose veins.
- Author
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Bruschi E, Como G, Zuiani C, Segatto E, Rocco M, Biasi G, and Bazzocchi M
- Subjects
- Adult, Aged, Female, Humans, Hypertrophy, In Vitro Techniques, Male, Middle Aged, Ultrasonography, Veins pathology, Varicose Veins diagnostic imaging, Varicose Veins pathology
- Abstract
Purpose: The aim of this study was to evaluate the ability of ultrasound (US) to measure the parietal thickness of varicose veins., Materials and Methods: In a blind in vitro analysis, 28 great saphenous veins, obtained after stripping surgery from 28 patients with chronic venous insufficiency, were examined with a digital US scanner ATL-HDI5000, linear 5-1 to 2-MHz broadband probe, compound imaging technique and analogic-digital zooming. We obtained one to three progressive measurements for each vein wall (total 67 parietal thicknesses). The samples, fixed in formalin, were sent to the pathology laboratory: sections were obtained at the same level of the sonographic planes, and images were obtained by digital camera mounted on an optical microscope. Measurements obtained at histology were considered as the gold standard. K-statistic was applied to compare sonographic and histologic measurements., Results: Considering only the hypoechoic wall portion, 29/29 (100%) diagnoses of hypotrophy (K=0.91), 19/22 (86%) diagnoses of normotrophy (K=0,47) and 12/16 (75%) diagnoses of hypertrophy (K=0.7) were obtained by sonography., Conclusions: In our preliminary experience, the in vitro study of varicose veins allows precise, at least morphological, detection of hypotrophic walls. If these preliminary data are confirmed in vivo, sonography could be used to discriminate patients eligible for conservative treatment instead of surgery.
- Published
- 2006
- Full Text
- View/download PDF
94. Diagnostic value of procalcitonin measurement in febrile patients with systemic autoimmune diseases.
- Author
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Scirè CA, Cavagna L, Perotti C, Bruschi E, Caporali R, and Montecucco C
- Subjects
- Autoimmune Diseases blood, Autoimmune Diseases complications, Blood Sedimentation, C-Reactive Protein analysis, Calcitonin Gene-Related Peptide, False Positive Reactions, Fever blood, Fever etiology, Humans, Leukocyte Count, Predictive Value of Tests, ROC Curve, Still's Disease, Adult-Onset blood, Still's Disease, Adult-Onset diagnosis, Autoimmune Diseases diagnosis, Calcitonin blood, Fever diagnosis, Glycoproteins blood, Protein Precursors blood
- Abstract
Objective: To determine the usefulness of plasma procalcitonin (PCT) measurement to suspect infectious etiology in febrile patients with systemic autoimmune disease., Methods: PCT, C-Reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) were measured in 44 consecutive inpatients with a diagnosis of systemic autoimmune disease and fever >38 masculine C. After careful microbiologic screening no obvious infection was demonstrated in 24 patients (Group A) while an infectious bacterial complication was diagnosed in 20 cases (Group B)., Results: Median PCT levels were significantly higher in the group B (1.11 vs 0.24 ng/ml; p = 0.0007), whereas the differences for CRP, WBC and ESR did not reach statistical significance. PCT also exhibited a good sensitivity and specificity (75%) in differentiating patients with infection from those with disease flare. With respect to positive and negative predictive values (71.4% and 78.2%), PCT markedly exceeded the other variables. By analyzing PCT values by disease we identified a false positive subgroup of patients suffering from adult onset Still's disease (AOSD), showing markedly elevated PCT levels in absence of infection. By excluding these patients, PCT showed a very good sensitivity and specificity (73.6% and 89.4%) and the area under receiver operating characteristics (ROC) curve rose from 0.801 to 0.904., Conclusion: Our data indicate that elevated PCT concentrations offer good sensitivity and specificity for the diagnosis of systemic bacterial infection in febrile patients with systemic autoimmune diseases. However, in fever associated with AOSD PCT may be elevated even in the absence of infectious complication.
- Published
- 2006
95. [Milwaukee shoulder syndrome (apatite associated destructive arthritis): therapeutic aspects].
- Author
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Epis O, Viola E, Bruschi E, Benazzo F, and Montecucco C
- Abstract
Milwaukee shoulder is a well defined clinical entity that can be observed in particular in older women. It is a destructive arthropathy associated with the deposition of calcium pyrophosphate dihydrate crystals, characterized by the presence of large amount of synovial fluid and a complete tear of the rotator cuff. Clinical features include pain, swelling and progressive functional impairment. The first-line treatment include the use of analgesic drugs and repeated arthrocentesis followed by intra-articular steroid administration; closed-needle tidal irrigation has been reported to be useful. In late phase we can observe narrowing of the acromion-humeral and of the gleno-humeral joint and progressive degenerative changes at the humeral head, leading to almost complete functional impairment. In these cases a surgical approach with total shoulder arthroplasty may be considered.
- Published
- 2005
- Full Text
- View/download PDF
96. Autoantibodies to heterogeneous nuclear ribonucleoproteins.
- Author
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Caporali R, Bugatti S, Bruschi E, Cavagna L, and Montecucco C
- Subjects
- Animals, Antibodies, Antinuclear history, Autoimmune Diseases immunology, Heterogeneous Nuclear Ribonucleoprotein A1, Heterogeneous-Nuclear Ribonucleoprotein Group A-B immunology, Heterogeneous-Nuclear Ribonucleoprotein Group C immunology, Heterogeneous-Nuclear Ribonucleoprotein K immunology, History, 20th Century, Humans, Immunoglobulin Isotypes blood, Rheumatic Diseases immunology, Antibodies, Antinuclear blood, Heterogeneous-Nuclear Ribonucleoproteins immunology
- Abstract
Heterogeneous nuclear ribonucleoproteins (hnRNPs) are among the most abundant proteins in the eukaryotic cell nucleus and play a direct role in several aspects of the RNA life including splicing, export of the mature RNAs and translation. To date, approximately 30 proteins have been identified. A growing body of evidence points to hnRNPs as an important target of the autoimmune response in rheumatic diseases. Autoantibodies to A and B proteins of the hnRNP complex have been detected in late 1980s in rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD). Beyond their role as diagnostic test in clinical practice, these autoantibodies are starting to be regarded as important tools to obtain deeper insight into the pathogenesis of autoimmune rheumatic diseases. Furthermore, new anti-hnRNP antibodies have been recognized in the last ten years extending the spectrum of anti-hnRNP reactivity in different autoimmune disorders.
- Published
- 2005
- Full Text
- View/download PDF
97. Block of Stat-1 activation in macrophages phagocytosing bacteria causes reduced transcription of CIITA and consequent impaired antigen presentation.
- Author
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Barbaro Ade L, Tosi G, Frumento G, Bruschi E, D'Agostino A, Valle MT, Manca F, and Accolla RS
- Subjects
- Antigen Presentation, DNA-Binding Proteins chemistry, Dimerization, Down-Regulation, Escherichia coli immunology, Genes, MHC Class II, HLA-DR Antigens genetics, HLA-DR Antigens metabolism, Humans, In Vitro Techniques, Interferon Regulatory Factor-1, Interferon-gamma pharmacology, Macrophages drug effects, Phosphoproteins metabolism, RNA, Messenger genetics, RNA, Messenger metabolism, Recombinant Proteins, STAT1 Transcription Factor, Trans-Activators chemistry, Transcription, Genetic, DNA-Binding Proteins metabolism, Macrophages immunology, Macrophages metabolism, Nuclear Proteins, Phagocytosis immunology, Trans-Activators genetics, Trans-Activators metabolism
- Abstract
The IFN-gamma-induced HLA class II expression in human macrophages was drastically reduced after phagocytosis of Escherichia coli. HLA class II down-modulation depended on phagocytosis of bacteria and could not be reproduced by phagocytosis of inert particles or by treatment with lipopolysaccharide. Study of the kinetics and molecular analysis showed that class II molecules and corresponding mRNA were up-regulated at 6 h after phagocytosis of bacteria. Subsequently, a progressive reduction of mRNA occurred, and, at 72 h, as little as 25% of the class II mRNA level of IFN-gamma-treated control cells was found. This was due to reduced transcription of the class II transcriptional activator CIITA, as a consequence of reduced immediate-early inducible factor (IRF-1) and particularly of reduced phosphorylated Stat-1 homodimers, nuclear factors both necessary for optimal triggering of the CIITA promoter. Failure to sustain IFN-gamma-induced CIITA up-modulation during phagocytosis of bacteria had functional implications, as human macrophages could not adequately process and present antigenic peptides to HLA-DR-restricted antigen-specific T cells. This is the first evidence that phagocytosis of bacteria can down-modulate HLA class II expression in normal human macrophages by acting at the level of expression of CIITA.
- Published
- 2002
- Full Text
- View/download PDF
98. Bone regeneration in the edentulous ridge expansion technique: histologic and ultrastructural study of 20 clinical cases.
- Author
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Scipioni A, Bruschi GB, Calesini G, Bruschi E, and De Martino C
- Subjects
- Adult, Alveolar Process anatomy & histology, Alveolar Process cytology, Female, Humans, Male, Microscopy, Electron, Scanning, Middle Aged, Osteoblasts ultrastructure, Osteocytes ultrastructure, Surgical Flaps, Alveolar Ridge Augmentation methods, Bone Regeneration, Dental Implantation, Endosseous methods, Jaw, Edentulous rehabilitation
- Abstract
The edentulous ridge expansion (ERE) technique is a partial-thickness flap procedure for implant surgery that was developed in 1986. The ERE technique permits the use of osseointegrated implants at sites whose minimal orofacial dimensions are insufficient for traditional implant surgery. The present work is a histologic and ultrastructural study of hard tissue repair modalities at edentulous sites that were treated with the ERE technique in 20 humans. Biopsies were obtained from the tissue regenerating within the surgically created bone gap between the mobile buccal and nonmobile lingual or palatal bone-periosteum plates ("bone flaps") on days 40, 90, 120, 150, and 480 (day 0 = day of implant insertion). The results suggest that osteoblasts differentiate from preexisting mesenchymal cells located on the original fissure walls, with consequent deposition of new bone in the surgically created intrabony defect.
- Published
- 1999
99. Localized management of sinus floor with simultaneous implant placement: a clinical report.
- Author
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Bruschi GB, Scipioni A, Calesini G, and Bruschi E
- Subjects
- Alveolar Process pathology, Alveoloplasty methods, Bite Force, Bone Regeneration, Collagen therapeutic use, Female, Follow-Up Studies, Humans, Jaw, Edentulous rehabilitation, Jaw, Edentulous surgery, Male, Maxilla pathology, Middle Aged, Osteogenesis, Surgical Flaps pathology, Treatment Outcome, Dental Implantation, Endosseous, Dental Implants, Maxilla surgery, Maxillary Sinus surgery
- Abstract
Localized management of sinus floor (LMSF) achieves implant placement and sinus lifting simultaneously. LMSF is a further application of the principles of the edentulous ridge expansion (ERE) technique. It comprises the dissection of a partial-thickness flap, the buccal expansion of the residual alveolar bone, and the fracture and elevation of the sinus floor with simultaneous implant placement. Three hundred three patients were treated with 499 implants placed using the LMSF between April 1988 and December 1993. The selected patients, who showed no signs of sinus pathology, exhibited insufficient vertical alveolar bone dimensions for the placement of dental implants with the traditional technique. The minimal residual alveolar bone height was between 5 and 7 mm. Based on the criteria established by Albrektsson and his coworkers in 1986, the success rate of the 499 implants placed with the LMSF was 97.5%.
- Published
- 1998
100. Gas chromatographic determination of chlorinated pesticides and PCBs in complex cosmetic matrices.
- Author
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Mariani E, Bargagna A, Longobardi M, and Bruschi E
- Subjects
- Chromatography, Gas methods, Humans, Insecticides pharmacokinetics, Skin Absorption, Cosmetics analysis, Insecticides analysis, Polychlorinated Biphenyls analysis
- Abstract
An investigation was performed in order to evaluate the presence as polluting agents of chlorinated hydrocarbons in complex cosmetic matrices. Chlorinated pesticides, such as Dieldrin, alpha-Endosulfan, Heptachlor, alpha-Hexachlorocyclohexane (alpha-HCH), Lindane and polychlorinated biphenyls (PCBs) such as Aroclor 1254, were studied in two ingredients and in three finished commercial products. The analytical procedure consists of extraction, extract clean-up, separation of pesticides from PCBs, identification and measurement. Analysis was performed by gas chromatography with electron-capture detector, identity of pesticides and PCBs was assumed from retention times and quantification was based on peak-height measurements.
- Published
- 1994
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