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The lymphoedema of the extremities is a rare complication of rheumatoid arthritis (RA); it does not appear to be correlated with positivity for rheumatoid factor nor with the clinical activity of the disease. The authors describe 6 cases of lymphoedema in patients affected by RA; in 3 of them the lymphoedema was localized in the upper and in the remaining cases in the lower limbs. Four patients, (one of whom has been subjected to a lymphoangiography which demonstrates an obstruction of the deep lymphatics), presented an increase of the plasma fibrinogen degradation products (FDP). This could confirm the hypothesis according to which the lymphoedema could be attributable to an obstruction of the lymphatics caused by fibrin and other degradation products of the coagulation system. In one case the authors underscore the therapeutic effectiveness of lymphodrainage associated with administration of diuretics.

The authors studied the incidence of atlanto-axial joint involvement by conventional radiography and CT in 183 patients with classical or definite rheumatoid arthritis (RA). In determining lesions the significance of factors such as age, sex, duration and severity of the disease was evaluated. Atlanto-axial subluxations turned out to be quite frequent (30%) in the series of patients examined and were directly correlated with age, duration and stage of the disease, and extraarticular manifestations. Clinical symptoms were evident in only 70.9% of cases, confirming the correlation reported by other authors between clinical manifestations and radiologically observed lesions. Traditional radiography performed in the dynamic position revealed a prevalence of anterior subluxation, whereas CT gave a precise indication of the entity and type of atlanto-axial lesion. In conclusion, the authors confirm the importance of such investigations in all patients with RA, even those without evident clinical manifestations. They also emphasize the necessity of periodic monitoring in view of the possible risk of mortality in these patients.

Pulsed signal therapy (PST) is an extension of pulsed electromagnetic fields (PEMF) therapy. PEMF have been used widely to treat non-healing fractures and related problems in bone healing since approval by the Food and Drug Administration in 1979.1,2 Recently, PEMF therapy has been used to treat patients with osteoarthritis (OA) of the knee and cervical spine, with encouraging results.3,4 In vitro studies have also shown a stimulating activity of PEMF on cartilaginous metabolism.5 PST, in contrast with PEMF, uses specific physiological changing rectangular pulses as stimuli, which are transmitted in a programmed alternating fashion that mimics the body’s natural streaming potentials for one hour of treatment. We studied the effects of PST on human OA chondrocytes cultivated in the presence and absence of a negative stimulus represented by interleukin 1β (IL1β) and we evaluated the concentration of proteoglycans (PGs) in the culture medium and the morphology of the chondrocytes after exposure to PST. Human OA chondrocytes were cultivated in alginate gel on Petri dishes for 72 hours with and without IL1β …

Metal compounds such as copper are known to be inhibitory or toxic to biological activity within wastewater treatments when reaching a certain threshold concentration. Little information on threshold values can be found for biofilm process like Biological Aerated Filters (BAFs). In this study, a BAF pilot plant (Biostyr®) for carbon removal and nitrification was operated to study its response to copper concentration variations. Biological activity was maintained at copper concentration higher than the stated thresholds for heterotrophic and autotrophic biomass in activated sludge systems. Carbon removal was not affected at copper concentrations around 20 mg/l. Autotrophic biomass growth was inhibited at a concentration above 2.5 mg Cu/l.

Background: Osteoarthritis (OA) is the most common form of arthritis and is often associated with disability and impaired quality of life. Objective: The aim of the study was to assess the efficacy and tolerability of glucosamine sulfate (GS) in the treatment of knee OA. Methods: Consecutive outpatients affected by primary monolateral or bilateral knee OA were enrolled in this double-blind, double-dummy, prospective, randomized, placebo-controlled trial. One group received GS 1500 mg QD for 12 weeks, and the other group received placebo QD for 12 weeks. The treatment period was followed by a 12-week treatment-free observation phase. Each patient was examined at baseline and at weeks 4, 8, 12, 16, 20, and 24. The primary efficacy criteria were pain at rest and during movement, assessed on a visual analog scale (VAS) of 0 to 100 mm. The secondary criteria included the Western Ontario and McMaster Universities (WOMAC) index for total pain score (W-TPS), total stiffness score (W-TSS), and total physical function score (W-TPFS). VAS, W-TPS, W-TSS, and W-TPFS were evaluated at baseline and at weeks 4, 8, 12, 16, 20, and 24. Analgesic drug consumption (ie, acetaminophen or NSAIDs) was also assessed. Results: Patient demographics were similar in the GS and placebo groups. Of 60 randomized patients (30 per group), 56 completed the study (28 treated with GS and 28 who received placebo). Statistically significant improvements in symptomatic knee OA were observed, as measured by differences in resting pain at weeks 8, 12, and 16 (all, P < 0.05 vs placebo) and in pain during movement at weeks 12 and 16 (both, P < 0.05). W-TPS was lower with GS than placebo at weeks 8, 12, and 16 (all, P < 0.01), and at week 20 (P < 0.05). W-TSS was also lower with GS than placebo at weeks 8, 12, 16, and 20 (all, P < 0.05). W-TPFS was lower with GS than placebo at weeks 8 (P < 0.05), 12 (P < 0.01), 16 (P < 0.05), and 20 (P < 0.05). Drug consumption was lower in the GS group than the placebo group at weeks 8, 12, 16, and 20 (all, P < 0.05). The incidence of adverse events was 36.7% with GS and 40.0% with placebo. Conclusions: GS 1500 mg QD PO for 12 weeks was associated with statistically significant reductions in pain and improvements in functioning, with decreased analgesic consumption, compared with baseline and placebo in these patients with knee OA. A carryover effect was detected after treatment ended.

The urinary excretion of proteins, N-acetil-3-glucosaminidase and leucine aminopeptidase, was measured in 50 patients with rheumatoid arthritis (RA), of whom 20 subjects were on nonsteroidal anti-inflammatory drugs (NSAIDs) and 30 on gold salts. No pathological changes of the above-mentioned urinary parameters have been observed in the group of RA patients, in comparison with control subjects and patients suffering from osteoarthritis treated with NSAIDs.

We present the first report of erythema nodosum occurring in a woman with an intestinal infection due to giardia lamblia, an association not previously described. The authors suggest the possible role of giardia infection in the pathogenesis of erythema nodosum.

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Uric acid binding to human plasma proteins has been studied in various physiological and paraphysiological conditions,including the following groups: I-a group of children aged 4-10 years; 2-a group of healthy males; 3-a group of subjects treated with estrogen preparations for prostatic cancer; 4-a group of regularly menstruating females with normal cycle; 5-a group of post-menopausal females; 6-a group of pregnant females; 7-a group of females treated with oral contraceptives; 8-a group of females treated with estrogen preparations for post menopausal symptoms. The results obtained demonstrate a significant correlation between the increase of plasma estrogen and the increase of the uric acid binding to human plasma proteins.