No abstract

SUMMARYActivated Th2 lymphocytes express the surface molecule CD30 and release a soluble form of the same molecule which can be detected both in vivo and in vitro. In the present study, high levels of soluble CD30 were found in the peripheral blood of patients with SSc, and a significant correlation with skin score and erythrocyte sedimentation rate (ESR) was detected. Furthermore, we observed a higher spontaneous release of soluble CD30 in the supernatants of unstimulated cultures of peripheral blood mononuclear cells from our patients compared with healthy controls. Taken together, these data suggest a possible involvement of Th2 cells in the immunopathogenesis of SSc, and the dosage of CD30 soluble in the peripheral blood may be helpful in following the outcome of the disease.

Diffuse idiopathic skeletal hyperostosis (DISH) is an ossifying systemic enthesopathy which involves not only the spine but which may also appear in other sites. Degenerative, inflammatory and metabolic factors have been reported for a possible pathogenic role in the new bone growth that characterises DISH. In the present study peripheral bone mineral density (BMD) has been measured in patients affected by DISH and the results compared to those of a control group. Forty-two patients (33 females and 9 males) affected by DISH and 84 controls (66 females and 18 males) were examined. All subjects underwent radiological study of the lumbar and dorsal spine and the pelvis. BMD was evaluated using dual-energy X-ray absorptiometry and the examination was performed in the distal radius. In DISH patients the mean value of BMD was significantly higher than in controls (P50.002), even when it was referred to sex subgroups. Statistical analysis showed significant differences between both the two male groups (P50.002) and the two female groups (P50.01). In the two female subgroups (DISH patients and controls) BMD was significantly inversely related to age and to the duration of the postmenopausal period. The present study showed higher BMD in DISH patients than in the control group.

artrite reumatoide (AR) colpisce fra lo 0,3 e l'1% della popolazione e in Italia il numero dei pazienti è stimato pari a 410.000 casi (1). Per impostare una corretta indagine sulla valutazione dei costi assistenziali per l'AR è necessario, anzitutto, definire il numero dei ricoveri/anno che si verificano in una casistica di pazienti con tale affezione. A tal fine si potrebbe prendere in considerazione un certo numero di pazienti e accertare quanti ricoveri si verificano in un determinato anno; tuttavia questo metodo non darebbe risultati attendibili in quanto generalmente i pazienti affetti da AR non ricorrono all'ospedale tutti gli anni, ma saltuariamente in rapporto alle diverse fasi della malattia. Per tale motivo abbiamo osservato un certo numero di pazienti per molti anni e accertato il numero di ricoveri per AR che si era complessivamente verificato. STIMA DELLA FREQUENZA ANNUALE DEI RICOVERIPer definire il numero medio annuo di ricoveri abbiamo selezionato, grazie alla collaborazione del Dipartimento di Terapia Medica-Sezione Reumatologia dell'Università di Roma "La Sapienza", dell'Associazione dei Malati Reumatici del Lazio e di alcuni Reumatologi che operano in strutture specialistiche del Lazio (ospedaliere ed ambulatoriali del SSN), 100 pazienti con AR e con anzianità minima di malattia di 10 anni.

An open clinical trial was carried out in 57 patients with osteoarthritis of the knee, hip or spine to assess the effectiveness and tolerability of etodolac. Patients received 200 mg etodolac twice daily for a period of 2 weeks. The results of clinical and patient assessments made at baseline and at the end of the study period showed that there was significant improvement in pain at rest and on active and passive movement, local tenderness, pain on climbing stairs, joint swelling and functional status. No significant changes were seen in clinical severity of the condition or, in patients with osteoarthritis of the knee, in the degree of knee flexion. Patients judged the therapeutic results to be good or excellent more often than the investigator (75% vs 50%). Tolerability of etodolac was very good with few, generally mild side-effects and only 2 patients were withdrawn, more as a precautionary measure than of necessity.