La ultrasonografía en la artritis psoriática / Ultrasound in psoriatic arthritis

Psoriatic arthritis is a chronic inflammatory disease, which presents in 6 percent to 42 percent of patients with psoriasis. It presents a myriad of clinical expressions, from arthritis to dactylitis, along with the typical cutaneous lesions of psoriasis. Musculoskeletal ultrasound has demonstrated to be of great use in the description and follow up of these clinical expressions. Through the development of new techniques such as power Doppler, it has been possible to measure disease activity as well as morphostructural changes. This review describes the main ultrasonographic findings in patients with psoriatic arthritis.

La artritis psoriática es una enfermedad inflamatoria crónica que se manifiesta en el 6 por ciento al 42 por ciento de los pacientes con psoriasis. Presenta una miríada de expresiones clínicas que van desde la artritis hasta la dactilitis, acompañando a las lesiones cutáneas típicas de la psoriasis. El ultrasonido musculoesquelético ha demostrado ser de gran utilidad en la descripción y seguimiento de estas alteraciones. Mediante el desarrollo de nuevas técnicas, como el Doppler de poder, es posible evaluar el grado de actividad de la enfermedad, así como los cambios morfoestructurales. El presente artículo describe los principales hallazgos ultrasonográficos en los pacientes con artritis psoriática.

Analysis of soil washing effectiveness to remediate a brownfield polluted with pyrite ashes.

Soil in a brownfield contaminated by pyrite ashes showed remarkably high concentrations of several toxic elements (Hg, Pb, Zn, Cu, Cd, and As). Initially, we assessed various physical, chemical and mineralogical properties of this soil. The data obtained, and particularly multivariate statistics of geochemical results, were useful to establish the predominant role of the soil organic matter fraction (6%) and iron oxyhydroxides in the binding of heavy metals and arsenic. In addition, we studied the viability of soil washing techniques to reduce the volume of contaminated soil. Therefore, to concentrate most of the contaminants in a smaller volume of soil, the grain-size fraction below 125 microm was treated by hydrocycloning techniques. The operational parameters were optimized by means of a factorial design, and the results were evaluated by attributive analysis. This novel approach is practical for the global simultaneous evaluation of washing effectiveness for several contaminants. A concentration factor higher than 2.2 was achieved in a separated fraction that contained less than 20% of the initial weight. These good yields were obtained for all the contaminants and with only one cycle of hydrocycloning. Hence full-scale soil washing is a plausible remediation technique for the study site.

POEMS syndrome: an Italian case with diagnostic and therapeutic implications.

A young Italian patient with a multisystem disorder and a solitary osteosclerotic bone lesion is described. His clinicopathological situation involved sensory-motor polyneuropathy, organomegaly, endocrine dysfunction, skin alterations, edema of the lower limbs and generalized lymphadenopathy. These features were consistent with the diagnosis of POEMS syndrome, reported primarily in Japanese patients. M components were not found in this patient's serum or urine. Bone marrow biopsy showed only a slight plasma cell infiltrate; histological study of the sural nerve evidenced a mixture of both axonal degeneration and segmental demyelinization. Lymph node biopsy revealed peculiar pathological changes resembling those of type II Castleman-like disease. A wide bone defect with osteosclerotic margins and trabeculation was evidenced in the right ilium. The relationship of these findings to plasma cell dyscrasias is discussed. After prednisone and local radiotherapy failed, the patient was treated with human recombinant interferon for 18 months. After three months of therapy he has experienced remarkable improvement of his neurological symptoms and almost complete recovery of organomegaly and lymphadenopathy. These improvements have continued to the present.

[Restrictive cardiomyopathy in eosinophilic leukemia: echocardiographic and nuclear magnetic resonance aspects]. / Miocardiopatia restrittiva in corso di leucemia eosinofila: aspetti ecocardiografici e di risonanza magnetica nucleare.

This paper reports a case of endomyocardial disease due to hypereosinophilic syndrome. Two-dimensional echocardiography showed prevalent right ventricular involvement, with obliteration of the apex due to an echogenic mass progressively filling the whole ventricular cavity. RMN accurately defined the presence and the characteristics of the infiltrative mass in the right ventricular chamber. A different intensity of spin-echo imaging sequence was used to differentiate between thrombotic and infiltrative leukemic images. It is concluded that prevalent right ventricular involvement during eosinophilic endomyocardiopathy is a relatively rare disease which can be detected and evaluated by the use of echocardiography and RMN studies.

Clinical efficacy of picotamide in long-term treatment of intermittent claudication.

The clinical efficacy of picotamide was investigated in a randomized, double-blind, placebo-controlled study in patients with peripheral occlusive arterial disease of the lower limbs at functional stage II of the Fontaine classification. Forty patients with a history of claudication for at least six months were admitted to the study and were given either 3 x 300 mg tablets of picotamide (20 subjects) or three identical placebo tablets (20 subjects) for six months. The two groups of patients were similar in regard to clinical features and potential risk factors. At the end of treatment painfree walking distance and systolic ankle-arm pressure ratio improved more in the picotamide than in the placebo group (p = 0.05). Systolic ankle pressure curves, determined before and after the six-month treatment, showed a positive trend to a higher postexercise ankle pressure and a faster return to the preexercise levels in the picotamide group; however, the difference was not statistically significant. Laboratory monitoring revealed a slight prolongation of bleeding time, a significant decrease in arachidonic acid-induced platelet aggregation, and an enhanced fibrinolysis with absence of interference with hemostasis in the picotamide group. One patient in the placebo group developed a major cardiovascular event (angina pectoris) during the study. These results indicate that picotamide is an effective drug that may modify the natural course of intermittent claudication and associated vascular problems.

Clinical investigation of the effect of ketanserin: a new antihypertensive drug.

The antihypertensive effect of a recently introduced antiserotoninic drug, ketanserin, was examined in a single-blind, placebo-controlled parallel group study in 28 patients with mild to moderate hypertension. Supine and standing blood pressure, electrocardiogram, heart rate and laboratory parameters of liver, kidney and bone marrow functions were checked before and after 3 months of treatment. After 12 weeks' treatment with ketanserin (20-40 mg twice a day), there was a highly significant reduction of both systolic and diastolic blood pressure, as compared to placebo in the supine position (p less than 0.0001/p less than 0.001). In the standing position, the reduction of systolic pressure was more significant than the diastolic pressure (p less than 0.0001/p less than 0.01). Eleven out of 28 hypertensive patients showed electrocardiographic evidence of left ventricular hypertrophy (LVH) according to the ECG criteria of Romhilt and Estes. Although a reduction of the mean point score for LVH as compared to placebo was observed in the ketanserin group, that difference was not statistically significant. These preliminary observations suggest a possible role of ketanserin in the regression of LVH due to essential hypertension.