Browsing by Author "JACOBELLI, S"

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    AMYLOIDOSIS SECONDARY TO GOUT - IDENTIFICATION WITH A MONOCLONAL-ANTIBODY TO AMYLOID PROTEIN-A
    (1988) JACOBELLI, S; VIAL, S; ROSENBERG, H; BENSON, MD; SCHEINBERG, MA
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    ANTICARDIOLIPIN ANTIBODIES IN ACUTE RHEUMATIC-FEVER
    (J RHEUMATOL PUBL CO, 1992) FIGUEROA, F; BERRIOS, X; GUTIERREZ, M; CARRION, F; GOYCOLEA, JP; RIEDEL, I; JACOBELLI, S
    Recent reports describe the association of antiphospholipid antibodies (aPL) with chorea or severe heart valve lesions in systemic lupus erythematosus, lupus-like disease, or the primary antiphospholipid antibody syndrome. We conducted a case series and a case-control investigation of patients with rheumatic fever with Sydenham chorea or other manifestations of rheumatic fever for anticardiolipin antibodies (aCL) during the acute attack and disease remission. Eighty percent of patients were positive for aCL during the rheumatic fever attack vs 40% when inactive (p = 0.035); IgG and IgM aCL increased significantly with disease activity. Individuals with or without Sydenham chorea were equally positive for aCL (76 and 83%, respectively). A significant association was found between IgM aCL and carditis: All patients with valvulitis had IgM aCL (100%) vs 37% of patients without valvular involvement (p = 0.02). aPL may play a role in the pathogenesis of some clinical manifestations of acute rheumatic fever.
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    CHOLESTEROL DISTRIBUTION AMONG LIPOPROTEIN FRACTIONS IN PATIENTS WITH GOUT AND NORMAL CONTROLS
    (1986) JACOBELLI, S; ARTEAGA, A; BIDEGAIN, F
    The relationship between gout and coronary disease is controversial. We studied the distribution of cholesterol among lipoprotein fractions separated by ultracentrifugation in a group of 29 gouty men and 34 healthy controls, matched by age, weight and serum glucose. Our results showed that patients had significantly higher serum triglycerides and cholesterol-VLDL and lower total cholesterol and cholesterol in LDL and HDL fractions. The comparison of both groups separated by weight and alcohol intake showed similar results. The cholesterol-LDL/cholesterol-HDL ratio was not significantly different between the groups. Based on these results, we conclude that our group of gouty patients may not be at greater risk of coronary disease than a similar control population.
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    CLINICAL EXPRESSION OF RHEUMATOID-ARTHRITIS IN CHILEAN PATIENTS
    (W B SAUNDERS CO, 1995) MASSARDO, L; AGUIRRE, V; GARCIA, ME; CERVILLA, V; NICOVANI, S; GONZALEZ, A; RIVERO, S; JACOBELLI, S
    In populations such as Northern Europeans in which the HLA-DR4 subtypes Dw14 and Dw4 show strong association with rheumatoid arthritis (RA), these alleles and the double allelic dose of the shared epitope are considered severity markers. The clinical expression of RA varies in different populations, which may be determined by variation in the prevalence of these markers. In the present study we analyzed the expression of RA in 112 consecutive Chilean patients and its relation to the prevalence of genetic factors, prompted by our previous observation that DR4 is weakly associated to RA in this population. Mean age was 50 +/- 14 years; 90% were seropositive and 87% were female, with a disease duration of 10 +/- 8 years. Extra-articular manifestations were found in 38% of patients, rheumatoid nodules in 27%, vasculitis in 8%, and Sjogren's syndrome in 29%. Functional capacity (ACR, 1991) I or II: 82%. 15% of patients stopped working. Hand radiographs scored according to Steinbrocker in 89 patients: I, 21%; II, 15%; III, 43%; IV, 21%. In this series, patients with less formal education seemed to have more benign arthritis. In 97 controls and in 65 (56%) RA patients the presence of DRB1 alleles corresponding to DR1 and DR4 serotypes, to DR4-Dw subtypes, and homozygocity, were determined by polymerase chain reaction followed by specific oligonucleotide hybridization. The shared epitope was present in 53% of RA patients and in 30% of controls (P = .0048, odds ratio [OR] = 2.64). A double allelic dose of the epitope was present in 15% of RA patients compared with 4% of controls (P = .026, OR = 4.23). In a subgroup of 31 erosive RA patients we did not find a significant association of disease severity with the shared epitope in a single or double allelic dose. None of the DR4 subtypes that associate with RA in other populations was found significantly more prevalent in our patients. The severity of RA in our study compared with published series was intermediate between British patients with severe RA and Creek patients with milder disease. This may be due to the high prevalence of Dw13*0403 in our population.
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    HIGH-DOSE INTRAVENOUS METHYLPREDNISOLONE THERAPY ASSOCIATED WITH OSTEONECROSIS IN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS
    (1992) MASSARDO, L; JACOBELLI, S; LEISSNER, M; GONZALEZ, M; VILLARROEL, L; RIVERO, S
    Osteonecrosis is related to the use of steroids in patients with systemic lupus erythematosus (SLE); its association with the use of 'pulses' of methylprednisolone (PMP) is not clear at present. In a retrospective analysis of 190 patients with SLE we found that 19% of 36 patients treated with PMP had osteonecrosis compared with 6% of 154 patients without that treatment (P < 0.04). Risk factors associated with osteonecrosis were PMP treatment, cushingoid appearance, steroid doses greater-than-or-equal-to 40 mg/day during the first month of treatment, a ratio of steroid dose in grams/year greater-than-or-equal-to 12, hematuria and proteinuria. In a stepwise regression model, when cushingoid appearance was excluded, PMP became the only significant factor (P = 0.045).
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    INORGANIC PYROPHOSPHATASE ACTIVITY OF SYNOVIAL-FLUID - KINETIC AND CLINICAL-STUDY
    (1978) JACOBELLI, S; KETTLUN, AM; SAPAGHAGAR, M
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    INSPIRATORY MUSCLE DYSFUNCTION AND UNEXPLAINED DYSPNEA IN SYSTEMIC LUPUS-ERYTHEMATOSUS
    (1985) JACOBELLI, S; MORENO, R; MASSARDO, L; RIVERO, S; LISBOA, C
    The role of inspiratory muscle dysfunction in lung volume restriction and unexplained dyspnea was studied in 16 patients with systemic lupus erythematosus [SLE]. Maximal mouth inspiratory pressure (PIM) and maximal transdiaphragmatic pressure (Pdimax) were measured. Pdi and its components were determined during quiet breathing. No significant association was found between the activity of the disease, several serologic markers and the in spiratory muscle dysfunction. No specific anti-skeletal muscle antibody was found in these patients. Significant correlations were found between the degree of dyspnea and PIM (r = 0.69, P < 0.01) and Pdimax (r = -0.75, P < 0.001); however, dyspnea did not correlate with specific lung compliance. Vital capacity correlated significantly with the degree of dyspnea (r = -0.813, P < 0.001) and with Pdimax (r = 0.544, P < 0.05). No correlation was found between vital capacity and specific lung compliance. Inspiratory muscle dysfunction can be an important mechanism in the pathogenesis of the lung volume restriction and dyspnea in patients with SLE.
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    NOVEL GENETIC-MARKERS OF RHEUMATOID-ARTHRITIS IN CHILEAN PATIENTS, BY DR SEROTYPING AND RESTRICTION-FRAGMENT-LENGTH-POLYMORPHISM ANALYSIS
    (1992) GONZALEZ, A; NICOVANI, S; MASSARDO, L; BULL, P; RODRIGUEZ, L; JACOBELLI, S
    Objective. The analysis of genetic markers of rheumatoid arthritis (RA) in a population in which the DR4 serotype is not strongly associated with the disease.
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    SURVIVAL OF CHILEAN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS
    (1994) MASSARDO, L; MARTINEZ, ME; JACOBELLI, S; VILLARROEL, L; ROSENBERG, H; RIVERO, S
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    TRANSIENT OSTEOPROSIS OF HIP
    (1977) VALENZUELA, F; ARIS, H; JACOBELLI, S
    Osteoporosis in a painful hip is usually a sign of inflammation or tumor. There does exist a self-limited clinical entity that presents with pain in the hip and where the only roentgenological manifestation is osteoporosis. Eight patients with this disease are described: 5 men and 3 women, ranging in age from 29-50 yr. In 4 patients, the onset of disease was related to sprain, pregnancy or delivery. Laboratory analyses and the clinical course of the disease excluded inflammation or a neoplasm as the cause. All patients fully recovered within 12 mo., with no sequelae. The etiology of the disease remains unknown.
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    WEAK ASSOCIATION BETWEEN HLA-DR4 AND RHEUMATOID-ARTHRITIS IN CHILEAN PATIENTS
    (BRITISH MED JOURNAL PUBL GROUP, 1990) MASSARDO, L; JACOBELLI, S; RODRIGUEZ, L; RIVERO, S; GONZALEZ, A; MARCHETTI, R