Browsing by Author "RIVERO, S"

Now showing 1 - 7 of 7
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    CLINICAL AND SEROLOGICAL IDENTIFICATION OF 2 FORMS OF COMPLETE HEART-BLOCK IN CHILDREN
    (1995) HUBSCHER, O; BATISTA, N; RIVERO, S; MARLETTA, C; ARRIAGADA, M; BOIRE, G; MENARD, HA; ARANA, RM
    Objective. To study the association of maternal antibodies to Ro(SSA) and/or La(SSB) with isolated complete congenital heart block (CCHB) in children according to the child's age at detection.
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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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    IMMUNOLOGICAL EVALUATION OF PATIENTS WITH INVASIVE-CARCINOMA OF THE GALLBLADDER
    (1993) CUBILLOS, L; GONZALEZ, S; SEPULVEDA, C; RIVERO, S; CALVO, A; CARACCI, M; TORRES, J; TAPIA, A; ZUNIGA, J; FALCON, C; FERREIRO, O; MARTINEZ, I
    Forty-three patients with invasive adenocarcinoma of the gallbladder were postoperatively studied in order to determine their general immunological status as well as the local immunohistological reaction to the tumor. At the end of the follow-up, they formed two groups: 19 living patients (group GL) and 24 dead patients (group GD). As a control group (GC), 21 patients with cholecistectomy for cholelithiasis and without carcinoma were simultaneously evaluated. In GL, most of the tumors were limited to the gallbladder wall, and in GD, most of the tumors were already disseminated at the time of diagnosis. GD presented a lower percentage of peripheral blood B lymphocytes, as compared to GL and GC cases. Skin tests of delayed hypersensitivity were significantly more reactive in GL cases than in GD cases, and less reactive in GD than in GC cases. The immunohistological evaluation of the gallbladder yielded a lower B lymphocyte infiltration in GD tumors than in the control cases. GL cases showed a higher intratumoral lymphocytic and mononuclear cell infiltration than GD cases. Although the clinical stage was higher in GD than in GL cases, there were also significant differences in the local immune response and the general immunological status. Patients with invasive gallbladder adenocarcinoma showing longer postoperative survival revealed normal or increased local and general immunological reactions, whereas patients with disseminated tumors showed an important humoral and cellular secondary immunodeficiency.
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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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    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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    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