Abstract:
OBJECTIVES:To describe the morbidity and mortality in Canadian scleroderma (SSc) patients focusing on gender, SSc type, and organ-specific prognosis in a cohort of patients seen from 1994 to 2004 in a Southwestern Ontario SSc clinic. We also compared this cohort to data from the literature, which showed that mean survival in recent studies has risen to 72 months versus 48 months in earlier studies. METHODS:This was a cohort study of all SSc patients followed at 1 rheumatology center. Data were abstracted by chart review and entered into a database. The demographic and clinical characteristics of SSc patients were compared between those who survived versus those who died over the 10-year follow-up period. Five- and 10-year survival rates were compared between cohort subsets (sex, diffuse/limited disease type, and organ involvement including the following: scleroderma renal crisis, interstitial lung disease (ILD), hypertension, cardiac, gastrointestinal involvement, pulmonary arterial hypertension, and antinuclear antibody positivity). RESULTS:One hundred eighty-five subjects (158 women), 63% with limited cutaneous SSc, were included. The mean disease duration until last visit or death was 9.1 years (7.9 years in diffuse and 9.8 years in limited). Although more women had either subtype, men were more likely to have diffuse cutaneous SSc (dcSSc) than women (67% of men had dcSSc versus 32% of women, P = 0.0009), and to have an earlier mean age of diagnosis (41.3 +/- 2.8 years old versus 49.7 +/- 1.2 years, P = 0.006). Overall mortality was 23%; 22% of men (n = 6) and 23% of women (n = 36) were deceased. The 5-year survival was 90% (95% for limited and 81% for diffuse) and the 10-year survival was 82% (92% for limited and 65% for diffuse). Deceased persons were more likely to have had dcSSc (P = 0.03), cardiac disease (P < 0.0001), ILD (P = 0.006), gastrointestinal disease (P = 0.01), and systemic hypertension (P = 0.009). Four of 13 patients with scleroderma renal crisis died. Survival analyses demonstrated that persons with dcSSc (P = 0.001), cardiac disease (P < 0.0001), and hypertension (P = 0.01) had worse survival rates than their counterparts without these disorders. The primary cause of death was ascertained for 33 of the 42 deceased individuals and included the following: pulmonary arterial hypertension (n = 5), renal complications (n = 9), ILD (n = 10), and cardiac complications (n = 9). There appears to be a trend toward longer survival of scleroderma patients over the past few decades. CONCLUSIONS:We conclude that cardiac involvement, dcSSc, and hypertension are associated with worse survival, and survival of patients with scleroderma is improving compared with older reports in the literature.
journal_name
Semin Arthritis Rheumjournal_title
Seminars in arthritis and rheumatismauthors
Al-Dhaher FF,Pope JE,Ouimet JMdoi
10.1016/j.semarthrit.2008.06.002subject
Has Abstractpub_date
2010-02-01 00:00:00pages
269-77issue
4eissn
0049-0172issn
1532-866Xpii
S0049-0172(08)00116-9journal_volume
39pub_type
杂志文章abstract::Subclinical alveolitis, as assessed by bronchoalveolar lavage (BAL) cell analysis, may be present in the lower respiratory tract of a high proportion of symptomless patients with connective tissue diseases (CTDs) with normal chest roentgenograms. The distribution of BAL cell types, mainly macrophages, lymphocytes, and...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/s0049-0172(97)80042-x
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:Central nervous system (CNS) involvement in primary Sjögren's syndrome (pSS) is controversial with regard to frequency, significance, and etiology. METHODS:We describe a young woman with pSS and severe CNS disease and review the literature on the pathophysiology, clinical significance, symptoms, diagnostic e...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/s0049-0172(99)80033-x
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVES:The EULAR Outcome Measures Library (OML) is a freely available database of validated patient-reported outcomes (PROs). The aim of this study was to provide a comprehensive review of validated PROs specifically developed for systemic sclerosis (SSc) to feed the EULAR OML. METHODS:A sensitive search was devel...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2016.10.002
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the prescription modalities of general practitioners (GPs) and specialists in symptomatic osteoarthritis (OA) patients enrolled in the AMICA study. PATIENTS AND METHODS:This study started in 2001 as a cohort investigation of OA patients seen by 2764 GPs and 316 specialists. Enrolled were 28,981 p...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,多中心研究
doi:10.1016/j.semarthrit.2005.02.001
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:The possibility that oral contraceptives offer a protective effect against the development of rheumatoid arthritis is still contentious. Of the 17 studies investigating this association, 11 have found a protective effect, and 6 have not. These differences are probably attributable to either selection or infor...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/s0049-0172(97)80025-x
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the outpatient health service utilisation of young people (YP) with juvenile idiopathic arthritis (JIA) during transfer from paediatric to adult care in Germany. METHODS:Based on claims data of a large German statutory health fund (BARMER GEK) we conducted a cohort study of 2008-2014. Insured YP ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2017.05.003
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:The Dead Sea, the deepest and most saline lake on earth, has been known from biblical times for its healing properties. The aim of this systematic review was to present critically the level of evidence for the claims of therapeutic effects of Dead Sea treatments in several rheumatologic diseases and psoriasi...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2012.02.006
更新日期:2012-10-01 00:00:00
abstract::Rheumatoid joint destruction is caused by (1) enzymatic digestion from articular surfaces of cartilage, (2) pannus formation, and (3) lysis of the matrix by activated chondrocytes. Pannus, a vascular and fibrous granulation tissue arising from the perichondral synovial membrane, extends onto cartilage surfaces as a la...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/0049-0172(92)90058-l
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVES:Systemic sclerosis (SSc) causes functional and structural microcirculatory dysfunction, affecting also distal extremities. Optical Near-InfraRed Spectroscopy (NIRS) of blood HbO2 saturation (stO2) is able to evaluate O2 delivery/consumption balance in the explored tissue. The NIRS-sensitive camera non-invasi...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2018.08.002
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of colchicine in reducing the frequency of attacks in patients with PFAPA. STUDY DESIGN:We conducted a 6-month open label, randomized, controlled study among patients with PFAPA who attend the Pediatric Rheumatology Clinic at the Rambam Medical Center in Israel. A total of 18 patient...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2015.07.005
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To report entry criteria and clinical features of patients with newly diagnosed and relapsing giant cell arteritis (GCA) enrolled in a randomized trial of tocilizumab, an interleukin-6 receptor-alpha inhibitor. METHODS:Newly diagnosed GCA was defined as diagnosis ≤6 weeks before baseline. Relapsing GCA was d...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.semarthrit.2016.11.002
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:To describe the characteristics and outcome of patients with giant-cell arteritis (GCA)-related ophthalmologic involvement at diagnosis. METHODS:In a retrospective single-center cohort of 409 consecutive patients with GCA, we retrieved 104 patients with visual symptoms at GCA diagnosis and we compared them to ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2019.09.008
更新日期:2020-04-01 00:00:00
abstract::Traditional pain management strategies have relied on the use of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen, as well as other adjuvant analgesics. However, the limited activity of these drugs and the substantial adverse effects associated with their use has left many patients without dep...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1053/sarh.2002.37218
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:Osseous sarcoidosis has been infrequently reported. We aimed to characterize the distribution of lesions, clinical presentation, treatment, and outcomes for osseous sarcoidosis. METHODS:Cases of osseous sarcoidosis were identified by directed inquiry to clinicians and electronic query. Cases were defined as ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2014.07.003
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The neurological and psychiatric manifestations of systemic lupus erythematosus (NPSLE) are a heterogeneous group of conditions with variable clinical presentation and significant morbidity and mortality. OBJECTIVES:Our aim was to comprehensively assess and present the evidence for treatments used in the ma...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2020.12.004
更新日期:2020-12-17 00:00:00
abstract:BACKGROUND:It has been well known that TNF-α inhibitor (TNFi) treatment for patients with rheumatoid arthritis (RA) is associated with anti-nuclear antibody (ANA) development. We previously reported that ANA development was associated with poor outcomes of infliximab (IFX) treatment (1). However, no replication studies...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2019.02.003
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:The sparing effect of hemiplegia in rheumatic diseases has been described, but reports on systemic sclerosis (SSc)-spectrum disorders are unusual. SSc-spectrum disorders are complex diseases of unknown origin characterized by multisystem involvement, skin and organ fibrosis, microvascular alterations, and im...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2014.10.011
更新日期:2015-04-01 00:00:00
abstract::Candida species are an uncommon cause of infectious arthritis, although the frequency has increased during recent years. Three cases of septic arthritis caused by Candida species are reported, and the literature is reviewed. The first patient developed a popliteal cyst infected by Candida albicans after multiple intra...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/0049-0172(93)80071-m
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVES:To report 3 cases ANCA-associated vasculitis (AAV) that developed in patients suffering from systemic sclerosis (SSc) and to review previously reported cases. METHODS:We describe 3 patients diagnosed with SSc who developed severe AAV that presented as crescentic glomerulonephritis (GN) and/or alveolar hemor...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2010.11.001
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:Behçet's disease (BD) theoretically affects all sizes and types of vessels; however, there have been few reports describing the clinical efficacy of using (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with BD. METHODS:Eight patients who were registered at the BD Specialty Clini...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2010.05.006
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:Rheumatoid arthritis (RA) is a chronic inflammatory condition with increased all-cause and cardiovascular mortality. Accumulating evidence indicates that the immune and autonomic nervous systems (ANS) are major contributors to the pathogenesis of cardiovascular disease. We performed the first systematic lite...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2014.06.003
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Last recommendations regarding cardiovascular risk (CVR) in rheumatoid arthritis (RA) patients were developed by the EULAR group in 2010. The aim is to update evidence-based recommendations about this worrying health problem. METHODS:We assembled a multidisciplinary workgroup (rheumatologists, endocrinologi...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2014.01.002
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVES:Management of abscess-associated spontaneous pyogenic vertebral osteomyelitis (PVO) is controversial. The role of magnetic resonance imaging (MRI) in follow-up and its relation with clinical outcome is often unclear. This study evaluates the clinical and MRI outcome of abscess-associated PVO under conservati...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2007.08.007
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:Contrary to digital clubbing, there is no clear definition for "pseudoclubbing" (PC). The aim of this study was to review the literature on this subject. Additionally, differences and similarities between clubbing and PC are shown. METHODS:The PubMed database (1950-2006) was searched for the keyword "pseudo...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2008.01.018
更新日期:2009-06-01 00:00:00
abstract::A number of studies show the efficacy of methotrexate (MTX) for rheumatoid arthritis (RA) in general. However, is there any reason to single this drug out for early RA? Mechanistically, it probably works differently in RA than in cancer, at least in part. Thus, in addition to dihydrofolate reductase-related effects, M...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/0049-0172(94)90083-3
更新日期:1994-06-01 00:00:00
abstract::Methotrexate therapy has been effective in the treatment of RA with short term experience suggesting little serious adverse reactions. Our review of 168 patients receiving methotrexate has identified nine patients with probable or possible methotrexate-induced pulmonary toxicity, giving a prevalence of 5% and an incid...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/0049-0172(87)90021-7
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:Treat-to-target (TTT) is a recommended strategy in the management of rheumatoid arthritis (RA), but various data sources suggest that its uptake in routine care in the US is suboptimal. Herein, we describe the design of a randomized controlled trial of a Learning Collaborative to facilitate implement...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.semarthrit.2016.02.009
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Systemic sclerosis (SSc) is an autoimmune systemic disease characterized by diffuse fibrosis of skin and visceral organs due to different genetic, infectious, and/or environmental/occupational causative factors, including the inhalation of silica dust. OBJECTIVES:To investigate serum trace elements includin...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2018.06.009
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To review the clinical features, diagnosis, treatment, and outcome of interferon-induced Raynaud's phenomenon. METHODS:The medical literature was reviewed from 1967 to November 2001 with the assistance of a MEDLINE search using the key words: Raynaud, Interferon, ischemia, thrombosis and necrosis. A qualitat...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1053/sarh.2002.34606
更新日期:2002-12-01 00:00:00
abstract::Magnetic resonance imaging (MRI) is an important tool in the evaluation of neuromuscular disorders. MRI accurately demonstrates muscle oedema, atrophy, subcutaneous pathology and fatty infiltration and also highlights the distribution of muscle involvement. This review examines the role of MRI in evaluation of the idi...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2016.11.001
更新日期:2017-04-01 00:00:00