Navegando por Palavras-chave "Raynaud's disease"
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- ItemAcesso aberto (Open Access)Ausência de correlação entre as alterações morfológicas e bioquímicas na microcirculação de pacientes com esclerose sistêmica(Sociedade Brasileira de Reumatologia, 2004-02-01) Kayser, Cristiane [UNIFESP]; Andrade, Luiz Eduardo Coelho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: The cold stimulus-fingertip lacticemy test (CS-FTL) evaluates a microcirculation biochemical component and presents abnormal results in systemic sclerosis (SSc). Nailfold capillaroscopy is a well established method for the assessment of morphological aspects of Raynaud's phenomenon associated with SSc. The present study sought to compare the nailfold capillaroscopy findings with the CS-FTL parameters in individual fingers of patients with systemic sclerosis. METHODS: 14 SSc patients with 3 fingers having discrepant degree of microangiopathic SD pattern by nailfold capillaroscopy were studied. Fingertip lacticemy was determined in the three fingers selected before (pre-CS-FTL) and 10 minutes after cold stimulus (post-CS-FTL). The percentage difference between post- and pre-CS-FTL was designated ΔCS-FTL. RESULTS: There was great intraindividual variability (between the different digits) in values of the CS-FTL test. There was no statistically significant difference in pre-CS-FTL, post-CS-FTL and ΔCS-FTL values when comparing the fingers with similar capillaroscopic pattern and the discrepant finger in the 14 SSc patients. There was no correlation between the morphological findings registered by nailfold capillaroscopy and the functional alterations measured by the CS-FTL test. CONCLUSIONS: The absence of correlation between morphological microangiopathic alterations detected by nailfold capillaroscopy and the functional perfusion alterations, verified by the CS-FTL test, suggests a relationship between the latter and proximal vascular lesions, such as arterioles, digital and palmar arch arteries.
- ItemSomente MetadadadosCold stimulus-fingertip lacticemy: Standardization of the test in normal volunteers and diagnostic application for systemic sclerosis(Elsevier B.V., 2005-07-01) Kayser, C.; Pucinelli, MLC; Fontenelle, SMA; Andrade, LEC; Universidade Federal de São Paulo (UNIFESP)Objectives: To standardize the cold stimulus-fingertip lacticemy test (CS-FTL) in normal individuals and to establish reference levels for discrimination of normal individuals and patients with systemic sclerosis (SSc).Methods: FTL was determined before (pre-CS) and 3, 8, and 13 min after cold stimulus (post-CS) in 94 normal controls according to gender and age. Diagnostic performance of Delta CS-FTL (percentage difference between post- and pre-CS-FTL) was tested comparing 25 SSc patients and the 94 normal individuals by ROC curve analysis.Results: Successive FTL determinations in the same fingertip yielded consistent results and the whole CS-FTL test proved to be reproducible. Pre-CS-FTL in SSc patients was higher than in normal controls (P < 0.001). FTL decreased after cold stimulus (negative Delta CS-FTL) in normal controls while SSc patients presented positive ACS-FTL. Gender did not influence pre-CS-FTL and post-CS-FTL in normal controls. the decrease in FTL after cold stimulus was more prominent for normal individuals between 25 and 34 years old in comparison to other age subgroups, with statistical significance for females at 3 min post-CS (P < 0.05). ROC curve analysis showed better diagnostic performance with post-CS-FTL at 8 and 13 min.Conclusion: CS-FTL test provides a reproducible quantitative biochemical parameter that reflects fingertip microcirculation status and was able to discriminate patients with SSc and normal controls, with optimal performance with post-CS-FTL at 8 to 13 min. (c) 2005 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosRaynaud's syndrome in children: systematic review and development of recommendations for assessment and monitoring(Clinical & Exper Rheumatology, 2016) Pain, C. E.; Constantine, T.; Toplak, N.; Moll, M.; Iking-Konert, C.; Piotto, D. P. [UNIFESP]; Ayaz, N. Aktay; Nemcova, D.; Hoeger, P. H.; Cutolo, M.; Smith, V.; Foeldvari, I.Objective. To develop recommendations for investigation and monitoring of children with Raynaud's syndrome, based on paediatric evidence collated by a systematic review. Method. A systematic review was undertaken to establish the paediatric evidence for assessment and monitoring of Raynaud's syndrome. An expert panel including members of the Paediatric Rheumatology European Society (PRES) Scleroderma Working Group, were invited to a consensus meeting where recommendations were developed based on evidence graded by the systematic review and where evidence was lacking, consensus opinion. A nominal technique was used where 75% consensus was taken as agreement. Results. The expert panel recommended testing anti-nuclear antibody (ANA), more specific antibodies associated with connective tissue disease and nail-fold capillaroscopy in all children presenting with Raynaud's syndrome as data suggests these can be risk factors for evolution into a connective tissue disease. The frequency of follow-up recommended depends on presence of these risk factors with the aim to detect evolving connective tissue disease early in high risk individuals. Those with no abnormalities on capillaroscopy and negative autoantibodies were deemed low risk of progression, whereas those with ANA positivity, specific autoantibodies and/or nailfold capillary changes were deemed high risk and more frequent follow-up was recommended. Conclusion. Recommendations, primarily based on consensus opinion, were agreed regarding investigation and monitoring of children who present with Raynaud's syndrome. Further prospective studies are needed to better define the risk factors for progression to connective tissue disease.