Navegando por Palavras-chave "ischemic ulcers"

Agora exibindo 1 - 2 de 2
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Bosentana no tratamento de úlceras de extremidades refratárias na esclerose sistêmica
    (Sociedade Brasileira de Reumatologia, 2009-06-01) Mariz, Henrique de Ataíde [UNIFESP]; Corrêa, Marcelo José Uchôa [UNIFESP]; Kayser, Cristiane [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Vasculopathy is a hallmark of systemic sclerosis (SSc) and may lead to complications such as ischemic ulcers, necrosis or amputation of fingers or lower limbs. Bosentan is a dual endothelin receptor antagonist currently used for prevention of digital ulcers in SSc. OBJECTIVE: To evaluate the efficacy of bosentan in the treatment of recurrent and refractory extremity ulcers in patients with SSc. PATIENTS AND METHODS: An open and observational study was performed with three patients from the Rheumatology Division of UNIFESP aged 31, 58 and 61 years with diagnosis of SSc. All patients presented one or more active extremity ulcer refractory to conventional treatment. The first one (P1) presented one digital ulcer; P2 presented three ulcers on the right lower limb; and P3 presented an ulcer on the right digit, leg and heel, and on left maleolar region. Bosentan was prescribed in a dose regimen of 62.5 mg twice a day for 4 weeks, followed by 125 mg twice a day for additional 4 or 8 weeks. All patients were evaluated regarding the number and diameter of the ulcers in weeks 0, 4, and 8, and one of them in week 12 as well. RESULTS: After the treatment with bosentan all patients presented complete resolution or reduction in the diameter of the ulcers. None of the patients presented a new ulcer. CONCLUSION: Bosentan was an effective treatment in refractory extremities ulcers and in the prevention of new ulcers in three SSc patients suggesting that this medication could be an option for patients with severe vascular involvement.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Tratamento de pacientes com úlceras isquêmicas secundárias à esclerose sistêmica com N-acetilcisteína endovenosa
    (Sociedade Brasileira de Reumatologia, 2006-04-01) Kayser, Cristiane [UNIFESP]; Luz, Karine Rodrigues da [UNIFESP]; Rocha, Livanio Ferreira da [UNIFESP]; Andrade, Luiz Eduardo Coelho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The repetitive ischemic-reperfusion episodes in patients with systemic sclerosis (SSc) cause an increase in free radical activity, which may be implicated in the inflammatory and vascular lesions observed in this illness. Endovenous N-acetylicysteine is a potent anti-oxidant agent and might be beneficial to the treatment of vascular events in SSc. This communication reports on the use of endovenous N-acetylcysteine in three SSc patients with active ulcers in fingers and toes. At baseline, two patients presented two finger ulcers each, and a third patient had three ulcers in the toes. All patients presented a decrease in the dimensions of at least one ulcer. Two patients presented complete healing of one ulcer. These preliminary results suggest that endovenous N-acetylcysteine may be an efficient therapeutic option for extremity ulcers in SSc patients and support future randomized double blind placebo-controlled trials.