MD News and Information

First-Line Combination of Ambrisentan and Tadalafil Reduces Risk of Clinical Failure Compared to Monotherapy in Pulmonary Arterial Hypertension Outcomes Study

Author: Bene MD, Pozzi MR, Rovati L, Mazzola I, Erba G, Bonomi S
Date Published: August-2014
Source: PubMed

Digital ulcers (DUs) occur in up to 50% of patients with Systemic Sclerosis (SSc). DUs are painful, recurring and lead to functional disability. Management of DUs includes pharmacologic and local therapy, the healing process is slow and the ulcer can become infected or evolve to gangrene. Autologous fat grafting (AFG) is a technique used to promote tissues repair. We used AFG to treat DUs refractory to conventional treatment to enhance healing process.


Fat Cell Transplants Boost Hand Function in SSc

Author: Rita Baron-Faust
Date Published: August-2014
Source: Rheumatology Network

Transplanted into their fingers, their own fat cells produce improvements in hand disability, pain, swelling and Raynaud’s phenomenon in as little as two months among patients with scleroderma, according to preliminary results from a small clinical trial in France. In the open-label, single-arm trial, autologous adipose-derived stromal/stem cells (ADSC) were aspirated from the abdomen, purified, and injected into the fingers of 12 women with systemic sclerosis (SSc), with no serious adverse consequences.


Joint and tendon involvement predict disease progression in systemic sclerosis: a EUSTAR prospective study

Author: J. Avouac, U. Walker, E. Hachulla, G. Riemekasten, G. Cuomo, et al
Date Published: August-2014
Source: Annals of the Rheumatic Diseases

Objective To determine whether joint synovitis and tendon friction rubs (TFRs) can predict the progression of systemic sclerosis (SSc) over time. Patients and methods We performed a prospective cohort study that included 1301 patients with SSc from the EUSTAR database with disease duration ≤3 years at inclusion and with a follow-up of at least 2 years. Presence or absence at clinical examination of synovitis and TFRs was extracted at baseline. Outcomes were skin, cardiovascular, renal and lung progression. Overall disease progression was defined according to the occurrence of at least one organ progression.


Sclerosis: Autologous Cell Transfers May Help Patients

Author: Jennifer Garcia
Date Published: August-2014
Source: Medscape Medical News

Injections of autologous stromal vascular fraction (SVF) may improve hand function and decrease pain among patients with systemic sclerosis (SSc), according to a new study published online August 11 in the Annals of the Rheumatic Diseases. The phase 1, open-label study enrolled 12 female patients with SSc and a Cochin Hand Function Scale score higher than 20/90. Patients receiving vasodilator or immunosuppressive therapy in the 3 months before or 6 months after enrollment were excluded from the study. Patients were administered subcutaneous injections of autologous SVF into each finger of both hands and were evaluated over the course of a 6-month period.


Prediction of pulmonary complications and long-term survival in systemic sclerosis.

Author: Nihtyanova SI, Schreiber BE, Ong VH, Rosenberg D, et al
Date Published: June-2014
Source: Arthritis & Rheumatology

Abstract - OBJECTIVE: To assess survival and incidence of organ-based complications in a large single-center cohort of unselected systemic sclerosis (SSc) patients, and to explore predictors of survival and clinically significant pulmonary fibrosis (PF) and pulmonary hypertension (PH). METHODS: The study cohort consisted of 398 consecutive SSc patients, followed up for up to 15 years. Cox proportional hazards analysis with demographic, clinical, and laboratory characteristics as predictor variables was used to develop prediction models for pulmonary complications and survival.


Pharmacologic Therapy for Pulmonary Arterial Hypertension in Adults: CHEST Guideline and Expert Panel Report

Author: D. Taichman, MD, PhD, FCCP; J. Ornelas, MS; L., MD; J. Klinger, MD, FCCP; et al
Date Published: August-2014
Source: Chest

OBJECTIVE: Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS: This guideline was based on systematic reviews of English language evidence published between 1990 and November 2013, identified using the MEDLINE and Cochrane Library databases. The strength of available evidence was graded using the Grades of Recommendations, Assessment, Development, and Evaluation methodology. Guideline recommendations, or consensus statements when available evidence was insufficient to support recommendations, were developed using a modified Delphi technique to achieve consensus.

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