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Binary options ultimatum systemic sclerosis

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Select yes, and let the download start. Install the game. Fois E. Dzeing-Ella A. Impact of systemic sclerosis on occupational and professional activity with attention to patients with digital ulcers. Arthritis Care Res Hoboken Hunsche E. Krieg T. Schwierin B. Rosenberg D. Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry.

Clin Exp Rheumatol 31 Suppl PubMed 8 Rannou F. Poiraudeau S. Berezneacute A. Baubet T. Le-Guern V. Cabane J. Arthritis Rheum Mestre-Stanislas C. Beacuterezneacute A. Rannou F. Guilpain P. Revel M. Impact of digital ulcers on disability and health-related quality of life in systemic sclerosis. Vail A. Wragg E. Taylor A. Moore T. Murray A. A prospective study of systemic sclerosis-related digital ulcers: prevalence, location, and functional impact. Scand J Rheumatol Carpentier PH.

Lok C. Gressin V. Hachulla E. Ischemic digital ulcers affect hand disability and pain in systemic sclerosis. Steen V. Nash P. The complexity of managing systemic sclerosis: screening and diagnosis. PubMed 13 Kowal-Bielecka O.

Landeweacute R. Avouac J. Chwiesko S. Miniati I. Czirjak L. Medsger TA Jr. Criteria for the classification of early systemic sclerosis. Fransen J. Walker UA. Riccieri V. Muller C. Khanna D. Johnson SR. Baron M. Manfredi A. Vukatana G. Moscatelli S.

Riato L. Bocci M. Predictive role of capillaroscopic skin ulcer risk index in systemic sclerosis: a multicentre validation study. Colaci M. DAmico R. Malagoli V. Giuggioli D. Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. Pizzorni C. Decuman S. Deschepper E. Bonroy C. Nailfold capillaroscopy for prediction of novel future severe organ involvement in systemic sclerosis.

Piette Y. Do worsening scleroderma capillaroscopic patterns predict future severe organ involvement A pilot study. De Keyser F. Van Praet JT. Decumnan S. Nailfold capillaroscopy for day-to-day clinical use: construction of a simple scoring modality as a clinical prognostic index for digital trophic lesions.

Herrick AL. Further confirmation that digital ulcers are associated with the severity of abnormality on nailfold capillaroscopy in patients with systemic sclerosis. Rheumatology Oxford Sebastiani M. Carraro V. Iudici M. Prediction risk chart for scleroderma digital ulcers: a composite predictive model based on capillaroscopic, demographic and clinico-serological parameters.

Clin Hemorheol Microcirc Hollaender R. Scott M. An observational cohort study of patients with newly diagnosed digital ulcer disease secondary to systemic sclerosis registered in the EUSTAR database. Clin Exp Rheumatol 33 Suppl S47 ndash Riemekasten G. Becker M. Moinzadeh P. Kreuter A. Melchers I. The Predict Study: Low risk for digital ulcer development in systemic sclerosis patients with increasing disease duration and lack of topoisomerase-1 antibodies.

Br J Dermatol Preliminary criteria for the classification of systemic sclerosis scleroderma. Secchi ME. Cutolo M. Scoring the nailfold microvascular changes during the capillaroscopic analysis in systemic sclerosis patients. Reliability of the qualitative and semiquantitative nailfold videocapillaroscopy assessment in a systemic sclerosis cohort: a two-centre study. Accardo S. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis.

Lee KL. Califf RM. Pryor DB. Rosati RA. Regression modelling strategies for improved prognostic prediction. Stat Med 3. Harrell F. Statistical models for prognostication. Bethesda MD. National Institutes of Health Mayes M. Matucci Cerinic M. Rainisio M. Pope J.

Digital ulcers in systemic sclerosis: prevention by treatment with bosentan, an oral endothelin receptor antagonist. Sauerbrei W. Influence of model-building strategies on the results of a case-control study. Stat Med Gruumlnig E. Bonderman D. Distler O. Tibshirani RJ. An introduction to the bootstrap.

Boca Raton FL. CRC Press CrossRef 36 Ingegnoli F. Ardoino I. Boracchi P. Airograve P. Ananieva LP. Et ai. Microvasc Res Lo Monaco A. Praino E. Grattagliano V. PubMed 38 Mihai C. Constantin PI. Gherge AM.

Digital ulcers predict a worse disease course in patients with systemic sclerosis. Therapeutic options for digital ulcers in patients with systemic sclerosis. J Dtsch Dermatol Ges 5. Shu J. Smuczek J. Meta-analysis of healing and prevention of digital ulcers in systemic sclerosis.

Capillaroscopy as an outcome measure for clinical trials on the peripheral vasculopathy in SScmdashis it useful Int J Rheumatol PubMed 42 Hofstee HM. Vonk NA. Voskuyl AE. Dijkmans BA. Postmus PE. Smulders YM. Nailfold capillary density is associated with the presence and severity of pulmonary arterial hypertension in systemic sclerosis.

Joyal F. Fritzler MJ. Roussin A. Abrahamowicz M. Boire G. Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynauds phenomenon to systemic sclerosis: a twenty-year prospective study of patients, with validation of proposed criteria for early systemic sclerosis.

Vasile M. Iannace N. Stefanantoni K. Sciarra I. Vizza CD. Systemic sclerosis patients with and without pulmonary arterial hypertension: a nailfold capillaroscopy study. Sekiyama JY. Proacutespero LC. Camargo CZ. Andrade LE. Nailfold capillaroscopy abnormalities as predictors of mortality in patients with systemic sclerosis.

PubMed 46 Ingegnoli F. Gualtierotti R. Biganzoli EM. Zeni S. Lubatti C. Improving outcome prediction of systemic sclerosis from isolated Raynauds phenomenon: role of autoantibodies and nail-fold capillaroscopy. Canestrini S. Martinelli N. Volpe A. Pieropan S. Ferrari M. Scleroderma patients nailfold videocapillaroscopic patterns are associated with disease subset and disease severity.

Teixeira A. Oliveira J. Almeida I. Almeida R. Aacuteguas A. Endothelial dysfunction and nailfold videocapillaroscopy pattern as predictors of digital ulcers in systemic sclerosis: a cohort study and review of the literature.

Clin Rev Allergy Immunol Ruaro B. Ravera F. Zampogna G. Longterm treatment with endothelin receptor antagonist bosentan and iloprost improves fingertip blood perfusion in systemic sclerosis. Vremis L. Longterm effects of endothelin receptor antagonism on microvascular damage evaluated by nailfold capillaroscopic analysis in systemic sclerosis.

Guillevin L. Cornelisse P. Elucidating the burden of recurrent and chronic digital ulcers in systemic sclerosis: long-term results from the DUO Registry. E-pub ahead of print. Allen PD. Hillier V. Taylor CJ. Computerized nailfold video capillaroscopymdasha new tool for assessment of Raynauds phenomenon.

Clinical implications from capillaroscopic analysis in patients with Raynauds phenomenon and systemic sclerosis review. OLeary N. Tracey A. Ennis H. Dinsdale G. A study comparing videocapillaroscopy and dermoscopy in the assessment of nailfold capillaries in patients with systemic sclerosis-spectrum disorders. Training in capillaroscopy: a growing interest.

Akdogan A. Atakan N. Nailfold capillaroscopy in systemic sclerosis: is there any difference between videocapillaroscopy and dermatoscopy Skin Res Technol Masetto A. Steele R. Arthurs E. Reliability of widefield capillary microscopy to measure nailfold capillary density in systemic sclerosis.

Clin Exp Rheumatol 28 Suppl S36 ndash Chung L. Gyger G. Hummers L. Mayes MD. Consensus opinion of a North American Working Group regarding the classification of digital ulcers in systemic sclerosis. Clin Rheumatol Roberts C. Silman A. Anderson M. Goodfield M. Lack of agreement between rheumatologists in defining digital ulceration in systemic sclerosis. Vasconcelos C. Predictive value of vascular disease biomarkers for digital ulcers in systemic sclerosis patients.

S ndash Xiao Y. Siemiatycki J. Modelling smoking history using a comprehensive smoking index: application to lung cancer. Leiden University Medical Center. The Netherlands 2 Haga Hospital. The Hague. The Netherlands 3 Department of Cardiology. The Netherlands 4 Department of Medical Statistics. The Netherlands 5 Department of Pulmonology. Meijs lumc. Methods Baseline characteristics and 1 year follow-up results of patients with SSc referred to a multidisciplinary healthcare programme were evaluated.

Progressive disease was defined as: death, 10 decrease in forced vital capacity, 15 decrease in diffusing capacity for carbon monoxide, 10 decrease in body weight, 30 decrease in estimated-glomerular filtration rate, 30 increase in modified Rodnan Skin Score with 5 or 0. The number of patients with progressive disease was determined. Univariable and multivariable logistic regression analyses were used to assess the probability of progressive disease for each individual patient.

Performance of the prediction model was evaluated using a calibration plot and area under the receiver operating characteristic curve. Results 63 patients had progressive disease, including 8 patients who died 18 months after first evaluation. Multivariable analysis showed that friction rubs, proximal muscular weakness and decreased maximum oxygen uptake as predicted, adjusted for age, gender and use of immunosuppressive therapy at baseline, were significantly associated with progressive disease.

Using the prediction model, the predicted chance for progressive disease increased from a pretest chance of 37 to Conclusions Using the prediction model, the chance for progressive disease for individual patients could be doubled. Friction rubs, proximal muscular weakness and maximum oxygen uptake as predicted were identified as relevant parameters.

Few studies have described algorithms on an individualised basis to predict mortality after 2 to 15 years of follow-up in systemic sclerosis SSc. What does this study add A prediction model assessing the chance for progressive disease for individual patients at short term was currently developed. How might this impact on clinical practice Using the prediction model, the predicted chance for progressive disease could be doubled from a pretest chance of 37 to Introduction Individualised management and treatment is one of the most important challenges in medicine.

Systemic sclerosis SSc is a rare multisystem disease which is highly heterogeneous in presentation and disease course. Recent evidence suggests that earlier initiation of adequate treatment based on regular screening for organ involvement contributes to improved survival. Given the associated treatment-related mortality during the first year, this treatment option underlines the need to identify patients with a high risk of severe organ involvement in the short term.

Numerous attempts have been made to identify predictors for severe organ involvement and mortality in SSc. In contrast, a recently published study containing observational data from the EUSTAR database described a model identifying, among patients with diffuse cutaneous SSc, those with a 44 chance of skin fibrosis progression during the first year, as compared to 9.

Whether it is possible to reliably identify patients at risk using such a model, given the heterogeneous nature of SSc, remains to be determined. The present study aimed to develop a model that predicts progressive disease in the short term, defined by either deterioration of organ functions, or mortality, in patients with SSc. The derived prediction model is evaluated for discriminative performance, and a cut-off value is determined in order to evaluate utility in clinical practice.

Patients and methods Study design This study is performed using data from a prospective cohort study in patients with SSc who participated in an annual 2-day multidisciplinary healthcare programme aiming to structure screening for organ involvement and to provide multidisciplinary care for patients with SSc. All participants gave written informed consent. Patients Data from all patients referred to the multidisciplinary healthcare programme between April and January were collected.

Patients were classified on the basis of their maximum skin score ever. For example, if a patient had had a skin score of 30 and underwent HSCT after which the skin score decreased to 6, the patient was still classified as DcSSc. For the current analysis, selected patients had to have participated in the care programme at least twice, with the second visit 1 year after the baseline visit range months. Multidisciplinary healthcare programme All patients participated in the healthcare programme that combines annual extensive organ screening with multidisciplinary team care.

Cardiopulmonary investigations included: high-resolution CT HRCT of the thorax, pulmonary function tests including analyses of forced vital capacity FVC and diffusing capacity for carbon monoxide DLCO , cardiopulmonary exercise test CPET including analyses of maximum heart rate, maximum wattage, maximum oxygen consumption VO2 and maximum ventilation , echocardiography and 24 h Holter electrocardiography ECG.

Furthermore, laboratory investigations including measurement of autoantibodies and nailfold videocapillaroscopy were performed. Diagnosis of interstitial lung disease ILD was determined on the basis of the presence of a non-specific interstitial pneumonia pattern or usual interstitial pneumonia pattern on the HRCT-thorax,21 as reported by the radiologist.

The systolic pulmonary artery pressure SPAP was estimated using echocardiography by an experienced cardiologist and elevated pulmonary pressure is defined using a cut-off value of 35 mm Hg. Furthermore, the presence of pericardial effusion was noted. The presence of arrhythmias was defined as the presence of multiform ventricular extrasystole gt per day, couplets or runs of ventricular tachycardia or supraventricular tachycardia of at least 30 s on 24 h Holter ECG monitoring.

Rituximab is given as part of a randomised placebo-controlled clinical trial RITIS , registered at www. Progressive disease Since we aimed to define risk for progressive disease in general, in order to guide clinical management, several variables were chosen, each reflecting a different organ system.

Cut-offs for these variables were based on reported values for minimal important difference MID. Selected variables were: 1 death before the second visit 2 decrease of 10 in FVC percentage of predicted 16 3 decrease of 15 in DLCO percentage of predicted 16 4 decrease of 10 in body weight24 5 decrease of 30 in estimated-glomerular filtration rate eGFR 25 6 increase of 30 in modified Rodnan Skin Score mRSS with a minimum of Statistical analysis Associations between baseline variables and the presence of progressive disease were evaluated and expressed as ORs with the 95 CIs and p values.

Missing values of variables used to define overall progressive disease and baseline predictors were replaced by multiple imputation using multiple regression modelling by the multiple imputations by chained equations procedure as implemented in SPSS. Therefore, VO2 max was not imputed and the missing-indicator method was used. Univariable logistic regression analysis was used to determine the independent association between baseline characteristics and overall progressive disease after 1 year of follow-up.

Possible correlations between all variables which were significantly contributing in the univariable logistic regression analyses were checked for multicollinearity using a variance inflation factor VIF of For the multivariable model, all predictor variables with a p value smaller than 0. Univariable and multivariable logistic regression analyses were always adjusted for previous and current immunosuppressive therapy including cyclophosphamide, methotrexate and HSCT at baseline.

Multivariable logistic regression analysis was adjusted for age and gender. The predicted probability of progressive disease was calculated for every patient. The predicted probabilities were compared with the observed percentage of patients with progressive disease. The positive predictive value PPV and negative predictive value NPV were determined for several cut-off values of the predicted probability.

The predictive performance of the model was assessed by examining measures of calibration and discrimination. Calibration refers to how close predicted progressive disease agrees with observed progressive disease and was assessed with a calibration plot.

For internal validation, a bootstrap procedure was performed for control for overfitting. Results Patient population By January , patients with SSc had had a second evaluation after a mean period of Eight patients died before the second visit could have been performed. Baseline characteristics of the included patients are presented in table 1. The patients were mostly women 80 , Caucasian 70 and, on average, 53 years SD Patients had a median disease duration of 2 years.

Baseline characteristics of the systemic sclerosis population with a baseline visit and 1 year follow-up At baseline, 63 39 patients were treated with immunosuppressive medication, including 55 32 patients who were previously treated with one or more immunosuppressive medications including autologous HSCT n13 , cyclophosphamide n18 , corticosteroids n28 , methotrexate MTX n28 and AZA n2 , HCQ n2 and 60 35 patients currently being treated with immunosuppressive medication, including mycophenolate mofetil MMF n6 , corticosteroids n24 , MTX n22 , AZA n5 and HCQ n7.

Change of treatment On the basis of the findings during the multidisciplinary healthcare programme, new immunosuppressive treatment one or more medications was started at baseline in 37 patients In none of the patients with previous HSCT was new immunosuppressive medication started.

Mortality Within 1 year after the first visit, eight patients mean age Three patients died due to ILD, one due to PAH, one due to adenocarcinoma of the lung in a non-smoker , one due to cardiac failure and one due to cytomegalovirus pneumonitis after allogeneic SCT. In one patient died at age 87 years after suffering from renal disease , the exact cause of death could not be determined.

All patients were classified as those with progressive disease, since for none of the patients could an association between SSc and death be ruled out with absolute certainty. Progressive disease Sixty-three patients showed overall progressive disease at follow-up evaluation according to the predefined criteria, including eight patients who died table 2. Incidence of progressive disease in SSc according to SSc subtype Progressive disease, N The organ systems and number of prespecified outcomes contributing to overall progressive disease are demonstrated in online supplementary figure 1.

The majority of the patients 71 had overall progressive disease based on one event, while in 13 of the patients two events and in 3 of the patients three events contributed to overall progressive disease. Missing values Age, gender, disease subset, SSc-related autoantibodies, friction rubs, proximal muscular weakness, eGFR, ESR and body weight were available for all patients. CPET was not performed in 11 patients due to an inability to cycle based on bad physical performance N4 and musculoskeletal disability N2.

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Reaction - The Official Website. Thread Deposit Binary Options Brokers. Because the no DU history subgroup was considered exploratory, it was not possible to identify variables that predicted DUs because of the small number of cases in this subgroup. We had anticipated at least 20 of cases, based on the report that 50 of patients with SSc experience DUs 1 and the fact that the first DU usually occurs early in the disease course 3 however, we observed only 4.

This may have 2 explanations. First, the SSc population may have changed in the last few years: patients with SSc may be diagnosed earlier than in the past, and preventive and efficient measures are now more widely used. Second, it might have been beneficial to restrict patients in the no DU history group to those with a first nonndashRaynauds phenomenon symptom within 1 year instead of 2 years in order to be closer to the population described by Hachulla et al 3 , in which 43 of patients had their first DU within 1 year of their first clinical sign of SSc.

NVC has the potential to be a useful tool for monitoring the progression of microvascular disease associated with SSc and for measuring the response to treatment 52, It is a well-established, noninvasive technique that allows for higher-magnification analysis compared with the older widefield capillaroscopic method 53, The training needed for the device is minimal sim5 days 55 and the required examination time is short sim10 minutes including image recording.

An NVC apparatus is more costly than handheld devices such as dermatoscopes, but NVC has been shown to permit more-detailed assessments 56 and the grading of more images During patient follow-up, detailed assessment and quantification of abnormalities is important, and therefore, handheld tools may not be as useful in this setting Overall, there are several key strengths of this study. First is its generalizability, ensured by the broad distribution of participating centers and patients representing current standard of care.

Second is its applicability in real-world clinical practice, owing to the broad study population, the simplicity and ease of clinical evaluation of the NVC, and the clinical risk factors that built the final model.

Third is its value in the management of patients with a history or presence of DUs. The scope of the CAP study was to determine risk factors for developing DUs by using NVC and other clinical characteristics in routine clinical practice and health care environments, including centers with different levels of NVC experience.

Thus, the ldquocenterrdquo was not regarded as a potential risk factor, which could allow generalizability of the study findings for patients with SSc outside of the study centers. The interrater variability of NVC assessments has been of concern, and the capillary density has been identified as the NVC variable with the best interrater agreement in earlier, smaller studies 28, In the CAP study, interrater variability was addressed by practical training and teaching booklets that were offered to the investigators.

Despite these efforts, the ambitious intention to allow extrapolation to the real-world setting may have introduced a large amount of noise that was detrimental to obtaining a final model with high discriminatory ability. Investigators were not blinded to the NVC and other clinical characteristics assessed at enrollment and may therefore have been biased in favor of a diagnosis of a new DU.

However, this was inherent to the real-world nature of the study, as physicians in clinical practice are not blinded to the results of other assessments. Although the wide geographic spread of centers permits generalizability, it was conducive to introducing heterogeneity in the data. The center effect could not be explored in depth because of the wide distribution of patients across a large number of centers, with a small number of cases per center.

Although it was estimated that cases would be a reasonable number for exploring risk factor associations with the development of DUs, only cases were observed in this cohort and, as such, the study was underpowered. Nevertheless, the modeling strategy ULR, MLR within-bundle, MLR across-bundles analyses , together with the reduction in the number of variables entered into the model and the bootstrap validation demonstrated the robustness of the variables in the final model, thereby compensating for the lower-than-prespecified number of cases.

Laboratory biomarkers were not included in this study, which could have helped to improve the discriminatory ability of the final model. Biomarkers have previously been shown to be useful for predicting DUs 60 and may be useful to include in future studies.

Given the nature of this real-world observational study, it was not feasible to determine the presence of an association between medication use and development of DUs. Future larger studies could be designed to explore this association by controlling for confounding factors such as DU disease severity and the use of medications individually and in combination in different countries.

The risk factors identified are simple to evaluate in the clinic, and the real-world nature of the study allows the results to be generalized to a wider SSc population, thereby providing the physician with useful information when considering a patients risk of future DUs.

We also thank Harald Heinzl CeMSIIS, Medical University of Vienna, Vienna, Austria for statistical consultation and assistance with the bootstrap analysis, as well as the wider group of statisticians for their contributions see Supplementary Materials, available on the Arthritis amp Rheumatology web site at onlinelibrary.

Cutolo and Smith had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Actelion Pharmaceuticals also paid for editorial assistance provided by Drs. The steering committee members, all of whom are authors of this article, and the 4 authors employed by Actelion Pharmaceuticals were involved in the decision to submit the article for publication.

Publication of this article was not contingent upon approval by Actelion Pharmaceuticals. Arthritis amp Rheumatology published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Publication History Issue online: 28 September Version of record online: 28 September Accepted manuscript online: 25 April Manuscript Accepted: 7 April Manuscript Received: 27 November Supporting Information Additional Supporting Information may be found in the online version of this article.

Supplementary Table S1. Bundle 1: Demographics Supplementary Table S2. Bundle 2: Systemic sclerosis clinical characteristics Supplementary Table S3. Bundle 3: Digital ulcer characteristics Supplementary Table S4. Bundle 4: Other clinical characteristics Supplementary Table S5. Bundle 5: Nailfold videocapillaroscopic characteristics: quantitative assessment 6 sub-bundles Supplementary Table S6.

Nailfold videocapillaroscopic characteristics: qualitative assessment 1 covariable Supplementary Table S7. Coding of the location of digital ulcers Please note: Wiley-Blackwell is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries other than missing content should be directed to the corresponding author for the article. Tyndall A. Czirjaacutek L. Denton C. Farge-Bancel D.

Kowal-Bielecka O. Ann Rheum Dis Denton CP. Pope JE. Matucci-Cerinic M. Digital ulcers: overt vascular disease in systemic sclerosis. Rheumatology Oxford 48 Suppl 3. PubMed 3 Hachulla E. Clerson P. Launay D. Lambert M. Morell-Dubois S. Queyrel V. Natural history of ischemic digital ulcers in systemic sclerosis: single-center retrospective longitudinal study.

J Rheumatol Brough GM. Black CM. Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis. Sulli A. Smith V. Assessing microvascular changes in systemic sclerosis diagnosis and management.

Nat Rev Rheumatol 6. Seror R. Fois E. Dzeing-Ella A. Impact of systemic sclerosis on occupational and professional activity with attention to patients with digital ulcers. Arthritis Care Res Hoboken Hunsche E. Krieg T. Schwierin B. Rosenberg D. Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry.

Clin Exp Rheumatol 31 Suppl PubMed 8 Rannou F. Poiraudeau S. Berezneacute A. Baubet T. Le-Guern V. Cabane J. Arthritis Rheum Mestre-Stanislas C. Beacuterezneacute A. Rannou F. Guilpain P. Revel M. Impact of digital ulcers on disability and health-related quality of life in systemic sclerosis.

Vail A. Wragg E. Taylor A. Moore T. Murray A. A prospective study of systemic sclerosis-related digital ulcers: prevalence, location, and functional impact. Scand J Rheumatol Carpentier PH. Lok C. Gressin V. Hachulla E. Ischemic digital ulcers affect hand disability and pain in systemic sclerosis. Steen V. Nash P. The complexity of managing systemic sclerosis: screening and diagnosis. PubMed 13 Kowal-Bielecka O. Landeweacute R. Avouac J. Chwiesko S.

Miniati I. Czirjak L. Medsger TA Jr. Criteria for the classification of early systemic sclerosis. Fransen J. Walker UA. Riccieri V. Muller C. Khanna D. Johnson SR. Baron M. Manfredi A. Vukatana G. Moscatelli S. Riato L. Bocci M. Predictive role of capillaroscopic skin ulcer risk index in systemic sclerosis: a multicentre validation study. Colaci M.

DAmico R. Malagoli V. Giuggioli D. Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. Pizzorni C. Decuman S. Deschepper E. Bonroy C. Nailfold capillaroscopy for prediction of novel future severe organ involvement in systemic sclerosis.

Piette Y. Do worsening scleroderma capillaroscopic patterns predict future severe organ involvement A pilot study. De Keyser F. Van Praet JT. Decumnan S. Nailfold capillaroscopy for day-to-day clinical use: construction of a simple scoring modality as a clinical prognostic index for digital trophic lesions.

Herrick AL. Further confirmation that digital ulcers are associated with the severity of abnormality on nailfold capillaroscopy in patients with systemic sclerosis. Rheumatology Oxford Sebastiani M. Carraro V. Iudici M. Prediction risk chart for scleroderma digital ulcers: a composite predictive model based on capillaroscopic, demographic and clinico-serological parameters.

Clin Hemorheol Microcirc Hollaender R. Scott M. An observational cohort study of patients with newly diagnosed digital ulcer disease secondary to systemic sclerosis registered in the EUSTAR database. Clin Exp Rheumatol 33 Suppl S47 ndash Riemekasten G. Becker M. Moinzadeh P. Kreuter A. Melchers I. The Predict Study: Low risk for digital ulcer development in systemic sclerosis patients with increasing disease duration and lack of topoisomerase-1 antibodies. Br J Dermatol Preliminary criteria for the classification of systemic sclerosis scleroderma.

Secchi ME. Cutolo M. Scoring the nailfold microvascular changes during the capillaroscopic analysis in systemic sclerosis patients. Reliability of the qualitative and semiquantitative nailfold videocapillaroscopy assessment in a systemic sclerosis cohort: a two-centre study.

Accardo S. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. Lee KL. Califf RM. Pryor DB. Rosati RA. Regression modelling strategies for improved prognostic prediction. Stat Med 3. Harrell F. Statistical models for prognostication. Bethesda MD. National Institutes of Health Mayes M.

Matucci Cerinic M. Rainisio M. Pope J. Digital ulcers in systemic sclerosis: prevention by treatment with bosentan, an oral endothelin receptor antagonist. Sauerbrei W. Influence of model-building strategies on the results of a case-control study. Stat Med Gruumlnig E. Bonderman D. Distler O. Tibshirani RJ. An introduction to the bootstrap. Boca Raton FL. CRC Press CrossRef 36 Ingegnoli F.

Ardoino I. Boracchi P. Airograve P. Ananieva LP. Et ai. Microvasc Res Lo Monaco A. Praino E. Grattagliano V. PubMed 38 Mihai C. Constantin PI. Gherge AM. Digital ulcers predict a worse disease course in patients with systemic sclerosis. Therapeutic options for digital ulcers in patients with systemic sclerosis.

J Dtsch Dermatol Ges 5. Shu J. Smuczek J. Meta-analysis of healing and prevention of digital ulcers in systemic sclerosis. Capillaroscopy as an outcome measure for clinical trials on the peripheral vasculopathy in SScmdashis it useful Int J Rheumatol PubMed 42 Hofstee HM. Vonk NA. Voskuyl AE. Dijkmans BA. Postmus PE. Smulders YM. Nailfold capillary density is associated with the presence and severity of pulmonary arterial hypertension in systemic sclerosis. Joyal F. Fritzler MJ. Roussin A.

Abrahamowicz M. Boire G. Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynauds phenomenon to systemic sclerosis: a twenty-year prospective study of patients, with validation of proposed criteria for early systemic sclerosis. Vasile M.

Iannace N. Stefanantoni K. Sciarra I. Vizza CD. Systemic sclerosis patients with and without pulmonary arterial hypertension: a nailfold capillaroscopy study. Sekiyama JY. Proacutespero LC. Camargo CZ. Andrade LE. Nailfold capillaroscopy abnormalities as predictors of mortality in patients with systemic sclerosis.

PubMed 46 Ingegnoli F. Gualtierotti R. Biganzoli EM. Zeni S. Lubatti C. Improving outcome prediction of systemic sclerosis from isolated Raynauds phenomenon: role of autoantibodies and nail-fold capillaroscopy. Canestrini S. Martinelli N. Volpe A. Pieropan S. Ferrari M. Scleroderma patients nailfold videocapillaroscopic patterns are associated with disease subset and disease severity. Teixeira A. Oliveira J. Almeida I. Almeida R. Aacuteguas A. Endothelial dysfunction and nailfold videocapillaroscopy pattern as predictors of digital ulcers in systemic sclerosis: a cohort study and review of the literature.

Clin Rev Allergy Immunol Ruaro B. Ravera F. Zampogna G. Longterm treatment with endothelin receptor antagonist bosentan and iloprost improves fingertip blood perfusion in systemic sclerosis. Vremis L. Longterm effects of endothelin receptor antagonism on microvascular damage evaluated by nailfold capillaroscopic analysis in systemic sclerosis. Guillevin L. Cornelisse P. Elucidating the burden of recurrent and chronic digital ulcers in systemic sclerosis: long-term results from the DUO Registry.

E-pub ahead of print. Allen PD. Hillier V. Taylor CJ. Computerized nailfold video capillaroscopymdasha new tool for assessment of Raynauds phenomenon. Clinical implications from capillaroscopic analysis in patients with Raynauds phenomenon and systemic sclerosis review. OLeary N. Tracey A. Ennis H. Dinsdale G. A study comparing videocapillaroscopy and dermoscopy in the assessment of nailfold capillaries in patients with systemic sclerosis-spectrum disorders.

Training in capillaroscopy: a growing interest. Akdogan A. Atakan N. Nailfold capillaroscopy in systemic sclerosis: is there any difference between videocapillaroscopy and dermatoscopy Skin Res Technol Masetto A. Steele R. Arthurs E. Reliability of widefield capillary microscopy to measure nailfold capillary density in systemic sclerosis.

Clin Exp Rheumatol 28 Suppl S36 ndash Chung L. Gyger G. Hummers L. Mayes MD. Consensus opinion of a North American Working Group regarding the classification of digital ulcers in systemic sclerosis. Clin Rheumatol Roberts C. Silman A. Anderson M. Goodfield M. Lack of agreement between rheumatologists in defining digital ulceration in systemic sclerosis. Vasconcelos C. Predictive value of vascular disease biomarkers for digital ulcers in systemic sclerosis patients.

S ndash Xiao Y. Siemiatycki J. Modelling smoking history using a comprehensive smoking index: application to lung cancer. Leiden University Medical Center. The Netherlands 2 Haga Hospital. The Hague.

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