Scleroderma Medical News: September 2007

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September 2007

Clinical trials in systemic sclerosis: lessons learned and outcomes. Advances have been made in the treatment of SSc but are hampered by its complex nature and disease heterogeneity. Most nonspecific antifibrotic compounds have exhibited few clinical benefits, although more targeted therapies that address SSc-specific abnormalities are showing some promise. Arthritis Research & Therapy 2007, 9(Suppl 2):S7. (Also see: Clinical Trials )

Therapeutic targets in systemic sclerosis. Substantial advances have been made in elucidating the pathogenesis of SSc, which has been facilitated in part by the development of more appropriate animal models. Targeting of several putative mediators is now feasible. Arthritis Research & Therapy 2007, 9(Suppl 2):S6. (Also see: Scleroderma Treatments and Clinical Trials )

Systemic sclerosis and related connective tissue diseases: present and future. Although considerable progress has been made in recent years, we have a long way to go. Early diagnosis and treatment with effective therapies are key to providing patients with the best possible long-term outcomes. Arthritis Research & Therapy 2007, 9(Suppl 2):S1. (Also see: Scleroderma Treatments and Connective Tissue Disease )

How does endothelial cell injury start? The role of endothelin in systemic sclerosis. This article reviews the role of endothelin as an example of a pleiotropic mediator with effects on various aspects of SSc pathogenesis, such as inflammation, vasculopathy and tissue remodelling. Arthritis Research & Therapy 2007, 9(Suppl 2):S2. (Also see: Causes of Scleroderma: Endothelin )

Reconstructive Hand Surgery for Scleroderma Joint Contractures. The most common surgical procedures have been digital sympathectomy, arthrodesis or arthroplasty of the proximal interphalangeal or both, and metacarpophalangeal joints. The Journal of Hand Surgery Volume 32, Issue 7, September 2007, Pages 1107-1112. (Also see: Joint Contractures )

Therapy-resistant inflammatory glaucoma responds to transscleral red laser cyclophotocoagulation. More than one treatment was needed in 52% of eyes, but no cases of hypotony, phthisis bulbi or other complications occurred. OSN Supersite. 09/04/07. (Also see: Eye Involvement )

Determinants of Reduced Walking Speed in People with Musculoskeletal Pain. Comorbidities, age, female sex, and lower socioeconomic position determine walking speed in people with joint pain. Issues such as poor vision and social-economic disadvantage may add to the effect of musculoskeletal disease, suggesting the need for a holistic approach to management of these patients. J Rheumatol 2007;34:1905-12. (Also see: Skeletal Involvement )

Probiotics for Preventing and Treating Nosocomial Infections. Probiotics can prevent episodes of antibiotic-associated diarrhea, but their utility in treating and preventing Clostridium difficile-associated diarrhea requires demonstration of benefit in multicenter clinical trials, preferably sponsored by the National Institutes. Chest. 2007; 132:286-294. (Also see: GI involvement and Alternative Therapies )

Generalized Linear Scleroderma in Childhood. A 6 year-old girl presented with linear hyperpigmented, indurated plaques on the upper and lower extremities of 9 months duration The onset followed a febrile illness that was diagnosed as typhoid. Dermatology Online Journal 13 (3): 34. 2007. (Also see: Juvenile Scleroderma and Linear Scleroderma )

Exhaled Nitric Oxide (NO) Levels in Systemic Sclerosis (SSc) With and Without Pulmonary Involvement. Our results indicate that exhaled air NO concentrations are lower in SSc patients with lung involvement than in those without, and that SSc patients without ILD or PH have higher exhaled NO values than healthy subjects. Chest. 2007; 132:575-580. (Also see: Pulmonary Involvement )

Comparison of Survival Among Patients With Connective Tissue Disease and Cardiomyopathy (Systemic Sclerosis, Systemic Lupus Erythematosus, and Undifferentiated Disease-UCTD). The diagnosis of cardiomyopathy and either undifferentiated CTD or systemic sclerosis appears to be a poor prognostic indicator compared with the diagnosis of idiopathic dilated cardiomyopathy (DCM). Patients with systemic lupus erythematosus and cardiomyopathy have a similar prognosis to those with idiopathic DCM. Finally, the presence of myocarditis does not alter the survival of patients with CTD and cardiomyopathy. (Sciene Direct) The American Journal of Cardiology Volume 100, Issue 3, 1 August 2007, Pages 513-517. (Also see: UCTD, Lupus, and Cardiac Involvement )