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A Thompson

Publications and source records attributed to A Thompson.

At least 37 records · Page 2Linked to original sources
PubMed2000

Iloprost and cisaprost for Raynaud's phenomenon in progressive systemic sclerosis.

OBJECTIVES: To assess the effects and toxicity of the following agents:Prostaglandin analogues together with other agents proposed for the treatment of Raynaud's phenomenom (RP) in scleroderma. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, and Medline up to 1996 using the Cochrane Collaboration search strategy developed by Dickersin et al.(1994). Key words included: raynaud's or vasospasm, scleroderma or progressive systemic sclerosis or connective tissue disease or autoimmune disease. Current Contents were searched up to and including April 7, 1997. All bibliographies of articles retrieved were searched and key experts in the area were contacted for additional and unpublished data. The initial search strategy included all languages. SELECTION CRITERIA: All randomized controlled trials comparing prostaglandin analogues versus placebo were eligible if they reported clinical outcomes within the start of therapy, and if the dropout rate was less than 35%. DATA COLLECTION AND ANALYSIS: Data were abstracted independently by two reviewers (DF, AT). Peto's odds ratios were calculated for all dichotomous outcomes and a weighted mean difference was calculated for all continuous outcomes. A fixed effects or random effects model was used if the data were homogeneous or heterogeneous, respectively. MAIN RESULTS: Seven randomized trials and 332 patients were included. Five of the seven trials were of parallel design. Five trials compared I.V. Iloprost and one trial studied p.o. Iloprost and another p.o. Cisaprost. Some trials were dose finding trials so various doses of Iloprost were used. Due to different efficacies of I.V. Iloprost, oral Iloprost and oral Cisaprost, the overall efficacy of these drugs was somewhat diluted. Intravenous Iloprost appears to be effective in the treatment of secondary Raynaud's phenomenon. REVIEWER'S CONCLUSIONS: Intravenous Iloprost is effective in the treatment of Raynaud's phenomenon secondary to scleroderma at decreasing the frequency and severity of attacks and preventing or healing digital ulcers. The effect seems to be prolonged after the intravenous infusion is given. Oral Iloprost may have less efficacy than intravenous Iloprost. However, Cisaprost has minimal or no efficacy when given orally for the treatment of Raynaud's phenomenon secondary to scleroderma.

Humans↗
PubMed2000

Ketanserin for Raynaud's phenomenon in progressive systemic sclerosis.

OBJECTIVES: To assess the effects and toxicity of the following agent: ketanserin versus placebo proposed for the treatment of Raynaud's phenomenon (RP) in scleroderma. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, and Medline up to 1996 using the Cochrane Collaboration search strategy developed by Dickersin et al.(1994). Key words included: Raynaud's or vasospasm, scleroderma or progressive systematic sclerosis or connective tissue disease or autoimmune disease. Current Contents were searched up to and including April 7, 1997. All bibliographies of articles retrieved were searched and key experts in the area were contacted for additional and unpublished data. The initial search strategy included all languages. SELECTION CRITERIA: All randomized controlled trials comparing ketanserin versus placebo were eligible if they reported clinical outcomes of interest. Trials with dropout rates greater than 35% were excluded. DATA COLLECTION AND ANALYSIS: Data were abstracted independently by two reviewers (DF, AT). Peto's odds ratios (OR) were calculated for all dichotomous outcomes, and a weighted mean difference (WMD) was carried out on all continuous outcomes. A fixed effects or random effects model were used if the data was homogeneous or heterogeneous, respectively. MAIN RESULTS: Three trials and 66 patients were included. The proportion improved was significantly better in the group on ketanserin with an odds ratio (OR) of 4.80 (95% CI 1.33, 17.37). However, when comparing ketanserin to placebo, the decrease in severity of RP attacks favoured placebo but this was not statistically significant. Side effects were significantly more common in the group using active treatment with an OR of 5.96 (95% CI 1.61, 22.06). Frequency of attacks did not change, but the duration of attacks decreased significantly in the ketanserin group. REVIEWER'S CONCLUSIONS: Ketanserin may have some efficacy in the treatment of Raynaud's phenomenon secondary to scleroderma. Overall, ketanserin is not significantly different from placebo for the treatment of Raynaud's phenomenon except for some decrease in the duration of attacks and more subjects improved on ketanserin compared to placebo. However, there were more side effects. It can be concluded that ketanserin treatment in Raynaud's phenomenon secondary to scleroderma is not clinically beneficial.

Humans↗
PubMed2000

Cyclofenil for Raynaud's phenomenon in progressive systemic sclerosis.

OBJECTIVES: To assess the effects and toxicity of Cyclofenil versus placebo for the treatment of Raynaud's phenomenon (RP) in scleroderma. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, and Medline up to 1996 using the Cochrane Collaboration search strategy developed by Dickersin et al.(1994). Key words included: Raynaud's or Vasospasm, Scleroderma or Progressive Systematic Sclerosis or Connective Tissue Disease or Autoimmune Disease. Current Contents were searched up to and including April 7, 1997. All bibliographies of articles retrieved were searched and key experts in the area were contacted for additional and unpublished data. The initial search strategy included all languages. SELECTION CRITERIA: All randomized trials comparing cyclofenil versus placebo were eligible if they reported any clinical outcomes within the trial. DATA COLLECTION AND ANALYSIS: Data were abstracted independently by two reviewers (DF, AT). Peto's odds ratio (OR) was calculated for all dichotomous outcomes, and a weighted mean difference was calculated for all continuous outcomes. A fixed effects or random effects model was used if the data were homogeneous or heterogeneous respectively. MAIN RESULTS: One trial with 38 patients was included. There was a trend for Cyclofenil to demonstrate more improvement and more dropouts compared to placebo, but there were no statistically significant differences. REVIEWER'S CONCLUSIONS: Cyclofenil is not effective in the treatment of Raynaud's phenomenon secondary to scleroderma.

Cyclofenil↗
PubMed2000

Prazosin for Raynaud's phenomenon in progressive systemic sclerosis.

OBJECTIVES: To determine the effects and toxicity of prazosin versus placebo proposed for the treatment of Raynaud's phenomenon (RP) in scleroderma. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, and Medline up to December 1996 using the Cochrane Collaboration search strategy developed by Dickersin et al.(1994). Key words included: Raynaud's or vasospasm, scleroderma or progressive systemic sclerosis or connective tissue disease or autoimmune disease. Current Contents were searched up to and including April 7, 1997. All bibliographies of articles retrieved were searched and key experts in the area were contacted for additional and unpublished data. The initial search strategy included all languages. SELECTION CRITERIA: Randomized controlled trials comparing prazosin versus placebo were eligible if they reported clinical outcomes from the start of therapy. Trials with a greater than 35% dropout were excluded. Trials were included if patients with diffuse or limited scleroderma were the subjects. If patients with other connective tissue diseases or primary Raynaud's were included, the trial was used if the data on the scleroderma patients could be extracted from the paper. DATA COLLECTION AND ANALYSIS: All data were abstracted by two independent and trained reviewers (DF, AT), and verified by a third reviewer (JP). Each trial was assessed independently by the same two reviewers for its quality using a validated quality assessment tool (Jadad 1996). Peto's odds ratios were calculated for all dichotomous outcomes and a weighted mean difference was carried out on all continuous outcomes. Fixed effects and random effects model were used if the data was homogeneous or heterogeneous, respectively. MAIN RESULTS: Two trials with a total of 40 patients were included. Prazosin has been found in two randomized controlled cross-over trials to be more effective than placebo in the treatment of Raynaud's secondary to scleroderma. However, the positive response is modest and side effects are not rare in those taking prazosin. REVIEWER'S CONCLUSIONS: Prazosin is modestly effective in the treatment of Raynaud's phenomenon secondary to scleroderma.

Adrenergic alpha-Antagonists↗
PubMed2000

Clinical improvement as reflected in measures of function and health-related quality of life following treatment with leflunomide compared with methotrexate in patients with rheumatoid arthritis: sensitivity and relative efficiency to detect a treatment effect in a twelve-month, placebo-controlled trial. Leflunomide Rheumatoid Arthritis Investigators Group.

OBJECTIVE: To examine correlations between clinical improvement as defined by the American College of Rheumatology (ACR) responder analysis and clinical improvement as determined by 4 function and/or health-related quality of life measures, and to estimate the sensitivity and relative efficiency of these measures compared with changes in the tender joint count in patients with rheumatoid arthritis (RA). METHODS: A 52-week, multicenter, double-blind controlled trial was conducted to compare treatment with leflunomide (n = 182), methotrexate (n = 180), or placebo (n = 118) in patients with active RA. ACR response rates and improvement in scores on the Health Assessment Questionnaire (HAQ), Problem Elicitation Technique (PET), and Medical Outcomes Survey Short Form 36 (SF-36) were compared in 438 of the patients. RESULTS: In comparing leflunomide with placebo, the patient global assessment, HAQ disability index, and SF-36 bodily pain scale were most responsive to treatment group differences. The modified HAQ (M-HAQ), PET Top 5, SF-36 physical component score, physician global assessment, pain intensity scale, and SF-36 physical functioning scale were more responsive to treatment group differences than was the tender joint count. In comparing methotrexate with placebo, the patient and physician global assessments were most responsive. These 2 measures, as well as the pain intensity scale and the C-reactive protein level, were more responsive to treatment group differences than was the tender joint count, while the SF-36 mental health component score was least responsive. A close correlation between changes in the M-HAQ and HAQ scores indicated that the M-HAQ was similarly responsive to change over time. Improvements in the PET, SF-36 physical component score, bodily pain, and physical functioning scales correlated with the ACR responder status. CONCLUSION: Both disease-specific and generic measures of function and health-related quality of life detect improvements in RA patients. Using both types of measures for evaluating therapies will identify discernible changes that are important to patients, and will facilitate comparisons across different disease states.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2000

Butyrate-inducible elements in the human gamma-globin promoter.

OBJECTIVE: Several agents including hydroxyurea, erythropoietin and butyric acid have been shown to reactivate gamma gene expression during adult stage development by unknown molecular mechanisms. In addition to inhibiting the enzyme histone deacetylase, butyrate may modulate transcription factor binding to specific DNA sequences defined as butyrate response elements (BREs). The purpose of this study was to identify promoter sequences involved in gamma gene activation by butyrate using truncation mutants in stable cell lines. MATERIALS AND METHODS: A detailed analysis of Agamma gene activation in the presence of alpha-aminobutyric acid and sodium butyrate was completed in stable mouse erythroleukemia (MEL) cell pools established with seven Agamma promoter truncation mutants. Functional studies were performed in a transient assay system followed by gel mobility shift assays to define protein binding patterns and to demonstrate transcription factor interactions in the gamma promoter BRE. RESULTS: Agamma promoter analysis in stable MEL cell pools revealed BREs between nucleotide-141 and -201, and nucleotide-822 and -893 (gammaBRE). The gammaBRE required the minimal Agamma promoter (-201 to +36) to stimulate gene expression. We observed a 6.1-fold (p < 0.05) increase in CAT activity for the minimal Agamma promoter alone compared with an 11.5-fold (p < 0.05) increase when the gamma promoter was combined with the -822 to -893 fragment. Protein binding studies demonstrated altered protein-DNA interactions in the gammaBRE after butyrate induction. The pattern for binding observed suggest both negative- and positive-acting transcription factors may interact in this region. CONCLUSION: The data supports the -822 to -893 region as a DNA regulatory element that contributes to Agamma gene inducibility by butyrate.

Animals↗
PubMed2000

Bacteriological safety and cost-effectiveness of a nonrefluxing valve in the irrigation system during outpatient flexible cystoscopy.

OBJECTIVE: To critically evaluate the infection rate associated with the use of a nonrefluxing irrigation system for outpatient flexible cystoscopy, by comparing it with conventional irrigation systems, and to determine the costs and benefits of this system of irrigation delivery. PATIENTS AND METHODS: All patients undergoing flexible cystoscopy on scheduled outpatient lists were considered for inclusion in the study; 143 patients of 220 undergoing cystoscopy fulfilled the study criteria. The study group of patients underwent cystoscopy with a new single-use nonrefluxing valve inserted into the same irrigation delivery system that was used for the whole endoscopy session, and the control group had the complete irrigation system changed after each endoscopic examination. Midstream urine samples were taken for analysis before cystoscopy and again 3-4 days later. Infection was defined as a pure growth of >/= 105 organisms/mL, with associated pyuria defined as >/= 10 pus cells per high power microscopic field. RESULTS: Complete data were available on 133 patients, with a further nine being excluded from the statistical analysis because they had a pre-existing urinary tract infection, leaving 64 patients in the study and 69 in the control groups. The overall infection rate for flexible cystoscopy was 3.2%, with no significant difference between the study and control groups. Cost savings of > 35% can be expected using the nonrefluxing valve method of irrigation delivery. CONCLUSION: The nonrefluxing valve caused no detectable increase in patient morbidity from bacterial infection when compared with conventional irrigation systems for flexible cystoscopy, and can save considerable costs.

Aged↗
PubMed2000

Automation of fluorescence in situ hybridization pretreatment: a comparative study of different sample types.

BACKGROUND: In fluorescence in situ hybridization (FISH) applications, the efficiency of probe hybridization is greatly enhanced by treating the cell or tissue preparation with a variety of reagents that make the target permeable while preserving important morphological features. Pretreatment protocols can be very labor intensive, adding cost to the test. The automation of specimen pretreatment eliminates human variation in the procedure through standardization of such variables as treatment times and temperatures. METHODS AND RESULTS: We developed an instrument, the VP 2000 Processor, that can process up to 50 specimens simultaneously under computer control. In this comparative FISH study of matched specimens, one set was processed according to the manual pretreatment protocol and compared with specimens processed by the VP 2000. Processed specimen types included paraffin-embedded breast tissue, uncultured amniocytes, bone marrow, peripheral-blood lymphocytes, and uroepithelial cells recovered from urine. Data show equivalent or brighter and more specific overall signal quality compared with matched manually executed controls. CONCLUSIONS: The automation of sample pretreatment for FISH provides a superior, more consistent level of performance than the manual format.

Amnion↗
PubMed2000

Kurtzke scales revisited: the application of psychometric methods to clinical intuition.

When developing his disability scales for multiple sclerosis, Kurtzke demonstrated perception and insight. However, 45 years later, the evaluation of his clinically derived scales remains limited, particularly for more disabled patients. Indeed, many of Kurtzke's assumptions underpinning the development of the Expanded Disability Status Scale (EDSS) and Functional Systems (FS) are untested. This study aims to build on previous work and provide a more detailed examination using psychometric methods of the EDSS and FS. There are three study objectives: (i) to examine comprehensively the psychometric properties of the EDSS in more disabled people with multiple sclerosis undergoing in-patient rehabilitation; (ii) to examine the reliability of the FS and test Kurtzke's assumptions that they measure different aspects of the neurological examination and measure different constructs from that measured by the EDSS; and (iii) to examine whether the FS can be summed to generate a summary score. The EDSS was examined for its acceptability (score distributions), reliability (inter- and intra-rater reproducibility, standard error of measurement), validity (convergent and discriminant validity, measurement precision, discrimination between individuals) and responsiveness (effect size). The FS were examined for their reliability (inter- and intra-rater reproducibility), intercorrelations, correlations with the EDSS and the extent to which they satisfy Likert's criteria as a summed rating scale. In this more disabled sample of people with multiple sclerosis, the EDSS is an acceptable measure but demonstrates limited variability. Inter-rater reproducibility (intraclass correlation coefficient; ICC = 0.78) is adequate for group comparison studies, but intra-rater reproducibility is variable (ICC = 0.62-0.94). Convergent and discriminant validity for the EDSS is supported, but its measurement precision relative to the Functional Independence Measure is limited (56%). Also, the EDSS has a limited ability to distinguish between individuals in terms of their disability and its responsiveness is poor (effect size = 0.10). Results indicate that the FS measure constructs distinct from each other (intercorrelations = -0.23 to +0. 52) and from the EDSS (correlations = -0.10 to +0.59). Intra-rater, but not inter-rater reproducibility is adequate for group comparison studies. The FS do not satisfy criteria as an eight-, seven- or six-item summed rating scale. Despite being based on sound clinical intuition, the lack of psychometric input into the development of the EDSS and FS has limited their usefulness as evaluative outcome measures in multiple sclerosis.

Adult↗
PubMed2000

Evaluating the role of botulinum toxin in the management of focal hypertonia in adults.

OBJECTIVES: To investigate the effects of EMG guided botulinum toxin (BTX-A) on impairment and focal disability in adults presenting with focal hypertonia. METHODS: A prospective, randomised, double blind, placebo controlled, parallel group trial was carried out with standardised assessment before and at 3 week intervals until 12 weeks after injection, in patients with focal hypertonia affecting upper or lower limbs. Botulinum toxin or placebo was injected with EMG guidance after multidisciplinary assessment. The modified Ashworth scale of spasticity, percentage passive range of joint motion, subjective rating of problem severity, the Rivermead motor assessment scale, a timed 10 metre walk (lower limb patients), nine hole peg test (upper limb patients), and a modified goal attainment scale were used as outcome measures. The patients were 52 adults; 34 male, 18 female; mean age 40.31, range 16-79 years; mean duration of symptoms 35 months (range 3 months to 22 years). Diagnoses included cerebrovascular accidents (23), head injury (12), incomplete spinal cord injury (six), tumour (five), cerebral palsy (three), and anoxic episodes (three). RESULTS: For each variable an overall score for the treatment period was computed by summing the scores from the 3, 6, 9, and 12 week assessments. These overall scores were significantly better in the treated group for the Ashworth scale, percentage passive range of movement, Rivermead lower limb, and subjective rating of problem severity. The significant treatment effect on the Ashworth scale was seen on analysis of variance (ANOVA) at 3 weeks and the subjective rating of problem severity at 3 and 6 weeks. The goal attainment scale score in both groups was similar at 12 weeks. CONCLUSION: Selective use of botulinum toxin to weaken muscles can lead to a reduction in resistance to passive movement about a distal limb joint. This allows for improvements in passive range of movement and focal disability, particularly in patients presenting with focal spasticity of the lower limb.

Adolescent↗
PubMed2000

Multiple pulmonary nodules in AIDS: usefulness of CT in distinguishing among potential causes.

PURPOSE: To determine whether the computed tomographic (CT) appearances of multiple pulmonary nodules in patients with acquired immunodeficiency syndrome (AIDS) can help differentiate the potential infectious and neoplastic causes. MATERIALS AND METHODS: The thoracic CT scans obtained in 60 patients with AIDS and multiple pulmonary nodules were reviewed retrospectively by two thoracic radiologists who were blinded to clinical and pathologic data. The scans were evaluated for nodule size, distribution, and morphologic characteristics. CT findings were correlated with final diagnoses. RESULTS: Thirty-six (84%) of 43 patients with opportunistic infection had a predominance of nodules smaller than 1 cm in diameter, whereas 14 (82%) of 17 patients with a neoplasm had a predominance of nodules larger than 1 cm (P <.001). Of the 43 patients with opportunistic infection, 28 (65%) had a centrilobular distribution of nodules; only one (6%) of 17 patients with a neoplasm had this distribution (P <.001). Seven (88%) of eight patients with a peribronchovascular distribution had Kaposi sarcoma (P <.001). CONCLUSION: In patients with AIDS who have multiple pulmonary nodules at CT, nodule size and distribution are useful in the differentiation of potential causes. Nodules smaller than 1 cm, especially those with a centrilobular distribution, are typically infectious. Nodules larger than 1 cm are often neoplastic. A peribronchovascular distribution is suggestive of Kaposi sarcoma.

AIDS-Related Opportunistic Infections↗
PubMed2000

Spallation performance of extracorporeal membrane oxygenation tubing.

During the prolonged roller pump use of extracorporeal membrane oxygenation (ECMO), tubing wear generates spallation. The spallation performance of Tygon S-65-HL was measured and compared with a potential new ECMO tubing, LVA (Portex 800-500-575). Spallation was measured by on-line laser diode particle counting (HIAC) during simulated ECMO. The effects of differing levels of occlusion and pump speed were examined, as was the effect of spallation over time. The spallation produced by Tygon S-65-HL was less than that seen with LVA during 24 h of simulated ECMO (p < 0.001), and after 72 h had fallen almost to zero. Spallation with Tygon tubing increases with increasing pump speed and decreases over time. There appears to be only a weak correlation with occlusion, which is surprising. The spallation performance of Tygon S-65-HL was variable and under some conditions exceeded that of LVA. Overall, however, Tygon S-65-HL produced less spallation than LVA. Therefore, LVA cannot be recommended for clinical ECMO use.

Equipment Design↗
PubMed2000

The diagnostic acceptability of low-bandwidth transmission for tele-ultrasound.

Ultrasound recordings were made of 100 consecutive patients attending for obstetric examination in Peterhead and 100 patients attending for non-obstetric examination in Aberdeen. Two identical video-conferencing machines were used to transmit and receive the original ultrasound images at data rates of 384 kbit/s and 128 kbit/s, thus producing a total of three tapes for each case. Four experienced observers, who were blinded to the transmission bandwidth, each viewed 300 examinations and decided whether the images were acceptable or not for diagnosis. Almost 100% of the obstetric ultrasound images on the original recordings were considered diagnostically acceptable, compared with 93% of the 384 kbit/s transmissions and 44% of the 128 kbit/s transmissions. Similarly, 99% of the non-obstetric ultrasound images were considered acceptable, compared with 87% of the 384 kbit/s transmissions and 21% of the 128 kbit/s transmissions. For the obstetric ultrasound images the intra-observer diagnostic agreement was 93% (kappa = 0.89) between the original and the 384 kbit/s transmissions, and 78% (kappa = 0.63) between the original and the 128 kbit/s transmissions. For the non-obstetric ultrasound images the respective intra-observer diagnostic agreements were 77% (kappa = 0.62) and 78% (kappa = 0.63). The quality of dynamic ultrasound images transmitted at 384 kbit/s was diagnostically acceptable, but was unsatisfactory at 128 kbit/s.

Female↗
PubMed2000

Clinical and radiographic predictors of the etiology of pulmonary nodules in HIV-infected patients.

STUDY OBJECTIVES: To determine the etiology and the clinical and radiographic predictors of the etiology of pulmonary nodules in a group of HIV-infected patients. DESIGN: Retrospective analysis. SETTING: A large urban hospital in San Francisco, CA. PATIENTS: HIV-infected patients evaluated at San Francisco General Hospital from June 1, 1993, through December 31, 1997, having one or more pulmonary nodules on chest CT. MAIN OUTCOME MEASURES: Three physicians reviewed medical records for clinical data and final diagnoses. Three chest radiologists blinded to clinical data reviewed chest CTs. Univariate and multivariate analyses were performed to determine clinical and radiographic predictors of having an opportunistic infection and the specific diagnoses of bacterial pneumonia and tuberculosis. RESULTS: Eighty seven of 242 patients (36%) had one or more pulmonary nodules on chest CT. Among these 87 patients, opportunistic infections were the underlying etiology in 57 patients; bacterial pneumonia (30 patients) and tuberculosis (14 patients) were the most common infections identified. Multivariate analysis identified fever, cough, and size of nodules < 1 cm on chest CT as independent predictors of having an opportunistic infection. Furthermore, a history of bacterial pneumonia, symptoms for 1 to 7 days, and size of nodules < 1 cm on CT independently predicted a diagnosis of bacterial pneumonia; a history of homelessness, weight loss, and lymphadenopathy on CT independently predicted a diagnosis of tuberculosis. CONCLUSIONS: In HIV-infected patients having one or more pulmonary nodules on chest CT scan, opportunistic infections are the most common cause. Specific clinical and radiographic features can suggest particular opportunistic infections.

AIDS-Related Opportunistic Infections↗
PubMed2000

The frequency and significance of anticardiolipin antibodies in scleroderma.

OBJECTIVE: To determine the frequency and significance of anticardiolipin antibodies (aCL) in scleroderma. METHODS: We serially tested for aCL in a standardized fashion in patients with scleroderma who were outpatients and gave consent to enter this study. RESULTS: Sixty-three patients participated in this study. Thirty-six had diffuse scleroderma and 27 had limited scleroderma. Three (4.8%) were positive for aCL, of whom 2 had limited scleroderma. In only one patient aCL may have been clinically significant. This woman had limited scleroderma for years and had medium vessel occlusive disease with gangrene eventually requiring midfoot amputations and chronic warfarin treatment. She did not have features of systemic lupus erythematosus or other overlap conditions. The other 2 patients had no manifestations of the antiphospholipid antibody syndrome. CONCLUSION: aCL in scleroderma rarely manifest clinically. The range of frequency of positive aCL in the literature is from 0 to 63%. From our study and the literature, we cannot ascertain if the prevalence is different in limited and diffuse scleroderma.

Adult↗