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At least 163 records · Page 9Linked to original sources
PubMed2004

Association between capillaroscopy, haemorheological variables and plasma proteins in patients bearing Raynaud's phenomenon.

Raynaud's phenomenon is a paroxysmal and reversible vasospasm affecting generally the acral circulatory regions. The relevance of the haemorheological alterations in these patients, as a source of ischemic events has been neglected. The objective of the present work was to evaluate and correlate the rheological blood properties, some biochemical parameters, e.g., plasma fibrinogen and immunoglobulin levels, and periungual capillaroscopy. The explicative variables considered were: blood viscosity, plasma viscosity, erythrocyte rigidity index, plasma fibrinogen, erythrocyte sedimentation rate, erythrocyte aggregate size, erythrocyte aggregation rate and serum immunoglobulin (IgG and IgM). The response variable was the nailfold capillary pattern categorised as either normal or pathological. Fibrinogen, erythrocyte aggregation rate and IgM are significantly higher in patients with a pathological pattern in comparison with patients bearing a normal one. The statistical analysis enabled us the modelling of the pathological pattern occurrence probability in function of plasma fibrinogen. Consequently, 100 mg/dl plasma fibrinogen increase, increases twice the probability of presenting a pathological pattern. Therefore, we can conclude that high levels of fibrinogen in Raynaud's phenomenon patients are associated with impaired skin microcirculation assessed by periungual capillaroscopy.

Adult↗
PubMed2005

Computerized nailfold video capillaroscopy--a new tool for assessment of Raynaud's phenomenon.

OBJECTIVE: To develop a computer based nailfold video capillaroscopy system with enhanced image quality and to assess its disease-subgroup resolving power in patients with primary and secondary Raynaud's phenomenon (RP). METHODS: Using frame registration software, digitized video images from the microscope were combined to form a panoramic mosaic of the nailfold. Capillary dimensions (apex, arterial, venous, and total width) and density were measured onscreen. Significantly, the new system could guarantee analysis of the same set of capillaries by 2 observers. Forty-eight healthy control subjects, 21 patients with primary RP, 40 patients with limited cutaneous systemic sclerosis (lcSSc), and 11 patients with diffuse cutaneous SSc (dcSSc) were studied. Intra- and interobserver variability were calculated in a subset of 30 subjects. RESULTS: The number of loops/mm was significantly lower, and all 4 capillary dimensions significantly greater, in SSc patients versus controls plus primary RP patients (p < 0.001 for all measures). When comparing control (+ primary RP) patients with SSc patients (lcSSc + dcSSc) the most powerful discriminator was found to be the number of loops/mm. Results for intra- and interobserver reproducibility showed that the limits of agreement were closer when both observers measured the same capillaries. CONCLUSION: The key feature of the newly developed system is that it improves reproducibility of nailfold capillary measurements by allowing reidentification of the same capillaries by different observers. By allowing access to previous measurements, the new system should improve reliability in longitudinal studies, and therefore has the potential of being a valuable outcome measure of microvessel disease/involvement in clinical trials of scleroderma spectrum disorders.

Adult↗
PubMed2005

[Classification of microangiopathy in systemic sclerosis].

AIM: To classify main types of morphological changes of nailfold capillaries in systemic sclerosis (SSc). MATERIAL AND METHODS: Nailfold videocapillaroscopy (NCS) was performed in 103 patients with SSc (34 patients with dSSc and 69 patients with ISSc) with a median age of 47.9 +/- 13.3 years and mean disease duration of 8.1 +/- 7.1 years. The control group consisted of 35 healthy persons. RESULTS: On the basis of a quantitative estimation of changes the main capillaroscopic patterns of structural changes of capillaries in SSc were distinguished. The first (early) type is characterized by changes mainly of sizes of capillaries and a rather moderate decrease of their amount. In the second (transitive) type simultaneously with change of the sizes of capillaries an appreciable decrease of the amount of capillaries with formation of avascular sites is observed. The third (late) type of changes is characterized by marked reduction of capillaries and plenty of avascular sites in the absence or presence of few dilated capillaries. NCS enables to reveal destruction and new growth of capillaries. The statistical analysis has shown authentic distinctions of NCS parameters between main types of changes and close association of these types with activity of the disease. CONCLUSION: Definition of a type of capillaroscopic changes can serve a reliable and objective criterion of a stage and activity of microangiopathy in SSc which reflects duration of illness as a whole.

Adolescent↗
PubMed2005

[Capillaroscopy in the diagnosis of systemic sclerosis].

Capillaroscopy is a safe, simple, non-invasive, low-cost analysis of the nailfold circulation. Vascular lesions play a significant role in the pathogenesis of systemic sclerosis. It has been shown that a characteristic microangiopathy, so-called "scleroderma pattern capillary abnormalities", --are present in the majority of patients with systemic sclerosis and already appear in the early stage of the disease. Due to this fact, capillarosopy is considered a practical tool for diagnosing and monitoring patients with systemic sclerosis. Capillaroscopy can help in the selection of patients that need more aggressive therapeutic interventions. Recently, the presence of typical capillaroscopic abnormalities has been suggested as one of the minor criteria for the early diagnosis and classification of systemic sclerosis. The present study presents the role of capillaroscopy in the management of patients with systemic sclerosis.

Diagnosis, Differential↗
PubMed2005

Morphologic changes in the microcirculation induced by chronic smoking habit: a videocapillaroscopic study on the human gingival mucosa.

PURPOSE: To analyze the gingival characteristics of microcirculation in vivo and to evaluate the effects of smoking by means of computerised videocapillaroscopic techniques. METHODS: 35 healthy non-smokers and 35 healthy smokers were examined. The characteristics of gingival microcirculation were examined using computerized videomicroscopic techniques. For each subject, visibility, course, tortuosity and any images characteristic of capillary loops, besides the possible presence of microhemorrhages, the average caliber of the capillary loops and the number of capillary loops visible per square millimeter were evaluated. The investigation was non-invasive and repeatable for each subject. RESULTS: The investigation of gingival mucosa revealed capillary loops with a course both parallel and perpendicular to the surface: close to marginal gingiva, the tops of the capillary loops often appeared as evenly distributed dots or commas; close to the papilla, microcirculation more frequently ran parallel to the surface, and its characteristics were similar to nail microcirculation. In smokers, it was possible to underline capillaries of a smaller caliber (P< 0.001) and a higher number of detectable capillaries (P< 0.001). An important correlation between the capillary tortuosity, close to the papilla, and the smoking habit (P< 0.001) was observed. This study has shown that the smoking habit represents a real risk factor for periodontal disease, which greatly affects microcirculation.

Adult↗
PubMedDate not supplied

Nailfold capillaroscopic findings in primary Sjögren's syndrome: clinical and serological correlations.

OBJECTIVE: To describe the capillaroscopic abnormalities observed in patients with primary Sjögren's Syndrome (pSS), associating them with clinical and serologic features, and comparing these findings to those observed in normal controls. METHODS: Sixty-one consecutive patients with pSS were studied by clinical evaluation, serology, and nailfold capillary microscopy (NCM). Twenty-one normal controls were also examined. Capillaroscopic findings were recorded in a standardized way by a blinded observer Capillary loss on NCM was evaluated using a deletion score. RESULTS: NCM was normal in 59.0% of pSS patients; 29.5% had non-specific abnormalities, and 11.5% presented a SD-like pattern. Patients presented a higher deletion score than controls (p < 0.001). Other capillaroscopic parameters (number of dilated, bizarre, and meandering capillaries; capillary hemorrhages; venous plexus visibility) did not differ significantly between patients and controls. Among patients, the deletion score was higher in those with systemic manifestations (p = 0.022) and Raynaud's phenomenon (p = 0.050). No association between the presence of antinuclear antibodies, rheumatoid factor, anti-SSA/Ro and anti-SSB/La with qualitative or quantitative NCM findings was found. Among the 7 patients with SD-like pattern on NCM, 6 had Raynaud's phenomenon, but only 2 presented autoantibodies related to systemic sclerosis (1 with anticentromere and 1 with low titer antitopoisomerase I). None of these patients met the ACR criteria for SSc. CONCLUSIONS: SD-like pattern on NCM is observed in a small but significant proportion of pSS patients. The association of systemic involvement with a higher deletion score may be related to the hypothesis that these manifestations represent clinical expressions of systemic vasculitis.

Adult↗