The Experts below are selected from a list of 24 Experts worldwide ranked by ideXlab platform
Ben A C Dijkmans - One of the best experts on this subject based on the ideXlab platform.
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double blind placebo controlled study of oral calcitriol for the treatment of localized and systemic scleroderma
Journal of The American Academy of Dermatology, 2000Co-Authors: Mieke M Hulshof, J Bouwes N Bavinck, Wilma Bergman, Ad A M Masclee, L Heickendorff, Ferdinand C Breedveld, Ben A C DijkmansAbstract:Abstract Background: Various treatments including corticosteroids, nonsteroidal anti-inflammatory drugs, D-penicillamine, interferon gamma, cyclosporine, and cytostatic drugs have been used with limited success in both morphea and systemic sclerosis (SSc). Objective: We investigated the effect of treatment with oral calcitriol in patients with localized or systemic scleroderma. Methods: A randomized, double-blind, placebo-controlled study of 9 months' duration with a 6-month follow-up was performed at the Department of Dermatology. A total of 27 patients (7 patients with SSc and 20 with morphea) were selected on a minimal skin score of 3 for patients with morphea and 12 for those with SSc. Each patient received calcitriol (0.75 μg/day for 6 months plus 1.25 μg/day for 3 months) or placebo for 9 months. Efficacy parameters included skin score, measurement of serum markers of collagen synthesis and degradation and, additional for the patients with SSc, oral aperture measurements, lung function studies, and Esophagus Motility. Results: The skin score in patients with morphea after 9 months' treatment showed no significant difference between the placebo and calcitriol groups (mean percentage reduction [SD] in skin score in the placebo group was −29.3 [57.9]; in the calcitriol group it was −19.4 [46.6]). The small group of patients with SSc was inadequate to allow us to draw any conclusions regarding efficacy. No significant change was found in the serum markers of collagen metabolism. Conclusion: In this study calcitriol was not more effective than placebo in patients with morphea. Because of the small group of patients with SSc treated, no conclusions regarding efficacy in SSc can be drawn. (J Am Acad Dermatol 2000;43:1017-23.)
Soren Kruseandersen - One of the best experts on this subject based on the ideXlab platform.
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non parametric classification of Esophagus Motility by means of neural networks
Methods of Information in Medicine, 1997Co-Authors: C Thogersen, Charlotte Rasmussen, K Rutz, Erik Jakobsen, Soren KruseandersenAbstract:Automatic long-term recording of esophageal pressures by means of intraluminal transducers is used increasingly for evaluation of esophageal function. Most automatic analysis techniques are based on detection of derived parameters from the time series by means of arbitrary rule-based criterions. The aim of the present work has been to test the ability of neural networks to identify abnormal contraction patterns in patients with non-obstructive dysphagia (NOBD). Nineteen volunteers and 22 patients with NOBD underwent simultaneous recordings of four pressures in the Esophagus for at least 23 hours. Data from 21 subjects were selected for training. The performances of two trained networks were subsequently verified on reference data from 20 subjects. The results show that non-parametric classification by means of neural networks has good potentials. Back propagation shows good performance with a sensitivity of 1.0 and a specificity of 0.8.
Mieke M Hulshof - One of the best experts on this subject based on the ideXlab platform.
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double blind placebo controlled study of oral calcitriol for the treatment of localized and systemic scleroderma
Journal of The American Academy of Dermatology, 2000Co-Authors: Mieke M Hulshof, J Bouwes N Bavinck, Wilma Bergman, Ad A M Masclee, L Heickendorff, Ferdinand C Breedveld, Ben A C DijkmansAbstract:Abstract Background: Various treatments including corticosteroids, nonsteroidal anti-inflammatory drugs, D-penicillamine, interferon gamma, cyclosporine, and cytostatic drugs have been used with limited success in both morphea and systemic sclerosis (SSc). Objective: We investigated the effect of treatment with oral calcitriol in patients with localized or systemic scleroderma. Methods: A randomized, double-blind, placebo-controlled study of 9 months' duration with a 6-month follow-up was performed at the Department of Dermatology. A total of 27 patients (7 patients with SSc and 20 with morphea) were selected on a minimal skin score of 3 for patients with morphea and 12 for those with SSc. Each patient received calcitriol (0.75 μg/day for 6 months plus 1.25 μg/day for 3 months) or placebo for 9 months. Efficacy parameters included skin score, measurement of serum markers of collagen synthesis and degradation and, additional for the patients with SSc, oral aperture measurements, lung function studies, and Esophagus Motility. Results: The skin score in patients with morphea after 9 months' treatment showed no significant difference between the placebo and calcitriol groups (mean percentage reduction [SD] in skin score in the placebo group was −29.3 [57.9]; in the calcitriol group it was −19.4 [46.6]). The small group of patients with SSc was inadequate to allow us to draw any conclusions regarding efficacy. No significant change was found in the serum markers of collagen metabolism. Conclusion: In this study calcitriol was not more effective than placebo in patients with morphea. Because of the small group of patients with SSc treated, no conclusions regarding efficacy in SSc can be drawn. (J Am Acad Dermatol 2000;43:1017-23.)
C Thogersen - One of the best experts on this subject based on the ideXlab platform.
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non parametric classification of Esophagus Motility by means of neural networks
Methods of Information in Medicine, 1997Co-Authors: C Thogersen, Charlotte Rasmussen, K Rutz, Erik Jakobsen, Soren KruseandersenAbstract:Automatic long-term recording of esophageal pressures by means of intraluminal transducers is used increasingly for evaluation of esophageal function. Most automatic analysis techniques are based on detection of derived parameters from the time series by means of arbitrary rule-based criterions. The aim of the present work has been to test the ability of neural networks to identify abnormal contraction patterns in patients with non-obstructive dysphagia (NOBD). Nineteen volunteers and 22 patients with NOBD underwent simultaneous recordings of four pressures in the Esophagus for at least 23 hours. Data from 21 subjects were selected for training. The performances of two trained networks were subsequently verified on reference data from 20 subjects. The results show that non-parametric classification by means of neural networks has good potentials. Back propagation shows good performance with a sensitivity of 1.0 and a specificity of 0.8.
Ellen C Ebert - One of the best experts on this subject based on the ideXlab platform.
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esophageal disease in scleroderma
Journal of Clinical Gastroenterology, 2006Co-Authors: Ellen C EbertAbstract:Progressive systemic sclerosis (PSS) causes smooth muscle atrophy and fibrosis of the distal two-thirds of the Esophagus. Motility studies show reduced-amplitude or absent peristaltic contractions in this region and normal or decreased lower esophageal sphincter pressure. Patients complain of dysphagia, heartburn, and regurgitation due to reflux and dysMotility. Complications include strictures found in 17% to 29% of patients and Barrett Esophagus is 0% to 37%. Candida esophagitis is a complication of PSS not seen with non-PSS reflux. Esophageal disease correlates with pulmonary involvement but not with disease in the stomach or intestines. Whether reflux contributes to the pulmonary disease is an open question. Although manometry is the gold standard for diagnosis, cine-esophagram and scintography are only slightly less sensitive and should be considered for following the patients. Symptoms correlate poorly with evidence of esophagitis or abnormal 24-hour pH recordings. As a result, it is unclear which patients should receive acid-reducing or prokinetic medications and which medication to use. Aspiration precautions are important in those with severe esophageal dysMotility. This review of the literature highlights many areas of uncertainty in the diagnosis and treatment of esophageal disease in PSS that can be addressed in clinical studies.