The Experts below are selected from a list of 138 Experts worldwide ranked by ideXlab platform
Marco Sebastiani - One of the best experts on this subject based on the ideXlab platform.
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predictive role of capillaroscopic Skin Ulcer risk index in systemic sclerosis a multicentre validation study
Annals of the Rheumatic Diseases, 2012Co-Authors: Marco Sebastiani, Andreina Teresa Manfredi, G Vukatana, S Moscatelli, L Riato, M Bocci, Michele Iudici, A Principato, Salvatore Mazzuca, P Del MedicoAbstract:Introduction The early detection of systemic sclerosis (SSc) patients at high risk of developing digital Ulcers could allow preventive treatment, with a reduction of morbidity and social costs. In 2009, a quantitative score, the capillaroscopic Skin Ulcer risk index (CSURI), calculated according to the formula ‘D×M/N 2’ , was proposed, which was highly predictive of the appearance of scleroderma digital Ulcers within 3 months of capillaroscopic evaluation. Objectives This multicentre study aims to validate the predictive value and reproducibility of CSURI in a large population of SSc patients. Methods CSURI was analysed in 229 unselected SSc patients by nailfold videocapillaroscopy (NVC). All patients were re-evaluated 3 months later with regard to the persistence and/or appearance of new digital Ulcers. Results 57 of 229 patients presented with digital Ulcers after 3 months. The receiver operating characteristic curve analysis showed an area under the curve of 0.884 (95% CI 0.835 to 0.922), with specificity and sensitivity of 81.4% (95% CI 74.8 to 86.89) and 92.98% (95% CI 83.0 to 98.0), respectively, at the cut-off value of 2.96. The reproducibility of CSURI was validated on a random sample of 81 patients, with a κ-statistic measure of interrater agreement of 0.8514. Conclusions The role of CSURI was confirmed in detecting scleroderma patients with a significantly high risk of developing digital Ulcers within the first 3 months from NVC evaluation. CSURI is the only method validated to predict the appearance of digital Ulcers and its introduction into routine clinical practice might help optimise the therapeutic strategy of these harmful SSc complications.
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capillaroscopic Skin Ulcer risk index a new prognostic tool for digital Skin Ulcer development in systemic sclerosis patients
Arthritis Care and Research, 2009Co-Authors: Marco Sebastiani, Andreina Teresa Manfredi, Michele Colaci, Roberto Damico, V Malagoli, Dilia Giuggioli, Clodoveo FerriAbstract:Objective Digital Ulcerations are one of the most frequent manifestations of microangiopathy in patients with systemic sclerosis (SSc; scleroderma). The early detection of SSc patients who are at high risk to develop digital Ulcers could allow a preventive treatment of these complications with reduction of morbidity and social costs. The aim of our study was to develop a capillaroscopic Skin Ulcer risk index (CSURI) that can predict the onset of new digital Ulcers by using nailfold videocapillaroscopy (NVC) in patients with SSc. Methods We performed NVC in 120 consecutive unselected patients with SSc (13 men, 107 women, mean ± SD age 56.1 ± 13.4 years, mean ± SD SSc duration 44.7 ± 60.7 months) to assess the total number of capillaries in the distal row (N), maximum loop diameter (D), number of megacapillaries (M), and the M:N ratio. Results Within 3 months since NVC examination, 35 of 120 patients experienced digital Ulcers. A significant association between ischemic lesions and the M:N ratio, N, and D was observed; the combination of these parameters allowed us to develop the CSURI, which is characterized by the formula D × M:N2. A receiver operating characteristic curve analysis showed an area under the curve of 0.926 for Ulcer appearance, with specificity and sensitivity of 85.9% and 94.3%, respectively, at the cutoff value of 2.94. Interestingly, 33 of 35 patients with new Skin Ulcers had a CSURI >2.94, but only 2 of 35 had a CSURI ≤2.94. Conclusion The proposed CSURI may represent a novel tool with the ability to predict the development of digital Ulcers in patients with scleroderma.
Rudiger B Mueller - One of the best experts on this subject based on the ideXlab platform.
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prospective evaluation of the capillaroscopic Skin Ulcer risk index in systemic sclerosis patients in clinical practice a longitudinal multicentre study
Arthritis Research & Therapy, 2018Co-Authors: Ulrich A Walker, Veronika K Jaeger, Katharina M Bruppacher, R Dobrota, Lionel Alois Etienne Arlettaz, Martin Banyai, Jorg Beron, Carlo Chizzolini, Ernst Groechenig, Rudiger B MuellerAbstract:Background Nailfold capillaroscopy (NC) is an important tool for the diagnosis of systemic sclerosis (SSc). The capillaroscopic Skin Ulcer risk index (CSURI) was suggested to identify patients at risk of developing digital Ulcers (DUs). This study aims to assess the reliability of the CSURI across assessors, the CSURI change during follow-up and the value of the CSURI in predicting new DUs.
Takashi Sawai - One of the best experts on this subject based on the ideXlab platform.
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vascular lesion in a patient of chronic active epstein barr virus infection with hypersensitivity to mosquito bites vasculitis induced by mosquito bite with the infiltration of nonneoplastic epstein barr virus positive cells and subsequent developmen
Human Pathology, 2005Co-Authors: Fumihiko Maeda, Hanae Onodera, Shoichi Chida, Mikiya Endo, Hiroyuki Kanno, Toshihide Akasaka, Takashi SawaiAbstract:This report describes a vasculitis and subsequently developing angiodestructive lymphoma in an 11-year-old Japanese-Filipino girl exhibiting mosquito allergy with the background of chronic active Epstein-Barr virus (EBV) infection. She developed necrotic Skin Ulcer at the site of mosquito bite, and histopathological examination revealed EBV-positive mononuclear cell infiltration throughout the wall of small-sized muscular artery. These EBV-positive lymphoid cells were oligoclonal in Southern blot analysis for EBV terminal repeats. Effectiveness of steroid therapy also supports the nonneoplastic nature. Approximately 1 year later, she developed progressive large Skin Ulcer without mosquito bites. Microscopically, the angiocentric or angiodestructive pattern of EBV-positive atypical cells supported the diagnosis of extranodal natural killer/T-cell lymphoma. Southern blot analysis revealed the monoclonal neoplastic nature of EBV-positive cells. In contrast to the primary mosquito bite lesion, natural killer/T-cell lymphoma cells exhibited the higher expression of EBV latent membrane protein 1 mRNA and the apparent protein expression detected by immunohistochemistry.
Clodoveo Ferri - One of the best experts on this subject based on the ideXlab platform.
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capillaroscopic Skin Ulcer risk index a new prognostic tool for digital Skin Ulcer development in systemic sclerosis patients
Arthritis Care and Research, 2009Co-Authors: Marco Sebastiani, Andreina Teresa Manfredi, Michele Colaci, Roberto Damico, V Malagoli, Dilia Giuggioli, Clodoveo FerriAbstract:Objective Digital Ulcerations are one of the most frequent manifestations of microangiopathy in patients with systemic sclerosis (SSc; scleroderma). The early detection of SSc patients who are at high risk to develop digital Ulcers could allow a preventive treatment of these complications with reduction of morbidity and social costs. The aim of our study was to develop a capillaroscopic Skin Ulcer risk index (CSURI) that can predict the onset of new digital Ulcers by using nailfold videocapillaroscopy (NVC) in patients with SSc. Methods We performed NVC in 120 consecutive unselected patients with SSc (13 men, 107 women, mean ± SD age 56.1 ± 13.4 years, mean ± SD SSc duration 44.7 ± 60.7 months) to assess the total number of capillaries in the distal row (N), maximum loop diameter (D), number of megacapillaries (M), and the M:N ratio. Results Within 3 months since NVC examination, 35 of 120 patients experienced digital Ulcers. A significant association between ischemic lesions and the M:N ratio, N, and D was observed; the combination of these parameters allowed us to develop the CSURI, which is characterized by the formula D × M:N2. A receiver operating characteristic curve analysis showed an area under the curve of 0.926 for Ulcer appearance, with specificity and sensitivity of 85.9% and 94.3%, respectively, at the cutoff value of 2.94. Interestingly, 33 of 35 patients with new Skin Ulcers had a CSURI >2.94, but only 2 of 35 had a CSURI ≤2.94. Conclusion The proposed CSURI may represent a novel tool with the ability to predict the development of digital Ulcers in patients with scleroderma.
Andreina Teresa Manfredi - One of the best experts on this subject based on the ideXlab platform.
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predictive role of capillaroscopic Skin Ulcer risk index in systemic sclerosis a multicentre validation study
Annals of the Rheumatic Diseases, 2012Co-Authors: Marco Sebastiani, Andreina Teresa Manfredi, G Vukatana, S Moscatelli, L Riato, M Bocci, Michele Iudici, A Principato, Salvatore Mazzuca, P Del MedicoAbstract:Introduction The early detection of systemic sclerosis (SSc) patients at high risk of developing digital Ulcers could allow preventive treatment, with a reduction of morbidity and social costs. In 2009, a quantitative score, the capillaroscopic Skin Ulcer risk index (CSURI), calculated according to the formula ‘D×M/N 2’ , was proposed, which was highly predictive of the appearance of scleroderma digital Ulcers within 3 months of capillaroscopic evaluation. Objectives This multicentre study aims to validate the predictive value and reproducibility of CSURI in a large population of SSc patients. Methods CSURI was analysed in 229 unselected SSc patients by nailfold videocapillaroscopy (NVC). All patients were re-evaluated 3 months later with regard to the persistence and/or appearance of new digital Ulcers. Results 57 of 229 patients presented with digital Ulcers after 3 months. The receiver operating characteristic curve analysis showed an area under the curve of 0.884 (95% CI 0.835 to 0.922), with specificity and sensitivity of 81.4% (95% CI 74.8 to 86.89) and 92.98% (95% CI 83.0 to 98.0), respectively, at the cut-off value of 2.96. The reproducibility of CSURI was validated on a random sample of 81 patients, with a κ-statistic measure of interrater agreement of 0.8514. Conclusions The role of CSURI was confirmed in detecting scleroderma patients with a significantly high risk of developing digital Ulcers within the first 3 months from NVC evaluation. CSURI is the only method validated to predict the appearance of digital Ulcers and its introduction into routine clinical practice might help optimise the therapeutic strategy of these harmful SSc complications.
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capillaroscopic Skin Ulcer risk index a new prognostic tool for digital Skin Ulcer development in systemic sclerosis patients
Arthritis Care and Research, 2009Co-Authors: Marco Sebastiani, Andreina Teresa Manfredi, Michele Colaci, Roberto Damico, V Malagoli, Dilia Giuggioli, Clodoveo FerriAbstract:Objective Digital Ulcerations are one of the most frequent manifestations of microangiopathy in patients with systemic sclerosis (SSc; scleroderma). The early detection of SSc patients who are at high risk to develop digital Ulcers could allow a preventive treatment of these complications with reduction of morbidity and social costs. The aim of our study was to develop a capillaroscopic Skin Ulcer risk index (CSURI) that can predict the onset of new digital Ulcers by using nailfold videocapillaroscopy (NVC) in patients with SSc. Methods We performed NVC in 120 consecutive unselected patients with SSc (13 men, 107 women, mean ± SD age 56.1 ± 13.4 years, mean ± SD SSc duration 44.7 ± 60.7 months) to assess the total number of capillaries in the distal row (N), maximum loop diameter (D), number of megacapillaries (M), and the M:N ratio. Results Within 3 months since NVC examination, 35 of 120 patients experienced digital Ulcers. A significant association between ischemic lesions and the M:N ratio, N, and D was observed; the combination of these parameters allowed us to develop the CSURI, which is characterized by the formula D × M:N2. A receiver operating characteristic curve analysis showed an area under the curve of 0.926 for Ulcer appearance, with specificity and sensitivity of 85.9% and 94.3%, respectively, at the cutoff value of 2.94. Interestingly, 33 of 35 patients with new Skin Ulcers had a CSURI >2.94, but only 2 of 35 had a CSURI ≤2.94. Conclusion The proposed CSURI may represent a novel tool with the ability to predict the development of digital Ulcers in patients with scleroderma.