The role of high-resolution manometry in the assessment of upper gastrointestinal involvement in systemic sclerosis: a systematic review

The objectives of this systematic review were to investigate the role of HRM in the assessment of SSc-associated upper GI involvement and to evaluate the correlation between HRM abnormalities and clinical characteristics and the effects of therapeutic interventions on HRM findings. Fifteen articles were included. Most (11/15) studies were of very good or good quality. Most studies assessed correlations between esophageal symptoms and esophageal dysmotility. Two studies assessed the effectiveness of buspirone and reported HRM findings. Studies assessing upper GI symptoms using validated questionnaires, such as the University of California Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 or Gastrointestinal Symptoms Severity Index score, found an association between absent contractility on HRM and upper GI symptoms, but even asymptomatic patients often have esophageal body dysmotility on HRM. Esophageal dysmotility positively correlates with the presence of interstitial lung disease on high-resolution computed tomography and reduced diffusion capacity (
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research

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ConclusionsThe L6db–L7mb region should be the first choice for miniscrew implantation in the MBS for the distalization of mandibular dentition.
Source: Progress in Orthodontics - Category: Dentistry Source Type: research
AbstractPurpose of ReviewThe purpose of this review is to provide the readers with current information and state-of-the-art of digital scanning systems within the orthodontics. Introducing the commercially available intraoral and facial scanning systems, as well as bringing future perspectives to these systems.Recent FindingsThe emergence of digital scanners associated with computer-aided design is one of today ’s key diagnostic tool enhancements in orthodontics. Among the main applications in orthodontics, it is the analysis for diagnosis, treatment planning, and prediction of the final result. There is a range of p...
Source: Current Oral Health Reports - Category: Dentistry Source Type: research
CONCLUSION: Ethnic variations in some SSc disease manifestations are observed. However, this does not result in significant differences in short-term survival but may affect longterm survival. PMID: 30824634 [PubMed - as supplied by publisher]
Source: Journal of Rheumatology - Category: Rheumatology Tags: J Rheumatol Source Type: research
AbstractPurpose of ReviewConnective tissue disease-related interstitial lung disease (CTD-ILD) previously was a relative contraindication to lung transplantation primarily due to extra-pulmonary involvement of the disease. Recent published information focusing on the diagnosis and management of the extra-pulmonary complexities associated with CTD-ILD that challenge the success of lung transplantation indicate similar outcomes when compared to idiopathic causes of interstitial lung disease. Recent literature examining appropriate wait-listing criteria, disease management, and outcomes after lung transplantation are discusse...
Source: Current Respiratory Care Reports - Category: Respiratory Medicine Source Type: research
ConclusionIn patients with RP, esophageal dysmotility, interstitial lung disease and pulmonary arterial hypertension should be tested for ACA in order to establish a prompt diagnosis and treatment of ssSSc.ResumenLa esclerosis sistémica sine esclerodermia (ESse) es una forma de esclerosis sistémica caracterizada por fenómeno de Raynaud (FR), afección visceral sin endurecimiento de la piel y anticuerpos anti-centrómeros (AAC). Se estudiaron a 10 pacientes con ESse, con prevalencia del 2%. Manifestaciones clínicas: FR 9/10, esofágica 8/10, hipertensión arterial pulmonar...
Source: Reumatologia Clinica - Category: Rheumatology Source Type: research
Overview: Combination therapy has become the standard of care for patients with PAH. Therapeutic options now include PDE-5 inhibitors, endothelian-receptor antagonists and prostacyclin analogues. With the recent availability of oral prostacyclin therapy, triple therapy for PAH has become an increasingly attractive, and successful, option. Below we provide a case report of a patient treated with the successive addition of PAH therapies. Case Presentation: KD is a 42 year old female with a history of scleroderma complicated by esophageal dysmotility, interstitial lung disease, chronic respiratory failure and PAH.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Source Type: research
In this study, we aimed to clarify the prevalence, clinical characteristics, and prognosis of patients with SSc who developed AE-ILD and to identify predictive factors for AE-ILD in our Japanese cohorts. Clinical data of patients who visited our department from 1990 to 2014 and fulfilled the 2013 classification criteria for SSc were retrospectively reviewed. A total of 139 patients were enrolled. The mean age of onset was 49.1 years, and 113 (81.3%) patients were female; 116 (83.5%) had limited cutaneous involvement, and the overall 10-year survival rate was 92.0%. Among 66 (47.5%) patients with ILD, 13 (9.4%) developed AE...
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
Conclusions: We confirm an association between oesophageal dysmotility and respiratory symptoms in SSc-ILD. Larger numbers of patients followed up over time will need to be recruited to estimate the association between GORD measures and longitudinal changes in symptoms or severity of SSc-ILD.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 1.5 Diffuse Parenchymal Lung Disease Source Type: research
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