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Ruxandra IONESCU

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Articles signed on MÆDICA, JCM:

Clinical Phenotype of Endothelial Dysfunction in Romanian Scleroderma Patients

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MÆDICA - a Journal of Clinical Medicine | Vol. 11, nr. 1, 2016 CNCSIS - CMR - B+ OBBCSSR

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Clinical Phenotype of Endothelial Dysfunction in Romanian Scleroderma Patients

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ABSTRACT

Objective: to identify the particularities of the clinical phenotype of endothelial dysfunction in a lot of Romanian patients from a reference center and compare it to data reported by international registries.

Material and methods: 51 patients were included in a cross-sectional study. The patients were evaluated for the pattern of disease, main visceral involvement, serum markers of disease.

Results: 41.2% patients had history of digital ulcers, 27.45% had pulmonary arterial hypertension; cardiovascular involvement also included: diastolic dysfunction in 31.1% of the patients, global systolic dysfunction in 9.8%, rhythm and conduction disturbances in 19.6%, peripheral vascular disease in 19.6%. Scleroderma renal crisis was identified in 2 patients.

Conclusions: Vascular complications are a major cause of morbidity and mortality in systemic sclerosis. Earlier therapeutic intervention demands improved screening and diagnosis in all cases.

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Clinical Phenotype of Endothelial Dysfunction in a Lot of Romanian Scleroderma Patients

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MÆDICA - a Journal of Clinical Medicine | Vol. 10, nr. 4, 2015 CNCSIS - CMR - B+ OBBCSSR

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Clinical Phenotype of Endothelial Dysfunction in a Lot of Romanian Scleroderma Patients

, , , , , , , , , , , and

ABSTRACT

Objective: to identify the particularities of the clinical phenotype of endothelial dysfunction in a lot of Romanian patients from a reference center and compare it to data reported by international registries.

Material and methods: 51 patients were included in a cross sectional study. The patients were evaluated for the pattern of disease, main visceral involvement, serum markers of disease.

Results: 41.2% patients had history of digital ulcers, 27.45% had pulmonary arterial hypertension; cardiovascular involvement also included: diastolic dysfunction in 31.1% of the patients, global systolic dysfunction in 9.8%, rhythm and conduction disturbances in 19.6%, peripheral vascular disease in 19.6%. Scleroderma renal crisis was identified in 2 patients.

Conclusions: Vascular complications are a major cause of morbidity and mortality in systemic sclerosis. Earlier therapeutic intervention demands improved screening and diagnosis in all cases.

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Dual X-Ray Absorptiometry Whole Body Composition of Bone Tissue in Rheumatoid Arthritis – a CrossSectional Study

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MÆDICA - a Journal of Clinical Medicine | Vol. 10, nr. 1, 2015

CNCSIS - CMR - B+ OBBCSSR

Dual X-Ray Absorptiometry Whole Body Composition of Bone Tissue in Rheumatoid Arthritis – a CrossSectional Study

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ABSTRACT

Objectives: Previous studies of bone tissue in rheumatoid arthritis (RA) using dual X-ray absorptiometry (DXA) concentrated on regions of interest that were used to diagnose osteoporosis. This study aimed to compare the whole body bone tissue (wbBT) of RA patients with healthy subjects and to identify the RA variables which significantly predict wbBT.

Methods: The study was cross-sectionally designed to include postmenopausal RA patients and agematched healthy female controls. All 107 RA patients and all 104 controls underwent clinical examination, laboratory tests and whole body DXA composition, which recorded total and regional bone indices. Non-parametric standard statistical test and regression models after data normalization were used to assess correlations, associations and differences.

Results: Compared to controls, RA patients had significantly lower whole body and regional bone mass (14.9 kg compared to 15.5 kg; p = 0.031). Disease duration (r = -0.402 ; p < 0.001), C-reactive protein (r = -0.279; p = 0.015) and inflammation (2.5% wbBT compared to 2.9%; p = 0.043), radiographic damage (14.3 kg compared to 16.2 kg; p < 0.001), disease activity scores (r = -0.275 ; p = 0.018 for HAQ) are significantly correlated/associated with lower wbBT. Clinical structural damage is associated with lower wbBT and it can significantly predict them (R2 = 0.014; p = 0.001), while glucocorticoid treatment, even in low doses, was associated with lower wbBT percent (2.6% compared to 2.8%; p = 0.045). Treatment with biologics was associated with a lower rate of whole body osteoporosis (0% compared to 22.2%; p = 0.013).

Conclusions: The main associated factors with the generalized bone loss in female RA patients are disease duration and disease activity. Clinical structural damage is the most powerful predictor of the whole body bone loss. These results suggest a general disturbance of skeletal bone metabolism in RA and could explain a greater risk of fragility fractures of non-central sites (e.g. ribs, tibia, ankles etc.) compared to post-menopause osteoporosis.

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