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3. Pulmonary hypertension in connective tissue diseases, new evidence and challenges

Author

Vonk, M.C., Vandecasteele, E., Dijk, A.P.J. van, Vonk, M.C., Vandecasteele, E., and Dijk, A.P.J. van

Abstract

Contains fulltext : 232639.pdf (Publisher’s version ) (Open Access), Pulmonary arterial hypertension is a lethal complication of different connective tissue diseases such as systemic sclerosis, mixed connective tissue disease and systemic lupus erythematosus. Although the treatment possibilities for patients with pulmonary arterial hypertension have increased in the last two decades and survival of patients with idiopathic pulmonary arterial hypertension has improved, the latter is not the case for patients with pulmonary arterial hypertension associated with connective tissue disease. In this narrative review, we review recent literature and describe the improvement of early diagnostic possibilities, screening modalities and treatment options. We also point out the pitfalls in diagnosis in this patient category and describe the unmet needs and what the focus of future research should be.

Published
2021

4. THU0367 INCIDENCE AND PREVALENCE OF SYSTEMIC SCLEROSIS-ASSOCIATED INTERSTITIAL LUNG DISEASE IN FLANDERS: A 12-YEARS COLLABORATIVE MULTICENTER PROSPECTIVE COHORT STUDY.

Author

Vandecasteele, E., primary, Melsens, K., additional, Blockmans, D., additional, Carton, C., additional, De Keyser, F., additional, De Langhe, E., additional, Lauwerys, B., additional, Piette, Y., additional, Vanhaecke, A., additional, Verbeke, K., additional, Wuyts, W., additional, Brusselle, G., additional, and Smith, V., additional

Published
2020
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5. Systemic sclerosis: State of the art on clinical practice guidelines

Author

Smith, V, Scire, C, Talarico, R, Airo, P, Alexander, T, Allanore, Y, Bruni, C, Codullo, V, Dalm, V, De Vries-Bouwstra, J, Della Rossa, A, Distler, O, Galetti, I, Launay, D, Lepri, G, Mathian, A, Mouthon, L, Ruaro, B, Sulli, A, Tincani, A, Vandecasteele, E, Vanhaecke, A, Vanthuyne, M, Van Den Hoogen, F, Van Vollenhoven, R, Voskuyl, A, Zanatta, E, Bombardieri, S, Burmester, G, Eurico, F, Frank, C, Hachulla, E, Houssiau, F, Mueller-Ladner, U, Schneider, M, Van Laar, J, Vieira, A, Cutolo, M, Mosca, M, Matucci-Cerinic, M, Smith V., Scire C. A., Talarico R., Airo P., Alexander T., Allanore Y., Bruni C., Codullo V., Dalm V., De Vries-Bouwstra J., Della Rossa A., Distler O., Galetti I., Launay D., Lepri G., Mathian A., Mouthon L., Ruaro B., Sulli A., Tincani A., Vandecasteele E., Vanhaecke A., Vanthuyne M., Van Den Hoogen F., Van Vollenhoven R., Voskuyl A. E., Zanatta E., Bombardieri S., Burmester G., Eurico F. J., Frank C., Hachulla E., Houssiau F., Mueller-Ladner U., Schneider M., Van Laar J. M., Vieira A., Cutolo M., Mosca M., Matucci-Cerinic M., Smith, V, Scire, C, Talarico, R, Airo, P, Alexander, T, Allanore, Y, Bruni, C, Codullo, V, Dalm, V, De Vries-Bouwstra, J, Della Rossa, A, Distler, O, Galetti, I, Launay, D, Lepri, G, Mathian, A, Mouthon, L, Ruaro, B, Sulli, A, Tincani, A, Vandecasteele, E, Vanhaecke, A, Vanthuyne, M, Van Den Hoogen, F, Van Vollenhoven, R, Voskuyl, A, Zanatta, E, Bombardieri, S, Burmester, G, Eurico, F, Frank, C, Hachulla, E, Houssiau, F, Mueller-Ladner, U, Schneider, M, Van Laar, J, Vieira, A, Cutolo, M, Mosca, M, Matucci-Cerinic, M, Smith V., Scire C. A., Talarico R., Airo P., Alexander T., Allanore Y., Bruni C., Codullo V., Dalm V., De Vries-Bouwstra J., Della Rossa A., Distler O., Galetti I., Launay D., Lepri G., Mathian A., Mouthon L., Ruaro B., Sulli A., Tincani A., Vandecasteele E., Vanhaecke A., Vanthuyne M., Van Den Hoogen F., Van Vollenhoven R., Voskuyl A. E., Zanatta E., Bombardieri S., Burmester G., Eurico F. J., Frank C., Hachulla E., Houssiau F., Mueller-Ladner U., Schneider M., Van Laar J. M., Vieira A., Cutolo M., Mosca M., and Matucci-Cerinic M.

Abstract

Systemic sclerosis (SSc) is an orphan disease characterised by autoimmunity, fibrosis of the skin and internal organs, and vasculopathy. SSc may be associated with high morbidity and mortality. In this narrative review we summarise the results of a systematic literature research, which was performed as part of the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases project, aimed at evaluating existing clinical practice guidelines or recommendations. Only in the domains 'Vascular & Ulcers' (ie, non-pharmacological approach to digital ulcer), 'PAH' (ie, screening and treatment), 'Treatment' and 'Juveniles' (ie, evaluation of juveniles with Raynaud's phenomenon) evidence-based and consensus-based guidelines could be included. Hence there is a preponderance of unmet needs in SSc referring to the diagnosis and (non-)pharmacological treatment of several SSc-specific complications. Patients with SSc experience significant uncertainty concerning SSc-related taxonomy, management (both pharmacological and nonpharmacological) and education. Day-to-day impact of the disease (loss of self-esteem, fatigue, sexual dysfunction, and occupational, nutritional and relational problems) is underestimated and needs evaluation.

Published
2018

7. The role of endothelial cells in the vasculopathy of systemic sclerosis: A systematic review: SSc vasculopathy: The role of endothelial cells

Author

Mostmans, Y, Cutolo, M, Giddelo, C, Decuman, S, Melsens, K, Declercq, H, Vandecasteele, E, De Keyser, F, Distler, O, Gutermuth, J, Smith, V, University of Zurich, and Mostmans, Y

Subjects
2403 Immunology, 10051 Rheumatology Clinic and Institute of Physical Medicine, 2723 Immunology and Allergy, 610 Medicine & health
Published
2017
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8. Systemic sclerosis: State of the art on clinical practice guidelines

Author

Smith, V. (Vanessa), Scirè, C.A. (Carlo Alberto), Talarico, R. (Rosaria), Airo, P. (Paolo), Alexander, T. (Tobias), Allanore, Y. (Yannick), Bruni, C. (Cosimo), Codullo, V. (Veronica), Dalm, V.A.S.H. (Virgil), Vries-Bouwstra, J.K. (Jeska) de, Della Rossa, A. (Alessandra), Distler, O. (Oliver), Galetti, I. (Ilaria), Launay, D. (David), Lepri, G. (Gemma), Mathian, A. (Alexis), Mouthon, L. (Luc), Ruaro, B. (Barbara), Sulli, A. (Alberto), Tincani, A. (Angela), Vandecasteele, E. (Els), Vanhaecke, A. (Amber), Vanthuyne, M. (Marie), Hoogen, F.H.J. van den, Van Vollenhoven, R.F. (Ronald F.), Voskuyl, R.A. (Robert), Zanatta, E. (Elisabetta), Bombardieri, S. (Stefano), Burmester, G.R. (Gerd), Eurico, F.J. (Fonseca João), Frank, C. (Charissa), Hachulla, E. (Eric), Houssiau, F. (Frederic), Mueller-Ladner, U. (Ulf), Schneider, M. (Matthias), Van Laar, J.M. (Jacob M), Vieira, A. (Ana), Cutolo, M. (Maurizio), Mosca, M. (Marta), Matucci-Cerinic, M. (Marco), Smith, V. (Vanessa), Scirè, C.A. (Carlo Alberto), Talarico, R. (Rosaria), Airo, P. (Paolo), Alexander, T. (Tobias), Allanore, Y. (Yannick), Bruni, C. (Cosimo), Codullo, V. (Veronica), Dalm, V.A.S.H. (Virgil), Vries-Bouwstra, J.K. (Jeska) de, Della Rossa, A. (Alessandra), Distler, O. (Oliver), Galetti, I. (Ilaria), Launay, D. (David), Lepri, G. (Gemma), Mathian, A. (Alexis), Mouthon, L. (Luc), Ruaro, B. (Barbara), Sulli, A. (Alberto), Tincani, A. (Angela), Vandecasteele, E. (Els), Vanhaecke, A. (Amber), Vanthuyne, M. (Marie), Hoogen, F.H.J. van den, Van Vollenhoven, R.F. (Ronald F.), Voskuyl, R.A. (Robert), Zanatta, E. (Elisabetta), Bombardieri, S. (Stefano), Burmester, G.R. (Gerd), Eurico, F.J. (Fonseca João), Frank, C. (Charissa), Hachulla, E. (Eric), Houssiau, F. (Frederic), Mueller-Ladner, U. (Ulf), Schneider, M. (Matthias), Van Laar, J.M. (Jacob M), Vieira, A. (Ana), Cutolo, M. (Maurizio), Mosca, M. (Marta), and Matucci-Cerinic, M. (Marco)

Abstract

Systemic sclerosis (SSc) is an orphan disease characterised by autoimmunity, fibrosis of the skin and internal organs, and vasculopathy. SSc may be associated with high morbidity and mortality. In this narrative review we summarise the results of a systematic literature research, which was performed as part of the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases project, aimed at evaluating existing clinical practice guidelines or recommendations. Only in the domains 'Vascular & Ulcers' (ie, non-pharmacological approach to digital ulcer), 'PAH' (ie, screening and treatment), 'Treatment' and 'Juveniles' (ie, evaluation of juveniles with Raynaud's phenomenon) evidence-based and consensus-based guidelines could be included. Hence there is a preponderance of unmet needs in SSc referring to the diagnosis and (non-)pharmacological treatment of several SSc-specific complications. Patients with SSc experience significant uncertainty concerning SSc-related taxonomy, management (both pharmacological and nonpharmacological) and education. Day-to-day impact of the disease (loss of self-esteem, fatigue, sexual dysfunction, and occupational, nutritional and relational problems) is underestimated and needs evaluation.

Published
2018
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9. THU0252 Nailfold capillaroscopy in systemic lupus erythematosus: a systematic review and critical appraisal

Author

Wijnant, S, primary, Ingegnoli, F, additional, Melsens, K, additional, Thevissen, K, additional, Keyser, F De, additional, Decuman, S, additional, Deschepper, E, additional, Distler, O, additional, Müller-Ladner, U, additional, Piette, Y, additional, Riccieri, V, additional, Ughi, N, additional, Vandecasteele, E, additional, Cutolo, M, additional, and Smith, V, additional

Published
2017
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12. Abstracts

Author

Barthelemy, O., primary, Silvain, J., additional, Brieger, D., additional, Bellemain-Appaix, A., additional, Cayla, G., additional, Beygui, F., additional, Lancar, R., additional, Collet, J. P., additional, Mercadier, A., additional, Montalescot, G., additional, Cha, K. S., additional, Nam, Y. H., additional, Kim, J. H., additional, Park, S. Y., additional, Park, T. H., additional, Kim, M. H., additional, Kim, Y. D., additional, Lee, H. C., additional, Ahn, M. S., additional, Hong, T. J., additional, Blanco, R., additional, Blanco, F., additional, Szarfer, J., additional, Garcia Escudero, A., additional, Gigena, G., additional, Gagliardi, J., additional, Rodriguez, A., additional, Sarmiento, R., additional, Affatatto, S., additional, Riccitelli, M., additional, Petris, A., additional, Datcu, M. D., additional, Pop, C., additional, Radoi, M., additional, Arsenescu-Georgescu, C., additional, Petrescu, I., additional, Petrescu, L., additional, Serban, L., additional, Nechita, E., additional, Tatu-Chitoiu, G., additional, Dorobantu, M., additional, Benedek, I., additional, Craiu, E., additional, Sinescu, C., additional, Ionescu, D. D., additional, Ginghina, C., additional, Minescu, B., additional, Izzo, A., additional, Mantovani, P., additional, Tomasi, L., additional, Dall'oglio, L., additional, Bonatti, S., additional, Rosiello, R., additional, Romano, M., additional, Agostini, F., additional, Zanini, R., additional, Zhao, Z. Y., additional, Wu, Y. J., additional, Li, J. J., additional, Yany, Y. J., additional, Qian, H. Y., additional, Tang, Y. D., additional, Timoteo, A. T., additional, Toste, A., additional, Lousinha, A., additional, Ramos, R., additional, Oliveira, J. A., additional, Ferreira, M. L., additional, Ferreira, R. C., additional, Cabades, C., additional, Diez Gil, J. L., additional, Aguar, P., additional, Sanmiguel, D., additional, Lopez-March, A., additional, Marmol, R., additional, Guerra, L., additional, Girbes, V., additional, Ferrando, J., additional, Rincon De Arellano, A., additional, Patricio, L., additional, Blondal, M., additional, Ainla, T., additional, Marandi, T., additional, Eha, J., additional, Oliveira, M. M., additional, Silva, M. N., additional, Cunha, P. S., additional, Feliciano, J., additional, Silva, S., additional, Kanovsky, J., additional, Kala, P., additional, Parenica, J., additional, Poloczek, M., additional, Prymusova, K., additional, Kubkova, L., additional, Spinar, J., additional, Olinic, D., additional, Homorodean, C., additional, Ober, M., additional, Olinic, M., additional, Andrioaia, C., additional, Condac, A., additional, Masmoudi, M., additional, Berdaoui, B., additional, Labidi, S., additional, Tapia Ballesteros, C., additional, Hernandez Luis, C., additional, Sandin, M. G., additional, Vegas, J. M., additional, Andion, R., additional, Martinez, N., additional, Gonzalez, I. A., additional, Alvarado, M., additional, Amat, I. J., additional, San Roman, J. A., additional, Garcia Gonzalez, M. J., additional, Arroyo Ucar, E., additional, Hernandez Garcia, C., additional, Dorta Martin, M., additional, Marrero Rodriguez, F., additional, Dragu, R., additional, Kapeliovich, M., additional, Hammerman, H., additional, Silva, D., additional, Cortez-Dias, N., additional, Jorge, C., additional, Silva Marques, J., additional, Carilho Ferreira, P., additional, Robalo Martins, S., additional, Almeida Ribeiro, M., additional, Calisto, C., additional, Fiuza, M., additional, Lopes, M. G., additional, Milicevic, P., additional, Panic, M., additional, Stankovic, I., additional, Milicevic, D., additional, Kalezic, T., additional, Kafedzic, S., additional, Ilic, I., additional, Cerovic, M., additional, Putnikovic, B., additional, Neskovic, A., additional, Rott, D., additional, Leibowitz, D., additional, Monhart, Z., additional, Reissigova, J., additional, Grunfeldova, H., additional, Jansky, P., additional, Valente, B., additional, Villanueva Benito, I., additional, Solla, I., additional, Paredes, E., additional, Diaz Castro, O., additional, Calvo, F., additional, Baz, J. A., additional, Iniguez, A., additional, Aleksova, A., additional, Gerloni, R., additional, Belfiore, R., additional, Carriere, C., additional, Barbati, G., additional, Fabris, E., additional, Possa, F., additional, Nait, D., additional, Milo, M., additional, Sinagra, G., additional, Marques, N., additional, Mimoso, J., additional, Gomes, V., additional, Agra Bermejo, R. M., additional, Emad Abu Assi, E. A. A., additional, Sergio Raposeiras Roubin, S. R. R., additional, Pilar Cabanas Grandio, P. C. G., additional, Carlos Pena Gil, C. P. G., additional, Jose Maria Garcia Acuna, J. M. G. A., additional, Jose Ramon Gonzalez Juanatey, J. R. G. J., additional, Daly, M. J., additional, Scott, P., additional, Owens, C. G., additional, Tomlin, A., additional, Smith, B., additional, Adgey, A. A. J., additional, Alvarez-Contreras, L. R., additional, Juarez, U., additional, Altamirano, A., additional, Arias, A., additional, Alvarez-San Gabriel, A., additional, Gonzalez-Pacheco, H., additional, Martinez-Sanchez, C., additional, Rahnavardi, M., additional, Keshtkar-Jahromi, M., additional, Vakili, H., additional, Gholamin, S., additional, Razavi, S. M., additional, Gilis-Januszewski, T., additional, Mellwig, K.- P., additional, Wiemer, M., additional, Gilis-Januszewski, J., additional, Peterschroeder, A., additional, Koerfer, J., additional, Horstkotte, D., additional, Vrsalovic, M., additional, Getaldic, B., additional, Vrkic, N., additional, Pintaric, H., additional, Khan, S., additional, Wasan, B., additional, Moretti, L., additional, Grossi, P., additional, Silenzi, S., additional, Testa, M., additional, Candelori, L., additional, Clementi, L. N., additional, Forlini, M., additional, Lando, L., additional, Pezzuoli, M. L., additional, Corradetti, P., additional, Leurent, G., additional, Pennec, P. Y., additional, Filippi, E., additional, Moquet, B., additional, Hacot, J. P., additional, Druelles, P., additional, Rialan, A., additional, Rouault, G., additional, Coudert, I., additional, Le Breton, H., additional, Gevaert, S., additional, Tromp, F., additional, Vandecasteele, E., additional, De Somer, F., additional, Van Belleghem, Y., additional, Bouchez, S., additional, Martens, F., additional, Herck, I., additional, De Pauw, M., additional, Ludka, O., additional, Sepsi, M., additional, Miklik, R., additional, Dusek, L., additional, Tomcikova, D., additional, Garcia-Acuna, J. M., additional, Aguiar-Souto, P., additional, Raposeiras Roubin, S., additional, Agra-Bermejo, R., additional, Jacquet, M., additional, Abu-Assi, E., additional, Gonzalez-Juanatey, J. R., additional, Ibatov, A., additional, Labrova, R., additional, Karlik, R., additional, Lokaj, P., additional, She, Q., additional, Deng, S. B., additional, Huang, S. H., additional, Gu, L. J., additional, Rong, J. I. A. N., additional, Wu, Z. K., additional, Li, Y., additional, Zhang, J., additional, Parascan, L., additional, Campanile, A., additional, Spinelli, L., additional, Santulli, G., additional, Ciccarelli, M., additional, De Gennaro, S., additional, Assante Di Panzillo, E., additional, Trimarco, B., additional, Iaccarino, G., additional, Bobescu, E., additional, Datcu, G., additional, Dobreanu, D., additional, Doka, B., additional, Charniot, J.- C., additional, Cosson, C., additional, Albertini, J. P., additional, Bittar, R., additional, Giral, P., additional, Cherfils, C., additional, Guillerm, E., additional, Bonnefont-Rousselot, D., additional, Rusali, A., additional, Cojocaru, L., additional, Parepa, I., additional, Koizumi, T., additional, Iida, S., additional, Sato, J., additional, Kikutani, T., additional, Muramatsu, T., additional, Nishimura, S., additional, Komiyama, N., additional, Lee, W. P., additional, Ong, B. B., additional, Haralambos, K., additional, Townsend, D., additional, Rees, J. A. E., additional, Williams, E. J., additional, Halcox, J. P., additional, Mcdowell, I., additional, Damjanovic, M., additional, Koracevic, G., additional, Djordjevic-Radojkovic, D., additional, Pavlovic, M., additional, Krstic, N., additional, Ciric-Zdravkovic, S., additional, Stojkovic, A., additional, Perisic, Z., additional, Apostolovic, S., additional, Faustino, A., additional, Seca, L., additional, Barra, S., additional, Caetano, F., additional, Providencia, R., additional, Silva, J., additional, Gomes, P., additional, Costa, G., additional, Costa, M., additional, Leitao-Marques, A., additional, Volkova, A. L., additional, Arutyunov, G. P., additional, Bylova, N. A., additional, Dayter, I. I., additional, Jao, Y. T. F. N., additional, Fang, C. C., additional, Chen, Y., additional, Yu, C. L., additional, Wang, S. P., additional, Valencia, J., additional, Perez-Berbel, P., additional, Ruiz-Nodar, J. M., additional, Pineda, J., additional, Bordes, P., additional, Quintanilla, M., additional, Mainar, V., additional, Sogorb, F., additional, Santos, N., additional, Serrao, M., additional, Cafe, H., additional, Silva, B., additional, Oliveira, R., additional, Caires, G., additional, Drumond, A., additional, Araujo, J., additional, Providencia, R. A., additional, Gomes, P. L., additional, Pais, J. R., additional, Mota, P., additional, Leitao-Marques, A. M., additional, Farhan, S., additional, Jarai, R., additional, Tentzeris, I., additional, Vogel, B., additional, Freynhofer, M. K., additional, Wojta, J., additional, Huber, K., additional, Poli, M., additional, Trambaiolo, P., additional, Corsi, F., additional, De Luca, M., additional, Mustilli, M., additional, Lukic, V., additional, Simonetti, M., additional, Ferraiuolo, G., additional, Lettino, M., additional, Casella, G., additional, Conte, M. R., additional, De Luca, L., additional, Geraci, G., additional, Ceravolo, R., additional, Pani, A., additional, Fradella, G., additional, Schratter, A., additional, Thiele, H., additional, Klemm, T., additional, Demmin, K., additional, Lehmann, D., additional, Mende, M., additional, Schuler, G., additional, Pittl, U., additional, Chernova, A., additional, Nikulina, S. U., additional, Naruke, T., additional, Inomata, T., additional, Yanagisawa, T., additional, Maekawa, E., additional, Mizutani, T., additional, Shinagawa, H., additional, Nishii, M., additional, Takeuchi, I., additional, Takehana, H., additional, Izumi, T., additional, Paulo, C., additional, Mascarenhas, J., additional, Patacho, M., additional, Pimenta, J., additional, Bettencourt, P., additional, Nardai, S., additional, Szabo, G. Y., additional, Berta, B., additional, Edes, I., additional, Merkely, B., additional, Delgado Silva, J., additional, Baptista, R., additional, Faria, R., additional, Trigo, J., additional, Gago, P., additional, Gheorghe, G., additional, Nanea, I. T., additional, Cristea, A., additional, Almarichi, S., additional, Martins, H., additional, Saraiva, F., additional, Jorge, E., additional, Mendes, P. L., additional, Monteiro, P., additional, Costa, S., additional, Franco, F., additional, Providencia, L. A., additional, Nanea, T., additional, Gheorghe, G. S., additional, Visan, S., additional, Paun, N., additional, Gaber, R., additional, Delewi, R., additional, Nijveldt, R., additional, De Bruin, H. A., additional, Hirsch, A., additional, Van Der Laan, A., additional, Bouma, B. J., additional, Tijssen, J. P. G., additional, Van Rossum, A. C., additional, Zijlstra, F., additional, Piek, J. J., additional, Rus, H., additional, Donea, M., additional, Ciurea, C., additional, Ifteni, G., additional, Casolo, G., additional, Chioccioli, M., additional, Magnacca, M., additional, Del Meglio, J., additional, Comella, A., additional, Baratto, M., additional, Lera, J., additional, Salvadori, L., additional, Tessa, C., additional, Vignali, C., additional, Keca, Z., additional, Momcilov Popin, T., additional, Panic, G., additional, White, R., additional, Mateen, F., additional, Weaver, A., additional, Agmon, Y., additional, Okisheva, E., additional, Tsaregorodtsev, D., additional, Sulimov, V., additional, Amat Santos, I. J., additional, Hernandez, C., additional, Tapia, C., additional, Campo, A., additional, Fredman, D., additional, Svensson, L., additional, Rosenqvist, M., additional, Tadel-Kocjancic, S., additional, Radsel, P., additional, Knafelj, R., additional, Gorjup, V., additional, Noc, M., additional, Zima, E., additional, Jenei, Z. S., additional, Kovacs, E., additional, Osztheimer, I., additional, Molnar, L., additional, Horvath, A., additional, Becker, D., additional, Geller, L., additional, Maggi, R., additional, Furukawa, T., additional, Viscardi, V., additional, Brignole, M., additional, Leal, S. R. N., additional, Dores, H., additional, Rosario, I., additional, Monge, J., additional, Carvalho, M. J., additional, Arroja, I., additional, Leitao, A., additional, Fonseca, C., additional, Aleixo, A., additional, Silva, A., additional, Keuleers, S., additional, Herijgers, P., additional, Herregods, M. C., additional, Budts, W., additional, Dubois, C., additional, Meuris, B., additional, Verhamme, P., additional, Flameng, W., additional, Van De Werf, F., additional, Adriaenssens, T., additional, Badran, H., additional, Elnoamany, M., additional, Lolah, T., additional, Olariu, C., additional, Macarie, C., additional, Mollik, M. A. H., additional, Hassan, A. I., additional, Paul, T. K., additional, Haque, M. Z., additional, Jahan, R., additional, Rahmatullah, M., additional, Khatun, M. A., additional, Rahman, M. T., additional, Chowdhury, M. H., additional, Bustamante Munguira, J., additional, Tamayo, E., additional, Garcia-Cuenca, I., additional, Bustamante, E., additional, Gualis, J., additional, Gomez-Martinez, M. L., additional, Florez, S., additional, Gomez-Herreras, J. I., additional, Ramirez Rodriguez, R., additional, Ramirez Rodriguez, A. M., additional, Garcia-Bello, M. A., additional, Hernadez Ortega, E., additional, Caballero Dorta, E., additional, Garcia Quintana, A., additional, Piro Mastraccio, V., additional, Medina Fernandez Aceytuno, A., additional, Assanelli, E., additional, De Metrio, M., additional, Rubino, M., additional, Lauri, G., additional, Cabiati, A., additional, Campodonico, J., additional, Grazi, M., additional, Moltrasio, M., additional, Marana, I., additional, Marenzi, G., additional, Lovlien, M., additional, Schei, B., additional, Picon-Heras, R., additional, Acebal, C., additional, Garcia Rubira, J. C., additional, Vivas Balcones, D., additional, Nunez-Gil, I., additional, Ruiz-Mateos, B., additional, Ibanez, B., additional, Fernandez-Ortiz, A., additional, Vintila, V. D., additional, Enescu, O. A., additional, Stoicescu, C. 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J., additional, Gomez Salvador, I., additional, San Roman Calvar, J. A., additional, Mamarasulov, T. M., additional, Todorovic, L., additional, Cherneva, Z. C. H., additional, Denchev, S. D., additional, Heltai, K., additional, Boytsov, A., additional, Nikulina, N. N., additional, Zanna, D., additional, Marangelli, V., additional, Caiati, C., additional, Picon Heras, R., additional, Loureiro, M. J., additional, Urazovskaya, I., additional, Vinogradova, D., additional, Vasilieva, E., additional, Shpektor, A., additional, Conti, E., additional, Musumeci, M. B., additional, Lauri, F. M., additional, Dito, E., additional, De Giusti, M., additional, Lallo, A., additional, Fusco, D., additional, Davoli, M., additional, Volpe, M., additional, Autore, C., additional, Gamra, H., additional, Dridi, Z., additional, Hassine, M., additional, Addad, F., additional, Gherissi, I., additional, Reda, A., additional, Mahjoub, M., additional, Bouraoui, S., additional, Abdennadher, M., additional, Betbout, F., additional, Mota, P. M. F. P., additional, Silva, J. D., additional, Jankovic Tomasevic, R., additional, Djordjevic, V., additional, Djordjevic Radojkovic, D., additional, Scafa Udriste, A., additional, Fruntelata, A., additional, Gainoiu, E., additional, Bogdan, S., additional, Zamfir, D., additional, Teodorescu, C., additional, Guran, M., additional, Constantinescu, D., additional, Konopka, A., additional, Banaszewski, M., additional, Wojtkowska, I., additional, Stepinska, J., additional, Vidergold, J. V., additional, Osipova, I. V., additional, Tavrovskaya, T. V., additional, Galkina, J. V., additional, Timofeev, A. V., additional, Vorobyov, R. I., additional, Vorobyova, E. N., additional, Matos, L., additional, Carvalho, A. C. C., additional, Oliveira, W., additional, Cintra, F., additional, Poyares, D., additional, Andersen, M., additional, Martins, R., additional, Tufik, S., additional, Ostadal, P., additional, Brada, J., additional, Horakova, S., additional, Mlcek, M., additional, Hrachovina, V., additional, Kittnar, O., additional, Gorudko, I. V., additional, Buko, I. V., additional, Cherenkevich, S. N., additional, Polonetsky, L. Z., additional, Plotkin, V. Y., additional, Timoshina, M. A., additional, Azanchevskaya, S. V., additional, Chromov-Borisov, N. N., additional, Vorlat, A., additional, Snoep, L., additional, Claeys, M. J., additional, Vrints, C. J., additional, Palazzuoli, A., additional, Caputo, M., additional, Quatrini, I., additional, Calabro, A., additional, Antonelli, G., additional, Campagna, M. S., additional, Franci, B., additional, Nuti, R., additional, Maisel, A., additional, Negrini, M., additional, Minora, T., additional, Marino, P., additional, Seregni, R., additional, Tavlueva, E., additional, Barbarash, O., additional, Barbarash, L., additional, Janota, T., additional, Kudlicka, J., additional, Malik, K., additional, Wichterle, D., additional, Hradec, J., additional, Body, R., additional, Carley, S. D., additional, Mcdowell, G., additional, Nuttall, M., additional, Wibberley, C., additional, France, M., additional, Cruickshank, J. K., additional, Mackway-Jones, K., additional, Leon, M., additional, Cozma, C., additional, Mitu, F., additional, Almeida, D. R., additional, Dias, C. B., additional, Burazor, I., additional, Burazor, M., additional, Krstic, M., additional, Lazovic, M., additional, Vukmanovic, M., additional, Djordjevic, J., additional, Radovanovic, Z., additional, Ilic, D., additional, Bosnjakovic, P., additional, Ferreira, A. C., additional, Mateus, P. S., additional, Fontes, P., additional, Teixeira, T., additional, Conte, G., additional, Menozzi, A., additional, Solinas, E., additional, Bolognesi, M. G., additional, Tadonio, I., additional, Mantovani, F., additional, Cattabiani, A., additional, Vignali, L., additional, Ardissino, D., additional, Tautu, O., additional, Alexandrescu, A., additional, Niculescu, R., additional, Jankovic, R., additional, Bozinovic, N., additional, Santos, C., additional, Costa, F., additional, Cardoso, G., additional, Correia, I., additional, Fountoulaki, K., additional, Kastellanos, S., additional, Voltirakis, E., additional, Kokotos, A., additional, Michalakeas, C., additional, Kontsas, K., additional, Hasioti, K., additional, Iliodromitis, E. T., additional, Sandin Fuentes, M. G., additional, Zatarain Nicolas, E., additional, Martinez Uruena, N., additional, Alvarado Montes De Oca, M., additional, Dytrych, V., additional, Kovarnik, T., additional, Smid, O., additional, Kral, A., additional, Aroutunov, A. G., additional, Intwala, S., additional, Jegere, I., additional, Shaalan, H. S. H., additional, Pagava, Z., additional, Agladze, R., additional, Shakarishvili, R., additional, Sharashidze, N., additional, Gujejiani, L., additional, Saatashvili, G., additional, Katova, T. Z., additional, Kostova, V., additional, Simova, Y., additional, Vukotic, S., additional, Rafajlovski, S., additional, Romanovic, R., additional, Antonijevic, N., additional, Gligic, B., additional, Hutyra, M., additional, Skala, T., additional, Horak, D., additional, Vindis, D., additional, Taborsky, M., additional, Contine, A., additional, Del Pinto, M., additional, Angeli, F., additional, Verdecchia, P., additional, Borgognoni, F., additional, Grikstaite, E., additional, Pantano, P., additional, Ambrosio, G., additional, Cavallini, C., additional, Bonanad, C., additional, Sanchis, J., additional, Bodi, V., additional, Nunez, J., additional, Bosch, X., additional, Heras, M., additional, Pellicer, M., additional, Llacer, A., additional, Adao, L., additional, Oliveira, M., additional, Goncalves, H., additional, Primo, J., additional, Gama, V., additional, Lombardi, C., additional, Metra, M., additional, Bugatti, S., additional, Pasotti, E., additional, Quinzani, F., additional, Adamo, M., additional, Villa, C., additional, Rovetta, R., additional, Manerba, A., additional, Mariani, M., additional, Dushpanova, A., additional, Baroni, M., additional, Cerone, E., additional, Nardelli, A., additional, Gianetti, J., additional, Berti, S., additional, Feliciano, F., additional, Soares, R., additional, Santos, S., additional, Kruger, A., additional, Vondrakova, D., additional, Herget, J., additional, Navarro, C., additional, Cromie, N. A., additional, Adgey, J. A. A., additional, Caeiro Pereira, D., additional, Braga, P., additional, Fontes Carvalho, R., additional, Rodrigues, A., additional, Goncalves, M., additional, Simoes, L., additional, and Borisov, K. V., additional

Published
2010
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16. Systemic sclerosis: state of the art on clinical practice guidelines

Author

Jeska K de Vries-Bouwstra, Jacob M van Laar, Ronald F van Vollenhoven, Els Vandecasteele, Alexandre E. Voskuyl, Charissa Frank, Tobias Alexander, Gemma Lepri, Fonseca João Eurico, Eric Hachulla, Angela Tincani, Alexis Mathian, Elisabetta Zanatta, Veronica Codullo, Alberto Sulli, Luc Mouthon, Marco Matucci-Cerinic, Vanessa Smith, Amber Vanhaecke, Gerd R Burmester, Marie Vanthuyne, Frank J. A. van den Hoogen, D. Launay, Matthias Schneider, Maurizio Cutolo, Rosaria Talarico, Yannick Allanore, Ilaria Galetti, Frédéric Houssiau, Virgil A. S. H. Dalm, Alessandra Della Rossa, Cosimo Bruni, Carlo Alberto Scirè, Ulf Mueller-Ladner, Oliver Distler, Stefano Bombardieri, Paolo Airò, Barbara Ruaro, Marta Mosca, Ana Rita Vieira, Immunology, Internal Medicine, Smith, V, Scire, C, Talarico, R, Airo, P, Alexander, T, Allanore, Y, Bruni, C, Codullo, V, Dalm, V, De Vries-Bouwstra, J, Della Rossa, A, Distler, O, Galetti, I, Launay, D, Lepri, G, Mathian, A, Mouthon, L, Ruaro, B, Sulli, A, Tincani, A, Vandecasteele, E, Vanhaecke, A, Vanthuyne, M, Van Den Hoogen, F, Van Vollenhoven, R, Voskuyl, A, Zanatta, E, Bombardieri, S, Burmester, G, Eurico, F, Frank, C, Hachulla, E, Houssiau, F, Mueller-Ladner, U, Schneider, M, Van Laar, J, Vieira, A, Cutolo, M, Mosca, M, Matucci-Cerinic, M, Scirè, Ca, Van den Hoogen, F, Voskuyl, Ae, Eurico, Fj, van Laar, Jm, and Matucci-Cerinic, M.

Subjects
ERN ReCONNET, European reference networks, clinical practice guidelines, nailfold videocapillaroscopy, systemic sclerosis, unmet needs, European reference network, Disease, INTERSTITIAL LUNG-DISEASE, RECOMMENDATIONS, DEVELOPING CRITERIA, PRACTICE PATHWAY, High morbidity, 0302 clinical medicine, Fibrosis, Medicine and Health Sciences, EXPERT CONSENSUS, Immunology and Allergy, 030212 general & internal medicine, skin and connective tissue diseases, integumentary system, Interstitial lung disease, unmet need, Clinical Practice, medicine.symptom, systemic sclerosi, clinical practice guideline, medicine.medical_specialty, Immunology, Systemic Sclerosis, NO, Pharmacological treatment, Unmet needs, 03 medical and health sciences, Rheumatology, medicine, SIMPLE CAPILLAROSCOPIC DEFINITIONS, Intensive care medicine, 030203 arthritis & rheumatology, business.industry, STEM-CELL TRANSPLANTATION, medicine.disease, Sexual dysfunction, SKIN ULCERS, FUNCTIONAL DISABILITY, clinical practice guidelines, ERN ReCONNET, European reference networks, nailfold videocapillaroscopy, systemic sclerosis, unmet needs, POINTS, business
Abstract

Systemic sclerosis (SSc) is an orphan disease characterised by autoimmunity, fibrosis of the skin and internal organs, and vasculopathy. SSc may be associated with high morbidity and mortality. In this narrative review we summarise the results of a systematic literature research, which was performed as part of the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases project, aimed at evaluating existing clinical practice guidelines or recommendations. Only in the domains ‘Vascular & Ulcers’ (ie, non-pharmacological approach to digital ulcer), ‘PAH’ (ie, screening and treatment), ‘Treatment’ and ‘Juveniles’ (ie, evaluation of juveniles with Raynaud’s phenomenon) evidence-based and consensus-based guidelines could be included. Hence there is a preponderance of unmet needs in SSc referring to the diagnosis and (non-)pharmacological treatment of several SSc-specific complications. Patients with SSc experience significant uncertainty concerning SSc-related taxonomy, management (both pharmacological and non-pharmacological) and education. Day-to-day impact of the disease (loss of self-esteem, fatigue, sexual dysfunction, and occupational, nutritional and relational problems) is underestimated and needs evaluation.

Published
2018

17. Stabilization of Microcirculation in Patients with Early Systemic Sclerosis with Diffuse Skin Involvement following Rituximab Treatment: An Open-label Study

Author

Michel De Pauw, Filip De Keyser, Saskia Decuman, Guy Brusselle, Valeria Riccieri, Vanessa Smith, Els Vandecasteele, Yves Piette, Barbara Ruaro, Alberto Sulli, Ellen Deschepper, Maurizio Cutolo, Karin Melsens, Carmen Pizzorni, Smith, V, Pizzorni, C, Riccieri, V, Decuman, S, Brusselle, G, Pauw M, De, Deschepper, E, Piette, Y, Ruaro, B, Sulli, A, Vandecasteele, E, Melsens, K, Keyser F, De, and Cutolo, M

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Immunology, Pilot Projects, Disease, Scleroderma, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Fibrosis, Internal medicine, medicine, Humans, Immunologic Factors, Immunology and Allergy, 030203 arthritis & rheumatology, Autoimmune disease, Scleroderma, Systemic, integumentary system, business.industry, Microcirculation, Microangiopathy, Middle Aged, medicine.disease, Dermatology, Surgery, Methotrexate, 030104 developmental biology, Nails, Microvessels, Female, Rituximab, business, Immunosuppressive Agents, Biomedical sciences, medicine.drug
Abstract

To the Editor: Systemic sclerosis (SSc) is a multisystemic autoimmune disease characterized by fibrosis of the skin and internal organs, generalized microvasculopathy, and antibody response against various cellular antigens. Severe organ involvement occurs early in the course of diffuse cutaneous SSc (dcSSc) and has a bad prognosis1. Survival of the first years of the disease is associated with improved outcome. Therapies that may help the patient overcome this early period seem warranted2. Rituximab (RTX) has been reported as optional therapy in SSc3,4,5. Our group reported stabilization of internal organ involvement during a 2-year followup in an open pilot study of a 2–treatment course (months 0 and 6) of RTX in patients with early dcSSc6,7. In our pilot studies, modified Rodnan skin score (mRSS) decreased significantly after RTX course. The percent of decrease in the open pilot studies was corroborated by a similar decrease in the percentage of collagen score in blindly assessed histopathological skin analyses. Because SSc is characterized by a pronounced microangiopathy over time … Address correspondence to Dr. V. Smith, Department of Rheumatology, Ghent University Hospital, Faculty of Medicine and Health Sciences, Department of Internal Medicine, Ghent University, De Pintelaan 185, B – 9000 Ghent, Belgium. E-mail: vanessa.smith{at}ugent.be

Published
2016
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18. A Belgian consensus on sotatercept for the treatment of pulmonary arterial hypertension.

Author

Vachiéry JL, Belge C, Cools B, Damen A, Demeure F, De Pauw M, Dewachter C, De Wolf D, Gabriel L, Godinas L, Guiot J, Haine S, Leys M, Meysman M, Pouleur AC, Ruttens D, Vandecasteele E, Vansteenkiste W, Weber T, Wirtz G, and Delcroix M

Subjects
Humans, Belgium, Consensus, Pulmonary Arterial Hypertension drug therapy, Pulmonary Arterial Hypertension physiopathology, Treatment Outcome, Hypertension, Pulmonary drug therapy, Hypertension, Pulmonary physiopathology, Activin Receptors, Type II therapeutic use, Recombinant Fusion Proteins therapeutic use
Abstract

Pulmonary arterial hypertension (PAH) is a rare disease affecting the small pulmonary vessels, ultimately leading to right ventricular failure and death. Current treatment options target three different pathways (endothelin, nitric oxide/cGMP and prostacyclin pathways). Despite their demonstrated efficacy, these therapies (commonly used in combination) do not cure the disease which is why novel pathways beyond the traditional 'big three' are being developed. Sotatercept is a ligand trap for multiple proteins within the TGF-β superfamily that was recently approved in the US for the treatment of PAH. Unlike currently available therapies, sotatercept has the potential to act as an anti-remodelling agent rather than a vasodilator. The safety and efficacy of subcutaneous (SC) sotatercept have been established in two multicentre, placebo-controlled randomised-controlled trials. The compound has been shown to consistently improve a variety of measurable endpoints, including exercise capacity, haemodynamics, quality of life and delay of clinical worsening. The drug appears to have an acceptable safety profile, although it is associated with an increased risk in developing telangiectasia and biological changes affecting platelet counts and haemoglobin. This study reviews the current evidence on SC sotatercept and provides a Belgian perspective on its place in the future treatment strategy for PAH.

Published
2024
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20. Pulmonary hypertension in interstitial lung disease: an area of unmet clinical need.

Author

Dhont S, Zwaenepoel B, Vandecasteele E, Brusselle G, and De Pauw M

Abstract

Pulmonary hypertension (PH) is present in an important proportion of patients with interstitial lung diseases (ILDs), encompassing a large, heterogeneous group of diffuse parenchymal lung diseases. Development of ILD-related PH is associated with reduced exercise capacity, increased need for supplemental oxygen, decreased quality of life and earlier death. Diagnosis of ILD-related PH is important and requires a high index of suspicion. Noninvasive diagnostic assessment can suggest the presence of PH, although right heart catheterisation remains the gold standard to confirm the diagnosis and to assess its severity. A comprehensive assessment is needed to make sure reversible causes of PH have been ruled out, including thromboembolic events, untreated hypoxaemia and sleep disordered breathing. The results of trials concerning pulmonary vasodilators in this particular patient group have been disappointing and, in some cases, were even associated with an increased risk of harm. Newer strategies such as medications administered through inhalation and combinations with antifibrotic drugs show encouraging results. Moreover, unravelling the role of the vasculature in the pathophysiology of pulmonary fibrosis and ILD-related PH may potentially unlock new therapeutic opportunities., Competing Interests: Conflict of interest: The authors declare that they have no competing interests., (Copyright ©The authors 2022.)

Published
2022
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21. An eye-opening case report of constrictive pericarditis.

Author

Dhont S, Van Belleghem Y, De Zaeytijd J, and Vandecasteele E

Abstract

Background: Constrictive pericarditis is characterized by the encasement of the heart by a stiff pericardium leading to impaired diastolic function, which ultimately leads to congestive heart failure., Case Summary: We report a case of a young woman, who first presented to the ophthalmologist with the sudden appearance of floaters and vision reduction. Eventually, invasive haemodynamic assessment led to the diagnosis of constrictive pericarditis leading to venous congestion., Conclusion: Understanding the pathophysiology and integrating the results of invasive and non-invasive diagnostic work up is important in making this challenging diagnosis., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2022
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22. Malignant cardiac tamponade: safety and efficacy of intrapericardial bleomycin instillation.

Author

Defruyt L, Özpak E, Gevaert S, De Buyzere M, Vandecasteele E, De Pauw M, and Tromp F

Subjects
Bleomycin adverse effects, Female, Humans, Male, Neoplasm Recurrence, Local, Retrospective Studies, Antineoplastic Agents therapeutic use, Cardiac Tamponade drug therapy, Lung Neoplasms drug therapy, Pericardial Effusion
Abstract

Background: Malignant cardiac tamponade is a life-threatening condition that requires prompt treatment and effective management to prevent recurrence. This paper describes safety and efficacy outcomes after intrapericardial instillation of bleomycin as well as possible predictors of survival., Methods: We performed a 10-year retrospective, single-center study to evaluate the safety and efficacy of intrapericardial instillation of bleomycin in patients with suspected malignant cardiac tamponade., Results: Intrapericardial instillation of bleomycin was performed in 31 cancer patients (9 men, 22 women) presenting with cardiac tamponade. Non-fatal complications occurred in 3 patients and relapse occurred in 1 patient. Overall survival was less than 10% at the end of the study. Median survival was 104 days (95% CI, 0-251 days). Survival was compared between different groups (defined by primary tumor, type of tumor, TNM stage and results of cytological analysis) with median survival being considerably higher when oncologic therapy was altered afterwards., Conclusions: The use of intrapericardial bleomycin instillation following pericardiocentesis for malignant cardiac tamponade is a safe procedure with a high success rate. Survival rates depend on further oncological treatment options available.

Published
2022
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23. The use of point-of-care ultrasound in new-onset dyspnea: an unexpected diagnosis.

Author

Özpak E, Defruyt L, Braeckeveldt L, Czapla J, and Vandecasteele E

Subjects
Dyspnea diagnostic imaging, Dyspnea etiology, Emergency Service, Hospital, Humans, Point-of-Care Testing, Ultrasonography, Echocardiography, Point-of-Care Systems
Abstract

In this article, we report a patient with new-onset dyspnea and symptoms suggestive of heart failure, who had an unexpected diagnosis of a large left atrial myxoma with diastolic protrusion into the left ventricle. We further underline the role of cardiac Point-of-Care Ultrasound (POCUS) in the initial evaluation of patients with cardiac complaints in the emergency room setting. It can help to differentiate the patients' symptoms in order to achieve a more accurate diagnosis and thus increase the efficacy of the established therapy. In some cases, as with this patient, it can help to establish a diagnosis which needs prompt therapy.

Published
2022
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24. Incidence, prevalence and long-term progression of Goh algorithm rated interstitial lung disease in systemic sclerosis in two independent cohorts in flanders: A retrospective cohort study.

Author

Vandecasteele E, Melsens K, Vanhaecke A, Blockmans D, Bonroy C, Carton C, Deschepper E, De Keyser F, Houssiau F, Piette Y, Vanthuyne M, Verbeke K, Westhovens R, Wuyts WA, De Langhe E, Brusselle G, and Smith V

Subjects
Algorithms, Humans, Incidence, Lung, Prevalence, Retrospective Studies, Lung Diseases, Interstitial epidemiology, Scleroderma, Systemic complications, Scleroderma, Systemic epidemiology
Abstract

Objectives: The epidemiology of interstitial lung disease (ILD) in systemic sclerosis (SSc) in Belgium is unknown. In literature, its prevalence varies between 19% and 52% in limited/diffuse cutaneous SSc (LcSSc/DcSSc). However, its prevalence in "early" SSc (pre-clinically overt SSc without [yet] skin involvement), nor its incidence rate in SSc (LcSSc/DcSSc/"early" SSc) has ever been described. Against this background, we aimed to determine the prevalence/incidence (rate) and progression of ILD in SSc., Methods: 12-year follow-up data of consecutive SSc patients, included in two Flemish cohorts (University Hospitals Ghent and Leuven), were retrospectively analysed. ILD was classified according to the simplified Goh algorithm. Progression of ILD was defined as a relative decline of FVC ≥10%, a combined relative decline of FVC 5-10% and DLCO ≥15%, or as an increase in HRCT extent., Results: 722 patients (60% LcSSc/ 20% DcSSc/ 20% "early" SSc, median (IQR) follow-up 39 [12-80] months) had baseline HRCT. 243 were rated to have ILD at baseline and 39 during follow-up (prevalence of 34%/ incidence rate of 20.3/1000PY, 95%CI:14.5-27.8). Amongst those with baseline ILD, 60% had lung functional progression at five years of follow-up. In the "early" SSc subgroup, eight patients were rated to have ILD at baseline and three during follow-up (prevalence of 6%/ incidence rate of 5.8/1000 PY, 95%CI:1.2-17.0)., Conclusion: Both LcSSc and DcSSc patients should be monitored for ILD evolution. The low prevalence and incidence of ILD in the "early" SSc subgroup may instruct future decisions on the construction of uniform patient follow-up pathways in "early" SSc., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2021
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25. Pulmonary hypertension in connective tissue diseases, new evidence and challenges.

Author

Vonk MC, Vandecasteele E, and van Dijk AP

Subjects
Connective Tissue Diseases complications, Dermatomyositis complications, Dermatomyositis therapy, Disease Management, Humans, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary etiology, Hypertension, Pulmonary physiopathology, Lupus Erythematosus, Systemic complications, Lupus Erythematosus, Systemic therapy, Mass Screening, Mixed Connective Tissue Disease complications, Mixed Connective Tissue Disease therapy, Prognosis, Pulmonary Arterial Hypertension diagnosis, Pulmonary Arterial Hypertension etiology, Pulmonary Arterial Hypertension physiopathology, Pulmonary Arterial Hypertension therapy, Scleroderma, Systemic complications, Scleroderma, Systemic therapy, Sjogren's Syndrome complications, Sjogren's Syndrome therapy, Connective Tissue Diseases therapy, Hypertension, Pulmonary therapy
Abstract

Pulmonary arterial hypertension is a lethal complication of different connective tissue diseases such as systemic sclerosis, mixed connective tissue disease and systemic lupus erythematosus. Although the treatment possibilities for patients with pulmonary arterial hypertension have increased in the last two decades and survival of patients with idiopathic pulmonary arterial hypertension has improved, the latter is not the case for patients with pulmonary arterial hypertension associated with connective tissue disease. In this narrative review, we review recent literature and describe the improvement of early diagnostic possibilities, screening modalities and treatment options. We also point out the pitfalls in diagnosis in this patient category and describe the unmet needs and what the focus of future research should be., (© 22020 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.)

Published
2021
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26. May capillaroscopy be a candidate tool in future algorithms for SSC-ILD: Are we looking for the holy grail? A systematic review.

Author

Smith V, Vanhaecke A, Guerra MG, Melsens K, Vandecasteele E, Paolino S, and Cutolo M

Subjects
Capillaries, Cross-Sectional Studies, Humans, Longitudinal Studies, Nails, Algorithms, Lung Diseases, Interstitial diagnosis, Microscopic Angioscopy, Scleroderma, Systemic diagnosis
Abstract

Objective: To investigate whether nailfold videocapillaroscopy (NVC), an increasingly worldwide used non-invasive tool to reliably evaluate the peripheral microcirculation, may be an outcome measure in future screening algorithms for systemic sclerosis related interstitial lung disease (SSc-ILD)., Methods: A systematic review to identify original research papers documenting an association between NVC and SSc-ILD was performed in 3 electronic databases according to the PRISMA guidelines. Subsequently, NVC parameters were subdivided according to the consented standardised capillaroscopic definitions of the EULAR Study Group on Microcirculation in Rheumatic Diseases / Scleroderma Clinical Trials Consortium on Capillaroscopy, into quantitative (capillary density, capillary dimension, capillary morphology and haemorrhages) and qualitative assessment (NVC pattern)., Results: The systematic search identified 310 unique search results, of which 2 cross-sectional and 1 longitudinal study were retained. In both cross-sectional studies, the presence of SSc-ILD was found to be inversely associated with capillary density (p = .008 and p = .005). The presence of a severe (active/late) NVC pattern was evaluated and associated with the presence of SSc-ILD in one of the cross-sectional studies. In the longitudinal study, incident SSc-ILD was associated with progressive capillary loss (p = .03) and the conversion to a worse (active/late) NVC pattern (p = .001/p = .003)., Conclusions: This first systematic literature review investigating the role of NVC in SSc-ILD using standardised capillaroscopic definitions uncovered associations between NVC and (incident) SSc-ILD. If large prospective studies further corroborate and elucidate these findings, NVC might possibly be a candidate outcome measure to be integrated in screening algorithms for incident/progressive SSc-ILD., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Published
2020
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27. Nailfold Videocapillaroscopy in Systemic Sclerosis-related Pulmonary Arterial Hypertension: A Systematic Literature Review.

Author

Smith V, Vanhaecke A, Vandecasteele E, Guerra M, Paolino S, Melsens K, and Cutolo M

Subjects
Capillaries, Cross-Sectional Studies, Humans, Microscopic Angioscopy, Nails, Pulmonary Arterial Hypertension, Scleroderma, Systemic complications
Abstract

Objective: Pulmonary arterial hypertension (PAH) is one of the leading causes of death in systemic sclerosis (SSc). Current screening algorithms are hampered by low positive predictive values. Outcome measures that could add to performance characteristics would be welcome. We aim to evaluate the role of nailfold videocapillaroscopy (NVC) using standardized definitions, in SSc-related PAH (SSc-PAH)., Methods: A systematic review to identify original research papers documenting an association between NVC and right heart catheterization-defined SSc-PAH was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Subsequently, NVC characteristics were subdivided into quantitative (capillary density, dimension, morphology, and hemorrhages), semiquantitative, and qualitative assessment (NVC pattern), according to the definitions of the European League Against Rheumatism Study Group on Microcirculation in Rheumatic Diseases., Results: The systematic search identified 316 unique search results, of which 5 were included in the final qualitative analysis. The occurrence of incident SSc-PAH unequivocally associated in 2 longitudinal studies with progressive capillary loss (p = 0.04 and p = 0.033) and the progression to a severe (active/late) NVC pattern (p = 0.05/0.01 and HR = 5.12, 95% CI 1.23-21.27). In 3 cross-sectional studies, SSc-PAH was found to be unequivocally inversely associated with capillary density (p = 0.001 and p < 0.05) and associated with the presence of a severe NVC pattern (p = 0.03 and p < 0.05)., Conclusion: This is the first systematic literature review investigating the role of NVC in SSc-PAH using standardized description, to our knowledge. Unequivocal associations were found between (incident) SSc-PAH and capillary density and NVC pattern. Integration of NVC into current screening algorithms to boost their performance may be a future step.

Published
2020
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28. [Practice in a unit for difficult patients for students of nursing studies].

Author

Vandecasteele E, Tandou M, Bara L, Bacon T, and Bouchard JP

Subjects
Dangerous Behavior, Humans, Mental Disorders psychology, Nursing Education Research, Nursing Evaluation Research, Education, Nursing organization & administration, Mental Disorders nursing, Psychiatric Department, Hospital, Students, Nursing psychology
Abstract

Units for difficult patients are secure psychiatric wards for people with mental health disorders who could have or who have displayed dangerous behaviour. In this article, four students in their 3rd year of nursing studies share their experience on such a ward during their practice placement at Cadillac general hospital. Their learning and discovery of nursing care alongside experienced professionals enabled them to develop their competencies and change their perception of psychiatry., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Published
2020
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29. Recurrent chest pain and dyspnoea in a patient with pulmonary arterial hypertension.

Author

Van Tittelboom N, Devos D, Thierry B, De Pauw M, and Vandecasteele E

Subjects
Adult, Compartment Syndromes diagnosis, Compartment Syndromes etiology, Compartment Syndromes physiopathology, Compartment Syndromes surgery, Diagnosis, Differential, Diagnostic Techniques, Cardiovascular, Disease Progression, Fatal Outcome, Female, Heart Atria diagnostic imaging, Heart Atria physiopathology, Humans, Prognosis, Tomography, X-Ray Computed methods, Aneurysm diagnosis, Aneurysm physiopathology, Aneurysm surgery, Coronary Artery Disease diagnosis, Coronary Artery Disease etiology, Coronary Artery Disease surgery, Familial Primary Pulmonary Hypertension diagnosis, Familial Primary Pulmonary Hypertension etiology, Familial Primary Pulmonary Hypertension physiopathology, Percutaneous Coronary Intervention methods, Pulmonary Artery diagnostic imaging, Pulmonary Artery pathology, Pulmonary Artery surgery, Vascular Grafting instrumentation, Vascular Grafting methods
Abstract

Background : Pulmonary arterial hypertension (PAH) is a devastating, life-threatening disease with poor prognosis when left untreated. The long-term prognosis is definitely influenced by the natural progression of PAH but late disease-specific complications may also contribute. Case summary : We present a patient with a long-standing idiopathic PAH in whom progressive dilatation of pulmonary trunk and pulmonary arteries leads to compression of the left main coronary artery and the left atrium with hemodynamic compromise. Conclusion : With the current treatment options, survival in PAH has improved. Guidelines focus on more aggressive treatment with initial combination therapy and earlier referral for transplantation.

Published
2019
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30. Systemic sclerosis: state of the art on clinical practice guidelines.

Author

Smith V, Scirè CA, Talarico R, Airo P, Alexander T, Allanore Y, Bruni C, Codullo V, Dalm V, De Vries-Bouwstra J, Della Rossa A, Distler O, Galetti I, Launay D, Lepri G, Mathian A, Mouthon L, Ruaro B, Sulli A, Tincani A, Vandecasteele E, Vanhaecke A, Vanthuyne M, Van den Hoogen F, Van Vollenhoven R, Voskuyl AE, Zanatta E, Bombardieri S, Burmester G, Eurico FJ, Frank C, Hachulla E, Houssiau F, Mueller-Ladner U, Schneider M, van Laar JM, Vieira A, Cutolo M, Mosca M, and Matucci-Cerinic M

Abstract

Systemic sclerosis (SSc) is an orphan disease characterised by autoimmunity, fibrosis of the skin and internal organs, and vasculopathy. SSc may be associated with high morbidity and mortality. In this narrative review we summarise the results of a systematic literature research, which was performed as part of the European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases project, aimed at evaluating existing clinical practice guidelines or recommendations. Only in the domains 'Vascular & Ulcers' (ie, non-pharmacological approach to digital ulcer), 'PAH' (ie, screening and treatment), 'Treatment' and 'Juveniles' (ie, evaluation of juveniles with Raynaud's phenomenon) evidence-based and consensus-based guidelines could be included. Hence there is a preponderance of unmet needs in SSc referring to the diagnosis and (non-)pharmacological treatment of several SSc-specific complications. Patients with SSc experience significant uncertainty concerning SSc-related taxonomy, management (both pharmacological and non-pharmacological) and education. Day-to-day impact of the disease (loss of self-esteem, fatigue, sexual dysfunction, and occupational, nutritional and relational problems) is underestimated and needs evaluation., Competing Interests: Conflicts of interest: VS, None to declare. CAS, None to declare. RT, None to declare. PA, None to declare. TA, None to declare. YA, consulted for Actelion, Bayer, Roche/Genentech, Inventiva, Medac, Pfizer, Sanofi, Servier, and UCB; and has received research grants from Bristol-Myers Squibb, Roche/Genentech, Inventiva, Pfizer, Sanofi. CB, None to declare. VC, None to declare. VD, None to declare. JVB, None to declare. ADS, None to declare. OD, had consultancy relationship and/or has received research funding from Actelion, AnaMar, Bayer, Boehringer Ingelheim, Catenion, CSL Behring, ChemomAb, Roche, GSK, Inventiva, Italfarmaco, Lilly, medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Novartis, Pfizer, Sanofi, and UCB in the area of potential treatments ofscleroderma and its complications. In addition, Prof. Distler has a patent mir-29 for the treatment of systemic sclerosis licensed. The real or perceived potential conflicts listed above are accurately stated. IG, None to declare. DL, None to declare. GL, None to declare. AM, None to declare. LM, None to declare. BR, None to declare. AS, None to declare. AT, None to declare. EV, None to declare. AV, None to declare. MV, None to declare. FVH, None to declare. RVV, consulted for AbbVie, AstraZeneca, Biogen, Biotest, BMS, Celgene, Gilead, GSK, Janssen, Lilly, Novartis, Pfizer, UCB; and received research support and grants from AbbVie, BMS, GSK, Pfizer, UCB. AV None to declare. EZ, None to declare. SB, None to declare. GB, None to declare. FJE, None to declare. CF, None to declare. EH, None to declare. FH, None to declare. UML, None to declare. MS, None to declare. JML, None to declare. AV, None to declare. MC, None to declare. MM, None to declare. MMC, has consultancy relationship and/or has received research funding for Actelion, BMS, Celgene, Chemomab, CSL Behring, Eli Lilly and Pfizer; and is a member of the college of emeritus presidents of the Italian Society of Rheumatology (SIR).

Published
2018
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31. An unexpected cause of liver cirrhosis and cardiomyopathy in a young man.

Author

Pauwels R, Vandecasteele E, Devos D, Pauwels W, and De Pauw M

Subjects
Adult, Diagnosis, Differential, Hemochromatosis complications, Hemochromatosis diagnosis, Hemochromatosis therapy, Humans, Male, Time-to-Treatment, Cardiomyopathies diagnosis, Cardiomyopathies etiology, Hemochromatosis congenital, Liver Cirrhosis diagnosis, Liver Cirrhosis etiology
Abstract

Introduction Juvenile hemochromatosis is a rare but severe form of hereditary hemochromatosis that typically presents early in life and can be fatal if left untreated. Case presentation We present the case of a 30-year-old man with a clear symptomatology of juvenile hemochromatosis, but in whom the diagnosis was initially mistaken for alcoholic liver disease because of known excessive use of alcohol, with the consequence that an adequate treatment was postponed. Discussion In this report, we discuss the diagnosis and treatment of juvenile hemochromatosis, focusing on the interaction between hemochromatosis and alcohol induced liver disease and how to differentiate both. We conclude that every young patient with suspected alcoholic liver disease and signs of iron overload should have a testing to rule out other iron overloading pathology, since early recognition and treatment with phlebotomy may prevent organ damage and improve life expectancy.

Published
2018
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32. Reproducibility and Utility of the 6-minute Walk Test in Systemic Sclerosis.

Author

Pugnet G, Marjanovic Z, Deligny C, Boussardon K, Benzidia I, Puyade M, Lansiaux P, Vandecasteele E, Smith V, and Farge D

Subjects
Adult, Disability Evaluation, Female, Humans, Male, Middle Aged, Prognosis, Reproducibility of Results, Scleroderma, Systemic mortality, Survival Rate, Exercise Tolerance physiology, Scleroderma, Systemic physiopathology, Walk Test, Walking physiology
Abstract

Objective: To assess the reproducibility and the utility of the 6-minute walk test (6MWT) in systemic sclerosis (SSc)., Methods: All patients with SSc who underwent at least two 6MWT within a minimum 3-month interval plus simultaneous routine clinical, biological, and functional evaluations were consecutively enrolled in this observational study over 6 years. Following American Thoracic Society guidelines, each 6MWT was repeated twice to assess the 6-minute walk distance (6MWD) reproducibility, with the highest value being reported for subsequent analysis., Results: Among 56 (38 female) included patients aged 46 ± SD 12.7 years, with 17 ± 10 modified Rodnan skin score (mRSS) and 1 ± 0.8 Scleroderma Health Assessment Questionnaire (SHAQ) at first referral, 277 6MWT evaluations (5 ± 3.9 6MWT per patient) were performed over 23 ± 22.5 months followup. Meanwhile, 8 deaths (87.5% SSc-related) occurred. The mean 6MWD absolute value was 457 ± 117 m with a 4 ± 2.2 mean Borg dyspnea score. The 6MWD intraclass correlation coefficient was 0.996 (95% CI 0.995-0.999, p < 0.0001). In multivariate linear regression analysis, these factors were independently associated with a lower 6MWD: sex (R 2 = 0.47, p < 0.0001), mRSS (R 2 = 0.47, p = 0.008), tendon friction rub (R 2 = 0.47, p = 0.003), SHAQ (R 2 = 0.47, p = 0.02), muscle disability score (R 2 = 0.47, p = 0.03), DLCO% (R 2 = 0.47, p = 0.0008), and left ventricular ejection fraction (R 2 = 0.47, p = 0.006). The 6MWD at first referral was an independent predictor for the overall mortality (HR 0.99, 95% CI 0.988-0.999) and the SSc-related mortality (HR 0.99, 95% CI 0.988-0.999)., Conclusion: We show strong reproducibility for the 6MWD and confirm the 6MWT utility to assess the overall prognosis of patients with SSc.

Published
2018
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33. A prospective, longitudinal study evaluating the baseline six-minute walk test as an individual reference value in systemic sclerosis patients.

Author

Vandecasteele E, Melsens K, De Keyser F, De Pauw M, Deschepper E, Decuman S, Piette Y, Thevissen K, Brusselle G, and Smith V

Subjects
Adult, Disease Progression, Female, Health Status, Humans, Hypertension, Pulmonary etiology, Hypertension, Pulmonary physiopathology, Longitudinal Studies, Lung Diseases, Interstitial etiology, Lung Diseases, Interstitial physiopathology, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Reference Values, Reproducibility of Results, Risk Factors, Scleroderma, Systemic complications, Scleroderma, Systemic physiopathology, Time Factors, Exercise Tolerance, Hypertension, Pulmonary diagnosis, Lung Diseases, Interstitial diagnosis, Scleroderma, Systemic diagnosis, Walk Test standards, Walking
Abstract

Objectives: Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are the leading causes of death in systemic sclerosis (SSc). Although the six-minute walk test (6MWT) is used for evaluating ILD and PAH, no data are available on the evolution of the six-minute walk distance (6MWD) in SSc patients without ILD and PAH and whether the baseline 6MWD could serve as individual reference value for the management of those who will develop PAH or ILD., Methods: Prospectively collected data of the first 6MWT (at baseline or 6-month follow-up) and the 6MWTs at 18-, 30-, 42-, 54-, and 66-month visit of 165 consecutive SSc patients without ILD and PAH, included in the Ghent University SSc Cohort between May 2006 and December 2016 were analysed., Results: 96-100% of the included patients performed a 6MWT during the follow-up visits. The mean 6MWD during the baseline 6MWT of 165 SSc patients without ILD and PAH (35% limited, 56% limited cutaneous, 9% diffuse cutaneous SSc) was 484.20+/-92.65m with no significant difference in the 6MWD at different follow-up visits as compared to baseline. In 46 SSc patients without ILD and PAH who performed a 6MWT at baseline and at 66-month visit, the 6MWD walked at 66-month visit correlated with the baseline 6MWD (r=0.564, p<0.001)., Conclusions: In SSc without ILD and PAH, the 6MWT is feasible and the 6MWD is clinically stable over a 66 months period. Hence, the individual 6MWD might be used as individual reference value in management of those who will develop PAH or ILD.

Published
2018

34. Nailfold capillaroscopy in systemic lupus erythematosus: A systematic review and critical appraisal.

Author

Cutolo M, Melsens K, Wijnant S, Ingegnoli F, Thevissen K, De Keyser F, Decuman S, Müller-Ladner U, Piette Y, Riccieri V, Ughi N, Vandecasteele E, Vanhaecke A, and Smith V

Subjects
Capillaries, Female, Humans, Male, Lupus Erythematosus, Systemic immunology, Microscopic Angioscopy methods, Nails blood supply
Abstract

Nailfold capillaroscopy is an easy, non-invasive technique to assess microvascular involvement in rheumatic diseases. Multiple studies describe capillaroscopic changes in systemic lupus erythematosus (SLE), including a wide range of non-specific findings. On behalf of the European League Against Rheumatism (EULAR) study group on microcirculation in rheumatic diseases, a systematic review was done to obtain all original research studies (in English) in which SLE patients had capillaroscopy. Forty such studies are identified. This article firstly provides a résumé of the results of these studies according to capillaroscopic parameters (density, dimensions, morphology, haemorrhages), semi-quantitative assessment and qualitative assessment of capillaroscopy in SLE patients. Secondly, the correlations between capillaroscopic parameters in SLE patients and clinical and laboratory parameters (including auto-immune parameters) are outlined. The following capillaroscopic parameters are found to be significantly more prevalent in SLE patients compared to healthy controls: tortuous capillaries, abnormal morphology and haemorrhages. Hairpin-shaped capillaries are significantly less prevalent than in healthy persons. The semi-quantitatively determined nailfold capillaroscopic score (NFC score) in SLE patients is also higher than in healthy controls. Several correlations between clinical and laboratory parameters and capillaroscopic parameters are identified in the review. Disease activity is correlated with NFC score in seven studies, with abnormal morphology (i.e. "meandering") in one study and with haemorrhages in one study. Frequent attacks of Raynaud's phenomenon (RP) and gangrene are significantly correlated with dilated capillaries. In two studies a possible correlation between anti-SSA antibodies and lower density of capillaries is withheld. About other immune parameters conflicting results are found. In one study a significant negative correlation is found between 24-hour proteinuria and abnormal morphology (i.e. "meandering"). For the first time, an overview of the nailfold capillaroscopic changes that have been described in SLE and their correlations with clinical and laboratory findings is given. Further large-scale research on the identification of capillaroscopic changes in SLE and their correlations with standardised clinical and laboratory parameters, is ongoing at the EULAR study group on microcirculation in rheumatic diseases., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Published
2018
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35. Two years follow-up of an open-label pilot study of treatment with rituximab in patients with early diffuse cutaneous systemic sclerosis.

Author

Melsens K, Vandecasteele E, Deschepper E, Badot V, Blockmans D, Brusselle G, De Langhe E, De Pauw M, Debusschere C, Decuman S, Deroo L, Houssiau F, Lenaerts J, Piette Y, Thevissen K, Vanthuyne M, Westhovens R, Wijnant S, De Keyser F, and Smith V

Subjects
Female, Follow-Up Studies, Humans, Male, Pilot Projects, Antirheumatic Agents therapeutic use, Rituximab therapeutic use, Scleroderma, Diffuse drug therapy
Abstract

Objectives: Following results in open-label studies of rituximab in patients with systemic sclerosis, a Belgian three-centre initiative was launched to explore safety and efficacy of rituximab in early, diffuse cutaneous systemic sclerosis (dcSSc)., Methods: Open-label study of 17 patients with early dcSSc, treated with two courses of rituximab, at month 0 and 6. Clinical examination, lung function testing, echocardiography, disease activity score (DAS) and functional status were performed at baseline and over 24 months of follow-up., Results: Modified Rodnan skin score (MRSS) changed significantly over time, with a mean of 25.5 (standard deviation [SD] 6.0) at baseline to 12.6 (SD 5.1) at month 24 (Mixed Model Analysis [MMA] p < 0.0001), which is a decrease of 51% at month 24 vs. baseline. DAS showed significant decrease over the total study period, with a score of 4.1 (SD 1.7) at baseline to 1.5 (SD 1.8) at month 24 (MMA p < 0.0001). Additionally, this was significant at all time points vs. baseline, both for MRSS and DAS. Internal organ status remained clinically stable throughout the study period. No statistically significant differences compared to baseline were found at the follow-up time points. Seven serious adverse events took place, all except for one, considered unrelated to study medication., Conclusions: This is the first multicentre Belgian collaboration investigating potential efficacy of rituximab in early dcSSc. Rituximab appears to be safe and tolerable and it may have beneficial effects on skin involvement, on overall disease activity and on stabilization of internal organ status in early dcSSc.

Published
2018
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36. Coup - contrecoup injury of the heart.

Author

Vandecasteele E, Devos D, Bové T, and Van Heuverswyn F

Subjects
Adolescent, Hemopneumothorax diagnosis, Hemopneumothorax etiology, Hemopneumothorax surgery, Humans, Intracranial Hemorrhage, Traumatic diagnosis, Intracranial Hemorrhage, Traumatic etiology, Intracranial Hemorrhage, Traumatic surgery, Magnetic Resonance Imaging, Cine methods, Male, Patient Care Management methods, Treatment Outcome, Troponin T blood, Cardiac Surgical Procedures methods, Contrecoup Injury diagnosis, Contrecoup Injury physiopathology, Contrecoup Injury therapy, Echocardiography, Transesophageal methods, Heart Aneurysm diagnostic imaging, Heart Aneurysm etiology, Heart Aneurysm surgery, Heart Injuries blood, Heart Injuries diagnosis, Heart Injuries physiopathology, Multiple Trauma diagnosis, Multiple Trauma physiopathology, Multiple Trauma therapy, Ventricular Septum diagnostic imaging, Ventricular Septum injuries, Ventricular Septum pathology
Published
2017
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37. Six-minute walk test in or out in evaluation of systemic sclerosis patients?

Author

Vandecasteele E, Thevissen K, Melsens K, De Keyser F, De Pauw M, Deschepper E, Decuman S, Piette Y, Brusselle G, and Smith V

Subjects
Adult, Aged, Female, Humans, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary physiopathology, Lung Diseases, Interstitial diagnosis, Lung Diseases, Interstitial physiopathology, Male, Middle Aged, Oxygen blood, Prospective Studies, Scleroderma, Systemic complications, Scleroderma, Systemic physiopathology, Walk Test
Abstract

Objectives: Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are the leading causes of death in systemic sclerosis (SSc) patients. Although the six-minute walk test (6MWT) is used for evaluating ILD and PAH in clinical practice, no data are available on six-minute walk distance (6MWD) and oxygen desaturation in SSc patients without ILD and PAH., Methods: Prospectively collected data of the 6MWTs at baseline and 6-month follow-up of 300 consecutive SSc patients, included in the Ghent University Hospital Systemic Sclerosis Unit between May 2006 and April 2015 were analysed., Results: The mean 6MWD of 165 SSc patients without ILD and PAH who performed a 6MWT at baseline or at the 6-month visit was 484±93m. Patients in the diffuse cutaneous (DcSSc) subgroup (435±94m) walked less than in the limited (LSSc) subgroup (499±91m, p=0.04) and tended to walk less than in the limited cutaneous (LcSSc) subgroup (483±92m, p=0.15). In 115 SSc patients without ILD and PAH who walked at both moments, there was no significant difference between the 6MWDs (mean difference -7.60m 95%CI [-19.93m; 4.73m], p=0.23) and the oxygen desaturation was not statistically different in 102 of them (mean difference 0.41% 95%CI [-0.49%; 1.31%], p=0.37)., Conclusions: In SSc without ILD and PAH, the 6MWD and oxygen desaturation is clinically stable over a 6 months period. The DcSSc subgroup walks less than the LSSc and the LcSSc subgroup.

Published
2017

38. Stroke due to non-bacterial thrombotic endocarditis as initial presentation of breast invasive ductal carcinoma.

Author

Detremerie C, Timmermans F, De Pauw M, Gheeraert P, Hemelsoet D, Toeback J, Bové T, and Vandecasteele E

Subjects
Aged, Endocarditis, Non-Infective diagnostic imaging, Female, Humans, Stroke diagnostic imaging, Breast Neoplasms complications, Breast Neoplasms diagnosis, Carcinoma, Ductal, Breast complications, Carcinoma, Ductal, Breast diagnosis, Endocarditis, Non-Infective etiology, Stroke etiology
Abstract

We present a case of a 71-year-old woman with recurrent stroke episodes due to non-bacterial thrombotic endocarditis (NBTE) leading to the diagnosis of an early-stage breast carcinoma. NBTE is associated with a variety of inflammatory states, including malignancy. NBTE presents itself with systemic embolization, mostly stroke. Treatment consists of treating the underlying condition and start of systemic anticoagulation therapy. Cardiac surgery is restricted to highly selected cases, since prognosis usually is limited by the neoplasm, which usually is in an advanced stage at time of diagnosis of NBTE. The malignancy usually is diagnosed prior to NBTE. Cases presenting with NBTE leading to the diagnosis of malignancy, however, are rarely reported. To our knowledge, we present the first case leading to the diagnosis of an early-stage breast carcinoma.

Published
2017
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39. Screening for pulmonary arterial hypertension in an unselected prospective systemic sclerosis cohort.

Author

Vandecasteele E, Drieghe B, Melsens K, Thevissen K, De Pauw M, Deschepper E, Decuman S, Bonroy C, Piette Y, De Keyser F, Brusselle G, and Smith V

Subjects
Adult, Algorithms, Cardiac Catheterization, Cost-Benefit Analysis, Echocardiography, Europe, Female, Humans, Hypertension, Pulmonary complications, Incidence, Male, Middle Aged, Predictive Value of Tests, Prevalence, Prospective Studies, Scleroderma, Systemic complications, Hypertension, Pulmonary diagnosis, Mass Screening methods
Abstract

Screening for pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) improves outcomes. The DETECT screening algorithm is recommended in a high-risk SSc subgroup. This study aims to compare prospectively the positive predictive value of screening using the DETECT algorithm and the 2009 European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines, and to compare their cost-effectiveness in an unselected, day-to-day SSc population. Post hoc , screening according to the 2015 ESC/ERS guidelines using echocardiographic parameters alone ("2015 echo screening") or combined with the DETECT algorithm ("2015 combined screening") in high-risk subjects was analysed.195 consecutive SSc patients included in the Ghent University Hospital SSc cohort were screened using different algorithms.The referral rate for right heart catheterisation was 32% (63 out of 195 patients) (46/4/13/34/40 patients using the DETECT algorithm/2009 guidelines/both/2015 echo screening/2015 combined screening). Right heart catheterisation was performed in 53 patients (84%) (36 (78%)/four (100%)/13 (100%)/28 (82%)/32 (80%) patients recommended by the DETECT algorithm/2009 guidelines/both/2015 echo screening/2015 combined screening). PAH was diagnosed in three patients (incidence 1.5%·year -1 , 95% CI 0.5-4.4), in whom all algorithms recommended a right heart catheterisation. The positive predictive value was 6% (95% CI 2-17%; three out of 49 patients) for the DETECT algorithm, 18% (95% CI 6-41%; three out of 17 patients) for the 2009 guidelines, 23% (95% CI 8-50%; three out of 13 patients) for both, 11% (95% CI 4-27%; three out of 28 patients) for the 2015 echo screening and 9% (95% CI 3-24%; three out of 32 patients) for the 2015 combined screening. The cost was EUR224/80/90/112 per patient using the DETECT algorithm/2009 guidelines/2015 echo screening/2015 combined screening.Echocardiography may remain a candidate first step for PAH screening in SSc., Competing Interests: Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com, (Copyright ©ERS 2017.)

Published
2017
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40. Disease activity indices in systemic sclerosis: a systematic literature review.

Author

Melsens K, De Keyser F, Decuman S, Piette Y, Vandecasteele E, and Smith V

Subjects
Health Status, Humans, Predictive Value of Tests, Prognosis, Quality of Life, Reproducibility of Results, Scleroderma, Systemic physiopathology, Scleroderma, Systemic psychology, Scleroderma, Systemic therapy, Severity of Illness Index, Decision Support Techniques, Disability Evaluation, Health Status Indicators, Outcome Assessment, Health Care methods, Scleroderma, Systemic diagnosis, Surveys and Questionnaires
Abstract

Objectives: Reviewing disease activity indices (DAI) in systemic sclerosis (SSc) and reporting their validation status., Methods: Literature was systematically reviewed on studies documenting the development of DAI, assessing the validation status of DAI and studies using a DAI in their analysis. The qualitative and quantitative validation status of existing DAI was assessed based on OMERACT and on definitions of the American College of Rheumatology (ACR) committee on quality measures., Results: Three DAI in SSc have been proposed in literature: the European Scleroderma Study Group (EScSG) activity index, the 12-point DAI and the Combined Response Index for Systemic Sclerosis (CRISS). The EScSG activity index is yet applied as an outcome measure in 48 different studies. The EScSG activity index and the CRISS are provisional partially validated DAI., Conclusions: Future studies are needed to fully validate the EScSG activity index and the CRISS and to assess the validation status of the 12-point DAI.

Published
2016

41. Assessment of sensitivity to change of the European Scleroderma Study Group activity index.

Author

Melsens K, De Keyser F, Decuman S, Brusselle G, De Pauw M, Deschepper E, De Wilde K, Elewaut D, Piette Y, Vandecasteele E, and Smith V

Subjects
Administration, Intravenous, Adult, Aged, Belgium, Drug Administration Schedule, Drug Therapy, Combination, Echocardiography, Female, Heart Diseases diagnosis, Heart Diseases drug therapy, Heart Diseases etiology, Humans, Immunosuppressive Agents adverse effects, Lung Diseases diagnosis, Lung Diseases drug therapy, Lung Diseases etiology, Male, Methylprednisolone administration & dosage, Middle Aged, Predictive Value of Tests, Remission Induction, Reproducibility of Results, Respiratory Function Tests, Risk Factors, Rituximab adverse effects, Scleroderma, Diffuse complications, Scleroderma, Diffuse diagnosis, Severity of Illness Index, Time Factors, Treatment Outcome, Immunosuppressive Agents administration & dosage, Rituximab administration & dosage, Scleroderma, Diffuse drug therapy
Abstract

Objectives: The European Scleroderma Study Group (EScSG) activity index meets nearly all the OMERACT-standards of truth, discrimination and feasibility. The sensitivity to change remains to be attested. This study assesses sensitivity to change of the EScSG activity index in patients with early and severe diffuse cutaneous Systemic Sclerosis (dcSSc) treated with rituximab., Methods: 12-month follow-up (open-label study) of 14 consecutive patients with early dcSSc. Patients received an infusion of two times 1000 mg rituximab at month 0 and 6, together with 100 mg methylprednisolone. Clinical read outs (modified Rodnan skin score [mRSS], lung function and echocardiography) and EScSG activity index were performed at month 0, 3, 6 and 12. Mixed models analyses (MMA) were used to evaluate changes in parameters over time., Results: There was a clinically significant change in skin score with a mean (SD) mRSS of 24.8 (4.44) at baseline and 10.4 (3.12) at month 12 (MMA p<0.001). Also the EScSG activity index decreased significantly, with a mean (SD) of 4.3 (1.79) at baseline and 0.7 (0.83) at month 12 (MMA p<0.001). The estimated mean change of the EScSG activity index was -3.6 (95%CI -4.9; -2.4) over 12 months. Indices of internal organ involvement remained stable throughout the study., Conclusions: A significant improvement of the EScSG activity index was observed, in line with the significant improvement of the mRSS and the stabilisation of internal organ involvement. To our knowledge, this is the first study to attest sensitivity to change of the EScSG activity index in the subset of 'early' dcSSc., Trial Registration: ClinicalTrials.gov Registration, http://clinicaltrials.gov, number NCT00379431.

Published
2016

42. Six-minute walk test in systemic sclerosis: A systematic review and meta-analysis.

Author

Vandecasteele E, De Pauw M, De Keyser F, Decuman S, Deschepper E, Piette Y, Brusselle G, and Smith V

Subjects
Adult, Aged, Female, Humans, Hypertension, Pulmonary physiopathology, Lung Diseases, Interstitial physiopathology, Male, Middle Aged, Scleroderma, Systemic complications, Hypertension, Pulmonary epidemiology, Lung Diseases, Interstitial epidemiology, Scleroderma, Systemic physiopathology, Walk Test methods
Abstract

Background: Pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) are the leading causes of death in systemic sclerosis (SSc). Although the six-minute walk test (6MWT) is generally used for evaluating PAH and ILD, utility in SSc is undetermined. This study evaluates the role of 6MWT in SSc by systematic review and meta-analysis., Methods: A systematic literature search on PubMed, Web of Science and Cochrane Library Online was performed using the medical subject heading search terms for "systemic sclerosis", "CREST" and "six minute walk test", "six minute walk distance (6MWD)", "(cardiopulmonary) exercise test", "treadmill test" or "step test"., Results: Meta-analysis of 43 included studies (3185 SSc-all patients) revealed that the mean 6MWD was comparable between the SSc-PAH and SSc-ILD-PH subgroups (288m [95% CI: 259-317m] vs 286m [95% CI: 259-314m], p=0.93). The pooled mean of 725 SSc-PAH patients was significantly lower than the pooled mean of 413 SSc-noPAH patients (430m [95% CI: 402-458m], p<0.001). 95 SSc-ILD-PH patients walked significantly less than 328 SSc-ILD patients (388m [95% CI: 362-415m], p<0.001) and significantly less than 86 SSc-noILD patients (420m [95% CI: 325-515m], p=0.008). 81-98% of the SSc-PAH/ILD/ILD-PH patients performed a 6MWT., Conclusions: During a 6MWT, SSc-PAH patients walk less than SSc-noPAH patients and SSc-ILD-PH patients walk less than SSc-ILD and SSc-noILD patients., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Published
2016
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43. Gender, TIMI risk score and in-hospital mortality in STEMI patients undergoing primary PCI: results from the Belgian STEMI registry.

Author

Gevaert SA, De Bacquer D, Evrard P, Convens C, Dubois P, Boland J, Renard M, Beauloye C, Coussement P, De Raedt H, de Meester A, Vandecasteele E, Vranckx P, Sinnaeve PR, and Claeys MJ

Subjects
Adult, Age Factors, Aged, Aged, 80 and over, Angioplasty, Balloon, Coronary methods, Female, Hospital Mortality, Humans, Male, Middle Aged, Myocardial Infarction therapy, Prognosis, Prospective Studies, Risk, Sex Factors, Treatment Outcome, Myocardial Infarction mortality, Registries statistics & numerical data
Abstract

Aims: The relationship between the predictive performance of the TIMI risk score for STEMI and gender has not been evaluated in the setting of primary PCI (pPCI). Here, we compared in-hospital mortality and predictive performance of the TIMI risk score between Belgian women and men undergoing pPCI., Methods and Results: In-hospital mortality was analysed in 8,073 (1,920 [23.8%] female and 6,153 [76.2%] male patients) consecutive pPCI-treated STEMI patients, included in the prospective, observational Belgian STEMI registry (January 2007 to February 2011). A multivariable logistic regression model, including TIMI risk score variables and gender, evaluated differences in in-hospital mortality between men and women. The predictive performance of the TIMI risk score according to gender was evaluated in terms of discrimination and calibration. Mortality rates for TIMI scores in women and men were compared. Female patients were older, had more comorbidities and longer ischaemic times. Crude in-hospital mortality was 10.1% in women vs. 4.9% in men (OR 2.2; 95% CI: 1.82-2.66, p<0.001). When adjusting for TIMI risk score variables, mortality remained higher in women (OR 1.47, 95% CI: 1.15-1.87, p=0.002). The TIMI risk score provided a good predictive discrimination and calibration in women as well as in men (c-statistic=0.84 [95% CI: 0.809-0.866], goodness-of-fit p=0.53 and c-statistic=0.89 [95% CI: 0.873-0.907], goodness-of-fit p=0.13, respectively), but mortality prediction for TIMI scores was better in men (p=0.02 for TIMI score x gender interaction)., Conclusions: In the Belgian STEMI registry, pPCI-treated women had a higher in-hospital mortality rate even after correcting for TIMI risk score variables. The TIMI risk score was effective in predicting in-hospital mortality but performed slightly better in men. The database was registered with clinicaltrials.gov (NCT00727623).

Published
2014
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44. Acute and critically ill peripartum cardiomyopathy and 'bridge to' therapeutic options: a single center experience with intra-aortic balloon pump, extra corporeal membrane oxygenation and continuous-flow left ventricular assist devices.

Author

Gevaert S, Van Belleghem Y, Bouchez S, Herck I, De Somer F, De Block Y, Tromp F, Vandecasteele E, Martens F, and De Pauw M

Subjects
Acute Disease, Adult, Critical Illness, Female, Heart Transplantation, Humans, Peripartum Period, Pregnancy, Retrospective Studies, Treatment Outcome, Cardiomyopathies therapy, Critical Care methods, Extracorporeal Membrane Oxygenation adverse effects, Heart-Assist Devices adverse effects, Intra-Aortic Balloon Pumping adverse effects, Pregnancy Complications, Cardiovascular therapy
Abstract

Introduction: Peripartum cardiomyopathy (PPCM) patients refractory to medical therapy and intra-aortic balloon pump (IABP) counterpulsation or in whom weaning from these therapies is impossible, are candidates for a left ventricular assist device (LVAD) as a bridge to recovery or transplant. Continuous-flow LVADs are smaller, have a better long-term durability and are associated with better outcomes. Extra corporeal membrane oxygenation (ECMO) can be used as a temporary support in patients with refractory cardiogenic shock. The aim of this study was to evaluate the efficacy and safety of mechanical support in acute and critically ill PPCM patients., Methods: This was a retrospective search of the patient database of the Ghent University hospital (2000 to 2010)., Results: Six PPCM-patients were treated with mechanical support. Three patients presented in the postpartum period and three patients at the end of pregnancy. All were treated with IABP, the duration of IABP support ranged from 1 to 13 days. An ECMO was inserted in one patient who presented with cardiogenic shock, multiple organ dysfunction syndrome and a stillborn baby. Two patients showed partial recovery and could be weaned off the IABP. Four patients were implanted with a continuous-flow LVAD (HeartMate II, Thoratec Inc.), including the ECMO-patient. Three LVAD patients were successfully transplanted 78, 126 and 360 days after LVAD implant; one patient is still on the transplant waiting list. We observed one peripheral thrombotic complication due to IABP and five early bleeding complications in three LVAD patients. One patient died suddenly two years after transplantation., Conclusions: In PPCM with refractory heart failure IABP was safe and efficient as a bridge to recovery or as a bridge to LVAD. ECMO provided temporary support as a bridge to LVAD, while the newer continuous-flow LVADs offered a safe bridge to transplant.

Published
2011
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45. Antimicrobial prophylaxis in liver transplant patients--a multicenter survey endorsed by the European Liver and Intestine Transplant Association.

Author

Vandecasteele E, De Waele J, Vandijck D, Blot S, Vogelaers D, Rogiers X, Van Vlierberghe H, Decruyenaere J, and Hoste E

Subjects
Anti-Bacterial Agents administration & dosage, Antifungal Agents administration & dosage, Antiviral Agents administration & dosage, Cytomegalovirus Infections prevention & control, Europe, Humans, Infection Control methods, Liver Failure, Acute surgery, Liver Transplantation adverse effects, Liver Transplantation statistics & numerical data, Societies, Medical, Surveys and Questionnaires, Anti-Infective Agents administration & dosage, Liver Transplantation methods, Postoperative Complications prevention & control
Abstract

Summary: Perioperative infections remain an important problem for patients undergoing liver transplantation (LT). For prevention of these infections, perioperative prophylaxis has become the standard procedure. Yet, either guidelines or data on current practice are lacking. The aim of the study was to gain insight into prophylactic antimicrobial strategies used in Europe. A survey questionnaire was sent out to all LT centers that are member of the European Liver and Intestine Transplant Association. In the survey questionnaire, we asked for details on the prophylactic antimicrobial regimen used in LT recipients. The response rate was 48%. Antibiotic prophylaxis for elective LT was provided by a first-line betalactam antibiotic or co-trimoxazole in 25%. Seventy-three per cent of those centers surveyed gave an extended spectrum, and one center used a 6-month rotation strategy. Antifungal prophylaxis was administered in 35% of centers in all LT recipients, in 53% of centers in patients at risk, and in 12% of centers not at all. Cytomegalovirus prophylaxis was never administered in 10%. In 12% of the centers surveyed, all the patients received cytomegalovirus prophylaxis, and another 78% of the centers gave it only to risk groups. In Europe, there is a considerable variation in the different antibiotic, antifungal and cytomegalovirus prophylactic strategies used for LT. These findings underscore the need for randomized controlled trials to determine the optimal prophylactic antimicrobial regimen.

Published
2010
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