Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Domestic water use in the United States: A life-cycle approach

Water and energy are two primary natural resources used by building occupants. A life-cycle assessment (LCA) is performed for water-consuming plumbing fixtures and water-consuming appliances during their operational life for four different building types. Within the cycle studied, water is extracted from the natural environment, subjected to water treatment, pumped to buildings for use, collected for wastewater treatment, and discharged back to the natural environment. Specifically, the impacts of water use, electricity and natural gas generation, energy consumption (for water and wastewater treatment, and for water heating), and the manufacture of water and wastewater treatment chemicals are evaluated both quantitatively and qualitatively on a generalized national level in the United States of America. It is concluded that water use and consumption within buildings have a much larger impact on resource consumption than the water and wastewater treatment stages of the life cycle. To study this more specifically, the resource consumption of four different building types - an apartment building, a college dormitory, a motel, and an office building - is considered. Of these four building types, the apartment has the highest energy consumption (for water and wastewater treatment, and for water heating) per volume of water used, whereas the office building has the lowest. Similarly, the calculated LCA score for the apartment building is typically greater than those of the other three building types. © 2006 by the Massachusetts Institute of Technology and Yale University