Pauling and Frech reply

We thank Dr. Hughes for his interest1 in our article2 reporting factors influencing Raynaud phenomenon (RP) symptom reporting in patients with systemic sclerosis (SSc). We presented data demonstrating differences in Raynaud symptom reporting using the Raynaud Condition Score (RCS) diary depending on season of enrollment2.</p

Pesticides As Pollutants Under The Clean Water Act

Climate change and shifting weather patterns affect the development and distribution of insects and other pests. Public agencies as well as private parties, such as farmers and ranchers, commonly use chemical and biological pesticides to combat the spread and entrenchment of these nuisances. Given the ubiquitous use of pesticides, it is not surprising that pesticide regulation involves important issues of law and public policy

Pädiatrisches stumpfes thorakoabdominales Trauma: Damage-Control-Resuscitation-Therapie

Zusammenfassung: Die Primärversorgung von Kindern mit schwerem stumpfem Bauchtrauma und begleitender Azidose, Koagulopathie und Hypothermie (letale Trias) erfordert ein effizientes multidisziplinäres Therapieregime zur Reduktion der Mortalität. Ein 5,5Jahre alter Junge wurde auf einem Bergbauernhof zwischen Traktorhinterrad und Hoftorumrandung im Torsobereich eingequetscht. Es kam zu einer Milzruptur Grad IV, einer Leberruptur Grad III, einer Pankreaslazeration Grad III, einer beidseitigen Lungenkontusion und einem begleitenden Weichteiltrauma mit Rhabdomyolyse. Aufgrund des schweren Traumas mit Auftreten einer Koagulopathie und einer kombinierten metabolisch-respiratorischen Azidose erfolgten die Gabe von Blutprodukten anstelle der von Kristalloiden, Akzeptanz einer permissiven Hypotension, Stabilisierung der Körpertemperatur im Sinne einer Damage-Control-Resuscitation-Strategie sowie eine Milz erhaltende operative Versorgung mittels Laparotomie. Es wird ein mögliches Therapieregime für das pädiatrische schwere Trauma mit Massentransfusion (MT) diskutier

Factors influencing Raynaud condition score diary outcomes in systemic sclerosis

Objective. Raynaud phenomenon (RP) in systemic sclerosis (SSc) could be influenced by clinical phenotype, environmental factors (e.g., season), and personal factors (e.g., coping strategies and ill-health perceptions). We studied the relative influence of a range of putative factors affecting patient-reported assessment of SSc-RP severity. Methods. SSc patients were enrolled at UK and US sites. Participants completed the 2-week Raynaud Condition Score (RCS) diary alongside collection of patient demographics, clinical phenotype, the Coping Strategies Questionnaire, Pain Catastrophizing Scale, Scleroderma Health Assessment Questionnaire (SHAQ), and both patient/physician visual analog scale (VAS) assessments for RP, digital ulcer disease, and global disease. Environmental temperature data were obtained at each site. A second RCS diary was completed 6 months after enrollment. Results. We enrolled 107 patients (baseline questionnaires returned by 94). There were significant associations between RCS diary variables and both catastrophizing and coping strategies. There were significant associations between RCS diary outcomes and both environmental temperature and season of enrollment. Age, disease duration, sex, disease subtype, smoking, and vasodilator use were not associated with RCS diary outcomes. The best-fitting multivariate model identified the patient RP VAS, SHAQ pain VAS, and SHAQ gastrointestinal VAS subscales as the strongest independent predictors of the RCS. Conclusion. Patient-reported assessment of SSc-RP severity is associated with a number of factors including pain, catastrophizing, and coping strategies. The effects of seasonal variation in environmental temperature on SSc-RP burden has implications for clinical trial design. Treatments targeting SSc-RP pain and the development of behavioral interventions enhancing coping strategies may reduce the burden of SSc-RP.</p

Factors influencing Raynaud condition score diary outcomes in systemic sclerosis

Objective. Raynaud phenomenon (RP) in systemic sclerosis (SSc) could be influenced by clinical phenotype, environmental factors (e.g., season), and personal factors (e.g., coping strategies and ill-health perceptions). We studied the relative influence of a range of putative factors affecting patient-reported assessment of SSc-RP severity. Methods. SSc patients were enrolled at UK and US sites. Participants completed the 2-week Raynaud Condition Score (RCS) diary alongside collection of patient demographics, clinical phenotype, the Coping Strategies Questionnaire, Pain Catastrophizing Scale, Scleroderma Health Assessment Questionnaire (SHAQ), and both patient/physician visual analog scale (VAS) assessments for RP, digital ulcer disease, and global disease. Environmental temperature data were obtained at each site. A second RCS diary was completed 6 months after enrollment. Results. We enrolled 107 patients (baseline questionnaires returned by 94). There were significant associations between RCS diary variables and both catastrophizing and coping strategies. There were significant associations between RCS diary outcomes and both environmental temperature and season of enrollment. Age, disease duration, sex, disease subtype, smoking, and vasodilator use were not associated with RCS diary outcomes. The best-fitting multivariate model identified the patient RP VAS, SHAQ pain VAS, and SHAQ gastrointestinal VAS subscales as the strongest independent predictors of the RCS. Conclusion. Patient-reported assessment of SSc-RP severity is associated with a number of factors including pain, catastrophizing, and coping strategies. The effects of seasonal variation in environmental temperature on SSc-RP burden has implications for clinical trial design. Treatments targeting SSc-RP pain and the development of behavioral interventions enhancing coping strategies may reduce the burden of SSc-RP.</p