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

Biological monitoring of workers exposed to cobalt metal, salt, oxides, and hard metal dust.

OBJECTIVE--The aim was to examine the relation between environmental and biological (blood and urine) indices of exposure to different chemical forms of cobalt. METHODS--A cross sectional study was undertaken in workers exposed to cobalt metal, oxides, and salts in a refinery and to a mixture of cobalt and tungsten carbide in a hard metal producing plant. RESULTS AND CONCLUSION--Although biological monitoring of workers exposed to cobalt oxides showed higher blood and urine concentrations than in non-exposed subjects, these indices poorly reflected the recent exposure level. By contrast, when exposure was to soluble cobalt compounds (metal, salts, and hard metals), the measurement of urine or blood cobalt at the end of the workweek could be recommended for the assessment of recent exposure. An eight hour exposure to 20 or 50 micrograms/m3 of a soluble form of cobalt would lead to an average concentration in a postshift urine sample collected at the end of the workweek of 18.2 or 32.4 micrograms of cobalt/g creatinine, respectively