ABSTRACT
Features of Sjögren's syndrome were sought in 26 patients with systemic sclerosis and in age- and sex-matched control subjects. The assessments included a structured history to establish symptoms of dry eyes and dry mouth. Schirmer's I and II tear tests. Rose Bengal staining with slit lamp microscopy of the eyes, measurement of basal and stimulatory salivary secretion. We measured sweat secretion rates from the skin. Salivary scintigraphy and skin biopsies were performed on the patients. Only one patient showed the complete picture of Sjögren's syndrome with both clinical and investigational evidence of lacrimal and salivary gland involvement. A further patient had an abnormal Schirmer's II test and xerostomia with reduced salivary secretion and an abnormal scan, but no ocular symptoms and no keratoconjunctivitis sicca on ophthalmological examination. Two patients had reduced salivary flow and a dry mouth. A number of patients and control subjects showed various individual symptoms and signs of lacrimal and salivary disorders. These features alone are not sufficient for the diagnosis of Sjögren's syndrome. There is a clear need to adopt strict criteria for diagnosing the condition. The association of Sjögren's syndrome with systemic sclerosis seems doubtful and if it does occur it is very much less common than previously suggested.
Subject(s)
Scleroderma, Systemic/complications , Sjogren's Syndrome/complications , Adult , Aged , Female , Humans , Male , Middle Aged , Saliva/metabolism , Scleroderma, Systemic/pathology , Scleroderma, Systemic/physiopathology , Sjogren's Syndrome/metabolism , Sjogren's Syndrome/physiopathology , Skin/pathology , Skin/physiopathology , Sweating , Tears/metabolismSubject(s)
C-Reactive Protein/analysis , Thermography/methods , Thrombophlebitis/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , PhlebographySubject(s)
Perfusion , Pleural Effusion/diagnostic imaging , Pulmonary Atelectasis/diagnostic imaging , Humans , Male , Middle Aged , RadiographyABSTRACT
Femoral artery Doppler signals were analysed from 68 patients with lower limb ischaemia undergoing biplanar angiography. These studies (pulsatility index, P.I. and LaPlace transform damping, LTD) were compared with clinical examination using this biplanar angiographic standard. Accuracy of femoral pulse palpation in predicting upstream stenosis was 67%. Biplanar angiography unmasked single plane stenosis underestimates in 21% of patients. In a subgroup of 39 lower limbs with aorto-iliac stenoses between 26 and 85% femoral LTD was the best predictor, being 84% accurate: whereas PI did not improve upon clinical examination. The need for biplanar angiography is underlined and the place of Doppler signal analysis in the assessment of arterial stenosis is confirmed.
