Raynaud's phenomenon is correlated with elevated systolic pulmonary arterial pressure in patients with systemic lupus erythematosus.

In patients with Systemic lupus erythematosus (SLE), Raynaud phenomenon (RP) is frequently present and associated with pulmonary hypertension (PHT). Elevated pulmonary artery systolic pressure (PASP) is an indicator of PHT and can be estimated noninvasively. We attempt to explore the significance of RP in SLE and to correlate it with clinical and serological parameters of the disease. The study population consisted of 34 patients (age, sex and disease duration matched) who fulfilled the revised SLE criteria of the American College of Rheumatology, and were categorized into two groups: Group 1 had patients having SLE and RP (2 males/15 females, mean age 45 +/- 18 years) and group 2 had patients with SLE but without RP (3 males/14 females, mean age 40 +/- 14 years. Detailed cardiac ultrasound was performed including measurement of PASP, while clinical and serological features of both groups were collected and correlated. Significant differences were shown in the presence of arterial hypertension (P < 0.05), arthralgias (P < 0.005), arthritis (P < 0.05), myalgias (P < 0.05), alopecia (P < 0.05) and PASP (P < 0.0001). No difference was observed among the cardiac ultrasound indices and the ejection fraction between the two groups. PASP was significantly correlated with RP, while no correlation was observed regarding the disease duration. In patients with SLE, the presence of RP was associated with elevation in PASP. Further investigation is needed to clarify the significance of this relation.

Carotid and noncoronary operations: simultaneous, staged, and delayed.

Carotid operation has been shown to be effective in the control of stroke in patients with asymptomatic bruits and transient ischemic attacks (TIAs). This procedure also has been demonstrated to be effective in the control of this disorder when performed simultaneously with coronary artery bypass operations. Similar studies have been reported in patients submitted to other operations. This is a study of 130 patients who had first carotid artery operation and then 215 noncoronary operations. Simultaneous operation was performed in 42, staged in 40, and both in eight patients. In addition, 40 patients were submitted to operation over 3 months after carotid operations. TIAs and one stroke occurred after carotid operation but no deaths. The cumulative results were eight TIAs and three strokes. Only one patient died of stroke. Results were similar in all groups, and therefore it is thought that carotid operation reduces the incidence of stroke following these operations and that simultaneous procedures are feasible in the majority of cases on a selective basis. Moreover, carotid operation seems to protect patients from stroke after operation performed months later.