In SSc, we evaluated the optimal percentile density score in SSc by quantitative CT densitometry, against pulmonary function. Lung volumes and the nth percentile density (between 1 and 99%) of the... Show moreIn SSc, we evaluated the optimal percentile density score in SSc by quantitative CT densitometry, against pulmonary function. Lung volumes and the nth percentile density (between 1 and 99%) of the entire lungs were calculated from CT histograms. The nth percentile density is defined as the threshold value of densities expressed in Hounsfield units. A prerequisite for an optimal percentage was its correlation with baseline DLCO% predicted. Regression analysis for the relation between DLCO% predicted and the nth percentile density was optimal at 85% (Perc85). There was significant agreement between Perc85 and DLCO %predicted and FVC% predicted. Of interest, two patients showed a marked change in Perc85 over a two year period, but the localisation of change differed clearly. We conclude that we identified Perc85 as optimal lung density parameter, which correlated significantly with DLCO and FVC, confirming a lung parenchymal structure-function relation in SSc. This provides support for future studies to determine whether structural changes do precede lung function decline. Show less
Patients with Systemic Sclerosis have to cope with an uncertain disease course, varying impact on physical functioning and limited treatment options. There is increasing acknowledgement of the... Show morePatients with Systemic Sclerosis have to cope with an uncertain disease course, varying impact on physical functioning and limited treatment options. There is increasing acknowledgement of the psychological burden that this entails, however, from a medical point of view, the impact of a disease is often expressed as a degree of physical disability . The International Classification of Functioning ( ICF ) WHO describes the functioning of people, but also the factors that affect functioning; the patient is placed central, and the following adherent domains are described: a) disease characteristics (body functions and structures), b ) activities and social participation , c ) contextual factors (available treatment) and d ) personal characteristics of patients. The aim of this thesis was to gain more insight into the impact of SSc on the health of patients with respect the ICF classification. The thesis includes a study of health care need, as well as the influence of systemic sclerosis in oral function, sexual function, hand function, impact of the disease on work status. Also a echogrdiographic technique named speckle tracking strain analysis, evaluating left ventricular function was studied. Finally, a multidisciplinary rehabilitation program was evaluated using an RCT . Show less
Ninaber, M.K.; Hamersma, W.B.G.J.; Schuerwegh, A.J.M.; Stolk, J. 2014
