Clinical trial
Trying and testing (The Hindu: 20171006)
http://www.thehindu.com/sci-tech/health/trying-and-testing/article19784625.ece
DAILY NEWS BULLETINLEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE DayFriday 20171006
What you should know before you opt for a clinical trial so you have the safest experience
possible
Clinical trials in India have got a bad rap, but things are changing, say doctors and scientists
who lead them. Think of scientific research as something for the greater good of humankind;
something that benefits society, even if not immediately, then in the generations to come,
says Professor Thangarajan Rajkumar, head of the Molecular Oncology department at Adyar
Cancer Institute, Chennai. He speaks with reference to clinical trials in India, and our
reluctance to be a part of them, perhaps partly because of our countrys history of corruption
with regard to them and partly because there are no sure-shot results.
India now has one of the most streamlined systems of research, with strict ethics committees
and a vigilant Drugs Controller General of India (DCGI), says Dr Pooja Sharma, Senior
Scientist at Medanta Institute of Education and Research, and founder of PARTAKE,
Gurgaon, a patient education programme.
Colin Gonsalves, founder of the Human Rights Law Network (HRLN), disagrees
vehemently, especially in cases where people see no way out and cannot afford treatment.
He speaks of unconscionability, when a legal contract is tilted against a vulnerable party, in
this case, the patient. He hopes to see the nexus between pharma companies and the medical
fraternity broken.
As long as clinical trials are allowed in India though, it is worth knowing a few basics if you
are offered one.
All trials are listed either on the Clinical Trial Registry (clinicaltrials.gov), a resource
provided by the US National Library of Medicine or on the Clinical Trials Registry India
(ctri.nic.in). Every trial has a number you can identify it with.
Trials are of two types: investigator-origin trials and pharma- or medical-device-driven ones.
The former is led by an institution/clinician and could be funded by the institution itself or by
a government agency. In the latter, research is designed by the company, the clinicians are
chosen by them and the team of researchers are given a fee by them. Bilateral agencies may
also fund certain trials, and these may be done through the government or certain NGOs.
Informed consent is at the heart of enrolment, so it is the participants right to know of every
aspect of the trial. There is a 16-point check-list for this, including letting the patient know of
the nature of the research, what the study is about, what it hopes to prove, what previous
studies say on the subject, risks, possible benefits, compensation (life and disability
insurance, travel allowance, compensation for loss of wages).
There is a confidentiality clause that does not allow the persons name to be disclosed. A
person can opt out of any study at any point in the process without being penalised and can
continue to have the standard of care treatment provided.
All expenses of the medical treatment are borne by the funding agency, including toxicity
management (either due to the new drug or the standard of care, like chemo).
Every trial will have to be approved by a government-recognised ethics committee,
consisting of an amalgam of people, ranging from clinicians, priests, lawyers, sociologists
and social workers. This body of people is available for the person enrolled in the study. They
also monitor the trial and will take a call on compensation in case of any adverse event.
Questions to ask
If you or anyone you know is offered a trial, ask these questions and insist on the answers in
writing. You may also choose to run it by a lawyer.
What is the drg/device and what is it meant for?
Has the drug/device been tested abroad or anywhere else in the country?
What phase is the trial at?
What are the possible adverse effects?
What is the standard line of treatment? (Some diseases may not have this).
Why am I being offered this trial if there are already best practices in place?
Is it going to be a placebo trial and will treatment given be as per current standards?
Is the new drug/approach in addition to the standard line of treatment?
What is the cure rate with the standard line of treatment and will the new medicine enhance it
(if there is some data on this)?
Will it reduce the time spent in the hospital (in case of a procedure/modality)?
By joining the trial, what is the level of toxicity I will be exposed to, and how will it impact
my life? Will the benefit be greater than the toxicity?
Is it possible to withdraw from the trial without compromising treatment?
Who will the agreement be with? (It should be with the funding agency, not an intermediary).
Who is the sponsor? Who is the principal investigator? Which is the institution that the
research is taking place?
Is there is an insurance policy in place and what are its terms?
App for heart patients
App for heart patients to help get instant treatment (The Hindu: 20171006)
http://www.thehindu.com/news/cities/Delhi/app-for-heart-patients-to-help-get-instant-
treatment/article19804142.ece
And also information of all nearest hospitals
The Cardiological Society of India here has launched a first-of-its-kind app Heart Attack
for Delhiites which will provide accurate information to people who suffer from heart
diseases or if they come to know of any such emergency situations.
A person suspected of having a heart attack, using this app, can immediately get the contact
information of all nearest hospitals/physician cardiologists [from his/her current location]
with heart care facilities, which he/she can choose to go. To help the patients, this app will
not give distance but the actual travel time based on the current traffic situation. Thus, this
app can be of immense help to the whole Delhi-NCR, noted a release issued by the Society.
Speaking at a seminar organised recently, where this app was launched, Professor Sundeep
Mishra from AIIMS and secretary of Cardiology Society of India, Delhi unit said, Heart
attacks and cerebrovascular diseases are now the No. 1 killers in India. Heart attacks are
characterised by high mortality rates and severe disabilities in many of those surviving.
Systematic network
Establishment of coronary care units and angioplasty during heart attacks has helped but it
has been realised that maximum benefit has happened when there is a systematic, organised
network right from the general physician, efficient ambulance service and advanced heart
centres which can undertake angioplasty or drug-based (thrombolysis) opening up of the
blocked artery, he said.
Delhi CSI president Dr. Harsh Wardhan said, Besides the Heart Attack app, the CSI is
also launching a Heart Attack Registry, which will track these travel times and suggest
improvements.
Biodiversity (The Asian Age: 20171006)
http://onlineepaper.asianage.com/articledetailpage.aspx?id=9126093
Heart Diseases (The Asian Age: 20171006)
http://onlineepaper.asianage.com/articledetailpage.aspx?id=9126100
Multivitamin
Could multivitamin use in pregnancy protect children from autism?
(Medical News Today: 20171006)
https://www.medicalnewstoday.com/articles/319660.php
A pregnant woman holding multivitamins
Researchers have linked multivitamin use in pregnancy with a lower risk of autism in
offspring.
The risk of autism may be reduced for children whose mothers use multivitamins during
pregnancy. This is the finding of new research published in The BMJ.
Study co-author Brian K. Lee, of the Dornsife School of Public Health at Drexel University
in Philadelphia, PA, and colleagues say that their study is only observational, but that the
findings suggest that prenatal vitamin use for autism prevention should be further
investigated.
Autism - which is also known as autism spectrum disorder (ASD) - refers to a number of
conditions affecting development, resulting in problems with social skills, communication,
and behavior. Individuals with autism may also have intellectual disabilities, such as
problems with thinking and learning.
According to the Centers for Disease Control and Prevention (CDC), around 1 in 68 children
in the United States are living with autism, up from 1 in 150 in 2002.
A number of studies have suggested that a mother's diet during pregnancy may influence the
risk of autism in offspring. A study published in 2013, for example, suggested that women
who had higher intakes of omega-3 and omega-6 fatty acids during pregnancy were around a
third less likely to have children with autism.
The new study from Lee and team builds on such results, after finding that multivitamin use
during pregnancy may be linked to a reduced risk of autism in children.
Multivitamins and autism risk
The research involved 273,107 mother and child pairs identified through a population register
in Sweden. The children were born between 1996 and 2007 and they were followed up until
2011, when they were aged between 4 and 15 years.
Mothers' supplement use at their first antenatal visit was assessed, and the pairs were
allocated to one of six groups as a result: iron supplements only; folic acid supplements only;
iron and folic acid supplements; multivitamins only; multivitamins with iron; and
multivitamins with folic acid.
Fever in pregnancy tied to higher risk of autism
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Data on autism diagnosis among offspring were gathered using computerized health registers
in Sweden.
The researchers found that children born to mothers who used multivitamins during
pregnancy - "with or without additional iron or folic acid" - were less likely to have autism
with intellectual disability, compared with mothers who did not use these supplements.
The team notes that there was no consistent link between the use of folic acid, iron
supplements, or both during pregnancy and a lower risk of autism among offspring.
Further investigation warranted
Because this study is purely observational, the researchers say that they are unable to prove
cause and effect between multivitamin use in pregnancy and reduced autism risk among
children.
"Given the current understanding and strength of evidence supporting the importance of
nutritional supplementation during pregnancy," they say, "these results on their own should
not change current practice."
The researchers also point to some study limitations. For example, they were unable to assess
any changes to supplement use among mothers after their first antenatal visit. "It is possible
that the reported supplement was not taken, or a supplement was taken but not reported," they
note.
Still, the team believes that its results warrant further investigation. The authors conclude:
"Maternal multivitamin supplementation during pregnancy may be inversely associated with
ASD with intellectual disability in offspring. Further scrutiny of maternal nutrition and its
role in the cause of autism is recommended."
Potassium
Potassium may help to prevent heart disease (Medical News Today:
20171006)
https://www.medicalnewstoday.com/articles/319655.php
Researchers suggest that dietary potassium could help to protect against heart disease.
Spinach, carrots, oranges, and bananas are just some fruits and vegetables that are rich in
potassium. According to a new study, we may want to consider increasing our intake of such
foods; they could help to protect us against heart disease.
Researchers have found that mice with low dietary potassium are more likely to experience
vascular calcification, which is characteristic of atherosclerosis. This is major risk factor for
heart disease.
Increasing dietary potassium, however, was found to reduce vascular calcification in the
rodents, suggesting that a diet rich in potassium could help to prevent heart disease.
The research team - led by Yabing Chen, Ph.D., a professor of pathology at the University of
Alabama at Birmingham (UAB) - recently reported their findings in JCI Insight.
Heart disease is the leading cause of death for both men and women in the United States,
killing around 610,000 people in the country every year.
Atherosclerosis is a key risk factor for heart disease. In atherosclerosis, deposits of fat,
cholesterol, calcium, and other substances accumulate in the arteries, forming what is referred
to as "plaque." Plaque hardens over time, restricting blood flow to the heart.
The new research from Prof. Chen and colleagues suggests that potassium supplementation
could be one way to help combat atherosclerosis and reduce the risk of heart disease.
Potassium and vascular calcification
Potassium is a mineral that is considered essential for the human body. It not only aids
muscle contraction and nerve and cell function, but it also helps to regulate the heartbeat.
Spinach and other leafy greens, as well as potatoes, carrots, oranges, and grapefruit, are just
some of the fruits and vegetables that are good sources of potassium. The mineral is also
available as a dietary supplement.
Meditation may help to lower heart disease risk
Meditation may help to lower heart disease risk
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For their study, the team fed mice high-fat diets supplemented with either low, normal, or
high levels of potassium. The mice used were deficient in a protein called apolipoprotein E,
which makes rodents more susceptible to atherosclerosis in response to a high-fat diet.
The researchers found that mice fed a low-potassium diet showed an increase in vascular
calcification and greater arterial stiffness, while mice fed a high-potassium diet showed a
significant reduction in both conditions.
The team also assessed the effects of varying potassium levels on cultured vascular smooth
muscle cells from mice, as well as on cultured cross sections of mouse arteries.
Study has 'important translational potential'
The cell culture analysis revealed that through a potassium transport channel called the
inward rectifier potassium channel, low-potassium conditions led to a rise in intracellular
calcium in vascular smooth muscle cells.
Also, the team found that low potassium triggers the calcium-activated cAMP response
element-binding protein (CREB), which increases autophagy - an intracellular degradation
process - in cells.
By inhibiting autophagy, the researchers found that they were able to prevent calcification in
vascular smooth muscle cells, indicating that autophagy plays a significant role in the
calcification process.
Through their analysis of cultured cross sections of mouse arteries and dietary experiments in
live mice, the researchers confirmed that low potassium may lead to vascular calcification via
calcium signaling, CREB, and autophagy. Increasing potassium levels, however, could
reduce these effects.
While human studies are now needed to demonstrate the efficacy of potassium against
vascular calcification in humans, the researchers believe that their current findings show
promise.
"The findings have important translational potential, since they demonstrate the benefit of
adequate potassium supplementation on prevention of vascular calcification in
atherosclerosis-prone mice, and the adverse effect of low potassium intake."
Women's dementia
Women's dementia risk increased by midlife hypertension (Medical News
Today: 20171006)
https://www.medicalnewstoday.com/articles/319637.php
a person having their blood pressure checked
Hypertension onset in midlife may be a dementia risk factor for women, but not for men, say
researchers.
Researchers have uncovered a possible sex difference in how blood pressure affects dementia
risk, after finding that women who get hypertension in their 40s are likelier to develop the
condition. But for men, hypertension in midlife appears to have no impact on dementia risk.
The study - conducted by researchers from Kaiser Permanente in Oakland, CA - was recently
published in the journal Neurology.
Around 75 million adults in the United States have high blood pressure, or hypertension,
putting them at increased risk of heart disease and stroke.
An array of studies have also suggested a link between high blood pressure and increased risk
of dementia.
For the new research, study co-author Rachel A. Whitmer, Ph.D., of the Kaiser Permanente
Division of Research, and colleagues sought to determine whether the link between
hypertension and dementia risk varies by age and sex.
The team reached their findings by assessing the data of 7,238 adults enrolled in the Kaiser
Permanente Northern California healthcare system.
Between 1964 and 1973, when subjects were an average age of 33 years, all participants had
their blood pressure measured. Blood pressure was assessed again between 1978 and 1985,
when they were aged 44, on average.
Around 31 percent of men and 14 percent of women had high blood pressure in their 30s, and
around 25 percent of men and 18 percent of women had high blood pressure in their 40s.
Hypertension and dementia: Women vs. men
The researchers tracked down 5,646 of the subjects who were still a part of the Kaiser
Permanente Northern California healthcare system between 1996 and 2015. During this
period, a total of 532 subjects received a dementia diagnosis.
The study results revealed that women who had high blood pressure in their 30s showed no
greater risk of dementia than those whose blood pressure remained normal.
Sniffing out dementia with a simple smell test
Sniffing out dementia with a simple smell test
Researchers suggest that a poor sense of smell could predict the risk of dementia.
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However, women who had high blood pressure during their 40s were found to have a 65
percent increased risk of dementia.
For women who experienced onset of hypertension in their 40s, dementia risk was increased
by 73 percent, compared with women whose blood pressure remained normal during their
30s and 40s.
Among men, the researchers found no evidence to suggest that high blood pressure during
their 30s or 40s was associated with an increased risk of dementia.
These results remained after accounting for a number of possible confounding factors,
including body mass index (BMI), diabetes, and smoking status.
Overall, the researchers say that their findings suggest that high blood pressure becomes a
dementia risk factor for women from their 40s, but this is not the case for men.
Commenting on what their findings may mean, the authors write:
"Sex differences in the timing of dementia risk factors have important implications for brain
health and hypertension management."
However, Dr. Whitmer notes that further research is required to pinpoint the "sex-specific
pathways through which the elevated blood pressure accelerates brain aging."
10 best asthma blogs
The 10 best asthma blogs (Medical News Today: 20171006)
https://www.medicalnewstoday.com/articles/319658.php
Asthma can sometimes be stressful and challenging. But it does not have to be a limiting
condition. We have selected the best asthma blogs that include useful tips and suggestions to
help you keep your symptoms under control.
Asthma is a lung condition that can make your airways narrow, swell, and produce extra
mucus, which causes breathing difficulties. Asthma affects around 18.4 million adults and 6.2
million children in the United States.
Some individuals may eventually grow out of asthma, while for others it is a life-long
condition. Asthma can be a significant problem that interferes with daily life and may lead to
an asthma attack, which can be life-threatening.
There is currently no cure for asthma, but its associated symptoms can be controlled with
medication. Asthma often changes over time, so it is important to work with your healthcare
provider to work out the best treatment for you, and to adjust as needed.
Asthma blogs feature experts in the asthma and allergy field as well as those who are living
with the condition. Medical News Today have identified the 10 best asthma blogs that
provide useful information about the condition, help you learn how to manage asthma, and
provide support.
Asthma and Allergy Foundation of America
AAFA logo
The Asthma and Allergy Foundation of America (AAFA) are a not-for-profit organization
founded in 1953. The AAFA exist to help improve the lives of people with asthma and
allergic disease through research, advocacy, and education.
The AAFA offer educational programs for those with asthma, for caregivers, and for
healthcare providers. They award research grants to support research for understanding the
disease, to develop better treatments, and to find cures. They also aim to be the voice for
people with asthma and allergies, and to create laws with the government that improve and
protect quality of life.
The AAFA blog features posts on asthma-related topics, such as how avoiding tobacco
smoke plays a key role in preventing asthma, how to avoid asthma triggers during holiday
celebrations that are held outside, and a checklist of forms you need for school if your child
has asthma.
Visit the AAFA blog.
Family Allergy & Asthma
Family Allergy & Asthma logo
Family Allergy & Asthma is a group of experts that specialize in allergy and asthma who
practice in more than 26 locations throughout Indiana and Kentucky. It is their goal to
remove the limitations placed on individuals due to their asthmatic or allergic conditions and
to give them their lives back.
Family Allergy & Asthma doctors provide services for asthma, allergy, and immunology,
such as allergy skin testing, stinging insect testing, immunotherapy, pulmonary function
testing, and patient education.
The latest asthma posts on their blog include an explanation of the cause of asthma, tips to
help manage asthma during the winter months, and how to prepare yourself, your child, and
their school when your child has asthma or allergies.
Visit the Family Allergy & Asthma blog.
Breathinstephen
Breathinstephen logo
Breathinstephen is a blogger who lives in the San Francisco Bay Area, CA. Steve has lived
with a severe and uncontrollable type of asthma since early childhood. His lung function is
only around 25 percent of what is normal, which makes breathing challenging for him most
of the time.
Steve created Breathinstephen after observing that there was no one blogging about what it is
like to live with severe asthma on a daily basis. He shares his experiences and observations in
a brutally honest way, as well as the challenges that he is faced with when trying to stay
physically fit in the face of asthma.
Popular posts on Breathinstephen include the differences between asthma and severe asthma,
the six recovery phases of a severe asthma exacerbation that required admission to hospital,
and the not-so-glamorous side of being a severely asthmatic marathon walker.
Visit the Breathinstephen blog.
Asthma Allergies Children
Asthma Allergies Children logo
Asthma Allergies Children are dedicated to presenting ideas about the treatment of asthma
and allergies in children. They aim to report new developments in research and practice,
legislation and regulation, and the marketplace from around the globe.
Asthma Allergies Children provide original content from asthma and allergy scientists,
experts, and practitioners whose ideas are shaping the future of this field of research.
The blog includes articles such as how consuming large amounts of cured meat could be a
risk factor for asthma, information on a new app that makes peak flow monitoring easier, and
the effect of a deadly type of air pollution on children with asthma.
Visit the Asthma Allergies Children blog.
My Life as an Asthma Mom
My Life as a Asthma Mom logo
Andrea Jensen authors the blog My Life as an Asthma Mom. Andrea has asthma, fell in love
with a man with a family history of asthma, and has three children with asthma. The family
has had multiple doctor's appointments, emergency room visits, and hospitalizations all
resulting from asthma.
Asthma has changed Andrea's life. Once an interior designer, Andrea went back to school
and gained a bachelor's degree in Public Health with the goal of helping other families to
learn more about asthma.
My Life as an Asthma Mom offers an insight into Andrea's life as well as providing advice
on how to avoid the pitfalls associated with asthma. Posts include the ways that asthma
affects the whole family, being thankful even when asthma prevents you from completing a
hiking trip, and coping with asthma when your child is competing in high school sports.
Visit the My Life as an Asthma Mom blog.
Bert's Blog
asthma & allergy friendly logo
The asthma & allergy friendly Certification Program is an independent program designed to
identify and scientifically test consumer products suitable for individuals with asthma and
allergies. The Certification Program is administered by the AAFA and in partnership with
Allergy Standards Limited.
Bert's Blog features on the asthma & allergy friendly website and covers anything and
everything to do with products and services for those with asthma and allergic disease. Bert
discusses asthma and allergy news and resources, tips, Q&As, and products and services that
are newly certified.
Recent posts on Bert's Blog include whether your pet is asthma and allergy friendly, five
allergens and triggers that could be hiding in your college dorm room, and ways to raise
awareness of asthma and allergies.
Visit Bert's Blog.
Asthma UK
Asthma UK logo
Asthma UK are a charity based in the United Kingdom that deliver advice and support to
people affected by asthma. Asthma UK fund research and support collaboration with the aim
of driving more investment into the unmet need of asthma.
Asthma UK's mission is to raise awareness of the severity of asthma, boost the number of
people engaging with them, their advice, and their support channel, and improve the
outcomes of asthma attacks, all elements of basic care, and hospital admissions.
Their blog includes inspiring stories from people with asthma, such as how Ali's exercise
routine has helped him to keep his asthma under control, how cycling helps to keep Kevin
healthy and positive, and how exercise helped Tina to manage her asthma symptoms and
inspired her to help other people become more active.
Visit the Asthma UK blog.
Anonymous-Asthma
Anonymous-Asthma logo
Olivia Fulton writes the blog Anonymous-Asthma. She was diagnosed with asthma at age 2
and has a strong history of asthma, eczema, and allergies in her family.
Through Anonymous-Asthma, Olivia charts the highs and lows of living with a form of
asthma that is difficult to manage. She uses the blog to raise awareness of asthma but also to
reflect on how she copes with living a normal life with asthma and the challenges that arise.
Posts on the blog include seeking out other opportunities with open arms when you are
unable to do what you want to do, how a good night's sleep can make a difference to asthma
symptoms, and learning that it is O.K. to say no sometimes if something is too hard.
Visit the Anonymous-Asthma blog.
Asth.ma
Asth.ma logo
Asth.ma is a blog from the view of asthma researcher, doctor, and mom Ann Chen Wu. She
is a researcher at Harvard Medical School and at Harvard Pilgrim Health Care Institute, both
in Boston, MA, and a pediatrician at Children's Hospital Boston, also in Massachusetts.
Ann has a daughter with persistent asthma and a son who experienced wheezing once during
an upper respiratory illness. Through her research, caring for her patients and daughter, and
her blog, she hopes to decrease morbidity from asthma.
Asth.ma covers issues such as the cost of asthma for school-aged children, the link between
the gut and lung microbiome and asthma, and questioning why asthma-related emergency
room visits and hospitalizations have not decreased in 10 years.
Visit the Asth.ma blog.
Allergy & Asthma Network
Allergy & Asthma Network logo
The Allergy & Asthma Network are a nonprofit education and advocacy group for people
with asthma, allergies, and associated conditions. Their mission is to put an end to the
needless suffering and death that results from asthma and allergies.
The Allergy & Asthma Network unite individuals, families, healthcare providers, and
industry and government decision-makers to improve the quality of life for those in the U.S.
with asthma and allergies. They specialize in making medical information understandable for
everyone.
Posts on the blog include common misconceptions about asthma, a potential solution for
keeping asthma in check at school, dispelling the myths related to asthma and allergies one
Tweet at a time, and what to do to reduce stress levels and resulting asthma flare-ups at
school.
Sclerodactyly
Sclerodactyly: What it is, causes, and treatment (Medical News Today:
20171006)
https://www.medicalnewstoday.com/articles/319608.php
Sclerodactyly is a tightening and thickening of the skin of the fingers. It can cause the fingers
to curl inward and the hands to form a clawed shape.
Systemic scleroderma causes sclerodactyly, which is an autoimmune disease and a rare form
of arthritis that affects fewer than 500,000 people in the United States. Not everyone with
scleroderma will get sclerodactyly.
This article looks at the causes and symptoms of sclerodactyly, as well as the treatment
options available to manage the condition.
Contents of this article:
Signs and symptoms
Causes
Associated conditions
Treatment options
Outlook
Signs and symptoms
hand forming claw shape
Sclerodactyly can cause the fingers and hand to form a clawed shape.
People with scleroderma may notice their hands become swollen and puffy before the onset
of sclerodactyly. It may also become difficult to bend the fingers.
The skin may:
feel tight or stretched
get thicker
become harder
appear shiny or wax-like
Initial symptoms may:
appear and then go away from time to time
last for weeks or years
be worse in the morning
In rare cases, these symptoms will eventually advance to the point of sclerodactyly, where the
hand forms a claw, and a person is unable to move their fingers.
Additionally, the underlying soft tissue may begin to waste away.
Causes
As noted earlier, sclerodactyly is caused by systemic scleroderma, an autoimmune disease.
When a person has an autoimmune disease, their immune system attacks healthy body tissue
after mistaking it for foreign invaders, such as bacteria or viruses.
In scleroderma, the body responds to a perceived attack by producing too much collagen, a
protein found in the skin. Collagen gives the skin its strength and elasticity, and it also helps
to replace dead skin cells.
It is thought that this overproduction of collagen occurs because the body believes there is an
injury that needs repairing. This extra collagen can interfere with normal bodily function,
causing the skin to become hard, leathery, and shiny.
The exact cause of scleroderma is unknown. There is a gene that makes some people more
likely to get the condition than others, but this gene alone does not cause the disease.
Risk factors
The biggest risk factor for sclerodactyly is having scleroderma, an autoimmune condition that
affects women more often than men.
Associated conditions
There are several different types of scleroderma:
Localized scleroderma
Man blowing on his hands
Raynaud's disease is one of the symptoms associated with limited scleroderma.
Symptoms of localized scleroderma usually only occur in a few places on the skin or
muscles. In general, this condition is mild and rarely spreads. People with localized
scleroderma do not usually develop systemic scleroderma.
There are two forms of localized scleroderma: morphea and linear scleroderma.
Morphea
Morphea is marked by waxy skin patches and can cause skin thickening. Over time, the
patches may vary in size or disappear altogether.
Morphea most commonly occurs in people aged 20 to 50.
Linear scleroderma
Linear scleroderma often begins as an area of hardened skin. This form of scleroderma most
commonly affects the arms, legs, neck, and forehead. In some cases, it can impact joint
motion.
Linear scleroderma most commonly develops in children.
Systemic scleroderma
Also known as systemic sclerosis, systemic scleroderma is the form of scleroderma that can
cause sclerodactyly.
This condition can affect:
blood vessels
food pipe
digestive tract
heart
joints
kidneys
lungs
muscles
skin
Systemic scleroderma can be diffuse or limited.
Diffuse scleroderma
In this form of systemic scleroderma, the skin can thicken at a rapid pace and affect a greater
surface area.
Those who develop diffuse scleroderma are at an increased risk of developing sclerosis, a
hardening of the body's internal organs.
Limited scleroderma
A more common form of systemic scleroderma, limited scleroderma causes slow and
contained skin thickening, which typically affects the hands and face.
Internal damage can occur, but it tends to be less frequent and less severe than in diffuse
scleroderma.
However, a condition called pulmonary hypertension is associated with limited scleroderma.
Pulmonary hypertension is marked by narrowing of the blood vessels in the lungs, which
causes shortness of breath.
Limited scleroderma is also known as CREST syndrome, which represents the first letters of
a range of symptoms associated with limited scleroderma.
CREST stands for:
calcinosis
Raynaud's disease
esophageal dysfunction
sclerodactyly
telangiectasia
Several of the above symptoms, such as calcinosis and telangiectasias, can also affect some
people with diffuse scleroderma.
Treatment options
There is no cure for sclerodactyly. Treatment aims at reducing symptoms and improving
quality of life for those with the condition.
Treatment is most effective when it is started in the early stages of sclerodactyly, highlighting
the importance of early action.
Available treatment options include:
Physical therapy and occupational therapy
nurse doing physical therapy on lady's hand
Physical therapy may be beneficial to some people with sclerodactyly.
Hand exercises may help some people with early symptoms of sclerodactyly, such as
swelling or tight skin. The exercises used are similar to those prescribed for people with
arthritis.
Some therapists are specially trained to make hand casts. These casts can be worn all the time
to ensure that if the hands harden, they take on a less restrictive shape than the claw-like
shape typical of sclerodactyly.
This may help people with the condition carry out their daily activities with greater ease.
Therapists may also recommend the use of hot wax machines to warm the hands and reduce
pain and stiffness.
Ultraviolet (UV) light
Using UV light therapy may help break down the hardened collagen in the skin tissue. A
portion of UV light, known as ultraviolet A1 (UVA1), is responsible for this effect.
UVA1 acts on certain collagen-producing cells in the skin called fibroblasts. The UVA1 light
leads the fibroblasts to break down the extra collagen that causes the skin thickening and
tightness.
Some research suggests people with sclerosing skin diseases will require between 20 and 40
exposures to UV light before they see results. Long-term side effects are still unknown.
Surgery
Those with sclerodactyly and other symptoms of systemic scleroderma that affect the hands
or feet may wish to consider surgical treatment.
Although surgery cannot completely cure scleroderma, it can provide symptom relief and
increase hand movement.
What is Scleroderma?
What is Scleroderma?
Scleroderma is the primary risk factor for sclerodactyly. Learn more about it here.
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Outlook
While there is no cure for sclerodactyly, there are several treatment options available to treat
its symptoms and improve a person's quality of life.
Receiving early treatment is key to preventing the hands from forming a claw shape, thus
reducing hand function.
Those who think they may have scleroderma or sclerodactyly should speak to their doctor as
soon as possible.
(Hindustan: 20171006)
http://epaper.livehindustan.com/story.aspx?id=2258997&boxid=97330888&ed_date=2017-
10-06&ed_code=1&ed_page=13
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(Hindustan: 20171006)
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10-06&ed_code=1&ed_page=13
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Medicine Price (Hindustan: 20171006)
http://epaper.livehindustan.com/story.aspx?id=2258999&boxid=97515420&ed_date=2017-10-
06&ed_code=1&ed_page=15
Exercise (Hindustan: 20171006)
http://epaper.livehindustan.com/story.aspx?id=2259008&boxid=98263220&ed_date=2017-10-
06&ed_code=1&ed_page=24
Pollution (Dainik Gagaran: 20171006)
http://epaper.jagran.com/ePaperArticle/06-oct-2017-edition-National-page_2-1714-19071-
262.html
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