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Article ; Online: A descriptive account of sequential nailfold capillaroscopy in scleroderma.

Patterson, Karen A / Walker, Jenny G / Roberts-Thomson, Peter

2019 Volume 51, Issue 6, Page(s) 669–672

MeSH term(s)	Adult ; Aged ; Capillaries/diagnostic imaging ; Capillaries/pathology ; Female ; Humans ; Male ; Microscopic Angioscopy/methods ; Middle Aged ; Nails/diagnostic imaging ; Nails/pathology ; Scleroderma, Diffuse/diagnostic imaging ; Scleroderma, Diffuse/pathology ; Scleroderma, Limited/diagnostic imaging ; Scleroderma, Limited/pathology
Language	English
Publishing date	2019-08-29
Publishing country	England
Document type	Comparative Study ; Letter
ZDB-ID	7085-3
ISSN	1465-3931 ; 0031-3025
ISSN (online)	1465-3931
ISSN	0031-3025
DOI	10.1016/j.pathol.2019.05.009
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Zs.A 723: Show issues

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Article ; Online: Blood Pressure Lowering in Patients With Central Hypertension: A Randomized Clinical Trial.

Sharman, James E / Otahal, Petr / Stowasser, Michael / Stanton, Tony / Reid, Christopher M / Nolan, Mark / Roberts-Thomson, Philip / Negishi, Kazuaki / Greenough, Robert / Stewart, Simon / Marwick, Thomas H / Abhayaratna, Walter P

Hypertension (Dallas, Tex. : 1979)

2024 Volume 81, Issue 6, Page(s) 1400–1409

Abstract: Background: Cuff blood pressure (BP) is recommended for guiding hypertension management. However, central BP has been proposed as a superior clinical measurement. This study aimed to determine whether controlling hypertension as measured by central BP ... ...

Abstract	Background: Cuff blood pressure (BP) is recommended for guiding hypertension management. However, central BP has been proposed as a superior clinical measurement. This study aimed to determine whether controlling hypertension as measured by central BP was beneficial in reducing left ventricular mass index beyond control of standard cuff hypertension. Methods: This multicenter, open-label, blinded-end point trial was conducted in individuals treated for uncomplicated hypertension with controlled cuff BP (<140/90 mm Hg) but elevated central BP (≥0.5 SD above age- and sex-specific normal values). Participants were randomized to 24-months intervention with spironolactone 25 mg/day (n=148) or usual care control (n=153). The primary outcome was change in left ventricular mass index measured by cardiac MRI. Cuff and central BPs were measured by clinic, 7-day home and 24-hour ambulatory BPs. Results: At 24-months, there was a greater reduction in left ventricular mass index (-3.2 [95% CI, -5.0 to -1.3] g/m Conclusions: Among individuals with central hypertension, spironolactone had beneficial effects in reducing LV mass. Secondary analyses showed that changes in LV mass were equally well associated with lower measured standard cuff BP and central BP. Registration: URL: https://www.anzctr.org.au/; Unique identifier: ACTRN12613000053729.
MeSH term(s)	Humans ; Male ; Female ; Middle Aged ; Hypertension/drug therapy ; Hypertension/physiopathology ; Spironolactone/therapeutic use ; Spironolactone/administration & dosage ; Blood Pressure/drug effects ; Blood Pressure/physiology ; Blood Pressure Determination/methods ; Antihypertensive Agents/therapeutic use ; Blood Pressure Monitoring, Ambulatory/methods ; Mineralocorticoid Receptor Antagonists/therapeutic use ; Aged ; Treatment Outcome ; Adult ; Hypertrophy, Left Ventricular/physiopathology ; Hypertrophy, Left Ventricular/drug therapy ; Heart Ventricles/physiopathology ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/drug effects
Language	English
Publishing date	2024-04-02
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Multicenter Study
ZDB-ID	423736-5
ISSN	1524-4563 ; 0194-911X ; 0362-4323
ISSN (online)	1524-4563
ISSN	0194-911X ; 0362-4323
DOI	10.1161/HYPERTENSIONAHA.123.21653
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Zs.A 1488: Show issues

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Article ; Online: Letter to the editor. Re: Specificity of anti-centromere antibodies for scleroderma.

Roberts-Thomson, P

Rheumatology international

2007 Volume 28, Issue 2, Page(s) 197–198

MeSH term(s)	Antibodies, Antinuclear/immunology ; Centromere/immunology ; Female ; Humans ; Male ; Middle Aged ; Scleroderma, Localized/immunology
Chemical Substances	Antibodies, Antinuclear
Language	English
Publishing date	2007-12
Publishing country	Germany
Document type	Letter
ZDB-ID	8286-7
ISSN	1437-160X ; 0172-8172
ISSN (online)	1437-160X
ISSN	0172-8172
DOI	10.1007/s00296-007-0390-x
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Zs.A 1639: Show issues

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Article ; Online: Evidence of chromosomal damage in scleroderma.

Patterson, K A / Walker, J G / Roberts-Thomson, P J / Bull, C F / Fenech, M

Pathology

2021 Volume 54, Issue 1, Page(s) 131–133

MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Autoantibodies/immunology ; Chromosome Aberrations ; DNA Damage ; Female ; Genomic Instability ; Humans ; Leukocytes, Mononuclear/immunology ; Male ; Micronuclei, Chromosome-Defective ; Middle Aged ; Neoplasms/complications ; Neoplasms/genetics ; Scleroderma, Systemic/complications ; Scleroderma, Systemic/genetics
Chemical Substances	Autoantibodies
Language	English
Publishing date	2021-06-30
Publishing country	England
Document type	Letter
ZDB-ID	7085-3
ISSN	1465-3931 ; 0031-3025
ISSN (online)	1465-3931
ISSN	0031-3025
DOI	10.1016/j.pathol.2021.04.004
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Zs.A 723: Show issues

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Article ; Online: Improving life expectancy of patients with scleroderma: results from the South Australian Scleroderma Register.

Kennedy, Nicholas / Walker, Jenny / Hakendorf, Paul / Roberts-Thomson, Peter

Internal medicine journal

2018 Volume 48, Issue 8, Page(s) 951–956

Abstract: Background: Scleroderma is a rare connective tissue disorder characterised by inflammation, vasculopathy and excessive fibrosis. Patients with scleroderma are known to have decreased life expectancy.: Aim: To investigate changes in life expectancy in ...

Abstract	Background: Scleroderma is a rare connective tissue disorder characterised by inflammation, vasculopathy and excessive fibrosis. Patients with scleroderma are known to have decreased life expectancy. Aim: To investigate changes in life expectancy in patients with scleroderma over a 30-year period. Methods: Utilising the South Australian Scleroderma Register, deceased patients were identified. We examined changes in age of death and duration of disease in these patients over three time periods: 1985-1994, 1995-2004 and 2005-2015. Analyses of scleroderma subtypes were performed, and comparisons were made to the general South Australian population. Results: A total of 413 deceased patients was identified. Females were overrepresented 315 to 98; 265 had limited scleroderma, 90 diffuse and 22 overlap disease. Over 30 years, the mean age of death improved from 66.4 to 74.5 years (P < 0.001). Duration of disease improved from 12.1 to 22.9 years (P < 0.001). Improvement in survival was seen in limited (P = 0.001), diffuse (P = 0.04) and overlap (P = 0.04) subgroups. The increase in survival was only seen for female (9.8 ± 4.2 years) but not male (1.4 ± 6.7 years) patients. Conclusion: Over the last 30 years, survival has significantly improved for female but not male patients. As no disease-modifying drugs have consistently been shown to alter disease course, this improvement is likely attributable to general improvements in medical care, including that of scleroderma-related complications. While the life expectancy for limited disease is now close to that of the general population, patients with diffuse and overlap disease continue to suffer from significant early mortality.
MeSH term(s)	Adult ; Aged ; Female ; Humans ; Life Expectancy/trends ; Male ; Middle Aged ; Patient Discharge/trends ; Registries ; Retrospective Studies ; Scleroderma, Systemic/diagnosis ; Scleroderma, Systemic/mortality ; South Australia/epidemiology ; Survival Rate/trends
Language	English
Publishing date	2018-03-23
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2045436-3
ISSN	1445-5994 ; 1444-0903
ISSN (online)	1445-5994
ISSN	1444-0903
DOI	10.1111/imj.13799
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Zs.A 792: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 424: Show issues

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Article ; Online: The influence of SBP amplification on the accuracy of form-factor-derived mean arterial pressure.

Schultz, Martin G / Picone, Dean S / Armstrong, Mathew K / Black, J Andrew / Dwyer, Nathan / Roberts-Thomson, Philip / Sturgess, David / Sharman, James E

Journal of hypertension

2021 Volume 38, Issue 6, Page(s) 1033–1039

Abstract: Objectives: Accurate assessment of mean arterial pressure (MAP) is crucial in research and clinical settings. Measurement of MAP requires not only pressure waveform integration but can also be estimated via form-factor equations incorporating peripheral ...

Abstract	Objectives: Accurate assessment of mean arterial pressure (MAP) is crucial in research and clinical settings. Measurement of MAP requires not only pressure waveform integration but can also be estimated via form-factor equations incorporating peripheral SBP. SBP may increase variably from central-to-peripheral arteries (SBP amplification), and could influence accuracy of form-factor-derived MAP, which we aimed to determine. Methods: One hundred and eighty-eight patients (69% men, age 60 ± 10 years) undergoing coronary angiography had intra-arterial pressure measured in the ascending aorta, brachial and radial arteries. Reference MAP was measured by waveform integration, and form-factor-derived MAP using 33 and 40% form-factors. Results: Reference MAP decreased from the aorta to the brachial (-0.7 ± 4.2 mmHg) and radial artery (-1.7 ± 4.8 mmHg), whereas form-factor-derived MAP increased (33% form-factor 1.1 ± 4.2 and 1.7 ± 4.7 mmHg; 40% form-factor 0.9 ± 4.8 and 1.4 ± 5.4 mmHg, respectively). Form-factor-derived MAP was significantly different to reference aortic MAP (33% form-factor -2.5 ± 4.6 and -1.6 ± 5.8, P < 0.001; 40% form-factor 2.5 ± 5.0 and 3.9 ± 6.4 mmHg, P < 0.001, brachial and radial arteries, respectively), with significant variation in the brachial form-factor required (FFreq) to generate MAP equivalent to reference aortic MAP (FFreq range 20-57% brachial; 17-74% radial). Aortic-to-brachial SBP amplification was strongly related to brachial FFreq (r = -0.695, P < 0.001). The 33% form-factor was most accurate with high aortic-to-brachial SBP amplification (33% form-factor MAP vs. reference aortic MAP difference 0.06 ± 3.93 mmHg, P = 0.89) but overestimated reference aortic MAP with low aortic-to-brachial SBP amplification (+5.8 ± 4.6 mmHg, P < 0.001). The opposite was observed for the 40% form-factor. Conclusion: Due to variable SBP amplification, estimating MAP via form-factors produces nonphysiological inaccurate values. These findings have important implications for accurate assessment of MAP in research and clinical settings.
MeSH term(s)	Aged ; Arterial Pressure/physiology ; Arteries/physiology ; Blood Pressure Determination/methods ; Blood Pressure Determination/standards ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results
Language	English
Publishing date	2021-02-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605532-1
ISSN	1473-5598 ; 0263-6352 ; 0952-1178
ISSN (online)	1473-5598
ISSN	0263-6352 ; 0952-1178
DOI	10.1097/HJH.0000000000002385
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Zs.A 1885: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 614: Show issues

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Article ; Online: Accuracy of cuff blood pressure and systolic blood pressure amplification.

Bui, Tan V / Picone, Dean S / Schultz, Martin G / Peng, Xiaoqing / Black, J Andrew / Dwyer, Nathan / Roberts-Thomson, Philip / Adams, Heath / Chen, Chen-Huan / Cheng, Hao-Min / Pucci, Giacomo / Wang, Jiguang / Goupil, Remi / Sharman, James E

Hypertension research : official journal of the Japanese Society of Hypertension

2023 Volume 46, Issue 8, Page(s) 1961–1969

Abstract: Automated cuff measured blood pressure (BP) is the global standard used for diagnosing hypertension, but there are concerns regarding the accuracy of the method. Individual variability in systolic BP (SBP) amplification from central (aorta) to peripheral ...

Abstract	Automated cuff measured blood pressure (BP) is the global standard used for diagnosing hypertension, but there are concerns regarding the accuracy of the method. Individual variability in systolic BP (SBP) amplification from central (aorta) to peripheral (brachial) arteries could be related to the accuracy of cuff BP, but this has never been determined and was the aim of this study. Automated cuff BP and invasive brachial BP were recorded in 795 participants (74% male, aged 64 ± 11 years) receiving coronary angiography at five independent research sites (using seven different automated cuff BP devices). SBP amplification was recorded invasively by catheter and defined as brachial SBP minus aortic SBP. Compared with invasive brachial SBP, cuff SBP was significantly underestimated (130 ± 18 mmHg vs. 138 ± 22 mmHg, p < 0.001). The level of SBP amplification varied significantly among individuals (mean ± SD, 7.3 ± 9.1 mmHg) and was similar to level of difference between cuff and invasive brachial SBP (mean difference -7.6 ± 11.9 mmHg). SBP amplification explained most of the variance in accuracy of cuff SBP (R
MeSH term(s)	Female ; Humans ; Male ; Arterial Pressure ; Blood Pressure/physiology ; Blood Pressure Determination/methods ; Brachial Artery/physiology ; Hypertension/diagnosis ; Middle Aged ; Aged
Language	English
Publishing date	2023-05-22
Publishing country	England
Document type	Journal Article
ZDB-ID	1175297-x
ISSN	1348-4214 ; 0916-9636
ISSN (online)	1348-4214
ISSN	0916-9636
DOI	10.1038/s41440-023-01311-0
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Zs.A 3898: Show issues

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Article ; Online: Expanding role for transcatheter aortic valve replacement: successful transfemoral implantation of a Medtronic CoreValve for severe aortic regurgitation.

Yeow, W L / Roberts-Thomson, P / Shetty, S / Yong, G

Heart, lung & circulation

2012 Volume 21, Issue 11, Page(s) 754–758

Abstract: Severe aortic regurgitation (AR), when intervention is required, is best managed by surgical aortic valve replacement (SAVR). Transcatheter aortic valve replacement (TAVR) for aortic stenosis has recently shown non-inferiority to SAVR and superiority to ... ...

Abstract	Severe aortic regurgitation (AR), when intervention is required, is best managed by surgical aortic valve replacement (SAVR). Transcatheter aortic valve replacement (TAVR) for aortic stenosis has recently shown non-inferiority to SAVR and superiority to medical management. Here we describe a successful TAVR for a patient with severe AR that was unsuitable for SAVR due to her high surgical risk.
MeSH term(s)	Aged ; Aortic Valve/surgery ; Aortic Valve Insufficiency/surgery ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/instrumentation ; Heart Valve Prosthesis Implantation/methods ; Humans
Language	English
Publishing date	2012-11
Publishing country	Australia
Document type	Case Reports ; Journal Article
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2012.03.010
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Zs.A 4988: Show issues

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Article ; Online: Comparison between cuff-based and invasive systolic blood pressure amplification.

Bui, Tan V / Picone, Dean S / Schultz, Martin G / Armstrong, Matthew K / Peng, Xiaoqing / Black, J Andrew / Dwyer, Nathan / Roberts-Thomson, Philip / Adams, Heath / Hughes, Alun D / Sharman, James E

Journal of hypertension

2022 Volume 40, Issue 10, Page(s) 2037–2044

Abstract: Objective: Accurate measurement of central blood pressure (BP) using upper arm cuff-based methods is associated with several factors, including determining the level of systolic BP (SBP) amplification. This study aimed to determine the agreement between ...

Abstract	Objective: Accurate measurement of central blood pressure (BP) using upper arm cuff-based methods is associated with several factors, including determining the level of systolic BP (SBP) amplification. This study aimed to determine the agreement between cuff-based and invasively measured SBP amplification. Methods: Patients undergoing coronary angiography had invasive SBP amplification (brachial SBP - central SBP) measured simultaneously with cuff-based SBP amplification using a commercially available central BP device (device 1: Sphygmocor Xcel; n = 171, 70% men, 60 ± 10 years) and a now superseded model of a central BP device (device 2: Uscom BP+; n = 52, 83% men, 62 ± 10 years). Results: Mean difference (±2SD, limits of agreement) between cuff-based and invasive SBP amplification was 4 mmHg (-12, +20 mmHg, P < 0.001) for device 1 and -2 mmHg (-14, +10 mmHg, P = 0.10) for device 2. Both devices systematically overestimated SBP amplification at lower levels and underestimated at higher levels of invasive SBP amplification, but with stronger bias for device 1 (r = -0.68 vs. r = -0.52; Z = 2.72; P = 0.008). Concordance of cuff-based and invasive SBP amplification across quartiles of invasive SBP amplification was low, particularly in the lowest and highest quartiles. The root mean square errors from regression between cuff-based central SBP and brachial SBP were significantly lower (indicating less variability) than from invasive regression models (P < 0.001). Conclusions: Irrespective of the difference from invasive measurements, cuff-based estimates of SBP amplification showed evidence of proportional systematic bias and had less individual variability. These observations could provide insights on how to improve the performance of cuff-based central BP.
MeSH term(s)	Arm ; Arterial Pressure ; Blood Pressure/physiology ; Blood Pressure Determination/methods ; Brachial Artery/physiology ; Female ; Humans ; Male
Language	English
Publishing date	2022-08-23
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	605532-1
ISSN	1473-5598 ; 0263-6352 ; 0952-1178
ISSN (online)	1473-5598
ISSN	0263-6352 ; 0952-1178
DOI	10.1097/HJH.0000000000003228
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Zs.A 1885: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 614: Show issues

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Article ; Online: Diagnostic utility of unidentified precipitin lines (UPLs) in immune precipitation assays.

Pajaro, Adeloisa / Nikoloutsopoulos, Tony / Roberts-Thomson, Peter

Pathology

2015 Volume 47, Issue 1, Page(s) 62–67

Abstract: Unidentified precipitin lines (UPLs) are lines in immune precipitin assays which do not characterise with known extractable nuclear antigen (ENA) antibodies. Currently, the clinical significance of UPLs is uncertain.The aim of this study was to determine ...

Abstract	Unidentified precipitin lines (UPLs) are lines in immune precipitin assays which do not characterise with known extractable nuclear antigen (ENA) antibodies. Currently, the clinical significance of UPLs is uncertain.The aim of this study was to determine the clinical and laboratory correlates of UPLs detected over a 3 year period in a regional immunopathology laboratory.A total of 144 patients with UPLs on ENA testing were retrospectively analysed.ENA by counterimmunoelectrophoresis (CIE) was performed on 11,869 patient samples with further characterisation being performed for 1437 positive results. Ten percent of the positive ENAs demonstrated UPLs. The majority of patients with UPLs were female (71%) with an average age of 60 years. Precipitin lines for both continuously growing myeloid cell line K562 and rabbit thymus extract (RTE) were more frequent (47%), compared to K562 only (41%) or RTE only (12%). The most common antinuclear antibody (ANA) patterns associated with UPLs were speckled (29%), homogenous (16%), mixed patterns (14%), with 30% negative ANA and 5% showing cytoplasmic patterns (Golgi, GWB, mitochondrial). Both ANA positive and ANA negative patients with UPLs were generally associated with connective tissue and autoimmune disease with the majority demonstrating a positive association of UPLs with Ro52 and/or Ro60/SSA detected by Euroimmun line immunoassay. UPLs frequently seen with a negative ANA were also identified in renal disease, pulmonary fibrosis/bronchiectasis and malignancy/lymphoma.UPLs have uncertain diagnostic utility at this stage and further work needs to be done to clarify this question. UPLs were found in systemic and organ specific autoimmune disease, renal, pulmonary and neoplastic disorders. UPLs can occur in both ANA positive and ANA negative sera. The nature of the precipitating antigen in UPLs is still obscure.
MeSH term(s)	Antibodies, Antinuclear/analysis ; Antigens, Nuclear/immunology ; Autoimmune Diseases/diagnosis ; Connective Tissue Diseases/diagnosis ; Connective Tissue Diseases/immunology ; Female ; Humans ; Immunoprecipitation ; Male ; Middle Aged ; Precipitins ; Retrospective Studies
Chemical Substances	Antibodies, Antinuclear ; Antigens, Nuclear ; Precipitins
Language	English
Publishing date	2015-01
Publishing country	England
Document type	Journal Article
ZDB-ID	7085-3
ISSN	1465-3931 ; 0031-3025
ISSN (online)	1465-3931
ISSN	0031-3025
DOI	10.1097/PAT.0000000000000189
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