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Systemic sclerosis (SSc) is a disorder characterized by skin thickness and vasculopathy. The objective of the study was to evaluate the therapeutic effect and safety of the association of pentoxyphylline and vitamin E in SSc patients. Twelve SSc patients (American College of Rheumatology criteria) enrolled this 24-week open-label study. Patients received daily 800 mg of pentoxyphylline and 800 UI of vitamin E and were evaluated at 4-week interval. The primary efficacy endpoint was the change in Modified Rodnan Skin Score (MRSS) at week 24. Nine diffuse SSc patients treated 6 months with cyclophosphamide were used as a historical control group. The mean age of the treated group was 43.6 years, and ten of 12 (84%) patients were women. Their mean MRSS reduced from 25.7 to 18.7 (p = 0.03) at 16th week and remained significantly reduced throughout the study. In contrast, only a trend of MRSS reduction was observed in the historical control group (p = 0.06). Two patients started the study with active ischemic ulcers and ended with a complete healing of them. No serious side effects were reported. Pentoxyphylline and vitamin E might be an alternative therapeutic approach in SSc patients.

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Background Life expectancy of people living with HIV (PLHIV) has been increasing since the advent of antiretroviral therapy. However, prevalence of non-communicable diseases (NCD) and associated deaths has followed the same trend. From these NCDs, those of cardiovascular origin have become the most prevalent among PLHIV. Purpose In this study we delineate a cascade of care for hypertension screening, diagnosis, treatment, drug adherence and control in PLHIV. Methods Male and female patients diagnosed with HIV above 40 years of age attending to an outpatient clinic of a reference tertiary care centre for infectious diseases were cross-sectionally screened for hypertension through blood pressure (BP) measurement during outpatient consultation. Results A total of 298 subject were enrolled. Of these, 107 (35.9%) presented elevated BP consistent with hypertension according to national guidelines. Of these, only 36 (33.6%) were aware of the diagnosis, 19 (17.7%) were on regular cardiological follow-up, 17 (15.8%) were under treatment and 11 (10.2%) responded to be adherent to BP lowering medication. Care Cascade HIV_HTN Conclusions Steep decline was revealed in several steps of the cascade of care, especially regarding the awareness level. Integrative methods for NCD and HIV care are urgently needed. Early screening of hypertension, diagnosis, treatment, adherence and ongoing BP control should be equal targets in HIV care. Finally, there is an urgent need to encourage HIV primary care and infectious disease health professionals to early screen for cardiovascular outcomes. Acknowledgement/Funding Fundação de Amparo à Pesquisa do Estado do Amazonas – FAPEAM