Results. Total and activated CEC counts were significantly higher in SSc patients compared with healthy controls and were positively correlated with the disease activity score. With respect to visceral involvement, significant correlation was observed between the CEC number and the severity of pulmonary hypertension. High levels of endothelial progenitors were observed in patients with SSc, and the counts were higher in the early stages of disease.

In our 6-year study, anti-TNFalpha agents infliximab and etanercept were well tolerated and safe, and were associated with only few serious, but all reversible, AEs. However, such inhibitors are associated with various and numerous AEs. Children and young adults affected by JIA should be carefully monitored so as to limit the risk of AEs during anti-TNFalpha therapy as much as possible.

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Objective. To construct a prognostic index based on nailfold capillaroscopic examinations that is capable of predicting the 5-year transition from isolated Raynaud's phenomenon (RP) to RP secondary to scleroderma spectrum disorders (SSDs).Methods. The study involved 104 consecutive adult patients with a clinical history of isolated RP, and the index was externally validated in another cohort of 100 patients with the same characteristics. Both groups were followed up for 1-8 years. Six variables were examined because of their potential prognostic relevance (branching, enlarged and giant loops, capillary disorganization, microhemorrhages, and the number of capillaries).Results. The only factors that played a significant prognostic role were the presence of giant loops (hazard ratio [HR] 2.64, P ‫؍‬ 0.008) and microhemorrhages (HR 2.33, P ‫؍‬ 0.01), and the number of capillaries (analyzed as a continuous variable). The adjusted prognostic role of these factors was evaluated by means of multivariate regression analysis, and the results were used to construct an algorithm-based prognostic index. The model was internally and externally validated.Conclusion. Our prognostic capillaroscopic index identifies RP patients in whom the risk of developing SSDs is high. This model is a weighted combination of different capillaroscopy parameters that allows physicians to stratify RP patients easily, using a relatively simple diagram to deduce the prognosis. Our results suggest that this index could be used in clinical practice, and its further inclusion in prospective studies will undoubtedly help in exploring its potential in predicting treatment response.Raynaud's phenomenon (RP) is defined as bouts of reversible vasospastic ischemia of the digits that are typically manifested upon exposure to the cold and/or in association with emotional stress. It is characterized by well-demarcated blanching (ischemia), which leads to cyanosis (deoxygenation), followed by postischemic red flushing upon rewarming (reperfusion). A biphasic or triphasic color change may occur. Episodes of RP may be accompanied by varying degrees of paresthesia, numbness, and pain (1,2).Previous population-based studies have shown that RP is a very common problem in clinical practice: its prevalence in the US is ϳ4-9% among women and ϳ3-6% among men (3,4). The prevalence of RP in Europe is 2-21% and is closely related to climatic conditions (5-7).RP may be primary (uncomplicated) when it occurs without an underlying disease or secondary when it develops in the context of an associated disorder.