Why is screening for interstitial lung disease (ILD) vital in SSc and MCTD patients?

systematic screening for ILD allows for earlier detection and intervention, perhaps improving outcomes for patients with systemic sclerosis (SSc) and mixed connective tissue disease (MCTD).

What screening method is recommended for interstitial lung disease (ILD)?

High-resolution computed tomography (HRCT) is strongly recommended for screening ILD in at-risk patients.

Are there specific monitoring recommendations after an interstitial lung disease (ILD) diagnosis?

Yes, monitoring recommendations are disease-specific and stratified by risk of ILD progression, with varying frequencies of lung function tests depending on the patient's risk profile.

what are the new treatment recommendations for interstitial lung disease (ILD) related to connective tissue diseases?

The guidelines offer specific treatment options for different connective tissue diseases, including tocilizumab for SSc-ILD and immunosuppressive treatments for IIM-ILD.

What connective tissue diseases should be screened for interstitial lung disease (ILD) according to the new guidelines?

The guidelines recommend screening for ILD in systemic sclerosis (SSc), mixed connective tissue disease (MCTD), rheumatoid arthritis (RA), idiopathic inflammatory myopathies (IIM), and Sjögren's disease (SjD).

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Q: Who developed the new guidelines for interstitial lung disease (ILD) screening and management?

The guidelines are a collaborative effort between the European Alliance of Associations for rheumatology (EULAR) and the European Respiratory Society (ERS).

Health

Hundreds of Foreign Objects Removed from Chinese Man’s Stomach

by Dr. Michael Lee – Health Editor November 28, 2025

written by Dr. Michael Lee – Health Editor

beijing – A 39-year-old man in china underwent surgery to remove 120 foreign objects from his stomach, according to a report published ‌in the Annals of medicine and Surgery. The patient initially presented at Tangshan Gongren Hospital with a week-long⁣ history of abdominal distension and black stools.

Initial blood tests revealed a slightly elevated white blood‌ cell count,⁤ but were otherwise normal.X-rays revealed⁣ numerous opaque objects within the stomach. Despite exhibiting symptoms of psychosis, no gastrointestinal perforation was detected.

Doctors learned⁤ the patient had been diagnosed with schizophrenia eight years prior, but discontinued treatment five years ago at his mother’s request. Following the cessation of medication, he developed a habit of consuming non-food items.

The medical team first stabilized the‍ patient’s mental state over⁢ a two-week period before proceeding with surgery. The operation revealed notable gastric dilatation, but no tumors or adhesions. Surgeons‌ successfully removed⁤ over 120 items, primarily composed of metal, including keys, nails, iron rods, needles, ⁢nail clippers, small knives, and ear spoons.

The patient ⁣recovered well post-operatively, receiving antibiotics and being discharged after ‍six days. A follow-up CT scan confirmed complete removal of the foreign objects,and the patient reported a resolution of abdominal pain.

Doctors recommended the patient resume antipsychotic⁤ medication and continue ‍with regular evaluations from a mental health professional.

November 28, 2025 0 comments

Business

CT Weather: How Hot Will It Be This Week & Safety Tips

by Priya Shah – Business Editor August 11, 2025

written by Priya Shah – Business Editor

Connecticut Faces First heat Emergency of 2025 as Temperatures Soar – A heat emergency has been declared for much of Connecticut as temperatures climbed above 90 degrees Fahrenheit on Tuesday, July 8, 2025, prompting health officials to urge residents to take precautions against heat-related illnesses.

The Centers for Disease Control and Prevention (CDC) advises careful planning of outdoor activities during periods of extreme heat. recommendations include wearing loose-fitting, lightweight, and light-colored clothing, and consistently applying sunscreen.

Officials emphasize the importance of checking on vulnerable individuals – especially older adults, young children, and those with pre-existing chronic medical conditions. The town of Braintree,Massachusetts,opened its splash pad to provide relief for children during the heatwave,as seen in photos taken on July 8th.

Individuals taking certain medications, specifically selective serotonin reuptake inhibitors (SSRIs) used to treat depression, may experience heightened sensitivity to heat, according to medical professionals. This can increase the risk of heat exhaustion.

Symptoms of heat exhaustion, as detailed by the Mayo Clinic, include excessive sweating, weakness, dizziness, low blood pressure when standing, muscle cramps, nausea, headache, and a rapid, weak pulse.These symptoms can develop quickly during strenuous activity in hot weather.

If heat exhaustion is suspected, immediate action is crucial. the Mayo Clinic recommends stopping all activity, moving to a cooler habitat – ideally air-conditioned – and rehydrating with cool water or electrolyte-rich sports drinks.

Medical attention should be sought if symptoms worsen or do not improve within one hour. Specifically, the Mayo Clinic advises calling a doctor or seeking emergency care if an individual experiences confusion, loss of consciousness, or an inability to drink fluids.

Connecticut residents seeking relief from the heat can find a list of cooling centers and public swimming facilities maintained by United way of Connecticut’s 2-1-1 hotline at https://uwc.211ct.org/hotweather/. This resource provides locations and hours of operation for cooling facilities across the state.

August 11, 2025 0 comments

Health

Delayed Brain Bleeds in Head Trauma Rare With Anticoagulants

by Dr. Michael Lee – Health Editor June 27, 2025

written by Dr. Michael Lee – Health Editor

Mild Head Trauma: Study Reveals Risks of Delayed Brain Bleeds

A recent study reveals that some individuals with mild traumatic brain injuries, who initially show no bleeding on a CT scan, might experience delayed intracranial hemorrhage if they take blood thinners. This finding underscores the importance of monitoring these patients closely.

Study Findings

Researchers examined 596 patients with mild traumatic brain injuries. These patients were also receiving anticoagulant therapy and initially presented with a negative CT scan. The median age of the participants was 83 years old; 46.5% were men. Atrial fibrillation was the most prevalent reason for anticoagulant use, and 74.5% of patients were on direct oral anticoagulants.

The primary goal was to determine the incidence of delayed intracranial hemorrhage (ICH). Secondary outcomes included the need for neurosurgical interventions and 30-day mortality. After 24 hours, all patients underwent a second CT scan. This follow-up was crucial in identifying delayed bleeds.

Delayed ICH developed in 2% of the patients, with subarachnoid hemorrhage and subdural hematoma being the most prevalent findings, occurring in five patients each. None of the individuals with delayed ICH needed neurosurgical intervention or died within a month.

“The low incidence of delayed ICH suggests that patients with minor traumatic brain injury and normal initial CT imaging may be safely discharged without extended hospital observation, provided they have no additional risk factors,”

— The Authors

Patients with delayed ICH were more likely to have experienced high-energy trauma. Additionally, there was a trend, though not statistically significant, toward a higher frequency of delayed ICH in those taking vitamin K antagonists compared to those on direct oral anticoagulants. According to the Centers for Disease Control and Prevention, around 2.8 million traumatic brain injury-related emergency department visits occurred in 2021 in the United States alone. (CDC 2021)

Important Considerations

During hospitalization, 66% of patients with delayed ICH experienced complications, including infections and delirium. The study, led by Jacopo Davide Giamello, was published in Injury on June 11, 2025.

The research had limitations, being a retrospective study from a single center, which could introduce bias. Information about long-term outcomes and medication adherence was not available. However, the data provides important insights into managing patients with mild head injuries who are on blood thinners.

June 27, 2025 0 comments

Health

Early, Aggressive BP Lowering Tied to Better ICH Outcomes

by Dr. Michael Lee – Health Editor June 19, 2025

written by Dr. Michael Lee – Health Editor

Aggressive Blood Pressure Control Improves Stroke Outcomes

Early Intervention is Key for Better Recovery and Reduced Risks

New research reveals that swiftly lowering blood pressure after an intracerebral hemorrhage (ICH) can significantly improve patient outcomes, potentially saving lives. Prompt treatment, especially within the first few hours, leads to better neurological function, fewer adverse events, and reduced mortality rates for those suffering from this type of stroke.

Early Treatment Yields Stronger Results

A pooled analysis of four Intensive BP Reduction in Acute Cerebral Hemorrhage Trials (INTERACT1-4) has confirmed the benefits of early, intensive blood pressure management for individuals experiencing ICH. The most positive results were found when the intervention was administered within three hours of the onset of ICH symptoms. Current guidelines suggest a systolic BP target of less than 180 mm Hg within one hour of symptom onset, whereas the intensive treatment approach aims for less than 140 mm Hg within the same timeframe.

The studies involved over 10,000 adults with acute ICH. Participants were randomly assigned to receive either intensive or guideline-recommended BP-lowering treatment within an hour of symptom onset. The primary outcome measure was functional recovery, determined using the modified Rankin scale. The intensive treatment group showed significantly lower mean systolic BP rates at one hour compared to the guideline group, 149.6 mm Hg versus 158.8 mm Hg, respectively.

“The data presented make a compelling case for ultra-early intensive blood pressure reduction as a potentially useful intervention to improve outcomes in people with acute ICH.”

—David J. Werring, PhD, Department of Translational Neuroscience and Stroke, University College London Queen Square Institute of Neurology, London

Those receiving intensive treatment also experienced reduced odds of neurological deterioration within seven days, along with fewer serious adverse events and deaths. According to the American Stroke Association, stroke is a leading cause of death in the United States, with nearly 800,000 strokes occurring annually (American Stroke Association).

Timing and Impact on Hematoma Growth

Investigators also assessed the impact of treatment timing and its effect on hematoma volume. Results from a CT substudy of almost 3000 participants revealed no significant effect on either relative or absolute hematoma growth in the initial 24 hours between intensive and guideline treatment approaches. However, when intensive BP lowering began within three hours of symptom onset, functional recovery improved, and hematoma growth was reduced in almost a quarter of patients.

Expert Insights

In an accompanying editorial, David J. Werring noted the importance of considering the specific pathophysiology of ICH, where hematoma expansion plays a major role in the first few hours. He suggested that intensive BP lowering could be a useful intervention to improve outcomes for individuals with acute ICH, emphasizing the need for further research.

The analysis was funded by a multitude of organizations worldwide, and the investigators disclosed various financial relationships. Despite the limitations of the study, the results underscore the critical importance of early intervention in managing ICH. More research is warranted, but the current findings strongly support the idea that, as Werring concluded, “time is brain” for those with ICH.

June 19, 2025 0 comments

Health

EULAR/ERS Guideline: Managing CTD-ILD – New Recommendations

by Dr. Michael Lee – Health Editor June 15, 2025

written by Dr. Michael Lee – Health Editor

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New Guidelines Call for Increased Interstitial Lung Disease Screening in Autoimmune Patients

Table of Contents

New Guidelines Call for Increased Interstitial Lung Disease Screening in Autoimmune Patients

BARCELONA, Spain – In a move set to reshape clinical practice, the European Alliance of Associations for Rheumatology (EULAR) and the European Respiratory Society (ERS) have jointly released new guidelines advocating for systematic screening of interstitial lung disease (ILD) in all patients diagnosed with systemic sclerosis (SSc) and mixed connective tissue disease (MCTD). The declaration was made at the EULAR 2025 Annual Meeting.

These complete, disease-specific recommendations aim to standardize the screening, diagnosis, and management of ILD across various connective tissue diseases (CTDs), including SSc, MCTD, rheumatoid arthritis (RA), idiopathic inflammatory myopathies (IIM), and Sjögren’s disease (SjD).The guidelines mark a notable step forward, representing the first collaborative effort between rheumatologists and pulmonologists in Europe to address ILD in this patient population.

Screening Recommendations for Interstitial Lung Disease

the cornerstone of the new guidelines is the strong recommendation for systematic ILD screening using high-resolution computed tomography (HRCT) in all SSc and MCTD patients, irrespective of pre-existing risk factors. This recommendation extends to patients with IIM, excluding those with inclusion body myositis. For individuals with RA,SjD,and other CTDs,the guidelines advise an initial assessment for disease-specific risk factors,followed by HRCT screening for those with identified risks.

Did You Know? The American Thoracic Society estimates that ILD affects approximately 15% of patients with rheumatoid arthritis[[1].

While previous recommendations supported screening in SSc, the inclusion of RA patients with risk factors marks a significant expansion. According to Dr. Bernhard Hellmich, this broadened scope is expected to identify more patients who could benefit from early therapeutic intervention, potentially leading to improved long-term outcomes.

Notably, the guidelines do not specify a screening frequency due to limited evidence. Dr. Anna-Maria Hoffmann-Vold suggests mirroring the diagnostic approach and reassessing for new ILD progression risk factors. The guidelines explicitly advise against substituting HRCT with pulmonary function tests or lung ultrasound for initial screening. However, forced vital capacity and diffusing capacity of the lungs for carbon monoxide can be incorporated in the presence of symptoms or CT abnormalities.

Monitoring ILD Progression After Diagnosis

The guidelines provide specific timeframes for monitoring ILD progression post-diagnosis, tailored to individual diseases and stratified by ILD progression risk. Clinicians are advised to assess risk based on prior lung function tests, HRCT results, the 6-minute walking test, and risk factors such as disease-specific circulating markers, disease activity, and HRCT patterns.

Based on these assessments, patients are categorized as high or low risk. Monitoring frequency varies accordingly. for high-risk patients with any CTD, lung function tests are recommended every 3-6 months during the initial years, followed by every 6-12 months thereafter. Lower-risk patients should undergo lung function tests every 6-12 months initially, and then annually.

Treatment Strategies for Interstitial Lung Disease

the new guidelines offer detailed treatment recommendations, outlining available options for each disease and providing guidance on selecting the most appropriate medication for individual patients. The guidelines strongly recommend tocilizumab for SSc-ILD patients with early diffuse SSc and signs of inflammation. For IIM-ILD patients, immunosuppressive treatment, including glucocorticoids, calcineurin inhibitors, rituximab, mycophenolate, or azathioprine, is recommended.

Other treatment recommendations are conditional, reflecting limited patient populations and a scarcity of randomized controlled trials. Individual treatment algorithms are provided for SSc-ILD, RA-ILD, and IIM-ILD.

Dr. Hellmich believes that these comprehensive guidelines will facilitate earlier treatment initiation, potentially improving patient prognosis. He noted that the inclusion of certain therapies in the EULAR guidelines may encourage their use in clinical practice,even if they are currently considered off-label.

Pro Tip: Staying informed about the latest research and guidelines is crucial for providing optimal care to patients with connective tissue diseases and interstitial lung disease.

The full guidelines are slated for publication next month in the Annals of the Rheumatic Diseases and European Respiratory Journal.

ct

Hundreds of Foreign Objects Removed from Chinese Man’s Stomach

Delayed Brain Bleeds in Head Trauma Rare With Anticoagulants

Mild Head Trauma: Study Reveals Risks of Delayed Brain Bleeds

Study Findings

Important Considerations

Early, Aggressive BP Lowering Tied to Better ICH Outcomes

Aggressive Blood Pressure Control Improves Stroke Outcomes

Early Intervention is Key for Better Recovery and Reduced Risks

Early Treatment Yields Stronger Results

Timing and Impact on Hematoma Growth

Expert Insights

EULAR/ERS Guideline: Managing CTD-ILD – New Recommendations

New Guidelines Call for Increased Interstitial Lung Disease Screening in Autoimmune Patients

Screening Recommendations for Interstitial Lung Disease

Monitoring ILD Progression After Diagnosis

Treatment Strategies for Interstitial Lung Disease

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