Raised N-TproBNP levels are directly related to the severity of PAH. In screening programs, SSc patients with an N-TproBNP in excess of 395 pg/mL have a very high probability of having pulmonary hypertension. Baseline and serial changes in N-TproBNP levels are highly predictive of survival. A 10-fold increase in N-TproBNP level on therapy is associated with a greater than three-fold increase in mortality, and may indicate therapeutic failure.

No abstract

Objective-To investigate the association between cause specific morbidity and deprivation in order to inform the debates on inequalities in health and health services resource allocation.Design-Cross sectional postal questionnaire survey ascertaining self reported health status, with validation of a 20!/o sample through general practitioner and hospital records.Setting-Inner city, urban, and rural areas of Avon and Somerset.Subjects-Stratified random sample of 28 080 people aged 35 and over from 40 general practices.Main outcome measures-Age and sex standardised prevalence of various diseases; Townsend deprivation scores were assigned by linking postcodes to enumeration districts. Relative indices of inequality were calculated to estimate the magnitude of the association between socioeconomic position and morbidity.Results-The response rate was 85 3%. The prevalence of most of the conditions rose with increasing material deprivation. The relative index of inequality, for both sexes combined, was greater than 1 for all conditions except diabetes. The conditions most strongly associated with deprivation were diabetic eye disease (relative index of inequality 3*21; 95% confidence interval 184 to 5.59), emphysema (2.72; 167 to 4.43) and bronchitis (2.27; 1-92 to 2.68). The relative index of inequality was significantly higher in women for asthma (P< 0.05) and in men for depression (P<0.01). The mean reporting of prevalent conditions was 107 for the most deprived fifth of respondents and 0*77 in the most affluent fifth (P < 0.001).

The prevalence of CAD in patients with SSc is similar and not greater to that expected in individuals without SSc.

Quality of life (QOL) assessment may improve the evaluation of treatment for oesophageal cancer but patient compliance using self completion questionnaires is often poor. The use of a proxy to estimate QOL might improve data collection from patients who are either unable or unwilling to complete the questionnaire. This study examined whether a doctor or patients' carers could accurately assess QOL using the QLQ-C30 questionnaire developed by the European Organisation for Research and Treatment of Cancer Study Group on Quality of Life. One doctor, 52 patients and 39 carers completed the instrument independently. Proxy and patient ratings were analysed for agreement using weighted kappa scores. Agreement was poor or moderate in most QOL scales and items (kappa < or = 60). This study demonstrates that a carer or doctor is not sufficiently accurate to postulate the patient's responses to the questionnaire. Quality of life data, therefore, should come from the patients themselves.