{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:25Z","timestamp":1787013745296,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T00:00:00Z","timestamp":1655164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Many indigenous non\u2010Caucasian populations, including Native Americans, have been reported to have higher rates, distinct clinical phenotypes, increased complications, and greater severity of systemic sclerosis (SSc). However, little is known of SSc specifically in Native Americans of the American Southwest. This study compared the clinical and serologic manifestations and outcomes of SSc in Native Americans and non\u2010Native Americans (non\u2010Natives) of this region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional retrospective study included 137 SSc patients (109 [80%] were non\u2010Native and 28 [20%] were Native Americans) followed over a mean of 11.5\u2009\u00b1\u20097.6\u2009years. Participants were repetitively evaluated with medical history, physical examination, echocardiography, chest imaging, and serologic testing. Disease characteristics and outcomes were statistically compared between Native Americans and non\u2010Native patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The estimated prevalence of SSc in Native Americans was 40.0 cases\/100\u2009000 vs 17.1 cases\/100\u2009000 for non\u2010Natives (odds ratio 2.34, 95% confidence interval [CI] 1.55\u20103.55,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). The cohorts were similar in terms age, age of onset, limited vs diffuse cutaneous SSc, telangiectasias, gastroesophageal reflux disease, Raynaud phenomenon, serologies, interstitial lung disease, pulmonary arterial hypertension, scleroderma renal crisis, cancer prevalence, and overall mortality (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u2009.05). However, for Native Americans, mortality specifically from fatal infections was 3.94\u2010fold that of non\u2010Natives (hazard ratio 6.88, 95% CI 1.37\u201034.64;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In Native Americans of the American Southwest, SSc is increased in prevalence but is phenotypically similar to SSc in non\u2010Natives. However, mortality due specifically to infection is increased in Native Americans with SSc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.14367","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T05:58:57Z","timestamp":1655186337000},"page":"916-925","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Systemic sclerosis in Native Americans of the American Southwest"],"prefix":"10.1111","volume":"25","author":[{"given":"N. 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