Raynaud fenomeni: Revizyonlar arasındaki fark
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Sayfa içeriği '== Raynaud fenomeni == Bir dolaşım problemi, soğuğa karşı bir hasasiyet vardır.Kan damarları kasılır veya daralır.Kan akımı büyük ölçüde azal...' ile değiştirildi |
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{{düzenle|Temmuz 2011}}
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[[Dosya:Raynaud's Syndrome.jpg |right|350 px]]
'''Raynaud fenomeni''' ya da '''Raynaud olgusu''', uzuvlarda oluşan bir kan [[dolaşım]] rahatsızlığıdır
özellikle soğuğa karşı uzuvların [[hipotermi]] direnci düşüktür.
Raynaud fenomeni (pronounced / reɪnoʊz /, bizdict: ra · noz ') Bir bir vazospastik bir bozukluk neden renk değişimi parmaklar, ayak parmakları olabilir. Fransız doktor için adli Maurice Raynaud (1834-1881), fenomenin neden vasospasms sonucu olduğuna inanılıyordu Duygusal stres ve soğuk klasik olan fenomenin tetikler.
== Sebepleri ==
ırsi damar hastalıkları ve çeşitli ilaçların yan etkisiyle özelliklede [[kemoterapi]] sürecinde uygulanan ağır ilaçların uzullardaki kılcal damarlarda birikmesine bağlı olarak gelişebildiğide gözlemlenmiştir.
== Tanı ==
damar hastalıklarına bağlı dolaşım bozukluğu veya damar tıkanıklığına bağlı olarak gelişebilmektedir
Raynaud fenomeni genel hatlarıyla 2 kategoride değerlendirilebilinir.
1. seviye ; ortam ısısına duyarlı parmak uçlarında soğuka bağlı parmak uçlarında hissizlik soğuk ortamlarda el ve ayak [[parmak]]ları beyaz ve mora çalan renk alırlar ve geçici uyuşmalar olur.
2. seviye ; ileri seviye kuru kangiren, doku çürümesine sebep olabilecek düzeyde
== tedavi ==
=== önleyici tedavi yöntemleri ===
hasta soguktan yine kacinmali ,
özellikle stresten uzak durulmali,
sigara azaltilmali mumkunse birakilmalidir.
soguga cikmadan evel cilde nitrogliserin iceren preparatlar surulur ,
=== cerrahi tedavi yöntemleri hakkında ===
hastanın yaşam kalitesini bozucu ve rahatsız edici düzeyde olması halinde
ca kanal blokeri alfa blokerler fayda saglayabilir.
çok şiddetli vakalarda tedavi gerekebilir.çok ciddi durumlarda ' [[sempatektomi]] 'adı verilen cerrahi işlem uygulanabilir, ( ayrıca bakınız [[Sympathectomy]] )
hastalık ilerleyen saffalarında Trofik bozukluk ve doku [[nekroz]]u oluşumuna sebep olabilir.
{{Hastalık-taslak}}
<!--
{{çeviri}}
{{Infobox disease |
Name = Raynaud's phenomenon |
Image = Raynaud's Syndrome.jpg |
Caption = Hands with Raynaud's phenomenon |
DiseasesDB = 25933 |
ICD10 = {{ICD10|I|73|0|i|70}} |
ICD9 = {{ICD9|443.0}} |
ICDO = |
OMIM = |
MedlinePlus = |
eMedicineSubj = med |
eMedicineTopic = 1993 |
MeshID = D011928
}}
In [[medicine]], '''Raynaud's phenomenon''' ({{pron-en|reɪˈnoʊz}}, {{USdict|rā·nōz′}}) is a [[vasospasm|vasospastic]] disorder causing discoloration of the [[finger]]s, [[toe]]s, and occasionally other extremities. This condition can also cause nails to become brittle with longitudinal ridges. Named for French physician [[Maurice Raynaud]] (1834–1881), the cause of the phenomenon is believed to be the result of vasospasms that decrease blood supply to the respective regions. [[Emotional stress]] and cold are classic triggers of the phenomenon.
It comprises both '''Raynaud's disease''' (also known as "Primary Raynaud's phenomenon"where the phenomenon is [[idiopathic]],<ref>{{DorlandsDict|nine/000956360|Raynaud disease}}</ref> and '''Raynaud's syndrome''' (''secondary Raynaud's''), where it is caused by some other instigating factor. Measurement of hand-temperature gradients is one tool used to distinguish between the primary and secondary forms.<ref name="pmid17018538">{{cite journal |author=Anderson ME, Moore TL, Lunt M, Herrick AL |title=The 'distal-dorsal difference': a thermographic parameter by which to differentiate between primary and secondary Raynaud's phenomenon |journal=Rheumatology |volume=46 |issue=3 |pages=533–8 |year=2007 |month=March |pmid=17018538 |doi=10.1093/rheumatology/kel330}}</ref>
It is possible for the primary form to progress to the secondary form.<ref name="pmid16732585">{{cite journal |author=Hirschl M, Hirschl K, Lenz M, Katzenschlager R, Hutter HP, Kundi M |title=Transition from primary Raynaud's phenomenon to secondary Raynaud's phenomenon identified by diagnosis of an associated disease: results of ten years of prospective surveillance |journal=Arthritis and Rheumatism |volume=54 |issue=6 |pages=1974–81 |year=2006 |month=June |pmid=16732585 |doi=10.1002/art.21912}}</ref>
In extreme cases, the secondary form can progress to [[necrosis]] or [[gangrene]] of the fingertips.
Raynaud's phenomenon is an exaggeration of [[vasomotor]] responses to cold or emotional stress. More specifically, it is a hyperactivation of the [[sympathetic system]] causing extreme [[vasoconstriction]] of the peripheral blood vessels, leading to tissue [[Hypoxia (medical)|hypoxia]]. Chronic, recurrent cases of Raynaud phenomenon can result in atrophy of the [[skin]], [[subcutaneous tissue]]s, and [[muscle]]. In rare cases it can cause [[Ulcer (dermatology)|ulceration]] and [[ischemic gangrene]].<ref name=robbins>{{cite book |author=Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. |title=Robbins and Cotran pathologic basis of disease |publisher=Elsevier Saunders |location=St. Louis, Mo |year=2005 |page=542 |isbn=0-7216-0187-1}}</ref>
== Symptoms ==
The condition can cause pain within the affected extremities, discoloration (paleness) and sensations of cold and/or numbness. This can often be distressing to those who are not diagnosed, and sometimes it can be obstructive. If someone with Raynaud's is placed in too cold a climate, it could potentially become dangerous.
The symptoms include several cyclic color changes:
# When exposed to cold temperatures, the [[blood]] supply to the fingers or toes, and in some cases the nose or earlobes, is markedly reduced; the skin turns pale or white (called [[pallor]]), and becomes cold and numb.
# When the [[oxygen]] supply is depleted, the skin colour turns blue (called [[cyanosis]]).
# These events are episodic, and when the episode subsides or the area is warmed, the blood flow returns and the skin colour first turns red ([[rubor]]), and then back to normal, often accompanied by [[Swelling (medical)|swelling]] and [[tingling]].
All three colour changes are observed in classic Raynaud's. However, not all patients see all of the aforementioned colour changes in all episodes, especially in milder cases of the condition. Symptoms are thought to be due to reactive [[hyperemia]]s of the areas deprived of blood flow.
In [[pregnancy]], this sign normally disappears due to increased surface [[blood flow]].
Raynaud's has also occurred in breastfeeding mothers, causing nipples to turn white and become extremely painful.<ref>{{cite journal |author=Holmen OL, Backe B |journal=BMJ |year=2009 |volume=339 |pages=b2553 |doi=10.1136/bmj.b2553 |title=An underdiagnosed cause of nipple pain presented on a camera phone}}</ref> [[Nifedipine]], a [[calcium channel blocker]] and [[vasodilator]] was recommended to increase blood flow to the extremities and noticeably relieved pain to the breast, in an extremely small study group.<ref>{{cite journal |author=Anderson JE, Held N, Wright K |title=Raynaud's phenomenon of the nipple: a treatable cause of painful breastfeeding |journal=Pediatrics |volume=113 |issue=4 |pages=e360–4 |year=2004 |month=April |pmid=15060268 |doi=10.1542/peds.113.4.e360}}</ref>
== Prevalence ==
The phenomenon is more common in women than men, with the [[Framingham Heart Study|Framingham Study]] finding that 5% of men and 8% of women suffer from it.{{Verify source|date=April 2009}}
== Epidemiology ==
It is important to distinguish Raynaud's ''disease'' from ''syndrome''. In order to [[diagnosis (medical)|diagnose]] these two forms of Raynaud's, a doctor may look for signs of [[arthritis]] or [[vasculitis]], and may conduct a number of [[medical laboratory|laboratory]] tests.
=== Primary Raynaud's (disease) ===
'''Raynaud's disease''', or "Primary Raynaud's", is diagnosed if the symptoms are ''[[idiopathic]]'', that is, they occur by themselves and not in association with other diseases. Some refer to Primary Raynaud's disease as "being allergic to coldness". It often develops in young women in their teens and early adulthood. Primary Raynaud's is thought to be at least partly [[Heredity|hereditary]], although specific genes have not yet been identified.<ref name="pmid16609626">{{cite journal |author=Pistorius MA, Planchon B, Schott JJ, Lemarec H |title=[Heredity and genetic aspects of Raynaud's disease] |language=French |journal=Journal Des Maladies Vasculaires |volume=31 |issue=1 |pages=10–5 |year=2006 |month=February |pmid=16609626 |url=http://www.masson.fr/masson/MDOI-JMV-01-2006-31-1-0398-0499-101019-200517601}}</ref>
[[tobacco smoking|Smoking]] worsens frequency and intensity of attacks, and there is a hormonal component. Caffeine also worsens the attacks. Sufferers are more likely to have [[migraine]] and [[Angina pectoris|angina]] than controls.
=== Secondary Raynaud's (syndrome) ===
'''Raynaud's syndrome''', or "Secondary Raynaud's", occurs ''secondary to'' a wide variety of other conditions.
Secondary Raynaud's has a number of associations:
* Connective tissue disorders:
** [[scleroderma]]<ref name="pmid17218139">{{cite journal |author=Gayraud M |title=Raynaud's phenomenon |journal=Joint, Bone, Spine |volume=74 |issue=1 |pages=e1–8 |year=2007 |month=January |pmid=17218139 |doi=10.1016/j.jbspin.2006.07.002}}</ref>
** [[systemic lupus erythematosus]]
** [[rheumatoid arthritis]]
** [[Sjögren's syndrome]]
** [[dermatomyositis]]
** [[polymyositis]]
** [[mixed connective tissue disease]]
** [[cold agglutinin disease]]
** [[Ehlers-Danlos Syndrome]]
* Eating disorders
** [[anorexia nervosa]]
* Obstructive disorders
** [[atherosclerosis]]
** [[Buerger's disease]]
** [[Takayasu's arteritis]]
** subclavian [[aneurysm]]s
** [[thoracic outlet syndrome]]
* Drugs
** [[Beta-blocker]]s
** cytotoxic drugs - particularly [[chemotherapy|chemotherapeutics]] and most especially [[bleomycin]]
** [[ciclosporin]]
** [[ergotamine]]
** [[sulfasalazine]]
** [[anthrax vaccines]] whose primary ingredient is the Anthrax Protective Antigen
* Occupation
** jobs involving vibration, particularly drilling
** exposure to [[vinyl chloride]], [[mercury (element)|mercury]]
** exposure to the cold (e.g. by working packing frozen food)
* Others
** [[hypothyroidism]]
** [[cryoglobulinemia]]
** [[Cancer|malignancy]]
** [[Complex regional pain syndrome|reflex sympathetic dystrophy]]
** [[carpal tunnel syndrome]]
** Magnesium Deficiency
** [[Erythromelalgia]], (the opposite of Raynaud's, with hot and warm extremities) often co-exists in patients with Raynaud's)<ref>{{cite journal |author=Berlin AL, Pehr K |title=Coexistence of erythromelalgia and Raynaud's phenomenon |journal=Journal of the American Academy of Dermatology |volume=50 |issue=3 |pages=456–60 |year=2004 |month=March |pmid=14988692 |doi=10.1016/S0190-9622(03)02121-2}}</ref>
It is important to realize that Raynaud's can ''herald'' these diseases by periods of more than 20 years in some cases, making it effectively their first presenting symptom. This can be the case in the [[CREST syndrome]], of which Raynaud's is a part.
Patients with Secondary Raynaud's can also have symptoms related to their underlying diseases. Raynaud's phenomenon is the initial symptom that presents for 70% of patients with [[scleroderma]], a skin and joint disease.
Raynaud's phenomenon which is limited to one hand (or to one foot) is referred to as Unilateral Raynaud's. This is an uncommon form, and it is always secondary to local or regional vascular disease. It commonly progresses within several years to affect other limbs as the vascular disease progresses.<ref>{{cite journal |author=Priollet P |title=[Raynaud's phenomena: diagnostic and treatment study] |language=French |journal=La Revue Du Praticien |volume=48 |issue=15 |pages=1659–64 |year=1998 |month=October |pmid=9814067}}</ref>
== Examination ==
A careful [[medical history|history]] will often reveal whether the condition is primary or secondary. Once this has been established, an examination is largely to identify or exclude possible secondary causes.
* Digital artery pressure: pressures are measured in the arteries of the fingers before and after the hands have been cooled. A decrease of at least 15[[mmHg]] is diagnostic (positive).
* [[Doppler ultrasound]]: to assess flow
* [[Full blood count]]: this can reveal a normocytic [[anaemia]] suggesting the [[anaemia of chronic disease]] or [[renal failure]]
* [[Blood test|Urea & Electrolytes]]: this can reveal renal impairment
* [[Thyroid function tests]]: this can reveal [[hypothyroidism]]
* An [[autoantibody]] screen, tests for [[rheumatoid factor]], [[Erythrocyte sedimentation rate]] and [[C-reactive protein]], which may reveal specific causative illnesses or a generalised inflammatory process
* [[Nailfold capillaroscopy|Nail fold vasculature]]: this can be examined under the microscope
== Treatment ==
Treatment options are dependent on the type of Raynaud's present. Raynaud's syndrome is treated primarily by addressing the underlying cause, but includes all options for Raynaud's disease as well. Treatment of primary Raynaud's focuses on avoiding triggers:
=== General care ===
* Avoid environmental triggers, e.g. cold, vibration, etc. Emotional stress is another recognized trigger; although the various sources of stress can not all be avoided, it is possible to learn healthier, more effective ways of dealing with them, which will reduce stress and its somatic pathology (damaging physical effects) overall.
* Keep your hands, feet and head warm—especially your fingers, toes, ears and nose—by wearing mittens, insulated footwear, a ski mask; by using [[hand warmer|hand-]] and [[foot warmer]]s, etc.
* [[smoking cessation|Quit smoking]].
* Avoid [[caffeine]] and other [[stimulants]] and [[vasoconstrictors]] that have not been prescribed to you by your doctor. Read product labels; caffeine is found not only in coffee and tea, stay-awake pills, many soft drinks and candies, but also in some cosmetics, soaps and shampoos(reference needed).
* Make sure all your doctors know about all the medicines you take and about all the [[Over-the-counter drug|OTC]] remedies you use, especially hormones and drugs that regulate hormones, such as [[hormonal contraception]], so that these professionals can make an assessment of your chemical regimen and make any changes that may be [[indicated]]. Contraception which is low in [[estrogen]] is preferable, and the [[progesterone only pill]] is often prescribed for women with Raynaud's.
* If you are diabetic, follow your diabetes treatment plan.
=== Emergency measures ===
* If white finger (Raynaud's) occurs unexpectedly and a source of warm water is available, allow tepid to slightly warm water to run over the affected digits while you gently massage the area. Continue this process until the white area returns to its normal, healthy color.
* If triggered by exposure in a cold environment, and no warm water is available, place the affected digits in a warm body cavity - arm pit, crotch, or even in the mouth. Keep the affected area warm at least until the whiteness returns to its normal, healthy color. Get out of the cold as soon as possible.
=== Drug therapy ===
* Treatment for Raynaud's phenomenon may include prescription medicines that [[vasodilation|dilate blood vessels]], such as [[calcium channel blocker]]s ([[nifedipine]]) or diltiazem.<ref name="pmid7212523">{{cite journal |author=Kahan A, Weber S, Amor B, Saporta L, Hodara M, Degeorges M |title=Nifedipine and Raynaud's phenomenon |journal=Annals of Internal Medicine |volume=94 |issue=4 pt 1 |pages=546 |year=1981 |month=April |pmid=7212523}}</ref><ref name="pmid6285445">{{cite journal |author=Kahan A, Weber S, Amor B, Saporta L, Hodara M, Degeorges M |title=[Controlled study of nifedipine in the treatment of Raynaud's phenomenon] |language=French |journal=Revue Du Rhumatisme et Des Maladies Ostéo-articulaires |volume=49 |issue=5 |pages=337–43 |year=1982 |month=April |pmid=6285445}}</ref> It has the usual common side effects of headache, flushing, and ankle [[edema]]; but these are not typically of sufficient severity to require cessation of treatment.<ref name="pmid3881908">{{cite journal |author=Smith CR, Rodeheffer RJ |title=Raynaud's phenomenon: pathophysiologic features and treatment with calcium-channel blockers |journal=The American Journal of Cardiology |volume=55 |issue=3 |pages=154B–157B |year=1985 |month=January |pmid=3881908 |doi=10.1016/0002-9149(85)90625-3}}</ref>
* There is some evidence that [[Angiotensin II receptor antagonist]]s (often [[Losartan]]) reduce frequency and severity of attacks,<ref name="pmid9408065">{{cite journal |author=Pancera P, Sansone S, Secchi S, Covi G, Lechi A |title=The effects of thromboxane A2 inhibition (picotamide) and angiotensin II receptor blockade (losartan) in primary Raynaud's phenomenon |journal=Journal of Internal Medicine |volume=242 |issue=5 |pages=373–6 |year=1997 |month=November |pmid=9408065 |doi=10.1046/j.1365-2796.1997.00219.x}}</ref> and possibly better than nifedipine.<ref name="pmid10616013">{{cite journal |author=Dziadzio M, Denton CP, Smith R, ''et al.'' |title=Losartan therapy for Raynaud's phenomenon and scleroderma: clinical and biochemical findings in a fifteen-week, randomized, parallel-group, controlled trial |journal=Arthritis and Rheumatism |volume=42 |issue=12 |pages=2646–55 |year=1999 |month=December |pmid=10616013 |doi=10.1002/1529-0131(199912)42:12<2646::AID-ANR21>3.0.CO;2-T}}</ref>
* Alpha-1 adrenergic blockers such as prazosin can be used to control Raynaud's vasospasms under supervision of a health care provider.<ref name="pmid762741">{{cite journal |author=Waldo R |title=Prazosin relieves Raynaud's vasospasm |journal=JAMA |volume=241 |issue=10 |pages=1037 |year=1979 |month=March |pmid=762741 |doi=10.1001/jama.241.10.1037}}</ref>
* In a study published in the November 8, 2005 issue of ''Circulation'', [[sildenafil]] (Viagra) improved both microcirculation and symptoms in patients with secondary Raynaud's phenomenon resistant to vasodilatory therapy. The authors, led by Dr Roland Fries (Gotthard-Schettler-Klinik, Bad Schönborn, Germany), report: "In the present study, capillary blood flow was severely impaired and sometimes hardly detectable in patients with Raynaud's phenomenon. Sildenafil led to a more than 400% increase of flow velocity."<ref name="pmid16275885">{{cite journal |author=Fries R, Shariat K, von Wilmowsky H, Böhm M |title=Sildenafil in the treatment of Raynaud's phenomenon resistant to vasodilatory therapy |journal=Circulation |volume=112 |issue=19 |pages=2980–5 |year=2005 |month=November |pmid=16275885 |doi=10.1161/CIRCULATIONAHA.104.523324 |doi_brokendate=2010-02-15 |url=http://circ.ahajournals.org/cgi/content/abstract/112/19/2980}}</ref>
* [[Fluoxetine]], a selective [[serotonin reuptake inhibitor]], and other [[antidepressant]] medications may reduce the frequency and severity of episodes if caused mainly due to psychological stressors.
=== Surgical Intervention ===
* In severe cases, a [[sympathectomy]]<ref name="pmid17098681">{{cite journal |author=Wang WH, Lai CS, Chang KP, ''et al.'' |title=Peripheral sympathectomy for Raynaud's phenomenon: a salvage procedure |journal=The Kaohsiung Journal of Medical Sciences |volume=22 |issue=10 |pages=491–9 |year=2006 |month=October |pmid=17098681 |doi=10.1016/S1607-551X(09)70343-2}}</ref> procedure can be performed. Here, the nerves that signal the blood vessels of the fingertips to constrict are surgically cut. [[Microvascular surgery]] of the affected areas is another possible therapy. Infusions of [[prostaglandin]]s, e.g. [[prostacyclin]], may be tried, with [[amputation]] in exceptionally severe cases.
* A more recent treatment for severe Raynaud's is the use of Botox. The 2009 article<ref>{{cite journal |author=Neumeister MW, Chambers CB, Herron MS, ''et al.'' |title=Botox therapy for ischemic digits |journal=Plastic and Reconstructive Surgery |volume=124 |issue=1 |pages=191–201 |year=2009 |month=July |pmid=19568080 |doi=10.1097/PRS.0b013e3181a80576}}</ref> studied 19 patients ranging in age from 15 to 72 years with severe Raynaud's phenomenon of which 16 patients (84%) reported pain reduction at rest. 13 patients reported immediate pain relief, 3 more had gradual pain reduction over 1-2 months. All 13 patients with chronic finger ulcers healed within 60 days. Only 21% of the patients required repeated injections. A 2007 article<ref>{{cite journal |author=Van Beek AL, Lim PK, Gear AJ, Pritzker MR |title=Management of vasospastic disorders with botulinum toxin A |journal=Plastic and Reconstructive Surgery |volume=119 |issue=1 |pages=217–26 |year=2007 |month=January |pmid=17255677 |doi=10.1097/01.prs.0000244860.00674.57}}</ref> describes similar improvement in a series of 11 patients. All patients had significant relief of pain.
=== Alternative and Experimental (Research) Approaches ===
* The extract of the [[Ginkgo biloba]] leaves (Egb 761, 80 mg) may reduce frequency of attacks.<ref name="pmid12710841">{{cite journal |author=Muir AH, Robb R, McLaren M, Daly F, Belch JJ |title=The use of Ginkgo biloba in Raynaud's disease: a double-blind placebo-controlled trial |journal=Vascular Medicine |volume=7 |issue=4 |pages=265–7 |year=2002 |pmid=12710841 |doi=10.1191/1358863x02vm455oa}}</ref>
* Two separate gels combined on the fingertip (somewhat like two-part [[epoxy]], they cannot be combined before use because they will react) increased blood flow in the fingertips by about three times. One gel contained 5% sodium nitrite and the other contained 5% ascorbic acid. The milliliter of combined gel covered an area of ~3 cm². The gel was wiped off after a few seconds.<ref name="pmid10568568">{{cite journal |author=Tucker AT, Pearson RM, Cooke ED, Benjamin N |title=Effect of nitric-oxide-generating system on microcirculatory blood flow in skin of patients with severe Raynaud's syndrome: a randomised trial |journal=Lancet |volume=354 |issue=9191 |pages=1670–5 |year=1999 |month=November |pmid=10568568 |doi=10.1016/S0140-6736(99)04095-7}}</ref>
* [[Piracetam]], a nootropic drug, can be useful as a long-term treatment for vasospastic disorders.
* Arginine, which increase nitrous oxide acts as a vasodilator
* Milder cases of Raynaud's can often be addressed by [[biofeedback]]<ref>{{cite journal |author=Karavidas MK, Tsai PS, Yucha C, McGrady A, Lehrer PM |title=Thermal biofeedback for primary Raynaud's phenomenon: a review of the literature |journal=Applied Psychophysiology and Biofeedback |volume=31 |issue=3 |pages=203–16 |year=2006 |month=September |pmid=17016765 |doi=10.1007/s10484-006-9018-2}}</ref> or other techniques to help control [[Autonomic nervous system|involuntary body functions]] like skin temperature.
* [[Fish oil]] supplements which contain long-chain [[omega-3 fatty acids]] may help to control symptoms of primary Raynaud's. There are few studies in the medical literature dealing with this subject. However, in one 1989 controlled, double-blinded study of 32 patients,<ref>{{cite journal |author=DiGiacomo RA, Kremer JM, Shah DM |title=Fish-oil dietary supplementation in patients with Raynaud's phenomenon: a double-blind, controlled, prospective study |journal=The American Journal of Medicine |volume=86 |issue=2 |pages=158–64 |year=1989 |month=February |pmid=2536517 |doi=10.1016/0002-9343(89)90261-1}}</ref> consumption of roughly 6.5 grams of long chain omega-3 fatty acids in the form of fish oil significantly increased the time to onset or entirely prevented symptoms in response to cold in patients with primary Raynaud's. Lower doses of fish oil such as may be commonly available from commercial vendors have not been studied and may not be as effective.
== Footnotes ==
{{reflist|2}}
-->
== Dış bağlantılar ==
* [http://www.niams.nih.gov/hi/topics/raynaud/ar125fs.htm Overview] at [[National Institutes of Health]]
* [http://healthlink.mcw.edu/article/926055412.html Overview] at [[Medical College of Wisconsin]]
* [http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/raynauds_disease.jsp Raynaud's Disease] at healthatoz.com
* {{YouTube|nRtNY6x1LAY|Raynaud's Phenomenon}}
* {{YouTube|gHYskEqj8Tc|Raynaud's Disease}}
* {{YouTube|5b7_DZOxHzc}}
* [http://www.nhlbi.nih.gov/health/dci/Diseases/raynaud/ray_what.html What Is Raynaud's Disease] at [[National Heart, Lung, and Blood Institute]]
* [http://www.mayoclinic.com/invoke.cfm?id=DS00433 Raynaud's Disease] at [[Mayo Clinic]]
* [http://www.raynauds.org.uk/potioncms/viewer.asp?a=117&z=25 Raynaud's & Scleroderma Association, a national charity and self help organisation, committed to supporting patients and carers who have these conditions]
* {{cite journal |author=Bakst R, Merola JF, Franks AG, Sanchez M |title=Raynaud's phenomenon: pathogenesis and management |journal=Journal of the American Academy of Dermatology |volume=59 |issue=4 |pages=633–53 |year=2008 |month=October |pmid=18656283 |doi=10.1016/j.jaad.2008.06.004}}
[[Kategori:Kardiyovasküler hastalıklar]]
[[Kategori:Tıp terimleri]]
[[de:Raynaud-Syndrom]]
[[en:Raynaud's phenomenon]]
[[es:Enfermedad de Raynaud]]
[[fi:Raynaud'n oireyhtymä]]
[[fr:Maladie de Raynaud]]
[[it:Fenomeno di Raynaud]]
[[ko:레이노 현상]]
[[nl:Fenomeen van Raynaud]]
[[pt:Fenômeno de Raynaud]]
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