bluuebunny/crossref_metadata_2025_split huggingface dataset:
POS0921 EFFICACY AND SAFETY OF ACEMETACIN IN THE TREATMENT OF 1215 ACTIVE ANKYLOSING SPONDYLITIS PATIENTS: DATA FROM A PROSPECTIVE COHORT MANAGED BY SMART-PHONE SPONDYLOARTHRITIS MANAGEMENT SYSTEM
Authors: Zhang J. , Hu L. , Ji X. , Wang Y. , Huang F. 
Published: May 2021

Background:Biological DMARDs have widely used in the treatment of AS in last two decades, but NSAIDs still serves as a cornerstone in the treatment. Given the wide use of Acemetacin in AS and relative lack of clinical evidence on the selection of NSAIDs in the treatment of AS, the investigation on acemetacin treating AS is of great significance.Objectives:Our study aims to investigate efficacy and safety of acemetacin in the treatment of AS.Methods:Data on efficacy and safety is available in 1215 patients from the Chinese Ankylosing Spondylitis Imaging Cohort (CASPIC), which is collected through the Smart-phone SpondyloArthritis Management System (SpAMS)[1]. Patients’ self-assessments are completed online at baseline and every subsequent clinic visit. Physician-reported assessments, laboratory tests, and treatments were recorded by rheumatologists at every clinic visit.Results:1215 patients with AS were registered, of whom 992 were treated with acemetacin and 123 were treated with other NSAIDs. The results showed that total back pain and BASFI were significantly improved after three-month treatment of acemetacin, while comparing to other NSAIDs (P=0.027 and 0.015, respectively). After six-month treatment, patients taking acemetacin showed greater improvement in PGA (P=0.013), total back pain (P=0.049), night back pain (P=0.047), BASFI (P=0.042), ASDAS (P=0.007) and CRP (P=0.032) compared to those taking other NSAIDs. During the follow-up periods, no serious adverse events were reported. Mild abnormal liver function occurred in nine patients (9/992) treated with acemetacin and in six patients treated with other NSAIDs (6/123). See Table 1 for details.Conclusion:Acemetacin showed better efficacy and acceptable safety profile in the treatment of active ankylosing spondylitis comparing with other NSAIDs.References:[1]Ji, X., et al., Improvement of Disease Management and Cost Effectiveness in Chinese Patients with Ankylosing Spondylitis Using a Smart-Phone Management System: A Prospective Cohort Study. BioMed research international, 2019. 2019: p. 2171475.Table 1.The comparation of two groups at 0, 3 and 6 months after treatmentBaseline3 months6 months95%CIP95%CIP95%CIPPGA-0.13(-0.49, 0.24)0.494-0.28(-0.74, 0.18)0.235-0.59(-1.06, -1.13)0.013*Total back pain-0.03(-0.37, 0.32)0.889-0.50(-0.94, -0.06)0.027*-0.44(-0.88, -0.002)0.049*Night back pain0.01(-0.36, 0.38)0.956-0.30(-0.75, 0.16)0.203-0.46(-0.91, -0.006)0.047*BASFI-0.30(-0.59, 0.004)0.053-0.55(-0.99, -0.11)0.015*-0.34(-0.67, -0.01)0.042*ASDAS-0.10(-0.29, 0.08)0.287-0.15(-0.46, 0.16)0.342-0.41(-0.70, -0.11)0.007*CRP-4.39(-8.87, 0.10)0.0550.91(-10.39, 12.21)0.874-7.86(-15.03, -0.68)0.032*Disclosure of Interests:None declared
POS0148 MATERNAL AND NEONATAL OUTCOMES IN PREGNANT WOMEN WITH PSORIASIS AND PSORIATIC ARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Xie W. , Huang H. , Zhang Z. 
Published: May 2021

Background:Psoriasis and psoriatic arthritis (PsA) are inflammatory diseases that affect women in their reproductive years. The evidence regarding the pregnancy outcomes in psoriasis and PsA is more limited and conflicting, to a large extent, confusing our knowledge on this topic.Objectives:We aim to investigate whether maternal psoriasis and PsA are associated with adverse pregnancy outcomes.Methods:We searched multiple electronic databases from inception to 3 August 2020, and reference lists of selected articles. Observational studies reporting at least one pregnancy outcomes in women with psoriasis or PsA with a comparator of general population or healthy subjects were included. Data were pooled by random-effects models (DerSimonian and Laird method) and expressed as odds ratio (OR) and 95% confidence interval (CI).Results:Overall, 16 studies were included in the meta-analysis. The pooled analyses showed pregnant women with psoriatic diseases have significantly higher risk of adverse maternal outcomes compared with general population (caesarean delivery: 1.33 (1.17-1.52); preterm birth: 1.32 (1.15-1.52); (pre)eclampsia: 1.28 (1.14-1.43); gestational diabetes: 1.19 (1.10-1.30); gestational hypertension: 1.30 (1.18-1.44) (Figure 1). However, no statistically increased risks of fetal complications were observed in women with psoriatic diseases (small for gestational age: 1.02 (0.93-1.11); low birth weight: 1.15 (0.93-1.42); congenital malformations: 1.03 (0.93-1.14); Apgar score <7: 1.07 (0.81-1.39); neonatal mortality: 1.13 (0.90-1.43); stillbirth: 1.19 (0.95-1.50)). Subgroup analysis found similar results in women with either psoriasis or PsA regarding maternal outcomes, but the magnitude of risk estimates seems to be greater in PsA.Conclusion:Pregnant women with psoriasis and PsA have excess risk of adverse maternal events, with seemingly higher risk in women with PsA, but not adverse neonatal events. Close monitoring of the mothers’ clinical status before and during pregnancy are decidedly required in daily practice.Figure 1.Forest plots of the odds ratio for the risk of adverse pregnancy outcomes in patients with psoriatic diseases.Disclosure of Interests:None declared
POS1137 IDENTIFYING ADULT HYPOPHOSPHATASIA IN THE RHEUMATOLOGY UNIT
Authors: Feurstein J. , Behanova M. , Haschka J. , Roetzer K. , Uyanik G. , Witsch-Baumgartner M. , Schett G. , Zwerina J. , Kocijan R. 
Published: May 2021

Background:The most frequent manifestation in adult Hypophosphatasia (HPP) is musculoskeletal pain.1,2 The unspecific nature of its clinical presentation may prevent correct diagnosis.3Objectives:Identifying adult hypophosphatasia in the rheumatology unit.Methods:Over a period of 10 years 9,522 patients were screened in a rheumatological outpatient unit. Serum ALP levels ≤ 40 U/l were found in 524 patients. After screening for secondary causes, 73 patients were invited for clinical evaluation. Genetic testing was performed in 23 patients with suspected HPP. Logistic regression models were used to estimate the association of each clinical factor with HPP.Results:Mutations in the ALPL gene were observed in 57% of genetically screened patients. Arthralgia, fractures and pain were the leading symptoms in HPP patients. Chondrocalcinosis (OR 29.12; 95% CI 2.02-1593.52) and dental disease (OR 8.33; 95% CI 0.93-143.40) were associated with HPP independent of BMI. Onset of symptoms in HPP was at 35.1 (14.3) years, with a mean duration from symptoms to diagnosis of 14.4 (8.1) years. Bone mineral density (BMD) and trabecular bone score (TBS) as well as bone turnover markers were not indicative for HPP.Conclusion:HPP can mimic joint diseases.4 Thus, in patients with uncertain rheumatologic complaints and low ALP, HPP should be considered as potential diagnosis.References:[1]Durrough C, Colazo JM, Simmons J, et al. Characterization of physical, functional, and cognitive performance in 15 adults with hypophosphatasia. Bone 2021;142:115695.[2]Seefried L, Kishnani PS, Moseley S, et al. Pharmacodynamics of asfotase alfa in adults with pediatric-onset hypophosphatasia. Bone 2021;142:115664.[3]Högler W, Langman C, Gomes da Silva H, et al. Diagnostic delay is common among patients with hypophosphatasia: initial findings from a longitudinal, prospective, global registry. BMC musculoskeletal disorders 2019;20(1):80.[4]Seefried L, Dahir K, Petryk A, et al. Burden of Illness in Adults With Hypophosphatasia: Data From the Global Hypophosphatasia Patient Registry. Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 2020;35(11):2171-78.Disclosure of Interests:None declared.
POS1155 INFECTIOUS RISK DURING BIOLOGIC THERAPY FOR INFLAMMATORY RHEUMATIC DISEASES: DATA FROM THE TUNISIAN BINAR REGISTRY
Authors: Boussaid S. , Ben Aissa R. , Kochbati S. , Elleuch M. , Abdelmoula L. , Laatar A. , Hamdi W. , Gharsallah I. , Bouagina E. , Baklouti S. , Bergaoui N. , Younes M. 
Published: May 2021

Background:The development of biologics for the treatment of systemic rheumatic diseases increased the risk of infections. The management of this complication deserves particular attention since it remains a major cause of morbidity and mortality.Objectives:The aim of our study was to determine infection frequency under biological treatment and consequences on the therapeutic management.Methods:Patients included in the Biological National Registry (BINAR) from 2016 to 2020. Data related to the disease, biological agents, and infections occurring under biologic disease-modifying antirheumatic drugs (bDMARDs) were collected.Results:The study included 298 patients with a mean age of 49.2 years [18-79] 175 patients with rheumatoid arthritis and 123 with spondyloarthritis (Axial Spondyloarthritis=48, Enteropathic Arthritis=41, Psoriatic Arthritis=34). Anti Tumor necrosis factor-alpha (Anti-TNF) agents were the most prescribed bDMARDs in 87.9% (n=263) of patients: Infliximab 20.4% (n=61),Etanercept 23.1%(n=69), Adalimumab 24.6%(n=74) and Certolizumab (n=79). No patients were treated with Golimumab. Tocilizumab and Rituximab were prescribed respectively in 10.4% (n=31) and 5% (n=15) of patients. Infections occured in 9 patients (3.1%) with a total of 13 infectious episodes 12 bacterial and a viral one. The site of infections was: respiratory (38%), urinary (15%), cutaneous (23%), ORL (8%), infective endocarditis (8%), and other (8%). The infectious agent was identified in only 3 patients. The outcomes were favorable in most cases except in one patient where there was a definitive interruption of bDMARDs. The patient was hospitalized for sepsis complicating a cutaneous infection with favorable outcomes under antibiotics within a week. The biological agent with higher risk of infections was Tocilizumab (p = 0.056), unlike Rituximab (p = 0.483) and Anti-TNF (p = 0.082). All patients who had an infectious episode were under corticosteroids.Conclusion:Our results confirm that bDMARDs are predisposing to infections, but data from BINAR showed that most infections were trivial with no serious outcomes. Therefore, infections should be assessed in patients under bDMARDs for an early therapeutic intervention.Disclosure of Interests:None declared.
Clinical application of foot strike run retraining for military service members with chronic knee pain
Authors: Mazzone Brittney , Yoder A , Condon R , Farrokhi S 
Published: May 2021

IntroductionMilitary training is associated with a high incidence of knee pain. Conversion from a rearfoot to non-rearfoot strike during running is effective at reducing knee pain in research environments. The purpose of this report was to demonstrate run retraining as a clinical intervention for service members with knee pain.MethodsSixteen service members with running-related chronic knee pain underwent run retraining that converted foot strike from a rearfoot to a non-rearfoot strike using real-time visual feedback. The Lower Extremity Functional Scale (LEFS) and Numerical Pain Rating Scale (NPRS) for knee pain during running were assessed pretraining, at the final training session and at a 1-month follow-up. During running, foot inclination angle and vertical ground reaction force (VGRF) average loading rate were measured pretraining and at 1 month of follow-up.ResultsService members underwent 7.4±1.0 training sessions over the course of 15.8±4.6 days. LEFS improved by 8±6 points immediately after retraining, with an overall improvement of 10±6 points from pretraining to 1-month follow-up (p<0.01). NPRS improved by 2.0±0.4 points immediately after retraining, with an overall improvement of 2.0±0.4 points from pretraining to 1-month follow-up (p<0.01). Conversion to a non-rearfoot strike pattern was apparent at follow-up for all but two patients. VGRF average loading rate decreased by 56%±17% (p<0.01) from pretraining to 1-month follow-up.ConclusionsKnee pain and function improved as a result of non-rearfoot strike run retraining, which supports the clinical use of this evidence-based intervention.
Protocol for the Acute Myocardial Infarction Study in Northeastern China (AMINoC): a real-world prospective cohort study
Authors: Li Tianyi , Wu Junduo , Liu Jia , Sun Wei , Qi Chao , Liu Bin , Wells George A , Wang Junnan 
Published: May 2021

IntroductionAcute myocardial infarction (AMI) has become one of the major causes of mortality and morbidity in China. However, little is known about the characteristics, medical care and outcomes of patients with AMI in Northeastern China. The Acute Myocardial Infarction Study in Northeastern China (AMINoC) is aimed at obtaining timely real-world knowledge in terms of characteristics, clinical care and outcomes of patients with AMI and at providing care-quality improvement efforts in Northeastern China.Methods and analysisThe AMINoC is a real-world, prospective, multicentre cohort study. The study selected 20 hospitals using stratified cluster sampling from different levels of hospitals among nine districts throughout Jilin Province. Hospitalised patients with a primary diagnosis of AMI in each site are consecutively enrolled for 1 year. Demographic characteristics, clinical data, treatments, outcomes and cost are collected by local investigators. Patient follow-up after discharge is planned for up to 2 years.Ethics and disseminationThe protocol has been approved by the ethics committee at the Second Hospital of Jilin University. The findings of this study will be published in peer-reviewed journals and medical conferences.Trial registrationNCT04451967.
Association of socioeconomic status with medical assistance in dying: a case–control analysis
Authors: Redelmeier Donald A , Ng Kelvin , Thiruchelvam Deva , Shafir Eldar 
Published: May 2021

ObjectivesEconomic constraints are a common explanation of why patients with low socioeconomic status tend to experience less access to medical care. We tested whether the decreased care extends to medical assistance in dying in a healthcare system with no direct economic constraints.DesignPopulation-based case–control study of adults who died.SettingOntario, Canada, between 1 June 2016 and 1 June 2019.PatientsPatients receiving palliative care under universal insurance with no user fees.ExposurePatient’s socioeconomic status identified using standardised quintiles.Main outcome measureWhether the patient received medical assistance in dying.ResultsA total of 50 096 palliative care patients died, of whom 920 received medical assistance in dying (cases) and 49 176 did not receive medical assistance in dying (controls). Medical assistance in dying was less frequent for patients with low socioeconomic status (166 of 11 008=1.5%) than for patients with high socioeconomic status (227 of 9277=2.4%). This equalled a 39% decreased odds of receiving medical assistance in dying associated with low socioeconomic status (OR=0.61, 95% CI 0.50 to 0.75, p<0.001). The relative decrease was evident across diverse patient groups and after adjusting for age, sex, home location, malignancy diagnosis, healthcare utilisation and overall frailty. The findings also replicated in a subgroup analysis that matched patients on responsible physician, a sensitivity analysis based on a different socioeconomic measure of low-income status and a confirmation study using a randomised survey design.ConclusionsPatients with low socioeconomic status are less likely to receive medical assistance in dying under universal health insurance. An awareness of this imbalance may help in understanding patient decisions in less extreme clinical settings.
Association of meteorological parameters with intussusception in children aged under 2 years: results from a multisite bidirectional surveillance over 7 years in India
Authors: Das Manoja Kumar 
Published: May 2021

ObjectivesThe study aimed to document the association between intussusception in Indian children and meteorological parameters and examine regional variations.DesignA bidirectional (retrospective and prospective) surveillance between July 2010 and September 2017.SettingAt 20 hospitals in India, retrospective case record review during July 2010 and March 2016 and prospective surveillance during April 2016 and September 2017 were performed.Participants2161 children aged 2–24 months with first intussusception episode were included.InterventionsThe monthly mean meteorological parameters (temperature, sunshine, rainfall, humidity and wind speed) for the study sites were collected.MethodsThe association between monthly intussusception cases and meteorological parameters was examined at pooled, regional and site levels using Pearson (r) and Spearman’s rank-order (ρ) correlation, factorial analysis of variance, and Poisson regression or negative binomial regression analyses.ResultsThe intussusception cases were highest in summer and lowest in autumn seasons. Pearson correlation analysis showed that temperature (r=0.056; p<0.05), wind speed (r=0.134; p<0.01) and humidity (r=0.075; p<0.01) were associated with monthly intussusception cases. Spearman’s rank-order correlation analysis found that temperature (ρ=0.049; p<0.05), wind speed (ρ=0.096; p<0.01) and sunshine (ρ=0.051; p<0.05) were associated with monthly intussusception cases. Poisson regression analysis resulted that monthly intussusception case was associated with rising temperature (North region, p<0.01 and East region, p<0.05), sunshine (North region, p<0.01), humidity (East region, p<0.01) and wind speed (East region, p<0.01). Factorial analysis of variance revealed a significant seasonal difference in intussusception cases for pooled level (p<0.05), 2–6 months age group (p<0.05) and North region (p<0.01). Significant differences in intussusception cases between summer and autumn seasons were observed for pooled (p<0.01), children aged 2–6 months (p<0.05) and 7–12 months (p<0.05).ConclusionsSignificant correlations between intussusception cases and temperature, humidity, and wind speed were observed at pooled and regional level in India. A peak in summer months was noted, which may be used for prediction, early detection and referral for appropriate management of intussusception.
PUTRA-Adol study: protocol for an observational follow-up study to assess the tracking of dietary patterns linked to cardiometabolic risk factors and its prospective relationship with non-alcoholic fatty liver disease, carotid intima-medial thickness and mental well-being during adolescence in Malaysia
Authors: Appannah Geeta , Emi Nor Aishah , Magendiran Mugambikai , Mohd Shariff Zalilah , Anuar Zaini Azriyanti , Shamsuddin Nurainul Hana , Suppiah Subapriya , Mohamad Saini Suraini , Thambiah Subashini C , Ching Siew Mooi 
Published: May 2021

IntroductionGrowing evidence suggesting that dietary intakes of adolescents are generally of poor quality but not adequately assessed in relation to the early manifestation of non-communicable diseases. This study aimed; (1) to examine tracking of an empirical dietary pattern (DP) linked to cardiometabolic risk factors and, (2) to assess prospective relationships between a DP characterised by high intakes of dietary energy density (DED) and added sugar, and cardiometabolic risk factors, non-alcoholic fatty liver disease (NAFLD), carotid intima-medial thickness (CIMT) and mental well-being during adolescence.Methods and analysisThe PUTRA-Adol is a prospective follow-up study that builds up from 933 Malaysian adolescents who were initially recruited from three southern states in Peninsular Malaysia in 2016 (aged 13 years then). Two sessions are planned; the first session will involve the collection of socio-economy, physical activity, dietary intakes, mental well-being, body image, risk taking behaviour, sun exposure, family functioning and menstrual (in women) information. The second session of data collection will be focused on direct assessments such as venesection for blood biochemistry, anthropometry and ultrasonography imaging of liver and bilateral carotid arteries. Z-scores for an empirical DP will be identified at 16 years using reduced rank regression. Multilevel modelling will be conducted to assess the tracking of DP and prospective analysis between the DP, cardiometabolic health, NAFLD, CIMT and mental well-being.Ethics and disseminationEthical approval for the conduct of this follow-up study was obtained from the Universiti Putra Malaysia’s Ethics Committee for Research Involving Human Subjects (JKEUPM) (Reference number: JKEUPM-2019–267). The findings from this study will be disseminated in conferences and peer-reviewed journals.DiscussionThe findings gathered from this study will provide evidence on prospective relationships between DPs, cardiometabolic risk factors, NAFLD, early atherosclerosis and mental well-being and that it may be mediated particularly DED and added sugar during adolescence.
Efficacy and safety of butylphthalide for patients who had acute ischaemic stroke receiving intravenous thrombolysis or endovascular treatment (BAST trial): study protocol for a randomised placebo-controlled trial
Authors: Zhang Xuelei , Wang Anxin , Zhang Jing Yu , Jia Baixue , Huo Xiaochuan , Zuo Yingting , Tian Xue , Wang Yilong , Miao Zhongrong 
Published: May 2021

IntroductionAs a neuroprotective medication, butylphthalide (NBP) may help protect against cerebral ischaemic injury. However, evidence on whether NBP influences the outcomes of patients who had acute ischaemic stroke who are receiving revascularisation treatment is limited. This study aims to evaluate whether additional NBP therapy can improve the functional outcome of patients who receive intravenous recombinant tissue plasminogen activator and/or endovascular treatment (EVT).Methods and analysisThe study will be a randomised, double-blind, placebo-controlled, multiple-centre, parallel group trial. The sample size is estimated at 1200 patients. Eligible patients will be randomised at a 1:1 ratio to receive either NBP or placebo daily for 90 days, which will include 14 days of injections and 76 days of capsules. The first use of NBP/placebo will be started within 6 hours of onset of ischaemic stroke. The primary outcome is the functional outcome as assessed by the 90-day modified Rankin Scale, adjusted for baseline scores on the National Institutes of Health Stroke Scale. The primary safety outcome is the percentage of serious adverse events during the 90 days of treatment. This trial will determine whether NBP medication benefits patients who had acute ischaemic stroke who receive intravenous thrombolysis or EVT.Ethics and disseminationThe protocol was written according to the general ethical guidelines of the Declaration of Helsinki and approved by the Institutional Review Board/Ethics Committee of Beijing Tiantan Hospital, Capital Medical University with approval number KY 2018-003-02. Ethics committees of all participating sites have approved the study . Results of the study will be published in peer-reviewed scientific journals and shared in scientific presentations.Trial registration numberNCT03539445.