tbuckley/cabot-search huggingface dataset:
OP0278 Does MRI Provide an Added Value Over Serum Creatine Kinase Measurement in Myositis?:
Authors: N. Pipitone, A. Notarnicola, A. Scardapane, L. Spaggiari, G. Levrini, F. Iannone, G. Lapadula, C. Salvarani
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> MRI is widely used to evaluate muscle inflammation in myositis. Muscle edema on STIR MRI sequences is thought to reflect active inflammation. However, it is unclear whether MRI has an added value over the cheaper measurement of serum creatine kinase (sCK) levels. <h3>Objectives</h3> To assess the concordance between sCK and MRI edema in a cohort of patients with myositis at their first presentation to our centers. <h3>Methods</h3> We enrolled in 2 Rheumatology centers 73 patients, 34 with dermatomyositis (DM) and 39 with polymyositis (PM) diagnosed according to Bohan and Peter criteria. 33% of patients were untreated. In all patients, sCK were measured and MRI sequences were acquired at the same time. MRI edema (1= present, 0= absent) was assessed bilaterally in 17 thigh and pelvic floor muscles. An MRI composite edema score (0-17) was calculated by adding the separate scores bilaterally and dividing them by two as described elsewhere (1). sCK was considered positive if values were above the upper limit of normal (190 U/l), while MRI was considered positive if the edema score was at least 1. The (single measures) intraclass correlation coefficient (ICC) between the Radiologists involved was 0.78. Muscle strength was measured by MMT (manual muscle testing) and graded according to the Medical Research Council extended scale (0-5). The ICC between the 2 physicians performing the MMT was 0.8. <h3>Results</h3> sCK and MRI were discordant in 47% of patients with myositis, more frequently in DM (59%) than in PM (39%). 56% of patients with DM, but only 15% of those with PM had a positive MRI with normal sCK. There was a significant correlation between MRI score and muscle strength of the hip flexors (Spearman9s rho 0.26, p 0.028) but not between MRI score and overall muscle strength. MRI scores did not correlate with sCK. No significant differences were found between treated and untreated patients for any study variable (Mann-Whitney test, p&gt;0.05). <h3>Conclusions</h3> MRI is a useful tool to assess disease activity in myositis, especially in DM, where it can be identify a sizeable number of patients who have normal sCK. Further studies of larger cohorts are warranted to confirm our findings. <h3>References</h3> Clin Exp Rheumatol 2012; 30:570-3 <h3>Disclosure of Interest</h3> None declared
FRI0050 Simple Clinical and Genetic Prognostic Markers of Secondary/Renal Amyloidosis in Rheumatoid Arthritis Patients: Table 1.
Authors: N. Dostanko, V. Yagur, K. Chizh
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Secondary amyloidosis (SAM) including renal amyloidosis (RAM) is a common severe outcome in rheumatoid arthritis (RA) patients. Some clinical markers were published as risk factors for SA [1]. <h3>Objectives</h3> To reveal simple clinical and genentic markers of SAM/RAM in RA patients and to estimate their prognostic value. <h3>Methods</h3> In the observational trial of RA patients (n=590: 482 women, 108 men) histologically confirmed secondary amyloidosis (SAM) was revealed in 5.8%, renal amyloidosis (RAM) – in 3.6%. This SAM/RAM frequency was considered as pretest probability. We investigated associations between SAM/RAM and a number of genetic markers (erythrocytic antigens of AB0, MN and Rh0 blood groups, HLA antigens of A, B, C, DR, DQ locuses) and clinical markers (sex, triggers, age of RA onset, early RA variant, RF during the first year of RA, extraarticular manifestations, comorbidity and rapid RA progress. Statistical significance of the revealed association was estimated by Fisher exact test (F). Likelihood ratio of positive (LR+) and negative (LR–) tests and prognostic odds ratio (pOR) as well as SAM/RAM post-test probability (Ppost) were calculated. <h3>Results</h3> We revealed no significant difference in SAM /RAM frequency between RA men and women (F, p2-t&gt;0.1). SAM Ppost in RF+ patients during the first 3 years of RA increases 2.5 times vs RF- patients. SAM Ppost in patients with rapid RA progress during the first 3 years (RA severity progression index (DSPI)&gt;+1SD[2]) increases 2.4 times vs patients with DSPI&lt;–1SD. Some co-morbidities were associated with SAM: coronary/cerebral atherosclerosis, gastroduodenal ulcer, cholelithiasis and chronic hepatitis (see table), but they shouldn9t be considered as independent SAM predictors because of their moderate pairwise correlation (R<sub>G</sub>=0.37-0.68). Severe anemia and chronic renal insufficiency increase SAM Ppost up to 35.1% and 55.2% correspondingly. SAM 2.8 times more frequent registered in patients with NSAID adverse drug reactions (ADRs) and 7.7 times more frequent – in patients with glucocorticoids (GK) ADRs vs patients without NSAID/GK ADRs. We revealed distinct negative correlation between methotrexate use and SAM (R<sub>G</sub>=-0.57, p=0.0002), as well as RAM (R<sub>G</sub>=-0.79, p&lt;0.0001). SAM Ppost increases 3.3, 2.8, and 2.5 times in the presence of N blood group, HLA B27 and HLA B18 correspondingly. N+/HLA-B18+phenotype increases SAM Ppost up to 46.2%, N+/HLA-B27+ and N+/HLA-B27+/HLA-B18+phenotypes – up to 42.8% and 69.9% correspondingly. N–/HLA-B27–/HLA-B18–phenotype decreases SAM Ppost up to 1.3%. HLA-B27 increases RAM Ppost up to 12.1% (pOR=6.0, LR+=3.7, LR–=0.62) and should be considered as RAM genetic marker. <h3>References</h3> Kuroda T et al. Clin Rheum.2005;3:1-8. Dostanko N et al. Ann Rheum Dis2011;70,S3:587. <h3>Disclosure of Interest</h3> None declared
Quantitation of Total-Body Tumor Cells (MOPC 104E). I. Subcutaneous Tumor Model2
Authors: Vithal K. Ghanta, Raymond N. Hiramoto
Journal: JNCI Journal of the National Cancer Institute (1974)

Journal Article Quantitation of Total-Body Tumor Cells (MOPC 104E). I. Subcutaneous Tumor Model Get access Vithal K. Ghanta, Vithal K. Ghanta Search for other works by this author on: Oxford Academic PubMed Google Scholar Raymond N. Hiramoto Raymond N. Hiramoto Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 52, Issue 4, April 1974, Pages 1199–1202, https://doi.org/10.1093/jnci/52.4.1199 Published: 01 April 1974 Article history Received: 10 September 1973 Accepted: 12 December 1973 Published: 01 April 1974
FRI0209 Gender-Specific Clinical Features of Early Axial Spondyloarthritis
Authors: E. Gubar, T. Dubinina, A. Dyomina, A. Godzenko, O. Rumyantseva, S. Shubin, A. Smirnov, S. Glukhova, S. Erdes
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> To analyze gender-specific clinical features of patients with early axSpA. <h3>Methods</h3> 150 patients with axSpA and &lt;5 years duration of inflammatory back pain (ASAS criteria) were examined. Patients fulfilled ASAS criteria and were examined according to ASAS guidelines. <h3>Results</h3> The Russian cohort of 150 axSpA patients included 59 (39.3%) men and 91 (60.7%) women. The women were significantly older: the median age of men was 25 (23-27), the age of women – 30 (26-34) (<i>p</i>=0.000001). Men were more often HLA B27 - positive (88% vs 75%; <i>p</i>=0.048). At the first examination, males more often than females had X-ray identified sacroiliitis (xSI): 65.5% vs 42.9% (<i>p</i>=0.007), and their AS was determined by the mNY criteria. Acute phase inflammation reactants (ESR and CRP) were significantly higher in men. Median ESR was 13 (6-32) mm/h in men, and 8 (5-15) mm/h – in women (<i>p</i>=0.02); median CRP 16. 7 (1.7-63.3) mg/L and 2.4 (0.9-7.8) mg/L, respectively (<i>p</i>=0.00004). Calcaneal enthesopathy (US examination) was significantly more often present in men (55.1%), than in women (32.1%; <i>p</i>=0.01). There was no statistically significant difference between men and women in terms of BASDAI and ASDAS activity indexes, presence of peripheral arthritis, coxitis, dactilitis, MRI-sacroiliitis, MRI-spondylitis, low BMD, BASFI functional index, family SpA history. <h3>Conclusions</h3> In the Russian cohort of axSpA patients, males seem to have a more aggressive disease than females: they have an earlier onset of axSpA, and earlier develop destructive changes in sacroiliac joints. Men are more often HLA B27 – positive. Calcaneal enthesopathy (US-examination) is more common in men. Acute phase reactants (ESR and CRP) are higher in men than in women. Functional BASFI status was similar in both genders. <h3>Disclosure of Interest</h3> None declared
THU0283 Incremental Costs of Giant Cell Arteritis in France
Authors: G. Pugnet, N. Costa, N. Bouscaren, R. Bourrel, M. Lapeyre-Mestre, L. Sailler, L. Molinier
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Giant cell arteritis (GCA) is the most frequent primary large-vessel vasculitis in patients aged over 50 years. Common early manifestations include constitutional symptoms, headache, visual loss, polymyalgia rheumatica (PMR), and jaw claudication. The incidence increases with age and is higher in populations of Northern European origin than in those of Mediterranean countries. The incidence of GCA in France is 10 to 20 per 100 000 people older than 50 years. <h3>Objectives</h3> The aim of this study is to assess the net costs due to GCA in France and to identify driver costs of this disease. <h3>Methods</h3> This retrospective study used an incidence-based approach. Incident GCA patients were identified in the French National Health Insurance System database (SNIIR-AM) from 2005 to 2008. For each case, 6 disease-free age and gender matched-controls were randomly selected. Their resources consumption was recorded over a 5 years period. Costs were estimated from the health insurance perspective. Direct medical, non-medical and indirect costs (i.e. daily benefits) were recorded. GCA patient9s costs were compared to control9s net costs then we calculated GCA net costs. <h3>Results</h3> 103 GCA patients and 606 controls were included. In the first year following the diagnosis, GCA patient9s costs were 8,139€ and control9s costs were 3,661€ (p&lt;0.001), the net GCA costs was 4,478€. This incremental cost was mainly due to inpatients, medications and paramedical costs, which accounted for 40%, 17% and 16%, respectively. GCA and controls costs decreased during the 5 year follow-up period from 8,139€ year one to 4,572€ year five for GCA and from 3,661€ to 3,054€ for controls. <h3>Conclusions</h3> GCA constitutes a huge economic burden in health insurance expenses. <h3>Disclosure of Interest</h3> None declared
Metastatic Renal Cell Cancer Treated With Antiangiogenic Therapy Monitoring by 18F-FDG PET/CT
Authors: J.R. García Garzon, Pere Bassa, Elena Llinares, Marina Soler, Merce Moragas, Eduard Riera
Journal: Clinical Nuclear Medicine (2015)

Renal cell carcinoma (RCC) is resistant to chemotherapy and radiotherapy in most cases, and surgery is the preferred option in patients with local tough advanced disease. Even in metastatic RCC, patient survival has been reported to improve after surgery. Considering the importance of angiogenesis in RCC pathogenesis, new inhibitors of vascular endothelial growth factor pathway show promising results. Imaging monitoring with F-FDG PET/CT may allow selecting the appropriateness and right time to implement these drugs, according to disease outcome.
Methicillin-Resistant<i>Staphylococcus aureus</i>Infections
Authors: Fredrick M Abrahamian, Gregory J Moran
Journal: New England Journal of Medicine (2007)

To the Editor: In his review of skin and softtissue infections caused by methicillin-resistant Staphylococcus aureus (MRSA), Daum (July 26 issue)1 cites a study2 indicating that intravenous trimethoprim–sulfamethoxazole (TMP-SMX) is significantly less effective than vancomycin for the treatment of serious S. aureus infections. However, in this randomized, double-blind, comparative trial of TMP-SMX and vancomycin, therapeutic failures occurred only in patients with methicillin-susceptible S. aureus (MSSA) infections. TMP-SMX was successful in treating all MRSA infections, including tricuspid-valve endocarditis. Clinical failures commonly occurred with MSSA tricuspid-valve endocarditis; otherwise, the cure rates with TMPSMX and with vancomycin were similar. On the basis of the results of this study, vancomycin may be superior for MSSA infections; however, the same cannot be concluded for MRSA infections. Although the currently available clinical data for community-associated MRSA skin infections are sparse, in this era of an increasing incidence of MRSA infection and concern about the variable efficacy of vancomycin, TMP-SMX may be a useful alternative in selected cases.
PWE-046 Audit at one year of guidelines for the use of faecal calprotectin in monitoring crohn’s disease
Authors: J Turvill, R Maxine, L Rook, G Robins, P Kant, S Smale
Journal: Gut (2015)

<h3>Introduction</h3> From January 2014 the Department of Gastroenterology at York Hospital introduced evidence based guidelines for the use of faecal calprotectin (FC) in monitoring patients with Crohn’s disease (CD) established on a management plan. These are summarised: FC &lt;100 mcg/g: likely quiescent disease. Manage patient expectantly in the first place and re-test at 12 months or consider withdrawal of therapy. Repeat FC 3 monthly if treatment step-down. FC 100–250: likely mild or quiescent disease. Manage patient expectantly in the first place and re-test at 6 months. FC &gt;250: likely active disease. Repeat FC and if &gt;250 again consider treatment escalation or re-investigation. Repeat FC 3 monthly after re-establishing management plan. <h3>Method</h3> An audit of these guidelines was registered with the Clinical Audit and Effectiveness Team. The negative and positive predictive values (NPV and PPV) of these guidelines at 1 year has been determined. <h3>Results</h3> Demographics: 106 patients have been entered into the audit. Compliance is 87%. Disease location (%): ileal 20, colonic 20, ileocolonic 60, perianal 8, upper GI 4. Previous surgery: 48%. Established therapy (%): none 20, mesalazine 15, azathioprine/6-mercaptopurine 35, methotrexate 5, infliximab 12, adalimumab 12, dual immunomodulation 13. 76% patients were clinically asymptomatic. With a FC cut off set &gt;250: NPV for active CD was: 0.89 (0.77–0.95) and PPV: 0.91 (0.79–0.97). FC &lt;100: of 34 evaluated 8 patients became symptomatic and were investigated; 2 had active CD. 6 had therapeutic reductions of whom 3 flared; 1 had surgery and 2 were re-captured (FC &lt;100). FC100–250: of 15 evaluated 4 patients became symptomatic within 6 months. For the asymptomatic remainder FC was stable in 15%, reduced in 15% and increased in 70% at 6 months. FC &gt;250: of 43 evaluated the repeat FC remained &gt;250 in 35 patients. 28 were investigated of whom 24 had active CD. 28 patients had treatment escalation but only 1 required bridging steroid. 2 patients had resections. 73% of those re-evaluated now have a repeat FC &lt;250. <h3>Conclusion</h3> This interim analysis confirms the applicability of these guidelines. Such a model is ideally suited to a nurse specialist service, identifying those patients that can be managed expectantly without recourse to invasive or expensive investigation and those that require proactive intervention before becoming symptomatic. The key elements to these guidelines are: a traffic light system of risk assessment, the confidence interval between repeat FC assessments, repeating the FC before acting if &gt;250 and recognising that FC monitoring does not replace clinical decision making. In conclusion such a model of FC monitoring has the potential to be safe, clinically- and cost-effective in those with CD established on a management plan. <h3>Disclosure of interest</h3> None Declared.
Measuring psychiatric utilization: the rubber yardstick
Authors: J Krizay
Journal: American Journal of Psychiatry (1980)

The author suggests that measuring utilization of benefits for nervous and mental disorders by using the percent of total benefits paid is imprecise because even small changes in the much larger portion of benefit payments that are attributable to nonpsychiatric services can make it appear that the level of psychiatric utilization has changed. His preferred measure is a calculation of covered charges attributable to psychiatric care per each person covered under the plan. The author illustrates his points by showing that, when properly calculated, psychiatric utilization under the Civilian Health and Medical Program of the Uniformed Services is much lower than that under many other plans.
Undetected HIV infection among patients admitted to an alcohol rehabilitation unit
Authors: J Mahler, D Yi, M Sacks, H Dermatis, A Stebinger, C Card, S Perry
Journal: American Journal of Psychiatry (1994)

Of 300 patients admitted to an alcohol rehabilitation unit, serological testing of discarded admission blood samples revealed that 31 (10.3%) had HIV infection. Chart records indicated that four patients were known to be HIV infected on admission, and HIV infection was detected in another three patients during hospitalization; however, 24 (77.4%) of the HIV-positive patients were discharged with their HIV infection still undetected.
Hot-spot Ki67 labeling index correlates with lymph-node status and prognosis in lung adenocarcinoma
Authors: A. Palleschi, C. Bareggi, M. Nosotti, A. Del Gobbo, V. Vaira, L. Rosso, P. Mendogni, R. Carrinola, S. Ferrero, M. Tomirotti, L. Santambrogio
Journal: Annals of Oncology (2015)
Egyptian prosecutors investigate the death of a girl during female genital mutilation
Authors: Owen Dyer
Journal: BMJ (2016)

An Egyptian private hospital was closed and under investigation after a 17 year old girl died of a suspected stroke during female genital mutilation (FGM).

Mayar Mohamed Mousa was under full anaesthesia and the procedure was carried out by a licensed female physician in a Suez hospital. Mousa’s twin sister had just undergone the same operation—which is illegal in Egypt and carries criminal penalties for both doctors and parents.

Egypt remains the country with the most cases of FGM, despite a determined government campaign to stop it. A 2013 UNICEF report found that over 27 million girls and women had undergone FGM procedures in Egypt.1 The tradition is current among both Muslims and …
Development of a proposed biosimilar product based on the demonstration of physicochemical, pharmacologic and clinical similarity to pegfilgrastim.
Authors: Kalpna Desai, Stephen Brokx, Sanyukta Kher, Tina Catalano, Devanshi Maharaja, Louise Scrocchi, Jason Dowd
Journal: Journal of Clinical Oncology (2015)

e13534 Background: Biosimilar development involves extensive analytical characterization to ensure similarity to the reference medicinal product to support the demonstration of similarity in terms of clinical efficacy and safety. We report the comparative physicochemical, functional and clinical characterization of the proposed biosimilar, Pegylated Apo-Filgrastim (Pelgraz), to the reference product Neulasta. Methods: A variety of orthogonal physicochemical methods were applied to analyze primary and higher order structures, purity, and biological activity. Methods included spectroscopic and chromatographic methods, and a cell based potency assay. A phase I study in 66 healthy volunteers assessed the PK/PD similarity of Pelgraz and Neulasta following single-dose administration of 6 mg. A Phase III efficacy and safety study in ~600 breast cancer patients receiving TAC chemotherapy in adjuvant setting assessed and compared Pelgraz to US and EU Neulasta. Both studies included immunogenicity assessment. Results: Pelgraz has the same primary and higher order structure as Neulasta, demonstrated by peptide mapping and hydrogen-deuterium exchange. As determined by SE-HPLC, purity of Pelgraz batches averaged 99.4% vs. 97.8% for Neulasta. Pelgraz was shown to be equivalent to Neulasta in cell based bioassays. Results from the phase I study demonstrated the PK and PD similarity of these products with the 90% Confidence Interval (CI) for primary PK endpoints (AUC and Cmax)and 95% CI for primary PD endpoints (AUEC and Emax of the absolute neutrophil count) lying within pre-defined acceptance margins of 80-125%. The phase III study demonstrated similarity of efficacy for Pelgraz and Neulasta as assessed by the primary efficacy endpoint Duration of Severe Neutropenia (DSN), with the 95% CI of the difference in mean DSN falling within the pre-defined equivalence margin of ± 0.5 days. The safety and immunogenicity profile of Pelgraz was similar to that of Neulasta. Conclusions: In vitro analyses demonstrate finger-print-like similarity, and the clinical program demonstrated that there are no clinically meaningful differences between Pelgraz and Neulasta.
Adjuvant imatinib mesylate in patients with primary high risk gastrointestinal stromal tumor (GIST) following complete resection: Safety results from the U.S. Intergroup Phase II trial ACOSOG Z9000
Authors: R. P. Dematteo, C. R. Antonescu, V. Chadaram, Y. N. You, L. McCall, R. Maki, A. Murgo, G. Demetri, P. Pisters, M. F. Brennan
Journal: Journal of Clinical Oncology (2005)

9009 Background: Imatinib mesylate benefits over 80% of patients with metastatic GIST, but whether it is tolerable and effective as an adjuvant therapy after complete resection of primary GIST is unknown. Methods: Patients who had undergone complete gross resection of a primary GIST that expressed KIT and who were at high risk (tumor size ≥10 cm, tumor rupture, or <5 peritoneal metastases) for recurrence were accrued from 48 institutions. Prospective central pathologic confirmation was an inclusion criterion and the diagnosis could not be confirmed in 9% of patients referred for entry. All patients were prescribed imatinib 400 mg daily for 1 year. Results: Among the 106 evaluable patients, the median age was 58 (19–79) years, with 60 (57%) males. The median tumor size was 13 (range 3–42) cm and most tumors originated in the stomach (50%) or small intestine (42%). There were 89 (84%) patients who had a tumor ≥10 cm and 28 (26%) patients had tumor rupture or multifocal disease. Imatinib was started at a median of 59 (range 25–84) days after operation. All patients have been in the study for at least 1 year. No grade 4 or 5 toxicity occurred. There were 19 (17%) patients who had grade 3 toxicity, the most common being neutropenia (2%), dermatitis (2%), or increased ALT (2%). The most frequent toxicities of any grade were edema (55%), fatigue (43%), nausea (42%), diarrhea (42%), and dermatitis (27%). Dose reduction due to toxicity occurred in 23 (22%) patients. There were 87 (82%) patients who completed the 1 year of imatinib therapy: 72 (68%) patients tolerated full dose imatinib without dose modification, 8 had a temporary dose reduction, and 7 finished at a lower dose. There were 19 (18%) patients who did not complete therapy, including 6 who had toxicity and 12 who withdrew consent. Conclusions: Imatinib given at a daily oral dose of 400 mg is well tolerated by most patients following the resection of a high risk primary GIST. Further follow up is required to determine the effect of adjuvant imatinib on survival in high risk GIST. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Novartis Novartis Novartis
Low Frequency Of IGHV4-39/IGHD6-13/IGHJ5 Rearrangement With Stereotyped HCDR3 (subset #8) In Russian and Ukrainian Chronic Lymphocytic Leukemia Patients
Authors: Bella Biderman, Nadiia Bilous, Nataliya Severina, Andrey Sudarikov, Eugene Nikitin, Iryna Kryachok, Iryna Abramenko, Anatoliy Chumak
Journal: Blood (2013)