tbuckley/cabot-search huggingface dataset:
SAT0259 Patient Reported Outcomes and Quality of Life in a Cohort of Patients Affected by Entheropathic Spondyloarthritis: Preliminary Results from a Monocentric Prospective Observational Study
Authors: M.M. Luchetti, A. Balloni, D. Benfaremo, L. Bolognini, A. Farinelli, S. Cedraro, M. Rossini, W. Capeci, L. Manfredi, L. Postacchini, S. Tedesco, G. Fava, I. Lorenzini, G. Pomponio, A. Gabrielli
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Enteropathic spondyloarthritis (ES) belongs to spondyloarthritis (SpA) and are the most frequent extra-intestinal manifestation in patients with inflammatory bowel diseases (IBD). The coexistence of gut and articular inflammation advocates an integrated approach for the clinical management of these patients in clinical practice (1). <h3>Objectives</h3> We carried out a clinical study, henceforth defined SPIB (SPondyloarthritis in Inflammatory Bowel disease), in the outpatient clinics and in the clinical ward of the gastroenterology and internal medicine departments, having the following end-points; a) the early diagnosis of ES; b) the evaluation of the quality of life before and after therapeutic integrated approach. <h3>Methods</h3> From January, 2014 to January 2015, 198 consecutive IBD pts were screened; 48 refused to participate to the study and 154 were evaluated at baseline and after 3 and 6 months for gastrointestinal symptoms and activity, patient-reported outcomes of the quality of life, and rheumatologic symptoms (Fig.1). After a gastroenterologist and rheumatologist evaluation, the therapeutic strategy was chosen in concert based on gastrointestinal and joint disease activity, and the presence of peripheral and/or axial involvement of the joints. <h3>Results</h3> 65 (33,6%) of the 154 pts complained of articular symptoms and in 51 of 65 (25,8% of all IBD pts) an active enteropathic SpA (ES) was diagnosed. Peripheral arthritis was present in 23 pts (45%) and axial involvement in 28 pts (55%). Articular symptoms had been present for 5±4,9 yrs in 51% of the ES pts. The quality of life in the cohort of ES pts, compared to that of IBD pts, was significantly worsened by articular symptoms (Fig.1A). 20 ES pts were treated with metotrexate, 2 with salazopyrine, 5 with infliximab, and 23 with adalimumab. After 6 months of treatment, 90% of the ES pts reported a significant improvement in their quality of life (Fig.1B). A significant improvement of both gastrointestinal (Fig. 1B) and articular disease (Fig.1C) was achieved in 88% of the patients, mostly in pts receiving anti-TNF-alfa drugs. <h3>Conclusions</h3> The early diagnosis of enteropathic spondyloarthritis and the choice of the optimal therapeutic strategy constitute a major topic in clinical practice (1). Our study confirmed the importance of an integrated clinical evaluation of ES pts carried out by the gastroenterologist and rheumatologist, for a correct diagnosis and the choice of the optimal therapeutic strategy. <h3>References</h3> Olivieri I. et al. Autoimmun Rev 2014, 8:822-30. <h3>Disclosure of Interest</h3> None declared
FRI0201 Efficacyand Safety of Simvastatinin Uveitis Associated with HLAB27 and/or Rheumatic Diseases: A Randomized, Open-Label Study: Table 1.
Authors: A. Biryukova, I. Shirinsky, V. Shirinsky
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Statins have been shown to reduce ocular inflammation in animal models and to prevent development of uveitis in observational studies. There have been no experimental human studies evaluating statins efficacy and safety in uveitis. <h3>Objectives</h3> To investigate the efficacy and safetyof simvastatin in patients with uveitis associated with HLAB27 and/or rheumatic diseases. <h3>Methods</h3> For this single-center, open-label, randomized study, we enrolled patients with acute uveitis, associated with HLAB27/rheumatic diseases. The patients were randomized to receive 40 mg simvastatin per day for 2 months with the local anti-inflammatorytreatmentor to local anti-inflammatory therapy alone.The studied outcomes were: visual acuity (letters score) conjunctival injection (grades 1-5), and anterior chamber reaction (grades 1-5), the frequency of visual field impairment and posterior synechia. Generalized estimating equations were used to model the relationship between simvastatin use by time interaction and changes in the outcome measures. <h3>Results</h3> Forty five patients were enrolled in the study. Twenty two (49%) of them were positive for HLA-B27 without extraocular manifestations, 18 (40%)had concomitant seronegative spondyloarthritis, 4 (9%) had juvenile idiopathic arthritis and 1 (2%) was diagnosed with Behcet9s disease. Twenty nine (64%) patients had intermediate uveitis, 13 (29%) anterior uveitis and 3 (7%) panuveitis. Twenty two patients were randomly assigned to receive simvastatinwith local treatment and 23 to local treatment alone. Simvastatin was associated with significant improvement in visual acuity, conjunctival injection and anterior chamber reaction. In patients treated with simvastatin the rates of posterior synechia and visual field impairment were less than in control group (Table).The treatment was well tolerated, only mild side effects were observed. <h3>Conclusions</h3> Our findings suggest that statins may have therapeutic potential in uveitis. These results should be confirmed in a double blind, randomized, controlled study. <h3>Disclosure of Interest</h3> None declared
PTU-044 Is there any value in performing a clo test at endoscopy in patients previously having a stool antigen test?
Authors: E Dhesi, B White, A Chitembwe, A Alisa, S Musa, K Besherdas
Journal: Gut (2015)

<h3>Introduction</h3> <i>Helicobacter pylori</i>(HP) infection is causally associated with gastritis, peptic ulcer disease, mucosal associated lymphoid tissue and gastric malignancy. Current ‘test and treat’ guidelines for dyspepsia recommend the non-invasive testing by way of stool antigen test (SAT) for diagnosis of HP, prior to eradication therapy. We observed that in clinical practice most patients attending upper gastrointestinal endoscopy for dyspepsia have HP testing at endoscopy by way of CLO (<i>Campylobacter</i>-Like-Organism) test. There is increasing evidence, however, that the CLO test has lower diagnostic accuracy (sensitivity 80%, specificity 90%) in comparison to the SAT (sensitivity 96%, specificity 98%). We hypothesised that there was no additional diagnostic value in a CLO test, if a patient had already undergone stool antigen testing prior to endoscopy. <h3>Method</h3> A single centre (north London endoscopy unit), retrospective analysis of 98 consecutive patients who had undergone stool antigen testing prior to a CLO test at OGD, for the investigation of dyspeptic symptoms was undertaken. The electronic patient record was scrutinised to compare the result of the CLO test and SAT in these patients. Of those who were stool antigen positive, it was noted whether they were documented to have received eradication therapy prior to their endoscopy. <h3>Results</h3> A total of 81 out of 98 patients tested (82.7%), were SAT negative. Within the cohort of stool antigen negative patients, 98.8% were also CLO test negative (80/81). CLO testing in the presence of a negative SAT detected one additional case of <i>H. Pylori</i>infection (1.2%, 1/81). Within the cohort of SAT positive patients (17/98 total patients), 35.3% (6/17) were CLO test positive. Only one of these patients had not been documented to receive eradication therapy prior to their CLO test. <h3>Conclusion</h3> In our study, 96 of 98 patients (98.0%) did not directly benefit from CLO testing, following stool antigen testing. CLO testing provided new diagnosis of <i>H.pylori</i>infection in only 1 out of the 98 cases, where SAT had already been undertaken. This study proves our hypothesis to be valid in 99.0% of the cases reviewed. We recommend that a CLO test should not be performed at endoscopy, if the SAT result is already available. This will help reduce the financial cost of obtaining the CLO test (biopsy NHS tariff plus CLO test cost, equating to £40 per patient) and also reduce the administration time associated in documentation of the CLO test result. <h3>Disclosure of interest</h3> None Declared.
FRI0082 Serum Level of Adiponectin in Rheumatoid Arthritis (RA) is Associated with Coronary Artery Disease
Authors: J.R. Eidet, T.P. Utheim, T. Lyberg, K. Mikkelsen, M. Liang, I. Hollan
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Adipokines exert pleiotropic actions, including immunoregulatory and matrix degrading effects. They seem to be involved in the pathogenesis of cardiovascular (CV) disease as well as inflammatory rheumatic disease (IRD), and, in theory, they might contribute to the accelerated atherosclerosis in IRD. While leptin increases CV risk, adiponectin may have a cardioprotective effect. <h3>Objectives</h3> The aim of this study was to compare serum levels of leptin and adiponectin in coronary artery disease (CAD) patients with and without RA, patients with RA without CAD and healthy controls (HC). <h3>Methods</h3> S-leptin and s-adiponectin were measured by ELISA in four groups of patients from the Feiring Heart Biopsy Study: 1) RA patients referred to coronary artery bypass grafting (CABG) (CAD+RA group, n=22); 2) Patients without RA, referred to CABG (CAD non-RA group, n=52); 3) RA patients without CAD (RA non-CAD group, n=17); and 4) HC (n=29). <h3>Results</h3> S-adiponectin was significantly lower in CAD+RA than in RA without CAD (Figure 1A). The mean s-leptin was significantly lower in HC than in CAD non-RA, CAD+RA and RA without CAD (Figure 1B). Leptin/adiponectin-ratio was significantly lower in HC than in CAD non-RA and CAD+RA (Figure 1C). In linear regression analyses, CAD was related to lower s-adiponectin levels, and this relationship was independant of age, sex, RA, s-triglycerides, s-HDL and ESR (Table 1). CAD was associated with higher s-leptin and leptin/adiponectin-ratio, and these associations were independent of age, sex and RA (Table 2 and 3). There were no significant associations between s-adiponectin, s-leptin or leptin/adiponectin-ratio and RA disease activity score 28 (DAS28). <h3>Conclusions</h3> CAD was related to higher levels of s-leptin and leptin/adiponectin ratio, but to lower levels of s-adiponectin. The relationship between s-adiponectin and CAD was independent of RA, age, sex, triglycerides, HDL and ESR. As for non-RA patients, adiponectin may infer a cardioprotective effect in RA patients that is, at least partly, independent of disease activity. <h3>Disclosure of Interest</h3> None declared
A Cancer Survey in Lourenço Marques, Portuguese East Africa
Authors: Prates, Manuel D., Torres, F. Oliveira
Journal: JNCI Journal of the National Cancer Institute (1965)

The organization of a Cancer Survey in Lourenço Marques, the capital of the Province of Mozambique, Portuguese East Africa, is described. In lieu of a census, a sample survey was devised by use of aerial photographs and random sampling. Eighty percent of the African population uses the State medical services. The pattern of tumor frequency remained unchanged during the 5-year period; 91.7 percent of tumors in males and 81.7 percent in females were confirmed histologically. Cancer of the liver was the most frequent tumor in men and in women (respectively 65.5% and 31.0% of all tumors). The cancer rates for the African population of Lourenço Marques were compared with those for Johannesburg Bantu and Coloreds, and U.S. whites and nonwhites. The unusually high cancer incidence rates in the population of Lourenço Marques were attributed to carcinoma of the liver, the incidence of which was 7 times higher than in Johannesburg Bantu and 58 times higher than in the U.S. whites. The incidence of cancer of the cervix was lower in the population of Lourenço Marques than in Johannesburg Bantu and U.S. nonwhites. Carcinoma of the corpus uteri was rare. Carcinomas of the bladder, among which squamous cell carcinomas predominate, were common and second to liver tumors in males. Lymphomas and Burkitt's tumor occurred frequently. Leukemia was less frequent than in the United States. Cancer in children under 10 occurred about as often as in the U.S. nonwhites. In the group 10 to 14 years old, the cancer incidence rate in both sexes was 4 times higher than the U.S. nonwhite rate because of the high morbidity from liver cancer.
The center responds to the fringe.
Authors: S M Grunberg
Journal: Journal of Clinical Oncology (1993)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1993.11.9.1837 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 7689095 The center responds to the fringe. S M GrunbergxS M GrunbergSearch for articles by this author https://doi.org/10.1200/JCO.1993.11.9.1837 PDF "The center responds to the fringe.." Journal of Clinical Oncology, 11(9), pp. 1837–1838© 1993 by American Society of Clinical Oncology
"Ex-Gays": Religiously mediated change in homosexuals
Authors: E M Pattison, M L Pattison
Journal: American Journal of Psychiatry (1980)

The authors evaluated 11 white men who claimed to have changed sexual orientation from exclusive homosexuality to exclusive heterosexuality through participation in a pentecostal church fellowship. Religious ideology and a religious community offered the subjects "folk therapy" experience that was paramount in producing their change. On the average their self-identification as homosexual occurred at age 11, their change to heterosexual identification occurred at age 23, and their period of heterosexual identification at the time of this study was 4 years. The authors report 8 men became emotionally detached from homosexual identity in both behavior and intrapsychic process; 3 men were functionally heterosexual with some evidence of neurotic conflict. On the Kinsey 7-point sexual orientation scale all subjects manifested major before-after changes. Corollary evidence suggests that the phenomenon of substantiated changed in sexual orientation without explicit treatment and/or long-term psychotherapy may be more more common than previously thought.
18F-FDG PET/CT Findings in a Splenic Lymphangioma
Authors: Ting Ji, Anren Kuang
Journal: Clinical Nuclear Medicine (2015)

A 16-year-old girl with abdominal pain for 3 years underwent FDG PET/CT scan for evaluating identifiable origin. The images showed multifocal, subcapsular thin-walled low-attenuation masses on CT and focal, slight increased 18F-FDG uptake on PET with an SUVmax of 3.0. Based on the findings, malignancy cannot be excluded. Then, pathologic examination was performed, and it was identified to be splenic lymphangioma. We herein presented the FDG PET/CT findings of this splenic lymphangioma, which is a rare benign vascular tumor and commonly caused by congenital malformation of the lymphatic vessels.
PWE-099 Porto-systemic shunt embolization and recurrent ascites: a single centre case series
Authors: F Figorilli, G Mehta, J MacNaughtan, D Patch, D Yu, R Jalan
Journal: Gut (2015)

<h3>Introduction</h3> Porto-systemic shunt embolization (PSSe) is an emerging procedure for the treatment of refractory hepatic encephalopathy (HE).<sup>1</sup>A criteria of MELD &lt;11 was proposed by Laleman <i>et al</i>as a cutodd to predict recurrent HE post embolization. No other significant liver-related complications were noted in this retrospective study. The aim of this retrospective study was to assess the efficacy and complication rate following PSSe at a single institution. <h3>Method</h3> All cirrhotic patients undergoing PSSe for refractory HE between March 2008 – September 2014 at Royal Free London were included in this study. Cirrhotic patients had refractory HE (West Haven score ≥2), an EEG pattern consistent with HE, and a demonstrable PSS on CT/MRI. All patients underwent embolization using Amplatz vascular plugs. Clinical and biochemical variables at the time of PSSe were recorded, and outcomes including HE grade, changes in MELD score and portal hypertension-related complications were noted. <h3>Results</h3> Ten patients underwent PSSe (M: 6; Age 60.9 ± 10.3 yr) and mean follow up was 37.3 ± 59.6 mo. A baseline MELD score &gt;11 was present in 5 patients. No significant change in mean MELD score was seen following PSSe (11.5 ± 2.8 vs 12.2 ± 6.9, pre vs post p = 0.57). No patients experienced variceal haemorrhage post PSSe. Five patients had diuretic controlled ascites prior to PSSe. Following PSSe two patients developed severe ascites requiring large volume paracentesis (Table 1). HE improved in 6 patients; recurrent HE developed in 4 patients – grade 3 in 2 patients, and grade 4 in 2 patients (Table 1). MELD &gt;11 did not predict occurence of ascites or HE post PSSe. <h3>Conclusion</h3> This small retrospective series demonstrates a 20% incidence of severe ascites post PSSe. With the caveat of the small size of this cohort, MELD score did not predict ascites or HE following PSSe. Further assessment of degree of portal hypertension, or of porto-systemic shunting, through hepatic haemodynamic and ICG studies may better predict the development of complications and the necessity for a concomitant TIPS at the time of PSSe. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Laleman W, <i>et al</i>. Embolization of large spontaneous portosystemic shunts for refractory hepatic encephalopathy: a multicenter survey on safety and efficacy. Hepatology 2013;57:2448–2457
SAT0200 Adherence to Therapy of Rituximab in Clinical Practice. NO Relation to Initial or Cumulative Dose Over the First 2 Treatment Years
Authors: J.T. Einarsson, M. Evert, L.E. Kristensen, P. Geborek, T. Saxne, M.C. Kapetanovic
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The optimal dosing for rituximab (RTX) in rheumatoid arthritis (RA) has been debated over the years, as the evidence from dose finding studies in RA are limited <h3>Objectives</h3> To explore the impact of different initial doses of RTX (500 mgx2 vs 1000 mgx2 and cumulative RTX dose during the first 2 treatment years) on drug adherence and possible predictors of long-term adherence to treatment in rheumatoid arthritis (RA) patients in clinical practice. <h3>Methods</h3> All RA patients starting RTX between January 2003 and April 2012 at the Departments of rheumatology in Malmö and Lund were prospectively included in the South Swedish Arthritis Treatment Register (SSATG). In addition, for validation of the RTX dose given and cause of treatment discontinuation, all medical records were subsequently scrutinized. We identified two different starting doses, 1000mg and 2000mg given in two divided doses. We calculated the cumulative dose at 12 and 24 months. Life-table estimation was used to determine drug adherence, adjusting for baseline characteristics. Logistic regression analysis was used to determine baseline predictors of adherence to treatment. <h3>Results</h3> In total, 153 patients (74.5% female) with RA were included. 74 patients (48%) started treatment with 2000mg and 79 patients (52%) with 1000mg. Patients starting with 2000mg had significantly higher DAS28, HAQ and CRP at baseline. There were no differences in age, sex, disease duration, concomitant DMARDs or presence of autoantibodies at baseline between these groups. Median survival on drug was 44.4 months. A total of 75 (49%) patients withdrew from treatment during the first 5 years. No significant difference was seen for drug adherence when comparing starting doses. The cumulative doses of the drug within the first 2 years did not influence drug adherence. Predictor analysis identified methotrexate use and low disease activity at baseline as positively associated with drug adherence. The figure shows Kaplan-Meier curve for Rituximab drug adherence with different starting doses (no significant difference p=0.096) <h3>Conclusions</h3> Neither different starting doses nor cumulative dose of rituximab during the first 2 treatment years influenced long-term adherence to therapy in RA patients treated in daily clinical practice. Methotrexate use and low disease activity at baseline was positively associated with drug adherence. <h3>Disclosure of Interest</h3> None declared
Clinical correlates of early-onset and late-onset poststroke generalized anxiety
Authors: C S Castillo, S K Schultz, R G Robinson
Journal: American Journal of Psychiatry (1995)

The authors' goal was to determine if generalized anxiety diagnosed while a patient was hospitalized for stroke (early onset) had the same clinical correlates as anxiety beginning 3 months or more after the stroke (late onset).Patients with acute stroke (N = 142) were examined while they were in the hospital and 3, 6, 12, and 24 months later for the presence of anxiety symptoms. Patients underwent a structured psychiatric interview as well as assessment of cognitive, physical, and social function at each visit. Patients with early-onset and late-onset poststroke generalized anxiety were identified and compared to patients without poststroke generalized anxiety.The frequency of early-onset poststroke generalized anxiety was 27% and that of late-onset poststroke generalized anxiety was 23%. Three-quarters of the anxious patients had comorbid major or minor depression. Patients who developed early-onset or late-onset poststroke generalized anxiety were no more socially, cognitively, or physically impaired than patients who did not develop anxiety. Early-onset but not late-onset anxiety was associated with a previous history of psychiatric disorder. The median duration of late-onset anxiety was 3.0 months, and that of early-onset anxiety was 1.5 months. The presence of anxiety was significantly associated with depression; onset of depression and onset of anxiety occurred at approximately the same time.These findings suggest that although early-onset and late-onset poststroke generalized anxiety are phenomenologically similar, they may be the result of different pathophysiological mechanisms.
An intervention to improve the reliability of manuscript reviews for the Journal of the American Academy of Child and Adolescent Psychiatry
Authors: J Strayhorn, J F McDermott, P Tanguay
Journal: American Journal of Psychiatry (1993)

The effects of methods used to improve the interrater reliability of reviewers' ratings of manuscripts submitted to the Journal of the American Academy of Child and Adolescent Psychiatry were studied.Reviewers' ratings of consecutive manuscripts submitted over approximately 1 year were first analyzed; 296 pairs of ratings were studied. Intraclass correlations and confidence intervals for the correlations were computed for the two main ratings by which reviewers quantified the quality of the article: a 1-10 overall quality rating and a recommendation for acceptance or rejection with four possibilities along that continuum. Modifications were then introduced, including a multi-item rating scale and two training manuals to accompany it. Over the next year, 272 more articles were rated, and reliabilities were computed for the new scale and for the scales previously used.The intraclass correlation of the most reliable rating before the intervention was 0.27; the reliability of the new rating procedure was 0.43. The difference between these two was significant. The reliability for the new rating scale was in the fair to good range, and it became even better when the ratings of the two reviewers were averaged and the reliability stepped up by the Spearman-Brown formula. The new rating scale had excellent internal consistency and correlated highly with other quality ratings.The data confirm that the reliability of ratings of scientific articles may be improved by increasing the number of rating scale points, eliciting ratings of separate, concrete items rather than a global judgment, using training manuals, and averaging the scores of multiple reviewers.