tbuckley/cabot-search huggingface dataset:
SAT0234 Counting Costs Under Severe Financial Constraints: A Cost of Illness Analysis of Spondyloarthropathies in Greece
Authors: N. Tsifetaki, M.P. Migkos, C. Papagoras, P.V. Voulgari, K. Athanasakis, A.A. Drosos
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> To investigate the total annual direct cost of patients with spondyloarthropathies (SpA) in Greece. <h3>Methods</h3> Retrospective study of 156 SpA patients fulfilling Assessment of SpondyloArthritis International Society (ASAS) classification criteria who were followed up regularly in the rheumatology clinic of University hospital of Ioannina. Sixty four had ankylosing spondylitis (AS) according to modified New York criteria and 92 psoriatic arthritis (PsA) according to classification criteria for psoriatic arthritis (CASPAR). Health resource use for each patient was elicited via a retrospective chart review which documented the use of monitoring visits, medications, laboratory/diagnostic tests and inpatient stays for the previous year from the date that the review took place. Costs were calculated from a third party payer perspective, and are reported in year 2014 Euros. <h3>Results</h3> The mean ± SD annual direct cost for the patients with SpA reaches € 8680±6627. For the patients with PsA and AS the cost is estimated to be approximately € 8097±6802 and € 9531±6322 respectively. Major cost drives were the cost of medications which represent 88.9%, 88.2% and 89.3% of the mean total direct cost for SpA, AS and PsA respectively. The total annual pharmaceutical expenditures for these patients reach the amount of € 7717±6615. Of the latter, 97.1% (€ 7499±6607) is the cost of the treatment with biologic DMARDs and only 2.8% (€ 218±455) is the cost of the annual non biologic pharmaceutical expenditures. The annual amount of the scheduled tests for all patients corresponds to 7.5% and for those performed on emergency basis 1.1% of the mean annual direct cost. Furthermore the cost for scheduled and emergency hospitalization as well as the cost of scheduled visits in outpatient clinic corresponds to 2.5% of the mean total annual direct cost for the patients with SpA. <h3>Conclusions</h3> The SpA carries substantial financial cost, especially in the era of new treatment options. Adequate access and treatment for SpA patients remains a necessity, even under the light of fiscal constraints. <h3>Disclosure of Interest</h3> None declared
SP0181 The Impact of Immune Check Point Inhibitors on Autoimmunity, The Endocrine Side Effects of Cancer Immunotherapy
Authors: S.M. Corsello
Journal: Annals of the Rheumatic Diseases (2015)

Immune check point inhibitors represent newly introduced drugs used in the treatment of cancer. These agents are antibody-based therapies targeting cytotoxic T-lymphocyte antigen 4 (CTLA4), programmed cell death 1 (PD-1), and programmed cell death ligand 1 (PD-L1). These agents, despite their high selectivity, are characterized by new typical endocrine side-effects in particular on autoimmunity. The spectrum of endocrine diseases experienced by patients treated with these drugs includes most commonly hypophysitis, more rarely thyroid diseases or abnormalities in thyroid function tests, and occasionally primary adrenal insufficiency. Hypophysitis represents a distinctive side effect of CTLA4-blocking antibodies and is a new form of autoimmune pituitary disease. In initial trials, the incidence of hypophysitis induced by anti-CTLA4-mAbs (ipilimumab and tremelimumab) varied considerably and seemed to be dose-dependent. Higher rate of hypophysitis has been reported with the administration of ipilimumab in combination with bevacizumab. Presenting symptoms of mAbs-induced hypophysitis are not specific, including headache, fatigue, weakness, while visual impairment may occur, but less frequently compared with classic lymphocytic hypophysitis. At MRI a pituitary swelling can appear sometimes with thickening of the stalk. As in patients with classic lymphocytic hypophysitis, high-dose glucocorticoids are used to treat anti-CTLA4- hypophysitis, but pituitary hormone deficits may be prolonged or even lifelong, despite the prompt initiation of glucocorticoid therapy. No cases of pituitary dysfunction were reported with lambrolizumab, a mAb against PD1. About thyroid function, immune checkpoint inhibitors may induce secondary hypothyroidism resulting from hypophysitis as well as these drugs are responsible for a relatively low incidence of thyroiditis. Hypoadrenalism occurs only in a few cases. In conclusion, immune check point inhibitors can alter endocrine glands in particular acting on autoimmunity. However, the precise mechanism of injury to the endocrine system triggered by these drugs is yet to be fully elucidated. <h3>Disclosure of Interest</h3> None declared
National Health Conference
Authors: H P FROES
Journal: New England Journal of Medicine (1938)

Dietary patterns have contributed to the rising prevalence of overweight and obesity among Indian adolescents. Yet there are limited studies on their perspectives on healthy eating. The purpose of this study was to understand perceptions and attitudes of Indian-origin adolescents in India and Canada that may contribute to healthy eating behaviour.Qualitative data collection and analysis of 13 focus group discussions (FGD) was conducted among 34 boys and 39 girls (total number of participants: 73) of different weight and socioeconomic status (SES) in rural and urban India, and urban Canada aged 11–18 years.All adolescents perceived homemade foods, and foods high in vitamins, minerals and fiber as healthy. Rural Indian adolescents also identified contaminant-free food as important. Opinions differed regarding the health value of consuming meat, and amongst Canadian adolescents, the health impact of Western versus Indian diets. Identified benefits of healthy eating included improved energy for Indians, and disease prevention for Canadians and urban Indians. Identified barriers across all settings included peers; and availability, access and affordability of unhealthy foods. Urban Indians and Canadian girls also reported academic stress and lack of time as barriers. Canadian girls reported limited parental supervision during mealtimes as an additional barrier. Facilitators to healthy eating included parents, friends and personal preferences for healthy foods.This study suggests potential targets for family-based and school-based education programs and policies to improve dietary habits of Indian and Indo-Canadian adolescents which include, culturally focused nutrition education and guidelines, academic stress management strategies, parental education, food hygiene regulations and restriction on the sale and advertising of unhealthy foods.
PWE-010 Radiofrequency ablation (rfa) is safe and effective for the treatment of gastric antral vascular ectasia refractory to apc – results of a national audit
Authors: JM Dunn, P Boger, E Cheong, M Fullard, A Leahy, T Murphy, H Smart
Journal: Gut (2015)

<h3>Introduction</h3> Gastric antral vascular ectasia (GAVE) is a cause of upper GI bleeding and chronic anaemia. Argon plasma coagulation (APC) is considered first line therapy for GAVE, although technique is variable and evidence for long term treatment success is lacking. Radiofrequency ablation (RFA) may provide an alternative therapeutic option for GAVE, due to controlled depth of ablation and ability to treat a wider field. <h3>Method</h3> Retrospective audit of patients with GAVE treated with RFA at 6 UK HALO registry centres, over an 18 month period (August 2013–Feb 2015). Patients were treated with an RFA Ultra 90 (at 12J x3), RFA 90 (at either 12J x4 or 15J x 3) or Channel device (12J x3). A no clean technique was used to minimise bleeding. End points were transfusion requirements post ablation, clinical response and endoscopic response. <h3>Results</h3> A total of 15 patients were treated, 60% female. Average age was 69 years (range 35–89 years). Aetiology was idiopathic 53%, cirrhosis/NASH 20%, Cardiac/renal disease 20%, Scleroderma 7%. A total of 216 Units of blood were transfused in the 6 months prior to RFA (median 2 per month pre RFA). Patients received a median of 2 treatment sessions 3 months apart. Two patients died during the follow up phase unrelated to RFA. A mean of 42 ablations were used at first session, and 67 at subsequent sessions. Transfusion requirements fell significantly for all patients post RFA, with 13/17 requiring no transfusion after a mean follow up of 2 months (range 1–6). Median number of transfusions was 12 (IQR 5–24) pre RFA vs. 0 (IQR 0–7) post RFA (paired t-test p &lt; 0.001). Mean Hb prior to RFA was 73 g/l, post RFA was 97 g/l. The majority of patients achieved clinical response (87%), with 20% achieving complete endoscopic response. <h3>Conclusion</h3> This national audit of practice demonstrates Radiofrequency Ablation is safe and effective for the treatment of GAVE refractory to APC. Significant reductions in transfusion requirements and clinical response were achieved. A national prospective study, with a standardised protocol and long term follow up, is warranted for this promising new technique. <h3>Disclosure of interest</h3> None Declared.
SP0063 Relapsing Polychondritis. How to Treat / Manage
Authors: X. Puéchal
Journal: Annals of the Rheumatic Diseases (2015)

Relapsing polychondritis (RP) is a rare disease in which recurrent bouts of inflammation, in some cases followed by destruction, affect the cartilage of the ears, nose, larynx, and tracheobronchial tree. At presentation, however, arthritis is the most common manifestation and more than half the patients have no evidence of chondritis. The subsequent development of chondritis provides the correct diagnosis in patients who present with polyarthritis, ocular inflammation, or skin or audiovestibular manifestations of unknown origin. A concomitant autoimmune disease is present in one-third of patients with RP. The pathogenesis of RP involves an autoimmune response to as yet unidentified cartilage antigens followed by cartilage matrix destruction by proteolytic enzymes. The diagnosis rests on clinical grounds and can benefit from use of Michet9s criteria. Anti-collagen type II and anti-matrilin-1 antibodies are neither sensitive nor specific and consequently cannot be used for diagnostic purposes. In addition to the physical evaluation and laboratory tests, useful investigations include dynamic expiratory computed tomography, magnetic resonance imaging, Doppler echocardiography, and lung function tests. Bronchoscopy has been suggested as a helpful investigation but can worsen the respiratory dysfunction. The treatment of RP is not standardized. The drug regimen should be tailored to each individual patient based on disease activity and severity. Glucocorticoid therapy is the cornerstone of the treatment of RP and is used chronically in most patients. Immunosuppressive agents are given to patients with severe respiratory or vascular involvement and to those with steroid-resistant or steroid-dependent disease. Methotrexate is often effective. Cyclophosphamide is used in severe forms. Biotherapy has been used in some cases with variable results and several patients experienced infections of which a few were fatal. <h3>Disclosure of Interest</h3> None declared
Major psychological complications and decreased health-related quality of life among survivors of Stevens-Johnson syndrome and toxic epidermal necrolysis
Authors: R.P. Dodiuk-Gad, C. Olteanu, A. Feinstein, R. Hashimoto, R. Alhusayen, S. Whyte-Croasdaile, Y. Finkelstein, M. Burnett, S. Sade, R. Cartotto, M. Jeschke, N.H. Shear
Journal: British Journal of Dermatology (2016)
An outbreak of legionnaire’s disease among visitors to a fair in Belgium, 1999
Authors: K De Schrijver, E van Bouwel, L Mortelmans, P van Rossom, T De Beukelaer, C Vael, K Dirven, H Goossens, M Leven, O Ronveaux
Journal: Eurosurveillance (2000)

Ninety-three cases of legionnaires disease (43 confirmed, 12 presumptive, and 38 possible/ clinical) were identified in an outbreak associated with a trade fair in Kapellen, Belgium in November 1999. Five cases died. Epidemiological investigation showed
Isotropic Versus Bipolar Functionalized Biomimetic Artificial Basement Membranes and Their Evaluation in Long‐Term Human Cell Co‐Culture
Authors: Angela Rossi, Laura Wistlich, Karl‐Heinz Heffels, Heike Walles, Jürgen Groll
Journal: Advanced Healthcare Materials (2016)

In addition to dividing tissues into compartments, basement membranes are crucial as cell substrates and to regulate cellular behavior. The development of artificial basement membranes is indispensable for the ultimate formation of functional engineered tissues; however, pose a challenge due to their complex structure. Herein, biodegradable electrospun polyester meshes are presented, exhibiting isotropic or bipolar bioactivation as a biomimetic and biofunctional model of the natural basement membrane. In a one‐step preparation process, reactive star‐shaped prepolymer additives, which generate a hydrophilic fiber surface, are electrospun with cell‐adhesion‐mediating peptides, derived from major components of the basement membrane. Human skin cells adhere to the functionalized meshes, and long‐term co‐culture experiments confirm that the artificial basement membranes recapitulate and preserve tissue specific functions. Several layers of immortalized human keratinocytes grow on the membranes, differentiating toward the surface and expressing typical epithelial markers. Fibroblasts migrate into the reticular lamina mimicking part of the mesh. Both cells types begin to produce extracellular matrix proteins and to remodel the initial membrane. It is shown at the example of skin that the artificial basement membrane design provokes biomimetic responses of different cell types and can thus be used as basis for the future development of basement membrane containing tissues.
The CIBMTR Chronic GVHD Risk Group Predicts Major Outcomes In An Independent Validation Cohort
Authors: John P. Klein, Michael T. Hemmer, Peigang Li, Corey S. Cutler, Alvaro Urbano-Ispizua, Daniel R. Couriel, Robert Peter Gale, Yoshihiro Inamoto, Joseph H. Antin, Brian J. Bolwell, Michael Boyiadzis, MHSc, Jean-Yves Cahn, Mitchell S. Cairo, Luis M. Isola, David A. Jacobsohn, Madan Jagasia, Thomas R. Klumpp, Effie W. Petersdorf, Stella Santarone, Harry C. Schouten, John R. Wingard, Stephen Spellman, Mbs, Daniel J. Weisdorf, Steven Z. Pavletic, Stephanie J. Lee, Mary M. Horowitz, Mukta Arora
Journal: Blood (2013)
THU0098 Serum Progranulin Autoantibodies in Rheumatoid Arthritis Associated with Higher Disease Activity: Table 1
Authors: G. Assmann, S. Zinke, M. Gerling, M. Ong, N. Fadle, K.D. Preuss, L. Thurner, M. Pfreundschuh
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Progranulin autoantibodies (PGRN) have been previously described in sera of patients with different autoimmune diseases such as ANCA associated vasculitis, large vessel vasculitis, Crohn9s disease, and psoriatic arthritis. Basically, progranulin seems to interact with TNF receptors 1 and 2 causing subsequently antiinflammatory effects. However, the presence of autoantibodies against progranulin was proved to result in lower serum progranulin levels, which is hypothesized to entertain proinflammatory environment due to lack of inhibited TNF alpha activity. Here we conducted a study evaluation the presence of PGRN in patients with rheumatoid arthritis, which is an autoimmune disorder with proven TNF alpha mediated joint inflammation. <h3>Objectives</h3> Prevalence of serum progranulin autoantibodies in RA with stratification into DAS28 subgroups with prognostic relevance. <h3>Methods</h3> From Nov 2011 till Dec 2013 sera of 307 RA patients (Saarland, Berlin) were collected and analyized for PGRN with ELISA (as previously published [1]) using a retrospective, blinded, non-randomized, two-center study design. All patients were on treatment with conventional DMARDs (n=193) or TNF inhibitors (n=114) at least for three months. All patients fullfill the ACR criteria from 1987 and the revised diagnostic EULAR/ACR criteria from 2011. RA patients characteristics concerning age, gender, treatment history, radiological joint imaging, and RF-/ACPA-serum status were availiable. DAS28 and HAQ representing RA activity were documented at study inclusion visit completed by the previous DAS28 scores as written in the patient9s chart under the same present antirheumatic treatment as availiable (retrospective analysis of data from three months till two years in the past). <h3>Results</h3> The overall prevalence of PGRN-Abs in RA patients was 26.6%. The RA patients were further stratifyied according to the lowest DAS 28 score during the observation period under the present treatment into patients with scores higher versus lower than 3.0 representing "good treatment response" or not, respectively. Table 1 demonstrates that the presence of PGRN-Abs is independent risk factor for failing "good treatment response" beyond erosive diesease, RF- and ACPA-positivity, HAQ score, and Larsen score in this setting. <h3>Conclusions</h3> PGRN-Abs in sera of RA patients seems to be predictive for poor response of conventional DMARDs and biological TNF-alpha blocking agents. However, further prospective studies with larger cohorts of RA patients are required to confirm the results. <h3>References</h3> Thurner L &amp; Assmann G, Arth Res Ther, 2013 <h3>Disclosure of Interest</h3> None declared
Aristolochic acid nephropathy
Authors: Joanna Witkowicz
Journal: BMJ (2012)

Aristolochic acid nephropathy is a chronic, fibrosing, interstitial nephritis caused by aristolochic acid (AA), which is a component of the plants of Aristolochiacae family. It was first reported in 1993, in Belgium as a Chinese herb nephropathy, in patients who received a slimming regimen containing AA. The term aristolochic acid nephropathy also includes Balcan endemic nephropathy and other endemic tubulointerstitial fibrosis. Moreover, AA is a human carcinogen which induces urothelial cancer. The AA-containing herbs are banned in many countries and FDA published the warnings concerning the safety of AA-containing botanical remedies in 2000. Regarding the increasing interest in herbal medicines, uncontrolled access to botanical remedies and replacement of one herb by another AA-containing compounds makes thousands of people all around the world at risk of this grave disease.
<i>Mycobacterium marinum</i>Infection of the Hand
Authors: L Ramakrishnan
Journal: New England Journal of Medicine (1997)

Figure 1. A 35-year-old laboratory researcher who was working with Mycobacterium marinum abraded the back of her left hand, and a tender, erythematous nodule developed (Panel A). Over the next few days, small amounts of yellowish fluid were discharged from the lesion and a line of tender, nodular lymphangitis appeared, extending from the medial aspect of the elbow approximately one third of the way up the arm. The nodules were approximately 0.5 cm in diameter, and there was no erythema of the surrounding skin. Gram's staining and acid-fast staining of the discharge from the lesion revealed inflammatory cells but no . . .
I-131 iodonorcholesterol uptake in adrenal hemangioma.
Authors: S Inanir, S D Sak, M Camurdanoğlu, N Kamel, S Aydintuğ
Journal: Clinical Nuclear Medicine (2001)

INANIR, SABAHAT*; DIZBAY SAK, SERPIL†; ÇAMURDANOĞLU, MEHMET‡; KAMEL, NURI§; AYDINTUĞ, SEMIH∥ Author Information
Plasma interleukin-6 concentrations, metabolic dysfunction, and asthma severity: a cross-sectional analysis of two cohorts
Authors: Michael C Peters, Kelly Wong McGrath, Gregory A Hawkins, Annette T Hastie, Bruce D Levy, Elliot Israel, Brenda R Phillips, David T Mauger, Suzy A Comhair, Serpil C Erzurum, Mats W Johansson, Nizar N Jarjour, Andrea M Coverstone, Mario Castro, Fernando Holguin, Sally E Wenzel, Prescott G Woodruff, Eugene R Bleecker, John V Fahy
Journal: The Lancet Respiratory Medicine (2016)
Two long-range clinical data bases are terminated: bang, whimper, or ripple?
Authors: J Laszlo
Journal: Journal of Clinical Oncology (1984)

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.1984.2.5.532 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 6374053 Two long-range clinical data bases are terminated: bang, whimper, or ripple? J LaszloxJ LaszloSearch for articles by this author https://doi.org/10.1200/JCO.1984.2.5.532 PDF "Two long-range clinical data bases are terminated: bang, whimper, or ripple?." Journal of Clinical Oncology, 2(5), pp. 532–533© 1984 by American Society of Clinical Oncology
Management of Diabetic Ketoacidosis in Severe Insulin Resistance
Authors: Cemre Robinson, Elaine Cochran, Phillip Gorden, Rebecca J. Brown
Journal: Diabetes Care (2016)

Syndromes of severe insulin resistance (IR) include mutations of or autoantibodies to the insulin receptor and lipodystrophy (1).Diabetic ketoacidosis (DKA), although rare, can occur in these patients, even in the context of hyperinsulinemia, due to impaired insulin signaling.DKA can be extremely challenging to treat, and few clinicians are experienced or comfortable in using the high doses of insulin required.We describe aggressive management of DKA in three patients with syndromic severe IR.
A Birth Cohort Study of Maternal and Infant Serum PCB-153 and DDE Concentrations and Responses to Infant Tuberculosis Vaccination
Authors: Todd A. Jusko, Anneclaire J. De Roos, Sue Y. Lee, Kelly Thevenet-Morrison, Stephen M. Schwartz, Marc-André Verner, Lubica Palkovicova Murinova, Beata Drobná, Anton Kočan, Anna Fabišiková, Kamil Čonka, Tomas Trnovec, Irva Hertz-Picciotto, B. Paige Lawrence
Journal: Environmental Health Perspectives (2015)

Reasons for the highly variable and often poor protection conferred by the Mycobacterium bovis bacille Calmette-Guérin (BCG) vaccine are multifaceted and poorly understood.We aimed to determine whether early-life exposure to PCBs (polychlorinated biphenyls) and DDE [1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene] reduces 6-month infant BCG vaccine response.Data came from families participating in a prospective birth cohort in eastern Slovakia. At birth, maternal and cord blood were collected for chemical analyses, and infants were immunized with BCG. Blood was collected from infants for chemical analyses and to determine 6-month BCG-specific immunoglobulin (Ig) G and IgA levels. Multivariable linear regression models were fit to examine chemical-BCG associations among approximately 500 mother-infant pairs, with adjustment for confounders.The median 6-month infant concentration of the prevalent congener PCB-153 was 113 ng/g lipid [interquartile range (IQR): 37-248], and 388 ng/g lipid (IQR: 115-847) for DDE. Higher 6-month infant concentrations of PCB-153 and DDE were strongly associated with lower 6-month BCG-specific antibody levels. For instance, BCG-specific IgG levels were 37% lower for infants with PCB-153 concentrations at the 75th percentile compared to the 25th percentile (95% CI: -42, -32; p < 0.001). Results were similar in magnitude and precision for DDE. There was also evidence of PCB-DDE additivity, where exposure to both compounds reduced anti-BCG levels more than exposure to either compound alone.The associations observed in this study indicate that environmental exposures may be overlooked contributors to poorer responses to BCG vaccine. The overall association between these exposures and tuberculosis incidence is unknown.Jusko TA, De Roos AJ, Lee SY, Thevenet-Morrison K, Schwartz SM, Verner MA, Palkovicova Murinova L, Drobná B, Kočan A, Fabišiková A, Čonka K, Trnovec T, Hertz-Picciotto I, Lawrence BP. 2016. A birth cohort study of maternal and infant serum PCB-153 and DDE concentrations and responses to infant tuberculosis vaccination. Environ Health Perspect 124:813-821; http://dx.doi.org/10.1289/ehp.1510101.