tbuckley/cabot-search huggingface dataset:
SP0028 A Happy Ending After All – Patient Initiated Research in Rheumatic Diseases in Sweden
Authors: U. Bergsten
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Patients9 involvement in healthcare and research has been a growing area in the last decades. In rheumatology this has been highlighted throughout different organizations such as The European League against rheumatism (EULAR) and Outcome measures in rheumatology (OMERACT) in order to increase the involvement of patients9 perspective in care and research. The Swedish Rheumatism Association (the national patient organization) and the Foundation of Research &amp; Development center at Spenshult decided to carry out a joint project to develop patient-initiated research in the rheumatic diseases. The project aimed to follow the working process of involving patients in a project group and to describe research issues that were of importance from the patient9s point of view. <h3>Method</h3> Five research partners were asked to join the project group together with a project leader with a formal research experience. The research partners had experiences of different rheumatic diseases such as rheumatoid arthritis, psoriasis arthritis, Sjögren9s syndrome and fibromyalgia. As a method to enable and promote patients9 interest the Dialogue model, (developed by Tineke Abma et al.) was chosen. The Dialogue model involves a gradual and systematic approach to stimulate and maintain a dialogue between different stakeholders9 issues and has been used in other disease areas. <h3>Results</h3> The inventory of research ideas and areas of importance from the patient perspective resulted in several aspects of living of a chronic disease, mostly focused on the patient9s <i>dignity, identity</i> and <i>quality of life</i>. The recurring theme was: “How can a person maintain or improve their quality of life despite a chronic illness?” Persons who participated in the focus groups communicated their experiences of having a rheumatic disease and the main theme was in relationship into what way the rheumatic condition has on all domains of life. <h3>Conclusion</h3> It is possible involving patients in an early phase of research in order to gain new research ideas. The working process should preferably be well structured and this project was inspired by the Dialog model. This model clarified the steps in the process and helped to engage all stakeholders in the dialogue on an equal basis. As a result of the project the patients9 view of important areas for research and implementation came into focus. <h3>Disclosure of Interest</h3> None declared
SAT0536 A Cut-off Value of the Decrease Ratio of Lymphocyte Counts for the Indication for Prophylaxis of Pneumocystis Pneumonia in Immunocompromised Hosts
Authors: H. Horiuchi
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> To elucidate the decrease ratio of lymphocyte counts as a contributing risk factor for Pneunocystis pneumonia (PCP) in immunocompromised hosts. <h3>Methods</h3> Twenty patients with PCP who received prednisolone (PSL), DMARDs or Biologics were enrolled from September 1984 to February 2013 in our hospital. Patient were classified as follows: Group 1: received only PSL (mean PSL: 27.0±5.4 mg/day) (n=13). Group 2: received PSL with DMARDs or Biologics (mean PSL: 8.4±2.9 mg/day) (n=7). Control group: non-PCP patients received only PSL without PCP prophylaxis (mean PSL: 16.5±2.5 mg/day) (n=13). Statististically, there is no significant differences about the doseage of PSL between Group1 and control group (p=0.36).The decrease ratio of the lymphocyte counts between just before receiving the immunosuppressants and at the onset of PSP (ΔLym) were calculated in each group. <h3>Results</h3> Primary diseases were CTD (n=14), non-CTD (n=6) in Group 1 and 2. CTD (n=13) were selected as a control group. Mean ΔLym in Group 1, 2 and Control group were 80.5±4.3%, 62.6±4.2% and 33.5%±8.0%, respectively. The mean ΔLym in Group1 was significantly decreased compared with those of in control group (80.5% vs 33.5%: p&lt;0.0001). In ROC analysis, the cut-off value of ΔLym for was 60.9% (sensitivity: 92.3%, specificity: 92.3%, odds ratio: 144.0). <h3>Conclusions</h3> ΔLym might be a new risk factor and an index parameter for the indication for prophylaxis of PCP. <h3>Disclosure of Interest</h3> None declared
Reply
Authors: N.P. Burrows, R.Russell Jones
Journal: British Journal of Dermatology (1997)

Journal Article Reply Get access N.P. Burrows, N.P. Burrows Department of Dermatology, Addenbrooke's Hospital, Cambridge CB2 2QQ, U.K. Search for other works by this author on: Oxford Academic Google Scholar R.Russell Jones R.Russell Jones St John's Institute of Dermatology, St Thomas's Hospital, London SE1 7EH, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 137, Issue 4, 1 October 1997, Page 651, https://doi.org/10.1111/j.1365-2133.1997.tb03808.x Published: 01 October 1997
SP0198 Aberrant Spinal Bone Formation – As? Case Discussion
Authors: I. Olivieri
Journal: Annals of the Rheumatic Diseases (2015)

Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) share the involvement of the axial skeleton and the peripheral entheses. Both diseases produce bone proliferations in the later phases of their course. Although the aspect of these bone proliferations is dissimilar, confusion of radiologic differential diagnosis between the two diseases exists mostly as a consequence of a lack of awareness of their characteristic clinical and radiographic features. The radiologic spinal findings are so different that it is possible to recognize the changes due to each disease even in patients in whom both diseases occur. On radiographs DISH is characterized by "flowing mantles" of ossifications occurring in the anterior longitudinal ligament and to a lesser extent in the paravertebral connective tissue and the peripheral part of the annulus fibrosus. Frequently, on lateral view radiolucency is noted between the new bone and the vertebral body. DISH may also involve the sacroiliac joints. The ossification of the joint capsule on the anterior surface of the joint can resemble the fusion of the sacroiliac joints on anteroposterior pelvis x-rays that may mistakenly be interpreted as post-inflammatory ankylosis of the joint (grade 4 sacroiliitis). Computed tomography (CT) can be helpful in these cases by demonstrating the normal aspect of the joint space and bony margins together with the presence of the anterior capsular ossification. On x-rays AS is characterized by the bone damage caused by sacroiliitis and by inflammation at the discovertebral junction at the attachment of the annulus fibrosus. The consequent close subchondral osteitis is radiologically characterized by a destructive vertebral lesion and sclerosis confined to the anterior corners of the vertebral bodies ("Romanus lesion"). The healing of these lesions and the adjacent periosteal reaction results in "squaring" of the vertebral bodies on lateral view of the spine. Simultaneously, the healing process proceeds in the periphery of the annulus fibrosus resulting in the formation of syndesmophytes that are vertical bony bridges joining adjacent vertebral bodies anteriorly and laterally and ultimately forming a "bamboo-spine". The confusion between DISH and AS may also extend to the clinical field because patients with DISH can occasionally have severe limitation of spinal mobility, along with postural abnormalities that resemble long-standing advanced AS. <h3>Disclosure of Interest</h3> None declared
Health-Related Quality Of Life In Transfusion-Dependent Patients With Myelodysplastic Syndromes Treated With Deferasirox. A Multicenter Prospective Study
Authors: Fabio Efficace, Valeria Santini, Giorgio La Nasa, Francesco Cottone, Carlo Finelli, Lorenza Borin, Giulia Quaresmini, Anna Di Tucci, Antonio Volpe, Daniela Cilloni, Giovanni Quarta, Grazia Sanpaolo, Flavia Rivellini, Flavia Salvi, Alfredo Molteni, Daniele Vallisa, Sergio Storti, Maria Teresa Voso, Giuliana Alimena, Susanna Fenu, Marco Vignetti, Franco Mandelli, Emanuele Angelucci
Journal: Blood (2013)
Dexamethasone suppression test in schizophrenia
Authors: J Sawyer, J J Jeffries
Journal: American Journal of Psychiatry (1983)

In a study of 20 inpatients who met DSM-III criteria for schizophrenia, there was a high incidence of depressed mood (N = 14), DSM-III melancholia (N = 6) and dexamethasone nonsuppression (N = 7). This incidence of positive DSTs (serum cortisol greater than 5 micrograms/dl at 3:30 or 10:00) was significantly higher than the expected rate based on a literature review (35% vs. 4%, p less than .001). A positive DST did not result in all cases in antidepressant pharmacotherapy, nor did a negative result preclude such treatment. Hence, clinicians in the study did not "treat the DST" in the absence of clinical evidence of depression. This study is consistent with others reporting a significant proportion of depressed schizophrenics. However, some studies have claimed no differences in response to dexamethasone between nondepressed and schizophrenic patients. These findings do not support a biological basis for the RDC differentiation of primary and secondary depression and challenge the DSM-III concept of schizophrenia as excluding the diagnosis of major depression. Viewed from a different perspective, the data may support recent reports casting doubt on the specificity of the DST.
Therapeutic Advances in Localized Pancreatic Cancer
Authors: Susan Tsai, Douglas B. Evans
Journal: JAMA Surgery (2016)

<h3>Importance</h3> It is estimated that pancreatic cancer (PC) will become the second leading cause of cancer-related death in the United States by 2030. <h3>Observations</h3> Clinical and preclinical data support the understanding that PC metastases occur early in the pathogenesis of this disease, even before the primary tumor can be detected. This has important implications for the clinical management of patients with localized PC, as surgery alone is unlikely to be curative for most patients. The delivery of postoperative adjuvant therapy is problematic in this disease because of the magnitude of the operation needed to remove the primary tumor, which can affect patient recovery and delay (sometimes indefinitely) the delivery of systemic therapy. For these reasons, the use of chemotherapy and/or chemoradiation prior to surgery (neoadjuvant therapy) is increasingly recognized as the preferred strategy for treatment sequencing. Neoadjuvant therapy is recommended for patients with borderline resectable PC and, at some centers, neoadjuvant therapy has been extended to patients with resectable PC as well. Importantly, therapeutic advances in multidrug systemic therapy and radiation therapy have already been adopted in the neoadjuvant setting where treatment toxicity will not be compounded by surgical recovery. In addition, the use of local-regional therapies in highly selected patients with locally advanced PC, following a prolonged period of induction systemic therapy, will be an area of intense scrutiny. Future improvements in diagnostic biomarkers may allow for real-time sequencing of multimodality therapy for individual patients based on a more accurate and timely assessment of treatment response. <h3>Conclusions and Relevance</h3> Neoadjuvant treatment sequencing allows patients to receive multimodality therapy in a manner that prioritizes early exposure to systemic therapy to maximize the treatment of micrometastatic disease in an immune-competent host prior to surgical intervention. Patients who complete all intended neoadjuvant therapy, including surgery, experience an overall survival benefit that is unmatched by a surgery-first approach.
A Gastric Hyperplastic Polyp Observed Endoscopically Before and After Autoamputation
Authors: T. Nakajima, T. Kamano, K. Watanabe, H. Meguro, K. Shibasaki
Journal: Endoscopy (2003)

Autoamputation of a gastric polyp is a relatively rare phenomenon and its precise mechanism is unclear. To learn more about the mechanism(s) involved, it is important to observe a polyp just before and just after its disappearance. We report a case of a gastric polyp that was observed endoscopically just before and then just after autoamputation. A 61-year-old woman with a thumb-sized, pedunculated hyperplastic polyp in the gastric antrum visited our institution for investigation of hematemesis. She was being treated with oral hypoglycaemic drugs for diabetes mellitus but was not taking any other medicine around that time. Emergency gastroscopy revealed a bleeding point near the polyp; gastroscopy the next day revealed that the polyp had disappeared. It was concluded that autoamputation of a gastric polyp may follow gastric injury induced by diabetes mellitus or oral antidiabetic drugs.
Serum Levels of Persistent Organic Pollutants and Insulin Secretion among Children Age 7–9 Years: A Prospective Cohort Study
Authors: Su Hyun Park, Eunhee Ha, Young Sun Hong, Hyesook Park
Journal: Environmental Health Perspectives (2016)

Persistent organic pollutants (POPs) are endocrine disruptors and have been suggested as possible risk factors for diabetes. Few studies have been performed to investigate this association among children.In this study, we prospectively examined the relationship between the serum concentration of POPs and glucose metabolism in children.Data were collected from the Ewha Birth & Growth Cohort Study, an ongoing birth cohort study initially constructed between 2001 and 2006. In 2010-2012, the POP concentration was measured in serum from a total of 214 children, 7-9 years of age. Using fasting glucose and insulin measurements at both baseline and the second year of follow-up, the homeostatic model assessment of beta-cell function (HOMA-β) and homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. Multiple linear regression analysis and a linear mixed-effects model were used to determine the relationship between POP tertiles and metabolic biomarkers.Compared with the lowest tertile of total marker PCBs, participants in the third tertile had decreased HOMA-β values, after adjustment for age, sex, body mass index z-score, mother's education, ponderal index, and history of breastfeeding (-18.94%; 95% CI: -32.97%, -1.98%). In a linear mixed model, the HOMA-β values were still lower in subjects in the highest compared with the lowest tertile of total PCBs at the 2-year follow-up period (108.3 vs. 135.0, respectively).The results of the study suggested that exposure to POPs among children might affect insulin secretory function, which could lead to an increased risk of developing diabetes. Citation: Park SH, Ha EH, Hong YS, Park H. 2016. Serum levels of persistent organic pollutants and insulin secretion among children age 7-9 years: a prospective cohort study. Environ Health Perspect 124:1924-1930; http://dx.doi.org/10.1289/EHP147.
THU0095 Difference in Physical Function Between Remission and Low Disease Activity in Early Rheumatoid Arthritis
Authors: E. Galuppi, I. Farina, F. Bergossi, C. De Giorgio, G. Ciancio, M. Govoni
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Remission is the optimal therapeutic goal in treating rheumatoid arthritis to target but low disease activity could constitute a valuable alternative goal especially in patients with long standing disease. Few data exist about the different clinical and functional implications of the two disease activity conditions especially in Early Rheumatoid Arthritis (ERA). <h3>Objectives</h3> To investigate whether aiming a state of remission yields some benefit when compared with low disease activity as regard to functional outcomes in an Early Rheumatoid Arthritis cohort of patients. <h3>Methods</h3> ERA patients fulfilling 2010 ACR/EULAR who consecutively attended our Early Arthritis Clinic between 2009-2014 were retrospectively analyzed. Patients with available follow-up of at least 1 year were included. Disease activity and functional disability has been evaluated using DAS28 and HAQ after 6 (T6) and 12 (T12) months from diagnosis. Standardized therapeutic approach has been performed according to EULAR guidelines. At T6 and T12 HAQ was compared between patients with different levels of disease activity according to the DAS28: remission (REM-DAS28&lt;2.6) and low disease activity (LDA-DAS28≤3.2). Data were analysed by using t student test. <h3>Results</h3> One hundred and thirty-nine patients completed the 1-year follow up. At baseline DAS28 and HAQ were respectively 4.59±1.1 and 0.95±0,7. At T6 81 (58%) patients achieved DAS28 remission and had an HAQ of 0.27±0.41, 22 (16%) patients were in DAS28 LDA with an HAQ of 0.49±0.5. At T12 83 (60%) patients achieved DAS28 REM and 27 (19%) DAS28 LDA with an HAQ respectively of 0.22±0.35 and 0.75±0.61. At both time points, HAQ resulted significally lower (p&lt;0.05) in REM groups compared to that in LDA. Within the period of observation (from T6 to T12) 11 patients changed from LDA to REM. When investigating the change in physical function in these patients we saw improvement of HAQ from 0.48±0.55 to 0.21±0.29. 13 patients moved from REM to LDA and HAQ deteriorated significantly (REM 0.33±0.3, LDA 0.74±0.49, <i>p</i>=0.01). <h3>Conclusions</h3> Even though LDA constitutes an alternative goal especially in patients with long standing disease, our analyses revealed that aiming a state of clinical REM within the first months of the disease, is much better also in term of physical function. Reaching early a good physical function not only will benefit the patient but also will improved major socioeconomic consequences of Rheumatoid Arthritis. <h3>References</h3> H Radner, JS Smolen, D Aletaha. Remission in rheumatoid arthritis: benefit over low disease activity in patient-reported outcomes and costs. Arthritis Research &amp; Therapy 2014;16:R56. <h3>Disclosure of Interest</h3> None declared
Assessment of an outreach street-based HIV rapid testing programme as a strategy to promote early diagnosis: a comparison with two surveillance systems in Spain, 2008–2011
Authors: M J Belza, J Hoyos, S Fernández-Balbuena, A Diaz, M J Bravo, L de la Fuente, collective the Madrid HIV rapid testing group
Journal: Eurosurveillance (2015)

We assess the added value of a multisite, street-based HIV rapid testing programme by comparing its results to pre-existing services and assessing its potential to reduce ongoing transmission. Between 2008 and 2011, 8,923 individuals underwent testing. We compare outcomes with those of a network of 20 sexually transmitted infections (STI)/HIV clinics (EPI-VIH) and the Spanish National HIV Surveillance System (SNHSS); evaluate whether good visibility prompts testing and assess whether it reaches under-tested populations. 89.2% of the new infections were in men who have sex with men (MSM) vs 78.0% in EPI-VIH and 56.0% in SNHSS. 83.6% of the MSM were linked to care and 20.9% had <350 CD4 HIV prevalence was substantially lower than in EPI-VIH. 56.5% of the HIV-positive MSM tested because they happened to see the programme, 18.4% were previously untested and 26.3% had their last test ≥2 years ago. The programme provided linkage to care and early diagnosis mainly to MSM but attendees presented a lower HIV prevalence than EPI-VIH. From a cost perspective it would benefit from being implemented in locations highly frequented by MSM. Conversely, its good visibility led to reduced periods of undiagnosed infection in a high proportion of MSM who were not testing with the recommended frequency.
Comparative Efficacy and Safety of Everolimus-Eluting Bioresorbable Scaffold Versus Everolimus-Eluting Metallic Stents
Authors: Xin-Lin Zhang, Li Zhu, Zhong-Hai Wei, Qing-Qing Zhu, Jian-Zhong Qiao, Qing Dai, Wei Huang, Xiao-Hong Li, Jun Xie, Li-Na Kang, Lian Wang, Biao Xu
Journal: Annals of Internal Medicine (2016)

Background: Theoretically, the everolimus-eluting bioresorbable vascular scaffold (BVS) could eliminate stent thrombosis and improve outcomes in patients having percutaneous coronary intervention. Purpose: To estimate the incidence of stent thrombosis after BVS implantation and to compare the efficacy and safety of BVSs versus everolimus-eluting metallic stents (EESs) in adults having percutaneous coronary intervention. Data Sources: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, conference proceedings, and relevant Web sites from inception through 20 January 2016. Study Selection: 6 randomized, controlled trials and 38 observational studies, each involving at least 40 patients with BVS implantation. Data Extraction: Two reviewers independently extracted study data and evaluated study risk of bias. Data Synthesis: The pooled incidence of definite or probable stent thrombosis after BVS implantation was 1.5 events per 100 patient-years (PYs) (95% CI, 1.2 to 2.0 events per 100 PYs) (126 events during 8508 PYs). Six randomized trials that directly compared BVSs with EESs showed a non–statistically significant increased risk for stent thrombosis (odds ratio [OR], 2.05 [CI, 0.95 to 4.43]; P = 0.067) and myocardial infarction (OR, 1.38 [CI, 0.98 to 1.95]; P = 0.064) with BVSs. The 6 observational studies that compared BVSs with EESs showed increased risk for stent thrombosis (OR, 2.32 [CI, 1.06 to 5.07]; P = 0.035) and myocardial infarction (OR, 2.09 [CI, 1.23 to 3.55]; P = 0.007) with BVSs. The relative rates of all-cause and cardiac death, revascularization, and target lesion failure were similar for BVSs and EESs. Limitation: Scarce comparative data, no published data from large trials with long-term follow-up, and limited quality and incomplete reporting of observational studies. Conclusion: Compared with EESs, BVSs do not eliminate and might increase risks for stent thrombosis and myocardial infarction in adults having percutaneous coronary intervention. Results of large trials with long-term follow-up are critically needed to establish the safety or at least the noninferiority of BVSs compared with EESs. Primary Funding Source: None.
Professional Liability Insurance for the Intern and Resident
Authors: C P HALL
Journal: JAMA (1965)

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