tbuckley/cabot-search huggingface dataset:
FRI0345 Tapering MTX in Patients with RA Using TNFI Treatment is Possible: Table 1.
Authors: S. Manders, M. van de Laar, S. Rongen-van Dartel, R. Bos, H. Visser, H. Brus, T. Jansen, H. Vonkeman, P. van Riel, W. Kievit
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Nowadays the focus is on tapering or stopping biological treatment in patients with rheumatoid arthritis (RA) because of the cost reduction. However, the use of methotrexate (MTX) can cause considerable burden for patients, therefore the quality of life of patients would increase if the MTX could be tapered or stopped. <h3>Objectives</h3> The objective of this study was: 1. to analyse if patients taper or stop MTX in daily practice while they are using Tumor Necrosis Factor inhibitor (TNFi) treatment and 2. the effect of taper or stop MTX on the effectiveness and the long term TNFi drug survival. <h3>Methods</h3> Data was obtained from the DREAM registry. Patients with RA started TNFi treatment in combination with MTX were included in this study. Drug survival of the TNFi was analysed using Cox proportional hazard model with taper or stop MTX as time-dependent covariate. Treatment effectiveness before and after taper or stop MTX was analysed using DAS28. Linear mixed models was used to analyse the difference of DAS28 over time (variable time) between taper and not taper (interaction term = no taper*time) and stop and not stop MTX. Analyses were corrected for possible confounders. <h3>Results</h3> Of the 1331 patients starting TNFi with MTX, 487 (36.6%) patients tapered their MTX and 177 of the 1331 (13.3%) stopped their MTX treatment. On average the DAS28 scores <i>decrease</i> after tapering (-0.39, -0.45) and after stopping MTX (-0.26, -0.06) at 6 and 12 month respectively. About 61% of the patients shows an improvement in DAS28 (DAS28&lt;0), 18% shows an increase between 0 and 0.6 DAS28 scores, and 21% shows an increase of &gt;0.6. On average patients that taper or stop have both stable DAS28 scores over time, the same course over time was showed, compared to patients that do not taper or stop MTX (Interaction no taper*time: B=0.00; CI=-0.01:0.00; p=0.339 and interaction no stop*time: B=0.00; CI=-0.01:0.01; p=0.647 respectively). Moreover, the long term drug survival of TNFi is even better in patients tapering MTX and the same in patients stopping MTX, see Table. <h3>Conclusions</h3> In daily practice, patients with RA do taper or stop their MTX dose when using TNFi treatment. This does not seem to influence the average DAS28 over time or the long term TNFi drug survival. This indicates that the right/correct patients are chosen to taper or stop MTX treatment in daily practice which could increase the quality of life in these patients. <h3>Disclosure of Interest</h3> None declared
THU0516 Health-Related Quality of Life in Patients with Newly Diagnosed JIA with Different Treatment Strategies (Acute-JIA Study): Table 1.
Authors: M. Tarkiainen, P. Tynjälä, P. Vähäsalo, L. Kröger, K. Aalto, M. Malin, A. Putto-Laurila, V. Honkanen, P. Lahdenne
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Health-related quality of life (HrQoL) is impaired in patients with juvenile idiopathic arthritis (JIA). <h3>Objectives</h3> To study HrQoL in patients with newly diagnosed JIA on three treatment strategies. <h3>Methods</h3> In ACUTE-JIA Study (1), 60 patients were randomized into three treatment arms: infliximab with methotrexate (TNF); a combination of methorexate, hydroxychloroquine, and sulphasalazine (COMBO), or methotrexate monotherapy (MTX). During the first year, at seven study visits, efficacy was measured with ACRped criteriae and HrQoL with Child Health Questionnaire (CHQ). <h3>Results</h3> All 20 patients continued intended therapy until week 54 in the TNF, 16 in COMBO, and 11 in MTX group. The last CHQ scores before discontinuation of the therapy were carried forward. Physical summary scores (PhS) and Psychosocial summary scores (PsS) improved from week 0 to 54 (Table 1) in all treatment groups with no differences between the groups. In all groups, significant improvements in PhS occurred over time until week 24 of the study, but not after that. In univariate analyses, CHAQ at weeks 0 (β=20.07; p&lt;0.001) and 12 (β=-14.75; p=0.04), and cumulative use of steroids (β=-3.89; p=0.006) correlated with absolute change in PhS from week 0 to 54 (R<sup>2</sup>=0.381). <h3>Conclusions</h3> During the first year of treatment of JIA, HrQoL improved in all treatment categories. Patients and parents seem to acknowledge a significant change in PhS during the first half-year, but not thereafter. <h3>References</h3> Tynjälä P, Vähäsalo P, Tarkiainen M, et al. Aggressive Combination Drug Therapy in Very Early Polyarticular Juvenile Idiopathic Arthritis (ACUTE-JIA): a multicentre randomised open-label clinical trial. Ann Rheum Dis. 2011 Sep;70(9):1605-12. <h3>Disclosure of Interest</h3> None declared
Reticulum Cell Sarcomas Induced in Mice by Rauscher Virus2
Authors: Peter J. Dawson, A. Howard Fieldsteel
Journal: JNCI Journal of the National Cancer Institute (1974)

Journal Article Reticulum Cell Sarcomas Induced in Mice by Rauscher Virus Get access Peter J. Dawson, Peter J. Dawson Search for other works by this author on: Oxford Academic PubMed Google Scholar A. Howard Fieldsteel A. Howard Fieldsteel Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 52, Issue 6, June 1974, Pages 1805–1809, https://doi.org/10.1093/jnci/52.6.1805 Published: 01 June 1974 Article history Received: 26 November 1973 Accepted: 11 March 1974 Published: 01 June 1974
FRI0237 Widespread Pain is Common in Patients with Axial Spondyloarthritis: A Topographical Analysis of Body Charts and the Relationship With Clinical Variables
Authors: T. Swinnen, E. Raddoux, T. Van Rietvelde, W. Dankaerts, R. Westhovens, K. de Vlam
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Pain is a core outcome domain in the assessment of axial spondyloarthritis (aSpA) and can be therapeutically challenging. To date, only (spinal) pain intensity is captured in this patient group via numerical rating scales. State-of-the-art physiological insights suggest a role for topographical analysis to classify underlying pain mechanisms in clinical practice<sup>1</sup>. Unfortunately, no data on "the spread of pain" are available in aSpA. <h3>Objectives</h3> To explore pain locations and widespread pain in patients with aSpA and to explore their relationship with clinical variables. <h3>Methods</h3> We collected demographics, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index total score (BASDAItot), stiffness items combined (BASDAIstiff) and spinal pain item (BASDAIpain) and the Bath Ankylosing Spondylitis Metrology Index (BASMI) in 125 participants with aSpA (male/female: 80/45; mean ± SD, age: 43.9±11.67 yrs; height: 171.06±9.54cm; weight: 76.96±15.27;BASMI: 3.27±1.78;BASFI: 3.81±2.57;BASDAI: 3.88±2.26; Biologicals yes/no: 65/60; disease duration: 13.23±9.99). Body charts divided in 80 body regions (20 spinal) were filled in by patients and informed on pain locations during the last week. Body charts were scored using a grid by two independent raters (mean kappa 0.940, range 0.778-1.00). Spearman rank correlations were used to examine relationships with clinical variables (p&lt;0.05). <h3>Results</h3> Low back pain was reported by 94 patients (75%), while only low back (22;18%), thoracic (2; 2%) and cervical (3; 2%) pain was remarkably rare. Similarly, leg pain was infrequent (right: 3; 2.4%, left: 1; 0.8%). Widespread pain in all spinal regions was common (49, 40%). Low back pain correlated with thoracic (R=0.377; P&lt;0.01) and cervical pain (R=0.180; P&lt;0.05). The sum of the all painful regions was associated with BASDAItot (R=0.547; P&lt;0.01), BASDAIpain (R=0.477; P&lt;0.01), BASDAIstiff (R=0.413; P&lt;0.01) and BASFI (R=0.405; P&lt;0.01), indicating that the spread of pain is a related but distinct clinical construct. BASMI was not related to body chart outcomes (p&gt;0.05). <h3>Conclusions</h3> Widespread spinal is a common clinical feature in aSpA that is associated with disease-specific outcome measures. Body charts add essential information in the assessment of pain and are a valuable focus for future research in aSpA. <h3>References</h3> Malfait AM, Schnitzer TJ. Towards a mechanism-based approach to pain management in osteoarthritis. Nat Rev Rheumatol. 2013 Nov;9(11):654-64. <h3>Disclosure of Interest</h3> None declared
THU0532 Juvenile Idiopathic Arthritis in Norway -A Hospital Based Registry: Table 1.
Authors: T.M. Ingebrigtsen, T. Garen, B. Flatø, H. Sanner
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> In 1999 a registry of patients with juvenile idiopathic arthritis (JIA) and juvenile onset connective tissue diseases was established at Oslo University Hospital, Rikshospitalet. <h3>Objectives</h3> To evaluate clinical characteristics in patients with JIA registered in the hospital based registry. <h3>Methods</h3> The registry is based on written informed consent. JIA patients were classified using ICD-10 codes and data was registered at one time point. Gender, date of registration and year for disease onset was recorded, in addition to onset type, number of active joints and physician9s global assessment of disease activity (VAS). <h3>Results</h3> A total of 1069 JIA patients were registered. Mean age at inclusion was 9 years, mean age at disease onset was 6 years, and 65% were female. The distributions in various ICD-10 subgroups are shown in table 1. The most frequent subgroups were pauciarticular and polyarthritis (seronegative). Physician9s global was higher in girls (n=664) than in boys (n=353) in the group as whole; median 1.6 (IQR 0.4-3.3) versus median 1.3 (IQR 0.3-2.8); p=0.049. When comparing physician9s global between JIA subgroups a difference was found between polyarthritis and pauciarticular arthritis, p=0,001. Patients with polyarthritis had higher physician9s global than both pauciarticular and systemic; p=0,024. In 992 patients data on onset type was available. Of these 66% had pauci, 26% poly, 6% systemic and 2% unknown onset type. In 854 patients data on active joint count at time of registration was available. In the group as whole 42% had none, 24% one, 13% two, 6% three, 3% four and 12% five or more active joints. <h3>Conclusions</h3> The age at onset and gender distribution is as expected. Girls had higher physician9s global than boys and those with polyarthritis had higher physician9s global than both systemic and pauciarticular arthritis. Ideally the register should have been based on the ILAR criteria instead of the ICD-10 codes. We consider the three subgroups pauci, poly and systemic to be the most consistent to the ILAR criteria. The registry is an important database for studies concerning outcome in JIA. <h3>Disclosure of Interest</h3> None declared
Pathogenesis of Viral Infections of the Nervous System
Authors: Richard T. Johnson, Cedric A. Mims
Journal: New England Journal of Medicine (1968)

Crossing from Blood to BrainA variety of mechanisms involving both blood–cerebrospinal-fluid–brain and more direct blood–brain pathways have been postulated to explain how viruses negotiate the cells and membranes separating the blood from susceptible cells in the brain.Virus in the blood might enter the cerebrospinal fluid by either passing or growing through the choroid plexus. Capillaries within the choroid plexes have been shown to have porous endothelium65 and to be surrounded by a loose stroma of connective tissue.66 In both these respects they differ from capillaries within the parenchyma of the brain. Pappas and Tennyson65 injected colloidal particles intravenously . . .
Endoscopic ultrasound-guided choledochojejunostomy with a lumen-apposing metal stent: a shortcut for biliary drainage
Authors: Amy Tyberg, Kunal Karia, Steven Zerbo, Reem Sharaiha, Michel Kahaleh
Journal: Endoscopy (2015)

Endoscopic-ultrasound (EUS)-guided biliary drainage is a therapeutic option for patients with biliary pathology and altered gastrointestinal anatomy in whom conventional endoscopic retrograde cholangiopancreatography (ERCP) has failed [1] [2] [3]. We present the case of a patient undergoing EUS-guided choledochojejunostomy with a fully covered, lumen-apposing metal stent ([Video 1]).
Adjuvant gemcitabine and cisplatin (GC) for locally advanced cancer of the bladder after radical cystectomy: A USC experience with molecular correlates
Authors: A. B. El-Khoueiry, S. T. Tagawa, D. I. Quinn, R. Panares, D. Tsao-Wei, J. Stein, D. G. Skinner, D. Raghavan
Journal: Journal of Clinical Oncology (2004)

4639 Background: Invasive bladder cancer has a 50% mortality rate. Adjuvant chemotherapy is used to try to improve survival, but is of unproven benefit. GC and MVAC have similar response rates and survival in the metastatic setting, with GC having less toxicity (JCO 17: 3068). We have used the GC regimen for patients with high grade bladder cancer with poor prognostic features after cystectomy when they have not been candidates for MVAC for medical or personal patient reasons. Methods: We conducted a retrospective study of patients treated with adjuvant chemotherapy between 1997 and 2002. Chemotherapy consisted of 3–4 cycles of adjuvant Gemcitabine 1000mg/m2 (days 1 & 8) and Cisplatin (35mg/m2 days 1 & 2). All patients undergoing radical cystectomy and receiving adjuvant GC at USC were eligible. Medical records were examined and tissues were studied for various molecular markers, including p53, ribonucleotide reductase (RR) and ERCC1. Results: 25 patients met inclusion criteria. Median age was 68; 72% were pT3 or pT4; 68% had lymph nodes involved. All patients had transitional cell carcinoma. P53 was mutated in 75%. The median number of cycles of GC was 3 (84% had 3–4 cycles). 11 patients (44%) had grade 3 or 4 hematologic toxicity and 2 (8%) had grade 3 non-hematologic toxicity. Median follow-up was 25.1 (8.7–49.7) months. 8 patients have died. The median time to recurrence was 49.7 (12.3–49.7+) months with median overall survival of 49.7+ (16.6–49.7+) months. Evaluation of tissue blocks for molecular correlates such as ERCC1 and RR is in progress and will be reported. Conclusions: Adjuvant GC chemotherapy is feasible and effective in the setting of locally advanced bladder carcinoma and will be studied in a prospective, randomized fashion. For the 17 patients with node-positive bladder cancer, adjuvant GC is associated with disease-free median survival of 23.6 (11.3, 49.7+) months and median survival of 23.8+ (16.6, 49.7+) months. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Eli Lilly
Organic affective illness associated with lead intoxication
Authors: R S Schottenfeld, M R Cullen
Journal: American Journal of Psychiatry (1984)

Psychiatrists treating patients with depression or nonspecific somatic complaints seldom think of lead intoxication as a possible cause. Because occupational exposure to lead is so common, these disturbances may often be associated with lead intoxication. To facilitate earlier clinical recognition and proper treatment among the many individuals at risk, the authors describe four cases of organic affective disturbance associated with lead intoxication, review the neuropsychiatric disturbances that have been reported with chronic exposure to lead, and report the results of their experience evaluating the psychiatric aspects of lead intoxication among individuals exposed in their work.
Olympic Games are likely to be free of Zika cases, say officials
Authors: Zosia Kmietowicz
Journal: BMJ (2016)

Organisers of the Rio 2016 Olympic Games have said that the chances of anyone becoming infected with the Zika virus during the competition, held in Brazil in August and September, are almost zero.

The numbers of Zika cases in Rio de Janeiro have dropped sharply in recent weeks and will fall to almost nothing during the dry winter months of the Olympic and Paralympic Games, said officials (fig).



Zika cases in Rio de …
Healthcare-associated infections in long-term care facilities (HALT) in Frankfurt am Main, Germany, January to March 2011
Authors: U Heudorf, K Boehlcke, M Schade
Journal: Eurosurveillance (2012)

Healthcare-associated infections (HAIs) are a potentially serious threat to elderly people living in longterm care facilities. Therefore, the European HALT (Healthcare-associated infections in long-term care facilities) project was launched in 2008. HAIs and the use of antibiotics were studied in all 40 nursing homes (100% response) in the city of Frankfurt am Main, Germany, from January to March 2011, using the HALT protocol. Of the 3,732 residents in the homes, 4.3% (n=161) had either signs or symptoms of infections and/or were on oral antibiotics. The most common infections were urinary tract infections (n=45; 1.2%), followed by infections of the respiratory tract (n=41; 1.1%) and skin except mycosis (n=25; 0.7%). The overall prevalence of oral antibiotic use was 2.4% (n=90). The most frequently prescribed oral antibiotics were quinolones (n=31), cephalosporins (n=19), penicillins (n=11) and co-trimoxazole (n=11). The prevalence of HAIs was about the same as that in a European pilot study carried out in November 2009 (5%), but was higher than in several national surveys carried out between May and September 2010 (1.6–3.6%).
TREM2 Risk Variant and Loss of Brain Tissue
Authors: Priya Rajagopalan, Derrek P. Hibar, Paul M. Thompson
Journal: New England Journal of Medicine (2013)

We were intrigued by reports of a discovery of a rare variant in TREM2 (1–3) that roughly triples the lifetime risk of Alzheimer’s disease (AD). The frequency of this risk variant was reported as 0.63% in the Icelandic population (1) and is somewhat variable across populations (see Supplement). Here we aimed to understand how the gene variant affects AD risk by mapping its effects on brain in 478 subjects (mean age: 75.5±6.5 years; 283M/195F; 100 with AD, 221 with mild cognitive impairment and 157 healthy controls) from the Alzheimer’s Disease Neuroimaging Initiative, scanned with brain MRI every year for 2 years (4). Using tensor-based morphometry, we computed the rates of brain tissue loss, per year, over 24 months from the baseline MRI in a statistically-defined region of interest, based on voxels with significant atrophic rates over time within the temporal lobes in AD (4). We then tested the hypothesis that annual brain loss rates, over time, in this region are associated with carrying the risk allele of rs9394721, a close proxy for the newly discovered risk variant, rs75932628, in TREM2 (r2=0.492; see Supplement). We report that TREM2 mutation carriers annually lose brain tissue up to 1.4–3.3% faster than non-carriers, in a pattern that mirrors the profile of AD pathology in the brain (Figure 1). Mutation carriers lose brain tissue twice as fast as healthy elderly people (Table 2S). After adjusting for age and sex, the risk allele was also significantly associated with smaller hippocampal volumes, elevated levels of cerebrospinal fluid (CSF) biomarker p-tau181p, which are usually observed in AD (5), and poorer cognitive performance (see Supplement) based on the standard clinical dementia rating scale (CDR) and Alzheimer’s Disease Assessment Scale (ADAS-cog), assessed at baseline MRI scan and after 24 months’ follow-up (Table 1S). The TREM2 risk variant may affect signaling by TREM2 receptors expressed on microglial cells in the brain, perhaps interfering with the anti-inflammatory functions of these cells and their removal of apoptotic tissue. This may affect brain amyloid clearance, leading to AD-like neurodegeneration and accelerated cognitive decline (2). Selection of carriers of this risk variant and probably other TREM2 risk variants for enrollment in trials of interventions to treat persons with Alzheimer’s disease, in which MRI scans are used in obtaining outcomes, should increase the power of such trials.



Figure 1

At a 24-month follow-up scan, these 3D regression coefficient maps show brain volume differences in the temporal lobe associated with carrying the TREM2 risk allele. The risk allele carriers showed significantly accelerated brain atrophy from 1.4–3.3% ...
Chemotherapy in seminoma: when is it appropriate initial treatment?
Authors: J R Daniels
Journal: Journal of Clinical Oncology (1985)

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.1985.3.10.1294 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 4045522 Chemotherapy in seminoma: when is it appropriate initial treatment? J R DanielsxJ R DanielsSearch for articles by this author https://doi.org/10.1200/JCO.1985.3.10.1294 PDF "Chemotherapy in seminoma: when is it appropriate initial treatment?." Journal of Clinical Oncology, 3(10), pp. 1294–1295© 1985 by American Society of Clinical Oncology
Clinical and histopathological features of fatal cases with dengue and chikungunya virus co-infection in Colombia, 2014 to 2015
Authors: Marcela Mercado, Jorge Acosta-Reyes, Edgar Parra, Lissethe Pardo, Angélica Rico, Alfonso Campo, Edgar Navarro, Diego Viasus
Journal: Eurosurveillance (2016)

We report clinical features and histopathological findings in fatal cases with dengue (DENV) and chikungunya (CHIKV) co-infection identified at the Colombian National Institute of Health between September 2014 and October 2015. Seven such cases were documented. Dengue serotype 2 virus was identified in six cases. All patients were adults and comorbidities were present in four. Fever, arthralgia or myalgia was present in all cases. The frequency of rash, haemorrhage, oedema, and gastrointestinal symptoms was variable. Laboratory findings such as thrombocytopenia, renal failure, and leukocyte count were also inconsistent between cases. Post-mortem tissue examination documented focal hepatocellular coagulative necrosis in three cases, incipient acute pericarditis in one and tubulointerstitial nephritis in one. This study provides evidence of mortality in patients with DENV and CHIKV co-infection. Fatal cases were characterised by variable clinical and laboratory features. Evaluation of histopathology of autopsy tissues provided evidence of the pathological consequences of the disease.
Spectrum and prognostic relevance of driver gene mutations in acute myeloid leukemia
Authors: Klaus H. Metzeler, Tobias Herold, Maja Rothenberg-Thurley, Susanne Amler, Maria C. Sauerland, Dennis Görlich, Stephanie Schneider, Nikola P. Konstandin, Annika Dufour, Kathrin Bräundl, Bianka Ksienzyk, Evelyn Zellmeier, Luise Hartmann, Philipp A. Greif, Michael Fiegl, Marion Subklewe, Stefan K. Bohlander, Utz Krug, Andreas Faldum, Wolfgang E. Berdel, Bernhard Wörmann, Thomas Büchner, Wolfgang Hiddemann, Jan Braess, Karsten Spiekermann
Journal: Blood (2016)
Mass psychogenic illness in nationwide in-school vaccination for pandemic influenza A(H1N1) 2009, Taiwan, November 2009–January 2010
Authors: W T Huang, C C Hsu, P I Lee, J H Chuang
Journal: Eurosurveillance (2010)

From 16 November 2009 to 22 January 2010, Taiwan investigated 23 clusters of mass psychogenic illness after vaccination (MPIV) in the nationwide in-school vaccination programme against the 2009 pandemic influenza A(H1N1). The median age of the 350 ill students (68% female) was 13 years. Intense media coverage of these events has driven public concerns about the safety of the pandemic influenza vaccine. In the future, countries should incorporate surveillance and communication strategies for MPIV in their pandemic preparedness plans.