tbuckley/cabot-search huggingface dataset:
FRI0034 Impact of Obesity on Disease Activity and Radiographic Progression in a Cohort of Early Rheumatoid Arthritis: Results from Espoir Cohort
Authors: C.I. Daien, J. Sellam, N. Rincheval, B. Fautrel, A. Saraux, J. Morel, J.-P. Daurès, B. Combe
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Obesity is an increasing condition. Previous transversal studies suggested that obesity in patients with rheumatoid arthritis (RA) was associated with a higher disease activity, a poor quality of life and a lower radiographic damage but longitudinal studies are lacking. <h3>Objectives</h3> We aimed to evaluate the impact of obesity at RA diagnosis on disease course including disease activity, health assessment questionnaire (HAQ-DI) and radiographic progression during the 3 first years. <h3>Methods</h3> 628 patients from the French early arthritis ESPOIR cohort, fulfilling the 2010 ACR/EULAR criteria at baseline, were analyzed. Inclusion characteristics of normal weight (body mass index [BMI] 18.5 to 25), overweight (25-30) and obese (≥30 kg/m<sup>2</sup>) patients were compared using Khi<sup>2</sup> and Kruskal Wallis. The outcome of DAS28 (and its components), HAQ-DI and Sharp score (and its components) was compared between BMI groups using repeated measures ANOVA and mixed models. <h3>Results</h3> 353 patients had a normal BMI; 178 patients were overweight and 97 patients were obese. At baseline, obese patients were older and less frequently female, had lower rheumatoid factor levels, a higher Sharp score, lower C reactive protein and erythrocyte sedimentation rate, a higher insulin resistance, a lower practice of sport, higher IL-1RA and leptin levels, lower adiponectin and Dickkopf-related protein 1/sclerostin ratio. Repeated measures ANOVA showed a significant interaction between BMI groups and disease activity overtime with higher DAS28 (p=0.0002) (Fig. 1A), ESR (p=0.012) and disease activity on a visual analog scale (VAS) (p=0.002) and HAQ-DI (p=0.0001) (Fig. 1B) for obese patients. All these results were confirmed in mixed model using random effects model for time. Moreover, metabolic syndrome was associated with a higher DAS28 over time (p=0.011), independently of obesity. Total and erosion Sharp score were not significantly different between BMI groups whereas joint narrowing was significantly higher in obese patients (p=0.016)(Fig. 1C). <h3>Conclusions</h3> Obesity at RA diagnosis is associated with a higher DAS28, a higher HAQ, a higher joint narrowing Sharp score over time but a similar total Sharp score than non-obese patients. Clinician should be aware of the differences that could influence the disease management. <h3>Acknowledgements</h3> An unrestricted grant from Merck Sharp and Dohme (MSD) was allocated for the first 5 years of the ESPOIR study. Two additional grants from INSERM supported part of the biological database. The French Society of Rheumatology, Pfizer, Abbott, and Roche-Chugaï also supported the ESPOIR cohort. <h3>Disclosure of Interest</h3> None declared
AB0963 Anxiety and Depression in Pediatric Systemic Lupus Eritematosus
Authors: C. Hernandez Lember, A. Diaz, R. Vasquez
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Anxiety and depression are frequent symptoms among children and adolescents with Systemic Lupus Eritematosus (SLE). Its impact and association with different factors require detailed analysis. <h3>Objectives</h3> The aim of this study was to determine the frequency of presentation of anxiety and depression symptoms in children and adolescents with SLE, as well as the association between these symptoms and their quality of life, disease activity index (SLEDAI) and immunosuppressant treatment. <h3>Methods</h3> SLE pediatric patients between 9 and 17 years of age were enrolled. They underwent an interview and had four variables evaluated: behavior abnormalities, immunosuppressant therapy, time of diagnosis, and SLEDAI. Data on depression and anxiety symptoms as well as quality of life were collected using the Children Depression Inventory (CDI), the Screen for Child Anxiety Related Disorders (SCARED) and the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). <h3>Results</h3> 40 patients were included. Mean age was 14±2 years old. Mean time of SLE diagnosis was 22 months. In 52% of cases (n=21) signs of disease activity were found SLEDAI &gt;5). 57% of patients (n=23) presented with anxiety and 37% (n=15) with depression. Finally, 37% (n=15) declared having suicidal ideation after SLE diagnosis. The mean PQ-LES-Q was 56,7 (SD ±7,32). Correlation analysis results showed a positive association between SCARED and CDI (p=0,009), with a weak correlation (correlation coefficient=0,4). As for SCARED and quality of life (PQ-LESQ), a weak negative correlation was found, which was not statistically significant (p=0,13). Analysis association between CDI and PQ-LES-Q evidenced a strong negative correlation (correlation coefficient= - 0,746) which was statistically significant (p&lt;0,000). Psychiatric manifestations and SLEDAI were evaluated finding no association between disease activity index and the presence of depression or anxiety symptoms (p&gt;0,05). Likewise, analysis of anxiety and medications used for SLE treatment was made. It showed that use of prednisone was associated with a higher prevalence of anxiety symptoms (p=0,004). Nonetheless, when comparing mean corticosteroid dose, it was observed that prednisone dose has no association with the presence or absence of psychiatric manifestations (p&gt;0,05). <h3>Conclusions</h3> Anxiety is more likely to be present in pediatric patients with SLE than depression. Anxiety is a vulnerability factor for developing depression symptoms and is related with the use of corticosteroids regardless of the dose. SLE has a major impact on quality of life and this impact becomes greater in the presence of depression symptoms. <h3>Disclosure of Interest</h3> None declared
Reply:
Authors: Hiroyuki Tsuchiya, Kentaro Kogure, Goshi Shiota
Journal: Hepatology (2012)

We thank Dr. Anna Alisi and her colleagues for their interest in our recent study. We agree that the mechanism underlying the antisteatotic effects of all-trans-retinoic acid (ATRA) is not simple and may involve several pathways. Previous studies have demonstrated that the constitutive activation of AKT in pten knockout or pik3ca transgenic mice resulted in better glucose tolerance than their wildtype counterparts, despite severe steatosis,1, 2 while akt2 knockout induced hyperglycemia, but alleviated steatosis in ob/ob mice.3 Because ATRA increased (although not significantly) AKT phosphorylation (Fig. 1) and decreased the hepatic lipid content in mice that were fed a high-fat, high-fructose (HFHFr) diet,4 the involvement of phosphatase and tensin homolog (PTEN) in the mode of action of ATRA remains to be clarified. Effects of 4-week ATRA therapy on AKT phosphorylation in mice fed an HFHFr diet. AKT phosphorylation was detected by western blot analysis of liver samples from control mice (white columns) or mice with nonalcoholic fatty liver disease, after 4 weeks of the HFHFr diet (gray column) or ATRA + HFHFr diet (black column). The data are expressed relative to the actin levels. **P < 0.01 versus control diet. We did not investigate PTEN expression but AKT phosphorylation was significantly higher in the HFHFr group and these results are consistent with the findings of Dr. Anna Alisi indicating that a high fructose-enriched diet could have inhibited PTEN activity. However, ATRA induced more intense AKT phosphorylation than that caused by the HFHFr diet, which suggests a mechanism different from that proposed by Dr. Anna Alisi. In fact, it has been reported that AKT phosphorylation is regulated by many molecules other than PTEN.5 At the moment, we lack sufficient data to determine whether PTEN activity regulation by ATRA affects the anti-insulin action in these models. It is possible that ATRA may regulate lipogenesis, partly by impairing insulin-induced AKT phosphorylation by PTEN. In addition, we hypothesize that the antisteatotic effects of ATRA may involve the up-regulation of the lipolytic transcription factors peroxisome proliferator-activated receptor α (PPARα) and PPARβ, with concomitant downregulation of the lipogenic transcription factors PPARγ and sterol regulatory element-binding protein 1.4 Insulin resistance causes complex metabolic abnormalities and it has been suggested that the lipogenic effect of insulin is even active in patients with nonalcoholic fatty acid patients.6 Therefore, further studies are necessary to clarify the precise mechanisms underlying the antisteatotic effects of ATRA. HIROYUKI TSUCHIYA, PH.D.1 KENTARO KOGURE, PH.D.1 GOSHI SHIOTA, M.D., PH.D.2 1Department of Biophysical Chemistry, Kyoto Pharmaceutical University, Kyoto, Japan 2Department of Genetic Medicine and Regenerative Therapeutics, Graduate School of Medicine, Tottori University, Yonago, Japan
Postpartum Depression
Authors: Lise M. Stevens, Cassio Lynm, Richard M. Glass
Journal: JAMA (2010)

Postpartum DepressionH aving a baby can be a joyous occasion, but being a new mother can also be stressful and difficult.Taking time to adjust to the demands and changes that come with parenting is normal, but about 13% of pregnant women and new mothers feel depressed and have related symptoms.When this occurs following childbirth, it is called postpartum depression.The October 20, 2010, issue of JAMA includes an article reporting that fish oil capsules taken during pregnancy did not result in lower levels of postpartum depression.This Patient Page is based on one previously published in the February 13, 2002, issue of JAMA.
Multiple exposures during a norovirus outbreak on a river-cruise sailing through Europe, 2006
Authors: L Verhoef, IL Boxman, E Duizer, S  A Rutjes, H Vennema, I H Friesema, A  M de Roda Husman, M Koopmans
Journal: Eurosurveillance (2008)

In the summer of 2006, several cruise-related viral gastroenteritis outbreaks were reported in Europe. One report came from a river-cruise, belonging to a ship-owner who had two other ships with outbreaks. This situation warranted onsite investigation in order to identify a potential common source of infection. A retrospective cohort study was performed among 137 people on board. Epidemiological questionnaire data were analysed using logistic regression. Stool, food, water and surface samples were collected for norovirus detection. Norovirus GGII.4-2006b was responsible for 48 gastroenteritis cases on this ship as confirmed in six patients. Identical norovirus sequences were detected in stool samples, on surfaces and in tap water. Epidemiological and microbiological data indicated multiple exposures contributing to the outbreak. Microbiological results demonstrated person-to-person transmission to be clearly present. Epidemiological results indicated that consuming tap water was a risk factor; however, this could not be concluded definitively on the basis of the available data. A common source for all cruise-related outbreaks was unlikely. The ongoing outbreaks on this ship demonstrated that evidence based guidelines on effective disinfection strategies are needed.
Interstitial pneumonitis with autoimmune features (IPAF): a work in progress
Authors: Fabrizio Luppi, Athol U. Wells
Journal: European Respiratory Journal (2016)

In clinical practice, it is common to encounter patients with an "idiopathic" interstitial pneumonia (IIP) associated with features suggestive of, but not diagnostic for, a classical connective tissue disease (CTD). In some cases, serological abnormalities are absent and in other cases, serological findings are suggestive of a specific CTD, but systemic clinical features are not. Alternatively, thoracic radiological or histopathological features are compatible with or highly suggestive of an underlying CTD, but diagnostic criteria built on serological and systemic clinical findings are not met. In suspected idiopathic pulmonary fibrosis (IPF), in particular, the designation of an underlying autoimmune process has profound management implications. The medical literature is punctuated by statements and series exploring aspects of this demi-semi-syndrome, variously termed "undifferentiated CTD associated interstitial lung disease" (UCTD-ILD), "lung-dominant CTD" and "autoimmune-featured ILD" [1–4]. However, the absence of standardised criteria has hindered progress and a new beginning was necessary. In a recent European Respiratory Society/American Thoracic Society research statement [5], the term "interstitial pneumonia with autoimmune features" (IPAF) was proposed to describe the presence of a combination of features from any two of three domains: a clinical domain, consisting of specific extrathoracic features; a serological domain, consisting of specific autoantibodies; and a morphological domain, consisting of specific chest imaging, histopathological or pulmonary physiological features. For the IPAF definition to be accepted, it needs to be shown to add information on the likely future disease course <http://ow.ly/10zy1P>
Avenues of Approach to the Gastric-Cancer Problem
Authors: Morris K. Barrett, M. D.
Journal: JNCI Journal of the National Cancer Institute (1946)

Journal Article Avenues of Approach to the Gastric-Cancer Problem Get access Morris K. Barrett, M. D. Morris K. Barrett, M. D. senior biologist National Cancer Institute, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 7, Issue 3, December 1946, Pages 127–157, https://doi.org/10.1093/jnci/7.3.127 Published: 01 December 1946 Article history Received: 20 November 1946 Published: 01 December 1946
Out of the Blue
Authors: Christopher J. Gibson, Kathryn A. Britton, Amy Leigh Miller, Joseph Loscalzo
Journal: New England Journal of Medicine (2014)

A 55-year-old man with a history of heart failure presented to the emergency department with pain and swelling of his right foot and leg, which began 3 days earlier. On the day of presentation, he noted new dusky discoloration of his right toes.
Auditory hallucinations and subvocal speech in schizophrenic patients
Authors: P A Bick, M Kinsbourne
Journal: American Journal of Psychiatry (1987)

Fourteen of 18 hallucinating schizophrenic patients reported that the voices they heard went away when they undertook a maneuver that precluded subvocalization. The same applied to 18 of 21 normal subjects who hallucinated under the influence of hypnotic suggestion. Control maneuvers had no such effect. The authors suggest that auditory hallucinations may be projections of schizophrenic patients' verbal thoughts, subvocalized due to deficient cerebral cortical inhibition.
Cocarcinogenic Action of Aspirin on Gastric Tumors Induced by N-Nitroso-N-methylnitroguanidine in Rats1
Authors: T H Chang, Y C Lee, K Y Lee, C H Sun, Y P Chang
Journal: JNCI Journal of the National Cancer Institute (1983)

Albino rats (noninbred) were divided into 4 groups: 1) 56 control rats, 2) 40 rats fed 1 ml aspirin suspension (40 mg/ml) twice a week, 3) 20 rats given N-nitroso-N-methylnitroguanidine (MNNG) solution (250 micrograms/ml) to drink ad libitum, and 4) 40 rats given both aspirin and MNNG. In 18 months, there were no gastrointestinal tumors in groups 1 and 2, 8 cases of gastric tumors in group 3, and 37 cases of gastric tumors in group 4. Adenocarcinomas of the glandular stomach were found in 21 of 40 rats in group 4 but in only 4 of the 20 rats in group 3; the difference in incidence was significant. Histologic and electron microscopic examination of the epidermoid carcinomas and adenocarcinomas in group 4 showed no difference from such tumors induced by MNNG only. Hyperplasia of the forestomach mucosa and hyperplasia of the pyloric gland region of the glandular stomach in group 4 were more severe.
Authors’ reply to Upton
Authors: Susan J Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodgers, Anthony J Avery, Darren M Ashcroft
Journal: BMJ (2015)

In response to Upton, the Clinical Practice Research Datalink (CPRD) includes limited anonymised information on the characteristics of health professionals.1 2 Sex and role are available and information on consultation volumes can be extracted. Data on GP density, full time equivalents, or other staff characteristics are unavailable. Such data are available nationally but cannot be linked to the practices in CPRD, which are anonymous. In …
First detection of tick-borne “Candidatus Neoehrlichia mikurensis” in Denmark 2011
Authors: M E Fertner, L Mølbak, T P Boye Pihl, A Fomsgaard, R Bødker
Journal: Eurosurveillance (2012)

This is the first reporting of the tick-borne zoonotic bacterium “Candidatus Neoehrlichia mikurensis” in Denmark. A total of 2,625 Ixodes ricinus ticks from 58 locations in Denmark were collected and analysed for “Ca. Neoehrlichia mikurensis”. A nested PCR revealed the presence of the bacterium at three geographically separate locations, which indicates that it is widely established in ticks.
Final results of the randomized phase II study of sequential docetaxel and irinotecan with infusion 5-fluorouracil/folinic acid in patients with advanced gastric cancer - GA-TAC
Authors: P. A. Lind, M. Gubanski, A. Johnsson, E. Fernebro, P. Flygare, I. Karlberg, L. Kadar, B. Glimelius
Journal: Journal of Clinical Oncology (2008)

4579 Background: The optimal chemotherapy combination in patients with metastatic gastric adenocarcinoma (GA) is yet to be determined. We compared two newer drugs, docetaxel (arm T) and irinotecan (arm C), in combination with infusion 5-Fu/lv sequentially and randomly assigned 81 patients to start with either of the two. Methods: Patients with biopsy proven, previously untreated locally advanced or metastatic GA, measurable lesions (RECIST), good performance status (KPS ≤2), and adequate haematological, renal and liver functions were randomly assigned to start with four courses of docetaxel 45 mg/m2 (arm T) or irinotecan 180 mg/m2 (arm C) with 44h-infusion 5-Fu/lv (d1 q 2 w). Radiological evaluations were conducted at base line and after four courses, ie at the switch of combinations, and at 16 weeks, ie at the conclusion of the 2nd drug combination. Changes in the levels of 10 different tumour markers were similarly monitored as well as SAE (CTC-criteria) and QOL (EORTC QLQ-C30). Results: Presently, all patients are accrued and evaluated for response after 8 weeks’ of treatment with either T or C and after completion of both combinations. CR, PR, SD, PD were seen in 0(2), 14(12), 13(7), 8(9) and 0(0), 17(17), 11(10), 9(5) cases after 8 weeks (16 weeks) in arm T and C, respectively (P>0.05). Median overall survival (OS) for both groups were 10.5 mos and there was no statistical difference between the survival curves of the two study arms (log-rank test: P>0.05). Conclusions: This is the first randomised comparison of two of the newer drugs in GA-therapy. No statistical difference favouring either arm T or C was found with respect to RR or median OS. The median OS of > 10 mos indicates that the sequential adminstration of the two newer combinations is effective and similar as for the ECF/EOX-combinations. The final analyses of the secondary end points progression free survival, rates of SAE and differences in QOL will be presented at the meeting. No significant financial relationships to disclose.
Cyclic AMP signal transduction in posttraumatic stress disorder
Authors: B Lerer, R P Ebstein, M Shestatsky, Z Shemesh, D Greenberg
Journal: American Journal of Psychiatry (1987)

Cyclic adenosine 3',5'-monophosphate (cAMP) signal transduction was examined in lymphocytes and platelets obtained from patients with posttraumatic stress disorder. Intact lymphocytes from the posttraumatic patients (N = 10) showed significantly lower basal, isoproterenol-, and forskolin-stimulated cAMP levels than those from 10 healthy control subjects. In platelet membrane preparations, basal, forskolin-, aluminum chloride plus sodium fluoride-, and prostaglandin E1-stimulated adenylate cyclase activity levels were all significantly lower in the posttraumatic group than in the control group. The authors discuss the potential role of their findings as a biological marker for posttraumatic stress disorder.
Treatment of Pemphigus with Corticosteroids
Authors: M J COSTELLO, L JAIMOVICH, M DANNENBERG
Journal: JAMA (1963)

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SAT0305 Determinants of Erectile Dysfuction in Patients with Gout:
Authors: J.W. Lee, S.G. Lee, G.T. Kim, E.K. Park, H.O. Kim
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Erectile dysfunction (ED) is prevalent among men with a variety of chronic medical conditions, including obesity, alcohol use, age, diabetes and cardiovascular disease. ED is caused by many factors such as psychogenic and organic (arteriogenic, cavernosal, neurogenic, anatomic and, endocrinologic) impairment. Gout is the most common inflammatory arthritis associated with subclinical endothelial dysfunction. <h3>Objectives</h3> We investigated the status of ED in patients with gout who were using uric acid lowering agents and did not developed a flare-up, compared to healthy controls and studied correlation of ED with brachial-ankle pulse wave velocity and medical conditions of patients with gout. <h3>Methods</h3> In this cross sectional study, total 208 male subjects were enrolled. Patients with well controlled gout (n=120) and health check-up controls (n=87). Erectile function was assessed by the International Index of Erectile Function (IIEF5) questionnaire. We checked brachial-ankle pulse wave velocity (baPWV), ankle brachial pressure index (ABI), heart rate variability (HRV) calculated by spectral analysis (high frequency (HF) and low frequency (LF)) and laboratory tests. <h3>Results</h3> There was no significant difference in age, weight, smoking, alcohol, blood pressure, serum uric acid and HRV variables between patients group and healthy control group. In IIEF total score, control group was higher than gout patients (17.9±0.7 Vs 14.1±0.5, p&lt;0.001). In patient group, IIEF total score 5 to 11, moderate to severe ED percent was higher than control group (34.3% Vs 11.4%, p&lt;0.001). In moderate to severe ED group, age, duration of gout, and baPWV were higher than none or mild ED group (Table). In univariate and multiple logistic analysis for the prediction of ED, age (over 60), PWV (over 1550) represented high odd ratio (10.526, 7.152 respectively, p&lt;0.001). After adjusted other variable factors, age and PWV were also independently associated with ED. <h3>Conclusions</h3> The prevalence of ED is higher in patients with gout. Moderate to severe ED is associated with age, duration of gout, baPWV. Age and baPWV are independently associated with ED. The result of baPWV that assesses arterial stiffness is significantly correlated with ED for patients with gout <h3>Disclosure of Interest</h3> None declared