tbuckley/cabot-search huggingface dataset:
FRI0232 Ultrasonographic features of gouty dactylitis of the hands
Authors: C.A. Guillen-Astete, B. Laso-Jimeno
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Dactylitis is a manifestation of gout that can occur on debut or throughout the course of the disease, although it is usually considered a sign of chronicity or a hallmark of long-term disease. Classically, the synovitis or tenosynovitis mediated by the deposit of microcrystals has been interpreted as an inflammatory effect due to proximity. The etiological prevalence based on imaging studies is unknown. <h3>Objectives</h3> To determine the prevalence of different ultrasonographic features of dactylitis of the hands in patients with gout. <h3>Methods</h3> A cross-sectional study was conducted based on a registry of ultrasound images of patients with gout and clinical dactylitis either in debut or throughout evolution. The selection of patients followed strictly clinical criteria based on the corresponding medical reports. All images were obtained in a medium-high gamma GE equipment and were obtained by the same operator over three years. Given that no comparisons were planned, no masking of the clinical situation of the patients was made in the eyes of the interpreter. The interpretation of findings was dichotomous in the determination of synovitis, tenosynovitis and enthesopathy according to EULAR definition criteria. The identification of tophi was made according to the definition of Avila Fernandes et al. (doi: 10.1007/s00256-010-1008-z) The overlapping of findings was counted independently at the moment of establishing the prevalence. <h3>Results</h3> We included images of 66 patients diagnosed with gout and with dactylitis of at least one finger at the time of the ultrasound evaluation. The mean age of the patients was 59.2 SD 4.3 years. Sixty-two patients were male. Of the total number of patients, 60 had tenosynovitis of the flexor tendinous apparatus (90.9%). Four of these patients also presented tenosynovitis of the tendinous extensor apparatus. No patient presented only extensor tenosynovitis. Enthesopathy was identified in 6 patients (9.1%), in no case did enthesopathy occur with power Doppler signal. Synovitis was identified in 43 patients (65.1%). Of these, in 13 patients a grade I was registered and in 26 a power Doppler signal was demonstrated. Tophi were identified in 16 patients (242%). <h3>Conclusions</h3> CONCLUSIONS: This is, as far as we know, the first iconographic study of gouty dactylitis based on ultrasound. According to our results, tenosynovitis of the flexors is the most frequent finding in gouty dactylitis while enthesopathy is rather rare. The presence of significant synovitis is the second most frequent finding while tophi as conditioning agents of synovitis were the least frequent finding. We understand that the knowledge of the echographic characteristics of gouty dactylitis can serve as a clinical guide when making therapeutic decisions in cases were this clinical sign lasts despite the control of other manifestations. <h3>Disclosure of Interest</h3> None declared
Trolleyology and the Dengue Vaccine Dilemma
Authors: Lisa Rosenbaum
Journal: New England Journal of Medicine (2018)

Trolleyology and the Dengue Vaccine Dilemma Governments in dengue-endemic regions are facing a dilemma: a new dengue vaccine could prevent many cases of severe illness, but it could simultaneously cause other cases in children previously unexposed to dengue. What is the right thing to do?
The BDNF Val66Met Prodomain Disassembles Dendritic Spines Altering Fear Extinction Circuitry and Behavior
Authors: Joanna I. Giza, Jihye Kim, Heidi C. Meyer, Agustin Anastasia, Iva Dincheva, Crystal I. Zheng, Katherine Lopez, Henrietta Bains, Jianmin Yang, Clay Bracken, Conor Liston, Deqiang Jing, Barbara L. Hempstead, Francis S. Lee
Journal: Neuron (2018)
Prostate-Specific Membrane Antigen Expression in Distal Radius Fracture
Authors: Sebastian Hoberück, Enrico Michler, Daniel Kaiser, Anne Röhnert, Klaus Zöphel, Jörg Kotzerke
Journal: Clinical Nuclear Medicine (2018)

Abstract A 79-year old man with prostate cancer under active surveillance for 5 years was referred for a PSMA-PET/MRI for re-evaluation because of a rising prostate-specific antigen value. PET/MRI revealed a ribbonlike tracer accumulation in a healing fracture of the distal radius. This case illustrates that PSMA expression may occur in healing bone fractures in the distal radius. It can be assumed that benign causes of tracer accumulations in the upper extremities are missed in PET/CT due to elevated position of the arms during image acquisition.
Physical exercise programme during pregnancy decreases perinatal depression risk: a randomised controlled trial
Authors: Marina Vargas-Terrones, Ruben Barakat, Belen Santacruz, Irene Fernandez-Buhigas, Michelle F Mottola
Journal: British Journal of Sports Medicine (2018)

Introduction The incidence of depression is high during the perinatal period. This mood disorder can have a significant impact on the mother, the child and the family. Objective To examine the effect of an exercise programme during pregnancy on the risk of perinatal depression. Methods Healthy women who were &lt;16 weeks pregnant were randomly assigned to two different groups. Women in the intervention group participated in a 60 min exercise programme throughout pregnancy, 3 days per week, which was conducted from October 2014 to December 2016. The Center for Epidemiological Studies-Depression Scale was used to measure the risk of depression at the beginning of the study (12–16 weeks), at gestational week 38 and at 6 weeks postpartum. Results One hundred and twenty-four pregnant women were allocated to either the intervention (IG=70) or the control (CG=54) group. No differences were found in the percentage of depressed women at baseline (20% vs 18.5%) (χ2=0.043; p=0.836). A smaller percentage of depressed women were identified in the IG compared with the CG at 38 gestational weeks (18.6% vs 35.6%) (χ2=4.190; p=0.041) and at 6 weeks postpartum (14.5% vs 29.8%) (χ2=3.985; p=0.046) using the per-protocol analysis. No significant differences were found using the intention-to-treat analyses, except in the multiple imputation analysis at week 38 (18.6% vs 34.4%) (χ2=4.085; p=0.049). Conclusion An exercise programme performed during pregnancy may reduce the prevalence of depression in late pregnancy and postpartum. Trial registration number NCT02420288 ; Results.
THU0484 Rebound-associated multiple vertebral fractures after discontinuation of denosumab: nine cases report
Authors: E. Fernández, D. Benavent, G. Bonilla, I. Monjo, S. García, M. Bernad, A. Balsa, P. Aguado
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Denosumab (DNB) is an IgG monoclonal antibody with high affinity for RANKL that transiently decreases bone resorption. It increases bone mineral density (BMD) and decreases turnover markers, reducing fracture risk in patients with osteoporosis (OP). Several cases of rapid loss of BMD, severe bone turnover rebound (BTR) and associated fractures have been reported after DNB discontinuation. A clinical alert has been generated from these findings. <h3>Objectives</h3> To evaluate the clinical and demographic features in a case series of patients with multiple vertebral fractures after discontinuation of denosumab. <h3>Methods</h3> An observational descriptive study analysing data from nine patients with multiple vertebral fractures after DNB discontinuation that were admitted to our Rheumatology service between 2015 and 2017. <h3>Results</h3> Nine women with postmenopausal OP that received treatment with DNB were included (table 1). Mean age at treatment onset was 66.9±8.0 SD years. Four of them had previous fragility fractures, and one of them had risk factors for secondary OP (treatment with aromatase inhibitors, case 8). Eight patients (88.9%) had already received treatment other than DNB. Mean DNB received doses was 6±1.6 SD. Mean T-score before treatment was −2.6±0.6 SD for femoral neck (FN) and −3.0±1.3 SD for lumbar spine. Mean T-score ±SD after 6 months or more of DNB discontinuation was −3.5±0.8 and −3.3±1.8, respectively. Bone turnover markers (BTM) remained elevated (CTX mean 0.143±0.663 SD ng/ml and P1NP 152.1±122.4 SD ng/ml). There were a total of 47 fractures, and all occurred spontaneously. Most affected vertebrae were D9, D12, L3 y L5. Two patients underwent vertebroplasty, suffering both of them vertebral fractures after surgery. <b>Table 1</b> Clinical features of the patients <h3>Conclusions</h3> This report of nine cases suffering multiple vertebral fractures early after the interruption of the DNB highlights the emerging concern on the subject in the scientific community and the need to clarify its pathogenic mechanism ("rebound effect") and support in solid evidence the new recommendations on its management. <h3>Disclosure of Interest</h3> None declared
Screening for Cardiovascular Disease Risk With ECG
Authors: Jill Jin
Journal: JAMA (2018)

US Preventive Services Task Force; Susan J. Curry, PhD; Alex H. Krist, MD, MPH; Douglas K. Owens, MD, MS; Michael J. Barry, MD; Aaron B. Caughey, MD, PhD; Karina W. Davidson, PhD, MASc; Chyke A. Doubeni, MD, MPH; John W. Epling Jr, MD, MSEd; Alex R. Kemper, MD, MPH, MS; Martha Kubik, PhD, RN; C. Seth Landefeld, MD; Carol M. Mangione, MD, MSPH; Michael Silverstein, MD, MPH; Melissa A. Simon, MD, MPH; Chien-Wen Tseng, MD, MPH, MSEE; John B. Wong, MD
AB0631 Is hyperhomocysteinemia (HHC) additional risk factors of thromboses in patients with systemic lupus erythematosus and antiphospholipid syndrome
Authors: T.M. Reshetnyak, N.V. Seredavkina, E.L. Nasonov, L.I. Patrushev
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> HHC may be additional factor of thrombosis in SLE patients <h3>Objectives</h3> To assess the role of HHC as additional risk factors in development of vascular complications in SLE and antiphospholipid syndrome (APS). <h3>Methods</h3> A total of 125 patients (24 M and 101 F, mean age 38±13 years and the disease duration 14±11 years) were divided into three groups: group 1 – SLE patients (n=51); group 2 – SLE +APS patients (n=49); group 3 – primary APS patients (n=25). Homocystein (HC) was assayed by high performance liquid chromatography. DNA diagnostics by the method of polymerase chain reaction was used to determine gene mutation C677T methylenetetrahydrofolate (MTHFR) reductase in 93 out of 125 patients. <h3>Results</h3> HHC (HC &gt;15 mcg/L) was diagnosed in 82 of 125 (66%) patients: in 59% patients of group 1, 67% – of group 2% and 76% – of group 3. There was a relationship between HHC and digital necrosis (DN): 80% of patients with DN had HHC while HHC was in 57% patients without DN (c<sup>2</sup>=4.76, p=0.03). Elevated level of HC was registered in 43 of 55 (78%) APS patients with thromboses vs. 9 of 19 (47%) aPL-positive SLE patients without thromboses (p=0.03). HHC occurred significantly more frequently in patients with arterial thromboses (in all 14 patients) than in patients with venous thromboses – in 16 of 23 (69.9%) pts (p=0.03) and in the absence of thromboses (p=0.04). HHC was associated with thromboses of cerebral (in 90%), peripheral arteries (in 84%) and myocardial infarction (in 79%) vs. 47% of patients without thromboses (p=0.005; p=0.04, p=0.04 respectively), (79 vs. 47%,). Mutation of C677T MTHFR was revealed in 33.3% of SLE patients, in 57.7% – of SLE +APS and in 63.2% – PAPS. Mutation C677T in the gene MTHFR was detected in 57% of examined patients, 20% of them had homozygous variant and 80% are heterozygous. Patients with a homozygous C677T MTHFR gene was observed the tendency to develop arterial thrombosis <h3>Conclusions</h3> More than 50% APS pts had elevated level of HC as additional thromboses factors. Correlation between HHC and thromboses, primarily arterial, in APS patients gives grounds for the role of HHC in development of vascular complications in SLE and APS pts. <h3>Disclosure of Interest</h3> None declared
Abstract 17063: Sleep Related Breathing Disorders and Heart Rate Variability in Young and Healthy Adults From the General Population
Authors: Stefanie Aeschbacher, Matthias Bossard, Mirco von Rotz, Tobias Schoen, Anna Maseli, Nicole Probst-Hensch, Arno Schmidt-Trucksäss, Jörg Leuppi, Martin Risch, Lorenz Risch, David Conen
Journal: Circulation (2015)

Background: The influence of sleep related breathing disorders on heart rate variability (HRV), a measure of autonomic nervous function, is not well studied. We therefore assessed the relationship of the Apnea-Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI) with 24-hour HRV in a large population of young and healthy adults. Methods: Individuals aged between 25-41 years with a body mass index ≤35km/kg2 and without known sleep apnea syndrome (SAS) or cardiovascular disease were included in the population-based GAPP-study. A 24-hour electrocardiogram (ECG) was obtained in every participant, and systematic post-processing performed with a dedicated software. The standard deviation of all normal RR intervals (SDNN) was used as main HRV marker. AHI and ODI were obtained from nighttime pulsoxymetry with nasal airflow measurements. Sleep apnea (SA) was defined as either an AHI ≥5 or an ODI ≥5. Multivariable regression models were constructed to assess the relationship of SDNN with either AHI or ODI and to adjust for a large number of confounders. Results: We included 1266 participants (47% men) with a median age of 35 years. Mean SDNN among men and women was 162 and 148ms (p&lt;0.0001), respectively. The proportion of participants with SA using an AHI- or ODI-based definition was 10 and 11%, respectively. Compared to individuals without SA, the beta coefficient (95% confidence interval (CI)) for SDNN was -7.48 (-14.75; -0.23, p=0.04) among those with an AHI-based SA definition, and was -11.45 (-18.39; -4.52, p=0.001) among those with an ODI-based SA definition. A highly significant inverse trend across different categories of AHI and ODI was observed, as shown in the Table. Conclusion: Early stages of sleep related breathing disorders are strongly associated with decreasing HRV in young and healthy adults, without evidence of a threshold. These findings suggest a tight link between sleep related breathing disorders and autonomic dysfunction.
OP0322 Are we treating with biological therapies women patients with real non-radiographic axial spondyloarthritis?
Authors: R.E. Nieto, C. Plasencia, D. Peiteado, A. Villalba, A. Balsa, V. Navarro-Compán
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> As a result of the development of the ASAS criteria for axial spondyloarthritis (axSpA), a new entity (non-radiographic axSpA –nr-axSpA) was created. In some countries major concerns have been raised with regard to this entity because this could imply administrating TNF inhibitors (TNFi) to non-SpA patients. Especially the possibility of treating women with fibromyalgia has been mentioned. <h3>Objectives</h3> To evaluate if the gender distribution and the pattern of patients have changed in clinical practice since TNFi were approved for nr-axSpA. <h3>Methods</h3> Dataset from a prospective cohort including all patients with axSpA treated with biological therapy (BT) since 2000 till August-2017 in a tertiary hospital was analysed. Patients' and disease' characteristics and disease activity parameters were collected at baseline. Based on the starting date for the first BT, patients were classified in two groups: i) before 2013 and ii) during or after 2013, since the nr-axSpA approval-date for TNFi in the country was July 2012. Gender distribution and other characteristics were compared between both groups using Chi-square and Student-t tests. <h3>Results</h3> In total, 385 axSpA patients initiated BT. Out of these, 266 initiated BT in period i) and 119 in period ii). The characteristics of patients in both groups are depicted in table 1. Importantly, no differences between period i) and ii) were observed regarding gender distribution (38% and 39% of women; p=0.8, respectively). Additionally, during period ii), the percentage of patients with nr-axSpA was similar for both genders and out of all patients with nr-axSpA, the majority (60%) were men. Overall, disease duration was shorter in period ii for both genders. Women in period ii) had significantly higher ASDAS, BASMI and CRP than women in period i) and higher ASDAS, BASDAI and BASFI than men in period ii). <h3>Conclusions</h3> In clinical practice, the frequency of women initiating BT have not increased since its approval for nr-axSpA. Additionally, women treated nowadays with BT have more objective parameters of disease activity than they used to do. This supports that when treating axSpA women (including nr-axSpA) with BT, we are currently treating axSpA -and not fibromyalgia- patients. <h3>Disclosure of Interest</h3> None declared
Letter by Su et al Regarding Article, “Carotid Stent Fractures Are Not Associated With Adverse Events: Results From the ACT-1 Multicenter Randomized Trial (Carotid Angioplasty and Stenting Versus Endarterectomy in Asymptomatic Subjects Who Are at Standard Risk for Carotid Endarterectomy With Significant Extracranial Carotid Stenotic Disease)”
Authors: Qiang Su, Ziliang Ye, Lang Li
Journal: Circulation (2018)
Abstract 12384: Novel Approach to Residual Risk, K-877, a Potent and Selective PPAR-α Modulator (SPPARMα), Added-on to Pitavastatin in Japanese Patients With Dyslipidemia
Authors: Koutaro Yokote, Shun Ishibashi, Shizuya Yamashita, Hidenori Arai, Eiichi Araki, Hideki Suganami, Tatsuhiko Kodama
Journal: Circulation (2015)

Background: Residual cardiovascular risk remains despite intensive treatment with statins. K-877, a Selective PPAR-α Modulator (SPPARMα), has shown significant reductions in atherogenic lipids with fewer adverse effects than existing PPARα agonists. We hypothesized that combination with pitavastatin may provide further reduction in atherosclerotic risk, particularly in dyslipidemic patients with hypertriglyceridemia, than statin alone. Methods: This was a multi-center double-blind parallel-group study. A total of 188 patients with fasting high TG (≥200, &lt;1000 mg/dL) and non-HDL-C (≥150 mg/dL), treated with pitavastatin (once daily, 2 mg/day) were randomized to 12-week treatment groups; placebo (n=46), twice-daily K-877 0.1 (n=45), 0.2 (n=49) and 0.4 mg/day (n=48). The primary endpoint was the percentage change in TG from baseline and incidence of adverse drug reactions (ADRs) and adverse events (AEs). Results: Fasting TG reduction was as follows; placebo: -6.9%, K-877 0.1, 0.2 and 0.4 mg: -46.1%, -53.4% and -52.0%. All K-877 groups had significant reductions compared with placebo (P&lt;0.001). Fasting non-HDL-C reductions were -5.9% with placebo and -11.3, -14.1 and -13.3% with K-877 0.1, 0.2 and 0.4 mg, respectively. Significant increase in HDL-C, and reductions in VLDL-C, remnant lipoprotein cholesterol and apoCIII compared to placebo were found in all K-877 groups (P&lt;0.01). Although K-877 had a neutral effect on total LDL-C, HPLC analysis revealed a significant reduction of very small LDL-C with K-877 compared to the placebo group (P&lt;0.05). Moreover, the highest dose of K-877 (0.4 mg/day) showed significant reduction of fasting blood glucose and HOMA-R compared to placebo (P=0.003 and 0.019, respectively). The incidence of AEs and ADRs in the K-877 groups was similar to that in placebo group. The study discontinuation rates were similar across all groups. Conclusions: K-877 significantly improved plasma lipoprotein profiles in dyslipidemia patients on stable statin treatment without increasing the rates of AEs/ADRs. Thus K-877 may be a useful therapy to reduce residual cardiovascular risk in dyslipidemia.
THU0667 Disease, work and personal related factors associated with presenteeism in patients with rheumatoid arthritis: results from the national rheumatoid arthritis society survey (NRAS)
Authors: S. Verstappen, M. Gignac, L. Lunt, D. Beaton, A. Bosworth, M. Bezzant, K. Walker-Bone
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> At-work productivity loss (i.e. presenteeism) is a major problem for patients with rheumatoid arthritis (RA) and employers and could be a marker of long-term absenteeism. To develop interventions to prevent presenteeism, a better understanding of which factors are associated with presenteeism is needed. <h3>Objectives</h3> To assess the association between disease and work related factors with presenteeism. <h3>Methods</h3> A large survey about employment amongst patients with RA was conducted in the UK using an online platform and inviting NRAS members and non-members to participate. Patients completed the multi-item Workplace Activity Limitation Scale (WALS; range 0–36 worst score), a measure of presenteeism. Other job related questions included: occupation (NS-SEC coding), job demand questions, help from colleagues (categorised into: always/often, sometimes, rarely/never) and a patient acceptable state questionnaire about work (PASS). Patients also completed the disease specific RAID questionnaire (score 0–10=worst score). Univariable and multivariable linear regression analyses were performed to assess the association between the disease and job related factors and presenteeism, adjusting for age and gender. <h3>Results</h3> 891 respondents were in paid work at the time of the survey (51.5% working for others, 33.1% self-employed and 15.4% on temporary sick leave). The majority of participants were women (91.5%) and 4.9% were aged 16–30, 69.2% 31–54% and 25.8% aged 55–74 years. Over half (51.5%) had a higher managerial, administrative or professional occupations, 33.1% an intermediate occupation, and 15.4% a routine/manual occupation. Mean (SD) RAID score was 5.2 (2.2). 58.2% rated their current job performance somewhat/much worse than before the onset of their arthritis. In univariable regression analyses greater disease activity, less control, lower support from colleagues and being in a unacceptable disease state (PASS) were associated with higher levels of presenteeism. In multivariable analysis, disease activity, ability to influence work and a unacceptable disease state remained statistically significantly associated with presenteeism. <h3>Conclusions</h3> In this large national survey in patients with RA we found that not only disease activity, but also having control, especially the flexibility to influence work and take breaks when needed, were associated with levels of presenteeism. Preventing presenteeism should therefore be aimed at managing the disease, but also toward adapting work circumstances and finding the right balance between work requirements and personal needs. <h3>Disclosure of Interest</h3> None declared
Management of congenital ichthyoses: European guidelines of care, part two
Authors: J. Mazereeuw‐Hautier, A. Hernández‐Martín, E.A. O'Toole, A. Bygum, C. Amaro, M. Aldwin, A. Audouze, C. Bodemer, E. Bourrat, A. Diociaiuti, M. Dolenc‐Voljč, I. Dreyfus, M. El Hachem, J. Fischer, A. Ganemo, C. Gouveia, R. Gruber, S. Hadj‐Rabia, D. Hohl, N. Jonca, K. Ezzedine, D. Maier, R. Malhotra, M. Rodriguez, H. Ott, D.G. Paige, A. Pietrzak, F. Poot, M. Schmuth, J.C. Sitek, P. Steijlen, G. Wehr, M. Moreen, A. Vahlquist, H. Traupe, V. Oji
Journal: British Journal of Dermatology (2018)

These guidelines for the management of congenital ichthyoses have been developed by a multidisciplinary group of European experts following a systematic review of the current literature, an expert conference held in Toulouse in 2016, and a consensus on the discussions. These guidelines summarize evidence and expert-based recommendations and intend to help clinicians with the management of these rare and often complex diseases. These guidelines comprise two sections. This is part two, covering the management of complications and the particularities of some forms of congenital ichthyosis.