tbuckley/cabot-search huggingface dataset:
AB0744 Does timing of initiation of anti-tnf agents affect the quality of life outcomes in patients with psoriasis and psoriatic arthritis?
Authors: PW Barnes, N Rich-Garg, D Choi, A Deodhar
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Psoriatic Arthritis (PsA) affects up to 30% of people with psoriasis<sup>1</sup>. While Tumor Necrosis Factor inhibitors (TNFi) are effective agents for PsA, the relationship between early treatment and patient reported outcomes in a real world setting has not been reported previously. <h3>Objectives</h3> To assess whether timely treatment with TNFi leads to better improvement in quality of life outcomes than delayed treatment. <h3>Methods</h3> This was a retrospective analysis of patients with PsA and/or Psoriasis (PsO) using TNFi with or without methotrexate, and who had a minimum of 2 visits at the Center of Excellence for Psoriasis and Psoriatic Arthritis at our university. Detailed demographic and clinical characteristics of this cohort have been published previously<sup>2</sup>. Demographics, quality of life measures (e.g. Routine Assessment of Patient Index Data – RAPID3, Psoriasis Quality of Life – PQoL12, Short Form 12 – SF-12), and clinical data (percent of body surface area involved with PsO – BSA%) were collected from patient-reported questionnaires and electronic medical records. Only those patients who had a chronological overlap of treatment exposure and QoL measures such as RAPID3, BSA, SF12 and PQOL were included. To ascertain treatment effects, a mixed-effects model was fitted to estimate the trend of each QoL outcome of a patient separately. Then, for all estimated trends of an outcome, a linear regression model was employed to explore the association between the magnitude of estimated trends and timeliness of TNFi treatments. <h3>Results</h3> The quality of life measures were not affected by how early after the disease onset TNFi treatment was started (in other words, no statistically significant associations between the effectiveness of TNFi treatment and disease duration) for RAPID3 (p=0.285), SF-12 (p=0.674), or BSA (p=0.078). For PQoL, there was a significant association between the trend of treatment effects and timeliness of treatment. A day of delay into treatment was resulted in a reduction of 4.4x10<sup>-4</sup>/day in the trend of PQoL scores (p=0.007). <h3>Conclusions</h3> In this sample of PsA &amp; PsO patients, timing of starting TNFi in patients with PsA had significant impact on improvements in the PQoL but not other quality of life measures such as RAPID3, SF-12 and BSA. A relatively short treatment history might have led to the negative correlations. <h3>References</h3> McLaughlin M, et.al. Early treatment of psoriatic arthritis improves prognosis. Practitioner 2014 258 (1777) 21–24. Truong B et.al. Demographics, clinical disease characteristics and quality of life in a large cohost of psoriasis patients with and without psoriatic arthritis. Clin, Cosm and Inv Dermatology 2015: 8: 563–569. <h3>Disclosure of Interest</h3> None declared
Children’s Health Must Remain a Focus in the Recovery From Hurricane Harvey
Authors: Aaron E. Carroll, Austin B. Frakt
Journal: JAMA Pediatrics (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
SAT0348 Association of vitamin d deficiency with reduced il10-producing regulatory b cells in systemic sclerosis
Authors: A Mavropoulos, C Liaskos, A Gkoutzourelas, CG Katsiari, DP Bogdanos, LI Sakkas
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> IL-10-producing regulatory B cells (Bregs), also known as B10 cells, are decreased and functionally impaired in patients with systemic sclerosis (SSc), particularly in those with SSc-associated interstitial lung disease (1). As serum 25-OH-vitamin D (vitD) levels are associated with clinical aspects in patients with SSc (2), we investigated whether there is any link between vitD levels and Breg levels. <h3>Objectives</h3> To assess whether or not vitD deficiency in SSc is associated with the percentages of circulating IL-10-producing Breg cells. <h3>Methods</h3> PBMCs and serum samples were isolated from 55 patients with systemic sclerosis. Serum VitD levels were measured using a commercially available sandwich ELISA kit. Phenotypic analysis of CD19, CD24, CD27, CD38 and intracellular expression of cytoplasmic IL-10 following bacterial CpG (ODN2006) and PMA/ionomycin stimulation was examined by flow cytometry using specific fluorochrome-conjugated monoclonal antibodies (BD Biosciences). <h3>Results</h3> Systemic sclerosis patients were divided into two groups (vitD deficient or not) based on a serum concentration cut off value of 20 ng/ml. The mean vitD levels in the deficient group were 14.11±3.6 ng/ml (n=17) whereas the mean vitD levels in the non-deficient group were 37.5±12.9 ng/ml (n=38). IL-10-producing B cells (B10 cells) were significantly decreased in vitD deficient patients compared to those with medium/high levels (p=0.02). CD19+CD27+ (memory) B cells were also significantly reduced in patients with VitD deficiency (p=0.004). In addition the ratio of naïve/memory B cells was significantly higher in VitD deficient patients (p&lt;0.05). Within the memory B cell fraction, the CD19+CD27+CD24hi cells also known as phenotypic memory Bregs, were mostly decreased (p=0.001). There was no significant association between CD19+CD38hiCD24hi (transitional) Bregs and VitD levels. <h3>Conclusions</h3> Our data suggest that vitamin D deficiency may account for reduced B10 cells in systemic sclerosis <h3>References</h3> Mavropoulos et al Arthritis Rheumatol. 2016;68:494–504. Arnson Y et al Autoimmun Rev. 2011;10:490–4. <h3>Disclosure of Interest</h3> None declared
SP0147 Can we prevent the onset of rheumatoid arthritis in high risk individuals?
Authors: KD Deane
Journal: Annals of the Rheumatic Diseases (2017)

Multiple studies have demonstrated that rheumatoid arthritis (RA) related biomarkers can identify individuals without inflammatory arthritis who are at high-risk for the future development of clinically apparent synovitis and classified RA. These findings have led to the development of several prevention trials in RA that have either been completed, or are underway. With these exciting developments as background, this lecture will discuss multiple aspects of RA prevention including the role of biomarkers and other factors in developing robust prediction models for future RA, and methods to identify individuals before they develop RA. In addition, this lecture will discuss specific preventive approaches to RA such as clinical trial design and choice of preventive interventions that are based on our growing understanding of the mechanisms of RA development. <h3>Disclosure of Interest</h3> None declared
AB1168 Touch study: technology and outcomes used in clinic in a day hospital
Authors: L Cunha-Miranda, C Miguel, C Silva, F Barcelos, R Marques, R Trinca, A Cardoso, J Borges, S Fernandes, H Santos, A Faustino
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Patient reported outcomes PRO are a key element in the global evaluation of patients, especially those followed in a day hospital. The use of touchscreen computers is one of the new features in the day hospital of Instituto Português de Reumatologia. <h3>Objectives</h3> to evaluate the transition from paper to touchscreen computers technology of the PRO in use in Reuma.pt <h3>Methods</h3> We considered a step up model of comparison with 2 months intervals one before the use of the touchscreen computers, one two months after the introduction of touchscreen computers and a third after an intermediate evaluation (comparison between interval 0 and 1) of the results.A specific formation to physicians and nurses to be aware of missing data from non-total completion of the questionnaires was introduced between the first and second evaluation. The percentage of questionnaires totally completed by number of patients were obtained for every period and diagnosis <h3>Results</h3> 631 day hospital appointments were evaluated according to diagnosis and interval and the percentage was obtained (Table 1) Only HADS had a significative (p&lt;0.000) improvement for every disease, with the use of the touchscreen computers from interval 1 to 2. On our intermediate evaluation comparing paper to tablet we saw a lower percentage of questionnaires fully completed (although not statistical significative) and a formal awareness formation addressing the causes was made with all the physicians and nurses of the day hospital. The PRO from Reuma.pt was not developed for tablets and some issues regarding missing data associated with that was found <h3>Conclusions</h3> The use of technology can contribute for better data in Reuma.pt and other national registries by saving time (medical and nurse) for clinical evaluation, by integrating patients in their evaluations and by cost reduction, and carbon footprint. Issues regarding the adaptability of software to tablet technology have to be addressed to insure an overall improvement. <h3>Disclosure of Interest</h3> None declared
FRI0235 Cncomitant use of intravenous methylprednisolone to obtain higher retention rate of abatacept in rheumatoid arthritis
Authors: H Sawada, M Suda, M Kishimoto, M Okada
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Abatacept (ABT) is a widely used biologic for treating rheumatoid arthritis (RA). <h3>Objectives</h3> Concomitant use of intravenous corticosteroids with ABT infusion may contribute to achieve earlier remission and higher retention rates. <h3>Methods</h3> We conducted a retrospective cohort study at St. Luke9s International Hospital, Tokyo, Japan, from January 2010 to June 2016. Patients who met the 2010 ACR/EULAR classification criteria for RA and treated with ABT were included in the study. We excluded patients who use two or more biologics prior to initiation of ABT. Our primary outcome was treatment retention rates of ABT at week 24. Secondary outcomes were changes in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) during follow-up (week 0 vs. week 8). We compared these outcomes between the patients receiving concomitant intravenous methylprednisolone (mPSL) with first 3 consecutive doses of ABT and those not receiving it. Log-rank analysis and Fisher9s exact test were applied for statistical analysis. <h3>Results</h3> 64 RA patients were included in the study. Mean age was 67.3 (± 14.2) and 55 (85.9%) were female. Among them, 13 (20.3%) received concomitant ABT with mPSL. The dosage of mPSL ranged from 30mg to 250mg (median dosage was 40mg). At week 24, the cumulative retention rates of the patients receiving mPSL (mPSL group) and those not receiving it (non-mPSL group) were 92.3% and 76.5%, respectively. There was no significant difference in the retention rates between the two groups (log-rank test, p=0.21) (figure). Changes in CRP between week 0 vs. week 8 were -1.56 mg/dl (± 2.92) in mPSL group and -1.08 mg/dl (± 2.17) in non-mPSL group (p=0.22), and those in ESR were -8.23 mm/h (± 18.40) in mPSL group and -6.61 mm/h (± 17.93) in non-mPSL group (p=0.75), respectively. <h3>Conclusions</h3> This is the first real world study to investigate whether ABT administrated with intravenous mPSL maintain higher retention rates in rheumatoid arthritis. Though there was no statistically significant difference, the retention rates of ABT at 24 weeks were higher among patients receiving ABT and mPSL concomitantly, compared with ABT mono-therapy group. It may reflect rapid improvement of the disease activity. <h3>Disclosure of Interest</h3> None declared
FRI0609 Usefulness of FDG-PET/CT imaging and serological biomarkers to predict relapse in IGG4-related disease
Authors: M Kato, H Ozaki, T Kameda, M Izumikawa, S Nakashima, H Shimada, R Wakiya, A Kondo, N Kadowaki, H Dobashi
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> IgG4-RD shows relapses frequently. It is important to search to the factors to predict relapse. Recent research has shown the usefulness of FDG-PET/CT for IgG4-RD because it is more sensitive than conventional imaging to detect organ involvement of the disease. It has been suggested that FDG-PET/CT is also useful for monitoring therapeutic response of IgG4-RD. <h3>Objectives</h3> We investigate the usefulness of FDG-PET/CT imaging and serological biomarkers to predict relapse in IgG4-RD. <h3>Methods</h3> We analyzed 24 patients with IgG4-RD treated for more than 1 year between 2008 and 2016 in our facility. The diagnosis for IgG4-RD was based on comprehensive diagnostic criteria for IgG4-RD. All cases underwent FDG-PET/CT at least once, and laboratory data were collected from their medical records retrospectively. Levels of serum C-reactive protein (CRP), eosinophil/leukocyte ratio, serum IgG, IgG4, IgA, IgM, IgE, sIL2-R and serum compliment were investigated. <h3>Results</h3> The patients had a mean age of 67.9 years (range: 50–87 years). In the cases with high FDG uptake on FDG-PET/CT, they had a greater number of organ involvements, higher serum IgG and sIL-2R levels. Eight patients experienced relapses following treatment. Higher serum IgG predicted relapses of IgG4-RD. FDG-PET/CT findings at baseline were not associated with relapse. FDG-PET/CT was performed in 13 patients after initiation of treatment and 4 patients had a relapse. There were no significant reduction of abnormal FDG uptake in 6 patients, and 4 of 6 patients relapsed. <h3>Conclusions</h3> In this study, we examined the factors to predict relapse in IgG4-RD. Patients with higher serum IgG were regarded as a risk of relapse, but FDG-PET/CT findings at baseline were not associated with relapse. FDG-PET/CT reexamined after initiation of treatment is useful to predict relapse of IgG4-RD. <h3>References</h3> Umehara H, Okazaki K, Masaki Y, et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol. 2012 Feb;22(1):21–30. Nakatani K. Utility of FDG PET/CT in IgG4-related systemic disease Clin Radiol. 2012 Apr;67(4):297–305. Zhang J, Chen H, Ma Y, et al. Characterizing IgG4-related disease with 18F-FDG PET/CT: a prospective cohort study. Eur J. Nucl Med Mol Imaging. 2014;41:1624–1634. <h3>Disclosure of Interest</h3> None declared
A cost comparison of the diagnostic modalities used in the detection of urothelial carcinoma in patients undergoing evaluation for hematuria
Authors: Songming Chen, Thomas Laroche, Darren Hamelinck, Dean E. Brenner, Jorge Marrero, Michelle Anderson, Diane Simeone, Randall Brand, Brian B. Haab
Journal: Cancer Research (2006)

1432  We have developed a new method for the detection of specific glycans on multiple proteins and have used this method to identify pancreatic-cancer-associated glycan alterations on serum proteins. Serum samples are incubated on antibody microarrays to capture multiple different proteins, and the levels of specific glycans on the captured proteins are detected using biotinylated lectins. Chemical blocking of the carbohydrate groups on the spotted antibodies prevents lectin binding to the capture antibodies. This method was used to profile specific glycan levels, using the lectins Aleuria Aurantia (AAL) and Wheat Germ Agglutinin (WGA), on 40 different cancer-related proteins in serum samples from 112 pancreatic cancer patients, 99 patients with benign pancreatic disease, and 106 healthy controls. Several antibodies bound proteins with glycan levels associated with both benign and malignant disease, and some glycan levels were unique to cancer. ELISA and western blot methods confirmed the glycosylation status of some of the proteins. Higher AAL binding, reflecting increased fucose levels, were seen on proteins such as clusterin, haptoglobin, alpha-1-antitrypsin, and kininogen, and lower fucose levels were seen on alpha-2-macroglobulin. AAL binding on proteins captured by antibodies targeting sialyl-Lewisx and O-linked N-acetyl glucosamine (O-GlcNAc) was elevated in cancer but not in benign disease. WGA binding revealed cancer-specific glycosylation on proteins containing the sialyl-Lewisa, Lewisa, and O-GlcNAc structures. About 60% of the cancer patients showed elevations in WGA-reactive sialyl-Lewisa protein, compared to almost no elevation among the control subjects or the patients with benign pancreatic disease. Glycan levels measured using additional lectins are being used to identify other alterations associated with disease, and the use of combined measurements from multiple antibodies and lectins are being used for the diagnostic classification of samples. This method provides rapid and reproducible profiling of specific glycan structures on multiple proteins, which should be valuable for biomarker development and the study of variation in glycan levels.
FRI0495 Use of melatonin in patients with psoriatic arthritis violations of emotional status
Authors: I Blaginina, O Rebrova, N Bludova, O Volman
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The ability of melatonin to reduce the activity of the sympathetic nervous system tone and of pituitary-adrenal system ensures its anti-stress properties. It can be used to reduce psycho-emotional manifestations of chronic pain in patients with psoriatic arthritis (PsA). <h3>Objectives</h3> To evaluate the effect of combined therapy with the use of melatonin on the expression of psycho-emotional disorders, and pain in patients with PsA. <h3>Methods</h3> High levels of anxiety and depressive disorders were established in the survey on Spielberger Anxiety Scale and on Hamilton Rating Scale for Depression (HRDS) in 43 patients with PsA (≥5 SJC and ≥5 TJC; CRP ≥0.3 mg/dL). The quality of life was studied by questionnaire Medical Outcomes Study Short Form (SF-36); the severity of morning stiffness, pain, patient9s health status (EWS) - using the 100-mm visual analog scale (VAS). All patients were receiving a stable dose of MTX for at least 6 months. They were divided into two groups; 1 group (n=22) additionally received 3 mg of melatonin at bedtime for 2 months of observation <h3>Results</h3> At the end of the observation period the frequency and the level of severity of depression by HRDS (p=0.0098), and the index of personal anxiety (P=0.009) in group 1 decreased. In the 2nd group above mentioned parameters have not changed. On the 1 group data of SF-36 evaluation: the physical health component has improved - the increase of RP and BP 57.4% and 37.8% from the baseline; vital activity and role functioning due to emotional state, have also increased by 35.6% and 43.5%, respectively. In the 2nd group (n=22) investigated parameters have not undergone significant changes in dynamics. In the 1 receiving melatonin group TJC and SJC have decreased by 15% and 22% (p=0.0079, p=0.0022, respectively) and their dynamics in the 2nd group was less significant (p=0.013 and p=0.017, respectively). Also, patients in group 1 have highly significant (p&lt;0.001) reduction in the severity of morning stiffness and joint pain, and in the 2nd group the changes were less significant (respectively, p=0.043, p=0.016). Positive dynamics of CRP in group 1 was more significant (p=0.003), than it was in 2 patients` group (p=0.033). <h3>Conclusions</h3> In the group of patients treated with melatonin was noted improvement in general condition (a significant improvement in the parameters of the physical components of health, reduction of depressive and psycho-vegetative disorders) and also more significant decrease of the intensity of pain and of morning stiffness duration, of TJC and SJC, than in not treated with melatonin patients. Inclusion of Melatonin in the comprehensive PsA therapy promotes not only reduction of depression symptoms and sleep disorders, but also reduces the severity of the chronic pain manifestations and, consequently, improves the quality of life of patients with this disease <h3>Disclosure of Interest</h3> None declared
Patient Commentary: Online screening for depression—old (paternalistic) wine in new (digital) bottles
Authors: David Gilbert
Journal: BMJ (2017)

When you are in mental and emotional distress, part of the agony is because the mind cannot make sense of what is happening inside or outside.1 In this situation I have wanted a diagnosis to help explain what I am going through and to give a semblance of choice and control. If what I am feeling is something others regard as real, maybe it becomes more amenable to being fixed. Diagnosis is a key that might unlock the prison cell of suffering.

On the other hand, I have also hated being given a diagnosis. Questions such as whether I’m “really” depressed ignore my wider unhappiness and what matters in my life. Diagnostic labels imprison me as a passive patient rather than consider me as a person.

So, does Google’s offer of the PHQ-9 test help to unlock or lock the prison cell? This diagnostic tool focuses on physiological and biomedical symptoms. It puts firm emphasis on dysfunction and frames distress from the outset as an illness. “Significant” scores position your problems as being amenable to doctors’ treatment. Maybe that’s fair enough, but let’s look at context.

The underpinning …