tbuckley/cabot-search huggingface dataset:
Upper GI Bleeding in Cirrhotic Patients: Which Method to Search for Helicobacter Pylori Infection?
Authors: Rinaldo Pellicano, Marilena Durazzo
Journal: Hepatology (2018)

To The Editor In a recent article, Ardevol et al. showed, in a multicenter cohort study, that patients with cirrhosis and acute peptic ulcer bleeding (PUB) had a survival rate similar to those with variceal bleeding. Few patients in both groups died from uncontrolled bleeding, which is the cause of death usually related to liver failure or comorbidities. The authors reported that among patients with PUB, the latter was related to Helicobacter pylori (H. pylori) infection in 29% of cases.1 We agree with the authors that H. pylori, the main cause of peptic ulcer and often of PUB in noncirrhotic patients, has a minor role in the case of cirrhosis.2 However, the importance of preventing partially or completely peptic ulcer recurrence, with or without rebleeding, renders the search for H. pylori mandatory. The methods to diagnose H. pylori infection can be classified as invasive or noninvasive, the former being based on biopsy specimens obtained at endoscopy. The choice of the test depends on the clinical context. Usually, during active bleeding, biopsy samples are obviously not collected. The Maastricht V/Florence Consensus Report highlights that serology, in conditions like bleeding, which may lead to a low bacterial load in the stomach and to a decreased sensitivity of all diagnostic methods, can be the optimal option.3 Because in the paper by Ardevol et al., it is unclear which method has been used to diagnose H. pylori infection, we believe that this important information will further enrich their interesting work. Potential conflict of interest Nothing to report.
Timing of Gastrointestinal Bleeding After Implantation of Left Ventricular Assist Devices Associates With Anatomic Location, Presentation, and Management
Authors: James H. Tabibian, Daniel P. Rhoades, Kimberly A. Forde, Rhondalyn C. McLean, Vinay Chandrasekhara
Journal: Clinical Gastroenterology and Hepatology (2018)
AB0245 Performance of the eular definition of arthralgia suspicious for progression to rheumatoid arthritisin combination with musculoskeletal ecography with doppler (USMD) in clinical practice
Authors: J. Calvo Gutiérrez, I.C. Aranda-Valera, M.A. Sastre Dominguez, R. Ortega Castro, M.C. Castro Villegas, A. Escudero Contreras, E. Collantes Estevez
Journal: Annals of the Rheumatic Diseases (2018)

Background: The MBDA score, based on 12 serum proteins, is a validated tool for assessing disease activity in RA patients.MBDA biomarkers may be influenced by age, sex and adiposity.Objectives: To develop and validate an adjusted MBDA score that accounted for these three factors, using BMI or serum leptin as proxies for adiposity.Methods: The MBDA score as a continuous variable was adjusted to account for age, sex and a proxy for adiposity (serum leptin) using data from 325,781 RA patients for whom MBDA tests had been ordered as part of routine care.Leptin values came from the MBDA test.As an alternative to using leptin to adjust for adiposity, a cohort of 1411 patients from 5 studies/registries (BRASS, Corrona-CERTAIN, InFoRM, OPERA, RACER) was used to adjust for BMI, which was not available in the larger cohort, adding this BMI adjustment to that for age/sex from the larger cohort.Both types of adjusted MBDA score use the low, moderate, and high disease activity cutpoints of the original MBDA score.The two adjusted MBDA scores and other variables were evaluated for the prediction of radiographic progression (RP) in the 2 cohorts with available data (OPERA, BRASS) using univariate and multivariate linear regression analyses.Rate of RP was assessed as the change in modified total Sharp score (DmTSS) per year after MBDA testing. Results:The MBDA score increased with age, BMI and leptin concentration.In univariate analysis of the combined OPERA and BRASS cohorts (n=555), the significant variables predicting DmTSS were leptin-adjusted MBDA score, seropositivity for RF or anti-CCP, BMI-adjusted MBDA score, MBDA score, BMI, CRP, baseline mTSS, disease duration, DAS28-CRP, SDAI, CDAI and DAS28* (table 1).The leptin-and BMI-adjusted MBDA scores were the first and third most significant univariate predictors of DmTSS.To compare them directly, DAS28-CRP, MBDA score, BMI-adjusted MBDA score and leptin-adjusted MBDA score were combined in pairs in regression analyses of DmTSS; the BMI-adjusted (p=0.0027) and leptin-adjusted MBDA score were significant (p=0.00063)after adjusting for DAS28-CRP (p=0.87 and 0.74, respectively) and the leptin-adjusted MBDA score was significant (p=0.024 and 0.020, respectively) after adjusting for either the MBDA (p=0.32) or BMI-adjusted MBDA scores (p=0.094).
SAT0355 The validity of gout diagnosis in primary and secondary care – results from a patients survey
Authors: A.J. Landgren, L.T.H. Jacobsson, U. Bergsten, M.I. Dehlin
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Gout affects 1%–2% of adults worldwide being the most common inflammatory arthritis and usually managed in primary care. The gold standard for definitive diagnosis of gout is the presence of monosodium urate crystals (MSU) in joints or tissues and the latest classification criteria from ACR-EULAR also have this as a central item. Microscopy is however seldom performed in primary care today. Although not intended as diagnostic there are several classification criteria, such as the Mexico and the Netherlands criteria that do not include microscopy. <h3>Objectives</h3> The aim of this study was to validate the diagnosis of gout in primary and secondary care according to the Mexico and the Netherlands criteria and items thereof through a patient survey. <h3>Methods</h3> All patients above 18 with an ICD10-diagnosis of gout at a visit in primary and secondary care<sup>Jan 2015</sup> through February 2017) were identified from 12 primary care centres and one rheumatology clinic within the Western Sweden Health Care Region. They were sent a questionnaire regarding comorbidities, demographics and gout characteristics. To test the validity of their gout diagnosis, questions of the two gout classification criteria Mexico and the Netherlands were posed. Self-reported knowledge about having gout, was included as an anchor point for the diagnosis. Positive predictive values (PPV) were calculated for these definitions. Structured telephone interviews collecting similar information were performed in 10% of non-responders. The ACR/EULAR criteria was not used, since it includes identification of MSU crystals and imaging as central items. <h3>Results</h3> 1589 individuals with a gout diagnosis were identified. 868 (54.6%) individuals responded. Mean age was 71 years and the proportion of men was 80%. 89% of secondary care patients had ever been treated with Allopurinol compared to 71% in primary care. The PPVs ranged from 78.5% to 94%, in secondary care, being lowest for the Netherlands criteria and highest for self-reported gout (table 1). Corresponding PPVs were marginally lower in primary care (but still over 70% for all criteria). Similar results were found among those interviewed by telephone (not shown). <h3>Conclusions</h3> The majority of patients diagnosed with gout in both primary and secondary care have had clinical symptoms compatible with the Netherlands and Mexico criteria for gout. Diagnoses of gout identified through health care registers is therefore a valid and useful tool for epidemiological research. Patients with gout in secondary care reported more features of gout than patients in primary care. <h3>Disclosure of Interest</h3> None declared
Annals Consult Guys – Talking to Our Patients About Firearm Injury
Authors: Geno J. Merli, Howard H. Weitz
Journal: Annals of Internal Medicine (2018)

Web Exclusives19 June 2018Annals Consult Guys – Talking to Our Patients About Firearm InjuryFREEGeno J. Merli, MD and Howard H. Weitz, MDGeno J. Merli, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this author and Howard H. Weitz, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W18-0011 SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Drs. Merli and Weiss (the Consult Guys) and their expert guest address the questions of a viewer who wants to help his patients' risks for firearm-related harms but is not sure how to talk about firearms or whether it is legal.For more videos from and information on Annals Consult Guys, visit go.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment Gerardo Maradiaga MD FACPHalifax medical specialists22 June 2018 Consult guys Thank you for this thoughtful discussion about this important topic. You have added clarity about how ro approach this issue. I am glad you are back. I am a big fan Author, Article, and Disclosure InformationAffiliations: Thomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Disclosures: Geno J. Merli, MD, reports the following: Research grants/contracts: Bristol-Myers Squibb, Bayer. Howard H. Weitz, MD, reports that he has no financial relationships or interests to disclose. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 19 June 2018Volume 168, Issue 12Page: CG1KeywordsDisclosureFirearm injuriesResearch grantsResearch reporting guidelines ePublished: 19 June 2018 Issue Published: 19 June 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.Loading ...
Secondhand smoke exposure and asthma outcomes among African-American and Latino children with asthma
Authors: Andreas M Neophytou, Sam S Oh, Marquitta J White, Angel C Y Mak, Donglei Hu, Scott Huntsman, Celeste Eng, Denise Serebrisky, Luisa N Borrell, Harold J Farber, Kelley Meade, Adam Davis, Pedro C Avila, Shannon M Thyne, William Rodríguez-Cintrón, José R Rodríguez-Santana, Rajesh Kumar, Emerita Brigino-Buenaventura, Saunak Sen, Michael A Lenoir, L Keoki Williams, Neal L Benowitz, John R Balmes, Ellen A Eisen, Esteban G Burchard
Journal: Thorax (2018)

Background Secondhand smoke (SHS) exposures have been linked to asthma-related outcomes but quantitative dose–responses using biomarkers of exposure have not been widely reported. Objectives Assess dose–response relationships between plasma cotinine-determined SHS exposure and asthma outcomes in minority children, a vulnerable population exposed to higher levels of SHS and under-represented in the literature. Methods We performed analyses in 1172 Latino and African-American children with asthma from the mainland USA and Puerto Rico. We used logistic regression to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalisations, emergency room visits or oral steroid prescription) in the previous year and asthma control. The shape of dose–response relationships was assessed using a continuous exposure variable in generalised additive logistic models with penalised splines. Results The OR for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with &lt;0.05 ng/mL, was 1.40 (95% CI 1.03 to 1.89), while the OR for poor asthma control was 1.53 (95% CI 1.12 to 2.13). Analyses for dose–response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposures. Conclusions Exposure to SHS was associated with higher odds of asthma exacerbations and having poorly controlled asthma with an increasing dose–response even at low levels of exposure. Our results support the conclusion that there are no safe levels of SHS exposures.
AB0668 Treatment of thrombotic events in behÇet disease: a systematic literature review
Authors: I. Janta, R.D. Gonzalez Benitez, B. Serrano Benavente, I. Monteagudo Saez
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Behçet's disease (BD) is a systemic disease which etiopathogenesis is largely unknown. It is characterised by a wide variety of clinical manifestations. Venous disorder is a serious manifestation being potentially life-threatening. There is little evidence on the management of the venous complications in BD. <h3>Objectives</h3> To perform a systematic literature review on the treatment used in venous thrombotic events in BD. <h3>Methods</h3> The objective was reformulated according to the PICO approach. Several synonyms for the main components (i.e. Behçet, thrombosis, treatment) were used. Search limits were applied for humans. The literature search was performed in Medline and Embase from databases inception to 1st November 2017. Only articles in English and Latin languages were retained. We excluded abstracts, reviews and letters. From the selected studies, data about the venous involvement and treatments were retired using a predefined data collection form. <h3>Results</h3> The literature search resulted in 1552 articles, of which 632 were captured in Medline and 920 in Embase. Figure 1 shows the study flow-chart for article selection. The main reasons for article exclusion after full-text review were the lack venous involvement and the lack of explanation of venous involvement treatment. 28 articles reporting 1904 patients were included in qualitative analysis. The mean (range; SD) duration time between the disease onset and the vascular onset was evaluated in 15 articles and was 4.9 (1.2–9.3; 2.7) years. Superficial thrombosis was evaluated in 6 (21.4%) articles, profound thrombosis in 19 (67.9%) articles, cerebral in 7 (25%), inferior or superior cava vein in 15 (53.6%) and Budd-Chiari syndrome in 8 (28.6%) articles. Table 1 shows the treatments described in the selected articles. Treatment response was evaluated in 20 (71.4%) articles; in 7 of these treatments response was evaluated in a subjective way. In total, 52 (2.7%) deaths were reported in relation to BD. In 319 (16.7%) patients, partial efficacy or recurrence of thrombosis was reported. Considering the heterogeneity of the reported data and the variability in the measures of treatment response, predictors of mortality risk cannot be analysed. However, in the reviewed articles, a higher mortality rate was observed in in patients with hepatic involvement due to Budd-Chiari syndrome. We have also observed a higher risk for the development of venous thrombosis in patients with patergia phenomenon and male sex. Two studies suggested that immunosuppressive treatment concomitant with anticoagulant treatment is associated with a lower risk of thrombosis relapse compared with anticoagulant treatment alone. <h3>Conclusions</h3> There is a great variability in the treatment of venous thrombosis related to Behçet's disease. Budd-Chiari syndrome seems to be related to a worse prognosis of the disease. <h3>Disclosure of Interest</h3> None declared
Abstract 462: Activation of Akt2 by Apolipoprotein E Protects ATP-binding Cassette A1 From Degradation
Authors: Hong Yang, Emmanuel U Okoro, Zhongmao Guo
Journal: Circulation Research (2016)

We previously reported that lipid-free apolipoprotein E (apoE) is able to increase ATP-binding cassette transporter A1 (ABCA1) transcription by activation of a signaling cascade involving very low-density lipoprotein receptor, apoE receptor 2, disabled-1, phosphatidylinositol 3-kinase (PI3K), protein kinase Cζ, and specificity protein 1 (Sp1). Here we demonstrated that treatment of RAW 264.7 murine macrophages with human apoE3 enhanced Akt phosphorylation, and upregulated ABCA1 protein and mRNA expression. Inhibition of PI3K weakened apoE3-induced Akt phosphorylation, and reduced ABCA1 protein and mRNA levels. In contrast, inhibition of Akt only diminished apoE-induced ABCA1 protein but not significantly alter ABCA1 mRNA level. Inhibition of protein synthesis did not erase the ability of apoE3 to increase ABCA1 protein level. Further, apoE3 increased the resistance of ABCA1 protein to calpain-mediated degradation without affecting calpain activity. Treatment of 264.7 cells with apoE3 selectively enhanced the phosphorylation of Akt1 and Akt2 but not Akt3. Knockdown of Akt1 enhanced the phosphorylation of Akt2. Vice versa, knockdown of Akt2 enhanced Akt1 phosphorylation. Underexpression of Akt1 or Akt2, respectively, increased and decreased ABCA1 protein level; while overexpression of these Akt isoenzymes caused changes in ABCA1 protein level opposite to those induced by knockdown of the corresponding Akt. These data imply that apoE3 guards against calpain-mediated ABCA1 degradation through Akt2. PI3K might be a step in the signaling pathway for apoE3 to trigger Akt2. [This study was supported by NIH grants SC1HL101431].
Phospholipase PLA2G6, a Parkinsonism-Associated Gene, Affects Vps26 and Vps35, Retromer Function, and Ceramide Levels, Similar to α-Synuclein Gain
Authors: Guang Lin, Pei-Tseng Lee, Kuchuan Chen, Dongxue Mao, Kai Li Tan, Zhongyuan Zuo, Wen-Wen Lin, Liping Wang, Hugo J. Bellen
Journal: Cell Metabolism (2018)
British Thoracic Society Guideline for the initial outpatient management of pulmonary embolism (PE)
Authors: Luke S G E Howard, Steven Barden, Robin Condliffe, Vincent Connolly, Christopher W H Davies, James Donaldson, Bernard Everett, Catherine Free, Daniel Horner, Laura Hunter, Jasvinder Kaler, Catherine Nelson-Piercy, Emma O’Dowd, Raj Patel, Wendy Preston, Karen Sheares, Campbell Tait
Journal: Thorax (2018)

► Patients with confirmed PE being treated in the OP setting should be offered treatment with either low molecular weight heparin (LMWH) and dabigatran, LMWH and edoxaban or a single-drug regimen (apixaban or rivaroxaban).Grade A ► Patients with suspected PE being treated in the OP setting may be treated with apixaban or on July 24, 2023 by guest.
Programming of Multicomponent Temporal Release Profiles in 3D Printed Polypills via Core–Shell, Multilayer, and Gradient Concentration Profiles
Authors: Alexander P. Haring, Yuxin Tong, Justin Halper, Blake N. Johnson
Journal: Advanced Healthcare Materials (2018)

Abstract Additive manufacturing (AM) appears poised to provide novel pharmaceutical technology and controlled release systems, yet understanding the effects of processing and post‐processing operations on pill design, quality, and performance remains a significant barrier. This paper reports a study of the relationship between programmed concentration profile and resultant temporal release profile using a 3D printed polypill system consisting of a Food and Drug Administration (FDA) approved excipient (Pluronic F‐127) and therapeutically relevant dosages of three commonly used oral agents for treatment of type 2 diabetes (300–500 mg per pill). A dual‐extrusion hydrogel microextrusion process enables the programming of three unique concentration profiles, including core–shell, multilayer, and gradient structures. Experimental and computational studies of diffusive mass transfer processes reveal that programmed concentration profiles are dynamic throughout both pill 3D printing and solidification. Spectrophotometric assays show that the temporal release profiles could be selectively programmed to exhibit delayed, pulsed, or constant profiles over a 5 h release period by utilizing the core–shell, multilayer, and gradient distributions, respectively. Ultimately, this work provides new insights into the mass transfer processes that affect design, quality, and performance of spatially graded controlled release systems, as well as demonstrating the potential to create disease‐specific polypill technology with programmable temporal release profiles.
AB0926 Effectiveness of certolizumab pegol in psoriatic arthritis. relationship with smoking status and bmi
Authors: J. Campos Esteban, A. Conesa Mateos, M. Fernandez-Prada, R. Expósito-Molinero, P. Rubio Muñoz, J.R. Lamua-Riazuelo, P. Navarro-Alonso, P. Ahijado Guzmán, R. Garcia-Portales, A. Urruticoechea-Arana, C.M. Gonzalez Fernandez
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Previous literature have investigated that tobacco and weight in patients with psoriatic arthritis (PsA) is associated with a poorer response to antiTNF. <h3>Objectives</h3> To investigate the response and survival of Certolizumab pegol (CZP) in PsA patient in daily clinical practice according to their baseline smoking status and Body Mass Index (BMI). <h3>Methods</h3> Multicentric cohort of PsA patients treated with CZP according to routine clinical practice. This study was approved by local Ethics Committee. Maximum observation time was 12 months. Effectiveness variables: DAS28 (CRP). Survival rate: Kapplan-Meier. <h3>Results</h3> 262 patients with PsA were included: 43.5% male, mean (SD) age 49.9 (11.9) years, mean (Q1-Q3) disease duration 6.9 (1.9–9.3) years, and 14.9% of patients were HLAB27 positive. Among these, 229 (87.4%) had known smoking status (29.7% smokers and 70.3% never smokers) and 85 (32%) had known BMI (median 26.9 kg/m<sup>2</sup>, SD 4.7). Statistically significant differences in DAS28 were observed at last visit comparing to baseline in both groups according to BMI and smoking status (table 1). CZP retention rate was 78.5% in non-smokers and 76.7% in smokers. In patients with BMI &lt;25 kg/m<sup>2</sup> CZP retention rate was 78.6% compared to 78.9%in patients with BMI ≥25 kg/m<sup>2</sup> (figure 1). No statistical differences were observed in both sub-groups. <h3>Conclusions</h3> In this daily clinical practice study of patientes with PsA treated with certolizumab pegol there was a significant decrease in DAS28-CRP independent of smoking status and BMI. No differences were found in the retention rate of certolizumab pegol based on these two variables. <h3>Disclosure of Interest</h3> J. Campos Esteban: None declared, A. Conesa Mateos: None declared, M. Fernandez-Prada: None declared, R. Expósito-Molinero: None declared, P. Rubio Muñoz: None declared, J. R. Lamua-Riazuelo: None declared, P. Navarro-Alonso: None declared, P. Ahijado Guzmán: None declared, R. Garcia-Portales Consultant for: Celgene, Speakers bureau: UCB, Pfizer, Roche, A. Urruticoechea-Arana: None declared, C. Gonzalez Fernandez Consultant for: Celgene, MSD, Novartis, Janssen, Speakers bureau: UCB, Abbvie, Pfizer, BMS, Roche, Celgene, Janssen