tbuckley/cabot-search huggingface dataset:
AB0905 The efficacy of trimethoprim/sulfamethoxazole to prevent acute-onset diffuse interstitial lung diseases with connective tissue disease patients
Authors: FY Chen, K Setoguchi, M Ogawa, S Kamei
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Acute-onset diffuse interstitial lung diseases (AoDILD) are highly mortal condition and their cause are often difficult to discriminate. Trimethoprim 80mg/sulfamethoxazole 400mg single strength (TMP-SMX SS) has been used for Pneumocystis Pneumonia (PCP) prophylaxis and highly effective but the dose was originally developed in pediatric cancer patient9s study and there is possibility that in connective tissue disease (CTD) patients, less dose can be as effective. <h3>Objectives</h3> The aim of this study is to examine hypothesis that taking TMP-SMX for PCP prophylaxis with CTD also have prophylactic effect against AoDILD and how about those effect in under dose patients for some reason <h3>Methods</h3> We retrospectively investigated data from 621 patients with TMP-SMX for PCP prophylaxis during and 43 patients who admitted for either acute respiratory failure/acute interstitial pneumonia/PCP/drug induced pneumonitis during 2004–2016 in our department. <h3>Results</h3> There was no single case who admitted to hospital due to AoDILD with TMP-SMX for PCP prophylaxis. There were 34 cases admitted for AoDILD and 9 cases (26%) were dead. Among 25 cases, 5 cases developed AoDILD after TMP-SMX cessation. 70 cases ware taking under dose prophylaxis for some reasons but there was also no AoDILD case. <h3>Conclusions</h3> Taking TMP-SMX for PCP prophylaxis may also have prophylactic effect against AoDILD. And those effect may also exist even under dose. <h3>References</h3> Hughes WT, et al.: N Engl J Med 1977;297:1419–26. <h3>Disclosure of Interest</h3> None declared
Higher adenoma detection rate with the endocuff: a randomized trial
Authors: Coty González-Fernández, David García-Rangel, Nancy Aguilar-Olivos, Rafael Barreto-Zúñiga, Adriana Romano-Munive, Guido Grajales-Figueroa, Luis Zamora-Nava, Félix Téllez-Avila
Journal: Endoscopy (2017)

Abstract Background and study aim Different techniques have been introduced to improve the endoscopist’s view and enhance the detection of polyps. The endocuff is a polymer sleeve cap that is connected to the tip of the colonoscope in order to improve visualization of the mucosa during colonoscopy. The aim of the study was to compare adenoma detection rates (ADR) of endocuff-assisted colonoscopy and conventional colonoscopy. Patients and methods Patients 50 years or older were randomized into two groups: an endocuff-assisted colonoscopy group and a conventional colonoscopy group without the endocuff. Results A total of 337 patients were included: 174 in the endocuff group and 163 in the conventional group. The median age was 61 years (interquartile range 55 – 70 years), and 74 % were women. The ADR was higher in the endocuff group than in the conventional group (22.4 % vs. 13.5 %; P = 0.02). The mean number of adenomas was 0.30 (SD 0.25) in the endocuff group and 0.21 (SD 0.26) in the conventional group (P = 0.02). The rate of ileal intubation was lower in the endocuff group (73 % vs. 87 %; P &lt; 0.001). No serious adverse events occurred with the use of the endocuff. Conclusions Endocuff colonoscopy achieved a greater ADR than conventional colonoscopy. Trial registered at ClinicalTrials.gov (NTC02387593).
AB1169 Compensatory increase in fcΓriib expression on b cells in patients with systemic sclerosis
Authors: N Yagi, T Matsushita, Y Hamaguchi, K Takehara
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Systemic sclerosis (SSc) is a systemic autoimmune disease that is characterized by excessive fibrosis and microvascular damage. The contribution of B cells to the pathology of SSc has been mainly recognized as polyclonal B cell activation and autoantibody production. The receptor for the Fc region of IgG (FcγRs) is member of the Ig superfamily, the members of which modulate the activation and inhibition of immune responses. FcγRIIB is the only FcγR that has an inhibitory function. Previous studies revealed that a decrease in the expression of FcγRIIB on B cells induced excessive immune responses and resulted in the development of autoimmunity. However, the expression levels of FcγRIIB on B cells in SSc currently remain unknown. <h3>Objectives</h3> We aimed to clarify how the abnormal activation of B cells involves inhibitory FcγRIIB on B cells in SSc patients. <h3>Methods</h3> Blood samples were collected from 76 SSc patients (38 limited cutaneous SSc [lcSSc], 38 diffuse cutaneous SSc [dcSSc]) and 59 healthy subjects. We evaluated the expression of FcγRIIB, CD80, CD86, and CD95 on B cell subsets. B cells were classified into five subsets depending on their surface molecular expression by flow cytometry: naïve B cells (CD19<sup>+</sup>IgD<sup>+</sup>CD27<sup>-</sup>), preswitched memory B cells (CD19<sup>+</sup>IgD<sup>+</sup>CD27<sup>+</sup>), double negative (DN) memory B cells (CD19<sup>+</sup>IgD<sup>-</sup>CD27<sup>-</sup>), switched memory B cells (CD19<sup>+</sup>IgD<sup>-</sup>CD27<sup>mid</sup>), and plasmablasts (CD19<sup>+</sup>IgD<sup>-</sup>CD27<sup>high</sup>). The mRNA expression of FcγRIIB was measured using real-time PCR. We examined the relationship between FcγRIIB expression and clinical features. <h3>Results</h3> The expression of FcγRIIB on SSc naïve B cells and DN memory B cells was significantly stronger than that on the B cells of healthy subjects (Figure 1) (p&lt;0.05 and p&lt;0.001, respectively). FcγRIIB mRNA expression on SSc B cells was also significantly stronger than that on the B cells of healthy subjects (p&lt;0.01). The expression of CD80, CD86, and CD95, activation markers on B cells, was stronger in all 5 B cell subsets, except for CD80 in switched memory B cells and plasmablasts. Patients with the stronger expression of FcγRIIB on DN memory B cells more frequently had interstitial lung disease than those with normal levels (p&lt;0.05). Cyclophosphamide pulse therapy significantly reduced the expression of FcγRIIB on preswitched memory B cells and switched memory B cells (p&lt;0.05 and p&lt;0.05, respectively). <h3>Conclusions</h3> Our results suggest that SSc B cells exhibit compensatory increases in the expression of FcγRIIB in order to suppress the abnormal activation of B cells, and the expression of FcγRIIB may be an indicator of the clinical severity of SSc. <h3>Disclosure of Interest</h3> None declared
THU0320 Different patterns of vascular involvement in PET/CT according to cranial symptoms in biopsy proven giant cell arteritis, a preliminary study
Authors: J Mestre Torres, I Navales, F Martínez, J Loureiro, S Bujan, C Pérez, M Simό, R Solans
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> GCA is the most frequent vasculitis in patients over 50 years old. It involves large vessels (LV) such as aorta, carotid, vertebral and subclavian arteries. After the development of new imaging techniques, extracranial LV involvement has been increasingly described. Past studies showed a trend in worse prognosis in those patients with aortitis at diagnosis but larger studies are needed to determine the clinical implications of these results. Correlation between symptoms at diagnosis and PET evaluation has not been done. <h3>Objectives</h3> To evaluate aortic and supraaortic involvement in a new onset GCA cohort through PET/CT. To compare aortic and supraaortic involvement in patients with and without cranial ischemic symptoms. <h3>Methods</h3> Prospective study including all newly diagnosed biopsy-proven GCA patients in 2016 according to ACR criteria. PET/CT was performed during initial evaluation. Clinical data, blood tests and PET/CT results were recorded. Ischemic symptoms included jaw claudication (JC) and visual symptoms. Analysis was made using Stata IC/14. Patients were compared according to clinical presentation (presence vs absence of ischemic symptoms) with Fisher exact test. <h3>Results</h3> 18 patients were included (63.6% were women). At diagnosis age was 77.4±8.7 years (mean ± SD). Patients presented headache (78.6%), polymyalgia rheumatica (14.3%), constitutional syndrome (42.8%), JC (42.9%) and visual symptoms (35.7%). On physical examination pulse was decreased in 78.6% of patients. Blood tests showed anemia in 71.4% with an ESR 90.41±33mm/h (mean ± SD). PET/CT was performed after (median, intercuartilic range) 6.5 days (2 - 10 days). Analysis of vascular uptake was semiquantitative. Aortic involvement was present in 42.9% of patients. Supraaortic and vertebral arteries were involved in 42.8%. Baseline characteristics were similar to other cohorts. At the time of diagnosis, proportion of aortitis was significantly lower (p=0.049) in patients with ischemic symptoms when compared to those without. We could not find any differences between these two groups when analyzing the presence of increased vascular uptake in carotid and vertebral arteries. Limitations of the study are the small size of the cohort and the variability of the PET/CT protocols among literature. However, we think this study is important because it shows the differences between these two subgroups of GCA. <h3>Conclusions</h3> In this study, patients with cranial ischemic symptoms showed less involvement of large vessels when compared to those GCA patients that presented with systemic symptoms. These results suggest that there may be different physiopathological subsets leading to GCA. Further studies are needed to better understand these mechanisms. <h3>Disclosure of Interest</h3> None declared
AB0297 Treatment with low-dose prednisone does not influence body composition during the first year of rheumatoid arthritis- a pilot study
Authors: A Raczkiewicz, O Bujakowska, A Juszkiewicz, B Kisiel, J Kur-Zalewska, M Tłustochowicz, W Tłustochowicz
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Early change in body composition is one of the risk factors of CVD in rheumatoid arthritis (RA). These changes have been atributed to inflammation and decreased physical activity. Glucocorticosteroids (GCS) reduces inflammation but may influence body composition. There is limited information about the effects of low-dose GCS on body composition in early RA. <h3>Objectives</h3> The aim of the study was to assess the presence of altered body composition in patients with early rheumatoid arthritis (eRA) and to determine whether low-dose prednisone affects body composition. <h3>Methods</h3> 65 consecutive eRA patients (49 women) aged 61±14 years were assessed at the time of diagnosis and after 12 months of treatment. All the patients had been treated with methotrexate (target dose 25–30mg/week) and tapered doses of prednisone (mean dose 4.8±3.4 mg/day). Disease activity score (DAS28), Health Assesment Questionnaire (HAQ), body mass index (BMI), waist/hip ratio, comorbidities, physical activity and smoking were recorded. Total and regional lean mass and fat mass were measured with dual energy X-ray absorptiometry (DXA). DXA measures were repeated after 12 months in 34 patients (24 women) and compared with baseline data. <h3>Results</h3> At baseline fat free mass index (FFMI; kg/m<sup>2</sup>) was below the 10th percentile of a reference population in 32% of the women and 25% of the men. Reduced FFMI correlated with baseline ESR. Fat mass index (FMI) was above 90th percentile in 28% of the women and 42% of the men. Fat mass index (FMI;kg/m<sup>2</sup>) correlated with HAQ, age and femoral BMD in women. After 12 months FFMI and FMI did not change significantly. There was no correlation between prednisone doses and the duration of prednisone treatment and changes in regional lean mass and fat mass. The decrase of FFMI (in 16 patients) was associated with higher mean ESR and lower vitamin D3 serum concentration. <h3>Conclusions</h3> Low FFMI was common in patients with eRA. The treatment with low-dose glucocorticosteroids did not influence altered body composition during the first year of eRA therapy. <h3>References</h3> Book C, Karlsson MK, Nilsson JA et al. Changes in body composition after 2 years with rheumatoid arthritis. Scandinavian Journal of Rheumatology 2011(40:2); 95–100. Schtz Y, Kyle UUG, Pichard C. Fat-free mass index and fat mass index percentiles in Caucasians aged 18–98 y. International Journal of Obesity 2002(26);953–960. Engvall IL, Brisman K, Hafström I et al. Treatment with low-dose prednisolone is associated with altered body composition but no difference in bone mineral density in rheumatoid atrhritis patients: a controlled cross-sectional study. Scandinavian Journal of Rheumatology 2010(40:3)161–168. <h3>Disclosure of Interest</h3> None declared
FRI0377 Abnormal nailfold capillaroscopy pattern is common in patients with connective tissue disease and associated with organ involvement
Authors: AM Van Roon, CC Huisman, AM van Roon, D Zhang, AJ Stel, AJ Smit, H Bootsma, DJ Mulder
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Nailfold capillary microscopy (NCM) has been shown to be associated with disease severity and internal organ involvement in non-consecutive systemic sclerosis (SSc) cohorts. NCM may help in early recognition of connective tissue disease (CTD) but it is unclear to which extent NCM abnormalities occur in several CTD and whether these are associated with organ involvement. <h3>Objectives</h3> To assess NCM in consecutive patients with Raynaud9s phenomenon (RP) and whether these are associated with signs of organ involvement. <h3>Methods</h3> NCM was assessed in consecutive patients with RP (n=759) by widefield videocapillaroscopy, according to standardized procedures at a dedicated vascular laboratory by trained and experienced technicians. The pattern was classified as normal (n=325), non-specific (n=188) or SSc pattern (early (n=106), active (n=140) or late (n=0) based on the Cutolo patterns). Potential pulmonary involvement was defined as forced vital capacity or diffusion capacity &lt;70%. Gastro-intestinal involvement as scintigraphically (Tc-99M colloid) oesophagus dysmotility. Skin involvement as puffy fingers or sclerodactyly. Patients were classified as primary RP (normal NCM and negative serology, n=226) or secondary RP (abnormal NCM and/or serology) groups: early SSc (n=195), SSc (n=40), incomplete Sjögren9s syndrome (iSS, n=5), primary SS (pSS, n=30), incomplete systemic lupus erythematodes (iSLE, n=42), SLE (n=30), mixed CTD (MCTD, n=7), rheumatoid arthritis (RA, n=15) or when not meeting criteria as other (n=169). None were diagnosed with polymyositis or dermatomyositis. <h3>Results</h3> SSc pattern was observed in 33% of patients with pSS, 17% SLE, 71% MCTD and 13% RA. Pulmonary, oesophageal and skin involvement was more frequent in secondary RP patients with an SSc pattern, even when analysing only those fulfilling definite criteria for CTD or after exclusion of early SSc and SSc patients. For secondary RP patients, absence of an SSc NCM pattern had a high negative predictive value for pulmonary (92%), oesophageal (91%) and skin (96%) involvement, while positive predictive values were low. <h3>Conclusions</h3> SSc pattern on NCM is common in CTD patients and is associated with frequent prevalence of organ involvement, even in the absence of (early) SSc. Although this was a retrospective cohort, these data underline the importance of assessing NCM in RP patients to evaluate the risk for organ involvement in CTD other than SSc, already in early disease stages. <h3>Disclosure of Interest</h3> None declared
SP0108 Herpes zoster: how to prevent, to diagnose and to treat
Authors: L Calabrese
Journal: Annals of the Rheumatic Diseases (2017)

Herpes Zoster is a major public health problem and is an infection that results from re-activation of latent varicella infection acquired most commonly naturally or more recently through immunization. The incidence of HZ is approximately twice that of the general population in patients with immune mediated inflammatory diseases (IMIDs). Underlying mechanisms are largely those which compromise cell mediated immunity and epidemiologic risks largely follow immunosenescent patterns (i.e. aging). Rheumatologists use a large variety of immunosuppressive drugs which further increase the risk of HZ and are obliged to recognize the clinical syndrome, its complications, apply effective therapy and be actively engaged in strategies to maximize immunization and prevention. This discussion will focus on recent advances in each of these areas highlighting newly described complications of HZ such as stroke and advances in vaccine development. <h3>Disclosure of Interest</h3> None declared
FRI0738-HPR Quality in rehabilitation for rheumatic and musculoskeletal diseases (RMDS): development and testing of a rmd rehabilitation quality indicator set
Authors: I Johansen, M Klokkerud, T Glott, M Larsen, K Lande, KB Hagen, I Kjeken
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rehabilitation in Norway is characterized by a lack of coordination across levels of care, and by large variations in content and quality. A means to monitor the quality of care is to use quality indicators (QI), which are related to structure (the settings in which care is given), process (what is actually being done) or outcome of health care. <h3>Objectives</h3> To develop and test a set of quality indicators for rehabilitation of people with RMDs. <h3>Methods</h3> The QI set was developed following the Rand/UCLA Method and pilot-tested for validity and feasibility in 29 specialist and primary care rehabilitation units. Pass rates were recorded in telephone interviews with managers of the rehabilitation units (structure QIs (yes/no)), or patients (process and outcome QIs (yes/no)). Time use and participants rating of face validity on a numeric rating scale (0–10, 10=high validity) were recorded. Separate QI pass rates and summary QI pass rates were calculated. <h3>Results</h3> A total of 164 patients (mean (SD) age 58.5 (16.5) years and 76% women) participated. Mean (range) validity score for managers/patients was 8.3 (8)/7.9 (9), and mean answering time was 6.0/5.5 minutes. A 100% summary pass rate was reached by only two of the rehabilitation units and 4% of the patients. <h3>Conclusions</h3> To our knowledge this is the first QI set developed to measure QI pass rates for rehabilitation of RMDs. The results indicate that the QI set is acceptable to respondents, and it9s validity and feasible format make it suitable for monitoring quality of rehabilitation. The large variety in pass rates suggests a high potential for quality improvement in rehabilitation. <h3>Disclosure of Interest</h3> None declared
SAT0454 Finger flexor tendon pulley complex involvement in psa: an high resolution ultrasonographic study
Authors: I Tinazzi, A Marchetta, D Chessa, D Mc Gonagle, P Macchioni
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Psoriatic Arthritis (PsA) is often associated with hand involvement including synovitis and tenosynovitis and dactylitis. At the micro anatomical level PsA is strongly linked to disease localisation to entheses and other sites of high mechanical stressing. Recently high resolution MRI has shown prominent abnormalities at the mini-entheses of the flexor tendon pulleys, a site of high physical stressing during finger flexion <h3>Objectives</h3> This study tested the hypothesis that sonographic abnormalities were common at the hand flexor tendon mini-entheses in PsA including the A1, A2 and A4 in patients without active hand arthritis or dactylitis at the moment of ultrasound (US) scanning <h3>Methods</h3> Consecutive patients affected by psoriasis (PsO) (23 cases), PsA (17) and healthy controls (HC) (19) were collected. The demographic charateristics are shown in Table 1. The cases were matched for sex, age and BMI. We excluded PsA patients with active arthritis or dactylitis at the moment of US study, the majority being under therapy with conventional DMARDs. The 2nd to 4th flexor tendons of the dominant hand were scanned with a high resolution linear probe (10–22 MHz) using an Esaote MyLab Twice machine. The sonograrapher was expert in muscolo skeletal ultrasound (MSKUS) and was blinded to the clinical details.The following changes were scored: tenosynovitis, A1, A2 and A4 pulley tendon thickness and pseudotensynovitis (peritendinous oedema). Pulleys were explored with transverse e longitudinal scan <h3>Results</h3> The A1, A2 and A4 pulleys were significantly thicker in PsA compared to PsO and healthy controls measuring both longitudinal and transverse scan (table 2 shows mean±SD value of transverse measures).In PsA patients A1, A2 and A4 pulleys thickness were above than the 95th percentile of HCs values respectively in 84%,80% and 100% of cases.Considering HCs and PsA we found that having a A1 thickness over the 95th percentile of HCs shows a sensibility of 82% and specificity of 100% for PsA. Using ROC curve analysis we found that the presence of one A1 thickness over the 95th percentile of HCs have a sensibility of 82% and specificity of 100% for PsA. Peritendinous oedema evaluated scanning the palmar side of proximal and intermediate phalanx was common in PsA patients (6/17) and absent in PsO and HCs <h3>Conclusions</h3> This study suggests that PsA cases have a much higher burden of abnormalities in the mini-entheses of the flexor tendons on the hand. With the improving resolution and capabilities of MKUS these findings may be relevant to understand the involvment of flexor tendon in PsA expecially in sites with high mechanical stressing. Measuring A1, A2 and A4 thickness could be useful in detecting PsA cases without clinical signs of sinovitis or dactylitis <h3>Disclosure of Interest</h3> None declared
Gα13 ablation reprograms myofibers to oxidative phenotype and enhances whole-body metabolism
Authors: Ja Hyun Koo, Tae Hyun Kim, Shi-Young Park, Min Sung Joo, Chang Yeob Han, Cheol Soo Choi, Sang Geon Kim
Journal: Journal of Clinical Investigation (2017)

Skeletal muscle is a key organ in energy homeostasis owing to its high requirement for nutrients. Heterotrimeric G proteins converge signals from cell-surface receptors to potentiate or blunt responses against environmental changes. Here, we show that muscle-specific ablation of Gα13 in mice promotes reprogramming of myofibers to the oxidative type, with resultant increases in mitochondrial biogenesis and cellular respiration. Mechanistically, Gα13 and its downstream effector RhoA suppressed nuclear factor of activated T cells 1 (NFATc1), a chief regulator of myofiber conversion, by increasing Rho-associated kinase 2-mediated (Rock2-mediated) phosphorylation at Ser243. Ser243 phosphorylation of NFATc1 was reduced after exercise, but was higher in obese animals. Consequently, Gα13 ablation in muscles enhanced whole-body energy metabolism and increased insulin sensitivity, thus affording protection from diet-induced obesity and hepatic steatosis. Our results define Gα13 as a switch regulator of myofiber reprogramming, implying that modulations of Gα13 and its downstream effectors in skeletal muscle are a potential therapeutic approach to treating metabolic diseases.