tbuckley/cabot-search huggingface dataset:
AB0487 Multicenter 24-week study to assess the efficacy and safety of tacrolimus in active rheumatoid arthritis patients
Authors: J. Hur, S. Hong, S. Kim, G. Kim, S. Choi
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatoid arthritis (RA) is characterised by persistent synovitis and structural joint damage with T cell-driven inflammation. Tacrolimus suppress activation of T cells through the inhibition of calcineurin. <h3>Objectives</h3> We evaluated the efficacy and safety of tacrolimus in Korean active RA patient who had inadequate response to disease-modifying anti-rheumatic drugs (DMARDs) including Methotrexate (MTX). <h3>Methods</h3> During the study period from Aug. 2012 to Jan. 2016 in this open labelled, multicenter study, 115 patients were enrolled with DAS28 ≥3.2. Patients received tacrolimus during 24 weeks. The initial dose was 1 mg once daily and was increased to 3 mg by every 4 weeks. The disease activity and safety was assessed. <h3>Results</h3> Data from 97 patients were evaluated in full set analysis. At week-24, EULAR response rate were 83.5% (81 of 97) with improvements from week-16 in 74.2% (72 of 97). Mean DAS28-ESR was continuously decreased of 5.64 at baseline, 4.14 (±1.22, p&lt;0.001) at week-16 and 3.66 (±1.39, p&lt;0.001) at week-24. Efficacy rates according to SDAI were 89.7% (87 of 97) and KHAQ-20 score decreased −2.42 (±4.37, p&lt;0.001) from baseline 7.27 (±4.59) at week-24. Mean ESR was decreased −10.97 (±24.16, p&lt;0.001) at week-16,–14.77 (±24.57, p&lt;0.001) at week-24 from baseline 46.05 (±23.22). Mean CRP was decreased from 2.86 (±7.85, p=0.0578) at baseline to 1.34 (±3.02, p=0.0367) at week-24. In serious adverse events (6 of 108, 5.56%), two cases (pneumonia, high glucose level) were related with tacrolimus and recovered with treatment. <h3>Conclusions</h3> This study demonstrated the efficacy of add on tacrolimus therapy to MTX in patients with active RA patients. <h3>Disclosure of Interest</h3> None declared
Family behind OxyContin named in lawsuit for the first time
Authors: Owen Dyer
Journal: BMJ (2018)

The state of Massachusetts is suing opioid maker Purdue Pharma and, for the first time, members of the Sackler family that owns the company, claiming that the drug maker violated the state’s consumer protection law by continuing to assure doctors that its flagship product OxyContin (oxycodone) had an unusually low risk of misuse when executives knew that it was being sought out by addicts.

In a suit on behalf of 670 residents of Massachusetts who took prescribed OxyContin as their first opioid and later died from an opioid overdose, the state names 16 current and former directors and executives, including Craig Landau, the current chief executive of Purdue Pharma, and eight members of the Sackler family.

“Every community in our Commonwealth suffers from the epidemic of addiction and death,” reads the legal complaint.1 “Purdue Pharma created the epidemic and profited from it through a web of illegal deceit.

“Purdue peddled falsehoods to keep patients away from safer alternatives. Even when Purdue knew people were addicted and dying, Purdue treated patients and their doctors as ‘targets’ to sell more drugs. At the top of Purdue, a small group of executives led the deception and pocketed …
AB1392 Effect of university structure on medical students’ knowledge during exam preparation
Authors: R. Sengewein, R. Brinks, G. Pongratz
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> In 2016 the German Society of Rheumatology found out that only seven faculties out of 37 could be classified as an independent rheumatological teaching unit. Amount of lecture hours and type varied largely between universities and was usually the most in universities with academic freedom. Besides the lack of lectures in rheumatology, all students have to pass a medical state examination ("Staatsexamen"), which is carried out by the IMPP ("Institut für Medizinische und Pharmazeutische Prüfungsfragen"). The written exam consists of 320 Multiple-Choice IMPP-Questions with only one correct answer out of five possible choices. Approximately five to ten questions, varying from exam to exam, also contain rheumatological content. After each exam questions are published and used by younger students for exam preparation. The e-Learning platform "Amboss" is frequently used by medical students for this reason in Germany. <h3>Objectives</h3> To investigate the effect of university structure on correct answering former IMPP-Questions during exam preparation. <h3>Methods</h3> We analysed former IMPP-Questions answered by students over a four-year period recorded on "Amboss"<sup>Oct. 2012</sup> – .<sup>Oct. 2016</sup> First time answered questions with rheumatological content from students during exam preparation were identified and extracted from the total record. Students with only a single or very few questions answered were not considered as being in exam preparation and excluded. A sensitivity analysis was done after exclusion. Students from independent (Group A) and non-independent (Group B) medical faculties were divided into two groups and investigated for the rate of correct answering IMPP-Questions. Statistical Analysis was done with the Statistical Software R (The R-Foundation for Statistical Computing; Version 3.4.1). <h3>Results</h3> A total of 176 questions with rheumatological content were identified. 32.166 students answered those questions or a subset of these (in total 2.610.217 questions). After excluding students not being in exam preparation 14.739 students were left, answering those questions 2.148.801 times. On an average 68,3% of the questions were answered correctly. The sensitivity analysis did not show a significant difference. 3330 students from Group A answered 495.614 questions, on an average 69,4% correct. 11.409 students from Group B answered 1.963.066 questions, on an average 68% correct. The difference between both groups was significant (p&lt;0.01). <h3>Conclusions</h3> Students from independent faculties answered more questions correct than from non-independent faculties. The difference was significant, but taking into account the few questions asked in the real exam the difference would have no relevance. <h3>Disclosure of Interest</h3> None declared
Development and implementation of the ACC SportSmart Warm-up programme: a nationwide sports injury prevention initiative in New Zealand
Authors: Mark L Fulcher, Isaac Carlson, Cameron Mitchell, Mario Bizzini, Jiri Dvorak
Journal: British Journal of Sports Medicine (2018)

There is an increasing body of literature showing that the risk of sustaining a sports-related injury can be substantially reduced. The best examples relate to the prevention of anterior cruciate ligament (ACL) and hamstring injuries.1–5 Multimodal programmes which incorporate aerobic, balance/proprioception and plyometric exercises are the most widely studied initiatives. One of these programmes, the 11+, was developed specifically for use in football. It has been shown to be effective in both men’s and women’s football, has been shown to improve measures of a player’s performance and has been shown to be cost-effective.2 6–8 More than 40 scientific papers have now been published demonstrating the programme’s efficacy.9 

Despite these good quality data, evidence-based injury prevention programmes are not widely implemented. Players, coaches and administrators have not widely engaged with these initiatives for a variety of reasons.9 Most current injury prevention strategies used in both recreational and professional sport are not validated and may lack efficacy.10 11

New Zealand, along with Switzerland, is often highlighted as a country where the 11+ has been successfully implemented.12 However, despite efforts to roll this programme out at a national level in New Zealand (starting in 2005), the uptake and penetration of the warm-up programme was initially relatively poor. In 2013, a survey showed that only 11% of all football players in New Zealand had ‘heard’ of the 11+ programme—meaning that the number regularly completing the programme was likely to be substantially lower than this figure.13 Despite the relatively poor uptake, the return on investment for each dollar spent on implementation was found to be NZD$8.20 for each invested dollar.12

New Zealand has a national insurance company called the Accident Compensation Corporation (ACC). This is a government-run 24-hour, no-fault insurance scheme that covers personal injury caused by accident. In …
Diabetes and Prediabetes Prevalence by Race and Ethnicity Among People With Severe Mental Illness
Authors: Christina V. Mangurian, Dean Schillinger, John W. Newcomer, Eric Vittinghoff, Susan M. Essock, Zheng Zhu, Wendy T. Dyer, Julie A. Schmittdiel
Journal: Diabetes Care (2018)

People with severe mental illnesses (SMI) such as schizophrenia and bipolar disorder have an increased risk for diabetes (1), in part due to treatment with both first- and second-generation antipsychotics (2). A large systematic review estimated that 15% of people with SMI have type 2 diabetes, a prevalence double that of age-matched samples from the general population during the same time period (1). Preliminary evidence suggests that racial/ethnic minorities with SMI may be at especially high risk for diabetes compared with whites; unfortunately, similar data regarding prevalence of prediabetes is more limited (2). Understanding of the prevalence of prediabetes and diabetes in a large, racially and ethnically diverse and representative sample is an important first step in reducing diabetes prevalence and related adverse outcomes in this particularly vulnerable population. In this study, we estimate diabetes and prediabetes prevalence among antipsychotic-treated patients within an integrated health care system and determine whether racial/ethnic differences exist.

In this retrospective cohort study of adults with SMI in Kaiser Permanente Northern California (KPNC), our primary outcome was evidence of diabetes. The cohort used for this study has been previously described (3). To estimate diabetes prevalence, the primary outcome measure was inclusion in the KPNC diabetes registry at any time before 31 December 2014 (4). To estimate our secondary outcome, prediabetes prevalence, we first excluded people who were in the …
Quantitative imaging of inflammatory disease: are we missing a trick?
Authors: Margaret A Hall-Craggs, Timothy P J Bray, Alan P Bainbridge
Journal: Annals of the Rheumatic Diseases (2018)

The role of conventional qualitative MRI is well established in the management of spondyloarthritis for assessment of inflammation and structural damage. The identification of a ‘positive’ MRI is now an important component of diagnostic pathways in spondyloarthritis.1 The role of q uantitative MRI (QMRI) is less established but offers the potential for direct measurement of disease characteristics. This approach is yielding huge benefits in fields such as oncology and neurology, where quantifiable measurements can be used to identify, stage and monitor disease. Given the influence that radiological assessment of disease burden has on treatment decisions, we argue that a quantitative imaging approach should be rigorously explored as a tool for assessment of inflammation in musculoskeletal imaging.

Typically for QMRI, a model is fitted to a series of images to yield maps of a defined physical characteristic of the tissue. Assessment can then take the form of …
Hydrocortisone plus fludrocortisone reduced mortality at 90 days in patients with septic shock
Authors: Brent A. Duran, Robert G. Badgett, Steven Q. Simpson
Journal: Annals of Internal Medicine (2018)

ACP Journal Club19 June 2018Hydrocortisone plus fludrocortisone reduced mortality at 90 days in patients with septic shockBrent A. Duran, DO, Robert G. Badgett, MD, Steven Q. Simpson, MDBrent A. Duran, DOUniversity of Kansas School of Medicine, Wichita, Kansas, USA (B.A.D., R.G.B.)University of Kansas School of Medicine, Kansas City, Kansas, USA (B.A.D., S.Q.S.)Search for more papers by this author, Robert G. Badgett, MDUniversity of Kansas School of Medicine, Wichita, Kansas, USA (B.A.D., R.G.B.)Search for more papers by this author, Steven Q. Simpson, MDUniversity of Kansas School of Medicine, Kansas City, Kansas, USA (B.A.D., S.Q.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2018-168-12-068 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationAnnane D, Renault A, Brun-Buisson C, et al; CRICS-TRIGGERSEP Network. Hydrocortisone plus fludrocortisone for adults with septic shock. N Engl J Med. 2018;378:809-18. https://pubmed.ncbi.nlm.nih.gov/29490185Clinical Impact RatingsEmergency Med: Hospitalists: Infectious Disease: Critical Care: References1 Annane D, Bellissant E, Bollaert PE, et al. Corticosteroids for treating sepsis. Cochrane Database Syst Rev. 2015;(12):CD002243. [PMID: 26633262] Google Scholar2 openMetaAnalysis Contributors. Septic shock treatment with corticosteroids. Version April 6, 2018. http://openmetaanalysis.github.io/sepsis-steroids/ (accessed 19 Apr 2018). Google Scholar3 Nguyen HB, Jaehne AK, Jayaprakash N, et al. Early goal-directed therapy in severe sepsis and septic shock: insights and comparisons to ProCESS, ProMISe, and ARISE. Crit Care. 2016;20:160. [PMID: 27364620] Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Kansas School of Medicine, Wichita, Kansas, USA (B.A.D., R.G.B.)University of Kansas School of Medicine, Kansas City, Kansas, USA (B.A.D., S.Q.S.)This article was published at Annals.org on 5 June 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHydrocortisone did not reduce mortality at 90 days in patients with septic shock Brent A. Duran , Robert G. Badgett , and Steven Q. Simpson Hydrocortisone did not reduce mortality at 90 days in patients with septic shock Brent A. Duran , Robert G. Badgett , and Steven Q. Simpson Metrics Cited byMelatonin Attenuates Sepsis-Induced Acute Lung Injury Through Improvement of Epithelial Sodium Channel-Mediated Alveolar Fluid Clearance Via Activation of SIRT1/SGK1/Nedd4-2 Signaling Pathway 19 June 2018Volume 168, Issue 12Page: JC68KeywordsFludrocortisoneForecastingIntensive care unitsMortalityRelative riskSerious adverse eventsShockSteroidsSystematic reviewsVasopressors ePublished: 19 June 2018 Issue Published: 19 June 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Toxicity of nifurtimox as second-line treatment after benznidazole intolerance in patients with chronic Chagas disease: when available options fail
Authors: C. Crespillo-Andújar, S. Chamorro-Tojeiro, F. Norman, B. Monge-Maillo, R. López-Vélez, J.A. Pérez-Molina
Journal: Clinical Microbiology and Infection (2018)
AB0217 Construct validation of the italian version of the 5-item compliance questionnaire for rheumatology (I-CQR5)
Authors: D. Azzolina, F. Ometto, B. Raffeiner, C. Botsios, M. Favero, D. Astorri, L. Friso, D. Gregori, J. Done, A. Doria
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The 5-item Compliance Questionnaire for Rheumatology (CQR5) allows the identification of patients likely to be high adherers (HA) to anti-rheumatic treatment (i.e. taking ≥80% of their medications correctly), or "low" adherers (LA).<sup>1</sup> <h3>Objectives</h3> The objective was to validate the construct of an Italian version of CQR5 in rheumatoid arthritis (RA). <h3>Methods</h3> Cross-cultural adaptation comprised: forward translation, synthesis of the translations, back-translation, expert committee assessment and field-testing. Validation was conducted administering the adapted version (I-CQR5) to RA patients (disease duration &gt;1 year, treated with ≥1 self-administered disease-modifying anti-rheumatic drug, capable of completing the questionnaire unaided) on one occasion. Questionnaires were anonymous but contained self-reported data. Construct validity and reliability were assessed with Rasch analysis (Partial Credit model Parametrisation, PCM). Martin-Loef Likelihood ratio test assessed invariance for gender, age, education, social status and disease duration. <h3>Results</h3> The adaptation process was closed by the expert committee assessment. I-CQR5 is reported in Figure 1. Among 604 patients, 274 were included in the validation process, 6 questionnaires were incomplete. Median age was 57 years (48–67), females were 201 (77%), disease duration was 13.5 years (8.8–19.3), most patients lived with partner/family (159,75%) and had a middle/secondary school education (184,69%). HA were 93 (67%) and LA 179 (35%). Factor analysis revealed ordered thresholds in most items, 2 factors were sufficient to explain variability (Chi-square=0.46,p=0.5) (Tab.1). Item-fit statistics showed overall agreement of items with parametrisation (Infit statistics=0.6–1.4; excluding item no.5). Chi-square showed agreement with PCM parametrisation by item (excluding the item no.1). Martin-Loef likelihood ratio test confirmed unidimensionality (Chi-square 65.8, df=53,p=0.11) and Separation Reliability Index confirmed internal consistency (Patient Separation Index 0.91) (Tab.1). I-CQR5 was invariant to age (Chi-square=40.6, df=28,p=0.059), education level (Chi-square=49.9, df=42,p=0.187), social status (Chi-square=10.5, df=15,p=0.79), disease duration (Chi-square=13.6, df=36,p=0.220); Martin-Loef test was significant for gender (Chi-square=25.4, df=14,p=0.031). <h3>Conclusions</h3> I-CQR5 was well understood by patients and construct validity, unidimensionality and internal consistency were confirmed by factor analysis and PCM. <h3>Reference</h3> [1] Hughes L, et al. A 5 item version of the Compliance Questionnaire for Rheumatology (CQR5) successfully identifies low adherence to DMARDs. BMC Musculoskelet Disord2013;14:286. <h3>Disclosure of Interest</h3> None declared
Helping to End Addiction Over the Long-term
Authors: Francis S. Collins, Walter J. Koroshetz, Nora D. Volkow
Journal: JAMA (2018)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Interdomain Stabilization Impairs CD4 Binding and Improves Immunogenicity of the HIV-1 Envelope Trimer
Authors: Peng Zhang, Jason Gorman, Hui Geng, Qingbo Liu, Yin Lin, Yaroslav Tsybovsky, Eden P. Go, Barna Dey, Tsion Andine, Alice Kwon, Mit Patel, Deepali Gururani, Ferzan Uddin, Christina Guzzo, Raffaello Cimbro, Huiyi Miao, Krisha McKee, Gwo-Yu Chuang, Loïc Martin, Francesca Sironi, Mauro S. Malnati, Heather Desaire, Edward A. Berger, John R. Mascola, Michael A. Dolan, Peter D. Kwong, Paolo Lusso
Journal: Cell Host & Microbe (2018)
SP0104 Indications and clinical implications of magnetic resonance imaging in spondyloarthrits
Authors: M. Østergaard
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that affects the sacroiliac joints and the spine. Whereas early disease is characterised by inflammation, severe structural damage may occur later in the disease course. Magnetic resonance imaging (MRI) can detect inflammatory lesions (bone marrow oedema (BME)/osteitis), and structural lesions (erosions, bone spurs, ankylosis and fat metaplasia). In patients suspected for axial spondyloarthritis (axSpA) in clinical practice, MRI has a key role for early diagnosis of axial SpA, since MRI is by far the best available method for early detection of inflammation in the spine and sacroiliac joints. MRI is also more sensitive and accurate for assessment of structural sacroiliac changes than conventional radiography. Differential diagnoses, including anatomical variations, degenerative disease, osteitis condensans ilii, infections and others, should of course always be considered. In patients with diagnosed axial SpA, MRI is the method of choice for sensitive objective monitoring of axial inflammation, and also peripheral inflammation and damage can be assessed. Whole-body MRI is a promising method, which may become important for simultaneous assessment of axial and peripheral disease manifestations in one examination. Furthermore, MRI can provide information which may help predict the response to therapy and the risk of subsequent progression of structural damage. The present talk will describe the indications and implications of using MRI in spondyloarthritis in the diagnosis and management of SpA, taking a starting point in the "EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice"; Mandl et al, Ann Rheum Dis 2015 74:1327–1339), the "Recommendations of the ESSR Arthritis Subcommittee for the Use of Magnetic Resonance Imaging in Musculoskeletal Rheumatic Diseases"; Sudo&amp;lstrok;-Szopi&amp;nacute;ska et al, Semin Musculoskelet Radiol 2015 19:396–411) and the recent update from The Assessment in SpondyloArthritis International Society (ASAS) MRI working group; Lambert et al. Ann Rheum Dis 2016 75:1958–1963). However, selected data from important clinical studies will also be described. <h3>Disclosure of Interest</h3> None declared