tbuckley/cabot-search huggingface dataset:
National Trends in Suicide Attempts Among Adults in the United States
Authors: Mark Olfson, Carlos Blanco, Melanie Wall, Shang-Min Liu, Tulshi D. Saha, Roger P. Pickering, Bridget F. Grant
Journal: JAMA Psychiatry (2017)

A recent increase in suicide in the United States has raised public and clinical interest in determining whether a coincident national increase in suicide attempts has occurred and in characterizing trends in suicide attempts among sociodemographic and clinical groups.To describe trends in recent suicide attempts in the United States.Data came from the 2004-2005 wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the 2012-2013 NESARC-III. These nationally representative surveys asked identical questions to 69 341 adults, 21 years and older, concerning the occurrence and timing of suicide attempts. Risk differences adjusted for age, sex, and race/ethnicity (ARDs) assessed trends from the 2004-2005 to 2012-2013 surveys in suicide attempts across sociodemographic and psychiatric disorder strata. Additive interactions tests compared the magnitude of trends in prevalence of suicide attempts across levels of sociodemographic and psychiatric disorder groups. The analyses were performed from February 8, 2017, through May 31, 2017.Self-reported attempted suicide in the 3 years before the interview.With use of data from the 69 341 participants (42.8% men and 57.2% women; mean [SD] age, 48.1 [17.2] years), the weighted percentage of US adults making a recent suicide attempt increased from 0.62% in 2004-2005 (221 of 34 629) to 0.79% in 2012-2013 (305 of 34 712; ARD, 0.17%; 95% CI, 0.01%-0.33%; P = .04). In both surveys, most adults with recent suicide attempts were female (2004-2005, 60.17%; 2012-2013, 60.94%) and younger than 50 years (2004-2005, 84.75%; 2012-2013, 80.38%). The ARD for suicide attempts was significantly larger among adults aged 21 to 34 years (0.48%; 95% CI, 0.09% to 0.87%) than among adults 65 years and older (0.06%; 95% CI, -0.02% to 0.14%; interaction P = .04). The ARD for suicide attempts was also significantly larger among adults with no more than a high school education (0.49%; 95% CI, 0.18% to 0.80%) than among college graduates (0.03%; 95% CI, -0.17% to 0.23%; interaction P = .003); the ARD was also significantly larger among adults with antisocial personality disorder (2.16% [95% CI, 0.61% to 3.71%] vs 0.07% [95% CI, -0.09% to 0.23%]; interaction P = .01), a history of violent behavior (1.04% [95% CI, 0.35% to 1.73%] vs 0.00% [95% CI, -0.12% to 0.12%]; interaction P = .003), or a history of anxiety (1.43% [95% CI, 0.47% to 2.39%] vs 0.18% [95% CI, 0.04% to 0.32%]; interaction P = .01) or depressive (0.99% [95% CI, -0.09% to 2.07%] vs -0.08% [95% CI, -0.20% to 0.04%]; interaction P = .05) disorders than among adults without these conditions.A recent overall increase in suicide attempts among adults in the United States has disproportionately affected younger adults with less formal education and those with antisocial personality disorder, anxiety disorders, depressive disorders, and a history of violence.
Glaucoma and intraocular pressure in EPIC-Norfolk Eye Study: cross sectional study
Authors: Michelle P Y Chan, David C Broadway, Anthony P Khawaja, Jennifer L Y Yip, David F Garway-Heath, Jennifer M Burr, Robert Luben, Shabina Hayat, Nichola Dalzell, Kay-Tee Khaw, Paul J Foster
Journal: BMJ (2017)

<b>Objectives</b>&nbsp;To report the distribution of intraocular pressure (IOP) by age and sex and the prevalence of glaucoma. <b>Design</b>&nbsp;Community based cross sectional observational study. <b>Setting</b>&nbsp;EPIC-Norfolk cohort in Norwich and the surrounding rural and urban areas. <b>Participants</b>&nbsp;8623 participants aged 48-92 recruited from the community who underwent ocular examination to identify glaucoma. <b>Main outcome measures</b>&nbsp;Prevalence and characteristics of glaucoma, distribution of IOP, and the sensitivity and specificity of IOP for case finding for glaucoma. <b>Results</b>&nbsp;The mean IOP in 8401 participants was 16.3 mm Hg (95% confidence interval 16.2 mm Hg to 16.3 mm Hg; SD 3.6 mm Hg). In 363 participants (4%), glaucoma was present in either eye; 314 (87%) had primary open angle glaucoma. In the remaining participants, glaucoma was suspected in 607 (7%), and 863 (10.0%) had ocular hypertension. Two thirds (242) of those with glaucoma had previously already received the diagnosis. In 76% of patients with newly diagnosed primary open angle glaucoma (83/107), the mean IOP was under the threshold for ocular hypertension (21 mm Hg). No one IOP threshold provided adequately high sensitivity and specificity for diagnosis of glaucoma. <b>Conclusions</b>&nbsp;In this British community, cases of glaucoma, suspected glaucoma, and ocular hypertension represent a large number of potential referrals to the hospital eye service. The use of IOP for detection of those with glaucoma is inaccurate and probably not viable.
OP0120 The role of smoking in the development and progression of structural damage in patients with ankylosing spondylitis: the preliminary results of a systematic review and meta-analysis
Authors: S Akar, YC Kaplan, S Ecemis, EK Arslan, O Gercik, D Solmaz
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Smoking may constitute a major risk factor for not only disease susceptibility but also disease severity in patients with ankylosing spondylitis (AS). Some previous cross-sectional and longitudinal studies suggested that smoking may be associated with cumulative spinal radiographic damage and regarded it as an independent predictor of spinal radiographic progression. <h3>Objectives</h3> The objective of this study is to determine whether smoking is associated with the cumulative radiographic spinal structural damage and radiographic progression in AS patients. In order to reach this objective, we conducted a systematic review and meta-analysis of the available studies to-date. <h3>Methods</h3> An electronic search was conducted from inception to June 21 2016 in EMBASE, MEDLINE/PubMed Cochrane Central Register of Controlled Trials databases. Cross-sectional and longitudinal cohort studies investigating the association between smoking and cumulative spinal structural damage or radiographic progression were included. The outcome of interest were the presence of syndesmophytes in cross-sectional studies and radiographic progression in longitudinal studies. Two independent reviewers carried out the screening process. The Quality assessment was done using The Agency for Healthcare Research and Quality (ARHQ) checklist and Newcastle-Ottawa scale. Authors of potential relevant studies were contacted for the unpublished data. Data from eligible cross-sectional studies were extracted and arranged in a 2x2 table. The odds ratios (ORs) and 95% confidence intervals (CIs) for the dichotomous outcome of interest were computed. Random-effects method was used to combine the outcome data in Comprehensive Meta Analysis Software Version 3.3.070. <h3>Results</h3> The combined data of eight eligible cross-sectional studies for the assessment of association between smoking and cumulative spinal structural damage suggested a significant association (OR, 2.02; 95% CI 1.51–2.70) (Figure 1). No significant heterogeneity was detected between studies (P=0.25, <i>I</i><sup>2</sup>=23.0%). The data from the longitudinal studies investigating the association between smoking and spinal radiographic progression is still been assessed. <h3>Conclusions</h3> The preliminary results of our meta-analysis showed that smoking is associated with increased cumulative spinal structural damage in patients with AS. Rheumatologists should encourage AS patients to quit smoking. <h3>Disclosure of Interest</h3> None declared
No overall increase in all cause mortality with HRT, study finds
Authors: Jacqui Wise
Journal: BMJ (2017)

The results of 18 years of follow-up should provide reassurance that there is no long term increase in all cause mortality or mortality from specific causes, such as cardiovascular disease or cancer, among women who received hormone replacement therapy (HRT) for five to seven years.1

The results of the study, published in JAMA , show that it is appropriate to offer HRT to women experiencing menopausal symptoms such as hot flushes and night sweats. However, the study found no long term reductions in all cause mortality among women who used HRT, so the results do not support using it for the prevention of cardiovascular or other chronic disease.

The effect of HRT on cancer mortality, especially breast cancer mortality, has been a subject of debate and has generated concern among women and a reluctance to prescribe among some GPs. The latest findings support the current NICE guidance published in 2015 …
THU0380 Results of a real life dose-reduction strategy for anti-tnfalpha inhibitors in a cohort of patients with spondyloarthritis
Authors: MC Castro-Villegas, P Font-Ugalde, M Romero-Gomez, M Arredondo-Lόpez, EC Lόpez-Medina, R Ortega-Castro, J Calvo-Gutierrez, A Escudero-Contreras, E Collantes-Estévez
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Published reports suggest that patients with Spondyloartrhitis (SpA) in remission under treatment with TNFalpha inhibitors (TNFi) could obtain the same benefit at lower dose of the drug. <h3>Objectives</h3> To evaluate effectiveness of a strategy of dose reduction of TNFi in SpA patients in clinical remission and to explore baseline characteristics predictive of maintenance of the response. <h3>Methods</h3> Retrospective observational study, including patients with SpA meeting ASAS criteria treated with TNFi following a dose optimization protocol (lower doses or longer intervals than aproved), from 2008 to 2015. Criteria for optimization was patients with BASDAI≤2 and/or C reactive protein level (CRP)≤5 mg/L for at least 6 months. Patients who relapsed (BASDAI&gt;2 and/or CRP&gt;5mg/L) returned to standard dose. Clinical/analytical parameters and drug9s survival time until relapse were recorded. SPSSv.17 software was used for contrast means. Survival Kaplan-Meyer curves was analysed. <h3>Results</h3> 149 SpA patients treated with TNFi, 32/149 patients (21.5%) included in optimization protocol. 27 patients (84.37%) with increased interval between doses, remaining with reduced dosification. Table 1 shows baseline characteristics of patients on optimization group (mean±SD or proportion). 18/32 patients (56.2%,IC:39.01–73.4) maintained clinical remission with optimized dose at 36.5 months (median). Table 2 shows activity parametres of both relapsed and maintained response patients. There were either baseline differences or at optimization time between patients who maintained remission and not, but relapsed patients showed higher CRP at optimization time, without statistically significant differences. 72.2% (13/18) of patients on sutained remission were naive for TNFi, although no significant difference compared to switcher patients on the median survival (31.9 vs 20.9 months, P=0.9). No baseline predictor of sustained response at optimized dose were found. CRP&lt;5 mg/L at optimization time showed a trend towards longer survival (43.4 vs 13.3 months), without differences statistically significant (p=0.09). <h3>Conclusions</h3> Optimization of TNFi in SpA is possible and allows up to half of patients to maintain clinical remission, but no baseline factors predictors of sustained response after optimization was found. <h3>Disclosure of Interest</h3> None declared
OP0132 Low-dose INTERLEUKIN-2 selectively restore regulatory T cell numbers in patients with behcet's disease
Authors: X Fu, J Li, X Li, J Luo, C Gao, Q Chen
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The lack of CD4<sup>+</sup>CD25<sup>+</sup>Foxp3<sup>+</sup> T regulatory cell (Treg) has been associated with human systemic autoimmune diseases, such as Behcet9s disease (BD). IL-2, an essential growth and survival factor for Treg cells.However, the significance of Treg cells in the pathogenesis and the effect of low dose of IL-2 on BD are remain to investigate. <h3>Objectives</h3> The lack of CD4<sup>+</sup>CD25<sup>+</sup>Foxp3<sup>+</sup> T regulatory cell (Treg) has been associated with human systemic autoimmune diseases, such as Behcet9s disease (BD). IL-2, an essential growth and survival factor for Treg cells.However, the significance of Treg cells in the pathogenesis and the effect of low dose of IL-2 on BD are remain to investigate. <h3>Methods</h3> Eighty patients with BD and seventy healthy donors were enrolled. CD4<sup>+</sup>T cell subsets in peripheral blood mononuclear cells from these people were measured by multicolour flow cytometry. Twenty-six patients were treated daily with subcutaneous injections of 0.5 million IU of human IL-2 for five consecutive days, CD4<sup>+</sup>T cell subsets were analysed before and after treatment by flow cytometry. <h3>Results</h3> Compared to health control,the absolute counts of circulating Treg cells were significantanty decreased in patients with BD (median:29.93 cell/uL VS median:33.16 cell/uL; p=0.039) and it is negative correlation with disease activity. While the ratios of Th17/Treg in patients with BD (median:0.29;n=80,p=0.034) were significantly higher than those of health control (median:0.2;n=70).No diffrernce in the absolute counts of circulating Th17 cells (CD4<sup>+</sup>IL-17<sup>+</sup>) between patients with BD and health control. Treatment of patients with BD with a low-dose of IL-2 regimen selectively increased the absolute counts of Treg cells, from a median of 18.97cell/uL to 74.68 cell/uL (at 5 days) (p=0.000). No significant difference was observed in the absolute counts of circulating Th17, Th1 and Th2 cells after IL-2 treatment. <h3>Conclusions</h3> Th17/Treg cells may play a role in the pathogenesis of Patients with BD, low-dose of IL-2 proposes a selective biological treatment strategy by restoring immune tolerance. <h3>Disclosure of Interest</h3> None declared
SP0020 Peripheral pathology in fibromyalgia
Authors: C Sommer
Journal: Annals of the Rheumatic Diseases (2017)

The pathophysiology of pain in fibromyalgia is complex. In recent years, an involvement of the thinly myelinated nerve fibers of the A-delta type and the unmyelinated C-fibers has been reported in fibromyalgia patients. Independent research groups have published consistent findings of objective injury to these "small nerve fibers". These included disturbances in function, electrical properties, and morphological integrity of these nerve fibers. While the reasons for this small fiber pathology and its contribution to FMS pain are still unclear, a new research field has emerged that will focus on uncovering the underlying pathophysiology. In this talk, I will summarize current findings and discuss their significance for the understanding of the fibromyalgia syndrome. <h3>Disclosure of Interest</h3> C. Sommer Grant/research support from: Kedrion, Speakers bureau: Baxalta, CSL Behring, Genzyme, Grifols, Pfizer
High Spontaneous In Vitro Myeloid Colony Formation in Chronic Myelomonocytic Leukemia is Associated with Mutations in Rasopathy Genes, Myeloproliferation and Inferior Prognosis
Authors: Klaus Geissler, Agnes Barna, Eva Jäger, Temeida Alendar, Elmir Ljubuncic, Ruth Jilch, Thomas Nösslinger, Michael Pfeilstöcker, Heinz Tüchler, Regina Reisner, Thamer Sliwa, Felix Keil, Sonja Burgstaller, Josef Thaler, Sigrid Machherndl-Spandl, Otto Zach, Ansgar Weltermann, Peter Bettelheim, Reinhard Stauder, Ilse Schwarzinger, Gregor Hörmann, Ulrich Jäger, Wolfgang R. Sperr, Paul Knöbl, Bruno Schneeweiss, Jörg Berger, Rajko Kusec, Leopold Öhler, Armin Zebisch, Heinz Sill, Ulrich Germing, Peter Valent
Journal: Blood (2016)
Whole body PD-1 and PD-L1 PET with <sup>89</sup>Zr-nivolumab and <sup>18</sup>F- BMS-986192 in pts with NSCLC.
Authors: Anna-Larissa N. Niemeijer, Egbert F. Smit, G.a.M.S. van Dongen, A.D. Windhorst, Marc C. Huisman, N. Harry Hendrikse, David K. Leung, Ralph Adam Smith, Wendy Hayes, Linda M. Velasquez, Samuel J. Bonacorsi, David J. Donnelly, Paul E. Morin, Erik Thunnissen, Alex J. Poot, Danielle J. Vugts, Joop De Langen
Journal: Journal of Clinical Oncology (2017)

e20047 Background: Tumor PD-L1 IHC relates moderately with treatment outcome following anti-PD-(L)1 monotherapy in pts with NSCLC. Aim: 1. To assess safety of the PET procedures. 2. To quantify PD-1 and PD-L1 expression in tumors with 89 Zirconium-labeled nivolumab ( 89 Zr-nivo) and 18 F-labeled BMS-986192 ( 18 F-PD-L1) PET. 3. To assess intra- and inter-patient tracer uptake differences in tumors. 4. To correlate PET results with IHC and treatment outcome. Methods: NSCLC pts eligible for treatment with nivolumab were included. Pts received a dynamic and static whole body 18 F-PD-L1 and a static 89 Zr-nivo PET scan. A baseline tumor biopsy was required and up to two additional biopsies were allowed in case PET showed heterogeneous tumor uptake. SUV peak was calculated for all delineable tumor lesions and related to PD-(L)1 IHC (28.8 assay) and response after 6 wks of nivolumab treatment. Results: 7 pts (5 ≥1%, 2 ≥50% and 2 negative by PD-L1 IHC) were enrolled and 11 lesions analyzed. No toxicity related to radiotracer administration was identified. Tumor uptake of both tracers was visualized in all pts. There was substantial variability among pts for 18 F-PD-L1 (mean SUV 5.4, range 2.2 - 14.4) and 89 Zr-nivo (mean SUV 5.0, range 1.6 - 9.7). Intra-patient tracer uptake heterogeneity was also seen: mean 2.5-fold (±0.96) and 2.3-fold (±0.86) differences between lesions for 18 F-PD-L1 and 89 Zr-nivo SUV, respectively. For lesions with &lt; 50% PD-L1 IHC mean 18 F-PD-L1 SUV was 3.4 (±2.9) as compared to 7.1 (±6.0) for lesions with ≥50% PD-L1 IHC (p = 0.22). For lesions with low PD-1 expression mean 89 Zr-nivo SUV was 6.9 (±2.7) as compared to 8.1 (±2.0) for lesions with high PD-1 expression (p = 0.44). Five pts were evaluable for response evaluation: 1 PR, 2 SD and 2 PD with 18 F-PD-L1 SUV values (most PET avid lesion) of 14.4 (PR), 2.0 and 5.4 (SD) and 6.4 and 6.6 (PD). Conclusion: 1.PET-imaging with both tracers is safe and feasible, with good tumor-to-normal tissue contrast. 2. Tumor uptake demonstrated substantial heterogeneity among pts and among tumors within the same pts. 3. Although higher 18 F-PD-L1 tumor uptake was seen in pts with ≥50% tumor PD-L1 IHC and the highest 18 F-PD-L1 SUV was measured in the responding pt, the dataset is still very small. Clinical trial information: 2015-004760-11.
FRI0393 Prevalence of myositis-specific antibodies in idiopathic inflammatory myopathy compared to disease and healthy controls
Authors: J-B Vulsteke, X Bossuyt, D Dillaerts, K Poesen, K Claeys, J Lenaerts, R Westhovens, D Blockmans, P De Haes, E De Langhe
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Myositis-specific autoantibodies (MSA) are increasingly recognized as important diagnostic and prognostic markers in idiopathic inflammatory myopathies (IIM) (polymyositis, dermatomyositis, sporadic inclusion body myositis and necrotizing autoimmune myositis). The prevalence of these MSAs in other systemic autoimmune rheumatic diseases and neuromuscular diseases is unclear. <h3>Objectives</h3> To compare positivity of MSA in a cohort of IIM patients to positivity in healthy controls and different systemic autoimmune rheumatic diseases (SARD) or chronic inflammatory demyelinating polyneuropathy (CIDP). <h3>Methods</h3> A line immunoassay (Myositis 12 IgG DOT for BlueDiver) for IgG autoantibodies against Jo-1, PL-7, PL-12, EJ, SRP, Mi-2, MDA-5, TIF1-γ, HMGCR, SSA/Ro52kD, SAE1/2 and NXP-2 antigens was performed in patients with IIM (n=146), healthy controls (blood donors, n=40) and disease controls (n=200). The disease control group consisted of patients with other SARD (rheumatoid arthritis, RA; systemic sclerosis, Ssc; Sjögren9s syndrome, SjS; and systemic lupus erythematosus, SLE) (n=40 for each disease group) and CIDP (n=40). A result &gt;10 arbitrary units was considered significantly positive. <h3>Results</h3> 50% of 146 patients with IIM tested positive for an MSA (table 1), compared to 3,5% of 200 disease controls (table 1). 1 SSc patient was positive for Jo-1, 1 CIDP patient was positive for PL12, 2 SSc patients were positive for TIF1-gamma, 2 patients (1 SSc and 1 SjS patient) were positive for SAE1/2, and 1 SjS patient was positive for NXP2. The prevalence of SAE1/2 and TIF1-gamma positivity was similar in the IIM and disease control group. No healthy control had a significantly positive MSA. <h3>Conclusions</h3> MSA positivity in patients with a clinical non-IIM diagnosis (other SARD or CIDP) is infrequent compared to positivity in the IIM group. For TIF1-gamma and SAE1/2 assay performance may need to be optimized. The distribution of subtypes of MSA in this IIM cohort is consistent with data of previous studies.<sup>1</sup> <h3>References</h3> Allenbach Y, Benveniste O. Diagnostic Utility of Autoantibodies in Inflammatory Muscle Diseases. J Neuromuscul Dis. 2015; 2:13–25. <h3>Disclosure of Interest</h3> None declared
Biomarkers associated with clinical outcome in advanced non-small cell lung cancer patients treated with TG4010
Authors: B. Acres, E. Quoix, R. Ramlau, G. Lacoste, B. Marie Bastien, A. Tavernaro, S. Bettinger, N. Bizouarne, J. M. Limacher, J. Y. Bonnefoy
Journal: Journal of Clinical Oncology (2009)

3027 Background: TG4010 is a targeted immunotherapy product. It was tested in combination with first-line chemotherapy in a randomized, controlled, multicenter phase II study in patients with advanced non small cell lung cancer (NSCLC) (ASCO 2008- Abstract No 8023) Methods: In addition to clinical endpoints, immune parameters were tested. Blood samples were drawn prior to therapy (day1) as well as at day 43 (after 6 injections of TG4010). Lymphocyte populations were assessed by 5-color flow cytometry. Plasma samples were tested for biochemical markers using multi-analyte profile technology. Results: Out of the 148 patients enrolled in the study, 138 were evaluable for immunological analyses. Baseline characteristics were similar in both arms. Day 1 blood samples show: i) a correlation between lower levels of inflammation-associated plasma proteins and a longer median survival in Arm 1 (TG4010 + chemotherapy) (p&lt; 0.001); ii) an improved clinical outcome with TG4010 in patients having normal levels of lymphocytes with an activated NK phenotype. Day 43 blood samples show: i) an association between higher levels of activated T lymphocytes and longer patient survival in Arm 1 (p &lt; 0.05). No such association was observed in patients in Arm 2 (chemotherapy alone); ii) a longer survival for patients with higher levels of Interferon γ in Arm 1 than in Arm 2 (p=0.0001). Patients in both Arm 1 and Arm 2 showed specific binding of MUC1 tetramers to circulating CD8+ lymphocytes. No significant association between either treatment arm or clinical outcome and MUC1 tetramer binding was detected. Conclusions: These results identify the level of activated NK cells at baseline as a predictive biomarker for selection of patients to be treated with TG4010. Biomarker data including Interferon γ support a Th1 dependent pathway of activity for TG4010. [Table: see text] [Table: see text]