tbuckley/cabot-search huggingface dataset:
OP0125 Dapsa and ultrasound show different perspectives of psoriatic arthritis activity: results from a longitudinal observational study of patients starting treatment with biologic dmards
Authors: S. Puksic, J. Sexton, P. Bolton-King, B. Michelsen, T.K. Kvien, H.B. Hammer
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Clinical disease activity in patients with psoriatic arthritis (PsA) may be assessed by DAPSA- a sum score of tender (of 68) and swollen (of 66) joints, CRP (mg/dl), patient's global assessment of disease activity (PGA) and patient's pain (0–10 VAS for both). Ultrasound (US) with grey scale (GS) and power Doppler (PD) is used to detect inflammation in joints as well as extra- articular structures. Discrepancies have previously been described between DAPSA and US.<sup>1</sup> <h3>Objectives</h3> To explore the associations between DAPSA and US assessments of disease activity during follow-up of patients with PsA starting bDMARD treatment. <h3>Methods</h3> Patients with PsA were included when initiating bDMARDs, and examined at 0, 3, 6, 9 and 12 months including 66 swollen/68 tender joint counts (SJC/TJC), examinator's global assessment VAS (EGA), patient reported outcome measures (PROMs; PGA, patient`s pain, RAID, MHAQ), laboratory measures (CRP, ESR, calprotectin) and US (46 joints, 8 flexor tendons, 14 entheses and 4 bursae with calculated GS and PD sum scores). DAPSA was calculated. PD sum score zero was defined as US remission. Generalised Estimating Equations (GEE) was used for longitudinal analysis. <h3>Results</h3> 47 patients (mean (SD) age 48.4 (12.8) years, disease duration 12.7 (10.9) years, 60% women) were included (68% biologic-naïve). The figure depicts high correlation between DAPSA and subjective assessments at baseline, while PD sum score was more strongly associated with SJC (r=0.49, p&lt;0.001), EGA (r=0.29, p=0.05) and DAS28 (r=0.35, p=0.015), but not with DAPSA (r=0.21, p=0.16) or PROMs. There was significant improvement at 3 months in all variables (p=0.046-&lt;0.001) (table 1). Longitudinally, TJC and patient`s pain had strongest association with DAPSA (standardised β 0.86 vs 0.52, both p&lt;0.001). DAPSA remission was obtained in 27%–33% of the patients and PD remission in 60%–70%, but their association was weak and not statistically significant (OR 1.4, 95% CI: 0.69 to 2.95, p=0.33). <h3>Conclusions</h3> In our observational PsA cohort DAPSA was mostly influenced by TJC and patient`s pain and had no significant association with a comprehensive US examination. This finding indicates possible limitations of using DAPSA in T2T strategy in PsA. <h3>Reference</h3> [1] Michelsen B, et al. Ann Rheum Dis2016;75:2108–13. <h3>Disclosure of Interest</h3> None declared
Government urged to clarify plan to protect drug supply in event of “no deal” Brexit
Authors: Gareth Iacobucci
Journal: BMJ (2018)

Members of the House of Lords have asked the government to clarify its contingency preparations to ensure the UK has continued access to drugs and medical products in the event of a “no deal” Brexit.

In a letter1 to the health secretary Matt Hancock, the House of Lords EU Home Affairs Sub-Committee said the evidence it had received had raised concerns that a no deal Brexit may limit the availability of drugs and medical products in the UK and result in potential …
Abstract 18146: Stress Speckle Tracking Imaging Parameters of Circumferential Deformation in Assesssing Ischemia for Patients With Moderate and High Probability of Coronary Artery Disease
Authors: Egle Rumbinaite, Jolanta J Vaskelyte, Ruta Zvirblyte, Mindaugas Vieželis, Tomas Lapinskas, Arnas Karuzas, Rimvydas Slapikas
Journal: Circulation (2015)

Introduction: Value of longitudinal strain and strain rate (SR) at rest and low dobutamine doses has been shown in small studies however little is known about circumferential strain, circumferential systolic and diastolic SR importance in early stages of dobutamine speckle tracking echocardiography (STE). Hypothesis: Hypothesis that circumferential strain, circumferential systolic and diastolic SR in early stages of dobutamine STE are markers of significant coronary stenosis in patients with moderate and high probability of coronary artery disease (CAD) was assessed. Methods: Dobutamine stress echocardiography and adenosine magnetic resonance imaging were perfomed to 101 patients with moderate and high probability of CAD. CAD was defined as ≥50% diameter stenosis on coronary angiography validated as hemodynamically significant by adenosine magnetic resonance. Patients were divided into two groups based on coronary angiography results: CAD (-) n=57 (56,44%) vs CAD (+) n=44 (43,56%). Circumferential strain, circumeferential systolic and early diastolic SR parameters at rest, low and high dobutamine doses were analysed using 2D STE. Results and Conclusions: There were no significant differences of clinical characteristics, conventional echocardiography and deformation parameters between the groups at rest. All analysed STE parameters at low dobutamine doses were significantly lower in patients wtih CAD (circumferential strain 23,84±7,25% vs 17,98±4,06%, p=0,01, circumferential systolic SR 2,70±0,74 s–1 vs 1,76±0,75 s–1, p=0,002; circumferential early diastolic SR 2,71±0,74 s–1 vs 1,76±0,75 s–1, p=0,002). Logistic regression analysis revealed that STE parameters at low dobutamine doses have significant predictive value for haemodinamically significant coronary stenoses. Circumferential strain, systolic and early diastolic SR obtained at low dobutamine doses are sensitive and specific markers of haemodynamically significant CAD.
Lipid nanoparticles that deliver IL-12 messenger RNA suppress tumorigenesis in MYC oncogene-driven hepatocellular carcinoma
Authors: Ian Lai, Srividya Swaminathan, Virginie Baylot, Adriane Mosley, Renumathy Dhanasekaran, Meital Gabay, Dean W. Felsher
Journal: Journal for ImmunoTherapy of Cancer (2018)

Interleukin-12 (IL-12) is a promising candidate for cancer immunotherapy because of its ability to activate a number of host immune subsets that recognize and destroy cancer cells. We found that human hepatocellular carcinoma (HCC) patients with higher than median levels of IL-12 have significantly favorable clinical outcomes. Here, we report that a messenger RNA (mRNA) lipid nanoparticle delivering IL-12 (IL-12-LNP) slows down the progression of MYC oncogene-driven HCC. IL-12-LNP was well distributed within the HCC tumor and was not associated with significant animal toxicity. Treatment with IL-12-LNP significantly reduced liver tumor burden measured by dynamic magnetic resonance imaging (MRI), and increased survival of MYC-induced HCC transgenic mice in comparison to control mice. Importantly, IL-12-LNP exhibited no effect on transgenic MYC levels confirming that its therapeutic efficacy was not related to the downregulation of a driver oncogene. IL-12-LNP elicited marked infiltration of activated CD44<sup>+</sup> CD3<sup>+</sup> CD4<sup>+</sup> T helper cells into the tumor, and increased the production of Interferon γ (IFNγ). Collectively, our findings suggest that IL-12-LNP administration may be an effective immunotherapy against HCC.
Abstract 16686: Healthcare Resource Utilization Associated With Venous Thromboembolism in Cancer Patients Treated With Anticoagulants in a Commercial Insurance Population
Authors: Alok A Khorana, Keith McCrae, Dejan Milentijevic, Nora McCormick, François Laliberté, Concetta Crivera, Patrick Lefebvre, Dominique Lejeune, Heather Rozjabek, Jeff Schein, Michael Streiff
Journal: Circulation (2017)

Introduction: Research among Medicare cancer patients shows healthcare resource use (HRU) associated with venous thromboembolism (VTE) treatment is lowest with rivaroxaban as compared to LMWH or warfarin (WAR); rivaroxaban is also associated with fewer re-hospitalizations due to VTE recurrence. This study analyzes HRU in younger cancer patients from a large commercial insurance claims database. Hypothesis: VTE-related HRU in cancer patients is lower with rivaroxaban than with LMWH or WAR in a commercial insurance claims database. Methods: Truven Health Analytics MarketScan databases were used to identify patients aged ≥18 newly diagnosed with cancer who then had first VTE (DVT or PE; excluding upper VTE) in 1/1/2013 - 9/30/2016 and anticoagulant (AC) initiation ≤7 days. Patients were put into LMWH, WAR, and rivaroxaban cohorts by index AC and followed to end of insurance eligibility or data. WAR users included those who started LMWH and WAR within 7 days. Inverse probability of treatment weights based on ...
Pre-participation health evaluation in adolescent athletes competing at Youth Olympic Games: proposal for a tailored protocol
Authors: Paolo Emilio Adami, Maria Rosaria Squeo, Filippo Maria Quattrini, Fernando Maria Di Paolo, Cataldo Pisicchio, Barbara Di Giacinto, Erika Lemme, Viviana Maestrini, Antonio Pelliccia
Journal: British Journal of Sports Medicine (2018)

To promote sports participation in young people, the International Olympic Committee (IOC) introduced the Youth Olympic Games (YOG) in 2007. In 2009, the IOC Consensus Statement was published, which highlighted the value of periodic health evaluation in elite athletes. The objective of this study was to assess the efficacy of a comprehensive protocol for illness and injury detection, tailored for adolescent athletes participating in Summer or Winter YOG.Between 2010 and 2014, a total of 247 unique adolescent elite Italian athletes (53% females), mean age 16±1,0 years, competing in 22 summer or 15 winter sport disciplines, were evaluated through a tailored pre-participation health evaluation protocol, at the Sports Medicine and Science Institute of the Italian Olympic Committee.In 30 of the 247 athletes (12%), the pre-participation evaluation led to the final diagnosis of pathological conditions warranting treatment and/or surveillance, including cardiovascular in 11 (4.5%), pulmonary in 11 (4.5%), endocrine in five (2.0%), infectious, neurological and psychiatric disorders in one each (0.4%). Based on National and International Guidelines and Recommendations, none of the athletes was considered at high risk for acute events and all were judged eligible to compete at the YOG. Athletes with abnormal conditions were required to undergo a periodic follow-up.The Youth Pre-Participation Health Evaluation proved to be effective in identifying a wide range of disorders, allowing prompt treatment, appropriate surveillance and avoidance of potential long-term consequences, in a significant proportion (12%) of adolescent Italian Olympic athletes.
Efficacy and safety of apalutamide (APA) in patients (pts) with nonmetastatic castration-resistant prostate cancer (nmCRPC) from SPARTAN: Asian subpopulation
Authors: P. Mainwaring, E. Small, H. Uemura, J.Y. Lee, S.-T. Pang, G. Marx, T.G. Kwon, T. Satoh, A. Bhaumik, S. Cheng, A. Londhe, A. Lopez-Gitlitz, M. Smith
Journal: Annals of Oncology (2018)
Screening Mammography for Average-Risk Women: The Controversy and NCCN's Position
Authors: Mark A. Helvie, Therese B. Bevers
Journal: Journal of the National Comprehensive Cancer Network (2018)

Breast cancer remains the most common nonskin cancer among women and a leading cause of morbidity and mortality. Early detection through screening and advances in treatment have contributed to a 39% mortality reduction in the United States since 1990. The NCCN Guidelines for Breast Cancer Screening and Diagnosis recommend annual mammographic screening for average-risk women beginning at age 40 years. Mammographic screening and subsequent treatment reduces breast cancer mortality based on a wide range of studies. This article highlights NCCN's position on screening mammography and the screening controversy.
Abstract 12149: Adverse Effects of First-Degree AV-Block in Patients With Sinus Node Dysfunction: Data From the Mode Selection Trial
Authors: Fredrik Holmqvist, Anne S Hellkamp, Kerry L Lee, Gervasio A Lamas, James P Daubert
Journal: Circulation (2013)

Objective:  Patients with a pacing indication and a first-degree AV-block (1st AVB) pose a clinical challenge. Atrial pacing exaggerates the AV-delay, while unnecessary right ventricular pacing has been shown to be detrimental. The prognostic impact of 1st AVB in patients with sinus node dysfunction (SND) and the impact of pacing in this setting is not known.   Methods:  In the Mode Selection Trial (MOST), 2010 patients with SND were randomized to either dual-chamber (DDDR) or ventricular (VVIR) pacing and followed for a median of 33 months. The lower rate was programmed to be ≥60 bpm. In the DDDR group, the AV delay was recommended to be between 120 and 200 ms. We report on clinical outcomes in patients with 1st AVB (PR-interval >200 ms) compared with patients who had a normal PR-interval at baseline.   Results:  Patients with 1st AVB (n=378) were older (median [Q1, Q3]; 76 [70, 82] vs. 73 [66, 79] years, P≤0.0001), more often male (57 vs. 49%, P=0.0049) and had more comorbidity, such as hypertension (66 vs. 60%, P=0.034) and heart failure (HF) (24 vs. 17%, P=0.0050) than patients with normal AV-conduction (n=1159). The percentage of pacing was higher among patients with 1st AVB in the VVIR (68 [34,91] vs. 56 [20,86] %, P=0.0076) as well as in the DDDR-arm (95 [82, 99] vs. 86 [52, 98] %, P≤0.0001). In multivariable analyses, patients with 1st AVB were at greater risk of death, stroke, or HF hospitalization (HR 1.31, 95% CI 1.06-1.61, P=0.013) (Figure). A trend towards a higher incidence of atrial fibrillation was seen (HR 1.24, 95% CI 0.98-1.55, P=0.069). No significant interactions between pacing arm and prolonged vs. normal PR were found for any end-point, and hazard ratios were consistent across subgroups.   Conclusion:  1st AVB is associated with more advanced disease but is still an independent predictor of poor clinical outcome, which may be driven by a higher percentage of ventricular pacing. Neither DDDR nor VVIR pacing, as employed in MOST, eliminate the negative effects associated with 1st AVB.
Abstract 15846: Where Do We Go From Here? Beyond the MagnaSafe Trial. A Focus Beyond CMR Safety
Authors: Robert W Biederman, Loretta Gevenosky, Huma Samar, June Yamrozik, Ronald Williams, Richard Lombardi, Moneal Shah, Christopher Bonnet, Mark Doyle
Journal: Circulation (2017)

Introduction: MRI is infrequently performed in patients with conventional PM/ICD’s. While recent studies such as MagnaSafe have unequivocally documented MRI safety in those with implanted devices, ...
Association of African Ancestry With Electrocardiographic Voltage and Concentric Left Ventricular Hypertrophy
Authors: Aya J. Alame, Sonia Garg, Julia Kozlitina, Colby Ayers, Ronald M. Peshock, Susan A. Matulevicius, Mark H. Drazner
Journal: JAMA Cardiology (2018)

<h3>Importance</h3> Compared with white individuals, black individuals have increased electrocardiographic voltage and an increased prevalence of concentric left ventricular (LV) hypertrophy. Whether environmental or genetic factors lead to these racial differences is unknown. <h3>Objective</h3> To determine whether proportion of genetically determined African ancestry among self-reported black individuals is associated with increased electrocardiographic voltage and concentric LV hypertrophy (LVH). <h3>Design, Setting, and Participants</h3> The Dallas Heart Study is a probability-based cohort study of English- or Spanish-speaking Dallas County, Texas, residents, with deliberate oversampling of black individuals. Participants underwent extensive phenotyping, which included electrocardiography (ECG), cardiac magnetic resonance imaging (CMR), and dual-energy radiography absorptiometry (DEXA) at a single center. Participants aged 18 to 65 years who enrolled in the Dallas Heart Study between July 2000 and December 2002, self-identified as black (n = 1251) or white (n = 826), and had ECG, CMR, and DEXA data were included in this analysis. Data were analyzed from June 2017 to September 2018. <h3>Exposures</h3> Proportion of African ancestry. <h3>Main Outcomes and Measures</h3> Electrocardiographic voltage (12-lead and 9-lead) and markers of concentric LVH as assessed by CMR (LV concentricity<sup>0.67</sup>[LV mass/end-diastolic volume<sup>0.67</sup>], LV wall thickness [LVWT], and prevalent LVH [defined by LV mass/height<sup>2.7</sup>]). <h3>Results</h3> Of the 2077 participants included in the study, 1138 (54.8%) were women, and the mean (SD) age was 45.2 (9.9) years. Black race and African ancestry were individually associated with increased ECG voltage, LV concentricity<sup>0.67</sup>, LVWT, and prevalent LVH in multivariable analyses adjusting for age, sex, systolic blood pressure, antihypertensive medication use, and body composition. When African ancestry and black race were entered together into multivariable models, African ancestry but not black race remained associated with ECG voltage, LVWT, LV concentricity<sup>0.67</sup>, and prevalent LVH. Among black participants, African ancestry remained associated with these 4 phenotypes (12-lead voltage: β, 0.05;<i>P</i> = .04; LVWT: β, 0.05;<i>P</i> = .02; LV concentricty<sup>0.67</sup>: β, 0.05;<i>P</i> = .045; prevalent LVH: odds ratio, 1.2; 95% CI, 1.03-1.4;<i>P</i> = .02). <h3>Conclusions and Relevance</h3> Genetically determined African ancestry was associated with electrocardiographic voltage, measures of concentric LV remodeling, and prevalent LVH. These data support a genetic basis related to African ancestry for the increased prevalence of these cardiovascular traits in black individuals.
Congolese fight against Ebola
Authors: Alison Shepherd
Journal: BMJ (2018)

John Wessels/AFP/Getty Images

Health workers embrace while putting on their personal protective equipment before heading into the red zone at a newly built Ebola centre supported by the charity Medecins Sans Frontieres in Bunia, in the Democratic Republic of the Congo.

The death toll from the most recent outbreak of Ebola virus disease has risen to more …
Open letter to Simon Stevens to ensure that tobacco dependence treatment is provided for every smoker cared for by the NHS, as part of the long term plan
Authors: Andrew Goddard, Wendy Burn, Lesley Regan, Russell Viner, Helen Stokes-Lampard, Ravi Mahajan, Evri Anagnostara, Sheila Hollins, Simon Wessely, Deborah Arnott, Shirley Cramer, Mark Watson, Carol Black, Richard Ashcroft, Nicholas Hopkinson
Journal: BMJ (2018)

The government’s ambition for a five year improvement in disability free life expectancy by 2035 is one that we can all share,1 but if it is to be achieved the NHS has to ensure that tobacco dependence treatment is provided for every smoker cared for by the NHS.

Smoking is the leading cause of years of life lost in the …
FRI0511 Thyroid artery involvement detected by colour-doppler ultrasonography in an incipient, single centre giant cell arteritis cohort
Authors: R. Ješe, Ž. Rotar, M. Tomšič, A. Hočevar
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The inflammation of thyroid arteries (ThA) is not commonly considered and investigated in giant cell arteritis (GCA). <h3>Objectives</h3> To estimate the frequency of the superior and/or inferior ThA involvement as detected by Colour Doppler Sonography (CDS). <h3>Methods</h3> We conducted a prospective single centre study between 1 <sup>October 2013</sup> and 30 September 2017. The CDS of superior and inferior ThA was performed in all newly diagnosed, treatment naive GCA patients in addition to the routinely evaluated temporal, facial, occipital and large supraaortic arteries. The superior and inferior ThA were identified at their respective anatomical locations in close proximity to the thyroid gland and examined using the standard Doppler settings for temporal arteries. Arteries were evaluated in two planes for the highly specific halo sign. Laboratory thyroid function tests consisted of TSH, T3 and T4 measurements at the time of GCA diagnosis (prior to any steroid therapy). Characteristics of GCA cases with inflamed ThA were explored and compared to the GCA group without ThA involvement. <h3>Results</h3> During the 48 months we performed the CDS of the multiple arteries in 124 consecutive GCA patients (median age 74.7 (IQR 66.5–79.1) years, 65% female). We observed the halo sign on either superior or inferior ThA in 11 (8.9%) cases. All the patients with ThA involvement also had CDS signs of temporal artery involvement, which was confirmed by temporal artery biopsy in all 11 cases. There was a positive trend for correlation between fever (≥38°C) and/or dry cough in the patients with ThA involvement (fever: RR 2.99, CI 0.98–9.06, p=0.07; dry cough: RR 2.73, CI 0.89–8.3, p=0.10). Four patients reported symptoms consistent with thyroid gland pathology. None of the patients with ThA involvement had symptoms of polymyalgia rheumatica. No correlation was found with other clinical and demographic characteristics, including weight loss, headache, jaw claudication and visual disturbances. Sixteen out of 124 GCA patients (12.9%) had a history of thyroid dysfunction (11 hypothyroidism, 1 hyperthyroidism, 1 euthyroid goitre; 3 patients had thyroid surgery because of either goitre or suspected malignancy). In 2/16 patients we also found CDS signs of ThA involvement, yet the thyroid function tests were normal at the time of GCA diagnosis in these patients. Laboratory signs of thyroid dysfunction were found in 3/11 (27.2%) patients with ThA involvement (2 latent hyperthyroidism, 1 latent hypothyroidism), none of these patients had previous history of thyroid disease. <h3>Conclusions</h3> In our incipient GCA cohort, a tenth of all patients had ultrasonographic signs of ThA involvement. To the best of our knowledge, this is the first study that systematically assessed the ThA involvement. <h3>Disclosure of Interest</h3> None declared
Recovery of Voluntary Movement After Paralysis
Authors: Jennifer Abbasi
Journal: JAMA (2018)

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Alisertib (MLN8237), an Oral Selective Inhibitor of Aurora Kinase a, Has Clinical Activity and Restores GATA1 Expression in Patients with Myelofibrosis
Authors: Naseema Gangat, Brady Lee Stein, Christian Marinaccio, Ronan Swords, Justin M. Watts, Sandeep Gurbuxani, Olga Frankfurt, Jessica K. Altman, Jeremy Q. Wen, Noushin Farnoud, Christopher Famulare, Akshar Patel, Roberto Tapia, Amy Handlogten, Yvonne Trang Dinh, Kristen Englund, Shradha Patel, Juan Carlos Nobrega, Dalissa Tejera, Amber Thomassen, Harald Stein, Juehua Gao, Peng Ji, Raajit K. Rampal, Francis J. Giles, Ayalew Tefferi, John D. Crispino
Journal: Blood (2018)