tbuckley/cabot-search huggingface dataset:
FRI0300 Neurological involvement in primary sjÖgren syndrome
Authors: T Ben Salem, I Naceur, M Tougorti, M Lamloum, I Ben Ghorbel, MH Houman
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Prevalence of neurological involvements (NI) in primary Sjögren Syndrome (pSS) varies from 10 to 60% and depends on whether they are screened systematically or only when they are symptomatic. <h3>Objectives</h3> The aim of the study was to describe the prevalence, clinical patterns and treatment of NI in pSS. <h3>Methods</h3> We performed a retrospective study of patients with pSS (American-European Consensus Group criteria) and followed in an internal medical department over a period of 15 years. Patients with NI were enrolled after excluding other potential causes. We did investigate neurologic systems only when patients present with symptoms. <h3>Results</h3> Primary Sjögren Syndrome was diagnosed in 155 patients, 41 had neurological manifestations (26.4%). They were 5 male and 36 female. The mean age at disease onset was 49 +/-13 years. The average delay from NI onset to pSS diagnosis was four months for peripheral nervous system (PNS) and 12 months for central nervous system (CNS). NI revealed the disease in 14 cases (34%). CNS and PNS involvements were respectively found in 27 and 19 cases (six patients had both PNS and CNS). In patients with CNS disorders, headache was the most frequent symptom (n=11). Pyramidal syndrome was found in 9 cases and cerebellar syndrome in one patient. Aseptic meningitis was noted in two cases. Brain MRI was performed in 22 cases and showed abnormalities in 82% of cases. T2 and flair weighted hyperintensities were periventricular (n=11), subcortical (n=5), frontal (n=3) and parietal (n=2). Myelitis was found in one patient. Patients with PNS showed paresthesia (92%), motor deficit (22%) and decreased tendon reflex (18%). Sensory-motor neuropathy was described in 4 cases, pure sensory neuropathy in 6 cases (including one case of small fiber neuropathy) and motor neuropathy in one patient. Mononeuropathy multiplex was found in 4 cases and polyradiculoneuritis in one patient. Neuromuscular biopsy was performed in five patients and showed vasculitis in two cases. Trigeminal nerve and cochlear nerve were respectively involved in four and one patients. Antinuclear antibodies, anti-SSA and anti-SSB antibodies were respectively positive in 71%, 50% and 28% of cases. NI were treated with corticosteroids and immunosuppressive therapy in respectively 56% and 41% of cases. Outcome was good in 48% of the patients. Comparison of clinical and biological features in patients with and without NI showed no significant differences, only fatigue was significantly associated to NI (45.5% vs 12.9%; p=0.005). <h3>Conclusions</h3> In our series, NI prevalence was similar to other groups. CNS involvements were more frequent than PNS manifestations whereas in other ethnic groups they are less frequent. <h3>Disclosure of Interest</h3> None declared
Two valves in the pharynx
Authors: Shiroh Isono
Journal: European Respiratory Journal (2017)

Obstructive sleep apnoea (OSA) is caused by repetitive closure of the upper airway during sleep. While the retropalatal airway is reported to be the most collapsible site [1], any state-dependent segments within the upper airway are candidates for closure. Correct identification of the closure site in each OSA patient could lead to the development of individualised OSA treatment strategies [2]. In this issue of the European Respiratory Journal , Azarbarzin et al. [3] propose a model for prediction of epiglottic collapse for each breath by assessing the nasal airflow waveform in sleeping OSA patients. They employed a machine-learning approach to identify characteristic waveform features for constructing the predictive algorithm and validation of the final predictive model. They found that a nasal airflow signal with greater discontinuity index (rapid and marked reduction of inspiratory airflow immediately after achieving the maximum airflow) and greater jaggedness index (repeated deviations of the airflow from the mean value during inspiration) predicts epiglottic collapse. Furthermore, the non-calibrated nasal pressure signal is demonstrated to be equally usable for determining the epiglottic collapse, increasing applicability to clinical practice. However, it is noteworthy that this study does not completely clarify why the discontinuity and jaggedness features are produced by the epiglottic collapse. Whereas application of machine-learning and artificial intelligence technologies is a promising means for solving multifactorial difficult medical problems, as is proved in this study, these technologies should be utilised through careful selection of physiologically and clinically meaningful variables in order to avoid inclusion of meaningless variables in the prediction model. So, what is the physiology behind the success of the prediction? The epiglottis and soft palate function as one-way valves limiting flow during inspiration and expiration <http://ow.ly/85JB30epWOC>
Surgeon Influence on Variation in Receipt of Contralateral Prophylactic Mastectomy for Women With Breast Cancer
Authors: Steven J. Katz, Sarah T. Hawley, Ann S. Hamilton, Kevin C. Ward, Monica Morrow, Reshma Jagsi, Timothy P. Hofer
Journal: JAMA Surgery (2017)

Rates of contralateral prophylactic mastectomy (CPM) have markedly increased but we know little about the influence of surgeons on variability of the procedure in the community.To quantify the influence of the attending surgeon on rates of CPM and clinician attitudes that explained it.In this population-based survey study, we identified 7810 women with stages 0 to II breast cancer treated in 2013 to 2015 through the Surveillance, Epidemiology, and End Results registries of Georgia and Los Angeles County. Surveys were sent approximately 2 months after surgery. Surveys were also sent to 488 attending surgeons identified by the patients.We conducted multilevel analyses to examine the impact of surgeon influence on variations in patient receipt of CPM using information from patient and surgeon surveys merged to Surveillance, Epidemiology, and End Results data.A total of 5080 women responded to the survey (70% response rate), and 377 surgeons responded (77% response rate). The mean (SD) age of responding women was 61.9 (11) years; 28% had an increased risk of second primary cancer, and 16% received CPM. Half of surgeons (52%) practiced for more than 20 years and 30% treated more than 50 new patients with breast cancer annually. Attending surgeon explained a large amount (20%) of the variation in CPM, controlling for patient factors. The odds of a patient receiving CPM increased almost 3-fold (odds ratio, 2.8; 95% CI, 2.1-3.4) if she saw a surgeon with a practice approach 1 SD above a surgeon with the mean CPM rate (independent of age, diagnosis date, BRCA status, and risk of second primary). One-quarter (25%) of the surgeon influence was explained by attending attitudes about initial recommendations for surgery and responses to patient requests for CPM. The estimated rate of CPM was 34% for surgeons who least favored initial breast conservation and were least reluctant to perform CPM vs 4% for surgeons who most favored initial breast conservation and were most reluctant to perform CPM.In this study, attending surgeons exerted influence on the likelihood of receipt of CPM after a breast cancer diagnosis. Variations in surgeon attitudes about recommendations for surgery and response to patient requests for CPM explain a substantial amount of this influence.
AB0986 Family mediterranean fever gene mutations: a poorly studied cause of intermittent hydrartrosis
Authors: M Espinosa Malpartida, C Barbadillo Mateos, C Ramos Giraldez, BJ Flores Robles, E González Vioque, C Merino Argumanez, M Jimenez Palop, J Sanz Sanz, H Godoy Tundidor, J Campos Esteban, JL Andreu Sanchez, LF Villa Alcazar, J Mulero Mendoza
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Familial Mediterranean Fever (FMF) is an inherited autoinflammatory disorder caused by <i>mutations in the MEFV gene</i> encoding pyrine, characterized by recurrent episodes of fever and serositis. Some patients with FMF present <i>incomplete penetrance</i> of the disease and may manifest only as <i>intermittent arthritis</i>. <h3>Objectives</h3> Characterization of <i>musculoskeletal clinical manifestations</i> in patients with mutations of the MEFV gene in our hospital. <h3>Methods</h3> We retrospectively reviewed clinical records of patients with mutations detected in the Family Mediterranean Fever MEFV gene in our hospital from January 1, 2008 to October 1, 2016. We collected parameters such as age at diagnosis, age of onset Of the symptoms, sex, affected joints, other extra-articular manifestations and type of MEFV gene mutation. <h3>Results</h3> Seven patients with MEFV gene mutations were reviewed, all of them were women, ranging in age from 14 to 61 years old. Two of them had <i>recurrent knee monoarthritis</i>, one had a history of <i>arthritis</i> in the hands and erratic <i>arthralgias</i>, one had erratic arthralgias and two had no musculoskeletal manifestations. The 2 patients with intermittent hydrartrosis responded satisfactorily to <i>colchicine</i>, but not the other patients with other musculoskeletal manifestations. <h3>Conclusions</h3> <i>Genetic testing</i> of the common <i>mutations of the MEFV gene</i> should be considered in patients with <i>recurrent episodes of monoarthritis</i> without justifying cause (palindromic rheumatism, intermittent hydrartrosis, etc.) <h3>Disclosure of Interest</h3> None declared
FRI0144 Evaluation of factors affecting fatigue in patients with rheumatoid arthritis
Authors: G Kilinc Kamaci, S Unsal Delialioglu, S Ozel, F Yurdakul, H Bodur
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Fatigue is a common and disturbing symptom in patients with Rheumatoid arthritis (RA) (1,2). Measuring fatigue, understanding its contributory factors, and treating it lead to better patient outcome (3). <h3>Objectives</h3> The aim of this study is to investigate the relation between fatigue and pain, functional status, disease activity in patients with RA and to determine the effect of fatigue on the quality of life of patients with RA. <h3>Methods</h3> A total of 141 patients (103 female, 38 male) who were diagnosed RA according to ACR (American College of Rheumatology) diagnostic criteria were included in the study. Fatigue Symptom Inventory (FSI) was used for evaluation of fatigue. While the disease activity was determined using the Disease Activity Score-28 (DAS28), the Health Assessment Questionnaire (HAQ) was used to determine the functional status. The pain intensity was determined using 10 cm Visual Analogue Scale-Pain (VAS-pain). <h3>Results</h3> The mean age of the patients is 54.67±10.70 years and the mean duration of illness is 14.31±10.89 years. When the relationship between fatigue and other factors was examined, a statistically significant relationship was found between FSI fatigue severity scores (maximum, minimum, mean, current), FSI duration scores (number of days felt tired, amount of time felt tired), FSI interference score and HAQ, number of swollen joints, number of tender joints, VAS rest and VAS motion values (p&lt;0.05). There was a statistically significant lower correlation between FSI fatigue severity scores (at least, mean) and DAS28 (r: 0.216, r: 0.181, respectively). There was no significant relationship between FSI scores and age, duration of illness, steroid use <h3>Conclusions</h3> Fatigue affects patients independently of disease duration in patients with RA. Fatigue is associated with disease activity, functional status, and pain. For this reason, fatigue in RA patients should be considered as an important symptom that should not be overlooked and should be struggled. <h3>References</h3> Steenbergen HW, Tsonaka R, Huizinga TWJ, Boonen A, Helm-van Mill AHM. Fatigue in rheumatoid arthritis; a persistent problem: a large longitudinal study. RMD Open 2015;1:e000041. Dartel SAA, Repping-Wuts JWJ, Hoogmoed D, Bleijenberg G, Riel PLCM, Fransen J. Association between fatigue and pain in rheumatoid arthritis: does pain precede fatigue or does fatigue precede pain? Arthritis Care Res (Hoboken). 2013 Jun;65(6):862–9. Singh H, Arya S, Talapatra P, Lather K, Mathur R, Singhania A, Chaudhary V. Assessment of Fatigue in Rheumatoid Arthritis (by Functional Assessment of Chronic Illness Therapy-Fatigue Score) and Its Relation to Disease Activity and Anemia. J Clin Rheumatol. 2014 Mar;20(2):87–90. <h3>Disclosure of Interest</h3> None declared
AB1131 Risk of developing atherosclerosis in patients with rheumatoid arthritis
Authors: I Starodubtseva
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Patients with chronic inflammatory diseases have an increased risk of developing atherosclerosis. Pro-inflammatory cytokines such as interleukin-(IL-)1beta and tumor necrosis factor-(TNF-)alpha, C-reactive protein (CRP) influence on the progression and development of both rheumatoid arthritis (RA) and atherosclerosis. <h3>Methods</h3> 620 patients with RA (diagnosis according to ACR /EULAR) from the rheumatology in-patient clinic with the mean age of 43.4±10; 95.4% ACCP – positive patients, activity on DAS (Disease Activity Score) 28 II, III; 85.4% female with the disease duration for about 3–15 years were enrolled in the trial. We assessed the level of IL-1 with the use of ELISA. <h3>Results</h3> The constructed model surfaces indicated the interdependence of IL-1, the activity of DAS 28 and the level of LDH in RA patients. The correlative and regressive analysis of the results showed the statistically significant correlation of TG, LDG and markers of inflammation IL-1, DAS 28: p=0.627 (p&lt;0.01), p=0.527 (p&lt;0.01), p=0.712 (p&lt;0.01), p=0.776 (p&lt;0.01) accordingly. The correlation coefficient between hs-CPR and the indicators of the lipid profile revealed similar interconnections. <h3>Conclusions</h3> According to the results of modeling, disease activity on DAS and markers of inflammation (IL-1 and hs-CRP) as a markers of the severity of inflammatory process in RA patients are risk factors for developing atherosclerosis. The analysis of inflammation indicators in RA patients allows to assess the risk of developing and progressing atherosclerosis. The data enables to select the best possible personified therapy for such patients at the early stage of the disease. <h3>Disclosure of Interest</h3> None declared
Improved Tumor Targeting and Longer Retention Time of NIR Fluorescent Probes Using Bioorthogonal Chemistry
Authors: Xianghan Zhang, Bo Wang, Na Zhao, Zuhong Tian, Yunpeng Dai, Yongzhan Nie, Jie Tian, Zhongliang Wang, Xiaoyuan Chen
Journal: Theranostics (2017)

The traditional labeling method for targeted NIR fluorescence probes requires directly covalent-bonded conjugation of targeting domains and fluorophores in vitro.Although this strategy works well, it is not sufficient for detecting or treating cancers in vivo, due to steric hindrance effects that relatively large fluorophore molecules exert on the configurations and physiological functions of specific targeting domains.The copper-free, "click-chemistry"-assisted assembly of small molecules in living systems may enhance tumor accumulation of fluorescence probes by improving the binding affinities of the targeting factors.Here, we employed a vascular homing peptide, GEBP11, as a targeting factor for gastric tumors, and we demonstrate its effectiveness for in vivo imaging via click-chemistry-mediated conjugation with fluorescence molecules in tumor xenograft mouse models.This strategy showed higher binding affinities than those of the traditional conjugation method, and our results showed that the tumor accumulation of click-chemistry-mediated probes are 11-fold higher than that of directly labeled probes.The tracking life was prolonged by 12-fold, and uptake of the probes into the kidney was reduced by 6.5-fold.For lesion tumors of different sizes, click-chemistry-mediated probes can achieve sufficient signal-to-background ratios (3.5-5) for in vivo detection, and with diagnostic sensitivity approximately 3.5 times that of traditional labeling probes.The click-chemistry-assisted detection strategy utilizes the advantages of "small molecule" probes while not perturbing their physiological functions; this enables tumor detection with high sensitivity and specific selectivity.
THU0260 Low plasma concentrations of apolipoprotein m correlate to disease activity and endothelial dysfunction in sle
Authors: A Bengtsson, H Tydén, C Lood, B Gullstrand, B Dahlbäck, A Jönsen
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> ApoM is an antiatherogenic and vasculoprotective 25kDa apolipoprotein suggested to play a role in keeping endothelial barrier integrity. <h3>Objectives</h3> The aims of the current study were to determine the impact of SLE disease activity on apoM levels and investigate if apoM levels reflect endothelial function in SLE. <h3>Methods</h3> Plasma concentrations of apoM were measured with ELISA in two SLE cohorts, all patients fulfilling ≥4 American College of Rheumatology (ACR) classification criteria for SLE, and 100 healthy controls (HC). Patients in cohort I had active disease as evaluated with SLEDAI scores. In cohort II endothelial function was measured by EndoPAT 2000 and correlated to apoM levels. A low Reactive Hyperemia Index (RHI) value indicated endothelial dysfunction (ED). <h3>Results</h3> In cohort I, the plasma levels of apoM were found to be significantly decreased in SLE (p&lt;0.0001), and the apoM concentrations correlated inversely to disease activity (SLEDAI, r= -0.29, p=0.0063. ApoM was also significantly lower in patients with active nephritis, leukopenia, anti-DNA antibodies or rash compared to patients without these manifestations. In cohort II, using linear regression analysis, there was a positive correlation between apoM levels and the RHI value, indicating endothelial dysfunction, in the younger SLE patients: β=0.94 CI 95% 0.22,1.65 r=0.32 p=0.011. <h3>Conclusions</h3> SLE related inflammation may have an impact on lower plasma apoM, which may affect the endothelium and the process towards cardiovascular disease. <h3>Disclosure of Interest</h3> None declared
AB1136 The age of onset of rheumatoid arthritis correlates with air pollution and health expenditure: results from multinational databases
Authors: JD Castillo-Ortiz, A Barajas-Ochoa, I Peláez-Ballestas, A Ramirez-Gomez, FJ Aceves-Avila, JJ Castaneda-Sanchez, C Ramos-Remus
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Environmental variables contribute up to half of the variation in the rheumatoid arthritis (RA) susceptibility. We have recently reported that the age of RA onset (RAo) varies across latitudes around the world, starting younger around the Tropic of Cancer (1). Latitude gradients have been used as a surrogate for studying the influence of the environment on the risks of disease in order to generate hypotheses for further investigation. <h3>Objectives</h3> This is an exploratory study to assess whether the age of RAo correlates with tropospheric pollutants (2), electromagnetic fields, Inequality-adjusted Human Development Index (I-HDI) and Health Expenditures as per national census of participating countries. <h3>Methods</h3> The age of RAo was obtained from the GEO-RA group database that involves 2,481 patients from 41 countries. Information of the tropospheric pollutant PM10 (particulate matter 10μ), the I-HDI, and Health Expenditures per capita was obtained from the World Health Organization9s reports. The average of each country9s electromagnetic fields (nanotesla, nT) from the past 50 years was calculated using geographic coordinates per country through the magnetic field calculator of The National Centers of Environmental Information. Pearson9s correlation and linear regression were used to evaluate the correlation of these environmental variables with the age of RAo by country. <h3>Results</h3> Complete data sets were available in 35 of the 41 countries. Overall, the mean age of RAo was 44±4.8 years, the annual average of PM10 of 57.5±39.3 μg/m<sup>3</sup>, the Health Expenditure per capita of US $2,212±2,742, and the electromagnetic fields of 41,900±8,720 nT. The age of RAo was younger in countries with high PM10 levels (r= -0.61, p&lt;0.01), high inequality (I-HDI, r=0.59, p&lt;0.01), and low Health Expenditure per capita (r=0.61, p&lt;0.01); the age of RAo did not correlate with nT. A significant linear regression equation was found [F(2,32)=13.61, p&lt;0.01, R2=0.46] in the age of RAo, Health Expenses per capita (β=0.0007; CI 95% 0.00004 to 0.001) and PM10 levels (β=-0.044; CI 95% -0.085 to -0.002). <h3>Conclusions</h3> The tropospheric pollutant PM10 and the components of the Health Expenditure per capita such as the provision of health services, family planning activities and nutrition activities are variables worth to further study through hypothesis-testing designs. <h3>References</h3> GEO-RA Group. Latitude gradient influences the age of onset of rheumatoid arthritis: a worldwide survey. Clin Rheumatol 2016. DOI: 10.1007/s10067–016–3481–9. Essouma M, Noubiap JJ. Is air pollution a risk factor for rheumatoid arthritis? J Inflamm (Lond) 2015; 12:48. DOI: 10.1186/s12950–015–0092–1. <h3>Disclosure of Interest</h3> None declared