tbuckley/cabot-search huggingface dataset:
SAT0544 Subgroups in radiographic features in patients with hip osteoarthritis: results of the AMS-OA cohort
Authors: RAM Pouw, M van der Esch, M van der Leeden, D Reiding, LD Roorda, J Dekker, WF Lems
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Radiographic features are important in diagnosing hip osteoarthritis (OA)<sup>1,2</sup>. In daily practice, only the anterior-posterior view is visualized but not the false profile view. Since we assessed radiographic features in both types of radiographic hip images in the AMS-OA cohort, we were able to examine the differences in radiographic features in two regions of the hip (superior-lateral and central-axial region). <h3>Objectives</h3> (i) To describe the presence of radiographic features in patients with hip OA; and (ii) to determine whether radiographic features differ between the superior-lateral and central-axial region of the hip. <h3>Methods</h3> Data from 97 patients with bilateral hip pain and a Kellgren and Lawrence score of ≥1 of the Amsterdam Osteoarthritis (AMS-OA) cohort of patients with knee and/or hip OA were used. Standard radiographic images were examined of patients in an erect position, both with an anterior posterior view and with a false profile view, which is an oblique lateral view of the hip. Radiographic images were scored by an experienced radiologist (DR) and an independent researcher (ME). Consensus between two raters was achieved for each score. Four radiographic features were scored: presence of joint space narrowing, osteophytes, sclerosis and cysts. All joint features were scored separately for the superior-lateral and the central-axial region of the hip. A Fisher9s exact test was performed for testing the significance of the differences between the two regions of the hip. <h3>Results</h3> Table 1 shows the frequencies of radiographic features (joint space narrowing, osteophytes, sclerosis and cysts) in the superior-lateral and the central-axial region of the left and right hip joint of patients with hip OA. Significant differences between the two regions were found for osteophytes, sclerosis and cysts with the highest frequency of these features in the superior-lateral region of the hip. <h3>Conclusions</h3> In our cohort we found as expected, that joint space narrowing of the hips was the most frequent feature (&gt;80% in both the superior- lateral and central-axial region). Moreover, osteophytes, sclerosis and cysts were more frequently present in the superior-lateral region. Our findings indicate that hip OA may exist of two subgroups with differences in radiographic features (i.e., superior-lateral and central-axial). Future research should confirm these results and focus on possible associations with biomechanical and physical function variables. <h3>References</h3> Altman RD, Gold GE. Atlas of individual radiographic features in osteoarthritis, revised. Osteoarthritis and Cartilage (2007); 15, A1-A56. Krishanu B, Gupta MD, Duryea J, Weissman BN. Radiographic evaluation of osteoarthritis. Radiol Clin N Am 42 (2004) 11–41. <h3>Disclosure of Interest</h3> None declared
THU0099 The 2010 classification criteria and a more aggressive treatment strategy improve clinical outcomes in seropositive but not seronegative rheumatoid arthritis
Authors: G Crepaldi, S Bugatti, F Benaglio, G Sakellariou, A Manzo, C Montecucco, R Caporali
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Current guidelines recommend an early and intensive treatment in patients diagnosed with rheumatoid arthritis (RA), and the 2010 ACR/EULAR Classification Criteria were developed with the aim of allowing earlier diagnosis and treatment (1,2). Recent studies highlighted some differences in disease activity between seropositive and seronegative RA patients at disease onset (3). <h3>Objectives</h3> To investigate whether the application of the 2010 ACR/EULAR Classification Criteria and a more aggressive treatment strategy improve clinical outcomes in patients with early RA irrespective of the autoantibody status. <h3>Methods</h3> 584 early, treatment-naïve RA patients were recruited in the years 2005–2014. RA diagnosis was made according to the ACR 1987 criteria in 2005–2010 (n=360, cohort 1987), and to the 2010 ACR/EULAR criteria in 2011–2014 (n=224, cohort 2010). Patients were classified in autoantibody (Ab)-negative (negative rheumatoid factor (RF) and/or anticitrullinated peptide antibody (ACPA) and Ab-positive (RF and/or ACPA positive). Methotrexate (MTX) was used at the initial dosage of 10 mg/week in cohort 1987, and 15 mg/week in cohort 2010, and progressively increased if low disease activity (LDA) (DAS28≤3.2) was not met. The frequency and predictors of LDA and clinical remission (DAS28&lt;2.6) over 6 months were assessed by Cox regression. <h3>Results</h3> In Ab-negative patients, LDA and clinical remission were achieved in 62.8% and 37.2% of the cases, and the 2010 cohort did not show significantly improved outcomes (HR [95% CI] 0.86 [0.611.23] for LDA$;$ 1.04 [0.651.69] for remission) (Figure 1A,B). In contrast, in Ab-positive patients, the application of the 2010 classification criteria and higher dosages of MTX were associated with increased frequency of LDA after adjustment for confounders (age, sex, prednisone, baseline DAS28$;$ HR [95% CI] 1.39 [1.012]) (Figure 1C). Clinical remission was achieved in 41.3% of the cases, compared to 29.6% in the 1987 cohort (p=0.17) (Figure 1D). <h3>Conclusions</h3> Early diagnosis and a more aggressive treatment strategy with MTX lead to significantly improved outcomes in autoantibody positive RA. The management of seronegative patients remains suboptimal. <h3>References</h3> Smolen JS et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis 2016. Aletaha D et al. 2010 rheumatoid arthritis classification criteria: an ACR/EULAR collaborative initiative. Ann Rheum Dis 2010. Nordberg LB et al. Patients with seronegative RA have more inflammatory activity compared with patients with seropositive RA in an inception cohort of DMARD naive patients classified according to 2010 ACR/EULAR criteria. Ann Rheum Dis 2017. <h3>Disclosure of Interest</h3> None declared
Joined-up planning across the whole system is essential to improve mental health
Authors: Woody Caan
Journal: BMJ (2017)

How delightful to foresee 21 000 new posts in mental health.1 As a teacher, I would be delighted to help to build a revived, multidisciplinary workforce. As an academic, I would assume population mental health and developments across the lifecourse informed workforce planning.2 The first 19 pages of Health Education England’s plan, however, do not contain any population …
OC-012 Codyceps cicadae and its active constitutions prevent ccl4-induced hepatic fibrosis in balb/c mice via anti-oxidation
Authors: B-J Ke, C-L Lee
Journal: Gut (2017)

Introduction  Hepatic fibrosis is caused by chronic liver injury and repeated repair with scar tissue accumulation in the liver. It is the last reversible stage before liver cirrhosis and hepatocellular carcinoma (HCC). Cordyceps cicadae is a well-known Chinese herbal medicine for treating palpitations and eye diseases. Recent research indicates that C. cicadae contains large quantities of adenosine, N6-(2-hydroxyethyl)-adenosine (HEA) and polysaccharides, which are reported to have anti-oxidation and anti-inflammatory activities. This study investigated the effect of C. cicadae and its active constitutions on carbon tetrachloride (CCl4)-induced liver fibrosis in BALB/c mice  Method  Male mice were injected 0.5 µL/g CCl4 (in corn oil) 3 times a week for 4 weeks to induce hepatic fibrosis and treated with C. Cicadae mycelium, adenosine, HEA, and polysaccharides daily for 6 weeks. The levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) indicated liver function. The collagen levels were determined by serum procollagen-III-peptide (PIIIP), liver hydroxyproline (HYP) and picrosirius red (PSR) stained paraffin-embedded tissue sections. The anti-oxidative enzymes and thiobarbituric acid reactive substances (TBARS) were measured.  Results  AST, ALT and ALP levels were reduced significantly by treatment of C. Cicadae mycelium, adenosine, HEA, and polysaccharides compared with the CCl4 group. Moreover, serum PIIIP, liver HYP, and relative liver weight were decreased in all of the sample groups. Furthermore, TBARS levels were decreased by C. Cicadae mycelium, adenosine, HEA, and polysaccharides. However, after CCl4 administration, superoxide dismutase (SOD) and catalase (CAT) activities were increased compared with the control group and treatment of C. Cicadae mycelium, adenosine, HEA, and polysaccharides promoted higher levels of SOD and CAT to protect oxidative damage by reactive oxygen species (ROS).  Conclusion  C. Cicadae mycelium, adenosine, HEA, and polysaccharides had potential to prevent hepatic fibrosis via anti-oxidation in CCl4-induced hepatic fibrosis.  Disclosure of Interest  None Declared
FRI0349 The SNP RS6871626 located in IL12B region may influence on vascular lesions of takayasu arteritis
Authors: T Nakajima, H Yoshifuji, C Terao, K Murakami, R Nakashima, Y Imura, K Ohmura, T Mimori
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Takayasu arteritis (TAK) is a type of large vessel vasculitis, which affects aorta and its main branches. We previously found a single nucleotide polymorphism (SNP), rs6871626 located in <i>IL12B</i> region, as a susceptible gene to TAK and reported that the risk allele at the SNP is associated with the risk of aortic regurgitation (AR)<sup>1)</sup>. However, there have been no studies on the association of the SNP with the organ involvements other than AR in TAK patients. <h3>Objectives</h3> To investigate the association of the SNP with arterial and organ involvements except for AR. <h3>Methods</h3> We examined the medical records of 85 patients with TAK, stratified them into three groups according to the allele at the SNP, AA (n=26), AC (n=43) and CC (n=16) (A is a risk allele), and investigated the association of the SNP and organ involvements. <h3>Results</h3> There were no differences in the complication rates of carotid arterial lesions among the groups (AA 78.9%, AC 63.9% and CC 80.0%). The proportion of patients with lesions in descending aorta (Numano classification<sup>2)</sup> IIb∼V) was 75.0% in AA, 44.2% in AC 44.2% and 25.0% in CC and the proportion in AA was significantly higher than in CC (p=0.0096). Moreover, estimated glomerular filtration rate (eGFR) was significantly lower in AA than in CC (61.3±26.9ml/min/1.73m<sup>2</sup> vs. 81.5±28.8 ml/min/1.73m<sup>2</sup>, p=0.042). <h3>Conclusions</h3> The SNP rs6871626 located in <i>IL12B</i> may influence on the occurrence of descending aortic lesions in TAK patients and this may lead to renal dysfunction. <h3>References</h3> Terao C et al. Am J Hum Genet. 2013; 93(2): 289–97. Hata A et al. Int J Cardiol. 1996; 54 Suppl: S155–163. <h3>Disclosure of Interest</h3> None declared
THU0489 Adiposity and inflammatory activity in juvenile idiopathic arthritis could they be related?
Authors: G Diaz-Cordoves Rego, R Galindo-Zavala, E Nuñez-Cuadros, S Manrique-Arija, N Mena Vazquez, C Domic-Bueno, M Rojas-Gimenez, C Fuego-Varela, R Caparros-Ruiz, L Cano-Garcia, A Fernandez-Nebro
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Adults with rheumatoid arthritis have been shown to have a reduction in lean mass and increased adiposity, despite presenting normal Body Mass Index (BMI). Several studies have shown increased adiposity induces a proinflammatory state which lead to a worse response to treatment. There are few publications about this subject in juvenile idiopathic arthritis (JIA) <h3>Objectives</h3> Describing body composition and anthropometric parameters in JIA patients, and evaluating relationship between adiposity and inflammatory in these children. <h3>Methods</h3> Observational cross-sectional study, in JIA patients from 4 to 15 years, monitored by a Pediatric Rheumatology Unit. Monoarticular forms were excluded. Anthropometric, clinical and treatment data were recorded. DXA (measuring bone and fat mass) were obtained. Fat Mass Index (FMI) was defined as fat mass (kg)/height (m<sup>2</sup>) and fat-free mass index (FFMI) as lean mass (kg)/height (m<sup>2</sup>). JADAS27 index was used to evaluate inflammatoty activity. <h3>Results</h3> We analyzed 80 patients, whose characteristics are shown in table 1. The most frequent JIA subtype was oligoarticular (16.3% extended,47.5% persistent) followed by polyarticular (25.1%). Twenty five percent of patients had uveitis. Fifty percent them had inactive disease with treatment, 26% had activity and 23% were inactive without treatment. Regarding the treatment, 52.5% were on methotrexate and 30% on a biological drug (22.5% antiTNFα, 5% antiIL-1, 2.5% antiIL-6). Disease duration average was 6.6 years (± 3.7SD). JADAS27 index mean score was 2 (±4SD), CRP 4.7mg/l (±9,5SD), ESR 8.7mm (±7,2SD) and CHAQ 0.17 (± 0,38SD). Anthropometric parameters are shown in table 1. Mean JADAS27 index score in patients with normal BMIwas lower (1.7±3.6 SD) than mean JADAS27 index score in overweight and obese patients (3.3±6.0SD), although this difference was not significantly (p=0.255). In multiple linear regression, an increase of 0.3 JADAS27 was observed for each unit of FMI increase (p=0.03). This relationship was maintained in the multivariate analysis (B0.015; p0.01) independently of JIA subtype and received treatment. <h3>Conclusions</h3> In JIA patients, there is a linear relationship between FMI and disease activity measured by JADAS27, but most patients had a normal BMI. The establishment of this relationship (fat-inflammatory activity) would be transcendental due to the need to optimize the recommendations in the JIA approach. <h3>References</h3> Alvarez-Nemecye J, Buenfil-Rello FA, Pacheco Pantoja El. Association between body composition and disease activity in rheumatoid arthritis. A sistematic review. Reumatol Clin. 2016;12(4):190–5. <h3>Disclosure of Interest</h3> None declared
Characterization of Pulmonary Metastases in Children With Hepatoblastoma Treated on Children’s Oncology Group Protocol AHEP0731 (The Treatment of Children With All Stages of Hepatoblastoma): A Report From the Children’s Oncology Group
Authors: Allison F. O’Neill, Alexander J. Towbin, Mark D. Krailo, Caihong Xia, Yun Gao, M. Beth McCarville, Rebecka L. Meyers, Eugene D. McGahren, Greg M. Tiao, Stephen P. Dunn, Max R. Langham, Christopher B. Weldon, Milton J. Finegold, Sarangarajan Ranganathan, Wayne L. Furman, Marcio Malogolowkin, Carlos Rodriguez-Galindo, Howard M. Katzenstein
Journal: Journal of Clinical Oncology (2017)

Purpose To determine whether the pattern of lung nodules in children with metastatic hepatoblastoma (HB) correlates with outcome. Methods Thirty-two patients with metastatic HB were enrolled on Children’s Oncology Group Protocol AHEP0731 and treated with vincristine and irinotecan (VI). Responders to VI received two additional cycles of VI intermixed with six cycles of cisplatin/fluorouracil/vincristine/doxorubicin (C5VD), and nonresponders received six cycles of C5VD alone. Patients were imaged after every two cycles and at the conclusion of therapy. All computed tomography scans and pathology reports were centrally reviewed, and information was collected regarding lung nodule number, size, laterality, timing of resolution, and pulmonary surgery. Results Among the 29 evaluable patients, only 31% met Response Evaluation Criteria in Solid Tumors (RECIST) for measurable metastatic disease. The presence of measurable disease by RECIST, the sum of nodule diameters greater than or equal to the cumulative cohort median size, bilateral disease, and ≥ 10 nodules were each associated with an increased risk for an event-free survival event ( P = .48, P = .08, P = .065, P = .03, respectively), with nodule number meeting statistical significance. Ten patients underwent pulmonary resection/metastasectomy at various time points, the benefit of which could not be determined because of small patient numbers. Conclusion Children with metastatic HB have a poor prognosis. Overall tumor burden may be an important prognostic factor for these patients. Lesions that fail to meet RECIST size criteria (ie, those &lt; 10 mm) at diagnosis may contain viable tumor, whereas residual lesions at the end of therapy may constitute eradicated tumor/scar tissue. Patients may benefit from risk stratification on the basis of the burden of lung metastatic disease at diagnosis.
AB0425 Treatment of patients with rheumatoid arthritis in poland - estimate the frequency of use of methotrexate during a random appointment with a rheumatologist
Authors: K Sikorska-Siudek, M Przygodzka, R Radomski, S Bojanowski
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> In accordance with the EULAR/ACR reomendations disease-modifying antirheumatic drugs (DMARDs), particulary metotrexate (Mtx) should be applied after diagnosis of rheumatoid arthritis (RA). The goal of the treatment is to get remission/low disease activity <h3>Objectives</h3> The aim of this study was evaluation of the RA treatment, the frequency of use of Mtx and its dose application during control visits to rheumatologist in Poland. The disease activity was evaluated by using disease activity 28 joint score (DAS-28). <h3>Results</h3> There were analysed 301 case records of patients diagnosed with RA on the basis of the ACR 1997 and/or ACR/EULAR 2010 criteria. Patients recently diagnosed were excluded from analysis. In the examined group were 226 women and 75 men, median age 58.0, disease duration 5.0 Patients were divided in groups depending on the type of applied therapy 215 (71%) patients were treated with Mtx monotherapy or combined with other DMARDs. 161 patients (53%) took glucocorticosteroids simultaneously. Average DAS28 – 5.09, disease duration 6.2 At 18 patients (6%) contraindications against the Mtx were stated. 127 patients (59%) took high dosage of Mtx (20–30 mg/week), 84 (39%) low dosage (7.5–15 mg /week) 31 patients (10%) were treated other than Mtx DMARDs in monotherapy or in combined therapy 14 (45%) took glucocorticosteroids simultaneously, average DAS 28 – 4.82, disease duration 5.0 55 (18%) patients didn9t undergo treatment of DMARDs in the moment of analysis, 11 (20%) patients underwent treatment with glucocorticosteroids. Duration of disease 2.1 average DAS 28 5,43. <h3>Conclusions</h3> In patients treated with DMARDs in it also with Mtx a remission and/or a low activity of illness weren9t being observed what is indicating for the ineffective treatment with RA. Mtx wasn9t applied in recommended doses in spite of the moderate or high activity of illness There were patients who never had been treated with DMARDs. Causes of this occurrence require further research <h3>Disclosure of Interest</h3> None declared
AB0483 Responsiveness of lupus impact tracker among chinese patients with lupus
Authors: CC Mok, J Block, M Jolly
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Lupus Impact Tracker (LIT), a 10 item, patient reported outcome tool for patients with systemic lupus erythematosus (SLE) has undergone psychometric validation and responsiveness studies in the US and Europe. <h3>Objectives</h3> To report results on responsiveness of Lupus Impact Tracker among Chinese patients with SLE. <h3>Methods</h3> 430 patients with SLE meeting the ACR classification criteria were recruited in Hong Kong, China at a single center. LIT scores from two visits one year apart were analyzed for responsiveness and Minimal Clinically Important Difference (MCID) against patient report and physician assessed anchors of changes in health. Two patient reported anchors were used (Global change in health and item 2 of Short Form 36 form). Physician assessed anchors of change in health were disease activity (Physician global assessment-PGA, SELENA-SLEDAI) and damage (SLICC-SDI/ACR). Change in PGA of ≥0.3 and SELENA-SLEDAI of ≥4 in either direction was used to define worsening in disease activity. Analysis of variance was used to compare changes in LIT score against the anchors. <h3>Results</h3> Mean (SD) age of participants was 42 (14) years. Ninety five percent were women. Mean (SD) PGA, SELENA-SLEDAI and SDI at baseline were 0.5 (0.5), 2.9 (3.0) and 0.7 (1.2) respectively. Mean (SD) LIT score at baseline was 27.8 (18.2). Mean changes in LIT scores in response to worsening, no change or improvement based on patient report and physician assessments are shown in Table 1. MCID for “some worsening” were -4.0 and -3.9 on patient reported health question and SF36 question 2 respectively. <h3>Conclusions</h3> LIT shows responsiveness to changes in both patient-reported and physician assessed changes in health status among Chinese SLE patients. <h3>Disclosure of Interest</h3> None declared
Impact of Radiotherapy on Complications and Patient-Reported Outcomes After Breast Reconstruction
Authors: Reshma Jagsi, Adeyiza O. Momoh, Ji Qi, Jennifer B. Hamill, Jessica Billig, Hyungjin M. Kim, Andrea L. Pusic, Edwin G. Wilkins
Journal: JNCI Journal of the National Cancer Institute (2017)

Patients considering postmastectomy radiation and reconstruction require information regarding expected outcomes to make preference-concordant decisions. A prospective multicenter cohort study of women diagnosed with breast cancer at 11 centers between 2012 and 2015 compared complications and patient-reported outcomes of 622 irradiated and 1625 unirradiated patients who received reconstruction. Patient characteristics and outcomes between irradiated and unirradiated patients were analyzed using ttests for continuous variables and chi-square tests for categorical variables. Multivariable mixed-effects regression modelsassessed the impact of reconstruction type and radiotherapy on outcomes after adjusting for relevant covariates. All statistical tests were two-sided. Autologous reconstruction was more commonly received by irradiated patients (37.9% vs 25.0%, P < .001). Immediate reconstruction was less common in irradiated patients (83.0% vs 95.7%, P < .001). At least one breast complication had occurred by two years in 38.9% of irradiated patients with implant reconstruction, 25.6% of irradiated patients with autologous reconstruction, 21.8% of unirradiated patients with implant reconstruction, and 28.3% of unirradiated patients with autologous reconstruction. Multivariable analysis showed bilateral treatment and higher body mass index to be predictive of developing a complication, with a statistically significant interaction between radiotherapy receipt and reconstruction type. Among irradiated patients, autologous reconstruction was associated with a lower risk of complications than implant-based reconstruction at two years (odds ratio [OR] = 0.47, 95% confidence interval [CI] = 0.27 to 0.82, P = .007); no between-procedure difference was found in unirradiated patients. The interaction was also statistically significant for satisfaction with breasts at two years (P = .002), with larger adjusted difference in satisfaction between autologous vs implant approaches (63.5, 95% CI = 55.9 to 71.1, vs 47.7, 95% CI = 40.2 to 55.2, respectively) in irradiated patients than between autologous vs implant approaches (67.6, 95% CI = 60.3 to 74.9, vs 60.5, 95% CI = 53.6 to 67.4) in unirradiated patients. Autologous reconstruction appears to yield superior patient-reported satisfaction and lower risk of complications than implant-based approaches among patients receiving postmastectomy radiotherapy.