tbuckley/cabot-search huggingface dataset:
SP0016 The differential diagnosis of raynaud's phenomenon and practical approach to assessment with a focus on imaging
Authors: AL Herrick
Journal: Annals of the Rheumatic Diseases (2017)

Raynaud9s phenomenon is the term used to describes episodic vasospasm of the digital vasculature in response to cold exposure and/or emotional distress. The majority of people with Raynaud9s phenomenon have primary (idiopathic) Raynaud9s phenomenon which is 9benign9 in that it does not progress to irreversible digital ischaemia, and is not associated with any underlying disease. Conversely, when Raynaud9s phenomenon is secondary to an underlying disease/condition (for example to a systemic sclerosis-spectrum disorder), it can be severe, sometimes progressing to digital ulceration and/or gangrene. Raynaud9s phenomenon is often the presenting feature of connective tissue disease and therefore provides a window of opportunity for early diagnosis. The first step in management of Raynaud9s phenemenon is establishing the diagnosis. Is this primary or secondary Raynaud9s, and if secondary, then to what? While a careful history and examination are always the first steps, different laboratory tests and vascular imaging studies can be used to reach the correct diagnosis. This presentation will provide practicing rheumatologists with a practical approach to the diagnosis and assessment of Raynaud9s phenomenon, focussing on the diagnostic and prognostic role of vascular imaging (including nailfold capillaroscopy and thermography). <h3>Disclosure of Interest</h3> None declared
AB1125 Prediction of chronic damage in systemic lupus erythematosus by using machine-learning models
Authors: F Ceccarelli, M Sciandrone, C Perricone, G Galvan, F Morelli, LN Vicente, I Leccese, L Massaro, E Cipriano, FR Spinelli, C Alessandri, G Valesini, F Conti
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The increased survival in Systemic Lupus Erythematosus (SLE) patients implies the development of chronic damage, occurring in up to 50% of cases after a follow-up of 10 years. Its prevention is a major goal in the SLE management. During the last years, it has been suggested that Artificial Neural Networks (ANNs) could be a useful prediction tool in medical <i>scenarios</i>, by using patients9 data as inputs and the specific outcomes as outputs. The International Conference on Advanced Computing and Communication Systems in 2015 underlined the possible application of sophisticated data analysis tools, such as machine learning methods, in SLE patients, in the light of their potential application to diagnostic and prediction purposes. <h3>Objectives</h3> In the present study, we aimed at predicting chronic damage in a large monocentric SLE cohort by using neural networks. <h3>Methods</h3> For the present analysis, we used data from 413 SLE patients (1997 ACR criteria; M/F 30/383; mean age ± SD 46.3±11.9 years; mean disease duration ± SD 174.6±112.1 months, mean follow-up period ±SD 63.9±30.7 months). At each visit, the patients underwent a complete physical examination and clinical and laboratory data were collected in a standardized, computerized, and electronically filled form. All the patients were evaluated at least twice per year. Autoantibodies and complement serum levels were also registered. Chronic damage was assessed by the SLICC/ACR Damage Index (SDI). We applied Recurrent Neural Networks (RNNs) as a machine-learning model to predict the risk of chronic damage. The clinical data sequences registered for each patient during the follow-up were used for building and testing the RNNs. We used 27 clinical and laboratory items for the mathematical model. <h3>Results</h3> At the first visit, 35.8% of patients had an SDI≥1, with a mean±SD value of 1.7±1.1. For the RNN model, two groups of patients were analyzed: patients with SDI=0 at the baseline, developing damage during the follow-up (N=38), and patients without damage (SDI=0). In particular, in the first group, we used all the visits before the development of damage, and in the second group, we considered patients with at least 5 visits and a follow-up of 2 years. We created a mathematical model with an AUC value of 0.77, able to predict damage development. A threshold value of 0.35 (sensitivity 0.74, specificity 0.76) seems able to identify patients at risk to develop damage. <h3>Conclusions</h3> We applied RNNs to identify a prediction model for SLE chronic damage. By using longitudinal data, including laboratory and clinical items, we created a mathematical model able to identify patients at higher risk to develop chronic damage. <h3>Disclosure of Interest</h3> None declared
AB0770 Change of psoriatic arthritis impact of disease (PSAID12) questionnaire related to change in disease activity in early psoriatic arthritis
Authors: K Wervers, JJ Luime, I Tchetverikov, AH Gerards, MR Kok, CWY Appels, W van der Graaff, JHLM van Groenendael, L-A Korswagen, JJ Veris-van Dieren, JMW Hazes, M Vis
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The Psoriatic Arthritis Impact of Disease 12-item questionnaire (PsAID12) has been developed to measure impact of Psoriatic Arthritis (PsA) for purposes of monitoring and clinical management. Although validated in patients with longstanding disease, data on validity and sensitivity to change in early PsA is lacking. <h3>Objectives</h3> We aim to relate change in disease activity to change in PsAID12 score in early PsA and evaluate which PsAID domains are more likely to change. <h3>Methods</h3> Patients with a new diagnosis of PsA were included in the Dutch southwest Early Psoriatic Arthritis cohoRt (DEPAR). For this analysis, patients that have PsAID12 (range 0–10) and Composite Psoriatic Disease Activity Index (CPDAI, range 0–15) data at two consecutive visits (i.e. 3 months apart) within the first year were included. In case multiple periods per patients were available, the first time period was chosen. The change in PsAID is compared to the change in disease activity over this period, measured with the CPDAI using Spearman9s correlation coefficient. Change in score on individual domains of the PsAID was analysed in subgroups of patients that perceived improvement in health and those that perceived worsening. The SF-36 question on self-perceived change in health was used to determine these subgroups. <h3>Results</h3> 143 unique patients had at least one period with two PsAID and CPDAI measurements (67 from baseline-3 months, 26 3–6 months, 25 6- 9 months and 25 9–12 months). Mean age was 51 (SD 13.7) and 70 (49%) were male. The initial median PsAID was 3.35 (IQR 1.4–5.1) and the subsequent score was 2.25 (0.95–4.8 with a mean delta of 0.52 (P&lt;0.01). Median first CDPAI score was 4 (2–7) and 3 (1–5) for the second with a mean delta of 0.45 (P&lt;0.05). The difference in PsAID score was significantly but moderately correlated with the difference in CPDAI (Spearman9s rho 0.267, P=0.0013). 58 patients (41%) report a better health status compared to 3 months ago. Figure 1 shows that patients with self-perceived improvement of health have the highest improvement in pain and only domains of skin problems and embarrassment/shame did not improve significantly. Patients reporting worsening of health (n=29) only have significantly lower scores in fatigue, discomfort and social domains. <h3>Conclusions</h3> Improvement in CPDAI disease activity is significantly but moderately associated with improvement in PsAID score, with the biggest improvement in the pain domain in patients with a self-reported improvement of health. <h3>Disclosure of Interest</h3> None declared
SP0184 Role of microenvironment and endogenous pathways to break tolerance
Authors: P Lamprecht
Journal: Annals of the Rheumatic Diseases (2017)

Break of tolerance driving autoimmune disease is initiated by a combination of predisposing genetic and environmental factors resulting in self-perpetuating chronic inflammation and tissue damage. Effector molecules and cells targeting tissues housing the inciting autoantigen(s) maintain tissue damage and the autoimmune response. Granulomatosis with polyangiitis (GPA, formerly Wegener9s granulomatosis) is a prototypical autoimmune disease characterized by extravascular necrotizing granulomatous inflammation and a systemic autoimmune vasculitis associated with anti-neutrophil cytoplasmic autoantibodies specific for the neutrophil- and monocyte-derived serine-protease proteinase 3 (PR3-ANCA). GPA is strongly associated with <i>HLA-DPB1*0401</i> polymorphisms. Its association with the <i>R620W</i> variant of the <i>PTPN22</i> gene has been linked to reduced immune-regulatory interleukin (IL)-10 transcription. Epidemiological studies and molecular analysis of immune cells suggests a multifactorial pathogenesis of GPA, in which a potentially metachronous and individually varying sequence of infectious agents contributes to the break of tolerance and chronic inflammation sustaining autoimmunity in GPA. <h3>Disclosure of Interest</h3> None declared
THU0475 Evaluation of pelvic floor strength and urinary incontinence in women with fibromyalgia
Authors: MAG Pontes Filho, HCSC Fusco, EAG Ferreira, AP Marques
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Fibromyalgia (FM) is characterized by the <i>American College of Rheumatology</i> as chronic widespread pain referred for at least 3 months. In 2010, a new diagnostic criteria was proposed and includes symptoms such as fatigue, sleep disorder and memory. Currently, pelvic floor dysfunctions and urinary incontinence (UI) are considered public health problems with high prevalence and great impact on quality of life (QoL) and on women9s self-esteem. Physiotherapists have been working to create a new treatment proposal that can cover all aspects of FM, however there are few studies that include pelvic floor evaluation and urinary continence of this population. <h3>Objectives</h3> To assess the strength of the pelvic floor and urinary loss in women with FM. <h3>Methods</h3> We evaluated 126 sexually active women, aged between 19 and 65 years, with and without medical diagnosis of FM, matched for age and menopausal status, in a single center. The exclusion criteria were sexually transmitted or neurological diseases, pregnancy and use of medications with urinary side effects (urinary loss or retention). We collected in a single interview personal and gynecological data, applied the King Health Questionnaire (KHQ) for incontinent women and accomplished the evaluation of pelvic floor muscle strength according to the Oxford Classification Modified and perineometry. The participants signed the Informed Consent Form. We used for statistical analysis t test for independent variables and Mann-Whitney Test for the others. <h3>Results</h3> The FM patients presented the weaker pelvic floor (p&lt;0.001) and had lower values in perineometry (p=0.04) than control women. Regarding urinary loss, 64.5% reported UI against 26.6% of women without FM. In the KHQ evaluation, in General Health and Emotions domains, women with FM presented worse performance (p&lt;0.001 and p=0.046, respectively). <h3>Conclusions</h3> Urinary incontinence is a frequent finding in FM, and it could be related to the degree of strength of the pelvic floor muscles. This condition affects negatively QoL, especially with regard to emotions and general health. <h3>References</h3> Wolfe, et al. The American College of Rheumatology Preliminary Diagnistic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care &amp; Research, v.2, n.5, pg. 600–610, 2010. Jones, K. D. et al. Pelvic Floor and Urinary Distress in Women with Fibromyalgia. Pain Management Nursing, v. 16, n. 6, p. 834–840, Dec 2015. <h3>Acknowledgements</h3> This study received funds from CAPES (Coordination for the Improvement of Higher Education Personnel - Government Research Agency) with scholarship to one of the co-authors. <h3>Disclosure of Interest</h3> None declared
THU0364 Immunogenicity of anti-tnf drugs and clinical response in patients with spondyloarthritis
Authors: D Geiger, Y Degboe, T Barnetche, A Cantagrel, A Ruyssen-Witrand, A Constantin
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Antidrug antibodies (ADAb) seem to be associated with a loss of response in immune-mediated inflammatory diseases (1) and in psoriatic arthritis (2). <h3>Objectives</h3> To assess the effect of ADAb on clinical response in patients with spondyloarthritis (SpA) treated with anti-TNF drugs. <h3>Methods</h3> We conducted a systematic literature review of controlled trials and observational studies assessing the effect of ADAb on response to anti-TNF drugs (Adalimumab (ADL), Certolizumab (CTZ), Etanercept (ETA), Golimumab (GOL) and Infliximab (INF)) in patients with axial or peripheral SpA. Databases analysed were PubMed, the Cochrane library, and ACR/EULAR meeting abstracts, until January 2017. A meta-analysis was performed using the inverse variance approach and statistical heterogeneity was assessed with the Cochran Q-test and I<sup>2</sup> values. A statistical threshold of 5% was considered as significant. <h3>Results</h3> Over 1,387 publications screened, 7 studies were selected for meta-analysis (3–9). These studies were observational studies (n=6) or controlled trial (n=1); involved patients with axial or peripheral SpA (n=6) or psoriatic arthritis (n=1); included treatments with ADL (n=4), ETA (n=1), INF and INF biosimilar (n=2), or various anti-TNF drugs (n=1). ADAb rates varied between anti-TNF drugs: 0% for ETA, 13.6–31.4% for ADL, 0–28.9% for INF. Patients with ADAb were less often responders than patients without ADAb in 6 studies, more often responders in one study, while the risk ratio (RR) for response was not assessable in one study due to the absence of ADAb. The weighted pooled RR (95% CI) for response to anti-TNF drugs was 0.73 (0.54–0.98) in ADAb+ in comparison with ADAb- patients (p=0.04) (see figure). There were trends towards more infusion reactions and lower serum drug levels in patients with ADAb (data not shown). <h3>Conclusions</h3> According to the results of this meta-analysis, ADAb positivity is associated with a lower rate of response to anti-TNF agents in patients with SpA. <h3>References</h3> The immunogenicity of anti-TNF therapy in immune-mediated inflammatory diseases: a systematic review of the literature with a meta-analysis, Garcês.S and al, ARD 2014; 72:1947–1955. The comparative immunogenicity of biologic therapy and it9s clinical releavance in psoriatic arthritis: a systematic review of the literature, Balsa.A and al, ACR 2016, Abstract number 1691. <h3>Disclosure of Interest</h3> None declared
Effect of Amino Acids on the Induction of Leukemia in Mice
Authors: Julius White, G. Burroughs Mider, Walter E. Heston
Journal: JNCI Journal of the National Cancer Institute (1944)

Journal Article Effect of Amino Acids on the Induction of Leukemia in Mice Get access Julius White, Julius White senior biochemist National Cancer Institute, National Institute of Health, United State Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar G. Burroughs Mider, G. Burroughs Mider National Cancer Institute, National Institute of Health, United State Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar Walter E. Heston Walter E. Heston geneticist National Cancer Institute, National Institute of Health, United State Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 4, Issue 4, February 1944, Pages 409–411, https://doi.org/10.1093/jnci/4.4.409 Published: 01 February 1944
FRI0746-HPR The factors affecting stair climbing in patients who have an affected knee joint with oligoarticular juvenile idiopathic arthritis
Authors: SN Arman, E Tarakci, O Kasapcopur
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Juvenile idiopathic arthritis (JIA) encompasses a complex group of disorders with arthritis as a common feature. Patients with JIA may experience significant disability owing to muscular weakness, joint pain, contracture, and reduced mobility. Stair climbing performance is frequently used as a measure of lower extremity funtions in patients with chronic disease. <h3>Objectives</h3> The aim of this study was to investigating the factors affecting stair climbing in patients who have an affected knee joint with oligoarticular JIA. <h3>Methods</h3> 30 patients (aged 6–18 years) who have an affected knee joint with oligoarticular JIA were included in this study. Active range of motion (AROM) of knee was evaluated with universal goniometer. Muscular strength was estimated at maximal isometric force for the muscles of the lower extremities by using a portable handheld dynamometer (Lafayette, LA). Postural balance control was evaluated by using the Flamingo Balance Test (FBT). Static balance was measured by using the Functional Reach Test (FRT). Stair climbing performance was assessed with 10-stair climbing test (10SCT). All tests were performed thrice and the mean values of all were recorded. Relations between the factors affecting stair climbing in JIA were assessed by multiple linear regression analysis. <h3>Results</h3> The mean age was 9.63±2.76 and the mean disease duration was 4.41±2.16 years. Significant relationships were found between 10SCT and hip flexion muscle strength (r=-0.45 p=0.013), hip external rotation muscle strength (r=-0.48 p=0.007), knee extension muscle strength (r=-0.45 p=0.015) and dorsiflexion muscle strength (r=-0.37 p=0.044). According to linear regression analysis, stair climbing performance was affected by only hip flexion muscle strength (β=-0.40 p=0.026). However, it was not found relationships between AROM, FRT, FBT and 10SCT (p&gt;0.05). <h3>Conclusions</h3> Stair climbing is a biomechanically complex activity of daily life for children. In current study, it was found that stair climbing performance was related with lower extremity muscle strengths in patients with JIA. Althought patients with JIA had only one affected knee joint, hip flexion muscle strength was primary predictor of stair climbing performance. We suggested that stair climbing performance should be considered in patients with juvenile idiopathic arthritis. Thus, not only affected joint, but also all lower extremity joints should be assessed multidimensionally. <h3>Disclosure of Interest</h3> None declared
Serine protease allergen favours Th2 responses via <scp>PAR</scp>‐2 and <scp>STAT</scp>3 activation in murine model
Authors: K. Agrawal, N. Arora
Journal: Allergy (2017)

Abstract Background Protease activity of Per a 10 favours Th2 responses by differential regulation of IL ‐12p70 and IL ‐23 cytokine subunits. This study aimed to elucidate the underlying mechanism of differential regulation of IL ‐12p70 and IL ‐23. Methods PAR ‐2 activation was blocked in murine model by administering SAM 11 before each sensitization. CD 11c + p‐ STAT 3 + cells were measured in lungs by flow cytometry. BMDC s were pretreated with SAM 11 or isotype control or stattic and stimulated with Per a 10. p‐ STAT 3 levels were measured using Western blot. Transcript levels of IL ‐12p35, IL ‐12/23p40 and IL ‐23p19 were measured using RT ‐ PCR . Cytokine levels were analysed using ELISA . Results Protease activity of Per a 10 increased p‐ STAT 3 levels in mouse lungs, which was reduced upon PAR ‐2 blockage. Percentage of p‐ STAT 3 + CD 11c + cells was higher in Per a 10‐administered mice and was reduced upon PAR ‐2 blockage. IL ‐12p35 and IL ‐12p70 levels were higher, and IL ‐23p19 and IL ‐23 levels were lower in both SAM 11‐treated mice and BMDC s indicating a role of PAR ‐2‐mediated signalling. IL ‐4, TSLP , IL ‐17A, EPO activity, total cell count and specific IgE and IgG1 levels were lower in SAM 11‐administered mice. Inhibiting STAT 3 activation via stattic also leads to lower levels of IL ‐23p19 and IL ‐23 and higher levels of IL ‐12p35. Conclusions Per a 10 leads to PAR ‐2 activation on BMDC s resulting in downstream activation of STAT 3 to regulate the balance between IL ‐12/ IL ‐23 subunits causing a cytokine milieu rich in IL ‐23 to favour Th2 polarization.
AB0664 Level of satisfaction in patients with idiopathic inflammatory myopathies
Authors: N Loghin-Oprea, S Vetrila, L Mazur-Nicorici, M Cebanu, V Salaru, M Mazur
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Idiopathic Inflammatory Myopathies (IIM) are the group of rare diseases that carry a significant impact on patient9s quality of life, influenced by the level of patient9s satisfaction regarding medical services. <h3>Objectives</h3> To assess the patient9s satisfaction and quality of life. <h3>Methods</h3> A cross-sectional study was performed from December 2015 to December 2016. There were included consecutive patients that fulfilled the Bohan and Peter<sup>1</sup> criteria for IIM. The collected information was about demographic data, clinical and laboratory findings. The patient9s satisfaction was assessed by self-administered Patient Satisfaction Questionnaire (PSQ III)<sup>2</sup>, which is a 50-item tool, covering 7 domains: general satisfaction, technical quality, interpersonal aspects, communication, financial aspects, time spent with doctor, access/availability/convenience. To estimate the quality of life we applied Short Form-8 questionnaire with 8 items for 8 domains and two components: mental and physical. <h3>Results</h3> There were 32 patients enrolled in the study, including 23 females and 9 males, mean age 52.5±14.26 (range 25–78), the disease duration was 8.3±5.3 (range 0.5–12) years. The physical component was lower 37.49±8.49, than the mental component 44.96±6.24 points, we determined that the quality of patient9s life was reduced. The PSQ III results were: general satisfaction 20±2.93, technical quality 36.8±5.93, interpersonal aspects 26.50±4.92, communication 19.7±3.25 and access/availability/convenience indicated 44.75±6.29 score. The time spent with doctor was 7±1.15, a border score. The average result in the financial aspects domain was 21.6±6.6, lower than the midpoint scoring (24). We identified correlation between the quality of life and the access/availability/convenience PSQ III domain. For the mental compound the correlation was moderate (r=0.5 p&lt;0.005) and for physical domain it was weak (r=0.27 p&lt;0.005), these results can be explained by the fact that patients got accustomed with the disease, but they are more interested in access to care and require increasement of the duration of medical consultation. <h3>Conclusions</h3> Patients with idiopathic inflammatory myopathies have reduced quality of life; however they are satisfied of the medical attendance. The dissatisfaction was with the financial aspect, due to the long-term disease course and high indirect costs. <h3>References</h3> Bohan A, Peter JB. N Engl J Med 1975 Feb 13;292(7):344–7. Ware J.Jr. et al. Defining and measuring patient satisfaction with medical care. Eval Program Plann. 1983; 6(3–4): 247–63. <h3>Disclosure of Interest</h3> None declared
A non-cytotoxic dendrimer with innate and potent anticancer and anti-metastatic activities
Authors: Shiqun Shao, Quan Zhou, Jingxing Si, Jianbin Tang, Xiangrui Liu, Meng Wang, Jianqing Gao, Kai Wang, Rongzhen Xu, Youqing Shen
Journal: Nature Biomedical Engineering (2017)