tbuckley/cabot-search huggingface dataset:
Abstract 3933: Local Cytokine Release is Increased in Less Mature Collateral Arteries and Reflects Collateral Arterial Oxygen Pressure in Man
Authors: Stephan H Schirmer, Niels van Royen, Perry D Moerland, Joost O Fledderus, Jan Baan, José P Henriques, René J van der Schaaf, Marije M Vis, Jan J Piek
Journal: Circulation (2008)

Background: The molecular background of the maturation of the human collateral circulation in response to coronary narrowings is poorly understood, particularly because of the complexity to evaluate coronary collateral growth in-vivo. Local sampling of collateral blood in patients could provide valuable insights in this process. We sought to determine metabolic parameters and plasma cytokine profiles in the human coronary collateral circulation in relation to collateral maturation. Methods and Results: We used a Proxis® proximal embolic protection device (St. Jude Medical) to perform blood sampling directly from the coronary collateral circulation in 60 patients with non-total (n=25) or total coronary occlusions (n=35). Coronary collateral flow index (CFI) was assessed by intracoronary pressure measurements. Oxygenation and lactate content was measured as well as 30 cytokines potentially involved in collateral artery growth, using a custom-made multiplex assay. Oxygen gradient between systemic and collateral arterial correlated inversely with CFI (R=−0.63, p&lt;0.001). No rise in lactate or change in pH was found in collateral blood. Locally increased plasma levels were found for bFGF, Eotaxin, MIF, MCP-1, VEGF and TGFbeta, while SCF was significantly decreased. The highest cytokine gradients were found in patients with the least developed collateral circulation. The majority of cytokines correlated more strongly with pO2 extraction across the collateral bed than with CFI. Conclusion: Upregulation of cytokines at the site of coronary collateralization and in collateral vessels with enhanced oxygen gradient between systemic and collateral arterial blood demonstrate increased inflammatory activity in arteries where oxygen delivery is insufficient. Less pronounced cytokine gradients in collateral arteries in CTOs indicate reduced arteriogenic activity in these vessels. Determining oxygen gradient may be a more sensitive tool for the assessment of the functional capacity of the collateral circulation in patients than measurements of CFI.
Insertion of percutaneous endoscopic gastrostomy tubes with jejunal extensions using the “wedge” technique: a novel method to prevent retrograde tube migration into the stomach
Authors: Michael Sey, Hannah Gregor, Jamie Gregor, Brian Yan
Journal: Endoscopy (2017)

Background and study aim In percutaneous endoscopic gastrostomy (PEG) with jejunal extension (PEGJ) procedures, retrograde migration of the jejunal extension tube into the stomach during endoscope withdrawal is a frustrating problem. We describe the novel "wedge" technique for inserting the jejunal extension tube, utilizing single-balloon enteroscopy to anchor it in place. Patients and methods Prospective 1-year study of consecutive patients undergoing PEGJ insertion at a single tertiary care center. The primary outcome was number of pyloric intubations required to place the jejunal extension tube. Secondary outcomes included success rate, time, and complications related to jejunal extension tube insertion. Results 17 patients underwent the procedure. The jejunal extension tube was inserted at the first attempt in 15 patients (88.2 %) and 2 required another pyloric intubation. Abdominal X-ray showed that all PEGJ tubes were successfully seated in the proximal jejunum. The mean (SD) time required for jejunal extension insertion was 16.9 (8.6) minutes. Two adverse events occurred due to PEG insertion although none were related to the jejunal extension insertion itself. Conclusions: The "wedge" technique is an effective and easy method for inserting a jejunal extension tube after PEG insertion.
THU0383 Incidence of uveitis in non-steroidal anti-inflammatory drugs versus tumor necrosis factor inhibitors users among patients with ankylosing spondylitis: a retrospective cohort study
Authors: MJ Kim, EE Lee, EY Lee, YW Song, EB Lee
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Uveitis associated with ankylosing spondylitis (AS) often recurs and may lead to ocular complications. It remains to be known whether non-steroidal anti-inflammatory drugs (NSAIDs) or TNF inhibitors (TNFi) is more effective in reducing the recurrence of uveitis in patients with AS. <h3>Objectives</h3> To evaluate the effect of NSAIDs and TNFi on preventing recurrence of uveitis in patients with AS. <h3>Methods</h3> This retrospective cohort study included 1061 patients diagnosed with AS at Seoul National University Hospital between January 2004 and December 2015. Patients9 clinical factors and laboratory findings were collected from the patients9 electric medical records. Patients were divided into those who were treated with NSAIDs (n=623) or TNFi (n=438) which included etanercept, adalimumab, infliximab and golimumab. The incidence rates of new-onset uveitis during each treatment was compared using Cox proportional hazard model after adjusting age, sex, disease duration, history of uveitis, smoking status, ESR, CRP, and HLA-B27. Propensity-score matched comparison was also performed as sensitivity analysis (n=168 in the TNFi group and n=168 in the NSAID group). <h3>Results</h3> Among the 1061 patients, those in the TNFi group had longer disease duration (11.75±7.14 vs 6.22±4.42 years), higher ESR, CRP level (40.97±33.87 vs 23.32±22.09 mm/h, 2.69±3.41 vs 1.12±1.93 mg/L, respectively) and higher proportion of patients who had previous history of uveitis before the treatment (22.4 vs 15.4%). The incidence rates of uveitis were 3.60 (95% CI 2.97 to 4.42) per 100 person-year in the NSAID group and 6.03 (95% CI 5.15 to 7.04) per 100 person-year in the TNFi group. The adjusted hazard ratio for the new-onset uveitis during the treatment in the TNFi group versus the NSAID group was 1.28 (95% CI 0.80 to 2.06) (p=0.304). When compared with NSAID group, etanercept group showed higher incidence of uveitis than the other TNFi: etanercept (HR 1.96 [1.41 to 2.74]), adalimumab (HR 0.65 [0.40 to 1.05]), infliximab (HR 0.50 [0.22 to 1.14]) and golimumab (HR 0.79 [0.25 to 2.50]). The propensity score-matched population was also consistent with the crude comparison between NSAID group and TNFi group (HR 1.29 [0.73 to 2.28]) (p=0.388). <h3>Conclusions</h3> The effect of TNFi on reducing the incidence of uveitis is comparable to NSAIDs in patients with AS. Uveitis occurred more commonly with treatment with etanercept compared with the other treatments. <h3>Disclosure of Interest</h3> None declared
AB0551 The impact of temporal artery biopsy on diagnosis of giant cell arteritis in clinical practice
Authors: E Kaltsonoudis, D Kirochristos, A Bai-Papoudou, P Voulgari, AA Drosos
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Temporal artery biopsy (TAB) is the current gold standard for diagnosis of giant cell arteritis (GCA). Clinical manifestations of GCA include cranial symptoms, features of polymyalgia rheumatica (PMR), fever of unknown origin (FUO) and large vessel involvement, following by elevation of C- reactive protein (CRP) and erythrocyte sedimentation rate (ESR). In these patients TAB confirms diagnosis. <h3>Objectives</h3> In the current study the impact of TAB on diagnosis of GCA in a large number of patients is presented. <h3>Methods</h3> 245 patients who had undergo TAB were evaluated. All patients were more than 50 years old and were admitted in a tertiary University Hospital during the period 2006–2016. More specifically 164 were admitted in the division of internal medicine (DIM), 53 in the rheumatology clinic (RC), 6 in the eye clinic (EC) and 3 in the neurology clinic (NC). All the clinical and laboratory data were recorded and analyzed appropriately. <h3>Results</h3> The mean age of the patients was 68,6±5,6 year and 61,5% were women. 49/245 patients had positive TAB (21,17%). More specifically 5/6 positive TAB (83,3%) were ordered by the EC with signs of visual disturbances, mainly visual loss, diplopia and headache. 12/56 positive TAB (22,6%) were ordered by the RC with clinical features of headache and PMR. 31/164 (18,9%) with positive TAB were ordered by DIM with clinical signs of PMR, FUO and anemia of chronic disease and finally 1/3 with positive TAB (33,3) were ordered by the NC with clinical features of severe headache. All patients with positive TAB had elevated levels of CRP and ESR. <h3>Conclusions</h3> In elderly patients with cranial symptoms, visual disturbances, PMR, FUO and raised acute phase reactants, the possibility of GCA is very high and TAB is necessary to confirm diagnosis. <h3>Disclosure of Interest</h3> None declared
THU0587 Public awareness of rheumatic diseases in cyprus - need for improvement
Authors: J Joseph, I Armata, A Antoniadou, P Maini
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Public awareness regarding rheumatic diseases is a constant aim of patient societies and health care professionals in rheumatology. A high level of awareness will help identification and early treatment, it would avoid unnecessary investigations and costs and more importantly, it would assist functioning of patients with such conditions in society, with the understanding and support they deserve. <h3>Objectives</h3> The aim was to study public awareness regarding rheumatic conditions. Specifically, what constitutes a rheumatic condition, which doctor deals with these, what is their frequency and what age groups are affected. <h3>Methods</h3> During the rheumatic diseases awareness week in May 2016, doctors, medical students and members of the Cyprus League against Rheumatism, walked the streets of major cities and invited passers-by to answer a few simple questions. This was optional and at the end of the questions, information was provided, based on the answers and on any additional queries raised by people. <h3>Results</h3> 400 people provided answers. There were slightly more women than men and ages ranged from 13 to 86 years. Almost 50% did not know what a rheumatologist does. Only 11% could name 3 rheumatic conditions. Although the majority stated that rheumatic diseases occur in the elderly, 2/3 were unaware that they can affect children. Most people correctly identified which specialists should deal with asthma or eczema, but a huge majority did not know who should be consulted for back pain, tendon problems or osteoporosis. Although 75% had heard of rheumatoid and osteoarthritis, 75% of people had never heard of ankylosing spondylitis or fibromyalgia and only about half had heard of psoriatic arthritis or lupus. Most people stated that rheumatic conditions in general, affect 10–20% of people. <h3>Conclusions</h3> There was significant lack of awareness as to what rheumatologists do, what constitutes a rheumatic disease, the fact that it affects young people and the link between rheumatology and back pain, tendon problems and osteoporosis. All these points need to be included in public education. Of the major rheumatic diseases, the next awareness campaign needs to include ankylosing spondylitis, fibromyalgia, psoriatic arthritis and lupus. <h3>Disclosure of Interest</h3> None declared
SP0185 Divergences between objective and self-reported physical function in fibromyalgia
Authors: M Henriksen
Journal: Annals of the Rheumatic Diseases (2017)

In fibromyalgia (FM), intolerance to physical activity, with increased pain and experience of early muscle fatigue, is a predominant feature. Furthermore, shorter endurance times and higher perceived effort during physical activity compared with healthy controls are characteristic. However, there are discrepancies between physical functioning as perceived by the patients and as measured objectively or during performance tests. For example, in 840 FM patients and 122 healthy controls, we found reduced muscle strength in approximately 50% of the FM patients. However, the patients with subnormal muscle strength did not self-report worse symptoms or more physical disablement than those with normal muscle strength. Much like central sensitization of pain, it has been suggested that impaired sensory-motor interaction is present in FM, which may be a cause for observed discrepancies between perceived and objective signs of muscle fatigue. That is, the sensory inputs to the central nervous system during a physical activity are over-interpreted, leading to amplified sensations of fatigue and discomfort normally associated with exhausting muscle work. To illuminate this we conducted a controlled experiment, in which FM patients and health controls completed a muscle exhaustion test, while objective measures of muscle fatigue were collected by electromyography in parallel with reporting of perceived muscle fatigue. The results suggest that among FM patients, central nervous system processes normally associated with muscular fatigue were present, yet without any evidence of peripheral muscle fatigue. The study supports a hypothesis about abnormal sensory-motor interaction among FM patients that can explain the discrepancies between perceived and observed physical disability in FM. <h3>Disclosure of Interest</h3> None declared
AB0883 The sensitivity of gout specific ultrasound signs at metatarsophalangeal joints would be better by the dorsal surface examination
Authors: MA Mahdi, H Rkain, M Erraoui, R Watfeh, S Aktaou, L Tahiri, R Bahiri, F Allali, N Hajjaj-Hassouni
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> To compare the prevalence of ultrasonographic gout specific signs at the dorsal and plantar surfaces of the metatarsophalangeal joints (MTP). <h3>Methods</h3> This is a cross-sectional study which includes 15 patients with chronic gout, defined according to the American College of Rheumatology criteria (ACR 1977). Ultrasound (US) examination was performed using a high-frequency linear probe (Toshiba Xario®, frequency (8–14 MHz)) in B mode. 150 articular sites were studied at their dorsal and plantar surfaces. The ultrasound has objectified the presence of two signs: hyperechoic band over the superficial margin of the articular cartilage described as a double contour (DC) and the tophaceous deposits at the joint cavity. We compared the prevalence of the two signs between the dorsal and palmar surfaces at each site studied. <h3>Results</h3> The mean age at onset was 54.7±12,6 years, and the median diagnosis duration was 0 (0.3) years). The results of the US examination are summarized in Table 1. <h3>Conclusions</h3> Our study suggests that globally, DC predilect significatily in dorsal than in plantar surfaces of MTP joints. These results should be verified on a larger population. <h3>Disclosure of Interest</h3> None declared
THU0045 IL-21 and IL-22 are involved in bone destruction in rheumatoid arthritis patients
Authors: E Kuca-Warnawin, W Kurowska, A Radzikowska, G Pracon, T Burakowski, M Olszewska, I Slowinska, I Sudol-Szopinska, W Maslinski
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Inflammatory process in bone marrow (BM) observed on MRI scans of rheumatoid arthritis (RA) patients (called bone marrow oedema) was shown to proceed joint destruction in RA. Our previous studies supported the concept that BM actively participate in the pathogenesis of RA by TLR triggered B cell activity (1), increased number of activated T cells and increased level of proinflammatory cytokines (2,3). Cytokines play a key role in the bone destruction of rheumatoid arthritis. <h3>Objectives</h3> To investigate the levels of IL-21 and IL-22 in RA BM plasma and their association with bone destruction. <h3>Methods</h3> BM samples were obtained from RA and osteoarthritis (OA) patients during total hip replacement surgery. Levels of IL-17AF, IL-21, IL-22, RANKL and cathepsin K in BM plasma were determined by specific ELISA tests. We analyzed pelvic radiographs of 22 patients with RA admitted to the NIGRR and subjected to total hip replacement. Radiographs were taken a day or two before surgery. In our study we assessed hip joint changes semi-quantitatively with the use of the proposed scoring system including primary RA (juxta-articular osteoporosis, axial joint space narrowing, inflammatory cyst presence, bony erosion) and late RA changes (axial migration of the femoral head, femoral head deformation, avascular necrosis of femoral head, femoral head subluxation). <h3>Results</h3> We found increased levels of activated T cell associated cytokines IL-21 (924.8 pg/ml vs 688.6 pg/ml, p&lt;0.05) and IL-22 (94.5 pg/ml vs 65.8 pg/ml, p&lt;0.05) in BM plasma of RA patients in comparison to osteoarthritis (OA) patients. Interestingly levels of both of these cytokines strongly correlated positively with concentration of osteoclastogenesis/osteoclast activity marker RANKL and cathepsin K. Surprisingly level of IL-17AF did not correlate with RANKL or cathepsin K. Furthermore, concentration of IL-21 was statistically significantly higher in patients with more severe radiologically assessed bone destruction. Median value of concentration of IL-21 in RA patients with small bone destruction was 797.4 pg/ml, with mild bone destruction was 1037.8 pg/ml, with severe bone destruction (1079.0 pg/ml). <h3>Conclusions</h3> Our results show an association between BM plasma levels of IL-21 and IL-22 and bone destruction, supporting the hypothesis that IL-21 and IL-22 are important pathogenic factors of this disease. Therapy targeting IL-21 and IL-22 may be of value in preventing bone erosions in patients with RA. <h3>References</h3> W Rudnicka et al.: Eur J Immunol 2009; 12. E Kuca-Warnawin et al.: Ann Rheum Dis Jan;70(1):227–33. E Kuca-Warnawin et al.: Reumatologia 2016;54(2):51–3. <h3>Acknowledgements</h3> This work was sponsored by grant No UMO-2011/03/B/NZ6/05035 from National Science Centre, Poland. <h3>Disclosure of Interest</h3> None declared
FRI0333 Ocular involvement in behÇet's disease about 221 cases
Authors: K Echchilali, W Bouissar, M Moudatir, F-Z Alaoui, H Elkabli
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Behçet9s disease (BD) is a chronic systemic inflammatory disorder of unknown etiology. It9s chracterised by recurrent oral aphtosis and genital ulcer. Ocular involvement has been recognized since the time of Hypocrates. Estamates of the prevalence vary in different countries and may represent differences in the disease, in acces to health care and in availabale treatments. <h3>Objectives</h3> The aim of this study is to describe the epidemiological and clinical characteristics in moroccan patients with ocular BD. <h3>Methods</h3> retrospective study in internal medicine department over 13 years and including 221 patients with ocular BD. The diagnosis was performed by the International Study Group for Behçet9s Disease and/or the International Criteria for Behçet9s Disease. <h3>Results</h3> 221 (prevalence: 43%) had ocular involvement.154 men and 63 women (sex ratio: 2.5). The mean age at the onset of ocular involvement was 30.5 years. This achievement was inaugural in 18.55% of cases. The average time of diagnosis in other cases was 3.41 years.There was a high prevalence of Uveitis (total: 34%, anterior: 32%, posterior: 31.2). Retinal Vasculitis was noted in 37 eyes and retinal detachment in 17 eyes. Neurological events were associated in 13.57% of cases, joint and vascular events in respectively 18 and 17 cases. The topical corticosteroid therapy was prescribed in 27, 14% of cases, oral in 47, 51% and bolus in 29, 41%. 47, 51% of casers received Cyclophosphamide and 19% received Azathioprine. Cyclosporine was administered in 3 cases, interferon and Infkiximab in 2 cases each. The evolution was good in 111 cases (50.22%), treatment failure was noted in 24% of cases and recidivism in 16.74% of cases.63 patients have evolved into blindness which was bilateral in 51.1% of cases. <h3>Conclusions</h3> Only early diagnosis and appropriate management can improve the prognosis of ocular involvement in BD. <h3>Disclosure of Interest</h3> None declared
Erythroid-Specific Variant of the Nuclear Exportin Xpo7 Conserved Only in Mammals May Explain Functional Differences Between Mammalian Definitive and Lower Vertebrate (or Primitive) Erythropoiesis
Authors: Sandra Martinez-Morilla, Srividhya Venkatesan, Seibel Katharina, Jeffrey D. Cooney, Barry H. Paw, Dirk Gorlich, Shilpa M Hattangadi
Journal: Blood (2016)
AB0233 Remission according to RAPID3 (routine assessment of patient index data 3) in patients with rheumatoid arthritis: a cross-sectional study from routine care at 3 usa sites
Authors: I Castrejon, MJ Bergman, KA Gibson, Y Yazici, JA Block, T Pincus
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> RAPID3 remission criteria provide similar results to DAS28 criteria, although less stringent compared to ACR/EULAR Boolean criteria. RAPID3 remission criteria are more feasible in routine care<sup>1</sup> and have been reported at 25% in patients from France<sup>1</sup> and 21% from Norway<sup>2</sup>. <h3>Objectives</h3> We examined the proportion of patients in remission and 3 other severity categories according to RAPID3 at 3 sites at which MDHAQ is completed by all patients in routine care. <h3>Methods</h3> All patients seen at each rheumatology site complete an MDHAQ/RAPID3 at all visits in the waiting area as part of their routine care. The MDHAQ includes 0–10 scores for physical function, pain and patient global estimate, compiled into a 0–30 RAPID3, as well as scores for fatigue, RADAI self-report of painful joints, and demographic data. Physicians complete a global assessment (DOCGL) on a 0–10 visual analog scale (VAS). A random visit with complete questionnaire data for each RA patient from each site was included in the analyses. The proportion of patients in 4 RAPID3 categories, high severity (&gt;12/30), moderate severity (6.1–12), low severity (3.1–6), and remission (≤3), was computed. MDHAQ demographic and clinical measures and DOCGL were compared in the 4 RAPID3 severity groups using chi-square and ANOVA tests. <h3>Results</h3> 420 RA patients from the 3 sites were analyzed. Remission rates according to RAPID3 severity ranged from 23% to 26%, similar to reported rates from France and Norway. Low severity ranged from 7–24%, moderate severity from 23–29% and high severity from 21–46%. Age and sex were similar in the disease severity categories at the 3 sites (Table). Patients in the moderate and high severity groups at each site had higher scores for fatigue, RADAI self-reported joint pain, and DOCGL. <h3>Conclusions</h3> Similar RAPID3 remission rates were seen at 3 USA sites (about 24%), comparable to results from France and Norway. <h3>References</h3> Castrejon I, Dougados M, et al. J Rheumatol 2013, 40(4):386–393. Uhlig T, Lie E, et al. J Rheumatol 2016, 43(4):716–723. <h3>Disclosure of Interest</h3> I. Castrejon: None declared, M. Bergman: None declared, K. Gibson: None declared, Y. Yazici: None declared, J. Block: None declared, T. Pincus Shareholder of: Health Report Services, Inc