tbuckley/cabot-search huggingface dataset:
FRI0437 Effects of ankylosing spondylitis on plantar pressure distribution
Authors: E Mesci, N Mesci, A İçağasıoğlu
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> It is considered that postural changes that occur in patients with ankylosing spondylitis (AS) are biomechanically compensated for by contribution from movements of hip, knee and ankle joints [1]. The effects of this phenomenon on the foot, the most distal segment of the kinetic chain, have not been fully elucidated. <h3>Objectives</h3> In the present study, our aim was to investigate possible changes in plantar load distribution in AS patients. <h3>Methods</h3> The study enrolled 30 AS patients diagnosed as per modified New York criteria and 30 healthy controls matched for age, gender and body mass index. Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) scores were obtained for all patients. Using a foot pressure platform, the distance from the center of pressure (CoP) to the posterior heel line was measured in centimeters (cm) in both groups (DCoP) (figure 1). Percent total plantar load distribution over the proximal half and distal half of the foot was calculated. <h3>Results</h3> Mean DCoP distance was significantly shorter in AS patients 9.65±0.96 cm) in comparison to that of control group (10.41±0.89 cm) (p=0.011). While the percent total plantar pressure applied on proximal half of the foot was 60.46±7.62% in AS patients, it was only 55.95±6.21% in the control group (p=0.031). However, AS patients had less percent pressure applied on the distal half of the foot (39.53±7.62%) versus control patients (44.04±6.21%) (p=0.031). The mean ratio of the percent pressure distribution over the proximal half of the foot to the percent pressure distribution over the distal half of the foot was significantly greater in AS patients (1.64±0.62) compared to control group (1.31±0.35) (p=0.037). <h3>Conclusions</h3> Plantar pressure distribution seems to be displaced towards the heel in the sagittal plane due to biomechanical changes in patients with ankylosing spondylitis. This points out to the significance of the lower extremities in the compensation of postural changes in AS patients. <h3>References</h3> Murray HC, Elliott C, Barton SE, Murray A: Do patients with ankylosing spondylitis have poorer balance than normal subjects? Rheumatology 2000, 39:497–500. <h3>Disclosure of Interest</h3> None declared
Targeting Prostate Cancer Subtype 1 by Forkhead Box M1 Pathway Inhibition
Authors: Kirsi Ketola, Ravi S.N. Munuganti, Alastair Davies, Ka Mun Nip, Jennifer L. Bishop, Amina Zoubeidi
Journal: Clinical Cancer Research (2017)

Abstract Purpose: Prostate cancer was recently classified to three clinically relevant subtypes (PCS) demarcated by unique pathway activation and clinical aggressiveness. In this preclinical study, we investigated molecular targets and therapeutics for PCS1, the most aggressive and lethal subtype, with no treatment options available in the clinic. Experimental Design: We utilized the PCS1 gene set and our model of enzalutamide (ENZR) castration-resistant prostate cancer (CRPC) to identify targetable pathways and inhibitors for PCS1. The findings were evaluated in vitro and in the ENZR CRPC xenograft model in vivo. Results: The results revealed that ENZR CRPC cells are enriched with PCS1 signature and that Forkhead box M1 (FOXM1) pathway is the central driver of this subtype. Notably, we identified Monensin as a novel FOXM1-binding agent that selectively targets FOXM1 to reverse the PCS1 signature and its associated stem-like features and reduces the growth of ENZR CRPC cells and xenograft tumors. Conclusions: Our preclinical data indicate FOXM1 pathway as a master regulator of PCS1 tumors, namely in ENZR CRPC, and targeting FOXM1 reduces cell growth and stemness in ENZR CRPC in vitro and in vivo. These preclinical results may guide clinical evaluation of targeting FOXM1 to eradicate highly aggressive and lethal PCS1 prostate cancer tumors. Clin Cancer Res; 23(22); 6923–33. ©2017 AACR.
AB1088 The patients' viewpoint on a specialised biologic service
Authors: E Cefai, D Balzan, C Mercieca, AA Borg
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Biologic disease modifying anti-rheumatic drugs (DMARDs) have been a major breakthrough in the treatment of inflammatory arthritis. In clinical practice, providing timely monitoring to ensure continued efficacy and safety remains a challenge. The availability of a dedicated clinic for patients on biologics may help meet these standards. <h3>Objectives</h3> The aim of this study was to get the patients9 perspective of our dedicated biologic clinic and identify any unmet needs. <h3>Methods</h3> Patients attending the biologic clinic between April and September 2016 and who were on a biologic for more than 2 years were interviewed by a trainee following their clinic visit. The patients were asked about their level of satisfaction on various aspects including waiting times, education, involvement in decision-making and duration of consultations. <h3>Results</h3> 44 patients (23 females, 21 males) participated in the survey, of whom 21 suffered from rheumatoid arthritis, 17 from ankylosing spondylitis and 6 from psoriatic arthritis. The mean age of participants was 55.1 (SD 12.62) years. The mean DAS28 was 2.26 (SD 1.03) and the mean BASDAI was 4.21 (SD 2.4). Disease duration was less than 5 years in 20%, 6 to 10 years in 30% and more than 10 years in 50%. Overall satisfaction with arthritis education before initiation of treatment was 91%, which then dropped to 76% after treatment initiation. Satisfaction with education regarding biologic therapy was more consistent at 84% and 81% before and after starting treatment, respectively. 84% of patients reported to be satisfied with their involvement in the decision to start and continue biologic therapy. 77% of patients were satisfied with a consultation lasting 15 to 20 minutes and 77% were also satisfied with 6-monthly visits. The most valued source of education was communication with the caring rheumatologist (n=32), followed by specialist nurse education (n=15), Internet resources (n=14) and use of leaflets (n=13). 95% of patients reported to have rarely or never missed an appointment. The rheumatology advice line was used by 54% of patients, whilst the rest reported that they did not need it since starting the biologic. The greater majority of advice line users were very satisfied with the service provided. Amongst the unmet needs mentioned, were better arthritis education and the introduction of telephone consultations. <h3>Conclusions</h3> Even though most patients were clinically well-controlled, continued education delivered by the caring rheumatologist and specialist nurse is still greatly valued. Patients attending this clinic highly valued the staff dedication and had good communication with their caring clinician. They were highly satisfied with the length and frequency of consultations. Nonetheless, a significant number suggested the need to introduce telephone consultations, which could be considered for those stable patients after receiving proper education. <h3>Disclosure of Interest</h3> None declared
AB0441 Using of subcutaneous methotrexate in aged patients with seropositive ra
Authors: Y Muraviev, G Gridneva, E Luchikhina, N Demidova, V Lebedeva, D Karateev
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Increasing life expectancy is a global process involving multiple nations, thus deeper insights into methotrexate (MTX) therapeutic potential in aged people is of paramount importance, as MTX still remains an anchor DMARD in RA management. <h3>Objectives</h3> To assess the results of 12-months therapy with subcutaneous MTX (SC MTX) injections in RA patients aged more than 60 years. <h3>Methods</h3> The 12 months open study included pts with active RA (DAS28 &gt;3,2), meeting ACR/EULAR (or ACR 1987) criteria, with RA lasting up to 3 years, and naïve to SC MTX. All pts were RF and/or ACPA-positive, 68% had increased BMI, 31% - obesity, 8% were smokers, 25% were taking oral GCS (≤10 mg/day equivalent to <i>prednisolone</i>).All pts were administered SC MTX monotherapy once a week as a DMARD, starting at 10–15 mg/week, with subsequent 5 mg up-titration each 1–2 weeks (to max 30 mg/week) up to achieving the target (remission or minimum disease activity) or up to emergence of an adverse drug reaction (ADR). Folic acid (min 5 mg/week) was administered at any day(s) except for the day of SC MTX injection for ADR prophylaxis. Disease activity was scored using DAS28. GEBA were administered in pts with insufficient SC MTX clinical effect. Pts were monitored within universal institutional REMARKA program, envisaging physical examination, blood analysis and biochemistry panel (including liver enzymes and creatinine). STATISTICA 10 software was used for data processing. <h3>Results</h3> 32 RA pts (28 females, 4 males) were included (mean disease duration 12±10 months, mean age - 65,7±4,7 years, mean DAS28 score -5,6±0,9. Cumulative SCMT dose by the end of the study reached 264±180 mg). The therapeutic target (remission or minimum disease activity based on DAS28 score) was achieved in 20 pts receiving SCMT monotherpay, 12 pts required administration of GEBAs. Adverse drug reactions (ADRs) were documented in 10 pts, including cases of more than one ADR at a time: breast abscess (1), alopecia (2), diarrhea (2), skin rash (1), a metallic aftertaste (1), local post-injection reactions (1), nausea (2), elevation of liver enzymes (3), leucopenia (1), pneumonia (1). There were 5 cases of SC MTX monotherpay discontinuation (2 - temporary, and 3 - permanent). The majority of pts (88%) could manage self-injection without additional training or assistance from medical staff. <h3>Conclusions</h3> 62,5% of aged RA pts participating in the study managed to achieve the therapeutic target after 12 months of SC MT monotherapy, although 31% ADRs rate required temporary (2)/permanent (3) SCMT discontinuation. <h3>Disclosure of Interest</h3> None declared
Ambient Air Pollution and Cancer Mortality in the Cancer Prevention Study II
Authors: Michelle C. Turner, Daniel Krewski, W. Ryan Diver, C. Arden Pope, Richard T. Burnett, Michael Jerrett, Julian D. Marshall, Susan M. Gapstur
Journal: Environmental Health Perspectives (2017)

The International Agency for Research on Cancer classified both outdoor air pollution and airborne particulate matter as carcinogenic to humans (Group 1) for lung cancer. There may be associations with cancer at other sites; however, the epidemiological evidence is limited.The aim of this study was to clarify whether ambient air pollution is associated with specific types of cancer other than lung cancer by examining associations of ambient air pollution with nonlung cancer death in the Cancer Prevention Study II (CPS-II).Analysis included 623,048 CPS-II participants who were followed for 22 y (1982-2004). Modeled estimates of particulate matter with aerodynamic diameter <2.5µm (PM2.5) (1999-2004), nitrogen dioxide (NO2) (2006), and ozone (O3) (2002-2004) concentrations were linked to the participant residence at enrollment. Cox proportional hazards models were used to estimate associations per each fifth percentile-mean increment with cancer mortality at 29 anatomic sites, adjusted for individual and ecological covariates.We observed 43,320 nonlung cancer deaths. PM2.5 was significantly positively associated with death from cancers of the kidney {adjusted hazard ratio (HR) per 4.4 μg/m3=1.14 [95% confidence interval (CI): 1.03, 1.27]} and bladder [HR=1.13 (95% CI: 1.03, 1.23)]. NO2 was positively associated with colorectal cancer mortality [HR per 6.5 ppb=1.06 (95% CI: 1.02, 1.10). The results were similar in two-pollutant models including PM2.5 and NO2 and in three-pollutant models with O3. We observed no statistically significant positive associations with death from other types of cancer based on results from adjusted models.The results from this large prospective study suggest that ambient air pollution was not associated with death from most nonlung cancers, but associations with kidney, bladder, and colorectal cancer death warrant further investigation. https://doi.org/10.1289/EHP1249.
OP0111 The association between sonographic enthesitis and radiographic joint damage in psoriatic arthritis
Authors: A Polachek, R Cook, V Chandran, D Gladman, L Eder
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Enthesitis is a common clinical finding and a key pathogenic feature in psoriatic arthritis (PsA). Ultrasound is emerging as a preferred method to assess enthesitis. Little is known about the relation between the presence of enthesitis and the severity of joint damage in patients with PsA. <h3>Objectives</h3> Our objective was to examine the association between sonographic enthesitis and the severity of radiographic features of damage in the peripheral and axial joints in PsA. <h3>Methods</h3> A cross-sectional study was conducted in consecutive patients with PsA. The MAdrid Sonography Enthesitis Index (MASEI) scoring system was used to quantify the extent of sonographic entheseal abnormalities in 12 entheseal sites. Total MASEI was further categorized into: bone scores (enthesophytes, erosions) and soft tissue scores (structural changes, vascularization, bursitis). Radiographic joint damage in the peripheral joints and spine was assessed independently of the ultrasound results using the modified Steinbrocker score, Modified New York Criteria for sacroiliitis and the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Additionally, the presence of ankylosis, arthritis mutilans and periostitis in the hands or feet was determined. Linear and logistic regression models were used to assess the association between MASEI score and the radiographic features of joint damage after controlling for age, sex, BMI, PsA duration and the use of DMARDs and biologic medications. <h3>Results</h3> 222 patients were included (58% men) with mean (s.d.) age of 55.9 (12.9) years and PsA duration of 16.7 (12.4) years. The mean MASEI score was 15.6 (12.6). The mean modified Steinbrocker score was 18.1 (32.3), <i>mSASSS</i> was 1.7 (7.3) and 37% had sacroiliitis. Multivariate regression analyses found an association between higher scores of MASEI scores and peripheral joint damage: modified Steinbrocker score (β 9.26, p&lt;0.0001), joint ankylosis (Odds Ration (OR) 2.09, p=0.0001) and arthritis mutilans (OR 1.73, p=0.005). The association between MASEI scores and periostitis was of borderline statistical significance (OR 1.29, p=0.06). Similarly, an association was found in multivariate analyses between higher MASEI scores and axial damage as measured by mSASSS (β 1.55, p≤0.0001) and sacroiliitis (OR 1.36, p=0.02). Sub-analysis showed that the MASEI bone score were more strongly associated with radiographic damage outcomes than the MASEI soft tissue score. <h3>Conclusions</h3> The severity of sonographic enthesitis is a marker of radiographic peripheral and axial joint damage in PsA. The association was found with both erosive and bone formation lesions. These findings highlight the potential role of enthesitis in the pathogenesis of articular damage in PsA. <h3>Disclosure of Interest</h3> None declared
SP0040 How to scan the hip, new approach and demo
Authors: I Möller
Journal: Annals of the Rheumatic Diseases (2017)

The exploration of the hip includes not only intraarticular findings such as synovitis or lesions of the labrum but also the dynamic exploration of the tendons and muscles surrounding it as well as of the neurovascular bundles of interest. All this is an essential complement in the differential diagnosis of the rheumatic patient. The iliopsoas tendon as well as the hip adductors will be demonstrated during the presentation. The anterior and antero internal part of the groin region constitute a relatively frequent consultation and study of the tendinous snapping and its differential diagnosis with the snapping of intraarticular origin can be made by means of the musculoskeletal ultrasound. It requires systematization and knowledge of the regional anatomy. <h3>Disclosure of Interest</h3> None declared
Disease Staging and Prognosis in Smokers Using Deep Learning in Chest Computed Tomography
Authors: Germán González, Samuel Y. Ash, Gonzalo Vegas-Sánchez-Ferrero, Jorge Onieva Onieva, Farbod N. Rahaghi, James C. Ross, Alejandro Díaz, Raúl San José Estépar, George R. Washko
Journal: American Journal of Respiratory and Critical Care Medicine (2017)

Rationale: Deep learning is a powerful tool that may allow for improved outcome prediction.Objectives: To determine if deep learning, specifically convolutional neural network (CNN) analysis, could detect and stage chronic obstructive pulmonary disease (COPD) and predict acute respiratory disease (ARD) events and mortality in smokers.Methods: A CNN was trained using computed tomography scans from 7,983 COPDGene participants and evaluated using 1,000 nonoverlapping COPDGene participants and 1,672 ECLIPSE participants. Logistic regression (C statistic and the Hosmer-Lemeshow test) was used to assess COPD diagnosis and ARD prediction. Cox regression (C index and the Greenwood-Nam-D’Agnostino test) was used to assess mortality.Measurements and Main Results: In COPDGene, the C statistic for the detection of COPD was 0.856. A total of 51.1% of participants in COPDGene were accurately staged and 74.95% were within one stage. In ECLIPSE, 29.4% were accurately staged and 74.6% were within one stage. In COPDGene and ECLIPSE, the C statistics for ARD events were 0.64 and 0.55, respectively, and the Hosmer-Lemeshow P values were 0.502 and 0.380, respectively, suggesting no evidence of poor calibration. In COPDGene and ECLIPSE, CNN predicted mortality with fair discrimination (C indices, 0.72 and 0.60, respectively), and without evidence of poor calibration (Greenwood-Nam-D’Agnostino P values, 0.307 and 0.331, respectively).Conclusions: A deep-learning approach that uses only computed tomography imaging data can identify those smokers who have COPD and predict who are most likely to have ARD events and those with the highest mortality. At a population level CNN analysis may be a powerful tool for risk assessment.
Annals Story Slam - On Raking Sand
Authors: Arno Kumagai
Journal: Annals of Internal Medicine (2017)

Web Exclusives19 September 2017Annals Story Slam - On Raking SandFREEArno Kumagai, MDArno Kumagai, MDFrom University of Toronto, Toronto, Ontario, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W17-0049 SectionsAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Video. Annals Story Slam - On Raking Sand "On Raking Sand," by Dr. Arno Kumagai (Duration 08:36)Building on the popular Annals feature “On Being a Doctor,” storytellers share stories about the experience of doctoring on video.For more videos from and information on Annals Story Slam, visit go.annals.org/StorySlam. Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: From University of Toronto, Toronto, Ontario, Canada.Current Author Address: Arno Kumagai, MD, University of Toronto, Toronto, Ontario, Canada; e-mail, arno.[email protected]ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 19 September 2017Volume 167, Issue 6Page: SS1 ePublished: 19 September 2017 Issue Published: 19 September 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.Loading ...
Impact of Ixekizumab Treatment on Depressive Symptoms and Systemic Inflammation in Patients with Moderate-to-Severe Psoriasis: An Integrated Analysis of Three Phase 3 Clinical Studies
Authors: Christopher E.M. Griffiths, Maurizio Fava, Andrew H. Miller, James Russell, Susan G. Ball, Wen Xu, Nayan Acharya, Mark Hyman Rapaport
Journal: Psychotherapy and Psychosomatics (2017)

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Depression is a common comorbidity in psoriasis, and both conditions are associated with systemic inflammation. The efficacy of ixekizumab, a high-affinity monoclonal antibody that selectively targets interleukin (IL)-17A, was evaluated in patients with moderate-to-severe plaque psoriasis (psoriasis) and depressive symptoms that were at least moderately severe. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Data were integrated from 3 randomized, double-blind, controlled phase 3 trials. At baseline and week 12, depressive symptoms and inflammation were assessed by the 16-item Quick Inventory of Depressive Symptomology - Self-Report (QIDS-SR&lt;sub&gt;16&lt;/sub&gt;) and by a high-sensitivity assay of serum C-reactive protein (hsCRP), respectively. A subgroup of patients with at least moderately severe depressive symptoms at baseline (QIDS-SR&lt;sub&gt;16&lt;/sub&gt; total score ≥11) was analyzed. Improvement in psoriasis was assessed by the Psoriasis Area and Severity Index (PASI). &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Approximately 10% of the overall psoriasis population had at least moderately severe depressive symptoms at baseline. At week 12, comorbid patients treated with ixekizumab had significantly greater improvements in their QIDS-SR&lt;sub&gt;16&lt;/sub&gt; total score (ixekizumab 80 mg every 2 weeks [Q2W], -7.1; ixekizumab 80 mg every 4 weeks [Q4W], -6.1) vs. placebo (-3.4) (&lt;i&gt;p&lt;/i&gt; &lt; 0.001, both comparisons) and higher rates of remission of depressive symptoms (ixekizumab Q2W, 45.2%; ixekizumab Q4W, 33.6%) vs. placebo (17.8%) (&lt;i&gt;p&lt;/i&gt; ≤ 0.01, both comparisons). Patients treated with ixekizumab also had significant reductions in hsCRP and PASI compared to placebo. Etanercept treatment was not associated with significant improvements in depressive symptoms compared to placebo. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; In this comorbid population, 12 weeks of ixekizumab therapy resulted in remission of depression for approximately 40% of patients and improved systemic inflammation as indicated by hsCRP.