tbuckley/cabot-search huggingface dataset:
THU0255 Comparison of remission and lupus low activity state as predictors of organ damage
Authors: M Petri, LS Magder
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Outcome measures that combine control of SLE activity and prednisone reduction are clinically relevant. A clinical goal in SLE is to reduce risk of long-term organ damage. <h3>Objectives</h3> We assessed whether two recently proposed disease activity outcomes were predictive of future damage. <h3>Methods</h3> For each month of follow-up in a large SLE cohort, we determined whether the patient was in Clinical Remission (as defined by the DORIS work group) or low lupus disease activity state (LLDAS) (as defined by Franklyn et al.). Clinical Remission was defined as a PGA&lt;0.5, clinical SLEDAI=0 and no prednisone or immunosuppressants. Clinical Remission on Treatment allowed for prednisone≤5mg/day and immunosuppressant use. LLDAS was defined as a SLEDAI ≤4, PGA ≤1.0, no major organ activity, and no new activity. LLDAS on treatment allowed for prednisone use ≤7.5 mg/d and immunosuppressants. Damage was defined using the SLICC/ACR index. <h3>Results</h3> There were 81,118 person-months observed among 2,026 patients (92% female, 53% Caucasian, 39% African-American). Table 1 shows the rates of damage, per person month, in subgroups defined by Remission or LLDAS. Damage rates were relatively low when LLDA was achieved at least 50% of the time. These rates were similar to those experienced by patients who met a more stringent treatment restriction with Remission on Treatment at least 50% of the time. <h3>Conclusions</h3> The equivalence of LLDAS and DORIS remission on treatment is welcome news, as LLDAS on treatment &gt;50% of the time is an easier goal to achieve (3 times more person-months observed in our cohort) and more realistic as a clinical trial outcome. <h3>Disclosure of Interest</h3> None declared
Relationship of the 21-gene recurrence score assay with tumor grade and KI67% in breast cancer.
Authors: Ioana Bonta, Dacian Bonta, Michelle Marie Loch, Rita A. Blanchard
Journal: Journal of Clinical Oncology (2015)

e12559 Background: In breast cancer there are several pathologic features such as tumor grade and ki67% (proliferation index), used to estimate the behavior of particular tumor. A 21-gene recurrence score assay (Oncotype Dx) is diagnostic tool used by clinicians to estimates the likelihood of breast cancer recurrence and chemotherapy benefit for patients with early stage, hormone-receptor positive breast cancer. The goal of our research is to compare Oncotype Dx with pathologic prognostic markers routinely reported by the pathology labs. Methods: : We performed a retrospective analysis of a dataset of 105 patients with ER-positive, M0, breast cancer, treated at Boston University Medical Center between November 2006 and May 2013. The recorded data included ER, Ki67%, TNM stage, and Oncotype Dx recurrence score. The database also included information about recurrence status and development of other malignancies (second oncologic event). Statistical methods employed were linear correlation and t-test. Results: The average Oncotype Dx score was 17.3 for grade 1 tumors; 19.0 for grade 2 tumors; and 26.4 for grade 3 tumors. The correlation coefficient between Oncotype Dx and Ki67% was 0.41. When stratified by tumor grade, the correlation between Oncotype Dx and Ki67% persisted for grade 2 and 3 tumors, but was not observed for grade 1 tumors. Patients with a second oncologic event had an average Oncotype Dx score of 23.5, significantly higher than patients without a second oncologic event (average Oncotype Dx score 19.1), p = 0.04. Conclusions: : 1) In our dataset, 21-gene recurrence score is correlated with tumor grade. Oncotype Dx and Ki67% are correlated for grade 2 and 3 tumors. 2) Increased Oncotype Dx score is correlated with the occurrence of a second oncologic event.
SAT0659 Comparison between eight different ultrasonographic scores for hand assessment in rheumatoid arthritis -a cross-sectional study
Authors: S Hussain, P Sivakumaran, L Attipoe, C Ciurtin
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic inflammatory condition associated with well-recognised inflammatory joint features, which are amenable to ultrasound (US) examination. The implementation of US scoring systems in addition to clinical examination could help standardise the way RA is monitored; however, due to variation in local availability of US and sonographer expertise, different scoring systems have been used in clinical practice (1). Despite significant research progress in supporting the role of US in RA, there is no consensus as to which scoring system is most useful. <h3>Objectives</h3> To assess whether simplified US protocols for hand examination correlate significantly with a 22 hand joint US score in patients with established rheumatoid arthritis, and correlate the US examination with the disease activity score (DAS-28 score). <h3>Methods</h3> This is a cross-sectional study of 224 RA patients stratified based on their DAS-28 scores and assessed using eight preselected US examination protocols including 22, 18, 16, 14, 10, 8 and two different combinations of 4 joints, respectively. Student T, Mann-Whitney U and Kuskal-Wallis tests were employed for analysis of clinical, laboratory and US parameters in the RA patient groups (P&lt;0.05 was considered significant). Spearman9s coefficients were used to correlate permutations of pairs of US scores, and US and DAS-28 scores. <h3>Results</h3> We found a significant difference between different US hand scores and their ability to detect the presence of active and chronic inflammation in RA patients. The DAS-28 scores correlated very well (R=0.89–1, P&lt;0.05) with the total Power Doppler (PD) scores generated by all US protocols irrespective of patients9 disease activity. Simplified US scores missed information on presence of erosions (P&lt;0.05), but were equivalent to the extensive 22 joint score in appreciating the amount of chronic and active inflammation compared to the extensive 22 joint score (P=0.15, P=0.11, respectively). <h3>Conclusions</h3> This study showed that preselected simplified US scores could be used in clinical practice to appreciate reliably the disease activity in patients with established RA; however they are less reliable in appreciating the disease burden when compared with an extended protocol for US examination of 22 hand joints. All the simplified US scores correlated very well with DAS-28 scores. <h3>References</h3> Mandl, P., et al., A systematic literature review analysis of ultrasound joint count and scoring systems to assess synovitis in rheumatoid arthritis according to the OMERACT filter. J Rheumatol, 2011. 38(9): p. 2055–62. <h3>Acknowledgements</h3> S. Hussain and P. Sivakumaran contributed equally to the study. <h3>Disclosure of Interest</h3> None declared
AB0610 Nailfold capillary microscopy and low body mass index in raynaud's phenomenon patients
Authors: AM Van Roon, A Eman Abdulle, AM van Roon, AJ Stel, AJ Smit, H Bootsma, DJ Mulder
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Underweight patients develop Raynaud9s phenomenon (RP) more frequently. [1] In a small study, skin temperature and perfusion in RP patients was positively associated with body mass index (BMI). [2] In clinical practice, we frequently observe an abnormal nailfold capillary microscopy (NCM) in underweight subjects with presumably primary RP, from which the implications are unknown. <h3>Objectives</h3> The aim is to study whether being underweight is associated with the presence of more abnormalities on NCM. <h3>Methods</h3> NCM, assessed by widefield videocapillaroscopy, was retrospectively assessed in consecutive patients with suspected RP. Patients were included when they had negative serology and did not develop any definite connective tissue disease or organ involvement after a maximum of 5 years follow-up. NCM pattern was classified as normal, non-specific, early, active or late, based on the Cutolo patterns. Weight and height were measured for clinical practice and patients were divided by BMI category: underweight (BMI&lt;18.5 kg/m<sup>2</sup>), normal weight (BMI 18.5–25 kg/m<sup>2</sup>), and overweight (BMI &gt;25 kg/m<sup>2</sup>). Dilated and giant capillaries were counted as well as the total number of capillaries. <h3>Results</h3> A total of 352 patients were included (median age 40.6 years (24.9–52.9), male/female: 111/241), of which 47 were underweight, 220 normal weight and 85 overweight. Patients who were underweight presented more abnormalities (dilated capillaries, capillary loss or giant capillaries) on NCM, as shown in figure 1. BMI was negatively associated with NCM pattern, number of dilated capillaries and number of giant capillaries (r=-0.247, r=-0.225 and r=-0.221 respectively, all p&lt;0.001) and positively with the total number of capillaries (r=0.260, p&lt;0.001). <h3>Conclusions</h3> In addition to well-known thermoregulatory abnormalities, clear NCM pattern abnormalities are more frequently observed in underweight patients with primary RP. BMI was negatively associated with the number of dilated capillaries and positively with capillary density. These data potentially suggest that damage to the microvasculature in underweight patients with primary RP may occur independently of the presence or development of a CTD and may be explained by other mechanisms. <h3>References</h3> Roquelaure Y, Ha C, Le Manac9h AP, Bodin J, Bodere A, Bosseau C, et al. Risk factors for Raynaud9s phenomenon in the workforce. Arthritis Care Res (Hoboken) 2012 Jun;64(6):898–904. Giurgea GA, Mlekusch W, Charwat-Resl S, Mueller M, Hammer A, Gschwandtner ME, et al. Relationship of age and body mass index to skin temperature and skin perfusion in primary Raynaud9s phenomenon. Arthritis Rheumatol 2015 Jan;67(1):238–242. <h3>Disclosure of Interest</h3> None declared
SAT0327 Nutritional status in patients with systemic sclerosis
Authors: A Wojteczek, M Ziętkiewicz, S Małgorzewicz, Z Zdrojewski
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Systemic sclerosis (SSc) is a chronic connective tissue disease characterized by involvement of multiple organs. Many clinical aspects, such as gastrointestinal involvement, mood disturbances, functional status, and inflammation, may lead to disease-related malnutrition [1]. The connection between inadequate nutritional status and systemic sclerosis is still not well established. It is important to identify the symptoms of malnutrition, because it is known as a predictor of poor clinical outcome [2]. <h3>Objectives</h3> To assess nutritional status in patients with systemic sclerosis. <h3>Methods</h3> The study involved fifty-two patients with SSc (44 women and 8 men, mean age 54,3±11,7 year) who were diagnosed according to ACR/EULAR criteria. The assessment of nutritional status was determined by subjective global assessment (SGA), body mass index (BMI) and level of serum albumin. Appetite was assessed by simplified nutritional appetite questionnaire (SNAQ). In all patients hand grip strength and triceps skinfold were established. The C-reactive protein (CRP), lipid profile, and level of haemoglobin/lymphocytes were measured in serum. <h3>Results</h3> Inadequate nutritional status was diagnosed in 14 patients (26,9%) with SSc. According to SGA 11 (21,15%) patients had signs of mild malnutrition, while 41 (78,85%) were well-nourished. Considering BMI, 1 patient (1,92%) was underweight, 24 (46,15%) were eutrophic, 21 (40,38%) overweight and 6 (11,54%) obese. Significantly lower BMI had patients with inadequate nutritional status (23,17±4,47 vs. 25,98±3,34; p=0,009). Low level of serum albumin was detected in 5 patients (9,6%) with SSc. Level of serum albumin and appetite were significantly decreased in patients with inadequate nutritional status (p=0,009; p=0,003). No statistical differences were noticed in hand grip strength, triceps skinfold, lipid profile, levels of CRP and haemoglobin/lymphocytes. <h3>Conclusions</h3> Malnutrition in systemic sclerosis is still underestimated clinical issue. This study provides useful data about nutritional status of patients with systemic sclerosis. Altered level of albumin and decreased appetite may lead to worsening in nutritional status. Assessment of nutritional status in this group of patients should be performed regularly, because it can be potentially modified. <h3>References</h3> Harrison E, Herrick AL, McLaughlin JT, Lal S. Malnutrition in systemic sclerosis. Rheumatology 2012;51:1747–1756. Krause L, et al. Nutritional status as marker for disease activity and severity predicting mortality in patients with systemic sclerosis. Ann Rheum Dis 2010;69:1951–1957. <h3>Disclosure of Interest</h3> None declared
Factors leading to the decision for contralateral prophylactic mastectomy in patients with breast cancer
Authors: M. Yi, K. K. Hunt, B. K. Arun, I. Bedrosian, A. M. Gutierrez Barrera, H. M. Kuerer, G. Babiera, E. A. Mittendorf, F. Meric-Bernstam
Journal: Journal of Clinical Oncology (2009)

1528 Background: Women with breast cancer have an increased risk of developing contralateral breast cancer in their lifetime. Thus increasing numbers of women have been electing to undergo contralateral prophylactic mastectomy (CPM) at the time of their initial breast cancer treatment. The objective of this study was to identify factors that determine the decision for CPM in patients at a major cancer center. Methods: 2,544 women with Stage 0-III unilateral primary breast cancer who underwent surgery to the breast at our institution from January 2000 to August 2006 were identified from a prospectively maintained database. Patient and tumor characteristics were evaluated and comparisons were made between patients who did or did not undergo CPM using logistic regression. Results: Of the 2,544 patients, 1254 (49.3%) underwent total mastectomy for their known cancer; 282 (22.5%) of these patients underwent immediate or delayed CPM. Overall, 171 patients (6.7%) had genetic testing; and the use of testing increased in the latter years of the study (3.% in 2000–2002 vs. 8.2% in 2003–2006, p&lt;.0001). 49 of 171 patients had genetic testing prior to surgery. 10 had a deleterious BRCA1/2 mutation, 9 of whom had a CPM (p=.002). 14 patients without a mutation also had a CPM. Multivariate analysis revealed factors associated with use of CPM were: age younger than 50, white race, family history of breast cancer, higher clinical tumor stage, invasive lobular histology, and use of reconstruction (Table). Conclusions: Both patient and tumor characteristics influence selection of CPM. Although the use of genetic testing is increasing, most women elect to undergo CPM without having genetic testing. Evidence-driven models are needed to better inform women of their absolute risk of contralateral breast cancer as well as competing risk from their primary breast cancer in order to empower them in their active-decision-making. [Table: see text] No significant financial relationships to disclose.
Cancer Nanomedicines Stabilized by π-π Stacking between Heterodimeric Prodrugs Enable Exceptionally High Drug Loading Capacity and Safer Delivery of Drug Combinations
Authors: Hangxiang Wang, Jianmei Chen, Chang Xu, Linlin Shi, Munire Tayier, Jiahui Zhou, Jun Zhang, Jiaping Wu, Zhijian Ye, Tao Fang, Weidong Han
Journal: Theranostics (2017)

Combination therapy using distinct mode-of-action drugs has sparked a rapidly growing interest because this paradigm holds promise for improving the therapeutic efficacy of anticancer therapy. However, the current drug combination therapy refers to administering individual drugs together, which is far from a perfect regimen for cancer patients. The aim of this work was to demonstrate that synergistic delivery of two chemotherapeutic drugs in a single nanoparticle reservoir could be achieved through the rational chemical ligation of the drugs followed by supramolecular nano-assembly via blending of the drugs with a minimal amount of matrix. Choosing 7-ethyl-10-hydroxycamptothecin and taxanes, which are rich in aromatic structures, as model compounds, we show that the heterodimeric conjugates of the two agents are miscible with lipids to form systemically injectable nanomedicines. The compatibility between the prodrug conjugates and lipid carriers is substantially augmented by the intermolecular π-π stacking and alleviated polarity, thus enabling an exceptionally high drug loading (DL) capacity (~92%) and a gratifyingly long drug retention time within the micellar core. We further observed superior therapeutic outcomes in a mouse tumor model without detecting accompanying systemic toxicity. This structure-based, self-assembled cancer nanomedicine increased the potency and drug tolerability in animals and thus offers a robust strategy for simultaneously formulating two or more drugs in single nanovehicles.
AB0989 Rheumatologic complications of thalassemia: should rheumatologists join the management team?
Authors: MHA Noureldine, AT Taher, AA Haydar, A Berjawi, MA Khamashta, I Uthman
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Beta-thalassemia major is accompanied by progressive multiple organ systems involvement due to the disease pathophysiology as well as iron overload from blood transfusions on a regular basis. Rheumatologists are not frequently involved in the multidisciplinary management of the disease, in which rheumatologic complications are relatively common. <h3>Objectives</h3> To highlight the rheumatologic complications of beta-thalassemia, which include musculoskeletal manifestations such as arthritis and arthropathies, joint effusions, osteoporosis, bone fractures, and arthralgias as well as connective tissue diseases such as pseuoxanthoma elasticum (PXE). <h3>Methods</h3> We searched the literature through GoogleScholar and PubMed for all publications reporting on rheumatologic manifestations in beta-thalassemia. The following keywords were used: thalassemia, rheumatoid arthritis, osteoarthritis, iron-overload, septic arthritis, deferiprone-related arthropathy, crystal arthritis, effusions, osteoporosis, fractures, bone marrow hyperplasia, scoliosis, aseptic necrosis, arthralgia, myalgia, and pseudoxanthoma elasticum. All reports published between 1970 and 2016 were included. <h3>Results</h3> Arthralgia and low back pain are among the most common musculoskeletal manifestations of thalassemia. Many studies are reporting an increased rate of RA in hemoglobinopathies such as thalassemia, the association of which may be attributed to genetic factors. Arthritis may develop secondary to iron deposition in the synovial tissue or due to iron chelators such as deferiprone, which may provoke a self-limited arthritis due to synovial destruction sustained by free radicals production during iron interchange. Several studies reported increased incidence (16%&gt;30%) of arthropathy in beta-thalassemia patients on deferiprone therapy. Multiple etiologies contribute to osteoarthritis in thalassemia patients such as bone marrow expansion, iron deposition within the joint, and hypoparathyroidism. Only few cases of Salmonella enteriditis septic arthritis were described in thalassemia patients. The associations between osteoporosis and hypogonadism, diabetes, and vitamin D and calcium deficiency were found significant. Skin lesions of PXE were reported in up to 16% in beta-thalassemics. <h3>Conclusions</h3> The pathophysiology of thalassemia and subsequent blood transfusions affect almost every organ system. Rheumatologic manifestations ranging from musculoskeletal complications to connective tissue diseases are common among thalassemia patients. Rheumatologists are highly encouraged to be involved in the multidisciplinary approach for the management of beta-thalassemia. <h3>Disclosure of Interest</h3> None declared
FRI0655 Ultrasound findings of feeding vessels and bone surface irregularity in wrist joints of healthy controls
Authors: K Misaki, K Ikeda, K Inoue
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Musculoskeletal ultrasound (MSKUS) is capable of visualizing synovitis and bone damage such as erosion. In particular, synovial vascularity as measured by power Doppler (PD) is correlated to rheumatoid arthritis disease activity, and PD signal reveals the prevalence of subclinical synovitis overlooked on physical examination. It is frequently difficult to distinguish bone erosion from normal concave surface of the bone. It is necessary for us to know these normal structures well in evaluating disease activity by using MSKUS. Here we examine the normal feeding vessels and bone surface irregularity in wrist joints. <h3>Objectives</h3> To clarify the distribution of feeding vessels in wrist joints and lunate surface irregularity of healthy controls by using MSKUS <h3>Methods</h3> The dorsal side of the bilateral wrists was scanned in 2 perpendicular planes with 2D-probe in healthy volunteers. The distribution and bilaterality of feeding vessels in the capsule and the extensor tendon sheath of wrist joint, and the evaluation of bone surface irregularity at lunate were validated. <h3>Results</h3> The distribution and bilaterality (Blt) of feeding vessels in healthy volunteers (n=30) were as follows: Above-trapezoid (Rt:100.0%, Lt:100.0%, Blt:100.0%), intra-extensor digitorum tendon sheath (Rt:86.7%, Lt:66.7%, Blt:43.3%), intra-extensor digiti minimi tendon sheath (Rt:30.0%, Lt:30.0%, Blt:10.0%), above-capitate (Rt:23.3%, Lt:30.0%, Blt:10.0%), above-triangular fibrocartilage complex (Rt:16.7%, Lt:30.0%, Blt:6.7%), distal radial side of the radio-carpal joint (Rt:20.0%, Lt:23.3%, Blt:0.0%), distal end of the ulna (Rt:10.0%, Lt:16.7%, Blt:0.0%), dorsal side of the lunate (Rt:6.7%, Lt:0.0%, Blt:0.0%), palmar side of the extensor digitorum tendon sheath (Rt:0.0%, Lt:3.3%, Blt:0.0%). Feeding vessels from vascular channels were depicted at lunate (Rt:53.3%, Lt:46.7%, Blt:43.3%), the distal side of the radius (Rt:20.0%, Lt:16.7%, Blt:3.3%), triquetrum (Rt:10.0%, Lt:16.7%, Blt:0.0%) and capitate (Rt:6.7%, Lt:10.0%, Blt:0.0%). The frequency of the bone surface irregularity at lunate in healthy volunteers (n=47) and the transverse diameter (TD) (Mean±S.D.) of those were Rt longitudinal plane:57.4% (TD1.26±0.33mm), Rt transverse plane: 51.1% (TD1.20±0.31mm), Lt longitudinal plane: 68.1% (TD1.06±0.28mm), and Lt transverse plane: 42.6% (TD1.29±0.31mm). Bilateral evaluation of those was 53.2%. <h3>Conclusions</h3> MSKUS evaluation in wrist joints revealed various normal vessels and bone surface irregularity of lunate. It is necessary to distinguish a normal pattern from a pathological pattern in MSKUS examination. <h3>Disclosure of Interest</h3> None declared