tbuckley/cabot-search huggingface dataset:
FRI0371 Clinical algorithms for the diagnosis and prognosis of interstitial lung disease in systemic sclerosis
Authors: V Hax, M Bredemeier, ALD Moro, TR Pavan, MV Vieira, EH Pitrez, RMDS Chakr, RM Xavier
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Interstitial lung disease (ILD) is currently the primary cause of death in systemic sclerosis (SSc). Thoracic high-resolution computed tomography (HRCT) is considered the gold standard for diagnosis. Recent studies have proposed several clinical algorithms to predict the diagnosis and prognosis of SSc-ILD. <h3>Objectives</h3> To test the clinical algorithms to predict the presence and prognosis of SSc-ILD, and to evaluate the association of extent of ILD with mortality in a cohort of SSc patients. <h3>Methods</h3> Prospective cohort study, including 177 SSc patients assessed by clinical evaluation, laboratory tests, pulmonary function tests, and HRCT. Three clinical algorithms, combining lung auscultation, chest radiography and % predicted forced vital capacity (FVC)[1], were applied for the diagnosis of different extents of ILD on HRCT. Univariate and multivariate Cox proportional models were used to analyze the association of algorithms [1,2] and the extent of ILD on HRCT with the risk of death using hazard ratios (HR). <h3>Results</h3> The prevalence of ILD on HRCT was 57.1% and 79 patients died (44.6%) in a median follow-up of 11.1 years. For identification of ILD with extent ≥10 and ≥20% on HRCT, all algorithms presented a high sensitivity (&gt;89%) and a very low negative likelihood ratio (&lt;0.16). For prognosis, survival was decreased for all algorithms, especially the algorithm C (HR 3.47, 95% CI 1.62–7.42), which identified the presence of ILD based on crackles on lung auscultation, findings on chest X-ray or FVC &lt;80%. Extensive disease as proposed by Goh and Wells (extent of ILD &gt;20% on HRCT or, in indeterminate cases, FVC &lt;70%) had a significantly higher risk of death (HR 3.42, 95% CI 2.12 to 5.52). Survival was not different between patients with extent of 10 or 20% of ILD on HRCT, and analysis of 10-year mortality suggested that a threshold of 10% may also have a good predictive value for mortality. However, there is no clear cutoff above which mortality is sharply increased. <h3>Conclusions</h3> Clinical algorithms had a good diagnostic performance for extents of SSc-ILD on HRCT with clinical and prognostic relevance (≥10 and ≥20%), and were also strongly related to mortality. Therefore, they probably could be used to obviate the requirement of HRCT in some cases. <h3>References</h3> Steele R, Hudson M, Lo E, Baron M. Clinical decision rule to predict the presence of interstitial lung disease in systemic sclerosis. Arthritis Care Res (Hoboken) 2012;64:519–24. Goh NSL, Desai SR, Veeraraghavan S, Hansell DM, Copley SJ, Maher TM, et al. Interstitial lung disease in systemic sclerosis: A simple staging system. Am J Respir Crit Care Med 2008;177:1248–54. <h3>Disclosure of Interest</h3> None declared
SP0141 New ra, but what about a new baby?
Authors: A Willemze
Journal: Annals of the Rheumatic Diseases (2017)

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease affecting women often in their childbearing years. In this case presentation a 35 year old female patient is illustrated with a recently diagnosed rheumatoid arthritis with active disease and a wish to conceive in the nearby future. Management of disease activity in patients who wish to conceive or during pregnancy might be a challenge due to limited treatment options. How should we treat this patient taking into account her wish to conceive in the nearby future? Should the patient postpone her wish to conceive because of active disease? <h3>Disclosure of Interest</h3> None declared
AB1096 Timed up and go test (TUG) for sarcopenia screening
Authors: LI Filippin, VON Teixeira, NC Oliviera, DD Berwanger, F Miraglia
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Sarcopenia is a multifactorial syndrome characterized by a decrease of muscle mass and force together with functional performance impairment. Sarcopenia has been described as an independent predictor factor of health adverse outcomes such as falls, decreased quality of life, enhanced risk of death and higher treatment costs. However, there are just a few screening tolls of low cost and easy applicability to detect sarcopenia. In this context, a standard mobility assessment such as the TUG test has recently been described as a predictor of sarcopenia. <h3>Objectives</h3> To evaluate the performance of <i>timed up and go</i><i>test</i> (TUG) as a screening toll for sarcopenia in the elderly. <h3>Methods</h3> This is a cross-sectional home study with 211 elderly participants of the South Region of Brazil. Sarcopenia diagnosis criteria was based on the European Working Group on Sarcopenia in Older People (EWGSOP). Individuals that presented low muscle mass (women: ≤6.37kg/m<sup>2</sup> and men: ≤8.90kg/m<sup>2</sup>) added to decreased handgrip strength (women: &lt;20kgf and men: &lt;30kgf) and/or walking speed (≤0.8m/s) were considered sarcopenic. TUG test quantifies functional mobility through the task of getting up from a chair, walking 3m and come back to sit on the chair. <h3>Results</h3> Based on EGWSOP criteria for sarcopenia, 17.1% (n=36) received the sarcopenia diagnosis. A ROC curve was constructed to evaluate the discriminatory power of TUG (AUC: 0.73 [IC 0.67 – 0.78; p=0.0001]). TUG test presented high sensibility (88.9%) and negative predictive values (93.2%), with a cutoff point of 7.5 seconds (figure 1). <h3>Conclusions</h3> Detecting the beginning of sarcopenia could allow for early interventions and slow the syndrome process, preventing further hospitalizations and economic burden. In this context, TUG is an easy, fast and low-cost test with high sensibility for sarcopenia detection that could be used as screening toll for this syndrome. <h3>References</h3> Barbosa-Silv TG, Bielemann RM, Gonzalez MC, et al. Journal of Cachexia, Sarcopenia and Muscle. 2016; 7:136–143. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Age Ageing. 2010;39(4):412–23. da Silva Alexandre T, de Oliveira Duarte YA, Ferreira Santos JL, Wong R, Lebrão ML. J Nutr Health Aging. 2014;18(8):751–6. Ishii S, Tanaka T, Shibasaki K, Ouchi Y, Kikutani T, Higashiguchi T, et al. Geriatr Gerontol Int. 2014;14 Suppl 1:93–101. Malmstrom TK, Morley JE. J Am Med Dir Assoc. 2013;14(8):531–2. Martinez BP, Gomes IB, Oliveira CS, Ramos IR, Rocha MD, Forgiarini Júnior LA, et al. Clinics (Sao Paulo). 2015;70(5):369–72. <h3>Acknowledgements</h3> Conselho Nacional de Desenvolvimento Científico e Tecnolόgico (CNPq); Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS). <h3>Disclosure of Interest</h3> None declared
STX2171, a 17 beta-Hydroxysteroid Dehydrogenase Type 3 (17 beta-HSD3) Inhibitor, Is Efficacious In Vivo in a Novel Hormone-Dependent Prostate Cancer Model.
Authors: J M Day, P A Foster, H J Tutill, J D Hargrave, F Schmidlin, N Vicker, Potter Bvl., M J Reed, A Purohit
Journal: Endocrine Reviews (2010)
FRI0441 Neck pain in ankylosing spondylitis: focus on active inflammation at the craniocervical junction on mri
Authors: G Slobodin, I Rosner, A Awisat, D Rimar, A Shpigelman, D Militianu
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> A wide spectrum of structural changes in the elements of craniocervical junction in patients with ankylosing spondylitis (AS) has been recently described in a retrospective study using computed tomography [1]. The clinical significance of these findings requires further elaboration. <h3>Objectives</h3> To explore and describe inflammatory MR imaging findings in the craniocervical junction in patients with AS and neck pain. <h3>Methods</h3> Eighteen patients with AS and continuing neck pain, as well as 9 patients with fibromyalgia of the same age and similar level of severity of neck pain, who served as a control group, underwent relevant rheumatologic examination, X-ray of cervical spine and MRI study, which included STIR, CUBE T2, FSE and FSE FAT SAT sequences before and after administration of gadolinium. <h3>Results</h3> In the AS group, 12 males and 6 females diagnosed by 1984 New York criteria, of median age 40.5 years (range 31–61 years) and median disease duration of 8 (range 1–35) years, with 13 under treatment with anti-TNF agents were studied. All patients suffered from neck pain, with median VAS of 7 (range 2.5–10). Range of neck spine motion was limited in all but 3 patients. Seven of 18 patients had evidence of cervical syndesmophytes on X-ray. In addition to expected findings of syndesmophytes, active inflammatory lesions were seen in MR imaging in two of 18 patients with AS and in none with fibromyalgia (Fig. 1). Both AS patients with positive MRI were on anti-TNF therapy during the study and did not have syndesmophytes at the cervical spine as also by X-ray films. <h3>Conclusions</h3> Active inflammation of both entheses and joints of the craniocervical junction was demonstrated by MRI in some patients with AS and persistent neck pain. Active lesions at the craniocervical junction should be included in the differential diagnosis of neck pain in AS. <h3>References</h3> Slobodin G, Shpigelman A, Dawood H, Rimar D, Croitoru S, Boulman N, Rozenbaum M, Kaly L, Rosner I, Odeh M. Craniocervical junction involvement in ankylosing spondylitis. Eur Spine J. 2015 Dec;24(12):2986–90. <h3>Disclosure of Interest</h3> None declared
AB0158 Tauroursodeoxycholic acid decreases the expression of erad components and the accumulation of salivary mucins induced by pro-inflammatory cytokines
Authors: N Albornoz, S Aguilera, M-J Barrera, I Castro, P Carvajal, S González, C Molina, U Urzúa, D Jara, C Leyton, M-J González
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The salivary glands of Sjögren9s syndrome patients show endoplasmic reticulum (ER) stress characterized by intracellular accumulation of secretory products such as MUC1<sup>1</sup>, dilated ER cisternae<sup>2</sup> and high levels of pro-inflammatory cytokines. Previous results from our laboratory revealed an increase of the ATF6α pathway of the UPR<sup>3</sup> and activation of ER-associated protein degradation (ERAD)<sup>3</sup>. Increased expression of proteins involved in ERAD (SEL1L and EDEM1) has been reproduced <i>in vitro</i> in human submandibular gland (HSG) cells treated with TNF-α or IFN-γ<sup>2</sup>. Tauroursodeoxycholic acid (TUDCA) is a chemical chaperone utilized for alleviate ER stress by enhancing the folding of proteins<sup>3</sup>. <h3>Objectives</h3> The aim of this study was to evaluate if TUDCA decreases EDEM1, SEL1L, and MUC1 expression induced by pro-inflammatory cytokines in salivary gland epithelial cells. <h3>Methods</h3> HSG-cells were incubated with 10 ng/mL of IFN-γ or TNF-α for 24h. Alternatively, cells were incubated with cytokines for 6h and then co-incubated with TUDCA (150 and 250 μM) up to 24h. EDEM1, SEL1L and MUC1 protein and mRNA levels were determined by Western-blot and RT-qPCR, respectively. EDEM1 and SEL1L localization was determined by immunofluorescence. <h3>Results</h3> HSG cells stimulated with IFN-γ or TNF-α showed a significant increase of EDEM1 and SEL1L protein and mRNA levels. Importantly, TUDCA co-incubation caused a significant decreased expression of both molecules. Treatment with both cytokines induced a cytoplasmic increase of staining intensity of EDEM1 and SEL1L, which was suppressed by TUDCA. HSG cells stimulated with cytokines showed a significant increase of MUC1 protein and mRNA levels, which was also suppressed by TUDCA. <h3>Conclusions</h3> Decreased expression of MUC1, SEL1L and EDEM1 in the presence of TUDCA suggests that this chemical chaperone promotes folding of proteins in the ER, by decreasing ERAD activity and ER stress induced by pro-inflammatory cytokines in HSG cells. These results enable us to propose that TUDCA might alleviate the ER stress of salivary glands from Sjögren9s syndrome patients. <h3>References</h3> Oral Dis. 2015;21(6):730–8. Arthritis Rheum. 2003 Sep;48(9):2573–84. J Autoimmun. 2016;75:68–81. Prion. 2014;8(2). pii: 28938. <h3>Acknowledgements</h3> Supported by Fondecyt-Chile [#1160015] (MJG, SA, CM, SG, IC). <h3>Disclosure of Interest</h3> None declared
AB0277 Patient reported outcomes explain the lack of agreement between physician and patient perceived remission in early rheumatoid arthritis
Authors: SA Turk, L Rasch, WF Lems, L van Tuyl, D van Schaardenburg, MM ter Wee
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid arthritis (RA) patients increasingly reach a state of absence of disease activity, or remission. However, the proportion of patients classified as in remission varies substantially between definitions and are often determined by disease activity score (DAS). But, the importance of patients9 perspective is increasingly recognized, which often result in discordance between patients and physician assessment. <h3>Objectives</h3> To determine how often patients and physicians agree on a state of remission according to different definitions, as well as the difference in patient reported and clinical outcomes between patients in and not in self-perceived remission. <h3>Methods</h3> In 84 consecutive early RA patients, Boolean remission, EULAR response and ACR 70 criteria were determined after 12 weeks of treatment with a fixed schedule methotrexate and prednisone. Physician perceived remission (PhR) was defined as a global assessment of ≤20 on a visual analogue scale, phrased: "<i>How active do you think the RA of your patient is today?"</i>. Patient perceived remission (PatR) was phrased as: "<i>Would you say that, at this moment, your disease activity is as good as gone? Yes/no"</i>. In patients in PhR, the change in components of the DAS44 and questions of the Rheumatoid Arthritis Impact of Disease (RAID) and Health Assessment Questionnaire (HAQ) were compared between patients in and not in self-perceived remission. <h3>Results</h3> The agreement on remission between patients and physicians was 64% and was dependent of the definition of remission. In Boolean remission, EULAR good response and ACR70 remission agreement was: 86%, 63% and 80% respectively (table). Patients in PhR, the patients in PatR had more improvement on all RAID subdomains. There were no significant differences in clinical outcomes (ESR was significantly different at baseline, but not after 12 weeks; see figure). <h3>Conclusions</h3> Two-third of the patients agreed with the physician on being in remission. In all different definitions for remission, this discordance between physician and patient on perceived remission remained similar. Patients in self-perceived remission had more improvement in components of the RAID, but not in clinical outcomes. Further research is needed to identify domains of patients perceived remission. <h3>Disclosure of Interest</h3> None declared
Effect of Inpatient Palliative Care During Hematopoietic Stem-Cell Transplant on Psychological Distress 6 Months After Transplant: Results of a Randomized Clinical Trial
Authors: Areej El-Jawahri, Lara Traeger, Joseph A. Greer, Harry VanDusen, Sarah R. Fishman, Thomas W. LeBlanc, William F. Pirl, Vicki A. Jackson, Jason Telles, Alison Rhodes, Zhigang Li, Thomas R. Spitzer, Steven McAfee, Yi-Bin A. Chen, Jennifer S. Temel
Journal: Journal of Clinical Oncology (2017)

Purpose Inpatient palliative care integrated with transplant care improves patients' quality of life (QOL) and symptom burden during hematopoietic stem-cell transplant (HCT). We assessed patients' mood, post-traumatic stress disorder (PTSD) symptoms, and QOL 6 months post-transplant. Methods We randomly assigned 160 patients with hematologic malignancies who underwent autologous or allogeneic HCT to inpatient palliative care integrated with transplant care (n = 81) or transplant care alone (n = 79). At baseline and 6 months post-transplant, we assessed mood, PTSD symptoms, and QOL with the Hospital Anxiety and Depression Scale and Patient Health Questionnaire, PTSD checklist, and Functional Assessment of Cancer Therapy-Bone Marrow Transplant. To assess symptom burden during HCT, we used the Edmonton Symptom Assessment Scale. We used analysis of covariance while controlling for baseline values to examine intervention effects and conducted causal mediation analyses to examine whether symptom burden or mood during HCT mediated the effect of the intervention on 6-month outcomes. Results We enrolled 160 (86%) of 186 potentially eligible patients between August 2014 and January 2016. At 6 months post-transplant, intervention participants reported lower depression symptoms on the Hospital Anxiety and Depression Scale and Patient Health Questionnaire (adjusted mean difference, -1.21 [95% CI, -2.26 to -0.16; P = .024] and -1.63 [95% CI, -3.08 to -0.19; P = .027], respectively) and lower PTSD symptoms (adjusted mean difference, -4.02; 95% CI, -7.18 to -0.86; P = .013), but no difference in QOL or anxiety. Symptom burden and anxiety during HCT hospitalization partially mediated the effect of the intervention on depression and PTSD at 6 months post-transplant. Conclusion Inpatient palliative care integrated with transplant care leads to improvements in depression and PTSD symptoms at 6 months post-transplant. Reduction in symptom burden and anxiety during HCT partially accounts for the effect of the intervention on these outcomes.
Protein phosphatase 2A (PP2A) has significant role in CAPE-induced apoptosis of CCRF-CEM cells via effecting human telomerase reverse transcriptase activity
Authors: Fahri Sahin, Cigir Biray, Buket Kosova, Cumhur Gunduz, Nur Selvi, Hikmet Hakan Aydin, Gulperi Oktem, Nejat Topcuoglu, Guray Saydam
Journal: Cancer Research (2005)

3335   More than 70% of chemotherapeutic agents currently used for treatment of leukemia have been derived from natural sources. Complications associated with classical drugs have brought forth new researches to develop new cancer treatment agents. CAPE (caffeic acid phenethyl ester) is one of the most effective components of propolis which is collected by honey bees. The aim of this study is to investigate the cytotoxic and apoptotic effects of CAPE in CCRF-CEM cell line and to clarify the role of serin/threonine protein phosphatase 2A (PP2A) and h TERT (human telomerase reverse transcriptase) activity as an underling mechanism of CAPE-induced apoptosis. Trypan blue dye exclusion test and XTT methods were used to evaluate the cytotoxic and ELISA based on detection of oligonucleotids which can be seen during apoptosis. Acridine orange/Ethidium bromide dye technique based on detection of apoptotic bodies with fluorescent microscope were used to evaluate apoptosis. Cytotoxic effect of CAPE was detected in dose and time dependent manner with the IC 50  of 1 micromolar. ELISA and Acridine Orange/Ethidium bromide methods have shown remarkable apoptosis at 48th hour in CAPE treated cells. To investigate the role of PP2A in CAPE-induced apoptosis of CCRF-CEM cells, we performed combination studies with CAPE and Calyculin A and Okadaic acid, which are very well known inhibitors of PP2A, in IC 50  of all drugs. Combination studies revealed synergistic effect of both drugs by concomitant use. Western blot analyses of PP2A catalytic and regulatory subunits showed down regulation of expression of PP2A catalytic subunit in CAPE treated cells at 48th hour. Since PP2A is important in hTERT (telomerase catalytic subunit) activation and deactivation, we also performed hTERT activity in CAPE treated cells simultaneously. Treating cells with IC 50  of CAPE for 96 hours with the intervals of 24 hour showed marked reduction of hTERT activity. The reduction of hTERT activity in CAPE treated CCRF-CEM cells was more prominent in initial 48 hours in dose and 24 hour time dependent manner. The developed variation of hTERT activity in CAPE treated CCRF-CEM cells may be the reason of protein phosphatase interaction occured after treatment with CAPE. Apart from the familiar reasons for apoptotic effects of CAPE, protein phosphatases and hTERT activity may be crucial in CAPE- induced apoptosis and cytotoxicity of treated cell line. The results collectively suggest that the CAPE-induced decline in telomerase activity is not a consequence of CCRF-CEM cell apoptosis and that it may be caused principally by the dephosphorylation of telomerase components mediated by PP2A activation.
AB0398 Impact of body composition on response to biotherapy in rheumatoid arthritis
Authors: S Bouden, D Kaffel, W Hamdi, MM Kchir
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Biological therapies had greatly improved the treatment of rheumatoid arthritis (RA). The response to biologics may be influenced by many factors. Little is known about the impact of body composition inRA biologics. <h3>Objectives</h3> We aimed to investigate the impact of obesity (BMI≥30) andbody composition (lean mass/ fat mass)on response to biotherapy in RA. <h3>Methods</h3> A retrospective study was performed over a period of 11 years (2006–2016). Patients diagnosed RA (according to the ACR 1987 criteria) and treated by biologics were enrolled. Body composition (lean mass/ fat mass) was measured by X-ray biphotonic absorption (DXA). The threshold of signification was set for a value of p&lt;0.05. <h3>Results</h3> Fifty patients were enrolled, including 5 men and 45 women (sex ratio=0.11). The mean age was 66 years [38–79]. The mean duration of RA was 5 years [1–30]. The mean duration of treatment with biologics was 38 months [6–120]. Thirty nine patients were treated by TNF alpha inhibitors (25 etanercept, 7 adalimumab, 6 infliximab and 1 certolizumabpegol), 6 rituximab and 5 tocilizumab. Nine patients had a normal weight (18%), 17 had overweight (34%) and 24 had obesity (49%). The average percentage of fat mass was 44.8 [23–54], with a median of 46. While comparing obese patients with others, we did not notice a significant difference in the mean variation of the DAS28 at 6 months for TNF alpha inhibitors nor for all biotherapies combined (respectively p=0.6 and p=0.9). The same result was observed while comparing the DAS28 according to the body composition (relative to the median of the percentage of the fat mass: for TNF alpha inhibitors (p=0,6) and for all biotherapies combined (p=0,09)). <h3>Conclusions</h3> In our study, there was no change in response to biologics in patients with RA. Further prospective studies with a larger size will be required to confirm or reverse these results. <h3>References</h3> Iannone F, Lopalco G and al. Impact of obesity on the clinical outcome of rheumatologic patients in biotherapy. Autoimmun Rev. 2016 May;15(5):447–50. doi: 10.1016. Gardette A, Ottaviani S. Body mass index and response to tocilizumab in rheumatoid arthritis: a real life study. Clin Rheumatol. 2016 Apr;35(4):857–61. doi: 10.1007. <h3>Disclosure of Interest</h3> None declared
Diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous meningitis in HIV-infected adults: a prospective cohort study
Authors: Nathan C Bahr, Edwin Nuwagira, Emily E Evans, Fiona V Cresswell, Philip V Bystrom, Adolf Byamukama, Sarah C Bridge, Ananta S Bangdiwala, David B Meya, Claudia M Denkinger, Conrad Muzoora, David R Boulware, Darlisha A Williams, Kabanda Taseera, Dan Nyehangane, Mugisha Ivan, Patrick Orikiriza, Joshua Rhein, Kathy Huppler Hullsiek, Abdu Musubire, Katelyn Pastick, Pamela Nabeta, James Mwesigye, Radha Rajasingham
Journal: The Lancet Infectious Diseases (2017)

WHO recommends Xpert MTB/RIF as initial diagnostic testing for tuberculous meningitis. However, diagnosis remains difficult, with Xpert sensitivity of about 50-70% and culture sensitivity of about 60%. We evaluated the diagnostic performance of the new Xpert MTB/RIF Ultra (Xpert Ultra) for tuberculous meningitis.