tbuckley/cabot-search huggingface dataset:
SP0057 Calcium crystals and their link to osteoarthritis
Authors: J Bertrand
Journal: Annals of the Rheumatic Diseases (2017)

Calcification of cartilage is a common finding during osteoarthritis (OA). We have shown that it is mainly of the BCP type and not the CPPD type of crystal formation. BCP cartilage calcification is directly linked to the severity of cartilage degradation and, therefore, OA severity. We have also shown that with increasing hypertrophic differentiation of chondrocytes, the amount of calcification increases in vivo and in vitro. This indicates a link between chondrocyte hypertrophy andcartilage calcification. The pyrophosphate pathway is known to be involved in tissue calcification. It functions to keep the sensitive balance of pyrophosphate (PPi) and phosphate (Pi), thereby preventing the generation of calcium-phosphate crystals. One key player in this pathway is the nucleotide pyrophosphatase phosphodiesterase (NPP1), which has been demonstrated to be regulated by inflammatory mediators such as IL-1. In our cohort of OA patients, the expression of collagen X and NPP1, but not ANK and TNAP, correlated with cartilage calcification and also with the Mankin-Score. NPP1 expression inverse correlated with the calcification, whereas collagen X was upregulated. This finding was confirmed in experimental murine OA using the DMM mouse model. Furthermore, NPP1mut/mut mice (ttw/ttw) exhibit more calcification activity than wild type controls in joints as well as in cartilage of non weight bearing areas, including ear cartilage, suggesting that mechanical stress is not required for the induction of calcification. NPP1mut/mut (ttw/ttw) mice developed typical OA-like changes as evaluated by histological analysis as well as in vivo imaging and histological stainings. Intriguingly, calcification was associated with increased expression of the hypertrophic cartilage marker collagen X and the bone marker collagen I. Additionally, BCP crystals are able to activate chondrocyte differentiation via the WNT signaling pathway. NPP1 is an important player in OA-associated cartilage calcification. Pathologic calcification of cartilage resembles in many aspects cartilage transformation into bone. Taken together, the data suggest that OA is characterized by the re-activation of molecular signalling cascades that at least in part resemble endochondral ossification. <h3>Disclosure of Interest</h3> None declared
An Appeal for Evidence-Based Resident Duty Hours Reform
Authors: Elaine C. Khoong, Anne S. Linker
Journal: JAMA Internal Medicine (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
SAT0302 Analysis of 9302 patients from the big data international primary sjÖgren syndrome cohort: clinical presentation at diagnosis of european vs non-european patients
Authors: P Brito-Zerόn, N Acar-Denizli, M Zeher, A Rasmussen, R Seror, T Mandl, X Li, C Baldini, J-E Gottenberg, D Danda, R Priori, L Quartuccio, G Hernandez-Molina, AA Kruize, S-H Park, M Kvarnström, S Praprotnik, D Sene, E Bartoloni, R Solans, Y Suzuki, D Isenberg, M Rischmueller, G Nordmark, G Fraile, A Sebastian, A Vissink, T Nakamura, V Valim, R Giacomelli, V Devauchelle-Pensec, B Hofauer, M Bombardieri, V Trevisani, D Hammenfors, SE Carsons, SG Pasoto, J Morel, S Retamozo, TA Gheita, F Atzeni, C Vollenveider, X Mariette, M Ramos-Casals
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> Baseline characterization of European patients diagnosed with primary Sjögren syndrome (SS) according to the 2002 AE criteria. <h3>Methods</h3> The Big Data Sjögren Project was formed in 2014 to take a “high-definition” picture of the main features of primary SS by merging international SS databases. International experts of the EULAR-SS Task Force were invited to participate. By January 2017, the database included 9302 consecutive patients recruited from 21 countries of the 5 continents. <h3>Results</h3> A total of 6586 (71%) patients were included from European countries. In comparison with non-European countries, European patients had a higher mean age (54 v 51yrs, p&lt;0.001), higher frequency of men (7% v 5%, p=0.001), dry eyes (94% vs 88%, p&lt;0.001), dry mouth (94% vs 91%, p&lt;0.001), and lower frequency of abnormal ocular (84 vs 86%, p=0.049) and oral (75 vs 81%, p&lt;0.001) tests. Immunologically, European patients had a lower frequency of anti-Ro/La antibodies (69 vs 78%, p&lt;0.001) and a higher frequency of RF (50 vs 47%, p=0.01), low C4 (14 vs 9%, p&lt;0.001) and cryoglobulins (8% vs 3%, p&lt;0.001). Logistic regression identified as independent variables older age (OR 1.02), male gender (OR 2.62), abnormal oral tests (OR 0.26), anti-Ro/La antibodies (OR 0.69), RF (OR 1.76), low C4 (OR 1.97) and cryoglobulins (OR 3.85). <h3>Conclusions</h3> European patients are diagnosed at older age, are more frequently men, and presented a lower frequency of anti-Ro/La antibodies and a higher frequency of immunological markers related to mixed cryoglobulinemia. <h3>Disclosure of Interest</h3> None declared
Return to work and lost earnings after acute respiratory distress syndrome: a 5-year prospective, longitudinal study of long-term survivors
Authors: Biren B Kamdar, Kristin A Sepulveda, Alexandra Chong, Robert K Lord, Victor D Dinglas, Pedro A Mendez-Tellez, Carl Shanholtz, Elizabeth Colantuoni, Till M von Wachter, Peter J Pronovost, Dale M Needham
Journal: Thorax (2017)

Delayed return to work is common after acute respiratory distress syndrome (ARDS), but has undergone little detailed evaluation. We examined factors associated with the timing of return to work after ARDS, along with lost earnings and shifts in healthcare coverage.Five-year, multisite prospective, longitudinal cohort study of 138 2-year ARDS survivors hospitalised between 2004 and 2007. Employment and healthcare coverage were collected via structured interview. Predictors of time to return to work were evaluated using Fine and Grey regression analysis. Lost earnings were estimated using Bureau of Labor Statistics data.Sixty-seven (49%) of the 138 2-year survivors were employed prior to ARDS. Among 64 5-year survivors, 20 (31%) never returned to work across 5-year follow-up. Predictors of delayed return to work (HR (95% CI)) included baseline Charlson Comorbidity Index (0.77 (0.59 to 0.99) per point; p=0.04), mechanical ventilation duration (0.67 (0.55 to 0.82) per day up to 5 days; p<0.001) and discharge to a healthcare facility (0.49 (0.26 to 0.93); p=0.03). Forty-nine of 64 (77%) 5-year survivors incurred lost earnings, with average (SD) losses ranging from US$38 354 (21,533) to US$43 510 (25,753) per person per year. Jobless, non-retired survivors experienced a 33% decrease in private health insurance and concomitant 37% rise in government-funded coverage.Across 5-year follow-up, nearly one-third of previously employed ARDS survivors never returned to work. Delayed return to work was associated with patient-related and intensive care unit/hospital-related factors, substantial lost earnings and a marked rise in government-funded healthcare coverage. These important consequences emphasise the need to design and evaluate vocation-based interventions to assist ARDS survivors return to work.
FRI0647 Color doppler as a valuable procedure for early diagnosis of ocular vascular changes in behÇet's disease
Authors: HH Al Sherbeni, S Metawie, R Abdel salam, H Azizi
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Ocular involvement is a common and serious manifestation of Behçet9s disease (BD). It occurs in about 70% of the patients and is associated with a high risk of blindness (Kaçmaz et al., 2008). Color Doppler is used for imaging retrobulbar vasculature. It measures the peak systolic velocity (PSV) and end diastolic velocity (EDV), from which the resistance index (RI) is calculated in the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary artery (PCA) to detect any abnormality in the retrobulbar vessels (Nagaoka, 2006). <h3>Objectives</h3> To determine and compare the orbital Color Doppler haemodynamic parameters of Behçet9s patients with those of healthy subjects and to evaluate the OA, CRA, PCA flow velocities and resistance indices (RIs). <h3>Methods</h3> This study included thirty patients suffering from Behçet9s disease satisfying at least 3 of the criteria of BD according to the International Study Group for Behçet9s disease in 1990. 20 age/sex-matched healthy subjects served as a control group. All patients were subjected to history taking, clinical examination, full ophthalmological examination, routine laboratory investigations and Color Doppler ultrasound (CDU) examination. <h3>Results</h3> The patients9 age ranged from 18 to 45 years with a mean of 31.0±7.5. Their disease duration ranged from 0.25 to 20 years with a mean of 5.71±5.84. There were diminished blood flow velocities of the OA, CRA and PCA as the peak systolic velocity (PSV) and end diastolic velocity (EDV) of these arteries were lower than normal while resistance flow indices (RIs) were higher than normal. <h3>Conclusions</h3> Behçet9s disease patients with ocular involvement have lower CRA, PCA and OA blood flow velocities than healthy control. CDU is helpful in early diagnosis of ocular Behçet9s disease activity as it is a widely used, easy-to-perform and accurate method. <h3>References</h3> Kaçmaz O., Kempen J.H., Newcomb C., Gangaputra S., Daniel E., et al.(2008): The Systemic Immunosuppressive Therapy for Eye Diseases: Cohort Study Group. Am J Ophthalmol; 146(6): 828–836. Nagaoka T. (2006): Physiological mechanism for the regulation of ocular circulation: Nippon Ganka Gakkai Zasshi. 110 (11): 872–8. The International Study Group for Behçet9s disease (1990): Criteria for diagnosis of Behçet9s disease. Lancet; 335:1078–1080. <h3>Disclosure of Interest</h3> None declared
General practice funding rose by 3% last year
Authors: Gareth Iacobucci
Journal: BMJ (2017)

Investment in general practice increased by 3% in real terms in the UK last year, official figures have shown. But the BMA has expressed concern that last year’s increase was less than the 5% increase in 2015-16, despite government pledges to invest more in general practice.

The data from NHS Digital show that in 2016-17 total investment in general practices increased by 3.2% in England, 2.7% in Wales, 2% in Scotland, and 1.3% in Northern Ireland in real terms.1

In cash terms there was a 5.1% increase across the UK (5.2% in England, 4.7% in Wales, …
Evaluation of the 2016 Infectious Diseases Society of America/American Thoracic Society Guideline Criteria for Risk of Multidrug-Resistant Pathogens in Patients with Hospital-acquired and Ventilator-associated Pneumonia in the ICU
Authors: Pervin Korkmaz Ekren, Otavio T. Ranzani, Adrian Ceccato, Gianluigi Li Bassi, Eva Muñoz Conejero, Miquel Ferrer, Michael S. Niederman, Antoni Torres
Journal: American Journal of Respiratory and Critical Care Medicine (2017)
AB0682 The incidence rate of inflammatory myopathies in slovenia
Authors: Ž Rotar, A Hočevar, M Krošel, S Praprotnik, M Tomšič
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Annual incidence rates of inflammatory myopathies (IM) vary widely from 1.16–19.0 per 10<sup>6</sup> of adults.1 Our aim was to, for the first time, determine the incidence rate of IM in our population. <h3>Objectives</h3> To determine the incidence rate of IM in our population. <h3>Methods</h3> We retrospectively collected incident cases of IM from 1 January 2005 to 31 December 2016 at our department of rheumatology which is a part of an integrated secondary/tertiary university teaching hospital that is the only referral center for two well defined regions representing roughly a third of the national adult population. Tertiary cases are referred to our department from the entire country. We identified the cases by searching the electronic patient records (PRs) for ICD-10 codes M05, M33–35, M60, G73.7, G72.4. The paper and electronic PRs were scrutinized to assess clinical, laboratory and histopathological data. Descriptive statistics was used to describe our group of patients. The adult population size of the two regions served by our department was obtained from the national statistics institute database. The annual incidence rate for IM was then calculated. <h3>Results</h3> During the 12-year observation period we identified 117 new cases of IM from a well-defined adult white Caucasian population aged 18 or above. 38 cases were excluded from analyses since they were referred to our department from outside the two regions we serve on the secondary and tertiary level. Thus, we analyzed 79 cases of IM (63% female; median (IQR) age 67 (55–75) years; 44% ever smokers). The median time to diagnosis was 5 (IQR 3–12) months. We diagnosed 29% patients with dermatomyositis, 25% with anti-synthetase syndrome, 18% with polymyositis, 9% with statin induced necrotizing autoimmune myopathy, 9% with concomitant myositis as a part of connective tissue disease, 6% with paraneoplastic myositis, and 4% with undifferentiated myositis. The IM cases were most often diagnosed in the summer months (32.9%), followed by spring (24.1%), fall (22.8%), and winter (20.3%). The clinical and laboratory characteristics at presentation are shown in Table 1. Muscle biopsy was performed in 93% of patients. Notably, patients with swallowing difficulties had more commonly had Raynaud phenomenon (RR 3.7 (95% CI 1.4–9.4), p=0.008). <h3>Conclusions</h3> The averaged 12-year annual incidence of IM in the population under study was 9.4 (95% CI 7.5–11.8) per 10<sup>6</sup> adults. <h3>References</h3> Meyer A, et al. Rheumatology 2015. <h3>Disclosure of Interest</h3> None declared
AB0936 Flexibility and strength of the trunk in chronic low back pain two years after a functional restoration program
Authors: R Maaoui, S Zrida, I Ksibi, N Mouhli, H Rahali, M Sghir, W Kossomtini
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Low-back pain affects significatively the flexibility and the muscular strength of the trunk. It was demonstrated in literature the positive effect of restoration programs in these parameters at short-term evaluation. <h3>Objectives</h3> Evaluate the flexibility and the muscular strength and endurance of the trunk two years after a functional restoration program <h3>Methods</h3> Prospective study on patients with low back pain evaluated before, at the end of the restoration program and two years later. We have evaluated the following parameters: trunk flexibility by use of the Schöber index and the finger–ground distance test (FGD), hamstring flexibility by measurement of the thigh-leg (TL) angle, back flexor and back extensor endurance, assessed with the Shirado test and the Sorensen test, respectively. <h3>Results</h3> Thirty patients were evaluated. Initially, the results reported decreased flexibility: 53% with FGD &gt;15.53 cm; 37% with the thigh-leg (TL) angle &gt;15° and decreased muscle endurance: Schirado 30.26±29.662s; Sorensen 26.3860±18.5208s. The short-term efficacy of the program showed significatively improvement in all parameters (p=0,01). However, this improvement decreased 2 years later but it remains significant. This loss can be attributed to the fact that 70% of patients abandoned self-rehabilitation exercises <h3>Conclusions</h3> The restoration program seems to have good effect in short and long term evaluations in the flexibility and muscular strength of the trunk. <h3>Disclosure of Interest</h3> None declared
The <i>MUC5B</i> promoter polymorphism is associated with specific interstitial lung abnormality subtypes
Authors: Rachel K. Putman, Gunnar Gudmundsson, Tetsuro Araki, Mizuki Nishino, Sigurdur Sigurdsson, Elías F. Gudmundsson, Gudny Eiríksdottír, Thor Aspelund, James C. Ross, Raúl San José Estépar, Ezra R. Miller, Yoshitake Yamada, Masahiro Yanagawa, Noriyuki Tomiyama, Lenore J. Launer, Tamara B. Harris, Souheil El-Chemaly, Benjamin A. Raby, Michael H. Cho, Ivan O. Rosas, George R. Washko, David A. Schwartz, Edwin K. Silverman, Vilmundur Gudnason, Hiroto Hatabu, Gary M. Hunninghake
Journal: European Respiratory Journal (2017)

The MUC5B promoter polymorphism (rs35705950) has been associated with interstitial lung abnormalities (ILA) in white participants from the general population; whether these findings are replicated and influenced by the ILA subtype is not known. We evaluated the associations between the MUC5B genotype and ILA in cohorts with extensive imaging characterisation.We performed ILA phenotyping and MUC5B promoter genotyping in 5308 and 9292 participants from the AGES-Reykjavik and COPDGene cohorts, respectively.We found that ILA was present in 7% of participants from the AGES-Reykjavik, 8% of non-Hispanic white participants from COPDGene and 7% of African-American participants from COPDGene. Although the MUC5B genotype was strongly associated (after correction for multiple testing) with ILA (OR 2.1, 95% CI 1.8-2.4, p=1×10-26), there was evidence of significant heterogeneity between cohorts (I2=81%). When narrowed to specific radiologic subtypes, (e.g. subpleural ILA), the MUC5B genotype remained strongly associated (OR 2.6, 95% CI 2.2-3.1, p=1×10-30) with minimal heterogeneity (I2=0%). Although there was no evidence that the MUC5B genotype influenced survival, there was evidence that MUC5B genotype improved risk prediction for possible usual interstitial pneumonia (UIP) or a UIP pattern in non-Hispanic white populations.The MUC5B promoter polymorphism is strongly associated with ILA and specific radiologic subtypes of ILA, with varying degrees of heterogeneity in the underlying populations.
Can molecular profiling enhance radiotherapy? Impact of personalized targeted gold nanoparticles on radiosensitivity and imaging of adenoid cystic carcinoma
Authors: Inbal Hazkani, Menachem Motiei, Oshra Betzer, Tamar Sadan, Dimitri Bragilovski, Leon Lubimov, Aviram Mizrachi, Tuvia Hadar, Mattan Levi, Irit Ben-Aharon, Izhack Haviv, Rachela Popovtzer, Aron Popovtzer
Journal: Theranostics (2017)

Personalized molecular profiling has an established role in selection of treatment for metastatic disease; however, its role in improving radiosensitivity and functional imaging has not been evaluated.In the current study, we examined molecular profiling as a tool for designing personalized targeted gold nanoparticles (GNP) to serve as dual-modal tumor radiosensitizers and functional imaging enhancers.To this end, molecular profiling of a patient's salivary gland adenoid cystic carcinoma (ACC) was performed, and anaplastic lymphoma kinase (ALK) mutation was detected.The extracted tumor was subcutaneously injected into mice, which were then treated either with radiation, the specific ALK inhibitor crizotinib, or a combination of therapies.One of these combinations, namely, ALK-targeted GNP (via crizotinib coating), was found to enhance radiation treatment, as demonstrated by a significant decrease in tumor volume over 24 days.In parallel, ALK-targeted GNP substantially augmented tumor visualization via computed tomography.The mechanism of radiosensitivity enhancement was mostly related to a diminished cell repair mechanism in tumors, as demonstrated by proliferating cell nuclear antigen staining.These findings indicate that personalized molecular profiling is an effective technique for enhancing cancer theranostics.
THU0323 The incidence rates of anca-associated vasculitides in northern germany (schleswig-holstein) remain stable between 1998 to 2014
Authors: K Herlyn, WL Gross, E Reinhold-Keller
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> To assess the incidence of ANCA-associated vasculitides (AAV) in a stable population by registering all newly diagnosed patients in a large region in Northern Germany. To investigate the epidemiology and pattern of AAV over seventeen years in a prospective study. <h3>Methods</h3> Between 1/1/98 and 31/12/14 all newly diagnosed cases of AAV (Granulomatosis with polyangiitis (GPA), microscopic polyangitis (MPA), eosinophilic granulomatosis with polyangitis (EGPA)) as defined by the Chapel Hill Consensus Conference 1992 were identified in a large mixed rural/urban northern German region consisting of 2,83 million habitants in a population-based prospective study. The following sources were explored on a regular basis: (a) departments of all hospitals, including their outpatient clinics; (b) all departments of pathology, and (c) the reference immunological laboratories serving the catchment area. All cases were re-evaluated by the authors. <h3>Results</h3> Within the observation period of seventeen years 551 patients were identified as having a new diagnosis of AAV in the catchment area, the incidence rate was 12 (range 8 -16)/million/year. GPA represents 70% of the AAV with an incidence rate of 7.9 (range 6–12)/million/year (95% CI 1;11 - 5<i>;19</i>), MPA with an incidence rate of 2.4 (range 1–5)/million/year (CI 0;3 – 1;9) and EGPA 1.1 (range 0–2)/million/year (CI 0;4). Incidence rates of GPA were on average three times higher than those of MPA and seven times higher than CSS. The incidence rates were stable between 1998 and 2014, our observations did not reveal significant differences. Gender differences were not observed. People diagnosed with MPA were on average 66.4 years old. <h3>Conclusions</h3> Results of our unique population based vasculitis register over seventeen years assessing the incidence of AAV in a region of 2.83 million habitants in northern Germany demonstrate stable incidence rates for AAV. Variances between years have been observed, but no pattern or periodicity. Compared to other studies investigating small regions or referral centers the incidence rates for AAV were comparable to the incidence rates observed in Norway, Sweden and the United States, lower than those in United Kingdom, but higher than in Spain and Vilnius. The incidence rates of MPA are significantly higher in Japan, whereas GPA and CSS have rarely been diagnosed. <h3>Disclosure of Interest</h3> None declared
Comment on Jackson et al. Insulitis in Autoantibody-Positive Pancreatic Donor With History of Gestational Diabetes Mellitus. Diabetes Care 2017;40:723–725
Authors: Lucien Marchand, Lorna Garnier, Nicole Fabien, Charles Thivolet
Journal: Diabetes Care (2017)

We read with interest the article by Jackson et al. (1) illustrating mild insulitis in the pancreas of a 28-year-old lean Hispanic female with recent gestational diabetes mellitus (GDM) who died of anoxic encephalopathy of unknown etiology 32 days after cesarean delivery. She was positive for GAD antibody (GADA) and islet cell antibody, while autoantibodies against insulin, IA-2, and zinc transporter 8 (ZnT8A) were negative. This observation, as well as earlier studies (2), raises a possible role of …