tbuckley/cabot-search huggingface dataset:
AB0307 Differential association of age and disease activity with carotid intima-media thickness in men and women with rheumatoid arthritis
Authors: D Taverner, S Paredes, R Ferre, L Masana, A Castro, JC Vallve
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid arthritis (RA) is the most common chronic inflammatory condition and is characterized by an increase risk in cardiovascular (CV) disease. Carotid intima-media thickness (cIMT) is a surrogate marker of CV disease and many studies have evaluated the relationship between cIMT and RA disease activity with contradictory results. <h3>Objectives</h3> To evaluate in RA patients the association between both cIMT and carotid plaque presence and clinical RA features and analytical measurements. <h3>Methods</h3> We selected 214 RA patients according to the American College of Rheumatology criteria. Conventional clinical evaluation and analytical measurements were performed, including a standard lipid profile. We used My Lab 50 X-Vision sonograph to measure cIMT and atherosclerotic plaque presence <h3>Results</h3> No differences between men and women regarding age, body mass index, glycaemia, LDL-C and TG were observed. However, men had a significantly higher waist circumference, systolic and diastolic BP and lower levels of HDLc. On the other hand, women had significantly higher values of DAS28 (3.7 vs 2.99), HAQ, and VSG with no differences in other inflammatory variables (rheumatoid factor, ACPA, CRP or fibrinogen). Moreover, 74% of patients had pathological cIMT without gender differences and 43% had plaque presence in the carotid artery with a significant higher percentage in men (57%) than women (36%). Overall, men had significantly higher cIMT (0.678 vs 0.627 mm) but when disease activity (DAS28) was considered, we observed that such difference was due to patients that were in remission or in low activity. Men and women with moderate and high disease activity had no statistical differences in cIMT. Furthermore, across women cIMT was significantly higher in those with high disease activity compared with remission. This effect was not observed in men. Multivariate linear regression with cIMT showed a significant interaction between age and gender, so that the effect of age on cIMT was significantly more pronounced in men than in women. <h3>Conclusions</h3> We have described that in our RA cohort, disease activity measured with DAS28 and age are differentially associated with cIMT in men and women. Our results could explain the contradictory results published in the literature and it can be justified by a higher incidence of RA in women and by the hormonal-genetic status. <h3>Disclosure of Interest</h3> None declared
AB0724 Higher likelihood of anti-tnf prescription in men vs women with ankylosing spondylitis despite similar disease burden: results from routine care at two academic rheumatology centers of usa and spain
Authors: M Blasco-Blasco, I Castrejόn, M Ruiz-Cantero, V Jovaní, E Pascual, J Block, T Pincus
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Ankylosing spondylitis (AS) has been considered to be more prevalent in men compared to women. Besides, the clinical presentation in women is thought to be milder and more peripheral than in men. Some studies have suggested a higher burden of disease in women<sup>1,2</sup> but others not confirm these differences<sup>3,4</sup>. <h3>Objectives</h3> To evaluate possible gender differences in men and women with AS seen in routine care at two academic rheumatology centers of the USA and Spain. <h3>Methods</h3> Sixty one men and 30 women with AS in Spain and 61 men and 31 women in the USA completed a Multidimensional Health Assessment Questionnaire (MDHAQ). The MDHAQ includes (0–10 scores) for physical function, pain, patient global estimate (PATGL), compiled into a 0–30 RAPID3, and fatigue scores. Furthermore, demographic data, biological (anti-TNFα) and DMARD therapies, were obtained from the medical records. A comparative analysis of men and women was performed by Mann-Whitney U tests for non-parametric quantitative data (median/interquartile range), and Chi square tests for qualitative data (frequencies/percentajes). <h3>Results</h3> We have not detected significant differences in men and women for function, pain, PATGL, or fatigue although a trend towards higher RAPID3 values was seen in females in both sites (Table). Anti-TNFα medications were prescribed more often in men than in women (81.2% vs 65.6%, in all patients p=0.02), statistically significant in Spain (82% vs 60%, p=0.02), and numerically higher in the USA (80.3% vs 71%, p=0.31). DMARD medications tend to be more prescribed in women than men in all patients (17.2% vs 23%, p=0.35) although no statistically significant. <h3>Conclusions</h3> Men with SpA receive anti-TNFα more likely than women; although disease burden appears somewhat higher in women. This pattern is similar in both Spain and the USA, though statistically significant only in the Spanish population. Other parameters may be having weight in the management of SpA, such as radiographic signs versus peripheral manifestations. <h3>References</h3> van der Horst-Bruinsma IE, et al. Ann Rheum Dis 2013. Ortega Castro R, et al. Reumatol Clin 2013. Gremese E, et al. Rheumatology (Oxford) 2014. Shahlaee A, et al. Clin Rheumatol 2015. <h3>Acknowledgements</h3> University Institute for Gender Studies (University of Alicante) supported MBB. <h3>Disclosure of Interest</h3> M. Blasco-Blasco: None declared, I. Castrejόn: None declared, M. Ruiz-Cantero: None declared, V. Jovaní: None declared, E. Pascual: None declared, J. Block: None declared, T. Pincus Shareholder of: Health Report Services, Inc.
AB1003 Median and ulnar nerve cross-sectional area in carpal tunnel syndrome with extraterritorial spread of sensory symptoms
Authors: B Mansiz Kaplan, M Akdeniz Leblebicier, I Yagci
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> To evaluate the relationship between extramedian spreading of sensorial symptoms and median and ulnar nerve cross-sectional area in patient with carpal tunnel syndrome (CTS), to compare the ultrasonographic and electrophysiological findings in patients with CTS whose sensorial symptoms are extramedian spreading or median distribution only. <h3>Methods</h3> Patients with CTS were divided into two groups as with and without extramedian symptoms and were assessed clinically, electrophysiologically and ultrasonographically by three blind investigators. In electrophysiological tests, median and ulnar nerve conduction studies were performed. Nerve cross-sectional areas were measured at hamatum hook, psiform bone, radio-ulnar joint, one-third distal part of forearm, and medial epicondyle for median nerve; radio-ulnar joint, psiform bone, one-third distal part of forearm, and medial epicondyle for ulnar nerve by ultrasonography. <h3>Results</h3> The study was completed with 61 patients (108 hands). Extramedian symptoms were present in 31 patients (54 hands). Finger grip strength was lower, pain values evaluated with visual analogue scale were higher in these patients (p&lt;0.05). There was no statistically significant difference in electrophysiological and ultrasonographic parameters between two groups. <h3>Conclusions</h3> These results suggest that extramedian spread in CTS patients is more related to central and peripheral sensitization than peripheral causes. <h3>Disclosure of Interest</h3> None declared
SAT0419 Similarities and differences between HLA B27 positive and HLA B27 negative spondyloarthritis: results from the esperanza cohort
Authors: P Serrano, V Navarro-Compán, S Rodríguez, M Fernández, P Zarco, E de Miguel
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The diagnostic relevance of HLA B27 for spondyloarthritis (SpA) is well established and highlighted by its inclusion in the classification criteria. However, the clinical relevance of this gen on the disease manifestations is unclear. <h3>Objectives</h3> To investigate the influence of HLA B27 status on disease manifestations in patients with recent-onset SpA. <h3>Methods</h3> Baseline database from ESPeranza cohort (&lt;45 years, symptoms duration 3–24 months and with inflammatory back pain or asymmetrical arthritis or spinal/joint pain plus ≥1 SpA features) was used. Inclusion period in the program was 2008–2011. For this study, 377 fulfilling the ASAS classification criteria for SpA were included. A descriptive analysis was used to compare demographic and clinical characteristics between HLA B27+ and HLA B27- patients for both subgroups, axial SpA and peripheral SpA. Chi- square test for qualitative variables and Student-t test for quantitative variables were employed to compare variables among groups. <h3>Results</h3> A total of 291 patients (75% B27+ and 25% B27-) were classified as axial SpA and 86 (33% B27+ and 67% B27-) as peripheral SpA. Results (mean –standard deviation- and relative frequencies) are presented in the table. In axial SpA, B27+ patients were younger, more frequently males and with a family history of SpA while B27- patients had more frequently psoriasis, IBD and poorer quality of life. In peripheral SpA, B27- had more frequently psoriasis and reported higher BASDAI. <h3>Conclusions</h3> In patients with SpA, HLA B27 status influences on the presentation of the disease. In axial SpA, the presence of B27 is associated with an earlier onset, male predominance and more frequency of family history of SpA. In peripheral SpA, the presence of B27 is linked with lower subjective parameters of disease activity. In both, axial and peripheral SpA, the absence of B27 is associated with psoriasis, IBD and poor quality of life. <h3>Disclosure of Interest</h3> None declared
Response to Osimertinib in Choroidal Metastases from EGFRmt T790M–Positive Non–Small Cell Lung Adenocarcinoma
Authors: Filippo Gustavo Dall’Olio, Celeste Ruatta, Barbara Melotti, Francesca Sperandi, Antonio Pasquale Ciardella, Andrea Ardizzoni
Journal: Journal of Thoracic Oncology (2017)
SP0175 What is new in juvenile idiopathic arthritis
Authors: NM Wulffraat
Journal: Annals of the Rheumatic Diseases (2017)

Juvenile Idiopathic Arthritis comprises 7 subcategories. As the insights in pathogenesis progress so does the need for reclassification that is based more on biology than on clinical phenotypes. After a series of clinical trials for new biologicals, now trials are started that test specific treatment strategies such as treat to target an d step down studies. Especially rapid induction of remission is currently a major aim, followed by biomarked guided tapering of medication. The expending number of potential biomarkers forms the basis for the creation of personalized medicin, a strategy aimed at providing individualized medication choices. Since most pediatric rheumatic conditions are rare, international collaboration is vital. The recently created European Reference Networks (ERN) will prove instrumental here. <h3>Disclosure of Interest</h3> None declared
cTag-PAPERCLIP Reveals Alternative Polyadenylation Promotes Cell-Type Specific Protein Diversity and Shifts Araf Isoforms with Microglia Activation
Authors: Hun-Way Hwang, Yuhki Saito, Christopher Y. Park, Nathalie E. Blachère, Yoko Tajima, John J. Fak, Ilana Zucker-Scharff, Robert B. Darnell
Journal: Neuron (2017)
Rates and Trends of Pediatric Acute Lymphoblastic Leukemia — United States, 2001–2014
Authors: David A. Siegel, S. Jane Henley, Jun Li, Lori A. Pollack, Elizabeth A. Van Dyne, Arica White
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

Acute lymphoblastic leukemia (ALL) is the most prevalent cancer among children and adolescents in the United States, representing 20% of all cancers diagnosed in persons aged <20 years, or >3,000 new cases each year (1). Past studies reported increasing trends of ALL overall and among Hispanics, but these represented ≤28% of the U.S. population and did not provide state-based estimates (1-3). To describe U.S. ALL incidence rates and trends among persons aged <20 years during 2001-2014, CDC analyzed rigorous data (based on established publication criteria) from the United States Cancer Statistics data set, which includes incidence data on approximately 15,000 new cases per year of all types of invasive cancer among children and adolescents aged <20 years (4). The data set represented 98% of the U.S. population during the study period. Overall incidence of pediatric ALL during 2001-2014 was 34.0 cases per 1 million persons and among all racial/ethnic groups was highest among Hispanics (42.9 per 1 million). Both overall and among Hispanics, pediatric ALL incidence increased during 2001-2008 and remained stable during 2008-2014. ALL incidence was higher in the West than in any other U.S. Census region. State-specific data indicated that the highest rates of pediatric ALL incidence were in California, New Mexico, and Vermont. These demographic and geographic ALL incidence data might better inform public health interventions targeting the following areas: exposures to recognized risk factors for leukemia; ALL treatment, including clinical trial enrollment; survivorship care planning; and studies designed to understand the factors affecting changes in pediatric cancer incidence.
Treating breathlessness <i>via</i> the brain: changes in brain activity over a course of pulmonary rehabilitation
Authors: Mari Herigstad, Olivia K. Faull, Anja Hayen, Eleanor Evans, F. Maxine Hardinge, Katja Wiech, Kyle T.S. Pattinson
Journal: European Respiratory Journal (2017)

Breathlessness in chronic obstructive pulmonary disease (COPD) is often discordant with airway pathophysiology ("over-perception"). Pulmonary rehabilitation profoundly affects breathlessness, without influencing lung function. Learned associations influence brain mechanisms of sensory perception. We hypothesised that improvements in breathlessness with pulmonary rehabilitation may be explained by changing neural representations of learned associations. In 31 patients with COPD, we tested how pulmonary rehabilitation altered the relationship between brain activity during a breathlessness-related word-cue task (using functional magnetic resonance imaging), and clinical and psychological measures of breathlessness. Changes in ratings of breathlessness word cues positively correlated with changes in activity in the insula and anterior cingulate cortex. Changes in ratings of breathlessness-anxiety negatively correlated with activations in attention regulation and motor networks. Baseline activity in the insula, anterior cingulate cortex and prefrontal cortex correlated with improvements in breathlessness and breathlessness-anxiety. Pulmonary rehabilitation is associated with altered neural responses related to learned breathlessness associations, which can ultimately influence breathlessness perception. These findings highlight the importance of targeting learned associations within treatments for COPD, demonstrating how neuroimaging may contribute to patient stratification and more successful personalised therapy.
First Experimental Assessment of Protein Intrinsic Disorder Involvement in an RNA Virus Natural Adaptive Process
Authors: Justine Charon, Amandine Barra, Jocelyne Walter, Pauline Millot, Eugénie Hébrard, Benoît Moury, Thierry Michon
Journal: Molecular Biology and Evolution (2017)

Intrinsic disorder (ID) in proteins is defined as a lack of stable structure in physiological conditions. Intrinsically disordered regions (IDRs) are highly abundant in some RNA virus proteomes. Low topological constraints exerted on IDRs are expected to buffer the effect of numerous deleterious mutations and could be related to the remarkable adaptive potential of RNA viruses to overcome resistance of their host. To experimentally test this hypothesis in a natural pathosystem, a set of four variants of Potato virus Y (PVY; Potyvirus genus) containing various ID degrees in the Viral genome-linked (VPg) protein, a key determinant of potyvirus adaptation, was designed. To estimate the ID contribution to the VPg-based PVY adaptation, the adaptive ability of the four PVY variants was monitored in the pepper host (Capsicum annuum) carrying a recessive resistance gene. Intriguingly, the two mutants with the highest ID content displayed a significantly higher ability to restore infection in the resistant host, whereas the less intrinsically disordered mutant was unable to restore infection. The role of ID on virus adaptation may be due either to a larger exploration of evolutionary pathways or the minimization of fitness penalty caused by resistance-breaking mutations. This pioneering study strongly suggests the positive impact of ID in an RNA virus adaptive capacity.
SAT0612 The use of 18F-FDG-PET in the diagnosis of polymyalgia rheumatica (PMR) – a prospective study of 99 patients suspected of PMR
Authors: L Henckaerts, O Gheysens, S Vanderschueren, K Goffin, D Blockmans
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Previous studies have shown that the majority of patients with polymyalgia rheumatica (PMR) have increased fluorodeoxyglucose (FDG)-uptake around the shoulders, hips and processes of the cervical and lumbar spine on positron emission tomography (PET) (1). The specificity of these findings for PMR is not known. <h3>Objectives</h3> To determine the specificity and sensitivity of FDG-PET findings for the diagnosis of PMR. <h3>Methods</h3> A prospective monocentric study in a tertiary care centre. All patients underwent FDG-PET scanning before treatment with glucocorticoids was started. The clinical suspicion of PMR was quantified by the treating physician on a scale from 1 to 5. FDG-uptake was scored visually in 12 articular regions (cervical spinous processes, lumbar spinous processes, left and right sternoclavicular joint, left and right ischial tuberosity, left and right greater trochanter, left and right hip and left and right shoulder) (score 0–2) and a total skeletal score was calculated reflecting the FDG-uptake in these 12 articular regions. ROC analysis was performed to determine the optimal clinical and total skeletal score for diagnosing PMR. The golden standard for a diagnosis of PMR was the judgment of an experienced clinician after at least six months of follow-up. <h3>Results</h3> 99 consecutive patients with a possible clicinal diagnosis of PMR were included in this study. Sixty-seven patients were finally diagnosed with PMR while 32 patients got another diagnosis. A clinical score of 4 or more had a sensitivity of 67.2%, specificity of 87.5%, positive predictive value (PPV) of 91.8% and a negative predictive value (NPV) of 56.0% for the diagnosis of PMR. A total skeletal score of 16 or more had a sensitivity, specificity, PPV, NPV of respectively 85.1%, 87.5%, 93.4% and 73.7%. <h3>Conclusions</h3> FDG-PET before starting glucocorticoid therapy improves the diagnostic accuracy compared to a clinical scoring system in patients with clinical suspicion of PMR. <h3>References</h3> Blockmans D, De Ceuninck L, Vanderschueren S, Knockaert D, Mortelmans L, Bobbaers H. Repetitive 18-fluorodeoxyglucose positron emission tomography in isolated polymyalgia rheumatica: a prospective study in 35 patients. Rheumatology (Oxford) 2007; 46: 672–7. <h3>Disclosure of Interest</h3> None declared
THU0486 Angiopoetin-2 as a new valuable marker of disease activity in children with juvenile idiopathic arthritis
Authors: J Świdrowska-Jaros, E Smolewska
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Angiopoetin-2 (ANG-2) is one of the main angiogenesis modulators. As synovial angiogenesis is considered to be an important early step in the course and pathogenesis of juvenile idiopathic arthritis (JIA), it may be a valuable marker of activity of the disease. <h3>Objectives</h3> To evaluate ANG-2 serum and synovial fluid levels in JIA patients and its possible correlation with disease activity and the degree of ultrasound-detected synovial angiogenesis. <h3>Methods</h3> Serum levels of vascular markers were measured in 63 patients with JIA (aged 1,5–17) and 31 age-matched healthy controls. Synovial fluid was collected from 17 JIA patients. Disease activity (low, medium and high) was assessed by JADAS-27 scale. Ultrasound examination of inflamed joints was performed in each JIA patient and synovial angiogenesis was evaluated by means of Power Doppler ultrasonography (PDUS) and the 4th grade vascularity scale (0–3). <h3>Results</h3> ANG-2 serum levels were higher in children with JIA comparing to the healthy controls (5,5±1,2 ng/ml vs. 1.9±1.4 ng/ml). Serum concentration of ANG-2 in JIA children increased with disease activity (1,4±0,9 ng/ml vs. 1,4±1,0 ng/ml vs. 1,8±2,2 ng/ml), whereas Ang-2 levels in the synovial fluid were the highest in the high disease activity (3,4±2,5 ng vs. 12,5±9,5 ng/ml vs. 26,4±9,0 ng/ml, p&lt;0,05). Concentration of ANG-2 in serum correlate with the synovial vascularization obtained by PDUS (0–3, accordingly 1,5±0,8 ng/ml vs. 1,3±0,9 ng/ml vs. 1,5±1,0 ng/ml vs. 13,2±8,7 ng/ml, p&lt;0,01) The same pattern was observed for ANG-2 levels in synovial fluid and PDUS grade (0–3, accordingly 3,8±1,0 ng/ml vs. 5,1±4,1 ng/ml vs. 13,5±2,0 ng/ml, p&lt;0,01). <h3>Conclusions</h3> ANG-2 might be a valuable marker in JIA children with high disease activity. Together with ultrasound examination, it may add more information about disease severity, what may be helpful in introducing the correct therapy. <h3>Disclosure of Interest</h3> None declared
AB0967 Clinical, laboratory profiles and long-term outcome of juvenile cutaneous pan: a single center experience
Authors: RA Castellanos-Moreira, JM Mosquera, SC Rodriguez-Garcia, J Calzada, A Vicente, E Iglesias, R Bou, J Anton
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Cutaneous polyarteritis nodosa (cPAN) is an immune complex-mediated rare disease that affects small and medium sized vessels in the dermis and subcutaneous tissue. The clinical course is characterized by periodic exacerbations and remissions that may persist for many years. Most patients respond to NSAIDs and glucocorticoids (GC), whereas some may require DMARDs and/or immunomodulatory therapy. <h3>Objectives</h3> To describe the diferrent clinical patterns, laboratory findings and long term outcomes of juvenile cPAN in a tertiary care hospital. <h3>Methods</h3> Retrospective observational study, including all patients diagnosed with cPAN between 2002–2016. Diagnosis relied on clinical features confirmed by histological study. Recorded data included clinical features, laboratory results and long-term outcomes. <h3>Results</h3> 10 children were included (7 female), mean age at onset was 9.9 years (r:4.1–16.3). Delay from symptoms onset to biopsy confirmed diagnosis was 2±2.3 months; 4 patients underwent a second biopsy due to inconclusive results in the first performed. Clinical features included cutaneous (100%) and osteomuscular involvement (50%), fever (40%), neuropathy (10%) and weight loss (10%). Reported cutaneous symptoms were 8 patients with nodules, 4 livedo, 4 purpura, 1 ulcer and 1 necrosis. Most lesions were localized in the lower limbs (8), even though it was also reported in upper limbs (3) and trunk (3). Most cases exhibited raised CRP, ESR and leukocyte count with a mean of 26.4±47.9 (mg/L), 27.7±29.7 (mm/h), and 8.6±5.3 (x 10<sup>9</sup>/L) respectively. As first line therapy, all patients received GC and 6 NSAIDs. 8 were given a DMARD such as HCQ or MTX. Due to persistent activity or relapse, rescue treatment with pulse-GC (20%), MMF (10%) or IVIG (20%) was instituted. Only 1 patient received penicillin prophylaxis due to relapses associated with streptococcal infection. Mean follow-up was 3.9 years (r: 1.1–10.4). 4 patients had a monophasic disease, six suffered ≥2 relapses. At last follow-up 9 patients were on remission, even though 3 were off-therapy. No complications were reported. <h3>Conclusions</h3> Clinical and laboratory findings in our series was similar to previous reports. However, our patients presented a greater number of relapses and DMARDs requirement. <h3>Disclosure of Interest</h3> None declared