tbuckley/cabot-search huggingface dataset:
SP0119 Predicting fracture risk: accuracy and feasibility of tools
Authors: AA Marques
Journal: Annals of the Rheumatic Diseases (2017)

Several therapeutic options and screening strategies are available to effectively decrease fracture risk. However the main clinical challenge still consists in accurately identifying and selecting individuals for bone densitometry and for pharmacological treatment, in order to increase efficiency and minimize individual and societal costs. The World Health Organization provided an operational definition of osteoporosis as a bone mineral density (BMD) that lies 2.5 or more standard deviations below the average value for young healthy women of the same gender and ethnical background [T-score ≤-2.5]. However, BMD has limited sensitivity and specificity in the prediction of fracture. In fact, a large number of conditions have been firmly established as risk factors for the occurrence of fragility fractures, independently from BMD. These have been combined into prediction algorithms to estimate fracture probability and are currently available for calculate the risk of fractures. However, the existing tools differ in many relevant aspects: from their own feasibility, to the number and availability of clinical risk factors included, the accessibility of BMD measurements and, finally, their performance in different settings. With this session we aim to identify and synthesize the best available evidence on the accuracy and feasibility of the currently available tools designed to predict fracture risk. Several therapeutic options and screening strategies are available to effectively decrease fracture risk. However the main clinical challenge still consists in accurately identifying and selecting individuals for bone densitometry and for pharmacological treatment, in order to increase efficiency and minimize individual and societal costs.The World Health Organization provided an operational definition of osteoporosis as a bone mineral density (BMD) that lies 2.5 or more standard deviations below the average value for young healthy women of the same gender and ethnical background [T-score ≤-2.5]. However, BMD has limited sensitivity and specificity in the prediction of fracture. In fact, a large number of conditions have been firmly established as risk factors for the occurrence of fragility fractures, independently from BMD. These have been combined into prediction algorithms to estimate fracture probability and are currently available for calculate the risk of fractures. However, theexisting tools differ in many relevant aspects: from their own feasibility, to the number and availability of clinical risk factors included, the accessibility of BMD measurements and, finally, their performance in different settings.With this session we aim to identify and synthesize the best available evidence on the accuracy and feasibility of the currently available tools designed to predict fracture risk. <h3>Disclosure of Interest</h3> None declared
Corticosteroids for sore throat: a clinical practice guideline
Authors: Bert Aertgeerts, Thomas Agoritsas, Reed A C Siemieniuk, Jako Burgers, Geertruida E Bekkering, Arnaud Merglen, Mieke van Driel, Mieke Vermandere, Dominique Bullens, Patrick Mbah Okwen, Ricardo Niño, Ann van den Bruel, Lyubov Lytvyn, Carla Berg-Nelson, Shunjie Chua, Jack Leahy, Jennifer Raven, Michael Weinberg, Behnam Sadeghirad, Per O Vandvik, Romina Brignardello-Petersen
Journal: BMJ (2017)

What is the role of a single dose of oral corticosteroids for those with acute sore throat? Using the GRADE framework according to the BMJ Rapid Recommendation process, an expert panel make a weak recommendation in favour of corticosteroid use. The panel produced these recommendations based on a linked systematic review triggered by a large randomised trial published in April 2017. This trial reported that corticosteroids increased the proportion of patients with complete resolution of pain at 48 hours. Box 1 shows all of the articles and evidence linked in this Rapid Recommendation package. The infographic provides the recommendation together with an overview of the absolute benefits and harms of corticosteroids in the standard GRADE format. Table 2 below shows any evidence that has emerged since the publication of this article. Clinicians and their patients can find consultation decision aids to facilitate shared decision making in MAGICapp (www.magicapp.org/goto/guideline/JjXYAL/section/j79pvn).
Assessment of cancer-related fatigue, pain, and quality of life in cancer patients after palliative care team referral: A multicenter observational study (JORTC PAL-09).
Authors: Satoru Iwase, Takashi Kawaguchi, Tempei Miyaji, Hiroto Ishiki, Keisuke Ariyoshi, Takuhiro Yamaguchi
Journal: Journal of Clinical Oncology (2015)

e20550 Background: Cancer-related fatigue (CRF) greatly influences quality of life (QOL) in cancer patients ; however, no specific treatments have been established for CRF, and at present, no medication has been approved in Japan. Systematic research using patient-reported outcome to examine symptoms, particularly fatigue, has not been conducted in palliative care settings in Japan. Objects: The objective was to evaluate fatigue, pain, and QOL in cancer patients after the point of intervention by palliative care teams (PCTs). Methods: Patients who were referred to PCTs at three institutions, were asked to complete the Brief Fatigue Inventory (BFI), Brier Pain Inventory (BPI), and EORTC QLQ-C15-PAL at and 14 days after the intervention by PCTs. Results: Of 183 patients recruited, 86% were diagnosed with recurrence or metastasis. At the point of PCT referral, the prevalence of moderate to severe fatigue and pain was 59.5% and 64.1%, respectively. One hundred and twenty four patients (68%) were evaluated after the intervention. The mean Global Fatigue Score (GFS) was improved from 4.0 to 3.5 (p = 0.028). The change of mean BFI-1 (now), BFI-2(average), BFI-3(worst) score were 3.7 to 3.7, (p = 0.804), 3.7 to 3.4 (p = 0.202), and 4.3 to 4.0 (p = 0.232), respectively. The mean GHS/QOL and BPI-3 (the worst pain) score was ameliorated form 43.0 to 49.0 (p = 0.026), and 5.0 to 4.0 (p < .0001). GHS/QOL, Pain Management Index (PMI), GFS and ECOG PS at baseline were found to be prognostic factors for the BFI-3(worst) score after the intervention. Conclusions: The intensity of fatigue were persisted despite the PCT referral. It was observed that patients have high prevalence of CRF and pain at the point of PCT referral in Japan, and pain and QOL may be ameliorated by the PCT referral.
Review: Real-world use of nonsteroidal antiinflammatory drugs is associated with acute myocardial infarction
Authors: Terry Quinn
Journal: Annals of Internal Medicine (2017)

ACP Journal Club19 September 2017Review: Real-world use of nonsteroidal antiinflammatory drugs is associated with acute myocardial infarctionTerry Quinn, MDTerry Quinn, MDInstitute Cardiovascular Medical Sciences, Glasgow University, Glasgow, Scotland, UK (T.Q.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2017-167-6-030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationBally M, Dendukuri N, Rich B, et al. Risk of acute myocardial infarction with NSAIDs in real world use: Bayesian meta-analysis of individual patient data. BMJ. 2017;357:j1909. https://pubmed.ncbi.nlm.nih.gov/28487435Clinical Impact RatingsGIM/FP/GP: Cardiology: References1 Waxman HA. The lessons of Vioxx—drug safety and sales. N Engl J Med. 2005;352:2576-8. [PMID: 15972862] Google Scholar2 Saragiotto BT, Machado GC, Ferreira ML, et al. Paracetamol for low back pain. Cochrane Database Syst Rev. 2016;(6):CD012230. [PMID: 27271789] Google Scholar Author, Article, and Disclosure InformationAffiliations: Institute Cardiovascular Medical Sciences, Glasgow University, Glasgow, Scotland, UK (T.Q.)This article was published at Annals.org on 5 September 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAnalgesic Drugs and Cardiac SafetyAnalgesic Drugs and Cardiac SafetyClofibrate Treatment Decreases Inflammation and Reverses Myocardial Infarction-Induced Remodelation in a Rodent Experimental Model 19 September 2017Volume 167, Issue 6Page: JC30KeywordsAcute myocardial infarctionAnalgesicsCyclooxygenase 2DatabasesDrugsIbuprofenNSAIDsOdds ratioRandomized trialsSystematic reviews ePublished: 19 September 2017 Issue Published: 19 September 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Semaphorin-3E attenuates neointimal formation via suppressing VSMCs migration and proliferation
Authors: Jie-Hong Wu, Yanan Li, Yi-Fan Zhou, James Haslam, Opoku Nana Elvis, Ling Mao, Yuan-Peng Xia, Bo Hu
Journal: Cardiovascular Research (2017)

The migration and proliferation of vascular smooth muscle cells (VSMCs) are crucial events in the neointimal formation, a hallmark of atherosclerosis and restenosis. Semaphorin3E (Sema3E) has been found to be a critical regulator of cell migration and proliferation in many scenarios. However, its role on VSMCs migration and proliferation is unclear. This study aimed to investigate the effect of Sema3E on VSMCs migration, proliferation and neointimal formation, and explore possible mechanisms.We found that the expression of Sema3E was progressively decreased during neointimal formation in a carotid ligation model. H&E-staining showed lentivirus-mediated overexpression of Sema3E in carotid ligation area attenuated neointimal formation. Immunofluorescence staining showed that the receptor (PlexinD1) of Sema3E was expressed in vascular walls. In cultured mouse VSMCs, Sema3E inhibited VSMCs migration and proliferation via plexinD1 receptor. The inhibitory effect was mediated, at least in part, by inactivating Rap1-AKT signalling pathways in VSMCs. Moreover, we found that PDGFBB down-regulated the expression of Sema3E in VSMCs and Sema3E notably inhibited the expression of PDGFB in endothelial cells. In addition, the number of Sema3E-positive VSMCs was diminished in plaques of atherosclerotic patients. Results from a public GEO microarray database showed a negative correlation between Sema3E and PDGFB transcriptional levels in the human plaques examined.Our study demonstrates that Sema3E/plexinD1 inhibits proliferation and migration of VSMCs via inactivation of Rap1-AKT signalling pathways. The mutual inhibition between PDGF-BB and Sema3E after vascular injury plays a critical role in the process of neointimal formation.
FRI0199 Systematic review and meta-analysis on certolizumab pegol for rheumatoid arthritis in adults
Authors: JA Bernal, P Vela, V Ruiz García, A Burls, JB Cabello, S Bort-Martí
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The appearance of tumor necrosis factor-alpha (TNFalpha) inhibitors dramatically changed the prognosis of rheumatoid arthritis. Certolizumab pegol (CZP) is a human Fab fragment of anti-TNFalpha monoclonal antibody which is approved for the treatment of rheumatoid arthritis. We performed a systematic review and meta-analysis, with Cochrane methodology, of the effects of CZP in rheumatoid arthritis. <h3>Objectives</h3> To assess the clinical benefits and harms of CZP in patients with rheumatoid arthritis. <h3>Methods</h3> We performed a search of electronic database (Cochrane Database, MEDLINE, EMBASE, Web of Knowledge and clinicaltrials.gov) until 26th September 2016. We searched for randomized controlled trials of CZP in rheumatoid arthritis compared to any other agent including placebo. <h3>Results</h3> 14 trials were included for the meta-analysis, 12 (5422 patients) in the pooled analysis for benefits and 14 (5499 patients) in the pooled analysis for safety. The overall possibility of bias seemed to be low but the quality of the evidence was low due to the risk of attrition bias. With the approved dose - CZP 200 mg subcutaneous every other week with the first three doses of 400 mg - CZP showed statistically significant improvements at 24 weeks compared to placebo in: ACR50 absolute improvement 27% (95% CI 20% to 33%), RR 3.8 (95% CI 2.42 to 5.95) and NNT=4 (95% CI 3 to 8); DAS28 &lt;2.6 - original definition of remission - with RR 3.79 (95% CI 1.90 to 7.56); HAQ with -12% absolute improvement (95% CI -9% to -14%); and erosion score with -0.29% (95% CI -0.42% to -0.17%). There are also data available at 12 weeks with RR of 1.99 (95% CI 1.44 to 2.76) of achieving DAS28&lt;2.6 with CZP 200 mg dose. The proportion of patients achieving DAS28&lt;2.6 was still higher with CZP at 52 weeks with RR of 1.83 (95% CI 1.53 to 2.18). Serious adverse events were more frequent for CZP 200 mg dose with a RR of 1.47 (95% CI 1.13 to 1.91) and NNH of 32. There have been eight adverse events leading to death in CZP 200 mg group versus two in the control group (not statistically significant) and 10 patients developing tuberculosis versus two in the control group (not statistically significant). <h3>Conclusions</h3> There is low level evidence from randomized controlled trials that CZP as monotherapy or combined with methotrexate improved ACR50, DAS28, HAQ and joint damaged on x-ray. Adverse events were more frequent with active treatment. <h3>Disclosure of Interest</h3> None declared
THU0733-HPR Rehabilitation in warm climate for young adults with inflammatory rheumatic disease. a 12 months randomized controlled trial
Authors: IR Nilssen, H Koksvik, K Grønning, A Steinsbekk
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rehabilitation in warm climate has long been an established non-pharmacological treatment for patients with inflammatory rheumatic disease (IRD) in Norway. It has however not been tailored to the needs of young adults, who often have different challenges than older adults with IRD. <h3>Objectives</h3> The aim of this study was to investigate if a rehabilitation program in warm climate tailored to young adults from 20 to 35 years had effect on physical function and self-management/coping, 12 months after completed intervention. <h3>Methods</h3> This was an open randomized controlled pilot trial, with a 2-group parallel design and a 1:1 allocation ratio. Patients were recruited from three different rheumatology outpatient clinics in central Norway. The intervention group received a 17 day long rehabilitation stay in Spain. The main component of the tailored intervention was intensive exercise (2–3 times per/day), individual physiotherapy (daily) and patient education. The control group received treatment as usual. The primary outcome measure was physical function assessed by the "30 second Sit to Stand test" (30sSTS, number of sit and stand during 30 seconds, higher score is better) and self-management/coping measured by the "Effective Musculoskeletal Consumer Scale" (EC17, higher score is better). <h3>Results</h3> Forty patients (mean age 27.5, 65% female) with IRD (intervention/control: 3/2 rheumatoid arthritis, 3/9 juvenile idiopathic arthritis, 4/5 psoriatic arthritis, 8/3 ankylosing spondylitis and 2/1 polyarthritis) were randomized. 19 out of 20 patients completed the intervention. At twelve months follow up there were 3 patients lost to follow up from the intervention group, and 2 in the control group. Patients in the intervention group had a significant improvement in the 30sSTS test 3, 6 and 12 months after completed intervention, compared to the control group (Table 1). The within group analysis showed that both groups improved at 6 and 12 months. The EC17 showed no difference between the two groups at 3, 6 or 12 months. <h3>Conclusions</h3> The results indicate that the intervention group significantly improved their physical function one year after the intervention compared to the control group, but there was no effect on self-management/coping. These results might reflect that the focus of the intervention was mainly intensive exercise, and less on self-management /coping. This was a small study and the results should be interpreted with caution. <h3>Disclosure of Interest</h3> None declared
Dopamine induces soluble α-synuclein oligomers and nigrostriatal degeneration
Authors: Danielle E Mor, Elpida Tsika, Joseph R Mazzulli, Neal S Gould, Hanna Kim, Malcolm J Daniels, Shachee Doshi, Preetika Gupta, Jennifer L Grossman, Victor X Tan, Robert G Kalb, Kim A Caldwell, Guy A Caldwell, John H Wolfe, Harry Ischiropoulos
Journal: Nature Neuroscience (2017)
THU0714 Investigating the effects of hypermobility on balance variables
Authors: M Selmani, A Elvan, B Akcay, G Kenar, AM Birlik, S Angin, IE Simsek
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Hypermobility syndrome (HMS) is a clinical syndrome in which the range of motion of the joint is observed above normal ranges without being associated with a rheumatic disease. Excessive joint motion in HMS reduces joint stability and joint position sense and also can cause pain. Decreased muscle tone and tensile forces of the tendons cause decreased locomotor system stiffness and impairment of proprioception mechanisms. These problems in proprioceptive mechanisms can lead to balance-related disorders in individuals with hypermobility syndrome <h3>Objectives</h3> The aim of this study was to investigate the possible effects of hypermobility on balance variables. <h3>Methods</h3> 50 hypermobile (5 males and 45 females) volunteers diagnosed with Brighton Scale and 50 healthy (21 males and 29 females) volunteers were included in this cross sectional study. Participants with a score of 4 or over according to the Beighton scale were referred to a rheumatologist and were administered Brighton scale. Participants who were diagnosed by the physician were included in the hypermobile group. The objective balance evaluation was conducted using a balance platform. Evaluation variables were; static balance on single foot, static balance on both feet, limits of stability test and tandem walking. analysis was performed using independent samples t-test. <h3>Results</h3> The mean age was found 21,69±2,13 years old for the control group and 20,09±2,65 years old for the HMS group. Body Mass Index was found 22,13±3,54 kg/m<sup>2</sup> in the control group and 21,54±3,50 kg/m<sup>2</sup> in the HMS group. HMS group showed significant wider step width in tandem walking (p=0,001), significantly longer reaction time (p=0,23, p=0.030), significantly higher end-point excursion (p=0.003, p=0,026, p=0,049), significant higher mean maximum excursions (p=0.018) (Table 1). <h3>Conclusions</h3> In this study it was found that hypermobility has significant effects on the stability limits test and tandem walking. In previous studies it was found that hypermobility affects the static balance assessment variables (1, 2), but in this study dynamic balance assessment variables were affected. <h3>References</h3> Iatridou K, Mandalidis D, Chronopoulos E, Vagenas G, Athanasopoulos S. Static and dynamic body balance following provocation of the visual and vestibular systems in females with and without joint hypermobility syndrome. J Bodyw Mov Ther. 2014 Apr;18(2):159–64. doi: 10.1016/j.jbmt.2013.10.003. Juul-Kristensen B, Johansen K, Hendriksen P, Melcher P, Sandfeld J, Jensen BR. Girls with generalized joint hypermobility display changed muscle activity and postural sway during static balance tasks. Scand J Rheumatol. 2015 Sep 1:1–9. <h3>Disclosure of Interest</h3> None declared
AB1008 Distributions of antibodies in sle patients in different ethnic groups in xinjiang
Authors: C Xiaomei, W Lijun
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Objectives</h3> The aim of this study was to explore distributions of antibodies in SLE patients in different ethnic groups in xinjiang. <h3>Methods</h3> Data were obtained from 670 patients with SLE from Department of Rheumatology and immunology in our hospital between January 2012 and October 2016.All patients fulfilled the 1997 ACR SLE classification criteria. Data about their gender, age, ethnic groups and result of antibodies test were collected. <h3>Results</h3> Totally 670 completed data were collected.there are 438 (65.37%) of these patients (68.22%) were Han population,136 (20.29%)were Uighur, 43 (6.42%) were Kazakh, 30 (4.48%) were hui people and 23 were other minorities live in xinjiang. The titer of ANA was higher in minorities than Han population (Z=-3.516, P&lt;0.01). As compared with Han population, the positive rate of anti-Smith antibaodies and anti-SSA antibodies in SLE patients, significantly higher than han population (χ<sup>2</sup>=5.902, <i>P</i>&lt;0.017; χ<sup>2</sup>=42.787, <i>P</i>&lt;0.001, respectively). However, there are no significant different of the positive rate ofanti-SSA antibodies, anti-Scl-70 antibodies, anti-Jo-1 antibodies,anti-ds-DNA antibodies between Han population and minorities. <h3>Conclusions</h3> Distributions of antibodies in SLE patients were different between Han population and minorities.the positive rate of anti-Smith antibaodies and anti-SSA antibodies in SLE patients were significantly higher than han population. <h3>Disclosure of Interest</h3> None declared
THU0040 Novel akt activator sc-79 is a potential treatment for alcohol-induced osteonecrosis of the femoral head
Authors: C Yixuan
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Alcohol is known to be one ofthe leading risk factors for osteonecrosis of the femoral head. However, the underlying etiology and protective strategiesof alcohol-induced osteonecrosis of the femoral headhavenot been clarified. <h3>Objectives</h3> The aim of this study was to explore the molecular mechanism of alcohol-induced osteonecrosis of the femoral head, and to investigate the protective effect of SC-79 on the disease. <h3>Methods</h3> In vitro, we employed RT-PCR, alizarin red staining, alkaline phosphatase activity testing, western blot, immunofluorescence staining to investigate the effect of ethanol on hBMSCs. In vivo experiments, immunofluorescence staining, TRAP, TUNEL and micro-CT were performed to investigate the development of ONFH. <h3>Results</h3> In vitro, we found that ethanol could significantly impair the expression of osteogenic genes of RUNX2 and OCN, downregulate osteogenic differentiation, impair IGF-1 induced membrane recruitment of the Akt, suppress the Akt-Ser473 phosphorylationand the subsequent activation of Akt/GSK3β/β-catenin signaling in bone mesenchymal stem cells. Functional studies further confirmed this signaling was the critical mediator during the ethanol-induced inhibitory effects on osteogenesis of BMSCs.Thus, the dephosphorylation of Akt-Ser473 in Akt/GSK3β/β-catenin signaling pathway might be a potential mechanism in the pathogenesis of alcohol-induced osteonecrosis of the femoral head.SC-79, a novel Akt activator was introduced in this study to block the dephosphorylation effect of ethanol on Akt-Ser473 both in vitro and in vivo. In the rat model of alcohol-induced osteonecrosis of the femoral head, micro-CT and histopathological analyses revealed obvious osteonecrosis changes in alcohol-administrated rats while significantly less developed in SC-79 injected rats. OPN, OCN and COL1 immunofluorescence staining revealed that osteogenic response of femoral heads was markedly reduced after alcohol administration, but significantly reversed by SC-79 treatment. <h3>Conclusions</h3> Hence, we discovered alcohol-induced osteonecrosis of the femoral headwas associated with the suppression of the Akt-Ser473 in Akt/GSK3β/β-catenin pathway in BMSCs. The administration of SC-79, to elevate Akt activation, might be a clinical strategy to prevent the development of alcohol-inducedosteonecrosis of the femoral head. <h3>Acknowledgements</h3> The current study was supported by National Natural Science Foundation of China (81272003, 81301572) and SMC-Chen Xing Plan for Splendid Young Investigators of Shanghai Jiao Tong University. <h3>Disclosure of Interest</h3> None declared