tbuckley/cabot-search huggingface dataset:
Effects of Intensive Systolic Blood Pressure Control on Kidney and Cardiovascular Outcomes in Persons Without Kidney Disease
Authors: Srinivasan Beddhu, Michael V. Rocco, Robert Toto, Timothy E. Craven, Tom Greene, Udayan Bhatt, Alfred K. Cheung, Debbie Cohen, Barry I. Freedman, Amret T. Hawfield, Anthony A. Killeen, Paul L. Kimmel, James Lash, Vasilios Papademetriou, Mahboob Rahman, Anjay Rastogi, Karen Servilla, Raymond R. Townsend, Barry Wall, Paul K. Whelton
Journal: Annals of Internal Medicine (2017)

Background: The public health significance of the reported higher incidence of chronic kidney disease (CKD) with intensive systolic blood pressure (SBP) lowering is unclear. Objective: To examine the effects of intensive SBP lowering on kidney and cardiovascular outcomes and contrast its apparent beneficial and adverse effects. Design: Subgroup analyses of SPRINT (Systolic Blood Pressure Intervention Trial). (ClinicalTrials.gov: NCT01206062) Setting: Adults with high blood pressure and elevated cardiovascular risk. Participants: 6662 participants with a baseline estimated glomerular filtration rate (eGFR) of at least 60 mL/min/1.73 m2. Intervention: Random assignment to an intensive or standard SBP goal (120 or 140 mm Hg, respectively). Measurements: Differences in mean eGFR during follow-up (estimated with a linear mixed-effects model), prespecified incident CKD (defined as a >30% decrease in eGFR to a value <60 mL/min/1.73 m2), and a composite of all-cause death or cardiovascular event, with surveillance every 3 months. Results: The difference in adjusted mean eGFR between the intensive and standard groups was −3.32 mL/min/1.73 m2 (95% CI, −3.90 to −2.74 mL/min/1.73 m2) at 6 months, was −4.50 mL/min/1.73 m2 (CI, −5.16 to −3.85 mL/min/1.73 m2) at 18 months, and remained relatively stable thereafter. An incident CKD event occurred in 3.7% of participants in the intensive group and 1.0% in the standard group at 3-year follow-up, with a hazard ratio of 3.54 (CI, 2.50 to 5.02). The corresponding percentages for the composite of death or cardiovascular event were 4.9% and 7.1% at 3-year follow-up, with a hazard ratio of 0.71 (CI, 0.59 to 0.86). Limitation: Long-term data were lacking. Conclusion: Intensive SBP lowering increased risk for incident CKD events, but this was outweighed by cardiovascular and all-cause mortality benefits. Primary Funding Source: National Institutes of Health.
FRI0294 Ultrasound of the salivary glands helps to distinguish between primary and secondary sjÖgren syndrome
Authors: R Bergner, H Sattler, D Wadsack, C Löffler
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Previous studies have demonstrated typical findings in the ultrasound of salivary glands (USG) in patients with primary Sjögren syndrome (pSS) compared with healthy controls. However, it is unknown, if these findings are only seen in patients with pSS but also in patients with secondary Sjögren syndrome (sSS) or other connective tissue diseases with positive Ro-SSA/La-SSB antibodies. <h3>Methods</h3> We used an ultrasound score developed by Zhang [1] to investigate salivary glands with a score ranging from 0–48. We compared the score from patients with pSS according the criteria of the American-European Consensus Group (group 1) with patients who fulfilled the clinical criteria (1–4), but were Ro-SSA/La-SSB negative (group 2), with patients who had another rheumatic disease, but had sicca symptoms and were Ro-SSA and/or La-SSB positive (sSS) (group 3), with patients with other rheumatic disease without Ro-SSA or La-SSB antibodies (group 4), with patients with other rheumatic disease with Ro-SSA antibodies but no sicca symptoms (group 5) and with patients with no rheumatic disease (group 6), respectively. We investigated the parotid and the submandibular salivary glands bilaterally. The USG was assessed with a score from 0–48 points with a maximum of 12 points for 4 items each (hyoechoic areas, hyperechoic reflexes, inhomogeneity and distinct organ border). If available the score was correlated with the scintigraphically measured function of the salivary glands. <h3>Results</h3> We included USG of 92 patients in our study. Group 1 (n=33) had a score of 16.6±11.6; group 2 (n=7) 2.4±3.5; group 3 (n=16) 8.6±9.5; group 4 (n=16) 5.3±7.8; group 5 (n=11) 4.5±6.7 and group 6 (n=9) 1.5±2.3, respectively. The score between group 1 and all other groups was significantly different (p&lt;0.01), with no significant differences between all other groups. In 25 patients a scintigraphy of the salivary glands was available. The excretory function in the scintigraphy highly significantly correlated with the ultrasound score (r=0.53, p&lt;0.001). <h3>Conclusions</h3> USG showed significantly higher scores in patients with pSS, than in patients with sSS or other rheumatic disease. USG as a non invasive investigation might be similarly helpful for the diagnosis of pSS like salivary gland functional tests. USG findings can reliable distinguish between pSS and sSS associated with other rheumatic disease, also if they are positive for Ro-SSA/La-SSB. <h3>References</h3> Zhang X, Zhang S, He J, Hu F, Liu H, Li J, Zhu J, Li Z. Ultrasonographic evaluation of major salivary glands in primary Sjögren9s syndrome: comparison of two scoring systems. Rheumatology (Oxford). 2015 Sep;54(9):1680–7. <h3>Disclosure of Interest</h3> None declared
FRI0658 Leg elevation does not substantially affect tbs results
Authors: D Krueger, E Siglinsky, D Tran, L Del Rio, N Binkley
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Lumbar spine dual energy X-ray absorptiometry (DXA) scans are typically acquired with the patient9s legs elevated on a positioning block thereby flattening the normal lumbar lordosis. With GE densitometers it is also possible to acquire lumbar spine scans with the legs down. BMD values obtained with legs down vs. legs elevated does minimally differ, however it is unknown if leg elevation affects trabecular bone score (TBS) results. <h3>Objectives</h3> The purpose of this study is to assess the effect of leg position on TBS. <h3>Methods</h3> Lumbar spine (L1-L4) DXA scans were acquired in legs up and legs down positioning using GE Healthcare Prodigy and iDXA densitometers. The "OneScan" feature mode was not used. These scans were analyzed with enCORE software v 12.3 or 14.1. All scans were re-processed using Medimaps TBS Calculator v2.3 or TBS iNsight v3.0.2 to obtain TBS results. Linear regression and Bland-Altman analyses were performed to compare TBS results in the legs up vs. legs down position. <h3>Results</h3> Sixty-four women, mean age and BMI 65.1 years (range 28.2–86.6) and 26.4 kg/m<sup>2</sup> (range 18.1–34.8) were studied on three Prodigy densitometers. Fifty women, mean age and BMI 68.6 years (range 15.2–92.5) and 26.2 kg/m<sup>2</sup> (range 19.9–35.1) were studied on a iDXA densitometer. With Prodigy and standard legs up positioning, the L1-L4 BMD ranged from 0.738–1.549 g/cm<sup>2</sup> and was highly correlated with legs down positioning, R<sup>2</sup> =0.99. TBS results ranged from 1.072–1.632 and were also highly correlated, R<sup>2</sup> =0.93 with a mean bias of -0.005 TBS units between leg positions (Figure). With iDXA and standard legs up positioning, the L1-L4 BMD ranged from 0.753–1.622 g/cm<sup>2</sup> and was highly correlated with legs down positioning, R<sup>2</sup> =0.97. TBS results ranged from 1.040–1.455 and were also highly correlated, R<sup>2</sup> =0.90 with a mean bias of 0.00 TBS units between leg positions (data not shown). <h3>Conclusions</h3> Leg positioning minimally affects TBS results with GE Healthcare Prodigy and iDXA densitometers but the difference from legs up to legs down is likely of no clinical significance. <h3>Disclosure of Interest</h3> D. Krueger: None declared, E. Siglinsky: None declared, D. Tran Employee of: Medimaps, L. Del Rio: None declared, N. Binkley: None declared
THU0578 Spectrum of the diseases with orbital involvement in rheumatology: single-center study
Authors: V Vasilyev, V Gorodetskiy, T Safonova, N Probatova, N Kokosadze, A Pavlovskaya, A Kovrigina, I Gaiduk
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> It is assumed that in ophthalmological clinical practice lymphoproliferative disorders in patients with affection of different orbital organs and tissues constitute 25–55% and 21% of patients have IgG4-related ophthalmic disease [1,2]. <h3>Objectives</h3> To evaluate the most common conditions affecting the orbit in rheumatologic clinical practice. <h3>Methods</h3> During 2004 – 2016 years 138 patients (male – 33, female - 105) with eyelid edema and/or tumefactive lesions in the orbit were examined in Nasonova Research Institute of Rheumatology. In all patients full clinical, ophthalmological, serological (rheumatoid factor, C-reactive protein, IgG, IgG4, IgM, IgA, ANA, anti-Ro/La, C3/C4 complement) examination was carried. In all cases diagnosis was verified pathomorphologicaly with immunohystochemical staining (anti-CD 138, CD 68, IgG, IgG4, κ-chain, λ-chain). Diagnosis was established on the basis of pathomorphological examination of different tissues: orbit – 79 patients, parotid salivary gland – 40, submandibular salivary gland – 14, nasal – 4, lymph nodes – 3 and other – 6. In 79 cases (54%) the diagnosis was established on the results of orbital biopsy. <h3>Results</h3> Different non-neoplastic diseases were diagnosed in 108 patients (78.5%) and 30 had different conditions of hematological spectrum, including malignant conditions in 25 (18.2%) patients (see table 1). Some patients at baseline had simultaneous involvement of the major salivary glands (23 patients with IgG4-related disease, 35 with sarcoidosis, 12 with non-Hodgkin lymphomas and 2 with AL-amyloidosis). The most rare conditions affecting the orbit were Cogan9s syndrome, relapsing polychondritis, Erdheim-Chester disease, NK/T-cell nasal lymphoma and calcifying aponeurotic fibroma. <h3>Conclusions</h3> In rheumatologic practice in 78.5% of patients with orbital involvement different non-neoplastic conditions are diagnosed: IgG4-related ophthalmic disease (35.0%), granulematous lesions (29%). The most common hematological disorders in rheumatologic clinic are non-Hodgkin lymphomas (17.5%) and histiocytosis (3.5%). <h3>References</h3> Japanese study group of IgG4-related ophthalmic desease. A prevalence study 0f IgG4-related ophthalmic disease in Japan.JpnJOphthalmol.2013;57: 573–579. Shields JA et al. Survey of 1264 patients with orbital tumors and simulating lesions: the 2002 Montgomery Lecture, part I. Ophthalmology.2004;111: 997–1008. Goto H et al. Diagnostic criteria for IgG4-related ophthalmic disease. JpnJOphthalmol.2015;59:1–7. <h3>Disclosure of Interest</h3> None declared
Clinical profile and prognosis of metastatic breast cancer (MBC) patients with long-lasting response to eribulin (E): Results of the EXTER study.
Authors: Francisco Ayala, Margarita Feijoo, Noelia Martinez, Jesús Florián Gericó, Amalia Gomez, Pedro Sánchez Rovira, Valero Pedro Jimenez, Nerea Ancizar Lizarraga, Sonia Candamio, Maria Helena Lopez de Ceballos, Guillermo Lopez-Vivanco, Serafin Morales, Manuel Ruiz Borrego, Margarita Rodriguez Moral, Juan Virizuela Echaburu
Journal: Journal of Clinical Oncology (2015)

e12022 Background: Eribulin, an anti-microtubule agent, has emerged as the only drug showing overall survival benefit at or beyond the third line treatment of MBC. However, no clinical factors are available to identify the group of patients with maximum benefit of treatment with E. The aim of this study was to analyze the clinical profile of MBC patients with longer response to E in the setting of third or subsequent lines of treatment. Methods: We performed an observational, retrospective study in 30 hospitals participating in a national pre-market program of Special Circumstances Access to Eribulin. All consecutive MBC patients treated with E for at least 7 months until Jan-14 were included. Clinical variables, including those related to MBC diagnosis and previous treatment, were collected. Response was evaluated according to RECIST 1.1 criteria. Results: We included 45 patients MBC patients. Median age was 57. Ten patients had stage IV at diagnosis; in the other 35, median time to metastatic recurrence was 3.8 years. Symptoms were present in 50% and ECOG was 0-1 in 85.3% at the beginning of treatment with E. Most patients had non-visceral disease (73.3%) and ≤ 2 disease locations (75%). BC subtype distribution was: 11.1% triple negative, 13.1% HER2 positive, 80% hormone receptors positive. Median time since MBC diagnosis was 3.9 years and the median number of chemotherapy lines before E was 4 (26.7% ≥ 6 lines). Patients were treated with E for a median of 11 cycles (8.5 months) and all of them achieved a partial response (55.6%) or stabilization (44.4%), with a median time to response of 74 days and disease free survival of 10 months. Median overall survival since first cycle of E was 21 months, being visceral disease the only significant predictor of survival (HR 3.3; p = 0.048) in a multivariate Cox model. Conclusions: Prolonged response and survival is achievable with eribulin in some extensively pre-treated MBC patients. Although the global characteristics of this group matched those reported for the patients included in the pivotal study of E (EMBRACE trial), an apparently higher proportion of patients with hormone receptor positive, non-visceral and late recurrence MBC was found.
Inferior Vena Cava Filters to Prevent Pulmonary Embolism
Authors: Behnood Bikdeli, Saurav Chatterjee, Nihar R. Desai, Ajay J. Kirtane, Mayur M. Desai, Michael B. Bracken, Frederick A. Spencer, Manuel Monreal, Samuel Z. Goldhaber, Harlan M. Krumholz
Journal: Journal of the American College of Cardiology (2017)
Degree of anemia, indirect markers of hemolysis, and vascular complications of sickle cell disease in Africa
Authors: Marie Dubert, Jacques Elion, Aissata Tolo, Dapa Aly Diallo, Saliou Diop, Ibrahima Diagne, Ibrahima Sanogo, Suzanne Belinga, Odette Guifo, Guillaume Wamba, Françoise Ngo Sack, Kouakou Boidy, Ismael Kamara, Youssouf Traore, Cheick Oumar Diakite, Valérie Gbonon, Blaise Felix Faye, Moussa Seck, Indou Deme Ly, David Chelo, Roland N’Guetta, Ibrahima Bara Diop, Bamba Gaye, Xavier Jouven, Brigitte Ranque
Journal: Blood (2017)
Twenty four hour glucose monitoring halves adverse birth outcomes in pregnant women with type 1 diabetes, study finds
Authors: Susan Mayor
Journal: BMJ (2017)

Monitoring blood glucose levels continuously during pregnancy with an implanted device halved complications associated with hyperglycaemia in babies born to women with type 1 diabetes compared with standard finger prick testing, an international trial has reported.1

One in two babies born to women with type 1 diabetes may have complications— including premature or still birth, congenital anomalies, or being larger than average—resulting from exposure to maternal hyperglycaemia. There has been no reduction in these complications over the past 40 years.

“Keeping blood sugar levels within the normal range during …
THU0143 Cholesterol efflux capacity of hdl is otherwise improved by different biologic-dmards in rheumatoid arthritis
Authors: F Cacciapaglia, S Perniola, J Härdfeldt, M Nivuori, O Magazzino, MG Giannotta, M Giannini, MG Anelli, A Moschetta, F Iannone
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Rheumatoid arthritis (RA) patients have an increased mortality for cardiovascular (CV) events, not completely explained by impaired cholesterol levels or other traditional CV risk factor (1). Target therapy with effective control of systemic inflammation have been demonstrated to improve articular outcomes, but the effect on CV risk is still under investigation (2). The ability of high-density lipoprotein (HDL) to accept cholesterol from macrophages (HDL cholesterol efflux capacity; HDLc-EC) is a key step in reverse cholesterol transport, with significant consequences on incident atherosclerotic CV disease (3), but this marker in RA have still alternate evidence (4,5). <h3>Objectives</h3> To assess the effects of different biological DMARDs on HDLc-EC in RA <h3>Methods</h3> Disease activity data and blood samples from 40 patients with RA before and up to 12 months after starting a biologic therapy were collected. The study included patients starting intravenously administered Abatacept (ABA;n=10), Infliximab (INF;n=10), Tocilizumab (TCZ;n=10), and Rituximab (RTX;n=10), at approved dose regimens for RA treatment. HDLc-EC was measured on paired serum samples using THP-1 macrophages and a fluorometric assay for cholesterol measurement. ANOVA was used to compare paired continuous data, and Pearson9 r value was calculated for correlations. <h3>Results</h3> Disease activity assessed by DAS28-CRP and CDAI significantly dropped during all treatments. No significant changes in total and high or light density cholesterol fractions were detected. HDLc-EC at baseline was 22±3% with a statistically significant increase up to 25±3% and 27±4% after 6 and 12 months of treatment, respectively (P&lt;0.001) [Figure A]. Patients treated with INF and RTX demonstrated the higher rise in HDLc-EC, already after 6 months and lasting up to 12 months of treatment. ABA and TCZ treated patients after 6 months had a slight HDLc-EC rising, with a subsequent plateau. We observed an opposite correlation between HDLc-EC and disease activity by DAS28-CRP and CDAI (r=-0.2;P=0.01) [Figure B]. Finally, no CV events were detected during the study follow-up. <h3>Conclusions</h3> Biologic treatment can influence the HDLc-EC of RA patients, already after 6 months of therapy, and is associated with changes in disease activity and inflammatory status. Infliximab and Rituximab seem to have an enhanced impact on HDLc-EC. Future studies need to address the mechanisms beyond these intriguing findings. <h3>References</h3> Arts EE et al. Ann Rheum Dis. 2015;74:998–1003. Woodworth TG, den Broeder AA. Best Pract Res Clin Rheumatol. 2015;29:543–9. Rohatgi A. et al. N Engl J Med 2014;371:2383–93. Liao KP et al. J Am Heart Assoc. 2015;4(2). Ormseth MJ. et al. Arthritis Rheumatol. 2016;68:2099–105. <h3>Disclosure of Interest</h3> None declared
FRI0311 Endovascular intervention versus surgery in patients with takayasu arteritis: a meta-analysis
Authors: JH Jung, GG Song, SJ Choi, YH Lee, J-H Kim
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Although medical treatment has advanced, surgical treatment is needed to control the progression and symptoms of Takayau arteritis (TA). Endovascular intervention or surgical revascularization is performed; however, there are few comparative studies of these methods. <h3>Objectives</h3> There are many studies about surgery and endovascular intervention; however, it is still unclear which treatment has better a benefit/risk ratio. Because neither meta-analysis nor large-scale studies are available for surgical treatment of TA, we conducted a meta-analysis to examine the outcome of surgical treatment. <h3>Methods</h3> A meta-analysis comparing endovascular intervention and surgery outcomes was performed using the MEDLINE and Embase databases. <h3>Results</h3> A total of 14 studies of 598 patients and 1,049 lesions were included. Endovascular intervention was performed in 418 lesions and surgery in 631 lesions. Restenosis was more common in endovascular intervention than in surgery (odds ratio [OR] =2.74, 95% confidence interval [CI] =1.75–4.27, <i>p</i> &lt;0.00001). Other complications, including stroke, did not differ between endovascular intervention and surgery (OR =0.75, 95% CI =0.49–1.15, <i>p</i> =0.19). There was no difference in mortality between the two groups (OR =1.11, 95% CI =0.50–2.46, <i>p</i> =0.81). <h3>Conclusions</h3> This meta-analysis showed the superiority of surgical revascularization over endovascular intervention. <h3>References</h3> Saadoun D, Lambert M, Mirault T, et al. Retrospective analysis of surgery versus endovascular intervention in Takayasu arteritis a multicenter experience. Circulation 2012;125:813–9. Nakagomi D, Jayne D. Outcome assessment in Takayasu arteritis. Rheumatology 2016;55:1159–71. Labarca C, Makol A, Crowson CS, Kermani TA, Matteson EL, Warrington KJ. Retrospective comparison of open versus endovascular procedures for takayasu arteritis. J Rheumatol 2016;43:427–32. Lee GY, Jeon P, Do YS, et al. Comparison of outcomes between endovascular treatment and bypass surgery in Takayasu arteritis. Scand J Rheumatol 2014;43:153–61. Kalangos A, Christenson JT, Cikirikcioglu M, et al. Long-term outcome after surgical intervention and interventional procedures for the management of Takayasu9s arteritis in children. J Thorac Cardiovasc Surg 2006;132:656–64. <h3>Acknowledgements</h3> No grants or other support were received for this study. <h3>Disclosure of Interest</h3> None declared
Glia-specific enhancers and chromatin structure regulate NFIA expression and glioma tumorigenesis
Authors: Stacey M Glasgow, Jeffrey C Carlson, Wenyi Zhu, Lesley S Chaboub, Peng Kang, Hyun Kyoung Lee, Yoanne M Clovis, Brittney E Lozzi, Robert J McEvilly, Michael G Rosenfeld, Chad J Creighton, Soo-Kyung Lee, Carrie A Mohila, Benjamin Deneen
Journal: Nature Neuroscience (2017)
THU0520 Pelvic ultrasound in the assessment of sexual maturity in girls with juvenile idiopathic arthritis
Authors: LM Gonçalves, SH Machado, RM Xavier, PJC Marόstica, C Kopacek, IRS Lucena
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Delayed puberty is common in children with chronic illnesses such as Juvenile Idiopathic Arthritis (JIA),especially in cases with an earlier age of onset.Its etiology is multifactorial and includes low weight,complications arising from the disease itself and the adverse effects of treatment. <h3>Objectives</h3> To compare uterine and ovarian size as well as artery pulsatility between girls with juvenile idiopathic arthritis (JIA) and healthy participants using abdominal pelvic ultrasound,and identify these findings and pubertal staging,sex hormones and disease characteristics in girls with JIA. <h3>Methods</h3> This study involved 44 girls with JIA and 59 healthy controls aged between six and 18 incomplete years.Pelvic ultrasound was used to determine uterine volume and length,the corpus/cervix ratio,ovarian volume and length,and the pulsatility index (PI) of uterine arteries.Hormone levels were also measured in girls with JIA. <h3>Results</h3> All US parameters were associated with Tanner stages in the control group (p&lt;0.001).Uterine and ovarian measures were smaller in girls with JIA than in the control group.The mean PI of uterine arteries was higher in girls with JIA.Comparisons by age group revealed that uterine volumes were smaller in girls with JIA aged between 10 and 11 years (p=0.004) and 14 to 15 years (p=0.042),and the corpus/cervix ratio was smaller in girls aged 10 to 11 years (p=0.007).US measures were not associated with disease factors in the JIA group.LH and estradiol levels were found to be positively associated with ovarian and uterine size (p&lt;0.001),but negatively correlated with the mean PI of uterine arteries (p&lt;0.01). <h3>Conclusions</h3> Pelvic US is a sensitive method for the assessment of sexual maturation in girls,and can identify developmental delays in girls with JIA which may not be detected by Tanner staging. <h3>References</h3> Pozo J,Argente J.Delayed puberty in chronic illness.Best Pract Res Clin Endocrinol Metab 2002;16:73–90. Holm K,Laursen EM,Brocks V,Muller J.Pubertal maturation of internal genitalia:authors9 reply.Ultrasound Obstet Gynecol 1995;6:452–3. <h3>Disclosure of Interest</h3> None declared