tbuckley/cabot-search huggingface dataset:
SP0179 What could clinicians do better in clinical communication?
Authors: P. Boyd
Journal: Annals of the Rheumatic Diseases (2018)

Through personal experience and study I am a patient expert in the area of communication between clinicians and patients in clinical situations. Therefore I am in a position to provide constructive suggestions on how this interpersonal relationship can be improved As a patient with systemic RA, fibromyalgia, raynaud9s, IBD and non-obstructive sleep apnoea I have extensive experience in dealing with HCPs in clinical settings. I studied communications and media at university and post-graduate level and I am a sought-after speaker on communications models on a national and European level. I will seek to give examples of both positive and negative patient experiences with clinicians. I will explain communications models such as Shannon9s and Berlo9s as they pertain to clinical settings. I will then look to suggest changes and improvements that can be made in clinical situations by both clinicians and patients. By using the communication models I will illustrate the personal experiences I have had in clinical settings – both positive and negative. Improving communication is a joint effort between both the clinician and the patient. At the conclusion of the presentation, delegates will have a clearer understanding of the relevant communications models. They will also have an understanding of techniques to implement which will be of assistance in clinical settings. Despite this lecture being about clinicians improving communication, it is important to recognise that the patient plays just as important a role in the relationship. A patient must be willing to meet the clinician in the middle and ensure positive communication is a two-way enterprise. The clinician may be able to take the lead to a greater extent but the essence of communication requires a minimum of two people. <h3>Disclosure of Interest</h3> None declared
SAT0406 Chikungunya virus and the rheumatology: observation of 76 cases during an epidemic in brazil
Authors: M. C. D.F. Salgado, Y. D. F.B. Chagas, J.L.P. Vaz, F.C. Freire, V. Vigneron, A. Vaz
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Chikungunya fever is caused by a virus of the family Togaviridae and the genus Alphavirus, The first epidemic occurred in Africa in 1952, transmitted by mosquitoes of the genus Aedes. In Brazil, the first cases were registered in 2014. Clinical manifestations include fever, polyarthralgia, joint oedema, arthritis and morning stiffness. Diagnosis is confirmed by IgM/IgG serology for Chikungunya. The persistence of joint symptoms for a long time is an important feature of the disease. <h3>Objectives</h3> To evaluate the prevalence of rheumatologic manifestations in 76 patients with Chikungunya infection, during an epidemic occurred in 2016 in the city of Rio de Janeiro, Brazil. <h3>Methods</h3> To evaluate the prevalence of rheumatologic manifestations in 76 patients with Chikungunya infection, during an epidemic occurred in 2016 in the city of Rio de Janeiro, Brazil. <h3>Results</h3> Females were the most prevalent: 65 patients (85,5%); male sex: 11 (14,5%). The mean age of the patients was 57,17 years, The youngest at age 24 and the oldest 87 years old. The time between the onset of symptoms and the first consultation with a rheumatologist ranged from 11 days to the highest period of 40 weeks. Among articular symptoms, polyarthralgia occurred with higher prevalence (39 patients, 51,31%), affecting wrists, ankles, shoulders, knees and hands. Twenty six patients had arthritis (34,21%), Tendinopathy in 27 regions, being more common in shoulders, ankles and wrists and including De Quervain. Paresthesias occurred in 7 patients, prevailing carpal tunnel syndrome and one patient presented dactylitis. Symptoms persisted for months in all patients. <h3>Conclusions</h3> Chikungunya is an endemic disease in Brazil, with severe joint manifestations and chronic symptoms. Often there is delay in starting treatment with rheumatologist, resulting in worsening of the clinical picture. <h3>References</h3> [1] Lima-Camara TN. Emerging arboviruses and public health challenges in Brazil. Revista Saude Publica2016;50:36:2016. [2] Petersen LR, Powers AM. Chikungunya: epidemiology. F1000 Faculty Reviews2016;5:82. [3] Rodriguez-Morales AJ, Gil-Restrepo AF, Ramirez-Jaramillov, et al. Chikungunya chronic inflammatory rheumatism: results from a retrospective follow-up study of 283 adult and child cases in La Virginia, Risaralda, Colombia. F1000 Faculty Reviews2016;5:360. <h3>Disclosure of Interest</h3> None declared
AB0386 Relationship between extra-articular manifestations and joint surgery in rheumatoid arthritis
Authors: O. Saidane, M. Sellami, R. Barhoumi, A. Ben Tekaya, H. Ajlani, R. Tekaya, I. Mahmoud, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Extra-articular organ involvement is a serious condition in rheumatoid arthritis (RA) associated with increased mortality. These manifestations may affect the course of the disease, but could they accelerate the joint destruction and shorten the pre- joint surgical period? <h3>Objectives</h3> Our objective was to study the impact of extra-articular manifestations (EAM) on joint surgery during RA management. <h3>Methods</h3> It is a retrospective comparative study involving 500 RA patients (according to 1987 ACR or 2010 ACR/EULAR criteria) in rheumatology department between 2000 and 2014. The assessment of EAM was systematically done in RA diagnosis and during management. We compared 2 groups of RA patients according to the presence or not of EAM. <h3>Results</h3> We enrolled 422 women and 78 men with mean age of 53.3 years (21–83) and mean disease duration of 12 years [2–40]. RA was Rheumatoid Factor positive and erosive in 71.4% and 90% cases respectively. A surgical procedure was considered necessary in 59 cases (11.8%). An EAM was diagnosed in more than a half of patients (62.4%) with a predominance of ocular and bone manifestation, mainly xerophthalmia (173 cases, 34.6%) and osteoporosis (120 cases, 24%). Secondary Sjögren's syndrome was confirmed in 70 cases. Pulmonary manifestations related to RA were noted in 70 patients (14%), especially diffuse interstitial pulmonary in 48 cases (9.6%). Renal involvement was present in 45 patients, of which interstitial renal disease was the most common manifestation (29 patients, 64.4%). Rheumatoid nodules (4.6%) and small vessel vasculitis (0.6%) were the most frequent skin manifestations. A significantly higher incidence of joint surgery was noted in osteoporotic RA patients (OR=1.91; p=0.029). There was no significant correlation between joint surgery resort and other EAM (table 1). <h3>Conclusions</h3> Our study concluded to a higher incidence of EAM during RA management. Osteoporosis was the only EAM associated to greater frequency of joint surgery. <h3>Disclosure of Interest</h3> None declared
Exposure to Polycyclic Aromatic Hydrocarbons and Accelerated DNA Methylation Aging
Authors: Jun Li, Xiaoyan Zhu, Kuai Yu, Haijing Jiang, Yizhi Zhang, Biqi Wang, Xuezhen Liu, Siyun Deng, Jie Hu, Qifei Deng, Huizhen Sun, Huan Guo, Xiaomin Zhang, Weihong Chen, Jing Yuan, Meian He, Yansen Bai, Xu Han, Bing Liu, Chuanyao Liu, Yanjun Guo, Bing Zhang, Zhihong Zhang, Frank B. Hu, Wenjing Gao, Liming Li, Mark Lathrop, Catherine Laprise, Liming Liang, Tangchun Wu
Journal: Environmental Health Perspectives (2018)

Background: Aging is related to an increased risk of morbidity and mortality and is affected by environmental factors. Exposure to polycyclic aromatic hydrocarbons (PAHs) is associated with adverse health outcomes; but the association of such exposure with DNA methylation aging, a novel aging marker, is unclear. Objectives: Our aim was to investigate the association of PAH exposure with methylation aging. Methods: We trained and validated a methylation age predictor suitable for Chinese populations using whole blood methylation data in 989 Chinese and 160 Caucasians. We defined two aging indicators: Δage, as methylation age minus chronological age; and aging rate, the ratio of methylation to chronological age. The association of PAH exposure with aging indicators was evaluated using linear regressions in three panels of healthy Chinese participants (N=539, among the aforementioned 989 Chinese participants) whose exposure levels were assessed by 10 urinary monohydroxy-PAH metabolites. Results: We developed a methylation age predictor providing accurate predictions in both Chinese individuals and Caucasian persons (R=0.94–0.96, RMSE=3.8–4.3). Among the 10 urinary metabolites that we measured, 1-hydroxypyrene and 9-hydroxyphenanthrene were associated with methylation aging independently of other OH-PAHs and risk factors; 1-unit increase in 1-hydroxypyrene was associated with a 0.53-y increase in Δage [95% confidence interval (CI): 0.18, 0.88; false discovery rate (FDR) FDR=0.004] and 1.17% increase in aging rate (95% CI: 0.36, 1.98; FDR=0.02), whereas for 9-hydroxyphenanthrene, the increase was 0.54-y for Δage (95% CI: 0.17, 0.91; FDR=0.004), and 1.15% for aging rate (95% CI: 0.31, 1.99; FDR=0.02). The association direction was consistent across the three Chinese panels with the association magnitude correlating with the panels' exposure levels; the association was validated by methylation data of purified leukocytes. Several cytosine-phosphoguanines, including those located on FHL2 and ELOVL2, were found associated with both aging indicators and monohydroxy-PAH levels. Conclusions: We developed a methylation age predictor specific for Chinese populations but also accurate for Caucasian populations. Our findings suggest that exposure to PAHs may be associated with an adverse impact on human aging and epigenetic alterations in Chinese populations. https://doi.org/10.1289/EHP2773
AB1429-HPR Kinesiotaping might help to improve postural displacements in adolescents
Authors: E Ilie, L. Rusu
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The optimal posture plays an important role for preventing musculoskeletal problems. The therapeutic effects of kinesiotaping have been shown in forward head posture and rounded shoulder posture in adults previously.<sup>1,2</sup> However, as to our knowledge, the effect of kinesiotaping on total posture has not been evaluated before in adolescents. <h3>Objectives</h3> To investigate the effect of kinesiotaping application on total posture in adolescents. <h3>Methods</h3> Twenty children (11 M/9 F) with postural displacements were enrolled in the study. The postural displacements were evaluated with a mobile application (PostureScreen) which was validated for postural assessment previously. The total scores which were obtained from the anterior view was used for the analysis. Assessments were performed at baseline and 45 min following the kinesiotaping application. The kinesiotaping application was performed as seen in Figure 1. <h3>Results</h3> The median age was 12.5 years (IQR: 11.0/15.0 years), the median height was 145.5 cm (IQR: 142.5/166.5 cm) and the median weight was 38.0 kg (IQR: 33.5/51.0 kg). A significant improvement was observed in anterior angulation degrees. While the baseline score was 8.70<sup>o</sup> (IQR: 4.10<sup>o</sup>/14.55<sup>o</sup>), the score improved following kinesiotaping application to 4.35<sup>o</sup> (IQR:2.35<sup>o</sup>/6.30<sup>o</sup>) (p=0.009). No significant changes were detected in anterior translation, lateral translation and lateral angulation parameters (p&gt;0.05). <h3>Conclusions</h3> According to our results kinesiotaping has a potential to improve postural displacements in adolescents. The improvement in the posture might be resulted from a sustained feedback on the trunk by the kinesiotaping. However, future longitudinal studies which are mainly focused on the chronic effect of kinesiotaping are needed to reveal the real potential of kinesiotaping on the postural displacements in adolescents. <h3>References</h3> [1] Shih HS, Chen SS, Cheng SC, Chang HW, Wu PR, Yang JS, Lee YS, Tsou JY. Effects of Kinesio taping and exercise on forward head posture. J Back Musculoskelet Rehabil2017;30:725–33. [2] Gak HB, Lee JH, Kim HD. Efficacy of kinesiology taping for recovery of dominant upper back pain in female sedentary worker having a rounded shoulder posture. Technol Health Care2013;21:607–12. <h3>Disclosure of Interest</h3> None declared
MAGE-A3 immunotherapeutic as adjuvant therapy for patients with resected, MAGE-A3-positive, stage III melanoma (DERMA): a double-blind, randomised, placebo-controlled, phase 3 trial
Authors: Brigitte Dreno, John F Thompson, Bernard Mark Smithers, Mario Santinami, Thomas Jouary, Ralf Gutzmer, Evgeny Levchenko, Piotr Rutkowski, Jean-Jacques Grob, Sergii Korovin, Kamil Drucis, Florent Grange, Laurent Machet, Peter Hersey, Ivana Krajsova, Alessandro Testori, Robert Conry, Bernard Guillot, Wim H J Kruit, Lev Demidov, John A Thompson, Igor Bondarenko, Jaroslaw Jaroszek, Susana Puig, Gabriela Cinat, Axel Hauschild, Jelle J Goeman, Hans C van Houwelingen, Fernando Ulloa-Montoya, Andrea Callegaro, Benjamin Dizier, Bart Spiessens, Muriel Debois, Vincent G Brichard, Jamila Louahed, Patrick Therasse, Channa Debruyne, John M Kirkwood
Journal: The Lancet Oncology (2018)
Randomised controlled trial of adjunctive inspiratory muscle training for patients with COPD
Authors: Noppawan Charususin, Rik Gosselink, Marc Decramer, Heleen Demeyer, Alison McConnell, Didier Saey, François Maltais, Eric Derom, Stefanie Vermeersch, Yvonne F Heijdra, Hanneke van Helvoort, Linda Garms, Tessa Schneeberger, Klaus Kenn, Rainer Gloeckl, Daniel Langer
Journal: Thorax (2018)

Background This study aimed to investigate whether adjunctive inspiratory muscle training (IMT) can enhance the well-established benefits of pulmonary rehabilitation (PR) in patients with COPD. Methods 219 patients with COPD (FEV 1 : 42%±16% predicted) with inspiratory muscle weakness (PImax: 51±15 cm H 2 O) were randomised into an intervention group (IMT+PR; n=110) or a control group (Sham-IMT+PR; n=109) in this double-blind, multicentre randomised controlled trial between February 2012 and October 2016 (ClinicalTrials.gov NCT01397396 ). Improvement in 6 min walking distance (6MWD) was a priori defined as the primary outcome. Prespecified secondary outcomes included respiratory muscle function and endurance cycling time. Findings No significant differences between the intervention group (n=89) and the control group (n=85) in improvements in 6MWD were observed (0.3 m, 95% CI −13 to 14, p=0.967). Patients who completed assessments in the intervention group achieved larger gains in inspiratory muscle strength (effect size: 1.07, p&lt;0.001) and endurance (effect size: 0.79, p&lt;0.001) than patients in the control group. 75 s additional improvement in endurance cycling time (95% CI 1 to 149, p=0.048) and significant reductions in Borg dyspnoea score at isotime during the cycling test (95% CI −1.5 to −0.01, p=0.049) were observed in the intervention group. Interpretation Improvements in respiratory muscle function after adjunctive IMT did not translate into additional improvements in 6MWD (primary outcome). Additional gains in endurance time and reductions in symptoms of dyspnoea were observed during an endurance cycling test (secondary outcome) Trial registration number NCT01397396 ; Results.
AB1166 The association of the early onset of remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome with dipeptidyl peptidase-4 (DPP4) inhibitor
Authors: Y. Yoshioka, M. Mitsuhashi, A. Kato, D. Kanai, A. Suda, S. Nagaoka
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome is a rare inflammatory arthritis, characterised by absence of rheumatoid factor, symmetrical distal synovitis, pitting oedema of the hands and feet. In recent years the use of dipeptidyl peptidase-4 (DPP4) inhibitor has increased and some reports have described the association of RS3PE syndrome with DPP4 inhibitor. <h3>Objectives:</h3> We have tried to investigate the association of RS3PE syndrome with DPP4 inhibitor in our hospital. <h3>Methods:</h3> In Japan DPP4 inhibitor was released in December 2009, so we retrospectively analysed background, treatment and clinical course of 25 patients with RS3PE syndrome diagnosed between <sup>December 2009</sup> and December 2016 in our hospital. We divided them in two groups according to DPP4 inhibitor prescription and compared two groups. <h3>Results:</h3> Our cases included 18 males and 7 females, and the mean age of RS3PE syndrome onset was 76 years old. The mean follow-up period was 32.5 months. Six patients had diabetes mellitus and DPP4 inhibitor was prescribed in five of six patients (83.3%). (sitagliptin 3 cases, teneligliptin 1 case, alogliptin 1case). The duration of RS3PE syndrome onset after DPP4 inhibitor prescription was mean 22.9 months, and two cases developed within a half year, two cases after two years. Compared with non DPP4 inhibitor group, the mean age of RS3PE syndrome onset was significantly low (70 vs 78.5, p=0.023), and HbA1c (NGSP) was high (7.3% vs 6.02%, p=0.00022) in DPP4 inhibitor group. The occurrence of flare was four cases in non DPP4 inhibitor group and zero in DPP4 inhibitor group, but was not statistically different (p=0.275). Other clinical features were not significantly different. <h3>Conclusions:</h3> DPP4 inhibitor group was significantly younger than non DPP4 inhibitor group, and the possibility that DPP4 inhibitor contributed to the early onset of RS3PE syndrome was suggested. <h3>References</h3> [1] Oyama K, Taniguchi J, et al. Remitting seronegative symmetrical synovitis with pitting edema syndrome in individuals with type 2 diabetes mellitus or impaired glucose tolerance. Diabetes Res Clin Pract. 2015Oct;110(1):e5–8. [2] McCarty DJ, O'Duffy JD, et al. Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE Syndrome). JAMA 1985; 254: 2763–2767. <h3>Disclosure of Interest</h3> None declared
AB0357 The support of medical clerks in rheumatic disease clinic aids t2t practice for rheumatologists and improves disease activities of patients with rheumatoid arthritis
Authors: I. Matsushita, H. Motomura, T. Hiraiwa, S. Arai, C. Ota, T. Kimura
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> With treat-to-target (T2T), the physician always has to evaluate disease activity and joint damage of rheumatoid arthritis (RA) patients exactly to maintain the activities of daily living of the patient for the long term. However, the amount of work required by physicians to complete T2T can be onerous, so the cooperation of medical staff is necessary to practice T2T. <h3>Objectives</h3> The purpose of this study is to clarify the role and effectiveness of medical clerks (MCs) in a rheumatic disease clinic. <h3>Methods</h3> In our rheumatic disease clinic, MCs have supported rheumatologists since April 2011. We individually evaluated 50 RA patients in May 2010 (before MC support: "preceding period"), April 2011 (1 year after the start of MC support: "early period"), April 2013 (3 years after the start of MC support: "middle period"), April 2015 (5 years after the start of MC support: "late period") and April 2017 (7 years after the start of MC support: "last period"). We assessed the prevalence of T2T practice, disease activity, and drug use. When all components of the Simplified Disease Activity Index (SDAI) of patients had been listed in the medical record and radiography of hand and foot joints had been undertaken more than once a year, the medical examination was defined as "T2T practice". Disease activity was assessed using the SDAI and Clinical Disease Activity Index (CDAI). <h3>Results</h3> Prevalence of T2T practice was 50%, 86%, 94%, 100% and 100% at preceding, early, middle, late and last periods, respectively. Prevalence of T2T practice increased after the start of MC support. Accordingly, disease activities improved gradually. SDAI remission was 30.8% in the preceding period, 28.5% in the early period, 30% in the middle period, 58% in the late period and 56% in the last period, respectively. CDAI remission improved towards the last phase, similar to that seen with the SDAI. The mean dose of methotrexate (MTX) increased gradually towards the last phase, but the prevalence of MTX use did not show a remarkable change. Prevalence of use of biological disease-modifying anti-rheumatic drugs did not increase during the study period. <h3>Conclusions</h3> MC support in rheumatic disease clinics aids T2T practice for rheumatologists. The disease activities of RA patients can be improved by MC support. <h3>Disclosure of Interest</h3> None declared
Effect of restricting the legal supply of prescription opioids on buying through online illicit marketplaces: interrupted time series analysis
Authors: James Martin, Jack Cunliffe, David Décary-Hétu, Judith Aldridge
Journal: BMJ (2018)

To examine the effect on the trade in opioids through online illicit markets ("cryptomarkets") of the US Drug Enforcement Administration's ruling in 2014 to reschedule hydrocodone combination products.Interrupted time series analysis.31 of the world's largest cryptomarkets operating from October 2013 to July 2016.The proportion of total transactions, advertised and active listings for prescription opioids, prescription sedatives, prescription steroids, prescription stimulants, and illicit opioids, and the composition of the prescription opioid market between the US and elsewhere.The sale of prescription opioids through US cryptomarkets increased after the schedule change, with no statistically significant changes in sales of prescription sedatives, prescription steroids, prescription stimulants, or illicit opioids. In July 2016 sales of opioids through US cryptomarkets represented 13.7% of all drug sales (95% confidence interval 11.5% to 16.0%) compared with a modelled estimate of 6.7% of all sales (3.7% to 9.6%) had the new schedule not been introduced. This corresponds to a 4 percentage point yearly increase in the amount of trade that prescription opioids represent in the US market, set against no corresponding changes for comparable products or for prescription opioids sold outside the US. This change was first observed for sales, and later observed for product availability. There was also a change in the composition of the prescription opioid market: fentanyl was the least purchased product during July to September 2014, then the second most frequently purchased by July 2016.The scheduling change in hydrocodone combination products coincided with a statistically significant, sustained increase in illicit trading of opioids through online US cryptomarkets. These changes were not observed for other drug groups or in other countries. A subsequent move was observed towards the purchase of more potent forms of prescription opioids, particularly oxycodone and fentanyl.