tbuckley/cabot-search huggingface dataset:
FRI0575 Evaluation of screening questionnaires for psoriasic arthritis in a sample of patients with psoriasis in a third level hospital
Authors: M.D. Ruiz Montesino, V. Moreira Navarrete, A.M. Carrizosa Esquivel, C. León Caro, J.J. Pérez Venegas, D. Mendoza Mendoza
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psoriatic arthritis (PsA) is an erosive joint inflammatory disease associated with psoriasis. Between 5% and 35% of patients with psoriasis may develop PsA. Screening questionnaires have been developed for dermatologists in order to make them suspect which patients should be referred to the rheumatologist for evaluation. <h3>Objectives</h3> To know the percentage of patients with PsA detected by the questionnaires in a group of psoriasis patients coming from an outpatient dermatology clinics. <h3>Methods</h3> The study was carried out in the rheumatology unit in collaboration with dermatology. Patients with cutaneous psoriasis who had not previously been diagnosed of any type of arthritis, from a dermatology clinic, were recruited consecutively. Patients were invited to participate in the study and referred to the rheumatology research unit where they signed the informed consent. Then, the questionnaires were administered. <h3>Results</h3> From November 2014 to December 2015, 53 patients were recruited: 30 women and 23 men. The mean age was 44 (±13) years. The average duration of psoriasis was 11 (±9) years. 61% had affected nails and skin. 11% of patients received no treatment for psoriasis and 13% received treatment with MTX or PUVA. The mean PASI was 3 (±4). The quality of life, measured by DLQI, was 1 (±2). 50% of patients had all the screening questionnaires positive. EARP was the questionnaire that tested positive in a higher percentage of patients, 70%. 68% of the patients had some painful joint and only 8% had some inflammation. Only 9 patients met CASPAR classification criteria and were diagnosed as PsA, of which 56% were in topical treatment by dermatology. These 9 patients had higher PASI than those undiagnosed and were the only ones who had swollen joints. The screening questionnaire that detected all these 9 patients was the EARP, but it was positive in 65% of patients who did not meet CASPAR criteria. <h3>Conclusions</h3> The percentage of patients with PsA who was identified by EARP questionnaire was 100%, but with a high proportion of FP. PASE detected 33%, TOPAS 55% and PEST 44%. Therefore, questionnaires available are useless in daily clinical practice, due to lack of specificity or sensitivity. The development of a small questionnaire for dermatologist based on CASPAR criteria could be more effective <h3>References</h3> [1] Stern RS, Nijsten T, Feldman SR, Margolis DJ, Rolstad T. Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction. J Investig Dermatol Symp Proc. 2004Mar;9(2):136–9. [2] High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screeesinoning questionnaires. Ann Rheum Dis2013;72:736–740. <h3>Disclosure of Interest</h3> None declared
SAT0313 Lipid profile of psoriatic arthritis patients. a five-year study
Authors: M. Migkos, E. Kaltsonoudis, T.E. Markatseli, A.A. Drosos, P.V. Voulgari
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. Many studies have shown alterations in lipid profile of PsA patients and an association with increased cardiovascular risk. <h3>Objectives</h3> To evaluate the changes of lipid profile in PsA patients treated with conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) and/or with biological DMARDs (bDMARDs) in a five-year period. <h3>Methods</h3> We studied 254 patients diagnosed with PsA according to CASPAR and ASAS (for those with axial disease) criteria. Patients were followed up at predefined time points [baseline, 24 weeks (wks), 48 and 240 wks after initiation of treatment. We recorded levels of Total Cholesterol (CHOL), Low Density Lipoproteins (LDL), High Density Lipoproteins (HDL) and Triglycerides (TGL). The disease activity was assessed by using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), disease activity score-28 (DAS) -C-Reactive Protein (CRP), DAS28-erythrocyte sedimentation rate (ESR), Health Assessment Questionnaire (HAQ), and inflammatory marker CRP and ESR. Patients were categorised in three treatment groups: patients treated with bDMARDs: anti-tumour necrosis factor alpha (TNFa) agents, patients treated with csDMARDs and combined therapy (bDMARDs and csDMARDs). Disease Phenotype and epidemiological features of PsA patients were also recorded. <h3>Results</h3> There were 137 male and 117 female patients. The (Mean ±SD) age of the patients was 56,11±14,64 years and the body mass index (BMI) was 27,86±5,12. Thirty-nine per cent of the patients presented as asymmetric oligoarthritis, 25,6% as symmetric polyarthritis while 27,6% had axial involvement with or without peripheral arthritis. Total CHOL and LDL levels were significantly associated with disease duration (p&lt;0,05) while TGL and HDL were not significantly correlated. We found that HDL levels were significantly correlated with disease activity through time. More specific lower disease activity was associated with higher HDL levels for all disease activity scores and CRP at all time points (p&lt;0,05). The significance was lost only for ESR. No association was found between the HDL levels and the different therapeutic option used. The rest of lipid profile levels did not show statistical significant association with disease activity at any time point for all disease activity indexes, including CRP and ESR. <h3>Conclusions</h3> Lipid profile of PsA patients seems to improve with better control of disease activity. More specifically high HDL levels are associated with low disease activity and these changes appear to be independent of the therapeutic choices. <h3>Disclosure of Interest</h3> None declared
Laryngeal Tube Insertion vs Endotracheal Intubation for Out-of-Hospital Cardiac Arrest—Reply
Authors: Henry E. Wang, Robert H. Schmicker, Mohamud R. Daya
Journal: JAMA (2019)

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A rare cause of chronic cough
Authors: Lynn Decoster, Ann Van der Goten, Isabel Eerens, Karolien Goffin, Anja De Rycke
Journal: Thorax (2019)

A 64-year-old female patient was referred to the pulmonary outpatient clinic with a 3-year history of non-productive cough and intermittent wheezing. The cough was mainly present during the day and could be triggered by talking or drinking cold drinks. She also mentioned seasonal rhinoconjunctivitis during spring and summertime. Clinical examination was unremarkable. Chest X-ray and pulmonary function tests were normal. A histamine provocation test was borderline positive (PD20=0.37 mg). Laboratory analysis showed positive radioallergosorbent tests for grass and tree pollen. A diagnosis of cough-predominant, atopic asthma was made and inhaled corticosteroids (fluticasone) were prescribed. Three months later, the patient returned for a follow-up visit. Her cough had only partially improved. She now mentioned that her cough could also be triggered by rotating her head to the left or by touching the right side of her neck, where she occasionally had noticed a swelling of fluctuating dimensions. On clinical examination, no mass was palpable but the cough could indeed be elicited by touching the …
Prenatal Smoke Exposure Dysregulates Lung Epithelial Cell Differentiation - Role for the AREG/EGFR Axis
Authors: K. Lkhagvadorj, Z. Zeng, J. Song, M. Reinders-Luingers, W. Kooistra, S. Krauss-Etschmann, J. Cao, M. Hylkema
Journal: American Journal of Respiratory and Critical Care Medicine (2018)
Bleeding and Thrombotic Risk in Low Dose Heparin Infusion As Compared to Standard Dose Heparin Infusion
Authors: Forat Lutfi, Rohit Boshnoi, Vikas Patel, Aisha Alfasi, Michael Setteducato, Shuyao Zhang, Chintan Shah, Saji Kurian, Chethana Kamath, Dae Jun Kim, Martina C. Murphy
Journal: Blood (2018)
THU0396 Combined positron emission tomography and magnetic resonance imaging for the assessment of systemic sclerosis gastrointestinal involvement
Authors: S.-A. Ng, S. Marchesseau, Y. Wang, J. Schaefferkoetter, W. Xie, D. Ng, J. Totman, A.H. Low
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The gastrointestinal (GI) tract is affected in 90% of patients with systemic sclerosis (SSc), a disease characterised by excessive fibrosis. Baseline GI involvement is an independent predictor of 2 year mortality in patients with early diffuse cutaneous SSc. There is an urgent need to develop non-invasive methods of assessing SSc GI involvement for early diagnosis and monitoring. Novel non-invasive tools such as fluorodeoxyglucose-positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) have been used in oncology. Development of a new MRI sequence, T1 MOLLI (modified look-locker inversion recovery) mapping, has been used in cardiac imaging for detection and quantification of diffuse fibrosis. <h3>Objectives</h3> In this pilot study comparing SSc patients with healthy controls, we investigated whether FDG-PET-MRI is able to detect fibrosis and inflammation associated with SSc GI tract involvement. <h3>Methods</h3> We recruited 16 patients fulfilling the 2013 ACR/EULAR criteria for SSc and 15 healthy age-matched (within 5 years) controls. Severity of GI involvement was determined by the total Gastrointestinal Tract score (GIT, from University of California Los Angeles Scleroderma Clinical Trials Consortium). All subjects fasted 6 hours prior and had non-spicy low-residue diet 3 days prior. Subjects were injected with FDG (6mCi) 1 hour prior and 10 mg hyoscine butylbromide (to reduce peristalsis) immediately before scanning. Breath-hold native T1 MOLLI mapping was acquired. FDG uptake was quantified by specific uptake value (SUV). All SSc patients and 5 controls underwent PET-MRI protocol. The remaining 10 controls only had MRI scanning. Student t-test was performed and statistical significance was taken to be p&lt;0.05. <h3>Results</h3> Demographics and clinical features of our study cohort are shown in table 1. Mean T1 values on MRI for the large and small bowels were significantly higher in SSc patients than healthy controls (large bowel: 1113±189 ms vs 856±182 ms respectively, p=0.0006; small bowel: 1331±246 ms vs 1169±123 ms respectively, p=0.0296), indicating the presence of GI fibrosis. Mean PET SUV values for the large bowels were also higher in SSc patients than healthy controls (1.12±0.23 vs 0.82±0.23 respectively, p=0.0217). <h3>Conclusions</h3> MRI T1-MOLLI mapping demonstrated evidence of bowel fibrosis in SSc patients. FDG-PET showed increased large bowel inflammation in patients. FDG-PET-MRI may potentially be a useful diagnostic and monitoring tool for SSc GIT disease. <h3>Disclosure of Interest</h3> None declared
Primary care groups frustrated by variations in funding
Authors: Gavin Yamey
Journal: BMJ (1999)

The NHS Executive was heavily criticised by primary care groups in England for its unilateral imposition of excessive rules and regulations, at the second annual conference of the NHS Alliance in Birmingham last week.

The executive has issued three sets of guidance outlining the roles and responsibilities of primary care groups. These cover local health improvement programmes, health service development through cost effectiveness initiatives and clinical governance, and the commissioning of services.

But Dr Michael Dixon, chairman of the alliance, which represents over 200 of England's 481 primary care groups, advised participants: …
Infection at the Time of Initial Therapy for Hairy Cell Leukemia Is Associated with Inferior Time to Next Treatment
Authors: Narendranath Epperla, Mirela Anghelina, Qiuhong Zhao, Akwasi Agyeman, James S. Blachly, Kerry A. Rogers, Gerard Lozanski, Christopher C. Oakes, Michael R. Grever, Leslie Andritsos
Journal: Blood (2018)
Role model: Bob Klaber
Authors: Kathy Oxtoby
Journal: BMJ (2019)

Paediatrics is a partnership with children, their parents, families, and carers, says Bob Klaber, "You have to put patients and families at the centre of everything.That's what healthcare should be about."Klaber's own family played a part in his choice of medicine as a career.His mother is a retired GP, his father a
SAT0540 Treatment with intravenous immunoglobulin in the vasculitis anca positive. 27 cases studied in a single reference centre
Authors: N. Aviles Mendez, V. Calvo Rio, J. Loricera, B. Atienza Mateo, J.L. Martin Varillas, J. Blanco, R. Blanco, M.A. Gonzalez-Gay
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> Intravenous immunoglobulins (IGIV) is a therapeutic alternative in vasculitis ANCA+specially in cases of refractory or superinfection.We study the efficiency and safety in the short and long term of the IGIV in the vasculitis ANCA. <h3>Methods</h3> Descriptive and observational study of 27 patients with vasculitis ANCA from a reference tertiary hospital. We analysed the treatments received, the clinical and analytical variables and the indexes of activity and evolution <b>(TABLE)</b>.Birmingham Vasculitis Activity (BVAS) was the activity index used, and for prognosis Five Factory Score (FFS).Results are indicated as mean ±SD when there is a normal distribution,or as median [25–75 IQR] when there is an usual one. <h3>Results</h3> 27 patients were analysed (14 W/13 M). At the beginning of the IGIV the average age was 57.8±15.98 and the vasculitis average development was 1.29±0.68. The vasculitis ANCA subtypes were: <b>a)</b>granulomatosis with polyangiitis (n=14; 51.8%), <b>b)</b>microscopic polyangiits (n=9; 33.3%), <b>c)</b>eosinophilic granulomatosis with polyangiitis (n=2; 7.4%), <b>d)</b> pulmonary-renal syndrome with ANCA positive (n=1; 3.7%) and <b>e)</b> indeterminate vasculits ANCA positive (n=1, 3.7%). Previously to the treatment with IGIV, apart from steroids, they also received: cyclophosphamide (n=12, 44.4%), metotrexate (n=6, 22.2%), infliximab (n=5, 18.5%), rituximab (n=4, 14,8%), azatioprine (n=3, 11.1%), mycophenolate (n=3, 11.1%) and plasmapheresis (n=1; 3.7%). Refractioness (n=18) and suspicious of infection (n=9) were the reasons for the application of IGIV. The IGIV guideline was 0.4 g/kg/day for 5 consecutive days. 66.6% received methylprednisolona IV concomitant (0.5–1 g/day for 3 days). After a follow-up of 80±68.four months we observed clinical and analytical improvement, as well as, in the activity indexes <b>(TABLE)</b>. The majority of the side effects were lower and IGIV was suspended in just one patient due to severe effects of congestive heart disease. <h3>Conclusions</h3> IGIV seems to be an effective and secure therapy in the treatment of vasculitis ANCA. <h3>Acknowledgements</h3> All members of Rheumatology <h3>Disclosure of Interest</h3> None declared
THU0442 Is behcet’s syndrome getting milder? a retrospective analysis of initial presentation findings throughout 4 decades
Authors: E. Dincses, Y. Ozguler, D. Ucar, Y. Ozyazgan, S. Ugurlu, G. Hatemi, M. Melikoglu, S. Yurdakul, H. Yazici, E. Seyahi
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> There is some evidence that incident Behcet's syndrome (BS) might be becoming less severe.<sup>1</sup> <h3>Objectives</h3> We compared clinical findings at presentation of BS patients registered in a large, long standing dedicated multidisciplinary outpatient clinic at 4 time points during a 40 years period. <h3>Methods</h3> There were 4 groups. Group 1 included patients registered in 1979–1981, Group 2 those registered in 1990, Group 3 in 2000 and Group 4 in 2010. Only demographic and clinical findings at initial presentation were recorded. <h3>Results</h3> As shown in table 1, over 4 decades, male/female ratio decreases gradually. While mean age at presentation does not change, the median disease duration got shorter. Almost all clinical manifestations except genital ulcers and neurological involvement tended to decrease in frequency. This was also true when genders were separately analysed. Importantly the severity of vascular and eye disease decreased (table 1,2). The slope of vascular disease was more obvious. <h3>Conclusions</h3> Our observations support the notion that incident BS might be getting milder. There might be a list of explanations for this observation. 1. It might be a biological phenomenon due to changing environmental causes. In this line the significant decrease in papulopustular lesions could be due to a more sanitary environment while the rather unchanging frequency of neurologic involvement might be its possible independence from the environment. 2. It might be that the awareness of BS is increasing and we are recognising less severe cases. 3. Another explanation might be the more effective treatment these patients received before they were referred which was not specifically sought in this survey. <h3>Reference</h3> [1] Cingu AK, et al. Comparison of presenting features and three-year disease course in Turkish patients with Behçet uveitis who presented in the early 1990s and the early 2000s. Ocul Immunol Inflamm2012. <h3>Disclosure of Interest</h3> None declared
SP0036 Free fatty acids: good or bad in rheumatology?
Authors: L.A. Joosten, Leo AB Joosten
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Free fatty acids (FFA's) are grouped based on the length of their carbon chains into short chain fatty acids (SCFAs), medium chain fatty acids (MCFAs) and long chain fatty acids (LCFAs). The most FFAs are released after breakdown of triglycerides in adipose tissue and the liver. However, SCFAs including acetate, propionate and butyrate are derived from the fermentation of fibres in the gut. In this presentation, the good or the bad properties of FFA's to control or aggravate inflammation in general will be discussed. With special focus on rheumatic disorders, such as rheumatoid arthritis and gout. In addition, the synergy of LCFAs with damage associated molecular patterns (DAMPs) will be addressed. Finally, the therapeutic value of SCFAs will be discussed in rheumatic disorders. <h3>Disclosure of Interest</h3> None declared
FRI0299 Mucosal-associated invariant t cell deficiency in systemic lupus erythematosus is realted to an intrinsic defect in the ca2+/calcineurin/nfat1 signallingpathway
Authors: Y.-W. Park, Y.-N. Cho, H.-M. Jin, S.-J. Kee
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Mucosal-associated invariant T (MAIT) cells contribute to protection against certain microorganism infections and play an important role in mucosal immunity. However, the role of MAIT cells remains enigmatic in autoimmune diseases. <h3>Objectives</h3> Here, we examined the level and function of MAIT cells in patients with rheumatic diseases. <h3>Methods</h3> Patients with systemic lupus erythematosus (SLE; n=54), rheumatoid arthritis (RA; n=66), Behçet's disease (n=9), ankylosing spondylitis (n=21), and healthy controls (n=136) were enrolled in the study. MAIT cell, cytokine and programmed death-1 (PD-1) levels were measured by flow cytometry. <h3>Results</h3> Circulating MAIT cell levels were significantly reduced in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients. In particular, this MAIT cell deficiency was more prominent in CD8 +and double-negative T cell subsets, and significantly correlated with disease activity, such as SLE disease activity index (SLEDAI) and 28-joint disease activity score (DAS28). Interestingly, MAIT cell frequency was significantly correlated with natural killer T (NKT) cell frequency in SLE patients. IFN-gamma in MAIT cells was impaired in SLE patients, which was due to an intrinsic defect in the Ca2+/calcineurin/NFAT1 signalling pathway. In SLE patients, MAIT cells were poorly activated by alphagalactosylceramide-stimulated NKT cells, thereby showing the dysfunction between MAIT cells and NKT cells. Notably, an elevated expression of PD-1 in MAIT cells and NKT cells was associated with SLE. In RA patients, MAIT cell levels were significantly higher in synovial fluid than in peripheral blood. <h3>Conclusions</h3> Our study primarily demonstrates that MAIT cells are numerically and functionally deficient in SLE. In addition, we report a novel finding that this MAIT cell deficiency is associated with NKT cell deficiency and elevated PD-1 expression. These abnormalities possibly contribute to dysregulated mucosal immunity in SLE. <h3>Disclosure of Interest</h3> None declared
Outcome and Determinants of Failure to Complete 6-8 Cycles of Primary R-CHOP Treatment for Reasons Unrelated to Progression Among Patients with Diffuse Large B-Cell Lymphoma (DLBCL)
Authors: Karin Ekstrom Smedby, Sara Harrysson, Per-Ola Andersson, Gunilla Enblad, Sara Ekberg, Mats Jerkeman, Sandra Eloranta
Journal: Blood (2018)
Results of a Prospective, Multicenter, Phase I/II Clinical Study in Pediatric and Adult Patients Using TCR Alpha/Beta and CD19 Depleted Haploidentical Hematopoietic Stem Cell Grafts Following Reduced-Intensity Conditioning
Authors: Peter Lang, Rupert Handgretinger, Roland Meisel, Stephan Mielke, Dietger Niederwieser, Paul G. Schlegel, Johann Greil, Ansgar Schulz, Peter Bader, Arne Brecht, Donald Bunjes, Jurgen Kuball, Michael Schumm, Matthias K. Eyrich, Vladan Vucinic, Markus Wiesneth, Halvard Bonig, Kasper Westinga, Sandra Karitzky, Silke Holtkamp, Michaela Malchow, Christiane Siewert, Stefanie Biedermann, Wolfgang Bethge
Journal: Blood (2018)
Use of an additional working channel for endoscopic mucosal resection (EMR +)of a pedunculated sessile serrated adenoma in the sigmoid colon
Authors: Edris Wedi, Richard Knoop, Carlo Jung, Volker Ellenrieder, Steffen Kunsch
Journal: Endoscopy (2019)

A 64-year-old man was admitted to our hospital after screening colonoscopy revealed multiple polyps including a tumor-suspicious lesion in the transverse colon. Ileocolonoscopy revealed a flat adenoma at the cecum and a colorectal tumor of the transverse colon in close proximity to the right colonic flexure. As an extended right hemicolectomy was considered the treatment of choice, neither lesion was removed during colonoscopy. In the rectosigmoid, however, an additional large pedunculated polyp (Paris 0-Ip, 2 × 1 × 5 cm) with a broad base was detected. Owing to the flat base, an unfavorable location behind a colonic fold, and high mobility of the polyp, a conventional endoscopic mucosal resection (EMR) procedure was difficult to perform. Consequently, we decided to perform a novel grasp-and-snare technique termed EMR + technique ([Video 1]).