tbuckley/cabot-search huggingface dataset:
SAT0114 INCREASED PREVALENCE AND SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH CHEST PAIN AND SEROPOSITIVE RHEUMATOID ARTHRITIS: AN ANALYSIS FROM A LARGE-SCALE POPULATION COHORT REFERRED FOR CARDIAC COMPUTED TOMOGRAPHY
Authors: Andreas Bugge Tinggaard, Annette de Thurah, Ina Trolle Andersen, Anders Hammerich Riis, Josephine Therkildsen, Simon Winther, Ellen-Margrethe Hauge, Morten Böttcher
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Inflammation plays a central role in the development of atherosclerosis and inflammatory disease might promote progression of CAD. <h3>Objectives</h3> To examine the impact of the most frequent systemic inflammatory disease, rheumatoid arthritis (RA), on the prevalence and severity of coronary artery disease (CAD) in patients referred for rule out of CAD by cardiac computed tomography (CCT). <h3>Methods</h3> In total, 39,534 patients from a mandatory national CCT database were included. Patients with a validated RA diagnosis were subgrouped based on serology, treatment with biological disease-modifying anti-rheumatic drugs (DMARDs), and the need for flare treatment with intraarticular and intramuskular glucocorticoid injections (GCIs). Outcomes were coronary artery calcium score (CACS) &gt; 0 and CACS &gt; 400. Differences in prevalences were assessed by odds ratios (OR). Outcomes were adjusted for cardiovascular risk factors and comorbidities. <h3>Results</h3> A total of 337 (0.9%) patients with RA were identified. OR for having CACS &gt; 0 was 1.17 (0.91-1.50) for overall RA and 1.33 (1.00-1.77) for seropositive RA. Patients who had received ≥1 GCI in the period 3 years prior to the CCT had an OR of 1.49 (0.99-2.27) for having CACS &gt; 0. The OR for having CACS &gt; 400 was 1.31 (0.95-1.81) for overall RA and 1.49 (1.04-2.12) for seropositive RA. OR for having CACS &gt; 400 was 1.43 (0.99-2.07) for RA patients treated with conventional synthetic DMARDs, but 1.01 (0.51-1.99) for patients treated with biological DMARDs. <h3>Conclusion</h3> Coronary artery calcifications are more frequent in RA patients being seropositive or needing flare treatment. The occurrence of severe calcification is more frequent in seropositive RA patients and in RA patients not escalated to biological DMARDs. These findings support the hypothesis that systemic inflammation accelerates the atherosclerotic process leading to increased coronary artery calcium, which may explain the increased risk of cardiovascular events among RA patients. <h3>Disclosure of Interests</h3> None declared
Количественный анализ скорости антисекреторного эффекта комбинированного ингибитора протонной помпы Эзолонг
Authors: Yu.M. Stepanov, А.V. Salenko
Journal: GASTROENTEROLOGY (2019)

Актуальность. Лечение кислотозависимых заболеваний является актуальной проблемой современной гастроэнтерологии, что обусловлено широким распространением этой группы нозологий в структуре заболеваний желудочно-кишечного тракта. Ведущее место в лечении этих заболеваний занимают ингибиторы протонной помпы. Критериями их выбора является время начала действия, выраженность и длительность кислотосупрессии, устойчивость эффекта в течение суток, наличие различных дозировок препарата. Именно поэтому в последние годы предпочтение отдается комбинированным препаратам. Сейчас в Украине используется новое поколение комбинированных средств, представителем которых является Эзолонг. Это лекарственное средство, которое кроме высококачественного эзомепразола (в дозировке 20 или 40 мг) содержит еще и антацид в виде натрия гидрокарбоната (1080 мг). Именно это сочетание делает данный препарат уникальным. Цель: определить скорость воздействия комбинированного препарата Эзолонг (эзомепразол 40 мг + натрия гидрокарбонат 1080 мг) на состояние желудочной кислотопродукции и степень ее ингибирования при использовании разовой дозы препарата. Материалы и методы. Под наблюдение было взято 20 пациентов с различными формами хронического гастродуоденита. Уровень кислотопродукции оценивался с помощью внутрижелудочного рН-мониторинга с применением ацидографа АГ-1. Далее больные получали разовую дозу Эзолонга (40 мг) и находились под наблюдением в течение 3 часов. Результаты. Проанализировав скорость антисекреторного действия разовой дозы Эзолонга, выявили, что у большинства больных (95 %) прием данного препарата приводит к повышению уровня интрагастрального рН до гипоацидных цифр (от 3,0 до 7,8), у некоторых пациентов отмечаются даже анацидные значения рН. Доказано, что для Эзолонга характерно быстрое начало действия (в среднем 6 минут) и достоверное повышение рН до выраженной гипо­ацидности. Выводы. Прием Эзолонга обеспечивает активное, мощное и длительное подавление желудочной кислотопродукции, является эффективным и безопасным при лечении кислотозависимых заболеваний.
Lyme Disease Risks in Europe under Multiple Uncertain Drivers of Change
Authors: Sen Li, Lucy Gilbert, Sophie O. Vanwambeke, Jianjun Yu, Bethan V. Purse, Paula A. Harrison
Journal: Environmental Health Perspectives (2019)

Background: Debates over whether climate change could lead to the amplification of Lyme disease (LD) risk in the future have received much attention. Although recent large-scale disease mapping studies project an overall increase in Lyme disease risk as the climate warms, such conclusions are based on climate-driven models in which other drivers of change, such as land-use/cover and host population distribution, are less considered. Objectives: The main objectives were to project the likely future ecological risk patterns of LD in Europe under different assumptions about future socioeconomic and climate conditions and to explore similarity and uncertainty in the projected risks. Methods: An integrative, spatially explicit modeling study of the ecological risk patterns of LD in Europe was conducted by applying recent advances in process-based modeling of tick-borne diseases, species distribution mapping, and scenarios of land-use/cover change. We drove the model with stakeholder-driven, integrated scenarios of plausible future socioeconomic and climate change [the Shared Socioeconomic Pathway (SSPs) combined with the Representative Concentration Pathways (RCPs)]. Results: The model projections suggest that future temperature increases may not always amplify LD risk: Low emissions scenarios (RCP2.6) combined with a sustainability socioeconomic scenario (SSP1) resulted in reduced LD risk. The greatest increase in risk was projected under intermediate (RCP4.5) rather than high-end (RCP8.5) climate change scenarios. Climate and land-use change were projected to have different roles in shaping the future regional dynamics of risk, with climate warming being likely to cause risk expansion in northern Europe and conversion of forest to agriculture being likely to limit risk in southern Europe. Conclusions: Projected regional differences in LD risk resulted from mixed effects of temperature, land use, and host distributions, suggesting region-specific and cross-sectoral foci for LD risk management policy. The integrated model provides an improved explanatory tool for the system mechanisms of LD pathogen transmission and how pathogen transmission could respond to combined socioeconomic and climate changes. https://doi.org/10.1289/EHP4615
AB0400 FREQUENCY OF BIOLOGIC/SMALL MOLECULE MONOTHERAPY FOR RHEUMATOID ARTHRITIS IN THE EU: REAL-WORLD EVIDENCE FROM A PATIENT AUDIT STUDY
Authors: Phil pouliot, Lynn Price
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Biologic/small molecule therapy has been the standard of care for adult patients diagnosed with rheumatoid arthritis (RA) who have failed conventional DMARD therapy, resulting in familiarity, comfort, and satisfaction among physicians. Prior recommendations of combining biologics/small molecules with a DMARD like methotrexate (MTX) have recently been challenged by clinical data demonstrating the effectiveness of IL-6 and JAK inhibitors as monotherapy. <h3>Objectives</h3> This research sought to evaluate the frequency of biologic/small molecule monotherapy regimens among European RA patients who were recently switched from one biologic/small molecule to another. <h3>Methods</h3> An independent market analytics firm collaborated with rheumatologists in France (n=62), Germany (n=66), Italy (n=61), Spain (n=68) and the UK (63) to conduct an online retrospective chart review of RA patients who had switched treatment from one biologic/small molecule to another in the prior twelve weeks. Rheumatologists were able to submit up to seven RA patient charts. A total of 1,312 patient charts were collected via a market-specific compliant audit form in September 2018 and included patient and physician demographics, patient treatment history, and clinical/non-clinical patient parameters. <h3>Results</h3> Overall, the analysis of patient chart audits revealed that 22% of all recently switched patients were switched to a biologic/small molecule monotherapy regimen. The frequency of monotherapy was highest in Germany (32%) and lowest in the UK (13%). Monotherapy was more frequent for patients switched to infliximab (39%) and tofacitinib (39%) and lowest for those switched to tocilizumab IV (12%) and rituximab (11%). When combined into classes of agents, frequency of monotherapy among recently switched patients was 25% for TNFs, 24% for JAK inhibitors, 23% for IL-6 inhibitors, and 16% for non-JAK/IL-6 AMOAs (abatacept or rituximab). On a country-specific level, rates of TNF monotherapy were highest in Germany (38%) and lowest in the UK (16%). IL-6 monotherapy was also more common in Germany (27%) but least common in France (17%). JAK monotherapy was highest in France (34%) and lowest in the UK (7%), while monotherapy for abatacept/rituximab was highest in Germany (32%) and again lowest in the UK (13%). <h3>Conclusion</h3> The popularity of biologic/small molecule monotherapy varies by EU5 country and while rates are highest for TNF inhibitors, use of biologic/small molecule monotherapy for patients recently switched to a JAK or IL-6 inhibitor are comparable. <h3>Disclosure of Interests</h3> None declared
Triple-negative receptor status and the 2007 St. Gallen consensus guidelines for early breast cancer
Authors: V. Caggiano, K. R. Bauer, C. A. Parise
Journal: Journal of Clinical Oncology (2009)

547 Background: The 2007 St Gallen consensus statement describes three risk categories and provides guidelines for treatment. We previously described the distribution of ER/PR/HER2 in breast cancer and analyzed the triple-negative subtype. We now examine the 2007 St Gallen consensus-risk categories with respect to the ER/PR/HER2 subtypes. Methods: Using the population-based California Cancer Registry from 2000 through 2006, we identified 63,925 cases of stages I-III first primary invasive female breast cancer with known status of ER, PR, and HER2. We retrospectively assigned cases to risk categories using pathologic tumor size and grade, age, and status of ER, PR, HER2, and lymph nodes. Extensive peritumoral vascular invasion was not readily available and could not be utilized. We determined the ER/PR/HER2 subtypes for each risk category and performed five-year relative survival. Results: Five year relative survival was 95% or greater for the low risk (LR), node-negative intermediate risk (NNIR), and node positive (1–3) intermediate risk (NPIR) categories. The 5-year relative survival for the node positive (1–3) high-risk (NPHR) category was 85% and 74% for the node positive (&gt; 3) high-risk (NPHR4) category; both had significantly worse survival than the low- and intermediate-risk categories. Classification of the risk categories by ER/PR/HER2 subtype showed no differences between the subtypes in the low risk category and clear differences in all other risk categories. All ER-negative subtypes had the worst survival within the NNIR, NPHR, and NPHR4 categories. The triple negative subtype had the worst survival in all of these risk categories. The greatest differences in 5-year relative survival were noted in the NPHR4 category with survival ranging from 85% in the ER+/PR+/HER2- subtype to 50% in the triple negative subtype. Conclusions: The St Gallen risk model clearly separates early breast cancer into three risk categories and helps with treatment decisions. Use of the ER/PR/HER2 subtypes within these categories clearly illustrates the heterogeneity of the intermediate and high risk categories and may prove to be important in this era of tailored therapy. No significant financial relationships to disclose.
Annals Graphic Medicine - Oneness in Medicine
Authors: Naveed Shah
Journal: Annals of Internal Medicine (2019)

Web Exclusives18 June 2019Annals Graphic Medicine - Oneness in MedicineFREENaveed ShahNaveed ShahAdelphi University, Garden City, New York (N.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G18-0029 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Adelphi University, Garden City, New York (N.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G18-0029.Author/Illustrator Information: Naveed Shah is a sophomore studying biological sciences at Adelphi University. She is passionate about population medicine, bridging health care disparities, and illustrating medicine through artwork (e-mail, [email protected]adelphi.edu).This article was published at Annals.org on 11 June 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 18 June 2019Volume 170, Issue 12Page: W125-W126KeywordsConflicts of interestDisclosureHealth care ePublished: 11 June 2019 Issue Published: 18 June 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
S827 CLINICAL RESPONSES AND PHARMACOKINETICS OF FULLY HUMAN BCMA TARGETING CAR T CELL THERAPY IN RELAPSED/REFRACTORY MULTIPLE MYELOMA
Authors: C. Li, J. Zhou, J. Wang, G. Hu, A. Du, X. Zhou, Z. Hong, L. Meng, L. Chen, X. Mao
Journal: HemaSphere (2019)

Background: Previous studies indicate patients with relapsed/refractory multiple myeloma (RRMM) who receive high‐dose BCMA‐targeting CAR‐T cells may achieve better remission but have worse adverse events. Moreover, once the disease progresses again, the re‐infusion of CAR‐T cells is not effective. To solve this dilemma, we have developed a novel BCMA‐targeting CAR‐T (CT103A) with a lentiviral vector containing a CAR structure with a fully human scFv, CD8a hinger and transmembrane, 4–1BB co‐stimulatory and CD3z activation domains. Aims: The primary objectives are to characterize the safety and tolerability in patients with R/R MM. The secondary objectives include evaluation of anti‐myeloma activity, cytokines, CAR‐T cell persistence, and pharmacokinetics. Methods: ChiCTR1800018137 is a single‐center and single‐arm trial of CT103A in patients with RRMM. Between September 21, 2018, and January 21, 2019, nine patients (including 3 patients having relapsed after being given a murine BCMA CAR‐T) received CT103A in 3+3 dose‐escalation trial (three doses at 1, 3, 6 × 10 6 /kg) after a conditioning chemotherapy regimen of cyclophosphamide and fludarabine. All Patients had received a median of 4 prior lines (range 3 ‐ 5) of MM therapy. Results: At the time of the February 4, 2019 data analysis, the overall response rate was 100% (Table1), and all patients had a rapid response within 14 days, with 67% (2/3) reaching CR/sCR at the lowest dose. The pharmacokinetics of CT103A were assessed by a digital polymerase chain reaction. Robust expansions were seen even at the lowest dosage level. In addition, Cmax and AUC0‐28 reached levels comparable to reported CD19 CAR‐T. In the first two dose groups, the grade of cytokine release syndrome (CRS) was 0 ‐ 2. In the 6 × 10 6 /kg dose group, DLT had been observed in one patient. Summary/Conclusion: Data from this early‐stage clinical study showed the unparalleled safety and efficacy of CT103A. Major AEs were transient, manageable, and reversible. three patients who relapsed the murine BCMA CAR‐T were treated with CT103A, two patients achieved CR, and one patient achieved VGPR. 100% ORR and a rapid response within 2 weeks, suggests CT103A could be developed as a competitive therapeutic to treat patients with RRMM. image
Correlates of HIV RNA concentrations in cerebrospinal fluid during antiretroviral therapy: a longitudinal cohort study
Authors: Alessandro Livelli, Florin Vaida, Ronald J Ellis, Qing Ma, Micol Ferrara, David B Clifford, Ann C Collier, Benjamin B Gelman, Christina M Marra, Justin C McArthur, J Allen McCutchan, Susan Morgello, Ned Sacktor, David M Simpson, Igor Grant, Scott L Letendre, Ian Abramson, Muhammad T. Al-Lozi, Sarah L. Archibald, J. Hampton Atkinson, Brookie M. Best, David B. Clifford, Ann C. Collier, Clint Cushman, Matthew S. Dawson, Ronald J. Ellis, Christine Fennema-Notestine, Donald R. Franklin, Benjamin B. Gelman, Igor Grant, Eleanor Head, Robert K. Heaton, Trudy Jones, Scott Letendre, Kenneth R. Maravilla, Thomas D. Marcotte, Christina M. Marra, Justin C. McArthur, J. Allen McCutchan, Letty Mintz, Susan Morgello, Thomas P. Naidich, Ned Sacktor, David M. Simpson, David M. Smith, Keith C. Stegbauer, Cheuk Y. Tang, Mengesha Teshome
Journal: The Lancet HIV (2019)
S1599 RITUXIMAB MAINTENANCE FOR PATIENTS WITH DIFFUSE LARGE B‐CELL LYMPHOMA IN FIRST COMPLETE REMISSION: RESULTS FROM A RANDOMIZED HOVON‐NORDIC LYMPHOMA GROUP PHASE III STUDY
Authors: P. Lugtenburg, P. Brown, B. van der Holt, F. D’Amore, H. Koene, E. de Jongh, R. Fijnheer, O. Loosveld, L. Böhmer, H. Pruijt, G. Verhoef, M. Hoogendoorn, Y. Bilgin, M. Nijland, K. Lam, B. de Keizer, D. de Jong, J. Zijlstra
Journal: HemaSphere (2019)

Background: This randomized phase III trial assessed whether intensification of rituximab (R) during the first 4 cycles of R‐CHOP can improve outcome of diffuse large B‐cell lymphoma (DLBCL) patients compared with standard R‐CHOP. Patients in complete remission (CR) after induction treatment were randomized between rituximab maintenance and observation. Intensification of rituximab was not more effective than standard R‐CHOP, showing same CR‐rates and progression free survival after induction (ASCO 2016 # 7504). Here, we report the results of the second randomization for rituximab maintenance therapy. Aims: To assess in a prospective, multicenter, randomized phase III study in patients with DLBCL the efficacy of maintenance treatment with rituximab in comparison to no further treatment on disease free survival. Methods: Patients in CR after R‐CHOP were randomized between 24 months of rituximab maintenance 375 mg/m 2 intravenous every 8 weeks (n = 199) or observation (n = 199). CT scans were performed at 6, 12, 18 and 24 months in both arms. The primary endpoint was disease free survival (DFS) from maintenance randomization. Secondary endpoints were overall survival (OS) and adverse events (AEs). ( www.trialregister.nl NTR1014). Results: Median age was 65 years (range 31–80), 48% were 66 years or older and 49% were male. The majority of patients (54%) had a high‐intermediate or high aa‐IPI score. After a median follow‐up of 79.9 months (maximum 125.7 months), the 5‐year DFS rate was 79% for rituximab maintenance versus 74% for observation. This difference was not statistically significant, with a hazard ratio of 0.83 (95% confidence interval 0.57–1.19, p = 0.31, adjusted for age and aa‐IPI). The secondary endpoint OS was also not significantly different (85% versus 83% at 5 years). No clinical subgroup benefited from rituximab maintenance. Toxicity was mild. Among patients who received rituximab maintenance CTCAE grade 3 and 4 AEs were reported in 17% and 6% of patients, respectively. Infection was the most frequent AE, a grade 3 infection occurred in 6% of patients. Neutropenia was seen in 1% (grade 3) and 3% (grade 4) of patients. Summary/Conclusion: Rituximab maintenance therapy provides no additional benefit for DLBCL patients in first CR after R‐CHOP.
Trends in Meeting Physical Activity Guidelines Among Urban and Rural Dwelling Adults — United States, 2008–2017
Authors: Geoffrey P. Whitfield, Susan A. Carlson, Emily N. Ussery, Janet E. Fulton, Deborah A. Galuska, Ruth Petersen
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

Since the release of the 2008 Physical Activity Guidelines for Americans (https://health.gov/paguidelines/2008/pdf/paguide.pdf), the age-adjusted percentage of adults meeting the combined aerobic and muscle-strengthening guidelines increased from 18.2% to 24.3% in 2017 (1). Trends in urban and rural areas, across demographic subgroups, and among subgroups within urban and rural areas have not been reported. CDC analyzed 2008-2017 National Health Interview Survey (NHIS) data to examine trends in the age-standardized prevalence of meeting physical activity guidelines among adults aged ≥18 years living in urban and rural areas. Among urban and rural residents, prevalence increased from 19.4% to 25.3% and from 13.3% to 19.6%, respectively. Nationally, all demographic subgroups and regions experienced increases over this period; increases for several groups were not consistent year-to-year. Among urban residents, the prevalence was higher during 2016-2017 than during 2008-2009 for all demographic subgroups and regions. During the same period, prevalence was higher across all rural-dwelling subgroups except Hispanics, adults with a college education, and those living in the South U.S. Census region. Urban and rural communities can implement evidence-based approaches, including improved community design, improved access to indoor and outdoor recreation facilities, social support programs, and community-wide campaigns to make physical activity the safe and easy choice for persons of all ages and abilities (2-4). Incorporating culturally appropriate strategies into local programs might help address differences across subgroups.