tbuckley/cabot-search huggingface dataset:
Reducing Firearm Injuries and Deaths in the United States
Authors: Paul Franke
Journal: Annals of Internal Medicine (2019)

Letters18 June 2019Reducing Firearm Injuries and Deaths in the United StatesPaul Franke, MDPaul Franke, MDSamuel Simmonds Memorial Hospital, Longmont, Colorado (P.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0159 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although I strongly support the American College of Physicians' (ACP's) process of developing policy positions, I am disappointed that the position paper on firearm safety (1) did not advocate the use of “smart” gun technology. As physicians, we have the ability to reduce the number of accidental firearm-related injuries and deaths through policy recommendations and in our actual clinical practice. How could we not embrace technology that prevents accidental discharge of a firearm by family members, especially children? This commercially available technology does not infringe on Second Amendment rights and obviates firearm owners' consistent failures to secure ...Reference1. Butkus R, Doherty R, Bornstein SS; Health and Public Policy Committee of the American College of Physicians. Reducing firearm injuries and deaths in the United States: a position paper from the American College of Physicians. Ann Intern Med. 2018;169:704-7. [PMID: 30383132]. doi:10.7326/M18-1530 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Samuel Simmonds Memorial Hospital, Longmont, Colorado (P.F.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0159. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoReducing Firearm Injuries and Deaths in the United States: A Position Paper From the American College of Physicians Renee Butkus , Robert Doherty , Sue S. Bornstein , and Reducing Firearm Injuries and Deaths in the United States James Webster Reducing Firearm Injuries and Deaths in the United States Ethan B. Ludmir , M. Ali Elahi , and B. Ashleigh Guadagnolo Reducing Firearm Injuries and Deaths in the United States Renee Butkus , Robert Doherty , and Sue S. Bornstein Metrics 18 June 2019Volume 170, Issue 12Page: 910KeywordsChildrenConflicts of interestDisclosureFire safetyFirearm injuries ePublished: 18 June 2019 Issue Published: 18 June 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
PB2143 HEPATITIS B VIRUS INFECTION MIGHT CONTRIBUTE TO MULTIPLE MYELOMA PROGRESSION THROUGH 1Q21 AMPLIFICATION
Authors: P. Xu, D. Guo
Journal: HemaSphere (2019)

Background: Hepatitis B virus (HBV) is not only a hepatotropic virus but also a lymphotropic virus. The association between HBV and hematologic malignancies has also been described, but the correlation between HBV infection and multiple myeloma (MM) has remained controversial. Aims: This study aimed to assess the prevalence of HBV infection in patients with MM and investigate their characteristics and prognostic significance. Methods The clinical data of 165 patients with MM receiving at least four cycles of chemotherapy from April 2008 to February 2017 in Nanjing Drum Tower Hospital were collected. HBV markers were determined by an enzyme‐linked immunosorbent assay. Results: The rates of an acute or chronic HBV infection and resolved HBV infection in patients with MM were 12.12% and 26.06%, respectively. The gain of 1q21 was statistically significant in HBV‐positive and HBV‐negative patients (54% vs. 38.2%, P = 0.048), and the level of alanine transaminase (ALT) in HBV‐infected patients was significantly higher than that of the non‐infected group (63.29 vs. 24.66 U/L, P = 0.043). Lactate dehydrogenase, serum creatinine, and serum calcium levels were found as significant risk factors of overall survival. The progression‐free survival (PFS) of HBV‐positive patients was shorter than that of HBV‐negative patients (18.97 vs. 29.67 months P = 0.006), and HBV positive was considered an independent prognostic factor of PFS. Summary/Conclusion: HBV infection might contribute to MM progression through 1q21 amplification, and HBV markers should be closely monitored in patients with MM.
Abstract 11257: Hmgb-1 Signal Via Tlr-9 Plays Critical Role iIn Vascular Remodeling
Authors: Mayuko Higashida, Yoichiro Hirata, Hirotsugu Kurobe, Yutaka Nakaya, Tetsuya Kitagawa, Masataka Sata
Journal: Circulation (2011)

[Background] High-mobility group box-1 (HMGB1) is a highly conserved nuclear protein that modulates chromatin structure. Recent reports suggest that HMGB1 acts as an important mediator in inflammat...
Management of psoriasis as a systemic disease: what is the evidence?
Authors: N.J. Korman
Journal: British Journal of Dermatology (2019)

Psoriasis is a chronic, systemic immune‐mediated disease characterized by development of erythematous, indurated, scaly, pruritic and often painful skin plaques. Psoriasis pathogenesis is driven by proinflammatory cytokines and psoriasis is associated with increased risk for comorbidities, including, but not limited to, psoriatic arthritis, cardiovascular disease, diabetes mellitus, obesity, inflammatory bowel disease and nonalcoholic fatty liver disease compared with the general population. To explore the pathophysiological relationship between psoriasis and its common comorbidities and discuss the need for new treatment paradigms that include strategies to reduce systemic inflammation in patients with moderate‐to‐severe psoriasis. This narrative review summarizes the published evidence related to the ability of biological therapies to ameliorate the consequences of systemic inflammation in patients with psoriasis. Current evidence suggests that preventing damage associated with inflammation, and preventing development of future inflammatory damage and comorbidities, may be a potentially achievable treatment goal for many patients with moderate‐to‐severe plaque psoriasis when biological therapies are utilized early in the disease. Encouraging data from recent studies suggest that the loftier goal of reversing existing inflammatory damage and improving signs and symptoms of inflammatory comorbidities could also possibly be attainable. Results from ongoing prospective studies regarding the effects of biologics on markers of systemic inflammation in patients with psoriasis will strengthen the clinical evidence base that can be used to inform treatment decisions for patients with moderate‐to‐severe psoriasis. What's already known about this topic? Psoriasis is a systemic inflammatory disease and treatments are needed to optimize patient outcomes. What does this study add? This review discusses new psoriasis treatment paradigms that may potentially reduce effects of systemic inflammation. Evidence demonstrating that biological treatment may prevent or reverse inflammatory damage associated with psoriasis comorbidities is reviewed.
PB2064 USE OF RNASCOPE TECHNOLOGY TO DETERMINE STAT‐3 EXPRESSION IN HUMAN DIFFUSE LARGE B‐CELL LYMPHOMA
Authors: R. Tamma, F. Gaudio, G. Ingravallo, F. Albano, T. Perrone, T. Annese, S. Ruggieri, E. Maiorano, G. Specchia, D. Ribatti
Journal: HemaSphere (2019)

Background: Diffuse large B‐cell lymphoma (DLBCL) is the most common and one of the most heterogeneous lymphomas. Therefore, it is critical to further stratify cases of DLBCL into biologically similar and clinically meaningful subgroups, which will not only guide prognostic assessment and facilitate therapeutic decisions, but also stimulate further research to understand the pathogenesis and develop potential novel treatments. Signal transducer and activator of transcription 3 (STAT3) is a transcription factor that exerts important biological functions related to cell proliferation, differentiation, survival, angiogenesis and immune response. Aims: In this study, we used RNAscope technology in order to evaluate STAT3 RNA expression in human DLBCL in selected groups of activated B‐cell–like DLBCL (ABC‐DLBCL) patients and germinal center B‐cell–like DLBCL (GBC‐DLBCL) patients. Methods This retrospective study reviewed data from patients diagnosed with DLBCL collected from the archive of the Section of Pathology of the University of Bari, Hospital Policlinico, Bari, Italy, between 2009 and 2013. All patients had pathologically confirmed DLBCL. Tumors were divided into two histological subgroups: one that includes ABC patients and another that includes GCB patients. Results: The results have shown that ABC DLBCL tissue samples contained more STAT3‐positive cells as compared with GCB tissue samples. Moreover, the immunofluorescence analysis showed that tumor vessels in ABC samples appeared lined by endothelial cells expressing both FVIII and STAT3 signals, while in GCB samples, only few vessels expressed both FVIII and STAT3. These data confirm other reports showing that STAT3 is highly expressed and activated in ABC‐DLBCL samples and the tumor vessels appeared lined by endothelial cells expressing both FVIII and STAT3. Summary/Conclusion: An improved understanding of tumor biology and the role of the tumor microenvironment has led to advances in the diagnosis, classification, prognostics, as well as novel treatments of patients with hematologic malignancies. Ongoing dynamic and correlation studies of tumor biology and the contribution of the tumor microenvironment should be promoted in the context of novel drug development in order to identify optimal therapies for various lymphomas, and improve the curability of these diseases.
PB2358 THE IMPACT OF THE NUMBER OF CD34 + CELLS TRANSPLANTED IN ENGRAFTMENT AFTER AUTOLOGOUS TRANSPLANTATION OF HEMATOPOIETIC PROGENITORS
Authors: D. Andrade Luís, C. Guedes, A. Roque, A. Esesumaga, C. Borges, C. Geraldes, J. Tomaz
Journal: HemaSphere (2019)

Background: Despite the emergence of new therapeutic options, autologous hematopoietic stem‐cell transplantation (AHCT) is still one of the pillars in the treatment of patients with multiple myeloma (MM), especially in younger and fit patients. However, the ideal number of transplanted CD34 + cells to maximize post‐transplant results is still under discussion. Aims: Verify the corelation between the number of cell CD34 + infused and the outcomes in neutrophils and platelets recovery and transfusional requirements. Methods: Prospective analysis of 243 autologous transplants in patients with multiple myeloma for 10 years from January 2007 to December 2017,in a single institution. For this study, where analysed: the myeloma subtype, the age of diagnosis, the time from diagnosis to transplantation, the conditioning used, the number of days of hospitalization, number of cells infused, the number of days of engraftment, number of days with neutrophils&lt; 0,5 × 10 9 /L, number of days with platelets&lt; 20 × 10 9 , number of transfused platelets pools, number of transfused red blood cells (RBC). The statistical treatment of the data was done in SPSS version 24. Results: In this sample 217 patients were analysed, of whom 79 were females (36,4%) and 138 were males (64%). The medium age of diagnosis was 54.28 years (27 – 77 years) and of transplantation was 58.42 years (28 – 72 years). The most frequent subtype of MM was IgG kappa (45,7%), IgA kappa and IgG lambda (both with 13,2%). The median time from diagnosis to transplant was 533 days. The conditioning regimen used in the majority of the patients was melphalan 200 (97%), and the mean time of hospitalization was 19 days (12 – 77). The number of cells CD34 + infused ranged from 1.40 to 13 × 10 6 cells/kg, with a average of 3.49 cells/kg. In this study, no correlation was verified between the number of cells CD34 + infused and the number of days with neutrophils&lt; 0,5 × 10 9 /Lor with the transfusion need for RBC. The average number of days of engraftment was 13 days (9 – 28), and there is also no correlation between the number of cells CD34 + infused. However, there is an inversely proportional and statistically significant correlation (p &lt; 0.01 and p &lt; 0.05, respectively) related to the number of days with platelets&lt; 20 × 10 9 /L as well as to the number of transfused platelets pools. Summary/Conclusion: An increased number of transplanted CD34 + cells was shown to have a significant impact in time until recovery of the number of platelets, and was associated with lower transfusion dependencepost‐AHCT. The remaining variables evaluated did not show to be dependent on the number of transplanted cells.
THU0660 CHARACTERIZATION OF SCLERODERMA PATIENTS ACCORDING TO RO52 AND KU ANTIBODIES
Authors: Julien Caballero Castro, Alfredo Guillén del Castillo, L. Eduardo Callejas-Moraga, Dolores Colunga Argüelles, Luis Sáez-Comet, Manuel Rubio-Rivas, Ana Argibay, Jose Antonio Vargas-Hitos, Jose Antonio Todolí Parra, Isabel Perales Fraile, Carmen Pilar Simeón-Aznar
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Systemic Sclerosis (SSc) is an autoimmune desease that is characterized by progressive and severe fibrosis with cutaneous and visceral involvement, fibroproliferative vasculopathy and alterations of cellular and humoral immunity, very heterogenous from the clinical and immunological point of view. There are many types of antibodies related to the disease that are used in the diagnosis and characterization. Antibodies anti-Ku and anti-Ro52 have been found, although they are not specific to the disease, that could play an important role in the prognosis and clinical expression. <h3>Objectives</h3> To evaluate the clinical pattern and prognosis of SSc patients who carry antibodies Anti-Ku and Anti-Ro52. <h3>Methods</h3> A retrospective, multicentric study of SSc patients included in the Spanish Registry of Scleroderma (RESCLE). Clinical, demographic, prevalence, serological, and survival data were analyzed <h3>Results</h3> A total of 401 samples were analyzed for anti-Ku with 12 positive results (3%). For anti-R052, 1724 sampled were analyzed with 246 positive results (14%). It is observed, from the multivariant analysis, that patients with anti-Ro52 presented, in higher frequency, an association with Sicca syndrome (p&lt;0.001) and its coexistence with the antibody anti-La (OR 44.8 with 95% CI and p&lt;0.001). Regarding patients with anti-Ku, no clinical association was found with statistical significance. <h3>Conclusion</h3> As opposed to finding SSc specific antinbodies such as anti-centromere (ACA), anti-topoisomerase I (ATA), and anti-RNA polymerase III (ARA), the presence of anti-Ku or anti-Ro52 is not conclusive of any distinctive clinical profile. <h3>References</h3> [1] Mehra S., et al. Autoantibodies in systemic sclerosis. Autoinmunity Reviews 2013; 12:340-354. [2] Stern E., Denton C. The Pathogenesis of systemic Sclerosis. Rheum Dis Clin North Am 2015; 41(3):367-82. [3] Cavazzana I., et al. A subset of systemic sclerosis but not of systemic lupus erythematosus is defined by isolated anti-Ku autoantibodies. Clin Exp Rheumatology 2013; 31:118-21. [4] Iniesta N.; et al. Influence of antibody profile in clinical features and prognosis in a cohort of Spanish patients with systemic sclerosis. Clin Exp Rheumatology 2017; 35(suppl. 106)S00-S00. <h3>Disclosure of Interests</h3> None declared
SP0053 HOW TO PREVENT AND MANAGE FATIGUE IN PATIENTS WITH RA
Authors: James Galloway
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Fatigue is, similar to pain, a subjective symptom that occurs in many different diseases, particularly in patients with RA. Indeed, RA patients consistently report fatigue as one of the most disabling features of the disease (second only to pain). Fatigue is multifactorial in origin and reflects a complex construct of psychological, biochemical and physiological processes. <h3>Objectives:</h3> If we are to effectively support our patients with RA, we must address fatigue. This requires understanding of which of our interventions work. At the end of the talk you should be familiar with how you can help manage fatigue, know which non-pharmacological interventions have a robust evidence and be aware of the impact of our different mode of action targeted RA therapies upon fatigue. For most our patients, a multimodal approach is needed. <h3>Methods:</h3> This talk will present a narrative review of the evidence base around fatigue interventions in RA. <h3>Disclosure of Interests:</h3> James Galloway Consultant for: Pfizer Inc
PS1549 SELF‐REPORTED PHYSICAL ACTIVITY IS PREDICTIVE OF SURVIVAL IN ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION (HCT)
Authors: R. Jayani, J. Pidala, H. Jim, J. Zhou, Q. Mo, A. Mishra
Journal: HemaSphere (2019)

Background: Increased physical activity is associated with improved survival in patients undergoing cancer treatment. However, the association of self‐reported physical activity and activity intensity with HCT outcomes is less clear. Aims: The goal of this study is to evaluate the relationship of self‐reported physical activity and HCT outcomes. Methods: Data was collected from the Moffitt Cancer Center Health Research Informatics and transplant databases. Between 01/01/2011 and 7/5/2018, 587 patients received an allogeneic HSCT and completed IPAQ short form. IPAQ scoring algorithm was used to ascertain metabolic equivalent of task‐minutes (MET‐minutes) per day. Based on MET‐minutes/day aggregate score, patients were subsequently divided into three activity categories: low (n = 337), moderate (n = 52), and vigorous (n = 198). Results: Median follow‐up was 41.7 months (range 11.4–267months). Patients with lower physical activity were older (Age = 59.67 [20.3–75.4] and had more comorbidities (HCT‐CI = 3 [0–9]), in comparison to patients with moderate and vigorous activity. Males reported vigorous activity more commonly (66.7%) in comparison to females (33.3%) whereas low activity level was similar for each gender (females 51.3%, males 48.7%). There was no significant difference in Karnofsky performance status (KPS), Armand disease risk, conditioning intensity, number of prior chemotherapy regimens, and cardiopulmonary function amongst the three categories (Table 1). Patients with vigorous physical activity had lower risk of NRM in comparison to low and moderate activity (Figure 1). In multivariate modeling, after accounting for KPS, graft‐versus host disease, and FEV1, physical activity level was an independent predictor of non‐relapse mortality with lower activity levels associated with increased risk of NRM (HR: low 1.7 (95% CI: 1.07–2.93); moderate 2.11 (95% CI: 1.03–4.31); overall P = 0.049). However, no association was seen between activity level and overall survival or relapse free survival (P = NS). Summary/Conclusion: Self‐reported vigorous activity prior to HCT is an independent predictor of NRM after HCT. This easy to employ tool can be of utility in the clinic to risk stratify HCT candidates. Further studies are warranted to evaluate impact of self‐reported physical activity on HCT outcomes. image
PB1860 A TURKISH CHILD PRESENTED WITH NEONATAL THROMBOCYTOPENIA ASSOCIATED WITH GNE MUTATION WITHOUT ASSOCIATED MUSCLE WASTING
Authors: E. Yilmaz, A. Ozcan, J.M. Verboon, M. Karakukcu, V.G. Sankaran, E. Unal, T. Patıroglu
Journal: HemaSphere (2019)

Background: Mutations in the glucosamine (UDP‐N‐acetyl)‐2‐epimerase/N‐acetyl mannosamine kinase (GNE) gene have previously reported in children with myopathy, however, recently GNE gene mutations were reported to be causative in nine children with thrombocytopenia without associated muscle wasting. Aims: Here we share our experience of a child with macrothrombocytopenia without muscle wasting associated with GNE. Methods: The clinical and genetic features of child with GNE is reported Results: A 30‐day‐old male was referred to Pediatric Hematology Clinic of Erciyes University with complaints of generalized petechial rash, ecchymoses just after birth and it was learned that he received intravenous immunoglobulin and platelet transfusions due to suspected neonatal allo‐immune thrombocytopenia at another medical center. His parents were first cousins. He was referred to our hospital NICU with thrombocytopenia. Blood count analyses revealed a hemoglobin of 10.6 g/dL, leukocyte count of 7810 x10 9 /L, and platelet count of 6 x10 9 /L. The blood smear showed giant platelets. The bone marrow aspiration showed mild granulocyte maturation. He developed severe transfusion depended mucosal bleedings due to severe thrombocytopenia and neutropenia, so hematopoietic stem cell transplantation was planned. As no matching donor was found from the family or unrelated family, alpha beta depleted haploidentical hematopoietic stem cell transplantation (HSCT) from his father was performed. Although myeloid and platelet engraftments were achieved at +14, +13 days consequently, the chimerism decreased and the patient underwent a second haploidentical HSCT with mesenchymal stem cell support. Nevertheless, the chimerism did not improve and the patient died despite supportive treatment. Using whole exome sequencing, we identified a predicted pathogenic missense variant in the GNE gene (chr9:36219976:C&gt;T, p.590:Gly&gt;Arg) present in the heterozygous state in both parents and homozygous in the affected child. Summary/Conclusion: GNE mutations must be kept in mind for children with macrothrombocytopenia. Although our experience is limited, we speculate that there may be some underlying bone marrow micro‐environmental problem that resulted in early rejection after HSCT.
PS954 TIME FROM RANDOMIZATION TO FIRST SUBSEQUENT INDUCTION/SALVAGE THERAPY IN PATIENTS WITH RELAPSED/REFRACTORY ACUTE LYMPHOBLASTIC LEUKEMIA TREATED WITH INOTUZUMAB OZOGAMICIN IN THE PHASE 3 INO‐VATE TRIAL
Authors: E. Jabbour, M. Stelljes, A. Advani, D.J. DeAngelo, T. Wang, A. Neuhof, E. Vandendries, H. Kantarjian
Journal: HemaSphere (2019)

Background: Additional salvage regimens are burdensome for relapsed/refractory acute lymphoblastic leukemia (ALL) patients (pts) due to therapy‐associated toxicities, which may affect quality of life with poor efficacy. In INO‐VATE (Kantarjian et al, NEJM 2016), pts receiving inotuzumab ozogamicin (InO) vs standard chemotherapy (SC) had significantly greater remission rates and longer overall survival; after study treatment discontinuation, overall fewer subsequent induction/salvage therapies (STs, mainly burdensome chemotherapies) were used in the InO group vs SC. Aims: To investigate the treatment of InO on the time to the first ST (TST) in the INO‐VATE trial. Methods: Study design was published. Adults with CD22+ ALL who were due to receive 1st or 2nd salvage treatment were randomized 1:1 to InO (n = 164) or SC (n = 162). TST was time from randomization to the start of the first ST. Pts who did not receive any ST were censored. Data cutoff: Jan 4, 2017. Results: Fewer InO pts had ST vs SC pts (Table). Among the censored pts, 83/108 (76.9%) in the InO vs 54/69 (78.3%) in the SC group died, 23/108 (21.3%) vs 5/69 (7.2%) were alive at the end of the study, and 2/108 (1.9%) vs 10/69 (14.5%) were no longer being followed for survival. TST was longer in pts receiving InO vs SC. Overall median (95% CI) TST was 18.8 (14.7–NA) vs 3.9 (2.4–5.1) months; hazard ratio (HR) = 0.34, 97.5% CI: 0.23–0.49, 1‐sided P &lt; 0.0001. For pts (InO: 85, SC: 126) who never received hematopoietic stem cell transplantation (HSCT) on study, fewer InO pts had ST vs SC pts; TST was significantly longer in InO vs SC. For pts (InO: 70, SC: 18) who had HSCT directly after salvage, TST was extended in InO vs SC. Summary/Conclusion: In this study, treatment with InO provided the benefit of extended TST, effectively allowing patients a longer time period until an ST was needed in both patients who proceeded to as well as those who did not proceed to HSCT. image