tbuckley/cabot-search huggingface dataset:
Prasterone (Intrarosa) for Dyspareunia
Authors: Rebecca Hayes, Michele Birch
Journal: JAMA (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Dual bronchodilation with tiotropium/olodaterol further reduces activity-related breathlessness <i>versus</i> tiotropium alone in COPD
Authors: François Maltais, Joseph-Leon Aumann, Anne-Marie Kirsten, Éric Nadreau, Hemani Macesic, Xidong Jin, Alan Hamilton, Denis E. O'Donnell
Journal: European Respiratory Journal (2019)

The 3-min constant speed shuttle test (CSST) was used to examine the effect of tiotropium/olodaterol compared with tiotropium at reducing activity-related breathlessness in patients with chronic obstructive pulmonary disease (COPD). This was a randomised, double-blind, two-period crossover study including COPD patients with moderate to severe pulmonary impairment, lung hyperinflation at rest and a Mahler Baseline Dyspnoea Index &lt;8. Patients received 6 weeks of tiotropium/olodaterol 5/5 µg and tiotropium 5 µg in a randomised order with a 3-week washout period. The speed for the 3-min CSST was determined for each patient such that an intensity of breathing discomfort ≥4 (“somewhat severe”) on the modified Borg scale was reached at the end of a completed 3-min CSST. After 6 weeks, there was a decrease in the intensity of breathlessness (Borg dyspnoea score) at the end of the 3-min CSST from baseline with both tiotropium (mean –0.968, 95% CI −1.238– −0.698; n=100) and tiotropium/olodaterol (mean −1.325, 95% CI −1.594– −1.056; n=101). The decrease in breathlessness was statistically significantly greater with tiotropium/olodaterol versus tiotropium (treatment difference −0.357, 95% CI −0.661– −0.053; p=0.0217). Tiotropium/olodaterol reduced activity-related breathlessness more than tiotropium in dyspnoeic patients with moderate to severe COPD exhibiting lung hyperinflation.
Abstract 24044: Therapeutic Effects of human Pluripotent Stem Cell-derived Lymphatic Endothelial Cells encapsulated with Nanomatrix Gel on Experimental Lymphedema
Authors: Shin-Jeong Lee, Young-Doug Sohn, Dongchan Sohn, Young-sup Yoon
Journal: Circulation (2017)

Background: Current systems generating lymphatic endothelial cell (LEC) from human induced pluripotent stem cells (hPSCs) have limited value due to low purity, the use of undefined components for differentiation, and poor cell survival in vivo. Here, we developed a fully defined system to differentiate hPSCs into LECs and evaluated their therapeutic and engraftment potential when encapsulated in a nanomatrix gel (PA-RGDS). Methods and Results: hPSCs were cultured with GSK3β inhibitor on collagen-coated plates for 2-3 days to induce differentiation into the mesodermal lineage. The mesodermally differentiated cells were then cultured with VEGFC, VEGFA, EGF, and bFGF for another 6 days and double-sorted by PDPN and FLT4. These hPSC-PDPN+FLT4+ cells (hPSC-derived lymphatic endothelial cells, hPSC-LECs) showed highly purified and fully functional LEC characteristics in vitro. These hPSC-LECs express LEC markers such as PDPN, LYVE1, PROX1, and FLT4 at the mRNA level and the protein level, and formed tube-like structures in Matrigel. We next determined the lymphatic vascular reparative effects of engineered hPSC-LECs. After inducing lymphedema in the tail of mouse, hPSC-LECs, hPSC-LECs encapsulated with PA-RGDS, human dermal lymphatic endothelial cells (hdLEC), PA-RGDS, or PBS were injected into the tail of mouse. Tail thickness significantly decreased in the groups injected with hPSC-LECs with or without PA-RGDS compared to the other groups at day 28. At day 45, mice injected with PA-RGDS encapsulated hPSC-LECs showed significant decrease in the tail diameter compared to all other groups including those injected with hPSC-LECs. Histological examination demonstrated that the skin thickness was significantly reduced and the density of lymphatic vessels was markedly increased when the hPSC-LECs were encapsulated with PA-RGDS compared to others. Conclusion: This study demonstrated for the first time that hPSC can be differentiated into LECs in a clinically compatible manner with a high yield. Furthermore, nanomatrix encapsulated hPSC-LECs can substantially improve lymphedema in mouse tail through enhancement of cell survival and lymphatic neovascularization. This engineered hPSC-LEC therapy represents a novel option for treating lymphedema.
Ibrutinib, Bendamustine, Rituximab Combination for Relapsed and Refractory Aggressive B Cell Lymphoma — Interim Analysis of Phase II Clinical Trial
Authors: Meirav Kedmi, Elena Ribakovsy, Ohad Benjamini, Ginette Schiby, Iris Barshack, Stephen P Raskin, Yael Eshet, Ramit Mehr, Guy Bitansky, Arnon Nagler, Abraham Avigdor
Journal: Blood (2018)
FRI0019 Are disease activity, disability or psychological factors most associated with patients with rheumatoid arthritis being satisfied with their condition after 12 months following treatment onset?
Authors: J. Gwinnutt, K. Hyrich, M. Lunt, A. Barton, S. Verstappen
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> An important treatment goal in the management of patients with rheumatoid arthritis (RA) is patients being satisfied with their condition, the patient acceptable symptom state (PASS). It is unclear whether reduction in disease activity, the main therapeutic aim of RA treatment, is associated with reaching PASS, or whether reductions in other factors are also important. <h3>Objectives</h3> To analyse change over one year of disease activity, patient reported outcomes (PROs) and psychological factors and their association with PASS at one year. <h3>Methods</h3> The Rheumatoid Arthritis Medication Study (RAMS) is a prospective cohort of patients with RA starting MTX for the first time in the United Kingdom. At baseline and one year, patients reported demographics and completed pain and fatigue visual analogue scales (VAS-pain/VAS-fatigue), the Hospital Anxiety and Depression Scale (HADS-A, HADS-D) and the Health Assessment Questionnaire (HAQ). A research nurse performed a 28 swollen and tender joint count (SJC28/TJC28) and the disease activity score (DAS28) was calculated. Patients answered the question “Is your current condition satisfactory, when you take your general functioning and your current pain into consideration?” at baseline and at one year. Only patients not in PASS at baseline are included in this analysis. Change in disease related factors (SJC28, TJC28, DAS28), PROs (HAQ, VAS-pain, VAS-fatigue), and psychological factors (HADS-A, HADS-D) from baseline to one year were calculated (see table 1). Predictors of PASS at one year were assessed using multivariable logistic regression, adjusting for age and gender. The discriminative power of disease activity, PROs and psychological factors were assessed by comparing the area under the curve (AUC) of the receiver operating characteristic curve. <h3>Results</h3> Of 358 not in PASS at baseline (mean (SD) age: 58.1 (13.0) years; 244 (68.2%) women), 241 (67.3%) were in PASS after one year. The only independent predictors of PASS were change in HAQ, VAS-pain and HADS-D (OR (95% CI) per unit change from baseline: HAQ 0.38 (0.16, 0.91); VAS-pain 0.96 (0.95, 0.98); HADS-D 0.86 (0.75, 0.99)). The model containing PROs had significantly greater AUC compared to a disease activity model (0.91 vs. 0.84, p=0.004) and a psychological factors model (0.91 vs. 0.81, p&lt;0.0001). <h3>Conclusions</h3> Change in PROs have a greater association with attaining PASS at one year compared to disease related or psychological factors and should be taken into account when designing treatment strategies. <h3>Disclosure of Interest</h3> None declared
Chronic Severe Pain and Use of Prescription Pain Medications in Older Survivors of Hematologic Malignancies (HM) Several Years after Treatment with Blood or Marrow Transplantation (BMT): A Report from BMTSS
Authors: Naveed Farrukh, Lindsey Hageman, Yanjun Chen, Jessica Wu, Emily Ness, Liton F. Francisco, Mariel Parman, Wendy Landier, Mukta Arora, Saro H. Armenian, Grant R Williams, Smita Bhatia
Journal: Blood (2018)
Platelet Transfusions in Neonates — Less Is More
Authors: Martha C. Sola-Visner
Journal: New England Journal of Medicine (2019)

Thrombocytopenia is common in preterm neonates. At some point during their stay in the neonatal intensive care unit, this condition affects up to 73% of infants with a birth weight of less than 1000 g.1 The smallest and most premature infants also have the highest incidence of bleeding; in approximately 30% of neonates born with a weight of less than 1500 g, an intracranial hemorrhage develops, usually in the first week of life.2 Because of the high rates of both thrombocytopenia and bleeding in this population, it has been widely accepted that preterm infants should receive platelet transfusions at higher . . .
OP0130 Risk of cancer in patients with psoriasis/psoriatic arthritis: a population-based study in the province of british columbia
Authors: J.A Avina-Zubieta, A. Dominique, T.A. Simon, H. Tavakoli
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psoriasis (PsO) is a relapsing chronic autoimmune disease of the skin. Up to one-third of patients (pts) also develop inflammatory arthritis, known as psoriatic arthritis (PsA). PsO/PsA, like other forms of chronic inflammatory arthritis, are often associated with complications such as cardiovascular disease and infections. However, data on the risk of cancer in pts with PsO/PsA at population level are limited. <h3>Objectives</h3> To assess the risk of cancer in pts with newly diagnosed PsO/PsA at the population level. <h3>Methods</h3> We created a population-based matched retrospective cohort of PsO/PsA pts diagnosed between 1 January 1997 and 31 December 2012 using administrative health data from British Columbia, Canada. We identified all incident cases of PsO/PsA and an equal number of controls matched on sex, age and calendar year. PsO/PsA cases met ≥1 of the following: 1 diagnostic code for PsO/PsA by a rheumatologist/dermatologist; ≥2 diagnostic codes for PsO/PsA, ≥2 months apart in a 2 year period by a non-rheumatologist/dermatologist; or ≥1 hospitalisation with diagnostic code for PsO/PsA. We evaluated incident cancers during follow-up from the Cancer Registry in both cohorts. Adjusted risk of cancers was estimated using a generalised estimating equation extension of multivariate Poisson regression models. <h3>Results</h3> We identified 81 568 incident cases of PsO/PsA (mean age 48.5 years [SD 17.8], 51.5% female). Individuals with PsO/PsA were at significantly higher risk of being diagnosed with 8/41 types of cancer examined, including eye and orbit (4 fold), female genital (3 fold), non-melanoma skin (2 fold), prostate (males; 1.1 fold) (table 1). Incidence of rectal and colon cancer was lower among PsO/PsA pts relative to the non-PsO/PsA cohort (table 1). PY=patient years <h3>Conclusions</h3> This general population-based study demonstrates that pts with PsO/PsA have an increased risk of several types of cancer, and a decreased risk of rectal and colon cancer. This association highlights the need to further explore potential risk factors and pathways that contribute to these complications. <h3>Acknowledgements</h3> This study received an unrestricted grant from Bristol-Myers Squibb for an investigator-initiated project in PsO/PsA. <h3>Disclosure of Interest</h3> J. A. Avina-Zubieta Grant/research support from: Bristol-Myers Squibb, A. Dominique Employee of: Bristol-Myers Squibb, T. Simon Employee of: Bristol-Myers Squibb, H. Tavakoli Grant/research support from: Bristol-Myers Squibb
FRI0007 Performance of musculoskeletal ultrasonography (MSUS) and optimal cutoff criteria for patients at risk for rheumatoid arthritis: a meta-analysis
Authors: A. Castro, J. Diaz, S. Kumar
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The identification of patients with rheumatoid arthritis (RA) in the early stages of the disease leads to early treatment and improved outcomes. MSUS is a relatively easy, accessible and low cost method, which has been proven more sensitive in detecting findings suggestive of inflammatory arthritis than clinical or radiographic exams. Evidence shows that MSUS seems to bring additional knowledge when assessing the joints on patients with suspected RA, however, there is still controversy whether it can improve substantial discriminatory value for early arthritis. <h3>Objectives</h3> To assess the diagnostic value of MSUS and optimal cutoff criteria for the diagnosis of RA in patients with arthralgia and non-classified arthritis. <h3>Methods</h3> We conducted a meta-analysis for original studies evaluating ultrasound on patients with arthralgias and non-classified arthritis, published in Pubmed, EMBASE and Cochrane databases until December 2017. Statistical analysis included <i>i)</i> the calculation of sensitivity and specificity for ultrasound <i>ii) summary receiver operating characteristic</i> (SROC) <i>curve</i>s for a linear regression model <i>iii)</i> I squared test for heterogeneity. <h3>Results</h3> Sixteen studies were included in the review. The overall sensitivity and specificity were 0.75 (95% CI 0.62, 0.88) and 0.72 (95% CI 0.60, 0.83) respectively. The overall diagnostic odds ratio (DOR) was 11.45 (95% CI 6.52, 20.11). The relative DOR for studies performed in Asia (10.43, p=0.002), published before 2013 (15.71, p=0.001) and involving MCP (11.27, p=0.003) and MTP (2.78, p=0.021) exhibited higher diagnostic performance. Meta-regression after adjusting for country, year, and type of joint involved, showed that Grey Scale (GS) ≥1 RDOR 6.0 (95% CI 1.6, 22.5; p=0.009) and Power Doppler (PD) ≥1 RDOR 3.9 (95% CI 1.3, 11.7, p=0.018) had greater diagnostic accuracy when compared to higher cutoff values. <h3>Conclusions</h3> MSUS is a valuable diagnostic tool when used in patients with arthralgia and at risk for RA. GS ≥1 and PD ≥1 combined have better discriminative ability for diagnosing RA due that the overall specificity is greater than for either alone. <h3>References</h3> [1] Lage-Hansen PR, et al. Rheumatol Int2017Feb;37(2):179–187. [2] Pratt AG, et al. Arthritis Res Ther2013;15:R118. <h3>Disclosure of Interest</h3> None declared
THU0618 Hypophosphatasia in french tertiary care hospitals
Authors: E. Ebstein, T. Thomas, B. Cortet, K. Briot, C. Roux
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Hypophosphatasia is a rare heritable metabolic disorder. Its prevalence is estimated at 1: 1 00 000. Its diagnosis can only be established after genetic confirmation. A low serum total alkaline phosphatase (ALP) level is the hallmark for the diagnosis of hypophosphatasia. Its prevalence is 0.05% in the general population and may be associated with symptoms similar to those of adult forms of hypophosphatasia: excess of joint pathology (chondrocalcinosis, osteoarthritis), periarticular disorders (calcifications, tendinopathies enthesopathies), and disorders of bone mineralization (risk of fracture). <h3>Objectives</h3> The aim of this study was to assess the recognition of persistent low ALP in 3 tertiary care hospitals in France. <h3>Methods</h3> All of the ALP assays of 3 tertiary care hospitals measured in 2013 were reviewed. Persistent hypophosphatasemia was defined by at least one assay &lt;30 IU/L without any assay &gt;40 IU/L. Selected records were analysed to eliminate secondary causes of hypophosphatasemia. A telephone questionnaire was conducted with included patients from the rheumatology and internal medicine departments. <h3>Results</h3> In 2013, 288,851 PAL assays were performed in 1 24 044 patients. Excluding emergency and intensive care unit services, 216,817 PAL assays were performed in 83 657 patients. 716 patients had a value ≤30 IU/L. Of these, 174 had 1 single dosage, 542 multiple dosages, of which 186 never had value &gt;40. 31 patients were excluded due to secondary hypophosphatasemia: severe caloric restriction (n=10), massive surgery (n=6), cancer/hemopathy (n=8), acute pathology -sepsis/voluntary drug intoxication (n=4), high-dose corticosteroid therapy (n=3)). 155 patients were selected; the prevalence of hypophosphatasemia in hospitals is therefore 0.124%. Hypophosphatasemia was noticed in the summary discharge in 1,3%. 4 patients received bisphosphonates despite low PAL (before treatment) and 2 patients had a fracture under treatment. Of the 155, 38 were followed in the rheumatology and internal medicine departments and 33 answered a standardised telephone questionnaire (78% women, average age 43.8 years). 11 patients reported a history of fracture, 2 patients had a history of rickets in childhood, and 1 had known hypophosphatasia in the family. 9 patients had tooth enamel disorders, 7 had gingival recession, 3 had spontaneous tooth loss, and 1 had lost their deciduous teeth by the age of 3 years. <h3>Conclusions</h3> The prevalence of hypophosphatasemia is higher in hospitals than in the general population. This biological anomaly is almost never recorded in the files. However, the existence of hypophosphatasemia should be systematically reported as it is a contraindication to anti-resorptive therapy because of the risk of atypical femoral fracture. <h3>Disclosure of Interest</h3> None declared
AB0757 Persistent crp elevation is associated with high morbidity in systemic sclerosis
Authors: A. Mitev, D. Feldmann, A.-M. Kanne, T. Hugle, P.M. Villiger, R.E. Voll, S. Finzel, F. Kollert
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Elevated levels of C-reactive protein (CRP) in systemic sclerosis (SSc) have been linked to early inflammatory stages of the disease. <h3>Objectives</h3> This study has been set to investigate CRP levels in a longitudinal cohort of SSc patients and to correlate these findings to comorbidities and disease characteristics. <h3>Methods</h3> In this retrospective study patients with SSc were recruited from the outpatient clinic of the Department of Rheumatology and Clinical Immunology, University Medical Centre Freiburg. Only patients with at least three consecutive visits at our centre over at least one year were included in this study. CRP serum levels were measured at every visit and categorised as positive if CRP concentrations were ≥5 mg/L. Subjects with elevated CRP levels at more than 80% of visits were defined as being persistently positive. The longitudinal CRP profile was correlated to comorbidities and disease characteristics. <h3>Results</h3> A total of 1852 consecutive visits of 131 SSc patients were analysed. Over the observed time span (91<sup>136–56</sup> months) 19% (n=25) of patients had continuously elevated CRP levels, whereas in 29% (n=38) CRP levels were always in the normal range. There was no association between disease duration and CRP levels at first visit (p&gt;0.5). Persistent CRP elevation was associated (p&lt;0.05) with anti-topoisomerase I-antibodies, diffuse cutaneous SSc (dcSSC), modified Rodnan skin score (mRSS), pulmonary fibrosis, and cardiac arrhythmia, whereas no associations with arthritis or malignancy were found (p&gt;0.1). In a patient with dcSSc and persistent elevated CRP even cyclophosphamide and autologous stem cell transplantation did not alter CRP levels. <h3>Conclusions</h3> Persistently elevated CRP levels characterise a more severe fibrotic phenotype and a higher prevalence of cardiac arrhythmias. <h3>Disclosure of Interest</h3> None declared
Guidance for programmatic management of latent tuberculosis infection in the European Union/European Economic Area
Authors: Senia Rosales-Klintz, Judith Bruchfeld, Walter Haas, Einar Heldal, Rein M.G.J. Houben, Femke van Kessel, Mike Mandelbaum, Alberto Matteelli, Giovanni Battista Migliori, Anouk Oordt-Speets, Ivan Solovic, Martina Vašáková, Suzanne Verver, Sake J. de Vlas, Marije J.M. Vonk Noordegraaf-Schouten, Gerard de Vries, Dominik Zenner, Marieke J. van der Werf
Journal: European Respiratory Journal (2019)

Worldwide efforts are being made to end tuberculosis (TB) by 2035 following the ambitions outlined in the World Health Organization (WHO) End TB strategy [1] and the United Nations Sustainable Development Goals [2]. Countries with a low incidence of TB, i.e. less than 10 incident cases per 100 000 population per year, should strive for TB elimination [3]. To this end, timely detection and treatment of latent tuberculosis infection (LTBI) is an important intervention [3]. Currently, the existence and implementation of national strategies including public health interventions targeting LTBI is heterogeneous across the European Union/European Economic Area (EU/EEA) [4]. To support the EU/EEA countries with developing national policies, as well as the planning and implementation of programmatic management of LTBI into national strategies for TB control, the European Centre for Disease Prevention and Control (ECDC) conducted a comprehensive assessment of the available evidence and developed an evidence-based guidance [5]. The guidance, published in October 2018, elaborates on population-level measures for LTBI management tailored to the EU/EAA context and it is complementary to the WHO guidelines [6]. Here, we summarise the process that was followed to develop the guidance and we outline the key components proposed for programmatic management of LTBI, to inform European healthcare professionals. Management of latent tuberculosis infection is crucial to end TB in low-incidence settings <http://ow.ly/pEcD30mJ8zL>