tbuckley/cabot-search huggingface dataset:
THU0651 The influence of age, gender, employment status, or education on the choice of bio-similar vs. bio-original variant of the same bdmard in patients with ra or as starting biological therapy – real life data from the czech biologics registry attra
Authors: J. Zavada, L. Nekvindova, K. Pavelka, J. Vencovsky
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Perceptions on bio-originator (bo) and bio-similar (bs) biologics among HCPs and pts, as well administrative regulations or economic incentives may influence their utilisation in clinical practice. The ATTRA registry captures more than 95% of pts with RA and AS treated with biologics in the Czech Republic (CZ). Access to biological therapy in CZ is limited to about 30 authorised centres. Bs infliximab (INF) has been prescribed in CZ since 11/2013, and bs etanercept (ETA) since 1/2016 concurrently with bo INF and ETA. There has been no administrative regulation concerning the use of bs or bo in CZ. <h3>Objectives</h3> To explore whether age, gender, employment status, or level of education influence the choice of bs vs. bo variant of the same bDMARD in pts with RA or AS starting bDMARD in CZ. <h3>Methods</h3> Data from the ATTRA registry on pts with RA or AS starting their first bDMARD between 11/2013 and 10/2017 were used. The start of bo vs. bs ETA, or bo vs. bs INF as the first bDMARD was the main outcome of interest. Multivariate logistic regression analysis was used to explore the impact of education, employment status, age and gender on the start of a first bDMARD after adjustment for disease characteristics, and the bDMARD molecule. <h3>Results</h3> 560 pts started ETA (22.6% bo, 14.2% bs) or INF (9.7% bo, 53.5% bs) in the study time frame. In the multivariate model (<b>table 1</b>) pts starting ETA (ref. INF) had lower odds to receive a bs (OR 0.11, CI95% 0.07–0.17), and pts with primary education (vs. secondary or tertiary) had higher odds to receive any bs (OR 1.84, CI95% 1.08–3.13). When we performed separate analyses for pts treated in academic/public hospitals (n=314), the adjusted OR for pts with primary education was 0.78 (CI95% 0.37–1.64), while in private centres (n=246) the OR was 5.32 (CI 95% 2.32–12.16). When we introduced an interaction term for type of practice x level of education, the adjusted OR for pts with primary education in private centres was 2.26 (CI95%, 1.14–4.46, p=0.019). <h3>Conclusions</h3> We found that in private centres providing biological therapy in CZ, pts with primary education had higher adjusted odds to obtain bs as the first bDMARD. We cannot exclude that different pt characteristics and residual confounding may have been involved. The interpretation is complex and related not only to perception of bs by HCPs and pts, but also to unmeasured economic incentives and other factors. <h3>Acknowledgements</h3> This work was supported by the project (Ministry of Health, Czech Republic) for consensual development of research organisation 0 23 728 <h3>Disclosure of Interest</h3> None declared
Abstract 16941: Machine Learning Enhanced Predictions of Hospital Readmission or Death in Heart Failure
Authors: Zhaohui Su, Tom Brecht, Francis O'Donovan, Costas Boussios, Vandana Menon, Rich Gliklich, Gregg Fonarow
Journal: Circulation (2017)

Introduction: Readmissions are common, costly and often preventable. The LACE risk score is an established index to quantify the risk of readmission or death. We used machine learning to develop a ...
AB0952 High prevalence of inflammatory and non-inflammatory liver and gastrointestinal diseases in young patients with psoriatic arthritis: a hospital-based study
Authors: N. Batkaeva, E. Batkaev, T. Korotaeva
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psoriatic arthritis (PsA) is associated with numerous comorbidities, including gastrointestinal (GI) and liver diseases (LD). But there is limited data about the prevalence of these disorders among patients (pts) with PsA and severe psoriasis (PsO) in Russian population. <h3>Objectives</h3> to evaluate the prevalence of LD and GIT comorbidity in a hospital-based cohort of PsA pts. <h3>Methods</h3> 417 (304 Male (M.)/113 Female (F.) PsA pts, according the CASPAR criteria, mean age 38.5±11.3/36.1±11.0 years (yrs) accordingly, PASI 49,4±0.56, PsA duration 6.6±7.4 years were included. PsA pts with all GIT and LD, including Diseases of oesophagus, stomach and duodenum (K20–K31), Disorders of gallbladder, biliary tract and pancreas (K80–K87), Alcoholic and toxic liver disease (K70–K77) (LD), Viral hepatitis (B15–B19) (VH), non-infectious enteritis and colitis (K55-K63) NEC) were identify in the hospital Database and coding by International Statistical Classification of Disease and Related Health Problems (ICD-10) between 2010–2015 years. M±m, t-test, (%) were calculated. All p&lt;0.05 were considered to indicate statistical significance. <h3>Results</h3> 229 (159 – M./70 – F.) out of 417 pts (54.9%) had LD and GIT disorders. Gallbladder, biliary tract and pancreas disease coding as K80–K87 were found in significantly more cases in F. compare to M. pts – in 26 out of 70 pts (37.4%) and in 31 out of 159 pts (19.4%) accordingly (p&lt;0.05). NEC coding as K55-K63 was found in M. only – in 1 out of 159 (0.62%) pts. Diseases of oesophagus, stomach and duodenum coding as K20–K31 were found in 96 out of 229 pts (42%). All of the alcoholic, toxic and viral liver disease were found in 75 out of 229 pts (32.75%). LD coding as K70–K77 were found in 33 out of 75 pts (44%). VH coding as B15–B19 were found in 42 out of 75 pts (56%). No significantly gender differences were found in those group of pts. <h3>Conclusions</h3> GIT and LD were found in more than half of young pts with PsA and severe PsO. That information should be taken in account during the choice of safety therapy in this group of pts. <h3>Disclosure of Interest</h3> None declared
SAT0641 Performance and agreement of different operators and histological techniques for the assessment of germinal centres in minor salivary glands in primary sjÖgren’s syndrome
Authors: A. Alunno, P. Cipriani, G. Coletti, B. Bigerna, M. Manetti, P. Di Benedetto, O. Bistoni, G. Cipolloni, V. Liakouli, P. Ruscitti, R. Gerli, R. Giacomelli, F. Carubbi
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> A standardisation of minor salivary gland (MSG) histopathology in primary Sjögren's syndrome (pSS) has been recently proposed by the EULAR study group on Sjögren's syndrome. Although there is strong agreement that germinal centres (GCs) should be routinely identified, due to their prognostic value, a consensus regarding the best protocol is still lacking. <h3>Objectives</h3> Aim of this study was to compare the performance of different histological techniques and operators with variable experience in MSG histopathology to identify GCs in pSS MSGs. <h3>Methods</h3> MSG biopsies from 50 pSS patients were studied. Three blinded operators (expert rheumatologist, expert pathologist and rheumatologist with scarce experience on MSG histopathology) scored one slide stained with haematoxilin and eosin (H and E). Consecutive slides were processed by immunofluorescence and immunohistochemistry to assess CD3/CD20, CD21 and Bcl-6 expression. <h3>Results</h3> Overall, the prevalence of GC in MSG specimens (namely the presence of at least one focus positive for at least one operator or histological technique) ranged between 26% and 52%. By separate assessment of 225 foci, the best agreement was between H and E-stained sections evaluated by the expert rheumatologist and CD3/CD20 segregation (Cohen's kappa=0.72). In the foci with CD21 positivity, the agreement with the expert rheumatologist further increased (Cohen's kappa=0.75). Among the 3 methods employed, the best agreement was observed between B/T-cell segregation and the positivity for CD21 staining (0.84). The absence of Bcl-6 in a focus does not necessarily rule out the presence of the GC detected with other stainings, <h3>Conclusions</h3> GC assessment on H and E-stained sections should be performed with caution, as it is dependent on the background and expertise of the operator. The combination of H and E with CD3/CD20 and CD21 staining should be recommended as it is reliable, feasible, able to overcome the bias of operator experience and easily transferrable into routine practice. <h3>Disclosure of Interest</h3> None declared
Using Healthcare Claims Data to Analyze the Prevalence of Chronic Myeloid Leukemia in France: A Nationwide Population-Based Study
Authors: Stephanie Foulon, Pascale Cony-Makhoul, Agnes Guerci-Bresler, Marc Delord, Eric Solary, Alain Monnereau, Julia Bonastre, Pascale Tubert Bitter
Journal: Blood (2018)
Connexin-43 Is a Negative Regulator of Mitochondrial Fission, Mitophagy and Apoptosis of Dividing Hematopoietic Stem Cells through the Drp1-Pink1 Axis
Authors: Abhishek K Singh, Karin Golan, Mark J Althoff, Ekaterina Petrovich-Kopitman, Ashley M Wellendorf, Fatima Mohmoud, Mayla Bertagna, Daniel Gonzalez-Nieto, Luis C Barrio, Tsvee Lapidot, Jose A Cancelas
Journal: Blood (2018)
THU0633 Acute from of sarcoidosis (LÖFGREN SYNDROME) in rheumatology practice
Authors: O.N. Egorova, B.S. Belov, S.G. Radenska-Lopovok
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> <i>Löfgren syndrome</i> (LS) is the acute form of sarcoidosis, characterised by erythema nodosum (EN), joints involvement, fever and intrathoracic lymphadenopathy. LS clinical polymorphism leads to diagnostic errors. <h3>Objectives</h3> To study the clinical, laboratory and radiological features of early stages of sarcoidosis in a cohort of patients referred to rheumatology centre. <h3>Methods</h3> The study included 125 patients (104 females and 21 males, mean age 42±12 y) with clinical and radiological features of LS. All patients were referred to rheumatology centre with EN diagnosis. The median duration of disease was 1 (0,5–2,0) months. All patients were subjected to comprehensive clinical and laboratory-instrumental examination, including biochemical panel and immunological parameters, chest X-ray or CT, as well as (15 cases) histopathology examination of nodular biopsy specimens of the skin and subcutaneous fat. <h3>Results</h3> In 97% pts EN involved the lower legs, mostly the anterior surface, in 35% - the hips, in 25% - the upper limbs and in 3% - the trunk. Symmetric lesions were documented in 50% of patients. Confluence of nodules forming conglomerates was registered in 48% pts. The involvement of more than 50% of lower leg surface (68%) was directly associated with the number of nodules (p&lt;0.001; r=0.60) and C-reactive protein level (p=0.006; r=0,38). There was a direct correlation between the number of nodules and EN duration (p=0.04; r=0.20), and also the tendency to nodules confluence (p&lt;0.001; r=0,39). Joint involvement was documented in 106 (85%) patients, with predominantly ankle (66,4%) and knee (40%) joints affected. Asymmetry of joint involvement was documented in 8% pts. Articular manifestations preceded the emergence of EN in 35 (28%) patients by mean 12±9 days. There was a significant direct correlation between the duration of articular syndrome and appearance of nodules and their number (p=0.02; r=0.45). Joint involvement after EN manifestation – in an average 12±7 days – was documented in 10% of cases. Male gender (odds ratio (OR) 6.5; confidence interval (CI) 1.2–35; p=0,026) and presence of nodular conglomerates (OR 4,8; CI 1.4–16.1; p=0.01) were the key predictors of ground glass opacity (GGO) CT phenomenon. In 90% of patients EN did not relapse, and articular syndrome almost completely regressed during 1 year follow-up. <h3>Conclusions</h3> Patients with an acute form of sarcoidosis require coordinated action of different medical specialties, including rheumatologists, to determine the scope of further examination and adequate therapeutic regimen. <h3>Disclosure of Interest</h3> None declared
Endoscopic ultrasound-guided fine needle injection of alcohol for ablation of an insulinoma: a well documented successful procedure
Authors: Flávio Silva, Rogério Colaiacovo, Osvaldo Araki, Anna Fernanda Domene, José Lima Junior, André de Moricz, Lucio Rossini
Journal: Endoscopy (2019)

A 21-year-old woman presented with recurrent hypoglycemia, syncope, and episodic seizures, associated with rapid weight gain (body mass index [BMI] 60). Hyperinsulinemia was confirmed and she was started on treatment with diazoxide. Magnetic resonance imaging showed a 1.5-cm nodule at the pancreatic head. Endoscopic ultrasound (EUS) confirmed a 1.5-cm hyperechoic nodule within the pancreatic head, between the common bile duct and the main pancreatic duct. EUS-guided fine needle aspiration (EUS-FNA) was performed with a 22-gauge needle (Echo-Tip; Cook Medical, Limerick, Ireland) ([Fig. 1]) and the definitive diagnosis of an insulinoma was established by immunohistochemical analysis ([Fig. 2]).
FRI0154 Added value of biomarkers compared to routine clinical parameters for the prediction of radiographic spinal progression in axial spondyloarthritis
Authors: J. Rademacher, L. Tietz, L. Le, A. Hartl, M. Rudwaleit, J. Sieper, U. Mansmann, D. Poddubnyy
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Structural damage in the spine determines the functional status and spinal mobility in axial spondyloarthritis (axSpA). Already present syndesmophytes, elevated C-reactive protein, cigarette smoking, and to a lesser extent male sex are routine clinical parameters predicting radiographic spinal progression. In the last years, several biomarkers with a predictive value for radiographic spinal progression were identified. It is, however, not known, if biomarkers have a meaningful added value over clinical parameters in prediction of radiographic spinal progression in axSpA. <h3>Objectives</h3> The objective of the study was to examine whether adding biomarkers to the routine clinical parameters would improve prediction of radiographic spinal progression in axSpA. <h3>Methods</h3> Altogether 117 patients with ankylosing spondylitis who completed a 2 year clinical and radiographic follow-up in the ENRADAS trial were included. Radiographic spinal progression was defined as a worsening of the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) by ≥2 points after 2 years. A clinical prediction model for radiographic spinal progression was constructed out of already present syndesmophytes, elevated CRP, cigarette smoking, and male sex. Serum biomarkers measured at baseline included: matrix metalloproteinase-3, vascular endothelial growth factor (VEGF), calprotectin, leptin, high molecular weight adiponectin (HMW-APN), osteoprotegerin, sclerostin, N-terminal telopeptide, procollagen type II N-terminal propeptide, and serum amyloid A. <h3>Results</h3> Repeated cross-validation analyses revealed the following biomarker combination with added predictive value for radiographic progression compared to the clinical model (syndesmophytes, smoking, elevated CRP, and sex): Leptin +HWM-APN+VEGF. A combination of these biomarkers resulted in an Area Under the Curve (AUC) of AUC<sub>Biomarkers</sub>=0.731 (95%CI 0.614–0.848), thus numerically superior to the clinical model (AUC<sub>Clinical</sub>=0.665 (95%CI 0.553–0.776)). A combination of both models resulted in improvement of the predictive value reflected by the AUC<sub>Clinical+Biomarkers</sub>=0.768 (95%CI 0.666–0.871); though this improvement was not statistically significant compared to the clinical model in the permutation test (p=0.051). However, when only considering the part of receiver operating characteristic (ROC) curves with a specificity of ≥75%, the improvement becomes statistically significant (partial AUC<sub>Clinical+Biomarkers</sub>=0.119 versus partial AUC<sub>Clinical</sub>=0.053; p=0.010). <h3>Conclusions</h3> Biomarkers are able to improve prediction of radiographic spinal progression in axSpA, especially if used in addition to the clinical parameters, but the added value seems to be rather small. <h3>Disclosure of Interest</h3> None declared
Acute Microvascular Impairment Post-Reperfused STEMI Is Reversible and Has Additional Clinical Predictive Value
Authors: Alessandra Borlotti, Michael Jerosch-Herold, Dan Liu, Dafne Viliani, Alessia Bracco, Mohammad Alkhalil, Giovanni Luigi De Maria, Keith M. Channon, Adrian P. Banning, Robin P. Choudhury, Stefan Neubauer, Rajesh K. Kharbanda, Erica Dall’Armellina
Journal: JACC. Cardiovascular imaging (2019)

This study sought to investigate the clinical utility and the predictive relevance of absolute rest myocardial blood flow (MBF) by cardiac magnetic resonance (CMR) in acute myocardial infarction.Microvascular obstruction (MVO) remains one of the worst prognostic factors in patients with reperfused ST-segment elevation myocardial infarction (STEMI). Clinical trials have focused on cardioprotective strategies to maintain microvascular functionality, but there is a need for a noninvasive test to determine their efficacy.A total of 64 STEMI patients post-primary percutaneous coronary intervention underwent 3-T CMR scans acutely and at 6 months (6M). The protocol included cine function, T2-weighted edema imaging, pre-contrast T1 mapping, rest first-pass perfusion, and late gadolinium enhancement imaging. Segmental MBF, corrected for rate pressure product (MBFcor), was quantified in remote, edematous, and infarcted myocardium.Acute MBFcor was significantly reduced in infarcted myocardium compared with remote MBF (MBFinfarct 0.76 ± 0.20 ml/min/g vs. MBFremote 1.02 ± 0.21 ml/min/g, p < 0.001), but it significantly increased at 6M (MBFinfarct 0.76 ± 0.20 ml/min/g acute vs. 0.85 ± 0.22 ml/min/g at 6M, p < 0.001). On a segmental basis, acute MBFcor had incremental prognostic value for infarct size at 6M (odds of no LGE at 6M increased by 1.4:1 [p < 0.001] for each 0.1 ml/min/g increase of acute MBFcor) and functional recovery (odds of wall thickening >45% at 6M increased by 1.38:1 [p < 0.001] for each 0.1 ml/min/g increase of acute MBFcor). In subjects with coronary flow reserve >2 or index of myocardial resistance <40, acute MBF was associated with long-term functional recovery and was an independent predictor of infarct size reduction.Acute MBF by CMR could represent a novel quantitative imaging biomarker of microvascular reversibility, and it could be used to identify patients who may benefit from more intensive or novel therapies.
Locoregional Therapy, Immunotherapy and the Combination in Hepatocellular Carcinoma: Future Directions
Authors: Meaghan S. Dendy, Johannes M. Ludwig, Stacey M. Stein, Hyun S. Kim
Journal: Liver Cancer (2019)

Image-guided locoregional therapies (LRTs) have long been a vital part of treatment regimens for hepatocellular carcinoma (HCC). Ablation, chemoembolization, and radioembolization are examples of commonly used treatment techniques for HCC. This review describes the various methods utilized to treat HCC in the field of interventional oncology and also focuses on new and novel treatment concepts being developed in the field including the use of novel immunotherapy agents and combination therapy of LRTs with immunotherapy.
Right Ventricular–Pulmonary Artery Coupling—Let’s Not Lose the Forest for the Trees—Reply
Authors: Kotaro Nochioka, Amil M. Shah
Journal: JAMA Cardiology (2019)

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PRMT5-mediated H4R3sme2 Confers Cell Differentiation in Pediatric B-cell Precursor Acute Lymphoblastic Leukemia
Authors: Mei Mei, Ruidong Zhang, Zhong-Wei Zhou, Zhengzhou Ying, Jincheng Wang, Han Zhang, Huyong Zheng, Shilai Bao
Journal: Clinical Cancer Research (2019)

Little is known about the function of histone arginine methylation in acute lymphoblastic leukemia (ALL). The objective was to evaluate whether protein arginine methyltransferase 5 (PRMT5) plays a role in pediatric ALL and to determine the possible mechanism of epigenetic regulation.We used bone marrow samples from patients with pediatric ALL, the Nalm6 cell line, mature B-cell lines, and mouse xenograft models to evaluate the function of PRMT5 in ALL tumorigenesis.This study showed that PRMT5 and the symmetric dimethylation of H4R3 (H4R3sme2) were upregulated in most initially diagnosed (n = 15; 100%) and relapsed (n = 4; 75%) bone marrow leukemia cells from patients with pediatric B-cell precursor ALL (BCP-ALL) and were decreased when the disease was in remission (n = 15; 6.7%). Downregulation of H4R3sme2 by PRMT5 silencing induced BCP-ALL cell differentiation from the pre-B to immature B stage, whereas overexpressed PRMT5 with enhanced H4R3sme2 promoted human mature B cells to dedifferentiate back to the pre-B II/immature B stages in vitro. High PRMT5 expression enhanced the proportion of CD43+/B220+/sIgM- B leukocytes in recipient mice. CLC and CTSB were identified as potential target genes of PRMT5 in BCP-ALL cells and were inhibited by H4R3sme2 in gene promoters.We demonstrate that enhanced PRMT5 promotes BCP-ALL leukemogenesis partially by the dysregulation of B-cell lineage differentiation. H4R3sme2 and PRMT5 may serve as potential sensitive biomarkers of pediatric BCP-ALL. Suppression of the activation of PRMT5 may offer a promising therapeutic strategy against pediatric BCP-ALL.