tbuckley/cabot-search huggingface dataset:
Treatment of rheumatoid arthritis
Authors: Paul Emery
Journal: BMJ (2006)

Rheumatoid arthritis is a systemic disease that affects the synovial joints. It is a persistent chronic disease that spreads from joint to joint and affects about 0.5% of people worldwide. Not that long ago it was believed that antirheumatic therapy made little, if any, difference to the long term outcome of the disease.1 It was thought to be difficult to see patients appropriately early enough in the disease's progression, that an accurate diagnosis was not possible, and that therapies were ineffective. All this has now changed and this review examines these changes.



Fig 1 
Normal radiograph of metacarpal phalangeal joint (left) and same joint on ultrasonography (middle) and magnetic resonance imaging (right) showing erosions. M=metacarpus; P=phalange. Arrows represent erosions



I obtained references from Medline, my personal archives, and the proceedings of the last two major international meetings—the European League against Rheumatism, Vienna and the American College of Rheumatology, San Diego. Search terms used were “inflammatory arthritis”, “rheumatoid arthritis”, “early rheumatoid arthritis”, “therapy”, “biologics”, “biologicals”, “anti-TNF therapy”, “DMARDS”, and “NSAIDs”.

The standard treatment of patients with rheumatoid arthritis has included non-steroidal anti-inflammatory drugs. Although these drugs improve symptoms and signs, they do little to alter the structural progression and long term disability associated with rheumatoid arthritis. In the past, further therapy using disease modifying antirheumatic drugs was only prescribed when there was radiographic evidence of erosions (holes in bones). Disease modifying antirheumatic drugs were thought to reduce the damage shown on radiographs (disease modification), but although objective evidence for this effect was hard to obtain, proof has now been unequivocally shown. Disease modifying antirheumatic drugs are thought to act by direct or indirect inhibition of cytokines, unlike non-steroidal anti-inflammatory drugs, which act mainly by inhibiting cyclooxygenase and thereby reducing the production of inflammatory prostaglandins (inhibiting symptoms but not influencing structural damage).

The …
Recovery from COVID-19 in a patient with spondyloarthritis treated with TNF-alpha inhibitor etanercept
Authors: Pierre-Marie Duret, Eden Sebbag, Auriane Mallick, Simon Gravier, Lionel Spielmann, Laurent Messer
Journal: Annals of the Rheumatic Diseases (2020)

The novel coronavirus (severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), responsible for the coronavirus disease 2019 (COVID-19)) outbreak is a major public health concern worldwide, while it is spreading globally.

It is not yet known whether immunomodulatory treatments used in patients with autoimmune and rheumatic diseases are associated with better or poorer outcomes over the course of COVID-19.

We report the case of a recovery from COVID-19 in a 60-year-old immunocompromised man, treated with tumour necrosis factor-alpha (TNF-α) inhibitor (the soluble TNF receptor: etanercept 50 mg, subcutaneous, weekly) and methotrexate (20 mg subcutaneous, weekly), for spondyloarthritis.

One week after the categorisation of eastern France as a new cluster of COVID-19 and 2 days after the weekly subcutaneous injection of 50 mg etanercept, the patient developed fever (up to 39°C), cough, myalgias and diarrhoeas. Five days after the onset of symptoms, the patient was referred to the local emergency department where the SARS-CoV2 was detected by real-time reverse transcription (RT)-PCR on a nasopharyngeal swab. There was no sign of respiratory …
Controlled Dynamics of Neural Tumor Cells by Templated Liquid Crystalline Polymer Networks
Authors: Jinghua Jiang, Netra Prasad Dhakal, Yubing Guo, Christian Andre, Lauren Thompson, Omar Skalli, Chenhui Peng
Journal: Advanced Healthcare Materials (2020)

Abstract The ability to control the alignment and organization of cell populations has great potential for tissue engineering and regenerative medicine. A variety of approaches such as nano/microtopographical patterning, mechanical loading, and nanocomposite synthesis have been developed to engineer scaffolds able to control cellular properties and behaviors. In this work, a patterned liquid crystal polymer network (LCN) film is synthesized by using a nematic liquid crystal template in which the molecular orientations are predesigned by photopatterning technique. Various configurations of polymer networks such as linear and circular patterns are created. When neural tumor cells are plated onto the templated LCN films, the cell alignment, migration, and proliferation are directed in both linear and curvilinear fashions following the pattern of the aligned polymer chains. A complex LCN pattern with zigzag geometry is also fabricated and found to be capable of controlling cell alignment and collective cellular organization. The demonstrated control of cell dynamics and organization by LCN films with various molecular alignments opens new opportunities to design scaffolds to control cultured cell organization in a manner resembling that found in tissues and to develop novel advanced materials for nerve repair, tissue engineering, and regenerative medicine applications.
Abstract 15689: Adaptive Cardiac Remodeling to Chronic Pressure Overload Requires the Expression of Placental Growth Factor in the Spleen and Deployment of Adaptive/Reparative Macrophages to the Left Ventricle
Authors: Daniela Carnevale, Sara Perrotta, Giuseppe Cifelli, Valentina Fardella, Raimondo Carnevale, Giuseppe Lembo
Journal: Circulation (2018)

Introduction: Cardiac remodeling is the process established by the left ventricle (LV) to respond to different challenging stimuli. Although immunity has been clearly shown to participate to LV rem...
Abstract 14886: First-year vs Long-term Assessment of Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults
Authors: Quanhe Yang, Anping Chang, Matthew D Ritchey, Fleetwood Loustalot
Journal: Circulation (2017)

Introduction: Higher levels of antihypertensive medication adherence lowers risk for cardiovascular disease (CVD), but medication adherence frequently fluctuates over time. Few studies examined eff...
We call for iCAALL: International Collaboration in Asthma, Allergy and Immunology
Authors: Jan Lötvall, Ruby Pawankar, Dana V. Wallace, Cezmi A. Akdis, Lanny J. Rosenwasser, Richard W. Weber, A. Wesley Burks, Thomas B. Casale, Richard F. Lockey, Nikolaos G. Papadopoulos, Stanley M. Fineman, Dennis K. Ledford
Journal: Journal of Allergy and Clinical Immunology (2012)
Corrigendum to: “BAP1 mutations define a homogeneous subgroup of hepatocellular carcinoma with fibrolamellar-like features and activated PKA” [J Hepatol (2020) 1–13]
Authors: Théo Z. Hirsch, Ana Negulescu, Barkha Gupta, Stefano Caruso, Bénédicte Noblet, Gabrielle Couchy, Quentin Bayard, Léa Meunier, Guillaume Morcrette, Jean-Yves Scoazec, Jean-Frédéric Blanc, Giuliana Amaddeo, Jean-Charles Nault, Paulette Bioulac-Sage, Marianne Ziol, Aurélie Beaufrère, Valérie Paradis, Julien Calderaro, Sandrine Imbeaud, Jessica Zucman-Rossi
Journal: Journal of Hepatology (2020)
Reply to Francesco Montorsi, Marco Bandini, and Andrea Necchi’s Letter to the Editor re: Malte W. Vetterlein, Jakob Klemm, Philipp Gild, et al. Improving Estimates of Perioperative Morbidity After Radical Cystectomy Using the European Association of Urology Quality Criteria for Standardized Reporting and Introducing the Comprehensive Complication Index. Eur Urol 2020;77:55–65
Authors: Malte W. Vetterlein, Philipp Gild, Margit Fisch, Michael Rink
Journal: European Urology (2020)
An International Collaborative Consensus Statement on En Bloc Resection of Bladder Tumour Incorporating Two Systematic Reviews, a Two-round Delphi Survey, and a Consensus Meeting
Authors: Jeremy Yuen-Chun Teoh, Steven MacLennan, Vinson Wai-Shun Chan, Jun Miki, Hsiang-Ying Lee, Edmund Chiong, Lui-Shiong Lee, Yong Wei, Yuhong Yuan, Chun-Pong Yu, Wing-Kie Chow, Darren Ming-Chun Poon, Ronald Chan, Fernand Lai, Chi-Fai Ng, Alberto Breda, Mario Wolfgang Kramer, Bernard Malavaud, Hugh Mostafid, Thomas Herrmann, Marek Babjuk
Journal: European Urology (2020)
Nutrition, Thrombosis, and Cardiovascular Disease
Authors: Francesco Violi, Daniele Pastori, Pasquale Pignatelli, Roberto Carnevale
Journal: Circulation Research (2020)

Previous studies reported an inverse association between healthy dietary patterns (such as Mediterranean diet) and the incidence of cardiovascular events. As the mechanism accounting for cardiovascular disease is prevalently due to the atherothrombosis, where a pivotal role is played by platelet activation, it would be arguable that diets with protective effects against cardiovascular disease exert an anti-atherothrombotic effect via inhibition of platelet activation. There are several and sparse typologies of studies, which investigated if single nutrients by diets recognized as having cardiovascular protection may exert an antithrombotic effect. The most investigated nutrients are key components of the Mediterranean diets such as fruits and vegetables, fish, olive oil, and wine; other diets with protective effects include nuts and cocoa. Here we summarize experimental and human interventional studies which investigated the antithrombotic effects of such nutrients in experimental models of thrombosis or analyzed biomarkers of clotting, platelet, and fibrinolysis activation in human; furthermore in vitro studies explored the underlying mechanism at level of several cell lines such as platelets or endothelial cells. In this context, we analyzed if nutrients affect simultaneously or separately clotting, platelet, and fibrinolysis pathways giving special attention to the relationship between oxidative stress and thrombosis as most nutrients are believed to possess antioxidant properties.
Human erythroleukemia genetics and transcriptomes identify master transcription factors as functional disease drivers
Authors: Alexandre Fagnan, Frederik Otzen Bagger, Maria-Riera Piqué-Borràs, Cathy Ignacimouttou, Alexis Caulier, Cécile K. Lopez, Elie Robert, Benjamin Uzan, Véronique Gelsi-Boyer, Zakia Aid, Cécile Thirant, Ute Moll, Samantha Tauchmann, Amina Kurtovic-Kozaric, Jaroslaw Maciejewski, Christine Dierks, Orietta Spinelli, Silvia Salmoiraghi, Thomas Pabst, Kazuya Shimoda, Virginie Deleuze, Hélène Lapillonne, Connor Sweeney, Véronique De Mas, Betty Leite, Zahra Kadri, Sébastien Malinge, Stéphane de Botton, Jean-Baptiste Micol, Benjamin Kile, Catherine L. Carmichael, Ilaria Iacobucci, Charles G. Mullighan, Martin Carroll, Peter Valent, Olivier A. Bernard, Eric Delabesse, Paresh Vyas, Daniel Birnbaum, Eduardo Anguita, Loïc Garçon, Eric Soler, Juerg Schwaller, Thomas Mercher
Journal: Blood (2020)
CRISPR interference-mediated noggin knockdown promotes BMP2-induced osteogenesis and calvarial bone healing
Authors: Mu-Nung Hsu, Fu-Jen Yu, Yu-Han Chang, Kai-Lun Huang, Nam Ngoc Pham, Vu Anh Truong, Mei-Wei Lin, Nuong Thi Kieu Nguyen, Shiaw-Min Hwang, Yu-Chen Hu
Journal: Biomaterials (2020)
Accurate diagnosis of lymphoma on whole-slide histopathology images using deep learning
Authors: Charlotte Syrykh, Arnaud Abreu, Nadia Amara, Aurore Siegfried, Véronique Maisongrosse, François X. Frenois, Laurent Martin, Cédric Rossi, Camille Laurent, Pierre Brousset
Journal: npj Digital Medicine (2020)

Histopathological diagnosis of lymphomas represents a challenge requiring either expertise or centralised review, and greatly depends on the technical process of tissue sections. Hence, we developed an innovative deep-learning framework, empowered with a certainty estimation level, designed for haematoxylin and eosin-stained slides analysis, with special focus on follicular lymphoma (FL) diagnosis. Whole-slide images of lymph nodes affected by FL or follicular hyperplasia were used for training, validating, and finally testing Bayesian neural networks (BNN). These BNN provide a diagnostic prediction coupled with an effective certainty estimation, and generate accurate diagnosis with an area under the curve reaching 0.99. Through its uncertainty estimation, our network is also able to detect unfamiliar data such as other small B cell lymphomas or technically heterogeneous cases from external centres. We demonstrate that machine-learning techniques are sensitive to the pre-processing of histopathology slides and require appropriate training to build universal tools to aid diagnosis.
PTH-055 Outcomes of a tertiary centre’s real world experience with colonic self expanding metal stents (SEMS)
Authors: Caroline Louise Sharratt, Hafiz Muhammad Umair, Saher Sultan, Martin James, Steve Ryder, Guru Aithal, Krish Ragunath, Suresh Vasan Venkatachalapathy
Journal: Endoscopy (2018)

<h3>Introduction</h3> Olonic self-expanding metal stents (SEMS) are recommended in the management of malignant strictures, with obstruction. ublished studies have low caseloads and may not reflect real world practice. <h3>Methods</h3> All cases coded with endoscopic or image guided insertion of stent or tubal prosthesis (codes H214, H243, H244, H273, H274, H314) were reviewed to identify colonic SEMS cases. Electronic notes, endoscopy and radiology reports were reviewed. Data on, site of SEMS, indication, insertion method immediate late complications30-daymortality were noted. <h3>Results</h3> Episodes were coded of which 101 colonic stent insertions. SEMS insertions included local and tertiary referrals, either planned or in an emergency setting. Of the 101 cases, 58.4% of patients were male (n=59), with a median age of 75 years (range 28–95 years). The majority of SEMS (91.1%, n=92) were inserted endoscopically with fluoroscopy, with the remaining nine cases being inserted radiologically, by multiple operators. Indications for insertion included palliative (n=72) or curative (n=21) malignancy (defined by treatment intention on MDT outcome), with 4 cases being for benign disease. Most patients (79.2%) requiring SEMS had obstructive symptoms. complications included cases of perforation (%)of unknown cause. One case had an 8 day unplanned readmission. cases of stent migration (%) cases of stent occlusion secondary to tumour in-growth (%) cases (3.96%) of delayed perforation (which were felt to be tumour related). All cause 30 day mortality rate was 14.9% (n=15), with only 7 cases (6.93%) relating to stent failure or complication. <h3>Conclusions</h3> This large real-world data review highlights complication rates of SEMS in a heterogeneous population with multiple operators over 7 years of both emergency and planned procedures for malignant colonic strictures. Colonic SEMS is aand relatively safe therapeutic option for thepalliative management of colonic malignancy with obstruction
PTH-009 Avoidable factors are identified in 70% of post colonoscopy colorectal cancers (PCCRCS)
Authors: Rebecca Anderson, Roland Valori
Journal: Endoscopy (2018)

<h3>Introduction</h3> CCRC is cancer arising 6–36 months after a negative colonoscopy. PCCRCs arise from incompletely or unresected lesions, or are missed or new lesions. PCCRC rates are a key quality marker for colonoscopy. The aim of this study was to test the utility of the World Endoscopy Organisation (WEO) algorithm for categorising avoidable factors leading to PCCRC.<sup>1</sup> <h3>Methods</h3> All PCCRCs diagnosed between 01/06/10 and 31/12/16 at one trust were identified by cross-referencing coding and endoscopy data. A root-cause analysis was undertaken for each using the WEO algorithm (figure 1). <h3>Results</h3> 27 PCCRCs were reviewed (age 37–85, median 70). 5 patients had inflammatory bowel disease (IBD), 20 diverticulosis and 1 Lynch syndrome. Chromoendoscopy was used in 1 IBD patient. Adenomas had previously been seen in the cancerous bowel segment in 8 cases (29.6%): 3/8 arose from resected lesions; and 5/8 from unresected lesions. 2/5 unresected lesions were deliberately not investigated further (patient/MDT decision). Bowel preparation was poor in 6 colonoscopies (22.2%). 24 were reported as complete, but only 12 had adequate caecal photographs (44.4%). Overall, follow-up procedures were delayed or not requested in 11 cases (40.7%). <h3>Conclusions</h3> Although the WEO algorithm is a useful tool for PCCRC categorisation, a category for conservatively managed cases is missing. Further, a judgement is still required to conclude whether a PCCRC was avoidable or unavoidable. In this cohort, 70% of PCCRCs (19/27) were probably avoidable; 5 possibly avoidable and 3 likely unavoidable. The following are influencing factors and possible means of addressing them: PCCRC rates are high in patients with existing colon pathology. Rates would reduce in certain groups with greater vigilance and use of chromoendoscopy. Surveillance timeframes were often breached. Effective processes should reduce delays. Bowel preparation was often poor. If these colonoscopies are not repeated, the decision should be recorded. Some adenomas were overlooked while endoscopists focussed on large polyps. Early repeat colonoscopy should be considered after complicated procedures. Photodocumentation was adequate in 44.4% of cases. Inadequate photos may be a marker for other shortcomings and repeat colonoscopy considered if caecal documentation is incomplete. These findings indicate that PCCRC rates could be reduced by up to 70% if avoidable factors are addressed. There is a need for quality improvement studies targeting these factors to quantify their impact on PCCRC rates. <h3>References</h3> 1. Beintaris I et al. UEG Journal. 2017;<b>5</b>:PO436
Quality and Safety in Healthcare, Part LXX
Authors: Jay A. Harolds
Journal: Clinical Nuclear Medicine (2020)

The chief medical officer ideally has a degree in business, hospital administration, or related subjects and has also pursued training in leadership. This is very important to be able to read and interpret financial documents, understand the language of hospital executives, and be able to advise the administrators and physicians on many projects. The chief medical officer must be trusted by both the C-suite executives and the medical staff and be able to communicate effectively and diplomatically with both. In order to optimize value, it is important to engage the medical staff and to align the goals of not only the executives and doctors, but also of the patients and their families.
SAT0710-HPR RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY OSTEOPOROSIS DIAGNOSIS ON FEMORAL NECK: A SPANISH CLINICAL EXPERIENCE
Authors: Diana Ovejero Crespo, Xavier Nogues, Adolfo Diez-Perez
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Radiofrequency Echographic Multi Spectrometry (REMS) is an innovative echographic technology able to provide the most important densitometric parameters by a fully automatic approach. Its high accuracy with respect to the conventional Dual X-ray absorptiometry (DXA) has been shown in a very recently published multicenter clinical trial [1]. <h3>Objectives:</h3> To evaluate the performance of the REMS technology in osteoporosis diagnosis, with respect to DXA(Clinical Gold Standard), when applied on femoral neck. <h3>Methods:</h3> DXA and REMS acquisitions were performed on the femoral neck in 324 female patients, aged between 51 and 70 year, recruited at the Department of Internal Medicine of the Hospital del Mar (Barcelona, Spain). REMS technology is based on a automatic integrated processing of the native unfiltered "raw" (RF) signals, which can be employed to assess the bone health status through comparisons with reference spectral models previously derived from osteoporotic and healthy patients. The data shown have been obtained in the strictest adherence to manufacturer's procedures and indications. REMS accuracy was assessed by investigating its discriminating ability between osteoporotic and non-osteoporotic patients and by evaluating the correlation between REMS and DXA measurements. <h3>Results:</h3> The REMS approach is effectively able to discriminate between osteoporotic and non-osteoporotic patients with a sensitivity equal to 93% and a specificity equal to 95%. These data are further emphasized by the obtained Pearson Correlation value (<i>r</i> = 0.90; <i>p</i>&lt;0.001). REMS accuracy was confirmed also by Cohen's kappa coefficient (<i>k</i>) equal to 0.76. Finally, a very low average difference (expressed as bias ± 2 SD) between REMS and DXA measured BMD (-0.006 ± 0.078 g/cm<sup>2</sup>) was shown. <h3>Conclusion:</h3> In conclusion, REMS technology has proven to be an accurate non-ionizing approach to detect osteoporosis disease at the femoral neck. The performance of this radiation-free technique opens new perspectives for early diagnosis and screening of osteoporosis in clinical and epidemiological studies. <h3>Reference</h3> [1] Di Paola et al, Osteop. Int., 2018 <h3>Disclosure of Interests:</h3> Diana Ovejero Crespo: None declared, Xavier Nogues Speakers bureau: Amgen and Eli Lilly, Adolfo Diez-Perez Speakers bureau: Lilly, Amgen, GSK and UCB
Metronomic chemotherapy of cyclophosphamide plus methotrexate for advanced breast cancer: Real‐world data analyses and experience of one center
Authors: Qianyi Lu, Kaping Lee, Fei Xu, Wen Xia, Qiufan Zheng, Ruoxi Hong, Kuikui Jiang, Qinglian Zhai, Yuan Li, Yanxia Shi, Zhongyu Yuan, Shusen Wang
Journal: Cancer Communications (2020)

Real-world data of the CM regimen [cyclophosphamide (CTX) plus methotrexate (MTX)] in metronomic pattern for advanced breast cancer is limited to small-sample or retrospective studies. This study was aimed to determine the effectiveness and safety of CM regimen in treating advanced breast cancer and to identify which patients are most likely to benefit from metronomic CM regimen.Patients with advanced breast cancer who received the metronomic CM regimen at least once between January 2009 and February 2019 in Sun Yat-sen University Cancer Center were included. Clinicopathological characteristics were collected. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier estimates. Characteristics between patients with PFS < 6 months and ≥6 months were compared using the Chi-square test. Univariate and multivariate Cox regression model was used to estimate the prognostic factors for PFS and OS.A total of 186 patients were included. The median age and follow-up were 49 years and 13.3 months, respectively. Over 50% of the patients were estrogen receptor/progesterone receptor-positive, and 60.8% had been heavily treated (≥3 lines). The objective response rate was 3.8%, the disease control rate at 12 weeks was 41.4%, and the clinical benefit rate at 24 weeks was 31.2% (58/186). The median PFS was 4.0 months [95% confidence interval (CI): 3.6-4.7 months], the median duration of clinical benefit was 9.5 months (95% CI: 8.2-10.8 months), and the median OS was 26.8 months (95% CI: 20.9-37.7 months). Multivariate analysis for PFS revealed the CM regimen as maintenance therapy and no liver metastasis as favorable prognostic factors. Furthermore, patients without liver metastasis were more likely to have a PFS over 6 months than those with liver involvement (P = 0.022). Liver, lymph node, and brain metastases were unfavorable prognostic factors for OS. The CM regimen was well-tolerated without newly reported adverse events.The CM regimen was effective in selected patients. In clinical practice, it would be better used as maintenance therapy and in patients without liver metastasis. Further follow-up investigation should be performed to examine its effect when used in combination with other treatments and determine predictive biomarkers.
Abstract 14935: Beneficial Stroke-Free Survival of Paracorporeal Continuous Flow Support in Children: A Single-Center Experience
Authors: Ryan S Bishop, Jodie L Lantz, Nathanya Baez-Hernandez, Maria Bano, Ryan J Butts, Robert D Jaquiss, Ryan R Davies, David L Sutcliffe
Journal: Circulation (2019)

Introduction: Ventricular assist device (VAD) support in small children with end-stage heart failure remains challenging despite improving outcomes. Pulsatile paracorporeal (p-PC) devices have long...