tbuckley/cabot-search huggingface dataset:
THU0371 Correlation between irregular menstruation and disease activity of systemic lupus erythematosus :1 year cohort study
Authors: N. Oguro, N. Yajima, M. Saito
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Systemic lupus erythematosus (SLE) often occurs to young women of reproductive age. Not only the disease but the treatment itself could affect the capability of getting pregnant. In clinical scene, we often experience SLE patients having menstrual irregularity before their relapse. Reports about correlation between menstrual irregularity and disease activity of SLE was very limited. <h3>Objectives</h3> We started this study, that this study could be a suggestion for clinician to use the symptom as a warning sign for relapse. <h3>Methods</h3> The study design was prospective cohort.67 patients who fulfilled ≥4 of the American College of Rheumatology (ACR) criteria for the classification of SLE whose age was 20 to 45 years old and treated as outpatient at Showa University Hospital from Feb 2016 to Jan 2017 were recruited. At the initial point, patients' disease were not active and were receiving maintenance therapy. Loss to follow up was eliminated. We set the main exposure as menstrual irregularity and the primary outcome as whether they would have relapse within 1 year from the registration. We defined the menstrual irregularity as deviation from the normal menstruation, which is 'flow occur every 25 to 35 days and last three to seven days'. We had questionnaire formed from each patient. Definition of relapse was the doctor's decision, to intensify the patients' treatment. We set the confounding as age, Japan Perceived Stress Scale (JPSS), current smoking, history of treatment with IVCY and logistic regression analysis was performed. <h3>Results</h3> The mean age was 35.7 years old. Irregular menstruation patients were 11 (16.4%). The relapse group was 12 (17.9%) and those of normal group was 59 (89%). There was no significant difference in patients' background between both groups. Adjusted with the cited confounding variable there was no significant difference between the both groups (Odds ratio 2.25; 95% Confidence Interval (CI) 0.24 to 20.7; p=0.47). <h3>Conclusions</h3> We investigate that whether menstrual irregularity could be the predictor for the disease relapse, but we could not prove the significant relation. <h3>References</h3> [1] Shabanova SS. Ovarian function and disease activity in systemic lupus erythematosus, Clinical and Experimental Rheumatology2008;26:436–441. [2] Silva CAA. Risk factors for amenorrhea in juvenile systemic lupus erythematousus(JSLE):A Brazilian multicenter cohort study. Lupus2007;16:531–536. [3] LE Harward. The impact of cyclophosphamide on menstruation and pregnancy in woman with rheumatologic disease; Lupus 2013 22;81 [4] Wenhong Ma, Subclinical impairment of ovarian reserve in systemic lupus erythematosus patients with normal menstruation not using alkylating therapy. Journal of women's health,2013;22:4255 <h3>Disclosure of Interest</h3> None declared
AB1131 Il-33, a novel cytokine for fmf? how is it related with disease pathogenesis?
Authors: A.B. Kelesoglu Dincer, E.G. Aydemir Gülöksüz, M. Torgutalp, M.E. yayla, E. uslu yurteri, S. sezer, I.E. okatan, G. Kınıklı, T.M. Turgay, A. Ateş
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Familial Mediterranean Fever (FMF) is an autosomal recessive inherited autoinflammatory disease characterised with unpredictable attacks of fever, polyserositis and arthritis. The disease is associated with MEFV gene mutation causing dysfunction of pyrin protein. This dysfunction of pyrin is related with abberant production of proinflammatory cytokines, especially IL-1β and IL-18. IL-33 is a novel proinflammatory cytokine that belongs to interleukin (IL)−1 superfamily. When released from epithelial, endothelial and fibroblasts, it binds to its spesific receptor ST2 and induces the production of inflammatory cytokines. IL-33/ST2 pathway has been recently shown to be related with several rheumatological diseases such as rheumatoid arthritis, systemic lupus erythematosus. <h3>Objectives</h3> As it is well known that inhibition of IL-1 pathway is the cornerstone of FMF treatment, the aim of this study was to evaluate the role of IL-33, a member of IL-1 family, in the pathogenesis of FMF. <h3>Methods</h3> Seventy-six FMF patients and 30 sex-age matched healthy controls were enrolled in the study. <h3>Results</h3> The demographic data of FMF patients and healthy controls are demonstrated in Table 1. Serum IL-33 and its soluble receptor ST2 (sST2) were analysed with ELISA. There was no statistically significant difference between IL-33 and sST2 levels in FMF and control groups (p=0.687 and p=0.054, respectively) (table 1). FMF patients were grouped as active and inactive disease according to Autoinflammatory Disease Activity Index (AIDAI) for the past 31 days and ≥9 was accepted as active disease. The serum IL-33 and sST2 levels were similar in both active and inactive groups (p=0.362 and p=0.706, respectively). In active group, C-reactive protein and serum-amyloid A levels were significantly higher than inactive group. (p=0.01, p=0.015 respectively) (table 2). <h3>Conclusions</h3> In this study, significant differences were not found in serum IL-33 and sST2 levels neither in FMF vs control nor active vs inactive FMF groups. This may be because of, unlike the other members of IL-1 superfamily, IL-33 mainly induces T helper (Th)2 immune responses. On the other hand, the pathogenesis of FMF is mainly dependent on Th17 cell activation and Th1 cell differentiation via IL-18 induction. As a result, it can be concluded that even if IL-33 is a component of IL-1 family, it has no role in the pathogenesis of FMF. As far as we know, this is the first study in the literature. Therefore, further studies with larger sample size are needed to confirm this result. <h3>Disclosure of Interest</h3> None declared
SAT0523 Evolution of visual affection in patients with giant cell arteritis treated with tocilizumab
Authors: D. Prieto-Peña, J. Loricera, C. Moriano, E. Díez, J. Nárvaez, A. Mera, E. Pérez-Pampín, V. Aldasoro, M. Varela, N. Álvarez-Rivas, C. Barbazán, C. Ordás-Calvo, F. Sivera, C. Gómez, J. Toyos, A. Conesa, M. Belmonte, F. Navarro, V. Calvo-Río, C. González-V, N. Palmou-Fontana, L. Domínguez-Casas, M. Calderón-Goercke, J. Hernández, M. González-Gay, R. Blanco
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Giant cell arteritis (GCA) is a large vessel vasculitis that has a special predilection for extracranial branches of the external carotid artery. Among its most fearsome complications is visual affectation. Tocilizumab (TCZ) is a monoclonal antibody directed against the interleukin 6 receptor that has shown utility in the treatment of GCA. <h3>Objectives</h3> Our aim was to assess the evolution of visual clinic in patients with GCA treated TCZ. <h3>Methods</h3> Retrospective multicentre study of 20 GCA patients with visual involvement treated with TCZ. The efficacy of this drug on visual symptoms was evaluated. <h3>Results</h3> We evaluated 20 patients (14 women and 6 men) with a mean age ±SD of 73.7±10.1 years with GCA and visual symptoms. In total there were 23 affected eyes. The symptoms reported were: unilateral blindness (n=6), unilateral blurred vision (n=6), unilateral amaurosis fugax (n=3), unilateral hemianopsia (n=2), bilateral blindness (n=1), bilateral blurred vision (n=1), bilateral hemianopsia (n=1). Before starting treatment with TCZ all patients had received high doses of prednisone, with a mean ±SD of 54.2±13.8 mg/day (range of doses: 40–80 mg/day). In addition, 9 of them also received intravenous corticosteroid boluses. In addition, 13 patients received traditional immunosuppressants: methotrexate (MTX) (n=12), cyclophosphamide (n=2), leflunomide (n=1) and azathioprine (n=1). Regardless of corticosteroids, TCZ was administered as monotherapy in 14 patients, while in 6 it was administered in combination with MTX. The TABLE shows the evolution of the visual affectation of these patients. Throughout a median follow-up [RIC] of 9<sup>4–18</sup> months, none of the 7 patients who had a blindness regained vision. The 2 patients who presented unilateral hemianopsia recovered vision. The patient with bilateral hemianopsia and the patient with bilateral blurred vision experienced a partial improvement. The rest of the patients achieved a complete recovery. <h3>Conclusions</h3> Although TCZ seems to be also useful in the treatment of visual manifestations of ACG, once blindness is established, it does not seem to be effective. <h3>Disclosure of Interest</h3> None declared
SP0040 Parents support for children with rmds in education
Authors: M. Kepic
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> My presentation will contain situation in schools all across the Europe (at least 13 countries/results from a survey and info which I get from our Associations, members of ENCA). It is serious situation. First I will present the problems, we, parents, are struggling with every day. I will also prepare and present possible solutions. One country is extra good in solutions and they really take good care for children with autoimunne conditions and we can learn from them. I will also present a concrete good solution. Solutions should be used as a prepared document for all the countries. That is a goal of ENCA. <h3>Disclosure of Interest</h3> None declared
THU0285 The effect of family history on disease phenotypes in 1393 psoriatic arthritis patients
Authors: D. Solmaz, S.B. Ureyen, G. Kimyon, E.K. Gunal, A. Dogru, O. Bayindir, E. Dalkilic, C. Ozisler, M. Can, S. Akar, G.Y. Cetin, S. Yavuz, L. Kilic, E.F. Tarhan, O. Kucuksahin, A. Omma, E. Gonullu, F. Yildiz, E.D. Ersozlu, M. Cinar, M.A. Tufan, A. Erden, S. Yilmaz, S. Pehlevan, T. Duruoz, U. Kalyoncu, S.Z. Aydin
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Psoriatic arthritis (PsA) has a genetic background, approximately 40% of patients having a family history of psoriasis or PsA in first-degree relatives, which may impact the disease features. <h3>Objectives</h3> The aim of this study was to evaluate the effects of family history of psoriasis or PsA on the disease phenotypes. <h3>Methods</h3> The demographic and clinical data were retrieved from the longitudinal, multicenter PsArt-ID (Psoriatic Arthritis-International Database). Family history of psoriasis and PsA were investigated for 1st and 2nd degree relatives separately. The effect of the family history of psoriasis and/or PsA on disease phenotypes and severity were analysed, calculating the relative risks (RR). <h3>Results</h3> 1393 patients had the data for family history, 444 (31.9%) of whom was positive for psoriasis and/or PsA. The majority of the family history was only psoriasis (333/444; 75%) and 58.5% (260/444) of the patients had first-degree relatives affected. There was no differences in maternal or parental transmission rates however women had more psoriasis and/or PsA in their family (67.3% vs 32.7% p: 0.028). Patients with a family history had an earlier onset of age for psoriasis (29±14.8 vs 31±14.9 p: 0.007), more frequent nail involvement (50.7% vs 29.6% p: 0.032), more frequent enthesitis (28.2% vs 17.7% p&lt;0.001) and deformities (25.2% vs 19.9% p: 0.05) and were able to achieve minimal disease activity (MDA) less often. (38.6% vs 49.5% p: 0.045). Plaque psoriasis was more common if the family history was positive for psoriasis whereas pustular psoriasis was more frequent when the family history was positive for PsA (figure 1). Family history of psoriasis were found as a risk factor for a younger onset (RR: 1.138), for nail disease (RR: 1.179), for enthesitis (RR: 1.504) and for not achieving MDA (RR: 1.246) whereas family history of PsA was a risk factor for having deformities (RR: 1.215) (table 1). <h3>Conclusions</h3> The family history of psoriasis and PsA has impacts on skin phenotypes, musculoskeletal features and the disease severity. The differences between family history of psoriasis and PsA and pustular vs plaque phenotypes may point out to a different genetic background and pathogenic mechanisms in these subsets. <h3>Disclosure of Interest</h3> None declared
Abstract 20035: Impact of Sex on Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Multicenter U.S. Registry
Authors: Aya J Alame, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, R M Wyman, Mitul Patel, John Bahadorani, William Lombardi, J A Grantham, David E Kandzari, Nicholas Lembo, Jeffrey Moses, Ajay J Kirtane, Catalin Toma, Anthony Doing, James Choi, Barry Uretsky, Judit Karacsonyi, Erica Resendes, Aris Karatasakis, Barbara A Danek, Bavana V Rangan, Subhash Banerjee, Emmanouil S Brilakis
Journal: Circulation (2016)

Introduction: The effect of sex on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods: Using data collected from 14 e...
Abstract 19065: Clinical Innovation: A Multi-Disciplinary Program For Early Recognition and Treatment of Systemic Hypertension in Children and Adolescents
Authors: Michelle Kaplinski, Heather Griffis, Fang Liu, Craig Tinker, Nina C Laney, Melodee Mendoza, Meryl S Cohen, Kevin Meyers, Shobha Natarajan
Journal: Circulation (2017)

Introduction: Pediatric hypertension (HTN) is a growing problem but continues to be underdiagnosed and undertreated. The divisions of Cardiology and Nephrology at our institution developed a comprehensive outpatient HTN program to 1) screen children at risk for HTN, 2) assess cardiovascular health status, and 3) optimize medical management. We present our findings of this unique population since initiation of this innovative program. Methods: Data was collected from all initial patient visits to the Hypertension and Vascular Evaluation (HAVE) program at the Children's Hospital of Philadelphia between 12/2011 and 12/2015. Demographic, nutrition, activity level, clinical and diagnostic data were evaluated using descriptive statistics. Results: There were 242 patients referred to the HAVE program, including those with morbid obesity and/or primary hypertension (26%), solid organ transplants (25%), diabetes (12%), renal artery stenosis (10%), and aortic coarctation (8%). The average age was 14.5±4.2 years. Fi...
FRI0646 Synovial tissue histopathology findings in early ra. is it usefull? analysis of the belgian cap48 cohort.
Authors: C. Galant, L. Meric De Bellefon, B. Lauwerys, T. Sokolova, M. Stoenoiu, V. Badot, A. Nzeusseu, F. Houssiau, P. Durez
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> The development of ultrasound-guided synovial biopsy will enable synovial tissue collection from small joints and will facilitate histopathological studies, thus improving the understanding of early rheumatoid arthritis (ERA). The CAP48 cohort is an original multicentre prospective observational study of early Rheumatoid Arthritis (RA) patients up to 50 years old supported by a charity program of the Belgian French speaking radio-television (RTBF). <h3>Objectives:</h3> The objectives of this cohort are to observe if a tight control favour remission at 6 months and to define synovial markers for severy and response to therapy. <h3>Methods:</h3> RA patients fulfilling the ACR/EULAR 2010 criteria and naïve to DMARDs therapy were recruited. Synovial biopsies before treatment were obtained using an ultrasound guided needle biopsy (US-NB) of the small joints or miniarthroscopy of the knee. RA disease activity measures including DAS28CRP domains were evaluated every 3 months and treatment was adapted by the treating physician. Tissues were assessed for quality. Retrieved tissue was fixed, stained and paraffin embedded for blinded tissue pathotype description. <h3>Results:</h3> A synovial biopsy was performed in 37 patients using US-NB in n patients. Patients were classified according 4 types of synovial histopathology findings. Baseline characteristics of the cohort is summarized in table 1. All patients in the diffuse lymphoïd group were ACPA negative and the majority of the ACPA positive patients were classified in the pauci immune and fibrous group. As shown in figure 1, the pauci immune ERA group showed lower DAS28-CRP response than the other groups. <h3>Conclusions:</h3> Synovial tissue analysis could provide a step change towards personalized medicine in daily clinical practice for disease stratification and treatment selection of ERA. In the CAP48 cohort, a high number of these young and ERA patients achieved remission at 6 months but a lower response was observed in the pauci immune group. Further analyses are ongoing to define individual synovial markers of severity and response. <h3>Disclosure of Interest:</h3> None declared
MicroRNA-92a-1–5p increases CDX2 by targeting FOXD1 in bile acids-induced gastric intestinal metaplasia
Authors: Ting Li, Hanqing Guo, Hong Li, Yanzhi Jiang, Kun Zhuang, Chao Lei, Jian Wu, Haining Zhou, Ruixue Zhu, Xiaodi Zhao, Yuanyuan Lu, Chongkai Shi, Yongzhan Nie, Kaichun Wu, Zuyi Yuan, Dai-Ming Fan, Yongquan Shi
Journal: Gut (2019)

Gastric intestinal metaplasia (IM) is common in the gastric epithelium of patients with chronic atrophic gastritis. CDX2 activation in IM is driven by reflux of bile acids and following chronic inflammation. But the mechanism underlying how bile acids activate CDX2 in gastric epithelium has not been fully explored.We performed microRNA (miRNA) and messenger RNA (mRNA) profiling using microarray in cells treated with bile acids. Data integration of the miRNA/mRNA profiles with gene ontology (GO) analysis and bioinformatics was performed to detect potential miRNA-mRNA regulatory circuits. Transfection of gastric cancer cell lines with miRNA mimics and inhibitors was used to evaluate their effects on the expression of candidate targets and functions. Immunohistochemistry and in situhybridisation were used to detect the expression of selected miRNAs and their targets in IM tissue microarrays.We demonstrate a bile acids-triggered pathway involving upregulation of miR-92a-1-5p and suppression of its target FOXD1 in gastric cells. We first found that miR-92a-1-5p was increased in IM tissues and induced by bile acids. Moreover, miR-92a-1-5p was found to activate CDX2 and downstream intestinal markers by targeting FOXD1/FOXJ1 axis and modulating activation of nuclear factor kappa B (NF-κB) pathway. Furthermore, these effects were found to be clinical relevant, as high miR-92a-1-5p levels were correlated with low FOXD1 levels and high CDX2 levels in IM tissues.These findings suggest a miR-92a-1-5p/FOXD1/NF-κB/CDX2 regulatory axis plays key roles in the generation of IM phenotype from gastric cells. Suppression of miR-92a-1-5p and restoration of FOXD1 may be a preventive approach for gastric IM in patients with bile regurgitation.
AB1360 Range and consistency of outcome measures reported in randomised trials in dermatomyositis: a systematic review
Authors: A.H. Kelly, G. Hassett, D. Singh-Grewal, A. Tong
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Dermatomyositis – an idiopathic inflammatory myopathy- can be resistant and unresponsive to initial treatments and require chronic therapy. Symptoms including muscle weakness and skin rash can lead to severe complications and impair quality of life. There are a paucity of randomised trials in dermatomyositis, which may not consistently report outcomes that are important to patients and their clinicians. <h3>Objectives</h3> To assess the scope and consistency of outcomes reported in randomised trials in dermatomyositis. <h3>Methods</h3> MEDLINE, Embase, CINAHL, PsycINFO were searched to February 2017 for randomised trials in children and adults with dermatomyositis. The frequency and characteristics of the outcome domains and measures reported were then analysed. Similar outcomes were grouped into outcome domains and classified as surrogate, clinical or patient-reported outcomes. The frequency and characteristics of the outcome domains and measures reported were then analysed. <h3>Results</h3> We included 18 trials (n=844 participants), reporting 680 outcome measures. These were grouped into 27 different outcome domains; including 12 (44%) clinical outcomes, 9 (33%) surrogate/biochemical outcomes, and 6 (22%) patient-reported outcomes. The 5 most frequently reported outcome domains were: physical function (13 trials, 72%), muscle strength (12, 67%), muscle inflammation (12, 67%), biomarkers (11, 61%), and composite i.e. myositis disease activity (10, 56%). <h3>Conclusions</h3> The majority of outcomes reported in trials in dermatomyositis are clinical outcomes and few are patient-reported. Establishing a core set of patient-important outcomes may improve the consistency and relevance of outcomes reported in trials in dermatomyositis to inform decision-making. <h3>Disclosure of Interest</h3> None declared
Gastroschisis Trends and Ecologic Link to Opioid Prescription Rates — United States, 2006–2015
Authors: Tyiesha D. Short, Erin B. Stallings, Jennifer Isenburg, Leslie A. O’Leary, Mahsa M. Yazdy, Michele K. Bohm, Mary Ethen, Xiaoli Chen, Tri Tran, Deborah J. Fox, Jane Fornoff, Nina Forestieri, Emily Ferrell, Glenda M. Ramirez, Jamie Kim, Jing Shi, Sook Ja Cho, Kirstan Duckett, Norm Nelson, Katherine Zielke, Kristen St. John, Brennan Martin, Carolina Clark, My-Phuong Huynh, Colin Benusa, Jennita Reefhuis
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

Prevalence of gastroschisis, a serious birth defect of the abdominal wall resulting in some of the abdominal contents extending outside the body at birth, has been increasing worldwide (1,2). Gastroschisis requires surgical repair after birth and is associated with digestive and feeding complications during infancy, which can affect development. Recent data from 14 U.S. states indicated an increasing prevalence of gastroschisis from 1995 to 2012 (1). Young maternal age has been strongly associated with gastroschisis, but research suggests that risk factors such as smoking, genitourinary infections, and prescription opioid use also might be associated (3-5). Data from 20 population-based state surveillance programs were pooled and analyzed to assess age-specific gastroschisis prevalence during two 5-year periods, 2006-2010 and 2011-2015, and an ecologic approach was used to compare annual gastroschisis prevalence by annual opioid prescription rate categories. Gastroschisis prevalence increased only slightly (10%) from 2006-2010 to 2011-2015 (prevalence ratio = 1.1, 95% confidence interval [CI] = 1.0-1.1), with the highest prevalence among mothers aged <20 years. During 2006-2015, the prevalence of gastroschisis was 1.6 times higher in counties with high opioid prescription rates (5.1 per 10,000 live births; CI = 4.9-5.3) and 1.4 times higher where opioid prescription rates were medium (4.6 per 10,000 live births; CI = 4.4-4.8) compared with areas with low prescription rates (3.2 per 10,000 live births; CI = 3.1-3.4). Public health research is needed to understand factors contributing to the association between young maternal age and gastroschisis and assess the effect of prescription opioid use during pregnancy on this pregnancy outcome.
Let more overseas doctors work in NHS to fill shortages, say physician colleges
Authors: Abi Rimmer
Journal: BMJ (2019)

Senior doctors have called on the UK government to increase the number of physicians from outside the European Economic Area who are able to work in the NHS.

In evidence submitted to the Migration Advisory Committee, which is reviewing immigration rules,1 the federation of the Royal Colleges of Physicians called for all physician posts to be included on the shortage occupation list—the official list of jobs for which there are not enough UK resident workers to fill vacancies.

The federation, which comprises the Royal …