tbuckley/cabot-search huggingface dataset:
AB0554 Factors affecting quality of life in indian patients with systemic lupus erythematosus
Authors: B. Pinto, S. Grover, M. Rathi, A. Dhooria, A. Sharma
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> SLE has a profound impact on Quality of Life (QoL). In addition to disease activity and damage, other factors such as fatigue, fibromyalgia and psychiatric comorbidities also influence QoL.<sup>1</sup> However, there is lack of data in the form of comprehensive assessment of all these factors in the same cohort. <h3>Objectives</h3> To assess the quality of life and its correlates among patients with SLE. <h3>Methods</h3> Using a cross-sectional study design, 144 patients with SLE were assessed for disease activity and damage by using SELENA –SLEDAI and SLICC/ACR damage Index (SDI)), depression (by using Patient Health Questionnaire-9 (PHQ9), anxiety (by using Generalised Anxiety Disorder 7 (GAD7)), fatigue (by using Fatigue severity scale (FSS)) and fibromyalgia (as per using ACR 2010 criteria). QoL was assessed using a generic Qol scale – Short Form 36 (SF-36).2 Statistical analysis was done using STATA version 14. <h3>Results</h3> The study sample included 140 females and 4 males. Mean age of the participants was 32.48 (SD-7.26) years and the mean duration of illness was 3.92(SD-3.76) years. The mean SELENA SLEDAI and SDI was 3.42±4.04 and 0.26±0.65 respectively. Prevalence of depression (PHQ9 ≥10) and anxiety (GAD7 ≥10) was 25% and 22.9% respectively. Fatigue (FSS ≥4) was present in 51.4%. Physical domains of SF36 were affected more often than the mental domains, 71.5% of the respondents had scores less than 50 in Physical component Summary (PCS) and 61.1% in Mental Component Summary (MCS) of SF36. No correlation was found between disease activity and damage and various domains of SF36. Depression, anxiety and fatigue had a significant negative correlation with all the domains of SF36 (table 1). On multivariate regression only fatigue was an independent predictor of PCS of QoL. <h3>Conclusions</h3> Fatigue, depression and anxiety have a greater influence on QoL in SLE than disease activity and damage. Of these, fatigue appears to be the most important variable which influences QoL. <h3>References</h3> [1] Schmeding A, Schneider M. Fatigue, health-related quality of life and other patient-reported outcomes in systemic lupus erythematosus. Best Pract Res Clin Rheumatol. 2013;27(3):363–375. [2] Maruish ME (Ed). <i>NEW SF36v2 User Guide</i>, <i>3rd Edition</i>.; 2011. <h3>Acknowledgements</h3> Mr. John Michael Raj, Department of Biostatistics, St. John's National Academy of Health Sciences, Bengaluru <h3>Disclosure of Interest</h3> None declared
AB1324 Studying the relationship between body mass index, bmi, and bone mineral density, bmd, of lumbar vertebrae and femoral neck
Authors: K. Talash, M. Bukhari
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> There is a well known association between BMI and BMD in as much that patients with higher BMI have higher BMD, secondary to factors including muscle mass and fat mass<sup>1</sup>. However it is not clear whether this relationship is equal in all areas of the body assessed for bone mineral density (BMD) estimation, which tradtionally are the lumbar vertebrae, and different areas of the femur. Our study sets out to establish if this association exists in the lumbar vertebrae and femoral neck, since Dual Energy X-ray Absorptiometry (DEXA) scans measure BMD of both. <h3>Objectives</h3> To explore the relationship between BMI and BMD in a cohort of patients referred for DEXA scan. <h3>Methods</h3> Data was used from patients referred for DEXA scan to Royal Lancaster Infirmary between (2006 and 2010). The following were recorded: age, sex, height, weight, BMI, BMD at L1-L4, BMD at femoral neck (left and right) and BMD at hip (left and right). Male and female patients were analysed separately. A Linear regression model was fitted using BMI with BMD at L1, L2, L3, L4, total right hip, total left hip, right neck of femur and left neck of femur as explanatory variables. Adjusted r-squared (r2) values were used to compare the fit of the models, both with and without age-adjustment. <h3>Results</h3> 35759 patients were used in the study, of which 84% were female. Mean age was 62.2 years (SD 12.8), mean height was 161.9 cm (SD 8.3), mean weight was 70.4 kg (SD 15.3), mean BMI was 26.8 kg/cm2 (SD 5.2). <h3>Conclusions</h3> Our study identifies that there is a positive correlation between increasing BMI and BMD at lumbar vertebrae and at the hips, in both male and female patients. We also identified age as a contributing factor. The relationship between BMI and BMD appears to be more significant in the hip and neck of femur than the lumbar spine. When studying the lumbar spine we found that the association is greater the higher up the lumbar spine, with most positive correlation being in L1 of female patients. This would indicate that using the lower lumbar spine might not be appropriate to assess bone health. <h3>Reference</h3> [1] Reid IR. Relationships among body mass, its components, and bone. Bone. 2002;5:547–55 <h3>Disclosure of Interest</h3> None declared
AB0950 Minimal disease activity in real life in psoriatic arthritis
Authors: S.B. Ureyen, D. Solmaz, N. Al Asoimi, E. Dalkilic, M. Can, A. Erden, C. Ozisler, M. Cinar, L. Kilic, U. Kalyoncu, S.Z. Aydin
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Minimal disease activity<b> (</b>MDA) is an important target in patients with psoriatic arthritis (PsA), however it is also criticised for having low threshold for patient reported outcomes (PRO). <h3>Objectives</h3> The aim of the study was to assess the prevalence of MDA components in patients with PsA and to evaluate disease characteristics and patterns in patients with or without MDA. <h3>Methods</h3> PsArt-ID (Psoriatic Arthritis- International Database) is a prospective, multicentre web-based registry (www.trials-network.org). PsA patients who had at least 1 year of disease duration were included for this analysis. Patients were considered in MDA when they met at least 5/7 of the MDA criteria (figure 1). <h3>Results</h3> In January 2018, 1283 patients from Turkey and 119 patients from Canada were recruited, 317 of whom had full data for MDA and were included in this analysis. The demographics, disease characteristics and patterns in patients with MDA achieved vs not are summarised in the table. There were no differences regarding demographics in both groups. The monoarthritis subtype (RR: 2.01, 95% CI: 1.579–2.559), the absence of enthesitis (RR: 1.570, 95% CI: 1.027–2.398) and the absence of distal interphalangeal joint disease (RR: 1.1, 95% CI: 1.001–1.25) were associated with higher probability of achieving MDA. Across different domains included in MDA, pain VAS≤15 and PtGA ≤20 could less frequently be achieved even when MDA is fulfilled as 44.5% and 26.5% of patients respectively still did not fulfil these domains (figure 1). On the other hand, for patients that did not achieve MDA, the body surface area (51.2%) and swollen joint count (53.5%) domains could be achieved in the majority of the patients and 93.5% of them had no enthesitis using the Leeds enthesitis index. Physician global assessment (&gt;21 vs≤20) and BASDAI (&gt;41 vs≤40, only for axial disease) had only moderate agreement with MDA (achieved or not) (kappa=0.47, p=0.05 and kappa=0.469, p=0.072; respectively). All data were given n/total n (percentage (%)) or median (first-third percentiles)*. MDA: minimal disease activity; PsA: Psoriatic Arthritis; DIP: distal interphalangeal. <h3>Conclusions</h3> The MDA criteria provide an objective target for treatment in trials and clinical practice; however in real life PROs are the most significant barriers to achieve MDA within all domains. Leeds enthesitis index was not able differentiate MDA, for being negative in the vast majority of the patients. Monoarthritis subtype is a good prognostic factor whereas DIP joint disease and history of enthesitis are poor prognostic factors to achieve MDA. <h3>Disclosure of Interest</h3> None declared
Abstract 18766: Low-Density-Lipoprotein-Cholesterol and Risk of Diabetes: A Mendelian Randomization Study
Authors: Marianne Benn, Stefan Stender, Bo K Lauridsen, Anne Tybjaerg-Hansen, Børge G Nordestgaard
Journal: Circulation (2016)

Introduction: Low levels of low-density-lipoprotein (LDL)-cholesterol due to statin treatment has been associated with increased risk of type 2 diabetes. Hypothesis: We tested the hypothesis that low LDL-cholesterol due to genetic variants in the HMGCR, PCSK9, NPC1L1, ABCG8, APOE genes, and variants combined are associated with high risk of type 2 diabetes in the general population. Methods: We examined associations of plasma LDL-cholesterol levels with observational risk of type 2 diabetes; genetic variants with plasma LDL-cholesterol levels; and genetic variants with risk of type 2 diabetes as an indication of causality using a Mendelian randomization design in 110,217 participants from the Copenhagen General Population Study and the Copenhagen City Heart Study. Results: In observational analyses, risk of type 2 diabetes was 702% (95% confidence interval: 620%-793%) higher in participants with an LDL-cholesterol <1.5mmol/L versus ≥3.0mmol/L. HMGCR, PCSK9, NPC1L1, ABCG8, and APOE genotypes combined were ...
The impact of stress on epidermal barrier function: an evidence‐based review
Authors: M. Maarouf, C.L. Maarouf, G. Yosipovitch, V.Y. Shi
Journal: British Journal of Dermatology (2019)

The epidermal barrier functions to limit skin infection and inflammation by inhibiting irritant and immunogen invasion. Abundant evidence suggests that psychological stress stemming from crowding, isolation, nicotine smoking, insomnia, mental arithmetic tasks, physical pain, real‐life stressors (examinations and marital strain) and lack of positive personality traits may impart both acute and chronic epidermal dysfunction. To review the relationship between stress and epidermal barrier dysfunction. A review of the PubMed and Embase databases was conducted to identify all English‐language case–control, cross‐sectional and randomized control trials that have reported the effect of stress on epidermal barrier function. The authors’ conclusions are based on the available evidence from 21 studies that met the inclusion and exclusion criteria. Psychological stressors upregulate the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production. This ultimately leads to aberrant barrier dysfunction, characterized by decreased epidermal lipid and structural protein production, decreased stratum corneum hydration and increased transepidermal water loss. This evidence‐based review explores the adverse effects of psychological stressors on epidermal barrier function. Future investigations using more real‐life stressors are needed to elucidate further their impact on skin physiology and identify practical stress‐relieving therapies that minimize and restore epidermal barrier dysfunction, particularly in at‐risk populations. What's already known about this topic? The literature reports the negative effect of stress on prolonged wound healing. Less is known about the relationship between stress and epidermal barrier dysfunction, a chronic, superficial wound involving the upper epidermal layers. What does this study add? Psychological stressors impact epidermal barrier function by activating the hypothalamic–pituitary–adrenal axis to stimulate local and systemic stress hormone production. Stress hormones negatively affect the epidermal barrier by decreasing epidermal lipids and structural proteins, decreasing stratum corneum hydration and increasing transepidermal water loss. Identification of such stressors can promote stress‐avoidance and stress‐reduction behaviours that protect epidermal barrier function and prevent certain dermatological conditions.
Abstract P179: Lifetime Variation in the Impact of Cardiovascular Risk Factors on CVD Outcomes and Mortality: Lifetime Risk Pooling Project
Authors: Norrina B Allen, Hongyan Ning, Lihui Zhao, John Wilkins, Donald Lloyd-Jones
Journal: Circulation (2018)

Introduction: Prior studies have suggested that there are age-specific differences in the association of traditional cardiovascular risk factors (RFs) with cardiovascular disease (CVD) and mortality later in life, but few have directly tested this. Hypothesis: We hypothesized that elevated RF levels at younger ages are more strongly associated with CVD and mortality. Methods: We used a synthetic cohort including black and white participants (ppts) of CARDIA, MESA, Framingham, Jackson Heart, ARIC and CHS. RF levels included SBP, BMI, total cholesterol and glucose from ages 20. Outcomes included CVD incidence and total mortality. We implemented a Cox proportional hazards model with time-varying coefficients adjusted for age, sex, race, cohort, smoking status and time-varying effects for other risk factors. Results: We included 41,387 ppts (55% female, 30% black). Hazard ratios (HR) per standard deviation in risk factor levels at every 5 years of age are shown in the figure. Effects of SBP and BMI varied significantly by age, with early adulthood levels imparting the greatest relative hazards for CVD incidence and mortality. Ignoring time-dependent differences, the mean effect for every 1 SD higher SBP would be a hazard ratio (HR) of 1.3 for CVD and HR 1.2 for mortality (as shown by the dashed lines). However, association of SBP with outcomes varied by age, with the largest HR (~1.5) early in adulthood (ages 20-50), decreasing below 1.3 by age 70. Similarly, early adult levels of total cholesterol were associated with higher HRs for CVD; however its association with mortality did not differ by age. Higher glucose levels were significantly associated with CVD and mortality, with consistent associations across the lifespan. Conclusions: Strength of associations of RFs on CVD incidence and mortality are not consistent across the lifespan and vary by RFs and outcomes. These patterns and their differences may provide insights into vulnerable age periods when elevated RF levels impart a proportionally greater risk for future CVD and death.
FRI0182 Erosions at the sacroiliac joints and fatty lesions at the spine are the most discriminant lesions for recent onset axspa recognition
Authors: A. Moltó, L. Gossec, M. Lefevre-Colau, R. Beaufort, V. Foltz, J. Laredo, P. Richette, P. Dieudé, P. Goupille, A. Feydy, M. Dougados
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> To evaluate the performances of MRI (SIJ and Spine) structural lesions suggestive of axSpA for its recognition. <h3>Methods</h3> Observational cross-sectional national multicentre study. <i>Patients:</i> a) Recent onset axSpA patients: first, a sample of 100 patients representative in terms of imaging abnormalities of the global DESIR recent onset axSpA cohort based on the results of the previously published central reading of baseline films of DESIR were selected. b) Recent onset CBP patients: consecutive in- and outpatients consulting for recent mechanical CBP, initiating before the age of 45 y and with a maximum age of 50 y, in four tertiary care Hospitals were included in the study. <i>Imaging:</i> MRI scans (T2-STIR and T1 sequences) of the SIJ and cervico-thoracic and thoraco-lumbar spine were performed in both groups with identical protocol. <i>Central reading:</i> an experienced reader (AM) centrally read all MRI scans, blinded for clinical diagnosis.<i> Statistical analysis:</i> prevalence of lesions suggestive of axSpA was compared in both groups. Sensitivity, specificity and positive likelihood ratio (LR+) of each lesion were calculated. <h3>Results</h3> A total of 98 patients with recent onset CBP were included, and compared to 100 recent onset axSpA patients. Age and gender were comparable (mean (SD) 36.2 (9.9) vs. 32.2 (8.7)y, and 41.8% and 45% males, in the CBP vs. axSpA groups, respectively). Prevalence of chronic lesions of the SIJ was significantly greater in the axSpA group. Presence of at least 3 subchondral bone erosions at the SIJ performed the best for axSpA discrimination. Prevalence of chronic lesions of the spine was comparable in the two groups. The presence of at least 5 fatty lesions was the most discriminant, with high specificity. <h3>Conclusions</h3> Presence of at least 3 erosions at the MRI-SIJ and at least 5 fatty lesions at the MRI-spine seemed to performed well for axSpA recognition. <h3>Disclosure of Interest</h3> None declared
AB1008 Comparison of bone mineral density between rheumatoid arthritis patients and healthy individuals over seven years from the tomorrow study
Authors: M. Tada, K. Inui, Y. Sugioka, T. Okano, Y. Yamada, K. Mandai, K. Mamoto, T. Koike, H. Nakamura
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Despite advances in treatment, rheumatoid arthritis (RA) remains a key cause of secondary osteoporosis and is also a risk factor for fragility fracture. We have previously reported that bone mineral density (BMD) was lower in patients with RA than in healthy individuals (HI) and examined changes in BMD over 3 years<sup>1</sup>. <h3>Objectives</h3> To observe BMD changes over 7 years and identify factors that affect BMD changes in patients with RA. <h3>Methods</h3> We analysed data from the TOMORROW study (UMIN000003876), a prospective cohort for patients with RA and age- and sex-matched HI. BMD was measured at three parts (whole body, lower limb, lumbar spine) using dual-energy X-ray absorptiometry (DXA). We compared the percentage change in BMD (%ΔBMD) at the three parts in RA and HI from 2010 to 2017. Factors affecting%ΔBMD in RA were analysed. <h3>Results</h3> Participants comprised 172 HI and 119 RA, after excluding those who dropped out (HI, n=21; RA, n=19) or underwent implant surgery (HI, n=12; RA, n=60). Height and weight reduced significantly over 7 years (p&lt;0.001 each) in both groups (table 1). The%ΔBMDs of RA were −2.6% (whole body), −3.6% (lower limb), and 1.8% (lumbar spine), compared to −2.0%, −2.7%, and 0.6%, respectively, for HI. No significant differences in BMD for the whole body or lower limb were seen during 7 years, while BMD of the lumbar spine was significantly increased in both groups (p&lt;0.0001). No significant differences between groups were identified. In patients with RA, DAS28ESR improved significantly over 7 years (p=0.008; table 1) and%ΔBMD of the lumbar spine correlated significantly with cumulative period of treatment for osteoporosis (r=0.341, p&lt;0.001). The cumulative period of osteoporosis treatment was identified as a regulatory factor for increasing BMD of the lumbar spine (odds ratio: 1.36; p=0.003) adjusted by age and sex (table 2). However, cumulative period of biologics, change of glucocorticoid and DAS28ESR were not detected as factors affecting BMD by logistic regression analysis. <h3>Conclusions</h3> BMD of the whole body and lower limb tended to decrease slightly over 7 years in both groups. However, BMD of the lumbar spine increased significantly. Continued osteoporosis treatment is important for increasing BMD at the lumbar spine in patients with RA. <h3>Reference</h3> [1] Use of bisphosphonate might be important to improve bone mineral density in patients with rheumatoid arthritis even under tight control: the TOMORROW study. Rheumatol Int2017;37:999–1005. <h3>Disclosure of Interest</h3> None declared
FRI0350 Lupus low disease activity state (LLDAS-50) is a significant predictor for damage accrual and mortality: a norwegian cohort analysis
Authors: C. Sharma, W. Raymond, G. Eilertsen, J. NOSSENT
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Disease activity in patients with Systemic Lupus Erythematosus (SLE) is an important contributor to organ damage and premature mortality. Current indices to capture disease activity are not well suited to reflect their contribution to long term outcome. Lupus Low Disease Activity State (LLDAS) has been developed as an alternative measure of long term disease activity. <h3>Objectives</h3> To determine whether 50% of time spent in Lupus Low Disease Activity State (LLDAS-50) impacts on mortality and damage accrual in SLE <h3>Methods</h3> A retrospective analysis of prospectively collected data was conducted on 3650 clinic visits by 207 patients in the Tromsø Lupus Cohort. Lupus Low Disease Activity State −50 (LLDAS50) score was defined as at least 50% of follow-up time with SLE Disease Activity Index (SLEDAI) ≤4, no new disease activity, prednisone ≤7.5 mg/day and no escalation of maintenance immunosuppressant therapy. Cox regression analysis was used to evaluate the impact of LLDAS50 in terms of mortality and damage development (either new or severe) by Systemic Lupus Erythematosus Clinical Criteria (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI). New damage was defined as a rise in SDI by 1 from baseline whereas severe damage was defined as a rise of 3 points or more from baseline. <h3>Results</h3> The median age at diagnosis of the cohort was 34 years with the majority (84%) being female. The median follow-up time was 125 months. A total of 69 patients (33.5%) spent at least half of their follow up time in LDAS, thus achieving LLDAS50. After correction for age and gender, LLDAS-50 was associated with a significant reduction in risk of having any new damage (OR 0.65; 95% CI 0.44–0.96, p&lt;0.01), severe damage (OR 0.46; 95% CI 0.25–0.83, p&lt;0.01), and also a reduction in mortality risk (OR 0.42; 95% CI 0.21–0.82, p&lt;0.01). These values were also tested for those patients who spent 30% or more time in LDAS, and were also found to be significant for death (OR 0.46, 95% CI. 26-0.83, p&lt;0.05) but not for new damage (OR 0.92, 95% CI 0.62–1.35, p=0.67) or severe damage (OR 0.71, 95% CI 0.42–1.19, p=0.19). <h3>Conclusions</h3> The significant reduction in the risk of long term damage and mortality supports the use of LLDAS50 as a therapeutic goal. <h3>Disclosure of Interest</h3> None declared
A Polymorphism in Toll-like Receptor 2 Gene Is Associated with Occurrence of Bacterial Infections in Sickle Cell Disease Patients
Authors: Karina Tozatto-Maio, Robert Girot, Indou Deme Ly, Vanderson Rocha, Ana Cristina Silva Pinto, Ibrahima Diagne, Yahia Benzerara, Carla Luana Dinardo, Simone Kashima, Itaua Leston Araujo, Chantal Kenzey, Guilherme Henrique Hencklain Fonseca, Evandra Rodrigues, Fernanda Volt, Luciana Ribeiro Jarduli, Annalisa Ruggeri, Christina Mary Mariaselvam, Sandra Fatima Menosi Gualandro, Hanadi Elayoubi, Renato Cunha, Barbara Cappelli, Belinda Pinto Simões, Eliane Gluckman, Ryad Tamouza
Journal: Blood (2018)
Echocardiography-Fluoroscopy Fusion Imaging for Guidance of Congenital and Structural Heart Disease Interventions
Authors: Pei-Ni Jone, Alexander Haak, Nils Petri, Michael Ross, Gareth Morgan, Dominik M Wiktor, Edward Gill, Robert A Quaife, John C Messenger, Ernesto E Salcedo, John D Carroll
Journal: JACC. Cardiovascular imaging (2019)
Impaired Tumor-Necrosis-Factor-α-driven Dendritic Cell Activation Limits Lipopolysaccharide-Induced Protection from Allergic Inflammation in Infants
Authors: Holly Bachus, Kamaljeet Kaur, Amber M. Papillion, Tatiana T. Marquez-Lago, Zhihong Yu, André Ballesteros-Tato, Sadis Matalon, Beatriz León
Journal: Immunity (2019)
2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction
Authors: R. Scott Wright, Jeffrey L. Anderson, Cynthia D. Adams, Charles R. Bridges, Donald E. Casey, Steven M. Ettinger, Francis M. Fesmire, Theodore G. Ganiats, Hani Jneid, A. Michael Lincoff, Eric D. Peterson, George J. Philippides, Pierre Theroux, Nanette K. Wenger, James Patrick Zidar
Journal: Journal of the American College of Cardiology (2011)