tbuckley/cabot-search huggingface dataset:
AB1379 Potential diagnostic serum immunological marker panel in primary and secondary osteoarthritis in sri lankan patients
Authors: S. Rankotgedera, I. Atukorala, D. Munidasa, L. Wijayaratne, P. Udagama
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Osteoarthritis (OA) is commonly perceived as a degenerative joint disease but it is now established that inflammation contributes to OA. ThoughOA is categorised into primary and secondary osteoarthritis, most clinicians manage patients of both categories in a similar manner. <h3>Objectives</h3> The current study aimed to identify potential diagnostic markers of primary and secondary OA. Two cohorts of Sri Lankan patients, one with primary OA and another with secondary OA were assessed for a selected panel of immunologic mediators i.e. cytokines (TNF-α, IL-1β, IL-6, IL-10) and nitric oxide derivatives (NOx). <h3>Methods</h3> A case control study was conducted with 40 OA patients (Primary, n=30; Secondary, n=10), and 60 age and gender matched controls (normal healthy, n=30; Systemic Lupus Erythematosus (SLE) disease control, n=30). The socioeconomic and demographic data were accrued via an interviewer administered questionnaire. Sandwich ELISAs assayed serum cytokine levels, while the 'Griess assay' measured serum NOx levels. <h3>Results</h3> In comparison to healthy controls, OA patients showed significantly higher serum concentrations of all five analytes tested (p&lt;0.05). Patients with primary OA had significantly higher levels of TNF-α and IL-1β and lower level of IL-6 in serum compared to disease controls (SLE) (p&lt;0.05). secondary OA patients exhibited a significant increase in serum TNF-α and IL-1β and lower serum IL-10 levels compared to disease controls (p&lt;0.05). In the two test groups, the serum levels of TNF-α and IL-6 were significantly elevated in secondary OA patients (p&lt;0.05). The NOx concentrations between the two test groups was not significantly different. The Th1:Th2 cytokine ratio (TNF-α:IL-10) was significantly higher in secondary OA compared with primary OA (p&lt;0.05). The Receiver operating characteristic (ROC) curves identified TNF-α and IL-10 as potential diagnostic biomarkers of both primary OA and secondary OA compared with healthy controls. IL1-β and IL-6 may be used specifically as diagnostic biomarkers for primary and secondary OA, respectively, when compared with healthy individuals.TNF-α is a suitable biomarker for the diagnosis of both primary and secondary OA when compared to SLE patients, whereas IL-6 and IL-1β were apparent explicit markers of primary OA, while IL-10 was exclusive for secondary OA. <h3>Conclusions</h3> This preliminary study suggests that higher levels of inflammatory cytokines are present in secondary OA compared to primary OA. Furthermore, distinct markers for primary and secondary OA were identified, indivative of the potential for developing different therapeutic agents for the different types of OA. <h3>Acknowledgements</h3> The authors acknowledge the University of Colombo, Sri Lanka for funding. <h3>Disclosure of Interest</h3> None declared
AB0493 Effectiveness of subcutaneous presentation of methotrexate in patients with rheumatoid artrhitis
Authors: L. Villarreal, M. Rivero, D. Buitrago-Garcia, M. Cabrera, P. Santos-Moreno
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Methotrexate (MTX) is one of the most used drugs for the treatment of rheumatoid arthritis (RA) and has become the gold standard of therapy. It can be given via oral, intramuscular or subcutaneous (SC). MTX is a highly effective therapy for patients with RA; however, oral MTX has been associated with gastrointestinal intolerance diminishing the adherence of patients to treatment and increasing the switching to biological therapy. Thus, the use of SC methotrexate can improve its efficacy compared to oral MTX. <h3>Objectives</h3> The aim was to determine the effectiveness and safety of SC MTX in patients with rheumatoid arthritis. <h3>Methods</h3> We performed a retrospective descriptive analysis; our main goal was to provide real-life data regarding effectiveness of SC MTX in patients with RA. We excluded patients who were in remission. Clinical follow-up was designed by the authors according to DAS28 as follows: every 3–5 weeks (DAS28 &gt;5.1), every 7–9 weeks (DAS28 ≥3.1 and ≤5.1), and every 11–13 weeks (DAS28 &lt;3.1). Tender joint count (TJC), swollen joint count (SJC) and DAS28 were measured on each visit. Therapy had to be adjusted with DAS28 &gt;3.2 unless patient's conditions don't permit it; regarding the effectiveness of SC MTX we calculated means, and standard deviations for continuous variables and categorical variables were presented as rates. We performed a bivariate analysis using Pearson's chi<sup>2</sup> <h3>Results</h3> A total of 132 patients meet our inclusion criteria, 88% were female and 12% male. Mean age was 61 years±9. Mean DAS28 at baseline was 3.8±0.83, while at 12 months mean DAS28 was 3.28±1.12. Clinical disease activity CDAI at baseline had a mean of 9.6±7.2 and at 12 months 7.8±7.5. We achieved remission in 33% of patients according to DAS28% and 29% according to CDAI, also it was a significant decrease in patients with moderate disease activity see table 1. Finally, there was a statistical significance between disease activity at baseline compared to disease activity at 12 months (p&lt;0.005). It was not observed major complaints with SC MTX, only 5% of the patients reported some mild and transient discomfort at the local application site. <h3>Conclusions</h3> Subcutaneous MXT is an effective and safe alternative for the treatment in patients with RA and intolerance to oral MTX, and could be a good option to prevent a premature switching to biological therapy. <h3>Disclosure of Interest</h3> None declared
External validation of risk factors for malignant ventricular arrhythmias in lamin A/C mutation carriers
Authors: Marine Thuillot, Carole Maupain, Estelle Gandjbakhch, Xavier Waintraub, Françoise Hidden‐Lucet, Richard Isnard, Flavie Ader, Stephanie Rouanet, Pascale Richard, Philippe Charron
Journal: European Journal of Heart Failure (2019)
Measles: two US outbreaks are blamed on low vaccination rates
Authors: Janice Hopkins Tanne
Journal: BMJ (2019)

Measles outbreaks on the east and west coasts of the United States have been blamed on low vaccination rates and imported cases. Over 200 cases have been reported, including several hospital admissions but no deaths.

Most cases have occurred in people who have not been vaccinated with the measles, mumps, and rubella vaccine (MMR vaccine) or who have not received the two recommended doses, at ages 12-18 months and 4-6 years. Most states allow parents to use religious reasons to opt out of vaccinations that are required for day care or school attendance, but 18 states allow parents to opt out for philosophical reasons.

Measles kills about one child in 1000, and the under 5s, over 20s, and people with compromised immune systems are most at risk.1

The World Health Organization has listed …
AB1044 The education of patients with gout improves the effects of treatment
Authors: S.-J. Yoo, S.W. Kang, S.C. Shim, J. Kim, I.S. Yoo, C.K. Park
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The recent studies about gout demonstrated the correlation between gout and cardiovascular disease (CVD). The urate lowering therapy (ULT) ameliorates the outcomes of CVD. The poor adherence with ULT in patients with gout is the main obstacle. It is induced mainly due to a lack of adequate information about the efficacy of ULT. <h3>Objectives</h3> This study was performed to analyse the effects of the education for patients with gout. <h3>Methods</h3> 116 patients with gout were enrolled and categorised by two groups, education and non-education. The face to face education was conducted by the specially educated nurse. And all participants in two groups received an leaflet about general information of gout including lifestyle advice, nutrition and drugs of ULT. The patients in non-education group were also educated by nurse on their second visit (after two or three month from first visit). The score of patients' satisfaction using the visual analogue scale (from 0 to 100 mm) and questionnaire about satisfaction and questionnaire of patients' knowledge about disease (gout) were assessed. And we analysed patients' serum uric acid level and drug compliance. <h3>Results</h3> A total of 116 patients were randomised to education or non-education group equally. Patients' satisfaction in visual analogue scale was significantly higher in education group (education group: 82.7±21.0 mm, vs. non-education group: 72.8±20.7 mm, p&lt;0.001). Patients' satisfaction questionnaire was significantly higher in education group (education group: 3.89±0.5, vs. non-education group: 3.69±0.4, p=0.017). The level of knowledge about gout was higher in education group (education group: 7.4±2.0, vs. non-education group: 6.2±2.3, p=0.004). The serum uric acid level on second visit is decreased after education (baseline: 5.97±1.93 mg/dL, vs. second visit: 5.32±1.35 mg/dL, p=0.001). Besides drug compliance on second visit is improved after education (baseline: 89.6%±16.4%, vs. second visit: 94.3%±9.9%, p=0.018). <h3>Conclusions</h3> The face to face education for gout improved the patients' satisfaction, drug adherence and serum uric acid level. The education is very important part in treatment of gout. <h3>References</h3> [1] Singh JA, Strand V. Gout is associated with more comorbidities, poorer health-related quality of life and higher healthcare utilisation in US veterans. Ann Rheum Dis2008;67:1310–6. [2] Reesi F, Jenkins W, Doherty MPatients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational study. Ann Rheum Dis201372: 826–830. [3] Cho SK, Kim D, Choi J, et al. Impact of Patient Education on the Satisfaction of Rheumatoid Arthritis Patients: A Randomized Trial of Nurse-led Versus Medical Docter-led Education. J Rheum DisVol. 23, No. 2, April, 2016. <h3>Disclosure of Interest</h3> None declared
After the Storm — A Responsible Path for Genome Editing
Authors: George Q. Daley, Robin Lovell-Badge, Julie Steffann
Journal: New England Journal of Medicine (2019)

Interview with Dr. George Daley on the prospects for using genome editing to prevent genetic diseases. (10:11)Download Though the first application of embryo editing was deeply flawed, not least because it didn't address an unmet clinical need, and has prompted calls for a ban, halting research and deliberation on more responsible ways to maximize human benefit would be unwise.
Tube-assisted suction: a novel technique for removing massive food residue during gastroscopy
Authors: Xianhui Zeng, Ping Yan, Liansong Ye, Linjie Guo, Nianhong Wu, Bing Hu
Journal: Endoscopy (2019)

A 44-year-old man with achalasia was scheduled to undergo peroral endoscopic myotomy for recurrence after Heller myotomy. Massive food residue was observed in the lower esophagus, despite repeated and adequate fasting ([Fig. 1]). Repeated irrigation and suction by the endoscope (GIF-Q260J; Olympus, Tokyo, Japan) failed to remove the food residue. Grasping forceps (basket type, FG-16L-1; Olympus) did not work either. Therefore, tube-assisted suction was performed ([Video 1]).
Combined Targeting of BET Family Proteins and BCL2 Is Synergistic in Acute Myeloid Leukemia Cells Overexpressing S100A8 and S100A9
Authors: Riikka Karjalainen, Minxia Liu, Ashwini Kumar, Alun Parsons, Liye He, Dishaben Rameshbhai Malani, Mika Kontro, Kimmo Porkka, Caroline A Heckman
Journal: Blood (2018)
Follicular Lymphoma Grade 3A Exhibits Pathological and Cytogenetic Diversity, but Similar Prognosis Compared to FL Grade 1-2: Pooled Analysis of 1757 Follicular Lymphomas from the PRIMA and Relevance Trials
Authors: Camille Laurent, Danielle Canioni, Bettina Fabiani, Véronique Meignin, Catherine Chassagne-Clément, Peggy Dartigues-Cuillères, Christiane Copie, Guillaume Cartron, Franck Morschhauser, Gilles Salles, Luc Xerri
Journal: Blood (2018)
THU0179 Mir-382–5p targeting il-33 gene as biomarker to predict subclinical atherosclerosis progression in patients with early rheumatoid arthritis
Authors: T.H. Cheng, Q. Shang, E. K. M. Li, M. Li, W.Y. Mak, K.Y. Kwok, I.C.W. Yim, P.C.H. Wong, V.W.N. Lao, S.H.T. Pang, E.W.L. Kun, L.S. Tam
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Patients with rheumatoid arthritis(RA) had increased risk of cardiovascular disease(CVD). IL-33, a member of the IL-1 family, plays an important role in the pathogenesis of RA and development of CVD. Yet, plasma IL-33 level was not detectable in most subjects which limits it's utility as a biomarker for CVD. Meanwhile, microRNAs(miRNAs) targeting IL-33 gene expression might play a role. <h3>Objectives</h3> To ascertain if dysregulated miRNAs targeting <i>IL-33</i> gene expression in earlyRA patients were associated with subclinical atherosclerosis progression <h3>Methods</h3> 73 ERA patients were recruited for this 1 year cohort study. Potential miRNAs binding to <i>IL-33</i> gene were predicted by miRanda. 10 miRNAs with the highest possibility of targeting functional sites of <i>IL-33</i> gene were quantified in cell free plasma samples. cel-miR-39 was used as spike-in control. Carotid plaque(CP) was identified using high-resolution ultrasound annually. Plaque progression(PP) was defined as an increased region harbouring plaque. <h3>Results</h3> CPs were identified in 25 (34%) and 31 (43%) subjects at baseline and month 12 respectively. 16 (22%) subject had plaque progression(PP +group). At baseline, subjects in PP +group were older, with lower pain and patient global scores, a higher proportion on conventional synthetic DMARDs, and higher cardiovascular risk compared to patients without plaque progression (PP-) (table 1). Plasma level of miR-382–5 p in the PP +group was significantly higher than that in the PP- group after adjusting for baseline difference (table 1). Using multivariate logistic regression, miRNA-382–5 p was an independent predictor for plaque progression(OR:2.534, 95%CI=1.079–5.952, p=0.033) after adjustment of baseline characteristics. [AUC:0.66,95% CI:0.51–0.81,p=0.048]. Other independent predictor included higher baseline Framingham risk score, diastolic BP and lower pain score. <h3>Conclusions</h3> miR-382–5 p was an independent predictor for progression of subclinical atherosclerosis and may serve as a novel biomarker for cardiovascular risk assessment in ERA patients. <h3>Acknowledgements</h3> Acknowledgement to Hong Kong Society of Rheumatology Project Fund for supporting this project. <h3>Disclosure of Interest</h3> None declared
AB0286 Assessment of treatment adherence in rheumatoid arthritis italian patients using a validated version of the 5-item compliance questionnaire for rheumatology (I-CQR5)
Authors: F. Ometto, B. Raffeiner, C. Botsios, D. Astorri, L. Friso, D. Azzolina, M. Favero, J. Done, D. Gregori, A. Doria
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The 5-item Compliance Questionnaire for Rheumatology (CQR5) allows the identification of patients likely to be high adherers (HA) to anti-rheumatic treatment (i.e. taking ≥80% of their medications correctly), or "low" adherers (LA).<sup>1</sup> We have previously validated an Italian version of the questionnaire (I-CQR5) following standardised guidelines. <h3>Objectives</h3> The objective was to investigate what factors are associated with high treatment adherence according to I-CQR5 in RA. <h3>Methods</h3> RA patients (disease duration &gt;1 year, undergoing treatment with ≥1 self-administered biological or conventional synthetic disease-modifying anti-rheumatic drugs (bDMARDs, csDMARDs), capable of completing the questionnaire unaided) completed I-CQR5 on one occasion. I-CQR5 were anonymous and clinical data were retrieved anonymously from the local database. To investigate what factors were associated with high adherence, we included demographic and social characteristics, clinical and treatment information. Factors achieving a p&lt;0.10 in univariate analysis were included in the multivariate regression analysis. <h3>Results</h3> Among 604 RA patients, 328 patients were enrolled, 18 questionnaires were incomplete. Median age of the patients was 57 years,<sup>48–67</sup> females were 232 (82%), disease duration was 12 years;<sup>7–19</sup> 193 (64.3%) patients were treated with bDMARDs and 107 (54.6%) with csDMARD only; 270 (90.3%) were in low disease activity or remission (figure 1). HA were found to be 35.2% (109/310) of the patients.40.2% (79/193) were on bDMARDs and 22.4% (24/107) on csDMARDs. Older age, lower education level, higher prednisone daily dose, use of a csDMARD (particulary hydroxychloroquine and sulfasalazine) and higher patient-VAS were significantly more frequent in LA compared with HA (figure 1). In the multivariate analysis, bDMARD treatment and employment resulted independently associated with high adherence: OR 2.88 (1.36–6.1), p=0.006 and OR 2.36 (1.21–4.62), p=0.012 respectively (table 1). <h3>Conclusions</h3> Only one third of Italian RA patients were highly adherent to treatment according to I-CQR5. Treatment with bDMARDs and employment status were the major determinants of treatment adherence, increasing by almost 3-fold the likelihood of being highly adherent. <h3>Reference</h3> [1] Hughes L, et al. A 5 item version of the Compliance Questionnaire for Rheumatology (CQR5) successfully identifies low adherence to DMARDs. BMC Musculoskelet Disord2013;14:286. <h3>Disclosure of Interest</h3> None declared
AB0421 Low rates of retention of biologic dmard monotherapy in patients with rheumatoid arthritisin real life settings
Authors: A. Lazarini, K. Thomas, E. Kaltsonoudis, A. Drosos, P. Tsatsani, S. Gazi, L. Pantazi, K.A. Boki, P. Katsimbri, D. Boumpas, K. Fragkiadaki, M. Tektonidou, P.P. Sfikakis, K. Karagianni, L. Sakkas, E. Grika, P. Vlachoyiannopoulos, G. Evangelatos, A. Iliopoulos, T. Dimitroulas, A. Garyfallos, K. Melissaropoulos, P. Georgiou, M. Areti, C. Georganas, P. Vounotrypidis, G. Kitas, D. Vassilopoulos
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> A number of cross-sectional studies have shown that approximately one quarter of rheumatoid arthritis (RA) patients are being treated with biologic disease modifying anti-rheumatic drugs (bDMARDs) as monotherapy. Data regarding the retention of bDMARD monotherapy in real-life settings are limited. <h3>Objectives</h3> To study the survival rate of bDMARD monotherapy in RA patients in daily clinical practice. <h3>Methods</h3> Multicenter (11 hospital, 3 private office practices), prospective, RA epidemiological study in Greece. At baseline and after one year of follow-up, demographics, disease characteristics, treatments, co-morbidities and serious events (serious infections, cardiovascular events, neoplasms, osteoporotic fractures) were collected via a web-based platform. <h3>Results</h3> 1.323 RA patients with paired evaluations one year apart (mean interval: 13.2±3.7 months) were included. Among 611 bDMARD treated patients, 155 patients (25%) were on bDMARD monotherapy (women: 87%, mean age: 60.4 years, mean disease duration: 15 years, RF and/or anti-CCP positive: 66%, TNFi therapy: 57%). The majority had been previously on and had discontinued their csDMARDs (90%). During follow-up, 15% (n=24) discontinued their bDMARD; most of them stayed off any type of therapy (83%) while the rest continued with synthetic DMARD (csDMARD) monotherapy (17%). From the remaining 131 patients, 96 (73%) remained on bDMARD monotherapy (85%, n=82 on the same biologic) while in 27% (n=35) a csDMARD was added. Serious events occurred in 7.7% of patients (n=12). Overall, at the end of 1st year, approximately half of patients (53%, n=82) remained on their initial bDMARD monotherapy. Factors associated with continuation of the same bDMARD by multivariate analysis were a low HAQ score (OR=0.48, 95% C.I.=0.23–0.99, p=0.047) and corticosteroid use (OR=2.2, 95% C.I.=1.02–5.1, p=0.044) at baseline as well as the absence of a serious event during the 1st year of follow-up (OR=0.14, 95% C.I.=0.016–1.3, p=0.094). <h3>Conclusions</h3> In real life settings, only half of patients who are on bDMARD monotherapy continue the same agent one year later. Low HAQ score, corticosteroid use and absence of a serious event during therapy predicted bDMARD monotherapy survival. <h3>Acknowledgements</h3> Supported by grants from the Greek Rheumatology Society and Professional Association of Rheumatologists. <h3>Disclosure of Interest</h3> None declared
FRI0453 Hospitalisation and survival analysis in systemic sclerosis patients with concomitant or isolated pulmonary hypertension and interstitial lung disease in the multiethnic scleroderma cohort singapore
Authors: M. Noviani, E.S. Seyed, S.M.Y. Kua, G.Y.L. Chan, G.G. Teng, W.G. Law, A. Santosa, A. Lim, J.L. Tan, E.L.W. Tay, J.W.L. Yip, S.C. Ng, A.H.L. Low
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Concomitant pulmonary hypertension and interstitial lung disease in systemic sclerosis (SSc-PH-ILD) represents a distinct subpopulation of SSc with poorer prognosis in Western studies. In Asian patients, characterisation of SSc-PH-ILD is still lacking. <h3>Objectives</h3> To analyse hospital admissions, survival and prognostic markers among SSc patients with PH, ILD or concomitant PH-ILD in the Scleroderma Cohort Singapore. <h3>Methods</h3> In this study involving 3 tertiary Rheumatology institutions Jan 2008 to , Oct 2016 SSc patients with significant pulmonary involvement were included. ILD was based on high resolution computed tomography and predicted FVC &lt;70%. PH was based on either echocardiographic systolic pulmonary arterial pressure (sPAP) ≥50 mmHg, or right heart catheterization (RHC) findings of mean PAP≥25 mmHg. Hospitalisation rates and survival of SSc patients with PH, ILD or PH-ILD were compared. Risk factors of poor outcomes were identified by multivariate stepwise Cox regression analysis. <h3>Results</h3> Among 490 patients, 92 had ILD, 50 PH and 43 PH-ILD (table 1). Of 93 patients with PH or PH-ILD, 56 were based on echocardiography and 37 on RHC. The 5 year survival was 79%, 87% and 90% in PH, PH-ILD and ILD subgroup, respectively (figure 1). In multivariable analysis, PH was significantly associated with 2.8-fold increased risk of death. Male gender, malabsorption, digital ulcerations and renal crisis were also significantly associated with mortality (table 2). No significant difference in hospital admissions/year among different subgroups. Increased hospital admissions were associated with renal crisis, right heart failure and use of PH medications. <h3>Conclusions</h3> Compared to those with ILD or PH-ILD, SSc-PH patients had increased mortality, but not hospitalisation rates. This could be due to small sample size or short follow up duration. We identified risk factors associated with worse outcomes in SSc patients with significant pulmonary involvement. <h3>Disclosure of Interest</h3> None declared