tbuckley/cabot-search huggingface dataset:
AB0616 The correlation between focus score and ultrasonography of major salivary glands in primary sjÖgren syndrome
Authors: A. Sebastian, J. Silicki, A. Hałoń, P. Wiland
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Currently, the role of salivary gland ultrasonography (SGUS) in the diagnosis of <i>primary Sjögren's syndrome</i> (pSS) is being determined. So far, in none of the proposed classification criteria for pSS SGUS is taken into consideration. The most recent analyses of patients show that SGUS can prove to be useful in the identification of even early forms of pSS. <h3>Objectives</h3> We analized the SGUS changes in patients with pSS and its correlations with focus score (FS) of minor salivary glands and immunological and laboratory profile. <h3>Methods</h3> We included 68 patients with pSS in the mean age of 51, based on the classification criteria from 2002. <h3>Results</h3> In 33 (48%) patients were abnormal findings in major salivary glands detected (table 1). Scattered hypoechogenic changes of different size were the most common observed changes in SGUS, mainly in parotid glands. The FS was significantly higher in patients with changes in SGUS compare to the patients with normal images of major salivary glands (2.6 SD 1.3 vs 1.8 SD 1.2; p=0.02). In patients with SGUS abnormalities the hypergammaglobulinemia was most often observed (1.7 g/dl vs 1.2 g/dl; p=0.02). There was not the correlation between changes in major salivary glands and age (p=0.5), CRP value (p=0.1), ESR value (p=0.1), with blood cell count (p=0.1), rheumatoid factor (p=0.1), dry eye (p=01.), oral dryness (p=0.2), anty-SSA antibodies (p=0.5), anty-SSB antibodies (p=0.2), anty-Ro52 antibodies (p=0.4) observed. <h3>Conclusions</h3> SGUS is a useful tool in patients with pSS. The abnormal images in SGUS of major salivary glands correlated with focus score of minor salivary glands and hypergammaglobulinemia but not with specific antibodies. <h3>Disclosure of Interest</h3> None declared
How to get started in quality improvement
Authors: Bryan Jones, Emma Vaux, Anna Olsson-Brown
Journal: BMJ (2019)

What you need to know• Participation in quality improvement can help clinicians and trainees improve care together and develop important professional skills• Effective quality improvement relies on collaborative working with colleagues and patients and the use of a structured method• Enthusiasm, perseverance, good project management skills, and a willingness to explain your project to others and seek their support are key skillsQuality improvement (box 1) is a core component of many undergraduate and postgraduate curriculums. [1]2][3][4][5] Numerous healthcare organisations, 6 professional regulators, 7 and policy makers 8 recognise the benefits of training clinicians in quality improvement. Box 1: Defining quality improvement 1Quality improvement aims to make a difference to patients by improving safety, effectiveness, and experience of care by: Using understanding of our complex healthcare environment Applying a systematic approach Designing, testing, and implementing changes using real time measurement for improvement
FRI0388 Risk of preventable admissions among patients with systemic lupus erythematosusprior and subsequent diagnosis
Authors: T.-T. Chung, C.-F. Kuo, J.-S. Chen, M.-J. Chiou
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Preventable hospitalizations for specific conditions are considered preventable because appropriate outpatient care should potentially avoid hospitalisation for these conditions. Although not all of the hospitalizations can be prevented, to identify the rate of preventable hospitalizations among patients with systemic lupus erythematosus (SLE) can help us to understand the excess potential preventable hospitalizations and to provide an action to the SLE patients. <h3>Objectives</h3> To investigate the risk of preventable hospitalisation in patients with SLE before and after initial diagnosis of the disease. <h3>Methods</h3> We identified 4483 adult patients with incident SLE between 2005 and 2009 using the Taiwan National Health Insurance Database. Each SLE patients were matched to five controls without SLE during the same study period, by age and sex. The index date was the first date of SLE diagnosis and their matched controls. We estimated the incidence and incidence rate ratios (IRRs) of preventable hospitalisation by conditional Poisson regression, adjusted for age, sex, Elixhauser Comorbidity Index, number of outpatient visits and hospitalizations 1-y prior to index date, residence urbanisation, income levels, occupation and the number of physicians at the patients' residence. <h3>Results</h3> The overall incidence of preventable hospitalisation was 1.88 (95% CI, 1.74 to 2.03) per 1000 person-months among SLE patients and 0.53 (95% CI, 0.49 to 0.56) per 1000 person-months among controls, giving an adjusted IRR of 3.57 (95% CI, 3.25 to 3.93). The IRRs especially higher in heart failure, bacterial pneumonia and urinary tract infection and the respective estimates were were 2.85 (95% CI, 2.14 to 3.80),4.67 (95% CI, 4.03 to 5.42) and 3.84 (95% CI,3.35 to 4.41). <h3>Conclusions</h3> Risk of preventable hospitalisation is higher in patients with SLE. <h3>Disclosure of Interest</h3> None declared
Robust Cell Selections and Depletions across Various Hematopoietic Cell Fractions on the Clinimacs Plus Instrument
Authors: Thejaswi Bikkani, Katherine Li, Anusha Rao, Angela Pickett, Xiaobai Li, Minoo Battiwalla, Richard W. Childs, John Barrett, Andre Larochelle, Elizabeth Kang, David F. Stroncek, Sandhya R. Panch
Journal: Blood (2018)
Effect of ethanol on lipid metabolism
Authors: Min You, Gavin E. Arteel
Journal: Journal of Hepatology (2019)

Hepatic lipid metabolism is a series of complex processes that control influx and efflux of not only hepatic lipid pools, but also organismal pools. Lipid homeostasis is usually tightly controlled by expression, substrate supply, oxidation and secretion that keep hepatic lipid pools relatively constant. However, perturbations of any of these processes can lead to lipid accumulation in the liver. Although it is thought that these responses are hepatic arms of the 'thrifty genome', they are maladaptive in the context of chronic fatty liver diseases. Ethanol is likely unique among toxins, in that it perturbs almost all aspects of hepatic lipid metabolism. This complex response is due in part to the large metabolic demand placed on the organ by alcohol metabolism, but also appears to involve more nuanced changes in expression and substrate supply. The net effect is that steatosis is a rapid response to alcohol abuse. Although transient steatosis is largely an inert pathology, the chronicity of alcohol-related liver disease seems to require steatosis. Better and more specific understanding of the mechanisms by which alcohol causes steatosis may therefore translate into targeted therapies to treat alcohol-related liver disease and/or prevent its progression.
Microvascular Dysfunction in Dilated Cardiomyopathy
Authors: Ankur Gulati, Tevfik F Ismail, Aamir Ali, Li-Yueh Hsu, Carla Gonçalves, Nizar A Ismail, Kaushiga Krishnathasan, Natasha Davendralingam, Pedro Ferreira, Brian P Halliday, Daniel A Jones, Ricardo Wage, Simon Newsome, Peter Gatehouse, David Firmin, Andrew Jabbour, Ravi G Assomull, Anthony Mathur, Dudley J Pennell, Andrew E Arai, Sanjay K Prasad
Journal: JACC. Cardiovascular imaging (2019)
FRI0579 Diagnostic utility of metatarsophalangeal synovitis identified by ultrasonography for early rheumatoid arthritis
Authors: M. Okamoto, K. Fujikawa, A. Mizokami, Y. Endo, M. Mine, A. Kawakami
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> In patients with rheumatoid arthritis (RA), synovitis can occur at not only hand and finger joints but also the metatarsophalangeal (MTP) joints. However, power Doppler ultrasonography (PDUS) findings of the MTP joints and its diagnostic utility remain unclear in patients with early RA. <h3>Objectives</h3> The present study investigated whether the detection of MTP synovitis by PDUS is useful for the diagnosis of early RA. <h3>Methods</h3> The study enrolled 174 patients with suspected RA within 6 months of onset. We assessed the articular synovium using grey scale (GS) and power Doppler (PD) signals with a semi-quantitative method (grades 0–3) in both hand and finger joints (22 joints) and MTP joints (10 joints) by PDUS. In addition, we evaluated bone erosion and intermetatarsal bursitis. We defined GS grade ≥1 and PD grade ≥1 as PDUS synovitis. We evaluated the diagnostic accuracy of PDUS synovitis for RA. <h3>Results</h3> Of the 174 patients, 59 were diagnosed with RA and 115 did not have RA. Among the patients with RA, 47 (80%) had PDUS synovitis in the hand and finger joints and 32 (54%) had PDUS synovitis in the MTP joints. The frequencies of PDUS synovitis in each MTP joint, bone erosion of the fifth MTP joint, and intermetatarsal bursitis were significantly higher in patients with RA than in those without RA. The diagnostic accuracy of PDUS synovitis in the hand and finger joints was good, with a sensitivity of 80%, specificity of 77%, and accuracy of 78%. On considering the MTP joints in addition to the hand and finger joints, the diagnostic accuracy improved, with a sensitivity of 92%, specificity of 74%, and accuracy of 80%. In this study, 7 patients (12%) with RA had synovitis in the MTP joints and not in the hand and finger joints. <h3>Conclusions</h3> When synovitis cannot be detected in the hand and finger joints by PDUS, scanning of the MTP joints could be useful for the diagnosis of early RA. RA, rheumatoid arthritis Fisher's exact probability test <h3>Disclosure of Interest</h3> None declared
AB1409-HPR Gait stability in individuals with chronic idiopathic neck pain
Authors: M Kirmizi, I.E. SIMSEK, A. ELVAN, O. AKCALI, S. ANGIN
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Gait stability ratio (GSR) is represented by step counts per metre during walking. Higher GSR value means to increase in time spent on double support period and decrease in dynamic components of gait, which refers to more stable gait pattern. Recent studies showed that individuals with chronic idiopathic neck pain (CINP) demonstrate altered balance and gait parameters. However, it is not clear whether GSR is affected in individuals with CINP. <h3>Objectives</h3> We have hypothesised that GSR could be altered in individuals with CINP because of their altered gait pattern. Therefore the aim of the study was to compare GSR, gait speed, step length and cadence between individuals with CINP and healthy controls and investigate the relationship between disability and spatiotemporal gait parameters in individuals with CINP. <h3>Methods</h3> Twenty-five individuals with CINP (17 female – 8 male, mean age: 37,28±13,47) and 25 healthy controls (17 female – 8 male, mean age: 36,6±14,2) recruited into this study. Participants with CINP completed the Turkish version of Neck Disability Index (NDI). All participants performed the 10-metre walking test in three walking conditions: Preferred walking (PW), walking with head rotation (HRW), walking at maximum speed (MAXW). Video analysis method involving slow motion camera (120 fps) was used to measure spatiotemporal gait parameters. GSR was calculated by dividing cadence (step/s) to gait speed (m/s). Independent samples t-test was used to compare groups for GSR and other gait parameters. Pearson correlation coefficients were computed to find associations between NDI and gait parameters. <h3>Results</h3> Individuals with CINP exhibited slower gait speed and cadence in all walking conditions (p&lt;0.05). In individuals with CINP, step length was found to be shorter in only HRW (p&lt;0.05), however, GSR was higher in HRW and MAXW (p&lt;0.05). GSR values calculated in three walking conditions were found to be moderately correlated with NDI (r=507 for PW, r=533 for HRW, r=516 for MAXW, p&lt;0.05). A negative and moderate correlation was found between preferred walking speed and NDI (r=-473, p&lt;0.05). <h3>Conclusions</h3> Our results suggested that neck pain have a negative impact on gait parameters. Also, individuals with CINP had a more stable gait pattern involving less dynamic components. Assessment of GSR and related gait parameters in different walking conditions may be addressed in clinical assessment of CINP and may provide additional information for management of such disability. <h3>References</h3> [1] Cromwell RL, Newton RA. Relationship between balance and gait stability in healthy older adults. Journal of Aging and Physical Activity2004;12(1):90–100. [2] Uthaikhup S, Sunkarat S, Khamsaen K, Meeyan K, et al. The effects of head movement and walking speed on gait parameters in patients with chronic neck pain. Manual therapy2014;19(2):137–41. <h3>Disclosure of Interest</h3> None declared
rAAVrh74.MCK.GALGT2 Protects against Loss of Hemodynamic Function in the Aging mdx Mouse Heart
Authors: Rui Xu, Ying Jia, Deborah A. Zygmunt, Paul T. Martin
Journal: Molecular Therapy (2019)

Dilated cardiomyopathy is a common cause of death in patients with Duchenne muscular dystrophy (DMD). Gene therapies for DMD must, therefore, have a therapeutic impact in cardiac as well as skeletal muscles. Our previous studies have shown that GALGT2 overexpression in mdx skeletal muscles can prevent muscle damage. Here we have tested whether rAAVrh74.MCK.GALGT2 gene therapy in mdx cardiac muscle can prevent the loss of heart function. Treatment of mdx hearts with rAAVrh74.MCK.GALGT2 1 day after birth did not negatively alter hemodynamic function, tested at 3 months of age, and it prevented early left ventricular remodeling and expression of fibrotic gene markers. Intravenous treatment of mdx mice with rAAVrh74.MCK.GALGT2 at 2 months of age significantly improved stroke volume and cardiac output compared to mock-treated mice analyzed at 17 months, both at rest and after stimulation with dobutamine. rAAVrh74.MCK.GALGT2 treatment of mdx heart correlated with increased glycosylation of α-dystroglycan with the CT glycan and increased utrophin protein expression. These data provide the first demonstration that GALGT2 overexpression can inhibit the loss of cardiac function in the dystrophin-deficient heart and, thus, may benefit both cardiac and skeletal muscles in DMD patients.
Targeting FLT3 mutations in AML: review of current knowledge and evidence
Authors: Naval Daver, Richard F. Schlenk, Nigel H. Russell, Mark J. Levis
Journal: Leukemia (2019)

Abstract Genomic investigations of acute myeloid leukemia (AML) have demonstrated that several genes are recurrently mutated, leading to new genomic classifications, predictive biomarkers, and new therapeutic targets. Mutations of the FMS-like tyrosine kinase 3 ( FLT3 ) gene occur in approximately 30% of all AML cases, with the internal tandem duplication (ITD) representing the most common type of FLT3 mutation ( FLT3 -ITD; approximately 25% of all AML cases). FLT3 -ITD is a common driver mutation that presents with a high leukemic burden and confers a poor prognosis in patients with AML. The prognostic value of a FLT3 mutation in the tyrosine kinase domain ( FLT3 -TKD), which has a lower incidence in AML (approximately 7–10% of all cases), is uncertain. Accumulating evidence demonstrates that FLT3 mutational status evolves throughout the disease continuum. This so-called clonal evolution, together with the identification of FLT3 -ITD as a negative prognostic marker, serves to highlight the importance of FLT3 -ITD testing at diagnosis and again at relapse. Earlier identification of FLT3 mutations will help provide a better understanding of the patient’s disease and enable targeted treatment that may help patients achieve longer and more durable remissions. First-generation FLT3 inhibitors developed for clinical use are broad-spectrum, multikinase inhibitors; however, next-generation FLT3 inhibitors are more specific, more potent, and have fewer toxicities associated with off-target effects. Primary and secondary acquired resistance to FLT3 inhibitors remains a challenge and provides a rationale for combining FLT3 inhibitors with other therapies, both conventional and investigational. This review focuses on the pathological and prognostic role of FLT3 mutations in AML, clinical classification of the disease, recent progress with next-generation FLT3 inhibitors, and mechanisms of resistance to FLT3 inhibitors.
Is Watch-and-Wait Ready for Prime Time?
Authors: Charles R. Thomas
Journal: JAMA Oncology (2019)

J. Joshua Smith, MD, PhD; Paul Strombom, MD; Oliver S. Chow, MD; Campbell S. Roxburgh, MD, PhD; Patricio Lynn, MD; Anne Eaton, MS; Maria Widmar, MD; Karuna Ganesh, MD, PhD; Rona Yaeger, MD; Andrea Cercek, MD; Martin R. Weiser, MD; Garrett M. Nash, MD, MPH; Jose G. Guillem, MD, MPH; Larissa K. F. Temple, MD, MSc; Sree B. Chalasani, MD; James L. Fuqua, MD; Iva Petkovska, MD; Abraham J. Wu, MD; Marsha Reyngold, MD, PhD; Efsevia Vakiani, MD, PhD; Jinru Shia, MD; Neil H. Segal, MD, PhD; James D. Smith, MD, PhD; Christopher Crane, MD; Marc J. Gollub, MD; Mithat Gonen, PhD; Leonard B. Saltz, MD; Julio Garcia-Aguilar, MD, PhD; Philip B. Paty, MD
Efficacy and safety of antiscabietic agents: A systematic review and network meta-analysis of randomized controlled trials
Authors: Kunlawat Thadanipon, Thunyarat Anothaisintawee, Sasivimol Rattanasiri, Ammarin Thakkinstian, John Attia
Journal: Journal of the American Academy of Dermatology (2019)

Many drugs have been used to treat scabies, but it is unclear which of them is the most efficacious.To evaluate the comparative efficacy and safety of antiscabietic agents.A systematic review of randomized controlled trials was conducted. Direct and network meta-analyses were applied to 13 antiscabietic agents on 3 outcomes (cure, persistent itching, and adverse events). Their probability of having highest efficacy and safety was estimated and ranked.A network meta-analysis of 52 trials including 9917 patients indicated that permethrin (the reference treatment) had a significantly higher cure rate than sulfur, malathion, lindane, crotamiton, and benzyl benzoate. Combination permethrin plus oral ivermectin had a nonsignificantly higher cure rate than permethrin. Combination permethrin plus oral ivermectin was ranked highest in terms of cure, topical ivermectin in terms of persistent itching, and synergized pyrethrins in terms of adverse events. On the basis of clustered ranking, permethrin, oral ivermectin, and synergized pyrethrins seemed to retain balance between cure and adverse events.There are small numbers of trials and patients in some comparisons and a high risk of bias in some trials.There is no 1 treatment that ranked highest in all aspects. Physicians should consider the drug's efficacy and safety profiles, along with ease of administration.
AB1226 The diagnostic value of serum kl-6 in connective tissue disease associated interstitial lung disease
Authors: X. Wu, C.N. Luo, Y.M. Shi, L.J. Wu
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The connective tissue diseases is a group of inflammatory, immune-mediated diseases.CTD often leads to autoimmunity and subsequent tissue injury. It is an important contribute to thoracic changes, particularly interstitial lung disease, is are the main causes of mortality and morbidity among patients with connective tissue diseases. Prognosis and response to therapy are the most pressing challenges for connective tissue disease-associated ILD (CTD-ILD). At present, the basic methods for the diagnosis of various types of ILD includes high-resolution computed tomography, bronchoscopy, and surgical lung biopsy. In addition, continuous lung function tests are commonly used to monitor disease activity and predict the outcome of patients with ILDs, But these tests require specific inspection machines and Repeatability is not good. At present, many biomarkers have been developed to detect ILDs, and the most important biomarkers is KL-6 and lung surface active protein A (SP- A) and surfactant protein D (SP – D) witch secreted by alveolar epithelial type II cells. But Relevant studies have shown that the sensitivity, specificity and accuracy of KL-6 are higher than SP-A and SP-D. <h3>Objectives</h3> To evaluate the diagnosis of the serum Krebs von den Lungen-6 (KL-6) for the interstitial lung disease(ILD) associated with connective tissue diseases(CTD). <h3>Methods</h3> We retrospectively analysed the medical records of 50 patients with CTD associated ILD,46 CTD patients without ILD. Measurement of serum KL-6 levels and pulmonary function tests performed in parallel were reviewed.T test, X<sup>2 test, non-parametric test, SPSS and correlation analysis were used for data analysis</sup>. <h3>Results</h3> The significantly higher levels of KL-6 were determined in the CTD-ILD group than in either the CTD without pulmonary involvement group(P&lt;0.05) . Serum KL-6 correlated negatively with forced vital capacity(FVC%) (%predicted), forced expiratory volume in one second (FEV1)(%predicted) and diffusing capacity of the lung for carbon monoxide (DLCO) (% predicted). By the ROC curves of serum KL-6 levels in 96 patients. The optimal cutoff value of serum KL-6 for a diagnosis of CTD-ILD was 500 mg/L, and the sensitivity and specificity were82.0% and 89.1%, respectively. The area under the curve (AUC) was 0. 877. By multivariate analysis, we found only the reduced DLCOSB%, and elevated serum KL-6 <h3>Conclusions</h3> The serum KL-6 is a valuable biomarker for CTD-ILD diagnosis and even as a predictive factor could be used to identify the clinical development of ILD. <h3>Disclosure of Interest</h3> None declared
William “Tiger” Watson: started his medical career as a prisoner of war
Authors: Chris Mahony
Journal: BMJ (2019)

With a medical career that began in a prisoner of war camp in the second world war and stretched to aid work in Africa by way of general practice in Shrewsbury, William Watson’s life would have been exotic and interesting enough.

As reflected in other obituaries since his death on 29 December, however, the most dramatic moment of his life came in 1942 at the age of 20, when he participated in what the media dubbed “the greatest raid of them all.” Watson earned the Military Cross for his role in the 1942 attack on the dock at St Nazaire, a facility the Allies feared would allow a large German battleship, the Tirpitz , to attack their Atlantic convoys. The dock could not be destroyed by conventional bombing, so more than 600 British military personnel sailed 250 miles to Normandy and up the river Loire to St Nazaire. They succeeded in destroying the pumping and winding gear for the dock, and HMS Campbeltown , an old destroyer packed with explosives on a delayed fuse, blew it up the next day. …