tbuckley/cabot-search huggingface dataset:
Underestimating the true impact of obesity
Authors: Jacob M Bradshaw, Samuel Ensor, Harry Lorenz, Christopher Spence, Guy Hucker
Journal: The Lancet Public Health (2019)

The ever-increasing burden that obesity exerts on population health was recently explored in The Lancet Public Health by Solja Nyberg and colleagues.1Nyberg ST Batty GD Pentti J et al.Obesity and loss of disease-free years owing to major non-communicable diseases: a multicohort study.Lancet Public Health. 2018; 3: e490-e497Summary Full Text Full Text PDF PubMed Scopus (164) Google Scholar The authors measured the loss of disease-free years attributable to major non-communicable diseases (NCDs) in obese adults compared with those who were normal weight. Individuals lost 3–4 more disease-free years if they were mildly obese and 7–8 more disease-free years if they were severely obese. These results show the alarming extent of obesity's impact on health; however, the true effect is likely to be even higher than reported. The decision to use the six commonest NCDs could have led to an underestimation of the true effect size because obesity contributes a large morbidity burden through diseases not included in their analysis, such as musculoskeletal conditions and depression.2Luppino FS de Wit LM Bouvy PF et al.Overweight, obesity, and depression.Arch Gen Psychiatry. 2010; 67: 220Crossref PubMed Scopus (2572) Google Scholar Lower back pain has been extensively linked to increased body-mass index3Shiri R Karppinen J Leino-Arjas P Solovieva S Viikari-Juntura E The association between obesity and low back pain: a meta-analysis.Am J Epidemiol. 2010; 171: 135-154Crossref PubMed Scopus (514) Google Scholar and is the leading cause of disability-adjusted life-year loss globally.4Vos T Allen C Arora M et al.Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015.Lancet. 2016; 388: 1545-1602Summary Full Text Full Text PDF PubMed Scopus (4492) Google Scholar Furthermore, as shown by the authors, the effect of their chosen conditions, particularly type 2 diabetes, was likely to be underestimated as only data from hospital and death registries were used. This data selection omits the huge burden of obesity-associated morbidity that exists solely in primary care.5Ard J Obesity in the US: what is the best role for primary care?.BMJ. 2015; 350: 1-10Crossref Scopus (22) Google Scholar It also could explain part of the considerable difference in disease-free years lost between mild and severe obesity; co-morbid conditions suffered by those with mild obesity are less likely to be severe enough to require inpatient management. The effect of obesity through NCDs is likely to be more alarming than reported and this effect permeates through all social classes. More must be done through public health policy to tackle all levels of obesity. We declare no competing interests.
Abstract 13858: Early Hemoglobin Decrease in Heart Failure With Acute Pulmonary Edema
Authors: Masaaki Konishi, Yasushi Matsuzawa, Hiroyuki Suzuki, Eiichi Akiyama, Noriaki Iwahashi, Kiyoshi Hibi, Masami Kosuge, Toshiaki Ebina, Kentaro Sakamaki, Satoshi Morita, Satoshi Umemura, Kazuo Kimura
Journal: Circulation (2013)

Background: Diuretic therapy, which is a mainstay of acute heart failure syndrome (AHFS) treatment, is also reported to be associated with harmful effect. In particular, acute pulmonary edema (APE)...
Live donor liver transplantation for patients with hepatocellular carcinoma offers increased survival vs. deceased donation
Authors: Nicolas Goldaracena, Andre Gorgen, Adam Doyle, Bettina E. Hansen, Koji Tomiyama, Wei Zhang, Anand Ghanekar, Les Lilly, Mark Cattral, Zita Galvin, Markus Selzner, Mamatha Bhat, Nazia Selzner, Ian McGilvray, Paul D. Greig, David R. Grant, Gonzalo Sapisochin
Journal: Journal of Hepatology (2019)
AB0582 Soluble triggering receptor expressed on myeloid cells-1 (STREM-1) and adrenomedulin are elevated in patients with systemic lupus erythematosus
Authors: I. Jeremic, N. Stojanovic, Z. Stanojevic, B. Jovanovic, J. Tosic, S. Vidicevic, A. Isakovic
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Adrenomedulin is a peptide firstly isolated from human phaeochromocytoma with vasodilatory effects. Secretion of adrenomedulin is modified by inflammatory cytokines and it may be important as a suppressor of lupus nephritis activity. Triggering receptor expressed on myeloid cells-1 (TREM) is a member of immunoglobulin superfamily clearly elevated in inflammatory conditions. Some subgroups of patients with systemic lupus erythematosus-SLE may have especially elevated levels of s-TREM. <h3>Objectives</h3> The aim of this study was to examine adrenomedulin and s-TREM levels in patients with SLE and healthy controls and to assess their relation with SLE disease activity index-SLEDAI <h3>Methods</h3> Serum samples from 50 SEL patients and 40 healthy blood donors were analysed. Serum levels of adrenomedulin, s-TREM, complement components C3 and C3, and anti-dsDNA antibodies were measured <h3>Results</h3> Patients with SLE had higher adrenomedulin (9.8±4.5 vs. 15.3±7.2 pg/mL, p&lt;0.05) and s-TREM (11.7±4.1 vs. 20.3±13.1 pg/mL) (p&lt;0.05) levels. s-TREM showed correlation with anti-dsDNA antibodies (ρ=0.405, p&lt;0.05) and SLEDAI score (ρ=0.386, p&lt;0.001). In multivariate analysis s-TREM did not appear as an independent predictor of SLEDAI score, while only anti-dsDNA antibodies were significant in multivariate analysis. <h3>Conclusions</h3> Increased adrenomedulin and s-TREM are found in lupus sera. Despite of correlation with SLEDAI score, s-TREM is not better then anti-dsDNA antibodies as a predictor of SLE disease activity. <h3>Disclosure of Interest</h3> None declared
Amelioration of Rigosertib Treatment Related Genitourinary (GU) Adverse Events (AEs) in Patients with Myelodysplastic Syndromes: Implementation of Novel Dosing Regimen Derived through Pharmacokinetic Modeling in Phase 2 Study of Oral Rigosertib in Combination with Azacitidine
Authors: David Taft, Tarang Vora, Chen Ren, Patrick S. Zbyszewski, Joseph Morgan, Michael E. Petrone, Steven M. Fruchtman, Manoj Maniar
Journal: Blood (2018)
AB0470 Influence of using adalimumab in complex treatment on frequency of eyes involvement in patients with jia
Authors: T. Marushko, O. German, J. Golubovska
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Exra-articular organs involvement in JIA is frequent and mostly incudes rheumatoid uveitis in ANA-positive oligoarthritis. In Ukraine almost 10% of children with JIA during systematic ophthalmologic examination have signs of ocular involvement. Early treatment with biological agents can influence inflammation progression in eyes of the JIA patients Objectives: Objective of the study was to investigate the frequency of recurrences of uveitis in patients with JIA and eyes involvement on methotrexate alone and methotrexate with adalimumab. Methods: There were 23 patients with JIA and rheumatoid uveitis involved into the study. Mean age was 9,6 (4–16) years. Among them there were 14 (61%) girls and 9 (39%) boys. Serological characteristic included 17 (74%) patients with positive ANA, and 3 (13%) children with positive HLA-B27. All patients received 15 mg/m2/week of SC methotrexate. During onset and recurrence of uveitis all children received glucocorticoids with slowly tapering dosage (from 1 mg/kg/day to 0.2–0.1 mg/kg/day) until uveitis remission. Of 23 patients 11 (47,8%) received adalimumab in standard doses. Study were hold for 5 years during which every child were investigated by ophthalmologist every 3 months irrespectively of clinical status. Results: During 5 year follow up in "methotrexate" group (n=12) there were 15 episodes of uveitis recurrence (0,25 episodes per patient/year). Of them 10 (66,6%) were revealed only by ophthalmological assessment and had no obvious clinical signs (subclinical uveitis). Same time only 2 episodes of uveitis recurrence were registered in "methotrexate +adalimumab" group (0,04 episodes per patient/year) (p&lt;0.05). Conclusions: Adding adalimumab to methotrexate in complex treatment of patients with JIA and eyes involvement allows decreasing frequency of both clinically evident and subclinical recurrences of rheumatoid uveitis. <h3>Disclosure of Interest</h3> None declared
Alcohol‐Related Liver Disease: Areas of Consensus, Unmet Needs and Opportunities for Further Study†
Authors: Gyongyi Szabo, Patrick S. Kamath, Vijay H. Shah, Mark Thursz, Philippe Mathurin, Giovanni Addolorato, Ramon Bataller, Patrizia Burra, Laurent Castera, Helena Cortez Pinto, Anna Mae Diehl, Bin Gao, Sir Ian Gilmore, Jochen Hampe, Rehm Jürgen, Michael Karin, Alexander Krag, David Leon, Christopher Leptak, Alexandre Louvet, Michael Lucey, Craig McClain, Laura Nagy, Georges‐Philippe Pageaux, Arun Sanyal, Bernd Schnabl, Dina Tiniakos, Christian Trautwein, Hidekazu Tsukamoto
Journal: Hepatology (2019)

A joint meeting of the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD) was held in London on September 30 and October 1, 2017. The goals of the meeting were to identify areas of broad agreement and disagreement, develop consensus, and determine future directions to ultimately reduce the burden, morbidity, and mortality of alcohol-related liver disease (previously termed alcoholic liver disease). The specific aims of the meeting were to identify unmet needs and areas for future investigation, in order to reduce alcohol consumption, develop markers for diagnosis and prognosis of disease, and create a framework to test novel pharmacological agents with pre-specified treatment endpoints. A table summary of these goals and aims is provided in the context of epidemiology, current management strategies, next steps for future trials and translational science.
AB0624 Dyslipidemia in systemic lupus erythematosus: correlation with disease severity and cytokines
Authors: S. Huang, Z. Zhang, S. Wu, J. Qi, D. Wang, G. Yao, L. Sun
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> The patients with systemic lupus erythematosus (SLE) are obviously at high risk of cardiovascular disease (CVD) and the relationships between disturbed lipid metabolism and lupus activity remain to be elucidated. We evaluated dyslipidemia in association with disease severity, organ involvement and cytokines in patients with SLE. <h3>Methods</h3> Outpatients with SLE (n=105) and healthy controls (n=75) were recruited in this study. The concentrations of plasma tumour necrosis factor receptors A(sTNFRA), tumour necrosis factor receptors B(sTNFRB) and adipokine angiopoietin-like 4 (ANGPTL4)were measured by ELISA. The clinic and laboratory data were collected from patient records using electronic data processing. The data collected included serum lipid (TG, TC, HDL, LDL, ApoA1, ApoB), renal function (proteinuria, albuminuria, creatinine, blood urea nitrogen, uric acid), liver function (Alanine transaminase [ALT], glutamic oxalacetic transaminase [AST], total protein, albumin, globulin), blood system (lymphocyte, white blood cell [WBC], platelet[PLT], haemoglobin[HB]). <h3>Results</h3> Compared with the healthy controls, the level of serum TG, TC, LDL, ApoB were significantly increased, while HDL and ApoA1 were decreased. The serum levels of LDL and ApoB were positively correlated to SLEDAI, while HDL and ApoA1 were negatively correlated to SLEDAI. The patients with lupus nephritis had more severe dyslipidemia. The blood TG, TC, LDL, ApoB levels were positively correlated to 24 hour proteinuria and serum creatinine, urea nitrogen, uric acid. The blood levels of TG, TC, LDL, ApoB were positively correlated to serum total protein, albumin, globulin. The serum level of ANGPTL4 was positively correlated to HDL and ApoA1 as well as sTNFRA and sTNFRB with TG <h3>Conclusions</h3> Dyslipidemia in SLE was significantly correlated with SLEDAI and kidney involvement. The circulated levels of sTNFRA, sTNFRB and ANGPTL4 were associated with dyslipidemia in SLE. <h3>Disclosure of Interest</h3> None declared
Abstract 16538: Interaction Between Oxidized LDL, Angiotensin II and Oxidative Stress
Authors: Rusan A Catar, Claudia Goettsch, Ashraf Taye, Anja Hofmann, Coy Brunssen, Gregor Muller, Susann Lehmann, Undine Schubert, Barbara Ludwig, Christian G Ziegler, Stefan R Bornstein, Alexander W Krug, Thomas Walther, Henning Morawietz
Journal: Circulation (2016)

Introduction/Hypothesis: The interaction between oxidized low-density-lipoprotein (oxLDL) and angiotensin II (Ang II), the impact of Ang II receptor 1 (AT1) receptor blockade on lipoprotein-induced...
Efficacy of dose adjusted infusional chemotherapy: Etoposide, cytoxan, doxorubicin, vincristine and prednisone (EPOCH) in untreated adult T-cell leukemia lymphoma (ATLL).
Authors: Vaibhav Verma, Nikhil Mukhi, Anam Ahmed, Geeti Sharma, Albert S. Braverman, Gurinder Singh Sidhu
Journal: Journal of Clinical Oncology (2015)

e19527 Background: ATLL is an aggressive T cell lymphoma (TCL) associated with HTLV1 infections, endemic to certain regions. The acute and lymphomatous types have the poorest prognoses of any TCL, and their responses to standard therapy with CHOP, are brief. Methods: Charts of patients at Kings County Hospital in Brooklyn, NY from 2002-14 with acute and lymphomatous ATLL were retrospectively reviewed. They were treated with EPOCH, and had serology positive for HTLV1 Results: Records of 43 patients were reviewed, 34females and 23males. Median age at diagnosis was 54 years (range 31-78). Stage at diagnosis was 26%, 51%, 16%, 6% in stage I, II, III, IV respectively. Median follow up period is 6.6 months (m). At the end of follow up 34 patients were dead, 5 alive and rest lost to follow up. EPOCH was associated with overall survival of 6.7m and progression free survival of 4.8m. Complete responses were seen in 26% of EPOCH treated patients. In patients who underwent second or third line chemotherapy, median PFS after 1st and 2nd relapse were 6.8 weeks and 61 days. No patient underwent stem cell transplant (SCT). CNS involvement at presentation was 5%. CNS relapse rate in patients who got intrathecal (IT) methotrexate (MTX) versus who didn’t was 14% and 21%. All patients with CNS relapse were also found to have a concurrent peripheral relapse. Pts with Calcium over 11 had worse survival than those below 11, of 3.5 m vs 8 m. Patients with LDH twice the normal limit had worse survival that those without that, 4.7 m vs. 12 m. Patients with bone marrow involvement by ATLL had worse survival that those without, 3.8 m vs 11.7 m. Conclusions: EPOCH induces remissions in a significant minority of ATLL patients, of short duration, and hardly change prognosis. Such remissions might be a good time to initiate allogeneic SCT, but the value of this treatment is not yet established. IT MTX shows no impact on recurrence.
Case 2-2019: A 36-Year-Old Man with Rash, Abdominal Pain, and Lymphadenopathy
Authors: Steven T. Chen, Alexis M. Cahalane, Edward T. Ryan, Ruth K. Foreman
Journal: New England Journal of Medicine (2019)

A 36-year-old man was admitted to the hospital because of abdominal pain, rash, and lymphadenopathy. Diffuse papules and hyperpigmented nodules on the skin and right axillary lymphadenopathy were noted. Imaging revealed mediastinal lymphadenopathy and liver lesions. A diagnosis was made.
SAT0328 Weight-loss improves disease activity in obese patients with psoriatic arthritis
Authors: E. Klingberg, A. Bilberg, S. Björkman, B. Eliasson, I. Larsson
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Obesity is over-represented in patients with psoriatic arthritis (PsA) and associated with increased risk of getting the disease, higher disease activity, poorer effect of treatment and in addition cardiovascular co-morbidity. <h3>Objectives</h3> The aim of this study was to determine the effects of weight-loss treatment on disease activity in patients with PsA and obesity <h3>Methods</h3> Patients with PsA (Caspar criteria) and obesity (body mass index BMI≥33 kg/m<sup>2</sup>) where recruited from three Rheumatology clinics in the Western Sweden. Weight-loss treatment with Very Low Energy liquid Diet (VLED), which comprises a daily energy intake of 640 kcal, was given during 12–16 weeks, depending on BMI. The first strict period was followed by a structured reintroduction of an energy restricted diet during 18 weeks. The treatment was given within the framework of a structured program including support and medical follow-up at the Obesity Unit at Sahlgrenska University Hospital. Treatment with DMARDs and biologics was held constant from 3 month before baseline until 6 months after baseline. The patients were assessed with 66/68 joints count, back-mobility tests, body surface area (BSA), questionnaires, ESR, CRP and BMI at baseline, 3 and 6 months. The number of patients reaching Psoriatic Arthritis Response Criteria (PsARC) and Minimal Disease Activity (MDA) was calculated. <h3>Results</h3> Totally 41 PsA patients, median age 54 (IQR 48–62) years, 63% women were included. The median weight-loss was 18.7 (IQR 14.6–26.5) kg. BMI decreased from median 35.2 (34.1–38.1) to 29.7 (26.2–31.5) kg/m<sup>2</sup>. A majority of the disease activity parameters improved significantly (Table). Totally 16 patients (39.0%) reached PsARC and the number of patients with MDA increased from n=12 (29%) to n=22 (54%), p&lt;0.001 between baseline and the 6 months visit. <h3>Conclusions</h3> Weight-loss treatment with VLED had significant positive effects on disease activity in joints, entheses and skin in patients with PsA and obesity. <h3>Disclosure of Interest</h3> E. Klingberg Grant/research support from: The VLED used in this study was sponsored by Cambridge Weight Plan., A. Bilberg: None declared, S. Björkman: None declared, B. Eliasson: None declared, I. Larsson: None declared
Effect of Indacaterol/Glycopyrronium on Pulmonary Perfusion and Ventilation in Hyperinflated Patients with Chronic Obstructive Pulmonary Disease (CLAIM). A Double-Blind, Randomized, Crossover Trial
Authors: Jens Vogel-Claussen, Christian-Olaf Schönfeld, Till F. Kaireit, Andreas Voskrebenzev, Christoph P. Czerner, Julius Renne, Hanns-Christian Tillmann, Korbinian Berschneider, Simone Hiltl, Johann Bauersachs, Tobias Welte, Jens M. Hohlfeld
Journal: American Journal of Respiratory and Critical Care Medicine (2019)

Rationale: In the CLAIM study, dual bronchodilation with indacaterol/glycopyrronium (IND/GLY) significantly reduced hyperinflation, which translated into improved cardiac function, measured by left ventricular end-diastolic volume and cardiac output. Pulmonary microvascular blood flow (PMBF) is reduced in chronic obstructive pulmonary disease (COPD); however, the effect of reduced lung hyperinflation on PMBF remains unknown. Objectives: To determine the effect of lung deflation with IND/GLY on PMBF and regional pulmonary ventilation using magnetic resonance imaging (MRI) in hyperinflated patients with COPD. Methods: In this double-blind, randomized, two-period crossover study, gadolinium-enhanced MRI and phase-resolved functional lung MRI were used to measure PMBF and regional ventilation, respectively, in patients with COPD receiving IND/GLY versus placebo. Measurements and Main Results: Sixty-two patients were randomized to receive once-daily IND/GLY (110/50 μg) for 14 days, followed by 14 days of placebo, or vice versa. Treatment periods were separated by a 14-day washout. Sixty patients were included in the per-protocol analysis. MRI measurements showed significant improvements in total PMBF (P = 0.006) and regional PMBF (P values for individual lobes were between 0.004 and 0.022) in response to IND/GLY versus placebo. Regional ventilation was also significantly improved with IND/GLY, as evidenced by a 12.4% increase versus placebo (P = 0.011), a 14.3% relative decrease in ventilation defect percentage of nonventilated/hypoventilated lung tissue (cutoff was defined as 0.075 regional ventilation; P = 0.0002), and a 15.7% reduction in the coefficient of variation of regional ventilation compared with placebo (P < 0.0001). Conclusions: Pharmacologic intervention with IND/GLY improves pulmonary microvascular blood flow and regional ventilation in patients with COPD with hyperinflation. Clinical trial registered with www.clinicaltrials.gov (NCT02442206).
FRI0695 Dmard monitoring guidelines and shared prescribing in primary care – is more education required?
Authors: G. Choudhury, M. K. Nisar
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> DMARDs remain the mainstay of inflammatory arthritis therapy. Though an effective treatment, these drugs have the potential to cause serious harm. Vigilant drug monitoring, reflected in recently updated BSR guidelines, is necessary to prevent potentially life threatening complications. National Patient Safety Agency has also issued several alerts regarding DMARDs and methotrexate overdose remains a 'never event'. Prescribing medications, including DMARDs for rheumatology patients, is one of the chief responsibilities of primary care doctors. <h3>Objectives:</h3> We undertook a pilot survey of regional GPs to understand their level of prescribing confidence with an aim to develop a targeted teaching program. <h3>Methods:</h3> Based on BSR DMARD monitoring audit tool and regionally approved shared care guidelines, a focus group discussion with GP educators and CCG Medicine Optimisation Team was organised. Ten items were unanimously identified as core knowledge required for safe prescribing. A questionnaire was created based on these elements. GPs were surveyed at their educational meeting in our academic institution. Replies were compiled to ascertain their understanding of safe prescribing and troubleshooting DMARD related issues. <h3>Results:</h3> There are 95 actively practicing GPs in the region. 41 (43%) GPs contributed to the survey. 22 (56%) were men. 27 (65%) had been practicing for 5–15 years (range &lt;5 to &gt;20 years). 34 (83%) regularly prescribed DMARDs. Only 15/41 (36%) felt confident in prescribing whereas 7/41 (17%) were neutral and remaining 46% did not feel confident. 49% participants were able to rightly answer questions pertaining to safe prescribing. Again most (70%) felt unable to confidently manage blood-monitoring issues such as neutropenia or abnormal liver function tests. Only four (9%) were able to correctly address the concerns related to administration of live vaccines whilst taking DMARDs. Nine GPs were unaware of avoiding trimethoprim co-prescription with methotrexate. <h3>Conclusions:</h3> To our knowledge, this is the first survey to demonstrate that there are serious shortcomings in GPs' understanding of safe DMARD prescribing. Lack of confidence amongst front line medical staff remains the main cause of this issue. Despite frequent education bulletins and alerts from national bodies including NICE, BSR and NPSA and active measures taken in recent past to identify better ways to address the concerns, this study highlights major knowledge gaps among everyday prescribers in primary care. Dedicated strategy and better collaboration with GPs, with focus on drug monitoring education, are pivotal to providing better care for patients prescribed DMARDs in the community. <h3>Disclosure of Interest:</h3> None declared