tbuckley/cabot-search huggingface dataset:
SP0023 How to assess mechanical and inflammatory tendinitis + demo
Authors: U. Fredberg
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Tendinopathy is a frequent disorder that may last for several years and impair the quality of life of athletes, non-athletes and patients with inflammatory joint diseases where tendinopathy is a frequent complication. The diagnosis can often be made alone by clinical examination, but in the selected cases, imaging can be determined for the correct diagnosis and treatment. US has several significant advantages over MRI. The greatest strength of the US is that it is interactive and the examiner is in contact with the patient, and any site of reported pain or tenderness can be directly correlated with its real-time scan appearance on the screen. The ultrasonographer can make use of the dynamic real-time character of US, so that tendons can be studied throughout their range of motion and side-to-side comparison is always available during the US examination. This unique advantage over other cross-sectional imaging modalities like MRI is of course especially applicable in the evaluation of mobile structures such as tendons. Tissue with few mobile protons emits little or no signal and, therefore, the internal architecture of the tendon is not well demonstrated in MRI. In contrast, US shows the fine internal structure of tendons, and US therefore pictures the anatomic border of the tendon more precisely than MRI, and in agreement with this the "standard deviation" (SD) and "range of the mean difference" from repeated measurement are less in US than in MRI. It is easy to change to a higher-frequency US transducer to obtain greater spatial resolution. The spatial resolution of US is much better than that of MRI if both examinations are performed with the most modern equipment. Furthermore, US can demonstrate the neovascularisation (Doppler) and the stiffness of the tissue (elastography) in tendinopathy. In the lecture, the ultrasound typical findings of different mechanical and inflammatory tendinopathies are reviewed and completed with a live demonstration of ultrasound scan of a tendon. <h3>Disclosure of Interest</h3> None declared
Publisher Correction: Immune genes are primed for robust transcription by proximal long noncoding RNAs located in nuclear compartments
Authors: Stephanie Fanucchi, Ezio T. Fok, Emiliano Dalla, Youtaro Shibayama, Kathleen Börner, Erin Y. Chang, Stoyan Stoychev, Maxim Imakaev, Dirk Grimm, Kevin C. Wang, Guoliang Li, Wing-Kin Sung, Musa M. Mhlanga
Journal: Nature Genetics (2019)
THU0341 Low vitamin d is associated with thrombosis in systemic lupus erythematosus
Authors: M. Petri, W. Fu, D.W. Goldman
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Low vitamin D is common in systemic lupus erythematosus (SLE). It is also found in antiphospholipid syndrome. Vitamin D has effects on tissue factor, PAI-1, thrombomodulin and platelet aggregation that suggest it has an anti-thrombotic role. We asked whether low vitamin D was associated with thrombosis in SLE, adjusting for lupus anticoagulant. <h3>Objectives</h3> We asked whether low vitamin D was associated with thrombosis in SLE, adjusting for lupus anticoagulant. <h3>Methods</h3> A total of 1,392 SLE patients were included in the analysis. At the first visit when vitamin D was measured, 76.7% had levels of 25-hydroxyvitamin D&lt;40 ng/mL. The SLE patients were: 92% female, mean age 42.9 years, and ethnicity 50% Caucasian, 41% African American. 27% patients had a history of thrombosis; 7% stroke, 4% MI and 14% DVT. <h3>Results</h3> Vitamin D, measured either as a continuous variable or as "low" (&lt;40 ng/mL) vs. normal, was associated with any thrombosis and with DVT. <h3>Conclusions</h3> Low vitamin D was significantly associated with any thrombosis and with DVT (even after adjustment for lupus anticoagulant). In prospective models it remained significantly associated with any thrombosis. As supplementation with vitamin D was proven to reduce thrombosis in an oncology randomised clinical trial, vitamin D replacement should become routine in SLE patients at risk for thrombosis. <h3>Disclosure of Interest</h3> None declared
Incidence rate and burden of illness at the Pyeongchang 2018 Paralympic Winter Games
Authors: Wayne Derman, Phoebe Runciman, Esme Jordaan, Martin Schwellnus, Cheri Blauwet, Nick Webborn, Jan Lexell, Peter van de Vliet, James Kissick, Jaap Stomphorst, Young-Hee Lee, Keun-Suh Kim
Journal: British Journal of Sports Medicine (2019)

To describe the incidence rate (IR) and illness burden (IB) at the Pyeongchang 2018 Paralympic Winter Games.A total of 567 athletes from 49 countries were monitored for 12 days over the Pyeongchang 2018 Games (6804 athlete days). Illness data were obtained daily from teams with (41 teams, 557 athletes) and teams without (8 teams, 10 athletes) their own medical support, through electronic data capturing systems.There were 87 illnesses reported, with an illness IR of 12.8 illnesses per 1000 athlete days (95% CI 10.2 to 16.0) and IB of 6.8 days lost per 1000 athlete days (95% CI 3.4 to 13.5). The highest IR was reported for Para snowboard (IR of 19.7 [95% CI 12.0 to 32.2]). Illnesses in the respiratory system (IR of 4.1 [95% CI 2.9 to 5.9]; IB of 1.4 [95% CI 0.6 to 3.0]), skin and subcutaneous system (IR of 2.5 [95% CI 1.5 to 4.1]; IB of 0.6 [95% CI 0.1 to 2.9]), and eye and ocular adnexa (IR of 1.6 [95% CI 0.9 to 3.1]; IB of 0.5 [95% CI 0.1 to 3.3]) were the most common.This is the first study to report both the IR and IB in this setting. There was a high IR of illness in the new sport of Para snowboard. The respiratory system had both the highest IR and IB.
THU0437 Illness perception and its correlates in patients with in anca-associated vasculitis – preliminary report
Authors: A. Masiak, K. Nowicka-Sauer, D. Banaszkiewicz, B. Grygiel-Górniak, M. Komorniczak, A. Hajduk, Z. Zdrojewski
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Illness perception (IP) is one of the most important factors related to health related quality of life, psychological and physical functioning and medical adherence.<sup>1,2</sup> <h3>Objectives</h3> To explore illness perception and its relationship with chosen clinical, socio-demographic and psychological variables in patients with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). <h3>Methods</h3> 38 patients (57.9% women; median age 57 years; range 18–85; median disease duration: 11.5, range: 1–248 months) with GPA (28 patients) and MPA (10 patients). Inpatients recruited in 3 clinical centres were asked to complete Brief-Illness Perception Questionnaire (B-IPQ),<sup>3</sup> Hospital Anxiety and Depression Scale-Modified (HADS-M) and Multidimensional Fatigue Inventory-20 (MFI-20). Socio-demographic variables included age, sex, education and marital status. Medical files were reviewed to gather data on disease duration and its activity (assessed using Birmingham Vasculitis Activity Score version 3, BVASv3). p≤0.05 was considered significant. <h3>Results</h3> 63% of patients had active disease as defined by BVASv3. Median total score of B-IPQ was 48.5 points (range 24–64). There were no significant differences in illness perception (B-IPQ total score) between groups according to sex, education and marital status. No significant relationships between IP and age, disease duration and its activity were noted. Significant positive correlations were observed between B-IPQ total score and MFI-20 total score, general, physical and mental fatigue as well as depression, anxiety and irritability (table 1). <h3>Conclusions</h3> In the studied group illness perception was not related to clinical and socio-demographic factors. More negative illness perception was related to higher levels of fatigue, depression, anxiety and irritability. The results suggest that psychotherapeutic interventions seem vital for improving illness perception in this population. <h3>References</h3> [1] Hagger MS, Orbell S. A meta-analytic review of the common-sense model of illness representation. Psych Health2003;18:141–84. [2] Morgan C, McBeth J, Cordingley L, et al. The influence of behavioral and psychological factors on medication adherence over time in rheumatoid arthritis patients: a study in the biologics era. Rheumatology2015;54:1780–91. [3] Nowicka-Sauer K, Banaszkiewicz D, Sta&amp;sacute;kiewicz I, et al. Illness perception in Polish patients with chronic diseases: Psychometric properties of the Brief Illness Perception Questionnaire. J Health Psychol2015;21:1739–49. <h3>Disclosure of Interest</h3> None declared
AB0464 ‘real life’ biological drug tapering results in few flares of disease and significant cost savings
Authors: S. Batool, M. Perry, D. Russell
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The treatment of rheumatic diseases has been revolutionised in the biologic era. Remission and low disease activity are realistic targets. Several trials have suggested that dose reduction is achievable without loss of clinical effect. However, 'real life' response data is still lacking. <h3>Objectives</h3> To increase interval dose of biologic drugs in a standard rheumatology clinic setting To assess the clinical response and determine potential cost savings <h3>Methods</h3> Patients were identified by database interrogation and hospital prescription record, from a regional population of 4 00 000 over a 2 year period. All rheumatic conditions treated with anti-TNF and IL-6 blockers were potentially accepted for tapering. Those with low disease activity scores (RA and PsA DAS &lt;2.1, AS BASDAI &lt;4.1) for &gt;1 year were screened and invited to consider dose reduction following discussion in a clinic. <h3>Results</h3> 154 biologic patients were screened and 97 contacted to consider dose tapering. Of these, 40 patients agreed to participate in biologic dose reduction. Demographics: Mean age 51 years, 18 male patients and 22 females, concomitant MTX use in 49%. Diagnosis: RA-24, PsA −9, AS- 7. Drugs tapered included Adalimumab (28), Etanercept (5), Golimumab (5) and Tocilizumab (2). 8 patients flared during the programe and response was recaptured in 2 patients after increasing dose. 32 patients were successfully maintained on reduced dose with no requirement to date to increase dosing frequency. Biologic drug was completely withdrawn in 1 patient and 2 patients were commenced on reduced dose of DMARD. Prior to dose reduction mean DAS was 1.91 and mean BASDAI was 2.45. Low disease activity scores were recorded (mean DAS 2.1, mean BASDAI 2.6) post dose reduction (although incomplete data capture). Estimated cost savings are between 170,000 EUR and 340000 EUR for the 2 years. <h3>Conclusions</h3> Successful tapering of biologic drugs can be achieved and sustained in non-trial settings for patients with low disease activity. Significant cost savings have been confirmed with likelihood of recurrent savings over future years. <h3>Reference</h3> [1] Edwards C, Fautrel B, Schulze-Koops H, Huizinga T, Kruger K. Dosing down with biologic therapies: a systematic review and clinicians' perspective2018. <h3>Acknowledgements</h3> Ms Vandana Raghuvir Medical student at Glasgow University <h3>Disclosure of Interest</h3> None declared
Endothelial to Mesenchymal Transition in Cardiovascular Disease
Authors: Jason C. Kovacic, Stefanie Dimmeler, Richard P. Harvey, Toren Finkel, Elena Aikawa, Guido Krenning, Andrew H. Baker
Journal: Journal of the American College of Cardiology (2019)

Endothelial to mesenchymal transition (EndMT) is a process whereby an endothelial cell undergoes a series of molecular events that lead to a change in phenotype toward a mesenchymal cell (e.g., myofibroblast, smooth muscle cell). EndMT plays a fundamental role during development, and mounting evidence indicates that EndMT is involved in adult cardiovascular diseases (CVDs), including atherosclerosis, pulmonary hypertension, valvular disease, and fibroelastosis. Therefore, the targeting of EndMT may hold therapeutic promise for treating CVD. However, the field faces a number of challenges, including the lack of a precise functional and molecular definition, a lack of understanding of the causative pathological role of EndMT in CVDs (versus being a “bystander-phenomenon”), and a lack of robust human data corroborating the extent and causality of EndMT in adult CVDs. Here, we review this emerging but exciting field, and propose a framework for its systematic advancement at the molecular and translational levels.
THU0520 Assessment of cardiovascular risk in patients with fibromyalgia by carotid-femoral pulse wave velocity – results of a prospective study
Authors: K. Triantafyllias, M. Stortz, M. de Blasi, C. Leistner, J. Weinmann-Menke, A. Schwarting
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Autonomic dysfunction, a basic element of fibromyalgia (FM), has been in some cases related to increased risk of cardiovascular (CV) disease. CV risk associates with aortic stiffness, which can be reliably assessed by carotid-femoral pulse wave velocity (cfPWV). <h3>Objectives</h3> Aims of this study were to test the hypothesis of increased cfPWV in a group of patients with FM and to examine its association with FM associated parameters and selected traditional CV risk factors. <h3>Methods</h3> We performed measurements of cfPWV in 99 FM patients and 102 healthy controls. The difference between cfPWV values in the two groups after controlling for possible confounding factors was evaluated through multiple regression analysis. The associations of cfPWV with FM related parameters such as pain severity on the EuroQol visual analogue scale (EQ-VAS) and FM tender points were also analysed. Finally, we explored the relationship of cfPWV with various laboratory parameters (patients' group) and traditional CV risk factors (both groups). <h3>Results</h3> Adjusted statistical analyses for confounding factors showed significantly higher cfPWV values in FM patients in comparison to controls (<i>p<sub>adj</sub></i>=0.044). cfPWV associated significantly with age in both the patients and the control group (<i>rho</i>=0.614, p&lt;0.001 and <i>rho</i>=0.678, p&lt;0.001 accordingly). Moreover, cfPWV correlated in the control group with systolic, diastolic and mean arterial pressure (p&lt;0.001, p=0.013 and p&lt;0.001 accordingly) as well as with Body Mass Index (p=0.003). <h3>Conclusions</h3> Our data reveal that patients with FM have higher aortic stiffness than healthy controls, even after adjusting for confounding factors of cfPWV. Therefore, FM may be associated with an increased CV risk. To our knowledge, this is the largest study to examine the gold standard assessment method of aortic stiffness in patients with FM and the first one to find increased cfPWV-values in comparison to healthy subjects. <h3>Disclosure of Interest</h3> None declared
AB1087 Prolonged response with tumour necrosis factor alfa inhibition in a 5 year old boy with severe manifestations of il-36 receptor antagonist deficiency (DITRA)
Authors: D. Clemente, J.C. López Robledillo, A. Torrelo, A. Hernández, E. Villalobos
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Deficiency of the interleukin (IL)−36 receptor antagonist (DITRA) is an autosomal recessive autoinflammatory syndrome caused by mutations in the IL36RN gene. Clinical manifestations of DITRA include recurrent episodes of generalised skin postulation, fever, systemic inflammation and leukocytosis. An uniformly effective treatment for DITRA has not yet been identified. <h3>Objectives</h3> We present a case of a 5 year old patient with DITRA with prolonged response with tumour necrosis factor alfa inhibition with adalimumab. <h3>Methods</h3> A five-year-old came to our dermatology clinic after worsening of a previous diagnosed plaque psoriasis, with an erythematous scaly dermatitis that extended throughout the trunk. Treatment with acitretin and cyclosporin were not effective and patient developed in few weeks a generalised erythroderma with pustules covering almost every part of his body, including palms and soles. He was admitted for the onset of fever and irritability due to painful rubbing of the skin. Family history of recurrent fevers or psoriasis were not revealed. Parents were not consanguineous. Complete blood count showed leukocytosis with neutrophilia and thrombocytosis, with an erythrocyte sedimentation rate (ESR) of 6 mm/hr and a C-reactive protein (CRP) of 8,4 mg/dl. Biochemistry panel revealed a mild elevation of liver enzymes without other abnormalities. Antinuclear antibody (ANA) and rheumatoid factor were negative with normal serum immunoglobulin and complement. Blood culture grew E. Coli, S. Maltophila and S. epidermidis. Skin biopsy showed acanthosis and papillomatosis with perivascular polymorphous inflammatory cells. Genetic analyses showed a homozygous mutation in the IL36RN gene (pSer113Leu). No mutations were detected in IL1RN and CARD 14 genes. <h3>Results</h3> Treatment was initiated with intravenous methylprednisolone 2 mg/kg/day and subcutaneous anakinra 2 mg/kg/day. Cefotaxime and co-trimoxazole were added until blood cultures were negative. Although skins lesions improved during the following days and patient was finally discharged, symptoms reappeared when decreasing the steroid dose. Three months later adalimumab and methotrexate were started, allowing the patient to end treatment with corticoids without evidence of activity of the disease. <h3>Conclusions</h3> After incomplete response with anakinra, inhibition of tumour necrosis factor alfa resulted in a prolonged response in our patient with deficiency of the interleukin (IL)−36 receptor antagonist (DITRA). <h3>Disclosure of Interest</h3> None declared
A randomized double-blind placebo-controlled trial of autologous platelet-rich plasma intradermal injections for the treatment of vulvar lichen sclerosus
Authors: Andrew T. Goldstein, Leia Mitchell, Vaishnavi Govind, Debra Heller
Journal: Journal of the American Academy of Dermatology (2019)

To the Editor: We performed a randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of autologous platelet-rich plasma (PRP) for the treatment of vulvar lichen sclerosus (LS). A total of 30 patients (mean age, 52.6 years; 29 whites and 1 Hispanic) with biopsy-proven active LS were recruited. One participant withdrew after randomization but before treatment, and 29 completed the study. Patients were randomized to receive either placebo (saline injections) (10 subjects) or 2 separate treatments of PRP separated by 6 weeks (20 subjects).
AB0625 Systemic lupus erythematosus in egyptian cohort of patients: a multicenter study
Authors: S.A. Elbakry, N. Afifi, S.A. Hussein, N. Mohannad, I.H. Bassyouni, N.F. Abou elezz
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that mainly affects females in the reproductive age.<sup>1</sup> The disease presents with a diverse spectrum of clinical and immunological manifestations which has been studied in many countries and ethnic groups. Data from North Africa especially Egypt are minimal. <h3>Objectives</h3> To study the clinical and immunological characteristics of an Egyptian cohort with SLE and compare it with data from MENA region and international data. <h3>Methods</h3> In this retrospective study, data of 569 SLE patients who fulfilled the modified American College of Rheumatology (ACR) criteria for the diagnosis of SLE<sup>2</sup> were collected from three tertiary care centres in Cairo and Alexandria from the period of January 2014 to December 2017. Disease activity was assessed by using the SLE disease activity index (SLEDAI).<sup>3</sup> <h3>Results</h3> Of 569 patients 92.6%were females and 4.7% males with mean age at presentation 26.3±8.8 years and median disease duration four years (min 0.08-max 30 years). The main presenting symptom was musculoskeletal (arthritis/arthralgia) in 44.1% followed by fever in 39.4% and nephritis in 14.2%. Renal affection was present in 374 patients (65.7%) and renal biopsy was done in 268 patients with the most common is class III and IV lupus nephritis {18.3% and 14.1% respectively} (table 1). Antinuclear antibodies (ANA) was positive in all patients and immunofluorescence pattern was done in 256 patients; homogenous pattern was the most common followed by speckled (29.9% and 13.4% respectively). Anticardiolipin antibodies was positive in 71.2% while lupus anticoagulant was detected in 50.8% (table 2). Mean SLEDAI was 13.38±9.75 with proteinuria in 58.9%, increased binding to DNA in 54.9% and low complement in 45.5%. <h3>Conclusions</h3> These data are similar to that reported from MENA region; however, with little difference from international data as regard presenting symptom and immunological pattern. Differences observed among ethnic groups probably reflect the genetic component of ethnicity. <h3>References</h3> [1] Mills JA. Systemic lupus erythematosus. New Engl J Med1994;330:1871–1879. [2] Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40:1725. [3] Bombardier C, Gladman D, Urowitz M, et al. Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum1992;35:630–640. <h3>Disclosure of Interest</h3> None declared
Decision-making in pulmonary endarterectomy surgery
Authors: Robin Condliffe, Syed Rehan Quadery, David P. Jenkins, Iain J. Armstrong, David G. Kiely
Journal: European Respiratory Journal (2019)

<b>Clarification of certain issues related to the UK pulmonary endarterectomy referral pathway, emphasising the importance of referral of all patients with CTEPH to a surgical team</b>http://ow.ly/Db6I30mwbVP
SP0168 The use of xo inhibitors in ckd – pros and cons
Authors: N. Dalbeth
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> The association of chronic kidney disease (CKD) and hyperuricaemia is well established, and many observational studies have reported that hyperuricaemia is associated with development and progression of CKD. Potential mechanisms of this observation will be discussed, including the potential for urate as an 'innocent bystander' or as a causal mediator contributing directly to kidney injury. Xanthine oxidase inhibitors (XOIs) are the most widely used urate-lowering drugs. Current evidence for efficacy and safety of XOIs for preventing or delaying progression of chronic kidney disease will be presented, both in the general population and in people with gout. The challenges of XOI use in people with CKD will also be discussed, with specific reference to allopurinol dosing in CKD, and cardiovascular safety of febuxostat. <h3>Disclosure of Interest</h3> N. Dalbeth Consultant for: Kowa, Horizon
Abstract 20625: The Significance of Right Ventricular Regional Strain in Determining the Global Right Ventricular Function
Authors: Tomoko Ishizu, Yoshihiro Seo, Yumiko Tanaka-Onishi, Hitoshi Horigome, Yasushi Kawakami, Kazutaka Aonuma
Journal: Circulation (2016)

Background: We performed clinical studies to assess the significance of right ventricular (RV) regional strain of a novel 3D-speckle tracking imaging (STE) system in determining the RV ejection fra...