tbuckley/cabot-search huggingface dataset:
OP0002 No difference in the risk of malignancy in tocilizumab versus tnf inhibitor initiators in patients with rheumatoid arthritis: a multi-database cohort study
Authors: S.C. Kim, A. Pawar, R.J. Desai, S. Gale, M. Klearman, K. Sarsour, D.H. Solomon, S. Schneeweiss
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Few studies have conducted head-to-head comparisons of malignancy risk between different types of biologics in rheumatoid arthritis (RA). <h3>Objectives</h3> To examine the rate of incident malignancy excluding non-melanoma skin cancer (NMSC) in RA patients newly treated with tocilizumab (TCZ) versus TNF inhibitors (TNFi). <h3>Methods</h3> We conducted a cohort study using data from 3 U.S. healthcare claims databases (2010–2015) – Medicare, IMS PharMetrics Plus or Truven MarketScan. Adults aged ≥18 years with RA who newly started TCZ or a TNFi after failing a different TNFi, abatacept or tofacitinib were included. The primary outcome was incident malignancy excluding NMSC based on 2 diagnosis codes within 2 months (specificity &gt;98%). The 10 most frequently occurring cancers, leukaemia and human papilloma virus-related cancer and all-cause mortality were analysed as individual secondary endpoints. (table 1). For the primary as-treated analysis, follow-up time started the day after cohort entry and ended on treatment discontinuation, outcome occurrence, disenrollment, death, or the end of study period. To control for &gt;60 potential confounders, TCZ starters were propensity score (PS)-matched to TNFi starters with a variable ratio of 1:3 within each database. Hazard ratios (HR) from the 3 PS-matched cohorts were combined by a fixed-effects model. <h3>Results</h3> We included a total of 10,393 TCZ initiators PS-matched to 26,357 TNFi initiators. A total of 118 malignancies occurred in TCZ starters and 322 in TNFi starters across the three databases. The IR of malignancy per 100 person-years ranged from 0.81 (IMS) to 2.18 (Medicare) in TCZ and from 0.98 (MarketScan) to 2.16 (Medicare) in TNFi. The risk of incident malignancy was similar between the two groups across all three databases (table 1), with a combined HR of 0.92 (95% CI: 0.74 to 1.14) in TCZ versus TNFi. Secondary analyses by cancer subtype and all-cause mortality showed similar results. <h3>Conclusions</h3> This large multi-database cohort study found no difference in the risk of malignancy excluding NMSC in patients with RA who newly start TCZ versus TNFi. <h3>Disclosure of Interest</h3> S. Kim Grant/research support from: Roche, Pfizer, Bristol-Myers Squibb, A. Pawar : None declared, R. Desai: None declared, S. Gale Employee of: Genentech, M. Klearman Employee of: Genentech, K. Sarsour Employee of: Genentech, D. Solomon Grant/research support from: Roche, Pfizer, Lilly, Amgen, CORRONA, S. Schneeweiss Grant/research support from: Genentech/Roche, Boehringer Ingelheim, Consultant for: Aetion, WHISCON, LLC
The RNA Binding Protein MSI2 Has Increased RNA Binding Activity in Leukemic Stem Cells Compared to Normal Hematopoietic Stem Cells
Authors: Diu Nguyen, Yuheng Lu, Zi-ning Choo, Christopher Chin, Camila Prieto, Saroj Gourkanti, Christina Leslie, Michael G. Kharas
Journal: Blood (2018)
Abstract 18970: Development of Therapeutic Strategies for Takotsubo Syndrome: Insights From a Rat Model
Authors: Sven Y Surikow, Thanh H Nguyen, Irene Stafford, Matthew Chapman, Kuljit Singh, Giovanni Licari, Betty H Raman, Michael P Frenneaux, John D Horowitz
Journal: Circulation (2017)

Introduction: Takotsubo syndrome (TS) results from an aberrant response to stimulation of myocardial NOS-coupled β2-adrenoceptors, occurring most commonly in the ageing female heart. TS is also associated with myocardial inflammation, with biochemical and immunohistochemical evidence of nitrosative stress and resultant activation of the energy-depleting enzyme poly(ADP-ribose) polymerase (PARP-1). Clinically, the main problems associated with TS are (i) impaired LV systolic function, which resolves slowly and (ii) risk of arrhythmic death, particularly in the early course of TS. Hypothesis: In the current study, we sought to compare the effects on mortality and short term LV systolic dysfunction of two interventions affecting the signal transduction pathway initiated by aberrant β2-adrenoceptor stimulation. Nω-Nitro-L-arginine methyl ester hydrochloride (LNAME) inhibits β2-adrenoceptor-coupled NOS stimulation, while 3-aminobenzamide (3AB) limits activation of PARP-1 secondary to nitrosative stress. Method...
SAT0407 Mycobacterial infections in a rheumatology unit of a tertiary hospital
Authors: M. Espinosa Malpartida, C. Ramos Giráldez, C. Merino Argumánez, O. Rusinovich, M. García Moreno, C. Barbadillo Mateos, J. Campos Esteban, H. Godoy Tundidor, J. Sanz Sanz, C.M. Isasi, M. Jiménez Palop, J.L. Andreu Sánchez, L.F. Villa
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Many treatments for rheumatic diseases, especially the new ones such as anti-TNF or anti-IL6 therapies, are known to increase the risk of tuberculosis (TB) and nontuberculous mycobacterial (NTM) infections. <h3>Objectives</h3> To determine the incidence of mycobacterial infections in patients of the rheumatology unit in our hospital. <h3>Methods</h3> We retrospectively reviewed the results of microbiological studies for the detection of mycobacteria requested for patients of the Rheumatology service in our hospital from January 1, 2008 to October 1, 2017. We reviewed the clinical histories of the patients in whom a positive result was obtained. Different clinical and microbiological parameters were collected: age, gender, type of sample, isolated germ, infection location, antimicrobial treatment, main basal disease and immunosuppressive treatment received at the time of sampling. <h3>Results</h3> We reviewed 719 samples from 311 patients. The 28 samples that were positive for mycobacteria corresponded to 16 patients (50% males, with a mean age of 58.6 years). <i>M. avium complex</i> (MAC) was isolated in 10 patients, <i>M.tuberculosis complex</i> (MTB) in 4 patients and <i>M. gordonae</i> in two cases. Seven clinical infections occurred (5% of the total studied patients), 4 due to MTB and 3 to MAC. The predominant involvement was pulmonary (5 patients, one of them also with spondylodiscitis); one patient had infectious oligoarthritis with cutaneous involvement and another patient lymph node involvement. Six of the 7 patients with mycobacterial infection were receiving chronic treatment with prednisone (or equivalent dose of corticosteroids)&gt;5 mg/day (85.71%). In two of them adalimumab was associated, and methotrexate in other two. <h3>Conclusions</h3> The incidence of mycobacterial infections in patients with rheumatic diseases has increased, coupled with prolonged corticosteroid therapy – sometimes at high doses – and biological therapies. In our unit, an incidence of mycobacterial infections of 5% has been observed in the last 10 years. Most of the patients with clinical infection were under treatment with prednisone (or equivalent dose of corticosteroids)&gt;5 mg/day. We conclude that the need for chronic corticosteroid therapy should be balanced carefully in each patient, trying to reduce the dose and/or suspend it as soon as possible. <h3>Disclosure of Interest</h3> None declared
Allogeneic Stem Cell Transplantation Overcomes the Negative Prognostic Impact of TP53 Alterations in Mantle Cell Lymphoma
Authors: Richard J Lin, Caleb Ho, Patrick Hilden, Juliet Barker, Sergio Giralt, Paul A. Hamlin, Ann A. Jakubowski, H.R. Castro-Malaspina, Esperanza B. Papadopoulos, Miguel-Angel Perales, Craig S. Sauter
Journal: Blood (2018)
John Beavis: trauma and orthopaedic surgeon who trained doctors in disaster zones
Authors: Rebecca Wallersteiner
Journal: BMJ (2019)

CREDIT: Medical Aid for Palestinians

Born in 1940, in Brighton, to unmarried parents, John Beavis grew up in an extended Scottish-Irish family and soon shone at Varndean school, Brighton, where he developed his lifelong love of Shakespeare. His adoptive father, William, a navy cook, sadly died in the London blitz.

Despite his modest background, Beavis was able to benefit from the opportunities provided by the Labour government with the birth of the NHS, free secondary education, and social welfare—particularly benefiting bright children like him. He read medicine at University College London and qualified in 1967. His success made him determined to give back to a society that had given him so much.

An old fashioned socialist, Beavis shared his ideals with his wife, Kate Frankland, a teacher, whom he had known since adolescence. They married before Beavis had fully qualified as a doctor and their long and happy marriage produced three children.

From 1967 to 1973 Beavis served in a Royal Marines commando unit as a lieutenant medical officer, which inspired his interest in trauma, orthopaedics, and reconstructive surgery. He worked as a trauma and orthopaedic …
AB0333 Analysis of the association of compound indicates of disease activity and qualifications of functional capacity and quality of life related to health in patients with rheumatoid arthritis
Authors: B.F. Althoff, I.A. Pereira, T. Fontana, Y. Alfaro, C.J. Ferreira
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The correlation analysis of ICADs with questionnaires of functional evaluation and quality of life is essential, since it is the outcomes that matter to the patients. <h3>Objectives</h3> To evaluate the correlations between ICADs with questionnaires of functional capacity (HAQ) and health-related life quality (SF12). <h3>Methods</h3> Cross-sectional study with 100 out-patients of Santa Catarina, participants of a multicenter cohort, followed between August 2015/January 2016. Evaluated ICADs were: DAS-28 VHS, DAS-28 PCR, SDAI, CDAI, RADAI. The questionnaires were: HAQ and SF12. Tests Qui Square, test t Student, prevalence ratio and Pearson's correlation were used, with reliability interval 95%. Approved by Ethics Committee in Research of UNISUL. <h3>Results</h3> Moderate correlation between ICADs and HAQ (variation r 0,52–0,65). Weak correlation between ICADs and SF12 (Physical: variation r 0,15–0,24 and Mental: variation r 0,40–0,45). <h3>Conclusions</h3> ICADs correlate poorly with quality of life, assessed by SF12, but moderately with functional limitation, assessed by HAQ. <h3>References</h3> [1] Medeiros MMC, Oliveira BMGB, Cerqueira JVM, Quixadá RTS, Oliveira IMX. Correlação dos índices de atividade da artrite reumatoide (DAS-28 VHS, DAS28- PCR, SDAI, CDAI) e concordância dos estados de atividade da doença com vários pontos de corte numa população do nordeste brasileiro. Rev Bras Reumatol2015;55(6):477–84. [2] Oliveira LM, Natour J, Roizenblatt S, Araujo PMP, Ferraz MB. Acompanhamento da capacidade funcional de pacientes com artrite reumatoide por três anos. Rev Bras Reumatol2015;55(1):62–7. [3] Marques WV, Cruz V A, Rego J, Silva NA. Influência das comorbidades na capacidade funcional de pacientes com artrite reumatoide. Rev Bras Reumatol2016;56(1):14–21. [4] Radner H, Smolen JS, Aletaha D. Remission in rheumatoid arthritis: benefit over low disease activity in patient-reported outcomes and costs. Arthritis Res Ther2014;16:R56. [5] Radner H, Smolen JS, Aletaha D. Comorbidity affects all domains of physical function and quality of life in patients with rheumatoid arthritis. Rheumatology2011;50:381–8. [6] Yang G, Bykerk VP, Boire G, Hitchon CA, Thorne C, et al. Does socioeconomic status affect outcomes in early inflammatory arthritis? Data from a Canadian Multisite Suspected Rheumatoid Arthritis Inception cohort. J Rheumatol2015;42(1):46–54. [7] Mota LM, Cruz BA, Brenol CV, Pereira IA, Fronza LSR, et al. Guidelines for the diagnosis of rheumatoid arthritis. Rev Bras Reumatol2013;53(2):141–57. [8] Dritsaki M, Petrou S, Williams M, Lamb SE. An empirical evaluation of the SF-12, SF-6D, EQ-5D and Michigan Hand Outcome Questionnaire in patients with rheumatoid arthritis of the hand. Health Qual Life Outcomes2017;15(20):2–11. <h3>Disclosure of Interest</h3> None declared
Ipilimumab and nivolumab in the treatment of recurrent malignant pleural mesothelioma (INITIATE): results of a prospective, single-arm, phase 2 trial
Authors: Maria J Disselhorst, Josine Quispel-Janssen, Ferry Lalezari, Kim Monkhorst, Jeltje F de Vries, Vincent van der Noort, Emmy Harms, Sjaak Burgers, Paul Baas
Journal: The Lancet Respiratory Medicine (2019)
Lung Adenocarcinomas Manifesting as Radiological Part-Solid Nodules Define a Special Clinical Subtype
Authors: Ting Ye, Lin Deng, Shengping Wang, Jiaqing Xiang, Yawei Zhang, Hong Hu, Yihua Sun, Yuan Li, Lei Shen, Li Xie, Wenchao Gu, Yue Zhao, Fangqiu Fu, Weijun Peng, Haiquan Chen
Journal: Journal of Thoracic Oncology (2019)
SAT0646 Development and validation of a deep learning algorithm for classifying anti-nuclear antibody patterns in indirect immunofluorescence images
Authors: C.-H. Lin, C.-F. Kuo, Y.-F. Fang, P.-H. Tsai, Y.-F. Chen
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Antinuclear antibody (ANA) is a valuable test in the evaluate for a variety of autoimmune diseases. It can be detected using immunofluorescence (IIF) which yield both serum titers and also staining patterns. The manual titration of ANA is laborious and evaluation of staining patterns by a microscope requires experts to make correct classification. Deep learning is a collection of computational methods that enable an algorithm to 'learn' from a large set of data to acquire 'skills' that are characteristic of human intelligence, for example, complex pattern recognition. Application of these methods to ANA pattern classification requires further assessment and validation. <h3>Objectives</h3> To train a deep convoluted neural network to create an algorithm for automated classification of ANA patterns in images of indirect immunofluorescence. <h3>Methods</h3> We construct a deep convoluted neural network based on inception V3. The model adopted a deep learning architecture with 21 layers and ANA images were used to train to detect speckled, homogenous, nucleolar, centromere, dense fine speckled, cytoplasmic and mitochondrial patterns. The data were collected from rheumatology patients from June 2016 to October 2017. We validate the performance of the model using a separate set of images. <h3>Results</h3> Our data set consisted of 81822 ANA images from 8839 patients. The overall accuracy was 99.46% after 200 epochs of iteration using the training dataset (65 458 images) and the accuracy was 96.33% using the validation dataset (16.64 images). The sensitivity was 97.1% for speckled pattern, 91.4% for homogenous pattern, 97.1% for nucleolar pattern, 97.1% for centromere pattern, 97.2% for cytoplastmic pattern, and 100% for both dense fine speckled and mitochondrial patterns. The specificity was also good, ranged between 97.1% and 100%. <h3>Conclusions</h3> In this study, an algorithm based on deep convoluted neural network had high sensitivity and specific for detecting specific ANA patterns. Further research is needed to determine the feasibility to deploy the technology in routine clinical works to assist rheumatologists to interpret ANA. <h3>Disclosure of Interest</h3> None declared
Elotuzumab, Lenalidomide, and Dexamethasone (EloRd) As Salvage Therapy for Patients with Multiple Myeloma: Italian, Multicenter, Retrospective Clinical Experience with 180 Cases Outside of Controlled Clinical Trials
Authors: Massimo Gentile, Daniele Derudas, Monica Galli, Stefano Rocco, Concetta Conticello, Catello Califano, Nicola Giuliani, Silvia Mangiacavalli, Enrico Attingenti, Alessandra Lombardo, Marino Brunori, Elena Rossi, Elisabetta Antonioli, Roberto Ria, Renato Zambello, Donatella Vincelli, Angela Bonalumi, Agostina Siniscalchi, Raffaella Stocchi, Massimo Martino, Stelvio Ballanti, Dominella Gangemi, Alfredo Gagliardi, Vittorio Montefusco, Barbara Gamberi, Alessandra Pompa, Anna Recchia, Giovanni Tripepi, Ferdinando Frigeri, Sara Bringhen, Elena Zamagni, Francesca Patriarca, Valerio De Stefano, Francesco Di Raimondo, Felicetto Ferrara, Fortunato Morabito, Maria Teresa Petrucci, Massimo Offidani
Journal: Blood (2018)
Hypocapnia, mitochondria and surfactant secretion
Authors: Beata Kosmider, Karim Bahmed, Steven Kelsen
Journal: Thorax (2019)

Surfactant, a phospholipoprotein produced and stored by alveolar type II (ATII) cells, lowers surface tension in the alveolus and distal airways and is essential for normal lung mechanics and gas exchange.1 Decreases in surfactant production induced by prematurity or disease cause alveolar collapse, hypoxemia and reductions in lung compliance, thereby requiring greater distending pressures to inflate the lung and increases in the work of breathing.2 Prior studies dating back >30 years have shown that alveolar hypocapnia causes depletion of lamellar bodies in ATII cells and decreases surfactant production.3 However, the mechanism(s) underlying the effect(s) of hypocapnia on surfactant secretion by ATII cells are not well understood.

The paper by Kiefmann et al 4 in Thorax sheds light on molecular mechanisms which may contribute to the effects of alveolar hypocapnia on surfactant production in vivo. The authors examined surfactant secretion, cytosolic and mitochondrial calcium and alveolar volume and compliance in two rodent preparations: isolated, blood-perfused rat lungs …
Right Ventricular Junctional Late Gadolinium Enhancement Correlates With Outcomes in Pulmonary Hypertension
Authors: Manuel De Lazzari, Alberto Cipriani, Stefania Rizzo, Giulia Famoso, Benedetta Giorgi, Giuseppe Tarantini, Gaetano Thiene, Francesco Tona, Sabino Iliceto, Cristina Basso, Martina Perazzolo Marra
Journal: JACC. Cardiovascular imaging (2019)
THU0384 Salivary gland ultrasonography and stimulated salivary flow correlated with salivary gland biopsy among patients with sjÖgren syndrome and sicca symptoms: experience from a single medical centre in taiwan
Authors: Y.P. Tsao, M.H. Chen, S.Y. Wu, C.Y. Wu, W.S. Chen, C.C. Lai, C.Y. Tsai
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Sjögren's syndrome is an autoimmune disease that involves several organs. In the latest classification criteria, salivary minor gland is one of the major factor contributing to the diagnosis. Ultrasonography is a non-invasive, easy accessible tool in evaluation the contour and structure of salivary glands, which have been shown to have efficacy in monitoring the disease status of Sjögren's syndrome as well as in diagnosis the disease. Otherwise, salivary flow rate is another component of classification criteria, and its association with disease activity remains to be elucidated. <h3>Objectives</h3> To investigate the efficacy of salivary gland ultrasonography and salivary flow rate in patients with Sjögren's syndrome and Sicca symptoms. <h3>Methods</h3> Total 97 patients of primary or secondary Sjögren's syndrome, and patients with sicca symptoms were enrolled. Ultrasonography was performed at parotid and submandibular glands with 13–16MHz linear probe. Each gland was scored from 0 to 4. Minor salivary gland biopsy results were examined by pathologist with Chisholm-Mason grade. Unstimulated salivary flow rate was recorded first, and stimulated salivary flow rate was tested after 5 min of sugar-free chewing gum stimulation. Patients' symptoms were recorded by ESSPRI questionnaires. <h3>Results</h3> Total 56 primary Sjögren's Syndrome, 10 secondary Sjögren's Syndrome, and 31 patients with sicca symptoms were enrolled. Significant correlations were noted between unstimulated salivary flow rate and minor gland biopsy (p=0.029), stimulated salivary flow rate and biopsy (p=0.006), salivary gland ultrasonography and minor gland biopsy (p&lt;0.001), and minor gland biopsy with serum anti-SSB (La) level (p=0.009). The correlations between minor gland biopsy and serum anti-SSA (Ro) level was not significant. The stimulated salivary flow rate also correlated with self-reported dryness in ESSPRI questionnaires (p=0.018). The salivary gland ultrasonography also correlated with ESSPRI (p&lt;0.001) and the three factors in ESSPRI (dryness, p&lt;0.001; pain, p=0.039; fatigue, p=0.002). <h3>Conclusions</h3> Both salivary gland ultrasonography and salivary flow rate correlated with the severity of salivary minor gland biopsy. The stimulated salivary flow rate had better correlations with the biopsy result than unstimulated flow, and it also correlated with patients' self-reported dryness symptoms. Salivary gland ultrasonography had correlations with symptoms of patient. These non-invasive methods may play roles in evaluation of the disease activity. <h3>Disclosure of Interest</h3> None declared
AB0682 Risk factors associated with relapse of anti-neutrophil cytoplasmic antibody-associated vasculitis
Authors: M. Nakahara, H. Yamashita, Y. Takahashi, K. Araki, N. Mino, K. Suga, A. Yashima, H. Kaneko
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Several factors increasing the risk of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis have been reported. These include pulmonary and cardiovascular lesions, PR3-ANCA-positivity in patients with granulomatosis with polyangiitis, and persistent ANCA-positivity or an increase in the titer of such antibodies. <h3>Objectives</h3> We aimed to identify potentially novel factors predicting relapse in patients with ANCA-associated vasculitis. <h3>Methods</h3> We reviewed data on 73 patients (61 with microscopic polyangiitis [MPA], 12 with granulomatosis with polyangiitis [GPA]; 46 females) treated in our centre from 1998 to 2017 for whom medical histories were available. All achieved at least one remission after induction therapy. Relapse was defined as novel organ involvement or a need for therapy intensification. Follow-up continued to the first relapse or for as long as possible if no relapse was noted. <h3>Results</h3> The median age at disease onset (interquartile range) was 74 years (range: 67–80 years). The relapse rate was 42.5% (MPA 41%, GPA 50%), thus not significantly different between the two groups (p=0.75). The median follow-up duration was 23 months (range: 11–65 months) and the median time to relapse was 18 months (range: 10.5–54 months). Although pulmonary and cardiac lesions reportedly increase the relapse rate, neither contributed significantly to the rate in this study. Furthermore, ANCA-positivity after remission and increases in ANCA levels prior to relapse did not significantly increase the relapse risk. In terms of medical histories recorded at the time of first onset of disease, the frequency of diabetes, dyslipidemia, coronary artery disease, and cerebral infarction did not differ significantly between patients who did and did not relapse. However, in MPA patients, a history of hypertension was significantly less in those who relapsed (p=0.01). In a multiple logistic regression analysis adjusted for sex and age, history of hypertension was a significant predictor of fewer relapse (odds ratio: 0.23; 95% confidence interval 0.07–0.69, p=0.009). <h3>Conclusions</h3> In addition to known factors, a history of hypertension recorded at the time of disease onset may predict fewer MPA relapse. <h3>References</h3> [1] Kyndt X, et al. Am J Med. 1999May;106(5):527–33. [2] Hogan SL, et al. Ann Intern Med. 2005Nov 1;143(9):621–31. <h3>Disclosure of Interest</h3> None declared
Low specificity of washout to diagnose hepatocellular carcinoma in nodules showing arterial hyperenhancement in patients with Budd-Chiari syndrome
Authors: Morgane Van Wettere, Yvonne Purcell, Onorina Bruno, Audrey Payancé, Aurélie Plessier, Pierre-Emmanuel Rautou, Dominique Cazals-Hatem, Dominique Valla, Valérie Vilgrain, Maxime Ronot
Journal: Journal of Hepatology (2019)
Expediting Comprehensive Molecular Analysis to Optimize Initial Treatment of Lung Cancer Patients With Minimal Smoking History
Authors: Ibiayi Dagogo-Jack, Hayley Robinson, Mari Mino-Kenudson, Anna F. Farago, Vashine Kamesan, A. John Iafrate, Alice T. Shaw, Jochen K. Lennerz
Journal: Journal of Thoracic Oncology (2019)