tbuckley/cabot-search huggingface dataset:
AB1042 THE EFFECT OF INTRA-ARTICULAR STEROID INJECTION ON THE CARTILAGE THICKNESS IN JUVENILE IDIOPATHIC ARTHRITIS
Authors: Nihal Sahin, Sumeyra Ozdemir Cicek, Aysenur Pac Kisaarslan, Muammer Hakan Poyrazoglu, Ruhan DüŞünsel
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Intra-articular corticosteroid injection is a choice in the treatment of juvenile idiopathic arthritis (JIA), especially in large and few joints involvement. Intra-articular steroid injection provides relief in active synovitis but its effects on cartilage are controversial. <h3>Objectives</h3> The aim of this study is to evaluate the effect of intra-articular steroid injection on distal femoral cartilage thickness in patients with JIA by ultrasonography. <h3>Methods</h3> Distal femoral cartilage thicknesses were measured before the procedure and 6 months later by ultrasonography in the patients that were injected an intra-articular steroid to the knee. <h3>Results</h3> The mean age of the patients was 12.1±4,8 years. Nine of patients were girls and 2 were boys. The mean disease duration was 5,1±4,2 years. Ten patients had oligoarticular JIA and one patient had enthesitis-related arthritis. The number of patients injected to the right knee was 3, the left knee was 5 and both the knee was 3. The femoral cartilage thickness before the procedure was 3.0 mm [min-max 2.0-3.65 mm], 6 months after the procedure was 2.95 mm [min-max 2.0-3.55 mm] and there was no statistical difference (p&gt;0,05). <h3>Conclusion</h3> In this study, no effect of intra-articular steroid treatment on cartilage was observed. However, the number of patients is lack. Therefore, we planned a comprehensive study with more patients. <h3>References</h3> [1] Huppertz HI, Tschammler A, Horwitz AE, Schwab KO. Intraarticular corticosteroids for chronic arthritis in children: efficacy and effects on cartilage and growth, J Pediatr. 1995;127(2):317-21. [2] Pradsgaard DØ, HØrlyck A, Spannow AH, Heuck C, Herlin T. A Comparison of Radiographic Joint Space Width Measurements Versus Ultrasonographic Assessment of Cartilage Thickness in Children with Juvenile Idiopathic Arthritis, JRheum 2019; 46:doi:10.3899/jrheum.170571. <h3>Disclosure of Interests</h3> None declared
AB0387 SATISFACTION OF PATIENTS AND PHYSICIANS WITH TREATMENTS FOR RHEUMATOID ARTHRITIS: A NATIONWIDE SURVEY IN CHINA
Authors: Nan Jiang, Pingting Yang, Shengyun Liu, LI Hongbin, Lijun Wu, Xiaofei Shi, Yongfei Fang, Yi Zhao, Jian Xu, Zhenyu Jiang, Zhenbiao Wu, Xingwang Duan, Qian Wang, Xinping Tian, Mengtao Li, Xiaofeng Zeng
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Treatment satisfaction is important for adherence to therapy both for patients and physicians. There is no full understanding of the treatment satisfaction for rheumatoid arthritis (RA) in China. <h3>Objectives</h3> The aim is to explore the treatment satisfaction between rheumatologists and RA patients across China and the factors associated with patients' satisfaction. <h3>Methods</h3> We conducted a prospective, multicenter, observational study of physicians and patients in 12 centers from 11 provinces across China between March and April 2018 (NCT03483597). The Treatment Satisfaction Questionnaire for Medication version II (TSQM-II) was used to assess the treatment satisfaction of patients and physicians regarding to csDMARDs and bDMARDs therapy. Multiple linear regression analysis was used to determine the factors independently associated with patients' satisfaction. <h3>Results</h3> 1237 patients (82.5% female) with a mean age (SD) of 48.9 (13.4) years and 146 rheumatologists (72.6% working&gt;5 years) were included in this survey. The patients' satisfaction (n=335) with bDMARDs was higher than physicians' satisfaction (n=146) regarding the side effects (95.0±14.3 vs. 84.6±15.7, p&lt;0.001) and convenience (74.6±21.2 vs. 69.1±16.5, p=0.002) (Table1). Among physicians, global satisfaction with bDMARDs was higher than that with csDMARDs (75.0 vs. 66.7, p&lt;0.05) (Table1). Satisfaction of each questionnaire item toward therapy in patients and rheumatologists were also shown in radar charts (Figure 1). The multivariable regression analysis showed that age and quality of communication with physician was positively associated with patients' satisfaction, while level of education (bachelor or above), self-assessment of disease severity and treatment costs were inversely associated with satisfaction. <h3>Conclusion</h3> For bDMARDs, the treatment satisfaction of patients with RA is generally better than that of physicians. Physicians' satisfaction with bDMARDs is higher than that with csDMARDs. The independently factors associated with the treatment satisfaction of patients with RA are age, education, disease severity, the patient-physician communication, and treatment costs, which could be targeted in routine clinical care. <h3>References</h3> None <h3>Acknowledgement</h3> The authors acknowledge contributions from the HealthCloud Co., Ltd as the system provider. <h3>Disclosure of Interests</h3> None declared
Metabolic stress in cancer cells induces immune escape through a PI3K-dependent blockade of IFNγ receptor signaling
Authors: Koen A. Marijt, Marjolein Sluijter, Laura Blijleven, Sofie H. Tolmeijer, Ferenc A. Scheeren, Sjoerd H. van der Burg, Thorbald van Hall
Journal: Journal for ImmunoTherapy of Cancer (2019)

T-cell mediated immunotherapy brought clinical success for many cancer patients. Nonetheless, downregulation of MHC class I antigen presentation, frequently occurring in solid cancers, limits the efficacy of these therapies. Unraveling the mechanisms underlying this type of immune escape is therefore of great importance. We here investigated the immunological effects of metabolic stress in cancer cells as a result of nutrient deprivation.TC1 and B16F10 tumor cell lines were cultured under oxygen- and glucose-deprivation conditions that mimicked the tumor microenvironment of solid tumors. Presentation of peptide antigens by MHC class I molecules was measured by flow cytometry and via activation of tumor-specific CD8 T cell clones. The proficiency of the IFNy-STAT1 pathway was investigated by Western blots on phosphorylated proteins, transfection of constitutive active STAT1 constructs and qPCR of downstream targets. Kinase inhibitors for PI3K were used to examine its role in IFNy receptor signal transduction.Combination of oxygen- and glucose-deprivation resulted in decreased presentation of MHC class I antigens on cancer cells, even in the presence of the stimulatory cytokine IFNy. This unresponsiveness to IFNy was the result of failure to phosphorylate the signal transducer STAT1. Forced expression of constitutive active STAT1 fully rescued the MHC class I presentation. Furthermore, oxygen- and glucose-deprivation increased PI3K activity in tumor cells. Pharmacological inhibition of this pathway not only restored signal transduction through IFNy-STAT1 but also improved MHC class I presentation. Importantly, PI3K inhibitors also rendered tumor cells sensitive for recognition by CD8 T cells in culture conditions of metabolic stress.These data revealed a strong impact of metabolic stress on the presentation of tumor antigens by MHC class I and suggest that this type of tumor escape takes place at hypoxic areas even during times of active T cell immunity and IFNy release.
Abstract 14011: Abnormalities in Myocardial Performance Index in Single Left Ventricles After Fontan Are Driven by Abnormal Relaxation
Authors: Michael V Di Maria, Carmen Lopez, Bruce Landeck, Adel Younoszai, Mark Friedberg, Kendall Hunter, Luc Mertens
Journal: Circulation (2017)

Background: Assessment of ventricular function in single ventricle (SV) heart disease remains challenging due to morphologic heterogeneity and distorted ventricular geometry. The myocardial perform...
PF182 CLINICOBIOLOGIC CHARACTERISTICS AND OUTCOME OF ELDERLY FRAIL PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA INCLUDED IN A SPECIFIC PROTOCOL (ALL‐07FRAIL)
Authors: J.M. Ribera, O. García‐Calduch, C. Gil, J. González‐Campos, M.J. Moreno, P. Barba, M.L. Amigo, D. Martínez‐Carballeira, N. Alonso, J.M. Bergua, S. Mercadal, A. Cladera, F. Vall‐Llovera, A. García‐Guiñón, A. López, E. Lavilla, M. Sierra, J.M. Hernández‐Rivas
Journal: HemaSphere (2019)

Background: Elderly patients with ALL are frequently excluded from clinical studies, especially if they have criteria of frailty. Treatment of these patients is considered palliative, but here are scarce studies analysing the tolerability and outcome of elderly frail patients included in specific trials. Aims: Here we present the clinicobiologic characteristics and outcome of elderly frail patients with Philadelphia chromosome‐negative (Ph‐neg) ALL included in the ALL‐07FRAIL (NCT01358201) study from the Spanish PETHEMA Group. Methods: Older (55–65 yrs.) and elderly (&gt;65 yrs.) patients with Ph‐neg ALL with Charlson comorbidity index &gt;3 were included in this study. Treatment schedule: pre‐phase (dexamethasone [DXM] for 1 week + triple intrathecal therapy [TIT]). Induction: vincristine (VCR) 1 mg/week x 4 wks and DXM (10 mg/m 2 /d x 28d) and TIT (d1 and d35). No consolidation. Maintenance: mercaptopurine (MP) (50 mg/m 2 /d) and methotrexate (MTX) (20 mg/m 2 /wk) for 2 years from CR, with monthly reinductions with VCR (1 mg), DXM (40 mg/m 2 , d1,2) and TIT during the 1 st year. Results: From 2008 to 2018, 58 patients (pts) were included in the ALL FRAIL07 study. Mean (SD) age 73 (7) yrs., 42 pts (72%) over 70 yrs., 38 males (66%), median WBC count 8.2 x10 9 /L (0.3–475), CNS involvement 5 pts (9%), B‐cell precursor ALL 48/56 (86%)(pro‐B [n = 12], common [n = 23], pre‐B [n = 12], non‐specified [n = 1]), T‐ALL 8/56 (14%)(pro‐T [n = 1], pre‐T [n = 4], mature T [n = 1], non‐specified [n = 2]). Results of induction treatment (n = 57, 1 on treatment): early death 9 (16%), failure 17 (30%), complete remission 31 (54%). The most frequent Grade 3–4 toxicities in induction were: neutropenia 39/51 pts (77%), thrombocytopenia 30/51 (59%), infection 11/51 (22%), neurologic 4/49 (8%) and gastrointestinal 2/49 (4%). Outcome of CR patients: treatment‐related mortality 6 (19%), withdrawn from study 2 (6%), relapse 20 (65%), persistent CR1 3 (10%). The cumulative incidence of relapse at 3‐yrs was 80% (median: 11.1 months [95%CI: 5.2–25.9]). With a median follow‐up of 23.7 months (0.1–53.7), 4 patients are alive, with a median OS of 7.7 months (95% CI, 5.6–9.9)(Figure 1). Summary/Conclusion: Older and elderly frail patients with Ph‐neg ALL can benefit from a structured study using non‐genotoxic drugs, with good tolerability and acceptable CR rate and survival. These results could serve as control for strategies including new drugs in this difficult‐to‐treat population. image
SP0143 CASE 1 DISCUSSANT: HOW IS TACKLING OLIGO-ARTICULAR DISEASE DIFFERENT FROM POLYARTHRITIS? CAN WE USE TRIAL RESULTS FROM POLY-ARTICULAR PSA IN A PATIENT WITH MONO/OLIGO-ARTHRITIS?
Authors: Laura C Coates
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Oligoarthritis is a well recognised phenotype in psoriatic arthritis (PsA) where less than 5 joints are involved with active arthritis. In cohort studies, the proportion of patients presenting with mono/oligoarthritis varies from 20-70% depending on the timeframe studied and duration of disease. However most studies of therapeutic agents in PsA have focused on polyarticular disease. Although the majority of studies accept a minimum of 3 active joints for inclusion, the average tender and swollen joint counts are usually over 10 at baseline. <h3>Objectives:</h3> To review data supporting treatment of psoriatic mono/oligoarthritis including comparisons of response rates in therapeutic trials in PsA and the differential performance of outcome measures in this subtypes of disease. <h3>Results:</h3> When considering the applicability of RCT data to mono/oligoarthritis in PsA it is important to address the populations included in these studies. Nearly all large therapeutic studies exclude monoarthritis, and while some oligoarthritis patients are eligible for inclusion in most RCTs, the demographics of the population included suggest that this is a minority. Unfortunately most clinical trials have not reported the efficacy results separately for oligoarthritis and polyarthritis patients. The other key consideration is that the outcome measures used in the majority of trials are developed and validated on patients with polyarticular PsA. Thus assessing effectiveness of therapies may be limited in the oligoarthritis population as the response measures are less sensitive to change. <h3>Conclusion:</h3> Although data from polyarticular RCT populations is often used to choose therapies in oligoarticular PsA, there is a real paucity of data to ensure that we are treating these patients optimally. Future research is needed to address the variable prognosis seen in mono/oligoarticular PsA, to ensure that appropriate outcome measures are used to test different therapies and to provide clear evidence on the efficacy of drugs in this important subtype of disease. <h3>Disclosure of Interests:</h3> Laura C Coates Grant/research support from: AbbVie, Celgene, Lilly, Novartis and Pfizer, Consultant for: AbbVie, Amgen, BMS, Celgene, Galapagos, Gilead Sciences Inc., Janssen, Lilly, Novartis, Pfizer, Prothena Corp and UCB
Abstract 18974: Diabetes Mellitus and the Development of Atrial Fibrillation by Gender in Hispanics, African Americans and Non-Hispanic Whites
Authors: Eric H Shulman, Dmitriy Nevelev, Tina Shah, Faraj Kargoli, Luigi Di Biase, John Fisher, Jorge Romero, Soo Kim, Jay Gross, Andrew Krumerman, Kevin J Ferrick
Journal: Circulation (2017)

Introduction: It is known that women with diabetes mellitus (DM) have a higher risk to develop atrial fibrillation (AF) compared to men with DM. However, it is unknown whether gender risk differenc...
PB1995 THE EFFECTS OF ANTITUMOR THERAPY ON BONE REMODELING IN PATIENTS WITH HODGKIN'S LYMPHOMA
Authors: M. Voytko, T. Pospelova, V. Klimontov, O. Fazullina
Journal: HemaSphere (2019)

Background: Cures have been achieved in a significant proportion of patients with Hodgkin lymphoma (HL) for many years. Treatment for HL has been associated with adverse late effects. One of those consequences of antitumor therapy may be a change in bone mineral density (BMD). Hemoblastosis is considered as a strong risk factor for secondary osteoporosis and major low‐energy fractures. The decrease in BMD can be associated with polychemotherapy, including various combinations of cytostatic drugs and glucocorticoids, as well as with hypogonadism caused by toxic effects of radiotherapy and chemotherapy, tumor process, low physical activity and other factors. Aims: To assess the bone mineral density (BMD) in patients with HL. Methods: The study included 103 patients with HL from the City Hematology Center of Novosibirsk, from 19 to 72 years of age (median 49 years [33;55]). The disease was staged according to the Ann Arbor staging system: 55 patients had early stage disease and 48 patients had advanced stage disease (stage III to IV). All subjects received first‐line regimens (ABVD, BEACOPP‐14, et al.). Eighteen patients with advanced stages and unfavorable prognosis obtained second‐line regimens (DHAP, ESHAP). Radiotherapy was performed in 57 (55,3%) individuals. Complete remission was achieved in 60 of 103 patients (58,2%), and partial remission was recorded in 32 ones (31%). The BMD was assessed by dual‐energy X‐ray absorptiometry with GE Lunar Prodigy densitometer (USA). The assessed variables were BMD and T‐ or Z‐criterion (when appropriate) at the lumbar spine (L1–L4), proximal femur, femoral neck and forearm of a non‐dominant arm. Fracture Risk Assessment Tool (WHO FRAX, web version 3.8, adjusted for Russia) was used to determine the risk of major osteoporotic fractures. Results: The decreased BMD was revealed in 47 observed HL subjects (45,6%), 30 of them diagnosed osteoporosis. The decline in BMD was more frequent in patients aged ≥50 years as compared to younger ones (χ2 = 5,75; p = 0,02). More patients with radiotherapy in anamnesis had decreased BMD compared to patients who received chemotherapy only (χ2 = 8,82; p = 0,003) More than half of the patients (60 %) receiving regimens containing glucocorticosteroids had BMD decrease. Based on FRAX assessment, the 10‐year risk of major low‐energy fractures and the hip fractures was expectedly higher in patients with osteoporosis and osteopenia as compared to subjects with normal BMD (p &lt; 0,05). A comparative analysis revealed that patients younger than 50 years old had more often lower values of BMD and Z‐score of the lumbar spine. In turn, the femoral neck was the most frequent localization of osteoporosis in patients older 50 years and postmenopausal women. Summary/Conclusion: The study demonstrates high prevalence of decreased BMD in patients with HL. The decrease in BMD is associated with radiotherapy and chemotherapy with glucocorticoids.
Evaluation of a molecular point-of-care testing for viral and atypical pathogens on intravenous antibiotic duration in hospitalized adults with lower respiratory tract infection: a randomized clinical trial
Authors: D. Shengchen, X. Gu, G. Fan, R. Sun, Y. Wang, D. Yu, H. Li, F. Zhou, Z. Xiong, B. Lu, G. Zhu, B. Cao
Journal: Clinical Microbiology and Infection (2019)
Abstract 19222: Persistence of Late Potentials Found during Repeat Ablation of Ventricular Tachycardia: A Mechanism for Recurrence?
Authors: Roderick Tung, Justin Hayase, Ricky Yu, Noel Boyle, Kalyanam Shivkumar
Journal: Circulation (2012)

Background: Recurrence of scar-mediated ventricular tachycardia (VT) approaches 50% in patients at 6-12 months. Outcomes from multiple procedures are not well characterized. Changes in electroanatomic substrate and the persistence of late potentials (LP) during a repeat procedure have not been reported. Methods: Patients who underwent both initial and repeat VT ablation between 2004-11 at Ronald Reagan UCLA Medical Center were analyzed. Electroanatomic maps (NAVX, St. Jude Medical, Minneapolis, MN and CARTO, Biosense-Webster, Diamond Bar, CA) from both the initial and repeat ablation procedures were analyzed for LP, defined as low-voltage electrograms with onset outside of the QRS complex. All studies were adjudicated by a second observer. Results: 23 patients underwent both initial and repeat ablation at our institution, of which 16 patients had electroanatomic maps from both studies available for analysis. There were 3 patients who underwent 3 ablations, and the rest underwent a single repeat procedure. Substrates included 10 non-ischemic cardiomyopathy (NICM), 4 ischemic cardiomyopathy (ICM), and 2 arrhythmogenic right ventricular dysplasia (ARVD). The overall success rate, defined as no VT recurrence at 1 year, was 25% (4/16) (ARVD=2, ICM=2). All patients (13/13) who had LP identified on initial procedure had persistence of LP on repeat procedure. The remaining patients (3/3) who had no LP identified on initial procedure, again had no LP targets on repeat ablation. Conclusions: In this retrospective consecutive series of patients with recurrent VT, those with LP identified on the initial procedure exhibited persistence of LP during repeat mapping and ablation. This may be an important mechanism of recurrence, suggesting that more extensive substrate modification of all late activity is necessary. In patients without LP identified on the initial procedure, no LP were identified on repeat mapping. In patients that require repeat ablation, 25% experience freedom from VT recurrence at 1 year after their last procedure.
AB0184 FLOW CYTOMETRIC IMMUNOPHENOTYPING OF SALIVARY GLANDS IN PRIMARY SJÖGREN’S SYNDROME
Authors: Paul Milne, Anastasia Resteu, Aleksandra Ivovic, Emmanuella Traianos, David Storey, Jessica Tarn, Richard Siegel, Peter Campbell, Wan Fai Ng, Matthew Collin
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Primary Sjögren's Syndrome (PSS) is a common autoimmune disease of unknown aetiology. It is characterised by inflammatory infiltration of exocrine glands, development of a sicca syndrome and a 20-fold increase in the risk of developing lymphoma. Standard pathological evaluation is based on a lymphocyte 'focus score' but little is known about the composition of the lymphoid infiltrate or its relationship to disease markers such as autoantibodies and the risk of lymphoma. <h3>Objectives:</h3> The aim of the study was to use flow cytometry to characterise the lymphoid infiltrate in more detail. <h3>Methods:</h3> Salivary glands were collected from 103 subjects attended the Newcastle Sjogren's clinic who had undergone minor salivary gland biopsy as part of the diagnostic investigations which also include testing for anti-SSA/SSB antibodies, Schirmer's tests and unstimulated oral salivary flow. 70 with confirmed PSS, 15 with potential or early-stage PSS and 18 with non-SS. Salivary glands were digested in collagenase for 3 hours and sort-analysed using a BD Biosciences FACSFusion flow cytometer. Sorted cells from 6 patients were Giemsa stained to observe cell morphology. All subjects have given their written informed consent according to the principles of Helsinki and the project has received local REC approval. <h3>Results:</h3> Salivary glands contain multiple lymphoid populations including CD19+ B cells, CD19+CD38+ plasmablasts, CD19-CD38+ plasma cells, and predominantly central memory CD4+ and CD8+ T cells. The focus score is associated with an increase in the total number of lymphocytes of up to 10-fold. In particular there is a striking increase CD19-CD38+ cells with restricted kappa light chain expression associated with the most advanced cases. By morphology these cells have the appearance of plasma cells with frequent Russell bodies and occasional binucleated forms. <h3>Conclusion:</h3> Flow cytometry of dispersed salivary gland demonstrates and association between lymphoid cells and the focus score in PSS patients. The dominant B cell population in PSS salivary gland is a CD19-negative tissue plasma cell with evidence of kappa light chain restriction in advanced disease. <h3>Disclosure of Interests:</h3> Paul Milne: None declared, Anastasia Resteu: None declared, Aleksandra Ivovic: None declared, Emmanuella Traianos: None declared, David Storey: None declared, Jessica Tarn: None declared, Richard Siegel Employee of: Employee of Novartis since June 2018., Peter Campbell: None declared, Wan Fai Ng: None declared, Matthew Collin: None declared