tbuckley/cabot-search huggingface dataset:
AB1059 Contribution of ct-guided discovertebral biopsy during infectious spondylodiscitis
Authors: S. Lataoui, S. Belghali, H. Zaghouani, S. Sridi, K. Baccouche, S. Majdoub, N. Elamri, F. Bouzayene, H. Zeglaoui, D. Bakir, E. Bouajina
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Infectious spondylodiscitis is an infection involving the vertebral endplates and the intervertebral discs. The diagnosis is based on a combination of clinical symptoms, biological and radiological findings. Identifying the causative germ is sometimes difficult and a CT-guided discovertebral biopsy (DVB) might be of help, with varying success rates. <h3>Objectives</h3> The aim of this study was to assess the contribution of CT-guided DVB in the diagnosis of infectious spondylodiscitis in a rheumatological environment in Tunisia. <h3>Methods</h3> A retrospective study including patients diagnosed with infectious spondylodiscitis in the rheumatology department of Farhat Hached hospital, Sousse, Tunisia, between 1998 and 2017. Only patients who underwent a DVB for etiologic diagnosis of infectious spondylodiscitis were included in this study. <h3>Results</h3> Thrity five patients, with 12 (34.3%) women, were included. The mean age was 57.31±19.14 years [15–83 years]. All patients presented with back pain for 83.06±73.32 days [10–330 days], seven (20%) patients had fever and six (17.1%) patients had abnormal neurological signs on examination. The mean WBC, CRP and ESR levels were respectively 8170.83±3476.94 elements/mm<sup>3</sup>, 50.22±59.22 mg/L and 86.85±50.74 mmh1. The affected levels were the lumbar in 23 (65.7%) cases and dorsal spine in 9 (25.7%) cases. Three patients (8.6%) had both dorsal and lumbar spondylodiscitis. First DVB was contributive in 11 (31.4%) cases. Isolated germs were staphylococcus aureus in 4 (36.4%) cases, tuberculosis in 3 (27.3%) cases, and brucellosis, coagulase negative staphylococcus, enterobacter cloacae, streptococcus oralis in one case each. Only one patient underwent a second DVB attempt, which was contributive, isolating a staphylococcus aureus. The rest of patients were treated based on late bacteriological findings (2 cases of brucellosis, 2 cases associated with Escherichia coli urinary infection and 1 case with pulmonary tuberculosis), or presumption arguments (6 cases treated as pyogenic infection and 12 cases as tuberculosis). <h3>Conclusions</h3> DVB remains essential for the positive diagnosis of infectious spondylodiscitis. Nevertheless, its bacteriological insufficient contribution should not delay therapeutic management based on presumption arguments. <h3>Disclosure of Interest</h3> None declared
Abstract 18642: Pkcd Mediated Serine Phosphorylation of Stat3 Worsens Abdominal Aortic Aneurysm by Enhancing Rip3 Expression & Necrosis
Authors: Kartik Gupta
Journal: Circulation (2017)

Introduction: Receptor interacting kinase 3 (RIP3/ RIPK3) plays a decisive role in necroptosis. The upregulated levels of RIP3 found in atherosclerosis and aneurysm is likely to skew the cellular i...
Prevalence of Pediatric Surgical Conditions Across Somaliland
Authors: Tessa Concepcion, Mubarak Mohamed, Shugri Dahir, Edna Adan Ismail, Dan Poenaru, Henry E. Rice, Emily R. Smith
Journal: JAMA Network Open (2019)

Although surgical conditions are increasingly recognized as causing a significant health care burden among adults in low- and middle-income countries (LMICs), the burden of surgical conditions among children in LMICs remains poorly defined.To estimate the prevalence of pediatric surgical conditions across Somaliland using a nationwide community-based household survey.This cross-sectional study was conducted through a national community-based sampling survey from August through December 2017 in Somaliland. Participants were 1503 children surveyed using the Surgeons OverSeas Assessment of Surgical Need (SOSAS).The SOSAS survey contains 2 components, including a section on household demographics, deaths, and financial information and sections querying children's history of surgical conditions.In this cross-sectional study that included 1503 children (55.6% male; mean [SE] age, 6.4 [0.1] years), 221 surgical conditions were identified among 196 children, yielding a mean (SE) prevalence of pediatric surgical conditions of 12.2% (1.5%). Only 53 of these 221 surgical conditions (23.7%) had been surgically corrected at the time of the survey. The most common conditions encountered were congenital anomalies (33.8%) and wound-related injuries (24.6%). Nationally, an estimated 256 745 children have surgical conditions, with an estimated 88 345 to 199 639 children having unmet surgical needs.Using national sampling, this study found that children have a high burden of surgical conditions in Somaliland. These data highlight the need for a scale-up of pediatric surgical infrastructure and resources to provide the needed surgical care for children in LMICs.
Larotrectinib in adult patients with solid tumours: a multi-centre, open-label, phase I dose-escalation study
Authors: D.S. Hong, T.M. Bauer, J.J. Lee, A. Dowlati, M.S. Brose, A.F. Farago, M. Taylor, A.T. Shaw, S. Montez, F. Meric-Bernstam, S. Smith, B.B. Tuch, K. Ebata, S. Cruickshank, M.C. Cox, H.A. Burris, R.C. Doebele
Journal: Annals of Oncology (2019)

NTRK1, NTRK2 and NTRK3 gene fusions (NTRK gene fusions) occur in a range of adult cancers. Larotrectinib is a potent and highly selective ATP-competitive inhibitor of TRK kinases and has demonstrated activity in patients with tumours harbouring NTRK gene fusions.
AB0251 Are acpa associated with more bone loss over time in patients with ra?
Authors: J.A.M.P. Amkreutz, E.C. de Moel, L. Heimans, C.F. Allaart, T.W.J. Huizinga, D. van der Woude
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Anti-citrullinated protein antibodies (ACPA) are one of the most important serological markers for rheumatoid arthritis (RA) and have been suggested to play a pathophysiologic role by directly binding to osteoclasts. However, the effect of ACPA on systemic bone mineral density (BMD) and in particular their effect on changes in BMD over time is currently unknown. <h3>Objectives</h3> The aim of this study was to determine whether ACPA associate with changes in BMD over time in patients with RA. <h3>Methods</h3> Yearly dual X-ray absorptiometry (DXA) scores were performed during 5 years of follow-up in 412 patients with recent-onset RA participating in the IMPROVED study<sup>1</sup>, a clinical trial in which patients were treated according to a remission- (disease activity score &lt;1.6) steered strategy. The effect of the presence of ACPA on 1) Z-scores of lumbar spine and hip over time, and 2) prevalence of osteopenia/osteoporosis (defined as a T-score ≤−1) over time was analysed using generalised estimating equations. Analyses were adjusted for age, gender, BMI, symptom duration, smoking status, disease activity, prednisone intake, usage of bisphosphonates, calcium intake and serum 25-OH vitamin D levels. <h3>Results</h3> ACPA-positive patients had a significantly lower lumbar spine (p=0.04) and hip (p=0.01) Z-score at baseline. There was no difference in prevalence of osteoporosis/osteopenia at baseline between ACPA-positive and ACPA-negative patients (OR (95% CI) 1.02 (0.55 to 1.19)). We hypothesised that ACPA-positive patients would have more BMD loss over time compared to ACPA-negative patients. However, ACPA-positivity did not associate with a stronger decline in Z-score over time at lumbar (p=0.43) or femoral sites (p=0.67). Additionally, no effect of ACPA-positivity was found on the development of osteoporosis/osteopenia over time (p=0.23). <h3>Conclusions</h3> ACPA-positive patients have a significantly lower baseline BMD compared to ACPA-negative patients. Surprisingly, ACPA do not associate with a decrease in BMD over time in patients who were treated according to a tight control strategy. These results indicate that ACPA alone do not contribute to bone loss after disease onset in the absence of inflammation/disease activity. <h3>Reference</h3> [1] Wevers-de Boer K, et al. Ann Rheum Dis. 2012Sep;71(9):1472–7. <h3>Disclosure of Interest</h3> None declared
Midkine drives cardiac inflammation by promoting neutrophil trafficking and NETosis in myocarditis
Authors: Ludwig T. Weckbach, Ulrich Grabmaier, Andreas Uhl, Sebastian Gess, Felicitas Boehm, Annette Zehrer, Robert Pick, Melanie Salvermoser, Thomas Czermak, Joachim Pircher, Noah Sorrelle, Mary Migliorini, Dudley K. Strickland, Karin Klingel, Volker Brinkmann, Ulrike Abu Abed, Urs Eriksson, Steffen Massberg, Stefan Brunner, Barbara Walzog
Journal: The Journal of Experimental Medicine (2019)

Heart failure due to dilated cardiomyopathy is frequently caused by myocarditis. However, the pathogenesis of myocarditis remains incompletely understood. Here, we report the presence of neutrophil extracellular traps (NETs) in cardiac tissue of patients and mice with myocarditis. Inhibition of NET formation in experimental autoimmune myocarditis (EAM) of mice substantially reduces inflammation in the acute phase of the disease. Targeting the cytokine midkine (MK), which mediates NET formation in vitro, not only attenuates NET formation in vivo and the infiltration of polymorphonuclear neutrophils (PMNs) but also reduces fibrosis and preserves systolic function during EAM. Low-density lipoprotein receptor–related protein 1 (LRP1) acts as the functionally relevant receptor for MK-induced PMN recruitment as well as NET formation. In summary, NETosis substantially contributes to the pathogenesis of myocarditis and drives cardiac inflammation, probably via MK, which promotes PMN trafficking and NETosis. Thus, MK as well as NETs may represent novel therapeutic targets for the treatment of cardiac inflammation.
Association between severe drought and HIV prevention and care behaviors in Lesotho: A population-based survey 2016–2017
Authors: Andrea J. Low, Koen Frederix, Stephen McCracken, Salome Manyau, Elizabeth Gummerson, Elizabeth Radin, Stefania Davia, Herbert Longwe, Nahima Ahmed, Bharat Parekh, Sally Findley, Amee Schwitters
Journal: PLoS Medicine (2019)

Background A previous analysis of the impact of drought in Africa on HIV demonstrated an 11% greater prevalence in HIV-endemic rural areas attributable to local rainfall shocks. The Lesotho Population-Based HIV Impact Assessment (LePHIA) was conducted after the severe drought of 2014–2016, allowing for reevaluation of this relationship in a setting of expanded antiretroviral coverage. Methods and findings LePHIA selected a nationally representative sample between November 2016 and May 2017. All adults aged 15–59 years in randomly selected households were invited to complete an interview and HIV testing, with one woman per household eligible to answer questions on their experience of sexual violence. Deviations in rainfall for May 2014–June 2016 were estimated using precipitation data from Climate Hazards Group InfraRed Precipitation with Station Data (CHIRPS), with drought defined as <15% of the average rainfall from 1981 to 2016. The association between drought and risk behaviors as well as HIV-related outcomes was assessed using logistic regression, incorporating complex survey weights. Analyses were stratified by age, sex, and geography (urban versus rural). All of Lesotho suffered from reduced rainfall, with regions receiving 1%–36% of their historical rainfall. Of the 12,887 interviewed participants, 93.5% (12,052) lived in areas that experienced drought, with the majority in rural areas (7,281 versus 4,771 in urban areas). Of the 835 adults living in areas without drought, 520 were in rural areas and 315 in urban. Among females 15–19 years old, living in a rural drought area was associated with early sexual debut (odds ratio [OR] 3.11, 95% confidence interval [CI] 1.43–6.74, p = 0.004), and higher HIV prevalence (OR 2.77, 95% CI 1.19–6.47, p = 0.02). It was also associated with lower educational attainment in rural females ages 15–24 years (OR 0.44, 95% CI 0.25–0.78, p = 0.005). Multivariable analysis adjusting for household wealth and sexual behavior showed that experiencing drought increased the odds of HIV infection among females 15–24 years old (adjusted OR [aOR] 1.80, 95% CI 0.96–3.39, p = 0.07), although this was not statistically significant. Migration was associated with 2-fold higher odds of HIV infection in young people (aOR 2.06, 95% CI 1.25–3.40, p = 0.006). The study was limited by the extensiveness of the drought and the small number of participants in the comparison group. Conclusions Drought in Lesotho was associated with higher HIV prevalence in girls 15–19 years old in rural areas and with lower educational attainment and riskier sexual behavior in rural females 15–24 years old. Policy-makers may consider adopting potential mechanisms to mitigate the impact of income shock from natural disasters on populations vulnerable to HIV transmission.
Abstract 18352: Long-term Follow-up and Outcome in Patients With an Extra-anatomic Ascending-descending Aortic Bypass for Complex Coarctation and Aortic Arch Pathology
Authors: Ophelie Loup, Kerstin Wustmann, Stephan R Schenker, Florian Schoenhoff, Jean-Pierre Pfammatter, Markus Schwerzmann, Thierry P Carrel, Alexander Kadner
Journal: Circulation (2017)

Background: Extra-anatomical ascending-descending aortic bypass (EAADAB) is a safe surgical option for the relief of complex coarctation and aortic arch obstruction, but long-term functional outcom...
Abstract 17820: Risk of Sudden Cardiac Death in Sarcoidosis - A Population-Based Study From Olmsted County, Minnesota
Authors: Anwar A Chahal, Peter A Brady, Cynthia S Crowson, Eric L Matteson, Patompong Ungprasert
Journal: Circulation (2017)

Introduction: Sarcoidosis is an inflammatory, non-caseating, granulomatous disorder of unknown etiology which can affect any body system (including the heart) and is associated with increased risk of cardiovascular disease. However, the risk and incidence of sudden cardiac death (SCD) is unknown. Hypothesis: The risk of SCD in persons with sarcoidosis is higher than in the general population. Methods: A population based cohort of all 345 incident cases (50% males) of sarcoidosis and 345 age- and sex-matched comparators in Olmsted County, MN, USA during 1976-2013 was used to assess SCD risk. Each case was manually reviewed and abstracted. Mortality, including time, place and cause of death were individually reviewed for SCD events. SCD incidence rates are reported per 100,000 person-years and Cox proportional hazards models used for comparing groups. Results: Mean (SD) age at diagnosis of sarcoidosis was 45.6 (13.6) years. Follow-up: median 12.9 (6.0, 23.4) years; total 5,220 person-years. Of the 58 deaths...
Errors in Analysis in Study of New Persistent Opioid Use After Surgery
Authors: Chad M. Brummett, Stephanie E. Moser, Brahmajee K. Nallamothu
Journal: JAMA Surgery (2019)

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Abstract 17707: Long-Term Treatment With Linagliptin Provides Multiple Ultrasonic-Evaluated Antiatherosclerotic Effects Independent of Diabetic Improvement for Type-2 Diabetics Receiving Statin
Authors: Tatsuaki Murakami, Hiromasa Kokado
Journal: Circulation (2017)

Introduction: Diabetes mellitus (DM) is thought to be highly involved in complex atherothrombogenic processes, but the long-term antiatherosclerotic therapies in patients with type-2 DM have not be...
Intratumor heterogeneity comparison among different subtypes of non-small-cell lung cancer through multi-region tissue and matched ctDNA sequencing
Authors: Yaxiong Zhang, Lianpeng Chang, Yunpeng Yang, Wenfeng Fang, Yanfang Guan, Aiwei Wu, Shaodong Hong, Huaqiang Zhou, Gang Chen, Xi Chen, Shen Zhao, Qiufan Zheng, Hui Pan, Lanjun Zhang, Hao Long, Haoxian Yang, Xin Wang, Zhesheng Wen, Junye Wang, Hong Yang, Xuefeng Xia, Yuanyuan Zhao, Xue Hou, Yuxiang Ma, Ting Zhou, Zhonghan Zhang, Jianhua Zhan, Yan Huang, Hongyun Zhao, Ningning Zhou, Xin Yi, Li Zhang
Journal: Molecular Cancer (2019)

Understanding of intratumor heterogeneity (ITH) among different non-small cell lung cancer (NSCLC) subtypes is necessary. Whether circulating tumor DNA (ctDNA) profile could represent these ITH is still an open question. We performed 181 multi-region tumor tissues sequencing and matched ctDNA sequencing from 32 operative NSCLC to compare ITH among different NSCLC subtypes, including EGFR-mutant lung adenocarcinoma (LUAD), KRAS-mutant LUAD, EGFR&KRAS-wild-type LUAD, and lung squamous cell carcinoma (LUSC), and examine potential value of ctDNA for ITH analysis. ITH is evaluated by ITH index (ITHi). If the somatic genetic alteration is shared by all the tissue regions, it is defined as trunk mutation. Otherwise, it is called branch mutation. The ITHi will be higher, if the tumor has less trunk mutations. We found EGFR-mutant LUAD showed significantly higher ITHi than KRAS-mutant LUAD/wild-type LUAD (P = 0.03) and numerically higher ITH than LUSC. For trunk mutations, driver mutations were identified at a higher proportion than passenger mutations (60% vs. 40%, P = 0.0023) in overall, especially in EGFR-mutant LUAD (86% vs. 14%, P = 0.0004), while it was opposite in KRAS-mutant LUAD (40% vs. 60%, P = 0.18). For branch mutations, the proportions of driver mutations and passenger mutations were similar for each NSCLC subtype. ctDNA analysis showed unsatisfactory detections of tumor-derived trunk and branch mutations (43% vs. 23%, P = 4.53e-6) among all NSCLC subtypes. In summary, EGFR-mutant LUAD has the highest ITH than other NSCLC subtypes, offering further understanding of tumorigenesis mechanisms among different NSCLC subtypes. Besides, ctDNA maybe not an appropriate method to reflect ITH.
AB0459 Remission rate of tocilizumab in controlled trials and observational studies: systematic review of rheumatoid arthritis
Authors: O. Kucuksahin, L. Kılıç, Z. Aşlar, C. Bes, V. Yazısız, A. Yazıcı, D. Solmaz, T. Kaşifoğlu, U. Kalyoncu
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> In concept, the state of remission constitutes a clinical condition in which no active disease is present. Target of rheumatoid arthritis (RA) is achieve to remission. Tocilizumab (TOC) is a humanised monoclonal antibody that binds to the interleukin-6 receptor <h3>Objectives</h3> The aim of this study was to assess the remission rate of TOC for the treatment of RA patients in randomised controlled trials (RCTs) and longitudinal observational studies (LOS). <h3>Methods</h3> In January 2017, a systematic Review (SR) was performed in PUBMED MEDLINE. Publications were identified using the MeSH terms: (''rheumatoid arthritis and Tocilizumab'') with a limitation to ''humans'', ''all adults: 19+years'', ''English'' and ''clinical trials''. All available studies describing the retention rate of TOC were recruited to SR. Retention rate of TOC were calculated according to route (SC or IV), dosage (4 mg/kg vs 8 mg/kg), monotherapy or combination with methotrexate. Of the 662 publications identified by the literature search, 42 were recruited in the analysis. Retention rates of TOC at 12–16 weeks, 24–32 weeks, 48–52 weeks, 2. Years, 3. Years and 5. years were analysed. Open label extension period of RCTs included to LOS. The causes of withdraw of TOC were recorded as inefficacy, adverse event, and others. <h3>Results</h3> Of the 34 studies, 13 (38%) were RCTs and 21 (62%) were LOSs. Totally 12 043 patients (9834 (81%) female) were pooled to analysis that 6190 patients (51%) were from RCTs. The mean age was 53 years and mean disease duration was 9 years. Seropositivty was 73.6% for rheumatoid factor and 72.2% for ACPA. Overall, 5493 (54.6%) of patients were biologic-naïve. TOC was used as monotherapy (2469/6077, 35.4%), or concomitant with methotrexate (8037/11429, 70.3%). Available baseline DAS-28 score, CDAI, SDAI, and HAQ-DI score were 6.2, 32.1, 33.3, and 1.49 respectively. Remission rate of TOC according to study type were shown in table 1. <h3>Conclusions</h3> These systematic literature results show that treatment with of TOC has a high likelihood of inducing a clinically important benefit in terms of different remission criteria. Remission achieved both RCTs and real life results Moreover, remission rate of TOC in LOSs was comparable with other biologic DMARDs, as well. <h3>Disclosure of Interest</h3> None declared
SAT0417 Predictive value of fetal umbilical artery doppler in preterm birth in patients with systemic lupus erythematosus
Authors: Z. Zhan, D. Chen, Q. Qiu, X. Wang, Y. Zhan
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Pregnancies in women with systemic lupus erythematosus (SLE) resulted in an increase of preterm birth. The predictive value of fetal umbilical artery Doppler examinations for adverse pregnancy outcomes has been reported, while not widely be assessed in SLE pregnant women. <h3>Objectives</h3> To examine the predictive value of the fetal umbilical artery Doppler on preterm birth in pregnant women with SLE. <h3>Methods</h3> A fetal Doppler ultrasound examination was performed on all fetuses during the third trimester (28~36 weeks of gestation).The Doppler flow parameters of umbilical arteries were recorded, including pulsatility parameter (PI), resistance index (RI), the peak value of umbilical arteries at end-systole (Vmax, also abbreviate as S) and the peak value of umbilical arteries at end-diastole (Vmin, also abbreviate as D).The value of S/D was automatically calculated. The clinical data from 160 live births of SLE patients were analysed retrospectively. <h3>Results</h3> The mean age of SLE patients at pregnancy was (29.7±3.7) years old (20~37). Totally, 52 patients (32.5%) were preterm births and 76 (47.5%) were fullterm births without any other adverse pregnancy outcomes. The rate of preterm birth before 34 weeks was 26.9% and the number changed to 73.1% for those preterm deliveries after 34 weeks. Iatrogenic preterm birth was the most common cause of preterm birth (30 cases), followed by spontaneous preterm birth (12 cases) and preterm premature rupture of membranes (10 cases). The pulsatility index (PI), resistance index (RI) as well as S/D value of SLE patients with pre-term delivery was higher than that of patients with full-term delivery (p&lt;0.05). The area below the ROC curve for PI, RI and S/D was 0.6 (95%CI 0.5~0.7),0.7 (95%CI 0.6~0.8) and 0.6 (95%CI 0.5~0.7), respectively. PI with cut-off value of 1.0 indicated the highest risk of preterm birth, with sensitivity of 34.6% and specificity of 84.2%. Regarding 0.7 as the cut-off value for RI to predict preterm birth, the sensitivity was 50.0% and the specificity was 81.6%. The optimal cut-off value for S/D was 2.8, at which sensitivity (50.0%) and specificity (81.6%) had the best combination. <h3>Conclusions</h3> Pregnancies in lupus still had an increased risk of preterm birth. Umbilical artery Doppler was a useful monitoring measure for preterm birth in lupus pregnancies. <h3>Disclosure of Interest</h3> None declared