tbuckley/cabot-search huggingface dataset:
THU0733-HPR Effect of custom-made foot orthoses versus placebo in patients with rheumatoid arthritis: randomised clinical trial
Authors: M. Reina-Bueno, P.V. Munuera-Martínez, C. Vázquez-Bautista, S. Pérez-García, C. Rosende-Bautista
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatoid Arthritis (RA) affects among 0.3% and 1.5% of people.<sup>1</sup> Foot involvement occurs in more than 85% of people with RA.<sup>2</sup> One of the most prevalent deformities is rearfoot valgus.<sup>3</sup> <h3>Objectives</h3> To study whether the use of custom made foot orthoses improves pain, foot function, and quality of life in RA patients. <h3>Methods</h3> This randomised clinical trial was carried out in the University of Seville and of A Coruña. Inclusion criteria: to be over 18 years and to have diagnosis of RA with involvement in the foot. Exclusion criteria: Acute phase, neurological problems or cognitive impairment. Participants were given an informational form. They had to use physiological footwear and assigned foot orthoses during at least 8 hours/day, for 3 months. Participants were randomly assigned to one of the two groups: Experimental Group (A) (foot orthosis with a Rovalfoam upper sheet and polypropylene) and Control Group (B) (5mm-thick Rovalfoam sheet, without adaptation). The SF-12, the Visual Analogue Pain Scale (EVA), the Manchester Questionnaire and the Foot Function Index (FFI) are administered at the first visit and at the last review. <h3>Results</h3> The final sample consisted of 47 participants with RA, 53.2% were group A and 46.8% were group B. This At the initial moment between groups, there were no statistically significant differences. Data obtained baseline and end of the follow-up period were compared within the control group, and showed significant differences in some FFI domains (days with pain, disability and total). In the experimental group there was a statistically significant decrease in EVA scale, some Manchester questionnaire domains (pain and total sections) and in some FFI domains (activity limitation and total; there was a very statistically significant in EVA scale and in some FFI domains (pain and total). There was no significant difference in the SF-12 scale between these two moments. <h3>Conclusions</h3> Custom made foot orthoses improved foot pain and function in people with RA who participate in this study. However, this treatment did not have a positive effect on their quality of life. <h3>References</h3> [1] Novak P, et al. Influence of foot orthoses on plantar pressures, foot pain and walking ability of rheumatoid arthritis patients-a randomised controlled study. Disabil Rehabil2009;31(8):638–45. [2] Bongi SM, et al. A comparison of two podiatric protocols for metatarsalgia in patients with rheumatoid arthritis and osteoarthritis. Clin Exp Rheumatol2014;32:855–63. [3] Barn R, et al. Kinematic, kinetic and electromyographic response to customized foot orthoses in patients with tibialis posterior tenosynovitis, pes plano valgus and rheumatoid arthritis. Rheumatol2014;53(1):123–30. <h3>Disclosure of Interest</h3> None declared
AB1140 Comparison of cut-off values for ferritin to discriminate adult onset still’s disease from other causes of fever of unknown origin: results of a prospective study
Authors: E. Bilgin, A. Erden, B. Armagan, L. Kılıç, A. Sarı, G. Yardımcı, E. Bilgin, A. Akdoğan, Ö. Karadağ, S. Apraş Bilgen, I. Ertenli, S. Kiraz, U. Kalyoncu
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Adult onset Still's disease (AOSD) is a rare, auto-inflammatory disease that commonly presents as fever of unknown origin (FUO). As AOSD can cause complications as reactive lymphohistiocytosis that can be mortal, discriminating AOSD from FUO is important. Ferritin, an acute phase reactant, is commonly high in patients with AOSD as a part of systemic inflammation. <h3>Objectives</h3> To determine a cut-off value of ferritin that favours AOSD over FUO. <h3>Methods</h3> Data from patients who admitted to Hacettepe University Hospitals, inpatients sections of department of internal medicine with the complaint of FUO collected prospectively during 30 months. Patients with uncertain diagnosis after all diagnostic procedures excluded. AOSD patients followed at Hacettepe University department of rheumatology were included. Of AOSD patients whose initial test ferritin levels were not available also excluded. For determination of cut-off values, receiver operator curve (ROC) analysis were done for each predetermined value. Upper normal level in our laboratory for ferritin is 336 ng/ml. <h3>Results</h3> Total 150 patients (n=63, for AOSD; n=87, for FUO) were included. Median ferritin level was significantly higher in <sup>AOSD group [1705</sup> (657–6417) ng/ml vs. 424 (141–1188) ng/ml, p&lt;0001]. FUO group were also divided into three subgroups: rheumatologic (n=31, 35.6%), infectious (n=28, 32.2%) and malignant (n=28, 32.2%) causes. Median ferritin levels for these subgroups were 222 (104–1020), 527 (145–1057), 599 (166–2766) ng/ml, respectively. Area under curve (AUC) 95% confidence intervals, sensitivity and specificity for predetermined cut-off values are given in Table-1. ROC curve for all ferritin levels are given in Figure 1. <h3>Conclusions</h3> For each cut-off values for ferritin, test performances were quite well to differentiate patients with AOSD from FUO. While ferritin levels higher than upper normal level have 98 percent sensitivity, ferritin levels higher than 5 times of upper normal level have 82 percent specificity. Large number of patients in each FUO subgroup is needed to determine ferritin test performance for each particular group of patients to differentiate from AOSD. <h3>Disclosure of Interest</h3> None declared
THU0370 The significance of non-mydriatic fundus examination operated by rheumatologists in screening for retinopathy of systemic lupus erythematosus (SLE)
Authors: M. Yang, Q. Lv, Z. Lin, J. Qi, X. Guo, J. Gu
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Retinopathy is a common fundus lesion in SLE patients. Non-mydriatic Fundus Camera images directly and objectively and avoids the mydriatic drug-induced glaucoma attack, which can not only reduce the suffering of patients but also save saves time and costs. <h3>Objectives</h3> To understand the significance of non-mydriatic fundus examination operated by rheumatologists in screening for retinopathy of SLE. <h3>Methods</h3> After professional training, rheumatologists use non-mydriatic fundus camera to take fundus photography of inpatients in our department and record the clinical features and laboratory test results of the patients. The results of fundus photography are interpreted by both ophthalmologists and rheumatologists. The fundus results of SLE patients from July 2016 to June 2017 were analysed. 35 cases (62 eyes) of retinopathy were defined as experimental group, and 35 cases (70 eyes) without retinopathy were randomly selected as the control group. <h3>Results</h3> A total of 203 patients with SLE with an average age of 38.4±11.6 years acquired bilateral fundus results, including 28 males and 175 females (86.2%). Ocular lesions were found in 51 (25.1%) cases, of which 35 (62.6%) were common retinopathy. There were 5 cases of retinal atrophy and pigmented degeneration (4 binocular, 1 monocular), 9 cotton spots (6 binocular, 3 monocular), 7 flaming bleeding (7 binocular), 14 choroiditis with drusen (9 binocular, 5 monocular), arteries tortuous or occluded in 5 (3 binocular, 2 monocular). The SLEDAI score, anti-dsDNA level and C3 decline rate of the experimental group were significantly higher than those of the control group (p&lt;0.05 or p&lt;0.01), while the titer of antinuclear antibody, the positive rate of anti-SM antibody, the positive rate of anti-phospholipid antibodies, and the erythrocyte sedimentation rate had no significant difference (p&gt;0.05). Subsequently, we followed up 16 patients with retinopathy and SLEDAI score ≥10 and achieved remission (SLEDAI score ≤4) with glucocorticoid and immunosuppressive agents with an average duration of 6.5±4.5 months. The second examination showed that retinal lesions were improved in 9 cases (56.25%), 3 cases (18.75%) were unable to judge due to the appearance of optical media change which may cased by glucocorticoid, and 4 cases (25%) showed no obvious changes. <h3>Conclusions</h3> Non-mydriatic fundus examination performed by rheumatologists may assist rheumatologists in screening for retinopathy in SLE patients, assessment of disease activity and treatment outcome. <h3>Disclosure of Interest</h3> None declared
FRI0745-HPR Implicit and explicit attitudes and associations of rheumatoid arthritis patients towards conventional disease modifying anti-rheumatic drugs as possible targets for improving medication adherence
Authors: M. Van Heuckelum, E. van den Ende, L. Vandeberg, S. van Dulmen, A. Linn, B. van den Bemt
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Medication adherence to conventional disease modifying anti-rheumatic drugs (cDMARDs) is suboptimal in patients with rheumatoid arthritis (RA) with medication adherence rates ranging from 30 to 80% [1]. Since existing interventions are only partially effective, identifying (modifiable) factors associated with non-adherence might help to find targets for more effective adherence-improving interventions. There is growing evidence that not only explicit attitudes (conscious responses) are responsible for behaviour, but also implicit attitudes (unconscious responses) might be involved [2]. <h3>Objectives:</h3> The aim of this study is to examine implicit and explicit attitudes of RA patients towards cDMARDs, and their association with medication adherence. <h3>Methods:</h3> A multicenter observational cohort study in two rheumatology specialized centres was initiated to examine implicit and explicit attitudes of 254 consecutive adult RA patients (ACR 2010 criteria) treated with at least one cDMARD for a minimum period of one year. Prior to their regular consultation, patient's implicit attitudes were measured with the Single Category Implicit Association Test and explicit attitudes were evaluated with a bipolar evaluative adjective scale and the validated Beliefs about Medicines Questionnaire (BMQ-specific). Primary outcome was self-reported medication adherence measured with the validated Compliance Questionnaire on Rheumatology. <h3>Results:</h3> Implicitly, more patients displayed negative attitudes (49.0%) and sickness related associations (60.9%) than explicitly (21.3% and 23.5% respectively). Only significant correlations between explicit attitudes and associations of RA patients and beliefs about medicines were found. The lowest levels (48.8%) of self-reported adherence were found in patients who displayed congruent negative (implicit and explicit) attitudes. The highest levels (71.4%) of self-reported adherence were found in patients who displayed congruent (implicit and explicit) health (versus sickness) related associations. <h3>Conclusions:</h3> Implicit attitudes and associations of RA patients were not always congruent with explicit attitudes and associations. Slightly higher adherence rates were found in patients who displayed positive explicit attitudes and associations. However, implicit and explicit attitudes and associations of RA patients towards cDMARDs and their adherence should be further investigated with MEMS (medication event monitoring system) devices. <h3>References</h3> 1] BJF van den Bemt, et al. Expert Rev Clin Immunol2012May;8(4):337–51. doi:10.1586/eci.12.23 2] Linn, et al. Front Pharmacol. 2016Aug 10;7:233. doi:10.3389/fphar.2016.00233. eCollection 2016 <h3>Disclosure of Interest:</h3> None declared
AB0877 Analysis of the association of the peripheral involvement of the spondyloarthritis with the extra-articular manifestations
Authors: M.D.S. Mastella, I.M.S. Vale, M.M. Pereira, M.J. Carmo, G.R.W. Castro, I.A. Pereira
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> Patients with SpA present peripheral involvement, such as arthritis and enthesitis, or only axial involvement, such as sacroiliitis and sindesmophytes. The differentiation of the peripheral and axial presentation is important, being able to guide different therapeutic strategies. <h3>Methods</h3> This is a retrospective observational study, conducted in two clinics in Florianópolis. The population was composed of patients with AS and non-radiographic and peripheral axial SpA, according to the criteria of modified New York and ASAS group, respectively, served from 1997 to 2017. <h3>Results</h3> 153 patients were analysed, 82 were male (53.59%), 71.29% were HLA B27 positive (77/108 tested), 87.3% had sacroiliitis detected on x-ray, CT or MRI, 104 presented peripheral involvement (67.97%) and 49 (32.02%) purely axial involvement. Arthritis occurred in 86 (56.2%) and enthesitis in 57 (37.3%) patients. The use of synthetic DMARD occurred in 78.4% of the patients, more frequently in the group with peripheral involvement, with methotrexate being used in 74% versus 56.3% of those with purely axial involvement (p&lt;0.05). The use of biological DMARD occurred in 104 (68%), in the majority of the anti-TNF class (96.1%), with the highest frequency of use in patients with axial involvement (77.1% versus 64.4%), but not statistically significant (p&gt;0.05). Extra-articular manifestations were found in 72 (47.1%) of the patients, with uveitis being the most frequent (26.8%). The presence of uveitis occurred in 68.3% of patients with isolated axial involvement versus 31.7% of patients with peripheral involvement (p=0.179). The cutaneous involvement occurred in 18.3% of the patients with peripheral involvement compared to 8.3% of those with an isolated axial condition. Regarding bowel involvement and cardiovascular impairment, there was no significant difference in prevalence between the two groups. <h3>Conclusions</h3> Extra-articular manifestations are frequent in SpA, but are not more frequent in patients with peripheral involvement versus patients with pure axial involvement. Peripheral involvement is associated with greater use of synthetic DMARDs when compared to pure axial involvement. <h3>Disclosure of Interest</h3> None declared
AB1476-HPR Effects of wearable technology as virtual rehabilitation on functional outcomes in patients with anterior cruciate ligament reconstruction
Authors: O Aydogdu, Z. Sarı
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Virtual rehabilitation systems play an increasing role in rehabilitation. They provide an interactive environment and increased motivation for patients during the session.<sup>1</sup> In recent years, intervention methods based on virtual reality have been studied. However, existing studies are limited because most of them focused on the balance ability of the elderly or studied in stroke patients with same systems.<sup>2</sup> Thus, it is necessary to investigate the effects of virtual rehabilitation in patients with Anterior Cruciate Ligament (ACL) Reconstruction. <h3>Objectives</h3> The purpose of this study was to investigate the effects of a wearable technology as virtual rehabilitation which provides visual and auditory stimulus aimed for educating and controlling the joint on proprioception, postural stability and fear of re-injury in patients with ACL reconstruction. <h3>Methods</h3> Nineteen patients (age=28.47±6.18 years, height=176.31±6.06 cm, weight=79.47±14.38 kg) with ACL reconstruction were participated in this study. In addition to conventional physiotherapy, a virtual rehabilitation treatment applied with visual and auditory stimulus three times in a week for 8 weeks. Knee proprioception, postural stability and fear of re-injury were measured with Biodex System Pro 4 Isokinetic Dynamometer, Pedalo Sensamove System, Tampa Kinesiophobia Score, respectively. <h3>Results</h3> There were statistically significant improvements in measures of proprioception (p=0.003), postural stability (p=0.001), and fear of re-injury (p=0.001) between pre- and post – treatment. <h3>Conclusions</h3> According to the results, wearable technology as virtual rehabilitation may be beneficial on proprioception, postural stability, and fear of re-injury to treat patients with anterior cruciate ligament reconstruction. We conclude that devices used as wearable technologies should be used as treatment modalities in clinical services because of providing feedback, easy to carry and interactive treatment. <h3>References</h3> [1] Ferreira Dos Santos L, Christ O, Mate K, et al. Movement visualisation in virtual reality rehabilitation of the lower limb: a systematic review. Biomed Eng Online. 2016Dec 19;15(Suppl 3):144. [2] Park EC, Kim SG, Lee CW. The effects of virtual reality game exercise on balance and gait of the elderly. J Phys Ther Sci. 2015Apr;27(4):1157–9. <h3>Acknowledgements</h3> This study was supported by Marmara University, Scientific Research Research Projects Committee (Project Number: SAG-C-DRP-200716–0374) and TÜBİTAK, The Scientific and Technological Research Council of Turkey (Project Number: 115E351). <h3>Disclosure of Interest</h3> None declared
THU0634 Risk of sudden cardiac death in patients with sarcoidosis: a population-based retrospective cohort study
Authors: A.A. Chahal, P.A. Brady, C.S. Crowson, V.K. Somers, E.L. Matteson, P. Ungprasert
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Sarcoidosis is an inflammatory, non-caseating, granulomatous disorder of unknown etiology which can affect any body system including the heart and can be associated with increased risk of cardiovascular disease including sudden cardiac death (SCD). However, the risk and incidence of SCD are unknown. <h3>Objectives</h3> We sought to determine whether the risk of SCD in patients with sarcoidosis is higher than in the general population. <h3>Methods</h3> A population-based cohort of 345 incident cases of sarcoidosis (50% female; 90% Caucasian, 5% African-American; mean age 45.6 years) among Olmsted County, Minnesota residents in 1976–2013 was identified from a comprehensive medical record-linkage system. Medical records of those cases were individually reviewed to confirm the diagnosis of sarcoidosis which required physician diagnosis supported by histopathology, compatible clinical presentation and exclusion of other granulomatous diseases. A total of 345 sex and age-matched comparators (50% female; 95% Caucasian, 1% African-American; mean age 45.4 years) were also identified from the same underlying population. Mortality, including time, place and cause of death of cases and comparators were individually reviewed for SCD events. SCD incidence rates are reported per 1 00 000 person-years and Cox proportional hazards models were used for comparisons between groups. <h3>Results</h3> The median length of follow-up was 12.9 (6.0–23.4) years and 15.8 (6.8–25.5) for cases and comparators, respectively. Of the 58 deaths in patients with sarcoidosis, 10 were due to definite/probable SCD, versus 57 all-cause and 9 definite/probable SCDs in comparators. Incidence rate of SCD in sarcoidosis was 192 per 1 00 000 person-years (PY) (95% confidence interval (CI), 92–352) versus 155 per 100,000 PY (95% CI, 71–294) in comparators, corresponding to the hazard ratio of 1.28 (95% CI, 0.52–3.17, p=0.59). Analysis by time of SCD, sex, age, calendar year of incidence/index date also did not reveal a significantly different rate of SCD between the 2 groups as demonstrated in table 1. <h3>Conclusions</h3> In this first ever population-based evaluation of SCD in sarcoidosis, patients are not at increased risk for SCD (all sub-types). These findings may reflect actual risk, but estimates may be affected by low statistical power. Future studies may further elucidate the risk and nature of cardiac death among patients with sarcoidosis. <h3>Disclosure of Interest</h3> None declared
Outcomes of Hypothermia in Addition to Decompressive Hemicraniectomy in Treatment of Malignant Middle Cerebral Artery Stroke
Authors: Hermann Neugebauer, Hauke Schneider, Julian Bösel, Carsten Hobohm, Sven Poli, Rainer Kollmar, Jan Sobesky, Stefan Wolf, Miriam Bauer, Sascha Tittel, Jan Beyersmann, Johannes Woitzik, Peter U. Heuschmann, Eric Jüttler
Journal: JAMA Neurology (2019)

Moderate hypothermia in addition to early decompressive hemicraniectomy has been suggested to further reduce mortality and improve functional outcome in patients with malignant middle cerebral artery (MCA) stroke.To investigate whether moderate hypothermia vs standard treatment after early hemicraniectomy reduces mortality at day 14 in patients with malignant MCA stroke.This randomized clinical trial recruited patients from August 2011 through September 2015 at 6 German university hospitals with dedicated neurointensive care units. Of the patients treated with hemicraniectomy and assessed for eligibility, patients were randomly assigned to either standard care or moderate hypothermia. Data analysis was completed from December 2016 to June 2018.Moderate hypothermia (temperature, 33.0 ± 1.0°C) was maintained for at least 72 hours immediately after hemicraniectomy.The primary outcome was mortality rate at day 14 compared with the Fisher exact test and expressed as odds ratio (ORs) with 95% CIs. Rates of patients with serious adverse events were estimated for the period of the first 14 days after hemicraniectomy and 12 months of follow-up. Secondary outcome measures included functional outcome at 12 months.Of the 50 study participants, 24 were assigned to standard care and 26 to moderate hypothermia. Twenty-eight were male (56%); the mean (SD) patient age was 51.3 (6.6) years. Recruitment was suspended for safety concerns: 12 of 26 patients (46%) in the hypothermia group and 7 of 24 patients (29%) receiving standard care had at least 1 serious adverse event within 14 days (OR, 2.05 [95% CI, 0.56-8.00]; P = .26); after 12 months, rates of serious adverse events were 80% (n = 20 of 25) in the hypothermia group and 43% (n = 10 of 23) in the standard care group (hazard ratio, 2.54 [95% CI, 1.29-5.00]; P = .005). The mortality rate at day 14 was 19% (5 of 26 patients) in the hypothermia group and 13% (3 of 24 patients) in the group receiving standard care (OR, 1.65 [95% CI, 0.28-12.01]; P = .70). There was no significant difference regarding functional outcome after 12 months of follow-up.In patients with malignant MCA stroke, moderate hypothermia early after hemicraniectomy did not improve mortality and functional outcome compared with standard care, but may cause serious harm in this specific setting.http://www.drks.de, identifier DRKS00000623.