tbuckley/cabot-search huggingface dataset:
AB0742 PREVALENCE AND RISK FACTORS OF OSTEOPOROSIS IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS
Authors: H. Bettaieb, H. Ferjani, K. Maatallah, H. Boussaa, D. Kaffel, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2021)

Background: Childhood rheumatic diseases are associated with reduced Bone mass and increased risk of fractures (1). Several factors may interact to determine osteoporosis other than direct bone detrimental effects of the disease or its treatment. Objectives: In this work, we aimed to investigate the prevalence of bone loss in patients with JIA and to determine the relative factors associated with osteoporosis during this chronic disease. Methods: A retrospective monocentric study was carried out on JIA patients (ILAR criteria).Dual-energy x-ray absorptiometry (DEXA) was used to determine bone status. Disease activity was evaluated by JADAS10 (Juvenile Arthritis Disease Activity Score) in poly and oligoarticular subtypes and by BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) in arthritis related enthesitis form. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were noted. The data were analyzed using the SPSS statistical package. A p value &lt; 0.05 was considered significant. Results: The sample included 40 JIA (25 male and 15 female) with a mean age at disease onset of 11.3 ± 3.6 years. The median disease duration was 90 months [7-408].The median JIA diagnosis delay was 8 months [1-108]. The JIA subgroups were in decreasing order of frequency: Enthesitis-related Arthritis (n=27), Polyarticular RF- (n=4), Polyarticular RF+ (n=1), Oligoarticular (n=4), Systemic (n=2), Psoriatic Arthritis (n=1) and Undifferentiated (n=1). Median ESR and CRP were 29 mm/hour [2-98] and 14.5 mg/l [0-70] respectively. Median BASDAI score was 4.3 [1-9.7]. Median JADAS10 score was 1[1-21]. Overall, 45% of patients had osteoporosis, 27.5% had osteopenia, and 27.5 % had normal bone densitometry. None of the patients had a history of vertebral or peripheral fractures. Thirty per cent of patients (n=12) were on long term corticosteroid therapy with a mean dose of 6.6 ± 2.8 mg/day. Only 12.5% (n=5) of them had a regular physical activity. Osteoporosis was associated with age at JIA onset (p=0.005), disease duration (p=0.001), ESR (p=0.08), CRP (p=0.04), BASDAI score (p=0.017) and sedentarily (p=0.026). Osteopenia was only associated with corticosteroid therapy (p=0.01). Neither osteoporosis (p=0.37) nor Osteopenia (p=0.25) was associated with disease activity score. Conclusion: In our study, osteoporosis was a common feature during JIA. A long term corticosteroid therapy and sedentarily seem to be correlated with more impaired bone abnormalities. Hence, targeted interventions are urgently required to preserve bone health during JIA. References: [1]McDonagh JE. Osteoporosis in juvenile idiopathic arthritis. Curr Opin Rheumatol. 2001;13(5):399-404. Disclosure of Interests: None declared
AB0313 THE CLINICAL CHARACTERISTICS OF PATIENTS WITH IMMUNE-ASSOCIATED ADVERSE PREGNANCY
Authors: W. Su, Y. Zhuang, J. Zhu
Journal: Annals of the Rheumatic Diseases (2021)

Background: Immune-associated adverse pregnancy is the adverse pregnancy outcomes induced by autoimmune factors or autoimmune diseases, including infertility, recurrent spontaneous abortion, failed assisted reproduction, fetal growing restriction. It is helpful to explore the mechanism and improve the management by analyzing the clinical characteristics of patients with immune-associated adverse pregnancy. Objectives: To find the risk factors of Immune-associated adverse pregnancy by analyzing the clinical characteristics of patients with immune-associated adverse pregnancy. Methods: The patients involved in this study were from the multi-department clinic of immune-associated adverse pregnancy, during April 2019 and August 2020. They were diagnosed with autoimmune diseases according to relative classification standards or with autoimmune abnormality. Patients with adverse pregnancy due to anatomic, endocrine, infectious and chromosomal factors were excluded. Results: A total of 107 patients were included. The average age was 29.3 years old. The number of total adverse pregnancy was 115 and the average was 1.07. For the diagnosis, 22 (22.4%) were autoimmune abnormality (with autoantibody but cannot be classified to any autoimmune disease), 30 (28.0%) were antiphospholipid syndrome (APS), 17 (15.9%) were systemic lupus erythematosus (SLE), 13 (12.1%) were mixed connective tissue disease (MCTD), 8 (7.5%) were undifferentiated connective tissue disease, 5 (4.7%) were Sjogren syndrome (SS), other autoimmune disease account for 10 (9.4%). For the antibodies, the positive rate of ANA was 44.8% (48/107), anti-SSA 36.4% (39/107) anti-RNP 15.0% (16/107), anti-dsDNA8.4% (9/107), anti-Sm 9.3% (10/107), anticardiolipin antibody 17.8% (19/107), anti-B2GP1 24.3% (26/107), LA 8.4% (9/107), non-criteria antiphospholipid antibody 3.7% (4/107). Conclusion: Our data showed that autoimmune abnormality, SLE, APS, MTCD and SS impacted immune-associated adverse pregnancy the most. The most crucial antibodies were ANA, anti-SSA, anti-RNP, anti-dsDNA and antiphospholipid antibodies. Disclosure of Interests: None declared
AB0750 FUNCTIONAL CONDITION OF KIDNEYS IN THE LONG-TERM COURSE OF SLE IN ADOLESCENTS
Authors: L. Bohmat, N. Shevchenko, I. Bessonova
Journal: Annals of the Rheumatic Diseases (2021)

Background: Lupus nephritis is the most severe and adverse systemic lupus erythematosus (SLE) syndrome. According to modern recommendations, the clinical manifestations of active nephritis should be taken under medical control in 6 months after the start of the disease’s treatment 1 . Objectives: The aim of this study was to examine the functional status of the kidneys in children with SLE in the course of the disease for more than one year. Methods: The analysis included case histories of 43 patients with SLE, mostly females (41), aged 7 to 18 years (mean age 14.4 years) with disease duration of 4.75 ± 0.58 years of whom 22 were less than three years, 21 - more than three years. All children received corticosteroid therapy, at the time of the examination the average dose was 13.85 ± 1.86 mg per day in terms of prednisolone. The second component of therapy was azathioprine (average dose 97.61 ± 2.11 mg). All children received hydroxychloroquine (5 mg/kg per day). To determine the functional state of the kidneys a clinical analysis of urine, a study of the scope of specific gravity of urine during the day (Zymnytsky test), the content of creatinine and urea in serum to determine the glomerular filtration rate (GFR), the level of microalbuminuria per day were evaluated. Results: Renal involvement in the developed SLE occurred in 73.08% of patients. Among them, therapy during the first 6 months was considered quite effective in 58.06% of patients. It was found that in children with disease duration from one to three years proteinuria was registered in 68.18%, a decrease in GFR in 4.45% and hyperfiltration in 9.09%. In the group of children with duration of SLE more than three years revealed deeper changes in renal function; there was proteinuria in 90.47%, the frequency of GFR decreased was in 19.04%, a decrease of renal concentration function was in 14.28% of cases. Indicators of renal function in children with SLE depending on the duration of the disease (M ± m) Indicator Duration of the disease from 1 year to 3 years n = 22 over 3 years n = 21 Creatinine, mmol/l 0,080 ± 0,014 0,090 ± 0,018 Мочевина, mmol/l 5,66 ± 1,42 5,63 ± 1,61 GFR, ml/min 117,05 ± 19,68 100,20 ± 18,98 * Microalbuminuria, mg/day 24,41 ± 13,13 34,73 ± 24,76 Density min 1,007 ± 0,005 1,006 ± 0,005 Density max 1,024 ± 0,005 1,019 ± 0,005 ** *р&lt;0,03;**р&lt;0,01 the probability of differences when comparing between groups Conclusion: Long-term follow-up of children with SLE over one year reveals a prolongation of renal dysfunction, which worsens after three years, and is the basis for the development of irreversible renal impairment. References: [1]European evidence-based recommendations for the diagnosis and treatment of childhood-onset lupus nephritis: the SHARE initiative /Noortje Groot, Nienke de Graeff, Stephen D Marks et all. //Ann Rheum Dis. 2017 Dec;76(12):1965-1973. Disclosure of Interests: None declared
Preliminary Investigation of In situ Thrombus Within Patent Foramen Ovale in Patients With and Without Stroke
Authors: Chaowu Yan, Hua Li
Journal: JAMA (2021)

growth rate of SGTF samples was 1.49 times greater (95% CI, 1.43-1.54)than it was for non-SGTF samples; this suggests that the mean number of secondary transmissions per SGTF case was 1.34 times greater (95% CI, 1.31-1.38).Fifty-nine of 69 samples meeting confirmatory testing criteria had valid results.B.1.1.7 was identified in 33% (2 of 6) of samples by whole-genome sequencing in late December 2020 and probable B.1.1.7 was confirmed in 96% in January 2021 (51 of 53 screened positive by a laboratory-developed N501Y RT-PCR test, 5 of which the 25 subjected to wholegenome sequencing were confirmed as B.1.1.7).Discussion | This study found that SGTF was a reliable marker of B.1.1.7,and that prevalence of B.1.1.7 has consistently grown more rapidly than preexisting variants, suggesting increased transmissibility. 2 As in the UK, 3 the prevalence of B.1.1.7 increased during a province-wide lockdown period (December 26, 2020, to February 9, 2021) when non-B.1.1.7 variants were effectively brought under control.This study has limitations.Prevalence trends may have been affected by unperceived changes in testing patterns.Furthermore, the SGTF approach has imperfect specificity (approximately 98% in this study), because non-B.1.1.7 variants with low viral burden or possessing the 69-70 deletion can trigger SGTF. 6Despite this, SGTF prevalence was concordant with B.1.1.7 prevalence from an independent point prevalence survey. 5B.1.1.
Clinical Course and Risk Factors for Infection in Severe Forms of Alcohol‐Associated Liver Disease
Authors: Lukas Otero Sanchez, Eleni Karakike, Hassane Njimi, Antonella Putignano, Delphine Degré, Maya Hites, Frédérique Jacobs, Christophe Moreno, Eric Trepo, Thierry Gustot
Journal: Hepatology (2021)

Background and Aims Infection is a major driver of mortality in patients with advanced alcohol‐associated liver disease (ALD). The epidemiology and clinical course of patients infected with life‐threatening forms of ALD, including severe alcohol‐associated hepatitis (sAH) and decompensated alcohol‐associated cirrhosis (DAC), and specific risk factors for infection remain mostly unknown. Approach and Results In this observational study, we assessed all infectious episodes occurring within a 90‐day period from diagnosis in all consecutive patients with biopsy‐proven sAH (modified Maddrey’s discriminant function ≥ 32, Model for End‐Stage Liver Disease [MELD] ≥ 18) and DAC (MELD ≥ 18) without alcohol‐associated hepatitis in our tertiary hospital between 2003 and 2016. A total of 207 patients were included: 139 with sAH and 68 with DAC. One hundred seventeen (84%) patients with sAH and 41 (60%) patients with DAC experienced at least one infection episode at 90 days ( P &lt; 0.001). In multivariable analysis, factors associated with the development of infection were the presence of sAH and baseline MELD score. Bacterial infections represented the most common infection in the two groups, and only the MELD score was independently associated with the occurrence of bacterial infection. In both groups, pneumonia was the most prevalent bacterial infection, and gram‐negative bacilli were the main pathogens. Invasive fungal infections (IFI) occurred in 20 (14.5%) patients with sAH and 3 (4.5%) with patients with DAC ( P &lt; 0.05). Multivariable regression showed that younger age, higher MELD, and corticosteroid therapy were independently associated with IFI. The 90‐day cumulative incidence of death in patients infected with sAH and patients infected with DAC was 46% and 41.5%, respectively ( P = 0.43). Conclusions Patients with sAH are more susceptible to develop infection than those with DAC. In life‐threatening forms of ALD, patients who were infected share a similar mortality rate. Corticosteroid treatment, not sAH, seems to be the main risk factor triggering IFI.
POS1144 SERUM URIC ACID TO CREATININE RATIO IS ASSOCIATED WITH URINARY URIC ACID EXCRETION IN PATIENTS WITH GOUT
Authors: Z. Zhong, Y. Huang, X. Huang, Q. Huang, Y. Liu, T. W. LI
Journal: Annals of the Rheumatic Diseases (2021)

Background: Underexcretion of uric acid is the dominant mechanism leading to hyperuricemia [1] and the 24-hour urinary uric acid excretion is an important measurement. However, it is inconvenient due to accurate timing and complete collection of the specimen. Objectives: The aim of this study was to investigate the relationship between serum uric acid to creatinine ratio (sUACR) and 24-hour urinary uric acid excretion in gout patients. Methods: A total of 110 gout patients fulfilling 2015 ACR/EULAR classification criteria from Guangdong Second Provincial General Hospital from January 2019 to January 2021 were retrospectively enrolled in this study. Patients were divided into underexcretion group (&lt;3600 μmol/24h) and non-underexcretion group (≥3600 μmol/24h). The correlation between sUACR and 24-hour urinary uric acid excretion was analyzed by the Pearson’s correlations analysis. Receiver operation characteristic (ROC) curves were performed to assess the utility of sUACR for discriminating between underexcretion group and non-underexcretion group. Furthermore, the risk factors of uric acid underexcretion were evaluated using binary logistic regression analysis. Results: sUACR in the underexcretion group was significantly lower than the non-underexcretion group (p=0.0001). Besides, sUACR was positively correlated with 24-hour urinary uric acid excretion (r=0.4833, p&lt;0.0001). Furthermore, ROC suggested that the area under the curve (AUC) of sUACR was 0.728, which was higher that of serum uric acid and creatinine. The optimal cutoff point of sUACR was 5.2312, with a sensitivity and specificity of 71.9% and 67.9%. Logistic analysis results revealed that decreased sUACR (&lt;5.2312) was an independent risk factor of underexcretion of uric acid (OR =5.510, 95% CI: 1.952-15.550, P=0.001). Conclusion: sUACR is lower in gout patients with underexcretion of uric acid and may serve as a useful and convenient marker of assessing underexcretion of uric acid in gout patients. References: [1]Perez-Ruiz F, Calabozo M, Erauskin GG, Ruibal A, Herrero-Beites AM. Renal underexcretion of uric acid is present in patients with apparent high urinary uric acid output. Arthritis Rheum 2002; 47: 610–13. Figure 1. A. Comparison of serum uric acid to creatinine ratio between underexcretion group and non-underexcretion group. B. Correlation between serum uric acid to creatinine ratio and 24h uric acid excretion. Disclosure of Interests: None declared.
POS0611 THE EFFECT OF RITUXIMAB BIOSIMILAR THERAPY ON THE EXPRESSION OF INTERFERON-STIMULATED GENES (“INTERFERON SIGNATURE”) IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: A. Avdeeva, E. Tchetina, G. Markova, E. Nasonov
Journal: Annals of the Rheumatic Diseases (2021)

Background: Type I interferons (IFN-Is) are a group of molecules with pleiotropic effects on the immune system forming a crucial link between innate and adaptive immune responses. The type I interferon pathway has been implicated in the pathogenesis of a number of rheumatic diseases, including rheumatoid arthritis. IFN activity is usually quantified using expression of interferon-stimulated genes (ISGs) referred to as an IFN signature. Acellbia (BIOCAD) is the first Russian rituximab (RTX) biosimilar which was approved for medical use in rheumatoid arthritis (RA) patients in Russia and some CIS countries. Objectives: To evaluate the changes in expression of ISGs in patients (pts) with RA during RTX biosimilar therapy Methods: 20 RA pts (18 woman, Me;IQR age 61.5(54-66.5) years, disease duration 39.5(20-84) months, mean DAS 28 5.6(4.9-6.8)) received two intravenous RTX biosimilar infusions (600 mg №2) in combination with DMARDs and glucocorticoids. Laboratory biomarkers were assessed at baseline and 24 weeks after the first infusion of RTX. 5 genes (IFI44L, MX1, IFIT 1, RSAD2, EPSTI1) were selected for evaluation of the “interferon signature” (Type I IFN gene signature – IFNGS). IFI44L and IFIT1 expression was undetectable, therefore the remaining three genes (MSX1, EPSTI1, RSAD2) were included into further analysis. IFNGS was calculated as the average expression values of the three selected genes. The control group included 20 age and gender matching healthy donors. Results: The baseline expression levels of MX1-11.48 (5.45-19.38), EPSTI1-12.83 (5.62-19.64), RSAD2-5.16 (2.73-10.4), and IFNGS-10.3 (5.18-17.12) in RA patients were significantly higher compared to healthy donors– 1,26 (0,73-1,6); 1,06 (0,81-1,48); 0,93 (0,72-1,19); 1,09 (0,92-1,42), (p&lt;0.05, respectively). IFNGS was detected in 15 (75%) patients, and was not found in 5 (15%) patients. RTX induced reduction in disease activity, and the level of acute phase reactants (ESR, CRP) after 12 and 24 weeks of therapy, p&lt;0.05 (fig.1). Increased RSAD 2 expression (p&lt;0.05) and a trend to increasing IFNGS levels (p=0.06) were documented in the whole group, and also in patients with moderate treatment effects by week 24. Among patients with a good EULAR response to therapy, changes in expression were not significant (p&gt; 0.05) (fig.1) Figure 1. Conclusion: Expression of IFN-stimulated genes was increased in RA patients compared to healthy donors. Increased RSAD2 and IFNGS expression was documented in patients with moderate effect of RTX therapy, therefore, these findings have important clinical relevance as predictors of RA clinical course which necessitates personified approach to treatment. Disclosure of Interests: None declared
Suspend intellectual property rights for covid-19 vaccines
Authors: Priti Krishtel, Rohit Malpani
Journal: BMJ (2021)

<h3>BACKGROUND AND PURPOSE:</h3> Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome is a rare mitochondrial disorder affecting children and young adults. Stroke-like episodes are often associated with acute cortical lesions in the posterior cerebral cortex and are classically described as asymmetric and transient. In this study we assessed the anatomic distribution of acute cortical lesions, the incidence of symmetry, and the temporal evolution of lesions. <h3>MATERIALS AND METHODS:</h3> This was a retrospective cohort study of patients who had a confirmed genetic diagnosis of a pathogenic variant associated with MELAS and MR imaging performed at our center (2006–2018). Each MR imaging study was assessed for new lesions using T1, T2, FLAIR, DWI, ADC, and SWI. The anatomic location, symmetry, and temporal evolution of lesions were analyzed. <h3>RESULTS:</h3> Eight patients with the same pathogenic variant of MELAS (MT-TL1 m.3243A&gt;G) with 31 MR imaging studies were included. Forty-one new lesions were identified in 17 of the studies (5 deep, 36 cortical). Cortical lesions most commonly affected the primary visual cortex, the middle-third of the primary somatosensory cortex, and the primary auditory cortex. Thirty of 36 cortical lesions had acute cortical diffusion restriction, of which 21 developed cortical laminar necrosis on subacute imaging. Six of 11 studies with multiple lesions showed symmetric cortical involvement. <h3>CONCLUSIONS:</h3> Acute cortical lesions in MELAS most commonly affect the primary visual, somatosensory, and auditory cortices, all regions of high neuronal density and metabolic demand. The most common pattern of temporal evolution is acute cortical diffusion restriction with subacute cortical laminar necrosis and chronic volume loss. Symmetric involvement is more common than previously described.
Patterns in COVID-19 Vaccination Coverage, by Social Vulnerability and Urbanicity — United States, December 14, 2020–May 1, 2021
Authors: Vaughn Barry, Sharoda Dasgupta, Daniel L. Weller, Jennifer L. Kriss, Betsy L. Cadwell, Charles Rose, Cassandra Pingali, Trieste Musial, J. Danielle Sharpe, Stephen A. Flores, Kurt J. Greenlund, Anita Patel, Andrea Stewart, Judith R. Qualters, LaTreace Harris, Kamil E. Barbour, Carla L. Black
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

Disparities in county-level vaccination coverage by social vulnerability have increased as vaccine eligibility has expanded. By May 2021, vaccination coverage was lower among adults living in counties with low socioeconomic status and higher percentages of households with children, single parents, and people with disabilities.
Invariant natural killer T-cell subsets have diverse graft-versus-host-disease–preventing and antitumor effects
Authors: Kristina Maas-Bauer, Juliane K. Lohmeyer, Toshihito Hirai, Teresa Lopes Ramos, Furqan M. Fazal, Ulrike M. Litzenburger, Kathryn E. Yost, Jessica V. Ribado, Neeraja Kambham, Arielle S. Wenokur, Po-Yu Lin, Maite Alvarez, Melissa Mavers, Jeanette Baker, Ami S. Bhatt, Howard Y. Chang, Federico Simonetta, Robert S. Negrin
Journal: Blood (2021)
Prophylactic high‐dose methotrexate in diffuse large <scp>B</scp> cell lymphoma, authors' response
Authors: Robert Puckrin, Douglas A. Stewart
Journal: American Journal of Hematology (2021)

In conclusion, it must be emphasized that there are no randomized data to support the addition of prophylactic HD-MTX to chemoimmunotherapy in DLBCL, and the adoption of this practice is based on limited evidence in the form of retrospective studies with small sample sizes, absence of comparator arms, and/or lack of controlling for baseline differences between groups.3-6 More recently, several of the largest observational studies to date, including our own, have failed to demonstrate a significant reduction in CNS relapse risk with prophylactic HD-MTX.8-10 In addition, the intercalation of prophylactic HD-MTX with R-CHOP has been shown to significantly increase the risks of mucositis, hepatoxicity, febrile neutropenia, and systemic treatment delays.8, 11 This latter point is particularly concerning given that patients at high risk of CNS relapse are also at increased risk of systemic progression/relapse. Administering an unproven prophylactic therapy that may compromise the delivery of curative-intent systemic therapy should be carefully evaluated on an individual basis, and we feel there is insufficient evidence to routinely recommend prophylactic HD-MTX for all patients with high-risk DLBCL. As we await the results of further studies to shed light on this controversial and important topic, we feel our study reminds us of the importance of offering our patients therapies that have been proven effective, rather than using treatments that have not yet been definitively proven ineffective. R.P. has no conflict of interest to disclose. D.S. has received honoraria for ad hoc advisory boards from Roche, Janssen, Abbvie, Gilead, Celgene, Novartis, AstraZeneca, Amgen, Sandoz, and Teva. Data sharing not applicable - no new data generated