tbuckley/cabot-search huggingface dataset:
THU0642-HPR EVOLUTION OF THE PERCEPTIONS OF RA PATIENTS AFTER EDUCATION PATIENT SESSION TEACHING METHOTREXATE SELF-INJECTION A PROSPECTIVE PILOT STUDY
Authors: S. Afilal, H. Rkain, B. Berchane, J. Moulay Berkchi, S. Fellous, T. Fatima Zahrae, A. Ilham, N. Alami, T. Latifa, N. Hajjaj-Hassouni, F. Allali
Journal: Annals of the Rheumatic Diseases (2020)

Background: Methotrexate is a gold standard for treatment of RA. In our context, RA patients prefer to be injected by paramedics rather than self-injecting. This can be explained by patients’ bad perceptions of self-injection or lack of information. Appropriate self-injection education can therefore be an important element in overcoming these obstacles and improving disease self-management. Objectives: Compare the RA patients’ perceptions on methotrexate self-injection before and after a patient education session. Methods: Prospective pilot study that included 27 consecutive patients (81.5% female, mean age 44.4 years, illiteracy rate 40.7%) with RA (median duration of progression of 4 years, mean delay in referral for specialist of 6 months, median duration of methotrexate use of 1 year). The patients benefited from an individual patient education session to learn how to self-inject with methotrexate subcutaneously. The patient education session was supervised by a nurse and a rheumatologist with a control a week later. Perceptions of the reluctance to self-inject and the difficulties encountered by patients were assessed before the patient education session, after the 1st and 2nd self-injection of methotrexate using a 10 mm visual analog scale. Patients also reported their level of satisfaction (10 mm VAS) after the 1st and 2nd self-injection. Results: The mean duration of patient education session is 13 min. Table I compares the evolution of the degrees of reluctance to self-injection, the difficulties encountered, and the satisfaction experienced by the patients. Table 1. Evolution of RA patients’ perceptions on the methotrexate self-injection. (N = 27) Before After the 1 st self-injection After the 2end self-injection p VAS reluctance (0-10mm) 6,5 ± 3,6 2,2 ± 2,9 1,0 ± 2,3 &lt;0,0001 VAS difficulty (0-10mm) 7,5 ± 2,6 2,5 ± 2,7 1,0 ± 1,9 &lt;0,0001 VAS satisfaction (0-10mm) - 8,9 ± 1,8 9,5 ± 1,5 0,002 Conclusion: This study suggests the effectiveness of a methotrexate self-injection patient education session in RA patients. It also highlights the value of patient education in rheumatologic care. A large-scale study is necessary to better interpret and complete these preliminary results from this pilot study. Disclosure of Interests: None declared
Identification of new Tumor Associated Antigens (TAA) for mammary cancer immunological prevention
Authors: Raffaele A. Calogero, Francesca Cordero, Silvia Saviozzi, Nicola Cirenei, Simona Rolla, Elena Quaglino, Guido Forni, Federica Cavallo
Journal: Cancer Research (2006)

685  One of the most significant tenet of tumor immunology is the assumption that the immune system is able to discriminate between normal and neoplastic tissues. Identification of TAAs on preneoplastic cells will provide the opportunity to trigger the immune system against transformed cells at their earliest manifestation. The availability of mouse models of autochthonous carcinogenesis offers an unprecedented opportunity to identify this kind of TAAs and to test the efficacy of the immune control of preneoplastic lesions. By combining the information provided by the genome sequence and the expression profiles of entire transcriptomes, these mouse models can also lead towards the identification of TAAs expressed during progressive stages of carcinogenesis (Cavallo et al. BMC Bioinformatics 2005). Using an aggressive mouse mammary carcinoma model based on the over expression of mutated HER2 (BALB-neuT) we searched by mean of genome wide transcriptional analysis new TAAs. These TAAs will be used in conjunction with HER2 to improve the efficacy of HER2 based DNA vaccination. Using AB 1700 (Applera USA) genome-wide mouse microarrays we identified 1328 genes over-expressed at the stage of lobular carcinoma with respect to the preneoplastic lesion. Furthermore, since our interest is linked to the development of vaccination protocols in humans, our attention was focused only on those genes out of the 1328 having an orthologous sequence in human. The cross-mapping was performed using Celera annotation system (panther.appliedbiosystems.com) and 1197 human orthologous probe identifiers were linked to 983 out of the 1328 genes. An important issue for an ideal TAA is a low expression in normal tissues. Therefore we investigated the expression of the 1197 human probes, within the transcription profiles of 24 out of 31 normal tissues available in the Applera proprietary microarray data set “Body Map”. From this data set we selected 658 putative human TAAs characterized by an expression similar to HER2. To evaluate the expression of TAAs in human breast cancer specimens we performed a meta-analysis of the van’t Veer set (van’t Veer et al. Nature 2002). 407 out of 658 putative TAAs were identified in the van Veer set and 17 of them were shown to be expressed at levels near to that of HER2. Particularly notable within the putative TAAs is the MFI2 gene which is not present in the van’t Veer set, but is characterized by a strong up-modulation in the mouse tumors, a limited expression in normal tissues and encodes a cell-surface glycoprotein found on melanoma cells (Guo et al. Exp Mol Pathol. 2003). These characteristics make MFI2 an interesting TAA to be further investigated for its ability to improve the efficacy of HER2-driven DNA vaccination.
Advances in the treatment of cholangiocarcinoma: Effect of online education on clinician knowledge and confidence.
Authors: Geoff Roy Fisher, Sanneke Koekkoek, Camille Scot-Smith, David Malka
Journal: Journal of Clinical Oncology (2021)

302 Background: This study determined whether online continuing medical education could improve the knowledge and confidence of clinicianson the latest developments in the treatment of cholangiocarcinoma (CCA). Methods: A 30-minute online video panel discussion was launched for countries outside the USA in March 2020. Data was collected to June 2020. Educational effect assessed with repeated-pairs pre-/post-activity, where individual participants served as their own control. Three multiple-choice, knowledge questions and one self-efficacy, five-point Likert scale confidence question were analyzed. Chi-squared test assessed pre- to post-activity change (5% significance level, P &lt;.05). Magnitude of change in total number of correct responses overall, and for each question, were determined with Cramer’s V (&lt;.06=Modest, 0.06-0.15=Noticeable, .16-.26=Considerable, &gt;.26=Extensive). Results: 85 oncologists (oncs) and 44 gastroenterologists (gastros) completed pre- and post-activity questions. A considerable educational effect was observed for both oncs (V=.174, P&lt;.0001) and gastros (V=.246, p&lt;.0001) with average % of correct responses increasing from 62 to78% and 47 to 71%, respectively. Clinicians with 3/3 answers correct increased post-activity (11 to 48% for oncs, 28 to 51%, for gastros). Improvements in % of correct responses post-activity were seen for questions on the molecular target for pemigatinib, the subtype of CCA where IDH mutations are detectable, and the need for comprehensive molecular testing at diagnosis of metastatic CCA (relative improvements: 31%, 38%, and 11% for oncs; 155%, 50% and 14%, for gastros). 78% of oncologists’ and 72% of gastros’ responses were improved or reinforced post-activity. 21% of all participants stated they would modify treatment plans. Confidence in incorporating routine broad molecular testing in the treatment of CCA improved post-activity with a total average confidence shift of 25% for oncs and 32% for gastros. Conclusions: This on-demand, online video panel discussion resulted in a considerable education effect. Online medical education is valuable in improving knowledge and confidence, as well as identifying areas of continued educational need.
The relationship between preterm birth and sleep in children at school age: A systematic review
Authors: Simone S.M. Visser, Willemijn J.M. van Diemen, Laura Kervezee, Agnes van den Hoogen, Olaf Verschuren, Sigrid Pillen, Manon J.N.L. Benders, Jeroen Dudink
Journal: Sleep Medicine Reviews (2021)

Premature birth (before 37 weeks of gestation) has been linked to a variety of adverse neurological outcomes. Sleep problems are associated with decreased neurocognitive functioning, which is especially common in children born preterm. The exact relationship between prematurity and sleep at school age is unknown. A systematic review is performed with the aim to assess the relationship between prematurity and sleep at school age (5th to 18th year of life), in comparison to sleep of their peers born full-term. Of 347 possibly eligible studies, nine were included. The overall conclusion is that prematurity is associated with earlier bedtimes and a lower sleep quality, in particular more nocturnal awakenings and more non-rapid eye movement stage 2 sleep. Interpretations and limitations of the review are discussed. Moreover, suggestions for future research are brought forward, including the need for a systematic approach with consistent outcome measures in this field of research. A better understanding of the mechanisms that influence sleep in the vulnerable group of children born preterm could help optimize these children's behavioral and intellectual development.
Elastase and exacerbation of neutrophil innate immunity are involved in multi‐visceral manifestations of COVID‐19
Authors: Jean‐Louis Guéant, Rosa‐Maria Guéant‐Rodriguez, Julien Fromonot, Abderrahim Oussalah, Huguette Louis, Celine Chery, Mickael Gette, Stanislas Gleye, Jonas Callet, Jeremie Raso, François Blanchecotte, Patrick Lacolley, Régis Guieu, Véronique Regnault
Journal: Allergy (2021)

Many arguments suggest that neutrophils could play a prominent role in COVID-19. However, the role of key components of neutrophil innate immunity in severe forms of COVID-19 has deserved insufficient attention. We aimed to evaluate the involvement of neutrophil elastase, histone-DNA, and DNases in systemic and multi-organ manifestations of COVID-19. We performed a multicenter study of markers of neutrophil innate immunity in 155 cases consecutively recruited in a screening center, local hospitals, and two regional university hospitals. The cases were evaluated according to clinical and biological markers of severity and multi-organ manifestations and compared to 35 healthy controls. Blood neutrophil elastase, histone-DNA, myeloperoxidase-DNA, and free dsDNA were dramatically increased, and DNase activity was decreased by 10-fold, compared with controls. Neutrophil elastase and histone-DNA were associated with intensive care admission, body temperature, lung damage, and markers of cardiovascular outcomes, renal failure, and increased interleukin-6 (IL-6), IL-8, and CXCR2. Neutrophil elastase was an independent predictor of the computed tomography score of COVID-19 lung damage and the number of affected organs, in multivariate analyses. The increased blood concentrations of NE and neutrophil extracellular traps were related to exacerbation of neutrophil stimulation through IL-8 and CXCR2 increased concentrations and increased serum DAMPs, and to impaired degradation of NETs as a consequence of the dramatic decrease in blood DNase activity. Our results point out the key role of neutrophil innate immunity exacerbation in COVID-19. Neutrophil elastase and DNase could be potential biomarkers and therapeutic targets of severe systemic manifestations of COVID-19.
Follicular Thyroid Carcinoma Metastases on Round Ligament of Liver
Authors: Amparo García-Burillo, Jaime Alejando Monturiol-Duran, Carmela Iglesias-Felip, Diego Villasboas-Rosciolesi, Joan Castell-Conesa
Journal: Clinical Nuclear Medicine (2021)

We describe a case of a 69-year-old woman with follicular thyroid cancer of long evolution, with thyroidectomy 20 years before, who had remained clinically stable until now, when she started to present abnormal levels of serum thyroglobulin. An 123I whole-body scan showed a high uptake in the upper right half of her abdomen, and an 18F-FDG PET/CT located this focus at the liver's round ligament. Pathology findings after surgery showed the focus to be a differentiated thyroid cancer metastasis. This is an unusual presentation of differentiated thyroid cancer metastasis.
Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Moderna COVID-19 Vaccine — United States, December 21, 2020–January 10, 2021
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

As of January 20, 2021, a total of 24,135,690 cases of coronavirus disease 2019 (COVID-19) and 400,306 associated deaths had been reported in the United States (https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days). On December 18, 2020, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for Moderna COVID-19 vaccine administered as 2 doses, 1 month apart to prevent COVID-19. On December 19, 2020, the Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation for use of Moderna COVID-19 vaccine (1). As of January 10, 2021, a reported 4,041,396 first doses of Moderna COVID-19 vaccine had been administered in the United States, and reports of 1,266 (0.03%) adverse events after receipt of Moderna COVID-19 vaccine were submitted to the Vaccine Adverse Event Reporting System (VAERS). Among these, 108 case reports were identified for further review as possible cases of severe allergic reaction, including anaphylaxis. Anaphylaxis is a life-threatening allergic reaction that occurs rarely after vaccination, with onset typically within minutes to hours (2). Among these case reports, 10 cases were determined to be anaphylaxis (a rate of 2.5 anaphylaxis cases per million Moderna COVID-19 vaccine doses administered), including nine in persons with a documented history of allergies or allergic reactions, five of whom had a previous history of anaphylaxis. The median interval from vaccine receipt to symptom onset was 7.5 minutes (range = 1-45 minutes). Among eight persons with follow-up information available, all had recovered or been discharged home. Among the remaining case reports that were determined not to be anaphylaxis, 47 were assessed to be nonanaphylaxis allergic reactions, and 47 were considered nonallergic adverse events. For four case reports, investigators have been unable to obtain sufficient information to assess the likelihood of anaphylaxis. This report summarizes the clinical and epidemiologic characteristics of case reports of allergic reactions, including anaphylaxis and nonanaphylaxis allergic reactions, after receipt of the first dose of Moderna COVID-19 vaccine during December 21, 2020-January 10, 2021, in the United States. CDC has issued updated interim clinical considerations for use of mRNA COVID-19 vaccines currently authorized in the United States (3) and interim considerations for preparing for the potential management of anaphylaxis (4).
FRI0223 Long term follow-up in 68 patients with primary sjÖgren’s syndrome: clinical and serological features
Authors: P Ostuni, P Sfriso, C Grava, C Botsios, L Semerano, S Todesco
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> There are few studies, regarding pSS long-term clinical course. Moreover, it has often been studied in limited groups of patients, employing different recruitment and diagnostic criteria. <h3>Objectives</h3> During a 10 years follow-up we longitudinally studied the clinical evolution, the rate of severe complications and mortality in a large cohort of patients with pSS. <h3>Methods</h3> We evaluated 68 consecutive outpatients with pSS according to the Fox's criteria: 67 females and 1 male, followed since January 1987 to November 2000. The patients were divided into 2 groups according to the autoantibodies pattern at the diagnosis: anti-Ro and/or La positive and anti-Ro/La negative. The prevalence of several clinical and serological abnormalities, evaluated at the beginning of the study, was compared with the prevalence observed at the end of the follow-up. Moreover, a 10 years Kaplan-Meier survival analysis was performed, considering as end points the development of lymphoproliferative disorders, death and the association death/lymphoproliferation, in order to establish how the progression of the disease might affect survival and major morbidity of pSS. Finally, we analysed whether pSS is associated with an increase of the mortality rate in comparison with the general population. <h3>Results</h3> Eight patients from the study group died (13.2% up to 10 years of follow-up). The prevalence of arthritis in Ro and/or La positive cases was significantly higher at the beginning of the follow-up in comparison with the end of the study (p = 0.041). On the contrary, a significant higher prevalence of lymphoproliferative disorders was present in Ro and/or La positive group at the end of the follow-up (p = 0.041). We also observed significantly lower levels of C4 and significant higher IgG, IgA and ESR in the Ro and/or La positive group than in the Ro/La negative group, either at the beginning (respectively p = 0.003 p &lt; 0.0001 p = 0.0014 p = 0.0007) or at the end (p = 0.007 p = 0.0005 p = 0.013 p &lt; 0.0001) of the follow-up. Lymphoproliferative disorders were diagnosed in 5 patients. The development of this complication was associated with the assessment, in all the cases, of purpura, parotid swelling and low C4 levels. The 10 years-survival rate of all the pSS patients resulted 86.5% that was under the survival rate of the Italian general population (90%) (p = n.s). <h3>Conclusion</h3> The glandular manifestations of pSS were distinctively present in the majority of the patients already at the time of the diagnosis and the serological picture remained typically constant during all the follow up. Increased IgG, IgA and ESR as well as low C4 levels were significantly prevalent in the Ro and/or La positive group. Finally, we have not found any significant increase in the mortality of pSS patients in comparison with the general population.
Pre-Procedural Blood Glucose Levels: A New Risk Marker for Contrast-Induced Acute Kidney Injury in Patients Without Diabetes With Acute Myocardial Infarction**Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.
Authors: Martin A. Alpert, Carl Carlino
Journal: Journal of the American College of Cardiology (2010)
Do Patents for Antiretroviral Drugs Constrain Access to AIDS Treatment in Africa?
Authors: A Attaran, L Gillespie-White
Journal: JAMA (2001)

Public attention and debate recently have focused on access to treatment of acquired immunodeficiency syndrome (AIDS) in poor, severely affected countries, such as those in Africa. Whether patents on antiretroviral drugs in Africa are impeding access to lifesaving treatment for the 25 million Africans with human immunodeficiency virus infection is unknown. We studied the patent statuses of 15 antiretroviral drugs in 53 African countries. Using a survey method, we found that these antiretroviral drugs are patented in few African countries (median, 3; mode, 0) and that in countries where antiretroviral drug patents exist, generally only a small subset of antiretroviral drugs are patented (median and mode, 4). The observed scarcity of patents cannot be simply explained by a lack of patent laws because most African countries have offered patent protection for pharmaceuticals for many years. Furthermore, in this particular case, geographic patent coverage does not appear to correlate with antiretroviral treatment access in Africa, suggesting that patents and patent law are not a major barrier to treatment access in and of themselves. We conclude that a variety of de facto barriers are more responsible for impeding access to antiretroviral treatment, including but not limited to the poverty of African countries, the high cost of antiretroviral treatment, national regulatory requirements for medicines, tariffs and sales taxes, and, above all, a lack of sufficient international financial aid to fund antiretroviral treatment. We consider these findings in light of policies for enhancing antiretroviral treatment access in poor countries.
Re-print: Maintenance (r) Alpha Lipoic Acid Reduces Sudden Cardiac Death in Geriatric Diabetes Mellitus II Patients
Authors: Gary L Murray, Joseph Colombo
Journal: Clinical Cardiology and Cardiovascular Interventions (2020)

Background: Diabetes carries a two-fold risk of Sudden Cardiac Death (SCD). Diabetic Autonomic Neuropathy (DAN), often progressing to Cardiovascular Autonomic Neuropathy (CAN, critically low parasympathetic tone [P]), increases death 3.5-fold over 5 years, half sudden or non- renal. Oxidative stress is a major cause of DAN. Also, increased sympathetic tone (S), High Sympathovagal Balance [SB&gt;2.5] increases SCD risk. Objective: Dysautonomic diabetic II patients were treated with the antioxidant (r) Alpha Lipoic Acid (ALA), autonomic function followed, and Sudden Death (SD) compared to untreated patients. Methods: 133 patients (mean age 66y/o) with DAN or CAN, diagnosed using the ANX 3.0 Autonomic Monitor (Physio PS, Inc., Atlanta, GA) was offered (r)-ALA: 83 agreed (Group 1), and 50 refused (Group 2). P and S were re- measured up to 3 times/yr (mean f/u 6.31 yrs); SCDs were recorded. Results: A 43% Relative Risk Reduction (RRR) in SCD occurred with (r)- ALA (25% SCD Group 1 vs. 44% SCD Group 2, p=0.0076). Initial to final patients with high SB or CAN were 21.7%-12% (p=0.010), 10.8%- 15.7% (p=0.045), Group 1 vs. 24%-22% (p=ns), 6%-12% (p=0.083), Group 2. Only Group 1 survivors increased mean resting P. The progressive increase in P’s decline, increasing CAN risk, in the other patients correlated with mortality (p&lt;0.001) and (r) ALA dose. Initially, Group 1 had insignificantly less high SB (p=0.449) and significantly more CAN (p=0.013) vs. Group 2. Finally, Group 1 had significantly less high SB (p=0.0967) vs. Group 2, also improving to insignificantly more CAN (p=0.261). Conclusion: (r)-ALA was associated with a 43% RRR of SCD and favorable P and S changes.