tbuckley/cabot-search huggingface dataset:
POS1382 RITUXIMAB FOR INDUCTION OF REMISSION IN TYPE 1 AUTOIMMUNE PANCREATITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: M. Lanzillotta, G. Capurso, Z. Wallace, O. Karadag, L. Dagna, E. Della Torre
Journal: Annals of the Rheumatic Diseases (2021)

Background: Type I autoimmune pancreatitis (AIP) is a rare form of pancreatitis that belongs to the IgG4-related disease (IgG4-RD) spectrum (1). Autoimmune pancreatitis responds brilliantly to glucocorticoids, but iatrogenic toxicity associated with prolonged steroid therapy represents a relevant clinical concern in the long-term (2). B cell depletion therapy proved to be effective in inducing IgG4-RD remission, yet most evidence are derived from small and heterogenous cohorts. Objectives: We performed a systematic review and meta-analysis to estimate the remission rate following rituximab-based induction treatment. Methods: Two reviewers searched MEDLINE, SCOPUS, and EMBASE until December 2020 to identify studies on remission rate and relapse rate of Type I AIP after induction of remission with rituximab. Studies involving three or more patients were included, including the most recent or most numerous cohorts in case of duplicates This study was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled effects were calculated using a random-effects model and expressed in terms of pooled remission, relapse and adverse effects (AEs) rates. Results: Seven cohort studies met inclusion criteria for the meta-analysis for a total of 101 patients. Reasons for rituximab administration were relapsing disease (63.5%), new diagnosis (18.5%) or glucorticoids intolerance (17.9%). The median follow-up time was 18.5 months. The pooled rate of complete response at 6 months from induction of remission was 88.9% (95% CI 80.5%-93.9%) without heterogeneity (I 2 =0%) (Figure 1). The median time to relapse was 9.75 months. The pooled estimate of relapse rate was 21% (95% CI 10.5%-40.3%) with moderate heterogeneity (I 2 =51%), being 35.9% (95% CI 17.3%-60.1%) in the 4 studies with rate of other organs involvement (OOI)&gt;80% and as low as 10.1% (4.8%-20.3%) in the others. The pooled estimate of rituximab-related AEs was 25% (95% CI 8.8%53%) with substantial heterogeneity (I 2 =73.6%). There was no publication bias. Conclusion: Treatment of type I AIP with rituximab is associated with high remission rate, a higher relapse rate in presence of OOI and limited AEs. Randomized controlled trials with adequate power are needed to confirm these findings. References: [1]Lanzillotta M, Mancuso G, Della-Torre E. Advances in the diagnosis and management of IgG4 related disease. BMJ. 2020;369:m1067 [2]Lanzillotta M, Vinge-Holmquist O, Overbeek KA, et al. PrescrAIP: A Pan-European Study on Current Treatment Regimens of Auto-Immune Pancreatitis. Front Med (Lausanne). 2020;7:408 Disclosure of Interests: None declared
Prevalence of human papillomavirus in young men who have sex with men after the implementation of gender-neutral HPV vaccination: a repeated cross-sectional study
Authors: Eric P F Chow, Sepehr N Tabrizi, Christopher K Fairley, Rebecca Wigan, Dorothy A Machalek, Suzanne M Garland, Alyssa M Cornall, Steph Atchison, Jane S Hocking, Catriona S Bradshaw, Prisha Balgovind, Gerald L Murray, Marcus Y Chen
Journal: The Lancet Infectious Diseases (2021)
AB0611 OSTEOPOROSIS IN RHEUMATOID ARTHRITIS: A NECESSARY EVIL?
Authors: S. Athimni, S. Bouden, A. Ben Tekaya, A. Dghais, O. Saidane, R. Tekaya, I. Mahmoud, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2021)

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease that is characterized by local and general bone loss. Osteoporosis (OP) is one of the most frequent comorbidities associated with RA. Many factors are incriminated in bone loss in RA such as inflammation, glucocorticoid (GC) use, and immobility. Objectives: -To determine the prevalence of OP in a population of actual RA patients. -To determine the risk factors of bone mineral density (BMD) reduction Methods: One hundred-fifty-two RA followed in the rheumatology department between 2015-2020 were enrolled in the study. The diagnosis of RA was established according to the American College of rheumatology/European League Against Rheumatism (ACR/EULAR) criteria 2010. BMD in lumbar spine and total hip was systematically measured in the recruited patients. Measures were taken with dual-energy x-ray absorptiometry (DEXA), and age-specific values were compared with pooled values from a local population of healthy subjects free from earlier fractures. Results: The mean age was 42.7±13 years. The sex ratio M/F was 0.24. The mean onset disease was 6±1.8 years. Fifty-sex patients (36.3%) were receiving conventional treatment DMARDs and 96 (63.6%) were under biological treatment. 35.5% were taken steroids with mean doses at 7.7±3.3mg/day. RF and ACPA were positive respectively in 87.3% and 82.4% of the patients. The mean disease activity score DAS28CRP was 4.8 ±2.7. Sixty-eight point eight 68.8% of the RA population had bone loss: 37.5% had osteopenia and 31.3% had OP. Regarding the OP group, sex ratio M/F was 0.45. The mean age was 42±5.3 years. Among the 31 women, 77.4% had postmenopausal OP. The BMI average was 31.18 ± 6.19 kg/m 2 . Fifteen patients (33.33%) had OP in the hip site and 20 patients had OP in the lumbar site (48.8%). Ten patients had both trabecular and cortical OP. Advanced age, glucocorticoid use and high DAS28CRP were independent risk factors for OP (respectively p=0.04, p=0.02 and p=0.01). Body mass index, smoking, disease duration high Health Assessment Questionnaire (HAQ) score (p=0.545) and smoking (p=0.326) were not associated with high risk of OP. The biological treatment was not a protective factor in OP (p=0.972). All the population subjects were free from earlier fractures, the fractural risk estimated by dint of the mean FRAX TM score was at 1.4 ± 2.3. Conclusion: Previous studies estimated that, approximately, osteoporosis affected one-third of RA patients which is in concordance with our study. Advanced age, glucorticoid treatment and severe disease were the most common risk factor in our study. Disclosure of Interests: None declared.
A Systematic Review on Methods and Tools for the In Situ Fenestration of Aortic Stent-Graft
Authors: Roberta Piazza, M. Carbone, R. N. Berchiolli, V. Ferrari, M. Ferrari, S. Condino
Journal: IEEE Reviews in Biomedical Engineering (2021)

In situ fenestration of stent-graft represents a potential option for the treatment of aortic diseases in patients unsuitable for standard endovascular repair. The best fenestration strategy to restore perfusion of collateral vessels after their coverage by an endograft depends mainly on the anatomical area. Several tools are employed as fenestration devices, including needles, radiofrequency probes, and laser systems, used in conjunction with other instrumentation to provide enough support and stability during the procedure. In this systematic review, the approaches to reach the correct fenestration site both in human, animal, and in in vitro environments are described and discussed, highlighting advantages and limitations. Both commercial and dedicated solutions for the intraoperative modification of the fabric material are reported as well. The clinical interest in this procedure has so far encouraged researchers to develop and refine both methods and tools to solve the current limitations of this technique, intending to extend the indications for endovascular treatment to a broader range of patients.
Factors Associated With Healing of Diabetes-Related Foot Ulcers: Observations From a Large Prospective Real-World Cohort
Authors: Yuqi Zhang, Susanna Cramb, Steven M. McPhail, Rosana Pacella, Jaap J. van Netten, Qinglu Cheng, Patrick H. Derhy, Ewan M. Kinnear, Peter A. Lazzarini
Journal: Diabetes Care (2021)

Diabetes-related foot ulcers (DFUs) affect around 20 million people annually and are a leading cause of the global disability burden (1). DFUs are complex to treat, take months to heal, result in poorer quality of life, and place patients at high risk of hospitalization and amputation. Thus, understanding the influence that different factors have on healing of DFUs is vital.

Various demographic, comorbidity, limb, ulcer, and treatment-related factors associated with healing of DFUs have been identified from cohorts attending mostly metropolitan tertiary centers (2–4). However, very few studies have prospectively investigated the influence that these and other factors have on healing in more real-world DFU cohorts attending geographically diverse secondary and tertiary centers. Therefore, we aimed to investigate the influence of 34 factors on healing in a large real-world DFU cohort.

We prospectively examined 4,832 consecutive patients with DFU(s) that presented for their first visit to 1 of 65 secondary or tertiary diabetic foot services, across 15 of 17 regions in Queensland (Australia), between July 2011 and December 2017. A DFU was defined as a full-thickness wound below the ankle on a person with diabetes. For DFU clinical and research purposes, foot-related health professionals using the Queensland High Risk Foot Form (QHRFF) directly examined each patient clinically at their first (and subsequent) visit for 4 demographic, 9 comorbidity, 6 limb, 3 ulcer, and 12 treatment factors (5). For those with multiple DFUs, we used the most severe score for each factor and the combined ulcer size from all DFUs (5). Factors from the first visit were used as the baseline. Subsequent visit examinations determined if the DFU(s) healed, …
OP0070 ONSET TO DIAGNOSIS TIME PREDICTS SURVIVAL RATE IN TAKAYASU ARTERITIS
Authors: A. Popov, I. Borodina, L. Shardina
Journal: Annals of the Rheumatic Diseases (2021)

Background: Takayasu arteritis (TA) is large vessel vasculitis. In spite of relatively high 5 to 15 years survival rate, TA affects young persons and causes major cardiovascular events, disability and preterm deaths [1]. Nowadays, though new high-resolution visualization and effective treatment options are available, quite a large number of TA patients remain undiagnosed and untreated for years [2]. Objectives: To assess the influence of timely TA diagnosis and treatment initiation on the survival rate and cardiovascular events risk. Methods: A retrospective cohort study included 183 patients (139 females, 44 males), enrolled during the period from 1979 to 2018 after TA diagnosis verification according to ACR1990 criteria [3]. All subjects have been followed up at the Sverdlovsk Regional Clinical Hospital 1. Cox regression model was used to compare survival rate. Results: By enrollment, females median age was 35 [25%-75%: 24 - 44] and in males median age was 34 [26 -42]. Median time duration from the first symptoms onset to the diagnosis verification was 3 [1-7] years in females and [1.5 - 8] years in males. The most common affected arteries were subclavian (55%), carotid (53%), and renal (42%). 5-year survival rate was 92%; 10-year survival rate was 90%; 15-year survival rate was 80%. The median term of survival was 34 [20 - 41] years. 31 deaths (18 males and 13 females) occurred during the follow-up period. Median age of death was 36 [32-44] in females, and 50 [40-57]) in males. The average disease course duration at the time of death was 9.25 years, median term being 6.5 [3-16] in females and 5 [3-10] in males. Also a total of 72 cardiovascular events were recorded during the follow-up period: 27 in men and 45 in women. The median duration of AT course by the development of the first ever event was 10 (5 -20). There were 24 cases of ischemic stroke, 3 transient ischemic attacks, 4 cases of hemorrhagic stroke. Median age of the first ever event was 38 (30 - 49.5). Time duration 4 years or more from AT symptoms onset to diagnosis was associated with significantly more frequent cardiovascular events (OR 1.8; 95% CI 1.07 – 3.34); and premature deaths (see table) by the 5 th year of follow up (OR 2.9; 1.27- 6.55). Conclusion: In a retrospective cohort, time duration 4 years or more from TA symptoms onset to diagnosis verification was associated with higher risk of cardiovascular events and lower survival rate. References: [1]Mirouse C. et al. Ann. Rheum. Dis. 2018; 77(2): 10-48 [2]Dejaco C. et al. Ann. Rheum. Dis. 2018;77: 636-643 [3]Arend W.P. et al. Arthritis Rheum. 1990; 3(8): 1129-1134. Disclosure of Interests: Artem Popov Speakers bureau: Novartis, Menarini, AstraZeneca, Pfizer, Severnaya Zvezda, Romepharm, Irina Borodina: None declared, Lubov Shardina: None declared
Elastic-band traction technique for cannulating intradiverticular papilla during endoscopic retrograde cholangiopancreatography
Authors: Ruggero Ponz de Leon Pisani, Giuseppe Dell’Anna, Francesco Vito Mandarino, Maria Napolitano, Vito Lerna, Giuseppe Cangelli, Pier Alberto Testoni
Journal: Endoscopy (2021)

An 84-year-old man attended the emergency department because of jaundice, fever, and abdominal pain. Blood tests showed an increase in conjugated bilirubin and cholestasis markers. He underwent abdominal ultrasound, which revealed common bile duct dilation (12 mm in size) and the presence of several bile stones. Diagnosis of acute cholangitis was made [1] and he underwent urgent therapeutic endoscopic retrograde cholangiopancreatography (ERCP), according to guidelines [2].
POS1486-HPR DAILY ACTIVITY IMPAIRMENT IS MEDIATED BY BOTH ORAL DRYNESS AND ORAL HEALTH RELATED QUALITY OF LIFE IN PATIENTS WITH PRIMARY SJÖGREN’S SYNDROME
Authors: Y. Yenisoy, A. Kapusuz, E. N. Çakir, K. Abacar, İ. Tatli, F. Türe-Özdemir, M. Yay, Ü. Karaçayli, N. Inanc, H. Direskeneli, G. Mumcu
Journal: Annals of the Rheumatic Diseases (2021)

Background: Both oral functions and oral health-related quality of life (OHRQoL) are poorly affected by low salivary flow rate in patients with primary Sjögren’s syndrome (pSS). Objectives: The aim of the study was to evaluate the effects of oral dryness and OHRQoL on daily life in patients with primary Sjögren’s syndrome (pSS). Methods: In this cross-sectional study, 86 patients with pSS (M/F: 5/81; mean age: 52.4 ± 11.6 years) were included. The data were collected by clinical examination and a questionnaire regarding patient-reported outcome measures (PROMs). Patient filled PROMs regarding Oral Health Impact Profile-14 (OHIP-14) for OHRQoL, Work Productivity and Activity Impairment scale (WPAI) for Daily life and the EULAR Sjogren’s Syndrome Patient Reported Index (ESSPRI) for their symptoms. Unstimulated whole saliva flow rates (U-WSFR) of patients were calculated as ml/min. Increases in PROMs and decreases in U-WSFR reflected poor conditions. After preliminary analysis, a mediation analysis was used to evaluate the relations among variables. Results: WPAI-Daily activity impairment score was higher in patients with low U-WSFR (≤0,1 ml/min) than the others (67±29,8 vs 52,5±28,6) (p=0.042). Both U-WSFR (0,43±0,57 ml/min) and ESSPRI-Dryness score (6.31 ± 2.71) were correlated with scores of OHIP-14 (25,96±17,13)(r:- 0,38 p=0.000; r: 0,37 p=0.000) and WPAI-Daily activity impairment (57,96±29,71)(r: -0,36 p=0.004; r: 0,53 p=0.000). Moreover, scores of ESSPRI-Pain (5,16±3,12) and ESSPRI-Fatigue (5,41±2,97) were also related to WPAI-Daily activity impairment score (r: 0,41 p=0.001; r:0,49 p=0.000, respectively). In the mediation analysis, WPAI-Daily activity impairment score (57.9 ± 29.7) was directly mediated by ESSPRI-Dryness score (p=0.0010) and indirectly mediated by OHIP-14 score (25.9 ± 17.1) (p=0.0357). After mediation analysis, a bootstrap analysis with 5000 replications was applied to estimate the mediation effect to generate 95% CI. Percentile bootstrap of OHIP-14 score was found to be an effective mediator for Daily activity impairment based on 5000 bootstrap samples. Conclusion: Both oral dryness and poor OHRQoL in patients with pSS affected daily activity impairment. Therefore, the patients’ needs for improving oral health were critical components of treatment plans to improve the daily activity of SjS patients. Disclosure of Interests: None declared
AB0901-HPR SOCIAL AND PSYCHOLOGICAL IMPACT OF THE CONTAINEMENT DURING COVID-19 PANDEMIC ON PATIENTS WITH CHRONIC INFLAMMATORY RHEUMATIC DISEASES
Authors: T. El Joumani, H. Rkain, T. Fatima Zahrae, H. Kenza, A. Radouan, N. Laila, S. Bahloul, E. A. Nada, T. Latifa, N. Hajjaj-Hassouni, F. Allali
Journal: Annals of the Rheumatic Diseases (2021)

Background: Covid-19 pandemic had a worldwide impact on the population, global economy and health care systems. Objectives: To evaluate the psychological state and social impact of patients with Chronic Inflammatory Rheumatic Diseases (CIRD) during this pandemic in order to understand how to optimize their quality of life. Methods: It’s a cross-sectional survey, where the data were collected through the online survey tool “google forms”. A pilot test were conducted with the study committee members who analyzed the apparent validity of the questionnaire and identified issues that could lead to misunderstandings, and their suggestions were refined by a retest reliability until general agreement. The social and psychological impacts were evaluated by 14 questions exploring the different effects of the containment on negative feelings, interest in the family, changes in daily activities and plans, quality of sleep, practice of physical activity before and during containment, as well as the impact of the Coronavirus on psychological health. Statistical Analysis System IBM SPSS Statistics V20.0.0 was used to analyze the survey data. Results: 350 patients had participated in this online survey (mean age of 46,1 ± 14,4, 68% were women, 15.7% were illiterate, 45.7% were unemployed, rural residence in 11.7% of cases). Patients reported that their mental health has been negatively affected by Coronavirus in 59.1% of cases. Table 1 summarizes the psychological events during the containment. Table 1. Negative feelings during the containment Negative feelings (% ) N = 350 Hopelessness 23.7 Anxiety 55.4 Fear 29.7 Frustration 22.9 Loneliness 17.4 Anger 22.6 Powerlessness 24.3 Patients reported that they paid more attention to their family in 87.1% during containment. Their daily lives and their life plans had changed because of Coronavirus(in 89.7% and 81.4%). Sleep during the pandemic has been negatively affected in 72.6% of patients. Physical activity practice had significantly decreased during containment (26.6% vs 51.7%) Conclusion: This study illustrates the social and psychological impact of COVID-19 pandemic on patients with CIRD. In the light of those results, we have lunched an awareness campaign to reinforce psychologic and social support of patients with CIRD during this global health crisis. Disclosure of Interests: None declared
Equity and the JAMA Network
Authors: Phil B. Fontanarosa, Annette Flanagin, John Z. Ayanian, Robert O. Bonow, Neil M. Bressler, Dimitri Christakis, Mary L. Disis, S. Andrew Josephson, Melina R. Kibbe, Dost Öngür, Jay F. Piccirillo, Rita F. Redberg, Frederick P. Rivara, Kanade Shinkai, Clyde W. Yancy
Journal: JAMA Psychiatry (2021)

The key objective of JAMA is "To promote the science and art of medicine and the betterment of the public health"; similar objectives and mission statements are supported by all 12 JAMA Network Journals.Together this family of journals is committed to publishing the best research, reviews, and opinion articles to advance medical science, promote public health, and improve patient care.The ultimate goal is to promulgate truth in science and medicine.On February 23, 2021, a podcast titled "Structural Racism for Doctors-What Is It?" was posted by the JAMA Network and on the following day, a tweet was posted to promote the podcast.Assertions in both that disavowed the presence of structural racism in medicine and among physicians were wrong, misguided, and uninformed.An extensive evidence base strongly supports the presence of structural racism in medicine and its adverse influence on health. 1 The process for reviewing and publishing the podcast and tweet was also flawed.On March 4, 2021, Howard Bauchner, MD, editor in chief of JAMA and the 12 JAMA Network Journals, took responsibility and issued an apology for the podcast and tweet.This editorial team also expresses a profound apology for the misinformation in the podcast and tweet and recognizes the hurt, anger, and outrage that resulted.These events and developments make it clear that JAMA and the JAMA Network Journals can and must do better and advance toward inclusion and antiracism in all journal-related activities.Even though these journals have made progress, additional commitment and work are needed to build on and intensify these efforts to achieve meaningful, sustainable change.For instance, previous efforts include the more than 650 research, review, and opinion articles on race, racism, and racial and ethnic disparities and inequities that have been published in JAMA and the JAMA Network Journals since 2015, 1 including editorials in JAMA on topics such as race and medical research, 2 race and poverty and medicine, 3 enhancing diversity in medical schools, 4 and equity related to COVID-19 vaccines. 5n addition, within the past year, JAMA Network Open and JAMA Health Forum issued calls for manuscripts on prevention and effects of systemic racism in health 6,7 ; JAMA Psychiatry initiated an editorial fellowship prioritized to early-career academic psychiatrists from underrepresented backgrounds; and JAMA Surgery issued a "Call to Action" to all surgery journal editors for diversity in the editorial and peer review process.
Coordination Needed to Address Clinician Well-being and the Opioid Epidemic
Authors: Humayun J. Chaudhry, Cheryl Walker-McGill, Victor J. Dzau
Journal: JAMA (2021)

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