tbuckley/cabot-search huggingface dataset:
AB0640 MORTALITY IN CALCIUM PYROPHOSPHATE CRYSTAL DEPOSITION DISEASE: PRELIMINARY DATA
Authors: M. Elisеev, A. Novikova, O. Sheliabina, M. Chikina
Journal: Annals of the Rheumatic Diseases (2021)

Background: Calcium pyrophosphate crystal deposition disease (CPPD) is associated with a high frequency of comorbidities and vascular calcification [1], but it is unknown whether these factors affect cardiovascular mortality. Objectives: To study the structure of mortality in patients with CPPD and compare with the structure of mortality in the Russian Federation. Methods: 217 patients with crystal-verified diagnosis of CPPD (McCarty criteria) were included in the prospective study, aged ≥18 years, mean age 59.2 ± 12.6 years, 82 (38%) men and 134 (62%) women. The median follow-up was 3.9 [1.9; 7.2] years, patients were followed up for at least a year. The exclusion criteria are the presence of other rheumatic diseases with arthritis symptoms. The examination of patients included the history taking, assessment of anthropometric parameters, the presence of comorbidity and the following laboratory tests: determination of serum creatinine level (with calculation of glomerular filtration rate (eGFR) using the MDRD formula), total cholesterol (TC), C-reactive protein (CRP). Statistica 12.0 package was used for statistical data processing. Results: A total of 217 patients were included. Arterial hypertension was detected in 115 (53%) patients, coronary heart disease in 51 (24%) patients, diabetes mellitus in 26 (12%) patients, chronic renal failure in 17 (8%) patients, hyperparathyroidism in 18 (8%) patients, chronic heart failure in 22 (10%) patients. 65 (30%) patients had a family history for CVD, 31 (14%) patients were smokers. 122 (56%) patients had an increased level of total cholesterol&gt; 5.0 mmol/L and 54 (25%) patients – the level of CRP&gt;5 mg/L. 23 (11%) patients, 12 (52%) men and 11 (48%) women, died, the average age of the deceased being 62.7±9.2 years. In 15 (65%) cases out of 23, death occurred due to cardiovascular complications, which is higher than the cardiovascular mortality rate in the Russian Federation (53%). Among CVD, the distribution was as follows: acute myocardial infarction - 6 (40%) patients,apoplectic attack - 5 (33) patients, thrombosis - 2 (13%) patients, rhythm disturbances – 1 (7%) patient and decompensation of chronic heart failure - 1 (7%) patient. Conclusion: CVD is the main cause of death in patients with CPPD and the total frequency of mortality from CVD exceeds the population one. Further research is needed, including studies of the risk factors for overall and cardiovascular mortality in patients with CPPD. References: [1]Abhishek A, Doherty S, Maciewicz R, et al. Association between low cortical bone mineral density, soft-tissue calcification, vascular calcification and chondrocalcinosis: a case-control study. Ann Rheum Dis. 2013;73(11):1997-2002. doi: 10.1136/annrheumdis2013-203400 Disclosure of Interests: Maxim Elisеev Speakers bureau: Berlin Chemie Menarini Group, Novartis International AG, EGIS, Aleksandra Novikova: None declared., Olga Sheliabina: None declared., Maria Chikina: None declared.
Geriatric Oncology Comes of Age: Advancing the Science of Caring for Older Adults With Cancer
Authors: William Dale, Paul B. Jacobsen, Supriya G. Mohile
Journal: Journal of Clinical Oncology (2021)

Article Tools OVERVIEWS Caring for Older Adults With Cancer Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.21.00887 Journal of Clinical Oncology - published online before print May 27, 2021 PMID: 34043451 Geriatric Oncology Comes of Age: Advancing the Science of Caring for Older Adults With Cancer William Dale , MD, PhD1xWilliam DaleSearch for articles by this author; Paul B. Jacobsen, PhD2xPaul B. JacobsenSearch for articles by this author; and Supriya G. Mohile, MD, MS3xSupriya G. MohileSearch for articles by this author Show More 1City of Hope National Medical Center, Duarte, CA2National Cancer Institute, Bethesda, MD3University of Rochester Medical Center, Rochester, NY https://doi.org/10.1200/JCO.21.00887 First Page Full Text PDF Figures and Tables © 2021 by American Society of Clinical OncologyAUTHOR CONTRIBUTIONSConception and design: All authorsAdministrative support: William DaleManuscript writing: All authorsFinal approval of manuscript: All authorsAccountable for all aspects of the work: All authorsAUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTERESTGeriatric Oncology Comes of Age: Advancing the Science of Caring for Older Adults With CancerThe following represents disclosure information provided by the authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO’s conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/authors/author-center.Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).Supriya G. MohileConsulting or Advisory Role: Seattle GeneticsResearch Funding: CareviveNo other potential conflicts of interest were reported.
Psychiatric Comorbidities Are Highly Prevalent in Nonesophageal Eosinophilic Gastrointestinal Diseases
Authors: Craig C. Reed, Corey J. Ketchem, Talya L. Miller, Evan S. Dellon
Journal: Clinical Gastroenterology and Hepatology (2021)

The prevalence of psychiatric comorbidity in nonesophageal eosinophilic gastrointestinal disorders (EGIDs) has not been studied. We aimed to ascertain the prevalence of psychiatric diagnoses and psychiatric medication use in children, adolescents, and adults with EGIDs and to assess whether psychiatric comorbidity affects clinical presentation.This was a retrospective cohort study of newly diagnosed patients with a nonesophageal EGID at the University of North Carolina from 2008 to 2020. Psychiatric diagnoses and medications were extracted from medical records. We compared the clinical and demographic features of EGID patients with and without psychiatric diagnoses.Of 79 patients (mean 23.3 years of age, 53% male, 78% White) with a nonesophageal EGID diagnosis, 40 (51%) were diagnosed with a comorbid psychiatric disease. Anxiety (37%) and depression (28%) were most common. There were also 40 (51%) patients treated medically for a psychiatric diagnosis. Patients with a psychiatric diagnosis were more commonly ≥18 years of age at the time of EGID diagnosis (odds ratio [OR], 3.95, 95% confidence interval [CI], 1.20-13.02) and had endorsed symptoms of nausea (OR, 5.31; 95% CI, 1.33-21.22) and dysphagia (OR, 4.24; 95% CI, 1.18-15.26).Psychiatric diagnoses were very common in nonesophageal EGID patients with approximately 7 in 10 adults and one-third of children diagnosed. Similar proportions were found for psychiatric medication use. We also found that psychiatric illness may influence age of clinical presentation and symptoms. Providers should assess for concomitant psychiatric comorbidities in EGID patients.
POS0148 MATERNAL AND NEONATAL OUTCOMES IN PREGNANT WOMEN WITH PSORIASIS AND PSORIATIC ARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: W. Xie, H. Huang, Z. Zhang
Journal: Annals of the Rheumatic Diseases (2021)

Background: Psoriasis and psoriatic arthritis (PsA) are inflammatory diseases that affect women in their reproductive years. The evidence regarding the pregnancy outcomes in psoriasis and PsA is more limited and conflicting, to a large extent, confusing our knowledge on this topic. Objectives: We aim to investigate whether maternal psoriasis and PsA are associated with adverse pregnancy outcomes. Methods: We searched multiple electronic databases from inception to 3 August 2020, and reference lists of selected articles. Observational studies reporting at least one pregnancy outcomes in women with psoriasis or PsA with a comparator of general population or healthy subjects were included. Data were pooled by random-effects models (DerSimonian and Laird method) and expressed as odds ratio (OR) and 95% confidence interval (CI). Results: Overall, 16 studies were included in the meta-analysis. The pooled analyses showed pregnant women with psoriatic diseases have significantly higher risk of adverse maternal outcomes compared with general population (caesarean delivery: 1.33 (1.17-1.52); preterm birth: 1.32 (1.15-1.52); (pre)eclampsia: 1.28 (1.14-1.43); gestational diabetes: 1.19 (1.10-1.30); gestational hypertension: 1.30 (1.18-1.44) (Figure 1). However, no statistically increased risks of fetal complications were observed in women with psoriatic diseases (small for gestational age: 1.02 (0.93-1.11); low birth weight: 1.15 (0.93-1.42); congenital malformations: 1.03 (0.93-1.14); Apgar score &lt;7: 1.07 (0.81-1.39); neonatal mortality: 1.13 (0.90-1.43); stillbirth: 1.19 (0.95-1.50)). Subgroup analysis found similar results in women with either psoriasis or PsA regarding maternal outcomes, but the magnitude of risk estimates seems to be greater in PsA. Conclusion: Pregnant women with psoriasis and PsA have excess risk of adverse maternal events, with seemingly higher risk in women with PsA, but not adverse neonatal events. Close monitoring of the mothers’ clinical status before and during pregnancy are decidedly required in daily practice. Figure 1. Forest plots of the odds ratio for the risk of adverse pregnancy outcomes in patients with psoriatic diseases. Disclosure of Interests: None declared
Dysbiosis exacerbates colitis by promoting ubiquitination and accumulation of the innate immune adaptor STING in myeloid cells
Authors: Liraz Shmuel-Galia, Fiachra Humphries, Xuqiu Lei, Simona Ceglia, Ruth Wilson, Zhaozhao Jiang, Natalia Ketelut-Carneiro, Sage E. Foley, Susanne Pechhold, JeanMarie Houghton, Khaja Muneeruddin, Scott A. Shaffer, Beth A. McCormick, Andrea Reboldi, Doyle Ward, Ann Marshak-Rothstein, Katherine A. Fitzgerald
Journal: Immunity (2021)
AB0610 NORMOCALCAEMIC HYPERPARATHYROIDISM AND BONE HEALTH – WORSE THAN ANTICIPATED?
Authors: D. Masieh, S. Deshpande, M. K. Nisar
Journal: Annals of the Rheumatic Diseases (2021)

Background: Since the formal recognition of normocalcaemic hyperparathyroidism (nHPT) as a distinct entity in 2008, several studies have been published describing the characteristics of these individuals. Controversy exists regarding diagnostics and the role of parathyroidectomy in such cases. A chief reason for lack of consensus is the disagreement among experts regarding the potential complications and a bias towards perhaps benign nature of this condition. Objectives: In order to understand the challenges posed by this cohort, we aim to characterise these patients at presentation to our metabolic bone diseases unit with a focus on bone health. Methods: We interrogated our departmental database and undertook retrospective analysis of all patients presenting to metabolic bone service at our large university teaching hospital with a catchment population of 350,000. Individuals were included in the survey based on criteria of Vit D &gt;70 nmol/L, normal calcium (2.20-2.60 mmol/L), eGFR&gt;60ml/min and PTH &gt;6.9 pmol/L measured twice at least three months apart. Results: Over six months review period, of 134 referrals, 42 (31%) were identified with nHPT. Follow up duration was two years. Mean age was 60 years (25-86). 38 (90%) were women with 31 (81%) post menopause. 34 (80%) were of Caucasian descent. All had comorbidities with median of five (1-14). Polypharmacy (&gt;4 prescribed medicines) was common (36/42, 85%) with mean of seven prescribed medications (0-22). Mean Vit D was 88 (70.4-133.6), calcium 2.43 (2.26-2.58), creatinine 69.8 (48-115) and PTH 8.8 (7.2-14.2). Ten (24%) had already had fragility fractures with mean of two (0-4). 21 had DXA scan with mean T score of -3.78 (-2.1 - -6.0). 13/21(31%) had osteoporosis. Oral and IV bisphosphonates, denosumab and teriparatide were prescribed to 12 (28.5%), 14 (33%), 4 (10%) and one patient respectively. Conclusion: Our study suggests high prevalence of nHPT among patients referred to metabolic bone service with confirmed bone health issues. Nearly a third of patients have nHPT in this secondary care setting and a quarter have already suffered fragility fractures. These patients carry high comorbidity, polypharmacy and osteoporosis burden. Management of such patients is challenging owing to complex interplay of various ailments. Bone active agents are required for nearly two-thirds of this group. Though the natural course of nHPT is an area of active research, our data adds to the growing body of evidence that this is not a benign condition with particularly high fracture burden and poor bone quality. nHPT is perhaps responsible for the onset and progression of the similar osseous complications as described in classical PHPT. Further longitudinal studies are required to help devise best management plan to mitigate against the skeletal encumbrance of nHPT. Disclosure of Interests: None declared.
AB0071 RELATIONSHIP BETWEEN PRO-INFLAMMATORY CYTOKINE AND ATHEROGENIC INDEXES IN AXIAL RADIOGRAPHIC SPONDYLOARTHRITIS
Authors: K. Ben Ali, M. Slouma, L. Kharrat, A. Tezeghdenti, R. Dhahri, E. Ghazouani, I. Gharsallah, L. Metoui, B. Louzir
Journal: Annals of the Rheumatic Diseases (2021)

Background: The cardiovascular burden in inflammatory rheumatic diseases is well recognized. This burden has been reported in spondyloarthritis. Atherogenic indexes are known with their role of predicting cardiovascular risk. Objectives: The aim of our study was to determine the relation between pro-inflammatory cytokines and atherogenic indexes in spondyloarthritis. Methods: We performed a cross sectional study including 38 patients with spondyloarthritis according to ASAS criteria. For each patient we measured interleukin (IL)1, IL6, IL17, IL23 and tumor necrosis factor (TNF) alpha, total Cholesterol (CT), Triglycerides (TG), High density lipoprotein Cholesterol (HDLc) and Low density lipoprotein cholesterol (LDLc). We also calculated the following ratios: CT/HDLc, TG/HDLc, LDLc/HDLc, and LogTG/HDLc. Disease activity was measured using ASDAS (Ankylosing Spondylitis Disease Activity Score) and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index). Statistical analysis was performed using IBM SPSS Statistics 25. Results: The mean age were 45.4±12.5 years. There were 33 Male (sex ratio were 6.6). The mean C-reactive protein(CRP) were 29.6 ±40.34mg/L, mean erythrocyte sedimentation rate(ESR) were 41±33.9mm. The mean ASDASCRP, BASDAI were 2.8±1.24, 3.7±2.12, respectively. Active disease were noted in 68 % of patients using ASDASCRP score. The mean IL1, IL6, IL17, IL23, TNF alpha were 11.6 ±25pg/ml, 15.4±45.9pg/ml, 84.6±77.9pg/ml, 15.3±15.26pg/ml, 25.3± 47.9pg/ml respectively. The mean CT,HDLc,LDLc, TG were 4.47±0.93mmol/l, 1.09±0.3mmol/L, 2.77±0.78mmol/L, 1.29±0.54mmol/L respectively. The mean CT/HDLc, TG/HDLc, LDL/HDLc, LogTG/HDLc were 4.28±1.26, 1.22±0.6, 2.7±1.06, 0.03±0.23, respectively. Correlations were found between TG/HDLC ratio and IL1 (p&lt;0.01, r=0.515), IL6(p&lt;0.05; r=0.407), Log TG/HDLc and IL1 (p&lt; 0.05, r=0.369), and IL6(p&lt;0.05; r=0.333) However, no correlations were noted between atherogenic indexes and IL7, IL17, IL23, TNFalpha. Conclusion: Our study showed a correlations between atherogenic indexes and both IL1 and IL6. These findings suggests that serum IL-6 and IL1 levels in spondyloarthritis contribute to the development of cardiovascular disease atherosclerosis. References: [1]Lau et al. Role of Adipokines in Cardiovascular Disease. Circ J. 2017; 81(7): 920-8. Disclosure of Interests: None declared
Clinical Activity of Selitrectinib in a Patient With Mammary Analogue Secretory Carcinoma of the Parotid Gland With Secondary Resistance to Entrectinib
Authors: Vaia Florou, Christopher Nevala-Plagemann, Jonathan Whisenant, Patricia Maeda, Glynn W. Gilcrease, Ignacio Garrido-Laguna
Journal: Journal of the National Comprehensive Cancer Network (2021)

NTRK gene fusions are found in &lt;1% of all cancers but are uniformly present in mammary analog secretory carcinomas (MASC) of the salivary glands. Two selective histology-agnostic tropomyosin receptor kinase (TRK) inhibitors are currently approved for malignancies with these oncogenic fusions. Resistance to TRK inhibition has been recognized, and the mediating mechanisms are presently being studied. This report describes a patient diagnosed with an MASC of the parotid gland who after undergoing multiple lines of treatment was found to have an ETV6-NTRK3 fusion and initiated TRK-targeted therapy using entrectinib. Upon disease progression, we performed tumor genetic sequencing that showed a secondary resistance mutation. The patient subsequently responded to selitrectinib, a next-generation TRK inhibitor.
Baseline and early functional immune response is associated with subsequent clinical outcomes of PD-1 inhibition therapy in metastatic melanoma patients
Authors: Alexandre Gérard, Jerome Doyen, Marion Cremoni, Laurent Bailly, Kevin Zorzi, Caroline Ruetsch-Chelli, Vesna Brglez, Alexandra Picard-Gauci, Laura Troin, Vincent L.M. Esnault, Thierry Passeron, Henri Montaudié, Barbara Seitz-Polski
Journal: Journal for ImmunoTherapy of Cancer (2021)

Background Despite significant progress with antiprogrammed cell death protein 1 (PD-1) therapy, a substantial fraction of metastatic melanoma patients show upfront therapy resistance. Biomarkers for outcome are missing and the association of baseline immune function and clinical outcome remains to be determined. We assessed the in vitro nonspecific stimulation of immune response at baseline and during anti-PD-1 therapy for metastatic melanoma. Methods Previously untreated metastatic melanoma patients received nivolumab and radiotherapy as part of the multicentric phase II trial NIRVANA ( NCT02799901 ). The levels of Th1, Th2 and Th17 cytokines on in vitro non-specific stimulation of innate and adaptive immune cells were measured in patient sera before treatment, and at week 2 and week 6 after the beginning of the treatment, and correlated with tumorous response, progression-free survival (PFS) and occurrence of immune-related adverse events (irAEs). The results in melanoma patients were compared with those of a cohort of 9 sex and age-matched healthy donors. Results Seventeen patients were enrolled in this ancillary study. Median follow-up was 16 months (2.2–28.4). The 12-month PFS rate was 67.7%. The incidence of irAEs of any grade was 58.8%. Without in vitro stimulation no differences in cytokines levels were observed between responders and non-responders. On in vitro stimulation, metastatic patients had lower Th1 cytokine levels than healthy donors at baseline for tumor necrosis factor-α and interferon-γ (IFN-γ) (1136 pg/mL vs 5558 pg/mL, p&lt;0.0001; and 3894 pg/mL vs 17 129 pg/mL, p=0.02, respectively). Responders exhibited increasing cytokine levels from baseline to week 6. Non-responders had lower interleukin 17A (IL-17A) levels at baseline than responders (7 pg/mL vs 32 pg/mL, p=0.03), and lower IFN-γ levels at week 6 (3.3 ng/mL vs 14.5 ng/mL, p=0.03). A lower level of IL-17A at week 2 and a lower level of IFN-γ at week 6 correlated with worse PFS (p=0.04 and p=0.04 respectively). At baseline, patients who developed irAEs had higher IL-6 levels (19.3 ng/mL vs 9.2 ng/mL, p=0.03) and higher IL-17A levels (52.5 pg/mL vs 2.5 pg/mL, p=0.009) than those without irAEs. Conclusions Our findings indicate that cytokine levels after in vitro non-specific stimulation could be a promising biomarker to predict the outcome of PD-1 inhibition therapy.
Congenital cytomegalovirus infection
Authors: Megan H Pesch, Katie Kuboushek, Michael M McKee, Marc C Thorne, Jason B Weinberg
Journal: BMJ (2021)

### What you need to know

Congenital cytomegalovirus (cCMV) infection is a common congenital infection, affecting one in every 100-200 live births globally.1 Long term neurodevelopmental sequelae occur in a quarter of children affected. This article provides a clinical update of the literature on the prevention, diagnosis, treatment, and anticipatory management of infants and children with cCMV. Recommendations from the 2015 European Society of Paediatric Infectious Diseases (ESPID) Expert Consensus Group (largely based on expert opinion) are presented along with more recent literature relevant to the general practitioner.2

Cytomegalovirus (CMV) can cause self-limited generalised symptoms such as fatigue and lymphadenopathy in most healthy individuals, including pregnant people.3 cCMV infection occurs when CMV transplacentally infects a developing fetus. The virus can cause damage to the placenta, and replicate in fetal central nervous system (CNS) cells, which may result in disrupted fetal development, miscarriage, or intrauterine fetal demise.4 Neonates with cCMV may experience a wide range of signs, symptoms, and long term sequelae (fig 1), although most experience no recognisable signs or symptoms.3



Fig 1 
Expected incidence of disease manifestations and developmental outcomes of infants with congenital cytomegalovirus demonstrated in 1000 hypothetical infants born with congenital cytomegalovirus



Neonates born with …
POS1387 QUANTIFICATION OF BONE MARROW EDEMA BY MRI OF THE SACROILIAC JOINTS IN PATIENTS DIAGNOSED WITH AXIAL SPONDYLOARTHRITIS: RESULTS FROM THE ESPERANZA COHORT
Authors: R. Almodovar, P. Zarco-Montejo, A. Bueno, C. Garcia-Monco, E. De Miguel, C. Tornero, M. Moreno Martinez Losa, J. Gratacos-Masmitja, R. Mazzucchelli
Journal: Annals of the Rheumatic Diseases (2021)

Background: The present study analyzes the added value of quantification by MRI of SI joints by comparing it to the standard interpretation with ASAS criteria for the classification of patients with axSpA of recent onset and a six-year follow-up. Objectives: To evaluate if the quantification of bone marrow edema (BME) of the sacroiliac (SI) joints by magnetic resonance imaging (MRI) improves capacity for axial spondyloarthritis (axSpA) classification in comparison to the assessment of sacroiliitis by means of ASAS classification criteria. Methods: Prospective study from the ESPeranza cohort involving 66 subjects with an available MRI of the SI joints at baseline. This subgroup includes patients with axSpA (n=28), peripheral spondyloarthritis (n=10) and a group with other diagnoses that were not spondyloarthritis (n=28). Measures of diagnostic usefulness (area under the curve (AUC), sensitivity, specificity, Youden’s J statistic, LR+ and LR-) were calculated for MRI of the SI joints according to ASAS criteria and for MRI quantified by means of SCAISS (Spanish tool for semi-automatic quantification of sacroiliac inflammation by MRI in spondyloarthritis). This analysis was stratified in patients who were HLA-B27 positive and negative. Results: Out of a total of 66 MRI of the SI joints, 20 (30.3%) were positive according to ASAS criteria. Out of these 20 subjects, 18 patients with final diagnosis of axSpA had a positive MRI, and 2 patients did not have axSpA. Out of the 66 patients of the cohort, 23 (34.8%) patients were HLA-B27 positive and 42 (63,6%) were negative. AUC value with bone marrow edema (BME) quantification was 0.919 (CI95% 0.799-1) for HLA-B27 positive patients and 0.884 (CI95% 0.764-1) for HLA-B27 negative patients. A SCAISS cutoff point of 80 units obtained a specificity of 94.4% and LR+ 7.5, while assessment by ASAS criteria showed a specificity value of 90% and LR+ 6.4. Conclusion: For patients with suspected axSpA, quantification of BME improves the predictive capacity of MRI of the SI joints, for both HLA-B27 positive and negative patients. Disclosure of Interests: None declared