tbuckley/cabot-search huggingface dataset:
SAT0035 Ankylosing spondylitis, psoriatic arthritis and reactive arthritis show increased bone resorption and differ with regard to bone formation
Authors: J Grisar, M Aringer, K Redlich, PM Bernecker, W Wolozcszuk, JS Smolen, P Pietschmann
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> It is well established that rheumatoid arthritis is associated with severe alterations of bone metabolism. In seronegative spondylarthropathies (SSPs), however, data on bone turnover are scarce and conflicting. <h3>Objectives</h3> <h3>Methods</h3> We studied biochemical markers of bone resorption (urinary deoxy-pyridinoline (D-Pyr) and cross-linked telopeptide of collagen-1 (ICTP)), bone formation markers (osteocalcin (OC) and bone specific isoenzyme of alkaline phosphatase (BAP)) as well as serum levels of osteoprotegerin (OPG, a glycoprotein which prevents the differentiation and activation of osteoclasts) in 30 patients with ankylosing spondylitis (AS), 23 patients with psoriatic arthritis (PsoA), 10 patients with reactive arthritis (ReA) and sex- and age matched healthy controls (HC). <h3>Results</h3> Markers of bone resorption were significantly increased in AS, PsoA and ReA patients (Table 1). In contrast, bone formation markers were found to be heterogeneous: OC was increased in AS, but not in PsoA or ReA and the levels of BAP were elevated only in patients suffering from PsoA (Table 1). Serum levels of OPG were significantly increased in the AS and PsoA-group (Table 1). Furthermore, dual energy x-ray absorptiometry (DXA) measurements of the lumbar spine and the femoral neck, performed in a subgroup of patients, showed clearly decreased T-scores (lumbar spine -0.99 ± 1.33, femoral neck -1.95 ± 1.33) in patients suffering from AS. In PsoA bone mineral density was within the normal range. * = p &lt; 0.05. ** = p &lt; 0.001. <h3>Conclusion</h3> Our results suggest significant alterations of bone metabolism in patients with SSPs. It is tempting to speculate that the increased OPG levels in AS and PsoA may represent a compensatory mechanism following enhanced bone resorption.
Response to Open Peer Commentaries on “Compelled Authorizations for Disclosure of Health Records: Magnitude and Implications”
Authors: Mark A. Rothstein, Meghan K. Talbott
Journal: The American Journal of Bioethics (2007)

Lee Black and Emilie E. Anderson (2007) make a key point about the important role of physicians in protecting the confidentiality of health records. Regardless of the design features of a health record system, the first requirement of health privacy and confidentiality is trust by patients in their health care providers. If patients lack trust in their physicians’ commitment to protect their sensitive health information, they will not disclose matters essential to their health and they may even forego medical care altogether. We agree that the ethical duty of physicians to protect the confidentiality of patient health records does not change with the advent of electronic health records. The American Medical Association’s (AMA’s) Code of Ethics, section 5.07, which Black and Anderson quote, provides, in part, that “[r]elease of confidential medical information from the data base should be confined to the specific purpose for which the information is requested and limited to the specific time frame requested . . . ” (AMA 2006). Contextual access criteria, which, in our main article, we urge policy makers to research, develop and incorporate into the Nationwide Health Information Network (NHIN), would substantially assist physicians and other custodians of health records by facilitating more targeted disclosures of health information in response to an authorization. The AMA’s statement that disclosures “should be confined” to relevant matters is of little practical value if there is no way for a physician to respond easily and accurately to a request for disclosure of a certain class of health information. Physicians simply do not have the time to scour health records to assess what entries in a voluminous record meet the criteria for disclosure. Black and Anderson suggest that physicians are in a “unique position to help patients understand what the disclosure means and how to limit such disclosures to the
Research Priorities in Atrial Fibrillation Screening
Authors: Emelia J. Benjamin, Alan S. Go, Patrice Desvigne-Nickens, Christopher D. Anderson, Barbara Casadei, Lin Y. Chen, Harry J.G.M. Crijns, Ben Freedman, Mellanie True Hills, Jeff S. Healey, Hooman Kamel, Dong-Yun Kim, Mark S. Link, Renato D. Lopes, Steven A. Lubitz, David D. McManus, Peter A. Noseworthy, Marco V. Perez, Jonathan P. Piccini, Renate B. Schnabel, Daniel E. Singer, Robert G. Tieleman, Mintu P. Turakhia, Isabelle C. Van Gelder, Lawton S. Cooper, Sana M. Al-Khatib
Journal: Circulation (2021)

Clinically recognized atrial fibrillation (AF) is associated with higher risk of complications, including ischemic stroke, cognitive decline, heart failure, myocardial infarction, and death. It is increasingly recognized that AF frequently is undetected until complications such as stroke or heart failure occur. Hence, the public and clinicians have an intense interest in detecting AF earlier. However, the most appropriate strategies to detect undiagnosed AF (sometimes referred to as subclinical AF) and the prognostic and therapeutic implications of AF detected by screening are uncertain. Our report summarizes the National Heart, Lung, and Blood Institute’s virtual workshop focused on identifying key research priorities related to AF screening. Global experts reviewed major knowledge gaps and identified critical research priorities in the following areas: (1) role of opportunistic screening; (2) AF as a risk factor, risk marker, or both; (3) relationship between AF burden detected with long-term monitoring and outcomes/treatments; (4) designs of potential randomized trials of systematic AF screening with clinically relevant outcomes; and (5) role of AF screening after ischemic stroke. Our report aims to inform and catalyze AF screening research that will advance innovative, resource-efficient, and clinically relevant studies in diverse populations to improve the diagnosis, management, and prognosis of patients with undiagnosed AF.
Clinical features, radiological profiles, pathological features and surgical outcomes of pituicytomas: a report of 11 cases and a pooled analysis of individual patient data
Authors: Jian-Hua Cheng, Ding Nie, Bin Li, Song-Bai Gui, Chu-Zhong Li, Ya-Zhuo Zhang, Luigi Maria Cavallo, Peng Zhao
Journal: Military Medical Research (2021)

Pituicytoma is an extremely rare low-grade glial tumor that is closely related to the neurohypophysis axis. Most studies of pituicytomas include only several cases. To better understand this disease, we reviewed a series of cases of pituicytomas. The diagnosis and treatment of pituicytoma must be further elucidated.Eleven patients with pituicytoma admitted to Beijing Tiantan Hospital from 2012 to 2019 were selected. The clinical features, including radiological and histological examination, surgical records and prognosis were reviewed. Sixty-eight other previously published cases of pituicytoma also were used to analyze the predictive factors for the results. The Cox regression model was used for univariate and multivariate analyses.Our patients included 5 males (45.5%) and 6 females (54.5%), with a mean age of 49.3 years. The tumor was located in the suprasellar region in 5 patients (45.5%), intrasellar region in 4 patients (36.4%), and intrasellar-suprasellar region in 2 patients (18.2%). All patients were misdiagnosed with other common tumors in the sellar region before the operation. During the operation, gross total resection (GTR) of the tumor was achieved in 6 patients (54.5%), and subtotal resection (STR) was achieved in 5 patients (45.5%). The mean progression-free survival (PFS) time was 29.82 months. Tumor progression after surgical resection occurred in 4 patients (36.4%). Among them, 60.0% of the patients (cases 4, 5, 7) with STR experienced progression, while 16.7% of the patients (case 2) with GTR experienced progression. Combined with the 68 cases in the literature, GTR was an independent risk factor for PFS time (P < 0.05).Pituicytomas are more common in middle-aged people and the sellar region. The clinical manifestations of pituicytomas are different, but no diagnostic clinical features have been identified other than an abnormally abundant blood supply. Currently, GTR is the best approach for the treatment of pituicytomas. More patients and longer follow-up periods were needed to further elucidate the biological features of pituicytomas.
Incessant Pericarditis as a Risk Factor for Complicated Pericarditis and Hospital Admission
Authors: Massimo Imazio, Emanuele Pivetta, Alessandro Andreis, Chiara Serra, Federica Carbone, Monica Masoero, Marco Ottino, Anna Ravetti, Anna Renzetti, Silvia Totaro, Antonio Brucato, Yehuda Adler, Carla Giustetto, Mauro Rinaldi, Enrico Lupia, Gaetano Maria De Ferrari
Journal: Circulation (2021)
Protease-triggered bioresponsive drug delivery for the targeted theranostics of malignancy
Authors: Yanan Li, Cangang Zhang, Guo Li, Guowei Deng, Hui Zhang, Yongbing Sun, Feifei An
Journal: Acta Pharmaceutica Sinica B (2021)

Proteases have a fundamental role in maintaining physiological homeostasis, but their dysregulation results in severe activity imbalance and pathological conditions, including cancer onset, progression, invasion, and metastasis. This striking importance plus superior biological recognition and catalytic performance of proteases, combining with the excellent physicochemical characteristics of nanomaterials, results in enzyme-activated nano-drug delivery systems (nanoDDS) that perform theranostic functions in highly specific response to the tumor phenotype stimulus. In the tutorial review, the key advances of protease-responsive nanoDDS in the specific diagnosis and targeted treatment for malignancies are emphatically classified according to the effector biomolecule types, on the premise of summarizing the structure and function of each protease. Subsequently, the incomplete matching and recognition between enzyme and substrate, structural design complexity, volume production, and toxicological issues related to the nanocomposites are highlighted to clarify the direction of efforts in nanotheranostics. This will facilitate the promotion of nanotechnology in the management of malignant tumors.
Omega-3 Consumption Assessment in Vegetarian Diets
Authors: Carolina Pimentel
Journal: Clinical Cardiology and Cardiovascular Interventions (2020)

Understanding feeding consumption and nutrient ingestion in vegetarian diet is essential to foster nutritional adequacy.The goal was assessing Omega-3 consumption in such diets.It is a transversal study, performed with 09 vegetarian adults.The ingestion was achieved by means of 24-Hour Reminder and the nutrients were defined by nutritional software.The results disclosed that the diet is rich in ALA (alpha-linolenic acid), however the functions are performed by EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).ALA is capable of converting inefficiently in the other ones.In the present study, ALA consumption is above DRI's (2.55g± 2.14), but when it is converted to EPA (326mg) and DHA (65.5mg) is below EFSA guidance and North American cardiovascular disease prevention and treatment guidelines.It was possible to conclude that this nutrient is essential to health, and in vegetarian diet, it is not achieved, a special care is required in diet planning.
SAT0527 COMBINED EFFECT OF COMMON VARIANTS IN EXON 2 OR EXON 3 AND A PATHOGENIC MUTATION IN EXON 10 OF THE MEDITERRANEAN FEVER GENE ON INFLAMMASOME ACTIVATION IN JAPANESE PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER
Authors: T. Koga, Y. Endo, K. Furukawa, K. Agematsu, A. Yachie, J. Masumoto, K. Migita, A. Kawakami
Journal: Annals of the Rheumatic Diseases (2020)

Background: Familial Mediterranean fever (FMF) is an autoinflammatory disease that is caused by Mediterranean fever ( MEFV ) gene mutations. It is characterized by recurrent and self-limiting febrile attacks within a short period. Although the pathologic significance of MEFV exon 2 or exon 3 common variants in patients with FMF is modest and these variants are usually associated with less severe clinical presentations of FMF (1, 2), their combined effects with pathogenic mutation in exon 10 remain to be evaluated. Objectives: To determine the combined effect of common variants on clinical manifestations and inflammasome activity, we compared the clinical and laboratory characteristics between the coexistence and non-coexistence of MEFV exon 2 or exon 3 variants in patients with FMF that had a heterozygous MEFV exon 10 mutation. Methods: We excluded patients with FMF that had two MEFV exon 10 mutations in one or more alleles and those with MEFV variants in exons other than in exons 2, 3, or 10. Finally, we reviewed 131 Japanese patients with FMF that had a heterozygous MEFV exon 10 mutation, and they were divided into the groups with and without MEFV exon 2 or exon 3 variants of 34 and 97, respectively. All enrolled patients had only a heterozygous M694I mutation in exon 10 of the MEFV gene. We measured serum IL-18 levels at remission without febrile attacks in the groups with and without MEFV exon 2 or exon 3 variants of 9 and 31, respectively. Results: In the univariate analysis, the group with variants in exon 2 or exon 3 had significantly earlier onset (16.0 years v.s. 20.5 years, p = 0.04), a higher percentage of thoracic pain with febrile attacks (68% v.s. 44%, p = 0.02), a higher frequency of attack (1.0/month v.s. 0.5/month, p = 0.02), and a higher IL-18 level in the serum at remission (606.3 pg/ml v.s. 168.4 pg/ml, p = 0.04, Figure 1) compared to the group without these variants. Importantly, multivariate analyses showed that the coexistence of MEFV exon 2 or exon 3 variants and an exon 10 mutation was independently and significantly associated with earlier onset of FMF (p = 0.049) and thoracic pain (p = 0.03). Figure 1. Conclusion: Our results suggest that the coexistence of MEFV exon 2 or exon 3 variants and a MEFV exon 10 mutation has combined effects on inflammasome activation in the Japanese population. References: [1]Migita K, Uehara R, Nakamura Y, et al. Familial Mediterranean fever in Japan. Medicine (Baltimore). 2012 Nov;91(6):337-43. [2]Shinar Y, Livneh A, Langevitz P, Genotype-phenotype assessment of common genotypes among patients with familial Mediterranean fever. J Rheumatol. 2000;27(7):1703. Disclosure of Interests: None declared
OP0294 DIFFERENTIAL INFLUENCE OF CO-MORBIDITIES ON SITE OF FRAGILITY FRACTURES
Authors: M. Dey, M. Bukhari
Journal: Annals of the Rheumatic Diseases (2020)

Background: Fragility fractures (FF) can occur at various sites of the skeleton, and are associated with multiple risk factors [1]. The prevalence of FF markedly increases with age. As the longevity of the population increases, so will the incidence of FF, and that of associated co-morbidities and risk factors. There are few data on co-morbidities associated with fractures at each site. Objectives: Identify associations of co-morbidities with sites of FF, by applying cluster analysis. Methods: We reviewed 28868 patients presenting for BMD estimation at a district general hospital in North West England, 2004-2016. We identified patients who had sustained one or more FF at time of presentation. Site(s) of FF were recorded for each patient, including femur, forearm, humerus, pelvis, ribs, spine, tibia or fibula. The following co-morbidities or treatments were recorded: excess alcohol consumption (previous or current); bisphosphonates; coeliac disease; family history of FF; hormone replacement therapy; hyperparathyroidism; hyperthyroidism; inflammatory bowel disease; polymyalgia rheumatica; rheumatoid arthritis; smoking (previous or current); corticosteroids (previous or current). Cluster analysis was performed on fracture sites and co-morbidities, using Jaccard similarity coefficient, and plotted on a dendrogram. Results were divided into an optimal number of clusters, derived using the elbow and silhouette methods. Results: 11003 of 28868 patients had sustained one or more FF at time of BMD estimation. Overall, 84.6% patients were female, mean age 67.5years, and median T-score -1.12 SD. Cluster analysis was performed for FF sites and co-morbidities, with Jaccard similarity coefficients calculated. 4 clusters were identified (Figure 1): FF of forearm (n=5054), tibia/fibula (n=2617), spine (n=2352), associated with family history of FF, smoking, corticosteroids, and bisphosphonate treatment; FF of pelvis (n=300) associated with hyperparathyroidism, PMR, coeliac disease, and HRT; FF of femur (n=1181) and humerus (n=1131) associated with IBD and RA; FF of ribs (n=1022) associated with alcohol and hyperthyroidism. Conclusion: Cluster analysis demonstrated 4 distinct subgroups of FF sites and associated co-morbidities. To our knowledge, this is the first study applying cluster analysis to evaluate co-morbidities associated with FF sites. Risk factors may influence trabecular more than cortical bone, accounting for the difference in clusters. Knowledge of risk factors associated with FF site subgroups will aid prophylaxis and management in at-risk patients. References: [1]Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet (London, England). 2002 Jun 1;359(9321):1929–36 Disclosure of Interests: Mrinalini Dey: None declared, Marwan Bukhari Speakers bureau: Bristol-Myers Squib, UCB celltech, Roche/Chugai, Pfizer, Abbvie, Merck, Mennarini, Sanofi-aventis, Eli-Lilly, Janssen, Amgen and Novartis.
Mediation of Interleukin‐23 and Tumor Necrosis Factor–Driven Reactive Arthritis by <i>Chlamydia</i>‐Infected Macrophages in SKG Mice
Authors: Xavier Romand, Xiao Liu, M. Arifur Rahman, Zaied Ahmed Bhuyan, Claire Douillard, Reena Arora Kedia, Nathan Stone, Dominique Roest, Zi Huai Chew, Amy J. Cameron, Linda M. Rehaume, Aurélie Bozon, Mohammed Habib, Charles W. Armitage, Minh Vu Chuong Nguyen, Bertrand Favier, Kenneth Beagley, Max Maurin, Philippe Gaudin, Ranjeny Thomas, Timothy J. Wells, Athan Baillet
Journal: Arthritis & Rheumatology (2021)

ZAP-70W163C BALB/c (SKG) mice develop reactive arthritis (ReA) following infection with Chlamydia muridarum. Since intracellular pathogens enhance their replicative fitness in stressed host cells, we examined how myeloid cells infected with C muridarum drive arthritis.SKG, Il17a-deficient SKG, and BALB/c female mice were infected with C muridarum or C muridarum luciferase in the genitals. C muridarum dissemination was assessed by in vivo imaging or genomic DNA amplification. Macrophages were depleted using clodronate liposomes. Anti-tumor necrosis factor (anti-TNF) and anti-interleukin-23p19 (anti-IL-23p19) were administered after infection or arthritis onset. Gene expression of Hspa5, Tgtp1, Il23a, Il17a, Il12b, and Tnf was compared in SKG mice and BALB/c mice.One week following infection with C muridarum, macrophages and neutrophils were observed to have infiltrated the uteri of mice and were also shown to have carried C muridarum DNA to the spleen. C muridarum load was higher in SKG mice than in BALB/c mice. Macrophage depletion was shown to reduce C muridarum load and prevent development of arthritis. Compared with BALB/c mice, expression of Il23a and Il17a was increased in the uterine and splenic neutrophils of SKG mice. The presence of anti-IL-23p19 during infection or Il17a deficiency suppressed arthritis. Tnf was overexpressed in the joints of SKG mice within 1 week postinfection, and persisted beyond the first week. TNF inhibition during infection or at arthritis onset suppressed the development of arthritis. Levels of endoplasmic reticulum stress were constitutively increased in the joints of SKG mice but were induced, in conjunction with immunity-related GTPase, by C muridarum infection in the uterus.C muridarum load is higher in SKG mice than in BALB/c mice. Whereas proinflammatory IL-23 produced by neutrophils contributes to the initiation of C muridarum-mediated ReA, macrophage depletion reduces C muridarum dissemination to other tissues, tissue burden, and the development of arthritis. TNF inhibition was also shown to suppress arthritis development. Our data suggest that enhanced bacterial dissemination in macrophages of SKG mice drives the TNF production needed for persistent arthritis.
Abstract 9755: Bleeding Complications During Long-term Dual Antiplatelet Treatment In Diabetic Patients Treated With 1St Generation Drug Eluting Stent Implantation
Authors: Vassilis Voudris, Panagiotis Karyofillis, Constantinos Doulaptsis, Ioannis Moukas, Sophia Thomopoulou, Dennis V Cokkinos
Journal: Circulation (2012)

Background:  Dual antiplatelet treatment (DAPLT) for at least 12 months is recommended after drug-eluting stent (DES) implantation. We investigate the frequency, correlates, and clinical significance of bleeding complications in diabetic patients (pts) on long-term DAPLT (5 years) after 1 st  generation DES implantation.   Methods:  We assessed 610 consecutive diabetes mellitus (DM) pts (male 80%, mean age 65±9 years) after 1 st  generation DES implantation (sirolimus 80%, paclitaxel 10%, combination 10%). Five years clinical follow-up (FU), obtained in 587/610 (96%) of them; at the end of FU, 211(36%) pts were on single APLT (SAPLT) and 376 (64%) on DAPLT. Bleeding complications were defined according to PLATO and TIMI definitions. Hard end-point (HEP) was considered the combination of death, non-fatal myocardial infarction, and cerebrovascular accident; stent thrombosis (ST) is assessed according to ARC definition.   Results:  There was no difference in the incidence of ST and HEP in pts treated with DAPLT vs. SAPLT. The incidence of bleeding was higher on DAPLT pts (14.6% vs 3.8%, p    Conclusions:  Long-term DAPLT in DM pts treated with 1 st  generation DES is associated with higher risk of overall and minor but not major bleeding. Smoking was an independent predictor for overall and major bleeding according to PLATO definitions.
HOSPITAL ADMISSIONS FOR AORTIC STENOSIS IN PREGNANCY IN THE UNITED STATES: A TWELVE-YEAR ANALYSIS
Authors: Neiberg de Alcantara Lima, Ricardo Lessa de Castro, Cuyler Huffman, Mireya Diaz, Carol Cavalcante de Vasconcelos Lima, Mark Schauer, Silvia Teresa Linares, Thomas A Melgar
Journal: Journal of the American College of Cardiology (2020)