tbuckley/cabot-search huggingface dataset:
AB0740 IMPACT OF DIAGNOSIS DELAY ON DISEASE PARAMETERS DURING JUVENILE IDIOPATHIC ARTHRITIS
Authors: H. Bettaieb, H. Ferjani, K. Maatallah, D. Kaffel, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2021)

Background: Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in childhood (1). Prompt diagnosis is mandatory to avoid joint destruction and growth abnormalities. However, it’s often misdiagnosed by pediatricians and general practitioners leading to longer diagnosis delay (2). Objectives: The aim of this study was to evaluate the lag time between JIA symptoms onset and diagnosis and its impact on disease activity and bone loss. Methods: A retrospective monocentric study was carried out on JIA patients (ILAR criteria). Diagnosis delay was collected from the patient’s medical files. Disease activity at JIA diagnosis 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. The data were analyzed using the SPSS statistical package. A p value &lt; 0.05 was considered significant. Results: We enrolled 48 JIA (31 male and 17 female) with a mean age at disease onset of 11.2 ± 3.8 years. The median disease duration was 84 months [2-408]. The median JIA diagnosis delay was 8 months [1-108]. The JIA subgroups were in decreasing order of frequency: Enthesitis-related Arthritis (n=32), Polyarticular RF- (n=4), Polyarticular RF+ (n=2), Oligoarticular (n=6), Systemic (n=2), Psoriatic Arthritis (n=1) and Undifferentiated (n=1). At diagnosis, median ESR and CRP were 44 mm/hour [2-100] and 24 mg/l [2-86] respectively. Median JADAS10 score was 4 [0-21]. Median BASDAI score was 6.2 [2-9.4]. At follow-up, five patients (10.4%) had atlantoaxial subluxation and 17 had coxitis (43.8%). At bone densitometry, 45% of patients had osteroposis and 27.5% had osteopenia. An agreement was assessed between a long diagnosis delay and the following parameters: male gender (p=0.04) and osteoporosis (p=0.018). A Significant positive correlation was found between delay in JIA diagnosis and BASDAI score (p=0.047, r=0.63). No association was found between JIA diagnosis delay and JADAS score (p=0.56). Neither ESR (p=0.19) nor CRP (p=0.42) was associated with JIA diagnosis delay. Finally, no link was observed with the occurrence of hip arthritis (p=0.281) or atlantoaxial subluxation (p=0.137). Conclusion: In this study, delay in diagnosis was associated with higher disease activity scores and bone loss. Our results suggest that early identification and treatment of JIA leads to improved outcomes as well as bone mass. References: [1]Petty R.E., Southwood T.R., Manners P. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390. [2]Foster HE, Scott C, Tiderius CJ,et al. Improving musculoskeletal health for children and young people - A ‘call to action’. Best Pract Res Clin Rheumatol. 2020 Oct;34(5):101566. Disclosure of Interests: None declared
AB0711 FOLLOW-UP OF PATIENTS UNDER BIOLOGICS IN THE ERA OF LOCKDOWN
Authors: V. F. Boussougou, K. Nassar, S. Janani
Journal: Annals of the Rheumatic Diseases (2021)

Background: The management of patients with inflammatory rheumatic diseases under biologics has raised many questions about the global management of patients in the time of COVID-19 pandemic. This period could have been particularly painful for the patients due to the virus itself, and to the difficulty to access to healthcare facilities due to the lockdown. Objectives: To assess the impact of the lockdown in patients under biologics. Methods: This is a descriptive study, conducted between 03/01/2021 and 07/31/2021 in the Department of Rheumatology of the University Hospital of Ibn Rochd in Casablanca. Inclusion criteria were all patients on biologics during the lockdown period. The number of painful, swollen joints, pain visual analogue scale, and disease activity were collected before and during the lockdown. Results: Thirty-one patients under biologics were included. The average age was 43.4 years. There were 17 males and 14 females (sex ratio M/F 1,21). Cormibidities were hypertension and type 2 diabetes (9.7%), hypertension and dyslipidemia (6.5%), arrhythmia (6.5%), smoking (9.7%), hypertension and dysthyroidism (3.2%). All the patients were under biologics with an average duration of 2 years distributed as follows: 3 patients on etanercept (9.67%), 8 patients on tocilizumab (28.8%), 10 patients on infliximab (32.25%), 5 patients on adalimumab (16.12%)), 4 patients under golimumab (12.90%), 1 under secukinumab (3.22%). Biologics were associated with conventional synthetic disease-modifying antirheumatic drugs in 38.7% (methotrexate 12.9%, salosopyrine25, 8%), corticosteroids in 25.7%, non-steroidal anti-inflammatory drugs in 16.1%. The disease activity before COVID-19 of the patients was: 48.39% weak activity, 35.4% remission, 16.13% moderate activity. No patient reported a flare of the disease. During lockdown, 5 patients reported a flare of their disease (16.12%) They were followed for: 2 spondyloarthritis, 1 rheumatoid arthritis, 1 psoriatic arthritis, 1 adult onset Still’s disease. All the patients have temporarily stopped their drugs because they couldn’t come to their appointments because of the lockdown. Conclusion: Our study notes that the patients who kept their follow-up during lockdown have maintained a control of their disease activity. Our results are consistent with the observations of a French study on the impact of lockdown on the activity of rheumatoid arthritis. However, those who couldn’t come to their control appointment due to the lockdown had a flare of their disease. This study remains limited due to the monocentric nature and the small size of our sample. Disclosure of Interests: None declared
Payer-Negotiated Prices in the Diagnosis and Management of Thyroid Cancer in 2021
Authors: Roy Xiao, Vinay K. Rathi, Cary P. Gross, Joseph S. Ross, Rosh K. V. Sethi
Journal: JAMA (2021)

This study examines price availability and variation for thyroid cancer care at National Cancer Institute (NCI)–Designated Cancer Centers following a 2021 CMS policy reform requiring hospitals to disclose commercial payer-specific negotiated prices for all items and services.
Implications and pitfalls for cancer diagnostics exploiting extracellular vesicles
Authors: Ana Špilak, Andreas Brachner, Ulrike Kegler, Winfried Neuhaus, Christa Noehammer
Journal: Advanced Drug Delivery Reviews (2021)

Early detection of cancer in order to facilitate timely therapeutic interventions is an unsolved problem in today's clinical diagnostics. Tumors are detected so far mostly after pathological symptoms have emerged (usually already in progressed disease states), within preventive screenings, or occasionally as incidental finding. The emergence of extracellular vesicle (EV) analytics in combination with liquid biopsy sampling opened a plethora of new possibilities for the detection of tumors (and other diseases). This review gives an overview of the diversity of currently known EV species and the relevant cargo molecules representing potential biomarkers to detect, identify and characterize tumor cells. A number of molecules reported in recent years to be valuable targets for different aspects of cancer diagnostics, are presented. Furthermore, we discuss (technical) challenges and pitfalls related to the various potential applications (screening, diagnosis, prognosis, monitoring) of liquid biopsy based EV analytics, and give an outlook to possible future directions of this emerging field in oncology.
Abstract 15929: Relationship Between Changes in Pericoronary Adipose Tissue Attenuation and Plaque Progression by Coronary CTA
Authors: Markus Goeller, Balaji K Tamarappoo, Alan C Kwan, Yuka Otaki, Sebastien Cadet, Frederic Commandeur, Piotr J Slomka, Xi Chen, Heidi Gransar, Moritz H Albrecht, Daniel S Berman, Mohamed Marwan, Stephan Achenbach, Damini Dey
Journal: Circulation (2018)

Introduction: By indirectly measuring adipocyte lipid content, pericoronary adipose tissue (PCAT) CT attenuation measured from CTA may be a new promising metric to identify coronary inflammation. H...
Functional trait effects on ecosystem stability: assembling the jigsaw puzzle
Authors: Francesco de Bello, Sandra Lavorel, Lauren M. Hallett, Enrique Valencia, Eric Garnier, Christiane Roscher, Luisa Conti, Thomas Galland, Marta Goberna, Maria Májeková, Alicia Montesinos-Navarro, Juli G. Pausas, Miguel Verdú, Anna E-Vojtkó, Lars Götzenberger, Jan Lepš
Journal: Trends in Ecology & Evolution (2021)
Neuropsychiatric Events in Systemic Lupus Erythematosus: Predictors of Occurrence and Resolution in a Longitudinal Analysis of an International Inception Cohort
Authors: John G. Hanly, Caroline Gordon, Sang‐Cheol Bae, Juanita Romero‐Diaz, Jorge Sanchez‐Guerrero, Sasha Bernatsky, Ann E. Clarke, Daniel J. Wallace, David A. Isenberg, Anisur Rahman, Joan T. Merrill, Paul R. Fortin, Dafna D. Gladman, Murray B. Urowitz, Ian N. Bruce, Michelle Petri, Ellen M. Ginzler, M. A. Dooley, Rosalind Ramsey‐Goldman, Susan Manzi, Andreas Jonsen, Graciela S. Alarcón, Ronald F. van Vollenhoven, Cynthia Aranow, Meggan Mackay, Guillermo Ruiz‐Irastorza, S. Sam Lim, Murat Inanc, Kenneth C. Kalunian, Soren Jacobsen, Christine A. Peschken, Diane L. Kamen, Anca Askanase, Vernon Farewell
Journal: Arthritis & Rheumatology (2021)

To determine predictors of change in neuropsychiatric (NP) event status in a large, prospective, international inception cohort of patients with systemic lupus erythematosus (SLE).Upon enrollment and annually thereafter, NP events attributed to SLE and non-SLE causes and physician-determined resolution were documented. Factors potentially associated with the onset and resolution of NP events were determined by time-to-event analysis using a multistate modeling structure.NP events occurred in 955 (52.3%) of 1,827 patients, and 593 (31.0%) of 1,910 unique events were attributed to SLE. For SLE-associated NP (SLE NP) events, multivariate analysis revealed a positive association with male sex (P = 0.028), concurrent non-SLE NP events excluding headache (P < 0.001), active SLE (P = 0.012), and glucocorticoid use (P = 0.008). There was a negative association with Asian race (P = 0.002), postsecondary education (P = 0.001), and treatment with immunosuppressive drugs (P = 0.019) or antimalarial drugs (P = 0.056). For non-SLE NP events excluding headache, there was a positive association with concurrent SLE NP events (P < 0.001) and a negative association with African race (P = 0.012) and Asian race (P < 0.001). NP events attributed to SLE had a higher resolution rate than non-SLE NP events, with the exception of headache, which had comparable resolution rates. For SLE NP events, multivariate analysis revealed that resolution was more common in patients of Asian race (P = 0.006) and for central/focal NP events (P < 0.001). For non-SLE NP events, resolution was more common in patients of African race (P = 0.017) and less common in patients who were older at SLE diagnosis (P < 0.001).In a large and long-term study of the occurrence and resolution of NP events in SLE, we identified subgroups with better and worse prognosis. The course of NP events differs greatly depending on their nature and attribution.
Association of Second-Opinion Strategies in the Histopathologic Diagnosis of Cutaneous Melanocytic Lesions With Diagnostic Accuracy and Population-Level Costs
Authors: Anna N. A. Tosteson, Stephanie Tapp, Linda J. Titus, Heidi D. Nelson, Gary M. Longton, Mackenzie Bronson, Margaret Pepe, Patricia A. Carney, Tracy Onega, Michael W. Piepkorn, Stevan R. Knezevich, Raymond Barnhill, Martin A. Weinstock, David E. Elder, Joann G. Elmore
Journal: JAMA Dermatology (2021)

Diagnostic variation among pathologists interpreting cutaneous melanocytic lesions could lead to suboptimal care. To estimate the potential association of second-opinion strategies in the histopathologic diagnosis of cutaneous melanocytic lesions with diagnostic accuracy and 1-year population-level costs in the US. Decision analysis with 1-year time horizon including melanocytic lesion diagnoses available from US pathologists participating in the Melanoma Pathology Study (M-Path) and from the study panel of reference pathologists who classified cases using the MPATH-Dx classification tool. M-Path data collection occurred from July 2013 through March 2015; analyses for the present study were performed between April 2015 and January 2021. Various second-opinion strategies for interpretation of melanocytic cutaneous lesions. Estimated accuracy of pathologists' diagnoses, defined as concordance with the reference panel diagnoses, and 1-year postbiopsy medical costs under various second-opinion strategies. Expected percentage of concordant diagnoses, including percentages of overinterpretation and underinterpretation, and 1-year costs of medical care per 100 000 in the US population. Decision-analytic model parameters were based on diagnostic interpretations for 240 cases by 187 pathologists compared with reference panel diagnoses. Without second opinions, 83.2% of diagnoses in the US were estimated to be accurate-ie, concordant with the reference diagnosis; with overinterpretation (8.0%) or underinterpretation (8.8%), and 16 850 misclassified diagnoses per 100 000 biopsies. Accuracy increased under all second-opinion strategies. Accuracy (87.4% concordance with 3.6% overinterpretation and 9.1% underinterpretation) and cost (an increase of more than $10 million per 100 000 biopsies per year) were highest when second opinions were universal (eg, performed on all biopsies), relative to no second opinions. A selective second-opinion strategy based on pathologists' desire or institutional requirements for a second opinion was most accurate (86.5% concordance; 4.4% overinterpretation; 9.1% underinterpretation) and would reduce costs by more than $1.9 million per 100 000 skin biopsies relative to no second opinions. Improvements in diagnostic accuracy with all second-opinion strategies were associated with reductions in overinterpretation but not underinterpretation. In this decision-analytic model, selective second-opinion strategies for interpretation of melanocytic skin lesions showed the potential to improve diagnostic accuracy and decrease costs relative to no second opinions or universal second opinions.
AB0218 NON MEDICAL SWITCH FROM ADALIMUMAB ORIGINATOR TO THE BIOSIMILAR GP2017 IN PATIENTS AFFECTED BY CHRONIC ARTHRITIS
Authors: M. Colaci, M. L. Aprile, A. La Rosa, A. DI Maggio, L. Malatino
Journal: Annals of the Rheumatic Diseases (2021)

Background: The non-medical switch (NMS) from originator drugs to biosimilars is a possible strategy adopted by rheumatologists in order to control the expansion of pharmaceutic costs for the treatment fo patients affected by chronic arthritis. To date, few real life data on the switch from adalimumab (ADA) originator to its biosimilars are available. Objectives: We aimed to evaluate efficacy and safety in a single-Centre cohort of patients affected by chronic arthritis who switched from ADA originator to the biosimilar GP2017. Methods: Patients affected by rheumatoid arthritis (RA), psoriatic arthritis (PA) and axial spondyloarthritis (axSpA) already on therapy with ADA originator in remission or low disease activity for at least 6 months were switched to GP2017 (March- June 2020). Data on disease activity (DAS28-PCR/CDAI/SDAI; DAPSA; BASDAI), eventual adverse events and causes of withdrawal of therapy were collected at 2, 4 and 6 months after the switch. Results: 88 patients were enrolled (M/F 36/52; mean age 55.8 ± 12 years; 25 RA, 32 PA, 31 axSpA, mean duration of therapy 6.3 ± 3.8 years). No statistically significant difference was observed in median DAS28-PCR/CDAI/SDAI values at the baseline and after 6 months [1.03 (0.96-3.43) vs. 1.21 (0-3.7) / 0 (0-15) vs. 0 (0-17) / 0 (0-15) vs. 0.5 (0-17.5)], DAPSA [0 (0-12.2) vs. 0 (0-15)] and BASDAI [0 (0-4.3) vs. 0 (0-6.4)]. The retention rate was 93.2%. 6/88 patients (6.8%) switched back to the originator. The causes of discontinuation were: disease reactivation in a single case (1.1%), subjective reasons/nocebo effect in 5/88 cases (5.7%), including: general malaise and transient increased of blood pressure (n.1), dizziness, paraesthesia, arthralgia, headache (n.1), itch sine materia (n.1) and subjective worsening without objective disease flare (n.2). Conclusion: This is the first real life study showing that the NMS from ADA originator to GP2017 represents a safe practice that maintains the efficacy of the current treatment. However, a few cases of switchback were described, mainly attributed to nocebo effect [1]. References: [1]Fleischmann R, Jairath V, Mysler E et al . Nonmedical Switching From Originators to Biosimilars: Does the Nocebo Effect Explain Treatment Failures and Adverse Events in Rheumatology and Gastroenterology? Rheumatol Ther 7: 35–64 (2020). Disclosure of Interests: None declared
Serum receptor activator of nuclear factor kappa‐Β ligand/osteoprotegerin ratio correlates with severity and suggests fracture's risk in older women with atopic dermatitis
Authors: Takashi Sakai, Nadine Herrmann, Laura Maintz, Tim Joachim Nümm, Thomas Welchowski, Thomas Bieber
Journal: Allergy (2021)

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
To Howard Bauchner, MD, Visionary Editor in Chief of <i>JAMA</i>—A Sincere Thank You and a Fond Farewell
Authors: Phil B. Fontanarosa, Annette Flanagin
Journal: JAMA (2021)

But most important, he brought to JAMA and the JAMA family of journals extraordinary vision and creativity, a commitment to absolute excellence, highest integrity and ethical principles, and an insatiable drive and unrelenting work ethic.The past 10 years of Howard Bauchner's leadership have represented unprecedented progress, growth, and innovation for JAMA and the JAMA Network of scientific publications.His diligence, perseverance, evidence-based approach, and keen instincts have led these journals to new levels of success that never seemed imaginable, except perhaps to him and his strategic "moon shots."During Howard Bauchner's tenure and guided by his leadership, the major accomplishments achieved, with the editors and editorial and publishing staff, have profoundly changed the stature, trajectory, and reach of JAMA and the JAMA Network Journals (see Box on next page).In addition, he has championed editor and staff development and pro-motions; generously offered professional, personal, and health care advice to countless many; and frequently reminded all: personal well-being and family first.As announced on June 1, 2021, Howard Bauchner has decided to step down from his role as Editor in Chief of JAMA and the JAMA Network effective June 30, 2021. 2 Even though this decision was undoubtedly difficult, it reflects his honor, his loyalty to the journals, and his commitment to and care for the JAMA Network editors and staff.He has always maintained that being Editor in Chief of JAMA and the JAMA Network is a position of honor and he has indicated he will miss the joy, exhilaration, and intellectual stimulation of being Editor, as well as the remarkable individuals he has worked with and met.Howard Bauchner, MD, JAMA's 16th Editor in Chief, has left an indelible legacy of progress, innovation, and excellence in medical journalism, as reflected by his accomplishments, and because of his vision and leadership, he has positioned JAMA and the JAMA Network Journals well for the challenges scientific publications will face in the future.For those reasons, and for so many more, the JAMA and JAMA Network editors and editorial staff express sincere gratitude and extend a fond farewell and very best wishes.
Equitable Access to Liver Transplant: Bridging the Gaps in the Social Determinants of Health
Authors: Russell Rosenblatt, Hannah Lee, AnnMarie Liapakis, Keri E. Lunsford, Andrew Scott, Pratima Sharma, Julius Wilder
Journal: Hepatology (2021)

The COVID-19 pandemic and social justice movement have highlighted the impact of social determinants of health (SDOH) and structural racism in the United States on both access to care and patient outcomes. With the evaluation for liver transplantation being a highly subjective process, there are multiple ways for SDOH to place vulnerable patients at a disadvantage. This policy corner focuses on three different methods to reverse the deleterious effects of SDOH-identify and reduce implicit bias, expand and optimize telemedicine, and improve community outreach.
Pulmonary immuno-thrombosis in COVID-19 ARDS pathogenesis
Authors: James S. O’Donnell, Flora Peyvandi, Ignacio Martin-Loeches
Journal: Intensive Care Medicine (2021)

Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) is responsible for coronavirus disease 2019
(COVID-19). Recent data highlight a pivotal role for pulmonary immuno-thrombosis in COVID-19 in the pathogenesis of severe COVID-19.
New Guideline Diagnosis of Fibrotic Hypersensitivity Pneumonitis in Idiopathic Pulmonary Fibrosis
Authors: Reoto Takei, Yasuhiko Yamano, Kensuke Kataoka, Toshiki Yokoyama, Toshiaki Matsuda, Tomoki Kimura, Mutsumi Ozasa, Junya Fukuoka, Takeshi Johkoh, Yasuhiro Kondoh
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

"New Guideline Diagnosis of Fibrotic Hypersensitivity Pneumonitis in Idiopathic Pulmonary Fibrosis." American Journal of Respiratory and Critical Care Medicine, 204(5), pp. 603–605