Definite synovitis was present in the majority of knees with or without effusion with the commonest sites being posterior to the PCL and in the suprapatellar recess. Joint effusion as measured on PD fs images does not only represent effusion but also synovial thickening.

This study demonstrates that C pneumoniae can frequently be detected in atheromatous plaques in coronary arteries. However, its distribution did not correlate with severity or extent of disease.

Cross sectional studies cannot determine whether C. pneumoniae is a cause of atherosclerosis since they do not show whether infection precedes or follows its development. However, our results suggest that the organism is not an important factor in graft failure or atherosclerosis.

Background: The objectives were to assess the excess deaths among Nursing Home (NH) residents during the first wave of the COVID-19 pandemic, to determine their part in the total excess deaths and whether there was a mortality displacement. Methods: We studied a cohort of 494,753 adults in 6,515 NHs in France exposed to COVID-19 pandemic (from March 1st to May 31st, 2020) and compared with the 2014–2019 cohorts using data from the French National Health Data System. The main outcome was death. Excess deaths and standardized mortality ratios (SMRs) were estimated. Result: There were 13,505 excess deaths. Mortality increased by 43% (SMR: 1.43). The mortality excess was higher among males than females (SMR: 1.51 and 1.38) and decreased with increasing age (SMRs in females: 1.61 in the 60–74 age group, 1.58 for 75–84, 1.41 for 85–94, and 1.31 for 95 or over; Males: SMRs: 1.59 for 60–74, 1.69 for 75–84, 1.47 for 85–94, and 1.41 for 95 or over). No mortality displacement effect was observed up until August 30th,2020. By extrapolating to all NH residents nationally (N = 570,003), we estimated that they accounted for 51% of the general population excess deaths (N = 15,114 out of 29,563). Conclusion: NH residents accounted for half of the total excess deaths in France during the first wave of the COVID-19 pandemic. The excess death rate was higher among males than females and among younger than older residents.

ImportanceNursing home (NH) residents are particularly vulnerable to SARS-CoV-2 infections and coronavirus disease 2019 (COVID-19) lethality. However, excess deaths in this population have rarely been documented.ObjectivesThe primary objective was to assess the number of excess deaths among NH residents during the first wave of the COVID-19 pandemic in France. The secondary objectives were to determine the number of excess deaths as a proportion of the total excess deaths in the general population and determine whether a harvesting effect was present.DesignWe studied a cohort of 494,753 adults (as of March 1st, 2020) aged 60 and over in 6,515 NHs in mainland France. This cohort was exposed to the first wave of the COVID-19 pandemic (from March 1st to May 31st, 2020) and was compared with the corresponding, reference cohorts from 2014 to 2019 (using data from the French National Health Data System).Main outcome and measuresThe main outcome was all-cause death. Weekly excess deaths and standardized mortality ratios (SMRs) were estimated.ResultThere were 13,505 excess deaths among NH residents. Mortality increased by 43% (SMR: 1.43). The mortality excess was higher among males than among females (SMR: 1.51 and 1.38, respectively) and decreased with age (SMRs in females: 1.61 in the 60-74 age group, 1.58 for 75-84, 1.41 for 85-94, and 1.31 for 95 or over; Males: SMRs: 1.59 for 60-74, 1.69 for 75-84, 1.47 for 85-94, and 1.41 for 95 or over). We did not observe a harvesting effect (up until August 30th, 2020). By extrapolating to all NH residents nationally (N=570,003), the latter accounted for 51% of the total excess deaths in the general population (N=15,114 out of 29,563).ConclusionNH residents accounted for about half of the total excess deaths in France during the first wave of the COVID-19 pandemic. The excess death rate was higher among males than females and among younger residents than among older residents. We did not observe a harvesting effect. A real-time mortality surveillance system and the identification of individual and environmental risk factors might help to design the future model of care for older dependent adults.Key pointsDuring the first wave of the COVID-19 pandemic in France, the mortality among nursing home residents increased by 43%.Nursing home residents accounted for 51% of the total excess deaths in France.The excess mortality was higher among younger residents than among older residents.The excess mortality was higher among males than among females.We did not observe a harvesting effect during the study period (ending on August 30th, 2020, i.e., three months after the end of the first wave).

Introduction: A minority of patients (pts) with advanced melanoma achieve long-term survival with immunotherapy and those who relapse following immune checkpoint inhibition (ICI) or BRAFi have limited treatment options. The intrinsic anti-tumor activity and broad neoantigen-specific TCR repertoire of unselected autologous TIL may provide advantages over other treatments in solid tumors, including ICI-refractory melanoma. Methods: This is a retrospective analysis of a single-center experience of TIL for treatment of advanced cutaneous melanoma. Unselected autologous young TIL derived from digested tumor tissue were manufactured under a MHRA Manufacturing Specials license. Pts with advanced cutaneous melanoma and no other treatment options received non-myeloablative lymphodepleting chemotherapy (cyclophosphamide 60 mg/kg/d x 2d, fludarabine 25 mg/m2/d x 5 d [Cy/Flu]), followed by TIL infusion and post-TIL high-dose (HD) IL-2 (600,000-720,000 IU/Kg) on a compassionate use basis. Efficacy for 15 imaging-evaluable pts was reported by investigator assessment of CT/MRI per RECIST 1.1; 6 additional pts were followed using non-RECIST 1.1 imaging (PET) and clinical monitoring. Clinically significant adverse events (AEs) with onset post-TIL infusion were reported for all treated pts. Data cutoff date: 31-DEC-2019. Results: Between OCT-2011 and AUG-2019, 21 pts with advanced cutaneous melanoma were treated with Cy/Flu, TIL (median 31.9 x109 cells infused), and HD IL-2 (median 8 doses). All had high-risk metastatic disease (median 4 sites, stage IV M1d [38%]), an average of 3 prior therapies (any ICI [91%], PD-1 [57%], BRAFi [52%], and MEKi [24%]). With a median follow up of 52.2 mos, the response rate in imaging-evaluable pts (n=15) was 53% with a CR rate of 13%; DCR was 73% including 3 (20%) pts with stable disease. Additional durable responses were observed in the 6 pts followed by PET and clinical monitoring. Responses were generally consistent across subgroups including age, number of disease sites, tumor burden, brain metastases, number of prior lines of therapies, prior PD-1 blockade, prior BRAFi, and prior MEKi. For all treated pts, the median survival was 21.3 mos. Toxicity was generally self-limited and consistent with Cy/Flu and HD IL-2. Common AEs (≥20%, any grade) were thrombocytopenia (62%), pyrexia (57%), rigors (43%), neutropenia (29%), tachycardia (29%), pulmonary edema (24%), and vascular leak (24%); no treatment-related deaths were observed. Conclusion: The high response rate observed in this series exceeds the 41% ORR estimated for TIL in advanced cutaneous melanoma (meta-analysis by Dafni et al. Ann Oncol., 2019) and highlights the successful bench-to-bedside application of unselected autologous TIL to address unmet medical need in advanced melanoma. Use of tumor digests as starting material for manufacturing of TIL demonstrates feasibility of this approach. A multicenter Phase 2 trial of this therapy in advanced melanoma is planned for 2021. Citation Format: Robert E. Hawkins, Yizhou Jiang, Paul C. Lorigan, Fiona C. Thistlethwaite, Manon Pillai, Martine Thomas, Natalia Kirilova, John S. Bridgeman, Gray Kueberuwa, Ryan S. Guest, Zachary J. Roberts. Clinical Feasibility and Treatment Outcomes with Unselected Autologous Tumor Infiltrating Lymphocyte Therapy in Patients with Advanced Cutaneous Melanoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB150.

Conclusion Birthweight has a U-shaped relationship with obesity in middle age. This relationship tends towards being J-shaped after adjustment for adult height. Objective Incidence of type 2 diabetes mellitus (T2DM) in the UK has increased by two-thirds in the last decade. Understanding the reasons for the unfavourable trend may help inform efforts to curb future increases. The association between T2DM and adiposity has been established. However, few attempts have been made to quantify the contribution of adiposity changes to the observed time trend in T2DM. We estimated the proportion of the time trend in T2DM incidence in British men over 24 years that may be explained by increasing population body mass index (BMI) levels. Design Longitudinal study. Setting 24 British towns. Participants 6460 men from a socially and geographically representative cohort of older British men, followed up for doctor-diagnosed T2DM incidence between 1984 (aged 45 to 65 years) and 2007 (aged 67 to 89 years) inclusive. Men with a diagnosis of diabetes before 1984 were excluded. Main outcome measures The age-adjusted increase in the hazard of T2DM between 1984 and 2007 and the contribution of changing BMI to this increase, derived from Cox proportional hazards modelling with time-updated covariates. Results Between the periods 1984e1992 and 1999e2007, the ageadjusted hazard of T2DM more than doubled (hazard ratio 2.33, 95% CI 1.75 to 3.10). An estimated 26% (95% CI 17 to 38) of this hazard increase could be statistically explained by a populationaveraged age-adjusted increase in BMI from 1984 to 1999 of 1.42 kg/ m 2 (95% CI 1.10 to 1.74). Earlier and later portions of the follow-up were examined separately. Between 1984e1992 and 1992e1999, T2DM incidence increased by half (hazard ratio 1.59, 95% CI 1.23 to 2.05). 22% (95% CI 12 to 48) of this increase could be explained by rising BMI. Between 1992e1999 and 1999e2007, a similar increase in T2DM incidence was observed (hazard ratio 1.47, 95% CI 1.17 to 1.84). 31% (95% CI 17 to 81) of this increase was explained by BMI. Conclusion BMI changes can account for an appreciable portion of the increase in T2DM. Control and reversal of rising adiposity levels is therefore an important priority in controlling the diabetes epidemic. There remained a large "unexplained" portion of the T2DM increase. This may reflect imprecision of BMI as a measure of visceral fat or the independent contributions of changes in other determinants, such as physical activity and diet. The presence of other contributing factors would suggest the need for a more multifactorial approach to combat rising T2DM in the population. Objective To compare changes in BMI and waist circumference in the past 30 years among English children aged 11e16 years. 047 IS THE RECENT RISE IN TYPE 2 DIABETES MELLITUS 048Design Cross-sectional health examination surveys. Setting The Health Survey for England (HSE) is a survey of a random sample of the general population living in private households in England. Participants A new, nationally ...

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