A longitudinal single-cell atlas of anti-tumour necrosis factor treatment in inflammatory bowel disease.

Precision medicine in immune-mediated inflammatory diseases (IMIDs) requires a cellular understanding of treatment response. We describe a therapeutic atlas for Crohn's disease (CD) and ulcerative colitis (UC) following adalimumab, an anti-tumour necrosis factor (anti-TNF) treatment. We generated ~1 million single-cell transcriptomes, organised into 109 cell states, from 216 gut biopsies (41 subjects), revealing disease-specific differences.

FIT negative clinic as a safety net for low-risk patients with colorectal cancer: impact on endoscopy and radiology utilisation-a retrospective cohort study.

Background: Faecal immunochemical testing (FIT) is recommended by the National Institute for Health and Care Excellence to triage symptomatic primary care patients who have unexplained symptoms but do not meet the criteria for a suspected lower gastrointestinal cancer pathway. During the COVID-19 pandemic, FIT was used to triage patients referred with urgent 2-week wait (2ww) cancer referrals instead of a direct-to-test strategy. FIT-negative patients were assessed and safety netted in a FIT negative clinic.

Why Studying Urgency Is Urgent.

Bowel urgency, the sudden and immediate need to have a bowel movement, is one of the most widely reported and debilitating symptoms of ulcerative colitis. Urgency has a profound impact on patient well-being, often resulting in patient disengagement from education, employment, and social activities. Although its prevalence correlates with disease activity, it is present in states of both disease flare and remission.

Update on the management of multiple sclerosis during the COVID-19 pandemic and post pandemic: An international consensus statement.

In this consensus statement, we provide updated recommendations on multiple sclerosis (MS) management during the COVID-19 crisis and the post-pandemic period applicable to neurology services around the world. Statements/recommendations were generated based on available literature and the experience of 13 MS expert panelists using a modified Delphi approach online. The statements/recommendations give advice regarding implementation of telemedicine; use of disease-modifying therapies and management of MS relapses; management of people with MS at highest risk from COVID-19; management of radiological monitoring; use of remote pharmacovigilance; impact on MS research; implications for lowest income settings, and other key issues.

Estimated and projected burden of multiple sclerosis attributable to smoking and childhood and adolescent high body-mass index: a comparative risk assessment.

Background: Smoking and childhood and adolescent high body-mass index (BMI) are leading lifestyle-related risk factors of global premature morbidity and mortality, and have been associated with an increased risk of developing multiple sclerosis (MS). This study aims to estimate and project the proportion of MS incidence that could be prevented with elimination of these risk factors.

Methods: Prevalence estimates of high BMI during childhood/adolescence and smoking in early adulthood, and relative risks of MS, were obtained from published literature.

Epidemiology of Epstein-Barr virus infection and infectious mononucleosis in the United Kingdom.

Background: Epstein-Barr Virus (EBV) is a ubiquitous gamma-herpesvirus with which ~ 95% of the healthy population is infected. EBV infection has been implicated in a range of haematological malignancies and autoimmune diseases. Delayed primary EBV infection increases the risk of subsequent complications.

Effect of different financial competing interest statements on readers' perceptions of clinical educational articles: a randomised controlled trial.

Objectives: To investigate how different competing interest (COI) statements affect clinical readers' perceptions of education articles.

Design: Randomised controlled trial.

Setting And Participants: Random sample of UK doctors.

Association between diabetes and subsequent Parkinson disease: A record-linkage cohort study.

Objective: To investigate the association between type 2 diabetes mellitus (T2DM) and subsequent Parkinson disease (PD).

Methods: Linked English national Hospital Episode Statistics and mortality data (1999-2011) were used to conduct a retrospective cohort study. A cohort of individuals admitted for hospital care with a coded diagnosis of T2DM was constructed, and compared to a reference cohort.

Associations between clinically diagnosed testicular hypofunction and systemic lupus erythematosus: a record linkage study.

Systemic lupus erythematosus (SLE) has a high female predominance with a 9:1 female-to-male sex ratio, but males have poorer clinical outcomes than females. Gonadal hormones may mediate gender differences in SLE, but their role in SLE remains largely uncharacterised. We aimed to investigate a potential association between testicular hypofunction (TH), as a proxy for low testosterone levels, and SLE in males.

Psychiatric disorders in children with demyelinating diseases of the central nervous system.

Introduction: The profile of psychiatric disorders associated with multiple sclerosis (MS) may differ in children. We aimed to assess the risk of psychiatric disorders in children with MS and other demyelinating diseases, and vice versa.

Patients And Methods: We analyzed linked English Hospital Episode Statistics, and mortality data, 1999-2011.

Dietary factors and pediatric multiple sclerosis: A case-control study.

Background: The role of diet in multiple sclerosis (MS) is largely uncharacterized, particularly as it pertains to pediatric-onset disease.

Objective: To determine the association between dietary factors and MS in children.

Methods: Pediatric MS patients and controls were recruited from 16 US centers (MS or clinically isolated syndrome onset before age 18, <4 years from symptom onset and at least 2 silent lesions on magnetic resonance imaging).

Maternal and perinatal characteristics of infants who, later in life, developed multiple sclerosis: Record-linkage study.

Background: Pre-natal and early life factors may have a role in multiple sclerosis (MS) pathogenesis in some people. However, the reporting of any influence of maternal and perinatal factors on MS risk has been limited. We aimed to study maternal and perinatal characteristics of babies who went on to develop MS.

Viral hepatitis and Parkinson disease: A national record-linkage study.

Objective: To study associations between viral hepatitis and Parkinson disease (PD).

Methods: A retrospective cohort study was done by analyzing linked English National Hospital Episode Statistics and mortality data (1999-2011). Cohorts of individuals with hepatitis B, hepatitis C, autoimmune hepatitis, chronic active hepatitis, and HIV were constructed, and compared to a reference cohort for subsequent rates of PD.

Perinatal characteristics and obstetric complications in mothers with multiple sclerosis: Record-linkage study.

Background: Multiple sclerosis (MS) predominantly onsets in women of reproductive age. The possibility of adverse obstetric and perinatal outcomes is a likely source of concern to pregnant women with MS and their clinicians. We aimed to compare the characteristics of the pregnancies of mothers with or without MS.

Effect of different financial competing interest statements on readers' perceptions of clinical educational articles: study protocol for a randomised controlled trial.

Introduction: Financial ties with industry are varied and common among academics, doctors and institutions. Clinical educational articles are intended to guide patient care and convey authors' own interpretation of selected data. Author biases in educational articles tend to be less visible to readers compared to those in research papers.

Gender identity disorders and multiple sclerosis risk: A national record-linkage study.

Background: An altered balance of gonadal hormones in males with gender identity disorders (GIDs) may increase multiple sclerosis (MS) risk both inherently and secondary to treatment in undergoing male-to-female conversion.

Objective: We investigated any association between GIDs and MS through analysis of record-linked hospital statistics.

Method: Analysis of English Hospital Episode Statistics, 1999-2012.

No evidence for higher risk of cancer in patients with multiple sclerosis taking cladribine.

Objective: To compare the cancer risk of cladribine and other disease-modifying drugs (DMDs) in trials of people with relapsing multiple sclerosis (pwRMS).

Methods: Meta-analysis of phase III trials of licensed DMDs for pwRMS and a phase III trial of cladribine (CLARITY). Cancer rates were compared using Fisher exact test.

Funding source and primary outcome changes in clinical trials registered on ClinicalTrials.gov are associated with the reporting of a statistically significant primary outcome: a cross-sectional study.

Background: We and others have shown a significant proportion of interventional trials registered on ClinicalTrials.gov have their primary outcomes altered after the listed study start and completion dates. The objectives of this study were to investigate whether changes made to primary outcomes are associated with the likelihood of reporting a statistically significant primary outcome on ClinicalTrials.

Clinical associations between gout and multiple sclerosis, Parkinson's disease and motor neuron disease: record-linkage studies.

Background: Uric acid has antioxidant effects on neurons. Abnormally high levels of uric acid are, however, associated with gout. Previous studies have suggested that high levels of uric acid (and the presence of gout) may exert a protective effect against the risk of developing some neurological diseases.