Iron deficiency anaemia in a stable chronic intestinal failure cohort: Prevalence, associations and outcomes.

Background & Aims: Current estimates of the prevalence of iron deficiency anaemia (IDA) in patients with chronic intestinal failure (CIF) exceed those seen in general population, however, the studies to-date are limited. The aim of this study was to determine the point prevalence of IDA in a large cohort of stable home parenteral nutrition (HPN) dependent adults managed by a specialist Intestinal Failure Unit.

Methods: This was a retrospective cohort study of HPN-dependent adults managed by a national UK IF Reference Centre between 01/01/2019 and 31/12/2019.

Development and validation of the Crohn's disease-intestinal failure-wean (CDIF-Wean) Score to predict outcomes of intestinal rehabilitation.

Background & Aims: Enteral autonomy, a key outcome of intestinal rehabilitation in patients with intestinal failure (IF), is challenging to predict due to disease complexity and heterogeneity. The aim of this cohort study is to develop and validate a multivariate model to predict enteral autonomy in patients with IF caused by Crohn's disease (CDIF), and to derive an outcome-based severity classification for CDIF.

Methods: The CDIF-Wean Score was constructed and internally validated in a cohort of 182 patients with CDIF from a tertiary IF unit.

Prediction of chronic severe intestinal failure-associated liver disease by current criteria in adults: A descriptive cohort study.

Introduction: Intestinal failure-associated liver disease covers a spectrum of conditions from mild to end-stage disease. Currently, there are 9 diagnostic criteria divided to four categories: cholestasis, steatosis, fibrosis, and unclassified. Our aim was to evaluate the application of these criteria to patients with chronic severe liver disease in patients with intestinal failure.

Defining gene ends: RNA polymerase II CTD threonine 4 phosphorylation marks transcription termination regions genome-wide.

Defining the beginning of a eukaryotic protein-coding gene is relatively simple. It corresponds to the first ribonucleotide incorporated by RNA polymerase II (Pol II) into the nascent RNA molecule. This nucleotide is protected by capping and maintained in the mature messenger RNA (mRNA).

Chyme reinfusion therapy in adults with severe acute intestinal failure: A descriptive cohort study.

Background: Chyme reinfusion therapy treats patients with high-output fistulas or stomas by returning chyme to the distal gut. The role of this treatment in severe acute intestinal failure is currently unclear. The primary outcome of this study was a successful establishment of chyme reinfusion therapy, defined by the ability to replace parenteral nutrition for nutrition support.

Multi-chamber parenteral nutrition (PN) bags are safe and cost-effective in replacing compounded PN regimens in hospitalised patients.

Background & Aims: There is varied international practice in the use of ready-made multi-chamber bags (MCBs) and compounded parenteral nutrition (PN). Recent national aseptic pharmacy capacity limitations have restricted compounded PN production so we aimed to explore outcomes associated with the increased use of MCB vs compounded regimens during a period of change in PN supplies.

Methods: This was a point prevalence study conducted over two time periods, Period 1: 01.

Disease Recurrence and Long-term Outcomes Following the Development of Intestinal Failure in Crohn's Disease: Over 20 Years of Experience from a National Reference Centre.

Background And Aims: Intestinal failure [IF] is a recognised complication of Crohn's disease [CD]. The aim of this study was to identify factors predicting the development and recurrence of CD in patients with IF [CD-IF], and their long-term outcomes.

Methods: This was a cohort study of adults with CD-IF admitted to a national UK IF reference centre between 2000 and 2021.

Standardised survival and excess Life Years Lost in patients with type 3 intestinal failure.

Background & Aims: Long term outcomes have been reported in home parenteral nutrition (HPN)-dependent patients with type 3 intestinal failure (IF), but there are limited survival data standardised to the general population that would help provide a meaningful prognosis for patients and clinicians. The primary aim of this study was therefore to investigate the survival of HPN-dependent patients and to evaluate the specific impact of type 3 IF on their life expectancy standardised to that of the general population.

Methods: This was a cohort study of adult patients initiated on HPN between 1978 and 2018 at a national UK IF reference centre and followed up until death or censoring date of 31st December 2020.

Barrett's oesophagus with indefinite for dysplasia shows high rates of prevalent and incident neoplasia in a UK multicentre cohort.

Aims: Barrett's oesophagus with indefinite for dysplasia (IDD) carries a risk of prevalent and incident dysplasia and oesophageal adenocarcinoma. This study seeks to determine the risk of neoplasia in a multicentre prospective IDD cohort, along with determining adherence to British Society of Gastroenterology (BSG) guidelines for management and histology reporting.

Methods: This was a cohort study using prospectively collected data from pathology databases from two centres in the North West of England (UK).

Long-term survival following fungal catheter-related bloodstream infection for patients with intestinal failure receiving home parenteral support.

Background: A fungal-related catheter-related bloodstream infection (CRBSI) is less frequent than those induced by bacteria. In the past, a single episode of fungal CRBSI has been used as a marker of home parenteral nutrition (HPN) failure and thus a possible indication for intestinal transplantation.

Methods: Survival outcomes were assessed from a prospectively maintained database of patients initiated on HPN for underlying chronic intestinal failure between 1993 and 2018, with a censoring date of December 31, 2020.

Home Parenteral Nutrition in Patients with Advanced Cancer: Quality Outcomes from a Centralized Model of Care Delivery.

Lack of expertise in home parenteral nutrition (HPN) management has been reported as a barrier to its initiation in patients with advanced cancer (AC), and there are limited data describing hospital readmissions and HPN-related complications. We aimed to assess a centralized approach for managing HPN in AC and evaluate associated outcomes, including hospital readmissions and HPN-related complications. This was a cohort study of adults with AC requiring palliative HPN between 2010-2018 at a tertiary intestinal failure (IF) center, primarily utilizing a centralized model of HPN oversight to discharge patients remotely from an oncology center to their homes over a wide geographic area.

Hybrid model of compounded and multichamber bag parenteral nutrition for adults with chronic intestinal failure.

Background: Although international guidelines support the use of commercially available multichamber bags (MCBs), the majority of home parenteral nutrition (HPN) in the United Kingdom has been compounded PN, tailored to the patient. However, national capacity limitations in aseptic facilities have necessitated the increased use of MCBs. There are no studies evaluating the appropriateness or benefits of using a "hybrid" regimen incorporating both MCBs and compounded PN in patients already established on compounded HPN.

CLP1-dependent premature transcription termination opposes neurodegeneration.

Usage of alternative mRNA 3' ends has profound functional consequences, particularly in the nervous system. In this issue of Neuron, LaForce et al. (2022) dissect the effect of CLP1 on mRNA 3' end diversity in motor neuron models of neurodegeneration.

Long-Term Outcomes in Patients with Intestinal Failure Due to Short Bowel Syndrome and Intestinal Fistula.

Short bowel syndrome (SBS) and enterocutaneous or enteroatmospheric fistulas are common indications for home parenteral nutrition (HPN). However, there are few data describing factors influencing surgical decision-making or outcomes particularly following fistula development. We aimed to compare outcomes between patients with SBS and fistulas and explore surgical decision-making.

Sepsis outcomes in patients with pre-existing liver disease.

Aim Of The Study: To determine the characteristics, including the use of various diagnostic criteria, outcomes and treatment strategies in septic patients treated outside of the critical care area with pre-existing liver disease (LD).

Material And Methods: The study population included patients recruited into two annual 24-hour prospective point-prevalence studies on the general wards and emergency departments across all Welsh acute hospitals in 2016 and 2017. Data were collected on patient demographics, observations and SIRS, SOFA and qSOFA scores.

Vitamin D repletion in primary hyperparathyroid patients undergoing parathyroidectomy leads to reduced symptomatic hypocalcaemia and reduced length of stay: a retrospective cohort study.

Introduction: Vitamin D deficiency co-exists with and can confuse the diagnosis of primary hyperparathyroidism (PHPT). Vitamin D replete (VDR) status may prevent significant postparathyroidectomy hypocalcaemia; however, reports from previous studies are conflicting. This study aimed to assess differences in early and/or late postoperative hypocalcaemia and length of stay (LOS) postparathyroidectomy between VDR and vitamin D non-replete (VDNR) PHPT patients.

The Use of Different Sepsis Risk Stratification Tools on the Wards and in Emergency Departments Uncovers Different Mortality Risks: Results of the Three Welsh National Multicenter Point-Prevalence Studies.

Objectives: To compare the performance of Sequential Organ Failure Assessment, systemic inflammatory response syndrome, Red Flag Sepsis, and National Institute of Clinical Excellence sepsis risk stratification tools in the identification of patients at greatest risk of mortality from sepsis in nonintensive care environments.

Design: Secondary analysis of three annual 24-hour point-prevalence study periods.

Setting: The general wards and emergency departments of 14 acute hospitals across Wales.

Four consecutive yearly point-prevalence studies in Wales indicate lack of improvement in sepsis care on the wards.

The 'Sepsis Six' bundle was promoted as a deliverable tool outside of the critical care settings, but there is very little data available on the progress and change of sepsis care outside the critical care environment in the UK. Our aim was to compare the yearly prevalence, outcome and the Sepsis Six bundle compliance in patients at risk of mortality from sepsis in non-intensive care environments. Patients with a National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled into four yearly 24-h point prevalence studies, carried out in fourteen hospitals across Wales from 2016 to 2019.

Body composition in patients with type 2 intestinal failure.

Background: Measurement of body composition is a valuable clinical tool for nutrition assessments, but there are no data on the merits of assessment modalities in type 2 intestinal failure (IF). The aim of this study was to evaluate the prevalence of low muscle mass and quality in type 2 IF, comparing bioelectric impedance analysis (BIA) and computed tomography (CT) at the third lumbar vertebra level.

Methods: Patients admitted with acute severe (type 2) IF to a national UK IF center who had BIA measurement and CT scan as part of routine care within 40 days of anthropometric measurement were included in this cross-sectional study.

Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study.

Background: We aimed to identify the prevalence of acute hypoxaemic respiratory failure (AHRF) in the intensive care unit (ICU) and its associated mortality. The secondary aim was to describe ventilatory management as well as the use of rescue therapies.

Methods: Multi-centre prospective study in nine hospitals in Wales, UK, over 2-month periods.

Diagnostics of Mutations in MMR/ Genes and Their Role in the Treatment and Care of Patients with Lynch Syndrome.

Lynch syndrome (LS), also known as hereditary nonpolyposis colorectal cancer (HNPCC), is a disorder caused by an autosomal dominant heterozygous germline mutation in one of the DNA mismatch repair (MMR) genes. Individuals with LS are at an increased risk of developing colorectal and extracolonic cancers, such as endometrial, small bowel, or ovarian. In this review, the mutations involved with LS and their diagnostic methods are described and compared, as are their current uses in clinical decision making.

PRINS lncRNA Is a New Biomarker Candidate for HPV Infection and Prognosis of Head and Neck Squamous Cell Carcinomas.

Numerous studies have shown that human papillomavirus (HPV) infection is one of the important risk factors for head and neck squamous cell carcinoma (HNSCC) progression and affects the expression of multiple genes, which might serve as new biomarkers. This study examines the effects of HPV infection on long non-coding RNA (lncRNA) expression and the immune system, particularly PRINS (Psoriasis susceptibility-related RNA Gene Induced by Stress). The Cancer Genome Atlas (TCGA) expression data for lncRNA genes and clinical data were analyzed by GraphPad Prism 5/7.

Liquid lncRNA Biopsy for the Evaluation of Locally Advanced and Metastatic Squamous Cell Carcinomas of the Head and Neck.

Long non-coding RNA (lncRNA) are RNA molecules that are more than 200 nucleotides long and have the ability to modify the activity of genes. They can be found in both healthy and cancer tissues, as well as in plasma, saliva and other bodily fluids. They can also be used as biomarkers of early detection, prognosis and chemotherapy resistance in several cancer types.