An international genome-wide meta-analysis of primary biliary cholangitis: Novel risk loci and candidate drugs.

Backgrounds & Aims: Primary biliary cholangitis (PBC) is a chronic liver disease in which autoimmune destruction of the small intrahepatic bile ducts eventually leads to cirrhosis. Many patients have inadequate response to licensed medications, motivating the search for novel therapies. Previous genome-wide association studies (GWAS) and meta-analyses (GWMA) of PBC have identified numerous risk loci for this condition, providing insight into its aetiology.

Gonadectomy in conditions affecting sex development: a registry-based cohort study.

Objectives: To determine trends in clinical practice for individuals with DSD requiring gonadectomy.

Design: Retrospective cohort study.

Methods: Information regarding age at gonadectomy according to diagnosis; reported sex; time of presentation to specialist centre; and location of centre from cases reported to the International DSD Registry and who were over 16 years old in January 2019.

X Chromosome Contribution to the Genetic Architecture of Primary Biliary Cholangitis.

Background & Aims: Genome-wide association studies in primary biliary cholangitis (PBC) have failed to find X chromosome (chrX) variants associated with the disease. Here, we specifically explore the chrX contribution to PBC, a sexually dimorphic complex autoimmune disease.

Methods: We performed a chrX-wide association study, including genotype data from 5 genome-wide association studies (from Italy, United Kingdom, Canada, China, and Japan; 5244 case patients and 11,875 control individuals).

A Prospective Observational Study Assessing the Relationship Between Solitary Thyroid Nodule Size and Incidence of Malignancy.

Background Solitary thyroid nodule (STN) is a well-documented entity. Autopsy data indicate a 50% prevalence of thyroid nodules >10 mm in patients without clinical evidence of thyroid disease. Prevalence of palpable nodules is 4-7%.

Rheumatoid arthritis related interstitial lung disease - improving outcomes over 25 years: a large multicentre UK study.

Objective: This study explores whether the prognosis of interstitial lung disease in rheumatoid arthritis (RA-ILD) has improved over time and assesses the potential influence of drug therapy in a large multicentre UK network.

Methods: We analysed data from 18 UK centres on patients meeting criteria for both RA and ILD diagnosed over a 25-year period. Data included age, disease duration, outcome and cause of death.

Shingles (Herpes Zoster) Mimicking Acute Abdomen.

Shingles is a very well-known viral infection caused by the varicella-zoster virus leading to painful skin rash. Although shingles can occur anywhere, it most often appears as a single stripe of blisters around the hypochondriac region. We are presenting a rare atypical presentation of shingles, as our patient presented with a picture of the acute abdomen a couple of days prior to the eruption of skin lesions.

Artificial Intelligence in Various Medical Fields With Emphasis on Radiology: Statistical Evaluation of the Literature.

Background Artificial intelligence (AI) has significantly impacted numerous medical specialties with high emphasis on radiology. Associated novel diagnostic methods have become a rapidly emerging hot topic, and it is essential to provide insights into quantitative analysis of the growing literature. Purpose The purpose of this study is to highlight future academic trends, identify potential research gaps, and analyze scientific landscape of AI in the field of medicine.

Characteristics of Chest CT Images in Patients With COVID-19 Pneumonia in London, UK.

Background and objective Novel coronavirus 2019 (COVID-19) outbreak was first reported in Wuhan, Hubei Province in China in December 2019; it has then spread quickly and exponentially beyond the Chinese borders and is now regarded as a global pandemic. We aimed to evaluate the chest CT radiological characteristics and lesion distribution patterns in patients of COVID-19 pneumonia in London, UK. Methods We performed a retrospective study and reviewed data of patients with clinically suspected COVID-19 who underwent chest CT between February 1 and May 5, 2020.

A challenging case of a chyle leak following axillary lymph node clearance.

Chyle leak following axillary lymph node clearance is a rarely reported complication. We present a case of chylous leakage following axillary lymph node clearance, which was diagnosed on clinical grounds. Surgical re-exploration was undertaken due to ongoing high output.

Postoperative critical care and high-acuity care provision in the United Kingdom, Australia, and New Zealand.

Background: Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional 'high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment.

Methods: We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ.

Artificial intelligence in radiology: friend or foe? Where are we now and where are we heading?

The use of artificial intelligence (AI) has been rapidly progressing in medicine, particularly in radiology. AI has also been the source of great innovation and a prominent topic of discussion within radiology societies and ground-breaking research in recent years. Despite the risks and quality assurance issues involved in AI, it offers tremendous opportunities for changing how radiological services are delivered.

Predicting responses in patients with rheumatoid arthritis to disease-modifying agents using baseline clinical data.

Objectives: The optimal treatment for active rheumatoid arthritis (RA) is unresolved, particularly in early RA. We used data from an observational cohort to develop the simple predictor algorithm and evaluated its application in two completed clinical trials in early and established RA. We assessed whether using a simple algorithm can identify patients who have persisting active disease despite treatment with disease-modifying drugs (DMARDs).

Can Rheumatologists Predict Eventual Need for Orthopaedic Intervention in Patients with Rheumatoid Arthritis? Results of a Systematic Review and Analysis of Two UK Inception Cohorts.

Purpose Of Review: The structural damage caused by rheumatoid arthritis (RA) can often be mitigated by orthopaedic surgery in late disease. This study evaluates the value of predictive factors for orthopaedic intervention.

Methods: A systematic review of literature was undertaken to identify papers describing predictive factors for orthopaedic surgery in RA.

Achieving consensus on minimum data items (including core outcome domains) for a longitudinal observational cohort study in rheumatoid arthritis.

Objectives: To obtain consensus on the minimum data items for an observational cohort study in RA in the UK and to make available the process for similar studies and other rheumatic conditions.

Methods: Individuals with a diverse range of expertise and backgrounds were invited to participate in a process of proposing a minimum core dataset (MCD) for research studies, commissioned by Arthritis Research UK as part of the larger INBANK project. The group included patients and representatives from clinical and academic rheumatology, outcomes science, stratified medicine, health economics, and national professional and academic bodies/committees.

HLA-DRB1 Amino Acid Positions 11/13, 71, and 74 Are Associated With Inflammation Level, Disease Activity, and the Health Assessment Questionnaire Score in Patients With Inflammatory Polyarthritis.

Objective: Rheumatoid arthritis (RA) susceptibility HLA-DRB1 haplotypes based on amino acid positions 11/13, 71, and 74 predict radiographic damage. The mechanism of action is unknown, but it may be mediated by inflammation. We undertook this study to systematically investigate the effect of these amino acids on nonradiographic measures of disease activity/outcomes.

Secular Changes in Clinical Features at Presentation of Rheumatoid Arthritis: Increase in Comorbidity But Improved Inflammatory States.

Objective: To examine secular trends in demographics, clinical manifestations, and comorbidity on first presentation of rheumatoid arthritis (RA) prior to disease-modifying antirheumatic drug treatment.

Methods: A total of 2,701 patients were recruited over 25 years to 2 UK-based RA inception cohorts: the Early Rheumatoid Arthritis Study (9 centers; 1986-2001) and the Early Rheumatoid Arthritis Network (23 centers; 2002-2012). Trends in demographic and baseline clinical/laboratory and radiographic variables and comorbidities were estimated using mixed-effects models, including random effects for recruitment center.

Association between rheumatoid arthritis disease activity, progression of functional limitation and long-term risk of orthopaedic surgery: combined analysis of two prospective cohorts supports EULAR treat to target DAS thresholds.

Objectives: To examine the association between disease activity in early rheumatoid arthritis (RA), functional limitation and long-term orthopaedic episodes.

Methods: Health Assessment Questionnaire (HAQ) disability scores were collected from two longitudinal early RA inception cohorts in routine care; Early Rheumatoid Arthritis Study and Early Rheumatoid Arthritis Network from 1986 to 2012. The incidence of major and intermediate orthopaedic surgical episodes over 25 years was collected from national data sets.