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The present world is badly affected by novel coronavirus (COVID-19). Using medical kits to identify the coronavirus affected persons are very slow. What happens in the next, nobody knows. The world is facing erratic problem and don’t know what will happen in near future. This paper is trying to make prognosis of the coronavirus recovery cases using LSTM(Long Short Term Memory). This work exploited data of 258 regions, their latitude and longitude and the number of death of 403 days ranging from 22-01-2020 to 27-02-2021. Specifically, advanced deep learning-based algorithms known as the LSTM, play a great effect on extracting highly essential features for time series data (TSD) analysis.There are lots of methods which already use to analyze propagation prediction. The main task of this paper culminates in analyzing the spreading of Coronavirus across worldwide recovery cases using LSTM deep learning-based architectures.

The expanding portfolio of targeted therapies for ulcerative colitis (UC) suggests that a more precise approach to defining disease activity will aid clinical decision-making. This prospective study used genome-wide microarrays to characterize gene expression in biopsies from the most inflamed colon segments from patients with UC and analyzed associations between molecular changes and short-term outcomes while on standard-of-care treatment. We analyzed 141 biopsies—128 biopsies from 112 UC patients and 13 biopsies from eight inflammatory bowel disease unclassified (IBDU) patients. Endoscopic disease was associated with expression of innate immunity transcripts, e.g. complement factor B (CFB); inflammasome genes (ZBP1 and PIM2); calprotectin (S100A8 and S100A9); and inflammation-, injury-, and innate immunity-associated pathway analysis terms. A cross-validated molecular machine learning classifier trained on the endoscopic Mayo subscore predicted the endoscopic Mayo subscore with area-under-the-curve of 0.85. A molecular calprotectin transcript score showed strong associations with fecal calprotectin and the endoscopic Mayo subscore. Logistic regression models showed that molecular features (e.g. molecular classifier and molecular calprotectin scores) improved the prediction of disease progression over conventional, clinical features alone (e.g. total Mayo score, fecal calprotectin, physician global assessment). The molecular features of UC showed strong correlations with disease activity and permitted development of machine-learning predictive disease classifiers that can be applied to expanded testing in diverse cohorts.

•Transnasal endoscopy (TNE) presents an alternative to a standard per oral gastroscopy.•TNE can be done in outpatients and therefore improve endoscopy capacity.•TNE services improve workforce efficiency.•TNE is better tolerated than a standard per oral gastroscopy by the majority of patients. To assess the impact of pilot transnasal endoscopy (TNE) services on workforce efficiency, allocated procedure times and patient tolerance of procedures. The aim was to also understand the challenges of setting up a TNE service. Six-month data were collected from ten sites. Data captured included productivity, performance, workforce numbers, facilities and quality metrics. A patient survey was done to capture patients’ experience. An eight Likert-style and open question survey was designed and used. Pilot sites were visited using a semi-structured interview process. About 30% of the pilot sites carried out the TNE service outside of the endoscopy unit. There is an overall 25% improvement in workforce efficiency with TNE. Of those patients who had both a TNE and an oesophagogastroduodenoscopy, 78% reported that having the TNE procedure was a better experience. All sites reported that they will continue providing TNE beyond the pilot period. Sites carrying out TNE reported a high satisfaction with the services. Overall satisfaction with the quality of TNE imaging was very high. This multicentre pilot project shows evidence that the integration of TNE services has a positive impact in increasing capacity and patient satisfaction. This should set the scene for scaling this up on a wider capacity. TNE services, particularly with an introduction into outpatients, will improve service capacity in endoscopy, patients will tolerate the procedures more, national 2-week wait and Faster Diagnosis Standard targets will improve, and it is potentially more cost efficient overall.

Background Myocarditis is a rare complication of therapy with mesalazine, a drug widely prescribed in the treatment of inflammatory bowel disease. Case presentation We report a case of myocarditis occurring in a 49-year-old British man 10 days following initiation of mesalazine therapy for treatment of ulcerative colitis. He presented with troponin-positive chest pain, and the diagnosis of myocarditis was confirmed on the basis of cardiac magnetic resonance imaging, which showed subepicardial delayed gadolinium enhancement in the basal to middle inferior and inferolateral segments of the heart. The patient’s symptoms and condition improved upon stopping mesalazine, and he made a full recovery. Conclusions Mesalazine-induced myocarditis may be more common than first appreciated and is potentially fatal. Therefore, it is imperative that clinicians be aware of this potentially life-threatening adverse effect of mesalazine therapy and warn patients to seek urgent medical attention if cardiac symptoms arise.

ObjectiveTo assess outcomes in patients with iron-deficient inflammatory bowel disease (IBD) treated with ferric maltol in UK real-world practice.Design/MethodThis observational, multicentre, retrospective cohort study included adults with IBD and iron-deficiency anaemia (IDA; haemoglobin ≥95 to <120 g/L (women) or ≥95 to <130 g/L (men) plus serum ferritin <30 µg/L or transferrin saturation <20%) who received ferric maltol. Data were extracted from patient records. The primary analysis was the proportion of patients with normalised haemoglobin (≥120 g/L (women); ≥130 g/L (men)) over 12 weeks. Iron indices and safety were assessed.ResultsThirty of 59 patients had data for the primary outcome, 19 of whom (63%) achieved haemoglobin normalisation at week 12. Mean±SD haemoglobin was 127±16 g/L at week 12 (increase of 14±17 g/L from baseline). Overall, 27 patients achieved haemoglobin normalisation by the end of the observation period; mean±SD time to normalisation was 49.5±25.6 days. Nine of 17 patients had normalised serum ferritin (30–300 µg/L) at week 12, and 16 patients had normalised ferritin at the end of the observation period; mean±SD time to normalisation was 71.3±27.6 days. Twenty-four adverse events occurred in 19 patients (32%); most frequent adverse events were abdominal pain or discomfort (n=9) and constipation (n=3).ConclusionFerric maltol increases haemoglobin and iron indices and is generally well tolerated in patients with IBD and IDA treated in clinical practice. These real-world data support findings from randomised controlled trials.

ObjectiveTo examine real-world treatment persistence, colectomy-free survival and treatment switching patterns in UK patients with ulcerative colitis (UC) prescribed golimumab or adalimumab.DesignThis was a retrospective chart review study in adult patients diagnosed with UC using data from 16 National Health Service sites in the UK. Patient records were included in the study if they had initiated first or second-line adalimumab or golimumab between 1 March 2016 and 30 September 2017 (index date). Subjects were required for ≥6 months post treatment initiation. Demographics, clinical characteristics, treatment-related data and colectomy data were extracted over a follow-up period of 6–12 months. Treatment persistence rate was the primary outcome. Colectomy-free survival and treatment switching were secondary outcomes. Outcomes were compared between treatments using χ2 tests and Fisher’s exact test for categorical variables. The t-tests were used for continuous variables. Time-to-event variables were evaluated using Kaplan-Meier curves and log-rank tests.ResultsThe study included a total of 183 patients (96 (52.5%) prescribed adalimumab; 87 (47.5%) golimumab), and patients were mostly first line (79.8%). Demographic and clinical characteristics were generally similar between treatment groups. Persistence rates within 12 months were 64.6% for adalimumab and 64.4% for golimumab (p=0.681). Overall, 20.2% switched to other therapy within 1 year, with 8.2% golimumab and 12.0% adalimumab switching to another biologic. Of patients prescribed adalimumab, 14.6% had ≥1 dose change, mainly dose escalations. In the 12 months post treatment initiation, 8.2% of patients underwent colectomy, with no significant difference in colectomy-free survival by treatment, p=0.73.ConclusionThis study provides evidence of clinical outcomes and real-world persistence for adalimumab and golimumab in UC. The persistence rates of both therapies were above 64.0% at 12 months following treatment initiation. In addition, the 1-year colectomy-free survival was relatively similar between the two treatments.

A 66-year-old patient presented to a clinic to be investigated for a diagnosis of gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS). GAPPS is a rare, autosomal-dominant syndrome manifesting with extensive polyposis of the stomach and predisposes patients to gastric adenocarcinoma. Gastroscopy and biopsy confirmed a diagnosis of GAPPS, showing polyposis in a typical antrum-sparing distribution. Due to the rarity of GAPPS, accepted management pathways remain contentious, especially regarding if and when to advise gastrectomy to minimise the risk of malignant polyp transformation. Moreover, the similarity in presentation of GAPPS and other stomach polyposis syndromes raises concerns about missed cases and lack of follow-up.

IntroductionEosinophilic esophagitis (EoE) is a chronic immune-mediated inflammatory condition of the oesophagus. Randomized control trials frequently use histological remission as a definition of treatment effect, although in clinical practice there is often de-escalation of therapy once there is patient reported improvement in symptoms. However, persistent mucosal inflammation still risks tissue re-modelling and may lead to fibrosis and stricture formation. We aim to assess if patient reported outcomes (PRO) of symptom improvement were a good predictor of histological remission.MethodsWe performed a retrospective observational analysis and identified 30 patients with EoE at Barts Health NHS trust between 2016-2020. EoE was defined as symptoms of dysphagia and/or food bolus obstruction with eosinophil count ≥15 per high power field in proximal and distal oesophageal biopsies. All patients had subsequent follow up with clinical, endoscopic and histologic re-assessment after a minimum eight week period of treatment. Dichotomous outcomes were compared between patient reported global improvement in symptoms (improvement or no improvement) and histological remission (eosinophil count <15 eos/hpf).Results19/30 (63.33%) patients were male. The median age was 35.9 years (age range 23-56). 18/30 (60%) patients had atopic disorders whilst 8/30 (26.67%) had IgE mediated food allergies. 22/30 (73.33%) received PPI as first line therapy, 6/30 (20%) received topical steroids and 2/30 (6.67%) had combined therapy with PPI and inhaled fluticasone. All patients had a minimum of 8 weeks treatment prior to re-assessment. The mean duration of therapy was 38 weeks (+/- 24.28). There was no association between PRO of global symptom improvement and histological remission across all treatment groups (p=0.55). There was a mean increase of 10.33 eos/hpf on repeat biopsies. When specifically assessing outcomes following PPI therapy; 18/22 (81.8%) reported improvement in symptoms, however only 4/22 (18.2%) achieved histological remission (p=0.55).ConclusionsMicroscopic disease activity can persist despite patient reported symptom improvement. Hence histology is the ideal marker of inflammation for disease activity. Our findings support European guidelines reinforcing that targeting mucosal healing should be the goal of therapy. Treatment should not de-escalated if there is ongoing mucosal inflammation. Standardised definitions of histologic response and remission using validated scoring systems, as well as a biopsy procurement protocol are needed to further guide clinical practice and decision making.