NICE

BACKGROUND: The National Institute for Health and Care Excellence (NICE) developed a guideline on drug misuse prevention in vulnerable populations. Part of the guideline development process involved evaluating cost-effectiveness and determining which interventions represented good value for money. METHODS: Economic models were developed for seven interventions which aimed to prevent drug use in vulnerable populations. The models compared the costs (to the health and crime sectors) and health benefits (in quality-adjusted life years (QALYs)) of each intervention and its comparator...

P-type ATPases, including MNK and WLN proteins, are responsible for active Cu efflux. These ATPases are also associated with resistance to cisplatin. In this work, we produced different metal-binding domains (MBDs) of ATPase (9 out of 12 domains), and compared their reactivity towards cisplatin. The reaction rates of the MBDs can be largely different; the reaction of MNK6 is about 6 times faster than that of WLN2. Copper coordination favors the platination of the MBDs to different extents. The rate of platination was generally grater for holo-MBDs than for apo-MBDS (particularly in the case of WLN4 and WLN2), however it was negligibly affected in the case of MNK6...

BACKGROUND: Pulmonary hypertension (PH) is a heterogeneous, debilitating condition with highly relevant impact on functional capacity, quality of life, and life-expectancy. OBJECTIVES: This study aims to provide long-term data on the Portuguese PH population, by characterising the clinical presentation, evolution, and outcomes of PH patients in a specialised referral centre. METHODS: Retrospective analysis of a cohort of 101 patients with pre-capillary PH (pcPH) referenced to an expert tertiary care referral centre in northern Portugal from 2002 to 2013...

The production of facial expressions (FEs) is an important skill that allows children to share and adapt emotions with their relatives and peers during social interactions. These skills are impaired in children with Autism Spectrum Disorder. However, the way in which typical children develop and master their production of FEs has still not been clearly assessed. This study aimed to explore factors that could influence the production of FEs in childhood such as age, gender, emotion subtype (sadness, anger, joy, and neutral), elicitation task (on request, imitation), area of recruitment (French Riviera and Parisian) and emotion multimodality...

Copper-64 is an attractive radionuclide for PET imaging and is frequently used in clinical applications. The aim of this study was to perform a side-by-side comparison of the in vitro and in vivo performance of 64Cu-NODAGA-JR11 (NODAGA = 1,4,7-triazacyclononane,1-glutaric acid,4,7-acetic acid, JR11 = p-Cl-Phe-cyclo(D-Cys-Aph(Hor)-D-Aph(cbm)-Lys-Thr-Cys)D-Tyr-NH2), a somatostatin receptor 2 antagonist, with the clinically used sst2 agonist 64Cu-DOTA-TATE ((TATE = D-Phe-cyclo(Cys-Tyr-D-Trp-Lys-Thr-Cys)Thr). In vitro studies demonstrated Kd values of 5...

The terrorist attack of July 14, 2016 in Nice (France) was a devastating event. A man voluntarily drove a truck into a crowd gathered for the fireworks display on the seaside "Promenade des Anglais," plowing pedestrians down over more than 2 km before being shot dead. At the time of this report, a total of 86 casualties and more than 1200 formal complaints for physical and psychological injuries have been recorded. The aim of this work is to describe the forensic management of this event and its immediate aftermath...

AIMS: Healthcare guidelines are an important vehicle in establishing up-to-date evidence based medicine (EBM) in clinical practice. Due to varying development processes, clinical guidelines created by different institutions can often contain contrasting recommendations. This can have implications for optimal and standardized patient care across management settings. METHODS: The similarities and differences of treatment recommendations made in the National Institute for Health and Care Excellence (NICE), The European Association of Urology (EAU), and the International Consultation on Continence (ICI) guidelines for neurogenic lower urinary tract dysfunction (NLUTD) were assessed...

Background: A platelet count >400 × 109/l (i.e. thrombocytosis) is a recently discovered risk marker of cancer. The risk of undiagnosed cancer in patients with thrombocytosis is 11.6% for men and 6.2% for women, well above the 3% risk threshold set by National Institute for Health and Care Excellence (NICE) for cancer investigation. Patients with a platelet count at the upper end of the normal range (325-400 × 109/l) could be at increased risk of undiagnosed malignancy. Objective: To quantify the risk of an undiagnosed cancer in patients with a platelet count at the upper end of the normal range...

Introduction: The cost of treatment and follow-up of cancer patients in the UK is substantial. In a budget-constrained system such as the NHS, it is necessary to consider the cost-effectiveness of the range of management strategies at different points on cancer patients' care pathways to ensure that they provide adequate value for money. Sources of data: We conducted a systematic literature review to explore the cost-effectiveness of follow-up strategies of patients previously treated for cancer with the aim of informing UK policy...

No abstract text is available yet for this article.

The NICE classification is widely used around the world as a universal NBI endoscopic classification that is available without magnifying endoscopy. On the other hand, as histopathological criteria of curative endoscopic resection for early colorectal cancers is getting clear in Japan, endoscopists are required to diagnose their invasion depth accurately with magnifying endoscopy and obtain deeper histopathological materials by endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD). Therefore, we need a new classification which provides accurate qualitative and quantitative diagnosis linking to the appropriate treatment strategy including polypectomy, EMR/ESD, and surgery...

BACKGROUND: Evidence-based medicine is the application of research findings to inform individual clinical decisions. There is a tension-both philosophical and practical-between the average result from a population study and the circumstances and needs of an individual patient. This personal account of "evidence-based" trauma care illustrates and explores this tension. THE CASE: The author, a keen athlete, describes her experience of a high-impact cycle accident that led to limb fractures (which were diagnosed and treated according to evidence-based guidelines) and also an occult injury to the cervical spine (which was not diagnosed at the time)...

PURPOSE: Teriparatide (TPD) is a skeletal anabolic agent used in patients with severe post-menopausal osteoporosis (PMO) and steroid-induced osteoporosis who are at hish risk of fracture. Predictors of therapeutic response to teriparatide in real-life setting are not well characterised. We investigated potential factors associated with teriparatide response in post-menopausal women with established osteoporosis. METHODS: We carried out a retrospective survey of 48 women, aged 73...

No abstract text is available yet for this article.

Recent guidelines from the National Institute for Health and Care Excellence (NICE) have suggested that the medical management of osteoradionecrosis (ORN) of the jaws should be used in clinical trials only, and some drugs and therapeutics committees have withdrawn funds for such prescriptions. With increased scrutiny on the use of these agents, the aims of this study were to ascertain current trends in the presentation and management of ORN, with particular focus on which agents are being used.

No abstract text is available yet for this article.

OBJECTIVES: The UK Register of Prostate Embolisation (UK ROPE) study aimed to assess the efficacy and safety of Prostate Artery Embolisation (PAE) for Lower Urinary Tract Symptoms secondary to Benign Prostatic Hyperplasia (LUTS/BPH) patients. The main secondary aim was an indirect comparison with transurethral resection of the prostate (TURP). SUBJECTS/PATIENTS AND METHODS: As a joint initiative between BSIR, BAUS and NICE, this study recruited 305 patients across 17 UK urological / interventional radiology centres: 216 PAE, 89 TURP...

OBJECTIVES: To determine whether replacement of protocol-driven repeat prostate biopsy (PB) with multiparametric magnetic resonance imaging (mpMRI) +/- targeted repeat prostate biopsy (TB) in evaluating men on active surveillance (AS) for low-volume low- to intermediate-risk prostate cancer (PCa) altered the likelihood or time to treatment, or reduced the number of repeat biopsies required to trigger treatment. PATIENTS AND METHODS: 445 patients underwent AS from 2010-2016 at our institution with median follow-up of 2...

Introduction: Persistent urine leakage after suprapubic cystostomy in tetraplegic subjects occurs due to shrinkage of the urinary bladder and bladder spasms. The patient's social life is adversely affected as clothes become wet, smelly, and require frequent changing, thus increasing the workload of carers. Case presentation: A 48-year-old male sustained C-4 complete (AIS:A) tetraplegia while swimming in 2007. Suprapubic cystostomy was performed in 2009. From 2012, this patient had urine leakage around the suprapubic catheter, which became progressively more frequent...

Extreme learning machines have gained a lot of attention by the machine learning community because of its interesting properties and computational advantages. With the increase in collection of information nowadays, many sources of data have missing information making statistical analysis harder or unfeasible. In this paper, we present a new model, coined spatial extreme learning machine, that combine spatial modeling with extreme learning machines keeping the nice properties of both methodologies and making it very flexible and robust...