Anti-fibrinolytics for mucosal bleeding in adults with life-limiting illnesses: a systematic review.

Introduction: Patients with life-limiting illnesses are at increased risk of mucosal bleeding. Usual management includes anticipatory planning and sedation, alongside anti-fibrinolytics, despite a lack of evidence for their use. Anti-fibrinolytic agents (tranexamic acid and aminocaproic acid) produce effective haemostasis in different clinical settings.

Co-localization of the sodium-glucose co-transporter-2 channel (SGLT-2) with endothelin ETA and ETB receptors in human cardiorenal tissue.

Unlabelled: Endothelin (ET) receptor antagonists are being investigated in combination with sodium-glucose co-transporter-2 inhibitors (SGLT-2i). These drugs primarily inhibit the SGLT-2 transporter that, in humans, is thought to be mainly restricted to the renal proximal convoluted tubule, resulting in increased glucose excretion favouring improved glycaemic control and diuresis. This action reduces fluid retention with ET receptor antagonists.

Inducible apelin receptor knockdown reduces differentiation efficiency and contractility of hESC-derived cardiomyocytes.

Aims: The apelin receptor, a G protein-coupled receptor, has emerged as a key regulator of cardiovascular development, physiology, and disease. However, there is a lack of suitable human in vitro models to investigate the apelinergic system in cardiovascular cell types. For the first time we have used human embryonic stem cell-derived cardiomyocytes (hESC-CMs) and a novel inducible knockdown system to examine the role of the apelin receptor in both cardiomyocyte development and to determine the consequences of loss of apelin receptor function as a model of disease.

Advance care planning ahead of life-altering clinical deterioration in secure settings: Do not wait until a crisis.

All professionals involved in someone's care should be equipped to support individuals, and the people close to them, to understand how their health is likely to change, consider the burdens and likely outcomes of treatment options and make realistic, informed recommendations to guide future care. This can be particularly challenging in forensic mental health, when it covers cardiopulmonary resuscitation alongside recommendations about acute hospital admission and medical escalation within and outside of hospital settings. Some clinicians question whether or not the harms of raising the spectre of invasive ventilation and potential mortality risks unnecessary anxiety and psychological harm amongst detained patients.