Publications by authors named "Jardine M"
Effectiveness of Enhanced Recovery After Surgery (ERAS) Protocol in Pancreatic Surgery - A Systematic review and Meta-Analysis of Randomized Controlled Trials.
J Gastrointest Surg
January 2025
Introduction: The Enhanced Recovery After Surgery (ERAS) protocol represents an advancement in perioperative care to reduce surgical stress and accelerate recovery. This meta-analysis evaluates the effectiveness of ERAS in pancreatic surgery.
Objective: To assess the impact of the ERAS protocol compared with conventional hospital care on postoperative outcomes, including length of hospital stay (LOS), hospital costs, readmission rates, and infection rates in patients undergoing pancreatic surgery.
Objective: We have shown that men aged 50 years+ at high risk of type 2 diabetes treated with testosterone together with a lifestyle program reduced the risk of type 2 diabetes at 2 years by 40% compared to a lifestyle program alone. To develop a personalized approach to treatment, we aimed to explore a prognostic model for incident type 2 diabetes at 2 years and investigate biomarkers predictive of the testosterone effect.
Design: Model development in 783 men with impaired glucose tolerance but not type 2 diabetes from Testosterone for Prevention of Type 2 Diabetes; a multicenter, 2-year trial of Testosterone vs placebo.
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been proven to prevent decline in kidney function and failure. Whether SGLT2i affect the risk of contrast-associated acute kidney injury (CA-AKI) remains uncertain.
Methods: Use of SGLT2i was assessed in consecutive diabetics undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) from January 2020 to May 2023 at a tertiary hospital in Chongqing, China.
Importance: Chronic kidney disease (CKD) is a global health priority affecting almost 1 billion people. New therapeutic options and clinical trial innovations such as adaptive platform trials provide an opportunity to efficiently test combination therapies.
Objective: To describe the design and baseline results of the Global Kidney Patient Trials Network (GKPTN) and the design and structure of the global adaptive platform clinical trial Chronic Kidney Disease Adaptive Platform Trial Investigating Various Agents for Therapeutic Effect (CAPTIVATE) to find new therapeutic options and treatments for people with kidney disease.
Background: Patients with IgA nephropathy and severe proteinuria have a high lifetime risk of kidney failure. The efficacy and safety of the selective endothelin type A receptor antagonist atrasentan in reducing proteinuria in patients with IgA nephropathy are incompletely understood.
Methods: We are conducting a phase 3, multinational, double-blind, randomized, controlled trial involving adults with biopsy-proven IgA nephropathy, a total urinary protein excretion of at least 1 g per day, and an estimated glomerular filtration rate of at least 30 ml per minute per 1.
Article Synopsis
- This study aimed to assess whether DMX-200, a chemokine receptor antagonist, combined with candesartan, could improve outcomes for hospitalized adults under 65 with moderate to severe COVID-19.
- Conducted in ten hospitals in India, the trial was double-blind and placebo-controlled but was terminated early due to challenges in recruitment, resulting in only 49 participants.
- Preliminary results showed both treatment groups had similar outcomes, with no significant differences in disease progression, ICU admissions, or length of hospital stays, indicating that the intervention may not have had a notable impact.
Background And Hypothesis: Studies in patients with heart failure have indicated that sodium-glucose cotransporter 2 (SGLT2) inhibitors increase iron use and enhance erythropoiesis. In this post-hoc analysis of the CREDENCE trial, we evaluated the effects of canagliflozin on iron metabolism in patients with chronic kidney disease (CKD) and whether the effects of canagliflozin on hemoglobin and cardiorenal outcomes were modified by iron deficiency.
Methods: We measured serum iron, total iron binding capacity (TIBC), transferrin saturation (TSAT) and ferritin at baseline and 12 months.
Key Points: The vascular endothelial growth factor B inhibitor CSL346 (8 or 16 mg/kg q4w) did not reduce urinary albumin-creatinine ratio at week 16 versus placebo in patients with type 2 diabetes mellitus and diabetic kidney disease. CSL346 was generally well tolerated at both doses; however, CSL346 (16 mg/kg) significantly increased diastolic BP versus placebo.
Background: Increased vascular endothelial growth factor B (VEGF-B) expression in patients with diabetic kidney disease (DKD) is associated with increased lipid deposition in glomerular podocytes.
Article Synopsis
- SGLT2 inhibitors and GLP-1 receptor agonists both have positive effects on cardiovascular and kidney health in patients with type 2 diabetes, leading to a study comparing their benefits when used together or separately.
- A meta-analysis from various trials showed that SGLT2 inhibitors effectively reduced risks of major cardiovascular events and kidney disease progression for patients whether or not they were taking GLP-1 receptor agonists.
- The consistency of these benefits across different outcomes indicates that SGLT2 inhibitors can be beneficial for all diabetic patients, regardless of GLP-1 receptor agonist usage.
Background And Hypothesis: Heart failure is characterized as cardiac dysfunction resulting in elevated cardiac filling pressures with symptoms and signs of congestion. Distinguishing heart failure from other causes of similar presentations in patients with kidney failure is challenging but necessary, and is needed in randomized controlled trials (RCTs) to accurately estimate treatment effects. The objective of this study was to review heart failure events, their diagnostic criteria and adjudication in RCTs of patients with kidney failure treated with dialysis.
View Article and Find Full Text PDFAims: People with type 2 diabetes (T2D) face high risks of heart failure (HF) hospitalizations that are often recurrent, especially as kidney function declines. We examined the effects of canagliflozin on total HF events by baseline kidney function in patients with T2D at high cardiovascular risk and/or with chronic kidney disease.
Methods And Results: Leveraging pooled participant-level data from the CANVAS programme (n = 10 142) and CREDENCE trial (n = 4401), first and total HF hospitalizations were examined.
Aims: To assess adherence and persistence to sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP1-RA), and dipeptidyl peptidase-4 inhibitors (DPP4i) in routine care.
Methods: Using retrospective healthcare data from the Stockholm region, Sweden, we evaluated new-users of these agents during 2015-2020. We investigated adherence (≥80 % of days covered by an active supply), persistence (no treatment gap ≥ 60 days), and predictors for non-adherence and non-persistence.
Article Synopsis
- Neurological issues are prevalent in children hospitalized with SARS-CoV-2-related multisystem inflammatory syndrome (MIS-C), potentially leading to lasting cognitive and functional problems.
- This study investigates how severe neurological symptoms during hospitalization relate to new cognitive and functional impairments upon discharge among children under 18.
- Over 3,500 patients were examined, revealing that those with severe neurological manifestations had a higher likelihood of experiencing new morbidities at discharge compared to those without such issues.
Inflammation mediated by interleukin-6 (IL-6) is strongly associated with cardiovascular risk. Here we evaluated clazakizumab, a monoclonal antibody targeting the IL-6 ligand, in a phase 2b dose-finding study. Adults with cardiovascular disease and/or diabetes receiving maintenance dialysis with high-sensitivity C-reactive protein (hs-CRP) ≥ 2 mg l at baseline were randomized to receive clazakizumab (2.
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- Calciphylaxis is a rare and serious disorder linked to high rates of illness and death, particularly in patients undergoing kidney replacement therapy (KRT) in Australia and New Zealand.
- A study analyzed cases from the ANZDATA registry between 2019 and 2022, finding that 333 patients experienced calciphylaxis, primarily affecting older women with diabetes and obesity.
- The research showed a significant mortality risk associated with calciphylaxis, with half of the patients dying within 12 months of diagnosis and a much higher risk of death for those diagnosed within the first year after starting dialysis.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors were initially developed for their glucose-lowering effects and have shown a modest glycaemic benefit in people with type 2 diabetes mellitus (T2DM). In the past decade, a series of large, robust clinical trials of these therapies have demonstrated striking beneficial effects for various care goals, transforming the chronic disease therapeutic landscape. Cardiovascular safety studies in people with T2DM demonstrated that SGLT2 inhibitors reduce cardiovascular death and hospitalization for heart failure.
View Article and Find Full Text PDFClinical Trial registry name and registration number: ClinicalTrials.gov Identifiers: NCT02065791 (CREDENCE), NCT03036150 (DAPA-CKD), NCT03594110 (EMPA-KIDNEY).
View Article and Find Full Text PDFArticle Synopsis
- * A meta-analysis included 78,607 patients from 11 trials, revealing that SGLT2i reduced MACE by 9%, primarily due to lower rates of cardiovascular death rather than incidents of myocardial infarction or stroke.
- * Results showed consistent benefits from SGLT2i in patients with diabetes, heart failure, and chronic kidney disease, suggesting wide applicability for improving heart-related outcomes among these populations.