Publications by authors named "M L Sagmeister"
Article Synopsis
- The audit aimed to assess and improve the completeness and accuracy of the National Joint Registry (NJR) dataset specifically for elbow arthroplasty surgeries.
- In a two-phase approach, Phase 1 compared NJR data with NHS England Hospital Episode Statistics (HES), identifying thousands of unmatched and inaccurate records, particularly for radial head arthroplasties (RHAs).
- Phase 2 involved collaboration among 142 NHS hospitals to correct and update records, resulting in an improved completeness of the NJR dataset from 63% to 93% and accuracy from 94% to 98%.
Context: 11-oxygenated androgens are a group of adrenal-derived steroids that require peripheral activation. In vitro data highlight a putative role for 11β-hydroxysteroid dehydrogenase type 2 (HSD11B2) in 11-oxygenated androgen biosynthesis, converting 11β-hydroxyandrostenedione (11OHA4) to 11-ketoandrostenedione (11KA4), the direct precursor of the potent androgen 11-ketotestosterone (11KT). As the kidney is the major site of HSD11B2 expression, we hypothesized that patients with chronic kidney disease (CKD) would have reduced 11-oxygenated androgen biosynthesis due to impaired HSD11B2 activity.
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- Systemic excess of glucocorticoids, such as in Cushing's syndrome, leads to various metabolic issues, influenced by the enzyme 11β-HSD1.
- A study on mice revealed that high doses of corticosterone increased metabolic rates and carbohydrate use, especially in female wild type (WT) mice, but also caused fat accumulation.
- Notably, 11β-HSD1 knockout mice were protected from these metabolic changes, highlighting its role in the effects of glucocorticoid excess and hyperphagia.
Rationale: In inflammatory diseases such as rheumatoid arthritis (RA), steroid metabolism is a central component mediating the actions of immuno-modulatory glucocorticoids and sex steroids. However, the regulation and function of cellular steroid metabolism within key leukocyte populations such as macrophages remain poorly defined. In this study, the inflammatory regulation of global steroid metabolism was assessed in RA macrophages.
View Article and Find Full Text PDFExternal validation of a multivariable prediction model for identification of pneumonia and other serious bacterial infections in febrile immunocompromised children.
Arch Dis Child
December 2023
Article Synopsis
- The study aimed to validate and update the Feverkids tool, a clinical prediction model designed to help differentiate between bacterial pneumonia, serious bacterial infections (SBIs), and non-SBI causes of fever in immunocompromised children.
- Conducted in 15 hospitals across nine European countries, the study involved observational data from febrile immunocompromised children aged 0-18 years.
- Results showed improved accuracy in predicting bacterial pneumonia and SBIs after model updates, indicating effective thresholds that can help minimize unnecessary medical interventions and antibiotic use.