2,146 results match your criteria: "Clinical Sciences Centre[Affiliation]"

Natriuresis guided diuresis in patients admitted to hospital with heart failure - barking up the wrong tree?

J Card Fail

November 2024

Department of Cardiology, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Cottingham, Kingston-Upon-Hull, East Riding of Yorkshire, HU16 5JQ.

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Article Synopsis
  • A study investigated how metabolic syndrome (MetS) traits and liver fibrosis affect the risk of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD).
  • Data from over 234,000 participants were analyzed, revealing that a significant portion had MASLD and MetS; certain traits like hypertension and type 2 diabetes increased CKD risk, especially when combined with advanced liver fibrosis.
  • The findings suggest that the presence and number of MetS traits, along with liver fibrosis, significantly raise the risk of CKD and the likelihood of developing ESRD over time.
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Article Synopsis
  • GLP-1 receptor agonists (GLP-1RA) and SGLT-2 inhibitors (SGLT-2I) are effective in improving cardiovascular outcomes for people with type 2 diabetes (T2D), but using them separately may not help patients with existing heart conditions.
  • A systematic review analyzed data from over 107,000 participants to see if combining these two treatments could provide better cardiovascular protection, particularly for those with a history of heart attacks (MI) or heart failure (HF).
  • The results indicated that the combination therapy may result in additional cardiovascular benefits compared to using either treatment alone, suggesting it should be prioritized for T2D patients with prior heart issues to enhance their cardiovascular health.
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Background: The non-prewhitening computational model observer with eye filter (NPWE) has been shown to reasonably predict human observer performance in general radiography and is an appropriate substitute when real clinical trials are not feasible. In this study, the NPWE model observer is used to detect specific tasks (circular designer nodules) ranging between 1 and 30 mm in diameter using chest and abdomen phantom images acquired across the diagnostic energy range (60-125 kVp) with and without an anti-scatter grid.

Purpose: The aim of this study was to derive tube voltage (kVp) settings that return maximal NPWE detectability (d') of designer nodules, for digital radiography (DR) chest and abdomen imaging.

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The transcription factor IKZF1 is essential for B cell development, and recurrently mutated in human B-ALL. IKZF1 has been ascribed both activating and repressive functions via interactions with coactivator and corepressor complexes, but the relative abundance of IKZF1-associated coregulators and their contribution to IKZF1-mediated gene regulation are not well understood. To address this, we performed an unbiased identification of IKZF1-interacting proteins in pre-B cells and found that IKZF1 interacts overwhelmingly with corepressors and heterochromatin-associated proteins.

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Efficacy of providing energy expenditure information to guide weight loss interventions in people with obesity: A randomized controlled trial.

Clin Obes

September 2024

Department of Cardiovascular & Metabolic Medicine, Institute of Life Course and Medical Sciences, Clinical Sciences Centre, Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK.

Resting energy expenditure (REE) and metabolic fuel utilization (carbohydrate or fat) proxied by respiratory quotient (RQ) from indirect calorimetry enables more precise measurement of energy needs and fat oxidation capacity. The study compared the effectiveness of providing energy expenditure information during diet and exercise weight intervention versus standard of care (SOC) on weight loss outcomes. Fifty-two participants with obesity were recruited from a specialist weight loss service, randomized 1:1 to intervention (INT) or SOC only.

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Introduction: Painful idiopathic distal sensory polyneuropathy (IDSP) and fibromyalgia syndrome (FMS) are cryptogenic chronic pain syndromes. The contribution of small fibre pathology (SFP) in FMS remains controversial. This study aims to quantify small nerve pathology in participants with IDSP and FMS and identify relationships of SFP with sensory phenotypes.

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The beginning of wisdom is the definition of terms: counting heart failure hospitalizations.

Eur Heart J Qual Care Clin Outcomes

September 2024

Department of Cardiology, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Cottingham, East Riding of Yorkshire, HU16 5JQ, UK.

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Objective: To evaluate the sensitivity of human papillomavirus (HPV) tested urine to detect high-grade cervical precancer (cervical intraepithelial neoplasia grade 2+ [CIN2+]) using two urine collection devices.

Design: Randomised controlled trial.

Setting: St Mary's Hospital, Manchester, UK.

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Background: Loop diuretics are commonly prescribed in the community, not always to patients with a recorded diagnosis of heart failure (HF). The rate of HF events in patients prescribed loop diuretics without a diagnosis of HF is unknown.

Methods: This was a propensity-matched cohort study using data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office of National Statistics in the UK.

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SGLT2 Inhibitors - The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review.

Diabetes Ther

May 2024

Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Clinical Sciences Centre, Aintree University Hospital, University of Liverpool, Liverpool, UK.

Article Synopsis
  • SGLT2 inhibitors are effective medications for managing type 2 diabetes (T2DM), providing not only glucose control but also protective benefits against cardiovascular and kidney complications.
  • These medications have proven to be cost-effective and can lead to significant economic savings due to lower rates of serious health events compared to other treatments.
  • Despite their benefits, there is some hesitancy among healthcare providers in prescribing SGLT2is, prompted by confusion regarding their use and outdated perceptions about their safety; updated guidelines aim to clarify their advantages and recommended application in T2DM management.
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The double burden of malnutrition in individuals: Identifying key challenges and re-thinking research focus.

Nutr Bull

June 2024

Section of Nutrition, Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.

Article Synopsis
  • The 'double burden of malnutrition' means that some people can be both undernourished and overweight at the same time, which is a big problem in many countries.
  • Even though some places have improved their nutrition, more people in cities are becoming overweight, especially after growing up with poor nutrition.
  • Researchers believe we need to rethink how we study this issue and focus more on different factors like the environment and food systems to come up with better solutions.
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Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions - Part I: Loop Diuretics.

Curr Heart Fail Rep

April 2024

Department of Cardiology, Castle Hill Hospital, Hull University Teaching Hospitals Trust, Castle Road, Cottingham, East Yorkshire, UK.

Purpose Of Review: Fluid retention or congestion is a major cause of symptoms, poor quality of life, and adverse outcome in patients with heart failure (HF). Despite advances in disease-modifying therapy, the mainstay of treatment for congestion-loop diuretics-has remained largely unchanged for 50 years. In these two articles (part I: loop diuretics and part II: combination therapy), we will review the history of diuretic treatment and the current trial evidence for different diuretic strategies and explore potential future directions of research.

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Medicines optimization prior to discharge in patients admitted to hospital with heart failure.

ESC Heart Fail

April 2024

Department of Cardiology, Hull University Teaching Hospital Trust, Castle Hill Hospital, Kingston upon Hull, East Riding of Yorkshire, UK.

Aims: Approximately half of patients with heart failure and a reduced ejection fraction (HeFREF) are discharged from hospital on triple therapy [angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs), beta-blockers (BBs), and mineralocorticoid receptor antagonists (MRAs)]. We investigated what proportion of patients are on optimal doses prior to discharge and how many might be eligible for initiation of sacubitril-valsartan or sodium-glucose co-transporter-2 inhibitors (SGLT2Is).

Methods And Results: Between 2012 and 2017, 1277 patients admitted with suspected heart failure were enrolled at a single hospital serving a local community around Kingston upon Hull, UK.

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Body Fat Depletion: the Yin Paradigm for Treating Type 2 Diabetes.

Curr Atheroscler Rep

January 2024

Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.

Purpose Of Review: To highlight that body fat depletion (the Yin paradigm) with glucose-lowering treatments (the Yang paradigm) are associated with metabolic benefits for patients with type 2 diabetes mellitus (T2DM).

Recent Findings: The sodium-glucose cotransporter-2 inhibitor-mediated sodium/glucose deprivation can directly improve glycemic control and kidney outcome in patients with T2DM. The glucose deprivation might also promote systemic fatty acid β-oxidation to deplete ectopic/visceral fat and thereby contribute to the prevention of cardiovascular diseases.

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Molecular Mechanisms Linking Diabetes with Increased Risk of Thrombosis.

Int J Mol Sci

December 2023

Biomedical Institute for Multimorbidity, Centre for Biomedicine, Hull York Medical School, University of Hull, Hull HU6 7RX, UK.

This review will provide an overview of what is currently known about mechanisms linking poor glycaemic control with increased thrombotic risk. The leading causes of death in people with diabetes are strokes and cardiovascular disease. Significant morbidity is associated with an increased risk of thrombosis, resulting in myocardial infarction, ischaemic stroke, and peripheral vascular disease, along with the sequelae of these events, including loss of functional ability, heart failure, and amputations.

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Staged design recommendations for validating relative sensitivity of self-sample human papillomavirus tests for cervical screening.

J Clin Epidemiol

February 2024

Centre for Cancer Screening, Prevention and Early Detection, Wolfson Institute of Population Health, Queen Mary University of London, London EC1M 6BQ, UK. Electronic address:

Objectives: To ensure that the emerging methods for human papillomavirus (HPV) testing on self-collected samples in cervical screening are evaluated robustly.

Study Design And Setting: We assess paired study designs for relative sensitivity of self-collected vs. traditional clinician-collected samples in detection of high-grade cervical intraepithelial neoplasia.

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Objective: To understand whether self-sampling can reduce carbon emissions (CO e) from the NHS cervical screening programme (NHSCSP) by comparing the carbon footprint of three sampling strategies: routine cervical sampling, vaginal self-sampling and first-void (FV) urine collection.

Design: Descriptive study.

Setting: National Health Service (NHS), United Kingdom (UK).

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Background: Climate change is an era-defining health concern, with healthcare related emissions paradoxically compounding negative impacts. The NHS produces 5% of the UK's carbon footprint, with operating theatres a recognised carbon hotspot. NHS England aims to become Net Zero by 2045.

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Objective: This study assessed the effect of 1-year administration of diazoxide choline extended-release tablet (DCCR) on hyperphagia and other complications of Prader-Willi syndrome (PWS).

Methods: The authors studied 125 participants with PWS, age ≥ 4 years, who were enrolled in the DESTINY PWS Phase 3 study and who received DCCR for up to 52 weeks in DESTINY PWS and/or its open-label extension. The primary efficacy endpoint was Hyperphagia Questionnaire for Clinical Trials (HQ-CT) score.

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Background: Over-the-counter therapies, such as Vicks VapoRub, are frequently used in the management of upper respiratory tract infection symptoms. Of these, acute cough is the most bothersome; however, the mechanisms involved have not been fully elucidated. The temperature-sensitive transient receptor potential (TRP) channels, including TRPA1, TRPV1, TRPM8 and TRPV4, are potential candidates.

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Background: Surgical site infections (SSI) complicate up to 40% of surgical procedures, leading to increased patient morbidity and mortality. Previous research identified disparities in SSI prevention guidelines and clinical practices across different institutions. The study aims to identify variations in SSI prevention practices within and between specialties and financial systems and provide a representation of existing SSI preventative measures to help improve the standardization of SSI prevention practices.

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