3,595 results match your criteria: "Liverpool University Hospital[Affiliation]"

Crimean-Congo hemorrhagic fever (CCHF) is a major emerging infectious disease threat, and children are reported to have a milder disease course compared with adults, in contrast to other viral hemorrhagic fevers. The aim of this study was to compare adult and pediatric patients with CCHF to improve understanding of pathogenesis and the natural history of the disease. A retrospective analysis of all children and adults admitted with confirmed CCHF between 2011 and 2020.

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What's New After NICE Acne Guidelines.

Dermatol Ther (Heidelb)

October 2024

Sussex Community Dermatology Service, NHS England, Bedford, England.

Article Synopsis
  • - Acne is a common skin condition worldwide that presents management challenges due to varying grading systems, severity factors, and its chronic nature, which necessitates ongoing treatment to prevent scarring.
  • - The UK Acne Working Group reviews the latest NICE guidelines to offer practical insights for better acne management based on current evidence.
  • - The group highlights new findings since the original NICE guidelines, including new acne treatments, methods for assessing severity, strategies for treating body acne, and hormonal therapies specifically for adult women.
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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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Explant analysis can provide important understanding of how artificial joints perform in the human body. The articulating surfaces of the metacarpal head and the radius cup from a chromium nitride coated metal-on-metal Motec wrist implant were analysed. Due to bone resorption and aseptic loosening, the implant was removed after 6 years in the patient, and metallosis was observed during removal.

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Background: Tirzepatide, a novel dual agonist of glucagon-like-peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), has demonstrated greater magnitude of weight loss compared to semaglutide in a phase 3 clinical trial. However, the effect of tirzepatide on incidence of type 2 diabetes (T2D) in individuals with overweight and obesity, and the effect on major adverse cardiovascular outcomes in individuals with pre-existing T2D, remains unknown.

Methods: We performed a retrospective cohort study of anonymised electronic medical records using the TriNetX network (TriNetX LLC, Cambridge, MA, USA) a global federated database.

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Objectives: The objective of this study is to evaluate the analytical and diagnostic performance of a high-sensitivity point-of-care (POC) cardiac troponin I assay, the Quidel TriageTrue™ (QuidelOrtho Inc, San Diego, USA), compared to central laboratory testing (CLT) in accelerated diagnostic protocols (ADP) in real time in a clinical environment.

Methods: In a nested sub-study of a pragmatic randomised control trial, consecutive patients with suspected acute coronary syndrome (ACS) and chest pain <12 h duration were randomised to the ESC 0/1 and 0/3-h ADP. Subjects underwent sampling for Quidel TriageTrue POC hs-TnI whole blood and plasma, CLT hs-TnT Roche Elecsys and a validated, NICE approved CLT High sensitivity cardiac troponin I (hs-TnI) (Siemens Attellica) at each time point.

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Background: There is a growing burden of non-obese people with diabetes mellitus (DM). However, their cardiovascular risk (CV), especially in the presence of cardiovascular-kidney-metabolic (CKM) comorbidities is poorly characterised. The aim of this study was to analyse the risk of major CV adverse events in people with DM according to the presence of obesity and comorbidities (hypertension, chronic kidney disease, and dyslipidaemia).

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Urethroplasty- a single centre single surgeon experience.

Ir J Med Sci

December 2024

Aintree University Hospital, Liverpool University Hospital Foundation Trust, Lower Lane, Fazakerley, Liverpool, England, L9 7AL.

Introduction: Male urethral stricture affects 100 in 100,000 men. These are investigated using uroflowmetry, retrograde urethrography and cystourethroscopy. Management is usually endoscopic with urethral dilation or direct visual internal urethrotomy, although they have high failure rates.

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Article Synopsis
  • - The study examines a rare clinical symptom, subretinal exudation, in patients with untreated choroidal melanoma, involving 886 patients treated between 2017 and 2023 at a UK hospital.
  • - Out of these, 8 cases (0.90%) were identified with subretinal exudates, with a mean age of 51; symptoms varied from asymptomatic to visual disturbances, with imaging revealing fluid and exudates present.
  • - The findings suggest that these lipid exudates could be an unusual but significant indicator for early diagnosis, as all biopsied cases showed low-risk melanoma, potentially indicating a better prognosis.
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Objective: This study aims to prioritise the themes identified from the three gap analyses performed by a combination of scientists, clinicians, patients and members of the public to determine areas in breast cancer care where research is lacking. We also aimed to compare the priorities of areas of agreed research need between patients, the public, clinicians and scientists.

Design: A cross-section of patients, public, clinicians and scientists completed a prioritisation exercise to rank the identified themes where research is lacking in breast cancer care.

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  • The study investigates the effects of dietetic intervention on protein nutrition disorders in patients with alkaptonuria (AKU), specifically focusing on those undergoing nitisinone therapy versus those who are not.
  • It involved 201 AKU patients and measured various health metrics, showing that diet management led to improved body composition and reduced biochemical markers of protein breakdown.
  • Findings indicate that active dietary support helps maintain lean body mass and reduces the occurrence of corneal keratopathy, highlighting the importance of tailored dietary interventions in AKU treatment.
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  • Uveal melanoma treatment has changed from removing the eye to less invasive methods, but complications can still happen after these treatments.
  • A team of experts reviewed research on how to use special eye surgery to fix problems caused by uveal melanoma.
  • Better tools and techniques in eye surgery now help doctors manage and prevent complications like bleeding and other serious issues.
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Background: The spring ligament fibrocartilaginous complex (SLFC), which is essential for stabilizing the medial longitudinal arch, features a little-explored fibrocartilaginous facet within its superomedial aspect, articulating with the talar head. This research aimed to provide a detailed anatomical description of this facet, designated as the spring ligament articular facet (SLAF).

Methods: Nine normally aligned cadaveric lower limbs were dissected, approaching the SLFC from a superior direction.

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Delays in both the presentation and referral of soft tissue lesions have been extensively recorded in the existing literature. Such delays may result in lesions invading into surrounding tissues including neurovascular structures, increasing the risk of surgical complications and adverse consequences for patients. Delays in initiation of treatment of soft tissue sarcomas have further been associated with increased rates of metastasis.

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This literature review evaluates any possible links between primary open-angle glaucoma (POAG) and caloric restriction (CR), body mass index (BMI), and exercise, aiming to map the extent of the literature. Its primary objective is to recognise the nature and breadth of research evidence, identify possible gaps in these topics and develop future studies. The databases searched were MEDLINE (PudMed), Scopus and ScienceDirect, in April 2023 for articles published in English, with no date restriction.

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Aspirin and Ticagrelor Versus Aspirin and Clopidogrel or Prasugrel and the Effect on Staphylococcal-associated Infections: A Real-world Study.

Clin Ther

September 2024

Department of Medicine, University Hospital Aintree, Liverpool University NHS Foundation Trust, Liverpool, United Kingdom; Liverpool Centre for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Department of Cardiovascular & Metabolic Medicine, Institute of Life Course and Medical Sciences and Pain Research Institute, University of Liverpool and Liverpool University Hospital NHS Foundation Trust, Liverpool, United Kingdom. Electronic address:

Purpose: Antiplatelet therapy is used for the primary and secondary prevention of thrombotic diseases such as acute coronary syndrome (ACS). These patients are more vulnerable to infections, as such, strategies are required to mitigate these risks.

Methods: We conducted a retrospective cohort study using TriNetX, a global federated health research network that includes both inpatient and outpatient electronic medical records from health care organizations worldwide.

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Patients presenting with chest pain represent a significant proportion of Emergency Department (ED) attendances but only a minority, typically 10%, have a final diagnosis of myocardial infarction (MI). Prompt discharge of patients without MI will alleviate ED overcrowding as well as improve patient satisfaction and reduce exposure to risk of hospital acquired infections such as Covid 19. The measurement of cardiac troponin (cTn) by a high sensitivity method is recommended by the National Institute for health and Care Excellence (NICE) for rapid categorization of patients presenting with chest pain.

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Cardio-reno-vascular protection in type 2 diabetes mellitus: new insights into pharmacotherapeutic management.

Expert Opin Pharmacother

August 2024

Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.

Introduction: From 2008 and following the withdrawal of rosiglitazone, obligatory cardiovascular outcomes trials are performed for glucose lowering drugs introduced to the market to ensure their cardiovascular (CV) safety. Paradoxically, these studies have demonstrated CV safety but also shown additional cardio-reno-vascular protection of some therapeutic agents. Additionally, nonsteroidal mineralocorticoid receptor antagonists (ns-MRA) have emerged as novel drugs for cardio - and renoprotection in type 2 diabetes (T2D) and chronic kidney disease (CKD).

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Article Synopsis
  • Cardiac autonomic neuropathy (CAN) is a serious complication in diabetes that can lead to cardiovascular events, but it's not commonly diagnosed due to time constraints.
  • A study explored using AI and deep learning to analyze retinal images from diabetic patients for diagnosing CAN, successfully applying techniques like ResNet 18 and Multiple Instance Learning.
  • The results showed high accuracy, with the AI model identifying 93% of CAN cases and 89% of non-CAN cases, particularly excelling in distinguishing severe CAN stages, indicating a promising diagnostic tool for clinical practice.
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  • Conventional management of acute TTP involves the immediate treatment of suspected cases while waiting for ADAMTS13 deficiency test results, with new rapid assays like the HemosIL AcuStar improving accessibility and diagnostic speed.
  • A multi-centre study examined discrepancies between rapid (AcuStar) and traditional ELISA assays in patients suspected of TTP, highlighting that strong clinical suspicion correlates well with results while low suspicion may lead to inconsistencies.
  • For patients with high suspicion of acute TTP, the AcuStar assay matched the ELISA results accurately, whereas discrepancies (particularly in cancer or sepsis cases) occurred when TTP suspicion was low, stressing the need for solid testing protocols in diagnosis.
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Background: Biologic therapies are associated with increased infection risk among elderly patients with inflammatory bowel disease (IBD). However, there are few data on the safety and effectiveness of ustekinumab compared with anti-tumor necrosis factor (anti-TNF) agents in the elderly.

Methods: The study sought to compare the safety and effectiveness of ustekinumab and anti-TNF agents in elderly Crohn's disease (CD) patients.

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