1,059 results match your criteria: "Molecular and Clinical Sciences Research Institute[Affiliation]"

Postnatal outcome of fetal cortical malformations: systematic review.

Ultrasound Obstet Gynecol

November 2024

Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.

Objective: Parental counseling for fetal malformations of cortical development (MCD) is based on data from studies in children and adults undergoing imaging investigation for abnormal neurodevelopment. However, such postnatal findings may not be applicable to prenatally diagnosed cases. The aim of this study was to review the existing data on postnatal neurodevelopmental outcome for fetuses diagnosed with MCD.

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We assess the UK Biobank (UKB) Polygenic Risk Score (PRS) Release, a set of PRSs for 28 diseases and 25 quantitative traits that has been made available on the individuals in UKB, using a unified pipeline for PRS evaluation. We also release a benchmarking software tool to enable like-for-like performance evaluation for different PRSs for the same disease or trait. Extensive benchmarking shows the PRSs in the UKB Release to outperform a broad set of 76 published PRSs.

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Article Synopsis
  • The study explores fetal and offspring heart adaptations in cases of fetal growth restriction (FGR) compared to healthy controls over time.
  • Using advanced echocardiographic techniques, researchers found significant differences in heart geometry and function between FGR and healthy fetuses, including increased cardiac output and impaired diastolic function in FGR cases.
  • Findings suggest that changes in heart structure and function associated with FGR may be linked to chronic lack of oxygen from the placenta, potentially leading to long-term cardiovascular issues in affected children.
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Article Synopsis
  • Many heart failure (HF) patients do not receive optimal doses of RAAS inhibitors due to worries about hyperkalemia (HK).
  • The CARE-HK registry enrolled 2558 adults with chronic HF, primarily those with reduced ejection fraction, to evaluate RAASi treatment patterns and HK management across clinical practices in Europe and the USA.
  • The study aims to better understand how RAAS inhibitors are used in patients at high risk for HK and to analyze their treatment outcomes in routine medical settings.
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Potential vertical transmission of Oropouche virus during the current outbreak.

Lancet Infect Dis

November 2024

Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London SW17 0QT, UK; Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK; Royal College of Obstetricians and Gynaecologists, London, UK. Electronic address:

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Development and validation of prediction models for fetal growth restriction and birthweight: an individual participant data meta-analysis.

Health Technol Assess

August 2024

WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.

Background: Fetal growth restriction is associated with perinatal morbidity and mortality. Early identification of women having at-risk fetuses can reduce perinatal adverse outcomes.

Objectives: To assess the predictive performance of existing models predicting fetal growth restriction and birthweight, and if needed, to develop and validate new multivariable models using individual participant data.

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Obesity and underweight are a growing health problem worldwide and a challenge for clinicians concerning antithrombotic therapy, due to the associated risks of thrombosis and/or bleeding. This clinical consensus statement updates a previous one published in 2018, by reviewing the most recent evidence on antithrombotic drugs based on body size categories according to the World Health Organization classification. The document focuses mostly on individuals at the extremes of body weight, i.

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Zibotentan in Microvascular Angina: A Randomized, Placebo-Controlled, Crossover Trial.

Circulation

November 2024

British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom (A.M., N.S., P.W.M., P.W., C.B.).

Background: Microvascular angina is associated with dysregulation of the endothelin system and impairments in myocardial blood flow, exercise capacity, and health-related quality of life. The G allele of the noncoding single nucleotide polymorphism enhances expression of the endothelin-1 gene () in human vascular cells, potentially increasing circulating concentrations of Endothelin-1 (ET-1). Whether zibotentan, an oral receptor selective antagonist, is efficacious and safe for the treatment of microvascular angina is unknown.

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Collagen IV deficiency causes hypertrophic remodeling and endothelium-dependent hyperpolarization in small vessel disease with intracerebral hemorrhage.

EBioMedicine

September 2024

School of Cardiovascular and Metabolic Health, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK. Electronic address:

Background: Genetic variants in COL4A1 and COL4A2 (encoding collagen IV alpha chain 1/2) occur in genetic and sporadic forms of cerebral small vessel disease (CSVD), a leading cause of stroke, dementia and intracerebral haemorrhage (ICH). However, the molecular mechanisms of CSVD with ICH and COL4A1/COL4A2 variants remain obscure.

Methods: Vascular function and molecular investigations in mice with a Col4a1 missense mutation and heterozygous Col4a2 knock-out mice were combined with analysis of human brain endothelial cells harboring COL4A1/COL4A2 mutations, and brain tissue of patients with sporadic CSVD with ICH.

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Since the 1960s, cardiologists have adopted several binary classification systems for acute myocardial infarction (MI) that facilitated improved patient management. Conversely, for chronic stable manifestations of myocardial ischaemia, various classifications have emerged over time, often with conflicting terminology-e.g.

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Since the 1960s, cardiologists have adopted several binary classification systems for acute myocardial infarction (MI) that facilitated improved patient management. Conversely, for chronic stable manifestations of myocardial ischemia, various classifications have emerged over time, often with conflicting terminology-eg, "stable coronary artery disease" (CAD), "stable ischemic heart disease," and "chronic coronary syndromes" (CCS). While the 2019 European guidelines introduced CCS to impart symmetry with "acute coronary syndromes" (ACS), the 2023 American guidelines endorsed the alternative term "chronic coronary disease.

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Clinical and neuroradiological spectrum of biallelic variants in NOTCH3.

EBioMedicine

September 2024

Department of Neurogenetics, UCL Institute of Neurology London Queen Square and National Hospital for Neurology and Neurosurgery, University College London, London, United Kingdom. Electronic address:

Background: NOTCH3 encodes a transmembrane receptor critical for vascular smooth muscle cell function. NOTCH3 variants are the leading cause of hereditary cerebral small vessel disease (SVD). While monoallelic cysteine-involving missense variants in NOTCH3 are well-studied in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), patients with biallelic variants in NOTCH3 are extremely rare and not well characterised.

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Dyslipidaemia is a common chronic kidney disease (CKD) and contributes to excessively elevated cardiovascular mortality. The pathophysiology is complex and modified by comorbidities like the presence/absence of proteinuria, diabetes mellitus or drug treatment. This paper provides an overview of currently available treatment options.

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Introduction: Selective fetal growth restriction (sFGR) in monochorionic twin pregnancy, defined as an estimated fetal weight (EFW) of one twin <10th centile and EFW discordance ≥25%, is associated with stillbirth and neurodisability for both twins. The condition poses unique management difficulties: on the one hand, continuation of the pregnancy carries a risk of death of the smaller twin, with a high risk of co-twin demise (40%) or co-twin neurological sequelae (30%). On the other, early delivery to prevent the death of the smaller twin may expose the larger twin to prematurity, with the associated risks of long-term physical, emotional and financial costs from neurodisability, such as cerebral palsy.

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All about clinical trials.

Eur Heart J Cardiovasc Pharmacother

October 2024

Molecular and Clinical Sciences Research Institute, St. George's, University of London, Cranmer Terrace, London SW170RE, UK.

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The functional importance of the anterior temporal lobes (ATLs) has come to prominence in two active, albeit unconnected literatures-(i) face recognition and (ii) semantic memory. To generate a unified account of the ATLs, we tested the predictions from each literature and examined the effects of bilateral versus unilateral ATL damage on face recognition, person knowledge, and semantic memory. Sixteen people with bilateral ATL atrophy from semantic dementia (SD), 17 people with unilateral ATL resection for temporal lobe epilepsy (TLE; left = 10, right = 7), and 14 controls completed tasks assessing perceptual face matching, person knowledge and general semantic memory.

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Objectives: As part of the FERN feasibility study, this qualitative research aimed to explore parents' and clinicians' views on the acceptability, feasibility and design of a randomised controlled trial (RCT) of active intervention versus expectant management in monochorionic (MC) diamniotic twin pregnancies with early-onset (prior to 24 weeks) selective fetal growth restriction (sFGR). Interventions could include laser treatment or selective termination which could lead to the death or serious disability of one or both twins.

Design: Qualitative semi-structured interviews with parents and clinicians.

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SARS-CoV-2 infection during pregestational and early pregnancy periods has an unclear impact on fetal development. Although vertical transmission is rare, potential effects on the developing fetal brain are plausible. However, robust evidence linking maternal SARS-CoV-2 infection to congenital anomalies is limited due to inadequate tracking of infection history and methodological flaws in published studies.

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Patatin-like phospholipase domain-containing lipase 8 (PNPLA8), one of the calcium-independent phospholipase A2 enzymes, is involved in various physiological processes through the maintenance of membrane phospholipids. Biallelic variants in PNPLA8 have been associated with a range of paediatric neurodegenerative disorders. However, the phenotypic spectrum, genotype-phenotype correlations and the underlying mechanisms are poorly understood.

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Emergency delivery in pregnancies at high probability of placenta accreta spectrum on prenatal imaging: a systematic review and meta-analysis.

Am J Obstet Gynecol MFM

October 2024

Department of Obstetrics and Gynecology, Center for Fetal Cand High-Risk Pregnancy, University of Chieti, Chieti, Italy (Lucidi, D'Amico, and D'Antonio). Electronic address:

Background: Placenta accreta spectrum disorders are associated with a high risk of maternal morbidity, particularly when surgery is performed under emergency conditions. This study aimed to investigate the incidence of emergency cesarean delivery in patients with a high probability of placenta accreta spectrum disorders on prenatal imaging and to compare the maternal and neonatal outcomes between patients requiring emergency cesarean delivery and those not requiring emergency cesarean delivery.

Data Sources: MEDLINE, Embase, Cochrane, and ClinicalTrials.

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Sonographic Cortical Development and Anomalies in the Fetus: A Systematic Review and Meta-Analysis.

Biomedicines

June 2024

Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, 66100 Chieti, Italy.

The aim of this systematic review is to report the normal cortical development of different fetal cerebral fissures on ultrasound, describe associated anomalies in fetuses with cortical malformations, and evaluate the quality of published charts of cortical fissures. The inclusion criteria were studies reporting development, anomalies, and reference charts of fetal cortical structures on ultrasound. The outcomes observed were the timing of the appearance of different cortical fissures according to different gestational age windows, associated central nervous system (CNS) and extra-CNS anomalies detected at ultrasound in fetuses with cortical malformation, and rate of fetuses with isolated anomaly.

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Evidence-based interventions to address persistent maternal mortality rates.

Ultrasound Obstet Gynecol

November 2024

Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.

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The utility of dynamic contrast-enhanced intranodal magnetic resonance lymphangiography (MRL) in the investigation of primary lymphatic anomalies.

Clin Radiol

October 2024

Molecular and Clinical Sciences Research Institute, St George's University of London, London SW17 0RE, UK; Dermatology and Lymphovascular Medicine, St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK.

Article Synopsis
  • The study aimed to describe a technique called DCMRL to identify central lymphatic abnormalities in patients with primary lymphatic issues and discuss the usefulness of the findings.
  • Twenty-eight patients underwent dynamic MRI after gadolinium was injected into their inguinal lymph nodes, with a technical success rate of 82.1%.
  • The results revealed various lymphatic pathologies, such as obstructions and leaks, and led to protocol improvements for better imaging; two patients benefited from embolization, demonstrating DCMRL's safety and effectiveness.
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Thrombospondin-1 Drives Cardiac Remodeling in Chronic Kidney Disease.

JACC Basic Transl Sci

May 2024

Kidney Injury Group, Centre for Transplant and Renal Research, Westmead Institute for Medical Research, Westmead, New South Wales, Australia.

Patients with chronic kidney disease (CKD) face a high risk of cardiovascular disease. Previous studies reported that endogenous thrombospondin 1 (TSP1) involves right ventricular remodeling and dysfunction. Here we show that a murine model of CKD increased myocardial TSP1 expression and produced left ventricular hypertrophy, fibrosis, and dysfunction.

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