11,641 results match your criteria: "National Institute for Health Research[Affiliation]"

New thinking and a new direction in bronchiectasis.

Lancet Respir Med

November 2024

Respiratory Medicine Unit and Oxford Respiratory National Institute for Health Research Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK. Electronic address:

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Patients with schizophrenia receiving antipsychotic treatment present lower mortality rates than those who do not. However, the non-adherence rate is high, which can be partially addressed using long-acting injectable (LAI) antipsychotics. The impact of LAI treatments on all-cause mortality compared to oral antipsychotics remains unclear.

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Article Synopsis
  • * The REPPORT trial is a multicenter study comparing personalized rehabilitation to surgery for managing this condition, targeting 276 participants across the UK and using random assignment to treatment groups.
  • * The trial will evaluate effectiveness based on participant-reported outcomes over 18 months and gather additional data on health impacts and resource use, with results set to be shared in peer-reviewed publications.
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Evaluating the role of aldosterone synthesis on adrenal cell fate.

Front Endocrinol (Lausanne)

August 2024

Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Hypertension affects one-third of the adult population worldwide, with primary aldosteronism (PA) accounting for at least 5-10% of these cases. The aldosterone synthase enzyme (CYP11B2) plays a pivotal role in PA manifestation, as increased expression of CYP11B2 leads to excess aldosterone synthesis. Physiological expression of CYP11B2 in humans is normally limited to cells of the adrenal zona glomerulosa under tight homeostatic regulation.

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Harnessing transcriptomic signals for amyotrophic lateral sclerosis to identify novel drugs and enhance risk prediction.

Heliyon

August 2024

Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

Article Synopsis
  • This study explores genetic associations related to amyotrophic lateral sclerosis (ALS) and aims to provide insights into potential treatments and risk prediction.
  • The researchers identified 118 genes linked to ALS using advanced statistical methods and discovered possible repurposing opportunities for six drugs, noting varying impacts of drug classes on ALS risk.
  • The results suggest that new genetic analyses can enhance understanding of ALS mechanisms and improve predictions of disease risk and patient outcomes.
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A gut microbiota rheostat forecasts responsiveness to PD-L1 and VEGF blockade in mesothelioma.

Nat Commun

August 2024

National Institute for Health Research Biomedical Research Centre & Cancer Research UK Experimental Cancer Medicine Centre, University of Leicester, Leicester, UK.

Malignant mesothelioma is a rare tumour caused by asbestos exposure that originates mainly from the pleural lining or the peritoneum. Treatment options are limited, and the prognosis is dismal. Although immune checkpoint blockade (ICB) can improve survival outcomes, the determinants of responsiveness remain elusive.

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Background: Current treatments for bipolar depression have limited effectiveness, tolerability and acceptability. Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation method that has demonstrated treatment efficacy for major depressive episodes. tDCS is portable, safe, and individuals like having sessions at home.

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CT Myocardial Perfusion and CT-FFR versus Invasive FFR for Hemodynamic Relevance of Coronary Artery Disease.

Radiology

August 2024

From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.S., R.S., M.T.H., C.L.S., F.B.); Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany (C.B., K. Nikolaou, P.K., C.P.A.); Department of Computed Tomography, Siemens Healthcare GmbH, Forchheim, Germany (S.F., C.S.); Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands (F.M.A.N., K. Nieman); Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, Barts National Institute for Health Research Biomedical Research Centre, Queen Mary University of London, London, United Kingdom (F.P.); Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (R.V.); and Stanford University School of Medicine and Cardiovascular Institute, Stanford, Calif (K. Nieman).

Background CT-derived fractional flow reserve (CT-FFR) and dynamic CT myocardial perfusion imaging enhance the specificity of coronary CT angiography (CCTA) for ruling out coronary artery disease (CAD). However, evidence on comparative diagnostic value remains scarce. Purpose To compare the diagnostic accuracy of CCTA plus CT-FFR, CCTA plus CT perfusion, and sequential CCTA plus CT-FFR and CT perfusion for detecting hemodynamically relevant CAD with that of invasive angiography.

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Systematic review: Mortality associated with raised faecal immunochemical test and positive faecal occult blood results.

Aliment Pharmacol Ther

October 2024

National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Queen's Medical Centre, Nottingham, UK.

Background: Faecal haemoglobin (f-Hb) testing is used in colorectal cancer (CRC) screening and increasingly to guide the investigation in patients with symptoms suggestive of CRC. Studies have demonstrated increased mortality with raised f-Hb.

Aims: To assess the association of raised f-Hb with all-cause, non-CRC (any cause excluding CRC) and cause-specific mortality.

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Novel diagnostic approaches and management of coronary microvascular dysfunction.

Am J Prev Cardiol

September 2024

Translational and Clinical Research Institute, Faculty of Medical Sciences, NewcastleUniversity, Newcastle upon Tyne, UK.

Article Synopsis
  • - Ischaemic heart disease (IHD) has mainly been linked to obstructive coronary artery disease (CAD), but over 50% of patients have non-obstructive coronary arteries, leading to interest in angina due to these non-obstructive conditions (ANOCA/INOCA).
  • - INOCA includes various causes like coronary microvascular dysfunction (CMD) and vasospastic angina, with CMD resulting from poor vasodilatory capacity of small blood vessels; it is particularly more common in women and linked to worse heart health outcomes.
  • - Research has improved the understanding and classification of these conditions, including the use of advanced imaging and testing methods to better diagnose CMD and inform treatment strategies for affected patients. *
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Aims: To undertake a Priority Setting Partnership (PSP), identifying the most important unanswered questions in type 1 diabetes in Ireland and the United Kingdom and to compare these to priorities identified in a 2011 PSP.

Methods: A steering committee (including eight individuals with lived experience/charity representatives and six clinicians) designed a survey which asked stakeholders to list three questions about type 1 diabetes. This was disseminated through social media, direct email contact, and printed posters.

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Background: Pulmonary Rehabilitation (PR) services typically offer programmes to support individuals living with COPD make rehabilitation choices that best meet their needs, however, uptake remains low. Shared Decision-Making (SDM; e.g.

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Importance: Many studies show the adverse consequences of insufficient nurse staffing in hospitals, but safe and effective staffing is unlikely to be just about staff numbers. There are considerable areas of uncertainty, including whether temporary staff can safely make up shortfalls in permanent staff and whether using experienced staff can mitigate the effect of staff shortages.

Objective: To explore the association of the composition of the nursing team with the risk of patient deaths.

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  • Eczema and psoriasis are inflammatory skin diseases that have different molecular causes, necessitating more detailed research to improve diagnosis and treatment.
  • The study used non-invasive skin sampling to analyze proteins in various skin types from individuals with psoriasis and eczema, revealing IL-36γ as a strong biomarker for psoriasis and elafin as a better indicator for distinguishing between the two conditions.
  • Findings show significant differences in protein expression between healthy and diseased skin, with implications for developing targeted therapies based on these molecular markers.
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  • - Guselkumab, an interleukin-23p19 subunit inhibitor, has shown significant improvements in clinical outcomes and patient-reported results in patients with moderate-to-severe psoriasis, emphasizing the need for personalized treatment approaches based on these factors.
  • - A post hoc analysis of the VOYAGE 1 trial revealed that 22.2% of patients maintained complete skin clearance for over three years, with this group showing lower baseline rates of obesity and depression, and a higher rate of non-smokers compared to those who did not maintain clearance.
  • - Despite achieving full skin clearance, some patients still reported quality-of-life impacts, particularly in the areas of symptoms and feelings, indicating that clinical measures alone may not fully capture the
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Multiphoton intravital microscopy (MP-IVM) is an imaging technique used for the observation of living organisms at a microscopic resolution. The tissue of interest is exposed through a window allowing imaging of cells in real time. Using MP-IVM, the temporospatial kinetics of leukocyte transendothelial migration can be visualized and quantitated using reporter mice and cell-specific fluorophore-conjugated monoclonal antibodies to track the leukocytes within and outside of vascular beds.

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International consensus statement on the diagnosis and management of phaeochromocytoma and paraganglioma in children and adolescents.

Nat Rev Endocrinol

December 2024

Department of Medicine III, University Hospital Carl Gustav Carus, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.

Phaeochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumours that arise not only in adulthood but also in childhood and adolescence. Up to 70-80% of childhood PPGL are hereditary, accounting for a higher incidence of metastatic and/or multifocal PPGL in paediatric patients than in adult patients. Key differences in the tumour biology and management, together with rare disease incidence and therapeutic challenges in paediatric compared with adult patients, mandate close expert cross-disciplinary teamwork.

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Glycated haemoglobin is a major predictor of disease severity in patients with NAFLD.

Diabetes Res Clin Pract

November 2024

Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford and NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Electronic address:

Objectives: Currently, non-invasive scoring systems to stage the severity of non-alcoholic fatty liver disease (NAFLD) do not consider markers of glucose control (glycated haemoglobin, HbA1c); this study aimed to define the relationship between HbA1c and NAFLD severity in patients with and without type 2 diabetes.

Research Design And Methods: Data were obtained from 857 patients with liver biopsy staged NAFLD. Generalized-linear models and binomial regression analysis were used to define the relationships between histological NAFLD severity, age, HbA1c, and BMI.

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Hippocampal Glutamate, Resting Perfusion and the Effects of Cannabidiol in Psychosis Risk.

Schizophr Bull Open

January 2023

Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Background: Preclinical and human data suggest that psychosis onset involves hippocampal glutamatergic dysfunction, driving hyperactivity and hyperperfusion in a hippocampal-midbrain-striatal circuit. Whether glutamatergic dysfunction is related to cerebral perfusion in patients at clinical high risk (CHR) for psychosis, and whether cannabidiol (CBD) has ameliorative effects on glutamate or its relationship with perfusion remains unknown.

Methods: Using a double-blind, parallel-group design, 33 CHR patients were randomized to a single 600 mg dose of CBD or placebo; 19 healthy controls did not receive any drug.

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Background: The genetic and environmental aetiology of autistic and Attention Deficit Hyperactivity Disorder (ADHD) traits is known to vary spatially, but does this translate into variation in the association of specific common genetic variants?

Methods: We mapped associations between polygenic scores for autism and ADHD and their respective traits in the Avon Longitudinal Study of Parents and Children (N = 4,255-6,165) across the area surrounding Bristol, UK, and compared them to maps of environments associated with the prevalence of autism and ADHD.

Results: Our results suggest genetic associations vary spatially, with consistent patterns for autistic traits across polygenic scores constructed at different p-value thresholds. Patterns for ADHD traits were more variable across thresholds.

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Article Synopsis
  • Prehabilitation is a program that helps patients get ready for surgery using exercise, nutrition, and mental support to improve their recovery.
  • A study looked at 23 articles involving 1,849 older patients to see how well these programs worked before major surgeries.
  • The results showed that most patients liked prehabilitation and did well in following the program, which also helped them walk better after surgery, although it didn't significantly lower complications.
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  • A study in Ethiopia examined different methods to measure face washing behavior in the context of trachoma elimination, highlighting the need for reliable indicators.
  • The research compared survey reports, pictorial recall, and facial cleanliness assessments to structured observations to evaluate accuracy.
  • Results showed that self-reported face washing was generally overestimated, and while pictorial recall had high specificity, its low sensitivity indicated challenges in accurately capturing washing behaviors.
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  • - The study presents a deep learning system aimed at speeding up the identification of new biomarkers for age-related macular degeneration (AMD) using a large dataset of retinal OCT images from 3,456 adults aged 51-102 years.
  • - A neural network trained with self-supervised learning identified features in 46,496 OCT images, which were then categorized into 30 clusters to help specialists assign clinical meanings to these features.
  • - The results showed that 27 out of 30 clusters had distinct characteristics related to AMD, with 7 corresponding to established biomarkers and 16 potentially representing new or recent biomarker combinations not currently used in grading systems.
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Background: Pulmonary vein isolation (PVI) ablation is the established gold standard therapy for patients with symptomatic drug refractory atrial fibrillation (AF). Advancements in radiofrequency (RF) ablation, have led to the development of the novel contact force-sensing temperature-controlled very high-power short-duration (vHPSD) RF ablation. This setting delivers 90 W for up to 4 seconds with a constant irrigation flow rate of 8 mL/min.

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  • The study aimed to compare the occurrence of breakthrough COVID-19 infections (BIs) in fully vaccinated patients with systemic lupus erythematosus (SLE) against those with other rheumatic autoimmune diseases (rAIDs), non-rheumatic autoimmune diseases (nrAIDs), and healthy controls (HCs).
  • Results showed that 10.7% of SLE patients reported at least one BI, with frequencies similar to HCs and nrAID patients but higher than those with other rAIDs.
  • Overall, vaccinated SLE patients experienced comparable levels of COVID-19 infection frequency and severity as healthy individuals, with no significant association found between demographic factors or treatments and BIs in SLE patients.
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