112 results match your criteria: "UCL Hospitals Biomedical Research Centre[Affiliation]"

Objective: We aimed to evaluate the risks of death and cardiovascular death of different subtypes of masked hypertension, defined by either isolated daytime or nighttime blood pressure (BP) elevation, or both, compared with patients with normal both office and 24-h BP.

Methods: We selected 4999 patients with masked hypertension (normal office BP and elevated 24-h BP). They were divided in three different categories: isolated daytime masked hypertension (elevated daytime BP and normal nighttime BP, 800 patients), isolated nighttime masked hypertension (elevated nighttime BP and normal daytime BP, 1069 patients) and daytime and nighttime masked hypertension (elevation of both daytime and nighttime BP, 2989).

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Differences in recording of cancer diagnosis between datasets in England: A population-based study of linked cancer registration, hospital, and primary care data.

Cancer Epidemiol

November 2024

ECHO (Epidemiology of Cancer Healthcare & Outcomes), Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, UCL (University College London), 1-19 Torrington Place, London WC1E 7HB, UK. Electronic address:

Article Synopsis
  • The study examines discrepancies in cancer case status and diagnosis dates between cancer registry (CR) data and electronic health records (EHRs) for five types of cancer over a period from 1999 to 2018.
  • Among the findings, agreement in cancer diagnoses varied significantly between datasets, with combined CPRD-HES data confirming 84% to 92% of diagnoses compared to CR, but lower rates for individual data sources like HES and CPRD.
  • The research concludes that while combined primary and secondary care data may often reflect case status accurately, inconsistencies in diagnosis dates could affect cancer risk estimates and diagnostic pathways in studies.
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Trends in Pediatric Hospital Admissions Caused or Contributed by SARS-CoV-2 Infection in England.

J Pediatr

January 2025

Institute of Cardiovascular Science, UCL, London, United Kingdom; Biomedical Research Centre, Great Ormond Street Hospital for Children, London, United Kingdom. Electronic address:

Objective: To investigate the changing characteristics of SARS-CoV-2-related pediatric hospital admissions over time.

Study Design: This was a national, observational cohort study from July 1, 2020, to August 31, 2023, using English population-linked electronic health records. We identified 45 203 children younger than 18 years old in whom SARS-CoV-2 either caused or contributed to hospitalization, excluding those admitted with "incidental" infection.

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Resistant Hypertension and Mortality: An Observational Cohort Study.

Hypertension

November 2024

University College London (UCL) Institute of Cardiovascular Science and National Institute for Health Research, UCL Hospitals Biomedical Research Centre, United Kingdom (B.W.).

Background: Resistant hypertension is characterized by elevated blood pressure (BP) despite using 3 antihypertensive agents. Ambulatory BP monitoring (ABPM) detects the presence of white-coat resistant hypertension (24-hour BP <130/80 mm Hg). The aim of the study was to evaluate risks of death in resistant hypertension compared with controlled hypertension, as well as in ABPM-confirmed (24-hour BP ≥130 or 80 mm Hg), versus white-coat resistant hypertension.

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Blood pressure (BP) is a key contributor to the lifetime risk of preclinical organ damage and cardiovascular disease. Traditional clinic-based BP readings are typically measured infrequently and under standardized/resting conditions and therefore do not capture BP values during normal everyday activity. Therefore, current hypertension guidelines emphasize the importance of incorporating out-of-office BP measurement into strategies for hypertension diagnosis and management.

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There is scarce evidence of the role of clinic and ambulatory BP indices, as well as blood pressure phenotypes in the prognosis of stroke survivors. We aimed to evaluate the association between ambulatory BP indices and mortality in patients with a previous stroke. Our study was an observational cohort study from individuals included in the Spanish Ambulatory Blood Pressure Registry from March 2004 to December 2014.

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Background And Aims: Guidelines suggest similar blood pressure (BP) targets in patients with and without diabetes and recommend ambulatory BP monitoring (ABPM) to diagnose and classify hypertension. It was explored whether different levels of ambulatory and office BP and different hypertension phenotypes associate with differences of risk in diabetes and no diabetes.

Methods: This analysis assessed outcome data from the Spanish ABPM Registry in 59 124 patients with complete available data.

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Artificial Intelligence-Derived Risk Prediction: A Novel Risk Calculator Using Office and Ambulatory Blood Pressure.

Hypertension

January 2025

Department of Internal Medicine III, Cardiology, Angiology, Intensive Care Medicine, Universitätsklinikum des Saarlandes, Saarland University, Homburg/Saar, Germany (M.B., L.L., F.M.).

Background: Quantification of total cardiovascular risk is essential for individualizing hypertension treatment. This study aimed to develop and validate a novel, machine-learning-derived model to predict cardiovascular mortality risk using office blood pressure (OBP) and ambulatory blood pressure (ABP).

Methods: The performance of the novel risk score was compared with existing risk scores, and the possibility of predicting ABP phenotypes utilizing clinical variables was assessed.

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Prognostic Relevance of Short-Term Blood Pressure Variability. The Spanish ABPM Registry.

Hypertension

May 2024

Hypertension Unit and Cardiorenal Translational Laboratory, Madrid, Spain (J.S., L.M.R.).

Background: The prognostic relevance of short-term blood pressure (BP) variability in hypertension is not clearly established. We aimed to evaluate the association of short-term BP variability, with all-cause and cardiovascular mortality in a large cohort of patients with hypertension.

Methods: We selected 59 124 patients from the Spanish Ambulatory Blood Pressure Monitoring Registry from 2004 to 2014 (median follow-up: 9.

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Objective: To report a validation of the Riester Big Ben Square Desk Aneroid Sphygmomanometer according to the international protocol developed by the Working Group on Blood Pressure Monitoring of the European Society of Hypertension 2002 (ESH-IP 2002) in the interest of transparency. This legacy publication is intended to assure users that the device satisfied the requirements in place at that time.

Methods: Performance of the device was assessed by participants' age, sex, arm circumference and entry SBP/DBP.

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Objective: It has been suggested that a blunted nocturnal blood pressure (BP) decline is associated with a poor prognosis. Nevertheless, it remains unclear if an abnormal dipping is deleterious per se or it merely reflects an elevated BP during sleep. We aimed to assess the prognostic value of nocturnal BP decline, with or without concomitant elevated nocturnal BP.

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Ambulatory blood pressure monitoring and mortality - Authors' reply.

Lancet

March 2024

Institute of Cardiovascular Science and National Institute for Health Research, University College London (UCL), UCL Hospitals Biomedical Research Centre, London W1T 7DN, UK. Electronic address:

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Background: The treatment landscape for relapsing multiple sclerosis (MS) has changed dramatically in recent decades, including an increasing number of high-efficacy disease-modifying therapies (DMTs) with varied administration and monitoring requirements. Coupled with greater focus on earlier treatment, these factors have resulted in stretching of the capacity of MS specialist services and allied healthcare professionals (HCPs). To assist with the effective planning of MS services in the UK NHS, this study quantified the administration and monitoring time burden associated with high-efficacy DMTs (alemtuzumab, cladribine tablets, fingolimod, natalizumab, and ocrelizumab) for relapsing MS.

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Aortic distensibility (AD) is important for the prognosis of multiple cardiovascular diseases. We propose a novel resource-efficient deep learning (DL) model, inspired by the bi-directional ConvLSTM U-Net with densely connected convolutions, to perform end-to-end hierarchical learning of the aorta from cine cardiovascular MRI towards streamlining AD quantification. Unlike current DL aortic segmentation approaches, our pipeline: (i) performs simultaneous spatio-temporal learning of the video input, (ii) combines the feature maps from the encoder and decoder using non-linear functions, and (iii) takes into account the high class imbalance.

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Identifying and ranking novel independent features for cardiovascular disease prediction in people with type 2 diabetes.

medRxiv

October 2023

Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom.

Background: CVD prediction models do not perform well in people with diabetes. We therefore aimed to identify novel predictors for six facets of CVD, (including coronary heart disease (CHD), Ischemic stroke, heart failure (HF), and atrial fibrillation (AF)) in people with T2DM.

Methods: Analyses were conducted using the UK biobank and were stratified on history of CVD and of T2DM: 459,142 participants without diabetes or a history of CVD, 14,610 with diabetes but without CVD, and 4,432 with diabetes and a history of CVD.

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Background And Aims: Whether bedtime versus morning administration of antihypertensive therapy is beneficial on outcomes is controversial. We evaluated the risk of total and cardiovascular mortality in a very large observational cohort of treated hypertensive patients, according to the timing of their usual treatment administration (morning versus evening).

Methods: Vital status and cause of death were obtained from death certificates of 28 406 treated hypertensive patients (mean age 62 years, 53% male individuals), enrolled in the Spanish Ambulatory Blood Pressure Monitoring (ABPM) Registry between 2004 and 2014.

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A taxonomy of early diagnosis research to guide study design and funding prioritisation.

Br J Cancer

November 2023

ECHO (Epidemiology of Cancer Healthcare & Outcomes), Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, UCL (University College London), 1-19 Torrington Place, London, WC1E 7HB, UK.

Researchers and research funders aiming to improve diagnosis seek to identify if, when, where, and how earlier diagnosis is possible. This has led to the propagation of research studies using a wide range of methodologies and data sources to explore diagnostic processes. Many such studies use electronic health record data and focus on cancer diagnosis.

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Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.

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Background: Treatment with cladribine tablets, a high-efficacy disease-modifying therapy (DMT), has been available in England since 2017 for patients with highly active relapsing multiple sclerosis (MS). Real-world data on treatment completion, persistence and switching in patients treated with cladribine tablets are beginning to emerge, but only small single and multicentre cohorts have reported so far. This longitudinal retrospective observational study (CLARENCE) evaluated a large cohort (>1900) of patients with highly active relapsing MS, receiving cladribine tablets across England, to determine rates of treatment completion, persistence and switching in the real world.

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Objective: Hypertension management is directed by cuff blood pressure (BP), but this may be inaccurate, potentially influencing cardiovascular disease (CVD) events and health costs. This study aimed to determine the impact on CVD events and related costs of the differences between cuff and invasive SBP.

Methods: Microsimulations based on Markov modelling over one year were used to determine the differences in the number of CVD events (myocardial infarction or coronary death, stroke, atrial fibrillation or heart failure) predicted by Framingham risk and total CVD health costs based on cuff SBP compared with invasive (aortic) SBP.

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Article Synopsis
  • The text lists a diverse group of individuals from various countries involved in a specific academic or professional field, highlighting the international collaboration.
  • The names represent a wide range of nationalities, including participants from continents such as North America, Europe, Asia, and South America.
  • The purpose of this assembly may be related to research, a conference, or a project aiming to address global issues in their field of expertise.
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Background: Patients with antibody deficiency respond poorly to coronavirus disease 2019 (COVID-19) vaccination and are at risk of severe or prolonged infection. They are given long-term immunoglobulin replacement therapy (IRT) prepared from healthy donor plasma to confer passive immunity against infection. Following widespread COVID-19 vaccination alongside natural exposure, we hypothesized that immunoglobulin preparations will now contain neutralizing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike antibodies, which confer protection against COVID-19 disease and may help to treat chronic infection.

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Diagnostic windows in non-neoplastic diseases: a systematic review.

Br J Gen Pract

September 2023

ECHO (Epidemiology of Cancer Healthcare & Outcomes), Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London (UCL), London.

Article Synopsis
  • * A systematic review identified 27 studies across 17 non-neoplastic conditions, finding diagnostic windows ranging from 28 days to 9 years, though many conditions lacked enough data to determine precise lengths.
  • * The findings suggest that many non-neoplastic conditions can be detected much earlier than current practices allow, highlighting the need for more research to refine estimates of diagnostic windows and improve early diagnosis strategies.
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