188 results match your criteria: "University Hospitals Leicester NHS Trust[Affiliation]"

Article Synopsis
  • The study evaluates the implementation of perinatal health equity dashboards aimed at addressing disparities in maternal and neonatal outcomes in healthcare settings.
  • Challenges identified include issues with data accuracy, completeness, and the difficulty of collecting consistent information, especially from diverse ethnic groups.
  • Further research is necessary to understand the long-term impact of these dashboards on reducing health inequalities while enhancing their effectiveness through improved data collection methods.
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Aims: This expert consensus reviews the reality of primary care clinical management of people with type 2 diabetes (T2D) on non-intensive insulin therapy, with an emphasis on the use of continuous glucose monitoring (CGM) technology for effective care in this participant group. Here, we identify key unmet needs for skills and systems development within this frontline healthcare setting, along with major challenges and opportunities associated with managing these changes effectively.

Methods: The authors participated in two primary care consensus panels held on 28 November 2023 and on 21 May 2024.

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Article Synopsis
  • The study assessed the effectiveness of enhanced insulin secretion and sensitivity measurements in diagnosing and managing gestational diabetes mellitus (GDM) among pregnant women at risk.
  • A total of 1,308 pregnant women were analyzed using a standard 75 g oral glucose tolerance test (OGTT) and categorized into specific GDM subtypes based on their insulin resistance and insufficiency levels.
  • Results showed that many women classified as having GDM exhibited unique characteristics, including a subgroup that was insulin-sensitive but displayed high blood sugar after meals, indicating the need for refined diagnostic criteria.
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Post-transplant IgA nephropathy: a rapidly evolving field of kidney transplant medicine.

J Nephrol

November 2024

Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

IgA nephropathy is the commonest pattern of primary glomerular disease in the world, with high rates of progression to kidney failure. As IgA nephropathy commonly causes kidney failure at a young age, kidney transplantation is commonly used to treat kidney failure. However, high rates of recurrent disease in the allograft remain a common management challenge.

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Unlabelled: Dietary fibre improves glycaemic control in type 2 diabetes, but its therapeutic role in women with diabetes in pregnancy is unclear. We assessed the effect of dietary fibre on markers of glycaemic control in women with diabetes in pregnancy.

Methods: We searched four databases (Cochrane Library, MEDLINE, Embase and Web of Science) to identify RCTs exploring the effect of dietary fibre, high-fibre diets or fibre supplementation on fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG) and requirement for insulin therapy, among other glycaemic makers in pregnant women with diabetes.

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Article Synopsis
  • Confocal laser endomicroscopy (CLE) offers real-time, high-resolution imaging of the stomach lining and is more effective than traditional methods like chromoendoscopy for diagnosing atrophic gastritis and predicting intraepithelial neoplasia.
  • It has a higher diagnostic accuracy for superficial gastric cancer than standard white-light endoscopy and can improve outcomes by requiring fewer biopsies.
  • Technological advancements and AI in histopathological analysis may help overcome CLE's limitations, making it a valuable tool for early gastric cancer screening while minimizing risks of complications from multiple biopsies.
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The mucosal microbiome and IgA nephropathy: a new target for treatment?

Kidney Int

December 2024

John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK; Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. Electronic address:

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Background: The increased risk of pregnancy complications in type 1 diabetes is mainly attributed to maternal hyperglycemia. However, it is unclear whether other potentially modifiable factors also contribute to risk in this population.

Purpose: We sought to assess whether high BMI and excessive gestational weight gain (GWG) are associated with perinatal complications in type 1 diabetes.

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The management of tarsal tunnel syndrome: A scoping review.

J Clin Orthop Trauma

July 2024

Department of Trauma and Orthopaedic Surgery, University Hospitals Leicester NHS Trust, University Hospitals of Leicester Headquarters, Level 3, Balmoral Building, Leicester, United Kingdom.

Background: Tarsal tunnel syndrome, also known as posterior tibial neuralgia, is a compressive neuropathy of the posterior tibial nerve or one of its divisions (calcaneal, lateral plantar or medial plantar nerve) within the tarsal tunnel. This scoping review aims to systematically map and summarise current literature regarding the management of tarsal tunnel syndrome.

Methods: PubMed, Embase, Emcare, Medline and Cinahl were searched using the terms 'tarsal tunnel', 'syndrome', 'entrapment', 'compression', 'posterior tibial', 'neuropathy' and 'neuralgia.

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The use of albuminuria or proteinuria for risk prediction in IgAN.

Nephrol Dial Transplant

December 2024

Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

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Article Synopsis
  • Neurological issues are prevalent in children hospitalized with SARS-CoV-2-related multisystem inflammatory syndrome (MIS-C), potentially leading to lasting cognitive and functional problems.
  • This study investigates how severe neurological symptoms during hospitalization relate to new cognitive and functional impairments upon discharge among children under 18.
  • Over 3,500 patients were examined, revealing that those with severe neurological manifestations had a higher likelihood of experiencing new morbidities at discharge compared to those without such issues.
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Background: Intravenous (IV) antibiotic use in secondary care in England is widespread. Timely appropriate intravenous to oral switch (IVOS) has the potential to deliver significant clinical and operational benefits. To date, antimicrobial stewardship (AMS) efforts around IVOS have not focused on the nursing staff who administer antibiotics, which represents a significant gap in AMS programmes.

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Purpose: Here, we report the sensitivity of a personalized, tumor-informed circulating tumor DNA (ctDNA) assay (Signatera) for detection of molecular relapse during long-term follow-up of patients with breast cancer.

Methods: A total of 156 patients with primary breast cancer were monitored clinically for up to 12 years after surgery and adjuvant chemotherapy. Semiannual blood samples were prospectively collected, and analyzed retrospectively to detect residual disease by ultradeep sequencing using ctDNA assays, developed from primary tumor whole-exome sequencing data.

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The identification of mitotic figures is essential for the diagnosis, grading, and classification of various different tumors. Despite its importance, there is a paucity of literature reporting the consistency in interpreting mitotic figures among pathologists. This study leverages publicly accessible datasets and social media to recruit an international group of pathologists to score an image database of more than 1000 mitotic figures collectively.

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Background: Transcatheter aortic valve implantation (TAVI) serves a growing range of patients with severe aortic stenosis (AS). TAVI has evolved to a streamlined procedure minimizing length of hospital stay.

Aims: To evaluate the safety and efficacy of an early discharge (ED) strategy after TAVI.

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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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: Angioid streaks (ASs) are a rare retinal condition and compromise visual acuity when complicated with choroidal neovascularization (CNV). They represent crack-like dehiscences at the level of the Bruch's membrane. This objective narrative review aims to provide an overview of pathophysiology, current treatment modalities, and future perspectives on this condition.

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Charting new frontiers in IgA nephropathy: a paradigm shift toward precision medicine and early intervention?

Kidney Int

April 2024

John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK; Mayer IgA Nephropathy Laboratories, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. Electronic address:

Advancements in glomerular transcriptomics offer a promising avenue toward precision medicine in IgA nephropathy. Traditional prognostic biomarkers, including proteinuria, blood pressure, and histomorphometry, fall short at capturing the complexity of IgA nephropathy and can only crudely guide therapeutic decisions. This issue needs to be addressed urgently as pathway-specific treatments become available.

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Use of autogenous fascia lata slings in the surgical correction of ptosis: a systematic review of the literature and meta-analysis.

Br J Oral Maxillofac Surg

February 2024

Honorary Professor of Surgery, Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, United Kingdom. Electronic address:

Article Synopsis
  • - Ptosis is when the upper eyelid is positioned too low, and its treatment varies based on severity and muscle function; this review focuses on using autogenous fascia lata slings (AFLS) for surgery.
  • - A total of 30 studies involving 3,690 patients were reviewed, showing a 2.79 mm improvement in eyelid position after surgery with a 21.3% complication rate, including issues like lagophthalmos and residual ptosis.
  • - AFLS surgery presents a 13.4% reoperation rate mostly for cosmetic reasons, and overall, AFLS shows comparable complication rates to traditional methods while offering better outcomes in terms of the need for additional surgeries.
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Patients with end-stage kidney disease (ESKD) have a high symptom-burden and high rates of morbidity and mortality. Despite this, evidence has shown that this patient group does not have timely discussions to plan for deterioration and death, and at the end of life there are unmet palliative care needs. Advance care planning is a process that can help patients share their personal values and preferences for their future care and prepare for declining health.

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