Glenfield Hospital

About: Glenfield Hospital is a healthcare organization based out in Leicester, United Kingdom. It is known for research contribution in the topics: Population & Extracorporeal membrane oxygenation. The organization has 1382 authors who have published 1812 publications receiving 99238 citations. The organization is also known as: Glenfield General Hospital.

Clinical trial: oral prednisolone metasulfobenzoate (Predocol) vs. oral prednisolone for active ulcerative colitis.

Abstract: Summary Background Systemic corticosteroids are effective in ulcerative colitis but commonly cause side effects. Aim To compare the safety and efficacy of a sparingly absorbed formulation of prednisolone metasulfobenzoate (Predocol) with a conventional tapering course of oral prednisolone. Method In a double-blind randomized study, 59 active ulcerative colitis patients received Predocol 40 mg/day for 6 months, 61 received Predocol 60 mg/day for 6 months and 61 received prednisolone 40 mg/day for 2 weeks, tapered to week 8, followed by placebo until 6 months. Results Steroid-related side effects assessed using a 10-cm visual analogue scale were fewer at 2 months with Predocol 40 mg [VAS 8.1 cm (2.6), mean (s.d.)], or 60 mg [8.1 (2.1)] compared with prednisolone [6.7 (2.7); P = 0.01]. Mood changes affected 43% receiving prednisolone at 4 weeks vs. 8% for Predocol 40 mg (P = 0.001). Remission rates (Powell-Tuck ≤2) at 2 months were Predocol 40 mg 46%, Predocol 60 mg 28% and tapering prednisolone 41% (P = 0.13). Visual analogue scale for efficacy also showed non-inferiority for Predocol 40 mg/day. Remission rates at 6 months were Predocol 40 mg 51%, Predocol 60 mg 38% and tapering prednisolone 32% (P = 0.08). Conclusion Predocol 40 mg/day has similar efficacy but markedly fewer side effects than a conventional tapering prednisolone regimen (ISRCTN14133410).

A Clinical Tool to Predict Low Serum Selenium in Patients with Worsening Heart Failure.

Abstract: Selenium is an essential micronutrient, and a low selenium concentration ( 80% of patients with low selenium (sensitivity of 44%, specificity of 80%). Given that selenium and iron overlap in their physiological roles, we evaluated the shared determinants and prognostic associates. Both deficiencies shared similar clinical characteristics, including the model risk factors and, in addition, a low protein intake and high levels of C-reactive protein. Low selenium was associated with a similar or worse prognosis compared to iron deficiency. In conclusion, although it is difficult to exclude low selenium based on clinical characteristics alone, we provide a prediction tool which identifies heart failure patients at higher risk of having a low selenium status.

Thrombosis and coagulopathy in COVID-19 patients requiring extracorporeal membrane oxygenation.

Abstract: From the *Department of Cardiothoracic Critical Care Medicine and ECMO, University Hospitals of Leicester National Health Service Trust, Glenfield Hospital, Leicester, United Kingdom; †Leicester Medical School, University of Leicester, Leicester, United Kingdom; ‡University of Birmingham, Institute of Inflammation and Ageing, Centre of Translational Inflammation Research, Birmingham Acute Care Research, Birmingham, United Kingdom; and §Columbia University College of Physicians and Surgeons, New York, NY, USA; the Center for Acute Respiratory Failure, New York–Presbyterian Hospital, New York, NY, USA. Submitted for consideration May 2020; accepted for publication in revised form May 2020. Disclosure: Daniel Brodie is on the medical advisory boards for Breethe, Xenios, and Hemovent and is a past medical advisory board member for Baxter and ALung Technologies; he is currently on the trial steering committee for the VENT-AVOID trial sponsored by ALung Technologies. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Correspondence: Hakeem Yusuff, Department of Cardiothoracic Critical Care Medicine and ECMO, University Hospitals of Leicester National Health Service Trust, Glenfield Hospital, Groby Road, Leicester LE39QP, United Kingdom. Email: hakeem.yusuff1@nhs.net The coronavirus disease 2019 (COVID-19) pandemic has challenged intensivists caring for patients with severe respiratory disease, associated multiorgan dysfunction, and high mortality.1 Extracorporeal membrane oxygenation (ECMO) has been used to manage patients with COVID 19-associated severe respiratory or cardiac failure with mortality in excess of 50%.2,3 A significant feature of this disease appears to be an excess of thrombosis and there have been reports of an incidence of more than 30% of intensive care unit (ICU) admissions.4 The etiology of thrombosis in this setting may be closely linked with the hyperinflammatory response of the immune system when exposed to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).5 In addition, there is early development of a disseminated intravascular coagulation (DIC)-like picture in a subset of patients, the management of which is made more complicated if providing systemic anticoagulation to prevent thrombosis and maintain the extracorporeal circuit. The purpose of this editorial is to briefly discuss COVID-19-associated procoagulant and anticoagulant states in the context of ECMO support.