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.

Maternal and fetal outcomes in pregnancies complicated by Marfan syndrome

Abstract: Objectives Information to guide counselling and management for pregnancy in women with Marfan syndrome (MFS) is limited. We therefore conducted a UK multicentre study. Methods Retrospective observational study of women with MFS delivering between January 1998 and March 2018 in 12 UK centres reporting data on maternal and neonatal outcomes. Results In total, there were 258 pregnancies in 151 women with MFS (19 women had prior aortic root replacements), including 226 pregnancies ≥24 weeks (two sets of twins), 20 miscarriages and 12 pregnancy terminations. Excluding miscarriages and terminations, there were 221 live births in 139 women. Only 50% of women received preconception counselling. There were no deaths, but five women experienced aortic dissection (1.9%; one type A and four type B—one had a type B dissection at 12 weeks and subsequent termination of pregnancy). Five women required cardiac surgery postpartum. No predictors for aortic dissection could be identified. The babies of the 131 (65.8%) women taking beta-blockers were on average 316 g lighter (p Conclusion There were no maternal deaths, and the aortic dissection rate was 1.9% (mainly type B). There with no identifiable factors associated with aortic dissection in our cohort. Preconception counselling rates were low and need improvement. Aortic size measurements increased marginally following pregnancy.

British Thoracic Society guideline for bronchiectasis in adults

Abstract: The full British Thoracic Society Guideline for Bronchiectasis in Adults is published in Thorax. The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline. The appendices are available in the full guideline.

The plasma ammonia response to cycle exercise in COPD.

Abstract: The plasma ammonia response to exercise in chronic obstructive pulmonary disease (COPD) was examined and the relationship between plasma ammonia concentration and muscle adenine nucleotide metabolism was explored. In total, 25 stable COPD patients and 13 similar-aged controls underwent incremental and constant-work rate cycle exercise tests. Arterialised venous blood was sampled at rest, at 1-min intervals during exercise and

Bcl-2 is an independent prognostic factor and adds to a biological model for predicting outcome in operable non-small cell lung cancer.

Abstract: Introduction: The underlying biology of a tumour may hold the key to predicting the outcome for an individual patient as well as identifying potential therapeutic targets. Using epidermal growth factor receptor (EGFR) and matrix metalloproteinase (MMP)-9 immunoexpression combined with microvessel counts we have developed a prognostic model for operable non-small cell lung cancer (NSCLC) which predicts outcome independent of stage (Thorax, 56 (2001) 561–566). The aim of this study was to evaluate the impact of bcl-2 expression upon survival in this model. Methods: This was a retrospective analysis of 167 patients with resected stage I–IIIa NSCLC and >60 days post-operative survival. Minimum follow-up was 2 years. Immunohistochemistry was performed on paraffin-embedded tissue sections for bcl-2, EGFR, MMP-9 and the microvessel marker CD34 to evaluate the relationships between, and impact on survival of, these biological markers. Results: Tumour cell MMP-9 ( P =0.002), microvessel count > median ( P =0.01), bcl-2 ( P =0.02) and stage ( P =0.02) were independent prognostic factors. Bcl-2 expression was associated with an improved survival in all sub-groups of our prognostic model. Conclusion: bcl-2, EGFR and MMP-9 expression and angiogenesis provide prognostic information independent of TNM stage. Prognostic models offer the potential of tailoring the therapeutic management for an individual patient.

Cardiac surgery outcome during the COVID-19 pandemic: a retrospective review of the early experience in nine UK centres.

Abstract: Early studies conclude patients with Covid-19 have a high risk of death, but no studies specifically explore cardiac surgery outcome. We investigate UK cardiac surgery outcomes during the early phase of the Covid-19 pandemic. This retrospective observational study included all adult patients undergoing cardiac surgery between 1st March and 30th April 2020 in nine UK centres. Data was obtained and linked locally from the National Institute for Cardiovascular Outcomes Research Adult Cardiac Surgery database, the Intensive Care National Audit and Research Centre database and local electronic systems. The anonymised datasets were analysed by the lead centre. Statistical analysis included descriptive statistics, propensity score matching (PSM), conditional logistic regression and hierarchical quantile regression. Of 755 included individuals, 53 (7.0%) had Covid-19. Comparing those with and without Covid-19, those with Covid-19 had increased mortality (24.5% v 3.5%, p < 0.0001) and longer post-operative stay (11 days v 6 days, p = 0.001), both of which remained significant after PSM. Patients with a pre-operative Covid-19 diagnosis recovered in a similar way to non-Covid-19 patients. However, those with a post-operative Covid-19 diagnosis remained in hospital for an additional 5 days (12 days v 7 days, p = 0.024) and had a considerably higher mortality rate compared to those with a pre-operative diagnosis (37.1% v 0.0%, p = 0.005). To mitigate against the risks of Covid-19, particularly the post-operative burden, robust and effective pre-surgery diagnosis protocols alongside effective strategies to maintain a Covid-19 free environment are needed. Dedicated cardiac surgery hubs could be valuable in achieving safe and continual delivery of cardiac surgery.