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.

The minimal important difference for the endurance shuttle walk test in individuals with chronic obstructive pulmonary disease following a course of pulmonary rehabilitation

Abstract: The endurance shuttle walk test (ESWT) is frequently used as an outcome measure for pulmonary rehabilitation (PR). The minimal important difference (MID) for the ESWT after a course of rehabilitati...

Unravelling the mystery of the ‘minimum important difference’ using practical outcome measures in chronic respiratory disease:

Abstract: It is important for clinicians and researchers to understand the effects of treatments on their patients, both at an individual and group level. In clinical studies, treatment effects are often rep...

Rationale and design of the randomised controlled trial to assess the impact of liraglutide on cardiac function and structure in young adults with type 2 diabetes (the LYDIA study)

Abstract: The prevalence of type 2 diabetes (T2DM) in younger adults is growing. Compared to the late onset T2DM, it is well recognized that the disease tends to behave more aggressively in the younger age group with evidence of premature micro and macrovasular diseases and shorter life span. This increased mortality is largely attributed to cardiovascular complications. In a recent pilot study, young adults with T2DM were found to have significantly lower peak diastolic strain rate (PEDSR) on cardiac MRI (CMR), a forerunner of diabetic cardiomyopathy. Liraglutide, a glucagon like peptide-1 (GLP-1) analogue, is one of the new classes of glucose lowering therapies licensed to be used in management of T2DM. In randomised controlled trials, liraglutide improves glycaemic control by 1–1.5 % with an added benefit of weight loss of 2–3 kg. In addition, there is emerging evidence elucidating the cardioprotective effects of GLP-1 analogues independent of glycaemic control. In a small study, liraglutide has also been shown to improve cardiac function in patients with coronary ischaemia or congestive heart failure. This is a prospective, randomised, open-label, blind end-point (PROBE) active-comparator trial. A total of 90 obese eligible participants with T2DM (18–50 years) will be randomised to either liraglutide 1.8 mg once daily or sitagliptin 100 mg once daily for 26 weeks. The primary aim is to assess whether liraglutide improves diastolic function compared to sitagliptin as measured by PEDSR using CMR. Although newer classes of GLP-1 analogues are made available in recent years, there are very few published studies demonstrating the beneficial effect of GLP-1 analogues on cardiovascular endpoints. In a recently published LEADER study, liraglutide has shown superiority to placebo in a population of type 2 diabetes with high risk of cardiovascular disease. To the best of our knowledge, there are no published studies establishing the effect of liraglutide on cardiac function in younger patients with T2DM on a larger scale. The LYDIA study will comprehensively describe changes in various parameters of cardiac structure and function in patients treated with liraglutide aiming to provide new evidence on effect of liraglutide on diastolic function in young obese people with T2DM. Trial Registration ClinicalTrials.gov identifier: NCT02043054

What should we do about blood pressure and stroke

Abstract: As we draw towards the end of this millennium, it will become clear whether the aspirations raised by the Health of the Nation document will be realized with regard to the reduction in mortality from stroke. The target of a 40% decrease in stroke deaths by the year 2000 in those aged 65–74 years may initially have appeared optimistic without any specific new interventions, but mortality rates have been consistently falling in both the UK and most, but not all, Westernized countries over the past 2–3 decades.1 This decrease in mortality is probably due to a combination of decreased stroke incidence and stroke severity, as well as a reduction in death rate following the acute event. However, in the UK there are still over 120 000 strokes per annum, about 20% being due to a recurrence. Overall, 20% will die within the first few months of the event, and up to 35% of the survivors will still be dependent after a year.2 Primary stroke reduction must come from attacking the major risk factors, of which hypertension remains the primary treatable cause. This editorial deals primarily with the relation between ischaemic stroke and blood pressure (BP), and the benefits or otherwise of BP reduction in both primary and secondary prevention. Data from prospective observational studies have highlighted the strong association between increasing BP levels and stroke incidence for both cerebral haemorrhage and infarction. In the Prospective Studies Collaboration, a meta-analysis of 45 studies involving 450 000 subjects aged 15–99 years with a mean follow-up of 16 years, diastolic blood pressure (DBP) levels were closely related to stroke risk after adjustment for other potential confounding variables; for every 10 mmHg DBP increase, stroke risk rose by 80%.3 However the BP/stroke relation varies with age, the gradient being much steeper in younger …