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 applications of assessment of airway inflammation using induced sputum.

Abstract: Airway diseases account for a significant proportion of the respiratory physician's workload. Traditionally, conditions are classified according to clinical symptoms and abnormalities of function, although the major categories of airway disease (asthma, chronic cough and chronic obstructive pulmonary disease (COPD)) show considerable overlap in terms of both clinical picture and response to anti­inflammatory treatment with corticosteroids. All of the above conditions are associated with airway inflammation, although to date there has been little interest in its routine measurement in clinical practice. The recent development of simple, safe and valid noninvasive techniques for the assessment of airway inflammation has increased interest in such an approach 1, 2. A number of techniques are available, ranging from measurement of exhaled nitric oxide levels to performing differential cell counts and assessment of mediator concentrations in induced sputum. Relatively little is known about the relationship between these different markers, although it is likely that they measure different aspects of the inflammatory response 3. A clearer understanding is desirable since some techniques are more suited to routine clinical use than others. Induced sputum cell and mediator measurements are particularly well validated 1, and normal ranges from a relatively large adult population have been published 4. The present article summarises clinical studies pointing to the usefulness of induced sputum analysis in the following conditions: 1) asthma; 2) cough; 3) COPD; and 4) other respiratory conditions. Asthma is commonly associated with sputum eosinophilia. Up to 80% of corticosteroid­naive subjects 1, 2 and >50% of corticosteroid­treated subjects 5 with currently symptomatic asthma have a sputum eosinophil count that is outside the normal range. Subjects with severe acute asthma usually exhibit marked sputum eosinophilia, although predominant neutrophilia has been noted in some studies in which subjects …

Multiancestry Genome-Wide Association Study of Lipid Levels Incorporating Gene-Alcohol Interactions

Abstract: A person's lipid profile is influenced by genetic variants and alcohol consumption, but the contribution of interactions between these exposures has not been studied. We therefore incorporated gene-alcohol interactions into a multiancestry genome-wide association study of levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides. We included 45 studies in stage 1 (genome-wide discovery) and 66 studies in stage 2 (focused follow-up), for a total of 394,584 individuals from 5 ancestry groups. Analyses covered the period July 2014-November 2017. Genetic main effects and interaction effects were jointly assessed by means of a 2-degrees-of-freedom (df) test, and a 1-df test was used to assess the interaction effects alone. Variants at 495 loci were at least suggestively associated (P < 1 × 10-6) with lipid levels in stage 1 and were evaluated in stage 2, followed by combined analyses of stage 1 and stage 2. In the combined analysis of stages 1 and 2, a total of 147 independent loci were associated with lipid levels at P < 5 × 10-8 using 2-df tests, of which 18 were novel. No genome-wide-significant associations were found testing the interaction effect alone. The novel loci included several genes (proprotein convertase subtilisin/kexin type 5 (PCSK5), vascular endothelial growth factor B (VEGFB), and apolipoprotein B mRNA editing enzyme, catalytic polypeptide 1 (APOBEC1) complementation factor (A1CF)) that have a putative role in lipid metabolism on the basis of existing evidence from cellular and experimental models.

Baseline characteristics of patients with heart failure with preserved ejection fraction in the EMPEROR-Preserved trial

Abstract: Aims: EMPEROR-Preserved is an ongoing trial evaluating the effect of empagliflozin in patients with heart failure with preserved ejection fraction (HFpEF). This report describes the baseline characteristics of the EMPEROR-Preserved cohort and compares them with patients enrolled in prior HFpEF trials. Methods and results: EMPEROR-Preserved is a phase III randomized, international, double-blind, parallel-group, placebo-controlled trial in which 5988 symptomatic HFpEF patients [left ventricular ejection fraction (LVEF) >40%] with and without type 2 diabetes mellitus (T2DM) have been enrolled. Patients were required to have elevated N-terminal pro B-type. natriuretic peptide (NT-proBNP) concentrations (i.e. >300 pg/mL in patients without and >900 pg/mL in patients with atrial fibrillation) along with evidence of structural changes in the heart or documented history of heart failure hospitalization. Among patients enrolled from various regions (45% Europe, 11% Asia, 25% Latin America, 12% North America), the mean age was 72 ± 9 years, 45% were women. Almost all patients had New York Heart Association class II or III symptoms (99.6%), and 23% had prior heart failure hospitalization within 12 months. Thirty-three percent of the patients had baseline LVEF of 41–50%. The mean LVEF (54 ± 9%) was slightly lower while the median NT-proBNP [974 (499–1731) pg/mL] was higher compared with previous HFpEF trials. Presence of comorbidities such as diabetes (49%) and chronic kidney disease (50%) were common. The majority of the patients were on angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor–neprilysin inhibitors (80%) and beta-blockers (86%), and 37% of patients were on mineralocorticoid receptor antagonists. Conclusion: When compared with prior trials in HFpEF, the EMPEROR-Preserved cohort has a somewhat higher burden of comorbidities, lower LVEF, higher median NT-proBNP and greater use of mineralocorticoid receptor antagonists at baseline. Results of the EMPEROR-Preserved trial will be available in 2021.

The relationship between motion of the shoulder and the stated ability to perform activities of daily living.

Abstract: One hundred and twenty-five patients who were seen because of symptoms related to the shoulder completed a questionnaire regarding their ability to perform activities of daily living. The ability was graded, and the grades were related to the range of motion of the shoulder with use of correlation analysis and simple and multiple linear regression analyses. All but two activities of daily living were found to correlate significantly (p 0.5, Spearman rank correlation) were found for activities that are performed regularly by most patients, such as using a comb or washing the back. Less of a correlation (r < or = 0.5) was found for activities in which pain might constitute a large element or that are less specific, such as sleeping on the affected shoulder or performing work-related activities. The stated ability to perform various activities of daily living is part of a number of scoring systems for shoulder function. This implies that the ability to perform these activities reflects, among other factors, the range of motion of the shoulder. The relationships found in the present report validate various activities of daily living as measures of shoulder function and may help in the design of follow-up questionnaires.