Author: Jason Curtis

Coronavirus Disease 2019: the Pivotal Role of UK Clinical Oncology and the UK Coronavirus Cancer Monitoring Project (2021)

Posted on by

Type of publication:
Journal article

Author(s):
*Best ; Starkey, T.; *Chatterjee, A.; Fackrell, D.; *Pettit, L.; *Srihari, N.; Tween, H.; Olsson-Brown, A.; Cheng, V.; Hughes, D.J.; Lee, A.J.X.; Purshouse, K.; Arnold, R.; UK Coronavirus Cancer Monitoring Project Team; Sivakumar, S.; Cazier, J.-B.; Lee, L.Y.W.

Citation:
Clinical Oncology; Jan 2021; vol. 33 (no. 1), e50-e53

Abstract:

Link to full-text [no password required]

GLP-1 receptor agonists in type 2 diabetes: An underused asset? (2020)

Posted on by

Type of publication:
Journal article

Author(s):
*Morris, David

Citation:
Journal of Diabetes Nursing; Aug 2020; vol. 24 (no. 5); p. 1-11

Abstract:
As our understanding of the incretin hormone system has increased, a number of drugs targeting this system have been developed. The realisation of this potential has developed rapidly, and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are now a standard feature in management guidelines for type 2 diabetes. This article reviews the operation of the incretin system and the mechanism by which GLP-1 RAs act to provide benefit in type 2 diabetes. The availability and indications for use of the GLP-1 RAs, and their clinical benefits and disadvantages, are summarised. The position of GLP-1 RAs in the management of type 2 diabetes is discussed pragmatically, with reference to various key guidelines.

Managing diabetes during the COVID-19 pandemic (2020)

Posted on by

Type of publication:
Journal article

Author(s):
*Morris, David

Citation:
Practice Nursing; Nov 2020; vol. 31 (no. 11); p. 450-455

Abstract:
People with diabetes are known to be more severely affected by COVID-19 than the general population. David
Morris provides an overview of how to manage the illness in this group The outbreak of a new viral infection in
Wuhan, a city in Habei Province, China, became evident in December 2019. For most individuals who contract
COVID-19 the disease is mild to moderate. Older people are disproportionately affected with serious disease,
while children appear less likely to experience serious illness. A number of conditions are linked to increased
severity of disease and poorer outcomes including both type 1 and type 2 diabetes. This article looks at why
those with diabetes are at higher risk, and how to manage diabetes during the pandemic.

Link to full-text [no password required]

Cauda equina compression in metastatic prostate cancer (2020)

Posted on by

Type of publication:
Journal article

Author(s):
*Siddiqui R.S.; *Cheruvu M.S.; *Ansari H.; *Van Liefland M.

Citation:
BMJ Case Reports; Dec 2020; vol. 13 (no. 12)

Abstract:
A 67-year-old man presented to his general practitioner with intermittent episodes of unilateral sciatica over a 2-month period for which he was referred for an outpatient MRI of his spine. This evidenced a significant lumbar vertebral mass that showed tight canal stenosis and compression of the cauda equina. The patient was sent to the emergency department for management by orthopaedic surgeons. He was mobilising independently, pain free on arrival and without neurological deficit on assessment. Clinically, this patient presented with no red flag symptoms of cauda equina syndrome or reason to suspect malignancy. In these circumstances, National Institute for Health and Care Excellence guidelines do not support radiological investigation of the spine outside of specialist services. However, in this case, investigation helped deliver urgent care for cancer that otherwise may have been delayed. This leads to the question, do the current guidelines meet clinical requirements?

Link to full-text [NHS OpenAthens account required]

Cardiovascular disease incidence in 21 years follow-up in severe and non-severe familial hypercholesterolaemia (FH) : Data from the UK Simon Broome FH register (2020)

Posted on by

Type of publication:
Conference abstract

Author(s):
Iyen B.; Qureshi N.; Weng S.; Roderick P.; *Capps N.; Durrington P.; Mcdowell I.; Soran H.; Neil A.; Humphries S.E.

Citation:
Atherosclerosis; December 2020; vol. 315

Abstract:
Background: The Simon Broome (SB) FH register has previously reported a 2.2-fold higher Cardiovascular Disease (CVD) mortality in those with "severe-FH" (SFH) compared to "non-severe-FH" (NSFH). Here we examine CVD morbidity over 21 years follow-up, by linking the register participants with the UK secondary care Hospital Episode Statistics (HES) database.
Method(s): SFH and NSFH were as defined by the 2016 International Atherosclerosis Society criteria. Patients aged 20-79 years (52% female) were recruited from 21 UK lipid clinics and followed between 1997-2018. Outcomes analysed were composite CVD (first HES outcome of coronary heart disease (CHD), myocardial infarction, stable or unstable angina, stroke, TIA, PVD, heart failure, PCI and CABG) and then CVD subtypes. The excess Standardised Morbidity Ratio (SMbR) compared to an age-matched UK general practice sample was calculated (95% Confidence intervals).
Result(s): Of the 3553 SB register subjects, linkage with HES was available for 2988 (84%) participants, of whom 1,646 (66.7%) met the SFH definition. Overall the composite CVD SMbR was 6.55(6.20-6.92). In the SFH group (27,680 pyrs follow-up and 762 events) the SMbR for any CVD event was 9.38 (8.74-10.07), while in the NSFH group (13,750 pyrs follow-up and 237 events) was 5.87(5.17-6.67). For CHD the estimates were 11.88(11.01-12.82) vs 7.38(6.45-8.47) respectively.
Conclusion(s): CVD morbidity in conventionally treated FH patients was over 6-fold higher than the general population, with rates in those with SFH 60% higher than those with NSFH. This emphasises the potential value of more intensive lipid-lowering, and management of other risk factors for those with FH.

Case report: Evaluating the role of ultrasound in the diagnosis of bilateral persistent sciatic arteries (2020)

Posted on by

Type of publication:
Conference abstract

Author(s):
*Bell S.

Citation:
Ultrasound; 2020; vol. 28 (no. 2)

Abstract:
Peripheral vascular disease (PVD) affects 13% of the population aged over 50 in the western world and can be divided into two main groups: organic and functional. Other less common causes to include in the differential diagnosis in younger patients are Buerger's disease and anatomical variants such as duplication of the superficial femoral artery and persistent sciatic arteries (PSAs). PVD is a major cause of morbidity and mortality globally. Symptoms vary from cold extremities, intermittent claudication, to acute and critical ischaemia. All of these have a significant financial burden on critical healthcare resources. This case report evaluates the role of ultrasound in the diagnosis of bilateral PSAs. A 16-year-old female was referred by her GP to the vascular clinic presenting with bilateral intermittent claudication. On examination, missing dorsals pedis pulses were noted bilaterally. No previous imaging was available and the patient was referred for a lower limb Doppler ultrasound. Initial ultrasound scanning demonstrated no evidence of diseased vessels causing the patient's pain, but unusual arterial anatomy. Both superficial femoral arteries tapered to the distal thigh, where collaterals were demonstrated. Following the scan a diagnosis of persistent bilateral sciatic arteries was made. Ultrasound, due to its many advantages, is usually the first line imaging investigation to assess the peripheral arteries. In this case ultrasound was able to demonstrate that there was no evidence of any organically diseased vessels, but an anatomical variant causing the patient's symptoms. However, it was unable to demonstrate the overall view of the lower limb vasculature, the origin of the PSA, or provide all information to classify the sub type in view of any potential treatment or surgery. Although ultrasound is useful in the diagnosis of PSA, it lacks the ability to assess the whole of the peripheral circulation.