Publications
620 results found
Syms R, Taylor-Robinson S, Trovato G, 2023, Circular Medicine – Being Mindful of Resources and Waste Recycling in Healthcare Systems, Risk Management and Healthcare Policy
Alfadda AA, Almaghamsi AM, Sherbeeni SM, et al., 2023, Alterations in circulating lipidomic profile in patients with type 2 diabetes with or without non-alcoholic fatty liver disease, Frontiers in Molecular Biosciences, Vol: 10
<jats:p><jats:bold>Objective:</jats:bold> Non-alcoholic fatty liver disease (NAFLD) and Type 2 diabetes mellitus (T2DM) often coexist and drive detrimental effects in a synergistic manner. This study was designed to understand the changes in circulating lipid and lipoprotein metabolism in patients with T2DM with or without NAFLD.</jats:p><jats:p><jats:bold>Methods:</jats:bold> Four hundred thirty-four T2DM patients aged 18–60 years were included in this study. Fatty liver was assessed by FibroScan. The comprehensive metabolic lipid profiling of serum samples was assessed by using high-throughput proton NMR metabolomics.</jats:p><jats:p><jats:bold>Results:</jats:bold> Our data revealed a significant association between steatosis and serum total lipids in VLDL and LDL lipoprotein subclasses, while total lipids in HDL subclasses were negatively associated. A significant positive association was found between steatosis and concentration of lipids, phospholipids, cholesterol, and triglycerides in VLDL and LDL subclasses, while HDL subclasses were negatively associated. Furthermore, a significant, association was observed between fibrosis and concentrations of lipids, phospholipids, cholesterol, and triglycerides in very small VLDL, large, and very large HDL subclasses. Subgroup analysis revealed a decrease in the concentrations of lipids, phospholipids, cholesterol, and other lipid biomolecules in patients using antilipemic medications.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold> The metabolomics results provide evidence that patients with T2DM with higher steatosis grades have altered lipid metabolomics compared to patients without steatosis. Increased lipid, phospholipids, cholesterol, and triglycerides concentration of VLDL and LDL subclasses are associated with steatosis in patients with T2DM.</jats:p>
Miletic H, Taylor-Robinson S, 2022, LOVING YOUR LIVER: the complete guide to liver detox, Publisher: Europa Edizioni, ISBN: 9791220127356
Loving Your Liver. The Complete Guide to Liver Detox is a comprehensive guide to liver “maintenance”. Written in a simple and intuitive way, it helps understand what the liver is, what it does, how it works, how it is affected by our lifestyle, the most common diseases that can affect it and most importantly, how to take care of it. Of course, the key to a good liver detox lies in nutrition and for this very reason the learning journey with Hrvoje Miletic and Simon Taylor-Robinson ends with a section entirely dedicated to a number of delicious recipes that are good for the liver without sacrificing taste.Hrvoje Miletic is a noted food expert in Croatia and across Europe. He holds international diplomas in culinary affairs and in management. Hrvoje’s experience in the United Kingdom and across Europe has moulded his culinary experience and flair. He is currently a food researcher and entrepreneur, using his skills to help people lead a healthy lifestyle. His considerable expertise is reflected in the book.Simon Taylor-Robinson is a medical doctor. He trained as a gastroenterologist and hepatologist. He has conducted medical research on liver disease with projects around the world. During his career, he has combined being a clinical doctor with liver expertise with being a medical researcher and a teacher at the undergraduate and postgraduate level. He also holds several honorary Professorial appointments at institutions in sub-Saharan Africa and in Asia.
Alsaleh M, Sithithaworn P, Khuntikeo N, et al., 2022, Urinary metabolic profiling of liver fluke-induced cholangiocarcinoma—a follow-up study, Journal of Clinical and Experimental Hepatology, ISSN: 0973-6883
Background/Aims:Global liquid chromatography mass spectrometry (LC-MS) profiling in a Thai population has previously identified a urinary metabolic signature in Opisthorchis viverrini-induced cholangiocarcinoma (CCA), primarily characterised by disturbance in acylcarnitine, bile acid, steroid, and purine metabolism. However, the detection of thousands of analytes by LC-MS in a biological sample in a single experiment potentially introduces false discovery errors. To verify these observed metabolic perturbations, a second validation dataset from the same population was profiled in a similar fashion.Methods:Reverse-phase ultra-performance liquid-chromatography mass spectrometry was utilised to acquire the global spectral profile of 98 spot urine samples (from 46 healthy volunteers and 52 CCA patients) recruited from Khon Kaen, northeast Thailand (the highest incidence of CCA globally).Results:Metabolites were differentially expressed in the urinary profiles from CCA patients. High urinary elimination of bile acids was affected by the presence of obstructive jaundice. The urine metabolome associated with non-jaundiced CCA patients showed a distinctive pattern, similar but not identical to published studies. A panel of 10 metabolites achieved a diagnostic accuracy of 93.4% and area under the curve value of 98.8% (CI = 96.3%–100%) for the presence of CCA.Conclusions:Global characterisation of the CCA urinary metabolome identified several metabolites of biological interest in this validation study. Analyses of the diagnostic utility of the discriminant metabolites showed excellent diagnostic potential. Further larger scale studies are required to confirm these findings internationally, particularly in comparison to sporadic CCA, not associated with liver fluke infestation.
Taylor-Robinson SD, 2022, Do medical algorithms always benefit the patient?-a patient perspective, QJM: an international journal of medicine, ISSN: 1460-2393
Alfadda AA, Sherbeeni SM, Alqutub AN, et al., 2022, Transient elastography for the prevalence of non-alcoholic fatty liver disease in patients with type 2 diabetes: Evidence from the CORDIAL cohort study., Saudi Journal of Gastroenterology, Vol: 28, Pages: 426-433, ISSN: 1319-3767
Background: Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in patients with type 2 diabetes mellitus (T2DM). This study aimed to investigate the prevalence of NAFLD among Saudi patients with T2DM using transient elastography. Methods: A total of 490 patients with T2DM who attended diabetes and primary care clinics were recruited. Controlled attenuation parameter (CAP) and liver stiffness measurements (LSM) were obtained via FibroScan to assess steatosis and fibrosis. Results: Of the examined 490 patients with T2DM, 396 (80.8%) had hepatic steatosis (CAP ≥248 dB/m): 326 (66.5%) had severe steatosis (CAP ≥280 dB/m), while 41 (8.4%) and 29 (5.9%) had mild (CAP ≥248 to <268 dB/m) and moderate steatosis (CAP ≥268 to <280 dB/m), respectively. Of the 396 patients with steatosis, only 35 (8.8%) had LSM ≥7.9 kPa, suggesting the presence of fibrosis, while 361 (91%) had LSM <7.9 kPa, indicating the absence of fibrosis. Increased body mass index (BMI), waist circumference, systolic blood pressure (SBP), and alanine aminotransferase (ALT) were positively associated with both steatosis and fibrosis. After adjusting for age and gender, data from logistic regression analysis demonstrated BMI, waist circumference, SBP, ALT, and high-density lipoprotein (HDL) as significant independent factors for steatosis, while SBP was the only significant predictor associated with fibrosis. Conclusions: Our results demonstrate an increase in prevalence of NAFLD in Saudi patients with T2DM, based on transient elastography and CAP score. The risk of NAFLD appears to be higher in T2DM patients with abdominal obesity, elevated SBP, and increased ALT levels, which supports the screening of these conditions in patients with T2DM.
Tan YY, Woulfe F, Chirambo GB, et al., 2022, Framework to assess the quality of mHealth apps: a mixed-method international case study protocol, BMJ Open, Vol: 12, ISSN: 2044-6055
Introduction: Healthcare professionals (HCPs) often recommend their patients to use a specific mHealth app as part of health promotion, disease prevention and patient self-management. There has been a significant growth in the number of HCPs downloading and using mobile health (mHealth) apps. Most mHealth apps that are available in app stores employ a ‘star rating’ system. This is based on user feedback on an app, but is highly subjective. Thus, the identification of quality mHealth apps which are deemed fit for purpose can be a difficult task for HCPs. Currently, there is no unified, validated standard guidelines for assessment of mHealth apps for patient safety, which can be used by HCPs. The Modified Enlight Suite (MES) is a quality assessment framework designed to provide a means for HCPs to evaluate mHealth apps before they are recommended to patients. MES was adapted from the original Enlight Suite for international use through a Delphi method, followed by preliminary validation process among a population predominantly consisting of medical students. This study aims to evaluate the applicability and validity of the MES, by HCPs, in low, middle and high income country settings.Methods and analysis: MES will be evaluated through a mixed-method study, consisting of qualitative (focus group) and quantitative (survey instruments) research, in three target countries: Malaŵi (low income), South Africa (middle income) and Ireland (high income). The focus groups will be conducted through Microsoft Teams (Microsoft, Redmond, Washington, USA) and surveys will be conducted online using Qualtrics (Qualtrics International, Seattle, Washington, USA). Participants will be recruited through the help of national representatives in Malawi (Mzuzu University), South Africa (University of Fort Hare) and Ireland (University College Cork) by email invitation. Data analysis for the focus group will be by the means of thematic analysis. Data analysis for the survey will use
Pereira C, Perera AH, Rudarakanchana N, et al., 2022, Cytokine changes in cerebrospinal fluid following vascular surgery on the thoracic aorta., Scientific Reports, Vol: 12, Pages: 1-8, ISSN: 2045-2322
There is growing evidence that surgery can drive an inflammatory response in the brain. However, the mechanisms behind this response are incompletely understood. Here, we investigate the hypotheses that 1. Cerebrospinal fluid (CSF) cytokines increase after vascular surgery and 2. That these changes in CSF cytokines are interrelated. Patients undergoing either open or endovascular elective surgery of the thoracic aorta were invited to participate in this study. Cerebrospinal fluid samples were taken before surgery and on the first post-operative day. These were analysed for the presence of ten cytokines by immunoassay to examine for post-operative changes in cytokine levels. After surgery, there were significant increases in six out of the ten measured CSF cytokines (IL-1β, 2, 6, 8, 10 and 13). This included changes in both putative pro-inflammatory (IL-1β, 6 and 8) and putative anti-inflammatory (IL-2, 10 and 13) cytokines. The greatest increases occurred in IL-6 and IL-8, which showed a 63-fold and a 31-fold increase respectively. There was strong intercorrelation between CSF cytokines after the operation. Following surgery on the thoracic aorta, there was a marked increase in CSF cytokines, consistent with a potential role in neuroinflammation. The ten measured cytokines showed intercorrelation after the operation, indicating that a balance between multiple pro- and anti-inflammatory cytokines may be present.
Bridge S, Pagano S, Sheridan D, et al., 2022, Autoantibodies to apolipoprotein A-1 in chronic hepatitis C infection: a role in hepatic fibrosis and cirrhosis?, Publisher: ELSEVIER, Pages: S493-S494, ISSN: 0168-8278
U MRA, Shen EY-L, Cartlidge C, et al., 2022, Optimised systematic review tool: Application to candidate biomarkers for the diagnosis of hepatocellular carcinoma, Cancer Epidemiology, Biomarkers and Prevention, Vol: 31, Pages: 1261-1274, ISSN: 1055-9965
This review aims to develop an appropriate review tool for systematically collating metabolites that are dysregulated in disease and applies the method to identify novel diagnostic biomarkers for hepatocellular carcinoma (HCC). Studies that analysed metabolites in blood or urine samples where HCC was compared with comparison groups (healthy, pre-cirrhotic liver disease, cirrhosis) were eligible. Tumour tissue was included to help differentiate primary and secondary biomarkers. Searches were conducted on Medline and EMBASE. A bespoke 'risk-of-bias' tool for metabolomic studies was developed adjusting for analytical quality. Discriminant metabolites for each sample type were ranked using a weighted score accounting for the direction and extent of change and the risk of bias of the reporting publication. A total of 84 eligible studies were included in the review (54 blood, 9 urine and 15 tissue), with six studying multiple sample types. High-ranking metabolites, based on their weighted score, comprised energy metabolites, bile acids, acylcarnitines and lysophosphocholines. This new review tool addresses an unmet need for incorporating quality of study design and analysis to overcome the gaps in standardisation of reporting of metabolomic data. Validation studies, standardised study designs and publications meeting minimal reporting standards are crucial for advancing the field beyond exploratory studies.
Taylor-Robinson SD, 2022, Mixed benefits from virtual outpatient appointments - a patient perspective, QJM: an international journal of medicine, ISSN: 1460-2393
Haeussinger D, Dhiman RK, Felipo V, et al., 2022, Hepatic encephalopathy, NATURE REVIEWS DISEASE PRIMERS, Vol: 8, ISSN: 2056-676X
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Pereira C, Dani M, Taylor-Robinson S, et al., 2022, Putative involvement of cytokine modulation in the development of peri-operative neurocognitive disorders, International Journal of General Medicine, Vol: 15, Pages: 5349-5360, ISSN: 1178-7074
Following surgery, local cytokine-driven inflammation occurs, as part of the normal healing process. Cytokines in thecentral nervous system such as IL-6 and IL-8 may also be elevated. These cytokine changes likely contribute to neuroinflammation,but the complex mechanisms through which this occurs are incompletely understood. It may be that perioperative changes in pro- andanti-inflammatory cytokines have a role in the development of perioperative neurocognitive disorders (PND), such as post-operativedelirium (POD). This review considers the current evidence regarding perioperative cytokine changes in the blood and cerebrospinalfluid (CSF), as well as considering the potential for cytokine-altering therapies to prevent and treat PND.
Taylor-Robinson SD, Morgan MY, Olupot-Olupot P, et al., 2022, Societal reopening after the COVID-19 pandemic, Public Health, Vol: 205, Pages: e5-e5, ISSN: 0033-3506
Sheridan D, Shawa I, Thomas EL, et al., 2022, Infection with the hepatitis C virus causes viral genotype-specific differences in cholesterol metabolism and hepatic steatosis, Scientific Reports, Vol: 12, ISSN: 2045-2322
Background: Lipids play essential roles in the hepatitis C virus (HCV) life cycle and patients with chronic HCV infection display disordered lipid metabolism which resolves following successful anti-viral therapy. It has been proposed that HCV genotype 3 (HCV-G3) infection is an independent risk factor for hepatocellular carcinoma and evidence suggests lipogenic proteins are involved in hepatocarcinogenesis.Aims: We aimed to characterise variation in host lipid metabolism between participants chronically infected with HCV genotype 1 (HCV-G1) and HCV-G3 to identify likely genotype-specific differences in lipid metabolism.Methods: We combined several lipidomic approaches: analysis was performed between participants infected with HCV-G1 and HCV-G3, both in the fasting and non-fasting states, and after sustained virological response (SVR) to treatment. Sera were obtained from 112 fasting patients (25% with cirrhosis). Serum lipids were measured using standard enzymatic methods. Lathosterol and desmosterol were measured by gas-chromatography mass spectrometry (MS). For further metabolic insight on lipid metabolism, ultra-performance liquid chromatography MS was performed on all samples. A subgroup of 13 participants had whole body fat distribution determined using in vivo magnetic resonance imaging and spectroscopy. A second cohort of (non-fasting) sera were obtained from HCV Research UK for comparative analyses: 150 treatment naïve patients and 100 non-viraemic patients post-SVR.Results: HCV-G3 patients had significantly decreased serum apoB, non-HDL cholesterol concentrations, and more hepatic steatosis than those with HCV-G1. HCV-G3 patients also had significantly decreased serum levels of lathosterol, without significant reductions in desmosterol. Lipidomic analysis showed lipid species associated with reverse cholesterol transport pathway in HCV-G3.Conclusions: We demonstrated that compared to HCV-G1, HCV-G3 infection is characterised by low LDL cholesterol lev
Taylor-Robinson SD, Morgan MY, Spearman CW, et al., 2022, Why SARS-CoV-2 vaccination still matters in Africa, QJM: an international journal of medicine, Vol: 115, Pages: 191-192, ISSN: 1460-2393
Dave U, Taylor-Robinson S, 2022, Maintaining resilience in today’s medical environment: personal perspectives on self-care, International Journal of General Medicine, Vol: 2022, Pages: 2475-2478, ISSN: 1178-7074
Background: The practice of medicine is becoming increasingly more stressful, owing to technological development, increased expectations, infrastructure deficiencies, lack of resources and healthcare systems that are struggling to cope in the face of the COVID-19 pandemic around the world.Objective: In this article, we explore ways to reduce stress and improve resilience in the work place in order to enhance wellbeing in the medical profession, but also, ultimately to protect patient safety.Synopsis: We discuss attention to regular mealtimes, protected sleep and daily exercise, together with consideration of mindfulness, gratefulness, self-compassion, self-care and being part of supportive networks as ways to reduce stress.Conclusions: While such techniques are not guaranteed to mitigate stress, psychology studies have shown that awareness of and attention to these components of a healthy lifestyle have the potential to reduce the adverse effects of increasing professional demands.
Edwards C, Suliman AAA, Taylor-Robinson S, et al., 2022, Rebalancing the research equation in Africa: principles and process, BMJ Open, Vol: 12, ISSN: 2044-6055
Background: Many examples of research excellence in Africa have been driven by partnerships led by the global North and have involved localised infrastructure improvements to support the best of international research practice.Objective: In this article, we explore a possible mechanism by which local research networks, appropriately governed, could begin to support national African research programmes by allying research delivery to clinical service.Summary: This article explores the concept that sustainable research effort needs a well-trained and mentored workforce, working to common standards, but which is practically supported by a much developed information technology (IT) infrastructure throughout the continent.Conclusions: The balance of investment and ownership of such a research programme needs to be shared between local and international funding, with the emphasis on developing global South–South collaborations and research strategies which address the environmental impact of medical research activity and mitigate the impact of climate change on African populations. Healthcare must be embedded in the post-COVID-19 approach to research development.
Fertleman M, Pereira C, Dani M, et al., 2022, Cytokine changes in cerebrospinal fluid and plasma post-emergency orthopaedic surgery, Scientific Reports, Vol: 12, ISSN: 2045-2322
Neuroinflammation after surgery and its contribution to peri-operative neurocognitive disorders (PND) is not well understood. Studying the association between central and peripheral cytokines and neuroinflammation is a prelude to the development of treatments for PND. Here, we investigate the hypotheses that there is a greater cytokine response in cerebrospinal fluid (CSF) than plasma after orthopaedic surgery, and that plasma cytokine levels are directly related to CSF cytokine levels, indicating that plasma cytokine levels may have potential as biomarkers of neuroinflammation. Patients admitted with a fractured neck of femur were invited to participate in this study. Participants had a spinal catheter inserted just prior to induction of anaesthesia. Samples of blood and CSF were taken before, immediately after, and on the first day following emergency surgery. The catheter was then removed. Samples were analysed for the presence of ten cytokines by immunoassay. A spinal catheter was successfully inserted in 11 participants during the 18-month study period. Five plasma cytokines (IL-4, IL-6, IL-10, IL-12p70 and IL-13) rose significantly following surgery, whereas all ten CSF cytokines rose significantly (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, IFN-γ and TNF-α) (adjusted-p < 0.05). Central (CSF) cytokine levels were consistently higher than their peripheral (plasma) counterparts after surgery, with some patients having a particularly marked neuroinflammatory response. The greatest increases occurred in IL-8 in CSF and IL-6 in plasma. There were significant, strong positive correlations between several of the measured cytokines in the CSF after surgery, but far fewer in plasma. There was no significant correlation between cytokine levels in the plasma and CSF at each of the three time points. To our knowledge, this is the first study to analyse paired samples of plasma and CSF for cytokine levels before and after emerg
Cordell HJ, Fryett JJ, Ueno K, et al., 2022, Corrigendum to ‘An international genome-wide meta-analysis of primary biliary cholangitis: Novel risk loci and candidate drugs’ [J Hepatol 2021;75(3):572–581], Journal of Hepatology, Vol: 76, Pages: 489-489, ISSN: 0168-8278
Oleribe O, Olawepo O, Ezechi O, et al., 2022, Describing the epidemiology of COVID-19 in Nigeria: an analysis of the first year of the pandemic, Journal of Health Care for the Poor and Underserved, Vol: 33, Pages: 33-46, ISSN: 1049-2089
We report the COVID-19 experience across Nigeria from March 2020 to March 2021. Demographics were obtained from Nigerian Center for Disease Control. By 21 March 2021, 161,737 people were confirmed positive for SARS-COV-2. Overall, testing rates were 0.8% of the population, with positivity rates of 9.6%, complete recovery rates without long-term sequelae of 91.4%, and case fatality rates of 1.3%. Most Nigerian regions contributed to figures for recent cases and deaths in 2021. The picture may change as testing is scaled-up to include community testing. Given so-called “pandemic fatigue” among the general population, various conspiracy theories being prevalent, and the recent introduction of COVID-19 vaccines in Nigeria, we assume that Nigeria is at a pivotal stage of the outbreak. Effort must be made by government to learn successful strategies in other countries to adapt to prevent a rise in case numbers and deaths.
Chowdhury D, Mahmood F, Edwards C, et al., 2021, Five-day outcome of hepatitis E-induced acute liver failure in the ICU, Egyptian Liver Journal, Vol: 11, Pages: 1-9, ISSN: 2090-6226
BackgroundHepatitis E virus (HEV) is an important cause of acute liver failure (ALF) in Bangladesh with pregnant mothers being more vulnerable. As HEV occurs in epidemics, it limits medical capabilities in this resource-poor country. Cerebral oedema, resulting in raised intracranial pressure (ICP), is an important cause of morbidity and mortality. Practical treatments are currently few.To study the baseline characteristics and clinical outcome of HEV-induced ALF in a recent HEV epidemicTo detect raised ICP clinically and observe response to mannitol infusion.This was a prospective cohort study from June until August 2018 of 20 patients admitted to the intensive care unit (ICU) of a major Bangladeshi Referral Hospital with HEV-induced ALF. We diagnosed HEV infection by detecting serum anti-HEV IgM antibody. All were negative for hepatitis B surface antigen and hepatitis A IgM antibody. Data were collected on 5-day outcome after admission to ICU, monitoring all patients for signs of raised ICP. An intravenous bolus of 20% mannitol was administered at a single time point to patients with raised ICP.ResultsTwenty patients were included in the study. Ten (50%) patients, seven (70%) females, received mannitol infusion. HE worsened in eight (40%): seven female and three pregnant. Glasgow Coma scores deteriorated in six (30%): all (100%) females and three pregnant. Consciousness status was not significantly different between pregnant and non-pregnant subjects, nor between those who received mannitol and those who did not. Six patients met King’s College Criteria for liver transplantation.ConclusionsFemale patients had a worse outcome, but pregnancy status was not an additional risk factor in our cohort. Mannitol infusion was also not associated with a significant difference in outcome.
Oleribe OO, Idigbe IE, Osita-Oleribe P, et al., 2021, Perceptions and opinions of Nigerians to the management and response to COVID-19 in Nigeria., Pan African Medical Journal, Vol: 40, Pages: 1-11, ISSN: 1937-8688
Introduction: we present a qualitative analysis of opinions of the Nigerian general public as to how successful healthcare strategies have been in containing the COVID-19 outbreak. Methods: an online qualitative survey was conducted, consisting of 30 semi-structured questions. Results: four hundred and ninety-five (495) respondents participated, ranging in age from 18 to 59 years. Over 40% of all respondents were critical of public health information. Participants saw provision of social support measures (n = 83), lack of economic, financial and social support (n = 65), enforcement of restrictions on movement outside the home, availability of face-masks and social distancing (n = 53) and provision of COVID-19 testing (n = 48) as the major things that were handled poorly by the government and health authorities. Conclusion: we advocate coordinated forward planning for public safety until vaccines are widely available; while social distancing should continue. Policymakers need to be adaptable to changing conditions, given fluctuating case numbers and fatality rates.
Oleribe O, Suliman A, Taylor-Robinson S, et al., 2021, Possible reasons why Sub-Saharan Africa experienced a less severe COVID-19 Pandemic in 2020, Journal of Multidisciplinary Healthcare, Vol: 2021, Pages: 3267-3271, ISSN: 1178-2390
Both scientific authorities and governments of nations worldwide were found lacking in their COVID-19 response and management, resulting in significant distrust by the gen-eral public in 2020. Scientific and medical bodies often failed to give the right counsel on the appropriate course of action on COVID-19, because proven steps were not known, while many governments around the world took ineffective, late or inappropriate COVID-19 control and containment strategies. If the 2020 COVID-19 incidence rates are to be believed, much of sub-Saharan Africa had a lower disease prevalence than expected. We put forwards six factors peculiar to much of sub-Saharan Africa that may have accounted for the pandemic landscape there in 2020. We also discuss why the situation has become more serious in 2021.
Taylor-Robinson S, Trovato G, 2021, Semi-elective cervical disc replacements for cervical myelopathy: a qualitative study, Patient Preference and Adherence, Vol: 2021, Pages: 2455-2458, ISSN: 1177-889X
Cervical disc prolapse can be accompanied by severe pain, numbness, paraesthesiae and muscle weakness. The choice lies between a conservative approach with physiotherapy and pain modulating drugs, such as gabapentin, or a more active surgical approach, ranging from nerve decompression through vertebral foraminotomy through to cervical disc replacement. We relate the experience of a medically qualified patient in having disc prolapse at three cervical levels and what it was like to experience a lonely and difficult post-surgical recovery. Despite this, the patient would still choose active surgical decompression over a non-interventional approach. The reasons for this are discussed from the patient perspective, of which there is little directly in the medical literature.
Taylor-Robinson S, De Souza Lopes P, Zdravkov J, et al., 2021, Should commercial sex workers have unrestricted healthcare access across the world?, International Journal for Equity in Health, Vol: 20, Pages: 1-5, ISSN: 1475-9276
We argue commercial sex workers have rights to healthcare and psychosocial support. While decriminalization is not legally enacted in most countries, we would suggest these workers rights include freedom from harassment and opportunities to lead healthy lives. The need for healthcare access for all is heightened in the COVID-19 pandemic where some people flout rules on lockdown by engaging with commercial sex workers and may unwittingly spread SARS-CoV-2 in so doing. Unrestricted healthcare access without stigma for commercial sex workers protects them, and has a beneficial societal effect on those who engage with them and on their contacts.
Alsaleh M, Leftley Z, OConnor T, et al., 2021, Mapping of population disparities in the cholangiocarcinoma urinary metabolome, Scientific Reports, Vol: 11, Pages: 1-12, ISSN: 2045-2322
Phenotypic diversity in urinary metabolomes of different geographical populations has been recognized recently. In this study, urinary metabolic signatures from Western (United Kingdom) and South-East Asian (Thai) cholangiocarcinoma patients were characterized to understand spectral variability due to host carcinogenic processes and/or exogenous differences (nutritional, environmental and pharmaceutical). Urinary liquid chromatography mass spectroscopy (LC–MS) spectral profiles from Thai (healthy = 20 and cholangiocarcinoma = 14) and UK cohorts (healthy = 22 and cholangiocarcinoma = 10) were obtained and modelled using chemometric data analysis. Healthy metabolome disparities between the two distinct populations were primarily related to differences in dietary practices and body composition. Metabolites excreted due to drug treatment were dominant in urine specimens from cholangiocarcinoma patients, particularly in Western individuals. Urine from participants with sporadic (UK) cholangiocarcinoma contained greater levels of a nucleotide metabolite (uridine/pseudouridine). Higher relative concentrations of 7-methylguanine were observed in urine specimens from Thai cholangiocarcinoma patients. The urinary excretion of hippurate and methyladenine (gut microbial-host co-metabolites) showed a similar pattern of lower levels in patients with malignant biliary tumours from both countries. Intrinsic (body weight and body composition) and extrinsic (xenobiotic metabolism) factors were the main causes of disparities between the two populations. Regardless of the underlying aetiology, biological perturbations associated with cholangiocarcinoma urine metabolome signatures appeared to be influenced by gut microbial community metabolism. Dysregulation in nucleotide metabolism was associated with sporadic cholangiocarcinoma, possibly indicating differences in mitochondrial energy production pathways between cholangiocar
Alfadda A, Sherbeeni SM, Alqutub AN, et al., 2021, THE PREVALENCE OF STEATOSIS AND FIBROSIS IN A SAUDI TYPE 2 DIABETES POPULATION: EVIDENCE FROM THE CORDIAL STUDY, Publisher: WILEY, Pages: 1126A-1127A, ISSN: 0270-9139
Taylor-Robinson SD, 2021, Covid-19 dysphonia-unconscious bias and the Central role of speech and language therapists., QJM: an international journal of medicine, Vol: 114, Pages: 762-763, ISSN: 1460-2393
Brindley PJ, Bachini M, Ilyas SI, et al., 2021, Cholangiocarcinoma., Nat Rev Dis Primers, Vol: 7
Cholangiocarcinoma (CCA) is a highly lethal adenocarcinoma of the hepatobiliary system, which can be classified as intrahepatic, perihilar and distal. Each anatomic subtype has distinct genetic aberrations, clinical presentations and therapeutic approaches. In endemic regions, liver fluke infection is associated with CCA, owing to the oncogenic effect of the associated chronic biliary tract inflammation. In other regions, CCA can be associated with chronic biliary tract inflammation owing to choledocholithiasis, cholelithiasis, or primary sclerosing cholangitis, but most CCAs have no identifiable cause. Administration of the anthelmintic drug praziquantel decreases the risk of CCA from liver flukes, but reinfection is common and future vaccination strategies may be more effective. Some patients with CCA are eligible for potentially curative surgical options, such as resection or liver transplantation. Genetic studies have provided new insights into the pathogenesis of CCA, and two aberrations that drive the pathogenesis of non-fluke-associated intrahepatic CCA, fibroblast growth factor receptor 2 fusions and isocitrate dehydrogenase gain-of-function mutations, can be therapeutically targeted. CCA is a highly desmoplastic cancer and targeting the tumour immune microenvironment might be a promising therapeutic approach. CCA remains a highly lethal disease and further scientific and clinical insights are needed to improve patient outcomes.
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