Chester Medical School
http://hdl.handle.net/10034/337531
2024-03-29T09:56:21Z
2024-03-29T09:56:21Z
Retinol-binding protein 4 (RBP4) circulating levels and gestational diabetes mellitus: a systematic review and meta-analysis
Leca, Bianca M.
Kite, Chris
Lagojda, Lukasz
Davasgaium, Allan
Dallaway, Alex
Chatha, Kamaljit Kaur
Randeva, Harpal S.
Kyrou, Ioannis
http://hdl.handle.net/10034/628566
2024-03-27T09:58:57Z
2024-03-12T00:00:00Z
Retinol-binding protein 4 (RBP4) circulating levels and gestational diabetes mellitus: a systematic review and meta-analysis
Leca, Bianca M.; Kite, Chris; Lagojda, Lukasz; Davasgaium, Allan; Dallaway, Alex; Chatha, Kamaljit Kaur; Randeva, Harpal S.; Kyrou, Ioannis
Background: Gestational diabetes mellitus (GDM) is a prevalent condition where diabetes is diagnosed during pregnancy, affecting both maternal and fetal outcomes. Retinol-binding protein 4 (RBP4) is a circulating adipokine which belongs to the lipocalin family and acts as a specific carrier protein that delivers retinol (vitamin A) from the liver to the peripheral tissues. Growing data indicate that circulating RBP4 levels may positively correlate with GDM. Thus, this systematic review and meta-analysis aimed to investigate the potential relationship between circulating RBP4 levels and GDM when measured at various stages of pregnancy. Methods: MEDLINE, CINAHL, EMCARE, EMBASE, Scopus, and Web of Science databases were searched to identify studies comparing pregnant women with and without GDM, whose circulating RBP4 levels were measured in at least one pregnancy trimester. Findings were reported using standardized mean difference (SMD) and random-effects models were used to account for variability among studies. Furthermore, the risk of bias was assessed using the RoBANS tool. Results: Out of the 34 studies identified, 32 were included in the meta-analysis (seven with circulating RBP4 levels measured in the first trimester, 19 at 24–28 weeks, and 14 at >28 weeks of pregnancy). RBP4 levels were statistically higher in the GDM group than in controls when measured during all these pregnancy stages, with the noted RBP4 SMD being 0.322 in the first trimester (95% CI: 0.126–0.517; p < 0.001; 946 GDM cases vs. 1701 non-GDM controls); 0.628 at 24–28 weeks of gestation (95% CI: 0.290–0.966; p < 0.001; 1776 GDM cases vs. 1942 controls); and 0.875 at >28 weeks of gestation (95% CI: 0.252–1.498; p = 0.006; 870 GDM cases vs. 1942 non-GDM controls). Significant study heterogeneity was noted for all three pregnancy timepoints. Conclusion: The present findings indicate consistently higher circulating RBP4 levels in GDM cases compared to non-GDM controls, suggesting the potential relevance of RBP4 as a biomarker for GDM. However, the documented substantial study heterogeneity, alongside imprecision in effect estimates, underscores the need for further research and standardization of measurement methods to elucidate whether RBP4 can be utilized in clinical practice as a potential GDM biomarker. Systematic review registration: PROSPERO (CRD42022340097: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022340097).
2024-03-12T00:00:00Z
Best practice for embryology staffing in HFEA licensed assisted conception centres-guidance from Association of Reproductive & Clinical Scientists
Kasraie, Jason
Kennedy, Hannah
http://hdl.handle.net/10034/628560
2024-03-25T09:33:02Z
2024-12-31T00:00:00Z
Best practice for embryology staffing in HFEA licensed assisted conception centres-guidance from Association of Reproductive & Clinical Scientists
Kasraie, Jason; Kennedy, Hannah
The Association of Reproductive and Clinical Scientists (ARCS) has long promoted the importance of externally accredited training and assessment of scientific staff within assisted conception centres to ensure professional registration and relevant training at all levels. This not only gives scientific staff the opportunity to empower themselves but also acts to ensure assisted conception centres maintain the highest standards of care and quality for patients whilst meeting HFEA requirements for staffing and training. It also provides assurance to patients that treatment is being delivered by highly trained and competent staff. Clinical embryology practice requires intense concentration, with increasingly complex treatment plans and options coupled with the ever-present consequences of clinical error at the forefront of practitioners’ minds, exhaustion and burn out are very real risks. Overloading embryology teams is likely to lead to increased error rates and serious incidents. This guideline aims to bring the sector in line with other Clinical Science specialities to optimise patient care, increase safety, reduce risk (including the risk of legal action against centres and individuals), ensure the use of recognised job titles with appropriate levels of remuneration, and provide centres with a template to work towards for appropriate levels of scientific staffing.
2024-12-31T00:00:00Z
Methadone as an adjuvant analgesic
Shahab, Julita
Willis, Derek
http://hdl.handle.net/10034/628545
2024-03-15T09:01:09Z
2024-03-01T00:00:00Z
Methadone as an adjuvant analgesic
Shahab, Julita; Willis, Derek
Methadone as an 'adjuvant' has proven to be effective and safe to be used in conjunction with opioids. Generally, only a low dose is required to improve pain control. [Abstract copyright: © Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.]
This article is not available on ChesterRep
2024-03-01T00:00:00Z
Non-tuberculous mycobacterial pulmonary disease (NTM-PD): Epidemiology, diagnosis and multidisciplinary management
Kumar, Kartik
Ponnuswamy, Aravind
Capstick, Toby Gd
Chen, Christabelle
McCabe, Douglas
Hurst, Rhys
Morrison, Lisa
Moore, Fiona
Gallardo, Matt
Keane, Jennie
Harwood, Shirley
Sinnett, Tanya
Bryant, Sarah
Breen, Ronan
Kon, Onn Min
Lipman, Marc
Loebinger, Michael R.
Dhasmana, Devesh J.
http://hdl.handle.net/10034/628527
2024-03-08T01:37:23Z
2024-01-17T00:00:00Z
Non-tuberculous mycobacterial pulmonary disease (NTM-PD): Epidemiology, diagnosis and multidisciplinary management
Kumar, Kartik; Ponnuswamy, Aravind; Capstick, Toby Gd; Chen, Christabelle; McCabe, Douglas; Hurst, Rhys; Morrison, Lisa; Moore, Fiona; Gallardo, Matt; Keane, Jennie; Harwood, Shirley; Sinnett, Tanya; Bryant, Sarah; Breen, Ronan; Kon, Onn Min; Lipman, Marc; Loebinger, Michael R.; Dhasmana, Devesh J.
Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause significant disease in both immunocompromised and immunocompetent individuals. The incidence of NTM pulmonary disease (NTM-PD) is rising globally. Diagnostic challenges persist and treatment efficacy is variable. This article provides an overview of NTM-PD for clinicians. We discuss how common it is, who is at risk, how it is diagnosed and the multidisciplinary approach to its clinical management. [Abstract copyright: Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.]
2024-01-17T00:00:00Z