A5058660951- Chronic Obstructive Pulmonary Disease (COPD) Research
- Cystic Fibrosis Research Advances
- Respiratory Support and Mechanisms
- Ion Transport and Channel Regulation
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Neonatal Respiratory Health Research
- Metabolism, Diabetes, and Cancer
- Pneumonia and Respiratory Infections
- Pediatric health and respiratory diseases
- Inhalation and Respiratory Drug Delivery
- Cardiovascular Health and Disease Prevention
- Health Systems, Economic Evaluations, Quality of Life
- Pharmaceutical Practices and Patient Outcomes
- Ion channel regulation and function
- Long-Term Effects of COVID-19
- Pleural and Pulmonary Diseases
- Sepsis Diagnosis and Treatment
- Asthma and respiratory diseases
- Diabetes Management and Research
- Hormonal Regulation and Hypertension
- Nutrition and Health in Aging
- Tracheal and airway disorders
- COVID-19 Clinical Research Studies
- Antibiotics Pharmacokinetics and Efficacy
- Neuroendocrine Tumor Research Advances
St George's, University of London
2013-2023
St George’s University Hospitals NHS Foundation Trust
2018-2023
King Edward Memorial Hospital
2023
Dalhousie University
2022
University of Alabama at Birmingham
2015-2022
Izaak Walton Killam Health Centre
2022
British Pharmacological Society
2015-2021
Penn State Milton S. Hershey Medical Center
2020-2021
Amgen (United States)
2021
The University of Melbourne
2020
Hyperglycaemia is associated with poor outcomes from pneumonia, myocardial infarction and stroke, but the effect of blood glucose on acute exacerbations chronic obstructive pulmonary disease (AECOPD) has not been established. Recent UK guidelines do comment measurement or control in AECOPD. A study was therefore undertaken to determine relationship between concentrations, length stay hospital, mortality patients admitted AECOPD.Data were retrieved electronic records for AECOPD lower...
In animals, glucose concentrations are 3-20 times lower in lung lining fluid than plasma. humans, normally low (<1 mmol/l) nasal and bronchial fluid, but they elevated by inflammation or hyperglycemia. Furthermore, is associated with increased respiratory infection intensive care patients. Our aims were to estimate normal from distal human sampled noninvasively determine effects of hyperglycemia disease on concentrations. Respiratory was as exhaled breath condensate, measured chromatography...
<h3>Objective</h3> To assess the impact of home telemonitoring on health service use and quality life in patients with severe chronic lung disease. <h3>Design</h3> Randomised crossover trial 6 months standard best practice clinical care (control group) addition telemonitoring. <h3>Participants</h3> 68 disease (38 COPD; 30 respiratory failure due to other causes), who had a hospital admission for an exacerbation within randomisation either used long-term oxygen therapy or arterial saturation...
Background: COPD and radiographic bronchiectasis frequently coexist but the effect of this on clinical course is not fully understood. We determined impact outcomes in patients, independent coexisting emphysema bronchial wall thickening (BWT). Methods: patients admitted with first exacerbation 1998–2008 were identified retrospectively using ICD10 codes J44.0,1,8,9. Patients suitable CT scans graded for severity bronchiectasis, BWT a 5 point scale (0-absent, 1-minor, 2-mild, 3-moderate,...
Abstract Background Loss of muscle mass is a co‐morbidity common to range chronic diseases including obstructive pulmonary disease (COPD). Several systemic features COPD increased inflammatory signalling, oxidative stress, and hypoxia are known increase the expression growth differentiation factor‐15 (GDF‐15), protein associated with wasting in other diseases. We therefore hypothesized that GDF‐15 may contribute COPD. Methods determined serum patients analysed association exercise...
<h3>Background</h3> Diabetes is a risk factor for respiratory infection, and hyperglycaemia associated with increased glucose in airway surface liquid of <i>Staphylococcus aureus</i> infection. <h3>Objectives</h3> To investigate whether elevation basolateral/blood concentration promotes growth pretreatment the antidiabetic drug metformin affects this relationship. <h3>Methods</h3> Human epithelial cells grown at air–liquid interface (±18 h pre-treatment, 30 μM–1 mM metformin) were inoculated...
<b>Background:</b> The risk of nosocomial infection is increased in critically ill patients by stress hyperglycaemia. Glucose not normally detectable airway secretions but appears as blood glucose levels exceed 6.7–9.7 mmol/l. We hypothesise that the presence these predisposes to respiratory infection. <b>Methods:</b> An association between bronchial aspirates and was examined 98 patients. Patients were included if they expected require ventilation for more than 48 hours. Bronchial analysed...
Background Over 30% of adult patients with pleural infection either die and/or require surgery. There is no robust means predicting at baseline presentation which will suffer a poor clinical outcome. A validated risk prediction score would allow early identification high-risk patients, potentially directing more aggressive treatment thereafter. Objectives To prospectively assess previously described (the RAPID (Renal (urea), Age, fluid Purulence, Infection source, Dietary (albumin)) score)...
<h3>Background</h3> Severe exacerbations of COPD are commonly associated with hyperglycaemia, which predicts adverse outcomes. Metformin is a well-established anti-hyperglycaemic agent in diabetes mellitus, possibly augmented anti-inflammatory effects, but its effects unknown. We investigated accelerated metformin therapy severe exacerbations, primarily to confirm or refute an effect, and secondarily explore on inflammation clinical outcome. <h3>Methods</h3> This was multicentre, randomised,...
Abstract The glucose concentration of the airway surface liquid (ASL) is much lower than that in blood and tightly regulated by epithelium. ASL elevated patients with viral colds, cystic fibrosis, chronic obstructive pulmonary disease, asthma. Elevated also associated increased incidence respiratory infection. However, mechanism which increases under inflammatory conditions unknown. aim this study was to investigate effect proinflammatory mediators (PIMs) on mechanisms governing homeostasis...
Aims Prescribing is a complex skill required of doctors and, increasingly, other healthcare professionals. Use personal formulary can help to develop this skill. In 2006–9, we developed core list the 100 most commonly prescribed drugs. Our aim in present study was update ‘starter formulary’ ensure its continued relevance for prescriber training. Methods We analysed large contemporary primary and secondary care datasets identify frequently medicinal products. Items were classified into...
Lung disease and elevation of blood glucose are associated with increased concentration in the airway surface liquid (ASL). Raised ASL is susceptibility to infection by respiratory pathogens including Staphylococcus aureus Pseudomonas aeruginosa. We have previously shown that anti-diabetes drug, metformin, reduces glucose-induced S. growth across vitro epithelial cultures. The aim this study was investigate whether metformin has potential reduce P. aeruginosa infections (Calu-3) cultures...
The T594M polymorphism of the epithelial sodium channel is found in approximately 5% people African origin and significantly associated with high blood pressure. Although could increase renal absorption through affected channels, it not known whether this causes hypertension. Amiloride specifically inhibits overactive channels effectively controls pressure Liddle's syndrome, which hypertension caused by separate mutations. aim study was to determine amiloride effective lowering individuals...
Glucose is not detectable in airways secretions of normoglycaemic volunteers, but present at 1-9 mmol x l(-1) from people with hyperglycaemia. These observations suggest the existence a blood glucose threshold which appears secretions, similar to that seen renal and salivary epithelia. In study we determined nasal secretions. Blood concentrations were raised healthy human volunteers by 20% dextrose intravenous infusion or 75 g oral load. Nasal measured using modified oxidase sticks as...
Glucose in airway surface liquid (ASL) is maintained at low concentrations compared to blood glucose. Using radiolabelled [3H]-d-glucose and [14C]-l-glucose, detection of d- l-glucose by high-performance chromatography metabolites nuclear magnetic resonance, we found that glucose applied the basolateral side H441 human epithelial cell monolayers a physiological concentration (5 mM) crossed apical paracellular diffusion. Transepithelial resistance monolayer was inversely correlated with...
People with cystic fibrosis (CF) who develop related diabetes (CFRD) have accelerated pulmonary decline, increased infection antibiotic-resistant Pseudomonas aeruginosa and exacerbations. We previously shown that glucose concentrations are elevated in airway surface liquid (ASL) of people CF, particularly those CFRD. therefore explored the hypotheses homeostasis is altered CF epithelia elevation flux into ASL drives bacterial growth, an effect over above other transmembrane conductance...
Osteoarthritis (OA) is the most prevalent arthritis worldwide and characterized by chronic pain impaired physical function. We hypothesized that heightened in hand OA could be reduced with duloxetine or pregabalin. In this prospective, randomized clinical study, we recruited 65 participants, aged 40-75 years, a Numerical Rating Scale (NRS) for of at least 5. Participants were to one following three groups: duloxetine, pregabalin, placebo. The primary endpoint was NRS score, secondary...
Background This study was designed to investigate the genetic evidence for repurposing of GLP1R (glucagon‐like peptide‐1 receptor) agonists prevent heart failure (HF) and whether potential benefit exceeds conferred by more general glycemic control. Methods Results We applied 2‐sample Mendelian randomization genetically proxied agonism on HF as main outcome left ventricular ejection fraction secondary outcome. The associations were compared with those control same outcomes. Genetic obtained...