A5013381966- Adrenal Hormones and Disorders
- Hormonal Regulation and Hypertension
- Hormonal and reproductive studies
- Pituitary Gland Disorders and Treatments
- Diabetes Treatment and Management
- Stress Responses and Cortisol
- Diet and metabolism studies
- Bariatric Surgery and Outcomes
- Pathogenesis and Treatment of Hiccups
- Bone health and osteoporosis research
- Long-Term Effects of COVID-19
- Regulation of Appetite and Obesity
- Urticaria and Related Conditions
- Pharmacology and Obesity Treatment
- Bone health and treatments
- Adrenal and Paraganglionic Tumors
- COVID-19 Clinical Research Studies
- Vitamin D Research Studies
- Microscopic Colitis
- Systemic Lupus Erythematosus Research
- Potassium and Related Disorders
- Clinical Laboratory Practices and Quality Control
- Rheumatoid Arthritis Research and Therapies
- Helicobacter pylori-related gastroenterology studies
- Health Services Management and Policy
Imperial College Healthcare NHS Trust
2016-2024
Imperial College London
2015-2024
North West London Pathology
2021-2024
Diabetes Australia
2023
King's College London
2011-2021
Charing Cross Hospital
2017-2018
OBJECTIVE Roux-en-Y gastric bypass (RYGB) augments postprandial secretion of glucagon-like peptide 1 (GLP-1), oxyntomodulin (OXM), and YY (PYY). Subcutaneous infusion these hormones (“GOP”), mimicking levels, reduces energy intake. Our objective was to study the effects GOP on glycemia body weight when given for 4 weeks patients with diabetes obesity. RESEARCH DESIGN AND METHODS In this single-blinded mechanistic study, obese prediabetes/diabetes were randomized (n = 15) or saline 11) weeks....
Abstract Context The COVID-19 pandemic continues to exert an immense burden on global health services. Moreover, up 63% of patients experience persistent symptoms, including fatigue, after acute illness. Endocrine systems are vulnerable the effects as many glands express ACE2 receptor, used by SARS-CoV-2 virion for cellular access. However, adrenal and thyroid gland function remain unknown. Objective Our objectives were evaluate in survivors. Methods A prospective, observational study was...
The A883F germline mutation of the rearranged during transfection (RET) proto-oncogene causes multiple endocrine neoplasia 2B. In revised American Thyroid Association (ATA) guidelines for management medullary thyroid carcinoma (MTC), has been reclassified from highest to high-risk level, although no well-defined risk profile this exists.To create a appropriate classification among ATA levels.Retrospective analysis.International collaboration.Included were 13 carriers.The intervention was...
Patients who need glucocorticoid replacement in both primary and secondary adrenal insufficiency (AI) have the choice of either once-daily prednisolone or thrice-daily hydrocortisone. A recent European study found no difference between hydrocortisone users several markers including glucose, weight, body mass index, systolic diastolic blood pressure waist circumference, although an increase cholesterol low-density lipoprotein (LDL) was suggested a subgroup these patients. The aim this to...
Osteoporosis results from disturbances in bone formation and resorption. Recent nonhuman data suggest that the reproductive hormone kisspeptin directly stimulates osteoblast differentiation vitro thus could have clinical therapeutic potential. However, effects of on human metabolism are currently unknown.To assess vivo.In study: Mono- cocultures osteoblasts osteoclasts treated with kisspeptin. Clinical Randomized, placebo-controlled, double-blind, 2-way crossover study 26 men investigating...
The COVID-19 pandemic has drastically changed the delivery of secondary care services. Self-collection capillary blood at home can facilitate monitoring patients with chronic disease to support virtual clinics while mitigating risk SARS-CoV-2 infection and transmission.To investigate comparability whole plasma venous samples for 15 routinely used biochemical analytes develop pilot a user-friendly home-collection kit outpatient clinical services.To requested analytes, simultaneous were...
Abstract Aims To determine whether a continuous infusion of glucagon‐like peptide receptor (GLP‐1R)/glucagon (GCGR) co‐agonist, G3215 is safe and well tolerated in adults with overweight or obesity. Methods A phase 1 randomized, double blind, placebo‐controlled trial obese participants, without type 2 diabetes. Results Twenty‐six participants were recruited randomized 23 completing 14‐day subcutaneous placebo. The most common adverse events nausea vomiting, which mild cases mitigated by...
Abstract Background This study examined the pharmacokinetic profile of prednisolone. Methods Using a newly developed ultra-performance liquid chromatography MS/MS method, prednisolone profiles in healthy volunteers and patients with adrenal insufficiency already treated were prospectively analyzed tertiary center. Results Twelve day curves analyzed. Six secondary provided 7 3 5 curves, 1 which was administered divided doses. The mean dose required for adequate replacement hypoadrenal 3.86...
Roux-en-Y gastric bypass (RYGB) is an established treatment for type 2 diabetes and obesity. The study objective was to establish RYGB's effects on glycemic variability (GV) hypoglycemia.This a prospective observational of 10 participants with obesity prediabetes or who underwent RYGB. Patients were studied before RYGB (Pre) 1 month, year, years postsurgery continuous glucose measurement (CGM). A mixed-meal test (MMT) conducted at Pre, year.After RYGB, mean CGM decreased (at years), GV...
Patients with adrenal insufficiency (AI) have a higher mortality than the general population, possibly because of excess glucocorticoid exposure at inappropriate times. The cortisol circadian rhythm is difficult to mimic twice- or thrice-daily hydrocortisone. Prednisolone once-daily alternative which may improve patient compliance through its convenience.Prednisolone day curves can be used accurately downtitrate patients minimum effective dose. This study aimed review prednisolone and...
Adrenal insufficiency (AI) is a life-threatening condition which requires long term glucocorticoid replacement. The insulin tolerance test (ITT) the current gold standard for diagnosis of secondary AI, but widely accepted cut-off value peak cortisol less than 500 nmol/L assumes that anyone who does not reach this has AI and thus full used to diagnose also founded on outdated assays. Use in an era more specific immunoassays therefore risks misdiagnosis, subsequent unnecessary exposure...
Adrenal Insufficiency (AI), especially iatrogenic-AI, is a treatable cause of mortality. The difficulty in obtaining 9 am cortisol levels means samples are taken at suboptimal times, including substantial proportion the afternoon. Low afternoon often provoke short Synacthen tests (SSTs). It important that this does not lead to patients misdiagnosed with AI, exposing them excess mortality and morbidity inappropriate steroid replacement therapy.
Pituitary and adrenal insufficiency must not be overlooked when weaning patients down from high-dose steroids. Prednisolone can used as glucocorticoid replacement therapy, with most needing 3-4 mg once daily.
The incidence of conversion from a laparoscopic to an open approach during nephrectomy is reported at 6-8%. Conversion procedure may be necessary control haemorrhage or allow progress in dissection but the well established benefits minimally invasive surgery (MIS) are obviously lost. Hand-assisted laparoscopy (HAL) also offers patient MIS. We have used HAL convert pure difficult nephrectomies, rather than converting traditional surgery.A review our prospective database was carried out...