Inflammation and Obesity Correlate in Pulmonary Hypertension but Associate with Diverging Outcomes.

Rationale & Objectives: Inflammation is associated with all types of Pulmonary Hypertension (PH) both as a known cause and/or a putative confounder. The most common marker of inflammation, C-reactive protein (CRP), has not been widely studied in PH. This study set out to clarify if CRP informed clinical endotyping and outcomes.

Exploring the patient experience of chronic hepatitis D (CHD) and assessment of content validity of the Hepatitis Quality of Life Questionnaire and (HQLQv2) and the Fatigue Severity Scale (FSS).

Background: Chronic hepatitis D (CHD) is the most severe form of viral hepatitis, which results in accelerated progression to cirrhosis and poor prognosis compared with other hepatitis infections, impacting patients' health-related quality of life (HRQoL). To adequately capture patient perspectives of new hepatitis D virus (HDV) treatments in clinical trials, patient-reported outcome (PRO) measures that are valid and assess key concepts relevant to the patient are needed. This study aimed to explore the patient experience of CHD and evaluate the content validity of the Hepatitis Quality of Life Questionnaire (HQLQv2) and the Fatigue Severity Scale (FSS) for use in an HDV population.

StratosPHere 2: study protocol for a response-adaptive randomised placebo-controlled phase II trial to evaluate hydroxychloroquine and phenylbutyrate in pulmonary arterial hypertension caused by mutations in BMPR2.

Background: Pulmonary arterial hypertension is a life-threatening progressive disorder characterised by high blood pressure (hypertension) in the arteries of the lungs (pulmonary artery). Although treatable, there is no known cure for this rare disorder, and its exact cause is unknown. Mutations in the bone morphogenetic protein receptor type-2 (BMPR2) are the most common genetic cause of familial pulmonary arterial hypertension.

Early neutrophil trajectory following clozapine may predict clozapine response - Results from an observational study using electronic health records.

Background: Clozapine has unique effectiveness in treatment-resistant schizophrenia and is known to cause immunological side-effects. A transient spike in neutrophils commonly occurs in the first weeks of clozapine therapy. There is contradictory evidence in the literature as to whether neutrophil changes with clozapine are linked to treatment response.

Autoimmunity Is a Significant Feature of Idiopathic Pulmonary Arterial Hypertension.

Autoimmunity is believed to play a role in idiopathic pulmonary arterial hypertension (IPAH). It is not clear whether this is causative or a bystander of disease and if it carries any prognostic or treatment significance. To study autoimmunity in IPAH using a large cross-sectional cohort.

Mendelian randomisation and experimental medicine approaches to interleukin-6 as a drug target in pulmonary arterial hypertension.

Background: Inflammation and dysregulated immunity are important in the development of pulmonary arterial hypertension (PAH). Compelling preclinical data supports the therapeutic blockade of interleukin-6 (IL-6) signalling.

Methods: We conducted a phase 2 open-label study of intravenous tocilizumab (8 mg·kg) over 6 months in patients with group 1 PAH.

Approaches to treat pulmonary arterial hypertension by targeting BMPR2: from cell membrane to nucleus.

Pulmonary arterial hypertension (PAH) is estimated to affect between 10 and 50 people per million worldwide. The lack of cure and devastating nature of the disease means that treatment is crucial to arrest rapid clinical worsening. Current therapies are limited by their focus on inhibiting residual vasoconstriction rather than targeting key regulators of the cellular pathology.

Prevalence of treatment resistance and clozapine use in early intervention services.

Background: Treatment resistance causes significant burden in psychosis. Clozapine is the only evidence-based pharmacologic intervention available for people with treatment-resistant schizophrenia; current guidelines recommend commencement after two unsuccessful trials of standard antipsychotics.

Aims: This paper aims to explore the prevalence of treatment resistance and pathways to commencement of clozapine in UK early intervention in psychosis (EIP) services.

Acute psychosis in glycogen storage disease: a rare but severe complication.

Glycogen storage disease type 1 (GSD-1) is a group of inherited metabolic disorders characterised by the inability to use intracellular glucose stores. It is associated with a high risk of hypoglycaemia, as well as long-term complications including growth retardation, hepatocellular adenomas, renal disease, hypertriglyceridaemia and hyperuricaemia. Treatment involves slow absorption carbohydrates, for example, cornstarch.

Clozapine discontinuation in early schizophrenia: a retrospective case note review of patients under an early intervention service.

Aim: Research in patients with treatment-resistant schizophrenia has demonstrated that clozapine discontinuation is associated with poor outcomes. There is, however, a paucity of research investigating the impact of clozapine discontinuation specifically in younger patients with more recent onset schizophrenia. A case note review was therefore conducted to ascertain medium-term prognoses in patients with treatment-resistant schizophrenia under an early intervention service (EIS) following clozapine discontinuation.

Rates of criminal victimization in an early intervention for psychosis service - a cross sectional survey.

Background: There is a growing body of research looking into the high rates of victimization amongst people with severe mental illness. Studies to date have tended to look at victimization rates in people with chronic mental illness over a wide age range. However, national crime surveys indicate that younger people are more likely to be the victim of crime than older people.

Staff attitudes towards particular client difficulties in assertive outreach teams.

Objective: Over recent years in England there has been widespread development of assertive outreach teams supporting patients with severe mental illness living in the community. Assertive outreach staff members are exposed to a variety of new stressors and risks. This study investigated the emotional impact on keyworkers of working with assertive outreach patients.

Quantitative risk assessment of rabies entering Great Britain from North America via cats and dogs.

Great Britain has been rabies-free since 1922, which is often considered to be in part due to the strict laws requiring that imported cats and dogs be vaccinated and quarantined for 6 months immediately on entry into the country. Except for two isolated incidents, this quarantine policy has contributed to ensuring that Great Britain has remained free of rabies. In 2000, amendments to the UK quarantine laws were made and the Pet Travel Scheme (PETS) was launched for companion animals traveling from European Union countries and rabies-free islands.