Alan J. Jaap

Oxidative stress rather than triglyceride accumulation is a determinant of mitochondrial dysfunction in in vitro models of hepatic cellular steatosis

There is still debate about the relationship between fat accumulation and mitochondrial function in nonalcoholic fatty liver disease. It is a critical question as only a small proportion of individuals with steatosis progress to steatohepatitis. In this study, we focused on defining (i) the effects of triglyceride accumulation and reactive oxygen species (ROS) on mitochondrial function (ii) the contributions of triglyceride, ROS and subsequent mitochondrial impairment on the metabolism of energy substrates.

Initial experiences of a student assistantship

Evidence suggests that medical graduates are underprepared to work as junior doctors. To ease transition in the UK, the General Medical Council (GMC) recommended the introduction of a student ‘assistantship’. This is a period of training where final‐year students take on duties of a foundation doctor under supervision. This study explored the experiences of the first cohort of students and junior doctors participating in the assistantship in one UK medical school in 2012.

CSII from patient to politics; a national and local perspective

Continuous subcutaneous infusion of insulin (CSII), or insulin pump therapy, is increasingly recognised as an important treatment option for type 1 diabetes. In the UK, however, patient usage remains low, owing in part to the politics surrounding funding. In this article, current CSII use in Scotland is discussed and the evidence base and cost effectiveness of the therapy, with respect to biochemical parameters and quality of life reviewed. The guidance on CSII use from national organisations (Scottish Intercollegiate Guideline Network and the National Institute for Health and Clinical Excellence) is also presented. There is strong support for CSII among patients, and personal patient stories are included to highlight the potential impact of CSII on everyday life. Finally, we discuss our local strategy for recruiting and commencing pump therapy and the local and national challenges faced. As CSII use increases, it is important that all doctors, nurses and allied health professionals have an awareness of what it is and how it works. Patients need ongoing support to best manage their health and health professionals should ensure that the most appropriate and cost-effective therapies are being offered. Br J Diabetes Vasc Dis 2012;12:91-96

Comparison of the effects of long-term pioglitazone and rosiglitazone therapy on liver enzymes in type 2 diabetes

AimsInsulin resistance is a major factor influencing the progression of non-alcoholic fatty liver disease (NAFLD). Hence, insulin sensitisers such as thiazolidinediones (TZDs) are a potential treat...

Electronic-nose breath print distinguishes non-alcoholic fatty liver disease from healthy lean control: A pilot study

Sensor 1, Sensor 2, Sensor 3 and Sensor 4 identified NAFLD cirrhosis patients with AUC 0.96 (standard error=0.043; p<0.001), 0.89 (standard error=0.046; p<0.001), 0.98 (standard error =0.016; p<0.001) and 0.96 (standard error=0.022; p<0.001) respectively eNose was able to differentiate between healthy from; non-cirrhotic NAFLD (p<0.001, CVV 96.8%) and NAFLD cirrhotic (p<0.001, CVV 95.1%). This method, designed to reflect the generalization property of the k-nearest neighbour’s (k-NN) classifier, scored a classification rate of 96%. METHODS