Derriford Hospital

About: Derriford Hospital is a healthcare organization based out in Plymouth, United Kingdom. It is known for research contribution in the topics: Population & Transplantation. The organization has 2892 authors who have published 3137 publications receiving 84438 citations.

Trends in the incidence rates of tonsil and base of tongue cancer in England, 1985-2006.

Abstract: INTRODUCTIONThe aim of this study was to investigate whether incidence rates of tonsil and base of tongue cancer in England are increasing using data from the UK cancer registry. SUBJECTS AND METHODSCancer registrations for oral cavity and oropharynx cancer from 1985–2006 in England were obtained from the National Cancer Information Service. Population estimates were obtained from the Office for National Statistics. Age-adjusted incidence rates and age-specific incidence rates were calculated. The sexes were considered separately as incidence rates are known to differ significantly between men and women. Linear regression was performed to establish whether there was a relationship between incidence rates and time. RESULTSThere has been an increase in all oral cavity and oropharyngeal cancer in the study period. Linear regression analysis suggests that approximately 90% of the variance in age-adjusted incidence rates for men and women for tonsil, base of tongue and other oral cavity cancer is explained by ...

Effects of the European Working Time Directive on anaesthetic training in the United Kingdom

Abstract: Decreases in the hours worked by trainee anaesthetists are being brought about by both the New Deal for Trainees and the European Working Time Directive. Anticipated improvements in health and safety achieved by a decrease in hours will be at the expense of training time if the amount of night-time work remains constant. This audit examined the effects of a change from a partial to a full shift system on a cohort of trainee anaesthetists working in a large district general hospital in the South-west of England. Logbook and list analyses were performed for two 10-week periods: one before and one after the decrease in hours. An 18% decrease in the number of cases done and an 11% decrease in the number of weekly training lists were found for specialist registrars. A 22% decrease in the number of cases done and a 14% decrease in the number of weekly training lists were found for senior house officers. Furthermore, a decrease of one service list per specialist registrar per week was seen, which will have implications for consultant manpower requirements.

A prospective cohort study comparing the African and European hernia

Abstract: The prevalence of inguinal hernia in Ghana, western Africa, is as high as 7.7% of the population. The elective operation rate is significantly lower because many of the hernias are repaired as emergencies. This discrepancy results in a pool of longstanding large hernias. This prospective cohort study compared consecutive patients having day case local anaesthetic inguinal hernia repairs under the Plymouth Hernia Service, UK, and in Ghana, Africa. Assessment was made of hernia size and subscapular skin-fold thickness. In the Ghanaian group, data were collected on patient age, type of inguinal hernia, duration of the hernia, and disability caused. A total of 241 patients were included in the study (UK: n = 106, Ghana: n = 135). The mean age of the UK group was 62 years (range 28–91 years) and of the Ghanaian group 34 years (range 2 months–80 years). One hundred and twelve (82.9%) of the Ghanaian hernias were indirect. Ninety (67%) of the Ghanaian hernias extended into the scrotum compared with 7 (6.0%) in the UK group. The Ghanaian hernias were significantly larger (P = 0.01) and the patients significantly thinner (P = 0.02). In the Ghanaian group, 22 (16%) of the patients were unable to work due to their hernia, and in a further 87 (64%) patients, the hernia limited daily activity. One hundred and fifteen (85%) of the Ghanaian hernias were present for more than 1 year, and of those, 50 (37%) had been present for more than 5 years. In Ghana (a developing country), the hernia is larger than the UK hernia. The majority of Ghanaian hernias are indirect and occur in a young population. This places an economic burden on the country. Appropriate management is needed to reduce the pool of these hernias.

Ultrasound criteria in the diagnosis of polycystic ovary syndrome (PCOS)

Abstract: Not all women with the polycystic ovary syndrome (PCOS) on ultrasound (US) will have the syndrome, and clinical and biochemical features of PCOS may be present without US features. The sensitivity of US in detecting PCOS was, therefore, prospectively determined in 72 women (32 PCOS and 40 controls). The most sensitive features were the presence of 10 or more follicles (82% and 69% in the left and right ovary) and a peripheral distribution of follicles (81.8% and 71.9% in the left and right ovary). Although ovarian enlargement and stromal brightness were not as sensitive as the previous criteria, stromal brightness was most specific. Combining all the criteria predicted a diagnosis of PCOS or control correctly in 86.4% of cases. This study shows that established US criteria of polycystic ovaries remain of value in the diagnosis of PCOS; however, the discrepancy between the left and right ovaries is an interesting but unexplained finding.

Cushing's disease treated by trans-sphenoidal selective adenomectomy in mid-pregnancy.

Abstract: The clinical course and diagnosis of a patient with Cushing's disease complicated by pregnancy is described, and the anaesthetic management of trans-sphenoidal selective adenomectomy performed during the second trimester outlined. Problems included obesity, diabetes, hypertension and a suboptimal airway. Fibreoptic awake intubation and intravenous anaesthesia were used. Insulin requirements decreased substantially after surgery. Early administration of hydrocortisone after surgery avoided the risk of an addisonian crisis but delayed biochemical confirmation of a metabolic cure.