Glenfield Hospital

About: Glenfield Hospital is a healthcare organization based out in Leicester, United Kingdom. It is known for research contribution in the topics: Population & Extracorporeal membrane oxygenation. The organization has 1382 authors who have published 1812 publications receiving 99238 citations. The organization is also known as: Glenfield General Hospital.

Thorax: the Cappuccino years.

Abstract: We are now about half way through our term of office (unless we are prematurely fired for terminal misbehaviour); here we review where we are, and where we are going, and have the first instalment of the showcase of some of our best articles from last year. We have maintained our second position with an improved impact factor (6.84) over 2011, we continue to attract very high quality manuscripts, and handling times have come down (all good news). We owe these achievements to our associate editors and editorial board, the reviewers, and especially those who have submitted such great manuscripts. An especially large bouquet to the editorial staff, in particular Renuka Patel for her work on Hot Topics and marketing, Bryony Skinner, who has stepped magnificently into the breach, Allison Lang and our unsung heroine Sarah Szatkowski, who keeps us sane when ScholarOne is driving us to Prozac or haloperidol or both. Don't leave us! We acknowledge we need to speed up further, and get the impact factor higher—both are a work in progress. However, average time from submission to first decision for all manuscripts is less than 30 days, and accepted manuscripts appear on-line in an average of 25 days. We have had out first randomised controlled trial protocol to review for consideration for fast-track publication when the study is completed—an offer which does not depend on the result being positive—investigators please note. Hot off the Breath continues to generate controversy—totally drug resistant tuberculosis (TB) and the roaring PANTHER being cases in point. We have had two themed issues (North American, to coincide with American Thoracic Society and cystic fibrosis (CF), to coincide with the US CF Foundation annual meeting). In 2013, we will have a Tuberculosis themed issue for World TB day (March 24th) and plan a Pneumonia themed issue …

Brain monitoring in adult and pediatric ECMO patients : The importance of early and late assessments

Abstract: Monitoring brain integrity and neurocognitive function is a new and important target for the management of a patient treated with extracorporeal membrane oxygenation (ECMO), in particular because of the increasing awareness of cerebral abnormalities that may potentially occur in this setting. Continuous regular monitoring, as well as repeated assessment for cerebral complications has become an essential element of the ECMO patient management. Besides well-known complications, like bleeding, ischemic stroke, seizures, and brain hypoperfusion, other less defined yet relevant injury and clinical manifestations are increasingly reported and impacting on ECMO patient prognosis at short term. Furthermore, it is becoming more evident that neurologic complication may not occur only in the early phase. Indeed, other potential adverse events related to the long-Term neurocognitive function have been also recently documented either in children or adult ECMO patients. Despite increasing awareness of these aspects, generally accepted protocols and clinical management strategies in this respect are still lacking. Current means to monitor brain perfusion or detecting ongoing cerebral tissue injury are rather limited, and most techniques provide indirect or post-insult recognition of irreversible tissue injury. Continuous monitoring of brain perfusion, serial assessment of brain-derived serum biomarkers, timely neuro-imaging, profesand post-discharge counselling for neurocognitive dysfunction, particularly in pediatric patients, are novel pathways focusing on neurologic assessment with important implications in daily practice to assess brain function and integrity not only during the ECMO-related hospitalization, but also at long-Term to re-evaluate the neuropsychological integrity, although well designed studies will be necessary to elucidate the cost-effectiveness of these management strategies.

Management of asthma in adults: current therapy and future directions

Abstract: Asthma is increasing in prevalence worldwide and results in significant use of healthcare resources. Although most patients with asthma can be adequately treated with inhaled corticosteroids, an important number of patients require additional therapy and an increasing number of options are available. A further minority of patients develop severe persistent asthma which remains difficult to manage despite current pharmacological therapies. This review discusses the various treatment options currently available for each stage of asthma severity, highlights some of the limitations of current management, and outlines directions which may improve the management of asthma in the future.

Regional differences in dynamic cerebral autoregulation in the healthy brain assessed by magnetic resonance imaging.

Abstract: A novel method is described for mapping dynamic cerebral blood flow autoregulation to assess autoregulatory efficiency throughout the brain, using magnetic resonance imaging (MRI). Global abnormalities in autoregulation occur in clinical conditions, including stroke and head injury, and are of prognostic significance. However, there is limited information about regional variations. A gradient-echo echo-planar pulse sequence was used to scan the brains of healthy subjects at a rate of 1 scan/second during a transient decrease in arterial blood pressure provoked by a sudden release of pressure in bilateral inflated thigh cuffs. The signal decrease and subsequent recovery were analyzed to provide an index of autoregulatory efficiency (MRARI). MRI time-series were successfully acquired and analyzed in eleven subjects. Autoregulatory efficiency was not uniform throughout the brain: white matter exhibited faster recovery than gray (MRARI = 0.702 vs. 0.672, p = 0.009) and the cerebral cortex exhibited faster recovery than the cerebellum (MRARI = 0.669 vs. 0.645, p = 0.016). However, there was no evidence for differences between different cortical regions. Differences in autoregulatory efficiency between white matter, gray matter and the cerebellum may be a result of differences in vessel density and vasodilation. The techniques described may have practical importance in detecting regional changes in autoregulation consequent to disease.

A randomized controlled trial of the compuLsive Exercise Activity TheraPy (LEAP): a new approach to compulsive exercise in anorexia nervosa

Abstract: Objective: To compare the efficacy of the compuLsive Exercise Activity theraPy (LEAP) programme integrated with manualised cognitive behavioural therapy for anorexia nervosa (CBT-AN) compared to CBT-AN alone. Method: Seventy-eight adults were randomised to CBT-AN, delivered with or without 8 embedded sessions of LEAP, for a total of 34 individual outpatient sessions. Participants were assessed at baseline, the end of the first phase of CBT-AN (which included LEAP), mid-therapy, end of therapy, and at 3 and 6-months follow-up. Linear mixed effects modelling was used for comparing trajectories over time by group in primary outcomes of pathological exercise cognitions and secondary outcomes of exercise frequency, BMI, eating disorder (ED) symptoms, AN stage of change, anxiety/depression, and health related quality of life. Results: There were significant improvements over time in all outcomes. There were no significant differences between treatment groups in primary outcome measures. Fidelity and end-of- treatment participant satisfaction were satisfactory across both conditions. Discussion: CBT-AN and LEAP added to CBT-AN resulted in improved attitudes and beliefs towards exercise and general improvements in BMI and eating disorder psychopathology in people with AN.