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.

Investigating and managing suspected pulmonary embolism in an outpatient setting: the Leicester experience

Abstract: Having established an ambulatory service for patients with suspected and proven PE, we reviewed our outcomes. All patients referred from June 2010 to May 2012 were analysed. Of 971 patients referred, 905 underwent complete assessment (66 admitted as ineligible). 754 (77.7%) patients were discharged and required no follow-up. 96 (10.6%) patients had PE confirmed of whom 70 (72.9%) were managed as outpatients. 14 (1.6%) patients have died since attending the clinic; no death was related to PE. This audit shows that ambulatory investigation and management of selected low risk patients with suspected PE is safe and reduces hospital admissions.

Persistent Thebesian Sinusoids Presenting as Ischemic Heart Disease

Abstract: A 54-year-old man with no significant past medical history or modifiable cardiovascular risk factors was admitted with chest pains and palpitations. ECG revealed atrial fibrillation with fast ventricular response that reverted to sinus rhythm after intravenous administration of digoxin. His 12-hour troponin I level was marginally elevated (0.07 ng/mL; normal range <0.06 ng/mL). Subsequent serial 12-lead ECGs (Figure 1) demonstrated widespread dynamic ST-segment and T wave changes. The patient was treated for an acute coronary syndrome and became pain free on intravenous administration of glyceryl trinitrate and glycoprotein IIB/IIIA antagonist. Coronary angiography demonstrated pristine epicardial coronaries but a bizarre appearance of capillary blush draining into the left venticular cavity, during both left main stem and right coronary artery injection (Figure 2A and 2B and Movie I and II). In absence of any myocardial tumor, ventricular hypertrophy, or …

A review of Hand Surgery Provision in England.

Abstract: This study reviews hand surgical activity and the resources available for provision of hand surgery in England in 2001. Operation rates for three common procedures, viz. carpal tunnel release, Dupuytren's surgery and ganglion surgery, were considered. The local population and the number of hand surgeons in each NHS Hospital Trust were compared. We identified 275 consultant surgeons with an interest in hand surgery working in the NHS in England. Approximately two-thirds were orthopaedic surgeons, almost one-third were plastic surgeons and a small number were accident and emergency surgeons. Half of all hand surgeons worked in large units, with three or more hand surgeons, but almost 20% of hand surgery was delivered in hospitals in which there was no surgeon with a declared interest in hand surgery. Surgery rates for Dupuytren's contracture varied from 0.04 to 0.36 cases per 1,000 population per annum and for carpal tunnel syndrome varied from 0.25 to 1.31 cases per 1,000 per annum. We found a correlation between rates of surgery and the number of hand surgeons, locally. A recent audit (Burke, Dias, Heras-Pelou, Bradley, & Wildin, 2004. Providing care for hand disorders, a reappraisal of need. Journal of Hand Surgery, 29B: 575-579.) has suggested that one hand surgeon is required to meet the needs of a population of 125,000, with a national requirement for 393 hand surgeons. We conclude that there are insufficient hand surgeons in England and believe that the wide local variations in hand surgery rates are indicative of a significant unmet demand for hand surgery in the English population.

Cardiac Magnetic Resonance of Acute Myocarditis in an Human Immunodeficiency Virus Patient Presenting With Acute Chest Pain Syndrome

Abstract: A 34-year-old woman of Afro Caribbean origin presented to the HIV clinic with a few days’ history of chest pain, chills, and malaise. The chest pain was intermittent, severe, central, radiating to the left arm, worse on lying down, and better on sitting forward. This was preceded by an episode of collapse after palpitations a week earlier. On examination, she had a regular pulse of 84 bpm, blood pressure of 131/71 mm Hg, respiratory rate of 20, temperature of 38°C, and oxygen saturation of 99% on air. Cardiovascular, respiratory, abdominal, and neurological examinations were normal. ECG demonstrated anterolateral ischemic changes (Figure 1). Chest radiograph was normal. Figure 1. ECG showing anterolateral ischemic changes. Biochemical profile was as follows: C-reactive protein, 296 mg/dL; troponin, 3.8 ng/mL; CD4 count, 459; viral load, <50; and hemoglobin, 9.1 g/dL. Her antistreptolysin O titer was 1 in 40, and no antistreptolysin antibodies were detected. Viral titers were negative for cytomegalovirus, adenovirus, Coxiella burnetii , chlamydia (group) and Mycoplasma pneumoniae , enterovirus (including echoviruses, coxsackie …

Solitary metastatic adenocarcinoma of the sternum treated by total sternectomy and chest wall reconstruction using a Gore-Tex patch and myocutaneous flap: a case report

Abstract: The consequences of bone metastasis are often devastating. Although the exact incidence of bone metastasis is unknown, it is estimated that 350,000 people die of bone metastasis annually in the United States. The incidence of local recurrences after mastectomy and breast-conserving therapy varies between 5% and 40% depending on the risk factors and primary therapy utilized. So far, a standard therapy of local recurrence has not been defined, while indications of resection and reconstruction considerations have been infrequently described. This case report reviews the use of sternectomy for breast cancer recurrence, highlights the need for thorough clinical and radiologic evaluation to ensure the absence of other systemic diseases, and suggests the use of serratus anterior muscle flap as a pedicle graft to cover full-thickness defects of the anterior chest wall. We report the case of a 70-year-old Caucasian woman who was referred to our hospital for the management of a retrosternal mediastinal mass. She had undergone radical mastectomy in 1999. Computed tomography and magnetic resonance imaging revealed a 74.23 × 37.7 × 133.6-mm mass in the anterior mediastinum adjacent to the main pulmonary artery, the right ventricle and the ascending aorta. We performed total sternectomy at all layers encompassing the skin, the subcutaneous tissues, the right pectoralis major muscle, all the costal cartilages, and the anterior part of the pericardium. The defect was immediately closed using a 0.6 mm Gore-Tex cardiovascular patch combined with a serratus anterior muscle flap. Our patient had remained asymptomatic during her follow-up examination after 18 months. Chest wall resection has become a critical component of the thoracic surgeon's armamentarium. It may be performed to treat either benign conditions (osteoradionecrosis, osteomyelitis) or malignant diseases. There are, however, very few reports on the results of full-thickness complete chest wall resections for locally recurrent breast cancer with sufficient safety margins, and even fewer reports that describe the operative technique of using the serratus anterior muscle as a pedicled flap.