Keele University

About: Keele University is a education organization based out in Newcastle-under-Lyme, United Kingdom. It is known for research contribution in the topics: Population & Stars. The organization has 11318 authors who have published 26323 publications receiving 894671 citations. The organization is also known as: Keele University.

Incidence, clinical management, and mortality risk following self harm among children and adolescents: cohort study in primary care.

Abstract: Objectives To examine temporal trends in sex and age specific incidence of self harm in children and adolescents, clinical management patterns, and risk of cause specific mortality following an index self harm episode at a young age. Design Population based cohort study. Setting UK Clinical Practice Research Datalink—electronic health records from 674 general practices, with practice level deprivation measured ecologically using the index of multiple deprivation. Patients from eligible English practices were linked to hospital episode statistics (HES) and Office for National Statistics (ONS) mortality records. Participants For the descriptive analytical phases we examined data pertaining to 16 912 patients aged 10-19 who harmed themselves during 2001-14. For analysis of cause specific mortality following self harm, 8638 patients eligible for HES and ONS linkage were matched by age, sex, and general practice with up to 20 unaffected children and adolescents (n=170 274). Main outcome measures In the first phase, temporal trends in sex and age specific annual incidence were examined. In the second phase, clinical management was assessed according to the likelihood of referral to mental health services and psychotropic drug prescribing. In the third phase, relative risks of all cause mortality, unnatural death (including suicide and accidental death), and fatal acute alcohol or drug poisoning were estimated as hazard ratios derived from stratified Cox proportional hazards models for the self harm cohort versus the matched unaffected comparison cohort. Results The annual incidence of self harm was observed to increase in girls (37.4 per 10 000) compared with boys (12.3 per 10 000), and a sharp 68% increase occurred among girls aged 13-16, from 45.9 per 10 000 in 2011 to 77.0 per 10 000 in 2014. Referrals within 12 months of the index self harm episode were 23% less likely for young patients registered at the most socially deprived practices, even though incidences were considerably higher in these localities. Children and adolescents who harmed themselves were approximately nine times more likely to die unnaturally during follow-up, with especially noticeable increases in risks of suicide (deprivation adjusted hazard ratio 17.5, 95% confidence interval 7.6 to 40.5) and fatal acute alcohol or drug poisoning (34.3, 10.2 to 115.7). Conclusions Gaining a better understanding of the mechanisms responsible for the recent apparent increase in the incidence of self harm among early-mid teenage girls, and coordinated initiatives to tackle health inequalities in the provision of services to distressed children and adolescents, represent urgent priorities for multiple public agencies.

Methods for the evaluation of biocompatibility of soluble synthetic polymers which have potential for biomedical use: 1 - Use of the tetrazolium-based colorimetric assay (MTT) as a preliminary screen for evaluation of in vitro cytotoxicity

Abstract: A tetrazolium-based colorimetric assay (MTT) was first introduced by Mossman in 1983 to assess the potential of novel antitumour agents, and it has been used here to evaluate the cytotoxicity of several soluble synthetic polymers proposed as drug carriers Polymers including poly-l-lysine (molecular weight 57 000) were incubated (up to 1 mg ml−1) with two human cell lines, hepatocellular carcinoma (HepG2) and lymphoblastoid leukaemia (CCRF), adherent and suspension cells, respectively Tests were carried out in the presence and absence of serum proteins The assay was first modified to optimize the colorimetric profiles produced by the cell lines following incubation with MTT, to increase both the test sensitivity and the reproducibility of the method Polymer toxicity observed using the MTT test was compared with data obtained using other methods; [3H]thymidine or [3H]leucine incorporation and counting cell numbers Poly-l-lysine was very toxic to both cell lines with approximate IC50-values of 60 and 30 µg ml−1 for HepG2 and CCRF, respectively, the values obtained being similar for each of the three different viability methods used In the absence of serum proteins the toxicity of poly-l-lysine increased, the IC50-values falling to 255 µg ml−1 for the adherent and 08 µg ml−1 for the suspension cell line Other polymers such as poly-l-proline, polyethylene glycol, dextran, polyvinylpyrrolidone and poly-l-glutamic acid were not cytotoxic (MTT assay), either in the presence or in the absence of serum proteins The MTT assay is a useful technique for the primary and rapid evaluation of the cytotoxicity of soluble polymers

Relationship of opioid use and dosage levels to fractures in older chronic pain patients.

Abstract: Background Opioids have been linked to increased risk of fractures, but little is known about how opioid dose affects fracture risk.

Risk of Late Relapse or Reinfection With Hepatitis C Virus After Achieving a Sustained Virological Response: A Systematic Review and Meta-analysis

Abstract: Infection with the hepatitis C virus (HCV) is a significant public health concern associated with a high burden of morbidity and mortality [1, 2]. Recent estimates suggest that worldwide, of the 185 million individuals infected, over 700 000 people die annually as a result of infection [3, 4]. The attainment of a sustained virological response (SVR), defined as aviremia 12 or 24 weeks after the completion of antiviral therapy (SVR12 or SVR24), is associated with an improved prognosis compared with patients either untreated or failing therapy. These benefits include improved histology, reduced risk of hepatocellular carcinoma, and improved overall survival [5, 6]. Despite these benefits, treatment uptake for chronic HCV has been low due to complexities of treatment and poor success rates. The availability of new highly efficacious regimens provides the foundation for marked treatment scale-up; however, high costs are currently limiting access [7–10]. One challenge to treatment scale-up is the risk of HCV recurrence, either as late relapse post-SVR or reinfection following treatment. HCV recurrence is a particular concern in patients with ongoing high-risk behaviors, such as injecting drug users (IDUs), who are more susceptible to reinfection, and also patients coinfected with human immunodeficiency virus (HIV) who may be at increased risk of relapse due to their immunocompromised status [11–15]. A number of studies have been carried out to examine the durability of treatment-induced SVR in patients with chronic HCV in a variety of patient populations. Our aim was to systematically review the existing evidence and undertake meta-analysis to provide summary estimates of the recurrence rate by risk group. The secondary aim was to evaluate the contribution of late relapse and of reinfection to the recurrence rate. This work fits within the theme one of the PROGRESS framework for prognosis research (“fundamental prognosis research”) and will provide a clearer understanding of HCV recurrence to inform the provision of antiviral therapy [16].