Leicester General Hospital

About: Leicester General Hospital is a healthcare organization based out in Leicester, United Kingdom. It is known for research contribution in the topics: Population & Transplantation. The organization has 2481 authors who have published 3034 publications receiving 107437 citations.

Predictors of Service Use for Mental Health Problems Among British Schoolchildren

Abstract: Background: Most previous studies of service use in relation to mental health have examined services in the USA. We wanted to provide up-to-date findings from a general population sample of British schoolchildren. Method: A total of 2461 children aged 5-15 from the 1999 British Child and Adolescent Mental Health Survey were followed up for 3 years. We examine the relationship between a wide variety of potential predictors gathered in 1999 and the use of services over the following 3 years. Results: Contact with most services was predicted by three factors: the impact of psychopathology; contact with teachers or primary health care; and parents' and teachers perceptions that the child had significant difficulties. Other predictors were specific to each service. Conclusions: Education of parents, teachers and other important adults might increase the proportion of children with impairing psychiatric disorders reaching services. Abbreviations: DAWBA Development and Well-Being Assessment. Key Practitioner Message: • The impact of psychopathology on the child or on others predicted contact with most public sector services. • The recognition of psychopathology by key adults, particularly parents and teachers predicted contact with teachers, educational specialists and paediatrics in relation to mental health. • Regional differences in contact with public sector services for mental health services suggest that the organisation of services can influence who is and is not seen.

Examination of insulin injection sites: an unexpected finding of localized amyloidosis.

Abstract: A 34-year-old man with a 17-year history of Type 1 diabetes mellitus attended an annual review clinic in December 1999 and complained of a lump on his right thigh. His diabetic control was moderate (HbA 1c 8.3%), and he displayed no long-term complications of diabetes. A firm well-defined 7-cm mass clinically distinct to adjacent areas of lipohypertrophy was found in the anterior aspect of his right thigh, an area that represented his current insulin injection site. Numerous smaller lesions of similar consistency were noted at other regular injection sites in his upper limbs and the contra-lateral thigh. No other clinical abnormalities were present and routine biochemical tests were unremarkable. Surgical excision was performed at a later date under general anaesthesia, revealing that the lesion was composed entirely of a waxy grey material. Histological examination showed the majority of the tissue to be amorphous acellular eosinophilic material possessing a mild chronic inflammatory cell infiltrate. The acellular matrix, when stained with Congo red and viewed through cross-polarized light, demonstrated the classical apple-green birefringent properties of amyloid (Fig. 1). This finding was corroborated by the appearance of non-branching fibrils on transmission electron microscopy. The association between the unusual and apparently localized soft tissue amyloid deposits and the insulin injection sites was considered and investigated further. Although parenteral drug abuse may occasionally result in reactive systemic (AA) amyloidosis by virtue of producing

The use of digital images in pathology

Abstract: Digital images are routinely used by the publishing industry, but most diagnostic pathologists are unfamiliar with the technology and its possibilities. This review aims to explain the basic principles of digital image acquisition, storage, manipulation and use, and the possibilities provided not only in research, but also in teaching and in routine diagnostic pathology. Images of natural objects are usually expressed digitally as 'bitmaps'--rectilinear arrays of small dots. The size of each dot can vary, but so can its information content in terms, for example, of colour, greyscale or opacity. Various file formats and compression algorithms are available. Video cameras connected to microscopes are familiar to most pathologists; video images can be converted directly to a digital form by a suitably equipped computer. Digital cameras and scanners are alternative acquisition tools of relevance to pathologists. Once acquired, a digital image can easily be subjected to the digital equivalent of any conventional darkroom manipulation and modern software allows much more flexibility, to such an extent that a new tool for scientific fraud has been created. For research, image enhancement and analysis is an increasingly powerful and affordable tool. Morphometric measurements are, after many predictions, at last beginning to be part of the toolkit of the diagnostic pathologist. In teaching, the potential to create dramatic yet informative presentations is demonstrated daily by the publishing industry; such methods are readily applicable to the classroom. The combination of digital images and the Internet raises many possibilities; for example, instead of seeking one expert diagnostic opinion, one could simultaneously seek the opinion of many, all around the globe. It is inevitable that in the coming years the use of digital images will spread from the laboratory to the medical curriculum and to the whole of diagnostic pathology.

Diabetes prevalence, process of care and outcomes in relation to practice size, caseload and deprivation: national cross-sectional study in primary care

Abstract: ObjectiveTo examine the association between practice list size, deprivation and the quality of care of patients with diabetes.DesignPopulation-based cross-sectional study using Quality and Outcomes Framework data.SettingEngland and Scotland.Participants55 522 778 patients and 8970 general practices with 1 852 762 people with diabetes.InterventionsNone.Main outcome measuresSeventeen process and surrogate outcome measures of diabetes care.ResultsThe prevalence of diabetes was 3.3%. Prevalence differed with practice list size and deprivation: smaller and more deprived practices had a higher mean prevalence than larger and more affluent practices (3.8% versus 2.8%). Practices with large patient list sizes had the highest quality of care scores, even after stratifying for deprivation. However, with the exception of retinal screening, peripheral pulses and neuropathy testing, differences in achievement between small and large practices were modest (<5%). Small practices performed nearly as well as the largest p...