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Institution

Leicester Royal Infirmary

HealthcareLeicester, United Kingdom
About: Leicester Royal Infirmary is a healthcare organization based out in Leicester, United Kingdom. It is known for research contribution in the topics: Population & Carotid endarterectomy. The organization has 5300 authors who have published 6204 publications receiving 208464 citations.


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Journal ArticleDOI
TL;DR: A μ‐opioid receptor‐mediated activation of phospholipase C is demonstrated, via a pertussis toxin‐sensitive G protein, that is Ca2+‐dependent, that could play a part in the cellular mechanisms of opioid action.
Abstract: The cellular mechanisms underlying opioid action remain to be fully determined, although there is now growing indirect evidence that some opioid receptors may be coupled to phospholipase C. Using SH-SY5Y human neuroblastoma cells (expressing both mu- and delta-opioid receptors), we demonstrated that fentanyl, a mu-preferring opioid, caused a dose-dependent (EC50 = 16 nM) monophasic increase in inositol (1,4,5)trisphosphate mass formation that peaked at 15 s and returned to basal within 1-2 min. This response was of similar magnitude (25.4 +/- 0.8 pmol/mg of protein for 0.1 microM fentanyl) to that found in the plateau phase (5 min) following stimulation with 1 mM carbachol (18.3 +/- 1.4 pmol/mg of protein), and was naloxone-, but not naltrindole- (a delta antagonist), reversible. Further studies using [D-Ala2, MePhe4, Gly(ol)5]enkephalin and [D-Pen2,5]enkephalin confirmed that the response was specific for the mu receptor. Incubation with Ni2+ (2.5 mM) or in Ca(2+)-free buffer abolished the response, as did pretreatment (100 ng/ml for 24 h) with pertussis toxin (control plus 0.1 microM fentanyl, 26.9 +/- 1.5 pmol/mg of protein; pertussis-treated plus 0.1 microM fentanyl, 5.1 +/- 1.3 pmol/mg of protein). In summary, we have demonstrated a mu-opioid receptor-mediated activation of phospholipase C, via a pertussis toxin-sensitive G protein, that is Ca(2+)-dependent. This stimulatory effect of opioids on phospholipase C, and the potential inositol (1,4,5)trisphosphate-mediated rises in intracellular Ca2+, could play a part in the cellular mechanisms of opioid action.

95 citations

Journal ArticleDOI
TL;DR: In this article, a systematic review of the randomised trials was conducted to determine whether patch angioplasty is more effective than primary closure in carotid endarterectomy, and whether one type of patch is better than another.

95 citations

Journal ArticleDOI
TL;DR: This study demonstrated the efficacy of TEAM in discontinuing the process of aneurysm expansion, which leads to shrinkage or arrest of growth of the aneurYSm, while persistent endoleak is associated with progressive expansion.

95 citations

Journal ArticleDOI
TL;DR: It remains questionable whether the observed 9% risks can be justified in any asymptomatic patient with unilateral carotid disease, but it is suggested that staged CAS plus CABG is an attractive and less invasive alternative to CEAPlusCABG.

95 citations

Journal ArticleDOI
TL;DR: Using the highly sensitive technique of HRCT, evidence is found to suggest that the incidence of bronchiectasis in lifelong non-smoking RA patients may be much higher than previously reported.
Abstract: OBJECTIVES--To define pulmonary involvement on high resolution computed tomography (HRCT) of the thorax in lifelong non-smoking rheumatoid arthritis patients and to relate the results to pulmonary function, bronchial reactivity, and a variety of clinical and serological factors. METHODS--Twenty lifelong non-smoking RA patients (mean age 59 years (range 44-72; 18 females) were studied. Detailed medical and drug histories were taken. Protease inhibitor phenotype (Pi) and HLA-DR4 status were assessed. Schirmer's tear tests were performed to detect keratoconjunctivitis sicca (KCS). Spirometry, flow volume loops, and gas transfer factor measurement were recorded. The degree of bronchial reactivity (PC20 FEV1) was measured by a methacholine inhalation test. Chest and hand radiographs and HRCT of the lung were performed in all patients. RESULTS--Thirteen patients were HLA-DR4 positive. Eighteen had the Pi MM and two the Pi MS phenotype. Eight patients had evidence of KCS on Schirmer's tear testing. Ten patients achieved PC20 FEV1 in the methacholine inhalation test. All the patients had normal chest radiographs and all showed evidence of erosive arthropathy on hand radiographs. Five patients (25%) showed basal bronchiectasis and one mild interstitial lung disease on HRCT. All five patients with bronchiectasis had the Pi MM phenotype, four had HLA-DR4, four had KCS and three achieved PC20 FEV1; these values were not significantly different (p > 0.05) from those in patients without bronchiectasis. CONCLUSION--Using the highly sensitive technique of HRCT, we found evidence to suggest that the incidence of bronchiectasis in lifelong non-smoking RA patients may be much higher than previously reported.

95 citations


Authors

Showing all 5314 results

NameH-indexPapersCitations
George Davey Smith2242540248373
Nilesh J. Samani149779113545
Peter M. Rothwell13477967382
John F. Thompson132142095894
James A. Russell124102487929
Paul Bebbington11958346341
John P. Neoptolemos11264852928
Richard C. Trembath10736841128
Andrew J. Wardlaw9231133721
Melanie J. Davies8981436939
Philip Quirke8937834071
Kenneth J. O'Byrne8762939193
David R. Jones8770740501
Keith R. Abrams8635530980
Martin J. S. Dyer8537324909
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20234
202219
2021168
2020120
2019110
2018121