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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.


Papers
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Journal ArticleDOI
TL;DR: Patients with Crohn’s disease are at risk of osteoporosis and premature fracture, however, the pathophysiology underlying bone loss remains poorly understood and the optimum treatment has not been established.
Abstract: Background: Patients with Crohn’s disease are at risk of osteoporosis and premature fracture. However, the pathophysiology underlying bone loss remains poorly understood and the optimum treatment has not been established. Aim: To investigate mechanisms of bone loss in Crohn’s disease using biochemical markers of bone turnover. Methods: Bone mineral density was measured at the hip and spine using dual-energy X-ray absorptiometry in 117 patients (48 male) with Crohn’s disease. Bone turnover was assessed by measuring serum osteocalcin (BGP), pro-collagen carboxy-terminal propeptide (PICP), bone specific alkaline phosphatase (BALP) and urinary deoxypyridinoline (DPD); and compared to age-matched healthy controls (n = 28). Results: Bone mineral density was reduced (z-score < −1) in 48 (41%) patients with Crohn’s disease. Mean values for bone formation markers in patients with Crohn’s disease were all within the normal reference range (BGP 8.92 (± 3.23) ng/mL (normal range 3.4–10.0), BALP 17.6 (± 12.6) U/L (normal range 11.6–43.3), PICP 95.1 (± 46.5) ng/mL (normal range 69–163)) and were not significantly different to the control population. However, mean urinary DPD was significantly higher in patients with Crohn’s disease compared to healthy controls (10.97 (± 9.22) n M DPD/m M creatinine vs. 5.02 (± 1.03) n M DPD/m M creatinine, difference in means = 5.95, 95% CI: −9.6 to −2.3, P = 0.00001) and compared to the UK reference range DPD levels were increased in 74 (63%) patients. Conclusions: Bone resorption as evidenced by urinary DPD was frequently increased in patients with Crohn’s disease and was significantly higher than in an age-matched control population. The high levels of urinary DPD suggest increased bone collagen degradation may contribute to osteoporosis in patients with Crohn’s disease. These results suggest anti-resorptive agents such as the bisphosphonates may be effective treatment for osteoporosis in Crohn’s disease.

76 citations

Journal ArticleDOI
TL;DR: There was a very small but statistically significant association between observer ratings of deficits in social functioning (daily social and living skills) and self-reported family social networks size and Behavioural problems were also associated with smaller family networks.
Abstract: It has been suggested that deficits or impairments in social functioning may explain the depleted support networks of the mentally ill. With this in mind, 145 long-term users of day care psychiatric facilities, 57% of whom had a life-time diagnosis of schizophrenia, were examined to determine whether deficits in social and survival skills explained deficits in their social networks. Compared with patients with acute depression, long-term patients had smaller social networks. There was a very small but statistically significant association between observer ratings of deficits in social functioning (daily social and living skills) and self-reported family social networks size. Behavioural problems were also associated with smaller family networks. Among the long-term patients, duration of service contact and type of disorder (affective vs nonaffective psychosis) were not related to network size. These preliminary findings are discussed.

76 citations

Journal ArticleDOI
TL;DR: Assessing the attitudes of older people in East Midlands through the development and administration of a survey found that although a third of the respondents were in favour of discussing ACP if the opportunity was available with their GP, only a relative minority had actively engaged.
Abstract: Background: advance care planning (ACP) is a process to establish an individual's preference for care in the future; few UK studies have been conducted to ascertain public attitudes towards ACP.Objective: the aim of this study was to assess the attitudes of older people in East Midlands through the development and administration of a survey.Design: the survey questionnaire was developed on the basis of a literature review, exploratory focus groups with older adults and expert advisor input. The final questions were then re-tested with lay volunteers.Setting: thirteen general practices were enrolled to send out surveys to potential participants aged 65 or older. There were no additional inclusion or exclusion criteria for participants.Methods: simple descriptive statistics were used to describe the responses and regression analyses were used to evaluate which items predicted responses to key outcomes.Results: of the 5,375 (34%) community-dwelling older peoples, 1,823 returned questionnaires. Seventeen per cent of respondents had prepared an ACP document; of whom, 4% had completed an Advance Decision to Refuse Treatment (ADRT). Five per cent of respondents stated that they had been offered an opportunity to talk about ACP. Predictors of completing an ACP document included: being offered the opportunity to discuss ACP, older age, better physical function and male gender. Levels of trust were higher for families than for professionals. One-third of the respondents would be interested in talking about ACP if sessions were available.Conclusion: although a third of the respondents were in favour of discussing ACP if the opportunity was available with their GP, only a relative minority (17%) had actively engaged. Preferences were for informal discussions with family rather than professionals.

76 citations

Journal ArticleDOI
TL;DR: It is proposed that the adoption of a single modality of mobile MDCT could replace the current use of multiple radiological sources within a mass fatality mortuary.
Abstract: Mobile multi-detector computed tomography (MDCT) scanners are potentially available to temporary mortuaries and can be operational within 20 min of arrival. We describe, to our knowledge, the first use of mobile MDCT for a mass fatality incident. A mobile MDCT scanner attended the disaster mortuary after a five vehicle road traffic incident. Five out of six bodies were successfully imaged by MDCT in c. 15 min per body. Subsequent full radiological analysis took c. 1 h per case. The results were compared to the autopsy examinations. We discuss the advantages and disadvantages of imaging with mobile MDCT in relation to mass fatality work, illustrating the body pathway process, and its role in the identification of the pathology, personal effects, and health and safety hazards. We propose that the adoption of a single modality of mobile MDCT could replace the current use of multiple radiological sources within a mass fatality mortuary.

75 citations

Journal ArticleDOI
TL;DR: A combination of TCD monitoring and completion angioscopy provided the maximum yield in terms of diagnosing technical error and establishing the cause of perioperative morbidity.

75 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