Leicester Royal Infirmary

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.

Dunnigan-Kobberling syndrome: an autosomal dominant form of partial lipodystrophy

Abstract: Dunnigan-Kobberling syndrome is a form of partial lipodystrophy characterized by sparing of the face. Despite descriptions of six families since 1974, details of total body adipose tissue distribution and studies of carbohydrate and fat metabolism are lacking. The mode of inheritance also remains unclear, with most authors favouring an X-linked dominant transmission lethal in the hemizygous male. We examined 23 members of a family, of whom at least eight had partial lipodystrophy. Auxological evaluation and cross-sectional imaging showed absence of subcutaneous fat, presence of adipose tissue inside the body cavities, and skeletal muscle hypertrophy. Biochemical evaluation identified insulin resistance but revealed inadequate suppression of non-esterified fatty acids. In this family, male-to-male transmission supports an autosomal dominant mode of inheritance for Dunnigan-Kobberling syndrome.

Risk assessment of fragility fractures: summary of NICE guidance.

Abstract: Osteoporosis is characterised by low bone mass and structural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture, particularly fractures that result from mechanical forces that would not ordinarily result in fracture, known as fragility fractures. The prevalence of osteoporosis rises markedly with age, and in women this rises from 2% at 50 years to more than 25% at 80 years. Risk of fracture is also increased by factors such as lifestyle, drug treatments, family history, and other conditions that cause secondary osteoporosis. Several validated risk assessment tools are available to predict fracture risk. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on risk assessment of fragility fractures.1 NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Who needs risk assessment?

Taste, Smell and Appetite Change After Roux-en-Y Gastric Bypass Surgery

Abstract: It is apparent from day-to-day practice that patients frequently report changes to their appetite, taste and smell after weight loss surgery. There has been surprisingly little written in the literature on this. The aim of the current study was to assess these parameters in a cohort of patients undergoing Roux-en-Y gastric bypass surgery. Questionnaires relating to appetite, taste and smell were administered to 188 patients who had undergone Roux-en-Y gastric bypass surgery at our institution during the years 2000–2011. Responses were received from 103 patients (55 %). Sensory changes in appetite, taste and smell were noted by 97, 73 and 42 % of patients, respectively. Seventy-three percent of patients reported aversion to specific foods after surgery, with meat products the most commonly cited (33 %). Patients who experienced food aversions experienced more postoperative weight loss and reduction in BMI, compared to their counterparts without these features. This study indicates that subjective changes in appetite, taste and smell are very common after Roux-en-Y gastric bypass. Patients are now routinely counselled about these changes as part of the informed consent process for surgery.