Institution
Leicester Royal Infirmary
Healthcare•Leicester, 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 published on a yearly basis
Papers
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TL;DR: An appreciation of the condition and its likely aetiological factors should improve awareness and possibly reduce the imperative to perform an emergency laparotomy on an otherwise well patient with an unexplained pneumoperitoneum.
Abstract: Intraperitoneal free gas seen radiologically as air under the diaphragm nearly always indicates a perforated abdominal viscus that requires surgical intervention. Rarely, however, the presence of a pneumoperitoneum may not indicate an intra-abdominal perforation and thus may not require laparotomy. Such a situation is termed spontaneous or nonsurgical pneumoperitoneum. In this review, we explore the aetiological mechanisms and the pathophysiology of the appearance of intra-abdominal free gas. An appreciation of the condition and its likely aetiological factors should improve awareness and possibly reduce the imperative to perform an emergency laparotomy on an otherwise well patient with an unexplained pneumoperitoneum.
117 citations
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TL;DR: Results indicate that peri-tendonous injection of methyl prednisolone acetate is of no value in Achilles paratendonitis.
Abstract: A prospective, randomised, double-blind study of 28 patients presenting with Achilles paratendonitis was undertaken in order to evaluate the role of peritendonous injection of methy prednisolone acetate (Depo Medrone). At presentation patients were either administered peri-tendonous injection of 40 mgs of methyl prednisolone acetate suspended in 1 ml of 0.25% marcaine or 2 ml of 0.25% marcaine alone. Response was gauged by resolution of pain, tenderness and return to normal activity. Patients who failed to respond to initial treatment were crossed over to the other group at 12 weeks. All patients received standardised physiotherapy. Results indicate that peri-tendonous injection of methyl prednisolone acetate is of no value in Achilles paratendonitis.
116 citations
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TL;DR: The data confirm for the first time a definite association of heterozygous COL4A3/COL4A4 mutations with familial microscopic haematuria, thin basement membrane nephropathy and the late development of familial proteinuria, CRF, and ESRD, due to FSGS, indicating that the term 'benign familial haematureia' is a misnomer, at least in this cohort.
Abstract: Background. Heterozygous mutations in the COL4A3/ COL4A4 genes are currently thought to be responsible for familial benign microscopic haematuria and maintenance of normal long-term kidney function. Methods. We report on 11 large Cypriot pedigrees with three such mutations. A total of 236 at-risk family members were genetically studied, and 127 (53.8%) carried a heterozygous mutation. Clinico-pathological correlations were available in all of these patients. Renal biopsies in 21 of these patients all showed various stages of focal, segmental glomerulosclerosis (FSGS). Thirteen of these biopsies were also studied with EM and showed thinning of the glomerular basement membrane. Results. Mutation G1334E (COL4A3) was found in six pedigrees, mutation G871C (COL4A3) in four and mutation 3854delG (COL4A4) in one pedigree. Clinical and laboratory correlations in all 127 mutation carriers (MC) showed that microscopic haematuria was the only urinary finding in patients under age 30. The prevalence of ‘haematuria alone’ fell to 66% between 31 and 50 years, to 30% between 51 and 70 and to 23% over age 71. Proteinuria with CRF developed on top of haematuria in 8% of all MC between 31 and 50 years, to 25% between 51 and 70 years and to 50% over 71 years. Altogether 18 of these 127 MC (14%) developed ESRD at a mean age of 60 years. Two members with different mutations married, and two of their children inherited both mutations and developed adolescent, autosomal recessive Alport syndrome (ATS), confirming that these mutations are pathogenic. Conclusions. Our data confirm for the first time a definite association of heterozygous COL4A3/COL4A4 mutations with familial microscopic haematuria, thin basement membrane nephropathy and the late development of familial proteinuria, CRF, and ESRD, due to FSGS, indicating that the term ‘benign familial haematuria’ is a misnomer, at least in this cohort. A strong hypothesis for a causal relationship between these mutations and FSGS is also made. Benign familial haematuria may not be so benign as commonly thought.
116 citations
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01 Nov 1999
TL;DR: A method is presented to measure the magnetic fields generated from the eddy currents for each of three orthogonal gradient pulse vectors, and then to ascertain the image distortion that occurs in subsequent diffusion-weighted images with arbitrary gradient pulse vector amplitude and direction.
Abstract: Diffusion-weighted echo-planar magnetic resonance imaging is potentially of great importance as a diagnostic imaging tool; however, the technique currently suffers a number of limitations, including the image distortion caused by the eddy current induced fields when the diffusion-weighting magnetic field gradient pulses are applied. The distortions cause mis-registration between images with different diffusion-weighting, that then results in artifacts in quantitative diffusion images. A method is presented to measure the magnetic fields generated from the eddy currents for each of three orthogonal gradient pulse vectors, and then to use these to ascertain the image distortion that occurs in subsequent diffusion-weighted images with arbitrary gradient pulse vector amplitude and direction, and image plane orientation. The image distortion can then be reversed. Both temporal and spatial dependence of the residual eddy current induced fields are included in the analysis. Image distortion was substantially reduced by the correction scheme, for arbitrary slice position and angulation. This method of correction is unaffected by the changes in image contrast that occur due to diffusion weighting, and does not need any additional scanning time during the patient scan. It is particularly suitable for use with single-shot echo planar imaging.
116 citations
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TL;DR: Self treatment of anogenital warts withpodophyllotoxin showed greater efficacy and cost effectiveness than clinic based treatment with podophyllin, and podophyLLotoxin treatment was the least cost effective treatment.
Abstract: Objectives: To evaluate the efficacy and cost effectiveness of self applied podophyllotoxin 0.5% solution and podophyllotoxin 0.15% cream, compared to clinic applied 25% podophyllin in the treatment of genital warts over 4 weeks. Methods: We conducted a randomised controlled trial in 358 immunocompetent men and women with genital warts of 3 months’ duration or less. Results: In the principal analysis both podophyllotoxin solution (OR 2.93, 95% CI 1.56 to 5.50) and podophyllotoxin cream (OR 1.97, 95% CI 1.04 to 3.70) were associated with significantly increased odds of remission of all warts compared to podophyllin. We performed two further analyses. When subjects defaulting from follow up were assumed to have been cured odds of remission of all warts were also significantly increased both for podophyllotoxin solution (OR 3.04, 95% CI 1.68 to 5.49) and for podophyllotoxin cream (OR 2.46, 95% CI 1.38 to 4.40). When subjects defaulting from follow up were assumed not to have been cured odds of remission of all warts were significantly increased for podophyllotoxin solution (OR 1.92, 95% CI 1.13 to 3.27), but not for podophyllotoxin cream (OR 1.17, 95% CI 0.69 to 2.00). Local side effects were seen in 24% of subjects, and recurrence of warts within 12 weeks of study entry in 43% of all initially cleared subjects, without statistically significant differences between the treatment groups. Direct, indirect, and total costs were similar across the three treatment groups. Podophyllotoxin solution was the most cost effective treatment, followed by podophyllotoxin cream, with podophyllin treatment being the least cost effective. Conclusions: Self treatment of anogenital warts with podophyllotoxin showed greater efficacy and cost effectiveness than clinic based treatment with podophyllin.
116 citations
Authors
Showing all 5314 results
Name | H-index | Papers | Citations |
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George Davey Smith | 224 | 2540 | 248373 |
Nilesh J. Samani | 149 | 779 | 113545 |
Peter M. Rothwell | 134 | 779 | 67382 |
John F. Thompson | 132 | 1420 | 95894 |
James A. Russell | 124 | 1024 | 87929 |
Paul Bebbington | 119 | 583 | 46341 |
John P. Neoptolemos | 112 | 648 | 52928 |
Richard C. Trembath | 107 | 368 | 41128 |
Andrew J. Wardlaw | 92 | 311 | 33721 |
Melanie J. Davies | 89 | 814 | 36939 |
Philip Quirke | 89 | 378 | 34071 |
Kenneth J. O'Byrne | 87 | 629 | 39193 |
David R. Jones | 87 | 707 | 40501 |
Keith R. Abrams | 86 | 355 | 30980 |
Martin J. S. Dyer | 85 | 373 | 24909 |