North Bristol NHS Trust

About: North Bristol NHS Trust is a healthcare organization based out in Bristol, United Kingdom. It is known for research contribution in the topics: Population & Medicine. The organization has 2204 authors who have published 2811 publications receiving 61110 citations.

Use of CRM 470/RPPHS Has Not Achieved True Consensus for Ceruloplasmin Measurement

Abstract: The use of primary protein reference material CRM 470/RPPHS (1) was intended to lead to reduced method-dependent variation in specific protein analyses. Observations from UK NEQAS for Specific Proteins indicate that this is true for most proteins, but not for ceruloplasmin. Because the measurement of ceruloplasmin is an important part of the initial screening procedure for Wilson disease, we deemed it important to publicize this anomaly to the clinical chemistry community, including both analysts and the diagnostic industry. UK NEQAS distributes specimens for chosen analytes to be analyzed by participating laboratories by their usual laboratory methods as though they were patient specimens. For the Specific Proteins Scheme, monthly distributions are made of material derived from pooled human donor serum stored at 4 °C; the pools reported here contained sodium azide (1 g/L) as preservative. The method used by each laboratory is recorded by UK NEQAS so that results may be studied for method-related differences. Data are analyzed by both method principle (e.g., turbidimetry) and then by the instrument or reagent used. All participants classified under nephelometric method A used …

Outcome of the management of open ankle fractures in an ortho-plastic specialist centre

Abstract: Introduction We reviewed the functional outcome of 68 patients with open ankle fractures managed in an orthoplastic specialist centre. Materials and methods Patients managed at Frenchay Hospital over a 6 year period were divided into 3 groups: group P were patients initially seen and managed at Frenchay Hospital (an orthoplastic specialist centre), group S were patients stabilised at a different unit and referred for definitive management, while group R were patients managed in a different unit and referred following complications. Injuries were graded using the AO score and outcome was measured using the Enneking score (both validated). Results 19 patients (group P, mean age: 43 years), 26 patients (group S, mean age: 41 years) and 23 patients (group R, mean age: 41.9 years) made the cohort. 82.4% patients required free tissue transfer. Mean AO scores of groups P, S and R were 11.5, 12.3 and 9.7 (p + 0.03). Mean number of procedures for P, S and R were 2.6, 3.5 and 4.2 (p = 0.0006). Mean follow up time was 55.5, 61.0 and 57.0 weeks respectively (p = 0.72). Mean Enneking scores for groups P, S and R were 63.3, 74.8 and 73.5 (p = 0.16). Conclusion Patients from groups S and R underwent more procedures. However, a similar outcome can be achieved, highlighting the importance of managing such injuries in an orthoplastic specialist centre.

A systematic review of McKittrick-Wheelock syndrome.

Abstract: Introduction McKittrick–Wheelock syndrome describes the condition of extreme electrolyte and fluid depletion caused by large distal colorectal tumours, usually the benign villous adenoma. Patients ...

Evaluating the impact of cycle helmet use on severe traumatic brain injury and death in a national cohort of over 11000 pedal cyclists: a retrospective study from the NHS England Trauma Audit and Research Network dataset

Abstract: Objectives In the last 10 years there has been a significant increase in cycle traffic in the UK, with an associated increase in the overall number of cycling injuries. Despite this, and the significant media, political and public health debate into this issue, there remains an absence of studies from the UK assessing the impact of helmet use on rates of serious injury presenting to the National Health Service (NHS) in cyclists. Setting The NHS England Trauma Audit and Research Network (TARN) Database was interrogated to identify all adult (≥16 years) patients presenting to hospital with cycling-related major injuries, during a period from 14 March 2012 to 30 September 2017 (the last date for which a validated dataset was available). Participants 11 patients met inclusion criteria. Data on the use of cycling helmets were available in 6621 patients. Outcome measures TARN injury descriptors were used to compare patterns of injury, care and mortality in helmeted versus non-helmeted cohorts. Results Data on cycle helmet use were available for 6621 of the 11 192 cycle-related injuries entered onto the TARN Database in the 66 months of this study (93 excluded as not pedal cyclists). There was a significantly higher crude 30-day mortality in un-helmeted cyclists 5.6% (4.8%–6.6%) versus helmeted cyclists 1.8% (1.4%–2.2%) (p<0.001). Cycle helmet use was also associated with a reduction in severe traumatic brain injury (TBI) 19.1% (780, 18.0%–20.4%) versus 47.6% (1211, 45.6%–49.5%) (p<0.001), intensive care unit requirement 19.6% (797, 18.4%–20.8%) versus 27.1% (691, 25.4%–28.9%) (p<0.001) and neurosurgical intervention 2.5% (103, 2.1%–3.1%) versus 8.5% (217, 7.5%–9.7%) (p<0.001). There was a statistically significant increase in chest, spinal, upper and lower limb injury in the helmeted group in comparison to the un-helmeted group (all p<0.001), though in a subsequent analysis of these anatomical injury patterns, those cyclists wearing helmets were still found to have lower rates of TBI. In reviewing TARN injury codes for specific TBI and facial injuries, there was a highly significant decrease in rates of impact injury between cyclists wearing helmets and those not. Conclusions This study suggests that there is a significant correlation between use of cycle helmets and reduction in adjusted mortality and morbidity associated with TBI and facial injury.