Institution
North Bristol NHS Trust
Healthcare•Bristol, United Kingdom•
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.
Papers published on a yearly basis
Papers
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TL;DR: Whether melatonin reduces the frequency of nocturia episodes in MS patients, and therefore whether ‘Circadin’ has the potential to reduce LUTS and fatigue, and improve cognition and overall quality of life is evaluated.
Abstract: Nocturia is a common urinary symptom of multiple sclerosis (MS) which can affect quality of life (QoL) adversely. Melatonin is a hormone known to regulate circadian rhythm and reduce smooth muscle activity such as in the bladder. There is limited evidence supporting use of melatonin to alleviate urinary frequency at night in the treatment of nocturia. The aim of this study was to evaluate the effect of melatonin on the mean number of nocturia episodes per night in patients with MS. A randomized, double blind, placebo controlled crossover trial was conducted. 34 patients with nocturia secondary to multiple sclerosis underwent a 4-day pre-treatment monitoring phase. The patients were randomized to receive either 2 mg per night (taken at bedtime) of capsulated sustained-release melatonin (Circadin®) or 1 placebo capsule for 6 weeks followed by a crossover to the other regimen for an additional 6 weeks after a 1-month washout period. From the 26 patients who completed the study, there was no significant difference observed in the signs or symptoms of nocturia when taking 2 mg melatonin compared to placebo. The primary outcome measure, mean number of nocturia episodes on bladder diaries, was 1.8/night at baseline, and 1.4/night on melatonin, compared with 1.6 for placebo (Medians 1.70, 1.50, and 1.30 respectively, p = 0.85). There was also no significant difference seen in LUTS, QoL and sleep quality when taking melatonin. No significant safety concerns arose. This small study suggests that a low dose of melatonin taken at bedtime may be ineffective therapy for nocturia in MS. (EudraCT reference) 2012–00418321 registered: 25/01/13. ISRCTN Registry: ISRCTN38687869
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20 citations
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TL;DR: Either MNO combination therapy or an increased MNO dose (>400 mg/day) should be considered when treating A. baumannii infections as the burden of such infections increases.
19 citations
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TL;DR: There was good agreement on the location of the T5 dermatome, but one in seven anaesthetists were inaccurate by two or more dermatomes, and the knowledge of relevant dermatome levels should be an integral part of obstetric anaesthetic training.
Abstract: The extent of a regional block for Caesarean section must be tested and documented before surgery commences. In recent years a block to 'touch' that includes T5 has increasingly been considered the best predictive test for a pain-free Caesarean section. Our survey examines the consistency with which different anaesthetists identified the location of the T5 dermatome. Seventy-three anaesthetists were asked to mark a point on an anatomical picture to indicate where they would test for T5. Overall there was good agreement on the location of the T5 dermatome, but one in seven anaesthetists were inaccurate by two or more dermatomes. There were no statistically significant differences between the subgroups of senior house officer, specialist registrar and consultant anaesthetists. The knowledge of relevant dermatome levels should be an integral part of obstetric anaesthetic training.
19 citations
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TL;DR: The neuroSAFE PROOF feasibility study is designed to assess whether it is feasible to randomise men to NeuroSAFE RALP versus a control arm of ‘standard of practice’ RALp, and to investigate functional outcomes on potency, continence and quality of life.
Abstract: Introduction Robot-assisted laparoscopic prostatectomy (RALP) offers potential cure for localised prostate cancer but is associated with considerable toxicity. Potency and urinary continence are improved when the neurovascular bundles (NVBs) are spared during a nerve spare (NS) RALP. There is reluctance, however, to perform NS RALP when there are concerns that the cancer extends beyond the capsule of the prostate into the NVB, as NS RALP in this instance increases the risk of a positive surgical margin (PSM). The NeuroSAFE technique involves intraoperative fresh-frozen section analysis of the posterolateral aspect of the prostate margin to assess whether cancer extends beyond the capsule. There is evidence from large observational studies that functional outcomes can be improved and PSM rates reduced when the NeuroSAFE technique is used during RALP. To date, however, there has been no randomised controlled trial (RCT) to substantiate this finding. The NeuroSAFE PROOF feasibility study is designed to assess whether it is feasible to randomise men to NeuroSAFE RALP versus a control arm of ‘standard of practice’ RALP. Methods NeuroSAFE PROOF feasibility study will be a multicentre, single-blinded RCT with patients randomised 1:1 to either NeuroSAFE RALP (intervention) or standard RALP (control). Treatment allocation will occur after trial entry and consent. The primary outcome will be assessed as the successful accrual of 50 men at three sites over 15 months. Secondary outcomes will be used to aid subsequent power calculations for the definitive full-scale RCT and will include rates of NS; PSM; biochemical recurrence; adjuvant treatments; and patient-reported functional outcomes on potency, continence and quality of life. Ethics and dissemination NeuroSAFE PROOF has ethical approval (Regional Ethics Committee reference 17/LO/1978). NeuroSAFE PROOF is supported by National Institute for Healthcare Research Research for Patient Benefit funding (NIHR reference PB-PG-1216-20013). Findings will be made available through peer-reviewed publications. Trial registration number NCT03317990.
19 citations
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TL;DR: BRCA1/2 mutation status does not preclude treatment with wide local excision and radiotherapy and further large prospective trials are required, given the retrospective studies with inherent flaws and small patient numbers.
19 citations
Authors
Showing all 2226 results
Name | H-index | Papers | Citations |
---|---|---|---|
Debbie A Lawlor | 147 | 1114 | 101123 |
Stephen T. Holgate | 142 | 870 | 82345 |
Paul Jackson | 141 | 1372 | 93464 |
E. Thomson | 103 | 992 | 51777 |
Paul Abrams | 91 | 505 | 51539 |
Susan M. Ring | 91 | 268 | 45339 |
Richard Baker | 83 | 514 | 22970 |
Seth Love | 74 | 344 | 30535 |
Kenneth R Fox | 70 | 269 | 19099 |
Evan L. Flatow | 70 | 245 | 15692 |
Paul Roderick | 67 | 392 | 20741 |
Robert J. Hinchliffe | 66 | 298 | 14818 |
Tim Cook | 61 | 340 | 14170 |
Jasmeet Soar | 57 | 252 | 20311 |
Salomone Di Saverio | 55 | 338 | 9123 |