Institution
North Tees and Hartlepool NHS Foundation Trust
Healthcare•Stockton-on-Tees, United Kingdom•
About: North Tees and Hartlepool NHS Foundation Trust is a healthcare organization based out in Stockton-on-Tees, United Kingdom. It is known for research contribution in the topics: Population & Randomized controlled trial. The organization has 164 authors who have published 138 publications receiving 3040 citations.
Papers
More filters
••
University of Oxford1, Nottingham University Hospitals NHS Trust2, University of Leicester3, North Manchester General Hospital4, Northampton General Hospital5, North Tees and Hartlepool NHS Foundation Trust6, University Hospitals Birmingham NHS Foundation Trust7, University of Manchester8, James Cook University Hospital9, Cardiff and Vale University Health Board10, King's College London11, University Hospital Southampton NHS Foundation Trust12, University of Cambridge13, University of Nottingham14, University of Edinburgh15
TL;DR: In patients hospitalized with COVID-19, dexamethasone reduced 28-day mortality among those receiving invasive mechanical ventilation or oxygen at randomization, but not among patients not receiving respiratory support.
Abstract: Background: Coronavirus disease 2019 (COVID-19) is associated with diffuse lung damage Corticosteroids may modulate immune-mediated lung injury and reducing progression to respiratory failure and death
Methods: The Randomised Evaluation of COVID-19 therapy (RECOVERY) trial is a randomized, controlled, open-label, adaptive, platform trial comparing a range of possible treatments with usual care in patients hospitalized with COVID-19 We report the preliminary results for the comparison of dexamethasone 6 mg given once daily for up to ten days vs usual care alone The primary outcome was 28-day mortality
Results: 2104 patients randomly allocated to receive dexamethasone were compared with 4321 patients concurrently allocated to usual care Overall, 454 (216%) patients allocated dexamethasone and 1065 (246%) patients allocated usual care died within 28 days (age-adjusted rate ratio [RR] 083; 95% confidence interval [CI] 074 to 092; P<0001) The proportional and absolute mortality rate reductions varied significantly depending on level of respiratory support at randomization (test for trend p<0001): Dexamethasone reduced deaths by one-third in patients receiving invasive mechanical ventilation (290% vs 407%, RR 065 [95% CI 051 to 082]; p<0001), by one-fifth in patients receiving oxygen without invasive mechanical ventilation (215% vs 250%, RR 080 [95% CI 070 to 092]; p=0002), but did not reduce mortality in patients not receiving respiratory support at randomization (170% vs 132%, RR 122 [95% CI 093 to 161]; p=014)
Conclusions: In patients hospitalized with COVID-19, dexamethasone reduced 28-day mortality among those receiving invasive mechanical ventilation or oxygen at randomization, but not among patients not receiving respiratory support
798 citations
••
University of Cambridge1, University College Hospital2, Royal Victoria Infirmary3, Queen's University4, Queen Alexandra Hospital5, University of Hertfordshire6, North Tyneside General Hospital7, County Durham and Darlington NHS Foundation Trust8, South Shields9, North Tees and Hartlepool NHS Foundation Trust10
TL;DR: The Cytosponge-TFF3 test is safe and acceptable, and has accuracy comparable to other screening tests, and may be a simple and inexpensive approach to identify patients with reflux symptoms who warrant endoscopy to diagnose BE.
Abstract: Background
Barrett's esophagus (BE) is a commonly undiagnosed condition that predisposes to esophageal adenocarcinoma. Routine endoscopic screening for BE is not recommended because of the burden this would impose on the health care system. The objective of this study was to determine whether a novel approach using a minimally invasive cell sampling device, the Cytosponge, coupled with immunohistochemical staining for the biomarker Trefoil Factor 3 (TFF3), could be used to identify patients who warrant endoscopy to diagnose BE.
244 citations
••
TL;DR: This extended classification of joint implant related pathology is a practical histopathologic classification based on defined morphological criteria covering the complete spectrum of pathohistologic changes in periprosthetic tissues providing a stable and reproducible tool for the surgical pathologist.
Abstract: This extended classification of joint implant related pathology is a practical histopathologic classification based on defined morphological criteria covering the complete spectrum of pathohistologic changes in periprosthetic tissues. These changes may occur as a consequence of endoprosthetic replacement of large joints and may lead to a reduction in the prosthesis survival rate. We describe the established consensus classification of the periprosthetic membrane, in which aseptic and septic prosthetic loosening can be subdivided into four histological types, as well as histopathological criteria for additional significant pathologies including endoprosthetic-associated arthrofibrosis, particle-induced immunological, inflammatory and toxic mechanisms (adverse reactions), and bone tissue pathologies. These characteristic tissue alterations and their relationships are summarized in the extended classification. Since particle heterogeneity in periprosthetic tissue is high and particle identification is a necessary part of diagnosis, the identification of different types of particles is described in the histopathological particle algorithm. The morphological qualities of prosthetic material particles and the demarcation between abrasion and non-abrasion endogenous particles are also summarized. This feasible classification which is based on low cost standard tissue processing and examination and on well-defined diagnostic criteria is a solid platform for the histological diagnosis of implant associated pathologies providing a stable and reproducible tool for the surgical pathologist. Since this classification is suitable for standardized histopathological diagnostics, it might also provide a useful data set for joint arthroplasty registers, particularly for registers based on so-called routine data.
240 citations
••
University of Oxford1, University of Leicester2, King's College London3, North Tees and Hartlepool NHS Foundation Trust4, Wrightington, Wigan and Leigh NHS Foundation Trust5, Royal Oldham Hospital6, James Cook University Hospital7, University of Edinburgh8, University of Manchester9, University Hospital Southampton NHS Foundation Trust10, Lancaster University11, University of Nottingham12, University of Bristol13
TL;DR: In this article, the authors evaluated the safety and efficacy of tocilizumab in adult patients admitted to hospital with COVID-19 with evidence of both hypoxia and systemic inflammation.
Abstract: SUMMARY Background Tocilizumab is a monoclonal antibody that binds to the receptor for interleukin (IL)-6, reducing inflammation, and is commonly used to treat rheumatoid arthritis. We evaluated the safety and efficacy of tocilizumab in adult patients admitted to hospital with COVID-19 with evidence of both hypoxia and systemic inflammation. Methods This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation Findings Between 23 April 2020 and 24 January 2021, 4116 adults were included in the assessment of tocilizumab, including 562 (14%) patients receiving invasive mechanical ventilation, 1686 (41%) receiving non-invasive respiratory support, and 1868 (45%) receiving no respiratory support other than oxygen. Median CRP was 143 [IQR 107-204] mg/L and 3385 (82%) patients were receiving systemic corticosteroids at randomisation. Overall, 596 (29%) of the 2022 patients allocated tocilizumab and 694 (33%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·86; 95% confidence interval [CI] 0·77-0·96; p=0·007). Consistent results were seen in all pre-specified subgroups of patients. In particular, a clear mortality benefit was seen in those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital alive within 28 days (54% vs. 47%; rate ratio 1·22; 95% CI 1·12-1·34; p Interpretation In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the level of respiratory support and were additional to the benefits of systemic corticosteroids. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research (Grant ref: MC_PC_19056).
221 citations
••
University of Oxford1, University of Leicester2, North Manchester General Hospital3, Northampton General Hospital4, North Tees and Hartlepool NHS Foundation Trust5, University Hospitals Birmingham NHS Foundation Trust6, University of Manchester7, James Cook University Hospital8, Cardiff and Vale University Health Board9, University of Edinburgh10, King's College London11, University Hospital Southampton NHS Foundation Trust12, University of Cambridge13, Nottingham University Hospitals NHS Trust14, University of Nottingham15
TL;DR: In patients hospitalized with COVID-19, hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death.
Abstract: Background Hydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease 2019 (COVID-19) on the basis of in vitro activity, uncontrolled data, and small randomized studies. Methods The Randomised Evaluation of COVID-19 therapy (RECOVERY) trial is a randomized, controlled, open-label, platform trial comparing a range of possible treatments with usual care in patients hospitalized with COVID-19. We report the preliminary results for the comparison of hydroxychloroquine vs. usual care alone. The primary outcome was 28-day mortality. Results 1561 patients randomly allocated to receive hydroxychloroquine were compared with 3155 patients concurrently allocated to usual care. Overall, 418 (26.8%) patients allocated hydroxychloroquine and 788 (25.0%) patients allocated usual care died within 28 days (rate ratio 1.09; 95% confidence interval [CI] 0.96 to 1.23; P=0.18). Consistent results were seen in all pre-specified subgroups of patients. Patients allocated to hydroxychloroquine were less likely to be discharged from hospital alive within 28 days (60.3% vs. 62.8%; rate ratio 0.92; 95% CI 0.85-0.99) and those not on invasive mechanical ventilation at baseline were more likely to reach the composite endpoint of invasive mechanical ventilation or death (29.8% vs. 26.5%; risk ratio 1.12; 95% CI 1.01-1.25). There was no excess of new major cardiac arrhythmia. Conclusions In patients hospitalized with COVID-19, hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death. Funding Medical Research Council and NIHR (Grant ref: MC_PC_19056). Trial registrations The trial is registered with ISRCTN (50189673) and clinicaltrials.gov (NCT04381936).
206 citations
Authors
Showing all 164 results
Name | H-index | Papers | Citations |
---|---|---|---|
Matthew D. Rutter | 47 | 171 | 12565 |
Jane Metcalf | 14 | 20 | 1624 |
Richard Harrison | 11 | 24 | 1186 |
Matthew J. Dewhurst | 10 | 20 | 379 |
D. W. Borowski | 9 | 12 | 291 |
Roisin Bevan | 9 | 29 | 394 |
B Prudon | 9 | 10 | 6980 |
Iosif Beintaris | 8 | 25 | 266 |
Sadie Jones | 7 | 19 | 228 |
Avinash Aujayeb | 7 | 76 | 255 |
S Natu | 7 | 16 | 998 |
Matthew D. Rutter | 5 | 7 | 273 |
Duncan Light | 5 | 7 | 188 |
A. J. Farrier | 5 | 12 | 63 |
Anil Agarwal | 5 | 8 | 93 |