Royal Devon and Exeter Hospital

About: Royal Devon and Exeter Hospital is a healthcare organization based out in Exeter, United Kingdom. It is known for research contribution in the topics: Population & Randomized controlled trial. The organization has 2282 authors who have published 2526 publications receiving 78866 citations. The organization is also known as: RD&E.

The herbicide linuron inhibits cholesterol biosynthesis and induces cellular stress responses in brown trout.

Abstract: The herbicide linuron is used worldwide, and has been detected in surface waters as well as in food and drinking water. Toxicological studies have reported that linuron acts as an antiandrogen in vitro and in vivo and disrupts mammalian male reproductive function. However, global mechanisms of linuron toxicity are poorly documented. We used RNA-seq to characterize the hepatic transcriptional response of mature male brown trout exposed for 4 days to 1.7, 15.3, and 225.9 μg/L linuron. We identified a striking decrease in the expression of transcripts encoding the majority of enzymes forming the cholesterol biosynthesis pathway. We also measured a very significant decrease in total hepatic cholesterol in fish exposed to 225.9 μg/L linuron and a negative correlation between total cholesterol and linuron treatment concentration. We hypothesize that inhibition of cholesterol biosynthesis may result from the disruption of androgen signaling by linuron. Additionally, there was increased expression of a number of transcripts involved in cellular stress responses, including cyp1a (up to 560-fold), molecular chaperones, and antioxidant enzymes. We found some evidence of similar patterns of transcriptional change in fish exposed to an environmentally relevant concentration of linuron, and further research should investigate the potential for adverse effects to occur following chronic environmental exposure.

Diabetic muscle infarction: an unusual cause of leg swelling in a diabetic on continuous ambulatory peritoneal dialysis.

Abstract: chronic renal failure; diabetes; diabetic (Figure 1). His C-reactive protein was 44 mg/l initiallymuscle infarction; peritoneal dialysis rising subsequently to 214 mg/l. A biopsy taken fromthe right thigh (Figure 2) showed extensive necrosis ofskeletal muscle, with numerous neutrophil polymorphs(left) and florid fibrovascular proliferation in adjacent

An evaluation of 'fast track' in AE: a discrete event simulation approach

Abstract: This longitudinal study provides primary evidence on the impact that a fast-track strategy in a hospital Emergency Department has on patient wait time. The study uses a discrete event simulation model to predict output within a variety of triage categories and compares these with post-implementation results. The results of the study indicate a significant reduction in patient wait time with 13.2% of the population waiting longer than 4 h prior to implementation compared with 1.4% post-implementation. However, while this fast-track strategy significantly improves service delivery to patients with minor conditions, service for patients with more acute conditions is not proportionately improved.

Dacryocystorhinostomy in South West England

Abstract: Purpose To assess the pre-operative management, surgical technique employed, success rate and patient satisfaction following surgery in patients undergoing dacryocystorhinostomy (DCR) in South West England. Method Two hundred and forty-two patients who underwent DCR were retrospectively studied. A telephone questionnaire was used to assess patient satisfaction in 100 patients. Results One hundred and thirteen (46%) patients had nasolacrimal duct obstruction, half of whom had a history of dacryocystitis, 70 (29%) had canalicular obstruction and 8 (3%) had mixed blockage. The site of blockage was not known or recorded in 51 patients (22%). Seventy-five (31%) patients underwent DCR, 151 (62%) DCR with insertion of silicon tubes, 9 (4%) DCR and Lester Jones tube, and 7 (3%) canaliculodacryocystorhinostomy (CDCR). Overall an 83.5% success rate was reported by the surgeons. The success rate for patients with a history of dacryocystitis was 98%, for nasolacrimal duct obstruction 96% and for canalicular obstruction 82%. When the site of blockage was not known or recorded the success rate was 60%. Where the name of the surgeon was not recorded there was a 15% successful outcome. Eighty per cent of patients reported some improvement in their symptoms following surgery. Conclusions DCR is an effective surgical procedure with a high rate of patient satisfaction. Pre-operative identification of the site of the blockage is likely to improve surgical outcome.