Journal articles: 'Middlesex Hospital (London, England)'

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Hill, Oscar. "Alfred William Beard, Middlesex Hospital, London." Psychiatric Bulletin 16, no. 01 (January 1992): 63–64. http://dx.doi.org/10.1192/s0955603600106890.

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Coker, R. J., N. Desmond, M. Poznansky, C. Smith, M. S. Shafi, D. Bell, J. F. Riordan, and S. Murphy. "Experience of HIV Disease in a London District General Hospital." International Journal of STD & AIDS 6, no. 1 (January 1995): 47–49. http://dx.doi.org/10.1177/095646249500600110.

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The aim of this paper is to describe and discuss the experience of HIV disease in Central Middlesex Hospital, London up to June 1993. A retrospective study of the total number of HIV-positive patients cared for was performed. In addition, prospectively collected data as part of local epidemiological surveillance from January 1987 to June 1993 on all HIV test requests was analysed. Between January 1987 and June 1993 3695 individuals were tested for HIV-1 antibody at Central Middlesex Hospital. Of these, 101 HIV-1 seropositive individuals were identified and have attended this District General Hospital. Seven HIV-1 seropositive individuals were identified from before December 1986. Sixty (56%) had acquired their infection heterosexually. Thirty-eight (35%) originated from the UK and 47 (44%) from sub-Saharan Africa; the remaining 23 (21%) originated from the rest of Europe, South America and the Caribbean. Thirty-four (31%) of the patient group developed AIDS during follow-up at the hospital and in 26 individuals AIDs developed within 2 months of their first positive HIV result. The mean survival of 20 patients after AIDS-defining diagnoses was 7 months 18 days. This unselected group of HIV-1 seropositive patients present late in the course of their HIV disease and survival following AIDS is poor.

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Buchinsky, Moshe, and Ben Polak. "The Emergence of a National Capital Market in England, 1710–1880." Journal of Economic History 53, no. 1 (March 1993): 1–24. http://dx.doi.org/10.1017/s0022050700012365.

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Was eighteenth-century London's financial market linked to domestic real capital markets? When did English capital markets cease to be regionally segmented? We compare London interest rates with annual registered property transactions in Middlesex and in West Yorkshire. This evidence, though tentative, suggests that London financial markets were weakly linked to local real capital markets in the mid-eighteenth century. By the late eighteenth century those links were strong. Regional markets were still segmented in the mid-eighteenth century but were integrated by the time of the Napoleonic War.

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Baron, J. H. "Frederick Cayley Robinson's Acts of Mercy murals at the Middlesex Hospital, London." BMJ 309, no. 6970 (December 24, 1994): 1723–24. http://dx.doi.org/10.1136/bmj.309.6970.1723.

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AIRD, L. A., and P. H. S. SILVER. "Women doctors from The Middlesex Hospital Medical School (University of London) 1947-67." Medical Education 5, no. 3 (January 29, 2009): 232–41. http://dx.doi.org/10.1111/j.1365-2923.1971.tb01828.x.

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McLoughlin, Liam. "Churchill’s fractured neck of femur." Journal of Medical Biography 27, no. 3 (March 14, 2019): 129–36. http://dx.doi.org/10.1177/0967772018785858.

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In June 1962 at the age of 87 years, Sir Winston Churchill (1874–1965) fell over in his hotel room at the Hotel de Paris in Monte Carlo and sustained a fracture to the neck of his left femur. He was flown back to London and the fracture operated on at The Middlesex Hospital by two eminent orthopaedic surgeons, Mr Phillip Newman (1911–1994), Consultant to the The Middlesex Hospital and The Royal National Orthopaedic Hospital, Stanmore, and The Institute of Orthopaedics, London, and Professor Herbert Seddon (1903–1977), Consultant to the The Royal National Orthopaedic Hospital, Stanmore, and Director of The Institute of Orthopaedics under whom Churchill was admitted as a private patient. Churchill’s recovery was complicated by the development of deep vein thrombosis. During his convalescence, Churchill befriended Seddon who recorded his time with him in his private papers. On 21 August, Churchill was discharged to his home at 28 Hyde Park Gate which had been modified during his admission and made a return to public life in November 1962 at a dinner at the dining club he had originally founded, The Other Club.

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Parisaei, M., A. Govind, J. Clements, P. Arora, H. Lashkari, and P. Kapila. "Prevalence of vitamin D deficiency in a North London antenatal population." Obstetric Medicine 4, no. 3 (August 23, 2011): 113–16. http://dx.doi.org/10.1258/om.2011.110049.

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Objective We evaluated the prevalence of vitamin D deficiency in the antenatal patients attending North Middlesex University Hospital between March 2008 and March 2009. Study design A prospective study of maternal levels of vitamin D at booking. Results The prevalence of both deficient and insufficient levels of 25[OH]D was 87.6% across all included patients. Conclusion There is a high prevalence of asymptomatic vitamin D deficiency in the antenatal booking population.

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Aboud, Zainab, R. Balasubramanian, and R. Vashisht. "Evaluation of lymphoedema at West Middlesex University Hospital and assessment practice across West London Hospitals." European Journal of Surgical Oncology (EJSO) 35, no. 11 (November 2009): 1222. http://dx.doi.org/10.1016/j.ejso.2009.07.076.

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Katona, C. L. E., and M. M. Robertson. "Who makes it in psychiatry: CV predictors of success in training grades." Psychiatric Bulletin 17, no. 1 (January 1993): 27–29. http://dx.doi.org/10.1192/pb.17.1.27.

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A recent paper by Lewis (1991) found authorship of a publication to be the only variable that significantly predicted whether applicants for a senior registrar (SR) rotation in psychiatry at a London teaching hospital were shortlisted. We have re-examined curriculum vitae (CV) predictors of shortlisting at SR level within a comparable London teaching hospital rotation (University College and Middlesex Medical School, UCMSM), and extended the study to examine applicants for the corresponding SHO/registrar (REG) rotation. We have also compared the two groups in terms of demographic data and academic achievements. Our intention was to replicate Lewis' findings, and to examine in more detail the possible predictive effects of academic achievement and ethnicity.

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Shields, D. A., S. Andaz, R. D. Abeysinghe, J. B. Porter, J. H. Scurr, and P. D. Coleridge Smith. "Plasma Lactoferrin as a Marker of White Cell Degranulation in Venous Disease." Phlebology: The Journal of Venous Disease 9, no. 2 (June 1994): 55–58. http://dx.doi.org/10.1177/026835559400900203.

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Objective: To measure plasma lactoferrin as a marker of neutrophil degranulation in groups of patients with varying severity of venous disease and compare with age- and sex-matched control subjects. Design: Prospective study of patients with varicose veins compared with a group of control subjects with no history or clinical findings of varicose veins. Setting: The Middlesex Hospital Vascular Laboratory, Mortimer Street, London WIN 8AA, UK. Patients: Patients referred to the Middlesex Hospital Vascular Laboratory for investigation of venous disease. Control subjects were obtained from within the laboratory and hospital staff, and from a group of Patients attending the London Foot Hospital for routine chiropody. Neither group had arterial disease nor any other illness or medication known to alter white cell activity. Interventions: 10 ml of blood taken from an arm vein into EDTA for a neutrophil count and measurement of Plasma lactoferrin using an ELISA. Results: Significantly raised plasma lactoferrin was found in all four groups of patients compared with their controls ( p = 0.0156 for uncomplicated varicose veins, P = 0.01 for lipodermatosclerosis, p = 0.0413 for active venous ulceration, and p = 0.0005 for healed ulcers, Mann-Whitney U-test). Differences between medians (95% confidence interval) for the four groups were 269 (62–603), 199 (60–314), 133 (44–218) and 215 (98–349) ng/ml respectively. There was no difference in the neutrophil count between the patient and control groups, and correcting plasma lactoferrin for the neutrophil count did not remove significance in any group. Conclusions: This study shows evidence of increased neutrophil activation as shown by increased degranulation in patients with venous disease.

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Mangion, Carmen M. "‘Tolerable Intolerance’: Protestantism, Sectarianism and Voluntary Hospitals in Late-nineteenth-century London." Medical History 62, no. 4 (September 7, 2018): 468–84. http://dx.doi.org/10.1017/mdh.2018.43.

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This article interrogates the complicated understanding of sectarianism in institutional cultures in late-nineteenth-century England through an examination of the practice of religion in the daily life of hospital wards in voluntary hospitals. Voluntary hospitals prided themselves on their identity as philanthropic institutions free from sectarian practices. The public accusation of sectarianism against University College Hospital triggered a series of responses that suggests that hospital practices reflected and reinforced an acceptable degree of ‘tolerable intolerance’. The debates this incident prompted help us to interrogate the meaning of sectarianism in late nineteenth-century England. How was sectarianism understood? Why was it so important for voluntary institutions to appear free from sectarian influences? How did the responses to claims of sectarian attitudes influence the actions of the male governors, administrators and medical staff of voluntary hospitals? The contradictory meanings of sectarianism are examined in three interrelated themes: the patient, daily life on the wards and hospital funding. The broader debates that arose from the threat of ‘sectarianism in hospital’ uncovers the extent to which religious practices were ingrained in hospital spaces throughout England and remained so long afterwards. Despite the increasing medicalisation and secularisation of hospital spaces, religious practices and symbols were embedded in the daily life of voluntary hospitals.

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Phillips. "Child Abandonment in England, 1741–1834: The Case of the London Foundling Hospital." Genealogy 3, no. 3 (June 29, 2019): 35. http://dx.doi.org/10.3390/genealogy3030035.

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The prevailing view of abandoned children in the eighteenth and nineteenth centuries comes from Dickens’ Oliver Twist. Twist was born and raised in a workhouse in nineteenth-century London. However, the workhouse was not the only, or even, the main place to which children were abandoned. The London Foundling Hospital opened in 1741 and, although admission rules were often strict, between the years 1756 and 1760, any child presented to the Hospital was admitted. This article examines the ways in which children were abandoned to the Foundling Hospital and how these children were cared for in the period 1741–1834. It charts the children’s journeys through the Hospital, from their initial abandonment and admission to their eventual discharge—either through death, apprenticeship, or marriage—or their continued residence at the institution. This article provides insights into the multiple experiences of childhood abandonment and details the utility of the Hospital’s surviving records. It argues that children admitted to the London Foundling Hospital received life chances they would otherwise not have received. The Hospital provided nursing, clothing, medical care, both an academic and vocational education, and a living space for those unable to survive alone in adulthood.

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Tretter, Justin T., and Jeffrey P. Jacobs. "Global Leadership in Paediatric and Congenital Cardiac Care: “Coding our way to improved care: an interview with Rodney C. G. Franklin, MBBS, MD, FRCP, FRCPCH”." Cardiology in the Young 31, no. 1 (January 2021): 11–19. http://dx.doi.org/10.1017/s104795112000476x.

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AbstractDr Rodney Franklin is the focus of our third in a planned series of interviews in Cardiology in the Young entitled, “Global Leadership in Paediatric and Congenital Cardiac Care.” Dr Franklin was born in London, England, spending the early part of his childhood in the United States of America before coming back to England. He then attended University College London Medical School and University College Hospital in London, England, graduating in 1979. Dr Franklin would then go on to complete his general and neonatal paediatrics training in 1983 at Northwick Park Hospital and University College Hospital in London, England, followed by completing his paediatric cardiology training in 1989 at Great Ormond Street Hospital for Children in London, England. During this training, he additionally would hold the position of British Heart Foundation Junior Research Fellow from 1987 to 1989. Dr Franklin would then complete his training in 1990 as a Senior Registrar and subsequent Consultant in Paediatric and Fetal Cardiology at Wilhelmina Sick Children’s Hospital in Utrecht, the Netherlands. He subsequently obtained his research doctorate at University of London in 1997, consisting of a retrospective audit of 428 infants with functionally univentricular hearts.Dr Franklin has spent his entire career as a Consultant Paediatric Cardiologist at the Royal Brompton & Harefield Hospital NHS Foundation Trust, being appointed in 1991. He additionally holds honorary Consultant Paediatric Cardiology positions at Hillingdon Hospital, Northwick Park Hospital, and Lister Hospital in the United Kingdom, and Honorary Senior Lecturer at Imperial College, London. He has been the Clinical Lead of the National Congenital Heart Disease Audit (2013–2020), which promotes data collection within specialist paediatric centres. Dr Franklin has been a leading figure in the efforts towards creating international, pan European, and national coding systems within the multidisciplinary field of congenital cardiac care. These initiatives include but are not limited to the development and maintenance of The International Paediatric & Congenital Cardiac Code and the related International Classification of Diseases 11th Revision for CHD and related acquired terms and definitions. This article presents our interview with Dr Franklin, an interview that covers his experience in developing these important coding systems and consensus nomenclature to both improve communication and the outcomes of patients. We additionally discuss his experience in the development and implementation of strategies to assess the quality of paediatric and congenital cardiac care and publicly report outcomes.

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Mant, Madeleine. "‘A Little Time Woud Compleat the Cure’: Broken Bones and Fracture Experiences of the Working Poor in London’s General Hospitals During the Long Eighteenth Century." Social History of Medicine 33, no. 2 (April 30, 2018): 438–62. http://dx.doi.org/10.1093/shm/hky023.

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Summary This article draws upon admission and discharge records from four of London’s voluntary general hospitals (St Thomas’, Guy’s, Middlesex and London) to examine the fracture causes and experiences of the working poor. The article reveals that in-patients generally spent sufficient time in the hospital for significant fracture healing to occur. The diagnosis of fracture is considered within the context of Enlightenment medical education, pathological collections and contemporary clinical nosology. Using surgeons’ and physicians’ clinical notebooks, this article illustrates the fracture treatment received in the voluntary general hospitals and the range of risk factors encountered by the working poor.

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Shields, D. A., S. K. Andaz, J. B. Porter, J. H. Scurr, and P. D. Coleridge Smith. "Soluble Markers of Leucocyte Adhesion in Patients with Venous Disease." Phlebology: The Journal of Venous Disease 12, no. 3 (September 1997): 82–85. http://dx.doi.org/10.1177/026835559701200302.

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Objective: To measure soluble CD54 (ICAM-1) and CD62E (E-selectin) as markers of neutrophil adhesion in four groups of patients with varying severity of venous disease and compare the values obtained with those in age- and sex-matched control subjects. Design: Prospective study of patients with varicose veins compared with a group of control subjects with no history or clinical findings of varicose veins. Setting: The Middlesex Hospital Vascular Laboratory, London. Patients: Patients referred to the Middlesex Hospital Vascular Laboratory for investigation of venous disease. Neither patients nor controls had arterial disease, any other systemic illness, or were on any medication known to alter white cell activity. Interventions: Ten millimetres of blood taken from an arm vein into EDTA for a neutrophil count and soluble CD54 and CD62E, measured using an ELISA. Results: Similar levels of soluble CD54 and CD62E were found in all four groups of patients compared with their controls ( p = 0.71 for soluble CD54 for all patients compared with all controls, and p = 0.65 for soluble CD62E, Mann–Whitney U-test). There was no difference in the neutrophil count between the controls and patients in any group ( p = 0.74 for all subjects, Mann–Whitney U-test). Conclusion: This study shows no evidence of increased soluble CD54 or CD2E or CD62E in patients with venous disease, despite previous work showing increased CD54 and neutrophil degranulation in patients with venous disease. The reason for this is currently unknown.

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Planskoy, B., P. D. Tapper, A. M. Bedford, and F. M. Davis. "Physical aspects of total-body irradiation at the Middlesex Hospital (UCL group of hospitals), London 1988 - 1993: II.In vivoplanning and dosimetry." Physics in Medicine and Biology 41, no. 11 (November 1, 1996): 2327–43. http://dx.doi.org/10.1088/0031-9155/41/11/006.

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Munro, Christina H., Ruth Henniker-Major, Virginia Homfray, and Rita Browne. "Improving the antenatal and post-partum management of women presenting to Sexual Health Services with positive syphilis serology through audit." International Journal of STD & AIDS 28, no. 9 (January 25, 2017): 929–31. http://dx.doi.org/10.1177/0956462417691443.

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The incidence of congenital syphilis remains low in the UK, but the morbidity and mortality to babies born to women who are untreated for the condition make testing for the disease antenatally one of the most cost-effective screening programmes. Women attending North Middlesex Hospital, UK with a positive syphilis test at their antenatal booking visit are referred to St Ann’s Sexual Health Clinic, London, for management and contact tracing. We were concerned that our initial audit revealed that a large proportion of women referred to our service never attended and recorded partner notification was poor. Following the implementation of recommendations, specifically the introduction of an electronic referral system, re-audit showed an improvement in attendance, contact tracing, documentation and communication.

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Cybulska, E. "Continuing educational forum in psychogeriatrics for professional carers in the community." Psychiatric Bulletin 19, no. 11 (November 1995): 689–90. http://dx.doi.org/10.1192/pb.19.11.689.

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It has been common knowledge that professional carers in the community, institutions, and perhaps also in hospitals lack appropriate training in issues related to mental health problems in the elderly. Many crises in the community appear to be precipitated not so much by the gravity of the problems the elderly pose, but by panic or the fear of the unknown among the carers. Arie et al (1985) postulate that the joint teaching of different professions can be a fruitful training for subsequent team work, while Beynon & Croker (1983) reported that shared tutorials in geriatrics at the Middlesex Hospital in London were very successful. The negative features of institutionalised care can be counteracted through training and management (Wilkin et al, 1985).

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Shields, D. A., S. Andaz, R. D. Abeysinghe, J. B. Porter, J. H. Scurr, and P. D. Coleridge Smith. "Neutrophil Activation in Experimental Venous Hypertension." Phlebology: The Journal of Venous Disease 9, no. 3 (September 1994): 119–24. http://dx.doi.org/10.1177/026835559400900307.

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Objective: To investigate the white cell trapping hypothesis of venous ulceration by measuring plasma lactoferrin as a marker of neutrophil degranulation in normal volunteers in two experimental models of venous hypertension. Design: A prospective study of volunteers with no history or clinical evidence of venous disease. Setting: The Middlesex Hospital Vascular Laboratory, Mortimer Street, London WIN 8AA, UK. Patients: Volunteers within the Middlesex Hospital Vascular Laboratory with no history or clinical findings of venous or arterial disease, no other systemic disease, on no medication known to alter white cell activity, and with no recent infection. Interventions: Venous blood was taken from cannulae in both feet and the right arm for a neutrophil count and Plasma lactoferrin, measured using an ELISA, during application of a tourniquet to 80 mmHG for 30 min to the right leg while supine, 5 min after release of tourniquet, and then during a 30 min period of standing. Results: During application of a tourniquet to the right leg there was a significant rise in plasma lactoferrin and in lactoferrin corrected for the neutrophil count ( p < 0.05, Wilcoxon). In the unoccluded leg, although Plasma lactoferrin rose, this was not significant when corrected for the rise in neutrophil count. After standing for 30 min, the lactoferrin and neutrophil count increased in all three limbs; corrected lactoferrin showed a significant increase in the legs ( p < 0.02), though not in the arm. Conclusion: Increased neutrolphil degranulation occurs during periods of short-term venous hypertension in normal volunteers, in keeping with the white cell trapping hypothesis.

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Felder, S. L., and M. Davis. "LO37: Routine application of defibrillation pads and time to first shock in prehospital STEMI complicated by cardiac arrest." CJEM 19, S1 (May 2017): S40. http://dx.doi.org/10.1017/cem.2017.99.

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Introduction: ST-segment elevation myocardial infarction (STEMI) remains a significant cause of morbidity and mortality in North America, with recent studies suggesting that between 4 to 11% of patients diagnosed with STEMI suffer an out-of-hospital-cardiac arrest (OHCA). Previously published research has shown that shorter time to initial defibrillation in patients with VF/VT OHCA increases functional survival. The purpose of this study is to assess whether the routine application of defibrillation pads in STEMI decreases the time to initial defibrillation in those who suffer OHCA. Methods: Ambulance call records (ACR) for patients diagnosed with STEMI in Middlesex-London in the prehospital setting from Jan 1, 2012 to Jun 30, 2016 were reviewed. Patients were included in the study if they were 18 years of age or older with a confirmed diagnosis of STEMI and suffered an OHCA with an initial shockable rhythm (VF or VT) while in paramedic care. The pre-pad protocol (routine application of defibrillation pads in STEMI patients) was implemented by Middlesex-London EMS in July 2014. If inclusion criteria were met, ACRs were reviewed to determine whether the pre-pad protocol was implemented and to extract the time to initial defibrillation and relevant demographic and event features. Associated hospital charts were reviewed to evaluate inpatient event features and survival. T-test was used to assess the difference between mean times to defibrillation. Results: 446 patients were diagnosed with prehospital STEMI. Of those, 11 patients experienced a paramedic witnessed cardiac arrest. Four of the 11 had defibrillation pads applied upon diagnosis of STEMI. In patients who received pre-pad application, the mean time to initial defibrillation was 17.71 sec, compared to 72.71 sec in patients who had pads applied following arrest (MD 54.97 sec CI 22.69 to 87.24 sec). All patients treated with the pre-pad protocol survived to discharge from hospital, while one patient in the routine care group died in the ED. Conclusion: Routine application of defibrillation pads decreases the time to initial defibrillation in STEMI patients who suffer OHCA. Larger studies are required to evaluate whether this decreased time to defibrillation translates into mortality benefit in this subset of patients who experience OHCA.

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Thompson, Andrew, Mary Shaw, Glynn Harrison, Davidson Ho, David Gunnell, and Julia Verne. "Patterns of hospital admission for adult psychiatric illness in England: analysis of Hospital Episode Statistics data." British Journal of Psychiatry 185, no. 4 (October 2004): 334–41. http://dx.doi.org/10.1192/bjp.185.4.334.

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BackgroundThe assessment and reporting of national patterns of psychiatric hospital admissions is important for strategic service development and planning.AimsTo investigate patterns of psychiatric hospital admissions of patients aged 16–64 years in England.MethodWe used the Department of Health's national Hospital Episode Statistics data on admissions to National Health Service hospitals in England between April 1999 and March 2000, to investigate patterns by region, gender, age and diagnosis.ResultsThe annual admission rate for England was 3.2 per 1000 population. There were marked regional variations and rates were higher in males than in females. Depression and anxiety together were the most common (29.6%) reason for admission. Length of stay exceeded 90 days in 9.2% of admissions and 1 year in 0.9% (highest in London and for psychoses).ConclusionsDepression and anxiety together were the most frequent diagnoses leading to hospitalisation. There has been a reversal of the previously reported predominance of female admissions. Regional variations in activity and the significant numbers of patients remaining for long periods in acute’ in-patient care have important policy implications.

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Shallcross, L. J., K. Williams, S. Hopkins, R. W. Aldridge, A. M. Johnson, and A. C. Hayward. "Panton-Valentine leukocidin associated staphylococcal disease: a cross-sectional study at a London hospital, England." Clinical Microbiology and Infection 16, no. 11 (November 2010): 1644–48. http://dx.doi.org/10.1111/j.1469-0691.2010.03153.x.

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Vinson, Gavin P., and John P. Coghlan. "James Francis Tait. 1 December 1925—2 February 2014." Biographical Memoirs of Fellows of the Royal Society 65 (September 5, 2018): 381–404. http://dx.doi.org/10.1098/rsbm.2018.0015.

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James F. Tait FRS, with his wife Sylvia A. S. Tait FRS, made an indelible contribution to life science and medicine with the isolation and characterization of aldosterone, the most potent mineralocorticoid hormone produced by the mammalian adrenal cortex. Trained as a physicist, Tait turned to endocrinology during his first academic appointment at the Medical School of the Middlesex Hospital in London, where he met Sylvia. Their collaboration resulted in this major achievement within five years of his appointment, and they were both elected to fellowships of the Royal Society in 1959, when James was just 34. Shortly afterwards the Taits moved to the Worcester Foundation for Experimental Biology in Massachusetts, where he virtually created the study of hormone dynamics, using sophisticated techniques involving isotopically labelled hormone infusions. Many of his most highly cited papers stem from this period. In 1970 the Taits returned to the Middlesex Hospital, when he was appointed to the Joel Chair of Physics as Applied to Medicine. Here they continued studies on aldosterone and other adrenal steroids, using animal cell models. He continued to be active after retiring in 1982, and published a history of aldosterone in 2009. As a hobby he made a magnificent photographic record of the churches and abbeys of Yorkshire. Although, initially, recognition of aldosterone's clinical significance was slow, today it is thought that 10% of the incidence of essential hypertension is attributable to excess aldosterone. Aldactone, the earliest aldosterone antagonist, as well as more recently developed blockers, have proved effective in congestive heart failure. Sixty years after its discovery, aldosterone remains a rich and dynamic research field.

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Eden, Allaina, Claire Purkiss, Gabriella Cork, Adam Baddeley, Kelly Morris, Leah Carey, Mike Brown, Laura McGarrigle, and Samantha Kennedy. "In-patient physiotherapy for adults on veno-venous extracorporeal membrane oxygenation – United Kingdom ECMO Physiotherapy Network: A consensus agreement for best practice." Journal of the Intensive Care Society 18, no. 3 (June 14, 2017): 212–20. http://dx.doi.org/10.1177/1751143717705801.

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Clinical specialist physiotherapists from the five severe respiratory failure centres in England where respiratory extracorporeal membrane oxygenation (ECMO) is practiced have established this consensus agreement for physiotherapy best practice. The severe respiratory failure centres are Wythenshawe Hospital, Manchester; Glenfield Hospital, Leicester; Papworth Hospital, Cambridge; Guy’s and St Thomas’ Hospital, London and The Royal Brompton Hospital, London. Although research into physiotherapy and ECMO is increasing, there is not a sufficient amount to write evidence-based guidelines; hence the development of a consensus document, using knowledge and experience of the specialist physiotherapists working with patients receiving ECMO. The document outlines safety aspects, practicalities and additional treatment considerations for physiotherapists conducting respiratory care and physical rehabilitation.

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Melnychuk, Mariya, Stephen Morris, Georgia Black, Angus I. G. Ramsay, Jeannie Eng, Anthony Rudd, Abigail Baim-Lance, Martin M. Brown, Naomi J. Fulop, and Robert Simister. "Variation in quality of acute stroke care by day and time of admission: prospective cohort study of weekday and weekend centralised hyperacute stroke unit care and non-centralised services." BMJ Open 9, no. 11 (November 2019): e025366. http://dx.doi.org/10.1136/bmjopen-2018-025366.

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ObjectiveTo investigate variations in quality of acute stroke care and outcomes by day and time of admission in London hyperacute stroke units compared with the rest of England.DesignProspective cohort study using anonymised patient-level data from the Sentinel Stroke National Audit Programme.SettingAcute stroke services in London hyperacute stroke units and the rest of England.Participants68 239 patients with a primary diagnosis of stroke admitted between January and December 2014.InterventionsHub-and-spoke model for care of suspected acute stroke patients in London with performance standards designed to deliver uniform access to high-quality hyperacute stroke unit care across the week.Main outcome measures16 indicators of quality of acute stroke care, mortality at 3 days after admission to the hospital, disability at the end of the inpatient spell, length of stay.ResultsThere was no variation in quality of care by day and time of admission to the hospital across the week in terms of stroke nursing assessment, brain scanning and thrombolysis in London hyperacute stroke units, nor was there variation in 3-day mortality or disability at hospital discharge (all p values>0.05). Other quality of care measures significantly varied by day and time of admission across the week in London (all p values<0.01). In the rest of England there was variation in all measures by day and time of admission across the week (all p values<0.01), except for mortality at 3 days (p value>0.05).ConclusionsThe London hyperacute stroke unit model achieved performance standards for ‘front door’ stroke care across the week. The same benefits were not achieved by other models of care in the rest of England. There was no weekend effect for mortality in London or the rest of the England. Other aspects of care were not constant across the week in London hyperacute stroke units, indicating some performance standards were perceived to be more important than others.

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Beaver, Dan. "The Great Deer Massacre: Animals, Honor, and Communication in Early Modern England." Journal of British Studies 38, no. 2 (April 1999): 187–216. http://dx.doi.org/10.1086/386189.

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I need not complain of the times; every traveler tells them; they are as clear to see as an Angel in the sun. (Henry Osborne, October 1642)In early October 1642, a tract of forest and deer chase in the Severn valley, northwest of Gloucester, known as Corse Lawn, became the site of a grisly spectacle. Richard Dowdeswell, a steward of the property, described the scene in a letter to Lionel Cranfield, earl of Middlesex, the absentee owner resident in Great St. Bartholomew in London. Dowdeswell delivered terrifying news of how “a rising of neighbors about Corse Lawn” destroyed more than 600 of Middlesex's deer in a “rebellious, riotous, devilish way,” a hideous consequence of what Dowdeswell termed “this time of liberty.” Dowdeswell rode to the scene from his estate at Pull Court, a few miles from the chase, and “appeased the multitude, yet some scattering companies gave out in alehouses that they would not only destroy the remainder of deer but rifle your Lordship's house at Forthampton and pull it down to the ground and not let a tree or bush stand in all the chase.” The deer massacre became an assault on the chase, the forest, and the manor house of Forthampton, an estate close to the chase but not included in the meets and bounds of the forest. Middlesex's tenant at Forthampton Court, his brother-in-law Henry Osborne, prudently moved his household to Gloucester until Dowdeswell acquired a formal statement of protection from the earl of Essex to defend the forest, the deer left in the chase, and the house in Forthampton.

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Lomas, Howard. "The Development of the BABP." Behavioural Psychotherapy 19, no. 2 (April 1991): 211–15. http://dx.doi.org/10.1017/s0141347300012246.

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On a cold and dull Autumn Friday in 1972, I was among hordes of Behaviour Changers/Modifiers/Engineers/Therapists (all to become Psychotherapists) making their way from the four corners of Britain to the Middlesex Hospital in London. We were all going to a meeting to discuss the setting up of a National Association for those interested in Behavioural … whatever. When I arrived, I was refused entry unless I paid £3 annual membership fee to the very smartly dressed bouncer on the door who claimed to be the Treasurer. “But I thought the meeting was to decide if we are going to form an Association and, if so, to elect the officers!” My protests were in vain, as would have been my 460 mile day trip if I had not parted with my £3 — I have never really mastered contingency management!

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Planskoy, B., A. M. Bedford, F. M. Davis, P. D. Tapper, and L. T. Loverock. "Physical aspects of total-body irradiation at the Middlesex Hospital (UCL group of hospitals), London 1988 - 1993: I. Phantom measurements and planning methods." Physics in Medicine and Biology 41, no. 11 (November 1, 1996): 2307–26. http://dx.doi.org/10.1088/0031-9155/41/11/005.

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Powell, Michael, and Neil Kitchen. "THE DEVELOPMENT OF NEUROSURGERY AT THE NATIONAL HOSPITAL FOR NEUROLOGY AND NEUROSURGERY, QUEEN SQUARE, LONDON, ENGLAND." Neurosurgery 61, no. 5 (November 1, 2007): 1077–90. http://dx.doi.org/10.1227/01.neu.0000303204.07866.d6.

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Watson, James, and Stephanie Daley. "The use of section 135(1) of the Mental Health Act in a London borough." Mental Health Review Journal 20, no. 3 (September 14, 2015): 133–43. http://dx.doi.org/10.1108/mhrj-02-2015-0007.

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Purpose – The purpose of this paper is to determine the incidence of the use of section 135(1) of the Mental Health Act 1983 in a London borough and describe the main features of the population subject to that section. Design/methodology/approach – Uses of section 135(1), hospital stay, and demographic data were gathered from service and patient records over one year. Means, medians, modes and standard deviation were calculated for interval data. Nominal data were cross-tabulated and the chi square test applied where appropriate. Study data were compared to census and national hospital data; the significance of proportional population differences were calculated using the Z-test. Findings – In total, 63 uses of section 135(1) were recorded. It was primarily used with people with psychotic diagnoses (79 per cent), and was used predominantly in black populations, and among people aged 40-54. People admitted to hospital after section 135(1) use who had psychosis diagnoses had median spells in hospital that were double the corresponding national median. Research limitations/implications – Total uses of section 135(1) in the borough equated to 25 per cent of the national total for all section 135 admissions recorded in 2012/2013. Hospital statistics in England focusing on admissions alone may fail to reflect a more widespread use of this section. Further research is required to confirm and develop the findings of this small scale study. Practical implications – The repeated use of this section is suggested as a marker for reviewing practice and resource allocation to prevent or shorten hospital admissions for people with psychosis diagnoses. Originality/value – This paper highlights gaps in NHS data collection in England relevant to policy makers, mental health service providers, and the police service.

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Helminski, Janet Odry. "Cognitive Styles: Some Implications for Teaching and Training. Jobling HJ(The London Hospital School of Physiotherapy-Northeast London Polytechnic, London, England), Physiotherapy 73:335-338, 1987." Journal of Physical Therapy Education 2, no. 2 (July 1988): 35. http://dx.doi.org/10.1097/00001416-198807000-00011.

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Cairns, M. D., M. D. Preston, T. D. Lawley, T. G. Clark, R. A. Stabler, and B. W. Wren. "Genomic Epidemiology of a Protracted Hospital Outbreak Caused by a Toxin A-Negative Clostridium difficile Sublineage PCR Ribotype 017 Strain in London, England." Journal of Clinical Microbiology 53, no. 10 (July 15, 2015): 3141–47. http://dx.doi.org/10.1128/jcm.00648-15.

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Clostridium difficileremains the leading cause of nosocomial diarrhea worldwide, which is largely considered to be due to the production of two potent toxins: TcdA and TcdB. However, PCR ribotype (RT) 017, one of five clonal lineages of human virulentC. difficile, lacks TcdA expression but causes widespread disease. Whole-genome sequencing was applied to 35 isolates from hospitalized patients withC. difficileinfection (CDI) and two environmental ward isolates in London, England. The phylogenetic analysis of single nucleotide polymorphisms (SNPs) revealed a clonal cluster of temporally variable isolates from a single hospital ward at University Hospital Lewisham (UHL) that were distinct from other London hospital isolates.De novoassembled genomes revealed a 49-kbp putative conjugative transposon exclusive to this hospital clonal cluster which would not be revealed by current typing methodologies. This study identified three sublineages ofC. difficileRT017 that are circulating in London. Similar to the notorious RT027 lineage, which has caused global outbreaks of CDI since 2001, the lineage of toxin-defective RT017 strains appears to be continually evolving. By utilization of WGS technologies to identify SNPs and the evolution of clonal strains, the transmission of outbreaks caused by near-identical isolates can be retraced and identified.

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Balinskaite, Violeta, Alex Bottle, Louise Johanna Shaw, Azeem Majeed, and Paul Aylin. "Reorganisation of stroke care and impact on mortality in patients admitted during weekends: a national descriptive study based on administrative data." BMJ Quality & Safety 27, no. 8 (October 27, 2017): 611–18. http://dx.doi.org/10.1136/bmjqs-2017-006681.

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ObjectiveTo evaluate mortality differences between weekend and weekday emergency stroke admissions in England over time, and in particular, whether a reconfiguration of stroke services in Greater London was associated with a change in this mortality difference.Design, setting and participantsRisk-adjusted difference-in-difference time trend analysis using hospital administrative data. All emergency patients with stroke admitted to English hospitals from 1 January 2008 to 31 December 2014 were included.Main outcomesMortality difference between weekend and weekday emergency stroke admissions.ResultsWe identified 507 169 emergency stroke admissions: 26% of these occurred during the weekend. The 7-day in-hospital mortality difference between weekend and weekday admissions declined across England throughout the study period. In Greater London, where the reorganisation of stroke services took place, an adjusted 28% (relative risk (RR)=1.28, 95% CI 1.09 to 1.47) higher weekend/weekday 7-day mortality ratio in 2008 declined to a non-significant 9% higher risk (RR=1.09, 95% CI 0.91 to 1.32) in 2014. For the rest of England, a 15% (RR=1.15, 95% CI 1.09 to 1.22) higher weekend/weekday 7-day mortality ratio in 2008 declined to a non-significant 3% higher risk (RR=1.03, 95% CI 0.97 to 1.10) in 2014. During the same period, in Greater London an adjusted 12% (RR=1.12, 95% CI 1.00 to 1.26) weekend/weekday 30-day mortality ratio in 2008 slightly increased to 14% (RR=1.14, 95% CI 1.00 to 1.30); however, it was not significant. In the rest of England, an 11% (RR=1.11, 95% CI 1.07 to 1.15) higher weekend/weekday 30-day mortality ratio declined to a non-significant 4% higher risk (RR=1.04, 95% CI 0.99 to 1.09) in 2014. We found no statistically significant association between decreases in the weekend/weekday admissions difference in mortality and the centralisation of stroke services in Greater London.ConclusionsThere was a steady reduction in weekend/weekday differences in mortality in stroke admissions across England. It appears statistically unrelated to the centralisation of stroke services in Greater London, and is consistent with an overall national focus on improving stroke services.

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Shami, S. K., S. J. Chittenden, J. H. Scurr, and P. D. Coleridge Smith. "Skin Blood Flow in Chronic Venous Insufficiency." Phlebology: The Journal of Venous Disease 8, no. 2 (June 1993): 72–76. http://dx.doi.org/10.1177/026835559300800207.

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Objective: To evaluate the skin temperature, laser Doppler flux (LDF), concentration of moving blood cells (CMBC) and speed of blood cells (SBC) in the liposclerotic and clinically normal skin of patients with chronic venous insufficiency. Design: Parallel groups study comparing patients with chronic venous insufficiency with control subjects. Setting: Vascular laboratory, Middlesex Hospital, University College and Middlesex School of Medicine, London, UK. Participants: Twenty patients with lipodermatosclerosis and chronic venous insufficiency comprised the disease group, and 15 subjects without venous disease comprised the control group. Main outcome measures: The skin temperature, LDF, CMBC and SBC were assessed in the gaiter area and on the dorsum of the foot. Results: A higher LDF (median LDF and interquartile range (IQR) = 132 (66–289), p = 0.001 (Mann-Whitney) and skin temperature (Median temperature and IQR = 31.1 (29.6–32.4), p = 0.001) was found in the liposclerotic skin of patients with chronic venous insufficiency compared with normal controls (median LDF and IQR = 49 (32–58); median temperature and IQR = 28 (27–30.3)). Similarly the LDF on the dorsum of the foot (median LDF and IQR = 73 (59–127), p = 0.03) and skin temperature on the dorsum of the foot (median temperature and IQR = 31.1 (30.4–32.1), p = 0.002) was significantly higher in the patients with chronic venous insufficiency compared with normal controls (median LDF and IQR = 55 (36–66), median temperature and IQR = 29.5 (26.7–30.7)). Conclusions: This study demonstrates that there is increased skin blood flow in both liposclerotic skin and clinically normal skin in patients with chronic venous insufficiency.

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Bunker, D. L. J., G. Pappas, P. Moradi, and M. B. Dowd. "RADIOGRAPHIC SIGNS OF STATIC CARPAL INSTABILITY WITH DISTAL END RADIUS FRACTURES: IS CURRENT TREATMENT ADEQUATE?" Hand Surgery 17, no. 03 (January 2012): 325–30. http://dx.doi.org/10.1142/s0218810412500256.

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Patients presenting with distal end radius fractures may have concomitant carpal instability due to disruption of the scapholunate ligament. This study examined the incidence of static radiographic signs of carpal instability in patients with distal radial fractures before and after fracture treatment. We performed a retrospective radiographic study of 141 patients presenting to Central Middlesex Hospital, London between January 2002–May 2004 with distal end radius fractures. We used abnormal scapholunate angle as the primary indicator of possible carpal dissociation. Abnormal scapholunate angles were noted in 39% of patients at presentation and 35% of patients after treatment with no statistically significant intra-patient variability. Persistent static radiographic signs of carpal instability are high in this subset of patients. The long-term morbidity of persistent wrist instability may be avoided by early radiological diagnosis with clinical correlation to identify carpal ligament injuries and initiate treatment that addresses both the bony and ligamentous components of the injury.

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Tsaregradskiy, A. "Care and Treatment of Epileptics in England. - Fletches Beach, Médecin au "West End Hospital, London". Archines de neurologie, 1903 octobre." Neurology Bulletin XII, no. 1 (January 2, 2021): 269–71. http://dx.doi.org/10.17816/nb57228.

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Romanchishen, Anatoly F., Kristina V. Vabalayte, and Marina H. Tovbina. "Sir James Berry (1860-1946) (To the 150th Anniversary)." International Journal of Head and Neck Surgery 2, no. 2 (2011): 77–78. http://dx.doi.org/10.5005/jp-journals-10001-1055.

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ABSTRACT James Berry was born at Kingston, Ontario, where his father had business interests, but was educated at Whitgift School, South Croydon, London. He spent his student time at St Bartholomew's Hospital and became a fellow of the Royal College of Surgeons. Later, he became consultant surgeon and emeritus lecturer for clinical surgery at the Royal Free Hospital in London. He retired from praxis in 1927. Berry pioneered thyroid surgery in England and wrote a textbook on the subject . With his first wife he assembled and led a medical team to Serbia in World War I. They were captured by the Hungarians and repatriated through Switzerland, only to return to continue their work in Romania.

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Powell, Andrew. "Operating in the Theatre of the Mind Therapy Both Tender and Bold." British Journal of Psychiatry 159, no. 6 (December 1991): 13–14. http://dx.doi.org/10.1192/s0007125000031895.

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Psychodrama-Inspiration and Technique, edited by Paul Holmes and Marcia Karp, is published by Routledge, London (£14.99 (pb), £35.00 (hb), 253 pp., 1991). Paul Holmes is a child and adolescent psychiatrist, formerly consultant at St George's Hospital, London, and now based in Mexico. He is a member of the London Centre for Psychotherapy and was the first chairman of the British Psychodrama Association. Marcia Karp trained in psychodrama in the USA under its founder, Dr J. L. Moreno. Since moving to England, where she established the Holwell Centre for Psychodrama Training, she has been instrumental in setting up training schemes throughout Europe.

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Coley, N. G. "George Pearson MD, FRS (1751-1828): ‘The greatest chemist in England’?" Notes and Records of the Royal Society of London 57, no. 2 (May 22, 2003): 161–75. http://dx.doi.org/10.1098/rsnr.2003.0203.

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George Pearson, the son of an apothecary, studied medicine at Edinburgh under Joseph Black. He entered medical practice at Doncaster in 1777, but moved to London and became a physician at St George's Hospital in 1787. He lectured on chemistry and was the first English chemist to adopt the oxygen theory; he was elected FRS in 1791. One of the first to advocate Jenner's cowpox vaccination, he thought himself superior to Jenner in promoting it. He expected recognition and when this was given exclusively to Jenner, became embittered. His reputation was damaged and he has largely been forgotten.

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Silvester, Alexander. "Jean Martin Charcot (1825–93) and John Hughlings Jackson (1835–1911): neurology in France and England in the 19th century." Journal of Medical Biography 17, no. 4 (November 2009): 210–13. http://dx.doi.org/10.1258/jmb.2009.009039.

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In 1862 Jean Martin Charcot was appointed Physician at the Salpêtrière Hospital in Paris, and simultaneously John Hughlings Jackson was appointed as assistant physician at the National Hospital for the Paralysed and Epileptic, Queen Square, London. Both men made significant contributions to the development of neurology, many of which remain important to contemporary neurologists. The achievements and the work of Charcot and Hughlings Jackson are considered in the light of their respective localities and medical education, and the structure of hospital institutions and political allegiances are compared in the late 19th century in France and Britain.

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Durkin, Natalie, and Mark Davenport. "Centralization of Pediatric Surgical Procedures in the United Kingdom." European Journal of Pediatric Surgery 27, no. 05 (September 25, 2017): 416–21. http://dx.doi.org/10.1055/s-0037-1607058.

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AbstractThe NHS provides more than 98% of all surgical procedures in infants and children in the United Kingdom through a comprehensive network of secondary (typically for the general surgery of childhood) and tertiary (specialist neonatal and specialist pediatric surgery) centers [n = 22]), typically located within large conurbations. It was originally envisaged that these specialized centers would be able to provide the full range of surgical interventions (aside from organ transplantation). However, there has been a trend toward centralization of some key procedures, previously thought to be within general neonatal surgery.The architype for centralization is the management of biliary atresia (BA). Since 1999, within England and Wales, this has been exclusively managed in three centers (King's College Hospital, London; Birmingham Children's Hospital and Leeds General Infirmary). All of these provide facilities for the diagnosis of BA, primary surgical management (Kasai portoenterostomy), and liver transplantation if required. The case for centralization was made by rigorous national outcome analysis during the 1990s showing marked disparity based on case volume and driven by parents' organizations and national media. Following centralization, national outcome data showed improvement and provided a benchmark for others to follow.The management of bladder exstrophy was later centralized in England and Wales, albeit not based on strict outcome data, to two centers (Great Ormond Street, London and Royal Manchester Children's Hospital).

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Evans, Kathryn, Peter Tyrer, Naresh Gandhi, Alwyn Lamont, and Phil Harrison-Read. "Importance of local differences in comparing hospital and community psychiatric services." Epidemiologia e psichiatria sociale. Monograph Supplement 6, S1 (April 1997): 137–44. http://dx.doi.org/10.1017/s1827433100000903.

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Most of the studies that are frequently cited as examples of effective comprehensive community care, (i.e. they reduce the demand for hospital beds without any loss in treatment efficacy (Stein & Test, 1980; Hoult & Reynolds, 1984; Muijen et al., 1992) were carried out before the introduction of the Care Programme Approach (CPA) in 1991 (Department of Health, 1990) which at present only applies to England. As the CPA derives from these earlier studies the discrepancies between hospital and community based aftercare might be expected to become less, as now all services in England are expected to include a significant community element. However, there can still be important differences between those services focusing on community care as the main priority and those in which the hospital system is paramount.The psychiatric services in the area covered by North West London Mental Health Trust (NWL Trust) represented a natural test of these two approaches as they had parallel hospital and community based teams covering the same catchment areas respectively, North Paddington, in Westminster and Brent, in outer London.At this point it is useful to provide more detailed description of the two geographical areas at the time of the study and the community and hospital based teams that were involved.

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Duke, Martin. "Leonard Craske (1878–1950): From medical student to sculptor." Journal of Medical Biography 17, no. 3 (August 2009): 177–78. http://dx.doi.org/10.1258/jmb.2009.009027.

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Summary Leonard Craske (1878–1950), born and raised in London, England, spent two years as a medical student at St Thomas’ Hospital Medical School. Following this, he worked as an actor and studied drawing and sculpting. After emigrating to the USA and settling in Boston, he became an accomplished sculptor, creating the well-known Fishermen's Memorial in Gloucester, Massachusetts, the work for which he is best remembered.

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Walsh, Julie, and Julie Walsh. "Oliver Sacks." Exchanges: The Interdisciplinary Research Journal 1, no. 1 (October 1, 2013): 1–11. http://dx.doi.org/10.31273/eirj.v1i1.69.

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Renowned neurologist and author Dr Oliver Sacks is a visiting professor at the University of Warwick as part of the Institute of Advanced Study. Dr Sacks was born in London. He earned his medical degree at the University of Oxford (Queen’s College) and the Middlesex Hospital (now UCL), followed by residencies and fellowships at Mt. Zion Hospital in San Francisco and at University of California Los Angeles (UCLA). As well as authoring best-selling books such as Awakenings and The Man Who Mistook His Wife for a Hat, he is clinical professor of neurology at NYU Langone Medical Center in New York. Warwick is part of a consortium led by New York University which is building an applied science research institute, the Center for Urban Science and Progress (CUSP). Dr Sacks recently completed a five-year residency at Columbia University in New York, where he was professor of neurology and psychiatry. He also held the title of Columbia University Artist, in recognition of his contributions to the arts as well as to medicine. He is a fellow of the Royal College of Physicians and the Association of British Neurologists, the American Academy of Arts and Sciences, and the American Academy of Arts and Letters, and has been a fellow of the New York Institute for the Humanities at NYU for more than 25 years. In 2008, he was appointed CBE.

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Wilkinson, Greg. "Mental Health Services Planning." Bulletin of the Royal College of Psychiatrists 9, no. 7 (July 1985): 138. http://dx.doi.org/10.1192/s0140078900022161.

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A timely conference on Mental Health Services Planning, organized jointly by the Royal College of Psychiatrists and the Department of Health and Social Security, took place in London in March 1985. The conference concentrated on difficulties associated with the implementation of government policies for mental health service planning in England and Wales. Particular emphasis was given to the problems of transition from hospital-based services to community-based services.

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Bennett, Katie. "Robotic Surgery: da Vinci® and beyond." Bulletin of the Royal College of Surgeons of England 94, no. 1 (January 1, 2012): 8–9. http://dx.doi.org/10.1308/147363512x13189526438431.

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In 2001 the first da Vinci® robot (Intuitive Surgical Inc) was installed in the UK at St Mary's hospital, London. It was initially used for high-volume, standard surgical procedures. More than 10 years on, 27 robots are in use in England. The da Vinci® robot, used primarily in urology but also in gynaecology, ENT, colorectal, cardiology and paediatrics, is making an indelible mark on the NHS.

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CATHCART, S. J., J. LAWRENCE, A. GRANT, D. QUINN, C. J. M. WHITTY, J. JONES, P. L. CHIODINI, and G. FRASER. "Estimating unreported malaria cases in England: a capture–recapture study." Epidemiology and Infection 138, no. 7 (November 18, 2009): 1052–58. http://dx.doi.org/10.1017/s0950268809991130.

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SUMMARYA capture–recapture study was undertaken to estimate the incidence and likely total burden of malaria cases in England. Cases diagnosed by the national Malaria Reference Laboratory (MRL) between July 2003 and December 2004 were matched with cases reported to Hospital Episode Statistics using demographic, geographical, parasitological, and temporal information. A total of 3861 cases were recorded in one or both datasets; the ‘unknown population’ was estimated as 746 cases (95% CI 677–822) giving a total of 4607 cases (95% CI 4446–4767) over 18 months. Eighty-four percent (95% CI 83–85) of cases were recorded in one or both datasets. Fifty-six percent (95% CI 54–58) of cases were captured by the MRL surveillance system; ascertainment for Plasmodium falciparum and London cases was higher at 66% and 62%, respectively. Improving case ascertainment will facilitate effective measures to reduce the burden of this preventable disease in the UK.

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Abu-Own, A., J. H. Scurr, and P. D. Coleridge Smith. "Assessment of Intermittent Pneumatic Compression by Strain-Gauge Plethysmography." Phlebology: The Journal of Venous Disease 8, no. 2 (June 1993): 68–71. http://dx.doi.org/10.1177/026835559300800206.

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Objective: To compare the physiological effects of a sequential gradient pneumatic compression device (SCD) with a single-chamber pneumatic compression device (Venodyne). Design: Single patient group with treatment crossover. Setting: Department of Surgery, University College and Middlesex Hospital, London, UK. Subjects: Thirty-four limbs of 17 normal adult volunteers were studied. Interventions: Sequential gradient compression was applied to one leg and single-chamber compression to the other lower limb for 10 min. The compression devices were then swapped to the opposite leg for a further 10 min period. Outcome measures: The increase in foot volume (distal venous distension) in response to each compression, and the subsequent decrease in foot volume (distal venous emptying), were measured. The overall reduction of foot volume (net effect) during the period of compression was calculated. Results: The results indicate the net effect was a decrease in foot volume (median decrease 0.35 ml%, 95% CI: 0.21% to 0.45%) with the SCD and no change with the Venodyne (median decrease 0.09 ml%, 95% CI: −0.25% to 0.22%). Conclusion: We conclude that sequential intermittent pneumatic compression of the calf and thigh is less likely to cause distal blood trapping and foot swelling than single-chamber calf compression.

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Connell, Alistair, Hugh Montgomery, Stephen Morris, Claire Nightingale, Sarah Stanley, Mary Emerson, Gareth Jones, et al. "Service evaluation of the implementation of a digitally-enabled care pathway for the recognition and management of acute kidney injury." F1000Research 6 (June 30, 2017): 1033. http://dx.doi.org/10.12688/f1000research.11637.1.

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Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians. It is uncertain, however, whether ‘alerting’ alone improves care quality. We have thus developed a digitally-enabled care pathway as a clinical service to inpatients in the Royal Free Hospital (RFH), a large London hospital. This pathway incorporates a mobile software application - the “Streams-AKI” app, developed by DeepMind Health - that applies the NHS AKI algorithm to routinely collected serum creatinine data in hospital inpatients. Streams-AKI alerts clinicians to potential AKI cases, furnishing them with a trend view of kidney function alongside other relevant data, in real-time, on a mobile device. A clinical response team comprising nephrologists and critical care nurses responds to these AKI alerts by reviewing individual patients and administering interventions according to existing clinical practice guidelines. We propose a mixed methods service evaluation of the implementation of this care pathway. This evaluation will assess how the care pathway meets the health and care needs of service users (RFH inpatients), in terms of clinical outcome, processes of care, and NHS costs. It will also seek to assess acceptance of the pathway by members of the response team and wider hospital community. All analyses will be undertaken by the service evaluation team from UCL (Department of Applied Health Research) and St George’s, University of London (Population Health Research Institute).

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Connell, Alistair, Hugh Montgomery, Stephen Morris, Claire Nightingale, Sarah Stanley, Mary Emerson, Gareth Jones, et al. "Service evaluation of the implementation of a digitally-enabled care pathway for the recognition and management of acute kidney injury." F1000Research 6 (August 7, 2017): 1033. http://dx.doi.org/10.12688/f1000research.11637.2.

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Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians. It is uncertain, however, whether ‘alerting’ alone improves care quality. We have thus developed a digitally-enabled care pathway as a clinical service to inpatients in the Royal Free Hospital (RFH), a large London hospital. This pathway incorporates a mobile software application - the “Streams-AKI” app, developed by DeepMind Health - that applies the NHS AKI algorithm to routinely collected serum creatinine data in hospital inpatients. Streams-AKI alerts clinicians to potential AKI cases, furnishing them with a trend view of kidney function alongside other relevant data, in real-time, on a mobile device. A clinical response team comprising nephrologists and critical care nurses responds to these AKI alerts by reviewing individual patients and administering interventions according to existing clinical practice guidelines. We propose a mixed methods service evaluation of the implementation of this care pathway. This evaluation will assess how the care pathway meets the health and care needs of service users (RFH inpatients), in terms of clinical outcome, processes of care, and NHS costs. It will also seek to assess acceptance of the pathway by members of the response team and wider hospital community. All analyses will be undertaken by the service evaluation team from UCL (Department of Applied Health Research) and St George’s, University of London (Population Health Research Institute).

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Journal articles on the topic 'Middlesex Hospital (London, England)'

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