A retrospective analysis of 20,178 adult neurological infection admissions to United Kingdom critical care units from 2001 to 2020.

Background: Neurological infection is an important cause of critical illness, yet little is known on the epidemiology of neurological infections requiring critical care.

Methods: We analysed data on all adults with proven or probable neurological infection admitted to UK (NHS) critical care units between 2001 and 2020 reported to the Intensive Care National Audit and Research Centre. Diagnoses, physiological variables, organ support and clinical outcomes were analysed over the whole period, and for consecutive 5-year intervals within it.

A case series of vaccine-induced thrombotic thrombocytopenia in a London teaching hospital.

The ChAdOx1 nCoV-19 vaccine has been associated with increased risk of thrombosis. Understanding of the management of these rare events is evolving, and currently recommended treatments include human normal immunoglobulin and nonheparin anticoagulation such as direct oral anticoagulants. Our report describes three consecutive patients presenting to a London teaching hospital with vaccine-induced thrombotic thrombocytopenia (VITT), also referred to as vaccine-induced prothrombotic immune thrombocytopenia.

FN3K expression in COPD: a potential comorbidity factor for cardiovascular disease.

Introduction: Cigarette smoking and oxidative stress are common risk factors for the multi-morbidities associated with chronic obstructive pulmonary disease (COPD). Elevated levels of advanced glycation endproducts (AGE) increase the risk of cardiovascular disease (CVD) comorbidity and mortality. The enzyme fructosamine-3-kinase (FN3K) reduces this risk by lowering AGE levels.

The 'top 100' drugs and classes in England: an updated 'starter formulary' for trainee prescribers.

Aims: Prescribing is a complex skill required of doctors and, increasingly, other healthcare professionals. Use of a personal formulary can help to develop this skill. In 2006-9, we developed a core list of the 100 most commonly prescribed drugs.

Metformin in severe exacerbations of chronic obstructive pulmonary disease: a randomised controlled trial.

Background: Severe exacerbations of COPD are commonly associated with hyperglycaemia, which predicts adverse outcomes. Metformin is a well-established anti-hyperglycaemic agent in diabetes mellitus, possibly augmented with anti-inflammatory effects, but its effects in COPD are unknown. We investigated accelerated metformin therapy in severe COPD exacerbations, primarily to confirm or refute an anti-hyperglycaemic effect, and secondarily to explore its effects on inflammation and clinical outcome.

Safety of metformin in patients with chronic obstructive pulmonary disease and type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is commonly associated with chronic obstructive pulmonary disease (COPD). Metformin is a valuable treatment for T2DM, and may offer additional benefits in COPD. However, due to its rare association with lactic acidosis, its safety in COPD is uncertain.

Safety of Metformin in Patients with Chronic Obstructive Pulmonary Disease and Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) is commonly associated with chronic obstructive pulmonary disease (COPD). Metformin is a valuable treatment for T2DM, and may offer additional benefits in COPD. However, due to its rare association with lactic acidosis, its safety in COPD is uncertain.

Dissemination and uptake of a new treatment pathway for paracetamol poisoning in the UK: a survey of healthcare professionals.

Aims: On 3 September 2012, the UK Medicines and Healthcare Products Regulatory Agency (MHRA) notified healthcare professionals of immediate changes to the intravenous acetylcysteine license terms, altering the treatment pathway for paracetamol poisoning. We sought to evaluate awareness of this amongst healthcare professionals.

Methods: We surveyed doctors, nurses and pharmacists in the 1-12 week period following the implementation date.

Determining the volume of toxic liquid ingestions in adults: accuracy of estimates by healthcare professionals and members of the public.

Context: Ingestion of toxic liquids is common, and the volume ingested is often important for clinical decision-making. However, the accuracy and interpretation of volume estimates in the context of toxicological exposures is poorly characterised in adult practice.

Objective: To inform the interpretation of volume estimates when expressed in forms commonly encountered in toxicological practice: (1) semi-quantitative volume descriptors, such as 'mouthfuls'; (2) quantitative self-estimates of ingestion volume, for example, millilitres; and (3) estimates of residual volume in containers.