HIV enteropathy and 'Slim disease': Historical and current perspectives.

Objectives: Chronic diarrhoea and severe wasting associated with HIV infection were first described in East African patients as slim disease (SD) in 1985. The main histological features are flattening of the villi (villous atrophy) and crypt hyperplasia (elongated crypts), i.e.

Inhibition of survivin expression after using oxaliplatin and vinflunine to induce cytogenetic damage in vitro in lymphocytes from colon cancer patients and healthy individuals.

Chemotherapy drugs usually inflict a lethal dose to tumour cells with the consequence that these cells are being killed by cell death. However, each round of chemotherapy also causes damage to normal somatic cells. The DNA cross-linking agent oxaliplatin (OXP), which causes DNA double-strand breaks, and vinflunine (VFN), which disrupts the mitotic spindle, are two of these chemotherapy drugs which were evaluated in vitro using peripheral lymphocytes from colorectal cancer patients and healthy individuals to determine any differential response.

Accuracy of classification of invasive lobular carcinoma on needle core biopsy of the breast.

Although the UK National Institute for Health and Care Excellence guidelines recommend that in patients with biopsy-proven invasive lobular carcinoma (ILC), preoperative MRI scan is considered, the accuracy of diagnosis of ILC in core biopsy of the breast has not been previously investigated. Eleven pathology laboratories from the UK and Ireland submitted data on 1112 cases interpreted as showing features of ILC, or mixed ILC and IDC/no special type (NST)/other tumour type, on needle core biopsy through retrieval of histology reports. Of the total 1112 cases, 844 were shown to be pure ILC on surgical excision, 154 were mixed ILC plus another type (invariably ductal/NST) and 113 were shown to be ductal/NST.

Severe maternal sepsis in the UK, 2011-2012: a national case-control study.

Background: In light of increasing rates and severity of sepsis worldwide, this study aimed to estimate the incidence of, and describe the causative organisms, sources of infection, and risk factors for, severe maternal sepsis in the UK.

Methods And Findings: A prospective case-control study included 365 confirmed cases of severe maternal sepsis and 757 controls from all UK obstetrician-led maternity units from June 1, 2011, to May 31, 2012. Incidence of severe sepsis was 4.

National pilot audit of intermediate care.

The National Service Framework for Older People resulted in the widespread introduction of intermediate care (IC) services. However, although these services have shared common aims, there has been considerable diversity in their staffing, organisation and delivery. Concerns have been raised regarding the clinical governance of IC with a paucity of data to evaluate the effectiveness, quality and safety of these services.

Incidence and risk factors for amniotic-fluid embolism.

Objective: To estimate the incidence of amniotic-fluid embolism and to describe risk factors, management, and outcomes.

Methods: Through a population-based cohort study and nested case-control analysis, using the UK Obstetric Surveillance System, we identified 60 women in the United Kingdom who had an amniotic-fluid embolism between February 2005 and February 2009 and 1,227 women for the control group. We investigated the potential factors underlying amniotic-fluid embolism using an exploratory logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Long term follow up of men with Alfuzosin who voided successfully following acute urinary retention*.

Introduction: Acute urinary retention (AUR) is one of the commonest causes of admission in urology ward and successful voiding with alpha-blockers has been reported. However, long-term efficacy of Alfuzosin, following an episode of AUR is lacking. This is a continuation of our earlier reported study.

Risk assessment of skin in rheumatic disease.

Patients with a rheumatic disease are considered to be at high risk of developing skin problems because of their restricted mobility, vascular complications and the type of medication they are taking.

Specialist general practitioners and diabetes clinics in primary care: a qualitative and descriptive evaluation.

Aims: The aim of this study was to evaluate an innovative approach to the provision of primary care-based diabetes services in Bradford, UK. The service model differs from others in comprising 19 clinics which offer a specialist service, intermediate between primary and secondary care, to all patients within the Bradford area.

Methods: The study included: analysis of referral, attendance and register data; questionnaires to general practitioners (GPs) and specialist clinic providers; qualitative interviews with clinic and other professional staff and patients; and an economic analysis.

Is using lignocaine gel prior to flexible cystoscopy justified? A randomized prospective study.

Objective: We evaluate the discomfort and efficacy of instilling 2% lignocaine gel (Instillagel) versus smearing water-soluble gel (Aquagel) around the flexible cystoscope and external urethral meatus in men undergoing flexible cystoscopy for the first time and the overall efficacy of lignocaine gel in completion of the procedure.

Materials And Methods: A total of 140 patients divided into two groups, were randomized for this study: group A (n = 70) received approximately 11 ml of 2% lignocaine gel (Instillagel) intraurethrally for approximately 15 min, while in group B (n = 70) approximately 10-15 ml of water-soluble gel (Aquagel) was smeared around the scope and external urethral meatus. Total completion time for each procedure was recorded.

A problem of communication? Diabetes care among Bangladeshi people in Bradford.

People of Bangladeshi origin in the UK continue to experience poorer health and poorer healthcare than other sections of the community. Although communication with medical and nursing staff has long been recognised as key to the provision of effective healthcare services, efforts to overcome communication problems have often been minimal: many practitioners and patients rely on informal interpreters, usually family members, to assist them, despite the shortcomings of these arrangements. The present paper examines the experiences of 12 Bangladeshi people in Bradford, obtained during the course of a wider evaluation of diabetes services.

Developing a primary care-based stroke model: the prevalence of longer-term problems experienced by patients and carers.

Background: Over the last two decades, the need for a longer-term perspective to stroke management has become increasingly recognised. This paper reports a component of a larger project aimed at developing a systematic, primary care-based service for stroke aftercare.

Aim: To identify the types and prevalence of longer-term problems experienced by stroke patients and their carers in the United Kingdom (UK).

Treatments for gestational diabetes and impaired glucose tolerance in pregnancy.

Background: Gestational diabetes and impaired glucose tolerance (IGT) in pregnancy affects between 3 and 6% of all pregnancies and both have been associated with pregnancy complications. A lack of conclusive evidence has led clinicians to equate the risk of adverse perinatal outcome with pre-existing diabetes. Consequently, women are often intensively managed with increased obstetric monitoring, dietary regulation, and in some cases insulin therapy.

Public health in hospitals: the missing link in health improvement.

Traditionally, public health professionals have scorned hospitals as the antithesis of community health. Secondary care remains notably distant from public health practice and policy. Yet hospitals consume over 50 per cent of the health budget and over a quarter of the population have contact with hospital services every year.

Amniotic fluid embolism.

Purpose Of Review: To review the recent literature on amniotic fluid embolism and how it may influence the clinical management and further study of the condition. Morbidity and mortality from amniotic fluid embolism in the international context will be described, given the recent Confidential Enquiries into Maternal Deaths in the United Kingdom and other studies. With this rare condition we need to look for clues as to how to facilitate diagnosis and improve outcomes.

Inhaler devices for the treatment of asthma and chronic obstructive airways disease (COPD).

The research evidence on the effectiveness of inhaler devices for the treatment of asthma and chronic obstructive pulmonary disease published in a recent issue of Effective Health Care is reviewed.

A service users' research advisory group from the perspectives of both service users and researchers.

Much has been written about the importance of involving service users in the research process. Far less is available about the experience of involvement from the perspective of service users themselves. The present paper is a joint account by service users and researchers of a service users' advisory group set up to support and advise a project to evaluate diabetes services in Bradford, UK.

Randomised, placebo controlled, double blind study of alfuzosin SR in patients undergoing trial without catheter following acute urinary retention.

Introduction: Acute urinary retention caused by bladder outlet obstruction resulting from prostatic enlargement is one of the commonest causes for acute admission to urology wards. More recently, there has been a trend to commence treatment with alpha-blockers after catheterisation followed by a trial without catheter (TWOC), in the hope that surgery may be avoided in a significant proportion of patients. There is no conclusive evidence of the efficacy of this treatment.

Day surgery: an exciting new career pathway.

It could be argued that day surgery is seen as a poor relation to more exciting specialties, but the health secretary's campaign to expand day surgery has signalled a sea change in approach. A wide variety of procedures can be carried out in a day-surgery unit and nursing involvement is crucial. With the scope of day surgery increasing, it offers exciting opportunities and expanded roles for nurses.

The suitability of ISO 9001 as a quality system for a medical illustration department.

The Medical illustration Department within Bradford Hospitals NHS Trust is typical of many such units in the UK that are facing increasing competition from the commercial sector and Private Finance Initiatives, and at the same time, being driven by NHS initiatives towards having a demonstrable quality system. It was considered that having a recognized quality management system would ensure that the service provided was more efficient and effective, improve quality, guard against competition, be an asset if the organization was benchmarked against others, and provide evidence of quality assurance to our customers. This paper summarizes the history of quality management, discusses a number of quality systems in the NHS in general, and in Bradford Hospitals NHS Trust in particular, and puts forward the reasons for choosing ISO9001.