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Chesterfield, United Kingdom

Groves J.,Chesterfield Royal Hospital
BMJ (Online) | Year: 2010

Objective To determine whether the author's 20.9 lb (9.5 kg) carbon frame bicycle reduced commuting time compared with his 29.75 lb (13.5 kg) steel frame bicycle. Design Randomised trial. Setting Sheffield and Chesterfield, United Kingdom, between mid-January2010 and mid-July2010. Participants One consultant in anaesthesia and intensive care. Main outcome measure Total time to complete the 27 mile (43.5 kilometre) journey from Sheffield to Chesterfield Royal Hospital and back. Results The total distance travelled on the steel frame bicycle during the study period was 809 miles (1302 km) and on the carbon frame bicycle was 711 miles (1144 km). The difference in the mean journey time between the steel and carbon bicycles was 00:00:32 (hr:min:sec; 95% CI -00:03:34 to 00:02:30; P=0.72). Conclusions A lighter bicycle did not lead to a detectable difference in commuting time. Cyclists may find it more cost effective to reduce their own weight rather than to purchase a lighter bicycle.

Sivathasan N.,University of Leicester | Goodfellow P.B.,Chesterfield Royal Hospital
Journal of Clinical Pharmacology | Year: 2011

The potential dangers of chlorhexidine must be conveyed to the medical community. Health care professionals have little knowledge about the side effects and complications that may arise from this increasingly used compound. The suggestions in this case study may help to reduce the risk of adverse effects. © 2011 The Author(s).

Dodd M.C.,Chesterfield Royal Hospital | Collini P.J.,Foundation Medicine | Collini P.J.,University of Sheffield | Dockrell D.H.,Foundation Medicine | Dockrell D.H.,University of Sheffield
Thorax | Year: 2013

Records were reviewed (n=1052) for patients admitted to a large general intensive care unit (GICU) and examined for HIV testing criteria published in UK national testing guidelines (UKNG). All actual tests sent from GICU were also examined for comparison. Strict application of the UKNG revealed 30% of patients met criteria for HIV testing on admission to GICU. With pragmatic application, 18% of admissions met criteria for testing. Less than 5% of admissions were actually tested when no testing guideline was adopted. Discussion: The UKNG can be adopted in a representative GICU to increase HIV testing rate by 4-6-fold.

Krishnamurthy A.,Chesterfield Royal Hospital
BMJ case reports | Year: 2013

A 56-year-old smoker presented with a 3-day history of intermittent chest pain. Cardiovascular examination on admission was normal. ECG showed minimal (<1 mm) ST elevation in lead III, and right-sided leads revealed similar mild ST-elevation. Troponin I was elevated at 10.91. He was managed as a delayed-presentation ST-elevation myocardial infarction case. 12 h following admission, he developed oxygen-resistant hypoxia and hypotension. There were no clinical or radiological signs of pulmonary congestion. CT pulmonary angiogram revealed no pulmonary embolus. A bubble-contrast echocardiogram confirmed an active interatrial right-to-left shunt without Valsalva provocation. His hypoxia steadily improved over the following 24 h and he did not require any shunt closure. A repeat bubble contrast echocardiogram showed that the shunt was now only active following a Valsalva manoeuvre. Transoesophageal echocardiography confirmed a patent foramen ovale. This is a rare but important cause of resistant hypoxia following a right-heart infarct.

Ali F.,Chesterfield Royal Hospital
Orthopaedics and Trauma | Year: 2013

Clinical examination of the knee starts with observing the patient standing and then walking. On sitting, patella height, tracking and crepitus can be demonstrated. With the patient supine the traditional sequence of look, feel and move of the joint is performed, followed by testing in turn the ligamentous and capsular structures. © 2013 .

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