News Article | February 23, 2017
Villa Care Group, a Leeds based healthcare company and Leeds Teaching Hospitals NHS Trust have signed an agreement to open the Bilberry Unit at Wharfe Villa Care Group, a Leeds based healthcare company and Leeds Teaching Hospitals NHS Trust have signed an agreement to open the Bilberry Unit at Wharfedale Hospital in Otley, a facility providing nursing beds. The beds will be for existing older patients who have finished their acute episode of care at St James’s University Hospital or Leeds General Infirmary and are medically fit for discharge from the Trust, but are waiting whilst assessment or packages of care are put in place. Nursing and care in the Bilberry Unit will be provided by Villa Care Group, while Leeds Teaching Hospitals will provide physio and occupational therapy staff. Howard Taylor, Managing Director of Villa Care Group said: “We are pleased to be working in partnership with the Leeds Teaching Hospitals on this important initiative. This is a positive and innovative collaboration for the Trust and Leeds as a whole and most importantly for the patients, who can benefit from a programme designed to advance them to the next stage of care. “Wharfedale Hospital provides an excellent modern facility that is an important part of the area’s healthcare community, and this unit will enhance that role.” The admission of patients from the Trust hospitals with subsequent discharge from the unit to their next stage of care or home is a key provision of the unit’s operation. Since opening, the unit has reached its full operating level, releasing much needed capacity back to the acute hospitals in Leeds with many patients having already been discharged home or onto long term care, at levels exceeding expectations. Villa Care opened the unit on time and on budget. Villa Care is a Leeds based healthcare provider operating nursing homes, nursing domiciliary care and a healthcare consultancy division. Villa Care Ltd is registered with the Care Quality Commission (CQC). Issued by Villa Care: 0113 265 9353 Media contact: Howard Taylor For more information on Villa Care Group visit www.villacaregroup.com
Robinson P.,Leeds Teaching Hospitals |
Robinson P.,University of Leeds
American Journal of Roentgenology | Year: 2012
OBJECTIVE. This article provides a review of femoroacetabular impingement (FAI) and the role MRI is attempting to fulfill in this complex and sometimes controversial condition. A perspective on the current status and on the advantages of 1.5-T MR arthrography is presented, and its usefulness in this setting is compared with the potential of nonarthrographic 3-T MRI. CONCLUSION. With its increasing availability, 3-T MRI has the potential to provide routine, less invasive assessment of the hip for FAI. © American Roentgen Ray Society.
Hill Q.A.,Leeds Teaching Hospitals
Blood Reviews | Year: 2010
The survival prospects of critically ill patients with haematological malignancy (HM) are reviewed, as are the variables which might influence decisions about the limitation of life sustaining therapies (LLST). Approximately 40% of patients with HM admitted to ICU survive to hospital discharge and a broad admission policy is warranted. Short term survival is predicted by the severity of the underlying physiological disturbance rather than cancer specific characteristics, although the prognostic importance of neutropenia and prior stem cell transplantation remains to be clarified. Survival to hospital discharge in cancer patients following cardio-pulmonary resuscitation (CPR) is only 6-8%. Poor performance status and progressive deterioration despite ICU support appear to predict worse outcome. Patients should be provided with realistic information in order to make an informed decision about CPR. Decisions about LLST must be individualised. Consideration should be given to the patient's wishes and prognosis, the immediate clinical circumstances and their potential reversibility. © 2009 Elsevier Ltd. All rights reserved.
O'Connor P.J.,Leeds Teaching Hospitals
Seminars in Musculoskeletal Radiology | Year: 2013
To the practicing clinical radiologist, knowledge of the ultrasound appearances of crystal diseases is important. Assessment of bone or soft tissue changes related to rheumatoid arthritis is a rare clinical indication for ultrasound, whereas crystal diseases have a broad spectrum of presentations requiring clinical diagnostic imaging. Psoriatic arthritis is an entheseal disease with secondary joint involvement, where imaging findings include inflammatory enthesopathy with erosions as well as flexor tendon tenosynovitis. The ultrasound features of crystal deposition diseases and psoriatic arthritis in soft tissues and joints are relatively characteristic, and an awareness of these appearances is vital to the practicing musculoskeletal sonologist. © 2013 by Thieme Medical Publishers, Inc.
Flood K.,Leeds Teaching Hospitals |
Nicholson A.A.,Leeds Teaching Hospitals
CardioVascular and Interventional Radiology | Year: 2013
Purpose: To describe the presentation, treatment, and outcomes for 14 patients with aneurysms of the inferior pancreaticoduodenal arteries associated with occlusive lesions of the celiac axis, and to review the literature for similar cases. Methods: Over a period of 12 years, 14 patients (10 women and 4 men) ranging in age from 26 to 50 (mean 46) years were demonstrated to have aneurysms of the inferior pancreaticoduodenal artery origin associated with stenosis or occlusion of the celiac axis. All patients were treated by a combination of surgery and interventional radiology. Results: Outcome data collected between 3 months and 4 years (mean 2 years) demonstrated that all aneurysms remained excluded, and all 14 patients were well. The 49 case reports in the literature confirm the findings of this cohort. Conclusion: In inferior pancreaticoduodenal artery aneurysm resulting from celiac occlusive disease, endovascular treatment is best achieved by stenting the celiac axis and/or embolizing the aneurysm when necessary. © 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Mosley E.,Leeds Teaching Hospitals
Paediatrics and Child Health (United Kingdom) | Year: 2015
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatological disease of childhood. Symptom control is important in the initial management. Following definitive diagnosis methotrexate remains the first-line treatment for children with JIA. For those in whom methotrexate is ineffective, in whom it is not tolerated or in children whose disease affects the spine biologic agents play an important role. Biologics are a new group of treatments including monoclonal antibodies, soluble cytokine receptors or receptor antagonists that target key pathways of the immune system implicated in inflammation. These new drugs provide symptomatic relief, improvement in disease activity, prevention of damage, and promote normal growth and development for children with JIA. In order to optimize outcomes for children with JIA the British Society of Paediatric and Adolescent Rheumatology (BSPAR) recommends that whenever possible management and treatment initiation should be undertaken at a specialist centre within a clinical network. © 2015 Published by Elsevier Ltd.
Sivalingam V.N.,University of Manchester |
Myers J.,University of Manchester |
Nicholas S.,Leeds Teaching Hospitals |
Balen A.H.,Leeds Teaching Hospitals |
Crosbie E.J.,University of Manchester
Human Reproduction Update | Year: 2014
Background: Metformin is an effective oral anti-hyperglycaemic drug used as first-line medical treatment for type 2 diabetes. It improves systemic hyperglycaemia by reducing hepatic glucose production and enhancing peripheral insulin sensitivity. It also stimulates fat oxidation and reduces fat synthesis and storage. The molecular mechanism of this drug is thought to be secondary to its actions on the mitochondrial respiratory chain. Methods: This paper reviews the relevant literature (research articles up to October 2013) on the use of metformin in infertility, polycystic ovary syndrome (PCOS), pregnancy and gynaecological cancers. We present a comprehensive discussion of the evidence supporting the efficacy of metformin in these clinical conditions. Result: Metformin is used clinically off-label in the management of hirsutism, acne and insulin resistance in PCOS, although the evidence for anti-androgenic effects is inconsistent. Metformin is also used to improve ovulation in women with PCOS both alone and in combination with clomiphene citrate. Trial findings are conflicting but metformin treatment in IVF/ICSI cycles may reduce the risk of ovarian hyperstimulation syndrome and increase live birth rates. Metformin also appears to be effective and safe for the treatment of gestational diabetes mellitus (GDM), particularly for overweight and obese women. Studies have shown that metformin is safe in pregnancy and women with GDM treated with metformin have less weight gain during pregnancy than those treated with insulin. One study with a 2-year follow-up demonstrated that babies born to women treated with metformin also developed less visceral fat, making them less prone to insulin resistance in later life. These findings have sparked interest in the use of metformin for pregnant, obese, non-diabetic women. On-going clinical trials are underway to determine if women treated prophylactically with metformin have a reduced incidence of GDM and demonstrate less weight gain during pregnancy. The hypothesis in these studies is that babies born to obese women on prophylactic metformin will also have better outcomes. Epidemiological studies have linked metformin exposure to a decreased risk of cancer. Pre-clinical experiments report that metformin has a growth-static effect on several cancers, including endometrial cancer, which may be partly due to the effect of metformin on the PI3K/AKT/mTOR signal transduction pathway. A number of on-going early phase clinical trials aim to explore the anti-cancer effects of metformin and investigate its potential as a chemopreventative or adjuvant treatment. Conclusions: Obesity is on the rise in developing countries and is strongly linked to several reproductive health problems, including PCOS, GDM and endometrial cancer. Traditional lifestyle measures aimed at weight reduction are challenging to implement and maintain. Metformin may be a valuable alternative to, or adjunct for, modifying the toxic effects of obesity in these populations. This review will appraise the evidence for the use of metformin for the prevention and treatment of adverse health outcomes in obstetrics and gynaecology. © The Author 2014.
Rowbotham E.L.,Leeds Teaching Hospitals |
Grainger A.J.,Leeds Teaching Hospitals
American Journal of Roentgenology | Year: 2011
OBJECTIVE. The purpose of this article is to review some of the most common reasons for ultrasound intervention around the hip joint, and describe the techniques involved. CONCLUSION. Ultrasound alleviates the need for exposure to radiation and is already the modality of choice for aspiration of the hip joint, an intervention that may be helpful in guiding antimicrobial therapy and help avoid the need for surgical intervention. Ultrasound can also be used to access the hip for diagnostic or therapeutic injection. © American Roentgen Ray Society.
Bowen D.T.,Leeds Teaching Hospitals
Best Practice and Research: Clinical Haematology | Year: 2013
The myelodysplastic syndromes (MDS) are morphologically and genetically heterogeneous, and as such a single etiological factor is implausible. Therapy-related MDS has a clear etiology but the predisposition factors remain unclear. Most MDS (>90%) is not therapy-related and an etiology for this majority of patients, and indeed of better defined (morphological or genetic) subgroups cannot yet be ascertained. Exposure to occupational and environmental toxins is not obviously a major etiological contributor. The exceptions may be exposure to low concentrations of benzene and to tobacco smoke (which contains benzene amongst other carcinogens), but even these xenobiotics produce only modestly increased Hazard ratios for the development of MDS. It seems likely that low penetrance genetic variants may influence predisposition, and these may include pathways for xenobiotic metabolism, DNA repair and other quantitative trait loci.© 2013 Elsevier Ltd. All rights reserved.
Morgan S.S.,Leeds Teaching Hospitals |
Brooke B.,Leeds Teaching Hospitals |
Harris N.J.,Leeds Teaching Hospitals
Journal of Bone and Joint Surgery - Series B | Year: 2010
We present the outcomes in 38 consecutive patients who had total ankle replacement using the Ankle Evolution System with a minimum follow-up of four years. Pain and function were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score and regular standardised anteroposterior and lateral weight-bearing radiographs were obtained. Patient satisfaction and complications were recorded and the survival of the implants was demonstrated by the Kaplan-Meier method. The mean follow-up was for 57.8 months (48 to 80). The cumulative survival rate at six years was 94.7% (95% confidence interval 80.3 to 98.7). The mean total AOFAS score was 88.1 (53 to 100). The mean score for pain was 35.8 (20 to 40). Ten patients presented with edge-loading of whom nine had corrective surgery. Two ankles were revised, one to an arthrodesis and the other to replace the tibial component. Nine patients showed radiological evidence of osteolysis. They had minimal non-progressive symptoms and further surgery was not undertaken. Nevertheless, the concerns about osteolysis led to the implant being withdrawn by the manufacturer. The medium-term results of the ankle evolution system ankle replacement are satisfactory with high patient satisfaction, but the rate of osteolysis is of some concern. The long-term benefit of this procedure has yet to be determined. ©2010 British Editorial Society of Bone and Joint Surgery.