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Ballard A.J.,The Royal Bournemouth Hospital
Pathology Research and Practice | Year: 2015

The role of Epstein-Barr virus (EBV) in the pathogenesis of breast cancer is still unclear, although a growing body of evidence supports a link. The aim of this study was to investigate if EBV infection was more prevalent in invasive ductal carcinoma or invasive lobular carcinoma. An immunohistochemical marker for EBV (Epstein-Barr virus nuclear antigen 1 (EBNA1) clone E1-2.5) was applied to a tissue micro array section. The tissue micro array contained 80 cases of invasive ductal carcinoma, and 80 cases of invasive lobular carcinoma. Each case was scored as positive or negative for nuclear expression of EBNA1 in tumor cells using standard light microscopy.EBNA1 staining was evident in the tumor cells of 63 cases (39.4% of tumor cases). By tumor type (ductal/lobular) EBV infection was noted in 34 (42.5%) cases of invasive ductal carcinoma and 29 (36.2%) cases of invasive lobular carcinoma, this difference was not found to be significant (P = 0.518).This study indicates that EBV infection is equally distributed across the ductal and lobular tumor types. © 2015 Elsevier GmbH. Source


Allen S.,The Royal Bournemouth Hospital | Allen S.,Bournemouth University | Khattab A.,Bournemouth University | Bagust J.,Bournemouth University
Clinical Respiratory Journal | Year: 2012

Introduction and Objectives: There is a need for a measure of airway status that is easier for patients to use. If airflow is briefly occluded at the onset of inspiration, the maximum rate of pressure fall, dP/dtmax can be measured. After the occlusion is released, the maximum rate of change of inspiratory airflow (dF/dtmax) can be measured and expressed as a ratio of dP/dtmax to generate an index of inspiratory conductance (IC). We explored the characteristics of IC as a preliminary step towards developing it as an easy-to-use alternative. Methods: To measure IC, we constructed an apparatus consisting of a pneumotachograph, a low-resistance spring-loaded valve and a pressure transducer to measure airflow and pressure drop at the start of inspiration. We studied 30 healthy adults to define the values of the index, its stability and its response to external inspiratory resistive loads. Results: Mean IC was 2.49 (SD 0.96) Ls -1kPa -1, with no significant difference between men and women. The index was stable with a mean long-term variation of 11.25% around the normalised mean, compared with 2.1% for forced expiratory volume in 1s (FEV1) and within-test variation <5%. In response to external resistive loading, IC fell in a non-linear but consistent manner from 3.96 (0.32) to 0.96 (0.10) Ls -1kPa -1 across an added resistance range of 0-70kPasL -1. Conclusion: We showed that IC was measurable with a minimal need for subject participation. It was stable and reproducible in normal individuals and responded to added inspiratory resistive loads in a way that suggested it could be of clinical utility. © 2011 Blackwell Publishing Ltd. Source


Marshall H.,The Prince Charles Hospital | Jones S.,The Royal Bournemouth Hospital | Williams A.,The Royal Bournemouth Hospital
Journal of Radiology Case Reports | Year: 2010

We describe a case of chronic pulmonary aspergillosis complicated with a slowly growing aspergilloma followed for two decades without specific intervention. It developed with no background of local or systemic immune dysfunction in a middle aged female. The case illustrates many features of this disease as well as uniquely documenting the natural radiological evolution from a small non-specific cystic lesion to a massive aspergilloma. The aspergilloma subsequently autolysed and the patient's condition changed to an allergic phenotype with development of widespread bronchiectasis and pulmonary fibrosis. We briefly discuss the range of disease aspergillus can cause in humans, its differential diagnosis and treatments. Source


Starks I.,Wrexham Maelor Hospital | Wainwright T.W.,The Royal Bournemouth Hospital | Wainwright T.W.,Bournemouth University | Lloyd J.,The Royal Bournemouth Hospital | And 2 more authors.
Age and Ageing | Year: 2014

Background: Between August 2007 and May 2009, 2128 consecutive patients underwent either primary hip or knee joint replacement surgery at our institute on an enhanced recovery pathway. We aimed to investigate the potential benefits of this pathway in patients over the age of 85 years. Methods: Data extracted from Hospital Episode Statistics were analysed. This data are prospectively collected and independently collated. Results: In all patients median length of stay was reduced when compared with both our own data before the introduction of the pathway (6 to 4 days) and national averages over the same time period for both hip and knee replacements (5 to 4 days). Difference in length of stay was most pronounced in the group of patients aged 85 years and over (9 to 5 days for total hip replacement and 8 to 5 days for total knee replacement). Nearly all patients were discharged directly home (97.4%). Readmission rates were over 45% lower in patients aged 85 and over when compared with national averages (5.2 vs. 9.4%). Conclusions: This is the first series in the literature to assess the role of enhanced recovery pathways in the very elderly. This study not only shows that successful fast track rehabilitation can be achieved in the very elderly population undergoing elective joint replacement surgery, but that it is this cohort of vulnerable patients who have the most to gain from such multidisciplinary recovery programmes. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. Source


Mathieu S.,The Royal Bournemouth Hospital | Craig G.,Consultant in Critical Care and Anaesthesia
Journal of the Intensive Care Society | Year: 2011

Levosimendan is a drug which increases the sensitivity of the heart to calcium and which opens potassium channels, resulting in inodilation. Clinical trial data from patients suffering from heart failure have demonstrated that it improves haemodynamics without increasing intra-cellular calcium or oxygen consumption. However, there is no consistent evidence of mortality reduction. This narrative review summarises the key trials of its use in acute heart failure, acute coronary syndrome, cardiogenic shock and septic shock.© The Intensive Care Society 2011. Source

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