A5022176191- Atrial Fibrillation Management and Outcomes
- Acute Ischemic Stroke Management
- Neurosurgical Procedures and Complications
- Venous Thromboembolism Diagnosis and Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Retinal and Optic Conditions
- Hip and Femur Fractures
- Healthcare Quality and Management
- Cardiac Arrhythmias and Treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Drug-Induced Adverse Reactions
- COVID-19 and healthcare impacts
- Primary Care and Health Outcomes
- Cardiac Arrest and Resuscitation
- Frailty in Older Adults
- Potassium and Related Disorders
- Parkinson's Disease Mechanisms and Treatments
- Veterinary Orthopedics and Neurology
- Cerebral Venous Sinus Thrombosis
- Human-Animal Interaction Studies
- Autopsy Techniques and Outcomes
- Pharmaceutical Practices and Patient Outcomes
- Nursing Roles and Practices
- Healthcare Technology and Patient Monitoring
- COVID-19 and Mental Health
Glan Clwyd Hospital
2015-2025
Betsi Cadwaladr University Health Board
2012-2023
National Health Service Wales
2023
Airedale General Hospital
2022
University College London
2022
Whittington Hospital
2022
Wrexham Maelor Hospital
2000-2001
Withybush General Hospital
2000-2001
Chronic subdural haematoma (CSDH) is predominantly a disease of the elderly. Most existing data come from studies done several decades ago. We examined incidence, risk factors, clinical presentation, management and outcome in elderly patients with CSDH by retrospective study period 1996-1999 three district hospitals North Wales. 40 cases were identified >65 years, incidence this population being 8.2/100,000. Falls (57%) antithrombotic therapy (33%) most frequent factors. The common...
Whether infarct size modifies the treatment effect of early vs late direct oral anticoagulant (DOAC) initiation in people with ischemic stroke and atrial fibrillation is unknown.
Background: Chronic subdural haematoma (CSDH) is a condition predominantly affecting the elderly. We reported an incidence of 8.2 per 100 000 year in people above age 65 2002. Aim: Since recent studies have demonstrated higher incidence, we repeated our study to estimate current CSDH amongst North Wales. Design: used radiological reports identify patients with over 1-year period. Methods: collected data on demographics, clinical presentations, indications for brain imaging, drug history and...
Extracranial internal carotid artery stenosis accounts for 15–20% of ischaemic strokes and endarterectomy (CEA) is the most frequently performed surgical intervention in stroke prevention.1 The risk death associated with operation has been estimated at about 5.6% (95%CI 4.4–6.9).2 Neurological complications following CEA are usually nature, due to embolization or occlusion artery. However, a small subset patients, cerebral hyperperfusion reperfusion causes post-operative neurological...
Abstract Background Older adults undergoing emergency abdominal surgery have significantly poorer outcomes than younger adults. For those who survive, the level of care required on discharge from hospital is unknown and such information could guide decision-making. The ELF (Emergency Laparotomy Frailty) study aimed to determine whether preoperative frailty in older was associated with increased dependence at time discharge. Methods a UK-wide multicentre prospective cohort patients (65 years...
Both angiotensin converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs can lead to functional renal insufficiency. In an observational study we assessed the frequency of this adverse effect in patients aged over 75 years receiving these combination. one year, out 1500 whose records were screened, 12 prescribed 2 developed acute failure, whom died other recovered after discontinuation both drugs. 4 showed deterioration function, which returned normal was stopped. Renal...
<h3>Abstract</h3> During the COVID-19 pandemic, many healthcare staff and others who work for NHS have been working from home (WFH) or shielding due to various health conditions, including pregnancy. While emphasis has given support wellbeing of those at frontline, little is known about contribution are remotely. This online survey attempts throw some light on how these workers contributing while WFH, resources they may not undertake their remote duties, perception whether valued workplace,...
Importance The net clinical effect of early vs later direct oral anticoagulant (DOAC) initiation after atrial fibrillation–associated ischemic stroke is unclear. Objective To investigate whether DOAC treatment associated with a benefit (NCB). Design, Setting, and Participants This was post hoc analysis the Early Versus Late Initiation Direct Oral Anticoagulants in Post–Ischaemic Stroke Patients With Atrial Fibrillation (ELAN) open-label randomized trial conducted across 103 sites 15...
Background and Purpose Antiplatelets are often used before direct oral anticoagulant (DOACs) initiation after an acute ischemic stroke related to atrial fibrillation (AF), but the evidence is weak. Here, we explored risks benefits of this approach.Methods A post-hoc analysis ELAN (Early versus Late Initiation Direct Oral Anticoagulants in Post-ischemic Stroke Patients with Atrial Fibrillation) trial data (NCT03148457) was conducted compare risk recurrent stroke, systemic embolism, major...
Chronic subdural haematoma (CSDH) is predominantly a disease of the elderly. Most existing data come from studies done several decades ago. We examined incidence, risk factors, clinical presentation, management and outcome in elderly patients with CSDH by retrospective study period 1996–1999 three district hospitals North Wales. 40 cases were identified > 65 years, incidence this population being 8.2/100000. Falls (57%) antithrombotic therapy (33%) most frequent factors. The common...
Even though Lazarus phenomenon is rare, it probably under reported. There no doubt that a reality but so far the scientific explanations have been inadequate. So only plausible explanation at least in some cases auto-PEEP and impaired venous return. In patients with PEA or asystole, dynamic hyperinflation should considered as cause short period of apnoea (30–60 seconds) be tried before stopping resuscitation. Since ROSC occurred within 10 minutes most cases, passively monitored for after...
Most patients with atrial fibrillation should be considered for antithrombotic therapy. In a retrospective survey we investigated practice in two hospitals. For at high risk, established guidelines recommend warfarin, or aspirin if anticoagulants are contraindicated; those medium either may used. Of 156 (acute, chronic paroxysmal), 119 were mean age 79 years. According to the guidelines, 89 of these suitable anticoagulation but only 49 (55%) received warfarin; 27 and 13 neither. risk (mean...
Abstract Background Social media has changed the way surgeons communicate worldwide, particularly in dissemination of trial results. However, it is unclear if social could be used recruitment to surgical trials. This study aimed investigate influence Twitter promoting The Emergency Laparotomy and Frailty (ELF) Study. Methods ELF Study was a UK-based, prospective, observational cohort that assess frailty on 90-day mortality older adults undergoing emergency surgery. A power calculation...
Despite modern diagnostics, the discordance between ante-and postmortem diagnoses is still around 25%, reiterating need for high post-mortem rates.In our study, 3.5% had class I errors that, they been detected during life, would or might have affected short-term outcome.Another 14% major errors, conditions recorded as primary cause of death that were clinically missed unrecorded but not outcome.There has an unexplained decline in hospital post mortems and more than a third UK autopsies are...
A 64 year old man comes to your surgery five days after an episode of visual loss in his left eye, followed by right sided weakness and speech disturbance lasting 10 minutes. He has made a complete recovery driven himself the ask whether he can return work. ### General points ### Assessing symptoms Onset —Symptoms are sudden TIA, as acute stroke. Insidious onset symptoms is unlikely be TIA. Intensity — Symptoms TIA maximal at onset. Gradual progression would point different pathology,...
Abstract Introduction The burden of PD has exponentially risen from 2.5 million in 1990, to 6.1 2016 (PD Collaborators. Lancet Neurol. 2018; 17(11):939-53). This is due ageing population, increased longevity, duration the disease and improved diagnosis. aim our study was identify trend on deaths related Parkinsonism over last decade. Methods We collected data Office National Statistics, using codes G20 (PD), G21 (Secondary Parkinsonism) G22 (Parkinsonism classified elsewhere), extract number...
Background: a 63‐year‐old woman presented with an 18‐year history of tremor, rigidity and akinesia. There was no response to treatment either levodopa or pergolide. Later focal neurological deficit developed, which led diagnosis fronto‐parietal meningioma. Outcome: surgical excision the meningioma abolished parkinsonism. Conclusion: cerebral tumour is uncommon cause Symptoms probably occur due compression distortion basal ganglia nigrostriatal pathway. Diagnosis underlying pathology can be...
SUMMARY To discover whether general practitioners are correctly notified of a patient's final diagnosis following hospital discharge, an observational study was undertaken in district hospital. The compared with the documented discharge summary and take‐home prescription. Two hundred discharges were studied. Only 163 (81%) summaries 138 (69%) prescriptions had correct diagnosis; 24 (12%) did not have any at all. In some cases differed between prescriptions. 122 (61%) both instances....