Essex Hospital Research Articles

Ethnic differences in the number of miscarriages, number of children, perceived family support and the impact of the disease on daily living in patients with systemic lupus erythematosus

Our aim was to test for ethnic differences in the number of children, number of miscarriages, family support and the impact of the disease on daily living among patients with systemic lupus erythematosus (SLE). Patients with SLE (n = 54) who attended two hospitals in Essex, UK, were asked to complete a semi-structured, validated questionnaire. The number of children and the number of miscarriages were reported numerically. The level of family support and the impact of the disease on daily living were reported using 10 cm visual analogue scales (VAS) in which 10 cm represented the maximum support and worst effect on daily living, respectively. There were 20 Caucasian, 22 Asian and 12 African/Afro-Caribbean patients. There were 50 females and four males. The mean ± standard deviation (SD) age was 45.9 ± 12.2 years, and the mean ± SD age at disease onset was 35.6 ± 11.1 years. Overall, 34/50 female patients (68 %) reported having children of their own, while 17/50 female patients (34 %) reported one or more miscarriages. The miscarriages were mostly reported by Caucasian patients (45 % versus 18.1 % for Asian and 33.3 % for African/Afro-Caribbean patients; P < 0.05). All of the groups received support from their families (90.7 % overall), but the level of support was greater for Caucasian (mean ± SD VAS, 6.6 ± 3.4 cm) than for Asian (5.4 ± 3.9 cm) and African/Afro-Caribbean (5.4 ± 4.9 cm) patients (P = 0.06). More than half of the patients (53.7 %) reported a severe impact of SLE on daily living, while 13 % reported a moderate impact, 22.2 % reported a mild impact and 11.1 % reported no impact. The impact of SLE on daily living was significantly worse for African/Afro-Caribbean patients compared with Asian patients (P < 0.05). Overall, one in two patients with SLE reported having children of their own, while one in three patients reported having at least one miscarriage. Ninety percent of the patients received family support for their disease. Miscarriages and family support were more frequently reported by Caucasian patients. Asian patients had more children and experienced fewer miscarriages, while African/Afro-Caribbean patients reported a worse impact of the disease on daily living compared with the other ethnic groups.

Arthur Wynn Tremenheere McDowall

After studying medicine in Scotland, Arthur Wynn Tremenheere McDowall moved to England to start his psychiatric training at Runwell Hospital in Essex. He did his higher training in psychiatry at...

PMO-221 Appropriateness of follow-up indications after colonic polyp removal: audit of current practice in a district general hospital

IntroductionDemand for colonoscopy is increasing worldwide due to the implementation of colon cancer screening programmes. According to current guidelines, the indication and timing for surveillance colonoscopy after removal of colonic...

MRSA contaminated venepuncture tourniquets in clinical practice

IntroductionMeticillin-resistant Staphylococcus aureus (MRSA) hospital-acquired infection is associated with increased patient mortality. National guidelines state that shared patient equipment must be cleaned after use. The authors sought to identify MRSA...

A&amp;E Attendances – X-rays not required: Jason Boutwell v Mid Essex Hospital Services NHST Trust (Central London County Court, 8/9/2011 – Judge Dight)

A&amp;E Attendances – X-rays not required: <i>Jason Boutwell v Mid Essex Hospital Services NHST Trust</i> (Central London County Court, 8/9/2011 – Judge Dight)

P-391 - Audit of mid essex old age liaison psychiatry consultation service

Introduction • One in four people who attend hospital for physical health needs will have a mental health problem. The figures for patients over the age of 65 are significantly higher with 60% requiring mental health care during their hospital stay. (No Health without Mental Health, Academy of Medical Royal Colleges 2009). • Psychiatric co-morbidity affecting older people admitted to general hospitals is an independent predictor of poor outcome, including, increased mortality, length of stay, loss of independent function and discharge to care homes (Royal College of Psychiatrists, 2005). Objectives • To evaluate the quality of delivery of inpatient liaison psychiatry service to Mid Essex Hospitals. Aims • To examine the referral pattern and reasons for referral. • To assess the timeliness of response and the effect of the consultation on the duration of stay. • To introduce measures to ensure better practice in the future. Methods • All referrals to Old Age liaison psychiatry consultation service from August 2010 to February 2011 were identified from the computer database. • 50 patients were randomly selected and their medical and psychiatric notes were analysed. • information ‘s including Patient demographics, referring team, medical reason for admission, duration of stay, referral reason, clinical diagnosis, medical comorbidities, Psychiatric comorbidities and management by the liaison psychiatry team were collected using an audit tool. Results • The results have been collected and is currently being statistically analysed. They would available in the next few weeks.

Stress as a trigger of disease flares in SLE

Patients with systemic lupus erythematosus were asked to report their perceptions as to whether stress can trigger disease flares. A total of 54 patients treated at two District General Hospitals in Essex were included in the analysis. They were 4 males and 50 females and were 20 Caucasians, 22 Asians, and 12 Africans/Afro-Caribbean. Thirty-three of 54 patients (61.1%) reported stress to be a trigger for disease flares. Although most (85%) of the Caucasian patients reported that stress triggered their disease flares, only 50% of the African/Afro-Caribbean patients and 45.4% of the Asian patients reported stress as a trigger for disease flares. No correlation was found between reported number of flares per year and characteristics such as age (P = 0.4), age at diagnosis (P = 0.8), age at disease onset (P = 0.6), or disease duration (P = 0.2). A trend towards a significant correlation was observed between the number of reported flares per year and the number of children a patient has (P = 0.07).

Face to face.

Vicki Leah qualified as a nurse in 1985. She has worked in a number of clinical leadership roles in acute care. Last year Vicki took up her post as nurse consultant - older people at Broomfield Hospital, part of Mid Essex Hospital Services NHS Trust, where she leads a multidisciplinary elderly assessment team which aims to improve the experience of older people in the hospital's emergency department and medical assessment unit. She spoke to Ruth Williams.

Why green means clean.

NURSING STAFF at Mid Essex Hospital Services NHS Trust have devised a new way to symbolise their commitment to preventing hospital-acquired infections.

The president of the Royal College of Surgeons of England

Bernie Ribeiro qualified in medicine at the University of London in 1967, and after house jobs in the Middlesex Hospital and St Alban9s he trained as a surgical registrar at Orsett General Hospital in Essex. He was elected as president of the Royal College of Surgeons in May 2005 and took office in July 2005. He retains clinical commitments as consultant general surgeon at Basildon and Thurrock General Hospital

Deep-vein thrombosis in two district hospitals in Essex.

Abstract Two groups, each of 50 patients over the age of 40 years, underwent elective operation at two district general hospitals in Essex. The incidences of calfvein thrombosis on routine 125I-fibrinogen scans after operation were 16 and 18 per cent respectively. The incidence in comparable samples of patients from three metropolitan teaching hospitals was about 33 per cent.

Kernicterus: Past, Present, and Future

The concept of a relationship between severe neonatal hyperbilirubinemia and kernicterus evolved slowly. Jaundice was recognized in ancient as well as biblical times as a manifestation of disease. However, according to Louis K. Diamond (Fig. 1), who reviewed the history of neonatal jaundice, (1) the first record concerning jaundice of the newborn appears to be by Barthomomaeus Metlinger in 1473 in his book Ein Regiment der Jungen Kinder . The occurrence of jaundice shortly after birth as well as some suggestions for homeopathic treatment were mentioned by Michael Ettmuller in his 1708 treatise “De Infantum Morbis.” (1) An early description of icterus neonatorum was published in 1742 in London by John Burton in his treatise “A Full View of All the Diseases Incident to Children.” He suggested that “jaundice generally yields to any gentle purgative.” (1) This same approach was used by Condie in 1853 in Philadelphia. (2) At that time, he wrote that icterus neonatorum seemed to be “connected with the want of a free evacuation of meconium.” He suggested the use of castor oil or a small measure of calomel or rhubarb. It is interesting that he noted that the jaundice was known at times to be accompanied by a “good deal of drowsiness.” There were several publications in France concerning neonatal jaundice in the late eighteenth and early nineteenth centuries, the most significant of which, according to Thor Hansen, (3) was the thesis submitted by Jacques Francois Hervieux and defended by him for his M.D. degree at the University of Paris in 1847. The thesis was entitled “De l’ictere des nouveau-nes” (On the jaundice of newborns). Thor Hansen, to whom we are grateful for having reviewed the original French thesis, pointed out that the introductory section of the Hervieux thesis contains a valuable review of works by …

The development of gravity models for hospital patient flows under system change: a Bayesian modelling approach.

This paper discusses models for the impact on patient referral flows from homes to hospitals of reconfigurations of emergency hospital services. Such system change might involve new hospital sites, or expanded bed numbers at some sites, together with possible closure of emergency units at other hospitals. In terms of a gravity model for the flows of patients, this corresponds to removing a destination or adding a new one. While retaining a gravity type approach to this problem, the relevance of supply weighting by distance within the broader accessibility concept is stressed since the independence from irrelevant alternatives property is generally inapplicable. This accessibility based approach may be implemented as a general linear model, with a Poisson outcome, and a Bayesian estimation and predictive approach is adopted. In the context of patient hospitalisations, this facilitates prediction of new patient flows following hospital reconfiguration. A UK based case study of small residential areas and hospitals in North East London and Essex is presented within the context of a review of emergency hospital siting in London.

Recent Developments in the Management of Neonatal Hyperbilirubinemia

After completing this article, readers should be able to: 1. Describe the morbidity associated with exchange transfusion used to treat neonatal hyperbilirubinemia. 2. Explain how phototherapy affects bilirubin. 3. Describe potential toxicities of phototherapy. 4. Explain the role of carboxyhemoglobin in hemolysis. 5. Delineate the guidelines for administering intravenous immunoglobulin to healthy ABO-incompatible Coombs-positive neonates. 6. Describe the action of protoporphyrins on bilirubin. Recent clinical trends toward early discharge coupled with a new, more relaxed, “kinder, gentler approach” to the treatment of newborn hyperbilirubinemia have thrust concerns about bilirubin-related toxicity once again to the forefront of neonatologists’ consciousness. In recent years we even have witnessed a resurgence of kernicterus, which had been rendered almost nonexistent in the 1970s and 1980s. Although exchange transfusion is the oldest and most effective method of treating hyperbilirubinemia, mortality associated with this therapy has been reported to be between 0.3% and 1.2% in healthy infants and as high as 10% to 25% in sicker preterm infants. Furthermore, potential morbidity related to exchange transfusion remains significant and includes anemia, apnea, bradycardia, hypothermia, sepsis, necrotizing enterocolitis, thromboembolic phenomena, graft versus host disease, transient metabolic abnormalities, and thrombocytopenia. Accordingly, it behooves us to re-evaluate other therapeutic modalities for hyperbilirubinemia that may be equally efficacious but less invasive. Ever since the 1950s, when Sister Ward of Rochford General Hospital in Essex noted that a jaundiced baby’s skin had “faded” in natural sunlight, physicians have been searching for artificial light sources that might be used safely to treat neonatal hyperbilirubinemia. Phototherapy, which has become the standard of care, has had such a dramatic impact that a recent editorial raised the concern that exchange transfusions are becoming extinct and lamented the fact that future generations of house officers may not receive adequate training in this procedure. Under the effects of phototherapy light with maximal irradiance in the …

Blood transfusion first for Southend Hospital.

A hospital in Essex has become the first in the UK to offer patients a full range of autologous blood components.

Obituary.

Frances Fowler SRN, a founder member of the Royal College of Nursing, died on March 8 1992 at Chadwell Heath Hospital in Essex. Miss Fowler, who was 100 when she died, qualified at the Royal Gwent Hospital in 1916 at the age of 25.

Nurse is suing for burns compensation.

A nurse who claims she suffered injury as a result of chemical exposure at Basildon and Orsett Hospitals in Essex is suing for compensation.

Advances in Non-Invasive Nephrology. Proceedings of the International Congress of Non-Invasive Diagnosis of Kidney Disease

Journal Article Advances in Non-Invasive Nephrology. Proceedings of the International Congress of Non-Invasive Diagnosis of Kidney Disease Get access Advances in Non-Invasive Nephrology. Proceedings of the International Congress of Non-Invasive Diagnosis of Kidney Disease, held in Vienna. September 1983, edited by Gert Lubec and Vito Campese. Pp. xi + 300, illustrated. John Libbey, London, Paris, 1985. £30, US$53, Ffr385. M J Weston M J Weston Chelmsford and Essex Hospital, London Road, Chelmsford, Essex CM2 OQH Search for other works by this author on: Oxford Academic Google Scholar Postgraduate Medical Journal, Volume 63, Issue 739, May 1987, Page 415, https://doi.org/10.1136/pgmj.63.739.415 Published: 01 May 1987

A Clinical Assessment of Bumetanide in Patients Not Responding to Other Diuretics

International Journal of Clinical PracticeVolume 28, Issue 9 p. 311-313 Clinical Trial A Clinical Assessment of Bumetanide in Patients Not Responding to Other Diuretics A. Pines MD, FRCPE, A. Pines MD, FRCPE East Herts Hospital, HertfordSearch for more papers by this authorK. S. Sreedharan MB, BS, K. S. Sreedharan MB, BS East Herts Hospital, HertfordSearch for more papers by this authorA. R. Nandi MB, BS, A. R. Nandi MB, BS Herts & Essex Hospital, Bishop's Stortford, HertsSearch for more papers by this authorB. T. Marsh MB, BS (HNRS.), D.OBST.RCOG, B. T. Marsh MB, BS (HNRS.), D.OBST.RCOG Leo Laboratories Limited, Hayes, MiddlesexSearch for more papers by this author A. Pines MD, FRCPE, A. Pines MD, FRCPE East Herts Hospital, HertfordSearch for more papers by this authorK. S. Sreedharan MB, BS, K. S. Sreedharan MB, BS East Herts Hospital, HertfordSearch for more papers by this authorA. R. Nandi MB, BS, A. R. Nandi MB, BS Herts & Essex Hospital, Bishop's Stortford, HertsSearch for more papers by this authorB. T. Marsh MB, BS (HNRS.), D.OBST.RCOG, B. T. Marsh MB, BS (HNRS.), D.OBST.RCOG Leo Laboratories Limited, Hayes, MiddlesexSearch for more papers by this author First published: 01 September 1974 https://doi.org/10.1111/j.1742-1241.1974.tb07318.xCitations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume28, Issue9September 1974Pages 311-313 RelatedInformation

Dietary intakes of geriatirc patients in hospital.

Individually weighed food intakes have been obtained over an 8-day period from 14 men (age range 63-91 years) 25 women (age range 61-94 years) resident in geriatric wards in an Essex hospital. Nutrient intakes have been computed from food composition tables vitamin C also by chemical analysis. Energy intakes were low compared with those obtained in other surveys, and were lowest for patients with the highest energy requirements as judged by activity. Average protein intakes were adequate and protein quality expressed as net dietary protein calories per cent was similar to that found in other hospitals, but maximum protein utilisation may have been limited by energy restriction. Fat-soluble vitamin intakes were generally low, as were intakes of most other nutrients considered. Low consumption of fortified cereals partially accounted for poor intakes of iron and nicotinic acid, while consumption of an average of 400 ml milk daily was largely responsible for satisfactory riboflavine and calcium intakes. Contrary to expectation, the long-term chronically ill patients who required the most nursing care and help with feeding had the highest intakes. Patients who were capable and therefore allowed to feed themselves made the poorest choice of food and consumed the least.