North Staffordshire Hospital Research Articles

Randomized controlled trial of the management of premenstrual syndrome and premenstrual mastalgia using luteal phase–only danazol

Objective: Our goal was to evaluate the efficacy and side effects of danazol 200 mg daily given only in the luteal phase of the menstrual cycle to treat premenstrual syndrome and premenstrual mastalgia. Study Design: We conducted a randomized, double-blind, placebo-controlled study of 3 menstrual cycles in a postgraduate medical school and National Health Service hospital. The subjects of the study were 100 women who had been referred to the premenstrual syndrome clinic at the North Staffordshire Hospital for the management of premenstrual syndrome and premenstrual breast pain. Outcome measures for the study included assessment of improvement in symptoms measured by specific daily visual analogue scales for 4 principal symptoms of premenstrual syndrome and for premenstrual mastalgia and assessment of side effects and adverse events. Results: Significant improvement in symptoms was seen in visual analog scores for mastalgia in months 1 ( P = .03), 2 ( P = .004), and 3 ( P = .01) of the study during active therapy compared with placebo. No improvement was seen for any other symptom or for the global premenstrual syndrome score. Side effects on danazol and on placebo were equal and minimal. Conclusions: Luteal phase–only danazol is not effective for the treatment of the general symptoms of premenstrual syndrome but appears highly effective for the relief of premenstrual mastalgia. This approach to therapy is associated with few side effects. Studies of cyclic mastalgia using strict diagnostic criteria are required to see whether the freedom from symptomatic side effects is found in longer-term studies and to determine whether such a regimen avoids potentially detrimental effects on the lipid status. (Am J Obstet Gynecol 1999;180:18-23.)

Improvement in patient compliance with long-term oxygen therapy following formal assessment with training

In the Department of Respiratory Medicine, North Staffordshire Hospital, patients fulfilling the Department of Health criteria for long-term oxygen therapy (LTOT) attend a practical teaching session on the use of their oxygen concentrator before commencing therapy. In the present study, we have audited the prescribing of LTOT in all patients in three health districts in the North West Midlands reviewed between June 1992 and July 1994. They were split into two groups. The first had the assessment and training programme in the department. Patients in the control group had been prescribed LTOT from outside the department without any formal training. In both groups of patients information was collated 6 months after starting LTOT by means of a questionnaire assessing patients', understanding of both their need for oxygen and their disease process, the dangers of oxygen therapy and present smoking habit. Objective information about the usage of each concentrator was obtained from engineer reports. Thirty-six patients (eight from the trained group and 28 controls) died before evaluation at 6 months. Forty-five patients (29 male, mean age 71 years) received training and 41 control patients (24 male, mean age 72 years) were evaluated. Thirty-seven (82%) patients who had received formal training were using their concentrator for greater than 15 h compared with only 18 (44%) of the controls ( P=0·0002). Forty-two (93%) patients who had received training understood why they were using LTOT compared with only 17 (41%) in the control group ( P=0·00001). Although both groups had a similar understanding of the dangers of smoking while on oxygen therapy, six (15%) of the control group were smoking as compared to only one (2%) of the trained group ( P=0·038). One of the control patients had received significant facial burns as a direct result of smoking while on oxygen. Further efforts are required to ensure that all patients prescribed LTOT should have a formal respiratory assessment as well as training to improve compliance and to obtain maximal benefits from such therapy.

Training event initiative, North Staffordshire Hospital Trust—Neuroscience Directorate

Training event initiative, North Staffordshire Hospital Trust—Neuroscience Directorate

How effective are we in the diagnosis of ectopic pregnancy? an 18-week clinical audit : Tiwari P.; Hughes M.; Kennedy H.; Egginton J.A. Department of Radiology, City General, North Staffordshire Hospital, Stoke-on-Trent, ST46QG, UK

How effective are we in the diagnosis of ectopic pregnancy? an 18-week clinical audit : Tiwari P.; Hughes M.; Kennedy H.; Egginton J.A. Department of Radiology, City General, North Staffordshire Hospital, Stoke-on-Trent, ST46QG, UK

Role of the general surgeon in a British trauma centre

A prospective audit of trauma patients seen or treated by the Department of General Surgery at the North Staffordshire Hospital Trauma Centre has been carried out, examining both the effect of a newly established trauma centre on overall workload and the outcome of patients admitted with severe injury. Trauma comprised approximately 2 per cent of the overall general surgical emergency workload. General surgeons were involved in the assessment of 25 per cent of severely injured patients but overall operated on fewer than 10 per cent of patients in this group. No patient died during the study period as a consequence of missed or inadequately treated intra-abdominal injury. These data suggest that there is insufficient work to justify specialist general surgical trauma surgeons in the UK. When general surgical intervention is required, however, it is usually vital and potentially life-saving.

Covert video surveillance--an assessment of the Staffordshire protocol.

An assessment of a protocol devised to guide practitioners thinking of using covert video surveillance. Such surveillance is particularly used to help identify cases of Munchausen's syndrome by proxy. The protocol in question has been written by staff at the Academic Department of Paediatrics, North Staffordshire Hospital, Stoke-on-Trent in association with their local Area Child Protection Committee and has been commended by the Department of Health to others wishing to implement covert video surveillance.

UK - composite membranes for glucose and hydrogen peroxide perm-selectivity: In ANALYST (121/4 (521–526) 1996) Y. Benmakroha, I. Christie, M. Desai & P. Vadgama of North Staffordshire Hospital Centre report on ‘Poly(vinyl chloride), polysulfone and sulfonated polyether-ether sulfone composite membranes for glucose and hydrogen peroxide perm-selectivity in amperometric biosensors’

UK - composite membranes for glucose and hydrogen peroxide perm-selectivity: In ANALYST (121/4 (521–526) 1996) Y. Benmakroha, I. Christie, M. Desai & P. Vadgama of North Staffordshire Hospital Centre report on ‘Poly(vinyl chloride), polysulfone and sulfonated polyether-ether sulfone composite membranes for glucose and hydrogen peroxide perm-selectivity in amperometric biosensors’

Eruptive acanthomas following sunburn

Journal Article Eruptive acanthomas following sunburn D.A. Fitzgerald, D.A. Fitzgerald Department of Dermatology, North Staffordshire Hospital, Hartshill. Stroke‐on‐Trent ST4 7PA, U.K. Search for other works by this author on: Oxford Academic Google Scholar M. Stephens, M. Stephens Department of Histopathology, North Staffordshire Hospital, Hartshill. Stroke‐on‐Trent ST4 7PA, U.K. Search for other works by this author on: Oxford Academic Google Scholar J.S.C. English J.S.C. English Department of Dermatology, North Staffordshire Hospital, Hartshill. Stroke‐on‐Trent ST4 7PA, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 133, Issue 3, 1 September 1995, Pages 493–494, https://doi.org/10.1111/j.1365-2133.1995.tb02690.x Published: 01 September 1995

A piecemeal impact

Siege Doctors shows a group of NHS doctors and nurses taking time out from their paid jobs in the comfortable NHS to do holiday work in Sarajevo. In five 50 minute parts it follows a £1.8 million operation funded by the Overseas Development Administration and set up by Tony Redmond, a consultant at North Stafford-shire Hospital and professor of emergency and disaster medicine at Keele. Professor Redmond is a veteran of Lockerbie and the Armenia earthquake and also supervised “Operation Irma.” All of these would have made better television than Siege Doctors. Only the first episode was available for preview. It does a good job of putting you in the shoes of the medical team—imbuing you with their feelings of trepidation as they are …

Worldwide Survey of Assisted Vaginal Delivery

Academic Department of Obstetrics and Gynaecology, Keele University, North Staffordshire Hospital, Stoke-on-Trent, United Kingdom. Int J Gynecol Obstet 1994;47:109-114

A multivariate analysis of factors related to the mortality of blunt trauma admissions to the North Staffordshire Hospital Centre.

To identify characteristics of blunt trauma admissions associated with mortality and to derive a linear logistic model for predicting the probability of mortality. A prospective observational study. Data were collected on blunt trauma patients admitted via the Accident and Emergency Department, North Staffordshire Hospital Centre. Univariate and multivariate analyses were performed of potential risk factors associated with mortality. The main outcome variable was survival or death occurring in hospital within 30 days of admission. Injury Severity Score, age, Revised Trauma Score, and place of injury (road traffic, home, or elsewhere) were independently related to mortality. The effect of age on mortality was best described using three categories: 0-64 excluding 15-24, 15-24, 65+. The survival probability model suggests that a person whose injury occurs in the home has a lower probability of survival than a patient with similar age and trauma scores who is involved in a road traffic accident. A model validation check indicated good agreement between model predictions and patient outcomes. The authors propose that use of this model may provide a more accurate evaluation of the mortality of British trauma admissions than would be obtained using models based on data from American trauma cases.

Secrecy in the NHS.

Seven years ago we collected 20 examples of secrecy surrounding health and the NHS in Britain.1 This month we repeated the exercise, and in three days we have discovered 30 examples. We will be pleased to hear of more. (1) Paragraph 330 of the Terms and Conditions of Service for Hospital Medical and Dental Staff says that “A practitioner shall be free, without prior consent of the employing authority, to publish books, articles, etc, and to deliver any lecture or speak, whether on matters arising out of his or her hospital service or not.” A growing number of trust hospitals have contracts which have replaced this with a gagging clause. The BMA's database records the following trusts as having at some time inserted a confidentiality or conflict of interest clause, or both, into contracts: Frimley Park Hospital; Walsgrave Hospital; St Helens and Knowsley Community Health; Mid Staffordshire General Hospitals; North Staffordshire Hospital Centre; Leicester Royal Infirmary; Royal Devon and Exeter Hospital; Ashford Hospital, Middlesex; and Heatherwood and Wexham Park Hospitals. For example, a recent confidentiality clause from a contract given to a consultant working for West Kent Health Authority reads: “In the course of your work you may have access to confidential information which should not be disclosed to any other person unless in the pursuit of your duties or with the specific permission of the employing authority.” Hansard reports that in March 1994, Dawn Primarolo (then opposition spokesperson for health) asked the secretary of state for health “what freedom NHS trusts have to vary the terms and conditions for service for hospital medical and dental staff in relation to the freedom of practitioners to publish articles or to speak on any issue without the prior consent of their employer.” The health minister, Brian Mawhinney, replied in a written …

A comparison of pulse oximetry and near infrared spectroscopy (NIRS) in the detection of hypoxaemia associated with apnoea: S.L. Watkin a, S.A. Spencer a, Y.A.B.A. Wickramasinghe b, P. Rolfe b, aAcademic Department of Paediatrics, bDepartment of Biomedical Engineering, North Staffordshire Hospital, Stoke-on-Trent, UK

A comparison of pulse oximetry and near infrared spectroscopy (NIRS) in the detection of hypoxaemia associated with apnoea: S.L. Watkin a, S.A. Spencer a, Y.A.B.A. Wickramasinghe b, P. Rolfe b, aAcademic Department of Paediatrics, bDepartment of Biomedical Engineering, North Staffordshire Hospital, Stoke-on-Trent, UK

Long chain polyunsaturated fatty acid (LCP) absorption in preterm infants: C. Morgan a, J. Stammers b, J. Colley b, S.A. Spencer a, D. Hull b, aAcademic Department of Paediatrics, North Staffordshire Hospital, University of Keele, Stoke-on-Trent and bDepartment of Child Health, University Hospital, Nottingham, UK

Long chain polyunsaturated fatty acid (LCP) absorption in preterm infants: C. Morgan a, J. Stammers b, J. Colley b, S.A. Spencer a, D. Hull b, aAcademic Department of Paediatrics, North Staffordshire Hospital, University of Keele, Stoke-on-Trent and bDepartment of Child Health, University Hospital, Nottingham, UK

Failure of laparoscopic uterine suspension to provide a lasting cure for uterovaginal prolapse.

BJOG: An International Journal of Obstetrics & GynaecologyVolume 101, Issue 8 p. 707-708 Failure of laparoscopic uterine suspension to provide a lasting cure for uterovaginal prolapse P. M. S. O'Brient, Corresponding Author P. M. S. O'Brient Professor Academic Department of Obstetrics and Gynaecology, Keele University School of Postgraduate Medicine, North Staffordshire Hospital Trust, Stoke-on-TrentProfessor P. M. S. O'Brien, Academic Department of Obstetrics and Gynaecology, Keele University School of Postgraduate Medicine, North Staffordshire Hospital Trust, Hilton Road, Stoke-on-Trent ST4 6SD, UK.Search for more papers by this authorJ. Ibrahim, J. Ibrahim Staff Grade Academic Department of Obstetrics and Gynaecology, Keele University School of Postgraduate Medicine, North Staffordshire Hospital Trust, Stoke-on-TrentSearch for more papers by this author P. M. S. O'Brient, Corresponding Author P. M. S. O'Brient Professor Academic Department of Obstetrics and Gynaecology, Keele University School of Postgraduate Medicine, North Staffordshire Hospital Trust, Stoke-on-TrentProfessor P. M. S. O'Brien, Academic Department of Obstetrics and Gynaecology, Keele University School of Postgraduate Medicine, North Staffordshire Hospital Trust, Hilton Road, Stoke-on-Trent ST4 6SD, UK.Search for more papers by this authorJ. Ibrahim, J. Ibrahim Staff Grade Academic Department of Obstetrics and Gynaecology, Keele University School of Postgraduate Medicine, North Staffordshire Hospital Trust, Stoke-on-TrentSearch for more papers by this author First published: August 1994 https://doi.org/10.1111/j.1471-0528.1994.tb13189.xCitations: 37Read 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 Volume101, Issue8August 1994Pages 707-708 RelatedInformation

Long chain polyunsaturated fatty acid (LCP) absorption in term infants : C. Morgan a, F. Corcoran a, L. Davies a, J. Stammers c, J. Colley c, S.A. Spencer b, D. Hull c, a,bAcademic Dept. Paediatrics, North Staffordshire Hospital, University of Keele, Stoke-on-Trent, UK, cDept. Child Health, University Hospital, Nottingham, UK

Long chain polyunsaturated fatty acid (LCP) absorption in term infants : C. Morgan a, F. Corcoran a, L. Davies a, J. Stammers c, J. Colley c, S.A. Spencer b, D. Hull c, a,bAcademic Dept. Paediatrics, North Staffordshire Hospital, University of Keele, Stoke-on-Trent, UK, cDept. Child Health, University Hospital, Nottingham, UK

Temporal relationship between apnoea and desaturation in preterm infants : S.L. Watkin a; S.A. Spencer a; A. Pryce b and D. Southall aaAcademic Department of Paediatrics, North Staffordshire Hospital and bDepartment of Mathematics, University of Keele, Stoke on Trent, UK

To obtain normal data on arterial oxygen saturation as measured by pulse oximetry (Spo2; Nellcor N200), we obtained 12-hour tape recordings of Spo2, photoplethysmographic waveforms, instantaneous pulse rate, and observations of breathing movements on 55 preterm neonates (25 girls) who had been admitted to one of four special care baby units but had no signs of respiratory distress and were breathing room air at 24 hours of age. Their median gestational age at birth was 35 weeks (range, 30 to 36), and their median age at the time of study 1 day (range, 1 to 7). Median baseline Spo2, measured only during regular breathing, was 99.4% (range, 90.7 to 100; 5th percentile, 95.5). Ten recordings (18%) contained a total of 83 episodes of desaturation (defined as a fall in Spo2 to ≤80% for ≥4 seconds). The 95th percentile for desaturation frequency was eight per recording. One infant had 55 episodes of desaturation and thus accounted for two thirds of all episodes observed. Only one of the episodes of desaturation in this infant, and none of those in the other nine infants, had been noted clinically, nor had the abnormally low baseline Spo2 (90.7%) in one infant. Baseline Spo2 in these nondistressed preterm neonates was higher than might be expected, given the Spo2 levels currently recommended for preterm infants with respiratory failure. A minority of infants, however, had a low baseline Spo2 or a high frequency of episodes of desaturation, the potential effects of which remain to be determined.

Insulin sensitivity in women with polycystic ovary syndrome: relationship to hyperandrogenemia

To evaluate the extent of decreased insulin sensitivity in relation to body mass index and its relationship to serum androgens in women with polycystic ovarian syndrome (PCOS). Comparative study of endogenous glucose disposal and serum insulin responses to oral glucose load with endocrine parameters in PCOS. Fertility and Endocrine Clinics, North Staffordshire Hospital Centre. Forty-nine obese and 16 nonobese women with PCOS were compared with 18 obese and 16 nonobese control women with regular ovulatory cycles and no features of PCOS. Basal concentrations of serum LH, FSH, T, androstenedione, sex hormone-binding globulin (SHBG), and free T index. Measurements of insulin sensitivity by rate of endogenous glucose disposal after i.v. bolus injection of insulin and glucose mediated insulin responses. Obese women with PCOS showed decreased insulin sensitivity and hyperinsulinemia to an extent greater than can be explained by obesity alone. Serum insulin showed inverse correlation with SHBG, and therefore hyperinsulinemia increased the bioavailability of androgens in obese PCOS. In nonobese PCOS, this method of assessment failed to reveal insulin resistance. Hyperandrogenemia and insulin resistance are independent features of PCOS. Hyperinsulinemia enhances expression of hyperandrogenemia by increasing bioavailability of androgens.

Rotation of the laryngeal mask airway

AnaesthesiaVolume 49, Issue 2 p. 169-169 Free Access Rotation of the laryngeal mask airway B. O'Connor, B. O'Connor North Staffordshire Hospital, Stoke-on-Trent, STB 6QGSearch for more papers by this author B. O'Connor, B. O'Connor North Staffordshire Hospital, Stoke-on-Trent, STB 6QGSearch for more papers by this author First published: February 1994 https://doi.org/10.1111/j.1365-2044.1994.tb03383.xAboutPDF 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 Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume49, Issue2February 1994Pages 169-169 ReferencesRelatedInformation

A trauma center for the United Kingdom

In July 1991, a pilot trauma center was established in the United Kingdom as part of a government-funded evaluation of trauma services. The North Staffordshire Hospital is at the center of a trauma system that serves 2 million people. This system involves the five surrounding hospitals and the ambulance service. Key developments have been the provision of a consultant trauma team leader in the center 24 hours a day, closer networking of all the hospitals, and an expansion of the paramedic training program. Two comparator sites have been identified and are also being studied. The results of this three-year experiment are being evaluated independently and by the trauma research group of Keele University. Whatever the outcome, the project will have a significant influence on the future development of trauma care in the United Kingdom.