Victoria Central Hospital

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist.

Investments in animal health and Veterinary Services can have a measurable impact on the health of people and the environment. These investments require a baseline metric that describes the burden of animal health and welfare in order to justify and prioritise resource allocation and from which to measure the impact of interventions. This paper is part of a process of scientific enquiry in which problems are identified and solutions sought in an inclusive way. It poses the broad question: what should a system to measure the animal disease burden on society look like and what value would it add? Moreover, it aims to do this in such a way as to be accessible by a wide audience, who are encouraged to engage in this debate. Given that farmed animals, including those raised by poor smallholders, are an economic entity, this system should be based on economic principles. These poor farmers are negatively impacted by disparities in animal health technology, which can be addressed through a mixture of supply-led and demand-driven interventions, reinforcing the relevance of targeted financial support from government and non-governmental organisations. The Global Burden of Animal Diseases (GBADs) Programme will glean existing data to measure animal health losses within carefully characterised production systems. Consistent and transparent attribution of animal health losses will enable meaningful comparisons of the animal disease burden to be made between diseases, production systems and countries, and will show how it is apportioned by people's socio-economic status and gender. The GBADs Programme will produce a cloud-based knowledge engine and data portal, through which users will access burden metrics and associated visualisations, support for decisionmaking in the form of future animal health scenarios, and the outputs of wider economic modelling. The vision of GBADs, strengthening the food system for the benefit of society and the environment, is an example of One Health thinking in action.

The majority of emerging infectious diseases are zoonoses, most of which are classified as "neglected". By affecting both humans and animals, zoonoses pose a dual burden. The disability-adjusted life year (DALY) metric quantifies human health burden since it combines mortality and morbidity. This review aims to describe and analyze the current state of evidence on neglected zoonotic diseases (NZDs) burden and start a discussion on the current understanding of the global burden of NZDs. We identified 26 priority NZDs through consulting three international repositories for national prioritization exercises. A systematic review of global and national burden of disease (BoD) studies was conducted using pre-selected databases. Data on diseases, location and DALYs were extracted for each eligible study. A total of 1887 records were screened, resulting in 74 eligible studies. The highest number of BoD was found for non-typhoidal salmonellosis (23), whereas no estimates were found for West Nile, Marburg and Lassa fever. Geographically, the highest number of studies was performed in the Netherlands (11), China (5) and Iran (4). The number of BoD retrieved mismatched the perceived importance in national prioritization exercises. For example, anthrax was considered a priority NZD in 65 countries; however, only one national study estimating BoD was retrieved. By summing the available global estimates, the selected NZDs caused at least 21 million DALYs per year, a similar order of magnitude to (but less than) the burden due to foodborne disease (included in the Foodborne Disease Burden Epidemiology Reference Group). The global burden of disease landscape of NZDs remains scattered. There are several priority NZDs for which no burden estimates exist, and the number of BoD studies does not reflect national disease priorities. To have complete and consistent estimates of the global burden of NZDs, these diseases should be integrated in larger global burden of disease initiatives.

Research Articles| October 02 2009 Subarachnoid Haemorrhage in the Elderly Subject Area: Geriatrics and Gerontology B.K. Ellenbogen B.K. Ellenbogen Geriatric Units at St. Catherine's Hospital Annexe, Birkenhead and Victoria Central Hospital, Wallasey Search for other works by this author on: This Site PubMed Google Scholar Gerontologia Clinica (1970) 12 (2): 115–120. https://doi.org/10.1159/000245269 Article history Published Online: October 02 2009 Content Tools Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation B.K. Ellenbogen; Subarachnoid Haemorrhage in the Elderly. Gerontologia Clinica 1 February 1970; 12 (2): 115–120. https://doi.org/10.1159/000245269 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsGerontologia Clinica Search Advanced Search Article PDF first page preview Close Modal This content is only available via PDF. 1970Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. You do not currently have access to this content.

The aim of this study was to determine the effectiveness of a school dental screening in encouraging school children aged 4 to 6 years to visit a dentist. One thousand five hundred and sixty-two children attending the 13 primary schools in Wallasey. Merseyside, were examined by a single trained examiner; those with urgent treatment needs or evidence of recent treatment were excluded. The remaining 528 children with signs of dental caries were entered into the study. Children within each school were stratified by age, sex and number of carious teeth and then allocated at random to test and control groups. Parents of children in the test group were advised by letter that their child would benefit from a more detailed clinical examination. A reply slip was attached to the letter and non-responders were carefully followed up. The control group received no such interventions. After 4 months, data on dental visits by both test and control group children were extracted from clinical records. Attendance data were obtained for 262 children (97 per cent) in the test group and 243 children (94 per cent) in the control group. Seventy-three per cent of the test group and 42 per cent of the control group visited the dentist over the review period; the difference of 31 per cent favour of the test group was statistically significant. Attendances at both general dental practitioners and community dental clinics were increased. The effect of the screening procedure was seen particularly in areas of lower socio-economic status.(ABSTRACT TRUNCATED AT 250 WORDS)

A prospective study of tropical pyomyositis (TP) in the Solomon Islands' Western Province followed 48 cases (mean age 10.6 years) from a population of 20,000 Melanesians over a two-year period. 32 patients were under 10 years and the male:female ratio was 1.7. Affected muscle was painful, swollen and often fluctuant but hard and indurated in presuppurative lesions. Abscesses, single in 40 and multiple in 8 subjects, were sited in the large muscles of the buttock, thigh, shoulder, arm and back on 52 occasions (90%). They contained 5-200 ml of pus which invariably grew penicillin-resistant Staphylococcus aureus sensitive to cloxacillin and erythromycin. All phage typable strains were identified as group 2 in contrast to the wider range of types found at carrier sites in otherwise healthy controls. TP was preceded by trauma in 30 cases (63%) and 26 (55%) of the patients had pre-existing pyoderma. Histological examination of clinically unaffected muscle biopsies from 10 subjects with solitary (7) or multiple (3) abscesses showed no abnormality. Serological evidence of previous infection with adenoviruses or myxoviruses was present in the same proportion (41-42%) of controls as of 22 patients tested. The results provide no evidence for antecedent diffuse myositis, viral or parasitic infections or nutritional deficiencies but support the role of trauma in localizing haematogenous skin staphylococci into damaged muscle.

The Liverpool Primary Care Mental Health Project (PCMHP) was set up in 1996 to provide mental health services in a primary care setting. This study describes and evaluates an impact of a working model of a multi-disciplinary team in close association with five Liverpool practices. The data were collected on all patients who came in contact with the PCMHP team during a three-year period and compared with the data available for the five neighboring teams on waiting time between referral and assessment, clinical outcome, in-patient bed usage, GPs' and patients' satisfaction with services. The number of new referrals remained the same over three years. The usage of inpatient beds dropped by 38% in the same period. Waiting time between referral and assessment for new patients reduced from six weeks to one-two weeks. GP's were highly satisfied with access to CMH Nurses, overall communication with the team and overall delivery of the services. Over 80% of patients were satisfied with the services. Integrated mental health services with primary care proved to be effective and satisfactory to GPs as well as to patients. This approach did not increase the workload of the mental health team.

Bacterial antimicrobial resistance (AMR) is among the leading global health challenges of the century. Animals and their products are known contributors to the human AMR burden, but the extent of this contribution is not clear. This systematic literature review aimed to identify studies investigating the direct impact of animal sources, defined as livestock, aquaculture, pets, and animal-based food, on human AMR. We searched four scientific databases and identified 31 relevant publications, including 12 risk assessments, 16 source attribution studies, and three other studies. Most studies were published between 2012 and 2022, and most came from Europe and North America, but we also identified five articles from South and South-East Asia. The studies differed in their methodologies, conceptual approaches (bottom-up, top-down, and complex), definitions of the AMR hazard and outcome, the number and type of sources they addressed, and the outcome measures they reported. The most frequently addressed animal source was chicken, followed by cattle and pigs. Most studies investigated bacteria-resistance combinations. Overall, studies on the direct contribution of animal sources of AMR are rare but increasing. More recent publications tailor their methodologies increasingly towards the AMR hazard as a whole, providing grounds for future research to build on.

A survey was used to investigate injuries in dogs competing in flyball. Complete surveys were obtained from 272 respondents with 589 dogs. In the past year, 23.3% of dogs were injured, with 34.1% injured during their career to date. Common injury sites were paws/digits, back, shoulder, and iliopsoas muscle/groin. Injury in previous years, modified by weight:height ratio, was a significant risk factor for injury. Dogs > 2 y of age had increased risk of injury, as did dogs with best times < 4.0 s. Canadian dogs had increased risk of injury (30.7% injured) compared to United States dogs (20.1% injured). This relationship was modified by participation in other sports, which generally reduced risk of injury in Canadian dogs. Further investigation of risk factors should include differences in training and competition between the United States and Canada, as well as injury prevention strategies.

Journal Article Systemic absorption from high-pressure spray-gun injuries Get access H D Kaufman, H D Kaufman Royal Southern Hospital, Liverpool Search for other works by this author on: Oxford Academic Google Scholar H O Williams H O Williams Victoria Central Hospital, Wallasey Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 53, Issue 1, January 1966, Pages 57–58, https://doi.org/10.1002/bjs.1800530114 Published: 08 December 2005

Two groups of elderly disabled patients referred to an occupational therapy (OT) department, one of higher and one of impaired cognitive status, defined by the mini-mental state examination (MMS), were assessed before and after one month's OT to see if mental status predicted improvement in dressing skills. The Kuriansky Activities of Daily Living performance test (KPT), the Set test (ST) and a specially designed dressing skills task (DST) were administered before and after treatment. Cognitive status as measured by the MMS and the ST were related to the global measure of activities of daily living (KPT) before treatment but not to the specific dressing skills task. There was no significant relationship between cognitive status and OT outcome either in terms of dressing, KPT performance or discharge. The therapist's prediction of outcome at the initial assessment was accurate. A subsidiary study found that all patients entering the hospital over a six week period, likely to benefit from OT were in fact referred.

BACKGROUND: The number of people with head and neck cancer who are home enterally fed continues to grow each year. Insertion of a feeding tube is common place in these patients and is considered to have a detrimental effect on quality of life. The present study aimed to investigate the daily impact of home enteral feeding (HEF) from the perspective of people who have had a diagnosis of head and neck cancer. METHODS: The methodology aligned with interpretative phenomenology analysis. People who were home enterally fed, with head and neck cancer, and aged ≥18 years were recruited. Data were collected using semi-structured interviews and analysis focused on what the daily impact of HEF meant for participants. RESULTS: Data saturation was achieved after interviewing 15 participants. Five cluster themes were identified. 'Deviation from the norm' encompassed change and loss of normality. 'Regaining control leading to empowerment' encompassed participant empowerment through development of new skills and adjusting the feeding regime. 'Creating a new normal' involved making adjustments to facilitate inclusion and participation. 'External modifiers of the HEF experience' and 'internal modifiers of the HEF experience' encompassed the identification of external and internal HEF factors that influenced HEF adaptation. CONCLUSIONS: HEF was found to influence peoples' daily lives substantially and required extensive adjustments for individuals to find a new normal. A greater level of interpretation was provided beyond the current evidence-base for this group. Policymakers and clinicians should recognise the wider impact of HEF and ensure that this awareness is embedded in clinical practice.

Cardiac arrest due to electrocution occurred in a young obstetric patient undergoing laparotomy. The patient subsequently died despite initial resuscitation. The cause was traced to an inappropriate and faulty switch in the base of the operating table; the circuit was completed by the ECG monitor which was of the direct earth type.

Journal Article Idiopathic infarction of the omentum Get access M S Cagney, M S Cagney Resident Surgical Officer Victoria Central Hospital, Wallasey Search for other works by this author on: Oxford Academic Google Scholar Gavin Milroy Gavin Milroy Honorary Surgeon Victoria Central Hospital, Wallasey Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 35, Issue 137, July 1947, Pages 95–97, https://doi.org/10.1002/bjs.18003513716 Published: 06 December 2005

Journal Article Eder–Puestow oesophageal dilatation: A new hazard Get access C J Sanderson, C J Sanderson Victoria Central Hospital, Wallasey Search for other works by this author on: Oxford Academic Google Scholar G A Trotter G A Trotter Victoria Central Hospital, Wallasey Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 67, Issue 4, April 1980, Pages 300–301, https://doi.org/10.1002/bjs.1800670427 Published: 07 December 2005

BACKGROUND: Bacterial antimicrobial resistance (AMR) is a global threat to both humans and livestock. Despite this, there is limited global consensus on data-informed, priority areas for intervention in both sectors. We compare current livestock AMR data collection efforts with other variables pertinent to human and livestock AMR to identify critical data gaps and mutual priorities. METHODS: We globally synthesized livestock AMR data from open-source surveillance reports and point prevalence surveys stratified for six pathogens (Escherichia coli, Staphylococcus aureus, non-typhoidal Salmonella, Campylobacter spp., Enterococcus faecalis, Enterococcus faecium) and eleven antimicrobial classes important in human and veterinary use, published between 2000 and 2020. We also included all livestock species represented in the data: cattle, chickens, pigs, sheep, turkeys, ducks, horses, buffaloes, and goats. We compared this data with intended priorities calculated from: disability-adjusted life years (DALYs), livestock antimicrobial usage (AMU), livestock biomass, and a global correlation exercise between livestock and human proportion of resistant isolates. RESULTS: Resistance to fluoroquinolones and macrolides in Staphylococcus aureus were identified as priorities in many countries but, less than 10% of these reported livestock AMR data. Resistance data for Escherichia coli specific to cattle, chickens, and pigs, which we prioritized, were also well collected. AMR data collection on non-typhoidal Salmonella and other livestock species were often not prioritized. Of 232 categories prioritized by at least one country, data were only collected for 48% (n = 112). CONCLUSIONS: The lack of livestock AMR data globally for broad resistance in Staphylococcus aureus could underplay their zoonotic threat. Countries can bolster livestock AMR data collection, reporting, and intervention setting for Staphylococcus aureus as done for Escherichia coli. This framework can provide guidance on areas to strengthen AMR surveillance and decision-making for humans and livestock, and if done routinely, can adapt to resistance trends and priorities.

This animal study investigated the fibrinolytic activity in the vein wall of the pig following venous stasis, which was induced artificially using an intermittently inflated pneumatic cuff. The method used to measure the fibrinolytic activity was modified from Todd's original technique. The area of lysis and the area of the vein wall were measured and expressed as a ratio, called the fibrinolytic index. After 3 h of intermittent venous stasis the fibrinolytic index was reduced by 68 per cent, significantly lower than the control group. The reduction of the fibrinolytic index by venous stasis could play an important part in the development of deep vein thrombosis.

Wounds with necrotising fasciitis are often malodorous and produce copious exudate. Selecting appropriate dressings can alleviate these symptoms and improve the patient's quality of life within a short time period.

The Global Burden of Animal Diseases (GBADs) programme will provide data-driven evidence that policy-makers can use to evaluate options, inform decisions, and measure the success of animal health and welfare interventions. The GBADs' Informatics team is developing a transparent process for identifying, analysing, visualising and sharing data to calculate livestock disease burdens and drive models and dashboards. These data can be combined with data on other global burdens (human health, crop loss, foodborne diseases) to provide a comprehensive range of information on One Health, required to address such issues as antimicrobial resistance and climate change. The programme began by gathering open data from international organisations (which are undergoing their own digital transformations). Efforts to achieve an accurate estimate of livestock numbers revealed problems in finding, accessing and reconciling data from different sources over time. Ontologies and graph databases are being developed to bridge data silos and improve the findability and interoperability of data. Dashboards, data stories, a documentation website and a Data Governance Handbook explain GBADs data, now available through an application programming interface. Sharing data quality assessments builds trust in such data, encouraging their application to livestock and One Health issues. Animal welfare data present a particular challenge, as much of this information is held privately and discussions continue regarding which data are the most relevant. Accurate livestock numbers are an essential input for calculating biomass, which subsequently feeds into calculations of antimicrobial use and climate change. The GBADs data are also essential to at least eight of the United Nations Sustainable Development Goals.

The Global Burden of Animal Diseases (GBADs) programme's key objective â€" to provide a systematic approach to determine the burden of animal disease â€" is as relevant to aquatic as to terrestrial animal production systems. However, to date GBADs methods have mainly been applied to terrestrial animal production systems. The challenges in applying GBADs methods, notably the Animal Health Loss Envelope (AHLE), vary considerably by production system. The authors demonstrate how the AHLE can be calculated for rainbow trout production in England and Wales and acknowledge that its application to other systems (e.g. hatchery production, polyculture and no-feed mollusc production) is more complex. For example, in small scale tropical fish production the impact of suboptimal nutrition on production would need to be addressed. Recirculating aquaculture systems have inherent high levels of biosecurity and disease control, and thus low levels of disease. Removing the capital and running costs associated with biosecurity fundamentally changes the system and invalidates the AHLE calculation. Lack of data from many systems, notably small-scale tropical finfish farming, means that expert opinion will be needed to support the application of GBADs methods. While calculation of the AHLE is the focus of this article, it should be noted that attribution to causes and value chain modelling are needed to generate data on the wider societal impact of aquatic animal diseases (and possible interventions), which governments require to support decision-making about resource allocation.