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  1. Article: Natural desiccated thyroid for the treatment of hypothyroidism?

    Heald, Adrian H / Taylor, Peter / Premawardhana, Lakdasa / Stedman, Mike / Dayan, Colin

    Frontiers in endocrinology

    2024  Volume 14, Page(s) 1309159

    Abstract: Primary hypothyroidism affects about 3% of the general population in Europe. Early treatments in the late ... ...

    Abstract Primary hypothyroidism affects about 3% of the general population in Europe. Early treatments in the late 19
    MeSH term(s) Humans ; Animals ; Swine ; Thyroxine/therapeutic use ; Triiodothyronine ; Hypothyroidism/drug therapy ; Administration, Oral
    Chemical Substances Thyroxine (Q51BO43MG4) ; Triiodothyronine (06LU7C9H1V)
    Language English
    Publishing date 2024-01-08
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2023.1309159
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Liothyronine prescribing in England: costs versus need.

    Heald, Adrian / Stedman, Mike / Okosieme, Buchi / Premawardhana, Lakdasa / Taylor, Peter / Dayan, Colin

    Lancet (London, England)

    2023  Volume 402, Issue 10417, Page(s) 2074–2075

    MeSH term(s) Humans ; Triiodothyronine ; Costs and Cost Analysis ; Drug Prescriptions ; England ; Practice Patterns, Physicians' ; Drug Costs
    Chemical Substances Triiodothyronine (06LU7C9H1V)
    Language English
    Publishing date 2023-11-15
    Publishing country England
    Document type Letter
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(23)01792-0
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  3. Article ; Online: "Not Wars, Water pumps"-From emotive to rational language in managing the Covid-19 pandemic.

    Stedman, Mike / Davies, Mark / Heald, Adrian

    International journal of clinical practice

    2020  Volume 74, Issue 10, Page(s) e13580

    Keywords covid19
    Language English
    Publishing date 2020-08-02
    Publishing country England
    Document type Editorial
    ZDB-ID 1386246-7
    ISSN 1742-1241 ; 1368-5031
    ISSN (online) 1742-1241
    ISSN 1368-5031
    DOI 10.1111/ijcp.13580
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  4. Article ; Online: Associations and mitigations

    Mark Davies / Adrian Heald / Mike Stedman / Patrick Harnett / Adam Robinson

    BMJ Open, Vol 12, Iss

    an analysis of the changing risk factor landscape for chronic kidney disease in primary care using national general practice level data

    2022  Volume 12

    Abstract: Objectives Early recognition of chronic kidney disease (CKD) should be achieved by every modern healthcare system. The objective of this study was to investigate CKD risk factor trends in England using general practice level data.Design Observational ... ...

    Abstract Objectives Early recognition of chronic kidney disease (CKD) should be achieved by every modern healthcare system. The objective of this study was to investigate CKD risk factor trends in England using general practice level data.Design Observational analysis of data at practice level for all general practices in England. Practice characteristics identified as potential CKD risk factors included comorbidities and local demography. Data were analysed using both univariate and multivariate analysis to identify significant factors that were associated with CKD diagnosis for the period 1 April 2019 to 31 March 2020.Setting Publicly available data from UK primary care sources including Primary Care Quality and Outcomes Framework database, practice-level prescribing data from the British National Formulary and Public Health England health outcome data.Participants All data submitted from 6471 medium to large practices in England were included (over 46 million patients).Risk factor analysis Potential risk factors were grouped into four classes based on existing literature: demographic factors, comorbidities, service and practice outcome factors, and prescribing data effects.Results The original model’s prediction of CKD improved from r2 0.38 to an r2 of 0.66 when updated factors were included. Positive associations included known risk factors with higher relative risk such as hypertension and diabetes, along with less recognised factors such as depression and use of opiates. Negative associations included NSAIDs which are traditionally associated with increased CKD risk, and prescribing of antibiotics, along with more northerly locations.Conclusions CKD is a preventable disease with high costs and consequences. These data and novel analysis give clearer relative risk values for different patient characteristics with some unexpected findings such as potential harmful association between CKD and opiates, and a more benign association with NSAIDs. A deeper understanding of CKD risk factors is important to update and ...
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Reducing fatigue-related symptoms in Long COVID-19: a preliminary report of a lymphatic drainage intervention.

    Heald, Adrian / Perrin, Raymond / Walther, Andreas / Stedman, Mike / Hann, Mark / Mukherjee, Annice / Riste, Lisa

    Cardiovascular endocrinology & metabolism

    2022  Volume 11, Issue 2, Page(s) e0261

    Abstract: In the early days of the first global wave of the COVID-19 pandemic, the potential for a postviral syndrome to manifest following COVID-19 infection was first recognized. Here, we present an analysis of a case series of the first 20 patients' data ... ...

    Abstract In the early days of the first global wave of the COVID-19 pandemic, the potential for a postviral syndrome to manifest following COVID-19 infection was first recognized. Here, we present an analysis of a case series of the first 20 patients' data collected in clinical practice to evaluate the potential of a possible alternative treatment for Long COVID.
    Methods: Face-to-face treatment sessions with Perrin technique practitioners occurred weekly involving effleurage/other manual articulatory techniques. The individuals being treated also undertook daily self-massage along with gentle mobility exercises. Patients recorded symptom severity using the self-report 54-item profile of fatigue-related states (PFRS) before and after treatment.
    Results: The mean age of male patients was 41.8 years (range, 29-53 years), and for female patients, 39.3 years (range, 28-50 years). None of the participants had a prior diagnosis of chronic fatigue syndrome, and all were new attendees to the clinics at the time of initial assessment. The average number of treatment sessions was 9.7 in men and 9.4 in women. The reduction in PFRS scores was 45% in men and 52% in women. The highest subscale scores on average were for fatigue, with the lowest for somatic symptoms. All subscale scores showed, on average, a similar reduction of approximately 50% postintervention, with the reduction in score relating to a decrease in the severity of symptoms.
    Conclusion: Our findings suggest that a specific manual lymphatic drainage intervention may help to reduce fatigue symptoms related to Long COVID. Perhaps preventing acute symptoms through early intervention.
    Language English
    Publishing date 2022-04-12
    Publishing country United States
    Document type Journal Article
    ISSN 2574-0954
    ISSN (online) 2574-0954
    DOI 10.1097/XCE.0000000000000261
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  6. Article ; Online: First episode psychosis and weight gain a longitudinal perspective in Cheshire UK: a comparison between individuals with nonaffective versus affective psychosis.

    Heald, Adrian H / Stedman, Mike / Daly, Chris / Warner-Levy, John Julian / Livingston, Mark / Hussain, Lamiece / Anderson, Simon

    Cardiovascular endocrinology & metabolism

    2023  Volume 12, Issue 3, Page(s) e0286

    Abstract: Early weight gain following initiation of antipsychotic treatment predicts longer-term weight gain, with attendant long-term consequences including premature cardiovascular events/death. An important question is whether there is a difference in weight ... ...

    Abstract Early weight gain following initiation of antipsychotic treatment predicts longer-term weight gain, with attendant long-term consequences including premature cardiovascular events/death. An important question is whether there is a difference in weight change over time between people with affective versus nonaffective psychosis. Here we describe the results of a real-world analysis of the BMI change in the months postdiagnosis with affective versus nonaffective psychosis.
    Methods: We undertook an anonymised search across one Primary Care Network in Cheshire, UK with a total population of 32 301 individuals. We reviewed the health records of anyone who had been diagnosed over a 10-year period between June 2012 and June 2022 for the first time with first episode nonaffective psychosis versus psychosis associated with depression or bipolar affective disorder (affective psychosis).
    Results: The overall % change in BMI was +8% in nonaffective psychosis individuals and +4% in those with a diagnosis of affective psychosis - however, the distribution was markedly skewed for nonaffective psychosis patients. Using caseness as >30% increase in BMI; affective = 4% cases and nonaffective = 13% cases, there was a three-fold difference in terms of increase in BMI. In regression analysis, the
    Conclusion: The differences observed here in the distribution of weight change over time between individuals with affective versus nonaffective psychosis may relate to underlying constitutional differences. The phenotypic and genetic factors underlying this difference remain to be defined.
    Language English
    Publishing date 2023-06-22
    Publishing country United States
    Document type Journal Article
    ISSN 2574-0954
    ISSN (online) 2574-0954
    DOI 10.1097/XCE.0000000000000286
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  7. Article: Changes in prescribing of psychotropic vs some physical health medication in primary care through the COVID-19 pandemic in England: a national-level survey.

    Waheed, Unaiza / Stedman, Mike / Davies, Mark / Solomon, Emma / Taylor, David / Heald, Adrian / Narayanan, Ram Prakash / Warner-Levy, John

    Journal of pharmaceutical policy and practice

    2023  Volume 16, Issue 1, Page(s) 169

    Abstract: Introduction: The COVID-19 pandemic globally impacted healthcare provision. Prescribing changes in common medications can be used as a marker for new diagnoses. We describe how the prescribing of specific psychotropics was impacted by the pandemic.: ... ...

    Abstract Introduction: The COVID-19 pandemic globally impacted healthcare provision. Prescribing changes in common medications can be used as a marker for new diagnoses. We describe how the prescribing of specific psychotropics was impacted by the pandemic.
    Methods: Primary Care Prescribing data for different classes of drugs from March 2017 to February 2022 were considered. To capture the impact during periods of restricted access to health services for new diagnoses/existing conditions, repeat prescriptions/episodic prescribing were included with account taken of historical trends. The pre-pandemic prescriptions issued each month from March 2018 to February 2020 were linearly extrapolated forward to give an expected annual growth (EAG). The monthly average expected prescriptions for the pandemic period (March 2020-February 2022) were compared.
    Results: Physical health medications had lower monthly prescriptions during the pandemic, most markedly for antibiotics - 12.5% (EAG - 1.3%). Bronchodilator prescribing showed a marked increase in the early pandemic months from March 2020 of 5% (EAG 0.1%). Mental health medication prescribing increased above trend for hypnotics/anxiolytics by 0.2% (EAG - 2.3%), while antidepressants fell by - 0.2% (EAG 5.0%), with no net change for antipsychotics (EAG 2.8%), but a temporary increase in antipsychotic prescribing in the early pandemic period. For all the main antidepressants prescribed in England (Sertraline, Mirtazapine, Venlafaxine, Fluoxetine and Citalopram), prescribing actually decreased in the main pandemic period vs historical trend.
    Conclusions: The increase in anxiolytic/hypnotic prescribing above trend links to pandemic effects on anxiety/worry. If anything, there was a slight fall in prescribing of the main antidepressants prescribed, which given prevailing circumstances at the time, suggests that access to services may have restricted access to timely assessment.
    Language English
    Publishing date 2023-12-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2734772-2
    ISSN 2052-3211
    ISSN 2052-3211
    DOI 10.1186/s40545-023-00655-9
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  8. Article ; Online: National level prescribing of psychotropic medication in primary care during the COVID-19 pandemic in England: potential implications for cardiometabolic health.

    Waheed, Unaiza / Stedman, Mike / Davies, Mark / Walther, Andreas / Solomon, Emma / Ollier, Bill / Heald, Adrian H

    Cardiovascular endocrinology & metabolism

    2022  Volume 11, Issue 4, Page(s) e0270

    Language English
    Publishing date 2022-09-05
    Publishing country United States
    Document type Journal Article
    ISSN 2574-0954
    ISSN (online) 2574-0954
    DOI 10.1097/XCE.0000000000000270
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  9. Article ; Online: COVID-19: Generate and apply local modelled transmission and morbidity effects to provide an estimate of the variation in overall relative healthcare resource impact at general practice granularity.

    Stedman, Mike / Lunt, Mark / Davies, Mark / Gibson, Martin / Heald, Adrian

    International journal of clinical practice

    2020  Volume 74, Issue 9, Page(s) e13533

    Abstract: Introduction: Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the name given to the 2019 novel coronavirus. COVID-19 is the name given to the disease associated with the virus. SARS-CoV-2 is a new strain of coronavirus not been previously ... ...

    Abstract Introduction: Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the name given to the 2019 novel coronavirus. COVID-19 is the name given to the disease associated with the virus. SARS-CoV-2 is a new strain of coronavirus not been previously identified in humans.
    Methods: Two key factors, case incidence and case morbidity, were analysed for England. When taken together they give an estimate of relative demand on healthcare utilisation. To analyse case incidence, the latest values for indicators that could be associated with infection transmission rates were collected from the Office of National Statistics (ONS) and Quality Outcome Framework (QOF) sources. These included population density, %age >16, at fulltime work/education, %age over 60, %BME ethnicity, social deprivation as IMD2019, location as latitude/longitude, and patient engagement as %self-confident in their own long-term condition management. Average case morbidity was calculated. To provide a comparative measure of overall healthcare resource impact, individual GP practice impact scores were compared against the median practice.
    Results: The case incidence regression is a dynamic situation but it currently shows that Urban, %Working, and age >60 were the strongest determinants of case incidence. The local population comorbidity remains unchanged. The range of relative healthcare impact was wide with 80% of practices falling at 20%-250% of the national median. Once practice population numbers were included we found that the top 33% of GP practices supporting 45% of the patient population would require 68% of COVID-19 healthcare resources. The model provides useful information about the relative impact of Covid-19 on healthcare workload at GP practice granularity in all parts of England.
    Conclusion: Covid-19 is impacting on the utilisation of health/social care resources across the world. This model provides a way of predicting relative local levels of disease burden based on defined criteria, thereby providing a method for targeting limited care resources to optimise national/regional/local responses to the COVID-19 outbreak.
    MeSH term(s) Adult ; Aged ; Betacoronavirus ; COVID-19 ; Comorbidity ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; England/epidemiology ; Facilities and Services Utilization ; Female ; General Practice/statistics & numerical data ; Health Resources/statistics & numerical data ; Humans ; Incidence ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 1386246-7
    ISSN 1742-1241 ; 1368-5031
    ISSN (online) 1742-1241
    ISSN 1368-5031
    DOI 10.1111/ijcp.13533
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