Ivan R Le Jeune

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Of the 24 NICE Guideline recommendations relating to CAP, 4 covered subjects not included in the BTS guideline (NICE recommendations 1.1.1, 1.2.12, 1.2.21, 1.2.22). Of the 137 BTS recommendations, 101 were not within the scope of the NICE guideline, 31 overlapped but with no major differences and 5 overlapped with some differences. Each BTS recommendation(More)
BACKGROUND Hyponatraemia is the most commonly identified electrolyte abnormality. Published data on severe hyponatraemia in general medical in-patients is lacking. AIM To determine the aetiology, adequacy of assessment, and outcome of severe hyponatraemia in general medical in-patients. DESIGN Retrospective case-note review. METHODS All general(More)
BACKGROUND Idiopathic pulmonary fibrosis (IPF) and sarcoidosis are common diagnoses in patients attending chest clinics, but little is known about the epidemiology of these diseases. We used data from a general practice database to provide information on the current incidence of IPF and sarcoidosis in the UK. METHODS Data were extracted for all patients(More)
AIMS The primary aim of this paper is to provide comprehensive contemporaneous data on the demographics, patterns of presentation and management of all episodes of deliberate self-poisoning presenting to a large regional teaching hospital over a 12 month period. METHODS We undertook detailed, retrospective analyses using information from electronic(More)
Pulmonary complications are common in patients with primary immune deficiency (PID). The aim of this study was to assess the usefulness of lung function tests (LFTs) in the management of these patients, and in particular to see if carbon monoxide transfer factor (TLCO) is needed in addition to spirometry. We studied 20 patients (11 female) with PID in a(More)
The performance of acute medical units (AMUs) against published quality indicators is variable. We aimed to identify the impact of case-mix and unit resources on timely assessment and discharge of patients admitted to 43 AMUs on a single day in June 2013, as part of the Society for Acute Medicine's benchmarking audit 2013. Performance against quality(More)
RATIONALE Previous studies have suggested that people with idiopathic pulmonary fibrosis (IPF) may be at increased risk of vascular disease. OBJECTIVES To quantify the risk of cardiovascular disease before and after a diagnosis of IPF. METHODS We used computerized primary care data from the Health Improvement Network to quantify the relative risk of(More)
BACKGROUND Transfusion thresholds for acute upper gastrointestinal bleeding are controversial. So far, only three small, underpowered studies and one single-centre trial have been done. Findings from the single-centre trial showed reduced mortality with restrictive red blood cell (RBC) transfusion. We aimed to assess whether a multicentre, cluster(More)
Timely medical assessment is integral to the safety and quality of healthcare delivery in acute medicine. Medical staff are an expensive resource. This study aimed to develop a modelling system that facilitated efficient workforce planning according to patient need on the acute medical unit. A realistic 24-hour 'supply' of junior doctors was calculated by(More)
Acute upper gastrointestinal bleeding (AUGIB) is the commonest reason for hospitalization with hemorrhage in the UK and the leading indication for transfusion of red blood cells (RBCs). Observational studies suggest an association between more liberal RBC transfusion and adverse patient outcomes, and a recent randomised trial reported increased further(More)