PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

The General Election of 1710

This thesis is a study of the forces at work in the General Election of 1710, the electioneering methods in which these forces found expression, and the results of those methods. The most useful sources have been contemporary correspondence of all kinds, particularly Harley's correspondence in the Portland Papers, published by the Historical Manuscripts Commission; the reports of election petitions in the Journals of the House of Commons, and contemporary pamphlets and newspapers. The number of political pamphlets and periodicals published at the time of the election was very large, and an attempt has been made to analyse this literature, to assess its influence and to deduce from it the issues upon which the election was fought. This is followed by a study of the use made by the Tories of the Sacheverell trial, both in the press and in other ways; of the influence of the clergy upon the elections, and the part played by the dissenters. The influence exerted in the form of patronage by the nobility, those methods the landed gentry and the Court is examined, but lack of positive evidence has made any satisfactory estimate of the amount of patronage impossible. There is, however, plenty of evidence of the methods of canvassing employed in 1710, and it is possible to compare the relative popularity of undue influence, riots, treating and bribery as means of securing votes. There is a separate chapter on the Scottish elections. A final chapter discusses the social status and political colour of the members returned, and attempts an estimate of the size of the Tory majority. The conclusions in this chapter are based upon the short biographies of all the members returned - both at the General Election and at by elections - which constitute the Appendix.<p