Jonathan N Lund

Jonathan N Lund

DM FRCS

About

340
Publications
109,037
Reads
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7,463
Citations
Additional affiliations
January 2004 - December 2006
York Hospital
January 2000 - December 2012
Derby Hospitals NHS Foundation Trust
Position
  • Royal Derby Hospital
January 1996 - December 2012
University of Nottingham
Position
  • The University of Nottingham
Education
September 2002 - March 2011
University of Nottingham
Field of study
  • Medical Education
April 1995 - March 1997
University of Nottingham
Field of study
  • Medicine (Surgery)
June 1988 - July 1990
University of Nottingham
Field of study
  • Medicine

Publications

Publications (340)
Article
Full-text available
Short, intermittent episodes of disuse muscle atrophy (DMA) may have negative impact on age related muscle loss. There is evidence of variability in rate of DMA between muscles and over the duration of immobilization. As yet, this is poorly characterized. This review aims to establish and compare the time‐course of DMA in immobilized human lower li...
Article
Background The publication of data from the National Emergency Laparotomy Audit (NELA) has resulted in overall improvement in post-operative mortality rates. However, little is known about the characteristics of patients that die in the immediate post-operative period. These patients may represent a missed opportunity for the consideration of palli...
Article
Background Surgeons are sometimes reluctant to manage uncomplicated appendicitis non-operatively. Reasons cited are unknown rates of recurrent appendicitis and the risk of missed appendiceal malignancy. The aim of this study was to address these uncertainties and determine the long-term efficacy of antibiotic versus operative management of appendic...
Article
Aims A significant proportion of patients never fully recover baseline activity levels following major abdominal surgery. Postoperative muscle atrophy may be a major contributing factor to this, but is often overlooked. This study aimed to quantify the degree of muscle loss in patients undergoing routine recovery following major abdominal surgery a...
Article
Full-text available
Background: Reduced cardiorespiratory fitness (CRF) is an independent risk factor for dependency, cognitive impairment and premature mortality. High-intensity interval training (HIIT) is a proven time-efficient stimulus for improving both CRF and other facets of cardiometabolic health also known to decline with advancing age. However, the efficacy...
Article
Full-text available
Background Declines in cardiorespiratory fitness (CRF) and muscle mass are both associated with advancing age and each of these declines is associated with worse health outcomes. Resistance exercise training (RET) has previously been shown to improve muscle mass and function in the older population. If RET is also able to improve CRF, as it has bee...
Article
Background: Sacrococcygeal pilonidal sinus disease is a common debilitating condition that predominantly affects young adults, with a profound impact on their activities of daily living. The condition is treated surgically, and in some cases the wound in the natal cleft is left open to heal by itself. Many dressings and topical agents are availabl...
Article
Aim: We planned a cross-sectional investigation (study 1) and a longitudinal training intervention (study 2) to investigate whether recreational dancing affords greater neuroprotective effects against age-related neuromuscular junction (NMJ) degeneration compared to general fitness exercise training. Methods: In study 1, we recruited 19 older vo...
Article
Full-text available
Therapeutic interventions aimed at enhancing blood flow may combat the postprandial vascular and metabolic dysfunction that manifests with chronological ageing. We compared the effects of acute curcumin (1000 mg) coupled with an oral nutritional supplement (ONS, 7.5 g protein, 24 g carbohydrate and 6 g fat) versus a placebo and ONS (control) on cer...
Article
Full-text available
Background: Futile is defined as 'the fact of having no effect or of achieving nothing'. Futility in medicine has been defined through seven guiding principles, which in the context of emergency surgery, have been relatively unexplored. This scoping review aimed to identify key concepts around surgical futility as it relates to emergency laparotom...
Article
Full-text available
The aim of surgical training across the 10 surgical specialties is to produce competent day 1 consultants. Progression through training in the UK is assessed by the Annual Review of Competency Progression (ARCP). Objective This study aimed to examine variation in ARCP outcomes within surgical training and identify differences in outcomes between s...
Article
Background Postoperative acute kidney injury (AKI) is a common complication of major gastrointestinal surgery with an impact on short- and long-term survival. No validated system for risk stratification exists for this patient group. This study aimed to validate externally a prognostic model for AKI after major gastrointestinal surgery in two multi...
Article
Full-text available
In recent years, artificial intelligence (AI) has shown great promise in medicine. However, explainability issues make AI applications in clinical usages difficult. Some research has been conducted into explainable artificial intelligence (XAI) to overcome the limitation of the black-box nature of AI methods. Compared with AI techniques such as dee...
Article
Full-text available
Postprandial macro- and microvascular blood flow and metabolic dysfunction manifest with advancing age, so vascular transmuting interventions are desirable. In this randomised, single-blind, placebo-controlled, crossover trial, we investigated the impact of the acute administration of green tea extract (GTE; containing ~500 mg epigallocatechin-3-ga...
Article
Full-text available
Aims Recent randomised controlled trials have shown that non-operative management of acute appendicitis with antibiotics can prevent the need for surgery in 71-84% of patients within 90-days. Changes in the management of appendicitis, brought about by the COVID-19 pandemic, have allowed for this large-scale observational study, which aims to report...
Article
Full-text available
Aims COVID-19 has had a global impact on all aspects of healthcare including surgical teaching and training. This study aimed to quantify the impact of COVID-19 on operative case numbers recorded by surgeons in training, and annual review of competency progression (ARCP) outcomes in the United Kingdom. Methods Anonymised operative logbook numbers...
Article
Aims Acute appendicitis is a common general surgical emergency, occurring in 90-100 per 100,000 patients per year. Clinical practice in the UK involves either a clinical or ultrasound (US) diagnosis, with computed tomography (CT) reserved for cases of suspected complicated appendicitis. Due to the COVID-19 pandemic management pathways were altered,...
Article
Introduction To achieve completion of training in general surgery, trainees are required to demonstrate competency in common procedures performed at Emergency Laparotomy (Em Lap). We describe the patterns of trainee led emergency laparotomy operating and the association between post-operative outcomes. Methods All patients who had an Em Lap were e...
Article
Full-text available
Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This internati...
Article
Full-text available
Impairments in muscle microvascular function are associated with the pathogenesis of sarcopenia and cardiovascular disease. High-intensity interval training (HIIT) is an intervention by which a myriad of beneficial skeletal muscle/cardiovascular adaptations have been reported across age, including capillarisation and improved endothelial function....
Article
Full-text available
Background: Uncomplicated acute appendicitis can be managed with non-operative (antibiotic) treatment, but laparoscopic appendicectomy remains the first-line management in the UK. During the COVID-19 pandemic the practice altered, with more patients offered antibiotics as treatment. A large-scale observational study was designed comparing operative...
Article
The COVID-19 pandemic has had a huge impact on society, healthcare in general and also on training in surgery. Cancellation of elective procedures, redeployment and establishment of green sites have combined with other factors to create significant gaps in training experience in operative and all other areas of surgery. There are nearly a million c...
Article
Background PREPARE-ABC is a pragmatic multi-centre randomised controlled trial including an internal pilot designed to assess the clinical and cost-effectiveness of pre- and post-operative exercise in relation to short- and longer-term post-operative recovery outcomes in colorectal cancer patients undergoing surgical resection. Here, we report on i...
Article
Full-text available
Introduction Surgical training in the UK is comprised of ten specialties: cardiothoracic, general, neurosurgery, oral and maxillofacial (OMFS), otolaryngology, paediatric, plastic, trauma and orthopaedics, urology and vascular surgery. Progression through training is assessed by the Annual Review of Competency Progression (ARCP). The aim is to exam...
Article
Aim To identify demographic factors, including protected characteristics, and training specific factors which predict a nonstandard Annual Review of Competency Progression (ARCP) outcome during Trauma and Orthopedic Specialty training in the United Kingdom (UK). Method A longitudinal cohort study using data from UKMED was performed. ARCP outcome w...
Article
Full-text available
Introduction: Serious health implications from having low levels of cardiorespiratory fitness (CRF) and being overweight in young adulthood are carried forward into later life. High-intensity interval training (HIIT) is a time-effective, potent stimulus for improving CRF and indices of cardiometabolic health. To date, few studies have investigated...
Article
Full-text available
Background Testing a hypothesis for ‘factors-outcome effect’ is a common quest, but standard statistical regression analysis tools are rendered ineffective by data contaminated with too many noisy variables. Expert Systems (ES) can provide an alternative methodology in analysing data to identify variables with the highest correlation to the outcome...
Article
Full-text available
Background: Postoperative pain is a common consequence of surgery and can have many negative perioperative effects. It has been suggested that the administration of analgesia before a painful stimulus may improve pain control. We defined pre-emptive nonsteroidal anti-inflammatories (NSAIDs) as those given before surgery but not continued afterward...
Article
Full-text available
Background The assessment of muscle mass is a key determinant of the diagnosis of sarcopenia. We introduce for the first time an ultrasound imaging method for diagnosing sarcopenia based on changes in muscle geometric proportions. Methods Vastus lateralis muscle fascicle length (Lf) and thickness (Tm) were measured at 35% distal femur length by ul...
Article
Full-text available
Background: Declines in cardiorespiratory fitness (CRF) and fat-free mass (FFM) with age are linked to mortality, morbidity and poor quality of life. High-intensity interval training (HIIT) has been shown to improve CRF and FFM in many groups, but its efficacy in the very old, in whom comorbidities are present is undefined. We aimed to assess the...
Article
Full-text available
Ageing is associated with postprandial muscle vascular and metabolic dysfunction, suggesting vascular modifying interventions may be of benefit. Reflecting this, we investigated the impact of acute cocoa flavanol (450–500 mg) intake (versus placebo control) on vascular (via ultrasound) and glucose/insulin metabolic responses (via arterialised/venou...
Preprint
Full-text available
The aim of surgical training across the ten surgical specialties is to produce competent day one consultants. Progression through training is assessed by the Annual Review of Competency Progression (ARCP). Objective This study aimed to examine variation in ARCP outcomes within surgical training and identify differences between specialties. Design A...
Article
Full-text available
Background COVID-19 has had a global impact on all aspects of healthcare including surgical training. This study aimed to quantify the impact of COVID-19 on operative case numbers recorded by surgeons in training, and annual review of competency progression (ARCP) outcomes in the UK. Methods Anonymized operative logbook numbers were collated from...
Article
In the United Kingdom (UK), it is projected that by 2035 people aged >65 years will make up 23% of the population, with those aged >85 years accounting for 5% of the total population. Ageing is associated with progressive changes in muscle metabolism and a decline in functional capacity, leading to a loss of independence. Muscle metabolic changes a...
Article
Full-text available
Colorectal surgery is associated with an above‐average mortality rate of ~15%. During surgery, maintenance of vital organ perfusion is essential in order to reduce postoperative mortality and morbidity, with renal perfusion of particular importance. Oesophageal Doppler monitors (ODM) are commonly used to try and provide accurate measures of fluid d...
Article
Full-text available
Background Cardiorespiratory fitness (CRF) has important implications for post‐operative recovery. The timed‐up‐and‐go (TUG) test is a cheap and simple method to assess a patient's functional performance; although how well TUG correlates with results of a cardiopulmonary exercise test (CPET), the gold standard measure of CRF is unknown. Therefore,...
Article
Background Complicated intra-abdominal infections (cIAIs) are associated with significant morbidity and mortality. The aim of this study was to describe the clinical characteristics of patients with cIAI in a multicentre study and to develop clinical prediction models (CPMs) to help identify patients at risk of mortality or relapse. Methods A mult...
Article
Full-text available
Systematic reviews and meta-analyses (SRMAs) are increasing in popularity, but should they be used to inform clinical decision-making in anaesthesia? We present evidence that the certainty of evidence from SRMAs in anaesthesia (and in general) may be unacceptably low because of risks of bias exaggerating treatment effects, unexplained heterogeneity...
Article
Full-text available
Background Coronavirus disease (COVID-19) has caused global disruption to health care. Non-urgent elective surgical cases have been cancelled, outpatient clinics have reduced and there has been a reduction in the number of patients presenting as an emergency. These factors will drastically affect the training opportunities of surgical trainees. The...
Article
Full-text available
To assess the efficacy of high-intensity interval training (HIIT) for improving cardiorespiratory fitness (CRF) in patients awaiting resection for urological malignancy within four weeks. A randomised control trial of consecutive patients aged (>65 years) scheduled for major urological surgery in a large secondary referral centre in a UK hospital....
Article
Full-text available
Background Attrition within surgical training is a challenge. In the USA, attrition rates are as high as 20–26%. The factors predicting attrition are not well known. The aim of this systematic review is to identify factors that influence attrition or performance during surgical training. Method The review was performed in line with PRISMA guidelin...
Article
Full-text available
Background Hypertension is a risk factor for both cardiovascular and cerebrovascular disease, with an increasing incidence with advancing patient age. Exercise interventions have the potential to reduce blood pressure in older adults, however, rates of exercise uptake and adherence are low, with ‘lack of time’ a commonly cited reason. As such, ther...
Article
Full-text available
Background Right-sided cancer accounts for approximately 30% of bowel cancer in women and 22% in men. Colonic resection can cause changes in bowel function which affect daily activity. The aims are to assess the impact of right hemicolectomy for cancer on bowel function and to identify useful treatment modalities for managing bowel dysfunction afte...
Article
Full-text available
Unfortunately, few of the collaborators names were incorrectly published in the original publication.
Article
Full-text available
Objective High‐intensity interval training (HIIT) has been shown to be more effective than moderate continuous aerobic exercise for improving cardiorespiratory fitness (CRF) in a limited time frame. However, the length of time required for HIIT to elicit clinically significant improvements in the CRF of older adults is currently unknown. The aim of...
Article
Full-text available
Background Acute appendicitis (AA) is the most common general surgical emergency. Early laparoscopic appendicectomy is the gold-standard management. SARS-CoV-2 (COVID-19) brought concerns of increased perioperative mortality and spread of infection during aerosol generating procedures: as a consequence, conservative management was advised, and open...
Research
Full-text available
Background Acute appendicitis (AA) is the most common general surgical emergency. Early laparoscopic appendicectomy is the gold-standard management. SARS-CoV-2 (COVID-19) brought concerns of increased perioperative mortality and spread of infection during aerosol generating procedures: as a consequence, conservative management was advised, and open...
Article
Full-text available
Background Abdominal wall hernia is a common surgical condition. Patients may present in an emergency with bowel obstruction, incarceration or strangulation. Small bowel obstruction (SBO) is a serious surgical condition associated with significant morbidity. The aim of this study was to describe current management and outcomes of patients with obst...
Article
Egger’s test is commonly used to assess potential publication bias in a meta-analysis via funnel plot asymmetry (Egger’s test is a linear regression of the intervention effect estimates on their standard errors weighted by their inverse variance). The performance of Egger’s and related tests has been extensively studied for binary outcomes, but not...
Article
Background and Goal of Study: Opioids are known to negatively influence adrenal hormones and have a negative effect on immune function [1]. However, it is unknown whether low dose, short course opioids typically prescribed after minor procedures, influence these physiological functions. We aimed to assess the effects of one week of codeine on immun...
Article
Background and Goal of Study: Postoperative pain is a common consequence of surgery and pre-emptive or preventive analgesia has been suggested to help reduce this. We have previously demonstrated little efficacy for preventive opioids [1]. This review aimed to assess whether NSAIDs have a pre-emptive or preventive effect in all types of surgery. M...
Code
STATA code to produce novel funnel plots and quantitative analysis for publication bias of continuous outcomes (requires downloaded software packages) Red text indicates code, which needs to be substituted with specific variable names in dataset (legend below) or descriptions of code where # is used as a prefix Nintervention= number in intervention...