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Bleeding
Classification and external resources
A bleeding human finger
ICD-10	R58
MeSH	D006470

Bleeding, technically known as hemorrhaging or haemorrhaging (see American and British spelling differences), is the loss of blood or blood escape from the circulatory system.^[1] Bleeding can occur internally, where blood leaks from blood vessels inside the body, or externally, either through a natural opening such as the vagina, mouth, nose, ear or anus, or through a break in the skin. Desanguination is a massive blood loss, and the complete loss of blood is referred to as exsanguination.^[2] Typically, a healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties, and blood donation typically takes 8–10% of the donor's blood volume.^[3]

Classification[link]

A subconjunctival hemorrhage is a common and relatively minor post-LASIK complication.

The endoscopic image of linitis plastica, a type of stomach cancer leading to a leather bottle-like appearance with blood coming out of it.

Micrograph showing abundant hemosiderin-laden alveolar macrophages (dark brown), as seen in a pulmonary hemorrhage. H&E stain.

Blood loss[link]

Hemorrhaging is broken down into four classes by the American College of Surgeons' Advanced Trauma Life Support (ATLS).^[4]

• Class I Hemorrhage involves up to 15% of blood volume. There is typically no change in vital signs and fluid resuscitation is not usually necessary.
• Class II Hemorrhage involves 15-30% of total blood volume. A patient is often tachycardic (rapid heart beat) with a narrowing of the difference between the systolic and diastolic blood pressures. The body attempts to compensate with peripheral vasoconstriction. Skin may start to look pale and be cool to the touch. The patient may exhibit slight changes in behavior. Volume resuscitation with crystalloids (Saline solution or Lactated Ringer's solution) is all that is typically required. Blood transfusion is not typically required.
• Class III Hemorrhage involves loss of 30-40% of circulating blood volume. The patient's blood pressure drops, the heart rate increases, peripheral hypoperfusion (shock), such as capillary refill worsens, and the mental status worsens. Fluid resuscitation with crystalloid and blood transfusion are usually necessary.
• Class IV Hemorrhage involves loss of >40% of circulating blood volume. The limit of the body's compensation is reached and aggressive resuscitation is required to prevent death.

This system is basically the same as used in the staging of hypovolemic shock.

Individuals in excellent physical and cardiovascular shape may have more effective compensatory mechanisms before experiencing cardiovascular collapse. These patients may look deceptively stable, with minimal derangements in vital signs, while having poor peripheral perfusion. Elderly patients or those with chronic medical conditions may have less tolerance to blood loss, less ability to compensate, and may take medications such as betablockers that can potentially blunt the cardiovascular response. Care must be taken in the assessment of these patients.

World Health Organization[link]

The World Health Organization made a standardized grading scale to measure the severity of bleeding.^[5]

Origin[link]

• Mouth
  • Hematemesis - vomiting fresh blood
  • Hemoptysis - coughing up blood from the lungs
• Hematochezia - rectal blood
• Hematuria - blood in the urine from urinary bleeding
• Upper head
  • Intracranial hemorrhage - bleeding in the skull.
  • Cerebral hemorrhage - a type of intracranial hemorrhage, bleeding within the brain tissue itself.
  • Intracerebral hemorrhage - bleeding in the brain caused by the rupture of a blood vessel within the head. See also hemorrhagic stroke.
  • Subarachnoid hemorrhage (SAH) implies the presence of blood within the subarachnoid space from some pathologic process. The common medical use of the term SAH refers to the nontraumatic types of hemorrhages, usually from rupture of a berry aneurysm or arteriovenous malformation(AVM). The scope of this article is limited to these nontraumatic hemorrhages.
• Lung
  • Pulmonary hemorrhage
• Gynecologic
  • Vaginal bleeding
    • Postpartum hemorrhage
    • Breakthrough bleeding
  • Ovarian bleeding. This is a potentially catastrophic and not so rare complication among lean patients with polycystic ovary syndrome undergoing transvaginal oocyte retrieval.^[6]
• Upper gastrointestinal bleed

Causes[link]

Bleeding arises due to either traumatic injury, underlying medical condition, or a combination.

Traumatic Injury[link]

Traumatic bleeding is caused by some type of injury. There are different types of wounds which may cause traumatic bleeding. These include:

• Abrasion - Also called a graze, this is caused by transverse action of a foreign object against the skin, and usually does not penetrate below the epidermis
• Excoriation - In common with Abrasion, this is caused by mechanical destruction of the skin, although it usually has an underlying medical cause
• Hematoma - Caused by damage to a blood vessel that in turn causes blood to collect under the skin.
• Laceration - Irregular wound caused by blunt impact to soft tissue overlying hard tissue or tearing such as in childbirth. In some instances, this can also be used to describe an incision.
• Incision - A cut into a body tissue or organ, such as by a scalpel, made during surgery.
• Puncture Wound - Caused by an object that penetrated the skin and underlying layers, such as a nail, needle or knife
• Contusion - Also known as a bruise, this is a blunt trauma damaging tissue under the surface of the skin
• Crushing Injuries - Caused by a great or extreme amount of force applied over a period of time. The extent of a crushing injury may not immediately present itself.
• Ballistic Trauma - Caused by a projectile weapon such as a firearm. This may include two external wounds (entry and exit) and a contiguous wound between the two

The pattern of injury, evaluation and treatment will vary with the mechanism of the injury. Blunt trauma causes injury via a shock effect; delivering energy over an area. Wounds are often not straight and unbroken skin may hide significant injury. Penetrating trauma follows the course of the injurious device. As the energy is applied in a more focused fashion, it requires less energy to cause significant injury. Any body organ, including bone and brain, can be injured and bleed. Bleeding may not be readily apparent; internal organs such as the liver, kidney and spleen may bleed into the abdominal cavity. The only apparent signs may come with blood loss. Bleeding from a bodily orifice, such as the rectum, nose, ears may signal internal bleeding, but cannot be relied upon. Bleeding from a medical procedure also falls into this category.

Medical condition[link]

'Medical bleeding' denotes hemorrhage as a result of an underlying medical condition (i.e. causes of bleeding that are not directly due to trauma). Blood can escape from blood vessels as a result of 3 basic patterns of injury:

• Intravascular changes - changes of the blood within vessels (e.g. ↑ blood pressure, ↓ clotting factors)
• Intramural changes - changes arising within the walls of blood vessels (e.g. aneurysms, dissections, AVMs, vasculitides)
• Extravascular changes - changes arising outside blood vessels (e.g. H pylori infection, brain abscess, brain tumor)

The underlying scientific basis for blood clotting and hemostasis is discussed in detail in the articles, Coagulation, hemostasis and related articles. The discussion here is limited to the common practical aspects of blood clot formation which manifest as bleeding.

Certain medical conditions can also make patients susceptible to bleeding. These are conditions that affect the normal "hemostatic" functions of the body. Hemostasis involves several components. The main components of the hemostatic system include platelets and the coagulation system.

Platelets are small blood components that form a plug in the blood vessel wall that stops bleeding. Platelets also produce a variety of substances that stimulate the production of a blood clot. One of the most common causes of increased bleeding risk is exposure to non-steroidal anti-inflammatory drugs (or "NSAIDs"). The prototype for these drugs is aspirin, which inhibits the production of thromboxane. NSAIDs inhibit the activation of platelets, and thereby increase the risk of bleeding. The effect of aspirin is irreversible; therefore, the inhibitory effect of aspirin is present until the platelets have been replaced (about ten days). Other NSAIDs, such as "ibuprofen" (Motrin) and related drugs, are reversible and therefore, the effect on platelets is not as long-lived.

There are several named coagulation factors that interact in a complex way to form blood clots, as discussed in the article on coagulation. Deficiencies of coagulation factors are associated with clinical bleeding. For instance, deficiency of Factor VIII causes classic Hemophilia A while deficiencies of Factor IX cause "Christmas disease"(hemophilia B). Antibodies to Factor VIII can also inactivate the Factor VII and precipitate bleeding that is very difficult to control. This is a rare condition that is most likely to occur in older patients and in those with autoimmune diseases. von Willebrand disease is another common bleeding disorder. It is caused by a deficiency of or abnormal function of the "von Willebrand" factor, which is involved in platelet activation. Deficiencies in other factors, such as factor XIII or factor VII are occasionally seen, but may not be associated with severe bleeding and are not as commonly diagnosed.

In addition to NSAID-related bleeding, another common cause of bleeding is that related to the medication, warfarin ("Coumadin" and others). This medication needs to be closely monitored as the bleeding risk can be markedly increased by interactions with other medications. Warfarin acts by inhibiting the production of Vitamin K in the gut. Vitamin K is required for the production of the clotting factors, II, VII, IX, and X in the liver. One of the most common causes of warfarin-related bleeding is taking antibiotics. The gut bacteria make vitamin K and are killed by antibiotics. This decreases vitamin K levels and therefore the production of these clotting factors.

Deficiencies of platelet function may require platelet transfusion while deficiencies of clotting factors may require transfusion of either fresh frozen plasma or specific clotting factors, such as Factor VIII for patients with hemophilia.

See also[link]

• Anaesthesia Trauma and Critical Care
• Aneurysm
• Autohemorrhaging
• Coagulation
• Exsanguination - death by bleeding
• Hemophage
• Hemophilia

Footnotes[link]

Leona Lewis
Lewis at the 2009 American Music Awards
Background information
Birth name	Leona Louise Lewis
Born	(1985-04-03) 3 April 1985 (age 27) Islington, London, England, UK
Genres	Pop, R&B
Occupations	Singer-songwriter, recording artist
Years active	2006–present
Labels	Syco, J, RCA
Website	leonalewismusic.co.uk

Leona Louise Lewis (born 3 April 1985) is a British singer and songwriter.^[1] Lewis came to prominence in 2006 when she won the third series of the British television series The X Factor.

Lewis has released two albums to date, Spirit and Echo, in 2007 and 2009 respectively. A multi-platinum selling artist and three-time Grammy Award nominee, her most successful single, "Bleeding Love", reached number one in over thirty countries around the world, and was the best-selling single worldwide in 2008.^[2] Other notable singles include "Better in Time", "Happy" and "I Got You". She was proclaimed 'Top New Artist' by Billboard magazine in 2008.

Lewis's debut tour, The Labyrinth, took place in 2010, and her third album, Glassheart, is scheduled for release in 2012. It was preceded by "Collide", a single from the album, which became her seventh top-five hit in the United Kingdom. Lewis's net worth was estimated at £12 million in April 2012.^[3]

Early life[link]

Lewis was born in the London Borough of Islington, to Aural Josiah "Joe" Lewis of Afro-Guyanese descent, and Maria Lewis of Welsh, Irish, and Italian descent.^[1][4][5] Her parents enrolled her at the Sylvia Young Theatre School. From there she attended the Italia Conti Academy and the BRIT School, where she learned to play instruments, such as the guitar and piano, in the hope of becoming a singer-songwriter.^[6][7] Lewis wrote her first full-length song at the age of 12.^[8] She initially trained in opera, but went on to singing jazz and blues, eventually leading to popular music, citing Minnie Riperton, Eva Cassidy and Stevie Wonder as her main influences.^[5] After leaving the BRIT School at 17, following a year abroad in Boston, Massachusetts in a transfer program,^[5] she took a number of jobs to fund studio time,^[9] recording a demo album called Twilight.^[10] The album, almost exclusively comprising her own compositions, was recorded under Spiral Music, a production company based in Fulham. "I tried to secure a record deal by doing things my own way. I worked very hard but I never managed to land a contract", said Lewis.^[11] Other demos were recorded under licence from UEG Entertainment, later included on an album called Best Kept Secret.^[12] None of Lewis's demos brought her significant attention, however, and she considered taking a hiatus from her music career to attend university. Then her boyfriend persuaded her to enter The X Factor which subsequently severed her connections with UEG.^[13]

Music career[link]

[edit] 2006: The X Factor

Lewis at the London premiere for Flushed Away, November 2006

Lewis auditioned for the third series of The X Factor in 2006, singing "Over the Rainbow". She was mentored by Simon Cowell and was announced the winner on 16 December 2006, winning a £1 million recording contract.^[14]

Her debut single, a cover of Kelly Clarkson's "A Moment Like This", was released on CD on 20 December 2006, and was available as a digital download from midnight on 17 December. It broke a world record after it was downloaded 50,000 times in thirty minutes.^[15] On 24 December, "A Moment Like This" was crowned the 2006 UK Christmas number-one single, having sold 571,253 copies, outselling the rest of the Top 40's sales combined.^[16] The single became the most downloaded song in 2006; it stayed at No. 1 for four weeks and stayed at the top spot in the Irish Singles Chart for six weeks.^[17]

[edit] 2007–09: Spirit and international breakthrough

In February 2007 Lewis signed a £5 million (US$9.7 million) five-album contract in the United States with Clive Davis's record label, J Records,^[18] and showcased for several American music executives.^[18][19][20] A press release described how Cowell and Davis would work together in a "first-of-its-kind" partnership on both the song and producer selection for Lewis's debut album, entitled Spirit.^[21] Lewis recorded tracks for the album in London, Miami, Los Angeles, New York City, and Atlanta,^[22] where she worked with several songwriters and record producers including Dallas Austin, Walter Afanasieff, Salaam Remi,^[23] Steve Mac,^[24] Stargate^[25] and Ne-Yo.^[26] It was released in November 2007 and entered both the Irish Albums Chart and the UK Albums Chart at number one, becoming the fastest-selling debut album in both countries, and the United Kingdom's fourth fastest selling album of all time.^[27][28][29] It was released in several other nations in January 2008, and went to number one in New Zealand, Australia, Austria, Germany, South Africa and Switzerland.^[30] Two more tracks were recorded in 2008 for the US release of the album: "Forgive Me", produced by Akon, and "Misses Glass", produced by Madd Scientist.^[31] It was released in the United States in April 2008 and entered the Billboard 200 at No. 1, making Lewis the first British artist to reach number one with a debut album.^[32] A special edition of Spirit was re-released in November 2008 in Europe, including the songs "Forgive Me", "Misses Glass" and a cover of the Snow Patrol song "Run". The album again went to number one in the UK Albums Chart. To date the album has sold over 6.5 million copies worldwide^[33] and has a 9× platinum certification in the UK.^[34]

Lewis performing at the Clive Davis Pre Grammy Gala in 2009

Lewis's second single, "Bleeding Love", produced by Ryan Tedder and written by Tedder and Jesse McCartney, was released in October 2007 in the UK, where it sold 218,805 copies in its first week, giving it the biggest first-week sales of 2007 to date.^[35][36] It entered the UK Singles Chart at number one, where it stayed for seven weeks,^[37] and in the Irish Singles Chart it remained at number one for eight weeks.^[38] It reached number one in the singles charts of New Zealand, Australia, France, Germany, Norway, Switzerland, Belgium, The Netherlands, Austria, Canada and the United States. "Bleeding Love" won The Record of the Year in December 2007.^[39] In February 2008, "Bleeding Love" entered the Billboard Hot 100 at number 85 and then went on to peak at number one for four non-consecutive weeks. The song became the first track by a UK female to reach number one since Kim Wilde's "You Keep Me Hangin' On" in 1987.^[40] Lewis's third single, a double A-side featuring "Better in Time" and "Footprints in the Sand", was released in the United Kingdom in March 2008, in aid of Sport Relief, and she visited South Africa for the charity.^[41] The single reached a peak of number two in the UK singles chart selling over 40,000 copies in its first week of physical release. "Better in Time" was released as Lewis's second single in the US, where it peaked at number 11 in the Billboard Hot 100.^[42] "Forgive Me" was released as Lewis's fifth single in November 2008; it reached number five in the UK.^[43] "Run" was released as a download-only single in the UK, reaching number one, and becoming the UK's fastest-selling download-only single with 69,244 copies sold in two days.^[44] Lewis's last single from Spirit, "I Will Be", was released in January 2009,^[45] only in North America; it peaked at number 66 on the Billboard Hot 100. In August 2008, she performed "Whole Lotta Love" with guitarist Jimmy Page of Led Zeppelin at the 2008 Summer Olympics closing ceremony in Beijing, representing the handover to London as the host of the 2012 Summer Olympics.^[46] In September 2008, she joined several female singers to perform a single for the anti-cancer campaign Stand Up to Cancer. The single, titled "Just Stand Up!", was performed live during the one-hour telethon that aired on all major US television networks.^[47] Lewis received three nominations for the 51st Grammy Awards in December 2008. "Bleeding Love" was nominated for Record of the Year and Best Female Pop Vocal Performance and Spirit was nominated for Best Pop Vocal Album. She was nominated for four BRIT Awards, in the categories British Female Solo Artist, British Breakthrough Act, British Album for Spirit, and British Single for "Bleeding Love",^[48] but despite being the favourite to win the most awards, she received none.^[49] She won two awards at the 2008 MOBO Awards: Best Album for Spirit and Best Video for "Bleeding Love".^[50] In December 2008 Lewis was named 'Top New Artist' by Billboard magazine.^[51]

[edit] 2009–10: Echo and The Labyrinth

Lewis performing on The Labyrinth tour in 2010

Lewis's second album, Echo, was given a worldwide release in November 2009.^[52] Production took place throughout 2009, including work with Ryan Tedder,^[53] Justin Timberlake,^[54] Max Martin,^[55] Arnthor Birgisson,^[56] Kevin Rudolf,^[57] and John Shanks.^[58] It was recorded in Los Angeles and took nine months to produce.^[59] Lewis described the album as "more guitar-driven" compared to Spirit.^[60] Lewis performed her first full UK show at the Hackney Empire in London on 2 November 2009, performing songs from Spirit and Echo.^[61][62] Echo reached number one in the UK Albums Chart and the top ten of Austria, Ireland and Switzerland.^[63] Despite previous attempts from Lewis's lawyers to ban the release of Best Kept Secret by UEG Music, claiming that the singer had not given her consent, the album was released in January 2009 when the label insisted it owned the rights to the music and Lewis would receive a 50% share of the album's profits. However, a television advert for the album was banned by the Advertising Standards Authority, who said in a statement: "We considered that the claim 'Leona Lewis's new album' misleadingly implied it was the singer's latest recording rather than a new CD of tracks recorded some years ago."^[64] The album was released to iTunes in standard and deluxe editions, and two EPs, "Private Party" and "Dip Down"/"Joy", were released in September 2009. The first single released from Echo was "Happy", which was written by Lewis, Tedder and Evan Bogart and produced by Tedder.^[65] The single was released on 15 September 2009,^[66][67] peaking at number two in the UK,^[68] and reaching the top ten in Austria, Belgium, Germany, Ireland, Japan and Switzerland.^[69] Lewis also recorded the theme song for the 2009 science fiction film Avatar, directed by James Cameron.^[70] The song, "I See You (Theme from Avatar)", was written by James Horner and Simon Franglen. It was nominated for Best Original Song at the 67th Golden Globe Awards.^[71] In January 2010, Lewis provided vocals on a cover of "Everybody Hurts", released to help raise money for victims of the 2010 Haiti earthquake.^[72] The second single from Echo, "I Got You", was released in February 2010. The song "My Hands" was used as the theme song for Final Fantasy XIII^[73] In April 2010, she featured on a duet with Italian singer Biagio Antonacci, called "Inaspettata (Unexpected)", from his album Inaspettata.^[74] They performed the song on the Italian TV show Io Canto on 22 October 2010.^[75] Lewis performed a 13-piece set list at the Rock in Rio festival in Lisbon, Portugal, on 22 May 2010, including songs from Spirit and Echo.^[76] Her first tour, titled The Labyrinth^[77] supporting Spirit and Echo, started in May 2010,^[78] with a theme based on the film Labyrinth.^[79] Lewis was scheduled to tour North America from July to August 2010 supporting Christina Aguilera's Bionic Tour,^[80] however, Aguilera cancelled the tour, leaving Lewis's plans unknown.^[81] A DVD of the tour, along with a ten-track CD, was released with the title The Labyrinth Tour Live from The O2 on 29 November 2010.^[82]

[edit] 2010–present: Hurt and Glassheart

Lewis began work on her third album shortly after she had completed The Labyrinth tour.^[83] She suggested the album would be "a bit different from what people have heard" from her before, adding that she planned to "go in and create and just see what happens".^[84] Lewis later described the album as "more progressive", "more eclectic", "more uptempo" and "a bit darker".^[85] Reports suggested that the album had taken a dubstep direction, with songwriters asked to submit dance songs and no ballads.^[86] It was also reported that Simon Cowell had set a deadline for the album for a summer 2011 release.^[87] On 25 May 2011, Lewis was named as an ambassador for BBC Radio 1's Hackney Weekend 2012, the BBC's biggest ever free-ticketed live music event, and one of the artists confirmed to be performing at the event, which will take place on 23 and 24 June 2012.^[88][89] Following the announcement, she performed a special Live Lounge at the Hackney Empire, with a reggae version of "Better in Time", which incorporated Rihanna's "Man Down", and a cover of Labrinth's "Let the Sun Shine".^[90][91] In June 2011, when asked about the upcoming album, Lewis described it as "energetic, deep, [and] unique". She also commented that it would have a darker tone and that she would be putting her "heart into [her] lyrics". She cited Tracy Chapman, Kate Bush and Tears for Fears as the album's primary influences.^[92]

On 14 July 2011, it was confirmed that "Collide" would be the first track to be taken from Lewis's third studio album, Glassheart. The dance-pop anthem, written by Autumn Rowe and produced by Sandy Vee, had its first UK radio play on The Scott Mills Show on BBC Radio 1 on 15 July 2011. It was released in the UK on 4 September 2011 and Germany on 9 September 2011.^[93][94][95] The single courted controversy after it was plagiarised from Swedish musician Avicii's 2010 song "Penguin".^[96] Berg took the case to the British High Court.^[97][98] Collide debuted on the official UK top 40 singles chart at number 4.

For the album, Lewis has worked with numerous writers and producers including: Ammo, Jonas Quant, Chuck Harmony, Claude Kelly, Ryan Tedder, Fraser T. Smith, Al Shux, Steve Robson,^[95] Dallas Austin,^[87] Rico Love^[99] and Ne-Yo.^[100] In May 2011, it was reported that Lewis had recorded a track called "Trouble" written by Emeli Sandé and Naughty Boy. Lewis also recorded a track called "Mountains" written by Sandé, Naughty Boy and Blazin' Squad members Flava (James Murray) and Mus (Mustafa Omer).^[99][101] It has been confirmed that the album is entitled Glassheart. Though originally announced to be released on 28 November in the UK, it has since been announced that the album will be released on 26 March 2012. However, it was later announced in January 2012 that the album would be delayed again to the 26 November 2012.^[102]

On 7 October, RCA Music Group announced it was disbanding J Records along with Arista Records and Jive Records. With the shutdown, Lewis (and all other artists previously signed to these three labels) will release her future material (including Glassheart) on the RCA Records brand.^[103][104]

On 29 October, Lewis performed as the featured performer for the closing of the 2011 Doha Film Festival, where she sang a setlist of ten songs, including 'Collide' and covers of OneRepublic's Apologize, Seal's Kiss from a Rose and Boney M's Rivers Of Babylon.^[105]

Before the release of Glassheart, Lewis released an EP on 9 December 2011, entitled Hurt: The EP, containing three covers as a holiday gift for her fans.^[106] On 22 December, Lewis performed a version of Snow Patrol's "Run" at the season finale of the U.S. X Factor.^[107][108] It was announced on 25 January 2012 that the album would be delayed again until late November 2012.^[109]

Artistry[link]

Voice[link]

A mezzo-soprano,^[110][111] Lewis is often compared with other singers such as Celine Dion, Whitney Houston^[112] and Mariah Carey.^[113] Lewis is also known to sing opera, stating that she practises operatic scales every week.^[112] Music critic Neil McCormick, of The Daily Telegraph, has praised Lewis's technical skills, writing, "Her mezzo-soprano range allows her to take melodies from luxurious low notes to high-flying falsetto, gliding with elegant power and impressive control through all kinds of fluctuations and modulations."^[110] Stephen Thomas Erlewine of AllMusic adds, "Lewis can hit [high belted] notes but make it seem easy, never straining her voice and building nicely to the climax."^[114] In the same vein, Slant describes Lewis's vocals as "technically unimpeachable".^[115]

Influences[link]

Lewis credits Mariah Carey and Whitney Houston as her major influences. She said, "when I was growing up I used to listen to Whitney Houston, Mariah Carey, those kind of big powerful kind of singers so that influences a lot my music and a lot of the songs I like to sing."^[116]

Other activities[link]

In October 2008, The Times reported that Lewis had turned down a seven-figure sum from Mohamed Al Fayed to open a Harrods sale. Lewis commented in the press that she turned down the deal on the grounds that Harrods is the only UK department store which continues to stock clothing made from animal fur.^[117] "It wasn't a million pounds that I was offered, as the papers reported, but even if it had been, I still would have turned it down."^[118] "I got a lot of flak for that. There were people who said I should have done it and given the money to charity, but that would have been such a contradiction."^[119] She announced in October 2008 that she was in the "bargaining period" of launching her own ethical line of accessories through Topshop,^[5][117] and that she was in the late stages of releasing her own perfume for Europe.^[120] Her perfume, Leona Lewis, was launched by LR in July 2009.^[121] In 2010, she set up a fashion company with her then boyfriend, Lou Al-Chamaa, called LOA Clothing Ltd.^[122]

Lewis signed a book deal in January 2009 to release an illustrated autobiography in October 2009. The book, entitled Dreams, contains mostly pictures taken by photographer Dean Freeman.^[123] In May 2012, Lewis returned to The X Factor as a guest judge during auditions in London for the ninth series.^[124]

Personal life[link]

Lewis lives in Hackney. She lived with her boyfriend Lou Al-Chamaa, former electrician turned A&R scout for Sony records, until their split in June 2010.^[125] Lewis and Al-Chamaa knew each other since she was approximately ten years old.^[126] A vegetarian since she was 12,^[23] Lewis won PETA's Sexiest Vegetarian along with Red Hot Chili Peppers frontman Anthony Kiedis in 2008,^[127] and Europe's Sexiest Vegetarian in 2009 with actor Scott Maslen.^[128] She also was named PETA's Person Of The Year for 2008.^[129] Lewis is a supporter of the World Society for the Protection of Animals^[130] and is a patron of Brentwood's Hopefield Animal Sanctuary.^[131]

Wikinews has related news: Leona Lewis assaulted at book signing in London, England Man charged with assaulting British singer Leona Lewis

At a book signing for Dreams on 14 October 2009 at the Piccadilly branch of Waterstone's book store in central London, Lewis was assaulted by a 29-year-old man from south London^[132][133] who was arrested at the scene;^[133] Lewis suffered bruising.^[134] The assailant was sectioned under the Mental Health Act^[133] and was charged with common assault,^[134] He admitted to the offence and was hospitalised for an indeterminate period.^[135]

Discography[link]

Albums

• 2007: Spirit
• 2009: Echo
• 2012: Glassheart

Tours[link]

• 2010: The Labyrinth

Awards and nominations[link]

References[link]