Publications by authors named "William Brindle"
Tailoring follow-up endoscopy in patients with severe oesophagitis.
Frontline Gastroenterol
March 2024
Objective: We aimed to investigate the clinical utility of follow-up oesophagogastroduodenoscopy (OGD2) in patients with severe oesophagitis (Los Angeles grades C or D) through evaluating the yield of Barrett's oesophagus (BO), cancer, dysplasia and strictures. Second, we aimed to determine if the Clinical Frailty Scale (CFS) may be used to identify patients to undergo OGD2s.
Design/method: Patients in NHS Lothian with an index OGD (OGD1) diagnosis of severe oesophagitis between 1 January 2014 and 31 December 2015 were identified.
Article Synopsis
- The ACE Index was initially developed to predict steroid non-response in patients with acute ulcerative colitis (UC) and has now been validated in a larger, independent patient cohort.
- In a study of 800 patients, the ACE Index showed a positive predictive value of 62.5% for those scoring a maximum of 3, indicating a significant portion did not respond to IV steroids, while 79.8% of patients with a score of 0 did respond.
- The validation suggests the ACE Index can assist in identifying high-risk patients for steroid non-response in acute UC cases, but further research is needed to enhance its accuracy and clinical application.
Article Synopsis
- Schizophrenia is a severe mental illness that significantly lowers quality of life and life expectancy, often accompanied by various health comorbidities.
- Despite known increased mortality rates among schizophrenia patients, the effects of gastrointestinal and liver diseases on them are not well understood, though issues like chronic liver disease and constipation from antipsychotic treatment are prevalent.
- There is a need for improved awareness and collaborative support within the medical community to ensure timely and appropriate care for these patients, especially in regard to digestive health and screenings like bowel cancer tests.
Article Synopsis
- In NHS Lothian, the incidence of collagenous colitis (CC) significantly increased from 1998-2003 to 2013-2018, with diagnosed cases rising from 25 to 224.
- The mean annual incidence jumped from 0.5 to 4.3 cases per 100,000 people, especially high in females over 60, whose rates surged from 2.3 to 22.4 per 100,000.
- The total number of colonoscopies conducted more than doubled, reflecting increased detection of CC parallels with the rising number of procedures performed.
Risk stratifying gastric ulcers: development and validation of a scoring system.
Frontline Gastroenterol
February 2021
Objective: Debate is ongoing regarding the need for universal endoscopic follow-up to ensure gastric ulcer healing. We aimed to assess the value of follow-up oesophago-gastro-duodenoscopies (OGDs) for gastric ulcer healing and stratify patients according to risk of malignancy by developing a risk score.
Design/method: All patients in National Health Service (NHS) Lothian with an index OGD and a diagnosis of gastric ulcer between 1 January 2014 and 31 December 2018 were identified.
Article Synopsis
- Diagnostic unsedated transnasal endoscopy (uTNE) is a safe and well-tolerated procedure gaining popularity in the UK, though it's still limited to a few centers.
- Recent studies indicate that uTNE's diagnostic accuracy for esophageal issues is on par with conventional endoscopy (cEGD), aided by technological advancements such as improved scopes and imaging techniques.
- uTNE presents advantages during the COVID-19 pandemic, offering less stress on the heart, reduced aerosol production, and quicker patient processing, making it a strong candidate for primary diagnostic endoscopic evaluation.
Article Synopsis
- The study aimed to identify factors that lead to poor wound healing in patients with perianal Crohn's disease after undergoing proctectomy, particularly in the context of biologic therapies.
- A review of 103 patient records revealed that 58.3% experienced wound healing failure at 6 months, and 39.8% at 12 months, with male gender being the only significant predictor of poor healing.
- The findings indicated that prior exposure to biologic therapies like infliximab and adalimumab was not linked to wound healing outcomes, while lower pre-operative C-reactive protein levels were associated with better healing at 6 months.
This study aimed to establish 5-year survival of patients diagnosed with bleeding small bowel (SB) angioectasia, with the hypothesis that many will suffer deaths relating to comorbidity rather than gastrointestinaI bleeding. SB capsule endoscopy (SBCE) procedures, performed for suspected SB bleeding or iron deficiency anemia, with angioectasia isolated as the cause of SB bleeding and at least 5 years of follow-up data were isolated (n = 125) along with an age-matched group with "normal" SBCE procedures (n = 125). These were retrospectively analysed with further information on mortality and comorbidity gathered through hospital records.
View Article and Find Full Text PDFBackground: Intravenous (IV) steroids remain the first-line treatment for patients with acute ulcerative colitis (UC). However, 30% of patients do not respond to steroids, requiring second-line therapy and/or surgery. There are no existing indices that allow physicians to predict steroid nonresponse at admission.
View Article and Find Full Text PDFObjective: Tranexamic acid reduces blood loss and transfusion in on-pump coronary artery bypass graft (CABG) surgery. Compared with on-pump, off-pump surgery is associated with less blood loss and transfusion. Therefore, tranexamic acid may be less effective for off-pump surgery, and its safety profile may be different in this setting.
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