1,994 results match your criteria: "Epsom & St Helier Hospital Trust[Affiliation]"

Based on the results of our meta-analysis, dual mobility implants appear to have the most efficacy in preventing instability following revision total hip arthroplasty. Notwithstanding, given the relatively small sample sizes of the included studies, in conjunction with heterogeneity in study design, it is important to recognize that further large randomized controlled trials are necessary to determine the optimal bearing surface to reduce the risk of instability after revision total hip arthroplasty.

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Article Synopsis
  • A significant number of people with diabetes develop chronic kidney disease (CKD), which often leads to end-stage kidney disease (ESKD) and is highly associated with cardiovascular disease (CVD) mortality.
  • Managing modifiable risk factors, such as hyperglycemia and hypertension, along with treating dyslipidemia is vital for patients with type 2 diabetes and CKD to reduce the risk of CVD.
  • Recent clinical trials demonstrate that medications like SGLT-2 inhibitors and GLP-1 receptor agonists can help protect kidney function in these patients, informing updated clinical practice guidelines for healthcare professionals.
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Artificial Intelligence Applications for Imaging Metabolic Bone Diseases.

Semin Musculoskelet Radiol

October 2024

Dipartimento di Scienze Mediche e Chirurgiche, Bologna University, Bologna, Italy.

Article Synopsis
  • AI is revolutionizing medical imaging for metabolic bone diseases (MBDs) like osteoporosis and rare conditions, enhancing diagnosis and management.
  • The article analyzes various AI techniques, recent advancements, and their clinical applications, while addressing ethical issues and future developments.
  • By combining AI with existing imaging methods, there is potential for improved diagnostic accuracy and patient outcomes in the treatment of MBDs.
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Purpose: The purpose of this study was to identify independent variables associated with chronic pain (CP) at 1 year following knee arthroplasty (KA) and whether this influenced functional outcomes.

Methods: This retrospective study was conducted over a 2-year period and included 2588 patients with completed Oxford knee score (OKS) and EuroQol (EQ)-five domains (5D) preoperatively and at 1 and 2 years postoperatively. The OKS pain component score was used to define patients with CP (≤14 points).

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In 2015, U.K. newborn screening (NBS) laboratory guidelines were introduced to standardize dried blood spot (DBS) specimen quality acceptance and specify a minimum acceptable DBS diameter of ≥7 mm.

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Concurrent Dandy-Walker malformation and persistent fetal vasculature: A case report.

Int J Surg Case Rep

October 2024

Epsom and St Helier University Hospitals NHS Trust, St Helier Hospital, Wrythe Lane, Carshalton, Surrey SM5 1AA, United Kingdom. Electronic address:

Introduction And Importance: Dandy-Walker malformation (DWM) is a rare cerebellar condition, and persistent fetal vasculature (PFV) is a congenital eye anomaly. This report presents the first known case of DWM with PFV.

Case Presentation: A 31-day-old male infant presented with right eye discharge, lethargy, and breath-holding spells.

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An innovative approach is crucially needed to manage relapse after allogeneic hematopoietic cell transplantation (HCT) in patients with advanced hematological malignancies. This review explores key aspects of haploidentical HCT with post-transplant cyclophosphamide, highlighting the potential and suitability of this platform for natural killer (NK) cell immunotherapy. NK cells, known for their unique abilities to eliminate cancer cells, can also exhibit memory-like features and enhanced cytotoxicity when activated by cytokines.

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This Good Practice Paper provides recommendations for the use of advanced imaging for earlier diagnosis and morbidity prevention in multiple myeloma. It describes how advanced imaging contributes to optimal healthcare resource utilisation by in newly diagnosed and relapsed myeloma, and provides a perspective on future directions of myeloma imaging, including machine learning assisted reporting.

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Purpose: The effect of cancellation and postponement of primary total hip arthroplasty (THA) or knee arthroplasty (TKA) on patient outcomes is unclear. The aim was to assess whether cancellation and delay to arthroplasty was associated with worse joint specific function and quality of life (QoL) 1-year postoperatively.

Methods: A single centre retrospective case-control study was performed for all patients planned to undergo THA or TKA in 2019.

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Objective: To elicit expert opinion and gain consensus on specific exercise intervention parameters to minimise hip bone mineral density (BMD) loss following traumatic lower limb amputation.

Methods: In three Delphi rounds, statements were presented to a panel of 13 experts from six countries. Experts were identified through publications or clinical expertise.

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Invasive Treatment Strategy for Older Patients with Myocardial Infarction.

N Engl J Med

November 2024

From the Translational and Clinical Research Institute, Faculty of Medical Sciences (V.K.), the Population Health Sciences Institute (H.M., M.D.T.), and the Newcastle Clinical Trials Unit (C.S., M. Bardgett, P.W., M.D.T., J.P.), Newcastle University, and the Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust (V.K., J.A.H., I.U.H.), Newcastle upon Tyne; Northumbria Healthcare NHS Foundation Trust, Cramlington (C.R., D.P.R.); the Faculty of Health Sciences and Wellbeing, School of Medicine, University of Sunderland Medical School, Sunderland (D.P.R.); North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees (J. Carter, J.Q.); Chesterfield Royal Hospital, Chesterfield (J. Cooke); South Tees NHS Foundation Trust, Middlesbrough (D.A.); County Darlington and Durham NHS Foundation Trust, Darlington (J. Murphy); Royal Derby Hospital, Derby (D.K.); University Hospital Ayr, Ayr (J. McGowan); Leeds Teaching Hospital NHS Trust, Leeds (M.V.); Torbay and South Devon NHS Foundation Trust, Torquay (D.F.); Manchester University NHS Foundation Trust, Manchester (H.C.); Epsom and St. Helier University Hospitals, Epsom (S.M.); Ninewells Hospital, Dundee (J.I.); Bradford Royal Infirmary, Bradford (S.L.); Blackpool Victoria Hospital, Blackpool (G.G.); United Lincolnshire Hospitals NHS Trust, Lincoln (K.L.); Wrightington Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan (A.S.); North Bristol NHS Trust, Bristol (A.G.D.); University Hospital of Leicester NHS Trust, Leicester (S.H.); Barts Health NHS Trust (M. Belder) and London School of Hygiene and Tropical Medicine (S.J.P.), London; the Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (M.D., D.E.N., K.A.A.F.); Norwich Medical School, University of East Anglia, Norwich (M.F.); and Sheffield Teaching Hospital, Sheffield (R.F.S.) - all in the United Kingdom.

Background: Whether a conservative strategy of medical therapy alone or a strategy of medical therapy plus invasive treatment is more beneficial in older adults with non-ST-segment elevation myocardial infarction (NSTEMI) remains unclear.

Methods: We conducted a prospective, multicenter, randomized trial involving patients 75 years of age or older with NSTEMI at 48 sites in the United Kingdom. The patients were assigned in a 1:1 ratio to a conservative strategy of the best available medical therapy or an invasive strategy of coronary angiography and revascularization plus the best available medical therapy.

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Article Synopsis
  • NICE recommends supervised exercise for men with prostate cancer on ADT, but it’s not commonly implemented in NHS practice.
  • The STAMINA programme aims to test how to effectively integrate these recommendations into NHS care through stakeholder workshops.
  • Key themes from the workshops included the need for specialized training, engaging champions for the program, and establishing clear communication and monitoring systems to aid successful implementation.
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IntroductionRespiratory sentinel surveillance systems leveraging computerised medical records (CMR) use phenotyping algorithms to identify cases of interest, such as acute respiratory infection (ARI). The Oxford-Royal College of General Practitioners Research and Surveillance Centre (RSC) is the English primary care-based sentinel surveillance network.AimThis study describes and validates the RSC's new ARI phenotyping algorithm.

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Society for Cardiovascular Magnetic Resonance 2023 Cases of SCMR case series.

J Cardiovasc Magn Reson

December 2024

Adult Congenital Heart Disease, The Prince Charles Hospital, Brisbane, Australia. Electronic address:

"Cases of SCMR" is a case series on the SCMR website (https://www.scmr.org) for the purpose of education.

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Introduction: Polycystic ovarian syndrome (PCOS) is the commonest endocrine condition affecting reproductive age women. Many biomarkers may aid assessment and management, however evidence is limited on their utility in clinical practice. We conducted a review of systematic reviews to identify the most useful biomarkers in the clinical management of PCOS.

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Conversion disorder after general anaesthesia for cystoscopy: A case report.

Saudi J Anaesth

June 2024

Senior Clinical Fellow of Anaesthesia and Intensive Care, Epsom and St Helier University NHS Trust, Surrey, United Kingdom.

Article Synopsis
  • Conversion disorder (CD) is a rare condition that can occur after general anesthesia, leading to sensory and motor deficits.
  • Before diagnosing CD, doctors must rule out any organic or metabolic causes of the symptoms.
  • A case study highlighted a 62-year-old woman who experienced quadriplegia and altered consciousness after awakening from anesthesia due to CD.
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Aim: The clinical burden of pelvic exenteration (PE) for locally advanced rectal cancer (LARC) is nationally under-reported. The widespread use of pelvic MRI since 2005 has increased the accuracy of local staging and awareness of the need for 'beyond TME (total mesorectal excision)' surgery. The aim of this study was to assess the volume of patients undergoing PE within England, which factors affected survival outcomes and whether the use of MRI has influenced these outcomes.

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Background: Optimal secondary prevention antithrombotic therapy for patients with antiphospholipid syndrome (APS)-associated ischemic stroke, transient ischemic attack, or other ischemic brain injury is undefined. The standard of care, warfarin or other vitamin K antagonists at standard or high intensity (international normalized ratio (INR) target range 2.0-3.

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Ageing well with diabetes: the role of technology.

Diabetologia

October 2024

Foundation for Diabetes Research in Older People (fDROP), Droitwich Spa, UK.

Over the past two decades there has been a substantial rise in the adoption of diabetes therapeutic technology among children, adolescents and younger adults with type 1 diabetes, and its use is now also advocated for older individuals. Older people with diabetes are more prone to experience hypoglycaemia because of numerous predisposing factors and are at higher risk of hypoglycaemic events requiring third-party assistance as well as other adverse sequelae. Hypoglycaemia may also have long-term consequences, including cognitive impairment, frailty and disability.

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(1) Background: This study aims to establish the knowledge, attitudes and current behaviours towards female fertility preservation (FP) services amongst healthcare professionals (HCPs) in the UK. (2) Methods: An online survey was advertised publicly on the social media platform between 25 February 2021 and 11 March 2021. (3) Results: In total, 415 participants fulfilled the inclusion criteria and completed the survey.

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Septic shock stands for a group of manifestations that will cause a severe hemodynamic and metabolic dysfunction, which leads to a significant increase in the risk of death by a massive response of the immune system to any sort of infection that ends up with refractory hypotension making it responsible for escalating the numbers of hospitalized patients mortality rate, Organisms that are isolated most of the time are , and . The WHO considers sepsis to be a worldwide health concern; the incidence of sepsis and septic shock have been increasing over the years while being considered to be under-reported at the same time. This review is a quick informative recap of the recent studies regarding diagnostic approaches using lactic acid (Lac), procalcitonin (PCT), Sequential Organ Failure Assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II) score, as well as management recommendations for using vasopressors, fluid resuscitation, corticosteroids and antibiotics that should be considered when dealing with such type of shock.

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Importance: Adenomyosis can reduce the chance of clinical pregnancy in women undergoing assisted conception. Treatment with prolonged gonadotrophin-releasing hormone analogue (GnRHa) downregulation prior to IVF/ICSI has been postulated to improve pregnancy outcomes.

Objective: We aimed to evaluate the effectiveness and safety of prolonged GnRHa treatment (minimum one month) versus no pre-treatment in women with adenomyosis undergoing IVF/ICSI using a systematic review and meta-analysis.

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Importance: There are reported benefits from vitrectomy for diabetic macular edema (DME); however, data precede anti-vascular endothelial growth therapy (VEGF) therapy, supporting a need to assess the current role of vitrectomy.

Objective: To determine rates of recruitment and efficacy outcomes of vitrectomy plus internal limiting membrane (ILM) peeling adjunctive to treat-and-extend (T&E) anti-VEGF injections for diabetic macular edema (DME).

Design, Setting, And Participants: This was a single-masked, multicenter randomized clinical trial at 21 sites in the United Kingdom from June 2018 to January 2021, evaluating single eyes of treatment-naive patients with symptomatic vision loss from DME for less than 1 year.

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TGFβ1 is a powerful regulator of fibrosis; secreted in a latent form, it becomes active after release from the latent complex. During tissue fibrosis, the EDA + isoform of cellular fibronectin is overexpressed. In pulmonary fibrosis it has been proposed that the fibronectin splice variant including an EDA domain (FN EDA+) activates latent TGFβ.

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