34,615 results match your criteria: "Guy's & St. Thomas' NHS Hospitals Trust[Affiliation]"

Background: Pregnancy and early childhood cohorts provide a framework for investigating the complex interplay between early-life exposures and health outcomes, thereby informing prevention strategies and interventions to improve maternal and child health. In this paper, we outline the objectives, methodologies and expected contributions of INSIGHT-2, a comprehensive cohort study dedicated to advancing our understanding of pregnancy and pregnancy complications towards improving the health and well-being of mothers and their offspring.

Methods: Over the course of 5 years, the study aims to establish a diverse cohort of 1700 pregnant women and to follow up their children up to 2 years of age.

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Polysomnography, the gold standard diagnostic tool in sleep medicine, is performed in an artificial environment. This might alter sleep and may not accurately reflect typical sleep patterns. While macro-structures are sensitive to environmental effects, micro-structures remain more stable.

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Objectives: This study aimed to determine the clinical utility of the androgen deprivation therapy (ADT)+docetaxel (DOCE)+androgen receptor-targeted agent (ARTA) triplet therapy in patients with metastatic hormone-sensitive prostate cancer (mHSPC) in the UK.

Design: A modified Delphi method. A steering group of eight UK healthcare professionals experienced in prostate cancer care discussed treatment challenges, developing 39 consensus statements across four topics.

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What place for daridorexant?

Drug Ther Bull

November 2024

Pharmacy, Guy's and St Thomas' NHS Foundation Trust, London, London, UK

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Article Synopsis
  • This study explores the outcomes and management of pediatric auditory brainstem implantation (ABI) for children with severe inner ear malformations, aiming to unify clinical practices and address current challenges.
  • A systematic review of relevant findings from the Third International Pediatric ABI Symposium analyzed data from multiple countries, highlighting trends in auditory outcomes, surgical approaches, and rehabilitation strategies.
  • Key conclusions emphasize the need for standardized guidelines and improved collaboration among healthcare professionals to enhance patient outcomes and guide future research in this specialized field.
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Navigating choice of JAK inhibitor (JAKi) therapy for patients with myelofibrosis who are JAKi-naïve and for those who have previously been treated with a JAKi.

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Importance: Prurigo nodularis (PN) is a chronic and debilitating skin condition, characterized by intense itch with multiple nodular lesions. Nemolizumab demonstrated significant improvements in itch and skin nodules in adults with moderate to severe PN in a previous 16-week phase 3 study (OLYMPIA 2).

Objective: To assess the efficacy and occurrence of adverse events in adults with moderate to severe PN treated with nemolizumab vs those receiving placebo.

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Cardiovascular Magnetic Resonance Reveals Cardiac Inflammation and Fibrosis in Symptomatic Patients with Post-COVID-19 Syndrome: Findings from the INSPIRE-CMR Multicenter Study.

J Clin Med

November 2024

University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair in Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 11527 Athens, Greece.

. Post-coronavirus disease-2019 (COVID-19) patients may develop cardiac symptoms. We hypothesized that cardiovascular magnetic resonance (CMR) can assess the background of post-COVID-19 cardiac symptoms using multi-parametric evaluation.

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Dysregulation of the renin-angiotensin-aldosterone-system (RAAS) in sepsis is a complex and early phenomenon with a likely significant contribution to organ failure and patient outcomes. A better understanding of the pathophysiology and intricacies of the RAAS in septic shock has led to the use of exogenous angiotensin II as a new therapeutic agent. In this review, we report a multinational and multi-disciplinary expert panel discussion on the role and implications of RAAS modulation in sepsis and the use of exogenous angiotensin II.

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Background: Valvular heart disease (VHD) represents a significant burden on healthcare systems worldwide, necessitating specialised care through multidisciplinary valve clinics. However, there is a lack of a standardised training and certification framework for clinical scientists and specialist physiologists (CSSPs) working within specialist valve clinics (SVCs). This study aimed to design, implement and validate a competency framework dedicated to training and certifying valve CSSPs to enhance patient outcomes and establish standardised care.

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Determining optimal timing of birth for women with chronic or gestational hypertension at term: The WILL (When to Induce Labour to Limit risk in pregnancy hypertension) randomised trial.

PLoS Med

November 2024

Department of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.

Article Synopsis
  • Chronic or gestational hypertension affects about 7% of pregnancies, and the WILL Trial aimed to find the best timing for delivery to improve outcomes for mothers and babies.
  • The trial involved women with hypertension at 36 to 37 weeks gestation who were randomly assigned to either an early delivery intervention at 38 weeks or usual care at term, analyzing maternal and neonatal outcomes.
  • Despite aiming for 540 participants, the trial ended early with only 403 participants due to slow recruitment, showing no significant difference in poor maternal outcomes between the two groups, while deliveries in the intervention group occurred about 0.9 weeks earlier.
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Fungal infections are increasingly prevalent; however, antifungal stewardship attracts little funding or attention. Previous studies have shown that knowledge of guidelines and scientific evidence regarding antifungals is poor, leading to prescribing based on personal experiences and the inherent biases this entails. We carried out a retrospective study of inpatient antifungal usage at two major hospitals.

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Non-Surgical Approaches to the Management of the Intrathoracic Goiter-A Systematic Review.

J Pers Med

October 2024

Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, King's College London, London SE1 7EH, UK.

Background: Intrathoracic goiters (ITGs) are usually managed by surgical excision, However, over recent years, non-surgical strategies are emerging as an alternatives for treating this condition.

Methods: A systematic review of research published since 2017 in the PubMed database was conducted and a total of 39 articles were retrieved, along with methodological issues and future directions in the research on ITGs.

Results: Several non-surgical treatments exist, including radio-iodine ablation (RIA) and mini-invasive approaches, such as transcervical microwave ablation (TcMA), transcervical radiofrequency ablation (TcRfA), or selective embolization of the thyroid arteries (SETA).

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The local molecular signature of human peripheral neuropathic pain.

Pain

November 2024

Nuffield Department of Clinical Neuroscience, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.

Focal nerve injuries are often associated with neuropathic pain. Preclinical research suggests altered neuroimmune signalling underlies such neuropathic pain; however, its cause remains poorly understood in humans. In this multicentre cohort study, we describe the local cellular and molecular signature of neuropathic pain at the lesion site, using Morton's neuroma as a human model system of neuropathic pain (n = 22; 18 women) compared with nerves from participants without nerve injury (n = 11; 4 women).

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Vascular involvement in idiopathic pulmonary fibrosis.

ERJ Open Res

November 2024

Department of Health Sciences, Respiratory Unit, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy.

Article Synopsis
  • Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with unknown causes, linked to vascular abnormalities and complications like pulmonary hypertension (PH).*
  • A literature review reveals crucial molecular mechanisms involved in vascular changes related to IPF, emphasizing their potential as prognostic markers and highlighting the impact of antifibrotic therapies.*
  • The findings suggest that the vasculature is integral to IPF's progression and that emerging treatments with a vascular focus may improve outcomes for patients.*
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Cow's milk allergy (CMA) remains one of the most common and complex paediatric food allergies. In the last decade, our understanding has advanced in terms of immunoglobulin E (IgE)-mediated CMA and focus is now also paid to non-IgE-mediated CMA, particularly in some Western countries where incidence rates are high. We have had significant progress in the last 10 years in relation to our understanding of existing supportive tests for IgE-mediated CMA, with the advancement of newer tests, such as the basophil activation test (BAT), which have shown great promise.

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Introduction: Gastroesophageal reflux disease (GORD) and aspiration are risk factors in the development of bronchiolitis obliterans syndrome (BOS) in the lung transplant population. The aim of this study was to investigate if allograft function and survival improved after anti-reflux surgery (ARS) in lung transplant recipients.

Methods: In accordance with PRISMA guidelines, we conducted a systematic search of MEDLINE, Embase, and the Cochrane library databases from inception until 13/01/2024.

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Background: Sphingosine-1-phosphate (S1P) is a signalling molecule that has an inhibitory role in atherosclerosis, inflammation, cell proliferation, and immunity. Cenerimod is a selective S1P receptor modulator under investigation for the treatment of systemic lupus erythematosus (SLE). We aimed to determine the efficacy, safety, and tolerability of four doses of cenerimod in adults with moderate-to-severe SLE receiving standard of care background therapy.

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Perinatal outcomes after selective third-trimester ultrasound screening for small-for-gestational age: prospective cohort study nested within DESiGN randomized controlled trial.

Ultrasound Obstet Gynecol

January 2025

Department of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Article Synopsis
  • This study examines the effectiveness of third-trimester ultrasound in detecting small-for-gestational age (SGA) babies, highlighting concerns about low detection rates and risks associated with false results.
  • Researchers analyzed data from the DESiGN trial, focusing on stillbirth and neonatal morbidity outcomes among pregnancies classified as either false-negative, true-positive, false-positive, or true-negative for SGA.
  • Findings revealed that false-negative SGA results significantly increased the risk of stillbirth compared to true-positive diagnoses, while the implications of false-positive results were also evaluated, indicating potential risks in misclassification during antenatal screening.
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Impact of Fluid Balance on the Development of Lung Injury.

Am J Respir Crit Care Med

November 2024

University Medical Center Göttingen, Department of Anesthesiology, University Medical Center Göttingen, Robert-Koch-Str 40, 37075, Gottingen, Germany.

Rationale: The pathophysiological relationship between fluid administration, fluid balance, and mechanical ventilation in the development of lung injury is unclear.

Objectives: To quantify the relative contribution of mechanical power and fluid balance in the development of lung injury.

Methods: Thirty-nine healthy female pigs, divided into four groups, were ventilated for 48 hours with high (~18J/min) or low (~6J/min) mechanical power; and high (~4L) or low (~1L) targeted fluid balance.

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Article Synopsis
  • Carriers of BRCA1/2 pathogenic variants were studied to determine their risk of developing cancers during childhood, adolescence, and young adulthood (CAYA).
  • Analysis of data from over 47,000 individuals revealed that while young women with BRCA1/2 mutations had a significantly increased risk of breast cancer in their 20s, no increased risk was found for other types of CAYA cancers.
  • The study concluded that there's little evidence to support routine genetic testing for children of BRCA1/2 carriers or for young cancer patients, as the overall cancer risk appears low aside from breast cancer in young women.
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Introduction: Regional anaesthesia provides important clinical benefits to patients but is underutilised. A barrier to widespread adoption may be the focus of regional anaesthesia research on novel techniques rather than evaluating and optimising existing approaches. Research priorities in regional anaesthesia identified by anaesthetists have been published, but the views of patients, carers and other healthcare professionals have not been considered previously.

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Cardiotoxicity in people undergoing cancer treatment - the role of the oncology nurse.

Asia Pac J Oncol Nurs

November 2024

Cardio-Oncology/Heart Failure Clinical Nurse Specialist, Cardio-Oncology Centre of Excellence, Royal Brompton Hospital, Part of Guy's and St Thomas' NHS Foundation, London, United Kingdom.

Cardiotoxicity is a significant complication of cancer treatment, and this review describes the cardiovascular risks associated with various therapies and emphasizes the crucial role of oncology nurses in managing these risks. Many cancer treatments, including cytotoxic therapies, radiation, targeted therapies, and immune-modulatory drugs, have been shown to increase the likelihood of cardiovascular toxicity, leading to conditions such as acute coronary syndrome, heart failure, and atrial fibrillation. Guidelines are now available to reduce treatment-related cardiovascular toxicity (CTR-CVT) and stress the importance of cardiovascular assessments before, during, and after cancer treatment.

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Objective: Establish whether pregnancies complicated by gestational diabetes mellitus (GDM) are associated with a fetal cardiac phenotype that predisposes to arrhythmia; utilising measurements derived from non-invasive abdominal fetal ECG.

Design: Prospective observational study.

Setting: Three tertiary obstetric units, United Kingdom.

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