2,114 results match your criteria: "Guy's and St. Thomas' Hospital[Affiliation]"

Granulocytes and mast cells in AllergoOncology-Bridging allergy to cancer: An EAACI position paper.

Allergy

September 2024

St. John's Institute of Dermatology, School of Basic & Medical Biosciences & KHP Centre for Translational Medicine, King's College London, London, UK.

Derived from the myeloid lineage, granulocytes, including basophils, eosinophils, and neutrophils, along with mast cells, play important, often disparate, roles across the allergic disease spectrum. While these cells and their mediators are commonly associated with allergic inflammation, they also exhibit several functions either promoting or restricting tumor growth. In this Position Paper we discuss common granulocyte and mast cell features relating to immunomodulatory functions in allergy and in cancer.

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Background: Ensuring equitable access to adequate standard of care for patients with rare hematological disease is one of the aims of the European Reference Network (ERN) EuroBloodNet. Stroke is one of the most devastating complications for children with sickle cell disease (SCD). For effective prevention of stroke risk, annual transcranial Doppler (TCD) according to a defined protocol is recommended for patients aged 2-16 years, with red blood cell transfusion therapy for those at risk.

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There is an apparent need for novel non-invasive colorectal cancer (CRC) screening tests that are more acceptable to patients and can reliably detect CRC or reduce the number of unnecessary colonoscopies performed in cancer-free patients. An emerging number of studies demonstrate the potential value of exhaled volatile organic compounds (VOCs) as a diagnostic and triaging test for CRC. A systematic appraisal and meta-analysis of the published evidence was done to determine whether exhaled VOCs can be used in the detection and screening of CRC.

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Reelin (RELN) is a secreted glycoprotein essential for cerebral cortex development. In humans, recessive RELN variants cause cortical and cerebellar malformations, while heterozygous variants were associated with epilepsy, autism, and mild cortical abnormalities. However, the functional effects of RELN variants remain unknown.

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Objectives: Toxicity-driven adaptive radiotherapy (RT) is enhanced by the superior soft tissue contrast of magnetic resonance (MR) imaging compared with conventional computed tomography (CT). However, in an MR-only RT pathway synthetic CTs (sCT) are required for dose calculation. This study evaluates 3 sCT approaches for accurate rectal toxicity prediction in prostate RT.

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Indeterminate biliary strictures pose a significant diagnostic dilemma for gastroenterologists. Despite advances in endoscopic techniques and instruments, it is difficult to differentiate between benign and malignant pathology. A positive histological diagnosis is always preferred prior to high risk hepatobiliary surgery, or to inform other types of therapy.

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Sleep-disordered breathing in children and adults with intellectual disability: mind the gap!

Thorax

October 2024

Sleep Disorders Centre, Guy's and St Thomas' Hospital NHS Foundation Trust; Faculty of Life and Sciences Medicine, King's College London, London, UK.

Background: In adults and children with intellectual disability (ID), sleep -disordered breathing (SDB) is thought to be common. However, large epidemiological studies are lacking, and there are few studies on optimal methods of investigation and even fewer randomised, controlled intervention trials of treatment.

Method: Peer-reviewed publications from various databases were examined in line with search terms relevant to ID and SDB spanning the years 200-2024.

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Background: The relationship between venous thromboembolism (VTE) and solid malignancy has been established over the decades. With rising projected rates of bladder cancer (BCa) worldwide as well as increasing number of patients experiencing BCa and VTE, our aim is to assess the impact of a preoperative VTE diagnosis on perioperative outcomes and health-care costs in BCa cases undergoing radical cystectomy (RC).

Methods: Patients ≥18 years of age with BCa diagnosis and undergoing open or minimally invasive (MIS) RC were identified in the Merative™ Marketscan Research Databases between 2007 and 2021.

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Inflammatory bowel disease remains a difficult disease to effectively treat, especially fistulizing Crohn's disease. Perianal fistulas in the setting of Crohn's disease remain an area of unmet need with significant morbidity in this patient population. Up to one third of Crohn's patients will have perianal fistulizing disease and current medical and surgical interventions are of limited efficacy.

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Purpose: To assess the effect of cryoablation on renal function (measured by estimated glomerular filtration rate [eGFR] or serum creatinine) for treating Stage I renal cancer.

Materials And Methods: The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were systematically searched from inception to May 1, 2023. Cohort studies that included data on change of eGFR and serum creatinine increase were included.

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Objectives: Risk stratification tools that predict healthcare utilisation are extensively integrated into primary care systems worldwide, forming a key component of anticipatory care pathways, where high-risk individuals are targeted by preventative interventions. Existing work broadly focuses on comparing model performance in retrospective cohorts with little attention paid to efficacy in reducing morbidity when deployed in different global contexts. We review the evidence supporting the use of such tools in real-world settings, from retrospective dataset performance to pathway evaluation.

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Antibody-based therapeutics for chronic rhinosinusitis with nasal polyps.

Expert Opin Biol Ther

June 2024

Department of Rhinology and Skull Base Surgery, Guy's and St Thomas' Hospital NHS, Foundation Trust, London, UK.

Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent inflammatory condition with heterogenous underlying endotypes, the most common being type 2 mediated inflammation. Several biologics have been developed to target specific pro-inflammatory cytokines and their receptors with proven efficacy in both quantitative and qualitative outcomes in patients with severe uncontrolled disease. However, there is an ongoing debate on the role of biologics relative to conventional therapies for CRSwNP and their efficacy in patient subgroups with non-polyp type 2 disease.

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Biomarkers of peanut allergy in children over time.

Allergy

October 2024

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

Background: Various biomarkers are used to define peanut allergy (PA). We aimed to observe changes in PA resolution and persistence over time comparing biomarkers in PA and peanut sensitised but tolerant (PS) children in a population-based cohort.

Methods: Participants were recruited from the EAT and EAT-On studies, conducted across England and Wales, and were exclusively breastfeed babies recruited at 3 months old and followed up until 7-12 years old.

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Active inflammatory arthritis in pregnancy is associated with an increased risk of adverse pregnancy outcomes. Treatment of active inflammation and maintenance of low disease activity with medication reduces these risks. Therapeutic decisions on disease-modifying antirheumatic drugs (DMARDs) in pregnancy are complicated by safety concerns, which have led to inappropriate withdrawal of treatment and consequential harm to mother and fetus.

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The Road to Precision Medicine for Acute Kidney Injury.

Crit Care Med

July 2024

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA.

Objectives: Acute kidney injury (AKI) is a common form of organ dysfunction in the ICU. AKI is associated with adverse short- and long-term outcomes, including high mortality rates, which have not measurably improved over the past decade. This review summarizes the available literature examining the evidence of the need for precision medicine in AKI in critical illness, highlights the current evidence for heterogeneity in the field of AKI, discusses the progress made in advancing precision in AKI, and provides a roadmap for studying precision-guided care in AKI.

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Background: Persistent lactation, or galactorrhoea, is a common problem which is infrequently seen in the setting of aesthetic surgery. Increasing frequency of aesthetic breast surgery such as breast augmentation suggests a need for improved understanding of the effect of galactorrhoea on surgical outcomes.

Case Report: A 34-year-old patient underwent day-case bilateral breast reduction/mastopexy combined with sub-muscular implant augmentation, abdominoplasty and bilateral liposuction to the flanks.

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Quality of Life in Symptomatic Septal Perforation.

Laryngoscope

November 2024

Rhinology and Skull Base Unit, ENT Department, Hospital Clínic, Universitat Barcelona, IDIBAPS, CIPERES, Barcelona, Spain.

Objective: The aim of this study is to investigate the impact of septal perforation (SP) on quality of life (QoL). SP is compared to the general population and patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) using the Sino-Nasal Outcome Test 22 (SNOT-22).

Methods: Prospective single-center study in a referral Rhinology Unit from January 2014 to March 2023.

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As a component of myeloablative conditioning before allogeneic hematopoietic stem cell transplantation (HSCT), Total Body Irradiation (TBI) is employed in radiotherapy centers all over the world. In recent and coming years, many centers are changing their technical setup from a conventional TBI technique to multi-isocenter conformal arc therapy techniques such as Volumetric Modulated Arc Therapy (VMAT) or Helical Tomotherapy (HT). These techniques allow better homogeneity and control of the target prescription dose, and provide more freedom for individualized organ-at-risk sparing.

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Article Synopsis
  • A study aimed to create a standardized operative report for rectal prolapse surgery by gathering consensus from pelvic floor surgeons, focusing on key descriptors necessary for comprehensive reporting.
  • The research involved a Delphi process where 176 surgeons from various regions voted on descriptors in multiple rounds, ultimately selecting 16 that achieved over 70% agreement.
  • The final agreed-upon descriptors included details about the surgery type, dissection methods, and the use of mesh and sutures, ensuring thorough documentation of the surgical procedure.
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Article Synopsis
  • Constipation is often seen as a common health issue in kids, but sometimes it can be linked to food allergies, especially cow's milk allergy.
  • Studies show that many kids with constipation improve when they stop eating cow's milk.
  • The Exploring Non-IgE-Mediated Allergy group is discussing how food allergies could be causing constipation in children, since there isn't enough information on this topic yet.
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Basophil activation test (BAT) or the mast cell activation test (MAT) are two in vitro tests that are currently being studied in food allergy as diagnostic tools as an alternative to oral food challenges (OFCs). We conducted a meta-analysis on BAT and MAT, assessing their specificity and sensitivity in diagnosing peanut allergy. Six databases were searched for studies on patients suspected of having peanut allergy.

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Pre-asthma: a useful concept? A EUFOREA paper. Part 2-late onset eosinophilic asthma.

Front Allergy

May 2024

Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium.

The concept of pre-diabetes has led to provision of measures to reduce disease progression through identification of subjects at risk of diabetes. We previously considered the idea of pre-asthma in relation to allergic asthma and considered that, in addition to the need to improve population health via multiple measures, including reduction of exposure to allergens and pollutants and avoidance of obesity, there are several possible specific means to reduce asthma development in those most at risk (pre- asthma). The most obvious is allergen immunotherapy (AIT), which when given for allergic rhinitis (AR) has reasonable evidence to support asthma prevention in children (2) but also needs further study as primary prevention.

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Carey Fineman Ziter Syndrome (CFZS) is a rare autosomal recessive disease caused by mutations in the MYMK locus which encodes the protein, myomaker. Myomaker is essential for fusion and concurrent myonuclei donation of muscle progenitors during growth and development. Strikingly, in humans, MYMK mutations appear to prompt myofiber hypertrophy but paradoxically, induce generalised muscle weakness.

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