300 results match your criteria: "Guys' and St Thomas Hospital[Affiliation]"

Mepolizumab improves quality of life and reduces activity impairments in patients with CRSwNP.

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Objective: To compare perioperative outcomes following robot-assisted partial nephrectomy (RAPN) in patients with age ≥ 70 years to age < 70 years.

Methods: Using Vattikuti Collective quality initiative (VCQI) database for RAPN we compared perioperative outcomes following RAPN between the two age groups. Primary outcome of the study was to compare trifecta outcomes between the two groups.

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Clinical Reasoning: A Teenage Girl With Progressive Hyperkinetic Movements, Seizures, and Encephalopathy.

Neurology

January 2023

From the Paediatric Neurology Department, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Metabolic Medicine Department, Evelina London Children's Hospital, London, UK; Clinical Neurophysiology Department, Evelina London Children's Hospital, London, UK; Clinical Genetics Department, Guys and St Thomas Hospital, London, UK; Neuroradiology Department, Evelina London Children's Hospital, London, UK; Women and Children's Health Institute, Faculty of Life Sciences & Medicine, King's College London, UK; Randall Centre for Cell and Molecular Biophysics, Muscle Signalling Section, Faculty of Life Sciences and Medicine (FoLSM), King's College London, UK; and Molecular Neurosciences, Developmental Neurosciences Programme, UCL Great Ormond Street Institute of Child Health, London, UK.

Article Synopsis
  • The "epilepsy-dyskinesia" spectrum is a complex and challenging area in diagnosing neurogenetic and neurometabolic conditions due to variability in symptoms and lack of specific biomarkers.
  • A detailed case study is presented of a teenage girl with unusual neurological symptoms starting from 14 months, showing progressive motor and cognitive issues, and multiple diagnostic tests returning unremarkable results.
  • The article highlights the importance of differential diagnosis and management in cases with neurological regression and emphasizes the role of next-generation sequencing for rapidly identifying underlying causes of these conditions.
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Aims: Post-infarction ventricular septal defect (PIVSD) is a mechanical complication of acute myocardial infarction (AMI) with a poor prognosis. Surgical repair is the mainstay of treatment, although percutaneous closure is increasingly undertaken.

Methods And Resuts: Patients treated with surgical or percutaneous repair of PIVSD (2010-2021) were identified at 16 UK centres.

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Critical illness is often complicated by acute kidney injury (AKI). In patients with severe AKI, renal replacement therapy (RRT) is deployed to address metabolic dysfunction and volume excess until kidney function recovers. This review is intended to provide a comprehensive update on key aspects of RRT prescription and delivery to critically ill patients.

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Infectious Proctitis due to Human Mpox.

Clin Infect Dis

February 2023

Department of HIV/GUM, Chelsea & Westminster Hospital, National Health Service (NHS) Foundation Trust, London, United Kingdom.

We describe 2 cases of infectious proctitis secondary to human monkeypox in patients presenting with rectal pain. These cases highlight the importance of multidisciplinary management of monkeypox and in expanding case definitions and enabling clinical recognition in patients presenting without skin rash.

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Background/objectives: Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines.

Methods: All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study.

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Article Synopsis
  • Cardiovascular magnetic resonance imaging (CMR) is considered the best test for diagnosing the cause of heart failure, but it's not always available.
  • A study of 176 patients with heart failure explored if measuring coronary disease through angiography could predict whether the cause was ischemic (related to reduced blood flow) or non-ischemic.
  • The findings showed that a BCIS jeopardy score of 6 or higher could effectively identify ischemic causes with 76% sensitivity and 97% specificity, suggesting angiography can help determine the cause of heart failure in these patients.
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Lentigo Maligna is a benign subtype of melanoma in situ and can progress to lentigo maligna melanoma, which is invasive. Complete surgical excision is the gold standard of treatment but requires large margins. If affecting the peri-ocular region, surgical excision leads to extensive defects, complex reconstructions, and functional impairment of the protection of the ocular surface.

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COVID-19 vaccine effectiveness against the omicron (BA.2) variant in England.

Lancet Infect Dis

July 2022

UK Health Security Agency, London NW9 5EQ, UK; National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene & Tropical Medicine, London, UK; NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, UK. Electronic address:

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Risk factors and classification of reintervention following deep venous stenting for acute iliofemoral deep vein thrombosis.

J Vasc Surg Venous Lymphat Disord

September 2022

Cardiovascular Division, Academic Department of Vascular Surgery, St Thomas' Hospital, King's College London, London, UK. Electronic address:

Background: Acute iliofemoral deep vein thrombosis (DVT) is associated with the development of post-thrombotic syndrome (PTS). Thrombolysis and deep venous stenting can restore vessel outflow and can reduce the incidence of PTS. However, for a proportion of patients, subsequent stenosis or reocclusion will necessitate further intervention.

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Background: Von Hippel-Lindau (VHL) disease is an inherited tumour predisposition syndrome and a paradigm for the importance of early diagnosis and surveillance. However, there is limited information on the "real world" management of VHL disease.

Methods: A national audit of VHL disease in the United Kingdom.

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Objectives: Sickle Cell Disease (SCD) is a genetic blood disorder affecting over 1 million people globally. The aim of this analysis is to explore the pain burden of patients with SCD in two countries: the United States and Ghana.

Methods: The Consortium for the Advancement of Sickle Cell Research (CASiRe) was created to better understand the clinical severity of patients with SCD worldwide.

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COVID-19, thrombosis and pregnancy.

Thromb Update

December 2021

Thrombosis & Haemophilia Centre, Guys and St Thomas' Hospital, London, UK.

Increased thromboembolic events have been seen in patients hospitalised with COVID-19 pneumonia, especially those with acute respiratory distress syndrome requiring intensive care support. The coronavirus pandemic has had varied effects on pregnant women globally. Concerns about the potential for thromboembolic events in the prothrombotic period of pregnancy and puerperium when combined with COVID-19 infection, and the impact this may have on maternal and infant morbidity and mortality has led to the development of expert-led guidance providing increased use of thromboprophylaxis in this group.

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Sex-Specific Risk Factors and Health Disparity Among Hepatitis C Positive Patients Receiving Pharmacotherapy for Opioid Use Disorder: Findings From a Propensity Matched Analysis.

J Addict Med

August 2022

From the Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada (BBD, LJM, AW, TO); Department of Family Medicine, Michael DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada (LN); Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford University, CA (BBD, GC, DK, AA); Department of Medicine, University of British Columbia, Vancouver Costal Health, Vancouver, Canada (DA); Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada (NS, AH, CC, AD, BP, ZS); Department of Health Research Evaluation and Impact (Formerly Department of Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, ON, Canada (LN, AW, LT, ZS); Northern Ontario School of Medicine, Sudbury ON, Canada (DCM); Canadian Addiction Treatment Centres, Markham ON, Canada (DCM); Guys and St. Thomas Hospital NHS Trust, London, United Kingdom (MB); Centre for Evaluation of Medicine, Hamilton, ON, Canada (LT); System Linked Research Unit, Hamilton, ON, Canada (LT); Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON, Canada (ZS).

Background: The incidence of opioid-related fatality has reached unparalleled levels across North America. Patients with comorbid hepatitis C virus (HCV) remain the most vulnerable and difficult to treat. Considering the unique challenges associated with this population, we aimed to re-examine the impact of HCV on response to medication assistant treatment for opioid use disorder and establish sex-specific risk factors affecting care.

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Introduction Acute appendicitis (AA) is the most common cause of acute abdomen in young adults. The diagnosis is usually made on various clinical findings. However, a missed case of acute appendicitis is a catastrophe as it later presents with life-threatening complications and results in medicolegal issues.

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Background: We wished to examine treatment and outcome patterns in older diffuse large B-cell lymphoma (DLBCL) patients, with a focus on the effect of route-to-diagnosis to outcome.

Methods: Data were extracted from Public Health England's National Cancer Registration and Analysis Service between 2013 and 2015 included route-to-diagnosis, disease characteristics and survival for 9186 patients ≥65 years. Systemic Anti-Cancer Therapy data identified front-line regimens, cycles and doses.

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Tenofovir DF (TDF) remains one of the preferred backbone agents for naïve HIV patients starting antiretroviral treatment (ART). The impact of TDF on renal function and metabolic parameters may vary by anchor agent. We investigated the impact of TDF in combination with 3 different integrase inhibitors on tubular and glomerular function, and metabolic parameters in ART-naïve patients.

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Objectives: To assess and compare peri-operative outcomes of patients undergoing robot-assisted partial nephrectomy (RAPN) for imperative vs elective indications.

Patient And Methods: We retrospectively reviewed a multinational database of 3802 adults who underwent RAPN for elective and imperative indications. Laparoscopic or open partial nephrectomy (PN) were excluded.

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Objectives: Metastatic involvement of nonregional supraclavicular or superior mediastinal lymph nodes in distal oesophageal cancer is rare but has important implications for prognosis and management. The management of nonregional lymph nodes which appear indeterminate on CT and FDG PET-CT (subcentimeter nodes or those with preserved normal morphology, but increased FDG avidity) can present a diagnostic dilemma. This study investigates the incidence, work-up and clinical significance of nonregional clinically indeterminate FDG avid lymph nodes.

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