612 results match your criteria: "Imperial College NHS Trust[Affiliation]"

Surgically based therapies in heart failure: implications for patients and nursing practice.

Eur J Cardiovasc Nurs

January 2025

UK Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, East Forvie, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK.

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Article Synopsis
  • The study evaluates the effectiveness of AI chatbots ChatGPT and Bard in answering multiple choice questions (MCQs) related to Intermediate Life Support and managing cardiac arrest.
  • Both chatbots had similar performances, with Bard slightly outperforming ChatGPT, although the difference wasn't statistically significant.
  • The explanations given by both chatbots, while not always correct, still contained useful information, highlighting their potential value in medical education.
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  • Simulation is the preferred method for teaching trauma management, with current exploration into virtual and augmented reality as alternative techniques.
  • A systematic search yielded 3815 studies, with 13 ultimately included, showing that while VR is positively received by users, objective assessment is needed.
  • VR is beneficial for training in trauma scenarios, but it won't replace traditional simulation soon; further research with larger groups is required for effective integration into medical education.
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Association of chemotherapy completion rates and overall survival with postoperative complications after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma.

HPB (Oxford)

November 2024

Department of Organ Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 København Ø, Denmark; Center for Surgical Translation and Artificial Intelligence Research (CSTAR), Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 København Ø, Denmark. Electronic address:

Introduction: Despite the benefits of surgical resection and adjuvant chemotherapy for pancreatic ductal adenocarcinoma (PDAC), over 30 % of patients fail to complete adjuvant oncological treatment. Whether postoperative complications affect chemotherapy completion rates and overall survival remains uncertain. We hypothesized that postoperative complications would be associated with chemotherapy delays, omission, and reduced overall survival (OS).

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Article Synopsis
  • The Revi system, developed by BlueWind Medical, is an innovative implantable device designed to treat urgency urinary incontinence, marking the first FDA-cleared neuromodulation device that can be used without prior conservative treatments.
  • In a study involving 151 women, 79% of those assessed at the 24-month mark showed significant improvement in their condition, with consistent efficacy over time and high rates of participant satisfaction.
  • The results highlight the Revi system's durability, effectiveness, and safety, with no serious adverse events reported throughout the study period.
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Background/objectives: Serous ovarian carcinoma (SOC) is the most common subtype of epithelial ovarian cancer, with high-grade (HGSOC) and low-grade (LGSOC) subtypes presenting distinct clinical behaviours. This study aimed to evaluate histopathologic features in SOC, correlating these with prognostic outcomes, and explore the potential clinical implications.

Methods: We analysed 51 SOC cases for lymphovascular space invasion (LVSI), tumour border configuration (TBC), microvessel density (MVD), tumour budding (TB), the tumour-stroma ratio (TSR), the stromal type, tumour-infiltrating lymphocytes (TILs), and tertiary lymphoid structures (TLSs).

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Introduction: Hepatocellular carcinoma (HCC) presents a formidable challenge in oncology, demanding innovative treatment approaches. Both adjuvant and neoadjuvant therapies, thanks to the introduction of immunotherapy, have emerged as promising strategies in the management of HCC, aiming to reduce the risk of relapse and ultimately to improve survival.

Areas Covered: This review considers current evidence, ongoing clinical trials, and future strategies to elucidate the evolving landscape of neoadjuvant and adjuvant treatments in HCC.

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Extrapulmonary sarcoidosis.

J Autoimmun

December 2024

Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.

Article Synopsis
  • - Sarcoidosis is a chronic inflammatory disease that arises in genetically susceptible individuals after exposure to certain antigens, primarily affecting the lungs but potentially impacting any organ, including the heart, nervous system, and eyes, which can lead to severe complications.
  • - Diagnosis is typically easier when typical symptoms and biopsy findings are present, but it becomes more complex when symptoms manifest in areas outside the lungs without accompanying lung issues.
  • - First-line treatment for sarcoidosis involves corticosteroids, while immunosuppressive or biologic medications are used for patients who do not respond to steroids or have refractory disease.
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Background & Aims: Current screening pathways, developed from tertiary care cohorts, underestimate the presence of Metabolic-dysfunction associated steatotic liver disease (MASLD) in patients with type 2 diabetes mellitus (T2DM) in the community. We developed, validated, and assessed cost-effectiveness of a new score for screening the presence of fibrosis due to MASLD in primary care.

Methods: Consecutive T2DM patients underwent screening for liver diseases with transient elastography (TE).

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Effect of adequacy of empirical antibiotic therapy for hospital-acquired bloodstream infections on intensive care unit patient prognosis: a causal inference approach using data from the Eurobact2 study.

Clin Microbiol Infect

December 2024

OUTCOMEREA Research Group, Drancy, France; Institut National de la Santé et de la Recherche Medicale, Infection Antimicrobial Modelisation Evolution, U1137, Team Decision Science in Infectious Diseases, Paris, France; Assistance Publique Hôpitaux de Paris, Bichat hospital, Medical and infectious diseases ICU, F75018, Paris France. Electronic address:

Article Synopsis
  • Hospital-acquired bloodstream infections (HA-BSI) in ICU patients can be life-threatening, and this study aimed to see how early adequate antibiotic treatment affects 28-day mortality rates for patients who survive at least one day after infection onset.
  • Using data from a multicenter study with 2,418 patients, researchers found that those who received adequate treatment within 24 hours had a lower 28-day mortality rate (32.8%) compared to those who were inadequately treated (40%).
  • The study concluded that inadequate antibiotic therapy within 24 hours contributes significantly to 28-day mortality, indicating that quicker treatment could greatly improve patient outcomes in cases of HA-BSI.
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Introduction Guidelines state that all female patients of childbearing age presenting with acute abdominal pain to a surgical department must have a pregnancy test with either urinary or serum beta-human chorionic gonadotropin (𝜷-HCG) testing. This allows complete evaluation of the patient and consideration of a wider range of differential diagnoses, including those that must not be missed, such as a possible ectopic pregnancy. Additionally, management options for conditions unrelated to pregnancy may differ in pregnant women.

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Background: Cardiovascular preventive strategies are guided by risk scores with unknown validity in cancer cohorts.

Objectives: This study aimed to evaluate the predictive performance of 7 established cardiovascular risk scores in cancer survivors from the UK Biobank.

Methods: The predictive performance of QRISK3, Systematic Coronary Risk Evaluation 2 (SCORE2)/Systematic Coronary Risk Evaluation for Older Persons (SCORE-OP), Framingham Risk Score, Pooled Cohort equations to Prevent Heart Failure (PCP-HF), CHARGE-AF, QStroke, and CHADS-VASc was calculated in participants with and without a history of cancer.

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Article Synopsis
  • Heart failure with preserved ejection fraction (HFpEF) is becoming the most common type of heart failure, but patients often lack access to specialized care, leading to poorer health outcomes.
  • The review will analyze existing literature and consult experts to assess current care pathways for HFpEF in the UK, aiming to create a better framework for treatment.
  • By combining insights from both academic and public sources, the findings will highlight challenges in care and inform improvements for HFpEF services, potentially benefiting broader healthcare practices in Europe.
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Background: Midwifery continuity of carer (MCoC) is a model of care in which the same midwife or small team of midwives supports women throughout pregnancy, birth and the postnatal period. The model has been prioritised by policy makers in a number of high-income countries, but widespread implementation and sustainability has proved challenging.

Methods: In this narrative review and synthesis of the global literature on the implementation and sustainability of midwifery continuity of carer, we identify barriers to, and facilitators of, this model of delivering maternity care.

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  • The study investigates common injury sites and imaging findings in penetrating injuries, focusing on gluteal, anterior abdominal wall, and junctional zone injuries, to identify diagnostic uncertainties.
  • A retrospective review of pediatric trauma cases from 2015 to 2019 reveals that gluteal injuries are the most frequent, primarily superficial, but with a significant minority presenting serious complications needing urgent treatment.
  • Although anterior abdominal wall and junctional zone injuries are rarer, they involve higher morbidity and diagnostic uncertainty, highlighting the need for thorough imaging to improve trauma diagnosis and management.
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Objectives: To develop a deep learning (DL)-model using convolutional neural networks (CNN) to automatically identify the fetal head position at transperineal ultrasound in the second stage of labor.

Material And Methods: Prospective, multicenter study including singleton, term, cephalic pregnancies in the second stage of labor. We assessed the fetal head position using transabdominal ultrasound and subsequently, obtained an image of the fetal head on the axial plane using transperineal ultrasound and labeled it according to the transabdominal ultrasound findings.

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Basilar artery occlusion (BAO) is a neurological emergency associated with a high risk for adverse outcomes. This review provides evidence on the therapeutic efficacy of intravenous thrombolysis (IVT) and endovascular therapy (EVT) in the treatment of BAO. Historically considered the primary intervention for acute ischemic stroke, IVT has been progressively combined with EVT, which has emerged from recent studies demonstrating clinical benefits, notably in patients presenting with severe stroke.

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Diabetes mellitus-Progress and opportunities in the evolving epidemic.

Cell

July 2024

Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.

Article Synopsis
  • - Diabetes is a complex metabolic disorder that causes high blood sugar and can lead to serious complications, affecting overall health and increasing the risk of death.
  • - Type 1 diabetes (T1D) is caused by the immune system destroying insulin-producing beta cells, while Type 2 diabetes (T2D) involves a combination of beta cell dysfunction and insulin resistance, often linked to obesity.
  • - Understanding the genetic and environmental factors that contribute to diabetes may help improve treatment and management strategies, potentially changing its widespread impact.
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Transition services-programs that support adolescents and young adults (AYAs) as they move from a child-centered to a more autonomous, adult-orientated healthcare system-have been associated with improved short- and long-term healthcare outcomes. Unfortunately, there is a paucity of evidence exploring transition services within the neurogastroenterology and motility (NGM) field. The overall aim of this article, endorsed by the American Neurogastroenterology and Motility Society and European Society of Neurogastroenterology and Motility, is to promote a discussion about the role of transition services for patients with NGM disorders.

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Background: Time-lapse imaging systems for embryo incubation and selection might improve outcomes of in-vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) treatment due to undisturbed embryo culture conditions, improved embryo selection, or both. However, the benefit remains uncertain. We aimed to evaluate the effectiveness of time-lapse imaging systems providing undisturbed culture and embryo selection, and time-lapse imaging systems providing only undisturbed culture, and compared each with standard care without time-lapse imaging.

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Purpose Of Review: The current review aims to highlight the role of multidisciplinary approach in the diagnosis of patients with cardiac and neurosarcoidosis. Multidisciplinary approach integrates the available clinical information, imaging and histopathological results aiming to reach a definite or at least provisional diagnosis and allow appropriate management. Multidisciplinary approach is the reference standard for diagnosis of interstitial lung disease and should be strongly considered in complex clinical conditions such as cardiac sarcoidosis (CS) and neurosarcoidosis.

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