3,677 results match your criteria: "King 's College Hospital NHS Foundation Trust[Affiliation]"

Morbidity related to major lung thoracoscopic resections in children.

Pediatr Med Chir

October 2024

Department of Pediatric Surgery and Urology, Robert-Debré University Hospital, Paris, France; Paris University, Paris, France; Université Paris Diderot-Sorbonne Paris Cité, Paris.

In pediatric thoracic surgery, reported predictors for increased risk are symptoms and active/previous infections (RAP). We investigated the adverse events related to Video-Assisted Thoracic Surgery (VATS) in pediatric patients when considering RAP predictors. A retrospective analysis of pediatric VATS major lung resections in 2008-2021 was conducted at three institutions.

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  • - The ATTEST-2 trial evaluated if tenecteplase, a newer thrombolytic agent, is at least as effective as the standard alteplase within 4.5 hours of an acute ischaemic stroke by comparing outcomes like the modified Rankin Scale (mRS) at 90 days post-treatment.
  • - Conducted across 39 UK stroke centers, the study randomly assigned 1,777 eligible stroke patients to receive either tenecteplase or alteplase, focusing on their recovery outcomes and safety, including complications such as bleeding.
  • - Results showed that tenecteplase was non-inferior to alteplase regarding the distribution of mRS scores, but it did not
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Undergraduates in medicine should receive a basic education to ensure understanding of dental concepts, including oral cancer, basic dental health advice, and oral and maxillofacial surgery (OMFS). This review aims to explore the exposure of OMFS and dental education in the UK medical undergraduate curriculum and follows PRISMA protocols. Four databases were used to search for literature: MEDLINE, EMBASE, SCOPUS, and Google Scholar.

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  • This systematic review explores the use of artificial intelligence (AI) in diagnosing and treating urolithiasis (kidney stones), highlighting its potential to improve accuracy and effectiveness in medical practice.
  • The study analyzed 71 original AI research papers, revealing that AI achieved high precision rates in stone composition (88.2%) and detection (96.9%), as well as solid accuracy in predicting stone passage and treatment outcomes (around 82-87%).
  • The findings suggest that AI could significantly enhance management strategies for urolithiasis, but further research is needed to cement its role in routine clinical use.
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Longitudinal Evaluation of Individuals With Severe Alpha-1 Antitrypsin Deficiency (Pi∗ZZ Genotype).

Gastroenterology

October 2024

Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN RARE LIVER), Aachen, Germany. Electronic address:

Background & Aims: Homozygous Pi∗Z mutation in alpha-1 antitrypsin (Pi∗ZZ genotype) predisposes to pulmonary loss-of-function and hepatic gain-of-function injury. To facilitate selection into clinical trials typically targeting only 1 organ, we systematically evaluated an international, multicenter, longitudinal, Pi∗ZZ cohort to uncover natural disease course and surrogates for future liver- and lung-related endpoints.

Methods: Cohort 1 recruited 737 Pi∗ZZ individuals from 25 different centers without known liver comorbidities who received a baseline clinical and laboratory assessment as well as liver stiffness measurement (LSM).

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Purpose: To report five cases of post-operative sterile endophthalmitis in patients who underwent pars plana vitrectomy with silicone oil injection for retinal detachment.

Methods: Review of the medical records of five patients who underwent pars plana vitrectomy with silicone oil injection at Southend University Hospital and the Royal Eye Infirmary, Derriford Hospital for rhegmatogenous or tractional retinal detachment.

Results: All five patients presented with signs of anterior chamber inflammation exhibiting flare, fibrin and hypopyon in the early or late post-operative period following vitrectomy with silicone oil injection.

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Background And Aims: Microstructural disturbances underlie dysfunctional contraction and adverse left ventricular (LV) remodelling after ST-elevation myocardial infarction (STEMI). Biphasic diffusion tensor cardiovascular magnetic resonance (DT-CMR) quantifies dynamic reorientation of sheetlets (E2A) from diastole to systole during myocardial thickening, and markers of tissue integrity [mean diffusivity (MD) and fractional anisotropy (FA)]. This study investigated whether microstructural alterations identified by biphasic DT-CMR: (i) enable contrast-free detection of acute myocardial infarction (MI); (ii) associate with severity of myocardial injury and contractile dysfunction; and (iii) predict adverse LV remodelling.

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Evaluation of US Elastography in Thyroid Nodule Diagnosis: The ElaTION Randomized Control Trial.

Radiology

October 2024

From the Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences (H.M., P.N., T.F.L.), Birmingham Clinical Trials Unit (R.W., A.P., J.T., J.D.), and Institute of Applied Health Research (K.B., A.P.), University of Birmingham, Robert Aitken Building, 2nd Floor, Birmingham, UK, B15 2TT; Department of Imaging Sciences, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK (P.S.S.); Department of Radiology, King's College Hospital NHS Foundation Trust, London, UK (P.S.S.); Department of Imaging, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK (G.M.); Department of Pathology, University Hospitals Leicester, Leicester, UK (P.D.F., K.M.); Department of Head and Neck Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (N.S.); Department of Radiology, Lister Hospital, Stevenage, UK (K.R.); Department of Radiology, Portsmouth Hospitals University NHS Trust, Portsmouth UK (J.B.); Department of Radiology, Leicester Royal Infirmary, Leicester, UK (R.V.); and Department of Radiology, Mid and South Essex NHS Foundation Trust, Basildon University Hospital, Basildon, UK (T.R.).

Article Synopsis
  • - The study aimed to compare the effectiveness of ultrasound (US) elastography-guided fine-needle aspiration cytology (FNAC) versus conventional US-guided FNAC in diagnosing thyroid nodules, focusing on reducing nondiagnostic results.
  • - Conducted across 18 hospitals in England, the trial involved 982 participants who were randomized to either the elastography (493 patients) or conventional method (489 patients), finding no significant differences in the nondiagnostic rates or time to diagnosis between the two methods.
  • - The results showed similar rates of malignancy and benign findings in both groups, indicating that US elastography-guided FNAC may not provide additional benefits compared to standard US-guided FNAC for thyroid nodules. *
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Data-driven, harmonised classification system for myelodysplastic syndromes: a consensus paper from the International Consortium for Myelodysplastic Syndromes.

Lancet Haematol

November 2024

Center for Accelerating Leukemia/Lymphoma Research at Comprehensive Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy. Electronic address:

Article Synopsis
  • The WHO and International Consensus Classification 2022 aim to improve diagnosis and treatment decisions for myelodysplastic syndromes, but disparities in their implementation exist.
  • A panel of experts used a data-driven method and the Delphi consensus process to align the two classifications, focusing on genomic features to create harmonized labels for distinct clusters.
  • Key findings identified nine genomic clusters, with the most significant linked to biallelic TP53 inactivation, and highlighted the inadequacy of traditional morphological assessments in capturing the complexity of these diseases.
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Does achieving apical patency increase postoperative pain during endodontics?

Evid Based Dent

October 2024

School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK.

Article Synopsis
  • - The study evaluated 12 randomized controlled trials (RCTs) on root canal treatments using various irrigation solutions, assessing outcomes like pain and analgesic use among individuals aged 14-65 without systemic diseases.
  • - A thorough literature search across major databases and gray literature up to May 2023 identified 92 articles, from which 50 underwent full-text review, ultimately including 12 studies after excluding duplicates and those that did not meet the criteria.
  • - The analysis utilized RevMan 5.4 software, with the inclusion of pain scores reported across ten studies, while three studies were excluded from meta-analysis due to methodological concerns.
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  • Nitrous oxide (NO) is a major greenhouse gas contributing to the healthcare sector's carbon footprint, with pre-utilisation losses of up to 95%, which can potentially be minimized by decommissioning NO manifolds.
  • A study involving 18 hospitals in Greater London collected data on NO utilization over five days, revealing that only 18% of procured NO was utilized, leading to estimated pre-utilisation losses of over 5 million liters.
  • The results indicated strong support among anaesthetists for decommissioning manifolds, highlighting both environmental and economic advantages in improving NO management.
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  • - The study explored the feasibility of using high-flow humidified oxygen (HiFlo) as a treatment for children aged 2-11 with acute severe asthma (ASA) who did not respond to standard inhaled bronchodilator treatment.
  • - In a randomized controlled trial involving 56 children, those receiving HiFlo experienced a lower treatment failure rate (64%) compared to the standard care group (86%), and they also had a faster time to meet hospital discharge criteria (29.3 hours vs. 36.8 hours).
  • - The findings suggest that HiFlo could be a promising intervention for childhood ASA, warranting a larger definitive trial to evaluate its effectiveness despite the initial lack of evidence.
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Extracorporeal pediatric renal replacement therapy: diversifying application beyond kidney failure.

Pediatr Nephrol

October 2024

Department of Pediatrics, Divisions of Pediatric Critical Care Medicine and Pediatric Nephrology, Washington University School of Medicine, St. Louis, MO, USA.

Article Synopsis
  • Extracorporeal renal replacement therapy (RRT), such as continuous renal replacement therapy (CRRT) and hemodialysis (HD), is being increasingly utilized for various critical conditions beyond just treating acute kidney injury (AKI) and volume overload in children.
  • This review highlights RRT's effectiveness in managing complications from sepsis, metabolic disorders, liver failure, drug overdoses, tumor lysis syndrome, and rhabdomyolysis, emphasizing its role in improving patient outcomes.
  • RRT assists in regulating fluid, electrolytes, and toxins while also aiding in immune response and correcting metabolic imbalances, making it a vital tool in treating critically ill pediatric patients.
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  • Ulnar-sided wrist pain is a complex issue that often poses diagnostic challenges due to various underlying conditions.
  • Midcarpal impaction syndromes, particularly Hamato-lunate and Triquetro-hamate impingement, are rare but notable causes of this type of wrist pain.
  • The article aims to clarify the recognition, diagnosis, and management of these syndromes by reviewing existing literature on the subject.
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  • Primary immunodeficiency diseases (PIDs) are genetic immune system disorders requiring lifelong immunoglobulin replacement therapy, usually delivered through IVIG or SCIG infusions.
  • Ig20Gly, a 20% immune globulin solution, is a replacement therapy approved for various age groups, with recent approvals for manual administration in Europe aimed at simplifying the process.
  • Manual administration of Ig20Gly allows for faster infusion rates, similar safety and satisfaction levels compared to infusion pumps, and potential cost savings for healthcare systems due to lower equipment and nursing needs.
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The European Society of Intensive Care Medicine (ESICM) has developed evidence-based recommendations and expert opinions about end-of-life (EoL) and palliative care for critically ill adults to optimize patient-centered care, improving outcomes of relatives, and supporting intensive care unit (ICU) staff in delivering compassionate and effective EoL and palliative care. An international multi-disciplinary panel of clinical experts, a methodologist, and representatives of patients and families examined key domains, including variability across countries, decision-making, palliative-care integration, communication, family-centered care, and conflict management. Eight evidence-based recommendations (6 of low level of evidence and 2 of high level of evidence) and 19 expert opinions were presented.

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Introduction: ElaTION is a large multi-centre pragmatic randomised controlled trial, performed in 18 secondary/tertiary hospitals across England, comparing elastography ultrasound-guided fine needle aspiration cytology (EUS-FNAC) with ultrasound-guided FNAC (US-FNAC) alone in the diagnostic assessment of thyroid nodules. Secondary trial outcomes, reported here, assessed the accuracy of ultrasound-alone (US) compared with US-guided FNAC to inform and update current practice guidelines.

Methods: Adults with single or multiple thyroid nodules who had not undergone previous FNAC were eligible.

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  • The study investigates the effectiveness of a surgical logbook for clinicians to document skin surgeries and analyze their outcomes, especially focusing on excision rates in a dermatology department.
  • Data was collected over a six-year period from over 5000 skin excisions, revealing a high overall complete excision rate of 97.07% and good diagnostic accuracy for various skin cancers.
  • The findings suggest that the logbook serves as a valuable educational and analytical tool that can enhance surgical practices and improve excision outcomes in clinicians' careers.
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Visual mismatch negativity in Parkinson's psychosis and potential for testing treatment mechanisms.

Brain Commun

September 2024

Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.

Article Synopsis
  • * The study investigates the mismatch negativity (a brain response to sensory changes) in individuals with and without visual hallucinations to determine its potential as a psychosis marker in Parkinson's.
  • * Results show that those with visual hallucinations exhibit reduced mismatch negativity compared to those without, suggesting that greater hallucination severity correlates with lower amplitude of this brain response, potentially linking serotonergic mechanisms to hallucinations.
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Gene-environmental influence of space and microgravity on red blood cells with sickle cell disease.

NPJ Genom Med

September 2024

Dutch Experiment Support Center (DESC), Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam Bone Center (ABC), Amsterdam UMC Location VU University Medical Center (VUmc) & Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081, LA Amsterdam, The Netherlands.

A fundamental question in human biology and for hematological disease is how do complex gene-environment interactions lead to individual disease outcome? This is no less the case for sickle cell disease (SCD), a monogenic disorder of Mendelian inheritance, both clinical course, severity, and treatment response, is variable amongst affected individuals. New insight and discovery often lie between the intersection of seemingly disparate disciplines. Recently, opportunities for space medicine have flourished and have offered a new paradigm for study.

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