836 results match your criteria: "Portsmouth Hospitals NHS Trust.[Affiliation]"

Risk factors for venous thromboembolism in patients undergoing neoadjuvant chemotherapy as treatment for ovarian cancer.

Eur J Obstet Gynecol Reprod Biol

December 2024

Department of Gynaecological Oncology, West Kent Cancer Centre, Maidstone and Tunbridge Wells NHS Trust, Hermitage Lane, Maidstone, Kent ME16 9QQ, United Kingdom.

Objective: During the treatment of ovarian cancer, the risk of venous thromboembolism (VTE) post operatively is well established, however, patients may be at even greater risk during neoadjuvant chemotherapy (NACT). This study aimed to determine the incidence and timing of VTE amongst patients undergoing NACT, whether there was an association with survival, and examine risk factors associated with the development of VTE.

Study Design: This was a retrospective cohort study of patients diagnosed with ovarian, fallopian tube and primary peritoneal cancer receiving neoadjuvant chemotherapy betweenApril 2011 and April 2022 at a gynaecological cancer centre in England.

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Purpose: Anorectal and urogenital dysfunctions are common after rectal surgery and have a significant impact on quality of life. Intraoperative pelvic autonomic nerve monitoring (pIONM) has been proposed as a tool to identify patients at risk of these functional sequelae. This systematic review aims to evaluate the diagnostic accuracy of pIONM in detecting anorectal and urogenital dysfunction following rectal surgery.

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Article Synopsis
  • The audit aimed to assess and improve the completeness and accuracy of the National Joint Registry (NJR) dataset specifically for elbow arthroplasty surgeries.
  • In a two-phase approach, Phase 1 compared NJR data with NHS England Hospital Episode Statistics (HES), identifying thousands of unmatched and inaccurate records, particularly for radial head arthroplasties (RHAs).
  • Phase 2 involved collaboration among 142 NHS hospitals to correct and update records, resulting in an improved completeness of the NJR dataset from 63% to 93% and accuracy from 94% to 98%.
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Local excision of early rectal cancer: A multi-centre experience of transanal endoscopic microsurgery from the United Kingdom.

World J Gastrointest Surg

October 2024

Department of General Surgery, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth PO6 3LY, Hampshire, United Kingdom.

Background: Total mesorectal excision remains the gold standard for the management of rectal cancer however local excision of early rectal cancer is gaining popularity due to lower morbidity and higher acceptance by the elderly and frail patients.

Aim: To investigate the results of local excision of rectal cancer by transanal endoscopic microsurgery (TEMS) approach carried out at three large cancer centers in the United Kingdom.

Methods: TEMS database was retrospectively reviewed to assess demographics, operative findings and post operative clinical and oncological outcomes.

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Article Synopsis
  • This study evaluates the effectiveness of Robot-assisted minimally invasive esophagectomy (RAMIE) for treating esophageal cancer at various centers globally, aiming to pinpoint areas for enhancement in surgical outcomes.
  • Over three time periods (2016-2023), data from 28 centers was analyzed, revealing improvements in textbook outcome rates, lymph node yields, and decreased hospital stays, particularly with McKeown procedures.
  • The results showed varying success rates in surgical outcomes and complications, with a noteworthy decrease in anastomotic leakage rates and hospital stays over time, highlighting advancements in surgical techniques.
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Background: On-call simulation has been shown to improve the confidence of prospective junior doctors in undertaking on-call shifts. Despite this, it is not mandated in UK medical school curricula, leading to variations in provision. Barriers to widespread implementation may include doubts surrounding effectiveness, feasibility of delivering on-call simulation across multiple sites and unknown costs.

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Arrhythmic Risk Stratification by Cardiovascular Magnetic Resonance Imaging in Patients With Nonischemic Cardiomyopathy.

J Am Coll Cardiol

October 2024

University Hospitals Birmingham Queen Elizabeth, Birmingham, United Kingdom; Aston Medical School, Aston University, Birmingham, United Kingdom. Electronic address:

Background: Myocardial fibrosis (MF) forms part of the arrhythmic substrate for ventricular arrhythmias (VAs).

Objectives: This study sought to determine whether total myocardial fibrosis (TF) and gray zone fibrosis (GZF), assessed using cardiovascular magnetic resonance, are better than left ventricular ejection fraction (LVEF) in predicting ventricular arrhythmias in patients with nonischemic cardiomyopathy (NICM).

Methods: Patients with NICM in a derivation cohort (n = 866) and a validation cohort (n = 848) underwent quantification of TF and GZF.

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Background: Type 2 diabetes is a common chronic disease that continues to increase in prevalence globally and is a major healthcare burden. Diabetes and hypertension frequently occur concurrently, and the use of antihypertensive agents is common in diabetic patients. One antihypertensive agent, verapamil, has tentatively shown potentially positive effects on glycemic control in assorted pre-clinical models.

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Forecasting the need for Renal Replacement Therapy (RRT) in intensive care units (ICUs) at an early stage can enhance patient outcomes and optimize resource allocation. The study aimed to develop a model for early prediction of Renal Replacement Therapy (RRT) requirement within 24 hours of ICU admission, utilizing machine learning techniques and SHapley Additive exPlanations (SHAP). It assessed various models including Random Forest (RF), Neural Network (NN), and XGBoost, using data from 34,000 ICU admissions.

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Species-level, metagenomic and proteomic analysis of microbe-immune interactions in severe asthma.

Allergy

November 2024

Nuffield Department of Medicine, Experimental Medicine Division, Respiratory Medicine Unit, John Radcliffe Hospital, University of Oxford, Oxford, UK.

Article Synopsis
  • The study aimed to characterize the airway microbiome in severe asthma at the species level and examine how specific bacteria relate to mucosal immune responses, particularly in a subgroup of asthma known for low type-2 inflammation.
  • Researchers analyzed sputum and nasal samples from two cohorts of adults with severe asthma using advanced sequencing techniques and integrated data with clinical and protein assessments.
  • Findings indicated that a significant portion of severe asthma cases were dominated by specific pathogens like H. influenzae and M. catarrhalis, with distinct relationships observed between these bacteria and inflammatory responses in the airways.
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Article Synopsis
  • Various anastomotic and reconstruction techniques were assessed in patients undergoing minimally invasive total (miTG) and distal gastrectomy (miDG) to understand their impact on postoperative complications.
  • A study involving over 4,200 patients found that miTG had significantly higher rates of complications like anastomotic leakage and overall morbidity compared to miDG.
  • The findings suggest that miDG is preferable for patients needing surgery, while linear stapled techniques should be favored in miTG to minimize risks.*
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Favourable outcomes with CPX-351 versus conventional 7 + 3 were demonstrated in the pivotal phase III trial in adults aged 60-75 years with newly diagnosed, highrisk/secondary acute myeloid leukaemia (AML). As a complement to the clinical trial and to address important data gaps, the CPX-351 Real-World Effectiveness and SafeTy (CREST-UK; NCT05169307) study evaluated the use of CPX-351 in routine clinical practice in the UK, in 147 patients with newly diagnosed therapy-related AML or AML with myelodysplasia-related changes. Best response of complete remission or complete remission with incomplete platelet or neutrophil recovery was achieved by 53% of evaluable patients.

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Hemospray® (hemostatic powder TC-325) as monotherapy for acute gastrointestinal bleeding: a multicenter prospective study.

Ann Gastroenterol

June 2024

Digestive Diseases and Surgery institute, Cleveland Clinic, London, UK (Apostolis Papaefthymiou, Alberto Murino, Benjamin Norton, Andrea Telese, Rehan Haidry).

Background: Hemostatic powders are used as second-line treatment in acute gastrointestinal (GI) bleeding (AGIB). Increasing evidence supports the use of TC-325 as monotherapy in specific scenarios. This prospective, multicenter study evaluated the performance of TC-325 as monotherapy for AGIB.

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This study aimed to use a musculoskeletal model to predict changes in spinal moments following simulated breast surgery. A female full body musculoskeletal model with a fully articulated thoracolumbar spine and independent moveable breast segments was customised for this study. Key findings suggest that the simulated removal of breast tissue (750 g to 1501 g) can reduce the magnitude of lumbar spine extensor moments by >0.

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Clinical remission with biologic therapies in severe asthma: a matter of definition.

Eur Respir J

June 2024

Wellcome Wolfson Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK

https://bit.ly/42IOVbA

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Early kidney injury may be detected by urinary markers, such as beta-2 microglobulin (B2M), tissue inhibitor of metalloproteinases-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7), kidney injury molecule-1 (KIM-1) and/or neutrophil gelatinase-associated lipocalin (NGAL). Of these biomarkers information on pathophysiology and reference ranges in both healthy and diseased populations are scarce. Differences in urinary levels of B2M, TIMP-2, IGFBP7, KIM-1 and NGAL were compared 24 h before and after nephrectomy in 38 living kidney donors from the REnal Protection Against Ischaemia-Reperfusion in transplantation study.

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