2,174 results match your criteria: "Royal Surrey County Hospital.[Affiliation]"

Introduction: Deep inspiration breath hold technique has shown promise in reducing cardiac toxicity and improving patient outcomes. However, there is a lack of consensus regarding the implementation of abdominal breath hold technique and its impact on cardiac dose. This systematic review and meta-analysis aim to provide insights into the comparative effectiveness of abdominal and thoracic breath hold in mitigating cardiac toxicity during radiation therapy for left-sided breast cancer.

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Objectives: Head and neck squamous cell carcinoma from unknown primary (HNSCCUP) is a rare and challenging condition. This study aimed to investigate the diagnostic pathways of suspected HNSCCUP patients in the United Kingdom.

Methods: A retrospective observational cohort study was conducted, over 5 years from January 2015, in UK Head and Neck centres of consecutive adults undergoing 18F-Fluorodeoxyglucose-PET-CT (PET-CT) within 3 months of diagnosis with metastatic cervical squamous cell carcinoma.

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Task-sharing with families for early detection of postoperative complications in resource-limited settings.

Br J Anaesth

December 2024

NIHR Global Health Research Unit on Global Surgery, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Postoperative mortality in Africa is twice that of wealthier countries. The SMARTER trial underscores this critical issue and aims to address the high mortality rates by harnessing a readily available resource requiring minimal funding. Conducted in Mbale, Uganda, this innovative trial trained family members to monitor basic vital signs following surgery.

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Background: Most patients with small-cell lung cancer (SCLC) present with extensive-stage (ES) disease and have a poor prognosis despite achieving high initial response rates to platinum-based doublet chemotherapy. This study evaluated whether adding hydroxychloroquine (HCQ) to chemotherapy could improve outcomes.

Methods: This was a randomised multicentre phase II trial.

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Positive reinforcement: Balancing negative and positive feedback for comprehensive improvement.

J Dent

December 2024

Restorative Dentistry, BDS Programme Lead at the School of Dentistry, Cardiff University, Cardiff, UK. Electronic address:

Patient feedback plays a vital role in healthcare, offering insights into the quality of care and promoting professional development. Despite the emphasis on feedback collection from regulatory bodies, institutional policies appear to focus on processing complaints and negative feedback over positive feedback. The aim of this study is to investigate the processes relevant to the systematic logging of patient feedback in the dental hospitals across the UK and the Republic of Ireland.

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Brachytherapy (BT) plays a key role in cancer treatment by delivering a high dose to a small volume over a short time. The use of BT is currently validated in a wide range of cancers such as cervical, prostate and breast cancers while being a favourable choice for organ preservation, such as in penile or rectal cancer, or in the setting of reirradiation. Consideration of the radiobiology of BT is integral to the choices made around dose and fractionation and combination with other techniques such as external beam radiotherapy (EBRT).

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A 66-year-old woman with no prior medical history presented to the emergency department with diplopia and parosmia. The neurological examination identified an isolated left abducens nerve (CN VI) palsy. A head CT scan, followed by a brain MRI, showed a large, locally advanced tumour in the left sphenoid sinus with extensive skull base involvement and perineural extension into the left orbit.

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Purpose: The ESPAC4 trial showed that adjuvant chemotherapy with gemcitabine plus capecitabine (GemCap) produced longer overall survival (OS) than gemcitabine monotherapy. Subsequently, the PRODIGE24-CCTG PA.6 trial showed even longer survival for modified fluorouracil, folinic acid, irinotecan, and oxaliplatin (mFOLFIRINOX) than gemcitabine but had more restrictive eligibility criteria.

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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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  • The study evaluated the accuracy and completeness of prostate cancer diagnosis records in two UK primary care databases (CPRD GOLD and Aurum) compared to linked Cancer Registry (CR) and Hospital Episode Statistics (HES) data from 2000-2016.
  • Results showed that Aurum had higher accuracy (87%) and completeness (77%) than GOLD (86% accurate, 65% complete), while both databases improved in date concordance over the years.
  • The study concluded that using linked CR or HES data is recommended to enhance case capture, highlighting the importance of understanding each data source's limitations for reliable cancer research.
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Instant Oncology: OPERA.

Clin Oncol (R Coll Radiol)

January 2025

Royal Surrey County Hospital, Egerton Road, Guildford, GU2 7XX, United Kingdom. Electronic address:

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Article Synopsis
  • - The increase in life expectancy is leading to higher rates of frailty and eye diseases in the elderly, with conditions like cataracts and glaucoma being particularly impactful, resulting in visual impairment that affects daily living and mental health.
  • - Visual impairment due to eye diseases is closely linked to cognitive decline, creating a vicious cycle where reduced sensory input worsens cognitive health, leading to issues like depression and social isolation.
  • - The review emphasizes the need for early intervention and interdisciplinary care to manage eye diseases and their cognitive implications in the elderly, highlighting the critical role of ophthalmologists in these efforts.
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The optimal duration of antibiotic prophylaxis for patients undergoing primary hip or knee arthroplasty remains debated. We conducted a systematic review and meta-analysis to compare the outcomes of single-dose versus extended antibiotic prophylaxis. Studies assessing these strategies for periprosthetic joint infection (PJI), revision surgery, and superficial surgical site infections were selected from systematic searches in PubMed, Embase, and the Cochrane Library.

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Objective: There is sometimes concern over the use of radiotherapy for cancer in individuals with rheumatoid arthritis (RA), but little evidence to support its avoidance. Identifying any association between RA and risk of radiotherapy toxicity could impact current guidance. We aimed to review the evidence base.

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Artificial intelligence in robot-assisted radical prostatectomy: where do we stand today?

J Robot Surg

November 2024

Consultant Urologist and Robotic Surgeon, Department of Urology, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, UK.

Background: The development of Artificial Intelligence (AI) is one of the most revolutionary changes in modern history. The combination of AI and Robotic surgery can be used positively for better patient outcomes.

Methods And Results: We aimed to conduct a review of AI and its role in robotic radical prostatectomy in modern day surgical practice.

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Aims: Patients with endometrial cancer who progress following first line therapy have improved survival outcomes with pembrolizumab and lenvatinib (pem/len) compared with standard of care chemotherapy, as demonstrated in KEYNOTE-775. This was in a group of trial patients with good performance status and excluded those with carcinosarcoma histology. In KEYNOTE-775 pem/len was associated with significant toxicity, leading to dose reductions, treatment cessation, and patient morbidity.

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Background: Prehabilitation is safe, feasible and may improve a range of outcomes in patients with oesophago-gastric cancer (OGC). Recent studies have suggested the potential of prehabilitation to improve body composition, sarcopenia and physical fitness, reduce surgical complications and improve quality of life. Despite this, prehabilitation services are not offered throughout all OGC centres in the UK.

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Hybrid closed-loop (HCL) systems remain underexplored within aviation, and as atmospheric pressure changes can independently affect insulin pumps and continuous glucose monitoring readings, this preliminary study assessed the feasibility of HCL safety evaluation, in both fasting and post-prandial states, by using hypobaric chamber to simulate flights. Participants with type 1 diabetes and on HCL were studied: Medtronic Guardian 4-Medtronic 780G-SmartGuard ( = 4), Dexcom G6-Omnipod DASH-Android APS ( = 1), and Dexcom G6-Ypsomed Pump-CamAPS ( = 1). Flight cabin pressures of 550 mmHg and 750 mmHg were simulated in a hypobaric chamber.

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Article Synopsis
  • - Digital breast tomosynthesis (DBT), when used with a synthetic 2D mammogram (S2D), exposes women to higher radiation but may enhance cancer detection compared to full-field digital mammography (FFDM) alone.
  • - A review of 17 studies, including 13 for meta-analysis, found that DBT plus S2D provided a higher cancer detection rate compared to FFDM alone, while also showing similar accuracy to DBT with FFDM.
  • - The findings suggest that integrating S2D with DBT in breast cancer screening is effective and maintains the safety and performance of the imaging process.
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Objectives: Qualitative faecal immunochemical tests for haemoglobin (FIT), for triaging for colorectal cancer investigations, are available for professional use. The aim was to evaluate these lateral flow tests. No previous analytical evaluations have been published.

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  • * Conducted across 24 sites in ten countries, 1200 cancer patients on opioid analgesics completed questionnaires assessing their constipation status, revealing that 59.5% met the criteria for OIC, but only 61.5% self-reported experiencing constipation.
  • * Results indicated that while 72% were prescribed laxatives or other treatments, only 66% consistently used them, leading to inadequate management of OIC due to poor assessment and treatment follow-up.
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  • The study analyzed risk factors for biochemical recurrence (BCR) after robot-assisted radical prostatectomy (RARP) using data from patients treated between 2018 and 2020, excluding those with certain complications or missing data.
  • Results indicated that the International Society of Urological Pathologists (ISUP) grade is a strong predictor for BCR, particularly for higher grades, while pT3b stage also significantly predicted BCR in patients with advanced tumors.
  • The findings conclude that ISUP grade and tumor stage are critical risk factors for BCR after RARP, with additional emphasis on the significance of positive surgical margins in pT2 cases and the pT3b substage in pT3 cases.
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Article Synopsis
  • * The article summarizes recommendations for handling fluids from the preoperative stage to hospital discharge, focusing on various surgical procedures while excluding certain categories like burn injuries and head and neck surgeries.
  • * Individualized fluid management is emphasized, considering the type of surgery and patient-specific factors, while ongoing gaps in knowledge highlight the need for further research in this area.
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