139 results match your criteria: "Royal Surrey Hospital[Affiliation]"

Background: Urinary Chemokine (C-C motif) ligand 14 (CCL14) is a biomarker associated with persistent severe acute kidney injury (AKI). There is limited data to support the implementation of this AKI biomarker to guide therapeutic actions.

Methods: Sixteen AKI experts with clinical CCL14 experience participated in a Delphi-based method to reach consensus on when and how to potentially use CCL14.

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A service evaluation of measuring fluid responsiveness in acutely unwell hypotensive patients outside of critical care.

Intensive Crit Care Nurs

October 2024

Royal Surrey Hospital NHS Foundation Trust, Guildford, UK; Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.

Introduction: Early recognition and prompt, appropriate management may reduce mortality in patients with sepsis. The Surviving Sepsis Campaign's guidelines suggest the use of dynamic measurements to guide fluid resuscitation in sepsis; although these methods are rarely employed to monitor cardiac output in response to fluid administration outside intensive care units. This service evaluation investigated the introduction of a nurse led protocolised goal-directed fluid management using a non-invasive cardiac output monitor to the standard assessment of hypotensive ward patients.

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Introduction: AKI is a frequent complication of critical illness and portends poor outcome. CCL14 is a validated predictor of persistent severe AKI in critically ill patients. We examined the association of CCL14 with urine output within 48 h.

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Hemoadsorption: consensus report of the 30th Acute Disease Quality Initiative workgroup.

Nephrol Dial Transplant

November 2024

Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany; and Outcomes Research Consortium, Cleveland, OH, USA.

Adsorption-based extracorporeal therapies have been subject to technical developments and clinical application for close to five decades. More recently, new technological developments in membrane and sorbent manipulation have made it possible to deliver more biocompatible extracorporeal adsorption therapies to patients with a variety of conditions. There are several key rationales based on physicochemical principles and clinical considerations that justify the application and investigation of such therapies as evidenced by multiple ex vivo, experimental and clinical observations.

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Objectives: To compare survival of patients who received LDR prostate brachytherapy relative to that of peers in the general population of England, UK.

Patients And Methods: Net survival was estimated for 2472 cases treated between 2002 and 2016 using population-based analysis guidelines. Life tables adjusted for social deprivation in England from the Office for National Statistics were used to match patients by affluence based on their postcode.

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Article Synopsis
  • * Hepatorenal syndrome (HRS), a severe type of AKI specifically found in patients with advanced cirrhosis and ascites, has an especially high mortality rate, making early detection vital.
  • * In 2023, experts from the International Club of Ascites and the Acute Disease Quality Initiative met to create new diagnostic criteria for HRS-AKI and to establish better practices for treatment and follow-up care for these patients.
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Article Synopsis
  • - Acute kidney injury (AKI) is a frequent post-surgery complication, with the risk increasing for more complex procedures due to various contributing factors like fluid imbalance, infection, inflammation, and tissue damage.
  • - Traditional AKI markers, such as serum creatinine and urine output, are not the best indicators in the acute phase, especially for surgical patients who may experience misleading results due to factors like fluid resuscitation.
  • - Recent research has focused on "novel" biomarkers for AKI, highlighting their potential to improve early identification and guide postoperative care for at-risk patients.
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The APIS Breast Cancer Subtyping Kit is an mRNA-based assessment of the seven parameters including three biomarkers routinely assessed in all the newly diagnosed breast cancers (BC), oestrogen receptor (ER), progesterone receptor (PR) and HER-2 and an additional four genes that create a novel proliferation signature, MKI67, PCNA, CCNA2 and KIF23. Taken together, the data are used to produce a molecular subtype for every sample. The kit was evaluated against the current standard protocol of immunohistochemistry (IHC) and/or in situ hybridisation (ISH) in breast cancer patients.

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Acute kidney disease beyond day 7 after major surgery: a secondary analysis of the EPIS-AKI trial.

Intensive Care Med

February 2024

Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.

Purpose: Acute kidney disease (AKD) is a significant health care burden worldwide. However, little is known about this complication after major surgery.

Methods: We conducted an international prospective, observational, multi-center study among patients undergoing major surgery.

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Frequency of naevus cells in lymph nodes of melanoma and breast cancer patients.

Pathol Res Pract

February 2024

Molecular Oncology Group, CRUK Manchester Institute, University of Manchester, Manchester, UK; Histopathology, Royal Surrey Hospital, Guildford, UK; Division of Clinical Medicine, University of Surrey, Guildford, Surrey, UK; Member of European Organisation for Research and Treatment of Cancer (EORTC) Melanoma Group, Brussels, Belgium.

Introduction: We aimed to study the frequency (prevalence) and histology of benign melanocytic naevus cells in regional lymph nodes in relation to age and sex and nodal location.

Material And Methods: Histopathology reports of sentinel lymph node (SLN) biopsies from melanoma patients, 2002 - 2014, and from breast cancer patients, 2010- 2019, were obtained from records of a single hospital in England. All sections were similarly processed and examined.

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Background: Proenkephalin A 119-159 (PENK) is freely filtered in the glomerulus with plasma levels correlating with glomerular filtration rate. Therefore, PENK has been proposed as an early indicator of acute kidney injury (AKI) although its performance is dependent on the clinical setting. This meta-analysis aimed to investigate the correlation between PENK levels and the development of AKI.

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Purpose: A re-transurethral resection of the bladder (re-TURB) is a well-established approach in managing non-muscle invasive bladder cancer (NMIBC) for various reasons: repeat-TURB is recommended for a macroscopically incomplete initial resection, restaging-TURB is required if the first resection was macroscopically complete but contained no detrusor muscle (DM) and second-TURB is advised for all completely resected T1-tumors with DM in the resection specimen. This study assessed the long-term outcomes after repeat-, second-, and restaging-TURB in T1-NMIBC patients.

Methods: Individual patient data with tumor characteristics of 1660 primary T1-patients (muscle-invasion at re-TURB omitted) diagnosed from 1990 to 2018 in 17 hospitals were analyzed.

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Mismatch repair-deficient (MMRd) colorectal cancers (CRCs) have high mutation burdens, which make these tumours immunogenic and many respond to immune checkpoint inhibitors. The MMRd hypermutator phenotype may also promote intratumour heterogeneity (ITH) and cancer evolution. We applied multiregion sequencing and CD8 and programmed death ligand 1 (PD-L1) immunostaining to systematically investigate ITH and how genetic and immune landscapes coevolve.

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When to discontinue renal replacement therapy. what do we know?

Curr Opin Crit Care

December 2023

Department of Critical Care and Surrey Peri-Operative, Anaesthesia and Critical Care Collaborative Research Group, Royal Surrey Hospital, Guildford, Surrey, UK.

Purpose Of Review: Acute kidney injury is common in intensive care patients. Supportive care involves the use of renal replacement therapies as organ support. Initiation of renal replacement therapy has been the subject of much interest over the last few years with several randomised controlled studies examining the optimal time to commence treatment.

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Cancer testis antigen gene 1B (CTAG1B) and its associated gene product; New York oesophageal squamous carcinoma 1 (NY-ESO-1), represent a unique and promising target for cancer immunotherapy. As a member of the cancer testis antigen family (CTA), the protein's restricted expression pattern and ability to elicit spontaneous humoural and cellular immune responses has resulted in a plethora of novel modalities and approaches attempting to harness its immunotherapeutic anti-cancer potential. Here, we discuss the structure and function of CTAG1B/NY-ESO-1 in both health and disease, immunohistochemical detection, as well as the most promising advances in the development of associated anti-cancer therapies.

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Purpose: Metastatic spinal cord compression (MSCC) is a severe complication of cancer that can lead to irreversible neurological impairment, necessitating prompt recognition and intervention. This retrospective, single-centre study aimed to determine the prognostic factors and survival rates among patients presenting with MSCC secondary to lung cancer.

Methods And Materials: We identified 74 patients with epidural metastases-related spinal cord compression and a history of lung cancer through the electronic database of Medway Maritime Hospital in the United Kingdom (UK), spanning the period from April 2016 to September 2021.

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In order to develop a standardized nomenclature for the mechanisms and materials utilized during extracorporeal blood purification, a consensus expert conference was convened in November 2022. Standardized nomenclature serves as a common language for reporting research findings, new device development, and education. It is also critically important to support patient safety, allow comparisons between techniques, materials, and devices, and be essential for defining and naming innovative technologies and classifying devices for regulatory approval.

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New biomarkers in acute kidney injury.

Crit Rev Clin Lab Sci

January 2024

Critical Care Unit, Royal Surrey Hospital, Guildford, Surry, UK.

Acute kidney injury (AKI) is a commonly encountered clinical syndrome. Although it often complicates community acquired illness, it is more common in hospitalized patients, particularly those who are critically ill or who have undergone major surgery. Approximately 20% of hospitalized adult patients develop an AKI during their hospital care, and this rises to nearly 60% in the critically ill, depending on the population being considered.

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Designing acute kidney injury clinical trials.

Nat Rev Nephrol

February 2024

The Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Acute kidney injury (AKI) is a common clinical condition with various causes and is associated with increased mortality. Despite advances in supportive care, AKI increases not only the risk of premature death compared with the general population but also the risk of developing chronic kidney disease and progressing towards kidney failure. Currently, no specific therapy exists for preventing or treating AKI other than mitigating further injury and supportive care.

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Context: Haematuria can be macroscopic (visible haematuria [VH]) or microscopic (nonvisible haematuria [NVH]), and may be caused by a number of underlying aetiologies. Currently, in case of haematuria, cystoscopy is the standard diagnostic tool to screen the entire bladder for malignancy.

Objective: The objective of this systematic review is to determine the diagnostic test accuracy of cystoscopy (compared with other tests, eg, computed tomography, urine biomarkers, and urine cytology) for detecting bladder cancer in adults.

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Purpose: To learn about the history and development of en bloc resection of bladder tumour (ERBT), and to discuss its future directions in managing bladder cancer.

Methods: In this narrative review, we summarised the history and early development of ERBT, previous attempts in overcoming the tumour size limitation, consolidative effort in standardising the ERBT procedure, emerging evidence in ERBT, evolving concepts in treating large bladder tumours, and the future directions of ERBT.

Results: Since the first report on ERBT in 1980, there has been tremendous advancement in terms of its technique, energy modalities and tumour retrieval methods.

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Acute kidney injury (AKI), which is a common complication of acute illnesses, affects the health of individuals in community, acute care and post-acute care settings. Although the recognition, prevention and management of AKI has advanced over the past decades, its incidence and related morbidity, mortality and health care burden remain overwhelming. The rapid growth of digital technologies has provided a new platform to improve patient care, and reports show demonstrable benefits in care processes and, in some instances, in patient outcomes.

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Objectives: This study aimed to determine if individual physical symptoms were predictive of psychological disorders.

Methods: This study was a secondary analysis of data from two studies which used the Memorial Symptom Assessment Scale-Short Form (MSAS-SF) to assess both physical and psychological symptoms. Correlation between individual symptoms and the validated psychological subscale (MSAS-PSYCH) were performed using Spearman's coefficient.

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