181 results match your criteria: "St Bartholomews Hospital[Affiliation]"

The role of medical physics experts in clinical trials: A guideline from the European Federation of Organisations for Medical Physics.

Phys Med

October 2024

Institute of Clinical Research, University of Southern Denmark, Denmark; Danish Center of Particle Therapy, Aarhus University Hospital, Denmark; Department of Oncology, Odense University Hospital, Denmark.

The EFOMP working group on the Role of Medical Physics Experts (MPEs) in Clinical Trials was established in 2010, with experts from across Europe and different areas of medical physics. Their main aims were: (1) To develop a consensus guidance document for the work MPEs do in clinical trials across Europe. (2) Complement the work by American colleagues in AAPM TG 113 and guidance from National Member Organisations.

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Background: The optimal timing of radiotherapy (RT) after radical prostatectomy for prostate cancer has been uncertain. RADICALS-RT compared efficacy and safety of adjuvant RT versus an observation policy with salvage RT for prostate-specific antigen (PSA) failure.

Patients And Methods: RADICALS-RT was a randomised controlled trial enrolling patients with ≥1 risk factor (pT3/4, Gleason 7-10, positive margins, preoperative PSA≥10 ng/ml) for recurrence after radical prostatectomy.

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Background: Pneumonitis is a well-described, potentially disabling, or fatal adverse effect associated with both immune checkpoint inhibitors (ICI) and thoracic radiotherapy. Accurate differentiation between checkpoint inhibitor pneumonitis (CIP) radiation pneumonitis (RP), and infective pneumonitis (IP) is crucial for swift, appropriate, and tailored management to achieve optimal patient outcomes. However, correct diagnosis is often challenging, owing to overlapping clinical presentations and radiological patterns.

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Background: Shorter regimens for drug-resistant tuberculosis (DR-TB) have non-inferior efficacy compared with longer regimens, but QT prolongation is a concern. T-wave morphology abnormalities may be a predictor of QT prolongation.

Research Design And Methods: STREAM Stage 1 was a randomized controlled trial in rifampicin-resistant TB, comparing short and long regimens.

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Patients with hypertrophic cardiomyopathy may exhibit impaired functional capacity, associated with increased morbidity and mortality. Systolic function is one of the determinants of functional capacity. Early identification of systolic disfunction may identify patients at risk for adverse outcomes.

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Gemcitabine and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin in Advanced or Metastatic Bladder Cancer: Results of a Large, Randomized, Multinational, Multicenter, Phase III Study.

J Clin Oncol

August 2023

From the Aarhus University Hospital, Aarhus; Herlev Hospital, University of Copenhagen, Herlev, Denmark; Northern Centre for Cancer Treatment, Newcastle General Hospital, Newcastle; St Bartholomews Hospital, London, United Kingdom; University of Torino, St Luigi Hospital, Orbassano; Santa Chiara Hospital, Pisa, Italy; The Princess Margaret Hospital, Toronto, Canada; National Institute of Oncology, Budapest, Hungary; Department of Urology, Bonn University, Bonn; Krankenhaus Nordwest, Frankfurt; Klinikum Ludwigshafen, Ludwigshafen, Germany; Centre Eugene Marquis, Rennes, France; Hospital Ciudad De Jaen, Jaen, Spain; Karolinska Hospital, Stockholm, Sweden; and Eli Lilly and Company, Indianapolis, IN.

Purpose: Gemcitabine plus cisplatin (GC) and methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) were compared in patients with locally advanced or metastatic transitional-cell carcinoma (TCC) of the urothelium.

Patients And Methods: Patients with stage IV TCC and no prior systemic chemotherapy were randomized to GC (gemcitabine 1,000 mg/m days 1, 8, and 15; cisplatin 70 mg/m day 2) or standard MVAC every 28 days for a maximum of six cycles.

Results: Four hundred five patients were randomized (GC, n = 203; MVAC, n = 202).

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Whither (or wither?) public health?

Clin Med (Lond)

July 2023

St Bartholomews Hospital, London, UK, and consultant bariatric physician, Bedfordshire Hospitals NHS Foundation Trust, Bedford, UK.

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Purpose Of Review: There have been several advances in the diagnosis and management of valvular heart disease (VHD) over the last decade. These have been reflected in the latest European and North American guidelines, although both contain significant similarities and differences. In this review, we highlight the important overlaps and variations between the updated guidelines and their previous versions to help guide the general cardiologist.

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Opioid sparing strategies for perioperative pain management other than regional anaesthesia: A narrative review.

J Anaesthesiol Clin Pharmacol

February 2022

Consultant in Pain Medicine and Clinical Network Director Pain, St. Bartholomews Hospital, Barts Health NHS Trust West field, London.

Article Synopsis
  • - Opioids are important for managing pain but can lead to serious risks and complications for patients, such as nausea, sedation, and respiratory issues.
  • - To minimize these opioid-related side effects, multimodal analgesia (using different types of pain relief methods) has been introduced, which includes both pharmacological and non-pharmacological techniques.
  • - While several pharmacological options like NSAIDs and acetaminophen show effectiveness in pain management, further research is needed to fully understand the impact of non-pharmacological methods like acupuncture and cognitive behavioral therapy.
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Purpose: Survival in stage I seminoma is almost 100%. Computed tomography (CT) surveillance is an international standard of care, avoiding adjuvant therapy. In this young population, minimizing irradiation is vital.

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Postradioiodine Graves' management: The PRAGMA study.

Clin Endocrinol (Oxf)

November 2022

Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK.

Objective: Thyroid status in the months following radioiodine (RI) treatment for Graves' disease can be unstable. Our objective was to quantify frequency of abnormal thyroid function post-RI and compare effectiveness of common management strategies.

Design: Retrospective, multicentre and observational study.

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Purpose: Preoperative nodal staging is important for planning treatment in cervical cancer and endometrial cancer, but remains challenging. We compare nodal staging accuracy of F-ethyl-choline-(FEC)-PET/CT, F-fluoro-deoxy-glucose-(FDG)-PET/CT, and diffusion-weighted-MRI (DW-MRI) with conventional morphologic MRI.

Experimental Design: A prospective, multicenter observational study of diagnostic accuracy for nodal metastases was undertaken in 5 gyne-oncology centers.

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Cardiopulmonary coupling indices to assess weaning readiness from mechanical ventilation.

Sci Rep

August 2021

Critical Care Center, Hospital Universitari Parc Taulí, Institut d'Investigació Parc Taulí I3PT, Universitat Autónoma de Barcelona, Sabadell, Spain.

The ideal moment to withdraw respiratory supply of patients under Mechanical Ventilation at Intensive Care Units (ICU), is not easy to be determined for clinicians. Although the Spontaneous Breathing Trial (SBT) provides a measure of the patients' readiness, there is still around 15-20% of predictive failure rate. This work is a proof of concept focused on adding new value to the prediction of the weaning outcome.

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Background: COVID-19 has become the most common cause of acute respiratory distress syndrome (ARDS) worldwide. Features of the pathophysiology and clinical presentation partially distinguish it from 'classical' ARDS. A Research and Development (RAND) analysis gauged the opinion of an expert panel about the management of ARDS with and without COVID-19 as the precipitating cause, using recent UK guidelines as a template.

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The Barts Health NHS Trust COVID-19 cohort: characteristics, outcomes and risk scoring of patients in East London.

Int J Tuberc Lung Dis

May 2021

The Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK, Newham University Hospital, Barts Health NHS Trust, London, UK.

Barts Health National Health Service Trust (BHNHST) serves a diverse population of 2.5 million people in London, UK. We undertook a health services assessment of factors used to evaluate the risk of severe acute respiratory coronavirus 2 (SARS-CoV-2) infection.

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Article Synopsis
  • The number of reproductive-age patients with inherited and congenital heart diseases getting implantable cardiac defibrillators (ICD) is on the rise, highlighting the need for careful pregnancy management in this high-risk group.
  • Healthcare providers, especially cardiologists and electrophysiologists, must understand the specific challenges and considerations of treating pregnant patients who have ICDs to ensure the best outcomes for both mother and baby.
  • The article covers key topics like arrhythmia pathophysiology, ICD implantation techniques, and guidelines for antenatal and device management during pregnancy and delivery.
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As a result of the COVID-19 pandemic, most institutions have changed the way patients are assessed or investigated. Using novel non-contact technology, it is possible to continuously monitor the lung function of peri-operative patients undergoing cardiothoracic procedures. Primarily, this results in increased patient surveillance, and therefore, safety.

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Introduction: The impact of a vascular complication (VC) in the setting of intraaortic balloon pump (IABP) supported PCI on clinical outcomes is unclear.

Methods: Using data from the BCIS National PCI Database, multivariate logistic regression was used to identify independent predictors of a VC. Propensity scoring was used to quantify the association between a VC and outcomes.

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Background: Recent studies have suggested that the routine use of aspiration thrombectomy catheters during primary percutaneous coronary intervention (PCI) do not result in improved mortality and may be associated with an increased stroke rate. This study sought to investigate this hypothesis.

Methods: This was an observational study analysing data from a prospective database of 6366 patients undergoing primary PCI between August 2003 and May 2015 at a UK cardiac centre.

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Management of penile cancer patients during the COVID-19 pandemic: An eUROGEN accelerated Delphi consensus study.

Urol Oncol

March 2021

Department of Urology, University College London Hospital, London, United Kingdom; Division of Surgery and Interventional Science, University College London, United Kingdom; NIHR Biomedical Research Centre, University College London Hospital, London, United Kingdom. Electronic address:

Objectives: To develop an international consensus on managing penile cancer patients during the COVID-19 acute waves. A major concern for patients with penile cancer during the coronavirus disease 2019 (COVID-19) pandemic is how the enforced safety measures will affect their disease management. Delays in diagnosis and treatment initiation may have an impact on the extent of the primary lesion as well as the cancer-specific survival because of the development and progression of inguinal lymph node metastases.

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With the growing SARS-CoV-2 pandemic, we need to better understand its impact in specific patient groups like those with Cystic Fibrosis (CF). We report on 181 people with CF (32 post-transplant) from 19 countries diagnosed with SARS-CoV-2 prior to 13 June 2020. Infection with SARS-CoV-2 appears to exhibit a similar spectrum of outcomes to that seen in the general population, with 11 people admitted to intensive care (7 post-transplant), and 7 deaths (3 post-transplant).

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The electrocardiographic PR interval reflects atrioventricular conduction, and is associated with conduction abnormalities, pacemaker implantation, atrial fibrillation (AF), and cardiovascular mortality. Here we report a multi-ancestry (N = 293,051) genome-wide association meta-analysis for the PR interval, discovering 202 loci of which 141 have not previously been reported. Variants at identified loci increase the percentage of heritability explained, from 33.

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Cardiorespiratory monitoring is crucial for the diagnosis and management of multiple conditions such as stress and sleep disorders. Therefore, the development of ambulatory systems providing continuous, comfortable, and inexpensive means for monitoring represents an important research topic. Several techniques have been proposed in the literature to derive respiratory information from the ECG signal.

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