685 results match your criteria: "The Royal Free Hospital[Affiliation]"

Objectives: Evaluating the outcomes of enhanced case management (ECM) for patients with tuberculosis (TB) in the North Central London TB Service (NCLTBS).

Design: Retrospective cohort study.

Setting: The NCLTBS provides care for persons diagnosed with TB across north and central London.

View Article and Find Full Text PDF

Ethanol for the management of alcohol withdrawal syndrome: a systematic review.

Clin Toxicol (Phila)

November 2024

Addictions Research Group, Applied Psychology Research and Innovation Group, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.

Introduction: Alcohol withdrawal is typically managed using benzodiazepines. However, modulation of both γ-aminobutyric acid-A and N-methyl-d-aspartate-receptors through ethanol provision may provide an alternative management strategy. This systematic review critically analyses the evidence surrounding the use of oral or intravenous ethanol for the management of alcohol withdrawal syndrome.

View Article and Find Full Text PDF

Advanced Endoscopic Imaging for Detection of Dysplasia in Inflammatory Bowel Disease.

Gastrointest Endosc Clin N Am

January 2025

Royal Free Unit for Endoscopy, The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Pond Street, London NW3 2QG, UK; University College London (UCL) School of Medicine, Gower Street, London WC1E 6BT, UK. Electronic address:

Inflammatory bowel disease (IBD) patients are at an increased risk of developing colorectal cancer. Dysplasia is often found in flat, subtle mucosal abnormalities; therefore, early detection is essential. Innovative enhanced endoscopy imaging techniques are increasingly available for endoscopists managing IBD, allowing an in-depth, close to histology evaluation of mucosal pattern and vascular architecture.

View Article and Find Full Text PDF

The Role of Piecemeal Endoscopic Mucosal Resection for Low-risk Larger Than 20 mm Nonpedunculated Polyps in the Right Colon.

Clin Gastroenterol Hepatol

November 2024

Royal Free Unit for Endoscopy, The Royal Free Hospital, University College London, Institute for Liver and Digestive Health, Hampstead, London, United Kingdom of Great Britain and Northern Ireland.

View Article and Find Full Text PDF

Establishing transparency and oversight of organ transplantation by regulatory agencies is of paramount importance to assure ethical, legal, and clinically robust transplantation practices. Registries reporting activity and outcome data of the donor and recipient, including donor source (living or deceased), must be developed for each transplant and should be a mandatory requirement to achieve accreditation to perform transplant surgeries. Collected data for the living organ donor must include the nationality, the nature of their relationship with the recipient, and the complications encountered by living donors that result in prolonged morbidity or mortality.

View Article and Find Full Text PDF
Article Synopsis
  • Blue Rubber Bleb Nevus Syndrome (BRBNS) is a rare congenital condition characterized by vascular malformations in the skin and gastrointestinal tract, but it lacks extensive research and descriptive data.
  • A multicenter study in Europe analyzed 44 BRBNS patients, revealing that the syndrome is typically diagnosed around age 12, primarily through clinical symptoms, with a significant number also experiencing gastrointestinal complications.
  • The study suggests that tests for d-dimer, fibrinogen levels, and Tie2/TEK mutations should be conducted when BRBNS is suspected, as they could aid in confirming the diagnosis.
View Article and Find Full Text PDF

Although there are guidance tables in the literature on surgical dosage for primary medial rectus resection-lateral rectus recession surgery, there is a lack of consensus on the surgical gains in medial rectus re-advancement (MRR) for the management of consecutive exotropia. We compared the surgical outcomes of primary medial rectus resection-lateral recession (RR) surgery, to MRR in patients with consecutive exotropia. Retrospective, electronic note review of consecutive patients undergoing primary RR surgery for basic exotropia (RR group), convergence insufficiency-type exotropia, and divergence excess, and consecutive patients undergoing MRR with or without lateral rectus recession (MRR group) for consecutive exotropia in a teaching university hospital.

View Article and Find Full Text PDF

Background: Nighttime aircraft noise may affect people's sleep, yet large-scale evidence using objective and subjective measures remains limited.

Objective: Our aim was to investigate associations between nighttime aircraft noise exposure and objectively measured sleep disturbance using a large UK cohort.

Methods: We used data from 105,770 UK Biobank cohort participants exposed and unexposed to aircraft noise who lived in 44 local authority districts near 4 international airports in England.

View Article and Find Full Text PDF

Gastric endoscopic mucosal resection is challenging due to the slippery mucosa, abundant blood vessels, and the presence of mucus. We developed gel immersion endoscopy to secure the visual field, even in a blood-filled gastrointestinal lumen in 2016. Clear gel with appropriate viscosity, instead of water, can prevent rapid mixture with blood and facilitate identification of the culprit vessel.

View Article and Find Full Text PDF
Article Synopsis
  • * A rare case is presented involving a 56-year-old man with paratesticular lesions, which were linked to an undescended testicle and an incidental nodule near the umbilicus.
  • * After thorough medical examinations, he was diagnosed with a metastatic midgut neuroendocrine tumor, highlighting the complexity of such tumors and their varied presentations.
View Article and Find Full Text PDF
Article Synopsis
  • Intraductal oncocytic papillary neoplasms (IOPNs) are now identified as distinct from intraductal papillary mucinous neoplasms (IPMNs), with limited information on their recurrence and survival outcomes.
  • A study analyzed outcomes of 415 patients with invasive IOPNs and adenocarcinoma from IPMN over a median of 6 years, finding similar recurrence rates between invasive IOPNs and ductal A-IPMN, but poorer survival compared to colloid A-IPMN.
  • The research concluded that invasive IOPNs behave like aggressive cancers, with adjuvant chemotherapy showing no significant impact on recurrence rates in any of the studied cancer types.
View Article and Find Full Text PDF
Article Synopsis
  • - Immunoglobin light chain (AL) amyloidosis is a rare disease mainly affecting the heart and kidneys through amyloid fibril buildup, making organ-specific evaluations crucial for understanding the disease's impact and guiding treatment.
  • - To promote new treatment developments, the Amyloidosis Forum convened to create guidelines for clinical trials, focusing on identifying effective assessment measures particularly from the insights of the Renal Working Group.
  • - Key recommendations include using estimated glomerular filtration rate (eGFR) and proteinuria to determine trial eligibility and track patient responses, while highlighting the importance of timely and accurate evaluation of treatment effects.
View Article and Find Full Text PDF
Article Synopsis
  • The study examines the outcomes of different precursor epithelial subtypes of adenocarcinoma from intraductal papillary mucinous neoplasms (A-IPMN), focusing on clinical features and recurrence patterns among patients who underwent pancreatic surgery.
  • A total of 297 patients were analyzed, revealing that gastric, pancreatobiliary, and mixed subtypes have similar outcomes that are worse than the intestinal subtype in terms of recurrence and overall survival.
  • The research found that adjuvant chemotherapy specifically improved survival rates in the pancreatobiliary subtype, but not in gastric, intestinal, or mixed subtypes, indicating a potential area for further exploration in treatment strategies.
View Article and Find Full Text PDF
Article Synopsis
  • Wild-type transthyretin amyloid cardiomyopathy (ATTRwt) is connected to heart failure, with this study focusing on how cardiac performance and mitochondrial function relate to different disease stages.
  • The research involved 47 patients diagnosed with ATTRwt and categorized into three groups based on disease severity, revealing significant issues like increased filling pressures during exercise even when resting pressures were normal.
  • Findings indicated that patients exhibited reduced cardiac output and impaired mitochondrial function, suggesting a complex interplay between heart health and mitochondrial performance in ATTRwt patients.*
View Article and Find Full Text PDF

Fabry disease, a multisystem X-linked disorder caused by mutations in the alpha-galactosidase gene. This leads to the accumulation of globotriaosylceramide (Gb3) and globotriaosylsphingosine (Lyso-Gb3), culminating in various clinical signs and symptoms that significantly impact quality of life. Although treatments such as enzyme replacement, oral chaperone, and emerging therapies like gene therapy exist; delayed diagnosis often curtails their effectiveness.

View Article and Find Full Text PDF

Gastric mucosal changes associated with long-term potassium-competitive acid blocker and proton pump inhibitor (PPI) therapy may raise concern. In contrast to that for PPIs, the evidence concerning the safety of long-term potassium-competitive acid blocker use is scant. Vonoprazan (VPZ) is a representative potassium-competitive acid blocker released in Japan in 2015.

View Article and Find Full Text PDF
Article Synopsis
  • - The study investigates factors affecting long-term survival and recurrence in patients with adenocarcinoma from intraductal papillary mucinous neoplasms, focusing on those who had pancreatic resection between 2010 and 2017 in Europe and Asia.
  • - It analyzed data from 288 patients, revealing that 48% experienced recurrence within about 98 months, with 35% remaining disease-free at the 5-year mark.
  • - Key negative predictors for long-term disease-free survival included multivisceral resection, tumor location in the pancreatic tail, poor differentiation, lymphovascular invasion, and perineural invasion, leading to the development of a predictive model with a good success rate.
View Article and Find Full Text PDF

Genetic hypertrophic cardiomyopathy (HCM) is classically caused by pathogenic/likely pathogenic variants in sarcomere genes (G+). Currently, HCM is diagnosed if there is unexplained left ventricular (LV) hypertrophy with LV wall thickness ≥15 mm in probands or ≥13 mm in at-risk relatives. Although LV hypertrophy is a key feature, this binary metric does not encompass the full constellation of phenotypic features, particularly in the subclinical stage of the disease.

View Article and Find Full Text PDF

Background: Liver disease is the third leading cause of premature death in the UK. Transplantation is the only successful treatment for end-stage liver disease but is limited by a shortage of suitable donor organs. As a result, up to 20% of patients on liver transplant waiting lists die before receiving a transplant.

View Article and Find Full Text PDF

Background: Biomarkers with strong predictive capacity towards transplantation outcome for livers undergoing normothermic machine perfusion (NMP) are needed. We investigated lactate clearing capacity as a basic function of liver viability during the first 6 h of NMP.

Methods: A trial conducted in 6 high-volume transplant centres in Europe.

View Article and Find Full Text PDF

Novel Multiplexed Plasma Biomarker Panel Has Diagnostic and Prognostic Potential in Children With Hypertrophic Cardiomyopathy.

Circ Genom Precis Med

June 2024

Centre for Paediatric Inherited & Rare Cardiovascular Disease, Institute of Cardiovascular Science, London, United Kingdom (E.F., A.B., I.H., G.N., J.P.K.).

Background: Hypertrophic cardiomyopathy (HCM) is defined clinically by pathological left ventricular hypertrophy. We have previously developed a plasma proteomics biomarker panel that correlates with clinical markers of disease severity and sudden cardiac death risk in adult patients with HCM. The aim of this study was to investigate the utility of adult biomarkers and perform new discoveries in proteomics for childhood-onset HCM.

View Article and Find Full Text PDF

Introduction: The Coronavirus Disease - 2019 (COVID-19) pandemic significantly impacted healthcare service provision and put diabetic patients at increased risk of adverse health outcomes. We aimed to assess the impact of the COVID-19 pandemic on the incidence and demographic shift of major lower-limb amputation in diabetic patients.

Methods: We performed a retrospective analysis of diabetic patient records undergoing major lower-limb amputation between 01/03/2019 and 01/03/2021 at the Royal Sussex County Hospital, the regional arterial hub for Sussex.

View Article and Find Full Text PDF
Article Synopsis
  • Patients with gastroesophageal reflux disease (GERD) often experience a recurrence of symptoms after stopping vonoprazan (VPZ) therapy, especially if they have a hiatal hernia.
  • In a study of 86 patients, 77% experienced a return of GERD symptoms within 6 months of stopping VPZ, with long-term therapy, alcohol use, and hiatal hernias being significant predictors of recurrence.
  • The study emphasizes that caution is needed when discontinuing acid suppression therapy for GERD, particularly in patients with a hiatal hernia, as symptom improvement usually occurs again after resuming VPZ treatment.
View Article and Find Full Text PDF