A single centre double blind randomised controlled trial investigating the use of dexamethasone in the treatment of acute tonsillitis. - The use of dexamethasone in the treatment of acute tonsillitis.

开始日期2010-09-02

申办/合作机构

Derby Hospitals NHS Foundation Trust

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100 项与 Derby Hospitals NHS Foundation Trust 相关的临床结果

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0 项与 Derby Hospitals NHS Foundation Trust 相关的专利（医药）

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311

项与 Derby Hospitals NHS Foundation Trust 相关的文献（医药）

2024-11-01·Urologic Oncology: Seminars and Original Investigations

Biomarkers associated with survival in patients with platinum-refractory urothelial carcinoma treated with paclitaxel

Article

作者: Toms, Charlotte ; Sundar, Santhanam ; Jovaisaite, Agne ; Crabb, Simon ; Huddart, Robert ; Powles, Thomas ; Ackerman, Charlotte ; Birtle, Alison ; Bahl, Amit ; Hussain, Syed ; Szabados, Bernadett ; Jackson-Spence, Francesca ; Jagdev, Santinder ; Protheroe, Andrew ; Young, Matthew ; Jones, Robert ; Chakraborti, Prabir

BACKGROUNDTaxane- based chemotherapy is widely used in patients with platinum- and immunotherapy refractory, metastatic urothelial carcinoma (mUC). Outcomes are poor and biomarkers associated with outcome are lacking. We aim to identify cancer hallmarks associated with survival in patients receiving paclitaxel.METHODSWhole-transcriptome profiles were generated for a subset of patients enrolled in a randomised phase II study investigating paclitaxel and pazopanib in platinum refractory mUC (PLUTO, EudraCT 2011-001841-34). Estimates of gene expression were calculated and input into the Almac proprietary analysis pipeline and signature scores were calculated using ClaraT V3.0.0. Ten key gene signatures were assessed: Immuno-Oncology, Epithelial to Mesenchymal Transition, Angiogenesis, Proliferation, Cell Death, Genome Instability, Energetics, Inflammation, Immortality and Evading Growth. Hazard ratios were calculated using Cox regression model and Kaplan-Meier methods were used to estimate progression free survival (PFS) and overall survival (OS).RESULTS38 and 45 patients treated with paclitaxel or pazopanib were included. Patients with high genome instability expression treated with paclitaxel had significantly improved survival with a HR of 0.29 (95% CI: 0.14-0.61, p=0.001) and HR 0.34 (95% CI: 0.17-0.69, p=0.003) for PFS and OS, respectively. Similarly, patients with high evading growth suppressor expression treated with paclitaxel had improved PFS and OS with a HR of 0.35 (95% CI: 0.19-0.77, p=0.007) and HR 0.46 (95% CI: 0.23-0.91, p=0.026), respectively. No other gene signatures had significant impact on outcome. In both paclitaxel and pazopanib cohorts, angiogenesis activation was associated with worse PFS and OS, and VEGF targeted therapy did not improve outcomes.CONCLUSIONHigh Genome-instability and Evading-growth suppressor biologies are associated with improved survival in patients with platinum refractory mUC receiving paclitaxel. These may refine mUC risk stratification and guide treatment decision in the future.

2024-07-01·Movement Disorders Clinical Practice

Improving Conversations about Parkinson's Dementia

Article

作者: Carroll, Camille ; Schrag, Anette ; O'Connell, Ruairiadh ; Henderson, Emily J ; Magee, Cathy ; Subramanian, Indu ; Hannaway, Naomi ; Dobreva, Ivelina ; Archibald, Neil ; Williams-Gray, Caroline H ; Roberts, Janet ; Lindop, Fiona ; Marr, Anne ; Ramaswamy, Bhanu ; Mohamed, Biju ; Foltynie, Tom ; Bhome, Rohan ; Yarnall, Alison J ; Liu, Ken ; Patterson, Katherine ; Bale, Claire ; Hugill, Cassandra ; Alston, Duncan ; Foley, Jennifer A ; Thomas, Joanne ; Suárez-González, Aida ; Jha, Ashwani ; Edwards, Emma ; Weil, Rimona S ; Amar, Khaled ; Roche, Moïse ; Silverdale, Monty ; Ruiz-Mendoza, Eladia ; Dore, Charlotte ; Massey, Luke ; Haunton, Victoria J ; Baldwin-Jones, Sion ; Rose, Sian

AbstractBackgroundPeople with Parkinson's disease (PD) have an increased risk of dementia, yet patients and clinicians frequently avoid talking about it due to associated stigma, and the perception that “nothing can be done about it”. However, open conversations about PD dementia may allow people with the condition to access treatment and support, and may increase participation in research aimed at understanding PD dementia.ObjectivesTo co‐produce information resources for patients and healthcare professionals to improve conversations about PD dementia.MethodsWe worked with people with PD, engagement experts, artists, and a PD charity to open up these conversations. 34 participants (16 PD; 6 PD dementia; 1 Parkinsonism, 11 caregivers) attended creative workshops to examine fears about PD dementia and develop information resources. 25 PD experts contributed to the resources.ResultsWhile most people with PD (70%) and caregivers (81%) shared worries about cognitive changes prior to the workshops, only 38% and 30%, respectively, had raised these concerns with a healthcare professional. 91% of people with PD and 73% of caregivers agreed that PD clinicians should ask about cognitive changes routinely through direct questions and perform cognitive tests at clinic appointments. We used insights from the creative workshops, and input from a network of PD experts to co‐develop two open‐access resources: one for people with PD and their families, and one for healthcare professionals.ConclusionUsing artistic and creative workshops, co‐learning and striving for diverse voices, we co‐produced relevant resources for a wider audience to improve conversations about PD dementia.

2024-04-01·International Journal of Gynecologic Cancer

Consensus on surgical technique for sentinel lymph node dissection in cervical cancer

Article

作者: Kocian, Roman ; Mathevet, Patrice ; Obermair, Andreas ; Hsu, Heng-Cheng ; Collins, Anna ; Cibula, David ; Garcia, Jaime R ; Buda, Alessandro ; Tsibulak, Irina ; Pareja, Rene ; Guani, Benedetta ; Scambia, Giovanni ; Zapardiel, Ignacio ; Ferron, Gwenaël ; Ramirez, Pedro T ; Leblanc, Eric ; Chacon, Enrique ; Fanfani, Francesco ; Bizzarri, Nicolò ; Covens, Allan ; Papadia, Andrea ; Frumovitz, Michael ; Querleu, Denis ; Leitao, Mario M ; Lecuru, Fabrice ; Mueller, Michael D ; Plante, Marie ; Mutombo, Alex ; Balaya, Vincent ; Kohler, Christhardt ; Tanner, Edward ; Abu-Rustum, Nadeem R

ObjectiveThe purpose of this study was to establish a consensus on the surgical technique for sentinel lymph node (SLN) dissection in cervical cancer.MethodsA 26 question survey was emailed to international expert gynecological oncology surgeons. A two-step modified Delphi method was used to establish consensus. After a first round of online survey, the questions were amended and a second round, along with semistructured interviews was performed. Consensus was defined using a 70% cut-off for agreement.ResultsTwenty-five of 38 (65.8%) experts responded to the first and second rounds of the online survey. Agreement ≥70% was reached for 13 (50.0%) questions in the first round and for 15 (57.7%) in the final round. Consensus agreement identified 15 recommended, three optional, and five not recommended steps. Experts agreed on the following recommended procedures: use of indocyanine green as a tracer; superficial (with or without deep) injection at 3 and 9 o’clock; injection at the margins of uninvolved mucosa avoiding vaginal fornices; grasping the cervix with forceps only in part of the cervix is free of tumor; use of a minimally invasive approach for SLN biopsy in the case of simple trachelectomy/conization; identification of the ureter, obliterated umbilical artery, and external iliac vessels before SLN excision; commencing the dissection at the level of the uterine artery and continuing laterally; and completing dissection in one hemi-pelvis before proceeding to the contralateral side. Consensus was also reached in recommending against injection at 6 and 12 o’clock, and injection directly into the tumor in cases of the tumor completely replacing the cervix; against removal of nodes through port without protective maneuvers; absence of an ultrastaging protocol; and against modifying tracer concentration at the time of re-injection after mapping failure.ConclusionRecommended, optional, and not recommended steps of SLN dissection in cervical cancer have been identified based on consensus among international experts. These represent a surgical guide that may be used by surgeons in clinical trials and for quality assurance in routine practice.

100 项与 Derby Hospitals NHS Foundation Trust 相关的药物交易

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100 项与 Derby Hospitals NHS Foundation Trust 相关的转化医学

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