The demographics of the global population is changing with increasing numbers of elderly and co-morbid patients. As a result, more elderly patients will be admitted to ICU, which will bring a number of ethical challenges. It is for this reason we have chosen to focus on this historically neglected and important patient population. Little is known about how or whether Family meetings (FM) are conducted in European ICUs. The aim of this trial is to determine whether FMs are ...

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Doctors and patients need to have evidence from clinical trials so that they can make the right treatment choices together. However, Malignant Pleural Effusion (MPE) trial results cannot be easily compared because they do not all measure the same information or ‘outcomes’ (e.g. pain.) This is because there is no agreement on which outcomes are the most important to patients with MPE, doctors and researchers. My study aims to address this by creating a core outcome set (COS). To ...

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Inflammatory bowel disease (IBD) includes conditions that cause inflammation in the colon (large intestine) and small intestine. The two main types of IBD are Crohn’s disease (CD) and Ulcerative Colitis (UC). While there is currently no cure for IBD, there are different treatments available to help manage the disease. Guselkumab is a new treatment recently approved for patients with moderate to severe UC or CD who have not responded well to other treatments or cannot tolerate them. This study ...

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This is a post-authorisation study evaluating the effectiveness and safety of belzutifan in routine clinical practice. It will include Adult (> = 18 years of age) patients with von Hippel-Lindau (VHL) disease for which a decision has been made by the treating physician to initiate belzutifan treatment. The study aims to enroll up to 100 patients with VHL disease-associated renal cell carcinoma (RCC) and/or central nervous system (CNS) hemangioblastoma. This includes approximately 40 patients with VHL disease-associated RCC and approximately ...

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Every year, 100 boys are born in the UK with Duchenne muscular dystrophy. These boys cannot make an important muscle protein. They become weaker as they get older and lose the ability to walk as teenagers. There is no cure, but medicines are being made that could help. These medicines will likely work better in younger boys, before muscle damage begins. We currently have no way of testing these medicines in children under four. In older children, we test how well ...

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Background: The international Prostate Imaging – Reporting and Data System (PI-RADS) steering committee has recommended on-table radiologist monitoring of patients during MRI to improve patient outcomes by reducing the use of costly and potentially dangerous GBCA injections. On-table monitoring would also facilitate upgrading the MRI scans to whole-body MRI (WB-MRI) if distant metastases were suspected - instead of rescheduling alternative follow-up imaging appointments. In most health systems around the world,there are significant shortfalls in the number of required radiologists for ...

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Background: Cutaneous squamous cell carcinoma (cSCC) is the most common skin cancer with metastatic potential and has an identifiable precancerous stage,actinic keratosis (AK). cSCC incidence exceeds 52,000 in UK and is increasing by 5% per annum with immunosuppression as a key risk factor. Multiple primary cSCC are common,especially in immunosuppressed organ transplant recipients,and incur significant morbidity and cost. Prevention of cSCC in immunosuppressed patients is a major unmet clinical need,yet this population has previously been excluded RCT data confirm that ...

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Sometimes, after a broken hand or wrist, surgery is needed to fix the bones. This is routinely performed in the NHS and is usually the case if the bones have fallen out of place. During the surgery, doctors will use metal wires to hold the bones in the right place while they heal. Once the bones have healed, the wires are then removed. There are currently no reliable studies to tell us if these wires are better left sticking out ...

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The pleura are two thin layers of tissue which cover the outside of the lungs. The pleura are vulnerable to many different diseases, including cancer from elsewhere in the body. The commonest cancer which spreads to the pleura is lung cancer. When this happens, the pleura become irritated and produce fluid which fills the space where the lung would normally be. This collection of fluid is called a pleural effusion and can make a patient very breathless. In general, a ...

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Each year in the UK at least 60,000 patients are diagnosed with heart failure. Coronary artery disease (narrowing of the blood vessels supplying the heart) is the most common cause of heart failure. Invasive coronary angiography is often done as the first line test to identify coronary artery. However, we know from work with our patient and public involvement groups that most patients would prefer to avoid invasive coronary angiography if possible. The aim of this trial is to establish if ...

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