Multiple sclerosis (MS) affects more than 130,000 people in the UK and over 2.5 million people worldwide. MS often begins with a relapsing-remitting phase (RRMS). However,over time,many people with RRMS start to find that they no longer recover after a flare-up (also known as a relapse) and get steadily worse,resulting in increased disability. This is known as secondary progressive MS (SPMS). A smaller number of people experience a gradual decline from the beginning,known as primary progressive MS (PPMS). SPMS and ...

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Research question: Does post-operative radiotherapy following surgery for pathological fractures improve pain and quality of life? Background: Approximately 70% of people with advanced breast and prostate cancer develop bone metastases, causing ‘pathological’ fractures requiring surgery to stabilise or replace the affected bone. Following surgery, patients usually receive radiotherapy (RT). Despite widespread use, no high-quality evidence exists that post-operative RT improves pain, quality of life nor reduces the risk of re-operation. RT has side-effects, requires additional hospital visits and scans, can delay other effective ...

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1 in 3 babies born prematurely before 32 weeks are at risk of developing retinopathy of prematurity (ROP), a condition caused by abnormal growth of blood vessels in the retina. ROP is a leading cause of childhood blindness worldwide and can significantly impact a child’s quality of life. In 2010, a clinical trial showed that a treatment called anti-VEGF, which works by stopping abnormal blood vessel growth, is effective in treating ROP. As a result, it has been widely used ...

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Cauda equina syndrome (CES) describes symptoms caused by a disc from the spine pushing on the nerves at the end of the spinal cord. These nerves supply the legs, bladder, anus and sexual organs, and can become damaged if compressed for too long. Most patients with CES require an emergency operation to take pressure off the nerves. First, we will recruit 2000 patients admitted with suspected CES across a number of NHS hospitals. These patients will be examined carefully by ...

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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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