Injuries to the chest can cause air or blood to collect in the space between the lungs and the ribs. Doctors usually put in a tube to drain it, but we’re not sure if using a smaller tube or a bigger one is better. We will be comparing two treatments: one uses a small tube put in the chest with a needle and wire (called a small bore Seldinger chest drain), and the other uses a large tube put in ...

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Broken bones can happen to anyone, at any age. Sometimes an operation is needed to hold the broken bones together while they heal. One of the complications of this operation is an infection in the area where the bone has been fixed. These are called fracture-related infections (FRI). They can be serious, and usually require more operations. Some surgeons use local antibiotic carriers during the operation to try to lower the risk of FRIs. These are placed directly into the ...

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Angina with Non-Obstructive Coronary Arteries (ANOCA) is a common condition where patients have chest pain despite no major blockages in their heart arteries. ANOCA is caused by problems in the smaller vessels, known as coronary microvascular dysfunction (CMD), or by sudden narrowing of the arteries, called vasospasm. CMD can occur through two main mechanisms: endothelium-dependent mechanisms, where the inner lining of the vessels (the endothelium) doesn’t properly control the widening of the blood vessels or increase in blood flow when ...

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The Registry of Pulmonary Hypertension in Neonates (RePHyNe) is a prospective global multicentre observational cohort data collection study designed to collect routine clinical data including diagnostic tests and treatments delivered as part of patients’ clinical care. Participants will be recruited by clinicians working in neonatal and paediatric intensive care units who routinely provide care for neonates and young infants with pulmonary hypertension < 3 months of age,corrected for prematurity. Written informed consent will be obtained from parents/guardians. Participants will undergo ...

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This study evaluates whether repeat surgical resection at glioblastoma recurrence improves deterioration‑free survival when added to standard second‑line medical therapy. Secondary objectives include assessing the impact of repeat surgery on health‑related quality of life,daily functioning,neurological symptoms,complications,adjuvant therapy completion,overall survival and cost‑effectiveness within the NHS. An optional sub‑study will explore the feasibility of passive physical activity monitoring using smartphones and wearable devices.

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In the United Kingdom each year about 7000 babies are born very preterm and need specialist neonatal care. Necrotising enterocolitis (NEC) is a serious gut condition affecting 1 out of 10 extremely preterm babies (those who are born before 28 completed weeks of pregnancy). Babies with NEC commonly require surgery and, of these, one out of three unfortunately will not survive. About half of NEC survivors have long-term neurodevelopmental problems like cerebral palsy or learning difficulties. Risk factors for NEC ...

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Sometimes, after a first-time shoulder dislocation, surgery is offered to help stop the shoulder from slipping out of place again. This is a common injury in young people, especially those who play sport. During surgery, doctors repair the damaged tissues around the shoulder using keyhole (arthroscopic) techniques, followed by rehabilitation to help regain movement and strength. Others are treated with rehabilitation alone to strengthen the shoulder without surgery. At the moment, there is no clear evidence to show which option ...

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Certain anti-seizure medications (ASMs) are known to carry a teratogenic risk and are associated with higher rates of impaired physical and neurodevelopmental outcomes in the children of women with epilepsy. However, there remains a considerable gap in our current knowledge regarding the risk/safety profile of the majority of ASMs when used during pregnancy, including commonly prescribed ASMs such as lamotrigine and levetiracetam. We will investigate the health and development of children who were exposed in utero to ASMs and whose ...

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Previous research has highlighted that children,young people and families have unmet information needs at the end of treatment. We do not currently know whether children,young people and families in the UK are receiving the information they need at the end of treatment and how far children and young people are included in the conversations. Provision of information at the end of treatment sets the foundations for children and young people being able to successfully engage with future long-term follow up services ...

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While blood transfusions save lives in the neonatal critical care setting, there is increasing awareness that transfusion of blood products is an independent predictor of adverse outcome. Infants in a neonatal intensive care unit (NICU) are among the most frequently transfused patients with the incidence and severity of major neonatal morbidities known to correlate with the number and volume of red blood cell (RBC) transfusions they receive. The spectrum of post-transfusion effects on organs and tissues which manifest ...

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