The liver plays a key role in producing the proteins involved in blood clotting (haemostasis), both proteins promoting clotting (pro-coagulants) and those preventing clotting (anti-coagulants). It also has a role in removing these proteins from the circulation. Patients with liver disease have complex changes in haemostasis, which is overall ‘rebalanced’. When patients with liver disease are sick, and admitted to hospital, this rebalanced haemostasis is thought to be more unstable. These patients are at high risk of both bleeding and ...

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A malignant pleural effusion (MPE) is a buildup of fluid around the lungs due to any type of cancer that has either started or spread to the lining of the lungs (pleura). This effects over 100 people per day in the UK and patients with MPE experience debilitating breathlessness due to fluid build up and delays in diagnosis. In the current investigation and management pathway for patients suspected MPE, patients have some fluid drawn off and analysed for cancer cells, but ...

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This is a single stage,single arm phase II,open,label,multi centre trial of patients with HER2 positive GOA who are ctDNA positive following neoadjuvant chemotherapy and surgery. HER2 positive will be defined as IHC3+ or IHC2+/ISH+ positive on diagnostic biopsy or resection specimen. ctDNA result will be determined using the Natera Signatera assay. All patients will be treated with trastuzumab deruxtecan at a dose of 6.4 mg/kg intravenously every 21 days for 6 months. If required patients may dose reduce to 5.4 ...

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The PROTECT-HF trial, funded by the British Heart Foundation, will compare two different pacing approaches for treating patients with slow heart rates. In it we will compare the standard approach for pacing, right ventricular pacing, with a new form of pacing, physiological pacing. With right ventricular pacing the pacemaker lead is positioned on the heart muscle in the right ventricle (the chamber of the heart which pumps blood to the lungs). This method is very effective at treating slow heart ...

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IELSG48 is a Phase III,interventional,multicenter,open label,randomized study to evaluate whether treatment with zanubrutinib in combination with rituximab will result in an improvement in PFS compared to treatment with rituximab in patients with previously untreated SMZL. Approximately 120 subjects will be randomized in a 1:1 ratio to receive zanubrutinib and rituximab Treatment Arm A) or rituximab (Treatment Arm B). The study will include a Screening Phase,a Treatment Phase,and a Follow-Up Phase. Subjects with investigator-confirmed progressive disease according to the Lugano 2014 criteria ...

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Clavicle (collar bone) fractures make up around 5% of all bone fractures. Usually, people fracture the middle part of their collarbone but sometimes the outer part on top of the shoulder breaks and separates. This is called a “displaced distal clavicle fracture”. These fractures can be very painful, make it hard to move your arm, disturb sleep and affect the appearance of your shoulder. Patients either undergo surgery to repair the collarbone with plates and screws or they wear a ...

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Sodium bicarbonate is widely,but not universally,used to treat metabolic acidosis in very preterm babies but the evidence underpinning its use is poor. The BASE trial aims to answer the question,‘In very preterm babies with metabolic acidosis,does giving them sodium bicarbonate or not impact on their health and development in the short and long term?’ The primary objective of the BASE trial is to evaluate the effect of sodium bicarbonate on survival to discharge from neonatal care without major morbidity. In this randomised ...

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REGN4018 and cemiplimab are the study drugs under investigation for the treatment of ovarian cancer. They are both investigational drugs, meaning they have not received approval from health authorities for the treatment of ovarian cancer. The purpose of this study is to learn about the safety of REGN4018 and to find out what dose of REGN4018 can be given alone or with cemiplimab to patients with ovarian cancer, without causing too many side effects. The study will also look at ...

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In one of the most severe congenital heart defects, hypoplastic left heart syndrome (HLHS), the left ventricle is underdeveloped and the prognosis is worse than in most other heart defects. The underdevelopment can occur gradually during fetal growth caused by a narrowing of the aortic valve. At some international centers, such fetuses are treated with a balloon dilation of the narrowed valve, but there is no scientifically sound evidence that this treatment is effective. The aim of this study is: 1/ ...

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The Meniscus is an important structure within the knee. One of its key roles is to cushion impact and protect the gliding surface of the joint from wear. Patients that have damaged their meniscus, and had a removal of the meniscus (a total meniscectomy), are more likely to develop persistent pain after this resulting in years of disability. At present, there are several treatment options ranging from knee therapy (physiotherapy) to a replacement meniscus also known as a ‘meniscal transplant’. Mensical transplant is thought ...

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