We will conduct a randomised,double-blind,placebo controlled,Phase 2 study to evaluate the effect of the selective 11β-HSD1 inhibitor,SPI-62,6mg once daily for 12-weeks,on metabolic,bone and cognitive phenotype in patients with adrenal adenomas and evidence of MACS. 40 patients with MACS will be recruited from tertiary referral endocrine centres. All participants will have baseline investigations performed before treatment. We will collect clinical data by collecting biological samples including serum,urine,adipose tissue and microdialysis,as well as questionnaires and cognitive function tests. All participants will have baseline ...

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Donor stem cell transplantation is used for treating patients with blood cancers. This is also called allogeneic stem cell transplantation. It is a very intense form of treatment which can cause significant complications. Graft versus host disease (GvHD) is one of the most serious side effects and occurs when the donor immune system attacks the normal tissues in the transplant recipient. There are two types of GvHD. Acute GvHD normally happens within 100 days of the transplant and chronic GvHD ...

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Background: Computerised Tomography (CT) imaging is frequently used in Emergency Departments to assess patients. This often requires patients to wait of up to several hours for a scan due to service pressures, with a further wait of up to several hours for a radiologist to look at the images and interpret the findings. This can lead to patients waiting a long time in the Emergency Department to be discharged home or have their problems diagnosed. We recently undertook a small ...

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Endometriosis is a common gynaecological disease affecting 10% of the female population due to the presence of uterus-like tissue outside of the uterus, often in the pelvis. The disease causes severe lower abdominal pain mostly during the monthly period, during or after sexual intercourse, and when emptying bowel and bladder. Currently, imaging methods such as ultrasound are ineffective at diagnosing the most common type of endometriosis, pelvic endometriosis. Therefore, we are heavily reliant on invasive surgery to make the diagnosis. ...

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Rehabilitation of movement after stroke depends on motor learning. Motor learning involves not only improvement during practice but also improvement between sessions, known as consolidation. Consolidation of learning depends on good sleep quality. However, there is growing evidence that sleep is disrupted after stroke and we recently showed that following brain injury, patients with poorer sleep show worse rehabilitation outcomes. This might occur because sleep disruption impairs consolidation directly, or might reflect other factors that influence both sleep and clinical ...

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The overall aim of the trial is to evaluate the efficacy of licensed targeted therapies in unlicensed indications,in rare adult,paediatric and TYA cancers with actionable genomic alterations (including common cancers with rare actionable alterations) and to identify genomic,transcriptomic and immune contextual influences on response to therapy. The ultimate aim is to transition positive findings ...

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Primary central nervous system lymphoma (PCNSL) is a rare type of brain tumour. It is an aggressive type of non-Hodgkin lymphoma that is found only in the brain or spinal cord. PCNSL is often treated with high-doses of chemotherapy. The first treatment doesn’t work for some patients (called ‘refractory’), and the lymphoma can come back (called ‘relapse’). Refractory or relapsed (RR) PCNSL is much more difficult to treat. There is currently no standard treatment for RR-PCNSL and further chemotherapy ...

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Many patients in intensive care units (ICU) need help to breathe from a breathing machine (ventilator). This condition is known as acute respiratory failure or lung failure. While on a breathing machine, it is difficult for patients to clear secretions (mucus) from the lungs. Breathing becomes harder if secretions are thick and dry. In some cases, the build-up of secretions can result in a lung infection (ventilator-associated pneumonia). Mucoactive medications (hereafter 'mucoactives') are sometimes prescribed to clear thick secretions. ‘Carbocisteine' and 'Hypertonic saline’ are two ...

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This is a pragmatic, a non-interventional, prospective observational cohort study planned to run for 6 years (Includes pregnancy and to the child’s 5th birthday). This study will build on the infrastructure formed as part of the main OPTIMISE:MS study, adding pregnancy-focused pharmacovigilance. Due to the need to contact healthcare providers for information over and above that recorded in the neurological records, this study needs additional approvals to the main study. The pregnancy study will meet the needs ...

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Head and neck cancer is a disease where tumours arise in the mouth, back of the nose, throat, or voice box. It is treated by combinations of surgery, radiotherapy and chemotherapy. Currently, people who finish treatment have a clinic review every 2-6 months for 5 years to check for the cancer coming back (recurrence). Finding recurrence early increases the chance of treating it successfully. However, many patients feel they are seen too frequently, and this can increase their worry about ...

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