In the UK, heart operations have steadily increased since 2010, and 36,166 heart operations were performed in 2016. Following cardiac surgery, patients currently attend their first outpatient review six weeks after hospital discharge, where recovery is assessed and fitness to commence cardiac rehabilitation (CR) is determined. CR is then started from eight weeks. In a survey we conducted in May/June 2017, 35 of the 42 UK cardiac centres responded, and confirmed this as current practice. The long interval before postoperative ...

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The spleen is often injured when the body sustains trauma. This leads to bleeding. The bleeding can be stopped by a big operation cutting open the belly or a small hole in your groin where a blood vessel can be accessed and through which the bleeding can be stopped. We do not know what types of injuries it is best to use this procedure. We do not know why we do not use the smaller technique ...

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Despite advances with the introduction of anti-GD2 immunotherapy,there is a major unmet need to develop new drugs for treatment of high-risk neuroblastoma. Around half of patients relapse despite intensive therapies,and outcome following relapse is dismal (<10% long term survival). The BEACON2 trial will confirm which combination of drugs tested in the phase II BEACON study should be taken forward and identify novel combinations that further improve survival in this patient group. Based on our experience in a previous trial (BEACON),the ...

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This is a platform trial testing the addition of experimental treatments to standard of care (SoC) with two randomised controlled trials called research comparisons. The platform design allows the addition of other research treatments into the structure following protocol amendment. The primary objectives of each comparison are to test whether survival and/or cancer outcomes can be improved by the addition of the research treatments to SoC in men with metastatic prostate cancer and starting long-term androgen deprivation therapy. Key secondary objectives ...

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We are looking for new and better ways to manage melanoma, an aggressive type of skin cancer. Surgery to remove the melanoma will cure the majority of patients with early stage disease. However, a small percentage of these patients will go on to develop further disease, which may spread to other places in their body. At present, following surgery, patients with early stage melanoma can either choose to have close monitoring with regular scans and skin checks or they can ...

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We will use state-of-the-art imaging to look at heart disease in people with haemophilia. Haemophilia is an inherited disorder in which blood does not clot properly because of lack of a key ‘glue’ blood component (chemicals known as factor VIII or IX). People with haemophilia are 40% less likely to die of heart disease, but we don’t know why. Understanding heart disease in people with haemophilia is important because better treatments for haemophilia mean that these patients are now ...

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To evaluate the effect of AP01 100 mg given twice daily (BID) and AP01 50 mg BID compared to AP01 placebo (hereafter referred to as placebo) on lung function over 52 weeks in subjects with PPF B17: Secondary objective(s) To evaluate the effect of AP01 100 mg given twice daily (BID) and AP01 50 mg BID compared to AP01 placebo (hereafter referred to as placebo) on lung function over 52 weeks in subjects with PPF B18: Full inclusion criteria

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Design: A 2x2 factorial pragmatic open-label randomised controlled trial,with an embedded randomised double-blind parallel group trial Setting: 60 general ICUs in the UK Target population: Adult patients who are critically ill due to sepsis Inclusion criteria - Adult patients admitted to ICU due to suspected sepsis and expected to stay for at least 48 hours - Receiving intravenous antibiotics for suspected sepsis - Initial early fluid resuscitation complete - Acute organ dysfunction due to infection Additional criteria for GM-CSF subset - Mechanically ventilated - Receiving vasopressors/inotropes - Absolute lymphocyte count <1.2 ...

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Cytomegalovirus (CMV), the international leading cause of neurodevelopmental impairment from infection acquired during pregnancy, is estimated to affect over 4200 babies and cost over £750 million each year in the UK. CMV is a common virus usually causing mild infection in healthy individuals, however CMV can cause serious disease if it affects a baby during pregnancy. Only the most severely affected cases of CMV acquired in pregnancy tend to be identified by healthcare professionals because there is currently no screening ...

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People with any condition that affects the liver over a long period of time can develop cirrhosis. Conditions that can lead to cirrhosis include alcohol excess, liver steatosis (lipid or fat accumulation in the liver) and infection with hepatitis B and C. One concern about people with cirrhosis is that they are at increased risk of developing liver cancer. People with cirrhosis are recommended to have an ultrasound scan (USS) every 6 months (surveillance) so that if a cancer develops, ...

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