The Guardian view on high-end science in the National Health Service
The genome project and improving ambulance response times both matterThe NHS has an extraordinary record of medical innovation. The link between smoking and lung cancer, the first baby born through IVF and the first heart, lung and liver transplant were all achievements of the health service. Now the 11 hospital trusts which will pioneer the 100,000 genome project have been named. They will recruit participants in an ambitious attempt to sequence the genetic make-up of up to 100,000 NHS patients, creating a database to allow researchers to identify the links between genetic variations and cancers and other rare diseases. At last the high hopes of gene sequencing may be translated into practical medicine. There is talk of genetics as a diagnostic tool, the development of personalised medicine and new, precision-targeted drugs that would amount to a revolution in healthcare. As the health secretary, Jeremy Hunt, argued in a speech last month, the NHS is remarkably good at advanced medical science.This tradition of medical creativity sits awkwardly with the other image of the NHS, as a sclerotic organisation that is as bad at delivering new ways of managing process as it is good at bringing in new ways of treating people. This may not be fair. Restraining the cost of healthcare is a global preoccupation, and the NHS delivers better outcomes for less money than any other comparable system. All the same, the unique politics of the NHS can lead to damaging contortions, as the weeke...
The objective of this compound is to decrease the rate of rectal toxicity related to radiation therapy, by creating a gap between the prostate and rectum. Secondary benefits include decreased urinary complications and improved sexual quality of life. The hydrogel spacer maintains space for approximately 3 months, and is absorbed in about 6 months.
To evaluate the efficacy and clinical impact of 3 Tesla in-bore trans-rectal magnetic resonance-guided biopsy (3T MRGB) for prostate cancer (PCa) detection based on PIRADSv2 in patients with either suspected prostate cancer or under active surveillance.
We describe our experience using MRI fused CBCT guidance for prostate biopsy. There are no published reports on the use of CBCT guidance in prostate biopsies. We hypothesize this technique will have an adequate safety profile while accurately detecting prostate cancer.
Image-guided thermal ablation has become the standard of care for treating early stage liver cancer. However, a significant limitation to a successful ablation procedure is the heat-sink effect, which may lead to suboptimal thermal dose delivery. Currently, there is no reliable method for quantifying the heat-sink effect due to limited information on blood vessel flow and its associated anatomy relative to the ablation zone. The purpose of this study was to use 4D-flow MRI to map out liver flow patterns and correlate flow rates with ablation zone volumes.
To report long-term outcomes of radioembolization (Y90) of hepatocellular carcinoma (HCC) patients within Milan Criteria and study success rate of bridging to liver transplantation (LT) vs drop-out rate from LT waitlist due to HCC progression.
Biphenotypic hepatocellular-cholangiocarcinoma (HCC-CC) is a rare type of primary liver cancer that carries a poor prognosis. Since most patients present at a stage too advanced for surgical resection, loco-regional liver directed therapy is often performed for palliative or downstaging purposes. The purpose of this study is to evaluate patient outcomes after Yttrium-90 radioembolization (Y90) in patients with HCC-CC.
Immunotherapy is a paradigm-shifting advance in cancer care, but the overall response rates remain low. There has been a renaissance in the concept of promoting the immune-responsiveness of the tumor immune microenvironment via intratumoral (IT) delivery of immunostimulatory agents. However, the optimal method for IT delivery of such medications that maximizes IT dispersion while minimizing perilesional leakage and systemic distribution is unknown. The purpose of this study was to characterize IT drug distribution and its influence on drug efficacy using conventional end-hole needles (EHNs) versus multi-sidehole needles (MSHN).
Ports and gastrostomy/gastrojejunostomy tubes (G/GJ-tubes) are common devices utilized during treatment of oncology patients. Combining port and G/GJ-tube placement into a single session can be advantageous from both patient care and resource utilization perspectives. We compared the rates of infection and other device complications in patients receiving a port and G/GJ-tube in one session compared with receiving the devices in two sessions.
We report a novel procedure for primary direct percutaneous jejunostomy under fluoroscopic guidance, utilizing a low profile technique which makes placement safe and efficacious.
To examine the efficacy of image-guided percutaneous interventions in pain and local tumor control in the treatment of osseous metastases from breast cancer.
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