scholarly journals Radiofrequency ablation for Barrett’s oesophagus related neoplasia with the 360 Express catheter: initial experience from the United Kingdom and Ireland—preliminary results

2021 ◽  
Author(s):  
Cormac G. Magee ◽  
David Graham ◽  
Charles Gordon ◽  
Jason Dunn ◽  
Ian Penman ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Barrett’S Oesophagus ◽  
Stricture Formation ◽  
Real World Data ◽  
Barrett's Oesophagus ◽  
The United Kingdom ◽  
Stricture Rate ◽  
End Of Treatment ◽  
The Uk

Abstract Background Radio-frequency ablation (RFA) for Barrett’s oesophagus (BE)-related neoplasia is currently used after endoscopic resection of visible neoplasia. The HALO 360 balloon has been used to ablate long segment BE. The Barrx™ 360 Express RFA self-sizing catheter (‘RFA Express’) may potentially allow quicker ablation times and improved treatment outcomes. The aim of this paper is to present real world data on the use of the 360 Express Device. Methods Centres in the UK and Ireland submitted cases where the RFA Express was used. The primary outcome was regression of BE at 3 months. Secondary outcomes were the rate of symptomatic stricture formation and resolution of intestinal metaplasia (CR-IM) and dysplasia (CR-D) at End of Treatment (EoT). Results 11 centres submitted 123 consecutive patients. 112 had a follow up endoscopy. The median age was 67 years (IQR 62–75). 3 dosimetries were used. The mean reduction in Circumferential (C) length was 78% ± 36 and mean reduction in Maximal length (M) was 55% ± 36. 17 patients (15%) developed strictures requiring dilation. There was a higher rate of stricture formation when the 12 J energy was used (p < 0.05). 47 patients had EoT biopsies, 40 (85%) had CR-D and 34(76%) had CR-IM. Conclusions The RFA 360 Express catheter shows reduction in length of baseline BE at 3 months after index treatment, and eradication of intestinal metaplasia and dysplasia at 12 months similar to other studies with earlier devices. It appears that the symptomatic stricture rate is slightly higher than previous series with the HALO 360 catheter. This study was performed as part of the HALO registry and has been approved by the Research Ethics Committee - MREC Number 08/H0714/27 Local project reference 08/0104 Project ID 15,033 IRAS Number 54678 EudraCT 2009-015980-1. Registered on ISRCTN as below: ISRCTN93069556. https://doi.org/10.1186/ISRCTN93069556

scholarly journals Does anti-reflux surgery control Barrett’s oesophagus progression?

2018 ◽  
Vol 5 (7) ◽  
pp. 2388
Author(s):  
Ali J. Alghazzawi ◽  
Ali A. Khabaza ◽  
Mohammed H. Al-Hijaji
Keyword(s):  
Intestinal Metaplasia ◽  
De Novo ◽  
Barrett’S Oesophagus ◽  
Electronic Database ◽  
Barrett's Oesophagus ◽  
Ovid Medline ◽  
Effective Option ◽  
Gastric Reflux

Controversy exists as to whether or not anti-reflux surgery can prevent the potential long-term complications of Barrett's oesophagus, in particular, dysplastic changes. Hence, literature was reviewed to find out effects of anti-reflux surgery on patients with Barrett's oesophagus. Data has been analysed using different electronic database including Ovid Medline, Scopus, Google Scholar and PubMed. Anti-reflux surgery is considered an effective option for rapid and long-term control of reflux symptoms. Most patients who were included in the studies had a satisfactory control of their symptoms after surgery. Successful procedures effectively abolished gastric reflux in the majority of patients. On the other hand, there were different patterns of Barrett's oesophagus segment progression after surgery regardless of the procedure's success. Many patients developed de novo Barrett's oesophagus, at the same time the intestinal metaplasia regressed in other patients, but the Barrett segment has remained unchanged in the majority of patients. Similarly, the pattern of dysplasia progression was different among patients. Surgery was effective in producing dysplasia regression in many patients, but it failed to prevent progression of columnar intestinal metaplasia into dysplasia in other patients.  In conclusion the potential long-term complications of Barrett's oesophagus can develop after anti-reflux surgery. Therefore, long life follow- up, after surgery, is mandatory.

scholarly journals Prevalence and Mortality of Individuals With X-Linked Hypophosphatemia: A United Kingdom Real-World Data Analysis

2019 ◽  
Vol 105 (3) ◽  
pp. e871-e878 ◽  
Author(s):  
Samuel Hawley ◽  
Nick J Shaw ◽  
Antonella Delmestri ◽  
Daniel Prieto-Alhambra ◽  
Cyrus Cooper ◽  
...  
Keyword(s):  
United Kingdom ◽  
Fibroblast Growth Factor 23 ◽  
Later Life ◽  
Population Based ◽  
Real World Data ◽  
The United Kingdom ◽  
Multisystemic Disease ◽  
The Uk ◽  
The Life Course

Abstract Background X-linked hypophosphatemia (XLH) is a rare multisystemic disease with a prominent musculoskeletal phenotype. We aim here to improve understanding of the prevalence of XLH across the life course and of overall survival among people with XLH. Methods This was a population-based cohort study using a large primary care database in the United Kingdom (UK) from 1995 to 2016. XLH cases were matched by age, gender, and practice to up to 4 controls. Trends in prevalence over the study period were estimated (stratified by age) and survival among cases was compared with that of controls. Findings From 522 potential cases, 122 (23.4%) were scored as at least possible XLH, while 62 (11.9%) were classified as highly likely or likely (conservative definition). In main analyses, prevalence (95% CI) increased from 3.1 (1.5–6.7) per million in 1995–1999 to 14.0 (10.8–18.1) per million in 2012–2016. Corresponding estimates using the conservative definition were 3.0 (1.4–6.5) to 8.1 (5.8–11.4). Nine (7.4%) of the possible cases died during follow-up, at median age of 64 years. Fourteen (2.9%) of the controls died at median age of 72.5 years. Mortality was significantly increased in those with possible XLH compared with controls (hazard ratio [HR] 2.93; 95% CI, 1.24–6.91). Likewise, among those with likely or highly likely XLH (HR 6.65; 1.44–30.72). Conclusions We provide conservative estimates of the prevalence of XLH in children and adults within the UK. There was an unexpected increase in mortality in later life, which may have implications for other fibroblast growth factor 23–related disorders.

Tu1097 HALO Radiofrequency Ablation for High Grade Dysplasia and Early Mucosal Neoplasia Arising in Barrett's Oesophagus: Interim Results Form the UK HALO Radiofrequency Ablation Registry

2012 ◽  
Vol 142 (5) ◽  
pp. S-745
Author(s):  
Rehan J. Haidry ◽  
Jason M. Dunn ◽  
Matthew R. Banks ◽  
Mohammed A. Butt ◽  
Abhinav Gupta ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
High Grade Dysplasia ◽  
Barrett’S Oesophagus ◽  
High Grade ◽  
Barrett's Oesophagus ◽  
The Uk

scholarly journals Improvement over time in outcomes for patients undergoing endoscopic therapy for Barrett's oesophagus-related neoplasia: 6-year experience from the first 500 patients treated in the UK patient registry

Gut ◽  
2014 ◽  
Vol 64 (8) ◽  
pp. 1192-1199 ◽  
Author(s):  
R J Haidry ◽  
M A Butt ◽  
J M Dunn ◽  
A Gupta ◽  
G Lipman ◽  
...  
Keyword(s):  
Endoscopic Therapy ◽  
Barrett’S Oesophagus ◽  
Patient Registry ◽  
Barrett's Oesophagus ◽  
The Uk ◽  
Over Time

Intestinal metaplasia in Barrett's oesophagus: An essential factor to predict the risk of dysplasia and cancer development

2016 ◽  
Vol 48 (2) ◽  
pp. 144-147 ◽  
Author(s):  
Marianna Salemme ◽  
Vincenzo Villanacci ◽  
Gianpaolo Cengia ◽  
Renzo Cestari ◽  
Guido Missale ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Cancer Development ◽  
Barrett’S Oesophagus ◽  
Essential Factor ◽  
Barrett's Oesophagus

Survey of the Use of Diffusion-Weighted Imaging for Cholesteatoma in the United Kingdom

ORL ◽  
2021 ◽  
pp. 1-7
Author(s):  
Sunil Dutt Sharma ◽  
Ahmad Hariri ◽  
Ravi Kumar Lingam ◽  
Arvind Singh
Keyword(s):  
United Kingdom ◽  
British Society ◽  
Petrous Apex ◽  
The United Kingdom ◽  
Diffusion Weighted ◽  
Clinical Scenarios ◽  
Head And Neck Imaging ◽  
The Mean ◽  
The Uk

<b><i>Background:</i></b> Non-echoplanar diffusion-weighted MRI (DWMRI) has a role in the surgical planning for cholesteatoma. <b><i>Aims/Objectives:</i></b> The aim of the study was to assess the use of DWMRI in the management of cholesteatoma across the UK, and measure clinicians’ confidence in the use of DWMRI. <b><i>Materials and Methods:</i></b> Telephone survey in 139 Otolaryngology Departments in the United Kingdom between March 2017 and July 2017, and asking radiology delegates at the British Society of Head and Neck Imaging 2017 meeting. <b><i>Results:</i></b> The response rate was 101 out of 139 Trusts (73%). Of those respondents who did have DWMRI available, 68/88 respondents (77%) use it for cholesteatoma. The mean confidence (±standard deviation) of the respondents with DWMRI in identifying cholesteatoma presence was 7.3 ± 2.1, in identifying volume of cholesteatoma was 6.8 ± 1.8, and in identifying subsites of cholesteatoma was 4.6 ± 2.1. <b><i>Conclusions and Significance:</i></b> DWMRI has a well-defined role in the follow-up of patients after cholesteatoma surgery, and those primary cases of cholesteatoma where the diagnosis is in question. The use of DWMRI for cholesteatoma is variable across the UK, but there are certain clinical scenarios where there is not enough awareness regarding the benefits of imaging (such as petrous apex cases of cholesteatoma).

scholarly journals A cost-effectiveness analysis of endoscopic eradication therapy for management of dysplasia arising in patients with Barrett’s oesophagus in the United Kingdom

2019 ◽  
Vol 35 (5) ◽  
pp. 805-815 ◽  
Author(s):  
Vicki Pollit ◽  
David Graham ◽  
Catherine Leonard ◽  
Alexandra Filby ◽  
Jessica McMaster ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cost Effectiveness ◽  
Eradication Therapy ◽  
Cost Effectiveness Analysis ◽  
Barrett’S Oesophagus ◽  
Barrett's Oesophagus ◽  
The United Kingdom ◽  
Effectiveness Analysis

scholarly journals Further Aspects of the UK Engine Technology Demonstrator Programme

1988 ◽  
Author(s):  
D. W. Hughes ◽  
W. J. Chrispin
Keyword(s):  
United Kingdom ◽  
Scale Development ◽  
Gas Turbine ◽  
Full Scale ◽  
Cost Overrun ◽  
The United Kingdom ◽  
Technology Demonstration ◽  
The Uk ◽  
Technology Demonstrator

In 1987, a paper entitled ‘The United Kingdom Engine Technology Demonstrator Programme’ (ASME 87-GT-203) was presented at the Gas Turbine Conference in Anaheim. That paper postulated that a programme of engine technology demonstration ahead of commitment to full-scale development was essential if past problems of cost overrun and inadequate performance at service entry were to be avoided. The paper concluded that the UK had established a balanced programme of technology demonstration, emphasising that Industry and Government must invest this activity with the same commitment traditionally given to projects if the full benefits were to be realised. This follow-up paper presents an expanded view of future programme objectives and how the programme elements formulated for their achievement are to be managed.

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