A5014536269- Inflammatory Bowel Disease
- Microscopic Colitis
- Eosinophilic Esophagitis
- Liver Diseases and Immunity
- Gastrointestinal disorders and treatments
- Liver Disease Diagnosis and Treatment
- Intestinal and Peritoneal Adhesions
- Acute Lymphoblastic Leukemia research
- Pediatric Hepatobiliary Diseases and Treatments
- Celiac Disease Research and Management
- SARS-CoV-2 and COVID-19 Research
- Gastrointestinal motility and disorders
- COVID-19 Clinical Research Studies
- Biosimilars and Bioanalytical Methods
- Esophageal and GI Pathology
- Diverticular Disease and Complications
- Mycobacterium research and diagnosis
- Hidradenitis Suppurativa and Treatments
- Clostridium difficile and Clostridium perfringens research
- Intestinal Malrotation and Obstruction Disorders
- Drug-Induced Hepatotoxicity and Protection
- Health Systems, Economic Evaluations, Quality of Life
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Abdominal Surgery and Complications
- Adrenal and Paraganglionic Tumors
Milton Keynes Hospital NHS Foundation Trust
2011-2023
Milton Keynes Hospital
2011-2022
University of Cambridge
2018-2021
Hospital Sant Joan de Déu Barcelona
2014
Abstract Background and Aims This study compares the effectiveness of different biologic therapies sequences in patients with inflammatory bowel disease [IBD] using real-world data from a large cohort long exposure. Methods Demographic, disease, treatment, outcome were retrieved for UK IBD BioResource. Effectiveness treatment was based on persistence free discontinuation or failure, analysed by Kaplan–Meier survival analysis inverse probability weighting to adjust differences between groups....
We present a case of 63-year-old woman with an acute history abdominal distension and shortness breath. She had no risk factors for liver disease though her prior medical was positive breast carcinoma, in remission 14 years. Examination investigations were initially consistent decompensated cirrhosis, thought to be due subclinical autoimmune hepatitis. Imaging revealed hepatic contour irregularity, atrophy the parenchyma numerous lesions highly suggestive multifocal hepatocellular carcinoma....
ABSTRACT Objective This audit examines the impact of a recently-commissioned clinician and patient support tool, on care pathways for Inflammatory Bowel Disease patients at Milton Keynes University Hospital, follow up appointments (including PIFUs), associated cost savings engagement experience. Design The was conducted using retrospective, consecutive case review appointment records enrolled onto iOWNA platform during 9-month period. Patient-clinician interactions were categorised depending...
There are many causes of raised liver function tests in HIV infection. This lesson discusses a case where autoimmune hepatitis, acute hepatitis B and toxoplasmosis were diagnosed lady presenting with abdominal pain jaundice. Oral steroids for may have worsened the clinical picture as her serology was not available at time. highlights importance waiting all results to return an ill jaundiced patient before deciding on active management treatment
<h3>Introduction</h3> Microscopic colitis is a common cause of chronic diarrhoea, particularly in older people, and the incidence increasing. As endoscopic appearance typically normal, diagnosis two subtypes, collagenous lymphocytic colitis, relies upon specific histology findings. When suspected, guidelines advise colonoscopy with full biopsy series due to reports patchy disease distribution, false negative rates up 40% reported flexible sigmoidoscopy.<sup>1</sup> However, more recent data...
<h3>Introduction</h3> The National Confidential Enquiry into Patient Outcome and Death for alcohol related liver disease highlighted the need to improve care of patients with decompensated disease. BSG BASL thereafter developed Liver Care Bundle toolkit aid provision evidence-based within 24 hours admission. We performed an audit delivered such before after introduction clinical practice in our hospital. <h3>Methods</h3> For initial (August 2014-March 2015), presenting were retrospectively...
<h3>Introduction</h3> Clostridium difficile infection is an important hospital acquired causing significant healthcare burden. Once patients have had C diff diarrhoea, recurrence rates are high with 44.8% of having a relapse their disease. Lactobacillus Casei probiotic that has been shown to reduce antibiotic-associated diarrhoea in elderly patients. There no studies analysing the use probiotics who established C.diff infection. <h3>Methods</h3> The study was single site, retrospective,...
A 47-year-old woman with a 36-month history of Crohn's disease one previous bowel resection treated azathioprine was found to have persistently raised mean corpuscular volume (MCV) on routine complete blood count testing. Despite vitamin B 12 replacement, her MCV remained elevated. bone marrow biopsy performed, which demonstrated myelodysplastic syndrome. Macrocytosis is common abnormality in patients disease, most commonly due deficiency and secondarily bacterial overgrowth. However, it...
A 61-year-old man presented with accumulation of ascites secondary to alcoholic liver disease. He had an ascitic drain sited and 24 hours later he developed acute colonic pseudo-obstruction (ACPO). This is a rare condition previously associated major surgery severe sepsis. The patient did well conservative management, avoided the need for endoscopic decompression or surgical intervention. We believe that this first report ACPO abdominal paracentesis.
Poster presentations thickness and disease extent in the small bowel between results from SICUS MR-Enterography.Results: identified site of CD with 96% sensitivity, 60% specificity, 92% diagnostic accuracy; it colon 70% 87% accuracy.Results MR-enterography correlated determination wall (rho=0.51)and (rho=0.72;P < 0.0001 for both).SICUS detected ileal stenosis 90% accuracy, pre-stenotic dilation 66% 80% 71% accuracy.SICUS abscesses 100% fistulas 81% accuracy.Conclusions: lesions complications...
This article discusses an elderly woman presenting with haematemesis and chest pain who underwent urgent oesophago-gastroduodenoscopy. revealed a large dissecting intramural oesophageal haematoma, initially mistaken for varix. is rare cause of but has characteristic endoscopic findings. It benign condition that may be managed conservatively both clinicians endoscopists should aware its classical presentation. Misdiagnosis the as cardiac ischaemia have adverse outcome if antiplatelet or...
Clinical: Diagnosis and outcome S83The second discrepancy concerns the nutritional aspects of IBD care.Patients did not receive information they expect on impact nutrition could have their disease (61%), nor specific recommendations believed need (66%).In addition, 79% Gastroenterologists Nurses reported lacking skills to provide its rationale, only 51% Nurses/34% often or consistently explain patients role in UC/CD.Conclusions: The results from this study question whether patients'...
A 21-year-old lady was admitted to a hospital with an 8-week history of bloody diarrhoea. She had been diagnosed ulcerative colitis 2 years previously and remained in remission until the gradual onset Her bowel frequency 20 times per day associated significant abdominal pain weight loss. started on intravenous steroids, topical therapy anti-tumour necrosis factor therapy; however, this failed achieve symptom control. Histology tissue obtained from flexible sigmoidoscopy eventually...
<h3>Introduction</h3> Azathioprine therapy is an immunosuppressive drug that widely used in the management of ulcerative colitis. 20% patients with normal TPMT are not able to tolerate and 30% do respond [1]. For who intolerant azathioprine, other medicines have been proposed these include methotrexate, mercaptopurine infliximab. <h3>Methods</h3> A cross sectional study was performed using Milton Keynes Hospital IBD database compare were azathioprine those tolerant. descriptive analysis...
<h3>Introduction</h3> Azathioprine is well established for the maintenance of remission in patients with Crohn’s disease and 87% on therapy are able to reduce steroid consumption. However, azathioprine less effective at treating recurrence seven need be treated prevent one (1). Intolerance occurs almost a third it has been proposed that intolerance poor prognostic marker may predispose more aggressive course. <h3>Methods</h3> A cross sectional study was performed using Milton Keynes Hospital...
<h3>Introduction</h3> A large number of unexplained gastro-intestinal disorders have been attributed to Irritable Bowel Syndrome (IBS) for decades. Discovery food sensitivities and high rate symptomatic response low FODMAP diet has revolutionised the treatment these conditions. The aim this study was assess triggering factors effect dietary intervention in relation with body mass index (BMI). <h3>Methods</h3> This a cross-sectional evaluating patients presenting IBS symptoms referred our...