Institution
Royal Shrewsbury Hospital
Healthcare•Shrewsbury, United Kingdom•
About: Royal Shrewsbury Hospital is a healthcare organization based out in Shrewsbury, United Kingdom. It is known for research contribution in the topics: Health care & Migraine with aura. The organization has 661 authors who have published 568 publications receiving 12794 citations.
Papers published on a yearly basis
Papers
More filters
••
University of Liverpool1, Royal Shrewsbury Hospital2, Royal London Hospital3, University of Newcastle4, Leeds General Infirmary5, Royal Hallamshire Hospital6, Arrowe Park Hospital7, Royal Victoria Infirmary8, Southern General Hospital9, Great Ormond Street Hospital10, Ninewells Hospital11, Walton Centre12, University Hospital of Wales13
TL;DR: Lamotrigine is clinically better than carbamazepine, the standard drug treatment, for time to treatment failure outcomes and is therefore a cost-effective alternative for patients diagnosed with partial onset seizures.
785 citations
••
University of Liverpool1, Royal Shrewsbury Hospital2, Royal London Hospital3, University of Newcastle4, Leeds General Infirmary5, Royal Hallamshire Hospital6, Arrowe Park Hospital7, Royal Victoria Infirmary8, Southern General Hospital9, Great Ormond Street Hospital10, Ninewells Hospital11, Walton Centre12, University Hospital of Wales13
TL;DR: Valproate is better tolerated than topiramate and more efficacious than lamotrigine, and should remain the drug of first choice for many patients with generalised and unclassified epilepsies, and because of known potential adverse effects of valproate during pregnancy, the benefits for seizure control in women of childbearing years should be considered.
774 citations
••
TL;DR: There may be a subgroup of patients who have severe migraine associated with a large right-to-left shunt in whom closure of the atrial defect may improve or abolish migraine.
421 citations
••
TL;DR: In this article, the authors compared the therapeutic outcomes after deep lamellar keratoplasty (DLK) and penetrating krinoplastic surgery (PK) in patients with keratoconus.
330 citations
••
TL;DR: It was concluded that surgery should not be undertaken routinely in patients with poor prognostic criteria, such as intra-abdominal carcinomatosis, poor performance status and massive ascites, and the relative lack of RCTs in this area.
Abstract: The paper highlights a series of questions that doctors need to consider when faced with end-stage cancer patients with bowel obstruction: Is the patient fit for surgery? Is there a place for stenting? Is it necessary to use a venting nasogastric tube (NGT) in inoperable patients? What drugs are indicated for symptom control, what is the proper route for their administration and which can be administered in association? When should a venting gastrostomy be considered? What is the role of total parenteral nutrition (TPN) and parenteral hydration (PH)? A working group was established to review issues relating to bowel obstruction in end-stage cancer and to make recommendations for management. A steering group was established by the (multidisciplinary) Board of Directors of the European Association for Palliative Care (EAPC) to select members of the expert panel, who were required to have specific clinical and research interests relating to the topic and to have published significant papers on advanced cancer patients in the last 5 years, or to have particular clinical expertise that is recognised internationally. The final constitution of this group was approved by the Board of the EAPC. This Working Group was made up of English, French and Italian physicians involved in the field of palliative care for advanced and terminal cancer patients; and of English, American and Italian surgeons who also specialized in artificial nutrition (Dr. Bozzetti) and a professor of health economics. We applied a systematic review methodology that showed the relative lack of RCTs in this area and the importance of retrospective and clinical reports from different authors in different countries. The brief was to review published data but also to provide clinical opinion where data were lacking. The recommendations reflect specialist clinical practice in the countries represented. Each member of the group was allocated a specific question and briefed to review the literature and produce a position paper on the indications, advantages and disadvantages of each symptomatic treatment. The position papers were circulated and then debated at a meeting held in Athens and attended by all panel members. The group reviewed all the available data, discussed the evidence and discussed what practical recommendations could be derived from it. An initial outline of the results of the review and recommendations was produced. Where there were gaps in the evidence, consensus was achieved by debate. Only unanimous conclusions have been incorporated. Subsequently the recommendations were drawn together by Carla Ripamonti (Chairperson) and Robert Twycross (Co-Chair) and refined with input from all panel members. The recommendations have been endorsed by the Board of Directors of the EAPC. It was concluded that surgery should not be undertaken routinely in patients with poor prognostic criteria, such as intra-abdominal carcinomatosis, poor performance status and massive ascites. A nasogastric tube should be used only as a temporary measure. Medical measures such as analgesics, anti-secretory drugs and anti-emetics should be used alone or in combination to relieve symptoms. A venting gastrostomy should be considered if drugs fail to reduce vomiting to an acceptable level. TPN should be considered only for patients who may die of starvation rather than from tumour spread. PH is sometimes indicated to correct nausea, whereas regular mouth care is the treatment of choice for dry mouth. A collaborative approach involving both surgeons and physicians can offer patients an individualized and appropriate symptom management plan.
275 citations
Authors
Showing all 664 results
Name | H-index | Papers | Citations |
---|---|---|---|
Peter W. Jones | 76 | 324 | 18761 |
Gavin D. Perkins | 74 | 579 | 27562 |
Ian D. Cooke | 63 | 318 | 13237 |
Christopher L.R. Barratt | 61 | 263 | 11593 |
Paul Cockwell | 43 | 191 | 6975 |
Lee Jeys | 35 | 193 | 4337 |
Fraser Birrell | 31 | 98 | 3953 |
Abd A. Tahrani | 31 | 178 | 3860 |
Tom Quinn | 30 | 164 | 3844 |
Adam D. Farmer | 27 | 97 | 2898 |
Thomas Pinkney | 24 | 103 | 2057 |
Dickon Hayne | 20 | 75 | 1419 |
Peter Wilmshurst | 19 | 68 | 1719 |
R.K. Agrawal | 16 | 31 | 3663 |
Paul Cool | 16 | 66 | 738 |