Royal Surrey County Hospital

About: Royal Surrey County Hospital is a healthcare organization based out in Guildford, United Kingdom. It is known for research contribution in the topics: Cancer & Population. The organization has 2222 authors who have published 3064 publications receiving 86753 citations.

A 10 cm × 10 cm CdTe Spectroscopic Imaging Detector based on the HEXITEC ASIC

Abstract: The 250 μ m pitch 80x80 pixel HEXITEC detector systems have shown that spectroscopic imaging with an energy resolution of <1 keV FWHM per pixel can be readily achieved in the range of 5–200 keV with Al-pixel CdTe biased to −500 V. This level of spectroscopic imaging has a variety of applications but the ability to produce large area detectors remains a barrier to the adoption of this technology. The limited size of ASICs and defect free CdTe wafers dictates that building large area monolithic detectors is not presently a viable option. A 3-side buttable detector module has been developed to cover large areas with arrays of smaller detectors. The detector modules are 20.35 × 20.45 mm with CdTe bump bonded to the HEXITEC ASIC with coverage up to the edge of the module on three sides. The fourth side has a space of 3 mm to allow I/O wire bonds to be made between the ASIC and the edge of a PCB that routes the signals to a connector underneath the active area of the module. The detector modules have been assembled in rows of five modules with a dead space of 170 μ m between each module. Five rows of modules have been assembled in a staggered height array where the wire bonds of one row of modules are covered by the active detector area of a neighboring row. A data acquisition system has been developed to digitise, store and output the 24 Gbit/s data that is generated by the array. The maximum bias magnitude that could be applied to the CdTe detectors from the common voltage source was limited by the worst performing detector module. In this array of detectors a bias of −400 V was used and the detector modules had 93 % of pixels with better than 1.2 keV FWHM at 59.5 keV. An example of K-edge enhanced imaging for mammography was demonstrated. Subtracting images from the events directly above and below the K-edge of the Iodine contrast agent was able to extract the Iodine information from the image of a breast phantom and improve the contrast of the images. This is just one example where the energy spectrum per pixel can be used to develop new and improve existing X-ray imaging techniques.

Breakthrough cancer pain (BTcP) management: a review of international and national guidelines

Abstract: Objective Breakthrough cancer pain (BTcP) is common and has a significant impact on the quality of life of patients with cancer. This review compares current national/international BTcP guidelines in order to identify disparities and priorities for further research. Methods Relevant guidelines were identified using searches of PubMed, the National Guideline Clearinghouse, the internet (commercial search engines), and correspondence with key opinion leaders and relevant pharmaceutical companies. Identified guidelines were compared, using the Association for Palliative Medicine of Great Britain and Ireland recommendations as the ‘reference’ guideline. Results Ten specific BTcP guidelines were identified/reviewed, as well as major international generic cancer pain guidelines. In general, there was good agreement between the specific BTcP guidelines, although there remain some differences in terms of definition, diagnostic criteria and treatment of BTcP. Disparities between the different BTcP guidelines invariably reflect personal opinion rather than research evidence. Generic cancer pain guidelines continue to support the use of oral opioids as rescue medication, while specific BTcP guidelines invariably endorse the use of transmucosal opioids as rescue medication. Conclusion Current guidelines agree on many aspects of the management of BTcP. However, the evidence to support current guidelines remains low grade, and so more research is needed in this area of care. Moreover, there needs to be an international consensus on the definition and diagnosis criteria of BTcP.

Screening and primary prevention of colorectal cancer: a review of sex-specific and site-specific differences.

Abstract: BackgroundColorectal cancer (CRC) is the second commonest cancer in England. Incidence rates for colorectal adenomas and advanced colorectal neoplasia are higher in men than in women of all age gro...

Stapled anastomoses in colorectal surgery : A prospective study

Abstract: But : Evaluer la fiabilite et l'efficacite des agrafeuses mecaniques dans les anastomoses coliques gauches. Type d'etude : Prospective. Provenance : Hopital regional, Royaume Uni. Patients : Deux cent dix huit patients consecutifs ayant eu une anastomose mecanique au cours d'une intervention programmee entre Juillet 1980 et Juillet 1994. Methodes : Cent cinquante quatre resections anterieures du rectum avec agrafage simple ou double, 36 retablissements de continuite apres intervention de Hartmann, et 28 coloproctectomies suivies d'anastomose ileoanale avec reservoir en J. Principaux criteres de jugement : La morbidite et la mortalite. Resultats : Il y a eu 5/154 desunions anastomotiques parlantes cliniquement apres resection anterieure du rectum (3%) et 1/28 apres anastomose ileoanale avec reservoir en J. Il n'y a pas eu de desunion anastomotique apres retablissement de continuite apres intervention de Hatmann. Le pourcentage global de desunion anastomotique parlante cliniquement s'elevait donc a 3%. Il y a eu 11/154 recidives locales apres resection anterieure du rectum (7%) avec un recul moyen de 18 mois, et 8 (73%) sont survenues dans les deux ans suivant l'intervention. Toutes les recidives sauf une sont survenues apres simple agrafage. Le stade de Dukes est reste le meilleur facteur predictf de recidive locale. Il y a eu 5 deces postoperatoires apres resection anterieure du rectum mais aucun apres retablissement de continuite apres intervention de Hartmann ou anastomose ileonale avec reservoir en J, donnant ainsi une mortalite postoperatoire globale de 2%. Conclusions : Les anastomoses colorectales mecaniques sont fiables et techniquement aisees, elles s'accompagnent d'un faible taux de desunion anastomotique cliniquement parlante et d'un taux acceptable de recidive locale apres resection anterieure du rectum.