Papalois V.,Imperial College Healthcare NHS Trust
Cirugia Espanola | Year: 2017
The European Union of Medical Specialists, founded in 1958, is the largest and oldest european medical organization. It includes 39 member states (of the European Union and others), and represents a total of 1.600.000 medical specialists. The main objective of the UEMS is to influence european healthcare politics by promoting the interests of the european medical specialists, establishing high standards in practice and training, as well as continuing medical education and professional development, and guaranteeing quality in specialist practice. The UEMS is developing several projects to face current and future challenges related to surgical training, education, acreditation, revalidation and professional development: i.- First, the UEMS is developing homogeneous requisites for European Training (ETRs), ii.- To manage the quality control process of the ETRs and evaluation of the organization, the UEMS has created the Council of european specialized medial evaluations (CESMA), iii.- The UEMS has been greatly involved in the acreditation process of training centres in all of Europe, iv.- in relation to continuing medical education, the European Accreditation Council for Continuing Medical Education (EACCME) is the main project of the UEMS for the accreditation of educational events and v.- the UEMS has established the Network of Accredited Clinical Skills Centres of Europe (UEMS-NASCE), that facilitates the accreditation and cooperation of training centres in Europe. In conclusion, with the great support of National Surgical Societies of the UEMS and the Surgery Section a series of solid projects have been established to support the professional development of the collective in Europe. This process constitutes a continuous effort that is very gratifying, with the aim to set the standards for a brilliant future for surgery students and specialized surgeons. © 2017.
News Article | May 5, 2017
Hemel Hempstead, UK: Needing little introduction, Imperial College Healthcare NHS Trust is one of the country’s largest trusts and teaching centres, providing acute and specialist healthcare for nearly two million people in north west London. The Trust comprises of 5 hospital sites - Charing Cross, St Mary’s, Queen Charlotte’s & Chelsea, Hammersmith and Western Eye – and is one of just seven dedicated health science centres in the UK. With academic links to the Imperial College itself, the Trust puts research into practice by applying medical studies and disciplines into their acute healthcare environment. Imperial College Healthcare invests significantly in its staff and resources. With over a million outpatients, 280,000 A&E attendances and 186,000 inpatients, a team of 10,000 doctors, nurses and health professionals support the Trust. One busy area of the hospital is the Imaging Department; nearly 500 staff and the best state-of-the-art diagnostic equipment offer a comprehensive range of radiology examinations. A truly integral part of the Trust’s clinical remit, Imaging uses the latest techniques to support Imperial College Healthcare’s teams in the diagnosis and treatment of the full range of medical problems and their vast range of apparatus supports the 119 modalities and 440,000 examinations. To manage radiology processes and to accommodate the sheer extent of patient examinations, Imperial College Healthcare’s Imaging department required sector-specific software solutions to support the department and provide traceability of appointments and clinical documents. From 2012, Imperial College Healthcare adopted a RIS (Radiology Information System) and PACS (Patient Archiving Communication System) from GE. After 3 years of use, the Trust took the decision to investigate new clinical systems to support the hospitals’ radiology processes. Laurence Musker, Radiology IT Programme Manager, comments: “Imperial College Healthcare started the process to procure a new provider of RIS and PACS. We were looking for improvements in our departmental workflow and needed certain efficiencies that an advanced workflow structure could offer”. Laurence had identified that technologies and radiology IT applications had become more sophisticated and innovative within the 3 years in which they had appointed their legacy system. In addition, the Trust’s own requirements were becoming more complex; more patients, larger administration surges and the sector requirement to “go paperless” brought added clerical challenges. It was becoming vital that Laurence and the Imperial College Healthcare team had a RIS and PACS framework that could not only support the department with clinical images, but bring a level of workflow intuition to smooth departmental practices and allow better management of patients and their bookings. In July 2015, after creating process, user and site criteria, Laurence was confident that the Trust could go out to tender with firm RIS/PACS solution stipulations. He comments: “Imperial College Healthcare NHS Trust needed a system that had proven success and could work immediately – straight off the shelf. We formerly ran a function-centric system - which did not allow for an efficient workflow in a very busy hospital environment - but times had changed since our early RIS. We had reached a detailed solution specification and criteria for a patient-centric RIS system.” Contract awarded to Soliton IT and Carestream Along with the emphasis on workflow, the Imaging department also stipulated autonomy of image communications - the Trust needed to send medical images which included routing to GPs and external referrals. They needed a concise interface that could be adopted by any of the radiology staff and used intuitively in point-of-care and examination sessions by radiographers where time-keeping and exam diligence where critical factors. The structure of RIS workflow management and PACS imaging support had to integrate seamlessly – both together to create a united enterprise-wide solution and with the Trust’s other clinical systems to enable fluid patient record sharing, reduction in printing tasks and transparency of clinical data. The potential cost and resource investment of 2 new applications meant that Laurence and his team had to see operational improvements and measurable benefits in the new RIS and PACS solution. In 2015, after assessing the market offerings for both RIS and PACS systems, Laurence appointed products from two market-leading vendors, Soliton IT for RIS and Carestream for PACS applications, with the intention of a compressed 1-year transition from the previous GE technology. Soliton IT, a UK-based RIS developer, had previously assured Laurence of their clinical experience with their excellent reputation in Reporting and VR (Voice Recognition) deployments. Soliton IT’s RIS product, Radiology+, provided Imperial College Healthcare with automation of radiology tasks with its advanced workflow dynamic, including modular features which were customised for both the Trust and individual users. Daily tasks such as scheduling patient appointments, protocolling, vetting, data-entry, inter-departmental messaging and departmental reporting tasks were displayed in intuitive worklist fashion, by clinical discipline, for easy identification. Equally, the “assign to” option allowed redistribution of protocolling and reporting tasks to tackle administration surges and reduce backlogs. In addition, Radiology+ offered an innovative statistics-generation element to the RIS; graphical statistical analysis on area performances highlighted, in quantative terms, where areas for improvement lay. Imperial College Healthcare’s principle of becoming a RIS -driven site was rewarded with quick tangible results. The new radiographic workflow of integrated RIS and PACS made huge differences to reporting procedures, and maintaining patient bookings had become easier due to concise and colour-coded scheduling interfaces available to the administration team. Within 3 weeks of deployment, the Trust had reduced their former appointment backlog and patients’ radiology experience had become smooth and more streamlined. The integration of Caresteam Vue PACS brought additional advantages in terms of clinical imaging functionality. Carestream Health is a worldwide provider of medical imaging systems with specialities in X-ray imaging platforms and a particular focus on PACS development. Their leading PACS application, Vue PACS, provided Imperial with the clinical tools and applications needed for radiologists to perform examinations with advanced visualization and 3D post processing. The combined Soliton IT and Carestream solution was already successfully in use in many other hospitals with seamless integration - bringing enhanced functionality to radiology and Imaging departments. Laurence comments on the compatibility of the 2 systems: “Radiology+ and Vue PACS integrate nicely together - both visually as an interface and functionally to offer improved processes to our radiographers, consultants and the radiology administration team. Radiologists found it easy to report and their workload management was easier to handle.” The changeover encompassed significant data migration which, considering both Soliton IT and Carestream’s previous deployments in large NHS Trusts, Laurence was confident could be handled efficiently and meticulously. Over 143TB (5-million studies) had to be migrated from their previous GE live PACS archive to the new application and Soliton IT showed their technical capability of implementing the data transfer for legacy RIS data with their own scripts. Radiology+ and Vue PACS integrated well with Imperial College Healthcare’s other HIS and OCS applications – Cerner PACS/OCS and Sunquest ICE (for the GP Diagnostic Cloud). Completed within 8-months (ahead of the year’s transition deadline), the dual solution went live on 30th May 2016 and is currently in use by over 300 radiology users. Ever considerate of future system potential, Laurence and the Imperial College Healthcare team have already plans to adopt Soliton IT’s Radiology+ Mobile – a portable version of the RIS with quick-fire data capture and optimised security which is suitable for mobile clinicians. Soliton IT’s additional development of the Trust’s Nuclear Medicine workflow also tackles the complex multi-procedure nature of this discipline, incorporating auto-scheduling for the stages of tiered patient bookings and dose management features. Laurence reflects on the Soliton IT and Carestream deployment at Imperial College Healthcare NHS Trust: “We had truly set ourselves a challenge with a “Big-Bang” Go Live across 3 large London hospital sites - and we are delighted to announce its success. The Trust was impressed with the integration qualities and emerging improvements of the Carestream and Soliton IT solution, and we were overwhelmed with Soliton IT’s flexibility with our requirements and willingness to adopt, build and develop all our needs into their product.” Maggie Buckley, Project Manager for Soliton IT, was responsible for RIS deployment at Imperial. She comments: “The Imperial College Healthcare implementation introduced several challenges for the Soliton IT Project Team. A previous experience had made the Trust uneasy about the change; we found ourselves working closely with Imperial to both overcome this and instil confidence in the new deployment. This close working relationship enabled us to address concerns, maintain project momentum and overcome any day-to-day issues which this complex installation presented. Imperial College Healthcare’s unique development requirements, whilst technically challenging, were successfully fulfilled and have since been incorporated into our standard deployment package. This will ultimately be of benefit to all our current and future customers. This multifaceted and high-pressure project benefitted from Soliton IT’s commitment and pro-active approach. As a result, we developed an excellent working relationship with the Trust which shall continue throughout the lifetime of the contract.” “When faced with the challenge of bidding to replace the legacy RIS-PACS Solution at Imperial College Healthcare - which included implementing and migrating legacy RIS and PACS data against a very aggressive timetable with associated penalties and liabilities - it became clear that Carestream, as a prospective Prime Contractor for the RIS-PACS-VNA solution at Imperial, would not be able to implement a 100% Carestream RIS-PACS-VNA solution in the restricted time given. We therefore chose to partner with Soliton IT for the RIS element of the RIS-PACS-VNA bid and were delighted to be awarded Prime Contractor for supply of this solution. Carestream sub-contacted the provision of the RIS to Soliton IT who provided a flexible, innovative and customised solution which met Imperial’s requirements and within the time constraints given. The Soliton IT and Carestream Implementation teams worked well together, as did the Commercial Teams who provided Imperial with the flexibility to choose, customise and optimise their workflow and provided them with the flexibility to adjust workflow as new developments become available and evolve over the duration of the 10 year agreement. Carestream looks forward to continuing to work with Soliton IT to meet the needs of Imperial College Healthcare NHS Trust.”
News Article | November 18, 2016
GSK to Present New Evolutions in Targeted RNA Drug Delivery Systems SMi Reports: 8th Annual 2017 RNA Therapeutics Summit takes place on 22nd and 23rd February in Central London. London, United Kingdom, November 18, 2016 --( With a focus on mRNA vaccines, the talk will delve further into key topics surrounding immune responses, animal models, platform technology and rapid response to emerging infectious diseases. In the run-up to his address, Dr Ulmer said, “RNA therapeutics, including recent exciting advancements in RNA-based vaccines, have the potential to be game-changing technologies. This conference will bring together thought leaders from across the technology area..." Now in its 8th year, the RNA event will aim to deliver a scientific toolkit of ideas to implement targeted delivery and mRNA. Attendees will not only learn about new academic research, but will also hear a selection of case studies from big pharma and bio-pharmaceutical companies currently making medical progress through RNA therapeutics. Other notable speakers on the agenda include: · Nagy Habib, Head of Surgery, Co-Founder, Imperial College Healthcare NHS Trust, MiNA Therapeutics Heinrich Haas, Vice President RNA Formulation & Drug Delivery, BioNTech RNA Pharmaceuticals Bo Rode Hansen, Global Head of RNA Therapeutics, Roche John Johnston, Clinical Assessor Biologicals & Biotechnology Unit, MHRA Nicole Meisner-Kober, Senior Investigator, RNA Biology, Novartis Institutes for Biomedical Research Steve Hood, Director, Bioimaging, GSK David Giljohann, CEO, Exicure Shai Erlich, Chief Medical Officer & President USA, Quark Pharmaceuticals Inc Amotz Shemi, CEO, SilenseedSanyogitta Puri, Associate Principal Scientist, AstraZeneca SMi’s 8th annual RNA Therapeutics conference will take place on 22nd & 23rd February 2017 at the Copthorne Tara Hotel in Kensington, London, UK. Further information including a detailed agenda and full speaker line-up is available at www.therapeutics-rna.com Contact Information: For all media enquiries contact Teri Arri on Tel: +44 (0)20 7827 6162 / Email: firstname.lastname@example.org To register for the conference, visit http://www.therapeutics-rna.com or contact Fateja Begum Tel: +44 (0)20 7827 6184 / Email: email@example.com To sponsor, speak or exhibit at the conference, contact Alia Malick on Tel: +44 (0)20 7827 6168 / Email: firstname.lastname@example.org About SMi Group: Established since 1993, the SMi Group is a global event-production company that specializes in Business-to-Business Conferences, Workshops, Masterclasses and online Communities. We create and deliver events in the Defence, Security, Energy, Utilities, Finance and Pharmaceutical industries. We pride ourselves on having access to the world's most forward thinking opinion leaders and visionaries, allowing us to bring our communities together to Learn, Engage, Share and Network. More information can be found at http://www.smi-online.co.uk London, United Kingdom, November 18, 2016 --( PR.com )-- SMi Group are thrilled to have Jeffrey Ulmer, Head of Preclinical Research & Development from GSK, present a keynote at RNA Therapeutics 2017 when it returns to Central London next February.With a focus on mRNA vaccines, the talk will delve further into key topics surrounding immune responses, animal models, platform technology and rapid response to emerging infectious diseases.In the run-up to his address, Dr Ulmer said, “RNA therapeutics, including recent exciting advancements in RNA-based vaccines, have the potential to be game-changing technologies. This conference will bring together thought leaders from across the technology area..."Now in its 8th year, the RNA event will aim to deliver a scientific toolkit of ideas to implement targeted delivery and mRNA. Attendees will not only learn about new academic research, but will also hear a selection of case studies from big pharma and bio-pharmaceutical companies currently making medical progress through RNA therapeutics.Other notable speakers on the agenda include:· Nagy Habib, Head of Surgery, Co-Founder, Imperial College Healthcare NHS Trust, MiNA TherapeuticsHeinrich Haas, Vice President RNA Formulation & Drug Delivery, BioNTech RNA PharmaceuticalsBo Rode Hansen, Global Head of RNA Therapeutics, RocheJohn Johnston, Clinical Assessor Biologicals & Biotechnology Unit, MHRANicole Meisner-Kober, Senior Investigator, RNA Biology, Novartis Institutes for Biomedical ResearchSteve Hood, Director, Bioimaging, GSKDavid Giljohann, CEO, ExicureShai Erlich, Chief Medical Officer & President USA, Quark Pharmaceuticals Inc Amotz Shemi, CEO, SilenseedSanyogitta Puri, Associate Principal Scientist, AstraZenecaSMi’s 8th annual RNA Therapeutics conference will take place on 22nd & 23rd February 2017 at the Copthorne Tara Hotel in Kensington, London, UK.Further information including a detailed agenda and full speaker line-up is available at www.therapeutics-rna.comContact Information:For all media enquiries contact Teri Arri on Tel: +44 (0)20 7827 6162 / Email: email@example.comTo register for the conference, visit http://www.therapeutics-rna.com or contact Fateja BegumTel: +44 (0)20 7827 6184 / Email: firstname.lastname@example.orgTo sponsor, speak or exhibit at the conference, contact Alia Malick on Tel: +44 (0)20 7827 6168 /Email: email@example.comAbout SMi Group:Established since 1993, the SMi Group is a global event-production company that specializes in Business-to-Business Conferences, Workshops, Masterclasses and online Communities. We create and deliver events in the Defence, Security, Energy, Utilities, Finance and Pharmaceutical industries. We pride ourselves on having access to the world's most forward thinking opinion leaders and visionaries, allowing us to bring our communities together to Learn, Engage, Share and Network. More information can be found at http://www.smi-online.co.uk Click here to view the list of recent Press Releases from SMi Group
News Article | October 26, 2016
All animal experimentation in this study was approved and performed according to the standards of the animal ethics committee at Imperial College London and to UK Home Office regulations (ASPA 1986). C57Bl/6 mice were purchased from Harlan UK Ltd; Col2.3–GFP, Col2.3–CFP18, nestin–GFP and mTmG25 mice were bred and housed at Imperial College London. For imaging experiments, female Col2.3–GFP and nestin–GFP mice >8 weeks old were used. osterix–CreGFP mice were provided by A. McMahon and backcrossed over eight generations into NSG mice and maintained at the Francis Crick Institute, Cancer Research UK26. Equal proportions of male and female osterix–CreGFP mice aged 11–14 weeks were used. T-ALL was generated as previously described27. Briefly, timed matings were established between C57Bl/6 mice and embryos harvested at E14.5. Single-cell suspensions were prepared from whole fetal livers isolated from the embryos. Suspensions were cultured in IL-3, IL-6, and stem cell factor conditioned media with 20% FCS for 3 days. Lin-xE cells were transfected by calcium phosphate with MigR1 plasmids containing either DsRed only or DsRed with NotchICNΔRamΔP as described previously28. We also used GFP-tagged plasmids when required. Supernatants containing recombinant retrovirus were removed and spun by centrifugation onto non-tissue-culture-treated plates coated with 15 μg/ml retronectin (Takara Clontech, CA). Fetal liver cells were cultured in the presence of virus for 3 days and transduction was assessed by flow cytometry. Primary lethally irradiated recipient mice (two doses of 5.5 Gy administered greater than three hours apart) were transplanted with 1 × 106 DsRed+ fetal liver cells by intravenous injection into the tail vein. Recipient mice were maintained on baytril-treated water to prevent infection for >6 weeks post-transplantation. Cohorts of reconstituted mice were the result of three independent fetal liver isolations and three independent transfections. Transformation of Notch-transduced non-malignant cells is highly heterogeneous in vivo, with onset of primary disease ranging from 6–25 weeks28 (Extended Data Fig. 1). More than 4 weeks post-reconstitution, peripheral blood was isolated from mice, red blood cells were lysed, and successful reconstitution determined by presence of DsRed+ cells. Mice reconstituted with NotchICNΔRamΔP-transduced fetal livers were monitored daily for signs of leukaemia onset or other signs of ill health. Mice were euthanized when any one or a combination of the following signs were observed: hunched posture, laboured breathing, weight loss, enlarged lymph nodes and/or spleen, peripheral white blood cell cellularity of 13 × 109 per litre or greater. No experiment exceeded the tumour burden approved by the Home Office and Imperial College ethics committee. Peripheral lymphoid organs were analysed by flow cytometry for DsRed or GFP, CXCR4, CD3, CD4 and CD8 expression. All FACS data was collected on a Fortessa flow cytometer (BD Biosciences, CA). Secondary recipients were sub-lethally irradiated (two doses of 3 Gy administered greater than three hours apart) and injected with 10,000 thawed, Ficoll purified T-ALL blasts and monitored as described earlier. In selected cases 10,000 secondary T-ALL cells were transplanted into tertiary recipients. For therapy experiments, mice were injected i.v. daily with 15 mg/kg dexamethasone sodium phosphate29, 30 (Sellekchem, MA) alone, 0.15 mg/kg vincristine sulfate salt (Sigma) alone or with a combination of 15 mg/kg dexamethasone, 0.15 mg/kg vincristine and 1,000 IU/kg l-asparaginase (medac; obtained from the Imperial College Healthcare NHS Trust Pharmacy). Reconstitution with MigR1 DsRed-transduced cells yields <50% chimaerism. For this reason, analysis of healthy BM cells by microscopy is inaccurate. Therefore, to obtain >95% chimaerism of healthy, red fluorescent BM to be used for imaging control experiments, whole BM mononuclear cells were isolated from femurs, hips and tibia of mTmG donor mice, suspended in phosphate balanced salt solution and administered intravenously to recipient mice at a dose of 2 × 106 cells/mouse. Recipient Col2.3–GFP or C57Bl/6 mice had been lethally irradiated (two doses of 5.5 Gy irradiation greater than 3 h apart) immediately before the transplant, and were maintained on baytril-treated water to prevent infection >6 weeks post-transplantation. Intravital microscopy was performed using a Leica SP5 and a Zeiss LSM 780 upright confocal microscope with a motorized stage. The SP5 was fitted with the following lasers: Argon, 546, 633 and a tunable infrared multiphoton laser (Spectraphysics Mai Tai 690-1020). The Zeiss LSM 780 was fitted with the following lasers: Argon, 561, 633 and a tunable infrared multiphoton laser (Spectraphysics Mai Tai DeepSee 690-1040). Signal was visualized with a Leica HCX IRAPO L ×25 water immersion lens (0.95 N.A) and a W Plan-Apochromat ×20 DIC water immersion lens (1.0 N.A). Collagen bone second harmonic generation signal and GFP and CFP signals were generated through excitation at 840 and 870 nm and detected with external detectors. Internal detectors were used to collect DsRed and Cy5 signal (and on some occasions, GFP). Prior to surgery, mice were administered analgesia with buprenorphine (0.1 mg/kg intraperitoneally (i.p.)). Anaesthesia was induced in mice with 4% isoflurane mixed with pure oxygen. This was gradually reduced to approximately 1% as anaesthesia stabilized. Surgery to attach the headpiece was then performed as described previously16. Large three-dimensional ‘tile scans’ of the entire BM cavity space were acquired by stitching adjacent, high-resolution z-stack images using a surgically implanted imaging window that ensures steady positioning of mice on the microscope. The calvarium has been demonstrated to be equivalent to the long bones such as the femur with regards to haematopoietic stem cell frequency, function and localization14, 22, and is the only BM compartment that allows longitudinal imaging through minimally invasive surgery16, 31. Blood vessels were highlighted by i.v. injection of 50 μl of 8 mg/ml 500 kDa Cy5-Dextran (Nanocs, MA). Cy5-Dextran was re-injected every 1–2 h to maintain blood vessel signal and cross reference for registration of blood vessel data in time-lapse analysis. For repeated imaging, protective intrasite gel (Smith & Nephew) was applied to the imaging window to preserve the bone integrity and prevent scar formation. The window was bandaged, and mice were allowed to recover from anaesthesia. Owing to the lock-and-key mechanism of the imaging window16, mice could then be re-anaesthetized and accurately repositioned on the microscope stage and the same BM areas re-imaged. After each imaging, analgesia was administered via oral buprenorphine in raspberry jelly at a dose of approximately 0.8 mg/kg. Microscopy data was processed using multiple platforms. Tile scans were stitched using Leica Application Systems (LAS; Leica Microsystems, Germany) and ZEN black (Zeiss, Germany) softwares. Raw data were visualized and processed using Fiji/Image J. Simulated data was prepared using FIJI macros to create, and overlay z-stack images on original tile-scan data. Using the internal random number algorithm, spheres matching the size of T-ALL cells (11–15 μm) were placed at random x,y,z coordinates. Simulated data FIJI macro is available on request. Automated cell segmentation, distance and volume measurements were performed in Definiens (Definiens Developer 64, Germany) using local heterogeneity segmentation32 to isolate osteoblast and nestin cells as well as vasculature, and a combination of seed detection algorithm and morphological growing and shrinking operations to detect leukaemia cells. Definiens rulesets for these functions are available upon request. Distance measurements from this segmentation were performed as described previously32. Cell tracking was performed using Imaris (Bitplane, Switzerland) and the FIJI plugin MTrackJ. For accuracy in cell tracking data, videos were registered when required before using four-dimensional data protocols implemented in Fiji33. Three-dimensional data rendering and measurement of cell division distances were performed in Volocity (Perkin Elmer, MA) and Definiens (Definiens Developer 64, Germany). T-ALL samples were harvested from bone marrow and FACS sorted based on fluorescent protein expression (DsRed or GFP) unless infiltration of bone marrow was complete. Control samples for microarray were prepared by FACS sorting for splenic CD4+ T cells, CD8+ T cells and CD4+CD8+ thymocytes from 8–14-week female C57Bl/6 mice. RNA was purified from samples using the Qiagen RNeasy mini kit (Netherlands) as per the manufacturer’s instructions. Purified RNA was prepared for hybridization using the Genechip WT Plus reagent kit (Affymetrix, CA) as per the manufacturer’s instructions and hybridized with genechip Mouse gene 2.0 ST array (Affymetrix, CA) by the MRC Genomics Facility (Imperial College London). Analysis was performed using R version 3.1.1. Data were normalized and summarized to ‘core’ level using the RMA method from the oligo package (version 1.30.0)34. Annotation was downloaded from the Affymetrix NetAffx Query website. Differential expression was determined using limma version 3.22.7 (ref. 35). Genes with Benjamini–Hochberg-adjusted P value < 0.05 and absolute log-fold-change >1 were deemed significant. Heatmaps of gene expression were generated with pheatmap package version 1.0.2. Primary human T-ALL samples were obtained from Barts Hospital (London) after informed consent via a protocol approved by the East London Research Ethics Committee and carried out in accordance with the principles of the Helsinki declaration (see Supplementary Table 2 for details), before treatment being administered to the patients. Primary cells from two distinct patients were immunophenotyped, and CD45+/CD7+/CD4−/low/CD8−/low cells sorted and infused i.v. in non-conditioned osterix–CreGFP/NOD/SCID/γ recipient mice. Primary xenograft transplantation was assessed via peripheral blood sampling and/or BM aspiration. BM and spleen-derived primary xenografts were infused i.v. in non-conditioned NOD/SCID/γ secondary recipient mice for therapy experiments. Intravital imaging was performed as described earlier. Human T-ALL cells were labelled by injecting 10 μg of PE-conjugated human CD45 antibody (clone HI30, Biolegend) 15–30 min before the imaging session. For dexamethasone therapy experiments, mice were treated with daily injections of 15 mg/kg i.v.30. Number of human T-ALL cells in therapy experiments was quantified using reference beads as described previously36. Hips and tibias were harvested and post-fixed overnight in periodate-lysine-paraformaldehyde fixative, at 4 °C. Bones were then washed with 0.1 M phosphate buffer, cryoprotected in sucrose (10–30% gradient), for 48 h, frozen in optimal cutting temperature compound (TissueTek) and stored at −80 °C. Sections were cut in a Leica Cryostat, using the Cryojane tape transfer system (Leica Microsystems) and stored at −80 °C. For staining, slides were re-hydrated in PBS, permeabilized in 0.1% Triton X-100, blocked in 5% goat serum and incubated with primary antibodies overnight, at 4 °C. After washing in PBS, slides were incubated with secondary antibodies, counter-stained with DAPI (Invitrogen), washed in 0.1% Triton X-100 and mounted using Prolong Diamond antifade (Invitrogen). The following antibodies were used: Alexa Fluor 647 mouse anti-Ki-67 (B56, BD Biosciences, 1:50), PE-conjugated human CD45 antibody (HI30, BD Biosciences, 1:100), rabbit anti-cleaved caspase-3 (Asp175, Cell Signaling, 1:100), goat anti-rabbit IgG Alexa Fluor 633 (Life Technologies, 1:400). TUNEL labelling was performed to detect apoptotic cells, according to the manufacturer’s instructions (DeadEnd Colorimetric TUNEL System, Promega). Images were obtained using a Zeiss LSM 780 upright confocal/two-photon combined microscope and analysed using Fiji/ImageJ. Cell counting was performed manually using the FIJI plugin Cell Counter. BM from human T-ALL xenotransplanted, untreated and treated mice was harvested and stained with DAPI (Invitrogen) and FITC mouse anti-Ki-67 set (BD Biosciences), according to the manufacturer’s instructions. Cells were analysed by flow cytometry and absolute numbers were obtained using reference beads as described previously36. T-ALL engraftment and infiltration was confirmed via peripheral blood sampling and/or tibia puncture. Once mice presented with signs of ill health (as described earlier), mice were euthanized and bones were digested with a DNase I/Collagenase (Sigma) solution. The total number of Osx–GFP+ cells was assessed by flow cytometry analysis using counting beads (CountBright, Life Technologies). Samples were obtained from patients after informed consent had been obtained, under full ethical approval by the Peter MacCallum Cancer Centre Human Research Ethics Committee. De-waxed human trephine biopsy sections (3 μM) were stained with osteocalcin antibody (Abcam ab93876, Cambridge), counterstained and mounted for viewing. All areas of each section were monitored for visible osteoblasts. The sample size required for the experiments was estimated based on the results of preliminary data. Blinding or randomization for animal experiments were not necessary due to the nature of the experiments. Statistical differences between the means of two data groups was determined by using two-tailed unpaired Student’s t-test, and P values < 0.05 were considered significant. Multiple group comparisons were performed using ANOVA with a Bonferroni correction, P values < 0.05 were considered significant.
Baylor Research Institute, Imperial College Healthcare Nhs Trust and Medical Research Council | Date: 2013-09-11
The present invention includes methods, systems and kits for distinguishing between active and latent mycobacterium tuberculosis infection in a patient suspected of being infected with Mycobacterium tuberculosis, the method including the steps of obtaining a patient gene expression dataset from a patient suspected of being infected with Mycobacterium tuberculosis; sorting the patient gene expression dataset into one or more gene modules associated with Mycobacterium tuberculosis infection; and comparing the patient gene expression dataset for each of the one or more gene modules to a gene expression dataset from a non-patient; wherein an increase or decrease in the totality of gene expression in the patient gene expression dataset for the one or more gene modules is indicative of active Mycobacterium tuberculosis infection.
Baylor Research Institute, Medical Research Council and Imperial College Healthcare Nhs Trust | Date: 2013-12-13
The present invention includes a method of determining a lung disease from a patient suspected of sarcoidosis, tuberculosis, lung cancer or pneumonia comprising: obtaining a sample from whole blood of the patient suspected of sarcoidosis, tuberculosis, lung cancer or pneumonia; detecting expression of (although not exclusive) six or more disease genes, markers, or probes selected from SEQ ID NOS.: 1 to 1446, wherein increased expression of mRNA of upregulated sarcoidosis, tuberculosis, lung cancer and pneumonia markers of SEQ ID NOS.: 1 to 1446 and/or decreased expression of mRNA of downregulated sarcoidosis, tuberculosis, lung cancer or pneumonia markers of SEQ ID NOS.: 1 to 1446 relative to the expression of the mRNAs from a normal sample; and determining the lung disease based on the expression level of the six or more disease markers of SEQ ID NOS.: 1 to 1446 based on a comparison of the expression level of sarcoidosis, tuberculosis, lung cancer, and pneumonia.
News Article | February 17, 2017
The researchers from Imperial College London analysed 20 pharmacies that were available for UK citizens to access online. This is one of the few studies to have examined the online availability of antibiotics and to have explored the potential effects on public health. The research is published in Journal of Antimicrobial Chemotherapy. Antibiotics are classed as prescription only medicines in the UK, meaning they cannot legally be sold to consumers without a valid prescription. In the study, the researchers found that although online versions of UK high street pharmacies were compliant with prescription regulations, 80 per cent of the online pharmacies surveyed let customers choose their dosages, the duration and choice of antibiotic treatments. This can lead to serious side effects in patients and increases the risk of antimicrobial resistance. Antimicrobial resistance is one the biggest threats to global health, food security, and development today, according to the World Health Organization (WHO).The study was carried out by academics from Imperial College London's NIHR Health Protection Research Unit for Healthcare Associated Infections and Antimicrobial Resistance, and Imperial College Healthcare NHS Trust. The team carried out their research by entering the search term 'buy antibiotics online' into Google and Yahoo. The team recognise that the study is a 'snapshot' of the online pharmacy industry, but it does provide insights into how it operates. The 20 pharmacies at the top of the search were analysed by the team. Dr Sara Boyd, a co-author and NIHR Academic Clinical Fellow in Infectious Diseases and Microbiology at Imperial, said: "These findings are a real concern, and raise several important issues regarding antibiotic resistance and patient safety with online pharmacies." All online medicine vendors selling to UK consumers must by law register with both the Medicines and Healthcare products Regulatory Agency (MHRA) and the General Pharmaceutical Council (or the Pharmaceutical Society of Northern Ireland). However, the researchers found that 75 per cent of online pharmacies included in the study lacked evidence of the appropriate registration status required by law. In other findings, the researchers discovered that 45 per cent of the online pharmacies analysed did not require a prescription from the patient. Only 30 per cent of websites in the survey asked consumers to complete a health questionnaire prior to purchase. Seventy per cent of the websites provided information on the safe usage of prescription medications, including potential side effects or adverse reactions when combined with other drugs. Professor Alison Holmes, of Imperial's Department of Medicine, added: "Improper use of antibiotics can mean that infections are not being treated appropriately, or that people are being unnecessarily exposed to antibiotics. This allows bacteria to become resistant to drugs that once killed them. As a result, it is essential that antibiotics are prescribed only when they are needed." Although a small study, the authors say that the research offers insight into the increasing use of the internet for a variety of purposes, including buying antibiotics. Dr Boyd said: "The way patients interact with healthcare is constantly evolving, and shifts in consumer behaviour mean more people are purchasing their goods online. Our study paves the way for larger, more thorough research into this worrying new trend so that we can ensure patient safety and promote the responsible use of antibiotics in all areas of healthcare provision." Martin Astbury, President of the Royal Pharmaceutical Society, said: "Unnecessary antibiotic use can result in serious side effects in individuals and has a major impact on wider public health by increasing antibiotic resistance. We cannot support access to antibiotics through a web form until the standards for prescribing by private providers reflect the standard of face to face consultations in the NHS. Those involved in supplying medicines online should ensure their processes are as robust as possible." All online pharmacies identified as illegally selling antibiotics to patients within the UK were reported to the Medicines and Healthcare products Regulatory Agency (MHRA), who promptly responded. The researchers are working together with numerous stakeholders to improve patient safety and antibiotic stewardship in this area. Anyone with a concern concerns about an online pharmacy should contact the MHRA directly. The study was partially funded by the National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, in partnership with Public Health England and Imperial College Healthcare NHS Trust.
News Article | November 10, 2016
RESEARCH TRIANGLE PARK, N.C.--(BUSINESS WIRE)--TransEnterix, Inc. (NYSE MKT:TRXC), a medical device company that is pioneering the use of robotics to improve minimally invasive surgery, today announced that it has installed a Senhance™ Robotic Surgical System in partnership with Imperial College London and St. Mary’s Hospital of the Imperial College Healthcare NHS Trust. “Imperial College London and the Imperial College Healthcare NHS Trust are among the leading centers for minimally invasive s
Gardiner M.D.,Imperial College Healthcare NHS Trust |
Nanchahal J.,Imperial College Healthcare NHS Trust
Journal of Plastic, Reconstructive and Aesthetic Surgery | Year: 2010
Free tissue transfer has revolutionised tissue reconstruction. Surgical technique is just one of many perioperative factors that determine the eventual outcome of the procedure. Many of these factors can be modified to ensure success. A search of the MEDLINE database using search terms related to perioperative management of free tissue transfer was performed. Further articles were identified by performing related-article searches in MEDLINE. The various perioperative factors that have been demonstrated to affect clinical outcome are discussed along with the current evidence for their optimisation. We present an algorithm for the management of patients undergoing free tissue transfer. © 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
News Article | December 12, 2016
INSIGHTEC congratulates Imperial College Healthcare NHS Trust for performing the first focused ultrasound treatments in the UK for essential tremor. Essential tremor is the most common movement disorder, affecting around one million people in the United Kingdom, and millions more worldwide. The most common symptom is hand tremor, but tremors can also affect the head, arms, voice, legs and torso. Patients often experience difficulty performing everyday tasks such as eating, dressing, writing, holding objects and even speaking. Patients who fail to respond to medication may be treated with surgical procedures such as Deep Brain Stimulation (DBS) or thalamotomy. A medical team at Imperial College Healthcare NHS Trust lead by Mr Dipankar Nandi, MD (Neurosurgeon), Professor Wladyslav Gedroyc, MD (Radiologist), and Dr Peter Bain (Neurologist) are performing non-invasive MR-guided Focused Ultrasound (MRgFUS) thalamic lesioning for treating essential tremor using the Exablate Neuro as part of a trial. The treatment starts with applying low energy ultrasound waves under magnetic resonance imaging (MRI) to identify the small part (3 mm X 3mm X 5 mm) of the brain that is thought to be responsible for causing tremors, part of the thalamus and sub -thalamic region. Once located, high intensity ultrasound waves are applied to heat and destroy only the target tissue. The whole procedure is performed while the patient is fully conscious and lying on the treatment bed in an MRI scanner. The result for certain patients is an immediate and significant reduction of their tremor. Non-invasive focused ultrasound treatment minimizes risk of infection, and the risks of bleeding, stroke or other surgical complications and allows patients to return home usually the same day. Mr Dipankar Nandi, Consultant Neurosurgeon who is performing the thalamotomy with MGFUS, said: "I have been performing DBS operations for over 15 years. This breakthrough allows us now to operate on these patients without the significant risks that inserting an electrode 15 cms deep into the brain entails. We are at the cusp of widening the applications of this innovative technology to help a wide variety of patients, some of whom had no therapeutic option before." "INSIGHTEC is the pioneer in non-invasive treatments. Patients with essential tremor now have a treatment option that allows them to be treated on an outpatient basis and quickly return to their daily life with improvement in their tremor," said Rick Schallhorn, INSIGHTEC'S Vice President Neurosurgery. INSIGHTEC is the world leader in MR-guided Focused Ultrasound (MRgFUS). The company's non-invasive therapy platforms, Exablate and Exablate Neuro, are transforming patient treatments for various indications in neurosurgery, oncology and women's health. A growing number of renowned physicians are realizing the clinical and economical value of focused ultrasound around the world. For more information, please visit: http://www.insightec.com