Staff Publication

A multicentered retrospective cohort study comparing JAK inhibitor therapies in moderate-to-severe ulcerative colitis (2026)

Posted on by

Type of publication:

Journal article

Author(s):

Kumar, Aditi; Baxter, Joshua; Rimmer, Peter; Noble, Ben; Bower, Joshua; Makki, Mujeeb Ullah; Hatta, Ayiesha; Chikhlia, Anmol; Cheesbrough, Jonathan; Disney, Ben; *Muir, Josh; *Karova, Mariya; *Butterworth, Jeffrey; Sagar, Nidhi; Al-Talib, Ismaeel; Nahal, Jasbir; Ali, Nasima; Sagar, Vandana; Varyani, Fumi; Smith, Sam; Bourne, Stephanie; Hsu, Yu-Kai; Eltahir, Almoiez; de Silva, Shanika; Harvey, Philip.

Citation:

Crohn's & Colitis 360. 8(2):otag045, 2026 Apr.

Abstract:

Background: Tofacitinib, filgotinib, and upadacitinib are Janus kinase inhibitors (JAKi) that have demonstrated efficacy in ulcerative colitis (UC) against placebo. This study aims to compare the clinical efficacy between these drugs.

Methods: This is a multicentered, retrospective cohort study. Patients with UC starting a JAKi were recruited between 2018 and 2024 when starting their first JAKi. Clinical remission and response, based on clinical scores, calprotectin, and endoscopic measurement, were assessed at 3 and 6 months. Both independent and combined variable outcomes were analyzed.

Results: Two hundred and seventy patients were included in the analysis, of which 70 (26%) were on upadacitinib, 51 (19%) on filgotinib, and 149 (55%) on tofacitinib. Clinical, biochemical, and endoscopic remission at 6 months was 91%, 71%, and 80% for upadacitinib; 78%, 67%, and 50% for filgotinib; 73%, 51%, and 44% for tofacitinib. Upadacitinib demonstrated significantly greater clinical response (P = .027) and remission (P = .037) rates at 6 months than tofacitinib. Drug persistence at 12 months was 86% for upadacitinib, 72% for filgotinib, and 69% for tofacitinib. Upadacitinib demonstrated significantly greater 6-month remission rates compared to tofacitinib in the bio-exposed cohort (71% vs 52%, P = .022) and in the bio-naive cohort (93% vs 50%, P = .009). The incidence rates for hospital admissions were 10.2, 21.9, and 14.1 and for colectomies were 6.7, 10.0, and 5.0 per 1000 patient-months at risk for upadacitinib, filgotinib and tofacitinib, respectively.

Conclusion: This study demonstrates that upadacitinib is more likely to achieve 6-month response and remission compared to tofacitinib. In both bio-naive and bio-exposed patients, upadacitinib was more likely to achieve remission at 6 months. The efficacy of JAKi does not appear diminished by prior biologic use.

DOI: 10.1093/crocol/otag045

Link to full-text [open access]

Improving Adequacy of Fine-Needle Aspiration Cytology in Non-Thyroid Head and Neck Patients Using Concurrent Liquid Cytology Sample Preparation: A Prospective Study (2026)

Posted on by

Type of publication:

Journal article

Author(s):

Yeung, Thomas; Oh, Soo; *Ahsan, Syed Farhan; *Harrison, Katherine; *Hope, Helen.

Citation:

Cytopathology. 2026 Apr 04.

Abstract:

OBJECTIVE: Cytological evaluation of head and neck masses is an important diagnostic tool and aspect of pre-operative planning in Ear, Nose and Throat surgery. Samples acquired via fine-needle aspiration cytology (FNAC) may be processed as dry slides (conventional) or as liquid cytological preparation. Adequacy, defined as the quantity and quality of cellular material obtained, is a determinant of correct cytological diagnosis. This study aimed to investigate the adequacy of dry slide samples alone versus dry slides in combination with liquid cytological preparation in non-thyroid masses.

METHODS: A single-centre study was undertaken between 2015 and 2018 at a District General Hospital Pathology unit. An initial retrospective analysis of adequacy data was undertaken over a nine month period from 1st January to 30th September 2015. All samples in this period were prepared as dry slides and obtained by two ENT surgeons and two radiologists. From 2017 onwards, samples were prepared as both dry slides and liquid cytology. Prospective re-audit of adequacy was undertaken over a nine month cycle in 2018. Individual clinicians' adequacy rates and overall adequacy were recorded in both cycles.

RESULTS: In the 2015 audit cycle, 134 of 207 (64.7%) samples were deemed adequate. In the 2018 re-audit, 156 of 202 (77.2%) samples were adequate. All four clinicians achieved higher adequacy rates in the re-audit cycle.

CONCLUSIONS: This study demonstrated promising improvement in overall and individual clinician adequacy rates following the introduction of liquid cytological preparation concurrently with dry slides. Collaborative research from further centres would increase sample size and allow higher validity.

DOI: 10.1111/cyt.70076

Intranetwork variation in neoadjuvant therapy delivery for borderline resectable and locally advanced pancreatic cancer: a UK multicentre cohort study (2026)

Posted on by

Type of publication:

Journal article

Author(s):

Labib, P L; Alarabiyat, M; Powell-Brett, S; Hall, L; Rehman, S; Edwards, D; Ma, Y T; Sivakumar, S; Good, J; Candish, C; Nagy, A; Tsalic, M; Hafeez, T; Kunene, V; *Chatterjee, A; Roberts, K J; Chatzizacharias, N.

Citation:

Annals of the Royal College of Surgeons of England. 2026 Apr 09.

Abstract:

INTRODUCTION: Pancreatic cancer (PC) treatment in the UK is coordinated via regional referral networks, but formal neoadjuvant chemotherapy (NAC) pathways for borderline resectable and locally advanced PC (BR/LAPC) are rare. This cohort study assessed intranetwork variation in access to diagnostics, time to treatment and patient outcomes following NAC for BR/LAPC in our network.

METHODS: All patients with BR/LAPC referred from regional network hospitals between 2017 and 2021 were reviewed. Data were collected on time from first diagnostic computed tomography scan to endoscopy, commencement of NAC, NAC regimens administered and patient outcomes.

RESULTS: In the 155 patients who commenced NAC, there were significant differences in median time to biliary drainage and endoscopic ultrasound between referral hospitals. Time from decision to treat to first administration of NAC was long (median 64 days). There were significant differences in the proportion of patients commenced on mFOLFIRINOX (0-100%, p<0.001) and the proportion completing NAC (0-100%, p=0.012). The likelihood of proceeding to surgical resection was similar between centres.

CONCLUSIONS: There is significant intranetwork variation in access to interventional endoscopy and choice of NAC regimen. Centralised tracking of patients receiving NAC, development of locally agreed treatment protocols and an update to national guidelines are needed to standardise NAC pathways for BR/LAPC.

DOI: 10.1308/rcsann.2026.0023

Link to full-text [open access - no password required]

Relationship between social deprivation, CEAP score and time to varicose vein surgery: A single-centre retrospective analysis (2026)

Posted on by

Type of publication:

Journal article

Author(s):

*Crossdale, Martin; *Damaraju, Sandeep; *Smith, Benjamin; *Alawattegama, Lakna Harindi; *Bhanderi, Shivam; *Jones, Steven.

Citation:

Phlebology. 2683555261444161, 2026 Apr 17.

Abstract:

Introduction: Inequalities in access to planned venous surgery are not well understood. We aimed to explore the relationships between disease severity, socioeconomic deprivation, procedure performed, and waiting times. Methods We analysed retrospectively collected data from 302 patients undergoing varicose vein surgery at a single NHS Trust in Shropshire, England between 1st January 2024 to 31st December 2024. Spearman's correlation, chi-squared testing, and Kruskal-Wallis tests were used to examine associations between CEAP score, Index of Multiple Deprivation (IMD) decile, procedure performed, referral-to-treatment time and time on the waiting list. Results The median age was 54 years (IQR 26), with equal male and female representation. The most common CEAP score was C2, median IMD decile was 6 (IQR 4), and median time on the surgical waiting list was 215 days (IQR 278). There was no statistically significant association between IMD and either wait time or CEAP score, in either England or Wales. CEAP score did not correlate with waiting list time (Spearman's rho = -0.031, p = 0.59). CEAP score was not associated with procedure performed (chi2 = 20.0, df = 35, p = 0.98). Similarly, no association was seen between IMD and procedure in England, Wales, Shropshire, or Telford & Wrekin. Conclusion In this cohort, socioeconomic deprivation was not associated with disease severity, procedure selection, or delays to intervention, although the under-representation of the most deprived deciles may limit the strength of this conclusion. The lack of correlation between CEAP score and waiting time may suggest there are other factors limiting clinical prioritisation.

DOI: 10.1177/02683555261444161

Is digital documentation always best? (2026)

Posted on by

Type of publication:

Journal article

Author(s):

Rai, Tanvi; *Millward, Helen; *Siddall, Kate; Riddell, Nathan S; *Elsmore, Amy; Dhadda, Amrit; *Willson, Seren; Collis, Rachel; *Parry-Smith, William; Collins, Peter; Hinton, Lisa; Bell, Sarah.

Citation:

International Journal of Gynaecology & Obstetrics. 2026 May 16.

DOI: 10.1002/ijgo.71079

In adult patients with suspected sepsis, is adjunct resuscitation with human albumin solution associated with improved patient-oriented outcomes? (2026)

Posted on by

Type of publication:

Systematic review

Author(s):

*Phelan, Harriet; Davie, Cameron.

Citation:

Emergency Medicine Journal. 2026 Jun 09.

Abstract:

A short systematic review was undertaken to answer the following three-part question: in adult patients with suspected sepsis, is adjunct resuscitation with human albumin solution (HAS) associated with improved patient-oriented outcomes? A systematic keyword search of EMBASE, MEDLINE, Cochrane and Google Scholar databases returned three relevant papers which were subsequently used in the final analysis. The author, year, country of publication, patient group studied, study type, key findings and study weaknesses are tabulated. The results suggest that resuscitation with HAS is not recommended in the emergency department in suspected sepsis and larger studies are required to address this clinical question.

DOI: 10.1136/emermed-2026-216135

Criteria for Return to Running After Surgical Repair of Acute Achilles Tendon Rupture: A Modified Delphi Consensus Study (2026)

Posted on by

Type of publication:

Journal article

Author(s):

Gaspar, Maxime; Maffulli, Nicola; Memain, Geoffrey; *Carmont, Michael R; Hardy, Alexandre; Arnaud, Choplin.

Citation:

Sports Medicine. 2026 Jul 26.

Abstract:

BACKGROUND: The annual incidence of Achilles tendon ruptures has increased by almost 3%. Despite the large amount of data available on post-injury treatment, there is a lack of evidence-based criteria to guide return to running after surgery.

OBJECTIVE: The aim of this study was to reach a consensus among experts on the criteria for resuming running following surgery for Achilles tendon rupture.

METHODS: Thirty-five international Achilles tendon experts were invited to participate in this modified Delphi study. The study was conducted in three rounds, with a threshold of 75% agreement (or disagreement) required for an item to achieve consensus. Sixteen clinical criteria were submitted to the expert panel. A five-point Likert scale was used. The study was conducted between January and June 2025.

RESULTS: Eight criteria achieved consensus after three rounds: seven criteria reached consensus for inclusion, and one criterion reached consensus for exclusion (calf circumference symmetry). The seven criteria were (1) the absence of pain in daily life; (2) the absence of pain during and after rehabilitation sessions; (3) walking without limping; (4) the ability to walk on tiptoes; (5) the ability to perform ten single-leg heel rises; (6) good single-leg balance; and (7) the patient feeling psychologically ready to resume running.

CONCLUSION: An expert consensus on the criteria to return to running after surgery for Achilles tendon rupture has been developed. These criteria, agreed by experts, may inform clinical decision making regarding return to running, but they require prospective validation before they can be used as decision rules. Further studies are needed to refine these criteria and evaluate their impact on functional outcomes during the return-to-running phase.

DOI: 10.1007/s40279-026-02506-4

Developing a comprehensive haemodynamic ultrasound assessment for critical care: Rationale and methodology from the FUSIC programme (2026)

Posted on by

Type of publication:

Journal article

Author(s):

*Miller, Ashley; Peck, Marcus; Conway, Hannah; Parulekar, Prashant; Rubino, Antonio; Stephens, Jennie; Wilkinson, Jonathan; Kirk-Bayley, Justin; Waraich, Manni; Griksaitis, Michael.

Citation:

The Journal of the Intensive Care Society. 17511437261470613, 2026 Jul 31.

Abstract:

Haemodynamic ultrasound is central to bedside assessment of circulatory failure in critical care. The Focused UltraSound in Intensive Care HaemoDynamics (FUSIC HD) programme was originally designed to provide a structured national framework for physiologically focused ultrasound assessment, distinct from comprehensive diagnostic echocardiography. Since publication of the original framework, experience from training cohorts, logbook review, and centralised summative assessment has shown that a broader range of haemodynamic parameters can be acquired and interpreted in routine practice. This article outlines the rationale, development process, and methodological principles underpinning the recent revision of the FUSIC HD dataset. The updated framework incorporates additional assessment of left ventricular performance, right ventricular function, and pulmonary vascular loading, together with a refined approach to estimating left atrial pressure while maintaining emphasis on physiological coherence, bedside feasibility, and avoidance of unnecessary diagnostic complexity. The aim is not to expand diagnostic echocardiography capability, but to support more integrated haemodynamic interpretation in critically ill patients within an established training and governance structure.

DOI: 10.1177/17511437261470613

Link to full-text [no password required]

The 2026 Surviving Sepsis Campaign Guidelines: The dissenting opinion (2026)

Posted on by

Type of publication:

Journal article

Author(s):

Spiegel, Rory; Haycock, Korbin; *Miller, Ashley; Weingart, Scott; Farkas, Joshua; Ajmo, Ian; Rola, Philippe.

Citation:

American Journal of Emergency Medicine. 110:411-415, 2026 Sep 15.

Abstract:

The Surviving Sepsis Campaign (SSC) Guidelines once represented what was considered the pinnacle of care for patients with sepsis and septic shock. Unfortunately, over the past decade, successive iterations of the guidelines have drifted from what is now considered optimal care for critically ill patients with sepsis and septic shock. Moreover, the guidelines have shifted from recommendations intended to guide and support physicians based on the best available evidence, to mandated "bundles" which exert substantial influence over what is considered "standard of care" in sepsis management. This. Document is intended to serve as a refutation of sorts. A rebuttal to the most controversial and influential recommendations in the Surviving Sepsis Campaign Guidelines, while also offering guidance on how clinicians might move beyond the protocolized, metric-based care that has become the current standard promoted by the SSC and similar organizations.

DOI: 10.1016/j.ajem.2026.09.025

Ileostomy creation for rectal cancer in England: An observational study of variation, and correlates using administrative data (2026)

Posted on by

Type of publication:

Journal article

Author(s):

*Olagunju, Naomi; *Cheetham, Mark; Savage, Katrein; Briggs, Tim W R; Gray, William K.

Citation:

Colorectal Disease. 28(9):e70622, 2026 Sep.

Abstract:

AIMS: The decision to create an ileostomy following anterior resection is a clinical one based on the judgement of the surgical team. However, there are few data to support decision-making. This study aimed to explore variation in, and factors associated with, ileostomy creation rates following surgery for rectal cancer in England.

METHODS: This exploratory, retrospective analysis used observational data from England's Hospital Episode Statistics (HES) dataset. All patients aged >=17 years undergoing an elective anterior resection with ileostomy creation from 1 April 2016 to 31 March 2024 were included. The primary outcome of interest was ileostomy creation at the time of index surgery.

RESULTS: In total, 17,540 anterior resections for rectal cancer were included, and 5,954 patients (33.9%) had a diverting ileostomy. Rates of ileostomy creation declined over time, from 38.6% in 2016/17 to 29.7% in 2023/24, while the number of anterior resections remained relatively stable, other than during the COVID-19 pandemic. There was substantial variation in ileostomy creation rates across hospital trusts from 5.8% to 62.5%. Greater odds of ileostomy creation were associated with younger age, male sex, mild/moderate frailty, living in a less deprived area, Asian ethnicity, higher surgeon and trust volume and earlier time periods.

CONCLUSIONS: Rates of ileostomy creation are falling, but there is huge variation in creation rates across providers and patient groups. Standardised guides on when to create an ileostomy may help reduce the extent of this variation.

DOI: 10.1111/codi.70622