Guy's and St Thomas' NHS Foundation Trust

About: Guy's and St Thomas' NHS Foundation Trust is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Randomized controlled trial. The organization has 7686 authors who have published 9631 publications receiving 399353 citations. The organization is also known as: Guy's and St Thomas' National Health Service Foundation Trust & Guy's and St Thomas' National Health Service Trust.

Genetic evolution of enterovirus 71: epidemiological and pathological implications.

Abstract: Since its discovery in the 1970s, enterovirus 71 (EV71) has become one of the most pathogenic enterovirus serotypes causing recurrent outbreaks in different parts of the world. Three waves of outbreaks globally have been recorded over the last three decades and more recently active circulation of EV71 is evident amongst countries in South East Asia and beyond. There is evidence of a continuous evolution in its genetic make up which is likely to impact on its epidemiology and pathological potential. This review examines the molecular genetics and evolution of EV71 in relation to its epidemiological and pathological properties. A thorough understanding of the relationship between the genetic changes and the resulting host-virus interaction is essential for successful control.

Penetrance for copy number variants associated with schizophrenia

Abstract: The discovery of 'high-risk' de novo copy number variants (CNVs) associated with neuropsychiatric disorders such as schizophrenia offers the opportunity to translate these findings into useful tools for clinical geneticists. However, this will require estimation of penetrance for these variants, which has not yet been properly considered. To facilitate this process, we estimated the penetrance of CNVs associated with schizophrenia, at 15q13.3, 1q21.1, 15q11.2, 17p12, 2p16.3, 16p13.1 and 16p11.2 with a novel Bayesian method applied to pooled data from published case-control studies. For these CNVs, penetrance for schizophrenia was between 2 and 7.4%, which contrasts with the much higher penetrance for schizophrenia of the 22q11.2 deletions found in velo-cardio-facial syndrome. The highest penetrance was for 15q13.3 deletion (6-9% in individual studies) and the lowest was for 15q11.2 (2%). CNVs confer much higher risk for schizophrenia than common variants, but their penetrance is substantially lower than Mendelian disorders or other syndromic conditions. Since these CNVs predispose to multiple disorders, including epilepsy, autism and intellectual impairment, penetrance estimates will also need to take into account diagnostic specificity, and their overall penetrance for any neuropsychiatric disorder is likely to be much higher. Thus, although CNVs are still far from being clinically useful or relevant to genetic counselling for specific disorders, their detection may hold an important clinical value in predicting negative developmental outcomes.

Mumps and the UK epidemic 2005

Abstract: The United Kingdom is in the grip of a nationwide mumps epidemic with almost 5000 notifications in the first month of 2005 alone.1 Most patients are aged between 19 and 23, and there is now the threat of outbreaks among under-immunised children. As a result of the measles, mumps, and rubella (MMR) vaccine, which was introduced in 1988, the current generation of practising doctors have little experience of mumps infection. Mumps may have permanent sequelae, and not all cases can be diagnosed clinically. Here we explain the basis of the current epidemic and review the epidemiology, clinical presentation, complications, laboratory confirmation, and treatment of mumps. We searched Medline for evidence based information on the internet, using a range of search terms. Other internet based resources included the websites of the Health Protection Agency (HPA), the World Health Organization (WHO), and the US Centers for Disease Control (CDC). We also used various formal texts. Mumps is an enveloped, single stranded RNA virus belonging to the family paramyxoviridae, which causes an acute infectious disease mainly in children and young adults.2 Transmission is by droplet spread, and humans are the only known host. Mumps is highly infectious and spreads rapidly in susceptible people living in close proximity. The number of secondary cases of infection expected to result from an index case of mumps in a fully susceptible population (R or basic reproduction number) is 10-12. By comparison, measles—a notoriously infectious virus—has an R of 15-17.3 The incubation period from infection to appearance of the characteristic swelling of the parotid glands is 15-24 days.4 The infectious period starts several days before the onset of parotitis and continues for several days afterwards.4 w1Infection control guidance for schools and nurseries advises that children stay away from school for …

Nonantibiotic prevention and management of recurrent urinary tract infection

Abstract: Urinary tract infections (UTIs) are highly prevalent, lead to considerable patient morbidity, incur large financial costs to health-care systems and are one of the most common reasons for antibiotic use worldwide. The growing problem of antimicrobial resistance means that the search for nonantibiotic alternatives for the treatment and prevention of UTI is of critical importance. Potential nonantibiotic measures and treatments for UTIs include behavioural changes, dietary supplementation (such as Chinese herbal medicines and cranberry products), NSAIDs, probiotics, D-mannose, methenamine hippurate, estrogens, intravesical glycosaminoglycans, immunostimulants, vaccines and inoculation with less-pathogenic bacteria. Some of the results of trials of these approaches are promising; however, high-level evidence is required before firm recommendations for their use can be made. A combination of these agents might provide the optimal treatment to reduce recurrent UTI, and trials in specific population groups are required.