Institution
Guy's and St Thomas' NHS Foundation Trust
Healthcare•London, United Kingdom•
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 & Medicine. 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.
Topics: Population, Medicine, Randomized controlled trial, Cancer, Breast cancer
Papers published on a yearly basis
Papers
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TL;DR: A substantial improvement in risk prediction of thrombosis or PL in SLE is proposed based on assessment of the GAPSS, a quantitative scoring system derived from the combination of independent risk for thromBosis and pregnancy loss.
Abstract: Objective. To develop and validate a risk score [global APS score (GAPSS)] derived from the combination of independent risk for thrombosis and pregnancy loss (PL), taking into account the aPL profile, conventional cardiovascular risk factors and the autoimmune antibody profile. Methods. This cross-sectional study included 211 consecutive SLE patients. Data on clinical manifestations, conventional cardiovascular risk factors, aPL profile, ANAs, ENA and anti-dsDNA were collected. Long-term low-dose aspirin, oral anticoagulant and HCQ treatment were also included in the analysis. Patients were randomly divided into two sets by a computer-generated randomized list. We developed GAPSS in the first set of patients (n = 106), assigning the risk factors identified by multivariate analysis weighted points proportional to the b-regression coefficient values. GAPSS was validated in the second set of patients (n = 105). The relationship between GAPPS and thrombosis and/or PL was analysed. Results. In the first set, higher values of GAPSS were seen in patients who experienced thrombosis and/ or PL compared with those without clinical events [GAPSS 9.3 (4.8) (range 119) and 5.3 (4) (range 016), P < 0.001]. Also taken separately, patients who experienced thrombosis or PL showed higher GAPSS compared with those without clinical events [GAPSS 9.6 (4.8) (range 119) vs 4.9 (5) (range 014), P = 0.027 for thrombosis; 7.3 (5) vs 3.9 (5.1) (range 016), P = 0.024 for PL, respectively]. In the second set, the results were similar, with statistically higher values of GAPSS in patients with a clinical history of thrombosis and/or PL compared with those without events [GAPSS 9.5 (5.6) (range 020) and 3.9 (4.1) (range 017), P < 0.001). Higher values were also seen when subclassifying the patients according to the clinical manifestation, thrombosis or PL [GAPSS 9.5 (5.6) (range 020) vs 4.8 (5.4) (range 017), P = 0.036 for thrombosis; 7.9 (3.3) vs 3.8 (5.4) (range 016), P = 0.037 for PL, respectively). Conclusion. These data propose a substantial improvement in risk prediction of thrombosis or PL in SLE based on assessment of the GAPSS, a quantitative scoring system.
223 citations
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TL;DR: It is indicated that FA patients with mutations in the FANCG gene and patients homozygous for null mutations in FANCA are high-risk groups with a poor hematologic outcome and should be considered as candidates both for frequent monitoring and early therapeutic intervention.
223 citations
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TL;DR: In this paper, the natural history of recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unknown, because fibrosis with persistent physiological deficit is a previously unknown condition.
Abstract: Rationale: The natural history of recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unknown. Because fibrosis with persistent physiological deficit is a previously ...
223 citations
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King's College London1, Guy's and St Thomas' NHS Foundation Trust2, Barts Health NHS Trust3, Cardiff University4, Aneurin Bevan University Health Board5, NHS Lothian6, St. George's University7, University College London Hospitals NHS Foundation Trust8, Cardiff and Vale University Health Board9, Northwick Park Hospital10
TL;DR: These guidelines aim to support clinical practice and help lower the threshold for performing awake tracheal intubation when indicated, and recognise that there are a range of techniques and regimens that may be effective and one such example technique is included.
Abstract: Awake tracheal intubation has a high success rate and a favourable safety profile but is underused in cases of anticipated difficult airway management. These guidelines are a comprehensive document to support decision making, preparation and practical performance of awake tracheal intubation. We performed a systematic review of the literature seeking all of the available evidence for each element of awake tracheal intubation in order to make recommendations. In the absence of high-quality evidence, expert consensus and a Delphi study were used to formulate recommendations. We highlight key areas of awake tracheal intubation in which specific recommendations were made, which included: indications; procedural setup; checklists; oxygenation; airway topicalisation; sedation; verification of tracheal tube position; complications; management of unsuccessful awake tracheal intubation; post-tracheal intubation management; consent; and training. We recognise that there are a range of techniques and regimens that may be effective and one such example technique is included. Breaking down the key practical elements of awake tracheal intubation into sedation, topicalisation, oxygenation and performance might help practitioners to plan, perform and address complications. These guidelines aim to support clinical practice and help lower the threshold for performing awake tracheal intubation when indicated.
222 citations
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Guy's and St Thomas' NHS Foundation Trust1, King's College London2, University of London3, University of Pennsylvania4, Torbay Hospital5, University of Auckland6, University of Cape Town7, University of Ottawa8, The Chinese University of Hong Kong9, Singapore General Hospital10, University of Toronto11, RWTH Aachen University12, Karolinska University Hospital13, Tata Memorial Hospital14, Monash University15, University of Padua16, Aga Khan University Hospital17, Utrecht University18
TL;DR: Around 1 in 10 healthcare workers involved in tracheal intubation of patients with suspected or confirmed CO VID‐19 subsequently reported a COVID‐19 outcome, which has human resource implications for institutional capacity to deliver essential healthcare services, and wider societal implications for COVID-19 transmission.
Abstract: Healthcare workers involved in aerosol-generating procedures, such as tracheal intubation, may be at elevated risk of acquiring COVID-19. However, the magnitude of this risk is unknown. We conducted a prospective international multicentre cohort study recruiting healthcare workers participating in tracheal intubation of patients with suspected or confirmed COVID-19. Information on tracheal intubation episodes, personal protective equipment use and subsequent provider health status was collected via self-reporting. The primary endpoint was the incidence of laboratory-confirmed COVID-19 diagnosis or new symptoms requiring self-isolation or hospitalisation after a tracheal intubation episode. Cox regression analysis examined associations between the primary endpoint and healthcare worker characteristics, procedure-related factors and personal protective equipment use. Between 23 March and 2 June 2020, 1718 healthcare workers from 503 hospitals in 17 countries reported 5148 tracheal intubation episodes. The overall incidence of the primary endpoint was 10.7% over a median (IQR [range]) follow-up of 32 (18-48 [0-116]) days. The cumulative incidence within 7, 14 and 21 days of the first tracheal intubation episode was 3.6%, 6.1% and 8.5%, respectively. The risk of the primary endpoint varied by country and was higher in women, but was not associated with other factors. Around 1 in 10 healthcare workers involved in tracheal intubation of patients with suspected or confirmed COVID-19 subsequently reported a COVID-19 outcome. This has human resource implications for institutional capacity to deliver essential healthcare services, and wider societal implications for COVID-19 transmission.
222 citations
Authors
Showing all 7765 results
Name | H-index | Papers | Citations |
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Christopher J L Murray | 209 | 754 | 310329 |
Bruce M. Psaty | 181 | 1205 | 138244 |
Giuseppe Remuzzi | 172 | 1226 | 160440 |
Mika Kivimäki | 166 | 1515 | 141468 |
Simon I. Hay | 165 | 557 | 153307 |
Theo Vos | 156 | 502 | 186409 |
Ali H. Mokdad | 156 | 634 | 160599 |
Steven Williams | 144 | 1375 | 86712 |
Igor Rudan | 142 | 658 | 103659 |
Mohsen Naghavi | 139 | 381 | 169048 |
Christopher D.M. Fletcher | 138 | 674 | 82484 |
Martin McKee | 138 | 1732 | 125972 |
David A. Jackson | 136 | 1095 | 68352 |
Graham G. Giles | 136 | 1249 | 80038 |
Yang Liu | 129 | 2506 | 122380 |