Royal London Hospital

About: Royal London Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Medicine. The organization has 4854 authors who have published 5081 publications receiving 168207 citations. The organization is also known as: London Infirmary & London Hospital.

Prehospital End-Tidal Carbon Dioxide Concentration and Outcome in Major Trauma

Abstract: Background. End-tidal carbon dioxide (Petco(2)) concentration is a marker of the pathophysiologic state because it is a reflection of cardiac output. Petco(2) correlates with outcome after prehospital primary cardiac arrest, but association with outcome from prehospital trauma has not been established.Method: Between 1998 and 2001, Petco(2) was recorded in 191 blunt trauma patients requiring prehospital intubation. Rapid sequence intubation was performed using suxamethonium (I mg/kg) and etomidate (0.2-0.3 mg/kg). Initial Petco(2), after endotracheal intubation (to) and Petco(2), at 20 minutes after endotracheal intubation (to) were recorded, together with survival to discharge.Results. Median Petco(2) at t(20) was 4.10 kPa in survivors and 3.50 kPa in non-survivors (95% confidence interval of difference between medians, 0.40 to 0.90 kPa; p < 0.0001). Petco(2) at t(20) was a better predictor of outcome than at to.Conclusion:Only 5% patients with Petco(2) < 3.25 kPa survived to discharge. Petco(2) at t(20) is of value in predicting outcome from major trauma.

Circulating MicroRNA Biomarkers in Melanoma: Tools and Challenges in Personalised Medicine

Abstract: Effective management of melanoma depends heavily on early diagnosis. When detected in early non-metastatic stages, melanoma is almost 100% curable by surgical resection, however when detected in late metastatic stages III and IV, 5-year survival rates drop to ~50% and 10–25%, respectively, due to limited efficacy of current treatment options. This presents a pressing need to identify biomarkers that can detect patients at high risk of recurrence and progression to metastatic disease, which will allow for early intervention and survival benefit. Accumulating evidence over the past few decades has highlighted the potential use of circulating molecular biomarkers for melanoma diagnosis and prognosis, including lactate dehydrogenase (LDH), S100 calcium-binding protein B (S100B) and circulating tumor DNA (ctDNA) fragments. Since 2010, circulating microRNAs (miRNAs) have been increasingly recognised as more robust non-invasive biomarkers for melanoma due to their structural stability under the harsh conditions of the blood and different conditions of sample processing and isolation. Several pre-analytical and analytical variables challenge the accurate quantification of relative miRNA levels between serum samples or plasma samples, leading to conflicting findings between studies on circulating miRNA biomarkers for melanoma. In this review, we provide a critical summary of the circulating miRNA biomarkers for melanoma published to date.

Mechanisms of Disease: cell death in acute renal failure and emerging evidence for a protective role of erythropoietin

Abstract: Acute renal failure--characterized by a sudden loss of the ability of the kidneys to excrete nitrogenous waste, and to maintain electrolyte homeostasis and fluid balance--is a frequently encountered clinical problem, particularly in the intensive care unit. Unfortunately, advances in supportive interventions have done little to reduce the high mortality associated with this condition. Might erythropoietin (EPO) have utility as a therapeutic agent in acute renal failure? This hormone mediates anti-apoptotic effects in the bone marrow, facilitating maturation and differentiation of erythroid progenitors. New evidence indicates that EPO also exerts anti-apoptotic effects in the brain, heart and vasculature, which can limit the degree of organ damage. Here, we review the emerging biological role of EPO in the kidney and the pathophysiology of ischemia-reperfusion injury in an attempt to understand the therapeutic potential of EPO in acute renal failure.