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.

UK National Guidelines on the Management of Syphilis 2008.

Abstract: *Manchester Centre for Sexual Health, The Hathersage Centre, 280, Upper Brook Street, Manchester M13 OFH; † Department of Genitourinary Medicine, Mortimer Market Centre, Off Capper Street, London WC1E 6JB; ‡ Department of Genitourinary Medicine, Ambrose King Centre, The Royal London Hospital, Turner Street, London E1 1BB; §Department of Genitourinary Medicine, Whittall Street Clinic, Whittall Street, B4 6DH; Department of Genitourinary Medicine, Outpatients Department, North Manchester General Hospital, Pennine Acute Hospitals NHS Trust, Crumpsall, Manchester M13 9WL; †† Department of Clinical Virology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL; ‡‡ Royal Infirmary of Edinburgh, 51 Little France Cr, Old Dalkeith Road, Edinburgh EH16 4SA, UK (the Syphilis Guidelines Revision Group 2008)

Screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation.

Abstract: OBJECTIVE To examine the performance of screening for early, preterm and term pre-eclampsia (PE) at 11-13 weeks' gestation by maternal factors and combinations of mean arterial pressure (MAP), uterine artery (UtA) pulsatility index (PI), serum placental growth factor (PlGF) and serum pregnancy-associated plasma protein-A (PAPP-A). METHODS The data for this study were derived from three previously reported prospective non-intervention screening studies at 11 + 0 to 13 + 6 weeks' gestation in a combined total of 61 174 singleton pregnancies, including 1770 (2.9%) that developed PE. Bayes' theorem was used to combine the prior distribution of gestational age at delivery with PE, obtained from maternal characteristics, with various combinations of biomarker multiples of the median (MoM) values to derive patient-specific risks of delivery with PE at < 37 weeks' gestation. The performance of such screening was estimated. RESULTS In pregnancies that developed PE, compared to those without PE, the MoM values of UtA-PI and MAP were increased and those of PAPP-A and PlGF were decreased, and the deviation from normal was greater for early than late PE for all four biomarkers. Combined screening by maternal factors, UtA-PI, MAP and PlGF predicted 90% of early PE, 75% of preterm PE and 41% of term PE, at a screen-positive rate of 10%; inclusion of PAPP-A did not improve the performance of screening. The performance of screening depended on the racial origin of the women; on screening by a combination of maternal factors, MAP, UtA-PI and PlGF and using a risk cut-off of 1 in 100 for PE at < 37 weeks in Caucasian women, the screen-positive rate was 10% and detection rates for early, preterm and term PE were 88%, 69% and 40%, respectively. With the same method of screening and risk cut-off in women of Afro-Caribbean racial origin, the screen-positive rate was 34% and detection rates for early, preterm and term PE were 100%, 92% and 75%, respectively. CONCLUSION Screening by maternal factors and biomarkers at 11-13 weeks' gestation can identify a high proportion of pregnancies that develop early and preterm PE. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.

European Maxillofacial Trauma (EURMAT) project: a multicentre and prospective study.

Abstract: The purpose of this study was to analyse the demographics, causes and characteristics of maxillofacial fractures managed at several European departments of oral and maxillofacial surgery over one year. The following data were recorded: gender, age, aetiology, site of facial fractures, facial injury severity score, timing of intervention, length of hospital stay. Data for a total of 3396 patients (2655 males and 741 females) with 4155 fractures were recorded. The mean age differed from country to country, ranging between 29.9 and 43.9 years. Overall, the most frequent cause of injury was assault, which accounted for the injuries of 1309 patients; assaults and falls alternated as the most important aetiological factor in the various centres. The most frequently observed fracture involved the mandible with 1743 fractures, followed by orbital-zygomatic-maxillary (OZM) fractures. Condylar fractures were the most commonly observed mandibular fracture. The results of the EURMAT collaboration confirm the changing trend in maxillofacial trauma epidemiology in Europe, with trauma cases caused by assaults and falls now outnumbering those due to road traffic accidents. The progressive ageing of the European population, in addition to strict road and work legislation may have been responsible for this change. Men are still the most frequent victims of maxillofacial injuries.

Acute colonic pseudo-obstruction

Abstract: Background: Acute colonic pseudo-obstruction is characterized by clinical and radiological evidence of acute large bowel obstruction in the absence of a mechanical cause. The condition usually affects elderly people with underlying co-morbidities, and early recognition and appropriate management are essential to reduce the occurrence of life-threatening complications. Methods: A part-systematic review was conducted. This was based on key publications focusing on advances in management. Results and conclusions: Although acute colonic dilatation has been suggested to result from a functional imbalance in autonomic nerve supply, there is little direct evidence for this. Other aetiologies derived from the evolving field of neurogastroenterology remain underexplored. The rationale of treatment is to achieve prompt and effective colonic decompression. Initial management includes supportive interventions that may be followed by pharmacological therapy. Controlled clinical trials have shown that the acetylcholinesterase inhibitor neostigmine is an effective treatment with initial response rates of 60–90 per cent; other drugs for use in this area are in evolution. Colonoscopic decompression is successful in approximately 80 per cent of patients, with other minimally invasive strategies continuing to be developed. Surgery has thus become largely limited to those in whom complications occur. A contemporary management algorithm is provided on this basis. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Accessory Muscles: Anatomy, Symptoms, and Radiologic Evaluation

Abstract: A wide array of supernumerary and accessory musculature has been described in the anatomic, surgical, and radiology literature. In the vast majority of cases, accessory muscles are asymptomatic and represent incidental findings at surgery or imaging. In some cases, however, accessory muscles may produce clinical symptoms. These symptoms may be related to a palpable swelling or may be the result of mass effect on neurovascular structures, typically in fibro-osseous tunnels. In cases in which an obvious cause for such symptoms is not evident, recognition and careful evaluation of accessory muscles may aid in diagnosis and treatment.