St Bartholomew's Hospital

About: St Bartholomew's Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Cancer. The organization has 11054 authors who have published 13229 publications receiving 501102 citations. The organization is also known as: St. Bartholomew's Hospital & The Royal Hospital of St Bartholomew.

Frequency of the Bcl-2/IgH Rearrangement in Normal Individuals: Implications for the Monitoring of Disease in Patients With Follicular Lymphoma

Abstract: PURPOSE: To determine the incidence and frequency of the Bcl-2/IgH rearrangement in the peripheral blood of normal individuals to define the potential complication this may pose for the molecular monitoring of disease in patients with follicular lymphoma (FL). MATERIALS AND METHODS: The incidence and frequency of the major breakpoint cluster region rearrangement in DNA extracted from peripheral blood or lymphoblastoid cell lines from 481 normal individuals was determined using a TaqMan real-time polymerase chain reaction assay (PE Applied Biosystems, Foster City, CA). RESULTS: Twenty three percent of samples were positive for the Bcl-2/IgH rearrangement, with approximately 3% of these at levels of more than 1 in 104 cells. CONCLUSION: The presence of circulating Bcl-2/IgH+ cells, other than those derived from the malignant clone, could confound the detection and quantitation of minimal residual disease in patients with FL, particularly at low levels of tumor burden.

Left ventricular hypertrophy and ambulatory blood pressure monitoring in chronic renal failure.

Abstract: was statistically significantly stronger than with outpatient systolic BP (r=0.25, 95% confidence Background. Left ventricular hypertrophy (LVH ) is both common and an important predictor of risk of interval 0.23-0.27). The same was true for the correla- tion between LVMI and mean 24-h ambulatory dia- death in end-stage renal failure ( ESRF ). In mild to moderate chronic renal failure (CRF ), the timing of stolic BP (r=0.42, 95% confidence interval 0.40-0.44), and outpatient diastolic BP (r=0.22, 95% confidence onset of LVH and the factors involved in its initial development have not been fully elucidated. The pre- interval 0.20-0.24). Conclusions. Twenty-four hour ambulatory BP record- sent study was undertaken to examine the prevalence and potential determinants of echocardiographically ing and echocardiography are required for accurate diagnosis of inadequate BP control and early LVH in determined LVH in this connection, and to compare 24-h ambulatory blood pressure ( BP) recordings with patients with chronic renal impairment, independent determinants of which are hypertension, male sex, BP measured at a previous clinic visit. Methods. From a cohort of 120 non-diabetic patients BMI, and anaemia. who had been attending a nephrology clinic, 118 agreed to participate in the study. Of these we selected for chronic renal failure (CRF ); hypertension; left ventri- analysis 85 stable patients (37 male). Patients with cular hypertrophy ( LVH ) known cardiovascular disease, those with a history of poor compliance with antihypertensive medication, and those in whom such medication had been changed in the previous 3 months were excluded. Clinic BP, Introduction 24-h ambulatory BP, echocardiography, body mass index (BMI ), serum creatinine (SCr), creatinine clear- Cardiovascular disease is the leading cause of death in ance (CrCl ), haemoglobin ( Hb), fasting cholesterol patients on renal replacement therapy (1-3). Left vent- (CHOL), triglyceride TRlGL), plasma glucose, calcium ricular hypertrophy (LVH ) is a strong predictor of (Ca), phosphate ( PO 4 ), alkaline phosphatase (ALK myocardial infarction, cardiac failure, sudden death, PHOS ), parathyroid hormone (PTH ) concentrations, and stroke in patients with essential hypertension and and 24-h urinary protein were assessed in all patients. normal renal function and those with end-stage renal Seventy-seven per cent were on antihypertensive disease ( ESRD) (4-7). LVH is common in ESRD and medication. frequently predates the initiation of dialysis treatment Results. LVH was detected in 16% of patients with (7-9 ), suggesting that the factors responsible may be CrCL >30 ml/min, and 38% of patients with CrCl present in early renal impairment. Information regard- <30 ml/min. By stepwise regression analysis, ambulat- ing the stage of renal impairment at which LVH occurs, ory systolic BP (P<0.0001), male gender (P<0.0001), the important factors involved in its initial develop- BMI (P<0.0002), and Hb concentration (P<0.002) ment, and optimum monitoring and management are were the only independent determinants of left ventri- scant. cular (LV ) mass. Nocturnal systolic BP (P<0.02) was A number of factors potentially affecting cardiovas- the main determinant of LVH in the group of patients cular outcome have been postulated or defined in with advanced CRF. The correlation between left patients with ESRD (3,7-14 ), but these have not been ventricular mass index (LVMI ) and mean 24-h ambu- assessed thoroughly in moderate renal impairment. latory systolic BP (r=0.52, 95% confidence interval The 24-h ambulatory BP profile in patients with CRF, those on haemodialysis, and renal transplant recipients

Late adverse reactions to intravascular iodinated contrast media.

Abstract: Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 8th European Symposium on Urogenital Radiology in Genoa. Late adverse reactions after intravascular iodinated contrast medium include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. A significant proportion of these reactions is unrelated to the contrast medium; however, allergy-like skin reactions are well-documented side effects of contrast media with an incidence of approximately 2%. Late reactions appear to be commoner after non-ionic dimers. The majority of late skin reactions after contrast medium exposure are probably T-cell-mediated allergic reactions. Patients at increased risk of late skin reactions are those with a history of previous contrast medium reaction and those on interleukin-2 treatment. Most skin reactions are self-limiting and resolve within a week. Management is symptomatic and similar to the management of other drug-induced skin reactions.

Adrenocortical carcinoma: the range of appearances on CT and MRI.

Abstract: OBJECTIVE. Adrenocortical carcinoma (ACC) is a rare, aggressive tumor arising from the adrenal cortex that typically presents late with a large mass. The increased use of cross-sectional imaging for unrelated reasons has led to a greater number of ACCs being detected incidentally at an earlier stage. Recognition of the typical clinical, biochemical, and imaging findings is imperative for rapid diagnosis, prompt intervention, and early use of the appropriate therapy. CONCLUSION. Cross-sectional imaging with CT and MRI is essential for determining the extent of local and distant tumor spread. Complete surgical resection is currently the only potentially curative treatment of ACC, and the information attained from CT and MRI is important to guide surgery and further patient management.

Superoxide anions enhance platelet adhesion and aggregation.

Abstract: 1. Superoxide dismutase (SOD, 60 u ml-1) or ferricytochrome c (70 microM) significantly inhibited thrombin-stimulated platelet adhesion to gelatin-coated plastic, whereas catalase (1000 u ml-1) or mannitol (1 mM) had no effect. 2. The platelet aggregation induced by low concentrations of thrombin (causing less than 45% maximal change in light transmission) was inhibited by SOD. Catalase or mannitol had no effect on platelet aggregation. 3. Pyrogallol (an O2- generator) enhanced both platelet adhesion to gelatin-coated plastic and platelet aggregation induced by thrombin; this enhancement was neutralized by SOD. 4. These results indicate that O2- increase both platelet adhesion and aggregation, whereas other free radicals such as hydrogen peroxide or hydroxyl radicals are not involved.