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.

An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group.

Abstract: This consensus document, a summary of the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), appraises the importance of ischaemia with non-obstructive coronary arteries (INOCA) Angina pectoris affects approximately 112 million people globally Up to 70% of patients undergoing invasive angiography do not have obstructive coronary artery disease, more common in women than in men, and a large proportion have INOCA as a cause of their symptoms INOCA patients present with a wide spectrum of symptoms and signs that are often misdiagnosed as non-cardiac leading to under-diagnosis/investigation and under-treatment INOCA can result from heterogeneous mechanism including coronary vasospasm and microvascular dysfunction and is not a benign condition Compared to asymptomatic individuals, INOCA is associated with increased incidence of cardiovascular events, repeated hospital admissions, as well as impaired quality of life and associated increased health care costs This consensus document provides a definition of INOCA and guidance to the community on the diagnostic approach and management of INOCA based on existing evidence from research and best available clinical practice; noting gaps in knowledge and potential areas for further investigation

An overview of randomised controlled trials of adjuvant chemotherapy in head and neck cancer

Abstract: Meta-analysis of the published results from 54 randomised controlled trials of adjuvant chemotherapy in head and neck cancer suggests that chemotherapy might increase absolute survival by 6.5% (95% confidence interval 3.1-9.9%). The odds ratio in favour of chemotherapy is 1.37 (95% confidence interval 1.24-1.5). Single-agent chemotherapy given synchronously with radiotherapy increased survival by 12.1% (95% confidence interval 5-19%). The benefit from neoadjuvant chemotherapy was less: a rate difference of 3.7% (95% confidence interval 0.9-6.5%). The results suggest that the investigation of optimal agents and scheduling for synchronous radiotherapy and chemotherapy might still be important in clinical trials in head and neck cancer.

Environmental tobacco smoke

Abstract: Environmental tobacco smoke is an important contaminant of indoor air. For a non- smoker living with a smoker the exposure is equivalent to about 1% of that from actively smoking 20 cigarettes a day (based on plasma cotinine).There is strong and consistent evidence that passive smoking increases the risk of lung cancer. It is estimated that there is an increase in risk of 24% (95% confidence interval 11—38%) compared to unexposed non-smokers, and several hundred lung cancer deaths per year in Britain are attributable to environmental tobacco smoke exposure. Passive smoking is associated with an increase in risk of chronic respiratory disease in adults of 25% (10—43%), and increases the risk of acute respiratory illness in children, by 50—100%. It is likely that passive smoking increases the risk of ischaemic heart disease, and that exposure in pregnancy lowers birthweight, but there is inconsistency between different estimates of the magnitude of risk.The overall hazard is sufficient to justify measures to restrict smoking in public places and workplaces, and to discourage people from smoking in their homes. Environmental tobacco smoke is probably the most important con- taminant of indoor air. It consists mainly of 'sidestream' smoke given off directly from the burning end of the cigarette; exhaled mainstream smoke is a minor component. The smoke differs in certain ways from active smoking: sidestream smoke is unfiltered (since it does not pass through the column of tobacco or the filter of the cigarette), and the nicotine is mainly in the gaseous phase in sidestream smoke and the paniculate phase in mainstream smoke. These differences notwithstanding, it is reasonable to expect in general that environmental tobacco smoke exposure, or passive smoking, would cause the same diseases as active smoking, but at a risk reduced approximately in proportion to the considerable dilution of the smoke. This expectation is secure in the case of smoking-relat ed cancers because of the evidence that carcinogens in general have no threshold. For other smoking related diseases there may plausibly be a threshold exposure level such that passive smoking constitutes too low a dose to convey any excess risk, or conceivably (though less plausibly) a near maximal response at low dose such that passive smoking conveys a risk of the same order of magnitude as active smoking.