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Institution

St Thomas' Hospital

HealthcareLondon, United Kingdom
About: St Thomas' Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Pregnancy. The organization has 12105 authors who have published 15596 publications receiving 624309 citations. The organization is also known as: St Thomas's Hospital & St. Thomas's.


Papers
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Journal ArticleDOI
TL;DR: The overall picture in this case was one of systemic malaria infection that fit the WHO classification for severe malaria, including cerebral pathology, which suggests that further study of knowlesi malaria will aid the interpretation of, often conflicting, information on malaria pathophysiology in humans.
Abstract: Background: Zoonotic malaria caused by Plasmodium knowlesi is an important, but newly recognized, human pathogen. For the first time, post-mortem findings from a fatal case of knowlesi malaria are reported here. Case presentation: A formerly healthy 40 year-old male became symptomatic 10 days after spending time in the jungle of North Borneo. Four days later, he presented to hospital in a state of collapse and died within two hours. He was hyponatraemic and had elevated blood urea, potassium, lactate dehydrogenase and amino transferase values; he was also thrombocytopenic and eosinophilic. Dengue haemorrhagic shock was suspected and a postmortem examination performed. Investigations for dengue virus were negative. Blood for malaria parasites indicated hyperparasitaemia and single species P. knowlesi infection was confirmed by nested-PCR. Macroscopic pathology of the brain and endocardium showed multiple petechial haemorrhages, the liver and spleen were enlarged and lungs had features consistent with ARDS. Microscopic pathology showed sequestration of pigmented parasitized red blood cells in the vessels of the cerebrum, cerebellum, heart and kidney without evidence of chronic inflammatory reaction in the brain or any other organ examined. Brain sections were negative for intracellular adhesion molecule-1. The spleen and liver had abundant pigment containing macrophages and parasitized red blood cells. The kidney had evidence of acute tubular necrosis and endothelial cells in heart sections were prominent. Conclusions: The overall picture in this case was one of systemic malaria infection that fit the WHO classification for severe malaria. Post-mortem findings in this case were unexpectedly similar to those that define fatal falciparum malaria, including cerebral pathology. There were important differences including the absence of coma despite petechial haemorrhages and parasite sequestration in the brain. These results suggest that further study of knowlesi malaria will aid the interpretation of, often conflicting, information on malaria pathophysiology in humans.

185 citations

Journal ArticleDOI
TL;DR: It is confirmed that CNS disease in SLE is significantly associated with the presence of aPL antibodies, and the CNS manifestations can occur in about half of SLE patients without any other evidence of lupus activity.

185 citations

Journal ArticleDOI
TL;DR: A novel biotinylated derivative of dimedone is synthesized, keeping the dione cassette required for sulfenate reactivity but adding the functionality of a biotin tag, highlighting the protein sulfenates as oxygen sensors in hearts loaded and subjected to hypoxia.

184 citations

Journal ArticleDOI
TL;DR: The aim of this work was to extend a technique based on optical tracking to register MR and X-ray images obtained from the sliding table XMR configuration by providing an improved calibration stage, real-time guidance during cardiovascular catheterization procedures, and further off-line analysis for mapping cardiac electrical data to patient anatomy.
Abstract: The hybrid magnetic resonance (MR)/X-ray suite (XMR) is a recently introduced imaging solution that provides new possibilities for guidance of cardiovascular catheterization procedures. We have previously described and validated a technique based on optical tracking to register MR and X-ray images obtained from the sliding table XMR configuration. The aim of our recent work was to extend our technique by providing an improved calibration stage, real-time guidance during cardiovascular catheterization procedures, and further off-line analysis for mapping cardiac electrical data to patient anatomy. Specially designed optical trackers and a dedicated calibration object have resulted in a single calibration step that can be efficiently checked and updated before each procedure. An X-ray distortion model has been implemented that allows for distortion correction for arbitrary c-arm orientations. During procedures, the guidance system provides a real-time combined MR/X-ray image display consisting of live X-ray images with registered recently acquired MR derived anatomy. It is also possible to reconstruct the location of catheters seen during X-ray imaging in the MR derived patient anatomy. We have applied our registration technique to 13 cardiovascular catheterization procedures. Our system has been used for the real-time guidance of ten radiofrequency ablations and one aortic stent implantation. We demonstrate the real-time guidance using two exemplar cases. In a further two cases we show how off-line analysis of registered image data, acquired during electrophysiology study procedures, has been used to map cardiac electrical measurements to patient anatomy for two different types of mapping catheters. The cardiologists that have used the guidance system suggest that real-time XMR guidance could have substantial value in difficult interventional and electrophysiological procedures, potentially reducing procedure time and delivered radiation dose. Also, the ability to map measured electrical data to patient specific anatomy provides improved visualization and a path to investigation of cardiac electromechanical models.

184 citations


Authors

Showing all 12132 results

NameH-indexPapersCitations
David J. Hunter2131836207050
Rory Collins162489193407
Steven Williams144137586712
Geoffrey Burnstock141148899525
Nick C. Fox13974893036
Christopher D.M. Fletcher13867482484
David A. Jackson136109568352
Paul Harrison133140080539
Roberto Ferrari1331654103824
David Taylor131246993220
Keith Hawton12565755138
Nicole Soranzo12431674494
Roger Williams122145572416
John C. Chambers12264571028
Derek M. Yellon12263854319
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20237
202235
2021654
2020595
2019485
2018462