St Thomas' Hospital

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.

Selected oxidized fragrance terpenes are common contact allergens

Abstract: Terpenes are widely used fragrance compounds in fine fragrances, but also in domestic and occupational products. Terpenes oxidize easily due to autoxidation on air exposure. Previous studies have shown that limonene, linalool and caryophyllene are not allergenic themselves but readily form allergenic products on air-exposure. This study aimed to determine the frequency and characteristics of allergic reactions to selected oxidized fragrance terpenes other than limonene. In total 1511 consecutive dermatitis patients in 6 European dermatology centres were patch tested with oxidized fragrance terpenes and some oxidation fractions and compounds. Oxidized linalool and its hydroperoxide fraction were found to be common contact allergens. Of the patients tested, 1.3% showed a positive reaction to oxidized linalool and 1.1% to the hydroperoxide fraction. About 0.5% of the patients reacted to oxidized caryophyllene whereas 1 patient reacted to oxidized myrcene. Of the patients reacting to the oxidized terpenes, 58% had fragrance-related contact allergy and/or a positive history for adverse reaction to fragrances. Autoxidation of fragrance terpenes contributes greatly to fragrance allergy, which emphasizes the need of testing with compounds that patients are actually exposed to and not only with the ingredients originally applied in commercial formulations.

The management and outcome of anastomotic leaks in colorectal surgery.

Abstract: Purpose Anastomotic leaks in colorectal surgery areassociated with significant morbidity and mortality andmay result in poor functional and oncological outcomes.Diagnostic difficulties may delay identification andappropriate management of leaks. The aim of this studywas to look at the diagnosis, clinical management andoutcomes of anastamotic leaks in our department.Method A retrospective audit and case note review of allpatients who underwent the formation of a colorectalanastomosis between January 1996 and December 2002(n = 1421) was performed. An anastomotic leak wasdefined as sepsis identified to have arisen from ananastomosis that subsequently required surgery, radio-logical drainage or intravenous antibiotics. Forty-onepatients (25 male, 16 female) with a median age of60 years (range 7–89 years) were identified as havingsuffered an anastomotic leak.Results The median time to diagnosis of an anastomoticleak following surgery was 7 days (range 3–29). Atre-operation, 21 patients (51%) underwent formation ofa stoma, and any who required the anastomosis to beformally taken down have been left with a ‘permanent’stoma. Currently only four of 12 patients (33%) whorequired a stoma for an anastomotic leak followinganterior resection have undergone stoma reversal. Elevenof 16 patients (69%) who had received a stoma followinganother colorectal procedure had undergone stomareversal. The mortality associated with an anastamoticleak in this series was 5% (n = 2).Conclusion Although anastomotic leaks following colo-rectal surgery are associated with significant morbidityand stoma formation, early and aggressive managementshould result in a low overall mortality. If an anastomosisis taken down following an anastomotic leak after anteriorresection, this will usually result in a ‘permanent’ stoma.Keywords anastomosis, leak, stoma, anterior resection

Na+/Ca2+ exchange and Na+/K+-ATPase in the heart.

Abstract: This paper is the third in a series of reviews published in this issue resulting from the University of California Davis Cardiovascular Symposium 2014: Systems approach to understanding cardiac excitation-contraction coupling and arrhythmias: Na(+) channel and Na(+) transport. The goal of the symposium was to bring together experts in the field to discuss points of consensus and controversy on the topic of sodium in the heart. The present review focuses on cardiac Na(+)/Ca(2+) exchange (NCX) and Na(+)/K(+)-ATPase (NKA). While the relevance of Ca(2+) homeostasis in cardiac function has been extensively investigated, the role of Na(+) regulation in shaping heart function is often overlooked. Small changes in the cytoplasmic Na(+) content have multiple effects on the heart by influencing intracellular Ca(2+) and pH levels thereby modulating heart contractility. Therefore it is essential for heart cells to maintain Na(+) homeostasis. Among the proteins that accomplish this task are the Na(+)/Ca(2+) exchanger (NCX) and the Na(+)/K(+) pump (NKA). By transporting three Na(+) ions into the cytoplasm in exchange for one Ca(2+) moved out, NCX is one of the main Na(+) influx mechanisms in cardiomyocytes. Acting in the opposite direction, NKA moves Na(+) ions from the cytoplasm to the extracellular space against their gradient by utilizing the energy released from ATP hydrolysis. A fine balance between these two processes controls the net amount of intracellular Na(+) and aberrations in either of these two systems can have a large impact on cardiac contractility. Due to the relevant role of these two proteins in Na(+) homeostasis, the emphasis of this review is on recent developments regarding the cardiac Na(+)/Ca(2+) exchanger (NCX1) and Na(+)/K(+) pump and the controversies that still persist in the field.