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.

Paravertebral somatic nerve block: a clinical, radiographic, and computed tomographic study in chronic pain patients.

Abstract: The spread of solution after a standardized paravertebral injection was studied to determine the precision and predictability of paravertebral spread. The spread of 5 ml of a solution of radiological contrast medium (sodium iothala-mate) and local anesthetic mixture after 45 (34 thoracic, 11 lumbar)

Bleeding and Recurrent Thrombosis in Definite Antiphospholipid Syndrome: Analysis of a Series of 66 Patients Treated With Oral Anticoagulation to a Target International Normalized Ratio of 3.5

Abstract: Background Prolonged anticoagulation is the treatment of choice for patients with thrombosis and the antiphospholipid syndrome However, there is still debate about the optimum intensity of anticoagulation Methods The study included 66 patients with antiphospholipid syndrome (Sapporo criteria) and previous thrombosis All were receiving oral anticoagulation to a target international normalized ratio of 35 Every patient was individually interviewed to recall major bleeding and thrombotic episodes during the previous 12 months Results Patients were mainly women and white The rate of major bleeding was 6 cases per 100 patient-years (95% confidence interval [CI] 16-150) The rate of intracranial bleed was 15 per 100 patient-years (95% CI, 004-84) None of the bleeding episodes was fatal The rate of thrombotic recurrences was 91 cases per 100 patient-years (95% CI, 33-196) Most recurrences took place in the same vascular bed as the original thrombosis Age, time receiving anticoagulant therapy, primary vs secondary antiphospholipid syndrome, positivity for anticardiolipin antibodies, positivity for lupus anticoagulant, previous arterial thrombosis, previous stroke, previous venous thrombosis, and previous thrombocytopenia were not predictive of bleeding events However, the risk of thrombotic recurrences was independently higher in patients who were receiving anticoagulation for longer periods Conclusions The risk of intracranial and fatal bleeding in patients with definite antiphospholipid syndrome and previous thrombosis treated with oral anticoagulation to a target international normalized ratio of 35 is similar than in groups of patients treated to lower target ratios The risk of thrombotic recurrences, even during anticoagulation, was high Most recurrences took place in the same territory as original thromboses

Regurgitation and oesophageal rupture with cricoid pressure: a cadaver study.

Abstract: The efficacy of cricoid pressure was studied in 10 adult cadavers. The oesophageal pressure that would result in regurgitation during measured values of cricoid pressure was determined. Oesophageal pressure, recorded by a 2 mm diameter oesophageal tube, was increased by oesophageal distension with saline, and incremental levels of cricoid force, 20, 30 and 40 Newtons, were applied with a cricoid yoke. With each 10 Newton increment of cricoid force there was a significant rise in the oesophageal pressure required to provoke regurgitation (p < 0.01). Thirty Newtons of cricoid force prevented regurgitation of saline in all cadavers with oesophageal pressures of up to 40 mmHg. Rupture of the oesophagus occurred in three cadavers: one at 30 and two at 40 Newtons of cricoid force, but there was no rupture at 20 Newtons of cricoid force. In the other seven cadavers oesophageal pressures were also studied with a 4.6 mm diameter (14 FG) oesophageal tube, which did not reduce the efficacy of cricoid pressure in preventing regurgitation.