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.

Clinical and experimental studies on the action of prostaglandins and their synthesis inhibitors on detrusor muscle in vitro and in vivo.

Abstract: Summary Experiments on muscle strips have shown that prostaglandin is naturally produced by the detrusor, and acts to increase the tone and spontaneous activity. An intimate relation between acetylcholine and prostaglandin has been demonstrated. Therapeutic application of prostaglandins has been successful in the treatment of chronic retention in women. Upjohn Limited kindly supplied the prostaglandin E2. This work was supported by a grant from the Endowment Fund of St Thomas's Hospital, and the muscle strip experiments were carried out in the Department of Pharmacology.

The risk of psoriatic arthritis remains constant following initial diagnosis of psoriasis among patients seen in European dermatology clinics.

Abstract: Background Estimates of psoriatic arthritis (PsA) prevalence among psoriasis patients vary widely (5-40%). The time to development of PsA in patients with plaque psoriasis also remains unclear. Objectives To examine whether length of time since diagnosis of psoriasis affects risk of developing PsA, and to assess differences in quality of life (QoL), work-related issues, comorbidities and healthcare resource utilization (HCRU) for patients with PsA vs. psoriasis. Methods This large cross-sectional observational study was conducted in the UK, Italy, France, Spain and Germany in 2006. Dermatologists who actively treated patients with psoriasis recruited 10 consecutive patients with psoriasis. Presence of PsA, body surface area (BSA) affected with psoriasis and HCRU were recorded; patients completed EUROQoL (EQ5D) and employment disadvantages questionnaires. Results Patients with psoriasis (n = 1560) included 126 with PsA. Ninety per cent of these patients with PsA were seen by dermatologists who involved a rheumatologist in the care of their patients with PsA. Survival analysis indicated that the incidence of PsA among psoriasis patients remained constant (74 per 1000 person-years), while the prevalence increased with time since diagnosis of psoriasis, reaching 20.5% after 30 years. In addition, those with high BSA currently affected by psoriasis were more likely to have developed PsA (P < 0.028). PsA patients reported reduced QoL compared with psoriasis patients (EQ5D score: 0.56 vs. 0.82: P < 0.0005), as well as more work problems. PsA patients were more likely to be hospitalized (0.27 +/- 0.84 vs. 0.14 +/- 0.71 per year; P < 0.0005) and have additional comorbidities than those without PsA. Conclusions The incidence of PsA was constant after initial diagnosis of psoriasis, leading to a higher prevalence of concomitant PsA over time. PsA is associated with decreased QoL and increased work-related problems, HCRU and comorbidities. Dermatologists should screen for PsA in their patients, especially long-standing patients who did not initially present with PsA.

A comparison of the effects of noxious and innocuous counterstimuli on experimentally induced itch and pain

Abstract: We have studied experimentally induced itch (using histamine iontophoresis) and pain (using topical mustard oil) in healthy human volunteers, measured using visual analogue scale (VAS) ratings. The effects of the following counterstimuli were evaluated: innocuous vibration; innocuous transcutaneous electrical nerve stimulation (TENS); innocuous warming of skin; noxious heating of skin; noxious chemical skin stimulation (using mustard oil); mildly noxious constant current transdermal electrical stimulation. Inncuous stimuli applied 2 min after histamine or mustard oil challenge produced a moded reduction of itch and pain ratings (20–30%), which did not persist for more than 20 sec when the counterstimuli were removed. These changes may well be due to distraction. The same stimuli (in some cases applied for periods of up to 1 h) given prior to the histamine or mustard oil, produced no significant reduction in evoked itch or pain. Noxious stimuli of all types applied 2 after histamine or mustard oil challenge produced a consistent and significant inhibition of itch (22.8–52.7%) which outlasted the period of counterstimulation application. In contrast, these stimuli had no significant effects on chemically induced pain. The anti-pruritic state produced by brief noxious stimuli were effective for periods of more than 30 min. The differential effects of noxious counterstimuli on itch and pain do not support the suggestion that itch is a subliminal form of pain. Noxious counterstimuli are likely to act via a central rather than peripheral mechanism. The novel finding that a persistent anti-pruritic state can be induced by transdermal constant current may be useful in conditions of clinical itch.