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.

Topical interventions for genital lichen sclerosus

Abstract: A B S T R A C T Background Lichen sclerosus is a chronic, inflammatory skin condition that most commonly occurs in adult women, although it may also be seen in men and children. It primarily affects the genital area and around the anus, where it causes persistent itching and soreness. Scarring after inflammation may lead to severe damage by fusion of the vulval lips (labia); narrowing of the vaginal opening; and burying of the clitoris in women and girls, as well as tightening of the foreskin in men and boys, if treatments are not started early. Affected people have an increased risk of genital cancers. Objectives To assess the effects of topical interventions for genital lichen sclerosus and adverse effects reported in included trials. Search methods We searched the following databases up to 16 September 2011: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE (from 2005), EMBASE (from 2007), LILACS (from 1982), CINAHL(from1981), British Nursing Index andArchive(from1985), ScienceCitation Index Expanded(from1945), BIOSIS Previews (from 1926), Conference Papers Index (from 1982), and Conference Proceedings Citation Index - Science (from 1990). We also searched ongoing trial registries and scanned the bibliographies of included studies, published reviews, and papers that had cited the included studies.

Improved functional recovery by ischaemic preconditioning is not mediated by adenosine in the globally ischaemic isolated rat heart

Abstract: The experiments described in this paper were designed and performed between 1991 and 1992 when I was in the final year of my Ph.D studentship. I was introduced to preconditioning at my first American Heart Association meeting in 1989 and was fascinated that evolution had devised an endogenous protective mechanism for the heart, which was far more effective than any intervention developed by man. Not surprising really, considering that evolution has been working on stress adaptation for a couple of a million years! Since the aim of my PhD project was to extend the window of preservation for donor hearts prior to transplantation, after the AHA meeting, I began experiments to explore whether ischaemic preconditioning could provide protection over and above that provided by cardioplegia. For the transplanted heart, we felt the most important parameter for assessment was contractile function. For a heart to be weaned off cardiopulmonary bypass, contractile function must recover sufficiently to support the body. It would be somewhat irrelevant for the transplanted heart if preconditioning reduced cell necrosis but left the heart so stunned that it could not maintain a sufficient cardiac output. However, in 1989, there were no published studies specifically investigating preconditioning-induced protection against contractile dysfunction. Therefore, my initial work characterised the phenomenon of preconditioning using the isolated ejecting rat heart and contractile function as the end-point of assessment [1] before proceeding to investigate whether preconditioning could …

Azathioprine treatment photosensitizes human skin to ultraviolet A radiation.

Abstract: Background: Evidence of the impact of breast screening is limited by biases inherent in non-randomised studies and often by lack of complete population data. We address this by estimating the effect of screen detection on cause-specific fatality in breast cancer, corrected for all potential biases, using population cancer registry data. Methods: Subjects (N = 26,766) comprised all breast cancers notified to the West Midlands Cancer Intelligence Unit and diagnosed in women aged 50–74, from 1988 to 2004. These included 10,100 screen-detected and 15,862 symptomatic breast cancers (6,009 women with interval cancers and 9,853 who had not attended screening). Our endpoint was survival to death from breast cancer. We estimated the relative risk (RR) of 10-year cause-specific fatality (screen-detected compared to symptomatic cancers) correcting for lead time bias and performing sensitivity analyses for length bias. To exclude self-selection bias, survival analyses were also performed with interval cancers as the comparator symptomatic women. Findings: Uncorrected RR associated with screen-detection was 0.34 (95% CI 0.31–0.37). Correcting for lead time, RR was 0.49 (95% CI 0.45–0.53); length bias analyses gave a range of RR corrected for both phenomena of 0.49–0.59, with a median of 0.51. Self-selection bias-corrected estimates yielded a median RR of 0.68. Interpretation: After adjusting for various potential biases, women with screen-detected breast cancer have a substantial survival advantage over those with symptomatic breast cancer.

Growth hormone for in vitro fertilization

Abstract: Background In an effort to improve outcomes of in-vitro fertilisation cycles the use of growth hormone has been considered. Improving the outcomes of in-vitro fertilisation is especially important for subfertile women who are considered 'poor responders'. Objectives To assess the effectiveness of adjuvant growth hormone in in-vitro fertilisation protocols. Search strategy We searched the Cochrane Menstrual Disorders and Subfertility Groups trials register (June 2009), the Cochrane Central Register of Controlled Trials (Cochrane Library Issue 2, 2009), MEDLINE (1966 to June 2009), EMBASE (1988 to June 2009) and Biological Abstracts (1969 to June 2009). Selection criteria All randomised controlled trials were included if they addressed the research question and provided outcome data for intervention and control participants. Data collection and analysis Assessment of trial risk of bias and extraction of relevant data was performed independently by two reviewers. Main results Ten studies (440 subfertile couples) were included. Results of the meta-analysis demonstrated no difference in outcome measures and adverse events in the routine use of adjuvant growth hormone in in-vitro fertilisation protocols. However, meta-analysis demonstrated a statistically significant difference in both live birth rates and pregnancy rates favouring the use of adjuvant growth hormone in in-vitro fertilisation protocols in women who are considered poor responders without increasing adverse events, OR 5.39, 95% CI 1.89 to 15.35 and OR 3.28, 95% CI 1.74 to 6.20 respectively. Authors' conclusions Although the use of growth hormone in poor responders has been found to show a significant improvement in live birth rates, we were unable to identify which sub-group of poor responders would benefit the most from adjuvant growth hormone. The result needs to be interpreted with caution, the included trials were few in number and small sample size. Therefore, before recommending growth hormone adjuvant in in-vitro fertilisation further research is necessary to fully define its role.