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Kim DH, Wit H, Thurston M, Long M, Maskell GF, Strugnell MJ, Shetty D, Smith IM, Hollings NP. An artificial intelligence deep learning model for identification of small bowel obstruction on plain abdominal radiographs. Br J Radiol 2021; 94:20201407. [PMID: 33904763 PMCID: PMC8173678 DOI: 10.1259/bjr.20201407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objectives: Small bowel obstruction is a common surgical emergency which can lead to bowel necrosis, perforation and death. Plain abdominal X-rays are frequently used as a first-line test but the availability of immediate expert radiological review is variable. The aim was to investigate the feasibility of using a deep learning model for automated identification of small bowel obstruction. Methods: A total of 990 plain abdominal radiographs were collected, 445 with normal findings and 445 demonstrating small bowel obstruction. The images were labelled using the radiology reports, subsequent CT scans, surgical operation notes and enhanced radiological review. The data were used to develop a predictive model comprising an ensemble of five convolutional neural networks trained using transfer learning. Results: The performance of the model was excellent with an area under the receiver operator curve (AUC) of 0.961, corresponding to sensitivity and specificity of 91 and 93% respectively. Conclusion: Deep learning can be used to identify small bowel obstruction on plain radiographs with a high degree of accuracy. A system such as this could be used to alert clinicians to the presence of urgent findings with the potential for expedited clinical review and improved patient outcomes. Advances in knowledge: This paper describes a novel labelling method using composite clinical follow-up and demonstrates that ensemble models can be used effectively in medical imaging tasks. It also provides evidence that deep learning methods can be used to identify small bowel obstruction with high accuracy.
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Affiliation(s)
- D H Kim
- The Department of Clinical Imaging, The Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - H Wit
- The Medical Imaging Department, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - M Thurston
- The Department of Clinical Imaging, The Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - M Long
- The Department of Clinical Imaging, The Royal Cornwall Hospitals NHS Trust, Truro, UK.,The Medical Imaging Department, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - G F Maskell
- The Department of Clinical Imaging, The Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - M J Strugnell
- The Department of Clinical Imaging, The Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - D Shetty
- The Department of Clinical Imaging, The Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - I M Smith
- The Department of General Surgery, The Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - N P Hollings
- The Department of Clinical Imaging, The Royal Cornwall Hospitals NHS Trust, Truro, UK
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Larcombe L, Hendricusdottir R, Attwood TK, Bacall F, Beard N, Bellis LJ, Dunn WB, Hancock JM, Nenadic A, Orengo C, Overduin B, Sansone SA, Thurston M, Viant MR, Winder CL, Goble CA, Ponting CP, Rustici G. ELIXIR-UK role in bioinformatics training at the national level and across ELIXIR. F1000Res 2017; 6. [PMID: 28781748 PMCID: PMC5521157 DOI: 10.12688/f1000research.11837.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2017] [Indexed: 11/20/2022] Open
Abstract
ELIXIR-UK is the UK node of ELIXIR, the European infrastructure for life science data. Since its foundation in 2014, ELIXIR-UK has played a leading role in training both within the UK and in the ELIXIR Training Platform, which coordinates and delivers training across all ELIXIR members. ELIXIR-UK contributes to the Training Platform’s coordination and supports the development of training to address key skill gaps amongst UK scientists. As part of this work it acts as a conduit for nationally-important bioinformatics training resources to promote their activities to the ELIXIR community. ELIXIR-UK also leads ELIXIR’s flagship Training Portal, TeSS, which collects information about a diverse range of training and makes it easily accessible to the community. ELIXIR-UK also works with others to provide key digital skills training, partnering with the Software Sustainability Institute to provide Software Carpentry training to the ELIXIR community and to establish the Data Carpentry initiative, and taking a lead role amongst national stakeholders to deliver the StaTS project – a coordinated effort to drive engagement with training in statistics.
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Affiliation(s)
- L Larcombe
- MRC Human Genetics Unit, The Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - R Hendricusdottir
- MRC Human Genetics Unit, The Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - T K Attwood
- School of Computer Science, University of Manchester, Manchester, M13 9PL, UK
| | - F Bacall
- School of Computer Science, University of Manchester, Manchester, M13 9PL, UK
| | - N Beard
- School of Computer Science, University of Manchester, Manchester, M13 9PL, UK
| | - L J Bellis
- Department of Genetics, University of Cambridge, Cambridge, CB2 3EH, UK
| | - W B Dunn
- Birmingham Metabolomics Training Centre, School of Biosciences, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - A Nenadic
- The Software Sustainability Institute, University of Manchester, Manchester, M13 9PL, UK
| | - C Orengo
- University College London, London, WC1E 6BT, UK
| | - B Overduin
- Edinburgh Genomics, University of Edinburgh, Edinburgh, EH9 3FL, UK
| | - S-A Sansone
- Oxford e-Research Centre, University of Oxford, Oxford, OX1 3QG, UK
| | - M Thurston
- Oxford e-Research Centre, University of Oxford, Oxford, OX1 3QG, UK
| | - M R Viant
- Birmingham Metabolomics Training Centre, School of Biosciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - C L Winder
- Birmingham Metabolomics Training Centre, School of Biosciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - C A Goble
- School of Computer Science, University of Manchester, Manchester, M13 9PL, UK
| | - C P Ponting
- MRC Human Genetics Unit, The Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - G Rustici
- Department of Genetics, University of Cambridge, Cambridge, CB2 3EH, UK
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Perry C, Thurston M. Early development of childhood overweight: a 2012 qualitative study of the process of infant weaning in Halton, United Kingdom. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku165.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Buyuktuncer Z, Kearney M, Ryan CL, Thurston M, Ellahi B. Fruit and vegetables on prescription: a brief intervention in primary care. J Hum Nutr Diet 2013; 27 Suppl 2:186-93. [PMID: 23651065 DOI: 10.1111/jhn.12109] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Increasing fruit and vegetable consumption is a goal for the U.K. Therefore, the effectiveness of a fruit and vegetable voucher scheme coupled with key 'five-a-day' consumption messages as a brief intervention in primary care consultations was assessed in the present study. METHODS One thousand one hundred and eighty-eight vouchers as a prescription for fruits and vegetables were routinely distributed to patients attending a primary healthcare centre in a deprived area, and 124 volunteer patients routinely attending the centre were included. Telephone-based questionnaires were used to examine changes in consumption over the short and medium term. Other key aspects assessed in the evaluation related to fruit and vegetable purchasing behaviour, knowledge relating to what constitutes a portion size, the relationship between food and health, and barriers to consumption. RESULTS Although 76.2% of participants used the prescription vouchers when purchasing fruits and vegetables, a significant change in the consumption or purchasing behaviour was not observed (P > 0.05). Participants' level of knowledge relating to the number of portions recommended and the portion size of different fruits and vegetables showed a moderate increase from baseline over the short and medium term. The primary barriers to fruit and vegetable consumption were reported as 'the quality of fresh fruits and vegetables' and 'the money available to spend on food'. CONCLUSIONS The use of 'the fruit and vegetable on prescription' scheme was an effective method of engaging participants in improving awareness of key diet-related health messages. However, further intervention is required to produce a significant impact on the actual behaviour change.
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Affiliation(s)
- Z Buyuktuncer
- Department of Clinical Sciences, Faculty of Applied Sciences, University of Chester, Chester, UK; Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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5
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Lucky A, Marshall K, Bush C, Thurston M, Graeber M, Cherill R. SDZ ASM 981 cream 1% is effective and safe in children and adolescents with atopic dermatitis. Clin Exp Dermatol 2008. [DOI: 10.1046/j.1365-2230.2001.00802-14.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
INTRODUCTION In the UK, young people have been identified as a specific group who experience poor sexual health and there is scope for improving this if sexual health services are sensitive and relevant to their needs. This paper reports on the work of two services which were set up specifically for young people, exploring whether the model of service provision adopted was successful in engaging this group. METHODS Routine monitoring data (anonymous) in relation to all contacts with the services were collected. After the services had become established, short questionnaires were administered to young people using them. RESULTS For service one, 425 contacts were recorded over 34 service sessions. Of these, 149 were new clients: 52% young men (78) and 48% young women (71), with a mean age of 14 years. There were 259 repeat contacts: 74% with young men (191) and 26% with young women (68). For service two, 399 contacts were recorded over 61 service sessions. Of these, 118 were new clients: 32% young men (38) and 68% young women (80), with a mean age of 16.8 years. There were 274 repeat contacts: 40% with young men (108) and 60% (166) with young women. All of the young people were generally very satisfied with the services they received. The youngest young people were less likely to indicate that they would have accessed other sexual health services. DISCUSSION AND CONCLUSIONS This study indicates that young people of both sexes, between the ages of 11 and 19 years, can be engaged by sexual health services, if provision is modelled on 'best practice' and what is known about the sexual health service needs of young people. Engagement with such services is a prerequisite for addressing the diversity of sexual health needs young people are likely to have in contemporary society and the findings of this study in relation to gender and age are particularly pertinent.
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Affiliation(s)
- C Perry
- Centre for Public Health Research, University of Chester, Chester, UK.
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Kearney M, Bradbury C, Ellahi B, Hodgson M, Thurston M. Mainstreaming prevention: prescribing fruit and vegetables as a brief intervention in primary care. Public Health 2005; 119:981-6. [PMID: 16185735 DOI: 10.1016/j.puhe.2005.08.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2005] [Indexed: 11/29/2022]
Abstract
UNLABELLED This paper examines a brief preventive intervention as a model for embedding public health action in primary care. BACKGROUND Low fruit and vegetable intake is a major risk factor for cancer, coronary heart disease and stroke. The recommended intake of five portions per day would reduce death rates from these causes by 20%. However, average daily consumption in the UK is under three portions, and it is significantly lower in men, young people and lower socio-economic groups. In order to tackle risk factors such as poor diet, the white paper Choosing Health promises action and funding to mainstream prevention and transform the NHS from a sickness service to a genuine health service. THE INTERVENTION To promote increased fruit and vegetable consumption, primary care professionals working in a deprived area issue prescriptions which offer the patient discounts on fruit and vegetable purchases. Hand over of each prescription to the patient is linked explicitly to key five a day messages. This brief intervention takes 1-2 min to deploy. IMMEDIATE OUTCOMES Evaluation is ongoing. However, early feedback suggests that the intervention of prescription plus key messages has a significant impact on patients in highlighting the connection between food and health. Clinicians express satisfaction at having a preventive intervention that can be deployed with confidence and consistency in routine primary care consultations. DISCUSSION This brief intervention is presented as a potential model for embedding prevention in the day-to-day work of health professionals. Primary care is a natural setting for the promotion of health, but despite success in implementing some public health programmes, it has a patchy record in primary prevention. The reasons for this are examined, the impact of new contractual and commissioning levers is explored, and a general framework for mainstreaming public health action in primary care is proposed.
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Affiliation(s)
- M Kearney
- Castlefields Health Centre, Chester Close, Runcorn, and Community Studies Unit, School of Medical Education, University of Liverpool, Liverpool L69 3GH, UK.
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8
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Luger T, Van Leent EJ, Graeber M, Hedgecock S, Thurston M, Kandra A, Berth-Jones J, Bjerke J, Christophers E, Knop J, Knulst AC, Morren M, Morris A, Reitamo S, Roed-Petersen J, Schoepf E, Thestrup-Pedersen K, Van Der Valk PG, Bos JD. SDZ ASM 981: an emerging safe and effective treatment for atopic dermatitis. Br J Dermatol 2001; 144:788-94. [PMID: 11298538 DOI: 10.1046/j.1365-2133.2001.04134.x] [Citation(s) in RCA: 140] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND SDZ ASM 981 is a selective inhibitor of the production of pro-inflammatory cytokines from T cells and mast cells in vitro. It is the first ascomycin macrolactam derivative under development for the treatment of inflammatory skin diseases. OBJECTIVES This study was designed to determine the safety and efficacy of SDZ ASM 981 cream at concentrations of 0.05%, 0.2%, 0.6% and 1.0% in the treatment of patients with atopic dermatitis and to select the concentration to be used in phase III studies. METHODS This was a double-blind, randomized, parallel-group, multicentre dose-finding study. A total of 260 patients were randomly assigned to treatment with SDZ ASM 981 cream at concentrations of 0.05%, 0.2%, 0.6%, or 1.0%, matching vehicle cream, or the internal control 0.1% betamethasone-17-valerate cream (BMV). Treatment was given twice daily for up to 3 weeks. RESULTS A clear dose-response relationship for SDZ ASM 981 was evident, with 0.2%, 0.6% and 1.0% SDZ ASM 981 creams all being significantly more effective than vehicle (P = 0.041, 0.001 and 0.008, respectively) in terms of baseline to end-point changes in the Eczema Area Severity Index (EASI) and pruritus score. The 1.0% cream was the most effective SDZ ASM 981 concentration. BMV was more effective than the SDZ ASM 981 creams tested in this study. It appears that the efficacy plateau was not reached with the SDZ ASM 981 creams within 3 weeks treatment. SDZ ASM 981 was well tolerated. Burning or a feeling of warmth were the only adverse events reported more frequently in the 0.6% and 1.0% SDZ ASM 981 treatment groups than in the vehicle treatment group (42.9%, 48.9% and 34.9%, respectively). Few systemic adverse events were reported during the study (headache was the most frequent systemic event reported by 15 of 252 patients) and none was considered to be related to treatment. The local tolerability profile of the 1.0% cream was similar to that of the lower concentrations. CONCLUSIONS 1.0% SDZ ASM 981 cream, which was shown to be safe, well tolerated and the most effective concentration in this study, was selected as the concentration to be further developed in phase III studies.
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Affiliation(s)
- T Luger
- Department of Dermatology, University of Muenster, Germany.
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9
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Hanifin JM, Thurston M, Omoto M, Cherill R, Tofte SJ, Graeber M. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. EASI Evaluator Group. Exp Dermatol 2001; 10:11-8. [PMID: 11168575 DOI: 10.1034/j.1600-0625.2001.100102.x] [Citation(s) in RCA: 737] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To test the reliability of the eczema area and severity index (EASI) scoring system by assessing inter- and intra-observer consistency. DESIGN Training of evaluators, application, and assessment over 2 consecutive days. SETTING An academic center. PATIENTS Twenty adults and children with atopic dermatitis (AD); cohort 1 (10 patients > or = 8 years) and cohort 2 (10 patients < 8 years). INTERVENTIONS None. MAIN OUTCOME MEASURE The EASI was used by 15 dermatologist evaluators to assess atopic dermatitis in cohort 1 and cohort 2 on 2 consecutive days. Inter- and intraobserver reliability were analyzed. RESULTS Overall intra-evaluator reliability of the EASI was in the fair-to-good range. Inter-evaluator reliability analyses indicated that the evaluators assessed the patients consistently across both study days. CONCLUSIONS This study demonstrated that the EASI can be learned quickly and utilized reliably in the assessment of severity and extent of AD. There was consistency among the evaluators between consecutive days of evaluation. These results support the use of the EASI in clinical trials of therapeutic agents for AD.
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Affiliation(s)
- J M Hanifin
- Department of Dermatology, Oregon Health Sciences University, Portland 97201-3098, USA.
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10
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Queille-Roussel C, Graeber M, Thurston M, Lachapelle JM, Decroix J, de Cuyper C, Ortonne JP. SDZ ASM 981 is the first non-steroid that suppresses established nickel contact dermatitis elicited by allergen challenge. Contact Dermatitis 2000; 42:349-50. [PMID: 10871099 DOI: 10.1034/j.1600-0536.2000.042006349.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- C Queille-Roussel
- Centre de Pharmacologie Clinique Appliquée à la Dermatologie, France
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Mrowietz U, Graeber M, Bräutigam M, Thurston M, Wagenaar A, Weidinger G, Christophers E. The novel ascomycin derivative SDZ ASM 981 is effective for psoriasis when used topically under occlusion. Br J Dermatol 1999. [PMID: 9990361 DOI: 10.1046/j.1365-2133.1998.02554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Topical SDZ ASM 981 has been found to be highly effective in preclinical models of T-cell-mediated skin disease. T cell activation is crucial in the pathogenesis of psoriasis. It has been hypothesized that SDZ ASM 981 may prove to be an effective treatment for chronic plaque psoriasis. Therefore, the study objective was to determine the efficacy, tolerability and safety of the new topical macrolactam, SDZ ASM 981, for chronic plaque psoriasis. Ten patients with chronic plaque-type psoriasis were treated with SDZ ASM 981 (0.3% and 1.0%), the corresponding ointment base (placebo) and open-labelled clobetasol-17-propionate ointment (0.05%) in a randomized, double-blind, within-subject comparison for 2 weeks using the microplaque assay. Evaluation was performed by daily determination of clinical scores for erythema and induration. The results of the study showed that, after 2 weeks of treatment, total scores described by 92% for clobetasol, by 82% for 1 SDZ ASM 981, by 63% for 0.3% SDZ ASM 981 and by 18% for the ointment base (placebo). No adverse drug effects were seen in any patient throughout the study. We conclude from our results that the new macrolactam SDZ ASM 981 (1%) is similar to clobetasol-17-propionate (0.05%) in plaque-type psoriasis when applied topically under occlusion for 2 weeks using the microplaque assay.
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Affiliation(s)
- U Mrowietz
- Department of Dermatology, University of Kiel, Germany.
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Mrowietz U, Graeber M, Bräutigam M, Thurston M, Wagenaar A, Weidinger G, Christophers E. The novel ascomycin derivative SDZ ASM 981 is effective for psoriasis when used topically under occlusion. Br J Dermatol 1998; 139:992-6. [PMID: 9990361 DOI: 10.1046/j.1365-2133.1998.02554.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Topical SDZ ASM 981 has been found to be highly effective in preclinical models of T-cell-mediated skin disease. T cell activation is crucial in the pathogenesis of psoriasis. It has been hypothesized that SDZ ASM 981 may prove to be an effective treatment for chronic plaque psoriasis. Therefore, the study objective was to determine the efficacy, tolerability and safety of the new topical macrolactam, SDZ ASM 981, for chronic plaque psoriasis. Ten patients with chronic plaque-type psoriasis were treated with SDZ ASM 981 (0.3% and 1.0%), the corresponding ointment base (placebo) and open-labelled clobetasol-17-propionate ointment (0.05%) in a randomized, double-blind, within-subject comparison for 2 weeks using the microplaque assay. Evaluation was performed by daily determination of clinical scores for erythema and induration. The results of the study showed that, after 2 weeks of treatment, total scores described by 92% for clobetasol, by 82% for 1 SDZ ASM 981, by 63% for 0.3% SDZ ASM 981 and by 18% for the ointment base (placebo). No adverse drug effects were seen in any patient throughout the study. We conclude from our results that the new macrolactam SDZ ASM 981 (1%) is similar to clobetasol-17-propionate (0.05%) in plaque-type psoriasis when applied topically under occlusion for 2 weeks using the microplaque assay.
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Affiliation(s)
- U Mrowietz
- Department of Dermatology, University of Kiel, Germany.
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Van Leent EJ, Gräber M, Thurston M, Wagenaar A, Spuls PI, Bos JD. Effectiveness of the ascomycin macrolactam SDZ ASM 981 in the topical treatment of atopic dermatitis. Arch Dermatol 1998; 134:805-9. [PMID: 9681343 DOI: 10.1001/archderm.134.7.805] [Citation(s) in RCA: 126] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To compare the safety and efficacy of 1% SDZ ASM 981 cream and a matching placebo cream in the treatment of patients with moderate atopic dermatitis. DESIGN A randomized, double-blind, placebo-controlled, right-and-left comparison study. SETTING Academic referral center. PATIENTS Thirty-four adult patients with moderate atopic dermatitis. INTERVENTION Topical 1% SDZ ASM 981 cream was applied twice daily (n=16) or once daily (n=18) and compared with a corresponding placebo cream base. MAIN OUTCOME MEASURES Efficacy was measured using a 4-point (0-3) scale for erythema, pruritus, exudation, excoriation, and lichenification (Atopic Dermatitis Severity Index [ADSI]). The ADSI score was defined as the sum of these 5 ratings (range, 0-15) and was determined on the pretreatment day (1 to 14 days before day 0) and on days 0, 2, 4, 7, 9, 11, 14, 16, 18, and 21. The percentage change from baseline (day 0) in the ADSI score was calculated on each of these days. Safety was evaluated by monitoring of adverse events, physical examination, hematologic examination, clinical chemistry studies, urinalysis, and measurement of blood levels of SDZ ASM 981. RESULTS Of the 38 patients recruited, 34 started and 28 completed treatment according to the protocol. Sixteen patients used the cream twice daily, with significant improvement after 2 days of treatment. Within 3 weeks of topical therapy with 1% SDZ ASM 981 cream twice daily, a mean reduction of 71.9% in the ADSI score was observed at the actively treated test sites compared with a mean reduction of 10.3% at the placebo-treated test sites (P<.001). Efficacy was significantly less in the group treated once daily (n=18), with mean reductions of 37.7% and 6.2%, respectively. The efficacy was especially apparent for pruritus and excoriation. There were no clinically relevant drug-related adverse effects. CONCLUSIONS Treatment with 1% SDZ ASM 981 cream was well tolerated. Twice-daily application of 1% SDZ ASM 981 cream was significantly more effective than use of the corresponding placebo and more effective than once-daily treatment. The new macrolactam ascomycin derivative SDZ ASM 981 is a promising agent for the treatment of patients with atopic dermatitis. More elaborate phase 2 and 3 trials are under way to fully investigate the potential of this medication.
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Affiliation(s)
- E J Van Leent
- Department of Dermatology, Academic Medical Center, University of Amsterdam, The Netherlands
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Ward A, Fisher R, Richardson L, Pooler JA, Squire S, Bates P, Shaposhnikov R, Hayward N, Thurston M, Graham CF. Genomic regions regulating imprinting and insulin-like growth factor-II promoter 3 activity in transgenics: novel enhancer and silencer elements. Genes Funct 1997; 1:25-36. [PMID: 9680326 DOI: 10.1046/j.1365-4624.1997.00001.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Transgenic lines (89) were made with constructs containing eight different combinations of candidate regulatory elements from the insulin-like growth factor-II (Igf2)-H19 region of mouse chromosome 7. In all constructs, promoter 3 of Igf2 was attached to a firefly luciferase reporter gene. Promoter 3 was the common element that imposed a decrease in reporter activity similar to that of endogenous Igf2 after birth. The specific activity of the reporter was measured on the day of birth in the liver and the brain, after each transgene had been transmitted by either the father or the mother. This procedure demonstrated that the quantity and organ distribution of expression from this promoter can be regulated by each element. The following new information was obtained. (a) The 5' differentially methylated region of Igf2 inhibits promoter 3 in the liver. (b) The conserved DNase I-hypersensitive Middle region between Igf2 and H19 is an enhancer of promoter 3 in the brain. (c) The H19 promoter inhibits Igf2 promoter 3 in the brain. The results confirmed that the H19 enhancer is a strong enhancer of promoter 3 in the liver. A new finding was that one genomic region regularly imposed imprinted gene expression. This was the H19 enhancer, and this region was sufficient to give higher expression on maternal transmission in the majority of transgenic lines. The full data are reported in Supplementary Publication SUP 50180 (8 pages), which has been deposited at the British Library Document Supply Centre, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom copies can be obtained on the terms indicated in Biochem. J. (1997) 21, 8-10.
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Affiliation(s)
- A Ward
- Zoology Department, University of Oxford, UK
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15
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Sampsel JW, Hinkle G, Nieroda C, Ignaszewski J, Thurston M, Martin EW. Gamma-detecting probe and autoradiographic studies of radiolabeled antibody B72.3 in CX-1 colon xenografts. J Surg Oncol 1990; 45:242-9. [PMID: 2250474 DOI: 10.1002/jso.2930450407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Nude mice bearing CX-1 colon tumors were injected with 50 microCi 125I-labeled monoclonal antibody (MAb) B72.3. Radioactivity in tumors was studied with the gamma detecting probe (GDP) on days 1, 3, 7, and 10 after MAb injection. On each day, two mice were sacrificed and sections were examined with autoradiography (ARG), immunoperoxidase methods (IMP), and routine stains. Mean probe counts showed increasing tumor to background ratios and ARG demonstrated a progressive increase in radionuclide in the tumors. The distribution of 125I was primarily around the vascular spaces on day 1, but by day 3 and progressively it appeared in tumor gland lumina and necrotic areas. A regional correlation was shown between radionuclide in vascular spaces and its sequestration in tumor elements.
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Affiliation(s)
- J W Sampsel
- Department of Surgery, Ohio State University College of Medicine, Columbus
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Martin DT, Hinkle GH, Tuttle S, Olsen J, Nabi H, Houchens D, Thurston M, Martin EW. Intraoperative radioimmunodetection of colorectal tumor with a hand-held radiation detector. Am J Surg 1985; 150:672-5. [PMID: 4073358 DOI: 10.1016/0002-9610(85)90405-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A hand-held gamma detection probe was used intraoperatively to localize primary and recurrent colorectal tumors in 28 patients 48 to 72 hours after they received an intravenous injection of 2.2 mCi of iodine-131 labeled anticarcinoembryonic antigen polyclonal baboon antibody. Preoperative evaluation included determination of serum carcinoembryonic antigen, barium enema, colonoscopy, chest film, computerized axial tomography, liver, spleen, and bone scans, and endoscopy when indicated. Preoperative whole-body imaging correctly localized primary tumors in only 33 percent of the patients, whereas it correctly demonstrated tumor in 64 percent of those with recurrent disease. Intraoperative tumor-to-background ratios derived from the detector probe were elevated in all patients, averaging 3.97:1 in primary lesions and 4.18:1 in recurrent tumors. Postoperatively, carcinoembryonic antigen was localized in tissues with the avidin-biotin peroxidase staining technique to confirm intraoperative readings. Variations in stain uptake in a patient could be correlated with variations in radiation detector readings in the same patient. Results support our previous work in nude mice, demonstrating the improved sensitivity and specificity of the hand-held gamma detection device over whole-body imaging for intraoperative localization of immunoradiolabeled tumors.
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Martin DT, Aitken D, Thurston M, Haagensen D, Hinkle G, Olsen J, Houchens D, Ovejera A, Carey LC, Martin EW. Successful experimental use of a self-contained gamma detecting device. Curr Surg 1984; 41:193-194. [PMID: 6744943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Bayliss J, Norell M, Ryan A, Thurston M, Sutton GC. Bedside haemodynamic monitoring: experience in a general hospital. Br Med J (Clin Res Ed) 1983; 287:187-90. [PMID: 6409246 PMCID: PMC1548683 DOI: 10.1136/bmj.287.6386.187] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Bedside right heart haemodynamic monitoring was carried out on 55 occasions over 18 months in the cardiac care unit of a district general hospital. The technique was used to assist in the management of 27 patients with acute heart failure by helping to select appropriate treatment. Although the catheters were flow guided, insertion and positioning were facilitated by fluoroscopy. The procedure was safe, with one complication arising; technical difficulties occurred in eight cases. Prediction of cardiac output and left ventricular filling pressure by clinical assessment proved to be accurate in only 55% of cases: in patients with acute heart failure there was a tendency to underestimate the cardiac output (25%) and overestimate the left ventricular filling pressure (37%), whereas in patients with chronic heart failure the filling pressure was more accurately estimated (71%). Haemodynamic measurement was often invaluable in selecting and adjusting treatment, particularly in critically ill patients.
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Thurston M. Mental illness: out and about. Nurs Mirror 1982; 155:56-7. [PMID: 6925243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Horn JR, Ferguson JT, Thurston M. Economic welfare: text of Hospital Service Tribunal decision. N Z Nurs J 1981; 74:11-2. [PMID: 6946330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Graveling B, Hickling JE, Pratt LG, Thurston M, Wrenn JC. Relax and recover. Nurs Times 1972; 68:996-8. [PMID: 5045343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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