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Kennedy NA, Kalla R, Warner B, Gambles CJ, Musy R, Reynolds S, Dattani R, Nayee H, Felwick R, Harris R, Marriott S, Senanayake SM, Lamb CA, Al-Hilou H, Gaya DR, Irving PM, Mansfield J, Parkes M, Ahmad T, Cummings JRF, Arnott ID, Satsangi J, Lobo AJ, Smith M, Lindsay JO, Lees CW. Thiopurine withdrawal during sustained clinical remission in inflammatory bowel disease: relapse and recapture rates, with predictive factors in 237 patients. Aliment Pharmacol Ther 2014; 40:1313-23. [PMID: 25284134 PMCID: PMC4232866 DOI: 10.1111/apt.12980] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 07/18/2014] [Accepted: 09/14/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Thiopurines (azathioprine and mercaptopurine) remain integral to most medical strategies for maintaining remission in Crohn's disease (CD) and ulcerative colitis (UC). Indefinite use of these drugs is tempered by long-term risks. While clinical relapse is noted frequently following drug withdrawal, there are few published data on predictive factors. AIM To investigate the success of planned thiopurine withdrawal in patients in sustained clinical remission to identify rates and predictors of relapse. METHODS This was a multicentre retrospective cohort study from 11 centres across the UK. Patients included had a definitive diagnosis of IBD, continuous thiopurine use ≥3 years and withdrawal when in sustained clinical remission. All patients had a minimum of 12 months follow-up post drug withdrawal. Primary and secondary end points were relapse at 12 and 24 months respectively. RESULTS 237 patients were included in the study (129 CD; 108 UC). Median duration of thiopurine use prior to withdrawal was 6.0 years (interquartile range 4.4-8.4). At follow-up, moderate/severe relapse was observed in 23% CD and 12% UC patients at 12 months, 39% CD and 26% UC at 24 months. Relapse rate at 12 months was significantly higher in CD than UC (P = 0.035). Elevated CRP at withdrawal was associated with higher relapse rates at 12 months for CD (P = 0.005), while an elevated white cell count was predictive at 12 months for UC (P = 0.007). CONCLUSION Thiopurine withdrawal in the context of sustained remission is associated with a 1-year moderate-to-severe relapse rate of 23% in Crohn's disease and 12% in ulcerative colitis.
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Castelnuovo B, Parkes Ratanshi R, Kakaire T, Sempa J, Reynolds S, Lamorde M. Monitoring Antiretroviral Therapy in Uganda: Budget Impact Analysis of Two Strategies for Viral Load Monitoring Versus Immunologic Monitoring. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A667. [PMID: 27202439 DOI: 10.1016/j.jval.2014.08.2463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Jama SH, Wright G, Reynolds S. 11 * SUPERVISED SELF-ADMINISTRATION PILOT SCHEME ON AN ELDERLY REHABILITATION WARD. Age Ageing 2014. [DOI: 10.1093/ageing/afu124.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Reynolds S, Mika A, Pike R, Blom A, Kemp D, Fischer K. Lectin pathway inhibition by parasitic scabies mites: Molecular characterisation of host–pathogen immune mechanisms. Mol Immunol 2013. [DOI: 10.1016/j.molimm.2013.05.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Reynolds S, Smirnov V. Modelling of two-and four-terminal thin-film silicon tandem solar cells. ACTA ACUST UNITED AC 2012. [DOI: 10.1088/1742-6596/398/1/012006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kazan SM, Reynolds S, Kennerley A, Wholey E, Bluff JE, Berwick J, Cunningham VJ, Paley MN, Tozer GM. Kinetic modeling of hyperpolarized (13)C pyruvate metabolism in tumors using a measured arterial input function. Magn Reson Med 2012; 70:943-53. [PMID: 23169010 DOI: 10.1002/mrm.24546] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 10/05/2012] [Accepted: 10/08/2012] [Indexed: 12/12/2022]
Abstract
Mathematical models are required to estimate kinetic parameters of [1-(13)C] pyruvate-lactate interconversion from magnetic resonance spectroscopy data. One- or two-way exchange models utilizing a hypothetical approximation to the true arterial input function (AIF), (e.g. an ideal 'box-car' function) have been used previously. We present a method for direct measurement of the AIF in the rat. The hyperpolarized [1-(13)C] pyruvate signal was measured in arterial blood as it was continuously withdrawn through a small chamber. The measured signal was corrected for T1 relaxation of pyruvate, RF pulses and dispersion of blood in the chamber to allow for the estimation of the direct AIF. Using direct AIF, rather than the commonly used box-car AIF, provided realistic estimates of the rate constant of conversion of pyruvate to lactate, kpl, the rate constant of conversion of lactate to pyruvate klp, the clearance rate constant of pyruvate from blood to tissue, Kip, and the relaxation rate of lactate T1la. Since no lactate signal was present in blood, it was possible to use a simple precursor-product relationship, with the tumor tissue pyruvate time-course as the input for the lactate time-course. This provided a robust estimate of kpl, similar to that obtained using a directly measured AIF.
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Etemad B, Redd A, Serwadda D, Lutalo T, Reynolds S, Gray R, Quinn T, Sagar M. Envelopes found early after acquisition compared to those in the chronically infected partner do not have enhanced alpha4 beta7 binding or utilization. Retrovirology 2012. [PMCID: PMC3441852 DOI: 10.1186/1742-4690-9-s2-p149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lane SJ, Reynolds S, Dumenci L. Sensory Overresponsivity and Anxiety in Typically Developing Children and Children With Autism and Attention Deficit Hyperactivity Disorder: Cause or Coexistence? Am J Occup Ther 2012; 66:595-603. [DOI: 10.5014/ajot.2012.004523] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Dou K, Lerma F, Jacobs M, Ottinger M, Seidel M, Herchko M, Reynolds S. SU-E-T-309: Dosimetric Study and Clinical Implementation of an HDR Applicator of SAVI for Partial Breast Irradiation. Med Phys 2012; 39:3774. [DOI: 10.1118/1.4735395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bakhtiari M, Parniani A, Lerma F, Reynolds S, Jordan J, Sedaghat A, Sarfaraz M, Rodgers J. SU-E-T-37: Evaluation of Software Systems That Estimate Patient Dose Errors Based on Planar IMRT QA Measurements. Med Phys 2012. [DOI: 10.1118/1.4735092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fischer K, Mika A, Pickering D, Reynolds S, McMillan D, Sriprakash K, Kemp D. Scabies mite complement inhibitors promote growth of Group A Streptococcus. Mol Immunol 2011. [DOI: 10.1016/j.molimm.2011.06.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mika A, Bergström F, Reynolds S, Willis C, Pickering D, Pike R, Blom A, Kemp D, Fischer K. Novel scabies mite serpins inhibit the three pathways of the human complement system. Mol Immunol 2011. [DOI: 10.1016/j.molimm.2011.06.320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dou K, Jacobs M, Ottinger M, Seidel M, Reynolds S. SU-E-T-365: Dosimetric Study of An HDR Applicator of SAVI for Partial Breast Irradiation. Med Phys 2011. [DOI: 10.1118/1.3612319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fisher K, Paxton R, Jackson H, Noble S, Thomsett K, Reynolds S, Hart K, Engel B. Comparison of screening tools in patients undergoing haemodialysis. J Hum Nutr Diet 2011. [DOI: 10.1111/j.1365-277x.2011.01175_8.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reynolds S, Smirnov V, Main C, Finger F, Carius R. Interpretation of Transient Photocurrents in Coplanar and Sandwich PIN Microcrystalline Silicon Structures. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-808-a5.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTWe report on the use of coplanar transient photoconductivity and post-transit time-of-flight spectroscopy techniques in the study of carrier transport in microcrystalline silicon films prepared over a range of crystallinities. Coplanar samples are susceptible to post-deposition oxidation and reversible adsorption of atmospheric gases, which may alter the apparent density of states. Coplanar measurements suggest lower deep defect densities in more highly crystalline films, but this is due at least in part to an increased occupancy of these states. A comparison of results obtained using both techniques suggests anisotropic transport, with reduced band tailing (greater structural order) along the direction of film growth, a larger defect concentration around the column boundaries, and a higher defect density within the amorphous tissue than in optimised single-component amorphous silicon films.
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Main C, Reynolds S, Zrinŝcak I, Merazga A. Extension of the Constant Photocurrent Method to Determine Densities of Occupied and Unoccupied Localised States. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-808-a9.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTThis paper examines the use of Constant Photocurrent (CPM) measurements on thin film semiconductors, employing steady (DC) and modulated (AC) sub-gap illumination, to determine the density of localised states (DOS) in the bandgap. AC and DC measurements often result in different apparent absorption spectra. It is demonstrated that it is possible not only to extract information from the respective 'absorption' spectra, on the DOS below the Fermi level - i.e. occupied states, but also on the density of unoccupied states above the Fermi level. The ability to discriminate between these two groups of states by using DC and AC modulated sub-gap light arises from the frequency dependence of the different excitation pathways by which free electrons can be produced. AC modulated excitation will reveal absorption associated with transitions from occupied states into the conduction band, while DC excitation will include transitions from the valence band into unoccupied defect states, followed by slow thermal emission to the conduction band. We examine the temperature dependence of the CPM spectra and present a simple analysis of the DC and AC absorption spectra which allows the two regions of the DOS, above and below the Fermi level, to be determined.
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Masud F, Masud T, Reynolds S, Masud S. Masud Anwar. West J Med 2010. [DOI: 10.1136/bmj.c3470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Seibert P, Whitener N, Coblentz M, Reynolds S, Schommer J, Otto C, Zimmerman C. P3.183 Implications of deep brain stimulation on sleep disturbances for individuals with movement disorders. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70747-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Seibert P, Whitener N, Otto C, Coblentz M, Schommer J, Reynolds S, Zimmerman C. P2.054 Exploring the effects of caffeine on men and women with movement disorders. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Seibert P, Whitener N, Coblentz M, Reynolds S, Schommer J, Zimmerman C. P2.055 Deep brain stimulation outcomes for Parkinson's disease and essential tremor. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70406-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fischer K, Bergström F, Reynolds S, Willis C, Johnstone M, Mika A, Langendorf C, Buckle A, Pike R, Blom A, Kemp D. Complement evasion of the scabies mite Sarcoptes scabiei. Mol Immunol 2009. [DOI: 10.1016/j.molimm.2009.05.270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Jones SM, Balk EJ, Hill TJ, Reynolds S. Setting up a store‐and‐forward telemedicine service for acute trauma in a hospital trust. ACTA ACUST UNITED AC 2009; 27:107-14. [PMID: 15799587 DOI: 10.1080/01405110400007866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Telemedicine is a valuable, but as yet underused, resource for the delivery of health-care to patients. This paper describes the development of a new store-and-forward telemedicine service at the Queen Victoria Hospital, which is a tertiary referral centre for plastic surgery in the United Kingdom. The practical requirements of such a system, and the technical and legal difficulties experienced during the initial stages, are also discussed.
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Kiers HD, Litchfield A, Reynolds S, Griesdale D, Gibney RT, Pickkers P, Chittock D, Sweet DD. Early goal-directed therapy of septic patients coming from the ward does not protect the kidneys. Crit Care 2009. [PMCID: PMC4084145 DOI: 10.1186/cc7423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Al-Rawahi GN, Reynolds S, Porter SD, Forrester L, Kishi L, Chong T, Bowie WR, Doyle PW. Community-associated CMRSA-10 (USA-300) is the predominant strain among methicillin-resistant Staphylococcus aureus strains causing skin and soft tissue infections in patients presenting to the emergency department of a Canadian tertiary care hospital. J Emerg Med 2008; 38:6-11. [PMID: 18325716 DOI: 10.1016/j.jemermed.2007.09.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Revised: 06/01/2007] [Accepted: 09/28/2007] [Indexed: 11/25/2022]
Abstract
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen first described among individuals with no contact with health care facilities. The purpose of this study was to determine the proportion of CA-MRSA, defined by pulsed field gel electrophoresis (PFGE), in MRSA skin and soft tissue infections presenting to the Emergency Department (ED). We also aimed to describe the laboratory and clinical characteristics of CA-MRSA infections. From June 1, 2001 to May 30, 2005, MRSA isolates from skin and soft tissue infections presenting to the ED were reviewed. They were characterized by antibiotic susceptibilities and PFGE, and the presence of staphylococcal cassette chromosome (SCC) mec type IVa and Panton-Valentine leukocidin (PVL) genes was assessed on representative isolates. The medical records were reviewed to define risk factors. There were 95 isolates available for analysis, of which 58 (61%) were CMRSA-10 (USA-300), the predominant clone from 2003 onward. All representative isolates (24%) tested in this group had PVL genes and SCCmec type IVa. Their antibiogram showed 100% susceptibility to trimethoprim-sulfamethoxazole, rifampin, and fusidic acid, and 79% to clindamycin. Clinical comparison of CMRSA-10 vs. hospital PFGE type strains showed 22% vs. 60%, respectively, for recent antibiotic use (p < 0.0001), 26% vs. 6%, respectively, for intravenous drug use (p < 0.05), and 57% vs. 6%, respectively, for soft tissue abscess (p < 0.001). CMRSA-10 is a major pathogen in skin and soft tissue abscesses in our ED. It has a characteristic susceptibility, and was associated with intravenous drug use, but not with recent antibiotic usage.
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Hill J, Pilkonis P, Morse J, Feske U, Reynolds S, Hope H, Charest C, Broyden N. Social domain dysfunction and disorganization in borderline personality disorder. Psychol Med 2008; 38:135-146. [PMID: 17892627 PMCID: PMC2828321 DOI: 10.1017/s0033291707001626] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Social dysfunction in personality disorder is commonly ascribed to abnormal temperamental traits but may also reflect deficits in social processing. In this study, we examined whether borderline and avoidant personality disorders (BPD, APD) may be differentiated by deficits in different social domains and whether disorganization of social domain functioning uniquely characterizes BPD. METHOD Patients were recruited from psychiatric clinics in Pittsburgh, USA, to provide a sample with BPD, APD and a no-personality disorder (no-PD) comparison group. Standardized assessments of Axis I and Axis II disorders and social domain dysfunction were conducted, including a new scale of 'domain disorganization' (DD). RESULTS Pervasive social dysfunction was associated with a 16-fold increase in the odds of an Axis II disorder. Both APD and BPD were associated with elevated social dysfunction. Romantic relationship dysfunction was associated specifically with BPD symptoms and diagnosis. DD was associated specifically with a categorical BPD diagnosis and with a dimensional BPD symptom count. CONCLUSIONS A focus on the inherently interpersonal properties of personality disorders suggests specific mechanisms (within and across interpersonal domains) that may help to account for the origins and maintenance of some disorders. In particular, BPD reflects disturbances in romantic relationships, consistent with a role for attachment processes, and in the organization of functioning across social domains.
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