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Biomedical subjects

W S Douglas

Publications and source records attributed to W S Douglas.

At least 19 recordsLinked to original sources
PubMed1997

Long-term efficacy and safety of cyclosporin in severe adult atopic dermatitis.

A prospective, open, multicentre study was performed to investigate the efficacy and safety of long-term treatment with cyclosporin in adults with severe atopic dermatitis. Subjects were treated for a maximum of 48 weeks. For the first 8 weeks, cyclosporin was administered at 2.5 mg/kg per day. The dose was then adjusted according to response. Disease activity was monitored using the six-area, six-sign score and the proportion of skin involved. Pruritus and sleep disturbance were assessed using four-point scales. Response was further evaluated on a five-point scale. Adverse events, blood pressure and serum biochemistry were monitored. Tolerability was assessed on a five-point scale. One hundred subjects were enrolled and 65 completed 48 weeks of treatment. Withdrawals occurred due to remission (three), inadequate response (seven), protocol violations (11) and adverse events (14, of which seven were probably treatment related). Cyclosporin produced rapid and highly significant improvements in all indices of disease activity. Sixty-five subjects considered that they had shown a considerable improvement or complete clearance of disease. Most patients relapsed after cessation of treatment, but neither signs nor symptoms had returned to baseline severity 8 weeks later. Blood pressure and serum creatinine levels increased slightly, and in one subject renal impairment was a major factor contributing to withdrawal of the drug. Overall, 85 subjects rated the tolerability of cyclosporin as good or very good. The results indicate that cyclosporin has a place in the long-term treatment of severe atopic dermatitis provided that appropriate patients are selected and careful monitoring is performed.

Adolescent↗
PubMed1996

Ionic imbalance as a source of toxicity in an estuarine effluent.

A toxicity identification evaluation (TIE) was conducted on the effluent from a petrochemical plant which discharges into an estuary. The effluent had been consistently toxic to mysid shrimp (Mysidopsis bahia) but not toxic to sheepshead minnows (Cyprinodon variegatus). Phase I effluent toxicity characterization tests revealed that treatment of the effluent with a cation exchange resin (Amberlite(R) IR-120 Plus) was partially effective at reducing, but not removing, toxicity. Phase II characterization tests revealed that four cations varied with toxicity: Ca and Sn were positively correlated with increasing toxicity; Mg and K were negatively correlated with increasing toxicity. Toxicity tests with SnCl2 revealed that the toxicity threshold for Sn was far above the concentrations present in the raw effluent. Reduction of Ca was shown to result in a significant improvement in survival, but some toxicity still remained. Further augmentation of the treated effluent with CaCl2, MgCl2, and KBr to restore the concentrations of Ca, Mg, K, and Br to natural seawater concentrations resulted in survival of all exposed organisms. Repeated success of this treatment regime on additional samples of the effluent as well as "mock effluent" studies confirmed that ion imbalance was the sole source of toxicity in this effluent. Process source water composition and essential ion balance are discussed as important components of marine effluent TIEs.

Animals↗
PubMed1995

Porokeratosis and Crohn's disease.

We report the cases of three patients with Crohn's disease in whom porokeratosis developed. Disseminated superficial actinic porokeratosis developed in two patients. In one of these patients, the skin lesions arose during an exacerbation of the bowel disease. In the third patient, who had congenital linear porokeratosis, the disseminated superficial form of the disorder developed during the first severe exacerbation of Crohn's disease. A family history of porokeratosis was present in one patient, but no relatives of any of these patients were known to have Crohn's disease. In all three patients, Crohn's disease was limited to the colon.

Adult↗
PubMed1995

Treatment of basal cell carcinoma by dermatologists in the United Kingdom. British Association of Dermatologists Audit Subcommittee and the British Society for Dermatological Surgery.

Details of presentation and treatment were obtained prospectively by questionnaire for 1366 patients with basal cell carcinoma, first attending under the care of 166 consultant dermatologists in the U.K., during a 2-week period. One thousand five hundred and ninety-seven tumours were reported in these patients (median age 71 years). Most were situated on the head and neck, and their median size was 9 mm. Excision was the most common treatment used in 58% of tumours, curettage and cautery was used in 24%, cryotherapy in 8%, and radiotherapy in 8%. On average, one in four tumours were referred to other specialists for treatment (range 0-70%). Very few patients (2%) were referred to a combined dermatology/radiotherapy/plastic surgery clinic, calling into question its value and availability. There was considerable variation in practices between dermatologists, demonstrating a clear need for individual, local audit of the management of this common dermatological problem. The data collected in this study form a suitable measure with which local performance may be compared.

Adolescent↗
PubMed1995

Guidelines for the management of chronic venous leg ulceration. Report of a multidisciplinary workshop. British Association of Dermatologists and the Research Unit of the Royal College of Physicians.

This document is the product of a multidisciplinary workshop held in November 1991 between the audit subcommittee of the British Association of Dermatologists and the Research Unit of the Royal College of Physicians. Participants included dermatologists, vascular surgeons, general practitioners, community nurses and physicians involved in care of the elderly. The text is based on papers submitted to, and presented and discussed at, the workshop, and on comments received in response to subsequent wide dissemination of the proceedings to speciality associations. Participants in the workshop, and contributors to the guidelines are: Dr B. R. Allen (Nottingham), Sister S. Bainsborough (Exeter), Professor K. Burnand (London), Professor D. Burrows (Belfast), Mr M. J. Callam (Bedford), Dr G. W. Cherry (Oxford), Dr R. P. R. Dawber (Oxford), Dr W. S. Douglas (Airdrie), Dr A. Y. Finlay (Cardiff), Dr D. Gawkrodger (Sheffield), Dr D. J. Gould (Truro), Dr A. Hopkins (Royal College of Physicians, London), Dr D. McGibbon (London), Dr A. M. Middleton (London), Dr L. Millard (Nottingham), Dr L. Rhodes (Liverpool), Professor T. J. Ryan (Oxford), Dr N. B. Simpson (Newcastle), Dr F. D. Skerrett (Fowey), Dr J. M. Sowden (Nottingham), Miss L. A. Stone (London), Dr R. Williams (Rhyl). Papers presented to the workshop (copies available from the Royal College of Physicians of London): 1. Callam M. J. Epidemiology, natural history and rate of recurrence of leg ulcers. 2. Ryan T. J. Pathology of venous leg ulcers. 3. Gould D. J. Assessment of severity; process and outcomes of care. 4. Millard L. The role of infection. 5. Cherry G. Treatment of known effectiveness. 6. Burnand K. Indications for surgical treatment.

Aged↗
PubMed1994

Contact dermatitis from the old formula E45 cream.

In the past 4 years, a high incidence (118/362) of positive patch test reactions to E45 cream were noted in 2 patch testing clinics. 18/54 of those patch tested to all the ingredients demonstrated allergies to ingredients. The most frequent was triethanolamine; lanolin allergy occurring in only 1 patient. The remaining reactions may be explained as irritant reactions resulting from triethanolamine stearate (TES) formation within the cream. The irritancy of triethanolamine stearate was demonstrated in patients and controls. Conductivity studies showed that TES arises from the combination of the ingredients triethanolamine and stearic acid. The formulation of E45 cream was being changed at the time of writing, with the removal of triethanolamine from the product.

Chemistry, Pharmaceutical↗
PubMed1993

Dermatology.

Explore the source record for details and available documents.

Dermatology↗
PubMed1991

Transient leukaemia cutis in hairy-cell leukaemia.

Leukaemic skin infiltration is uncommon in hairy-cell leukaemia (HCL), a neoplasm characterized by the presence of uniform mononuclear cells with cytoplasmic projections in the blood, bone marrow and spleen. A case is reported in which leukaemia cutis was a transient phenomenon, appearing soon after the onset of a continuous pyrexia associated with marked systemic upset which was subsequently shown to be due to pulmonary tuberculosis.

Humans↗
PubMed1990

Abnormal limb regeneration in adult newts exposed to a pulsed electromagnetic field.

This investigation examined two questions: 1) whether or not forelimb regeneration results in a faithful replacement of the distal skeletal pattern and 2) what effect exposure to a pulsed electromagnetic field (PEMF), the type reported to facilitate healing of human non-united bone fractures, would have on the process of limb regeneration. Of the native forelimbs, 98% (132 out 134) had a skeletal pattern that showed little difference with the only variation being the range of carpal bones (5-8). Following a 4-5 month postamputation period, the skeletal pattern of the normal regenerates was examined. While 72% (135 out of 188) of these forelimbs resembled the native group, 28% (53 out of 188) were abnormal. These abnormalities consisted of the loss of a digit, fused carpals, and long bone defects which occurred singly or in combination with one another. Exposure to a PEMF for the first 30 days postamputation, followed by a 3-4 month postamputation period, produced in addition to the normal (60%, 144 out of 240) and abnormal forelimbs (28%, 67 out of 240), a group of forelimbs with unique gross defects (12%, 28 out of 240). These defects, occurring singly or in combination, included the loss of two or more digits with associated loss of carpals, absence of the entire hand pattern, and abnormalities associated with the radius and ulna. We can offer no explanation for these observations.

Animals↗