Amersham Hospital

Buckinghamshire, United Kingdom

Amersham Hospital

Buckinghamshire, United Kingdom

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Weber C.M.,Cranfield University | Cauchi M.,Cranfield University | Patel M.,Cranfield University | Bessant C.,Cranfield University | And 3 more authors.
Analyst | Year: 2011

Previous studies have indicated that volatile compounds specific to bladder cancer may exist in urine headspace, raising the possibility that headspace analysis could be used for diagnosis of this particular cancer. In this paper, we evaluate the use of a commercially available gas sensor array coupled with a specifically designed pattern recognition algorithm for this purpose. The best diagnostic performance that we were able to obtain with independent test data provided by healthy volunteers and bladder cancer patients was 70% overall accuracy (70% sensitivity and 70% specificity). When the data of patients suffering from other non-cancerous urological diseases were added to those of the healthy controls, the classification accuracy fell to 65% with 60% sensitivity and 67% specificity. While this is not sufficient for a diagnostic test, it is significantly better than random chance, leading us to conclude that there is useful information in the urine headspace but that a more informative analytical technique, such as mass spectrometry, is required if this is to be exploited fully.


PubMed | Imperial College London, Amersham Hospital, St Thomas Hospital and London Northwest Healthcare NHS Trust
Type: | Journal: The British journal of dermatology | Year: 2016

Cronkhite-Canada syndrome is an acquired inflammatory polyposis syndrome in which alopecia, onychomadesis and hyperpigmentation occur concurrently with gastrointestinal symptoms. The pathophysiology of alopecia in Cronkhite-Canada Syndrome has not been definitively elucidated and we present evidence for alopecia incognita as a possible mechanism of hair loss. This article is protected by copyright. All rights reserved.


Willis C.M.,Amersham Hospital | Britton L.E.,Amersham Hospital | Harris R.,Cancer and Bio detection Dogs | Wallace J.,Center for Statistics in Medicine | Guest C.M.,Cancer and Bio detection Dogs
Cancer Biomarkers | Year: 2010

In a previous canine study, we demonstrated that volatile organic compounds specific to bladder cancer are present in urine headspace, subsequently showing that up to 70% of tumours can be correctly classified using an electronic nose. This study aimed to evaluate the sensitivity and specificity which can be achieved by a group of four trained dogs. In a series of 30 double-blind test runs, each consisting of one bladder cancer urine sample placed alongside six controls, the highest sensitivity achieved by the best performing dog was 73% (95% CI 55-86%), with the group as a whole correctly identifying the cancer samples 64% (95% CI 55-73%) of the time. Specificity of the dogs individually ranged from 92% (95% CI 82-97%) for urine samples obtained from healthy, young volunteers down to 56% (95% CI 42-68%) for those taken from older patients with non-cancerous urological disease. Odds ratio comparisons confirmed a significant decrease in performance as the extent of urine dipstick abnormality and/or pathology amongst the control population increased. Importantly, however, statistical analysis indicated that covariates such as smoking, gender and age, as well as blood, protein and /or leucocytes in the urine did not significantly alter the odds of response to the cancer samples. Our results provide further evidence that volatile biomarkers for bladder cancer exist in urine headspace, and that these have the potential to be exploited for diagnosis. © 2010/2011 - IOS Press and the authors. All rights reserved.


Bruze M.,Skåne University Hospital | Svedman C.,Skåne University Hospital | Andersen K.E.,University of Southern Denmark | Bruynzeel D.,VU University Amsterdam | And 5 more authors.
Contact Dermatitis | Year: 2012

Background. According to EU legislation, 26 fragrance substance allergens must be labelled on cosmetic products. For 12 of them, the optimal patch test concentration/dose has not been evaluated. Objectives. To establish the optimal patch test doses in mg/cm 2 for the 12 fragrance substances that are not included in fragrance mix I or II in the European baseline patch test series. Materials and Methods. Patch testing with the 12 fragrance substances was performed in a stepwise manner encompassing up to five rounds in at least 100 dermatitis patients for each round. Before patch testing, an individual maximum concentration/dose was determined for each fragrance substance. Results. The predetermined maximum patch test concentrations/doses could be tested for all 12 fragrance substances, with no observable adverse reactions being noted. Conclusions. For each fragrance substance investigated, it is recommended that half of the maximum patch test dose (mg/cm 2) be used for aimed and screening patch testing. © 2012 John Wiley & Sons A/S.


Clayton R.,Royal Berkshire Hospital | Clayton R.,Amersham Hospital | Chaudhry S.,United Dental Care | Ali I.,Churchill Hospital | And 3 more authors.
Clinical and Experimental Dermatology | Year: 2010

Aim. To determine whether there is an association between the use of angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and nonsteroidal anti-inflammatory drugs (NSAIDS) in women with mucosal (oral and vulval) lichen planus (LP) compared with a control population. Methods. This was a retrospective review of medical records in dedicated vulval and oral clinics in hospitals. The study population comprised 141 women with vulval LP and 106 women with oral LP. Medications taken at the time of diagnosis were recorded. Results. Patients with mucosal LP were more likely to be on NSAIDS and beta-blockers, but less likely to be on ACE inhibitors compared with controls. All three groups were found to have an inverse relationship with ACE inhibitors, but no association was found between patients with oral LP and beta-blockers. Conclusions. Beta-blockers and NSAIDS are associated with LP, suggesting that withdrawal of these drugs should be considered. Further studies are needed to confirm or refute the inverse relationship between mucosal LP and use of ACE inhibitors. © 2009 British Association of Dermatologists.


Orton D.,Amersham Hospital | Basketter D.,DABMEB Consultancy Ltd
Contact Dermatitis | Year: 2012

Although the large majority of users do not experience adverse skin reactions to hair dye products, a minority do. Most serious among these are allergic skin reactions, commonly to p-phenylenediamine and its derivatives. The consumer or hairdresser is expected (by the manufacturer) to limit the chance of expression of allergy by conducting a 'sensitivity test', which should provide the consumer with an alert for possible allergic reactivity. However, a self-conducted consumer test can only be useful if it meets a number of important criteria, including evidence that the test protocol works, that it can and is likely to be used successfully by the consumer or hairdresser, and that it does not present a significant health risk (e.g. an increased risk of developing allergy). In short, as with any in vivo test, the benefit must outweigh the risks. In formulating such a test, it should be determined in advance what are the acceptable levels of specificity (correct identification of negatives) and sensitivity (correct identification of positives). It is our view that any hair dye sensitivity test, whether supplied by the hair dye manufacturer or a third party, should be able to answer these questions. © 2012 John Wiley & Sons A/S.


Best W.,University College London | Greenwood A.,Amersham Hospital | Grassly J.,University College London | Grassly J.,Amersham Hospital | And 3 more authors.
Cortex | Year: 2013

Introduction: The majority of adults with acquired aphasia have anomia which can respond to rehabilitation with cues. However, the literature and clinical consensus suggest change is usually limited to treated items. We investigated the effect of an experimentally controlled intervention using progressive cues in the rehabilitation of noun retrieval/production in 16 participants with chronic aphasia. Method: Participants were sub-divided relative to the group according to performance on semantic tasks (spoken/written word to picture matching) and phonological output processing (presence/absence of word length effect and proportion of phonological errors in picture naming) in order to investigate outcome in relation to language profile. Cueing therapy took place weekly for 8 weeks. Results: Intervention resulted in significant improvement on naming treated items for 15/16 participants, with stable performance on control tasks. Change occurred at the point of intervention and not during pre-therapy assessments. We predicted particular patterns of generalisation which were upheld. Only participants classified as having relatively less of a semantic difficulty and more of a phonological output deficit demonstrated generalisation to untreated items. Outcome did not relate to traditional aphasia classification. Conclusion: A cueing hierarchy can improve word retrieval/production for adults with aphasia. In some cases generalisation to untreated items also occurs. The study demonstrates that the results of behavioural testing can be used to guide predictions of recovery with intervention. © 2013 Elsevier Ltd.


Wong T.,Amersham Hospital | Orton D.,Amersham Hospital
Clinics in Dermatology | Year: 2011

Allergic reactions to sunscreens are relatively rare. However, as the public become more conscious of the dangers of excessive sunlight exposure, the use of sunscreens is increasing. They are also being incorporated into general cosmetics on a more frequent basis. Sunscreens contain a variety of potential sensitizers which may lead to contact and/or photocontact allergic dermatitis, and as pharmaceutical companies continue to manufacture and incorporate new UV filters it is crucial that we remain up to date and aware of these agents to include in patch and photopatch testing batteries. Furthermore, the creation of a European consensus statement regarding methodology in photopatch testing has enabled greater standardization and comparison of patch test results across centers. © 2011 Elsevier Inc.


Esdaile B.,Amersham Hospital | Grabczynska S.,Amersham Hospital | George S.,Amersham Hospital
Photodermatology Photoimmunology and Photomedicine | Year: 2010

Solar urticaria is a rare immunoglobulin E-mediated photodermatosis characterized by the development of a pathognomic wheal and flare within minutes of photoexposure. A 26-year-old man presented with a history of sun-induced urticaria only in areas of pre-existing bruising, which we were able to replicate with monochromator testing. We were also able to demonstrate, by autologous in vitro studies, that a serum factor was responsible. © 2010 John Wiley & Sons A/S.


Dua J.,Amersham Hospital | Grabczynska S.,Amersham Hospital
Pediatric Dermatology | Year: 2014

Eccrine nevi are rare lesions characterized by a sharply demarcated area of localized hyperhidrosis. We present an 11-year-old girl with an eccrine nevus on her right lower forearm. To the best of our knowledge, this is the first case successfully controlled with topical glycopyrrolate wipes. © 2013 Wiley Periodicals, Inc.

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