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Biomedical subjects

D R Vernon

Publications and source records attributed to D R Vernon.

9 recordsLinked to original sources
PubMed2000

Manipulations of the metabolic response for management of patients with severe surgical illness: review.

The metabolic response to severe surgical illness is complex and varied. Much recent laboratory and clinical research has focused on increasing our understanding of the metabolic response and the development of new therapies designed to modify this response. Antiinflammatory agents can target harmful aspects of the metabolic response; the immune system can be stimulated; and anabolic factors can be used in an attempt to enhance recovery. The nutritional support of the surgical patient remains crucial, but the effects of new additives are being studied in a variety of surgical conditions. As yet, few of these "novel" agents have found an established role in the management of surgical patients. This review focuses on many "novel" agents or those that do not yet have a clearly defined role in surgical illness. Clinical trials in the areas of severe sepsis, major surgical trauma, and major elective surgery have been emphasized.

Animals↗
PubMed1998

Lung cancer--management and outcome in Glasgow, 1991-92.

Current practice and outcome for patients with lung cancer were determined by retrospective case note review of a random sample of all lung cancer cases registered for a calendar year and augmented by review of all surgical and radical radiotherapy cases. A total of 262 patients - 231 patients less than 75 years of age and 31 patients more than 75 years of age - represented 83% of the random sample. Eighty-three per cent of patients were seen within 2 weeks of referral. One-third reported symptoms occurring for less than 1 month and one-third had experienced symptoms for more than 3 months. The median time interval from first hospital contact until the making of a management decision was 18 days. The median interval from first contact to surgery was 63 days, and to starting radical radiotherapy 70 days. Histological confirmation was obtained in 69% of patients. Ten per cent of all lung cancer patients were calculated to have received chemotherapy. Five per cent of the whole cohort had definitive surgery and 64% of these were judged to be free of the disease at 3 years. Overall survival was 9% at 3 years, with no differences relating to cell type or area of residence. Many areas of good practice have been identified, but the lack of tumour staging or performance status data, the low proportion receiving chemotherapy or definitive surgery and the poor outcome after radical radiotherapy indicate the need for prospective audit and feedback of results. The long time interval from management decision to surgery and radiotherapy suggests organizational issues which need attention.

Adult↗
PubMed1984

Theophylline compounds in patients with reversible airways obstruction.

In a double blind cross-over comparison of a single dose 450-mg slow-release aminophylline (SRA) with placebo in eleven patients with stable, reversible airways obstruction SRA produced significantly greater increase in FEV1 and vital capacity from 2 to 9 hr after administration. A second double-blind cross-over comparison of 450-mg SRA with 400 mg of choline theophyllinate (CT) in eleven similar patients showed that SRA produced a slower rise in FEV1 and VC than CT. However, the increase in spirometric readings following SRA was sustained at 9 hr after administration where the spirometric recordings after CT were falling. Whereas CT produced a peak value in plasma theophylline at 1 hr, the highest values after SRA occurred at 4 or 8 hr after administration. The plasma theophylline level at 8 hr after SRA was significantly higher than that following CT. In this single-dose study, plasma theophylline levels obtained were within the normal therapeutic range and this was not exceeded and no side effects were recorded.

Adult↗
PubMed1980

Environmental factors in allergic bronchopulmonary aspergillosis.

Many workers have suggested that exposure to an environment rich in Aspergillus spores is aetiologically significant in allergic bronchopulmonary aspergillosis. This hypothesis has been investigated by means of an environmental survey in which eight urban dwelling patients with this disease and five atopic control patients took part. Enquiries were made about contact with known sources of Aspergillus fumigatus and air spora studies were conducted in the home. Findings were similar for both groups. No high spore concentrations were recorded in the homes of either group. Patients with allergic bronchopulmonary aspergillosis had not been more exposed to potentially rich sources of A. fumigatus than the atopic control patients. The view is expressed that specific host susceptibility is more important in the pathogenesis of allergic bronchopulmonary aspergillosis than environmental factors. Ince a patient is sensitized however minor increases in spore concentration can cause symptomatic disease producing the recognized winter exacerbations of allergic bronchopulmonary aspergillosis. Possible mechanisms allowing the development of the disease in the presence of low spore concentrations are discussed.

Adolescent↗
PubMed1976

A 12-month double-blind assessment of betamethasone valerate aerosol in the management of asthma.

A double-blind trial of the topically active corticosteroid, betamethasone valerate in aerosol form, in the control of chronic asthma is reported. The results show that this is an extremely effective therapeutic agent in non-steroid dependent but nonetheless moderately severe asthmatics. Patients were well controlled on 800 mug of betamethasone valerate daily and control was maintained over a 12-month period. This form of treatment has few undersirable side effects but there is probably an increased incidence of oropharyngeal and laryngeal candidiasis. In particular, adrenocortical suppression was not noted.

Adolescent↗