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Biomedical subjects

E Goodall

Publications and source records attributed to E Goodall.

18 recordsLinked to original sources
PubMed2001

A framework for developing excellence as a clinical educator.

The current emphasis on providing quality undergraduate and postgraduate medical education has focused attention on the educational responsibilities of all doctors. There is a greater awareness of the need to train doctors as educators and courses have been set up to satisfy this need. Some courses, such as those on how to conduct appraisal, are specific to one task facing a medical educator. Other courses take a broader view and relate educational theory to practice. In this paper we describe an outcome-based approach in which competence in teaching is defined in terms of 12 learning outcomes. The framework provides a holistic approach to the roles of the teacher and supports the professionalism of teaching. Such a framework provides the basis for the development of a curriculum for teaching excellence. It helps to define important competences for different categories of teachers, communicate the areas to be addressed in a course, identify gaps in course provision, evaluate courses, assist in staff planning and allow individuals to assess their personal learning needs. The framework is presented to encourage wider debate.

Curriculum↗
PubMed1996

The effects of D- and L-fenfluramine (and their interactions with D-amphetamine) on psychomotor function and mood.

This study reports the results on psychomotor functioning of D- and L-fenfluramine alone, and in combination with D-amphetamine, in a placebo-controlled trial on 12 normal male volunteers, in order to investigate their CNS activity in humans. The major findings were that D-amphetamine increased alertness, L-fenfluramine increased unhappiness whilst D-fenfluramine decreased hunger and increased the critical flicker fusion threshold. D-Amphetamine in combination with D-fenfluramine increased the critical flicker fusion threshold and in combination with L-fenfluramine the alerting action was diminished. The differing actions of the fenfluramine isomers and their interactions with D-amphetamine suggest that D-fenfluramine is predominantly serotonergic in its activity, whereas L-fenfluramine may be causing dopamine blockade, reducing certain actions of amphetamine possibly mediated by dopamine receptors. The significance of these results in relationship to the psychopharmacology of serotonin, dopamine, and noradrenaline is discussed.

Adult↗
PubMed1993

The prolactin response to d- and l-fenfluramine and to d-amphetamine in human subjects.

Twelve normal male volunteers took part in a double-blind placebo-controlled study to measure the effects of d- and l-fenfluramine singly and in combination with d-amphetamine on plasma prolactin levels. Both isomers of fenfluramine were found to differ significantly in their effects from d-amphetamine, and from placebo, causing prolactin levels to rise. d-Fenfluramine produced the greatest change. There were minor differences between the level of activity of the two drugs when given in conjunction with d-amphetamine. d-Amphetamine produced a non-significant reduction in prolactin secretion. The neurochemical basis for the experimental findings reported is considered, with special reference to the use of d-fenfluramine as a specific serotonergic probe.

Adult↗
PubMed1993

The effects of d- and l-fenfluramine (and their interactions with d-amphetamine) on cortisol secretion.

Twelve normal weight healthy male volunteers participated in a double-blind, placebo-controlled trial of the effects of d- and l-fenfluramine, d-amphetamine, and the interactions between the two isomers of fenfluramine with amphetamine, on cortisol secretion. d-Fenfluramine and d-amphetamine in combination produced the greatest cortisolaemic effect, suggesting that they act by differing neurochemical pathways. d-Fenfluramine produced a significant effect, but l-fenfluramine produced little effect, suggesting that the cortisol-releasing properties of racemic fenfluramine reside in the d-isomer.

Adult↗
PubMed1992

A comparison of the effects of d- and l-fenfluramine and d-amphetamine on energy and macronutrient intake in human subjects.

The anorectic activity of the d and l isomers of d-fenfluramine (d-FF) (l-FF) were compared with d-amphetamine (d-amp) when given separately and together in 12 healthy male volunteers. The study was double blind and placebo controlled. Food intake was measured using an automated food dispenser. Anorectic activity was examined using a) total energy intake b) nutrient selection c) selection of foods categorised by nonsweet/sweet taste. Total energy intake was significantly reduced by d-FF (17%) d-amp (26%) d-FF + d-amp (36%) and l-FF + d-amp (31%). d-Amp and both combinations significantly reduced energy intake from all macronutrients in the total food. d-FF reduced carbohydrate but not fat or protein intake derived from all foods. When nonsweet and sweet tasting foods were examined separately, l-FF also significantly reduced energy (by 19%), fat and carbohydrate intake from nonsweet food. Neither d-FF nor l-FF reduced protein from nonsweet food. No anorectic drug given alone reduced sweet food intake, only d-amp given with d-FF had this effect. In contrast to nonsweet food, d-FF did not reduce carbohydrate from sweet foods. The results are in agreement with previous work that d-FF spares protein consumption but suggest that d-FF does not selectively reduce carbohydrate intake per se.

Adult↗
PubMed1992

Centrally acting anorectic drugs: a clinical perspective.

This paper reviews the anorectic activity and effectiveness of catecholamine and serotoninergic anorectic drugs in the management of obesity. It discusses the clinical implications of the experimental findings and suggests prescribing strategies for effective long-term therapeutic benefit. The authors advocate that there is a role for the recently developed serotonin-mediated anorectic compounds in the treatment of obesity, particularly in those individuals with abnormal glucose tolerance or who are hypertensive.

Appetite Depressants↗
PubMed1992

The effects of lithium on body weight and food intake in normal subjects--a pilot study.

The possibility of lithium increasing hunger and food intake was examined in an open, pilot study involving five healthy male volunteers each of whom took lithium for 1 month at a dose to give mean 12 h serum lithium level of 0.5-0.8 mmol/l. Before starting lithium, after the first dose and again after 1 and 4 weeks on lithium, subjects attended the unit at lunch time. They were starting lithium, after the first dose and again after 1 and 4 weeks on lithium, subjects attended the unit at lunch time. They were weighed and ate their lunch time meal from a food dispenser similar to those in canteens. Subjective rating scales were completed before and after eating. No change in weight was seen. Food intake was slightly increased at the end of the month on lithium compared with the start but had fluctuated during the intervening weeks. There was no relationship between food intake and weight change.

Adult↗
PubMed1991

Chronically implanted intrafascicular recording electrodes.

A newly designed intrafascicular electrode for chronic neural recording was studied by implanting 12 electrodes in the radial nerves of 6 cats for 6 months. Action potentials were monitored at specified intervals throughout the experiment. The number and size of the signals recorded suggest that this type of electrode provides information that is appropriate for feedback control in functional electrical stimulation (FES) systems. Histology of the nerve revealed that the implants are biocompatible and that little damage is caused by the presence of the electrode.

Action Potentials↗
PubMed1988

Differential effect of d-fenfluramine and metergoline on food intake in human subjects.

This study investigated the effect of the 5-HT receptor blocker metergoline (MTG) on d-fenfluramine (d-FF)-induced reduction of food intake in 13 normal male human volunteer subjects. Food was freely available for 2h, 4h after drug administration, from a four-channel automated food dispenser. d-FF (30 mg) reduced total food intake and exerted a marked effect on non-sweet food which was attenuated by the addition of MTG (4 mg). d-FF had less effect on sweet-tasting food while intake of sweet food was significantly increased by MTG. There was a significant interaction between d-FF and MTG on sweet-tasting foods. No effect on MTG was observed on d-FF-induced changes in ratings of hunger.

Adolescent↗
PubMed1988

A clinical trial of the efficacy and acceptability of D-fenfluramine in the treatment of neuroleptic-induced obesity.

Twenty-nine overweight schizophrenic patients maintained on depot neuroleptic injections who wished to lose weight took part in a double-blind, placebo-controlled trial of 30 mg D-fenfluramine. All subjects received dietary advice. Sixteen patients completed the 12-week trial. Rate of weight loss was significantly greater in those taking D-fenfluramine. Side-effects were reported, but no deterioration in mental state was noted.

Adult↗
PubMed1988

Prevalence of obesity in patients receiving depot antipsychotics.

Antipsychotic drugs have long been noted to cause pronounced weight gain, and drug-induced obesity can assume major clinical importance in long-term medication in the management of chronic schizophrenia. Obesity is associated with increased morbidity and may reduce compliance, leading to a return of psychotic symptoms. In a survey of 226 patients attending depot neuroleptic clinics in one inner London borough, it was found that the prevalence of clinically relevant obesity was four times that in the general population.

Adult↗
PubMed1988

The interaction of metergoline, a 5-HT receptor blocker, and dexfenfluramine in human feeding.

Use of the 5-HT antagonist metergoline (MTG) has shown that dexfenfluramine (d-FF) influences food intake in animals via serotoninergic neurones. This study examined the interaction between d-FF and MTG in humans. Healthy male volunteers reported singly at 8:45 A.M. on four weekly occasions following an overnight fast. At 9:00 A.M. they received 30 mg d-FF or matching placebo and at 11:00 A.M. 4 mg MTG or placebo. Hunger and satiety were assessed hourly using visual analog scales (VAS). Subjects had access to a 4-channel automated food dispenser (AFD) from 1:15 to 3:15 P.M. Delivery and recording of each portion of known energy value was contingent on an appropriate button push. Subjects were offered two nonsweet snacks, plus fruit and a chocolate biscuit chosen to each subject's preference. Results for 13 subjects are reported. d-FF reduced hunger VAS, MTG had no effect on hunger and did not attenuate the effect of d-FF. d-FF reduced total food intake by 1306 kJ (312 kcal p less than 0.01) at 120 min. MTG increased food intake and attenuated the effect of d-FF on food intake but not significantly. d-FF markedly reduced the intake of nonsweet food; this was attenuated by MTG which alone had no effect on nonsweet food. d-FF had no effect on the intake of sweet tasting food during the first hour; by 120 min it had reduced energy intake by 342 kJ (82 kcal, t = 1.34, n.s.).(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Interactions↗
PubMed1987

Receptor blocking drugs and amphetamine anorexia in human subjects.

The interaction between the receptor antagonist thymoxamine (THYM), propranolol (PPL) and metergoline (MTG) with dexamphetamine (d-Amp)-induced anorexia was examined in a series of studies in normal female volunteers. Visual analogue scale (VAS) ratings of hunger were made and food intake was measured using an automated solid food dispenser (AFD). d-Amp (10 mg) significantly depressed hunger ratings compared to placebo in two of the three studies and its effect was countered by the addition of MTG (4 mg). d-Amp significantly reduced food intake compared to placebo in two studies. In all trials the reduction in food intake following d-Amp was significantly greater than would have been predicted from its effect on hunger. THYM (160 mg) and PPL (40 mg) were associated with no changes in food intake when given alone or with d-Amp, MTG increased food intake (but not significantly) and the combined effects of MTG and d-Amp was the algebraic sum of the effect of each; but there appeared to be no true pharmacological interaction between blocker and anorectic. The results indicated that there may be some dissociation between the effect of d-Amp on hunger and food intake but have failed to produce evidence that noradrenergic pathways are involved. The results are consistent with the theories that d-Amp anorexia does not involve the release of 5-hydroxytryptamine (5-HT) but that 5-HT pathways are involved in the feeding process.

Adult↗
PubMed1986

Serotoninergic mechanisms in human feeding: the pharmacological evidence.

This paper reviews the evidence of serotoninergic mechanisms in human feeding by considering the effects of 5-HT agonists, precursors and receptor antagonists on hunger, food intake and weight change in normal volunteers, obese people and psychiatric patients. Although there is compelling evidence for a serotonin (5-HT) mechanism being involved, the paper highlights the considerable individual variation in response to pharmacological manipulation of 5-HT. Such variation may reflect differences in the bio-availability of the drugs used. Subtle psychological factors may also play a role in blurring the pharmacological evidence for 5-HT involvement in the highly complex activity of human feeding.

Amitriptyline↗
PubMed1984

The clinical pharmacology of appetite suppressant drugs.

One way of gaining a greater understanding of the central mechanisms underlying hunger and the regulation of feeding behaviour in humans is to examine the actions and interactions on hunger and food intake of drugs with known or presumed pharmacological modes of action. To this end we have undertaken a number of studies which fall into three main categories: the mechanisms by which amphetamine anorexia is induced; the possible role of endogenous opioids in feeding; the action of amino acids thought to be involved in the regulation of feeding. In this field the potential for cross-fertilization between basic scientists working with laboratory animals and clinical scientists working with human subjects exists. For example, the clinical pharmacologist has been able to test out hypotheses on human subjects which could only have been developed using laboratory animals. Furthermore, using human subjects it is possible to extend the field of inquiry into an exploration of the subjective dimensions of appetite and hunger.

Animals↗
PubMed1982

Relationships between sensory stimulation and stereotyped behaviour in severely mentally retarded and autistic children.

The reinforcing properties of four sensory stimuli (continuous and flashing light, vibration and sound) which were under the subject's control, were examined and the effect on stereotyped behaviour observed. The subjects were 24 severely retarded children in three diagnostic groups; Down's, Rubella and a group which included neither of these diagnoses. Duration of stimulation with continuous light was significantly lower than the other three stimuli, but there were no differential effects on stereotypy, nor diagnostic group differences.

Adolescent↗
PubMed1981

Analysis of the anti-coccidial drug, halofuginone, in chicken tissue and chicken feed using high-performance liquid chromatography.

Methods are described for the analysis of the anti-coccidial drug, halofuginone, in chicken tissue at concentrations as low as 1 ppb (0.001 ppm) and in chicken feed at a concentration of 3 ppm, using high-performance liquid chromatography. The tissue analysis involves: enzymatic release of the halofuginone followed by ethyl acetate extraction under basic conditions, partition into ammonium acetate buffer, concentration using Sep-pakTM C18 cartridge. The feed analysis involves: ethyl acetate extraction under basic conditions, partition into hydrochloric acid, concentration using XAD-2 column chromatography. Both methods use high-performance liquid chromatography with ultraviolet detection for the final analysis. Precision and accuracy data for both methods are given.

Animal Feed↗