Search PubMed⌕ Search

Biomedical subjects

J Carmichael

Publications and source records attributed to J Carmichael.

At least 163 records · Page 9Linked to original sources
PubMed1983

Bromocriptine in severe adult asthma--a negative report.

A pilot study had suggested that bromocriptine (a dopamine agonist) might be of benefit in severe asthma, particularly in patients with marked diurnal variation in peak flow. Two studies are reported: (1) a longterm double-blind, controlled trial comparing bromocriptine (B) with placebo (P) in patients with severe asthma and, (2) a withdrawal study in patients who had received known bromocriptine, with apparent benefit, for at least one year. Of 27 patients (16B, 11P) admitted to the double-blind trial only eight (4B, 4P) completed 52 weeks on the trial drug as nine (6B, 3P) had been withdrawn for side-effects, eight (4B, 4P) for failure and two (2B) for both reasons. The results, based on changes in steroid dosage and other medication, daily symptom scores and PEF values, suggest that bromocriptine has little effect in asthma. In addition side-effects were frequent and troublesome. In the withdrawal study, ten patients who had been taking bromocriptine for a year or more were switched to an indistinguishable placebo if their asthma was considered to be stable. The results, of this second study, support the conclusion of the double-blind study, that bromocriptine has little beneficial effect in asthma.

Adult↗
PubMed1983

Nebulized salbutamol in life-threatening asthma: is IPPB necessary?

A double-blind crossover trial compared equal doses of nebulized salbutamol delivered with and without intermittent positive pressure breathing (IPPB) in 20 patients admitted to hospital with life-threatening asthma. No significant differences were observed between the two forms of treatment. It was concluded that the use of IPPB to administer nebulized salbutamol in oxygen had no advantage over passive inhalation in the initial treatment of patients with severe acute asthma.

Adolescent↗
PubMed1982

A multicentre phase II trial of vindesine in malignant melanoma.

Fifty-three evaluable patients with advanced malignant melanoma have been treated with vindesine 3 mg/m2 i.v. weekly for a minimum of 6 weeks. An objective response rate of 26% was attained with 17% complete remissions, 78% of which were in stage II disease. The treatment was well tolerated, with alopecia the only clinically significant side-effect (43% of patients). Vindesine is superior to DTIC and should be considered as the best currently available drug for malignant melanoma.

Adolescent↗
PubMed1982

Twice daily inhalation of a new corticosteroid, budesonide, in the treatment of chronic asthma.

The efficacy and side-effects of a new corticosteroid, budesonide, was assessed by comparison with beclomethasone dipropionate in double-blind, cross-over study of 30 patients with chronic asthma. The treatment regimens were budesonide 200 micrograms twice daily by conventional pressurized aerosol with a tube spacer attached and beclomethasone 100 micrograms four times daily via a conventional inhaler. Each treatment was given for four weeks. Results were analyzed using Student's t-test for paired comparisons. No significant differences were found for morning and evening peak flow rates, symptom scores, bronchodilator inhaler usage or forced vital capacity. Forced expiratory volume in one second after 4 weeks on each treatment was significantly higher following budesonide therapy (p less than 0.05), but the absolute changes were small and unlikely to be of clinical relevance. There were no major side-effects during either treatment period, but compared with pre-treatment levels serum creatinine and lactic dehydrogenase levels rose significantly during treatment with budesonide (p less than 0.01 and p less than 0.05 respectively). None of these results reflected clinically important biochemical or haematological changes. There was a significant reduction in neutrophil counts following treatment with beclomethasone (p less than 0.05). In the short term treatment of chronic asthma, budesonide administered twice daily is as effective as four times daily beclomethasone. A twice daily dosage regimen should improve patient compliance with therapy.

Adolescent↗
PubMed1982

Comparison of twice daily administration of a new corticosteroid budesonide with beclomethasone dipropionate four times daily in the treatment of chronic asthma.

The efficacy and side-effects of a new corticosteroid aerosol, budesonide and beclomethasone dipropionate were assessed in 30 patients with chronic asthma in a double-blind cross-over study. Budesonide was administered, 200 micrograms twice daily, from a conventional pressurized aerosol with a tube spacer extension attached and beclomethasone was given via a conventional inhaler in the recommended four times daily dose of 100 micrograms, each treatment being administered for one month. No clinically significant differences were found between the two treatments and no significant side-effects were observed.

Adolescent↗
PubMed1981

Corticosteroid resistance in chronic asthma.

Fifty-eight patients with chronic asthma in whom airflow obstruction was relieved by bronchodilator aerosols but not by oral corticosteroids were compared with 58 other chronic asthmatics who responded equally well to both treatments. The two groups were matched for age and sex. The only significant clinical differences between the two groups were that in the "corticosteroid-resistant" patients there was a more frequent family history of asthma and a longer duration of symptoms. Resistant patients also had a relatively lower peak expiratory flow rate in the morning than later in the day and a greater degree of bronchial reactivity to methacholine. Such features, however, may not be specific criteria of corticosteroid resistance since they were also observed in untreated asthmatics who subsequently responded well to corticosteroids. The failure of prednisolone to inhibit a monocyte-mediated bronchial reaction may explain why some chronic asthmatics do not respond to corticosteroids. Patients with corticosteroid-resistant asthma should be recognised at an early stage so that regular treatment with oral corticosteroids may be withdrawn. Failure to do this results in needless exposure to the risk of developing serious side effects.

Adrenal Cortex Hormones↗
PubMed1980

Comparison of fenoterol and terbutaline administered by intermittent positive pressure breathing.

The bronchodilator properties and side-effects of three doses of fenoterol (0.5 mg, 1 mg and 2 mg) and terbutaline (2.5 mg, 5 mg and 10 mg) were assessed in 12 patients with stable chronic asthma. The drugs were administered by intermittent positive pressure breathing (IPPB) in 40% oxygen via a Bennett ventilator. No differences likely to be of clinical significance were found between the effects of the three different dose levels of fenoterol and terbutaline, although terbutaline had a significantly greater duration of action. It is concluded that fenoterol 2 mg and terbutaline 10 mg can be administered by IPPB in 40% oxygen for the treatment of asthma.

Aged↗
PubMed1979

Comparison of salbutamol given intravenously and by intermittent positive-pressure breathing in life-threatening asthma.

A double-blind crossover trial was carried out during 22 episodes of life-threatening asthma in 19 patients to compare salbutamol given as a 500 microgram intravenous injection and as a 0 . 5% solution administered by intermittent positive-pressure breathing (IPPB) for three minutes. Relief of pulsus paradoxus was significantly better after IPPB than the intravenous treatment. Both treatments significantly improved the peak expiratory flow rate. Salbutamol given intravenously produced a mean increase in heart rate of over 20 beats/min five minutes after treatment compared with the relief of tachycardia that occurred after administration by IPPB. Four patients had noticeable cardiovascular side effects after salbutamol given intravenously, but no such effects were noticed after administration by IPPB. Two patients withdrawn shortly after entry into the trial because of a worsening clinical condition had received intravenous salbutamol. It is concluded that salbutamol given by IPPB is better than that given by slow intravenous injection in severe acute asthma.

Adolescent↗
PubMed1978

General practitioners and professional satisfaction.

One hundred and eighty-five general practitioners participated in a study regarding satisfaction from the doctor-patient relationship. Of these, 71% responded in writing to an open-ended item concerning personal satisfaction. Written responses were assigned to one or more of nine groupings formed by considering the content of general practice and conceptualising characteristics of the doctor-patient relationship. Four characteristics--activity, authority, objectivity and radionality (the clinical model) were assigned 299 written responses. Four characteristics--affinity, continuity, intimacy and reciprocity (the relational model) were assigned 287 responses. The paper discusses the two models, their respective characteristics and physician responses.

Humans↗
PubMed1978

Beclomethasone dipropionate dry-powder inhalation compared with conventional aerosol in chronic asthma.

In a double-blind study beclomethasone dipropionate inhaled as a dry powder in doses of 100 microgram four times daily and 150 microgram four times daily was compared with the conventional aerosol dose of 100 microgram four times daily in 20 outpatients with chronic asthma. Each of the three treatments was given for four weeks. The dry powder in a dose of 150 microgram four times daily had advantages over the other two treatments in terms of FEV1 and the number of exacerbations of asthma during the study. There were no adverse reactions to inhaling dry-powder beclomethasone. It was concluded that this new way of administering the drug was effective in chronic asthma, and should allow most patients with chronic asthma who cannot use conventional pressurised aerosols efficiently to benefit from inhaled corticosteroid treatment.

Adult↗
PubMed1977

Research in human sexuality education.

Since human sexuality courses are relatively recent additions to most U.S. medical school curricula, there are no established procedures for evaluating the courses. The purpose of this study was to test medical students' attitudes toward concepts in sexuality before and after a 5-day sexuality course using the semantic differential. The concepts students rated were "my sexuality", "masturbation", "homosexuality", and "my role in understanding sexual problems". Post-test scores were subtracted from pre-test scores and analysed by multivariate analysis of variance testing for significant difference from zero. Ninety-six second-year medical students completed the pre- and post-semantic differential tests. The changes between the pre- and post-tests were significant at the 0-001 level for all four concepts with the concept "homosexuality" showing the greatest change. The study suggests the semantic differential may be an effective instrument in assessing attitude changes. It also suggests the teaching techniques used in human sexuality courses may be successfully applied to other areas of medical education.

Adult↗