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Biomedical subjects

M B Allen

Publications and source records attributed to M B Allen.

At least 19 recordsLinked to original sources
PubMed2000

Reproducibility of bronchodilator response for a reservoir dry powder inhaler following routine clinical use.

The performance of dry powder inhaler (DPI) devices, particularly reservoir DPIs, may be influenced by environmental conditions. This study compared the bronchodilator efficacy and in vitro aerosol characteristics of salbutamol, delivered via a novel reservoir DPI (Clickhaler) and a conventional pressurized metered-dose inhaler (MDI) before and after use of the DPI in clinical practice. Following a screening visit, patients received cumulative doses of salbutamol (100, 200, and 400 microg) via DPI or MDI on separate days in a double-blind, crossover design before and after a 4-week period, during which the DPI was used as the patients' first-line bronchodilator. Lung function responses (forced expiratory volume in 1 sec [FEV1], forced vital capacity [FVC], and peak expiratory flow [PEF]) to salbutamol delivered by DPI and MDI and in vitro aerosol characteristics were not significantly different before and after the period of DPI patient use. DPI performance, assessed in vivo and in vitro, is maintained following an extended period of patient use.

Adult↗
PubMed1999

General practice spirometry in North Staffordshire.

Spirometry is suggested, in North American and European guidelines, to be the most important measurement of lung function for the management of patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to determine attitudes to and utilization of spirometry in general practices within North Staffordshire. All 95 practices in North Staffordshire were surveyed by telephone, using a standard proforma. Eighty-four practices (48 fundholding) containing 224 general practitioners (GPs) and serving 472,420 patients, agreed to take part. The survey was completed by practice nurses on 63 occasions, GPs on 14 and practice managers on seven. Eighteen practices possessed a spirometer, although eight did not use it. The measurements were performed by doctors in five of the practices, nurses in two and by both in three. Only two users had received formal training in the performance and interpretation of spirometry. Of the three practices using pneumotachograph spirometers, none knew how often the machine should be calibrated. Spirometry was used by five practices for diagnosis (although only four used it to determine forced expiratory volume in one second (FEV1)), three for monitoring and only one for bronchodilator reversibility testing. Although 44 (52%) practices thought that, ideally, spirometry should be available in the practice, only 10 of the 18 who had spirometers were currently providing this facility. Furthermore, the poor training puts into question the validity of some of the results obtained. Open access to hospital spirometry is one method of addressing these problems, and 73 (87%) practices, including 16 who already owned a spirometer, said that they would use such a service.

Data Collection↗
PubMed1996

Compliance with oral corticosteroids during steroid trials in chronic airways obstruction.

BACKGROUND: Corticosteroid trials are an important part of the assessment of patients with chronic airways obstruction, but false negative results will occur if the treatment is not taken. To determine compliance low dose phenobarbitone has been used as a marker. METHODS: Thirty six patients referred to a chest clinic for assessment of their airways obstruction were studied. They were instructed to take eight capsules (each containing 5 mg prednisolone and 0.5 mg phenobarbitone) per day for two weeks. The response was assessed by home peak flow monitoring and clinic spirometric tests. Plasma phenobarbitone levels were measured after the trial to enable calculation of the dose to plasma concentration ratio (level to dose ratio, LDR) and the result was compared with the reference range for fully compliant individuals. RESULTS: Five patients defaulted from follow up, 23 had LDR values within the expected range, and eight had low LDR values consistent with poor compliance. The nine patients with steroid responsive disease (> 20% improvement in peak flow or spirometric parameters) all had LDR values in the expected range. CONCLUSION: Excluding those who defaulted whose compliance must be questionable, eight (26%) patients did not fully comply with the steroid trial. Not all patients who fail to respond to a two week home steroid trial have a steroid "unresponsive" disease.

Adult↗
PubMed1995

Childhood cancer in Britain: the National Registry of Childhood Tumours and incidence rates 1978-1987.

The National Registry of Childhood Tumours contains population-based data on childhood cancers diagnosed throughout Great Britain from 1962 onwards. This paper describes the methodology of the Registry, presents incidence rates for 1978-1987 and describes other uses of the data. Total age-standardised annual incidence was 118.3 per million. The most frequent diagnostic groups were leukaemias (age-standardised rate 39.8), brain and spinal tumours (27.0), lymphomas (11.1), sympathetic nervous system tumours (8.3), kidney tumours (7.7) and soft-tissue sarcomas (7.5). Incidence rates were similar to those reported from other Western industrialised countries. The data are also used for a wide range of epidemiological and other studies. These include analyses of geographical variations in incidence, trends in survival, health of long-term survivors and their offspring and the genetics of childhood cancer. Information is frequently provided for clinicians and research workers, and series of specific types of cancer are compiled for further study. The Registry depends for the completeness and accuracy of its data on a wide range of organisations and individuals, and it is essential that this cooperation continues if the Registry is to be maintained.

Adolescent↗