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Biomedical subjects

M Buckley

Publications and source records attributed to M Buckley.

99 records · Page 6Linked to original sources
PubMedDate not supplied

Appropriateness of gastric antisecretory therapy in hospital practice.

BACKGROUND: Recent data indicate an exponential increase in proton pump inhibitor (PPI) prescribing, and concerns are raised regarding the appropriateness of these prescriptions and the financial implications. AIM: To survey the appropriateness of PPI prescription in a cohort of patients in a tertiary referral hospital. METHODS: Prescription records of all inpatients on a randomly selected day were reviewed. The appropriateness of prescription and relevant investigations were identified by interview of patients, review of patient records and of a computerised endoscopy records system. RESULTS: Thirty-two per cent (87 of 272) of all patients were on PPIs. A valid indication for therapy was not apparent in 63% of the patients on PPIs with the only predictive factor for inappropriate prescription being increasing age. Only 36 of the 87 patients on PPIs had undergone appropriate investigations for their gastrointestinal symptoms. Gender, age, speciality of admission or duration of hospital stay did not influence the appropriateness of prescription or performance of relevant investigations. CONCLUSION: There appears to be a widespread and inappropriate use of PPIs in hospital practice.

Aged↗
PubMedDate not supplied

The effect of fatigue, sleep deprivation and onerous working hours on the physical and mental wellbeing of pre-registration house officers.

The potential deleterious effects of doctors' long and arduous shifts have received relatively scant attention. This study addressed the effect of a 32 h on-call shift on 16 pre-registration medical house officers in St. James's Hospital, Dublin. We assessed 5 psychological parameters (Tension-Anxiety, Depression-Dejection, Vigour-Activity, Fatigue-Inertia and Confusion-Bewilderment) as well as 5 simple tests of alertness and concentration both pre- and post-call. The doctors were randomly assigned to be tested either pre- or post-call. On average the doctors got 4.5 hours sleep during a 32 h shift. This long shift had an adverse effect on all the psychological parameters (p < 0.05) except Depression-Dejection. The total mood disturbance score, which has been shown to correlate well with general psychological well-being, deteriorated significantly after the 32 h shift, p < 0.005. Two of the simple tests of alertness and concentration (Trail-making test and Stroop Color-Word test) also showed a significant fall-off in performance with sleep deprivation, p < 0.05, although the remaining tests (Delayed Story Recall, Critical Flicker Fusion and Three Minute Grammatical Reasoning Test) were not significantly impaired by the 32 h shift. This study shows that prolonged periods of duty without sleep adversely affect junior doctors, both in their psychological well-being and in their ability to carry out simple tasks.

Adult↗
PubMedDate not supplied

Hepatitis C among drug users: consensus guidelines on management in general practice.

BACKGROUND: Hepatitis C (HCV) is a common cause of morbidity among patients who attend general practitioners (GPs) in Ireland for methadone maintenance treatment. AIMS: To describe the development and content of guidelines for the management of HCV among current or former opiate users in the Eastern Regional Health Authority area attending GPs for methadone treatment. METHODS: The guidelines were produced in five stages: identification of key stakeholders; development of evidence-based draft guidelines; discussion of content; determination of 'Delphi'-facilitated consensus and review by a sample of GPs for whom the guidelines would be intended. RESULTS: The guidelines contain advice for GPs on all aspects of care of patients at risk of HCV, including general and preventative care, care of other bloodborne and hepatotoxic viruses, and the factors to be considered and appropriate evaluation prior to referring a patient for assessment at a hepatology unit. CONCLUSIONS: GPs have an important role to play in the care of patients at risk of, or infected with, HCV.

Adolescent↗
PubMedDate not supplied

Helicobacter pylori infection and gastric cancer: usefulness of screening high risk groups.

The presence of Helicobacter pylori is associated with approximately an 8 fold increase risk of developing gastric cancer. Helicobacter pylori is easy to diagnose non-invasively and effectively treated with antibiotics. More research into the natural history of Helicobacter pylori associated premalignant lesions, e.g. the reversibility of types 1 and 2 intestinal metaplasia, is necessary before a screening strategy can be developed. It also remains to be seen whether specific strains of H. pylori are associated with gastric cancer and whether differences in the host response to Helicobacter pylori infection affect the clinical outcome. When these issues are clarified it will be possible to identify individuals who are at high risk of developing gastric cancer and who will benefit from eradication. It is inevitable that asymptomatic individuals at high risk will be screened for the presence of Helicobacter pylori infection.

Female↗
PubMedDate not supplied

Guidelines for the management of Helicobacter pylori-related upper gastrointestinal diseases. Irish Helicobacter Pylori Study Group.

The discovery of H. pylori is the most important development in gastroduodenal disease this century. It has completely changed our understanding of conditions that occur in the upper gastrointestinal tract. Eradication of the bacterium will cure peptic ulcer disease, decrease the symptoms of non-ulcer dyspepsia and may prevent gastric cancer. There has been an exponential increase in the amount of research in this area in recent years and, consequently, there is considerable confusion as to how H. pylori-related conditions should be managed. It is hoped that these guidelines will clarify some of these issues.

Adult↗
PubMedDate not supplied

Death rights.

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Adult↗