Search PubMed⌕ Search

Biomedical subjects

M Church

Publications and source records attributed to M Church.

At least 19 recordsLinked to original sources
PubMed2003

Effect of GastroGard and three compounded oral omeprazole preparations on 24 h intragastric pH in gastrically cannulated mature horses.

REASONS FOR PERFORMING STUDY: Ulceration of the squamous gastric mucosa is commonly associated with intensive training programmes in horses, but only one compound ('Gastrogard') has been subjected to controlled scrutiny as to therapeutic efficacy. OBJECTIVES: To compare the gastric acid inhibitory efficacy of one manufactured ('GastroGard') and 3 generic pharmacy-compounded preparations of the proton pump inhibitor omeprazole (OME) in the mature horse. HYPOTHESIS: All OME preparations tested would induce a clinically acceptable effect. METHODS: Six healthy mature gastrically cannulated horses of various breeds, 3 mares and 3 geldings, were used. Each product was administered per os once daily (0730 h) at an equivalent dose of 4 mg OME/kg bwt, in a randomised complete repeated measures design for sequence of individual preparation treatment per horse. There was a minimum of 14 days between treatment regimens. A portable unit that recorded pH continuously was attached to a recording electrode fixed within the gastric lumen via the gastric cannula. Three 24 h recordings were made one day before and during Days 2 and 7 after commencement of a 7 day treatment with each of the 4 individual preparations. The horses were fed as usual throughout the study. RESULTS: Only the GastroGard and one other preparation induced a significant increase over baseline in mean percentage of time that the pH was > 4.0 and mean median intragastric pH, during the first 14 and 12 h post treatment respectively, for both Days 2 and 7 post treatment. Both these products had a vehicle pH > 8.0, in contrast to the 2 less effective products, where the vehicle pH was < 6.0. CONCLUSIONS: OME at 4 mg/kg per os s.i.d. can effectively maintain intragastric pH at an accepted anti-ulcerogenic level for at least 12 h post administration in mature horses. In contrast to GastroGard, it should not be expected that all compounded preparations of OME are equally effective in achieving this performance. It appears that vehicle pH might play an important part in determining preparation efficacy. POTENTIAL RELEVANCE: Optimal timing for daily dosing of athletic horses with an effective OME preparation, in order to suppress gastric squamous ulceration, might be 4-8 h prior to a training session.

Administration, Oral↗
PubMed1998

Effect of systemic beta-agonist therapy on IgE production in allergic subjects in vivo.

BACKGROUND: Although beta2-adrenoceptor agonists are widely used in the treatment of asthma, a number of studies have suggested that their long-term use may exacerbate the condition. One possible mechanism for this stems from the in vitro observation that beta2-agonists increase IgE synthesis by human blood mononuclear cells. OBJECTIVE: We sought to examine the effect of regular beta2-agonist therapy on IgE production in vivo in human volunteers. METHODS: Placebo or salbutamol (8 mg BD) tablets were given in a double-blind, randomized fashion to 25 volunteers allergic to grass pollen throughout a period encompassing the UK grass pollen season (April through September). Levels of serum IgE were measured monthly, and nasal IgE was measured at the height and end of the season. Efficacy was assessed through monthly recordings of symptoms of blocked nose (vascular) and other symptoms of rhinitis (nonvascular). RESULTS: For the whole group the geometric mean of serum IgE levels rose from a baseline of 58.7 IU/mL (range, 0 to 1027 IU/mL) to 140 IU/mL (range, 12 to 878 IU/mL) at the height of the pollen season (P =.0001). There was no significant difference between the magnitude of the rise in IgE between the groups with a ratio of increase for salbutamol/placebo of 1.17 (confidence interval = 0.78 to 1.75). There was no change in nasal IgE levels. Total and nonvascular symptom scores were reduced by salbutamol, reaching statistical significance at the height of the pollen season (P <.05). CONCLUSION: An oral dose of the beta2-agonist salbutamol, sufficient to maintain therapeutic levels and provide clinical benefit, does not accentuate the seasonal increase of IgE in human atopic volunteers.

Adrenergic beta-Agonists↗
PubMed1998

Assessing medical student effectiveness from the psychiatric patient's perspective: the Medical Student Interviewing Performance Questionnaire.

This study sought to develop and pilot-test a patient-completed rating scale of medical student effectiveness while training in psychiatry. Specifically, the study focused on: (1) examining the statistical reliability and validity of a new scale; (2) using the measure to assess patient satisfaction with medical student care during the psychiatry clerkship; and (3) providing some experience-based recommendations about utilizing patient feedback when training medical students in psychiatry. Data were collected over an entire academic year and involved 35 third-year medical students and ratings of their performance provided by 102 psychiatric inpatients. Participants were recruited from three inpatient units and the rate of participation was 62.5%. Principle components analyses of the Medical Student Interviewing Performance Scale (MSIPQ) showed that the overall scale consisted of two, theoretically relevant subscales called 'Rapport' and 'Treatment Feedback.' Each subscale had adequate reliability. In addition, the two subscales were shown to each account for unique variance in two separate questions assessing the patient's overall ratings of rapport and treatment helpfulness. Finally, patients' mean ratings of medical student effectiveness were examined and showed very high levels of satisfaction with the student-patient relationship and the quality of care received. This study is among the first to examine patient satisfaction with medical student providers among a general population of psychiatric inpatients. Recommendations are made about the ways in which the MSIPQ can be used to strengthen the training of medical students in psychiatry.

Adult↗
PubMed1996

Effect of resection margins on the recurrence of Crohn's disease in the small bowel. A randomized controlled trial.

OBJECTIVE: The authors assess the effect of surgical margin width on recurrence rates after intestinal resection of Crohn's Disease (CD). BACKGROUND: The optimal width of margins when resecting DC of the small bowel is controversial. Most studies have been retrospective and have had conflicting results. METHODS: Patients undergoing ileocolic resection for CD (N = 152) were randomly assigned to two groups in which the proximal line of resection was 2 cm (limited resection) or 12 cm (extended resection) from the macroscopically involved area. Patients also were classified by whether the margin of resection was microscopically normal (category 1), contained nonspecific changes (category 2), were suggestive but not diagnostic for CD (category 3), or were diagnostic for CD (category 4). Recurrence was defined as reoperation for recurrent preanastomotic disease. RESULTS: Data were collected on 131 patients. Median follow-up time was 55.7 months. Disease recurred in 29 patients: 25% of patients in the limited resection group and 18% of patients in the extended resection group. In the 90 patients in category 1 with normal tissue, recurrence occurred in 16, whereas in the 41 patients with some degree of microscopic involvement, recurrence occurred in 13. Recurrence rates were 36% in category 2, 39% in category 3, and 21% in category 4. No group differences were statistically at the 0.01 level. CONCLUSION: Recurrence of CD is unaffected by the width of the margin of resection from macroscopically involved bowel. Recurrence rates also do not increase when microscopic CD is present at the resection margins. Therefore, extensive resection margins are unnecessary.

Adult↗
PubMed1995

Role of elevated plasma soluble ICAM-1 and bronchial lavage fluid IL-8 levels as markers of chronic lung disease in premature infants.

BACKGROUND: Pulmonary neutrophilia characterises both the relatively transient inflammation associated with infant respiratory distress syndrome (IRDS) and the persistent inflammation of chronic lung disease. The possibility that persistently raised markers of inflammation indicate the development of chronic lung disease in low birth weight (< 1730 g) preterm (< 31 weeks) infants was therefore investigated. METHODS: Soluble ICAM-1 (sICAM-1) levels in plasma, and interleukin (IL)-8 and myeloperoxidase (MPO) levels in bronchial lavage fluid (BLF) obtained from 17 infants on days 1, 5, and 14 following birth were measured and correlations with the number of neutrophils in BLF sought. Peripheral neutrophils were isolated on Polymorphoprep and chemotactic responsiveness to IL-8 was assessed using micro Boyden chambers. RESULTS: Sixteen infants developed IRDS and, of these, 10 infants subsequently developed chronic lung disease. Levels of IL-8 in BLF at 14 days of age correlated with the long term requirement for intermittent positive pressure ventilation (IPPV). Interleukin 8 levels in BLF correlated with neutrophil numbers and MPO concentration, suggesting both recruitment and activation in response to this cytokine. Antibody depletion studies showed that approximately 50% of total neutrophil chemotactic activity in BLF was due to IL-8. No difference in peripheral neutrophil chemotactic responsiveness at any age was observed for infants with IRDS or chronic lung disease. Plasma soluble intercellular adhesion molecule (sICAM-1) was higher at 14 days of age in infants who developed chronic lung disease than in those with resolving IRDS, and correlated with severity of disease, as indicated by duration of IPPV. CONCLUSIONS: The results indicate that high levels of plasma sICAM-1 and IL-8 in BLF at day 14 correlate with the development of chronic lung disease and indicate the severity of disease.

Biomarkers↗
PubMed1993

On the seamy side.

Explore the source record for details and available documents.

Administrative Personnel↗
PubMed1991

Appreciating managers in the NHS.

The redefined roles within the NHS, and the changed organisational structures required to meet the challenges of the purchaser/provider environment, are bringing an unprecedented state of flux between organisations and their staff. New roles and altered responsibilities, more fluid organisational structures, all increase the risk of individuals being placed in inappropriate positions. Each one of these mismatches, argue Michael Church and Derek Houghton, represents a misuse of our most valuable resource--people, and is a cost or waste for the organisation.

Administrative Personnel↗
PubMed1990

A health promotion module for undergraduate medical students.

This paper describes a 4-day module on health promotion which is part of the undergraduate programme for medical students at the University of Edinburgh. Early experience of the module from both the learner and teacher perspectives are reported. The module is part of a new 4-week course on community medicine for fourth- and fifth-year students and is a collaborative venture between people working in the field of health promotion in the University, the local health service and the national health education organization, the Scottish Health Education Group. The aims of the module, together with details about the content, teaching methods and form of assessment are described. Some of the formal evaluation results are presented. The module has proved highly popular with both students and teachers. The paper concludes with a discussion of the key factors that have been important in the successful development of the module.

Attitude of Health Personnel↗
PubMed1988

Leukotriene C4 and histamine in early allergic reaction in the nose.

We have examined the measurements of LTC4 and histamine in nasal lavage fluids and blown secretions as a possible model of the early mediator events during nasal allergy. A nasal challenge with grass pollen extract was undertaken on two separate occasions in 20 patients with a history of seasonal rhinitis and a positive immediate skin test to grass pollen. A 2 ml nasal lavage was performed before allergen challenge, and blown secretion collected separately 15 min after the provocation, followed by a final 2 ml nasal lavage. The dilution of nasal secretion by the lavage fluid was determined using 99mTc-labelled albumin as an exogenous marker added to the fluid. The amounts of admixture in the nasal lavages did not correlate to the concentrations of LTC4 and histamine, indicating that the variable amounts of nasal secretion in nasal lavage do not constitute a confounding variable for measurements of LTC4 and histamine. In the pre-challenge lavages, the median concentrations, of LTC4 and histamine were 1.7 and 52 nmol/l respectively. Following allergen challenge neither LTC4 nor histamine measured in nasal lavage showed any significant change from pre-challenge baseline values. However, measurements of both mediators in the blown secretion showed a significantly higher concentration than in the pre- or post-challenge lavage samples, compatible with transitory release during the acute allergic reaction. However, it seems doubtful whether measurements of LTC4 or histamine can be compared between blown secretion and nasal lavage fluid, even if the dilution factor is disregarded.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗