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Biomedical subjects

M Heins

Publications and source records attributed to M Heins.

At least 37 records · Page 2Linked to original sources
PubMed1988

Nocturnal asthma: slow-release terbutaline versus slow-release theophylline therapy.

In a double-blind cross-over study, the effects of slow release (S-R) terbutaline tablets (b.i.d. 0.25 mg/kg per day) and S-R theophylline (5.31 mg/kg morning and 10.62 mg/kg evening) were compared in eleven patients with nocturnal asthma. On day seven of each treatment period, drug serum concentrations and peak expiratory flow (PEF) were measured every 2h over a 24-h period. During daytime, terbutaline concentrations ranged from 1.6-14.1 (median 4.5) microgram/l and during the night from 2.1-18.7 (median 4.9) micron/l. Theophylline concentrations ranged from 3.9-24.3 (median 11.5) mg/l during the day and from 3.3-20.9 (median 10.4) mg/l at night. Nocturnal wheezing occurred during theophylline treatment in four patients 7 times and during terbutaline treatment in six patients 22 times. Daytime PEF values were 472 +/- 161 l/min during theophylline therapy versus 445 +/- 169 l/min during terbutaline therapy (p less than 0.05). In the night and early morning there was no significant difference between PEF values with the two treatment forms. During theophylline treatment, fewer inhalations of beta 2-sympathomimetics were used, and there were fewer side effects. One patient experienced severe asthmatic attacks during the terbutaline treatment period. The patients preferred theophylline for the treatment of nocturnal asthma.

Adult↗
PubMed1987

Treatment of nocturnal asthma: the role of sustained-release theophylline and oral beta-2-mimetics.

In two double-blind, multiple-dose cross-over studies the therapeutic effects of SR theophylline preparations given once each night (mean 11.2 mg/kg per day) versus twice daily in equal doses (mean 10.3 mg/kg per day) (study I) and SR-terbutaline in equal doses (mean 0.25 mg/kg per day) versus SR theophylline in unequally divided daily doses (mean 5.3 mg/kg morning dose, 10.6 mg/kg evening dose) study II) were compared in 19 patients with nocturnal asthma. At the end of each treatment period drug serum concentrations and PEFR were measured every 2 hr over a 24-hr period. With the twice-daily, equally divided regimen, serum theophylline concentrations were lower at night than during the day (mean 9.4 +/- 0.9 versus 11.3 +/- 1.0 mg/l). With the single evening administration, serum theophylline concentrations were considerably higher at night (Cmax 16.3 +/- 1.4 mg/l) and the circadian variation of PEFR was significantly reduced. PEFR was higher during night and early morning (283 +/- 14 versus 217 +/- 11 l/min, P less than 0.005). During daytime in study II, PEFR values were slightly higher with theophylline than terbutaline. There was no significant difference in peak flow between either treatment during the night and early morning. However, additional use of inhaled beta-2-mimetics because of asthmatic attacks occurred more often during terbutaline (79 times in 8/10 patients) than theophylline treatment (29 times in 5/10 patients). Symptom scores, number of attacks and side-effects clearly favor the theophylline regimen. We conclude that for patients with nocturnal asthma a once-nightly dose of SR theophylline can be sufficient for stabilization of the airways.

Adult↗
PubMed1984

Perceived stress in medical, law, and graduate students.

Students in the medical and law schools and graduate students in chemistry and psychology at a single institution were asked to complete a questionnaire about events and activities related to their educational programs which they perceived to be stressful. The questionnaire was designed to elicit information about stress associated with academic activities, personal relationships, time pressures, and financial concerns. Information was also obtained about time utilization, health behaviors, crises, and support systems. The authors' hypothesis that medical students would report higher perceived stress levels than students in the other programs was not supported, as the highest total stress score was reported by law students. Factor analysis of a 31-item stress scale produced six separate factors pertaining to the sources of stress: academic concerns, time concerns, fear of failing, classroom interactions, economic issues, and world issues. Time restrictions and economic and academic issues had the highest mean stress scores. The hypotheses by the authors that students would report program-specific stresses and that utilization of support services would differ among the four groups of students were both supported. Implications of these findings are discussed.

Education, Graduate↗
PubMed1984

Perceptions of medical school faculty members and students on clinical clerkship feedback.

The authors in this study investigated faculty members' and students' perceptions of the feedback they provided or received, respectively, during the clerkships in all clinical departments at a university hospital. All faculty members who teach students in the clinical years and all third- and fourth-year medical students were surveyed. Respondents were asked to indicate, on a 7-point scale, the importance they attributed to eight feedback categories and to rate the frequency of actual feedback they felt was provided or received in these eight categories. The results indicate that while both faculty members and students perceived six of the eight feedback categories as equally important, they differed substantially in their ratings of the actual feedback provided or received.

Arizona↗
PubMed1983

Effect of immediate student evaluations on a multi-instructor course.

Immediate student feedback and peer evaluation by a single physician were used to evaluate and monitor an interdisciplinary multi-instructor course. Clinical Correlations with Pathology is taught during the second year of medical school by 50 instructors, each of whom has a limited exposure to sophomore medical students. The format of the course, in which the same students evaluate multiple lecturers in multiple content areas, provided a unique opportunity to demonstrate the reliability and validity of student evaluations. About one-half of the lectures were repeated by the same instructors the following year to the next class of medical students, who also evaluated all of the lectures. Comparison of two consecutive sophomore classes of medical students documented overall course improvement and showed higher ratings given to instructors who presented the same lecture both years. Student evaluation is a powerful technique that can result in positive changes leading toward course improvement.

Education, Medical↗
PubMed1983

Attitudes of pediatricians toward maternal employment.

The largest number of women in history is employed outside the home including 55% of mothers with children less than 18 years of age. The attitudes of pediatricians toward employed mothers were assessed by a mail survey to the entire membership of the American Academy of Pediatrics. Usable responses were received from 5,758 pediatricians (31%). Adequacy of child care and economic necessity were ranked as the most important factors considered by responding pediatricians when advising a mother inquiring whether she should work outside the home. One third of the respondents stated the child can be any age when the mother becomes employed. The majority of respondents did not feel there was a difference between children of employed mothers and homemaker mothers. Special considerations for employed mothers were provided by half of the respondents, more frequently by female than male pediatricians. Most respondents are supportive of mothers working outside the home, but bias against employed mothers does exist. Pediatricians whose spouses do not work outside the home, those in older age groups, and male pediatricians tended to hold more traditional attitudes toward maternal employment.

Age Factors↗
PubMed1981

Women in medical education: a decade of change.

The 1970s was a decade of remarkable growth for women in academic medicine. The percentage of women entering medical school, the number of women on medical-school faculties, and the number of women in senior administrative positions have all increased during the past 10 years. Although substantial modifications have occurred in admission practices and in the general responsiveness of academic medicine to women, it is difficult for women in medical academia to be optimistic, because the number of women at senior professorial ranks and in administrative positions has been slow to change. The challenge to academic medicine in the 1980s is to ensure that women have equal access to leadership positions.

Education, Medical↗