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Biomedical subjects

M McMurchie

Publications and source records attributed to M McMurchie.

9 recordsLinked to original sources
PubMed1998

Safety and immunogenicity of a candidate therapeutic vaccine, p24 virus-like particle, combined with zidovudine, in asymptomatic subjects. Community HIV Research Network Investigators.

OBJECTIVES: To evaluate the impact of therapeutic immunization with p24 virus-like particle (VLP) and zidovudine (ZDV) on p24 antibody titre (primary endpoint), CD4+ cell counts, cellular responses to the immunogen and recall antigens, and viral load (secondary endpoints) in subjects with asymptomatic HIV infection and CD4+ counts greater than 400 x 10(6) cells/l. DESIGN: A double dummy, double-blind randomized placebo-controlled Phase II trial of the therapeutic vaccine p24-VLP, with or without ZDV. METHODS: ZDV-naive subjects were randomized to one of three groups for 6 months: group A, ZDV 200 mg three times daily plus intramuscular administration of alum adjuvant monthly; group B, ZDV 200 mg three times daily plus p24-VLP (500 microg) in intramuscular alum monthly; group C, placebo capsules plus p24-VLP (500 microg) in intramuscular alum monthly. Subjects were followed for a further 6 months. RESULTS: Sixty-one patients received vaccinations. The mean CD4+ cell counts pretherapy for groups A, B, and C were 605 +/- 25, 668 +/- 43, and 583 +/- 30 x 10(6) cells/l, respectively. Treatment was well tolerated. At both 24 and 52 weeks there were no significant differences between the treatment groups in terms of antibody responses to p24, CD4+ or CD8+ cell counts, viral load, T-cell responses to p24, p17, recall antigen or mitogen, or markers of immune activation, despite induction of antibody and proliferative responses to the carrier protein of the vaccine. CONCLUSION: Vaccination with p24-VLP was well tolerated. p24-VLP either alone or in combination with ZDV did not significantly alter either antibody or proliferative responses to p24, or CD4+ cell number, immune activation or viral load over 12 months.

AIDS Vaccines↗
PubMed1996

Managing HIV. Part 2: Phases of disease. 2.4 HIV and advanced immune deficiency.

Advanced immune deficiency is defined as a CD4 cell count below 200/microL. This phase is marked by considerable medical intervention requiring close coordination between general practitioner and specialist, with the goal of minimising the patient's time in hospital. The patient must be assisted with the psychological adjustments that lead to death with dignity. Managing HIV in all its manifestations will make a great difference to the quality of both life and death.

Acquired Immunodeficiency Syndrome↗
PubMed1993

HIV seroconversion illness.

HIV seroconversion is associated with characteristic clinical findings which reflect the first interaction of HIV with the host immune system. Recognition of the characteristic clinical illness associated with HIV seroconversion helps to establish an early diagnosis and obviates the need for further investigation or empiric therapy. It may also afford a unique opportunity to institute counselling to prevent the further spread of HIV in the community.

Adult↗
PubMed1993

The role of the primary care physician.

Increased emphasis on community-based care of people with human immunodeficiency virus (HIV) infection and AIDS is recommended by the National HIV/AIDS Strategy. Patients prefer to be treated within their community, and primary care reduces the demand on scarce, costly, and already overloaded hospital facilities. Thus, there is an increasingly large role for primary care physicians to play in the management of people infected with HIV. The traditional primary health care approach of health promotion and disease prevention that focuses on case-finding, continuity of care and problem resolution, adapts well to HIV/AIDS. Primary care is holistic, patient based, and has as its focus healing rather than cure. Primary care physicians have a role in the prevention of HIV infection, in identifying asymptomatic seropositive people, in offering early therapeutic interventions, in the early detection of opportunistic infections and HIV-related malignancies, and in the ongoing management of chronic ill-health. For most people, the primary care sphere is the appropriate level for palliative and terminal care. There is also a role for primary care physicians in the psychosocial management of people with HIV/AIDS in supporting those close to the patient, and in educating the community in general about the social parameters of HIV/AIDS.

Australia↗
PubMed1991

Life after cancer.

Almost 50 per cent of people diagnosed with cancer will be cured. The physiological and psychosocial costs associated with cure for some long-term survivors can be relevant to their continuing care. General practitioners need to be aware of potential problems and seek appropriate advice about new symptoms.

Adult↗
PubMed1990

A randomised trial of general practitioner-written invitations to encourage attendance at screening mammography.

The aim of this study was to examine the effectiveness of general practitioner-written invitations to the Breast X-Ray Programme of the Central Sydney Area Health Service. Five out of six randomly selected general practices in Drummoyne participated. Within each practice, women aged 45 to 70 were individually randomised to receive or not receive a letter from their general practitioner (GP). Thirty-two per cent of women attended if invited compared to 7 per cent if they were not sent an invitation. An attendance of 38 per cent was obtained for women whose GP chose to send a letter with an appointment compared to 24 per cent for women whose GP chose to send a general invitation without an appointment. Combining all practices, women who consulted their GP within the previous 6 months were more likely to attend in response to the invitation (38 per cent) than women whose last consultation was more remote, dropping to 15 per cent in those who last attended that GP over 2 years earlier. Women aged 65 to 70 years old were at least as likely to respond to the invitation as women aged 45 to 64. Reminder letters were subsequently sent to a random half of nonrespondents who had attended the practice in the previous 12 months. A further 18 per cent of women attended after the reminder letter was sent (8/45), compared with 2 per cent in the control group (1/48). Twenty-seven per cent of women in Drummoyne had already attended for screening mammography before the trial.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Premenstrual syndrome. A general practice view.

Up to 95 per cent of women experience some physical or psychological symptoms in the premenstrual phase of the cycle. The authors describe the syndrome and provide a practical guide to management strategies for women experiencing severe symptoms in this part of their cycle.

Contraceptives, Oral↗