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Biomedical subjects

M Pirmohamed

Publications and source records attributed to M Pirmohamed.

96 records · Page 6Linked to original sources

Use of adrenal arterial embolization in severe ACTH-dependent Cushing's syndrome.

The management of a patient with severe Cushing's syndrome due to ectopic ACTH produced by a medullary carcinoma of the thyroid is described. Initial treatment with maximal adrenolytic medical therapy and two attempts at bilateral adrenal venous infarction had failed to control the disease, and she was at that time unfit for surgery. Subsequent use of bilateral adrenal arterial embolization enabled medical therapy to produce sufficient control of the Cushing's syndrome to allow bilateral adrenalectomy to be performed successfully, with resultant cure of the excessive cortisol production.

ACTH Syndrome, Ectopic↗

General practice nurses' knowledge of alcohol use and misuse: a questionnaire survey.

Nurses in general practice (termed practice nurses) are an under-utilized resource for the detection and management of patients with alcohol misuse. However, little is known about their knowledge and attitudes towards alcohol use and misuse. We therefore conducted a postal questionnaire survey of 132 practice nurses in Liverpool (UK). The results of our survey (response rate 77%) show that a knowledge and skills gap exists in the delivery of effective advice on alcohol-related issues. Indeed, our results suggest that only one in two women and one in three men are receiving correct advice on sensible limits of alcohol consumption, this despite the fact that alcohol histories are taken. Further training was requested by most nurses to develop their screening and health promotion roles, and to become involved in the management of patients with alcohol-related problems in primary care. We suggest practice nurses should be encouraged to become involved in screening for, and management of, alcohol-related problems. However, it is important to ensure that the nurses receive appropriate training and have adequate back-up facilities from doctors and other workers involved in the care of patients with alcohol-related problems.

Alcoholism↗

The role of polymorphisms of glutathione S-transferases GSTM1, M3, P1, T1 and A1 in susceptibility to alcoholic liver disease.

AIMS AND METHODS: Oxidant stress is proposed to be an important pathogenic factor in liver damage related to alcohol. The glutathione S-transferases (GSTs) are a group of polymorphic enzymes that are important in protection against oxidant stress. As there is evidence for genetic susceptibility to alcohol-related liver disease we have compared the frequency of polymorphisms of GSTM1, M3, P1, T1 and A1 by polymerase chain reaction (PCR) on leucocyte DNA in patients from North Staffordshire, Birmingham and Liverpool with alcohol-related chronic liver disease heavy drinking and normal local controls. RESULTS: There were no significant differences in GSTM1, GSTM3 or GSTP1 genotype frequencies among patients, drinking and non-drinking controls from the three centres. There was a significant increase in the GSTT1 null Liverpool alcoholic liver disease (ALD) patients compared with corresponding non-drinking controls (26.3 and 14.6%, respectively; P = 0.044, odds ratio (OR) = 2.1, 95% CI = 1.1-4.7) though this was not repeated in the Birmingham and North Staffordshire cohorts. For GSTA1, the -69 CC genotype was associated with increased risk of ALD in the Liverpool group, but a reduced risk in the North Staffordshire group. CONCLUSIONS: We have failed to demonstrate within the limitation of a case-control study a reproducible significant association of GST polymorphisms with susceptibility to ALD but there are suggestions that GSTA1 and GSTT1 warrant further study.

Chi-Square Distribution↗

Therapeutics 1995.

A joint conference on therapeutics with the Faculty of Pharmaceutical Medicine was held at the Royal College of Physicians on 28 June 1995, organised by Professor M C L'E Orme. A wide variety of topics was covered ranging from management of acute poisoning to the treatment of myocardial infarction, as well as the teaching of therapeutics in the new undergraduate medical curriculum. The aim of the conference was to provide an overview of the most recent therapeutic developments and controversies in the specific subject areas covered.

Bone Diseases, Metabolic↗

Reporting of adverse drug reactions: practice in the UK.

As the range of available drugs becomes increasingly wide, it is ever more important for adverse drug reactions and interactions to be reported. With the extended role of the nurse moving closer towards nurse prescribing, this article seeks to demystify the adverse drug reactions reporting system in the UK, and explain the role of nurses.

Adverse Drug Reaction Reporting Systems↗