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Biomedical subjects

M R Partridge

Publications and source records attributed to M R Partridge.

At least 55 records · Page 3Linked to original sources
PubMed1995

Asthma: lessons from patient education.

Asthma is a common condition. Recent understanding of the disease has meant that the inflammatory process in the airways is likely to be treated by the regular use of preventative therapy even when the patient is well. The evidence suggests that such treatment is often not taken. Audit suggests that poor communication and lack of information remains a common problem. There is increasing use of a team approach to the management of asthma, often necessitated by the sheer numbers of patients requiring regular review. Such an approach combined with the giving of control of their own condition to the patients, has now been shown to improve outcomes.

Asthma↗
PubMed1995

Delivering optimal care to the person with asthma: what are the key components and what do we mean by patient education?

The new understanding of the pathogenesis of asthma has led to an increasing perception of the disease as a chronic condition, rather than one consisting of acute exacerbations. Health professionals need to help patients to accept this new understanding, and this involves a consideration of how best to deliver care and how best to enhance compliance. Good communication is essential, and structured patient education has now been shown to be cost effective. All health professionals need to think how education may best be incorporated into their care. Such care will involve the development of a partnership between health professional and the patient and their loved ones, and the acquisition by patients of skills in self-management. Several unknowns remain regarding who benefits more from group education as opposed to individual education, and some details of guided self-management. However, in the face of clear evidence of the benefits of patient education, these areas for further study should not delay the adoption of a strong commitment to education by all of those who care for those with asthma.

Asthma↗
PubMed1994

Fulminant pregnancy-related Churg-Strauss syndrome.

Pregnancy has not hitherto been known to influence the course of Churg-Strauss syndrome. We describe a case where relapse occurred in four successive pregnancies. The disease proved fatal in the last pregnancy when aggressive treatment failed to reverse fulminant cardiac disease.

Adult↗
PubMed1994

Community asthma clinics: 1993 survey of primary care by the National Asthma Task Force.

OBJECTIVES: To establish a baseline of work done in primary care asthma clinics in the United Kingdom and to assess the degree of clinical delegation to nurses and the appropriateness of their training. DESIGN: Prospective questionnaire survey of asthma care in general practices and a subsidiary survey of all family health services authorities (FHSAs) of the number of asthma clinics in their area. SETTING: All 14,251 general practices in the United Kingdom and 117 FHSAs or health boards (Scotland and Northern Ireland). RESULTS: Questionnaires were returned by 4327 (30.4%) general practices, 54% being completed by practice nurses and 22% by general practitioners; in 24% profession was not stated. In all, 77.2% (3339/4327) of respondents ran an asthma clinic. 60 FHSAs state the number of asthma clinics at the time of the general practice survey (total 3653 clinics); within responding FHSAs 1702 (46.6%) practices running an asthma clinic replied to the general practice survey. Clinics exclusive for patients with asthma mostly occurred in practices with five or more general practitioners (70.2%), compared with single-handed practices (31.7%). The average number of asthma clinics run per practice was five a month; the average duration was 2 hours and 20 minutes. 1131 (48.8%) nurses ran clinics by themselves, 1180 (47.9%) with the doctor, and 39 (1.7%) had no medical input. Comprehensive questioning occurred other than for nasal (872, 26.1%) or oesophageal (335, 10.0%) symptoms and use of aspirin and non-steroidal drugs (1161, 33.4%). Growth in children was measured by only a third of respondents. Of the 1131 nurses who ran clinics alone, 251 (22.2%) did so without formal training entailing assessment. CONCLUSION: Asthma clinics are now common in general practice and much of their work is done by nurses, a significant minority of whom may not have had sufficient training. IMPLICATIONS: As this survey is probably biased toward the more asthma aware practices, greater deficiencies in training and standards may exist in other practices. Further evaluation of the effectiveness of asthma clinics is needed.

Asthma↗
PubMed1994

Randomized trial comparing weekly versus 3-week chemotherapy in small-cell lung cancer: a Cancer Research Campaign trial.

PURPOSE: A randomized trial of chemotherapy, given on either a 1-week or a 3-week schedule, was performed in small-cell lung cancer (SCLC) patients. The aim was to determine if weekly scheduling produced survival superior to conventional treatment. PATIENTS AND METHODS: Four hundred thirty-eight patients with SCLC with either limited disease (LD; 276 patients) or good-prognosis extensive disease (ED; 162 patients) were randomized. Weekly chemotherapy was 12 alternating cycles of ifosfamide/doxorubicin and cis-platin/etoposide (PE), while 3-week treatment was six alternating cycles of cyclophosphamide/doxorubicin/vincristine (CAV) and PE. Thoracic irradiation was administered 3 weeks after completion of chemotherapy to LD patients who attained a complete response (CR) or partial response (PR). Patients were well matched for clinical characteristics and prognostic factors. RESULTS: Overall response was the same in both arms: 82.3% (39.4% CR) with weekly and 81.1% (36.9% CR) with 3-week treatment. The median survival (MS) durations were 10.8 and 10.6 months for weekly and 3-week chemotherapy, respectively. The 2-year survival rates were 11.8% and 11.7% in the weekly and 3-week arms, respectively. Received dose-intensity (DI) was 73.9% of projected for weekly treatment and 92.7% for 3-week treatment. Hematologic toxicity was the major dose-limiting toxicity for the weekly treatment. CONCLUSION: This trial excludes at 90% power a benefit of greater than 10% for 2-year survival for weekly treatment. The received DI was reduced to a greater extent with weekly treatment, mainly due to hematologic toxicity.

Adult↗
PubMed1993

The impact of asthma guidelines on clinical practice. A review prepared for the GEPOR working group meeting, Milan, June 22-23 1993.

Guidelines on asthma management may be useful in defining optimal standards of care and as a basis for audit. They also have a role in the education of health professionals and offer a common approach for use by all who care for those with asthma. They should define the goals and outcomes expected from treatment and preferably outline several ways in which they may be achieved. It should be made clear when the recommendations are based upon the results of clinical trials and where they merely reflect current clinical practice. Areas for future research should be clearly outlined. The production of guidelines is only likely to influence patient care, if the guidelines are adapted and made relevant to individual districts or health establishments. There needs to be a realisation that they contain much more than advice about drug treatments. A more patient centred approach to management and attention to patient education is necessary if they are to be effective in reducing the morbidity associated with this common condition.

Asthma↗
PubMed1990

Carcinoma of the bronchus in young adults.

Thirty patients with bronchial carcinoma, aged 45 or less, were identified as having attended this or other local chest clinics. In four cases the diagnosis was reached after four or more months of investigations. In two of these cases, pulmonary tuberculosis was incorrectly suspected to be responsible for the illness of the patient. Compared with the disease as it affects all age groups, there appeared to be no greater incidence of any particular presenting symptom. In the group of patients studied, there was an excess of small cell carcinoma compared with that expected.

Adenocarcinoma↗
PubMed1990

Lung cancer.

Lung cancer has increased in importance as a cause of death over the last 60 years. It is now the commonest cancer in the UK, causing over 40,000 deaths per annum or an average of 110 per day. This review considers further aspects of epidemiology, aetiology and clinical features and discusses how we may better select the few who can be cured, so that the remainder receive more appropriate palliative therapy.

Adolescent↗