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Biomedical subjects

M Ward

Publications and source records attributed to M Ward.

At least 289 records · Page 16Linked to original sources
PubMed1984

Endoscopic sphincterotomy for common bile duct calculi.

A series of 74 patients having endoscopic sphincterotomy for common bile duct calculi is reported. Complete stone extraction was achieved in 53 cases (72%). Seventeen of 21 patients with retained calculi following recent biliary surgery had successful extractions (80%). Of 30 patients having had a cholecystectomy, 21 (70%) were successful, but only 15 of 23 patients with obstructive jaundice and no previous biliary surgery had the ducts cleared of calculi. Failure was due to multiple stones in the duct, or calculi too large to pass through the sphincterotomy. Endoscopic sphincterotomy is advocated in patients with obstructive jaundice due to stones, moving to early surgery should it prove unsuccessful. The results in patients with a T-tube in situ are comparable to extraction of the calculi along the T-tube tract.

Adult↗
PubMed1984

Failure of once daily inhaled corticosteroid treatment to control chronic asthma.

Twelve patients with chronic asthma received either high dose beclomethasone once a day or standard doses of beclomethasone three times a day in a double blind crossover trial to determine whether inhalation once a day would be sufficient. With the once a day regimen peak expiratory flow rates fell significantly, symptoms of nocturnal asthma increased, and two patients withdrew from the study because of worsening asthma. Whether control can be achieved with steroids inhaled once a day by simply increasing the total daily dose remains to be seen.

Adult↗
PubMed1984

Home nebulizers in severe chronic asthma.

Twenty-four outpatients who continued to have severe chronic asthma despite attending a chest clinic were studied. All were already using inhaled beta-agonists from a pressurized aerosol and regular inhaled corticosteroids. Nineteen were on long-term oral corticosteroids. Comparison was made between their symptoms and peak expiratory flow rate (PEFR) during 4 weeks on their usual treatment and the following month when they were also given 5 mg terbutaline night and morning by nebulizer. During the second month the symptom score for nocturnal asthma improved by 30% (P less than 0.01), for daytime wheeze by 23% (P less than 0.025) and shortness of breath by 15% (P less than 0.01). The prebronchodilator morning and evening PEFR increased by 8% (P less than 0.025) and 10% (P less than 0.01) respectively. A dose-response study with inhaled terbutaline in six patients before and after 4 weeks of nebulizer treatment showed no evidence of a decline in response. Home nebulizers produced considerable overall improvement. Because of variations in individual responses a monitored trial of the type which we have used is desirable before a decision is made on long-term treatment.

Adult↗
PubMed1983

Cardiovascular effects of yohimbine in anaesthetized dogs.

Injection of a small dose of yohimbine, an alpha 2-adrenoceptor blocking agent (0.1 mg X kg-1 i.v.) increased systolic blood pressure, heart rate and cardiac performance in anaesthetized dogs. A larger dose of this drug (1 mg X kg-1 i.v.) influenced the cardiovascular system in an opposite way. The tachycardiac effect of yohimbine was also observed when the drug was administered either into the vertebral artery or the cisterna magna of chloralosed dogs. The increase in heart rate was found to be due to an increase in sympathetic tone and to a decrease in vagal tone. Some data reported here suggest that yohimbine could impair central cardiovascular regulation by acting on the baroreceptor reflex pathway. Indeed, intracisternal administration of yohimbine at small doses (1) reduced the tachycardiac and pressor responses to carotid occlusion, (2) reduced the bradycardia produced by intravenous noradrenaline. It is also suggested from the results of this investigation that yohimbine decreases the vagal part of the bradycardia resulting from the stimulation of the aortic baroreceptors but not those resulting from the stimulation of carotid sinus baroreceptors. Intracisternal administration of yohimbine also produced a significant inhibition of the Bezold-Jarish reflex induced by intravenous veratridine.

Animals↗
PubMed1983

An open trial of pargyline in the treatment of attention deficit disorder, residual type.

Twenty-two patients who met the Utah criteria for attention deficit disorder, residual type (hyperactivity, minimal brain dysfunction in adults) received an open trial of pargyline (Eutonyl). Of these 22 patients, 13 (59%) showed a moderate to marked therapeutic response. Clinically useful features of pargyline in the treatment of attention deficit disorder, residual type are that its duration of action is greater than 24 hours and that it has not been abused. Pargyline inhibits monoamine oxidase, type B, and its therapeutic efficacy is compatible with the hypothesis that decreased phenethylaminergic function, dopaminergic function, or both play a role in the etiology of the disorder.

Adult↗
PubMed1983

Comparison of ranitidine and cimetidine in the treatment of chronic gastric ulcer. A double-blind trial.

The aim of the study was to compare the effectiveness of ranitidine and cimetidine in accelerating the healing of chronic gastric ulcer. 44 outpatients with endoscopically proven gastric ulcer whose duration of symptoms was greater than 4 weeks and who were without major systemic disease were studied. Patients were randomly allocated to receive either ranitidine, 150 mg twice a day or cimetidine, 200 mg three times a day and 400 mg at night for 4 weeks. If the ulcer had not healed, treatment was continued for a further 4 weeks, when patient assessment and endoscopy were repeated. By 4 weeks, 13 of 22 patients taking ranitidine (59%) and 14 of 22 patients taking cimetidine (64%) had healed (p2 = 1.0, 95% confidence interval - 20%, 38%). At 8 weeks, 91% on ranitidine and 91% on cimetidine had healed (p2 = 1.0, 95% confidence interval - 18%, 18%). Symptomatic improvement was similar with both drugs. Smoking did not influence healing rates. There were no major side effects with either medication. It is concluded that ranitidine and cimetidine are of similar efficacy in accelerating the healing of chronic gastric ulcer.

Adolescent↗
PubMed1983

Educating the staff.

Explore the source record for details and available documents.

Education, Medical, Continuing↗
PubMed1982

Midazolam, a water-soluble benzodiazepine, for gastroscopy.

Midazolam, a water-soluble benzodiazepine, was given intravenously in doses of 0.07 mg/kg as sedation prior to oesophago-gastro-duodenoscopy in 40 patients. This was very effective as a sedative in elderly patients but less so in the young, with a large individual variation in response. Pain on injection and venous thrombosis which are common with diazepam were not seen with midazolam.

Adult↗
PubMed1981

Early experience with a vertical spinning-disc nebuliser.

A new device for the administration of bronchodilators to asthmatics by nebulisation has been developed. Nebuliser therapy, in many patients more effective than other forms of drug delivery, has been limited by the need to provide patients with units driven by compressed air. Solutions can be nebulised by contact with a rapidly spinning horizontal disc. Adaptation of this method to a small nebuliser for clinical use is difficult, since a constant delivery of fluid the centre of the disc is necessary. The problem has been overcome in the new device in which the disc spins vertically in a reservoir. The performance of the prototype device was compared with that of a conventional compressed air nebuliser. The improvement is spirometry values of 8 asthmatic patients was similar for both nebulisers.

Adult↗
PubMed1981

Colonoscopic polypectomy.

Seven hundred and forty-one colonic polyps have been removed by colonoscopic polypectomy during 300 examinations. Up to 36 polyps were removed at a single examination. Colonoscopic treatment of villous adenomas to 7 cm has been successfully performed in elderly and infirm patients. There were no deaths or incidents of perforation and the only significant complications were two secondary haemorrhages requiring transfusion. The presence of a polyp was not definitely reported in 40% of barium enema X-ray examinations carried out within three months of polypectomy. Double contrast X-ray examinations were significantly more sensitive in the detection of polyps. Colonoscopic polypectomy is a safe and effective technique. All colonic polyps should be removed by this technique after diagnosis.

Adenoma↗