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Biomedical subjects

P Howard

Publications and source records attributed to P Howard.

At least 145 records · Page 8Linked to original sources
PubMed1985

Domiciliary oxygen and hypoxic cor pulmonale.

Long-term domiciliary oxygen has become an established therapy for hypoxic cor pulmonale associated with obstructive airways disease. Critical evaluation of patients to receive such treatment remains of great importance. Not all hypoxaemic patients will necessarily require therapy. The interaction of drug therapy with oxygen will assume increasing importance as new drugs such as almitrine bismesylate become available. Finally long-term oxygen must be clearly distinguished from portable oxygen and short burst oxygen which have quite different indications.

Aged↗
PubMed1985

Teaching and training in aviation medicine in the United Kingdom.

In the United Kingdom, training in aerospace medicine is provided by a range of post-graduate courses at the Royal Air Force Institute of Aviation Medicine. An Introductory Medical Officers' (IMO) course lasts for two weeks and is attended by all RAF doctors within the first few months of their entry to the Service. Its objective is to teach the elements of aviation physiology and medicine that they will need in the care of aircrew at a flying station. Four courses are held each year. A General Aviation Medicine (GAM) course is available to civilian doctors who wish to gain recognition as Authorized Medical Examiners of commercial aircrew, or who merely have an interest in the subject. It runs concurrently with the IMO course, and much of the material is common to both. Greater emphasis is, however, given to clinical teaching and to civil aviation. The GAM course also occupies two weeks of teaching. A course leading to the Diploma in Aviation Medicine is held once each year, and lasts for six months. It is open to all who have at least one year of previous experience, and has been attended by 244 military and civilian doctors from 25 countries. The D Av Med course covers every aspect of aerospace medicine at an advanced level, and its standard is at least as high as that of a M Sc degree. The Diploma is a recognised academic qualification awarded by the Royal College of Physicians. Royal Air Force medical officers receive an extra three weeks of training immediately following the D Av Med course, to educate them in procedures and policies specific to the RAF. This Advanced Course is essentially practical, and those who complete it are designated as Flight Medical Officers. They receive refresher training given at regular intervals thereafter. Aircrew are taught the basic principles of aviation medicine when they attend the RAF Aviation Medicine Training Centre for training in the use of their personal protective equipment assemblies. These courses are specific to the type of aircraft to be flown, and a pilot will undergo at least four during his flying career. Short courses of a specialised nature are also offered to clinical consultants, medical students, senior Air Force officers, nurses and others. It is now recognised in the United Kingdom that aviation medicine is a component of occupational medicine, and the Royal College of Physicians accepts the D Av Med as evidence of formal education in that branch of medicine.(ABSTRACT TRUNCATED AT 400 WORDS)

Aerospace Medicine↗
PubMed1985

Extrachromosomal replication of shuttle vectors in Dictyostelium discoideum.

We cloned a 12.3-kilobase (kb) endogenous plasmid, Ddp1, found in several wild-type and laboratory strains of Dictyostelium discoideum into pBR322. The cloned plasmids have been used to cotransform D. discoideum cells with B10S, a transformation vector carrying a gene fusion conferring resistance to G418. Whereas B10S DNA alone appears to integrate in a tandem array, the cloned Ddp1 plasmids replicate extrachromosomally and are stably maintained in the absence of selection with an average copy number of 50 to 100 copies per cell. The Ddp1-derived plasmids can be directly recovered by transforming Escherichia coli with bulk nuclear DNA from these cells. Preliminary deletion analysis indicates that not all regions of Ddp1 are necessary for stable replication in D. discoideum. Several recombinant vectors which replicate extrachromosomally in D. discoideum were also isolated. One contains the Act6-neor gene fusion from B10S recombined into one of the cloned derivatives of Ddp1 and can be used to directly transform D. discoideum amoebae, selecting for G418 resistance. Another recombinant is only 5.6 kb and resulted from a deletion of a 16.6-kb cloned Ddp1 hybrid plasmid. An analysis of the vector DNAs present in clones derived from single D. discoideum transformants is also described.

Cloning, Molecular↗
PubMed1984

An introduction to the clinical laboratory for pharmacists.

The intent of this article is to provide pharmacists with an introduction to the clinical laboratory. As clinical pharmacy services expand, interactions between pharmacists and the laboratory will increase. Laboratory results are an essential tool for pharmacists involved in monitoring drug therapy and adjusting dosing regimens. Laboratory medicine, however, is a complex and rapidly changing field with new analytical techniques and instruments continually being developed. Thus, methodologies vary greatly from one laboratory to another and even within the same laboratory from time to time. Quality control procedures are necessary to ensure accurate and reliable results. The medical technologists who staff clinical laboratories are highly trained professionals. Pharmacists should utilize the medical technologist as a consultant on the interpretation and limitations of laboratory tests. Likewise, there are many areas, such as therapeutic drug monitoring, in which the pharmacist can serve as a consultant to the laboratory. Pharmacists involved in patient care will benefit from a greater understanding of the clinical laboratory, and may also find new opportunities for clinical pharmacy practice and interaction with other health care professionals.

Humans↗
PubMed1983

Clinical experience with the oxygen concentrator.

The oxygen concentrator is an accepted means of delivery of long term domiciliary oxygen treatment. Conditions of use, however, need to be carefully defined. Fourteen concentrators were used for one year by patients with hypoxaemic chronic obstructive airways disease, and mechanical reliability, patient compliance with a regimen of 15 hours' use a day, smoking habits, and variation in arterial gas tensions studied. Though many patients failed to achieve either the desired daily use or the recommended arterial oxygen tension, problems were generally minor and could probably be overcome by careful supervision and planning. Overall the concentrator appeared to be the most economical means of providing oxygen treatment at home and was much preferred by patients who had previously used oxygen cylinders.

Blood Gas Analysis↗
PubMed1983

Breathlessness and portable oxygen in chronic obstructive airways disease.

Breathlessness was measured in 20 patients with severe chronic obstructive lung disease by the use of a visual-analogue scale. Severe resting arterial hypoxaemia was not a feature. The severity of breathlessness measured in this way did not correlate well with the results of spirometric tests or with walking ability. The use of portable oxygen was studied during simple walking tests for its effect on walking ability and the sensation of breathlessness. Portable oxygen improved exercise capacity but a placebo effect of the system probably accounted for some of the improvement. A clear improvement of distressing breathlessness was observed and represented a useful therapeutic response. Breathlessness and simple exercise ability were shown to respond independently to oxygen breathing. The value of short-term intermittent oxygen in patients with severe chronic obstructive lung disease needs to be evaluated in terms of both exercise ability and breathlessness.

Aged↗
PubMed1983

Cardiac output, pulmonary hypertension, hypoxaemia and survival in patients with chronic obstructive airways disease.

A prospective study of cor pulmonale in 74 patients relates pulmonary haemodynamics to survival. Mean arterial oxygen tension (PaO2) was 7.2 +/- 0.14 kPa and mean arterial carbon dioxide tension (PaCO2) 6.6 +/- 0.12 kPa at entry. Pulmonary artery pressure (PAP), pulmonary vascular resistance (PVR), and cardiac output (CO) sitting and supine and where possible on exercise, were measured every one or two years by a floating catheter technique. Survivors showed very little change in pulmonary artery pressure, pulmonary vascular resistance or cardiac output. Those who did not survive, showed a steady increase of PAP and PVR, whether or not they had received continuous oxygen therapy at home. Cardiac output remained normal or slightly elevated despite increasing pulmonary artery pressure. The relationship between VO2 (minute oxygen consumption) and cardiac output remained within the normal or greater than normal range, even on exercise. Although a deteriorating clinical situation may be paralleled by changes in pulmonary haemodynamics, it is questioned whether such changes are causally implicated in mortality.

Cardiac Output↗