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Biomedical subjects

S M MacLeod

Publications and source records attributed to S M MacLeod.

At least 19 recordsLinked to original sources
PubMed2002

Experimental keloid scar models: a review of methodological issues.

BACKGROUND: Keloid scars are benign fibrous proliferations in the dermis that arise after dermal trauma. The scars are raised in appearance and extend beyond the boundaries of the original wound. Scarring in predisposed individuals is out of proportion to the severity of the inciting wound. Current treatments sometimes yield early benefit but scars often resume exuberant growth. The pathophysiology of keloid scars is still poorly understood. In order for new treatments to be developed, the mechanisms leading to the formation of keloid scars must be further elucidated. The search for improved experimental models is of critical importance because such models have an important role to play in both the study of keloid formation and in the development of new therapies. OBJECTIVE: The objective of this article is to introduce the reader to the experimental models available for studying keloid scars and to outline the advantages and limitations of animal and tissue culture models. CONCLUSION: Both models may help to elucidate the pathways of keloid formation and promote development and testing of therapies. Tissue culture is better suited to studies of pathogenesis, whereas the animal models are more suitable for therapeutic testing.

Animals↗
PubMed1999

The role of research evidence in pharmaceutical policy making: evidence when necessary but not necessarily evidence.

The use of research evidence in policy making at the legislative and administrative levels would appear to be very selective. Focusing on pharmaceutical policy, this paper argues that research evidence is only one ingredient leading to a policy decision and that any examination of research transfer into policy must take into account the many other factors which impact on decision making. The paper describes the policy making process, barriers to the uptake of research evidence into policy and ways of improving research uptake into policy making. Examples are given from drug licensing, remuneration policies, post-marketing surveillance and product withdrawal from the market.

Drug and Narcotic Control↗
PubMed1996

Developing a Canadian prescribing practices network. Network Development Committee of the Canadian Prescribing Practices Network Project.

Expenditure on drug therapy in Canada has been growing at a faster rate than spending on any other aspect of health care. Increasing societal pressure to use scarce resources more efficiently, advances in communication technology and data indicating that there is room for improvement in drug prescribing suggest that the time has come for an organized linkage of the available drug-utilization and health-outcomes data-bases across the country. A national prescribing practices network would assist prescribers, researchers and policymakers to optimize prescribing with respect to both cost effectiveness and health outcomes. The authors outline the main concerns addressed in the 1994 report to the National Pharmaceutical Strategy and present the results of discussions by the Canadian Prescribing Practices Network Project with respect to the potential users and data sources of a national network and the communications technology on which it would rely.

Canada↗
PubMed1996

Improving physician prescribing practices: bridge over troubled waters.

The amelioration of drug prescribing practices holds out the prospect of improving health outcomes without increasing health care spending or the demands on hospital and ambulatory services. The challenge is to permit prescribers to assert their leadership as patient advocates while addressing the need for greater support in therapeutic decision making. Best practice includes the optimal use of drug and nondrug therapies and must be supported by research and the timely dissemination of information. The individualization of drug therapy will remain critical to quality prescribing and will depend on the appropriate preparation of prescribers for clinical decision making. The principal issues in improving prescribing practices were addressed at a workshop held by the CMA in Ottawa in October 1995, documents from which will be published in CMAJ, beginning with this issue (see pages 635 to 640). These issues deserve consideration by everyone with a stake in both cost-effectiveness and quality of care.

Canada↗
PubMed1996

Research in medical schools: rationale, priorities, roles and balance.

Although medical schools traditionally rest on the "three-legged stool" of research, education and service, it may often seem to the outsider that research is ascendant. In the past 50 years, medical schools' research success has been abundant; they are often most secure in contemplating their indispensable role in this domain. Recently, however, growing criticism of educational programs and increased competition for service responsibility (and the attendant revenue) from the nonacademic and private sectors have fuelled asymmetry. Research may well be the best bulwark against diminished importance or mediocrity, but it should be fortified by a new balance in which the medical schools' mission in education and service is reinforced. Unipolar concentration on the understanding of disease mechanisms must be eschewed in favour of a blended program of basic, clinical and population health sciences. Medical schools must pay greater attention to their responsibilities for training graduate students in a variety of health-related disciplines; in the future, nonphysician health care professionals will increasingly share the scientific preparation and views of physicians as they work in multiprofessional teams. Research will continue to thrive in the medical school of the future, but success will come from a careful assessment of current realities and a strategic resetting of priorities.

Research↗
PubMed1994

Social science education as a component of medical training.

The broad view of health espoused by the World Health Organization is now generally accepted by medical educators. Implicit in the new paradigm is a recognition of multiple determinants of health and of shifting divisions of professional responsibilities among providers. As a consequence, the importance of social and behavioural science education as a foundation to medical training is increasingly appreciated. At the same time medical programmes are under pressure to contend with the explosion of knowledge in basic biomedical and life sciences and with technological innovation. Curricula are being submerged in facts, causing medical schools to look for innovative teaching models that feature more flexible approaches to the diverse body of knowledge supporting professional practice. Independent learning methods are being explored and revised teaching programs are being organized around coordinating themes, such as aging, human development and environmental health. Future programmes must be designed to encourage multiprofessional approaches while fostering awareness of the important interplay between health care (both curative and preventive) and social/behavioural science. Within the curriculum students should be offered options that include sociology, child growth and development, gerontology, medical anthropology, psychology, medical geography, health economics, political science and related subthemes. More important than the inclusion of any specific discipline is the creation of an environment in which future physicians may be exposed to critical thinking across a wide range of themes that characterize the social and cultural context for medical practice. Such enquiry is also likely to drive a closer relationship between medical schools and their parent universities within which the social science expertize resides.(ABSTRACT TRUNCATED AT 250 WORDS)

Curriculum↗
PubMed1992

Comparison of methods for prediction of nephrotoxicity during development.

Drugs with nephrotoxic potential are continuously introduced into perinatal and pediatric medicine, and assessment of their relative toxicity is important. We compared different methods of assessment of renal damage during development in an attempt to establish their relative sensitivity, age and dose dependence. Newborn, 6- to 8-day-old and adult rats were treated for 7 days with intramuscular gentamicin (5, 10 or 20 mg/kg/day) or amikacin (5, 20 or 40 mg/kg/day). Renal damage was assessed by serum and urine creatinine, urine N-acetyl beta-glucosaminidase and beta 2-microglobulin, cortical sphingomyelinase in vivo and in vitro and morphologic changes in light and electron microscopy. As expected, there was a dose-dependent damage, with gentamicin being more nephrotoxic than amikacin, and with newborn rats more resistant. The light- and electron-microscopic assessment were more sensitive than all other methods, followed by urinary N-acetyl glucosaminidase and then by beta 2-microglobulin. Sphingomyelinase changes occurred only at the highest doses of gentamicin.

Aging↗