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A Culhane

Publications and source records attributed to A Culhane.

4 recordsLinked to original sources

Helicobacter Pylori eradication therapy: getting research into practice.

Helicobacter Pylori (H. Pylori) is the primary cause of duodenal ulcer (DU). Guidelines recommend that all patients with DU be considered for Helicobacter Pylori Eradication Therapy (HPET). However, the proportion of patients with DU on long term anti-ulcer medication receiving HPET is small. This study examined the effectiveness of the continuing medical education (CME) network of the Irish College of General Practitioners (ICGP) in promoting best practice in DU treatment among GPs in an eastern region of Ireland. Ninty eight GPs recruited from the CME network of the ICGP were randomised in two cohorts. Cohort 1 received an (early) intervention; GPs were asked to identify their patients with DU receiving long term anti-ulcer medication and prescribe HPET according to defined criteria. Cohort 2 received the intervention later. Prescribing of HPET was monitored using routine prescribing data. Twenty per cent (286/1,422) of patients in cohort 1 and 19.2% (127/661) in cohort 2 had a DU. After exclusions, 53% (152/286) in cohort 1 and 30.7% (39/127) in cohort 2, were eligible for HPET. A significantly higher proportion of patients in cohort 1 received HPET compared with cohort 2 during the early intervention period (13.8% vs 0.0%, p<0.05). Reasons for not prescribing HPET included concurrent illness in patients, failure to comply with treatment. Best practice guidelines on HPET treatment of DU can be successfully applied using CME networks. This model could be repeated in another therapeutic area where established research is not yet current practice.

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The contribution of the undergraduate rural attachment to the learning of basic practical and emergency procedural skills.

OBJECTIVE: To assess the effect of a four-week rural attachment on the knowledge and competency of medical students in basic practical and emergency procedures. DESIGN: A before and after comparison of self-reported level of competence in 72 basic, emergency, diagnostic and therapeutic procedural skills. PARTICIPANTS: Eighty-five final year medical students at the University of Western Australia in 1991. OUTCOME MEASURE: A student was considered competent if he or she claimed to be able to do a procedure either alone or with assistance. RESULTS: Over 50% of students were competent in 57 procedures after the attachment compared with 37 procedures before it. There were 26 procedures in which more than 20% of students increased their competence. CONCLUSION: A higher priority needs to be paid to the undergraduate teaching of procedural skills. Rural attachments can play an important part in training medical students in the practical skills required of interns.

Adult↗

Guidelines for the management of Helicobacter pylori-related upper gastrointestinal diseases. Irish Helicobacter Pylori Study Group.

The discovery of H. pylori is the most important development in gastroduodenal disease this century. It has completely changed our understanding of conditions that occur in the upper gastrointestinal tract. Eradication of the bacterium will cure peptic ulcer disease, decrease the symptoms of non-ulcer dyspepsia and may prevent gastric cancer. There has been an exponential increase in the amount of research in this area in recent years and, consequently, there is considerable confusion as to how H. pylori-related conditions should be managed. It is hoped that these guidelines will clarify some of these issues.

Adult↗