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Biomedical subjects

D Stableforth

Publications and source records attributed to D Stableforth.

8 recordsLinked to original sources
PubMed1987

Management of acute asthma: a survey of hospital practice and comparison between thoracic and general physicians in Birmingham and Manchester.

The assessment and treatment of 140 randomly selected patients with acute asthma admitted to hospitals in Birmingham and Manchester in 1978 were studied. A detailed history of attack severity was recorded in just over half the case notes on admission (55%) and objective evidence of severity was recorded in a smaller number (measurement of airflow obstruction in 31% and arterial blood gases in 42%). Twenty-one (31%) thoracic patients and 33 (45%) general medical patients received aerosolized bronchodilators from metered-dose inhalers alone and 31% of all patients were given no inhaled bronchodilator drugs. Although the asthma was considered severe enough to require admission to hospital 37% were not given a course of corticosteroid therapy. Response to treatment was monitored by serial peak flow measurements in only 51% overall. Discharge therapy included a bronchodilator inhaler and oral corticosteroids in less than half (43%) of patients. There was no major difference in severity of asthma in patients admitted under the care of 'thoracic' or 'general' physicians but significant differences were found in their assessment and treatment. 'Thoracic' physicians more often measured severity and the response to treatment objectively. They prescribed inhaled (rather than intravenous) bronchodilator drugs more frequently and were more likely to discharge patients with a bronchodilator inhaler, oral corticosteroids, prophylactic therapy and an outpatient follow-up appointment.

Acute Disease↗
PubMed1986

Maintenance chemotherapy for anaplastic small cell carcinoma of the bronchus: a randomised, controlled trial.

Since March 1980, 309 patients with anaplastic small cell carcinoma of the bronchus (ASCB) have received remission induction therapy prior to randomisation to maintenance (M) or no maintenance (NM) chemotherapy. Induction therapy consisted of six courses of vincristine, doxorubicin and cyclophosphamide (VAC) given IV every 3 weeks. Those with limited disease also received mediastinal irradiation. Consenting patients with no unequivocal residual disease were randomised to have no further treatment until relapse or a further eight courses of VAC, at a lower dosage, every 4 weeks. Patients failing to achieve randomisation status received palliative treatment only. The median survival for all patients with limited disease (LD) is 363 days and that for patients with extensive disease (ED) is 272 days (P less than 0.00001). Sixty-one patients with ED were randomised. Those having maintenance chemotherapy lived significantly longer (median 372 days) than those who did not continue therapy (median 259 days) (P = 0.006). An imbalance in the proportion of 'complete remitters' randomised to maintenance therapy does not account for this difference. There is no significant difference between the M and NM groups in the 32 randomised LD patients. Continuing treatment during remission with agents used to induce the remission can prolong survival in patients with extensive stage ASCB.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

The addition of nedocromil sodium to maintenance therapy in the management of patients with bronchial asthma.

The addition of nedocromil sodium to maintenance asthma therapy was investigated in a 12-week double-blind group comparative trial. Maintenance therapy consisted of inhaled corticosteroid and inhaled bronchodilator; oral bronchodilator usage at constant dose was allowed but sodium cromoglycate was forbidden. Compared with placebo, the nedocromil sodium group showed greater improvement in severity of asthma and changes in lung function assessed at clinic visits, and in night-time asthma, morning tightness and PEFR recorded on diary cards. The nedocromil sodium group also showed a reduction in the diurnal variation of PEFR.

Adolescent↗
PubMed1983

Death from asthma.

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Adrenergic beta-Agonists↗