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Biomedical subjects

M C Champion

Publications and source records attributed to M C Champion.

14 recordsLinked to original sources
PubMed1990

Woodstove smoke and CO emissions: comparison of reference methods with the VIP sampler.

A new field sampler has been developed for measuring the particulate matter (PM) and carbon monoxide emissions of woodburning stoves. Particulate matter is determined by carbon balance and the workup of a sample train which is similar to a room-temperature EPA Method 5G train. A steel tank, initially evacuated, serves as the motive force for sampling and also accumulates a gas sample for post-test analysis of time-averaged stack CO and CO2 concentrations. Workup procedures can be completed within 72 hours of sampler retrieval. The system has been compared to reference methods in two laboratory test series involving six different woodburning appliances and two independent laboratories. The correlation of field sampler emission rates and reference method rates is strong.

Air Pollutants↗
PubMed1989

Measuring gastric contents during general anaesthesia: evaluation of blind gastric aspiration.

Various medications have been reported to decrease gastric content volume and thus risk for pulmonary aspiration. The majority of studies have used blind gastric tube aspiration of stomach contents as the method of measuring the volume of gastric contents. This study evaluated the accuracy of this method by first measuring gastric content volume using blind gastric aspiration and then aspirating residual content in the stomach, using a visually guided flexible fiberoptic gastroscope. Ten obese patients undergoing elective surgery were studied. Gastric contents were collected using a multi-orificed gastric tube and blind aspiration. Immediately after this was completed, residual gastric volume was collected using a visually guided gastroscope. The sum of these two aspirate volumes (true total gastric volume) was statistically compared with the blind aspirate volume. The blind aspirate volume underestimated true total gastric volume by an average of 14.7 ml and was significantly different from true total gastric volume (p less than 0.05). Blind gastric aspiration was thus demonstrated only to approximate true gastric volume. Its use to measure precisely gastric volume cannot, therefore, be recommended.

Adult↗
PubMed1989

Management of idiopathic, diabetic and miscellaneous gastroparesis with cisapride.

There have been several long term studies (greater than 4 weeks) of cisapride in a variety of gastroparetic conditions. All of these studies have used cisapride 10 mg t.i.d. or q.i.d. Chronic idiopathic dyspepsia Cisapride has been shown to be effective in both improving symptoms and also delayed gastric emptying in a six week study. In another placebo controlled study of two weeks, gastric emptying was improved but symptoms did not improve significantly. Diabetic gastroparesis In a four week study, cisapride has been shown to be effective in improving symptoms and solid phase gastric emptying. A six weeks study demonstrated both improvement of solid and liquid gastric emptying and symptoms. Progressive systemic sclerosis Cisapride was effective in improving symptoms over a four week period. Myotonic dystrophy Cisapride was effective in improving solid phase gastric emptying and symptoms over a four week period. Combined studies In two combined studies, cisapride has been shown to be effective in a variety of gastroparetic conditions. One year studies In three open long term studies, cisapride appears to be the first prokinetic agent to demonstrate long term efficacy for up to one year.

Cisapride↗
PubMed1988

Domperidone.

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Colonic Diseases, Functional↗
PubMed1987

Cutaneous hypersensitivity to vitamin K1 injection.

Cutaneous hypersensitivity to vitamin K1 injection has been reported once in North America. This case and most of the others in European literature have been associated with alcoholic liver disease. We report six patients who developed persistent skin hypersensitivity reactions at the site of vitamin K1 injection. These cases are the first reported to occur in liver disease associated with primary biliary cirrhosis, chronic myeloid leukemia, amyloidosis, and preeclampsia. Patch and intradermal skin tests demonstrated a hypersensitivity that seems to have an immune basis and is restricted to fat-soluble vitamin K1. This finding suggests that patients with any type of liver disease may be at risk for vitamin K hypersensitivity and that the hypersensitivity may be a marker of liver disease.

Adult↗
PubMed1986

Domperidone, a new dopamine antagonist.

Domperidone is a dopamine antagonist that has recently been released in Canada. Unlike metoclopramide hydrochloride, the other available dopamine antagonist, it does not readily enter the central nervous system. Domperidone acts as both an antiemetic and an upper gastrointestinal tract prokinetic agent. It is rapidly absorbed after oral administration, and few side effects have been reported. Domperidone has been approved for use in Canada for the symptomatic management of upper gastrointestinal tract motility disorders and to prevent gastrointestinal symptoms associated with the use of dopamine agonist agents in Parkinson's disease. The pharmacologic features, indications and side effects of domperidone are reviewed.

Administration, Oral↗
PubMed1985

Medical education reduces inappropriate use of cimetidine in a teaching hospital.

Before and after an education program to improve appropriate prescribing of cimetidine in an 810-bed teaching hospital, all new prescriptions written during a 4-week period were investigated, and information was obtained as to the indications for use, the dosage and concurrent drug therapy. The prescriptions were judged appropriate or inappropriate according to indications for cimetidine approved by the Department of National Health and Welfare's Health Protection Branch. After the program 63% of the prescriptions were deemed appropriate, compared with 40% before the program. The proportion of patients at risk of drug interactions, however, remained virtually unchanged. The results suggest that medical education can reduce the inappropriate use of cimetidine in teaching hospitals.

Canada↗
PubMed1985

The effect of cimetidine and ranitidine on serum high density lipoprotein subfractions.

Of the two major subfractions of high density lipoprotein (HDL), HDL2 cholesterol (HDL2-C) and not HDL3 cholesterol (HDL3-C) correlates negatively with coronary heart disease. To study the effect of cimetidine and ranitidine on HDL subfractions, 6 healthy males received cimetidine (600 mg bid) ranitidine (150 mg bid) and placebo (one tab bid) for 1 week each, in random order. Measurements of HDL cholesterol (HDL-C), HDL2-C, HDL3-C were made on day 7 of each week. Comparing cimetidine with placebo, HDL2-C/HDL-C, HDL2-C/total cholesterol and HDL2-C/HDL3-C increased significantly while HDL3-C/HDL-C decreased. There was no difference in HDL-C parameters between ranitidine and placebo. Cimetidine treatment results in redistribution of HDL subfractions in favour of HDL2. The mechanism is not H2-receptor antagonism as ranitidine had no such effect.

Adult↗
PubMed1985

Conference on insulin pump therapy in diabetes. Multicenter study of effect on microvascular disease. Recruitment, Randomization, and baseline characteristics of the treatment groups.

The general and ophthalmologic eligibility criteria were applied in the course of formal screening of selected members of clinic populations at the six treatment centers between August 1980 and November 1981. Patients eligible on the grounds of the history and general physical examination underwent a detailed ophthalmologic examination and determination of C-peptide status. Initial rates of recruitment were slow, which occasioned modifications of the eligibility criteria and a prolongation of the recruitment phase. All six clinics approached their goal of at least six patients in each of the continuous subcutaneous insulin infusion (CSII) and conventional insulin treatment (CIT) groups, with a final total of 70 randomized subjects. The method of paired randomization was acceptable, but led to some delay during periods of slow recruitment activity. Data from two patients who chose to drop out of the study shortly after randomization are included in the baseline characteristics. There was no difference between treatment groups with respect to age or duration of known diabetes, body weight, systolic blood pressure, proportion of cigarette smokers, retinopathy level as assigned by analysis of stereofundus photographs, or microaneurysm counts performed on fluorescein angiograms. A trend toward milder retinopathy in the CIT group proved to be statistically insignificant. Subsequent assessment of stereofundus photographs at the Fundus Photograph Reading Center indicated that six patients were misclassified by treatment center ophthalmologists with respect to ophthalmologic eligibility. We conclude that recruitment goals were met and randomization was successful.

Adolescent↗
PubMed1985

Observations on control of glycemia with conventional insulin therapy or continuous subcutaneous insulin infusion.

Determination of glycemic differences between groups treated with continuous subcutaneous insulin infusion (CSII) or conventional insulin therapy (CIT) was central to the major objective of the study. Assessment of glycemia was based on 24-h inhospital profiles of plasma glucose; pre- and postprandial and bedtime (seven time points) diurnal profiles performed monthly on outpatient samples; and glycosylated hemoglobin (HbA1) measured bimonthly at each center. The correlation between plasma glucose determinations in the central laboratory and in local laboratories was 0.988. Significance of differences between treatments was by analysis of variance and least-squares regression. At baseline, mean inhospital plasma glucose and HbA1 concentrations and insulin dosages were identical in the groups randomized to CSII or CIT. A prompt decrement of indices of glycemic control during CSII was observed such that mean decrements sustained over the 8-mo treatment period in home and in hospital plasma glucose profiles and HbA1 relative to values obtained during CIT (P less than 0.0001). The likelihood of CSII-treated patients achieving glycemic indices within the normal range was increased. The standardization of the mean and the M-value calculated from inhospital glucose profiles during CSII and CIT at 4 and 8 mo indicated that there was less plasma glucose fluctuation during CSII. The method of pooling standardized local HbA1 measurements from the six centers appeared to be an adequate substitute for centrally performed HbA1 determinations. Advantages of inhospital plasma glucose measurements in terms of accuracy and ability to obtain nocturnal samples contrasted with the likelihood of increased realism and superior correlation with HbA1 in home-obtained samples.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗
PubMed1985

Conference on insulin pump therapy in diabetes. Multicenter study of effect on microvascular disease. Origin and design of the Kroc Collaborative Study.

Although the benefits of metabolic intervention on the microvascular complications of diabetes mellitus remain unproven, it is generally assumed though not proven that prognosis in terms of blindness and renal failure will reflect the long-term glycemic response to therapy. Treatment goals however remain poorly defined. Costs and hazards of achieving near-normoglycemia in insulin-dependent diabetes mellitus (IDDM) are major. A multicenter trial was proposed to test the hypothesis that in IDDM two levels of mean glycemia, sufficiently separated to examine the control/complications relationship, could be maintained by the six collaborating centers, using randomized patient allocation to conventional insulin therapy (CIT) and continuous subcutaneous insulin infusion (CSII) as the alternative treatment modalities. Methods of maintaining and monitoring metabolic control and of assessing renal and retinal responses were to be applied, evaluated, and possibly improved. All clinics shared a common experimental protocol, which received ethical approval at each treatment center. Retinal assessment facilities were provided by the Fundus Photograph Reading Center at the University of Wisconsin in Madison, and at the Diabetic Retinopathy Department, Royal Postgraduate Medical School, Hammersmith, United Kingdom. The Central Biochemistry Laboratory was at the University of Newcastle, United Kingdom. Collaborators agreed on policy for recruitment, baseline assessment, and randomization of patients with IDDM, complicated by early microvascular disease. CIT took the form of the unchanged prestudy regimen; glycemic goals were set for CSII and their achievement based on inpatient and outpatient sampling of plasma glucose. Glycosylated hemoglobin was measured, retinal abnormalities recorded photographically, and urinary albumin excretion quantitated at baseline, 4, and 8 mo in all patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Trials as Topic↗