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Biomedical subjects

M Edmunds

Publications and source records attributed to M Edmunds.

At least 19 recordsLinked to original sources
PubMed1995

Modulatory impact of acid and pepsin on esophageal hydrophobicity in humans.

OBJECTIVES: The role of hydrophobicity in the pathophysiology of the gastrointestinal tract is well established as a protective mechanism against the impact of lumenal acid and pepsin. Hydrophobic properties of esophageal secretion in humans remain largely unknown. METHODS: We have studied, therefore, hydrophobicity by using fluorescence probe in human esophageal secretion, elaborated under the impact of saline followed by HCl, HCl/pepsin, and final saline. RESULTS: Basal hydrophobicity of human esophageal secretion, elaborated during mucosal exposure to saline, was 237 +/- 32. This value, however, declined 72% during mucosal exposure to HCl (66 +/- 14 vs 237 +/- 32; p < 0.001) and 87% during mucosal exposure to acid supplemented with pepsin (30 +/- 4 vs 237 +/- 32; p < 0.001). Moreover, hydrophobicity upon perfusion with HCl/pepsin was 55% lower than after perfusion with HCl alone (30 +/- 4 vs 66 +/- 14), although the result was insignificant. Substitution of saline for HCl/pepsin solution during the last perfusion period resulted in a partial recovery of hydrophobicity in esophageal secretion (131 +/- 30 vs 30 +/- 4; p < 0.001), although this value was lower than the basal hydrophobicity value (131 +/- 30 vs 237 +/- 32; p = 0.028). In addition, we continuously observed a significant shift in the fluorescence emission maximum from 508 +/- 6.4 to 486 +/- 0.9 (p < 0.001) during perfusion with starting saline, to 492 +/- 1.6 (p < 0.001) during exposure to HCl, to 493 +/- 1.1 (p < 0.001) during perfusion with HCl/pepsin, and to 488 +/- 0.9 (p < 0.001) during infusion of final saline. The maximum emission wavelength after esophageal exposure to initial saline also was significantly lower than the maximum emission upon perfusion with HCl (492 +/- 1.6 vs 486 +/- 0.9; p < 0.05) and HCl/pepsin (493 +/- 1.1 vs 486 +/- 0.9; p < 0.05). Although basal hydrophobicity in males was similar to corresponding values recorded in females, mucosal exposure to HCl (pH 2.1) resulted in an 84% decline in females but only 60% in males. Therefore, the hydrophobicity value in females during the perfusion period with HCl was 52% lower than in males (p = 0.129). CONCLUSIONS: Esophageal secretion exhibits its hydrophobic nature presumably through the presence of mucus components such as mucin and mucin-associated phospholipids. The inhibitory impact of HCl and HCl/pepsin solutions on esophageal hydrophobicity may play a role in the pathogenesis of mucosal damage by gastroesophagel refluxate.

Adult↗
PubMed1991

Evaluation of a multicomponent group smoking cessation program.

BACKGROUND: Participants who had completed a multicomponent group smoking cessation program were interviewed to determine their smoking status and satisfaction with the program. METHODS: The follow-up interviews occurred an average of 20 months after entry to the program, with a response rate of 80% (89 out of 111 enrollees). Most individuals interviewed (82%) were able to quit for at least 24 hr; 25% were able to maintain nonsmoking status for 1 year or longer. RESULTS: Initial quit rates were comparable for both men and women, but women were more than twice as likely to have relapsed by the time of the follow-up interview. Participants rated self-monitoring as the most helpful of 10 program components, including nicotine fading, nicotine gum, group support, health information, and talks by ex-smokers. Ratings for the program overall were higher than the rating of any individual component. CONCLUSIONS: Since earlier studies have found that successful quitters use more coping strategies than relapsers, multicomponent programs offer participants an opportunity to learn a variety of techniques and choose the combination that works best for them.

Adult↗
PubMed1990

Systemic vasculitis in the 1980s--is there an increasing incidence of Wegener's granulomatosis and microscopic polyarteritis?

Thirty-six cases of Wegener's granulomatosis (WG) and microscopic polyarteritis (MPA) presenting to the nephrology service in Leicester between 1980 and 1989 were reviewed. Apart from the diagnostic respiratory tract lesions seen in WG, cases of MPA and WG could not be distinguished by age and sex, range and severity of organ involvement, response to treatment (oral prednisolone and cyclophosphamide), mortality or renal outcome. The combined incidence of WG and MPA in 1980-86 was 1.5/million/year. Following the introduction in January 1987 of an assay for anti-neutrophil cytoplasmic antibody (ANCA), the incidence of WG and MPA increased in 1987-89 to 6.1/million/year (p less than 0.0001). Cases seen during these two periods did not differ by any clinical parameter except that later cases had less severe renal disease at referral and improved renal outcome. Median serum creatinine was significantly lower at presentation in 1987-89 (p less than 0.02). Of those surviving 3 months from presentation only 1/20 in 1987-89 had end stage renal failure compared with 4/10 in 1980-86 (p less than 0.02). These findings may reflect increasing diagnostic awareness of WG and MPA among physicians since the introduction of ANCA.

Adult↗
PubMed1986

Strychnine poisoning: clinical and toxicological observations on a non-fatal case.

The successful supportive management of an acute strychnine ingestion is described; clinical and biochemical findings are reported. A gas chromatographic assay for serum strychnine has been applied to the analysis of 19 serial blood samples. Four hours post ingestion, the serum strychnine concentration was 1.6 mg/L. This declined with T 1/2 [corrected] of 10 hours over a period of 50 hours. First order kinetics are indicated. Management of strychnine poisoning in general is discussed in the light of this case and the limited knowledge of the pharmacokinetics of the alkaloid in man.

Adult↗
PubMed1984

When you think the doctor is wrong.

When there is conflict between nurse practitioners and physicians regarding appropriate therapy for clients, must the nurse practitioner always defer to physician direction? Factors to consider in answering this question are presented based on interviews with clinically active practitioners.

Clinical Competence↗
PubMed1984

Do nurse practitioners still practice nursing?

This article explores whether the nurse practitioner continues to utilize his/her nursing skills in the expanded role. Eight important nursing actions or attitudes are defined to describe practitioner nursing performance.

Communication↗
PubMedDate not supplied

Non clinical problems: nurse practitioner-physician competition.

The expected increase in the number of practicing physicians does not necessarily mean that new health practitioners will not have a role. It may mean that adaptation and renegotiation of the roles are required. Filling unmet national needs, including providing primary care in undeserved areas and delivering preventive care can be achieved without unreasonable feelings of competition if nurse practitioners remain flexible and respond to new opportunities.

Competitive Behavior↗
PubMedDate not supplied

Gender and the nurse practitioner role.

Many nurse practitioners are recognizing that some role development problems arise because they are women seeking more power and responsibility in a traditionally male-dominated world. Specific keys to reduce these pressures are given for the nurse practitioner.

Female↗
PubMedDate not supplied

Concepts of power.

Explore the source record for details and available documents.

Assertiveness↗