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Biomedical subjects

M J Galloway

Publications and source records attributed to M J Galloway.

At least 37 records · Page 2Linked to original sources
PubMed1999

An audit of waiting times in a haematology clinic before and after the introduction of point-of-care testing.

Haematology patients are frequent attenders at haematology clinics either as a result of their illness or their treatment. We identified that waiting times in the haematology clinic were an important quality indicator for patients within the haematology service. In this study we have surveyed 50 consecutive patients in order to establish maximum waiting times in the haematology clinic. We then prospectively audited waiting times against these standards. An evaluation of the introduction of an air-tube transport system for conveying samples to the laboratory combined with the electronic transfer of results back to the clinic in an attempt to reduce waiting times has been compared with the introduction of point-of-care testing in the clinic. Point-of-care testing was introduced by transporting our backup analyser from the haematology laboratory to the clinic on a weekly basis. The tests were performed by nurse specialists who were already in the clinic and had been trained in the use of the analyser. The patient survey resulted in the establishment of a maximum waiting time of 30 min with a longer term aim to reduce this to a maximum of 20 min. The introduction of an air-tube transport system linked to electronic transfer of results, despite repeated audits, could not achieve the waiting time standard. Once point-of-care testing had been introduced, the clinic waiting times consistently achieved the standard that had been set by patients.

Hematology↗
PubMed1997

CHOP-based chemotherapy is as effective as alternating PEEC/CHOP chemotherapy in a randomised trial in high-grade non-Hodgkin's lymphoma. Scotland and Newcastle Lymphoma Group.

The aim of this study was to test whether survival for patients with high-grade non-Hodgkin's lymphoma (NHL) can be improved with a non-cross-resistant regimen as compared to a CHOP-based regimen. This is a multicentre study comprising 325 adult patients, median age 58 years, with high-grade non-Hodgkin's lymphoma: patients of any age and performance status were eligible provided they were able to receive the drugs in the regimens. Patients were randomised to either B-CHOP-M (bleomycin, cyclophosphamide, doxorubicin, vincristine, prednisolone and methotrexate) or PEEC-M (methylprednisolone, vindesine, etoposide, chlorambucil and methotrexate) alternating with B-CHOP-M. At a median follow-up of 9 years, there was no significant difference in overall survival or disease-free survival between the two arms. Toxicities for the two regimens were equivalent. This study confirms that for relatively unselected patients with high-grade non-Hodgkin's lymphoma, an alternating multidrug regimen does not improve upon the results obtained with B-CHOP-M.

Adult↗
PubMed1997

The use of an all oral chemotherapy (idarubicin and etoposide) in the treatment of acute myeloid leukaemia in the elderly: a report of toxicity and efficacy.

Acute myeloid leukaemia (AML) is predominantly a disease of the elderly but such patients are not always appropriate candidates for intensive intravenous (i.v.) based treatment regimens. The development of the anthracycline idarubicin which is highly effective in the treatment of AML and is active when given orally has made it possible to design anti-leukaemic regimens which may be given orally and be particularly useful in those elderly patients with AML considered unsuitable for standard intensive aggressive treatments. We have assessed an oral regimen combining idarubicin 30 mg/m2 and etoposide 80 mg/m2 for 3 consecutive days as initial treatment in 28 elderly patients with AML (median age 69 years, range 56-81) who were not considered suitable for more intensive i.v. chemotherapy schedules. Following informed consent, two patients died before treatment began and one patient withdrew prior to treatment. Twenty-five patients underwent one to four courses of treatment. The schedule was well tolerated with minor nonhaematological toxicity. The first course was given in hospital, eight of 21 subsequent courses of treatment were given entirely as an out-patient. Eleven patients responded to treatment with nine (36%) achieving complete remission (CR). The median survival for all patients was 3 months, but for the nine who achieved a CR it is 9 months with six patients still alive, five in first CR and one in second CR. We conclude that a combination of idarubicin and etoposide given orally as first-line treatment in elderly patients with AML is safe and effective. In some patients this means treatment and follow-up can be given entirely on an out-patient basis.

Acute Disease↗
PubMed1995

Introduction of computer assisted control of oral anticoagulation in general practice.

The number of patients referred to hospital clinics for monitoring of oral anticoagulation continues to rise rapidly. Introduction of computer programs for the control of oral anticoagulation improves the quality of anticoagulant control in hospital clinics. This approach has now been extended to include patients managed in general practice. Results confirm that the quality of anticoagulation can also be improved in these patients. A standard approach to anticoagulation for hospital and community based patients has also facilitated the transfer of patients on warfarin from the hospital anticoagulant clinics to the community with no deterioration in the quality of anticoagulant control. As a result, the workload in the hospital anticoagulant clinic has fallen for the first time.

Anticoagulants↗
PubMed1988

Amiloride prevents amphotericin B related hypokalaemia in neutropenic patients.

Twenty neutropenic patients with various haematological disorders were randomised prospectively to receive either intravenous amphotericin B alone or amphotericin B and oral amiloride 5 mg twice a day for treatment of confirmed or suspected fungal infection. Patients receiving amiloride had a significantly higher plasma potassium (p less than 0.01), a significantly lower urinary potassium loss (p less than 0.01), and required significantly less potassium chloride supplementation to maintain their plasma potassium within the normal range (p less than 0.001). Amiloride was well tolerated, had no clinically important side effects, and provided effective control of plasma potassium in patients treated with amphotericin B.

Adolescent↗
PubMed1987

Elevated fibrinopeptide A levels in patients with clinically localised breast carcinoma.

58 patients with clinically localised breast carcinoma, treated by either mastectomy alone or lumpectomy plus local radiotherapy, have now been followed for up to 51 months (median 12 months). 21 of the 58 patients (36.2%) had a persistently elevated or rising fibrinopeptide A level after surgery and 11 of these patients (52%) to date have subsequently developed recurrent breast carcinoma up to 27 months after the fibrinopeptide A level became elevated (median 6 months). Conversely, only 2 (5.4%) of the 37 patients with persistently normal post-operative fibrinopeptide A levels have developed recurrent disease. Elevated fibrinopeptide A levels appear to be a marker of persistent tumour activity and precede clinical recurrence in certain patients with breast carcinoma, but normal values do not exclude recurrent or residual disease.

Adult↗
PubMed1986

HTLV-III antibody and T-cell subset ratios in haemophiliacs and their spouses.

44% of 63 British patients with either haemophilia A or B were HTLV-III antibody positive (HTLV-VIII+). HTLV-III+ was more frequent in high factor VIII concentrate users and 75% of severely affected haemophilia A patients were HTLV-III+. All eight patients who were exposed to factor IX concentrate were HTLV-III-. 17 haemophilia A patients who received only British made factor VIII concentrate (average 12,000 units/year) were HTLV-III-. Two of 63 patients had evidence of a pre-AIDS type symptom complex and both were HTLV-III+. Information from a cohort of 21 Liverpool haemophiliacs suggests that HTLV-III was first introduced into this country in 1981. OKT4/T8 ratios were abnormal in 52% of 21 patients studied but this finding was not confined to either HTLV-III+ or HTLV-III- individuals. The spouses of 14 HTLV-III+ haemophiliacs were all HTLV-III-.

Adolescent↗
PubMed1985

Elastase-alpha 1 antitrypsin complexes in acute leukaemia.

30 consecutive patients with acute leukaemia were studied prior to commencement of treatment in order to assess the incidence and significance of raised elastase (ELP) - alpha 1 antitrypsin complex level. In addition the reliability of detecting low factor XIII subunit levels as an indicator of in vivo release of ELP was evaluated. While 15 patients had raised levels of ELP alpha 1 antitrypsin complex levels, only 4 of these had reduced levels or factor XIII subunits A and S. In addition increased levels of ELP- alpha 1 antitrypsin complex were not associated with any marked disturbance of routine coagulation tests. Patients with raised ELP- alpha 1 antitrypsin complex levels had significantly higher circulating white cell and blast cell counts as compared to those patients with normal levels of this complex. In patients entering remission the levels of ELP- alpha 1 antitrypsin complex returned to normal.

Acute Disease↗