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Biomedical subjects

M L Willcox

Publications and source records attributed to M L Willcox.

10 recordsLinked to original sources
PubMed2004

Decreasing clinical efficacy of chloroquine in Ankazobe, Central Highlands of Madagascar.

The clinical efficacy of chloroquine was assessed in the Primary Health Centre of Ankazobe, Central Highlands of Madagascar. This study shows an increase in the level of chloroquine resistance with the appearance of early treatment failures and RIII resistance. Furthermore, the prevalence of clinical treatment failures is approaching the level of 25%, at which WHO recommends a change of first-line drug.

Adolescent↗
PubMed1999

A clinical trial of 'AM', a Ugandan herbal remedy for malaria.

BACKGROUND: Mortality and morbidity from malaria is still high in Africa, and may further increase as resistance to antimalarial drugs spreads. Many people rely on herbal medicines as the first line of treatment. Yet there has been very little clinical research into their effectiveness. METHODS: Patients being treated for malaria at a herbalists' clinic in South-West Uganda were followed up and their response to a particular herb, 'AM', was monitored. Eighty-eight patients were enrolled; 72 were followed up for at least 2 days, and were questioned about side-effects. Nineteen patients infected with Plasmodium falciparum had initial parasite counts sufficiently high for parasite clearance to be assessed. RESULTS: No severe adverse reactions were observed, although about 50 per cent experienced minor side-effects. Although complete parasite clearance was achieved in only one case, the geometric mean of parasite counts had declined significantly by day 7. There was also a marked symptomatic improvement in 17 of the 19 patients. CONCLUSIONS: AM appears safe, although it is not always well tolerated. Significant symptomatic improvement and a reduction of parasite counts were observed in patients taking AM. There is a need for further research, such as a randomized controlled trial, to assess the efficacy of this treatment.

Adolescent↗
PubMed1997

Tobacco control programmes for universities: a feasibility study.

BACKGROUND: University may be a good time for smoking cessation, because younger, lighter smokers are more successful at stopping. METHODS: An initial survey of 4141 students at Cambridge and Anglia Polytechnic universities identified the prevalence of smoking; questionnaires were given to smokers asking about desire to stop. Some respondents were invited to a discussion, but very few came. Those wanting to quit were sent a second questionnaire about what help they wanted. On National No Smoking Day, 101 students were interviewed about "stop smoking' advertisements, and those wanting to stop smoking were offered different forms of help. Lastly, student union welfare officers at 54 universities in the United Kingdom were interviewed over the telephone, about what motivation and support they provide for students to stop smoking, and what more they would consider providing. RESULTS: Prevalence of smoking varied according to university, subject studied and sex. Desire to quit varied with subject studied, duration of habit and amount smoked. Some "stop smoking' TV adverts were widely remembered, but their motivational impact remains unclear. Most of those wanting to stop found it difficult, but few requested help unless approached directly. Only books were widely used, and innovative ones seemed most popular. Few student unions provided effective encouragement or help for students to stop smoking. Most said they would consider doing more. CONCLUSIONS: There is a need for smoking cessation programmes at universities. More research is needed on ways of motivating those who do not want to stop. "Direct marketing' of books seems the best way of reaching those who want to stop. The effectiveness of different books needs to be evaluated. There is great potential for improving the quality, quantity and availability of cessation aids through student unions.

Adolescent↗
PubMed1997

The impact of multiple drug therapy on leprosy disabilities.

In an overview of controlled trials, it is shown that bactericidal drugs increase the short-term risk of Type I reactions, but prevent the long-term development of new impairments caused by bacterial proliferation. Clinical experience suggests that the clofazimine component of multiple drug therapy (MDT) has reduced the incidence of Type II reactions or erythema nodosum leprosum (ENL). The principal impact of MDT, compared with monotherapy, has been to reduce the duration of active disease, thus preventing the deterioration of disability scores. Reduction of population disability rates is mainly achieved by earlier detection and treatment. MDT has a number of indirect benefits such as improved compliance, decreased cost, and increased motivation and availability of leprosy workers. However, MDT must be supplemented by other measures to prevent and treat disabilities.

Clinical Trials as Topic↗
PubMed1986

Bronchoalveolar lavage fluid neutrophils increase after corticosteroid therapy in smokers with idiopathic pulmonary fibrosis.

Patients with idiopathic pulmonary fibrosis (IPF) are often cigarette smokers and are often being treated with corticosteroids at the time of bronchoalveolar lavage. We addressed the question of whether or not the bronchoalveolar lavage fluid (BALF) neutrophil content of patients with IPF undergoes changes in smokers different from those in nonsmokers after institution of corticosteroids. Eighteen patients were studied (10 smokers and 8 nonsmokers). Fourteen patients (6 smokers and 8 nonsmokers) were treated orally with prednisone. The histologic assessment of alveolar inflammation and inflammatory small airways disease was no different in smokers than in nonsmokers. None of the smokers treated with prednisone had pathologic evidence of emphysema in addition to IPF. Five of 6 smokers showed an increase in BALF neutrophils after 3 months of prednisone (p less than 0.05), whereas the nonsmokers' BALF neutrophils decreased or remained unchanged. This increase in BALF neutrophils in smokers was not associated with concomitant or subsequent clinical deterioration but, in fact, with clinical improvement after 3 months of therapy. These data indicate that the combination of cigarette smoking and corticosteroid therapy influences the BALF neutrophil content in patients with IPF and suggest that interval changes in BALF neutrophil content may not reflect the status of the inflammatory process or structural derangements in the lungs of some patients with IPF.

Aged↗