Feasibility, uptake and impact of a hospital-wide tobacco addiction treatment pathway: Results from the CURE project pilot.

Introduction: Providing comprehensive tobacco addiction treatment to smokers admitted to acute care settings represents an opportunity to realise major health resource savings and population health improvements.

Methods: The CURE project is a hospital-wide tobacco addiction treatment service piloted in Wythenshawe Hospital, Manchester, UK. The core components of the project are electronic screening of all patients to identify smokers; the provision of brief advice and pharmacotherapy by frontline staff; opt-out referral of smokers to a specialist team for inpatient behavioural interventions; and continued support after discharge.

Innovations in curriculum design: a multi-disciplinary approach to teaching statistics to undergraduate medical students.

Background: Statistics is relevant to students and practitioners in medicine and health sciences and is increasingly taught as part of the medical curriculum. However, it is common for students to dislike and under-perform in statistics. We sought to address these issues by redesigning the way that statistics is taught.

A randomised, blinded, placebo-controlled, dose escalation study of the tolerability and efficacy of filgrastim for haemopoietic stem cell mobilisation in patients with severe active rheumatoid arthritis.

Autologous haemopoietic stem cell transplantation (HSCT) represents a potential therapy for severe rheumatoid arthritis (RA). As a prelude to clinical trails, the safety and efficacy of haemopoietic stem cell (HSC) mobilisation required investigation as colony-stimulating factors (CSFs) have been reported to flare RA. A double-blind, randomised placebo-controlled dose escalation study was performed.

Unrelated volunteer bone marrow transplantation: initial experience at St Vincent's Hospital, Sydney.

Background: Only 30% of patients with leukaemia have an HLA-compatible family member able to act as a marrow donor. The recent development of volunteer bone marrow donor registries has supplied HLA-matched donors for a number of such individuals.

Aims: To define the problem and outcome of the first cohort of patients given HLA-matched unrelated volunteer bone marrow transplants at St Vincent's Hospital, Sydney.

The tolerance to and pharmacokinetics of penciclovir (BRL 39,123A), a novel antiherpes agent, administered by intravenous infusion to healthy subjects.

The tolerance to and pharmacokinetics of intravenously administered penciclovir (BRL 39,123A), a novel anti-herpes agent, were investigated in 15 healthy male subjects. The volunteers were divided into three groups, receiving either 10, 15 or 20 mg/kg penciclovir by a 60 min constant-rate infusion. Blood samples were taken sequentially up to 48 h after the start of the infusion and urine collections made at appropriate intervals up to 72 h.

The effects of dietary fibre on upper and lower gastro-intestinal transit times and faecal bulking.

A total of 10 obese patients (body mass index greater than 25) undergoing treatment with a very low-calorie (330 kcal/day) liquid diet were treated without and with 10.5 or 21 g/day dietary fibre. Mean (+/- SE) faecal bulking increased significantly (P less than 0.

Temocillin: lymph penetration and protein binding.

Temocillin, a novel betalactam antibiotic, was administered in doses of 1,2 and 4 g i.v. to 12 healthy subjects and the plasma concentrations of free and protein bound temocillin assayed and protein binding parameters were calculated.

Human pharmacology of renzapride: a new gastrokinetic benzamide without dopamine antagonist properties.

The activity of the substituted benzamide renzapride on the upper gastrointestinal tract has been investigated. It has been shown to enhance stomach emptying in normal subjects; doses of 2 and 5 mg decreasing by 21 and 37% respectively the volume of gastric contents aspirated 80 min after a test meal. Renzapride was found to reduce the oro-caecal transit time as assessed by the lactulose/breath hydrogen method in a dose related manner from 0.

Comparison of orocaecal transit times assessed by the lactulose/breath hydrogen and the sulphasalazine/sulphapyridine methods.

The lactulose/breath hydrogen and the sulphasalazine/sulphapyridine methods of assessing orocaecal transit time have been compared. In a two part crossover study in healthy normal subjects the median orocaecal transit time by the SLZ/SP method was 4.84 hours but only 2.

The variability in oro-cecal transit time assessed using a bean-based test meal and its use in the study of the effect of metoclopramide and BRL 24924 on transit time.

The inter and intra subject variation in the oro-cecal transit time assessed using the bean/breath hydrogen method was studied and analyzed to allow estimation of the number of patients/subjects required to show a drug-induced difference for given levels of statistical significance and power. Thus at the conventional 5% level of significance and for a test with 90% power, a dozen subjects should be sufficient to show a drug-induced change which is 25% or greater. Two crossover studies are described using 20 mg metoclopramide and 2 mg BRL 24924, orally, against placebo to investigate their action on oro-cecal transit time.

Statistical analysis of the lactulose/breath hydrogen test in the measurement of orocaecal transit: its variability and predictive value in assessing drug action.

The variability in the orocaecal transit time as measured by the lactulose/breath hydrogen method has been studied for three conditions: lactulose given with a meal, subjects sitting; lactulose given with a meal, subjects semirecumbent; lactulose given in aqueous solution, subjects semirecumbent. Thirty three healthy subjects attended on up to 12 occasions. It was found that administration of the lactulose with a meal significantly reduced the variability (p less than 0.

An HPLC assay for sulphapyridine in plasma and its use to assess small bowel transit time after the administration of sulphasalazine.

An HPLC assay for sulphapyridine is described. The use of the assay to measure sulphapyridine produced by the action of large bowel flora on 2 g of orally administered sulphasalazine as a means of assessing oro-colonic transit time is discussed. The assay is applied to show the action on oro-colonic transit time of a novel gastrokinetic agent BRL 24924 which brought about a 62.

Effect of drugs on oro-caecal transit time assessed by the lactulose/breath hydrogen method.

The comparative actions of two benzamides; the one metoclopramide, having and the other, BRL 20627, lacking dopamine receptor antagonist properties have been investigated on orocaecal transit time (OCTT) using the lactulose/breath hydrogen method. In addition, the action of codeine, propantheline and domperidone on OCTT has been assessed. Similar quantitative reductions in apparent OCTT were found with metoclopramide and BRL 20627 thus, metoclopramide 20 mg orally and 10 mg i.

Pharmacokinetics of parenteral ticarcillin formulated with clavulanic acid: Timentin.

The pharmacokinetics of a formulation of clavulanate potentiated ticarcillin (Timentin) have been investigated following a bolus intravenous injection of 1.2 g, infusions of 3.2 g over periods ranging from 30 minutes to three hours, and a bolus dose of 1.

Augmentin bioavailability following cimetidine, aluminum hydroxide and milk.

Previous studies [Jackson et al. 1980] have shown that the bioavailability of Augmentin is not affected by food. The present work has shown that aluminum hydroxide, milk and cimetidine do have some influence on the bioavailability of a single dose of oral Augmentin, but the small differences observed are unlikely to be of therapeutic importance.

Parenteral augmentin: pharmacokinetics.

The pharmacokinetics of intravenous Augmentin have been investigated and the data found to fit a two compartment model. In the first study, to a crossover design, a bolus injection of 1.2 g Augmentin was given to 8 healthy volunteers with and without probenecid.

The QT interval and cycle length: the influence of atropine, hyoscine and exercise.

Twenty-seven healthy male subjects of mean age 24.3 +/- 4.0 years and mean weight 74.

Amoxycillin/clavulanic acid: the effect of probenecid.

The effect of probenecid on the combination of amoxycillin/clavulanic acid has been compared with the effect on amoxycillin alone and it has been shown that probenecid, whilst producing its expected effect on amoxycillin, did not affect the clavulanic acid concentration of the combination. A possible minor role for tubular secretion of clavulanic acid is discussed.

Systolic time intervals: the effect of stroke volume in healthy young men.

1. Positional change and exercise were used to gain a range of heart rates and stroke volumes in 20 healthy male subjects, and a regression plane computed for the 3 principal systolic time intervals. The addition of stroke volume as a second physiological variable was shown to result in an increase in the coefficient of determination of 13% for the LVET and 10% for the PEP.

Streptokinase and anisoylated streptokinase plasminogen complex. Their action on haemostasis in human volunteers.

A new fibrinolytic agent, BRL 26921, a member of the novel class of thrombolytic agents; the acyl enzymes, has been compared with streptokinase. It has been shown that this new agent, which can bind to fibrin before releasing activator, does not result in clinically significant destruction of the haemostatic system when compared to an equivalent dose of streptokinase.

Active and passive avoidance learning in controls and schizophrenic patients on racemic propranolol and neuroleptics.

Normal controls and schizophrenic patients on propranolol as sole drug or combined with neuroleptics showed superior active and passive avoidance learning to schizophrenic patients who were medicated with conventional neuroleptics only. Active avoidance involved responding quickly, passive avoidance withholding a response to avoid an unpleasant noise and reacting to the appropriate stimulus. This may reflect an improvement brought about by propranolol in the limbic regulation of stimulus and response processes.

Propranolol and blood glucose: simultaneous measurements over a wide range of doses and the effect of propranolol on the glucose tolerance test.

No correlation was found between blood glucose and simultaneous measurements of plasma propranolol concentration in patients with schizophrenia, on a daily dose of 80 mg to 1800 mg of propranolol as an adjunct to phenothiazine medication. The Glucose Tolerance Test (GTT) in ten patients on propranolol and phenothiazines did not differ significantly from those of a matched control group on phenothiazine alone. Two patients with mild diabetes showed no significant change in their GTT after stopping propranolol.