J H McKillop's research while affiliated with University of Glasgow and other places

“Prediction is very difficult, particularly about the future.” Niels Bohr (1885–1962). We are living in an exciting period due to current innovations and developments in science. As we learn more about the human gene, we try to cluster disorders and diseases in order to have a positive effect on medicine [1]. The Institute for Systems Biology (Seattle, WAS, USA) have developed the P4 medicine (or Predictive, Preventive, Personalised and Participatory medicine), in a move from traditional reactive medicine to proactive medicine. In the future, will the doctor actively search for the patient to predict and prevent a disease rather than wait? Will personalised and participatory care be given to all patients? [2]. There is no doubt that public health demand and research advances are pushing medicine into an era of transformation [3]. Fast moving societal, economical and technological changes are also reshaping the medical profession in general. The mobility of both patients and doctors within the European Union has focused even greater attention on the competency of doctors and their ability to practice medicine. Technological changes have introduced new concepts and challenges in how medical education is conducted, both by instruction and assessment. In this milieu of complex and ever-evolving healthcare systems, how does the physician develop? How does one set expectations, provide experiences and evaluate outcomes which are the basic actions for providing a comprehensive programme in developing the physician as a professional? [4]. These trends will particularly impact on the practice of respiratory medicine. Therefore, it is crucial that the profession keeps pace. This requires particular efforts on behalf of the medical education reforms that have become relevant. The European Respiratory Society (ERS) took the first step in taking on the challenge. The ERS School organised an educational research seminar …

The aim of this study was to investigate whether atenolol, labetalol and methyldopa, which are commonly used for the treatment of hypertension in pregnancy, can induce antioxidant activity. Reactive oxygen species scavengers (plasma thiol, red cell lysate thiol, red cell superoxide dismutase, red cell membrane thiol and plasma glutathione) were measured after incubation of peripheral blood with atenolol and methyldopa, respectively. The results showed that atenolol and labetalol could significantly raise the levels of plasma thiol and membrane thiol but had no effects on lysate thiol, superoxide dismutase and glutathione. The effects on membrane thiol occurred after 60 min incubation and on plasma thiol after 120 min incubation. The data also suggest that atenolol and labetalol at lower concentrations tend to have additive effects on reactive oxygen species scavengers but at higher concentrations do not. Methyldopa had no significant effect on any of the parameters measured. These findings suggest that atenolol and labetalol are able to induce higher levels of antioxidant activity.

Myocardial imaging was performed following intravenous administration of Thalliumzo1 (TIm1)at rest and during maximal exercise testing in 39 patients presenting with chest pain. Image data were computer analysed and compared with the results of coronary arteriography and left ventriculography. In 26 patients with coronary artery disease (CAD) TIm1 perfusion defects were present in 12 at rest and 24 on exercise. In 13 patients with normal vessels, perfusion defects were present in 2 at rest and one on exercise. Resting TI201 image data corresponded to the presence or absence of impaired LV wall mo- tion in 21 of 26 patients with coronary artery disease. Exercise scans were more accurate than rest scans in detecting the presence of CAD,(TI201:scintigram-rest sensitivity- 46 %; exercise sensitivity-92 %; P < 0.005). Perfusion defects on the exercise T1201 scinti- gram tended to reflect the distribution of vessel disease, but prediction of individual coronary lesions from the scan findings was not possible. These data suggest that TI201 myocardial im- aging is a useful non-invasive technique for the investigation of patients presenting with chest pain. Rest P I scintigrams correspond to LV appearance on the ventriculogram and perfusion defects on the exercise TIrn1 scintigram detect the presence of CAD.

Acute medical management is an important component of the Modernising Medical Careers (MMC) project which has recently been implemented in the UK. A web-based interactive course in acute medicine has been developed which complements the clinical teaching provided to senior medical students at the University of Glasgow. A study was undertaken to evaluate the teaching and assess the knowledge of acute medicine among final year medical students using an online questionnaire. The undergraduate medical school Virtual Learning Environment (VLE) was constructed using the Moodle learning management system. The online questionnaire was constructed as part of the interactive acute medicine course hosted on the VLE. Final year students using this course were asked to complete the questionnaire anonymously. A 5-point Likert scale was used to assess different aspects of acute medical management and evaluate the teaching. From 210 students using the website, 99 (47.1%) completed the online questionnaire. Nephrology and neurology were identified as the most challenging specialties in acute medicine. The areas of acute management in which students felt they lacked most knowledge were drug overdose and acute renal failure. Drug prescribing was also identified as an area of the curriculum requiring further development. This approach to blended learning is popular with our medical students. Online evaluation has helped with curriculum development and, by identifying important areas of acute medicine teaching that can be improved, is feeding into our curriculum revision.

The aim of this study was to determine in vitro whether calcium channel blockers (nifedipine and nimodipine) exert their antiperoxidative effect by changing the antioxidant levels. Four antioxidant markers in red blood cells were investigated: membrane thiol, lysate thiol, lysate total glutathione and lysate superoxide dismutase. These antioxidant markers were measured after cells were incubated with varying concentrations of nifedipine and nimodipine (1–1000 ng/ml) for different time periods (0–120 min). The results showed that neither nifedipine nor nimodipine significantly increased antioxidant levels. In conclusion, it appears that calcium channel blockers are unable to elevate the levels of the physiological antioxidant agents detected in this in vitro experiment.

The 2006 EANM Congress, held in Athens, Greece, was once again a major event in the nuclear medicine scientific and educational calendar. The scientific programme, which included the second biennial ISRTRD meeting, confirmed the major developments taking place in (1) the diagnostic and prognostic uses of nuclear medicine imaging (both in PET and in single-photon studies), (2) radionuclide therapies, (3) radiochemistry and radiopharmacy, and (4) physics. This paper outlines the major findings in each of these areas.