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Biomedical subjects

D Ingram

Publications and source records attributed to D Ingram.

At least 19 recordsLinked to original sources
PubMed1992

An interactive videodisc 'cancer patients and their families at home', designed for education in primary health care.

This article describes the development of an interactive videodisc program to support professional education in the field of cancer for the primary health care team. Based on a survey of needs, it concentrates on common symptoms and their control, and problems in communication. The educational approach adopted was chosen on the basis of an extensive consideration of the needs, and what was felt most appropriate for adult learners. Plans were carefully reviewed at each stage, with external advisers, and the prototype system independently evaluated in four sites before completing the package. With financial backing from the 'Europe against Cancer' initiative of the European Commission, and close cooperation with national practitioners, Dutch, German, Greek and Portuguese versions of the package have been developed. Local differences in practice are taken into account and translations of key aspects are provided.

Home Care Services↗
PubMed1991

Preventing breast cancer: is it possible?

Breast cancer is a common cause of suffering and death in Australia. Improvements in detection and therapy will make only small inroads into mortality, and will not reduce suffering. Reducing the incidence of breast cancer by preventive measures is a logical step, and this paper reviews how it might be achieved. Reducing the population's exposure to known risk factors for breast cancer is logical; however, the potential for improvement is limited. Reduction in age at first pregnancy is impractical and measures such as weight reduction and reducing consumption of fat and alcohol are likely to be only partially successful. Increasing activity in youth is a concept that requires further investigation, but is a possible area of promise. Exogenous hormone use probably contributes little to the incidence of breast cancer, but prescribing patterns for post-menopausal oestrogens are changing and require monitoring. The use of hormone manipulation to prevent breast cancer has considerable potential benefit. Two approaches have been proposed. The first involves reversible suppression of ovarian function by luteinizing hormone-releasing hormone (LHRH) agonists after child-bearing has finished, combined with low-dose conjugated equine oestrogen to compensate for oestrogen loss. The other involves the use of the anti-oestrogen, tamoxifen. Both measures have the potential to halve breast cancer incidence. There is some evidence that non-hormonal chemoprevention is possible, but clinical trial data are lacking.

Adolescent↗
PubMed1991

Stereotactic fine needle aspiration biopsy (SFNB) of breast: preliminary results in Perth with the TRC mammotest machine. Cytological aspects.

Stereotactic fine needle aspiration biopsy (SFNB) was carried out on 404 mammographically detected impalpable breast lesions from 389 women between October 1988 and January 1990. Seventy-three lesions were excised, and 38 were carcinomas. Thirty-six of the 38 carcinomas had been diagnosed as atypical, suspicious or malignant by cytology; in the remaining 2 only fat and fibrous tissue were present in smears. The sensitivity of cytological diagnosis in detecting malignancy was therefore 94.8% (36 of 38 cases). A cytological diagnosis of malignancy was made in 23 cases (5.7%) and in 5 (1.2%) the findings were suspicious of malignancy. All of these were confirmed as carcinoma histologically; the predictive value of a positive cytological diagnosis was therefore 100%. In 32 cases (7.9%) the cytological findings were atypical but inconclusive. Twenty-three of these lesions were excised, and 8 proved to be carcinoma (34.8%). No case assessed radiologically and cytologically as benign has subsequently proven to be malignant. Twenty-two of 28 cases of invasive carcinoma were given an unequivocal cytological diagnosis of malignancy; 2 were suspicious of malignancy, and in 3 the findings were atypical but inconclusive. Of the 10 pure duct carcinoma-in-situ (DCIS) lesions, (26.3% of the cancers) 1 was diagnosed cytologically as malignant, 3 as suspicious of malignancy, and 5 as atypical. The sensitivity of SFNB in detecting DCIS lesions was therefore similar to invasive carcinomas, but cases of DCIS were more likely to be given a suspicious or atypical diagnosis rather than a definite diagnosis of malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Exertional myocardial ischemia in diabetes: a quantitative analysis of anginal perceptual threshold and the influence of autonomic function.

Patients with diabetes are prone to silent myocardial infarction and silent exertional ischemia. Although the mechanism is not clear, it may reflect a specific impairment of the sensory innervation of the heart. To test this hypothesis, anginal perceptual threshold was measured in 32 diabetic patients and 36 nondiabetic control patients, all of whom had typical exertional angina. Anginal perceptual threshold was defined as the time from onset of 0.1 mV ST depression to the onset of chest pain during treadmill stress electrocardiography. Although ST depression occurred earlier in the diabetic than in the nondiabetic group (111 +/- 82 versus 216 +/- 162 s, p less than 0.005), the anginal perceptual threshold in the diabetic group was delayed by a mean of 86 s (149 +/- 76 versus 63 +/- 59 s, p less than 0.001), with 95% confidence intervals of 53 to 119 s. Autonomic function tests were abnormal in the diabetic group, and in both groups regression analyses (using a third order polynomial) showed marked prolongations of anginal perceptual threshold as the heart rate responses to the Valsalva maneuver decreased to below the normal range (r = 0.5, p less than 0.001). There was a similar though less pronounced relation between anginal perceptual threshold and the heart rate responses to deep breathing (r = 0.3, p less than 0.02). These data suggest that prolongation of the anginal perceptual threshold may be caused by autonomic neuropathy involving the sensory innervation of the heart. To test sensory function, median nerve conduction studies were performed in 19 patients (10 diabetic and 9 nondiabetic).(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1990

House dust mite allergen levels and an anti-mite mattress spray (natamycin) in the treatment of childhood asthma.

Natamycin, a fungicide marketed as Tymasil, is claimed to reduce house dust mite numbers and would therefore be expected to improve asthma in children with mite sensitivity. We have tested this assertion by a double-blind, placebo-controlled trial. There was no significant effect on levels of Der p I in mattress dust between active and placebo groups at the end of the spraying period. Histamine inhalation challenge PC20, clinic visit symptom scores and lung function tests reflecting either large or small airways obstruction were also unchanged. Therefore this product is not a therapeutic option for mite-allergic patients using the manufacturer's recommended dose and method of administration. Other factors influencing the Der p I levels were also investigated. Of these, only month of measurement and bedroom wall humidity showed any association.

Adolescent↗
PubMed1990

Tamoxifen use, oestrogen binding and serum lipids in postmenopausal women with breast cancer.

Tamoxifen is widely used in the management of breast cancer, including long-term use in women with early disease to reduce recurrence and mortality. Although remarkably side-effect free, concern has been expressed that its anti-oestrogen activity may extend to lipid metabolism and so result in the premature development of coronary heart disease. In a study of breast cancer patients, those taking Tamoxifen tended to have lower cholesterol concentrations (predominantly low-density lipoprotein cholesterol) and raised triglyceride concentrations. These changes are likely to be protective for coronary heart disease, suggesting Tamoxifen has an oestrogenic rather than anti-oestrogenic effect as regards lipid metabolism.

Aged↗
PubMed1989

Estradiol binding to plasma proteins after changing to a low-fat diet.

Breast cancer development is believed to be associated with both dietary fat consumption and the proportion of biologically available estradiol in the serum. A study was undertaken to determine if a reduction in fat consumption would influence the binding, and thus the bioavailability, of estradiol. Groups of pre- and postmenopausal women were randomized to begin either a standard western diet (40% energy from fat) or a low-fat diet (20% energy from fat). After two months, each woman changed over to the alternate diet. Blood samples were taken at the end of each dietary period. Change of diet made no significant difference to the proportions of nonprotein-bound (free), albumin-bound, or sex hormone binding globulin-bound estradiol in this study. However, the number of women studied and the duration of change were relatively small.

Adult↗
PubMed1979

Inversion of subject NP and Aux in children's questions.

Bellugi has proposed a stage of language acquisition in which children invert subject NP and Aux in yes-no but not wh questions. It was proposed that this stage would be found in a sampling of questions from young children. Cross-sectional samples of questions were collected from young children between 2:0 and 3:11. The results did not bear out this expectation. Based on percentages of inversion, none showed this stage. The results are discussed in terms of the importance of frequency in determining stages of acquisition and the use of children's data as psychological evidence for linguistic rules.

Child, Preschool↗
PubMed1978

Recurrent biliary calculi due to non-absorbable cystic duct ligatures.

A non-absorbable cystic duct ligature may migrate into the common bile duct and act as a nidus for recurrent stone formation. Four case histories are presented and the problem is discussed. This sequel may be prevented by the use of absorbable sutures to ligate the cystic duct, thereby reducing the number of patients facing the hazards of recurrent biliary surgery.

Adult↗
PubMed1978

Immunochemical studies of 5-bromodeoxyuridine.

Specific antibodies for BrdUrd and IdUrd have been produced and characterized by immunochemical studies. Studies as determined by hapten-inhibition showed a cross reactivity of less than 0.001% to thymidine, and no cross reactivity to bromodeoxycytidine, uridine or methyl cytosine. The equilibrium constant determination for anti-BrdU and IdUrd was 4.2 x 10(8)M-1. Unfractionated antiserum, produced under the conditions herein described, can be employed for the specific cytological detection of DNA replication.

Animals↗
PubMed1977

A procedure for dissociating Ayre scrape samples.

The dissociation of cervical cell suspensions after various chemical and enzymatic treatments was monitored by using the Centrifugal Cytology rotor to produce glutaraldehyde-fixed dispersions on conventional microscope slides and subsequent Pap staining. A special program was written in RPG II to record and analyze the results of the dissociation experiments in terms of white blood cells and the true cervical cells ("other cells"), and the degree of dissociation and recovery of both classes of cells. Since accurate differential counts on the untreated Ayre scrapes were difficult, the samples were syringed gently to break up the large or adventitious clumps. Cumulated results from control preparations indicate that the white blood cells and "other cells" are composed respectively of 92 and 63% single cells. The cells were further dissociated by: dissolving the cervical mucin sequentially with dithiothreitol and iodoacetic acid; depolymerizing the nucleohistone gel with ribonuclease; solubilizing the desmosomes with EDTA; removing the remaining cellular agglutinins with Varidase; and finally mechanical dispersion by hypertonic shock. The optimum procedure for dissociation involves the use of ribonuclease, dithiothreitol, iodoacetic acid EDTA, Varidase and sucrose shock. The white blood cells are now monodisperse and 81% of the "other cells" are found as single cells. If nuclear separation by two diameters is considered sufficient 98% of the "other cells" are single. The slide preparations are now sufficiently good that a scanning system is feasible.

Autoanalysis↗
PubMed1977

Optimization of the binding of dissociated exfoliated cervico-vaginal cells to glass microscope slides.

In order to monitor the development of a cell dissociation technique, it was essential to utilize the Centrifugal Cytology rotor to produce glutaraldehyde-fixed even cellular dispersions. The Cytology rotor has been improved to insure rapid alignment with the centrifugal field during both acceleration and deceleration, and the fixative is now delivered to the surface of the slide. The dissociation of the cells results in a loss of their adhesion to glass slides. Three bonding agents were tested: (a) Poly-L-Lysine; (b) Mayer's albumin fixative; (c) positively charging the slides with a silicone coating. The results with 65% albumin-coated slides were clearly superior to the other two. The addition of a postfixation step of 95% ethanol/4% polyethylene glycol did not significantly affect the recovery of the cells, but did eliminate some unevenness in the Centrifugal Cytology preparations, flattened the cells and expedited the procedure.

Albumins↗