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Biomedical subjects

D Ingram

Publications and source records attributed to D Ingram.

At least 73 records · Page 4Linked to original sources

Ciliary abnormalities in respiratory disease.

One hundred and sixty seven children, ranging in age from 5 weeks to 16 years, with chronic upper or lower respiratory tract problems, or both, were investigated for ciliary dyskinesia. Abnormal ciliary function was found in 18 cases all of whom had chronic lower respiratory disease and most of whom also had upper respiratory problems. Fifteen of the 18 cases had reduced ciliary beat frequencies (less than 10 Hz) associated with dyskinesia and the other three showed apparent absence of ciliated cells. Of the 15 cases with reduced ciliary beat frequencies, ciliary ultrastructure was normal in seven cases but abnormal with missing dynein arms and occasional abnormalities of microtubular arrangement in eight. Respiratory symptoms in the perinatal period were more common in children with abnormal ciliary function and present in all those with ultrastructural abnormalities or absence of ciliated cells compared with 34 (26%) of 132 children, in whom symptoms were recorded, with normal ciliary function. This study would suggest that all children with unexplained chronic respiratory disease, in particular those with symptoms starting in the perinatal period, should be investigated for ciliary dyskinesia.

Adolescent↗

Preclinical and subclinical events in motor neuron disease.

It is suggested that in motor neuron disease there is a long preclinical period of relative tolerance and compensation before presentation with apparently focal features. During this phase the disease becomes disseminated through the motor system. The mode of acquisition of the disease, its relation to a possible genetic factor, and the processes leading to tolerance, to latency or progression, to the relative involvement of upper and lower motor neurons, to involvement of spinocerebellar pathways, and to asymmetry are fundamental problems in understanding the disease.

Adult↗

Feelings about AIDS.

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Acquired Immunodeficiency Syndrome↗

Effect of whooping cough in infancy on subsequent lung function and bronchial reactivity.

Thirty-six children younger than 1 yr of age hospitalized for whooping cough approximately 9 yr previously (cases) were compared with 36 control children of the same age and sex. Subjects were sampled from participants in an earlier large field study of the long-term sequelae of whooping cough. Respiratory symptoms were more common in cases, although the differences were not statistically significant. Cases were significantly more likely either to be atopic or to have a family history of wheezing illness. There were no significant differences between cases and control subjects in lung function indices derived from maximal expiratory flow volume loops or from single-breath nitrogen washout tests or in bronchial reactivity as judged by the histamine challenge PC20. The evidence from both the present and the earlier study indicates that whooping cough is unlikely to be a causal factor in later respiratory illnesses and symptoms and that no deficit in lung function can be detected in later childhood. The disease may, however, occur more frequently or be more easily recognized in children with environmental or constitutional factors that predispose to respiratory morbidity.

Asthma↗

The pharmacokinetics and dynamics of oxprenolol: a simulation study with six subjects.

Experimental results of plasma concentration determinations and lowering of exercise heart rate for six subjects taking a conventional tablet and a sustained release preparation of oxprenolol have been analysed by a comprehensive computer simulation model. Individual plasma values were simulated using a lest squares procedure and the results were applied to evaluate individual release patterns following dosage with the sustained release preparation. Application of the model to the lowering of exercise heart rate indicated that the response is in a steady state with the plasma values and that the response-concentration relation is of the saturable, Emax, type. The parameters for this were evaluated for each subject for the results after a dose of a conventional tablet. These parameters were applicable to the results after dosage with a sustained release preparation. The method should be applicable to other sustained release preparations.

Adult↗

Computer simulation to predict patient responses to alterations in the ventilation regime.

We have developed a technique for simulating artificially ventilated patients using a computer model of the respiratory system and have investigated its ability to predict the patient's response to alterations in the ventilation regime. The majority of those studied were in a stable condition following cardiac surgery. Predictions for PaO2 showed a reasonable correlation with measured values (r = 0.94), although individual predictions could differ appreciably (SEE = +/- 17.3 mmHg). Predictions for PaCO2 correlated less well (r = 0.89, SEE = +/- 2.0 mmHg) and there was a consistent tendency to overestimate this variable. The least accurate predictions were those for PvO2 (r = 0.61, SEE = +/- 3.8 mmHg). Errors in prediction were attributable to deficiencies in the model (most importantly the three-compartment lung and the modelling of CO2 production, storage and excretion), compounded by unpredictable alterations in the patient's physiology (mainly Vo2, Vco2 and Qt). However, allowing for accepted clinical variability and routine measurement accuracy, the predictions are generally reasonable. This suggests that, with some further modifications, computer modelling of this, and other, systems may prove to be a clinically and educationally useful technique.

Adult↗

Perforated peptic ulcer--a seasonal disease?

All hospital admissions for perforated peptic ulcer in the State of Western Australia from 1971 to 1981 inclusive were used to study the seasonal fluctuation, prevalence and mortality. This represented 1187 admissions. A significant seasonal peak was found during November, December and January. There was a marked reduction in admissions in the last three years, i.e. 1979-81, representing a 35% drop from previous levels. The overall mortality was 6.6%, but was 1.8% in patients less than 65 years, and 17.3% in patients 65 years or older.

Aged↗

The use of computerized learning in intensive care: an evaluation of a new teaching program.

A computer-assisted learning program in respiratory intensive care was introduced into the undergraduate curriculum at University College Hospital. Educational effectiveness was assessed. This method of learning was found to be highly acceptable to students. The improvement in students knowledge of the subject was up to three times greater in those who used the computer program, than a control group of students who received only teaching by conventional means, (P = 0 X 016). The results of a questionnaire designed to elicit students' attitudes to this learning experience are discussed.

Anesthesiology↗

Acute pancreatitis in identical twins.

Identical twins, 34-years-old at the time, developed abdominal pain of similar character while at a holiday resort. Both had drunk a greater amount of alcohol than usual, approximately eight 200-mL glasses of beer. The symptoms in one twin forced him to present to hospital where his plasma amylase level was found to be 2300 u/L. The other had the same symptoms, but did not present to hospital; however, when the symptoms later recurred, he also was found to have pancreatitis. Acute pancreatitis occurring simultaneously in identical twins has been reported only on one previous occasion.

Acute Disease↗

Self-instruction and assessment in techniques of intensive care using a computer model of the respiratory system.

There are considerable logistical difficulties involved in providing an adequate training programme for each new doctor when starting intensive care. One solution is to use an interactive computer terminal and provide programmes for self-instruction and assessment. Using a computer model of the respiratory system linked to a computer-assisted instructional driver we have developed instructional exercises on the management of artificial ventilation and the treatment of respiratory failure. Each teaching session contains explanatory text, multiple choice questions and model simulations. The student can interact with the simulations, appropriate assistance being provided when required, while his answers are marked and assessed with further explanation when necessary. The use of computer models adds a new dimension to computer-assisted learning techniques and is particularly applicable to intensive care medicine.

Computer-Assisted Instruction↗