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Biomedical subjects

D Ralston

Publications and source records attributed to D Ralston.

7 recordsLinked to original sources

Cooking and oxygen. An explosive recipe.

BACKGROUND: Home oxygen therapy is commonly prescribed for the treatment of chronic obstructive pulmonary disease (COPD). The risks of smoking while using this therapy have been well described. OBJECTIVE: To discuss the Royal Brisbane Hospital Burns Unit's experience and present case studies which illustrate the danger of alternative ignition sources while using home oxygen. DISCUSSION: The dangers of home oxygen therapy can be minimised by careful patient selection, education and ongoing monitoring.

Accidents, Home↗

Effectiveness of telemedicine in the outpatient pulmonary clinic.

BACKGROUND: Over the past several years, there has been a resurgence of interest in telemedicine. Despite this renewed interest, some health care providers remain skeptical regarding the effectiveness of telemedicine for the delivery of health care. OBJECTIVE: The objective of this prospective, crossover study was to determine if there was any difference between care delivered using video conferencing-based telemedicine technology and that given by a traditional face-to-face encounter in a pulmonary medicine clinic. METHODS: Two pulmonologists sequentially examined 40 individuals via video conferencing-based telemedicine technology and by the traditional face-to-face method. Two additional pulmonologists, in a blinded fashion, compared the results for consistency in the history, examination with focus on auscultation of the lungs, diagnostic impression, and evaluation and treatment plans. RESULTS: Evaluation of patients by telemedicine was as effective as the traditional mode. The telemedicine physician and the physician examining the patient in the traditional manner were able to elicit the same key complaints and hear the same adventitious sounds on auscultation of the lungs. CONCLUSION: Telemedicine can enable the provision of high-quality care in a pulmonary clinic setting.

Adult↗

Variations in properties of L-forms of Pseudomonas aeruginosa.

In a study of the pathogenic potentials of Pseudomonas L-forms, three unstable L-forms were derived by carbenicillin inductionfrom a mouse virulent strain of Pseudomonas aeruginosa, Rosenthal 180. One L-form, induced on a sucrose-stabilized medium, grew more slowly and differed in a number of properties from two other L-forms induced on a medium supported with polyvinylpyrilidone. After adaptation to a common liquid medium, the three L-forms differed with respect to colonial shape on solid medium, growth rate, certain biochemical properties, antibiotic sensitivities and antigenic surface, and virulence for mice. The L-form may revert in vitro to a serotype different from that of the parent culture. The revertant may acquire new antibiotic resistances and sensitivities in the absence of previous exposure to the drugs and enhanced resistance to the L-inducing agent. The three L-forms showed a characteristically lower, but wide, range of virulence than did the parental form. Though death of mice was accompanied by reversion of the L-forms in vivo to the bacterial form, reversion in vivo was not necessary for virulence of L-forms. Modification of residual cell wall antigens accompanied the induction of each L-form as determined by type-specific antisera.

Agglutination Tests↗

Influencing care in acute myocardial infarction: a randomized trial comparing 2 types of intervention.

The purpose of this study was to evaluate performance feedback delivered by on-site presentations compared to mailed feedback on improving acute myocardial infarction (AMI) care. We used a randomized trial including 18 hospitals nested within the Cooperative Cardiovascular Project. Patients comprised AMI Medicare patients admitted before (n = 929, 1994 and 1995) and after intervention (n = 438, 1996). Control hospitals received written feedback by mail. The experimental intervention group received a presentation led by a cardiologist and a quality improvement specialist. We assessed the proportion of patients receiving appropriate AMI care before and after the intervention. Both univariate and multivariate analyses demonstrated no effect of the intervention in increasing the proportion of patients who received reperfusion, aspirin, beta-blockers, or angiotensin-converting enzyme inhibitors. On-site feedback presentations were not associated with a larger improvement in AMI care compared to the mailed feedback. Other interventions, such as opinion leaders and patient-directed interventions, may be necessary in order to improve the care of AMI patients.

Aged↗