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F G Inglis

Publications and source records attributed to F G Inglis.

17 recordsLinked to original sources
PubMed1995

Surgical care in rural Canada: training and planning for the future.

The survey results reported by Chiasson and Roy in this issue (see pages 1447 to 1452) document a growing problem with the provision of surgical services in rural western Canada. Recognizing the need to improve access to surgical services in rural communities, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada have proposed guidelines for training family physicians in resuscitative and surgical techniques as well as in the safe transfer of seriously ill patients to specialized facilities. It is hoped that these guidelines will provide the basis of a national policy for general-practice training that will improve the standard of surgical care in rural communities.

Canada↗
PubMed1995

The community general surgeon: a time for renaissance.

The practice of general surgery in smaller Canadian communities requires a broad scope of training, and recently the Royal College of Physicians and Surgeons of Canada introduced training requirements to meet the needs of these communities. The traditional role of physicians and surgeons in relation to the hospital boards is changing, with the development of regional health boards. Surgeons must be adaptable to these changes while striving to preserve the standards of surgical care in the new environment. The 1990 Canadian Medical Association manpower studies indicated that there will soon be a major shortage of general surgeons in Canada. In 1990, 48% of general surgeons in Canada were over 55 years of age. In communities with a population of 10,000 or less, there were relatively more general surgeons than other specialists, but, again, they were proportionately older. Recruitment to general surgery is a concern. A survey of 205 residents obtaining the Royal College fellowship in surgery between 1991 and 1993 revealed that 107 took post-fellowship training; of these, 46 developed academic careers, 17 became community surgeons and 44 were lost to surgical practice (they went into cardiac surgery or emigrated). Ninety-eight did not take further training; of these, 5 developed academic careers, 87 chose community practice and 6 emigrated. The role of the general practitioner in providing surgical services in remote areas was the topic of discussion between the Canadian Association of General Surgeons (CAGS), the Royal College and the College of Family Physicians of Canada. Guidelines were developed and approved by the CAGS.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Post-mortem rates and junior doctors in Tayside--three years after the Joint Working Party report.

The total number of post-mortem examinations performed in Ninewells Hospital, Tayside's principal teaching hospital has fallen progressively over the last nine years despite publication in 1991 of the Joint Working Party report, 'The Autopsy and Audit'. There were 57% fewer autopsies carried out in 1994 than in 1986. Review of recent post-mortem rates in Ninewells Hospital, Dundee Royal Infirmary, Royal Victoria Hospital and Ashludie Hospital shows a wide variation and no ward, unit or hospital studied achieved rates adequate to satisfy the recommendations of the Joint Working Party report. A questionnaire sent to all Junior House Officers in Tayside in July 1994 showed that the Working Party report's clinical recommendations relating to junior medical staff concerning training to seek permission for autopsies, responsibility for obtaining permission for autopsies and attendance at the post-mortem room have not been implemented. Urgent implementation of the Joint Working Party reports clinical recommendations is called for to prevent clinical post-mortem examinations becoming obsolete.

Autopsy↗
PubMed1993

The effect of ursodeoxycholic acid therapy on gallstone formation in the morbidly obese during rapid weight loss.

UNLABELLED: Obesity is a significant risk factor for cholesterol gallstone formation, particularly when patients are morbidly obese and rapidly losing weight. Our objective, in a double-blind, placebo-driven trial of ursodeoxycholic acid, was to study the prevention of gallstone development in 29 morbidly obese subjects after bariatric surgery. These subjects included 20 women and nine men, ages 43 +/- 7.3 yr, weight 142.5 +/- 31 kg (mean +/- SD), representing 224% +/- 28.2% of their ideal body weight. Gallbladders were free of stones according to preoperative ultrasound and palpation at surgery. Microscopy of aspirated gallbladder bile revealed cholesterol crystals present in only one patient. After recovery from vertical-band gastroplasty, 13 patients received ursodeoxycholic acid 1000 mg/day. Ten patients completed the 3-month study: two were noncompliant, one experienced heartburn. Fourteen of 16 subjects on matching placebo also were compliant; two were not. There were no differences in clinical characteristics or bile composition between these two groups on entry into the study. The cholesterol saturation index in these obese patients at 1.62 +/- 0.46 was definitely supersaturated, and higher than that in 10 non-obese patients without stones (0.96 +/- 0.29) or 10 with pigment stones (1.01 +/- 0.28) (p < 0.05). At 3 months, the two obese groups had similar weight loss (17% of preoperative weight) and had repeat ultrasounds. Six of the 14 placebo-treated patients (43%) developed gallstones: two became symptomatic, requiring cholecystectomy. There was no correlation between the risk of developing gallstones and pretreatment bile composition or the degree of weight loss. None of 10 patients or ursodeoxycholic acid formed gallstones. CONCLUSIONS: Morbid obesity is associated with gallbladder bile supersaturated with cholesterol. A high percentage will develop gallstones following gastroplasty. This can be prevented by ursodeoxycholic acid therapy.

Adult↗
PubMed1992

Persistence of metaldehyde during acute molluscicide poisoning.

A case is presented in which a 37-year-old man took an overdose of Slugit, liquid containing metaldehyde. Significant concentrations were found in his serum and urine for several days afterwards. Acetaldehyde and ethanol were not detected. The significance of these findings is discussed.

Acetaldehyde↗
PubMed1992

Colorectal leiomyosarcomas: a pathobiologic study with long-term follow-up.

Colorectal leiomyosarcoma (CLM) is an uncommon tumour. Reports of its occurrence have been published mostly as single cases or small series. This study documents 12 cases of CLM that were seen over a 28-year period in Saskatchewan. The annual incidence of CLM was 0.45 per million people and constituted 0.12% of all colorectal malignant tumours seen during the study period. CLMs had a predilection for the rectum and sigmoid and commonly were associated with rectal bleeding or abdominal pain. More than half the tumours were detected by sigmoidoscopy. A correct preoperative or intraoperative histologic diagnosis of leiomyosarcoma was made in only two out of six cases. A potentially curative surgical procedure was done in 10 of the 12 patients. The mean follow-up was 6.9 years. Eight patients had tumour recurrence or metastasis, or both. From the findings of this study the authors recommend wide excision of colorectal smooth-muscle tumours whenever there is a suggestion of malignancy.

Adult↗
PubMed1986

Symposium on surgical manpower in the smaller community. The Canadian Association of General Surgeons' questionnaire: results and observations.

The Canadian Association of General Surgeons distributed a questionnaire to members located in communities of 40 000 population or less. The objective was to establish a minimal referral base of general surgeons, to identify the scope of procedures performed and the adequacy of training for serving smaller communities and to gain knowledge of the need for other specialists and the activity of the general practitioner-surgeons in smaller centres. A review of 92 replies indicated that, in general, these surgeons are very satisfied with the hospital and laboratory facilities, and perform a broad range of operative procedures for which there is abundant operating time. In communities of 10 000 to 20 000 there appears to be a need for extra training in obstetric, gynecologic and orthopedic procedures. Most of the larger communities have an adequate number of other surgical specialists with the exception of neurosurgeons. Of the respondents, 80% practised on a referral basis only with an average of 10 referring general practitioners; 24% were in competition with general practitioner-surgeons, but most indicated that this is a diminishing problem. It appears that practice in small communities provides a very rewarding and professionally challenging surgical career.

Canada↗
PubMed1980

Abdominal pain due to Enterobius vermicularis.

The authors describe an unusual case of an 11-year-old girl who had right lower quadrant pain due to unilateral salpingitis, suppurative omentitis and periappendicitis. The etiologic agent was the parasite Enterobius vermicularis. A review of the literature revealed that pinworm may be the cause not only of appendicitis, but of inflammatory reactions in other intra-abdominal sites and that the frequency of this occurrence is probably higher than has previously been suspected.

Abdomen, Acute↗
PubMed1965

Histoplasmosis and thrombocytopenic purpura: transmission by renal homotransplantation.

Two patients with disseminated histoplasmosis are reported. One patient presented with severe thrombocytopenic purpura and splenomegaly. Histoplasmin skin test, blood and bone marrow cultures and smears, sputum cultures, and chest radiographs were negative for Histoplasma capsulatum. She died on the sixth hospital day from a massive intracerebral hemorrhage. Cardiorespiratory function was maintained until one kidney was removed for homotransplantation. The second patient, with chronic glomerulonephritis and uremia, received the renal homograft from the first patient. Initial signs of homograft rejection developed five days postoperatively. Diffuse thrombocytopenic purpura occurred shortly thereafter. Spores of Histoplasma capsulatum were observed in blood smears, in leukocyte concentrates, and in five-day leukocyte cultures from the blood obtained prior to death. Disseminated histoplasmosis was found in both patients at autopsy. The severe platelet deficit in both cases suggests that systemic histoplasmosis should be considered as a cause of thrombocytopenic purpura.To our knowledge, this is the first reported instance of direct transmission of Histoplasma capsulatum, and must be considered a hazard in homotransplantation.In vitro leukocyte cultures as a method for early diagnosis of certain disseminated fungous infections needs further investigation.

Adult↗