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Biomedical subjects

I M Stell

Publications and source records attributed to I M Stell.

8 recordsLinked to original sources
PubMed1997

Trouble with tuna: two cases of scombrotoxin poisoning.

Two cases of scombrotoxin poisoning after exposure to tuna are described, the second being unusual in that tinned, rather than fresh, tuna was involved. This relatively rare condition needs to be distinguished from an allergic reaction, for which it can easily be mistaken.

Adult↗
PubMed1996

Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirate will resolve the issue. Septic olecranon bursitis should be treated by aspiration, which may need to be repeated, and a long course of antibiotics. Some cases will need admission, and a few will need surgical treatment. Non-septic olecranon bursitis can be managed with aspiration alone. Non-steroidal anti-inflammatory drugs probably hasten symptomatic improvement. Intrabursal corticosteroids produce a rapid resolution but concern remains over their long term local effects. Recovery from septic olecranon bursitis can take months.

Anti-Bacterial Agents↗
PubMed1996

Asthma management in accident and emergency and the BTS guidelines--a study of the impact of clinical audit.

OBJECTIVE: To determine whether the care of asthma patients in accident and emergency Departments (A&E) is improved by clinical audit of asthma management. METHODS: The quality of care during continuous cycles of clinical audit was compared with that one year later, after an audit programme had ended and most of the medical staff had changed. This was done by a retrospective case notes review of all asthma cases (n = 79) in April and May 1993, compared to the same months (n = 93) in 1994. RESULTS: The quality of care was higher during the audit in a number of areas, as determined by conformity to the British Thoracic Society (BTS) guidelines. Comparing the management of episodes for the earlier to the later study periods, the significant differences were: the ability to complete a sentence in one breath was recorded in 63% and 33% of episodes; a nebuliser was given when indicated in 97% and 88%; when indicated a chest x ray was ordered in 73% and 43%; and arterial blood gases were measured in 73% and 33% of episodes. CONCLUSIONS: The initial assessment and management of asthma was better when the audit was in progress. However, in both study periods some areas of care did not receive the attention recommended in the BTS guidelines, these were all areas which would have influenced asthma control after discharge.

Adult↗
PubMedDate not supplied

Age changes in the epithelial lining of the human larynx.

The change in size of the larynx with respect to age was investigated. In general the female larynx grows smaller with increasing age, but there is no similar age effect in men. The incidence and extent of squamous metaplasia was also studied. Two parts of the larynx showed age-related changes: in men, metaplasia of the vestibular folds became more common with age up to the age of 60, but then became less common again. In men also, the incidence and extent of squamous metaplasia increased with ageing. These age-related changes may relate to the development of laryngeal carcinoma, an event which must be preceded by squamous metaplasia.

Adult↗