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Biomedical subjects

P Rutledge

Publications and source records attributed to P Rutledge.

13 recordsLinked to original sources
PubMed2001

Assessment of impact of information booklets on use of healthcare services: randomised controlled trial.

OBJECTIVES: To investigate the effect of patient information booklets on overall use of health services, on particular types of use, and on possible interactions between use, deprivation category of the area in which respondents live, and age. To investigate the possibility of a differential effect on health service use between two information booklets. DESIGN: Randomised controlled trial of two patient information booklets (covering the management and treatment of minor illness). SETTING: 20 general practices in Lothian, Scotland. PARTICIPANTS: Random sample of patients from the community health index (n=4878) and of those contacting out of hours services (n=4530) in the previous 12 months in each of the study general practices. INTERVENTION: Booklets were posted to participants in intervention groups (3288 were sent What Should I Do?; 3127 were sent Health Care Manual). Patients randomised to control group (2993) did not receive a booklet. MAIN OUTCOME MEASURES: Use of health services audited from patients' general practice notes in 12 months after receipt of booklet. RESULTS: Receipt of either booklet had no significant effect on health service use compared with a control group. However, nine out of ten matched practices allocated to receive Health Care Manual had reduced consultation rates compared with matched practices allocated to What Should I Do? CONCLUSION: Widespread distribution of information booklets about the management of minor illness is unlikely to reduce demand for health services.

Family Practice↗
PubMed1998

Surface ultrastructure of plerocercoids of Bombycirhynchus sphyraenaicum (Pintner, 1930) (Cestoda: Trypanorhyncha).

Light microscopy studies have previously shown that Bombycirhynchus sphyraenaicum is an exceptional trypanorhynch cestode, characterised by a poeciloacanthous armature and two enormous bothridia, which overlap parts of the pars bulbosa, a character combination unique within the trypanorhynchs. Plerocercoids of B. sphyraenaicum from the fish Lates calcarifer (Centropomidae) were investigated by scanning and transmission electron microscopy. Results revealed that the tegument of the anterior margin of the distal bothridial surface bears three kinds of microtriche; palmate microtriches, 8 microns high, with seven to eight digitiform processes; equalized filamentous microtriches, 5-6 microns long, with cap and base each forming 50% of the length, borne on undulations beneath the palmate microtriches, and cap-dominated filamentous microtriches, 5-6 microns long, with the cap forming 75% of the length, borne on the apex of putative sensory papillae. Integumental connections link the bases of the palmate microtriches, forming transverse girdles around the worm, which may serve to coordinate traction. At regular intervals between the palmate microtriches are papillae, covered with filamentous microtriches extending above the palmate microtriches. A cilium emerges from a bulb at the apex of each papilla; other structures in the bulb include an electron-dense cuff, and two electron dense collars. The posterior part of the bulb tapers and passes into the tegumental cytoplasm. These adorned papillae, observed for the first time in trypanorhynch cestodes, are identified as putative mechanoreceptors.

Animals↗
PubMed1996

Polarization vision in cuttlefish in a concealed communication channel?

Polarization sensitivity is well documented in marine animals, but its function is not yet well understood. Of the cephalopods, squid and octopus are known to be sensitive to the orientation of polarization of incoming light. This sensitivity arises from the orthogonal orientation of neighboring photoreceptors. Electron microscopical examination of the retina of the cuttlefish Sepia officinalis L. revealed the same orthogonal structure, suggesting that cuttlefish are also sensitive to linearly polarized light. Viewing cuttlefish through an imaging polarized light analyzer revealed a prominent polarization pattern on the arms, around the eyes and on the forehead of the animals. The polarization pattern disappeared when individuals lay camouflaged on the bottom and also during extreme aggression display, attacks on prey, copulation and egg-laying behavior in females. In behavioral experiments, the responses of cuttlefish to their images reflected from a mirror changed when the polarization patterns of the reflected images were distorted. These results suggest that cuttlefish use polarization vision and display for intraspecific recognition and communication.

Journal Article↗
PubMed1994

Medicolegal issues.

Malpractice claims for failure to diagnose breast cancer are on the increase. Obstetrician-gynecologists are frequently targeted as defendants in these claims. A significant increase in the frequency and severity of these claims can be predicted by virtue of the widespread incidence and severity of the disease, coupled with changes in tort law. Physicians can learn risk management and loss prevention techniques by studying claims data and actual medical malpractice cases.

Adult↗
PubMed1989

Pancreatic duct obstruction in rabbits causes digestive zymogen and lysosomal enzyme colocalization.

The pancreatic duct of anesthetized rabbits was cannulated and, in some animals, flow of pancreatic exocrine secretions was blocked by raising the cannula to a vertical position. Blockage for 3-7 h caused a rapid and significant rise in serum amylase activity and an increase in amylase activity within the pancreas. The concentration of lysosomal enzymes in the pancreas was not altered but they became redistributed among subcellular fractions and, as a result, an increased amount was recovered in the 1,000-g, 15-min pellet, which was enriched in zymogen granules. Immunofluorescence studies indicated that lysosomal enzymes become localized within organelles which, in size and distribution, resemble zymogen granules. They also contain digestive enzyme zymogens. Blockage of pancreatic secretions also caused lysosomal enzyme-containing organelles to become more fragile and subject to in vitro rupture. These changes noted after short-term pancreatic duct obstruction are remarkably similar to those previously noted to occur during the early stages of diet and secretagogue-induced experimental pancreatitis, observations that have suggested that colocalization of digestive enzyme zymogens and lysosomal hydrolases might result in intracellular digestive enzyme activation and be an important early event in the evolution of those forms of experimental acute pancreatitis.

Amylases↗
PubMed1979

Initial experiences with continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) has been initiated on 51 patients: 27 females (mean age -- 43.9 years) and 24 males (mean age -- 46.4 years). This group has been observed for a total of 1420 patient weeks of treatment (27.3 patient years). Thirty-six episodes of peritonitis have been noted among 19 patients. The overall incidence was one episode per 39.4 patient weeks. Recurrent episodes of peritonitis resulted in discontinuation of CAPD in five (9.8%) of the patients. Three (5.9%) of the patients were unable to continue with CAPD because of its inability to control extracellular fluid balance. In the patients who transferred from intermittent peritoneal dialysis to CAPD, there was a 4.5 mg/dl drop in serum creatinine and a 34 mg/dl drop in mean BUN values. There was a rise of approximately 2 gm in the hemoglobin levels of this group of patients. If the problem of peritonitis can be solved, CAPD will become the dialytic treatment of choice for the majority of patients with end-stage renal disease.

Adult↗