PubMed Health⌕ Search

Biomedical subjects

S Ingram

Publications and source records attributed to S Ingram.

At least 19 recordsLinked to original sources
PubMed2001

Clinical governance: learning and changing practice.

CONTEXT: This paper describes a very simple, non-threatening method for improving communication and sharing learning points. OBJECTIVE: To test whether sharing anonymised reporting of problems and helpful hints is acceptable and useful to staff. DESIGN: A pink slip (pinkie) was designed and made available in every clinic venue. All staff were asked to write about any episodes where practice was less than optimum or to share good clinical experiences. The forms could be completed anonymously if preferred. A senior nurse collated the reports monthly and fed them back to all staff as a report. In May 2000 all staff were surveyed for their opinion of the scheme. RESULT: Over 22 months, 139 'pinkies' were returned. Fifty-six of the 100 'less than optimum' events were classified as 'system failures'. The response to the staff survey was very positive, with 62% of staff replying. Fifty-four of the 55 staff found the scheme helpful. A third of those who responded had contributed and all but two individuals felt able to contribute if the situation arose again. CONCLUSION: This simple system of self completed pink slips has allowed examples of less than optimum practice and helpful suggestions to be shared across a large service that has a predominantly part time work force providing services from over 15 venues. The system is seen as non-threatening and was acceptable to over 95% of the staff who responded to the survey. Fifty percent of doctors and nurses had made a submission. Changes in practice have resulted since its introduction.

Ambulatory Care Facilities↗
PubMed1999

Epidermal diseases in bottlenose dolphins: impacts of natural and anthropogenic factors.

Experimental studies have highlighted the potential influence of contaminants on marine mammal immune function and anthropogenic contaminants are commonly believed to influence the development of diseases observed in the wild. However, estimates of the impact of contaminants on wild populations are constrained by uncertainty over natural variation in disease patterns under different environmental conditions. We used photographic techniques to compare levels of epidermal disease in ten coastal populations of bottlenose dolphins (Tursiops truncatus) exposed to a wide range of natural and anthropogenic conditions. Epidermal lesions were common in all populations (affecting > 60% of individuals), but both the prevalence and severity of 15 lesion categories varied between populations. No relationships were found between epidermal disease and contaminant levels across the four populations for which toxicological data were available. In contrast, there were highly significant linear relationships with oceanographic variables. In particular, populations from areas of low water temperature and low salinity exhibited higher lesion prevalence and severity. Such conditions may impact on epidermal integrity or produce more general physiological stress, potentially making animals more vulnerable to natural infections or anthropogenic factors. These results show that variations in natural environmental factors must be accounted for when investigating the importance of anthropogenic impacts on disease in wild marine mammals.

Animals↗
PubMed1997

Efficacy and kinetics of opioid action on acutely dissociated neurons.

Opioids have been shown to cause a potent inhibition of neurons in the locus ceruleus (LC) in vivo in brain slices and isolated neurons; however, the kinetics of opioid action have not been described. In this study, we used acutely isolated LC neurons to examine opioid and alpha2-adrenoceptor action on potassium and calcium currents. [Met]Enkephalin (ME), [D-Ser2,Leu5,Thr6]-enkephalin, etorphine, and [D-Ala2,N-Me-Phe4,Gly-ol5]enkephalin increased potassium conductance, whereas morphine and naloxone were antagonists. The time constant of potassium channel activation was approximately 0.7 sec and was the same for each agonist. The amplitude of the current and the time constant of decay were dependent on the agonist, suggesting that agonist efficacy and affinity, respectively, determined these parameters. The amplitude of potassium current induced by the alpha2-adrenoceptor agonist UK14304 was not significantly different from that induced by ME, but the time constant of current activation was half that of ME, and the decline was more rapid. When potassium conductances were blocked with the combination of internal cesium and external barium, opioid and alpha2 agonists had no effect at potentials more negative than -50 mV and decreased barium currents at potentials between -40 and +20 mV. Both morphine and clonidine caused a small inhibition of barium current. In dorsal root ganglion cells, morphine alone had small and inconsistent effects on the calcium current, but it always competitively antagonized the inhibition caused by [D-Ala2,N-Me-Phe4,Gly-ol5]enkephalin. The results in isolated LC neurons suggest 1) the amplitude and time course of the opioid-induced potassium current depend on agonist efficacy and affinity and 2) the coupling of both mu-opioid and alpha2-adrenoceptors to calcium channels seems to be more efficient than that to potassium channels.

Animals↗
PubMed1997

Assessment of postruminal amino acid digestibility of roasted and extruded whole soybeans with the precision-fed rooster assay.

The objectives of these studies were to predict the effects of roasting and extrusion temperatures of whole soybeans (SB) on intestinal protein digestibility in cattle. Intestinal digestibility was assessed with a two-stage in vitro or in situ ruminal incubation/precision-fed cecectomized rooster bioassay. In Exp. 1, whole SB (raw SB or SB roasted to 141, 149, or 157 degrees C exit temperature from a commercial roaster and steeped for 30 min) were incubated in strained ruminal fluid and McDougall's buffer (50:50) at 39 degrees C for 16 h. In Exp. 2, SB (ground raw SB or SB extruded at 116, 138, or 160 degrees C) were placed in polyester bags (20 x 30 cm) and suspended in the ventral rumen of steers for 16 h. Lyophilized residue of the in vitro or in situ incubations and samples of raw SB and most extensively heated SB (roasted SB at 157 degrees C or extruded SB at 160 degrees C) for each respective experiment were crop-intubated to cecectomized roosters. Total excreta were collected for 48 h after intubation and lyophilized, and amino acid (AA) concentrations were determined. In Exp. 1, total AA digestibility was 61.6 and 84.5% for unincubated whole raw SB and 157 degrees C roasted SB, respectively, and 66.2, 88.9, 91.3, and 91.6% for in vitro residues of whole raw SB and SB roasted at 141, 149, and 157 degrees C, respectively. Trypsin inhibitor (TI) activity was 20.09, 1.69, 1.54, and 1.84 mg/g fat-free DM for unincubated whole raw SB and 141, 149, and 157 degrees C roasted SB, respectively, and 30.84, 1.01, .90, and .26 mg/g fat-free DM for in vitro residues of whole raw SB, 141, 149, and 157 degrees C roasted SB, respectively. In Exp. 2, total AA digestibility was 68.5 and 87.7% for unincubated ground raw SB and 160 degrees C extruded SB, respectively, and 81.9, 91.3, 89.7, and 89.4% for in situ residues of ground raw SB and 116, 138, and 160 degrees C extruded SB, respectively. Trypsin inhibitor activity was 17.61, 4.89, 4.08, and 1.56 mg/g fat-free DM for unincubated ground raw SB, 116, 138, and 160 degrees C extruded SB, respectively, and 3.62, .59, .55, and .21 mg/g fat-free DM for incubated ground raw SB, 116, 138, and 160 degrees C extruded SB, respectively. Heat treatment by roasting and extrusion improved AA digestibilities of SB, but there were no differences detected among the roasting or extrusion temperatures. Ruminal fermentation did not eliminate the negative effects of TI activity on intestinal digestibility of AA in whole SB but did reduce TI activity in ground SB.

Amino Acids↗
PubMed1994

Colour Doppler sonography of the normal paediatric testis.

Colour Doppler imaging (CDI) potentially provides the facility to differentiate torsion of the testis from inflammatory pathology. Normal control data are required for the purposes of interpretation of abnormal findings. Fifty boys with normal testes were examined by CDI using the Acuson 128XP System. Testicular blood flow was demonstrated in both testes in 58% of boys whilst 34% had no detectable flow. Eight per cent had demonstrable flow demonstrated on one side only. These results indicate that caution should be exercised in diagnosing testicular torsion on colour flow findings alone.

Adolescent↗
PubMed1994

Colour Doppler sonography of femoral vein stenosis: a report of three cases.

Colour Doppler sonography (CDS) is becoming an increasingly popular method of examining the deep venous system of the lower limb, particularly in the investigation of possible deep venous thrombosis (DVT). We describe a further application of CDS observed in three intravenous (i.v.) drug abusers who presented with symptoms mimicking a DVT. All three cases had femoral vein stenosis occurring at their injection site. This was demonstrated by CDS and at the same time DVT excluded.

Adult↗
PubMed1994

Ultrasound evaluation of the paediatric prostate.

OBJECTIVE: To document the shape, echogenicity and volume range of the normal paediatric prostate on transabdominal ultrasound, and to determine the feasibility of imaging the seminal vesicles and prostatic urethra with transabdominal ultrasound. PATIENTS AND METHODS: Transabdominal ultrasound of the prostate was performed in 36 boys, aged 7 months-13.5 years (mean 7.7 years), with normal prostates. RESULTS: Generally the prostate was hypoechoic, ellipsoidal in shape with a volume range of 0.4-5.2 ml (mean 1.2). The seminal vesicles were demonstrated in 56% of boys but only occasionally could the urethra be visualized. No colour flow was demonstrated within the prostate. CONCLUSION: The paediatric prostate can be easily visualized by transabdominal ultrasound. This technique may be of value in the investigation of incontinence, posterior urethral valves and seminal vesicle pathology, and in the monitoring of prostatic volume in hypogonadal boys.

Adolescent↗
PubMed1993

Colour Doppler imaging of the acute paediatric scrotum.

The differentiation of the causes of acute scrotal pathology by clinical means alone is prone to inaccuracy, resulting in inappropriate surgical exploration. Colour Doppler imaging (CDI) provides the facility to assess blood flow. Torsion of the testis impedes blood flow, whereas it is enhanced or normal in inflammatory pathology. We have investigated 40 cases of acute scrotal disease by means of CDI in which the radiologist performing the test was unaware of the preliminary clinical diagnosis. The clinical diagnostic accuracy was 60%, whereas the diagnostic accuracy of CDI was 82%. CDI provides an effective means of enhancing diagnostic accuracy.

Acute Disease↗
PubMed1991

Computed tomographic findings in two patients with vascular hamartomas.

The clinical, computed tomographic (CT) and histological findings of two patients with vascular hamartomas are presented. The appearances on CT of the two lesions were markedly different. Although both lesions were histopathologically benign, one showed a more disorganized architecture on histology and clinically behaved in a more aggressive manner. The CT findings in this case reflected the histological picture and could have been interpreted as a malignant process if viewed in isolation. Review of the literature and the cases presented suggest that the CT appearances of vascular hamartomas can be diverse, and to avoid a misdiagnosis the radiological features should be considered in conjunction with the clinical and histopathological findings.

Adolescent↗
PubMed1990

Double-blind comparison of topical lignocaine-prilocaine cream (EMLA) and lignocaine infiltration for arterial cannulation in adults.

In a double-blind, double-dummy study, the efficacy of topical 5% EMLA cream was compared with that of lignocaine infiltration in alleviating the pain of arterial cannulation. Forty unpremedicated adults were allocated randomly to four groups to receive EMLA cream alone, EMLA and 0.9% saline infiltration, EMLA and 1% lignocaine infiltration or placebo cream and 1% lignocaine infiltration. Following arterial cannulation, pain was assessed by the patient using a visual analogue score and by an independent observer using a four-category verbal rating score. Significantly lower pain scores were observed in all patients receiving EMLA compared with those receiving placebo cream and lignocaine infiltration by both patient (P less than 0.01) and observer (P less than 0.001) assessments. There were no significant differences between the three EMLA groups.

Administration, Topical↗
PubMed1977

The R.D.A.

Explore the source record for details and available documents.

California↗