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Biomedical subjects

R Inglis

Publications and source records attributed to R Inglis.

At least 19 recordsLinked to original sources
PubMed1992

[Roentgen studies of the skull in head injuries--a multicenter study].

The multi-center study presented reveals that 76% of the conventionally performed X-ray investigations of the skull can be avoided without any relevance concerning the non-diagnosis of severe injuries. Only in 3.2% of all patients investigated a skull X-ray had instantaneous therapeutically consequences. Thus routinely performed skull X-rays are no longer acceptable in the light of cost reduction and radiation load. The clinical-neurological investigations however are inevitable to perform the state of the art treatment of patients with head injuries today, leading to computerized tomography if necessary. A check-list of clinical findings is presented to get the indications for conventional X-rays of the skull and to manage an effective use of such investigations in appropriate clinical situations.

Adolescent↗
PubMed1992

[The use of computer-readable copy in the assessment of joint movement according to the neutral-zero method in expert disability evaluation and research studies].

Standardization and categorization are indispensable principles to be applied to patients' data already when data are investigated. Only through this every kind of data processing with computers gains any sense and helps to remove errors from data-transfer and removes mistakes from statistics. Transferring the contents of the investigation-sheets for joint-measures of the German insurance on environmental health to machine-readable encounter-sheets data collecting errors and data transfer errors could be minimized excellently. For the first time the standardization developed could be applied to joint measures of the spine in patients after spine injuries and compared with clinical- and X-ray-findings.

Computers↗
PubMed1992

[Multiple trauma management: reliable documentation of the 1st phase supplying a standardized, machine-readable encounter sheet for the emergency rescue team].

Adjust preclinical treatment is an inevitable compound of polytrauma-management. Instantaneously applied expert therapy of the traumatic shock and acutely performed diagnosis of the pattern and dignity of injuries often are crucial for the patients' outcome. Precise documentation of the first phase of treatment thus gains importance for clinical investigations to come and for questions put scientifically. Applying data processing with data input through an optical mark reader a standardized encounter sheet, that proved to be usable as a checklist, has been developed in our hospital for the emergency-rescue-team. Being simple to use and handy to fill out it serves as a clinical record as well as a means for direct data input to a personal computer. The encounter sheet is presented in this paper together with first results of the application in daily routine.

Adolescent↗
PubMed1992

Continuous regional treatment with fluoropyrimidines for metastases from colorectal carcinomas: influence of modulation with leucovorin.

Hepatic regional treatment represents an attempt to improve tumor response by increasing drug concentration with low systemic toxicities. Recently in vitro and clinical studies have shown that the cytotoxicity of 5-fluorodeoxyuridine (FUDR) and 5-fluorouracil (5FU) can be potentiated by high doses of leucovorin (LCV). Two pilot studies with intraarterial FUDR, 5FU, and LCV were initiated. Since 1982, 221 patients with colorectal liver metastases were treated by various forms of long-term monthly continuous regional treatment using implantable ports or pumps. FUDR (0.05 to 1.7 mg/kg/d) was administered alone or combined with 5-FU and leucovorin. In 61 patients curative liver resection was possible and was followed by adjuvant arterial treatment. Overall median survival time (MST) was 15 months and increased to 36 months after liver resection. This was influenced by the following important factors: treatment, number of metastases, extent of infiltration, tumor volume, and minimal intraoperatively diagnosed extrahepatic disease. The response rate varied from 69% to 23%. Time of development of extrahepatic progression was not delayed by additional systemic treatment. Local side effects significantly depended on the duration of arterial infusion. The rate of biliary sclerosis ranged from 19% to 0%. Occurrence of chemical hepatitis was between 7% and 38%. In contrast, after combined intraarterial treatment with LCV, systemic side effects, mainly stomatitis and diarrhea, were dose limiting. Despite the improvement of survival after regional treatment, further randomized trials are mandatory to compare regional with relevant systemic treatment.

Colorectal Neoplasms↗
PubMed1991

[Electronic data processing in the hospital: current status, options, "branch packets", customer-specific software and users' needs].

Data management in hospitals used to be the data management of the hospital-management in the last 15 years, not however the data management the doctors performed. The acceptance for electronic means slowly rising more software is used in the clinics today but still by the doctors privately. Software specialists have registered the growing market available for their products. That is why the danger to accept even unusuable software rises every day, as unexperienced software-beginners as doctors mostly are often relied on offers without being told about their dignity and usefulness.

Electronic Data Processing↗
PubMed1991

["Scoring"--benefits and pitfalls].

Problems of calculations and predictions on more than two particles moving are known in mathematics and physics since a long time already. However in medicine as there is lack of knowledge about the complexity of the pathophysiological behaviour of "systems" doctors tend to invent scores, scales and indices to make parameters more intelligible to them without concern on underlying interdependencies and redundancies. There is nothing to say against this kind of proceeding as long as the resulting data are not processed statistically. However, since the personal computer was invented there was and especially today is no need to summarize data any longer to gain the degree of understanding, in the contrary, the only data that really count are those that are processed correctly according to statistics, and thus doctors do not have to keep an eye any longer on incomplete intermediate results.

Computer Graphics↗
PubMed1990

[Occupational accidents with possible HIV contamination].

From January 1st, 1984 until December 31st, 1988 586 employees of the University Clinic of Frankfurt, West-Germany, were treated after occupational accidents with potentially HIV-contaminated materials. The majority of the patients were admitted because of lacerations that occurred with used injection needles. Up to now the sero-conversion of a patient after this special kind of trauma has not been documented in West-Germany. In our clinic we found an infection in one employee, which is due to an occupationally acquired injury.

Accidents, Occupational↗
PubMed1990

[Digital computer arthrometry of the upper ankle joint using a personal computer. A new procedure].

The digital computerarthrometry (DCAM) was developed as a very cost-effective device to calculate the pathologic angles of injured joints. The joint's data are captured by a frame grabber-board installed in a personal computer after takeover from the X-rays by a video camera. Measurements are performed using a commercially available software package which displays the X-ray-photograph on a separate screen besides the one used to manipulate the computer. With this system the calculations of angles and distances of the injured joints are performed with considerably higher precision as it could be done before. As a further possibility bone density measurements may be done from the X-rays as it had been tried to before computers could be used. Our first results seem to present our system as an alternative to the costly workstations, that had to be used until now.

Ankle Joint↗
PubMed1990

[Categorization of clinical findings; reduction of data without loss of information].

Depending on the individual skill of doctors the results of clinical investigations and laboratory findings are weighted differently according to their reliability today. Dealing with medical data the statistical way they have to be handled differently as well depending on the degree of reproducability and thus reliability. The problem of safety and quality of data in medicine is known to every experienced doctor as long as he himself "processes" them, nevertheless data tend to be treated uncritically when "automatically" processed by a computer. A way out of this pitfall is given by standardization of data using check-lists without transfer to any kind of coding-system or thesauri because none of those systems exists today that is capable of regaining the input-informations as they were from the codes.

Databases, Factual↗
PubMed1990

[The application of an electronic data processing system in surgical intensive care].

To assure quality and progression of surgical intensive-care therapy appropriate equipment is mandatory to ensure documentation and quality-control. In our hospital data processing of any information concerning the patients treated in the intensive-care unit has become part of the daily routine. This paper presents and discusses the underlying concept.

Critical Care↗
PubMed1989

Prevention of extrahepatic disease during intraarterial floxuridine of colorectal liver metastases by simultaneous systemic 5-fluorouracil treatment? A prospective multicenter study.

Fifty-two (52) patients with nonresectable hepatic-only metastases from colorectal carcinoma (tumor volume less than 75%) were treated by intraarterial FUdR, 0.2 mg/kg/d x 14 days/month (IA) using implantable pumps (Infusaid). They were randomized either for IA or for IA + systemic 5-FU 700 mg/m2/d x 3 days/month (IA/IV). Forty-six (46) patients were evaluable (26 IA; 20 IA/IV). Both groups were comparable in respect to primary tumor stage, age, liver function tests, tumor markers and extent of tumor infiltration. Twenty-six (26) patients (56%) demonstrated a complete (CR) or partial response (PR) with at least a 50% decrease in CEA levels and a significant tumor volume reduction (IA 50%; IA/IV 65%). Quality of response was significantly correlated with median survival (MS) time of 25 months for CR and PR. Approximate MS for IA and IA/IV was 16 and 19.5 months, respectively, and approximate median survival time to extra- and/or intrahepatic progression was 9 months (IA) and 11 months (IA/IV). Incidence of extrahepatic recurrence was not influenced by any treatment (IA 62%; IA/IV 60%). Overall approximate median time to occurrence of extrahepatic disease was 12.5 months (IA 13; IA/IV 10). Liver disease progression was observed in 38 patients (IA 85%; IA/IV 80%). A median time of 8 months to diagnosis of liver disease progression was calculated for IA, and IA/IV was 11.5 months. Incidence of chemical hepatitis for IA and IA/IV was 54 and 45%, while biliary sclerosis occurred in 15% and 10% of the cases, respectively, and did not correlate with response rates. Systemic side effects (25%) were only observed in the IA/IV group and induced significantly more interruptions of therapy than in the IA group. It is concluded from this study that additional systemic 5-FU treatment does not prevent the occurrence of extrahepatic disease under local chemotherapy of the liver.

Adenocarcinoma↗