A continuing medical education course for physicians and mid-level practitioners.
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Biomedical subjects
Publications and source records attributed to T C Brown.
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The use of monoamineoxidase inhibitors in the treatment of depression is increasing again in Australia. This paper outlines changes in prescribing, the problems associated with monoamineoxidase (MAO) inhibitors and how they relate to the practice of anaesthesia.
The effect of hypothermia on the action of d-tubocurarine (d-TC) was studied under carefully controlled experimental conditions. It was found that with computer controlled infusion, 60% less d-TC was required to sustain 75% muscle paralysis in cats, during steady-state, in vivo, when the temperature was changed from 37 degrees C to 30 degrees C. The corresponding relaxant consumption rates were 0.136 +/- 0.025 and 0.055 +/- 0.012 mg/kg/1/2 hr respectively. When there was no temperature change the maintenance dosage of d-TC remained constant for up to four hours denoting the equilibrium phase of the relaxant kinetics. Temperature transitions introduced dynamic changes in these kinetics and altered the constancy of the maintenance dosage.
Experiments were conducted on puppies to compare the cardiovascular toxicity of imipramine, amitriptyline, and doxepin. The drugs were infused at weekly intervals to produce arrhythmias and/or hypotension. Imipramine was less arrhythmogenic and caused less fall in blood pressure for a given dose than amitriptyline or doxepin.
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Blood levels of lignocaine and bupivacaine were measured in children following caudal, subcutaneous and tracheal administration. The highest peak levels were in children under 3 years following tracheal spray but all blood levels were below accepted toxic adult levels for anaesthetised patients. No toxic manifestations were seen.
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Pheniramine is efficiently adsorbed by Norit Medicinal Activated Charcoal in vitro. Administration of activated charcoal after pheniramine ingestion in dogs resulted in significantly lower blood levels. Norit or another proven effective activated charcoal would be of value in first-aid treatment of pheniramine poisoning.
The development and use of supplementary learning modules for audiovisual aids designed for wider audiences was found to be a feasible approach for the education of family practice residents. This approach allows programs to direct learner attention to areas of greatest interest in family practice. It was not excessively time consuming to develop the two modules and extensive technical expertise with media was not required. It was found that the modules were adaptable to individual or group use. This teaching method appears to be an excellent learning tool for residents. Supplementary learning modules may be useful for medical students and other health-care providers in family practice. Further economy of time and other innovations using this basic approach could result from recruiting family practice residents and other students to develop their own learning modules on topics of individual interest.
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Experiments were conducted to compare the efficacy of six commonly available charcoals in adsorbing halothane in a paediatric T-piece system. Tests were also done to compare the effect of mass of charcoal and canister shape and size on adsorption and airways resistance. It was found that charcoals vary in their adsorptive capacity and that the size and shape of cannisters is important.
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Recent years have seen increasing interest in the use of audiovisual teaching materials throughout medical education. There is good evidence that different individuals learn best in different ways according to their particular learning styles, personalities, and learning needs. Audiovisual materials can provide flexible approaches to meet varied learning needs and facilitate self-instruction. In the past, there has been no systematic method of identification and evaluation of audiovisual teaching materials relevant to family practice. This paper describes the experience of a review process which was initiated three years ago. A complete list is presented of audiovisual teaching materials which have been reviewed for family practice and future directions of the review process are discussed.
Pulmonary morphologic alterations secondary alterations secondary to intravenous drug abuse have been previously identified by histopathologic study of autopsy and biopsy material. Recent investigative efforts have been directed toward defining functional abnormalities that would allow for early clinical diagnosis. For this reason, 12 asymptomatic addicts were studied with roentgenography, spirometry, single breath diffusing capacity (DLco), 99Tc perfusion and 133 Xe ventilation scanning. Nine of the twelve were heavy cigarette smokers. None reported historical evidence of chronic bronchitis or right-sided endocarditis. The DLco was the only significant routine pulmonary function abnormality (p less than .001) observed in these patients. The DLco was significantly reduced even after correction for smoking habits (p less than .001). The decrease in DLco correlated with the number of perfusion defects detected by 99Tc scanning (r = -.560). There was no correlation between DLco and the number of defects on the 133Xe ventilation scan, age, pack-years smoked, or other routine pulmonary function tests. Further, there was no correlation between the number of perfusion and the number of ventilation defects. The data suggest that the decrease in DLco found in these addicts is the result of reduction of the pulmonary capillary bed secondary to vascular or interstitial granulomatosis.
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