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  • 1
    Electronic Resource
    Electronic Resource
    A confidential enquiry into methadone-related deaths (1999)
    Oxford, UK : Carfax Publishing, Taylor & Francis Ltd
    Addiction 94 (1999), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aim. To assess the acceptability and usefulness of the confidential enquiry process in examining methadone-related deaths. Design. An audit of patient care. Setting. Glasgow, Scotland, UK (population 915 000) Participants. All doctors who, in the final 14 days of the patient's life, had attended a patient who suffered a methadone-related death. Measurements. The medical care of each case was assessed by peer review and the results of these assessments returned to the responsible clinician(s). Findings. (1) The audit cycle was completed in 32 of the 34 reported cases (94%). (2) Twenty-eight of 33 doctors (85%) found the audit to be helpful. (3) As a result of the enquiry, the majority of doctors whose patient management had attracted criticism intended to amend their practice. (4) Shortcomings in clinical care were identified in 18 cases (56%) and problems in the organization of services in 22 (69%). Conclusions. (1) The model of audit piloted here was found to be highly acceptable to participants. (2) The episodes of substandard care that were uncovered provided useful opportunities to improve the future management of patients who were being prescribed methadone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.1999.941217894.x
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  • 2
    Electronic Resource
    Electronic Resource
    Gray whales and the structure of the Bering Sea benthos (1983)
    Springer
    Oecologia 59 (1983), S. 224-225 
    Details
    ISSN: 1432-1939
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Summary The purpose of this study was to look at the effect of foraging by gray whales on the benthic community. The gray whale, the only mysticete whale which feeds mainly upon benthic organisms, relies on the amphipod crustacean assemblages of the northern Bering Sea and the Chukchi Sea for most of its annual food intake. Foraging whales leave identifiable depressions 0.6 to 3 m long in the bottom sediments in their wake. Patterns in the infaunal community composition appeared to be correlated with the size of the pit and by inference, the age of the pit. Large, deep pits were characterized by species considered early colonists of disturbed areas. Smaller, shallow depressions did not have elevated numbers of early colonists. Abundance of Ampelisca macrocephala, the dominant bottom organism and whale prey item, was depressed in all pits sampled.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00378840
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Stability of morphine and buprenorphine in whole blood (1998)
    Springer
    International journal of legal medicine 111 (1998), S. 165-167 
    Details
    ISSN: 1437-1596
    Keywords: Key words Morphine ; Buprenorphine ; Stability ; Whole blood
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Notes: Abstract Delays between time of sampling and time of toxicological analysis are common, therefore the length of time that postmortem blood can be stored at various temperatures (e.g. 4°, 25°, –20° C) was evaluated for the effect on the stability of morphine and buprenorphine from day one up to one year. Solid phase extraction and GC-MS were used for the isolation and quantification of the drugs. Morphine and buprenorphine were found to be very stable for up to 6 months under these storage conditions, where at least 85% and 77% of morphine and buprenorphine respectively, were recovered. The study showed that a reasonable amount of the drugs (not less than 70%) was still detectable after one year of storage regardless of the temperature when blood samples were stored in silanized glass vessels.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004140050141
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  • 4
    Electronic Resource
    Electronic Resource
    Sedation in intensive care: morphine and renal function (1986)
    Springer
    Intensive care medicine 12 (1986), S. 359-365 
    Details
    ISSN: 1432-1238
    Keywords: Sedation ; Morphine ; Renal failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intravenous morphine infusions have been administered to 12 critically-ill patients during controlled ventilation. Acute oliguric renal failure was present in 4 patients, who were treated with a combination of haemofiltration and haemodialysis. Severity of physiological disturbance was assessed using a modified APACHE Score, level of sedation by a linear-analogue scale, and blood morphine levels by high-pressure liquid chromatography. Morphine clearance was impaired in renal failure, and was dependent on haemofiltration volumes; accumulation of morphine did not occur during this form of treatment. Conscious level was clearly more closely related to the degree of physiological disturbance than blood morphine levels; and for a given blood morphine level, depression of consciousness was more pronounced the greater the degree of physiological disturbance. Use of a physiological sickness score may help to clarify some of the factors influencing cerebral function during critical illness. Careful clinical monitoring of level of sedation is important in patients with oliguric renal failure receiving morphine, and haemofiltration appears to reduce the risk of morphine accumulation in these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00292926
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  • 5
    Electronic Resource
    Electronic Resource
    EDTA chelation and zinc antagonism with cadmium in sediment: effects on the behavior and mortality of two infaunal amphipods (1984)
    Springer
    Marine biology 84 (1984), S. 125-130 
    Details
    ISSN: 1432-1793
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract The two species of infaunal amphipod crustaceans Rhepoxynius abronius (Phoxocephalidae) and Eohaustorius sencillus (Haustoriidae) are characteristic of nearshore sandy bottoms along the California (USA) coast, and are highly sensitive to moderate levels of heavy metals. In laboratory experiments, both zinc and the chelator EDTA increased the survival of amphipods in sediment containing otherwise lethal levels of cadmium (8.5 μg g-1), which are representative of moderately polluted environments. In simple choice experiments, amphipods prefer sediment with complexed cadmium. The behavioral and survival patterns of both species were similar in the experiments. EDTA prevented about 50% of the added cadmium from initially being incorporated into the sediment, and increased the rate of cadmium released from the sediment. These data illustrate the limitations of operational definitions of chemical analyses, since weak-acid (0.5 N HCl) leaches that were intended to provide an estimate of the “biologically available” metal concentrations extracted both toxic and EDTA-complexed cadmium species and did not account for their antagonistic interctions with zinc.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00392996
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    Paper (German National Licenses)
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