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Biomedical subjects

B T Williams

Publications and source records attributed to B T Williams.

At least 91 records · Page 5Linked to original sources
PubMed1985

Prevalence of hypoxaemic chronic obstructive lung disease with reference to long-term oxygen therapy.

Of the Sheffield population aged 45 years or more, an estimated 0.3% (confidence interval 0.06%-0.5%) had intra-arterial oxygen pressures less than or equal to 7.3 kPa and forced expiratory volumes less than 50% of predicted values (ie, had hypoxaemic chronic obstructive lung disease). According to both the USA Medicare criteria for reimbursement and the UK Department of Health and Social Security draft guidelines for prescribing long-term oxygen, 603 (confidence interval 134-1072) subjects in Sheffield would be eligible to have oxygen supplied by concentrator, and 60 000 (confidence interval 13 000-107 000) in England and Wales. This is considerably higher than the number now prescribed long-term oxygen by general practitioners. In less than a quarter of the cases was there hypercapnia (PaCO2 greater than or equal to 6.1 kPa). The majority of those most severely affected were current smokers, and one-quarter were receiving no medication. General practitioners are unlikely to be able to assess accurately a patient's need for long-term oxygen treatment without specialised advice and measurement.

Aged↗
PubMed1985

Differences in durations of stay for surgery in the NHS and private sector in England and Wales.

Median durations of stay in England and Wales for eight "marker" operations were consistently shorter for patients in pay beds in the National Health Service than for patients in independent acute hospitals or public sector beds. This pattern was seen for both preoperative and postoperative stay and among specific age groups. Differential use of other hospitals for part of the period of care was not a factor, except for patients having hip replacement operations treated in NHS pay beds, one in seven of whom appeared to transfer to public sector care postoperatively. These findings suggest that there is scope for a possible further reduction in durations of stay in public sector beds and, within the private sector, for an assessment of whether spells in independent hospitals need be longer than in NHS pay beds.

Adolescent↗
PubMed1984

Contribution of the private sector to elective surgery in England and Wales.

From a sample of 12 959 records of patients treated in 148 of the 153 independent acute hospitals in England and Wales in 1981, it was estimated that 344 008 patients were admitted during that year. Residents of England and Wales admitted for inpatient elective surgery other than termination of pregnancy represented 162 000 of these cases. From 1980 Hospital Inpatient Enquiry data it was estimated that a further 57 000 similar elective treatments were undertaken in National Health Service pay-beds. The 219 000 patients treated in the combined private sector represented 13.2% of the total case-load in domestic inpatient elective surgery. For certain operations this proportion rose to 26%, and for some regions the private sector cases represented more than 20% of the total work-load; therefore when assessing the need for, and provision of, acute health care in England and Wales, the contribution of the private sector cannot be ignored.

Adolescent↗
PubMed1984

Inotropic and vasodilator effects of amrinone on isolated human tissue.

The effects of amrinone on human umbilical artery and human myocardium were studied. Amrinone produced dose related increases in tension, dT/dtmax and dT/dtmin in myocardium from patients who were NYHA grade I (n = 1) and II (n = 4). The responses to amrinone of these tissues were similar to the response seen in normal guinea-pig myocardium (n = 34). The drug had no inotropic effect on tissue from NYHA grade III patients (n = 5). The inotropic response of the tissues to amrinone was inversely related to length of history and severity of heart failure in the patients from whom the tissues were obtained. Amrinone caused dose related relaxation of the human umbilical artery. The vasodilator properties, but not the positive inotropic effects of amrinone were detectable at concentrations of the drug obtained during oral therapy (0.4 to 4.0 micrograms X ml-1). These findings support the view that in patients with congestive cardiac failure amrinone acts by vasodilatation with no clinically important positive inotropic effect.

Aminopyridines↗
PubMed1984

An "unavoidable" death in a people's marathon.

With the increase in jogging and distance running as a means of attaining and maintaining fitness, and in the light of the difficulty in advising certain groups of patients about their capacity for such exercise, we report on several potentially avoidable factors in the death of a 45 year old Sheffield Marathon runner in June 1983.

Adrenal Insufficiency↗
PubMed1984

Medical arrangements in 108 open-entry Britain marathons, 1983.

In 108 open-entry full marathons held in Great Britain in 1983 (35 incorporating shorter races) the number of static first-aid posts varied from 0 to 28 (median 9). In 54 (50%) the first of these was within 3 miles of the start but in 11 (10%) there were none in the first 10 miles. Mobile first-aid arrangements did not compensate for the absence of static posts. The numbers of qualified first-aid staff ranged from 1-250 in events with fewer than 1,000 entrants (67%), and 18-930 in larger events. Intravenous infusion facilitates were available in 59 (55); defibrillators in 34 (31%). Drink stations were provided in all events but in at least 40 they were spaced more than 2 1/2 miles apart on average. Oral and intravenous fluid replacement facilities were available to no greater extent in summer events than at other times of the year; 25 of the 57 summer events started at or after 11.00 hrs. Races with fewer than 10 first-aid posts had mean contact rates of 75 per 1,000 entrants (S.E. 15.4); those with 10 or more, 107 per 1,000 (S.E. 14.4). Only 160 runners were taken to hospital from all events combined (2 deaths). The mean hospital contact rate was 1.6 per 1,000 entrants, and was not related to the size of entry, density of first-aid posts nor sophistication of the first-aid offered. The inadequacy of arrangements in some marathons for preventing dehydration and treating collapsed runners on the course suggests that marathon organizers should be required to apply consistent, high standards to their arrangements for preventing and treating medical problems.

First Aid↗
PubMed1983

Isolated unruptured aneurysm of the left coronary sinus of Valsalva.

An isolated unruptured aneurysm of the left coronary sinus of Valsalva was detected incidentally in a patient with a bicuspid aortic valve in whom the left circumflex coronary artery arose from the right coronary artery. With the patient on cardiopulmonary bypass, the mouth of the aneurysm was closed by suturing the reflected posterior cusp of the aortic valve to the aortic root. A Starr-Edwards prosthetic aortic valve was inserted, and an aortocoronary saphenous vein bypass graft maintained good blood flow down the left anterior descending coronary artery. Previous reports of this rare condition and its treatment are discussed.

Aortic Aneurysm↗
PubMed1983

MPD syndrome.

Explore the source record for details and available documents.

Humans↗
PubMed1983

Why does domiciliary oxygen consumption vary from area to area?

Home oxygen therapy is used mainly for chronic respiratory disease. Differences in the gross quantities of oxygen supplied for home use in eight areas in 1982 reflected differences in the user-proportions of their populations, but not the amounts consumed per user. Similar user-proportions were found among areas with markedly dissimilar levels of respiratory disease. In the majority of cases the decision to use oxygen therapy was taken by the general practitioner.To ensure that the known benefits of oxygen therapy are more widely obtained, potential recipients need to be more accurately ascertained. More frequent resort to pulmonary function testing at the primary care level is indicated.

England↗