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Biomedical subjects

B Williams

Publications and source records attributed to B Williams.

At least 433 records · Page 24Linked to original sources
PubMed1984

Prophylaxis of infection in patients with aplastic anemia receiving allogeneic marrow transplants.

One hundred one patients with severe aplastic anemia underwent allogeneic marrow transplantation and received one of three forms of infection prophylaxis: oral nonabsorbable antibiotics and isolation and decontamination in a laminar airflow room (36 patients); prophylactic granulocyte transfusions from a single family member donor (33 patients); or conventional treatment in single rooms with hand-washing and mask precautions (31 patients). During the period of granulocytopenia, patients in the laminar airflow rooms acquired fewer infections than either of the other groups, but this difference was statistically significant only when compared with the group receiving conventional treatment. Patients in the laminar airflow rooms had significantly fewer infections after engraftment as compared with the other two groups. Incidence of interstitial pneumonia and graft rejection was not different among the three groups. Acute graft-versus-host disease occurred later (Day 47) in the group in the laminar airflow rooms as compared with the group receiving prophylactic granulocyte transfusions (Day 23) or the group receiving conventional treatment (Day 20). The incidence of grades II to IV acute graft-versus-host disease was less in the patients in the laminar airflow rooms but only reached borderline significance (p = 0.08) when compared with the conventionally treated patients. The survival at Day 100 was 92 percent for the group in the laminar airflow rooms, 79 percent for the group receiving prophylactic granulocyte transfusions, and 64 percent for the group receiving conventional treatment.

Adolescent↗
PubMed1984

Corticotropin-induced desensitization: steroidogenic and cyclic AMP responses in superfused adrenocortical cells.

The characteristics of the sensitization and desensitization of superfused, rat dissociated adrenal fasciculata cells were examined. The dynamic output of steroids and cyclic AMP was determined following pulsed treatment with various agonists. Repeated doses of identical small amounts of ACTH or ACTH gave gradually increasing responses which were maximal after 3-4 injections, but then desensitized the adrenal cells. An initial dose of 2.5 X 10(-11) moles of ACTH, itself insufficient to stimulate steroidogenesis in this system, had the effect of priming the cells, which showed an enhanced initial response and achieved maximum responsiveness on the second injection of 4 X 10(-13) moles ACTH. Thereafter, although the cells exhibited a diminishing steroid output, a dose at the end of the experiment of 8 X 10(-12) moles ACTH restored the maximum responsiveness, and demonstrated that cell loss or death could not account for the desensitization effect. Only a sensitization of the cells was observed following repeated doses of 5 X 10(-6) moles cyclic AMP. Since no desensitization effect was discernible for this agonist, it was concluded that in this system the lesion giving rise to the desensitization effect occurred prior to the adenylate cyclase catalytic unit for the generation of cyclic AMP within the cell and the receptor-nucleotide-regulatory protein complex is thus implicated in the desensitization mechanism for adrenal steroidogenesis. The studies demonstrate the exquisite sensitivity of adrenal cells to the desensitizing effects of even brief intermittent pulses of ACTH.

Adrenal Cortex↗
PubMed1984

A suprasellar subarachnoid pouch; aetiological considerations.

A child with hydrocephalus treated by a valved shunt was reinvestigated after developing a shunt infection. A pouch was discovered invaginating the floor of the third ventricle and filling slowly with CSF from the region of the interpeduncular cistern. Histology and mechanisms of this pouch formation are discussed.

Arachnoid↗
PubMed1984

Central conduction time following surgery for cerebral aneurysm.

Somatosensory evoked potentials have been recorded serially in 21 patients following aneurysm surgery. Central conduction time correlated reasonably well within the patient's clinical state at the time of testing, but it did not act as a useful predictor of clinical deterioration.

Adolescent↗
PubMed1984

Kidney length correlated with age: normal values in children.

Normal kidney length was measured on the excretory urogram in 262 children 0 to 14.5 years of age (422 kidneys). While mean values were similar to those in the literature, the standard deviation (0.785 cm) was much lower than that reported previously.

Adolescent↗
PubMed1983

Iohexol in urography.

Thirty patients injected intravenously with a nonionic contrast medium, iohexol, for urography were compared with 30 patients similarly injected with sodium iothalamate. Comparable radiographic results were obtained in these patients with normal renal function. Few minor responses were observed with the iohexol, suggesting that it may prove to be an attractive contrast medium for this purpose.

Clinical Trials as Topic↗
PubMed1983

Campylobacter jejuni as a bacterial cause of diarrhoea in Ile-Ife, NIgeria.

A total of 495 diarrhoea and non-diarrhoea patients whose ages ranged between 5 and 39 years were examined for the presence of Campylobacter jejuni, Salmonella and Shigella species. About 12% of the specimens from diarrhoea patients were positive for Campylobacter jejuni compared with 6% and 10% for Salmonella and Shigella species. In contrast 2%, 0% and 1% of the samples from non-diarrhoea patients were positive for Campylobacter jejuni, Salmonella and Shigella species respectively. Most (62%) of the Campylobacter jejuni from diarrhoea patients were isolated from children under the age of 10 years. This compared with 26% and 37% for Salmonella and Shigella species in this age group. The frequency of isolation of Campylobacter jejuni in diarrhoea patients was highest during the dry months of the year. This study demonstrates the importance of Campylobacter jejuni as a major bacterial cause of diarrhoea in this part of the world.

Adolescent↗
PubMed1983

Surgical management of subdural empyema.

The methods and results of surgical management in 42 patients under 20 years of age with subdural empyema are described. Based on this experience and on a review of the literature, primary craniotomy with radical removal of pus has increasingly become the authors' preferred method of treatment, in addition to appropriate antibiotic treatment with survival figures of around 90% expected.

Adolescent↗
PubMed1983

A critical appraisal of "terminal ventriculostomy" for the treatment of syringomyelia.

The clinical course of 31 patients who underwent attempted excision of the filum terminale and tip of the conus for syringomyelia is summarized. Of these patients, 17 had had some previous surgical intervention. Eleven patients were continuing to deteriorate at the time of the operation. In three cases, marked postoperative improvement was reported, and objective improvement was thought to result from the conus excision. Eighteen more patients claimed improvement in their preoperative symptoms of loss of pain sensibility, deafness, or reduced motor function, although most of such claims were unverified by objective clinical assessment. Sixteen of the patients who improved have since proceeded to deteriorate. In five of the patients, there was a long-standing improvement of at least subjective phenomena. Thirteen patients were not improved even subjectively and some of these have continued to grow worse. Proof that the greater part of the syrinx was in communication with the conus or filum was difficult to obtain even when the conus was dilated. No correlations have been found to suggest that the operation might be more effective if the central canal was patent at the conus or the filum, nor was there a correlation between a good clinical result and either the age of the patient or the age of the syrinx as judged by the history. The operation did not seem to be more or less beneficial if previous surgery had been performed. The suggestion is made that for syringomyelia with hindbrain abnormalities, other than dense arachnoiditis (particularly if there is evidence of pressure dissociation at the foramen magnum), craniovertebral decompression remains the procedure of choice. In syringomyelia with marked hydrocephalus, drainage by a valved shunt may be the preferred first procedure. If myelotomy is planned it should probably be done where the syrinx is wide, and it is more likely to succeed if the syrinx is drained to a low-pressure area outside the theca, such as the peritoneum or pleura, rather than the subarachnoid space.

Adolescent↗
PubMed1983

Late seizures and morbidity after subdural empyema.

A survey of 89 patients with subdural empyema was conducted to assess the incidence of late seizures and morbidity in this disease. Twenty-four patients died during the acute stage of the illness and, of the 65 survivors, 13 were lost or had incomplete follow-up review. Hemiparesis occurred in 48 of the survivors during the acute stage, and all but nine recovered completely. Thirteen patients had a visual field deficit and all recovered; in three of these 13 who had speech disorders the deficits persisted. Recovery from neurological morbidity was not related to the type of surgical treatment; however, the mortality rate was improved by craniotomy. The same incidence of early seizures occurred in those who died (62%) as in those who survived (63%). Of those who had no early seizures, 42% had late seizures, the majority appearing within 16 months. Of those who had early seizures, 71% did not have subsequent attacks. The highest incidence of seizures occurred in patients who had their empyema in the second and third decades of life. The incidence of late seizures was not influenced by the method of surgical treatment, the degree of deterioration of consciousness during the acute stage of the illness, nor by occurrence of early seizures. A significantly increased incidence of early seizures was associated with paranasal sepsis, but not with late seizures.

Acute Disease↗
PubMed1983

Increasing radiographer productivity by an incentive point system.

Because of a very low technologist productivity in their Radiology Department, the authors describe a Productive Point System they developed and implemented to solve this personnel problem. After establishing the average time required to perform all exams, point credits (one point for every ten minutes utilized) were assigned to each exam performed, thereby determining an index of production. A Productive Index of 80% was considered realistic and was the equivalent of 192 points for a 40-hour work week. From 1975 to 1978 personal productivity increased from 79% to 113%. This resulted in an average yearly fiscal savings of over $20,000.00 for this three-year period. There was also a significant improvement in exam efficiency and quality, job attitude, personnel morale, and public relations. This program was highly successful because technologist acceptance and cooperation was complete, and this occurred mainly because the system supports the normal occupational goals and expectations of technologists.

Efficiency↗
PubMed1983

In vitro antibacterial activity of water-soluble extract of aghalokpe.

Water-soluble extracts of the bark of aghalokpe, a big tropical tree which grows in the rainforest of Bendel State of Nigeria, showed in vitro antibacterial activity against several of the Enterobacteriaceae. The activity was more pronounced with gram-positive than the gram-negative species. The minimum inhibitory concentration (MIC) which is in the range of 3.125-50 micrograms/ml, compares well with some broad-spectrum antibiotics on the market. The extract was remarkably effective against Neisseria gonorrhoea.

Enterobacteriaceae↗