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Biomedical subjects

G B Williams

Publications and source records attributed to G B Williams.

52 records · Page 3Linked to original sources
PubMed1977

A haematuria diagnostic service.

In a haematuria diagnostic service, covering experience with 95 patients, 12 new cases of cancer of the bladder, one of cancer of the kidney, and one of cancer of the penis were identified--all at an early stage. Patients presenting with haematuria were investigated rapidly without disruption of the routine work of the urological unit. Patients who identified the symptoms and sought advice early were given a definite diagnosis quickly, and treatment for any malignant disease was started early. The delay that undoubtedly endangers patients' lives has been considerably reduced by this service.

Adolescent↗
PubMed1977

Survival in 200 patients treated by haemodialysis and renal transplantation.

The survival rates in 200 patients with terminal renal failure treated by maintenance haemodialysis and renal transplantation were analysed. The overall survival rate (+/- SE) was 81-4 +/- 3% at two years, 68-4 +/- 4% at five years, and 60-8 +/- 4-8% at eight years. Survival was inversely related to age: in those aged 15-34 years overall survival was 89-7 +/- 3-7% at two years, 87-8 +/- 4-1% at five years, and 83-9 +/- 5-5% at eight years. Eighty per cent of the surviving patients were able to work full time. The survival rate in patients returned to dialysis after graft rejection was 87-5% +/- 8-3 at three years.

Adolescent↗
PubMed1977

The treatment of advanced bladder cancer with methotrexate.

61 patients with advanced bladder cancer were treated with methotrexate. 3 different regimes were used, 2 given on an out-patient and 1 on an in-patient basis. A response rate of 56% was found in patients who received 100 mg of methotrexate intravenously every 2 weeks as an out-patient. Provided that renal function is checked before therapy and is normal, then methotrexate can be used safely; it being well tolerated and having few serious side-effects.

Bone Neoplasms↗
PubMed1976

Gangrene of the hand: a complication of radial artery cannulation.

Radial artery cannulation for constant monitoring of arterial pressure and blood gases has become commonplace in the care of the seriously ill. The radial artery is readily accessible and is often regarded as carrying a negligible complication risk, because there is extensive collateral arterial flow in the hand. To the rarely reported cases of gangrene of the hand secondary to cannulation of the radial artery, this publication adds two, both survivors. One, a 46-year-old female with a clinical picture suggestive of mild Raynaud's disease, was treated by closed mitral commissurotomy; the second, a 44-year-old female, was treated for drug overdose complicated by cardiac arrest and renal shutdown.

Adult↗
PubMedDate not supplied

Doctoral preparation of nursing faculty.

Is the doctorate necessary for all nurse educators? Should nurse educators hold a doctorate or is a non-nursing doctorate acceptable? The authors report on a survey which looked at information concerning the number of doctorally prepared nursing faculty and the institutional requirement of a doctorate as the terminal degree in nursing.

Education, Nursing, Graduate↗
PubMedDate not supplied

Short-term grief after an elective abortion.

OBJECTIVE: To identify the short-term grief response after elective abortion. DESIGN: Descriptive, comparative study. SETTING: Instruments were administered in a women's health clinic. PARTICIPANTS: Ninety-three women, 45 who had a history of elective abortion within the past 1 to 14 months and 48 who had never had an abortion. Inclusion criteria included no perinatal losses within the past 5 years; no documented psychiatric history; and ability to read, write, and comprehend English. MAIN OUTCOME MEASURES: Nature and intensity of short-term grief. RESULTS: Women with a history of elective abortion experienced grief in terms of loss of control, death anxiety, and dependency. Although there were no statistically significant differences in the intensity of grief in women who had a history of elective abortion and the comparison group, there was an overall trend toward higher grief intensities in the abortion group. Presence of living children, perceived pressure to have the abortion, and the number of abortions appear to affect the intensity of the short-term grief response. CONCLUSION: Elective abortion has the potential for eliciting a short-term grief response. Research is needed to identify which women are at greatest risk. This grief response should be acknowledged and appropriate interventions undertaken.

Abortion, Legal↗
PubMedDate not supplied

Delayed pneumothorax: a complication of subclavian vein catheterization.

Subclavian catheterization is a reliable, well-described technique of central venous access for a variety of indications. Significant complications are associated with the procedure. Detection of the majority of complications is afforded by the postinsertion chest x-ray. Delayed pneumothorax, a relatively unrecognized complication of subclavian catheterization, is caused by a slow pleural air leak which appears to be associated with the "difficult" insertion as illustrated by three case reports. A repeat or "delayed" chest roentgenogram should be considered in the following situations: Difficult subclavian insertions requiring multiple attempts. Suspicion of pleural injury such as aspiration of air during insertion or subcutaneous emphysema with a normal postinsertion chest x-ray. The presence of another major complication. If the patient complains of persistent pleuritic or back pain after insertion. Preoperatively after previous difficult insertion of a central venous line. Postoperatively when a subclavian catheter is inserted intraoperatively.

Aged↗
PubMedDate not supplied

Total parenteral nutrition by a nutrition support team: improved quality of care.

Most of the studies that have examined the effect of nutrition support teams (NST) on the quality of total parenteral nutrition (TPN) have found reductions in the frequency of metabolic and central venous catheter related complications. Previous studies have not examined the patterns of nutrient delivery (eg, calories and protein) when TPN is provided either by a primary physician or by a NST. We compared the quality of TPN care provided by our NST or by primary physicians utilizing nonspecialized hospital personnel and resources. As expected, catheter complications were significantly less frequent in NST patients. Assessment of nutritional status and nutrient requirements as well as nitrogen balance were performed and documented significantly more often in NST patients. In addition, nutritional goals for calories and protein were achieved and positive nitrogen balance documented more often in NST patients. The need to consult the NST physician to utilize the NST was not well received by primary attending and resident physicians and resulted in nonuse of the team. In the future, modification of NST policies will be explored to encourage greater utilization of the NST without compromising the high standard of nutrition care delivered by the NST.

Catheterization↗
PubMedDate not supplied

Laparoscopic cholecystectomy in an academic hospital: evaluation of changes in perioperative outcomes.

OBJECTIVE: Evaluate changes in perioperative outcomes over an 82-month period in patients undergoing laparoscopic cholecystectomy by a single attending surgeon in an academic hospital. METHODS: A retrospective review of 1025 consecutive patients undergoing laparoscopic cholecystectomy from September 1992 to February 1997 was compared to the initial 600 patients from May 1990 to August 1992. Statistical analysis included Chi square with Yates correction and Fischer's exact test. RESULTS: Over the 82-month period there were no significant differences in the overall conversion rate to open cholecystectomy (p=0.26), intraoperative complications (p = 0.81), postoperative complications (p = 0.054) or mortality rates (p=0.66). There were 3 (0.5%) bile duct injuries in the initial 600 patients and only 1 (0.1%) in the group of 1025 patients (p=0.065). There was an increase (p<0.001) in laparoscopic cholecystectomies performed for acute cholecystitis and biliary dyskinesia and an increase (p<0.001) in the percentage of cases performed overall and for acute cholecystitis by the surgery residents over the last 54 months. Despite this, the conversion rates to open cholecystectomy in patients with acute cholecystitis decreased (p < 0.001) over the last 54 months. Additionally, more patients (p < 0.001) were discharged on the day of surgery in the most recent group. CONCLUSION: Laparoscopic cholecystectomy can be performed safely by surgery residents under the direct supervision of an experienced laparoscopist without significant changes in perioperative outcomes. Despite an increased percentage of cases being performed for acute cholecystitis over the last 54 months, conversion rates to open cholecystectomy and biliary tract injury rates have decreased, and the perioperative morbidity has remained the same.

Academic Medical Centers↗