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Biomedical subjects

G Williams

Publications and source records attributed to G Williams.

At least 973 records · Page 54Linked to original sources
PubMedDate not supplied

Intracranial internal carotid artery stenosis: longterm prognosis.

Sixty-six patients with greater than or equal to 50% stenosis of an intracranial internal carotid artery (IICA) were followed-up for an average of 3.9 years. Eighteen patients (27.3%) experienced ischemic events; 8 (12.1%) had isolated TIA and 10 (15.2%) a stroke. The observed stroke rate for patients 35 years and older are 13 times the expected infarction rate for a normal population. Patients with tandem extracranial stenosis had a greater risk of stroke than patients with isolated IICA stenosis. Thirty-three patients (50%) died during follow-up and 55% of all deaths were cardiac related. The observed 5 year survival rate was 60% compared to an expected rate of 87%. Patients with IICA stenosis had a higher risk of stroke and death compared to a previously reported referral population with ICA occlusion. IICA stenosis is a marker of extensive cerebrovascular and systemic atherosclerotic disease, especially coronary artery disease.

Adult↗
PubMedDate not supplied

Vertebral artery stenosis: long-term follow-up.

Ninety-six patients with greater than or equal to 50% unilateral vertebral artery (VA) stenosis were followed up for an average of 4.6 years. In 89 patients (93%) at least one VA origin was involved, while the intracranial VA was affected in 3 patients (3%). Seventy-four patients (77%) had greater than or equal to 50% stenosis of at least one internal carotid artery, of whom 52 underwent carotid endarterectomy. None of the patients had definite vertebrobasilar transient ischemic attacks (VB TIA). Nineteen patients (19.8%) experienced non-localizing symptoms possibly compatible with VB TIA, none of whom had a stroke. Twenty-three patients (24%) had strokes. The only two patients (2%) who sustained a brainstem infarction had fatal strokes and both were known to have basilar artery stenosis in addition to their VA stenosis. The observed stroke rate was 8.5 times the expected infarction rate for a normal population. Forty patients died during follow up. The observed 5-year survival rate was 60% compared to 87% in a matched normal population. Eight deaths (20% of all deaths) were caused by stroke and 21 deaths (52.5% of all deaths) were cardiac related. VA stenosis is most frequently located at the VA origin (93%), and is associated with a low incidence of brainstem infarction.

Arteriosclerosis↗
PubMedDate not supplied

Regret.

Explore the source record for details and available documents.

Consumer Behavior↗
PubMedDate not supplied

Predictors of job satisfaction in remote hospital nursing.

This research examined the relationship between the content of work, the work environment and job satisfaction among nurses working in a teaching hospital located in a remote area of Central Australia. Using the results of recent meta-analyses of job satisfaction, a conceptual framework was developed that predicted that work content (variety, autonomy, task identity and feedback) and work environment (ward facilities, collaboration with medical staff, cohesion amongst nurses, staffing, pooling and respected by others) would influence job satisfaction. A descriptive survey of 135 nurses employed in a 170 bed hospital was undertaken. Strongest predictors of job satisfaction were job variety, feedback and collaboration with medical staff. Other moderate correlates were cohesion amongst nurses and task identity. This study demonstrated that feedback from colleagues and supervisors should never be trivialised as a strategy to improve job satisfaction. Furthermore, the need to be considered as part of the health care team by the medical profession can be influenced by proactive workplace strategies and policies.

Adult↗
PubMedDate not supplied

Continuous intravenous insulin infusion in the management of brittle diabetes: etiologic and therapeutic implications.

Continuous intravenous insulin infusion (CIVII) was used to treat five brittle insulin-dependent diabetic women (aged 16-29 yr) who had failed to achieve satisfactory glycemic control during intensified subcutaneous insulin treatment including continuous subcutaneous insulin infusion (CSII). Insulin was infused through an indwelling central venous catheter by a portable pump for 3-16 mo. During CIVII, only three subjects obtained satisfactory glycemic control and only for short periods. Generally, as with CSII, control was erratic and unpredictable and three subjects intermittently had high insulin requirements (200 U/day). By contrast, three stable insulin-dependent diabetic subjects achieved near-normoglycemia within 1-3 days of starting CIVII with daily insulin dosages of 30-90 U. The lives of all five brittle subjects continued to be disrupted by frequent hospital admissions during CIVII treatment. Deliberate interference with their own treatment (including tampering with pumps and central venous catheters) was thought to be a major contribution to instability in two of the brittle subjects. In the others, the ineffectiveness of CIVII suggests that brittleness was not due solely to defective subcutaneous insulin absorption, as had previously been suggested in other CSII-unresponsive brittle subjects. Although CIVII has reportedly been successful in managing brittle diabetes, the technique may not be useful in all brittle individuals, as illustrated by the poor glycemic responses of these subjects and the serious complications (including local infection, septicemia, and thrombosis) they suffered.

Adolescent↗
PubMedDate not supplied

The Brisbane floods, January 1974: their impact on health.

In the 12 months following the Brisbane flood of 1974, 234 flooded families (695 persons) and 163 non-flooded families (507 persons) were interviewed to ascertain changes in health status. We found that the number of visits to general practitioners, hospitals and specialists were all significantly increased for flooded persons in the year following the flood. Persistent psychological symptoms, which included irritability, nervous tension and depressed mood, predominated in those seeking medical care, and the consumption of sleeping tablets and psychotropic drugs rose. Increased psychological symptoms were significantly more common in female than in male flood victims and significantly more common in both sexes than increased physical complaints. There was no increase in mortality after the flood. The incidence of psychiatric symptoms was directly related to dissatisfaction with help received.

Adult↗
PubMedDate not supplied

A history of surgery for congenital heart disease in Papua New Guinea.

Cardiothoracic surgery in Papua New Guinea (PNG) was somewhat ad hoc prior to 1956 but later settled into an arrangement in which visiting teams from overseas selected mostly adult patients for a limited range of closed heart operations to be done locally or overseas. In 1978 the late Professor John Biddulph was instrumental in facilitating a more formal arrangement with the Royal Prince Alfred Hospital whereby patients were selected by a visiting cardiologist on an annual basis to be transferred to Sydney for cardiac surgery. This subsequently developed into a predominantly paediatric program based at the Royal Alexandra Hospital for Children in Sydney, which successfully ran until 1992. In 1993 a program began, based at the Sydney Adventist Hospital, in which a voluntary cardiac team has been visiting annually to perform both open and closed heart surgery. This program has proved to be very successful with a high output and a low mortality. Despite this long history of surgery for congenital heart disease in PNG, no definite long-term plans have eventuated. Because the financial situation of the country does not allow for a major cardiothoracic unit, the current arrangement whereby noninvasive investigation and some closed surgery are performed at Port Moresby General Hospital is appropriate for the foreseeable future.

Australia↗
PubMedDate not supplied

Hepatitis B vaccination among Vietnamese-American children in a Boston community clinic.

PURPOSE: This manuscript describes one community health center s efforts to provide catch-up immunization for hepatitis B for Vietnamese Americans aged 7 to 17. METHODS: A chart review of 151 Vietnamese-American children seen at the health center was conducted in Spring, 2001. Letters were sent to notify parents of their children's immunization status. One month later, the investigators attempted to contact the parents by phone. The interviews were done to conduct a survey about hepatitis B virus (HBV), and to encourage parents whose children needed further follow-up to do so. PRINCIPAL FINDINGS: Chart review revealed that 2% (n=3) of the patients were chronically infected with HBV, and 28% (n=42) were known to be already immune due to prior exposure. Thirteen patients had either moved or were obtaining care elsewhere. Of those needing vaccination (n=93), 76 (82%) completed the series of three vaccines. Of the remaining 17 patients needing further follow-up, 9 were vaccinated in the community clinic, for a 91% vaccination rate (85 of 93). For this survey, a 63% survey response rate was achieved among the patients' parents (55 of 88 eligible households). Of parents reporting that their children had a hepatitis B vaccination (HepB), study investigators were unable to confirm 25% by chart review. Although letters were sent regarding their children's HBV status, only 71% reported having heard of HBV, and 60% reported having heard of HepB vaccine. The children's receipt the HepB vaccine was not significantly associated with the parents' having heard of HBV or HepB vaccination, the parents' length of time in the United States, their health insurance status, or their level of education. CONCLUSIONS: These findings suggest that parents need more education about HBV, and that the information they provide about their children's vaccination status may not be reliable.

Adolescent↗
PubMedDate not supplied

Efficacy of mass single-dose diethylcarbamazine and DEC-fortified salt against bancroftian filariasis in Papua New Guinea six months after treatment.

The efficacy of two diethylcarbamazine (DEC) treatment strategies to control bancroftian filariasis, diethylcarbamazine-fortified salt (DEC-FS) and a single DEC dose on mass administration, was evaluated in two communities in Papua New Guinea with pretreatment antigen prevalence of 55% and 71%. In the first community 0.2% w/w diethylcarbamazine-fortified salt was distributed monthly to accepting households at no cost for 12 months. In the second community a single DEC dose based on body size but designed to give about 6 mg/kg was administered to eligible acceptors. Despite wide variation in antigen prevalence among study villages there were marked reductions in prevalences under both treatment strategies. Among individuals antigenaemic on day 0, DEC-FS and a single DEC dose gave filaria antigen clearance rates of 43% and 13%, respectively. In the salt-treated community the incidence of antigenaemia after 6 months in acceptors from households that received 5 kg or more of DEC-FS was 14% whereas in those receiving less than 5 kg salt was 4%. The incidence rates in the second community in those that received < 2.5 and > or = 2.5 tablets were 16% and 8%, respectively. The two treatment strategies were simple to manage and appropriate for developing countries and were widely accepted. DEC-FS was more efficacious than single-dose DEC tablets but a single administration of DEC tablets is easier to administer.

Adolescent↗