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H Williams

Publications and source records attributed to H Williams.

317 records · Page 18Linked to original sources
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A refreshing change.

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Education, Nursing, Continuing↗
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Quantifying patient engagement with nurses: validation of a scale with AIDS patients.

The purpose of this study was to develop and test a measure of patient engagement with nurses, which is a quantifiable outcome of nurse-patient encounters. This measure, based on verbatim patient statements, was tested with a multi-site sample of 162 hospitalized patients with acquired immune deficiency syndrome (AIDS). Although developed and tested with acutely ill AIDS patients, the scales are not AIDS specific and hold promise as a general measure of the outcomes of nurse-patient encounters in other acute and chronic illnesses.

Acquired Immunodeficiency Syndrome↗
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In vitro and in vivo biotransformations of the potent leukotriene D4 antagonist verlukast in the rat.

Verlukast, (S)3-((((3-(2-(7-chloroquinolin-2-yl)-(E)-ethenyl)phenyl)- 3-dimethylamino-3-oxopropylthio)methyl)thio)propionic acid, formerly known as MK-679, is a potent leukotriene D4 antagonist. Verlukast was incubated with rat liver microsomes under oxidative conditions to generate five metabolites, which were identified as the four possible isomeric monosulfoxides (M1-M4), and the N-hydroxymethyl amide (M5). This latter metabolite loses the elements of formaldehyde to yield the N-monomethyl amide (M6). These metabolites were isolated from a large microsomal incubation and were characterized by UV, 1H-NMR, and fast atom bombardment-MS. These data were identical to those obtained from synthetically prepared standards. Microsomal incubations of verlukast supplemented with UDP-glucuronic acid yielded the acyl glucuronide metabolite (M7), which was isolated and characterized by UV, 1H-NMR, and fast atom bombardment-M5. Verlukast was regenerated from M7 upon treatment with either beta-glucuronidase or strong aqueous base (pH greater than 11). The metabolites described above were all detected in bile collected from a rat dosed with verlukast.

Animals↗
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Computed tomographic (CT) guided percutaneous fine-needle aspiration biopsy: the Yale experience.

Fifty-one CT-guided percutaneous fine-needle aspiration biopsies (PFNAB) were performed on 46 consecutive patients over 15 months. Cytologies were obtained to identify primary or secondary malignancy in the abdomen, pelvis, retroperitoneum, bone, and paraspinal region. Adequate cytologic material was obtained in 50 of 51 biopsies. There were 29 true-positive, 0 false-positive, 12 true-negative, and two false-negative cases with an overall accuracy rate of 95 percent. There was one minor complication, mesenteric hemorrhage, which did not require transfusion. Fifteen of the 51 biopsies were performed on outpatients. The procedure is an accurate, safe, and cost-effective nonsurgical means of diagnosing primary or secondary malignancy.

Adult↗
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The MRCP (UK) examination from the patient's point of view.

Each year approximately 3,200 volunteer patients attend the examinations of the Royal College of Physicians in England and Wales. A confidential postal questionnaire concerning patients' experiences and satisfaction was administered to those attending North Tees General Hospital in June 1992 with a 90% response rate. The majority of patients derive some enjoyment from the experience and do not mind being repeatedly examined, some even up to eight times per session; but they do feel neglected if examined only once per session. Twenty-two per cent of first time attenders would have liked to have had more information about the proceedings beforehand.

Clinical Competence↗
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Recognition of dermatological conditions by junior doctors on general medical wards.

Although we know something about the prevalence of various dermatological conditions in the community, virtually nothing is known about the prevalence and type of skin conditions affecting general medical patients in hospital. This has important implications for both undergraduate training and the continuing education of junior doctors about common skin disorders. In this study we examine the prevalence of skin conditions in 100 in-patients on four general medical wards, and assess the awareness and diagnostic accuracy of junior doctors encountering common dermatological conditions in their patients. Forty-six patients had one or more skin conditions, excluding seborrhoeic warts, skin tags, benign pigmented naevi and Campbell De Morgan spots. The 16 junior doctors correctly diagnosed 64% of common skin conditions that should have been covered in the undergraduate curriculum but detected only 43% of the two malignant skin lesions (basal cell carcinomas) identified in the study. The presence of skin conditions was rarely recorded in the notes, even when the condition was potentially relevant to the general medical condition of the patient. This study highlights the need for greater awareness of skin disease amongst junior doctors in order to avoid unnecessary patient morbidity.

Clinical Competence↗
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Gamma-hydroxybutyrate (GHB): a new drug of misuse.

Accident and Emergency Departments offer a unique opportunity for identifying and monitoring new drugs of misuse. This series of six case reports describes the potentially serious medical complications associated with the use of gamma-hydroxybutyrate (GHB) a new drug of misuse on the UK scene. Profound unconsciousness occurred in all cases and despite full (and often rapid) recovery all patients required medical intervention. Adverse effects occurred both when GHB was used alone or in combination with other illicit drugs and alcohol.

Adjuvants, Anesthesia↗