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Biomedical subjects

L A Williams

Publications and source records attributed to L A Williams.

119 records · Page 7Linked to original sources
PubMedDate not supplied

Clinical predictors of malaria in Gambian children with fever or a history of fever.

Diagnosis of malaria in children is difficult without laboratory support because the symptoms and signs of malaria overlap with those of other febrile illnesses such as pneumonia. Nevertheless, in many parts of Africa diagnosis of malaria must be made without laboratory investigation. Therefore, a scoring system has been developed to assist peripheral health care workers in making this diagnosis. Four hundred and seven Gambian children aged 6 months to 9 years who presented to a rural clinic with fever or a recent history of fever were investigated. A diagnosis of malaria was made in 159 children who had a fever of 38 degrees C or more and malaria parasitaemia of 5000 parasites/microL or more. Symptoms and signs in children with malaria were compared with those in children with other febrile illnesses to identify features which predicted malaria. Symptoms and signs were incorporated into various logistic regression models to test which were best independent predictors of malaria and these regression models were used to construct simple scoring systems which predicted malaria. A nine terms model predicted clinical malaria with a sensitivity of 89% and a specificity of 61%, values comparable to those obtained by an experienced paediatrician without laboratory support. The ability of peripheral health care workers to diagnose malaria using this approach is now being investigated in a prospective study.

Antimalarials↗
PubMedDate not supplied

A culture fair: a creative, fun, and informative method of cultural awareness education.

Nursing has long realized that the impact of a person's culture is an important component of planning the care of individuals. Recently the Joint Commission on the Accreditation of Health Care Organizations has begun to require evidence that healthcare workers have knowledge of the impact of cultural background on patient and family response to health and illness. An education fair is a creative and fun method of educationg large numbers of employees with consideration for cost, time, and resource management. This article will address how to assess and utilize available resources for organizing and setting up a culture fair.

Attitude of Health Personnel↗
PubMedDate not supplied

Human rabies exposures and postexposure prophylaxis in South Carolina, 1993-2002.

OBJECTIVES: South Carolina mandates reporting of animal bites and manages distribution of biologics for rabies postexposure prophylaxis (PEP). Incidence and epidemiologic characteristics of potential human rabies exposures and preventive treatment in South Carolina from 1993 through 2002 were examined to help assess the burden of PEP in the state and determine if the incidence of rabies exposures has changed over time. METHODS: Data on animal exposure investigations and PEP administration at the state and county level were examined, and the annual incidences of potential rabies exposures and human PEP courses were calculated. RESULTS: The incidence of animal exposures for which investigations were initiated was 297.9 per 100,000 population per year, and the incidence of PEP was 10.6 per 100,000 population per year. At the county level, the incidence of PEP appeared inversely correlated with the population density. Most courses of PEP were administered following exposures to domestic species, although these animals accounted for only a small proportion of rabid animals in the state. The annual PEP incidence was similar throughout the study period, but it was markedly higher than estimates from 1981 (< 5/100,000 population per year). CONCLUSIONS: The incidence of PEP in South Carolina is higher than previously thought, and these findings suggest that incidence extrapolations for other states and at the national level may be underestimated. An accurate estimation of the incidence of PEP and an understanding of rabies epidemiology is important at the state level to allow for better public health planning.

Animals↗
PubMedDate not supplied

Technical considerations in the use of external condom catheter systems.

Since the advent of rehabilitation engineering new advances have been made that have revolutionized condom catheter drainage systems (CCDS). An innovative CCDS has been designed that ensures unobstructed urine flow. Its condom catheter has several unique design features. It has a double row of convolutions near the catheter tip that prevent kinking and twisting so that the pathway remains open. The condom catheter features a unique inner flap that fits snugly on the glans to prevent backflow of urine on the shaft. This condom catheter is connected to a vented leg bag that eliminates the development of a partial vacuum in the connecting tube. This vacuum can create siphoning, which in turn interferes with urine flow into the leg bag. In addition, a new rechargeable battery-operated clipper has been developed that makes nick-free hair removal from the genitals exceptionally easy. This atraumatic hair removal eliminates the pubic hair that becomes trapped under the condom catheter. The clinical impact of these new advances in CCDS requires further investigation.

Hair Removal↗
PubMedDate not supplied

Targeting adriamycin to tumour cells by means of an affinity ligand; a model system for drug delivery.

Actively migrating tumour cells possess the proteolytic enzyme guanidinobenzoatase (GB) in an uninhibited form. This enzyme has been used as a target for the delivery of adriamycin to invasive tumour cells in frozen sections. An adriamycin-agmatine complex has been prepared which act as a competitive inhibitor of GB. Competition experiments have demonstrated that the adriamycin-agmatine complex competes with 9-aminoacridine for the active centre of GB associated with invasive tumour cells, located in the lymph nodes and in squamous cell carcinoma of the oral cavity. The technique described should be generally applicable to the targeting of drugs to cells.

Agmatine↗
PubMedDate not supplied

A fluorescent study of ligands for guanidinobenzoatase, a protease associated with tumour cells.

We have employed ethanol-fixed wax embedded sections of human breast tumours and smears of rat leukaemia cells to provide test systems with recognisable tumour cells amongst normal cells. We have used 9-aminoacridine to locate cells possesing guanidinobenzoatase, an enzyme which degrades fibronectin and which binds 9-aminoacridine to its active centre. The binding of 9-aminoacridine to tumour cells allows these cells to be located by fluorescent microscopy. Pre-treatment of these sections with BZAR, a known inhibitor of guanidinobenzoatase inhibited the binding of 9-aminoacridine to the tumour cells. These techniques defined the tumour cells in the sections; we then demonstrated by fluorescent microscopy that both Texas red-agmatine and BZAR also bound to the guanidinobenzoatase of these tumour cells. These fluorescent probes have been used as model compounds to illustrate the ability of both N-substituted agmatines and N-substituted arginines to deliver desired molecules to an enzyme on the surface of tumour cells. Replacement of these fluorescent moieties by cytotoxic moieties attached to the same ligands could lead to selective drug delivery to tumour cells.

Animals↗
PubMedDate not supplied

An unusual cause of knee locking: a case report.

Intra-articular tumors of the knee joint causing intermittent locking are extremely rare. A 39-year-old woman with the complaint of joint locking had a pedunculated intra-articular mass and nodular synovitis.

Adult↗