Search PubMed⌕ Search

Biomedical subjects

L Williams

Publications and source records attributed to L Williams.

At least 199 records · Page 11Linked to original sources
PubMed1992

Neuropsychiatric effects of drugs in the elderly.

Since the elderly consume large numbers of drugs, drug-induced disease must be high on the list as a suspected cause of changes in behavior. Neuropsychiatric side effects of drugs in the elderly are not rare events. While proceeding to investigate medical, neurological, and psychiatric causes of a change in the cognitive status or behavior in an elderly patient, it is important to consider a possible psychotoxic drug as an offender or co-offender. Failing to do so may lead to inappropriate testing and further unnecessary and possibly deleterious therapeutic measures. In the case of dementia, the worst treatment would be institutionalization before identifying a drug as the cause of the cognitive dysfunction.

Aged↗
PubMed1991

Quadruple immunosuppression in renal allografts--the Auckland experience.

Recipients of live related and first cadaveric renal allografts were retrospectively reviewed before and after institution of a standardized regimen incorporating greater immunosuppression, (by the addition of antilymphocyte preparations). The two review groups were comparable with 11 live related and 27 first cadaver grafts in each. Despite a small advantage in terms of graft survival and diminished rejection, this was at the expense of septic morbidity. The implications of this are discussed.

Antilymphocyte Serum↗
PubMed1991

A survey of inpatient antibiotic use in a teaching hospital.

To assess the appropriateness of inpatient antibiotic use, a 4-week prospective survey in medical, surgical and gynaecological wards was undertaken at Groote Schuur Hospital. A total of 224 prescriptions comprising 680 antibiotics were analysed. Of all patients in the medical, gynaecology and surgery wards, 27%, 26.5% and 32%, respectively, were prescribed antibiotics. The greatest number of inappropriate prescriptions--54%--were found in the gynaecology ward. Prophylactic antibiotic use was highest in the surgical ward at 41% where a very satisfactory 91% was considered appropriate, whereas 66% of gynaecological prophylaxis was inappropriate. Therapeutic use was highest and more often appropriate in the medical wards. Antibiotics classified as restricted according to the hospital antibiotic policy were generally used appropriately, whereas inappropriate choice, dose, frequency of administration, duration, and unnecessary antibiotic use were encountered in 22-100% of cases with unrestricted antibiotics. Particular problems pinpointed in this survey included excessive dosages of penicillin G and amoxycillin, an irrational protocol for the treatment of pelvic sepsis in gynaecology, and frequent inappropriate selection of erythromycin. The greatest expenditure was on amikacin, the only aminoglycoside allowed according to the existing antibiotic policy.

Adult↗
PubMed1991

Asynchronous development of the rat colon.

Mucosal ridge and fold formation, apoptosis and the occurrence of secondary lumina within the epithelium are morphological features associated with the development of the colon. These processes, however, do not occur synchronously in the various segments of the colon. In the caecum and ascending colon of the rat, fold formation, apoptosis and secondary lumina result in the development of villi by day 22 after conception, and by postnatal day 3 in the transverse colon. These villi persist in the rat colon until approximately postnatal day 10. The presence of colonic villi may be correlated with the increased food intake and fluid absorption during this early postnatal period. Villus formation does not take place in the developing descending colon.

Animals↗
PubMed1991

The use of a brief movement restriction procedure to eliminate severe inappropriate behavior.

The effect of a brief movement restriction (BMR) procedure on the maladaptive behavior of two severely mentally retarded persons was evaluated using a multiple baseline research design. Following a functional analysis of the maladaptive behaviors, baseline data were collected on the frequency of smearing in a six year old boy and the frequency of aggression-destruction and stereotypic behavior in a 24 year old man. Following the baseline period a treatment package that included reinforcement for alternative behavior and BMR were first introduced for feces smearing. After feces smearing had shown a reduction with the first client the treatment package was introduced for aggression and destruction with the second client. After aggression and destruction had been reduced, the treatment package was added for stereotypy. The treatment package completely eliminated each of the target behaviors and they remained absent during a long follow-up period.

Adult↗
PubMed1991

Mastopexy.

Explore the source record for details and available documents.

Adult↗
PubMed1991

Teaching trauma management in the accident and emergency department.

Since their introduction into the United Kingdom, Advanced Trauma Life Support Courses (ATLS) have preferentially offered places to Consultants and Senior Registrars. It is usual, however, for the initial resuscitation of the seriously injured patient to be performed by relatively inexperienced junior staff. It is incumbent upon those medical staff who are ATLS providers or instructors to design local courses, based upon ATLS principals, to train their junior staff in a structured approach to managing these patients. We describe one such local course which may serve as a model for others.

Curriculum↗
PubMed1991

HTLV-I-associated myelopathy associated with blood transfusion in the United States: epidemiologic and molecular evidence linking donor and recipient.

Six months after receiving 58 units of blood components, a 65-year-old white man from New York City, with no other risk factors for human T-lymphotropic virus type I (HTLV-I) infection, developed HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Investigation of blood donors identified a 25-year-old white Hispanic woman from Florida whose platelets had been given to the patient and who was seropositive for the virus on a serum specimen obtained 2 years after the donation. She was born in Cuba and had had 2 sexual relationships with men who either had been born in or had resided in the Caribbean. Polymerase chain reaction (PCR) studies of peripheral blood mononuclear cells indicated that both donor and recipient were infected with HTLV-I. Molecular studies of a 595-nucleotide sequence in the 5' envelope region of HTLV-I indicated that the viruses from donor and recipient were identical in each of 32 positions in which published HTLV-I sequences demonstrate molecular heterogeneity; the donor and recipient viruses were also identical in 2 additional positions in which they differed from all published sequences. Transfusion-associated HAM/TSP has occurred in the United States, but additional cases should be prevented by screening blood donations for HTLV-I. Molecular studies of HTLV-I may prove useful in defining the genetic heterogeneity of HTLV-I isolates in the United States and in studying transmission of this virus.

Adult↗
PubMed1991

Juvenile crime and drug abuse: a prospective study of high risk youth.

Results from an ongoing, longitudinal study of juvenile detainees focusing on the relationship between their drug use and delinquency/crime, are summarized. Three hundred and ninety-nine youths were first interviewed in 1986/87, and 41 percent were found to be urine positive for recent drug use at the time of detention. We reinterviewed 305 of the youths approximately one year later, and found their drug use and delinquency persisted, and in some cases increased, over time. Treatment intervention is needed for the drug involved youths in the study to reduce their cycle of drug use and crime.

Adolescent↗
PubMed1991

Recidivism among high-risk youths: study of a cohort of juvenile detainees.

We report some results from an ongoing, longitudinal study of juvenile detainees. Analyses were directed toward determining whether the youth's alcohol or other drug use and their emotional/psychological problems at entry into the detention center predicted subsequent arrests for new offenses. Statistically significant relationships were found between the youths' demographic characteristics (age, race, gender), referral history, reason for placement in the detention center, and cocaine use (as measured by urinalysis) and recidivism. However, the magnitudes of these relationships were low to moderate in value, suggesting that a longer follow-up period is needed to more meaningfully study this issue.

Adolescent↗
PubMed1991

Recidivism among high risk youths: a 2 1/2-year follow-up of a cohort of juvenile detainees.

We report some results from a longitudinal study of juvenile detainees. Analyses were directed toward determining whether the youths' alcohol or other drug use and their emotional/psychological problems at entry into the detention center predicted subsequent arrests for new offenses during the 24 and 30 months following their initial interviews. Statistically significant relationships were found between the youths' demographic characteristics (age, race, gender), referral history, reason for placement in the detention center, cocaine use (as measured by urinalysis), and recidivism. The magnitude of these relationships increased with the length of the follow-up period.

Adolescent↗
PubMed1991

Assessment of ovarian tumor vascularity with transvaginal color Doppler sonography.

This report describes the results of transvaginal color Doppler sonography (TV-CDS) of 43 surgically proved ovarian masses. Waveform analyses of the signals arising from specific vessels (i.e., peripheral, central, septal) adjacent to and within these masses were correlated to those seen on macroscopic pathologic evaluation. The mean and standard deviation of the pulsatility indices (PI) of 32 benign lesions (1.8 +/- 0.8) were higher than 11 malignant ones (0.8 +/- 0.6) (P = 0.03). However, the range of benign (4.0 to 0.7) and malignant (1.5 to 0.4) lesions did overlap. Low PIs (less than 1.0) were found in five relatively benign lesions (one case each of dermoid cyst, cystadenoma containing a dermoid cyst, endometrioma, benign sclerosing stromal tumor, and thecoma), but also in all 11 malignant or borderline malignant lesions (nine cystadenocarcinomas, two germ cell tumors), causing an overlap between the PIs of some benign and malignant masses. With a 100% negative predictive value, our preliminary data suggest that TV-CDS can effectively exclude malignancy. However, with a positive predictive value of 73%, one in four malignant lesions diagnosed by TV-CDS will be benign.

Adolescent↗
PubMed1991

Pregnancy, STDS, and AIDS prevention: evaluation of New Image Teen Theatre.

New Image Teen Theatre combines peer education and theatre in an informative and entertaining package. This study was undertaken to assess the effectiveness of New Image Teen Theatre on altering teenagers' attitudes, knowledge, and intentions regarding sexual behavior. A total of 143 adolescents between the ages of 13 and 19 viewed the performance. The performance focused on the prevention of pregnancy, AIDS, and STDs and included content aimed at increasing communication. Teen participants completed pretest and posttest questionnaires. Almost half of the adolescents reported having engaged in sexual intercourse. About one third of the sexually active reported never using birth control, and only 21% reported consistent use of condoms. These results confirm adolescents' risk for pregnancy, STDs, and AIDS in particular. Following the performance, the teens reported significantly more willingness to discuss sexual issues with others, significantly greater intention to use birth control (for sexually active teens), and demonstrated significantly greater sexual knowledge. Furthermore, they indicated that they had experienced more positive emotions than negative emotions while viewing the production. Results suggest that theatre education may set the stage for more comprehensive interventions designed to prevent pregnancy, STDs, and AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Nursing implications of immunosuppression in transplantation.

The numbers and survival rates of patients undergoing solid organ transplantation have increased over the past decade. The use of immunosuppressive drugs has contributed greatly to the success of transplantation. Drugs such as cyclosporine, steroids, azathioprine, ATG/ALG, OKT3, and new drugs under investigation such as FK506 are being used on a daily basis by nurses who care for organ transplant patients. This article reviews these medications and the implications for nurses administering these drugs.

Antibodies, Monoclonal↗
PubMed1990

How easy is it to contact the duty medical doctor responsible for acute admissions?

OBJECTIVE: To ascertain ease or difficulty of contacting duty junior doctors responsible for acute medical admissions by telephone. DESIGN: Telephone survey of hospitals in six health regions in England and Wales. SETTING: 70 Randomly selected hospitals, 15 of which were excluded because of non-acceptance of acute medical admissions. PARTICIPANTS: 71 Duty doctors (duty house physicians, senior house officers, or registrars responsible for acute medical admissions) in 48 hospitals; seven duty doctors in seven hospitals were excluded (four declined to participate and three required a written explanation of the survey). 67 Doctors gave full information to all questions. MAIN OUTCOME MEASURES: Time taken for hospital switchboards and duty doctors to reply to telephone call, diagnoses of patients recently admitted, and on call rotas and hours of sleep of duty doctors. RESULTS: Hospital switchboards responded within 30 seconds in 87 (74%) calls, and in 76 calls (64%) the duty doctor requested was contacted within a further two minutes. Chest pain, possibly due to myocardial infarction, was the most common reason for acute medical admissions. Nearly half (48%) of the duty doctors in larger hospitals reported having 4-5 hours sleep or less on their nights on call. Most (30) were on a one in three rota; two were on a one in two rota. CONCLUSIONS: Despite impressions to the contrary contacting the duty medical team by telephone seemed fairly easy. Although most junior doctors were on a rota of one in three or better, insufficient recognition may be given to their deprivation of sleep during nights on duty.

Communication↗