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Biomedical subjects

M H Williams

Publications and source records attributed to M H Williams.

At least 91 records · Page 5Linked to original sources
PubMed1986

Rate of improvement of pulmonary function in sarcoidosis during treatment with corticosteroids.

Serial measurements of vital capacity were obtained in 11 patients with impaired pulmonary function due to sarcoidosis during 12 courses of corticosteroid treatment. Vital capacity improved promptly and approached a maximum value in about three weeks. A three week trial is probably sufficient to show whether or not corticosteroids are effective in a patient with sarcoidosis.

Adult↗
PubMed1986

Bullous pulmonary damage in users of intravenous drugs.

Among a large group of users of illicit intravenous drugs, the incidence of bullous pulmonary damage was noted to be 2 percent (6/387). Bullous damage was significantly different in the drug users than in those who did not use drugs. The drug users were significantly younger than the nonusers, their bullae were large and confined to the upper lobes, and alpha 1-antitrypsin deficiency was very unlikely. These features strongly implicate intravenous drug abuse in the pathogenesis of these patients' bullous pulmonary damage.

Adult↗
PubMed1986

Positional effects on distribution of ventilation in chronic obstructive pulmonary disease.

Ventilation is distributed predominantly to the dependent lung in normal persons in the decubitus position. We evaluated the distribution of ventilation in four patients with mild-to-moderate chronic obstructive pulmonary disease using 81mKr gas. Patients were tested in the sitting and right and left decubitus positions with and without the application of positive end expiratory pressure (PEEP). In contrast to findings in controls, ventilation was predominantly distributed to the nondependent lung in patients in the decubitus position. Mean ventilation in the right lung decreased from 51% of the total in the sitting position to 31% in the right decubitus position; it increased with the application of 10 cm PEEP. Reduced ventilation in the dependent lung most likely is caused by closure of the airways after a decrease in volume. Application of PEEP resulted in increased lung volume and preferential distribution of ventilation to the dependent lung.

Aged↗
PubMed1986

Evaluation and treatment of insanity acquittees in the community.

This paper describes the monitored outpatient treatment program for Psychiatry Security Review Board (PSRB) clients in the largest single community treatment agency in the Oregon system. We describe 161 persons referred to this agency for evaluation and treatment. Ninety-one PSRB clients received treatment and of this group 51% had their conditional release revoked by the PSRB. The most frequent cause of revocation was noncompliance with treatment. There were only 11 crimes committed during the study period, four of which were in the felony range. The majority of PSRB clients are chronically mentally ill persons. We discuss both the treatment approach and our results in light of a recently published research agenda for insanity acquittees.

Adult↗
PubMed1985

Aerosol beclomethasone in patients with steroid-responsive chronic obstructive pulmonary disease.

Some patients with chronic obstructive pulmonary disease have favorable responses to treatment with oral corticosteroids with increase in one-second forced expiratory volume of 30 percent or more above the baseline. The benefit of long-term steroid therapy may be outweighed by the side effects. Twelve patients who had previously demonstrated a response to oral corticosteroids were studied in a double-blind randomized crossover trial comparing prednisone (30 mg daily) with beclomethasone (metered-dose inhaler, 16 puffs daily) for two weeks each with a two-week washout period between the two regimens. Those who were taking prednisone tapered the dose to 5 mg daily and those taking beclomethasone discontinued it for two weeks before the beginning of the study. History, physical examination, and pulmonary function were monitored. The mean one-second forced expiratory volume increased from 0.65 to 1.00 liter after prednisone therapy and it increased from 0.63 to 0.81 liter after aerosol beclomethasone (difference significant, p less than 0.01 by paired t test). Only five of 12 patients had an increase in one-second forced expiratory volume with steroid aerosol, an increase that was at least 50 percent that achieved by prednisone. In most patients with steroid-responsive chronic obstructive pulmonary disease, aerosol beclomethasone is not an adequate substitute for oral steroids.

Administration, Oral↗
PubMed1985

Arteriovenous malformations: complications of surgical intervention and implications for nursing.

Arteriovenous malformations occur in approximately 4 percent of the population and are frequently seen in young adulthood. Controversy exists in the neurosurgical community as to the management of arteriovenous malformations; the four most common methods are medical management, radiation, embolization, and surgical intervention. Complications occur frequently regardless of the treatment selected. These complications are discussed using a selected patient population and case studies. Nursing diagnosis is used and a plan of care formulated for each problem. A one-year follow-up status will also be given for the selected patient population.

Adolescent↗
PubMed1984

Effect of bronchodilator therapy administered by canister versus jet nebulizer.

Bronchodilator efficacy of metaproterenol sulfate aerosol therapy delivered either by canister or jet nebulizer was compared in 25 patients, 13 with severe asthma and 12 with COPD. Treatment was carried out in double-blind crossover fashion on 2 days and consisted of either metaproterenol sulfate solution 15 mg in 2.3 ml administered from a jet nebulizer or three puffs of metered-dose metaproterenol sulfate (total 1.95 mg) inhaled sequentially. FVC and FEV1 were monitored before and after therapy for 2 hr. In 13 asthmatic patients, FEV1 increased from a baseline mean of 0.83 L to 1.57 L at 2 hr after jet nebulizer therapy and increased from 0.84 L to 1.52 L after canister therapy. In 12 patients with COPD, FEV1 increased from 0.58 L to 0.78 L after jet nebulizer therapy and from 0.57 L to 0.76 L after canister therapy. FVC also increased similarly after each form of therapy. The two types of aerosol therapy were equally effective and were without side effects. Canister therapy has the advantage over jet nebulizer therapy by being convenient and cheaper.

Administration, Intranasal↗
PubMed1984

Vitamin and mineral supplements to athletes: do they help?

Although the general implications of this review would be that vitamin and mineral supplements are ineffective as ergogenic aids when added to the diet of an athlete who is well-nourished, there may be certain instances in which supplementation is warranted. For example, wrestlers on low calorie diets and high levels of energy expenditure may not be receiving a balanced intake of nutrients. Young male athletes and female athletes of all ages should be aware of iron-rich foods and include them in the daily diet. The female athlete who experiences a heavy menstrual flow may consider commercial iron preparations; hemoglobin and other hemotologic variables may be evaluated in order to determine the need for supplementation. More research is needed, particularly with large doses of the vitamin B-complex and vitamin C. Although some of the studies cited herein have used large doses, some athletes have been reported to consume massive dosages, for example, 10,000 mg of vitamin C daily. Unfortunately, there may be some adverse side effects of such massive doses, and it may not be ethical to conduct research with humans at those high intake levels. Do these massive dosages elicit a pharmacodynamic effect on some metabolic reactions that are favorable to physical performance? More research with vitamin E at altitude also appears to be warranted, as does iron supplementation to iron-deficient, but not anemic, athletes. As noted earlier, the current data base suggests that vitamin and mineral supplements are unnecessary for the athlete receiving a balanced diet. However, only with additional controlled research may we expand that data base to help answer some of the questions that still remain relative to nutrition and athletic performance. There are still a large number of athletes who believe that the "racers edge" may be found in a tablet.

Ascorbic Acid↗
PubMed1983

Lactic acidosis in severe asthma.

Twelve patients with severe asthma in whom lactic acidosis developed are presented. All had an arterial blood pH level lower than that expected for the measured partial pressure of arterial carbon dioxide, all had an abnormally large anion gap, and the blood lactate level exceeded 2.8 mmol/liter. Respiratory acidosis subsequently developed in eight patients, and six required intubation. Lactic acidosis can develop in patients with severe asthma. Such patients are in danger of the development of respiratory failure and must be treated vigorously and observed closely.

Acidosis↗
PubMed1983

Bronchodilator response to oral aminophylline and terbutaline versus aerosol albuterol in patients with chronic obstructive pulmonary disease.

Bronchodilator efficacy of oral administration of aminophylline (400 mg) and terbutaline sulfate (5 mg) was compared with inhalation of three puffs of albuterol sulfate in 17 patients with stable chronic obstructive pulmonary disease in a double-blind crossover study. Two hours after either form of therapy, the patients were treated again with three puffs of albuterol. Forced expiratory volume in one second (FEV1) increased significantly more from the baseline value after albuterol aerosol than after oral medication at 30, 60, and 120 minutes (paired t test, p less than 0.01). After three puffs of albuterol at 120 minutes, FEV1 increased to similar values an hour later on both days in 14 of 17 patients. Thirteen patients complained of side effects during oral therapy and none during aerosol therapy. Maximum bronchodilatation was achieved by albuterol aerosol in 14 of 17 patients, and addition of oral therapy produced no further increase of flow rate in these patients. Bronchodilator aerosol is the logical choice for treatment of chronic obstructive pulmonary disease because it is more effective than oral therapy and because it is free from side effects.

Aerosols↗
PubMed1983

Relationship of wheezing to the severity of obstruction in asthma.

Ninety-three asthmatic patients were examined on 320 occasions for wheezing and peak expiratory flow rate (PEFR). The presence of a wheeze (either reported by the patient or found on examination) was associated with a significantly lower PEFR. Expiratory wheezing was usually accompanied by inspiratory wheezing; this biphasic wheezing was associated with a lower PEFR than only expiratory wheezing. Loudness and the high pitch of wheezing were associated with more severe obstruction. Most expiratory wheezing lasted throughout the entire expiration. Expiratory or inspiratory wheezing of high pitch, moderate to severe intensity, and spanning the entire phase of the breath was associated with a lower PEFR than wheezing without these characteristics. Although characterization of wheezing has a general relationship to the severity of airway obstruction, an objective measurement of expiratory flow rate is necessary for the evaluation of each patient's condition.

Adolescent↗