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Biomedical subjects

N Williams

Publications and source records attributed to N Williams.

At least 235 records · Page 13Linked to original sources
PubMed1994

Incidence and management of catheter-related sepsis in patients receiving home parenteral nutrition.

Fifty patients, comprising 24 male and 26 female of median age 43 (range 15-67) years, received a total of 2620 patient-months of home parenteral nutrition (median 48 (range 2-130) months). There were 13 episodes of bacterial catheter sepsis (of which the catheter was successfully salvaged by an antibiotic-fibrinolytic 'lock' technique in four cases) and ten of exit-site sepsis (all managed by elective catheter replacement), representing an incidence of 1 septic complication per 113 patient-months of parenteral nutrition. This low incidence of catheter-related sepsis was achieved by strict adherence to established protocols of catheter management.

Adolescent↗
PubMed1994

Differential effects of transforming growth factor-beta 1 on distinct developmental stages of murine megakaryocytopoiesis.

The effect of transforming growth factor-beta 1 (TGF beta 1) on three developmental stages of megakaryocytopoiesis was investigated. Using a murine bone marrow agar culture system, titrated doses of TGF beta 1 were added to cultures assaying primitive high proliferative megakaryocyte progenitors, committed megakaryocyte precursors, and nondividing, endoreduplicating megakaryocytes. The growth of high proliferative megakaryocyte colony-forming cells (HPP-CFU-Mk) that require the growth factors interleukins-1, 3 and 6 (IL-1 + IL-3 + IL-6) for colony detection was abrogated by the addition of 1 ng TGF beta 1/ml. The sensitivity of committed megakaryocyte progenitors (colony-forming unit-megakaryocyte, CFU-Mk) to TGF beta 1 depended on the growth factor combination. TGF beta 1 (1 ng/ml) completely inhibited megakaryocyte colony formation from CFU-Mk only in cultures stimulated by low doses of IL-3. TGF beta 1 (> 10 ng/ml) could only marginally inhibit megakaryocyte colony formation generated in the presence of either high doses of IL-3 or the combination of low dose IL-3 + IL-6. TGF beta 1 inhibited both IL-3-dependent and IL-6-dependent megakaryocyte growth but tenfold higher doses of TGF beta 1 were required to inhibit growth generated by the combination of IL-3 + IL-6. The data showed that the capacity of TGF beta 1 to inhibit distinct differentiation stages of the megakaryocytopoietic lineage depended on the concentration and combination of growth factors involved.

Animals↗
PubMed1994

The mitochondrial ATP synthase of Trypanosoma brucei: structure and regulation.

The structure and regulation of the Trypanosoma brucei mitochondrial ATP synthase is reviewed. This enzyme complex which catalyzes the synthesis and hydrolysis of ATP within the mitochondrion is a multisubunit complex which is regulated in several ways. Several lines of evidence have shown that the ATP synthase is regulated through the life cycle of Trypanosoma brucei. The enzyme complex is present at maximal levels in the procyclic form where mitochondrial activity is the highest and cytochromes and Kreb's cycle components are present. The levels of the ATP synthase are decreased in the bloodstream forms where the levels of the mitochondrial cytochromes are absent or substantially decreased. In recent preliminary work we have shown the presence of an ATP synthase inhibitor peptide which may indicate an additional level of complexity to the regulation.

Animals↗
PubMed1994

Employing a practice nurse--role and training implications in an Irish context.

All 102 nurses known to be practising as practice nurses in the Republic of Ireland were sent a questionnaire for completion anonymously. A response rate of 56% was obtained. Over half the respondents had commenced practice nursing since the new General Medical Services contract in 1989 following a career break, the median duration of which was 5.5 years. Two thirds had completed midwifery training but only one was a qualified Public Health Nurse. An examination of the tasks performed by the respondents suggests that Irish practice nurses are already filling an extended role beyond their treatment room duties with 46% involved in smoking counselling, 74% in counselling on cholesterol and 37% involved in asthma care. Nurses providing antenatal care or taking cervical smears were not, however, more likely to have completed midwifery training.

Education, Nursing↗
PubMed1994

Comparison of perceived occupational health needs among managers, employee representatives and occupational physicians.

The aim of this study was to assess how occupational health providers view the importance of different occupational health functions compared with their customers (managers and union representatives). A postal survey was undertaken requesting that managers of medium and large companies, union representatives and occupational physicians rank in order of importance 13 listed functions of an occupational health service which have appeared in the published literature. The results were analysed and tabulated to allow comparison of the responses among the four groups. The two functions ranked as most important by all four groups were advice on the work environment and advice on medical retirement. Dental services as an occupational health service function were ranked as least important by all four groups, with provision of physiotherapy services by occupational health departments also perceived as relatively unimportant by managers of medium and large companies. A wide discrepancy of views was revealed between physicians, managers and unions over the importance of immunization for travel and work and the rehabilitation and resettlement of sick and injured workers. The physicians ranked these functions as more important than the managers or union representatives. Managers of medium-sized companies also ranked counselling in the workplace much higher than the other respondents. The study shows the dilemma that occupational health services may face in deciding what functions should be provided compared to what their customers wish to be provided.

Administrative Personnel↗
PubMed1994

Catheter-related morbidity in patients on home parenteral nutrition: implications for small bowel transplantation.

Until recently, Home Parenteral Nutrition (HPN) has been the only real option for patients with intestinal failure. Small bowel transplantation (SBT) is advancing rapidly, however, and may soon provide an alternative for these patients. One of the arguments in favour of SBT is the alleged morbidity of prolonged parenteral nutrition. We have assessed the catheter-related morbidity in a large cohort of patients on HPN. A total of 88 central venous catheters were required in 50 patients. The main complications were sepsis (24 episodes) and occlusion (18 episodes). The overall incidence of catheter-related morbidity was one episode per 46 patient-months of HPN.

Adolescent↗
PubMed1994

Acute appendicitis in the under-5 year old.

During a 10-year period we operated on 816 children with a diagnosis of acute appendicitis. Of these, 36 (4.5%) were under 5 years of age. A retrospective analysis was made of these 36 cases to assess the natural history, management and outcome in these children. Abdominal pain was the commonest symptom but was not invariable, being present in only 32 of the 36 children while vomiting was present in 28 children. Localized tenderness in the right iliac fossa was present in 21 children and generalized in 10. In 5 children there was a delay in diagnosis in excess of 18 h. The overall perforation rate was 50% as assessed macroscopically and was inversely proportional to the child's age. There was no mortality and the wound sepsis rate was 16.6%. The low incidence of acute appendicitis in very young children means that it is often overlooked. A high index of suspicion may contribute to earlier diagnosis and thereby reduce morbidity.

Acute Disease↗
PubMed1994

Hand arm vibration syndrome.

As the UK's commonest prescribed disease hand arm vibration syndrome presents a considerable risk to a large sector of the working population. Dr Nerys Williams examines the condition and offers advice for its management.

Arm Injuries↗