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Biomedical subjects

R B Williams

Publications and source records attributed to R B Williams.

At least 145 records · Page 8Linked to original sources
PubMed1988

Hip pain.

Hip pain can be categorized as either anterior groin pain, lateral trochanteric pain, or posterior buttock pain. Reproduction of the pain during passive and active range of motion of the hip against resistance provides the most accurate localization. The very important intra-articular diagnoses with poorer prognoses and more urgent requirement for treatment, such as a septic joint and hip fracture, often present with anterior groin pain. Trochanteric bursitis is the most common cause of lateral pain next to osteoarthritis. Buttock pain occasionally represents a radiation from lumbar disc or facet joint disease but more commonly is muscular in origin. Management of osteoarthritis of the hip successively challenges the primary care physician to provide effective patient education regarding NSAIDs, assistive devices for walking, and optimal timing of total hip arthroplasty.

Diagnosis, Differential↗
PubMed1988

Effects of propranolol on cardiovascular and neuroendocrine responses to mental arithmetic in type A men.

beta-Adrenergic hyperreactivity has been proposed as a pathogenic mechanism of increased coronary risk in Type A individuals. This study compared the effects of propranolol, diazepam, and placebo on cardiovascular and neuroendocrine responses to a stressful cognitive task in six young Type A males. Although diazepam did not differ from placebo, propranolol attenuated heart rate and norepinephrine responses and enhanced cortisol responses to the task. Findings suggest that propranolol has reciprocal effects on the norepinephrine and cortisol components of the "fight-flight" response. Possible central nervous system mechanisms are described.

Adult↗
PubMed1987

Refining the type A hypothesis: emergence of the hostility complex.

Recent negative research findings have raised questions regarding the robustness of the Type A hypothesis. A growing body of evidence suggests that not all aspects of the global Type A behavior pattern are pathogenic, but only those concerned with hostility and anger. Biologic mechanisms responsible for increased risk of coronary disease in persons with high levels of hostility and anger appear to involve increased cardiovascular and neuroendocrine responses to behavioral challenge, and, possibly, inadequate parasympathetic antagonism of sympathetic nervous system effects. Future research should concentrate on further refining our understanding of the hostility complex and its pathophysiologic mechanisms.

Coronary Disease↗
PubMed1987

Parental history of hypertension and cardiovascular responses to behavioral stress in young black women.

Beta-adrenergic sympathetic nervous system (SNS) hyperresponsivity to behavioral stress may play a role in the onset of sustained high blood pressure--particularly in persons with a parental history of hypertension. Although hypertension is extremely prevalent among blacks, the association between parental history of hypertension and cardiovascular hyperresponsivity has not been explored in this group. The present study examined the influence of parental history of hypertension on cardiovascular stress reactivity in a group of young black females. Contrary to previous findings with whites, black subjects with a parental history of hypertension exhibited significantly smaller systolic blood pressure and forearm blood flow increases, and moderately smaller diastolic blood pressure increases to the task. Parental history subjects also exhibited slower heart rates throughout each experimental condition. The results suggest that blacks at risk from hypertension may not exhibit the beta-adrenergic hyperresponsivity to behavioral stress observed in whites. These results may suggest that beta-adrenergically mediated hyperresponsivity may be less involved in the development of hypertension among blacks.

Adult↗
PubMed1987

Gout and pseudogout of the temporomandibular joint.

The temporomandibular joint is rarely affected by gout or pseudogout. The following article presents two case reports that demonstrate gout and pseudogout of the temporomandibular joint. The surgical treatment and diagnostic criteria for these entities are presented and discussed.

Adult↗
PubMed1987

Psychological correlates of hostility among patients undergoing coronary angiography.

The Cook-Medley Hostility (Ho) scale (Cook & Medley, 1954) has been associated with increased risk for coronary heart disease (CHD). There is relatively little information about the psychosocial correlates of the Ho scale in clinical or adult populations, however. In this study, 132 patients (mean age = 53 years) referred for diagnostic coronary angiography completed a battery of self-report questionnaires including the Minnesota Multiphasic Personality Inventory (MMPI), Hopkins Symptom Check List (SCL-90), State-Trait Personality Inventory (STPI), Type A Self-Rating Inventory (TASRI), and Perceived Social Support Scale (PSSS). Examination of the pattern of correlations among the Ho scale and the psychometric instruments revealed that the Ho scale may be viewed as tapping four general behavioural dimensions including anger and hostility, neuroticism, social maladjustment and ineffective coping style. These findings serve to further understanding about the psychological dimensions of hostility as measured by the Cook-Medley Ho scale.

Adult↗
PubMed1987

Psychological factors in coronary artery disease: epidemiologic evidence.

This article reviews the epidemiologic evidence linking psychological factors and various indexes of coronary heart disease (CHD) that has been gathered since the Amelia Island Conference in 1978. In general, studies of populations not selected according to CHD risk support the conclusion that the global type A construct is predictive of increased risk of coronary events. In high-risk groups, including patients undergoing coronary angiography, the evidence with respect to global type A is much less clear. This stems from the fact that most of these studies, although generally failing to find statistically significant relationships between coronary events and type A behavior, are flawed in a number of ways, including inadequate statistical power of results, use of less than adequate instruments, and failure to take an apparent interaction between type A behavior and age into account. Nevertheless, taken together, these findings suggest that it may be possible to identify measures of coronary-prone behavior that are more powerful than the global type A measure. Extensive evidence suggests that such measures may be found in the domain of hostility and anger. Measures of hostility and anger coping styles have been found to be associated with coronary atherosclerosis in populations in which global type A was not related to disease, and measures of hostility have predicted increased coronary events and total mortality in prospective population samples followed for from 20 to 25 years. Preliminary evidence suggests that hostility/anger characteristics may account for the increased coronary risk associated with global type A behavior.(ABSTRACT TRUNCATED AT 250 WORDS)

Anger↗
PubMed1987

Multidimensional work sampling to evaluate the effects of computerization in an outpatient pharmacy.

The effectiveness of multidimensional work sampling versus direct observation in evaluating the effects of computerization in an outpatient pharmacy was studied. A direct-entry, self-reporting method of multidimensional work sampling was used to measure and compare the relative times spent on various tasks before and after computerization in the outpatient pharmacy of a 475-bed teaching hospital. Analysis of variance was used to evaluate differences in the types of functions performed, differences in functions among the five employees (two pharmacists, one pharmacy intern, and two technicians), and differences in functions on a week-to-week basis. Data obtained by multidimensional work sampling were compared with data obtained by direct observation to determine the level of agreement between the two methods. Also, a time clock method was used to measure and compare the time required for prescription processing before and after computerization. After computerization, the percentage of time spent on some clerical tasks decreased by 26.7%, but this decrease was offset by a significant increase of 27.7% in the percentage of time spent entering information into the computer. Time spent on clinical tasks did not change significantly. A significant difference among employees was found in the percentage of time spent on clinical functions. The differences in time spent on clinical or clerical functions from week to week were not significant. The time to process a set of prescriptions increased after computerization, primarily because of the time needed to enter information into the computer. However, computerization enabled the generation of patient profiles. Multidimensional work sampling is an accurate method of work measurement that may be more useful than direct observation in capturing clinical functions.

Drug Prescriptions↗
PubMed1986

Medical, psychological and social correlates of work disability among men with coronary artery disease.

This study identifies the medical, psychologic and social factors that independently affect employment in patients with coronary artery disease (CAD). At coronary angiography, extensive clinical, psychological and social profiles were collected on 814 men younger than 60 years with documented CAD. Clinical factors studied included measures of symptom severity, prior myocardial infarction, coronary anatomy and left ventricular function. Psychosocial factors studied included the Minnesota Multiphasic Personality Inventory (MMPI), Zung Depression and Anxiety Scales, a type A structured interview, Jenkins Activity Survey and measures of education and social support. Multiple logistic regression analyses were used to assess the relative strength of the relation between these different factors and the patients' employment status. Many single factors differed between the 204 men (25%) who were disabled and the 610 (75%) who were not. Disabled men were less educated but no different in age, marital status or number of dependents. Disabled men had lower ejection fractions and higher indexes of angina, previous myocardial infarction and coexisting vascular disease. Disabled men also were more depressed and anxious and had lower ego strength and higher hypochondriasis scores on the MMPI, but were no different in type A behavior. By multivariable analysis, the most significant (p less than 0.01) independent predictors of work disability were, in decreasing order of importance, low education level, history of myocardial infarction, high levels of depression and high levels of hypochondriasis. It is concluded that psychological and social factors are strongly related to work status in patients with CAD, and may be more important than medical factors.

Anxiety↗
PubMed1986

Hapantotypes: a possible solution to some problems of parasite nomenclature.

Parasites usually have several morphologically distinct stages in their life cycles. Some infect different host species at different stages of their development, and many are distinguished partly by the lesions caused in their hosts. Molecular techniques, seeking to clarify host-parasite relationships, often attempt definition o f species or subspecies in terms of enzyme profiles, DNA 'finger-prints', or other subcellulor characteristics. So, under the International Code of Zoological Nomenclature, what carries the species name? Which 'specimen' represents the unique name-bearing reference for a specific name? The problem is particularly daunting for parasitologists. In this article, Ray Williams discusses the idea that instead of a single 'type specimen', a suite of specimens - the hapontotype - representing several stages in the life cycle of a species would be a more useful concept.

Journal Article↗
PubMed1986

Type A behavior, family history of hypertension, and cardiovascular responsivity among black women.

The purpose of this study was to determine the effects of Type A behavior and family history of hypertension on cardiovascular reactivity to mental stress in a group of employed black women. Measures of heart rate and of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken at rest, during a mental arithmetic task, and during the Type A Structured Interview (SI). Results indicated that the Type A behavior pattern was associated with SBP and DBP hyperresponsivity during the SI but not during mental arithmetic. Additionally, certain speech components of the Type A pattern, as well as features of the potential-for-hostility component, were also related to cardiovascular responses during the SI. Family history of hypertension did not influence the cardiovascular parameters either alone or in combination with Type A behavior. The results suggest that many of the cardiovascular response characteristics of the Type A pattern that have been observed in predominantly white samples also hold true for blacks. Replication of these findings with other subgroups of blacks, such as young females and middle-aged males, will help document the generality of these findings within the black population.

Adult↗
PubMed1986

Packed cell volume of blood from male domestic chicks.

The packed cell volumes of blood from healthy chicks of domesticated fowl were required for studies on avian malaria and data were specially generated under standardised conditions. The mean packed erythrocyte volume for chicks 15 to 43 d old (34 males of two egg laying breeds) was 28.7% (range 23 to 39%). The 95% confidence limits for a single reading in a healthy chick were 24.6 to 32.9%. Therefore, a value of less than or equal to 24% is regarded as subnormal and a value of greater than or equal to 33% is regarded as supranormal when readings are taken to the nearest 1%.

Animals↗
PubMed1986

Paroxysmal atrial fibrillation in racehorses.

The paper describes five cases of atrial fibrillation detected after racing. In four of them, the arrhythmia disappeared spontaneously within 24 h and they were regarded as paroxysmal in type. In the fifth case, which won its race, the arrhythmia persisted for at least 45 h after racing. It was therefore regarded as an example of persistent atrial fibrillation. It was then treated with quinidine sulphate which restored sinus rhythm. It would seem that paroxysmal atrial fibrillation may be a cause of sudden decrease in racing performance.

Animals↗