Search PubMed⌕ Search

Biomedical subjects

S J Williams

Publications and source records attributed to S J Williams.

At least 127 records · Page 7Linked to original sources
PubMed1982

Evaluation of ocular irritancy potential: intralaboratory variability and effect of dosage volume.

A series of 7 compounds was evaluated for ocular irritancy potential in the rabbit eye when applied at volumes of 100 microliters (1 material) or 10 microliters (7 materials). All of the materials had been rated for ocular irritancy in previous tests and ranged in efficacy from mild to corrosive. Eyes were examined by two independent readers for up to 21 days post-dosing and evaluated by the Draize system. Only differences among rabbits were found to contribute to the observed variability of the scores obtained. Also, a dose-effect relationship was clearly discernable in terms of both duration of effect and maximal score. When these materials were tested at 10 microliters, the rank correlation of severity was not changed. Therefore, reducing the volume of test material instilled into the rabbit eye moderates the response without compromising test sensitivity.

Animals↗
PubMed1981

The United States Veterans Administration health care system as a model of regionalization.

The regionalization of health services is fundamentally based on a system of allocation of resources. The VA appears to have adopted the philosophies of regionalization by forming a network of 28 medical care districts that share the system budgeting responsibility. This approach tends to ignore population aspects, specifically: the needs of the veterans, the interplay of medical school affiliation, the internal effects of incentives for high inpatient censuses, the effect of district leadership. A fourfold research plan is suggested, including an intense investigation of (1) the veteran population, (2) the decision-making process in resource allocation, (3) the relationship of the Va to its environment, especially the health care structure of the communities where facilities operate, and (4) the problems associated with health delivery planning and resource allocation in general.

Cost Allocation↗
PubMed1981

Comparison of inhaled and intravenous terbutaline in acute severe asthma.

In patients with acute severe asthma, 5 mg of terbutaline by inhalation and 500 microgram intravenously in divided doses both produced equally effective but not maximal bronchodilatation. There was no difference in the production of side-effects. These results support the view that inhaled therapy can be as effective in patients with acute severe asthma as injected treatment. In view of the risks of intravenous treatment, especially using high doses, inhaled bronchodilator therapy would seem advisable as initial treatment.

Acute Disease↗
PubMed1981

Comparison of intravenous and inhaled terbutaline in the treatment of asthma.

In a double-blind crossover controlled study, intravenous (IV) or nebulized terbutaline was given to eight patients with moderately severe asthma on two separate days. Four incremental doses of terbutaline were given by each route to establish a maximal effect. Both routes of administration produced significant increases increases in FEV1, FVC, PEFR, MEF50% single-breath TLC, and effective pulmonary blood flow. A decrease in slope of alveolar argon plateau was observed with both routes, but helium responsiveness showed variable changes with no significant or consistent effect seen. There was no significant difference between responses to incremental doses and maximal response apart from pulse rate, which rose during IV treatment. These results showed that the IV route had no advantage in terms of effectiveness or site of action over the inhaled route. Since IV treatment can produce systemic side effects, inhaled bronchodilator therapy should be used as the route of choice.

Adult↗
PubMed1980

Planning and decision making for ambulatory surgery.

There has been rapid growth in the number of ambulatory surgical centers in the United States over the past few years. Yet little research has been done to assist community health planners and surgeons in decision making and planning for ambulatory surgery. In this paper, an analytical framework is developed to assist surgeons in deciding whether to perform a procedure on a ambulatory or an inpatient basis. The Hospital Discharge Survey data collected by the National Center for Health Statistics are also analyzed to investigate their applicability in this analytical framework as well as to aid planners in developing community-wide ambulatory surgery projections. In spite of the limitations on the available data, the models developed here suggest possible future avenues for planning ambulatory surgeries.

Adolescent↗
PubMed1980

Ozone induced alterations in phenol red absorption from the rat lung.

The effect of inhaled ozone (O3) on the integrity of lung transport processes for phenol red has been determined. Phenol red (1, 10, or 100 mumol) was applied intratracheally to rat lungs in vivo and in an isolated lung preparation. In both test systems the rates of removal were found to be similar and to compare favorably with reported values. Animals exposed to O3 for 24 h demonstrated loss of carrier-mediated transport for this ion. The effect was also found to be related to the concentration of O3. These results indicate that the carrier-mediated component of phenol red removal from the airways of the lung may be used as a marker for pulmonary membrane damage resulting from the inhalation of atmospheric toxicants.

Absorption↗
PubMed1980

Regionalization in the Veterans Administration health care system: rhetoric and realities.

Criticisms of the Veterans Administration health care system have centered in part on the ability of the system to reallocate resources in response to the changing needs of veterans. VA hospitals use traditional budgeting and planning processes; new programs and projected increases in workload are added to the previous year's budget to yield the budget for the succeeding year. Since these activities occur on an individual institution bases, there is little effort to plan cooperatively between hospitals or to reassess the fundamental allocation of resources based on veteran needs. Over the past two years, the VA has devised a program of regionalized budgeting and planming. The publicity surrounding VA regionalization reflects the idealized potential of shared resources and joint planning within each of the newly created VA medical districts. The reality of the program, however, when examined on a national basis and illustrated by an in-depth study of five hospitals in one district, indicates that there has been little use of resource allocation methodology and that few planning resources have been allocated to this effort. As a result, the district program is a collation of individual hospital budgets, and plans to yield the district budget and plans. Regionalization is unlikely to succeed in any meaningful manner within the VA unless further changes occur in district resource allocation methods.

Age Factors↗
PubMed1980

How to meet the new demands in ambulatory care.

Faced with increasing pressures to become more competitive, many hospitals are rethinking their ambulatory care services. This article suggests considerations that should be addressed in the organization and design of ambulatory care services and outlines a plan of action for boards and administrations wishing to expand their involvement in ambulatory care.

Ambulatory Care↗
PubMed1980

Paraganglioma of the duodenum: a case report.

Paraganglioma of the duodenum is a tumor which typically occurs in the ampullary region and which has been regarded as benign. This patient, as well as most of the 25 similar cases previously described, presented with upper gastrointestinal bleeding. Diagnosis may be elusive, particularly when a Billroth II anastomosis has been done previously. Careful identification of the ampulla is mandatory to ensure safe excision of the tumor. The possibility of multicentricity in these tumors heightens the necessity of distinguishing them from ampullary carcinoma at operation.

Ampulla of Vater↗
PubMed1979

Mental health services: utilization by low income enrollees in a prepaid group practice plan and in an independent practice plan.

Mental health services were included in a comprehensive package of benefits available to low income enrollees in a prepaid group practice plan (PGP) and in an independent practice plan (IPP) under the Seattle Prepaid Health Care Project. There were no out-of-pocket costs for enrollees. Utilization of services was studied for four years under conditions that might simulate universal entitlement. The analyses indicated that females used substantially more mental health services than males and that enrollees aged 20-44 used more services than those in other age groups. The prepaid group practice generally experienced higher utilization than the prepaid independent plan. Significant racial differences were evident with whites using more services than blacks and black males using strikingly few services. The prepaid independent plan was oriented toward physician providers and emphasized individual psychotherapy while the prepaid group practice employed a diversity of practitioners and therapeutic modalities. The data indicated that the per cent of enrollees using any mental health services was twice as great in the PGP as in the IPP. However, once access to the provider system was achieved, the number of services utilized was greater in the PGP. Inpatient services were also examined. A significantly higher proportion of IPP enrollees were admitted for inpatient care as compared to PGP enrollees. Finally, the cost of mental health services was less than ten per cent of total health service costs in both plans.

Adolescent↗