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Biomedical subjects

S Williams

Publications and source records attributed to S Williams.

At least 685 records · Page 38Linked to original sources
PubMed1985

Motivation.

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Humans↗
PubMed1985

The form and presentation of tuberculosis over a 10-year interval in Leeds.

Over the 10-year period 1973-82 1958 cases of tuberculosis were notified in Leeds (population 728 000). Records were traced for 1673 patients and analysed for age, race, sex, sputum status, site of tuberculosis, route of diagnosis and occupation. These results are presented. The tuberculosis screening service at the Leeds Chest Clinic diagnosed 172 cases of tuberculosis from 13 794 contacts screened and 41 cases from 12 572 newly arrived immigrants representing 10.3% and 2.4% respectively of the cases for whom records could be traced. Of these cases discovered by the tuberculosis screening service 25 were sputum positive. A further 15 cases were diagnosed from 2638 contacts screened by the static Mass Miniature Unit. The cost of the screening service at the Leeds Chest Clinic is estimated to be a minimum of 2000 pounds for every case of tuberculosis diagnosed.

Adolescent↗
PubMed1985

Factors influencing erythrocyte sedimentation in patients with chronic renal failure.

Erythrocyte sedimentation was studied in stable patients with chronic renal failure free of complicating illnesses. The mean (+/- SD) Westergren erythrocyte sedimentation rate was 49 +/- 26 mm/hr in patients not receiving dialysis and 60 +/- 33 mm/hr in patients receiving hemodialysis. Both values are significantly higher than normal. Because anemia accelerates the Westergren determination, we restudied the patients with the zeta sedimentation ratio (ZSR), a method unaffected by hematocrit. In nine patients not receiving dialysis and 49 patients receiving hemodialysis, the ZSR was significantly higher than normal. The ZSR correlated positively with plasma fibrinogen concentration. Recombination experiments showed that the abnormal factor accelerating erythrocyte sedimentation was a constituent of plasma. Thus, erythrocyte sedimentation is accelerated in stable patients with chronic renal failure and a plasma factor, probably fibrinogen, is responsible. An elevated erythrocyte sedimentation rate in this population lacks diagnostic usefulness.

Blood Sedimentation↗
PubMed1985

Celiac axis compression syndrome: factors predicting a favorable outcome.

There is still considerable doubt about the existence of the celiac axis compression syndrome. Asymptomatic compression or narrowing of the celiac artery is common, and it is difficult to understand why some patients have significant symptoms while others have none. One major problem emerges from a study of the literature, in that there is no precise definition of the clinical features of a syndrome. Patients with all kinds of abdominal symptoms and varying psychiatric and medical backgrounds have been included in previous studies. It is not surprising, then, that there is no agreement on whether surgery is ever justified. We reported a small series of 11 patients whose clinical features have been carefully documented. Regression analysis of results suggests that good surgical results can be achieved in selected patients by decompression of the artery and restoration of the normal arterial lumen. Patients likely to benefit are those with epigastric pain related to food or hunger who do not have a galaxy of other unrelated symptoms. It is suggested that these factors be included in subsequent definitions of the celiac axis compression syndrome, so that some uniformity be introduced into the writing and thinking about this confusing problem.

Abdomen↗
PubMed1984

How soon after myocardial infarction should plasma lipid values be assessed?

Because acute myocardial infarction may affect plasma lipid concentrations it is commonly recommended that assessment of these concentrations should be delayed until about three months after the acute event. A study was therefore conducted of fasting plasma lipid concentrations in 58 patients with acute myocardial infarction. Measurements were made during their stay in hospital (days 1, 2, and 9) and three months later. Triglyceride concentrations remained unchanged throughout. Values of total cholesterol, low density lipoprotein, and high density lipoprotein all fell significantly between the first two days and day 9. Total cholesterol and low density lipoprotein also showed significant falls between days 1 and 2. Nevertheless, fasting plasma lipid concentrations showed no significant difference at any time during the first 48 hours from values measured three months later. After the infarction 26 patients changed to eating less fat or less energy, or both. More patients had hypercholesterolaemia in the first 48 hours than at three months. These results suggest that lipid state may be assessed as accurately, and possibly more accurately, during the first 48 hours after acute myocardial infarction than at three months.

Adult↗
PubMed1984

Mammary skin oedema: a new prognostic indicator for breast cancer.

Mammary skin thickening shown on the mammogram was measured in 220 patients with non-inflammatory breast cancer, and the mean skin oedema was derived by taking the mean of five measurements from separate sites on the breast (upper part, lower part, medial part, lateral part, and areola) after subtracting the corresponding figures from the opposite (normal) breast. The prevalence of appreciable oedema (greater than 0.25 mm) was 70% for tumours less than 1 cm and 100% for tumours more than 3 cm in diameter. This measure of oedema correlated positively and significantly with tumour size and lymph node status. In a minimum of 60 months' follow up patients developing recurrence had significantly higher oedema values. The amount of oedema also predicted recurrence better than lymph node status, tumour size, or tumour stage. Oedema and tumour size, information available preoperatively, provide a simple means of assessing prognosis before definitive treatment.

Breast Neoplasms↗
PubMed1984

Risk of breast cancer in women with history of benign disease of the breast.

A consecutive series of 791 women who had attended diagnostic breast clinics during 1967-70 and been found to be free of malignant disease were later traced to determine their subsequent incidence of breast cancer. Of the 770 (97%) successfully traced, 22 had developed breast cancer. Based on data from the Welsh Cancer Registry only eight cases of breast cancer had been expected, so that the excess risk for the group was 2.7. The increased risk occurred in all age groups and in women deemed "essentially normal" as well as in those who had had a pathological abnormality. The risk was increased when epithelial hyperplasia was present. No excess mortality from breast cancer was apparent, but follow up was short. More breast symptoms were experienced and more biopsies performed than expected in this group of women. Women with a past history of benign breast disease have a slightly increased risk of breast cancer. Selective screening of these women, however, may be uneconomic and a cause of groundless anxiety.

Adolescent↗
PubMed1984

The effect of antiarrhythmic agents on myocardial contractility and arrhythmia frequency.

Most patients requiring antiarrhythmic therapy for ventricular arrhythmias have underlying organic heart disease which causes left ventricular dysfunction. Treatment of these patients' arrhythmias requires knowledge of the hemodynamic as well as antiarrhythmic effects of the available agents. These effects may differ during acute and chronic oral therapy. Several of the newer agents and quinidine are very effective in suppressing ventricular ectopic activity, allowing demonstration of drug effect during ambulatory monitoring. The clinical significance of this for prevention of sudden death has yet to be shown. However, prevention of ventricular tachycardia or fibrillation in the electrophysiology laboratory and suppression of ambient ectopy may generally be separate phenomena, as has been demonstrated for amiodarone.

Anti-Arrhythmia Agents↗
PubMed1984

Vertical control as an important ingredient in the treatment of severe sagittal discrepancies.

The control of vertical development, in particular in the maxillary molar region, has often been suggested as a method of implementing sagittal change in treatment of Class II skeletal discrepancies. A group of twenty-eight Italian children in the early mixed-dentitional stage, with increased overjet and distal molar relationship, were treated orthodontically with a combination of a removable maxillary splint and high-pull extraoral traction. While only slight dorsal repositioning of the maxilla could be observed, an effective retardation of the vertical maxillary development was recorded, as well as a pronounced forward displacement of the mandibular symphysis. Distal movement of the maxillary dentition contributed likewise to the elimination of overjet observed clinically. The center of mandibular rotation was evaluated for each patient and displayed a pronounced variation illustrating different responses to the same type of appliance by different patients. The clinical implications of the above findings are discussed, and the necessity for constant appraisal of results during treatment is stressed.

Alveolar Process↗
PubMed1984

A controlled trial of health education in the physician's office.

Screening of 6,144 patients in a general practice clinic to assist physician case-finding uncovered 983 (16%) who were uncontrolled hypertensives. Following physician recommendation, 115 patients volunteered for a controlled trial to test the effectiveness of supplementary strategies to the pharmaceutical management of high blood pressure. A study of nonparticipants indicated that about 7% of the practice population was eligible for cardiovascular health education. One group received a health education program, a second was allocated to self-monitor their blood pressure for 6 months, a third group was allocated to both strategies, and the final group, acting as a control, continued to receive their usual care. Physician monitoring of patients continued for the duration of the study and blood pressures decreased in all patients. The study's most important outcome was the joint reduction of blood pressure and medication strength. These were assessed by a "blind" clinician before and after the interventions according to criteria set out in the "stepped-care" approach to management of high blood pressure. People allocated to a health education program conducted in the doctor's common room did twice as well on this measure as those who were not so educated. Daily self-monitoring of blood pressure for 6 months proved to be too much for the majority of those so instructed. It is concluded that the general practice setting remains an important place for health education to prevent cardiac disease and suggestions are made for incorporating this into everyday practice.

Australia↗
PubMed1984

Human adult endothelial cell growth in culture.

The purpose of the present study was to culture human adult endothelial cells (HAECs) on a long-term basis in the laboratory. Previous inability to accomplish this has been the major impediment to the in vitro study of endothelialization of prosthetic grafts with human cells, a problem of significant clinical relevance. We have been successful in developing a technique that allows HAECs from human adult arteries, veins, and capillaries to proliferate vigorously in culture for up to 80 population doublings. HAECs are grown on a gelatin surface (medium 199 containing 20% fetal calf serum). Heparin and endothelial cell growth factor (ECGF) are required for optimal growth. With this technique, which will be described in detail, over 10(23) HAECs can be produced from each 1 cm2 of vascular tissue. This makes large numbers of HAECs available for high-density seeding on prosthetic grafts prior to implantation. It also permits for the first time with human cells the in vitro study of prosthetic grafts--HAEC interactions and the factors that enhance optimal growth and adherence to prosthetic materials. It is hoped that identification of the factors promoting graft endothelialization in combination with high-density seeding will lower graft thrombogenicity and therefore result in greater graft longevity than has been possible heretofore.

Adult↗