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Biomedical subjects

S Williamson

Publications and source records attributed to S Williamson.

125 records · Page 7Linked to original sources
PubMed1978

Organisation of bank of raw and pasteurised human milk for neonatal intensive care.

In 1976 a human-milk bank was established at King's College Hospital to serve the neonatal intensive care unit. The bank is staffed by two part-time nurses, who interview prospective donors, organise collections, prepare samples for bacteriological screening, and process the milk. On average 25 litres a month may be collected from about 15 donors, of which at least two-thirds is free enough of bacteria to be fed raw (unheated) to sick and low-birth-weight infants. Most of the remainder may be used after holder pasteurisation. The bank provides an adequate supply of milk of consistent nutritional quality and permits a more informed approach to the dietary management of infants of low birth weight.

Costs and Cost Analysis↗
PubMed1978

Effect of heat treatment of human milk on absorption of nitrogen, fat, sodium, calcium, and phosphorus by preterm infants.

Seven very low birthweight (less than 1.3 kg) preterm infants, aged between 3 and 6 weeks were fed raw, pasteurised, and boiled human milk for 3 consecutive weeks. Serial metabolic balance techniques were used to assess the absorption and retention of calcium, phosphorous, sodium, and nitrogen, and the absorption of fat. Fat absorption was reduced by approximately one-third when raw milk was heated. It is suggested that the improved fat absorption from the raw milk may be related to the preservation of milk lipases. A reduction in the amount of N retained was also noted when the infants were fed boiled milk. There were no obvious differences in the absorption of N or the absorption and retention of Ca, P, and Na between the three milks. All infants gained weight most rapidly during the week in which they were fed raw milk. The mean weight gain during this time was approximately one-third greater than that during similar periods when pasteurised or boiled milk was administered

Body Weight↗
PubMed1975

Hydrocephalus.

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

Effect of angiotensin-converting-enzyme (ACE) inhibitor trandolapril on human diabetic neuropathy: randomised double-blind controlled trial.

BACKGROUND: Diabetes is a common cause of polyneuropathy. The development and progression of nephropathy, retinopathy, and neuropathy are closely related. Angiotensin-converting enzyme (ACE) inhibitors delay progression of both nephropathy and retinopathy. We investigated the effect of ACE inhibition on diabetic neuropathy. METHODS: We recruited 41 normotensive patients with type I or type II diabetes and mild neuropathy into a randomised double-blind placebo-controlled trial. Changes in the neuropathy symptom and deficit scores, vibration-perception threshold, peripheral-nerve electrophysiology, and cardiovascular autonomic function, were assessed at 6 and 12 months. The primary endpoint was the change in peroneal nerve motor conduction velocity. FINDINGS: We found no significant difference at baseline for age, HbA1c, blood pressure, or severity of neuropathy between two groups. There was no change in HbA1c over the treatment period. Peroneal motor nerve conduction velocity (p=0.03) and M-wave amplitude (p=0.03) increased, and the F-wave latency (p=0.03) decreased and sural nerve action potential amplitude increased (p=0.04) significantly after 12 months of treatment with trandolapril compared with placebo. Vibration-perception threshold, autonomic function, and the neuropathy symptom and deficit score showed no improvement in either group. INTERPRETATION: The ACE inhibitor trandolapril may improve peripheral neuropathy in normotensive patients with diabetes. Larger clinical trials are needed to confirm these data before changes to clinical practice can be advocated.

Adult↗
PubMedDate not supplied

Phase II trial of edatrexate in relapsed or refractory germ cell tumors: a Southwest Oncology Group study (SWOG 9124).

Up to 30% of patients with advanced germ cell tumors will fail induction chemotherapy or will relapse. New agents with activity in this still potentially curable subgroup of patients are needed. Edatrexate (10-ethyl, 10-deaza-aminopterin) is a methotrexate analogue that has preclinical and clinical activity in breast, lung, and head and neck cancers, as well as in non-Hodgkin's lymphomas. A phase II trial of edatrexate in relapsed or refractory malignant germ cell tumors was conducted by the Southwest Oncology Group (SWOG). Twenty-five patients were enrolled in the trial. Edatrexate was administered intravenously at a dose of 80 mg/m2 weekly for four weeks followed by a one-week rest period. The treatment course was repeated every five weeks. Among the 23 patients evaluable for response, there were no objective responses with all patients developing progressive disease. Thirteen patients (56%) developed Grade 3-4 toxicities, predominantly stomatitis and malaise/fatigue/lethargy. One patient developed Grade 4 anemia while another developed grade 4 anemia and thrombocytopenia. No patients discontinued treatment due to toxicity nor were there any toxic deaths. Edatrexate administered in this dose and schedule has no antitumor activity and has substantial toxicity in patients with relapsed or refractory germ cell tumors.

Adolescent↗
PubMedDate not supplied

Factors in the intestinal absorption of oral cholecystopaques.

Interest in the pharmacokinetics of cholecystopaques initially centered on transport from blood to bile. The data obtained in this effort have been valuable and have shown that the maximal iodine concentration achievable in the bile is quite similar for all of the currently available compounds. This concentration is, of course, dose dependent. the transport of contrast material from the bowel to the blood has been shown to be quite variable. Considerable progress was made in understanding this. The tremendous differences in absorption of iopanoic acid depending upon the pH of the administered solution was an initial revelation. The development of the concept that there is a water layer through which the cholecystopaque must pass before reaching the lipid membrane of the intestinal cell has added clarity to understanding the difference in absorption between water-soluble and water-insoluble cholecystopaques. A complete knowledge of what might enhance or inhibit absorption is not known. There is beginning to be an understanding of how intestinal dose relates to plasma levels. This should lead to an optimal dose-timing scheme for each cholecystopaque. The basic assumption is that the highest iodine concentration in the gallbladder leads to the most accurate cholecystography. If this is true, the gallbladder needs to be offered bile at the maximum concentrations during the period preceding filming. To accomplish this, the appropriate plasma level necessary for maximum excretion is needed. Experimental data suggest that our current clinical methods in regard to dose and dose timing need revision to optimize cholecystography. This revision needs to take place with a careful look at toxicity. Accepting the present premise that oral cholecystography can be improved, perhaps without a significant increase in morbidity, a fundamental question to be asked is: is it worth it?

Animals↗
PubMedDate not supplied

Harnessing IT systems to support patient care: good practice.

The incorporation of information management and technology into healthcare environments has long been advocated, but resistance from clinicians and perceived financial constraints have laboured its successful implementation in many trusts. This article looks at the reasons behind these problems and highlights the benefits to patients of effective use of information technology in the delivery and documentation of patient care.

Benchmarking↗
PubMedDate not supplied

The caudal regression syndrome in infants of diabetic mothers.

Ultrasonography as part of the pre-natal diagnosis in high risk pregnancies may detect a number of fetal malformations that need to be re-evaluated for continuation or termination of pregnancy. Two fetuses, in two different patients with diabetes mellitus, were found to have significant intrauterine malformations detected by ultrasonography at 18 and 20 weeks gestational age, respectively. Post-mortem examination on both fetuses demonstrated the findings known as the caudal regression syndrome. The clinico-pathological features and obstetrical management of diabetic mothers whose pregnancies are complicated with this rare malformation are discussed.

Abnormalities, Multiple↗
PubMedDate not supplied

Computerization of a nursing financial management system using continuous quality improvement as a framework.

The Nursing Financial Management System, developed by the Department of Nursing Administrative Services (DNAS), depended on a manual data-retrieval and report process to integrate patient acuity, nursing resource, and hospital financial data. Manual processes proved to be extremely labor-intensive and cost inefficient. Approximately 52% of DNAS resources, totaling $45,542 annually, were dedicated to data re-entry functions and report generation. Additionally, time required to produce manual reports created a service gap in that delays caused inefficient management of nursing resources at the unit level. The DNAS used a continuous quality improvement framework to improve data management by automating data retrieval and report generation. Computerization increased department staff productivity with subsequent labor cost savings/avoidance. After computerization, the report process consumed 6% of department labor resources compared with 52% using the manual process. Redistribution of DNAS resources prevented hiring additional staff to manage expanding workload. Finally, timely reporting to unit management resulted in significant reduction in hospital costs, because nursing resource use was matched with patient care demands.

Computer Communication Networks↗