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Biomedical subjects

S Willis

Publications and source records attributed to S Willis.

87 records · Page 5Linked to original sources
PubMed1989

Seroprevalence of human immunodeficiency virus infection in a prenatal population at high risk for HIV infection.

To determine the seroprevalence of human immunodeficiency virus infection in prenatal patients at high risk for HIV infection we tested 513 women from December 1985 through July 1987 at an inner-city hospital in Atlanta, Georgia. Demographic and HIV risk information was collected from all seropositive women. Twenty-nine (6%) of the 513 women tested were positive for HIV on enzyme-linked immunosorbent assay and Western blot analysis. Twenty-six (90%) of seropositive women gave a history of intravenous drug use. Two (7%) had sexual partners known to have AIDS or AIDS-related complex (ARC), and one (3%) was Haitian. Seropositive women were at remarkable risk for other sexually transmitted diseases. The majority of pregnancies ended in term births. This serosurvey defines an obstetric population with a high seroprevalence, and has stimulated us to institute routine voluntary antepartum screening for HIV.

Adolescent↗
PubMed1989

Management of oesophageal stenosis in epidermolysis bullosa dystrophica.

Seven patients with epidermolysis bullosa dystrophica and chronic and recurrent oesophageal lesions such as spasm, strictures, and complete occlusion were studied. Dysphagia could be cured with drugs if it was caused by bullae formation or spasm. If oesophageal strictures were present, endoscopy and bouginage with corticosteroid prophylaxis during the quiescent phase of the disease was a safe and useful procedure. We have also given corticosteroids, which reduced the oedema caused by bullae formation and oral phenytoin, which reduced epithelial detachment by inhibiting collagenase activity. Verapamil counteracted oesophageal spasm and pureed food during periods of dysphagia reduced blistering of the upper oesophagus.

Adolescent↗
PubMed1989

Routine antepartum human immunodeficiency virus infection screening in an inner-city population.

Human immunodeficiency virus (HIV) infection occurs disproportionately among inner-city minority women of reproductive age. Once pregnant, these women have a high risk of delivering infants with perinatally acquired infection. Identification and counseling of HIV-infected parturients may be an effective means of preventing perinatal HIV infection. Few data are available on the seroprevalence of HIV infection in the inner-city population or on the clinical and demographic determinants of risk. To better characterize HIV infection in inner-city parturients in Atlanta, we conducted routine antepartum screening for HIV antibody in 3472 women. Ten (2.8 per 1000) were seropositive on enzyme-linked immunosorbent assay (ELISA) and Western blot testing. Four women were seropositive on repeat ELISA but negative on Western blot. Four infected women had had heterosexual contact with a person at risk for HIV, three were intravenous drug users, one had possibly become infected via blood transfusion, and two had no apparent risk factors. Seven of the seropositive women had no self-identified risk factors and would not have been identified if screening had been performed using current Centers for Disease Control criteria. Ten percent of the women screened had self-identified risk factors for HIV infection and were seronegative. Ninety-six percent of women consented to HIV testing. These data suggest that inner-city parturients in Atlanta are at risk for HIV infection and that routine antepartum HIV screening can be performed provided the appropriate multidisciplinary team is in place for counseling and follow-up.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Primary gastric lymphoma. Problems in staging and management.

A retrospective review of 28 patients with primary gastric lymphoma was performed to determine the optimal treatment modality. The presenting signs and symptoms resembled peptic ulcer disease or gastric carcinomas. The majority of the lymphomas were of the diffuse histiocytic subtype. There was a 75 percent resectability rate in those patients operated on. Palliative resection produced a 5 year duration of survival of 28 percent and curative resection, 43 percent. Eighteen patients underwent a subtotal gastrectomy, and a total of 10 patients presented with stage I disease. The longest median duration of survival at last follow-up was 32 months for patients with stage IB disease compared with a median duration of survival of 8 months for those with stage III disease. Adjuvant radiotherapy and chemotherapy may improve survival after a curative resection is performed if there is serosal penetration or nodal involvement.

Adult↗
PubMedDate not supplied

Omega-conotoxin GVIA specifically blocks neuronal mechanisms in rat ileum.

Omega Conotoxin is a peptide venom of the marine snail Conus geographus which has been postulated as a neural specific calcium channel blocker in several systems. In the present study in rat ileum strips omega-conotoxin GVIA specifically blocked neuronal responses evoked by electrical field stimulation in a dose-dependent manner, but did not block responses induced by carbachol or direct depolarization with KCl. On the other hand the dyhydropyridine calcium channel blocker nitrendipine (10(-7) M) showed no specificity and blocked electrical field stimulation as well as carbachol- and KCl-induced contractions. This indicates that contractions of intestinal smooth muscle which can be blocked by dihydropyridine calcium channel blockers or Ca2+-free medium are not reduced by the neurotoxin omega-conotoxin. Omega-conotoxin caused even a little increase of the responses elicited by depolarisation with KCL. Omega-conotoxin blocked however neural mediated contractions which might suggest that it interacts with a distinct neuronal calcium channel and, in addition to tetrodotoxin, could provide a useful pharmacological tool to discriminate between muscular and neural sites of action of excitatory or inhibitory agents.

Animals↗
PubMedDate not supplied

Does botulinum type-A toxin affect motor activity after proctocolectomy and ileal pouch-anal anastomosis? An experimental study in dogs.

AIM OF THE STUDY: The use of anticholinergic drugs has provided a useful therapeutic approach to reduce stool frequency in patients with proctocolectomy and ileal pouch-anal anastomosis (IPAA). Botulinum type-A (BTA) toxin has been shown to specifically block acetylcholine release in the intestinal wall. Therefore this study investigated the effect of BTA on small intestinal and J-pouch motility after IPAA. MATERIAL AND METHODS: Proctocolectomy and IPAA were performed in 4 dogs. The motility of the small intestine and the ileal pouch was recorded by serosal electrodes and strain gauge transducers. The intestinal transit time was determined radiologically and pouch compliance was determined manometrically. Multiple measurements were performed before and after endoscopic injection of BTA into the pouch wall. RESULTS: This treatment did not significantly influence stool frequency, intestinal transit time or pouch compliance. Intrinsic pouch motility was characterized by irregular contractions, the amplitudes and frequencies of which remained unchanged after BTA administration. With the exception of lower contraction amplitudes directly proximal to the pouch, there were no significant differences in the characteristics of the migrating myoelectric complex or in the fed pattern of the small intestine and ileal pouch. CONCLUSIONS: BTA does not significantly affect ileal pouch motility. The beneficial effects of anticholinergic drugs therefore seem to be due to their multifactorial mode of action and not to the inhibition of cholinergic neurons in the pouch.

Anal Canal↗
PubMedDate not supplied

Falls in elderly people: is the risk suitably assessed?

Results of the annual screening of people over the age of 75 years were used to determine whether the risk of falling in this age group is adequately assessed. The study group comprised primary healthcare professionals employed within six counties throughout England and Wales. Three per cent of respondents indicated that they use formal risk assessment tools when undertaking screening of people over 75 years. Analysis of the answers provided by these respondents, and of their assessment tools used, indicates that none of the tools are suitable for identifying those people at risk of falling within the home environment. Ninety-seven per cent of respondents indicated that they did not use a formal risk assessment tool for this age group. Analysis of the data provided by these respondents identified that the information gathered did suitably identify those people at risk of falling within the home.

Accidental Falls↗
PubMedDate not supplied

Needle and catheter colonization in pregnant diabetic patients using the continuous subcutaneous insulin infusion pump.

The incidence of bacterial colonization and risk of infection associated with the use of continuous insulin infusion pump (CIIP) was examined in 11 pregnant diabetic patients. All patients received instruction on specific aspects of CIIP and needle insertion technique according to the protocol used in our institution. A total of 220 cultures was performed on the subcutaneous needle and connective tubing. There was no clinical evidence of infection. In conclusion, the risk of infectious cutaneous complications in the pregnant diabetic patient using CIIP is not increased over the nonpregnant diabetic population.

Catheters, Indwelling↗
PubMedDate not supplied

Three top Canadian and personal health concerns of a random sample of Nova Scotian women.

We sought to understand the subjective reports of women's health concerns. A randomly dialled telephone survey was conducted resulting in a sample of 458 women (Caucasian/European = 302, Native/Aboriginal = 81, Black = 75), aged 18-81. Women were asked in an open-ended format to list their three top health concerns for themselves and then for Canadian women. Responses were recorded verbatim and categorized into one of nine mutually exclusive health concern categories. The three main health concerns for Canadian women were: Psychosocial Issues, Other Specific Illnesses, and Cancer. The three most important personal health concerns were Psychosocial Issues, Other Specific Illnesses, and Heart and Related Diseases. Few ethnic differences were noted. Results suggest that it is important to recognize and attempt to alleviate health concerns about stress and depression, which are not usually considered as being major health problems by health care professionals.

Adult↗
PubMedDate not supplied

The metabolism and toxicity of halogenated carbanilides. Biliary metabolites of 3,4,4'-trichlorocarbanilide and 3-trifluoromethyl-4,4'-dichlorocarbanilide in the rat.

In separate experiments, after repeated oral administration of 3,4,4'-trichlorocarbanilide (TCC) and 3-trifluoromethyl-4,4'-dichlorocarbanilide (TFC) to rats, the biliary metabolites of each were isolated and identified. The major TCC biliary metabolite was found to be 2'-hydroxy-TCC. This compound was isolated mainly from the nonconjugated and the glucuronide fractions. Other metabolites present in substantial quantities were 6-hydroxy-TCC and 2',6-dihydroxy-TCC mainly as glucuronides and 3'-hydroxy TCC mainly as the sulfate conjugate. Small amounts of 3',6-dihydroxy-TCC were isolated from each of the fractions. No unchanged TCC was found in the bile. Only traces of other metabolites were found, and no N-hydroxylated products were observed. The major TFC biliary metabolite was the glucuronide conjugate of 2'-hydroxy-TFC. The only other metabolite of TFC was 3'-hydroxy-TFC, which was the predominant metabolite in the sulfate-conjugated fraction.

Animals↗