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Biomedical subjects

T Williams

Publications and source records attributed to T Williams.

At least 289 records · Page 16Linked to original sources
PubMed1984

Modifying delivery technique of fenoterol from a metered dose inhaler.

Twenty-eight outpatients with bronchial asthma inhaled one puff of fenoterol hydrobromide (200 mcg) from a metered dose inhaler, either held in three different mouth positions or from three different starting lung volumes. Inhaling bronchodilator with closed mouth was significantly less effective than when the mouth was open, or when the inhaler was four cm from the open mouth. Inspiration of drug beginning from 75% of vital capacity resulted in better bronchodilation than starting at residual volume. Patients are likely to obtain maximum benefit from metered dose inhalers when the mouth is open and the inspiratory volume is small.

Aerosols↗
PubMed1984

Formation of tubuloreticular inclusions in human lymphoma cells compared to the induction of 2'-5'-oligoadenylate synthetase by leucocyte interferon in dose-effect and kinetic studies.

Exposure of human lymphoblastoid cell cultures to leukocyte interferon initiated the formation of membranous tubuloreticular inclusions (TRI) within the endoplasmic reticulum or perinuclear envelope. In four different cell lines originating from patients with lymphocytic cancers (Daudi, Raji, H-SB2, and SB), this unique ultrastructural effect displayed a log-linear relationship to increasing doses of interferon-alpha and was dose and time dependent. TRI morphogenesis began within 12 hr in Daudi or Raji cells exposed continuously to 500 IU of leukocyte interferon/ml, but only at 20 hr after 2- to 4-hr pulse exposures to 50 to 100 IU/ml. The TRI accumulation, determined by thin-section counts, reached maximal levels of up to 16% of cell sections within 48 to 72 hr. Experiments with Raji cells indicated a decrease in TRI formation during successive cell divisions; detection of TRI after a pulse of interferon was enhanced when DNA replication was arrested. TRI morphogenesis appeared to be independent of several other known biological actions of interferons. It manifested later than the induction of 2'-5'-oligoadenylate synthetase activity which has been correlated with establishment of the antiviral state and occurred in cell lines, including DaudiKIFNR, which resist the growth-inhibitory effects of leukocyte interferon. Participation of new polypeptide synthesis was indicated by experiments with inhibitors of transcription (actinomycin D) or translation (cycloheximide): TRI morphogenesis was blocked when actinomycin D was added 4 hr after interferon and was reduced when cycloheximide was added for the interval of 13 to 23 hr after interferon.

2',5'-Oligoadenylate Synthetase↗
PubMed1983

Effects of dietary manipulation on vascular status of patients with peripheral vascular disease.

In a one-year, double-blind clinical trial, 45 patients with peripheral vascular disease (PVD) were randomly assigned to either the American Heart Association Hyperlipidemia Diet C (n = 20) or a low-fat, high-fiber, complex carbohydrate diet similar to the Pritikin Maintenance Diet (n = 25). Vascular status and blood lipid levels were monitored at 0, 2, 4, 6, and 12 months. Walking distance increased significantly in both groups, with no difference between groups. No vascular parameters changed significantly, suggesting that increased walking distance was due to improved metabolic capacity of the muscle. A trend toward lower blood lipid values was observed, with no significant differences within or between groups. We conclude that while patients with PVD benefit from a program of diet and exercise, there is no apparent advantage to the more difficult complex carbohydrate diet.

Aged↗
PubMed1983

Oligohydramnios: clinical associations and predictive value for intrauterine growth retardation.

Intrauterine growth retardation (IUGR) is difficult to diagnose before birth. Sonographically diagnosed oligohydramnios has been reported to be highly sensitive and reliable in detecting IUGR in carefully prescreened patients. To evaluate the clinical associations of oligohydramnios and its usefulness as a method of antenatal screening for IUGR on a large obstetric service, the consecutive ultrasound examinations of 2,453 viable singleton pregnancies with intact membranes were surveyed. The 96 (3.9%) pregnancies found to be complicated by oligohydramnios were compared with 96 with the same biparietal diameters, but with normal volumes of amniotic fluid. Mothers with oligohydramnios were younger, of lower parity, and at increased clinical risk for IUGR. Of 96 infants from oligohydramnios-complicated pregnancies, 38 (40%) were small for gestational age (SGA), compared with eight (8%) infants from pregnancies without oligohydramnios. Of 46 SGA births, 38 (83%) were preceded by sonographically diagnosed oligohydramnios (p less than 0.0001). IUGR associated with oligohydramnios tended to occur in young hypertensive gravid women, whereas non-oligohydramnios-associated IUGR tended to occur in gravid women with low prepregnancy weight. With correction for the incidences of oligohydramnios and IUGR in the unselected population, it is shown that four in 10 cases of oligohydramnios would result in SGA births (40% predictive value of an abnormal test), but that only 16% of SGA births would be preceded by sonographically diagnosed oligohydramnios. Eighty-four percent of the cases would be missed. These results suggest that, although the presence of oligohydramnios should increase the clinician's index of suspicion for IUGR, routine sonographic screening to detect oligohydramnios is not warranted.

Adolescent↗
PubMed1983

Is weighing babies in clinics worth while?

An appraisal of the widely implemented clinic practice of weighing babies to monitor their physical well being showed that these weighing practices are often inadequately administered through faulty weighing techniques, insufficient use of centile charts, and misunderstanding of normal variations in, and nutritional influences on, early weight gain. If measurements of weight are accurate and the counts of weight gain plotted on centile charts and the resulting profile sensibly interpreted it becomes a valuable method of monitoring health. Possibly the greatest benefit is that the mothers have the opportunity to discuss any anxieties about the baby's health.

Aging↗
PubMed1983

Clostridium difficile and inflammatory bowel disease.

Stools from 109 patients with inflammatory bowel disease (13.4%) contained Clostridium difficile or its toxin, an incidence similar to the stools of 99 control patients with diarrhoea (11.9%), but significantly higher than the stools of 77 control patients with a normal bowel habit (1.4%). Sixty-six per cent of the diarrhoea controls, but only 11% of the inflammatory bowel disease patients, reported recent antibiotic use: however, 67% of inflammatory bowel disease patients were taking sulphasalazine. The presence of Cl difficile in the stool was not related to the clinical assessment of inflammatory bowel disease relapse, but it was related to hospital admission. During the one year study, 31 of the 109 patients (28%) with inflammatory bowel disease had one or more stool samples that were positive for Cl difficile.

Anti-Bacterial Agents↗
PubMed1983

Marketing to nurses through an incentive program.

Attracting and retaining nursing staff is described as a marketing problem in this article. Nurse administrators can market their institutions to current and potential employees as desirable employers. The nurses in turn present a favorable image of the institution to the community at large if they are satisfied with their jobs. A vehicle to accomplish this task of marketing is the Incentive Career Mobility Plan. Implemented a year ago as a pilot project, this incentive program is achieving its goal of improving employee morale and retention by rewarding self-improvement.

Career Mobility↗
PubMed1982

Fibrosing alveolitis, bronchiolitis obliterans, and sulfasalazine therapy.

A patient with ulcerative colitis had extensive upper zone pulmonary disease while taking sulfasalazine. Pulmonary function tests showed progressive restrictive and obstructive disease. Lung biopsy showed bronchiolitis obliterans and chronic interstitial pneumonia or fibrosing alveolitis with a mild eosinophilic infiltrate. The patient improved after receiving steroid therapy. A review of the literature of lung disease related to ulcerative colitis and sulfasalazine is presented.

Aged↗
PubMed1982

Meeting the challenge of research in family medicine: report of The Study Group on Family Medicine Research.

The challenge of research in family medicine is addressed in this paper by describing the rationale for research, appropriate content areas, resources available, and needs for the future. Family medicine has the opportunity to study health and disease in humans within their natural habitat over long periods of time, and to examine the multiple aspects of personal and family health care delivery. Resources for research include large primary care study populations, practitioner and faculty researchers, and technical support systems. The basic needs for the future are to increase the quantity and quality of researchers and to attract more funds designed for research. It is recommended that family medicine practitioners and teachers support research and participate more actively; that family medicine academic units provide their learners more research curricular time and their faculties more research activity time, and that they develop Family Medicine Research Centers; that family medicine professional organizations raise funds to support research, promote research opportunities for their members, and communicate to others the research activities, resources, and needs of family medicine; and that the requirements for residency training be modified to include elective research opportunities.

Canada↗
PubMed1982

Hydrodynamic and rejection properties of a coil dialyzer.

Compliance of coil dialyzers follows a linear dependence on pressure when measured in saline; compliance measurements with non-wetting fluids are inappropriate and underestimate the blood compartment expansion experienced with pressure. The arithmetic mean of inlet and outlet pressures can be used to predict ultrafiltration rate independent of venous outlet pressure, and blood compartment volume varies both with inlet pressure and blood flow. The rejection of carbohydrate marker solutes increases from about 10% for 1,200 Daltons to 100% for 12,000 Dalton species.

Compliance↗
PubMed1981

A within-subject comparison of the effects of morphine on lateral hypothalamic and central gray self-stimulation.

The effects of chronic administration of morphine (20 mg/kg) on self-stimulation (SS) of the central gray and lateral hypothalamus were investigated in a within-subject design. The magnitude and time course of the drug-produced changes in SS at the two placements were similar within subjects but varied substantially across subjects. These results are interpreted in the light of evidence pertaining to the anatomical linkage of the substrates for the rewarding effects of central gray and lateral hypothalamic stimulation. The facilitation of SS may be due to a drug-produced sensitization of reward-related neurons. If so, morphine acts either beyond the point of convergence of the two substrates or at an earlier stage in each substrate. The across-subject variability is attributed to individual differences in sensitivity to the effects of the drug. The importance of controlling for this subject variable is stressed.

Animals↗
PubMed1981

The diagnosis of pleural effusions by fiberoptic bronchoscopy and pleuroscopy.

Fiberoptic bronchoscopy was carried out in 28 patients with an undiagnosed pleural effusion. In four patients, the diagnosis was made by this examination. Three patients had bronchial carcinomas, and one had tuberculosis. None of these four patients had roentgenographic evidence of pulmonary infiltrates, atelectasis, or mass lesions. Pleuroscopic examination was performed in 14 patients with the fiberoptic bronchoscope. The diagnosis was made in three. Prior nondiagnostic blind needle biopsy had been carried out in 11 patients and in all three diagnosed by pleuroscopy. Two patients had metastatic carcinoma of the pleural and one tuberculosis. Of 12 patients with effusions and positive Mantoux tests who had no other evidence of tuberculosis, none had clinical evidence of the disease during the period of follow-up. We conclude that bronchoscopic and pleuroscopic examination is of value in the work-up of patients with undiagnosed pleural effusions without roentgenographic evidence of mass lesion or atelectasis.

Adult↗
PubMed1981

Pharmacokinetic comparison of intravenous and oral chloramphenicol in patients with Haemophilus influenzae meningitis.

The pharmacokinetics of chloramphenicol following intravenous and oral administration were studied in 14 infants with Haemophilus influenzae meningitis. Following five days of treatment with intravenous chloramphenicol (100 mg/kg/day every six hours), oral chloramphenicol was substituted at the same dose. Multiple serum levels of chloramphenicol were determined after an intravenous dose on day 4 and after an oral dose on day 10. CSF levels were measured six hours after intravenous or oral chloramphenicol dose on those days (CSF trough). Following intravenous administration, the mean peak serum level of 15.0 micrograms/ml was reached at 45 minutes. In comparison, after oral chloramphenicol in the same dosage, the mean peak serum level of 18.5 micrograms/ml was achieved at two to three hours. The mean serum half-life of the drug (6.5 hours) was significantly longer after oral administration than after intravenous chloramphenicol (4.0 hours) (P less than .001). The increased serum half-life following orally administered chloramphenicol was occasionally associated with drug accumulation. In addition, mean trough CSF levels were somewhat higher when the patient received oral medication (6.6 micrograms/ml) compared to intravenous administration (4.2 micrograms/ml) (P less than .001). For any treatment regimen for H influenzae meningitis that includes a period of oral chloramphenicol therapy the patient should be hospitalized to ensure compliance. Because of the wide range of individual variation in serum half-life that may result in accumulation, periodic monitoring of serum chloramphenicol levels is also recommended.

Administration, Oral↗
PubMed1980

Resistance and recovery studies on ultraviolet-irradiated spores of Bacillus pumilus.

A spore suspension model and a procedure for recovering ultraviolet (UV)-irradiated spores of Bacillus pumilus were investigated. A most-probable-number tube dilution method using double-strength Trypticase soy broth was found to be superior to the agar plate method for recovering optimal numbers of spores irradiated with sublethal doses of UV energy. Aqueous suspensions of B. pumilus survived UV doses up to 108,000 ergs/mm2 as determined by a most-probable-number recovery and estimation procedure. Resistance and stability data were consistent and reproducible, indicating the dependability of this method for recovering UV-damaged spores. The procedures used to collect information concerning resistance characteristics for two strains of B. pumilus are discussed.

Bacillus↗