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Biomedical subjects

W W Williams

Publications and source records attributed to W W Williams.

At least 91 records · Page 5Linked to original sources
PubMed1982

Piperacillin v Carbenicillin in the therapy for serious infections.

One hundred seven patients were treated with either piperacillin (56) or carbenicillin (51) in an open randomized trial of hospitalized patients with pleuropulmonary (40), urinary tract (26), gynecologic (21), skin and soft-tissue (eight), joint (five), bone (three), and miscellaneous other infections (four). Patients with urinary tract infections were given 150 mg/kg/day of piperacillin sodium or 200 mg/kg/day or carbenicillin sodium in divided doses every six hours intravenously. Patients with other infections were given 250 mg/kg/day of piperacillin sodium and 450 mg/kg/day of carbenicillin sodium; 53/56 (95%) patients treated with piperacillin and 45/51 (88%) patients treated with carbenicillin were cured clinically. In general, the drugs were well tolerated. There were, however, more adverse experiences in the groups taking carbenicillin. Of special interest was the finding of liver function test abnormalities in 17/78 (21%) carbenicillin recipients (evaluative and nonevaluative cases). We concluded that piperacillin was effective and safe. It has potential for use in a great variety of infections.

Adult↗
PubMed1979

Border disease: a sequential study of surviving lambs and an assessment of its effect on profitability.

Pregnant Dorset horn gimmers inoculated with a non-cytopathic strain of the border disease virus produced "hairy shaker" lambs that were individually affected to a varying degree. Surviving lambs were observed for a period of up to 20 weeks when neurological signs were seen to gradually disappear. During this time live virus was isolated from a wide variety of sites in nearly all of the infected lambs. The infected animals grew at a significantly slower rate compared with the controls, particularly during the first 15 weeks. Several morphological defects are described the most consistent being the decreased weight of the central nervous system. By 20 weeks body-weights were about 20 per cent lower and carcase quality scores were reduced. An assessment is made of the economic losses attributable to BD taking into consideration carcase quality at 20 weeks and the perinatal losses.

Animals↗
PubMedDate not supplied

Rapid activation of the alternative pathway of complement by extracorporeal membrane oxygenation.

Extracorporeal membrane oxygenation (ECMO) is an effective therapy for patients with severe respiratory distress syndromes. However, an inflammatory response has been observed with the use of this therapy. We measured complement activation in vivo in two adults receiving ECMO for acute respiratory distress syndrome (ARDS). Production of complement activation fragments C4d, Bb, iC3b, and SC5b-9 was determined using commercial ELISA kits. In both patients there was intense activation of complement that peaked 1 hour (mean SC5b-9 increase to 1135% of baseline) after the start of ECMO and occurred predominantly via the alternative pathway (Bb production). Early and acute complement activation may be responsible for the initiation of the inflammatory response that has been observed in patients treated with ECMO.

Adult↗
PubMedDate not supplied

Infection control during parenteral nutrition therapy.

Parenteral nutrition therapy can achieve an anabolic state in patients who are unable to maintain normal nitrogen balance; however, it may be associated with infectious complications. Infections may be related to contamination of the cannula and the cannula wound, of the infusate, or of other parts of the parenteral nutrition system. A variety of microorganisms has been associated with these infections. The exact mechanisms that initiate cannula-related infection are poorly understood. Susceptibility of the host, the method and site of cannula insertion, colonization of parenteral nutrition cannulas, use of parenteral nutrition systems for multiple purposes, cannula material, and other factors may all play some role. Controlling infections depend on many factors, including quality control processes to ensure sterility of parenteral nutrition solutions, attention to aseptic technique during cannula insertion, procedures to prevent in-use contamination, proper care of the cannula insertion site, and proper management of other parts of the parenteral nutrition system. In addition, infectious complications appear to be reduced by an organized team that follows infection control protocols. Many facets of parenteral nutrition therapy are based on data from uncontrolled clinical investigations. Well-designed, controlled clinical trials may provide data that will further minimize the risks associated with parenteral nutrition therapy.

Acinetobacter↗
PubMedDate not supplied

Hepatitis B vaccination programs for health care personnel in U.S. hospitals.

A random sample of 232 U.S. hospitals was surveyed. Of those hospitals, 75 percent had hepatitis B vaccination programs. The presence of a program was associated with hospital size (60 percent of those with 100 beds, 75 percent with 100-499 beds, 90 percent with 500 or more beds; P = 0.0013) and hospital location (urban 86 percent; rural 57 percent; P less than 0.001). The frequency of needlestick exposures per month among hospital personnel and hospital location were directly related to and best predicted the existence of hepatitis B vaccination programs. All hospitals with programs offered vaccine to high-risk personnel (as defined by the hospital). Seventy-seven percent of hospitals paid all costs for vaccinating high-risk personnel; 19 percent paid for any employee to be vaccinated regardless of risk status. Forty-six percent of hospitals with programs were estimated to have vaccinated more than 10 percent of all eligible personnel, and 13 percent to have vaccinated more than 25 percent of eligible personnel. The highest compliance rates were associated with hospitals paying for the vaccine and requiring vaccination of high-risk personnel. Fifty-four percent of hospitals attributed noncompliance to concern regarding vaccine safety and effectiveness. The reasons why there was no vaccination program in 58 hospitals were (a) low incidence of hepatitis B virus infections among personnel, (b) cost of vaccine, and (c) vaccination being offered as part of a needlestick protocol. Full utilization of hepatitis B vaccine could eliminate the occupational hazard that hepatitis B virus presents to health care personnel.

Economics, Hospital↗