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Biomedical subjects

W Watson

Publications and source records attributed to W Watson.

At least 37 records · Page 2Linked to original sources
PubMed1996

Sucralfate suppresses Helicobacter pylori infection and reduces gastric acid secretion by 50% in patients with duodenal ulcer.

BACKGROUND & AIMS: The mechanism(s) by which sucralfate heals duodenal ulcers remains unclear. The aim of this study was to determine the effect of sucralfate on Helicobacter pylori infection and on the accompanying hypersecretion of gastric acid the infection induces in patients with duodenal ulcer. METHODS: Basal and gastrin-releasing peptide (GRP) stimulated gastrin release and acid secretion. H. pylori density, gastric urease activity, and severity of gastritis were studied in patients with duodenal ulcer who were positive for H. pylori before, during, and after 4 weeks' treatment with sucralfate (2 g twice daily). RESULTS: The density of H. pylori decreased by 70% during sucralfate treatment and returned to the pretreatment level after discontinuation of therapy. This suppression of H. pylori infection was accompanied by an 80% decrease in gastric urease activity. GRP-stimulated plasma gastrin concentrations, GRP-stimulated acid output, and basal acid output all decreased by approximately 50% during sucralfate therapy and returned to pretreatment levels after treatment was discontinued. CONCLUSIONS: These findings indicate that sucralfate markedly suppresses H. pylori infection and the accompanying hypersecretion of acid the infection induces in patients with duodenal ulcer. These effects are likely to be important mechanisms by which the drug promotes duodenal ulcer healing.

Adult↗
PubMed1994

Intravenous torsemide as adjunctive therapy in patients with acute pulmonary edema.

The safety and efficacy of intravenous (i.v.) torsemide as adjunctive therapy for acute cardiogenic pulmonary edema was evaluated. Thirteen patients were treated with i.v. torsemide and six patients, with i.v. furosemide, as a positive control. Doses of torsemide, 20 mg or 40 mg, and furosemide, 40 mg or 80 mg, were administered initially. The dose was titrated as necessary over the next 24 hours. In patients who received i.v. torsemide, median fractional sodium excretion significantly increased from 2.88% (0.04-10.1%) at baseline to 6.76% (0.71-11.6%) at peak (P = 0.0342). Hourly urine volume increased from 134 mL (25-400 mL) to 375 mL (145-790 mL) (P = 0.0034). Torsemide administration resulted in a significant improvement in both pulmonary rales and orthopnea. None of the patients experienced serious adverse events or required withdrawal from the study. These results suggest that i.v. torsemide is an effective and well-tolerated diuretic in patients with acute cardiogenic pulmonary edema.

Acute Disease↗
PubMed1994

Mobilisation of Ph-negative peripheral blood stem cells in CML with idarubicin and cytarabine.

Recent interest in autologous transplantation in chronic myeloid leukaemia (CML) has focused on attempts to select out putatively normal Ph-negative progenitor cells for subsequent reinfusion after high dose therapy. One way in which this may be achieved is by collecting peripheral blood stem cells (PBSCs) during the early regenerative phase following chemotherapy when Ph-negative cells seem to have a short term proliferative advantage. Data now suggest that it is possible to collect Ph-negative (and occasionally PCR negative) progenitor cells in a significant number of CML patients, a proportion of whom will go on to achieve a cytogenetic remission post-autografting. The durability of these remissions and the effect on long term survival remain to be established and at present this form of therapy should be reserved for those unsuitable for allogeneic transplantation who have failed to achieve a major cytogenetic response to interferon-alpha.

Cell Separation↗
PubMed1994

Genograms. Practical tools for family physicians.

A genogram can help a physician integrate a patient's family information into the medical problem-solving process for better patient care. A genogram allows a physician to obtain medical and psychosocial information from a patient easily and, as a result, to have a better understanding of the context of the presenting symptoms.

Conflict, Psychological↗
PubMed1993

Splenectomy predisposes to fungal sepsis through defective phagosome formation.

Postsplenectomy septic sequelae may be fatal, but the mechanisms are unclear. We hypothesized that peritoneal macrophage (PM phi) antimicrobial function is abnormal following splenectomy and that this may predispose to increased mortality from the fungal pathogen Candida albicans. Study 1 (in vivo): female CD-1 mice were randomized into control (C), laparotomy (L), or laparotomy+splenectomy (L + S) and inoculated with C. albicans (10(7) organisms, ip) and were studied for mortality. Study 2 (in vitro): mice were randomized to C, L, or L + S groups. Twenty-four hours later, PM phi were harvested and studied for their antifungal activity, including percentage PM phi ingestion of C. albicans and vacuolar sealing of C. albicans within PM phi, percentage C. albicans killing, and superoxide anion (O2-) generation, the mechanism by which candida are killed. Results showed decreased phagocytosis and killing of C. albicans in the L + S group (P < 0.05 vs C) and reduced vacuolar sealing (P < 0.05 vs C) but significantly higher O2- release compared to that in other groups (P < 0.05). Mortality in the L + S group from C. albicans sepsis was significantly higher than that in the other groups (60% compared to 20% in the L group and 13% in C, P < 0.02). This may have resulted from L + S-induced defective phagocytosis of C. albicans and depressed C. albicans killing but increased O2- release in response to candida. This discrepancy between decreased killing and increased O2- may result from increased leakage of O2- from more unsealed vacuoles in the L + S group. Thus, L + S may predispose to candida-induced mortality through defective PM phi intracellular candida killing while enhancing the release of O2- extracellularly from unsealed vacuoles, causing tissue injury.

Animals↗
PubMed1993

Paradoxical effect of pilus expression on binding of antibodies by Haemophilus influenzae.

Haemophilus influenzae type b (Hib) pili are surface proteins that are associated with the ability of Hib to attach to human epithelial cells. Like pilus expression of other bacteria, expression of Hib pili undergoes phase variation. We observed that Hib in the piliated phase (Hib p+) bound monoclonal antibodies directed against six conserved, surface-exposed, nonpilus Hib outer membrane epitopes to a greater extent than Hib in the nonpiliated phase (Hib p-). However, after extended incubation, p+ and p- cells bound these antibodies in a similar fashion. The differential in nonpilus antibody binding to p+ and p- Hib was not related to the presence of the type b capsule. In addition, Hib p+ organisms whose pilin gene was insertionally inactivated and did not produce pili and Hib in the nonpiliated phase bound the nonpilus Hib antibodies similarly. Hib p+ and p- organisms did not differ in their binding of anti-type b capsule antibody, and the binding was specific for the epitopes recognized by the antibodies. In complement-dependent bactericidal assays, the nonpilus antibodies killed Hib p+ more effectively than Hib p-. The increased binding to, and killing of, Hib p+ by a variety of nonpilus antibodies may be important for host defense against invasive Hib.

Animals↗
PubMed1992

Bioelectrical impedance analysis in the measurement of the body composition of surgical patients.

The evaluation of nutritional status in surgical patients remains a difficult problem. Bioelectrical impedance analysis (BIA) is a new method of body composition analysis which is easily performed at the bedside. This study determined the accuracy of BIA in the measurement of total body water (TBW) and potassium (TBK) in a heterogeneous group of surgical patients. The resistance and reactance components of impedance were measured with a whole body impedance analyser. Tritiated water dilution and whole body monitoring were the reference methods for TBW and TBK analysis. With the BIA technique the coefficient of variation for the estimation of TBW was 8.1 per cent and for TBK was 6.4 per cent. Allowing for the errors of the reference methods these results show that BIA is of limited value in the estimation of TBW but may provide a useful index of TBK.

Adult↗
PubMed1991

Immunoglobulin and cytokine production by neonatal lymphocytes.

Growth and differentiation of cord blood B cells were studied using T cell-depleted populations. In the absence of in vitro activation, cord blood B cells proliferated in response to cytokines including interleukin-2 (IL-2) and interleukin-4 (IL-4); anti-mu-stimulated cord B cells had a lesser response to IL-2 than adult cells. IgM synthesis by cord blood B cells was enhanced by interleukin-6 (IL-6) and decreased by IL-2. In cultures activated by Staphylococcus aureus Cowan I (SAC), cord blood B cells produced lesser increases in IgM than adult B cells regardless of the cytokine added. Cord blood B cells produced no IgG or IgA with any cytokine preparation with or without SAC activation. Supernatants of cord blood T cells pulse-stimulated with phytohaemagglutinin and phorbol myristate acetate contained less IL-2 and IL-6 and had less growth and differentiation activity than adult T cell supernatants. The results confirm a limited cord blood B cell response and also suggest a limitation in production of B cell stimulatory lymphokines by cord blood T cells.

Adult↗
PubMed1991

Utility of Leopold maneuvers in screening for malpresentation.

Malpresentation is a common complication of pregnancy. Using ultrasound as the gold standard, we prospectively tested Leopold maneuvers as a screen for nonvertex presentation in the third trimester. In our hands this technique performed poorly. Values for sensitivity, specificity, positive predictive value, and negative predictive value were 28, 94, 24, and 95%, respectively, in a population with a 7% prevalence of noncephalic presentation. Much of the correlation between the screening and diagnostic tests seemed to arise from chance (kappa = 0.13).

Breech Presentation↗
PubMed1990

The bottom line.

Explore the source record for details and available documents.

Attitude to Death↗
PubMed1989

Secretion of antidiuretic hormone in neurosurgical patients: appropriate or inappropriate?

In neurosurgical patients with hyponatraemia (plasma sodium less than 130 mmol/l) and natriuresis, increased antidiuretic hormone (ADH) secretion may be appropriate rather than inappropriate. Ten such patients were studied prospectively to assess circulating ADH concentration and body fluid volumes. Compared with a control group, the mean plasma ADH level was significantly elevated (0.9 pmol/l (s.e.m. = 0.2) versus 0.2 pmol/l (s.e.m. = 0.1], the total body water was normal (101% (s.e.m. = 3) versus 100% (s.e.m. = 6], while the blood volume was significantly reduced (89% (s.e.m. = 3) versus 104% (s.e.m. = 5]. The elevated ADH level was therefore appropriate to a reduced blood volume. This suggests that, in neurosurgical patients with hyponatraemia, fluid restriction could be dangerous. Serial observations in this small group of patients showed that salt replacement and normal fluid intake resulted in a fall in the elevated ADH levels.

Acute Disease↗
PubMed1988

A model to evaluate alternative methods of defibrillation threshold determination.

The voltage (or, equivalently, energy) at which defibrillation occurs for a specific episode of fibrillation can be represented by specifying or estimating the probability of successful defibrillation for each voltage or energy. This relation of voltage to probability is the probability function. For a series of attempts, the probability function predicts the frequency with which defibrillation will occur at a given voltage. By defining the defibrillation threshold (DFT) as the voltage at which the probability function takes on a specific value, say 50%, a method of defibrillation threshold determination can be evaluated by how accurately and precisely it estimates the "true" defibrillation threshold. By utilizing estimated probability functions from animals and humans, the relative performance of different methods of defibrillation threshold determination can be evaluated. Three methods were evaluated using published animal data and human clinical data: (1) stepping down to the first voltage that fails; (2) stepping up to the first voltage that succeeds; and (3) doing both 1 and 2 and averaging. In all cases, Method 3 has lower total error. Definitions of defibrillation threshold other than the 50% level can also be evaluated in this fashion.

Animals↗
PubMed1986

Tumor stage mycosis fungoides in a patient treated with long-term corticosteroids for asthma and atopic-like dermatitis.

An association between atopy and the Sézary syndrome has been recognized in some patients. Our case represents an association between adult-onset asthma and atopic-like dermatitis, markedly elevated IgE levels, and the development of tumor stage mycosis fungoides (MF) in a patient receiving long-term corticosteroid therapy. The chronic eczematous dermatitis may have represented evolving MF in which the specific diagnosis was delayed by treatment with topical and systemic corticosteroids until advanced tumor stage disease. This case, in conjunction with prior reports, suggests that an atopic diathesis can be associated with both leukemic and nonleukemic forms of cutaneous T-cell lymphoma.

Adrenal Cortex Hormones↗
PubMed1984

Environment and treatment: methodological notes on program evaluation and institutional culture.

This paper discusses the evaluation of a small regional children's rehabilitation centre. Several data sets were obtained including patient records and physical examinations of and interviews with Centre graduates. Originally, the project sought to describe the Centre's growth and determine successful programs. Design changes led to an examination of the relationship between institutional culture and the subsequent lifestyles of the graduates. The data strongly suggested that the institution's value orientation, which stressed successful accomplishment of daily living activities, life skills, had an impact upon an 'isolate lifestyle' apparent in the graduates. Standard statistical analysis are not able to support these conclusions. The methodological problems which lead to weaknesses in evaluation designs are discussed. It was concluded that researchers lack the methodological tools which would permit them to 'go beyond' simply reporting demographics, attitudes and opinions and making inferences into testing the relationships between institutional practices and subsequent behaviours.

Adolescent↗
PubMed1983

Injectable collagen: a clinical overview.

Injectable bovine collagen is extremely effective in the correction of contour defects of the skin due to scarring and age-induced rhytides and folds. The rate of adverse reactions is low. Of 5,109 patients treated in clinical trials, 1.3 percent experienced temporary local inflammation at the site of injection. Techniques of injection and proper patient selection are presented. Repeat implantations at intervals of six to twenty-four months are often required to maintain full correction of cutaneous contour defects.

Cicatrix↗