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Biomedical subjects

W Wilson

Publications and source records attributed to W Wilson.

At least 91 records · Page 5Linked to original sources
PubMed1993

Networking: an overview for leaders of academic medical centers.

Organizations face a unique challenge over the next decade. When technology was expensive, it was arguably necessary to use an undifferentiated, or monolithic, model for computer-based solutions to problems. This has fundamentally changed. Technology is now so inexpensive that solutions are not limited by costs, but rather by how well the implementors understand the many different problem domains. Thus, academic medical centers are faced with successive waves in information technology use. First, there will be a wave of innovation, driven by the need for specialization in problem solving. This will be followed by consolidation of the best of the approaches into the core systems of the institution. The average level of heterogeneity (cost) will be higher, but the overall quality of the solutions (benefit) will also be higher. If one can develop a strategy for managing and creatively limiting the heterogeneity, the cost-benefit ratio will be much more favorable. While there may be other strategies that will do this, we support the use of a strategy centered on enterprise networking. This strategy emphasizes not simply technology but also the cultural and organizational changes that empower innovation--within a framework that makes it possible to simply implement interoperability and data sharing within nearly all solutions. The organizations that survive the coming period of change and external pressure will be those that do the best job of managing their resources. Information will continue to be one of the most important resources.(ABSTRACT TRUNCATED AT 250 WORDS)

Academic Medical Centers↗
PubMed1993

Long-term ineffectiveness of suspension material and musculofascial suspensions: a rabbit model.

The literature describes various methods of platysma and SMAS modification to enhance rhytidoplasty. This paper evaluates suspension materials: autogenous fascia and dermis, Gore- Tex, and a nylon suture to elevate the panniculus carnosus in a rabbit model using 15 animals. In the second part of this paper, 16 rabbits were used to evaluate imbrication and advancement techniques of the latissimus dorsi muscle. The ineffectiveness of permanently moving a viable, innervated muscle under tension is discussed.

Animals↗
PubMed1993

High-dose adrenaline in adult in-hospital asystolic cardiopulmonary resuscitation: a double-blind randomised trial.

Forty intensive care unit patients requiring cardiopulmonary resuscitation were randomised to receive either the standard dose of adrenaline (1 mg every five minutes) or high-dose adrenaline (10 mg every five minutes). In the majority of patients, overwhelming sepsis was the major contributing factor leading to cardiac arrest. In this group of patients no difference could be detected in response to high-dose adrenaline compared with the standard dose. Although no side-effects were noted with this high dose of adrenaline, more investigation is required prior to its routine use in cardiopulmonary resuscitation.

Adult↗
PubMed1992

Clinical phenotype and molecular analysis of a three-generation family with an interstitial deletion of the short arm of chromosome 5.

We report on a 3-generation family with an interstitial deletion of the short arm of chromosome 5. Varied manifestations were found among the affected individuals including microcephaly, hypertonia, and micrognathia; mental retardation was common to all affected individuals. High resolution chromosome analysis was interpreted as del(5) (pter- > p14.3::p13.3- > qter). Molecular comparison of the deletion in this family with individuals with other 5p deletions suggests that the clinical findings are due specifically to the chromosomal material deleted from 5p13.

Abnormalities, Multiple↗
PubMed1992

Alcohol problems in later life: evaluation of a model community education program.

Described is the development and evaluation of a three hour multi-media community education program on alcohol problems in later life. Designed for families, older adults and service providers, the program provides information and skills needed to recognize and to take appropriate action with regard to alcohol abuse among the elderly. Compared to a control group, program participants had significant gains in knowledge and in their intent to take appropriate action in response to alcohol problems.

Aged↗
PubMed1992

Alcohol problems and depression in later life: development of two knowledge quizzes.

Effective measures of knowledge about mental health in later life are valuable in both needs assessments and educational program evaluations. Described is the development of two short, true/false quizzes, one on alcohol problems and one on depression and suicide in later life. These quizzes can be used to plan and evaluate community education programs on mental health problems in later life. Procedures for developing other knowledge assessments are presented.

Aged↗
PubMed1992

Septic shock: does adrenaline have a role as a first-line inotropic agent?

Fifteen adult patients, admitted to Baragwanath Hospital ICU with septic shock after adequate fluid loading and on no other inotropic agents, were given adrenaline in incremental doses. Oxygen transport and haemodynamic variables were monitored with each dose increment until a systolic blood pressure of 120 mmHg was obtained. This was reached on an average dose of adrenaline of 0.16 +/- 0.02 micrograms/kg/min. Mean arterial blood pressure increased by 22 +/- 2 mmHg mainly due to an increase in cardiac index (1 +/- 0.2 l/min/m2) and systemic vascular resistance index (130 +/- 41 dyn.s.cm.-5m-2) with a small increase in heart rate of 8 +/- 3 beats per minute. Oxygen delivery was increased with no significant increase in oxygen consumption and lactate levels increased. Adrenaline is therefore an effective initial inotropic agent. Patients may respond to lower doses than when used concurrently with other inotropic agents but there was still a significant dose variation in response. We cannot, however, exclude a deleterious effect on oxygen utilization.

Adult↗
PubMed1992

A path to integration in an academic health science center.

This article describes a networking and integration strategy in use at the University of Michigan Medical Center. This strategy builds upon the existing technology base and is designed to provide a roadmap that will direct short-term development along a productive, long-term path. It offers a way to permit the short-term development of incremental solutions to current problems while at the same time maximizing the likelihood that these incremental efforts can be recycled into a more comprehensive approach.

Integrated Advanced Information Management Systems↗
PubMed1991

Squamous cell carcinoma of the anus and HIV infection.

We retrospectively reviewed six patients with squamous cell carcinoma of the anus (SCCA) and human immunodeficiency virus (HIV) infection treated between 1985 and 1988. All six patients were homosexual men. Five patients had AIDS and one was HIV-positive. The most common symptoms and signs were pain (n = 5), mass (n = 5), and bleeding (n = 5). The average tumor size was 3.2 cm with a range of 1-10 cm. Five tumors were located in the anal canal and one at the anodermal junction. One patient was treated with biopsy alone, one with local excision, one with wide local excision and radiation therapy, and two with diverting colostomy. The average follow-up was 8 months. Of the five AIDS patients, two died, one was transferred to a hospice facility, one was lost to follow-up, and one remains alive 1 year following treatment. The HIV-positive patient died secondary to metastatic SCCA. This group of patients raises the question of a possible association between HIV and SCCA.

Acquired Immunodeficiency Syndrome↗
PubMed1991

The Brief Social Phobia Scale.

An observer measure of social phobic symptoms, referred to as the Brief Social Phobia Scale, consists of 11 items, 7 evaluating commonly feared or avoided situations and 4 additional items measuring autonomic distress. Symptoms represented by the scale items are found frequently in social phobia, and the instrument demonstrates acceptable interrater and test-retest reliability, internal consistency, concurrent validity against other measures of social phobia, and the ability of patients to change as a result of treatment. It can also detect differences between active treatment and placebo treatment. A comparison of the sensitivity of this scale with other scales in detection of size of effect also is presented.

Humans↗
PubMed1991

A model community education program on depression and suicide in later life.

This paper describes the development and evaluation of a 3-hour multimedia community education program on depression and suicide in later life. Designed for families, older adults, and service providers, the program provides information and teaches skills needed to recognize and respond to depression and suicidal behavior in the elderly. Compared with a control group, program participants had significant gains in knowledge and in their intent to take appropriate action in support of a depressed person.

Adult↗
PubMed1991

Out of the darkness: group cognitive therapy for depressed elderly.

1. Depression affects an estimated 50% of the population over age 65. With the current expansion of the elderly in this country, the problem will continue to increase. 2. Depressed individuals view situations negatively when more positive interpretations are equally valid. The thrust of cognitive therapy is to replace the faulty and negative perceptions with more valid and positive ones. 3. Cognitive therapy was found to be effective in the elderly. Residents attended sessions regularly, and the change in the depression level for group participants was highly significant statistically and clinically noticeable.

Aged↗
PubMed1991

Spleen function in children with sickle B+ thalassemia.

Splenic function in patients with sickle B+ (SB+) thalassemia has been poorly documented. We evaluated the clinical course and splenic function in 12 children with SB+ thalassemia with simultaneous technetium sulfur colloid spleen scans and determination of pitted erythrocytes by direct interference contrast microscopy (DICM). All patients displayed normal uptake of radiocolloid. Mean percentage of pitted erythrocytes was 2.2% compared to 0.06% in 10 normal eusplenic controls and 13.8% in 10 sickle cell patients. In this group of children, who were carefully monitored for 136 patient years, there was no episode of bacteremia/sepsis, and a low prevalence of vaso-occlusive episodes. The slight increase in percentage of pitted erythrocytes of SB+ thalassemia patients does not seem to herald any clinically relevant loss of splenic function. SB+ thalassemia children younger than 10 years of age who do not seem to present a higher risk of invasive bacterial infections than eusplenic children, should receive conservative treatment for isolated febrile episodes and should not be submitted to prophylactic penicillin.

Adolescent↗