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Biomedical subjects

B O Williams

Publications and source records attributed to B O Williams.

62 records · Page 4Linked to original sources
PubMed1976

Metabolic changes during exercise testing of patients with ischaemic heart disease.

Nineteen patients who had recovered from a mild to moderately severe myocardial infraction 6--18 months previously were studied in order to investigate the relationship between the severity of myocardial insufficiency and metabolic changes developing during and after exercise. The patients were compared with six controls by means of a graded exercise test on a treadmill. Electrocardiographic records were made and blood pressure measured during and after the exercise and venous blood samples were taken for measurement of lactate, pyruvate, glycerol and free fatty acids. In five patients with moderate or advanced ischaemic electrocardiograph changes the blood lactate and pyruvate mean concentrations continued to rise up to a further 50% after they stopped exercising. The other patients, including some who developed symptoms suggestive of myocardial ischaemia, and all the controls, failed to show these marked increases in blood concentrations after the exercise. We conclude that the development of myocardial insufficiency during exercise is associated with marked increases in lactate and pyruvate concentrations in the peripheral blood particularly after the exercise has ceased.

Adult↗
PubMed1976

The elderly in a coronary unit.

The clinical features of myocardial infarction were compared in 104 patients over the age of 70 and 399 younger patients admitted to a coronary care unit. Absence of an age bar at 70 years has increased the number of admission to the unit by 24%, and the number of patients with proved infarcts by 26%. Severe complications are more common and mortality is doubled in the elderly. Although immediate management of primary ventricular fibrillation is as successful in older as in younger patients, treatment of the elderly with less dramatic conditions is less successful. The elderly survivors tend to spend longer in the coronary unit and subsequently in the general medical ward.

Adult↗
PubMedDate not supplied

Twice-weekly dosing for thyroxine replacement in elderly patients with primary hypothyroidism.

Seven female patients (mean age 86 years) with proven biochemical primary hypothyroidism were enrolled in a single-blind randomized crossover study, of standard daily versus twice-weekly thyroxine therapy, with each phase of one month's duration. The median daily dose of thyroxine was 100 micrograms (range 75-100 micrograms). Serum levels of thyroid hormones and thyrotrophin were very similar during twice-weekly thyroxine therapy to those during daily therapy and there were no statistically significant differences between trough and peak serum total triiodothyronine, free thyroxine, or thyrotrophin levels or systolic time intervals during twice-weekly thyroxine. Administration of thyroxine twice-weekly to elderly patients with primary hypothyroidism gives effective biochemical thyroid hormone replacement, with no evidence from the systolic time intervals of tissue thyrotoxicosis at expected peak thyroid hormone concentrations. Supervised twice-weekly thyroxine should be considered in patients with primary hypothyroidism who comply poorly with daily dosing.

Aged↗
PubMedDate not supplied

Bioavailability of pseudoephedrine and triprolidine from combination and single-ingredient products.

The bioavailability of pseudoephedrine and triprolidine from combination and single-ingredient products was evaluated in a randomized, four-way crossover study. Healthy men volunteers received single doses of a tablet containing triprolidine hydrochloride and pseudoephedrine hydrochloride, a syrup containing the same two drugs, and single-ingredient tablets of each drug. Blood samples were collected before each dose and at 13 sampling times over 24 hours for determination of drug concentrations by radioimmunoassay. Observed peak concentration (Cmax), corresponding observed peak time (tmax), area under the plasma drug concentration-time curve from dosing to time infinity (AUC), and the ratio between plasma clearance and extent of bioavailability (CL/F) were determined. Nonlinear regression analysis was used to obtain estimates of lag time for absorption, first-order rate constant for absorption, first-order rate constant for elimination, and ratio between volume of distribution and extent of bioavailability. Data were analyzed for 19 of 20 men entering the study; data were complete for 16 of these. Pseudoephedrine concentrations were significantly different for the combination tablet and the syrup at four sampling times; no significant differences were found between pseudoephedrine concentrations for the combination tablet and single-ingredient tablet. Cmax, tmax, AUC, and CL/F for pseudoephedrine were not significantly different for the three formulations. Triprolidine concentrations at 8 hours were significantly higher for the combination tablet than for the single-ingredient tablet, and tmax for triprolidine was significantly higher for the combination tablet than for the syrup. For both pseudoephedrine and triprolidine, the combination tablet was bioequivalent to the syrup and to the single-drug tablets.

Adolescent↗
PubMedDate not supplied

A formal overview of stroke unit trials.

We carried out a formal overview of the ten trials which compared the outcome of patients managed within a stroke unit with those managed in general wards. Care in a stroke unit was associated with an odds reduction for early mortality (median follow up 3 months) of 28% (95% confidence interval 8-44%; 2 p < 0.01), which was largely sustained (odds reduction 21% CI 1-37%; 2p < 0.05) at final review (median follow up 1 year). The odds reduction for a poor outcome (death or institutionalisation) at final review was 34% (95% CI 19-47%; 2p < 0.001). The mean length of stay in stroke units ranged from 61% to 133% (pooled result 96%) of that in general wards. Stroke patients managed within specialist units are more likely to be alive and living at home a year after the stroke than those managed in general wards. Stroke unit care does not apparently increase the time spent in hospital.

Brain↗