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Biomedical subjects

W W Williams

Publications and source records attributed to W W Williams.

At least 19 recordsLinked to original sources
PubMed1995

Mumps surveillance--United States, 1988-1993.

PROBLEM/CONDITION: CDC monitors the incidence of mumps in the United States through the passive reporting of cases to its National Notifiable Disease Surveillance System (NNDSS). REPORTING PERIOD COVERED: 1988-1993. DESCRIPTION OF SYSTEM: Weekly reports to the NNDSS from 48 states and the District of Columbia were used to calculate incidence rates for mumps. State immunization requirements were obtained from the U.S. Department of Health and Human Services. RESULTS: After the licensure of mumps vaccine in the United States in December 1967 and the subsequent introduction of state immunization laws in an increasing number of states, the reported incidence of mumps decreased substantially. The 1,692 cases of mumps reported for 1993 represent the lowest number of cases ever reported to NNDSS and a 99% decrease from the 152,209 cases reported for 1968. During 1988-1993, most cases occurred in children 5-14 years of age (52%) and in persons > or = 15 years of age (36%). Although the incidence decreased in all age groups, the largest decreases (> 50% reduction in incidence rate per 100,000 population) occurred in persons > or = 10 years of age. Overall, the incidence of mumps was lowest in states that had comprehensive school immunization laws requiring mumps vaccination and highest in states that did not have such requirements. INTERPRETATION: Because of the extensive use of mumps vaccine and the increased number of states that had enacted mumps immunization laws, the number of reported mumps cases decreased further since the marked decline that began during the early 1970s. The earlier shift in incidence from children of school ages to older persons that was noted during 1985-1988 continued until 1992, when the proportion of cases occurring in children of school ages increased and exceeded the proportions occurring in other age groups. ACTIONS TAKEN: All health-care providers are encouraged to a) report mumps cases to their local and state health departments for transmission to NNDSS and b) enact school immunization laws requiring mumps vaccination.

Adolescent↗
PubMed1995

High incidence of congenital rubella syndrome after a rubella outbreak.

Previous studies of the incidence of congenital rubella syndrome (CRS) after rubella outbreaks have been limited because most women with infection during the first trimester elected to have their pregnancies terminated. After a rubella outbreak in 1991 we measured prospectively the impact of maternal infection on CRS among the Amish in one county in Pennsylvania. We compared rubella serology of Amish women delivering before and after the outbreak and cord blood rubella IgM from Amish and non-Amish infants. Before the outbreak 20% of Amish women were susceptible to rubella; after the outbreak 4% were (P = 0.001). Of Amish infants 15% tested positive for rubella IgM; no non-Amish infants did (P < 0.001). This rubella outbreak in a largely unimmunized community led to a high rate of CRS. The annual CRS rate among the Amish was 2130/100,000 live births. Health care providers should promote immunization in all clients and intensify efforts among the Amish.

Antibodies, Viral↗
PubMed1992

KY nailing of impending and pathological fractures of the proximal femur.

Eight two patients underwent 86 Küntscher Y nailing for impending and pathological fractures of the proximal femur. All but five mobilised post-operatively, thus improving their quality of life. Eighteen patients died in hospital. Prophylactic nailing improved survival. Fifteen out of 86 nailings were followed by complications.

Aged↗
PubMed1992

Acute renal failure complicating pediatric cardiac surgery: a comparison of survivors and nonsurvivors following acute peritoneal dialysis.

The outlook for patients with cardiac surgery complicated by acute renal failure (ARF) is poor, with a reported mortality of 50-67%. In addition to assessing the impact of recent advances in pediatric cardiac surgery on the mortality rate and renal outcome of surgery complicated by ARF requiring peritoneal dialysis (PD), this study compares preoperative, operative, and postoperative variables in patients who survived surgery and those who did not survive. From 1982 through 1988, 44 postoperative cardiac patients developed ARF, and 40 (age: 2 days to 15 years) required PD. Seventeen of 40 patients survived (mortality 57.5%) and 16 of these patients recovered normal renal function. Preoperative variables, including operative age and weight, did not appear to directly influence survival. Operative profiles, including length of cardiopulmonary bypass, aortic cross-clamp time, and hypotension immediately off bypass, did not distinguish surviving patients from those that did not survive. Postoperative variables, such as postoperative hypotension treatment, arrhythmias, hematologic status, cardiac arrest with resuscitation, did not differentiate survivors from nonsurvivors. The mean duration of PD was less than 2 weeks, and complications were infrequent. Renal status following PD in survivors was usually normal. We conclude that recent advances in pediatric cardiac surgery have not further increased the high mortality of surgery complicated by ARF. Survival is associated with renal recovery and thus aggressive treatment using PD is warranted.

Acute Kidney Injury↗
PubMed1992

Complications associated with the use of the gamma nail.

At Kingston Hospital, the Gamma nail has only been used for the fixation of unstable intertrochanteric and subtrochanteric fractures of the femur. There have been 28 cases; 21 required distal locking. Of these, there were intraoperative difficulties in nine.

Adult↗
PubMed1991

Prevalence of measles antibodies in asymptomatic human immunodeficiency virus-infected adults.

One hundred five asymptomatic human immunodeficiency virus-seropositive adults were screened for measles antibody. Ages ranged from 21 to 59 years (mean, 35.7). CD4+ lymphocyte counts (range, 76-1137/mm3), percentage of CD4+ cells (6-42), CD4:CD8 ratio (0.08-1.3), measles antibody titers by EIA, and undocumented history of prior measles or immunization were obtained. Forty-six patients gave a history of measles but no immunization, 18 of immunization but no measles, 26 of immunization and measles, and 15 of neither measles nor vaccination. Only one patient (less than 1%) lacked levels of antibody considered protective. Neither the presence nor the level of antibody were predictable from patient age, history of measles or immunization, CD4+ lymphocyte count, percentage of CD4+ cells, or CD4:CD8 ratio. Nearly all subjects had antibody to measles, regardless of immunization or measles history. Whether these antibodies are truly protective is unknown.

Adult↗
PubMed1990

Decrease in cyclosporin-mediated prostacyclin production in renal versus carotid arteries: a mechanism for cyclosporin-induced hypertension.

Although the mechanism of cyclosporin (CsA)-induced hypertension is unknown, it has been shown to inhibit prostacyclin (PGI2) production directly, which may be a factor. We determined whether CsA had a differential effect on PGI2 production from the carotid artery (CA) and internal jugular vein (JV) compared to that from the renal artery (RA) and vein (RV) as a possible contributing factor to renovascular hypertension based upon the ability of organs to regulate their own blood flow according to local circumstances. The neck and renal vessels were removed from anesthetized adult female dogs (N = 8) and placed in a stimulation chamber, with Cell I being control (Hepes buffer), Cell II containing 0.3 mg/ml CsA, and Cell III containing CsA and 25 microM arachidonic acid (AA). Following serial stimulation periods, the supernatant was evaluated for PGI2 production by radioimmunoassay. PGI2 production from CA was significantly higher than that from RA following control and AA stimulation, 1474 +/- 382 pg/cm2-min vs 733 +/- 173 pg/cm2-min (P less than 0.05) and 2236 +/- 347 vs 1090 +/- 217 (P less than 0.01), respectively. CsA-induced PGI2 production from the carotid arteries was significantly greater than that from the renal arteries, 2944 +/- 586 vs 1003 +/- 235 (P less than 0.005). However, stimulation with AA following CsA resulted in sustained PGI2 production in both arteries that was similar to stimulation with CsA alone, 3014 +/- 600 vs 2944 +/- 586 for the carotids and 1278 +/- 280 vs 1003 +/- 235 for the renal arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Predictors of vaccination behavior among persons ages 65 years and older.

We estimated influenza vaccination coverage of 32 percent among persons 65 years of age and older from the 1987 Behavioral Risk Factor Surveillance System survey. Race other than White, obesity, lack of seatbelt use, and current smoking were associated with decreased likelihood of having been vaccinated. Controlling for these factors, the best predictor of having received influenza vaccination was having had a medical checkup within the last year (Odds Ratio = 2.40, 95% confidence interval = 1.84, 3.14).

Aged↗
PubMed1990

Measles, mumps, and rubella vaccines.

With widespread use of the live virus vaccines for measles, mumps, and rubella, there has been a dramatic decrease in the incidence of all three diseases. At the same time, an increasing proportion of the remaining cases are occurring in adolescents and adults. Thus, vaccinations for these three diseases of childhood must be included in a comprehensive program for adult immunization. The vaccines have a proven history of safety and efficacy and are usually administered together as combined measles-mumps-rubella (MMR) vaccine. Vaccination for measles, mumps, and rubella is particularly important for susceptible adults likely to come in contact with infected children. Adults at particularly high risk for exposure may include daycare center workers, teachers and other school employees, college students, medical personnel, and those planning to travel outside the United States.

Age Factors↗
PubMed1989

Vaccine-preventable diseases on college campuses: the emergence of mumps.

Because of the adverse health impact of vaccine-preventable diseases, particularly measles and rubella, on college campuses, the American College Health Association (ACHA) Committee on Immunization and the House of Delegates issued position statements in 1983 and 1984 stating that colleges and universities should institute prematriculation immunity requirements. Since then, many colleges have implemented requirements and some states have passed comprehensive college laws requiring proof of immunity at the time of matriculation. No college rubella outbreaks have been reported to the Centers for Disease Control (CDC) since 1985. Measles outbreaks, however, have continued to be reported. In 1986-1987, 315 college measles cases were reported from 15 states, comprising over 3% of the total cases reported to CDC. Thirty-six percent of college measles cases could have been prevented through full implementation of prematriculation immunity requirements. Outbreaks of mumps were reported among students attending 16 colleges and universities in 3 states where active surveillance was undertaken during the 1986-1987 academic year. These mumps outbreaks, the first reported in colleges since vaccine licensure in 1967, were responsible for considerable health impact and disruption of activities. The outbreaks paralleled the increase in mumps reported nationally, which was largely a result of illness among unvaccinated adolescents and young adults not previously exposed to mumps. A lack of routine mumps vaccination in the past has allowed accumulation of susceptible unvaccinated persons in middle schools, high schools, and colleges. Outbreaks are likely to occur in those colleges that draw students who attended primary and secondary school in states without comprehensive laws requiring mumps vaccination.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Vaccines of importance in the hospital setting. Problems and developments.

Hospital personnel may be exposed to or transmit certain vaccine-preventable diseases. Using immunizing agents optimally in hospitals will protect personnel as well as patients. Preventing illness in hospitals through comprehensive immunization policies can be more cost-effective than case management and outbreak control. Hospital-based immunization programs for patients provide an important strategy for immunizing high-risk patients. Immunizing patients protects them against preventable illnesses that may be acquired in the hospital or the community following discharge.

Cross Infection↗
PubMed1988

Intussusception secondary to squamous carcinoma of the lung.

This report describes unusual radiologic and pathologic findings in a patient with multiple small bowel metastases from squamous cell carcinoma of the lung. The diagnostic work-up revealed a large, pleural-based, right lung mass, a large left adrenal mass, two ulcerated small bowel masses, and a unique giant peduncular mass that caused intermittent intussusception. A pertinent review of the literature is presented.

Carcinoma, Squamous Cell↗
PubMed1988

Effects of in vivo monoclonal anti-I-A antibody treatment in neonatal mice on intrathymic and peripheral class II antigen expression.

Intrathymic, Ia-bearing antigen-presenting cells (APC) are believed to play an important role in the development of a mature, functional T-cell repertoire. We used chronic in vivo treatment of neonatal mice with anti-I-A monoclonal Ab (MAb) to examine the expression of I-A and I-E antigens on intrathymic and peripheral APC. Three weeks after continuous treatment with anti-I-A MAb, FACS analysis of unfractionated spleen cells revealed a 75-90% reduction in the number of I-A bearing cells. Splenic antigen-presenting capacity measured by the ability of unseparated or density gradient-enriched APC to stimulate I-A- or I-E-reactive T-cell hybridomas was also greatly reduced. In contrast to the expression of I-A and I-E molecules in the splenic APC, anti-I-A MAb treatment resulted in decreased thymic APC I-A expression without significant changes in I-E as measured by FACS analysis. This was confirmed in functional studies in which allo-I-A- or auto-I-A-reactive T-cell hybridomas could not be stimulated by treated thymic APC. Unlike splenic APC, anti-I-A-treated thymic APC did not differ significantly from normals in their ability to stimulate allo-I-E-reactive T hybridomas. This lack of linkage or comodulation of I-A and I-E expression on thymic but not splenic APC may allow us to study the role of I-A molecules and I-E molecules on the development and expansion of functional, mature T-cell repertoires.

Animals↗
PubMed1988

Immunization policies and vaccine coverage among adults. The risk for missed opportunities.

A substantial proportion of vaccine-preventable diseases occur among adults. Each year, there are more than 20,000 influenza-associated deaths during epidemics, approximately 40,000 deaths related to pneumococcal disease, and one to five cases of diphtheria. More than 300,000 hepatitis B infections occur annually, mostly in patients 15 to 29 years old. From 1982 to 1986, 96% of patients with tetanus were age 20 and older. Among young adults, 5% to 20% are susceptible to rubella and measles, and outbreaks occur where these persons congregate. Most adults are not immunized, despite recommendations for vaccines against these diseases. Vigorous efforts are needed to implement strategies to reduce disease incidence, morbidity, and death among adults.

Adult↗