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Williams AH. Spread the message on Medicare adequacy. Volunt Leader 1989; 29:4-5. [PMID: 10302794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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52
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53
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Sidki AM, Staley K, Boyes H, Landon J, Williams AH. Direct single-reagent fluorescence polarisation immunoassay for valproic acid in serum. J Clin Chem Clin Biochem 1988; 26:69-74. [PMID: 3130457 DOI: 10.1515/cclm.1988.26.2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A fluorescence polarisation immunoassay for quantitating serum concentrations of valproic acid was developed and validated. Its low molecular weight and lack of structural features caused difficulties in producing suitable antibodies. However, success was achieved using 2-propyl-6-aminohexanoic acid to make the fluorescein-labelled drug and two immunogens, the first using glutaraldehyde to link the drug derivative to keyhole limpet haemocyanin, and the second by carbodiimide activation of cellulose hydroxyl groups and coupling them to the drug derivative and killed Mycobacteria. It was found that both immunogens produced a good antibody response in sheep. The antibodies were highly specific and the assay results correlated well with an in-house gas-liquid chromatographic method.
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Affiliation(s)
- A M Sidki
- Department of Chemical Pathology, St. Bartholomew's Hospital, London, U.K
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54
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Webster A, Wilson AP, Williams AH, Treasure T, Grüneberg RN. The use of a new glycopeptide antibiotic, teicoplanin, in the treatment of bacterial endocarditis. Postgrad Med J 1987; 63:621-4. [PMID: 2962071 PMCID: PMC2428416 DOI: 10.1136/pgmj.63.742.621] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Teicoplanin, a new glycopeptide antibiotic, has been used to treat twelve patients with bacterial endocarditis due to Gram-positive organisms. Teicoplanin has activity against Gram-positive bacteria similar to vancomycin but therapeutic levels are maintained by a single daily dose, given as an intravenous bolus. Of six patients with native valve infections, two cases, due to viridans streptococci, were successfully treated with teicoplanin alone and two others, caused by Streptococcus faecalis, were cured by combinations including teicoplanin. One of these patients sustained high tone hearing loss during treatment. The remaining two patients were drug addicts with endocarditis due to Staphylococcus aureus which recurred despite repeated multiple therapy. Of six prosthetic valve infections, antibiotic combinations including teicoplanin cured three cases, caused by streptococci. Infection persisted or treatment was curtailed in three cases of Staphylococcus epidermidis endocarditis. In this small open study, teicoplanin appeared as effective as vancomycin in the treatment of endocarditis but had the considerable advantage of ease of administration.
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Affiliation(s)
- A Webster
- Department of Clinical Microbiology, University College Hospital, London, UK
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55
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Abstract
We present a case of invasive pulmonary aspergillosis when a blood culture isolate of Aspergillus fumigatus in an unusual medium was considered to be a genuine isolation. Early institution of appropriate therapy was successful.
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Affiliation(s)
- D W Denning
- Department of Oncology, University College Hospital, London
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56
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Foord RD, Butcher ME, Williams AH. The emergence of resistance of Pseudomonas aeruginosa in patients treated with ceftazidime. Scand J Infect Dis 1987; 19:143. [PMID: 3105046 DOI: 10.3109/00365548709032391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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57
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Abstract
Seventy-five hospital inpatients with bacteriologically confirmed urinary tract infections were allocated to treatment with ciprofloxacin 100 mg, ciprofloxacin 250 mg or co-trimoxazole 960 mg, all given orally twice a day for five days. The patients were generally elderly, with many complicating factors including indwelling catheters; 24% of the infections were caused by Pseudomonas aeruginosa. The cure rates at 28 days were 94%, 88% and 87%, respectively. Side effects were few and minor. Ciprofloxacin appears to be an effective and safe orally-administrable treatment even for complicated urinary tract infection.
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Williams AH. Course organizers in general practice. J R Coll Gen Pract Occas Pap 1986:1-39. [PMID: 2577940 PMCID: PMC2573681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In August/September 1984 a survey of the 267 course organizers in post in England and Wales was carried out. Eighty-two per cent replied to a questionnaire asking for details about their work and personal status. All 16 regions in England and Wales completed a questionnaire about levels of staffing and remuneration of those involved in general practice postgraduate education. The results show that there are considerable variations between regions in the role and responsibilities of course organizers, in their training, and in the facilities that are provided for them. The majority of course organizers reported a workload greater than the number of sessions for which they were remunerated. The effects of these factors on recruitment, tenure of post, and job satisfaction are discussed. Recommendations are made for improving the situation, including the removal of course organizer pay from the scale of trainers' pay, so that there can be flexibility in the number of sessions which can be held, improvement in training and certain facilities, and the implementation of national and local job descriptions.
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Abstract
Teicoplanin was used to treat 94 hospital in-patients of confirmed or presumed Gram-positive infections over a period of 12 months. Eighty-five patients were subsequently found to be evaluable; 31 had soft tissue infections, 10 endocarditis, 8 urinary tract infections, 12 septicaemias, 2 chest infections, 7 osteomyelitis or septic arthritis, and 15 were immunosuppressed patients with infected Hickman line site infections. The cure rate of the 85 evaluable episodes was 90% (76 cured). Teicoplanin was well tolerated intravenously and intramuscularly. Adverse reactions occurred in five patients. One patient suffered high tone hearing loss, two patients suffered transient rash, one developed a drug fever and one patient who had concomitant gentamicin developed vestibular damage. It is concluded that teicoplanin is a relatively safe and effacacious treatment for Gram-positive infection.
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61
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Wright PJ, Geytenbeek PE, O'Shea JD, Williams AH, Clarke IJ. The improvement of reproductive efficiency in post-partum ewes: some basic and some applied studies. Aust Vet J 1985. [DOI: 10.1111/j.1751-0813.1985.tb13924.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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62
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Shine B, Williams AH, Mainwaring-Burton RW. Immunofluorescence, immunofixation, and immunoelectrophoresis. Clin Chem 1985. [DOI: 10.1093/clinchem/31.5.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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63
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Shine B, Williams AH, Mainwaring-Burton RW. Immunofluorescence, immunofixation, and immunoelectrophoresis. Clin Chem 1985; 31:788. [PMID: 3921283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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64
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Williams AH, Grüneberg RN. Teicoplanin. J Antimicrob Chemother 1984; 14:441-5. [PMID: 6239854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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65
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Williams AH. A new look at learning needs in general practice. J R Coll Gen Pract 1984; 34:41-4. [PMID: 6694127 PMCID: PMC1959660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Over a period of 18 months, trainees in the West Midlands were given a multiple choice questionnaire at the start of the general practice year to assess their factual knowledge in 14 areas of medicine and were given the opportunity to take the same test six months later. Sixty-five trainees who completed the test twice are the basis of the study, and their results are compared with 99 trainers who completed the paper once. In the pre-training test, the trainees' scores were significantly lower than their trainers' in total and in most individual subjects. In the mid-training test, the trainees' knowledge of most subjects had improved significantly over the six months. These results indicate that the teaching and assessment of factual knowledge should not be dismissed as unimportant in general practice training.
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Williams AH. Brutalization or failure to tame. Public Health 1983; 97:320-3. [PMID: 6657906 DOI: 10.1016/s0033-3506(83)80070-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Abstract
Mature Merino ewes (n = 228) were fed rations at levels of either 5, 10, 15, 20, 30 or 40 g/kg daily from day 1 until day 35 after mating. Embryos were then removed from single ovulating ewes and, after being weighed and measured, were dissected and embryo liver weights were obtained. Plasma samples were taken from all ewes on days 5, 10, 15, 20, 27 and 35 after mating and later analysed for glucose concentrations.
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Williams AH, Tehan CC. What it means to make a merger. Health Serv Manager 1981; 14:1-3. [PMID: 10252222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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70
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Mooney GH, Williams AH. Economists in multidisciplinary teams: some unresolved problems in the conduct of health services research. Soc Sci Med Med Econ 1980; 14C:217-21. [PMID: 7423214 DOI: 10.1016/s0160-7995(80)80005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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71
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Williams AH. Medical staff merger is no easy task. Hospitals 1980; 54:55-8. [PMID: 7372293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The merger of medical staffs at two New York City hospitals proved to be a difficult task/There were problems with staff competition, meeting quorums, physical plant changes, and physician resistance to merger.
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72
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Quinn JJ, Taylor CR, Swanson V, Williams AH, Schneider BK, Higgins GR, Tindle BH, Powars D, Lincoln T, Chandor SB, Pattenagle P, Siegel SE, Lukes RJ. Childhood leukemia and lymphoma: correlation of clinical features with immunological and morphological studies. Med Pediatr Oncol 1979; 7:35-47. [PMID: 522822 DOI: 10.1002/mpo.2950070107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Malignant cells from 49 children with lymphoid neoplasms other than Hodgkin disease were evaluated by surface marker and morphologic studies. We classified the patients into three groups: 36 patients (74%) with acute lymphocytic leukemia; 7 (14%) classified as convoluted lymphocytic lymphoma/leukemia; and 6 (12%) with small noncleaved follicular center cell lymphoma/leukemia. Diffuse marrow involvement was present at diagnosis in some patients in the latter two groups, but their clinical course was not characteristic of the patients with acute lymphocytic leukemia. Male predominance, poor prognosis, and high incidence of central nervous system disease characterized patients in the convoluted lymphocytic and follicular center cell lymphoma/leukemia groups. Clinical presentation in these two groups differed. Proliferations of convoluted lymphocytes were associated with mediastinal masses and proliferations of follicular center cells with intraabdominal tumors. The high incidence of CNS disease in children with neoplasms of convoluted lymphocytes and follicular center cells suggests that these processes have a predilection for the CNS and that patients with them may benefit from CNS prophylaxis.
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Rosen PJ, Feinstein DI, Pattengale PK, Tindle BH, Williams AH, Cain MJ, Bonorris JB, Parker JW, Lukes RJ. Convoluted lymphocytic lymphoma in adults: a clinicopathologic entity. Ann Intern Med 1978; 89:319-24. [PMID: 686542 DOI: 10.7326/0003-4819-89-3-319] [Citation(s) in RCA: 85] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Twelve adults had a distinct clinicopathologic type of malignant lymphoma that closely resembles the mediastinal lymphomas of childhood. Nine patients presented with mediastinal masses, and seven had symptoms related to intrathoracic compression. Seven patients presented with or developed leukemia, and in four of these patients the central nervous system (CNS) became involved. Structurally, the tumor cells had a distinctive stippled chromatin pattern, in addition to the characteristic nuclear convolutions. Tumor cells from five patients were studied immunologically, and, in each case, the tumor cells formed rosettes with sheep erythrocytes. The response to combination chemotherapy was rapid and dramatic, but usually transient, with relapse in the CNS or previously involved sites. The above data strongly suggest that these cases represent a distinct clinicopathologic entity that should be treated similarly to childhood leukemia and lymphoma, with intensive multiple agent induction, CNS prophylaxis, possibly radiation therapy to initially involved sites, and prolonged maintenance.
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Williams AH, Taylor CR, Higgins GR, Quinn JJ, Schneider BK, Swansson V, Parker JW, Pattengale PK, Chandor SB, Powars D, Lincoln TL, Tindle BH, Lukes RJ. Childhood lymphoma-leukemia. I. Correlation of morphology and immunological studies. Cancer 1978; 42:171-81. [PMID: 352504 DOI: 10.1002/1097-0142(197807)42:1<171::aid-cncr2820420129>3.0.co;2-r] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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76
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Williams AH. Too old to teach? J R Coll Gen Pract 1977; 27:361-2. [PMID: 894636 PMCID: PMC2158102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The scores obtained by 71 generalpractitioner trainers on a 100-question multiple choice question paper were analyzed in relation to the number of years since the trainer qualified. No evidence was found that older trainers had poorer recall of clinical facts.
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77
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Abstract
The ultrastructural features of 20 cases of osteosarcoma are discussed. Characteristically, the malignant cells (osteoblasts) contained large quantities of dilated, anastomosing rough endoplasmic reticulum, ofter forming large lakes. Mitochondria were sparse. Similar features are seen in osteoblasts in normal developing bone. Marked ultrastructural similarities of cells from chondrosarcomatous, fibrosarcomatous and typical osteosarcomatous areas of these tumors strongly supports the concept that these neoplastic cells all arise from the same progenitor cell. Malignant giant cells were readily differentiated from benign osteoclasts. The most significant ultrastructural findings were the varying degrees of calcification in the intercellular areas (osteoid), ranging from an extensive dense deposition of hydroxyapatite crystals which obscured the underlying collagen fibers, to focal collectors, or puffs, of slender needle-shaped hydroxyapatite crystals deposited on or along collagen fibers. The earliest apparent evidence of calcification was the presence of small electron-dense particles on or in collagen fibers.
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78
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Williams AH. Problems of homosexuality. Br Med J 1975; 3:426-8. [PMID: 1156797 PMCID: PMC1673845 DOI: 10.1136/bmj.3.5980.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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79
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Williams AH. Medical advance and the resources of the community. Proc R Soc Med 1974; 67:1293-6. [PMID: 4449880 PMCID: PMC1645780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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80
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Cahill LP, Buckmaster JM, Cumming IA, Parr RA, Williams AH. The effect of the presence of a ram on the time of ovulation in ewes. J Reprod Fertil 1974; 40:475-7. [PMID: 4473542 DOI: 10.1530/jrf.0.0400475] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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81
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82
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83
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84
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Abstract
Care in the preparation and preservation of reagents, together with certain modifications in apparatus and technique, have eliminated the difficulties from plasma ammonia analysis. Ammonia contamination from the laboratory atmosphere has not proved an especial hazard, and no major setback has been encountered in the analysis of several thousand specimens over the last few years. The method has been found particularly suited to the performance of the occasional estimation, since, once prepared, all reagents are stable for a considerable time.
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85
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