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Biomedical subjects

P Fowler

Publications and source records attributed to P Fowler.

64 records · Page 4Linked to original sources
PubMed1983

Plasma concentrations of salbutamol after an oral slow-release preparation.

Studies were carried out to investigate the plasma concentrations of salbutamol after administration of a slow-release formulation (8 mg) compared with those after 1 and after 2 standard 4 mg tablets. In the first study, 9 subjects received, at random, either the slow-release tablet or a single standard tablet. Blood samples were taken and histamine challenge tests were carried out before and at fixed time intervals after drug administration. The procedures were repeated after an interval of at least 5 days with the alternative treatment. In the second study, plasma concentrations were measured in 5 of the subjects before and after taking 2 standard 4 mg tablets. The results showed that there was slower attainment of peak plasma concentrations after the slow-release formulation compared to those after one 4 mg and two 4 mg standard tablets. In addition, the 8 mg slow-release formulation produced lower peak plasma concentrations than did two 4 mg standard tablets. Protection against a bronchoconstricting histamine challenge lasted at least twice as long after the slow-release compared with after a single 4 mg standard tablet.

Administration, Oral↗
PubMedDate not supplied

Impact of patient counseling on acceptance of the levonorgestrel implant contraceptive in the United Kingdom.

Patient counseling is an important aspect of family planning. Patient choice, compliance, and satisfaction with a contraceptive method depend heavily on the counseling experience. This is especially true in the United Kingdom where contraceptives are provided to patients at no direct cost to them. Women are therefore more likely to choose a contraceptive option based on perceived desirability as opposed to cost. We surveyed physicians from six family planning centers in the United Kingdom who have extensive experience with levonorgestrel contraceptive implants with respect to counseling issues and patient acceptability of levonorgestrel implants. The physicians reported on their experience with 521 women. They acknowledged the need for and importance of counseling, and these centers provided preinsertion counseling 100% of the time. Primary responsibility for counseling was handled by the physician who spent, on average, 19 minutes per patient discussing the advantages and risks of levonorgestrel implants. Physicians felt that the majority of women (82%) accepting levonorgestrel implants had a positive experience. The incidence of bleeding irregularities was consistent with that reported in clinical trials, and this did not substantially affect the postinsertion acceptability of the product. Effective counseling is no doubt responsible for the high level of patient acceptance of these side effects. In a review of the literature, we found counseling to be a significant factor in a woman's tolerance of contraceptive-induced bleeding irregularities, which are frequently experienced with levonorgestrel implants. The results of our survey support the literature findings.

Adolescent↗
PubMedDate not supplied

Allograft anterior cruciate ligament reconstruction in a sheep model. The effect of synthetic augmentation.

The purpose of this study was to assess the effect of synthetic augmentation of a bone-patellar tendon-bone allograft on the basis of biomechanical, morphologic, and histologic evaluation. The anterior cruciate ligament was reconstructed in the left knee of 66 adult sheep. Half the knees received bone-patellar tendon-bone grafts alone, while the other half were augmented. All of the knees, including the contralateral controls, had gross and histologic examination, hydroxyproline assay for collagen content, and biomechanical testing in groups at 0, 4, 16, and 52 weeks postoperatively. Biomechanical testing included anteroposterior translation, ultimate tensile strength, energy to failure, stiffness, and mode of failure. Eight fresh bone-patellar tendon-bone allografts were compared to eight cryopreserved bone-patellar tendon-bone allografts for baseline data on the effects of the cryopreservation. Cryopreservation did not have any effect on graft characteristics. Gross and histologic examination did not reveal any significant difference between the augmented and nonaugmented groups at any of the time periods. In addition, hydroxyproline content of the allograft was not altered by augmentation throughout the study period. Biomechanical laboratory evaluation demonstrated the augmented group had significantly reduced anteroposterior translation (P less than 0.05) at 52 weeks compared to the nonaugmented group. The ultimate tensile strength was significantly higher (P less than 0.05) in the augmented group at 4 weeks, but at 52 weeks both groups had attained only 50% of the normal anterior cruciate ligament strength. Stiffness and energy to failure were similar in both groups at all time periods. From the results of this study, synthetic augmentation appears to improve initial strength and prevent late allograft laxity while allowing normal remodeling processes to occur in the bone-patellar tendon-bone allograft anterior cruciate ligament reconstruction.

Animals↗
PubMedDate not supplied

Knee flexor and extensor strength during concentric and eccentric muscle actions after anterior cruciate ligament reconstruction using the semitendinosus tendon and ligament augmentation device.

The purposes of this study were to compare operated and nonoperated knees after anterior cruciate ligament reconstruction using the semitendinosus tendon and a polypropylene ligament augmentation device, and to determine the interrelationships among strength, knee stability, and current activity levels. Isokinetic tests for knee flexion (prone position) and extension (sitting position) strength during concentric-eccentric muscle action cycles were completed at 60 and 180 deg/sec angular velocities, and passive anterior displacement were determined for 15 male and 15 female patients (mean age, 27 +/- 8 years; mean time since surgery, 21 +/- 3 months). With the exception of eccentric muscle actions during knee extension, peak torque and work done were significantly greater on the nonoperated leg (P < 0.05). Passive anterior displacement was significantly greater in the operated than the nonoperated knee (P < 0.01). Strength measurements tended to be modestly related to current activity level (R > 0.40 in 24 of 32 correlations; P < 0.05), whereas anterior displacement was not related to current activity level (R = -0.19, operated knee; R = -0.09, nonoperated knee; P > 0.05). Greater emphasis should be directed toward strengthening the knee flexors and knee extensors after this surgery. Although joint-specific tests (completed actively via isokinetic dynameter) are more related to activity levels than are knee laxity tests (completed passively via knee arthrometer), neither test should be relied on as the only predictor of activity level in this patient population.

Adult↗