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Biomedical subjects

T Baxter

Publications and source records attributed to T Baxter.

At least 19 recordsLinked to original sources

Administration of an alginate based gastric reflux suppressant on the bioavailability of omeprazole.

BACKGROUND & OBJECTIVE: Omeprazole treats gastro-oesophageal reflux disease (GORD) by inhibition of acid secretion whereas alginate based reflux suppressants work by forming a low density raft of near neutral pH which floats on the stomach contents and physically impedes gastro-oesophageal reflux. There is limited pharmacokinetic information regarding possible drug interaction between these two types of products, although these may be frequently co-prescribed to improve symptom control in GORD patients. This study was designed to determine whether the administration of a 10 per cent w/v liquid alginate suspension affected the pharmacokinetic profile of omeprazole. METHODS: This was a randomized, two-treatment, two-sequence, two-period crossover study in 26 volunteers. Each treatment was dosed for 3 consecutive days with a washout period of 7 days between dosing periods. Blood samples for pharmacokinetic analysis were taken over the 24 h period following the final dose of omeprazole. RESULTS: Geometric means and ratios were as follows: C(max) was 555 for omeprazole/alginate and 558 for omeprazole alone (ratio 99.55%, 90% confidence interval 82.75-119.75%; AUC(0-t) was 2050 for omeprazole/alginate and 2094 for omeprazole alone (ratio 97.90%, 90% confidence interval 87.83-109.12%); AUC(0-a) was 2247 for omeprazole/alginate and 2231 for omeprazole alone (ratio 100.74%, 90% confidence interval 90.05-112.70%). Mean values for T(max), K(el) and T(1/2) were also similar for the two treatment regimens. INTERPRETATION & CONCLUSION: As the 90 per cent confidence intervals for the geometric mean ratios for C(max), AUC(0-t), and AUC(0-alpha) are all contained within the bioequivalence interval of 80-125 per cent, it can be concluded that the administration of this liquid alginate suspension does not affect the pharmacokinetic profile of omeprazole.

Adolescent↗

Dissections after childbirth.

The occurrence of spontaneous internal carotid or vertebral artery dissection after childbirth remains rare. To our knowledge, seven cases of arterial dissection in the postpartum period have been described in the literature as single case reports. We report four additional cases of internal carotid and vertebral artery dissection in the puerperal period, documented by angiography. Physicians should consider the possibility of arterial dissection in any young patient presenting with acute ischemic stroke, including women in the postpartum period. The availability of modern noninvasive ultrasound and imaging techniques may result in earlier diagnosis and facilitate identification of this condition.

Adult↗

A cost effective, community based heart health promotion project in England: prospective comparative study.

OBJECTIVE: To determine whether a community based coronary heart disease health promotion project, undertaken over four years, was associated with changes in the prevalence in adults of lifestyle risk factors known to affect the development of coronary heart disease, and to estimate whether such an approach was cost effective. DESIGN: Prospective, comparative study of the effects of a health promotion intervention on coronary heart disease lifestyle risk factors, assessed by postal questionnaire sent to a randomly chosen sample, both at baseline and after four years. SUBJECTS: Intervention and control populations of adults aged 18-64 in Rotherham, both from areas with a high incidence of coronary heart disease and similar socioeconomic composition. MAIN OUTCOME MEASURES: Changes in prevalence of lifestyle risk factors between the control and intervention communities from 1991 to 1995. The effect of the intervention on certain lifestyle behaviours was evaluated using multiple logistic regression to model the proportion with a particular behaviour in the study communities as a function of age (18-40 or 41-64 years), sex, the year of observation (1991 or 1995), and area (intervention of control). RESULTS: 6.9% fewer people smoked and 8.7% more drank low fat milk in the intervention area, but no other statistically significant changes between the areas were detected. The estimated cost per life year gained was pounds 31. CONCLUSIONS: It is possible to have a cost effective impact on coronary heart disease lifestyle risk factors in a population of adults over four years using only modest resources.

Adolescent↗

Twenty-four hour plasma profile of sustained-release isosorbide mononitrate in healthy volunteers and in patients with chronic stable angina. Two open label trials.

AIMS: The plasma profile of a single dose of isosorbide mononitrate 25 mg (Elantan LA25) in healthy volunteers and in angina patients was examined. METHODS: In volunteers and patients, blood samples for pharmacokinetics were obtained pre-dosing and at intervals for 24 h after dosing. RESULTS: This formulation exhibited rapid absorption and plasma levels were maintained at > 100 ng ml-1 for up to 9 to 12 h. CONCLUSIONS: A comparison of the pharmacokinetics of Elantan LA25 in volunteers and patients indicates that the profiles are similar.

Adult↗

Sexual Dysfunction and the Primary Care Physician.

In addition to discussing the epidemiology and pathophysiology of sexual dysfunction, this comprehensive review addresses a host of chronic illnesses, including spinal cord injuries and endocrine, cardiopulmonary, hemato-oncologic, neurologic, nephrologic, rheumatologic, and orthopedic disorders. Subjects the physician should cover when taking the medical history and physical examination are detailed.

Journal Article↗

Quantitative measurement of cervical range of motion in patients with torticollis treated with botulinum A toxin.

Improvement in cervical range of motion in patients with spasmodic torticollis by botulinum A toxin injection is difficult to objectively measure. Recently, a three-dimensional cervical range of motion system (EMROM) that measures primary as well as secondary cervical angles has been developed. This system uses an electromagnetic tracking system for data collection and a personal computer for analysis and graphic display of the data. We have tested the EMROM system and, from our results, believe that it can be used clinically to objectively and accurately measure cervical range of motion in patients who have spasmodic torticollis and who receive botulinum toxin injections.

Adult↗