PubMed Health⌕ Search

Biomedical subjects

C Rowland

Publications and source records attributed to C Rowland.

28 records · Page 2Linked to original sources
PubMed1990

Hygienic hand disinfection tests in three laboratories.

A comparative study was made in three laboratories of a test for hygienic hand disinfection. Staphylococcus aureus was applied to the fingertips of a total of 74 volunteers (49 female and 25 male) and the effect of washing with three chlorhexidine preparations and one non-medicated soap was assessed after one and five applications. Fingertip inoculation is convenient and is a realistic representation of the in-use situation. Although significant differences were obtained between log10 reductions in test organisms using the same formulation in different centres, and different periods in the same centre, the maximum differences after a single application of a preparation were small, e.g. between centres 0.39 and between periods in the same centre 0.55, and after multiple applications the maximum difference between centres was 0.42 and between periods in the same centre it was 0.51. The differences between preparations were similar in all centres. This test compares well with other similar tests and products can be placed in rank order of effectiveness. It is concluded that this test, if carried out under the controlled conditions described, is sufficiently reproducible between laboratories and repeatable within laboratories to be used as a standard test.

Chlorhexidine↗
PubMed1989

Application of the hygienic hand-disinfection test to the gloved hand.

The Austrian Standard Hygienic Hand-Disinfection Test was adapted for comparing the effect of washing artificially contaminated hands (using Escherichia coli) with contaminated gloved hands, using liquid soap and rinsing with water. Tests showed that a single soap wash completely removed all the bacteria from the glove, and was more than 1000 times more effective on the glove than on the hand.

Escherichia coli↗
PubMed1988

Studies on perioperative skin flora.

Chlorhexidine in spirit is used to reduce the skin bacterial load before surgery; and recently prewashing with chlorhexidine scrub has been advocated. We describe three studies on cardio-thoracic surgical patients--particularly those having coronary artery grafts with long leg and sternal wounds. Two studies compared prewashes with chlorhexidine scrub (Hibiscrub-ICI) or soap. Study Number One (250 patients per group) was of wound infections; and Number Two (25 patients per group) was of alterations in skin flora for 10 days postoperation. Chlorhexidine scrub failed to reduce overall wound infection rates in Study 1, although leg wounds healed more quickly with less inflammation. Study Two showed that the scrub had a significant effect on skin flora that lasted at least 3 days postoperation. Study Number Three was of 100 patients (no chlorhexidine scrub) examined for methicillin-resistant coagulase-negative staphylococci (MRSE) by cultures of swabs from the leg, sternum and chest drain site before and after operation on methicillin agar. Three per cent of patients had MRSE preoperation (1 doctor) and 23% postoperation. One thousand strains were tested by agar dilution against methicillin and chlorhexidine. MRSE had a 2-8-fold increased resistance to chlorhexidine compared to a greater than 256-fold to methicillin. Thus although chlorhexidine has a marked persistent effect on skin flora, emergence of major resistance is unlikely. Use of postoperative chlorhexidine should be investigated further.

Bacteria↗
PubMed1988

What is in the surgeon's glove?

Three aspects of surgical hand hygiene have been studied: the attitude of the surgeon, the microbiology of glove changing during an operation, and the use of antiseptic-coated gloves together with different handwash routines. The survey revealed that the predominant factor in choice of agent for surgical hand hygiene was skin tolerance. The microbiological studies showed that 'closed' glove changing was to be preferred to 'open' changing, and that antiseptic-coated gloves further suppressed the skin flora, even after prolonged operations, compared to standard gloves.

Anti-Infective Agents, Local↗
PubMed1987

Multicenter study of trilostane: a new hormonal agent in advanced postmenopausal breast cancer.

Trilostane, an inhibitor of the production of adrenal estrogens, was administered, together with dexamethasone, to 97 eligible postmenopausal women with advanced breast cancer. Seventy-four patients who had either received trilostane for a minimum of 10 weeks or whose disease had progressed while on trilostane before this period were assessed for tumour response. Eighteen patients (25%) had objective responses (two complete, 16 partial); a further 21 patients had stable disease. The response rate among all 97 patients, including those not treated for a minimum 10-week period, was 19%. Thirty-two of 97 patients reported adverse reactions which were attributed to trilostane and/or dexamethasone. Therapy was stopped for 15 patients, and the dose of trilostane was reduced for ten. Diarrhea was the commonest side effect, being reported in 16 patients, of whom nine stopped treatment. Trilostane, given with a corticosteroid, is an effective alternative hormonal agent acting by adrenal blockade for postmenopausal women with advanced breast cancer.

Breast Neoplasms↗
PubMed1979

Individualizing gentamicin dosage regimens in burn patients with gram-negative septicemia: a cost--benefit analysis.

Services provided by a clinical pharmacokinetics laboratory were evaluated in terms of an accepted cost--benefit model, and a model to evaluate clinical services provided by the pharmacist is presented. A retrospective study was conducted to evaluate the impact, in terms of patient outcomes, of individualizing gentamicin dosage regimens in severely burned patients. Analysis was conducted using multivariate statistical techniques and appropriate nonparametric and parametric tests to determine significant differences. This analysis provided the necessary data to quantify the impact of the pharmacokinetic service. The findings suggest that significant differences do exist in comparing individually dosed patients against those who were not, based upon discriminant and multiple regression analyses and/or nonparametric tests. Furthermore, the results will be useful for insurance companies, third-party payers, and government agencies in deciding which innovative clinical services should be reimbursed.

Burns↗
PubMed1979

Cost-benefit analysis: a research tool for evaluating innovative health programs.

This article reviews the evaluation methodology known as cost-benefit analysis. Studies which have utilized this technique are presented and briefly reviewed. In addition, the closely related technique known as cost-effectiveness (C-E) analysis is described and contrasted with cost-benefit analysis. Several research articles utilizing C-E are described. It is recommended that cost-benefit analysis be used as a mechanism to evaluate innovative health programs. This may be the sole mechanism that will enable health practitioners to cost-justify their innovative services to the federal government and other third-party payers.

Cost-Benefit Analysis↗
PubMed1979

Cost of individualizing aminoglycoside dosage regimens.

The estimated annual costs associated with operating a clinical pharmacokinetics service within a 450-bed, metropolitan county hospital were studied. Using three aminoglycoside serum level determinations, a computer program estimates the patient's pharmacokinetic variables and calculates a dosage regimen which will maintain serum concentrations in the desired range. Pharmacists are involved in assessing the patient's initial clinical condition and in recommending doses and dosing intervals. Fixed costs included the costs of the physical facility and office equipment ($778/yr). Operating costs included salaries, equipment leasing fees, journal subscription fees and medical supplies ($73,915/yr). The estimated cost per blood sample analyzed for aminoglycoside content was $17.35/sample (4,305 samples/yr). The study provides a basis for comparing the cost of operating a pharmacokinetics service with the cost of other innovative pharmaceutical services.

Aminoglycosides↗