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Biomedical subjects

D L Cowen

Publications and source records attributed to D L Cowen.

At least 19 recordsLinked to original sources
PubMed1993

America's pre-pharmacopoeial literature.

The pharmacopoeia, whether official or quasi-official, represents a noteworthy responsibility and maturity in medical and pharmaceutical professional development. The absence of a high level of development in the British American colonies therefore accounts for the absence of any indigenous American pharmaceutical literature in the colonial period. By the same token, as medical education and science improved and as pharmacy developed autonomy in the early national period, there followed a burst of publications that preceded the issuance of the first Pharmacopoeia of the United States of America in 1820.

Colonialism↗
PubMed1992

Changing relationship between pharmacists and physicians.

The changing professional relationship between pharmacists and physicians in the United States from the beginning of the nineteenth century to the present is described. Throughout the nineteenth century, physicians intruded heavily on the pharmacist's domain, and medicine often viewed pharmacy with condescension. Toward the century's end, pharmacists gained more respect and recognition as the medical and pharmaceutical sciences grew and physicians found themselves relying on pharmacists. Hundreds of years of friction were not easily forgotten, though, and the two professions continued to hurl charges and countercharges and vie for power. With the emergence of the pharmacist as a full member of the health-care team and the crush of medical information in the twentieth century, greater cooperation is occurring, although irritations persist, especially in the areas of physician dispensing and therapeutic interchange. Improvements in the relationship between pharmacists and physicians were driven by growth in their fields and the trend toward specialization. As tensions ease, patient care should benefit.

Humans↗
PubMed1987

Suppression and treatment of urinary tract infection in patients with an intermittently catheterized neurogenic bladder.

We evaluated the optimal means of prevention and treatment of urinary tract infections in 46 patients with an intermittently catheterized neurogenic bladder. Suppression with nightly 160 mg. trimethoprim and 800 mg. sulfamethoxazole compared to placebo showed no difference in the rate of symptomatic or total urinary tract infections. Symptomatic urinary tract infections occurred at the same rate whether routine asymptomatic infections were treated or not. Three-day antibiotic treatment of urinary tract infections showed no decrease in the frequency of symptomatic or total urinary tract infections compared to 10-day therapy. The frequency of post-treatment urinary tract infection persistence, relapse and cure was identical in both groups. Suppressive antibiotics, treatment of asymptomatic urinary tract infections and full course antibiotic therapy offered no advantage over placebo, treatment of symptomatic urinary tract infection only and short course therapy in the management of urinary tract infection in patients with an intermittently catheterized neurogenic bladder.

Adult↗
PubMed1986

The evaluation of creatinine clearance in spinal cord injury patients.

The parameters of age, height, weight, serum creatinine and 24-hour urinary creatinine production were measured in 101 consecutive spinal cord injury patients (79 men and 22 women, 43 quadriplegics and 58 paraplegics) admitted to a rehabilitation hospital. Creatinine production was significantly lower than that of age and sex-matched hospitalized controls, upon whom commonly used nomograms for evaluation of endogenous creatinine clearance are based. Therefore, these nomograms grossly overestimate the creatinine clearance in paralyzed patients, which often results in aminoglycoside overdosage. Regression analysis identified the interval since injury and age as important determinants of creatinine production. We propose 2 simple equations and nomograms that should allow more accurate prediction of creatinine clearance in spinal cord injury patients.

Adult↗
PubMed1984

Pharmacy and freedom.

The development of pharmacy in Western civilization has been influenced by ideas of individual liberty; the impact of these ideas is traced. For a short time during the French Revolution, individuals without qualifications could practice pharmacy, but abuses prompted return of regulation; from 1803, pharmacy was closely regulated by the state. Liberal thinking in 19th-century Britain left control of pharmacy mainly within the profession; regulation was definitive rather than restrictive. With the influence of Jacksonian Democracy and freedom of trade in the United States, there were no effective pharmacy regulations until the late 19th century and few educational requirements for licensure until the 1920s. In Germany, the old system of concessions and privileges was upset after World War II when any qualified pharmacist was allowed to open a shop wherever desired in the American-occupied zone; the courts upheld this policy as the basis for establishment of pharmacies in West Germany. Liberty in dispensing drugs has been limited out of concern for the well-being of individuals and of society as a whole. In Great Britain and the U.S., restrictions on dispensing antedated laws establishing qualifications for pharmacists. The history of pharmacy demonstrates that there are moral and social barriers to realization of the ideals of liberty. History also suggests that if pharmacists assume responsibilities that use their specialized training, they can defend against inroads by nonpharmacists.

Civil Rights↗