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Biomedical subjects

M R Howard

Publications and source records attributed to M R Howard.

At least 73 records · Page 4Linked to original sources
PubMed1987

Premedication with lorazepam before bone marrow biopsy.

Fifty patients were randomised in a double blind placebo controlled study to examine the influence of lorazepam (4 mg orally) before bone marrow aspiration and trephine biopsy. Assessment was made by a visual analogue linear pain scale compiled after the procedure and again 24 hours later. There was no difference in the pain recalled immediately after the procedure between the two groups, but the next day the patients who had received lorazepam showed amnesia with a 60% (p less than 0.01) reduction in the pain scale; 36% of the patients in this group had no recall of the procedure at all. There was no amnesic effect in the group taking placebo. Side effects were few, and it is concluded that lorazepam is a useful premedication agent before bone marrow biopsy.

Adolescent↗
PubMed1986

Frequency of attendance at anticoagulant clinics.

The frequency of clinic attendance of long-term anticoagulant patients varies considerably between centres. At this hospital, patients with a record of good anticoagulant control are seen every 3 months, which is double the currently recommended period. To assess this policy, the British ratio of 461 patients on long-term anticoagulants was examined at each visit over the last year. 46% of patients had been seen only at 3-month intervals over the last 5 visits and their anticoagulant control was excellent, 88% of visits falling in the British ratio range 2.0-4.0. It is concluded that amongst chronic anticoagulant patients a significant subgroup may be identified who can safely be monitored at 3-monthly intervals, and this has considerable cost implications.

Ambulatory Care Facilities↗
PubMed1973

Therapeutic non-equivalence of digoxin tablets in the United Kingdom: correlation with tablet dissolution rate.

Seven types of digoxin 0.25 mg tablet in common use in the United Kingdom were administered to a total of 38 patients. Significant differences were found in the mean plasma digoxin levels and in the control of atrial fibrillation achieved with these brands. There was a close correlation between the dissolution rate of the tablets and the plasma digoxin levels. Measurement of in-vitro dissolution rate appears to be a valid method of ensuring that different tablets of digoxin are of equal efficacy. However, in some patients absorption of the drug is markedly sensitive to changes in dissolution rate and new pharmacopoeal standards should not be defined until very rapidly-dissolving formulations have been studied.

Administration, Oral↗
PubMed1973

Plasma digoxin concentration in children with heart failure.

A dosage schedule for digoxin medication is presented which has proved effective and safe in children of different ages with heart failure due to a variety of cardiac conditions. The plasma digoxin concentrations during maintenance therapy, using this schedule, agree closely with previously reported therapeutic adult plasma concentrations, though the results do not exclude the efficiency and safety of higher doses. A twice-daily dosage regimen is suggested.

Body Weight↗
PubMed1971

Effect of digoxin on A-V conduction.

The effect of digoxin on A-V conduction in 19 patients with known disease of their conduction tissue was studied while a demand pacing system was in position. Fifteen had transient complete heart block after myocardial infarction and four had chronic intermittent complete heart block. The patients were studied on return to sinus rhythm.In no instance was a return to either second- or third-degree heart block precipitated in these patients despite therapeutic levels and, in some cases, high serum level of digoxin for a period of seven days.The duration of complete heart block after myocardial infarction was 4.3 days in those taking digoxin while in heart block and 3.3 days in those who started digoxin only after return to sinus rhythm.

Aged↗
PubMed1970

Plasma digoxin concentrations in patients with atrial fibrillation.

Plasma digoxin concentrations were measured by radioimmunoassay in 116 patients with atrial fibrillation on long-term oral treatment with the drug, and in 23 patients with digoxin toxicity. The mean concentrations were 1.4 ng./ml. and 3.1 ng./ml., respectively. Though an overlap occurred between the therapeutic and toxic ranges, toxicity is unlikely to occur below a level of 2 ng./ml. Plasma concentration showed a poor correlation with resting heart rate during atrial fibrillation. In patients with good renal function, however, a significant correlation was found between oral dose and plasma concentration. No evidence was obtained for increased sensitivity to therapeutic concentrations of the drug in elderly subjects, but the doses required to achieve these concentrations tended to be less than in younger patients.

Administration, Oral↗
PubMedDate not supplied

PCR-SSO typing for DR4-Dw subtypes: application to unrelated bone marrow transplant donor selection.

Thirty-seven DR4-positive patient-unrelated bone marrow donor pairs previously DR/DQ restriction fragment length polymorphism (RFLP) typed and tested in mixed lymphocyte culture (MLC), have been DR4-Dw subtyped retrospectively using sequence specific oligonucleotide probes. We found that DR4-Dw subtyping substantially increased the accuracy of pre-MLC matching and could potentially accelerate donor searches by avoiding unnecessary MLC tests on Dw-mismatched donors.

Bone Marrow Transplantation↗