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Biomedical subjects

P Lawford

Publications and source records attributed to P Lawford.

16 recordsLinked to original sources

Engineering human tissue and regulation: confronting biology and law to bridge the gaps.

There are a number of difficulties confronting the regulation of human tissue engineered products, from the scientific, ethical and legal perspectives. Many of these issues are international in scope and any responses must consider the global implications of marketing and monitoring these products. The article argues that as tissue engineered products become more available regulatory authorities should not be pressured into adopting possibly inappropriate measures, but must consider all the factors relevant to human health, including the need for innovative regulatory mechanisms as well as innovative tissue products themselves.

Consumer Product Safety↗

A single dose comparison of a combination of fenoterol and ipratropium aerosols in bronchial asthma.

Nine patients with reversible obstructive airways disease were studied to compare the bronchodilator response to a combination of fenoterol and ipratropium aerosols with two dose levels of fenoterol alone. Using a double-blind, cross-over, single dose regime, 200 micrograms fenoterol hydrobromide and 80 micrograms ipratropium bromide was compared to 400 micrograms fenoterol + placebo, and to 200 micrograms fenoterol + placebo. There was no significant difference between the combination and either dose of fenoterol in terms of peak or duration of response as determined by absolute or percent change in forced expiratory volume in one second, or forced vital capacity, over baseline.

Aerosols↗

Pressurized aerosol inhaler technique: how important are inhalation from residual volume, inspiratory flow rate and the time interval between puffs?

Forty-three patients with obstructive airways disease took part in three studies designed to determine the importance of three modes of inhalation of a beta 2-agonist on bronchodilator response. Under the conditions of the test, lung volume at the time of aerosol release and the time interval between the 2 puffs had no significant effect upon bronchodilator response, but a fast inspiratory flow rate was found to be associated with a significant reduction in response.

Adolescent↗

A comparison of the duration of action of fenoterol and salbutamol in asthma.

Nine asthmatic subjects were given fenoterol or salbutamol aerosol in a double-blind, placebo controlled, crossover study to compare the duration of action of these two drugs. The dose of each drug used was determined in a separate study in 2 asthmatics when 400 micrograms of each drug by aerosol was found to produce the same degree of bronchodilatation. Both drugs produced significant bronchodilator response compared to placebo but, in the doses used, namely, salbutamol 4 puffs (equivalent to 1.6 mumol free base) fenoterol 2 puffs (equivalent to 1.0 mumol free base), only salbutamol showed a significant increase in FEV1 at 8 hours. There were no significant side-effects, or changes in pulse and blood pressure with either drug.

Adolescent↗

Blood changes in atherosclerosis and long after myocardial infarction and venous thrombosis.

The following clinical groups of volunteers were studied: patients long after recovery from myocardial infarction (MI), others after recovery from deep vein thrombosis (DVT), patients with intermittent claudication, with diabetes, and male and female controls who were well matched. All were subjected to many platelet and clotting tests together with clinical, biochemical and haematological measurements in an attempt to find long term abnormalities in these various diseases. The male MIs differed very significantly from the controls in having much more heparin neutralizing activity (P less than 0.001)and less anti-thrombin (P less than 0.01). Less significantly, some bleeding time tests indicated less bleeding and the patients' platelets were larger. The females with MI had in general the same abnormalities but to a lesser degree. The patients with intermittent claudication, none of whom had a history of MI, had almost the same abnormalities and to the same degree. In deep vein thrombosis the heparin neutralizing activity was also clearly increased; the other tests were generally in the same direction but many were not significant. The diabetics had shorter bleeding times but little else abnormal relative to the controls, suggesting a different pathological process. When all male patients and controls were "scored" according to the degree of atherosclerosis there was a close overall correlation between the degree of atherosclerosis and the increase in the HNA level (r = --0.50, n = 66, P less than 0.001) and the decreased anti-thrombin (r = 0.25, n = 66, P less than 0.05).

Antithrombins↗

Heparin neutralizing activity test in the diagnosis of acute myocardial infarction.

We have previously shown in patients after recovery from a myocardial infarct (post-MI) that the heparin neutralizing activity (HNA) in the plasma is raised and that this activity may come from platelet factor 4 derived from activated platelets. This report concerns 89 patients admitted with acute chest pain; in 54, with evidence of acute infarction, the level of HNA is much higher than in a post-MI group or controls. Over the ensuing weeks the HNA decreases to the post-MI level. In 34 patients the evidence subsequently collected excluded a diagnosis of infarction; in these there were almost always normal amounts of HNA and little overlap with the results from the patients with infarcts. This easy test is therefore likely to prove clinically useful. Its significance is discussed. The platelet count and platelet volume are both abnormal in patients with acute infarction and also in the chest pain group so these tests do not help to discriminate.

Acute Disease↗