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Biomedical subjects

Sam Rowlands

Publications and source records attributed to Sam Rowlands.

11 recordsLinked to original sources
PubMed2006

The development of a nationwide central booking service for abortion.

BACKGROUND: Central booking services have been proven to facilitate access to abortion services. This in turn should reduce morbidity and mortality. City-wide models have previously been described. A nationwide central booking service has been developed in the UK. DEVELOPMENT: A nationwide central booking service was introduced in 1993. Initially a manual booking system was used. In 1996 the appointment system was computerised. OUTPUT: More than a quarter of a million calls are now received each year. The highest demand weekday is a Monday. The volume of calls peaks at mid-morning. There is a sustained rise in calls from the second week in January through to mid-February, peaking in the fifth week of the year. More than a quarter of calls originate from mobile phones. CONCLUSIONS: The computerised central booking service has radically improved the efficiency of the organisation. Waiting times can be actively managed using data from the system.

Abortion, Legal↗
PubMed2004

FFPRHC Guidance (January 2004). The copper intrauterine device as long-term contraception.

This Guidance provides information for clinicians providing women with copper-bearing intrauterine devices as long-term contraception. A key to the grades of recommendations, based on levels of evidence, is given at the end of this document. Details of the methods used by the Clinical Effectiveness Unit (CEU) in developing this Guidance and evidence tables summarising the research basis of the recommendations are available on the Faculty website (www.ffprhc.org.uk). Abbreviations (in alphabetical order) used include: acquired immune deficiency syndrome (AIDS); actinomyces-like organisms (ALOs); automated external defibrillator (AED); blood pressure (BP); British National Formulary (BNF); confidence interval (CI); copper-bearing intrauterine contraceptive device (IUD); emergency contraception (EC); Faculty Aid to Continuing Professional Development Topic (FACT); levonorgestrel-releasing intrauterine system (IUS); human immunodeficiency virus (HIV); Medicines and Healthcare products Regulatory Agency (MHRA); non-steroidal antiinflammatory drugs (NSAIDs); odds ratio (OR); pelvic inflammatory disease (PID); relative risk (RR); Royal College of Obstetricians and Gynaecologists (RCOG); Scottish Intercollegiate Guidelines Network (SIGN); sexually transmitted infection (STI); termination of pregnancy (TOP); World Health Organization (WHO); WHO Medical Eligibility Criteria (WHOMEC); WHO Selected Practice Recommendations (WHOSPR).

Consumer Product Safety↗
PubMed2003

Newer progestogens.

OBJECTIVE: To review the literature on the most recent progestogens to be developed, to provide clinical comparisons with older progestogens and to look at the potential of products not yet marketed. DATA SOURCES: Searches of Medline and Popline together with requests for bibliographies from the Population Council, Wyeth-Ayerst Research and Schering Health Care. STUDY SELECTION: Information from technical papers was used to ascertain the metabolic characteristics and receptor binding affinities of the compounds. Previous reviews were scrutinised in order to make comparisons with older compounds. Any available trials were examined to ascertain efficacy, bleeding patterns and tolerability, more weight being given to comparative trials. DISCUSSION: Five progestogens have been developed in the last decade. They are all devoid of androgenic activity; some have antiandrogenic activity. Combined oral contraceptive (COC) pills containing dienogest and drospirenone are already marketed. Nomegestrol and nestorone have been extensively studied as subdermal implants. CONCLUSIONS: Newer progestogens used in combination with oestrogen behave very similarly to existing products. Progestogen-only products using new progestogens have potential for significantly better tolerability due to their lack of androgenic activity.

Contraceptives, Oral, Combined↗
PubMed2003

The incidence of sterilisation in the UK.

OBJECTIVE: To estimate incidence rates for tubal occlusion and vasectomy, and to examine how these vary with age, geographical area and time. DESIGN: Search of patient files for operation codes in the years 1992-1999 and calculation of person time. POPULATION AND SETTING: General Practice Research Database. METHODS: Patient files of women aged 20-54 years and men aged 20-64 years were searched for sterilisation operation codes. Annual incidence rates in five year aged bands were calculated for sterilisation operations for both sexes. Figures were examined according to National Health Service Region and population density category of the general practices. The relationship between year of operation and mean age at operation was also examined. MAIN OUTCOME MEASURES: Incidence rates by year, age group and geographical area. RESULTS: The average annual incidence of sterilisation in the eight year period was 4.75 per 1000 person years at risk for women aged 20-54 and 4.48 per 1000 person years at risk for men aged 20-64. For women, there was a statistically significant 30% decrease in incidence of tubal occlusion over the study period. There was no change in vasectomy rates over time. About one-third of all vasectomies in the UK are estimated to be performed outside hospital and community clinic settings. The rates of sterilisation in both sexes were much lower in Greater London than elsewhere in the UK. CONCLUSIONS: The popularity of tubal occlusion appears to be on the decline. Since 1996, the UK has been one of very few countries in which sterilisation incidence in men is greater than that in women.

Adult↗
PubMed2002

Consultation rates from the general practice research database.

An analysis was undertaken of consultation rates in 226 UK general practices contributing to the General Practice Research Database. Over the period 1992-1998 the mean age-standard-ised consultation rate per person year at risk was 3.85 (3.01 for males and 4.71 for females). In contrast with younger ages, consultation rates among those aged 65years and over showed an upward trend over the seven-year period. Consultation rates were higher in areas of low population density as compared with higher density areas.

Adolescent↗
PubMedDate not supplied

Increased risk of achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids.

BACKGROUND: In several case reports, the occurrence of Achilles tendon rupture has been attributed to the use of quinolones, but the epidemiologic evidence for this association is scanty. METHODS: We conducted a population-based case-control study in the General Practice Research Database in the United Kingdom during the period 1988 through 1998. Cases were defined as all persons who had a first-time recording of an Achilles tendon rupture, and who had at least 18 months of valid history before the index date. As a control group, we randomly sampled 50 000 patients with at least 18 months of valid history who were assigned a random date as index date. RESULTS: We identified 1367 cases that met the inclusion criteria. The adjusted odds ratio (OR) for Achilles tendon rupture was 4.3 (95% confidence interval [CI], 2.4-7.8) for current exposure to quinolones, 2.4 (95% CI, 1.5-3.7) for recent exposure, and 1.4 (95% CI, 0.9-2.1) for past exposure. The OR of Achilles tendon rupture was 6.4 (95% CI, 3.0-13.7) in patients aged 60 to 79 years and 20.4 (95% CI, 4.6-90.1) in patients aged 80 years or older. In persons aged 60 years and older, the OR was 28.4 (95% CI, 7.0-115.3) for current exposure to ofloxacin, while the ORs were 3.6 (95% CI, 1.4-9.1) and 14.2 (95% CI, 1.6-128.6) for ciprofloxacin and norfloxacin, respectively. Approximately 2% to 6% of all Achilles tendon ruptures in people older than 60 years can be attributed to quinolones. CONCLUSIONS: Current exposure to quinolones increased the risk of Achilles tendon rupture. The risk is highest among elderly patients who were concomitantly treated with corticosteroids.

4-Quinolones↗