Nurses and the law. 13. Life and death.
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Biomedical subjects
Publications and source records attributed to A Martin.
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The bioequivalence of film-coated erythromycin stearate tablets produced by five different manufacturers was evaluated in a balanced incomplete block design involving the five formulations given to 30 fasted subjects over a 3-week study period. Serum levels of erythromycin activity were determined microbiologically. Statistical analysis of variance was performed on the observed bioavailability parameters: maximum serum concentration (Cmax), time to maximum serum concentration (Tmax), and area under the serum concentration-time curve (AUC). There was no statistical difference between formulations for the Tmax parameter. Formulation differences were found, however, based on the analysis of variance of the Cmax and AUC parameters. Two products, although not significantly different from one another, showed significantly greater Cmax and AUC values than the other three products.
Because killed Brucella abortus organisms cultured in smooth (S) or rough (R) phase were known to differentially influence humoral and cellular immune responses and to differ in their effects on T-dependent responses, the antitumor properties of killed B. abortus organisms, cultured in S- or R-phase and then inactivated, were compared in (C57BL/6 X DBA/2)F1 female mice with the use of 6 different transplantable tumors. In solid tumors, the antitumor effects produced by S-preparations were never improved by R-preparations. However, in ascites tumors, R-preparations gave the best antitumor results. These findings suggested that the defense mechanisms acrivated by immunostimulants may differ according to the site of tumor implantation. Among the other experimental factors studied, the route of B. abortus administration had a prominent role. Local injection at the site of tumor implantation before or after the graft gave better results than did systemic treatment. Systemic treatment could enhance the growth of Lewis tumor when applied 5 or 10 days before tumor graft but generally had an antitumor effect when given 1 day after the graft.
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The in situ rat gut technique was used to determine 14-C salicylic acid absorption from aqueous solutions containing 20% glycerol, 20% propylene glycol, 10% ethanol, and 20% polyethylylene glycols (PEG) 4000 and 6000. A phosphate buffer solution of salicylic acid served as a control. Observed rate constants for disappearance of activity from the gut are 0.031 min-1 for glycerol, 0.0327 min-1 for PEG 6000, 0.0395 min-1 for propylene glycol, 0.475 min-1 for polyethylene glycol 4000, 0.0558 min-1 for ethanol, and 0.0752 min-1 for the control. The rate of disappearance from the gut is significantly slower than control for 20% glycerol, PEG 4000 and PEG 6000 solutions (p less than or equal to 0.01). Activity disappears more rapidly from 10% ethanol solutions than from PEG 6000 and glycerol (p = 0.01). Water flux into and out of the intestinal lumen was estimated from tritiated inulin concentrations in the perfusate. A trend for increased loss of activity from ethanol and control solutions associated with net water efflux from the intestine was observed. These results suggest that the composition of drug delivery systems may significantly affect the absorption of drugs from solution.
The authors studied the effects on the child of 196 caesarian sections performed in the absence of foetal distress. The following were noted for each child: the time before the first cry, the Apgar score, pH and the need or not for resuscitation techniques. Each feature was studied in terms of different factors: foetal, obstetric, anaesthetic and surgical. The conclusions were as follows: caesarian section, which remains the best means of preventing obstetric trauma, has its own direct complications which are linked to the conditions in which the operation takes place. These can be reduced to a minimum or even completely suppressed if the caesarian section is performed under ideal conditions: few or no depressant drugs before the operation (the use of diazepam for induction should be abandoned); inclined position of 15 degrees, even of the mother has never suffered from utero-caval syndrome and if possible on a heated mattress; extraction of the infant between the 5th and 15th minutes; finally, and above all, prior labour is desirable whenever obstetric conditions permit.
Ogura's operation consists of resection via De Lima's approach of the bony floor of the orbit and the lateral wall of the ethmoid. The orbital periosteum is then incised in order to allow the orbital fat to enter the sinuses and thus decompress the orbit. In most cases the operation is performed on both sides at the same time. It is used in cases of malignant or severe thyrotoxic exophthalmos, or in the presence of optic neuritis. The results obtained were good in 9 cases with a marked reduction in exophthalmos and rapid cure of optic neuritis. An additional ophthalmological procedure is sometimes necessary in order to perfect the anesthetic result.
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By definition, haemodilution involves the use of filling solutions, but in this technique the role of different solutions has yet to be clearly defined. Amongst the criteria of choice used at the present time, two would seem to be essential: good tolerance, limiting the risks of complication and side effects to an absolute minimum; and a sufficiently long intravascular half-life ensuring good control of blood volume. On this basis, amongst the crystalloids Ringer lactate offers definite advantages. It is almost always used in association with a colloidal solution, very often human albumin or a dextran.