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Biomedical subjects

J Perez

Publications and source records attributed to J Perez.

At least 217 records · Page 12Linked to original sources

Kinetic disposition and diuretic effect of frusemide in acute pulmonary oedema.

The kinetic disposition and diuretic effect of frusemide was assessed in 16 patients with acute pulmonary oedema utilizing a specific gas-liquid chromatographic assay for the drug. Serum frusemide concentrations decayed biexponentially with wide variation in both alpha half-life (range 15-79 min) and beta half-life (range 127-1190 min). The beta phase half-life was inversely related to creatine clearance. The apparent volume of distribution varied greatly among the patients (range 0.085-0.818 l/kg), and patients with an acute myocardial infarction had a larger peripheral kinetic compartment. Patients with acute myocardial infarction excreted less unchanged drug and had a lesser urinary excretion of sodium and volume compared to patients without infarction. The urinary excretion of sodium, chloride, calcium and volume was linearly related to the urinary excretion of unchanged frusemide.

Adult↗

Pharmacokinetic disposition and protein binding of furosemide in newborn infants.

Using a one-compartment model, the pharmacokinetic disposition of furosemide was studied in eight premature and term neonates with fluid overload. Following a single intravenous injection of furosemide (1 to 1.5 mg/kg), multiple blood samples were obtained from a heelstick or an arterial catheter and analyzed for furosemide by gas liquid chromatography. The mean (+/- SE) apparent volume of distribution was 829.2 +/- 118.9 ml/kg; t1/2 was 7.7 +/- 1.0 hour; elimination rate constant was 0.102 +/- 0.013/hour and plasma clearance was 81.61 +/- 14.98 ml/kg/hour. Compared to the disposition of furosemide in normal adults. AVd is almost fourfold greater in the neonate with an eightfold prolongation in plasma t1/2, an eightfold decrease in Ke1, and a twofold decrease in plasma clearance. Neither gestational and postnatal age nor birth weight correlated with the pharmacokinetic variables. No significant change in reserve bilirubin-binding capacity after an intravenous dose of furosemide was noted. Slow elimination of furosemide may partly explain the prolonged diuretic and saluretic effect of furosemide in the neonate.

Bilirubin↗

Hemorrhoidectomy--how I do it: experience with the St. Mark's Hospital technique for emergency hemorrhoidectomy.

Eighty-five patients who had thrombosed hemorrhoids underwent emergency hemorrhoidectomy according to St. Mark's Hospital technique, with very good results. All specimens were found to have dilated blood vessels filled with thrombi of different sizes, with irregular, fibrotic or hyalinized vascular walls. Early complications included urinary retention and painful defecation in some patients. Late complications included only skin tags. No sepsis was found among our patients. Although operative bleeding can be tedious during the hemorrhoidectomy, it was a complication in the postoperative period of only one patient. Segmental, open hemorrhoidectomy performed according to the St. Mark's Hospital technique has been shown to be an ideal operation for the treatment of patients who have hemorrhoidal thrombosis, prolapse, edema, and bleeding.

Adult↗

Peritoneal localization of gallium-67.

Diffuse abdominal localization of 67Ga was found in two patients with peritonitis; one due to M. tuberculosis, and the other presumably pyogenic, following multiple perforations of the small bowel due to necrotizing ulcerating enteritis. After 7 months of antituberculous treatment of the first patient, a normal gallium distribution was noted. It is suggested that gallium scanning may be useful in the diagnosis of peritonitis and perhaps of other serosal infections.

Adult↗

Successful correction of all mechanical complications of ischemic heart disease in the same patient.

Extensive surgery for all of the mechanical complications of ischemic heart disease is feasible with early diagnosis, catheterization, and aggressive medical and surgical therapy. A patient is report who, after recovering from cardiogenic shock, required a coronary bypass, closure of ventricular septal defects, mitral valve replacement, aneurysmectomy, and temporary pacemaker wires. The outcome was successful.

Aged↗

A new apparatus for the localization of nonpalpable mammary lesions.

A new apparatus has been used for the localization of 46 nonpalpable mammary lesions seen in either of two radiological projections. This device compresses and immobilizes the breast independently of the mammography equipment and permits a three-dimensional localization of the lesion by using the technique of X-ray angulation. The results demonstrate the efficiency of the procedure. Transfixation of the lesions was established in 30 cases (65.2%), the guidewire passed very close to the lesion in 14 cases (30.4%), and in 2 cases (4.4%) the guidewire was seen to be less than 10 mm away from the lesion. Correct preoperative localization of the lesions permitted a correct diagnosis with minimal biopsies.

Adult↗

Airway compromise and delayed death following attempted central vein injection of propylhexedrine.

Propylhexedrine is a potent alpha-adrenergic drug available as a nasal decongestant, which drug abusers sometimes extract and inject into a central vein. A 25-year-old white male presented to a local emergency department 32 h after attempting to inject his right internal jugular vein with "home-made crank." Following injection, he noted right neck pain, followed by fever and chills. On emergency department admission, he had inspiratory stridor and respiratory distress. Massive edema of his right neck extended from his anterior chest to the right parotid. Neck radiographs showed extensive paracervical swelling with displacement of the trachea. The patient was taken to surgery for nasotracheal intubation with fiberoptic guidance and surgical exploration. The neck contained extensive necrotic tissue that was surgically debrided. In spite of treatment with antibiotics, he developed progressive renal failure and hypotension unresponsive to fluid therapy, followed by cardiopulmonary arrest and death.

Adult↗

cAMP-dependent phosphorylation system after short and long-term administration of moclobemide.

Accumulating evidence suggested that signal transduction cascade including protein phosphorylation is implicated in the neurochemical action of antidepressant agents. Clinical data indicated that moclobemide, a short acting and reversible inhibitor of monoamino oxidase type. A, is an effective antidepressant medication. However, little is known about the intracellular effects of this compound. Thus, in the present study we assessed the binding of cAMP to cAMP-dependent protein kinase (PKA) in rat cerebral cortex following short and long-term administration of moclobemide. The results showed that 21 days of treatment with moclobemide significantly increased the specific [32P]-cAMP covalent binding into the soluble 52-54 kDa cAMP-receptor. This effect was not seen following 1, 5 and 12 days of treatment. These findings suggest that PKA could be implicated in the biochemical effects of moclobemide.

Animals↗