Search PubMed⌕ Search

Biomedical subjects

P Paris

Publications and source records attributed to P Paris.

42 records · Page 3Linked to original sources
PubMed1982

Intravenous nitroglycerin perfusion techniques--clinical implications.

Two types of intravenous nitroglycerin (NTG) perfusion sets were studied using laboratory techniques. A known concentration of NTG was placed in each of these sets, and an evaluation was made as to the dose of NTG actually received by the patient after passage of the NTG solution through the sets. Set number one consisted of a glass container and polyvinyl chloride (PVC) tubing. After passage through this set, there was a rapid and significant decrease in the NTG concentration, i.e. the dose actually received by the patient is less than the dose theoretically administered. Set number two consisted of a polypropylene syringe and polyethylene tubing. After passage through this set, there was no significant change in the NTG concentration, i.e. the patient receives the full theoretical dose.

Angina Pectoris↗
PubMedDate not supplied

One liver for two: partition of the portal elements.

A cadaver liver is divisible into two transplants by section between right and left lobes, or section between left medial segment and left lateral segment medial to the umbilical cleft. To establish the ideal basis of partition of the portal elements, an anatomic study of 33 livers was performed. It is preferable to section the left portal vein, longer and more constant than the right, the right branch of the hepatic artery, larger and more constant than the left, and the left hepatic duct because of the vascularization of the common hepatic duct. To use the length of the left portal vein, it is necessary to section all its branches to segment I and then to resect this segment. After a section between the left medial segment and the left lateral segment medial to the umbilical cleft, the left medial segment always loses its total portal venous vascularization and should be resected. Before a split-liver, cholangiography and arteriography should be performed to detect anatomical variations without performing an extensive dissection which may endanger the vascularity of the bile ducts.

Adult↗
PubMedDate not supplied

When "enough" is not enough: new perspectives on optimal methadone maintenance dose.

Some methadone maintenance treatment (MMT) programs prescribe inadequate daily methadone doses. Patients complain of withdrawal symptoms and continue illicit opioid use, yet practitioners are reluctant to increase doses above certain arbitrary thresholds. Serum methadone levels (SMLs) may guide practitioners dosing decisions, especially for those patients who have low SMLs despite higher methadone doses. Such variation is due in part to the complexities of methadone metabolism. The medication itself is a racemic (50:50) mixture of 2 enantiomers: an active "R" form and an essentially inactive "S" form. Methadone is metabolized primarily in the liver, by up to five cytochrome P450 isoforms, and individual differences in enzyme activity help explain wide ranges of active R-enantiomer concentrations in patients given identical doses of racemic methadone. Most clinical research studies have used methadone doses of less than 100 mg/day [d] and have not reported corresponding SMLs. New research suggests that doses ranging from 120 mg/d to more than 700 mg/d, with correspondingly higher SMLs, may be optimal for many patients. Each patient presents a unique clinical challenge, and there is no way of prescribing a single best methadone dose to achieve a specific blood level as a "gold standard" for all patients. Clinical signs and patient-reported symptoms of abstinence syndrome, and continuing illicit opioid use, are effective indicators of dose inadequacy. There does not appear to be a maximum daily dose limit when determining what is adequately "enough" methadone in MMT.

Adult↗