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Biomedical subjects

J Guay

Publications and source records attributed to J Guay.

65 records · Page 4Linked to original sources
PubMed1989

Reye's syndrome. A reappraisal of diagnosis in 49 presumptive cases.

We retrospectively studied 49 patients who were discharged from Sainte-Justine Hospital, Montreal, Canada, or who died between 1970 and 1987 with a presumptive diagnosis of Reye's syndrome. Reye's syndrome was defined as certain, probable, unlikely, or excluded according to clinical, biological, and histologic criteria agreed on a priori by a panel of experts. Patient charts were reviewed blindly by three clinicians. Assessments were similar in 42 cases (86%) (weighted K = 0.78 to 0.85, which suggested substantial agreement); for the remainder, agreement was reached after discussion. Reye's syndrome was considered certain in 1 case (2%), probable in 11 (22%), unlikely in 21 (43%), and excluded in 15 (31%). Four children in the study group did not undergo biopsy or autopsy; in three of these, Reye's syndrome was unlikely according to clinical and biological criteria, and in one, the diagnosis was unclassifiable. The incidence of certain or probable Reye's syndrome was low in our institution during the study period. Our results suggest that the apparent disappearance of Reye's syndrome should be reassessed.

Adolescent↗
PubMed1988

Pharmacokinetics and clinical efficacy of intrarectal solution of acetaminophen.

Acetaminophen is frequently administered orally to children for its analgesic properties, although its potency has never been clearly evaluated in this population. In certain situations (patients vomiting or unconscious), acetaminophen has to be given rectally. However, the rectal absorption of suppositories is frequently erratic. We undertook this study first, to measure the absorption of an aqueous solution of acetaminophen administered rectally. Secondly, we evaluated acetaminophen's postoperative analgesic effects in children aged 1 to 8 years old undergoing adenoidectomy and/or tonsillectomy and compared its efficacy to meperidine. Twenty children received 20 mg.kg-1 of acetaminophen at the time of induction of anaesthesia while 20 others received 1 mg.kg-1 of meperidine intramuscularly. Thirty-two patients required meperidine in the Recovery Room. There was no statistical difference between the patients who received acetaminophen (18), and those who received meperidine (14). The absorption of acetaminophen was incomplete (peak serum concentration: 70.8 mumol.L-1) and delayed. We conclude that the rectal administration of acetaminophen at the induction of anesthesia results in incomplete and delayed absorption and does not prevent the occurrence of immediate postoperative pain in children undergoing adeno-tonsillectomy.

Acetaminophen↗
PubMed1986

Characteristics of interaction of the antiandrogen flutamide with the androgen receptor in various target tissues.

In rat adenohypophysial cells in primary culture, the specific uptake of [3H] testosterone (T) is completely blocked by increasing concentrations of the pure antiandrogen flutamide-OH, the active metabolite of flutamide at an IC50 value of 50 nM while unlabeled T causes a similar inhibition at an IC50 value of 0.5 nM. After 210 min of incubation of 3 nM [3H]T with the anterior pituitary cells, 80% of radioactivity is still present as unchanged T. Direct binding studies show that flutamide-OH and flutamide interact with the rat anterior pituitary androgen receptor at Ki values of 55 and 1275 nM, respectively. In rat ventral prostate (cytosolic and nuclear fractions) and cytosol from human prostatic carcinoma, rat uterus and mouse Shionogi mammary carcinoma, the Ki values ranged from 0.1 to 0.47, 0.6 to 2.7, 62 to 205 and 1450 to 7550 nM for dihydrotestosterone, T, flutamide-OH and flutamide, respectively . Since the ability of flutamide-OH to inhibit the uptake of [3H]T in intact adenohypophysial cells and to compete for binding to the adenohypophysial androgen receptor shows almost identical values at approximately 1% of the potency of T itself, it is most likely that the antiandrogen activity of flutamide-OH can be completely explained by the ability of the pure antiandrogen to displace androgen from their specific receptor in target tissues. In addition, the finding of similar binding characteristics in a series of other tissues suggests that a similar potency of the antiandrogen can be expected in the other androgen-target tissues.

Anilides↗
PubMed1982

[The social worker and family caregivers.].

The author believes in the necessity of enlisting citizen participation in the resolution of psychological and social problems, and proposes a comparative study of the characteristics of two types of intermediaries : the social or professional intermediary, and the natural helper. Closer to those he helps, and unencumbered by bureaucratic norms, it is easier for the natural helper to give his best. The author esteems that collaboration with the natural helper must be based on a respect for natural helper, without seeking its modification or co-optation.

English Abstract↗
PubMedDate not supplied

Theophylline poisoning. Pharmacological considerations and clinical management.

The recent marketing of slow release preparations of theophylline and new indications for the use of the drug have resulted in a marked increase in the sale of theophylline products. This phenomenon combined with the drug's highly variable pharmacokinetics has led to an increase in the number of theophylline intoxications. The morbidity and mortality rates associated with theophylline intoxication are significant. Therefore it is essential that clinicians are aware of the pathophysiology, clinical presentation and treatment of this poisoning. Theophylline intoxication mainly affects the gastrointestinal, cardiovascular and central nervous systems. Signs and symptoms range from mild gastrointestinal upset to serious central nervous system manifestations such as seizures, a symptom often associated with a bad prognosis. Theophylline serum concentrations are very useful for making decisions regarding treatment. However, their interpretation should take into account several factors such as the age of the patient and the type of intoxication (acute versus chronic). Prevention of gastrointestinal absorption should be the principal objective of treatment of an oral theophylline poisoning. The repetitive administration of activated charcoal not only prevents theophylline absorption but also increases its rate of Once absorbed, external methods such as haemodialysis and haemoperfusion can significantly accelerate the elimination of the drug from the body. Finally, the rapid suppression of seizures and cardiac arrhythmias are essential to prevent severe neurological sequelae and death. Since theophylline intoxication can be potentially life-threatening, its administration should be monitored with regular measurements of the serum theophylline concentration, especially in the very young and the very old.

Anticonvulsants↗
PubMedDate not supplied

Benzodiazepine poisoning. Clinical and pharmacological considerations and treatment.

Benzodiazepines are among the most frequently prescribed drugs worldwide. This popularity is based not only on their efficacy but also on their remarkable safety. Pure benzodiazepine overdoses usually induce a mild to moderate central nervous system depression; deep coma requiring assisted ventilation is rare, and should prompt a search for other toxic substances. The severity of the CNS depression is influenced by the dose, the age of the patient and his or her clinical status prior to the ingestion, and the coingestion of other CNS depressants. In severe overdoses, benzodiazepines can occasionally induce cardiovascular and pulmonary toxicity, but deaths resulting from pure benzodiazepine overdoses are rare. Quantitative determinations of benzodiazepines are not useful in the clinical management of intoxicated patients since there is no correlation between serum concentrations and pharmacological and toxicological effects. Benzodiazepine overdoses occurring during pregnancy rarely induce serious morbidity in mothers or fetuses, although large doses administered near delivery can induce respiratory depression in neonates. The teratogenic potential of benzodiazepines remains controversial, but is probably small if it exists at all. There is clear evidence that the prolonged use of even therapeutic doses of benzodiazepines will lead to dependence. The risk of developing significant withdrawal symptoms is related to dosage and duration of treatment. Prevention of gastrointestinal absorption should be initiated in all intentional benzodiazepine overdoses. Forced diuresis and dialysis techniques are not indicated since they will not significantly accelerate the elimination of these agents. Intravenous administration of flumazenil, a pure benzodiazepine antagonist, effectively reverses benzodiazepine-induced CNS depression.

Benzodiazepines↗
PubMedDate not supplied

A new class of leukotriene biosynthesis inhibitor: the development of MK-0591.

The evolution of MK-0591 (3-[1-(4-chlorobenzyl)-3-(t-butylthio)-5-(quinolin-2-ylmethoxy+ ++)indol-2-yl]- 2,2-dimethylpropanoic acid), 12, a potent, orally active leukotriene biosynthesis inhibitor is described. MK-0591 is currently undergoing clinical evaluation as a potential agent for the treatment of asthma and inflammatory bowel disease. It acts through a novel mechanism by a specific interaction with a membrane protein, 5-lipoxygenase activating protein (FLAP), which has been shown to be essential for LT synthesis in inflammatory cells. A brief comparison of its biological activity with that of its progenitors MK-886 and L-674,636 is described.

5-Lipoxygenase-Activating Proteins↗