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Biomedical subjects

N Lery

Publications and source records attributed to N Lery.

At least 19 recordsLinked to original sources
PubMed1996

Guidelines on artificial nutrition versus hydration in terminal cancer patients. European Association for Palliative Care.

Whether a terminally ill cancer patient should be actively fed or simply hydrated through subcutaneous or intravenous infusion of isotonic fluids is a matter of ongoing controversy among clinicians involved in the care of these patients. Under the auspices of the European Association for Palliative Care, a committee of experts developed guidelines to help clinicians make a reasonable decision on what type of nutritional support should be provided on a case-by-case basis. It was acknowledged that part of the controversy related to the definition of the terminal cancer patient, since this is a heterogeneous group of patients with different needs, expectations, and potential for a medical intervention. A major difficulty is the prediction of life expectancy and the patient's likely response to vigorous nutritional support. In an attempt to reach a decision on the type of treatment support (artificial nutrition vs. hydration) which would best meet the needs and expectations of the patient, we propose a three-step process: Step 1: define the eight key elements necessary to reach a decision; Step II: make the decision; and Step III: reevaluate the patient and the proposed treatment at specified intervals. Step I involves assessing the patient concerning the following: 1) oncological/clinical condition; 2) symptoms; 3) expected length of survival; 4) hydration and nutritional status; 5) spontaneous or voluntary nutrient intake; 6) psychological profile; 7) gut function and potential route of administration; and 8) need for special services based on type of nutritional support prescribed. Step II involves the overall assessment of pros and cons, based on information determined in Step I, in order to reach an appropriate decision based on a well-defined end point (i.e., improvement of quality of life; maintaining patient survival; attaining rehydration). Step III involves the periodic reevaluation of the decision made in Step II based on the proposed goal and the attained result.

Fluid Therapy↗
PubMed1993

[Not Available].

Explore the source record for details and available documents.

Ethics, Medical↗
PubMed1990

Influence of food on the bioavailability of diltiazem and two of its metabolites following the administration of conventional tablets and slow-release capsules.

The influence of food on the bioavailability of a conventional tablet and of a slow-release capsule of diltiazem was investigated in two separate groups of 24 healthy volunteers in two open crossover studies. Diltiazem, as a conventional tablet (2 x 30 mg, first group) or as a slow-release capsule (120 mg SR, second group), was administered in a fasting condition and 30 min after a breakfast of 784 kcal (23 per cent proteins, 55 per cent lipids, and 22 per cent of carbohydrates). Multiple blood samples were withdrawn during the next 24 h and diltiazem, desmethyldiltiazem, and deacetyldiltiazem were assayed by HPLC. Neither the rate of absorption, assessed by the rate constant of absorption, the peak plasma concentration, and the time required to reach the peak, nor the amount of drug reaching the systemic circulation, assessed by the area under the plasma concentration time curve (AUC infinity) were influenced by food, and that independently of the formulation. Compared to the fasting experiment, food did not affect either the rate of formation or the AUC infinity of desmethyldiltiazem or deacetyldiltiazem. The results of the present study show that the relative bioavailability of the single dose of diltiazem administered as a slow-release capsule is significantly higher (69 per cent) than that estimated after the administration of diltiazem in a conventional tablet. It was concluded that food does not influence the bioavailability of diltiazem administered as a conventional tablet or as a slow-release formulation.

Administration, Oral↗
PubMed1982

Interactions between alcohol and drugs.

There are many interactions between alcohol and drugs. Their practical incidences have already had some medico-legal illustrations, for example in their influence on car driving. This concept of interaction raises a more general problem still, ie that of the possible effects of alcohol on the chemical, toxicologic and nutritional conditions of the body. There is plenty of need for further experiments.

Acetaldehyde↗
PubMed1980

Inhibition by idrocilamide of the disposition of caffeine.

The pharmacokinetics of caffeine are greatly altered by concomitant administration of idrocilamide. In four healthy volunteers id rocilamide inhibited the biotransformation of caffeine and increased its half-life nine times. The untoward neuropsychiatric effects of idrocilamide are the consequence of abnormal accumulation of caffeine in regular consumers of caffeine-containing foods and beverages.

Adult↗
PubMed1980

[The experiment of medicaments on a healthy man. Its situation compared to the French law and the medical ethics (author's transl)].

After having looked at which was the value and the scientific extent of experiments on a healthy man, the authors show in which conditions this type of experiment can be considered as ethical. Two points are important in order to admit this ethical character: the necessity of the experiment and the existence of a collective benefit. Then, the juridical outline of these experiments is debated and the authors remind: --that medicinal products are experimented on the healthy man, --that there are texts which make official the acts offering risk, with collective benefit exclusively, --that a law imposes experiments for non-medicinal products. Finally, the types of responsibilities which could be looked at in case of experiment on a healthy man, with collective benefit, are debated.

Clinical Trials as Topic↗
PubMed1979

Aspirin and gastrointestional bleeding. Interest of plasma salicylate determination.

From history-taking and from analysis of plasma salicylate levels it is shown that a link exists between aspirin and gastrointestinal bleeding in 68% of cases. Salicylate levels alone indicate that aspirin has been taken in 22% of cases. Plasma salicylate measurement and endoscopy allow a better understanding of haemorrhagic lesions due to aspirin. Aspirin is responsible especially for haemorrhage from ulcers and acute gastritis or duodenitis. Aspirin is seen to be dangerous in a moderate number of susceptible individuals: those with peptic ulcer constitution or cirrhosis.

Aspirin↗