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Biomedical subjects

P Giguere

Publications and source records attributed to P Giguere.

10 recordsLinked to original sources
PubMed2005

Absence of circadian variation in the pharmacokinetics of lopinavir/ritonavir given as a once daily dosing regimen in HIV-1-infected patients.

AIMS: To compare the pharmacokinetics of lopinavir/ritonavir (LPV/r) 800/200 mg administered once daily in the morning compared with the evening. METHODS: This was a randomized, two-way, cross-over study in HIV+ subjects. In each subject the pharmacokinetics of each drug were characterized after 2 weeks of LPV/r 800/200 mg administered once daily at 08.00 h and 19.00 h. On study days, LPV/r was taken with a standardized meal (800 kCal, 25% from fat) after fasting for at least 5 h. LPV/r concentrations were measured by LC-MS/MS, and the data were analyzed by noncompartmental pharmacokinetic analysis. RESULTS: Fourteen subjects completed the study (all men, mean age/weight 44 year/81 kg). The median (interquartile range) LPV AUC(0,24 h), maximum plasma concentration (C(max)) and concentration at the end of the dosing interval (C(24 h)) after am and pm dosing was, respectively, 143 (116-214) mg l(-1) h, 12.8 (10.3-17.2) mg l(-1), 1.34 (0.58-3.25) mg l(-1), and 171 (120-232) mg l(-1) h, 12.9 (8.22-16.3) mg l(-1), 1.15 (0.59-1.98) mg l(-1). The geometric mean ratio (GMR, am : pm) and 95% CI of the LPV AUC(0,24 h), C(max), and C(24 h) was 0.91 (0.79, 1.06), 1.11 (0.94, 1.32), and 1.19 (0.72, 1.96), respectively. The median ritonavir C(max) after am and pm dosing was 1.05 and 0.90 mg l(-1), respectively. The GMR (95% CI) of the RTV AUC(0,24 h), C(max), and C(24 h) was 0.93 (0.80, 1.08), 1.27 (1.00, 1.63), and 1.04 (0.68, 1.60), respectively. Administration of LPV/r in a once-daily regimen was generally well tolerated. CONCLUSIONS: No differences were observed in the pharmacokinetics of LPV/r after am or pm dosing with food, which suggests that this once daily combination, can be taken in the morning or evening. Such flexibility in dosing may improve adherence.

Adult↗
PubMed1992

[Free myocutaneous flap of the latissimus dorsi in cervicofacial surgery].

Free myocutaneous latissimus dorsi transplants are exceptionally used in cervicofacial surgery. The authors have performed an anatomical study of 23 non-embalmed subjects, using injections of neoprene latex and barium sulfate into the axillary artery and dye injections. Dissections, arteriographs and corrosion show that the lower scapular pedicle is constant, with an average length of 9.5 cm and a caliber that is sufficient for vasuclar microsurgery. Eight patients with large T4 cervicocephalic neoplasms were operated, including two with tongue tumors, one with a tumor of the oropharynx, two oromandibular lesions, two lesions of the maxillary sinus and a neuroblastoma involving the middle level of the facial structures. A free myocutaneous latissimus dorsi transplant was used. The transplant was revascularised by neck vessels using microsurgical techniques. Complete success was obtained in all eight patients. Good functional, cosmetic and morphological results were obtained as a rule. In cervicofacial surgery, the authors have thus chosen and used a free myocutaneous latissimus dorsi transplant in three topographic indications: for the oropharynx, to fill large cavities, especially the maxillary sinus, and to fill the middle level of the facial structures and of the base of the skull.

Adult↗
PubMed1982

[Homografts of irradiated costal cartilage].

Preserved irradiated homologous rib cartilage is not frequently used in spite of many publications confirming its value. To draw attention of Canadian otolaryngologists, a review of 62 cases with at least two years follow-up is presented confirming the absence of resorption or immunology response. Furthermore preserved irradiated rib cartilage has been used as replacement for bone grafts in a series presented with illustrations of the stable results obtained. The change of behavior of homologous cartilage in human introduced by gamma irradiation would need to be investigated.

Adolescent↗
PubMed1977

[Bone grafting in facial malformations].

The possibilities of bone graft to the face are multiple. After reviewing the anatomy and physiology of bone grafting, the authors present different types of cases illustrating some of these possibilities. Each case of malformation of the face presents problems in which bone grafting is often an elegant solution with or without osteotomies. After describing the principles and techniques used in these cases, the authors comment upon 26 personal cases using mostly the intraoral approach for laying bone around the face. Three out of 26 have developed postoperative infections but only one case has needed removal of part of the bone grafts. Their youngest patient was 12 years old.

Adolescent↗
PubMed1976

[Malignant bilateral external otitis in a 10-year-old girl].

Malignant external otitis in which the prognosis is very severe has been recently described, as related to diabetes in old age. We present a case with malignant external otitis which occurred in a 10 year old girl, with a very peculiar development. Indeed, the external otitis which appeared at first on the left side was accompanied on this side by a facial paralysis, and six months later in the right, a malignant external otitis was also found without facial palsy. Furthermore, this young girl has been affected by an insipid diabetes, for which no hypophysial or renal pathology has been found. After reviewing the literature on that subject, the authors discuss the clinical aspect of that case and its treatment.

Child↗
PubMedDate not supplied

[Multiple free transplants in microsurgery for cervicofacial reconstruction].

Microsurgical techniques open the way for much creativity and originality for cervicofacial reconstruction and tumoral repair. Between 1976 and 1994, we performed 481 free transplants for cervico-facial reconstruction. A recently developed strategy has been the use of multiple free transplants, either simultaneously or successively. Between 1990 and 1994, we operated and reconstructed 9 patients using multiple free cervico-cephalic transplants after multitissular and agressive exeresis for tumoral or traumatic lesions. In 3 cases, the transplants were made simultaneously and in the 6 others successively. Three patients received 3 free transplants and 6 patients had 2. In 8 cases, each of the transplants was micro-anastomosed on different vessels. In one case, the two transplants were anastomosed in series, the most distal portion being connected to the most proximal portion (in comparison with the cervical vessels). One death occurred at 6 weeks due to infectious complications. The final result for the 8 other patients was good both morphologically and functionally. Indications for multiple free transplants include: complex tissue loss, multiple and massive tissue loss of the cervicocephalic region. This situation occurs particularly in case of voluminous tumours invading several structures, in multiple tumours and in firearm wounds. These series of patients allowed a definition of recommended techniques in case of difficulties in these very elaborate surgical procedures and confirmed that if the strategy is correctly planned, it is possible to greatly improve the quality of survival in these patients in terms of aesthetics, morphology and function.

Adolescent↗