The International journal of artificial organs
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Various totally implantable drug delivery systems from single access ports to micropumps are now available for administration of repeated boluses, and continuous or programmable infusions. In this respect, emphasis is given to a relatively cheap, totally implantable system for self-administering intraspinal opiates in the treatment of cancer pain. The SECOR pump system, developed by Cordis, consists of a dual pump with refill port and safety valve. ⋯ Clinical results demonstrated that this patient-controlled drug delivery system is safe and provides excellent pain relief associated with terminal cancer. A possible advantage of this drug delivery system over continuous infusion pumps is that patients can elect to have the morphine delivered only when they feel pain. Thus pain relief would be maximized and tolerance build-up would be minimized.
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Having examined the various disadvantages of the catheterization of the central veins performed using the Seldinger technique, we report our results of internal jugular vein catheterization under echographic guidance in 38 uremic patients. The echographic guidance technique allows an easier and safer utilization of the internal jugular vein as vascular access in emergency situations.
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Randomized Controlled Trial Clinical Trial
Contact, coagulation and platelet interaction with heparin treated equipment during heart surgery.
Heparin coating of an extracorporeal device may reduce blood activation. To evaluate protein and platelet interaction with Duraflo II surface treatment of the cardiopulmonary bypass (CPB) circuit, thirty coronary artery bypass grafting patients were randomly divided into two groups (Duraflo II, n = 15 or Control, n = 15). Binding of antibodies against factor XII, antithrombin III (ATIII) and platelet receptor GpIb were significantly higher (p < 0.01) on the Duraflo II treated surface. ⋯ During the second phase of CPB, after release of the aortic crossclamp, factor XII and thrombin were strongly activated in both groups indicated by a sharp increase in concentrations of T/AT complex as well as FPA. Platelet numbers tended to increase more in the control group during CPB than in the Duraflo II group, likely by interaction of platelet GpIb receptors on the Duraflo II treated surface (p < 0.01). However, platelet activation assessed by beta-TG was similar in both groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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This study determines the evolution of ECC in EEC. After recollecting the great stages of ECC since its routinely use in open heart surgery, the study situates its position in the entire world taking into account several indexes like the Gross National Product (GNP) and its evolution, the life expectancy and some other factors either technical or economical. ⋯ A more detailed analysis has been achieved for France thanks to a greater number of data. In such a study the major difficulty is to estimate the relevance and consistency of data which can change very quickly and are provided either by companies or by other organization.