RESUMEN
A liquid chromatography-tandem mass spectrometric assay for the determination of uracil, 5,6-dihydrouracil and beta-ureidopropionic acid in urine was developed to measure the activities of enzymes involved in pyrimidine breakdown. The assay was required to investigate the relation between the uracil-dihydrouracil ratio and toxicities observed after treatment with fluoropyrimidines drugs. After addition of stable isotopically labelled internal standards, the analytes were isolated from a 100-microl urine sample using liquid-liquid extraction with ethyl acetate-2-propanol. Compounds were separated on an Atlantis dC18 column, using ammonium acetate-formic acid in water as the eluent. The eluate was totally led into an electrospray interface with positive ionisation and the analytes were quantified using triple quadrupole mass spectrometry. The assay was validated in the range 1.6-1600 microM, using both, artificial urine and pooled urine as matrices. Intra-day precisions were < or = 8% and inter-day precisions were < or = 10%. Accuracies between 91 and 108% were found. The analytes were chemically stable under all relevant conditions and the assay was successfully applied in two clinical studies of cancer patients treated with 5-fluorouracil or capecitabine.
Asunto(s)
Enzimas/metabolismo , Pirimidinas/metabolismo , Uracilo/análogos & derivados , Uracilo/orina , beta-Alanina/análogos & derivados , Bioensayo , Calibración , Capecitabina , Estudios de Casos y Controles , Niño , Preescolar , Cromatografía Liquida , Desoxicitidina/análogos & derivados , Desoxicitidina/metabolismo , Desoxicitidina/uso terapéutico , Femenino , Fluorouracilo/metabolismo , Fluorouracilo/uso terapéutico , Humanos , Recién Nacido , Masculino , Espectrometría de Masa por Ionización de Electrospray , Uracilo/química , Uracilo/metabolismo , beta-Alanina/química , beta-Alanina/metabolismo , beta-Alanina/orinaRESUMEN
To study the impact of rehabilitation on disability in an unselected patient group with acutely and chronically disabling neurologic diseases, the Extended Barthel Index (EBI) was determined at the beginning and at the end of the rehabilitation stay in all patients admitted to our Neurorehabilitation Centre in Valens, Switzerland. Patients who reached the highest possible EBI score at entry ("ceiling effect"), with a short stay (<1 week), or with a deterioration due to other medical complications were excluded. Finally EBI data of 743 patients could be analyzed. The mean EBI at entry was 45 and 51 at discharge. The mean increase of the EBI score per week was 1.1 (SD, 1.7). The change of the EBI score was analyzed independently in patients with acute neurologic diseases admitted in the postacute phase (acute group) and patients with chronically disabling neurologic diseases (chronic group). As expected, the increase of the EBI score was higher in the acute group than in the chronic group; 80.8% of the acute group patients and 42.5% of the chronic group patients showed an increase of the EBI score at discharge. Both groups showed a significant EBI gain with a marked shift to higher EBI scores at discharge. The mean gain per week was 1.6 in the acute group and 0.5 in the chronic group, respectively. Analysis of EBI changes considering the different underlying diseases showed the highest increase in patients with stroke and traumatic brain injury.
Asunto(s)
Enfermedades del Sistema Nervioso Central/complicaciones , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/rehabilitación , Trastornos de la Comunicación/etiología , Trastornos de la Comunicación/rehabilitación , Evaluación de la Discapacidad , Trastornos Psicomotores/etiología , Trastornos Psicomotores/rehabilitación , Actividades Cotidianas , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Trastornos del Conocimiento/diagnóstico , Trastornos de la Comunicación/diagnóstico , Femenino , Hospitalización , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Pronóstico , Trastornos Psicomotores/diagnóstico , Índice de Severidad de la EnfermedadRESUMEN
Centrifugal blood pumps are considered to be generally superior to the traditionally used roller pumps in cardiopulmonary bypass. In our institute a new lightweight centrifugal sealless blood pump with a unique spherical thrust bearing and with a magnetic coupling was developed, the HiFlow. The small design makes the pump suitable for applications in complex devices or close to a patient. Hemolysis tests were carried out in which the BioMedicus pump BP-80 and a roller pump were used as reference. The centrifugal pump HiFlow showed the least blood trauma within the group of investigated pumps. In summary, the HiFlow pump concept with its low priming volume and limited contact surfaces shows great potential for clinical applications in cardiopulmonary bypass. Also, the possibility of using the pump as a short-term assist device with an option of a pulsatile driving mode was demonstrated.