RESUMEN
By-products obtained from winemaking processes still contain large amounts of phenolic compounds, especially phenolic acids, flavanols, flavonols, stilbenes, and flavonoids. Enzymatic hydrolysis was used for determination and characterization of phenolic acids, flavanols, flavonols, and stilbenes. Characterization of the flavonoids was achieved using acid hydrolysis with 0.1% hydrochloric acid. In addition, organic solvents as 50% methanol, 70% methanol, 50% acetone, 0.01% pectinase, and 100% petroleum ether were also evaluated. Reversed phase high-performance liquid chromatography (RP-HPLC) with diode array detector was used to identify phenolic compounds. Internal standard quantification was implemented using a five points of the UV-visible absorption data collected at the wavelength of maximum absorbance. A total of 16 phenolic compounds were determined. The content differed from 1.19 to 1124 mg kg(-1). Outcomes from HPLC study showed that gallic acid, (+) catechin hydrate, and (-) epicatechin gallate were the major phenolic compounds presented in the sample. Malvidin and pelargonidin 3-O-glucoside were the major anthocyanins monoglucosides.
RESUMEN
OBJECTIVE: The authors examined clinical differences between divalproex sodium and generic immediate-release valproic acid. METHOD: This 6-year prospective, quasi-experimental clinical trial compared the effectiveness and tolerability of divalproex and valproic acid. The dependent variables were length of hospital stay, rehospitalization rate, and adverse drug reactions in 9,260 psychiatric admissions. RESULTS: Inpatients who initially received divalproex sodium had a 32.7% longer hospital stay and 3.8% higher readmission rate than did patients who initially received valproic acid. Initial treatment with divalproex prolonged length of stay by 30.3% in patients treated with divalproex and valproic acid during different admissions. After other variables were controlled by multiway analysis of variance, the hospital stay of patients who continued the initial medication was 15.2% longer (2.0 days) for divalproex than valproic acid. Switching medications was more common for valproic acid, partly because of study design. Medication intolerance occurred in approximately 6.4% more patients taking valproic acid than divalproex. However, switching from valproic acid to divalproex did not significantly prolong length of stay, over that for continuous divalproex, or increase the rehospitalization rate. CONCLUSIONS: Lower peak valproate concentrations with divalproex sodium may have enhanced tolerability but may also explain the lower effectiveness. Extended-release divalproex could lower effectiveness further and require higher doses. Thus, inpatients are better served by beginning with generic valproic acid and by changing to delayed-release divalproex only if intolerance occurs. This would save up to one-third of inpatient costs and two-thirds of a billion dollars yearly in medication costs.
Asunto(s)
Anticonvulsivantes/uso terapéutico , Trastornos Mentales/tratamiento farmacológico , Ácido Valproico/uso terapéutico , Adulto , Análisis de Varianza , Anticonvulsivantes/efectos adversos , Preparaciones de Acción Retardada , Medicamentos Genéricos/uso terapéutico , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Trastornos Mentales/psicología , Readmisión del Paciente/estadística & datos numéricos , Estudios Prospectivos , Resultado del Tratamiento , Ácido Valproico/efectos adversosAsunto(s)
Dopamina/metabolismo , GABAérgicos/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Ácido Valproico/uso terapéutico , Ácido gamma-Aminobutírico/metabolismo , Adulto , Benzotropina/uso terapéutico , Antagonistas de Dopamina/uso terapéutico , Relación Dosis-Respuesta a Droga , Interacciones Farmacológicas , Femenino , Haloperidol/uso terapéutico , Humanos , Antagonistas Muscarínicos/uso terapéutico , Factores de TiempoRESUMEN
Se realizó un estudio observacional, descriptivo y prospectivo en 145 pacientes: 88 con diagnóstico de tuberculosis pleural confirmado por medio de cultivo o biopsia y 57 con derrame pleural no tuberculoso. Fue practicado en varias instituciones de salud de la ciudad de medellín durante el período de 1991-1993, con el fin de valorar la utilidad de la adenosín deaminasa en el diagnóstico de tuberculosis pleural. Se obtuvo para dicha prueba una sensibilidad de 92.04 por ciento y una especificidad de 89.47 por ciento, mostrando que la adenosín deaminasa es una importante herramienta diagnóstica de bajo costo en nuestro medio