RESUMEN

Nosocomial infections are a frequent concern in healthcare. Despite the available knowledge on nosocomial infections and preventive measures, outbreaks of infections continue to occur. An outbreak of severe sepsis in patients who underwent minor procedures in an operating theatre during two consecutive days is described and analysed in this study. We performed a retrospective cohort study using epidemiological data in order to investigate the source of infection together with microbiological and on-site investigations and interviews. Seven patients met the case definition of postoperative systemic inflammatory response syndrome (SIRS). All other patients operated on over the same period served as controls. Of the risk factors investigated, general anaesthesia and propofol were statistically significant (P=0.003). Klebsiella pneumoniae and Serratia marcescens were cultured from opened vials of propofol, propofol-related devices and from blood cultures from two of the patients. These strains were genotypically indistinguishable. Lapses in aseptic preparation, handling and storage of the propofol were observed, and were the most probable cause of the extrinsic contamination. The daily procedure of handling propofol was not performed according to the manufacturer's recommendations, the main departure being the use of a single-use vial for multiple patients. This study documents the risk of infection due to contaminated propofol and the importance of having written guidelines for its handling.

Asunto(s)

Anestésicos Intravenosos , Brotes de Enfermedades , Contaminación de Medicamentos , Klebsiella pneumoniae/aislamiento & purificación , Propofol , Sepsis , Serratia marcescens/aislamiento & purificación , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Estudios de Cohortes , Femenino , Guías como Asunto , Humanos , Higiene , Entrevistas como Asunto , Infecciones por Klebsiella/epidemiología , Infecciones por Klebsiella/microbiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Sepsis/epidemiología , Sepsis/etiología , Infecciones por Serratia/epidemiología , Infecciones por Serratia/microbiología , Síndrome de Respuesta Inflamatoria Sistémica/epidemiología , Síndrome de Respuesta Inflamatoria Sistémica/microbiología , Adulto Joven

RESUMEN

Roentgen stereophotogrammetric analysis (RSA) can be used to measure changes in anterior-posterior (A-P) knee laxity after anterior cruciate ligament (ACL) reconstruction. Previous measurements of A-P knee laxity using RSA have employed a tibial coordinate system with the origin placed midway between the tips of the tibial-eminences. However, the precision in measuring A-P knee laxity might be improved if the origin was placed on the flexion-extension axis of rotation of the knee. The purpose of this study was to determine whether a center-of-rotation tibial coordinate system with the origin placed midway between the centers of the posterior femoral condyles, which closely approximates the flexion-extension center-of-rotation of the knee, improves the precision in measuring A-P knee laxity compared to the tibial-eminence-based coordinate system. A-P knee laxity was measured using each coordinate system six times in three human cadaveric knees implanted with 0.8-mm diameter tantalum markers. For each laxity measurement, the knee was placed in a custom loading apparatus and biplanar radiographs were obtained while the knee resisted a 44 N posterior shear force and 136 N anterior shear force. A-P knee laxity was determined from the change in position of the tibia, with respect to the femur, resulting from the posterior and anterior shear forces. The precision for each coordinate system was calculated as the pooled standard deviation of A-P knee laxity measurements. The precision of the center-of-rotation coordinate system was 0.33 mm, which was about a factor of 2 better than the 0.62 mm precision of the tibial-eminence coordinate system (p=0.006). The 0.33 mm precision with the center-of-rotation coordinate system suggests that an observed change of either 0.56 mm (i.e. 1.7 standard deviations) or greater in A-P knee laxity over time is a real change and not due to measurement error when the new tibial coordinate system is used and other factors contributing to variability are controlled as was done in this study. Accordingly, clinicians and researchers should consider the use of this alternate tibial coordinate system when making serial measurements of A-P knee laxity using RSA because the improved precision allows for the observation of smaller differences.

Asunto(s)

Artrografía , Inestabilidad de la Articulación/diagnóstico por imagen , Articulación de la Rodilla/fisiología , Fotogrametría , Tibia/fisiología , Adulto , Anciano , Fenómenos Biomecánicos , Cadáver , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Persona de Mediana Edad , Rotación , Tibia/diagnóstico por imagen

RESUMEN

An increase in anterior laxity following reconstruction of the anterior cruciate ligament (ACL) can result from lengthening of the graft construct in either the regions of fixation and/or the region of the graft substance between the fixations. RSA could be a useful technique to determine lengthening in these regions if a method can be devised for attaching radio-opaque markers to soft tissue grafts so that marker migration from repeated loading of the graft is limited. Therefore, the objectives of this study were 1) to develop a method for attaching radio-opaque markers to an ACL graft that limits marker migration within the graft, 2) to characterize the error of an RSA system used to study migration, and 3) to determine the maximum amount of migration and the time when it occurs during cyclic loading of ACL grafts. Tendon markers were constructed from a 0.8-mm tantalum ball and a stainless steel suture. Ten double-looped tendon grafts were passed through tibial tunnels drilled in bovine tibias and fixed with a tibial fixation device. Two tendon markers were sewn to one tendon bundle of each graft and the grafts were cyclically loaded for 225,000 cycles from 20 N to 170 N. At specified intervals, simultaneous radiographs were obtained of the tendon markers and a radiographic standard of known length. The bias and imprecision in measuring the length of the radiographic standard were 0.0 and 0.046 mm respectively. Marker migration was computed as the change in distance between the two tendon markers along the axis of the tibial tunnel. Marker migration was greatest after 225,000 cycles with a root mean square (RMS) value of less than 0.2 mm. Because the RMS value indicates the error introduced into measurements of lengthening and because this error is small, the method described for attaching markers to an ACL graft has the potential to be useful for determining lengthening of ACL graft constructs in in vivo studies in humans.

Asunto(s)

Ligamento Cruzado Anterior/diagnóstico por imagen , Ligamento Cruzado Anterior/trasplante , Imagenología Tridimensional/métodos , Fotogrametría/métodos , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Soporte de Peso , Animales , Ligamento Cruzado Anterior/fisiopatología , Bovinos , Técnicas In Vitro , Movimiento , Oscilometría/métodos , Periodicidad , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Trasplantes

RESUMEN

Lengthening of a double-looped tendon graft construct used to reconstruct the anterior cruciate ligament (ACL) can result in an increase in anterior knee laxity and affect the stability of the reconstructed knee. Three possible regions where lengthening of the construct can occur are (1) the region of the tibial fixation, (2) the region of the femoral fixation, and (3) the region of the graft between the fixations. One objective of this study was to demonstrate the feasibility of using Roentgen stereophotogrammetric analysis (RSA) to determine the lengthening in each region of a double-looped graft construct subjected to cyclic loading. A second objective was to determine which region(s) contributes most to an increase in length of this graft construct. Radio-opaque markers were attached to ten grafts to measure the lengthening in each of the three regions. Each graft was passed through a tibial tunnel in a bovine tibia, looped around a rigid cross-pin, and fixed to the tibia with a Washerloc fixation device. The grafts were cyclically loaded for 225,000 cycles from 20 to 170 N. Prior to and at intervals during the cyclic loading, simultaneous radiographs were taken of the tibia and graft. RSA was used to determine the 3-dimensional coordinates of the markers from which the lengthening in each region was computed at each interval. The regions of the tibial and femoral fixations were the largest contributors to the increase in length of the graft, with maximum average values of 0.91 and 0.76 mm respectively after 225,000 cycles. The region between the fixations contributed least to lengthening of the graft, with a maximum average value of 0.23 mm. More than 90% of the lengthening in each region occurred before 100,000 cycles of loading. RSA proved to be a useful method for measuring lengthening in all three regions of the graft construct. Lengthening of the graft construct in both regions of fixation is sufficiently large that the combined contributions may cause a recurrence of instability in some knees.

Asunto(s)

Ligamento Cruzado Anterior/cirugía , Procedimientos Ortopédicos/instrumentación , Fotogrametría/métodos , Tendones/trasplante , Animales , Bovinos , Análisis de Falla de Equipo , Estudios de Factibilidad , Inestabilidad de la Articulación/prevención & control , Procedimientos Ortopédicos/métodos , Radiografía , Rodilla de Cuadrúpedos , Tendones/diagnóstico por imagen , Soporte de Peso/fisiología

RESUMEN

OBJECTIVE: To determine the direction and rate of change in the symptom of dyspnea in patients with chronic obstructive pulmonary disease (COPD) whose lung function has worsened over time. DESIGN: Secondary analysis of a longitudinal data set. SETTING: Outpatient clinic. PATIENTS: Thirty-four medically stable male subjects with chronic obstructive pulmonary disease studied for 5.3 +/- 3.5 years, with a mean reduction in FEV1 over the period studied of 330.9 +/- 288.0 mL. Subjects were 63.3 +/- 5.5 years of age at entry into the study. OUTCOME MEASURES: Dyspnea and functional status scores were obtained using the Pulmonary Functional Status and Dyspnea Questionnaire. RESULTS: There was no significant difference in reports of dyspnea from the beginning to the end of the study, despite significant reductions in lung function. Of all activities studied, dyspnea when raising arms overhead was the only activity showing a relationship to the slope of change in FEV1 %. CONCLUSION: These findings suggest that, although patients with chronic lung disease experience varying degrees of deterioration in lung function longitudinally, there is no evidence that they report worsening of dyspnea in tandem with these physiologic changes. In this study, patient ratings of dyspnea longitudinally were not directly linked to changes in lung impairment.

Asunto(s)

Disnea/fisiopatología , Enfermedades Pulmonares Obstructivas/fisiopatología , Progresión de la Enfermedad , Disnea/epidemiología , Volumen Espiratorio Forzado/fisiología , Humanos , Estudios Longitudinales , Enfermedades Pulmonares Obstructivas/epidemiología , Masculino , Persona de Mediana Edad , Pruebas de Función Respiratoria , Fumar/epidemiología , Encuestas y Cuestionarios , Factores de Tiempo

RESUMEN

OBJECTIVE: Describe the process of development and testing to reduce the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ) from 164 items to a modified questionnaire (the PFSDQ-M) consisting of 40 items. DESIGN: Instrument development and testing for reliability, validity, and practicality. SETTING: Hospital-based outpatients. PATIENTS: Testing was done on three groups of clinically stable patients with chronic obstructive pulmonary disease: a secondary analysis of 131 subjects for item selection, reliability, and validity; 50 additional subjects evaluating the PFSDQ-M for internal consistency, test-retest correlations, and construct validity; and 34 subjects from a longitudinal study for responsiveness. OUTCOME MEASURES: PFSDQ, PFSDQ-M, and spirometry. RESULTS: The practicality of the PFSDQ-M was supported by its sixth- to seventh-grade reading level, ease of reading (Flesch-Kincaid 69.5), self-administration, brief period for testing (7 minutes initially, 6 minutes on repeated testing), and limited missing data (< 8%). Reliability of the three components was supported by internal consistency alpha = 0.93 for change experienced by the patient with activities (CA), 0.95 for dyspnea with activities (DA), and 0.95 for fatigue with activities (FA). Good stability of the PFSDQ-M was demonstrated on test-retest; r = 0.70 for change, 0.83 for dyspnea, and 0.79 for fatigue (with activities). The usefulness of the PFSDQ-M in discriminating between dyspnea scores in patients based on their rate of deterioration in lung function was demonstrated. CONCLUSIONS: The PFSDQ was modified by reducing the number of activities evaluated, standardizing scaling formats, and adding a fatigue component. Findings suggest that the PFSDQ-M demonstrates initial reliability; good validity estimates, as seen with the factor analysis, and the dyspnea and activity scores appear responsive to physiologic changes in lung function over time.

Asunto(s)

Disnea/etiología , Enfermedades Pulmonares Obstructivas/diagnóstico , Anamnesis/estadística & datos numéricos , Espirometría/estadística & datos numéricos , Actividades Cotidianas/clasificación , Anciano , Atención Ambulatoria , Disnea/clasificación , Fatiga/clasificación , Fatiga/etiología , Femenino , Volumen Espiratorio Forzado , Humanos , Estudios Longitudinales , Enfermedades Pulmonares Obstructivas/clasificación , Enfermedades Pulmonares Obstructivas/rehabilitación , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Encuestas y Cuestionarios

RESUMEN

The human fetal membranes provide a sterile biomechanical container which adjust by growth to mid-pregnancy to the increase in fetal size, and by elasticity to the forceful movements of the fetus. The molecular basis for this elasticity is not known, yet reduced elasticity may lead to their premature rupture and preterm birth, a major problem in perinatal medicine. Classically, elastin confers the property of elastic recoil to elastic fibres which are assembled from a family of tropoelastin precursors. These are covalently cross-linked to form insoluble elastin by formation of desmosine and isodesmosine, catalysed by the enzyme lysyl oxidase. The amnion, chorion and decidua were shown by Northern analysis and RT-PCR to contain detectable levels of tropoelastin mRNA and the mRNA encoding lysyl oxidase. The proteins encoded by these mRNAs were also identified by Western blotting and immunolocalization. Further, insoluble elastin was extracted from the human fetal membranes and shown by comparison to elastin preparations from other elastic tissues to have a reasonable desmosine content. Finally, scanning electron microscopy confirmed the presence of multiple layers of an apparently very thin elastic system in this tissue. This biochemical and histopathologic study has demonstrated therefore that the human fetal membranes synthesize and deposit a novel elastic fibre. The presence of such an elastic system in these tissues provides, for the first time, a probable molecular basis for the elastic properties of this tissue.

Asunto(s)

Elastina/análisis , Membranas Extraembrionarias/química , Membranas Extraembrionarias/fisiología , Aminoácidos/análisis , Amnios/química , Northern Blotting , Corion/química , Decidua/química , Desmosina/análisis , Elasticidad , Femenino , Humanos , Inmunohistoquímica , Microscopía Electrónica de Rastreo , Reacción en Cadena de la Polimerasa , Embarazo , Proteína-Lisina 6-Oxidasa/genética , ARN Mensajero/análisis , Tropoelastina/genética

RESUMEN

OBJECTIVE: To assess the impact of the colour of a drug's formulation on its perceived effect and its effectiveness and to examine whether antidepressant drugs available in the Netherlands are different in colour from hypnotic, sedative, and anxiolytic drugs. DESIGN: Systematic review of 12 published studies. Six studies examined the perceived action of different coloured drugs and six the influence of the colour of a drug on its effectiveness. The colours of samples of 49 drugs affecting the central nervous system were assessed using a colour atlas. MAIN OUTCOME MEASURES: Perceived stimulant action versus perceived depressant action of colour of drugs; the trials that assessed the effect of drugs in different colours were done in patients with different diseases and had different outcome measures. RESULTS: The studies on perceived action of coloured drugs showed that red, yellow, and orange are associated with a stimulant effect, while blue and green are related to a tranquillising effect. The trials that assessed the impact of the colour of drugs on their effectiveness showed inconsistent differences between colours. The quality of the methods of these trials was variable. Hypnotic, sedative, and anxiolytic drugs were more likely than antidepressants to be green, blue, or purple. CONCLUSIONS: Colours affect the perceived action of a drug and seem to influence the effectiveness of a drug. Moreover, a relation exists between the colouring of drugs that affect the central nervous system and the indications for which they are used. Research contributing to a better understanding of the effect of the colour of drugs is warranted.

Asunto(s)

Fármacos del Sistema Nervioso Central/uso terapéutico , Color , Ansiolíticos/uso terapéutico , Antidepresivos/uso terapéutico , Química Farmacéutica , Estudios Cruzados , Método Doble Ciego , Humanos , Hipnóticos y Sedantes/uso terapéutico , Pacientes/psicología , Percepción , Placebos , Ensayos Clínicos Controlados Aleatorios como Asunto , Comprimidos , Resultado del Tratamiento

RESUMEN

Several overlapping cDNA clones were isolated from a lambda gt10 cDNA library constructed using poly A+ RNA from neonatal sheep lung. DNA sequence analysis of these cDNA recombinants revealed the complete derived amino acid sequence of sheep tropoelastin. A comparison of DNA sequences from individual sheep tropoelastin cDNA also confirmed the presence of several tropoelastin mRNA isoforms in neonatal lung tissue. Coding domains corresponding to exons 13, 14 and 33 were present in several of the sheep tropoelastin cDNA fragments but absent in others. The relative amount of alternate usage of these exons was quantitated by polymerase chain amplification. In confirmation of previous studies in other mammalian species, extensive alternate usage of exon 33 was observed in total RNA isolated from aorta, nuchal ligament and pulmonary artery from neonatal sheep. In striking contrast to all previous studies, however, exons 13 and 14 were shown to be subject to almost the same level of alternate usage as exon 33 in all three neonatal sheep tissues examined.

Asunto(s)

Empalme Alternativo , ARN Mensajero/análisis , Ovinos/genética , Tropoelastina/genética , Secuencia de Aminoácidos , Animales , Animales Recién Nacidos , Secuencia de Bases , ADN Complementario/análisis , ADN Complementario/química , ADN de Cadena Simple/biosíntesis , Exones , Pulmón/metabolismo , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa , Precursores del ARN/genética , ARN Mensajero/genética

RESUMEN

We have constructed several rat tropoelastin minigene recombinants encoding the complete sequence of rat tropoelastin, two isoforms of rat tropoelastin and a truncated tropoelastin lacking the domains encoded by exons 19-31 of the rat gene. Coding and non-coding domains in all these recombinants were placed under the transcriptional control of 3 kb of the promoter domain of the rat tropoelastin gene. These minigenes were used to prepare a total of 28 separate founder lines of transgenic mice. A species-specific reverse-transcriptase polymerase chain reaction (RT-PCR) assay was established to demonstrate the synthesis of rat and mouse tropoelastin mRNA in several tissues obtained from both neonatal and adult transgenic mice. Thermolytic digestion of insoluble elastin isolated from several neonatal mouse tissues revealed the presence of rat tropoelastin peptides in progeny from all those founder mice in which detectable levels of rat tropoelastin mRNA were noted. Phenotypic and histopathological assessment of transgenic and non-transgenic animals revealed the development of two diverse elastic tissue disorders. The progeny of two separate founder lines overexpressing the rat tropoelastin isoform lacking exon 33, developed an emphysematous phenotype in early adulthood. In contrast, transgenic mice, in which expression of the truncated rat tropoelastin minigene lacking exons 19-31 had been observed, died of a ruptured ascending aortic aneurysm. Tropoelastin gene mutations, therefore, will result in heritable disorders of elastic tissue. Moreover, different mutations in the tropoelastin gene will be responsible for very different abnormalities in elastic tissue function.

Asunto(s)

Tejido Elástico/metabolismo , Tropoelastina/genética , Animales , Masculino , Ratones , Ratones Transgénicos , Mutación , Fenotipo , Ratas , Tropoelastina/metabolismo

RESUMEN

OBJECTIVE: To develop and test the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ) that measures both intensity of dyspnea with activities and changes (reductions or improvements) in the ability of patients with chronic obstructive pulmonary, disease to perform daily activities. DESIGN: Instrument development and initial testing for validity and reliability. SETTING: Hospital-based pulmonary rehabilitation program. PATIENTS: One hundred thirty-one adult male patients with chronic obstructive pulmonary disease. Mean age was 63.7 +/- 6.2 years. OUTCOME MEASURES: Pulmonary Functional Status and Dyspnea Questionnaire, pulmonary function and exercise parameters. RESULTS: The PFSDQ is a 164-item paper and pencil self-administered questionnaire and consists of two components measuring dyspnea intensity with activities and changes in functional ability related to 79 activities of daily living. Activities are grouped into scales of self-care, mobility, eating, home management, social, and recreational. The dyspnea component measures the level of dyspnea patients report with these activities. The functional abilities component evaluates the degree to which the performance of activities has changed as the result of chronic obstructive pulmonary disease. The activities are relevant for adults of both sexes and reflect various energy workload requirements. Normative data for both components were described. Content and initial construct validity of the PFSDQ was supported by clinical experts and findings related related to expected theoretical relationships. Internal consistency reliability for both the dyspnea and functional abilities components was 0.91. The alpha coefficients for the scales ranged from 0.88 to 0.94. A case study was used to describe the clinical application of the PFSDQ. CONCLUSION: The PFSDQ can be used clinically and in research studies to assess dyspnea and changes in the functional ability of patients with pulmonary disease. Although further testing is warranted, initial evaluation supports the validity and reliability of the PFSDQ.

Asunto(s)

Disnea/fisiopatología , Enfermedades Pulmonares Obstructivas/fisiopatología , Encuestas y Cuestionarios , Actividades Cotidianas , Anciano , Flujo Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Valores de Referencia , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Capacidad Pulmonar Total

RESUMEN

It is uncertain whether there exists a nociceptive component in malignant nerve pain responsive to NSAIDs and opioids. 20 patients with malignant nerve pain were randomly assigned to treatment with naproxen 1500 mg versus slow-release morphine 60 mg daily during 1 week, followed by cross-over medication during the second week in a double-blind, double-dummy protocol. In the 16 evaluable patients, a significant (P < 0.05) reduction of 26% (S.E. +/- 7.9) in pain intensity was reached at day 7, compared to baseline pain. At day 7, significant pain relief of 32% (P < 0.05) was observed in the naproxen group, but not in the morphine group (21%, P = 0.14). Patients using morphine needed approximately twice as much paracetamol rescue than patients using naproxen. Additional pain relief could be observed in 4/9 patients with cross-over medication. These data support the concept of a nociceptive component in malignant nerve pain responding to NSAIDs and opioids, and favour the combination of both an anti-inflammatory drug and an opioid for symptomatic pain relief.

Asunto(s)

Morfina/uso terapéutico , Naproxeno/uso terapéutico , Neuralgia/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Estudios Cruzados , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Neuralgia/etiología , Dimensión del Dolor , Factores de Tiempo

RESUMEN

The stability of sufentanil (5 micrograms/ml as citrate) in admixtures with glucose 5% or bupivacaine hydrochloride (2 mg/ml) in 100 ml polyvinyl chloride portable pump reservoirs was investigated during simulated infusion by an epidural catheter at 32 degrees C for 48 h and during storage at 4 degrees C and 32 degrees C for 30 days. During both experiments a small decrease (< 5%) in concentration of sufentanil and bupivacaine was observed. No loss of sufentanil or bupivacaine could be detected (in both experiments) in the portable pump reservoirs when stored at 4 degrees C for 30 days. A significant decrease of sufentanil was observed when stored at 32 degrees C after 30 days when diluted with glucose (9.2%) or in combination with bupivacaine (8.9%); also, the bupivacaine concentration decreased significantly (4.1%). It is concluded that sufentanil in portable pump reservoirs can be used under patient conditions at 32 degrees C for 7 days when diluted with glucose 5% or 3 days in combination with bupivacaine hydrochloride.

Asunto(s)

Bupivacaína/química , Glucosa/química , Sufentanilo/química , Absorción , Color , Incompatibilidad de Medicamentos , Estabilidad de Medicamentos , Almacenaje de Medicamentos , Concentración de Iones de Hidrógeno , Bombas de Infusión , Infusiones Intravenosas , Inyecciones Epidurales/instrumentación , Soluciones , Sufentanilo/administración & dosificación , Temperatura

Asunto(s)

Albúminas/efectos adversos , Albúminas/análisis , Encefalopatía Hepática/inducido químicamente , Compuestos de Amonio Cuaternario/análisis , Anciano , Contaminación de Medicamentos , Humanos , Persona de Mediana Edad

RESUMEN

Thermolysin digests of human elastins were examined for reliable elastin peptide markers as determined by HPLC followed by amino acid sequencing of promising peaks. The tetrapeptide VAPG was found to occur in the early portion of the chromatogram in a highly reliable fashion. The peptide appears to be significantly amplified, when compared with the other peptides, in that it is derived from the hexapeptide repeat in elastin, VGVAPG, which repeats itself in two three-piece segments in the c-terminal portion of the tropoelastin molecule. VAPG serves as a highly reliable quantitative measure for human elastins, allowing sensitivities to less than a microgram. Thus, it is a significantly more accurate measure than other existing methods. Precision also appears to be enhanced because of the directness of the measurement. The use of VAPG as a quantitative marker for human elastin has clinical application in the study of elastin-based connective tissue diseases.

Asunto(s)

Elastina/análisis , Oligopéptidos/análisis , Fragmentos de Péptidos/análisis , Adulto , Secuencia de Aminoácidos , Aorta/química , Biomarcadores , Cromatografía Líquida de Alta Presión , Elastina/química , Elastina/genética , Exones , Femenino , Humanos , Recién Nacido , Masculino , Datos de Secuencia Molecular , Termolisina

RESUMEN

Sufentanil (5 micrograms/ml as citrate) was investigated for its stability when diluted with sodium chloride 0.9%, in 100 ml polyvinyl chloride portable pump reservoirs during administration under simulated epidural conditions at 32 degrees C for 48 h. Sufentanil was absorbed into the polyvinyl chloride, resulting in a reduction of 10.9% of the concentration after 48 h. The absorption of sufentanil (5 micrograms/ml as citrate), alone and in combination with bupivacaine hydrochloride (2 mg/ml), was investigated when diluted with sodium chloride 0.9% in combination with a citrate buffer (pH 4.6), in the same reservoirs under similar conditions. There was no loss of sufentanil after 48 h in both experiments. The effect of the pH on the absorption of sufentanil in polyvinyl chloride was investigated at different pH values. After storage for 21 days at 32 degrees C there was 5.1% loss of sufentanil at pH 4 and 80.6% loss at pH 6. The citrate buffer at the optimum pH (4.6) has a low, acceptable buffer capacity for epidural administration.

Asunto(s)

Sufentanilo/química , Absorción , Analgesia Epidural , Tampones (Química) , Bupivacaína/química , Química Farmacéutica , Cromatografía Líquida de Alta Presión , Almacenaje de Medicamentos , Concentración de Iones de Hidrógeno , Bombas de Infusión , Cloruro de Polivinilo , Sufentanilo/administración & dosificación

RESUMEN

Thirty-nine 40-day old male Sprague-Dawley rats (average wt. 115g) were divided into 4 groups and fed diets A, control; B, essential fatty acid (EFA) deficient; C, protein deficient; D, combined protein and EFA deficient. At the end of 5 weeks, lungs were removed from the animals for collagen and elastin quantitation and for morphometric measurements. The collagen content of the lungs which ranged from 95-100 micrograms/mg dried fat-free (D.F.F.) tissue, was not altered by protein or EFA deficiencies. The elastin content of lungs was markedly increased in diets C and D while the cross-linking (Isodesmosine-desmosine content) expressed as residues per 1,000 (R/1000) was not different in the four groups. The elastin content of lungs from group D animals was greater than group C suggesting an additive effect from the EFA deficiency in diet D. The morphometric measurements indicated no change in alveolar linear diameter (Lm) while the total alveolar surface area (ISAA1V) was decreased by the deficient diets C and D. The protein deficiency and the combined protein and EFA deficiencies produced an increased elastin content in lung. Elastin cross-linking and collagen quantity was not affected by the dietary treatments. The morphometric measurements indicated that protein deficiency in these animals did not produce structural changes in the lungs as indicated by alveolar dimensions.

Asunto(s)

Colágeno/análisis , Elastina/análisis , Ácidos Grasos Esenciales/deficiencia , Pulmón/química , Deficiencia de Proteína/metabolismo , Animales , Caseínas/administración & dosificación , Grasas de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Ácidos Grasos Esenciales/administración & dosificación , Pulmón/metabolismo , Masculino , Ratas , Ratas Sprague-Dawley

RESUMEN

The stability of sufentanil citrate (100 ml, 5 micrograms/ml) in an admixture with sodium chloride 0.9% injection was investigated when filled in a portable pump reservoir with PVC wall, a glass container and a polyethylene container, at 32 degrees C, 4 degrees C and -20 degrees C for up to 21 days. No change in colour was visually observed in any of the samples during the 21-day storage period. A slight precipitation was noticed in three out of nine portable pump reservoirs, one at each storage temperature. There was a slight rise in pH at each storage temperature in all samples. There was approximately 13% loss of sufentanil citrate in the portable pump reservoirs stored at 32 degrees C during 2 days and 60% loss after 21 days, due to absorption of sufentanil citrate in the reservoir wall. No loss of sufentanil citrate could be detected in the portable pump reservoirs when stored at -20 degrees C and 4 degrees C. However, a serious inhomogeneity of the sufentanil citrate solution occurred after thawing at room temperature in the portable pump reservoirs which had been kept at -20 degrees C. The homogeneity could be restored by shaking for approximately 10 min. There was no change in the sufentanil citrate concentrations in the glass containers and polyethylene containers stored at the three temperatures. The portable pump reservoirs stored at 32 degrees C also showed a significant loss of vehicle due to evaporation (1.0 +/- 0.1 ml a week). This could not be detected in any of the other samples.

Asunto(s)

Vidrio/química , Bombas de Infusión , Polietilenos/química , Sufentanilo/administración & dosificación , Sufentanilo/química , Absorción , Química Farmacéutica , Cromatografía Líquida de Alta Presión , Estabilidad de Medicamentos , Congelación , Temperatura

RESUMEN

Dietary lipid modulation of structural and passive mechanical properties of isolated rat abdominal aortic segments were assessed during the early developmental period. Rats were raised from conception to 90 days of age on semisynthetic diets containing various types and amounts of lipids. Aortic segments from three groups of rats fed high-fat diets (15%, wt/wt) consisting of olive oil, corn oil, or lard as the sole lipid sources were compared with those from rats fed a low-fat control diet containing corn oil (5%, wt/wt). Morphometric analysis of the tunica media demonstrated that rats raised on diets with a relatively low polyunsaturated fatty acid content (olive oil and lard) had greater numbers of elastic lamellae than rats raised on diets with opposite fatty acid indexes (high- and low-fat corn oil). Changes in elastin content of the tunica media, determined biochemically, paralleled those seen by morphometric analysis of the elastic lamellar number. Altered dietary fatty acid ratios were also associated with changes in smooth muscle cell number. In this regard, a decreased cellular density was observed in the olive oil and lard diets compared with the corn oil diet. The olive oil diet was unique amongst the dietary lipid regimens in raising, whereas the lard-containing diet lowered, indexes of aortic tissue elasticity. These results demonstrate an effect of chronic feeding of high dietary fat on the composition and biomechanical properties of the connective tissue matrix of abdominal aortic rings from young Sprague-Dawley rats.

Asunto(s)

Aorta Abdominal/fisiología , Tejido Conectivo/fisiología , Aceite de Maíz/farmacología , Grasas de la Dieta/farmacología , Aceites de Plantas/farmacología , Animales , Aorta Abdominal/anatomía & histología , Aorta Abdominal/efectos de los fármacos , Colágeno/metabolismo , Tejido Conectivo/anatomía & histología , Tejido Conectivo/efectos de los fármacos , Desmosina/metabolismo , Elasticidad , Elastina/metabolismo , Masculino , Aceite de Oliva , Ratas , Ratas Endogámicas , Valores de Referencia

RESUMEN

The stability of morphine hydrochloride in an admixture with sodium chloride 0.9% injection in a portable pump reservoir was investigated. Duplicate samples containing morphine hydrochloride 0.5, 1.5 and 2.5 mg/ml were stored in original 100 ml plastic drug reservoirs at 32 degrees C for 60 days. An amount of 3 ml was removed immediately after preparation and at fixed intervals in the weeks after. All samples were tested for loss of vehicle, for appearance of precipitation and for change in colour or pH. Furthermore, they were analysed for drug concentration using high pressure liquid chromatography. No precipitation or change in colour was observed in any of the sample admixtures. There was no change in the pH values of any of the morphine hydrochloride concentrations from day 4 and later on. Only between day 1 and day 4 a slight, but not significant rise could be detected. There was no loss of morphine hydrochloride of any importance at any concentration in the samples over 60 days when corrected for loss of vehicle. Loss of vehicle (0.8 +/- 0.1 ml a week), on the other hand, gave a rise in morphine hydrochloride concentration.

Asunto(s)

Bombas de Infusión , Morfina/análisis , Dietilhexil Ftalato/análisis , Estabilidad de Medicamentos