Place and role of new membranes in multiple organ failure: an advance or rumors.
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Biomedical subjects
Publications and source records attributed to D Ivanović.
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In this paper the second-derivative spectrophotometric and ion-pair reversed-phase high performance liquid chromatographic methods for the simultaneous determination of some diuretic ingredients are described. Optimal conditions of both techniques for the quantitative analysis of the two-component diuretic mixture of the Lometazid tablets were settled. The second-derivative order of the spectra in sodium hydroxide with the wavelength modulation was used. For the determination of amiloride hydrochloride the 'zero-crossing' technique was applied, but for methyclothiazide the peak amplitude had to be corrected. In the ion-pair RP-HPLC technique tetrabutylammonium hydroxide was applied as an ion-pairing agent using acetonitrile-phosphate buffer (45:55 v/v) as a mobile phase. The validation was done of both proposed methods.
A reversed-phase ion-pair high-performance liquid chromatografic method (RP-IPC) was developed to assay some water-soluble vitamins in solution dosage forms. Vitamins of the B-group B1, B2, B3, and B6, including vitamin C were determined in Oligovit coated tablets. In Beviplex coated tablets the vitamins B1, B2, B3, B6 and p-aminobenzoic acid were analysed. Hexanesulphonic acid sodium salt and triethanolamine in water methanol were used as mobile phase with adjusting pH to 2.8 with orthophosphoric acid. Phenol was used as an internal standard. For quantitative simultaneous analysis of vitamins in pharmaceutical formulations, the method of internal standard was used. All parameters for the validation of the method are given.
The analytical problem was to control the quality of imported antiasthmatic tablets containing ephedrine hydrochloride, theophylline, papaverine hydrochloride and hydroxyzine hydrochloride. The aim of the analytical method for the assay was to separate, identify and quantify all compounds, at the same time. A gradient capable RP-LC system was used, using a commercially packed Nucleosil C18 column connected to a dual channel variable, programmable wavelength detector. The analysis was performed in the gradient program of increasing concentration of acetonitrile in water. The influence of pH of the mobile phase was established. The proposed method is reliable, reproducible, easy to perform and satisfies the aim.
Two simple and accurate electrochemical methods for the determination of ibuprofen (CAS 15687-27-1) as a bulk drug and as an active compound in pharmaceutical formulations are presented. For the potentiometric determination of ibuprofen sodium hydroxide and triethanolamine were used as titrants. The influence of different solvents, such as water, methanol, acetonitrile, dimethyl sulfoxide and N,N-dimethylformamide, on the conductometric titrations was investigated. The same titrants as in the potentiometric titrations were used. The methods are accurate and results are reproducible in quantities ranging from 1 to 10 mg of ibuprofen in analysed pharmaceutical dosage forms. The relative standard deviation (n = 10) varies over the range 0.38-1.63%.
The present study on 5330 patients admitted to the internal intensive care unit over the five year period (1990-1994) indicated that consciousness disorders are most frequently associated with poisoning. On admission, the state of consciousness of 665 of these 5330 patients was retrospectively evaluated. Poisoning by drugs was most common among intoxications (93 patients of 154 cases of poisoning). Coma, which is the most severe manifestation of consciousness disorder, occurred very often in these patients. Poisoning caused by other agents was connected with other forms of consciousness disorders. Low Glasgow Coma Score (GCS) was a severe predictor, while the number of deaths among patients with GCS > 10 was low. Sepsis was the next most common cause of consciousness disorder among our patients (88 patients). Death rate in these patients was high, amounting to almost 50%, regardless of GCS on admission, suggesting that the severity of main event determines the outcome. Glycemia disorders, including hypoglycemia, hyperglycemia as well as hyperosmotic state, did not result in lethal outcome, regardless of GCS on admission. The highest death rate was registered in patients with cardiopulmonary arrest and lowest GCS on admission. Patients with cardiogenic shock, despite high GCS on admission, had high death rate.
We report a female patient presenting with sepsis and multi-organ failure following eclampsia and intrauterine childdeath. In the phase of recovery, the patient developed consciousness disorder and coma characterized by fasciculation, generalized myoclonia and respiratory insufficiency. The clinical picture corresponded to that of Lance Adam's syndrome. A quick change in the composition of body fluids in the polyuric phase of renal insufficiency associated with an antidiuretic hormone deficit was a cause of that disorder. Metabolic dysfunction and hyperexcitability of neurons developed as a result. Hyperexcitability of the caudal part of the medulla oblongata was responsible for the development of myoclonia. Following the correction of that disorder, the patient completely improved.
An extraordinary advance in basic sciences and technology did not reduce high lethality rate of the septic shock patients. The lethality rate of those patients was and still is around 50%. A new knowledge about a role of an inflammatory response on the infection in the later fatal course of the septic patients, led to the new approach in the treatment. A trial to block an endotoxin, cytokines, especially TNF and IL-1, as well as some other substances, in experimental models of sepsis, in spite of inconsistent results, is promising. A clinical experiences are disappointing, at first because of our still poor knowledge about various cytokines cascade, feedback mechanisms, cellular protective mechanisms, etc. The new chapter on the treatment of that highly lethal syndrome is open, though a final achievement of that approach is not clear till now.
The purpose of the present study was to determine the relative importance of different sources of nutrition information used by Chilean schoolers to learn the basics of nutrition. In this respect, a representative sample of 4,509 elementary and high-school children was randomly selected and stratified according to grade, sex, type of school and geographic area. Schoolers were individually interviewed in order to collect data related with socioeconomic status (SES) and sociocultural conditions, as well as to learn as to what they considered to be the most important sources of nutrition information influencing their nutritional learning, gathering the necessary data through a questionnaire especially designed for this purpose. Results indicated that 87.8% schoolers mentioned their family (mainly the mother), as the most important source of nutrition information; 10.7% said the school teacher, and 1.5%, mass media (0.8% television, 0.5% books, 0.1% magazines and 0.1% radio) without significant differences by sex, age and geographic area. The role attributed to the family (mother) was important in all SES categories, but proved to be significantly higher in the high SES group (91.9%) than in the low SES group (84.6%). The role attributed to the school teacher, in contrast, was lower (6.7%) in the high SES group than in the low SES group (13.8%) (p less than 0.001). In relation to mass media, the influence attributed to books and magazines was high in the high SES group, but television and radio were more important in the low SES group. On the other hand, significant differences found by type of school were related to SES. These findings could be useful in the establishment of food and nutrition policies, as well as in educational planning focused on the Chilean school population, considering that few studies have been carried out along these lines.
Recently, the dental filling material amalgam has again been a target of criticism, especially within the mass media. The controversy has been further fueled by the combination of the patients' desire for fillings to match tooth colouring and this latest wave of artificially created fear of the poison mercury. The investigation submitted here is seen as a contribution toward clearing up the issue of any risk. Using flameless atom absorption spectroscopy, blood and urine samples were taken from four test groups and examined for their mercury content. Two of the participating groups tested (dentists and assistants) were actively processing mercury while the other two, one with and one without amalgam fillings, served as control groups. In the daily preparation of amalgam, dental staff working in the dental office were subject to greater exposure to mercury vapours. Their blood readings, therefore, were double those of the control group, while their urine readings were much higher than those for people not working with mercury. The two control groups (with and without amalgam fillings) showed no significant difference in mercury levels, which implies that these slight traces of mercury can be attributed to food and the environment. Although the mercury readings of the dental office personnel were twice as high as that of the control group, there was no threat of mercury poisoning for any of the four groups. The continued use of amalgam fillings in teeth can be recommended without reservation and at no risk to the patient. Particular measures must be taken to guarantee the safety of office staff.
During 2 years and 3 months 230 patients suffering from acute myocardial infarction were treated at an Intensive Care Unit and a Department of Cardiology. Streptokinase was given intravenously to 54 of them. Out of 54 patients, in 52% the localisation of the myocardial infarction was in the anterior and in 48% in the posterior wall. The patients were divided in the three categories according to the onset of symptoms: up to 2 hours, 2-4 hours and 4-6 hours. The dose of streptokinase was 1,500,000 i.u. during 1.5 hours. The CPK and MBCPK level reached the maximum values up to 12 hours and was to lowest in the first group. In 74% of the patients the serum enzyme level showed successful reperfusion of a coronary artery. Electrocardiographic findings of a successful myocardial reperfusion amounted to 36% in the first, 40% in the second, and 17% in the third group. Malignant ventricular arrhythmias appeared in the first group in 3.6%, in the second in 12.5% and in the third group in 14.2%. The criteria for successful myocardial reperfusion by echocardiography (analysed regional wall motion) were present in 52% in the first, in 50% in the second, and in 17% in the third group. Coronarography and ventriculography were performed in 17 patients after 21 days of treatment, with successful results in 88% (15 out of 17 patients). In a group of 176 patients unable to be treated with streptokinase because of the onset of symptoms of myocardial infarction (more than 6 hours) or because of contraindications for that treatment, the lethality rate reached 17.6%. The lethality rate in the group of 54 patients treated with streptokinase was 5.5%. Local complication (hemorrhage) during the treatment was observed in one patient (2%).
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Gastric lesions were provoked in all rats that had received intraperitoneally a single dose of the dopamine antagonists haloperidol, metoclopramide or domperidone 24 h before. Dose-dependence was demonstrated for haloperidol. This drug induced gastric lesions as early as 90 min after its application. The ulcerogenic effect of haloperidol was completely prevented or markedly reduced by simultaneous applications of dopamine agonists bromocriptine or L-dopa. We conclude that the model of gastric lesions induced by dopamine antagonists could be successfully applied in further investigations of the role of dopamine in the pathogenesis of ulcer disease.
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