RESUMEN
ABSTRACT Purpose The percentage of parenchyma preserved plays a predominant role in predicting renal function after partial nephrectomy (PN). Currently there is no standard method to estimate preserved renal parenchyma. In this study we propose a formula of the percentage of resected and ischemic volume (PRAIV) determined by a geometric model and evaluate the relationships between renal functional change and PRAIV as well as other clinical parameters. Materials and Methods We identified 71 patients who underwent open PN between January 2004 and April 2014. Assuming the kidney to be an ellipsoid with bilaterally equal volume and tumor to be a sphere, we calculated PRAIV by integral calculus. Nadir estimated glomerular filtration rate (eGFR) between postoperative 3 and 12 months were recorded. The correlation between percent eGFR reduction, PRAIV, and other clinical parameters were examined. Results On univariate analysis, age (p=0.03), depth of tumor invasion (p=0.004), C index (p=0.003), RAIV (p=0.04), and PRAIV (p<0.001) were correlated with percent reduction of eGFR. However, only age (p=0.007) and PRAIV (p<0.001) were significantly correlated with percent reduction of eGFR on multivariate analysis. Depicting these values along the regression line, we found R2 was 0.194 and 0.073 for PRAIV and age, respectively. Conclusions PRAIV determined by a geometric model is a significant predictor of renal functional change after PN. Using PRAIV, we can estimate percent eGFR reduction preoperatively for better patient consultation and surgical planning.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Renales/cirugía , Isquemia Fría/métodos , Riñón/fisiopatología , Riñón/irrigación sanguínea , Riñón/patología , Neoplasias Renales/cirugía , Nefrectomía/métodos , Tamaño de los Órganos , Periodo Posoperatorio , Pregnanodionas , Valores de Referencia , Carcinoma de Células Renales/fisiopatología , Factores Sexuales , Análisis Multivariante , Reproducibilidad de los Resultados , Estudios Retrospectivos , Factores de Edad , Carga Tumoral , Tasa de Filtración Glomerular , Neoplasias Renales/fisiopatología , Persona de Mediana Edad , Modelos TeóricosRESUMEN
<p><b>AIM</b>To study the impurity in the drug megestrol acetate.</p><p><b>METHODS</b>Chromatography methods were used to separate the chemical constituents. Their structures were determined by NMR and MS spectral analysis.</p><p><b>RESULTS</b>Two new epimers were isolated from the mother liquid of the drug megestrol acetate.</p><p><b>CONCLUSION</b>These new epimers were identified as 17alpha-acetoxy-2beta,6alpha-dimethylprega-4-ene-3,20-dione (1) and 17alpha-acetoxy-2alpha,6alpha-dimethylprega-4-ene-3,20-dione (2).</p>
Asunto(s)
Contaminación de Medicamentos , Acetato de Megestrol , Química , Conformación Molecular , Estructura Molecular , Pregnanodionas , Química , EstereoisomerismoRESUMEN
Steroids produce anaesthesia besides producing the well known metabolic and hormonal effects. A number of anaesthetic steroids have been synthesized and tried clinically. Hydroxydione, althesin, minaxolone and pregnanolone are among those studied in detail. They act through GABAergic mechanism and are known to be advantageous over barbiturates.
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Mezcla de Alfaxalona Alfadolona/química , Anestésicos/química , Animales , Pregnanodionas/química , Pregnanolona/análogos & derivados , Esteroides/químicaRESUMEN
Em um ensaio aberto contolado foram estudados 30 pacientes portadores de doença reumatóide do adulto, seropositivos e em manutençäo terapêutica com prednisonam que foi substituída por deflazacort (na relaçäo 5 mg para 6 mg respectivamente). O deflazacort, assim como a aprednisona, também era administrado numa dose única pela manhä. Concluiu-se que o deflazacort é um novo glicocorticóide dotado de eficácia na terapêutica da doença reumatóide e, por apresentar açöes indesejáveis menos severas sobre o metabolismo ósseo e dos carboidratos, representa um avanço antiinflamatório hormonal, por períodos prolongados nesta enfermidade
Asunto(s)
Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Artritis Reumatoide/tratamiento farmacológico , Pregnanodionas/uso terapéutico , Antiinflamatorios/uso terapéutico , Química , Pregnanodionas/farmacologíaRESUMEN
Foram avaliadas comparativamente as influências do deflazacort e da prednisona sobre a tolerância a glicose e a secreçäo de insulina em 10 mulheres sadias. As voluntárias foram submetidfas ao teste de tolerância a glicose (GTT) em três etapas, sendo as glicemias dosadas pelo método da glicose-oxidase e as insulinemias pelo teste de radioimunoensaio. Os resultados obtidos demonstram menor açäo diabetogênica do deflazacort comparado com a prednisona