Electrochemical monitoring of the breast milk quality.

The electrochemical techniques were used to determine the total antioxidant capacity of breast milks and the results were compared with a commonly used spectrophotometric (2,2-diphenyl-1-picrylhydrazyl, DPPH) method. Breast milk from mothers of preterm infants was monitored in three lactation phases and after storage of expressed milk by monitoring changes in the total antioxidant capacity over a two year period. Statistical analysis showed there was no significant difference between the ability of the three methods to detect changes in breast milk after storage. Either of the electrochemical techniques studied could be successfully used to replace the time-consuming spectrophotometric method and can be applied to clinical trials.

[Implementation of the radiolabelled antibiotic in the detection of orthopedic infections].

The aim of the study is detection and evaluation of the orthopedic infections using 99mTc-ciprofloxacin, radiopharmaceutical supposed to distinguish inflammation from infection. There were 15 true positive findings, 9 true negative, and two were false positive, while 1 was false negative. Sensitivity was 94%, specificity 82%, positive predictive value 88%, negative predictive value 90% and accuracy 89%. According to our results, scintigraphy with 99mTc-ciprofloxacin is a useful method for detection and assessment of exact localization of orthopedic infections, which might be useful for (differential) diagnosis, surgical treatment in due time as well as monitoring of the treatment of conservative therapy.

First-order UV-derivative spectrophotometry in the analysis of omeprazole and pantoprazole sodium salt and corresponding impurities.

The first-order UV-derivative spectrophotometry, applying zero-crossing method was developed for the determination of omeprazole (OM), omeprazole sulphone (OMS), pantoprazole sodium salt (PANa), and N-methylpantoprazole (NPA) in methanol-ammonia 4.0% v/v, where the sufficient spectra resolutions of drug and corresponding impurity were obtained, using the amplitudes 1D(304), 1D(307), 1D(291.5) and 1D(296.5), respectively. Method showed good linearity in the ranges (microg ml(-1)): 1.61-17.2 for OM; 2.15-21.50 for OMS; 2.13-21.30 for PANa and 2.0-20.0 for NPA, accuracy and precision (repeatability and reproducibility). The experimentally determined values of LOD (microg ml(-1)) were 1.126; 0.76; 0.691 and 0.716 for OM, OMS, PANa and NPA, respectively. The obtained values of 2.91% w/w for OMS and 3.58% w/w for NPA in the presence of their parent drug, by applying the method of standard additions, point out the usage of the proposed method in stability studies. Zero-crossing method in the first-order derivative spectrophotometry showed the impurity-drug intermolecular interactions, due to the possible intermolecular hydrogen bonds, confirmed by divergences of experimentally obtained amplitudes for impurities OMS and NPA in comparison to expected values according to regression equations of calibration graphs.

Simultaneous HPLC determination of nitrendipine and impurities of the process of synthesis.

A method has been developed for separation of nitrendipine and its impurities of reaction partners and side reaction products by high-performance liquid chromatographic method on a RP-18 column and detection at 238 nm. The mobile phase composition that provided an acceptable nitrendipine resolution, in large excess and possible impurities, in a short elution time, is methanol:water (70:30) and pH 3. Linearity (r> or =0.999), reproducibility (RSD=0.8--1.4%), determination limit (0.5--2%) and recovery (99.8--102.3) were validated and found to be satisfactory. This method enables monitoring of the process of synthesis, as well as the choice of the synthetic design.

UV derivative spectrophotometric study of the photochemical degradation of nisoldipine.

The photodecomposition of nisoldipine ((+/-)3-isobutyl-5-methyl-1,4- dihydro-2,6-dimethyl-4-(2-nitrophenyl)-pyridine-3,5-dicarboxylate), whereby its 4-(2-nitrosophenyl) pyridine analogue is obtained as the photolytic product, was investigated under daylight exposure by means of UV derivative spectrophotometry. The optimal instrumental parameters (120 nm/min scan speed; 2 nm slit width; delta gamma = 10 nm and 5 s response time) for analogue derivative spectra were established for amplitudes 1D285 and 2D291 (measured to the baseline) of the nitroso analogue assay, as well as for 1D386 of the parent compound-nisoldipine assay. Using the first-order derivative spectrum, the minimum detectable amount of nitroso analogue in the presence of nisoldipine was equivalent to an impurity level of 5% and by the second-order derivative spectrum, the determination limit was equivalent to an impurity level of 2%. The degradation of nisoldipine followed within 30 days and the calculated maximal degradation rate was 1.6% per day for nisoldipine raw material, but significantly lower values of 0.19 and 0.15% per day were obtained for Nisoldin tablets (10 and 5 mg, respectively).

Quantitative analysis of sulpiride and impurities of 2-aminomethyl-1-ethylpyrrolidine and methyl-5-sulphamoyl-2-methoxybenzoate in pharmaceuticals by high-performance thin-layer chromatography and scanning densitometry.

A simple and reliable thin-layer chromatographic method for determining sulpiride and impurities of 2-aminomethyl-1-ethylpyrrolidine and methyl-5-sulphamoyl-2-methoxybenzoate was developed and validated. A methylene chloride-methanol-ammonia solution (25%; 18 + 2.8 + 0.4, v/v) solvent system is used for separation and quantitative evaluation of chromatograms. The chromatographic plate is first scanned at 240 nm to locate chromatographic zones corresponding to sulpiride and methyl-5-sulphamoyl-2-methoxybenzoate. Then 2-aminomethyl-1-ethylpyrrolidine is derivatized in situ with ninhydrin, and resulting colored spots are measured at 500 nm. The method is reproducible and convenient for quantitative analysis and purity control of sulpiride in its raw material and in its dosage forms.

[Tonsillo-pharyngeal form of tularemia]. / Tonzilofaringealni oblik tularemije.

Clinical, laboratory and serologic features of tonsillopharyngeal form of tularemia in 14 patients were analyzed in the study. The disease was ignored under the diagnosis of typical tonsillopharyngitis followed by cervical lymphadenopathy. Routine laboratory analyses results were non-specific and didn't reveal the disease etiology, while microagglutination test (MAT) of F. tularensis in the second week of disease was positive in 86% of patients. Skin tularin test was positive in all the tested patients during the first week of the disease. The best results in the treatment were achieved by administration of streptomycin and doxycycline. Well timed therapy prevented the lymph nodes colliquation, disease recurrence and infection generalization. The authors point out the significance of this clinical form of tularemia in the differential diagnosis of tonsillopharyngitis and cervical lymphodenopathy.

Gas chromatography-mass spectrometry determination of isosorbide 5-mononitrate and related impurities in raw materials and dosage formulations.

A straightforward quantitative method for gas chromatography-mass spectrometry determination of isosorbide 5-mononitrate (IS5MN) and its related impurities such as isosorbide (IS), isosorbide diacetate (ISDA) and isosorbide 2-acetate-5-nitrate (IS2A5N) in raw materials as well as in dosage formulations is developed. The recovery of these materials was found to be 100.4 +/- 2.4, 99.3 +/- 4.7, 97.8 +/- 5.2 and 100.1 +/- 3.1%, while the detection limits were 27.2, 1.26, 1.02 and 0.78 micrograms in dosage formulations for IS5MN, ISDA, IS2A5N, and IS, respectively. The applicability of the method was tested by analysing three different formulations of IS5MN.

[Clinico-laboratory characteristics and treatment of patients with trichinosis]. / Klinicko-laboratorijske karakteristike i lecenje bolesnika sa trihinelozom.

The severity of clinical features of trichinosis and cardiac involvement incidence were examined in the study. The values of eosinophiles, serum enzymes and serologic response to T. spiralis were determined in relation to the disease severity. Twenty-nine patients, of mean age from 24 to 29 years treated in the Clinic in the period from January to April 1995 were presented-7 with severe form of trichinosis, 10 with moderately severe and 12 with light. The fever was noticed in 93.1% of patients, gastrointestinal disorders in 65.5%, myalgias in 96.6%, facial edema in 79.3%, cardiac disorders in 31% and rash in 20.7%. Positive IIF test result was found in 100% of patients with severe clinical features, and only in 58.3% of patients with light clinical features. The patients were treated with mebendazole in the dose of 25 mg/kg BM a day during 14 days. It was concluded that severe trichinosis forms were frequently followed by myocardial damage, that severe forms responded faster and better serologically to trichinella and those patients should be treated with high mebendazole doses.

[Pharmacotherapy in neonates and infants]. / Farmakoterapija u novorodjenackom i dojenackom dobu.

Pharmacotherapy in neonates and infants includes the knowledge of many specific characteristics of this age. Haemodynamic and pharmacokinetic characteristics are coupled not only with intensive development of organs and organ systems, irst of all liver and kidneys, but also the specificity of drugs of pharmacotheray, aiming at acheiving the optimal dosing, either by correction of doses, or by increasing the time interval between the doses, or both... This helps in decreasing the time risk of early of delayed complications due to overdosing, but also helps in decreasing the unnecessary financial burden.

[Viral hepatitis C. Personal experience with diagnostic, monitoring and epidemiologic studies]. / Virusni hepatitis C. Nasa iskustva u dijagnostici, pracenju i epidemioloskim ispitivanjima.

In the period from 1991 to 1993, 18 patients with the acute viral hepatitis type C were treated and followed up--13 men and 5 women, the average age of 42 years. The group of 6 patients (4 men and two women) with the "old" proven liver cirrhosis, whose etiology was unknown for 20 years, was analyzed. The investigations showed that the acute viral hepatitis type C usually began with the mild subjective disorders. The half of the patients did not have either jaundice or hepatomegaly, only half of them recover, and the first cases of cirrhosis could have been expected almost as early as a year after the beginning of illness. The developed liver cirrhoses remained compensated for years. About 58% of patients got infected parenterally, and the rest of them could have gotten infected in other manner. ELISA test showed great reliability in proving the antibodies against the viral hepatitis type C in the confirming the diagnosis of illness.

[Clinical manifestations of infectious erythema in adults]. / Klinicko ispoljavanje infektivnog eritema kod odraslih.

The infectious erythema is usually childhood disease associated with rash and caused by parvovirus B19. At the beginning of 1993., at the Clinic for infectious and tropical diseases of the Military Medical Academy 36 patients were treated for this disease, the average age 21 years. The prodromal phase of illness lasted approximately 2.9 days, the elevated temperature 5.2 days, and 17 patients had temperature above 39 degrees C. The rash was usually maculo-papullous and lasted about 6 days. Four patients had the recurrence of rash. The polyarthralgia appeared for short in six patients and in one patient lasted longer than 4 months. The mild anemia during infectious erythema was observed in 18 patients. IgM antiparvo B19 antibodies were proven in serum in 91.7%, and IgG antibodies in 58.3% of patients.

[Personal experience in the treatment of chronic viral hepatitis B with recombinant interferon B alfa-2]. / Nasa iskustva u lecenju hronicnog virusnog hepatitisa B alfa-2 rekombinantnim interferonom.

Twelve patients were treated with alpha-2 recombinant interferon during 4 months. Patients were given daily dose of 3 million units three times a week. Therapeutic effect expressed as the percentage of HBeAG seroconversion or by the loss of antibodies for the core antigen in IgM fraction and by the core antigen loss from hepatic tissue, was achieved in 41.6% of patients. Corticosteroids, administered before interferon, could improve therapeutic effect. Better response to therapy was observed in patients with higher serum transaminase levels and with histopathologically confirmed chronic hepatitis. Predictive value of each immunological parameter of therapeutic effect requires further study.