Assuntos
Cuidados Críticos/economia , Guias como Assunto , Medicare/organização & administração , Medicare/normas , Gerenciamento da Prática Profissional/normas , Idoso , Estudos de Avaliação como Assunto , Feminino , Custos de Cuidados de Saúde/normas , Humanos , Masculino , New Jersey , Exame Físico/economia , Encaminhamento e Consulta/economia , Estados UnidosAssuntos
Antibacterianos/farmacologia , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/efeitos dos fármacos , Cefalotina/farmacologia , Ciprofloxacina/farmacologia , Clindamicina/farmacologia , Eritromicina/farmacologia , Humanos , Testes de Sensibilidade Microbiana , Penicilinas/farmacologia , Philadelphia , Rifampina/farmacologia , Streptococcus pyogenes/isolamento & purificação , Vancomicina/farmacologiaAssuntos
Infecções Estreptocócicas/diagnóstico , Streptococcus agalactiae/imunologia , Humanos , Lactente , Recém-Nascido , Testes de Fixação do Látex , Estudos Prospectivos , Estudos Retrospectivos , Sensibilidade e Especificidade , Infecções Estreptocócicas/imunologia , Streptococcus agalactiae/isolamento & purificaçãoRESUMO
The in vitro plasma protein binding was determined in nine maintenance hemodialysis patients who later underwent renal transplantation. The organic acid fluorescein (10 micrograms/ml) or the organic base quinidine (5 micrograms/ml) was added to the pre and post transplant serum of these patients. Drug concentrations were measured spectrophotofluorometrically after equilibrium dialysis. The results were compared with the plasma protein binding of eight normal volunteers. The patients on maintenance hemodialysis had lower plasma protein binding of fluorescein than normals (78 +/- 5% vs 89 +/- 4, p less than 0.001). Plasma protein binding improved significantly after renal transplantation (85 +/- 3, p less than 0.01) but was still lower than in normals (p 0.05). Plasma protein binding of quinidine was not significantly different than in normal volunteers (77 +/- 8%) either prior to (72 +/- 10%) or after (73 +/- 12%) kidney transplantation. Plasma protein binding of quinidine remains unaffected by renal transplantation. However, the abnormal plasma protein binding or organic acids in chronic renal failure may be significantly improved by renal transplantation.
