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2.
Int J Pharm ; 533(1): 315-319, 2017 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-28964903

RESUMO

The effects of γ-radiation sterilization on the parenteral excipient l-histidine were analysed by means of EPR spectroscopy. The irradiation process was found to induce the formation of a deamination radical which was persistent in the solid state. The nature and reactivity of the radicals following dissolution in water was evaluated using spin-trapping EPR experiments. The deamination radical was found to regenerate in solution in the presence of trace metals, potentially leading to radical induced degradation reactions occurring up to an hour after the dissolution process. Understanding this process is significant for the improved design of parental pharmaceutical formulations in which unwanted radical reactions after γ-radiation sterilization could lead to degradation of active ingredients.


Assuntos
Excipientes/efeitos da radiação , Radicais Livres/química , Raios gama , Histidina/efeitos da radiação , Esterilização/métodos , Espectroscopia de Ressonância de Spin Eletrônica , Excipientes/química , Histidina/química , Pós
3.
J Phys Chem A ; 112(41): 10147-51, 2008 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-18800821

RESUMO

The carbonate radical (CO 3 (*-)) is of importance in biology and chemistry. We used pulse radiolysis to generate the CO 3 (*-) radical and show there is no reaction with oxygen. However, in the presence of ammonia the CO 3 (*-) radical is removed by NO (*), which itself arises from the scavenging of NH 2 (*) by oxygen, and the mechanism of this process is reported. The CO 3 (*-) radical shows complex decay patterns in the presence of ammonia, which can be understood as a balance between the radical-radical reaction CO 3 (*-) + CO 3 (*-) and CO 3 (*-) + NH 2 (*) (the amino radical). Also, we report reactivity with glycine and alanine and with melanin models. The CO 3 (*-) reacts with both dopa-melanin (DM, a model of black eumelanin) and with cysteinyl-dopa-melanin (CDM, a model of red/blond phaeomelanin). However, the reaction rate constant is much higher with CDM than with DM.


Assuntos
Aminoácidos/química , Amônia/química , Carbonatos/química , Melaninas/química , Oxigênio/química , Radicais Livres/química , Cinética , Fatores de Tempo
4.
J Phys Chem A ; 112(6): 1234-7, 2008 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-18215026

RESUMO

We report the direct observation of the quenching of the weakly absorbing transient due to the amino radical by oxygen and, hence determine, by a totally direct method, the corresponding rate constant (k = (1.1 +/- 0.1) x 10(9) dm3 mol(-1) s(-1)). We also report the rate constants for the reactions of the amino radical with several amino acids and models of black eumelanin and blond/red phaeomelanin. These reactions lead to a mechanism, based on free radicals, that can explain why ammonia is useful in commercial hair (melanin) bleaching, avoiding excessive amino acid (hair protein) damage.


Assuntos
Aminas/química , Aminoácidos/química , Melaninas/química , Oxigênio/química , Amônia/química , Peróxido de Hidrogênio/química , Radical Hidroxila/química , Cinética , Oxirredução , Radiólise de Impulso , Análise Espectral
5.
Carbohydr Res ; 343(12): 2184-93, 2008 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-18226804

RESUMO

The interactions between Cu(II) ions and heparin were investigated using several complementary spectroscopic techniques. NMR indicated an initial binding phase involving specific coordination to four points in the structure that recur in slightly different environments throughout the heparin chain; the carboxylic acid group and the ring oxygen of iduronate-2-O-sulfate, the glycosidic oxygen between this residue and the adjacent (towards the reducing end) glucosamine and the 6-O-sulfate group. In contrast, the later binding phase showed little structural specificity. One- and two-dimensional correlated FTIR revealed that complex out of phase (asynchronous) conformational changes also occurred during the titration of Cu(II) ions into heparin, involving the CO and N-H stretches. EPR demonstrated that the environments of the Cu(II) ions in the initial binding phase were tetragonal (with slightly varied geometry), while the later non-specific phases exhibited conventional coordination. Visible spectroscopy confirmed a shift of the absorbance maximum. Titration of Cu(II) ions into a solution of heparin indicated (both by analysis of FTIR and EPR spectra) that the initial binding phase was complete by 15-20 Cu(II) ions per chain; thereafter the ions bound in the non-specific mode. Hetero-correlation spectroscopy (FTIR-CD) improved resolution and assisted assignment of the broad CD features from the FTIR spectra and indicated both in-phase and more complex out of phase (synchronous and asynchronous, respectively) changes in interactions within the heparin molecule during the titration of Cu(II) ions.


Assuntos
Cátions Bivalentes/química , Cobre/química , Heparina/química , Dicroísmo Circular , Espectroscopia de Ressonância de Spin Eletrônica , Ressonância Magnética Nuclear Biomolecular , Espectroscopia de Infravermelho com Transformada de Fourier/métodos
6.
Audiol Neurootol ; 12(6): 378-90, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17664869

RESUMO

Studies using the prestin knockout mouse indicate that removal of the outer hair cell (OHC) motor protein is associated with loss of sensitivity, frequency selectivity and somatic electromotility. Here we provide data obtained from another prestin mouse model that was produced commercially. In vivo electrical recordings from the round window indicate that the phenotype is similar to that of the original knockout generated by the Zuo group at St. Jude Children's Research Hospital. Hence, compound action potential (CAP) thresholds are shifted in a frequency-dependent manner and CAP tuning curves at 12 kHz are flat for masker frequencies between 3 and 18 kHz. Although CAP input-output functions at 6 kHz show a shift in sensitivity at low levels, responses approach wild-type magnitudes at high levels where the cochlear amplifier has less influence. In order to confirm that the loss of sensitivity and frequency selectivity is due to loss of prestin, we performed immunohistochemistry using a prestin antibody. Cochlear segments from homozygous mutant mice showed no fluorescence, while wild-type mice displayed a fluorescent signal targeted to the OHC's lateral membrane. Absence of prestin protein was confirmed using LDS-PAGE/Western blot analysis. These results indicate that the loss of function phenotype is associated with loss of prestin protein. Lack of prestin protein also results in a shortening of OHC length to approximately 60% of wild-type, similar to that reported previously by Liberman's group. The linkage shown between the loss of prestin protein and abnormal cochlear function validates the original knockout and attests to the importance of OHC motor function in the auditory periphery.


Assuntos
Modelos Animais de Doenças , Células Ciliadas Auditivas Externas/fisiologia , Proteínas Motores Moleculares/genética , Animais , Limiar Auditivo/fisiologia , Potenciais Microfônicos da Cóclea/genética , Éxons/genética , Marcação de Genes , Genótipo , Células Ciliadas Auditivas Externas/patologia , Heterozigoto , Homozigoto , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Mutantes , Camundongos Transgênicos , Microscopia Confocal , Fenótipo , RNA Mensageiro/genética
7.
J Phys Chem A ; 110(51): 13653-61, 2006 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-17181317

RESUMO

Spectral and photophysical properties of the indigo derivative Cibalackrot in keto and reduced (leuco) forms were studied by absorption spectra, fluorescence and pulse radiolysis and compared with the structurally similar indigo. With the keto form of this dye, fluorescence (phiF = 0.76) and intersystem crossing (phiT = 0.11) are dominant, whereas with indigo, efficient internal conversion (phiIC = 0.99) is observed, probably involving proton transfer through intramolecular hydrogen bonds. With Cibalackrot, this pathway is blocked, supporting the above model for indigo. With the reduced form of Cibalackrot, more than 98% of the absorbed quanta are dissipated through S1 approximately --> S0 internal conversion, which contrasts with leuco-indigo, where fluorescence (phiF = 0.35), internal conversion (phiIC = 0.53) and intersystem crossing (phiT = 0.125) are found to be competitive. In addition, a synthetic precursor of Cibalackrot (preCiba) was also investigated. This has a rigid molecular structure (with a moiety identical to Cibalackrot and the other to indigo), but intra- or intermolecular proton transfer is allowed between adjacent carbonyl and N-H groups. With this precursor in its keto structure the photophysical parameters are generally very close to those of the keto form of indigo, and different from those of Cibalackrot. A more detailed investigation of the time-decay profiles of preCiba in dioxane (and with added water and D2O) has shown that these follow biexponential laws with a shorter component of 14-25 ps, which appears associated with a risetime at longer wavelength emissions (and to a positive preexponential at shorter emission wavelengths) and a longer lived (decay) component of 104-130 ps. In the steady-state spectra of preCiba, the variation with temperature reveals a blue shift of the emission maxima, which is interpreted as the presence (simultaneous emission) of two species (keto and enol) in the excited state. Indigo and deuterated indigo are also found to present a similar behavior. The overall data are interpreted as to be due to an excited-state process involving the proton transfer between keto and enol forms. Rate constants with values of 7 x 10(10) s-1 for preCiba and 1.6 x 10(11) s-1 for deuterated indigo were obtained. This inverse isotope effect is justified on the basis of the proposed model for proton-transfer excited-state deactivation.


Assuntos
Compostos Heterocíclicos de 4 ou mais Anéis/química , Indóis/química , Corantes/química , Deutério , Índigo Carmim , Estrutura Molecular , Fotoquímica , Fotólise , Espectrofotometria
8.
Pigment Cell Res ; 19(5): 443-50, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16965273

RESUMO

A pulse radiolytic investigation has been conducted to establish whether a redox reaction takes place between dopaquinone and 5,6-dihydroxyindole (DHI) and its 2-carboxylic acid (DHICA) and to measure the rate constants of the interactions. To obviate possible confounding reactions, such as nucleophilic addition, the method employed to generate dopaquinone used the dibromide radical anion acting on dopa to form the semiquinone which rapidly disproportionates to dopaquinone. In the presence of DHI the corresponding indole-5,6-quinone (and/or tautomers) was also formed directly but, by judicious selection of suitable relative concentrations of initial reactants, we were able to detect the formation of additional indolequinone from the redox exchange reaction of DHI with dopaquinone which exhibited a linear dependency on the concentration of DHI. Computer simulation of the experimental time profiles of the absorption changes showed that, under the conditions chosen, redox exchange does proceed but not quite to completion, a forward rate constant of 1.4 x 10(6)/M/s being obtained. This is in the same range as the rate constants previously established for reactions of dopaquinone with cyclodopa and cysteinyldopa. In similar experiments carried out with DHICA, the reaction more obviously does not go to completion and is much slower, k (forward) =1.6 x 10(5)/M/s. We conclude that, in the eumelanogenic pathway, DHI oxidation may take place by redox exchange with dopaquinone, although such a reaction is likely to be less efficient for DHICA.


Assuntos
Simulação por Computador , Radicais Livres/química , Indóis/química , Modelos Químicos , Cinética , Oxirredução
9.
J Phys Chem B ; 110(16): 8278-83, 2006 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-16623508

RESUMO

Data are reported on the triplet states of a series of fluorene-based A-alt-B type alternating copolymers based on pulse radiolysis-energy transfer and flash photolysis experiments. From the pulse radiolysis experiments, spectra are given for eight copolymers involving phenylene, thiophene, benzothiadiazole, and oligothienylenevinylene groups. Quantum yields for triplet-state formation (PhiT) have been obtained by flash photolysis following laser excitation and in one case by photoacoustic calorimetry. In addition, yields of sensitized formation of singlet oxygen have been determined by time-resolved phosphorescence and are, in general, in excellent agreement with the PhiT values. In all cases, the presence of thiophene units is seen to increase intersystem-crossing quantum yields, probably because of the presence of the heavy sulfur atom. However, with the poly[2,7-(9,9-bis(2'-ethylhexyl)fluorene)-alt-1,4-phenylene] (PFP), thiophene S,S-dioxide (PFTSO2) and benzothiadiazole (F8BT) copolymers, low yields of triplet formation are observed. With three of the copolymers, the energies of the triplet states have been determined. With PFP, the triplet energy is virtually identical to that of poly[2,7-(9,9-bis(2'-ethylhexyl)fluorene)]. In contrast, with fluorene-thiophene copolymers PFaT and PF3T, the triplet energies are closer to those of thiophene oligomers, indicating that there is significant conjugation between fluorene and thiophene units but also that there is a more localized triplet state than with the homopolymers.


Assuntos
Fluorenos/química , Oxigênio/química , Algoritmos , Calorimetria , Fenômenos Químicos , Físico-Química , Cinética , Fotoquímica , Fotólise , Polímeros
10.
J Photochem Photobiol B ; 64(2-3): 176-8, 2001 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-11744404

RESUMO

There is current interest in the health benefits of dietary carotenoids and the possible deleterious effects on certain sub-populations such as smokers. Here we report in vivo protection of human lymphocytes, conferred by dietary supplementation of lycopene rich foods against the reactive oxygen species, NO(2)(*) radical (by electron transfer) and 1(O)(2) (by energy transfer). It was found that a lycopene rich diet, maintained for 14 days, increased the serum lycopene level 10 fold compared to serum obtained after the same period, where a typical western European diet had been consumed. Relative lymphocyte protection factors of 17.6 and 6.3 against NO(2)(*) radical and 1(O)(2), respectively, were obtained, which re-enforce epidemiological data, showing protection against several chronic diseases by tomato lycopene.


Assuntos
Antioxidantes/metabolismo , Carotenoides/metabolismo , Suplementos Nutricionais , Dióxido de Nitrogênio/metabolismo , Oxigênio Singlete/metabolismo , Fumar/efeitos adversos , Células Cultivadas , Humanos , Licopeno , Linfócitos/metabolismo , Oxidantes , Espécies Reativas de Oxigênio , Nicotiana
11.
FEBS Lett ; 500(3): 132-6, 2001 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-11445071

RESUMO

The one-electron reduction potentials of the radical cations of five dietary carotenoids (beta-carotene, canthaxanthin, zeaxanthin, astaxanthin and lycopene) in aqueous micellar environments have been obtained from a pulse radiolysis study of electron transfer between the carotenoids and tryptophan radical cations as a function of pH, and lie in the range of 980-1060 mV. These values are consistent with our observation that the carotenoid radical cations oxidise tyrosine and cysteine. The decays of the carotenoid radical cations in the absence of added reactants suggest a distribution of exponential lifetimes. The radicals persist for up to about 1 s, depending on the medium.


Assuntos
Carotenoides/química , Cátions/química , Micelas , Carotenoides/efeitos da radiação , Cisteína/química , Dipeptídeos/química , Radicais Livres/química , Concentração de Íons de Hidrogênio , Oxirredução/efeitos da radiação , Radiólise de Impulso , Espectrofotometria , Triptofano/química , Tirosina/química , Água/química
12.
J Photochem Photobiol B ; 60(1): 1-6, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11386675

RESUMO

Pulse radiolysis was used to generate the radical cations of beta-carotene and two xanthophylls, zeaxanthin and lutein, in unilamellar vesicles of dipalmitoylphosphatidyl choline. The rate constants for the reaction (repair) of these carotenoid radical cations with the water-soluble vitamin C were found to be similar (approximately 1x10(7) M(-1) s(-1)) for beta-carotene and zeaxanthin and somewhat lower (approximately 0.5x10(7) M(-1) s(-1)) for lutein. The results are discussed in terms of the microenvironment of the carotenoids and suggest that for beta-carotene, a hydrocarbon carotenoid, the radical cation is able to interact with a water-soluble species even though the parent hydrocarbon carotenoid is probably entirely in the non-polar region of the liposome.


Assuntos
1,2-Dipalmitoilfosfatidilcolina/química , Ácido Ascórbico/química , Luteína/química , beta Caroteno/química , Cátions , Radicais Livres/química , Lipossomos/química , Estrutura Molecular , Espectrofotometria Ultravioleta , Xantofilas , Zeaxantinas , beta Caroteno/análogos & derivados
13.
J Photochem Photobiol B ; 65(2-3): 177-83, 2001 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-11809377

RESUMO

Porphyrins such as protoporphyrin IX (PP IX) and uroporphyrin I (UP I) can be phototoxic to human cells. To study the protective ability of antioxidants (beta-carotene, lycopene, ascorbic acid and alpha-tocopherol), against such porphyrin phototoxicity, membrane destruction experiments (Jurkat cells) and human cell cultures (fibroblasts) were performed. Both beta-carotene and lycopene and also the combination of beta-carotene, ascorbic acid and alpha-tocopherol offered cell protection against PP IX phototoxicity. Investigations of both cell membrane protection and of cell growth showed differences in terms of the protection afforded by the anti-oxidants. Thus, for PP IX, carotenoids alone, and in combination with ascorbic acid and alpha-tocopherol, showed higher protection factors in general than UP I. However, for membrane protection there was significant protection against UP I by the combination of beta-carotene, ascorbic acid and alpha-tocopherol but not by any of these anti-oxidants alone. The membrane protection against PP IX by beta-carotene, and especially lycopene, is significant presumably because of the high lipophilicity of all these molecules. However, the hydrophilic UP I will cause phototoxicity mainly via H(2)O(2), radical or singlet oxygen production in the aqueous phase, and these reactive species may be generated some distance from the cell membrane. This may lead to the little or no protection observed for UP I by the individual antioxidants. Nevertheless, a combination of beta-carotene, ascorbic acid and alpha-tocopherol offers membrane protection against the phototoxicity of both porphyrins. This is believed to occur as a result of synergistic processes. Our results suggest that the treatment of porphyria cutanea tarda and erythropoietic protoporphyria may be improved by the use of a combination of the antioxidants studied.


Assuntos
Antioxidantes/metabolismo , Protoporfirinas/toxicidade , Uroporfirinas/toxicidade , Ácido Ascórbico/metabolismo , Carotenoides/metabolismo , Divisão Celular , Linhagem Celular , Membrana Celular/metabolismo , Fibroblastos/citologia , Humanos , Células Jurkat , Luz , Licopeno , Protoporfirinas/metabolismo , Uroporfirinas/metabolismo , alfa-Tocoferol/metabolismo , beta Caroteno/metabolismo
14.
Hear Res ; 145(1-2): 156-60, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10867288

RESUMO

In order to identify hair cell specific genes, it is essential to obtain isolated hair cells in quantity. While whole-cell recordings have been made from isolated inner hair cells (IHCs) from guinea pigs, detailed methods for obtaining a fairly large amount of isolated inner hair cells have not been published. Here we describe a protocol that can yield a fairly large amount of isolated gerbil IHCs. This technique can provide sufficient numbers of solitary IHCs for either electrophysiological studies of the cell's membrane properties or identifying genes related to IHC functions using techniques of molecular biology.


Assuntos
Cóclea/citologia , Células Ciliadas Auditivas Internas/citologia , Animais , Movimento Celular/fisiologia , Separação Celular/métodos , Estimulação Elétrica , Gerbillinae , Células Ciliadas Auditivas Internas/fisiologia , Células Ciliadas Auditivas Externas/citologia , Células Ciliadas Auditivas Externas/fisiologia , Técnicas de Patch-Clamp
15.
FEBS Lett ; 471(2-3): 125-7, 2000 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-10767406

RESUMO

There is a resurgence of interest in the role of electron transfer reactions involving beta-carotene in photosynthesis. There is also current debate on the health benefits of dietary carotenoids and the possible deleterious effects on certain sub-populations such as smokers. The impact of dietary carotenoids on health may well be also related to radical reactions. A key parameter in biological systems is therefore the one-electron reduction potential of the carotenoid radical cation, now reported for the first time in a model biological aqueous environment. The value obtained is 1.06+/-0. 01 V and is sufficiently high to oxidise cell membrane proteins, but is low enough to repair P(680).+ in the photosynthetic reaction centre.


Assuntos
Substâncias Redutoras/metabolismo , Água/metabolismo , beta Caroteno/metabolismo , Cátions/metabolismo , Cisteína/metabolismo , Transporte de Elétrons , Radicais Livres/metabolismo , Concentração de Íons de Hidrogênio , Micelas , Oxidantes/metabolismo , Complexo de Proteínas do Centro de Reação Fotossintética , Radiólise de Impulso , Soluções , Espectrofotometria Infravermelho , Termodinâmica , Triptofano/metabolismo , Tirosina/metabolismo
16.
J Assoc Res Otolaryngol ; 1(3): 195-210, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11545226

RESUMO

A frequency-dependent change in hearing sensitivity occurs during maturation in the basal gerbil cochlea. This change takes place during the first week after the onset of hearing. It has been argued that the mass of a given cochlear segment decreases during development and thus increases the best frequency. Changes in mass during cochlear maturation have been estimated previously by measuring the changes in cochlear dimensions. Fixed, dehydrated, embedded, or sputter-coated tissues were used in such work. However, dehydration of the tissue, a part of most histological techniques, results in severe distortion of some aspects of cochlear morphology. The present experiments, using a novel preparation, the hemicochlea, show that hydrated structures, such as the tectorial membrane and the basilar membrane hyaline matrix, are up to 100% larger than estimated previous studies. Therefore, the hemicochlea was used to study the development of cochlear morphology in the gerbil between the day of birth and postnatal day 19. We used no protocols that would have resulted in severe distortion of cochlear elements. Consequently, a detailed study of cochlear morphology yields several measures that differ from previously published data. Our experiments confirm growth patterns of the cochlea that include a period of remarkably rapid change between postnatal day 6 and 8. The accelerated growth starts in the middle of the cochlea and progresses toward the base and the apex. In particular, the increase in height of Deiters' cells dominated the change, "pushing" the tectorial membrane toward scala vestibuli. This resulted in a shape change of the tectorial membrane and the organ of Corti. The tectorial membrane was properly extended above the outer hair cells by postnatal day 12. This time coincides with the onset of hearing. The basilar membrane hyaline matrix increased in thickness, whereas the multilayered tympanic cover layer cells decreased to a single band of cells by postnatal day 19. Before and after the period of rapid growth, the observed gross morphological changes are rather small. It is unlikely that dimensional changes of cochlear structures between postnatal days 12 and 19 contribute significantly in the remapping of the frequency-place code in the base of the cochlea. Instead, structural changes affecting the stiffness of the cochlear partition might be responsible for the shift in best frequency.


Assuntos
Cóclea/crescimento & desenvolvimento , Orelha Interna/crescimento & desenvolvimento , Gerbillinae/crescimento & desenvolvimento , Animais , Membrana Basilar/crescimento & desenvolvimento , Órgão Espiral/citologia , Órgão Espiral/crescimento & desenvolvimento , Membrana Tectorial/crescimento & desenvolvimento
17.
Radiol Manage ; 21(3): 38-43, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10539362

RESUMO

Maximum capacity for mammography services had been reached at the Kaweah Delta Health Care District, a 504-bed, multicampus hospital district in Visalia, Calif., so the community supported the idea of better and easier access to cancer care. Kaweah Delta Foundation, the hospital's development arm, helped raise funds for a new community breast center after hearing from local women that they disliked traveling to Los Angeles or San Francisco for state-of-the-art technology in diagnosis. They also requested better education and quicker exam results. The new Center was the result of a collaborative effort between imaging services and the cancer care program at Kaweah Delta. A nearby hospital, with more space for parking and room to offer an education program, became the site of the new Center. New equipment that met MQSA guidelines was purchased. An architectural firm designed a layout for patient comfort and privacy and efficient throughput for high volume work. The purchase of a second mammography unit allowed the Center to offer same-day and next-day appointments, which increased both physician and patient satisfaction. Consultation services with a radiologist are now offered. An education program that includes group support meetings and referrals to an oncology clinical nurse specialist are also offered. A new mobile mammography unit, housed at a newly acquired hospital 13 miles away, serves the needs of women in the two-county rural area who have no transportation. With careful planning and collaboration, the volume of mammography services has doubled in a year. Customer service ratings have soared.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Centros Comunitários de Saúde/organização & administração , Mamografia , Serviço Hospitalar de Radiologia/organização & administração , California , Relações Comunidade-Instituição , Feminino , Hospitais com mais de 500 Leitos , Humanos , Relações Interinstitucionais , Programas de Rastreamento , Desenvolvimento de Programas
18.
J Oncol Manag ; 8(3): 10-2, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10538237

RESUMO

Maximum capacity for mammography has been reached at Kaweah Delta Health Care District Imaging Center. Increased need and support in the community for access to care was a driving force in development of a Breast Center. What follows is a case study of implementing a Breast Center in a semi-rural community in Central California, which involves a collaborative effort between Cancer Program and Imaging Services.


Assuntos
Neoplasias da Mama/diagnóstico , Centros Comunitários de Saúde/organização & administração , Mamografia/estatística & dados numéricos , Serviços de Saúde Rural/organização & administração , Neoplasias da Mama/prevenção & controle , California , Equipamentos e Provisões , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Satisfação do Paciente
19.
J Cataract Refract Surg ; 25(9): 1237-44, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10476508

RESUMO

PURPOSE: To measure the frequency of scleral perforation and identify related risk factors during local anesthetic injection for intraocular surgery. SETTING: Multispecialty eye hospital. METHODS: All patients (n = 50,000) having retrobulbar (26,857) or peribulbar (23,143) injections at the King Khaled Eye Specialist Hospital were reviewed. Cases of scleral perforation were analyzed for potential technical and ophthalmic risk factors, management of injuries, and visual and anatomic outcomes. Mean follow-up was 14.4 months (range 8 to 24 months). RESULTS: Seven (0.014%) needlestick injuries were identified, all of which had posterior staphyloma as the only identifiable risk factor. Applying a previously measured prevalence of 10.7% for posterior staphyloma in our surgery patients gave a scleral perforation rate of 0.13% (7 of 5350) for staphylomatous eyes. All perforated globes had originally planned cataract extraction within 8 weeks of injury. Additional management consisted of observation (2 cases), cryotherapy (2 cases), and vitreoretinal procedures for retinal detachment (3 cases) and subretinal hemorrhage (1 case). At last follow-up, all retinas were attached and 3 cases (42.8%) had a visual acuity of worse than 20/160. Both cases requiring multiple retinal detachment surgeries developed proliferative vitreoretinopathy and poor visual acuity. CONCLUSIONS: Eyes with posterior staphyloma sustained needlestick injuries at a rate of 1 in 760 compared with 0 injection perforations in more than 44,000 nonstaphylomatous eyes.


Assuntos
Anestesia Local , Injeções/efeitos adversos , Ferimentos Penetrantes Produzidos por Agulha/etiologia , Órbita , Esclera/lesões , Adulto , Idoso , Anestésicos Locais/administração & dosagem , Criocirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ferimentos Penetrantes Produzidos por Agulha/cirurgia , Retina/lesões , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Hemorragia Retiniana/etiologia , Hemorragia Retiniana/cirurgia , Perfurações Retinianas/etiologia , Perfurações Retinianas/cirurgia , Fatores de Risco , Acuidade Visual , Vitrectomia
20.
J Cataract Refract Surg ; 25(1): 83-90, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9888082

RESUMO

PURPOSE: To assess the outcome of cataract surgery in eyes with posterior staphyloma and identify predictors of surgical success. SETTING: Tertiary care referral center. METHODS: A retrospective analysis was conducted of 107 consecutive patients with posterior staphyloma and 107 control patients who had cataract surgery. Potential associations of preoperative variables with surgical success were analyzed using the chi-square test, multivariate linear regression, and Student t test. RESULTS: The staphyloma group was younger, had more women, and had a lower mean visual acuity preoperatively than the control group. All patients in the control group and all but 1 in the staphyloma group had intraocular lens (IOL) implantation at the time of cataract extraction. The rates of posterior capsule tear and vitreous loss were similar in the staphyloma and control groups. There was 1 case each of retinal detachment and IOL dislocation in the staphyloma group. The staphyloma group had significantly lower postoperative visual acuity than the control group; however, the percentage in the staphyloma group with a visual acuity of finger counting or worse decreased from 80.4% preoperatively to 16.8% postoperatively and the percentage with an uncorrected visual acuity of 20/160 or better increased from 5.6% to 67.3%. Myopic degeneration was judged to be the cause of postoperative acuity worse than 20/100 in 22.4% in the staphyloma and 0% in the control group; other causes for poor postoperative acuity were similar in the 2 groups. In the staphyloma but not the control group, decreased postoperative acuity was independently associated with age greater than 65 years and axial length greater than 29.0 mm. CONCLUSIONS: Myopic degeneration may limit the results of cataract extraction in up to one fourth of patients with posterior staphyloma. Nevertheless, a substantial improvement in mean visual acuity resulted that was not associated with a significant increase in surgical complications.


Assuntos
Extração de Catarata , Doenças da Esclera/complicações , Idoso , Feminino , Humanos , Complicações Intraoperatórias , Implante de Lente Intraocular , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual
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