Determination of allicin, S-allylcysteine and volatile metabolites of garlic in breath, plasma or simulated gastric fluids.

Various components of garlic and aged garlic extract, including allicin, S-allylcysteine (SAC) and volatile metabolites of allicin were determined in breath, plasma and simulated gastric fluids by HPLC, gas chromatography (GC) or HPLC- and GC-mass spectrometry (MS). Data indicate that allicin decomposes in stomach acid to release allyl sulfides, disulfides and other volatiles that are postulated to be metabolized by glutathione and/or S-adenosylmethionine to form allyl methyl sulfide. SAC can be absorbed by the body and can be determined in plasma by HPLC or HPLC-MS using atmospheric pressure chemical ionization (APCI)-MS.

The determination of metabolites of garlic preparations in breath and human plasma.

Gas Chromatography-Mass Spectrometry (GC-MS) was the major technique used to determine various metabolites after consumption of dehydrated granular garlic and an enteric-coated garlic preparation, in breath, plasma, and simulated gastric fluids. A special short-path thermal desorption device was used as an introduction technique for the gas chromatograph for the determination of volatiles. These garlic preparations release allicin, which decomposes in stomach acid or with time in the intestine to release allyl sulfides, disulfides and other volatiles, some of which are postulated to be metabolized by glutathione and/or S-adenosylmethionine to form allyl methyl sulfide, the main sulfur containing volatile metabolite. S-Allylcysteine, a non-volatile bioactive component of aged garlic preparations, was determined in human plasma and urine by HPLC-MS using the negative ion atmospheric pressure chemical ionization mode (APcI)- MS. The technique of selected ion monitoring was used for quantitation. A synthetic internal standard of deuterated S-allylcysteine was added to the plasma or urine to ensure recovery and to obtain reliable quantitative data.

Managing delirious older adults in the hospital.

Delirium is a common but underdiagnosed problem among hospitalized older adults. Delirium in this population has serious consequences and can contribute to the patient's demise. Consequently, understanding the nature of delirium in older adults is essential for safe clinical management. The delirious older adult requires physiological and environmental support, protection, judicious administration of medication, and diligent nursing care.

Understanding and increasing black kidney donation.

Blacks are at increased risk than others for developing chronic renal failure, a disease that is probably best treated with kidney transplantation. Tragically, donation among this race is low. The required request law, which fundamentally mandates that health care professionals seek donation, needs to be placed in a cultural context. Therefore, this law is discussed with particular emphasis on how it should be implemented, especially in regard to its importance for the Black population.

Automated partial exchange transfusion in sickle cell anemia.

Partial exchange transfusion is used to manage several of the complications of sickle cell anemia. Automated exchanges have been performed successfully in thirteen homozygous (SS) sickle cell patients and in one patient with hemoglobin SC. Although the expected acute increase in whole blood oxygen affinity occurred in each patient, there was no clinical evidence of detrimental effects during or immediately after each procedure, and in each case the patient was unchanged or improved when evaluated by exercise testing. By using a discontinuous-flow cell separator, it is possible to decrease the time required to achieve a 50 per cent exchange in an adult to approximately two hours. Transfusion of blood with an antigenic marker permits rapid evaluation of exchange efficiency during the procedure. When partial exchange transfusion is indicated, the discontinuous-flow cell separator provides a safe, rapid, and effective procedure.