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1.
Forensic Sci Int ; 262: 121-7, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26986972

RESUMO

In sports, the oral intake and intravenous administration of glycerol as a potential masking agent have been prohibited. The effect of glycerol on blood parameters was investigated by comparing the intravenous administration of glycerol (20g/200mL) with that of an electrolyte (8g glucose/200mL) as a comparator (n=7, fixed-dose-rate i.v. infusion, 200mL in 1h). This study was also designed to evaluate whether the urinary concentrations reached the positivity threshold after the intravenous infusion of glycerol. Significant decreases of the haemoglobin (HGB, g/dL), haematocrit (HCT, %) and OFF-h Score (OFF-score) values were observed after the infusion of glycerol (P<0.05 at 1-6h). The differences in the HGB, HCT and OFF-score between pre- and post-administration were -0.49±0.23g/dL (2h), -1.54±0.73% (2h) and -3.89±3.66 (2h), respectively. Glycerol infusion significantly increased the plasma volume by 12.1% (1h), 6.3% (2h) and 5.7% (3h) compared with the initial values. The infusion of the comparator also increased the plasma volume by 9.6% (1h), 5.8% (2h) and 4.9% (3h) compared with the values before infusion. There were no significant differences in the change of the plasma volume between the intravenous infusions of glycerol and the glucose-based electrolyte (as the comparator) (P≥0.05). This finding might indicate that glycerol itself only exhibited limited effects on the expansion of plasma. After administration of glycerol, the urinary glycerol concentrations increased from 0.0013±0.0004mg/mL to 6.86±2.86mg/mL at 1h and 6.45±3.08mg/mL at 2h. The intravenous infusion of glycerol can most likely be detected using the current urine analysis; however, the dependence of the concentration of urinary glycerol on the urine volume should be considered.


Assuntos
Dopagem Esportivo , Glicerol/sangue , Glicerol/urina , Substitutos do Plasma/análise , Adulto , Glicerol/administração & dosagem , Hemoglobinas/análise , Humanos , Infusões Intravenosas , Masculino , Substitutos do Plasma/administração & dosagem , Volume Plasmático , Adulto Jovem
3.
Drug Test Anal ; 3(11-12): 836-50, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22135086

RESUMO

A new multi-target approach based on liquid chromatography--electrospray ionization tandem mass spectrometry (LC-(ESI)-MS/MS) is presented to screen for various classes of prohibited substances using direct injection of urine specimens. With a highly sensitive new generation hybrid mass spectrometer classic groups of drugs--for example, diuretics, beta2-agonists--stimulants and narcotics are detectable at concentration levels far below the required limits. Additionally, more challenging and various new target compounds could be implemented. Model compounds of stimulant conjugates were studied to investigate a possible screening without complex sample preparation. As a main achievement, the integration of the plasma volume expanders dextran and hydroxyethyl starch (HES), commonly analyzed in time-consuming, stand-alone procedures, is accomplished. To screen for relatively new prohibited compounds, a common metabolite of the selective androgen receptor modulator (SARMs) andarine, a metabolite of growth hormone releasing peptide (GHRP-2), and 5-amino-4-imidazolecarboxyamide ribonucleoside (AICAR) are analyzed. Following a completely new approach, conjugates of di(2-ethylhexyl) phthalate (DEHP) metabolites are monitored to detect abnormally high levels of plasticizers indicating for illicit blood transfusion. The assay was fully validated for qualitative purposes considering the parameters specificity, intra- (3.2-16.6%) and inter-day precision (0.4-19.9%) at low, medium and high concentration, robustness, limit of detection (1-70 ng/ml, dextran: 30 µg/ml, HES: 10 µg/ml) and ion suppression/enhancement effects. The analyses of post-administration and routine doping control samples demonstrates the applicability of the method for sports drug testing. This straightforward and reliable approach accomplishes the combination of different screening procedures resulting in a high-throughput method that increases the efficiency of the labs daily work.


Assuntos
Dopagem Esportivo , Ensaios de Triagem em Larga Escala/métodos , Preparações Farmacêuticas/urina , Detecção do Abuso de Substâncias/métodos , Espectrometria de Massas em Tandem/métodos , Agonistas de Receptores Adrenérgicos beta 2/urina , Adulto , Idoso , Estimulantes do Sistema Nervoso Central/urina , Cromatografia Líquida/métodos , Diuréticos/urina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Entorpecentes/urina , Substitutos do Plasma/análise , Sensibilidade e Especificidade , Espectrometria de Massas por Ionização por Electrospray/métodos
4.
Drug Test Anal ; 3(11-12): 896-905, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22162432

RESUMO

A screening procedure specifically developed for the detection of saccharides and polyalcohols in human urine in the framework of doping control analysis is presented. The proposed method, set-up, and validated to detect the abuse of dextran, hydroxyethyl starch and mannitol as a doping practice in sport, involves only one enzymatic hydrolysis step and the direct injection into a liquid chromatography-tandem mass spectrometry (LC-MS/MS) system. The chromatographic conditions were optimized to allow the efficient separation of compounds with the same molecular weight. Good linearity (R(2) 0.990-0.995) and reproducibility of relative retention times (CV% lower than 1) and of relative abundances of characteristic ion transitions (CV% lower than 10) were obtained. The lower limits of detection and quantification were in the range of 30-100 µg/ml. Since the analytes studied are present also in non-doping products (e.g. in fruit as well as in food products and drugs additives), the developed method was also used to establish a range of reference urinary concentrations: 600 doping control samples and 30 samples from volunteers not using any medication were considered. While the hydrolysis products (isomaltose and maltose hydroxyl-ethylated), used as specific markers for the detection of dextran and hydroxyethyl starch abuse, were not detected in urine; mannitol was present in all urines in a concentration range of 30-1200 µg/ml. Since no criteria of positivity for mannitol has been established yet, the results obtained in this study could be considered, in combination with those of previous researches, as a starting point to fix a threshold value for doping control purpose.


Assuntos
Dextranos/urina , Dopagem Esportivo , Derivados de Hidroxietil Amido/urina , Manitol/urina , Substitutos do Plasma/análise , Detecção do Abuso de Substâncias/métodos , Cromatografia Líquida/métodos , Humanos , Limite de Detecção , Detecção do Abuso de Substâncias/economia , Espectrometria de Massas em Tandem/métodos , Fatores de Tempo
6.
Bioanalysis ; 3(2): 215-26, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21250849

RESUMO

Plasma volume expanders comprise a heterogeneous group of substances used in medicine that are intravenously administered in cases of great blood loss owing to surgery or medical emergency. These substances, however, can also be used to artificially enhance performance of healthy athletes in sport activities, and to mask the presence of others substances. These practices are considered doping, and are therefore prohibited by the International Olympic Committee and the World Antidoping Agency. Consequently, drug testing procedures are essential. The present work provides an overview of plasma volume expanders, assembling pertinent data such as chemical characteristics, physiological aspects, adverse effects, doping and analytical detection methods, which are currently dispersed in the literature.


Assuntos
Dopagem Esportivo , Preparações Farmacêuticas/análise , Substitutos do Plasma/análise , Detecção do Abuso de Substâncias/métodos , Humanos
7.
Artigo em Inglês | MEDLINE | ID: mdl-20586664

RESUMO

The gelatin plasma substitute is often polydisperse and heterogenous, making it difficult to determine the elimination rate and half-life in the body. In this study, one method was developed based on quantitative determination of hydroxyproline derivatives. Two plasma substitutes were prepared by succinylation and genipin-crosslinking, respectively. After transfusion, the blood samples were hydrolyzed and derivatized, and then analyzed by HPLC. A two-phase exponential association equation was used for fitting the time-concentration curves. The results indicated that this method could be used for quantitative determination of gelatin in blood, and the pharmacokinetic parameters such as elimination rate and half-life.


Assuntos
Gelatina/sangue , Hidroxiprolina/sangue , Hidroxiprolina/química , Substitutos do Plasma/análise , Animais , Vasos Sanguíneos/efeitos dos fármacos , Vasos Sanguíneos/metabolismo , Volume Sanguíneo/efeitos dos fármacos , Bovinos , Reagentes de Ligações Cruzadas/química , Dinitrofluorbenzeno/análogos & derivados , Dinitrofluorbenzeno/sangue , Gelatina/efeitos adversos , Gelatina/farmacocinética , Gelatina/farmacologia , Meia-Vida , Hemorragia/sangue , Hidrólise , Glicosídeos Iridoides/química , Iridoides , Masculino , Substitutos do Plasma/efeitos adversos , Substitutos do Plasma/farmacocinética , Substitutos do Plasma/farmacologia , Coelhos , Anidridos Succínicos/química
8.
Handb Exp Pharmacol ; (195): 327-54, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20020372

RESUMO

The list of prohibited substances in sports includes a group of masking agents that are forbidden in both in- and out-of-competition doping tests. This group consists of a series of compounds that are misused in sports to mask the administration of other doping agents, and includes: diuretics, used to reduce the concentration in urine of other doping agents either by increasing the urine volume or by reducing the excretion of basic doping agents by increasing the urinary pH; probenecid, used to reduce the concentration in urine of acidic compounds, such as glucuronoconjugates of some doping agents; 5alpha-reductase inhibitors, used to reduce the formation of 5alpha-reduced metabolites of anabolic androgenic steroids; plasma expanders, used to maintain the plasma volume after misuse of erythropoietin or red blood cells concentrates; and epitestosterone, used to mask the detection of the administration of testosterone. Diuretics may be also misused to achieve acute weight loss before competition in sports with weight categories. In this chapter, pharmacological modes of action, intended pharmacological effects for doping purposes, main routes of biotransformation and analytical procedures used for anti-doping controls to screen and confirm these substances will be reviewed and discussed.


Assuntos
Dopagem Esportivo/métodos , Inibidores de 5-alfa Redutase , Cromatografia Líquida , Diuréticos/análise , Epitestosterona/análise , Humanos , Espectrometria de Massas , Substitutos do Plasma/análise , Probenecid/análise , Uricosúricos/análise
9.
J Sci Med Sport ; 13(1): 13-5, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18768354

RESUMO

The artificial colloid hydroxyethyl starch (HES) is among the most frequently used plasma volume expanders in the medical field. However, in 1998, its misuse by the athletic community was officially reported and since 2000, HES is prohibited by the International Olympic Committee (IOC). Therefore, several methods enabling the detection of HES in urine were developed, most based on gas chromatography-mass spectrometry (GC-MS). In the present work, a simple and low-cost screening method, intended to reduce the number of samples to be analysed by GC-MS, was developed. The method is based on the acid hydrolysis of HES and detection of the resulting glucose and hydroxyethyl glucose derivatives by Benedict's reaction (reduction of copper sulfate to brick-red cuprous oxide by glucose and/or derivatives). Samples considered suspect were submitted to GC-MS analysis for identification of HES. The method was successfully applied for screening of HES in 2627 urine samples from 1346 Brazilian soccer players and 1281 athletes from the Pan-American Games (Rio de Janeiro, 2007); 71 (2.7%) samples, considered suspect, were submitted to GC-MS, but no positive results were found. Moreover, a thin layer chromatography (TLC) method was adapted for visualisation of the characteristic band pattern of HES hydrolysis products. The results indicate that the methods are efficient and useful for the screening of HES in urine.


Assuntos
Dopagem Esportivo , Cromatografia Gasosa-Espectrometria de Massas/métodos , Derivados de Hidroxietil Amido/urina , Substitutos do Plasma/análise , Brasil , Humanos , Futebol , Esportes
10.
Biomed Chromatogr ; 22(7): 695-701, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18348337

RESUMO

The increasing number of samples and target substances in doping control requires continuously improved screening methods, combining high-throughput analysis, simplified sample preparation, robustness and reliability. Hence, a rapid screening procedure based on liquid chromatography-electrospray ionization-tandem mass spectrometry with in-source collision-induced dissociation was developed. The detection of the polysaccharide-based plasma volume expanders dextran and hydroxyethyl starch (HES) in human urine was established without further sample preparation. The in-source fragmentation strategy of the approach represented a valuable tool in the analysis of the polysaccharide-based compounds, allowing the use of tandem mass spectrometry. After direct injection of urine specimens, analytes were chromatographically separated on a monolithic reverse-phase column and detected via multiple reaction monitoring of diagnostic ions at detection limits of 10 microg/mL for HES and 30 microg/mL for dextran. Validation was performed regarding the parameters specificity, linearity, precision (8-18%) and accuracy (77-105%) and the method was applied to the investigation of approximately 400 doping control samples and seven dextran and two hydroxyethyl starch post-administration samples. The approach demonstrated its capability as a rapid screening tool for the detection of dextran and hydroxyethyl starch and represents an alternative to existing screening procedures since time consuming hydrolysis or derivatization steps were omitted.


Assuntos
Cromatografia Líquida/métodos , Dextranos/urina , Derivados de Hidroxietil Amido/urina , Substitutos do Plasma/análise , Espectrometria de Massas em Tandem/métodos , Dextranos/química , Feminino , Humanos , Derivados de Hidroxietil Amido/química , Masculino , Substitutos do Plasma/química
11.
ASAIO J ; 53(3): 365-7, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17515730

RESUMO

Many centers advocate the use of a standby wet-primed extracorporeal membrane oxygenation (ECMO) circuit for rapid deployment during cardiopulmonary resuscitation. However, concerns with regard to the potential health hazards associated with the release of the plasticizer di-2(ethylhexyl)phthalate (DEHP) from the polyvinyl chloride (PVC) tubing exist. The purpose of this study was to determine the time course of DEHP release from a preprimed ECMO circuit and to evaluate the effect of PVC tubing coatings on DEHP release. Seven circuits including three uncoated (Medtronic, Medtronic with albumin, and Medtronic Super Tygon) and four attenuated surfaces (Carmeda, COBE Smart, Medtronic Trillium, and Terumo x-coated) were primed with Plasmalyte A. Samples of the circuit prime were collected over a period of 2 weeks and were analyzed for DEHP, using gas chromatography. Results were compared by using a two-tailed t test. One coated (Carmeda) and all three uncoated circuits leached DEHP. The greatest amount of leaching occurred in the uncoated Medtronic tubing with albumin. The COBE Smart, Medtronic Trillium, and Terumo x-coated circuits had undetectable amounts of DEHP (p = 0.006 vs Medtronic uncoated). Prepriming an ECMO circuit composed of uncoated PVC tubing is associated with DEHP release. Using coated PVC tubing appears to eliminate DEHP release over a 2-week period.


Assuntos
Materiais Revestidos Biocompatíveis/farmacocinética , Dietilexilftalato/farmacocinética , Oxigenação por Membrana Extracorpórea/instrumentação , Teste de Materiais , Plastificantes/farmacocinética , Reanimação Cardiopulmonar/instrumentação , Cromatografia Gasosa , Materiais Revestidos Biocompatíveis/análise , Dietilexilftalato/análise , Eletrólitos/análise , Oxigenação por Membrana Extracorpórea/efeitos adversos , Humanos , Técnicas In Vitro , Substitutos do Plasma/análise , Plastificantes/análise , Cloreto de Polivinila
12.
Biomed Chromatogr ; 19(10): 743-50, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15856492

RESUMO

Plasma volume expanders are used in sports in order to control haematological parameters and/or to mask erythropoietin (EPO) misuse. A reliable method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed for doping control purposes, enabling the identification and quantification of the plasma volume expander dextran in human urine. The dextran polymer was enzymatically hydrolysed by alpha-1,6-glucosidase (dextranase) followed by acetylation of the generated isomaltose subunits, allowing the chromatographic separation of different disaccharides, such as lactose, saccharose and isomaltose, as well as the identification and quantification of the analyte in human urine. The method was used to determine the basal concentration of isomaltose resulting from the enzymatic hydrolysis of polymeric 1,6-linked glucose in 238 routine doping control samples. In addition the concentration of dextran measured as isomaltose was estimated in seven urine specimens obtained from patients treated with dextran. Calibration curves for dextran were linear and reproducible. The inter- and intra-assay coefficients of variation for dextran ranged from 4.9 to 7.3% at three concentration levels between 53 and 1186 microg/mL. Recovery ranged from 97 to 112% (mean 106.9%). The assay limit of detection was 3.8 microg/mL and the lower limit of quantification was 12.5 microg/mL. In 96% of the investigated doping control samples, the concentrations of isomaltose were below the LLOQ of 12.5 microg/mL. Even the highest concentrations were approximately 100-300-fold lower than concentrations found in urine samples of patients after intravenous application of dextran. The presented results demonstrate the capability and reliability of the developed LC-MS/MS method for the identification and quantification of dextran in human urine and can be regarded as a method revealing the misuse of dextran in sports.


Assuntos
Cromatografia Líquida/métodos , Dextranos/urina , Isomaltose/análise , Espectrometria de Massas/métodos , Substitutos do Plasma/análise , Idoso , Idoso de 80 Anos ou mais , Dextranase/metabolismo , Dextranos/uso terapêutico , Dopagem Esportivo/prevenção & controle , Estabilidade de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade
13.
Rapid Commun Mass Spectrom ; 18(12): 1324-30, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15174187

RESUMO

The use of plasma volume expanders, especially those based on chemically modified polysaccharides such as hydroxyethyl starch, has found its way from the medical field to the athletic community in the everlasting drive for performance enhancement. As such, plasma volume expanders have been placed on the list of banned substances by the International Olympic Committee, and in turn require accurate and sensitive analytical tools for their detection in complex biological matrices. Here we present a relatively straightforward method for the detection of polysaccharide-based plasma volume expanders (PVE) in urine, based on the carefully controlled partial acid hydrolysis of urine (20 microL) in a total volume of 500 microL 4 M trifluoroacetic acid. Following the incubation (30 min at 100 degrees C) an aliquot of the hydrolysate is dried, re-suspended in the analytical matrix (e.g. 2,5-dihydroxybenzoic acid) and examined by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOFMS). The obtained mass spectrometric profile reveals a high number of characteristic peaks in the mass range between 500 and 3000 Da, a region that in urine samples devoid of PVE appears relatively clean, and thus allows the unambiguous identification of the presence of such PVE. This approach is fast (the mass profile can be obtained within 90 min), highly sensitive (the effective sample amount on the MALDI target is equivalent to 100 nL urine), needs little sample handling (four steps), requires no derivatisation and is devoid of interference from other biomolecules. The approach has been worked-out for hydroxy ethyl starch but can be applied to other polymer-derived plasma expanders such as dextran and probably the newly developed acetyl starch.


Assuntos
Dopagem Esportivo/métodos , Derivados de Hidroxietil Amido/urina , Substitutos do Plasma/análise , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Detecção do Abuso de Substâncias/métodos , Humanos , Urinálise
14.
Eur Respir J ; 22(5): 728-34, 2003 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-14621076

RESUMO

Under steady state conditions the intracellular pathway is the major route of collagen catabolism in tissues characterised by rapid collagen turnover. In the lung, the collagen is subject to continuous remodelling and turnover however, the intracellular pathway of collagen degradation is unusual under physiological conditions. The current authors previously described crystalloid inclusions in alveolar macrophages of mice with genetic emphysema at the time of septal disruption. Using an immunogold technique these inclusions were identified as collagen-derived products and related to intracytoplasmic collagen degradation. To examine whether a different degree of protease burden in lung interstitium may influence the route of intracellular collagen degradation, collagen phagocytosis by alveolar macrophages was studied in various mouse models of emphysema at the time when emphysema develops. Evident collagen by-products in alveolar macrophages were observed in destructive processes characterising spontaneous models of emphysema either with negligible (blotchy mouse) or moderate (pallid mouse) elastase burden. On the other hand, intracellular collagen by-products were appreciated only in a few macrophages from tight-skin mice with high elastolytic burden and could not be observed in mice with a very severe burden after elastase instillation. In conclusion, the interstitial level of proteases burden can affect the way by which the collagen is cleared (intracellularly versus extracellularly).


Assuntos
Colágeno/metabolismo , Macrófagos Alveolares/fisiologia , Fagocitose , Enfisema Pulmonar/fisiopatologia , Animais , Líquido da Lavagem Broncoalveolar/química , Soluções Cristaloides , Imuno-Histoquímica , Corpos de Inclusão/ultraestrutura , Soluções Isotônicas , Macrófagos Alveolares/metabolismo , Macrófagos Alveolares/ultraestrutura , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Mutantes , Elastase Pancreática/análise , Substitutos do Plasma/análise , Enfisema Pulmonar/metabolismo , Enfisema Pulmonar/patologia
15.
J Chromatogr B Biomed Sci Appl ; 744(2): 345-50, 2000 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-10993523

RESUMO

The plasma volume expander hydroxyethyl starch (HES) is usually administered in cases of hypovolaemic shocks but in 1998 the press reported its misuse in endurance sports. Since January 2000, it has been put on the list of prohibited substances of the International Olympic Committee (IOC) and its misuse is to ban by doping controls. Therefore, a rapid method enabling the screening for HES in human urine was developed which can be easily adopted by IOC laboratories to analyse routine urine samples for this remedy. Excretion study urine samples obtained from patients treated with HES, blank urine specimen and reference standards, were hydrolysed with hydrochloric acid and without any further purification of the resulting monosaccharides their per-timethylsilylated derivatives were performed. By means of gas chromatography-mass spectrometry the products were separated and the alpha- and beta-isomers of glucose, 2-, 3- and 6-hydroxyethyl glucose derivatives were identified. Typical ion traces of 2- and 3-substituted glucose (m/z 248, m/z 261 and m/z 235, m/z 248, respectively) support the fast determination of the substances whose electron impact mass spectra are presented and discussed.


Assuntos
Derivados de Hidroxietil Amido/urina , Substitutos do Plasma/análise , Adulto , Dopagem Esportivo , Feminino , Cromatografia Gasosa-Espectrometria de Massas/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Referência
16.
Anesth Analg ; 86(4): 856-60, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9539615

RESUMO

UNLABELLED: Acetyl starch (ACS) is a new synthetic colloid solution for plasma volume expansion and is now undergoing phase 2 clinical trials. We compared the pharmacokinetics of ACS with those of hydroxyethyl starch (HES) in 32 patients (ASA physical status I and II) undergoing elective surgery. In this randomized, double-blind trial, patients received either 15 mL/kg ACS 6% (average molecular weight [Mw] 200,000/molar substitution [MS] 0.5) or HES 6% (Mw 200,000/MS 0.5) i.v. up to a maximal dose of 1000 mL. Plasma colloid concentrations were measured by repetitive arterial blood sampling over 24.5 h. Plasma colloid concentrations were detected using a high-pressure liquid chromatography controlled enzymatic test. Standard pharmacokinetics were calculated, including initial half-life (t(1/2init)), i.e., the time required for a 50% decline of the maximal plasma colloid concentration at the end of drug infusion. Whereas HES was eliminated by second-order kinetics, ACS followed first-order characteristics. In the first hours after i.v. administration, t(1/2init) and clearances were similar in both groups. However, the terminal half-life of HES was significantly longer than that of ACS (9.29 +/- 1.43 h vs 4.37 +/- 1.06 h). After 16.5 and 24.5 h, ACS showed significantly lower plasma concentrations than HES, which indicates that the final degradation of ACS by esterases and amylase was significantly more rapid. ACS might be an alternative plasma volume expander, which avoids the accumulation of persisting macromolecules. IMPLICATIONS: We studied the pharmacokinetics of acetyl starch, a newly developed colloid solution for plasma volume substitution, compared with hydroxyethyl starch in 32 surgical patients undergoing elective major general surgical procedures. In contrast to hydroxyethyl starch, this new agent undergoes rapid and nearly complete enzymatic degradation.


Assuntos
Substitutos do Plasma/farmacocinética , Amido/análogos & derivados , Amido/farmacocinética , Adolescente , Adulto , Idoso , Amilases/metabolismo , Biodegradação Ambiental , Cromatografia Líquida de Alta Pressão , Coloides/administração & dosagem , Coloides/análise , Coloides/farmacocinética , Coloides/uso terapêutico , Método Duplo-Cego , Procedimentos Cirúrgicos Eletivos , Esterases/metabolismo , Feminino , Meia-Vida , Humanos , Derivados de Hidroxietil Amido/administração & dosagem , Derivados de Hidroxietil Amido/sangue , Derivados de Hidroxietil Amido/farmacocinética , Derivados de Hidroxietil Amido/uso terapêutico , Infusões Intravenosas , Substâncias Macromoleculares , Masculino , Taxa de Depuração Metabólica , Pessoa de Meia-Idade , Peso Molecular , Substitutos do Plasma/administração & dosagem , Substitutos do Plasma/análise , Substitutos do Plasma/uso terapêutico , Amido/administração & dosagem , Amido/sangue , Amido/uso terapêutico
17.
Arch Pathol Lab Med ; 121(6): 593-8, 1997 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9199624

RESUMO

OBJECTIVE: Intraluminal crystalloids have been described in the prostate, salivary gland, and ovary, but have not yet been reported in the breast. We report four cases of breast carcinoma in which these crystalloids were found in ducts with intraductal carcinoma or atypical hyperplasia. The presence of intraluminal crystalloids may be a useful adjunct in making a diagnosis of carcinoma or may be a feature to look for as a marker for the presence of carcinoma. DESIGN: Four cases of breast carcinoma containing intraluminal crystalloids were identified among 6900 surgical breast specimens between January 1990 and June 1995 at M. D. Anderson Cancer Center, Houston, Tex. Those sections with crystalloids identified by hematoxylin-eosin stain were stained with periodic acid-Schiff, Alcian blue, and mucicarmine stains. Immunohistochemical and ultrastructural studies and energy-dispersive x-ray analysis were also performed on these sections. RESULTS: The intraluminal crystalloids were eosinophilic, varied in shape and size, and did not exhibit birefringence under polarized light. Immunohistochemically, the crystalloids were negative for keratin, muscle-specific actin, and kappa and lambda light chains, but the surfaces stained positively for epithelial membrane antigen. By electron microscopy, the crystalloids had no limiting membrane and were composed of an electron-dense material with no discernible periodicity. By energy-dispersive x-ray element analysis, the crystalloids had no mineral content; however, sulfur was found, indicating a protein content. CONCLUSIONS: The pathogenesis and constituents of these intraluminal crystalloids remain to be determined. Inasmuch as intraluminal crystalloids have not been found in normal ducts or acini, or in ductal hyperplasia without atypia, their presence may serve as a marker for breast carcinoma.


Assuntos
Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Substitutos do Plasma/análise , Adulto , Idoso , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Neoplasias da Mama/ultraestrutura , Carcinoma Intraductal não Infiltrante/diagnóstico por imagem , Carcinoma Intraductal não Infiltrante/cirurgia , Carcinoma Intraductal não Infiltrante/ultraestrutura , Soluções Cristaloides , Microanálise por Sonda Eletrônica , Feminino , Humanos , Hiperplasia/patologia , Imuno-Histoquímica , Soluções Isotônicas , Microscopia Eletrônica , Pessoa de Meia-Idade , Mucina-1/análise , Radiografia , Enxofre/análise
18.
Am J Surg Pathol ; 21(6): 725-8, 1997 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9199652

RESUMO

Based on data from autopsy, radical prostatectomy, and cystoprostatectomy specimens, it has been suggested that the finding of intraluminal crystalloids in benign glands on needle biopsy may indicate a concurrent carcinoma; therefore, repeat biopsy is recommended. We studied data from 56 consecutive needle biopsies from the Johns Hopkins Hospital and Dianon Systems in which the diagnosis of intraluminal crystalloids in benign glands was rendered and follow-up data were subsequently obtained. Cases in which crystalloids were present in glands suspicious for cancer, in glands of high-grade prostatic intraepithelial neoplasia, or in adenosis were excluded from the study. Follow-up data included repeat biopsy results and serum prostatic specific antigen levels. Of the 56 men, 31 (55%) had repeat biopsy (two underwent transurethral resection of the prostate [TURP]); the remaining men were either noncompliant or had medical conditions precluding subsequent biopsy. Of the 31 men who underwent repeat biopsies, 23 (74%) had benign diagnoses, one (3%) had high-grade prostatic intraepithelial neoplasia, and seven (23%) had adenocarcinoma. There was no difference in serum prostate-specific antigen values between those with and without cancer on repeat biopsy. In a control population of men with a benign first biopsy not showing crystalloids, the incidence of cancer on repeat biopsy was 16.2%, which was not statistically significantly different from the incidence found in our study group. We conclude that men with prostate biopsy results showing benign glands with crystalloids are at no significantly higher risk of having cancer on repeat biopsy than if crystalloids were not present.


Assuntos
Adenocarcinoma/patologia , Substitutos do Plasma/análise , Próstata/citologia , Neoplasias da Próstata/patologia , Biópsia por Agulha , Distribuição de Qui-Quadrado , Soluções Cristaloides , Seguimentos , Humanos , Soluções Isotônicas , Masculino , Antígeno Prostático Específico/sangue , Hiperplasia Prostática/patologia , Medição de Risco
19.
Anesteziol Reanimatol ; (2): 15-7, 1991.
Artigo em Russo | MEDLINE | ID: mdl-1862977

RESUMO

Total calcium (CaT) and total magnesium (MgT) levels have been determined in 21 solutions used in cardiopulmonary bypass surgery and manufactured in the USSR. It has been found that a great number of solutions differ in CaT content from human plasma. Some solutions contain Ca, which is not required by the prescription. Even in one and the same lot solutions vary greatly in Ca content (gelatinol). A large number of the solutions tested does not correspond to blood in MgT content, either. Like Ca, this parameter is quite unstable. Such differences in CaT and MgT levels practically in all standard Soviet-made solutions make it impossible to determine accurately precise amount of the solution required. The optimal way of hypercalcemia and hypermagnesiuemia prevention is the elaboration of the solutions identical to blood in their Ca and Mg content, or the use of colloids, practically free of electrolytes (hexaethyl starch).


Assuntos
Cálcio/análise , Magnésio/análise , Substitutos do Plasma/normas , Anestesia , Circulação Extracorpórea , Humanos , Substitutos do Plasma/análise , Ressuscitação , U.R.S.S.
20.
J. pediatr. (Rio J.) ; 66(1/3): 9-12, jan.-mar. 1990. tab
Artigo em Português | LILACS | ID: lil-93932

RESUMO

Os autores analisaram os componentes do Plasma Fresco Congelado, no que se refere a taxa de albumina, glicose, ureia, sodio, potassio, pressao oncotica e osmotica. Observaram uma taxa de albumina de 3,45g, e um sodio medio de 158,8mEq/1, com uma osmolaridade media de 347,13mOsm/1 e pressao oncotica de 19,2mmHg. Frente a estes dados propoem que a propriedade expansora do plasma, se deva a uma acao mista de efieto oncotico e osmotico. Ressaltam o baixo teor de albumina e consequentemente a baixa pressao oncotica nas amostras de plasma estudadas, e comparam com dados da literatura


Assuntos
Pressão Osmótica , Substitutos do Plasma/análise , Plasma/análise , Albuminas/análise , Glucose/análise , Potássio/análise , Sódio/análise , Ureia/análise
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