RESUMO
In the course of a prospective selective digestive decontamination (SDD) trial to prevent nosocomial pneumonia (NP) during mechanical ventilation (MV), we carried out serial cultures of gastric aspirate to assess the importance of gastric colonization for potential respiratory pathogens and its relationship to the simultaneous gastric pH, to whether the patients were receiving Sucralfate or Ranitidine and to the nutritional biochemical parameters. If NP developed, a bronchial sample was taken by fibreoptic bronchoscopy to determine the causal organisms and its relationship to the previous gastric isolated. Results show: 1) Increase in aerobic Gram negative bacilli colonization during hospitalization. 2) Direct relationship between colonization level and gastric pH. 3) Greater pH in ranitidine vs sucralfate group. 4) Low incidence of NP (11%), the majority of these (66%) being early. 5) No bacteriological correlation between gastric colonization and aetiological agents of NP. 6) Close relationship between pharyngeal colonization and causative germs of pulmonary infection (40%).
Assuntos
Estado Terminal , Infecção Hospitalar/tratamento farmacológico , Pneumonia/epidemiologia , Respiração Artificial/efeitos adversos , Gastropatias/tratamento farmacológico , Adolescente , Adulto , Contagem de Colônia Microbiana , Estado Terminal/mortalidade , Infecção Hospitalar/complicações , Infecção Hospitalar/microbiologia , Feminino , Determinação da Acidez Gástrica , Humanos , Concentração de Íons de Hidrogênio , Incidência , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Pneumonia/etiologia , Pneumonia/microbiologia , Estudos Prospectivos , Ranitidina/uso terapêutico , Fatores de Risco , Gastropatias/complicações , Gastropatias/microbiologia , Sucralfato/uso terapêuticoRESUMO
A flow-injection method for the determination of tiopronin in the range 1 x 10(-7)-7 x 10(-5) M is described. The procedure is based on the chemiluminescent reaction of tiopronin with cerium(i.v.) in sulphuric acid medium using rhodamine 6G and quinine as fluorophors. The flow-injection method is rapid and precise and allows measurements of up to 80 solutions per hour. The applicability of the method to the determination of tiopronin in pharmaceutical preparations was demonstrated by investigating the effect of potential interferences and by analysing commercial preparations.
Assuntos
Análise de Injeção de Fluxo/métodos , Preparações Farmacêuticas/química , Tiopronina/análise , Artefatos , Medições Luminescentes , Reprodutibilidade dos TestesRESUMO
The spectrophotometric determination of trace amounts of diclofenac was carried out by liquid-liquid extraction using acridine yellow with a flow system. The determination of diclofenac sodium in the range of 3-80 micrograms ml-1 was possible with a sampling frequency of 40 samples h-1. The method was satisfactorily applied to the determination of diclofenac in pharmaceutical preparations.
Assuntos
Anti-Inflamatórios não Esteroides/análise , Diclofenaco/análise , Análise de Injeção de Fluxo/métodos , Preparações Farmacêuticas/química , Espectrofotometria/métodos , Aminoacridinas , Corantes FluorescentesRESUMO
Reasoned and consensual protocols, by means of diversification of the use of antibiotics, significantly influence their consumption, preventing and reducing the development of bacterial resistance against the Gram-negative microorganisms most frequently isolated in general hospitals. The increase in the consumption of piperacillin-tazobactam was found to be significantly associated with an increased resistance of E. cloacae, but less so in K. pneumoniae and E. coli. Its activity against P. aeruginosa and against P. mirabilis was not affected throughout the study and it maintained a high sensivity to the end against P. aeruginosa and against P. mirabilis and partial recovery of activity against A. baumannii. No statistically significant differences were found between the stable consumption of cefotaxime, ciprofloxacin, ceftazidime and imipenem and bacterial resistance against E. coli, P. aeruginosa, P. mirabilis, K. pneumoniae, E. cloacae and A. baumannii. Imipenem presented greater activity against E. coli, K. pneumoniae, E. cloacae and A. baumannii. Piperacillin-tazobactam showed greater activity against P. aeruginosa, while ciprofloxacin showed the least activity against E. coli and P. mirabilis. Cefotaxime had the least activity against E. cloacae, P. aeruginosa and A. baumannii. Ceftazidime showed stable activity and was similar to piperacillin-tazobactam against E. coli, P. mirabilis, K. pneumoniae, E. cloacae and A. baumannii.