Na základě indexu kompatibility, běžně užívaného u renálních transplantací, jsme se pokusili vytipovat ty pacienty po transplantaci srdce, u kterých by vzhledem k řadě shod v HLA systému mohla být účinná imunosuprese dosažena nižší dávkou léků. Retrospektivně jsme analyzovali 182 konsekutivních pacientů transplantovaných v CKTCH Brno od ledna 2001 do dubna 2010. Podle indexu kompatibility byli arbitrárně rozděleni na skupinu A (83 pacientů) s indexem kompatibility 0–17 a skupinu B (99 pacientů) s indexem kompatibility 18–26. Zaznamenali jsme signifikantně nižší výskyt AR stupně 2 ve skupině A (p ? 0,05), výskyt stupně 3 byl v obou skupinách stejný. Počtem infekcí se obě skupiny nelišily, stejně jako výskytem nádorových onemocnění, který byl relativně nízký. Dlouhodobé přežívání bylo v obou skupinách podobné, s tendencí k lepšímu průběhu v období mezi druhým až pátým rokem po transplantaci ve prospěch skupiny A.
Based on the Compatibility Index, routinely used in renal transplants, we attempted to identify those patients who had just had a heart transplant for whom a number of agreements in the HLA system meant that they could be receptive to lower doses of immunosuppressants. We carried out a retrospective analysis of 182 consecutive patients who had received transplants in the Centre of Cardiovascular and Transplantation Surgery in Brno from January 2001 to April 2010. According to their Compatibility Index, patients were arbitrarily divided into Group A (83 patients) with Compatibility Index 0–17 and Group B (99 patients) with Compatibility Index 18–26. We recorded a significantly lower incidence of step 2 acute cellular rejection in group A (p ? 0,05), with the incidence of level 3 being the same in both groups. There were no significant differences in rates of infections, nor in the malignancy rate, which was relatively low. Long-term survival was similar in both groups, with a tendency to better progress in Group A in the period from the 2nd–5th years following the transplant.
- Keywords
- akutní celulární rejekce,
- MeSH
- HLA Antigens isolation & purification MeSH
- Immunosuppressive Agents administration & dosage pharmacology therapeutic use MeSH
- Infections immunology MeSH
- Kaplan-Meier Estimate MeSH
- Humans MeSH
- Neoplasms immunology MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- Graft Rejection etiology drug therapy MeSH
- Retrospective Studies MeSH
- Statistics as Topic MeSH
- Histocompatibility Testing utilization MeSH
- Heart Transplantation immunology methods MeSH
- Outcome and Process Assessment, Health Care MeSH
- Check Tag
- Humans MeSH
Při sestavování receptur pro totální parenterální výživu (TPN) je nezbytné zvažovat i substituci vápníkem a fosforem. V některých klinických stavech nebo u určitých skupin nemocných bývá zapotřebí podávat tyto prvky ve vysokých koncentracích při redukovaném objemu, což kvůli vzájemným interakcím může být problematické. Proto bylo cílem práce experimentální sledování kompatibility komerčně dostupných nebo magistraliter získaných přípravků obsahujících sloučeniny vápníku a fosforu. Tyto přípravky byly zkoumány ve směsi s klinicky užívanými roztoky aminokyselin nebo s roztoky glukosy. Hodnocení se provádělo titračně do vzniku viditelné sraženiny a též pomocí lékopisné metody hodnocení částic pod hranicí viditelnosti. Bylo prokázáno, že hydrogenfosforečnan má nižší kompatibilitu a stabilitu ve směsích obsahujících soli vápníku ve srovnání s dihydrogenfosforečnanem nebo organickým fosforečnanem. Mezi dihydrogenfosforečnanem a organickým fosforečnanem však významné rozdíly zjištěny nebyly. Experiment potvrdil lepší stabilitu organické soli vápníku oproti anorganické pouze u vzorků obsahujících roztoky aminokyselin. Ze sledovaných roztoků aminokyselin nejlepší stabilizující vlastnosti měly roztoky určené pro použití v neonatologii a pediatrii.
When making prescriptions for total parenteral nutrition (TPN) it is necessary to take into consideration also substitution with calcium and phosphorus. Under some clinical conditions, or in certain groups of patients, it is necessary to supply these substances in high doses with a reduced volume, which due to mutual interactions may be problematic. This experimental paper therefore examined the compatibility of commercially available or individual preparations containing the compounds of calcium and phosphorus. These preparations were examined in a mixture with clinically employed solutions of amino acids or with solutions of glucose. The evaluation was performed by titration until the development of a visible precipitate and also by means of the pharmacopoeial method of evaluation of particles below the level of visibility. Hydrogen phosphate was found to possess a lower compatibility and stability in mixtures containing calcium salts in comparison with dihydrogen phosphate or organic phosphate. Nevertheless, no significant differences were found between dihydrogen phosphate and organic phosphate. The experiment confirmed a better stability of organic calcium salt versus the inorganic one only in the samples containing solutions of amino acids. Of the solutions of amino acids under study, the best stabilizing properties were found in the solutions intended for use in neonatology and paediatrics.
In this study, biodegradable poly(ε-caprolactone) (PCL) nanofibers (PCL-NF), collagen-coated PCL nanofibers (Col-c-PCL), and titanium dioxide-incorporated PCL (TiO2-i-PCL) nanofibers were prepared by electrospinning technique to study the surface and structural compatibility of these scaffolds for skin tisuue engineering. Collagen coating over the PCL nanofibers was done by electrospinning process. Morphology of PCL nanofibers in electrospinning was investigated at different voltages and at different concentrations of PCL. The morphology, interaction between different materials, surface property, and presence of TiO2 were studied by scanning electron microscopy (SEM), Fourier transform IR spectroscopy (FTIR), contact angle measurement, energy dispersion X-ray spectroscopy (EDX), and X-ray photoelectron spectroscopy (XPS). MTT assay and cell adhesion study were done to check biocompatibilty of these scaffolds. SEM study confirmed the formation of nanofibers without beads. FTIR proved presence of collagen on PCL scaffold, and contact angle study showed increment of hydrophilicity of Col-c-PCL and TiO2-i-PCL due to collagen coating and incorporation of TiO2, respectively. EDX and XPS studies revealed distribution of entrapped TiO2 at molecular level. MTT assay and cell adhesion study using L929 fibroblast cell line proved viability of cells with attachment of fibroblasts over the scaffold. Thus, in a nutshell, we can conclude from the outcomes of our investigational works that such composite can be considered as a tissue engineered construct for skin wound healing.
- MeSH
- Biocompatible Materials chemistry MeSH
- Cell Adhesion physiology MeSH
- Fibroblasts chemistry MeSH
- Photoelectron Spectroscopy methods MeSH
- Hydrophobic and Hydrophilic Interactions MeSH
- Collagen chemistry MeSH
- Skin chemistry MeSH
- Nanofibers chemistry MeSH
- Polyesters chemistry MeSH
- Surface Properties MeSH
- Titanium chemistry MeSH
- Tissue Engineering methods MeSH
- Tissue Scaffolds MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Combined infusions of propofol and sufentanil preparations are frequently used in clinical practice to induce anesthesia and analgesia. However, the stability of propofol emulsions can be affected by dilution with another preparation, sometimes leading to particle coalescence and enlargement. Such unwanted effects can lead to fat embolism syndrome after intravenous application. This study describes the physical stability of 5 commercially available propofol preparations mixed with sufentanil citrate solutions. METHODS: Two common markers of emulsion stability were used in this study; namely, the zeta potential and size distribution of the emulsion droplets. Both were measured using dynamic light scattering. The data for the pure propofol preparations and their mixtures with sufentanil citrate solution were compared. RESULTS: The absolute value of zeta potential decreased in 4 of the 5 propofol preparations after they had been mixed with sufentanil citrate. This effect indicates a lowering of repulsive interactions between the emulsion droplets. Although this phenomenon tends to cause agglomeration, none of the studied mixtures displayed a substantial increase in droplet size within 24 hours of blending. However, our long-term stability study revealed the instability of some of the propofol-sufentanil samples. Two of the 5 studied mixtures displayed a continual increase in particle size. The same 2 preparations showed the greatest reductions in the absolute value of zeta potential, thereby confirming the correlation of both measurement methods. The increase in particle size was more distinct in the samples stored at higher temperatures and with higher sufentanil concentrations. CONCLUSIONS: To ensure the microbial stability of an emulsion infusion preparation, clinical regulations require that such preparations should be applied to patients within 12 hours of opening. In this respect, we can confirm that during this period, none of the studied propofol-sufentanil mixtures displayed any physical instability that could lead to particle enlargement; thus, fat embolism should not be a risk after their intravenous application. However, our long-term stability study revealed differences between commercially available preparations containing the same active ingredient; some of the mixtures showed an increase in particle size and polydispersity over a longer period. Although our results should not be generalized beyond the particular propofol-sufentanil preparations and concentrations studied here, they do suggest that, as a general principle, a compatibility study should be performed for any preparation before the first intravenous application to exclude the risk of droplet aggregation.
- MeSH
- Anesthetics, Intravenous administration & dosage chemistry MeSH
- Chemical Phenomena * MeSH
- Drug Combinations MeSH
- Infusions, Intravenous MeSH
- Humans MeSH
- Propofol administration & dosage chemistry MeSH
- Drug Stability MeSH
- Sufentanil administration & dosage chemistry MeSH
- Particle Size MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
AIMS: To determine the impact of HLA compatibility measured by the Compatibility Index, on survival, rate of rejections, malignancies and infections in patients after heart transplantation (HTx). METHODS: We carried out a retrospective analysis of 182 consecutive patients who underwent heart transplantation in our center from January 2001 to April 2010. According to degree of HLA-A, B and DR matching (Compatibility Index, CI) the patients were divided in two groups, Group A (n=83) with an IC 0-17 and group B (n=99) with an IC 18-26. There was no significant difference in demographic parameters between recipients and donors. RESULTS: We found no difference in rates of rejections or infections between Group A and Group B (AR: 22 (26.5%) vs. 34 (34.3%), P=0.2539; infections: 21 (25.3%) vs. 27 (27%) P=0.7637). The distribution of infections in terms of type (bacterial, viral, fungal, including Aspergillus) was similar in both groups. The incidence of malignant tumours was infrequent (3 (3.6%) vs. 4 (4.0%), P=0.8817). We found trend toward lower level of tacrolimus in Group A. Long term survival was similar in both groups. CONCLUSIONS: Based on the results of our single-center trial, we found no impact of higher degree of HLA-A,-B, and -DR matching on survival, rejection episodes or infection. Further large studies are necessary to confirm our hypothesis that subjects with better HLA compatibility could require lower dose immunosuppression.
- MeSH
- Biomarkers metabolism MeSH
- Adult MeSH
- HLA Antigens immunology MeSH
- HLA-A Antigens immunology MeSH
- HLA-B Antigens immunology MeSH
- HLA-DR Antigens immunology MeSH
- Risk Assessment MeSH
- Immunosuppressive Agents therapeutic use MeSH
- Kaplan-Meier Estimate MeSH
- Middle Aged MeSH
- Humans MeSH
- Follow-Up Studies MeSH
- Graft Survival immunology MeSH
- Graft Rejection immunology MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Histocompatibility Testing * methods MeSH
- Heart Transplantation * methods mortality MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
OBJECTIVE: Severe fetomaternal transplacental hemorrhage increases the risk of fetal anemia. In the third trimester, the syncytiotrophoblast becomes thinner, especially in areas where it comes into intimate contact with villous capillaries, and forms a vasculosyncytial membrane. Our aim was to determine whether ABO compatibility puts the fetus at a greater risk of severe fetomaternal hemorrhage. DESIGN: Case study. SETTING: A tertiary care center. Sample and methods. Between 2003 and 2007, we evaluated eight cases of severe fetomaternal transfusion. The Kleihauer-Betke test was used for diagnosis of fetomaternal hemorrhage. We evaluated blood group compatibility between the mother and fetus and assessed the perinatal outcome. The Fischer's factorial test was used for testing a hypothesis. RESULTS: The incidence of adverse outcomes following transplacental hemorrhage was 75% (six of eight). There were two perinatal deaths and four infants were affected by post-hypoxic damage of varying severity. Fetomaternal ABO compatibility was present in seven of the eight cases. The risk of severe fetomaternal hemorrhage was significantly increased when there was ABO compatibility between the mother and fetus. This was associated with a very poor perinatal outcome. CONCLUSION: We recommend that resuscitation in utero by intrauterine transfusion should be considered before the 33rd week of gestation in cases of severe fetal anemia. In later gestation, urgent cesarean section is required with adequate resuscitation of the newborn.
- MeSH
- ABO Blood-Group System physiology MeSH
- Microscopy, Electron MeSH
- Fetomaternal Transfusion diagnosis etiology therapy MeSH
- Financing, Organized MeSH
- Blood Transfusion, Intrauterine MeSH
- Pregnancy Complications diagnosis etiology MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Placenta physiopathology ultrastructure MeSH
- Fetus MeSH
- Pregnancy MeSH
- Pregnancy Trimester, Third MeSH
- Check Tag
- Humans MeSH
- Infant, Newborn MeSH
- Pregnancy MeSH
- Female MeSH
One of the most fundamental, although controversial, questions related to the evolution of plant mating systems is the distribution of outcrossing rates. Self-compatibility, and especially autonomous self-pollination, can become particularly beneficial in anthropogenically degraded habitats with impoverished pollinator assemblages and increased pollen limitation. In a hand-pollination experiment with 46 meadow plants from the Železné hory Mts., Czech Republic, we evaluated the species' ability to adopt different mating systems. For a subset of the species, we also tested seed germination for inbreeding depression. Subsequently, we analysed relationships between the species' mating systems and 12 floral and life-history traits. We found a relatively discrete distribution of the studied species into four groups. Fully and partially self-incompatible species formed the largest group, followed by self-compatible non-selfers and mixed mating species. The germination experiment showed an absence of inbreeding depression in 19 out of 22 examined species. Nectar sugar per flower, nectar sugar per shoot and dichogamy were significant associated with the mating system. Spontaneous selfing ability and self-incompatibility in species of the meadow communities had a discrete distribution, conforming to the general distribution of mating and breeding systems in angiosperms. The low frequency of spontaneous selfers and the lack of inbreeding depression at germination suggest the existence of a selection against selfing at the later ontogenetic stages. Some floral traits, such as the level of dichogamy and amount of nectar reward, may strongly impact the balance between selfing and outcrossing rates in the self-compatible species and thus shape the evolution of mating systems.
- MeSH
- Plant Physiological Phenomena * MeSH
- Flowers MeSH
- Pollination * MeSH
- Grassland * MeSH
- Reproduction physiology MeSH
- Publication type
- Journal Article MeSH
Practical applications of Phase Change Materials (PCMs) often require their encapsulation in other materials, such as metals or plastics. This raises the issue of compatibility between PCMs and encapsulating materials, which has still not been sufficiently addressed. The study presented here follows existing research and provides experimental evaluation of the suitability of selected PCMs for proposed integration in building structures. Two organic PCMs, two inorganic PCMs and three representative plastics (polypropylene (PP-H), high density polyethylene (PE-HD) and polyvinylchloride (PVC-U)) were selected for compatibility tests. Evaluation of the results is based on the mass variations of the plastic samples during the test period. Plastic samples were immersed in PCMs and subjected to periodic heating and cooling (for 16 weeks) in a small environmental chamber simulating real operational conditions. The results show that the organic PCMs have a greater ability to penetrate the PE-HD and PP-H compared with the inorganic PCMs. The penetration of all PCMs was most notable during the first four weeks of the experiment. Later it slowed down significantly. Overall, the mass changes in PE-HD and PP-H samples did not exceed 6.9% when immersed in organic PCMs and 1.8% in inorganic PCMs. PVC-U samples exhibited almost negligible (less than 0.1%) mass variation in all cases.
- MeSH
- Polyethylene chemistry MeSH
- Polypropylenes chemistry MeSH
- Polyvinyl Chloride chemistry MeSH
- Publication type
- Journal Article MeSH
Pro identifikaci možných interakcí složek v lékových formách se studie obvykle provádějí ve stadiu farmaceutického vývoje. Takové studie mohou předpovídat kompatibilitu aktivních farmaceutických látek a pomocných látek za účelem optimalizace složení přípravku a vhodného nastavení parametrů technologického postupu. Vzájemná kompatibilita některých složek nově vyvinutého neuroprotektivního léčivého přípravku „Neuronukleos“, konkrétně kyseliny thioktové, pyridoxin-hydrochloridu, magnesium-stearátu a mag-nesium-laktátu, byla studována pomocí diferenciální skenovací kalorimetrie (DSC) a infračervené spektroskopie s Fourierovou transformací (FTIR). Žádné interakce mezi kyselinou thioktovou a pyridoxinhyd-rochloridem nebyly pozorovány. Byl vytvořen inter-molekulární komplex kyseliny thioktové a magnesium-stearátu, ve které kyselina thioktová nahrazuje krystalickou vodu magnesium-stearátu. Pro magnesium-laktát nebyly nalezeny žádné významné interakce ani s kyselinou thioktovou ani magnesium-stearátem. V rámci této studie byla prokázána farmaceutická kompatibilita většiny testovaných složek přípravku „Neuronukleos“ s jedinou výjimkou (kyselina thioktová a magnesium-stearát). Předkládaná studie navíc poskytuje hodnotné informace o tepelných jevech v určitém teplotním rozmezí, což je důležité pro nastavení parametrů technologického procesu.
To identify possible interactions of components in dosage forms, studies are usually carried out at the stage of pharmaceutical development. Such studies can predict compatibility of active pharmaceutical ingredients and excipients in order to optimize drug formulation and certain parameters of technological process. Compatibility of some components of a newly developed neuroprotective medicinal product "Neuronucleos", namely, thioctic acid, pyridoxine hydrochloride, magnesium stearate and magnesium lactate, was studied by means of differential scanning calorimetry (DSC) and Fourier-transform infrared spectroscopy (FTIR). No interactions were observed between thioctic acid and pyridoxine hydrochloride. Formation of an intermolecular complex between thioctic acid and magnesium stearate was established, in which this acid substitutes the crystalline water of magnesium stearate. No significant interactions were found for magnesium lactate with thioctic acid or magnesium stearate. Thus, pharmaceutical compatibility of the most of the tested "Neuronucleos" components was studied and established, with the only exception (thioctic acid with magnesium stearate). Moreover, the present study provides valuable information about thermal effects in a certain temperature range, which is important for setting the technological process parameters.
