Buchbesprechungen

Ohne Zusammenfassung     

Buchbesprechungen

Ohne Zusammenfassung     

Value of quantitative DNA analysis in endocrine tumors of the pancreas

BACKGROUND: In 55% of progressive care units, someone is assigned to watch the cardiac monitors at all times, but the effect of this practice on patients' outcomes has not been examined. OBJECTIVE: To evaluate the effect of continual observation of telemetry units by a monitor watcher on mortality, frequency of transfer to a critical care unit, and the occurrence of five life-threatening dysrhythmias. METHODS: Data for this quasi-experimental study were collected on 1185 patients for a 9-month period in 1993 when the cardiac progressive care unit had a monitor watcher and on 1198 patients for a 9-month period in 1994 when the unit had no monitor watcher. RESULTS: We found no significant differences in mortality, frequency of transfer to a critical care unit, or the occurrence of three of the five dysrhythmias examined. The presence of a monitor watcher was associated with significantly fewer episodes of sustained ventricular tachycardia but more bradyarrhythmias. For both sustained ventricular tachycardia and bradyarrhythmias, the monitor watcher variable remained in the final multivariate logistic regression models. CONCLUSIONS: The presence of a monitor watcher was not associated with lower rates of most adverse outcomes evaluated; however, fewer episodes of sustained ventricular tachycardia occurred when a monitor watcher was present. Sustained ventricular tachycardia is life-threatening, disturbing to the patient, and may result in a longer hospital stay while medical therapy is being adjusted. The results of this study support the use of a monitor watcher to prevent sustained ventricular tachycardia.     

Orthograde intestinal irrigation or Fordtran solution for bowel preparation in elective colorectal surgery. Prospective outcome study

In a prospective cohort study, which was carried out at the department for abdominal surgery of the university of Mainz from June to December 1993, two methods of bowel preparation for elective colorectal surgery were compared: oral bowel preparation with Fordtran a new polyethylene glycol solution (63 patients), and whole-gut lavage with Ringer's solution (37 patients). The serum chloride levels and the bodyweight increased significantly more in the whole-gut lavage group. These patients also showed a higher frequency of vomiting during bowel preparation. Neither the bowel cleansing effect nor the postoperative complications differed significantly between the two groups. Owing to these results, the better patient acceptance, and the easier handling and lower costs of PEG solution, we recommend this method of preoperative bowel preparation for elective colorectal surgery.     

Oral controlled drug delivery systems based on microporous polymers

Microporous polypropylene (PP) powder shows excellent properties for tabletting. Oral controlled release delivery systems were made by simply blending with drug and compressing to make both matrix and coated tablets. To prevent wetting problems and food interactions, sodium lauryl sulphate (SLS) was adsorbed prior to tabletting on the surface of the microporous PP. In order to reveal possible dosage form-food interactions a new and simple food interaction model (slight modification of the USP XX paddle method) is proposed to standardize both in vitro and in vivo testing procedures. The PP coated oxprenolol tablets show no food interactions when tested in vitro in the food simulation mixture. The same liquid food was used in the in vivo study. The PP coated oxprenolol tablets were given to six male volunteers with and without the food. The absorption profiles, which were calculated by numerical deconvolution, showed hardly any food interactions in vivo. The absolute bioavailability at 12 hours was 38±19% on an empty stomach and 37±20 for the food experiment. The developed coated tablets are able to control the release of oxprenolol at least 12 hours both with and without concomitant food intake. Their bioavailability is comparable to different OROS formulations of oxprenolol controlled release systems based on microporous PP are not only highly effective ones but also low cost formulation products.     

Separators for the electrolytic cell of the sulphuric acid hybrid cycle

Resistivity and stability examinations of about 40 separators in 30 w/o sulphuric acid were carried out. Additionally, examinations of the best types were made in the extended concentration range 10–55 w/o sulphuric acid. Cation exchange membranes of the type Neosepta were shown to be the most promising separators, showing a significantly lower resistivity than Nafion membranes, especially at H₂SO₄ concentrations higher than 30 w/o.