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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
61

Content determination of explosive precursors and narcotic salts using 35Cl-nuclear magnetic resonance

Bergqvist, Sandra January 2023 (has links)
Explosive precursors and narcotic salts are chemicals contributing to an undesirabledevelopment of the Swedish society, both in terms of criminal activities and harm to the environment. Reducing the illegal use of these chemicals is important in the work towards a safer society. National Forensic Centre (NFC) is the state agency responsible for forensic investigations for the Swedish Police Authority. The Drug Analysis and ChemistryTechnology section at NFC were both in need for an accurate quantification method to determine the content of Cl in narcotic salts and explosive precursors. Nuclear magnetic resonance (NMR) spectroscopy was assessed to be suitable since a recently published article had shown applicability of 35Cl NMR on narcotic salts. The aim of the method was to find the most appropriate parameter settings for the compounds of interest, including operating frequency, 90° pulse length, number of scans, relaxation time, and relaxation delay. To ensure a reliable and accurate method, the following validation parameters were studied; linearity, limit of detection (LOD), limit of quantification (LOQ), intermediate precision, trueness, repeatability, and ruggedness. Dimethyl sulfoxide (d6-DMSO) was chosen as the preferredsolvent for the Drug Analysis section since it is a common solvent for their 1H-NMR analysis. For explosive precursors results showed advantages of using deuterium oxide (D!O) as solvent, considering accuracy, solubility and shorter analysis time.Concluding, the chosen criteria of signal-to-noise (S/N) ratio >6 resulted in an LOQ of around 0.15g/L, though this was dependent upon the number of scans utilized. Successful pulse length experiments determined exact 90° pulse lengths for each sample and solvent combination. The longitudinal relaxation time T1 was also successfully determined, and since it was multiplied with five to ensure complete relaxation to stable state the relaxation delay D1was assumed as an insignificant parameter for the determination of chloride. Quantification was based upon the pulse-length based concentration determination (PULCON) using an external standard. The ruggedness can be studied additionally by another experienced operator (since trueness was strongly dependent upon the preparation of the external standard solution). The method displayed good linearity over the mass range normally utilized in such quantifications. The conclusion drawn in the thesis is that the method shows great promise but additional analyzes are still required before implementation at NFC
62

Pharmacologic investigation in mice of the effects of narcotic antagonists on dopamine agonist reversal of oxotremorine or reserpine

Namba, Mike Minoru 01 January 1980 (has links) (PDF)
In the present study, two different drugs were used to induce a Parkinson-like condition. The first drug was the centrally acting cholinergic agonist oxotremorine (OXTM) which readily induces tremor and rigidity in mice (54). This tremor has been reported to be antagonized by dopamine agonists such as L-dopa and apomorphine (50,54,55) as well as by anticholinergic drugs such as scopolamine (46) . The other drug used was reserpine which interferes with the neuronal storage of dopamine and results in its depletion in the brain (56). Reserpine induces tremor, rigidity, blepharoptosis (a drooping of the eyelids), and catalepsy (48,57-59). The catalepsy is readily reversed by the administration of L—dopa (48,60-62). Using these two models of Parkinson's disease, selected narcotic antagonists have been tested to determine if they could potentiate dopaminergic influences and restore the normal balances of acetylcholine and dopamine in the corpus striatum.
63

Cannabis in Uruguay : A case study of the regulated cannabis market in Uruguay

Pulido Moreno, Rodrigo January 2017 (has links)
This study deals with the impact of the legislative bill that enabled the creation of a regulated cannabis market in Uruguay as a means to combat organized crime in the country. This study will also explore the hypothesis that this legislative bill changed the legal character of criminality as well as reformulating narcotic issues from being a criminal issue into a public health issue. Analyzing the very specific case of Uruguay’s current narcotic policies becomes a means to explore the ideas that constitute Law Nr 19.172 “Marijuana and its derivatives” which might be indicative of the attitudes in society regarding criminality. This ties into the new iteration of the dichotomy between law and democracy as a result of this legislative reform in Uruguay and the possible new role of legal theory in a democratic country which is discussed in this article.
64

Missbruk bland assyrier/syrianer : - En kvalitativ hermeneutisk studie om fem före detta missbrukare / Abuse among Assyrians/Syriacs : - a qualitative hermeneutical study of five former abusers

Aydin, Thomas January 2009 (has links)
<p>Syftet med den här studien var att undersöka ett relativt outforskat område, nämligen missbruk bland assyrier/syrianer. Trots att folkgruppen har levt i Sverige i drygt 40 år och utgör en av landets större invandrargrupper, har det bedrivits väldigt lite forskning gällande missbruk bland populationen. Förhoppningen med studien är att den kan tillföra ytterligare kunskap som kan vara av betydelse för de som på något sätt kommer i kontakt med assyriska/syrianska missbrukare, exempelvis sociala myndigheter, behandlingsinstitutioner med flera, men även att studien kan frambringa en konstruktiv debatt, som författaren anser saknas bland den assyriska/syrianska folkgruppen, och belysa temat missbruk ytterligare.</p><p>Med hjälp av den kvalitativa metoden har fem före detta missbrukande assyrier/syrianer, med en bakgrund i ett narkotika- och/eller spelmissbruk studerats. Huvudfrågan har varit att studera hur respondenterna hamnat i ett missbruk, tiden under missbruk, samt hur man därefter tagit sig ur missbruket. Empirin insamlades via fyra enskilda intervjuer i det fysiska rummet samt en via e-mail. Resultaten har relaterats till de olika teorierna avvikande beteende, stämplingsteorin samt Goldbergs avvikarkarriärmodell.</p><p>Studiens huvudresultat är att respondenterna, i varierande grad, har upplevt en svår uppväxt. För flera har den ena föräldern gått bort i tidig ålder och i andra fall att föräldern helt enkelt varit frånvarande. Vidare har även några fått utstå fysiskt våld i olika former, hot, mobbning eller diskriminering, antingen i skolan, i hemmet eller ute i samhället. Det har visat sig att respondenterna upplevt en eller flera kriser kombinerat med sorg, vilket skapat en otrygghet i deras liv.</p><p>Vägen till att bryta sig ur missbruket har sett olika ut för individerna. Gemensamt för dem alla är att närmaste familjen fungerat som ett stöd. En av respondenterna kom att bli frälst och en annan genomgick diverse terapibehandlingar. Övriga har tagit sig ur på egen hand med stöd från familjen.</p> / <p>The purpose of this study is to investigate a relatively unknown domain, namely the one of abuse amongst Assyrians/Syriacs. Although the community has lived in Sweden for more than 40 years and yields one for the countries larger immigrant groups, there has been little research performed addressing the question of abuse within the community. Hopefully this study will provide useful knowledge to those whom in one way or another deal with abusing Assyrians/Syriacs, such as for instance rehabilitation institutes or social welfare authorities. It might also promote a constructive debate on the issue within this specific community, which the author thinks is lacking, and to further shed light on the question of abuse in general.</p><p>By the method of qualitative study, five former abusing Assyrians/Syriacs, with backgrounds in drug substance abuse and/or gambling addiction have been studied. The primary questions have been those of how the subjects got into abusing, the time during the abuse, and how the abuse was overcome. Empirical data was collected through four individual face-to-face interviews and one via e-mail, and the resulting conclusions were drawn by relating the data to the theories of deviant behavior, labeling theory and Goldbergs deviant career model.</p><p>The main result of the study is that the respondents to various degrees have suffered a difficult childhood. In the case of many of them one parent was deceased prematurely or for others the parent was largely absent. Furthermore, some had to endure physical violence in different forms, threats, bullying, or discrimination, either in school, at home or by society. It became evident that the respondents have experienced one or several crisis in combination with grief, which has created a sense of insecurity on their lives.</p><p>The path away from abuse has been different for the individuals, although they all share having had the support from the closest family. One of the respondents became a born-again Christian and another went through various therapy rehabilitation treatments. The others have managed on their own with the support from family.</p>
65

Missbruk bland assyrier/syrianer : - En kvalitativ hermeneutisk studie om fem före detta missbrukare / Abuse among Assyrians/Syriacs : - a qualitative hermeneutical study of five former abusers

Aydin, Thomas January 2009 (has links)
Syftet med den här studien var att undersöka ett relativt outforskat område, nämligen missbruk bland assyrier/syrianer. Trots att folkgruppen har levt i Sverige i drygt 40 år och utgör en av landets större invandrargrupper, har det bedrivits väldigt lite forskning gällande missbruk bland populationen. Förhoppningen med studien är att den kan tillföra ytterligare kunskap som kan vara av betydelse för de som på något sätt kommer i kontakt med assyriska/syrianska missbrukare, exempelvis sociala myndigheter, behandlingsinstitutioner med flera, men även att studien kan frambringa en konstruktiv debatt, som författaren anser saknas bland den assyriska/syrianska folkgruppen, och belysa temat missbruk ytterligare. Med hjälp av den kvalitativa metoden har fem före detta missbrukande assyrier/syrianer, med en bakgrund i ett narkotika- och/eller spelmissbruk studerats. Huvudfrågan har varit att studera hur respondenterna hamnat i ett missbruk, tiden under missbruk, samt hur man därefter tagit sig ur missbruket. Empirin insamlades via fyra enskilda intervjuer i det fysiska rummet samt en via e-mail. Resultaten har relaterats till de olika teorierna avvikande beteende, stämplingsteorin samt Goldbergs avvikarkarriärmodell. Studiens huvudresultat är att respondenterna, i varierande grad, har upplevt en svår uppväxt. För flera har den ena föräldern gått bort i tidig ålder och i andra fall att föräldern helt enkelt varit frånvarande. Vidare har även några fått utstå fysiskt våld i olika former, hot, mobbning eller diskriminering, antingen i skolan, i hemmet eller ute i samhället. Det har visat sig att respondenterna upplevt en eller flera kriser kombinerat med sorg, vilket skapat en otrygghet i deras liv. Vägen till att bryta sig ur missbruket har sett olika ut för individerna. Gemensamt för dem alla är att närmaste familjen fungerat som ett stöd. En av respondenterna kom att bli frälst och en annan genomgick diverse terapibehandlingar. Övriga har tagit sig ur på egen hand med stöd från familjen. / The purpose of this study is to investigate a relatively unknown domain, namely the one of abuse amongst Assyrians/Syriacs. Although the community has lived in Sweden for more than 40 years and yields one for the countries larger immigrant groups, there has been little research performed addressing the question of abuse within the community. Hopefully this study will provide useful knowledge to those whom in one way or another deal with abusing Assyrians/Syriacs, such as for instance rehabilitation institutes or social welfare authorities. It might also promote a constructive debate on the issue within this specific community, which the author thinks is lacking, and to further shed light on the question of abuse in general. By the method of qualitative study, five former abusing Assyrians/Syriacs, with backgrounds in drug substance abuse and/or gambling addiction have been studied. The primary questions have been those of how the subjects got into abusing, the time during the abuse, and how the abuse was overcome. Empirical data was collected through four individual face-to-face interviews and one via e-mail, and the resulting conclusions were drawn by relating the data to the theories of deviant behavior, labeling theory and Goldbergs deviant career model. The main result of the study is that the respondents to various degrees have suffered a difficult childhood. In the case of many of them one parent was deceased prematurely or for others the parent was largely absent. Furthermore, some had to endure physical violence in different forms, threats, bullying, or discrimination, either in school, at home or by society. It became evident that the respondents have experienced one or several crisis in combination with grief, which has created a sense of insecurity on their lives. The path away from abuse has been different for the individuals, although they all share having had the support from the closest family. One of the respondents became a born-again Christian and another went through various therapy rehabilitation treatments. The others have managed on their own with the support from family.
66

Surviving oppression under the rock : New York drug laws and the lived experiences of African American women in distressed households

Windsor, Liliane Cambraia 12 October 2012 (has links)
Drawing on standpoint and intersectionality theories, this study explores the degree to which New York State’s Rockefeller Drug Laws and interactions between criminal, educational, and welfare policies have contributed to the maintenance of a culture of surveillance in which the lives of African American women in distressed households are overseen and influenced by oppressive policies and governmental institutions. Qualitative secondary analysis of longitudinal ethnographic data was conducted. Two detailed family cases are the focus of the study. Findings demonstrate multiple disadvantages that impoverished African American families struggling with alcohol and/or other drugs (AOD) use and/or sale experience. These disadvantages accumulated intergenerationally, in a snowball effect making it difficult for participants to maintain stable lives. For instance, oppressive policies, discrimination, poverty, AOD use, and violence hindered many participants’ ability to obtain a high school degree which in turn contributed to the obstacles they faced finding meaningful employment. Findings explored the tension between participants’ experiences with oppression and the multiple ways they either assimilated or resisted their oppression. While the Rockefeller Drug Laws assume that harsh sentences deter people from AOD use/sale, none of the participants mentioned imprisonment as a motivator to avoid AOD. Participants’ classification of crack, cocaine, and heroin as the most dangerous AOD were congruent with the Rockefeller Drug Laws’ classification of AOD. However, the way the law dispensed prison sentences reduced people to their AOD use because it disregarded all other aspects of their lives. Unlike the Rockefeller Drug Laws, participants found drug use to be sometimes a functional activity insofar as it was an additional source of income and a coping strategy in dealing with oppression. Findings indicate that simply addressing problematic AOD use among impoverished African American families in New York at the micro level is not sufficient or feasible. While it is important to examine and address individual needs and problems associated to AOD use, macro forces such as lack of meaningful employment for unskilled workers must be addressed. Social workers must foster critical thought, support an operational definition of AOD abuse/dependence, and advocate for social justice within the field of AOD use. / text
67

A assistência farmacêutica básica em uma comissão intergestores regional do estado de São Paulo sob o olhar da investigação, da ação e da pesquisa / The basic pharmaceutical assistance on a intermanagerial regional health commission of the state of São Paulo from the perspective of investigation, action and research

Nambu, Mauricio Massayuki, 1971- 25 August 2018 (has links)
Orientador: Luciane Miranda Guerra / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-25T14:49:06Z (GMT). No. of bitstreams: 1 Nambu_MauricioMassayuki_M.pdf: 6110256 bytes, checksum: fb5c5c2f84a8fc982cb54524cde90aef (MD5) Previous issue date: 2014 / Resumo: A proposição do presente estudo foi avaliar as Assistências Farmacêuticas Básicas municipais das cidades que compõem a Comissão Intergestores Regional de Saúde (CIR) de Ourinhos-São Paulo, através de indicadores de estrutura, processo e resultado, e propor, de forma compartilhada e participativa, ações na perspectiva de impactar mudanças positivas nos indicadores verificados e na prática dos serviços. Trata-se de um estudo transversal descritivo, baseado em indicadores do manual prático de acompanhamento de políticas nacionais de medicamentos da Organização Mundial de Saúde (OMS), perfazendo neste estudo, um total de treze indicadores, caracterizados pela utilidade, descrição, padrão, fonte, metodologia de coleta, cálculo e limitações. Foram realizadas observações diretas em medicamentos, cadastros, relatórios e/ou documentos, entrevistas com os responsáveis pelas Assistências Farmacêuticas Municipais e visitas às unidades de saúde que dispensavam medicamentos para a atenção básica, perfazendo um número total censitário de doze municípios, 41 unidades de saúde e três Centrais de Abastecimento Farmacêutico, não anexas às unidades dispensadoras de medicamentos (farmácias). Em uma segunda etapa, foi realizada uma oficina temática direcionada a todos os municípios participantes do estudo. Verificou-se que 63,89% das unidades de saúde e 75% das centrais de abastecimento farmacêutico possuíam controle de estoque e 68,33% e 70%, cumpriam as boas práticas de armazenamento, respectivamente. Nas unidades de saúde foram encontrados, em média, 0,85 farmacêuticos por unidade; 14,79% de trabalhadores capacitados, 2,44% de listas de padronização afixadas nas farmácias, presença de 88,91% de medicamentos marcadores, 3,77% de medicamentos fora do prazo de validade, 1,99 medicamentos por prescrição, 63,98% de medicamentos prescritos, pertencentes à Atenção Básica, 80,21% de medicamentos prescritos pela denominação genérica, 74,94% de medicamentos prescritos e atendidos, sendo 73,57% na íntegra e 79,59% de medicamentos pertencentes ao Componente Básico da Assistência Farmacêutica dispensados. Na oficina temática, das doze cidades estudadas, sete responsáveis pelas Assistências Farmacêuticas municipais compareceram. Nesta, foram analisados os dados situacionais e elaboradas propostas para melhoria dos indicadores apurados, sendo as mesmas encaminhadas aos gestores e farmacêuticos responsáveis pelas respectivas Assistências Farmacêuticas dos doze municípios da CIR Ourinhos-São Paulo. Apesar dos índices não serem totalmente insatisfatórios, em sua maioria, os valores dos indicadores ficaram abaixo dos padrões estabelecidos pela literatura, demonstrando a necessidade de adequações na infraestrutura e da realização de capacitações para as Assistências Farmacêuticas municipais, visando maior qualidade de atenção aos usuários do sistema de saúde / Abstract: The proposition of this study was to evaluate the Municipal Basic Pharmaceutical Assistance of towns compounding the Intermanagerial Regional Health Commission (IRC) of Ourinhos-Sao Paulo, through indicators of structure, process and result, and propose, in a shared and participatory manner, actions to cause positive changes in the verified indicators and practice of services. It is a cross-sectional descriptive study, based on the attendance of Practical Manual Indicators of National Medicine Policies of the World Health Organization (WHO), totalizing thirteen indicators, characterized by utility, description, standard, source, collection methodology, calculation and limitations. Direct observations were made on medications, records, reports and/or documents, interviews with those responsible for Municipal Pharmaceutical Assistance, and visits to health facilities dispensing drugs for primary care, with total census number of twelve municipalities, forty one health units and three pharmaceutical supply centers, not attached to the units dispensing medications (pharmacies). In a second stage, a thematic workshop was directed to all municipalities participating in the study. It was found that 63.89% of health units and 75% of the pharmaceutical supply centers had stock control, 68.33% and 70% of them respectively, met the good storage practices. In the health units were found, on average, 0.85 pharmacists per unit; 14.79% skilled workers, 2.44% of standardization lists posted in pharmacies, the presence of 88.91% tracer drugs, 3.77% of drugs with expiry date, 1.99 medicine per prescription, 63,98% of prescribed drugs belonging to primary care, 80.21% of drugs prescribed by the generic denomination, 74.94% of the drugs prescribed and received, being 73.57% in full and 79.59% of drugs belonging to the dispensed Basic Pharmaceutical Component Assistance. In thematic workshop of the twelve cities studied, seven responsible for Municipal Pharmaceutical Assistance attended. It was analyzed the data situation and proposals for improvement were prepared for the checked indicators. The proposals were forwarded to managers and pharmacists responsible for their respective Pharmaceutical Assistance of the twelve municipalities of IRC Ourinhos-Sao Paulo. Despite the indices not being totally unsatisfactory, mostly the indicator values were below the standards established by the literature, demonstrating the need for adjustments in infrastructure and conducting training for the Municipal Pharmaceutical Assistance, improving the quality of care to the health system users / Mestrado / Odontologia em Saude Coletiva / Mestre em Odontologia em Saúde Coletiva
68

Paixão e droga como vínculos patológicos: um estudo psicanalítico sobre a relação de dependência entre sujeito e objeto / Passion and drug as pathological bonds: a psychoanalytical study on the relation of dependence between person and object

Silva, Antonieta Lira e 16 September 2005 (has links)
Made available in DSpace on 2017-06-01T18:08:34Z (GMT). No. of bitstreams: 1 antonieta silva.pdf: 574769 bytes, checksum: a44ea9c897e182f2065c63e59e8d9832 (MD5) Previous issue date: 2005-09-16 / The world where we live in is presenting overwhelming changes and some transformations also occur in the psychoanalytical clinic which appears with new forms of symptoms. When the man is born he needs someone in order to survive. Some of them needs to continue in this situation of dependency on somebody or something else and only this way he can links throughout life. Based on Freud and Lacan´s theories we try to understand this kind of linking that can contribute with significant form the relation of dependency between person and object. First of all we make some reflections about notion of person and object according to Freud and Lacan´s psychoanalysis making a clipping in the context of passion and drug. One distinguishes the object from desire, the object of necessity and the object of dependency. After that, we discuss the question of the pathological bond articulating it with a relation of dependency. We approached still some theorists with the link with a notion of object relation according to Lacan. We understand that under the pathological link one can find the relation of dependency. At last, we talked about the bond which is related between the subject and object in the sense of dependency which must be understood as related to a certain behavior characterized by abuse and excess and a relation between person and object becomes pathology due to intensity and preponderance independent from the characteristics of the subject. The dependence to the chosen object induces the person to the bondage. The person submits to anything in order to avoid loosing something and that is a rule for a person that presents an additive structure. So, the remarkable consequence is the perpetuation of a dependency situation in relation to somebody, denying the basic principle of becoming a subject / O mundo onde vivemos vem apresentando mudanças avassaladoras e, evidentemente, transformações também ocorrem na clínica psicanalítica, que se depara com novas formas dos sintomas. O homem, ao nascer, depende de alguém para continuar vivendo, o que confere a ele a característica de um desamparo fundamental, no qual necessita do suporte do outro para sua sobrevivência. Alguns necessitam permanecer na posição de dependente do outro ou de algo, forma com que ele consegue vincular-se ao longo da vida. Buscando entender essa forma de vinculação, objetivamos compreender, a partir das contribuições de Freud, de Lacan e de teóricos que podem acrescentar de forma significativa, a relação de dependência entre sujeito e objeto. Primeiramente, procedemos a uma reflexão das noções de sujeito e de objeto segundo a psicanálise, na perspectiva de Freud e Lacan, fazendo um recorte no contexto da paixão e da droga. Distinguimos o objeto de desejo, do objeto de necessidade e do objeto de dependência. Em seguida, discutimos a questão do vínculo patológico, articulando-o com a relação de dependência. Fizemos ainda algumas aproximações de teóricos do vínculo com a noção de relação de objeto conforme Lacan. Entendemos que, subjacente ao vínculo patológico, encontra- se uma relação de dependência. Finalizando, falamos de um vínculo que se estabelece entre sujeito e objeto no sentido de dependência, que deve ser entendida como relativa a determinados comportamentos caracterizados pelo abuso e pelo excesso, essa relação passa a se configurar numa patologia pela intensidade e preponderância, independente das características desse objeto. A dependência ao objeto escolhido leva o sujeito à servidão. Submeter-se a qualquer coisa para não perder é a regra do sujeito que apresenta uma estrutura aditiva. Logo, a conseqüência marcante é a perpetuação da situação de dependência em relação ao outro, negando-se o princípio básico da alteridade
69

Narcotic misuse in Sweden : Examining changes in age structure and gender from 1997- 2017 through events of hospitalizations and mortality

Wasson, Rachel Erin Elizabeth January 2020 (has links)
Aim: The motivation of this explorative study is to analyze the changing age structure of individuals misusing narcotics presenting with events of hospitalization or mortality. Methods: The data is derived from three anonymous, aggregated data sets for the mortality (n=4,999), hospitalization (n=143,264), and general population data. Descriptives, independent T-Tests, and simple linear regression is used for the analysis of age among events of mortality and hospitalizations throughout time. Results: The structure of ages among individuals with mortality linked to narcotic misuse does not significantly change. The trends in ages among males and females present themselves differently in mortality related to narcotic misuse as the female median ages continue to increase in age, whereas male median ages remain relatively stable. The age structure of individuals with hospitalizations linked to narcotic misuse has changed over time, with the males and females presenting similar significant trends in declining age. Conclusion: The changes in age structure among individuals misusing narcotics differ when measuring mortality and hospitalizations. Significant changes indicate that hospitalizations have increased over time and are more prevalent in younger adults, suggesting that more individuals are misusing narcotics at younger ages and requiring more medical care as they age and live longer lives.
70

Untersuchung zum Nutzen einer ungerichteten präanästhetischen Screeninguntersuchung von Blutbild und ausgewählten blutchemischen Parametern beim Hund

Praun, Ferdinand von 08 March 2011 (has links)
Der Sinn ungerichteter Reihenuntersuchungen, sogenannter Screening-untersuchungen, als Ergänzung zur präanästhetischen Untersuchung wird sowohl in Human- als auch Veterinärmedizin kontrovers diskutiert. Ziel dieser Arbeit war es, den Nutzen von Blutuntersuchungen beim Hund im Sinne eines ungerichteten Screenings zu prüfen. Bei 1537 Hunden wurde im Routinebetrieb der Klinik vor jeder Narkose zunächst eine standardisierte Anamnese erhoben und eine standardisierte klinische Untersu-chung durchgeführt. Im Anschluss hieran wurden Blutproben für die Untersuchung verschiedener Parameter des Blutbildes und der Blutchemie entnommen. 1123 Pati-enten wurden präanästhetisch vom Anästhesisten als „benötigt keine Laboruntersu-chung“ eingestuft. Diese Patientengruppe hätte ein ungerichtetes präanästhetisches Laborscreening betroffen und wurde für die Auswertung der Blutuntersuchung herangezogen. Der Anteile der Werte, die außerhalb des jeweiligen Referenzbereichs lagen, schwankte je nach Parameter zwischen 2 und 85 Prozent. Insgesamt wurden für die einzelnen Parameter deutlich mehr Abweichungen festgestellt als in vergleichbaren humanmedizinischen Studien. Der Anteil geringgradiger Abweichungen war hierbei sehr hoch. Aufregungsbedingte Blutbildveränderungen, Vorbehandlungen, der verwendete Referenzbereich und bei sehr jungen Hunden altersbedingte Abweichungen kamen als mögliche Ursachen für diese Veränderungen in Betracht. In elf Prozent der Fälle ließen sich deutliche Abweichungen einzelner Laborparameter vom Referenzbereich feststellen, die retrospektiv zu einer Neueinschätzung des jeweiligen Narkoserisikos beim Patienten führten. Hieraus hätte sich für 6,5 % aller Patienten eine Änderung im perioperativen Management ergeben. In humanmedizinischen Studien liegt der Anteil der Patienten, bei denen ein Laborscreening eine Änderung des Narkosemanagements ergeben hätte bei unter einem Prozent. Verschiedene spezifisch veterinärmedizinische Gründe werden für diese Diskrepanz vermutet. Aufgrund der Besitzeranamnese statt Patientenanamnese und aufgrund verschiedener Störfaktoren für die klinische Untersuchung wie Aufregung oder mangelnde Kooperationsbereitschaft des Patienten kann von einem höheren Prozentsatz nicht erfasster Patienten mit höhe-rem Narkoserisiko ausgegangen werden. Bezüglich aller untersuchten Patienten konnte ein deutlicher Einfluss des Alters auf die Risikoeinschätzung des Anästhesisten festgestellt werden. Eine Untersuchung auf Korrelationen zwischen Laborwerten und dem Alter der Tiere zeigte im Falle von Thrombozytenzahl, ALAT, Natriumkonzentration und Gesamteiweißkonzentration eine positive Korrelation zum Alter, im Falle der Glukose eine negative Korrelation. Der Einfluss des Alters auf die Laborparameter ist aber in allen Fällen zu gering ausgeprägt um für die Beurteilung der Laborparameter hinsichtlich einer Narkoserelevanz entscheidend zu sein. Die Altersstruktur der „laborauffälligen“ Patienten weist im Vergleich zu den „laborunauffälligen“ Patienten keinen statistisch sicherbaren Unterschied auf. Der Einfluss verschiedener Rassen auf die Variabilität der Laborparameter wurde anhand der Korrelation von Körpermasse und Laborparametern näherungsweise untersucht. Nur für Kreatinin konnte ein deutlicher Zusammenhang zwischen Kör-permasse und Laborwert festgestellt werden, was wahrscheinlich auf die unter-schiedliche Bemuskelung kleiner und großer Hunde, bezogen auf das Körperge-wicht, zurückzuführen ist. Für die Laborwertinterpretation relevante rassebedingte Unterschiede konnten jedoch nicht ausgemacht werden. Zusammenfassend zeigen die Ergebnisse dieser Studie deutliche Unterschiede zu denen vergleichbarer Humanmedizinischer Studien. Es können mittels eines unge-richteten Laborscreenings deutlich mehr relevante Laborwertveränderungen festge-stellt werden, die auch zu einer Neueinschätzung der Risikosituation für den Patienten führen können. Ein Einfluss des Alters auf die Zahl der Laborwertveränderungen konnte im Rahmen dieser Studie nicht festgestellt bzw. statistisch gesichert werden. Insgesamt zeigt der Anteil relevanter Laborwertveränderungen, dass präanästhetische Blutuntersuchungen beim Hund eine sinnvolle Ergänzung zur präanästhetischen Untersuchung darstellen können.

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