Philosophiae Doctor - PhD / The overall aim of this thesis was to prepare nanostructured more processable heteronuclear sulphonated polyanyline nanocomposites with electroconductive properties suitable for applications in biosensors. The sulphonated self-assembled polyaniline and derivatised polyaniline nanocomposites (SPAHs) were prepared by chemical oxidative polymerisation or electrical decomposition. The SPAHs prepared include those of polyaniline (PANi), poly-o-methoxyaniline (POMA) and poly-2.5 dimethoxyaniline (PDMA). Two types of sulphonic acids of heteronuclear aromatic hydrocarbons were used in the production of sulphonated SPAH composites. These were anthracene sulphonic acid (ASA) and naphthalene sulphonic acids (NSA) wich played both doping and surfactant roles. / South Africa

[pt] Os antibióticos eritromicina e canamicina, pertencentes às classes dos macrolídeos e aminoglicosídeos respectivamente, têm sua importância como agentes preservativos no processo de preparação e durante o processo de utilização da vacina contra a febre amarela - apresentação de cinco doses - produzida no Instituto de Tecnologia em Imunobiológicos, Bio-Manguinhos, FIOCRUZ, RJ. Este trabalho propõe apresentar duas novas abordagens para a determinação espectrofluorimétrica desses antibióticos, considerando o desempenho, inclusive com relação à seletividade, na análise dessa matriz específica (vacina). Um estudo preliminar do comportamento luminescente (fosforescência e fluorescência) dessas substâncias foi realizado em diferentes condições experimentais a fim de encontrar as que permitissem o desenvolvimento dos métodos analíticos. Para a eritromicina, que não apresentou luminescência nativa, foi utilizado um procedimento de derivação fotoquímica de soluções do analito preparadas em meio contendo ácido sulfúrico. Como resultado obteve-se um foto-produto que apresentou fluorescência em 412/465 nm. As condições experimentais foram otimizadas visando a maximização desse sinal fluorescente. Nesse caso, foram estudados o tempo de irradiação com UV, o tipo e a concentração do ácido utilizado, o tempo e a temperatura de aquecimento. O método foi parcialmente validado apresentando limites de detecção e de quantificação iguais a 0,25 ug mL-1 e 0,85 ug mL-1 respectivamente. A faixa linear do método estendeu-se até 200 ug mL-1 e os parâmetros de precisão e robustez foram bastante satisfatórios. O método foi aplicado na análise de uma simulação de vacina contra a febre amarela e na análise de medicamentos comerciais com um percentual de recuperação entre 98,2 e 105,2 %. A metodologia desenvolvida para a canamicina, que também não apresentou fluorescência natural, baseou-se na reação de oxirredução deste composto com o Ce (IV) produzindo o Ce (III), que é uma espécie fortemente fluorescente (255/360 nm). As intensidades dos sinais fluorescentes medidos no par excitação/emissão do Ce (III) foram diretamente proporcionais às concentrações de canamicina. As condições para a realização da reação foram estudadas, avaliando a quantidade de Ce (IV), a concentração e tipo de ácido usado no meio reacional e o tempo e temperatura de aquecimento. A ampla faixa linear (até 1000 ug mL-1) foi obtida, com limites de detecção e quantificação de 1,22 ug mL-1 e 4,08 ug mL-1, respectivamente. O percentual de recuperação obtido na análise da vacina diluída foi de 109,8 % e em amostra diluída de urina enriquecida com o analito foi de 103,4 %. / [en] The antibiotics erythromycin and kanamycin, members of the macrolide and aminoglycoside classes respectively, have their importance as preservative agents for the preparation process and during the using of the yellow fever vaccine, five doses presentation, produced in Technology on Immunobiologicals Institute, Bio- Manguinhos, FIOCRUZ, RJ. In this work two new approaches for the spectrofluorimetric determination of these antibiotics are presented, taking into consideration their selectivity performance for this specific matrix (vaccine). A preliminary study was performed to evaluate the luminescent behavior (phosphorescence and fluorescence) of these substances in different experimental conditions aiming to find the best ones that would lead to the development of the analytical methods. For erythromycin, which does not present native luminescence, a photochemical derivatization was employed using analite solutions prepared in sulfuric acid. As a result, a photo- product was obtained, which presented fluorescence at 412/465 nm. The experimental conditions were optimized aiming the maximization of the fluorescent signal. In this case, the studied parameters were the UV irradiation time, the type and concentration of the acid utilized, and the time and temperature used for the heating step. The method was partially validated, indicating limits of detection and quantification of 0.25 ug mL-1 and 0.85 ug mL-1, respectively. The linear dynamic range of the method extended up to 200 ug mL-1 and the parameters related to precision and robustness were very satisfactory. The method was applied in the analysis of a simulated yellow fever vaccine and in commercial pharmaceutical formulations. Recovery percent between 98.2 and 105.2 % were achieved. The methodology developed for kanamycin, which also do not presented natural fluorescence, was based on the oxirreduction reaction of this compound with Ce (IV), producing Ce (III), a strongly fluorescent species (255/360 nm). The fluorescence intensities, measured in the excitation/emission pair of Ce (III), was directly proportional to the kanamycin concentration. The reaction conditions were studied by the evaluation of the amount of Ce (IV), the type and concentration of the acid utilized in reactional medium and heating time and temperature. Large linear range (up to 1000 ug mL-1) was obtained, with detection and quantification limits of 1.22 ug mL-1 and 4.08 ug mL-1, respectively. The recovery percent obtained in the analysis of a diluted vaccine was 109.8 % while the recovery achieved for diluted spiked urine was 103.4 %.

Biliary excretion is an important elimination route for many drugs and metabolites. For such compounds, it is important to know the extent of excretion and drug exposure in the bile, e.g., for the risk assessment of drug interactions, liver toxicity and the effects of genetic variants. In this thesis, duodenal aspiration of bile was performed in healthy volunteers and complemented with experiments in an in vivo model in pigs to increase the understanding of the intestinal and hepatobiliary disposition of two direct thrombin inhibitors. The compounds investigated, ximelagatran and AZD0837, are both prodrugs that require bioactivation to exert their pharmacological effect. Upon co-administration with erythromycin and ketoconazole, respectively, altered plasma exposure to ximelagatran and AZD0837 and their respective metabolites has been observed. The main objective of this thesis was to characterize the biliary excretion of the compounds, and investigate whether this elimination route explains the observed drug-drug interactions. High plasma-to-bile AUC ratios were observed, in particular for ximelagatran, its active metabolite melagatran, and AR-H067637, the active metabolite of AZD0837. These high ratios indicate the involvement of active transporters in the biliary excretion of the compounds, which is important since transporters constitute possible sites for drug interactions. The effects of erythromycin and ketoconazole on the plasma exposure of the prodrugs and metabolites were confirmed in both the pig and the clinical studies. The changes seen in plasma for ximelagatran and its metabolites were partly explained by reduced biliary clearance. Inhibited CYP3A4 metabolism likely caused the elevated plasma levels of AZD0837, whereas reduced biliary clearance was seen for AR-H067637 suggesting an effect on its excretion into bile. In summary, the studies led to mechanistic insights in the hepatobiliary disposition of ximelagatran and AZD0837, and demonstrate the value of combined clinical and animal studies for the investigation of the biliary drug excretion.

Inadequate delivery of nutrition to the critically ill is common, and may adversely affect clinical outcomes, including survival. This thesis reports studies designed to characterise the gastrointestinal dysfunction underlying feed intolerance in the critically ill, as well as the pathophysiology of these dysfunctions, and investigate potential therapeutic measures. While it has been established that enteral nutrition is frequently unsuccessful in the critically ill, assessment of the success of feeding in an Australian intensive care unit (ICU) had not been performed previously. A prospective survey examined the incidence of, and risk factors for, feed intolerance in the ICU at the Royal Adelaide Hospital and demonstrated that, in 40 patients receiving enteral feeding, only about 60% of their nutritional requirements were met at the end of the first week. The main cause for this lack of success was large gastric residual volumes, indicative of delayed gastric emptying (GE). This study, accordingly, quantified the limitations of nutritional delivery in contemporary practice in a local ICU. The results suggest that a better understanding of the pathogenesis underlying this problem is warranted in order to direct research into improved therapies. Scintigraphy is the most accurate technique to measure GE, but is difficult to perform in the ICU. A simpler, more convenient, test would increase the accessibility of GE measurement for both research and clinical purposes. A study comparing a breath test technique and gastric residual volume measurement to the scintigraphic measurement of GE in 25 mechanically ventilated patients demonstrated that GE measured by a breath test technique closely correlated with that measured by scintigraphy. While the breath test had a specificity of 100% it only had a sensitivity of about 60% in the prediction of delayed GE. Similarly, gastric residual volume measurement correlated with scintigraphic measurement of GE but also lacked sensitivity. The breath test has previously been demonstrated to be highly reproducible and it represents a useful option for repeated measurement of GE in the same patient. It is therefore likely to be useful to determine changes in GE over time or in response to a therapeutic intervention. There is a lack of information about the prevalence and determinants of delayed GE in the critically ill. Previous studies have substantial limitations and scintigraphic measurement of GE has only rarely been used. A study comparing GE measured by scintigraphy in 25 patients to 14 healthy subjects demonstrated that GE was delayed in approximately 50% of the ICU patients (>10% retention at 4h) and markedly delayed in about 20% (>50% retention at 4h). Patients with trauma and sepsis appeared to have a relatively higher prevalence of delayed GE (80% and 75% respectively). In addition, the longer the patient had been in ICU the more normal the rate of GE. Quantification of delayed GE may prove useful by defining patients who may benefit from preventative or therapeutic options. The abnormalities in gastrointestinal motility underlying delayed GE in the critically ill are poorly characterised. Simultaneous manometric and gastric emptying measurements were performed in 15 mechanically ventilated patients and 10 healthy subjects. These studies demonstrated that delayed GE was associated with reduced antral activity, increased pyloric activity and increased retrograde duodenal activity in the patients. Persistent fasting motility during feeding was also frequently observed. Furthermore, the feedback response to small intestinal nutrients was enhanced. This latter observation may provide an explanation for the delayed GE and warrants further investigation. Recent studies suggest that the hormone cholecystokinin may be a mediator of increased small intestinal feedback and, if confirmed, this has clear therapeutic implications. Nutrient absorption has rarely been measured in the critically ill. GE and glucose absorption (using 3-O-methyl glucose) were measured simultaneously in 19 ICU patients and compared to 19 healthy subjects. Glucose absorption was shown to be markedly reduced in the patients. Slow GE was associated with delayed, and reduced, absorption. However, glucose absorption was also reduced in patients with normal GE suggesting that reduced glucose absorption in critical illness is only partly due to delayed GE. Accordingly, measures to improve the effectiveness of GE and thereby improve overall nutritional status may be compromised by abnormal small intestinal absorption. The mechanisms underlying this warrant further investigation. A number of therapeutic options directed at improving the delivery of nutrition were examined. In a study involving 20 mechanically ventilated patients, administration of 200mg erythromycin intravenously was shown to be superior to placebo for treating feed intolerance. The optimal dose of erythromycin, however, was unclear. In a subsequent study involving 35 ICU patients, GE was measured using a breath test technique, before and after 2 different doses of erythromycin or placebo and a ‘low’ intravenous dose (70mg) of erythromycin appeared to be as effective as a ‘moderate’ dose (200mg). Both doses were only effective in subjects who had delayed GE at baseline. Based on the outcome of these studies, low doses of erythromycin have subsequently been routinely used to treat feed intolerance in the critically ill patients at the Royal Adelaide Hospital. Animal and human studies suggested that the antibiotic, cefazolin, may have a prokinetic effect. Cefazolin, however, did not demonstrate similar prokinetic activity at a ‘low’ dose (50mg) in a critically ill cohort. The results of this study do not support the use of this agent, at this dose, as a prokinetic, in this population. If nasogastric administration of nutrition proves unsuccessful an alternative is to infuse nutrient directly into the small intestine. However, the placement of feeding tubes distal to the pylorus is technically difficult. A novel technique for postpyloric tube insertion was examined with promising results. In summary, the studies described in this thesis have provided a number of insights relevant to the management of the critically ill by quantifying the prevalence of feed intolerance and delayed GE, characterising some of the disturbances in gastrointestinal motility underlying this problem, and evaluating a number of therapeutic interventions. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1345143 / Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2008

Inadequate delivery of nutrition to the critically ill is common, and may adversely affect clinical outcomes, including survival. This thesis reports studies designed to characterise the gastrointestinal dysfunction underlying feed intolerance in the critically ill, as well as the pathophysiology of these dysfunctions, and investigate potential therapeutic measures. While it has been established that enteral nutrition is frequently unsuccessful in the critically ill, assessment of the success of feeding in an Australian intensive care unit (ICU) had not been performed previously. A prospective survey examined the incidence of, and risk factors for, feed intolerance in the ICU at the Royal Adelaide Hospital and demonstrated that, in 40 patients receiving enteral feeding, only about 60% of their nutritional requirements were met at the end of the first week. The main cause for this lack of success was large gastric residual volumes, indicative of delayed gastric emptying (GE). This study, accordingly, quantified the limitations of nutritional delivery in contemporary practice in a local ICU. The results suggest that a better understanding of the pathogenesis underlying this problem is warranted in order to direct research into improved therapies. Scintigraphy is the most accurate technique to measure GE, but is difficult to perform in the ICU. A simpler, more convenient, test would increase the accessibility of GE measurement for both research and clinical purposes. A study comparing a breath test technique and gastric residual volume measurement to the scintigraphic measurement of GE in 25 mechanically ventilated patients demonstrated that GE measured by a breath test technique closely correlated with that measured by scintigraphy. While the breath test had a specificity of 100% it only had a sensitivity of about 60% in the prediction of delayed GE. Similarly, gastric residual volume measurement correlated with scintigraphic measurement of GE but also lacked sensitivity. The breath test has previously been demonstrated to be highly reproducible and it represents a useful option for repeated measurement of GE in the same patient. It is therefore likely to be useful to determine changes in GE over time or in response to a therapeutic intervention. There is a lack of information about the prevalence and determinants of delayed GE in the critically ill. Previous studies have substantial limitations and scintigraphic measurement of GE has only rarely been used. A study comparing GE measured by scintigraphy in 25 patients to 14 healthy subjects demonstrated that GE was delayed in approximately 50% of the ICU patients (>10% retention at 4h) and markedly delayed in about 20% (>50% retention at 4h). Patients with trauma and sepsis appeared to have a relatively higher prevalence of delayed GE (80% and 75% respectively). In addition, the longer the patient had been in ICU the more normal the rate of GE. Quantification of delayed GE may prove useful by defining patients who may benefit from preventative or therapeutic options. The abnormalities in gastrointestinal motility underlying delayed GE in the critically ill are poorly characterised. Simultaneous manometric and gastric emptying measurements were performed in 15 mechanically ventilated patients and 10 healthy subjects. These studies demonstrated that delayed GE was associated with reduced antral activity, increased pyloric activity and increased retrograde duodenal activity in the patients. Persistent fasting motility during feeding was also frequently observed. Furthermore, the feedback response to small intestinal nutrients was enhanced. This latter observation may provide an explanation for the delayed GE and warrants further investigation. Recent studies suggest that the hormone cholecystokinin may be a mediator of increased small intestinal feedback and, if confirmed, this has clear therapeutic implications. Nutrient absorption has rarely been measured in the critically ill. GE and glucose absorption (using 3-O-methyl glucose) were measured simultaneously in 19 ICU patients and compared to 19 healthy subjects. Glucose absorption was shown to be markedly reduced in the patients. Slow GE was associated with delayed, and reduced, absorption. However, glucose absorption was also reduced in patients with normal GE suggesting that reduced glucose absorption in critical illness is only partly due to delayed GE. Accordingly, measures to improve the effectiveness of GE and thereby improve overall nutritional status may be compromised by abnormal small intestinal absorption. The mechanisms underlying this warrant further investigation. A number of therapeutic options directed at improving the delivery of nutrition were examined. In a study involving 20 mechanically ventilated patients, administration of 200mg erythromycin intravenously was shown to be superior to placebo for treating feed intolerance. The optimal dose of erythromycin, however, was unclear. In a subsequent study involving 35 ICU patients, GE was measured using a breath test technique, before and after 2 different doses of erythromycin or placebo and a ‘low’ intravenous dose (70mg) of erythromycin appeared to be as effective as a ‘moderate’ dose (200mg). Both doses were only effective in subjects who had delayed GE at baseline. Based on the outcome of these studies, low doses of erythromycin have subsequently been routinely used to treat feed intolerance in the critically ill patients at the Royal Adelaide Hospital. Animal and human studies suggested that the antibiotic, cefazolin, may have a prokinetic effect. Cefazolin, however, did not demonstrate similar prokinetic activity at a ‘low’ dose (50mg) in a critically ill cohort. The results of this study do not support the use of this agent, at this dose, as a prokinetic, in this population. If nasogastric administration of nutrition proves unsuccessful an alternative is to infuse nutrient directly into the small intestine. However, the placement of feeding tubes distal to the pylorus is technically difficult. A novel technique for postpyloric tube insertion was examined with promising results. In summary, the studies described in this thesis have provided a number of insights relevant to the management of the critically ill by quantifying the prevalence of feed intolerance and delayed GE, characterising some of the disturbances in gastrointestinal motility underlying this problem, and evaluating a number of therapeutic interventions. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1345143 / Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2008

The aim of the diploma thesis was to monitor seasonal concentration changes of 7 antibiotics norfloxacin, levofloxacin, ciprofloxacin, azithromycin, erythromycin, trimethoprim and sulfamethoxazole in wastewater influent and (cleaned) water effluent in the Sewage Treatment Plant (STP) České Budějovice. Time-proportional 24 hours pooled samples of wastewater were collected every month from March 2011 to February 2012 in the influent and effluent pof the STP. The concentrations of target compounds were determined by using in line SPE/LC-MS/MS analysis. The highest average concentration in the influent was detected in case of norfloxacin (0.563 microgram/l) and ciprofloxacin (0.406 microgram/l). The highest average concentration in the effluent was detected in the case of trimethoprim (0.255 microgram/l) and erythromycin (0.117 microgram/l). Higher concentration of antibiotics was measured in the colder periods of the year. It was connected with increased use of antibiotics and with less cleaning efficiency of the STP in this season. The highest removal efficiency was determined for norfloxacin and ciprofloxacin, the lowest for erythromycin. The influence of the season on the removal efficiency of antibiotics was found esp. for azithromycin,trimethoprim and sulfamethoxazole.

Erythromycin (ERY) is a macrolide antibiotic which is used in the treatment of acne vulgaris.Acne is a common skin condition that occurs when the sebaceous glands and hair shafts become infected by the bacteria Propionibacterium acnes. Acne is a chronic condition that may last for years and the severity of the effects of the disease on patients is often undermined especially in third world countries where more emphasis is placed on other more life-threatening diseases. It may cause considerable physical and emotional distress to sufferers along with the possibility of permanent scarring. Although use of topical ERY formulations is not the first line of treatment it has proven to be effective in treating inflammation of skin and skin structures cause by the responsible bacteria. To-date there are a variety of vehicles which are used in preparing topical ERY formulations namely ointment and gel bases, alcoholic solutions and pledgets. All the gel formulations on the market contain hydroxypropyl cellulose, alcohol and water along with the active ingredient(s). However, some gel formulations contain propylene glycol in addition to these excipients an example being Emgel®. Propylene glycol has been shown to affect the penetration of topically applied drugs through the skin suggesting that it would be highly likely that those formulations which contain propylene glycol may release more ERY into the skin following application. With this in mind, two ERY gel formulations were produced which contained different percentages of propylene glycol. According to the FDA guidelines, pharmacokinetic measurements in blood, plasma and/or urine of topical dermatological drug products are not feasible to document bioequivalence since the active ingredient(s) in topical formulations is/are not intended to be absorbed into the systemic circulation and in addition, concentrations in extracutaneous biological tissues would generally not be measurable. This limits determination of bioavailability and assessment of bioequivalence of such products to pharmacodynamic measurements, clinical trials and dermatopharmacokinetic (DPK) measurements such as tape stripping (TS) and microdialysis (MD).TS is a sampling technique which involves sequential removal of layers of the stratum corneum using strips of adhesive tape. This technique has found increasing use in DPK studies for investigation of drug kinetics in the skin following the application of a topical formulation. The technique has also been used as a diagnostic tool in assessing the quality of the stratum corneum in diseased skin. In the current research study, the tape stripping technique was used to investigate the pharmaceutical/biological availability of topical gel formulations containing ERY. MD is another DPK sampling technique which has been used to determine the amount of a topically applied drug that penetrates through the stratum corneum to reach deeper tissues of the skin. The in vivo sampling technique involves the insertion of microdialysis probes beneath the skin surface in the dermal tissue and allows for real-time sampling of the analyte at its target site. Recently in vitro MD has also been successfully used to assess the pharmaceutical availability of a topical corticosteroid, mometesone furoate, from topical formulations. Based on this work, microdialysis was used to determine the pharmaceutical availability of ERY from gel formulations which were developed for use in this research. The results of the pharmaceutical availability of ERY from in vivo tape stripping studies and the in vitro microdialysis studies were compared to establish correlation between the data. Pharmaceutical equivalence and bioequivalence data obtained from the respective studies on the gel formulations were investigated by statistical analysis of the data generated from both the in vitro and in vivo experiments. In summary the objectives of this research were: 1. To develop and validate a high performance liquid chromatography method suitable to analyse ERY concentrations obtained from in vitro microdialysis studies and in vivo tape stripping studies. 2. To prepare two different ERY gel formulations with different percentage content of propylene glycol. 3. To determine the pharmaceutical availability of ERY from two different gel formulations using in vitro microdialysis. 4. To develop and validate a tape stripping technique which could be used to determine percutaneous penetration and bioequivalence of the gel formulations. 5. To compare in vitro microdialysis and in vivo tape stripping data and attempt to establish a correlation between the two different approaches.

L'inhalation pulmonaire du contenu gastrique représente l'une des principales causes de mortalité liée à l'anesthésie en France. La physiopathologie de cette complication fait intervenir, entre autres, la présence d'un contenu gastrique à l'origine d'une augmentation de la pression intragastrique favorisant la survenue de régurgitations et d'inhalations pulmonaires lors de l'anesthésie générale. La prévention de cette complication repose sur l'identification des patients à risque, ainsi que sur l'établissement de stratégies permettant de réduire le contenu gastrique. Suivant ces deux objectifs, nous avons conduit quatre études. Nous avons décrit et évalué l'apport de la mesure échographique de l'aire de section antrale pour l'estimation du volume du contenu gastrique en période préopératoire afin d'identifier les patients à risque d'inhalation pulmonaire. Nous avons montré chez des volontaires sains que la perfusion de 250 mg d'érythromycine est efficace pour accélérer la vidange gastrique des aliments solides lors de la gastroparésie induite par un stress douloureux. Enfin, nous avons déterminé le niveau de pression inspiratoire minimisant l'insufflation d'air dans l'estomac tout en assurant une ventilation satisfaisante lors de la ventilation au masque facial précédant l'intubation trachéale. Ce dernier résultat doit contribuer à modifier les recommandations afin d'améliorer la sécurité des patients lors de la ventilation au masque facial en anesthésie. En perspective d'avenir, l'échographie antrale permettra la réalisation d'études cliniques visant à préciser chez les patients opérés en urgence le risque d'inhalation pulmonaire et évaluant l'efficacité des mesures de prévention / Pulmonary aspiration of gastric content is one of the main causes of mortality related to anesthesia in France. The pathophysiology of this complication involves, among others, the presence of gastric content causing an increase in intragastric pressure leading to regurgitation and pulmonary inhalation during general anesthesia. Prevention of this complication is based on both identifying patients at risk and developing strategies to reduce the gastric contents. Following these two objectives, we conducted four studies. We have described and assessed the contribution of the ultrasound measurement of the antral cross-sectional area for estimating the preoperative volume of gastric content, in order to identify patients at risk of pulmonary aspiration. We have shown in healthy volunteers that the infusion of erythromycin 250 mg was effective in accelerating gastric emptying of solids during gastroparesis related to acute painful stress. Finally, we determined the level of inspiratory pressure that minimizes the risk of gastric insufflation while providing adequate ventilation during facemask ventilation performed prior to tracheal intubation. This result should contribute to the revision of the current recommendations, in order to improve the patient safety during facemask ventilation. In the future, ultrasound measurement of antral area can be used in clinical studies in order to clarify the risk of pulmonary aspiration of gastric content in emergency surgical patients, and to assess the effectiveness of preventive measures

Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology and Toxicology Student: Veronika Ackermannová Supervisor: prof. Radomír Hrdina, MD, CSc. Title of diploma thesis: Topic and systemic treatment of acne vulgaris Acne vulgaris is a skin disease affecting the hair follicles and sebaceous glands. The disease manifests itself by increased sebum production, non-inflammatory (comedones) and inflammatory lesions (papules, pustules, nodules, cysts). It occurs predominantly in adolescents, but may persist into adulthood. It is a multifactorial disease, which is caused by several factors (internal and external stimuli). The major pathogenetic factors include increased sebum production, hyperkeratosis, P. acnes colonization and inflammation present. First, it is necessary to diagnose the type of acne in order to choose the right and effective therapy, because there is not only one type of acne. There are many types and variants of acne, and although they show similar symptoms (affecting the follicles of sebaceous glands), their cause often differs. There is no uniform classification system for acne vulgaris and it varies between authors. Some authors classify acne vulgaris according to severity into mild, moderate and severe, others into comedonic, papulopustular, nodulocystic...

Le développement de biofilms est étudié sur de longues périodes (de deux à sept mois) dans des réacteurs à disque tournant (RBC) et à lit fixe alimentés par des eaux résiduaires domestiques ou des substrats synthétiques en continu à l’échelle du laboratoire. Deux réacteurs ont été spécialement conçus pour des expériences. Les biofilms ont été soumis à des stress physiques (forces hydrodynamiques) ou chimiques (antibiotique). L’activité biologique des réacteurs a été suivie au cours du temps (dégradation de la pollution carbonée et azotée). Les phénomènes de détachement et de redéveloppement des biofilms ont été caractérisés sur des surfaces lisses ou structurées par des techniques d’analyse d’images non destructives. La quantité globale de biomasse présente est évaluée par l’opacité du biofilm et cette méthode d’évaluation a été validée par comparaison avec des méthodes classiques destructives (coloration au Cristal Violet, matières sèches). La macrostructure du biofilm, liées aux phénomènes de croissance, détachement et recroissance, a été évaluée à l’aide de deux méthodes de caractérisation de la texture visuelle : la méthode de cooccurrence de niveaux de gris (SGLDM) et la longueur des segments (GLRLM). Le travail montre l’efficacité de l’analyse d’images comme une méthode rapide et peu onéreuse dans l’étude des biofilms sur le long terme. / The development of biofilm has been studied over long periods of time (two to seven months) in laboratory-scale rotating biological contactors and fixed bed reactors continuously fed with municipal wastewater or synthetic growth media. Two reactors have been specifically designed for this purpose. The biofilms have been subject to hydrodynamic and chemical (antibiotics) stresses. The overall biological activity of the reactors have been monitored, in terms of carbon and nitrogen removal. The phenomena of sloughing and re-growth have been characterized on smooth and rough surfaces using image analysis non-destructive techniques. The amount of biomass present on the substratum has been evaluated by the biofilm opacity and this monitoring method has been validated by comparison with destructive methods such as crystal violet staining and dry weight. The biofilm macrostructure, related to growth, sloughing and re-growth phenomena, has been evaluated through visual texture characterization of the scanning gray level co-occurrence matrix (SGLDM) and the gray level run length method (GLRLM). The results shows the efficiency of image analysis as a rapid and cheap method to monitor biofilm development on the long term.