No abstract

Thermodynamic values of the ionization constants and tautomeric equilibrium constants of pyridoxine and 3-hydroxypyridine were determined in dioxane-water at 25 "C. The Born model is unable to explain the effect of the solvent on these constants. The logarithms of the equilibrium constants calculated change linearly according to the logarithm of the molar water content in the mixture, up to 40% dioxane in the case of pyridine ionizations, and up to 70% dioxane (maximum content investigated) for the phenol ionizations. The effect of protonation of either the phenolate or pyridinium nitrogen groups on the pK of the other group in these substances increases when the water content in the medium is decreased.

A remarkable temperature dependence on the 13C NMR and 15N NMR chemical shifts of pyridoxine in water (pH = 7.0) has been observed. C-3, C-6, and N-1 were the most sensitive nuclei to the temperature effect. This dependence has been explained on the basis of an equilibrium shift thermally induced between the neutral and the dipolar form of this molecule. The thermodynamic characterization of tautomeric equilibria that interconvert quickly on the NMR time scale can be carried out from the observed average 13C NMR and 15N NMR chemical shifts at different temperatures (5-90 degrees C). We have developed a new method for the estimation of the thermodynamic parameters of a given equilibrium by fitting the experimental data to a theoretical curve. This new method allows us to improve the fitting results on our previously proposed methodology. We show that there are linear correlations between the average chemical shifts obtained from different nuclei at the same temperature. This indicates that the parameters of the pure forms are related among them. We have carried out a simultaneous multiple function curve fitting of all data obtained from the most sensitive signals together using these linear correlations as restricted conditions in order to diminish the number of independent parameters to fit. To test the new methodology, we have studied the thermodynamics of the tautomeric equilibrium of pyridoxine in water. We have obtained delta H degree values ranging from -23.6 +/- 1.3 to -25.8 +/- 1.7 kJ/mol for this equilibrium depending on the used data set. This kind of methodology has, among others, the following advantages: It allows the use of a great number of experimental points from different signals in the fitting process, it yields very precise and accurate values of the tautomeric process, and it allows the resolution of the problem with only 13C NMR data in some cases saving NMR time.

Acute lung injury (ALI), including its most serious form called acute respiratory distress syndrome (ARDS), is a devastating disease that can occur at any age. ALI/ARDS accounts for only 5-8% of admissions to pediatric intensive care units (PICUs) but is fatal in 30-60% of cases. International multicenter prospective studies are needed to better understand pediatric ALI/ARDS. However, a reproducible definition of ALI/ARDS is crucial to ensure that study populations are homogeneous. We designed a retrospective review to test the inter-observer variability of chest radiograph interpretation for presence of the American-European Consensus Conference (AECC) radiographic criterion for ALI/ARDS. The medical files of 24 children ventilated for ALI/ARDS in our PICU between January 1993 and December 2002 were reviewed. Five pediatric radiologists and five pediatric intensivists interpreted one frontal chest radiograph (FCR) per patient taken on the day of ALI/ARDS diagnosis. Each reader indicated whether the radiograph showed the AECC radiographic criterion for ALI/ARDS. Data analysis involved comparing each reader to all the others based on the raw agreement and Kappa coefficient (kappa). Features in the 24 patients were consistent with earlier studies. Global inter-observer agreement beyond chance was fair (kappa = 0.29 +/- 0.02) among the five radiologists (kappa = 0.26 +/- 0.05) and among the five intensivists (kappa = 0.29 +/- 0.05). Thus, considerable inter-observer variability occurred in assessing the radiographic criterion for ALI/ARDS, as previously shown in adults. Given the low incidence of ALI/ARDS in children, this variability may have a large impact in studies of pediatric ALI/ARDS.