Thesis (M.S.) University of Missouri-Columbia, 2004. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file viewed on (June 30, 2006) Vita. Includes bibliographical references.

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Background: As part of this thesis work, we developed a Shower Technique protocol (‘STP’) for hemodialysis patients with healed central venous catheter (catheter) exit sites, designed to permit showering but not increase infection risk. Research question: Is it feasible to conduct a randomized control trial called the Hemodialysis Infection Prevention using Polysporin Ointment with Shower Technique in Satellite Centres (HIPPO SAT) study comparing the rate of CRB in adult satellite hemodialysis patients using STP versus standard catheter care alone with 6 month follow up? Study Design: The HIPPO SAT pilot study is a multi-centre randomized control trial. Eligible participants will be randomized to STP versus standard care after meeting predefined criteria to confirm healed tunneled catheter exit site. Primary Outcome: Feasibility will be determined based on 5 outcome measures: accuracy of the CRB rate documentation in the satellite setting, and percentage of patients screened, recruited, educated successfully in the STP (intervention arm), and using aspects of STP (% of contaminated patients in the control arm). Study Setting: In satellite units affiliated with 2 academic and 3 community centres in south central Ontario, Canada. Patient Population: Adult satellite Hemodialysis patients dialyzing via catheter with healed catheter exit sites. Intervention: STP and standard catheter care; or Control: standard catheter care; Analysis: Each measure of feasibility has its statistical threshold for success. If the threshold is reached in 4 of the 5 measures, the full HIPPO SAT study will be deemed feasible. Discussion: A pilot feasibility study of the larger study is critical due to the potential challenges associated with recruitment, compliance and contamination. / Thesis / Master of Science (MSc)

Thesis (M.E.)--University of Waikato, 2008. / Title from PDF cover (viewed September 18, 2008) Includes bibliographical references (p. 66-70)

The use of controlled release dosage forms has increased significantly in recent years as they result in increased patient compliance and higher therapeutic efficiency. This research focused on the development of a once daily dosage form that could be used for the treatment of hypertension. Both a separate sustained release dosage of metoprolol tartrate and a combination dosage form that included both an immediate release hydrochlorothiazide and a sustained release metoprolol component, were developed and evaluated. A matrix tablet, consisting of an ethylcellulose ranulation of metoprolol tartrate compressed into a hydrophilic hydroxypropyl methylcellulose polymer matrix, effectively sustained metoprolol release over a 22-hour experimental period. A multiparticulate combination dosage form that consisted of six coated mini matrix tablets of metoprolol and a powder blend of hydrochlorothiazide packed into a gelatin capsule, displayed zero order release kinetics for metoprolol release over 22 hours (r2=0.9946). The release of hydrochlorothiazide was found to be comparable to that of a commercially available product tested. Differential Scanning Calorimetry was used to identify possible incompatibilities between MPTA and excipients initially, and long term stability testing was used to assess to behaviour of the dosage form. Dissolution testing of the dosage forms was performed using USP Apparatus III, which was found to be more discriminating between the batches assessed. Dissolution curves were evaluated for similarity and difference using f1 and f2 fit factors. Samples were analyzed using a high performance liquid chromatographic method that was developed and validated for the simultaneous determination of the compounds of interest. Various factors influencing drug release from the developed dosage forms were assessed and recommendations for further optimization of the formulation are made. Factors evaluated included the quantity of granulating fluid, matrix polymer content, drug load and process variables, including drying time and compression force. The influence of various coating levels on drug release was assessed and none of the levels assessed were found to adequately retarded drug release over a 22-hour period. Combinations of tablets coated to different levels allowed for the successful development of a sustained release metoprolol component, which could be included into the combination dosage form.

Class of 2006 Abstract / Objectives: To determine the economic impact of controlled substance destruction in multiple long term care facilities in Southern Arizona and to identify related demographic characteristics of the patients and facilities. Methods: Subjects had controlled substance prescriptions destroyed at nursing homes serviced by a pharmacy nursing home provider in Tucson, Arizona. Controlled substances destruction records and existing prescription records were reviewed and data was collected on the name, strength, number of units destroyed, date of destruction and schedule of each controlled medication that was destroyed for a particular patient over the course of a year. Demographic data was collected on patient gender, age, type of insurance coverage and the size of the nursing home facilities. Results: A total of 1095 controlled substance prescriptions were destroyed during the time period of the study and the total cost of destroyed medication was $26,886.37. The average cost of destroyed medication per prescription was $24.55 ± 60.38 (mean ± SD). Schedule II controlled substances accounted for the highest total cost per prescription destroyed and destruction of unused controlled substances cost indigent insurance programs more than any of the other payers studied. There was no difference in mean cost per prescription destroyed by facility, therapeutic class or between women and men. Conclusions: The value of controlled substance destruction in long term care facilities is sizeable. To reduce waste, prescribers and pharmacy providers should initially dispense moderate quantities of controlled substances until it is apparent that the medication is tolerable and efficacious for the patient.

International Telemetering Conference Proceedings / October 26-29, 1992 / Town and Country Hotel and Convention Center, San Diego, California / The uncertainty in the gain of voltage controlled crystal oscillators (VCXOs) used in the implementation of certain analog phase-locked loops (PLLs) suggests some form of automatic tuning algorithm, both for pretuning and during operation. This paper proposes an adaptive PLL (APLL) algorithm to fill this need for PLLs used in the recovery of tones in noise. This algorithm makes use of a resonant error algorithm to remove the effects of VCXO noise, measurement noise, and parasitic poles. Both classical convergence theorems and robustness theorems that indicate the functionality of the proposed algorithm are given. Finally, the implementation of this algorithm is considered.

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