Background Failures in non-technical skills (NTS) contribute to adverse events in healthcare. Previous research has explored the assessment and training of these skills, and yet there is a lack of evidence for their impact on clinical outcomes. Gastrointestinal endoscopy is a high-pressure specialty, but to date there is little on the role of NTS in this area, or a method for their assessment. This MD project aims to measure NTS in endoscopy, explore their relationship with clinical outcomes, and identify those specific to this area of healthcare. Methods An observational study of endoscopy teams in real time, using the Oxford NOTECHS II assessment tool. Comparison of NTS performance with procedure outcomes and patient satisfaction. A qualitative interview study with staff members to establish the NTS specifically relevant to working in gastrointestinal endoscopy. Results Reliability of the Oxford NOTECHS II tool by a single rater in this environment was good. Positive relationships were found between NTS scores and polyp detection, scope withdrawal time and completion of items on a safety checklist. However, relationships with other outcomes, including patient satisfaction were weak, or inconclusive. The themes identified relating to NTS in gastrointestinal endoscopy were leadership, working together as a team, situation awareness, making decisions, the patient and communication. Conclusions Although few conclusive relationships were found between NTS performance and procedure outcomes, those positive associations found seem logical as they are likely to reflect increased care and vigilance. This may have been affected by a lack of variation in scores. The NTS relevant to this area are similar to other areas of healthcare. However, the interaction with and around the awake patient is unique to endoscopy and an important influence on the NTS that staff must possess. There is scope to develop a more specific tool for the assessment of NTS in endoscopy.

Dispepsia funcional e hipolactasia primária do tipo adulto (HPTA) são duas condições altamente prevalentes na prática clínica. Ambas podem coexistir ou até mesmo serem confundidas devido à sobreposição de alguns dos seus sintomas, principalmente a sensação de distensão abdominal. No entanto, a literatura é escassa em relação a estudos que tenham avaliado a associação entre a dispepsia funcional e a HPTA. O presente trabalho tem o objetivo investigar a associação entre a HPTA e a dispepsia funcional, através da análise molecular da HPTA em pacientes dispépticos funcionais e controles assintomáticos. Pacientes dispépticos funcionais (conforme os critérios de Roma III) e voluntários assintomáticos foram convidados para participar do estudo. Indivíduos com genótipo CC do polimorfismo de nucleotídeo único -13910C/T eram considerados portadores de HPTA. Os sintomas dispépticos (dor em abdômen superior, náuseas, vômitos, sensação de distensão abdominal e saciedade precoce) foram avaliados através de um questionário validado (Porto Alegre Dyspeptic Symptoms Questionnaire). Foram incluídos 408 indivíduos no estudo (197 dispépticos funcionais e 211 controles). HPTA foi identificada em 88 (44,7%) dispépticos funcionais e 107 controles (50,7%) (P=0,468). No grupo dos dispépticos funcionais, os escores dos sintomas dispépticos foram comparados entre os pacientes classificados como portadores de HPTA e aqueles classificados como “não portadores de HPTA”. Foi observado maior escore da sensação de distensão abdominal em dispépticos funcionais com HPTA do que em dispépticos sem HPTA (P=0,014). Não foram observadas diferenças entre os grupos em relação aos escores dos demais sintomas. Em conclusão, a ausência de diferença na frequência de HPTA entre todos os dispépticos funcionais e o grupo de indivíduos assintomáticos indica que não há uma associação entre a HPTA e a dispepsia funcional como um todo. No entanto, o maior escore da sensação de distensão abdominal entre os dispépticos funcionais com HPTA sugere um papel da HPTA em uma parcela dos pacientes com dispepsia funcional. / Functional dyspepsia and Adult Type Hypolactasia (ATH) are frequent conditions that may coexist or even be confounded. There may be some overlap between their symptoms, especially abdominal bloating. Studies on this association are scarce. The aim of the study is to investigate the association between functional dyspepsia and ATH, through molecular analysis of ATH in functional dyspeptics and asymptomatic individuals. Patients with functional dyspepsia according to Rome III criteria and volunteers for blood donation were invited to participate in the study. A CC genotype por -13910C/T SNP was diagnostic of ATH. Five symptoms of functional dyspepsia (upper abdominal pain, nausea, vomiting, abdominal bloating and early satiety) were evaluated using a validated questionnaire (Porto Alegre Dyspeptic Symptoms Questionnaire). A total of 408 subjects were included in the study (197 functional dyspeptics and 211 controls). Eighty-eight dyspeptic patients (44.7%) had ATH, compared to 107 individuals (50.7%) in the control group (P=0.468). In the group of dyspeptic patients, mean scores of symptoms were compared between those classified as ATH and non-ATH. Dyspeptic patients with ATH had higher scores for abdominal bloating, compared to non-ATH patients (P=0.014). The scores of the other dyspeptic symptoms were not statistically different between those two groups. In conclusion, the similar frequency of ATH in patients with functional dyspepsia and asymptomatic individuals indicate an absence of association between functional dyspepsia and ATH. However, our data of higher bloating scores among functional dyspeptics with ATH suggest a possible role of ATH in a subset of patients with functional dyspepsia.

Made available in DSpace on 2014-06-11T19:31:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-10-21Bitstream added on 2014-06-13T19:01:20Z : No. of bitstreams: 1 salustiano_cdp_dr_arafcf_parcial.pdf: 86471 bytes, checksum: ee7a3f86ed5d954c992727084adad5fe (MD5) Bitstreams deleted on 2015-06-25T13:00:52Z: salustiano_cdp_dr_arafcf_parcial.pdf,. Added 1 bitstream(s) on 2015-06-25T13:03:16Z : No. of bitstreams: 1 000726367_20151121.pdf: 77715 bytes, checksum: 9ef1ca3d6fb280acf83fda564061eb3b (MD5) Bitstreams deleted on 2015-11-27T16:10:06Z: 000726367_20151121.pdf,. Added 1 bitstream(s) on 2015-11-27T16:10:44Z : No. of bitstreams: 1 000726367.pdf: 1071257 bytes, checksum: aa7fdbf896155c5ee4a1761c2b89829b (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Objetivo: verificar a associação do estado nutricional com as características demográficas e clínicas de pacientes com câncer gastrointestinal e estimar a efetividade de diferentes métodos de diagnóstico do estado nutricional frente à Avaliação Subjetiva Global – Produzida Pelo Paciente Escore (ASG-PPP escore). Métodos: Participaram 143 pacientes adultos com câncer gastrointestinal, atendidos na Enfermaria de Oncologia Clínica do Hospital Amaral Carvalho (Jaú-SP), no período de novembro de 2010 a outubro de 2011. Foram levantadas informações para a caracterização demográfica e clínica. Os métodos de diagnóstico do estado nutricional testados foram a relação entre o Peso Real e o Peso Habitual (PR/PH), o Índice de Massa Corporal (IMC), o Índice de Risco Nutricional (NRI) e a Porcentagem de Adequação (Escore %) e como método padrão-ouro utilizou-se a ASG-PPP escore. Para estudos das associações de interesse utilizou-se o teste de qui-quadrado (2). Estimou-se a razão de prevalência (RP). A efetividade dos métodos para detecção do risco de desnutrição ou da presença de desnutrição foi avaliada. Construiu-se a curva ROC e sua área (AUROC) foi estimada. As áreas foram comparadas pela estatística z. Para cada método estabeleceu-se o melhor ponto de corte. Adotou-se nível de significância de 5%. Resultados: A prevalência de desnutrição entre os pacientes avaliados foi de 44,8%. Observou-se que os indivíduos com baixo nível de escolaridade e expostos a alguns sintomas relatados na ASG-PPP escore apresentaram maior chance (RP) de serem classificados como desnutridos. Todos os métodos apresentaram adequada capacidade discriminatória para detecção do risco de desnutrição e presença de desnutrição. O IMC foi significativamente melhor para detecção de desnutrição do que do risco de desnutrição... / Objective: To investigate the association between nutritional status and demographic and clinical characteristics of patients with gastrointestinal cancer and estimate the effectiveness of different methods of diagnosing nutritional status across the Scored Patient-Generated Subjective Global Assessment (scored PG-SGA). Methods: The participants were 143 adult patients with gastrointestinal cancer, cared for in the Infirmary of the Oncology Clinic of the Hospital Amaral Carvalho (Jaú- SP), from November 2010 to October 2011. A survey was conducted to collect information for the purpose of demographic and clinical characterization. Diagnostic methods of nutritional status were tested to the ratio between Real Weight and Habitual Weight (RW/HW), Body Mass Index (BMI), Nutritional Risk Index (NRI) and Percentage Adequacy (Score %) and as gold standard method the scored PG-SGA was used. For the associations of interest the Chi-square (2) test was used. The prevalence ratio (PR) was estimated. The effectiveness of the methods for detecting the risk for or presence of malnutrition was evaluated. A ROC curve was constructed and its area (AUROC) was estimated. The areas were compared using z statistics. For each method the best cut-off point was established. The level of significance adopted was 5%. Results: The prevalence of malnutrition was 44.8%. It was observed that individuals with low education level and exposed to some of the symptoms related in the scored PG-SGA presented greater chance (PR) of being classified as undernourished. All the methods showed adequate discriminatory capacity for detecting the risk of malnutrition and presence of malnutrition. The BMI was significantly better for detecting malnutrition than for the risk of malnutrition. The RW/HW was significantly better... (Complete abstract click electronic access below)

Submitted by SIMONE MANSO DE CARVALHO PELICIA null (carvalhomone@terra.com.br) on 2017-03-24T18:58:00Z No. of bitstreams: 1 DoutoradoSMCP.pdf: 867427 bytes, checksum: 88fac2bedf02a720ee41442baba399d2 (MD5) / Approved for entry into archive by Luiz Galeffi (luizgaleffi@gmail.com) on 2017-03-24T19:36:28Z (GMT) No. of bitstreams: 1 pelicia_smc_dr_bot.pdf: 867427 bytes, checksum: 88fac2bedf02a720ee41442baba399d2 (MD5) / Made available in DSpace on 2017-03-24T19:36:28Z (GMT). No. of bitstreams: 1 pelicia_smc_dr_bot.pdf: 867427 bytes, checksum: 88fac2bedf02a720ee41442baba399d2 (MD5) Previous issue date: 2017-02-20 / Introdução: A pré-eclâmpsia é a principal indicação médica para o nascimento prematuro. Apesar dos sintomas maternos parecerem resolvidos com o nascimento do concepto, há evidências cada vez maiores indicando que a pré-eclâmpsia está associada a alterações em longo prazo na mãe e filho. A falta de conhecimento sobre as alterações fisiopatológicas dos RN de mães com PE é um fator limitante nos cuidados neonatais e motivou a realização desse estudo Objetivo: Avaliar em RN de mães com pré-eclâmpsia as alterações de fluxo sanguíneo da artéria mesentérica superior (AMS) bem como a evolução neonatal, comparando os RN de mães com PE versus mães normotensas. Método: Estudo observacional prospectivo com 120 prematuros menores que 34 semanas divididos em 60 filhos de mães com pré-eclâmpsia pareados pela idade gestacional com 60 prematuros de mães normotensas no período de 2013 a 2106. Foram avaliados dados clínicos no primeiro mês de vida e fluxo sanguíneo da artéria mesentérica superior (AMS) por ultrassom Doppler nas primeiras 72 horas. Resultados: O ultrassom Doppler mostrou que há diminuição nos fluxos pico sistólico e diastólico dos filhos de mães com PE com controle de variáveis que influenciam a vasculatura neonatal (p<0,05). Na avaliação dados maternos e gestacionais houve aumento do número de casos das seguintes variáveis nas mães com PE: uso de corticoide ante natal, trabalho de parto prematuro, uso de antibiótico intraparto e parto cesárea. Nas variáveis de nascimento e neonatais encontramos que os filhos de mãe com PE são em maior número nas seguintes variáveis: peso para a idade gestacional, restrição de crescimento fetal e uso de ventilação com pressão positiva. A correlação dessas variáveis com a Dopplerfluxometria não mostrou alteração dos valores de pico sistólico e diastólico dos filhos de mães com pré-eclâmpsia. Conclusão: A pré-eclâmpsia altera o fluxo da AMS nos primeiros dias de vida, no entanto, não há aumento de intercorrências alimentares nesses recém-nascidos. / Introduction: Pre-eclampsia is the primary medical indication for preterm birth. Although maternal symptoms seem to be solved after the birth of the neonate, there are increasing evidences that pre- eclampsia is associated with effects in the mother and in the child in the long run. Lack of knowledge about the pathophysiological effects on the neonates from mothers having PE is a limiting factor in neonatal care and this has urged this study. Objective: Evaluating the changes in the blood flow of the superior mesenteric artery (MAS) in preterm neonates from mothers who have PE, as well as the neonatal evolution, comparing to neonates from mothers with PE versus normotensive mothers. Method: Prospective observational study with 120 premature neonates younger than 34 weeks divided into 60 babies from mothers with pre-eclampsia, paired by the gestational age with 60 preterm neonates from normotensive mothers within the period 2013 to 2016. Clinical data in their first month and the blood flow of the superior mesenteric artery (MAS) have been assessed by Doppler ultrasound in the first 72 hours. Results: Doppler ultrasound showed that there was a decrease in the systolic and diastolic peak flows of the neonates from mothers who had PE with control of variables influencing neonatal vasculature (p <0.05). In the evaluation of the maternal and of the gestational data, there was an increase in the number of cases of the following variables in mothers who had PE: antenatal corticoid use, preterm labor, intrapartum antibiotic use and cesarean delivery. In birth and neonatal variables it was found out that the neonates from mothers who had PE outnumber in the following variables: weight for gestational age, fetal growth restriction and the use of ventilation with positive pressure. The correlation of these variables with Doppler flowmetry has not shown alterations in the systolic and diastolic peak values in neonates from mothers having pre-eclampsia. Conclusion: Pre-eclampsia modifies the flow of the MAS in the first days of life; however, there is no increase in dietary complication in these newborn children.

Orientador: Ligia Maria Suppo de Souza Rugolo / Resumo: Introdução: A pré-eclâmpsia é a principal indicação médica para o nascimento prematuro. Apesar dos sintomas maternos parecerem resolvidos com o nascimento do concepto, há evidências cada vez maiores indicando que a pré-eclâmpsia está associada a alterações em longo prazo na mãe e filho. A falta de conhecimento sobre as alterações fisiopatológicas dos RN de mães com PE é um fator limitante nos cuidados neonatais e motivou a realização desse estudo Objetivo: Avaliar em RN de mães com pré-eclâmpsia as alterações de fluxo sanguíneo da artéria mesentérica superior (AMS) bem como a evolução neonatal, comparando os RN de mães com PE versus mães normotensas. Método: Estudo observacional prospectivo com 120 prematuros menores que 34 semanas divididos em 60 filhos de mães com pré-eclâmpsia pareados pela idade gestacional com 60 prematuros de mães normotensas no período de 2013 a 2106. Foram avaliados dados clínicos no primeiro mês de vida e fluxo sanguíneo da artéria mesentérica superior (AMS) por ultrassom Doppler nas primeiras 72 horas. Resultados: O ultrassom Doppler mostrou que há diminuição nos fluxos pico sistólico e diastólico dos filhos de mães com PE com controle de variáveis que influenciam a vasculatura neonatal (p<0,05). Na avaliação dados maternos e gestacionais houve aumento do número de casos das seguintes variáveis nas mães com PE: uso de corticoide ante natal, trabalho de parto prematuro, uso de antibiótico intraparto e parto cesárea. Nas variáveis de nascimento e n... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Pre-eclampsia is the primary medical indication for preterm birth. Although maternal symptoms seem to be solved after the birth of the neonate, there are increasing evidences that pre- eclampsia is associated with effects in the mother and in the child in the long run. Lack of knowledge about the pathophysiological effects on the neonates from mothers having PE is a limiting factor in neonatal care and this has urged this study. Objective: Evaluating the changes in the blood flow of the superior mesenteric artery (MAS) in preterm neonates from mothers who have PE, as well as the neonatal evolution, comparing to neonates from mothers with PE versus normotensive mothers. Method: Prospective observational study with 120 premature neonates younger than 34 weeks divided into 60 babies from mothers with pre-eclampsia, paired by the gestational age with 60 preterm neonates from normotensive mothers within the period 2013 to 2016. Clinical data in their first month and the blood flow of the superior mesenteric artery (MAS) have been assessed by Doppler ultrasound in the first 72 hours. Results: Doppler ultrasound showed that there was a decrease in the systolic and diastolic peak flows of the neonates from mothers who had PE with control of variables influencing neonatal vasculature (p <0.05). In the evaluation of the maternal and of the gestational data, there was an increase in the number of cases of the following variables in mothers who had PE: antenatal corticoi... (Complete abstract click electronic access below) / Doutor

Introduction. Safe closure of gastric luminal defects remains a big challenge for development of gastric endoscopic surgery. The aims of this thesis are to assess the effect and efficiency of Eagle Claw VIII (endoscopic suturing device)and adipose tissue-derived mesenchymal stem cells (ADMSCs) for closure and enhancing healing of gastric luminal defects. / Methods and Results. 1. Endoscopic suturing is superior to endoclips for closure of gastrotomy after NOTES. A 2cm linear incision on the body of porcine stomach was closed by hand suturing, Eagle Claw VIII or endoclips, respectively (n=17 for each group). The results indicated that all gastrotomies were successfully closed. Closure time was significantly longer in Eagle Claw VIII group. Bursting pressure of gastrotomies for Eagle Claw VIII was significantly higher than endoclips, but lower than hand suturing. Besides, both Eagle Claw VIII and endoclip closure encountered significantly technical challenges. This study suggested that Eagle Claw VIII had potential for endoscopic closure of gastrotomies, but need further refinement. / 2. ADMSCs for Acceleration of Healing of Sutured Gastric Perforation(SGP). ADMSCs were isolated and expanded in vitro, and characterized by stromal differentiations and cell surface markers. A 2cm SGP was produced on gastric body of rats. 5×10⁶ ADMSCs were transplanted into SGP by local injection (LI-ADMSCs) or topical spraying (TS-ADMSCs). Healing of SGP was assessed. LI-ADMCs significantly decreased peritoneal adhesion and wound dehiscence, and increased bursting pressure of SGP, when comparing to other experimental groups. Histologic analysis indicated that SGPs in LI-ADMSCs group had more re-epithelialization and collagen regeneration, and less inflammation. Expression of TGF-β1 was up-regulated, while IL-6 was down-regulated in LI-ADMSCs group, when comparing to fibrin and control groups. This study suggested that local injection of ADMSCs is an effective approach for accelerating the healing of SGP. / 3. Promoting Effect of ADMSCs on Healing of Gastric Ulcer is abrogated by NSAIDs. Gastric ulcer model in rats was successfully produced by using 70% acetic acid. A total of 1×10⁷ ADMSCs was locally injected into ulcer lesion. Ulcer area was measured at different time points. Therapeutic potentialof ADMSCs was assessed when NSAIDs was simultaneously administrated. The results demonstrated that ADMSCs significantly decreased ulcer area. Histologic assessment indicated that ADMSCs increased re-epithelialization, angiogenesis and collagen deposition, and suppressed inflammation. Transplanted ADMSCs homed into gastric ulcer lesion and differentiated into endothelial and smooth muscle cells. In addition, ADMSCs treatment increased the gene expressions for wound healing, and activated COX-2-PGE₂ and Erk1/2-MAPK signaling pathways. Repeated administration of Indomethacin reduced cell proliferation and angiogenesis, and eliminated ADMSCs-induced ulcer healing on day 10. The results suggested that ADMSCs promoted the healing of peptic ulcer, which is eliminated by NSAIDs. / Conclusions. Endoscopic suturing by Eagle Claw VIII is feasible for closure of gastrotomy, when comparing to endoclips. ADMSC promotes the healing of gastric luminal defects including SGP and ulcer. The promoting effect of ADMSC is PGE₂-dependent, and attenuated by NSAIDs. These evidences implied that combined use of endoscopic suturing and ADMSCs is a helpful approach for safe closure of gastrotomy and gastric perforation. / 引言：胃傷口癒合是胃消化內鏡手術發展的障礙之壹。本課題之目的是評價和探索Eagle Claw VIII和脂肪幹細胞(ADMSCs)縫合和促進胃內傷口癒合的效果和作用。 / 方法和結果：1. 內鏡縫合器Eagle Claw VIII閉合經胃自然腔道手術後傷口的效果評價體外豬胃體上造2cm的胃傷口模型，使用手工縫合、內鏡下Eagle Claw VIII縫合或內鏡夾閉合胃傷口；每組17個樣本。本研究提示所有胃傷口均成功閉合。Eagle Claw VIII縫合胃傷口時間顯著長於其他兩組的閉合時間。Eagle Claw VIII縫合的胃傷口破裂壓顯著高於內鏡夾閉組，但是明顯低於手工縫合組。此外，內鏡縫合和夾閉都面臨較大的技術難度。本研究提示Eagle Claw VIII有臨床運用的潛在價值，但需要進壹步改進。 / 2. 局部移植脂肪幹細胞促進胃穿孔癒合的實驗性研究：建立大鼠2cm胃體穿孔模型，局部註射或傷口表面塗抹法移植ADMSCs，觀察胃傷口癒合情況。局部註射移植ADMSCs顯著減輕胃傷口粘連和裂開發生率，增加胃傷口破裂壓。組織學分析提示ADMSCs治療促進傷口上皮和肉芽組織再生，抑制炎癥反應。此外，局部註射ADMSCs增加TGF-β1抑制IL-6表達。本研究提示局部註射移植ADMSCs是促進胃穿孔傷口癒合的有效方法。 / 3. 局部移植脂肪幹細胞促進胃饋瘍癒合的實驗性研究：使用70%醋酸建立大鼠胃體饋瘍模型；饋瘍病竈內局部註射移植1×107 ADMSCs。研究提示第10和15天ADMSCs顯著減小饋瘍面積。組織學研究提示ADMSCs增加饋瘍傷口上皮和血管再生，促進膠原蛋白分泌和抑制炎癥反應。移植的ADMSCs能夠在饋瘍病竈內成活，並分化成血管內皮細胞和平滑肌細胞。ADMSCs顯著提高促傷口癒合相關基因表達水準。此外，ADMSCs啟動COX-2-PGE2和Erk1/2-MAPK信號通路。第10天，和對照組相比，引哚美辛/ADMSCs組潰瘍病竈內細胞增殖和血管再生顯著降低、饋瘍癒合延遲。本研究提示脂ADMSCs促進胃饋瘍癒合；非甾體抗炎藥顯著減弱ADMSCs的促胃饋瘍癒合作用。 / 結論：與內鏡夾閉相比，Eagle Claw VIII內鏡縫合胃創口有可行性。ADMSCs促進胃穿孔和饋瘍癒合，且依賴於前列腺素E2；引哚美辛抑制前列腺素E2合成從而抑制ADMSCs促胃組織癒合之效能。本研究提示聯合使用內鏡縫合器和ADMSCs是促進胃傷口癒合的潛在有效方法。 / Thesis Ph.D. Chinese University of Hong Kong 2014. / Includes bibliographical references (leaves 152-162). / Abstracts also in Chinese. / Title from PDF title page (viewed on 11, October, 2016). / Liu, Liu. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Trabalho realizado no Instituto de Ciências Biomédicas Abel Salazar / Tese de mestrado integrado. Bioengenharia (Biotecnologia Molecular). Faculdade de Engenharia. Universidade do Porto. 2012

Thesis (M.Pharm. (Pharmaceutics) -- University of Limpopo, 2018 / Griseofulvin is an antibiotic fungistatic drug used in the treatment of dermatophyte and ringworm infections. About 50% of a dose of griseofulvin passes the gastro- intestinal tract unabsorbed and is excreted in faeces. Since griseofulvin is highly soluble in acidic pH, a gastro-retentive floating matrix system was developed to control dissolution rate and thereby enhance solubility in an effort to develop an improved and convenient dosage form. Preformulation studies included selection of excipients and evaluation of their compatibility with griseofulvin. Using the chosen excipients, floating tablets of griseofulvin were formulated. Floating tablets containing 100 mg of griseofulvin were prepared by wet granulation technique with varying ratios of Methocel™, Accurel MP and Polyvinylpyrrolidone as determined by Design Expert software. Pre and post-compression studies, buoyancy capability and dissolution studies were carried out to assess the influence of the tablet components. Results obtained revealed that a density of less than 0.00091 g/cm3 was necessary for tablet floatation. Tablets that float immediately upon contact with dissolution medium and continue floating for over 12 hours were achieved with at least 28% Accurel MP by mass of the tablet. Dissolution studies revealed that an increase in tablet hardness reduced the rate of griseofulvin release only up to 120 minutes. From 120 minutes onwards, tablet hardness had no significant influence on griseofulvin release from tablets. Methocel™ had the most significant influence on griseofulvin release. The amount of Methocel™ included in the formulation was indirectly proportional to the rate of griseofulvin release. Using Design Expert software, optimized formulation was achieved with 1% Polyvinylpyrrolidone, 30% Methocel™, 60% Accurel MP and hardness ranging between 8 – 9 N. Pre and post-compression parameters of the optimized tablets were found to be within pharmacopoeial limits and thus compressed tablets were of acceptable quality. Tablets produced floated immediately upon contact with the medium and remained floating for at least 12 hours. Griseofulvin was released from the optimized tablets in a near zero order fashion, with a total of 80.8% griseofulvin released at the end of the 12 hour dissolution test period. Results of accelerated stability studies indicated potential stability of the manufactured tablets months.

El objetivo del estudio fue identificar los helmintos gastrointestinales que afectan al majaz Agouti paca de vida libre de la cuenca del rio Yavarí Mirí, Loreto, Perú; y describir sus lesiones gastrointestinales macro y microscópicas. La investigación fue realizada durante el periodo de Agosto del 2010 a Agosto del 2012. La muestra estuvo conformada por 99 ejemplares que se obtuvieron de la caza de los pobladores locales de la Comunidad de Nueva Esperanza con fines de autoconsumo. Los tractos digestivos fueron colectados y conservados en formol al 10%. Se realizó la colección y posteriormente la identificación de helmintos adultos. Paralelamente se hizo el examen macroscópico y la toma de muestra de tejidos, para luego realizar la coloración convencional Hematoxilina – Eosina para el estudio histopatológico. Fueron identificados 10 helmintos pertenecientes a las especies Boehmiella wilsoni, Physocephalus mediospiralis, Physaloptera torresi, Eucyathostomum copulatum, Trichuris gracilis, Freitastrongylus angelae, Raillietina demerariensis, Stichorchis giganteus, Capillaria sp. y la familia Anoplocephalidae. La prevalencia general de helmintos gastrointestinales fue del 94.95%, siendo los de mayor presentación las especies Trichuris gracilis (60.6%) y Boehmiella wilsoni (60.6%), y de menor frecuencia al género Capillaria sp. y especie Physocephalus mediospiralis con 3 % cada uno. Se observó multiparasitismo en un 49.5 % de los individuos; el órgano más afectado fue el estómago (77.8%), seguido por los intestinos grueso (70.7%) y delgado (55.6%). A nivel macroscópico, el órgano más afectado fue el estómago presentando nódulos en la mucosa con presencia de helmintos en su interior. A nivel histológico, se identificó al nemátodo Boehmiella wilsoni como causante de la lesión nodular diagnosticada como gastritis eosinofílica granulomatosa. Los otros helmintos se localizaron en la luz gastrointestinal sin producir cambios patológicos aparentes. Este es el primer reporte en donde se describen lesiones anatomopatológicas relacionadas con helmintos gastrointestinales de A. paca de vida libre, además de ser el primer registro del nemátodo Freitastrongylus angelae en A. paca a nivel mundial. Por consiguiente, el hallazgo de los helmintos diagnosticados demuestra que el majaz de vida libre es reservorio de estos parásitos a nivel gastrointestinal. Palabras clave: majaz, Agouti paca, helmintos gastrointestinales, lesiones gastrointestinales. / Tesis

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