O aumento da demanda, a falta de fiscalização sanitária efetiva e de especificações adequadas para verificar a qualidade de drogas vegetais são fatores que contribuem para o acesso a produtos sem garantia da qualidade e segurança. Embora sejam consideradas seguras por sua origem natural, as drogas vegetais apresentam elevadas cargas microbianas e podem oferecer riscos potenciais aos usuários, tanto pela presença de microrganismos potencialmente patogênicos, quanto pela contaminação com toxinas. O objetivo deste estudo foi avaliar a contaminação microbiana presente em 91 amostras de drogas vegetais, o potencial toxigênico de fungos isolados e a presença de aflatoxinas, ocratoxina A e citrinina nestas amostras. Os resultados obtidos demonstraram que 73,6% das amostras apresentaram populações microbianas superiores a 2X103 UFC de bactérias aeróbias/g e 2X102 UFC de bolores e leveduras/g e que 81,3% apresentaram ao menos um dos microrganismos considerados indicadores de risco. Com relação à contaminação fúngica, observou-se o predomínio dos gêneros Aspergillus e Penicillium, sendo que a análise micotoxicológica revelou que 21,49% apresentaram capacidade para produção de aflatoxinas, ocratoxina A e citrinina. Apesar de fungos toxigênicos terem sido detectados em 35 amostras de drogas vegetais, a análise micotoxicológica, realizada conforme Farmacopéia Americana, não revelou a presença de aflatoxinas, ocratoxina A e citrinina em nenhuma das amostras de drogas vegetais, indicando que os microrganismos podem não terem sido submetidos a condições favoráveis à expressão de sua capacidade toxigênica. / The increase in the demand, the lack of effective sanitary fiscalization and adjusted specifications to verify the quality of crude herbal drugs are factors that contribute for accessing products without guarantee of the quality and safety. Although they are considered safe by their natural origin, herbal drugs present high microbial loads and can offer potential risks to the users, as much for the presence of potencially pathogenic microorganisms, how much for the contamination with toxins. The goal of this study was evaluated the microbial contamination present in 91 samples of crude herbal drugs, the toxigenic potencial of fungal isolates and the presence of aflatoxins, ochratoxin A and citrinin in these samples. The obtained results demonstrated 73.6% of the samples presented microbial populations higher than 2X103 CFU of aerobic bacteria/g and 2X102 CFU of yeast and molds/g and 81.3% presented at least one of the microorganisms considered as risk indicators. With regard to the fungal contamination, the Aspergillus and Penicillium genera were predominant and the mycotoxicological analysis revealed that 21.49% of these isolates presented ability for aflatoxins, ochratoxin A and citrinin production. Although toxigenic fungi have been detected in 35 samples of herbal drugs, the mycotoxicological analysis, carried through as The United States Pharmacopeia, showed no detection of aflatoxins, ochratoxin A or citrinin in any samples of herbal drugs, indicating that these fungi can not have been submitted a favorable conditions to the expression of their toxigenic ability.

O aumento da demanda, a falta de fiscalização sanitária efetiva e de especificações adequadas para verificar a qualidade de drogas vegetais são fatores que contribuem para o acesso a produtos sem garantia da qualidade e segurança. Embora sejam consideradas seguras por sua origem natural, as drogas vegetais apresentam elevadas cargas microbianas e podem oferecer riscos potenciais aos usuários, tanto pela presença de microrganismos potencialmente patogênicos, quanto pela contaminação com toxinas. O objetivo deste estudo foi avaliar a contaminação microbiana presente em 91 amostras de drogas vegetais, o potencial toxigênico de fungos isolados e a presença de aflatoxinas, ocratoxina A e citrinina nestas amostras. Os resultados obtidos demonstraram que 73,6% das amostras apresentaram populações microbianas superiores a 2X103 UFC de bactérias aeróbias/g e 2X102 UFC de bolores e leveduras/g e que 81,3% apresentaram ao menos um dos microrganismos considerados indicadores de risco. Com relação à contaminação fúngica, observou-se o predomínio dos gêneros Aspergillus e Penicillium, sendo que a análise micotoxicológica revelou que 21,49% apresentaram capacidade para produção de aflatoxinas, ocratoxina A e citrinina. Apesar de fungos toxigênicos terem sido detectados em 35 amostras de drogas vegetais, a análise micotoxicológica, realizada conforme Farmacopéia Americana, não revelou a presença de aflatoxinas, ocratoxina A e citrinina em nenhuma das amostras de drogas vegetais, indicando que os microrganismos podem não terem sido submetidos a condições favoráveis à expressão de sua capacidade toxigênica. / The increase in the demand, the lack of effective sanitary fiscalization and adjusted specifications to verify the quality of crude herbal drugs are factors that contribute for accessing products without guarantee of the quality and safety. Although they are considered safe by their natural origin, herbal drugs present high microbial loads and can offer potential risks to the users, as much for the presence of potencially pathogenic microorganisms, how much for the contamination with toxins. The goal of this study was evaluated the microbial contamination present in 91 samples of crude herbal drugs, the toxigenic potencial of fungal isolates and the presence of aflatoxins, ochratoxin A and citrinin in these samples. The obtained results demonstrated 73.6% of the samples presented microbial populations higher than 2X103 CFU of aerobic bacteria/g and 2X102 CFU of yeast and molds/g and 81.3% presented at least one of the microorganisms considered as risk indicators. With regard to the fungal contamination, the Aspergillus and Penicillium genera were predominant and the mycotoxicological analysis revealed that 21.49% of these isolates presented ability for aflatoxins, ochratoxin A and citrinin production. Although toxigenic fungi have been detected in 35 samples of herbal drugs, the mycotoxicological analysis, carried through as The United States Pharmacopeia, showed no detection of aflatoxins, ochratoxin A or citrinin in any samples of herbal drugs, indicating that these fungi can not have been submitted a favorable conditions to the expression of their toxigenic ability.

Abstract The using of Chinese medicine is the treasure of our traditional culture; although once it received the attraction of western medicine for a while. Along with the whole world nature therapy being in fashion, the using of Chinese medicine has obtained once again. Germany develops gingko correlation product from our tradition ancient book, created 30 hundred million dollars output values in a year, and South Korea's Korea ginseng , the year output value is also about 70-75 hundred million dollars by a single product. The WHO estimates, in the following ten years, the Chinese Medicine and the development of its related technique product, the market will grow above 10%, every year. The Chinese medicine industry, without doubt, will be the star of fresh technique Industry in this century. Therefore, according to the consideration of competition strategy, the major condition is to establish the standardized, and science Chinese medicine in order to develop the Chinese native medicine biotechnology. In other words, the stability, effective of the Chinese native medicine is closely linked to its internationalization development. However, because traditional Chinese medicine itself are various, and habitat distribution broad, down to the all previous dynasties books on Chinese medicine records or in the actual utilization, has the same name on foreign matter, or the variety chaotic situation, like adds on the geography, the climate and the recovery season again is different, frequently creates the traditional Chinese medicine ingredient the difference, but the domestically grown Large-scale planter is appropriate the herbal medicine to have residual quality question and so on the agricultural chemicals, heavy metal and excessive microorganism. Our Chinese medicine industry, nearly has not grown in recent years, the market scale 40 hundred million dollars (approximately 1.2hundred million Dollar) about, the industry competitive ability year. By year glided down again, when Canada has the traditional Chinese medicine to remain excessive question and so on agricultural chemicals, heavy metal, causes the Chinese native medicine industry development receives the serious limit. Therefore, the analysis constructs the construction Chinese native medicine quality control influence regarding the Chinese native medicine industry promotion competitive ability, for this research biggest goal. Besides SWOT, five strength and the theory of country competitive ability, the analysis competition strategy (superiority), and is loyal and the quality controlling of the present situation in mainland China by the Asian and Pacific various countries and Taiwan's present situation makes a comparative analysis. Also enplaning Chinese native medicine quality control, regarding Chinese native medicine industry competitive ability promotion importance, but besides the literature back coupling, the secondary material analysis, and distinction depth interview with the official, study grinds the from all walks of life experts, to prove that the influence of quality controlling machinery to the industrial, and even to regarding the industrial organization, the expense market and the internationalization influence. The main conclusions of this research are as follows: First, besides analyzing the present situation of Chinese medicine industry development and found out the problem, positively proposed the industrial competition strategy, and found that quality control has its priority and importance in the correlation competition strategy. Second, from the analyzing of the present situation quality controlling in mainland China and the Asian, we discovered the mechanism of Chinese native medicine quality control has become one of various countries' important strategies, therefore, it may provide the important reference for the development of our Chinese native medicine industry. Third, the quality controlling mechanism of Chinese native medicine will affect the Chinese native medicine industrial structure, the market scale and the commodity internationalization, following regarding industrial management, national policy and international marketing correlation research, will have the its pioneer value. Fourth, this research may be the reference of the government and the industrial development policy, and takes the important research direction to promote the country competitive ability.

Made available in DSpace on 2014-12-17T14:25:22Z (GMT). No. of bitstreams: 1 AlineCC_TESE.pdf: 5713119 bytes, checksum: 5863ea9920b2303b3df108c3054d1dd2 (MD5) Previous issue date: 2014-02-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / A asma ? uma doen?a cr?nica caracterizada por dispneia, tosse, espirro intermitente e opress?o tor?cica, sintomas decorrentes de processos fisiol?gicos como edema, aumento de secre??o de muco e contra??o da musculatura lisa br?nquica e tamb?m encontra nas plantas medicinais sugest?es para seu tratamento. A esp?cie Cissampelos sympodialis Eichl ? uma esp?cie vegetal bastante estudada, tendo sido avaliadas e comprovadas uma s?rie de a??es farmacol?gicas (anti-anafil?tica, anti-inflamat?ria e efeito imunomodulador) que a colocam em posi??o de destaque para terapia da asma. Esses efeitos farmacol?gicos s?o associados ? presen?a de alcaloides, destacando-se a warifte?na. O controle de qualidade do material vegetal segundo m?todos farmacopeicos foi realizado na busca de especifica??es de qualidade para as folhas de Cissampelos sympodialis e garantia de uso seguro desse insumo vegetal. A aplica??o de t?cnicas quimiom?tricas do tipo planejamento experimental foi ?til no estabelecimento de condi??es ?timas de extra??o para obten??o de extratos hidroalco?lcios das folhas de Cissampelos sympodialis, cuja otimiza??o ocorreu tamb?m atrav?s de an?lise univariada relacionada ao tamanho de part?cula do material vegetal e m?todo de extra??o. A monitora??o de atividade biol?gica anti-inflamat?ria, presumida atrav?s de modelos de cultura de c?lulas de linfonodos e macr?fagos para quantifica??o de citocinas associadas ao processo inflamat?rio, foi realizada para os extratos com maior e menor teor de warifte?na, decorrentes do planejamento experimental, na forma de suas respectivas fra??es aquosas. A rela??o do teor de warifte?na com a pot?ncia de atividade anti-inflamat?ria p?de ser sugerida, havendo ainda necessidade de otimiza??o da obten??o da fra??o aquosa. As condi??es padronizadas para obten??o do extrato hidroalco?lico envolvem a utiliza??o de material vegetal com part?culas de 500 ?m, na propor??o 1:10 (droga: solvente p/v), com o sistema de solvente extrator sendo etanol : ?gua na propor??o 80 : 20 (v/v), atrav?s da macera??o por 48h, com reposi??o de solvente ap?s as primeiras 24 h. Foram realizados alguns ensaios de secagem por spray dryer das fra??es aquosas obtidas, sendo sugerida a utiliza??o de maltodextrina, isolada ou em associa??o a di?xido de sil?cio coloidal, havendo ainda necessidade de ensaios definitivos. Todo o estudo foi realizado com o intuito de se obter insumo farmac?utico est?vel e de qualidade para futuro desenvolvimento de formula??es e consequente obten??o de medicamento fitoter?pico para o tratamento de asma

It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to provide information about their payer mix, implementation barriers, registry implementation, registry use, and clinic satisfaction. The survey instrument was validated by an expert panel which included practitioners and researchers. Statistical methods including Structural Equation Modeling were used for analysis and to test the research hypotheses. The majority of medical home practices that responded used some type of computerized registry, either with basic patient information or integrated with detailed clinical information. And on average, they somewhat used registries for population management, individual health management, proactive care and planned care visits. All practices encountered some combination of barriers when implementing a medical home program. Most practices reported clinic satisfaction at least improved after becoming a medical home. The results of the analysis show that indeed payer mix, in particular Medicare and private insurance, has a significant relationship with level of registry implementation. There were no significant relationships between barriers and registry implementation or use. More sophisticated registry implementation led to greater registry use. And registry use is associated with increased clinic satisfaction. This research fills an important gap in understanding Health IT use, registries in particular, among Patient-Centered Medical Homes. The findings suggest that: 1) Implementation barriers may not be influencing use of computerized registries in medical home practices; 2) Using more sophisticated computerized registries facilitates registry use, which can help improve clinic satisfaction; 3) Payer mix may influence use of more sophisticated Health IT in medical home practices.