No description available.

No description available.

No description available.

No description available.

Class of 2005 Abstract / Objectives: To determine the pharmacokinetic parameters of a patient population from drug concentration measurements records created by the pharmacokinetic service at a regional hospital in South Carolina, to predict peak and trough concentrations from three large dose-extended interval (LDEI) protocols to determine which method produce the highest percentage of concentrations that fall in the desired ranges, and to compare pharmacokinetic parameters of overweight and normal weight patients. Methods: This was a descriptive, retrospective study that used clinical data from 121 of 208 patient data forms. The collected data included patient age, gender, weight, height, serum creatinine (Scr), measured serum peak and trough concentrations, time of dosing, dose and dosing interval. These were used to determine individual pharmacokinetic parameters and predict peak and trough concentrations from three LDEI dosing protocols. Results: Method II produced the highest percentage of patients with peaks and troughs falling into the target range (95.9%). The Hartford method produced the highest percentage (79.3%) of patients achieving peak concentrations >20mg/L. All three methods achieved low troughs of <2mg/L, <1mg/L, <0.5mg/L, and <0.1mg/L at least 95%, 80%, 70%, and 50% of the time, respectively. No statistical significance was found between the group having actual body weight/ideal body weight ratio (ABW/IBW) greater than 1.2 and another group having ABW/IBW <1.2 for ABW, volume of distribution (V), elimination half-life (T1/2) and aminoglycoside clearance (Clag). Also, when overweight patients were excluded, a higher correlation between elimination rate constant (k) and creatinine clearance (CrCl) was found than when all patients were combined. In other words, as k increases, CrCl increases. Implications: Even though Method II produced the greatest percentage of peak and trough concentrations within its stated target range, the Hartford method may be the best dosing protocol to use since it achieves high peak concentrations (>20mg/L) while maintaining low trough concentrations. In addition, based on our data, we can assume that overweight people affect the predicted k value. There was no statistical significance between actual and predicted pharmacokinetic characteristics in overweight patients.

No description available.

Chronic infection with the hepatitis C virus infection (HCV) affects over 170 million individuals worldwide. In this thesis the natural history and management of hepatitis C in North- East London was investigated. The prevalence of cirrhosis in patients with chronic hepatitis C rises with increasing duration of infection. In Asian patients infected at birth, infection over 60 years causes cirrhosis in 71 % of infected individuals. Since the rate of fibrosis progression in Asian patients is the same as that seen in Caucasian patients, it is likely that similar rates of cirrhosis will be seen in all patients who are infected with HCV for over 60 years. Factors found to be associated with fibrosis progression were:- age and alcohol excess. Insulin resistance was associated with fibrosis progression. However, elevated serum ferritin or hepatiC iron were not. Knowledge of hepatitis C in the East of London was examined and found to be poor despite the Department of Health information campaign. Educational meetings and postal surveys improved the level of knowledge of HCV. However as our group only assessed knowledge immediately after completion of the sessions, such a testing regime does not address long-term knowledge retention. We examined current and novel management strategies for patients with chronic HCV. Current therapy involves pegylated interferon and ribavirin. We found that insulin resistance was a poor predictor of sustained virological response. Chinese herbal treatments for hepatitis C are widely used but poorly studied. Our group designed a randomised controlled double blind study to assess whether Chinese herbal treatment is effective and results from this study show that recruitment and retention in trials of alternative therapies are problematic and that the herbal remedy had little effect on viraemia and quality of life, although liver function tests did improve a little.

Old-age hippocampal sclerosis (HS), characterised by severe neuron loss in hippocampal CA1, is a poorly understood cause of dementia. At present no objective pathological HS criteria exist. In life HS is commonly diagnosed as Alzheimer's disease. HS aetiology is unclear, although it has been associated with both ischaemia and TAR-DNA-binding protein-43 (TDP-43)-related neurodegeneration. Variations in genes GRN, TMEM106B and ABCC9 are proposed as HS risk factors. The aim of this thesis was to investigate epidemiological, clinical, pathological and genetic characteristics of HS in older European populations. 976 brains donated for the Cambridge City over-75s Cohort, the Cognitive Function and Ageing Study and the Finnish Vantaa 85+ study were available for evaluation -including bilateral hippocampi from 302 individuals. A protocol capturing the extent and severity of hippocampal neuron loss was developed, establishing objective HS diagnosis criteria and allowing observation of distinct neuron loss patterns associated with ischaemia and neurodegeneration. 71 HS cases (overall prevalence: 7.3%) were identified. HS was significantly associated with an advanced age at death as well as dementia at the end of life. Neuropsychological and cardiovascular characteristics were similar between HS and AD, except for a longer duration of dementia and more disability in HS. HS was not associated with neurofibrillary tangles, amyloid plaques, or vascular pathologies, but all HS cases evaluated for TDP-43 showed neuronal inclusions in the hippocampal dentate and a high frequency of other glial, neuronal and neurite TDP-43 pathologies. GRN and TMEM106B but not ABCC9 variations were linked to HS. A moderating effect of TDP-43 on this association was detected. HS presented pathologically similarly to frontotemporal dementia cases with TDP-43 (FTLD-TDP) caused by mutations in GRN, but differed from other FTLD-TDP subtypes. Results of this thesis reveal the importance of HS in the oldest old in the population, the key role of TDP-43, as well as providing robust methods to capture HS characteristics for an area that has been under-researched but is clearly vital to understanding dementia in the oldest old.

Population dynamics is a South African secondary school biology syllabus topic which deals specifically with ecology or concepts within the realm of ecology. It is currently taught in a way which largely emphasises the teaching and learning of facts and concepts, often out of any context to which students can relate. While it is important to convey scientific concepts, it is just as important to address social and political issues regarding overpopulation and the environment. This research involved the administration of a questionnaire to Std 10 biology teachers in the Department of Education and Training (DET), which sought to obtain information about various aspects of teachers' teaching of population dynamics. These included their feelings toward the teaching of the specific sections of the population dynamics syllabus, and their knowledge and views of environmental issues and human population expansion. The findings of the research suggest that population dynamics is an important topic for students to learn about. The traditional teacher-centred approach to teaching is used by the teachers in the research sample. The sections considered by the teachers to be most important for learning were also considered the most interesting and the easiest to teach. The majority of the teachers in the research sample recognised that human population growth is a global and local problem and that South Africa cannot sustain its present population growth. The teachers in the sample show a diversity of opinions about sustainable development, and have a limited understanding of the links between population, poverty and consumption. Important information gained from the research will be significant in the development of a teaching and learning module on population dynamics that reflects the aims and purpose of environmental education.

Hypertension and nutrition: Fat-soluble vitamins A, D and E Weber J1 , Vlcek J1 , Suarez-Varella MM2 1 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic 2 Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of Valencia, Spain Arterial hypertension (AH) is a disease affecting population globally, and thus considered as a problem of public health and socioeconomic. Studies are trying to identify the connection between diet and the prevalence of arterial hypertension. Objective of the study was to determine possible association between an occurrence of AH and fat-soluble vitamins A, D and E intake. The nested, case-control population study investigation was grounded on database from the Spanish Hortega study, and performed on a random sample of 1,514 people (50.3 % women, 49.7 % men). From this sample we selected those aged ≥ 40 years old and untreated for hypertension and divided them into two groups: non-hypertensive (n = 429; 63.6 %) (controls), and newly diagnosed AH (n = 246; 36.4 %) (cases). Biochemical and anthropometric measurements, data on dietary intakes, education, socioeconomic status, place of residence, health habits, comorbidities, consumption of alcohol and tobacco were used for our...