A energia ultra-sônica é um dos recursos físicos amplamente utilizado e pesquisado nos tratamentos de fisioterapia e diagnósticos médicos. Sabe-se que diante de uma escassa literatura dos efeitos do ultra-som em tecidos sadios, muitos profissionais fisioterapeutas acabam realizando aplicações infundadas de métodos e parâmetros. O objetivo desta pesquisa foi avaliar possíveis alterações do tecido sadio in vivo de ratos Wistar irradiados com diferentes intensidades, analisando a histologia e morfometria. Foram utilizados 30 ratos da linhagem Wistar, distribuídos aleatoriamente em 5 grupos de 6 animais cada. Foi escolhida a região dorsal do lado direito para tratamento com área de 4 \'CM POT.2\'. O lado esquerdo serviu como controle em todos os grupos. O tratamento foi feito durante 4 dias com 2 minutos de irradiação. Para verificar a intensidade de saída, utilizou-se o dosímetro de precisão antes da aplicação do ultra-som em cada animal. Foi realizada uma análise histológica descritiva e morfometria por meio do software Image Tool. Como resultado pode-se observar um discreto infiltrado inflamatório e adelgaçamento das fibras da derme, principalmente dos grupos irradiados com 1.5 e 2 W/\'CM POT.2\'. Notou-se também um aumento na espessura da epiderme nas amostras dos animais irradiados quando comparado com o controle. Para avaliar os resultados quantitativos, utilizou-se como análise estatística ANOVA \"one way\" e o teste \"pos hoc\" de Tukey com nível de significância p < 0,01. Em 120 medidas da espessura da epiderme obtiveram-se diferenças significativas do grupo controle com os grupos irradiados com (1.0, 1.5 e 2.0 W/\'CM POT.2\'). Concluímos diante dos resultados que houve alterações no tecido sob ação do US nas doses maiores, o que nos alerta para possíveis implicações do uso do US em estética. / The ultrasound (US) energy is one of the resources widely used and researched in both physio-therapist treatment and in medical diagnosis. In front of a scarce literature about the US effects in healthy tissues, many professionals have carried out unfounded applications of methods and parameters. So, the aim of this research was evaluate, through the histology, possible alternations in healthy tissues of Wistar rats in vivo irradiated with different intensity, analyzing the qualitative and quantitative histological slides. We used 30 Wistar rats randomly distributed in 5 groups of animals each. The local chosen for receiving the treatment was the dorsal right side, whose area was 4 \'CM POT.2\'. The left side was used as control of the animal itself for all the groups. The rats underwent the treatment during 4 days exposed to 2 minutes of irradiation. In order to check the energy output, the precision dosimeter was used before US application in each animal. The histological slides were evaluated qualitatively in the microscope and quantitatively through the image tool software. The qualitative result shows a discrete inflammatory process with infiltration and atrophy dermis fibers, mainly in the groups with higher US dosage. In the quantitative aspect, we found epidermis thickness increased in the 1.5 and 2 W/\'CM POT.2\' of US, with statistical difference (ANOVA) compared to control. We conclude that US therapy can be dangerous with high dosage applied in the intact skin.

The purpose of this study was to determine if patients with head or neck cancer receiving radiation were satisfied with the nutrition counseling they were receiving and if they obtained any benefit. Radiation to the head or neck region promotes side effects such as taste changes and chewing and swallowing difficultly that decrease food and fluid intake. A reduction in nutrients leads to weight loss, and weight loss in cancer patients increases the risk of morbidity and morality as well as decreases quality of life. Subjects were recruited from a local cancer treatment facility and a survey was administered. Subjects were found to manage the side effects better after counseling from the registered dietitian, and a minimal amount of weight loss was observed. Registered dietitians when incorporated into a radiation treatment facility can provide an effective nutrition program targeted at reducing weight loss and improving quality of life.

Drugs exert their (therapeutic) effects via molecular-level interactions with proteins and other biomolecules. Computational prediction of drug-protein interactions plays a significant role in the effort to improve our current and limited knowledge of these interactions. The use of the putative drug-protein interactions could facilitate the discovery of novel applications of drugs, assist in cataloging their targets, and help to explain the details of medicinal efficacy and side-effects of drugs. We investigate current studies related to the computational prediction of drug-protein interactions and categorize them into protein structure-based and similarity-based methods. We evaluate three representative structure-based predictors and develop a Protein-Drug Interaction Database (PDID) that includes the putative drug targets generated by these three methods for the entire structural human proteome. To address the fact that only a limited set of proteins has known structures, we study the similarity-based methods that do not require this information. We review a comprehensive set of 35 high-impact similarity-based predictors and develop a novel, high-quality benchmark database. We group these predictors based on three types of similarities and their combinations that they use. We discuss and compare key architectural aspects of these methods including their source databases, internal databases and predictive models. Using our novel benchmark database, we perform comparative empirical analysis of predictive performance of seven types of representative predictors that utilize each type of similarity individually or in all possible combinations. We assess predictive quality at the database-wide drug-protein interaction level and we are the first to also include evaluation across individual drugs. Our comprehensive analysis shows that predictors that use more similarity types outperform methods that employ fewer similarities, and that the model combining all three types of similarities secures AUC of 0.93. We offer a first-of-its-kind analysis of sensitivity of predictive performance to intrinsic and extrinsic characteristics of the considered predictors. We find that predictive performance is sensitive to low levels of similarities between sequences of the drug targets and several extrinsic properties of the input drug structures, drug profiles and drug targets.

Bibliography: leaves 107-109 / 109 leaves, [26] leaves of plates : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, 1989

Background: Numerous studies have shown that estrogen replacement therapy (ERT) is an effective treatment for vasomotor symptoms, insomnia and vaginal dryness. Beneficial effects have also been shown on lipid patterns and on the incidence of osteoporotic fractures. As ERT increases the risk of endometrial adenocarcinoma, combinations with various progestogens have been developed in order to protect the endometrium. However, the addition of progestogens tends to reduce the beneficial effects of estrogens on mood, cognition and lipid metabolism. The added progestogen often causes side effects such as irritability and depression. There is evidence that the effect on wellbeing varies between women and with the type of progestogen used. Women who prefer to avoid withdrawal bleedings can be given continuous combined hormone replacement therapy (HRT). Unfortunately, irregular bleedings are common at the beginning of treatment and reduces compliance. Recently, several studies have reported an increased risk of breast cancer and venous thrombosis, and therefore long-term treatment with HRT for women without climacteric symptoms is no longer recommended. The ongoing debate has, for the time being, resulted in a recommendation that improving quality of life (QoL) by treatment of climacteric symptoms should be the only indication for prescribing HRT. Aims and methods: The aims of the study were to investigate bleeding patterns, changes in wellbeing at onset and during long-term treatment, and lipid and lipoprotein profiles with two different types of continuous combined HRT. In addition, women starting, and women switching from mainly sequential HRT were compared. The design was a randomised, double-blind, one year, prospective, multicentre study including 249 healthy postmenopausal women who were given continuous daily oral treatment with either combined 0.625mg conjugated estrogen (CE) and 5mg medroxyprogesterone acetate (MPA) or combined 2mg 17β - estradiol (E2) and 1mg norethisterone acetate (NETA). Bleedings, if any, were recorded daily throughout the study. The main outcome measures (changes in wellbeing and climacteric symptoms) consisted of daily ratings of 12 items on a validated symptom scale. Serum concentrations of lipids and lipoproteins were measured at baseline and after one year of treatment. Results and conclusions: The majority of drop-outs were confined to the first three months, and the main reasons were bleedings and/or decreased wellbeing. Drop-outs were three times more common in the E2/NETA group. During the first month, 67% of the women reported irregular bleedings. The number of bleeding days decreased on both treatments during the first four months. Treatment with CE/MPA resulted in less irregular bleedings and a shorter time to amenorrhoea compared to E2/NETA. As expected, "starters" experienced more sweats than "switchers" at the onset of treatment, but both groups improved significantly. Side effects such as breast tenderness, swelling, depression and irritability appeared during the first treatment week in both groups. The side effects of HRT appeared much more quickly than the benefits and were more frequent in women with a history of premenstrual syndrome (PMS). Breast tenderness was more common in the E2/NETA group throughout the whole study period. Apart from that, there were no differences between the two treatment regimens as regards effects on well-being at the end of the study. Lipoprotein(a) levels, an important risk factor for cardiovascular disease, decreased in both treatment groups. Triglyceride levels increased in women treated with CE/MPA, and levels of total cholesterol, high density lipoprotein and low density lipoprotein fell in the E2/NETA group. In conclusion, treatment with E2/NETA caused more bleeding problems than treatment with CE/MPA. CE/MPA was better tolerated than E2/NETA at the beginning of the study, but among the women remaining in the study there was no difference in QoL between the two treatment groups. HRT counselling should take into account that a history of PMS increases the likelihood of side effects and that these may precede any beneficial effects. Both treatments produced beneficial effects on lipid and lipoprotein levels, and neither of the regimens was superior in this respect.

Lack of patient adherence with medication results in health care costs and adverse clinical outcomes. Although fear of side effects can contribute to non-adherence, being informed about them can actually improve matters. Nonetheless, questions persist as to the most efficient way to convey that type of information to patients for a given medication. Information on side effects is largely limited to a simple list in medication leaflets, often without frequency data (that is, lacking detail as to how often they might occur). The decision-making literature suggests that the interpretation of information varies depending on the presentation format or the frame used. This study examined the impact of providing numerical information for side effect frequency, levels of illness severity, and side effect framing on the likelihood of taking an OTC medicine.<p> Participants received a headache scenario with three drug options (X, Y and Z) to consider for use. These painkillers had three levels of potency (defined as 50, 75, and 100% effective) and were accompanied with three levels of side effects (two, four, and six items). When considering their drug choice for the headaches, participants received drug information written without side effect frequency data, then again with side effect frequency data. Subjects rated their likelihood of taking Drug X, Y and Z on a scale of 1 (very unlikely) to 100 (very likely). Participants were also asked to show their likelihood of taking a different set of two medications for headaches (coined Drug N and P) based on positively-slanted or negatively-slanted wording in relation to chances of experiencing a side effect (heartburn).<p> Thirty subjects from Saskatoon over 50 years of age participated. The average age was 66.6 years and 63.3 percent of participants were female. Less than half of participants (n=11) had previous experience with side effects. Most participants were using at least one medicine (whether OTC or prescribed) and described themselves as knowledgeable or somewhat knowledgeable.<p> Participants were more likely to take the hypothetical drugs in the situations described when they received frequency data for side effects (p<0.05). Also, there was a significant higher mean likelihood of use when the drug was framed positively (p<0.01).<p> When considering decisions involving drug effectiveness and their side effects, the provision of frequency data increased patient likelihood of use. Framing the context in positive format also increased patient likelihood to use a medicine. This information could be important for pharmacists counseling on medication side effects, especially for those patients with medication adherence problems.

University of Macau / Institute of Chinese Medical Sciences

Syftet med studien var att beskriva vilka biverkningar individer som behandlas med antipsykotika upplever och dess konsekvenser för livskvaliteten samt hur vårdpersonalen kan ge stöd till drabbade individer i vardagen för att minska obehaget av biverkningar. Metoden som användes var en avgränsad systematisk litteraturstudie. Vetenskapliga artiklar söktes via två databaser. Totalt inkluderades tio artiklar som genomgick kvalitets- och resultatanalys. Resultatet visade att vanligt förekommande biverkningar av antipsykotika som patienterna upplevde och rapporterade var psykiska, extrapyramidala följt av endokrina och metaboliska effekter samt övriga biverkningar som autonoma, antikolinerga och allergirelaterade. Resultaten visade att en sjuksköterskeledd vårdtjänst kunde upptäcka fysiska problem som ohälsosam livsstil och fetma och därmed åstadkomma positiv livsförändig och viktnedgång. Studierna ger även förslag på copingstrategier som stöd vid biverkningar trötthet och viktuppgång. Slutsatsen: Studien har visat att patienter med psykossjukdomar upplevde olika biverkningar av antipsykotika som de måste ta för att förebygga återfall i psykos. Det finns omvårdnadsåtgärder och stöd till patienter som gör det lättare att klara vardagslivet trots biverkningar. Dock behövs mer forskning om omvårdnadsåtgärder och stöd. / The aim of this study was to describe the side effects experienced by individuals treated with antipsychotics, their consequence in life quality and how care staff can give support to these individuals to reduce discomfort of the side effects in their daily life. The method was a determinate literature review. The scientific articles where found in the database PubMed. A total of ten articles where included and were analyzed based on their quality and contents. The results showed that the most common of antipsychotic side effects that the patient experienced and reported  were psychic, extrapyramidal followed by endocrine and the metabolic issue and other side effects with autonomic, anticholinergic and allergy related. The result showed that a nurse-led service with provided care delivery could discover physical health problems such as unhealthy lifestyle and obesity, and consequently achieve positive changes of life and weight loss. The studies even gave suggestions of strategies to cope with sedation, tiredness and weight gain. Conclusion of this literature review was that the patients with psychotic illnesses perceived different side effects from the antipsychotic medication that they had to take to prevent fallback in psychos. There is even nursing care and support to patients which make daily life easier in spite of side effects. However more research is needed about nursing methods and support.

Lack of patient adherence with medication results in health care costs and adverse clinical outcomes. Although fear of side effects can contribute to non-adherence, being informed about them can actually improve matters. Nonetheless, questions persist as to the most efficient way to convey that type of information to patients for a given medication. Information on side effects is largely limited to a simple list in medication leaflets, often without frequency data (that is, lacking detail as to how often they might occur). The decision-making literature suggests that the interpretation of information varies depending on the presentation format or the frame used. This study examined the impact of providing numerical information for side effect frequency, levels of illness severity, and side effect framing on the likelihood of taking an OTC medicine.<p> Participants received a headache scenario with three drug options (X, Y and Z) to consider for use. These painkillers had three levels of potency (defined as 50, 75, and 100% effective) and were accompanied with three levels of side effects (two, four, and six items). When considering their drug choice for the headaches, participants received drug information written without side effect frequency data, then again with side effect frequency data. Subjects rated their likelihood of taking Drug X, Y and Z on a scale of 1 (very unlikely) to 100 (very likely). Participants were also asked to show their likelihood of taking a different set of two medications for headaches (coined Drug N and P) based on positively-slanted or negatively-slanted wording in relation to chances of experiencing a side effect (heartburn).<p> Thirty subjects from Saskatoon over 50 years of age participated. The average age was 66.6 years and 63.3 percent of participants were female. Less than half of participants (n=11) had previous experience with side effects. Most participants were using at least one medicine (whether OTC or prescribed) and described themselves as knowledgeable or somewhat knowledgeable.<p> Participants were more likely to take the hypothetical drugs in the situations described when they received frequency data for side effects (p<0.05). Also, there was a significant higher mean likelihood of use when the drug was framed positively (p<0.01).<p> When considering decisions involving drug effectiveness and their side effects, the provision of frequency data increased patient likelihood of use. Framing the context in positive format also increased patient likelihood to use a medicine. This information could be important for pharmacists counseling on medication side effects, especially for those patients with medication adherence problems.

published_or_final_version / abstract / Medicine / Master / Master of Philosophy