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Thesis (Ph.D.)--University of Wisconsin--Madison, 2006 / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (p. 186-199).

Thesis (Ph.D.)--University of Wisconsin--Madison, 2006 / Includes bibliographical references (p. 186-199). Also available on the Internet.

TRADUÃÃO DE INSTRUMENTO PARA AVALIAR A NÃO ADESÃO DAS MÃES AO TRATAMENTO DE SEUS FILHOS COM DOENÃAS CRÃNICAS E IDENTIFICAÃÃO DAS POSSÃVEIS DIFICULDADES QUE AS MÃES ENFRENTAM PARA OBTER E ADMINISTRAR MEDICAMENTOS AOS SEUS FILHOS NO DOMICÃLIO Autora: PatrÃcia Quirino da Costa. Orientador: Ãlvaro Jorge Madeiro Leite. Tese de doutorado em SaÃde Coletiva. Faculdade de Medicina. Universidade Federal do CearÃ,2012 Muitas crianÃas portadoras de doenÃas crÃnicas necessitam uso continuo de medicamentos para o controle da patologia. A adesÃo ao tratamento à um ponto crucial para se conseguir esse controle e diversos fatores tem sido identificados para a nÃo adesÃo em crianÃas, dentre estes a carÃncia de formulaÃÃes adequadas à faixa etÃria. O Beliefs and Behaviour Questionnaire avalia a nÃo adesÃo ao tratamento medicamentoso em adultos com doenÃa crÃnica. Apresenta 30 itens em 3 subseÃÃes: convicÃÃes, experiÃncias e comportamentos, e permite identificar fatores relacionados à nÃo adesÃo. Na crianÃa, o medicamento à administrado quase sempre por um cuidador, em geral a mÃe. O objetivo do trabalho foi adaptar culturalmente e validar o BBQ para avaliar a nÃo adesÃo das mÃes/cuidadores ao tratamento dos seus filhos com doenÃas crÃnicas, e conhecer em profundidade as dificuldades enfrentadas no tratamento domiciliar. Etapas da adaptaÃÃo: traduÃÃo, sÃntese das traduÃÃes e adaptaÃÃo cultural, retraduÃÃo, revisÃo tÃcnica, prÃ-teste. ValidaÃÃo feita pela AnÃlise dos Componentes Principais, aplicando o instrumento a 28 cuidadores de crianÃas portadoras de doenÃa crÃnica que estavam internadas em hospital estadual de referÃncia pediÃtrica, em Fortaleza, identificados sequencialmente; seguido-se visita domiciliar 30-40 dias pÃs-alta hospitalar. Aos mesmos cuidadores (acrescidos de dois) foi aplicado um questionÃrio semiestruturado onde se investigava as dificuldades encontradas na busca e administraÃÃo dos medicamentos prescritos na alta hospitalar. Os dados descritivos obtidos foram quantificados por estatÃsticas simples. As entrevistas foram gravadas, decupadas e analisadas qualitativamente com apoio na fenomenologia. O questionÃrio final BBQ-Br possui 24 itens divididos em 3 seÃÃes como no original; apresentou alta confiabilidade, verificada atravÃs da anÃlise da consistÃncia interna, e valores de alfa Cronbach elevados para todas as subseÃÃes. Os itens foram agrupados em cada seÃÃo como no artigo referÃncia e apresentaram elevada correlaÃÃo entre si, avaliada pelo teste de esfericidade de Bartlett. Participaram do estudo descritivo 30 cuidadores (26 mÃes, 2 pais, 1 tia e 1 avÃ), com grau de escolaridade predominante âensino fundamental incompletoâ e residÃncia em Ãreas pobres da cidade. Dos 25 cuidadores que buscaram medicamentos no SUS apenas 4 receberam todos os itens prescritos e 21 (70%) adquiriram algum medicamento em farmÃcias privadas. Principais dificuldades na administraÃÃo de medicamentos: sabor desagradÃvel, necessidade de partiÃÃo e dureza de comprimidos, ausÃncia de dispositivo dosador. EstratÃgias mais utilizadas: diluiÃÃo ou dissoluÃÃo em Ãgua com aÃÃcar; forÃar a deglutir. No estudo qualitativo foram identificadas dificuldades de compreensÃo das orientaÃÃes mÃdicas e na obtenÃÃo de medicamentos incluindo: desabastecimento das unidades de saÃde; medicamentos entregues fora da embalagem primÃria, sem bula, sem dispositivos para administraÃÃo e sem orientaÃÃo para o uso adequado. A mÃe procura cumprir a prescriÃÃo mÃdica, embora nÃo compreenda bem o seu significado, mas, diante das dificuldades toma decisÃes cujo alcance nÃo conhece, por exemplo, interromper um tratamento. A informaÃÃo adequada e facilidade de administraÃÃo sÃo fatores limitantes para que esse papel possa ser bem desempenhado. O questionÃrio BBQBr à potencialmente Ãtil para a identificar o potencial de nÃo adesÃo e os fatores envolvidos, fac

Diss. Linköping : Univ., 2004.

differential scanning calorimetric profile and the generation of much less intense and broader peaks in the powder X-ray diffraction pattern compared to beta-CD. FTIR analysis revealed significant physical interactions between CX oil and beta-CD in the granules, possibly due to complexation. Results from phase solubility measurements and proton nuclear magnetic resonance ( 1H-NMR) analysis of pure 3-butylidenephthalide (3-BDPH), a representative CX component, lend some support for the formation of a 1:1 stoichiometric inclusion complex between 3-BDPH and beta-CD. / Rhizoma chuanxiong (CX), the dried rhizome of Ligusticum Chuangxiong Hort. (Umbelliferae), has been extensively used in mainland China as a traditional herbal medicine for treating cardio-/cerebrovascular diseases and gynecological disorders. However, the active components in CX, which are predominantly essential oils, generally exhibit poor stability (mostly photo-oxidation), high volatility, low aqueous solubility, and extensive gut/hepatic metabolism, all of which can significantly reduce their oral bioavailability and therapeutic efficacy. The present project has investigated the feasibility of utilizing three formulation approaches to circumvent the aforementioned problems associated with the peroral delivery of CX (as crude oil mixture or individual components). / The first approach involved inclusion of CX oil in beta-cyclodextrin (beta-CD) as solid granules using a coprecipitation method optimized with the aid of an orthogonal study design. The resulting CX oil granules were colorless and odorless with a median particle size of 11.38mum; were stable to heat, light and moisture, and readily soluble in simulated gastric and intestinal fluids. The granules were largely amorphous, as evidenced by an absence of the melting endotherm for beta-CD in the formulation could be largely explicated by the complexation behavior and hydration properties of the two polymers blended in different weight percentages, as substantiated by turbidity measurement, viscosity determination and FTIR analysis of the pure polymer mixtures as well as swelling measurement of the formulated tablets. The sustained release behavior of 3-BDPH from the tablet was dependent on the relative proportion of the two polymers present, and could be similarly explained by the changes in hydration and complexation behavior of the polymers during the penetration of aqueous fluid into the tablet matrix. / The second approach involved incorporation of CX oil into surfactant micelles and liquid crystals as a self-emulsifying drug delivery system (SEDDS). An optimal formulation was developed through a judicial choice of excipients (lipids and surfactants/cosurfactant) and their proper combination in the correct proportions, as determined by the spontaneity of the emulsification process and the change in emulsion droplet size. The formulation was readily dispersible in water upon mild agitation, free from unpleasant odor, and stable in soft gelatin capsules for a storage period of at least 12 months under ambient condition. The optimal utilization of the lipid and surfactant blends in defined proportions in the formulation was further substantiated by interfacial tension determination and equilibrium phase analysis. / The third approach involved formulation of 3-BDPH (or crude CX oil) into a sustained-release buccoadhesive tablet, based on a systematic evaluation of the adhesive properties of two polymers (Carbopol 974P and hydroxypropyl methylcellulose K4M) used in the formulation. The adhesive properties of the formulation could be largely explicated by the complexation behavior and hydration properties of the two polymers blended in different weight percentages, as substantiated by turbidity measurement, viscosity determination and FTIR analysis of the pure polymer mixtures as well as swelling measurement of the formulated tablets. The sustained release behavior of 3-BDPH from the tablet was dependent on the relative proportion of the two polymers present, and could be similarly explained by the changes in hydration and complexation behavior of the polymers during the penetration of aqueous fluid into the tablet matrix. / Gao Yuan. / "April 2005." / Adviser: Albert H. L. Chow. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1585. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 193-223). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Thesis (M.S.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 35 pages. Includes bibliographical references.

Infusões prolongadas de 5-fluorouracil são mais seguras e potencialmente mais efetivas no tratamento do câncer de cólon metastático do que infusões rápidas da mesma medicação. No entanto, infusões prolongadas requerem a disponibilidade de um acesso venoso central, bem como de bombas de infusão dispendiosas. O desenvolvimento de fluoropirimidinas orais permitiu que pacientes fossem expostos ao 5-fluorouracil por longo tempo, com maior conveniência. UFT e leucovorin administrados três vezes ao dia demonstraram previamente uma eficácia equivalente, com menor toxicidade, quando comparados a um regime convencional de infusão rápida de 5- fluorouracil e leucovorin. Este estudo com 98 pacientes foi desenhado e conduzido com objetivo de demonstrar equivalência no tempo de progressão com o uso de UFT e leucovorin administrados duas vezes ao dia, com o uso da mesma combinação administrada três vezes ao dia. Objetivos secundários incluíram análise de toxicidade, resposta objetiva e sobrevida global. O tempo mediano de progressão foi de 3,8 meses, comparado com 3,5 meses observados com o uso da medicação três vezes ao dia e a taxa de resposta foi de 11%, com uma sobrevida mediana de 12,8 meses, sendo comparável aos resultados de 12% e 12,4 meses obtidas com o uso da combinação três vezes ao dia. A incidência de diarréia com graus 3 e 4 foi de 30% no regime de administração duas vezes ao dia, e 21% no de três vezes ao dia. Esses resultados sugerem que o uso de UFT e leucovorin duas vezes ao dia tem eficácia e toxicidade similares àquelas obtidas com o uso da mesma medicação três vezes ao dia. / Prolonged infusions have been shown to be safer and potentially more effective than bolus regimens of 5- fluorouracil as treatment for advanced colorectal cancer. However, infusional 5- fluorouracil requires central venous access and costly infusion pumps. Development of oral fluoropyrimidines has allowed longer exposures to 5-fluorouracil with increased convenience. UFT and leucovorin given thrice daily showed improved safety and no significant difference in survival or response rate compared with bolus 5- fluorouracil and leucovorin. This study with 98 patients was conducted to evaluate whether UFT and leucovorin given twice daily provided comparable time to progression (TTP) to the same combination administered three times a day. Secondary objectives included evaluation of toxicity, overall tumor response rate, and survival. Median time to progression was 3.8 months, compared with 3.5 months observed with the thrice-daily regimen. The twice-daily regimen had a response rate of 11% and median survival of 12.8 months, comparable to the 12% and 12.4 months seen with the thrice-daily regimen. The incidence of grade 3-4 drug-related diarrhea was 30% on the twice-daily and 21% on the thrice-daily schedule. Results suggest that the twice-daily schedule has similar safety and efficacy to the thrice-daily schedule.

<p>Serum amyloid A protein (SAA) is an acute phase protein that has recently gained increasing interest as a potential marker for disease and treatment monitoring. We investigated SAA and CRP levels in (a) patients with various common infectious diseases (n=98), (b) patients with pyelonephritis (n=37) versus patients with cystitis (n=32), (c) healthy individuals of varying ages (n=231), (d) very immature newborn infants with or without nosocomial infections (NIs) (n=72) and (e) patients with bacterial infections treated with cefuroxime (n=81). </p><p>SAA significantly correlated with CRP in viral as well as in bacterial infections (for the total group: r²=0.757, p<0.0001) and showed a systemic inflammatory response in 90% of the patients with cystitis as compared with 23% for CRP. Equally high efficiencies (0.96 and 0.94 for SAA and CRP, respectively) were observed in discriminating between pyelonephritis and cystitis. SAA and high sensitive (hs) CRP were lower in umbilical cords (p<0.0001) and higher in elderly adults (p<0.0001-0.03) than in the other age groups; higher in immature newborn infants than in term infants; and higher in the NI group than in the non-NI group. Interindividual variabilities of the time course of the biomarkers SAA and CRP were considerable. Because of the smoothed distribution of SAA and CRP (i.e. elevations were both essentially unchanged during the first 3 days of cefuroxime treatment), these markers were not useful when deciding parenteral-oral switch of therapy, which occurred within this time period in most cases.</p><p>SAA is a sensitive systemic marker in cystitis. SAA and hsCRP in umbilical cord blood are close to the detection limit and increase with age. They increase in relation to NI in very immature newborn infants and might therefore be used in diagnosis and monitoring. Finally, SAA and CRP in adults with bacterial infections could not predict an early parenteral-oral switch of antimicrobial therapy.</p>

Serum amyloid A protein (SAA) is an acute phase protein that has recently gained increasing interest as a potential marker for disease and treatment monitoring. We investigated SAA and CRP levels in (a) patients with various common infectious diseases (n=98), (b) patients with pyelonephritis (n=37) versus patients with cystitis (n=32), (c) healthy individuals of varying ages (n=231), (d) very immature newborn infants with or without nosocomial infections (NIs) (n=72) and (e) patients with bacterial infections treated with cefuroxime (n=81). SAA significantly correlated with CRP in viral as well as in bacterial infections (for the total group: r2=0.757, p&lt;0.0001) and showed a systemic inflammatory response in 90% of the patients with cystitis as compared with 23% for CRP. Equally high efficiencies (0.96 and 0.94 for SAA and CRP, respectively) were observed in discriminating between pyelonephritis and cystitis. SAA and high sensitive (hs) CRP were lower in umbilical cords (p&lt;0.0001) and higher in elderly adults (p&lt;0.0001-0.03) than in the other age groups; higher in immature newborn infants than in term infants; and higher in the NI group than in the non-NI group. Interindividual variabilities of the time course of the biomarkers SAA and CRP were considerable. Because of the smoothed distribution of SAA and CRP (i.e. elevations were both essentially unchanged during the first 3 days of cefuroxime treatment), these markers were not useful when deciding parenteral-oral switch of therapy, which occurred within this time period in most cases. SAA is a sensitive systemic marker in cystitis. SAA and hsCRP in umbilical cord blood are close to the detection limit and increase with age. They increase in relation to NI in very immature newborn infants and might therefore be used in diagnosis and monitoring. Finally, SAA and CRP in adults with bacterial infections could not predict an early parenteral-oral switch of antimicrobial therapy.