Cheung Kwok Lung. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 123-136). / ABSTRACT (English) --- p.i / ACKNOWLEDGMENTS --- p.1 / LIST OF FIGURES --- p.3 / LIST OF TABLES --- p.5 / LIST OF ABBREVIATIONS --- p.7 / Chapter I. --- INTRODUCTION AND OBJECTIVES --- p.8 / Chapter II. --- LITERATURE REVIEWS --- p.11 / Chapter II.A. --- Maternal Serum Alpha-fetoprotein Screeningin Singleton Pregnancies --- p.11 / Chapter II.A.1. --- Physiology of Alpha-fetoprotein --- p.12 / Chapter II.A.2. --- Historical Background of Screening by Alpha- fetoprotein --- p.12 / Chapter II.A.3. --- Factors that Influence Maternal Serum Alpha- fetoprotein Concentration --- p.13 / Chapter ILA.4. --- Elevated Maternal Serum Alpha-fetoprotein Concentration and Adverse Pregnancy Outcomes and Complications --- p.14 / Chapter II.A.4.a. --- Low Birth Weight --- p.16 / Chapter II.A.4.b. --- Fetal Loss --- p.17 / Chapter II.A.4.c. --- Pregnancy Induced Hypertension --- p.18 / Chapter II.B. --- Maternal Serum Human Chorionic Gonadotrophin Screening in Singleton Pregnancies --- p.18 / Chapter II.B.1. --- Physiology of Human Chorionic Gonadotrophin --- p.18 / Chapter II.B.2. --- Historical Background of Screening by Human Chorionic Gonadotrophin --- p.20 / Chapter II.B.3. --- Factors that Influence Maternal Serum Human Chorionic Gonadotrophin --- p.21 / Chapter II.B.4. --- Elevated Maternal Serum Human Chorionic Gonadotrophin Concentration and Pregnancy Complications --- p.21 / Chapter II.B.5. --- Maternal Serum AFP and hCG Concentrations and Adverse Outcomes or Complications in Twin Pregnancies --- p.23 / Chapter II.C. --- Mechanism for the Association between Adverse Outcomes and Elevated Maternal Serum Alpha- fetoprotein and Human Chorionic Gonadotrophin --- p.25 / Chapter III. --- METHODS --- p.28 / Chapter III.A. --- Study Population --- p.28 / Chapter III.B. --- Sample Collection and Analysis --- p.29 / Chapter III.C. --- Clinical Information --- p.30 / Chapter III.D. --- Microparticle Enzyme Immunoassay --- p.30 / Chapter III.D.1. --- Principles --- p.30 / Chapter III.D.1.a. --- Reaction Process --- p.31 / Chapter III.D.1.b. --- MEIA Assembly --- p.33 / Chapter III.D.1.c. --- Operation --- p.34 / Chapter III.D.2. --- AFP Assay --- p.34 / Chapter III.D.2.a. --- AFP Reagents --- p.34 / Chapter III.D.2.b. --- Sample Dilution --- p.36 / Chapter III.D.3. --- Total p-hCG Assay --- p.37 / Chapter III.D.3.a. --- Total p-hCG Reagents --- p.37 / Chapter III.D.3.b. --- Sample Dilution --- p.39 / Chapter III.D.4. --- Intra- and Inter-assay Variation --- p.39 / Chapter III.E. --- Data Handling --- p.42 / Chapter III.F. --- Statistical Analysis --- p.42 / Chapter III.F.1. --- Calculations of Median Values of Maternal Serum Alpha-fetoprotein and Human Chorionic Gonadotrophin Concentrations --- p.42 / Chapter III.F.2. --- Analysis for Adverse Outcomes or Complications --- p.43 / Chapter III.F.3. --- Adjustment of Alpha-fetoprotein and Human Chorionic Gonadotrophin for Gestational Age and Maternal Weight --- p.46 / Chapter IV. --- RESULTS --- p.48 / Chapter IV.A. --- Median Values of Maternal Serum Alpha-fetoprotein Human Chorionic Gonadotrophin --- p.48 / Chapter IV.B. --- Prediction of Adverse Outcomes by Maternal Serum Alpha-fetoprotein and Human Chorionic Gonadotrophin --- p.60 / Chapter IV.B. l. --- Preterm Delivery --- p.60 / Chapter IV.B.2. --- Spontaneous Preterm Delivery --- p.64 / Chapter IV.B.3. --- Premature Delivery --- p.68 / Chapter IV.B.4. --- Spontaneous Premature Delivery --- p.68 / Chapter IV.B.5. --- Other Outcomes or Complications --- p.72 / Chapter IV.B.6. --- Single Predictor for Most Adverse Outcomes --- p.74 / Chapter IV.C. --- Adjustment of Maternal Serum Alpha-fetoprotein and Human Chorionic Gonadotrophin for Maternal Weight and Gestational Age --- p.75 / Chapter IV.C.1. --- Distribution of Alpha-fetoprotein and Human Chorionic Gonadotrophin during Mid-trimester --- p.76 / Chapter IV.C.2. --- Adjustment of Alpha-fetoprotein for Maternal Weight and Gestational Age --- p.79 / Chapter IV.C.3. --- Adjustment of Human Chorionic Gonadotrophin for Maternal Weight and Gestational Age --- p.80 / Chapter IV.D. --- Predictiveness of Alpha-fetoprotein and Human Chorionic Gonadotrophin for Adverse Outcomes after Adjusted for Maternal Weight and Gestational Age --- p.83 / Chapter IV.D.l. --- Preterm Delivery --- p.86 / Chapter IV.D.2. --- Spontaneous Preterm Delivery --- p.86 / Chapter IV.D.3. --- Premature Delivery --- p.92 / Chapter IV.D.4. --- Spontaneous Premature Delivery --- p.92 / Chapter IV.D.5. --- Other Adverse Outcomes or Complications --- p.98 / Chapter IV.D.6. --- Single Predictor for Most Adverse Outcomes --- p.98 / Chapter V. --- DISCUSSIONS --- p.100 / Chapter V.A. --- Median Values of Maternal Serum Alpha-fetoprotein and Human Chorionic Gonadtrophin --- p.100 / Chapter V.B. --- Maternal Serum Alpha-fetoprotein and Human Chorionic Gonadotrophin Screening for Adverse Outcomes --- p.103 / Chapter V.C. --- Adjustment of Alpha-fetoprotein and Human Chorionic Gonadotrophin for Maternal Weight and Gestational Age --- p.109 / Chapter V.D. --- Predictiveness of Alpha-fetoprotein and Human Chorionic Gonadotrophin for Adverse Outcomes after Maternal Weight and Gestational Age Adjustment --- p.112 / Chapter V.E. --- Conclusions --- p.113 / Chapter V.F. --- Future Directions --- p.116 / APPENDIX 1 DATA BASE OF CLINICAL INFORMATION --- p.117 / APPENDIX 2 SEVERITY AND CLASSIFICATION OF PREGNANCY INDUCED HYPERTENSION --- p.122 / REFERENCES --- p.123

Made available in DSpace on 2016-04-27T13:10:24Z (GMT). No. of bitstreams: 1 Thatira Postali Jacinto Pezato.pdf: 1000855 bytes, checksum: 4600871594a9cccf53fdf8b3add0bcc1 (MD5) Previous issue date: 2014-08-08 / Today it exists a wide range and a larger consumption of medicines and little of the risks of those medicines is known for the patient, because the collection of safe information is still a difficult factor. The risk of damages becomes smaller when these are prescribed, released and administered by professionals of the health informed and qualified to understand and to identify potential situations of risk and like this, prevention measures can be taken for the safety of the use of the medicines. This work had as purpose to characterize and to identify the notifications of adverse reactions, adverse events and/or deviations of quality of medicines accomplished in the chemotherapy units and internments of a private hospital, in the period of May to November of 2013. In a first phase, the adverse reactions, quality deviations and adverse events were classified to medicines that happened the months of May, June and July of 2013 following by a training with small applied groups for the responsible researcher. This training was proceeded by the application of a questionnaire with closed questions that sought to measure the degree of the professionals' knowledge, the recognition of the adverse reactions inside to medicines and the importance of the farmacovigilância of the hospital. In the second phase, they were classified the notifications of adverse reactions, adverse events and quality deviations that happened the months of September, October and November of 2013. An increase of 387,5% of the notifications was observed after the training. It was also verified that little understanding exists on farmacovigilância for the professionals of the health, what favored the subnotificação. Was ended that the training on farmacovigilância propitiated the professionals of the health was effective, it increased the number of notifications in the studied units. It is understood that the education enlarges the communicative processes, it establishes the communication and these professionals' collaboration / Hoje existe uma ampla gama e um maior consumo de medicamentos e sabe-se pouco dos riscos desses medicamentos para o paciente, pois a coleta de informações seguras ainda é um fator dificultoso. O risco de danos torna-se menor quando estes são prescritos, dispensados e administrados por profissionais da saúde informados e capacitados para compreender e identificar situações potenciais de risco e assim, medidas de prevenção possam ser tomadas para a segurança do uso dos medicamentos. Este trabalho teve como finalidade caracterizar e identificar as notificações de reações adversas, eventos adversos e/ou desvios de qualidade de medicamentos realizada nas unidades de quimioterapia e internações de um hospital privado, no período de maio a novembro de 2013. Em uma primeira fase, foram catalogadas as reações adversas, desvios de qualidade e eventos adversos a medicamentos que aconteceram nos meses de maio, junho e julho de 2013 seguido de um treinamento com pequenos grupos aplicados pelo pesquisador responsável. Este treinamento foi procedido pela aplicação de um questionário com perguntas fechadas que visaram medir o grau de conhecimento dos profissionais, o reconhecimento das reações adversas a medicamentos e a importância da farmacovigilância dentro do hospital. Na segunda fase, foram catalogadas as notificações de reações adversas, eventos adversos e desvios de qualidade que aconteceram nos meses de setembro, outubro e novembro de 2013. Observou-se um aumento de 387,5% das notificações após o treinamento. Também se verificou que existe pouco entendimento sobre farmacovigilância pelos profissionais da saúde, o que favoreceu a subnotificação. Conclui-se que o treinamento sobre farmacovigilância propiciado aos profissionais da saúde foi efetivo, aumentou o número de notificações nas unidades estudadas. Compreende-se que a educação permanente amplia os processos comunicativos, estabelece a comunicação e a colaboração destes profissionais

Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in Medicine. Johannesburg, 2014 / Background: The causes of renal dysfunction in children treated for childhood cancers are multifactorial and clinical manifestations of dysfunction include hypertension, proteinuria and varying degrees of renal insufficiency. This study aimed to determine the different residual effects of cancer therapy on the renal system and factors associated with the residual effects in children treated for childhood cancers. Patients and Methods: The study was a descriptive cross sectional study that assessed 130 children, between the age of 1 and 18 years, who had completed treatment at Charlotte Maxeke Johannesburg Academic Hospital and were being followed up at the paediatric oncology clinic of the hospital. Results: After a median follow-up post treatment of 2 years, the various manifestations of renal dysfunction identified in the survivors included; decreased GFR, hypomagnesaemia, hypophosphataemia, proteinuria, haematuria and hypertension. In total, 34 survivors (26.15%) had at least one manifestation of renal dysfunction after completing treatment. The most prevalent manifestation of renal dysfunction detected was decreased GFR (17.69%). Hypomagnesaemia and hypophosphataemia were present in 8 (6.15%) and 6 (4.62%) of the survivors respectively. Patients who had renal dysfunction pre-treatment were three times more likely to have renal dysfunction post-treatment. Ifosfamide, Carboplatinum, and nephrectomy were significantly associated with a reduction in GFR Conclusion: A significant number of the survivors had a decreased GFR while some of them had hypomagnesaemia and hypophosphataemia. There was a strong association between pre-treatment and post-treatment renal dysfunction. These findings are very important in terms of decision making for individual patients with respect to selecting treatment modalities and dosages and also with respect to instituting nephro-protective measures to avoid further damage to the kidneys during and after treatment.

Adverse birth outcomes and adverse childhood experiences (ACE) are concerns in the United States, with potential to impact health indices now and in the future. The purpose of this study was to quantitatively examine the association between maternal exposure to ACE, low birth weight, and county of residence in the Appalachian population using the Life Course Approach as the theoretical framework. A cross-sectional study design and clustering strategy was used to randomly select potential respondents from a data set that was provided by Ohio Department of Health. Self-administered questionnaires were sent to potential respondents to collect information about ACE in the maternal population of Appalachia, Ohio with an overall response rate of 29.5% and 212 total participants. A chi-square analysis was completed and no significant association was found between county of residence and risk of low birth weight. However, statistically significant associations were found between the different types of ACE exposure and low birth weight delivery as well as Appalachian county of residence and exposure to ACE. As the sample of low birth weight deliveries was small, it is recommended that the relationship between ACE exposure and low birth weight be further studied to develop more purposeful health interventions to improve maternal health in Appalachia, Ohio specifically, as well as other rural communities. Reducing rates of adverse birth outcomes and chronic disease burden in Appalachia have potential to reduce health disparities between urban and Appalachian communities, allowing for positive social change for many socioeconomically disadvantaged communities and improving population health.

This study examined the potential significant differences in the distribution of adverse drug reactions (ADRs) by reporter (consumer versus physician) and patient outcome at case and event level. This study also contains exploratory questions to evaluate reporting of ADRs by consumers versus physician by system organ class (SOC) and reporter demographics within the United States Food & Drug Administration Adverse Event Reporting System (FAERS). The theoretical foundation applied in this quantitative study was the social amplification of risk framework. Data from the second quarter of 2016 were obtained from FAERS, and a total of 87,807 ADR reports corresponding to 143,399 ADRs were analyzed by utilizing the chi-square test, the odds ratio, and logistic regression. Cross-sectional design was employed to compare reporting of ADRs at the case and event level (case-based and event-based analyses, respectively) between reporters (consumer versus physician), specifically, for patient outcome, as well as SOC and reporter demographics. For both the case-based and event-based analyses, findings revealed that consumers reported more serious ADRs in comparison to physicians. Furthermore, findings confirmed a difference in ADR reporting between consumers and physicians depending on SOC groups. Additionally, consumers reported more nonserious ADRs in comparison to physicians. The results from this study may have implications for positive social change by augmenting pharmacovigilance systems at a national and international level to identify risks and risk factors spontaneously reported after drugs have been on the market.

No description available.

Diss. (sammanfattning) Linköping : Univ. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / The inexistence of medicines that act only in one target cell leads to a possible interaction at others cell structures which are not related to their therapeutic action, coming to the appearance of adverse drug reactions (ADR). The Pharmacovigillance System may lead to a better ADR analysis at a health or research institution, making itself essential for adverse events (AE) registering throughout clinical trials and more efficient investigation and notification afterwards. With the objective of evaluation of AE registered during bioequivalence trials, it was done a retrospective analysis of the voluntaries profiles from these trials in the period of 2000 to 2003. It was evaluated the frequency and the incidence of the events observed from the main pharmacological groups involved in the trials. For the two events more frequent from each pharmacological group, it was evaluated their causuality registered according to the present information found at the scientific literature. A total of 625 AE were analyzed with a mean value of 156 events per year, an incidence of 55,8% of AE per trial and a frequency of 13,89%. To make a standard causuality classification, it was proposed a specific classificatory model for bioequivalence trials. Therefore, the implementation of a standard method for AE causuality classification is essential for a better interpretation and safer notification of ADR. / A inexistÃncia de medicamentos que atuem exclusivamente em um Ãnico alvo celular permite a possÃvel interaÃÃo com outras estruturas que nÃo estÃo relacionadas com sua aÃÃo terapÃutica, vindo a gerar reaÃÃes adversas a medicamentos (RAM). O sistema da FarmacovigilÃncia viabiliza uma melhor anÃlise de RAM em uma instituiÃÃo de saÃde ou de pesquisa necessita, tornando-se fundamental para o registro de eventos adversos durante estudos clÃnicos, posterior investigaÃÃo e notificaÃÃo dos mesmos. Com o objetivo de avaliar os registros de eventos adversos de ensaios clÃnicos de bioequivalÃncia, realizou-se uma anÃlise retrospectiva dos prontuÃrios de voluntÃrios desses ensaios no perÃodo de 2000 a 2003. Foram avaliadas a freqÃÃncia e a incidÃncia dos eventos observados dos principais grupos farmacolÃgicos envolvidos nos ensaios. Para os dois eventos mais freqÃentes de cada grupo farmacolÃgico, avaliou-se sua causalidade registrada no estudo com as informaÃÃes presentes na literatura cientÃfica. Um total de 625 eventos adversos foram analisados, com uma mÃdia de 156 eventos por ano, incidÃncia de 55,8% de eventos adversos por ensaio e freqÃÃncia de 13,89%. Para a padronizaÃÃo da classificaÃÃo de causalidade, propÃs-se um modelo classificatÃrio especÃfico para ensaios de bioequivalÃncia Faz-se, entÃo, viÃvel a implementaÃÃo de um mÃtodo padronizado de classificaÃÃo de causalidade de eventos adversos para uma melhor interpretaÃÃo e notificaÃÃo segura de reaÃÃes adversas.