by Lee Suk Fan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 140-157). / Abstracts in English and Chinese. / Acknowledgements --- p.ii / Abstract --- p.iii / 槪論 --- p.v / List of Abbreviations --- p.vii / Chapter Chapter 1 --- Introduction --- p.1 / Chapter Chapter 2 --- Sex Difference in Alcohol Consumption on Hamster --- p.31 / Chapter Chapter 3 --- Effect of Chronic Alcohol Consumption --- p.65 / Chapter Chapter 4 --- Effect of Green Tea Polyphenols on Alcohol Metabolizing Enzymes in Hamster --- p.108 / Chapter Chapter 5 --- Conclusion --- p.135 / References --- p.140

Chu Ching Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 170-189). / Abstracts in English and Chinese. / Chapter 1 --- General Introduction --- p.1 / Chapter 1.1 --- Classes of Fatty Acids --- p.3 / Chapter 1.2 --- Polyunsaturated Fatty Acids (n-6 & n-3) --- p.4 / Chapter 1.2.1 --- "High Fish Oil Content in Diet, High n-3 PUFAs Intake, Fight against Cardiovascular Risk" --- p.4 / Chapter 1.2.2 --- n-3 Fatty Acids Improve Hypertension --- p.7 / Chapter 1.2.3 --- n-3 Fatty Acids Protect from Atherosclerosis --- p.8 / Chapter 1.2.4 --- PUFAs are Beneficial in Inflammation --- p.11 / Chapter 1.2.5 --- n-3 PUFAs Help to Control Tumour Growth --- p.13 / Chapter 1.3 --- Obesity and Eating Disorder --- p.14 / Chapter 1.3.1 --- "Obesity, a Companion of the Modern World" --- p.14 / Chapter 1.3.2 --- Health Risks Related to Obesity --- p.16 / Chapter 1.3.3 --- Management of Obesity --- p.19 / Chapter 1.3.4 --- Care Must be Taken to Prevent the Development of Eating Disorder or Other Psychological Disturbances during Weight Loss Programme --- p.21 / Chapter 2 --- Weight Cycling with ChowDiet --- p.24 / Chapter 2.1 --- Introduction --- p.24 / Chapter 2.1.1 --- Definition of Weight Cycling --- p.25 / Chapter 2.1.2 --- Incentives Leading to Weight Cycling --- p.26 / Chapter 2.1.3 --- Problems Aroused by Weight Cycling --- p.26 / Chapter 2.1.3.1 --- "Food Preference, Efficiency and Expenditure" --- p.27 / Chapter 2.1.3.2 --- Increased Overall and Central Adiposity --- p.28 / Chapter 2.1.3.3 --- Increased Morbidity and Mortality of Cardiovascular Disease --- p.29 / Chapter 2.1.3.4 --- Psychological Impact and Social Consequences --- p.30 / Chapter 2.2 --- Objective --- p.30 / Chapter 2.3 --- Materials and Methods --- p.31 / Chapter 2.3.1 --- Animal Handling --- p.31 / Chapter 2.3.2 --- Lipid Analysis --- p.35 / Chapter 2.3.2.1 --- Adipose Tissues --- p.35 / Chapter 2.3.2.2 --- Carcass --- p.36 / Chapter 2.3.3 --- Proximate Analysis --- p.37 / Chapter 2.3.3.1 --- Crude Fat --- p.37 / Chapter 2.3.3.2 --- Crude Protein --- p.38 / Chapter 2.3.3.3 --- Moisture --- p.40 / Chapter 2.3.3.4 --- Ash --- p.40 / Chapter 2.3.4 --- Serum Analysis --- p.41 / Chapter 2.3.4.1 --- Serum Triglycerides --- p.41 / Chapter 2.3.4.2 --- Serum Cholesterol --- p.42 / Chapter 2.4 --- Results --- p.44 / Chapter 2.4.1 --- Body Weight --- p.44 / Chapter 2.4.2 --- Food Intake --- p.44 / Chapter 2.4.3 --- Organ Weight --- p.47 / Chapter 2.4.3.1 --- Liver --- p.47 / Chapter 2.4.3.2 --- Adipose Tissues --- p.47 / Chapter 2.4.4 --- Lipid Analysis --- p.52 / Chapter 2.4.4.1 --- Adipose Tissues --- p.52 / Chapter 2.4.4.2 --- Carcass --- p.52 / Chapter 2.4.5 --- Proximate Analysis --- p.60 / Chapter 2.4.5.1 --- Crude Fat --- p.60 / Chapter 2.4.5.2 --- Moisture --- p.60 / Chapter 2.4.5.3 --- Crude Protein and Ash --- p.62 / Chapter 2.4.6 --- Serum Analysis --- p.64 / Chapter 2.4.6.1 --- Serum Triglycerides --- p.64 / Chapter 2.4.6.2 --- Serum Cholesterol --- p.64 / Chapter 2.5 --- Discussion --- p.66 / Chapter 3 --- Degrees of Food Restriction on Bod y Fa tty Acid Composition --- p.71 / Chapter 3.1 --- Introduction --- p.71 / Chapter 3.1.1 --- Skipping Breakfast --- p.71 / Chapter 3.1.2 --- "Nibbling, Grazing vs Gorging" --- p.72 / Chapter 3.1.3 --- Reducing Food Intake in Meals --- p.74 / Chapter 3.1.3.1 --- Anti-Aging Action --- p.74 / Chapter 3.1.3.2 --- Effects on Other Health Issues --- p.75 / Chapter 3.1.3.3 --- Energy Expenditure --- p.77 / Chapter 3.2 --- Objective --- p.78 / Chapter 3.3 --- Materials and Methods --- p.79 / Chapter 3.3.1 --- Animal Handling --- p.79 / Chapter 3.4 --- Results --- p.81 / Chapter 3.4.1 --- Body Weight --- p.81 / Chapter 3.4.2 --- Food Intake --- p.81 / Chapter 3.4.3 --- Organ Weight --- p.83 / Chapter 3.4.3.1 --- Liver --- p.83 / Chapter 3.4.3.2 --- Adipose Tissues --- p.83 / Chapter 3.4.4 --- Lipid Analysis --- p.88 / Chapter 3.4.4.1 --- Adipose Tissues --- p.88 / Chapter 3.4.4.2 --- Carcass --- p.88 / Chapter 3.4.5 --- Proximate Analysis --- p.102 / Chapter 3.4.5.1 --- Crude Fat --- p.102 / Chapter 3.4.5.2 --- Moisture --- p.102 / Chapter 3.4.5.3 --- Crude Protein and Ash --- p.103 / Chapter 3.4.6 --- Serum Analysis --- p.106 / Chapter 3.4.6.1 --- Serum Triglycerides --- p.106 / Chapter 3.4.6.2 --- Serum Cholesterol --- p.106 / Chapter 3.5 --- Discussion --- p.108 / Chapter 4 --- Food Restriction with Diets Containing Various Amount of FAT --- p.112 / Chapter 4.1 --- Introduction --- p.112 / Chapter 4.1.1 --- Adverse Effects of High-Fat Diets --- p.113 / Chapter 4.1.2 --- Adverse Effects of Low-Fat Diets --- p.114 / Chapter 4.2 --- Objective --- p.116 / Chapter 4.3 --- Materials and Methods --- p.117 / Chapter 4.3.1 --- Animal Handling --- p.117 / Chapter 4.4 --- Results --- p.120 / Chapter 4.4.1 --- Body Weight --- p.120 / Chapter 4.4.2 --- Food Intake --- p.120 / Chapter 4.4.3 --- Organ Weight --- p.122 / Chapter 4.4.3.1 --- Liver --- p.122 / Chapter 4.4.3.2 --- Adipose Tissues --- p.122 / Chapter 4.4.4 --- Lipid Analysis --- p.127 / Chapter 4.4.4.1 --- Adipose Tissues --- p.127 / Chapter 4.4.4.2 --- Carcass --- p.127 / Chapter 4.4.5 --- Proximate Analysis --- p.147 / Chapter 4.4.5.1 --- Crude Fat --- p.147 / Chapter 4.4.5.2 --- Moisture --- p.147 / Chapter 4.4.5.3 --- Crude Protein and Ash --- p.148 / Chapter 4.4.6 --- Serum Analysis --- p.151 / Chapter 4.4.6.1 --- Serum Triglycerides --- p.151 / Chapter 4.4.6.2 --- Serum Cholesterol --- p.151 / Chapter 4.5 --- Discussion --- p.153 / Chapter 5 --- Future Prospects --- p.159 / Chapter 5.1 --- Leptin --- p.159 / Chapter 5.2 --- Enzymes --- p.162 / Chapter 6 --- Conclusion --- p.166 / Chapter 7 --- References --- p.170

Orientador: Silvana Andrea Molina Lima / Resumo: A cultura de segurança pode ser definida como padrões de comportamento de indivíduos e/ou grupos, baseando-se em valores e atitudes, e que podem determinar a maneira como exercerão seu trabalho. Uma cultura de segurança positiva estabelece uma boa comunicação institucional e um compartilhamento eficaz da percepção sobre a importância da segurança e da confiança nas medidas preventivas adotadas. O presente trabalho teve como objetivo analisar a cultura de segurança do paciente sob a perspectiva dos enfermeiros de um hospital terciário do interior do estado de São Paulo. Trata-se de estudo quantitativo, transversal e descritivo. Foi aplicado o instrumento Hospital Survey on Patient Safety Culture (HSOPSC), validado e traduzido para o português pela ENSP – Fiocruz. A coleta dos dados foi realizada no período de agosto de 2017 a fevereiro de 2018. Após análise dos dados, verificou-se que a população é predominantemente do sexo feminino, e com idade média de 34,19 ± 6.29 anos. A maioria dos enfermeiros tem carga horária de trabalho entre 40 a 59 horas, um tempo de trabalho no hospital e na unidade menor de 5 anos. Em relação as dimensões do questionário sobre a cultura de segurança do paciente, foram avaliadas no geral, de forma positiva. Apenas a dimensão “Quadro de Funcionários” e “Percepção geral de segurança do paciente” foi avaliada de maneira negativa. A instituição possui uma cultura de segurança, uma vez que os profissionais enfermeiros realizam as notificações de ocorrênc... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Safety culture can be defined as a behavioral pattern of individuals and groups, based on their values and attitudes, and that determine the way in which they carry out their work. A safety culture is positive in relation to safety and an effective control of safety in safety and security in the preventive measures adopted. The present study had the objective of analyzing the patient 's culture from the perspective of the nurses of a tertiary hospital in the interior of the state of. This is a quantitative, cross-sectional study. The instrument Hospital Research on Patient Safety Culture, validated and translated into Portuguese by National public health school - Fiocruz, was applied. Data collection was performed from August 2017 to February 2018. After data analysis, the population was predominantly female, with a daily average of 34.19 ± 6.29 years. Most professionals have a working time between 40 and 59 hours. Regarding the dimensions of the filter on the safety culture of the patient, they were evaluated in general, in a positive way. Only one "Employee Scale" and "General Perception of Patient Safety" dimension was evaluated negatively. The institution has a safety culture, since nursing professionals perform events of adverse events such as the existence of an error and the incident without harm. The implementation, evaluation of results, investments in the systematic of errors and professional suitability can strengthen the security in the institution. It is conclude... (Complete abstract click electronic access below) / Mestre

Lam Wai-man Wynnie. / "April 2002." / Thesis (M.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 109-134). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web.

Liu Ming Ju. / "June 2003." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2003. / 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 Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Kwong Man Kwong. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 83-99). / TABLE OF CONTENTS --- p.i / ACKNOWLEDGEMENTS --- p.vi / LIST OF FIGURES --- p.vii / LIST OF ABBREVIATIONS --- p.ix / Chapter I. --- ABSTRACT --- p.1 / Chapter II. --- INTRODUCTION --- p.4 / Chapter III. --- LITERATURE REVIEW --- p.6 / Chapter A. --- EXCITATORY AMINO ACIDS AND EXCITOTOXICITY --- p.6 / Chapter 1. --- GLUTAMATE RECEPTORS --- p.7 / Chapter 2. --- NMDA RECEPTOR --- p.9 / Chapter 3. --- EXCITOTOXICITY --- p.10 / Chapter a. --- ACUTE PHASE --- p.10 / Chapter b. --- DELAYED PHASE --- p.11 / Chapter c. --- MECHANISM --- p.11 / Chapter i) --- Inhibition of Na+，K+-ATPase --- p.12 / Chapter ii) --- Impaired Mitochondrial Calcium Buffering --- p.12 / Chapter iii) --- Perturbation of Cytoskeletal Organisation --- p.13 / Chapter iv) --- Phospholipase Activation --- p.14 / Chapter v) --- Endonuclease Activation --- p.15 / Chapter vi) --- Protein Kinase C Activation --- p.15 / Chapter vii) --- Xanthine Oxidase Activation --- p.16 / Chapter viii) --- Nitric Oxidase Synthase Activation --- p.16 / Chapter B. --- APOPTOSIS --- p.19 / Chapter 1. --- MORPHOLOGICAL CHANGES --- p.19 / Chapter 2. --- BIOCHEMICAL AND MOLECULAR CHANGES --- p.20 / Chapter 3. --- APOPTOTIC MEDIATORS --- p.21 / Chapter a. --- INTERLEUKIN-1β CONVERTING ENZYME (ICE) --- p.21 / Chapter b. --- ENDONUCLEASE --- p.22 / Chapter c. --- NITRIC OXIDE SYNTHASE (NOS) --- p.23 / Chapter d. --- POLY(ADP-RIBOSE) POLYMERASE (PARP) --- p.24 / Chapter e. --- CALPAINS --- p.25 / Chapter IV. --- NMDA INDUCED APOPTOSIS IN RAT RETINA --- p.27 / Chapter A. --- RATIONALE --- p.27 / Chapter B. --- MATERIALS AND METHODS --- p.31 / Chapter 1. --- NMDA INDUCED EXCITOTOXICITY --- p.31 / Chapter a. --- INTRAVITREAL INJECTIONS --- p.31 / Chapter b. --- RETINAL GANGLION CELL COUNTS (RGCC) --- p.32 / Chapter i) --- Flat Preparation of Rat Retina --- p.33 / Chapter ii) --- RGCC --- p.33 / Chapter d. --- INNER RETINAL THICKNESS (IRT) --- p.34 / Chapter i. --- Preparation of Epoxyl Specimens --- p.34 / Chapter ii. --- Measurement of IRT --- p.36 / Chapter 2. --- DOSE RESPONSE STUDY OF NMDA --- p.36 / Chapter 3. --- NMDA INDUCED APOPTOSIS IN RAT RETINA --- p.37 / Chapter a. --- GEL ELECTROPHORESIS OF RETINAL DNA --- p.37 / Chapter b. --- HISTOPATHOLOGICAL STUDIES --- p.39 / Chapter i) --- Light Microscopy --- p.39 / Chapter ii) --- Terminal Deoxynucleotidyl Transferase-mediated dUTP-biotin Nick End Labelling (TUNEL) --- p.40 / Chapter iii) --- Electron Microscopy (EM) --- p.41 / Chapter c. --- MORPHOMETRY --- p.41 / Chapter i) --- TUNEL Positive Nuclei --- p.41 / Chapter ii) --- RGCC and IRT --- p.42 / Chapter 4. --- STUDY OF ENZYME INHIBITORS --- p.42 / Chapter C. --- RESULTS --- p.43 / Chapter 1. --- EXCITOTOXICITY IN RAT RETINA --- p.43 / Chapter a. --- RGCC --- p.43 / Chapter b. --- IRT --- p.44 / Chapter 2. --- DOSE DEPENDENT TISSUE RESPONSES AND REGIONAL RESPONSES --- p.44 / Chapter a. --- RGCC --- p.44 / Chapter b. --- IRT --- p.45 / Chapter 3. --- NMDA INDUCED APOPTOSIS IN RAT RETINA --- p.45 / Chapter a. --- RETINAL DNA GEL ELECTROPHORESIS --- p.46 / Chapter b. --- HISTOPATHOLOGY AND TUNEL --- p.46 / Chapter c. --- MORPHOMETRY OF TUNEL AT THE RGCL AND INL --- p.47 / Chapter d. --- TISSUE RESPONSES AT 7 DAYS AFTER INJECTION --- p.48 / Chapter e. --- EM --- p.48 / Chapter i) --- RGCL --- p.48 / Chapter ii) --- INL --- p.48 / Chapter 4. --- ENZYME INHIBITOR STUDY IN NMDA INDUCED EXCITOTOXICITY --- p.49 / Chapter a. --- EFFECT OF VARIOUS ENZYME INHIBITORS ON RGCC --- p.49 / Chapter b. --- EFFECT OF VARIOUS ENZYME INHIBITORS ON IRT --- p.50 / Chapter D. --- DISCUSSION --- p.51 / Chapter 1. --- NMDA INDUCED EXCITOTOXICITY IN RAT RETINA --- p.51 / Chapter 2. --- DOSE DEPENDENT RESPONSES AND REGIONAL RESPONSES --- p.55 / Chapter 3. --- NMDA INDUCED APOPTOSIS IN RAT RETINA --- p.58 / Chapter 4. --- INHIBITOR STUDY --- p.62 / Chapter a. --- ICE --- p.63 / Chapter b. --- ENDONUCLEASE --- p.65 / Chapter c. --- NOS --- p.67 / Chapter d. --- PARP --- p.69 / Chapter e. --- CALPAIN --- p.70 / Chapter V. --- NMDA INDUCED APOPTOSIS IN RABBIT RETINA --- p.72 / Chapter A. --- RATIONALE --- p.72 / Chapter B. --- MATERIALS AND METHODS --- p.73 / Chapter 1. --- INTRAVITREAL INJECTION OF NMDA --- p.73 / Chapter 2. --- HISTOPATHOLOGY AND TUNEL --- p.74 / Chapter 3. --- MORPHOMETRY OF TUNEL --- p.74 / Chapter 4. --- TISSUE RESPONSES AT 7 DAYS AFTER INJECTION --- p.74 / Chapter a. --- RGCC --- p.74 / Chapter b. --- IRT --- p.74 / Chapter 5. --- EM --- p.75 / Chapter C. --- RESULTS --- p.76 / Chapter 1. --- HISTOPATHOLOGY AND TUNEL --- p.76 / Chapter 2. --- MORPHOMETRY OF TUNEL --- p.77 / Chapter 3. --- TISSUE RESPONSES AT 7 DAYS POST INJECTION --- p.78 / Chapter a. --- RGCC --- p.78 / Chapter b. --- IRT --- p.78 / Chapter 4. --- EM --- p.79 / Chapter a. --- RGCL --- p.79 / Chapter b. --- INL --- p.79 / Chapter B. --- DISCUSSION --- p.80 / Chapter VI. --- CONCLUSION --- p.82 / Chapter VII. --- REFERENCES --- p.83 / Chapter VIII. --- FIGURES --- p.100

Chan Ching-Man Loren. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 126-144). / Abstracts in English and Chinese. / Acknowledgement --- p.ii / Abstract --- p.iii / Table of Content --- p.vii / List of Figure --- p.ix / List of Abbreviations --- p.xii / Chapter Chapter One --- General Introduction / Chapter 1.1 --- Doxorubicin --- p.1 / Chapter 1.2 --- Antioxidants --- p.11 / Chapter 1.3 --- Flavonoids --- p.17 / Chapter 1.4 --- Protection against doxorubicin-induced cardiotoxicity by antioxidant --- p.25 / Chapter 1.5 --- Aim of research --- p.25 / Chapter Chapter Two --- Study of Cardioprotection Effect of Flavonoids Against Doxorubicin-induced Toxicity in Sprague-Dawley Rats / Chapter 2.1 --- Introduction --- p.27 / Chapter 2.2 --- Materials and Methods --- p.29 / Chapter 2.3 --- Results --- p.37 / Chapter 2.4 --- Discussion --- p.51 / Chapter ChapterThree --- Study of Effect of Flavonoids in Chemotherapy of Doxorubicinin Tumor-bearing Mice / Chapter 3.1 --- Introduction --- p.54 / Chapter 3.2 --- Materials and Methods --- p.56 / Chapter 3.3 --- Results --- p.63 / Chapter 3.4 --- Discussion --- p.80 / Chapter ChapterFour --- Study of the Effect of Flavonoids on Doxorubicin-induced Cytotoxicity on Human Tumor Cell Line and Doxorubicin-resistant Human Tumor Cell Line / Chapter 4.1 --- Introduction --- p.83 / Chapter 4.2 --- Materials and Methods --- p.86 / Chapter 4.3 --- Results --- p.94 / Chapter 4.4 --- Discussion --- p.120 / Chapter Chapter five --- Conclusion --- p.122 / References --- p.126

Chun Chiu Ping, Holly. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 129-134). / Abstracts in English and Chinese. / Chapter 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- History of iodinated contrast media --- p.1 / Chapter 1.2 --- Classification of contrast media reactions --- p.4 / Chapter 1.3 --- Mechanisms of contrast media reactions --- p.6 / Chapter 1.4 --- The multi-factorial contrast media reactions --- p.9 / Chapter 1.5 --- Contrast reactions and patient gender --- p.10 / Chapter 1.6 --- Patient profile --- p.11 / Chapter 2 --- HYPOTHESES --- p.12 / Chapter 3 --- OBJECTIVES --- p.13 / Chapter 4 --- CLINICAL IMPLICATIONS --- p.14 / Chapter 5 --- METHODOLOGY --- p.15 / Chapter 5.1 --- Patient groups --- p.16 / Chapter 5.2 --- Choice of contrast media --- p.17 / Chapter 5.3 --- Amount of contrast media --- p.18 / Chapter 5.4 --- Practical points --- p.19 / Chapter 5.5 --- Double blindness of the study --- p.20 / Chapter 5.6 --- Inclusion/exclusion criteria --- p.21 / Chapter 5.7 --- Patient preparation --- p.23 / Chapter 5.8 --- Data acquisition --- p.26 / Chapter 5.9 --- Quality control --- p.27 / Chapter 5.10 --- Data management and analysis --- p.30 / Chapter 6 --- RESULTS --- p.31 / Chapter 6.1 --- Overall frequency of reactions --- p.33 / Chapter 6.2 --- Gender difference of reactions --- p.34 / Chapter 6.3 --- All reactions vs. dose level for different genders --- p.35 / Chapter 6.4 --- All reactions versus dose level - genders compared --- p.38 / Chapter 6.5 --- Patterns of reactions --- p.39 / Chapter 6.6 --- Reactions to different contrast media --- p.46 / Chapter 6.7 --- Management of reactions --- p.54 / Chapter 6.8 --- Summary of reactions --- p.56 / Chapter 7 --- DISCUSSION --- p.59 / Chapter 7.0 --- Introduction --- p.59 / Chapter 7.1 --- Reliability of patients' response --- p.66 / Chapter 7.2 --- Results of quality control (by comparators) --- p.67 / Chapter 7.3 --- "Overall frequency of reactions (both contrast media, immediate and delayed reactions)" --- p.71 / Chapter 7.4 --- Patients' age --- p.79 / Chapter 7.5 --- Why were there more delayed reactions after injecting nonionic Iopamiro? --- p.84 / Chapter 7.6 --- Factors affecting prevalence of reactions to contrast media in intravenous urography --- p.97 / Chapter 7.7 --- Further studies --- p.103 / Chapter 8 --- CONCLUSIONS --- p.104 / Chapter 8.1 --- Recommendations devised from the conclusions (Clinical implications) --- p.106 / Chapter 9 --- APPENDIXES --- p.107 / Chapter 9.1 --- "Appendix 1: Steroid cover regime in Diagnostic Radiology & Organ Imaging Department, Prince of Wales Hospital" --- p.107 / Chapter 9.2 --- Appendix 2: Data sheet to record patient history --- p.109 / Chapter 9.3 --- Appendix 3: Injection conditions and immediate reactions --- p.112 / Chapter 9.4 --- Appendix 4: Data sheet to record delayed reactions --- p.116 / Chapter 9.5 --- Appendix 5: Quality control by comparators --- p.122 / Chapter 10 --- REFERENCES --- p.130

nÃo hà / A farmacovigilÃncia à a ciÃncia relativa à detecÃÃo, avaliaÃÃo, compreensÃo e prevenÃÃo de reaÃÃes adversas ou quaisquer outros possÃveis problemas relacionados a medicamentos. No Brasil, a farmacovigilÃncia encontra-se em desenvolvimento. Ainda nÃo està completamente disseminada a cultura da notificaÃÃo espontÃnea, principalmente na oncologia, onde a ocorrÃncia de reaÃÃo adversa passa muitas vezes despercebida por ser considerada como um evento esperado, e, portanto, sem importÃncia significativa. Este estudo avaliou as aÃÃes de farmacovigilÃncia desenvolvidas numa instituiÃÃo hospitalar da cidade de Teresina-PI, atravÃs da monitorizaÃÃo de pacientes portadores de cÃncer de mama submetidos à terapia antineoplÃsica com o regime de combinaÃÃo FEC. Para isso, foi realizada uma investigaÃÃo baseada em uma revisÃo dos prontuÃrios desses pacientes para detectar o registro: de reaÃÃes adversas decorrentes da quimioterapia antineoplÃsica vigente e da distinÃÃo das mesmas, segundo os graus de severidade estabelecidos pelo National Cancer Institute (NCI); de intercorrÃncias clÃnicas devido à RAM ocorridas durante a terapia e de possÃveis alteraÃÃes no plano do tratamento protocolado (atrasos na realizaÃÃo dos ciclos de quimioterapia ou suspensÃo temporÃria da terapia, reduÃÃes das doses preconizadas) relacionadas com reaÃÃes adversas. De todas as reaÃÃes adversas observadas durante a investigaÃÃo, 2,07% foram registradas em nÃo conformidade com a terminologia qualitativa adotada pelo NCI e 15,06% nÃo foram graduadas quanto à severidade; alÃm disso, 100% das RAMs nÃo foram notificadas à autoridade sanitÃria competente (ANVISA) e nÃo existe um banco de dados institucional com essas reaÃÃes adversas. Foram ainda identificadas 17 (70,83%) intervenÃÃes clÃnicas devido à RAM realizadas em nÃvel ambulatorial e 7 (29,17%) intervenÃÃes clÃnicas devido à RAM que exigiram a hospitalizaÃÃo do paciente; atrasos ou suspensÃo temporÃria da realizaÃÃo dos ciclos de quimioterapia, com 8,70% decorrentes de causas clÃnicas, entre estas reaÃÃes adversas; e 8 (5,84%) casos de reduÃÃo das doses protocoladas devido à presenÃa e severidade de reaÃÃes adversas. Conclui-se que as aÃÃes de farmacovigilÃncia da instituiÃÃo hospitalar ainda sÃo incipientes, com falhas organizacionais que diminuem a confiabilidade das informaÃÃes registradas; alÃm disso, houve a comprovaÃÃo da importÃncia da farmacovigilÃncia em oncologia, onde a toxicidade dos fÃrmacos utilizados pode ser considerada fator limitante primÃrio para uma prÃtica terapÃutica ideal. / Pharmacovigilance is the science concerning the detection, assessment, understanding and prevention of adverse reactions or any other possible drug-related problems. In Brazil, pharmacovigilance is in the developmental stage. The culture of spontaneous reporting not yet fully spread, especially in oncology, where the occurrence of adverse reaction is often unnoticed because it is considered as an expected event, and therefore immaterial. This study evaluated the pharmacovigilance actions carried out at a hospital in the city of Teresina, PI, through the monitoring of patients with breast cancer undergoing anticancer therapy with the FEC protocol. An investigation was undertaken based on a review of the medical records of these patients to detect the registry: of adverse reactions resulting from cancer chemotherapy and the distinction of them according to the degrees of severity established by the National Cancer Institute (NCI); of clinical interventions due to ADR that occurred during therapy and possible changes in the plan of treatment protocol (delays in the achievement of cycles of chemotherapy or temporary suspension of therapy, reductions in the recommended doses) related with adverse reactions. Of all the adverse reactions observed during the investigation, 2,07% were not registered in accordance with the terminology adopted by NCI qualitative and 15,06% were not graded as to severity. In addition, 100% of ADRs were not reported to the recognized health authority (ANVISA) and there is not an institutional database with these adverse reactions. There were also 17 identified (70,83%) clinical interventions due to ADR performed on an outpatient basid and 7 (29,17%) clinical interventions due to ADR that required hospitalization of the patient; delays or temporary suspension of achievement of cycles of chemotherapy with 8,70% due to clinical causes among these adverse reactions; and 8 (5,84%) cases of dose reduction due to the presence and severity of adverse reactions. It is concluded that the pharmacovigilance actions of the hospital are still preliminary, with organizational flaws that reduce the reliability of the information recorded. In addition, there was evidence of the importance of pharmacovigilance in oncology, where the toxicity of drugs used may be considered a limiting factor necessary for an ideal therapeutic practice.

O presente estudo tem o objetivo de analisar as notificações dos incidentes relacionados à assistência à saúde em um hospital universitário brasileiro entre os anos de 2015 e 2016.Para tanto, foram coletados dados secundários dos Eventos Adversos (EA) ocorridos no hospital e registrados no sistema VIGIHOSP, e foram descritos eventos de 8 perfis distintos: Procedimentos cirúrgicos, Quedas, Identificação do Paciente, Flebite, Medicamentos utilizados, Perda do Cateter, Lesão na Pele, e Sangue e Hemocomponentes. Os resultados alcançados têm suporte na literatura, tanto em relação à porcentagem de ocorrência de cada notificação, como também no que diz respeito às notificações que se tornam EA. Uma lacuna foi identificada: a literatura científica reforça bastante o problema da subnotificação e as mazelas dela decorrentes; mas, além desse fato, o que este estudo chama atenção é para a efetividade das notificações incompletas. Sugere-se ao hospital pesquisado a promoção das notificações como parte de uma cultura de segurança, buscando mais os resultados do que os culpados. Propõe-se também a utilização dos EA como indicadores de resultado para a gestão hospitalar, atrelados aos objetivos de qualidade e de custo / This study aims to analyze the reports of incidents related to health care in a Brazilian university hospital during the years 2015 and 2016. To do so, secondary data from Adverse Events (AD) occurred at the hospital and were recorded in the VIGIHOSP system, and events of 8 different profiles were described: Surgical Procedures, Falls, Patient Identification, Phlebitis, Medications Used, Catheter Loss, Skin Injury, and Blood and Hemocomponents. The results obtained are supported in the literature, both in relation to the percentage of occurrence of each notification, as well as with regard to notifications that become AD. A gap has been identified: the scientific literature strongly reinforces the problem of underreporting and the ensuing problems; but beyond this fact, what this study calls attention to is the effectiveness of incomplete notifications. For the researched hospital is suggested to promote the notifications as part of a safety culture, seeking more results than the culprits. It is also proposed the use of AD as outcome indicators for the hospital management, linked to quality and cost objectives