Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 4 uppsatser.

A mucosite bucal (MB) é uma complicação comum no tratamento do câncer e o desenvolvimento de intervenções efetivas para sua prevenção e tratamento são vistos como prioridade nos cuidados de suporte ao paciente oncológico. O objetivo do presente estudo foi investigar fatores de risco relacionados à incidência de mucosite bucal em pacientes submetidos a transplante de células progenitoras hematopoiéticas (TCPH) e em pacientes oncológicos pediátricos. Foram realizados dois estudos: o primeiro analisando a relação entre a incidência de mucosite bucal e o estado de saúde bucal, neutropenia, leucopenia e níveis de IL-1β em pacientes submetidos ao TCPH; e, o segundo, avaliando a incidência de mucosite bucal em pacientes oncopediátricos submetidos a diferentes protocolos quimioterápicos e sua relação com toxicidade hematológica, hepática e renal. Estudo 1: Foram avaliados 54 pacientes submetidos ao TCPH coletados dados demográficos e de à história médica foram coletados. Todos os pacientes foram avaliados quanto a saúde bucal através da análise do índice de placa (IP), índice gengival (IG), número de dentes cariados, perdidos e obturados (CPOD) e exame da mucosa bucal. Todos os pacientes receberam tratamento dentário e orientações de higiene bucal prévio bem como, fotobiomodulação (FBM) com laser de diodo InGaAlP como protocolo preventivo para mucosite bucal. Os pacientes foram avaliados diariamente desde o condicionamento ate o final do transplante. Avaliações de mucosite bucal, níveis de neutrófilos e leucócitos e análise de IL-1β foram realizados nos períodos de condicionamento, D+3 e D+8. Os pacientes que apresentaram gengivite severa anterior ao condicionamento para o transplante e que apresentaram neutropenia grave e leucopenia mostraram associação com o desenvolvimento OM. Os pacientes com mucosite bucal apresentaram níveis mais baixos de IL-1β. Estudo 2: Foram acompanhados 172 ciclos de quimioterapia realizados em 40 pacientes pediátricos. Dados de toxicidade hematológica (níveis de plaquetas, leucócitos, neutrófilos e hemoglobina), hepática (níveis de bilirrubina, TGO, TGP) e renal (creatinina e uréia) nos períodos D1, D5, D10 e D15 foram coletados. Avaliação do grau de mucosite bucal foi realizado diariamente a partir de D1 até D15. Os pacientes que desenvolveram mucosite receberam FBM 3 vezes por semana como tratamento. Os resultados mostraram que a mucosite bucal em pacientes oncológicos pediátricos tem relação com o tipo de protocolo quimioterápico utilizado, com a diminuição nos níveis de plaquetas, leucócitos e hemoglobina bem como, com o aumento dos níveis de bilirrubina. Os níveis de plaquetas e de bilirrubina podem ser considerados como fatores de risco para predizer o desenvolvimento de mucosite bucal. Conclui-se que ambos os trabalhos vieram a contribuir para a elucidação de fatores envolvidos no desenvolvimiento de mucosite bucal em pacientes submetidos ao TCPH e em pacientes oncopediátricos. / Oral mucositis (OM) is a common complication in cancer treatment. The development of effective interventions for prevention and treatment are seen as priority in supportive care cancer patients. The aim of this study was to investigate risk factors related to the incidence of oral mucositis in patients undergoing to hematopoietic stem cells transplantation (HSCT) and in pediatric oncology patients. Two studies were performed: the first analyzing the relationship between oral mucositis incidence with oral health status, neutropenia, leukopenia, and IL-1β levels in patients undergoing to HPCT; and the second, evaluating the incidence of oral mucositis in pediatric oncological patients undergoing to different chemotherapy protocols and their relationship with toxicity haematological, of liver and of kidney. Study 1: A total of 54 patients undergoing to HSCT were collected demographic data and medical history. All patients were evaluated for the oral health through plaque index (PI), gingival index (GI), number of decayed, missing and filled (DMF) and oral mucosa examination. All patients received prior dental and oral hygiene as well as photobiomodulation (PBM) InGaAlP diode laser as a preventive protocol for oral mucositis. Patients were evaluated daily from the conditioning until the end of transplantation. Reviews of oral mucositis, neutrophil ans leukocytes levels and IL- 1β analysis were performed in periods of conditioning, D+3 and D+8. Patients with previous severe gingivitis to conditioning for transplantation and who had severe neutropenia and leukopenia showed association with OM development. The oral mucositis patients had lower levels of IL-1β. Study 2: Wewre analyzed a total of 172 cycles of chemotherapy conducted in 40 oncological pediatric patients. Haematological toxicity data (levels of platelets, leukocytes, neutrophils, and hemoglobin), liver (bilirubin, GOT, GPT) and renal (creatinine and urea) in the periods D1, D5, D10 and D15 were collected. oral mucositis grade evaluation was performed daily from D1 to D15. Patients who developed oral mucositis received three times a week PBM as treatment. The results showed that oral mucositis in pediatric oncology patients is related to the type of chemotherapy protocol used with the decrease in the levels of platelets, leucocytes and hemoglobin as well as with the increase of the bilirubin level. The levels of platelets and bilirubin may be considered as risk factors to predict the development of oral mucositis. We conclude that both studies contributed to the elucidation of factors involved in the development of oral mucositis in patients undergoing HSCT and pediatric oncology patients.

A mucosite bucal (MB) é uma complicação comum no tratamento do câncer e o desenvolvimento de intervenções efetivas para sua prevenção e tratamento são vistos como prioridade nos cuidados de suporte ao paciente oncológico. O objetivo do presente estudo foi investigar fatores de risco relacionados à incidência de mucosite bucal em pacientes submetidos a transplante de células progenitoras hematopoiéticas (TCPH) e em pacientes oncológicos pediátricos. Foram realizados dois estudos: o primeiro analisando a relação entre a incidência de mucosite bucal e o estado de saúde bucal, neutropenia, leucopenia e níveis de IL-1β em pacientes submetidos ao TCPH; e, o segundo, avaliando a incidência de mucosite bucal em pacientes oncopediátricos submetidos a diferentes protocolos quimioterápicos e sua relação com toxicidade hematológica, hepática e renal. Estudo 1: Foram avaliados 54 pacientes submetidos ao TCPH coletados dados demográficos e de à história médica foram coletados. Todos os pacientes foram avaliados quanto a saúde bucal através da análise do índice de placa (IP), índice gengival (IG), número de dentes cariados, perdidos e obturados (CPOD) e exame da mucosa bucal. Todos os pacientes receberam tratamento dentário e orientações de higiene bucal prévio bem como, fotobiomodulação (FBM) com laser de diodo InGaAlP como protocolo preventivo para mucosite bucal. Os pacientes foram avaliados diariamente desde o condicionamento ate o final do transplante. Avaliações de mucosite bucal, níveis de neutrófilos e leucócitos e análise de IL-1β foram realizados nos períodos de condicionamento, D+3 e D+8. Os pacientes que apresentaram gengivite severa anterior ao condicionamento para o transplante e que apresentaram neutropenia grave e leucopenia mostraram associação com o desenvolvimento OM. Os pacientes com mucosite bucal apresentaram níveis mais baixos de IL-1β. Estudo 2: Foram acompanhados 172 ciclos de quimioterapia realizados em 40 pacientes pediátricos. Dados de toxicidade hematológica (níveis de plaquetas, leucócitos, neutrófilos e hemoglobina), hepática (níveis de bilirrubina, TGO, TGP) e renal (creatinina e uréia) nos períodos D1, D5, D10 e D15 foram coletados. Avaliação do grau de mucosite bucal foi realizado diariamente a partir de D1 até D15. Os pacientes que desenvolveram mucosite receberam FBM 3 vezes por semana como tratamento. Os resultados mostraram que a mucosite bucal em pacientes oncológicos pediátricos tem relação com o tipo de protocolo quimioterápico utilizado, com a diminuição nos níveis de plaquetas, leucócitos e hemoglobina bem como, com o aumento dos níveis de bilirrubina. Os níveis de plaquetas e de bilirrubina podem ser considerados como fatores de risco para predizer o desenvolvimento de mucosite bucal. Conclui-se que ambos os trabalhos vieram a contribuir para a elucidação de fatores envolvidos no desenvolvimiento de mucosite bucal em pacientes submetidos ao TCPH e em pacientes oncopediátricos. / Oral mucositis (OM) is a common complication in cancer treatment. The development of effective interventions for prevention and treatment are seen as priority in supportive care cancer patients. The aim of this study was to investigate risk factors related to the incidence of oral mucositis in patients undergoing to hematopoietic stem cells transplantation (HSCT) and in pediatric oncology patients. Two studies were performed: the first analyzing the relationship between oral mucositis incidence with oral health status, neutropenia, leukopenia, and IL-1β levels in patients undergoing to HPCT; and the second, evaluating the incidence of oral mucositis in pediatric oncological patients undergoing to different chemotherapy protocols and their relationship with toxicity haematological, of liver and of kidney. Study 1: A total of 54 patients undergoing to HSCT were collected demographic data and medical history. All patients were evaluated for the oral health through plaque index (PI), gingival index (GI), number of decayed, missing and filled (DMF) and oral mucosa examination. All patients received prior dental and oral hygiene as well as photobiomodulation (PBM) InGaAlP diode laser as a preventive protocol for oral mucositis. Patients were evaluated daily from the conditioning until the end of transplantation. Reviews of oral mucositis, neutrophil ans leukocytes levels and IL- 1β analysis were performed in periods of conditioning, D+3 and D+8. Patients with previous severe gingivitis to conditioning for transplantation and who had severe neutropenia and leukopenia showed association with OM development. The oral mucositis patients had lower levels of IL-1β. Study 2: Wewre analyzed a total of 172 cycles of chemotherapy conducted in 40 oncological pediatric patients. Haematological toxicity data (levels of platelets, leukocytes, neutrophils, and hemoglobin), liver (bilirubin, GOT, GPT) and renal (creatinine and urea) in the periods D1, D5, D10 and D15 were collected. oral mucositis grade evaluation was performed daily from D1 to D15. Patients who developed oral mucositis received three times a week PBM as treatment. The results showed that oral mucositis in pediatric oncology patients is related to the type of chemotherapy protocol used with the decrease in the levels of platelets, leucocytes and hemoglobin as well as with the increase of the bilirubin level. The levels of platelets and bilirubin may be considered as risk factors to predict the development of oral mucositis. We conclude that both studies contributed to the elucidation of factors involved in the development of oral mucositis in patients undergoing HSCT and pediatric oncology patients.

Foi realizado um estudo retrospectivo, por meio da revisão de 72 prontuários de mulheres com diagnóstico de câncer de mama, submetidas ao tratamento quimioterápico neoadjuvante com epirrubicina e docetaxel e no adjuvante, epirrubicina e ciclofosfamida . Os prontuários revisados foram de mulheres na faixa de 30 a 60, acompanhadas no Ambulatório de Mastologia do Departamento de Ginecologia e Obstetrícia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP) e que receberam o tratamento quimioterápico entre os anos de 2003 e 2006. Resultados: As participantes foram divididas em dois grupos, sendo um das 31 mulheres que apresentaram neutropenia e o outro das 41 que não apresentaram. A média de idade das participantes foi de 47,8 anos. Entre as toxicidades gastrointestinais durante a neoadjuvância e a adjuvância observouse a mucosite (8,4% e 2%), náusea (18,6% e 18%) e vômito (3,3% e 18%). Outra intercorrência observada foi o extravasamento durante o tratamento quimioterápico que ocorreu em 17 (23,6%) mulheres. Observou-se que 43% das mulheres apresentaram neutropenia, que analisadas entre os ciclos de quimioterapia foram estatisticamente significantes para os ciclos dois e três da neoadjuvância com valores de p de 0,0016 e 0,0009 respectivamente, para os ciclos dois e três da adjuvância com valores de p de 0.0014 e 0.0030 respectivamente, para o final do tratamento neoadjuvante, anterior ao tratamento cirúrgico sendo o p-valor=<0.0001 e para o final do tratamento adjuvante, com p-valor=<0.0004. Quanto à ocorrência de anemia, esta não esteve relacionada com a presença ou não de neutropenia, entretanto observou-se que houve uma queda nos valores de HB durante a neoadjuvância, com ligeira recuperação no período de adjuvância, porém, não houve recuperação aos valores médios anteriores ao tratamento quimioterápico. A redução da dose foi utilizada para seis mulheres em decorrência da toxicidade hematológica. Registrou-se 152 atrasos entre os ciclos de quimioterapia. Realizado o teste do Log-Rank para o tempo de tratamento e de sobrevida, concluiu-se que esta foi igual para os dois grupos de mulheres. Conclusão: Por meio dos resultados deste estudo demonstra-se a necessidade de elaboração e implementação de protocolos de cuidados de enfermagem para pacientes oncológicos com a finalidade de avaliação dos eventos adversos e manejo mais adequado dos mesmos / Method: Thais study data were collected retrospectively reviewing the chart of 72 women with breast cancer, underwent to chemotherapy for the first time, that used epirubicin and docetaxel to neoadjuvant treatment and epirubicin and ciclophosphamid to adjuvant treatment. The data collection was done with the charts of women, with 30 to 60 years, treated in 2003 to 2006 in followed in the onco-gynecology and mastology sector- Gynecology and Obstetric Department of the University of São Paulo at Ribeirão Preto Medical School Hospital das Clínicas. Results: The participants had been divided in two groups, one with 31 women who had presented neutropenia and the other with 41 that had not presented. The average of age of the participants was of 47,8 years. The gastrointestinal toxicities during the neoadjuvant and adjuvant treatment observed mucositis (8.4% and 2%), nausea (18.6% and 18%) and vomiting (3.3% and 18%). Another observed toxicity was the extravasation during the chemotherapy treatment that occurred in 17 (23.6%) women. Was observed that 43% of the women had respectively presented neutropenia, who analyzed between the chemotherapy cycles had been statistical significant for cycles two and three of the neoadjuvant with values of p = 0,0016 and 0,0009 respectively, for cycles two and three of the adjuvant with values of p =0.0014 and 0.0030. And for the end of the neoadjuvant treatment, previous treatment to the surgical treatment being p-valor=< 0,0001 and for the end of the adjuvant treatment, with p-valor=< 0.0004. To anemia occurrence, this was not related with the presence or not of neutropenia, however it was observed that had a fall in the values of HB during the neoadjuvant, with fast recovery in the period of adjuvant. However, did not have recovery to previous the average values to the chemoterapy treatment. The reduction of the dose was used for six women in result of the hematologic toxicity. Was registered 152 doses delays between the chemotherapy cycles. The Log-Rank test for the time of treatment and survival, concluded that was equal for both groups. Conclusion: Through the results of this study demonstrates the necessity of develop and implement protocols for nursing care to women with breast cancer in order to assess the adverse events and most appropriate management of them

Objetivo: avaliar as habilidades cognitivo-linguísticas de crianças diagnosticadas com leucemia linfoide aguda durante o tratamento quimioterápico. Método: estudo clínico transversal observacional. Formaram o grupo pesquisa (GLL) 18 crianças com idades entre 7 anos e 10 anos e 11 meses, com diagnóstico de leucemia linfoide aguda e em tratamento quimioterápico, que não apresentavam síndromes genéticas, alterações neurológicas e/ou auditivas, não haviam realizado radioterapia e/ou transplante de medula óssea. Foi coletado grupo controle (GC), formado por 18 crianças hígidas, pareadas ao grupo pesquisa por idade, gênero e escolaridade materna. Foram aplicadas provas de avaliação da inteligência não-verbal, fonologia, vocabulário expressivo, fluência verbal, memória verbal de curto prazo e memória verbal operacional. Os dados coletados foram submetidos à análise estatística. Resultados: não houve diferenças estatísticas entre os grupos nas provas de inteligência e vocabulário expressivo. O grupo GLL apresentou desempenho inferior nas demais provas, com diferença significante apenas em memória operacional e na categoria \"partes do corpo\" da prova de fluência verbal. Conclusão: Esse estudo possibilitou uma primeira análise dos efeitos do tratamento quimioterápico em crianças com leucemia nas habilidades cognitivo-linguísticas. Não houve diferença no vocabulário expressivo, mas as habilidades de fluência verbal e memória parecem ser prejudicadas nessas crianças, quando comparadas ao grupo controle, apesar de não haver significância estatística em todas as variáveis / Objective: to evaluate the cognitive-linguistic abilities of children diagnosed with acute lymphoid leukemia during chemotherapy treatment. Methods: observational cross-sectional clinical study. The research group (GLL) was composed by 18 children aged between 7 years and 10 years and 11 months, with diagnosis of acute lymphoid leukemia receiving chemotherapeutic treatment, who did not present genetic syndromes, neurological and/or auditory alterations, had not undergone radiotherapy and/or bone marrow transplantation. A control group (GC) was collected, comprising eighteen healthy children, matched to the research group by age, gender and maternal schooling. Non-verbal intelligence, phonology, expressive vocabulary, verbal fluency, short-term verbal memory, and operational verbal memory were evaluated. The collected data were submitted to statistical analysis. Results: There were no statistical differences between groups in the intelligence and expressive vocabulary tests. The GLL group presented a worse performance in the other tests, but with significant difference only in operational memory and in the \"body parts\" category of the verbal fluency test. Conclusion: This study enabled a first analysis of the effects of chemotherapy treatment in children with leukemia on cognitive-linguistic abilities. There was no difference in expressive vocabulary, but verbal fluency and memory skills appear to be impaired in these children, when compared to the control group, although there was no statistical significance in all variables

Thesis (Ph.D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed on June 26, 2009). Includes bibliographical references.

Objetivo: avaliar as habilidades cognitivo-linguísticas de crianças diagnosticadas com leucemia linfoide aguda durante o tratamento quimioterápico. Método: estudo clínico transversal observacional. Formaram o grupo pesquisa (GLL) 18 crianças com idades entre 7 anos e 10 anos e 11 meses, com diagnóstico de leucemia linfoide aguda e em tratamento quimioterápico, que não apresentavam síndromes genéticas, alterações neurológicas e/ou auditivas, não haviam realizado radioterapia e/ou transplante de medula óssea. Foi coletado grupo controle (GC), formado por 18 crianças hígidas, pareadas ao grupo pesquisa por idade, gênero e escolaridade materna. Foram aplicadas provas de avaliação da inteligência não-verbal, fonologia, vocabulário expressivo, fluência verbal, memória verbal de curto prazo e memória verbal operacional. Os dados coletados foram submetidos à análise estatística. Resultados: não houve diferenças estatísticas entre os grupos nas provas de inteligência e vocabulário expressivo. O grupo GLL apresentou desempenho inferior nas demais provas, com diferença significante apenas em memória operacional e na categoria \"partes do corpo\" da prova de fluência verbal. Conclusão: Esse estudo possibilitou uma primeira análise dos efeitos do tratamento quimioterápico em crianças com leucemia nas habilidades cognitivo-linguísticas. Não houve diferença no vocabulário expressivo, mas as habilidades de fluência verbal e memória parecem ser prejudicadas nessas crianças, quando comparadas ao grupo controle, apesar de não haver significância estatística em todas as variáveis / Objective: to evaluate the cognitive-linguistic abilities of children diagnosed with acute lymphoid leukemia during chemotherapy treatment. Methods: observational cross-sectional clinical study. The research group (GLL) was composed by 18 children aged between 7 years and 10 years and 11 months, with diagnosis of acute lymphoid leukemia receiving chemotherapeutic treatment, who did not present genetic syndromes, neurological and/or auditory alterations, had not undergone radiotherapy and/or bone marrow transplantation. A control group (GC) was collected, comprising eighteen healthy children, matched to the research group by age, gender and maternal schooling. Non-verbal intelligence, phonology, expressive vocabulary, verbal fluency, short-term verbal memory, and operational verbal memory were evaluated. The collected data were submitted to statistical analysis. Results: There were no statistical differences between groups in the intelligence and expressive vocabulary tests. The GLL group presented a worse performance in the other tests, but with significant difference only in operational memory and in the \"body parts\" category of the verbal fluency test. Conclusion: This study enabled a first analysis of the effects of chemotherapy treatment in children with leukemia on cognitive-linguistic abilities. There was no difference in expressive vocabulary, but verbal fluency and memory skills appear to be impaired in these children, when compared to the control group, although there was no statistical significance in all variables

Tumor recurrence after chemotherapy is a major cause of patient morbidity and mortality. Recurrences are thought to be due to small subsets of stem-like cancer cells that are able to survive chemotherapy and drive tumor re-growth. A more complete understanding of stem-like cancer cell regulation is required to develop therapies to better target and eliminate these cells. Slow-cycling stem cells are integral components of adult epithelial tissues and may give rise to cancer stem cell populations that share similar characteristics. These slow-cycling adult stem cells are inherently resistant to traditional forms of chemotherapy and transference of this characteristic may help to explain therapy resistance in cancer stem cell populations. Using a novel application for the proliferation marker CFSE, we have identified populations of slow-cycling cancer cells with tumor initiating capabilities. As predicted, slow-cycling cancer cells exhibit a multi-fold increase in chemotherapy resistance and retain the ability to re-enter the cell cycle. Furthermore, we observed consistent over-expression of the CDK5 activator, p35, in slow-cycling cancer cells. Manipulation of p35 expression in cancer cells affects cell cycle distribution and survival when these cells are treated with traditional forms of chemotherapy. Additionally, we demonstrate that alterations in p35 expression affect BCL2 levels, suggesting a mechanism for the survival phenotype. Combined, our data suggest a model whereby slow-cycling stem-like cancer cells utilize the p35/CDK5 complex to slow cell cycling speed and promote resistance to chemotherapy. Future p35 targeting, in combination with traditional forms of chemotherapy, may help eliminate these cells and reduce tumor recurrence rates, increasing long-term patient survival.

Tse, Sui Man. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (leaves 95-104). / Abstracts in English and Chinese. / Abstract --- p.i / Acknowledgement --- p.v / Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Motivation --- p.1 / Chapter 1.1.1 --- Basic Concepts and Definitions --- p.2 / Chapter 1.2 --- Evolutionary Algorithms --- p.5 / Chapter 1.2.1 --- Chromosome Encoding --- p.6 / Chapter 1.2.2 --- Selection --- p.7 / Chapter 1.2.3 --- Crossover --- p.9 / Chapter 1.2.4 --- Mutation --- p.10 / Chapter 1.2.5 --- Elitism --- p.11 / Chapter 1.2.6 --- Niching --- p.11 / Chapter 1.2.7 --- Population Manipulation --- p.13 / Chapter 1.2.8 --- Building Blocks --- p.13 / Chapter 1.2.9 --- Termination Conditions --- p.14 / Chapter 1.2.10 --- Co-evolution --- p.14 / Chapter 1.3 --- Local Search --- p.15 / Chapter 1.4 --- Memetic Algorithms --- p.16 / Chapter 1.5 --- Objective --- p.17 / Chapter 1.6 --- Summary --- p.17 / Chapter 2 --- Background --- p.18 / Chapter 2.1 --- Multiple Drugs Tumor Chemotherapy --- p.18 / Chapter 2.2 --- Bioinformatics --- p.22 / Chapter 2.2.1 --- Basics of Bioinformatics --- p.24 / Chapter 2.2.2 --- Applications on Biomedical Systems --- p.26 / Chapter 3 --- A New Drug Administration Dynamic Model --- p.29 / Chapter 3.1 --- Three Drugs Mathematical Model --- p.31 / Chapter 3.1.1 --- Rate of Change of Different Subpopulations --- p.32 / Chapter 3.1.2 --- Rate of Change of Different Drug Concen- trations --- p.35 / Chapter 3.1.3 --- Toxicity Effects --- p.35 / Chapter 3.1.4 --- Summary --- p.36 / Chapter 4 --- Memetic Algorithm - Iterative Dynamic Program- ming (MA-IDP) --- p.38 / Chapter 4.1 --- Problem Formulation: Optimal Control Problem (OCP) for Mutlidrug Optimization --- p.38 / Chapter 4.2 --- Proposed Memetic Optimization Algorithm --- p.40 / Chapter 4.2.1 --- Iterative Dynamic Programming (IDP) . . --- p.40 / Chapter 4.2.2 --- Adaptive Elitist-population-based Genetic Algorithm (AEGA) --- p.44 / Chapter 4.2.3 --- Memetic Algorithm 一 Iterative Dynamic Programming (MA-IDP) --- p.50 / Chapter 4.3 --- Summary --- p.56 / Chapter 5 --- MA-IDP: Experiments and Results --- p.57 / Chapter 5.1 --- Experiment Settings --- p.57 / Chapter 5.2 --- Optimization Results --- p.61 / Chapter 5.3 --- Extension to Other Mutlidrug Scheduling Model . --- p.62 / Chapter 5.4 --- Summary --- p.65 / Chapter 6 --- DNA Sequencing by Hybridization (SBH) --- p.66 / Chapter 6.1 --- Problem Formulation: Reconstructing a DNA Sequence from Hybridization Data --- p.70 / Chapter 6.2 --- Proposed Memetic Optimization Algorithm --- p.71 / Chapter 6.2.1 --- Chromosome Encoding --- p.71 / Chapter 6.2.2 --- Fitness Function --- p.73 / Chapter 6.2.3 --- Crossover --- p.74 / Chapter 6.2.4 --- Hill Climbing Local Search for Sequencing by Hybridization --- p.76 / Chapter 6.2.5 --- Elitism and Diversity --- p.79 / Chapter 6.2.6 --- Outline of Algorithm: MA-HC-SBH --- p.81 / Chapter 6.3 --- Summary --- p.82 / Chapter 7 --- DNA Sequencing by Hybridization (SBH): Experiments and Results --- p.83 / Chapter 7.1 --- Experiment Settings --- p.83 / Chapter 7.2 --- Experiment Results --- p.85 / Chapter 7.3 --- Summary --- p.89 / Chapter 8 --- Conclusion --- p.90 / Chapter 8.1 --- Multiple Drugs Cancer Chemotherapy Schedule Optimization --- p.90 / Chapter 8.2 --- Use of the MA-IDP --- p.91 / Chapter 8.3 --- DNA Sequencing by Hybridization (SBH) --- p.92 / Chapter 8.4 --- Use of the MA-HC-SBH --- p.92 / Chapter 8.5 --- Future Work --- p.93 / Chapter 8.6 --- Item Learned --- p.93 / Chapter 8.7 --- Papers Published --- p.94 / Bibliography --- p.95

O câncer pediátrico é raro em números absolutos, porém quando comparado às incidências em adultos vem apresentando aumento nas taxas de incidência, exigindo um preparo do sistema de saúde para acompanhamento. Este acompanhamento não pode ser igual ao do adulto, visto que crianças possuem diferenças fisiológicas nas diferentes faixas etárias pediátricas. Sendo assim, estudos de utilização de medicamentos são importantes nesta população, a fim de promover o uso racional dos mesmos, bem como, garantir seu uso seguro e uma terapêutica eficaz. O presente estudo tem por objetivo avaliar as prescrições de antineoplásicos, na unidade de oncologia pediátrica de um hospital universitário de Porto Alegre, identificando os protocolos mais utilizados, e posteriormente contextualizando-os com o preconizado no referencial teórico. Foi realizado um estudo transversal prospectivo envolvendo internações realizadas na unidade de oncologia pediátrica do Hospital de Clínicas de Porto Alegre (HCPA). Foram analisadas 274 internações, das quais 40 eram primeira internação e 234 reinternações. A maioria dos pacientes tinha idade de 0 a 10 anos, uma discreta prevalência do sexo masculino, de raça/cor branca, residentes na mesorregião metropolitana. A principal forma de financiamento das internações foi o público, e a principal causa de internação foi o tratamento, sendo o mais frequente o quimioterápico. Foram analisados os protocolos utilizados durante as internações de pacientes com diagnóstico de Leucemia Linfocítica Aguda, Retinoblastoma e Sarcoma de Ewing. Os protocolos são conjunto de regras criadas a partir de grupos cooperativos ou da indústria farmacêutica, permitindo um maior conhecimento sobre os medicamentos utilizados na pediatria. A oncologia pediátrica com sua particularidade de ser uma doença culturalmente ligada ao óbito possui maior facilidade de estudos deste porte. Porém, ainda são necessários mais estudos de utilização destes medicamentos, a fim de agregar conhecimento aos protocolos de tratamento. / Pediatric cancer is rare in absolute numbers, but when compared to the incidence in adults has shown an increase in incidence rates, requiring a prepared system health for following. Pediatrics treatment can’t be the same as that of adults, because children have different physiological differences in pediatric age groups. Studies of medication use in this population are very important in order to promote the rational use of drugs, as well as to guarantee their safe use and effective therapy. The present study aims to evaluate the anticancer prescriptions in pediatric oncology unit of a university hospital in Porto Alegre, identifying the most used protocols, and contextualizing them later with the recommendations in the theoretical framework. A prospective cross-sectional study involving hospital admissions in the pediatric oncology unit of the Hospital de Clínicas de Porto Alegre (HCPA) was performed. We analyzed 274 admissions, which 40 were first admission and 234 were readmissions. These admissions most patients were aged 0 to 10 years, white race, a slight male prevalence, residing in Metropolitan Mesoregion. The financing the hospital admissions was public, and the maining cause of hospitalization was treatment, the most frequent being the chemotherapy. We analyzed the protocols used during the admissions of patients diagnosed with Acute Lymphocytic Leukemia, Retinoblastoma and Ewing's Sarcoma. Protocols are studies that allow a greater knowledge about medicines for pediatric use. The pediatric oncology with its characteristic of being a disease has culturally linked with death ease of studies of this size. However, more studies of medication use are still needed to use these drugs in order to knowledge to the treatment protocols.