A permeabilidade através do epitélio intestinal tem se tornado um importante aspecto a ser determinado nas avaliações biofarmacotécnicas envolvendo fármacos e medicamentos. A técnica mais empregada para essa determinação in vitro é aquela que utiliza a cultura de células Caco-2. Entretanto, ainda são discutíveis as condições para a realização desses experimentos, uma vez que a padronização das mesmas é fator fundamental para a confiabilidade dos resultados. Nesta tese, foram avaliadas as condições para realização dos estudos de permeabilidade através de membranas de células Caco-2 para a rifampicina, principal fármaco utilizado no tratamento da tuberculose. Para tanto, foram investigados fatores tais como a citotoxicidade da rifampicina em diferentes concentrações, a influência da concentração do fármaco sobre a permeabilidade, do pH de realização dos experimentos e da presença de proteínas do muco intestinal, além da influência de proteínas plasmáticas. Foi também investigado o potencial indutor da rifampicina sobre a expressão da glicoproteína-P (Pgp) e seu impacto na permeabilidade da própria rifampicina. Os estudos foram desenvolvidos utilizando membranas de células Caco-2 provenientes da American Type Culture Collection (ATCC) cultivadas em placas Transwel®, a quantificação da fração permeada foi por cromatografia líquida de alta eficiência com métodos validados. A análise da indução da expressão da Pgp foi realizada por PCR-RT. Demonstrou-se que as concentrações da rifampicina (10,0; 25,0 e 50,0 µg/mL) não ocasionaram danos às células Caco-2 no estudo de citotoxicidade pela técnica que emprega o sal do brometo de 3-(4,5-dimetil-2-tiazoli)-2,5-difenil-2H-tetrazólio (MTT). As concentrações de rifampicina (5,0; 10,0 e 25,0 µg/mL) não resultaram em valores estatisticamente diferentes de permeabilidade aparente (Papp) em células Caco-2 nas condições do estudo. A rifampicina apresentou valor de Papp significativamente maior em pH 6,8 dentre os valores de pH avaliados (5,8 ; 6,8; 7,4). A presença de muco simulado e de soro fetal bovino não resultou em valores de permeabilidade significativamente distintos do resultado obtido sem a sua adição ao experimento. A expressão da Pgp em células Caco-2 é induzida pela adição da rifampicina (10µg/mL), ocasionando diminuição da sua permeabilidade por mecanismo de efluxo. Pelos resultados de permeabilidade obtidos em todas as condições avaliadas, a rifampicina pode ser considerada um fármaco de alta permeabilidade de acordo com o Sistema de Classificação Biofarmacêutica. / The permeability through the intestinal epithelium has become an important aspect to be determined in evaluations involving drugs and pharmaceutical products. The most common technique for this determination in vitro is one that uses the culture of Caco-2 cells. Nevertheless, the conditions for carrying out such experiments are still questionable, since the standardization of them is essential to the reliability of the results. In this thesis, we evaluate the conditions for the studies of permeability of rifampicin through membranes of Caco-2 cells, the main drug used in the treatment of tuberculosis. To this end, we examined factors such as cytotoxicity of rifampicin at different concentrations, the influence of drug concentration on the permeability, as well as the pH of the experiments, the presence of proteins of intestinal mucus, and the influence of plasma proteins. It was also investigated the potential of rifampicin on the expression of P-glycoprotein (Pgp) and its impact on the permeability of rifampicin itself. The studies were developed using membranes of Caco-2 cells from American Type Culture Collection (ATCC) grown on plates Transwel®, and the quantification of the fraction of drug permeated was obtained by high performance liquid chromatography with validated methods. The analysis of induction of expression of Pgp was performed by RT-PCR. It was demonstrated that the concentrations of rifampicin (10,0; 25,0 and 50,0 µg/mL) did not cause damage to Caco-2 cells in the study of the cytotoxicity technique that uses a bromide salt of 3 - (4,5-dimethyl-2 - thiazol) -2,5-diphenyl-2H-tetrazolium (MTT). The concentrations of rifampicin (5,0; 10,0 and 25,0 &#181g/mL) did not result in statistically different values of apparent permeability (Papp) in Caco-2 cells under the conditions of the study. Rifampicin showed a value of Papp significantly higher at pH 6.8 in comparison with other measured pH values (5,8 and 7,4). The presence of mucus simulated and fetal calf serum did not result in permeability values significantly different from the result obtained without its addition to the experiment. The expression of P-gp in Caco-2 cells is induced by the addition of rifampicin (10 µg/ml), decreasing its permeability by efflux mechanism. Taking into account the results of permeability obtained in all conditions, the rifampicin can be considered a high permeability drug according to the biopharmaceutical classification system.

Orientador: Erika Veruska Paiva Ortolan / Resumo: Introdução: A classificação não eletiva de cirurgias em emergências e urgências é subjetiva e altamente variável entre os cirurgiões. Na tentativa de padronizar essa classificação e diminuir a subjetividade, o Grupo de Estudos da Sociedade Mundial de Cirurgias de Emergência, baseado na experiência adquirida em catástrofes, propôs a classificação para cirurgias de urgência em uma escala de cores que pudesse ser mais facilmente reproduzível. Este estudo avaliou a aplicabilidade do sistema Timing of Acute Care Surgery (TACS - Classificação para atendimento de cirurgias de urgência) em um hospital público terciário de um país em desenvolvimento. Métodos: Este foi um estudo longitudinal, ambispectivo, analítico, de centro único, de março a agosto de 2016 e 2017. Foram selecionadas quatro especialidades cirúrgicas; seus chefes classificaram previamente os seus procedimentos cirúrgicos de urgências e emergências de acordo com o sistema TACS. Para comparação, emergências foram consideradas como vermelhas e laranjas e urgências como amarelas, com tempo ideal para a cirurgia de 1 hora e 6 horas, respectivamente. Resultados: Os procedimentos não eletivos foram 61% do total de cirurgias. Houve predomínio das cores, vermelho, laranja e amarelo. Ocorreram várias alterações nas cores de forma ascendente. Não houve diferença na relação entre o tempo ideal para a cirurgia e o tempo real para a cirurgia antes e depois do sistema TACS. Houve melhora do tempo para cirurgias na cor amarela após o... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Background: The non-elective classification of surgeries in emergencies and urgencies is subjective and highly variable between surgeons. In an attempt to standardize this classification and diminish the subjectivity, the World Emergency Surgery Study Group, based on the experience gained from catastrophes, proposed the classification for emergency surgeries in a colour scale that could be more easily reproducible. This study evaluated the applicability of the Timing of Acute Care Surgery (TACS) system in a public tertiary hospital in a developing country. Methods: This was a longitudinal, ambispective, single-centre study from March to August of 2016 and 2017. Four surgical specialties were selected; their chiefs previously classified all the acute surgical procedures based on TACS. For comparison, emergencies were considered as red and orange and urgencies as yellow, with ideal time to surgery of 1 hour and 6 hours, respectively. Results: The non-elective procedures were 61 % of the total number of surgeries. Red, orange, and yellow were predominant. There were several changes in colours in an ascending manner. There was no difference in the ratio between ideal time to surgery and actual time to surgery before and after the TACS system. There was an improvement of the time to surgeries in the yellow colour after the TACS system. Night and day times influenced the time to surgery, with better results during nights. Conclusions: This is the first study that used the TACS on a... (Complete abstract click electronic access below) / Mestre

Submitted by William Justo Figueiro (williamjf) on 2015-07-18T13:12:39Z No. of bitstreams: 1 49c.pdf: 7911969 bytes, checksum: 0676e3d66dd0b95277c5a1fef4af7376 (MD5) / Made available in DSpace on 2015-07-18T13:12:39Z (GMT). No. of bitstreams: 1 49c.pdf: 7911969 bytes, checksum: 0676e3d66dd0b95277c5a1fef4af7376 (MD5) Previous issue date: 2011 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O constante aumento no volume de informações em diversas áreas do conhecimento, via produção de material bibliográfico, multimídia e web, fruto dos avanços de pesquisas e estudos científicos, tem gerado um problema que é o gerenciamento e integração da informação de diferentes fontes. Com isso, a busca desses conhecimentos acaba tornando-se complexa e custosa, visto o volume de informações em alguns domínios de conhecimento. No entanto, esse conhecimento é de grande importância aos especialistas para raciocinar e chegar a conclusões que são utilizadas em tomadas de decisão ou como meio de solucionar problemas do domínio. Com base nessas necessidades, essa dissertação propõe um sistema de auxílio à classificação que tem como meta, oferecer funcionalidades que permitam aos usuários especialistas realizar a manutenção de informações de um domínio na base de conhecimento e a disseminação dela entre os usuários do sistema, por meio de consultas e/ou sugestões acerca do conhecimento resultante. Onde os resultados apresentados pelo sistema, gerados por meio de um motor de inferência, são baseados em Sistemas Especialistas, que busca construir raciocínios a partir de informações que o usuário possui sobre as observações do cenário do domínio. Juntamente com o sistema de inferência é proposto a associação de imagens relacionadas ao conhecimento, como forma de ilustrar as informações e descrições, e algoritmos de Processamento de Imagens para a redução da subjetividade nos casos de dúvida em relação às características visuais do estudo de caso, visto a falta de definições discretas de algumas informações que descrevem o conhecimento. Como estudo de caso para demonstrar a aplicabilidade do sistema proposto, o trabalho foi focado no domínio da paleontologia, mais especificamente na classificação de espécies de Ostracodes, organismos que representam grande importância para a identificação de fontes petrolíferas. Como resultado do trabalho obteve-se um sistema robusto e genérico, permitindo o armazenando de um grande volume de informações, separado pela área do conhecimento e subdividido por domínios de trabalho. Avaliações realizadas com usuários demonstram a efetividade da ferramenta e apontaram para a evolução de funcionalidades. / The constant increase in the volume of information of several areas of knowledge, through the production of bibliographic, multimedia and web material, is a result of advancements of research and scientific studies, and has led to issues regarding the management and integration of it. Therefore, the search for this knowledge becomes complex and difficult, considering the amount of information in some domains. However, this knowledge shows great importance to experts, who can analyze this information and use it to reach conclusions that are used in decision making or as a way for solving specific problems. Based on these requirements, this dissertation proposes a system to aid classification task, aiming to provide functionalities that allow the expert to maintain domain information in a knowledge base. Also, it is possible to disseminate this information to the others users through searches and/or suggestions, presenting information about the resulting knowledge. The results presented by the system are generated by an inference engine based on Expert Systems, which seeks to produce reasoning from users information about the domain. Along with the inference system is proposed a combination of images related to the knowledge as a way of illustrating the information and descriptions. Also, Image Processing algorithms are employed to reduce subjectivity in cases of uncertainty, regarding the visual characteristics of the case of study, considering the lack of discrete definitions for some information that describe the knowledge. A system was proposed for integrating the Expert Systems and Image Processing techniques. As a way to demonstrate the system applicability, a pertinent problem of paleontology domain focused in classification of Ostracodes species, which have great importance to petroleum exploration, was developed. The system was validated with users and experts that highlight its contribution: able to concentrate and store a big volume of information of many domains, incorporating support decision by image processing, and to be precise to map the expert knowledge. The experts cited as a major contribution that the system represents an application destined to inexperienced users, like students and novice researchers, used in the learning/training process.

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2016-08-30T12:40:36Z No. of bitstreams: 1 PDF - Ana Paula Barbosa Felisberto.pdf: 15150593 bytes, checksum: 91492d03c403e10e2661ddddfff9d3fe (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2016-08-31T18:13:01Z (GMT) No. of bitstreams: 1 PDF - Ana Paula Barbosa Felisberto.pdf: 15150593 bytes, checksum: 91492d03c403e10e2661ddddfff9d3fe (MD5) / Made available in DSpace on 2016-08-31T18:13:01Z (GMT). No. of bitstreams: 1 PDF - Ana Paula Barbosa Felisberto.pdf: 15150593 bytes, checksum: 91492d03c403e10e2661ddddfff9d3fe (MD5) Previous issue date: 2015-08-24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Most active pharmaceutical ingredients are made largely for being administered orally. A major challenge for medicinal products development containing Active Pharmaceutical Ingredients (APIs) with low solubility, especially Class II according to Biopharmaceutical Classification System - BCS, is to add technology to the development process in order to increase the bioavailability of these APIs and at the same time ensure their stability. Thus, the objective was to develop analytical methods to characterize lyophilized solid dispersions of ibuprofen obtained by using carboxymethylcellulose (CMC), hydroxymethylpropylcellulose (HPMC) and polyethylene glycol (PEG) 6000, comparing them in terms of thermal stability. The dispersions were characterized correlating the data obtained by the following techniques: Differential Scanning Calorimetry (DSC), Differential Scanning Calorimetry Coupled to a Photovisual System (DSC-photovisual), Thermogravimetry Analysis (TG) and Vibrational Absorption using Fourier Transform Infrared Spectroscopy (FTIR) to investigate possible physical and/or chemical interaction between the ibuprofen and its excipients. For thermal stability evaluation, the products were subjected to dynamic thermogravimetric analysis, by applying Osawa kinetic model, and to isothermal analysis by Arrhenius model at temperatures of 125, 130, 135, 140 and 145 °C, showing zero order kinetics reaction for the drug in the two models applied. According to the data obtained from the thermal analysis for the characterization and stability, the lyophilized solid dispersions containing PEG as a dispersing agent were more stable. The DSC and FTIR data showed the absence of physical and chemical interaction between the formulation components. / A maioria dos insumos farmacêuticos ativos é viabilizada em grande parte para serem administrados por via oral. Um dos grandes desafios para o desenvolvimento de medicamentos contendo Insumos Farmacêuticos Ativos (IFAs) com baixa solubilidade, em especial os de Classe II relacionados no Sistema de Classificação Biofarmacêutica – SCB, é agregar tecnologias ao processo de desenvolvimento no sentido de aumentar a biodisponibilidade destes IFAs ao mesmo tempo que possa garantir a estabilidade dos mesmos. Assim, objetivou-se desenvolver metodologias analíticas para caracterizar dispersões sólidas liofilizadas de ibuprofeno obtidas com carboximetilcelulose (CMC), hidroximetilpropilcelulose (HPMC) e polietilenoglicol (PEG) 6000, comparando-as em termos de estabilidade térmica. As dispersões foram caracterizadas correlacionando-se os dados obtidos pelas técnicas de calorimetria exploratória diferencial (DSC), calorimetria exploratória diferencial acoplada ao sistema fotovisual (DSC-fotovisual), termogravimetria (TG) e espectroscopia vibracional de absorção na região do infravermelho com transformada de Fourier (FTIR), a fim de investigar possíveis interações físicas e/ou químicas entre o ibuprofeno e seus excipientes. Para avaliação da estabilidade térmica, os produtos foram submetidos à análise termogravimétrica dinâmica, aplicando-se o modelo cinético de Osawa, e isotérmica pelo modelo de Arrhenius nas temperaturas de 125, 130, 135, 140 e 145 °C, apresentando cinética de reação de ordem zero para o fármaco nos dois modelos aplicados. De acordo com os dados obtidos a partir da análise térmica para caracterização e estabilidade, as dispersões sólidas liofilizadas contendo PEG como agente dispersante mostraram-se mais estáveis. Nos dados de DSC e FTIR mostraram a ausência de interação física e química entre os componentes da formulação.

Inland salt lakes in Western Australia have been used by the mining industry for the disposal of excess water generated during the mining process. However, the impact of these operations on the salt lakes is poorly understood. This is mainly due to the lack of information on the biota and chemistry for the lakes. The main aim of this project was to develop a classification system for inland salt lakes of Western Australia based on abiotic and biotic factors such as sediment and water quality, invertebrates and algae to determine lakes with unique or significant features. Water and sediments collected from the salt lakes were generally characterised by an alkaline pH, high salinity and the majority of lakes being dominated by sodium and chloride. Concentrations of some metals were also high, particularly in surface water. A high degree of variation in water and sediment quality was demonstrated both within and between the study lakes. In addition, these parameters were shown to be influenced by geography, geology, stage of the hydrocycle within which the lake was sampled and the occurrence of dewatering discharge. Biota in the salt lakes must be able to cope in a harsh environment, adjusting to temporary water regime, high temperature, and high salinity. As such, the species richness of these systems is generally low. Diatoms (a group of algae) and invertebrates were investigated among the biota. A total of 56 diatom species were recorded from 24 lakes. The most common species were Amphora coffeaeformis, Hantzschia aff. baltica and Navicula aff. incertata. These species were shown to have broad tolerances to environmental variations. Sediment chemistry explained variations in diatom community structure, with zinc, moisture content and cobalt having the greatest and negative influence. / In terms of invertebrates, a total of 101 invertebrate taxa were recorded from 13 lakes in this study. Crustacea dominated and the greatest number of taxa was from the genus Parartemia. There were some differences in invertebrate community structure between lakes, most likely reflecting the high degree of speciation, and poor dispersal mechanisms of certain key species. Community structure was influenced by water quality, with phosphorus, bicarbonate and magnesium contributing to the variations in community structure. Among the 43 lakes chosen for this study a total of 17 lakes had received, or are currently receiving dewatering discharge. Sites receiving dewatering discharge generally reported higher concentrations of salts, nutrients and some metals in both water and sediments compared to natural lakes. Species richness of biota such as diatoms and invertebrates was lower at the lakes receiving dewatering discharge. However, the impact was generally localized within the pooled area of dewatering discharge. Also, despite these impacts, there appears to be signs of amelioration by flushing events. Currently there are no guidelines for water and sediment chemistry for inland salt lakes in Western Australia. Australian and New Zealand Environment and Conservation Council (ANZECC) guidelines are the most relevant available. Concentrations of cadmium, cobalt, chromium, copper, lead, nickel and zinc in surface water of the natural inland salt lakes were shown to exceed ANZECC guideline values. / Comparison with the relevant ANZECC sediment guidelines showed that they were applicable to the salt lakes, with the exception of nickel and chromium which were naturally high in the salt lake sediments. Classification of data using multivariate analysis was done for both dry and wet phases of the hydroperiod. Six groups were delineated for the sediment and diatom data, and four groups were defined for the water quality and invertebrate data. It was common for sites from particular lakes to fall in more than one group as a result of the variability in these systems. There are a number of practical applications of this system for the mining industry and it may be used as a predictive tool for determining the impact of dewatering discharge and highlighting unique salt lakes within the Goldfields of Western Australia.

[Tuncated abstract] This research thesis consists of five sections. Section one provides the background information (chapter 1) and a description of characteristics of the cohort and the methods of analysis (chapter 2). The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system is one of commonly used severity of illness scoring systems in many intensive care units (ICUs). Section two of this thesis includes an assessment of the performance of the APACHE II scoring system in an Australian context. First, the performance of the APACHE II scoring system in predicting hospital mortality of critically ill patients in an ICU of a tertiary university teaching hospital in Western Australia was assessed (Chapter 3). Second, a simple modification of the traditional APACHE II scoring system, the 'admission APACHE II scoring system', generated by replacing the worst first 24-hour data by the ICU admission physiological and laboratory data was assessed (Chapter 3). Indigenous and Aboriginal Australians constitute a significant proportion of the population in Western Australia (3.2%) and have marked social disadvantage when compared to other Australians. The difference in the pattern of critical illness between indigenous and non-indigenous Australians and also whether the performance of the APACHE II scoring system was comparable between these two groups of critically ill patients in Western Australia was assessed (Chapter 4). Both discrimination and calibration are important indicators of the performance of a prognostic scoring system. ... The use of the APACHE II scoring system in patients readmitted to ICU during the same hospitalisation was evaluated and also whether incorporating events prior to the ICU readmission to the APACHE II scoring system would improve its ability to predict hospital mortality of ICU readmission was assessed in chapter 10. Whilst there have been a number of studies investigating predictors of post-ICU in-hospital mortality none have investigated whether unresolved or latent inflammation and sepsis may be an important predictor. Section four examines the role of inflammatory markers measured at ICU discharge on predicting ICU re- 4 admission (Chapter 11) and in-hospital mortality during the same hospitalisation (Chapter 12) and whether some of these inflammatory markers were more important than organ failure score and the APACHE II scoring system in predicting these outcomes. Section five describes the development of a new prognostic scoring system that can estimate median survival time and long term survival probabilities for critically ill patients (Chapter 13). An assessment of the effects of other factors such as socioeconomic status and Aboriginality on the long term survival of critically ill patients in an Australian ICU was assessed (Chapter 14). Section six provides the conclusions. Chapter 15 includes a summary and discussion of the findings of this thesis and outlines possible future directions for further research in this important aspect of intensive care medicine.

Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

Es wird eine Konkordanz zwischen den beiden Klassifikationssystemen RVK und DDC für das Fach Psychologie vorgestellt. Eine im Vorfeld durchgeführte Befragung ergab, dass der Bedarf bei den Bibliotheksverbünden vorhanden ist. Bislang wurde aber der hohe individuelle Aufwand gescheut. Hintergrund für das Erarbeiten der Konkordanz war die Übernahme des Fachgebietes durch die Referentin. Für Bibliothekskataloge weltweit spielen Konkordanzen bei der Indexierung und beim Retrieval eine Rolle. Gegenüberstellungen zwischen verschiedenen Systemen sind essenzielle Vorraussetzungen für das Semantic Web. In der Kombination verschiedener Erschließungsverfahren wie z.B. social tagging Klassifizierung und normierter Sacherschließung können Konkordanzen dazu beitragen, in intelligenten, selbstlernenden Datenbanken zu stetig wachsenden, mit zusätzlichen Informationen angereicherten und verlinkten Datenpräsentation zu kommen. Für eine Weiterentwicklung bietet sich die Verknüpfung von Begriffen und Informationen an, die unter dem Begriff „Ontology learning“ beschrieben werden. Im Vorfeld der Konkordanzerstellung musste festgelegt werden, welche Klassifikation die Basis bildet, auf die das andere System abgebildet wird. Ebenso war zu prüfen, ob eine strukturierte Gegenüberstellung machbar ist. Kann die unterschiedliche Hierarchietiefe zwischen der RVK und sinnvoll abgebildet werden? Es ist denkbar, die Konkordanz in kollaborativer Zusammenarbeit mit anderen Bibliotheken weiterzuentwickeln sowie Crosswalks zu Thesauri und Metadaten zu schaffen. In der anschließenden Diskussion gibt es die Möglichkeit, den erreichten Stand nach inhaltlichen und formalen Aspekten zu bewerten und künftige Anwendungsmöglichkeiten zu erörtern. Dazu zählen u.a. Fragen der automatischen Konkordanzerstellung mittels statistischer Verfahren als auch die technischen Lösungsansätze des Inputs von Konkordanzen in Ontologien. In der Verzahnung von automatischen statistischen Verfahren und manuell erstellten Korrelationen sind weitere Synergien denkbar, die diskutiert werden können.

According to the National Drug Policy one of the health services objectives is to ensure the availability and accessibility of essential drugs to all citizens. An economic objective of the same policy is to promote the cost-effective and rational use of drugs (Department of Health, 1996). Currently, there is no system to scientifically determine the usage of medicines in the public sector and whether the current usage is satisfactory enough (John, 2004:2). The World Health Organization states that "good drug supply management is an essential component of effective and affordable health care services globally (World Health Organization, 1998:1). In the South African context, even though the Essential Drug List helps health care professionals to treat diseases in the public sector, it does not prescribe the minimum guidelines for medicine supply systems (Department of Health, 2006a). The general objective of this study was to develop a therapeutic medicine budget model in a district hospital in the public sector of the North-West Province to control medicine usage. This can be done after analysing the medicine usage patterns and then developing a framework for therapeutic budgeting by evaluating appropriate systems, i.e. the International Code for Disease (ICD-10) classification system, with the therapeutic budget model framework. Retrospective drug utilisation of six months (January 2007 until June 2007) was documented. A random sample population of 25% was selected (n = 1 494). After the data collection period of 9 weeks, the actual study population was only 18.67% (only 1 166 of the 1 494 patients files had a medicine history). All the medicine items prescribed were classified in the therapeutic budget model. Patient confidentially was assured by using a unique pin number on the survey form, so that no names of patients or other biographical details were collected from the patient files onto the survey form, which is in line with the requirements of the Ethics Committee approval conditions for the North-West University. The total number of medicine items dispensed during the study period was 11 768. The average cost per medicine item was R19.36 ± 86.79 for inpatients. The total number of consultations was 3 220. The average number of medicine items per consultation was 3.66 ± 1.98. The total cost of medicine items during the study period was R244 677.11. The average medicine cost per consultation for inpatients was R70.80 ± 177.72. The top three budget groups according to frequency represented 68.11% of all medicine used according to budget groups. The top three pharmacological groups according to total cost represented 61.68% of the total cost of pharmacological groups. The top three therapeutic codes according to frequency represented 18.75% of all therapeutic codes. The top three ICD-10 codes based on total cost represented 59.35% of all medical conditions diagnosed. The total hospital budget for 2007 was predicted at R3 276 750.00. Of this budget, 75% was for pharmaceuticals (R2 457 562.50). The total pharmaceutical medicine cost (excluding surgicals) from the study was R224 677.11 (this was for 18.67% of the total patient visits for six months) which can be calculated at R2 406 824.96 for all patients visits in a full year. The correlation between the actual budget and the projected budget showed a R50 737.54 surplus in the budget of the hospital. A therapeutic budget model can also help in achieving the following: • Proper preparation and planning of budgetary policies in a phased manner based on scientific evidence; • Evaluation of budgetary compliance, cost-efficiency of therapy and standard treatment guidelines (STG) / Essential Drug List (EDL) / formulary compliance; • Better procurement strategies based on demand, expenditure and inventory control; and • Better delivery and maintenance of quality health care by evaluating operational and clinical policies. The therapeutic budget model is a more appropriate manner to use in the projections of budgets and medicine usage. The scope of a therapeutic budget model to be implemented in the hospitals in the public sector of the North-West Province seems to be promising. / Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.