Submitted by admin tede (tede@pucgoias.edu.br) on 2016-08-17T17:57:20Z No. of bitstreams: 1 CYNTHIA LEAO BALDINI RIBEIRO.pdf: 1579335 bytes, checksum: 572a71d61283078013580904ce4f09b0 (MD5) / Made available in DSpace on 2016-08-17T17:57:20Z (GMT). No. of bitstreams: 1 CYNTHIA LEAO BALDINI RIBEIRO.pdf: 1579335 bytes, checksum: 572a71d61283078013580904ce4f09b0 (MD5) Previous issue date: 2013-08-01 / To determine the hematological reference values for various blood dosages in healthy and free-living adults of Cebus libidinosus (bearded capuchin monkeys) and Alouatta caraya (black howler), and to investigate the possible variations related to sex, blood samples were collected from 15 bearded capuchin monkeys (5 males and 10 females) and 47 from black howler monkeys (28 males and 19 females), all manually captured during the fauna rescue of the São Salvador hydroelectric plant located south of the State of Tocantins, in the upper Tocantins River. Therefore, 26 variables were evaluated and divided into the following groups: lipid profile (five variables), hematological profile (nine variables), biochemical (ten variables) and hormonal dosages (two variables). The results for each variable are presented and compared by sex, using descriptive statistics considering the minimum and maximum values, the mean and standard deviation. Significant differences were observed for C. libidinosus in only three variables (body weight, creatinin and T3 hormone) and significant sex difference in only one group of variables (hormones), whereas for A. caraya, significant difference was observed in eight variables (body weight, VLDL, triglycerides, total proteins, RDW, platelet count, LDH and alkaline phosphatase), and only the group of variables related to general biochemistry showed significant sex difference. The importance of this scientific work is due to its unprecedented nature related to the assessment and sexual variation of hematological and biochemical profile of free-living Cebus libidinosus and Alouatta caraya. / Com o objetivo de determinar os valores hematológicos de referência para várias dosagens sanguíneas em Cebus libidinosus (macacos-prego) e Alouatta caraya (bugios pretos) adultos, sadios, de vida livre e investigar as possíveis variações relacionadas ao sexo, foram colhidas amostras de sangue de 15 macacos-prego (5 machos e 10 fêmeas) e 47 bugios pretos (28 machos e 19 fêmeas), todos capturados manualmente durante o resgate de fauna da usina hidrelétrica São Salvador situada ao sul do Estado do Tocantins, no alto rio Tocantins. Foram avaliadas 26 variáveis distribuídas nos seguintes grupos: perfil lipídico (cinco variáveis), perfil hematológico (nove variáveis), dosagens bioquímicas (dez variáveis) e hormonais (duas variáveis). Os resultados obtidos para cada variável foram apresentados e comparados por sexo usando estatística descritiva considerando os valores mínimos, máximos, média e desvio padrão. Para C. libidinosus foi observada diferenças significativas em apenas três variáveis (Peso corporal, creatinina e hormônio T3), houve diferença significativa relacionada ao sexo em apenas um grupo de variáveis (hormônios), enquanto que para A. caraya foi observada diferença significativa em oito variáveis (peso corporal, VLDL, triglicérides, proteínas totais, RDW, plaquetas, DHL e fosfatase alcalina), apenas o grupo de variáveis relacionado à bioquímica geral apresentou variação relacionado aos sexos. A importância deste trabalho científico deve-se ao seu caráter inédito relacionado à avaliação e variação sexual do perfil hematológico e bioquímico de Cebus libidinosus e Alouatta caraya de vida livre.

“Off-label use” is defined as the use of medicine for indications other than recommended or registered for, e.g. the prescribing of a particular active substance for a patient younger than the substance is recommended or indicated for, or different formulations or dosages of a substance (Ekins-Daukes et al., 2004:349; Stedman’s medical dictionary, 2006). Off-label prescribing is common, and fluctuates by physician, patient and drug (Eguale et al., 2012:781). Drug classes most commonly prescribed off-label include anti-asthmatic, cardiovascular drugs and antidepressants. Lee et al. (2012:140) found that 9 out of 10 antidepressants prescribed were associated with unapproved usage of antidepressants. An antidepressant can be defined as a substance that prevents or relieves depression or depressive episodes (Mosby, 2009:115). There is paucity of information on the off-label prescribing practices of antidepressants in the South African private health sector. According to Eguale et al. (2012:781), the paucity of information on off-label prescribing practices may be, in part, ascribed to the difficulty in the establishment of reasons for treatment. The objective of this study was to determine the prescribing patterns of antidepressants as well as to identify off-label prescribing of antidepressants among adults in a section of the private health sector of South Africa by using a medicine claims database. A quantitative and observational, descriptive cross-sectional design was followed in this study. Data for a period of a year, from January to December 2010 were obtained for analysis. The data set consisted of medicine claims for a total number of 1 220 289 patients, containing a total of 8 515 428 prescriptions and 20 527 777 medicine items. The study population (patients receiving antidepressants 18 years and older) accounted for 14.8% (n = 1 220 289) of the total data set. The average age of patients receiving antidepressants was 56.1 ± 16.6 (median = 56.2) (Inter quartile range = 43.3–68.1). Results of the study showed that antidepressant prescriptions accounted for 8.3% (n = 8 515 428) of all prescriptions claimed during 2010. A total 3.5 % (n = 20 527 777) of antidepressants were claimed during the study period. Using the DU90% method it was established that the majority of antidepressant medicine items were prescribed by general practitioners (i.e. 75.7%, n = 702 285) and psychiatrists (14.9%, n = 702 285). Almost 72% (n = 702 885) of antidepressant medicine items claimed for the study population were for women. The most prescribed antidepressants (based on the DU90%) were amitriptyline (20.6%, n = 702 885), citalopram (19.2%), escitalopram (14.6%), fluoxetine (11.7%), venlafaxine (5.7%), paroxetine (5.2%), duloxetine (4.4%), sertraline (3.8%), bupropion (3.1%) and mirtazapine (2.6%). Amitriptyline accounted for 82.4% of off-label prescriptions (n = 2 635), whereas escitalopram and fluoxetine accounted for 4.2% and 3.8%, respectively. The tricyclic antidepressants (TCAs) were mostly prescribed off-label for migraine, headache and sleep disorders. The off-label prescribing of selective serotonin re-uptake inhibitors (SSRIs) included menopause, schizophrenia and headache. The off-label indicated prescriptions of the serotonin and noradrenaline re-uptake inhibitors (SNRIs) were mostly for schizophrenia and other anxiety disorders. Mirtazapine, a serotonin modulator/tetracyclic antidepressant, was mostly prescribed off-label for anxiety disorders. Off-label prescriptions for bupropion, a noradrenaline and dopamine re-uptake inhibitor mainly included other anxiety disorders and attention deficit hyperactivity disorder (ADHD). Furthermore, the prescribed daily dose (PDD) of each active antidepressant for all off-label indications was determined. In conclusion: This study investigated the off-label prescribing patterns of antidepressants among adults a section of the private health sector of a South Africa, using a large medicine claims database. Recommendations for future research were made. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014