Thesis (Ph. D.)--University of Washington, 1996. / Vita. Includes bibliographical references (leaves [56]-64).

Thesis (M. Med. Sc.)--University of Hong Kong, 2004. / Also available in print.

Thesis (M. Med. Sc.)--University of Hong Kong, 2005. / Also available in print.

Made available in DSpace on 2014-06-11T19:35:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-03-16Bitstream added on 2014-06-13T19:24:58Z : No. of bitstreams: 1 steiner_ml_dr_botfm.pdf: 512184 bytes, checksum: d483eb904ab985864204da709525a408 (MD5) / Libbs Farmaceutica / Avaliar comparativamente a eficácia da terapêutica de reposição hormonal (TRH) de baixa dose isolada ou associada à sinvastatina no comportamento de marcadores de risco cardiovasculares e do perfil lipídico e lipoprotéico em mulheres sintomáticas e com dislipidemia na pós-menopausa. Duzentas e quarenta e duas mulheres na pós-menopausa, sintomáticas e com dislipidemia foram randomizadas em três grupos de tratamento: A) estradiol (E2) 1mg/acetato de noretisterona (NETA) 0,5mg [E2/NETA] + sinvastativa 20mg; B) E2/NETA + placebo; e C) sinvastatina 20mg + placebo. A eficácia de cada tratamento foi avaliada pela melhora do perfil lipídico e lipoprotéico e dos sintomas climatéricos ao final de 16 semanas de tratamento. O colesterol total, o LDL-C, o colesterol não-HDL e a Apo B diminuíram de forma significativa (p<0,0001) ao final de 16 semanas no grupo que utilizou E2/NETA + sinvastatina e naquele tratado com sinvastatina + placebo. A relação Apo B/Apo A1 também apresentou redução significativa nestes dois grupos (p<0,0001 e p=0,0026 respectivamente). A Apo A1 diminuiu apenas no grupo que recebeu E2/NETA + sinvastatina (p=0,0055). O grupo E2/NETA + placebo não apresentou alterações significativas no perfil lipídico e lipoprotéico entre as visitas basal e final. Aquele que utilizou E2/NETA + sinvastatina apresentou redução significativa do HDL-C e da Apo A1 quando comparado às usuárias de sinvastatina + placebo (p=0,0233 e p=0,0231 respectivamente). No alívio dos sintomas climatéricos, os grupos que utilizaram E2/NETA foram superiores a sinvastatina + placebo. Em mulheres na pós-menopausa com dislipidemia, a associação de E2/NETA em baixa dose com sinvastatina aliviou os sintomas climatéricos de forma semelhante à observada com a E2/NETA isolada e melhorou o perfil lipídico e lipoprotéico de modo semelhante ao uso isolado da sinvastatina. O uso de E2/NETA sem... / To evaluate low-dose hormone therapy (HT) + simvastatin for vasomotor symptoms and cardiovascular risk markers. Symptomatic postmenopausal women (n=242) with dyslipidemia were randomized to one of three treatment groups: A) 1mg estradiol/0.5mg norethisterone acetate (E2/NETA) + 20mg simvastatin; B) E2/NETA + placebo; or C) 20mg simvastatin + placebo. Lipid and lipoprotein profiles and menopausal symptoms were evaluated after 16 weeks. Total cholesterol, LDL cholesterol, non-HDL cholesterol and Apo-B decreased (p<0.0001) in groups A and C, as did Apo-B/Apo-A1 (p<0.0001 and p=0.0026, respectively). Apo-A1 decreased only in group A (p=0.0055). HDL cholesterol and Apo-A1 were lower in A than C (p=0.0233 and p=0.0231, respectively). Relief of menopausal symptoms was better in A and B compared to C. HT + simvastatin were effective for the treatment of symptomatic postmenopausal women and improved the lipid profile similar to simvastatin alone. It also delivered an improvement in the simultaneous treatment of menopausal symptoms and dyslipidemia

Thesis (MTech (Biomedical Sciences))--Cape Peninsula University of Technology, 2015. / Previous international studies have documented a marked variation in transfusion practice for Total Hip Replacement (THR) surgery. This is despite widespread dissemination of clinical guidelines for the use of blood products. The cost and potential wastage of blood products as well as concerns regarding patient care and outcomes are important drivers of optimal blood management. The aim of this study was to audit red cell product utilisation for THR surgeries at two tertiary referral hospitals.

Class of 2016 Abstract / Objectives: Specific Aim #1: Assess no difference in patient satisfaction. Our working hypothesis is that there is no difference in satisfaction with follow-up calls in women receiving HRT from pharmacists or pharmacy intern students at Reed’s Compounding Pharmacy. Specific Aim #2: Assess patient satisfaction with follow-up calls from pharmacy student interns. Our working hypothesis is that women receiving HRT are satisfied with follow-up calls for their therapy when it is conducted by pharmacy student interns, which enhances proper treatment guidance and adherence. Methods: This study will be a descriptive, direct comparison study that will use data obtained through an online questionnaire consisting of the following: four questions determining the patient’s demographics and eighteen questions on patient satisfaction with follow-up calls from Reed’s Compounding Pharmacy with pharmacy student interns. Results: Of the estimated 60 patients sample size, only 31 questionnaires were completed. The largest proportion of patients was between the ages of 51 and 60 (58%). The length of therapy in participating women varied quite significantly with one-fourth of patients on HRT for 4-5 years or more (26%). The patient satisfaction of follow-up calls conducted by pharmacy intern students survey results indicated, in general, that patients agreed that they were satisfied with the service that they were receiving from the pharmacy interns. There was no disagreement with the items, the intern provides education that will help me understand how to take my medications, being pleased that the intern is following-up, having input on hormone therapy, and with the items regarding intern professionalism and intern knowledge. The greatest disagreement was with three items asking about comfort talking with either a female or male intern, and the item about paying extra to ensure follow-up calls. Results from this study were compared with results from five questions adapted using a questionnaire from DiMaggio et al. Note that this study used 7 response fields: strongly disagreed, somewhat disagreed, disagreed, no opinion, agreed, somewhat agreed, strongly agreed. Data from DiMaggio et al used 5 response fields: strongly disagreed, disagreed, no opinion, agreed, strongly agreed. Responses were grouped by strongly disagreed, somewhat disagreed, disagreed, and no opinion in one and strongly agreed, somewhat agreed, and agreed in the second. The data from both studies were compared by considering proportion of patients who agreed at some level with each item. There was no statistical difference between the two groups (p > 0.08); both groups showed a high level of agreement on the five satisfaction items. Conclusions: The women receiving hormone replacement therapy in this study were satisfied with follow-up calls from pharmacy student interns at Reed’s Compounding Pharmacy. There is no difference in satisfaction with follow-up calls in women receiving HRT from pharmacists or pharmacy student interns. In addition to satisfaction, women are satisfied with follow-up calls for their therapy when it is conducted by pharmacy student interns, which enhances proper treatment guidance and adherence.

Class of 2005 Abstract / Objectives: To assess whether the satisfaction of women with the pharmacist administered bio-identical hormone replacement therapy consultation service has improved since the implementation of a follow up call program at Reed’s Compounding Pharmacy. Methods: A questionnaire was mailed to 200 randomly selected women who had completed their HRT consultation and received all three follow-up calls provided by Reed’s Compounding Pharmacy within the time frame from July 22, 2003 to April 22, 2004. The returned surveys were then organized and analyzed using Microsoft Excel. Additionally, independent t-tests were used to compare data collected in 2001 vs. 2004 on relevant questionnaire items of interest. Main results: Of the 200 surveys sent out to patients, 125 replied (a response rate of 62.5%). Over 50% heard about it through referral from their provider, and almost 35.2% from a friend or a relative. Regarding the follow-up call service, 95.9% of the patients either agreed or strongly agreed that it was helpful; however, only 73.8% feel comfortable discussing their concerns with student interns, who are responsible for the follow-up calls. In the assessment of new health conditions developed after natural hormone therapy initiation, 94.3% of the respondents reported with no new health conditions. T-tests revealed an improvement in patient satisfaction items between 2001 and 2004 with p-values < 0.05. Principal Conclusions: The results of the study showed that there was an improvement in patient satisfaction with the consultation service since 2001, and most of the differences found were statistically significant. The survey result also showed that participants were happy about the follow-up calls, which in terms, perhaps contributed to the increase in satisfaction.

The focus of the research described in this section of the thesis is the synthesis of compounds expected to bind strongly to both the estrogen β and α receptors and act as estrogen agonists. Based on earlier results in our group and docking studies we prepared a series of A-CD analogs, compounds 1, in which the usual 13-methyl group was replaced by an ethyl group. Docking studies also indicated that substituents at C8 could lead to enhancement of binding to the estrogen receptor. With this in mind two such derivatives, compounds 2 were prepared. A major concern in the use of estradiol in hormone replacement therapy is its potential metabolism of dangerous ortho-quinones. The 1,2-naphthalenediol derivatives 3 avoid this possibility. They were predicted to be potent binders to the estrogen receptors with the naphthalene diol portion serving as rings A and B and the hydroxyl group taking the place of the 17-OH group of estradiol. The preparation of several derivatives of 2 is reported. The estrogen receptor binding [ERB] relative to estradiol as standard has been determined at the University of Illinois for a number of the compounds prepared in this thesis. Unfortunately, the results were not as encouraging as expected. Importantly, all of the 13-ethyl derivatives tested showed lower binding affinity compared to the 13-methyl analogs. Similarly, the derivatives with substituents at C8 do not show higher activity than those having only hydrogens at C8. Finally, the situation with the naphthalene derivatives is, at this stage, still not completely resolved. The binding for the compounds thus tested is quite low, but it must be admitted that the structures thus far synthesized have a much lower LogP than estradiol, a factor known to greatly decrease the binding constants to the estrogen receptors.

An algorithm is developed to determine the optimal component replacement rules to follow in managing a particular class of equipment. The work follows basically the models developed previously by S.E. Dreyfus and R.A. Howard. However, a different Markov state description has been used to extend the application of these models to systems of more than one component subject to stochastic failure and for which the failure of any component renders the entire system inoperative. The model, in effect, selects optimal replacement alternatives as individual components fail, under the uncertainty of further failures occurring in the same transition interval. The model was programmed for an I.B.M. 360/67 computer and the results for a hypothetical problem were checked through renewal theory. / Forestry, Faculty of / Graduate

Class of 2006 Abstract / Objectives: To create a conversion chart of non-oral estrogen replacement systems based on Cavg. Design: Meta-analysis. Methods: A literature search using two databases, drug manufacturer data, and the online FDA new drug application website was performed in May 2005. Of the original studies identified, those that were selected for analysis met the following inclusion criteria: 1) English in language 2) only included human subjects 3) reported the average blood concentration (Cavg) and 4) were not baseline adjusted. The Cavg data was entered into a spreadsheet and analyzed by an independent statistician. Results: Fifty studies were originally identified. Of these 50 studies, only 22 met inclusion criteria and were used to calculate the mean Cavg of different administration systems. The Cavgs were then used to create a comparison chart. Conclusions: Overall, there has been little research done that examines blood estradiol levels achieved through non-oral administration routes. The chart created from this meta-analysis is vital to health care providers because it allows a patient to be converted from one route to another while assuring the provider that the patient is receiving the same therapeutic benefit.