Postoperativt illamående och kräkning (PONV- Postoperative Nausea and Vomiting) är en vanlig förekommande kirurgisk komplikation. Orsaken till PONV är inte helt fastställd, till skillnad från patofysiologin vid generellt illamående. För patienten innebär PONV ett ökat lidande och längre vistelse på sjukhus. För att förebygga och lindra tillståndet PONV kan sjuksköterskan identifiera riskfaktorer hos patienten. Kirurgiska ingrepp har visats ge olika grader av illamående. Exempelvis innebär laparaskopi en ökad risk för PONV. Betydelsefullt är att sjuksköterskan har kunskap och kan identifiera, samt uppmärksamma, tidiga tecken hos patienten. Dessa tecken kan vara blekhet, kallsvettighet eller en ökad hjärtfrekvens. Syftet med litteraturstudien var att belysa sjuksköterskans omvårdnadsåtgärder vid postoperativt illamående och kräkning. Litteraturstudiens resultat baserades på 12 vetenskapliga artiklar. Resultatet visade att kombinationen av antiemetika och icke farmakologiska åtgärder ger en viss lindring av PONV. Det vore önskvärt att upptäcka omvårdnadsåtgärder som minskar incidensen av PONV eftersom en stor andel av sjukvården utgörs av kirurgiska patienter. Sjuksköterskans omvårdnadsåtgärder klargörs inte helt och borde tydliggöras genom mer forskning inom området. / Postoperative nausea and vomiting (PONV) is a common surgical complication. The cause of PONV is not precisely clear, in contrast to the pathophysiology of general nausea. Consequences of PONV include increased care suffering and longer duration in hospital care. To prevent or relieve PONV, nurses can identify risk factors. Surgical procedures have been shown to have various degrees of nausea, such as laparoscopy have an increased risk for PONV. It is significant that the nurse has knowledge about the relevant symptoms and can identify early signs of the patient. The aim of this study was to illuminate nursing interventions to prevent postoperative nausea and vomiting. The results of this literature study were based on 12 scientific articles. The results showed that the combination of antiemetic and non-pharmacological measures gave some relief of PONV. Desirable would be to identify nursing interventions that could decreased the incidence of postoperative nausea and vomiting of the surgical patients as they constitute a large proportion of patients within the health care. Recommended nursing strategies are not entirely clear and need to be clarified through further research on this topic, nursing care intervention.

Syftet med denna litteraturstudie var att beskriva sjuksköterskans omvårdnadsåtgärder gentemot patienter med cancer vid cytostatikarelaterat håravfall, fatigue, illamående och kräkning. De vetenskapliga artiklar som användes för denna litteraturstudie hämtades ur Högskolan Dalarnas databaser Elin@Dalarna och PubMed. Efter kvalitetsgranskning och betygsättning av artiklarna kvarstod 18 artiklar som ansågs relevanta och låg till grund för resultatet av denna studie. Samtliga artiklar bedömdes ha en god vetenskaplig kvalitet. Resultatet av denna litteraturstudie visade att behandling mot håravfall med kylmössa hade god effekt men att biverkningarna kunde vara svåra att uthärda. Information från sjuksköterskan om sminkningsteknik och användning av peruk, upplevdes av patenten vara viktig vid håravfall. Regelbunden träning och avslappningsövningar hade en positiv effekt på fatigue. Sjuksköterskans information till patienter om fatigue och egenvårdsåtgärder, visade sig också vara till hjälp för patienterna. Vidare lindrade akupressur besvären vid illamående och kräkning. Sjuksköterskornas regelbundna kontroller av cytostatikarelaterade biverkningar förbättrade omvårdnadens kvalitet

<p>Illamående och kräkningar hos kvinnor som behandlas med cytostatika mot bröstcancer är ettomfattande problem inom den onkologiska omvårdnaden. Många kvinnor upplever, trots välutvecklade läkemedel för att motverka cytostatika utlöst illamående och kräkningar denna, förmånga fruktade biverkan. Syftet med litteraturöversikten var att finna förebyggande ochlindrande icke farmakologiska metoder som kan hjälpa till att minska det cytostatika utlöstaillamåendet och kräkningarna som kan uppstå hos kvinnor med bröstcancer i samband medcytostatikabehandlingen och effekten av dessa metoder.</p><p>Som teoretiskt stöd användes Orem´s egenvårdsteori och för att identifiera metoderna gjordesen litteraturöversikt med kvantitativa originalartiklar ur vetenskapliga tidskrifter. De ickefarmakologiska metoderna som studerades var akupressur, elektroakupunktur, yoga,fysiskträning, massage och utbildning.Användandet av dessa icke farmakologiska metoder visade på en minskning av cytostatikautlöst illamående och kräkningar, antingen som placeboeffekt eller som faktisk effekt. Sombifynd diskuteras ångest och stress effekt på illamående och kräkningar, eftersom metodernavisat sig kunna inverka och förbättra kvinnornas sinnesstämning genom suggestion.De studerade icke farmakologiska metoderna är förhållandevis lätta att tillämpa och är inte såtidskrävande. Även om metoderna visat en minskning av illamående och kräkningar utlösta av cytostatika, är kunskapsbasen med avseende på effekten inte fullständig och detbehövs mer forskning.</p>

The role of 2-arachidonoylglycerol (2-AG) in nausea and vomiting was evaluated using a shrew (Suncus murinus) model of emesis and nausea-like behavior in rats, conditioned gaping. Shrews received JZL184, a selective MAGL inhibitor, prior to treatment with emetogenic lithium chloride (LiCl). The potential of exogenously administered 2-AG and arachidonic acid (AA) to regulate conditioned gaping was assessed in rats. The role of cannabinoid receptors and cyclooxygenase (COX) inhibition in suppression of vomiting and conditioned gaping was also evaluated. JZL184 dose-dependently suppressed vomiting in shrews, and was shown to inhibit MAGL in shrew brain tissue. The anti-emetic effects of JZL184 were prevented by the CB1 antagonist, AM251. Exogenous 2-AG suppressed LiCl-induced conditioned gaping, but was not prevented by AM251 or the CB2 antagonist, AM630. Instead, the COX inhibitor, indomethacin, prevented the suppressive effects of 2-AG, as well as AA. These results suggest that manipulations that elevate 2-AG may have anti-emetic/anti-nausea potential. / This research was supported by research grants from the Natural Sciences and Engineering Research Council of Canada (NSERC 92057) to Linda Parker, the Israel Science Foundation (DA009789) to Raphael Mechoulam, and the National Institutes of Health (DA009789, DA017259) to Benjamin Cravatt.

Background: The incidence of postoperative nausea and vomiting (PONV) can be reduced by dexamethasone. Single dose administration may cause elevated blood glucose levels in obese adults. No data are available for children. Objective: The aim was to evaluate perioperative blood glucose changes related to body weight in children who received dexamethasone. Methods: This prospective observational study included 62 children. All patients received total intravenous anesthesia and a single dose of dexamethasone (0.15mg/kg, maximum 8mg). Blood glucose levels were measured up to 6 hours. Standard deviation scores (SDS) were calculated using age- and gender-specific BMI percentiles, p<0.05. Results: 62 children (11.5±2.9years, median SDS 0.43, 29% overweight/obese) were included. Blood glucose level increased from 5.52±0.52 to 6.74±0.84mmol/l 6h after dexamethasone without correlation to the BMI-SDS. Conclusions: This study shows an increase of perioperative blood glucose (normoglycemic ranges) after single dose of dexamethasone but no BMI-dependent effect in children. Therefore, low-dose dexamethasone may be used in obese children for PONV prophylaxis.

Thesis (MNutr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Background: Nausea and vomiting during pregnancy (NVP) is a common medical condition. Due to possible harmful side-effects that conventional medicine may pose to the fetus, many mothers choose not to use it, and are left helpless against NVP. There is a need for alternative treatment to relieve NVP symptoms. Objectives: This systematic review (SR) investigated current evidence regarding ginger for the treatment of NVP. The primary objective was to assess the effectiveness of ginger in treating NVP. The secondary objective was to assess the safety of ginger during pregnancy, by identifying adverse events or side-effects. Search strategy: Electronic search of bibliographic databases (1966-February 2011). Selection criteria: Randomized controlled trials (RCTs) of the efficacy of ginger by any route, as treatment for NVP in pregnant women regardless of their age or stage of pregnancy. Data collection and analysis: The principal investigator and independent reviewer individually identified relevant studies, extracted data and assessed trial quality. Data analysis was performed using the RevMan5 software. Differences at the level of p<0.05 were considered to be statistically significant. Results: Eleven RCTs involving 1176 pregnant women were included. The quality of evidence was low, hence the high risk of bias and imprecision of results. Ginger significantly improved the symptoms of nausea when compared to placebo, when comparing the results of this SR to past SRs, and taking into account a meta-analysis performed on two relatively large included studies (mean difference (MD) 1.20, 95% confidence interval (CI) 0.56-1.84, p=0.0002, I2=0%). However, another meta-analysis on two smaller studies indicated no significant improvement in nausea. Ginger did not significantly improve nausea when compared to vitamin B6 (MD 0.34, 95% CI -1.52-2.20, p=0.7, I2=91%). Similarly, ginger did not significantly reduce the number of vomiting episodes during NVP, when compared to placebo, although there was a trend towards improvement (MD 0.72, 95% CI -0.03-1.46, p=0.06, I2=71%). Subgroup analyses performed seemed to favor the lower daily dosage of <1500mg ginger to possibly be more effective for the relief of nausea. Ginger did not pose a significant risk for spontaneous abortion when compared to placebo (RR 3.14, 95% CI 0.65-15.11, p=0.15; I2=0%), or to vitamin B6 (RR 0.49, 95% CI 0.17-1.42, p=0.19, I2=40%). Similarly, ginger did not pose a significant risk for the side effects of heartburn or drowsiness when compared to placebo or vitamin B6. When compared to dimenhydrinate, ginger posed a smaller risk for drowsiness (RR 0.08, 95% CI 0.03-0.18) and no increased risk for heartburn. Conclusions: This review suggests potential benefits of ginger in reducing nausea symptoms in pregnancy (bearing in mind the limited number of studies, variable outcome reporting and quality of evidence). Ginger did not have a significant impact on vomiting episodes, nor pose a risk for side effects or adverse events during pregnancy. Based on evidence from this SR, ginger could be considered a harmless and possibly effective alternative option for women suffering from the symptoms of NVP. Large RCTs are necessary to confirm the possible benefit of ginger as treatment for NVP. / AFRIKAANSE OPSOMMING: Agtergrond: Naarheid en vomering tydens swangerskap (NVS) is ‘n algemene mediese toestand. As gevolg van moontlike skadelike newe-effekte wat konvensionele medikasie kan veroorsaak vir die fetus, vermy baie moeders dit en word hulpeloos gelaat teen NVS. Dus is daar behoefte aan alternatiewe behandeling vir NVS. Doelwitte: Hierdie sistematiese literatuuroorsig (SO) het huidige literatuur ondersoek wat verband hou met gemmer vir behandeling van NVS. Die primêre doelwit was om effektiwiteit van gemmer as behandeling vir NVS te assesseer. Die sekondêre doelwit was om veiligheid van gemmer tydens swangerskap te assesseer, deur ongunstige gebeure en newe-effekte te identifiseer. Soektogstrategie: Elektroniese soektog van bibliografiese databasisse (1966-Februarie 2011). Seleksiekriteria: Verewekansigde gekontrolleerde proewe (RCTs) van gemmer deur enige roete as behandeling van NVS, in swanger vroue ongeag ouderdom of stadium van swangerskap. Dataversameling en –analise: Die hoof navorser en ‘n onafhanklike hersiener het individueel relevante studies geidentifiseer, data ekstraksie onderneem en studie-kwaliteit geassesseer. Data-analise is uitgevoer deur die RevMan5 sagteware te gebruik. Verskille by die vlak van p<0.05 was beskou as statisties betekenisvol. Hoof resultate: Elf RCTs waarby 1176 swanger vroue betrokke was, is ingesluit. Die studie-kwaliteit was swak, dus die hoë risiko vir sydigheid en onakkuraatheid van resultate. Gemmer het beduidend die simptome van naarheid verbeter in vergelyking met plasebo, wanneer die resultate van hierdie SO met vorige SO’s vergelyk word, en die meta-analise in ag geneem word wat op twee relatiewe groot ingeslote studies uitgevoer is (gemiddelde verskil (MD) 1.20, 95% vertrouens interval (VI) 0.56-1.84, p=0.0002,I2=0%). Kontrasterend, het ‘n ander meta-analise van twee kleiner studies geen beduidende verbetering in naarheid aangedui nie. Gemmer het nie beduidend naarheid verbeter wanneer dit met vitamien B6 vergelyk word nie (MD 0.34, 95% VI -1.52-2.20, p=0.7, I2=91%). Soortgelyk, het gemmer nie die aantal vomerings-episodes verminder, in verglyking met plasebo nie, maar daar was wel ‘n neiging na verbetering (MD 0.72, 95% VI -0.03-1.46, p=0.06, I2=71%). Die subgroup-analise blyk ten gunste te wees van die laer daaglikse dosis van <1500mg gemmer om meer effektief te wees vir die behandeling van naarheid. Gemmer het nie ‘n beduidende risiko ingehou vir spontane aborsie, wanneer dit vergelyk word met plasebo (relatiewe risiko (RR) 3.14, 95% VI 0.65-15.11,p=0.15;I2=0%), of vitamien B6 nie (RR 0.49, 95% VI 0.17-1.42,p=0.19;I2=40%). Soortgelyk, het gemmer nie ‘n beduidende risiko ingehou vir newe-effekte van sooibrand of duiseligheid, wanneer dit vergelyk word met plasebo of vitamien B6 nie. Wanneer dit vergelyk word met dimenhidrinaat, het gemmer ‘n kleiner risiko ingehou vir duiseligheid (RR 0.08, 95% VI 0.03-0.18) en geen verhoogde risiko vir sooibrand nie. Gevolgtrekkings: Hierdie SO dui ‘n potensiële voordeel van gemmer aan in vermindering van naarheid tydens swangerskap (inagnemend van die klein hoeveelheid studies, wisselende uitkomste-rapportering en studie-kwaliteit). Gemmer het nie ‘n beduidnede impak gehad op vomerings-episodes nie, en ook nie ‘n risiko ingehou vir newe-efekte of ongunstige gebeure tydens swangerskap nie. Volgens bewyse uit hierdie SO, kan gemmer beskou word as ‘n skadelose en moontlike effektiewe alternatiewe opsie vir vroue wat lei aan NVP. Grootskaalse RCTs is nodig om die moontlike voordeel van gemmer as behandeling vir NVS te bevestig.

Purpose: We aim to characterize a large cohort of CVS patients seen at MGH in order to better understand this disorder. In addition, as CVS patients are known to have a higher cannabis use than those with other functional disorders, characteristics specific to CVS marijuana user patients have yet to be determined. Therefore, we aim to determine the variables that are patient specific predictors of cannabis use in CVS. Methods: All patients with a CVS diagnosis were seen at our facility as inpatient, outpatient or in the emergency department and medical record numbers were identified via Research Patient Data Registry (RPDR) query search tool. From the medical records, we verified a diagnosis of CVS based on Rome III criteria and collected information on demographics, co-morbidities, health care utilization and substance abuse history over a 16 year time period (1997-2013). We then proposed patient specific predictor variables of marijuana use based on our experience with CVS patients and incorporated these variables into a model for predicting marijuana use. We used this model to examine the effect of patient characteristics on marijuana use via logistic regression with estimation of odds ratio and 95% confidence ratio. Results: A total of 91 CVS patients were obtained, 67% of which were male with a mean age of 28 years old, average age of first attack of 20.2 years and employment or full time student status in 62% of patients. Psychiatric conditions were present in 73% of individuals with anxiety present in 50% and depression in 47%. The presence of a chronic pain syndrome was found in 40%. Marijuana use was present in 76% of our cohort, daily alcohol use 53%, and narcotic use 27%. Men with CVS were at significantly greater risk for marijuana use compared to women (OR .23, 95% CI .07-.77) as well as daily alcohol use (OR 5.26, 95% CI 1.469-18.828). Individuals with a chronic pain syndrome were at significantly lower risk for cannabis use (OR .15, 95% CI .039-.575) and psychiatric illness, age and narcotic use were found not to be associated with marijuana use. On average, individuals presented to the ED 1.6 times/year with one patient having a high of 208 ED visits/year. Of those that presented more than once during the time period in study there was a median interval between visits of 103.6 days. Conclusion: We found that CVS patients had significant psychiatric co-morbidities, chronic pain syndromes, and history of substance abuse. We found male gender and alcohol use to be two variables that were predictors of marijuana use in the CVS population while the presence of a chronic pain syndrome decreased the likelihood of marijuana use. The significant employment rate and full time student status of our cohort suggests a higher degree of functionality. Further prospective studies are needed to determine the role of marijuana use in the CVS population in terms of quality of life, health care utilization, and severity of disease.

Uma das manifestações mais comuns em sala de recuperação anestésica é a náusea, geralmente associada à anestesia. Além do aspecto subjetivo do desconforto, os pacientes que não apresentam melhora desse sintoma podem ter alta retardada, tanto da sala de recuperação anestésica quanto hospitalar. Como conseqüências, temos a demora do retorno às funções normais, a elevação dos custos hospitalares e um menor grau de satisfação do paciente. O objetivo do presente estudo foi realizar uma análise crítica das evidências disponíveis na literatura sobre os fatores relacionados e características definidoras do diagnóstico de enfermagem náusea, no período pós-operatório imediato, por meio de uma revisão integrativa. No desenvolvimento deste estudo, utilizaram-se como fonte de levantamento de dados quatro base de dados: Lilacs, Pubmed, Cinahl e Cochrane - Revisões Sistemáticas, e a amostra constituiu-se de 31 estudos. A análise das publicações selecionadas demonstrou que as náuseas e vômitos no período pós-operatório são considerados eventos relacionados e, na maioria das vezes, avaliados como um evento único. Os fatores relacionados identificados, de acordo com a freqüência de aparecimento e nível de evidência, foram: sexo feminino, não fumante, história prévia de náuseas e vômitos no pós-operatório, história de náusea associada ao movimento, idade, tipo de cirurgia, uso de opióides no trans e pós-operatório, uso de anestésicos voláteis e administração de óxido nitroso. Em relação às características definidoras evidenciamos nos estudos analisados: palidez, taquicardia, aumento na salivação, transpiração, sensação de calor e frio, rubor, consciência do impulso do vômito, tonturas, bradicardia, dilatação pupilar, variações na pressão arterial, respiração profunda, rápida e irregular. A importância de aperfeiçoar e legitimar os elementos que fazem parte da Taxonomia II da NANDA (2006) está em possibilitar aos profissionais enfermeiros que atuam em centro cirúrgico e recuperação pós-anestésica o planejamento da assistência de enfermagem ao paciente nos três períodos da experiência cirúrgica, visando à minimização das complicações no pósoperatório e promover uma reabilitação mais rápida e tranqüila. / Nausea is one of the most common adverse events in the pots-anesthesia recovery room. It is usually associated to anesthesia. Besides the subjective aspect it can be very distressing for patients. The patients who are suffering from nausea and do show any improvement at all may have a late discharge from both the post-anesthesia recovery room and the hospital. The delayed return to normal functions, the high hospital costs, and the lower degree of the patient\'s satisfaction are some of the consequences. The aim of the present study was to perform a critical analysis of the available evidences in the literature about the related factors and the defining characteristics of nursing diagnosis nausea over the immediate postoperative period by means of an integrative review. During the development of this study systematic reviews and four databases for data collection were used: Lilacs, Pubmed, Cinahl, and Cochrane. From the screened reports, 31 of those were potentially relevant for the purpose of this study. The analysis of the retrieved studies showed that vomiting and nausea in the postoperative period are considered to be closely related and most of the time no distinction can be made between nausea and vomiting. The identified factors related according to the rate of appearance and evidence level were the following: female gender, non-smoking, prior history of vomiting and nausea in the postoperative period, history of nausea associated to motion, age, type of surgery, opioid use in a trans- and a postoperative period, use of volatile anesthetics, and nitrous oxide administration. In relation to the defining characteristics we highlighted the following: pallor, tachycardia, an increased secretion of saliva (sialorrhea, salivation), and perspiration, sensation of cold and heat, blush, awareness of the vomiting impulse, dizziness, bradycardia, pupillary dilation, arterial blood pressure changes, deep, fast, and irregular breathing. The importance to improve and to validate the NANDA\'s Taxonomy II (2006) elements is to enable the registered nurses, who work at surgery centers and anesthesia recovery rooms, to plan the nursing care for the patient in the 3-period of surgical experience aiming at to minimizing the complications in the postoperative period and to stimulate a fast and an undisturbed rehabilitation.

My thesis deals with hygienic knowledge monitoring of pupils at the age of 6 up to 10 years attending Hradská Elementary School in Humpolec. Further it is focused on pupil´s education related to the significance of observing hygienic rules and potential consequences which can result in case of their breach. In the end, after carrying out the education, I evaluated the pupils´ knowledge of the problems in question. The initial part of my thesis gives information about hygiene history, basic hygienic habits, selected infectious diseases of child age, these infections epidemiologic characteristic, diagnostics, clinical knowledge, precautionary measures and vaccination problems. This part was elaborated by using method of secondary data analysis. The quantitative research and lecture on the theme "Precaution of infectious disease with practising the right method of washing hands? were carried out in the second part of my thesis. The data acquired via two questionnaire inquiries are evaluated statistically by means of graphs. The acquired results are under discussion in the third part of my thesis. The pupils have basic knowledge of body care; they know which hygienic habits they should observe. Unfortunately they do not always do it. The necessity of hygienic rules observance is not preferred by children because they do not realize their importance. Children should improve their dental hygiene and method of washing hands. Observing hygiene is important in infectious diseases precaution and indisputably also because of everybody's feeling fine. In my opinion the education has an influence on improving the knowledge level in the field of hygienic habits and therefore its implementation makes sense. My thesis can be used as information material for work in the given field. Its results can be used to increase the children's knowledge level in personal hygiene.

Introduction: Nausea and vomiting are the most common and distressing side effects of chemotherapy because they negatively impact on quality of life and treatment compliance. Adequate control of nausea and vomiting in children receiving chemotherapy is imperative. Currently, the first-line drug for the prophylaxis and treatment of chemotherapy-induced nausea and vomiting (CINV) in paediatric patients is the serotonin (5HT3) receptor antagonist, ondansetron, administered intravenously. However, the parenteral route of administration of this drug is now being questioned as it is inconvenient for children and there is pressure to switch to an available oral formulation. The aim of this study was to evaluate the ease of administration, efficacy and cost-effectiveness of intravenous (IV) and oral tablet (OT) formulations of ondansetron in paediatric cancer patients receiving moderately emetogenic chemotherapy at the Steve Biko Academic Hospital in Pretoria, Gauteng (South Africa).Methods: It was an open-label, parallel, randomized trial. Thirty (30) patients scheduled to receive moderately emetogenic chemotherapy were recruited from the paediatric oncology department of the hospital. These patients were randomized to receive the same dose of either IV or OT ondansetron for the prophylaxis of CINV for one chemotherapy cycle. The efficacy of the agents was determined using a visual analogue scale (VAS) completed by the paediatric patients, which was compared to a one page questionnaire completed by the parents of the patients. Both questionnaires were completed at the end of chemotherapy (treatment period) as well as after a week without chemotherapy treatment (follow-up period). The patients’ plasma concentrations of ondansetron at four different time points were quantified by liquid chromatography tandem mass spectrometry (LC-MS/MS). The ondansetron plasma concentrations obtained in the IV group were compared to those obtained in the OT group. The cost-effectiveness calculations included the direct costs of antiemetic prophylaxis and treatment, the use of any rescue medication and the length of hospital stay. Results: The VAS revealed that patients who were given antiemetic prophylaxis with OT ondansetron experienced less acute and delayed nausea than the patients in the IV ondansetron group; however, these differences were not statistically significant (p=0.538). Vomiting was similar in the two groups (p=1). There was a statistically significant difference between the patients and their parents in the perception of acute nausea (p=0.018), with parents overstating the level of acute nausea felt by their children. The plasma concentrations of ondansetron in patients on the IV formulation were higher than the ones in patients on the OT formulation at all the time points investigated. At 30 minutes post-dosing the mean plasma concentration of ondansetron in the IV group was significantly higher than in the OT group (p=0.0015), but the differences in plasma concentrations between the two groups from 2 hours were fairly comparable. The cost of antiemetic prophylaxis for IV ondansetron was significantly higher than the cost of antiemetic prophylaxis using the equivalent OT dose (p=0.0351). Conclusion: For the prevention of CINV, OT ondansetron, a 5HT3 receptor antagonist, proved to be an easy to use and cost-effective alternative to IV ondansetron in paediatric cancer patients receiving moderately emetogenic chemotherapy treatment. / Dissertation (MSc)--University of Pretoria / Pharmacology / unrestricted