Browsing Institutt for farmasi by Title
DSpace/Manakin Repository
- Home
- Det helsevitenskapelige fakultet
- Institutt for farmasi
- Browsing Institutt for farmasi by Title
Browsing Institutt for farmasi by Title
Now showing items 1-20 of 135
Next Page-
Kiselev, Yury; Eriksen, Tonje Engevik; Forsdahl, Siri; Nguyen, Lan Huong Thi; Mikkola, Ingvild (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Pax6 and Pax6(5a) are two isoforms of the evolutionary conserved Pax6 gene often co-expressed in specific stochiometric relationship in the brain and the eye during development. The Pax6(5a) protein differs from Pax6 by having a 14 amino acid insert in the paired domain, causing the two proteins to have different DNA binding specificities. Difference in functions during development is proven by the fact that mutations in the 14 amino acid insertion for Pax6(5a) give a slightly different eye phenotype than the one described for Pax6. Whereas quite many Pax6 target genes have been published during the last years, few Pax6(5a) specific target genes have been reported on. However, target genes identified by Pax6 knockout studies can probably be Pax6(5a) targets as well, since this isoform also will be affected by the knockout. In order to identify new Pax6 target genes, and to try to distinguish between genes regulated by Pax6 and Pax6(5a), we generated FlpIn-3T3 cell lines stably expressing Pax6 or Pax6(5a). RNA was harvested from these cell lines and used in gene expression microarrays where we identified a number of genes differentially regulated by Pax6 and Pax6(5a). A majority of these were associated with the extracellular region. By qPCR we verified that Ncam1, Ngef, Sphk1, Dkk3 and Crtap are Pax6(5a) specific target genes, while Tgfbi, Vegfa, EphB2, Klk8 and Edn1 were confirmed as Pax6 specific target genes. Nbl1, Ngfb and seven genes encoding different glycosyl transferases appeared to be regulated by both. Direct binding to the promoters of Crtap, Ctgf, Edn1, Dkk3, Pdgfb and Ngef was verified by ChIP. Furthermore, a change in morphology of the stably transfected Pax6 and Pax6(5a) cells was observed, and the Pax6 expressing cells were shown to have increased proliferation and migration capacities. URI: http://hdl.handle.net/10037/4107 File(s) in this item: 1
article.pdf (927.5Kb) -
Willumsen, Sigrid Serine (Master thesis; Mastergradsoppgave, 20-May-2008)[+][-]
Abstract: Very little is known about introgression in bacteria. Introgression is the process where the genes of one species infiltrate the gene pool of another organism by subsequent backcross transformations of a hybrid with one of its parents. After the initial acquisition of foreign DNA, DNA from the newly made transformants is used as donor DNA in backcross transformations with the recipient. DNA is released to the environment after decomposing of dead cells, disrupting of cells or through excretion from living organisms. The extracellular DNA can be degraded after release, thus fragmented DNA can be taken up by bacteria. One previous unpublished study investigated the effect of introgression of foreign unselected DNA. The donor DNA in this study was of high molecular weight (20 to 30 kilo bases (Kb)) and it was suggested that introgression in backcross transformation could be a mechanism by which unselected DNA was eliminated from the genome. I wanted to study the effect of introgression when the foreign donor DNA was of low molecular weight (1000 to 4000 base pairs (bp)). We wanted to determine how fragmentation affects the speed at which unselected DNA from Acinetobacter sp. strain 16.4 was eliminated from the genome of Acinetobacter baylyi strain BD413 during the introgression process. I have developed a method for optimal fragmentation of DNA to the desired size for this study. The DNA was fragmented by sonication, which gave an effective, gradual reduction in the fragment size of DNA. The size of the sonicated DNA was checked on an agarose gel and I found out that a gel fraction between 1000 to 4000 bp was the desired size for fragmented DNA. The DNA was extracted from the gel piece and used as low molecular weight donor DNA. This method can be used to determine the effect of introgression when the foreign donor DNA is of low molecular weight (1000 to 4000 base pairs bp) and to get a better understanding for natural fragmentation of extracellular DNA in the environment. URI: http://hdl.handle.net/10037/1590 File(s) in this item: 1
thesis.pdf (2.637Mb) -
Møkleby, Tormund Aasjord (Master thesis; Mastergradsoppgave, May-2009)[+][-]
Abstract: Gemcitabine is a well established anticancer compound, and is in use today against several types of cancers. Gemcitabine has a short half life. Formulations of gemcitabine containing liposomes could extend it's half life, thereby maybe improving its effectiveness. Also, liposomes in the smaller size range have an advantage when it comes to treating cancer. They accumulate at the site of the tumor, and stay there for a longer time than it would have done in normal tissue(Massing and Fuxius 2000). Previous attempts to actively load gemcitabine into liposomes have used a pH gradient with acidic pH inside compared to more neutral pH on the outside of the liposomes, accomplished by an ammonium sulphate gradient. But this approach showed some difficulties; among other things that gemcitabine had a tendency to leak out in very short time. (Gravem 2006). In this thesis I have among other things investigated the possibility of loading gemcitabine into liposomes by precipitation. The hope was that this could give higher trapping efficiency and reduced leakage compared to the ammonium sulphate approach. Firstly, for comparable reasons and method development, an approach to load liposomes via an ammonium sulphate gradient was tried. Thought after encountering several problems the experiment was ended without any results indicating loading, most likely due to heavily diluted liposomes. Secondly I investigated if I could make gemcitabine precipitate. Firstly I tried a great range of different phosphate and sulphate salts, to test if any of them would cause a precipitation. Precipitation seemed to be independent of which salt used, but enhanced by factors such as high concentration of gemcitabine, alkaline conditions (pH ≥ 6), and low temperature. The two last conditions were the total opposites of loading via an ammonium sulphate gradient, and contained several contradictions as it meant that the outer pH had to be significantly lower to avoid precipitation and that a low temperature made it harder for gemcitabine to cross the membrane of the liposomes. An attempt to load gemcitabine into liposomes, using a pH 4 in the outer phase and pH 7 in the inner phase of the liposomes, with repeated cooling and freezing cycles, revealed poor loading. Thought optimizing conditions such as pHs, and time and temperatures in the cooling freezing cycles might enhance the loading a bit it is difficult to see this approach becoming a success. URI: http://hdl.handle.net/10037/2202 File(s) in this item: 1
thesis.pdf (1.114Mb) -
Berg, Ole Aleksander (Master thesis; Mastergradsoppgave, 20-May-2011)[+][-]
Abstract: Trauma to the skin in the form of severe wound, particularly burns, can facilitate colonization of potentially life threatening bacterial infections. To prevent infections of the wounded area, antimicrobial agents are recommended as standard treatment. Topical administration of antimicrobial agents, such as mupirocin, can provide local therapy, while avoiding the risks of systemic administration. Mupirocin-in-liposomes-in hydrogels were proposed as advanced delivery system for this purpose. Up to now, no liposomal mupirocin for topical administration has been reported. Chitosan was selected as hydrogel matrix due to its biodegradability and in-built antimicrobial and wound healing potentials. Phosphatidylcholine liposomes containing mupirocin, namely non-sonicated and sonicated liposomes, were characterized for vesicle size and size distributions. Non-sonicated vesicles entrapped in average 74 and sonicated 49 % of mupirocin calcium, respectively. Sonication reduced the original vesicle size from around 1 micron down to 135 nm. Liposomes (10 %, w/w) were incorporated in chitosan hydrogels and liposomal hydrogels evaluated for their textural properties. Hydrogels were found to exhibit satisfactory adhesiveness and cohesiveness, with corresponding stability profile. Microbiological assessment confirmed antibacterial properties of liposomally entrapped mupirocin incorporated in hydrogels. In vitro and ex vivo (on pig skin) drug release profiles of various formulations containing mupirocin were performed on Franz diffusion cells. Liposomal hydrogels were compared with marketed mupirocin product, Bactroban® cream. The release studies showed that liposomal size affects the release of the incorporated drug. Liposomal hydrogels were shown to provide sustained release of incorporated mupirocin. In conclusion, liposomal hydrogels developed for mupirocin offer the potential to increase retention time and provide sustained release of a drug, which are important parameters for improved treatment of wounds, including burns. URI: http://hdl.handle.net/10037/3689 File(s) in this item: 1
thesis.pdf (71.30Mb) -
Risberg, Kine (Master thesis; Mastergradsoppgave, 20-May-2010)[+][-]
Abstract: Escherichia coli(E.coli) belongs to the Enterobacteriaceae family of gram negative rods. It is the most common cause for bacterial sepsis. According to NORM (Norwegian system for surveillance of antibiotic resistance in microbes); E.coli is the main pathogen found in blood samples from humans submitted to Norwegian microbial laboratories (page 49 NORM report 2008)(1). E.coli is also the most common cause of human urinary tract infections (The Journal of the Norwegian Medical Association) (2). Empiric treatment for sepsis and urosepsis in Norway is betalactam antibiotics in combination with aminoglycosides(3). In case of allergy, patients with urosepsis are treated with quinolones and aminoglycosides(4). There is concern related to recent years development of resistance against gentamicin (aminoglycoside) and ciprofloxacin (quinolone) among E.coli strains (page 52 NORM report 2008) (1). This work was initiated as a first step to identify the most common mechanisms for aminoglycoside resistance in Enterobacteriaceae collected in western Norway. The focus for this work was to characterize antibiotic resistance and detect the presence of the genes encoding two aminoglycoside modifying enzymes. The genes chosen encodes two enzymes from the group aminoglycoside acetyltransferases (AAC`s); aac(6`)-Ib and aac(3)-IIc (aacC2). The use of ciprofloxacin has increased markedly during the past few years. Recent studies have reported a variant of AAC(6`)-Ib characterized by two amino acid changes, Trp102Arg and Asp179Tyr. This variant called AAC(6`)-Ib-cr inflicts ciprofloxacin resistance in addition to aminoglycoside resistance. We suspected that increased use of ciprofloxacin could cause selection of isolates resistant to aminoglycosides by selecting the isolates that possess AAC(6`)-Ib-cr. We decided to examine the prevalence of aac(6`)-Ib-cr in isolates of Enterobaceriaceae resistant aminoglycosides, in order to provide either indirect support or rejection of this hypothesis. URI: http://hdl.handle.net/10037/2747 File(s) in this item: 1
thesis.pdf (1.522Mb) -
Kristiansen, Vibeke Fam (Master thesis; Mastergradsoppgave, May-2007)[+][-]
Abstract: Very little is known on the gut microbial ecology in seals. Environmental populations of bacteria, like those found in the gut of wildlife presumably unexposed to human antibiotic use, may be a reservoir of clinically important resistance genes. The purpose of this study was to characterize the bacterial diversity in the colon of grey seals (Halichoerus grypus) and harbour seals (Phoca vitulina) at the cost of northern Norway by comparative sequence analysis of cloned 16S rRNA genes, and to determine the prevalence and diversity of blaTEM genes. Colon contents was collected from one male harbour seal and one female grey seal (pregnant) outside Ringvassøy (69.91ºN, 19.02ºE) in April-May 2006. No aerobic ampicillin resistant isolates were detected in the colon content from neither the harbour seal nor the grey seal. However, blaTEM alleles were detected in total DNA from tree of the eight colon samples of the grey seal, but no amplifications of the blaTEM genes were obtained in total-DNA from the two colon samples of the harbour seal. This indicates that the prevalence of blaTEM genes in the colon content of the harbour seal and the grey seal was low. A total of 153 assembled 16S rRNA gene sequences (~1,5 kb) were analyzed from the colon of the two seal species. From the harbour seal, 77 16S rRNA gene sequences were analyzed, identifying representatives associated with Firmicutes (all belonging to Clostridiales 49.4%), Bacteroidetes (all belonging to Bacteroidales 49.4%) and Fusobacteria (all belonging to Fusobacteriales 1.3%). From the grey seal, 76 16S rRNA gene sequences were obtained, including representatives from two bacterial phyla: Firmicutes (most of these were Clostridiales 72.4%) and Bacteroidetes (all belonging to Bacteroidales, 23.7%). The bacterial population in the colon of harbour seal and grey seal included species considered to be a part of the normal flora in e.g. humans and chickens. Only one clone from the harbour seal library showed >97% sequence similarity to their nearest database entries (BLAST). For the grey seal library about half of the clones showed <97% sequence similarity to their nearest database entries (BLAST). This indicates that several of the 16S rDNA sequences obtained from the seal colon represents novel bacterial species not yet isolated or characterized. Description: Dette er en hovedfagsoppgave URI: http://hdl.handle.net/10037/4330 File(s) in this item: 1
thesis.pdf (440.9Kb) -
Mobasheri, Mina (Master thesis; Mastergradsoppgave, 06-Jun-2011)[+][-]
Abstract: Pax6 og Pax6(5a) er to isoformer av den evolusjonært konserverte transkripsjonsfaktoren som blir uttrykt i blant annet hjernen, øyne, nese og pankreas hos virveldyr under embryoutvikling. Uttrykket av Pax6 vil vedvare hos voksne individer, blant annet i øyne, hjernen og pankreas. Den er viktig for vedlikehold av stamceller, men har også en stor betydning for celle differensiering i mange vev. Aniridia hos mennesker og small eye i mus er blant de sykdommene som forekommer pga. mutasjoner i ett Pax6-gen. Dersom det forekommer mutasjoner i begge Pax6 genene vil fosteret ved fødsel ikke ha øyne, deler av hjernen vil være manglende eller underutviklet og nasale strukturer vil også mangle. Derfor dør fosteret kort tid etter fødsel. Pax6 er også forbundet med kreftformer slik som glioblastoma. De to isoformene (Pax6 og Pax6(5a)) har forskjellige DNA bindings egenskaper, men blir uttrykt i de fleste celletyper samtidig, slik som i øyne. For å få en oversikt over hvilke målgener de to isoformene regulerer, ble det i forkant av dette prosjektet brukt genekspresjons microarray og en del av resultatene ble bekreftet ved hjelp av qPCR metoder. Det ble oppdaget et lite, men signifikant antall gener som ble regulert av Pax6 og/eller Pax6 i stabil transfekterte 3T3 fibroblaster. Noen av disse er felles målgen for begge isoformene. Men disse blir regulert i forskjellig grad av Pax6 og Pax6(5a). Et målgen som viste seg å bli regulert av både Pax6 og Pax6(5a) var Dickopf3(DKK3). DKK3 er et medlem av Dickkopf (DKK) familien som er antagonister av Wnt – signalveien. I disse undersøkelsene viste det seg at DKK3 er 18 fold oppregulert av Pax6(5a) i 3T3-fibroblaster fra mus, og 3 fold oppregulert av Pax6. Mulige målseter for Pax6 og Pax6(5a) i promoteren til både mus og menneske DKK3 genet har også blitt identifisert ved bruk av bioinformatikk. I denne oppgaven ble DKK3 promoteren fra mus og menneske klonet og ko–transfektert sammen med plasmider som kodet for Pax6 og Pax6(5a). Vi kunne tydelig se at mDKK3 promoteren ble positivt påvirket ved reporter gen assay analyser. Det ble også jort forsøk på å klone sebrafisk cDNA’ et som koder for DKK3, med tanke på å lage en probe for sebrafisk in situ hybridiseringer. Videre ble det utført transient transfeksjon av plasmider som koder for Pax6 og Pax6(5a) inn i 3T3-kontroll cellene for å se om korttids – uttrykket av Pax6 og Pax6(5a) gir samme resultat som de stabilt transfekterte cellelinjene med tanke på DKK3’ gen uttrykket. Protein uttrykket av Pax6 og Pax6(5a) ble bekreftet, men endringer i DKK3 RNA uttrykk kunne ikke identifiseres ved bruk av qPCR. URI: http://hdl.handle.net/10037/3424 File(s) in this item: 1
thesis.pdf (2.540Mb) -
Stafne, Bente Helene (Master thesis; Mastergradsoppgave, 20-May-2009)[+][-]
Abstract: Forbruket av legemidler hos mennesker og dyr øker stadig, og som en konsekvens av dette, skilles mer legemidler ut, og ender opp i miljøet, og kan ende opp i sjøvann, jord og drikkevann til slutt. Legemidler kan ha toksiske effekter på andre organismer enn dem de er ment for, særlig siden legemidlene ikke er designet for å brytes hurtig ned. Enkelte ikke-steroide antiinflammatoriske legemidler (NSAIDs) med noen metabolitter ble valgt ut, i et forsøk på å påvise disse legemidlene i sjø- og avløpsvann på Svalbard og i Tromsø. Det ble utviklet en væske-væske mikroekstraksjonsmetode for å ekstrahere prøvene, samt en analysemetode ved hjelp av UPLC-MS/MS. Resultatene viste at noen av legemidlene ble påvist i sjøvann, dog ingen i kvantifiserbare konsentrasjoner, mens i avløpsvann ble det kvantifisert de fire legemidlene og en av metabolittene. Det var naturlig nok høyere konsentrasjoner i avløpsprøvene fra Tromsø enn i Longyearbyen, folketallet tatt i betraktning. Den samme metoden ble også benyttet til et UV-forsøk over 15 dager, der det ble undersøkt hvorvidt de analyserte legemidlene brytes ned i UV-lys sammenlignet med en kontrolløsning i mørket. Det legemidlet som det selges mest av, ibuprofen, ble ikke brutt ned i UV-lys, mens både naproxen, ketoprofen og diklofenak ble brutt ned, mens kontrolløsningene ikke ble brutt ned for noen stoffer. Det kunne ikke påvises noen av de undersøkte metabolittene, hvilket tyder på at de undersøkte metabolittene ikke dannes under UV-nedbrytning. URI: http://hdl.handle.net/10037/2198 File(s) in this item: 1
thesis.pdf (15.52Mb) -
Jakobsen, Ingjerd Heiberg (Master thesis; Mastergradsoppgave, May-2009)[+][-]
Abstract: Industrial chemicals, pesticides and other similar compounds are all known to be a burden for the environment. In high concentrations they can all affect the biological environment in a manner that is dangerous for organisms. The presence of pharmaceuticals and personal care products (PPCPs) in the environment are of great interest regarding to their potential toxicity. Pharmaceuticals and PPCPs are discovered in soil, sludge, sewage and in the adjacent aquatic environment. The aim of this study was to develop and optimize a hollow fiber liquid- phase microextraction (HF-LPME) method for extraction and pre-concentration of benzodiazepines and its metabolites in sewage water. Different parameters like donor- and acceptor phases, fibers and organic phases were to be tested. The compounds that was to be investigated in this study were chosen by looking at sales statistics for benzodiazepines in Norway over a three years period, 2005-2007. Some metabolites of the compounds were also included. The chosen compounds were zopiclone, zopiclone-d8, zopiclone N-oxide, N-desmethyl zopiclone hydrochloride, zolpidem, zolpidem-d6, alprazolam, alprazolam 5-oxide, 1-hydroxy alprazolam, midazolam, midazolam- d5 and 1`-hydroxy midazolam. Later in the project clonazepam and 7-aminoclonazepam were included. Sewage water samples were collected at Langnes Sewage Treatment Plant (STP), Tromsø, before they were filtered and extracted by hollow fiber liquid phase microextraction and analysed on Ultra Performance Liquid Chromatography- Mass Spectrometry/ Mass Spectrometry (UPLC- MS/MS). Quantifiable amounds of zolpidem was found during the collection in January, midazolam and 1- hydroxyl midazolam were detectable. In April 1- hydroxy midazolam, midazolam and zolpidem were detectable. URI: http://hdl.handle.net/10037/2211 File(s) in this item: 1
thesis.pdf (1.016Mb) -
Antibiotikaforbruk til barn ved Rikshospitalet : målemetoder og analyse av forbruk i klinisk praksisLarsen, Christina Helene (Master thesis; Mastergradsoppgave, May-2008)[+][-]
Abstract: Bakgrunn: Ved Rikshospitalet har man fulgt forbruket av antibiotika nøye i en årrekke ved å benytte data fra sykehusapotekets legemiddelleveranser, som er basert på måleenheten definerte døgndoser (DDD). Bakgrunnen for dette prosjektet var et ønske fra Avdeling for sykehushygiene om å undersøke forbruket hos barn nærmere, da det er flere årsaker til at DDD ikke er en passende måleenhet for denne pasientgruppen. Formål: Undersøke hvordan DDD fungerer som måleverktøy og hvorvidt dette gir et riktig bilde av klinisk praksis, når det gjelder antibiotikaforbruk til barn på sykehuset. Kartlegge den praktiske bruken med hensyn på administrasjonsform, dosestørrelse, kombinasjonsbehandling og om terapi skyldes profylakse eller behandling. Materiale og metode: Studien omfattet alle pasienter som fikk systemiske antibiotika ved to sengeposter for barn på Rikshospitalet fra 13.11.07 til 13.12.07 og 14.01.08 til 28.02.08. Data ble hentet manuelt fra pasientenes journaler, med legemiddelkurver som hovedkilde. Innsamlingen foregikk ved at opplysninger som ble ansett som relevant for pasientenes antibiotikabruk ble overført fra journal til et registreringsskjema utviklet av studenten. Innsamlede data ble lagt inn i statistikkprogrammet SPSS. Opplysninger om mengde antibiotika levert fra sykehusapoteket ble innhentet, samt at beholdning ved sengepostenes medisinrom ble kvantifisert før start og etter slutt av innsamlingsperioden, slik at uttak av antibiotika fra medisinrom i løpet av perioden kunne kvantifiseres. Disse kildene til data om forbruk ble så sammenliknet med mengdene registrert som administrert til pasientene i følge journalmaterialet. Svinn ble kartlagt i andre periode ved å kvantifisere kasserte antibiotikarester. Resultater: Ved registreringsslutt var det 171 pasienter som hadde fått antibiotika. Disse utgjorde 32 % av det totale antall inneliggende pasienter. Ingen av de ulike kildene samsvarte når det gjaldt det totale antibiotikaforbruket oppgitt som antall DDD. Bare 69 % av mengden levert fra apoteket kunne gjenfinnes som administrert til pasientene. Den gjennomsnittlige ordinerte barnedosen som andel av DDD varierte fra 0,17 til 1,06 for de ulike antibiotika omfattet av studien. Konklusjon: Det var ikke overensstemmelse mellom de ulike kildene benyttet for å beskrive forbruket av antibiotika. Salgsstatistikk fra apoteket representerte ikke den reelle bruken registrert ved sengepostene. Det var stor variasjon blant de ulike midlene i forholdet mellom den faktiske dosen forskrevet til pasientene og DDD. For å kunne få et riktigere bilde av antibiotikaforbruk i form av pasienteksponering og utbredelse, må forbruket målt i DDD korrigeres for vanlig barnedosering av det aktuelle antibiotikumet ved avdelingen. URI: http://hdl.handle.net/10037/1585 File(s) in this item: 1
thesis.pdf (429.0Kb) -
Karlsen, Sølvi Merete (Master thesis; Mastergradsoppgave, 20-May-2008)[+][-]
Abstract: Bakgrunnen for oppgaven er økt oppmerksomhet rundt riktig antibiotikabruk. Antibiotika har i snart 30 år blitt brukt som profylakse i forbindelse med kirurgiske inngrep for å redusere morbiditet og mortalitet forårsaket av postoperative infeksjoner. Thoraxkirurgisk avdeling på Rikshospitalet fikk i februar 2007 nye retningslinjer for bruk av antibiotikaprofylakse ved kirurgiske inngrep. Formål Hensikten med oppgaven var å undersøke hvilken praksis som følges når det gjelder antibiotikaprofylakse ved kirurgiske inngrep ved Thoraxkirurgisk avdeling på Rikshospitalet for å vurdere om retningslinjene etterleves. Oppgaven hadde tre delmål: 1) Samle data for å gjennomgå journalført kirurgisk antibiotikaprofylakse ved Thoraxkirurgisk avdeling. 2) Forsøke å utvikle et analyseverktøy for å enkelt kunne kvantifisere etterlevelsen av retningslinjene. 3) Utføre en spørreundersøkelse med leger og sykepleiere på Thoraxkirurgisk avdeling for å få et inntrykk av deres forståelse angående antibiotikaprofylakse. Materiale og metode Pasientmaterialet besto av pasienter som hadde gjennomgått kirurgisk inngrep ved Thoraxkirurgisk avdeling ved Rikshospitalet i perioden 05.11.07-07.02.08. Datainnsamlingen foregikk på Thoraxkirurgisk sengepost og intensivavdeling. Det ble utviklet et registreringsskjema som ble brukt under datainnsamlingen. Det ble samlet data fra anestesiark, intensivark, overvåkningsskjema og kurver, som alle lå i en pasientmappe ved siden av sengen til pasientene. Ved behov ble pasientene søkt opp i Doculive (elektronisk verktøy for journalføring) i ettertid. Det ble utviklet et analyseverktøy for å systematisk kunne vurdere etterlevelsen av retningslinjene. Verktøyet ble formet som et flytskjema og tok for seg alle punktene i retningslinjene. Faktorer som ble vurdert var: Penicillinallergi, tidspunkt 1. dose, doseringsintervall peroperativt og postoperativt, og varigheten av profylaksen. Det ble også utviklet og utført en spørreundersøkelse angående forståelse av antibiotikaprofylakse med leger og sykepleiere. Studenten delte ut spørreskjemaer på et møte for sykepleiere, mens veileder fikk distribuert spørreskjemaer ut til legene. Resultat Det var 137 pasienter som ble inkludert i studien. Alle pasientene fikk riktig antibiotikum som profylakse, og det var to pasienter som ikke fikk riktig dose ifølge retningslinjene. Det var 19 pasienter (14 %) som ikke fikk 1. dose til riktig tidspunkt, og 32 pasienter (23 %) som ikke fikk en påfølgende dose i henhold til retningslinjene. 112 pasienter (82 %) fikk postoperative doser med for langt tidsintervall mellom dosene, og 74 pasienter (54 %) fikk profylakse i mer enn 24 timer. Voksne pasienter fikk flere postoperative doser enn barn. Analyseverktøyet fungerte bra for å kvantifisere hvorvidt retningslinjene var etterlevd, men for mer utfyllende resultater var det nødvendig å bruke en annen metode i tillegg. Spørreundersøkelsen antydet varierende kunnskap om antibiotikaprofylakse, og varierende kjennskap til retningslinjene. Konklusjon Retningslinjene for bruk av antibiotikaprofylakse ved kirurgi ved Thoraxkirurgisk avdeling på Rikshospitalet etterleves i varierende grad. De største problemene er at de postoperative dosene gis med for lange tidsintervall mellom dosene, og at profylaksen pågår for lenge. Det er nødvendig med videre arbeid for å øke etterlevelsen, enten ved å lage tydeligere retningslinjer eller ved å implementere retningslinjene på en bedre måte. URI: http://hdl.handle.net/10037/1592 File(s) in this item: 1
thesis.pdf (433.6Kb) -
Lian, Ingrid (Master thesis; Mastergradsoppgave, Jun-2008)[+][-]
Abstract: Background Diabetes is a rapidly and serious health problem in Scotland. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sights in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardise the pharmacists’ documentation of outcomes. Methods Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorised according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centred on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardise the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting. Results For the 47 study patients ( 44.7 % male, 85.1 % type 2 diabetes mellitus) mean (SD) age was 65.7 (12.6) years and mean (SD) time since diagnosis of diabetes was 14.9 (8.9) years. Overall number of identified care issues was 727 with mean (SD) 3.9 (1.3) care issues per care episode. Of the total care issues, 373 (51.3 %) were ‘checks’, 211 (29.0%) were ‘changes in drug therapy process’ and 147 (19.7 %) were ‘changes in drug therapy’ and an identified ‘drug therapy problem’ (DTP). Of the checks, 519 (88.9 %) were ‘monitoring’ checks, while all changes, 143 (100 %), were ‘adjustments’. The number of patients included in the application of the MAT guideline standards was 33. A total of 51 care issues leading to a change in the medication was identified and resulted in 130 guideline standards that were directing the goal of the medication change. Conclusion The results from the audit showed that the pharmacist made a major contribution to ensure effective and safe treatment for the patients and optimising drug doses. Lack of pharmacist documentation was the reason for discrepancy from practice in some areas of the pharmaceutical care delivery. A database would help to standardise the documentation of pharmacist actions and identification of pharmaceutical care issues. Further refinement of the tool will likely improve the ease of use and minimise the time required for application. URI: http://hdl.handle.net/10037/1593 File(s) in this item: 1
thesis.pdf (877.5Kb) -
Sakshaug, Solveig; Hartz, Ingeborg; Furu, Kari; Skurtveit, Svetlana; Engeland, Anders; Eggen, Anne Elise; Njølstad, Inger (Journal article; Tidsskriftartikkel; Peer reviewed, 05-Dec-2007)[+][-]
Abstract: Background: A previous study has shown that variations in threshold and intensity (lipid goal attainment) of statins for primary prevention contribute to regional differences in overall consumption of statins in Norway. Our objective was to explore how differences in prevalences of use, dosing characteristics, choice of statin and continuity of therapy in individual patients adds new information to previous results. Methods: Data were retrieved from The Norwegian Prescription Database. We included individuals from counties with high, average, and low statin consumption, who had at least one statin prescription dispensed during 2004 (N = 40 143). 1-year prevalence, prescribed daily dose (PDD), statin of choice, and continuity of therapy assessed by mean number of tablets per day. Results: The high-consumption county had higher prevalence of statin use in all age groups. Atorvastatin and simvastatin were dispensed in 79–87% of all statin users, and the proportion was significantly higher in the high-consumption county. The estimated PDDs were higher than the DDDs, up to twice the DDD for atorvastatin. The highconsumption county had the highest PDD for simvastatin (25.9 mg) and atorvastatin (21.9 mg), and more users received tablets in the upper range of available strengths. Continuity of therapy was similar in the three counties. Conclusion: Although differences in age-distribution seems to be an important source of variation in statin consumption, it cannot account for the total variation between counties in Norway. Variations in prevalences of use, and treatment intensity in terms of PDD and choice of statin also affect the total consumption. The results in this study seems to correspond to previous findings of more frequent statin use in primary prevention, and more statin users achieving lipid goal in the highest consuming county. URI: http://hdl.handle.net/10037/1388 File(s) in this item: 1
article.pdf (281.7Kb) -
Townsend, Jeffrey P.; Bøhn, Thomas; Nielsen, Kaare Magne (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Experimental approaches to identify horizontal gene transfer (HGT) events of non-mobile DNA in bacteria have typically relied on detection of the initial transformants or their immediate offspring. However, rare HGT events occurring in large and structured populations are unlikely to be detected in a short time frame. Population genetic modeling of the growth dynamics of bacterial genotypes is therefore necessary to account for natural selection and genetic drift during the time lag and to predict realistic time frames for detection with a given sampling design. Here we draw on statistical approaches to population genetic theory to construct a cohesive probabilistic framework for investigation of HGT of exogenous DNA into bacteria. In particular, the stochastic timing of rare HGT events is accounted for. Integrating over all possible event timings, we provide an equation for the probability of detection, given that HGT actually occurred. Furthermore, we identify the key variables determining the probability of detecting HGT events in four different case scenarios that are representative of bacterial populations in various environments. Our theoretical analysis provides insight into the temporal aspects of dissemination of genetic material, such as antibiotic resistance genes or transgenes present in genetically modified organisms. Due to the long time scales involved and the exponential growth of bacteria with differing fitness, quantitative analyses incorporating bacterial generation time, and levels of selection, such as the one presented here, will be a necessary component of any future experimental design and analysis of HGT as it occurs in natural settings. URI: http://hdl.handle.net/10037/4186 File(s) in this item: 1
article.pdf (2.524Mb) -
Ernst, Thomas; Gruber, Franz; Pelz-Ackermann, Oliver; Mikkola, ingvild; Maier, J; Pfirrmann, M; Muller, MC; Porkka, Kimmo; Niederwieser, D; Hochhaus, A; Lange, T (Journal article; Tidsskriftartikkel; Peer reviewed, 2009)[+][-]
-
Skogly, Stian (Master thesis; Mastergradsoppgave, 20-May-2009)[+][-]
Abstract: Introduction — The aim of Edinburgh Improved Anticipatory Care and Treatment (IMPACT) service is to reduce admissions and re-admissions to hospital for people with LTCs. The service consists of nurse case managers co-ordinating patients’ care, including reviewing medication. As a pilot project, an arrangement was made to refer such patients to a team of primary care pharmacists for clinical medication review. This project will examine the pharmaceutical care needs of this particular patient group and prepare an electronic system for reporting pharmaceutical care contributions in the evaluation of this service. Methods — A model of care for COPD was generated to characterise the pharmaceutical care needs of patients recruited into the anticipatory care service from a pharmacy perspective. A generic database was designed for the purposes of characterising patients and for addressing their pharmaceutical care needs. Anonymous and categorised pharmaceutical care plans from the pharmacists conducting the medical reviews was used to populate the database. A pharmaceutical care plan for COPD was proposed to match the database. A qualitative research approach was used in order to design the potential clinical tools in response to specific feedback obtained from a nominal group. The nominal group consisted of pharmacists, three from the primary care pharmacists and one specialist pharmacist. Results — There were 21 patients’ pharmaceutical care plans included for analysis of care provided to 13 females (62%) and 8; males (38%). The mean age was 74 years (SD 10, range 51-88). COPD are present in 57% of the records (n=12), ischaemic heart failure in 43% (n=9), chronic heart failure in 33% (n=7), chronic kidney disease 33% (n=7), depression in 29% (n=6), myocardial infarction in 29% (n=6), hypertension in 29% (n=6), and diabetes type 2 in 24% (n=5). There were 127 pharmaceutical care issues identified, an mean of 6 care issues per person. Checks accounted for 46 (36%), and there were 65 (51%) changes in drug therapy, and 16 (13%) changes in drug therapy process. The most common drug therapy problem was inappropriate compliance in 35% (n=23) out of all drug therapy problems identified (n=65). The database was face validated by the nominal group and is fit for purpose. Discussion — The population of the database toolkit was done to demonstrate the functionality of reporting important outcomes from the pilot. For further work it is possible to link disease, medications, and pharmaceutical care issues, which will produce reports indicating the kind of medications or diseases / co-morbidities that are generating most problems. The database is fit for purpose and can be used for further evaluating the medication reviews conducted by pharmacists. It can also be a teaching tool for use during pharmacy education. URI: http://hdl.handle.net/10037/2209 File(s) in this item: 1
thesis.pdf (1.874Mb) -
Berg, Camilla Torset (Mastergradsoppgave; Master thesis, May-2009)[+][-]
Abstract: Introduction The Edinburgh IMPACT (Improved Anticipatory Care and Treatment) is aimed at people with long term conditions, and focuses on improving patients’ quality of life and reducing preventable hospital admissions. The service is nurse led, and recently primary care pharmacists have been added to the team to perform a medication review pilot. Patients would be referred to the pharmacist, who would go to their house and review their medicines. The aim for this project was to assess pharmaceutical care needs of patients with heart failure, design a clinical document for the use in the care of these patients, and to develop a questionnaire to evaluate the medication review service. Methods A model of pharmaceutical care was adapted from a previous project, and was modified in order to show the multidisciplinary care for patients with heart failure. A pharmaceutical care plan for heart failure was developed by using a pharmaceutical care plan from previous work done on diabetes. A patient questionnaire with closed-ended questions was designed in order to evaluate the existing anticipatory care service. The draft care plan was revised following feedback from pharmacists in NHS Lothian. The draft patient questionnaire was piloted in two patients that had been seen by the pharmacist. Results The output from the project was a tool kit for documentation of the anticipatory care service to heart failure patients. The toolkit comprises; a model of care for heart failure, a two page clinical document (patient profile and care plan) that can be used in the care of patients with heart failure, and a patient questionnaire that enables other to evaluate the anticipatory care service when it is up and running properly. Conclusion The researcher has developed a set of tools that after some redesign and modifications can be used to support the care of patients with heart failure, and to evaluate the medication review service. URI: http://hdl.handle.net/10037/2179 File(s) in this item: 1
thesis.pdf (1.377Mb) -
Patel, Kinjal Tulsi (Master thesis; Mastergradsoppgave, 20-May-2011)[+][-]
Abstract: Introduction There is little data on immuno-suppressant administration and prescribing to transplant patients. It was considered a high risk area because errors in prescribing and administration of immuno-suppressants can potentially have serious consequences like graft loss, side effects and even death. The reality was however that the lack of data meant that no one knew whether this was an area for improvement or not. The need for data collection was recognised and the aim of this study was to develop and validate a tool to inform the analysis of the patient journey (Failure Mode Effect Analysis) and identify opportunities for quality improvement of immunosuppressant medication use. (Time did not allow for the FMEA to be conducted). Methods One-to-one semi structured interviews were conducted with clinical staff (2 pharmacists, 2 nurses and 6 doctors) to explore their perceptions of high risk areas. A case study was done to define the patient journey and identify potential areas where the patient might be at risk of harm. Analysis of database of incident reports (from 2010) was conducted. Lastly, analysis of pharmaceutical care issues identified by clinical pharmacists (2 pharmacists) was done. Results Some of the areas identified by staff from interviews were; need for consistent education to patient by all healthcare professions, need for education of staff, communication with primary healthcare professions with regard to risk associated with immuno-suppressants, teamwork amongst the staff on the ward and documentation of interventions. A patient journey detailed where and when high risk processes could occur. The patient journey identified the following areas as high risk: nurses being busy, interrupted or not giving appropriate education. Patients being non-compliant in medications and follow-up meetings, doctors not having clear handwriting, doctors not writing the formulation of immuno-suppressant etc. Database analysis confirmed that Datix® was not a well used reporting system and incidents were mainly in the immuno-suppressant administration category. The incidents reported emphasised the need to follow safe use of medicines policy. Pharmaceutical care issues were not well documented and there were no consistent interventions to confirm particular high risk areas. Discussion The richest data came from interviews and highlighted actions that could be used to reduce risk of harm from immuno-suppressive drug therapy. The data collected can be used to generate an FMEA for agreement and use by a multidisciplinary team. URI: http://hdl.handle.net/10037/3414 File(s) in this item: 1
thesis.pdf (6.611Mb) -
Starikova, Irina; Harms, Klaus; Haugen, Pål; Lunde, Tracy Munthali; Primicerio, Raul; Samuelsen, Ørjan; Nielsen, Kaare Magne; Johnsen, Pål Jarle (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Horizontal gene transfer (HGT) plays a major role in bacterial microevolution as evident from the rapid emergence and spread of antimicrobial drug resistance. Few studies have however addressed the population dynamics of newly imported genetic elements after HGT. Here, we show that newly acquired class-1 integrons from Salmonella enterica serovar Typhimurium and Acinetobacter baumannii, free of associated transposable elements, strongly reduce host fitness in Acinetobacter baylyi. Insertional inactivation of the integron intI1 restored fitness, demonstrating that the observed fitness costs were due to the presence of an active integrase. The biological cost of harboring class-1 integrons was rapidly reduced during serial transfers due to intI1 frameshift mutations leading to inactivated integrases. We use a mathematical model to explore the conditions where integrons with functional integrases are maintained and conclude that environmental fluctuations and episodic selection is necessary for the maintenance of functional integrases. Taken together, the presented data suggest a trade-off between the ability to capture gene cassettes and long-term stability of integrons and provide an explanation for the frequent observation of inactive integron-integrases in bacterial populations. URI: http://hdl.handle.net/10037/4776 File(s) in this item: 1
article.pdf (288.7Kb) -
Glad, Trine; Brusetti, Lorenzo; Aars, Jon; Bernhardsen, Pål; Nielsen, Kaare Magne; Andersen, Magnus; Sundset, Monica Alterskjær (Journal article; Tidsskriftartikkel; Peer reviewed, 2010)[+][-]
Abstract: Background Polar bears (Ursus maritimus) are major predators in the Arctic marine ecosystem, feeding mainly on seals, and living closely associated with sea ice. Little is known of their gut microbial ecology and the main purpose of this study was to investigate the microbial diversity in faeces of polar bears in Svalbard, Norway (74-81 degrees N, 10-33 degrees E). In addition the level of blaTEM alleles, encoding ampicillin resistance (ampr) were determined. In total, ten samples were collected from ten individual bears, rectum swabs from five individuals in 2004 and faeces samples from five individuals in 2006. Results A 16S rRNA gene clone library was constructed, and all sequences obtained from 161 clones showed affiliation with the phylum Firmicutes, with 160 sequences identified as Clostridiales and one sequence identified as unclassified Firmicutes. The majority of the sequences (70%) were affiliated with the genus Clostridium. Aerobic heterotrophic cell counts on chocolate agar ranged between 5.0 x 104 to 1.6 x 106 colony forming units (cfu)/ml for the rectum swabs and 4.0 x 103 to 1.0 x 105 cfu/g for the faeces samples. The proportion of ampr bacteria ranged from 0% to 44%. All of 144 randomly selected ampr isolates tested positive for enzymatic beta-lactamase activity. Three % of the ampr isolates from the rectal samples yielded positive results when screened for the presence of blaTEM genes by PCR. BlaTEM alleles were also detected by PCR in two out of three total faecal DNA samples from faeces three polar bears. Conclusion The bacterial diversity in faeces from polar bears in their natural environment in Svalbard is low compared to other animal species, with all obtained clones affiliating to Firmicutes. Furthermore, only low levels of blaTEM alleles were detected in contrast to their increasing prevalence in some clinical and commensal bacterial populations. URI: http://hdl.handle.net/10037/3067 File(s) in this item: 1
article.pdf (594.6Kb)
Now showing items 1-20 of 135
Next PageSearch Munin
Browse
-
All of Munin
-
This Community
Help
Munin is powered by DSpace 1.8.2
The University Library of Tromsø, N-9037 Tromsø
Tel: +47 77 64 40 00, E-mail: munin@ub.uit.no