RÉSUMÉ
Objetivo. Determinar la adherencia de pacientes oncológicos pediátricos a la medicación oral del mantenimiento y conocer sus creencias sobre la medicación.Población y métodos. Durante 2018-19, se recogió información de padres, adolescentes y oncólogos en seis hospitales públicos pediátricos de la Argentina. Se administraron cuestionarios de adherencia (Simplified Medication Adherence Questionnaire) y de creencias sobre la medicación (Beliefs About Medicines Questionnaire). Se consideró adherente a quien refirió tomar la medicación sin saltear dosis y respetando el tiempo de ayuno.Resultados. N = 203 pacientes. La adherencia informada por los padres fue del 75 %; la estimada por los oncólogos, del 82 %, y la referida por adolescentes, del 45 %. Las variables que mostraron asociación con la adherencia fueron solvencia económica, diagnóstico, hospital tratante, cantidad de hijos a cargo, tratamientos oncológicos realizados y existencia de obstáculos en el cumplimiento. Esta muestra no percibía los medicamentos como dañinos, pero consideró que se los utilizaba abusivamente. La mayoría percibía la necesidad de tomar la medicación antineoplásica para mantener/recuperar la salud, pero también expresó preocupaciones. La percepción sobre la medicación fue similar entre los padres y los adolescentes, y no se asoció con el nivel de adherencia.Conclusiones. La adherencia informada por los padres en esta muestra fue del 75 %. Los padres y los pacientes percibían la medicación como necesaria y manifestaron preocupaciones vinculadas al tratamiento
Objective. To determine the adherence to oral maintenance medication among pediatric cancer patients and know their beliefs about medications.Population and methods. Information was obtained from parents, adolescents, and oncologists from six public children's hospitals of Argentina during 2018 and 2019. Questionnaires on adherence (Simplified Medication Adherence Questionnaire) and beliefs about medication (Beliefs About Medicines Questionnaire) were administered. Patients were considered adherent if they referred taking their medication without missing a dose and complying with fasting time.Results. N = 203 patients. Parent-reported adherence was 75 %; adherence estimated by oncologists, 82 %; and that referred by adolescents, 45 %. The outcome measures associated with adherence were financial solvency, diagnosis, treating hospital, number of children under the care of the caregiver, cancer treatments received, and presence of barriers in compliance. Sample subjects did not perceive medications as harmful, but considered they were overused. Most subjects perceived the necessity to take antineoplastic agents to maintain or recover their health, but also expressed their concerns. The perception about medication was similar between parents and adolescents, and was not associated with the level of adherence.Conclusions. In this sample, parent-reported adherence was 75 %. Parents and patients perceived a necessity for medication and expressed their concerns about treatment.
Sujet(s)
Humains , Mâle , Femelle , Nourrisson , Enfant d'âge préscolaire , Enfant , Adolescent , Adhésion au traitement médicamenteux , Adhésion et observance thérapeutiques , Antinéoplasiques , Leucémies , Enquêtes et questionnaires , MaintenanceRÉSUMÉ
Abstract Antibodies and antibody fragments are nowadays among the most important biotechnological products, and Pichia pastoris is one of the most important vectors to produce them as well as other recombinant proteins. The conditions to effectively cultivate a P. pastoris strain previously genetically modified to produce the single-chain variable fragment anti low density lipoprotein (-) under the control of the alcohol oxidase promoter have been investigated in this study. In particular, it was evaluated if, and eventually how, the carbon source (glucose or glycerol) used in the preculture preceding cryopreservation in 20% glycerol influences both cell and antibody fragment productions either in flasks or in bioreactor. Although in flasks the volumetric productivity of the antibody fragment secreted by cells precultured, cryopreserved and reactivated in glycerol was 42.9% higher compared with cells precultured in glucose, the use of glycerol in bioreactor led to a remarkable shortening of the lag phase, thereby increasing it by no less than thrice compared to flasks. These results are quite promising in comparison with those reported in the literature for possible future industrial applications of this cultivation, taking into account that the overall process time was reduced by around 8 h.