https://repositorio.ufba.br/handle/ri/26512 Fri, 17 Apr 2026 04:37:10 GMT 2026-04-17T04:37:10Z https://repositorio.ufba.br/handle/ri/44158 Análise de custo-efetividade da introdução da terapia antifúngica empírica precoce em pacientes terapia intensiva com base em fatores de risco para infecções fúngicas invasivas Oliveira, Bianca Silva de Sousa Mistro, Sóstenes Background: Invasive fungal infections (IFI) represent a serious and increasing complication in the treatment of critically ill patients in intensive care units (ICUs) and impose a significant economic burden on healthcare systems. One of the biggest challenges in the management of IFI is the difficulty in defining an early and accurate diagnosis. In this context identifying risk factors for IFI has been a widely recommended strategy to improve treatment outcomes. However, uncertainty about the ideal time to initiate treatment can expose patients to both the risk of therapeutic failure and the occasional overuse of antifungals. Aim: to identify the ideal time to introduce empirical antifungal therapy based on the number of risk factors for IFI in patients admitted to the ICU. Method: Pharmacoeconomic study of the Cost-effectiveness Analysis type based on retrospective data of patients admitted to the ICU of a general hospital, which included all patients over 18 years of age followed from admission to discharge from the ICU. Results: A total of 446 patients with a median age of 50 years participated in the study. Nine risk factors were identified, of which previous exposure to broad-spectrum antibiotics, human immunodeficiency virus (HIV) infection, abdominal surgery, and hemodialysis were the factors most associated with the use of antifungals. Furthermore, in the cost-effectiveness analysis, the initiation of empirical antifungal therapy in ICU patients based on the presence of up to two risk factors for IFI is a more cost-effective strategy when compared with the presence of a greater number of risk factors. Conclusion: The early initiation of antifungal therapy based on the presence of up to two risk factors for IFI is a cost-effective strategy that can improve the ideal time to initiate antifungal treatment. UNIVERSIDADE FEDERAL DA BAHIA Dissertação Wed, 14 May 2025 00:00:00 GMT https://repositorio.ufba.br/handle/ri/44158 2025-05-14T00:00:00Z https://repositorio.ufba.br/handle/ri/43760 Custo-efetividade do cuidado qualificado no manejo do diabetes baseada em indicadores de qualidade Alves, Yasmin Vitória Andrade de Castro Mistro, Sóstenes Background: Diabetes mellitus (DM) is one of the most common non-communicable diseases worldwide and is associated with a substantial increase in the healthcare burden due to high rates of morbidity, mortality, and long-term complications. Evidence on the economic impact of quality of care for diabetes management, based on structured assessment indicators, in real-world primary care settings is scarce. This study aimed to evaluate the cost-effectiveness of providing qualified care to individuals with diabetes in primary healthcare settings, based on quality-of-care indicators. Methods: Quality indicators were defined in the categories of medical and family history, behavioral factors, pharmacotherapy and vaccination, use of technology, physical examination and laboratory evaluation. A cost-effectiveness analysis was conducted using a Markov-based model from the perspective of a municipal health manager in Brazil. Data were collected from 114 patients aged 60 years or older with type 2 diabetes mellitus in Vitória da Conquista. Patients were grouped based on whether 15 or more structured quality-of-care indicators were assessed during follow-up visits. The model simulated health state transitions over a 10-year time horizon, incorporating probabilities of complications, quality-adjusted life years (QALYs), and direct costs. Sensitivity and probabilistic analyses were performed to test model robustness. Results: It was found that in the group with 15 or more items assessed at visits, 17.4% had complications, and in the group with fewer than 15 items assessed, this percentage was 37.14%. Therefore, they were used as comparators in the economic model. The cost-effectiveness analysis showed that the most comprehensive assessment was the dominant strategy, with an incremental cost-effectiveness ratio of -US$9742.51. The factors that most influenced the model were quality-adjusted life years, the probability of experiencing complications, and the cost of diabetes. Conclusion: Qualified care with a comprehensive approach during follow-up visits was shown to be a cost-effective strategy for improving the quality of life of people with DM. Universidade Federal da Bahia Dissertação Mon, 21 Jul 2025 00:00:00 GMT https://repositorio.ufba.br/handle/ri/43760 2025-07-21T00:00:00Z https://repositorio.ufba.br/handle/ri/43199 Purificação e incorporação de C-FICOCIANINA em sistemas de liberação para avaliação da atividade cicatrizante Machado, Laiane dos Santos Ribeiro Marcelino, Henrique Rodrigues The increase in socio-environmental changes has encouraged the search for ecologically friendly inputs in the global industry. In this context, phycobiliproteins from microalgae have become an asset of great interest to the pharmaceutical, cosmetic, and food industries due to their diverse biological activities, color/fluorescence, non-toxicity, and origin from renewable sources. This work aims to demonstrate the value of this protein for pharmaceutical purposes, as it is applied to healing, as well as the development of a release system capable of maintaining the molecule's stability in aqueous media. To this end, a patent search for C-FC related to different drug delivery systems provided a basic overview of the market and future projections. In addition, delivery systems were developed to incorporate C-FC for healing use. Patent prospecting has shown that technological maturity concerning the topic is growing, and the presence of medicines on the market with bioactivity is not yet observed; the reasonable market projections encourage investment in research and development in this area. In addition, it was observed that C-FC can be incorporated into different delivery systems, with its therapeutic application being more predominant in anticancer drugs. In the development of the release systems, it was possible to observe that liposomes were not able to encapsulate the active ingredient due to the method used to make the system, but Synperonic® 127 and Carbopol® 996 gels were able to incorporate C-FC, the former being able to promote greater stability to the active ingredient. The results indicate that the formulation obtained may have woundhealing potential. UNIVERSIDADE FEDERAL DA BAHIA Dissertação Fri, 30 May 2025 00:00:00 GMT https://repositorio.ufba.br/handle/ri/43199 2025-05-30T00:00:00Z https://repositorio.ufba.br/handle/ri/39510 Adesão ao tratamento com infliximabe em pacientes com doenças inflamatórias imunomediadas atendidos em um centro de infusão de um hospital universitário em Salvador – BA Lauton, Priscilla Moreira Santos, Pablo de Moura Infliximab therapy is effective in controlling symptoms and attaining clinical remission of immune-mediated inflammatory diseases; however, treatment adherence is essential to achieve the therapeutic objective. This study aimed to determine the rate of adherence to infliximab treatment in patients treated at an infusion center at a university hospital. Method: This ambispective cohort study included patients treated at the HUPES infusion center of our university hospital between March 2022 and February 2023. Sociodemographic, clinical, and pharmacotherapeutic data were collected from patients through interviews and medical record reviews using a structured form. The adherence rate was defined as the proportion of days covered in a year. Patients who achieved an adherence rate >80% were considered adherent. Results: The treatment adherence rate was 91.04%. Individuals with inflammatory bowel diseases had a 39.1% higher risk of non-adherence to treatment compared with other patients. Most patients achieved remission or control of the underlying disease activity and had good functional capacities and quality-of-life indices. The main reason for absence on the scheduled date was difficulty traveling to the infusion center.Conclusions: Despite the reported difficulties, treatment adherence was observed to be high. As the study was conducted in a reference unit with multidisciplinary care and continuous monitoring for treatment effectiveness, safety, and adherence, welcoming and good communication between professionals and patients may have contributed to the high adherence rate. Universidade Federal da Bahia Dissertação Wed, 06 Dec 2023 00:00:00 GMT https://repositorio.ufba.br/handle/ri/39510 2023-12-06T00:00:00Z