Influência do uso de drogas ilícitas na análise seminal e hormonal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Potenciais interações medicamentosas responsáveis por internações hospitalares

As interações medicamentosas (IM) são consideradas um problema de saúde pública, pois podem causar resultados negativos à saúde dos usuários de medicamentos. Portanto o referido trabalho teve como objetivos: estimar a prevalência de internações hospitalares relacionadas a Potenciais IM (PIM); identificar os sinais e sintomas, e os fatores de risco para a hospitalização relacionados à PIM. Metodologia: Realizou-se estudo transversal na clínica geral de um hospital privado do interior de São Paulo (Brasil), em maio de 2006, com pacientes acima de 18 anos, com tempo de hospitalização superior a 24horas, sendo os mesmos entrevistados sobre os sintomas/motivos de internação e os medicamentos que haviam utilizado previamente à hospitalização. Calculou-se Odds-ratiopara identificar fatores de risco, sendo encontrado os seguintes resultados: 168 pacientes utilizando mais de um medicamento, dos quais 57 apresentaram PIM, sendo que em 17(10,1%), os sinais e sintomas da PIM possivelmente foram a causa da hospitalização. A maioria das manifestações clínicas das PIM foram sintomas cardiovasculares (44,3%), gastrintestinais (17,2%) e musculoesqueléticos (13,8%) e 10% das PIM foram consideradas potencialmente perigosas. Não foram detectados fatores de risco relacionados ao gênero, idade, uso de medicamentos de estreita faixa terapêutica para hospitalização por PIM. A polimedicação foi fator de risco para ocorrência de PIM (p < 0,0001) opostamente ao aumento da idade que revelou ser um fator de proteção (p=0,02). Conclusão: Se faz necessário seguimento farmacoterapêutico de pacientes que utilizam fármacos de estreita faixa terapêutica, pois estas substâncias estão frequentemente envolvidas em IM perigosas. Palavras-chave: Problema relacionado ao medicamento. Resultado negativo associado ao medicamento. Erros de medicação. Interações de medicamentos.

Aspectos psicossociais e condições bucais em dependentes químicos internados para desintoxicação

Pós-graduação em Odontologia - FOA

Fatores prognósticos para o abandono precoce do tratamento da dependência do álcool, crack e outras drogas em uma comunidade terapêutica

Pós-graduação em Saúde Coletiva - FMB

Epidemiologia molecular do vírus da Hepatite C: análise comparativa de diferentes regiões subgenômicas aplicadas a estudos de associação genética

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Mycobacterium tuberculosis population structure shift in a 5-year molecular epidemiology surveillance follow-up study in a low endemic agro-industrial setting in São Paulo, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Development of organic-inorganic polymeric film formers for controlled drug release and wound care

Film forming polymeric systems represents a new and unexplored technology of systems forskin or wounds protection and for controlled drug release. The aim of this work was to study the use of polymeric organic-inorganic ureasil-polyether hybrids synthesized by the sol-gel process as film forming system containing silver sulfadiazine as model drug. The film formationtime can be controlled by changing the precursor/catalyst ratio used during the step of hydrolysis and condensations. The results showed that the precursor/catalyst proportion influences both the visual characteristics and time required to form the film. The precursor/catalyst ratio equal to 20.8 m/v was considered ideal due to promote the homogeneous and transparent film formation in less than 5 minutes. The release profile of sulfadiazine is dependent on the characteristics of the matrixes: matrix more hydrophobic as ureasil-POP provided a slowed released mainly due to the low swelling of the matrix. The more hydrophilic ureasil-POE matrix presents a large capacity to swell and favors the faster release of the drug. The set of results showed the possibility of future use of these systems for treating wounds caused by burns.

Risk factors of oropharyngeal carriage of Pseudomonas aeruginosa among patients from a Medical-Surgical Intensive Care Unit

Oropharyngeal carriage of Pseudomonas aeruginosa is associated with increased risk of infection and may provide a source for spread of drug-resistant strains. In order to assess the incidence and risk factors of oropharyngeal carriage, we conducted a retrospective cohort study based on results of surveillance cultures (oropharyngeal swabs) from a medical-surgical intensive care unit, collected from March 2005 through May 2006. Variables investigated included demographic characteristics, comorbid conditions, invasive procedures, use of devices and use of antimicrobials. Thirty case patients with P. aeruginosa carriage were identified. Other 84 patients with surveillance cultures negative to P. aeruginosa were enrolled as control subjects. Case patients were more likely to have a solid malignancy (Odds Ratio [OR] = 12.04, 95% Confidence Interval [CI] = 1.93-75.09, p=0.008), Acquired Immunodeficiency Syndrome (AIDS, OR = 7.09, 95% CI=1.11-45.39, p = 0.04), central nervous system disease (OR = 4.51, 95% CI = 1.52-13.39, p = 0.007), or to have a central venous catheter placed (OR = 7.76, 95% CI = 1.68-35.79, p=0.009). The use of quinolones was a protective factor (OR = 0.13, 95% CI = 0.03-0.47, p = 0.002). The predominance of comorbidities as risk factors points out a group of patients to whom preventive measures should be directed.

High Prevalence of bla(CTX-M) Extended Spectrum Beta-Lactamase Genes in Klebsiella pneumoniae Isolates from a Tertiary Care Hospital: First report of bla(SHV-12), bla(SHV-31), bla(SHV-38), and bla(CTX-M-15) in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Self-medication in children and adolescents

Objective: To determine the prevalence of self-medication in children and adolescents in the municipalities of Limeira and Piracicaba, state of S (a) over tildeo Paulo, and to correlate results with sociodemographic indicators and with the use of health care services (public or private).Methods: Descriptive population-based study of a simple random sample from the two municipalities, comprised of 772 inhabitants from 85 urban census sectors selected through cluster sampling. Inclusion criteria: age <= 18 years; interview with one parent/tutor; consumption of at least one drug in the previous 15 days. Subjects were divided into two study groups according to their pattern of drug use: self-medication (lay advice) and medical prescription. Linear association tests, descriptive analysis of variables and multiple logistic regression tests were carried out to analyze data.Results: the prevalence of self-medication was 56.6%. Mothers (51%) and drugstore employees (20.1%) were most frequently responsible for self-medication. The main groups of self-prescribed drugs were: analgesic/antipyretic and non-hormonal anti-inflammatory drugs (52.9%); drugs acting on the respiratory tract (15.4%) and gastrointestinal drugs (9.6%); and systemic antibiotics (8.6%). The situation that most commonly motivated self-medication were respiratory diseases (17.2%), fever (15%), and headache (14%). Subjects in the age group of 7-18 years (odds ratio = 2.81) and public health care users (odds ratio = 1.52) showed increased risk for self-medication.Conclusions: the prevalence of self-medication in children and adolescents was high, which reinforces the need for public health interventions aiming at preventing this practice.

Assessment of pharmacotherapeutic safety of medical prescriptions for elderly residents in a long-term care facility

The present study aimed to estimate the prevalence of elderly using potentially inappropriate medications (PIM) and with occurrence of potentially hazardous drug interactions (PHDI), to identify the risk factors for the prescription of PIM and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. Therefore, a cross-sectional study was performed in a long-term care facility in São Paulo State, between December/2010 and January/2011. The medical records of the patients >= 60 years old who took any drugs were consulted to assess the pharmacotherapeutic safety of the medical prescriptions, in order to identify PIM and PHDI, according to the Beers (2003) and World Health Organization criteria, respectively. PI consisted of a guidance letter to the physician responsible for the institution, with the suggestions of safer equivalent therapeutics. Approximately 88% of the elderly took at least one drug, and for 30% of them the PIM had been prescribed. Most of the PIM identified (53.4%) act on the central nervous system. Among the 13 different DI detected, 6 are considered PHDI. Polypharmacy was detected as a risk factor for PIM prescription. After the PI there was no change in medical prescriptions of patients who had been prescribed PIM or PHDI. The data suggests that PI performed by letter, as the only interventional, method was ineffective. To contribute it a wide dissemination of PIM and PHDI among prescriber professionals is necessary for the selection of safer treatment for elderly. Additionally, a pharmacist should be part of the health care team in order to help promote rational use of medicines.

Interface of drug use

Packaging and labeling play a crucial role awhile protecting medicaments and transmitting a range of crucial information to the users. Taking into account the scarcity of specific studies in this area, it was considered great the need for a comprehensive survey about customers' satisfaction when handling these containers.

Methodological contributions towards the study of health care production: lessons from a research study on barriers and access in mental health

This article presents methodological contributions and a conceptual innovation for thinking about the production of health care, stemming from a study on access and barriers in mental health carried out in the municipality of Campinas (São Paulo, Brazil). The study used a cartographic approach and, after an initial identification of the most complex cases (on the part of the teams of workers), adopted the users as guides to explore the different levels of production of their lives and to evaluate the possibility of forming a network of existential connections that produce life as a fundamental analyzer of access or barriers to care.

The frequency of pharmacological pain relief in university neonatal intensive care units

Objective: To evaluate the use of drugs to relieve the pain of invasive procedures newborn infants cared for at a university hospital NICU. Methods: A prospective cohort study of all newborn infants hospitalized in four NICU during October 2001. The following data were collected: demographic data of the hospitalized newborn infants; clinical morbidity; number of potentially painful procedures and frequency of analgesic administration. Factors associated with the use of analgesia in this cohort of patients were studied by multiple linear regression using SPSS 8.0. Results: Ninety-one newborn infants were admitted to the NICU during the study period (1,025 patient-days). Only 25% of the 1,025 patient-days received systemic analgesia. No specific drugs were administered to relieve acute pain during any of the following painful events: arterial punctures, venous, capillary and lumbar punctures or intubations. For chest tube insertion, 100% of newborn infants received specific analgesia. For the insertion of central catheters 8% of the newborn infants received painkillers. Only nine of the 17 newborn infants that underwent surgical procedures received any analgesic dosage during the postoperative period. For 93% of patients under analgesia the drug of choice was fentanyl. The presence of mechanical ventilation increased the chance of newborn infants receiving painkillers by 6.9 times and the presence of chest tube increased this chance by five times. Conclusion: It is necessary to train health professionals in order to bridge the gap between scientific knowledge regarding newborn infant pain and clinical practice. Copyright © 2005 by Sociedade Brasileira de Pediatria.