870 resultados para Adverse drug reactions or ADR
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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A castanha-do-Brasil (Bertholletia excelsea H. B. K.) destaca-se por seus elevados teores em lipídios e proteínas de alta qualidade biológica, parâmetros que justificam a necessidade de maiores pesquisas e incentivos para a elaboração de novos produtos comerciais. No presente estudo, busca-se identificar novas formas de aproveitamento tecnológico dessas amêndoas pela indústria alimentícia, através de seu processamento sobre a forma de farinha sem alteração do teor energético. Os resultados após sua elaboração mostraram um produto com alto valor energético 431,48 kcal.100 g–1, teor de proteína de 45,92 g.100 g–1 e fibra alimentar de 17,14%. As análises térmicas indicam que a introdução de outro componente proteico, como o isolado proteico de soja, não altera as reações e comportamentos térmicos. Já as morfológicas evidenciaram estruturas granulares semelhantes à estrutura das matrizes de proteínas globulares. Constata-se que, após o processamento e obtenção de farinha, o produto mantém seu alto teor energético-proteico e, ao ser submetido a altas temperaturas, mantém suas características.
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Este estudo objetivou analisar os motivos que levam os pacientes coinfectados TB/HIV a abandonar o tratamento da TB e conhecer a conduta da equipe de saúde frente a esse abandono. A abordagem foi qualitativa. Utilizou-se a entrevista semiestruturada, aplicada a quarenta e cinco profissionais que atuam em uma Unidade de Referência no Pará. Após análise temática, foram construídas duas unidades: fatores relacionados aos doentes que dificultam adesão ao tratamento da TB; e fatores relacionados ao serviço que contribuem para o abandono. Mostrou-se, com relação aos pacientes, que a baixa condição socioeconômica foi o fator mais frequente que propicia o abandono. Também efeitos adversos dos medicamentos, uso de drogas lícitas, e pouca motivação pessoal facilitam esse desfecho. Quanto ao Serviço, as questões relacionadas à estrutura física, organização do processo de trabalho e acesso mostraram-se relevantes para não adesão. Os resultados apontam para a necessidade de alterar as práticas desenvolvidas nos Serviços.
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Pós-graduação em Química - IQ
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Endocarditis is a type of infection that is common in internal medicine wards and in haemodialysis clinics. The location that is most affected are the heart valves. Herein, we report a case of an uncommon abscess, a sub-endothelial abscess between the transition of the superior vena cava and the right atrium. There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter. Usually, this type of abscess is located in valves, either the tricuspid valve if related to catheters or injection drug use or the mitral valve if related to other causes. An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection.
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Background. Rubella vaccination is contraindicated during pregnancy. During mass immunization of women of childbearing age against rubella, women unknowingly pregnant may be vaccinated. To evaluate the effects of rubella vaccination during pregnancy, the Brazilian state of Sao Paulo conducted a follow-up study of pregnant women vaccinated during a rubella campaign in 2001.Methods. Women vaccinated during pregnancy were reported to a national surveillance system. In the state of Sao Paulo, follow-up of vaccinated women included household interviews. Serum samples from vaccinated women were tested for antirubella antibodies to classify susceptibility to rubella infection. Children born to susceptible mothers were tested for evidence of congenital rubella infection and evaluated for signs of congenital rubella syndrome.Results. The Sao Paulo State Health Department received 6473 notifications of women vaccinated during pregnancy. Serology performed for 5580 women identified 811 (15%) that were previously susceptible. Incidence of spontaneous abortion or stillbirth among previously susceptible vaccinated women was similar to women with prior immunity. Twenty-seven (4.7%) of 580 newborns tested had evidence of congenital rubella infection; none had congenital rubella syndrome.Conclusions. Mass rubella vaccination of women of childbearing age was not associated with adverse birth outcomes or congenital rubella syndrome among children born to women vaccinated during pregnancy.
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Living organisms are constantly subjected to the action of free radicals, which are one of the causes of oxidation reactions, because they have on free electron, what makes it very reactive. They are products of organism reactions or they are produced by exogenous factors, such as tobacco. Fatty acids are the most vulnerable target, and may suffer lipid peroxidation, what affects the cell structure. Cardiovascular diseases, cancer and diseases of aging are occurrence of these reactions in the organism related. The aliments are also subjected to suffer oxidation reactions, what make them unfit for consumption and decreasing the useful life. Synthetics antioxidants are used as aliments preservatives, but they present some toxicity for the organism. Studies for the utilization of natural antioxidants have gained more importance in recent decades, due to the conservation potential and low toxicity. Phenolics compounds are largely present at the vegetable kingdom and they present high antioxidant potential due to the neutralization and kidnapping of free radicals capacity. These compounds are used by the industry at the aliments conservation, specially the phenolics acids. The consumption of aliments rich in phenolic compounds, such as teas, wines and fruits are low incidence of degenerative diseases related. This study consists in a bibliographic revision that covers these compounds importance in diet and at the food conservation, and the methodologies and difficulties in the extraction process due to variety of molecules of this group.
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This research examines the merits of hallucinogenic plants considered and/or psychoactive substances, such as Cannabis sativa and Ipomoea violacea, using the isotope rates of stable isotope of oxygen (18O) and nitrogen (15N), continuing projects already developed by the research group at the Center for Stable Isotope (CIE), which evaluated the isotopes carbon-13. This paper helps in creating a database that we intent to use in evaluation of each plant merit. Through the IRMS (Isotope-Ratio Mass Spectrometry) technique, it has shown that some of the 24 samples of marijuana (Cannabis sativa L.) evaluated were similar to those grown in the regions of Fairbanks and Tanacross Alaska, USA. In turn, the 50 samples of Ipomoea violacea, coming from Botucatu (SP) and Três Lagoas (MS), got their differences detected, in order to clearly identify the discrepancies between their growing regions. Thus, it was possible not only to track the geographical differences between marijuana samples collected from different regions, but also evaluate the isotopic variation of leaf, flower and seed of Ipomoea violacea. With this database, it was possible to determine the origin region of the drug and/or detect where the cultivation was carried out, aiding in the search of the traffic control agencies, such as the Federal Police in Brazil
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Certain medicines are considered potentially inappropriate (PIM) for elderly people as they increase the risk of adverse drug events (ADE) and because safer alternative therapies are available on the market. In this context, in order to identify the instruments that assess the quality of medical prescriptions for elderly and to determine which drugs are considered PIM, a bibliographic survey was conducted in PUBMED, LILACS and PAHO databases, in February and March/2010. The search strategy included the use of health descriptors and a manual search in the references cited by selected papers. During the period of data collection, 15 instruments were identified. In 2012, with the publication of the update of Beers criteria, this instrument was included in the study. We identified 163 PIM of 25 therapeutic classes, of which 125 (76.7%) are marketed in Brazil. Of these, 31 (24.8%) are essential medicines (RENAME 2012), of which 13 have safer therapeutic equivalents and 19 (15.2%) are over-the-counter drugs. Data suggest the need for inclusion of safer alternatives for the elderly in the national list of essential medicines and the pharmaceutical care for early detection of ADE in this age group, in order to contribute to the safe use of medicines.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Objective: to describe technical complaints and adverse drug events reported in a sentinel hospital in São Paulo state in 2009 and 2010. Methods: This is a descriptive study. Information was obtained from the sentinel hospital Risk Management database. Results: we found 199 reports related to drugs: 70.0% were technical complaints, 21.0% ineffective therapy and 9.0% adverse reaction to medication. The pharmacological groups with highest number of reports were: drugs that act on alimentary tract and metabolism (25.1%), the nervous system (25.1%) and anti-infective drugs for systemic use (22.1%). Conclusion: technical complaints and adverse drug events were frequent, despite recognized underreporting. The characterization of these events could inform the adoption of control measures and permanent educational actions in health services in order to prevent their occurrence.
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BACKGROUND The safety and efficacy of adding antiretroviral drugs to standard zidovudine prophylaxis in infants of mothers with human immunodeficiency virus (HIV) infection who did not receive antenatal antiretroviral therapy (ART) because of late identification are unclear. We evaluated three ART regimens in such infants. METHODS Within 48 hours after their birth, we randomly assigned formula-fed infants born to women with a peripartum diagnosis of HIV type 1 (HIV-1) infection to one of three regimens: zidovudine for 6 weeks (zidovudine-alone group), zidovudine for 6 weeks plus three doses of nevirapine during the first 8 days of life (two-drug group), or zidovudine for 6 weeks plus nelfinavir and lamivudine for 2 weeks (three-drug group). The primary outcome was HIV-1 infection at 3 months in infants uninfected at birth. RESULTS A total of 1684 infants were enrolled in the Americas and South Africa (566 in the zidovudine-alone group, 562 in the two-drug group, and 556 in the three-drug group). The overall rate of in utero transmission of HIV-1 on the basis of Kaplan-Meier estimates was 5.7% (93 infants), with no significant differences among the groups. Intrapartum transmission occurred in 24 infants in the zidovudine-alone group (4.8%; 95% confidence interval [CI], 3.2 to 7.1), as compared with 11 infants in the two-drug group (2.2%; 95% CI, 1.2 to 3.9; P=0.046) and 12 in the three-drug group (2.4%; 95% CI, 1.4 to 4.3; P=0.046). The overall transmission rate was 8.5% (140 infants), with an increased rate in the zidovudine-alone group (P=0.03 for the comparisons with the two-and three-drug groups). On multivariate analysis, zidovudine monotherapy, a higher maternal viral load, and maternal use of illegal substances were significantly associated with transmission. The rate of neutropenia was significantly increased in the three-drug group (P < 0.001 for both comparisons with the other groups). CONCLUSIONS In neonates whose mothers did not receive ART during pregnancy, prophylaxis with a two-or three-drug ART regimen is superior to zidovudine alone for the prevention of intrapartum HIV transmission; the two-drug regimen has less toxicity than the three-drug regimen. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [NICHD] and others; ClinicalTrials.gov number, NCT00099359.)
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The aim of the present study was to obtain microparticles of hydrochlorothiazide, a diuretic drug that practically insoluble in water, by spray drying and to investigate the influence of process parameters using a three-level, three-factor Box-Behnken design. Process yields, moisture content, particle size, flowability, and solubility were used to evaluate the spray-dried microparticles. The data were analyzed by response surface methodology using analysis of variance. The independent variables studied were outlet temperature, atomization pressure, and drug content. The formulations were prepared using polyvinylpyrrolidone and colloidal silicon dioxide as the hydrophilic carrier and drying aid, respectively. The microparticle yield ranged from 18.15 to 59.02% and resulted in adequate flow (17 to 32 degrees), moisture content between 2.52 to 6.18%, and mean particle size from 45 to 59 mu m. The analysis of variance showed that the factors studied influenced the yields, moisture content, angle of repose, and solubility. Thermal analysis and X-ray diffractometry evidenced no drug interactions or chemical modifications. Photomicrographs obtained by scanning electron microscopy showed spherical particles. The solubility and dissolution rates of hydrochlorothiazide were remarkably improved when compared with pure drug. Therefore, the results confirmed the high potential of the spray-drying technique to obtain microparticulate hydrochlorothiazide with enhanced pharmaceutical and dissolution properties.