986 resultados para Safe use of medications


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Background:Heart failure (HF) is one of the leading causes of hospitalization in adults in Brazil. However, most of the available data is limited to unicenter registries. The BREATHE registry is the first to include a large sample of hospitalized patients with decompensated HF from different regions in Brazil.Objective:Describe the clinical characteristics, treatment and prognosis of hospitalized patients admitted with acute HF.Methods:Observational registry study with longitudinal follow-up. The eligibility criteria included patients older than 18 years with a definitive diagnosis of HF, admitted to public or private hospitals. Assessed outcomes included the causes of decompensation, use of medications, care quality indicators, hemodynamic profile and intrahospital events.Results:A total of 1,263 patients (64±16 years, 60% women) were included from 51 centers from different regions in Brazil. The most common comorbidities were hypertension (70.8%), dyslipidemia (36.7%) and diabetes (34%). Around 40% of the patients had normal left ventricular systolic function and most were admitted with a wet-warm clinical-hemodynamic profile. Vasodilators and intravenous inotropes were used in less than 15% of the studied cohort. Care quality indicators based on hospital discharge recommendations were reached in less than 65% of the patients. Intrahospital mortality affected 12.6% of all patients included.Conclusion:The BREATHE study demonstrated the high intrahospital mortality of patients admitted with acute HF in Brazil, in addition to the low rate of prescription of drugs based on evidence.

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AbstractIntroduction:Cardiac allograft vasculopathy (CAV) is a major limitation for long-term survival of patients undergoing heart transplantation (HT). Some immunosuppressants can reduce the risk of CAV.Objectives:The primary objective was to evaluate the variation in the volumetric growth of the intimal layer measured by intracoronary ultrasound (IVUS) after 1 year in patients who received basiliximab compared with that in a control group.Methods:Thirteen patients treated at a single center between 2007 and 2009 were analyzed retrospectively. Evaluations were performed with IVUS, measuring the volume of a coronary segment within the first 30 days and 1 year after HT. Vasculopathy was characterized by the volume of the intima of the vessel.Results:Thirteen patients included (7 in the basiliximab group and 6 in the control group). On IVUS assessment, the control group was found to have greater vessel volume (120–185.43 mm3 vs. 127.77–131.32 mm3; p = 0.051). Intimal layer growth (i.e., CAV) was also higher in the control group (27.30–49.15 mm3 [∆80%] vs. 20.23–26.69 mm3[∆33%]; p = 0.015). Univariate regression analysis revealed that plaque volume and prior atherosclerosis of the donor were not related to intima growth (r = 0.15, p = 0.96), whereas positive remodeling was directly proportional to the volumetric growth of the intima (r = 0.85, p < 0.001).Conclusion:Routine induction therapy with basiliximab was associated with reduced growth of the intima of the vessel during the first year after HT.

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Magdeburg, Univ., Fak. für Geistes-, Sozial- und Erziehungswiss., Diss., 2009

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Otto-von-Guericke-Universität Magdeburg, Fakultät für Wirtschaftswissenschaft, Univ., Dissertation, 2015

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This manuscript presents information about the ecology of Lontra longicaudis (Olfers, 1818) in the Taquari Valley, State of Rio Grande do Sul, southern Brazil. The study was carried out in two areas located in the Forquetinha Creek and in the Forqueta River from January to December 2003. The otters are specialist feeders (Bsta = 0.24), with a diet based mostly on fish, especially those of the families Loricariidae and Cichlidae. Most shelters used by the species were excavated burrows underneath tree roots, while shelters within rocks were used less frequently. The burrows showed great variation in size, being found on average 3.5 m (sd = 3.6 m) away from the margin and 2.5 m (sd = 1.2 m) above the water level. Scent marks were made preferentially on rocks and fallen tree trunks at the edge of the water. There was a tendency to increase the reutilization of latrines in detriment of using new sites throughout the sample period.

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This study investigates the Drosophilidae species associated to fruiting bodies of fungi in forested and anthropized environments of the Atlantic Rain Forest Biome, in south and southeastern Brazil. We collected samples of imagoes flying over and emerging from fruiting bodies of species of five fungi families, in six collection sites. We obtained 18 samples, from which emerged 910 drosophilids of 31 species from the genera Drosophila Fallen, 1823, Hirtodrosophila Duda, 1923, Leucophenga Mik, 1886, Mycodrosophila Oldenberg, 1914, Scaptomyza Hardy, 1849, Zaprionus Coquillett, 1901 and Zygothrica Wiedemann, 1830. The Drosophila species collected on fungi, as well as Zaprionus indianus Gupta, 1970, had previously been recorded colonizing fruits, demonstrating their versatility in resource use. Most of these species belong to the immigrans-tripunctata radiation of Drosophila. Our records expands the mycophagous habit (feeding or breeding on fungi) to almost all species groups of this radiation in the Neotropical region, even those supposed to be exclusively frugivorous. Assemblages associated to fungi of forested areas were more heterogeneous in terms of species composition, while those associated to fungi of anthropized areas were more homogeneous. The drosophilids from anthropized areas were also more versatile in resource use.

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We studied the influence of seasonality on the daily activity pattern and microhabitat use of three sympatric lizard species, Cnemidophorus ocellifer Spix, 1825 (Teiidae), Tropidurus montanus Rodrigues, 1987 and Eurolophosaurus nanuzae (Rodrigues, 1981) (Tropiduridae), in an area of campos rupestres (rocky fields) habitat in state of Minas Gerais, Brazil. Cnemidophorus ocellifer exhibited low density and activity concentrated within the hottest hours of the day, and was observed mainly on shaded rocks. Tropidurus montanus and E. nanuzae had similar activity patterns that did not vary between seasons. Activity of T. montanus was related to environmental temperatures. However, we did not find such relationships for E. nanuzae during the dry season. Both T. montanus and E. nanuzae were sighted mainly on exposed rocks. Extension of activity varied between seasons, shorter for C. ocellifer and longer for T. montanus and E. nanuzae during the rainy season.

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In order to evaluate the efficiency of different mammalian survey methods, we compared traditional sampling techniques (use of camera-traps on roads and artificial trails, track censuses, and direct field visualization) with an alternative sampling design (camera-traps positioned in natural areas such as natural trails and shelters). We conducted the study in a deciduous Atlantic-Forest park in southern Brazil, and additionally compared our results with a previous intensive study carried out in the same area. Our considerably smaller sampling effort (example: 336 trap.day for our camera-traps versus 2,154 trap.day for the earlier study) registered the presence of 85% of the local known species, with camera-traps being 68% efficient. Moreover, shelter camera-traps revealed a different species composition regarding most of other sampling methods. This sampling strategy involving natural forest sites was therefore able to effectively optimize the chances of evaluating species composition in a shorter period, especially with respect to lower-density and cryptic species, as well as to detect species that avoid open, disturbed sites such as roads and man-made forest trails.

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ABSTRACT In forest ecosystems, numerous species of insectivorous birds use certain tree species as feeding and nesting substrates. Between 2009 and 2010, the use of different floristic components as feeding substrate by the Pygarrhichas albogularis King, 1831 was evaluated in a southern Chilean secondary native forest. From a total of 13 trees and bush species, six tree species were used by P. albogularis as a feeding substrate. Tree use was limited to intermediate heights (11-20 m) and, mainly, to the trunk (40% of observations) and secondary branches (26%). Pygarrhichas albogularis showed a disproportionated use of N. dombeyi and an important use of trees with a greater age structure (DBH 81-100 cm). Nothofagus dombeyi presented a significantly greater tree bark crevice depth than E. cordifolia. In turn, covariance between crevice depth and invertebrate supply in tree bark was positive and significant. We consider bark depth and invertebrate supply to be the proximate causes explaining P. albogularis disproportionated use of Nothofagus dombeyi.