Intervenção Farmacêutica em Patologias Digestivas com Indicação Terapêutica de Medicamentos Não Sujeitos a Receita Médica

Cada vez mais o dia a dia do indivíduo é um stress constante, não tendo normalmente tempo para realizar de forma adequada e correcta os seus hábitos diários. Por vezes, essa falta de rotina diária, nomeadamente nas mudanças horárias constantes para efectuar as refeições, a fraca qualidade de alimentos que ingere, a escassez de líquidos, bem como a diminuta reserva de tempo para realizar as suas necessidades fisiológicas, leva a que perturbações digestivas se desenvolvam e ocorram. No surgimento de tais perturbações, maioritariamente, o indivíduo afectado desloca-se a uma farmácia com o objectivo de lhe resolver o problema em questão. Cabe assim, ao farmacêutico avaliar e indicar qual será a melhor opção para os sinais e sintomas que cada utente poderá apresentar. Desta forma, o farmacêutico irá seguir os vários passos que um correcto atendimento perante o utente deverá conter, colocando diversas questões a este com o intuito de averiguar e assegurar qual a patologia que poderá estar iminente, bem como certificar-se que a indicação farmacêutica e a respectiva dispensa, será a mais correcta para tal situação. As várias etapas em que o farmacêutico se rege, encontram-se normalmente em protocolos de intervenção farmacêutica, indicando todos os aspectos a ter em conta em cada patologia, as medidas não farmacológicas e farmacológicas e os aspectos aquando de referenciação ao médico. Direccionado através de todos estes tópicos, o farmacêutico irá realizar a indicação terapêutica mais adequada a cada situação, melhorando o estado patológico do utente. Pretende-se com esta revisão bibliográfica demonstrar como o farmacêutico deverá actuar perante o utente, proporcionar um maior conhecimento e entendimento de algumas perturbações digestivas, de forma a que a informação prestada ao doente seja a mais correcta, e demonstrar ao farmacêutico quais as opções terapêuticas de não prescrição médica disponíveis na sua farmácia, de modo a encontrar e indicar a melhor solução para cada situação específica.

The Influence of Body Condition on the Stopover Ecology of Least Sandpipers in the Lower Mississippi Alluvial Valley during Fall Migration

Many shorebirds are long-distance migrants and depend on the energy gained at stopover sites to complete migration. Competing hypotheses have described strategies used by migrating birds; the energy-selection hypothesis predicts that shorebirds attempt to maximize energy gained at stopover sites, whereas the time-selection hypothesis predicts that shorebirds attempt to minimize time spent at stopover sites. The energy- and time-selection hypotheses both predict that birds in better condition will depart sites sooner. However, numerous studies of stopover duration have found little support for this prediction, leading to the suggestion that migrating birds operate under energy and time constraints for only a small portion of the migratory season. During fall migration 2002, we tested the prediction that birds in better condition depart stopover sites sooner by examining the relationship between stopover duration and body condition for migrating Least Sandpipers (Calidris minutilla) at three stopover sites in the Lower Mississippi Alluvial Valley. We also tested the assumption made by the Lower Mississippi Alluvial Valley Migratory Bird Science Team that shorebirds stay in the Mississippi Valley for 10 d. The assumption of 10 d was used to estimate the amount of habitat required by shorebirds in the Mississippi Valley during fall migration; a period longer than 10 d would increase the estimate of the amount habitat required. We used multiple-day constancy models of apparent survival and program MARK to estimate stopover duration for 293 individually color-marked and resighted Least Sandpipers. We found that a four-day constancy interval and a site x quadratic time trend interaction term best modeled apparent survival. We found only weak support for body condition as a factor explaining length of stopover duration, which is consistent with findings from similar work. Stopover duration estimates were 4.1 d (95% CI = 2.8–6.1) for adult Least Sandpipers at Bald Knob National Wildlife Refuge, Arkansas, 6.5 d (95% CI = 4.9–8.7) for adult and 6.1 d (95% CI =4.2–9.1) for juvenile Least Sandpipers at Yazoo National Wildlife Refuge, Mississippi, and 6.9 d (95% CI = 5.5–8.7) for juvenile Least Sandpipers at Morgan Brake National Wildlife Refuge, Mississippi. Based on our estimates of stopover duration and the assumption made by the Lower Mississippi Alluvial Valley Migratory Bird Science Team, there is sufficient habitat in the lower Mississippi Valley to support shorebirds during fall migration.

Sufficiency of Favard's condition for a class of band-dominated operators on the axis

The purpose of this paper is to show that, for a large class of band-dominated operators on $\ell^\infty(Z,U)$, with $U$ being a complex Banach space, the injectivity of all limit operators of $A$ already implies their invertibility and the uniform boundedness of their inverses. The latter property is known to be equivalent to the invertibility at infinity of $A$, which, on the other hand, is often equivalent to the Fredholmness of $A$. As a consequence, for operators $A$ in the Wiener algebra, we can characterize the essential spectrum of $A$ on $\ell^p(Z,U)$, regardless of $p\in[1,\infty]$, as the union of point spectra of its limit operators considered as acting on $\ell^p(Z,U)$.

Condition number estimates for combined potential boundary integral operators in acoustic scattering

We study the classical combined field integral equation formulations for time-harmonic acoustic scattering by a sound soft bounded obstacle, namely the indirect formulation due to Brakhage-Werner/Leis/Panic, and the direct formulation associated with the names of Burton and Miller. We obtain lower and upper bounds on the condition numbers for these formulations, emphasising dependence on the frequency, the geometry of the scatterer, and the coupling parameter. Of independent interest we also obtain upper and lower bounds on the norms of two oscillatory integral operators, namely the classical acoustic single- and double-layer potential operators.

Differences between naïve and expert observers’ vergence and accommodative responses to a range of targets

Purpose: Vergence and accommodation studies often use adult participants with experience of vision science. Reports of infant and clinical responses are generally more variable and of lower gain, with the implication that differences lie in immaturity or sub-optimal clinical characteristics but expert/naïve differences are rarely considered or quantified. Methods: Sixteen undergraduates, naïve to vision science, were individually matched by age, visual acuity, refractive error, heterophoria, stereoacuity and near point of accommodation to second- and third-year orthoptics and optometry undergraduates (‘experts’). Accommodation and vergence responses were assessed to targets moving between 33 cm, 50 cm, 1 m and 2 m using a haploscopic device incorporating a PlusoptiX SO4 autorefractor. Disparity, blur and looming cues were separately available or minimised in all combinations. Instruction set was minimal. Results: In all cases, vergence and accommodation response slopes (gain) were steeper and closer to 1.0 in the expert group (p = 0.001), with the largest expert/naïve differences for both vergence and accommodation being for near targets (p = 0.012). For vergence, the differences between expert and naïve response slopes increased with increasingly open-loop targets (linear trend p = 0.025). Although we predicted that proximal cues would drive additional response in the experts, the proximity-only cue was the only condition that showed no statistical effect of experience. Conclusions: Expert observers provide more accurate responses to near target demand than closely matched naïve observers. We suggest that attention, practice, voluntary and proprioceptive effects may enhance responses in experienced participants when compared to a more typical general population. Differences between adult reports and the developmental and clinical literature may partially reflect expert/naïve effects, as well as developmental change. If developmental and clinical studies are to be compared to adult normative data, uninstructed naïve adult data should be used.

A shift to randomness of brain oscillations in people with autism

BACKGROUND: Resting-state functional magnetic resonance imaging (fMRI) enables investigation of the intrinsic functional organization of the brain. Fractal parameters such as the Hurst exponent, H, describe the complexity of endogenous low-frequency fMRI time series on a continuum from random (H = .5) to ordered (H = 1). Shifts in fractal scaling of physiological time series have been associated with neurological and cardiac conditions. METHODS: Resting-state fMRI time series were recorded in 30 male adults with an autism spectrum condition (ASC) and 33 age- and IQ-matched male volunteers. The Hurst exponent was estimated in the wavelet domain and between-group differences were investigated at global and voxel level and in regions known to be involved in autism. RESULTS: Complex fractal scaling of fMRI time series was found in both groups but globally there was a significant shift to randomness in the ASC (mean H = .758, SD = .045) compared with neurotypical volunteers (mean H = .788, SD = .047). Between-group differences in H, which was always reduced in the ASC group, were seen in most regions previously reported to be involved in autism, including cortical midline structures, medial temporal structures, lateral temporal and parietal structures, insula, amygdala, basal ganglia, thalamus, and inferior frontal gyrus. Severity of autistic symptoms was negatively correlated with H in retrosplenial and right anterior insular cortex. CONCLUSIONS: Autism is associated with a small but significant shift to randomness of endogenous brain oscillations. Complexity measures may provide physiological indicators for autism as they have done for other medical conditions.