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Izadora MC Barros, Thaciana S Alcântara, Alessandra R Mesquita, Monica L Bispo, Chiara E Rocha, Vagner Porto Moreira, Divaldo P Lyra Junior Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Brazil Objective: To assess the understanding and cultural acceptability of the United States Pharmacopeia Dispensing Information (USP-DI) in a group of elderly Brazilians.Methods: The study participants were individuals between 60 and 90 years old, of both sexes, with different levels of education and income. Fifteen of 81 pictograms from the USP-DI were presented to the elderly subjects, individually, without subtitles and in random order, so that the participants’ understanding of the pictograms could be evaluated.Results: The study included 116 participants. Only one of the selected pictograms reached the comprehension criterion established by the International Organization for Standardization 3864. With regard to the relationship between understanding and sociodemographic characteristics, age, wage income, and level of education were all found to be significantly associated with participants’ understanding of some of the pictograms.Conclusion: Most of the USP-DI pictograms evaluated were not well understood by the elderly Brazilians. This finding indicates that such pictograms need to be culturally adapted for the Brazilian context if they are to serve their purpose effectively in this country. Keywords: pictograms, understanding, elderly, Brazil

Indications Corridor and Limits of Exposure: This approach is suitable for petroclival lesions medial to V cranial nerve that extend in both middle and posterior fossa. It provides multiple surgical corridors with minimal brain retraction., Anatomic Essentials Need for Preoperative Planning and Assessment: Several critical neurovascular structures of the petrous bone are at risk during the approach. Meticulous reading of the preoperative images is fundamental. It is mandatory to perform a thin section computed tomography scan, an MRI, and, in case of petroclival meningiomas, a digital subtraction angiography., Essential Steps of the Procedure: In the first illustrative case, we present our current "mini-combined petrosectomy" with minimal drilling of the labyrinth. Positioning, skin incision, and craniotomy are illustrated in the video. Once all the important neurovascular structures are identified, we perform the anterior and the posterior petrosectomy, with preservation of the endolymphatic sac. We continue with dura mater opening and tentorium cutting. After tumor removal, we can appreciate an unique view of ipsilateral and contralateral cranial nerves, as well as pituitary stalk and major arteries., Pitfalls/avoidance of Complications: To avoid injuries to the main neurovascular structures, neuronavigation, neuromonitoring, and Doppler can be useful., Variants and Indications for Their Use: The second illustrative case shows an extension of the combined petrosectomy to the anterior fossa, this made possible to perform a transsylvian approach for this giant sphenopetroclival meningioma. The patients consented to the procedure and to the publication of his/her images. Appropriate consent was obtained for the publication of the cadaveric images., (Copyright © Congress of Neurological Surgeons 2023. All rights reserved.)

Background: Cancer is a major public health problem that imposes limitations on patients being treated. One of the strategies to improve health outcomes in cancer patients and promote the safety of their treatment is the provision of pharmaceutical clinical services (PCS). However, there is no evidence of health outcomes that are influenced by such services., Objective: Identify the health outcomes influenced by PCS in cancer patients., Methods: A systematic review was performed in the following databases: Cochrane Library, LILACS, PubMed, EMBASE, and Web of Science, and using the PRISMA Statement In addition to the search, we analyzed the references of systematic reviews and meta-analyses. The descriptors used were defined by the MeSH keywords "neoplasms," "pharmacists," and "pharmaceutical services". We analyzed the studies with an observational design published until March 2018 that used PCS and related them with the health outcomes. Two reviewers independently assessed titles, abstracts, and full texts according to the eligibility criteria, and then extracted data and assessed the methodological quality of the studies., Results: A total of 658 articles were found in the initial search, of which eight met the inclusion criteria. Six studies evaluated clinical outcomes: four assessed adverse reactions, one identified six barriers that prevented patients' adherence to medication and solved three of these barriers, and two evaluated PCS related to drug-related problems (DRP) in identification and resolution. Four studies identified a humanistic outcome: two evaluated the quality of life of patients on cancer treatment associated with improvement of symptoms, two investigated pain, and two performed a patient satisfaction survey on PCS. This systematic review identified only one study with an economic outcome, addressing the reduction of medical expenses related to the treatment of neutropenia that affects cancer patients. Most of the studies showed good methodological quality., Conclusions: This systematic review identified health outcomes associated with PCS in cancer patients: clinical (adverse drug reaction, DRP resolution, adherence, and pain), humanistic (quality of life and satisfaction), and economic outcomes (reduction of treatment costs for cancer)., Competing Interests: Declaration of competing interest The authors declare that no conflicts of interest regarding the research, authorship, and/or publication of this article., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Introduction: This study aims to investigate the clinical-functional results of a new surgical technique, Percutaneous Endoscopic Lumbar Interbody Fusion (PELIF), in patients with a clinical diagnosis of low back or sciatic pain and segmental instability who were submitted to surgery using this technique assisted by the attending physician., Materials and Methods: Patients completed a consent form and were clinically and radiographically re-assessed by independent evaluators using the visual analog scale (VAS) for pain, the Oswestry Disability Index (ODI), and the SF-36 Quality of Life Score in the pre- and postoperative periods. Their medical records were also reviewed for surgical time, length of hospital stay, need for blood transfusion, return to work, and radiographic fusion evaluation., Results: In the group of 19 patients with 33 levels operated, VAS and ODI decreased from 10.0 and 64% to 2.0 and 28%, respectively. The SF-36 showed significantly higher scores in 5 of its 7 domains at the end of the follow-up as compared to the preoperative period scores. Only 1 case of pseudoarthrosis was diagnosed radiographically., Conclusions: Percutaneous Endoscopic Lumbar Interbody Fusion (PELIF) has been shown to be a safe and efficient technique for the treatment of patients with segmental instability associated with low back or sciatic pain. Level of Evidence VI; Therapeutic Study; Case Series., Competing Interests: All authors declare no potential conflict of interest related to this article.

Background: Intervertebral disc changes are a multi-factorial problem whose main clinical feature is pain. Studies show that when clinical treatments fail, the proposed surgical treatments frequently present unsatisfactory results. Traditional lumbar arthrodesis causes important clinical and functional changes that can result in complications and jeopardize the patients' quality of life., Objectives: This study aims to investigate the clinical and functional results of minimally invasive spine surgery in patients with a clinical diagnosis of low-back or sciatic pain and segmental instability, finally correlating these results with the patients' return to work., Methods: Patients signed an informed consent form and were clinical and radiographically re-evaluated by independent professionals in the pre- and postoperative periods. Evaluation methods used the Oswestry disability index, as well as visual analog scale and Medical Outcomes Short Form Health Survey (SF-36) scores. We also retrieved epidemiological data, information on work resumption, and bone consolidation evaluations from the medical records., Results: We evaluated 19 patients who had been operated on 33 levels; visual analog scale and Oswestry disability index scores were initially reduced from 10% to 2% and from 64% to 28%, respectively. SF-36 scores were significantly higher in 5 of the 7 questionnaire scales at the end of the follow-up period. Most patients (68.4%) did not return to work after surgery; the others returned 2 to 67 months after the procedure. All patients received social security benefits after the surgery., Conclusion: Although the procedure presented positive results, it did not result in a satisfactory return-to-work rate. Our results should be analyzed in view of the low educational level and income of the patients, the manual nature of their labor, and the validity of social security benefits.

Background: Despite the increasing complexity of medication therapies and the expansion of pharmaceutical clinical services to optimize patient care working in collaboration with physicians. In this sense, interdisciplinary education has been encouraged. However, no instrument is available to measure attitudes toward collaborative relationships., Objective: To translate, cross-cultural adaptation and validation an instrument to measure collaboration attitudes toward students of medicine/pharmacy and physicians/pharmacists., Methods: The process of cross-cultural adaptation was carried out using international recommendations and was performed from January 2014 to April 2015. The instrument under consideration was translated and re-translated. A panel of experts compared the generated documents and the translation was evaluated for 20 undergraduate students of Pharmacy, 20 undergraduate students of Medicine and professionals (20 pharmacists and 20 physicians)., Results: The process of cross-cultural translation and validation result in the Portuguese version. Modifications to the grammatical structures were made in order to establish a cross-cultural similarity between the English and Portuguese versions. Regarding the evaluation of the expert panel, six questions required modifications., Conclusions: Psychometric evaluation demonstrated and confirmed the validity of the Brazilian-Portuguese version to assess collaborative attitudes among pharmacists and physicians. Moreover, the scale can be used to evaluate undergraduates and postgraduates and foster the development of teaching methods that promote comprehensive attitudes in patient care., Competing Interests: CONFLICT OF INTEREST Authors report no conflict of interest.

Polycyclic aromatic hydrocarbons (PAHs) cause a high environmental impact when released into the environment. The objective of this study was to evaluate the capacity to decontaminate polluted soils with phenanthrene as a model PAH using a combination of two technologies: electrokinetic remediation and Fenton process. Kaolinite was used as a model sample that was artificially polluted at the laboratory at an initial concentration of phenanthrene of 500 mg kg(-1) of dried kaolinite. The standard electrokinetic process resulted in negligible removal of phenanthrene from the kaolinite sample. Faster and more efficient degradation of this compound can be promoted by introduction of a strong oxidant into the soil such as hydroxyl radicals. For this reason, the Fenton reactions have been induced in several experiments in which H(2)O(2) (10%) was used as flushing solution, and kaolinite polluted with iron was used. When anode and cathode chambers were filled with H(2)O(2) (10%), the kaolinite pH is maintained at an acid value around 3.5 without pH control and an overall removal and destruction efficiency of phenanthrene of 99% was obtained in 14 days by applying a voltage gradient of 3 V cm(-1). Therefore, it is evident that a combined technology of electrokinetic remediation and Fenton reaction is capable of simultaneously removing and degrading of PAHs in polluted model samples with kaolinite.