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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

O objetivo do estudo foi analisar o perfil farmacoterapêutico dos pacientes com diabetes mellitus tipo 2 atendidos pelo serviço de cuidado farmacêutico no Sistema Único de Saúde. Tratou-se de um estudo quantitativo, transversal e foram avaliadas informações obtidas durante consultas farmacêuticas realizadas em pacientes portadores de diabetes mellitus tipo 2, atendidos em unidades de atenção primária de três municípios do estado do Paraná. Em média, os pacientes utilizavam 6,5±3,0 medicamentos. Para tratamento do diabetes, mais da metade dos pacientes associava insulina e antidiabéticos orais, sendo os mais prescritos a metformina e glibenclamida. Entre os medicamentos para tratamento das comorbidades, a hidroclorotiazida, losartana e sinvastatina foram os mais frequentes. As principais interações medicamentosas potenciais identificadas foram a associação entre antidiabéticos e diuréticos tiazídicos ou betabloqueadores ou inibidores da enzima conversora da angiotensina, além da associação entre sinvastatina e ciprofibrato. A polimedicação foi identificada na grande maioria dos pacientes avaliados.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Este estudo revisou intervenções terapêuticas e farmacológicas para o tratamento do transtorno por uso de Cannabis. Foram incluídos estudos de revisão que abordassem diretamente intervenções terapêuticas, farmacológicas ou psicossociais para a dependência de Cannabis. A busca identificou 430 artigos, dos quais 11 foram incluídos na revisão. Os resultados destacaram descobertas sobre farmacoterapia, intervenções mistas, psicoterapias e tratamentos digitais. Concluímos que, embora existam intervenções promissoras, como terapias comportamentais e programas digitais, são necessárias mais pesquisas rigorosas para enfrentar eficazmente o uso problemático de Cannabis.

Copyright of Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas is the property of Universidad de Santiago de Chile and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introdução: As complicações micro e macrovasculares da diabetes são resultado de um processo de caráter longo sobre a falta dos cuidados da diabetes, de que resultam problemas cardiovasculares, oftalmológicos e neuropáticos, requerendo por essas questões elevada atenção no tratamento. Descrição do caso: Apresenta-se o relato de caso de um paciente adulto de meia-idade, ex-fumador, com diagnóstico de diabetes mellitus, além da hipertensão e obesidade. A sua alimentação não saudável ao longo dos anos, sedentarismo e altos níveis de estresse resultou num quadro de isquemia vascular periférica, que intensificou as complicações da diabetes, ou seja, problemas micro e macrovasculares, entre eles, a retinopatia e a neuropatia. Por esse histórico, a farmacoterapia do paciente resultou entre as insulinas (regular e NPH), antiagregante plaquetátio, estatina, fibratos, psicotrópicos e os anti-hipertensores. Além disso, detetou-se que seus níveis glicémicos e hemoglobina glicada estão elevados. Ainda se verificaram alterações na lipoproteína de alta densidade (HDL) e triglicéridos. Algumas queixas do paciente no período noturno, como boca seca, tontura e sonolência, são problemas que podem estar relacionados com a terapia concomitante de venlafaxina, gabapentina e amitriptilina. Comentários: De forma geral, recomenda-se a este paciente a prática de exercício físico, como caminhada, por exemplo, diminuição do consumo de hidratos de carbono e sódio, além de algumas alterações na farmacoterapia do paciente.

Streptococcus agalactiae is considered a microorganism that causes serious neonatal infections and can lead to death. The colonization by GBE in pregnant women ranges from 5 to 35% and has its alteration widely according to region. However, through specific prenatal examinations it is possible to identify it and, thus, to promote measures of therapeutic intervention early. Therefore, the purpose of this study was to perform a literature review to identify the prevalence of β-hemolytic streptococcus in pregnant women and the role of prevention and treatment. The electronic search was carried out in the Pubmed, LILACS and the SCIELO online libraries and the CAPES Portal of Periodicals, without restriction on the period of publication, in the Portuguese, Spanish and English languages. We included fifteen studies that evaluated the prevalence of group B streptococcus, the means of screening, the gestational period of the examination, preventive measures and the pharmacology used. Most of the studies found prevalence between 5 to 35%, the appropriate gestational period was between the 35th to the 37th week. The screening is done from a rectal sample, with the same swab to increase sensitivity in carrying out the culture. The prophylaxis involves early screening and antibiotic therapy and the therapy used is typically with amoxicillin, penicillin, or cephalexin, which can be replaced in cases of sensitivity. It is concluded that the prevalence of colonization by group B streptococcus in the pregnant women of the studies evaluated was in agreement with the values found in the literature. It should be emphasized that the prevention should be performed between the 35th and 37th week of gestation so that a prophylaxis strategy can be made prior to delivery preventing complications that may affect the newborn. Hence the importance of appropriate therapy. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The purpose of this study is to evaluate the pharmaceutical interventions (PI) performed in PRM and the factors associated with their acceptance. Method: This is a descriptive and cross-sectional study that analyzed PIs performed on adult patients from two ICUs in Fortaleza, Brazil, in 2019. PIs were analyzed in the categories quantity of drug and pharmacological strategy, using the classification proposed by Sabater et al. The drugs were also classified by the Anatomical, Therapeutic, and Chemical Classification System and by the High Surveillance Drugs (FAV) classification. Results: 305 patients were included, most of them male (55.1 %), elderly (52.8 %) and treated in the surgical ICU (51.4 %). 1,317 PIs were analyzed and 88.0 % were accepted, being to replace one or more drugs (28.0 %), to add one or more drugs (27.7 %) and to change the dose (24.8 %) the most frequent types. The most prevalent therapeutic class was anti-infectives for systemic use (24.1 %) and AVFs were involved in 21.7 % of the PIs. An association was observed between PIs accepted and admission to the clinical ICU (p<0.0001), AVF (p=0.0013), substitution of one or more drugs (p=0.0062) and the class of blood substitutes and perfusion solutions. (p= 0.0187). Conclusions: A high number of PIs were performed and accepted, which reinforces the importance of the pharmacist in the review of medical prescriptions in the ICU. [ABSTRACT FROM AUTHOR]

La obesidad es una enfermedad crónica que genera altos costos en salud, cuyo tratamiento, en ocasiones, no se aborda o se lo hace de forma inadecuada, y muchas veces no se basa en la evidencia disponible. Es por ello que, a partir de una iniciativa de la Sociedad Argentina de Nutrición, diferentes sociedades científicas se reunieron con el objetivo de construir un documento actualizado, basado en una metodología científica, que aporte al mejor tratamiento de las personas que viven con obesidad en Argentina. Este es el primer Consenso Intersocietario para el tratamiento de la Obesidad en adultos en Argentina a partir del cual se obtuvieron recomendaciones para la práctica clínica basadas en la evidencia científica. Es una necesidad primordial contar con herramientas, adecuadas a la realidad local y consensuadas por expertos de distintas disciplinas.

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Italian Journal of Nursing (IJN) / Giornale Italiano di Infermieristica is the property of Collegio IPASVI MI-LO-MB - Ordine Professioni Infermieristiche MI-LO-MB and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Salud UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Sexual assault often triggers posttraumatic stress disorder (PTSD), a potentially chronic severe mental disorder. Most guidelines recommend selective serotonin reuptake inhibitors (SSRIs) and trauma-focused psychotherapies as treatment options. Interpersonal Psychotherapy (IPT), adapted for PTSD (IPT-PTSD), focuses on interpersonal consequences of trauma rather than confronting the trauma itself. Studies have found IPT-PTSD efficaciously reduced PTSD symptoms with limited attrition. No efficacy trials have compared IPT-PTSD and SSRI. We hypothesized IPT would reduce PTSD, anxiety, and depressive symptoms more than sertraline among women with PTSD following a recent sexual assault. Objectives: To compare the efficacy of IPT-PTSD to SSRI sertraline in a 14-week randomized clinical trial for women with PTSD following a recent sexual assault. Methods: Seventy-four women with PTSD who had suffered sexual assault in the last six months were randomly assigned to 14 weeks of IPT-PTSD (n = 39) or sertraline (n = 35). Instruments assessed PTSD, anxiety, and depressive symptoms. This randomized clinical trial was conducted in São Paulo, Brazil, using the Clinician-Administered PTSD Scale-5 (CAPS-5) as the primary outcome measure. Results: Both treatments significantly reduced PTSD, anxiety, and depressive symptoms, without between-group outcome differences. CAPS-5 mean decreased from 42.5 (SD = 9.4) to 27.1 (SD = 15.9) with sertraline and from 42.6 (SD = 9.1) to 29.1 (SD = 15.5) with IPT-PTSD. Attrition was high in both arms (p =.40). Conclusions: This trial showed within-group improvements without differences between IPT-PTSD and sertraline treatment of PTSD. Our findings suggest that non-exposure-based psychotherapies may benefit patients with PTSD, although we did not directly compare these treatments to an exposure therapy. Brazilian Clinical Trials Registry RBR-3z474z. Violence against women is widespread, but limited evidence on women with PTSD comes from developing countries. This Brazilian clinical trial compared interpersonal psychotherapy (IPT) versus sertraline to treat young women with PTSD following a recent sexual assault. Both interpersonal psychotherapy and sertraline lowered PTSD and depressive symptoms without significant between-group differences. [ABSTRACT FROM AUTHOR]

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Psicoterapia y Psicosomática is the property of Instituto de Estudios Psicosomaticos & Psicoterapia Medica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aimed to gather scientific evidence on the role of sociodemographic factors in adherence to antihypertensive drugs in Primary Health Care (PHC)_in Brazil. This is an integrative review with studies published between 2015 and 2019 in national journals. Original studies developed with hypertensive PHC users in Brazil were included and articles published outside the time range were excluded, as well as literature reviews, and those that did not focus on the elements of interest of this review. A total of 5 studies that investigated sociodemographic variables in the context of adherence to this class of drugs in PHC were selected. Although some studies have found a possible interference of some sociodemographic variables in adherence to antihypertensive drugs in Primary Care, there are, for each of these variables, divergent results, showing that the sociodemographic dimension may or may not interfere with medication adherence in a given population group. In this sense, there are also results suggesting that, with effective provision of assistance to users, such variables seem to lose their interference capacity in user adherence, in line with the hypothesis that organizational characteristics of health services have a much greater impact on adherence than sociodemographic differences. [ABSTRACT FROM AUTHOR]

Introducción: dado el envejecimiento poblacional que vive Chile, se hace cada vez más importante evaluar la seguridad y uso de medicamentos en adultos mayores. Una de las estrategias propuestas a nivel internacional es la deprescripción, que consiste en la disminución o eliminación de fármacos utilizados como tratamiento habitual. Para ello se diseñó esta revisión en donde se propuso analizar la evidencia disponible respecto a la práctica de deprescripción de medicamentos en pacientes adultos mayores. Material y método: se realizó una búsqueda de artículos publicados entre los años 2003 al 2018, en bases de datos como Science Direct, MEDLINE, TripdataBase y Web of Science, seleccionando aquellos con mayor nivel de evidencia. La discusión fue contratada con evidencia actualizada (2018-2021). Resultados: según la revisión la deprescripción, en general, se define como un proceso de retirada de la medicación inapropiada, bajo la supervisión de un profesional; siendo su principal causa la presencia de polifarmacia, y la prescripción de medicamentos potencialmente inapropiados. Los principales fármacos deprescritos con éxito (sin necesidad de ser reincorporados) corresponden a benzodiazepinas, antipsicóticos atípicos, corticoides, antidepresivos tricíclicos, estatinas e inhibidores de la bomba de protones. Conclusión: la deprescripción es un proceso poco estudiado, especialmente a nivel local; sin embargo, podría disminuir los problemas de salud, en especial los referidos a la seguridad de la farmacoterapia en los adultos mayores.

OBJETIVO: Os autores realizaram um estudo aberto prospectivo, acompanhando durante 6 meses, 20 pacientes com diagnóstico de transtorno obsessivo-compulsivo, tratados com a associação de terapia comportamental (TC) e fármacos inibidores da recaptação (IRS) da serotonina com o objetivo de verificar a eficácia da associação de terapia comportamental e psicofarmacoterapia na redução de sintomas obsessivocompulsivos. MATERIAIS E MÉTODOS: Foram utilizados como instrumentos para avaliar os resultados do tratamento as escalas YBOCS, Escala Global do NIMH, e Escala Subjetiva de Grau de Desconforto (SUDS), aplicadas antes do início, aos 3 e aos 6 meses de tratamento. RESULTADOS: Foi observada uma redução média na intensidade dos sintomas, aos 3 meses de 42% na escala YBOCS, de 14,28% na escala NIMH e de 24,4% na escala SUDS; aos 6 meses a redução foi de 72% na escala YBOCS, 71,42% na escala NIMH e de 61,9% na escala SUDS, respectivamente. O tratamento combinado se mostrou eficaz em 75% dos pacientes aos 3 meses, e em 85.6% aos 6 meses. CONCLUSÕES: Os resultados se revelaram independentes da idade, nível de instrução, situação conjugal, tempo de duração do transtorno, modo de início, presença ou não de evento precipitante, e da intensidade dos sintomas no início do tratamento. Entretanto pacientes que anteriormente haviam utilizado IRS obtiveram uma redução menor na intensidade do sintomas, avaliados pela escala YBOCS aos 6 meses, num nível estatisticamente significativo, (p

O cuidado farmacêutico ao usuário do SUS pode contribuir tanto para qualidade de vida quanto para a farmacoterapia correta deste usuário visando melhor adesão ao tratamento. O cuidado é uma prática direcionada a prevenção, identificação e resolução de problemas relacionados ao uso de medicamentos (PRM) para melhorar qualidade de vida das pessoas. O objetivo do trabalho foi realizar ações relacionadas ao cuidado farmacêutico em um ambiente público e carente de informações farmacológicas e não farmacológicas para análise de indicadores do serviço. Foram acompanhados 104 usuários utilizando um formulário durante a consulta farmacêutica, com o qual foi possível realizar a análise do caso de cada indivíduo. Dos usuários que participaramda pesquisa, 68 eram portadores de diabetes (DM) e 75 com hipertensão arterial sistêmica (HAS), sendo que 47 participantes possuíam estas duas doenças associadas. Foi também avaliada a correlação entre a HAS e os fatores de risco como tabagismo e dislipidemias. Foram identificados 72 usuários com problemas relacionados aos medicamentos (PRMs) e estes ausentes em 32 dos participantes. O PRM mais prevalente foi o que relaciona a administração e adesão do usuário ao tratamento. Diante de problemas relacionados aos medicamentos encontrados, durante as entrevistas, bem como as condições de saúde apresentadas pelos participantes, foram propostas intervenções farmacêuticas. Com as entrevistas sucessivas foi possível identificar aceitação quanto as intervenções relacionadas a farmacoterapia, aos hábitos alimentares e quanto ao controle de parâmetros como a pressão arterial e glicemia capilar dos usuários avaliados. Estas intervenções foram consideradas positivas e contribuíram com a melhoria na qualidade de vida.

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Problemas relacionados aos medicamentos (PRM) são causados por falhas que afetam a efetividade e segurança dos medicamentos e representam um importante desafio para os sistemas de saúde. Este estudo teve por objetivo identificar e avaliar casos de PRM no Pronto Socorro (PS) do Hospital das Clínicas Samuel Libânio (HCSL). Trata-se de um estudo descritivo e transversal, realizado por meio de entrevistas a pacientes que procuraram atendimento no PS do HCSL. A identificação e classificação dos PRM foram baseadas no Segundo Consenso de Granada. Dos 100 pacientes entrevistados, houve alta prevalência de PRM no grupo de pacientes acima de 60 anos (46%), porém não houve diferença significativa entre sexo feminino (24%) e masculino (22%). Grande parte dos entrevistados teve pouca adesão ao tratamento (68%) e nível de escolaridade baixo, sem ensino fundamental (62%). Entre os avaliados, todos apresentaram algum tipo de PRM, sendo os mais encontrados: inefetividade quantitativa (78%) e problema de saúde não tratado (16%). Os casos de PRM atendidos no PS do HCSL são comuns em pacientes com doenças crônicas, com idade acima de 60 anos, devido a não adesão ao tratamento. Esses resultados demonstram a importância da implantação do seguimento farmacoterapêutico pautado na educação e atenção primária à saúde.

Introduction: Aging is a dynamic process in which biochemical and physiological changes are related to a higher frequency of pathological processes, which ultimately lead the human being to death. Part of these alterations and pathologies are improved using medicines, so older adults are great consumers of medicines. Several instruments have been used to evaluate the use of inappropriate medications in older adults, with Beers Criteria frequently used. The concept of medication adherence has undergone changes over time and represents the degree to which the patient's behaviour corresponds and agrees with the recommendations of a doctor or other health professional. Medication non-adherence to entails a decrease in the quality of life of the patients and high costs for the health systems. Objectives: To characterize drug therapy in older adult users of a northern Portuguese community pharmacy, as well as to identify the presence of potentially inappropriate medications (PIMs) in the older adult and to assess medication adherence. Methods: Exploratory and descriptive study. The target population was older adult users of a community pharmacy in the municipality of Valpaços, Portugal. The data collection instrument used was a questionnaire applied in the form of a structured interview. The potentially inappropriate medications (PIMs) identification was based on the most recent version of the Beers Criteria published in 2019. The MAT (Measurement of Adherence to Treatments) scale was used to evaluate medication adherence. The statistical treatment included the calculation of absolute and relative frequencies, measures of central tendency and dispersion. Results: 60 older adult people were interviewed, 53.3% of them women. The average age was 78.35 years. Among these, 55.0% were married/had a non-marital partner, 71.7% lived accompanied, 26.7% had primary school education, 40.0% received less than 300 Euros monthly and 95.0% lived in the municipality of Valpaços. Each older adult person consumes on average 6 different types of medication per day. Major polymerization was present in 66.7% of older adults, and 94.2% of the drugs being prescribed by the physician. In 34.7% of the cases, the medication had been used for at least 1 year and only 3.4% reported feeling adverse reactions. Of the total 326 drugs identified, the most prescribed pharmacotherapeutic groups were drugs acting in the cardiovascular system 27.2% and in the digestive system 24.2%. Additionally, 15 drugs classified as potentially inappropriate medication were identified in the older adult. Most of the older adults (76.7%) did not adhere to drug therapy, these being mainly females with primary education, living with a partner and less than 300 euros/month. Conclusion: Polymedication and the use of potentially inappropriate medications are common in older adults. Medication adherence is low. [ABSTRACT FROM AUTHOR]

Copyright of CES Medicina is the property of Universidad CES and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper analyzes the indicators of somatization, obsessivecompulsive disorders, interpersonal sensitivity, anxiety, depression, phobic manifestations, paranoia, and psychoticism in the context of pharmacotherapy of epilepsy with barbiturates and valproates. Pharmacological therapy for epilepsy should rely on a rationally adjusted regimen with antiepileptic medicines being patient-tailored and targeted; it should have high efficiency and safety in relation to social functioning and quality of patients' life. The research findings show that the studied group of patients with epilepsy, exposed to valproate or barbiturate therapy, is characterized by heterogeneous clinical-psychopathological and pathopsychological features. Clinico-psychopathologically, barbiturates reveal severe affective disorders and psychopathic behavior in patients with epilepsy; pathopsychological examination refers to the prominence of indicators on the scales of somatization, depression, and psychoticism, expressed in the form of somatic complaints, individual organs and systems' disorders, and accompanied by mental equivalents, in particular on the side of the cardiovascular system, musculoskeletal system, gastrointestinal tract, etc.; depressive manifestations are also evident, reflecting the depth of affective disorders, dysphorias, suicidal tendencies, low mental activity with cognitive signs of depression, and the inclination to an avoidant, isolated lifestyle. Clinically, valproate therapy showed a predominantly neurotic character of mental changes; pathopsychological examination revealed the prevalence of obsessive-compulsive disorders, alternated with the anxiety, somatic and cognitive manifestations of anxiety. [ABSTRACT FROM AUTHOR]

O índice de utilização de Medicamentos Isentos de Prescrição (MIP) é grande entre a população que, por vezes, utilizam os medicamentos de forma incorreta ou se automedicam sem tomar conhecimento dos riscos que essa atitude pode causar. O presente estudo teve como objetivo a criação e teste de um aplicativo móvel, que permite ao usuário ter acesso a um bulário intuitivo e acessível, com informações diretas e claras a respeito de MIP. O aplicativo MediVoz foi desenvolvido e registrado no Instituto Nacional da Propriedade Industrial (INPI), processo 512018052096-0. Foram entrevistados indivíduos de ambos os sexos acima de 18 anos, que responderam a um questionário com questões sobre o uso de MIP e da funcionalidade do aplicativo. Foi observado que as mulheres apresentam maior frequência de uso destes medicamentos, (51,8%). Quando considerada a renda, os que mais fazem uso frequente de MIP recebem até 3 salários mínimos (52%). Dos entrevistados, 36% responderam que raramente buscam informações sobre os MIP antes de utilizá-los e 26% disseram que raramente recebem informações do farmacêutico sobre o MIP que compram. Em relação ao aplicativo, 97% dos entrevistados afirmaram que utilizariam o aplicativo Medivoz ao necessitar de informações sobre algum MIP e 98% acharam que a leitura e a pronuncia das informações pelo Medivoz facilitam o entendimento. Todos os entrevistados responderam que o aplicativo Medivoz facilita tirar dúvidas a respeito de MIP. Desta maneira, conclui-se que o Medivoz se mostrou uma ferramenta prática e útil para sanar dúvidas acerca dos MIP.

O Diabetes Mellitus é um problema de saúde pública que provoca inúmeras internações. Este estudo avaliou à adesão ao tratamento medicamentoso de pacientes diabéticos cadastrados no programa Hiperdia em uma unidade de saúde do município de Jequié-Ba. Trata-se de um estudo quantitativo, descritivo analítico e de corte transversal, que foi desenvolvido no Centro de Saúde Almerinda Lomanto e contou com 81 pacientes. Um formulário referente à aspectos sociodemográficos, hábito de vida e aspectos clínicos da doença foi aplicado, além dos testes de Morisky e Batalla, que avaliaram a adesão ao tratamento medicamentoso. A análise dos dados foi realizada pelo programa SPSS. A associação entre a adesão e as variáveis independentes foi analisada pelo teste de qui-quadrado (X2), a hipótese de associação foi aceita quando a probabilidade fosse ≤ 0,05. O perfil sociodemográfico demonstrou a maior prevalência de mulheres, idosos, solteiros, aposentados, com ensino fundamental incompleto e renda de 1- 2 salários mínimos. A adesão foi observada em 40,7% dos participantes, pelo teste de Batalla, e 51,9 % pelo teste de Morisky. Quanto à associação estatística, a adesão pelo teste de Morisky apresentou significância quando relacionada a renda, porém, pelo teste de Batalla, apenas a variável tabagismo foi significante. Não houve associação significativa entre as demais variáveis em ambos os testes. Os pacientes atendidos no Centro de saúde relataram dificuldade em aderir a terapêutica medicamentosa para diabetes, principalmente, por falta de informação sobre a doença e o tratamento, ressaltando a importância da comunicação dos pacientes com os profissionais de saúde.

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RESUMEN Introducción: Los adultos mayores generalmente presentan diferentes patologías, lo que implica un alto consumo de medicamentos, con lo cual, este grupo poblacional constituye uno de los que mayor cantidad de errores pueden cometer en el uso de fármacos. Objetivo: Evaluar el comportamiento del consumo de fármacos en una población perteneciente a la tercera edad. Métodos: Se realizó un estudio descriptivo de corte transversal en un consultorio médico del municipio Arroyo Naranjo de La Habana en el período entre octubre de 2018 y mayo de 2019. La población estuvo conformada por 365 pacientes geriátricos con diagnóstico de enfermedad crónica no transmisible (ECNT). Se realizó un muestreo al azar para un total de 67 pacientes seleccionados. Las variables analizadas fueron: edad, sexo, ECNT asociada y medicamentos consumidos. Los datos fueron obtenidos mediante revisión de historias clínicas y entrevistas realizadas. Se realizó un análisis porcentual para determinar prevalencia en cada variable analizada. Resultados: Los medicamentos que más destacaron en la muestra fueron los antihipertensivos e hipoglucemiantes. El consumo de medicamentos fue superior en los pacientes de 75 años en adelante y fundamentalmente en las mujeres. Los hombres, por su parte, constituyeron los más irresponsables en la adherencia al tratamiento. Conclusiones: Existió correspondencia entre los tratamientos y las patologías en la mayoría de los casos con excepción de algunos pacientes en los que la relación beneficio-riesgo del tratamiento no se cumplió totalmente. Sin embargo, de manera global, se considera que no existe un adecuado uso de los medicamentos en la muestra.

In this study, we will address DM2 that makes its carrier resistant to insulin and compromises its secretion, both factors are important in the appearance of signs and symptoms. The present study aimed to bring a bibliographic review about the importance of pharmaceutical care to patients with DM2, as well as to point out the risks of the irational use of medications and the impacts on the health of individuals who fight against this pathology. The results of the research reinforce the fact that the pharmacy professional is of paramount importance in adhering to the correct treatment for DM2, since it is already in the act of dispensing the drugs that most of the guidelines occur, pointing out possible effects and interactions in pharmacotherapy. In view of this, a crucial moment opens up for the importance of controlling glycemic levels to be exposed, both by means of medication and by changing habits, bringing actions to be developed during the treatment, improving the patient's quality of life. [ABSTRACT FROM AUTHOR]

Improving the efficacy of depression treatment is a clinical necessity. «Synergy» is the systematic process in which different treatments of and approaches to mood disorders are evaluated and made to work coherently to optimize their results. Depression treatment has shown to benefit from the synergy of pharmacological and psychological processes. Our aim was to evaluate present evidence as to synergizing psychological therapy and pharmacotherapy in mood disorders, reflecting the related brain systems and circulating biological substances. Multiple brain regions are involved in mood disorders, resulting in multiple-target effects of substances, each influencing neurobiological balance, and depending on individual aspects. Large studies showed that psychological treatment may, overall, be more effective than medication. However, the synergy of both provided significantly increased effects that were largely independent of each other, and each added about 50% to the overall effects of combined treatment. Identified neuropsychobiological pathways were found, as well as appreciable evidence that, in depression, the synergy of both treatments can be expected to produce better results through reciprocal effects in cortical, subcortical and visceral systems. In compromised situations such as pregnancy and adolescence, psychological treatments for mood disorders may have preference over drug treatment, but synergy remains essential. [ABSTRACT FROM AUTHOR]

A COVID-19 é uma doença infecciosa causada pelo coronavírus da síndrome respiratória aguda grave, a SARS-CoV-2. Esta é transmitida por meio de secreções, disseminadas por pessoas infectadas. As principais manifestações clínicas são: febre, tosse seca, cansaço, fadiga, falta de ar, dor de cabeça, náusea ou vômito. Infelizmente, não há até o momento, protocolo farmacoterapêutico para a covid-19, consequentemente, há grande disseminação de informações sobre alternativas terapêuticas sem estudos clínicos ou ainda estudos preliminares. Dessa forma, houve crescentes taxas de automedicação com fármacos como a azitromicina (AZT), ivermectina (IVT), hidroxicloroquina (HCQ), cloroquina (CQ) entre outros, os quais até o momento não possuem eficácia comprovada frente a doença podendo, até mesmo, gerar efeitos tóxicos. Neste contexto, o objetivo do presente estudo foi avaliar os principais medicamentos utilizados na automedicação da Covid-19, bem como as principais reações adversas que podem ser apresentadas pelos pacientes. Para tanto, realizou-se uma busca sobre os principais fármacos utilizados na farmacoterapia da Covid-19 através do DATASUS. A partir disso, constatou-se que os fármacos mais utilizados foram a HCQ, CQ, AZT e IVT, algumas destas utilizadas em associação. Com base nestes resultados foram avaliadas as possíveis reações adversas e riscos relacionados ao uso destes fármacos. A HCQ na dosagem de 600mg em associação a CQ resultou em aumento da temperatura corporal e prolongamento do intervalo QT, este último parâmetro também foi evidenciado na associação da HCQ com a AZT. Em relação a IVT houve manifestação de distúrbios gastrointestinais, fraqueza muscular, taquicardia, hipotensão, ataxia, rabdomiólise e coma. Contudo, há pouca informação na literatura sobre os possíveis efeitos adversos destes fármacos como automedicação para a doença por se tratar de algo recente. A automedicação acarreta graves riscos à saúde da população, que motivada pelo medo de uma nova doença, busca alternativas farmacológicas sem comprovação científica ou, ainda, que apresentam resultados preliminares, os quais não asseguram seu uso. Vale ressaltar que devido a urgência do estabelecimento de um protocolo terapêutico para a Covid-19, muitos estudos têm sido publicados com resultados divergentes e pequena amostragem o que dificulta a real percepção dos possíveis efeitos terapêuticos e adversos relacionados à farmacoterapia da Covid-19. Diante do exposto, destaca-se a necessidade de demais pesquisas que avaliem os riscos do uso indiscriminado das estratégias terapêuticas utilizadas para o tratamento da Covid-19.

Post-traumatic stress disorder is a common condition that affects millions of people across the world. Up to date recommendations based on the best available evidence are vital to prevent and treat this debilitating condition. In this issue, we are bringing together a series of systematic reviews and meta-analyses that underpinned the development of the 2018 International Society for Traumatic Stress Studies Guidelines. The strongest evidence was found for psychological treatments for PTSD, in particular for cognitive behavioural therapy with a trauma focus (CBT-TF)(generic), cognitive processing therapy (CPT), cognitive therapy (CT), eye movement desensitisation and reprocessing (EMDR) and prolonged exposure (PE). For the subgroup of military personnel and veterans, results were less impressive. Dropout from trauma-focused psychological treatments was higher than for other forms of psychological treatment for PTSD in adults. For early interventions, CBT-TF, CT and EMDR were recommended. With regard to pharmacological approaches, a number of them were effective but with a low effect size. Of the pharmacologically assisted psychotherapies, MDMA-assisted psychotherapy was promising. Six complementary and alternative approaches showed emerging evidence. We now have an evidence base for a diverse range of pharmacological, psychological and other approaches that should facilitate their implementation and lead to the more effective management of people affected by traumatic events. • A diverse range of pharmacological, psychological and other approaches now have an evidence base for the prevention and treatment of PTSD.• This editorial introduces the EJPT special issue that considers these interventions and their relative strengths in more detail. [ABSTRACT FROM AUTHOR]

Nowadays, antimicrobial resistance is considered a major public health problem. Bacterial resistance to antibiotics is a natural biological phenomenon. However, the indiscriminate use of the same potentiates this natural selection. Among the main mechanisms responsible for conferring bacterial resistance to antibiotics are the production of inactivating enzymes of drugs. Currently, the bacteria that have been evidenced by their capacity to produce resistance enzymes belong to the Enterobacteriaceae family. The enzyme KPC is a carbapenemase that confers resistance to carbapenemic antibiotics, in addition to inactivating agents P-lactams through the hydrolysis of these antibiotics. KPCs are not the only carbapenemic resistance enzymes, but they are currently the most clinically important due to their difficult detection by routine screening and have a high dissemination potential. The use of P-lactam antibiotics is recommended because they have high efficacy in their mechanism of action and because they have low toxicity, being widely used as a choice in antibiotic therapy. According to the CDC, resistance to carbapenems is a medical emergency that can be treated with the association of ceftazidime + avibactam, however, to preserve the sensitivity of the drug, it is necessary to go through a detailed criterion for its use. [ABSTRACT FROM AUTHOR]

Community-acquired pneumonia (CAP) is an acute infectious disease. Inflammation of the lower respiratory system, interstitium, and microvasculature, mainly of bacterial etiology, is a typical pathological sign of this disease. It is one of the leading causes of death from infectious diseases. The survey was conducted within the KNOCAP multicenter research project (the full name of the project "The assessment of students' and physicians' knowledge of community-acquired pneumonia basics"). We have assessed the knowledge and preferences of doctors and 85 senior medical students from Belgorod National Research University majoring in Medicine by surveying them two times -- before and after the conduction of educational activities. The first stage of the project was carried out in 2017-2018, the second one -- in 2018-2019. Educational activities were held during the educational process (in particular, during Clinical Pharmacology). The greatest difficulties appeared when answering the questions: the choice of the main criterion for the terminating antimicrobial therapy (AMT); the choice of the main diagnostic sign when examining a CAP patient; the choice of the criterion for CAP diagnosis confirmation. This study makes a significant contribution to the development of a practical health care system because it allows both identifying "weak spots" and improving the quality of CAP patients' management tactics. There is a necessity to conduct more studies about this matter since the current health care system is experiencing changes, and new clinical guidelines are published. [ABSTRACT FROM AUTHOR]

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Introduction: Drug interactions are a type of medication error that can cause harm to the patient. These must be detected during the validation of the prescription and corrected by the professional in charge of the patient care. The purpose of this study was the identification, classification and prevalence of drugs interactions, as well as the medications involved in outpatient consultations of patients with a medical complaint file from the National Medical Arbitration Commission (CONAMED). Material and methods: A descriptive, retrospective and cross-sectional observational study was carried out. The outpatient consultation prescriptions of the medical complaint files registered from 2013 to 2016 in the CONAMED pharmacotherapy system were reviewed. Results: 1,995 consultations were analyzed in 170 medical records. Only 1,720 met the inclusion criteria. The number of medications per consultation for the female sex was 5.1 ± 3.5 (p < 0.01). The average number of medications per consultation for patients = 65 years was 6.4 ± 3.8 (p < 0.01). The number of consultations with 5 or more medications (polypharmacy) in patients older than 65 or equal to 65 years was 305 (63.9%). The number of detected interactions according to severity were moderate 1415 (48.5%), higher 1,253 (43%), minor 193 (6.6%) and contraindicated 54 (1.9%), and according to their mechanism of action 46.8% correspond to pharmacodynamic interactions and 32.1% pharmacokinetics. The drugs most involved in the interactions are bezafibrate, pravastatin, captopril, metformin, acetylsalicylic acid, diclofenac, insulin and enalapril. Conclusion: Pharmacological interactions of a total of 8,282 medications prescribed in outpatient medical complaint records were analyzed. Pharmacological interactions occur more frequently in patients older than 65 years with polymedication and in the female gender. The majority are those that affect pharmacodynamics. The search for drug interactions with the use of softwares during the prescription should be carried out to improve treatment and patient safety. [ABSTRACT FROM AUTHOR]

Despite the successful achievements in modern applied medicine and the application of hypolipidemic drugs into clinical practice for the past 50 years, the issue of prevention and treatment of atherosclerotic vascular disease (AVD) remains unsolved. Implementation of the theory of immunopathogenesis of atherosclerosis that was experimentally proved by modern studies allows the specialists to expand the possibilities of pharmacotherapy and pharmacoprevention for AVD. Thus, the aim of the present study was to analyze new directions in the development of anti-atherosclerotic drugs (AAD) with a pathogenetic activity that suppressed chronic autoimmune inflammation in the areas of atherosclerotic damage of vessels. In the course of the study, the search and analysis of the publications in the databases Web of Science, PubMed, and RSCI (Russian Science Citation Index) for the period of 2016-2018 were performed. According to the performed analysis, the most perspective molecular targets for AAD are pro-inflammatory and anti-inflammatory cytokines that develop a disbalance in patients with AVD. Thus, the drugs that are based on monoclonal antibodies to the tumor necrosis factor α (TNFα), and pro-inflammatory interleukins (1β, 17A), used for the treatment of rheumatoid arthritis and psoriasis, can be used for the treatment of AVD. Recombinant interleukins 6, 13, 19, and substances that suppress the expression of interferon regulatory factors will also exert an antiatherogenic effect. The studies on the modeling of the pathogenesis of AVD in inbred animals showed that other molecular targets for AAD could be enzymes involved in the lipid and immune cells metabolism. They include inositolrequiring enzyme 1, proprotein convertase subtilisin/Kexin type 9, and the enzymes of paraoxonase family. Besides, the review includes the discussion of the successful application of drugs based on monoclonal antibodies to TNFα (infliximab), IL-17A (secukinumab) and IL-1β (canakinumab), as well as the drugs with antienzymatic activity (evolocumab and darapladib), in clinical practice for the treatment of AVD. The modern knowledge on molecular mechanisms of immunopathogenesis can give grounds for the development of drugs for pathogenetic pharmacotherapy and pharmacoprevention for the complications of AVD. The most effective solution would be the indication of drugs that affect the disbalance of cytokines and metabolic processes in the immune cells. [ABSTRACT FROM AUTHOR]

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Diabetes mellitus (DM) represents one of the greatest epidemics of our era, and this epidemiologic behavior has been projected to continue during several more decades. This prospect becomes alarming when considering that in general, only a third of the diabetic population achieves their metabolic control goals consistently. One of the main determinants of this failure may be the lack of adherence to pharmacologic treatments which may in turn be linked to frustrations concerning the efficacy and tolerability of the options currently available. Thus, the introduction of new alternatives for the treatment of DM is a priority study object in basic and applied biomedical research. Enriching the antidiabetic pharmacologic armamentarium is urgent in order to offer improved clinical results for this patient population. In this regard, innovative proposals have been put forward recently such as SGLT2 inhibitors, GLP-1 agonists, and new insulin formulations. Furthermore, miscellaneous drugs with significant activity on glucose homeostasis have been highlighted and may represent the window for new treatments in the future such as ranolazine and phosphate-sequestering agents. This review presents a summary of the current body of preclinical and clinical evidence on new proposals for antidiabetic pharmacologic treatment. [ABSTRACT FROM AUTHOR]