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Este estudo teve como objetivo realizar uma análise de possiveis interações medicamentosas baseadas em dados de prescrições médicas para pacientes idosos que fi zessem uso de medicamentos para dislipidemias em unidade básica de saúde na cidade de Santana do Cariri, CE. A coleta e análise dos dados ocorreu entre agosto e setembro de 2018 no município de Santana do Cariri, CE. Trata-se de um estudo descritivo, quantitativo, retrospectivo e transversal. Para a identificação das possíveis interações medicamentosas, foi utilizada a plataforma Micromedex®. Foram selecionados pacientes idosos portadores de alguma dislipidemia, com idade mínima de 60 e máxima de 89 anos. A amostra total foi 40 prescrições, onde a população foi de 103 receituários, em que 80% era do sexo feminino e 20% masculine. Foi identifi cado um total de 37 interações; dentre estas, sinvastatina é o que aparece com maior frequência interagindo com outros fármacos, dentre os quais, o mais frequente foi com o anlodipino. A interação desses dois fármacos provocam interação no paciente é considerada grave, pois o indivíduo corre o risco de apresentar miopatias e rabdomiólise. Diante desses resultados, é importante a implantação de um serviço de farmácia clínica, que possibilita identificar possíveis problemas relacionados a medicamentos e interações, melhorando a farmacoterapia e a qualidade de vida do paciente, benefi ciando com uma assistência eficiente para minimizar riscos à saúde.

As Práticas Integrativas e Complementares em Saúde (PICS) visam prestar um cuidado de forma holística, com o intuito de promover a saúde, e proporcionar um bom equilíbrio entre tecnologia, ciência e a humanização. Assim, o presente artigo tem como objetivo avaliar a percepção dos futuros egressos do curso de farmácia sobre o papel do farmacêutico nas PICS. Foi realizado uma pesquisa de campo em uma Faculdade de Farmácia no Cariri Cearense. Atualmente, a faculdade é constituída por 10 turmas do curso de farmácia. A amostra utilizada no estudo foi composta por alunos do nono e décimo semestre do curso de Farmácia. Os resultados do estudo mostram que 85,3% dos acadêmicos possuem conhecimento a respeito das PICS, no entanto, muitos não se sentem seguros quanto aos seus conhecimentos sobre as mesmas. Foi possível observar que os alunos indicariam a homeopatia, acupuntura, terapia floral e plantas medicinais para tratar determinadas enfermidades, sendo estas podendo ser realizadas por farmacêuticos conforme resoluções específicas. Por fim, considera-se que os resultados deste trabalho possam contribuir agregando valores sobre os achados evidenciados, auxiliando na discussão de novos estudos sobre as práticas integrativas e complementares.

Internet of Things (IoT) has been developing to become a free exchange of useful information between multiple real-world devices. Already spread all over the world in the most varied forms and applications, IoT devices need to overcome a series of challenges to respond to the new requirements and demands. The main focus of this manuscript is to establish good practices for the design of IoT devices (i.e., smart devices) with a focus on two main design challenges: power and connectivity. It groups IoT devices in passive, semi-passive, and active, giving details on multiple research topics. Backscatter communication, Wireless Power Transfer (WPT), Energy Harvesting (EH), chipless devices, Simultaneous Wireless Information and Power Transfer (SWIPT), and Wake-Up Radio (WUR) are some examples of the technologies that will be explored in this work.

Distinguishing airway vascular tumors from malformations can be challenging. Failure to treat a suspected airway hemangioma with a beta-blocker and systemic corticosteroid should raise suspicion of a possible airway malformation., Competing Interests: None declared., (© 2019 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Calcium fluoride (CaF 2 ), in both natural and synthetic forms, has been exhaustively studied and explored as thermoluminescent (TL) detector. However its sensitivity to ambient light points to the applicability of CaF 2 as OSL (Optically Stimulated Luminescence) detector, increasing the research about its luminescent properties. Although some properties to employ CaF 2 detectors with OSL technique have been already demonstrated, there is a lack of some essential information as the OSL response to different types and energy of ionizing radiation. In order to extend the use of Brazilian natural CaF 2 with OSL technique, we evaluated the efficiency and dosimetric properties of cold pressed CaF 2 :NaCl pellets. The CaF 2 detectors presented good reproducibility and negligible fading of the signal over one month after irradiation. The dose response using OSL, TL and residual TL showed linear behavior for different radiation beams (protons, photons and alpha and beta particles), being equivalent to the results obtained with BeO and MTS (LiF) detectors through OSL and TL technique respectively. Moreover, differences were observed in OSL efficiency according the beam type and energy; CaF 2 detectors presented a higher OSL and TL sensitivities to protons, photons and beta particles than to alpha particles. The energy response to photons obtained using OSL and residual TL intensities present an over response at lower photon energy similar to TL energy response. In addition, differences in the OSL curve shapes were observed according to radiation type and energy, pointing to the possibility of applying this material in mixed radiation fields and to estimate average LET (Linear Energy Transfer)., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

In this work, three different concepts are used to develop a fully passive sensor that is capable of measuring different types of data. The sensor was supplied by Wireless Power Transmission (WPT). Communication between the sensor and reader is established by a backscatter, and to ensure minimum energy consumption, low power techniques are used. In a simplistic way, the process starts by the transmission of two different waves by the reader to the sensor, one of which is used in power transmission and the other of which is used to communicate. Once the sensor is powered, the monitoring process starts. From the monitoring state, results from after processing are used to modulate the incoming wave, which is the information that is sent back from the reader to the tag. This new combination of technologies enables the possibility of using sensors without any cables or batteries to operate 340 cm from the reader. The developed prototype measures acceleration and temperature. However, it is scalable. This system enables a new generation of passive Internet of Things (IoT) devices., Competing Interests: The authors declare no conflict of interest.

Background: Many different intestinal parasite species can co-occur in the same population. However, classic diagnostic tools can only frame a particular group of intestinal parasite species. Hence, one or two tests do not suffice to provide a complete picture of infecting parasite species in a given population. The present study investigated intestinal parasitic infections in Beira, Mozambique, i.e. in the informal settlement of Inhamudima. Diagnostic accuracy of five classical microscopy techniques and real-time PCR for the detection of a broad spectrum of parasites was compared., Methodology/principal Findings: A cross-sectional population-based survey was performed. One stool sample per participant (n = 303) was examined by direct smear, formal-ether concentration (FEC), Kato smear, Baermann method, coproculture and real-time PCR. We found that virtually all people (96%) harbored at least one helminth, and that almost half (49%) harbored three helminths or more. Remarkably, Strongyloides stercoralis infections were widespread with a prevalence of 48%, and Ancylostoma spp. prevalence was higher than that of Necator americanus (25% versus 15%), the hookworm species that is often assumed to prevail in East-Africa. Among the microscopic techniques, FEC was able to detect the broadest spectrum of parasite species. However, FEC also missed a considerable number of infections, notably S. stercoralis, Schistosoma mansoni and G. intestinalis. PCR outperformed microscopy in terms of sensitivity and range of parasite species detected., Conclusions/significance: We showed intestinal parasites-especially helminths-to be omnipresent in Inhamudima, Beira. However, it is a challenge to achieve high diagnostic sensitivity for all species. Classical techniques such as FEC are useful for the detection of some intestinal helminth species, but they lack sensitivity for other parasite species. PCR can detect intestinal parasites more accurately but is generally not feasible in resource-poor settings, at least not in peripheral labs. Hence, there is a need for a more field-friendly, sensitive approach for on-the-spot diagnosis of parasitic infections., Competing Interests: The authors have declared that no competing interests exist.

Purposes: The objective of this study was to evaluate the effect of supplementation with vitamin C on intestinal anastomosis healing in malnourished rats., Methods: Male Wistar rats were divided into three groups: (1) sham, well-nourished rats that received vehicle; (2) FR+Veh, rats that were subjected to food restriction and received vehicle; and (3) FR+VC, rats that were subjected to food restriction and received vitamin C. Four days before surgery, the animals received vitamin C (100 mg/kg/day) via gavage and underwent colon resection with anastomosis in a single plane. The survival rate of rats was monitored until day 7 after surgery. Regarding anastomosis tissues, we examined intra-abdominal adhesion index, hydroxyproline content, collagen density, inflammatory parameters, and oxidative damage to proteins and lipids., Results: Malnutrition decreases body weight and increases mortality; the survival rate was 90 % in group 1, 60 % in group 2, and 80 % in group 3. Vitamin C was able to increase hydroxyproline concentration and density of collagen and decrease the intra-abdominal adhesion index, as well as the infiltration of neutrophils and oxidative damage to proteins in malnourished rats compared to group treated with vehicle., Conclusions: Preoperative vitamin C supplementation can improve the intestinal anastomosis healing, biochemical alterations, and prolong survival in rats subjected to food restriction.

Structural HIV prevention interventions have gained prominence as ways to address underlying social and cultural factors that fuel the HIV epidemic. Identifying theories that explain how structural interventions are expected to change such factors can substantially increase their success. The Tchova Tchova community dialogue program, a theory-based intervention implemented in 2009-2010 in the provinces of Zambezia and Sofala, Mozambique, aimed to change gender and sexual norms for HIV prevention. Through facilitated sessions, the program sparked critical thinking and open dialogue among participants. This article measures the program's effectiveness based on a sample of 462 participants and 453 nonparticipants. The results show that the program was successful in producing changes in three of the underlying structural factors of HIV: gender attitudes, gender roles, and HIV stigma. The program was also successful in changing other factors associated with HIV infection, including HIV prevention knowledge, discussion of HIV between sex partners, and having multiple sex partners.

Ethylmalonic acid (EMA) accumulates in tissues and biological fluids of patients affected by short-chain acyl-CoA dehydrogenase deficiency (SCADD) and ethylmalonic encephalopathy, illnesses characterized by neurological and muscular symptoms. Considering that the mechanisms responsible for the brain and skeletal muscle damage in these diseases are poorly known, in the present work we investigated the effects of acute EMA administration on redox status parameters in cerebral cortex and skeletal muscle from 30-day-old rats. Animals received three subcutaneous injections of EMA (6 μmol/g; 90 min interval between injections) and were killed 1 h after the last administration. Control animals received saline in the same volumes. EMA administration significantly increased thiobarbituric acid-reactive substances levels in cerebral cortex and skeletal muscle, indicating increased lipid peroxidation. In addition, carbonyl content was increased in EMA-treated animal skeletal muscle when compared to the saline group. EMA administration also significantly increased 2',7'-dihydrodichlorofluorescein oxidation and superoxide production (reactive species markers), and decreased glutathione peroxidase activity in cerebral cortex, while glutathione levels were decreased only in skeletal muscle. On the other hand, respiratory chain complex I-III activity was altered by acute EMA administration neither in cerebral cortex nor in skeletal muscle. The present results show that acute EMA administration elicits oxidative stress in rat brain and skeletal muscle, suggesting that oxidative damage may be involved in the pathophysiology of the brain and muscle symptoms found in patients affected by SCADD and ethylmalonic encephalopathy.

In the last years the area of health monitoring has grown significantly, attracting the attention of both academia and commercial sectors. At the same time, the availability of new biomedical sensors and suitable network protocols has led to the appearance of a new generation of wireless sensor networks, the so-called wireless body area networks. Nowadays, these networks are routinely used for continuous monitoring of vital parameters, movement, and the surrounding environment of people, but the large volume of data generated in different locations represents a major obstacle for the appropriate design, development, and deployment of more elaborated intelligent systems. In this context, we present an open and distributed architecture based on a multiagent system for recognizing human movements, identifying human postures, and detecting harmful activities. The proposed system evolved from a single node for fall detection to a multisensor hardware solution capable of identifying unhampered falls and analyzing the users' movement. The experiments carried out contemplate two different scenarios and demonstrate the accuracy of our proposal as a real distributed movement monitoring and accident detection system. Moreover, we also characterize its performance, enabling future analyses and comparisons with similar approaches.

The low average birth rate in developed countries and the increase in life expectancy have lead society to face for the first time an ageing situation. This situation associated with the World's economic crisis (which started in 2008) forces the need of equating better and more efficient ways of providing more quality of life for the elderly. In this context, the solution presented in this work proposes to tackle the problem of monitoring the elderly in a way that is not restrictive for the life of the monitored, avoiding the need for premature nursing home admissions. To this end, the system uses the fusion of sensory data provided by a network of wireless sensors placed on the periphery of the user. Our approach was also designed with a low-cost deployment in mind, so that the target group may be as wide as possible. Regarding the detection of long-term problems, the tests conducted showed that the precision of the system in identifying and discerning body postures and body movements allows for a valid monitorization and rehabilitation of the user. Moreover, concerning the detection of accidents, while the proposed solution presented a near 100% precision at detecting normal falls, the detection of more complex falls (i.e., hampered falls) will require further study.

Introduction: The association between biomarkers of oxidative stress and the prognosis of patients with traumatic brain injury (TBI) remains inconclusive., Objective: The objective was to investigate the association between plasma levels of lipid peroxidation (thiobarbituric acid reactive species [TBARS]) and protein oxidation (carbonyl) biomarkers and the hospital mortality of patients with severe TBI., Methods: Plasma levels of TBARS and carbonyl were determined in 79 consecutive patients with severe TBI (Glasgow Coma Scale [GCS] ≤8) at a median of 12 hours (interquartile range [IQ] 25-75, 6.5-19.0), 30 hours (IQ 25-75, 24.7-37.0), and 70 (IQ 25-75, 55.0-78.5) hours after TBI and were compared with age- and sex-matched controls. The association between the TBARS and carbonyl levels and the hospital mortality was analyzed by multiple logistic regression analysis., Results: The mean age of patients was 34.8 years. Eighty-six percent were male. The TBARS and carbonyl levels were significantly higher in patients than in controls. There was a trend (P = .09) for higher plasma levels of TBARS and carbonyl proteins at 12 hours, but not at 30 or 70 hours, after trauma in nonsurvivors than in survivors. These findings were not confirmed after the adjustments by multiple logistic regression analysis. The final model showed a higher adjusted odds ratio for death for patients with admission GCS lower than 5 (odds ratio [OR] = 4.04; 95% confidence interval [CI], 1.33-12.13; P = .01) than those with higher GCS scores. Abnormal pupils were also associated with higher mortality (OR = 3.97; 95% CI, 1.22-12.13; P = .02). There was a nonsignificant trend for association between glucose greater than or equal to 150 mm/dL in the first 12 hours and death than levels between 70 and 149 mg/dL (OR = 2.92; 95% CI, 0.96-9.02; P = .06)., Conclusions: Plasma levels of TBARS and carbonyl increase significantly in the first 70 hours after severe TBI but are not independently associated with the hospital mortality., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Reactive oxygen species and inflammation have been implicated in renal tubule cell injury. However, there is some controversy concerning whether antioxidants might attenuate oxidative damage and inflammation in humans after hypotension in the setting of critical illness. This study was a prospective, randomized, double-blinded, placebo-controlled study that included patients with hypotension. Patients were randomized to receive either N-acetylcysteine (NAC; 50 mg/kg by 4 hours followed by 100 mg/kg/d for 48 hours diluted in 5% glucose) and deferoxamine (DFX; at a single dose of 1000 mg diluted in 5% glucose) or placebo. The primary study outcome was the serum levels of markers of oxidative damage and inflammatory response. Secondary outcomes included the incidence of acute renal failure, serum creatinine at hospital discharge, intensive care unit length of stay, and length of hospital stay. Thirty patients were enrolled in the study. The use of NAC plus DFX decreased the oxidative damage parameters but not plasma interleukin-6 levels. In contrast, plasma nitrite levels increased 24 hours after NAC plus DFX administration. On analysis of secondary outcomes, it was observed that creatinine levels at hospital discharge were lower in patients receiving NAC plus DFX when compared with placebo. NAC plus DFX administration was able to decrease plasma markers of oxidative damage and creatinine levels at hospital discharge.

The technological advances in medical sensors, low-power microelectronics and miniaturization, wireless communications and networks have enabled the appearance of a new generation of wireless sensor networks: the so-called wireless body area networks (WBAN). These networks can be used for continuous monitoring of vital parameters, movement, and the surrounding environment. The data gathered by these networks contributes to improve users' quality of life and allows the creation of a knowledge database by using learning techniques, useful to infer abnormal behaviour. In this paper we present a wireless body area network architecture to recognize human movement, identify human postures and detect harmful activities in order to prevent risk situations. The WBAN was created using tiny, cheap and low-power nodes with inertial and physiological sensors, strategically placed on the human body. Doing so, in an as ubiquitous as possible way, ensures that its impact on the users' daily actions is minimum. The information collected by these sensors is transmitted to a central server capable of analysing and processing their data. The proposed system creates movement profiles based on the data sent by the WBAN's nodes, and is able to detect in real time any abnormal movement and allows for a monitored rehabilitation of the user.

Problem: There was no direct correlation between plasma and placental oxidative damage parameters and inflammation and evidence of TLR4 pathway activation in the placenta in preeclamptic (PE) patients., Method of Study: 33 PE patients and 33 normotensive pregnant women were included. The maternal section of the placenta and blood were collected to the determination of oxidative damage markers (thiobarbituric acid reactive species and protein carbonyls), inflammatory response (interleukin-6 and myeloperoxidase activity), and activation of the TLR-4-NF-kB pathway., Results: An increase of IL-6 levels in both plasma and placenta was observed, but myeloperoxidase activity was not significantly different comparing the groups. Oxidative damage parameters were increased in plasma and placenta in PE patients. A significant increase of the protein levels of TLR-4 and NF-kB was observed in the placenta., Conclusion: The TLR4-NF-kB pathway is upregulated in PE, probably generating local and systemic inflammatory response that is followed by local and systemic oxidative damage.

Introduction: Red blood cell transfusions are common in intensive care units. For many years, transfusions of red blood were thought to have obvious clinical benefits. However, in recent years, the risks and benefits of blood transfusions have been examined more carefully, including the risk of increased morbidity and mortality due to transfusion-related immunomodulation effects., Objectives: To evaluate red blood cell transfusion effects and the relationship of this procedure to the production of inflammatory cytokines and oxidative damage in critically ill patients admitted to an intensive care unit., Methods: For 6 months in 2008, we evaluated patients admitted to an intensive care unit who underwent packed red blood cell transfusions. Pre- and post-transfusion levels of interleukin-6, carbonylated proteins and thiobarbituric acid reactive substances were assessed., Results: Serum post-transfusion interleukin-6 levels were reduced, and thiobarbituric acid reactive substances and carbonylated proteins were significantly increased. No statistically significant relationship was found between the levels of pre- and post-transfusion interleukin-6 and thiobarbituric acid reactive substances and the mortality rate. However, there was a significant relationship between levels of post-transfusion carbonylated proteins and mortality., Conclusion: Red blood cell transfusion is associated with increased oxidative damage markers and reduced interleukin-6 levels in critically ill patients.

Sepsis is characterized by biochemical alterations in the central nervous system at early times and cognitive impairment at late times after induction in sepsis animal model. In order to understand at least in part the mechanism of disease, we have evaluated the effects of sepsis on cytokine levels in the cerebrospinal fluid (CSF); oxidative parameters; the activity of the electron transport chain enzymes; and creatine kinase (CK) activity in the brain of sepsis survivor rats 10 days after cecal ligation and perforation (CLP). Male Wistar rats underwent CLP with "basic support" or sham-operated. Ten days after surgery, the animals were killed and prefrontal cortex, cortex, hippocampus, striatum, cerebellum, and CSF were obtained. It was found a decrease in the levels of TNF-α (P = 0.001), IL-1β (P = 0.008), IL-6 (P = 0.038), and IL-10 (P = 0.022) in the CSF; an increase in the TBARS only hippocampus (0.027); an up-regulation in the activity of complex II (P = 0.024), III (P = 0.018), and IV (P = 0.047) only in the prefrontal cortex; a decrease in the CK activity in the cerebellum (P = 0.001) and striatum (P = 0.0001), and an increase in the hippocampus (P = 0.0001) and cortex (P = 0.0001). Oxidative stress and mitochondrial alterations observed during early times in sepsis, persisted up to 10 days after surgery. The cytokines levels during the early times were found at high levels, decreasing to low levels after 10 days. In conclusion, these findings may contribute for a better comprehension of the cognitive damage in sepsis survivor rats.

Oxidative stress plays an important role in the development of cognitive impairment in sepsis. Here we assess the effects of acute and extended administration of cannabidiol (CBD) on oxidative stress parameters in peripheral organs and in the brain, cognitive impairment, and mortality in rats submitted to sepsis by cecal ligation and perforation (CLP). To this aim, male Wistar rats underwent either sham operation or CLP. Rats subjected to CLP were treated by intraperitoneal injection with "basic support" and CBD (at 2.5, 5, or 10mg/kg once or daily for 9days after CLP) or vehicle. Six hours after CLP (early times), the rats were killed and samples from lung, liver, kidney, heart, spleen, and brain (hippocampus, striatum, and cortex) were obtained and assayed for thiobarbituric acid reactive species (TBARS) formation and protein carbonyls. On the 10th day (late times), the rats were submitted to the inhibitory avoidance task. After the test, the animals were killed and samples from lung, liver, kidney, heart, spleen, and brain (hippocampus) were obtained and assayed for TBARS formation and protein carbonyls. The acute and extended administration of CBD at different doses reduced TBARS and carbonyl levels in some organs and had no effects in others, ameliorated cognitive impairment, and significantly reduced mortality in rats submitted to CLP. Our data provide the first experimental demonstration that CBD reduces the consequences of sepsis induced by CLP in rats, by decreasing oxidative stress in peripheral organs and in the brain, improving impaired cognitive function, and decreasing mortality., (Copyright 2010 Elsevier B.V. All rights reserved.)