Unilateral and Bilateral Transcutaneous Tibial Nerve Stimulation in Women With Overactive Bladder Syndrome: A Randomized Controlled Study (UBTTNS-OAB Study).

INTRODUCTION: The efficacy of unilateral versus bilateral Transcutaneous Tibial Nerve Stimulation (TTNS) for women with Overactive Bladder Syndrome (OAB) remains uncertain. OBJECTIVE: To compare the efficacy of unilateral and bilateral TTNS in the tibial region in women with OAB. METHODS: This randomized, controlled, triple-blind clinical trial included women with OAB or urgency-predominant urinary incontinence (UUI). Participants were randomized (1:1) into the Unilateral Tibial Group or Bilateral Tibial Group. Before treatment, they underwent a pre-assessment including peripheral sensitivity examination and completion of sociodemographic data and seven validated questionnaires on urinary symptoms, quality of life, sleep, and psycho-emotional aspects. TTNS interventions were administered twice weekly (12 sessions, 30 min each). Posttreatment, participants underwent another physical examination and completed the same questionnaires, with a 30-day follow-up. Categorical variables were analyzed using Chi-square or Fisher's Exact Test, while numerical variables were assessed with the Mann-Whitney test. Group comparisons over time utilized intention-to-treat ANOVA (p < 0.05). RESULTS: Thirty-five women participated: 17 in the unilateral group and 18 in the bilateral group. Mean ages were 55.1 (±14.7) years and 52.7 (±12.6) years, respectively (p = 0.680). Initial OAB severity (ICIQ-OAB) did not differ significantly between groups (p = 0.561). Both groups showed significant improvement in ICIQ-OAB scores: unilateral group from 10.1 (±3.4) to 5.8 (±3.4) (p < 0.001), bilateral group from 9.3 (±3.3) to 5.1 (±4) (p < 0.001), with no intergroup difference (p = 0.395). Improvement in UUI symptoms was observed: unilateral group from 2.2 (±1.4) to 0.7 (±1.5), bilateral group from 1.5 (±1.9) to 0.2 (±0.5), without significant intergroup difference (p = 0.645). Quality of life scores improved similarly between groups (p = 0.055). CONCLUSION: TTNS appears to be effective in improving bladder storage and UUI symptoms in women with OAB, with no difference between unilateral and bilateral applications. CLINICAL TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (REBEC) (RBR: 96f2fgkn).

Validation and cultural translation for the Brazilian Portuguese version of the Estro-Androgenic- Symptom Questionnaire in Women.

Objective: This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause. Methods: In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment. Results: The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach's alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001). Conclusion: This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.

The Development and Pre-Clinical Anti-Inflammatory Efficacy of a New Transdermal Ureasil-Polyether Hybrid Matrix Loaded with Flavonoid-Rich Annona muricata Leaf Extract.

This study aimed to develop a novel ureasil-polyether transdermal hybrid matrix (U-PEO) loaded with Annona muricata concentrated extract (AMCE), which exhibits potent anti-inflammatory activity. The extract was obtained by maceration, a method that allowed for the extraction of a high concentration of flavonoids (39.27 mg/g of extract). In vivo tests demonstrated that 10 mg/kg of AMCE inhibited inflammation for 6 h. The physicochemical characterization of U-PEO with AMCE was conducted via a thermogravimetric analysis (TGA), while its surface was recorded using atomic force microscopy (AFM). The in vitro macroscopic swelling and release tests demonstrated the hydrophilic profile of the material and the percentage of AMCE released. The TGA results demonstrated that the system exhibited physical compatibility due to the thermal stability of U-PEO. Additionally, the AFM analysis revealed a rough and porous surface, with a particular emphasis on the system with AMCE. The release resulted in the liberation of 23.72% of AMCE within 24 h. Finally, the preclinical tests demonstrated that U-PEO with AMCE was also capable of effectively inhibiting inflammation for 6 h, a duration comparable to that of a commercial formulation. The results permit the advancement of the study towards the development of a transdermal system, thereby rendering its application in clinical studies feasible.

Effects of blood metal(loid) concentrations on genomic damages in sharks.

The use of effect biomarkers has contributed to the understanding of the sublethal effects of contaminants on different organisms. However, the analysis of genotoxic markers as an indicator of organism and environmental health in sharks is underexplored. Thus, the present study investigated the relationship between the genomic damage frequency in erythrocytes and metal(loid) concentrations in whole blood of three shark species (Galeocerdo cuvier, Negaprion brevirostris and Ginglymostoma cirratum), taking into account climatic seasonality. The results showed that G. cuvier, an apex predator, presented the highest total erythrocyte genomic damage frequencies together with the highest mean whole blood concentrations of Al, Cd, Cr, Fe, Mn, Ni, Pb and Zn. The shark N. brevirostris also presented high levels of metal(loid), indicating a greater susceptibility to these contaminants in species that preferentially feed on fish. In contrast, G. cirratum, a mesopredator, presented the lowest erythrocyte damage frequencies and whole blood metal(loid) concentrations. The presence of micronuclei was the most responsive biomarker, and Al, As and Zn had an important effect on the genomic damage frequencies for all species evaluated. Zn concentration influenced the binucleated cells frequencies and Al concentration had an effect on the total damage and micronuclei frequencies in G. cuvier and N. brevirostris. Binucleated cells and blebbed nuclei frequencies were affected by As concentration, especially in G. cirratum, while showing a strong and positive correlation with most of the metals analyzed. Nonetheless, baseline levels of metal(loid) blood concentrations and erythrocyte genomic damage frequencies in sharks have not yet been established. Therefore, minimum risk levels of blood contaminants concentrations on the health of these animals have also not been determined. However, the high genomic instability observed in sharks is of concern considering the current health status of these animals, as well as the quality of the environment studied.

Risk of meningomyelocele mediated by the common 22q11.2 deletion.

Meningomyelocele is one of the most severe forms of neural tube defects (NTDs) and the most frequent structural birth defect of the central nervous system. We assembled the Spina Bifida Sequencing Consortium to identify causes. Exome and genome sequencing of 715 parent-offspring trios identified six patients with chromosomal 22q11.2 deletions, suggesting a 23-fold increased risk compared with the general population. Furthermore, analysis of a separate 22q11.2 deletion cohort suggested a 12- to 15-fold increased NTD risk of meningomyelocele. The loss of Crkl, one of several neural tube-expressed genes within the minimal deletion interval, was sufficient to replicate NTDs in mice, where both penetrance and expressivity were exacerbated by maternal folate deficiency. Thus, the common 22q11.2 deletion confers substantial meningomyelocele risk, which is partially alleviated by folate supplementation.

Mobile app for pelvic floor muscle training for urinary incontinence during the coronavirus disease 2019 pandemic: clinical trial.

OBJECTIVE: The objective of this study was to evaluate the effects of home-based pelvic floor muscle training in women with urinary incontinence, addressing the difficulties arising from social isolation due to the coronavirus disease 2019 pandemic by utilizing a specialized mobile app. METHODS: This randomized, single-group clinical trial aimed to assess the efficacy of pelvic floor muscle training guided by a mobile app (Diario Saúde) in women with stress urinary incontinence. Participants were instructed via telephone to engage in pelvic floor muscle training exercises twice a day for 30 days. Pre- and post-treatment, participants completed validated questionnaires regarding urinary symptoms and quality of life through telephone interviews. Additionally, treatment adherence was evaluated. RESULTS: A total of 156 women were enrolled in the study, with a mean age of 49.3±14.2 years. Significant improvements in urinary incontinence symptoms and quality of life were observed following pelvic floor muscle training guided by the mobile app (p<0.001). Notably, 74.3% of the participants reported performing the exercises with appropriate frequency. Of the participants, 62% reported either complete or substantial improvement in urinary symptoms post-treatment. CONCLUSION: This study revealed notable enhancements in stress urinary incontinence, urinary storage, and overall quality of life subsequent to pelvic floor muscle training guided by a mobile app, particularly during the coronavirus disease 2019 pandemic. The mobile app demonstrated robust acceptance and adherence among women experiencing urinary incontinence.

Patient safety climate in Primary Health Care in Brazil: an integrative review / Clima de Segurança do Paciente na Atenção Primária à Saúde no Brasil: revisão integrativa / Clima de seguridad del paciente en la Atención Primaria de Salud en Brasil: una revisión integradora

Justification and Objectives: although Primary Health Care plays a central role in Brazil, much of the research that assesses safety culture and climate focuses on hospitals and few studies on this subject have explored this reality, thus justifying this study. The aim was therefore to identify the patient safety climate characteristics in Primary Health Care services in Brazil. Methods: an integrative review study. The MEDLINE via PubMed, LILACS, CINAHL and SciELO databases were used to search for studies. Results: nine articles were selected which reported on the negative safety climate in Primary Health Care. The five classes generated in the dendrogram are divided into two main categories: (1) Safe healthcare in Primary Health Care; and (2) Patient safety climate assessment in Primary Health Care services. Communication, organizational learning and teamwork were cited as enhancers of safe healthcare. Community health workers had a more negative safety climate perception. Working conditions and management support were rated negatively. Conclusion: strengthening the safety climate in Primary Health Care services favors quality of care and safe healthcare.(AU)

Justificativa e Objetivos: embora a Atenção Primária à Saúde tenha papel central no contexto brasileiro, grande parte das pesquisas que avaliam a cultura e o clima de segurança tem enfoque no âmbito hospitalar e poucas investigações sobre essa temática exploram essa realidade, justificando a elaboração deste estudo. Dessa forma, objetivou-se identificar as características do clima de segurança do paciente em serviços de Atenção Primária à Saúde no Brasil. Métodos: estudo de revisão integrativa. As bases de dados MEDLINE via PubMed, LILACS, CINAHL e SciELO foram utilizadas para busca das publicações. Resultados: foram selecionados nove artigos, que relataram sobre o clima de segurança negativo na Atenção Primária à Saúde. As cinco classes geradas no dendrograma se dividem em duas categorias principais: (1) Cuidado à saúde seguro na Atenção Primária à Saúde; e (2) Avaliação do clima de segurança do paciente nos serviços de Atenção Primária à Saúde. Comunicação, aprendizagem organizacional e trabalho em equipe foram citados como potencializadores do cuidado à saúde seguro. Os Agentes Comunitários de Saúde apresentaram percepção mais negativa do clima de segurança. As condições de trabalho e o suporte da gerência foram avaliados negativamente. Conclusão: o fortalecimento do clima de segurança nos serviços primários de saúde favorece a qualidade da assistência e o cuidado à saúde seguro.(AU)

Justificación y Objetivos: a pesar de que la Atención Primaria de Salud desempeña un papel central en Brasil, gran parte de las investigaciones que evalúan la cultura y el clima de seguridad se centran en los hospitales y pocos estudios sobre este tema han explorado esta realidad, lo que justifica el desarrollo de este estudio. Por lo tanto, el objetivo fue identificar las características del clima de seguridad del paciente en los servicios de Atención Primaria de Salud en Brasil. Métodos: estudio de revisión integradora. Se utilizaron las bases de datos MEDLINE vía PubMed, LILACS, CINAHL y SciELO para la búsqueda de publicaciones. Resultados: fueron seleccionados nueve artículos que informaban sobre el clima de seguridad negativo en los servicios de Atención Primaria de Salud. Las cinco clases generadas en el dendrograma se dividen en dos categorías principales: (1) Atención de salud segura en la Atención Primaria de Salud; y (2) Evaluación del clima de seguridad del paciente en los servicios de Atención Primaria de Salud. La comunicación, el aprendizaje organizativo y el trabajo en equipo se citaron como potenciadores de una asistencia sanitaria segura. Los trabajadores sanitarios comunitarios tenían una percepción más negativa del clima de seguridad. Las condiciones de trabajo y el apoyo de la dirección se valoraron negativamente. Conclusión: reforzar el clima de seguridad en la Atención Primaria de Salud favorece la calidad de la atención y la seguridad de la asistencia sanitaria.(AU)

Use of a Mobile Application for Pelvic Floor Muscle Training in Women With Urinary Incontinence: a Randomized Control Trial.

INTRODUCTION AND HYPOTHESIS: This study was aimed at evaluating the impact of a mobile app-guided pelvic floor muscle training (PFMT) program on urinary symptoms and quality of life in women suffering from urinary incontinence. METHODS: The study included women with stress urinary incontinence (SUI), who underwent a structured interview and completed validated questionnaires, including the Questionnaire for Urinary Incontinence Diagnosis (QUID), the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), and the Incontinence Quality of Life Questionnaire (I-QOL). These women were randomly assigned to one of two groups: the app group, which received a visual depiction on the expected contraction pattern through a mobile app to support their PFMT exercises, and the control (paper) group. Both groups were instructed to perform PFMT exercises twice daily for 30 days. Data were collected at baseline and at 30, 60, 90, and 120 days after completing the exercises. RESULTS: A total of 154 women participated, with 76 in the app group and 78 in the paper group. The mean ages were 61 (± 6.1) and 60.6 (± 6.8) in the app and paper groups respectively (p = 0.644). Both groups showed significant improvements in QUID SUI scores (p < 0.001), overactive bladder (OAB; p < 0.001), ICIQ-SF scores (p < 0.001), and quality-of-life scores (p < 0.001). When comparing the two groups, the app group exhibited a more substantial reduction in OAB (p = 0.017) as assessed by QUID and total (p = 0.042), psychosocial (p = 0.032) and social embarrassment (p = 0.006) I-QOL scores. CONCLUSIONS: The study findings suggest that PFMT guided by a mobile app with visual guidance leads to greater improvements in storage symptoms and quality of life than the home-based PFMT guidance.

Mobile app for pelvic floor muscle training for urinary incontinence during the coronavirus disease 2019 pandemic: clinical trial

SUMMARY OBJECTIVE: The objective of this study was to evaluate the effects of home-based pelvic floor muscle training in women with urinary incontinence, addressing the difficulties arising from social isolation due to the coronavirus disease 2019 pandemic by utilizing a specialized mobile app. METHODS: This randomized, single-group clinical trial aimed to assess the efficacy of pelvic floor muscle training guided by a mobile app (Diario Saúde) in women with stress urinary incontinence. Participants were instructed via telephone to engage in pelvic floor muscle training exercises twice a day for 30 days. Pre- and post-treatment, participants completed validated questionnaires regarding urinary symptoms and quality of life through telephone interviews. Additionally, treatment adherence was evaluated. RESULTS: A total of 156 women were enrolled in the study, with a mean age of 49.3±14.2 years. Significant improvements in urinary incontinence symptoms and quality of life were observed following pelvic floor muscle training guided by the mobile app (p<0.001). Notably, 74.3% of the participants reported performing the exercises with appropriate frequency. Of the participants, 62% reported either complete or substantial improvement in urinary symptoms post-treatment. CONCLUSION: This study revealed notable enhancements in stress urinary incontinence, urinary storage, and overall quality of life subsequent to pelvic floor muscle training guided by a mobile app, particularly during the coronavirus disease 2019 pandemic. The mobile app demonstrated robust acceptance and adherence among women experiencing urinary incontinence.

Validation and cultural translation for the Brazilian Portuguese version of the Estro-Androgenic- Symptom Questionnaire in Women

Abstract Objective This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause. Methods In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment. Results The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach's alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001). Conclusion This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.

Resenha: A Pandemia e o Trabalho em Saúde - Vozes do Cotidiano

Trata-se da resenha do livro A Pandemia e o Trabalho em Saúde - Vozes do Cotidiano, publicado em dezembro de 2022 pela Rede Unida. A obra é um compêndio de textos sobre as consequências da pandemia da doença COVID-19 na vida dos trabalhadores da saúde brasileiros.

Polyvinyl Alcohol Nanofibers Blends as Drug Delivery System in Tissue Regeneration.

Nanofibers have shown promising clinical results in the process of tissue regeneration since they provide a similar structure to the extracellular matrix of different tissues, high surface-to-volume ratio and porosity, flexibility, and gas permeation, offering topographical features that stimulate cell adhesion and proliferation. Electrospinning is one of the most used techniques for manufacturing nanomaterials due to its simplicity and low cost. In this review, we highlight the use of nanofibers produced with polyvinyl alcohol and polymeric associations (PVA/blends) as a matrix for release capable of modifying the pharmacokinetic profile of different active ingredients in the regeneration of connective, epithelial, muscular, and nervous tissues. Articles were selected by three independent reviewers by analyzing the databases, such as Web of Science, PubMed, Science Direct, and Google Scholar (last 10 years). Descriptors used were "nanofibers", "poly (vinyl alcohol)", "muscle tissue", "connective tissue", "epithelial tissue", and "neural tissue engineering". The guiding question was: How do different compositions of polyvinyl alcohol polymeric nanofibers modify the pharmacokinetics of active ingredients in different tissue regeneration processes? The results demonstrated the versatility of the production of PVA nanofibers by solution blow technique with different actives (lipo/hydrophilic) and with pore sizes varying between 60 and 450 nm depending on the polymers used in the mixture, which influences the drug release that can be controlled for hours or days. The tissue regeneration showed better cellular organization and greater cell proliferation compared to the treatment with the control group, regardless of the tissue analyzed. We highlight that, among all blends, the combinations PVA/PCL and PVA/CS showed good compatibility and slow degradation, indicating their use in prolonged times of biodegradation, thus benefiting tissue regeneration in bone and cartilage connective tissues, acting as a physical barrier that results in guided regeneration, and preventing the invasion of cells from other tissues with increased proliferation rate.

Comparative genomic damage among three shark species with different habits: Sublethal impacts of human origin in a protected island environment in the South Atlantic.

Elasmobranchs can bioaccumulate and biomagnify pollutants. However, few studies are directed to the effects of pollutants on the health of these animals, and in most cases, are limited to the analysis of biochemical markers. Thus, the incidence of genomic damage among shark species inhabiting a protected ocean island in the South Atlantic was investigated in association with the analysis of pollutants in seawater sample. High levels of genomic damage were identified, especially in Negaprion brevirostris and Galeocerdo cuvier, in addition to interspecific variations that may be related to characteristics such as animal size, metabolism and habits. High concentrations of Surfactants were observed in seawater sample, in addition to low concentrations of Cadmium, Lead, Copper, Chromium, Zinc, Manganese, and Mercury. The results evidenced the potential of shark species as a bioindicator of environmental quality and allowed assessing the anthropic impact on the archipelago, which currently drives its economy through tourism.

Effect of diazinon (organophosphate) on the composition and succession of Calliphoridae assemblages in rabbit carcasses in the Eastern Amazon.

Fatal poisonings with diazinon may occur both accidentally or intentionally in suicide cases. Forensic entomotoxicology can aid in understanding these deaths by detecting and analyzing the interference of toxic substances in the biology of necrophagous insects. Hence, this study sought to evaluate diazinon's effect on the composition and succession of calliphorid species in the tropical savannas of the Amazon. Nine rabbit carcasses were divided into three groups: one control and two diazinon treatments (100 mg/kg and 300 mg/kg); each group had three replicates. Three fragments of the Amazon tropical savanna were selected for the experiments. Daily collections of adult and immature calliphorids were performed. Five decomposition stages were observed: fresh, bloated, active decay co-occurring, advanced decay, and dry. Eight species of Calliphoridae were identified among the collected adults: Chloroprocta idioidea (0.1%), Chrysomya albiceps (58.3%), Chrysomya megacephala (14.2%), Chrysomya putoria (2.6%), Cochliomyia hominivorax (1.3%), Cochliomyia macellaria (0.5%), Lucilia eximia (19.8%), and Paralucilia paraensis (3.3%). The adult specimens in the control group with the highest abundance were observed only from the advanced decay stage onward. In the dry stage, abundance was higher in control than in treated carcasses. From the sampled 941 Calliphorid immatures, three species were identified: C. albiceps (76,3%), C. putoria (1%), and L. eximia (22,7). The number of immatures was higher in control than in treated carcasses. Therefore, diazinon interferes with the putrefaction timeframe in carcasses, slowing the decomposition stages and affecting their colonization by immature forms of Calliphoridae.

Current Practices in Brazil on Diagnosis and Management of Women With Vulvodynia.

OBJECTIVE: Vulvodynia (VVD) is a frequent and harrowing condition for which diagnosis and management remain insufficient. Our study aimed to describe and compare vulvovaginal signs and symptoms of Brazilian women with VVD and controls and describe previous medical assessment, past treatments, and vulvar pain relief among women with VVD. METHODS: This cross-sectional descriptive study included Brazilian women with (n = 151) and without VVD (n = 106). All women were assessed for vaginal infection, vulvar pain intensity by means of a cotton swab test based on a numerical rate scale, and answered the Female Sexual Function Index questionnaire and a structured instrument about current vulvar symptoms. Previous treatments were assessed in the VVD group, and vulvar pain relief achieved with previous treatments was qualified through a 4-point Likert scale. RESULTS: Volunteers were mainly White, with mean age of 30 years. Vulvovaginal signs and symptoms were significantly more frequent in women with VVD (p < .05), and vulvar pain duration was 5.8 (±4) years. More than 50% consulted with three or more physicians, and 49% remained without a conclusive diagnosis. Previous diagnosis and treatment of vulvovaginal infection were often reported by women with VVD. Most of the tried prescriptions were self-reported as providing only low vulvar pain relief. CONCLUSIONS: Prolonged duration of vulvar pain, multiple visits to health care professionals, and poor relief of pain are common aspects in the clinical history of women with VVD. In addition to pain, vulvar fissure, edema, erythema, vaginal discharge, and foul odor are common and should be considered to avoid misdiagnosis. Appropriate treatments to VVD are still poorly reported.

Interações potenciais entre os medicamentos comumente prescritos em cirurgia oral e os medicamentos em uso pelo paciente: estudo piloto / Potential interactions between drugs commonly prescribed in oral surgery and drugs used by the patient: a pilot study

Introdução: A alta prevalência do uso de medicamentos na população brasileira pode interferir na prescrição odontológica. Objetivos: Identificar os medicamentos em uso por pacientes atendidos em uma clínica de cirurgia oral menor e estimar os riscos de interações medicamentosas (IM) potenciais com fármacos comumente prescritos em procedimentos cirúrgicos. Materiais e Métodos: Realizou-se um estudo piloto analítico e transversal, sendo incluídos 24 pacientes atendidos na Clínica de Cirurgia Oral da Faculdade de Odontologia de uma universidade pública brasileira. Os dados foram coletados por meio de um questionário exploratório. Todos os medicamentos foram classificados no sistema Anatomical Therapeutic Chemical (ATC). As IM potenciais foram analisadas no banco de dados do Drugs® após correlação entre os medicamentos em uso pelo paciente e os medicamentos comumente prescritos em cirurgia oral.Resultados: Observou-se prevalência de 66,7% (n= 16) no uso de pelo menos 1 medicamento dentre os pacientes atendidos na clínica de cirurgia oral, com média de 3,5 (±2,2) medicamentos, sendo a polifarmácia identificada em 16,6% pacientes (n= 4). A média de idade dos usuários de medicamentos foi de 52 (±16) anos e totalizou-se 56 medicamentos. Os fármacos mais prevalentes foram aqueles atuantes nos sistemas nervoso e cardiovascular. Quando simuladas as adições dos fármacos comumente prescritos em cirurgia oral (anti-inflamatórios, analgésicos e antimicrobianos) aos medicamentos em uso pelos 16 pacientes, identificou-se 75 IM potenciais diferentes, sendo 61 (81%) de gravidade moderada e 14 (19%) de gravidade alta. As IM potenciais mais frequentes foram de anti-hipertensivos com anti-inflamatórios, enquanto as de importância clínica grave envolveram fármacos de ação central e analgésicos opioides. Conclusão: Observou-se alta prevalência na utilização de medicamentos pelos pacientes atendidos na clínica de cirurgia oral, com importante risco de interações com medicamentos prescritos em procedimentos cirúrgicos.

Introduction: The high prevalence of drug use in the Brazilian population can interfere with dental prescriptions.Objective: To identify drugs being used by patients seen at a minor oral surgery clinic and to estimate the risks of potential drug interactions (DI) with drugs commonly prescribed in surgical procedures. Materials and Methods: An analytical and cross-sectional pilot study was carried out, including 24 patients treated at the Oral Surgery Clinic of the Dental School of a Brazilian Federal University. Data were collected through an exploratory questionnaire. All drugs were classified in the Anatomical Therapeutic Chemical (ATC) system. Potential DI were analyzed in the Drugs® database after correlation between the drugs used by the patient and the drugs commonly prescribed in oral surgery.Results: There was a prevalence of 66.7% (n= 16) in the use of at least 1 medication among patients seen at the oral surgery clinic, with a mean of 3.5 (±2.2) medications, with polypharmacy identified in 16.6% patients (n= 4). Mean age of medication users was 52 (±16) years, totaling 56 medications. The most prevalent drugs were those acting on the nervous and cardiovascular systems. When the additions of drugs commonly prescribed in oral surgery (anti-inflammatory drugs, analgesics and antimicrobials) to the drugs used by the 16 patients were simulated, 75 different potential DI were identified, 61 (81%) of moderate severity and 14 (19%) of high gravity. The most frequent potential DIs were antihypertensives with anti-inflammatory drugs, while those of serious clinical importance involved centrally acting drugs and opioid analgesics. Conclusion: There was a high prevalence of medication use by patients seen at the oral surgery clinic, with a significant risk of interactions with prescribed medications in surgical procedures.

Phytochemical Characterization of Cannabis sativa L. Roots from Northeastern Brazil.

This article describes the phytochemical study of Cannabis sativa roots from northeastern Brazil. The dried plant material was pulverized and subjected to exhaustive maceration with ethanol at room temperature, obtaining the crude ethanolic extract (Cs-EEBR). The volatile compounds were analyzed by gas chromatography coupled with mass spectrometry (GC/MS), which allowed to identify 22 compounds by comparing the linear retention index (LRI), the similarity index (SI) and the fragmentation pattern of the constituents with the literature. By this technique the major compounds identified were: friedelan-3-one and ß-sitosterol. In addition, two fractions were obtained from Cs-EEBR by classical column chromatography and preparative thin layer chromatography. These fractions were analyzed by NMR and IR and together with the mass spectrometry data allowed to identify the compounds: epifriedelanol, friedelan-3-one, ß-sitosterol and stigmasterol. The study contributed to the phytochemical knowledge of Cannabis sativa, specifically the roots, as there are few reports on the chemical constituents of this part of the plant.