Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.042
Filtrar
Mais filtros








Filtros aplicados
  • Temas
    • Acesso a medicamentos e insumos estratégicos (remover)
Intervalo de ano de publicação
1.
Arq. ciências saúde UNIPAR ; 26(3): 643-656, set-dez. 2022.
Artigo em Português | LILACS | ID: biblio-1399314

RESUMO

O Diabetes Mellitus (DM) é uma doença crônica, que tem elevada prevalência na sociedade e representa um problema de saúde pública devido à natureza de suas complicações, acredita-se que a dificuldade na manutenção do tratamento, pode estar relacionada a deficiência ou falta de adesão. O estudo teve como objetivo relatar à adesão ao tratamento do Diabetes Mellitus na Atenção Primária a Saúde. Trata-se de um estudo descritivo, com abordagem qualitativa, realizado com 30 pacientes diabéticos de uma Unidade de Atenção Primária à Saúde de Guaiúba-CE, no período de agosto a outubro de 2021. A coleta de dados deu-se por entrevista semiestruturada utilizando questões norteadoras sobre adesão ao tratamento, adoção de práticas promotoras de saúde e posteriormente sujeita a análise de conteúdo. Observou-se que a adesão ao tratamento do diabetes envolve inúmeros desafios, relacionados principalmente ao usuário e sistemas de saúde/profissionais. Os maiores desafios encontrados foram em relação a supervalorização do tratamento medicamentoso frente a adoção de hábitos saudáveis e de ações promotoras de autocuidado. Nesse cenário, nota-se a importância de conhecer os fatores que influenciam na adesão ao tratamento com o intuito de se lançar estratégias para aperfeiçoar o planejamento de ações e intervenções a esses pacientes.


Diabetes Mellitus (DM) is a chronic disease that is highly prevalent in society and represents a public health problem due to the nature of its complications. The study aimed to report on the adherence to treatment of Diabetes Mellitus in Primary Health Care. This is a descriptive study, with a qualitative approach, conducted with 30 diabetic patients from a Primary Health Care Unit in Guaiúba-CE, in the period from August to October 2021. Data were collected through semi-structured interviews using guiding questions about adherence to treatment, adoption of health-promoting practices and later subjected to content analysis. It was observed that diabetes treatment adherence involves numerous challenges, mainly related to the user and health systems/professionals. The biggest challenges found were related to the overvaluation of drug treatment against the adoption of healthy habits and self-care promoting actions. In this scenario, it is important to know the factors that influence treatment adherence in order to develop strategies to improve the planning of actions and interventions for these patients.


La diabetes mellitus (DM) es una enfermedad crónica, que tiene una alta prevalencia en la sociedad y representa un problema de salud pública debido a la naturaleza de sus complicaciones, se cree que la dificultad para mantener el tratamiento puede estar relacionada con la deficiencia o falta de adherencia. El estudio tenía como objetivo informar sobre la adherencia al tratamiento de la Diabetes Mellitus en Atención Primaria. Se trata de un estudio descriptivo con enfoque cualitativo, realizado con 30 pacientes diabéticos de una Unidad de Atención Primaria de Salud de Guaiúba-CE, en el período de agosto a octubre de 2021. La recogida de datos se llevó a cabo mediante entrevistas semiestructuradas en las que se utilizaron preguntas orientativas sobre la adherencia al tratamiento y la adopción de prácticas de promoción de la salud, y posteriormente se sometieron a un análisis de contenido. Se ha observado que el acceso al tratamiento de la diabetes conlleva numerosos desafíos, relacionados principalmente con el usuario y los sistemas de salud/profesionales. Los mayores retos encontrados estaban relacionados con la sobrevaloración del tratamiento farmacológico frente a la adopción de hábitos saludables y acciones de promoción del autocuidado. En este escenario, se constata la importancia de conocer los factores que influyen en la adherencia al tratamiento para poner en marcha estrategias que mejoren la planificación de las acciones e intervenciones para estos pacientes.


Assuntos
Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Pacientes , Atenção Primária à Saúde/organização & administração , Diabetes Mellitus/tratamento farmacológico , Cooperação e Adesão ao Tratamento , Autocuidado/instrumentação , Sistema Único de Saúde , Preparações Farmacêuticas/análise , Exercício Físico/fisiologia , Saúde Pública , Doença Crônica/tratamento farmacológico , Diabetes Mellitus/diagnóstico , Tratamento Farmacológico , Dieta Saudável , Promoção da Saúde , Acesso aos Serviços de Saúde , Cuidados de Enfermagem/métodos
2.
J Int Med Res ; 50(10): 3000605221129674, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36262058

RESUMO

Newly-diagnosed or relapses of immunoglobulin A nephropathy (IgAN) have been associated with COVID-19 vaccination in the literature. Most reported cases were mild clinical diseases characterized by microscopic haematuria and do not require dialysis treatment. This current case report describes a 55-year-old male patient that presented to the emergency department with acute kidney injury after receiving the first dose of the mRNA-1273 COVID-19 vaccine. After admission, his renal function deteriorated rapidly, and then he developed uraemic encephalopathy. He underwent emergency haemodialysis with a rapid improvement in his mental status. Renal biopsy showed newly-diagnosed IgA nephropathy along with markedly elevated plasma level of galactose-deficient-IgA1 (Gd-IgA1) antibody. The patient did not receive immunosuppressive treatment and is now dialysis-free. Immune activation is considered an essential factor in developing or exacerbating IgAN following COVID-19 vaccination. This current case report demonstrates that elevated Gd-IgA1 antibody may be the potential mechanistic link between COVID-19 vaccination and IgAN.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Glomerulonefrite por IGA , Humanos , Masculino , Pessoa de Meia-Idade , Vacina de mRNA-1273 contra 2019-nCoV , Vacinas contra COVID-19/efeitos adversos , Galactose , Imunoglobulina A , RNA Mensageiro , Vacinação/efeitos adversos
3.
Pharmacol Res Perspect ; 10(5): e01007, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36102210

RESUMO

Pharmacy services within hospitals are changing, with more taking on medication reconciliation activities. This systematic review was conducted to determine the measured impacts of Pharmacy teams working in an acute or emergency medicine department. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was prospectively registered on PROSPERO, National Institute for Health and Care Research, UK registration number: CRD42020187487. The systematic review had two co-primary aims: a reduction in the number of incorrect prescriptions on admission by comparing the medication list from primary care to secondary care, and a reduction in the severity of harm caused by these incorrect prescriptions; chosen to determine the impact of pharmacy-led medication reconciliation services in the emergency and acute medicine setting. Seventeen articles were included. Fifteen were non-randomized controlled trials and two were randomized controlled trials. The number of patients combined for all studies was 7630. No studies included were based within the UK. All studies showed benefits in terms of a reduction in medicine errors and patient harm, compared to control arms. Nine articles were included in a statistical analysis comparing the pharmacy intervention arm with the non-pharmacy control arm, with a Chi2 of 101.10 and I2 value = 92%. However, studies were heterogenous with different outcome measures and many showed evidence of bias. The included studies consistently indicated that pharmacy services based within acute or emergency medicine departments in hospitals were associated with fewer medication errors. Further studies are needed to understand the health and economic impact of deploying a pharmacy service in acute medical settings including out-of-hours working.


Assuntos
Medicina de Emergência , Assistência Farmacêutica , Humanos , Erros de Medicação/prevenção & controle , Reconciliação de Medicamentos/métodos
4.
BMC Public Health ; 22(1): 1696, 2022 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-36071389

RESUMO

BACKGROUND: HPV-related anal cancer occurs in excess rates among people living with HIV (PLWH) and has been increasing in incidence. The HPV vaccine is an effective and safe approach to prevent and reduce the risk of HPV-related disease. Yet, HPV vaccine programs tailored and implemented in the HIV population are lagging for this high-risk group. METHODS: A pre-post intervention study design will be used to tailor, refine, and implement the 4 Pillars™ Practice Transformation Program to increase HPV vaccination among PLWH. Guided by the RE-AIM framework, the CHAMPS study will provide training and motivation to HIV providers and clinic staff to recommend and administer the HPV vaccination within three HIV clinics in Georgia. We plan to enroll 365 HIV participants to receive HPV education, resources, and reminders for HPV vaccination. Sociodemographic, HPV knowledge, and vaccine hesitancy will be assessed as mediators and moderators for HPV vaccination. The primary outcome will be measured as an increase in uptake rate in initiation of the HPV vaccine and vaccine completion (secondary outcome) compared to historical baseline vaccination rate (control). DISCUSSION: The proposed study is a novel approach to address a serious and preventable public health problem by using an efficacious, evidence-based intervention on a new target population. The findings are anticipated to have a significant impact in the field of improving cancer outcomes in a high-risk and aging HIV population. TRIAL REGISTRATION: NCT05065840; October 4, 2021.


Assuntos
Infecções por HIV , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Instituições de Assistência Ambulatorial , Infecções por HIV/prevenção & controle , Humanos , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Vacinação
5.
Adv Respir Med ; 90(5): 376-377, 2022 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-36136849

RESUMO

A 65-year-old woman presented to the Pulmonary Clinic for evaluation after Positron Emission Tomography/Computed Tomography (PET/CT), which was obtained for assessment of a 12 mm right middle lobe solitary pulmonary nodule [...].


Assuntos
COVID-19 , Fluordesoxiglucose F18 , Idoso , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Feminino , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons/métodos , Vacinação
6.
Am J Case Rep ; 23: e937212, 2022 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-35986502

RESUMO

BACKGROUND Adverse events following immunization (AEFIs) remain under recognized, particularly when the symptoms experienced are uncommon and mimic natural disease. In the context of the worldwide effort to provide protection against SARS-CoV-2 using multiple doses of vaccination and with the availability of multiple vaccines, the early recognition and prompt treatment of AEFIs has increased importance, as does the ability to carefully select an alternative after an AEFI occurs. CASE REPORT A 60-year-old woman presented for clinical immunology review with a 9-month history of glossitis and xerostomia. Onset of symptoms occurred following her first vaccination with a COVID-19 vaccine (BNT162b2). After partial interval improvement, her symptoms progressively worsened after a second vaccination and third booster vaccination with BNT162b2. While undergoing reviews from multiple specialists for possible underlying connective tissue disease, and with other causes of her symptoms being excluded, the patient's symptoms progressed, with worsening tongue swelling with new fissuring and xerostomia. The patient experienced an unintentional weight loss of 8 kg due to oral discomfort. It was only after this time that an AEFI was considered the cause of her presentation, after all other diagnostic considerations were considered unlikely. Targeted, symptomatic, localized treatment with topical oral corticosteroids was initiated, followed by a gradual tapering regimen, with excellent response. CONCLUSIONS This case highlights the need to consider AEFIs early in the differential diagnosis of unusual presentations and the importance of considering a trial of targeted symptomatic treatment for patients, even if diagnostic uncertainty remains.


Assuntos
Vacina BNT162 , COVID-19 , Glossite , Xerostomia , Sistemas de Notificação de Reações Adversas a Medicamentos , Vacina BNT162/efeitos adversos , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Feminino , Glossite/etiologia , Humanos , Pessoa de Meia-Idade , SARS-CoV-2 , Vacinação/efeitos adversos , Xerostomia/etiologia
7.
Goiânia; SES-GO; 23 ago. 2022. 9 p. ilus.
Não convencional em Português | LILACS, Coleciona SUS, CONASS, SES-GO | ID: biblio-1391037

RESUMO

A vacinação é a principal ferramenta de prevenção primária de doenças e uma das medidas mais bem-sucedidas em saúde pública, com melhor custo-efetividade (ABBAS et al , 2006; WHO, 2021a). Além disso, a imunização evita incapacidades e cerca de 2 a 3 milhões de mortes, em todo o mundo, a cada ano (UE, 2020; PAHO, 2022; WATSON et al., 2022). Não obstante os esforços implementados por organizações internacionais e locais, dados da OMS apontam que a cobertura vacinal global caiu de 86% em 2019 para 81% em 2021, o que significa que cerca de 25 milhões de crianças menores de 1 ano não receberam as vacinas básicas (WHO, 2021a). Já no Brasil (Figura 1), a cobertura manteve-se estável de 1999 a 2015 e em contrapartida, em 2016 e no último triênio, apresenta tendência de queda (BRASIL, 2022b). Diante dessa realidade, objetivou-se investigar as estratégias utilizadas para ampliar a vacinação, e assim, subsidiar a formulação e tomada de decisão em políticas públicas para mitigar a baixa cobertura vacinal


Vaccination is the main tool for primary disease prevention and one of the most successful and cost-effective public health measures (ABBAS et al , 2006; WHO, 2021a). In addition, immunization prevents disability and an estimated 2 to 3 million deaths worldwide each year (EU, 2020; PAHO, 2022; WATSON et al., 2022). Notwithstanding the efforts implemented by international and local organizations, WHO data indicate that global vaccination coverage dropped from 86% in 2019 to 81% in 2021, which means that about 25 million children under 1 year of age do not received the basic vaccines (WHO, 2021a). In Brazil (Figure 1), coverage remained stable from 1999 to 2015 and, on the other hand, in 2016 and in the last three years, it shows a downward trend (BRASIL, 2022b). Faced with this reality, the objective was to investigate the strategies used to expand vaccination, and thus subsidize the formulation and decision-making in public policies to mitigate the low vaccination coverage


Assuntos
Humanos , Criança , Adolescente , Adulto , Cobertura Vacinal/estatística & dados numéricos , Vacinação/tendências , Vacinação/estatística & dados numéricos , Cobertura Vacinal/história , Cobertura Vacinal/tendências
8.
Yale J Biol Med ; 95(2): 237-247, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35782472

RESUMO

Introduction: COVID-19, the infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), often presents with a spectrum of symptoms at varying levels of severity, ranging from asymptomatic patients to those with fatal complications, such as myocarditis. With increased availability of COVID-19 vaccines, the awareness of possible side effects has expanded as reports surface. This study reviewed cases of myocarditis following COVID-19 vaccination and with existing literature on COVID-19 infection-induced myocarditis to compare clinical courses and analyze possible mechanisms of action. Methods: A systematic review of literature was conducted to identify published case reports (as of February 3, 2022) pertaining to the development of myocarditis following COVID-19 vaccination with either Pfizer or Moderna for an in-depth analysis. Additional subgroup analyses were conducted based on age, past medical history, vaccine manufacturer, and dose number. Results: There were 53 eligible case reports that were included in this study. Patients were mostly male with a median age of 24 years, and the most reported symptom upon presentation was chest pain. Seventy percent of the cases involved the Pfizer vaccine with a majority of myocarditis developing subsequent to second dose. Resolution of symptoms was achieved in all but one patient. Clinical severity, as measured primarily by left ventricular ejection fraction, appeared to be worse among adult patients than pediatric, as well as for patients with comorbidities. Conclusion: This study revealed an observable association between COVID-19 vaccines and myocarditis. However, the clinical course and prognosis seem favorable and less prevalent than those conferred from natural infection.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Miocardite , Adulto , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Criança , Feminino , Humanos , Masculino , Miocardite/induzido quimicamente , Miocardite/diagnóstico , SARS-CoV-2 , Volume Sistólico , Vacinação/efeitos adversos , Função Ventricular Esquerda , Adulto Jovem
9.
Rev. méd. Urug ; 38(2)jun. 2022.
Artigo em Espanhol | LILACS-Express | LILACS, BNUY, UY-BNMED | ID: biblio-1389683

RESUMO

Resumen: Introducción: las benzodiacepinas constituyen un grupo farmacológico de amplia prescripción a nivel mundial desde su aparición en la década de 1960. El objetivo del presente estudio fue identificar la disponibilidad, las modalidades de prescripción y dispensación de benzodiacepinas en diferentes países de América Latina, según reglamentación vigente en cada país participante del estudio. Materiales y métodos: estudio observacional, descriptivo y transversal, realizado con los datos disponibles al año 2022 de todos los países miembros de la Red de Centros de Información de Medicamentos de LatinoAmérica y el Caribe (Red CIMLAC) que fueron parte del estudio. Se utilizaron las bases de datos de las agencias regulatorias, la reglamentación vigente y otros documentos necesarios para obtener la información sobre la dispensación y prescripción en cada país. Resultados: doce de los 20 países de la Red CIMLAC completaron el estudio. El total de benzodiacepinas disponible en cada país varió entre 6 y 12 (media: 9). De ellas, en promedio 5 estaban incluidas en listados de medicamentos esenciales nacionales. La mayoría de los países cuentan con combinaciones a dosis fijas con benzodiacepinas. En todos los países se realiza la prescripción por receta especial. Más de la mitad de los países cuentan con recomendaciones nacionales. Conclusiones: la amplia disponibilidad de benzodiacepinas comercializadas, la existencia de combinaciones a dosis fijas y la falta de recomendaciones nacionales pueden ser factores que contribuyan al uso irracional de este grupo terapéutico.


Summary: Introduction: benzodiazepines constitute a widely prescribed group of drugs around the world, since they appeared in the sixties. This study aims to identify the availability, prescription modalities and dispensing of benzodiazepines in different countries around Latin America, as per the legal provisions in force in each of the countries participating in the study. Method: observational, descriptive, transversal study based on the information available in 2022 about all the member countries of the Network Medicines Information Centers of Latin America and the Caribbean (CIMLAC Network) that were part of the study. The databases of regulatory authorities were used and the legal provisions in force and relevant documents were consulted in order to obtain information on benzodiazepines dispensing and prescription in each country. Results: twelve out of the 20 CIMLAC Network member countries completed the study. The total number of benzodiazepines available in the study ranged from 6 to 12 (mean was 9), and 5 of them on average were included in the national essential medications lists. Most countries have benzodiazepines fixed dose combinations and in all countries a special medical prescription is needed. More than half of the countries have national recommendations. Conclusions: the wide availability of benzodiazepines in the market, the existence of fixed-dose combinations and the lack of national recommendations may constitute factors that contribute to the irrational use of this group of drugs.


Resumo: Introdução: os benzodiazepínicos constituem um grupo farmacológico amplamente prescrito em todo o mundo desde seu surgimento na década de 1960. O objetivo deste estudo foi identificar a disponibilidade, prescrição e modalidades de dispensação de benzodiazepínicos em diferentes países da América Latina, de acordo com as regulamentações vigentes em cada país participante do estudo. Materiais e métodos: estudo observacional, descritivo e transversal, realizado com os dados disponíveis até o ano de 2022 dos países membros da Rede de Centros de Informação sobre Medicamentos da América Latina e do Caribe (Red CIMLAC) que faziam parte do estudo. As bases de dados das agências reguladoras, normas vigentes e outros documentos necessários foram utilizados para obter informações sobre dispensação e prescrição em cada país. Resultados: doze dos 20 países da Rede CIMLAC completaram o estudo. O número total de benzodiazepínicos disponíveis em cada país variou entre 6 e 12 (média: 9). Destes, uma média de 5 foram incluídos nas listas nacionais de medicamentos essenciais. A maioria dos países tem combinações de dose fixa com benzodiazepínicos. Em todos os países é necessário prescrição especial. Mais da metade dos países têm recomendações nacionais. Conclusões: a ampla disponibilidade de benzodiazepínicos comercializados, a existência de combinações em doses fixas e a falta de recomendações nacionais podem ser fatores que contribuem para o uso irracional desse grupo terapêutico.


Assuntos
Benzodiazepinas/uso terapêutico , Prescrições de Medicamentos , Uso de Medicamentos
10.
Ciênc. Saúde Colet. (Impr.) ; 27(6): 2471-2479, jun. 2022. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1375023

RESUMO

Resumo O cumprimento dos prazos legais para incorporação e disponibilização de tecnologias no Sistema Único de Saúde (SUS) é fundamental para o acesso da população aos medicamentos considerados essenciais. Objetivou-se analisar o cumprimento destes prazos comparando a Oncologia e o Componente Especializado de Assistência Farmacêutica (CEAF). Comparou-se os processos de incorporação de medicamentos no SUS da Oncologia e do CEAF que foram submetidos à Conitec no período de 01 de janeiro de 2017 a 30 de abril de 2020. No período, 83 processos de incorporação de medicamentos foram recomendados para incorporação pela Conitec, dos quais 13 (15,66%) eram da Oncologia e 70 (84,34%) eram do CEAF. Verifica-se que o tempo de análise e recomendação pela Conitec até a publicação da decisão pelo Ministério da Saúde foi, em média, 15 dias maior para processos que continham medicamentos oncológicos e o tempo para disponibilização das tecnologias incorporadas da área da oncologia foi, em média, 389 dias maior que do CEAF. Reconhece-se o importante avanço obtido com a criação da Conitec no Brasil, porém os resultados deste estudo apontam para a necessidade de aprimoramento do processo de disponibilização de tecnologias incorporadas no SUS, em especial da Oncologia.


Abstract Compliance with legal deadlines for the assessment and incorporation of technologies in Brazil's Unified Health System (SUS) is essential to ensure public access to essential medicines. The scope of this paper was to analyze the compliance with legal deadlines for incorporation and availability of medicines in the SUS, comparing Oncology and the Specialized Component of Pharmaceutical Assistance (SCPA). A comparison was made of the drugs incorporated that were submitted to Conitec in the period from January 1, 2017, to April 30, 2020. A total of 85 drugs were recommended for incorporation by Conitec, of which 15 (17.64%) were for Oncology and 70 (82.36%) were for SCPA. The time between analysis and recommendation by Conitec until the publication of the decision by the Ministry of Health was, on average, 86 days longer for oncological drugs and the availability timeframe of technologies incorporated in the oncology area was, on average, 389 days longer than for SCPA. The major progress achieved with the creation of Conitec in Brazil is acknowledged, but the results of this study point to a pressing need to improve the process of making available technologies incorporated into the SUS, especially in oncology.

11.
MMWR recomm. rep ; 71(11): 416-421, March 18, 2022. tab
Artigo em Inglês | BIGG | ID: biblio-1397081

RESUMO

The mRNA-1273 (Moderna) COVID-19 vaccine is a lipid nanoparticle-encapsulated, nucleoside-modified mRNA vaccine encoding the stabilized prefusion spike glycoprotein of SARS-CoV-2, the virus that causes COVID-19. During December 2020, the vaccine was granted Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA), and the Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation for use among persons aged ≥18 years (1), which was adopted by CDC. During December 19, 2020­January 30, 2022, approximately 204 million doses of Moderna COVID-19 vaccine were administered in the United States (2) as a primary series of 2 intramuscular doses (100 µg [0.5 mL] each) 4 weeks apart. On January 31, 2022, FDA approved a Biologics License Application (BLA) for use of the Moderna COVID-19 vaccine (Spikevax, ModernaTX, Inc.) in persons aged ≥18 years (3). On February 4, 2022, the ACIP COVID-19 Vaccines Work Group conclusions regarding recommendations for the use of the Moderna COVID-19 vaccine were presented to ACIP at a public meeting. The Work Group's deliberations were based on the Evidence to Recommendation (EtR) Framework,* which incorporates the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach† to rank evidence quality. In addition to initial clinical trial data, ACIP considered new information gathered in the 12 months since issuance of the interim recommendations, including additional follow-up time in the clinical trial, real-world vaccine effectiveness studies, and postauthorization vaccine safety monitoring. ACIP also considered comparisons of mRNA vaccine effectiveness and safety in real-world settings when first doses were administered 8 weeks apart instead of the original intervals used in clinical trials (3 weeks for BNT162b2 [Pfizer-BioNTech] COVID-19 vaccine and 4 weeks for Moderna COVID-19 vaccine). Based on this evidence, CDC has provided guidance that an 8-week interval might be optimal for some adolescents and adults. The additional information gathered since the issuance of the interim recommendations increased certainty that the benefits of preventing symptomatic and asymptomatic SARS-CoV-2 infection, hospitalization, and death outweigh vaccine-associated risks of the Moderna COVID-19 vaccine. On February 4, 2022, ACIP modified its interim recommendation to a standard recommendation§ for use of the fully licensed Moderna COVID-19 vaccine in persons aged ≥18 years.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Programas de Imunização/normas , COVID-19/prevenção & controle , Vacina de mRNA-1273 contra 2019-nCoV/administração & dosagem , Vacina de mRNA-1273 contra 2019-nCoV/imunologia
12.
Int. j. cardiovasc. sci. (Impr.) ; 35(3): 342-353, May-June 2022. tab
Artigo em Inglês | LILACS | ID: biblio-1375653

RESUMO

Abstract Background: Public programs that provide access to essential medications have played an important role in the care of hypertensive and diabetic patients. However, access in small municipalities has been poorly studied. Objectives: To describe the sociodemographic profile and the medication and health service usage of patients with systemic arterial hypertension and/or diabetes mellitus in a small municipality who use the public medication access programs Health has no Price (Saúde Não Tem Preço - SNTP) and the Minas Pharmacy Network. Methods: This cross-sectional study with 341 participants was conducted in 2019. Home interviews were conducted using a standardized, semi-structured questionnaire. The data are expressed as absolute and relative frequencies, and Pearson's chi-square test was used for comparisons between proportions (α = 5%). Results: Most of the participants (70.68%) had hypertension only, 11.14% had diabetes only, and 18.18% had both. Regarding the origin of the hypertension medications, 82.67% were provided by the Minas Pharmacy Network and/or SNTP programs. Regarding oral hypoglycemic agents and insulins, 88.61% were provided by the Minas Pharmacy Network and/or SNTP. Most participants were female (63.1%), at least 65 years of age (50.30%), non-White (66.96%), resided in an urban area (67.16%), were illiterate or had a low education level (89.94%), and had a maximum income ≤ 2 times the federal minimum salary (89.19%). Overall user perception was significantly better for SNTP (p=0.010). Conclusion: The results of this study indicate that programs which provide access to essential medications are important sources of hypertension and diabetes medications in the study area, especially for people with low incomes.


Assuntos
Diabetes Mellitus/epidemiologia , Política Nacional de Medicamentos , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Hipertensão/epidemiologia , Assistência Farmacêutica/provisão & distribuição , Estudos Transversais , Diabetes Mellitus/tratamento farmacológico , Hipertensão/tratamento farmacológico
13.
Notas enferm. (Córdoba) ; 22(39): 54-63, junio 2022.
Artigo em Espanhol | LILACS, BDENF - Enfermagem, BINACIS, UNISALUD | ID: biblio-1380372

RESUMO

Describir e identificar las razones por las cuales los padres o tutores no completaron el calendario de vacunación infantil en un Centro de Atención Primaria de Salud de la Ciudad de Corrientes en el año 2021. Metodología: Estudio descriptivo, transversal. Población: padres o tutores de niños con esquemas incompletos. Recolección de datos mediante encuesta validada en prueba piloto. Los datos plasmados en una matriz fueron sometidos a análisis descriptivos. Se contó con aval del Comité de Ética. Resultados: La muestra se integró con 53 unidades de análisis. Edad media 28 años; 79% eran las madres; 62% ya tenían dos o más hijos; 74% eran soltero/as; 47% no había concluido el secundario o la primaria; la mayoría eran desempleados o percibían planes sociales. El 66% pensaba que las vacunas curaban enfermedades;89% que las prevenían y 89% pensaban que eran seguras. Fuentes de información: el equipo médico y enfermería, 17% de familiares o amigos, 30% en internet o medios de comunicación. En motivosde incumplimiento, lo más frecuente falta de vacunas (31%), horarios de trabajo de padres o tutor (15%), enfermedades del infante (10%). Conclusión: La información sobre vacunas era brindada por equipo de salud, familias y medios de comunicación. Aunque afirmaban que prevenían enfermedades y eran seguras muchos sostenían que curaban enfermedades. Se señalaron como motivos del incumplimiento falta de vacunas, horarios laborales de los entrevistados y enfermedades del menor, restricciones horariasdel vacunatorio y por la pandemia[AU]


Describe and identify the reasons why parents or guardians did not complete the childhood vaccination schedule in a Primary Health Care Center of the City of Corrientes in the year 2021. Methodology: Descriptive, cross-sectional study. Population: parents or guardians of children with incomplete schemes. Data collection through a survey validated in a pilot test. The data captured in a matrix were subjected to descriptive analysis. It was endorsed by the Ethics Committee. Results: The sample was integrated with 53 units of analysis. Mean age 28 years; 79% were mothers; 62% already had two or more children; 74% were single; 47% had not completed secondary or primary school; most were unemployed or received social plans. 66% thought that vaccines cured diseases; 89% prevented them and 89% thought they were safe. Sources of information: the medical and nursing team, 17% from family or friends, 30% on the internet or the media. In non-compliance reasons, the most frequent lack of vaccines (31%), parent or guardian work schedules (15%), infant diseases (10%). Conclusion: The information on vaccines was provided by the health team, families and the media. Although they claimed that they prevented diseases and were safe, many maintained that they cured diseases. Reasons for non-compliance were noted as lack of vaccines, work schedules of the interviewees and illnesses of the minor, time restrictions of the vaccination and those given by the pandemic[AU]


Descrever e identificar os motivos pelos quais os pais ou responsáveis não completaram o calendário de vacinação infantil em um Centro de Atenção Primária à Saúde da Cidade de Corrientes no ano de 2021. Metodologia: Estudo descritivo, transversal. População: pais ou responsáveis de crianças com esquemas incompletos. Coleta de dados por meio de questionário validado em teste piloto. Os dados capturados em uma matriz foram submetidos à análise descritiva. Foi aprovado pelo Comitê de Ética. Resultados: A amostra foi integrada com 53 unidades de análise. Idade média 28 anos; 79% eram mães; 62% já tinham dois ou mais filhos; 74% eram solteiros; 47% não concluíram o ensino médio ou fundamental; a maioria estava desempregada ou recebia planos sociais. 66% achavam que as vacinas curavam doenças; 89% os preveniram e 89% acharam que eram seguros. Fontes de informação: equipe médica e de enfermagem, 17% de familiares ou amigos, 30% na internet ou na mídia. Nos motivos de não conformidade, a falta de vacinas mais frequente (31%), horários de trabalho dos pais ou responsáveis (15%), doenças infantis (10%). Conclusão: As informações sobre vacinas foram fornecidas pela equipe de saúde, famílias e mídia. Embora afirmassem que preveniam doenças e eram seguros, muitos sustentavam que curavam doenças. Os motivos da não adesão foram apontados como falta de vacinas, horários de trabalho dos entrevistados e doenças do menor, restrições de horário da vacinação e as dadas pela pandemia[AU]


Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde , Atitude Frente a Saúde , Poder Familiar , Programas de Imunização , Cooperação e Adesão ao Tratamento , Estudos Transversais
14.
BMC Health Serv Res ; 22(1): 653, 2022 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-35578203

RESUMO

BACKGROUND: Seasonal influenza vaccination of healthcare workers (HCW) is widely recommended to protect staff and patients. A previous systematic review examined interventions to encourage uptake finding that hard mandates, such as loss of employment for non-vaccination, were more effective than soft mandates, such as signing a declination form, or other interventions such as incentives. Despite these overarching patterns the authors of the review concluded that 'substantial heterogeneity' remained requiring further analysis. This paper reanalyses the evidence using Intervention Component Analysis (ICA) and Qualitative Comparative Analysis (QCA) to examine whether the strategies used to implement interventions explain the residual heterogeneity. METHODS: We used ICA to extract implementation features and trialists' reflections on what underpinned the success of the intervention they evaluated. The ICA findings then informed and structured two QCA analyses to systematically examine associations between implementation features and intervention outcomes. Analysis 1 examined hard mandate studies. Analysis 2 examined soft mandates and other interventions. RESULTS: In Analysis 1 ICA revealed the significance of 'leading from the front' rather than 'top-down' implementation of hard mandates. Four key features underpinned this: providing education prior to implementation; two-way engagement so HCW can voice concerns prior to implementation; previous use of other strategies so that institutions 'don't-go-in-cold' with hard-mandates; and support from institutional leadership. QCA revealed that either of two configurations were associated with greater success of hard mandates. The first involves two-way engagement, leadership support and a 'don't-go-in-cold' approach. The second involves leadership support, education and a 'don't-go-in-cold' approach. Reapplying the 'leading from the front' theory in Analysis 2 revealed similar patterns. CONCLUSIONS: Regardless of intervention type a 'leading from the front' approach to implementation will likely enhance intervention success. While the results pertain to flu vaccination among HCWs, the components identified here may be relevant to public health campaigns regarding COVID-19 vaccination.


Assuntos
COVID-19 , Vacinas contra Influenza , Influenza Humana , Vacinas contra COVID-19 , Pessoal de Saúde , Humanos , Influenza Humana/prevenção & controle , Revisões Sistemáticas como Assunto , Vacinação
15.
Saúde Redes ; 8(1): 69-83, 20220510.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1377996

RESUMO

Objetivo: descrever a compreensão de território por farmacêuticos que atuam na Atenção Básica. Métodos: Foram realizadas entrevistas com farmacêuticos alocados nas farmácias públicas de um município do Sul do Brasil. As entrevistas foram transcritas e analisadas por meio de análise temática de conteúdo. Resultados: Entrevistou-se treze farmacêuticos. As categorias temáticas elaboradas foram: território aprisionante, território distante e território desconhecido. Os resultados evidenciaram a atuação predominante do profissional como responsável pela gestão dos serviços farmacêuticos. A atuação profissional é dependente de recursos humanos e materiais adequados e da priorização de políticas de gestão voltadas à área da assistência farmacêutica. Conclusão: A compreensão do território nos serviços farmacêuticos da Atenção Básica à Saúde estabelece formas de atuação adequadas para tais serviços, no contexto dos 5.570 municípios contemplados na Política Nacional de Assistência Farmacêutica, conforme o preconizado na Lei 8.080/90.

16.
Int J Health Plann Manage ; 37(4): 1918-1925, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35384032

RESUMO

Vaccination is an important and cost-effective disease prevention and control strategy. Over the years, milestone discoveries in vaccine research and development as well as vaccine delivery systems, have contributed to expanded immunisation coverage and reduction in morbidity and mortality associated with vaccine-preventable diseases. While this outstanding development in vaccine delivery continues, there are considerable gaps in access to vaccines among populations living in fragile and conflict-affected zones which appeared to be the fault line of limited vaccine coverage. Despite progress in coronavirus disease 2019 (COVID-19) vaccine development, there are concerns about the feasibility of African countries affected by armed conflict and violence to effectively deliver COVID-19 vaccines at the unprecedented level required to fight against the virus. In this article we discuss the feasibility of access to COVID-19 vaccine among populations in conflict affected areas in Nigeria including methods that can be applied to reach and vaccinate populations in these settings.


Assuntos
COVID-19 , Vacinas , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Humanos , Nigéria , Vacinação
17.
J Dermatol ; 49(7): 732-735, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35373396

RESUMO

Skin disorders are frequent adverse events after coronavirus disease 2019 (COVID-19) vaccination. However, the pathogenesis of these disorders is not fully understood. Here, we report a case series of cutaneous adverse events following COVID-19 vaccination, and the results of our investigation reveal the underlying mechanism. Case 1: a 47-year-old female developed a wheal, confined to the COVID-19 vaccination site, 2 days after her first injection. She was treated with topical steroids and oral antihistamines. Case 2: a 51-year-old female showed generalized petechial erythema accompanied by fever, genital bleeding, thrombocytopenia, liver dysfunction, and disseminated intravascular coagulation, 2 days after her second injection. She was diagnosed with vaccine-induced macrophage activation syndrome and treated with anti-inflammatory therapy. Immunohistological analysis of the skin eruption, in both these cases, showed infiltration of CD123+ BDCA2+ plasmacytoid dendritic cells (p-DC). Despite the distinctive clinical features in these two cases, this finding suggests that p-DC might be involved in different cutaneous adverse events after COVID-19 vaccination.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Células Dendríticas , Eritema , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Eritema/induzido quimicamente , Feminino , Humanos , Pessoa de Meia-Idade , Vacinação/efeitos adversos
18.
J Pediatr ; 247: 150-154.e1, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35447123

RESUMO

Pediatric primary care is a trusted source for treatment and information. In the 6 months after coronavirus disease 2019 vaccines became available for adolescents, we administered 2286 doses (1270 to patients; 1016 to household members) to 1376 individuals (64.1% Black; 10.1% Latinx), providing opportunities to address family concerns in a familiar location.


Assuntos
COVID-19 , Vacinas , Adolescente , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Criança , Humanos , Atenção Primária à Saúde , Vacinação
19.
BMJ Case Rep ; 15(3)2022 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-35236680

RESUMO

Exacerbation of rheumatic disease after vaccination against SARS-CoV-2 is being reported. However, there are only a few cases of new-onset rheumatic diseases. We present two cases of new-onset persistent polyarthritis that developed in patients after receiving the mRNA vaccine against SARS-CoV-2. One patient had bilateral pleural effusions with markedly elevated serum interferon (IFN)-ß, while the other had no effusion, with serum IFN-ß comparable with that in healthy subjects. Other cytokines were unaltered in association with effusion. Both patients responded well to treatment with 20 mg prednisolone. Although more investigations are needed, the marked increase in serum IFN-ß levels observed in the case with pleural effusion may reflect an excessive response from the innate immune system to mRNA vaccines.


Assuntos
Artrite , COVID-19 , Pleurisia , Anticorpos Antivirais , Vacinas contra COVID-19/efeitos adversos , Humanos , Interferon beta , Pleurisia/etiologia , RNA Mensageiro , SARS-CoV-2 , Vacinação , Vacinas Sintéticas
20.
Ciênc. Saúde Colet. (Impr.) ; 27(3): 1191-1203, mar. 2022. tab
Artigo em Português | LILACS | ID: biblio-1364689

RESUMO

Resumo Estudo transversal da disponibilidade de medicamentos prescritos na Atenção Primária, com amostra probabilística de 1221 usuários das farmácias públicas de município polo de saúde em Minas Gerais, em 2017. Foram estimados indicadores de disponibilidade dos medicamentos e realizou-se regressão logística hierárquica, segundo o modelo comportamental de uso de serviços de saúde. Apenas 39,3% dos usuários receberam todos os medicamentos nas quantidades prescritas. Os medicamentos mais e menos disponíveis foram, respectivamente, os que atuam no sistema digestivo/metabolismo, e no sangue e órgãos hematopoiéticos. A disponibilidade integral do tratamento se mostrou associada a mais escolaridade (≥ 8 anos OR: 1,7; IC 95%: 1,3-2,4); proximidade até a farmácia (≤15 min OR: 1,7; IC 95%: 1,2-2,3); ausência de gastos privados com medicamentos (OR: 2,2; IC 95%: 1,7-2,9) e menor número de medicamentos prescritos (≤ 2 OR: 3,2; IC 95%: 2,3-4,4; 3/4 OR: 1,6; IC 95%: 1,2-2,1). Esses resultados mostram diferenças na disponibilidade de medicamentos dentro do SUS, evidenciando a necessidade de reorganização da rede de atendimento dos serviços de dispensação e do planejamento das aquisições de medicamentos, além da proposição de políticas públicas que priorizem a população mais vulnerável.


Abstract This is a cross-sectional study on the availability of prescribed medicines in Primary Health Care (PHC), with a probabilistic sample of 1,221 users of public pharmacies in a health pole municipality in Minas Gerais, in 2017. Medicine availability indicators were estimated, and a hierarchical logistic regression was performed, according to the behavioral model of health service use. Only 39.3% of patients received all medicines in the prescribed quantities. The most and the least available medicines were, respectively, those for the digestive system/metabolism, and for blood and hematopoietic organs. Full availability of the prescribed treatment was associated with higher schooling (≥ 8 years OR: 1.7; 95% CI: 1.3-2.4); proximity to the pharmacy (≤15 min OR: 1.7; 95% CI: 1.2-2.3); absence of out-of-pocket expenditure on medicines (OR: 2.2; 95% CI: 1.7-2.9), and a smaller number of prescription drugs (≤ 2 OR: 3.2; 95% CI: 2.3-4.4; 3/4 OR: 1.6; 95% CI: 1.2-2.1). These results showed differences in medicine availability within the Brazilian Unified Health System (SUS), and highlighted the need to reorganize the dispensing services network and pharmaceutical procurement planning, as well as to develop public policies to protect the vulnerable population.


Assuntos
Humanos , Farmácias , Assistência Farmacêutica , Medicamentos sob Prescrição , Atenção Primária à Saúde , Estudos Transversais
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA