Fluoride concentration in teas derived from Camellia Sinensis produced in Argentina.

To evaluate the fluoride concentration and pH of tea derived from Camellia sinensis produced and commercialized in Argentina. Forty-eight varieties of tea (black (n = 16), green (n = 21), red (n = 7), and white (n = 4)) commercialized in the form of leaves or tea bags were acquired. One bag or 2.0 ± 0.05 g of each product was infused for 5 min in 200 mL of distilled boiled water. The F- concentration was determined using an ion-selective electrode and pH was measured using a pH meter. The found fluoride concentrations ranged from 0.1 to 9.7 µg/mL and the pH ranged from 2.7 to 5.1. A higher fluoride concentration was observed in the leaves group (2.75 ± 2.65 µg/mL) compared to tea bags (1.10 ± 0.82 µg/mL) (p < 0.05). Regarding the type of tea, green and black tea were richer in F- than red and white tea. Fluoride and pH appeared not to be correlated (Pearson test). All the studied tea samples presented fluoride concentrations greater than the threshold recommended for drinking water. The pH proved to be low, which could be a risk for erosive tooth wear.

Inhibition of Staphylococcus aureus TetK and MsrA efflux pumps by hydroxyamines derived from lapachol and norlachol.

The present study aimed to evaluate the in vitro efflux pump inhibitory capacity of hydroxyamines derived from lapachol and norlachol, where compounds 3, 4, and 5 were tested against the S. aureus strains: RN4220 carrying the pUL5054 plasmid; and IS-58, endowed with the PT181 plasmid. The substances were synthesized from 2-hydroxy-quinones, lapachol and nor-lapachol obtaining the corresponding 2-methoxylated derivatives via dimethyl sulfate alkylation in a basic medium, which then reacted chemoselectively with 2-ethanolamine and 3-propanolamine to form the corresponding amino alcohols. The antibacterial action of the substances was quantified by determining the Minimum Inhibitory Concentration (MIC), while a microdilution assay was carried out to ascertain efflux pump inhibition of Staphylococcus aureus strains carrying the MsrA macrolide and the TetK tetracycline efflux pumps with the substances at a sub-inhibitory concentration. The results were subjected to statistical analysis by an ANOVA test and Bonferroni post hoc test. The MIC from the substances exhibited a value ≥ 1024 µg/mL. However, a significant reduction (p < 0.0001) of the erythromycin, tetracycline and ethidium bromide MIC was demonstrated when these were in combination with the substances, with this effect being due to a supposed efflux pump inhibition. The tested substances demonstrated effectiveness at decreasing the MIC of erythromycin, tetracycline and ethidium bromide, potentially by inhibiting the MsrA macrolide and the TetK tetracycline efflux pumps present in the tested S. aureus strains.

The neuroprotective effect of Riparin IV on oxidative stress and neuroinflammation related to chronic stress-induced cognitive impairment.

BACKGROUND: Cognitive impairment is identified as one of the diagnostic criteria for major depressive disorder and can extensively affect the quality of life of patients. Based on these findings, this study aimed to investigate the possible effects of Riparin IV (Rip IV) on cognitive impairment induced by chronic administration of corticosterone in mice. METHODS: Female Swiss mice were divided into four groups: control (Control), corticosterone (Cort), Riparin IV (Cort + Rip IV), and Fluvoxamine (Cort + Flu). Three groups were administered corticosterone (20 mg/kg) subcutaneously during the 22-day study, while the control group received only vehicle. After the 14th day, the groups were administered medications: Riparin IV (Rip IV), fluvoxamine (Flu), or distilled water, by gavage, 1 h after the subcutaneous injections. After treatment, mice underwent behavioral testing, and brain areas were removed for oxidative stress and cytokine content assays. RESULTS: The results revealed that Cort-treated mice developed a cognitive impairment and exhibited a neuroinflammatory profile with an oxidative load and Th1/Th2 cytokine imbalance. Rip IV treatment significantly ameliorated the cognitive deficit induced by Cort and displayed a neuroprotective effect. CONCLUSION: The antidepressant-like ability of Rip IV treatment against chronic Cort-induced stress may be due to its potential to mitigate inflammatory damage and oxidative stress. The antioxidant and anti-inflammatory effect observed indicates Rip IV as a possible drug for antidepressant treatment of non-responsive patients with severe and cognitive symptoms.

Exploring the neuroprotective potential of antimicrobial peptides from Dinoponera quadriceps venom against pentylenetetrazole-induced seizures in vivo.

Epilepsy affects around 50 million people worldwide and 30% of patients have difficulty controlling the disease. The search for substances that can fill the existing gaps in the treatment of epilepsy is of great importance. Arthropod venoms are promising sources for this purpose due to the presence of small peptides that modulate the activity of ion channels and neuron receptors. The aim of this study was to investigate dinoponeratoxins from the Dinoponera quadriceps ant venom (M-PONTX-Dq3a, M-PONTX-Dq3b and M-PONTX-Dq3c) as potential anticonvulsants. We evaluated them in a seizure model induced by pentylenetetrazole (PTZ) in male swiss mice. Interestingly, intraperitoneal treatment with each peptide increased the time until the first seizure and the percentage of survival, with M-PONTX-Dq3b showing the best results. M-PONTX-Dq3a was discarded due to the appearance of some signs of toxicity with the increase in malondialdehyde (MDA) levels in the striatum. Both, M-PONTX-Dq3b and M-PONTX-Dq3c decreased iNOS and TNF-α in the hippocampus. Notably, M-PONTX-Dq3c treatment decreased the levels of MDA and nitrite in the cortex and hippocampus. Our results indicate that, M-PONTX-Dq3b and M-PONTX-Dq3c have anticonvulsant activity and exhibit anti-inflammatory effects in epilepsy, offering new perspectives for biopharmaceutical development.

Salivary Fluoride Bioavailability after Brushing with Brazilian Red Propolis Dentifrice: A Clinical Study.

INTRODUCTION: Fluoride plays an important role in the control of dental caries, and currently new dentifrices are being associated with natural products. OBJECTIVE: This study aimed to evaluate the availability of fluoride in saliva samples after using a dentifrice incorporated with Brazilian red propolis (BRP, INPI Patent no. BR1020170110974) and to compare it to a conventional fluoridated dentifrice in healthy participants. METHODS: This study was conducted implementing a double-blind, randomized, controlled, and crossover design. Saliva samples of participants were collected at the following time points: 0 at baseline and 5, 15, 30, 45, and 60 minutes after brushing with each dentifrice. Salivary fluoride concentrations showed no statistically significant difference when comparing the two treatments (p > 0.05). All available fluoride concentrations in saliva decreased after one hour, with no significant difference between BRP and conventional fluoridated dentifrice treatment samples (p > 0.05). RESULTS: The results showed that there was no difference between the analyzed fluoride concentrations 1 hour after brushing with the different dentifrices. CONCLUSIONS: The results of this study suggest that the propolis incorporated in the dentifrice did not interfere with the kinetics and bioavailability of the fluoride ion in saliva samples, enabling its integration with the pharmaceutical formula and thereby promoting its anti-inflammatory and antimicrobial benefits without compromising the anticaries activity of the formulation.

The contributions of antioxidant activity of lipoic acid in reducing neurogenerative progression of Parkinson's disease: a review.

ABSTRACT This work reviews the evidence of the mechanism of neuronal degeneration in Parkinson's disease (PD) and the neuroprotective effect of lipoic acid and its use in the treatment of PD. PD is characterized by slow and progressive degeneration of dopaminergic neurons of the substantia nigra pars compacta, leading to reduction of the striatal dopaminergic terminals. It is known that several factors influence neuronal damage. Among these factors, oxidative stress, immune system activity, microglial cells, and apoptotic mechanisms are of major importance. Currently, several antioxidants have been studied with the aim of reducing/slowing the progression of neurodegenerative processes. Lipoic acid is considered a universal antioxidant because it is an amphipathic substance. Lipoic acid and its reduced form, dihidrolipoic acid, act against reactive oxygen species, reducing oxidative stress. Therefore, this antioxidant has been used in the treatment of many diseases, including a new perspective for the treatment of Parkinson's disease.

Antimicrobial Efficacy of Propolis-Containing Varnish in Children: A Randomized and Double-Blind Clinical Trial.

Dental caries is a sugar-dependent condition common in childhood, which causes microbiological imbalance in dental biofilm. The present study evaluated the antimicrobial efficacy of a 2.5% Brazilian Red Propolis (BRP) dental varnish to prevent caries in children. Seventy-five children with high caries risk, aged between 36 and 71 months and with no caries, were assigned to three groups to receive varnish treatment containing 2.5% BRP, 1% chlorhexidine, or 5% fluoride. The varnish was applied to the occlusal surfaces of the deciduous second molars on the first day of treatment (D1), after 90 days (D90), and 180 days of the start of treatment (D180). Saliva was collected to assess S. mutans before each varnish application and 180 days at the end of treatment (D360). Values were expressed in log10 (CFU/mL). Statistics were performed by applying repeated measures of variance analysis, Tukey's multiple comparisons test, and paired t-test. In the first dilution (1 : 10), there was microbial load reduction at the following periods: BRP in D0-D90 (p < 0.05) and D0-D180 (p < 0.01); fluoride in D0-D90 (p < 0.001); and chlorhexidine in D0-D180 (p < 0.05). In the second dilution (1 : 100), there was microbial load reduction in the groups at the following periods: BRP in D0-D90 (p < 0.05) and D0-D180 (p < 0.01); fluoride in D0-D180 (p < 0.05), and chlorhexidine in D0-180 (p < 0.01) and D0-360 (p < 0.05). The 2.5% BRP dental varnish was effective in decreasing S. mutans colonies in saliva when used within 90 days.

Camellia sinensis in Dentistry: Technological Prospection and Scientific Evidence.

PURPOSE: This study aimed to evaluate reports of patents for oral care formulations, based on Camellia sinensis (C. sinensis), deposited and granted in intellectual property banks. METHODS: A survey was conducted through collection, treatment, and analysis of extracted information from patent reports selected. The documentary research was conducted in January 2021 on formulations with C. sinensis for dental applications, including since the first patent deposits until the current time. The risk of bias of clinical trials with these formulations was analyzed to verify the scientific evidence. The data extracted represent the distribution of the number of patents by banks, annual evolution of patent deposits, applicant of patents by country, distribution of patents according to International Patent Classification codes, and the types of patented products. RESULTS: Data and information from 20 selected patents were extracted. The United States Patent and Trademark Office (USPTO) and World Intellectual Property Organization (WIPO) were the banks with the largest number of patents for products/formulations with C. sinensis for oral care applications with 7 (35%) and 6 (30%) patent registrations, respectively. Other banks did not provide patents related to the search. Patents of compositions were the largest with 14 filings, and the remainder of formulations are represented specially by mouthwashes and toothpastes. As for clinical application, 18 patents were filed as products with antimicrobial and antibiofilm action, while 2 patents are directed to the treatment of xerostomia. In general, the aspects of the studies of clinical efficacy pointed to a low risk of bias. CONCLUSION: The study pointed out a small number of products protected by patents for Camellia sinensis for oral care indication, highlighting mainly mouthwash compositions and formulations. In the methodological parameters of clinical trials carried out with the formulations, the majority pointed out a low risk of bias.

Clinical and Antimicrobial Evaluation of Copaifera langsdorffii Desf. Dental Varnish in Children: A Clinical Study.

BACKGROUND: The objective of this study was to evaluate the clinical and microbiological efficacies of (C. langsdorffii) dental varnish in children at high risk of dental caries.. METHODS: This is a longitudinal, randomized, controlled clinical trial. Ninety high-risk caries-free children (ICDAS II = 0) were recruited and randomly divided into three groups: C. langsdorffii, chlorhexidine, or fluoride. The varnishes were applied on the second deciduous molars for three times: baseline (D0), after 90 days (D90), and after 180 days (D180). Saliva was collected on D0, D90, D180, and D360 to evaluate S. mutans reduction. Statistics were carried out by ANOVA, Tukey's test, and the paired t-test. RESULTS: Copaiba varnish demonstrated significant S. mutans reduction: D360 versus D0 (p < 0.0001), D180 versus D0 (p < 0.001), D360 versus D90 (p < 0.001), D180 versus D90 (p < 0.001), and D360 versus D180 (p < 0.05). Chlorhexidine varnish significantly reduced S. mutans at D180 versus D0 (p < 0.05). Fluoride reduced at D180 versus D0 (p < 0.001). CONCLUSIONS: Three annual applications of this varnish showed substantial antimicrobial activity against S. mutans and caries prevention for up to 12 months.

Is Riparin III a promising drug in the treatment for depression?

Stress is crucially related to the pathophysiology of mood disorders, including depression. Since the effectiveness and number of the current pharmacological options still presents significant limitations, research on new substances is paramount. In rodents, several findings have indicated that corticosterone administration induces the manifestation of behavioral and neurochemical aspects of depression. Recently, riparin III has shown antidepressant-like properties in trials performed on animal models. Thus, our goal was to investigate the effects of riparin III on behavioral tests, monoamines levels, oxidative stress and cytokines levels in chronic corticosterone-induced model of depression. To do this, female swiss mice were treated with subcutaneous administration of corticosterone for 22 days. In addition, for the last 10 days, riparin III or fluvoxamine were also administered per os in specific test groups. Control groups received subcutaneous saline injections or distilled water per os. At the end of the timeline, the animals were killed and their hippocampi, prefrontal cortex, and striatum dissected for neurochemical analysis. Brain changes following corticosterone administration were confirmed, and riparin III could reversed the most abnormal behavioral and neurochemical corticosterone-induced alterations. These results suggest the potential antioxidant, anti-inflammatory and antidepressant effects of riparin III after a chronic stress exposure.

Melatonin: pharmacological aspects and clinical trends.

Melatonin, N-acetyl-5-methoxytryptamine, the major hormone produced by the pineal gland under the influence of the dark/light cycle, has been shown to have a large number of therapeutic possibilities. It has been utilized in several countries for circadian rhythm disorders, sleep disturbances, jet lag, and sleep-wake cycle disturbances in blind people, and shift workers. In our mechanism of act, the G(i) protein-coupled metabotropic melatonin receptors MT1 and MT2 are the primary mediators of the physiological actions of melatonin. This hormone plays an important role in the regulation of physiological and neuroendocrine functions, such as synchronization of seasonal reproductive rhythms and entrainment of circadian cycles. In addition to its chronobiological role, several pharmacological effects of melatonin have been reported in mammals including sedative, antioxidant, anxiolytic, antidepressant, anticonvulsant, and analgesic activities. There is some evidence from clinical trials that melatonin can be helpful in that event. Current trends of pharmacological functions of melatonin pointed out its use in the treatment of neurodegenerative and neoplastic diseases. These effects and uses of melatonin are mentioned but further confirmatory studies are needed in most of them.

Hospital Cost of Complications After Kidney Transplant.

BACKGROUND: Kidney transplant is considered the best treatment of rehabilitation for chronic kidney disease, but clinical and/or surgical complications may occur after transplant. The study aimed to assess the cost of complications after kidney transplant. MATERIALS AND METHODS: This is a descriptive, retrospective, and exploratory study that used data from Hospital Information System ("Sistema de Informação Hospitalar"). We identified the patients with records of kidney transplant in the states of northern and northeastern Brazil in 2013. These patients were followed up through the records, specifically from 2013 to 2017. The variables analyzed were sex, age, and period after transplant of readmissions (early, intermediate, or late), the main complications within 4 years after the kidney transplant, and cost of hospital admissions. RESULTS: There were 893 patients with records of kidney transplant in the regions of the study. During the follow-up period, 319 patients had complications. Most hospital readmissions involved male patients (63.6%; n = 203). Mean age was 45 (SD, 15.14) years. Patients developed complications mainly in the early period after transplant (70.22%; n = 224). The number of hospital admissions was 758. The main complications were regarding urinary tract (72.02%; n = 546), infections (19.79%; n = 150), and vascular and/or pulmonary (2.90%; n = 22). The total cost for the treatment of these complications was US $528,329.51. CONCLUSIONS: By analyzing the data it was possible to identify that there is a significant cost involved in the treatment of complications after kidney transplant.

Clinical and Microbiological Evaluation of Brazilian Red Propolis Containing-Dentifrice in Orthodontic Patients: A Randomized Clinical Trial.

AIM: To evaluate the efficacy of dentifrice containing brazilian red propolis (BRP) in adolescents under orthodontic treatment. Materials and Methods. This is a randomized, double-blind, clinical trial. A total of 92 participants free from caries were randomized into 2 groups; the first received fluoride dentifrice, and the second received fluoride dentifrice incorporated with BRP. The gingival bleeding index (GBI) was recorded, and saliva was collected on the baseline (D0) and after 28 days (D28) for microbiological analysis. Data from GBI and Colony Forming Units (CFU) (log10) were expressed as mean and standard deviation. RESULTS: The two groups reduced GBI significantly, with no difference in the intergroup analysis. In the intragroup analysis, it was observed that G2 (p < 0.001) had a significant reduction for Gram-negative bacteria, while there was significance (p < 0.001) had a significant reduction for Gram-negative bacteria, while there was significance (S. mutans bacteria, it was observed that only G2 had a statistically significant reduction (p < 0.001) had a significant reduction for Gram-negative bacteria, while there was significance (p < 0.001) had a significant reduction for Gram-negative bacteria, while there was significance (. CONCLUSIONS: Dentifrice containing BRP demonstrated better clinical and microbiological activity. Future studies are needed to better identify effects to establish the use of dentifrice containing propolis in biofilm control.

High Exploratory Phenotype Rats Exposed to Environmental Stressors Present Memory Deficits Accompanied by Immune-Inflammatory/Oxidative Alterations: Relevance to the Relationship Between Temperament and Mood Disorders.

Low-exploratory (LE) and high-exploratory (HE) rodents mimic human depressive and hyperthymic temperaments, respectively. Mood disorders (MD) may be developed by the exposure of these temperaments to environmental stress (ES). Psychiatric symptoms severity in MD patients is related to the magnitude of memory impairment. Thus, we aimed at studying the consequences of the exposure of LE and HE male Wistar rats, during periadolescence, to a combination of ES, namely, paradoxical sleep deprivation (PSD) and unpredictable stress (US), on anxiety-related behavior in the plus maze test, working (WM) and declarative memory (DM) performance. We also evaluated hippocampal immune-inflammatory/oxidative, as consequences of ES, and prevention of ES-induced alterations by the mood-stabilizing drugs, lithium and valproate. Medium exploratory (ME) control rats were used for comparisons with HE- and LE-control rats. We observed that HE-controls presented increased anxiolytic behavior that was significantly increased by ES exposure, whereas LE-controls presented increased anxiety-like behavior relative to ME-controls. Lithium and valproate prevented anxiolytic alterations in HE+ES rats. HE+ES- and LE+ES-rats presented WM and DM deficits. Valproate and lithium prevented WM deficits in LE-PSD+US rats. Lithium prevented DM impairment in HE+ES-rats. Hippocampal levels of reduced glutathione (GSH) increased four-fold in HE+ES-rats, being prevented by valproate and lithium. All groups of LE+ES-rats presented increased levels of GSH in relation to controls. Increments in lipid peroxidation in LE+ES- and HE+ES-rats were prevented by valproate in HE+ES-rats and by both drugs in LE+ES-rats. Nitrite levels were increased in HE+ES- and LE+ES-rats (five-fold increase), which was prevented by both drugs in LE+ES-rats. HE+ES-rats presented a two-fold increase in the inducible nitric oxide synthase (iNOS) expression that was prevented by lithium. HE+ES-rats showed increased hippocampal and plasma levels of interleukin (IL)-1ß and IL-4. Indoleamine 2, 3-dioxygenase 1 (IDO1) was increased in HE+ES- and LE+ES-rats, while tryptophan 2,3-dioxygenase (TDO2) was increased only in HE+ES-rats. Altogether, our results showed that LE- and HE-rats exposed to ES present distinct anxiety-related behavior and similar memory deficits. Furthermore, HE+ES-rats presented more brain and plasma inflammatory alterations that were partially prevented by the mood-stabilizing drugs. These alterations in HE+ES-rats may possibly be related to the development of mood symptoms.

Prevalence and characteristics of adverse drug events in Brazil. / Prevalência e características dos eventos adversos a medicamentos no Brasil.

The aim of this study was to describe the prevalence of adverse drug events (ADEs) and associated factors reported by users of medicines in Brazil. This was a cross-sectional population-based study conducted from September 2013 to February 2014 with data from the Brazilian National Survey on Access, Use, and Promotion of Rational Use of Medicines (PNAUM). The study included all individuals that reported the use of medicines and identified, among them, all those reporting at least one problem with the medicine's use. A descriptive analysis was performed to estimate ADE prevalence and 95% confidence intervals (95%CI) among the target variables. Crude and adjusted prevalence ratios were calculated using Poisson regression to investigate factors associated with ADEs. Overall ADE prevalence in Brazil was 6.6% (95%CI: 5.89-7.41), and after multivariate analysis, higher prevalence was associated with female gender, residence in the Central and Northeast regions, consumption of more medicines, "bad" self-rated health, and self-medication. The drugs most frequently reported with ADEs were fluoxetine, diclofenac, and amitriptyline. The most frequent ADEs were somnolence, epigastric pain, and nausea. Most reported ADEs were mild, avoidable, and associated with medicines used frequently by the population. The study provided knowledge on the size of the problem with use of medicines in Brazil.

O presente trabalho tem como objetivo descrever a prevalência e fatores associados a eventos adversos a medicamentos (EAM) referidos por usuários de medicamentos no Brasil. Trata-se de um estudo transversal de base populacional, realizado no período de setembro de 2013 a fevereiro de 2014, com dados coletados na Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM). Foram consideradas todas as pessoas que referiram o uso de medicamentos; entre elas, foram identificadas as que referiram pelo menos um problema com o uso do medicamento. Realizou-se uma análise descritiva para estimar a prevalência e os intervalos de 95% de confiança (IC95%) de EAM entre as variáveis estudadas, e foram calculadas as razões de prevalência bruta e ajustada, pela regressão de Poisson, na investigação dos fatores associados aos EAM. A prevalência de EAM no Brasil foi de 6,6% (IC95%: 5,89-7,41), sendo maior e estatisticamente significante após a realização da análise multivariada, entre pessoas do sexo feminino; residentes nas regiões Centro-oeste e Nordeste; que consumiam maior número de medicamentos; que percebiam seu estado de saúde como "ruim"; e que se automedicavam. Os EAM foram mais relatados para os medicamentos fluoxetina, diclofenaco e amitriptilina. Os EAM mais referidos pelos entrevistados foram sonolência, dor epigástrica e náuseas. Os EAM mais referidos pelos entrevistados foram de natureza leve, considerados evitáveis e estiveram associados a medicamentos de uso frequente pela população. Em razão desse estudo, foi possível conhecer a dimensão do problema ocasionado pelo uso de medicamentos no Brasil.

El presente trabajo tiene como objetivo describir la prevalencia y factores asociados a eventos adversos con medicamentos (EAM), informados por usuarios de medicamentos en Brasil. Se trata de un estudio transversal de base poblacional, realizado durante el período de septiembre de 2013 a febrero de 2014, con datos recogidos en la Encuesta Nacional sobre el Acceso, Utilización y Promoción del Uso Racional de Medicamentos en Brasil (PNAUM). Se consideraron a todas las personas que informaron del uso de medicamentos; entre ellas, se identificaron a las que informaron de por lo menos un problema con el uso del medicamento. Se realizó un análisis descriptivo para estimar la prevalencia y los intervalos de confianza a 95% (IC95%) de EAM entre las variables estudiadas, y se calcularon las razones de prevalencia bruta y ajustada, por la regresión de Poisson, en la investigación de los factores asociados a los EAM. La prevalencia de EAM en Brasil fue de un 6,6% (IC95%: 5,89-7,41), siendo mayor y estadísticamente significante tras la realización del análisis multivariado, entre personas del sexo femenino; residentes en las regiones Centro-Oeste y Nordeste; que consumían un mayor número de medicamentos; que percibían su estado de salud como "malo"; y que se automedicaban. Se informaron de más EAM en medicamentos como: fluoxetina, diclofenaco y amitriptilina. Los EAM más referidos por los entrevistados fueron somnolencia, dolor epigástrico y náuseas. Los EAM más referidos por los entrevistados fueron de naturaleza leve, considerados evitables y estuvieron asociados a medicamentos de uso frecuente por la población. Con motivo de este estudio, fue posible conocer la dimensión del problema ocasionado por el uso de medicamentos en Brasil.

Knowledge, skills and attitudes of hospital pharmacists in the use of information technology and electronic tools to support clinical practice: A Brazilian survey.

This study aimed to identify the knowledge, skills and attitudes of Brazilian hospital pharmacists in the use of information technology and electronic tools to support clinical practice. METHODS: A questionnaire was sent by email to clinical pharmacists working public and private hospitals in Brazil. The instrument was validated using the method of Polit and Beck to determine the content validity index. Data (n = 348) were analyzed using descriptive statistics, Pearson's Chi-square test and Gamma correlation tests. RESULTS: Pharmacists had 1-4 electronic devices for personal use, mainly smartphones (84.8%; n = 295) and laptops (81.6%; n = 284). At work, pharmacists had access to a computer (89.4%; n = 311), mostly connected to the internet (83.9%; n = 292). They felt competent (very capable/capable) searching for a web page/web site on a specific subject (100%; n = 348), downloading files (99.7%; n = 347), using spreadsheets (90.2%; n = 314), searching using MeSH terms in PubMed (97.4%; n = 339) and general searching for articles in bibliographic databases (such as Medline/PubMed: 93.4%; n = 325). Pharmacists did not feel competent in using statistical analysis software (somewhat capable/incapable: 78.4%; n = 273). Most pharmacists reported that they had not received formal education to perform most of these actions except searching using MeSH terms. Access to bibliographic databases was available in Brazilian hospitals, however, most pharmacists (78.7%; n = 274) reported daily use of a non-specific search engine such as Google. This result may reflect the lack of formal knowledge and training in the use of bibliographic databases and difficulty with the English language. The need to expand knowledge about information search tools was recognized by most pharmacists in clinical practice in Brazil, especially those with less time dedicated exclusively to clinical activity (Chi-square, p = 0.006). CONCLUSION: These results will assist in defining minimal competencies for the training of pharmacists in the field of information technology to support clinical practice. Knowledge and skill gaps are evident in the use of bibliographic databases, spreadsheets and statistical tools.

Drugs via enteral feeding tubes in inpatients: dispersion analysis and safe use of dispensers.

OBJECTIVE: This study aimed to improve knowledge about drug administration through enteral feeding tubes (EFTs) in order to minimize efficacy and safety problems. MATERIAL AND METHODS: The study was performed in a public secondary care hospital with level II accreditation by the National Accreditation Organization (Organização Nacional de Acreditação ONA), in Fortaleza, Ceará, north-eastern Brazil. RESULTS: One hundred and eight oral solid medications that could be administered through EFTs and were not available in liquid forms were evaluated via transformation of their solid dosage forms into liquid forms. Dispersion times and conditions were assessed to determine which medications should be crushed. We compared the use of dispensers and syringes and their connections to enteral feeding tubes and intravenous devices. Medications whose dispersion occurred within 20 minutes and could be visually perceived and whose content could be expelled without occluding the oral syringe were considered "satisfactory". CONCLUSIONS: The dispersion was "satisfactory" in 82 (75.9%) of the medications; they were classified as capable of being dispersed in water in the oral syringe for further administration via EFTs without the need for crushing. Use the dispenser instead of the syringe for drug administration was safer because the dispenser apparatus did not fit into equipment for intravenous drug administration.

Adverse reactions caused by antimicrobials in hospitalized pediatric patients: causality and avoidability analysis

Abstract In pediatrics, drug therapy is commonly performed through adaptations of the dosage forms to adult use, increasing the risk of adverse drug reactions. In this context, studies assessing the severity and avoidability of the adverse reactions in children, especially those caused by antimicrobials, are still scarce. This work aimed to investigate suspected antimicrobial adverse reactions (ATM-ADRs) in pediatric patients admitted to a public hospital in northeastern Brazil, focusing on causality and avoidability analysis. A cohort study was carried out over a period of six months in a 64-bed pediatric unit. The incidence of suspected adverse reactions caused by antimicrobials was 14.65%. Most reactions were rated as probable (89.13%), with moderate severity (84.78%) and possibly avoidable (45.65%). The analysis indicated that the use of a larger number of medications (p<0.0001) and longer hospital stay (p=0.004) were related to the occurrence of ATM-ADR. Our findings demonstrated that almost half of the suspected reactions could be prevented and that the antimicrobial's clinical management is relevant in this context. Besides, increasingly accurate adverse reaction classification instruments are essential. These results can support the development of therapeutic guidelines addressed to a safe and effective pharmacotherapy in the pediatric area

Medication errors in critical patients during medication reconciliation: analyses and clinical management

Abstract Medication errors (ME) are frequent in the admission of patients to the ICU and can be identified and prevented through medication reconciliation (MR). Our aim was to evaluate the incidence, type and severity of MEs and associated factors, identified during MR in the ICU. This is a prospective, analytical approach, performed in the ICU of a private hospital, where the MRs were evaluated from April to June 2016. The SPSS and Stata programs were used to analyse the data. Logistic regression was performed to determine the factors associated with MEs. MR was performed with 136 patients, of whom 126 (92.6%) used drugs regularly. The incidence of MEs was 16.3% (95% CI 11.5-21.2). The main classes of drugs involved were those acting on the nervous and cardiovascular systems. There were 128 pharmaceutical interventions (acceptance: 71.1%). Regarding severity, 65.5% (n=80) of the errors reached the patient, but there was no harm. The risk factors for MEs identified were: age ≥60 years, number of comorbidities >1 and previous use of drugs ≥9. The incidence of MEs found and the significant association with age, comorbidities and polymedication alert to the need for specific attention to prevent admission errors in the most susceptible patient groups.

Aplicação das medidas de prevenção e controle do SARS-CoV-2 entre universitários de instituição pública do Ceará, Brasil / Application of SARS-CoV-2 prevention and control measures among university students of a public institution in Ceará, Brazil

Introdução: Universidades são ambientes propícios à disseminação de infecções respiratórias agudas de elevada transmissibilidade, como a COVID-19. Objetivo: Avaliar a aplicação das medidas de prevenção e controle da COVID-19 entre estudantes de uma comunidade universitária do Ceará, Brasil. Método: Trata-se de estudo transversal desenvolvido junto aos estudantes da graduação de uma universidade pública do estado do Ceará, regularmente matriculados no semestre 2020.1, em atividades remotas (não presenciais). Para o cálculo da amostra, considerou-se uma população de 30.152 universitários, uma confiança de 95%, 3% de erro amostral e 50% de frequência esperada de uso das medidas de proteção e controle contra a COVID-19 (n = 1.031). Das 2.097 respostas recebidas, ocorreram 360 perdas e foram analisadas 1.737. A coleta de dados foi realizada em  dezembro de 2020, por meio de questionário eletrônico, disponibilizado online, para esta finalidade. Realizou-se uma análise descritiva dos aspectos pesquisados. Resultados: Apesar de 91,2% dos universitários referirem que sempre usavam máscara ao sair de casa, somente 1,4% cumpriram com todas as recomendações para seu manuseio correto; 43,3% referiram lavar as mãos conforme as recomendações das autoridades sanitárias, mas outras medidas de higiene pessoal foram insuficientes; 65,4% referiram que costumavam sair para participar de atividades que não eram de extrema necessidade; e 70,0% eram usuários de transportes públicos. Conclusões: As evidências encontradas predispõem os universitários a riscos frente a COVID-19.

Introduction: Universities are favorable environments for the spread of highly transmissible acute respiratory  infections, such as COVID-19. Objective: To evaluate the application of COVID-19 prevention and control measures among students from a public university in the state of Ceará, Brazil. Method: This is a cross-sectional study developed with undergraduate students, regularly enrolled in semester 2020.1, in remote (non-face-to-face) activities. To calculate the sample, a population of 30,152 students was considered, a confidence of 95%, 3% sampling error and 50% expected frequency of use of protection and control measures against COVID-19 (n = 1,031). Of the 2,097 responses received, 360 were lost and 1,737 were analyzed. Data collection was carried out in December 2020, through an electronic questionnaire, available online, for this purpose. A descriptive analysis of the researched aspects was carried out. Results: Although 91.2% of students reported that they always wore a mask when leaving the house, only 1.4% complied with all the  recommendations for its correct handling. 43.3% reported washing their hands according to the recommendations of the health authorities, but others' personal hygiene measures were insufficient; 65.4% reported that they used to go out to participate in activities that were not of extreme necessity; and 70.0% were public transport users. Conclusions: The evidence found predisposes university students to risks in the face of this pandemic.