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UNLABELLED: Anabolic-androgenic steroids are misused, including by women, but little is known about the cardiovascular effects of these drugs on women. AIM: To evaluated the effects of nandrolone decanoate (ND) and resistive physical exercise on cardiac contractility in young female rats. MAIN METHODS: Female Wistar rats were separated into 4 groups: C (untrained animals); E (animals were submitted to resistance exercise by jumping in water 5 times per week); ND (animals were treated with ND, 20mg/kg/week for 4weeks); and NDE (trained and treated). The haemodynamic parameters (+dP/dtmax, -dP/dtmin and Tau) were assessed in the left ventricle. The heart was collected for histological analyses and collagen deposition. The gastrocnemius muscle was weighed, and hypertrophy was assessed by the ratio of their weights to gastrocnemius/tibia length. The expression of calcium handling proteins was measured by western blot analysis. RESULTS: ND treatment and physical exercise increased cardiac contractility and relaxation. In addition, ND promoted increases in phospholamban phosphorylated (p-PLB) and isoforms of sarcoplasmic/endoplasmic reticulum calcium ATPase 2 (SERCA2a) expression, while resistance exercise increased the phosphorylation of PLB and expression of Na(+)/Ca(2+) exchangers (NCX). Cardiac hypertrophy and collagen deposition were observed after ND treatment. CONCLUSION: Regulatory components of cytosolic calcium, such as SERCA2a and p-PLB, play important roles in modulating the contractility and relaxation effects of ND in females.
Assuntos
Anabolizantes/farmacologia , Nandrolona/análogos & derivados , ATPases Transportadoras de Cálcio do Retículo Sarcoplasmático/metabolismo , Trocador de Sódio e Cálcio/metabolismo , Função Ventricular Esquerda/fisiologia , Remodelação Ventricular/fisiologia , Animais , Pressão Arterial/efeitos dos fármacos , Cálcio/metabolismo , Proteínas de Ligação ao Cálcio/metabolismo , Cardiomegalia/induzido quimicamente , Cardiomegalia/metabolismo , Cardiomegalia/patologia , Colágeno/metabolismo , Feminino , Frequência Cardíaca/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Miócitos Cardíacos/efeitos dos fármacos , Miócitos Cardíacos/metabolismo , Miócitos Cardíacos/patologia , Nandrolona/farmacologia , Decanoato de Nandrolona , Ratos WistarRESUMO
CONTEXT: Struthanthus vulgaris (Vell.) Mart. (Loranthaceae) has been widely used in traditional medicine in Brazil to bathe wounds. OBJECTIVE: The objective of this study is to investigate the in vitro wound healing effects, together with the antioxidant and antimicrobial activities of S. vulgaris leaf and branch extracts. MATERIAL AND METHODS: Ethanol leaf and branch extracts of S. vulgaris were investigated at 1-100 µg/ml concentrations in the scratch assay after 14 h. Antioxidant activity was investigated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical-scavenging assay, and the antibacterial activity was tested at concentrations up to 1000 µg/ml against Gram-positive and Gram-negative bacteria by the microdilution test after 24 h. The total phenolic and flavonoid contents were determined by colorimetric methods. RESULTS: Struthanthus vulgaris leaf and branch extracts at 100 µg/ml concentration stimulated migration and proliferation of fibroblasts and enhanced cell numbers by 56.2% and 18.6%, respectively. Antioxidant activity exhibited IC50 values of 24.3 and 18.9 µg/ml for the leaf and branch extracts, respectively. The ethanol leaf extract showed antimicrobial activity against the Gram-positive Staphylococcus mutans and Staphylococcus aureus bacteria, exhibiting minimum inhibitory concentration values of 125 and 500 µg/ml, respectively. An appreciable total phenolic content in the leaves (813.6 ± 2.7 mg/g) and branches (462.8 ± 9.6 mg/g), and relatively low concentration of flavonoids in the leaves (13.3 ± 4.3 mg/g) and branches (1.9 ± 0.2 mg/g), was detected. DISCUSSION AND CONCLUSION: The antioxidant and antibacterial activities, together with the strong ability to stimulate proliferation and migration of fibroblasts, provide some support for the traditional use of S. vulgaris.
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Antibacterianos/farmacologia , Antioxidantes/farmacologia , Loranthaceae/química , Extratos Vegetais/farmacologia , Cicatrização/efeitos dos fármacos , Animais , Antibacterianos/isolamento & purificação , Antioxidantes/isolamento & purificação , Compostos de Bifenilo/química , Linhagem Celular , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Fibroblastos/efeitos dos fármacos , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Picratos/química , Extratos Vegetais/isolamento & purificação , Folhas de Planta/química , Caules de Planta/químicaRESUMO
INTRODUCTION: Background: Brazil includes food as a social right, making the State responsible to the courts for the sufficient and adequate supply of enteral food. Objectives: to evaluate the supply of enteral diets in pharmacies in the state of Espirito Santo. Methods: to do this, we used the forms filled out by patients or legal representatives, containing medical records, to analyze the nutritional and social profiles of the users over two years, and the compliance of the administrative processes with the ordinance that instituted enteral food supplies was verified. Results: the sample was comprised of 204 patients receiving enteral nutrition, and the administrative procedures required to supply these patients were surveyed in seven (7/9) pharmacies. The data showed that the most common group was that of women (51 %), who were white (51 %), legally represented (91 %), and 73.5 years old (11 to 109 years). Information regarding missing anthropometric data, use of terms and calculations for obtaining enteral food other than those recommended, incomplete documents, alterations to the physical examinations suggestive of error, and nonobservance of inclusion and exclusion criteria were collected for this study. Conclusions: this study revealed that there were gaps in the process of enteral diet supply by the Espírito Santo pharmacies, both concerning compliance with the protocol and patient follow-up by the professional who assists both the patient and the pharmacist who provides the input.
INTRODUCCIÓN: Antecedentes: Brasil incluyó la alimentación como un derecho social, haciendo que el Estado sea responsable ante los tribunales del suministro suficiente y adecuado de alimentos. Objetivos: evaluar el suministro de dietas enterales en las farmacias estatales de Espírito Santo. Métodos: para hacer esto utilizamos los formularios cumplimentados por los pacientes y representantes legales que contienen registros médicos con el fin de analizar los perfiles nutricionales y sociales de los usuarios durante dos años; además, se verificó el cumplimiento de los procesos administrativos con la ordenanza que instituyó el suministro de alimentos. Resultados: la muestra comprendió 204 pacientes que recibieron nutrición enteral, investigándose los procedimientos administrativos requeridos para suministrar a estos pacientes en siete (7/ 9) farmacias. Los datos mostraron que el grupo más común era el de mujeres (51 %), de raza blanca (51 %) y representadas legalmente (91 %), de 73,5 años de edad (11 a 109 años). Para este estudio se recopiló información sobre los datos antropométricos faltantes, el uso de términos y cálculos para obtener alimentos distintos a los recomendados, documentos incompletos, alteraciones en los exámenes físicos sugestivos de error y la no observancia de los criterios de inclusión y exclusión. Conclusiones: este estudio reveló que había vacíos en el proceso de suministro de dietas enterales por parte de las farmacias de Espírito Santo en lo que respecta tanto al cumplimiento del protocolo como al seguimiento del paciente por el profesional que lo atiende y el farmacéutico que proporciona la información.
Assuntos
Nutrição Enteral/estatística & dados numéricos , Alimentos Formulados/provisão & distribuição , Farmácias/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Feminino , Regulamentação Governamental , Direitos Humanos/legislação & jurisprudência , Humanos , Legislação sobre Alimentos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Diabetes mellitus (DM) is a chronic disease marked by elevated blood glucose levels. Controlling DM involves adequate diet, physical exercises, medicines and monitoring the blood glucose and glycated hemoglobin (HbA1c) levels. This was a retrospective study of the process of dispensing long-acting insulin analogues to users with diabetes (types 1 and 2) who were registered at high-cost public pharmacies in public health system in a southeast state of Brazil, that sought to evaluate the fulfillment of the criteria of all the clinical protocol to provide these analogs. Of the 987 users registered in the health service, 315 met the inclusion criteria for the study. The evaluation of the dispensing processes of the long-acting insulin analogues revealed that the inclusion, exclusion, and suspension criteria of the protocol related with these insulin analogues were in some extend only partially fulfilled. Additionally, there was no difference between the initial and final fasting glycemic and HbA1c levels. It is concluded that the established criteria for dispensing long-acting insulin analogues were partly fulfilled by pharmacies, compromising the rational use of these analogues. It can directly impact the cost of maintaining the public health service and users' health.
Assuntos
Diabetes Mellitus Tipo 2 , Farmácias , Glicemia , Brasil , Protocolos Clínicos , Humanos , Hipoglicemiantes , Insulina , Insulina de Ação Prolongada , Saúde Pública , Estudos RetrospectivosRESUMO
INTRODUCTION: Misuse of AAS is emergent among both genders, however, few studies were performed evaluating AAS effects on female body and none evaluate the impact of nandrolone decanoate (ND) in renal function. AIM: Determine the effects of chronic treatment with ND on kidney function of female rats and evaluate the influence of oxidative stress on it. MATERIAL AND METHODS: Female rats were separated into two groups (n = 8 each), the treated group (DECA), which received ND at a dose of 20 mg/kg/week (i.m), and the control group (C), which was treated with the vehicle (peanut oil, i.m.). All treatments were performed during eight weeks. After this period, 24 h urine, blood and organs (heart, gastrocnemius muscle, liver and kidney) were collected. Organ hypertrophy was calculated, and kidney collagen content was evaluated. AOPP, TBARS, SOD and catalase activity were determined in the kidney. Moreover, proteinuria and creatinine clearance were also investigated. KEY-FINDINGS: Hypertrophy was observed in the liver, gastrocnemius muscle, heart and kidney. Kidney hypertrophy was followed by a reduced organ function and an increase in collagen deposition. Oxidative stress upsurge occurred in both proteins and lipids, followed by a reduction in SOD activity. SIGNIFICANCE: Administration of DN in rats was followed by renal damage and kidney fibrosis due to increased oxidative stress on that organ.
Assuntos
Injúria Renal Aguda/induzido quimicamente , Anabolizantes/efeitos adversos , Homeostase/efeitos dos fármacos , Decanoato de Nandrolona/efeitos adversos , Estresse Oxidativo/efeitos dos fármacos , Injúria Renal Aguda/metabolismo , Injúria Renal Aguda/fisiopatologia , Anabolizantes/farmacologia , Animais , Western Blotting , Catalase/metabolismo , Feminino , Rim/efeitos dos fármacos , Rim/metabolismo , Rim/patologia , Rim/fisiologia , Decanoato de Nandrolona/farmacologia , Ratos , Ratos Wistar , Superóxido Dismutase/metabolismoRESUMO
Abstract To evaluate the gastroprotective and antioxidant effects of pretreatment with water kefir on ulcers induced with HCl/ethanol. All pretreatments lasted 14 days. Male mice were separated into five groups: the control (C) group received vehicle without ulcer induction; the ulcerated (U) group received vehicle; the lansoprazole (L) group received 30 mg/kg/day lansoprazole; the water kefir (WK15 and WK30) groups received WK at a dose of 0.15 or 0.30 ml/kg/day, respectively. Gastroprotection was measured by ulcer area, ulcer index and ulcer reduction percentage. Antioxidant effects were quantified by measuring advanced oxidized protein products (AOPPs), superoxide dismutase (SOD), and catalase activity in the stomach. Pretreatment with WK at both doses promoted gastroprotection against HCl/ethanol-induced ulcers much like the pretreatment with lansoprazole. In addition, WK decreased protein oxidation while increasing SOD and catalase activity. We concluded that pretreatment with water kefir increases the activity of antioxidant enzymes, preventing gastric lesions induced by HCl/ethanol by maintaining the antioxidant performance in gastric tissue.
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Animais , Masculino , Camundongos , Úlcera Gástrica/dietoterapia , Produtos Biológicos/análise , Kefir/análise , Antioxidantes/efeitos adversos , Probióticos/análise , Produtos da Oxidação Avançada de ProteínasRESUMO
Abstract To assess the performance indicators for pharmaceutical services (PS) in primary health care (PHC), the level of satisfaction with pharmacy services among users and managers / pharmacists' impressions in relation to the findings were evaluated. The study used mixed methods, including a retrospective and descriptive study of the performance indicators for PS in PHC, an observational study on the level of satisfaction and a qualitative study of users' perception of pharmacy services at Health Units. Managers and pharmacists' impressions of the study results were also collected. Only 44.4% of pharmacies had a full-time pharmacist. From the establishments visited, 5.3% did not have an air-conditioned environment, and only 33.3% of the items essential to the Good Practices of Storage of Medicines and Supplies criteria were fulfilled. Although 77.9% of the prescribed medicines were dispensed, it did not reach the 80% standard. The satisfaction level of users was 3.2±0.6, indicating dissatisfaction with pharmacies' services. By means of an evaluation of each item within the questionnaire, it was possible to observe that variables related to pharmaceutical care presented low scores in relation to other domains, thus evidencing the fragility of the pharmaceutical- patient relationship in users' perception. Managers and pharmacists suggested that these results were related to the inadequate physical infrastructure of pharmacies, work overload, lack of recognition and undervaluation of pharmacists, lack of interaction within the PHC team, high turnover of pharmacists, and lack of PS prioritization by the administration. PS in PHC has structural and organizational weaknesses that require changes. In general, users are dissatisfied with pharmacies' services, especially with pharmaceutical care.
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Humanos , Masculino , Feminino , Pacientes , Satisfação Pessoal , Farmacêuticos/classificação , Assistência Farmacêutica/organização & administração , Atenção Primária à Saúde/classificação , Satisfação do Paciente/estatística & dados numéricos , Comportamento do Consumidor , Serviços Médicos de Emergência/organização & administração , Gestor de Saúde , Organização e Administração/estatística & dados numéricos , Farmácias , Diagnóstico da Situação de Saúde , Inquéritos e Questionários , Equipamentos e Provisões/provisão & distribuição , Avaliação da Pesquisa em SaúdeRESUMO
Abstract Diabetes mellitus (DM) is a chronic disease marked by elevated blood glucose levels. Controlling DM involves adequate diet, physical exercises, medicines and monitoring the blood glucose and glycated hemoglobin (HbA1c) levels. This was a retrospective study of the process of dispensing long-acting insulin analogues to users with diabetes (types 1 and 2) who were registered at high-cost public pharmacies in public health system in a southeast state of Brazil, that sought to evaluate the fulfillment of the criteria of all the clinical protocol to provide these analogs. Of the 987 users registered in the health service, 315 met the inclusion criteria for the study. The evaluation of the dispensing processes of the long-acting insulin analogues revealed that the inclusion, exclusion, and suspension criteria of the protocol related with these insulin analogues were in some extend only partially fulfilled. Additionally, there was no difference between the initial and final fasting glycemic and HbA1c levels. It is concluded that the established criteria for dispensing long-acting insulin analogues were partly fulfilled by pharmacies, compromising the rational use of these analogues. It can directly impact the cost of maintaining the public health service and users' health.
Resumo Diabetes mellitus (DM) é uma doença crônica marcada por níveis sanguíneos elevados de glicose. O controle do DM envolve dieta adequada, exercícios físicos, medicamentos e monitoramento dos níveis sanguíneos de glicose e de hemoglobina glicada (HbA1c). Trata-se de um estudo retrospectivo do processo de dispensação de análogos de insulina de ação prolongada a usuários com diabetes (tipos 1 e 2) cadastrados em farmácias públicas de alto custo do sistema público de saúde de um estado do Sudeste do Brasil, que buscou avaliar o cumprimento dos critérios do protocolo clínico para fornecimento desses análogos. Dos 987 usuários cadastrados no serviço de saúde, 315 preencheram os critérios de inclusão. A avaliação dos processos de dispensação dos análogos de insulina de ação prolongada revelou que os critérios de inclusão, exclusão e suspensão do protocolo dos análogos de insulina eram parcialmente cumpridos. Além disso, não houve diferença entre os níveis inicial e final de glicemia em jejum e HbA1c. Conclui-se que os critérios estabelecidos para dispensação de análogos de insulina de ação prolongada foram parcialmente cumpridos pelas farmácias, comprometendo o uso racional dos análogos. Os achados podem impactar diretamente no custo de manutenção do serviço público de saúde e na saúde do usuário.
Assuntos
Humanos , Farmácias , Diabetes Mellitus Tipo 2 , Glicemia , Brasil , Protocolos Clínicos , Saúde Pública , Estudos Retrospectivos , Insulina de Ação Prolongada , Hipoglicemiantes , InsulinaRESUMO
Probiotic consumption promotes numerous health benefits. The aim of this study is 1) to evaluate the antihypertensive effect of kefir in a hypertension rat model caused by the administration of the nitric oxide synthesis inhibitor, L-NAME, and 2) to evaluate the acute angiotensin converting enzyme (ACE) inhibitory activity of the soluble nonbacterial fraction (SNBF) of kefir. To develop the first aim, male rats were separated into three groups: control group (C) treated with 0.3 mL/100 g of milk; L-NAME group (LN) received 10 mg/kg of said inhibitor; and Kefir group (K) treated with 0.3 mL/100 g of kefir plus L-NAME (10 mg/kg of said inhibitor). The treatments were given by oral gavage twice a day for four weeks. For the second aim"instead additionally, male rats received angiotensin I (in bolus) in three doses (Ang I: 0.03, 3 and 300 µg/kg) and were separated into two groups: a) received captopril (30 mg/kg i.v.) and b)received SNBF of kefir (5 mL/kg i.v.). Blood pressure were evaluated before and after Ang I. After treatment, hemodynamic parameters were evaluated, heart weight was recorded, and body weight gain was calculated. SNBF of kefir did not decrease the blood pressure for L-NAMEtreated animals, and no changes were observed in the cardiac parameters. However, the SNBF of kefir demonstrated acute inhibition of ACE in vivo similar to that of captopril. Thus, our results suggest that kefir may improve human cardiovascular systems by using mechanisms independent of nitric oxide syntheses. Additionally, the renin angiotensin system is probably the most important system involved in kefir effect regarding hypertension.
Assuntos
Animais , Masculino , Ratos , Inibidores da Enzima Conversora de Angiotensina , Kefir/efeitos adversos , Pressão Sanguínea/genética , Probióticos/farmacologia , Anti-Hipertensivos/análise , Óxido Nítrico/efeitos adversosRESUMO
Metabolism of anabolic androgenic steroids is important for its physiological effects. The aim was to investigate the effects of finasteride (a 5α-reductase inhibitor - 5αR) on cardiac and mutagenic effects promoted by ND. Male Wistar rats were separated into three groups: CONT, received the vehicles of ND and finasteride (Peanut oil+Saline); DECA group, received ND (20 mg.kg.week-1, i.m.), and DECAF received ND and finasteride (100 µg.kg-1, i.p.), for four weeks. After, hypertrophy, cytokines and Angiotensin Converting Enzyme (ACE) activity was determined in heart. Bone marrow was used for micronucleus evaluation. Treatment with ND promotes increase in cardiac hypertrophy, ACE activity and disbalance among pro- and anti-inflammatory cytokines, and combination with finasteride worsened those effects. Association with finasteride ameliorates the toxic effects of ND on bone marrow cells, as was observed by a normalization of the number of micronucleate polychromatic erythrocytes and the mitotic index. Our data demonstrates that deleterious effects promoted by ND are depend, at least in part, of its metabolization. Also, inhibition of 5αR by finasteride present variated effects dependent on organ studied. It can promote increase on cardiac damage and a reduction on mutagenic effects of ND, which demonstrated that dehydronandrolone has diverse role on ND effects..
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UNLABELLED: Anabolic-androgenic steroids are misused, including women, but little is known about the cardiovascular effects of these drugs on females. AIM: Evaluated the effects of nandrolone decanoate (ND), physical exercise and estrogen deficiency on female rats. MAIN METHODS: Female Wistar rats were divided into 8 groups: S and OVX: (SHAM: sham surgery; OVX: ovariectomy, vehicle), SE and OVXE (resistance exercise 5 times a week, vehicle), SD and OVXD (treated with ND, 20 mg/kg/week for 4 weeks); SDE and OVXDE. Treatments were initiated 21 days after surgery. The BezoldJarisch reflex was assessed by Phenylbiguanide administration. The right atrium, kidney, and serum were collected for molecular analyses by RT-PCR of atrial natriuretic peptide (ANP), A-type natriuretic peptide receptor (NPR-A) and NPR-C. ELISA assay to estradiol and testosterone concentrations. The gastrocnemius muscle, heart and kidney weights/tibia length were measured.Morphometric analysis of heart was made (H/E) and collagen content of heart and kidney were evaluated using Pirossirius Red. KEY FINDINGS: ND treatment increased ANP expression on atrium and decreased NPR-A expression in kidney. Physical exercise and ovariectomy did not alter this parameter. NPR-C level was reduced in the SDE and OVXDE. Renal and cardiac hypertrophy was observed after ND treatment, with collagen deposition. Plasma estrogen concentrations were reduced and serum testosterone concentrations were increased after ND treatment. SIGNIFICANCE: ANP has an important role in modulating the cardiovascular effects of ND in females. Thismodulating may have occurred by the increasing ANP expression, reducing NPR-A and NPR-C expression levels, and changing sex hormone levels.
Assuntos
Pressão Arterial/efeitos dos fármacos , Fator Natriurético Atrial/metabolismo , Frequência Cardíaca/efeitos dos fármacos , Coração/efeitos dos fármacos , Rim/efeitos dos fármacos , Nandrolona/análogos & derivados , Anabolizantes/farmacologia , Animais , Pressão Arterial/fisiologia , Barorreflexo/efeitos dos fármacos , Biguanidas/farmacologia , Colágeno/metabolismo , Estradiol/sangue , Estrogênios/deficiência , Feminino , Expressão Gênica/efeitos dos fármacos , Coração/anatomia & histologia , Átrios do Coração/efeitos dos fármacos , Átrios do Coração/metabolismo , Frequência Cardíaca/fisiologia , Hipertrofia , Rim/anatomia & histologia , Rim/metabolismo , Músculo Esquelético/anatomia & histologia , Miocárdio/metabolismo , Nandrolona/farmacologia , Decanoato de Nandrolona , Peptídeo Natriurético Tipo C/biossíntese , Tamanho do Órgão/efeitos dos fármacos , Ovariectomia , Condicionamento Físico Animal , Ratos , Receptores do Fator Natriurético Atrial/biossíntese , Testosterona/sangue , Tíbia/anatomia & histologiaRESUMO
Contrast-induced nephropathy (NIC) is directly related to increased morbidity and mortality, and its treatment and prevention might be achieved by the administration of antioxidant products. The juçara palmetto (Euterpe edulis Martius) has fruits rich in phenolic compounds, which are known for their antioxidant activity. This work aimed to evaluate the nephroprotective activity of E. edulis pulp in the NIC animal model. The collected fruits were pulped, their contents of polyphenols and anthocyanins were quantified, and their antioxidant activity were evaluated. The nephroprotective effects were determined based on iodine contrast induction and evaluated by biochemical and histological analyses. The results showed that E. edulis pulp was rich in polyphenols (811 ± 16.7 mg EAG/g) and anthocyanins (181.25 mg/100 g) and had very strong antioxidant activity, as demonstrated by the DPPH (2,2-diphenyl-1-picryl-hydrazyl) method, which revealed an antioxidant activity index (AAI) of 3.4, and the 2,29-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) method, which revealed an IC50 of 0.59 ± 0.03 mg/mL. In the in vivo experiments, E. edulis pulp tended to provide renal protection and reduce renal dysfunction and tubular morphological lesions in mice after the induction of NIC, and these effects were obtained through the antioxidant activities of the polyphenols in the pulp.
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ABSTRACT The aim of this study was to evaluate the level of satisfaction of pharmaceutical services and to determine the socioeconomic profile of public pharmacy clients. This is a cross-sectional observational study using a quantitative approach. The sample was calculated from the monthly number of patients seen in pharmacies and was stratified for each pharmacy. Data were analysed using SPSS 11.5 software and by observing the simple relative frequencies for qualitative variables. For the quantitative variables, the analysis of variance (ANOVA) and post-hoc Fisher tests were performed. Data are expressed as mean ± standard deviation (SD). The results show that, in general, patients at "Farmácias cidadãs" are satisfied with the services. However, when stratified, we found that the greatest satisfaction was related only to structural and organizational aspects, while the pharmaceutical services are unsatisfactory. When relating satisfaction to the socioeconomic characteristics, a difference between waiting time (39.07 ± 19.53), attendance by pharmacist (8.91 ± 5.14) and education was observed. It is concluded that users are satisfied with the services of state "Farmácias cidadãs" of Espírito Santo, but there should be improvements in relation to pharmaceutical services and the interpersonal relationships between health professionals and users of the public health system in Brazil.
RESUMO O objetivo do presente estudo foi avaliar o nível de satisfação dos serviços farmacêuticos e a determinação do perfil socioeconômico de clientes de farmácias públicas. Trata-se de um estudo observacional transversal com abordagem quantitativa. A amostra foi calculada através de dados da quantidade mensal de pacientes atendidos nas farmácias e estratificada para cada unidade do Estado. Os dados foram analisados por meio programa SPSS 11.5, observando-se as frequências relativas simples para as variáveis qualitativas. Para as variáveis quantitativas efetuaram-se análise de variância de uma via (ANOVA) e teste post-hoc de Fisher. Os dados foram expressos como a média ± desvio padrão (DP). Os resultados revelam que, em geral, os usuários atendidos nas farmácias cidadãs estão satisfeitos com os serviços, porém, quando estratificado por pergunta, avaliou-se que a maior satisfação está relacionada apenas aos aspectos estruturais e organizacionais e que o serviço farmacêutico é insatisfatório. Quando relacionada à satisfação com as características socioeconômicas, observou-se diferença entre tempo de espera (39.07 ± 19.53), de atendimento pelo farmacêutico (8.91 ± 5.14) e escolaridade. Conclui-se que os usuários estão satisfeitos com os serviços das farmácias cidadãs estaduais do Espírito Santo, porém deve haver melhora em relação ao atendimento farmacêutico e à relação interpessoal entre profissionais de saúde e usuários do sistema público de saúde brasileiro.
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Farmácias/tendências , Assistência Farmacêutica/estatística & dados numéricos , Sistema Único de Saúde , Comportamento do ConsumidorRESUMO
The aims of this study were to evaluate the chemical profile, vascular reactivity, and acute hypotensive effect (AHE) of the ethanolic extract of leaves of Alpinia purpurata (Vieill) K. Schum (EEAP). Its chemical profile was evaluated using HPLC-UV, ICP-OES, and colorimetric quantification of total flavonoids and polyphenols. The vascular reactivity of the extract was determined using the mesenteric bed isolated from WKY. AHE dose-response curves were obtained for both EEAP and inorganic material isolated from AP (IAP) in WKY and SHR animals. Cytotoxic and mutagenic safety levels were determined by the micronucleus test. Rutin-like flavonoids were quantified in the EEAP (1.8 ± 0.03%), and the total flavonoid and polyphenol ratios were 4.1 ± 1.8% and 5.1 ± 0.3%, respectively. We observed that the vasodilation action of EEAP was partially mediated by nitric oxide (·NO). The IAP showed the presence of calcium (137.76 ± 4.08 μg mg-1). The EEAP and IAP showed an AHE in WKY and SHR animals. EEAP did not have cytotoxic effects or cause chromosomic alterations. The AHE shown by EEAP could result from its endothelium-dependent vascular action. Rutin-like flavonoids, among other polyphenols, could contribute to these biological activities, and the calcium present in EEAP could act in a synergistic way.
Os objetivos deste estudo foram avaliar o perfil químico de folhas de Alpinia purpurata K. Schum (AP), assim como a reatividade vascular e o efeito hipotensor agudo (EHA) do extrato etanólico de folhas de AP (EEAP). Avliou-se o perfil químico utilizando-se HPLC-UV, ICP-OES e quantificação colorimétrica de flavonoides e polifenóis totais. A reatividade vascular foi determinada utilizando leito mesentérico isolado de ratos WKY. Curvas dose-resposta do EEAP e do material inorgânico da AP (IAP) foram realizadas em animais SHR e WKY. Determinaram-se a segurança citotóxica e mutagênica pelo teste de micronúcleos. Flavonoides tipo rutina foram quantificados no EEAP (1,8±0,03%) e flavonoide total e polifenóis foram de 4,1±1,8% e 5,1±0,3%, respectivamente. Observou-se ação vasodilatadora do EEAP, mediada parcialmente pelo óxido nítrico (·NO). O IAP revelou a presença de cálcio (137,76±4.08 μg.mg-1 de Ca). O EEAP e IAP apresentaram EHA em animais WKY e SHR. Não se observaram efeitos citotóxicos e alterações cromossômicas provocadas pelo EEAP. O EEAP mostrou um EHA que poderia resultar de ação vascular dependente do endotélio. Rutina, entre outros polifenóis e flavonoides, poderia estar contribuindo para essas atividades biológicas e o cálcio presente no EEAP, poderia agir de maneira sinérgica.
Assuntos
Ratos , Zingiberaceae/classificação , Endotélio , Hipotensão/prevenção & controle , Cromatografia Líquida de Alta Pressão/classificação , Reatividade-Estabilidade , Polifenóis/análise , Classificação Internacional de Atenção PrimáriaRESUMO
The aim of the present work was to compare hepatitis C prevalence, genotypes, and risk factors between prisoners and non-prisoners in the city of Colatina, Espírito Santo, Brazil. This cross-sectional study involved approximately 1,600 residents and 730 prisoners, all of whom were living in Colatina. The percentage of individuals who tested positive for anti-HCV was 0.1% (2/1,600) in the non-prisoner group and 1.0% (7/730) in the prisoner group, confirming a higher risk of hepatitis C in the latter group. The percentage of subjects who progressed to HCV-RNA negative was 11.1% (1/9), confirming the high probability of evolution to chronicity. Genotype 1 was the most predominant genotype found. Factors associated with increased risk of hepatitis C were being male, being institutionalized, having an income of less than three minimum wages, having low educational attainment, and using injected drugs. Alcohol use, pain in the liver, migraine, and reported history of hepatitis were markedly associated with hepatitis C. The prison population tested positive for anti-HCV at a higher rate than the non-prison population.
O objetivo do presente trabalho foi comparar a prevalência, os genótipos e fatores de risco da hepatite C entre a população em geral e os presos na cidade de Colatina, Espírito Santo, Brasil. O presente estudo é transversal e comparou cerca de 1.600 moradores e 730 prisioneiros, todos eles vivendo em Colatina. A prevalência de anticorpos anti-HCV positivo foi de 0,1% (2/1.600), na população em geral, e de 1,0% (7/730) entre os presos, o que confirma o elevado risco nesse grupo. A percentagem de indivíduos que apresentam RNA-HCV negativo foi de 11,1% (1/9), confirmando a alta taxa de evolução para a cronicidade. O genótipo predominante foi o I. Fatores associados ao aumento do risco de hepatite C foram do sexo masculino, sendo institucionalizado, com renda de até três salários mínimos, baixa escolaridade e uso de drogas injetáveis. O uso de álcool, dor no fígado, enxaqueca e relato de histórias de hepatite apresentaram associação significativa com a hepatite C. A população carcerária teve maiores taxas de positividade para o anti-HCV do que a população não-prisional pesquisada.
Assuntos
Humanos , Prisioneiros/classificação , Hepatite C , Hepatite C/classificação , Diagnóstico , Medição de Risco/classificação , Anticorpos Anti-Hepatite C/imunologiaRESUMO
In 1820, French naturalist August Saint Hillaire, during a visit in Espírito Santo (ES), a state in southeastern Brazil, reported a popular use of Cyperaceae species as antidote to snake bites. The plant may even have a hypotensive effect, though it was never properly researched. The in vitro inhibitory of the angiotensin converting enzyme (ACE) activity of eigth ethanolic extracts of Cyperaceae was evaluated by colorimetric assay. Total phenolic and flavonoids were determined using colorimetric assay. The hypotensive effect of the active specie (Rhychonospora exaltata, ERE) and the in vivo ACE assay was measured in vivo using male Wistar Kyoto (ERE, 0.01-100mg/kg), with acetylcholine (ACh) as positive control (5 µg/kg, i.v.). The evaluation of ACE in vivo inhibitory effect was performed comparing the mean arterial pressure before and after ERE (10 mg/kg) in animals which received injection of angiotensin I (ANG I; 0,03, 03 and 300 µg/kg, i.v.). Captopril (30 mg/kg) was used as positive control. Bulbostylis capillaris (86.89 ± 15.20%) and ERE (74.89 ± 11.95%, ERE) were considered active in the in vitro ACE inhibition assay, at 100 µg/mL concentration. ACh lead to a hypotensive effect before and after ERE's curve (-40±5% and -41±3%). ERE showed a dose-dependent hypotensive effect and a in vivo ACE inhibitory effect. Cyperaceae species showed an inhibitory activity of ACE, in vitro, as well as high content of total phenolic and flavonoids. ERE exhibited an inhibitory effect on both in vitro and in vivo ACE. The selection of species used in popular medicine as antidotes, along with the in vitro assay of ACE inhibition, might be a biomonitoring method for the screening of new medicinal plants with hypotensive properties.
Em 1820, o naturalista francês August Saint Hillaire, durante uma visita ao Espírito Santo (ES), Estado do sudeste do Brasil, relatou o uso popular de espécies de Cyperaceae como antídoto para picadas de cobra. As espécies podem possuir efeito hipotensor, embora nunca tenham sido devidamente pesquisadas. A inibição in vitro da atividade da enzima conversora da angiotensina (ECA) de oito extratos etanólicos de Cyperaceae foi avaliada por ensaio colorimétrico. Totais de fenólicos e flavonóides foram determinados utilizando ensaio colorimétrico. O efeito hipotensor da espécie ativa (Rhychonospora exaltata, ERE) no ensaio de ECA in vitro foi avaliada in vivo utilizando-se machos Wistar Kyoto (ERE, 0.01-100 mg/kg), com a acetilcolina (ACh), como controle positivo (5 µg/kg, iv). A avaliação do efeito inibidor da ECA in vivo foi realizado comparando-se a pressão arterial média, antes e após ERE (10 mg/kg) nos animais que receberam injeção de angiotensina I (Ang I, 0,03, 03 e 300 µg/kg, iv). Captopril (30 mg/kg) foi utilizado como controle positivo. Bulbostylis capillaris (86,89±15,20%) e ERE (74,89±11,95%, ERE) foram considerados ativas no ensaio de inibição da ECA in vitro, na concentração de 100 µg/mL. A ACh gerou um efeito hipotensor, antes e depois da curva de ERE (-40 ± 5% -41 ± 3%). ERE apresentou efeito hipotensivo dependente da dose e um efeito inibidor da ECA in vivo. As espécies de Cyperaceae mostraram uma atividade inibidora de ACE in vitro, bem como elevado conteúdo de substâncias fenólicas e flavonóides. ERE exibiu um efeito inibidor da ECA tanto in vitro como in vivo. A seleção das espécies utilizadas na medicina popular como antiofídicos, juntamente com o ensaio in vitro de inibição da ECA, pode ser um método de biomonitoramento para a seleção de novas plantas medicinais com propriedades hipotensores.
Assuntos
Ratos , Técnicas In Vitro , Cyperaceae/classificação , Inibidores da Enzima Conversora de Angiotensina/farmacocinética , HipotensãoRESUMO
The aim of this study was to estimate the evolution of the field of Pharmaceutical Care (PC) by measuring the quality and quantity of the scientific production on the topic of PC in Brazil compared to two pioneering countries in the field, the United States of America (USA) and Spain. The databases Web of Science, Scopus, Medline, Lilacs and SciELO were used as sources for the literature search. Pharmaceutical Care, or the appropriate translations, was used as the search term for the literature search, which was limited to articles published between 1990 and 2009. A score of quality (SQ) was calculated using variables such as impact factor and the frequency of the citations. We included 3265 articles published in 544 journals. We found that there was a steady increase in scientific production since 1990 and that the USA had a higher quality of scientific production than Spain, whereas the Spain produced the highest quantity of articles. In comparison, the Brazilian production of scientific publications on PC is low in terms of both quality and quantity but has increased steadily since 2002. Nevertheless, Brazil has not yet reached the level of the USA or Spain. In conclusion, Brazil's scientific production has evolved over the second decade studied in this work, with particularly high levels of production in the last five years. However, an increase in the quantity and quality of the publications should be encouraged.
O objetivo deste estudo foi estimar a evolução da área de atenção farmacêutica (AF) através da medição da qualidade e quantidade da produção científica na área de AF no Brasil, comparando-a com os países pioneiros no ramo: Estados Unidos da América (EUA) e Espanha. Os bancos de dados Web of Science, Scopus, Medline, Lilacs e SciELO foram usados como fontes para a pesquisa. AF ou as respectivas traduções foram usadas como descritor para a pesquisa bibliográfica sendo incluídos artigos publicados no período de 1990 a 2009. A pontuação da qualidade (PQ) foi calculada, utilizando variáveis como fator de impacto e frequência das citações. Foram cincluídos 3.265 artigos publicados em 544 revistas. Verificou-se um aumento constante na produção científica desde 1990 sendo que os EUA possuíam maior qualidade, enquanto a maior quantidade de artigos foi produzida na Espanha. Em comparação, a produção brasileira na AF é baixa em qualidade e quantidade, mas tem aumentado desde 2002. Apesar disso, o Brasil ainda não atingiu o nível dos EUA ou Espanha. Em conclusão, o Brasil apresentou expressiva evolução na última década com maior desenvolvimento nos últimos cinco anos. Entretanto, melhoria na quanitdade e qualidade das publicações deve ser incentivada.
Assuntos
Benchmarking/métodos , Atividades Científicas e Tecnológicas , Assistência Farmacêutica/classificação , Publicações Científicas e Técnicas , /classificaçãoRESUMO
The objective of this study was to determine the impact of a pharmaceutical care (PC) program in a sample of public outpatients with metabolic syndrome (MS) who were being treated in Brazil's health system; the patients were randomized into PC or standard care. The pharmacotherapy follow-up (PF) was performed in a total of 120 patients with type 2 diabetes for 6 months. Adherence to treatment (measured with the Morisky test), negative outcomes associated with medication (NOM) and anthropometric and biochemical parameters were measured before and after PF. The Framingham scoring method was used to estimate changes in 10-year coronary heart disease risk scores in all patients. Ninety-six of 120 patients had characteristics of MS and were randomized into two groups (G): the control group (CG: 36) and the intervention group (IG: 38). Among the MS patients, 100% were taking a glucose-lowering drug; many were also taking anti-hypertensive drugs (CG: 72%; IG: 73%), and some patients were also taking hypolipemic drugs (CG: 12.0%; IG: 14.7%). Only 20.7% of the IG patients were considered adherent to their prescribed drugs. In the CG, an increase of coronary heart disease (CHD) risk (22±2 to 26±3; p<0.05) was observed, while in the IG, there was a reduction in CHD risk (22±2 to 14±2%; p<0.01). The PC program administered to patients with MS monitored through the primary healthcare services of the Brazilian public health system improved patient health, resulting in clinical improvements and a decrease in cardiovascular risk in IG patients over a period of ten years.
O objetivo deste estudo foi o de determinar o impacto de um Programa de atenção Farmacêutica (AF) em uma amostra de pacientes ambulatoriais de Sistema Público de Saúde do Brasil portadores de Síndrome Metabólica, randomizados em AF ou atenção à saúde usual. Realizou-se o seguimento farmacoterapêutico com 120 pacientes com diabetes tipo 2 durante seis meses. Avaliou-se o nível de aderência ao tratamento (teste Morisky), resultados clínicos negativos associados a medicamentos (RNM), parâmetros bioquímicos e antropométricos, antes e após o seguimento. O método de Framingham foi usado para calcular as variações no risco de doenças coronarianas em 10 anos em todos os pacientes. Dos 120 pacientes, 96 tiveram características de SM e foram então randomizados em dois grupos (G): Controle (GC: 36) e Intervenção (GI: 38). Entre os pacientes com SM, 100% faziam uso de medicamentos para diminuir a glicose, anti-hipertensivos (GC: 72%; GI: 73%) e hipoglicemiantes (GC: 12.0%; GI: 14.7%). Apenas 20,7% do GI foram considerados aderentes aos fármacos prescritos. No GC foi observado aumento do risco de Doença Arterial Coronariana (DAC) (22±2 para 26±3; p<0,05), enquanto no GI foi observado redução (22±2 para 14±2%; p<0,01). O Programa de AF para pacientes com SM monitorados na atenção primária do Sistema de Saúde Pública brasileiro melhora o funcionamento do serviço resultando na melhoria clínica dos pacientes com redução do risco de doença cardiovascular em um período de dez anos.
Assuntos
Humanos , Pacientes Ambulatoriais/classificação , Centros Comunitários de Saúde , Anormalidades Cardiovasculares , Síndrome Metabólica/classificação , Comportamento de Redução do RiscoRESUMO
The present study was designed to evaluate the satisfaction of users of a Pharmaceutical Care (PC) service in a private communitarian pharmacy in Vitória (ES, Brazil). In this transversal observational study, patient interviews were performed by an experimenter that had no relationship with the establishments evaluated. Data were collected using a structured questionnaire. The questionnaire used a five point Likert scale, in which smaller numbers represented lower levels of satisfaction. For comparison, user satisfaction was also evaluated for two pharmaceutical establishments that do not have standardized PC services. In these cases, age-matched patients were selected randomly. A higher level of satisfaction was reported by users of the PC service, with values between three and five. The higher averages for the establishment with PC service were the result of greater perceived pharmacist interest in the patient's health. As the same results were not obtained by the services without PC, it was concluded that this practice is very important to the satisfaction level of users of pharmacy services.
O presente estudo teve por objetivo avaliar a satisfação de usuários de um serviço de atenção farmacêutica, implantado em uma farmácia comunitária privada no município de Vitória - ES. Trata-se de um estudo observacional de corte transversal, cuja coleta dos dados se deu por meio da aplicação de um questionário de satisfação. O instrumento foi aplicado por indivíduo treinado e sem vínculo com os estabelecimentos avaliados. Foi utilizada uma escala de intensidade de cinco pontos do tipo Likert, cujo menor número representa a opção "ruim" e o maior à opção "excelente". Também foi avaliado, para efeito de comparação, o nível de satisfação de usuários de dois outros estabelecimentos farmacêuticos que não possuíam esta prática implantada. Neste caso, os pacientes foram selecionados de forma aleatória, porém pareados pela idade. Foi obtido um alto nível de satisfação dos usuários do serviço de atenção farmacêutica. Os valores obtidos estavam entre 3 e 5, numa escala que varia de 1 a 5 pontos, sendo que as médias mais altas se referiam ao interesse do farmacêutico pela saúde do paciente. Como nos demais estabelecimentos o nível de satisfação foi inferior, foi possível concluir que o serviço de atenção farmacêutica foi o responsável pelo excelente resultado obtido.