Pro-adherence complementary audiovisual educational intervention model for chronic myeloid leukemia patients treated with imatinib mesylate.

BACKGROUND: Imatinib mesylate (IM) treatment adherence is a challenge, especially in an economic-social population neglected from developing countries. OBJECTIVE: To create a new complementary audiovisual educational intervention model to improve IM treatment adherence of CML patients. METHODS: Two adherence verification methods were applied before and after intervention: modified Morisky-Green test and molecular responses (BCR-ABL transcripts quantification). Adherence estimates were calculated using univariate and multivariate component analysis (MCA) for the socio-demographic and clinical characteristics of patients. RESULTS: Modified Morisky-Green test results demonstrated a substantial increase of CML patient adherence from 23% (pre-film) to 65% (post-film). Greater improvement was obtained for patients presenting major molecular response (MMR) from 38% (pre-film) to 60% (post-film). Although slight gain for complete molecular response (CMR) from 23% (pre-film) to 26% (post-film) was achieved, it represents a total tumour regression. MCA identified that females <50 years-old, using less than two medications (no disease associated) and CMR condition were the most benefited with intervention. CONCLUSION: Audiovisual educational intervention was an effective complementary pro-adherence model, activating patient memory and improving IM treatment adherence. Although this intervention shows effective, not all patients responded as expected, being necessary a combination of educational and clinical interventions to improve IM adherence.

Occupational exposure evaluation of Brazil university community to the volatile organic compounds.

Occupational exposure to volatile organic compounds (VOC) might generate serious worker health damages. Therefore, biological monitoring is essential to evaluate exposure biomarkers from highly toxic chemicals, ensuring better attention to the worker health. In this study was developed and validated a bioanalytical method based on high-performance liquid chromatography coupled to photodiode array (HPLC-PDA) for the quantification of VOC biomarkers in urine samples from Federal University of Goias (UFG) workers. Samples were collected from 30 occupationally exposed subjects after application of a questionnaire survey. The following biomarkers hippuric acid, methyl-hippuric acid, mandelic acid, phenylglyoxylic acid and phenol were quantified, representing exposition to toluene, xylene, styrene, ethylbenzene, benzene and phenol solvents, respectively. Hippuric acid levels were found close to or above the reference values, although a subject had levels higher than preconized by Biological Limit Values (BLV) guideline of 4.0 mg/g creatinine. Five subjects had 3 and 4-methylhippuric acid ranging from 0.1 to 1.0 mg/g creatinine. These results indicate a moderate to high VOC exposure from UFG workers. Multivariate analysis generated four clusters and indicated that histotechnicians and graphic workers need especial attention on occupational VOC exposure. The results from this study reinforce the need for reliable methods able to the biological monitoring as an important tool for assessing occupational exposure.

Multivariate analysis applied in dataset of Poison Control Center of São Paulo, Brazil.

Multivariate analysis techniques could be used to identify possible intercorrelations in intoxications cases. The statistical analyses used were a multiple logistic regression, multiple correspondence analysis, principal component and hierarchical cluster analysis. Of the 320 samples analysed, 192 samples were positive for some of the investigated toxic agents, of which 100 were positive for ethanol and 131 were positive for other substances. It was possible to group the patients into 3 clusters, which appears 66.5% of this information in the three first factorial axes. On the first axis, the male patients were separated from the female patients. Patients exposed to drugs, between 30 and 39 years old were grouped in the same cluster. On the second factorial axis, patients who were intoxicated with ethanol and who became intoxicated with diazepam were grouped. This work contributed to the mapping of intoxication cases at the Poison Control Centre of the São Paulo city, Brazil (CCI-SP) and serves as an initial study for the creation of a database that could be updated constantly and thus could provide a toxicovigilance system for educational policies.