RESUMO
The objective of this study was to evaluate the impact of three continuing education seminars (within a period of 4 months) on the quality of patient management and rational drug use. The study was designed as a randomized controlled trial. Prescribers in 16 general health centers were allocated to an intervention (eight health centers) or a control (eight health centers) group. A total of 5,685 patient cards was analyzed for quality of case management and rational drug use. In the intervention health centers the average number of drugs per patient decreased from 2.3 to 1.9 (p = 0.005) and the proportion of patients managed with nonpharmacological treatment increased from 1 to 13.2%. Recorded history taking, examination, and diagnosis improved in the intervention health centers. More drugs were correctly chosen in the intervention health centers compared to control health centers (p = 0.03). The proportion of patients prescribed antibiotics decreased and the proportion of patients adequately managed increased in the intervention health centers. Our conclusion is that continuing education in the form of repeated seminars is effective in influencing prescribers and in promoting rational drug use in primary care.
Assuntos
Países em Desenvolvimento , Tratamento Farmacológico/estatística & dados numéricos , Educação Continuada , Pessoal de Saúde/normas , Adolescente , Adulto , Administração de Caso/normas , Administração de Caso/tendências , Criança , Tratamento Farmacológico/tendências , Feminino , Humanos , Masculino , Fatores de Tempo , ZâmbiaAssuntos
Aminopeptidases , Arthrobacter/enzimologia , Peptídeo Hidrolases , Caseínas , Cromatografia em Gel , Cromatografia por Troca Iônica , Cobalto , Dipeptídeos , Ácido Edético , Eletroforese , Magnésio , Manganês , Peptídeos , VibraçãoAssuntos
Carboxipeptidases/metabolismo , Zinco/análise , Sequência de Aminoácidos , Aminoácidos/análise , Carboidratos/análise , Carboxipeptidases/isolamento & purificação , Cromatografia de Afinidade , Cromatografia em Gel , Cromatografia por Troca Iônica , Cromatografia em Camada Fina , Compostos de Dansil , Diálise , Eletroforese em Papel , Eletroforese em Gel de Poliacrilamida , Galactose/análise , Glucosamina/análise , Concentração de Íons de Hidrogênio , Métodos , Peso Molecular , Polissacarídeos , Espectrofotometria , Espectrofotometria Ultravioleta , Relação Estrutura-Atividade , UltrafiltraçãoAssuntos
Farinha de Peixe , Produtos Pesqueiros , Proteínas do Leite/metabolismo , Fragmentos de Peptídeos , Peptídeo Hidrolases/metabolismo , Hidrolisados de Proteína , Bebidas , Fenômenos Químicos , Química , Estabilidade de Medicamentos , Alimentos , Géis , Peso Molecular , Fragmentos de Peptídeos/metabolismo , Proteínas/metabolismo , Solubilidade , ÁguaRESUMO
An agar-degrading bacterium, having a guanine-cytosine content of 50-5 mol% has been isolated from sewage. This Gram-negative rod grew well in a simple salts medium containing various carbohydrates. Growing bacteria dissolved gels and suspensions of agar and agarose rapidly, but did not attack cross-linked agars. Agarase was cell-bound in exponentially growing cultures but was released into the medium at stationary phase. Both cell extracts and culture filtrates released reducing sugars from agar solutions and prevented them from gelling. Gels were not dissolved by enzyme solutions, but the turbidity and iodine-binding properties of the agar were decreased.