الملخص
Objetivo: Estimar a prevalência do uso de analgésicos não opioides para alívio da dor entre graduandos de Enfermagem. Método: Estudo transversal, realizado com 142 estudantes de Enfermagem no interior do estado do Amazonas, Região Norte do Brasil. Os dados foram coletados no segundo semestre de 2017, utilizando questionário autoaplicável. Resultados: A prevalência do consumo de analgésicos não opioides foi de 68,3%; sendo o alívio das dores de cabeça (64,9%) e dores abdominais (14,4%) os principais motivos para uso. A maioria afirmou que: a dor interfere na realização de atividades diárias (77,3%); reconhecem que os analgésicos podem fazer mal à saúde (76,3%); consumiam analgésicos por conta própria (58,8%). Ainda, 47,4% indicavam medicamentos a terceiros e 93,8% estocavam medicamentos em suas casas. Conclusão: Constatou-se elevado consumo de analgésico, destacando o uso irracional -sem prescrição de profissional. Faz-se necessário fortalecer o ensino sobre o uso racional de medicamentos entre os alunos de Enfermagem, visando minimizar os riscos desta prática.
Objetivo: Estimar la prevalencia de analgésicos no opioides para el alivio del dolor entre los estudiantes de enfermería. Método: Estudio transversal, realizado con 142 estudiantes de enfermería en el interior del estado de Amazonas, Región Norte de Brasil. Los datos se recopilaron en el segundo semestre de 2017 utilizando un cuestionario autoadministrado. Resultados: La prevalencia del uso analgésico no opioide fue del 68,3%; ser el alivio de los dolores de cabeza (64,9%) y dolor abdominal (14,4%) las principales razones de uso. La mayoría declaró que: el dolor interfiere con el desempeño de las actividades diarias (77,3%); reconocen que los analgésicos pueden dañar la salud (76,3%); consumieron analgésicos por sí solos (58,8%). Además, el 47,4% reportó medicamentos a terceros y el 93,8% dijo que almacenaba los medicamentos en sus hogares. Conclusión: Hubo un alto consumo de analgésicos, destacando el uso irracional sin prescripción profesional. Es necesario fortalecer la enseñanza sobre el uso racional de los medicamentos entre los estudiantes de enfermería, con el objetivo de minimizar los riesgos de esta práctica.
Objective: To estimate the prevalence of non-opioid analgesics for pain relief among nursing undergraduates. Method: Cross-sectional study, conducted with 142 nursing students in the interior of the state of Amazonas, Northern Region of Brazil. Data were collected in the second half of 2017 using a self-administe redquestionnaire. Results: The prevalence of non-opioid analgesic use was 68,3%; being the relief of headaches (64,9%) and abdominal pain (14,4%) the main reasons for use. The majority stated that: pain interferes with the performance of daily activities (77.3%); they recognize that analgesics can harm health (76.3%); they consumed analgesics on their own (58.8%). Still, 47.4% indicated medicines to third parties and 93.8% reported that they stocked medicines in their homes. Conclusion: There was a high consumption of analgesics, highlighting irrational use -without professional prescription. It is necessary to strengthen the teaching on the rational use of medicines among nursing students, aiming to minimize the risks of this practice.
الموضوعات
Humans , Students, Nursing , Self Administration , Health Education , Analgesics, Non-Narcotic , Brazilالملخص
Opioid use disorder (OUD) has become a considerable global public health challenge; however, potential medications for the management of OUD that are effective, safe, and nonaddictive are not available. Accumulating preclinical evidence indicates that antagonists of the dopamine D3 receptor (D3R) have effects on addiction in different animal models. We have previously reported that YQA14, a D3R antagonist, exhibits very high affinity and selectivity for D3Rs over D2Rs, and is able to inhibit cocaine- or methamphetamine-induced reinforcement and reinstatement in self-administration tests. In the present study, our results illustrated that YQA14 dose-dependently reduced infusions under the fixed-ratio 2 procedure and lowered the breakpoint under the progressive-ratio procedure in heroin self-administered rats, also attenuated heroin-induced reinstatement of drug-seeking behavior. On the other hand, YQA14 not only reduced morphine-induced expression of conditioned place preference but also facilitated the extinguishing process in mice. Moreover, we elucidated that YQA14 attenuated opioid-induced reward or reinforcement mainly by inhibiting morphine-induced up-regulation of dopaminergic neuron activity in the ventral tegmental area and decreasing dopamine release in the nucleus accumbens with a fiber photometry recording system. These findings suggest that D3R might play a very important role in opioid addiction, and YQA14 may have pharmacotherapeutic potential in attenuating opioid-induced addictive behaviors dependent on the dopamine system.
الموضوعات
Rats , Mice , Animals , Analgesics, Opioid , Dopamine , Heroin/pharmacology , Dopamine Antagonists/pharmacology , Receptors, Dopamine D3/metabolism , Morphine/pharmacology , Behavior, Addictive/drug therapy , Self Administrationالملخص
A B S T R A C T Ayahuasca is a psychotropic infusion prepared by boiling the bark of Amazonian plants and has many psychopharmacological effects not fully understood. Some of those effects are used as treatment for different diseases. However, the side effects of ayahuasca, including ayahuasca-induced psychosis, are an important issue. Here we report the case of a patient who had a psychotic episode after taking ayahuasca and who was successfully treated with antipsychotic medication. Given the current spread of ayahuasca consumption in developed societies, the present case highlights the need for better understanding and regulation of the social-legal condition of ayahuasca and the need for further research. Additionally, psycho-education seems advisable in order to create awareness of the potential risks of the use of ayahuasca.
RESUMEN La ayahuasca es una bebida psicotrópica preparada a través de la cocción de plantas de la cuenca amazónica que tiene muchos efectos psicofarmacológicos no del todo estudiados. Algunos de esos efectos son usados como tratamiento de diversas patologías. Sin embargo, existen efectos secundarios de la ayahuasca que deben ser tenidos en cuenta, entre ellos psicosis inducida por ayahuasca. Reportamos un caso de un paciente que, tras autoadministración de ayahuasca, presentó un episodio psicótico y que fue satisfactoriamente tratado con antipsicóticos. Dada el uso cada vez más frecuente de ayahuasca en las sociedades desarrolladas, el caso actual resalta las necesidades de entender, regular e investigar el uso de la ayahuasca. Además, crear conciencia de los potenciales riesgos del uso de ayahuasca a través de la psicoeducación debería ser implementado.
الموضوعات
Humans , Male , Adult , Plants , Psychotic Disorders , Self Administration , Social Control, Formal , Awareness , Therapeutics , Antipsychotic Agents , Banisteriopsisالملخص
Resumen El VOT (video observed treatment) es la autoadministración de la terapia certificada mediante registro de imágenes en video y podría constituir para algunos pacientes una alternativa complementaria al DOT (directly observed treatment) en la administración del tratamiento ambulatorio de la Tuberculosis en Centros de Salud Primarios. Existen evidencias internacionales en que la estrategia VOT mejora la adherencia al tratamiento, empodera a los pacientes, reduce los costos para pacientes y el sistema de salud y ahorra el tiempo dedicado por los pacientes al traslado a centros de terapia. La disponibilidad masiva de teléfonos portátiles con capacidad de trasmitir videos en la población de Chile podría permitir realizar una investigación piloto de VOT.
VOT (Video Observed Treatment) is a video certificated self-administration of therapy and could be complementary to DOT (Directly Observed Treatment) for the administration of ambulatory tuberculosis treatment at Primary Health Centers. Reviewed international experience and evidence indicates that VOT improves treatment adherence, empowers patients, reduces health system costs and saves patient's transfer time to Therapy Centers. Given the high penetration of smartphones with videocall software in the Chilean population, the pre-requisites are provided to consider a VOT pilot research in Chile.
الموضوعات
Humans , Tuberculosis/drug therapy , Video Recording , Directly Observed Therapy/methods , Self Administration , Chile , Treatment Adherence and Compliance , Antitubercular Agents/administration & dosageالملخص
Resumen La automedicación y la autoprescripción son acciones de los pacientes; la primera como elemento del autocuidado que involucra medicamentos de venta libre y la segunda como una violación a la ley de salud, pues comprende medicamentos que solo pueden expenderse con receta. Todos los inconvenientes que se han atribuido a la automedicación en realidad lo son de la autoprescripción.
Abstract Self-medication and self-prescription are actions undertaken by patients; the former, as an element of self-care that involves over-the-counter drugs, and the latter, as a violation of the Statute of Health, since it includes drugs that can only be dispensed with a medical prescription. All the drawbacks that have been attributed to self-medication are actually associated with self-prescription.
الموضوعات
Humans , Self Care/methods , Self Medication , Self Administration , Prescription Drugs/administration & dosage , Attitude of Health Personnelالملخص
Abstract Background and objectives The Sphenopalatine Ganglion Block (SGB) is an effective, low-risk treatment option for Postdural Puncture Headache (PDPH) refractory to conservative management. Case report This report presents four complex cases of patients with headache related to low cerebrospinal fluid pressure. Three of them were successfully treated with the application of local anesthetic topical drops through the nasal cavity. Conclusion The novel approach described in this report has minimal risks of discomfort or injury to the nasal mucosa. It is quick to apply and can be administered by the patient himself.
Resumo Justificativa e objetivos: O Bloqueio do Gânglio Esfenopalatino (BGEP) é opção de tratamento efetivo associado a baixo risco para Cefaleia Pós-Punção Dural (CPPD) refratária às medidas conservadoras. Relato de caso: Este relato apresenta quatro pacientes com alta complexidade que apresentaram cefaleia relacionada à baixa pressão do líquido cefaloraquidiano. Três pacientes foram tratados com sucesso pela instilação de gotas de anestésico local tópico na cavidade nasal. Conclusões: A nova abordagem descrita neste relato apresenta riscos mínimos de desconforto ou lesão à mucosa nasal. A aplicação é rápida e pode ser administrada pelo próprio paciente.
الموضوعات
Humans , Male , Female , Adult , Post-Dural Puncture Headache/therapy , Sphenopalatine Ganglion Block/methods , Anesthetics, Local/administration & dosage , Administration, Intranasal , Self Administration , Treatment Outcome , Middle Aged , Nasal Mucosa/metabolismالملخص
Objetivo: Caracterizar la automedicación en pacientes adultos que asisten a la clínica Centro Médico Caribe Honduras, Tegucigalpa, Honduras. Abril 2019 Diseño Metodológico: Estudio descriptivo de corte transversal, realizado en las clínicas Médicas Caribe Honduras, Tegucigalpa, Honduras. Adultos que visitan la clínica en el mes de Abril (51) del 2019. Estuvo constituido por un universo y una muestra de 51 pacientes. Resultados: El 31% (16) de los pacientes automedicado están en el rango de 26-33 años, 59%(30) eran mujeres , el 100% (51) de procedencia urbana, y con escolaridad universitaria en 59% (30), patología más frecuente en el proceso de automedicación los procesos respiratorios en 35%(46), de enfermedades crónicas 92%(11) y en otras enfermedades el dolor de cabeza con 64%(36), las causas familiares la madre es la mayor influencia 39%(21), en las causas no familiares los dependientes de farmacia en primer lugar con 46%(35), y en el área profesional el área de enfermería encabeza el listado con 56%(9), y el medio de comunicación más influyente es la televisión con 57%(25). Los motivos de automedicación fueron la percepción leve de los síntomas con 45%(32), siendo los analgésicos el de mayor elección con 29%(46) y el lugar de obtención de los medicamentos automedicados es en farmacia. Conclusiones: Los pacientes que se automedicaron en el período de Abril la mayoría son personas jóvenes, universitarias del casco urbano, mujeres, con influencias familiares fuertes siendo la madre la creadora de esta cultura, y siendo de un nivel educativo alto deciden confiar su salud a personal poco calificado para esta práctica como ser dependientes de farmacias siendo los analgésicos los medicamentos más usados y las farmacias los lugares de obtención de estos
الموضوعات
Humans , Adult , Self Medication , Self Administration , Pharmaceutical Preparations , Public Health , Epidemiology, Descriptive , Cross-Sectional Studiesالملخص
ABSTRACT Objective: To demonstrate the most frequent errors in inhalation technique in patients with asthma undergoing treatment at a tertiary care hospital. Methods: A cross-sectional study with a convenience sample of asthma patients aged 18 years or over, treated at a pulmonology outpatient clinic of a tertiary care hospital. The assessment of inhalation technique of users of the dry powder inhalers Aerolizer®, Aerocaps and Diskus®, or metered-dose inhalers was based on the manufacturer's instructions for use of each inhaler device. Patients demonstrated the inhalation technique with empty inhaler devices, and it was considered correct when all stages were performed properly, or when errors probably did not interfere with the treatment outcome. Results: Among 71 participants, 43 (60.5%) performed inhalation technique incorrectly. Among metered-dose inhalers and dry powder inhalers users, inhalation technique errors were found in 84.2% and 51.9%, respectively (p=0.013). Errors were more frequent at the exhalation stage (67.4%), followed by breathing in (58.1%) and apnea (51.2%). In the group using dry powder inhalers, the most common errors occurred during exhalation and, for those using metered-dose inhalers, the most compromised stage was aspiration. Conclusion: Errors were more frequent among those using metered-dose inhalers compared with dry powder inhalers. Misconceptions are more common at the expiration stage among users of dry powder inhalers and in aspiration among those on metered-dose inhalers.
RESUMO Objetivo: Demonstrar os erros mais frequentes na técnica inalatória de pacientes com asma brônquica em tratamento em hospital terciário. Métodos: Estudo transversal, com amostra de conveniência de pacientes com asma, com 18 anos ou mais, em tratamento em ambulatório de pneumologia de um hospital terciário. A avaliação da técnica inalatória dos usuários dos dispositivos de pó seco Aerolizer ®, Aerocaps® ou Diskus®, ou de aerossóis dosimetrados teve como base as orientações da bula do fabricante de cada dispositivo inalatório. Os pacientes demonstraram a técnica inalatória com dispositivos inalatórios vazios, e ela foi considerada correta quando todas as etapas foram realizadas de forma apropriada, ou quando os equívocos provavelmente não interferiam no resultado do tratamento. Resultados: Entre os 71 participantes, 43 (60,5%) realizaram a técnica inalatória de forma incorreta. Dentre os usuários de aerossóis dosimetrados e dispositivos de pó seco, ocorreram erros de técnica inalatória em 84,2% e 51,9%, respectivamente (p=0,013). Os erros foram mais frequentes na etapa da expiração (67,4%), seguidos da aspiração (58,1%) e da apneia (51,2%). No grupo que usava dispositivos de pó seco, os erros mais comuns aconteceram na expiração e, nos que utilizavam aerossóis dosimetrados, a etapa mais comprometida foi a aspiração. Conclusão: Os erros foram mais frequentes entre os que usavam aerossóis dosimetrados em comparação com dispositivos de pó seco. Os equívocos foram mais comuns na etapa da expiração entre os usuários de dispositivos de pó seco e na aspiração entre os que usavam aerossóis dosimetrados.
الموضوعات
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Asthma/drug therapy , Administration, Inhalation , Medication Errors , Socioeconomic Factors , Self Administration/standards , Patient Education as Topic , Cross-Sectional Studies , Metered Dose Inhalers , Dry Powder Inhalers/instrumentation , Tertiary Care Centersالملخص
BACKGROUND: The aim of this study was to identify the painkillers preferred for self-administration by doctors working at general hospitals in the capital of the Republic of Korea.METHODS: We collected data, using a questionnaire, from 224 doctors working at secondary or tertiary hospitals in the capital of the Republic of Korea from July 1, 2017 to August 31, 2017. The questionnaire included questions on the preferred type of painkiller for each type of pain and the frequency of painkiller intake. Further, we evaluated the participants on the Likert scale to analyze the consideration and cognition of self-administration of painkillers.RESULTS: The doctors in this study tended to state the trade name of the painkillers rather than the generic name. They preferred acetaminophen for headache and nonsteroidal anti-inflammatory drugs for gastrointestinal (GI) pain, dysmenorrhea, toothache, and musculoskeletal pain. In the choice of painkiller for self-administration, they set utmost importance on the effectiveness of the medicine, followed by the potential side effects, physician's prescription, and the pharmacy's recommendation, in that order. The side effects attribute GI complications, hepatotoxicity, drug tolerance, and delayed diagnosis to painkiller use. There were some remarkable differences between surgeons and non-surgeons, men and women, and specialists and trainees in the conception of painkillers and pain control.CONCLUSION: This is the first study worldwide on the trait of the self-administration of painkillers by doctors, which can serve as a useful reference in clinical settings.
الموضوعات
Female , Humans , Male , Acetaminophen , Analgesics , Cognition , Delayed Diagnosis , Drug Tolerance , Dysmenorrhea , Fertilization , Headache , Hospitals, General , Musculoskeletal Pain , Prescriptions , Republic of Korea , Self Administration , Self Medication , Specialization , Surgeons , Tertiary Care Centers , Toothacheالملخص
La automedicación es una práctica de deno-minación moral subjetiva muy frecuente en los pacientes ambulatorios, en la cual estos optan por adquirir medicamentos sin pres-cripción médica para el alivio de dolencias, frecuentemente consideradas de baja seve-ridad. Objetivo: Determinar el conocimien-to, factores condicionantes y características de automedicación en los estudiantes de las carreras enfermería y medicina de la Escue-la Universitaria de Ciencias de la Salud de la Universidad Nacional Autónoma de Hondu-ras en el Valle de Sula (EUCS/UNAH-VS) en el primer semestre del 2017. Pacientes y Métodos: Estudio cuantitativo, alcance des-criptivo, transversal, prospectivo, realizado en estudiantes de la carrera de enfermería y medicina de la EUCS/UNAH-VS que cursa-ban el 2do y 3er año el primer semestre del 2017. La muestra fue no probabilística por conveniencia de 55 estudiantes pertene-cientes a cada carrera, en total 110. Resul-tados: Se encontró que 50 (90.9%) estu-diantes de enfermería y 49 (89.09%) de medicina admitieron automedicarse. La mayoría no conocen las indicaciones y/o efectos adversos de los fármacos utilizados para automedicarse. El 45.45% (25) de enfermería y 63.63% (35) ignoran la dosificación. Un 67.27% (37) de enfermería y 61.8% (34) de medicina desconocen los efectos adversos de las dosificaciones exce-sivas. La principal causa de automedicación fue la consideración de malestares como no graves, siendo manejados en casa. Conclu-sión: La mayoría de los estudiantes de ambas carreras desconocen sobre indica-ciones, efectos adversos y dosificación de los medicamentos y los toman considerando los malestares no graves y no por los efec-tos que el medicamento pueda causarles. El principal síntoma que presentaron es la cefalea y el medicamento que más consu-mían fué el acetaminofen...(AU)
الموضوعات
Humans , Male , Female , Self Medication/adverse effects , Students, Health Occupations , Self Administration/statistics & numerical data , Cross-Sectional Studies/methodsالملخص
La inyección subcutánea o intramuscular de mercurio elemental, sea accidental o intencional, es una forma poco frecuente de intoxicación. Presentamos el caso de un hombre de 22 años de edad, con antecedentes de rasgos psicóticos y lesiones autolíticas, que se inyectó mercurio elemental en el tejido celular subcutáneo del cuello, tórax y abdomen, tres meses antes de su internación. Las áreas afectadas fueron localizadas mediante el examen físico, radiografías y tomografías. Se realizó el dosaje de mercurio en sangre y orina. Se resecó quirúrgicamente el mercurio de las zonas comprometidas. La detección y remoción precoz del mercurio, mediante cirugía y eventual quelación, es necesaria para prevenir complicaciones a corto y largo plazo.
Accidental or intentional subcutaneous or intramuscular injection of metallic mercury is an uncommon form of intoxication. We present the case of a 22 year-old man, who had psychotic disorders and autoaggressive behavior, with a preceding history of self-injection of mercury into the soft tissues of the neck, thorax and abdomen. Clinical examination, radiographs, and computed tomography showed the affected area. Mercury was measured in blood and urine. The mercury was surgically resected from the affected areas. Early detection and removal of mercury from the body by physical removal or chelation is required to prevent short- and long-term toxicity.
الموضوعات
Humans , Male , Young Adult , Psychotic Disorders , Mercury/administration & dosage , Mercury Poisoning/surgery , Self Administration , Tomography, X-Ray Computed , Injections, Subcutaneousالملخص
Resumo OBJETIVO Identificar os fatores associados à autoaplicação de insulina em adultos com Diabetes Mellitus. MÉTODO Estudo transversal desenvolvido no município de Viçosa-MG, que avaliou 142 pacientes. A coleta de dados foi realizada entre abril e julho de 2013 mediante entrevista no domicílio do participante. Regressão logística múltipla foi utilizada. RESULTADO A prevalência de autoaplicação de insulina foi de 67,6%, apresentando associação com idade entre 57 e 68 anos (OR = 0,3; IC95%: 0,1 - 0,9), conviver com companheiro e filhos (OR = 2,5; IC95%: 1,1 - 5,0), ter 9 anos ou mais de estudo (OR = 8,4; IC95%: 1,9 - 37,9), morar em área não coberta pela Estratégia Saúde da Família (ESF) (OR = 2,8; IC95%: 1,1 - 7,0). CONCLUSÃO Autoaplicação de insulina mostrou-se associada à idade, escolaridade, situação conjugal e cobertura da ESF. O reconhecimento desses fatores pode contribuir para o desenvolvimento de estratégias para adesão à autoaplicação de insulina.
Resumen OBJETIVO Identificar los factores asociados con la autoadministración de insulina en adultos con diabetes mellitus. MÉTODOS Se trata de un estudio transversal desarrollado en el municipio de Viçosa-MG, en el que se evaluaron 142 pacientes. La recolección de datos se llevó a cabo entre abril y julio de 2013 mediante entrevistas en el hogar del participante. Se aplicó la regresión logística múltiple. RESULTADOS La prevalencia de la auto-administración de insulina fue de 67,6% y se asoció con edad entre 57 y 68 años (OR = 0,3; IC del 95%: 0,1 - 0,9), que viven con una pareja e hijos ( OR = 2,5; IC del 95%: 1.1 5,0), con 9 o más años de educación (OR = 8,4; IC del 95%: no 1,9-37,9), que viven en un área cubierta por la Estrategia de Salud de la familia (ESF) (OR = 2,8; IC del 95%: 1.1 7.0). CONCLUSIÓN La autoadministración de insulina se asoció con la edad, la educación, el estado civil y la cobertura del ESF. El reconocimiento de estos factores puede contribuir para la adhesión a la autoadministración de insulina.
ABSTRACT Objective: To identify the factors associated with the self-application of insulin in adult individuals with Diabetes Mellitus. Method: A cross-sectional study developed in the city of Viçosa-MG, which assessed 142 patients. The data collection was performed between April and July 2013 through an interview at the participant's home. Multiple logistic regression was used. Results: The prevalence of the self-administration of insulin was of 67.6%, and it was associated with ages between 57 and 68 years old (OR = 0.3, 95% CI: 0.1-0.9), living with a partner and children (OR = 2.5, 95% CI: 1.1-5.0), 9 years or more of study (OR = 8.4, 95% CI: 1.9-37.9), living in an area not covered by the Family Health Strategy (FHS) (OR = 2.8, 95% CI: 1.1 - 7.0). Conclusion: The self-application of insulin was associated with age, schooling, marital status, and the FHS coverage. The recognition of these factors may contribute to the adherence to the self-application of insulin.
الموضوعات
Humans , Male , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Diabetes Mellitus/drug therapy , Medication Adherence , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Brazil/epidemiology , Self Administration , Marriage , Catchment Area, Health , Comorbidity , Patient Education as Topic , Cross-Sectional Studies , Surveys and Questionnaires , Age Factors , Insurance Coverage , Racial Groups , Diabetes Mellitus/psychology , Diabetes Mellitus/epidemiology , Educational Status , Hospitalization/statistics & numerical data , Hypertension/epidemiology , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Middle Aged , National Health Programsالملخص
ABSTRACT Anaphylaxis is a severe, life-threatening generalized or systemic hypersensitivity reaction that requires rapid and adequate care. This study aimed to obtain an integrated view of the level of physicians' knowledge related with treatment of anaphylaxis in studies published within the last 5 years. Sixteen studies were found and four points were identified as of the great interest to the authors: (1) emergency pharmacological treatment, (2) epinephrine auto-injectors prescription, (3) knowledge of the main signs of anaphylaxis, and (4) admission of the patient to verify biphasic reactions. Concern about the use of intramuscular adrenaline as the first choice in relation with anaphylaxis was evident in most studies, rather than its use in the comparison dial, and especially low in a study that included data from Brazil, in which the frequency of its use was 23.8%. An adrenaline autoinjector is highly recommended among specialists for patients at risk of anaphylaxis, however, its use is still infrequent among non-specialists and in countries that this agent is not available. Intervention studies have shown improved medical knowledge of anaphylaxis following disclosure of the information contained in the international guidelines. The analysis of these studies reinforces the need to disseminate international guidelines for diagnosis and treatment of anaphylaxis, as well as providing an adrenaline autoinjector, to improve management and to prevent a fatal outcome.
RESUMO Anafilaxia é uma reação de hipersensibilidade generalizada ou sistêmica grave, com risco de morte, que exige atendimento rápido e correto. Este estudo teve como objetivo obter uma visão integrada do nível de conhecimento dos médicos no atendimento da anafilaxia à luz dos estudos publicados internacionalmente nos últimos 5 anos. Foram encontrados 16 estudos, com quatro pontos identificados como de maior interesse dos autores: (1) tratamento farmacológico de emergência, (2) prescrição de autoinjetores de adrenalina, (3) conhecimento dos principais indícios da anafilaxia e (4) observação do paciente para verificar reações bifásicas. A preocupação com o uso da adrenalina intramuscular como primeira escolha frente à anafilaxia foi evidente na maioria dos estudos, mas o conhecimento sobre seu uso se mostrou desigual e especialmente baixo em estudo que incluiu dados do Brasil, onde a frequência de seu uso foi de 23,8%. A adrenalina autoinjetável é altamente recomendada entre especialistas para pacientes em risco de anafilaxia, mas seu uso ainda é pouco frequente entre não especialistas e em países que não dispõem dela em seus mercados internos. Estudos de intervenção comprovaram a melhora no entendimento dos médicos sobre anafilaxia após a divulgação das informações contidas nas diretrizes internacionais. A análise dos estudos reforça a necessidade de disseminar as diretrizes internacionais no manejo da anafilaxia, bem como de disponibilizar a adrenalina autoinjetável, a fim de melhorar o atendimento e evitar um desfecho fatal.
الموضوعات
Humans , Attitude of Health Personnel , Epinephrine/administration & dosage , Practice Guidelines as Topic , Adrenergic Agonists/administration & dosage , Anaphylaxis/diagnosis , Anaphylaxis/drug therapy , Physicians/statistics & numerical data , Self Administration , Injections, Intramuscularالموضوعات
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Ophthalmic Solutions/administration & dosage , Self Administration/methods , Ophthalmic Solutions/adverse effects , Vision, Low , Frail Elderly , Medication Adherence , Self Report , Administration, Ophthalmic , Patient Reported Outcome Measuresالملخص
OBJECTIVES: To evaluate the colorimetric change in incisors and canines of adolescents aged 12 to 20 years submitted to at-home whitening and to evaluate satisfaction, sensitivity and discomfort during the procedures through a questionnaire. METHOD: Thirty adolescents were randomly assigned to the following groups: 1) 6.0% hydrogen peroxide (White Class with calcium - FGM); 2) 7.5% hydrogen peroxide (White Class with calcium - FGM); 3) 10% hydrogen peroxide (Oral B 3D White - Oral-B); 4) Control group - placebo. Assessments were performed prior to treatment as well as at 7, 30, 180 and 360 days after treatment. Friedman’s ANOVA was used to analyze color. The Kruskal-Wallis test followed by Dunn’s post hoc test was used to compare the groups at the different evaluation times. Answers on the questionnaires were ranked, and non-parametrical tests were employed. The groups were compared in each period using the Kruskal-Wallis test followed by the Student-Newman-Keuls test. Categorical data were analyzed using Fisher's exact test, and the Wilcoxon test was used for the analysis of different periods. P-values were corrected using the Hyan-Holm step-down Bonferroni procedure. Clinicaltrials.gov: NCT01998386. RESULTS: Similar results were obtained one month after treatment with both tooth whitening gels and whitening strips. Patients were partially satisfied with the treatment after the first and second weeks and would recommend it. All products demonstrated color stability after 12 months of follow-up. CONCLUSIONS: The bleaching procedure was efficient, and the patients could perceive its result. Further investigations are needed to determine the effects of bleaching on young teeth.
الموضوعات
Humans , Male , Female , Child , Adolescent , Young Adult , Hydrogen Peroxide , Tooth Bleaching Agents , Tooth Bleaching/methods , Analysis of Variance , Calcium , Color , Colorimetry , Dentin Sensitivity/chemically induced , Follow-Up Studies , Patient Satisfaction , Reproducibility of Results , Self Administration , Statistics, Nonparametric , Surveys and Questionnaires , Time Factors , Treatment Outcomeالملخص
ABSTRACT Objective: to analyze the self-care competence in the administration of insulin performed by older people aged 70 or over. Method: cross-sectional study carried out with 148 older people aged 70 or over, who performed self-administration of insulin. Data collection was carried out using a structured questionnaire and an adapted guide for the application of the Scale to Identify Self-Care Competence of Patients with Diabetes, at the participants' home. Data analysis included descriptive and inferential statistical tests, with forward logistic regression. Results: the prevalence of self-care competence in the administration of insulin was 35.1%. Handwashing error was the most frequent in self-administration of insulin. Self-care competence was negatively associated with retirees and positively associated with senior patients who performed capillary blood glucose monitoring and skin pinching during insulin application. Conclusion: there was low self-care competence and it was associated with both the sociodemographic and the clinical characteristics with regard to self-application of insulin by the older people.
RESUMO Objetivo: analisar a competência para o autocuidado na administração de insulina por idosos septuagenários ou mais de idade. Método: estudo transversal, com 148 idosos septuagenários ou mais de idade, que realizavam autoadministração de insulina. A coleta de dados deu-se por meio de questionário estruturado e guia adaptado para aplicação da Escala para Identificação da Competência do Diabético para o Autocuidado, no domicílio dos participantes. Na análise dos dados, foram compreendidos testes estatísticos descritivos e inferenciais, com regressão logística forward. Resultados: a prevalência da competência para o autocuidado na administração de insulina foi de 35,1%. Lavagem das mãos foi o erro mais frequente na autoaplicação de insulina. A competência para o autocuidado apresentou associação negativa para os aposentados e associação positiva para os idosos que realizavam glicemia capilar e prega subcutânea, durante a aplicação de insulina. Conclusão: a competência para o autocuidado foi baixa e esteve associada tanto às características sociodemográficas e clínicas quanto ao desempenho do idoso para a autoaplicação de insulina.
RESUMEN Objetivo: analizar la capacidad de autocuidado en la administración de insulina en adultos mayores de 70 años de edad o más. Método: estudio transversal realizado con 148 adultos mayores de 70 años de edad o más, que realizaban la autoadministración de insulina. La recolección de datos se llevó a cabo mediante un cuestionario estructurado y una guía adaptada para la aplicación de la Escala para la Identificación de la Capacidad de Autocuidado de Pacientes con Diabetes, en el hogar de los participantes. En el análisis de los datos, se incluyeron pruebas estadísticas descriptivas e inferenciales, con regresión logística forward. Resultados: la prevalencia de capacidad de autocuidado en la administración de insulina fue del 35,1%. El error en el lavado de manos fue el más frecuente en la autoadministración de insulina. La capacidad de autocuidado se asoció negativamente con los jubilados y se asoció positivamente con los adultos mayores que realizaban la monitorización de la glucemia capilar y el pellizco en la piel durante la aplicación de la insulina. Conclusión: la capacidad de autocuidado fue baja y se asoció con las características sociodemográficas y clínicas con respecto a la auto-aplicación de la insulina por los adultos mayores.
الموضوعات
Humans , Male , Female , Aged , Self Care , Diabetes Mellitus/drug therapy , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Self Administration , Cross-Sectional Studiesالملخص
O envelhecimento populacional, o aumento da prevalência de diabetes em idosos e o aumento da utilização de insulina no tratamento de diabetes tipo 2, demonstram a necessidade de estudos para orientar abordagens de cuidados para idosos insulinizados. O que se observa no cotidiano de vida do idoso é que as ações que envolvem o autocuidado para o controle da glicemia, como autoaplicação de insulina e automonitorização glicêmica, nem sempre são manejadas de forma adequada, dificultando o controle e expondo o idoso a maiores riscos de complicações crônicas e agudas. A prática de autoadministração de insulina pode sofrer interferências de diversos fatores, como incapacidades cognitivas, deficiências e perda de autonomia e independência, muito comuns em idosos e que precisam ser investigados para serem trabalhados e minimizados pela atuação dos profissionais de saúde. OBJETIVO: Analisar a competência para o autocuidado na administração de insulina por septuagenários ou mais idosos com Diabetes Mellitus (DM). METODOLOGIA: Trata-se de um estudo transversal, realizado por meio de visitas domiciliares, com 148 septuagenários ou mais idosos que adquiriram insulina em algum dos centros de saúde do distrito Noroeste de Belo Horizonte e que realizam a autoadministração domiciliar desse medicamento. Foi realizada a coleta de dados sóciodemográficos e clínicos dos idosos e registro das alterações nas capacidades físicas, mentais e motivacionais. No segundo momento ocorreu a observação no domicílio do processo de autoadministração de insulina e o registro dos erros e acertos encontrados. Para a avaliação das capacidades, foi utilizada a Escala para Identificação da Competência do Diabético para o Autocuidado, proposta por NUNES (1982). RESULTADOS: O perfil dos idosos caracterizou-se como uma população predominantemente feminina (64,2%), proveniente do interior de Minas Gerais (61,5%), sem cônjuge (54,7%), com escolaridade menor ou igual a 4 anos de estudo (59,5%)...
The aging population, the increasing prevalence of diabetes in the elderly and increased use of insulin to treat type 2 diabetes demonstrate the need for studies to guide approaches to care for elderly insulinized. What is observed in the elderly routine is that actions involving self-care to control blood sugar, such as self-administration of insulin and blood glucose monitoring, are not always managed properly, making it difficult to control and expose the elderly to greater risks of acute and chronic complications. The practice of self-administration of insulin may suffer interference from several factors, such as cognitive impairment, disability and loss of autonomy and independence, very common in the elderly, that need to be investigated in order to be worked out and minimized the role of health professionals. OBJECTIVE: To assess the competence for self-care insulin administration by septuagenarian or more older with diabetes. METHODOLOGY: This is a cross-sectional study, carried out through home visits, with 148 septuagenarian or more older who acquired insulin in any of the health centers in the Northwest district of Belo Horizonte and conducting the home self-administration of this drug. Collecting sociodemographic and clinical data of elderly and record of changes in the physical, mental and motivational was held. The second time was the observation of insulin self-administration process and registration of errors and hits found. For the assessment of capabilities, we used the Scale for Diabetic Racing identification for self-care, proposed by NUNES (1982). RESULTS: The profile of the elderly was characterized as a predominantly female population (64.2%), from the country side of Minas Gerais (61.5%), with no spouse (54.7%), with less than or equal to 4 years education study (59.5%). The predominant age group was 70 to 79 years (73.6%). In the evaluation of errors in insulin self-administration, the...
الموضوعات
Humans , Aged , Aged, 80 and over , Self Care , Diabetes Mellitus/drug therapy , Aged , Insulin , Self Administrationالملخص
Caloric diet, such as fat and sugar intake, has rewarding effects, and has been indicated to affect the responses to addictive substances in animal experiments. However, the possible association between sucrose reward and the motivation for addictive drugs remains to be elucidated. Thus, we carried out behavioral tests after sucrose self-administration training to determine the effects of sucrose experience on rats' motivation for cocaine, locomotor sensitivity to cocaine, basal locomotor activity, anxiety level, and associative learning ability. The sucrose-experienced (sucrose) group exhibited higher lever press, cocaine infusion and break point, as well as upshift of cocaine dose-response curve in cocaine self-administration test, as compared with the control (chow) group. Additionally, despite similar locomotor activity in open field test and comparable score in cocaine-induced conditioned place preference, the sucrose group showed higher cocaine-induced locomotor sensitivity as compared with the chow group. The anxiety level and the performance in vocal-cue induced fear memory were similar between these two groups in elevated plus maze and fear conditioning tests, respectively. Taken together, our work indicates that sucrose experience promotes the rats' motivation for cocaine.
الموضوعات
Animals , Rats , Cocaine , Conditioning, Classical , Conditioning, Operant , Memory , Motivation , Reward , Self Administration , Sucroseالملخص
Objective: Inhaler technique comprises a set of procedures for drug delivery to the respiratory system. The oral inhalation of medications is the first-line treatment for lung diseases. Using the proper inhaler technique ensures sufficient drug deposition in the distal airways, optimizing therapeutic effects and reducing side effects. The purposes of this study were to assess inhaler technique in pediatric and adult patients with asthma; to determine the most common errors in each group of patients; and to compare the results between the two groups.Methods: This was a descriptive cross-sectional study. Using a ten-step protocol, we assessed inhaler technique in 135 pediatric asthma patients and 128 adult asthma patients.Results: The most common error among the pediatric patients was failing to execute a 10-s breath-hold after inhalation, whereas the most common error among the adult patients was failing to exhale fully before using the inhaler.Conclusions: Pediatric asthma patients appear to perform most of the inhaler technique steps correctly. However, the same does not seem to be true for adult patients.
Objetivo: La técnica inhalatoria es un conjunto de procedimientos mediante el cual se administra un fármaco al sistema respiratorio. Se caracteriza por ser utilizada como primera línea para tratar las enfermedades pulmonares. Su correcta ejecución garantiza un mayor depósito del fármaco en la vía aérea distal, optimizando sus efectos terapéuticos y disminuyendo los efectos secundarios. Los objetivos de este estudio son describir la ejecución de la técnica inhalatoria en un grupo de pacientes asmáticos pediátricos versus un grupo de pacientes asmáticos adultos, definir los errores más comunes en cada grupo de pacientes y comparar los resultados entre ambos grupos.Métodos: Estudio descriptivo, transversal. Se evaluó la técnica inhalatoria según un protocolo de diez pasos en 135 pacientes asmáticos pediátricos y 128 pacientes asmáticos adultos.Resultados: Se encontró que el error más común en los pacientes pediátricos fue no realizar una apnea de 10 s después de la inhalación, mientras que en los pacientes adultos el principal error fue no exhalar completamente antes de aplicar el inhalador.Conclusiones: Se determinó que los pacientes asmáticos pediátricos cumplen con la mayoría de los pasos para una correcta técnica inhalatoria, lo que no se observa en los pacientes adultos.
الموضوعات
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Albuterol/administration & dosage , Asthma/drug therapy , Bronchodilator Agents/administration & dosage , Metered Dose Inhalers , Administration, Inhalation , Age Factors , Cross-Sectional Studies , Patient Education as Topic , Self Administration/instrumentation , Self Administration/methods , Time Factorsالملخص
Objetivo O objetivo deste trabalho foi avaliar objetivamente, com registro em vídeo, as dificuldades dos pacientes com glaucoma avançado na colocação de colírios hipotensores e na realização de tarefas do cotidiano. Métodos Realizou-se um estudo prospectivo observacional em pacientes com glaucoma avançado e perda visual. Os dados foram coletados durante 5 meses e posteriormente aplicados questionários (questões demográficas, qualidade de vida, autoadministração de colírios e aderência ao tratamento) e realizadas entrevistas e gravações das tarefas em vídeo (autoadministração dos colírios, leitura, subir e descer escadas, deambular em espaços apertados e pavimentos irregulares). Realizou-se avaliação oftalmológica com registro em formulário pré-definido e pesquisou-se a correlação entre os defeitos de campos visuais e as limitações dos pacientes. Resultados Com 25 participantes foram abtidos um total 12 horas de vídeo.Todos os doentes afirmaram ser capaz de colocar os colírios hipotensores e 68%afirmaram nunca ter falhado na instilação do colírio. No entanto, 20% não conseguiram instilar uma única gota no olho. Setenta e dois por cento (72%) dos pacientes afirmaram nunca tocar o frasco no olho, porém 40% afirmaram tocar. Houve dificuldade moderada nas atividades, especialmente ao deambular em espaços com obstáculos e em pavimentos irregulares. Alguns pacientes apresentaram mecanismos proprioceptivos de adaptação à baixa visão (como tatear o degrau com o pé). Houve uma correlação entre a severidade dos defeitos de campo visual e maior limitação nas atividades. Conclusão Os portadores de glaucoma avançado têm considerável dificuldade nas atividades da vida diária e na instilação de colírios, frequentemente com percepção deficiente. Alguns pacientes apresentam adaptações proprioceptivas para superar parte da limitação visual...
Objective The purpose of this study was to perform an objective videotaped evaluation of the difficulties of eyedrop instillation and daily tasks in patients with advanced glaucoma with visual impairment Methods A prospective observational study was performed in advanced glaucoma patients with visual impairment, during 5 months. Patients completed a survey (with demographic questions, quality of life, compliance and eyedrop instillation) with interview and video recording in specific daily tasks (eyedrop instillation, climbing stairs, walking in a crowded room and in an irregular floor). Ophthalmologic evaluation was performed and its results registered in a form. Correlation was searched between limitation in quality of life, tasks performance and visual fields. Results 25 patients were included, corresponding to 12h of videotaping. All patients reported being capable of self-instilling eyedrops. 68% of them reported no difficulty instilling the eye drops at home, however 20% of the patients were unable to instill a drop in the eye in the objective evaluation. 72% of the patients stated never touching the eye with the bottle but 40% touched the ocular surface with the bottle. There was a moderate difficulty in the other tasks, with some patients exhibiting proprioceptive mechanisms of adaptation to impaired vision. There was a tendency of correlation between limitation in tasks and visual field defects, but no statistically significant. Conclusion Patients with advanced glaucoma and visual impairment have marked difficulty in eye drop instillation and daily tasks, with a poor awareness of their inabilities. Some patients have proprioceptive adaptations that allow them to perform better than expected in tasks...