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

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

Monocrotaline: histological damage and oxidant activity in brain areas of mice.

This work was designed to study MCT effect in histopathological analysis of hippocampus (HC) and parahippocampal cortex (PHC) and in oxidative stress (OS) parameters in brain areas such as hippocampus (HC), prefrontal cortex (PFC), and striatum (ST). Swiss mice (25-30 g) were administered a single i.p. dose of MCT (5, 50, or 100 mg/kg) or 4% Tween 80 in saline (control group). After 30 minutes, the animals were sacrificed by decapitation and the brain areas (HC, PHC, PFC, or ST) were removed for histopathological analysis or dissected and homogenized for measurement of OS parameters (lipid peroxidation, nitrite, and catalase) by spectrophotometry. Histological evaluation of brain structures of rats treated with MCT (50 and 100 mg/kg) revealed lesions in the hippocampus and parahippocampal cortex compared to control. Lipid peroxidation was evident in all brain areas after administration of MCT. Nitrite/nitrate content decreased in all doses administered in HC, PFC, and ST. Catalase activity was increased in the MCT group only in HC. In conclusion, monocrotaline caused cell lesions in the hippocampus and parahippocampal cortex regions and produced oxidative stress in the HC, PFC, and ST in mice. These findings may contribute to the neurological effects associated with this compound.

Oxidative stress and epilepsy: literature review.

BACKGROUNDS: The production of free radicals has a role in the regulation of biological function, cellular damage, and the pathogenesis of central nervous system conditions. Epilepsy is a highly prevalent serious brain disorder, and oxidative stress is regarded as a possible mechanism involved in epileptogenesis. Experimental studies suggest that oxidative stress is a contributing factor to the onset and evolution of epilepsy. OBJECTIVE: A review was conducted to investigate the link between oxidative stress and seizures, and oxidative stress and age as risk factors for epilepsy. The role of oxidative stress in seizure induction and propagation is also discussed. RESULTS/CONCLUSIONS: Oxidative stress and mitochondrial dysfunction are involved in neuronal death and seizures. There is evidence that suggests that antioxidant therapy may reduce lesions induced by oxidative free radicals in some animal seizure models. Studies have demonstrated that mitochondrial dysfunction is associated with chronic oxidative stress and may have an essential role in the epileptogenesis process; however, few studies have shown an established link between oxidative stress, seizures, and age.

Reversal of cocaine withdrawal-induced anxiety by ondansetron, buspirone and propranolol.

Cocaine is used worldwide and considered a public health problem. Relapse from addiction is one of the difficulties faced by cocaine users, and in most cases according to the period of abstinence, users may present symptoms such as anxiety or depression. To evaluate the anxiety-like behavior induced by different periods, rats were treated for 7 days with cocaine 20 mg/kg, i.p., and 24 h, 7 and 21 days after drug withdrawal were submitted to the elevated plus maze (EPM) and the open field (OF) tests. In different protocol, propranolol (10 mg/kg, i.p.), ondansetron (4 mg/kg, i.p.) and buspirone (5 mg/kg, i.p.) were administered once after 24 h and 7 days of abstinence from cocaine to evaluate possible reversal or attenuation of the symptoms caused by cocaine withdrawal. EPM results showed a reduction in all parameters after 24 h and 7 days of the last exposure to cocaine, indicating anxiety-like behavior. In the OF test, 24 h and 7 days of abstinence showed increased locomotor activity, while in the withdrawal 21 days the animals not alter the locomotor activity. The administration of propranolol, ondansetron or buspirone after a 24 h abstinence period reduced the animals anxiety in the EPM, and in the OF all drugs were able to reduce locomotor activity. After abstinence 7 d, the drugs reduced locomotor activity in the OF, in the EMP propranolol and ondansetron reversed the anxiogenic effect induced by cocaine. These results suggest that the treatment of anxyogenic effects of abstinence from cocaine is dependent on the period of the withdrawal.

Quality of life of HIV+ patients undergoing pharmacotherapeutic follow-up

The influence of pharmacotherapeutic follow-up (PTF) on quality of life was evaluated in 45 HIV+ patients, who were undergoing initial antiretroviral therapy at a specialized care center in northeast Brazil. PTF lasted nine months and quality of life was analyzed at the 1st and 9th meetings using a questionnaire validated for Brazil. The study identified 643 problems related to antiretrovirals and there were 590 pharmaceutical interventions during the PTF. The comparative analysis between the results of the 1st and the 9th meeting was statistically significant for all domains of the questionnaire. For asymptomatic patients, only one domain was statistically significant. For symptomatic patients, six domains were significant. Patients with one year of HIV/AIDS diagnosis had statistically significant differences in five domains. The results suggest that the PTF contributed to improving quality of life, particularly for symptomatic patients and those diagnosed for at least one year - important target groups for Pharmaceutical Treatment.

A influência do seguimento farmacoterapêutico (SFT) sobre a qualidade de vida foi avaliada em 45 pacientes HIV+ assistidos em serviço de atendimento especializado do nordeste brasileiro. O SFT teve duração de 9 meses e a qualidade de vida foi analisada no 1º e 9º encontros através de questionário validado no País. Identificaram-se 643 problemas relacionados aos antirretrovirais e realizaram-se 590 intervenções farmacêuticas durante o SFT. A análise comparativa entre os resultados de qualidade de vida do 1º e 9º encontro foi estatisticamente significativa em todos os domínios do questionário. Quando analisados somente os pacientes assintomáticos, apenas um domínio apresentou significância estatística. Entre os sintomáticos, seis domínios foram significativos. Pacientes com até um ano de diagnóstico de HIV/AIDS apresentaram validade estatística em cinco domínios. Os resultados sugerem que o SFT contribuiu para a melhoria da qualidade de vida dos pacientes, sobretudo dos sintomáticos e/ou com até um ano de diagnóstico, representando grupos-alvo para a prática da Atenção Farmacêutica.

Mechanisms involved in the gastroprotective activity of esculin on acute gastric lesions in mice.

This work describes the gastroprotective actions of esculin (6,7-dihydroxycoumarin-6-o-glucoside) against indomethacin- or ethanol-induced lesions and verifies the role of nitric oxide, ATP-dependent K(+) channels, prostaglandins, transient receptor potential vanilloid 1 and antioxidant effects in the gastroprotective mechanism of esculin in the ethanol-induced gastric lesion model. The intragastric administration of esculin at doses of 12.5, 25 and 50 mg/kg was able to protect the gastric mucosa against ethanol (0.2 mL/animal p.o.), and esculin at doses of 25 and 50 mg/kg protected against indomethacin-induced lesions (20mg/kg p.o.). Administration of l-NAME (10mg/kg i.p.), glibenclamide (10mg/kg i.p.) or indomethacin (10mg/kg p.o.), but not capsazepine (5mg/kg p.o.), was able to reduce the gastroprotection promoted by esculin (25mg/kg) on the ethanol-induced lesions. Measurements of nitrite, a NO metabolite, were increased in the group that was pretreated with esculin. In terms of antioxidant activity as a gastroprotective mechanism of esculin, the results show that pre-treatment with esculin decreased the amount of GSH, increased SOD activity, did not interfere with the CAT activity and decreased both the MPO activity and the MDA amount. In conclusion, pre-treatment with esculin confers significant gastroprotective and antioxidant activity and leads to a reduction in gastric injury; the mechanisms underlying these effects include stimulation of endogenous prostaglandins, nitric oxide synthesis, opening of K(ATP) channels and reduction of free radicals or modulation of antioxidant enzyme systems.

Melatonin: pharmacological aspects and clinical trends.

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