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O uso racional de medicamentos é considerado um dos elementos-chave recomendados pela Organização Mundial de Saúde, cuja ausência pode acarretar consequências como reações adversas, diminuição da eficácia do medicamento, perdas de ordem econômica para o governo e/ou indivíduo, interações medicamentosas e agravo do quadro clínico do paciente. O serviço de orientação farmacêutica que envolve esse contexto foi discutido por poucos estudos, considerando-se interessante a utilização de um instrumento validado para demonstrar o impacto do fornecimento de orientação farmacêutica direcionada a pacientes em uso de medicamentos prescritos, o que constitui o objetivo desse trabalho. A metodologia utilizada foi estudo transversal conduzido em uma Unidade Básica de Saúde de Diamantina/ MG. Foi utilizado um questionário para medir o grau do conhecimento do paciente sobre seus medicamentos nos momentos pré e pós a realização de orientação farmacêutica. Após a orientação farmacêutica, observou-se diminuição do percentual de usuários que não conheciam seus medicamentos (73,2%; 93 para 33,9%; 43) e aumento do nível de conhecimento suficiente (14,2%; 18 para 18,9%; 24) e ótimo (11,0%; 14 para 47,2%; 60). Houve aumento do conhecimento dos usuários em todos os itens que compõem o questionário. A orientação farmacêutica apresentou impacto positivo sobre o conhecimento dos pacientes sobre seus medicamentos e constitui uma prática essencial para o Uso Racional dos Medicamentos.
The rational use of drugs is considered one of the key elements recommended by the World Health Organization, the absence of which can lead to consequences such as adverse reactions, decreased drug efficacy, economic losses for the government and/or individual, drug interactions, and worsening of the patient's clinical condition. The pharmaceutical orientation service that involves this context has been discussed by few studies, and the use of a validated instrument to demonstrate the impact of providing pharmaceutical guidance to patients on prescribed drugs is considered interesting and constitutes the objective of this work. The methodology used was a cross-sectional study conducted in a Primary Care Center in Diamantina, MG. A questionnaire was used to measure the patient's level of knowledge about their medications before and after receiving pharmaceutical guidance. After pharmaceutical orientation, there was a decrease in the percentage of users who did not know about their medications (73.2%; n=93 to 33.9%; n=43) and an increase in the level of sufficient knowledge (14.2%; n=18 to 18.9%; n=24) and excellent knowledge (11.0%; n=14 to 47.2%; n=60). There was an increase in users' knowledge of all the items that make up the questionnaire. Pharmaceutical orientation had a positive impact on patients' knowledge about their medications and constitutes an essential practice for the Rational Use of Medications.
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[This corrects the article DOI: 10.3389/fphar.2021.659503.].
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Objectives: The pregnancy period, with its peculiarities and specific symptoms that may or may not be physiological, can lead to medication use through prescription or even self-medication. This study aimed to assess self-medication practices among pregnant women, the most used medications, symptoms reported, and factors associated with this practice. Methods: This was a cross-sectional study conducted with pregnant women with an antenatal care (ANC) appointment in a tertiary teaching hospital referral in women's health. From April 2019 to February 2020, 297 pregnant women were interviewed. Self-medication was considered as the use of any medicine (including medicinal plants (MPs), herbal products, and vitamins) without a medical or dental prescription. The period considered to assess self-medication practice was the last 60 days prior to the study interview. Results: Among the 297 women interviewed, 107 (36.0%) had practiced self-medication in the previous 60 days. Acetaminophen was the most used medication, and headache was the most frequent symptom reported by self-medicated pregnant women. Pregnant women with high-school (73 (68.2%) (OR = 2.52; 95% CI 1.17-5.43; p = 0.018)) or university-level (23 (21.5%) (OR = 2.82; 95% CI 1.15-6.94; p = 0.024)) education had a higher risk of practicing self-medication when compared to women with lower education. Women in the first gestational trimester (35 (32.7%) (OR = 3.61; 95% CI 1.64-7.96; p = 0.002)) and with two or more pregnancies (87 (81.2%) (OR = 1.96; 95% CI 1.07-3.60; p = 0.029)) were more likely to practice self-medication than pregnant women in the second or third gestational trimester and in the first pregnancy, respectively. Conclusion: Self-medication was practiced by a considerable proportion of our sample, with the majority being OTC drugs. The factors associated with self-medication can help to improve prevention strategies regarding self-medication during pregnancy.
Assuntos
Humanos , Masculino , Feminino , Terapias Complementares , Promoção da Saúde , Centros de SaúdeRESUMO
ABSTRACT: Additives are used in high concentrate diets to prevent metabolic disorders in cattle. This study was designed to evaluate the effect of calcium sources and monensin on the control of ruminal acidosis in Nellore cattle that were abruptly shifted to a high (92.3%) concentrate diet. Eight cannulated steers were randomly assigned to two contemporary 4x4 Latin square. Treatments involved the addition of a calcium source, either limestone (LI) or a product derived from calcareous algae (CA), to the basic diet with or without the presence of monensin. Calcareous alga (Lithothamnium calcareum) is a natural and renewable product and a source of calcium carbonate. The quantity of added limestone, calcareous algae and monensin was 7.1g kg-1, 7.4g kg-1 and 30mg kg-1 DM, respectively. There was no effect of calcium source (P=0.607) or monensin (P=0.294) on feed intake or on the concentration of short chain fatty acids. Treatments with calcareous algae resulted in a higher mean ruminal pH (P=0.039), a shorter amount of time with the ruminal pH under 5.2 (P<0.001) and a better control of blood pH (P=0.006). Treatments with monensin also resulted in a shorter amount of time with the ruminal pH below 5.2 (P=0.023). Calcareous algae were shown to be effective in controlling adverse changes in the rumen and in blood variables for Nellore cattle that were subjected to an abrupt change to a high concentrate diet.
RESUMO: Os aditivos são amplamente utilizados em dietas com elevada proporção de concentrado a fim de prevenir distúrbios metabólicos em bovinos. Este estudo foi desenvolvido para avaliar o efeito das diferentes fontes de cálcio, com ou sem monensina sódica na dieta, no controle da acidose ruminal de bovinos Nelore, recebendo, de forma abrupta, uma dieta com elevada proporção (92,3%) de concentrado. Oito bovinos portadores de cânulas ruminais foram distribuídos em um delineamento quadrado latino (4x4) duplo contemporâneo. Os tratamentos foram a adição de diferentes fontes de cálcio, calcário calcítico (LI) ou produto a base de alga calcária (CA), com (WIMO) ou sem (WOMO) a presença de monensina, à dieta base. A alga calcária, Lithothamnium calcareum, é um produto natural, renovável e fonte de carbonato de cálcio, podendo ser uma alternativa no controle desses distúrbios. A inclusão de LI, CA e monensina foi de 7,1g kg-1, 7,4g kg-1 e 30mg kg-1 MS, respectivamente. Não houve efeito das fontes de cálcio e da monensina sobre o consumo alimentar e concentração total dos ácidos graxos de cadeia curta. Os tratamentos com AC resultaram em maior pH ruminal médio (P=0,039), menor tempo com pH ruminal abaixo de 5,2 (P<0,001) e um maior pH sanguíneo (P=0,006). Os tratamentos com monensina apresentaram menor tempo com pH ruminal abaixo de 5,2 (P=0,023). O produto a base de alga calcária foi eficiente no controle das mudanças adversas das variáveis ruminais e sanguíneas em bovinos Nelore submetidos a mudanças abruptas para dietas com elevada proporção de concentrado.
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Vinte e dois cordeiros machos não castrados, Dorper x Santa Inês, com aproximadamente 90 dias de idade e peso vivo médio inicial de 27,0±4,4kg, foram alimentados com uma dieta com elevada proporção de concentrado com 20% de pelete proteico-mineral (Grano Entero(r)), 5% de feno de capim coast-cross e 75% de milho, na forma de milho grão inteiro (MGI), milho grão moído (MGM) ou milho grão úmido (MGU), para avaliação de desempenho no confinamento por um período de 14 dias de adaptação às dietas e às instalações e de 65 dias de confinamento. Em seguida, os animais foram abatidos com peso vivo médio final (PVF) de 47,97±5,13kg e o conteúdo gástrico foi avaliado para quantificação de protozoários, e foi realizada avaliação papilar. O delineamento experimental foi o de blocos casualizados. Não houve diferença entre os tratamentos (P>0,05) quanto ao ganho de peso médio diário, eficiência alimentar, ingestão diária de matéria seca, características da carcaça e da carne. Os animais tratados com MGI tiveram maior conteúdo gástrico, menor pH ruminal, maior AP (% da superfície de absorção) e maior área papilar em comparação com os outros tratamentos. Os animais tratados com MGI tiveram melhores resultados para o peso final, mas para os demais parametros estudados não foi observada diferença.
Twenty-two males not neutered, Dorper x St. Agnes, with approximately 90 days of age and average live weight of 27.0±4.4kg were fed with a diet wich contained high concentrate with 20% protein pellet-mineral (Grano Entero (r)), 5% grass hay coast-cross and 75% corn in the form of whole kernel corn (MGI), ground corn grain (MGM) or high moisture corn (MGU) for performance evaluation in confinement for a period of 14 days of adaptation to the diets and facilities and 65 days of confinement. Then the animals were slaughtered at average final weight (PVF) of 47.97±5.13kg and gastric content was evaluated for quantification of protozoa, and a papillary review was conducted. The experimental design was in randomized blocks. There was no difference between treatments (P>0.05) for average daily weight gain, feed efficiency, daily dry matter intake, carcass characteristics and meat. MGI-treated animals had higher gastric contents, the lower ruminal pH greater AP (% of surface absorption) and the larger papillary area was compared with other treatments. Animals treated with MGI had better results for the final weight gain, but for the other parameters studied, no difference was observed.
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The objectives of this study were to evaluate and compare the effect of the corn grain processing (whole grain, dry beans ground, and wet grain) on carcass characteristics and meat quality in lambs. Twenty-two Dorper vs. Santa Inês uncastrated lambs (27 ± 4 kg BW; ±3 months old) were distributed in a randomized complete block (initial BW). The diets were composed of 20 % protein-mineral pellet, 5 % hay, and 75 % corn in the form of whole grain, ground grain, or wet grain. The harvest weight of animals fed whole corn (50.2 kg) and ground (49.03 kg) were equal and higher than the moisture corn fed lambs (44.89 kg); therefore, the same differences were expected to be seen in the cold vs hot carcass comparison. However, there was no difference between treatments comparing hot or cold carcass performance, averaging 47 and 46 %, respectively. Also unaffected by the treatments were subcutaneous fat thickness values, loin muscle area, pH, temperature, drip loss, water loss by cooking, color, and tenderness. It can be concluded that the shape and size of corn grain in diets of high concentrate resulted in no measurable influence on carcass traits, but whole grain is more easily managed by the producer.
