Are metabolic syndrome and its components associated with 5-year mortality in chronic obstructive pupmonary disease patients?

The aim of this study was to evaluate the risk of mortality according to the presence of metabolic syndrome in chronic obstructive pulmonary disease (COPD) patients who were followed for 5 years. We did not establish the influence of metabolic syndrome on mortality rate. However, an increase of 100 mg of triglycerides was associated with a 39% increase in the probability of death in the period of the study (hazard ratio 1.39, 95% confidence interval 1.06-1.83).

Increased production of hydrogen peroxide by peripheral blood monocytes associated with smoking exposure intensity in smokers.

BACKGROUND: Smoking is known to be associated with oxidative stress; however, it has not been elucidated whether the oxidative response is influenced by the intensity of smoking exposure. OBJECTIVES: Evaluate the effect of smoking exposure on the secretion of hydrogen peroxide (H2O2) by the peripheral blood monocytes of smokers. METHODS: A total of 25 smokers (50.3±8.8 years, 48% male) underwent the following evaluations: spirometry, pulse oximetry, body composition and total peripheral blood count. Peripheral blood monocyte (PBM) cultures were isolated and maintained, and IL-6 and TNF-α were measured in the plasma and in the supernatants of spontaneous and stimulated cultures. H2O2 was evaluated in the supernatants of the PBM cultures, and a subset of the PBM culture supernatants was stimulated with phorbol myristate acetate (PMA). We also evaluated 38 healthy controls (49.1±8.2 years, 42% male). RESULTS: The spontaneous and stimulated monocytes' secretion of H2O2 were statistically higher in the smokers than in the healthy controls (p<0.001). The H2O2 secretions were statistically significant higher after stimulation with PMA in both groups (p<0.001). In the multiple regression analysis, we identified a positive, statistically significant association between pack-years of smoking and the spontaneous secretion of H2O2 by PBM culture, adjusted for potential confounding variables. The association between PBM culture secretion of H2O2 and the production of TNF-α and IL-6 was not significant. CONCLUSION: We identified a positive association between higher production of H2O2 in smokers and higher smoking exposure during life. The influence of pack-years smoking may be a key modifiable factor in oxidative stress associated to smoking.

Analysis of medical prescriptions dispensed at health centers in Belo Horizonte, Minas Gerais, Brazil.

This article focuses on medical prescriptions dispensed at health centers under the Municipal Health Department in Belo Horizonte, Minas Gerais State, Brazil. The study analyzed 4,607 prescriptions from March to April 1999, grouped according to origin (internal or external). The analysis focused on information written on medical prescriptions. The main findings were: (a) an average of 2.4 drugs per prescription in both groups; (b) prescriptions filled out with 4 or more drugs accounted for 18.0% of internal and 17.6% of external prescriptions; (c) 84.3% of internal and 85.5% of external prescriptions provided no instructions for use of medication; (d) information on dosage regimen varied from 51.2% to 97.6% for internal and 57.9% to 96.5% for external prescriptions; (e) generic names were specified for 51.9% and 28.4% of all drugs on internal and external prescriptions, respectively; (f) prescriptions containing standard drugs from the Municipal Health Department accounted for 88.7% of internal and 76.4% of external prescriptions. Data analysis shows the need for continuing education of physicians and adoption of other methods to improve quality of prescriptions and promote rational use of drugs.

Analysis of medical prescriptions dispensed at health centers in Belo Horizonte, Minas Gerais, Brazil

Este trabalho avalia prescrições médicas aviadas em farmácias de unidades de saúde da Secretaria Municipal de Saúde de Belo Horizonte (SMS-BH), Brasil. Foram analisadas 4.607 prescrições, no período de março a abril de 1999, agrupadas segundo sua origem. A análise enfocou informações que deveriam constar em uma prescrição médica. Os principais resultados encontrados foram: (a) número médio de 2,4 medicamentos/prescrição para os dois grupos; (b) prescrição de quatro ou mais medicamentos em 18,0 por cento das prescrições internas e 17,6 por cento das externas; (c) ausência de recomendações de uso em 84,3 por cento das prescrições internas e 85,5 por cento nas externas; (d) presença de dados posológicos variando de 51,2 por cento a 97,6 por cento nas prescrições internas e de 57,9 por cento a 96,5 por cento nas externas; (e) utilização do nome genérico para todos os medicamentos em 51,9 por cento nas prescrições internas e 28,4 por cento nas externas e (f) prescrição com todos os medicamentos padronizados pela SMS-BH em 88,7 por cento das internas e 76,4 por cento das externas. A análise dos dados demonstra necessidade de educação continuada dos prescritores e adoção de outras medidas para melhoria da qualidade de prescrições, na perspectiva de promover o uso racional de medicamentos.