Classification of medicines and materials in hospital inventory management: a multi-criteria analysis.

BACKGROUND: In the hospital environment, to achieve an optimum level of operations and service, it is necessary to develop adequate inventory management system. Stocks can be managed, amongst other ways, through inputs classification, which is generally carried out based on a single criterion, such as monetary value, demand or criticality, which does not fully address the complexity of a hospital's inventory management system. Thus, the present study proposes a multi-criteria decision support model to help classify the stock of medicines and materials, enabling a more effective inventory management system for hospitals. METHODS: Methodologically, the study followed 3 stages: (1) preliminary phase; (2) modelling and choice phase; and (3) finalization phase. Each stage had a set of specific steps that were followed. The first stage identified the actors of the process, objectives, criteria and alternatives, establishing 5 criteria and 48 alternatives; the second stage was the choice and execution of the multi-criteria decision method to solve the problem. It was decided to use the Flexible and Interactive Tradeoff method for the sorting problematic. Finally, in the third stage, the sensitivity analysis for the developed model and the validation of the results with decision makers were carried out. In the study, 48 medicines and materials were included to validate the proposed model; however, the model could be used for more items. RESULTS: From the total of 48 medicines and hospital medical materials selected for the study, the classification of 34 of these alternatives to a single class was obtained through modelling and the other 14 alternatives were destined to two possible classes; moreover, the sensitivity analysis performed showed robust results. The items classified in class W should receive special attention by the stock manager; therefore, they should be monitored weekly. Items classified in class B should be monitored biweekly and finally, items classified in class M, should be monitored monthly. CONCLUSIONS: The classification of medicines and materials developed according to the inventory demands allowed more efficient purchasing decisions, optimizing the stock of materials and medicines at the hospital while optimizing the inventory manager's activities, saving time. Consequently, the proposed model can support the development of other multicriteria models in different hospital scenarios.

Model to support intervention prioritization for the control of Aedes aegypti in Brazil: a multi-criteria approach.

BACKGROUND: Despite continuous strategic investments to mitigate the complexity involving arboviruses control, it is still necessary to further research methods and techniques to achieve in depth knowledge and shorter response times in the application of intervention activities. Consequently, the current work focused its efforts on the development of a multicriteria decision support model for the prioritization of prompt response activities for Aedes aegypti control, based on a case study in the city of Natal/RN. METHOD: The research was carried out in three stages: a) preliminary; b) modelling and choice; and c) finalization; the second stage was made possible by the Flexible and Interactive Tradeoff (FITradeoff) method for ranking problematic. Furthermore, the research encompassed ten actors who were involved in the model construction, eight internal and two external to the Natal Zoonoses Control Center (ZCC-Natal) as well as the observation of four operating scenarios for arboviruses control, based on transmission levels; and, evaluation of eleven alternatives from six different criteria perspectives. RESULTS: Rankings of the interventions evaluated in each of the four control operation scenarios present in the city of Natal/RN were obtained, considering technical criteria guided by the Pan American Health Organization (PAHO). CONCLUSIONS: As a result, it was developed a structured decision-making model that could help decision makers to minimize the effects and risks associated with the proliferation of the vector.

The probiotic Lactobacillus fermentum 296 attenuates cardiometabolic disorders in high fat diet-treated rats.

BACKGROUND AND AIM: High-fat (HF) diet consumption has been associated with gut dysbiosis and increased risk of dyslipidemia, type 2 diabetes mellitus and hypertension. Probiotic administration has been suggested as a safe therapeutic strategy for the treatment of cardiometabolic disorders. This study was designed to assess the effects of probiotic Lactobacillus (L.) fermentum 296, a fruit-derived bacteria strain, against cardiometabolic disorders induced by HF diet. METHODS AND RESULTS: Male Wistar rats were divided into control diet (CTL); HF diet; and HF diet treated with Lactobacillus fermentum 296 (HF + Lf 296). The L. fermentum 296 strain at 1 × 109 colony forming units (CFU)/ml were daily administered by oral gavage for 4 weeks. The results showed that rats fed with HF diet displayed insulin resistance, reduced Lactobacillus spp. counts in feces, serum lipids, and oxidative profile. Rats fed on HF diet also demonstrated augmented blood pressure associated with sympathetic hyperactivity and impaired baroreflex control. The administration of L. fermentum 296 for 4 weeks recovered fecal Lactobacillus sp. counts and alleviated hyperlipidemia, sympathetic hyperactivity, and reduced systolic blood pressure in HF rats without affecting baroreflex sensibility. CONCLUSION: Our results suggest the ability of L. fermentum 296 improve biochemical and cardiovascular parameters altered in cardiometabolic disorders.

Solid-phase microextraction in the determination of methadone in human saliva by gas chromatography-mass spectrometry.

Solid-phase microextraction (SPME) with a 100-microm polydimethylsiloxane film fiber was applied to the determination of methadone and 2-ethylidine-3,3-diphenylpyrrolidine (EDDP) by GC-MS in human saliva and compared with liquid-liquid extraction. A shorter extraction time of 30 min with the fiber was obtained, speeding up the total analysis time. Linearity was found for SPME from 0.05 to 2.0 microg/mL (r = 0.9976 for methadone; r = 0.9988 for EDDP) with precision between 0.7 and 4.3% for saliva spiked with 0.2 and 1.5 microg/mL of methadone and EDDP. The limit of detection using SPME was 0.04 microg/mL for methadone and 0.008 microg/mL for EDDP. Analytical recoveries of SPME and liquid-liquid extraction ranged from 98.8 to 103.6%. The use of deuterated internal standard by both methods have yielded comparable results. Thus, the SPME method is highly accurate, precise, and useful for determination of methadone and EDDP in saliva.

Use of solid-phase microextraction (SPME) for the determination of methadone and its main metabolite, EDDP, in plasma by gas chromatography-mass spectrometry.

A simple, rapid method for the determination of methadone and its metabolite 2-ethylene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) in plasma using solid-phase microextraction (SPME) and gas chromatography-mass spectrometry is proposed. A 100-microm polydimethylsiloxane film fiber was exposed by immersion for 30 min in a diluted plasma solution (1:4 with buffer pH 9) containing both compounds and an internal standard (proadifen). Calibration curves were linear over the concentration range 50-2000 ng/mL. The analysis time was 45 min per sample. The determination of methadone and EDDP was subject to no interference. The performance of SPME was compared with that of liquid-liquid extraction, obtaining lower limits of detection for EDDP. The method using the two extraction procedures was applied to 10 plasma samples from methadone-treated patients.