Who are the most affected by Bothrops snakebite envenoming in Brazil? A Clinical-epidemiological profile study among the regions of the country.

Snakebite envenoming represents an important Neglected Tropical Disease (NTD) that mainly affects tropical and subtropical developing countries according to the World Health Organization (WHO). As a priority issue in the tropics, it is estimated that accidental encounter between snakes and humans is the leading cause of morbidity and mortality among all NTDs in the world. In Brazil, an extremely diverse country with continental dimensions, snakebite envenoming is the second leading cause of reported human envenoming. Treating the disease has been an unprecedented challenge for Brazilian Health Systems for decades. Despite access to Antivenom therapy and distributing it free of charge across the country, Brazil faces numerous issues regarding the notification process and accurate treatment targeting for at-risk populations. Thus, this study aimed to identify the temporal epidemiological dynamics of accidents caused by Bothrops snakes in Brazil, the country's major group of venomous snakes, based on secondary information from the online database provided by The Brazilian Notifiable Diseases Information System (SINAN). For this purpose, reported Bothrops snakebites between 2012 and 2021 were counted, then the data were analyzed. We looked at the frequency, occurrence, mortality rates, case fatality rate (CFR), age and gender distribution, and the time lapse between the incident and the initiation of Antivenom therapy. The data were also organized considering regional variations of the country. Throughout the studied period, a total of 202,604 cases of envenoming caused by Bothrops spp. were notified, resulting in 766 fatalities. These accidents were found to occur in variable proportions across different regions in Brazil, with notable concentrations observed in the North, Northeast, and Southeast regions. The epidemiological profile of patients varied greatly between the regions, revealing that snake envenoming is much more a social, economic, and ecological problem than a medical one. In conclusion, our study provides an overview of the clinical and epidemiological profile of envenoming by Bothrops snakes in Brazil. Notably, this is the first study to present such information in a country as vast and diverse as Brazil, encompassing a comparative analysis of its regions using SINAN data, that proves to be a very useful national tool to improve the control and management of envenoming.

Profile of intoxications served at the 24-hour emergency service unit

Intoxications represent a serious public health problem. According to the World Health Organization, 193,000 deaths per year are caused by unintended intoxications worldwide. This study aims to know the profile of intoxications at the 24-hour Emergency Service Unit in Divinópolis, in the state of Minas Gerais. This is a descriptive study in which the study population chosen were all patients treated for intoxications in the period from 2017 to 2018, registered in the health service; 421 cases of intoxications were recorded. The female gender was the most prevalent, and the age group with the most cases was 21 to 30 years. The main circumstance found was attempted suicide (83.1%), and the main causative agent was drugs (76.5%), with benzodiazepines being the main class responsible for intoxications. The most used treatment was gastric lavage and activated charcoal. This study demonstrates that knowledge about the city's intoxication profile is important for the development of treatment and patient management methods to better suit the demands of the municipality.

Development and validation of a method for phenobarbital in serum: anticonvulsant pharmacotherapy monitoring

The therapeutic drug monitoring (TDM) is an important strategy for the effectiveness and safety of long-term pharmacotherapy, such as the use of phenobarbital as an anticonvulsant drug in epilepsy. In this sense, HLPC has been presented as a technique for the measurement of phenobarbital in serum. However, the ideal conditions for carrying out the method must be established for each laboratory reality. An analytical method using HPLC was developed and validated in order to identify and quantify Phenobarbital in blood. The chromatographic conditions were C-18 column (Shimpack XR-ODS 50L x 3.0), acetonitrile-water mobile phase (30:70, v v-1), 0.2 mL min-1 flow and reading wavelength of 210 nm. Linearity was established in the range of 2.5 to 80 µg mL-1, the linear correlation coefficient was 0.9981. The average of the coefficient of variation of the precision was 5.30%. The relative standard error of the accuracy was -2.17% and of the recovery coefficient was 97.83%. In all eleven patients, phenobarbital concentrations were below the therapeutic range. The tested method was selective, linear, precise, accurate and showed good recovery.(AU)

Suicide attempts: epidemiologic trends towards geoprocessing.

In order to study data about suicide attempts and do the mapping of occurrence areas, it was developed an ecologic and exploring study, making use of techniques of geoprocessing, based on confirmed cases of suicide attempts. Cases of self-poisoning were included in the urban area of Campina Grande county, in the period of 2010-2013. A total of 446 suicide attempts were geo-referred, pointing up an incidence of 120 cases out of each 100,000 inhabitants. The sample was mostly feminine (66.4%), and 62.3% being up to 30 years old. Kernel's map remarked hot spot areas. Compared to surrounding areas the suicide risk of populations within the hot spots was increased (38%; Relative Risk = 1.38; p= 0.0029), with an average estimative of 165 suicide attempts out of 100,000 inhabitants. Through identification of hot spots and index of living conditions of the neighborhoods, it is possible to set priorities in terms of public policies for the prevention of suicide attempts and control of the marketing of substances that are potentially toxic.

Suicide attempts: epidemiologic trends towards geoprocessing / Tentativas de suicídio: tendências epidemiológicas quanto ao geoprocessamento

Abstract In order to study data about suicide attempts and do the mapping of occurrence areas, it was developed an ecologic and exploring study, making use of techniques of geoprocessing, based on confirmed cases of suicide attempts. Cases of self-poisoning were included in the urban area of Campina Grande county, in the period of 2010-2013. A total of 446 suicide attempts were geo-referred, pointing up an incidence of 120 cases out of each 100,000 inhabitants. The sample was mostly feminine (66.4%), and 62.3% being up to 30 years old. Kernel's map remarked hot spot areas. Compared to surrounding areas the suicide risk of populations within the hot spots was increased (38%; Relative Risk = 1.38; p= 0.0029), with an average estimative of 165 suicide attempts out of 100,000 inhabitants. Through identification of hot spots and index of living conditions of the neighborhoods, it is possible to set priorities in terms of public policies for the prevention of suicide attempts and control of the marketing of substances that are potentially toxic.

Resumo Para estudar os dados sobre tentativas de suicídio e mapear as áreas de incidência foi desenvolvido um estudo do tipo ecológico e exploratório, usando técnicas de geoprocessamento, com base em casos confirmados. Foram incluídos os casos de autoevenenamento, ocorridos na zona urbana do município de Campina Grande, para o período 2010-2013. Um total de 446 tentativas de suicídio foi georreferenciado, apontando uma incidência de 120 casos a cada 100.000 habitantes. A amostra foi majoritariamente feminina (66,4%), com 62,3% possuindo até 30 anos de idade. O mapa de Kernel evidenciou areas de hot spots. Populações dentro dos hot spots apresentaram um risco de suicídio 38% maior (Risco Relativo= 1,38; p = 0,0029), com uma estimativa média de 165 tentativas de suicídios por 100.000 habitantes. Através da identificação das áreas de hot spots e do índice de condições de vida dos bairros, pode-se estabelecer as prioridades em termos de políticas públicas de prevenção das tentativas de suicídio e de controle da comercialização de substâncias com potencial tóxico.

Patients' perception regarding the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment: a qualitative study.

BACKGROUND: Tuberculosis remains an important disease which mainly affects the majority of vulnerable individuals in society, who are subjected to poor living conditions and difficulties to access the services of public health. Under these circumstances, the present study aims to understand patients' perception in relation to the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment. METHODS: A qualitative descriptive cross sectional study was conducted in one large municipality at the state of Paraíba, Northeast of Brazil. The study subjects, who were residents of the study site, covered all tuberculosis cases diagnosed between March and June 2015. The sample was defined by the criteria of response saturation. All interviews were audio recorded, and data analysis was developed through the hermeneutic dialectic method and the theory of Generative Route Sense. The project was approved by the Research Ethics Committee of the University of São Paulo (USP). RESULTS: A total of 13 individuals were interviewed and the responses were identified into two analytical categories: the difficulties they had and the enabling factors they could mention during their tuberculosis treatment. Patients brought up social exclusion as an obstacle to treatment adherence, which, along with stigmatization, weakened their link with family members and health professionals. Moreover, economic precariousness was a major hindrance to the maintenance of a proper diet and transportation access to health centers. However, social support and directly observed treatment helped to break down barriers of prejudice and to promote individual and family empowerment. Finally, patients also reported that their will to live and faith gave them the strength to continue with the treatment. CONCLUSIONS: According to patients in this study, social support and the strengthening of links with family members and health professionals may reduce social exclusion and other difficulties they face, thus encouraging them to the adhere to tuberculosis treatment.

Epidemiologia social aplicada às intoxicações humanas / Social epidemiology applied to human intoxications / Epidemiología social aplicada a las intoxicaciones humanas

As intoxicações constituem um grave problema de saúde pública, seja pelo largo impacto na saúde individual e coletiva, seja pelo importante custo econômico e social, ou pelos riscos que oferece ao meio ambiente. Este estudo tem por objetivo analisar textos publicados em periódicos científicos acerca das intoxicações humanas, a fim de esclarecer o processo de adoecimento e a adequada tomada de decisão à luz dos pressupostos das teorias de Epidemiologia Social e da Teoria da História Natural da Doença. Trata-se de estudo com abordagem qualitativa que adota o método de revisão integrativa. Os estudos selecionados tratam de categorias de substâncias tóxicas e circunstâncias de envenenamento variadas. São esclarecidos aspectos referentes ao agente, ao ambiente e ao hospedeiro (tríade ecológica) envolvidos em eventos tóxicos. As prevenções primária, secundária e terciária das intoxicações humanas são elaboradas de acordo com características dos períodos pré-patológico e patológico. Concluiu-se que estudos com delineamento capaz de definir padrão, temporalidade e espacialização de agravos são indispensáveis e necessários para a formulação e implantação de políticas e programas preventivos de uso racional de substâncias químicas, orientando as ações em toxicovigilância.

Intoxication is a serious public health problem, due to the large impact on individual and collective health or to the significant economic and social cost, or risks to the environment. This study aims to analyze texts published in scientific journals about human intoxications, in order to clarify the process of illness and proper decision making in light of the assumptions of theories of Social Epidemiology and Theory of Natural History of Disease. It is a study with a qualitative approach that adopts the integrative review method. Selected studies address categories of toxic substances and varied poisoning circumstances. The aspects related to the agent, the environment and the host (ecological triad) involved in toxic events are clarified. The primary, secondary and tertiary preventions of human intoxications are elaborated according to characteristics of the pre-pathological and pathological periods. In conclusion, studies with a design capable of defining pattern, temporality and spatialization of diseases are indispensable and necessary for the formulation and implementation of policies and preventive programs for the rational use of chemical substances, guiding toxicovigilance actions.

Las intoxicaciones constituyen un grave problema de salud pública, sea por el amplio impacto en la salud individual y colectiva, sea por el importante costo económico y social, o riesgos que ofrece al medio ambiente. Este estudio tiene por objetivo analizar textos publicados en periódicos científicos acerca de las intoxicaciones humanas, a fin de esclarecer el proceso de enfermedad y la adecuada toma de decisión a la luz de los presupuestos de las teorías de Epidemiología Social y Teoría de la Historia Natural de la Enfermedad. Tratase de un estudio con enfoque cualitativo que adopta el método de revisión integrativa. Los estudios seleccionados tratan de categorías de sustancias tóxicas y circunstancias de envenenamiento variadas. Son aclarados aspectos referentes al agente, al ambiente y al hospedador (tríada ecológica) involucrados en eventos tóxicos. Las prevenciones primarias, secundarias y terciarias de las intoxicaciones humanas son elaboradas de acuerdo con características de los períodos pre-patológico y patológico. Concluyóse que estudios con delineamiento capaz de definir padrón, temporalidad y espacialización de agravios son indispensables y necesarios para la formulación e implantación de políticas y programas preventivos de uso racional de sustancias químicas, orientando las acciones en toxicovigilancia.

Spatial distribution of scorpions according to the socioeconomic conditions in Campina Grande,State of Paraíba, Brazil.

INTRODUCTION: Due to its frequency and morbidity, such as that caused by scorpions have achieved public health importance in certain regions of the world. The present exploratory ecological study aimed to characterize the epidemiological profile and spatial distribution of scorpion stings in Campina Grande, State of Paraíba in Northeastern Brazil. METHODS: Geographical information system techniques were used to record the scorpion stings, and Google Earth software, Track Maker, and ArcGIS 10 Esri were used as geocoding databases. The Moran test was used to evaluate spatial correlation, and the Pearson chi-square test was used to analyze associations between scorpion stings and socioeconomic variables. RESULTS: The study evaluated 1,466 scorpion stings. Envenomations were more frequent among women (n = 908, 61.9%), and most patients were aged 13-28 years (n = 428, 29.2%). The Southern region of the city had the largest number of registered cases (n = 548, 37.4%), followed by the Western region (n = 510, 34.8%). CONCLUSIONS: Spatial analysis of scorpionism revealed an irregular occurrence in Campina Grande. Further, no association was observed between the socioeconomic factors analyzed and the geographic location of the scorpion envenomations. Detection of spatial areas with an increased risk of scorpionism can help prioritize adoption of preventive measures in these regions to reduce the associated incidence and morbidity.

Spatial distribution of scorpions according to the socioeconomic conditions in Campina Grande,State of Paraíba, Brazil

Abstract: INTRODUCTION: Due to its frequency and morbidity, such as that caused by scorpions have achieved public health importance in certain regions of the world. The present exploratory ecological study aimed to characterize the epidemiological profile and spatial distribution of scorpion stings in Campina Grande, State of Paraíba in Northeastern Brazil. METHODS: Geographical information system techniques were used to record the scorpion stings, and Google Earth software, Track Maker, and ArcGIS 10 Esri were used as geocoding databases. The Moran test was used to evaluate spatial correlation, and the Pearson chi-square test was used to analyze associations between scorpion stings and socioeconomic variables. RESULTS: The study evaluated 1,466 scorpion stings. Envenomations were more frequent among women (n = 908, 61.9%), and most patients were aged 13-28 years (n = 428, 29.2%). The Southern region of the city had the largest number of registered cases (n = 548, 37.4%), followed by the Western region (n = 510, 34.8%). CONCLUSIONS: Spatial analysis of scorpionism revealed an irregular occurrence in Campina Grande. Further, no association was observed between the socioeconomic factors analyzed and the geographic location of the scorpion envenomations. Detection of spatial areas with an increased risk of scorpionism can help prioritize adoption of preventive measures in these regions to reduce the associated incidence and morbidity.

[Poisoning with household cleaning products in a city in Northeast Brazil]. / Avaliação das intoxicações por domissanitários em uma cidade do Nordeste do Brasil.

This study analyzes toxic exposures to household cleaning products based on data from the Center for Notification and Treatment of Poisoning (CEATOX) in Campina Grande, Paraíba State, Brazil, from 2007 to 2010. The data were collected from the reporting forms from the Information System on Notifiable Diseases (SINAN), analyzed with SPSS (Version 17). Chemical identification was performed in urine samples using high-resolution chromatography techniques (GC-MS and HPLC-UV). Six hundred and sixty cases of poisoning were reported, with pesticides as the principal causal agents (42.2%). Poisoning with household cleaning products occurred mainly in children (30.1%) and/or females (55.21%) who were exposed to the product accidentally (55.4%) by the oral route (82%). These data indicate that poisoning with household cleaning products in Campina Grande should be treated with specific prevention and control measures, including evaluation of ease of access to pesticides, in order to reach the goals set by the Brazilian National Health Plan for 2012-2015.

Avaliação das intoxicações por domissanitários em uma cidade do Nordeste do Brasil / Poisoning with household cleaning products in a city in Northeast Brazil / Evaluación de las intoxicaciones por productos domésticos en una ciudad del Nordeste de Brasil

This study analyzes toxic exposures to household cleaning products based on data from the Center for Notification and Treatment of Poisoning (CEATOX) in Campina Grande, Paraíba State, Brazil, from 2007 to 2010. The data were collected from the reporting forms from the Information System on Notifiable Diseases (SINAN), analyzed with SPSS (Version 17). Chemical identification was performed in urine samples using high-resolution chromatography techniques (GC-MS and HPLC-UV). Six hundred and sixty cases of poisoning were reported, with pesticides as the principal causal agents (42.2%). Poisoning with household cleaning products occurred mainly in children (30.1%) and/or females (55.21%) who were exposed to the product accidentally (55.4%) by the oral route (82%). These data indicate that poisoning with household cleaning products in Campina Grande should be treated with specific prevention and control measures, including evaluation of ease of access to pesticides, in order to reach the goals set by the Brazilian National Health Plan for 2012-2015.

Este trabalho analisa as exposições tóxicas a domissanitários registradas pelo Centro de Informação e Assistência Toxicológica de Campina Grande, Paraíba, Brasil, no período de 2007 a 2010. Os dados foram coletados das fichas de notificação do Sistema de Informação de Agravos de Notificação (SINAN), analisados pelo software SPSS (Versão 17), e a identificação química em amostras de urina foi feita por técnicas cromatográficas de alta resolução (CG-MS e HPLC-UV). Foram registradas 660 intoxicações e, considerando as variáveis de estudo, observados como principais agentes causais os agrotóxicos (42,2%).Os intoxicados por saneantes domésticos na região são predominantemente crianças (30,1%), e/ou do gênero feminino (55,21%), que se expõem ao produto acidentalmente (55,4%) pela via oral (82%). Diante desses dados, conclui-se que a intoxicação por domissanitários em Campina Grande e região deve ser tratada com ações específicas de prevenção e controle junto à população, como a avaliação da facilidade de acesso aos venenos agrícolas, para que se consiga atingir as metas estabelecidas pelo Plano Nacional de Saúde, para o quadriênio 2012-2015.

Este trabajo analiza las exposiciones tóxicas a productos domésticos registradas por el Centro de Información y Asistencia Toxicológica de Campina Grande, Paraíba, Brasil, durante el periodo de 2007 hasta 2010. Los datos fueron recogidos mediante la información proporcionada por el Sistema de Notificación de Enfermedades (SINAN) y analizados por el software SPSS (versión 17). La identificación química en muestras de orina fue realizada mediante alta resolución con técnicas de cromatografía (GC-MS y HPLC-UV). Se registraron 660 intoxicaciones y, teniendo en consideración las variables del estudio, se observó que los principales agentes causales eran los pesticidas (42,2%) y que los envenenados por productos domésticos de limpieza en la región eran en su mayoría niños (30,1%) y mujeres (55,21%), expuestos a un producto accidentalmente (55,4%) y por vía oral (82%). Con estos datos, se concluye que la intoxicación por productos de uso doméstico en la región debe ser tratada con acciones específicas para la prevención y el control, como la evaluación de la facilidad del acceso a venenos agrícolas para alcanzar los objetivos establecidos por el Plan Nacional de Salud.

Accidents caused by Bothrops and Bothropoides in the State of Paraiba: epidemiological and clinical aspects.

INTRODUCTION: Bothrops and Bothropoides snakes cause 70% of the ophidic accidents in Brazil. The species that cause ophidic accidents in State of Paraíba are Bothropoides erythromelas, Bothrops leucurus and Bothropoides neuwiedi. METHODS: This is a prospective and transverse study, following a quantitative approach of accidents involving Bothrops and Bothropoides admitted to the Toxicological Assistance and Information Centers of Campina Grande and João Pessoa (Ceatox-CG and Ceatox-JP), aimed at identifying the epidemiological and clinical profile of such accidents. All of the patients admitted had medical diagnoses and were monitored at Ceatox-CG or Ceatox-JP. RESULTS: The genera Bothrops and Bothropoides caused 91.7% of the ophidic accidents reported. Snake bites were frequent in men (75.1%), rural workers (65.1%), literate individuals (69%) between 11 and 20 years-old (21.7%), and toes the most common area attacked (52.7%). Most (86.6%) patients were admitted within 6 hours after the accident/bite, with a predominance of mild cases (64.6%). The annual occurrence in Paraíba was 5.5 accidents/100,000 inhabitants and lethality was 0.2%. CONCLUSIONS: Positive changes in the profiles of these accidents were verified, such as the non-application of inadequate solutions, including the use of tourniquet, coffee grounds, garlic, suction and/or cutting the bitten area. Moreover, the Itinerant Laboratory project, linked to Paraíba State University in partnership with Ceatox-CG, has contributed positively, providing several cities of the state with information regarding the prevention of accidents involving venomous animals. The local press has also contributed, reporting the educational work developed by the centers.

[Medical prescriptions: adequate orientation to medicine use?]. / Prescrição médica: orientações adequadas para o uso de medicamentos?

During physician's consultation, the lack of adequate information on medication to the patient is a major problem to reach the correct pharmacotherapy. This study aims at assessing the patient knowledge about prescribed drugs. In order to proceed the investigation, interviews were performed about type of medication, dosage, administration schedule, purpose, duration of treatment and side effects. From 199 patients interviewed after they had received a prescription, 53.8% didn't have any information about the medicine, 20.3% didn't know the dosage and 25.4% didn't know the medication schedule. The purpose of the medication was the information with the highest percentage of correct answers, with 75.1% of the patients showing good level of knowledge. Regarding to the duration of the treatment and side effects, 57.4% and 94.4% of the patients, respectively, didn't present any correct information. Results suggest that the majority of the patients didn't have sufficient and safe knowledge to the use of prescribed medication.

Accidents caused by Bothrops and Bothropoides in the State of Paraiba: epidemiological and clinical aspects / Acidentes causados por serpentes dos gêneros Bothrops e Bothropoides no Estado da Paraíba: aspectos clínicos e epidemiológicos

INTRODUCTION: Bothrops and Bothropoides snakes cause 70 percent of the ophidic accidents in Brazil. The species that cause ophidic accidents in State of Paraíba are Bothropoides erythromelas, Bothrops leucurus and Bothropoides neuwiedi. METHODS: This is a prospective and transverse study, following a quantitative approach of accidents involving Bothrops and Bothropoides admitted to the Toxicological Assistance and Information Centers of Campina Grande and João Pessoa (Ceatox-CG and Ceatox-JP), aimed at identifying the epidemiological and clinical profile of such accidents. All of the patients admitted had medical diagnoses and were monitored at Ceatox-CG or Ceatox-JP. RESULTS: The genera Bothrops and Bothropoides caused 91.7 percent of the ophidic accidents reported. Snake bites were frequent in men (75.1 percent), rural workers (65.1 percent), literate individuals (69 percent) between 11 and 20 years-old (21.7 percent), and toes the most common area attacked (52.7 percent). Most (86.6 percent) patients were admitted within 6 hours after the accident/bite, with a predominance of mild cases (64.6 percent). The annual occurrence in Paraíba was 5.5 accidents/100,000 inhabitants and lethality was 0.2 percent. CONCLUSIONS: Positive changes in the profiles of these accidents were verified, such as the non-application of inadequate solutions, including the use of tourniquet, coffee grounds, garlic, suction and/or cutting the bitten area. Moreover, the Itinerant Laboratory project, linked to Paraíba State University in partnership with Ceatox-CG, has contributed positively, providing several cities of the state with information regarding the prevention of accidents involving venomous animals. The local press has also contributed, reporting the educational work developed by the centers.

INTRODUÇÃO: As serpentes Bothrops e Bothropoides são responsáveis por 70 por cento dos acidentes ofídicos ocorridos no Brasil. As espécies causadoras de acidentes na Paraíba são Bothropoides erythromelas, Bothrops leucurus e Bothropoides neuwiedi. MÉTODOS: Tratou-se de um estudo prospectivo e transversal, com abordagem quantitativa dos acidentes botrópicos e botropóidicos atendidos e registrados pelos Centros de Assistência e Informação Toxicológica de Campina Grande e João Pessoa (Ceatox-CG e Ceatox-JP), com o objetivo de conhecer o perfil epidemiológico e clínico deste agravo. Todos os pacientes atendidos tiveram diagnóstico médico e acompanhamento pelos Ceatox CG e JP. RESULTADOS: Os gêneros Bothrops e Bothropoides foram responsáveis por 91,7 por cento dos acidentes ofídicos notificados. Atingindo frequentemente o sexo masculino (75,1 por cento), trabalhadores rurais (65,1 por cento), alfabetizados (69 por cento) e na faixa etária entre 11 a 20 anos (21,7 por cento), os dedos dos pés foram as regiões anatômicas mais acometidas (52,7 por cento). A maioria (86,6 por cento) dos pacientes foi atendida em até 6 horas após o acidente/picada com predominância de casos leves (64,6 por cento). A incidência anual no estado foi 5,5 acidentes/100.000 habitantes e a letalidade 0,2 por cento. CONCLUSÕES: Verificaram-se mudanças positivas no perfil desses acidentes, como a não utilização de medidas consideradas inadequadas (uso de torniquetes, borra de café, alho, incisão com sucção e outras). Além disso, o projeto Laboratório Itinerante, ligado a Universidade Estadual da Paraíba em parceria com o Ceatox-CG, tem contribuído positivamente, levando a várias cidades do estado informações sobre prevenção e tratamento dos acidentes causados por animais peçonhentos. A imprensa local também tem contribuído, divulgando esse trabalho educativo.

Prescrição médica: orientações adequadas para o uso de medicamentos? / Medical prescriptions: adequate orientation to medicine use?

O conhecimento insuficiente de informação dada ao paciente durante a consulta médica resulta em grandes dificuldades para a condução correta da terapêutica medicamentosa. Baseados nesse contexto, o estudo teve como objetivo avaliar o grau de conhecimento dos pacientes sobre os medicamentos prescritos na Atenção Básica no município de Esperança (PB). Para tal, foram entrevistadas 199 pessoas que, após consulta médica, receberam prescrição, tendo sido avaliado o nível de conhecimento desses pacientes em relação ao nome do medicamento, a dose, o horário, a finalidade, o tempo de uso e reações desagradáveis. Entre os entrevistados, 53,8 por cento evidenciaram desconhecer o nome do medicamento, 20,3 por cento a dosagem e 25,4 por cento o horário de utilização. O item em que se observou maior frequência de acerto foi finalidade do medicamento, tendo 75,1 por cento dos pacientes apresentado bom conhecimento. No que se refere ao tempo de uso e às reações desagradáveis, 57,4 por cento e 94,4 por cento dos pacientes, respectivamente, não possuíam nenhuma informação correta. Os resultados sugerem que a maioria dos pacientes não apresenta o conhecimento adequado e seguro para a utilização dos medicamentos prescritos.

During physician's consultation, the lack of adequate information on medication to the patient is a major problem to reach the correct pharmacotherapy. This study aims at assessing the patient knowledge about prescribed drugs. In order to proceed the investigation, interviews were performed about type of medication, dosage, administration schedule, purpose, duration of treatment and side effects. From 199 patients interviewed after they had received a prescription, 53.8 percent didn't have any information about the medicine, 20.3 percent didn't know the dosage and 25.4 percent didn't know the medication schedule. The purpose of the medication was the information with the highest percentage of correct answers, with 75.1 percent of the patients showing good level of knowledge. Regarding to the duration of the treatment and side effects, 57.4 percent and 94.4 percent of the patients, respectively, didn't present any correct information. Results suggest that the majority of the patients didn't have sufficient and safe knowledge to the use of prescribed medication.

Epidemiologia dos acidentes ofídicos notificados pelo Centro de Assistência e Informação Toxicológica de Campina Grande (Ceatox-CG), Paraíba / Epidemiologic profile of snakebites reported by the Poison Information Center of Campina Grande, Paraíba

Os acidentes causados por animais peçonhentos ainda constituem problema de Saúde Pública no Brasil. Embora a produção e a distribuição dos soros no país encontrem-se estabilizadas, há problemas relacionados à notificação de acidentes deste tipo em várias regiões. Considerando esta realidade, foi realizado um estudo transversal entre janeiro e dezembro de 2005, utilizando documentação indireta sobre os acidentes ofídicos ocorridos em Campina Grande e 80 municípios adjacentes à região, com o objetivo de conhecer o perfil epidemiológico e clínico deste tipo de caso. Todos os pacientes atendidos tiveram diagnóstico médico de acidente por serpentes realizado pelo Centro de Atendimento Toxicológico de Campina Grande (Ceatox-CG). Os dados foram coletados através da ficha de notificação do Sinan (Sistema Nacional de Notificação de Agravo do Ministério da Saúde). Para análise dos dados, foi utilizada estatística descritiva e os dados foram tabulados no programa Microsoft Excel 2003. Dos 1.443 atendimentos no Centro, 737 foram causados por animais peçonhentos e, destes, 277 foram provocados por serpentes peçonhentas e não peçonhentas. Os acidentes predominaram no sexo masculino, na faixa etária de 10 a 29 anos, principalmente em agricultores na zona rural, entre maio e novembro de 2005. O gênero Bothrops foi responsável pelo maior número de casos (71,5 por cento), e as extremidades superior e inferior do corpo foram os locais de maior predominância de ataques. Na extremidade inferior, foi atingido principalmente o pé. Em relação à gravidade, foram mais frequentes os acidentes classificados como leves causados pelo gênero Bothrops e apenas um paciente evoluiu para óbito. A média do tempo de atendimento, em horas, foi superior a 12 horas nos acidentes considerados graves, causados pelos gêneros Bothrops e Crotalus. Nossos resultados concordam com o perfil epidemiológico nacional dos acidentes ofídicos, atingindo com maior frequência o sexo masculino ...

Accidents caused by venomous animals are still a public health problem in Brazil. Although the production and distribution of antivenom is controlled, several regions have difficulties in reporting this type of accident. Considering such fact, a cross-sectional study was carried out using indirect files on venom accidents that occurred in Campina Grande, along with 80 small towns comprising the region, from January to December 2005. The main objective was to outline a better epidemiological and clinical profile of these cases. All patients admitted to the Poisoning Information Center of Campina Grande (CEATOX-CG) had their injuries medically diagnosed as injuries caused by venomous snakes. Data collection was based on the use of a reporting form by the National Reporting System - SINAN (Sistema Nacional de Notificação de Agravo do Ministério da Saúde). Data analysis consisted of descriptive statistics using Microsoft Excel 2003. A number of 737 out of 1,443 patients who received care at the medical center had their cases related to venomous animals, and 277 of the accidents had been caused by venomous and non- venomous snakes. Most accidents involved men, from 10 to 29 years of age, including peasants in rural areas, from May to November 2005. Most of the cases (71.5 percent) involved the Bothrops genus and upper and lower limbs, especially feet. As to severity, most of the cases were classified as mild, caused by the Bothrops genus, and only one patient died. The average length of time spent in providing care to the victims was over 12 hours in severe cases caused by Bothrops and Crotalus. Our results agree with the national epidemiological profile of snakebites, which are more frequent amongst male peasants aged from 10 to 49, affecting especially lower limbs, caused most often by the Bothrops genus.

Perfil epidemiológico das intoxicações alimentares notificadas no Centro de Atendimento Toxicológico de Campina Grande, Paraíba / Epidemiological profile of food intoxication reported by the Poisoning Information Center of Campina Grande, Paraíba

OBJETIVOS: Descrever as características sociodemográficas relacionadas às intoxicações alimentares notificadas pelo Centro de Atendimento Toxicológico de Campina Grande (CEATOX - CG), PB, em 2005. MATERIAL E MÉTODO: Trata-se de um estudo transversal, retrospectivo com abordagem quantitativa. Os dados foram obtidos das Fichas de Notificação do Sinitox (Sistema Nacional de Informações Tóxico-Farmacológicas). As variáveis coletadas foram: gênero, faixa etária, zona de residência do paciente, sazonalidade, ocupação, grau de instrução, alimento responsável pela intoxicação e evolução (cura/óbito). RESULTADOS: Foram registrados 162 casos de intoxicação por alimentos, de um total de 1.443 ocorrências de intoxicações e acidentes com plantas tóxicas e animais peçonhentos durante o ano de 2005. Observou-se que o gênero feminino foi o de maior percentual encontrado, com 56,2 por cento. A faixa etária entre 20 - 29 anos foi a mais prevalente, assim como a grande maioria dos pacientes notificados residia na zona urbana, representando 95,7 por cento (155) do total de casos de intoxicação alimentar (162). Com relação ao grau de instrução e ocupação 59,9 por cento e 44,4 por cento dos casos, respectivamente, não foram identificados. Os alimentos identificados nas intoxicações foram as carnes (11,0 por cento). Nenhum óbito foi registrado no período estudado. CONCLUSÃO: Conclui-se que as intoxicações por alimentos registradas no Ceatox-CG representam 11,2 por cento dos casos atendidos e notificados neste Centro, ocupando o terceiro lugar em relação aos outros agentes tóxicos. O sistema de notificação utilizado pelo Centro, apesar de possuir um grande volume de informações, não é preenchido devidamente, faltando aspectos importantes na análise final dos dados.

OBJECTIVES: This work aimed to identify socio-demographic aspects related to food intoxications reported by the Poisoning Information Center of Campina Grande (CEATOX - CG), PB, in 2005. METHODS: Retrospective study with a quantitative approach. Data were collected from the Sinitox (National of Toxic-Pharmacologic Information System) Reporting Forms. Features collected were: gender, age, residence zone of patient, period of the year, occupation, schooling, intoxicating food, and outcome (cure/death). RESULTS: Of the 1,443 intoxications and accidents with toxic plants and poisonous animals reported during the year of 2005, 162 were food intoxications. We observed that females were the most frequently intoxi-cated, with 56.2 percent. The 20-29 year-old-group was the most prevalent, and a great part of patients lived in the urban area, accounting for 95.7 percent (155) of all food intoxications (162). According to schooling and occupation, 59.9 percent and 44.4 percent of the cases, respectively, could not be identified. The most prevalent food in intoxications was meat (11.0 percent). No death was reported during the study period. CONCLUSION: Food intoxications registered at the Ceatox-CG account for 11.2 percent of the cases seen and reported in this Center, ranking third in relation to other toxic agents. Although the reporting system used by the Center has a large volume of information, it is not filled out properly, and, therefore, important aspects for the final analysis of data are missing.