Medicinal plants of the Caatinga, northeastern Brazil: Ethnopharmacopeia (1980-1990) of the late professor Francisco José de Abreu Matos.

ETHNOPHARMACOLOGICAL IMPORTANCE: The Caatinga (semi-arid region), is an exclusively Brazilian biome. Considering the scarcity of ethnobotanical and ethnopharmacological studies in this region before the year 2000, this study presents data from ethnobotanical expeditions carried out between 1980 and 1990, by the late professor Francisco José de Abreu Matos (1924-2008). The information revealed in this present work are valuable and remained unpublished until now. MATERIALS AND METHODS: The objective was to organize, systematize and analyze ethnobotanical and ethnopharmacological data using ethnobotanical analytical techniques. The most cited native species in each use category were selected for literature review of the pharmacological studies related to their ethnomedicinal uses. RESULTS: Revision of the botanical nomenclature led to the botanical confirmation of 272 plants, of which 84 (30.9%) were reclassified. These represented 71 families and 220 genera that were cited 1957 times. 153 (56.3%) of these plant species are native to Brazil, of which 36 (23.4%) are endemic to the Caatinga. The use reports (RU) associated with these plants, according to the body systems (ICPC-2) in decreasing order of UR and the ICF values were respiratory system (93 species, 407 UR, ICF 0.77), digestive system (119 species, 373 UR, ICF 0.68), general and nonspecific symptoms (95 species, 219 UR, ICF 0.58), female genital system (60 species, 184 UR, ICF 0.68), skin (71 species, 156 UR, ICF 0.55), cardiovascular (50 species, 99 UR, ICF 0.50), blood and immune system diseases (46 species, 96 UR, ICF 0.53), urological (44 species, 88 UR, ICF 0.51), musculoskeletal (33 species, 80 UR, ICF 0.60), psychological (21 species, 71 UR, ICF 0.60), while others represent less than 10.0% of the UR. The most cited plants in the disease categories were Dysphania ambrosioides (28), Pombalia calceolaria (28) Hymenaea courbaril (26), Myracrodruon urundeuva (50), Brassica juncea subsp. integrifolia (16), Scoparia dulcis (22), Phyllanthus niruri (14), Egletes viscosa (25), Lippia alba (16), Erythroxylum vacciniifolium (9) and Salvia rosmarinus (21). The most prominent clades of the medicinal plants based on cluster analysis were the Lamiids (Euasterids)-497 UR and the Fabids (Eurosids I) - 468 UR. Association between certain phylogenetic clades and use-category were also observed and discussed. CONCLUSION: This study demonstrated a new approach in ethnopharmacology by mapping plant usages to diseases prevalent in a community from old ethnobotanical travel reports. In addition to revealing the therapeutic potential of Caatinga species using cluster analysis.

Acute kidney injury and pancreatitis due to scorpion sting: case report and literature review.

Despite the high number of accidents due to scorpion stings in Brazil, severe cases in adults are seldomly reported. In the Northeast region of Brazil, Tityus stigmurus is the most prevalent species. A 69 year-old woman who was stung by a scorpion attended the emergency room 5 hours after envenomation. She got worse due to abdominal pain. Clinical findings were concordant with class III scorpion envenomation (major systemic manifestations), complicated by acute kidney injury and acute pancreatitis. Intensive supportive therapy was adopted. In the follow-up, 3 months later, she was completely recovered. This report is being brought to recommend the thorough management of victims of scorpion accidents, enabling early diagnosis of severe complications, which could lead to death if aggressive supportive measures are not early and adequately taken.

Care plan for HIV+ patients in specialized Aids centers in Brazil: Pharmacotherapeutic form and pilot study / Plano de cuidado para pacientes HIV+ em centro especializado em AIDS do Brasil: descrição da ficha farmacoterapêutica e estudo piloto

The objective of this study is to describe a pharmacotherapy form model to monitor patients' pharmacotherapeutic follow-up (PF) on antiretroviral therapy in a specialized center of Ceará, Brazil. Description comprises its structure up to application. The preparation and application of the PF registration model were carried out by means of a focal group. The following steps were used for the draft: 1. Review of the literature; 2. Diagnosis of place where pharmaceutical care was undertaken; 3. Choice of the PF method; 4. Selection of clinical indicators; 5. Evaluation by a committee of experts; 6. Development of a standard functional procedure with timetable and evaluation frequency of the tool's different sections or blocks. 7. Pilot study for evaluation of the form with 25 patients. PF form featured six sections comprising patient's personal data, pharmaceutical anamnesis and records of adherence evaluation, etc. The description and format of the sections are presented in current essay. Further, 322 issues related to antiretroviral drugs were reported during form filling. The multi-section PF form seemed appropriate and applicable for the report of issues related to antiretroviral drugs in HIV positive patients. It was also a helpful guide for pharmaceutical interventions by a multiprofessional team in specialized healthcare settings.

O objetivo deste estudo é descrever o modelo de ficha farmacoterapêutica utilizada no acompanhamento farmacoterapêutico (AFT) de pacientes em terapia antirretroviral em centro especializado do Ceará, Brasil, da sua estruturação à aplicação. Por meio de um grupo focal, o processo de elaboração e aplicação da ferramenta de registro foi realizado e envolveu as seguintes etapas: 1. revisão bibliográfica; 2. diagnóstico situacional do local de prestação do serviço farmacêutico; 3. escolha do método de AFT; 4. seleção de indicadores clínicos; 5. avaliação por comitê de especialistas; 6. elaboração de procedimento operacional padrão com roteiro e frequência de aferição dos diferentes blocos do instrumento; 7. estudo piloto para aplicação e avaliação inicial da ficha em 25 pacientes/usuários. A ficha de AFT envolveu seis blocos com dados pessoais, anamnese farmacêutica e registros de avaliação da adesão, etc. A descrição e formatação dos blocos são apresentadas no trabalho. Durante o uso da ficha no estudo piloto, foram identificados 322 problemas relacionados com medicamentos antirretrovirais. A ficha de AFT, estruturada com seus diferentes blocos, pareceu ser adequada e aplicável para o registro de problemas com antirretrovirais em pacientes HIV+, sendo útil para nortear intervenções farmacêuticas juntamente com a equipe multiprofissional em serviço de atendimento especializado.

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.