Evaluation of the acute toxicity of ellagic acid and gallic acid incorporated in Poloxamer407® gel, in Zophobas morio larvae.

Gallic acid (GA) has antioxidant, anti-inflammatory and antimicrobial properties, while ellagic acid (EA) demonstrates anticancer, antiviral and photoprotective activity. In this study, the combination of these substances incorporated into a poloxamer gel was tested to verify the individual effect of the substances, in addition to taking advantage of a probable complementary effect, aiming to provide additional therapeutic benefits. As a result of the incorporation, formulations containing GA, EA and GA + EA were obtained, which were evaluated for the effects of the Freeze-thaw cycle on pH, which revealed a significant decrease (p < 0.05) in most samples, including the vehicle (without drug) and the gel containing both drugs. No sample showed variation outside the normal pH range for the skin, with values ranging from 4.8 to 6.0. Regarding conductivity, the GA, EA and GA + EA formulations showed a reduction (p < 0.05) after the freeze-thaw cycle. The drug content in the formulations ranged from 95.86% to 101.35% initially to 91.30% to 101.51% after the freeze-thaw cycle. Regarding the drug release, the results revealed the following cumulative percentages: GA-3% - 92.58% after 1.5 h; AE-3% - 51.60% after 6 h; GA + EA (1.5% = 1.5%) - 99.91% after 2 h; GA + EA- (1.5% = 1.5%) released 57.06%, after 6 h. Regarding toxicity, it was observed that the group treated with GA showed a lower survival rate of the larvae (40%) at the dose 3000 mg/Kg in the formulation. Following the same trend, in the acute lethal concentration (ALC50) test performed using Zophobas morio larvae, an ALC50 of 2191.51 mg/Kg was observed for GA at 48 h. Melanin analysis showed a decrease in concentrations of 30 mg/Kg in the GA group, 3 mg/Kg of EA and 3, 300, 3000 mg/Kg of GA + EA, of the pure drugs. In the groups with the drugs incorporated into the gel, there was a significant decrease (P < 0.05) in melanin in the vehicle (gel), at concentrations of 300 and 3000 mg/Kg of GA and EA. On the other hand, in the combination of GA + EA, a reduction was observed at concentrations of 3 and 30 mg/Kg when compared to the control group. Thus, the gel showed good quality as a pharmaceutical formulation for topical use and low toxicity, making it promising for use in skin therapies.

Uso dos antifúngicos no tratamento da candidíase vulvovaginal: uma revisão integrativa / Use of antifungals in the treatment of vulvovaginal candidiasis: an integrative review

Objective: To identify scientific evidence available in the literature and analyze the action of antifungal drugs used for the treatment of vulvovaginal candidiasis. Methods:Integrative literature review conducted in the databases Medline/PubMed, Embase, Web of Science, Cochrane Library, CINAHL, SCOPUS and VHL; with the descriptors "woman", "antifungal agents"; "vulvovaginal candidiasis". Results:Ten scientific articles published between 1983 and 2020 were obtained. Of these, four were developed in Iran; followed by Mexico, England, Taiwan, Thailand, Denmark, and the United States. In terms of methodological design, most studies are clinical trials (n=8), and two are cross-sectional studies. Regarding the level of evidence, eight are level II, and only two investigations are level IV. Concerning the antifungal drugs used in the treatment, there was a predominance of clotrimazole (n=4; efficacy ranging from 42.4% to 98.3%), followed by econazole (n=2; efficacy between 39% and 89%), combined or not with another antifungal drug. Conclusion: The use of clotrimazole stands out, as it is highly effective in the treatment of vulvovaginal candidiasis. This study contributes to the advancement of knowledge and improvement of the clinical practice of nursing and other health professionals. It is expected that these results will encourage further studies and update clinical practices.Descriptors:Women;Antifungal Agents;Candidiasis, Vulvovaginal

Objective: To identify scientific evidence available in the literature and analyze the action of antifungal drugs used for the treatment of vulvovaginal candidiasis. Methods: Integrative literature review conducted in the databases Medline/PubMed, Embase, Web of Science, Cochrane Library, CINAHL, SCOPUS and VHL; with the descriptors "woman", "antifungal agents"; "vulvovaginal candidiasis". Results:Ten scientific articles published between 1983 and 2020 were obtained. Of these, four were developed in Iran; followed by Mexico, England, Taiwan, Thailand, Denmark, and the United States. In terms of methodological design, most studies are clinical trials (n=8), and two are cross-sectional studies. Regarding the level of evidence, eight are level II, and only two investigations are level IV. Concerning the antifungal drugs used in the treatment, there was a predominance of clotrimazole (n=4; efficacy ranging from 42.4% to 98.3%), followed by econazole (n=2; efficacy between 39% and 89%), combined or not with another antifungal drug. Conclusion:The use of clotrimazole stands out, as it is highly effective in the treatment of vulvovaginal candidiasis. This study contributes to the advancement of knowledge and improvement of the clinical practice of nursing and other health professionals. It is expected that these results will encourage further studies and update clinical practices.Descriptors:Women;Antifungal Agents;Candidiasis, Vulvovaginal

Anti-inflamatórios não esteroides tópicos para o alívio da dor artritica, beneficios para idosos / Non-steroid anti-inflammatory topics for arthritic pain relief, benefits for elderly / Temas antiinflamatorios no esteroides para el alívio del dolor artritico, beneficios para personas mayores

Objetivo: Identificar e analisar os anti-inflamatórios não esteroides tópicos para o alívio da dor artrítica, benefícios para idosos. Métodos: Trata-se de uma revisão integrativa realizada nas bases de dados no mês de maio de 2020, mediante consulta às bases de dados MEDLINE/PubMed, CINAHL, EMBASE, Web of Science, SCOPUS e índice bibliométrico LILACS, acessados por meio do Portal Periódicos da Comissão de Aperfeiçoamento de Pessoal de Ensino Superior, utilizando os descritores: idoso (Aged/elderly), anti-inflamatório não esteroide (Anti-Inflammatory Agents, Non-Steroidal) artrite (Arthritides/Polyarthritis). No qual foram selecionados 13 artigos sem limitador para tempo e idioma. Resultados: Detectou se que as variáveis mais evidenciadas foram: inglês (100%); artigos indexados na MEDLINE/PubMed (69,2%); pais com mais publicações Inglaterra (46%). Destaca-se que 69,3% dos artigos foram ensaios clínicos randomizados controlados; anti-inflamatório tópico mais usado diclofenaco sódico (61,5% seguido do cetoprofeno (38,7%). Conclusão: Concluiu se o diclofenaco e o cetoprofeno apresentam eficácia e segurança no alívio da dor artrítica, e baixa toxicidade cutânea local. (AU)

Objective To identify and analyze topical non-steroidal anti-inflammatory drugs for the relief of arthritic pain, benefits for the elderly. Methods: This is an integrative review carried out on the databases in May 2020, by consulting the MEDLINE / PubMed, CINAHL, EMBASE, Web of Science, SCOPUS and LILACS bibliometric index databases, accessed through the Portal Journals of the Higher Education Personnel Improvement Commission, using the descriptors: elderly (Aged / elderly), non-steroidal anti-inflammatory (Anti-Inflammatory Agents, Non Steroidal) arthritis (Arthritides / Polyarthritis). In which 13 articles were selected without time and language limitations. Results: It was found that the most evident variables were: English (100%); articles indexed in MEDLINE / PubMed (69.2%); parents with the most publications in England (46%). It is noteworthy that 69.3% of the articles were randomized controlled clinical trials; most commonly used topical anti-inflammatory diclofenac sodium (61.5% followed by ketoprofen (38.7%). Conclusion: Diclofenac and ketoprofen were concluded to be effective and safe in relieving arthritic pain and low local skin toxicity. (AU)

Objetivo: Identificar y analizar medicamentos antiinflamatorios no esteroideos tópicos para el alivio del dolor artrítico, beneficios para los ancianos. Métodos: Esta es una revisión integradora realizada en las bases de datos en mayo de 2020, consultando las bases de datos del índice bibliométrico MEDLINE / PubMed, CINAHL, EMBASE, Web of Science, SCOPUS y LILACS, a las que se accede a través del Portal Revistas de la Comisión de Mejoramiento del Personal de Educación Superior, utilizando los descriptores: artritis de edad avanzada (Ancianos / ancianos), antiinflamatorios no esteroideos (agentes antiinflamatorios, no esteroideos) (artritis / poliartritis). En el que se seleccionaron 13 artículos sin limitaciones de tiempo e idioma. Resultados: se encontró que las variables más evidentes fueron: inglés (100%); artículos indexados en MEDLINE / PubMed (69,2%); padres con más publicaciones en Inglaterra (46%). Es de destacar que el 69,3% de los artículos fueron ensayos clínicos controlados aleatorios; diclofenaco sódico antiinflamatorio tópico más utilizado (61.5% seguido de ketoprofeno (38.7%). Conclusión: Se concluyó que el diclofenaco y el ketoprofeno son efectivos y seguros para aliviar el dolor artrítico y la baja toxicidad local de la piel. (AU)

Impacto da complexidade da farmacoterapia sobre parâmetros bioquímicos e pressóricos no diabetes mellitus / Impact of the complexity of pharmacotherapy on biochemical and pressure parameters in diabetes mellitus

OBJETIVOS: Avaliar a complexidade da farmacoterapia no diabetes melito numa unidade básica de saúde e investigar eventuais correlações com variáveis bioquímicas e pressóricas. MÉTODOS: Trata-se de um estudo observacional, descritivo com delineamento transversal, que incluiu todos os indivíduos com diagnóstico primário de diabetes tipo 2 e com prescrição preenchida com pelo menos um antidiabético oral. A quantificação da complexidade do regime terapêutico foi realizada conforme o índice da complexidade da farmacoterapia, e este foi correlacionado com variáveis do perfil bioquímico: glicemia capilar, creatinina e filtração glomerular, e pressórico: pressão arterial sistólica e diastólica, através da análise de correlação de Spearman. RESULTADOS: A média do índice de complexidade da farmacoterapia foi de 9,42±0,48 pontos, sendo mais proeminente na seção B (5,03±2,57). O índice esteve correlacionado com a glicemia capilar (rho=0,538), pressão arterial sistólica (rho=0,520), creatinina (rho=-0,406) e filtração glomerular (rho=0,566). Esta correlação foi diretamente proporcional ao aumento da glicemia capilar (p<0,01), pressão arterial sistólica (p<0,01) e filtração glomerular (p<0,01), e inversamente proporcional à creatinina (p<0,05). CONCLUSÕES: Nossos achados revelaram que a polifarmácia no diabete melito contribuiu para a geração da complexidade da farmacoterapia, resultando em não adesão ao tratamento prescrito e consequentemente contribuindo, principalmente, para o descontrole glicêmico e pressórico.

AIMS: Assess the complexity of pharmacotherapy in diabetes mellitus in a basic health unit and investigate possible correlations with biochemical and pressure variables. METHODS: It is study observational, descriptive, cross-sectional study that included all patients with a primary diagnosis of type 2 diabetes and a prescription filled with at least one oral antidiabetic agent. The quantification of the complexity of the therapeutic regimen was performed according to the complexity index of the pharmacotherapy; and it was correlated with variables of the biochemical profile: capillary glycemia, creatinine and glomerular filtration, and pressure systolic and diastolic blood pressure, using the Spearman correlation analysis. RESULTS: The median of the complexity index of pharmacotherapy was 9.42±0,48 points, being more prominent in section B (5.03±2.57). The index was correlated with capillary glycemia (rho=0.538), systolic blood pressure (rho=0.520), creatinine (rho=-0.406) and glomerular filtration (rho=0.566). This correlation was directly proportional to the increase in capillary glycemia (p<0.01), systolic blood pressure (p<0.01) and glomerular filtration (p<0, 01), and inversely proportional to creatinine (p<0.05). CONCLUSIONS: Our findings revealed that polypharmacy in diabetes mellitus contributed to the generation of pharmacotherapy complexity, resulting in non-adherence to the prescribed treatment and consequently contributing mainly to the lack of glycemic and pressure control.

Complexidade terapêutica de diabéticos na atenção primária / Therapeutic complexity of diabetic patients in primary care

Objetivo Este artigo tem por objetivo avaliar a complexidade da farmacoterapia de pacientes diabéticos, usuários de uma Unidade Básica de Saúde. Métodos Trata-se de estudo observacional, descritivo com delineamento transversal. A avaliação da complexidade do regime terapêutico foi realizada com base no Índice da Complexidade da Farmacoterapia. Foi considerado o tratamento medicamentoso de uso contínuo dos pacientes, incluindo antidiabéticos e fármacos para hipertensão e dislipidemia. As variáveis independentes foram representadas pelas interações medicamentosas, total de medicamentos utilizados, número de vezes e frequência mensal de visitas à unidade de saúde. As potenciais interações medicamentosas foram avaliadas por meio da base de dados Drugdex System ­ Thomson Micromedex® ­ Interactions, e a assiduidade de consultas foi obtida pelas datas de cadastro e da última visita. Resultados Na amostra estudada, 52,0% dos participantes tinham idade superior a 60 anos, sendo 73,3% do sexo feminino e, em média, frequentavam a unidade de saúde 0,257±0,22 vezes ao mês. A média da complexidade da farmacoterapia foi de 9,42±4,24, sendo mais proeminente na seção B (frequência de doses): 5,03±2,57. Conclusão A partir da realização deste estudo foi possível identificar uma elevada complexidade da farmacoterapia, que apresentou associação positiva com diversos fatores: número de medicamentos, interações medicamentosas, consultas e frequência mensal à unidade básica de saúde.

Objective To evaluate the pharmacotherapy complexity of diabetic patients of a Basic Health Unit. Methods Observational, descriptive study with a cross-sectional design. The complexity assessment of the therapeutic regimen was performed by calculating the Pharmacotherapy Complexity Index. Continuous prescription drug treatment was considered, including antidiabetics and drugs for hypertension and dyslipidemia. The independent variables were represented by drug interactions, total medication used and monthly frequency of visits to the health unit. Potential drug interactions were evaluated using the Drugdex System ­ Thomson Micromedex® ­ Interactions database and consultation frequency was obtained through the date of registration and the last visit recorded. Results In the sample studied, 52.0% of the participants were over 60 years old, female (73.3%) and with an average frequency of visits to the health unit of 0.257±0.22 times a month. The complexity mean of pharmacotherapy was 9.42±4.24, being most prominent in section B (frequency of doses): 5.03±2.57. Conclusion Based on this study, it was possible to identify a high level of pharmacotherapy complexity and it was positively associated with several factors: amount of drugs, drug interactions, consultations and monthly frequency in the basic health unit.

Prevalência de dislipidemias e fatores de risco associados / Prevalence of dyslioidemias and associated risk factors

A dislipidemia caracteriza-se pela elevação dos níveis plasmáticos de colesterol de baixa densidade (LDL-c), redução dos níveis de colesterol de alta densidade (HDL-c) e/ou aumento de triglicérides (TG). Essas alterações evidenciam o risco para doenças cardiovasculares (DCV) e uma alta probabilidade de ocorrência de morte por eventos coronarianos. Objetivo: Avaliar a prevalência de dislipidemia e fatores de risco associados em pacientes ambulatoriais do hospital universitário da Universidade Federal do Piauí. Métodos: Trata-se de um estudo transversal, no qual a amostra foi constituída por 124 pacientes. Foram analisados os principais fatores de risco modificáveis: sobrepeso e sedentarismo, e não modificáveis: idade e sexo. Resultados: Foram selecionados 137 pacientes para participarem do estudo, porém 13 foram excluídos, pois apresentavam dados incompletos, permanecendo 124 pacientes. Os fatores de risco modificáveis mais prevalentes no estudo foram sobrepeso (75,86%) nos homens com dislipidemia e 84,48% nas mulheres com dislipidemia. O sedentarismo foi observado em 69% dos homens com dislipidemia e 61% das mulheres com dislipidemia. Os fatores de risco associados à dislipidemia foram a hipertensão, o diabetes mellitus e o tabagismo. Conclusões: A partir da realização deste estudo foi possível concluir que a maioria dos pacientes não tinha conhecimento prévio de seu perfil lipídico; a dislipidemia mais prevalente foi a hipertrigliceridemia isolada e o fator de risco mais prevalente foi o sobrepeso. Faz-se necessário o maior acompanhamento desses pacientes, aconselhando-os em relação a seus hábitos de vida para que possam ter uma melhor qualidade de vida. (AU)

Dyslipidemia is characterized by elevated plasma levels of low-density (LDL-c) cholesterol, reduced levels of high-density (HDL-c) cholesterol and / or increased triglycerides (TG). These changes evidence the risk for cardiovascular diseases (CVD) and a high probability of occurrence of death by coronary events. Objective: to evaluate the prevalence of dyslipidemia and associated risk factors in outpatients of the university hospital of the Federal University of Piauí.Methods: This is a cross-sectional study, in which the sample consisted of 124 patients. The main modifiable risk factors were analyzed: overweight and sedentary lifestyle, and not modifiable: age and sex. Results: A total of 137 patients were selected to participate in the study, but 13 were excluded because they had incomplete data, remaining 124 patients. The most prevalent modifiable risk factors in the sample were overweight (75.86%) in men with dyslipidemia and 84.48% in women with dyslipidemia. Sedentariness was observed in 69% of the men with dyslipidemia and 61% of the women with dyslipidemia. The risk factors associated with dyslipidemia were hypertension, diabetes mellitus and smoking. Conclusions:Ever since this study was carried out, it was concluded that most of dyslipidemia. Sedentariness was observed in 69% of the men with dyslipidemia and 61% of the women with dyslipidemia. The risk factors associated with dyslipidemia were hypertension, diabetes mellitus and smoking. Conclusions:Ever since this study was carried out, it was concluded that most of the patients had no prior knowledge of their lipid profile; the most prevalent dyslipidemia was hypertriglyceridemia alone and the most prevalent risk factor was overweight. Therefore, it is necessary to follow these patients better, advising them about their lifestyle so that they can have a better quality of life. (AU)