Intentional self-poisoning with medications: Occurrence, recurrence and suicide deaths.

This study aimed to identify the sociodemographic and clinical factors associated with the occurrence and recurrence of intentional self-poisoning with medications (ISP-M), and suicide deaths by ISP-M in the state of Mato Grosso, Brazil. In this cross-sectional analytical study, we used logistic regression models to analyze data obtained through health information systems. Factors associated with use of ISP-M as a method were female gender, white skin color, occurrence in urban areas and at home. The ISP-M as a method was less reported in people presumed under the influence of alcohol. Lower chance of death by suicide using ISP-M was found among young people and adults (under 60 years old).

Mental Health Care in Primary Health Care: An Integrative Review.

In this study, we analyzed recent studies on mental health approaches developed in primary health care to identify the emphasis of such interventions, their technical feasibility for the setting in question, and their levels of evidence. An integrative review was conducted of primary studies from the LILACS, PubMed, Embase, CINAHL, and Web of Science databases using the PRISMA search strategy. Nineteen studies were identified with a high level of evidence that contribute to the advancement of knowledge in the area. However, academic, cultural, and linguistic barriers still need to be overcome to facilitate sharing of such interventions' findings and protocols.

Chemical Analysis of Eruca sativa Ethanolic Extract and Its Effects on Hyperuricaemia.

In vivo assays and chemical analyses were performed on the ethanolic extract from leaves of Eruca sativa. UHPLC-ESI-QTOF analysis confirmed the presence of glucosinolates and flavonol glucosides. The major flavonoid of the ethanolic extract, kaempferol-3,4'-di-O-ß-glucoside, was isolated, a HPLC-DAD method developed and validated to quantify its content in the extract. In vivo experiments were carried out on Wistar rats with hyperuricaemia induced by potassium oxonate and uric acid. A hypouricaemic effect was observed in hyperuricaemic Wistar rats treated with ethanolic extract at dose of 125 mg/kg and kaempferol-3,4'-di-O-ß-glucoside at dose of 10 mg/kg. The main anti-hyperuricaemic mechanism observed in the extract was uricosuric. Kaempferol-3,4'-di-O-ß-glucoside was identified as an important component responsible for the total activity of the ethanolic extract and was considered as a good chemical and biological marker of the ethanolic extract of E. sativa. The obtained results indicated the potential of E. sativa in the treatment of hyperuricaemia and its comorbidities.

Biopharmaceutics considerations for direct oral anticoagulants.

Vitamin K antagonists (VKA) and direct oral anticoagulants (DOACs) have been clinically used in the treatment of coagulation disorders. There are four DOACs approved since 2010 (dabigatran etexilate, rivaroxaban, apixaban, and edoxaban), and they were designed to overcome the practical limitations of VKA. This review summarized biopharmaceutics considerations about DOACs, which are critically discussed, applying risk analyses to subside the further classification of these drugs according to the Biopharmaceutics Classification System (BCS). These discussions included data compiled about physicochemical properties, equilibrium solubility, permeability, and drug dissolution of DOACs. From the biopharmaceutics characteristics is possible to identify critical variables related to the absorption process, which can help in the design of new formulations. The data were compared with the criteria recommended by regulatory agencies for the biopharmaceutics classification according to the BCS. From that, these data may be used to discuss the approval of generic medicines by the BCS-based biowaiver, and the clinical risks arising from novel formulations with DOACs. However, although there are indications of biopharmaceutics classifications for DOACs, conclusive information to classify these compounds according to the BCS is lacking, requiring more experimental studies to achieve this aim. Conclusive information is essential for a safe decision about the biowaiver, as well as to guide the development of new formulations containing the DOACs.

Social support networks of users of crack cocaine and the role of a Brazilian health program for people living on the street: A qualitative study.

This cross-sectional qualitative study analyzed characteristics of social support for users of crack cocaine and the role of "Consultório na Rua" (CR), or "Office in the Street," a Brazilian program for people living on the street. Data were collected using 1) ethnographic field observations during the delivery of services from this program, 2) in-depth interviews with 17 users of crack cocaine, and 3) a focus group with professionals from CR. To analyze data, we used content analysis and analytical categories based on Social Network Analysis (SNA) theoretical statements. Results showed that family, peers, community members, and professionals from CR were the main social support providers. Participants mentioned receiving material, informational, and emotional support from CR members. It was observed that CR had a welcoming and inclusive approach, but CR team members identified challenges related to stigma directed toward people who use substances and live on the street. CR assumed a central role in the health and social assistance of users of crack cocaine living on the street, providing an important link to healthcare and social services. However, initiatives related to motivation to receive mental health services, treatment, or social reintegration were not observed in conjunction with this program.

A sustainable UPLC-UV method for quantification of donepezil hydrochloride in biorelevant media applied to dissolution profile comparison.

Donepezil hydrochloride is one of the most prescribed anti-Alzheimer's drugs, despite being available for more than two decades, chromatographic methods for the quantification of the drug in biorelevant media that mimics pH physiological conditions in vivo (pH 1.2, 4.5, and 6.8) are not available in the literature. These media are used in the dissolution test, an important tool, for registration and quality control of medicines. Considering the need for methods with this purpose, this work aimed to develop and validate a sustainable UPLC-UV method for quantification of donepezil hydrochloride in tablets, specifically on assay and dissolution profile, with reduced environmental impacts. The proposed method has a run time of 2 min and requires for each run, only 0.8 mL of solvents, providing excellent green analysis. The method proved to be selective, linear, precise, accurate, robust in the range of 2-14 µg/mL. Three products (reference, similar, and generic) were analyzed and showed very rapid dissolution. The average content varied from 100.2 ± 0.6% to 109.5 ± 2.1%. Using dissolution efficiency (DE), the drug release profiles were compared in different biorelevant media.

Wooden breast myopathy on broiler breast fillets affects quality and consumer preference.

INTRODUCTION: The emergence of myopathies such as wooden breast in the poultry industry generally associated with the fast development of the breast muscle of broilers has provided changes in the morphological structure of muscle tissues, as well as problems of meat qualitative attributes. The aim of this study was to evaluate physical, chemical, qualitative, and sensorial attributes of broiler fillets associated with severity levels of wooden breast (WB) myopathy in a poultry slaughterhouse. MATERIALS AND METHODS: Three hundred fillets in a poultry slaughterhouse were classified into three severity levels: normal (100 samples), moderate (100 samples), and severe (100 samples). RESULTS: After identification, classification, and description of changes, fillets with a severe WB level presented higher levels of red (a*), yellow (b*), and final pH. The lowest shear force and the highest myofibrillar fragmentation index were observed in fillets with a severe level when compared with normal fillets. The collagen content increased according to severity level. Tasters better evidenced the characteristic taste of chicken meat when tasting fillets with a severe WB level when compared with normal and moderate fillets. The succulence and preference of the Brazilian testers increased according to the severity level of the myopathy. CONCLUSION: In general, fillets with moderate and severe WB myopathy were affected not only in appearance but also in qualitative, physical, chemical, and sensory characteristics.

Violence, drugs, and psychiatric disorders: news from the Brazilian press.

The aim of this study is to describe the way that the Brazilian press reports on episodes of violence involving people with substance-related problems or psychiatric disorders. To develop this documentary study, we analyzed news reports from September 2009 to August 2015 in two major Brazilian newspaper who make their published articles available electronically in the Lexis Nexis Academic® database. The analyses were conducted using descriptive statistics and association tests. We identified 269 news stories related to these themes during the study period. The reported events occurred mainly in São Paulo and Rio de Janeiro, and 68% of the stories suggested a causal relationship between substance use or mental illness and violence. A marked minority (10%) of the stories made reference to prevention or treatment for the conditions studied. We concluded that the Brazilian press issues incomplete reports on episodes of violence involving people with substance-related problems or psychiatric disorders, emphasizing the relationships between these conditions and potential danger, particularly in cases involving drugs.

The Social Support Buffering Effect in the Relationship Between Perceived Stress and Alcohol Use Among Brazilian Women.

This cross-sectional study interviewed Brazilian women regularly attending primary care to investigate whether the relationship between social support and alcohol use is direct or is mediated by stress, in order to support the development of recommendations related to health prevention and mental health promotion actions. The results suggest that social support affects the outcome alcohol use in the women studied by buffering the effect of stress. Based on these results, recommendations are made for amplifying the social support network that prevents stress-induced alcohol use.

Evaluation of the losartan solubility in the biowaiver context by shake-flask method and intrinsic dissolution.

This study aimed at evaluating the shake-flask use as a universal method to evaluate drug solubility in a biowaiver context as proposed by FDA, EMA and ANVISA. The solubility of losartan was determined in three buffers using the shake-flask method, intrinsic dissolution (ID) and Quantum Chemistry. Moreover, the evaluation of a losartan dissolution profile from coated tablets was conducted. The losartan low solubility in pH 1.2 and high solubility in pH 6.8 were observed using the shake-flask method. However, the solubility results using ID demonstrated its high solubility in pH 1.2 and 6.8. It was not possible to find conclusive results regarding the solubility of the drug in pH 4.5. The studies conducted by Quantum Chemistry provide molecular and electronic data that helped understand the losartan solvation in different pH values. Our experimental results defined that losartan can be classified as a low-solubility drug. In addition, this work shows that shake-flask cannot be a universal method of solubility studies in biowaiver context. Individual analysis will be necessary. The intrinsic dissolution should be considered as a complementary method.

The use of benzodiazepines by women cared for at a Family Health Unit.

OBJECTIVE: Estimate the prevalence of benzodiazepine use by adult women at a Family Health Unit and identify the risk factors associated with this usage. METHOD: Quantitative cross-sectional study that employed secondary data developed at a Family Health Unit in the state of São Paulo, Brazil. We collected the data from the following sources: medical charts, registration forms, and the archive of prescriptions from the pharmacy at the referred health unit. We employed the chi-squared, Student's t, and Mann-Whitney tests, as well as logistic regression analysis. RESULTS: We identified 81 benzodiazepine users amongst 1,094 adult women (7.4%). Regarding the risk factors, the comparison between the groups of benzodiazepine users (n = 64) and non-users (n = 70) showed that having a chronic disease and using other psychotropic drugs were significantly associated with the use of benzodiazepines. CONCLUSION: The prevalence found was lower than the described in previous studies performed in Primary Health Units. The group that must receive greater attention regarding the consumption of benzodiazepines is that of middle-aged women or older, with low education levels, and chronic illnesses.

Mental Health Needs and Psychoactive Drug Use in a User Population of the Family Health Strategy (FHS) in Ribeirão Preto, São Paulo, Brazil.

This cross-sectional study was conducted in Family Health Care's field of  Ribeirão Preto city, São Paulo, Brazil to identify the prevalence of substance-related disorders and mental distress among patients with mental disorders. We also aimed to identify sociodemographic and social support risk factors. The data collection was done using medical records, the Social Support Questionnaire (SSQ-6), Self Report Questionnaire (SRQ-20) and home visits. Of the 272 families studied, 211 contained individuals with mental disorders, and 61 included individuals who had substance-related disorders, or both. The mental disorders recorded in these families were most frequently mood disorders, followed by neurotic disorders, stress-related disorders and somatoform disorders. Women received twice as many psychotropic prescriptions associated with non-psychiatric medication. A significant relationship was established between education and mental distress as measured using the SRQ-20 (p = 0.024). The SSQ-6 revealed a family presence of social support in all of the conditions established by the six questions.

Correction to: Mental Health Needs and Psychoactive Drug Use in a User Population of the Family Health Strategy (FHS) in Ribeirão Preto, São Paulo, Brazil.

The original version of this article unfortunately published without acknowledgement. The funding information and grant number is given below: Funding Research supported by Research in Public for the National Health Care System (PP-SUS), Grant number 12/51732-9.

Polymorphic and Quantum Chemistry Characterization of Candesartan Cilexetil: Importance for the Correct Drug Classification According to Biopharmaceutics Classification System.

The recommended method for the biopharmaceutical evaluation of drug solubility is the shake flask; however, there are discrepancies reported about the solubility of certain compounds measured with this method, one of them is candesartan cilexetil. The present work aimed to elucidate the solubility of candesartan cilexetil by associating others assays such as stability determination, polymorphic characterization and in silico calculations of intrinsic solubility, ionized species, and electronic structures using quantum chemistry descriptors (frontier molecular orbitals and Fukui functions). For the complete biopharmaceutical classification, we also reviewed the permeability data available. The polymorphic form used was previously identified as the form I of candesartan cilexetil. The solubility was evaluated in biorelevant media in the pH range of 1.2-6.8 at 37.0°C according to the stability previously assessed. The solubility of candesartan cilexetil is pH dependent and the dose/solubility ratios obtained demonstrated the low solubility of the prodrug. The in silico calculations supported the found results and evidenced the main groups involved in the solvation, benzimidazole, and tetrazol-biphenyl. The human absolute bioavailability reported demonstrates that candesartan cilexetil has low permeability and when associated with the low solubility allows to classify it as class 4 of the Biopharmaceutics Classification System.

Evaluation of social support and stress in nursing students. / Avaliação do apoio social e estresse em estudantes de enfermagem.

OBJECTIVE: To analyze the perception of stress and social support of nursing students considering the number of supporters and the satisfaction with them. METHOD: Quantitative, cross-sectional study performed with nursing students from a public university in the state of São Paulo, Brazil. We used the Stress Evaluation in Nursing Students scale and the Social Support Questionnaire. We performed the chi-squared test and analyzed the structure of the support network using software Gephi version 0.9.1. RESULTS: 192 students participated. Family and friends were the most mentioned supporters. Despite counting on a low number of supporters, most participants were satisfied with the perceived support. The students presented high intensity of stress in the "professional training" domain. Furthermore, the students who were pleased with the perceived social support presented low intensity of stress in accomplishing the theoretical activities of the undergraduate course. CONCLUSION: The creation of more welcoming spaces in the academic environment, the qualification of the social support, and the employment of strategies to improve the transition from the student stage to the professional stage are important recommendations that will contribute for positive outcomes regarding the coping with student stress.

Emergency Nursing Experiences in Assisting People With Suicidal Behavior: A Grounded Theory Study.

AIM: To understand emergency nursing experiences in assisting people with suicidal behavior. METHOD: Grounded theory study with symbolic interactionism conducted in 2015 to 2016 in Brazil with 19 nurses. RESULTS: Assistance for people with suicidal behavior is critical, challenging, evokes different feelings and requires knowledge, skills and emotional control. Nurses did not feel prepared or supported, and identified recurrent gaps and problems. Nurses occupied a limited role, restricted to attending to physical needs. They predominantly manifested opposition, judgments and incomprehension about patients. CONCLUSION: This study presents key elements to be addressed in interventions and investigations regarding nursing support, training and supervision.

Papillomaviruses: a systematic review.

In the last decades, a group of viruses has received great attention due to its relationship with cancer development and its wide distribution throughout the vertebrates: the papillomaviruses. In this article, we aim to review some of the most relevant reports concerning the use of bovines as an experimental model for studies related to papillomaviruses. Moreover, the obtained data contributes to the development of strategies against the clinical consequences of bovine papillomaviruses (BPV) that have led to drastic hazards to the herds. To overcome the problem, the vaccines that we have been developing involve recombinant DNA technology, aiming at prophylactic and therapeutic procedures. It is important to point out that these strategies can be used as models for innovative procedures against HPV, as this virus is the main causal agent of cervical cancer, the second most fatal cancer in women.

The Role of Social Support for Patients with Mental Disorders in Primary Care in Brazil.

The aim of this article was to identify the health care providers and other agencies in a given region where psychiatric patients included in the study reside. In addition, we evaluated how these patients perceive social support for specific needs related to mental health. This study was carried out using fieldwork and face-to-face semistructured interviews with 25 patients who were receiving psychiatric treatment through primary health care. We performed structural analysis of the data focusing on relationship structure. We identified that a significant number of health care providers were involved with the patients; however, some of them were ignored by patients interviewed. Participants cited mostly general practitioners, psychiatrists, and nurses, as professional references.

Structure of the Social Support Network of Patients with Severe and Persistent Psychiatric Disorders in Follow-Ups to Primary Health Care.

The objective of this study is to analyze the characteristics of social support networks of patients with psychiatric disorders at follow-up to primary care. This is a cross-sectional qualitative research study. Forty-five interviews were held with patients and their supporters. The results showed small and dense networks, with a strong emphasis on the bonds with formal supporters and a scant network of informal supporters. It is recommended to develop strategies to improve social support networks and use this as an outcome indicator related to social integration of these patients and to the quality of services involved with outpatient healthcare.

Meaning of Pharmacological Treatment for Families of People With Depression.

Medication adherence is related to patient satisfaction with family support. This research aimed to understand the meaning of pharmacotherapy to families of people with major depressive disorder. This qualitative study employed Grounded Theory and Symbolic Interactionism. Seventeen families of people with depression from a Brazilian clinic were included. Data was collected from 2013 to 2014, using open interviews, which were analyzed by open, axial, and selective coding. Medication represented "Tranquility and worry" because it re-established tranquility in family routine, but generated concerns. Thus, families were conflicted and ambivalent about medications, and they interfered with the promotion or impairment of adherence.