Pro-adherence complementary audiovisual educational intervention model for chronic myeloid leukemia patients treated with imatinib mesylate.

BACKGROUND: Imatinib mesylate (IM) treatment adherence is a challenge, especially in an economic-social population neglected from developing countries. OBJECTIVE: To create a new complementary audiovisual educational intervention model to improve IM treatment adherence of CML patients. METHODS: Two adherence verification methods were applied before and after intervention: modified Morisky-Green test and molecular responses (BCR-ABL transcripts quantification). Adherence estimates were calculated using univariate and multivariate component analysis (MCA) for the socio-demographic and clinical characteristics of patients. RESULTS: Modified Morisky-Green test results demonstrated a substantial increase of CML patient adherence from 23% (pre-film) to 65% (post-film). Greater improvement was obtained for patients presenting major molecular response (MMR) from 38% (pre-film) to 60% (post-film). Although slight gain for complete molecular response (CMR) from 23% (pre-film) to 26% (post-film) was achieved, it represents a total tumour regression. MCA identified that females <50 years-old, using less than two medications (no disease associated) and CMR condition were the most benefited with intervention. CONCLUSION: Audiovisual educational intervention was an effective complementary pro-adherence model, activating patient memory and improving IM treatment adherence. Although this intervention shows effective, not all patients responded as expected, being necessary a combination of educational and clinical interventions to improve IM adherence.

Determinação simplificada de carbamazepina, fenitoína, fenobarbital e lamotrigina em plasma emonitoração terapêutica por HPLC/PDA / Simplified determination of carbamazepine, phenytoin,phenobarbital and lamotrigine in plasma and therapeuticmonitoring by HPLC/PDA

Carbamazepina, fenitoína, fenobarbital e lamotrigina são bem conhecidos como fármacos anticonvulsivantes usados para o tratamento da epilepsia. A utilização destes fármacos é associada a várias reações adversas, tornando necessário o controle terapêutico. Os ensaios foram realizados por meio de cromatografia líquida de alta eficiência e o método de extração utilizado foi o líquido-líquido. Os fármacos e o padrão interno de zolpidem foram separados por uma coluna de fase reversa (ACE5, C18150x 4,6 mm d.i.). A fase móvel constituída de acetonitrila (30%) e ácido cítrico/tampão fosfato pH 5,0 (70%) foi utilizada sob gradiente de fluxo de 0,7 a 1,2 mL/min e o comprimento de onda utilizado para a detecção dos analitos foi fixado em 210 nm. A técnica apresentou linearidade ao longo do intervalo de 0,5 a 20,0μg/mL para carbamazepina/lamotrigina e de 2,0 a 64,0 μg/mL, para fenitoina/fenobarbital com coeficiente de correlação linear maior que 0,98. As amostras de sangue foram obtidas de pacientes adultos com diagnóstico de epilepsia em acompanhamento no Ambulatório Municipal de Psiquiatria de Goiânia. A média de recuperação obtida foi de 96,8% a 108,5% para carbamazepina/lamotrigina e de 93,8% a 108,8% para a fenitoina/fenobarbital. Os limites de quantificação, precisão (CV< 15,0 %)e exatidão (E > 85,0 %) demonstraram estar em conformidade com as exigências da ANVISA. Nove pacientes foram avaliados para confirmar a validade do método.

Carbamazepine, phenytoin, phenobarbital and lamotrigine are well known anticonvulsant drugs used in the treatment of epilepsy. However, these medications are associated with side effects and therefore require therapeutic monitoring. Blood samples of adult outpatients diagnosed with epilepsy at the Goiânia Municipal Psychiatry Clinic (Brazil) were collected and analyzed using high-performance liquid chromatography. The analytes and internal standard (zolpidem) were extracted by liquid-liquid extraction. A reversed phase column (ACE 5, C18, 150 x 4.6 mm i.d.) was used. The mobile phase was composed of acetonitrile (30%) and citric acid/phosphate buffer, pH 5.0 (70%). The gradient flow rate was from 0.7 to 1.2 mL/min and the detection wavelength was set at 210 nm for all analytes. The analysis revealed a linear range from 0.5 to 20.0μg/mL for carbamazepine/lamotrigine and 2.0 to 64.0 μg/mL for phenytoin/phenobarbital. Mean recovery ranged from 96.8% to 108.5% for carbamazepine/lamotrigine and 93.8% to 108.8% for phenytoin/phenobarbital. The quantification limit, precision (CV < 15%) and accuracy (A >85%) proved to be in accordance with the requirements stipulated by the Brazilian National Health Surveillance Agency (ANVISA). Nine outpatients were evaluated to confirm the validity of the method.

Descontaminação de escovas dentais: desenvolvimento e padronização de método para uso doméstico / Disinfection of toothbrushes: development and standardizaztion of method for domestic use

O objetivo deste estudo foi analisar a presença de microorganismos em 50 escovas dentais em uso superior a 30 dias, imersas em solução diluída de água sanitária em tempos predeterminados, a fim de detectar qual o tempo de imersão seria eficaz na eliminação dos microorganismos presentes nas escovas dentais. Os resultados demonstraram que a imersão da região das cerdas das escovas dentais na solução diluída de água sanitária por um tempo mínimo de 8 horas é um método válido na descontaminação das cerdas impregnadas por inúmeros microorganismos, podendo ser considerado como um método sanitizante de uso doméstico