Analysis of the impacts of pharmaceutical intervention in the treatment of leprosy patients in a public university hospital

Terapias e procedimentos eficazes para melhorar a adesão a tratamentos é uma preocupação para o Sistema Único de Saúde e para os profissionais da área. No entanto, a baixa adesão pode causar sérias implicações para as doenças, como o controle da hanseníase, podendo surgir resistência aos medicamentos e implicar falha terapêutica. Além disso, vários fatores podem estar associados a esse comportamento e devem ser avaliados para uma melhor compreensão e um melhor direcionamento do cuidado farmacêutico. Diante dessa questão, o objetivo deste trabalho é testar a hipótese de que os instrumentos educacionais desenvolvidos pela pesquisadora, assim como o cuidado farmacêutico, aumentam a adesão ao tratamento de pacientes diagnosticados com hanseníase de um hospital público universitário. Para desenvolver a pesquisa, elaborou-se um estudo longitudinal com o uso de testes quanti e qualitativos com a finalidade de avaliar (i) a adesão ao tratamento, (ii) os conhecimentos e (iii) os impactos físicos e sociais ocasionados pela doença. Os pacientes realizaram o tratamento da hanseníase no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, no período de outubro de 2020 a junho de 2021. Foram elaborados, então, materiais educativos utilizados junto aos pacientes e, depois disso, avaliou-se o impacto do acompanhamento farmacêutico e dos materiais instrutivos na adesão ao tratamento e na participação social. Foi possível obter que a adesão ao tratamento aumentou significativamente após a intervenção de cuidado farmacêutico e de educação em saúde, conforme o Teste de Morisky-Green (78,4%>35,1%). Pacientes classificados em \"sem limitação\" ou \"leve limitação\" pela escala SALSA tiveram 27 vezes mais chance de serem aderentes ao tratamento, de acordo com o teste de Haynes-Sackett (THS). Pacientes que obtiveram classificação de \"sem restrição\" ou \"leve restrição\" na Escala de Participação tiveram 9,2 vezes mais chance de serem aderentes ao tratamento, de acordo com o THS. Além disso, a metodologia foi mais eficaz em pacientes do sexo masculino com baixa escolaridade do que em mulheres, que já apresentavam alta adesão. Portanto, conclui-se que o cuidado farmacêutico tem eficácia no uso correto de medicamentos durante o tratamento e que a educação em saúde pode contribuir para uma melhora na realidade social desse indivíduo.Effective therapies and procedures to improve adherence to treatments is a concern for the Unified Health System and professionals in the area. However, poor adherence can have serious implications for diseases, such as leprosy control, and drug resistance may arise and lead to therapeutic failure. In addition, several factors may be associated with this behavior and should be evaluated for a better understanding and better targeting of pharmaceutical care. Faced with this issue, the objective of this study is to test the hypothesis that the educational instruments developed by the researcher, as well as pharmaceutical care, increase adherence to treatment of patients diagnosed with leprosy at a public university hospital. To develop the research, a longitudinal study was carried out using quantitative and qualitative tests in order to assess (i) adherence to treatment, (ii) knowledge and (iii) the physical and social impacts caused by the disease. Patients underwent leprosy treatment at the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, from October 2020 to June 2021. Educational materials were then prepared for use with the patients and, after that, the impact of pharmaceutical monitoring and instructional materials on treatment adherence and social participation. It was possible to obtain that adherence to treatment increased significantly after the intervention of pharmaceutical care and health education, according to the Morisky-Green Test (78.4%>35.1%). Patients classified as \"no limitation\" or \"mild limitation\" by the SALSA scale were 27 times more likely to be compliant with treatment, according to the Haynes-Sackett test (THS). Patients who scored \"no restriction\" or \"light restriction\" on the Participation Scale were 9.2 times more likely to be compliant with treatment, according to the THS. In addition, the methodology was more effective in male patients with low education than in women, who already had high adherence. Therefore, it is concluded that pharmaceutical care is effective in the correct use of medicines during treatment and that health education can contribute to an improvement in the social reality of this individual

Antimicrobial potential of Casearia sylvestris against oral bacteria

Abstract Aim The aim of this study was to obtain Casearia sylvestris leave extracts by different extractive methods, including the obtention of essential oil, in order to compare their antimicrobial activities to conventional mouthwash chlorhexidine against oral bacteria. Material and method For this evaluation, extracts from the leaves were obtained by different methods of extraction (infusion, decoction, maceration and percolation) using different solvent systems: water 100%, ethanol 100%, methanol 100%, water: ethanol 3:7; water: ethanol 7:3; water: methanol 7:3 and water: methanol 3:7. The essential oil, which corresponds to a volatile fraction, was obtained by hydrodistillation using Clevenger modified apparatus. The microdilution broth method was used to determine the values of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for the following microorganisms: Streptococcus mutans ATCC 25175, S. mitis ATCC 49456, S. sanguinis ATCC 10556, S. salivarius ATCC 25975, Lactobacillus casei ATCC 11578 and Enterococcus faecalis ATCC4082. Chlorhexidine gluconate was used as a positive control. Result All extracts evaluated in the used protocol displayed MIC values higher than 400 µg/mL and few showed bactericidal activity. The antimicrobial activity of essential oil was higher than the activity of the extracts, and the best minimum inhibitory concentration and minimum bactericidal concentration values were obtained against L. casei (MIC of 0.023 µg/mL and MBC of 0.046 µg/mL) and S. mutans (MIC of 25 µg/mL and MBC of 50 µg/mL), respectively. Conclusion The essential oil of Casearia sylvestris has significant antimicrobial activity against oral microorganisms

Evaluation of Mucoadhesive Gels with Propolis (EPP-AF) in Preclinical Treatment of Candidiasis Vulvovaginal Infection

Vulvovaginal candidiasis is the second cause of vaginal infection in the USA. Clinical treatment of C. albicans infections is routinely performed with polyenes and azole derivatives. However, these drugs are responsible for undesirable side effects and toxicity. In addition, C. albicans azole and echinocandin resistance has been described. Propolis is a bee product traditionally used due to its antimicrobial, anti-inflammatory, and other properties. Therefore, the present work aimed to evaluate different propolis presentations in order to evaluate their in vitro and in vivo efficacy. The methodologies involved antifungal evaluation, chemical analysis, and the effects of the rheological and mucoadhesive properties of propolis based gels. The obtained results demonstrated the fungicide action of propolis extracts against all three morphotypes (yeast, pseudohyphae, and hyphae) studied. The highest level of fungal cytotoxicity was reached at 6–8 hours of propolis cell incubation. Among the based gel formulations developed, the rheological and mucoadhesive results suggest that propolis based carbopol (CP1%) and chitosan gels were the most pseudoplastic ones. CP1% was the most mucoadhesive preparation, and all of them presented low thixotropy. Results of in vivo efficacy demonstrated that propolis based gels present antifungal action similar to clotrimazole cream, suggesting that future clinical studies should be performed

Validation of a RP-HPLC-DAD Method for Chamomile (Matricaria recutita) Preparations and Assessment of the Marker, Apigenin-7-glucoside, Safety and Anti-Inflammatory Effect

Chamomile is a medicinal plant, which presents several biological effects, especially the anti-inflammatory effect. One of the compounds related to this effect is apigenin, a flavonoid that is mostly found in its glycosylated form, apigenin-7-glucoside (APG), in natural sources. However, the affectivity and safety of this glycoside have not been well explored for topical application. In this context, the aim of this work was to develop and validate a reversed-phase high-performance liquid chromatography (RP-HPLC-DAD) method to quantify APG in chamomile preparations. Additionally, the safety and the anti-inflammatory potential of this flavonoid were verified. The RP-HPLC-DAD method was developed and validated with linearity at 24.0–36.0 μg/mL range (r=0.9994). Intra- and interday precision (RSD) were 0.27–2.66% and accuracy was 98.27–101.21%. The validated method was applied in the analysis of chamomile flower heads, glycolic extract, and Kamillen cream, supporting the method application in the quality control of chamomile preparations. Furthermore, the APG safety was assessed by MTT cytotoxicity assay and mutagenic protocols and the anti-inflammatory activity was confirmed by a diminished TNF-α production showed by mice macrophages treated with APG following LPS treatment

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora