Inappropriate drug use and polypharmacy among older Adults of family health program

O objetivo do estudo foi descrever o perfil de utilização de medicamentos e estimar a prevalência e fatores associados à polifarmácia e ao uso de medicamentos inadequados entre idosos do Programa Saúde da Família de um Centro de Saúde de Belo Horizonte. Foram realizadas, em 2003, entrevistas domiciliares com 242 idosos. As variáveis dependentes foram a polifarmácia e o uso de medicamentos inadequados. Análises descritiva, univariada e multivariada dos dados foram conduzidas. Verificou-se elevada prevalência de polifarmácia (27,7%), automedicação (22,3%) e uso de medicamentos inadequados (33,5%). Os fatores associados à polifarmácia foram: cinco ou mais problemas de saúde, uso de medicamentos inadequados e gasto com medicamentos no último mês, enquanto os associados ao uso de medicamentos inadequados foram idade igual ou superior a 70 anos, baixa escolaridade e o uso de cinco ou mais medicamentos. A implementação de medidas voltadas para a otimização do tratamento farmacoterapêutico é fundamental.This study aimed to describe the drug use profile and to estimate the prevalence and factors associated with polypharmacy and inappropriate drug use among older people catered for by the Family Health Program of a Health Care Center in Belo Horizonte. In 2003, 242 home-based interviews were conducted with elderly. Dependent variables were polypharmacy and inappropriate drug use. Descritive, univariate and multivariate data analysis were conducted. The prevalence of polypharmacy (27,7%), self-medication (22,3%), inappropriate drug use (33,5%), and drug use in manners other than prescribed (21,9%) was verified. Factors associated with polypharmacy were: reports of five or more health problems, inappropriate drug use and expenses with drugs in previous month. Factors associated with inappropriate drug use were: age equal or higher than 70 years, unfinished primary school and use of five or more drugs. The implementation of measurements to optmize pharmacotherapeutic treatment of elderly people is fundamental.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Inappropriate drug use and polypharmacy among older Adults of family health program

O objetivo do estudo foi descrever o perfil de utilização de medicamentos e estimar a prevalência e fatores associados à polifarmácia e ao uso de medicamentos inadequados entre idosos do Programa Saúde da Família de um Centro de Saúde de Belo Horizonte. Foram realizadas, em 2003, entrevistas domiciliares com 242 idosos. As variáveis dependentes foram a polifarmácia e o uso de medicamentos inadequados. Análises descritiva, univariada e multivariada dos dados foram conduzidas. Verificou-se elevada prevalência de polifarmácia (27,7%), automedicação (22,3%) e uso de medicamentos inadequados (33,5%). Os fatores associados à polifarmácia foram: cinco ou mais problemas de saúde, uso de medicamentos inadequados e gasto com medicamentos no último mês, enquanto os associados ao uso de medicamentos inadequados foram idade igual ou superior a 70 anos, baixa escolaridade e o uso de cinco ou mais medicamentos. A implementação de medidas voltadas para a otimização do tratamento farmacoterapêutico é fundamental.This study aimed to describe the drug use profile and to estimate the prevalence and factors associated with polypharmacy and inappropriate drug use among older people catered for by the Family Health Program of a Health Care Center in Belo Horizonte. In 2003, 242 home-based interviews were conducted with elderly. Dependent variables were polypharmacy and inappropriate drug use. Descritive, univariate and multivariate data analysis were conducted. The prevalence of polypharmacy (27,7%), self-medication (22,3%), inappropriate drug use (33,5%), and drug use in manners other than prescribed (21,9%) was verified. Factors associated with polypharmacy were: reports of five or more health problems, inappropriate drug use and expenses with drugs in previous month. Factors associated with inappropriate drug use were: age equal or higher than 70 years, unfinished primary school and use of five or more drugs. The implementation of measurements to optmize pharmacotherapeutic treatment of elderly people is fundamental.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Inappropriate drug use and polypharmacy among older Adults of family health program

O objetivo do estudo foi descrever o perfil de utilização de medicamentos e estimar a prevalência e fatores associados à polifarmácia e ao uso de medicamentos inadequados entre idosos do Programa Saúde da Família de um Centro de Saúde de Belo Horizonte. Foram realizadas, em 2003, entrevistas domiciliares com 242 idosos. As variáveis dependentes foram a polifarmácia e o uso de medicamentos inadequados. Análises descritiva, univariada e multivariada dos dados foram conduzidas. Verificou-se elevada prevalência de polifarmácia (27,7%), automedicação (22,3%) e uso de medicamentos inadequados (33,5%). Os fatores associados à polifarmácia foram: cinco ou mais problemas de saúde, uso de medicamentos inadequados e gasto com medicamentos no último mês, enquanto os associados ao uso de medicamentos inadequados foram idade igual ou superior a 70 anos, baixa escolaridade e o uso de cinco ou mais medicamentos. A implementação de medidas voltadas para a otimização do tratamento farmacoterapêutico é fundamental.This study aimed to describe the drug use profile and to estimate the prevalence and factors associated with polypharmacy and inappropriate drug use among older people catered for by the Family Health Program of a Health Care Center in Belo Horizonte. In 2003, 242 home-based interviews were conducted with elderly. Dependent variables were polypharmacy and inappropriate drug use. Descritive, univariate and multivariate data analysis were conducted. The prevalence of polypharmacy (27,7%), self-medication (22,3%), inappropriate drug use (33,5%), and drug use in manners other than prescribed (21,9%) was verified. Factors associated with polypharmacy were: reports of five or more health problems, inappropriate drug use and expenses with drugs in previous month. Factors associated with inappropriate drug use were: age equal or higher than 70 years, unfinished primary school and use of five or more drugs. The implementation of measurements to optmize pharmacotherapeutic treatment of elderly people is fundamental.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Comparison of Analytical Methods Of Serum Untargeted Metabolomics

Funding Information: IV. ACKNOWLEDGEMENTS This research was funded by Fundação para a Ciência e a Tecnologia (FCT), grant DSAIPA/DS/0117/2020 and RNEM-LISBOA-01-0145-FEDER-022125 (Portuguese Mass Spectrometry Network). Centro de Química Estrutural is a Research Unit funded by FCT through projects UIDB/00100/2020 and UIDP/00100/2020. Institute of Molecular Sciences is an Associate Laboratory funded by FCT through project LA/P/0056/2020. Publisher Copyright: © 2023 IEEE.Metabolomics has emerged as a powerful tool in the discovery of new biomarkers for medical diagnosis and prognosis. However, there are numerous challenges, such as the methods used to characterize the system metabolome. In the present work, the comparison of two analytical platforms to acquire the serum metabolome of critically ill patients was conducted. The untargeted serum metabolome analysis by ultraperformance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) enabled to identify a set of metabolites statistically different between deceased and discharged patients. This set of metabolites also enabled to develop a very good predictive model, based on linear discriminant analysis (LDA) with a sensitivity and specificity of 80% and 100%, respectively. Fourier Transform Infrared (FTIR) spectroscopy was also applied in a high-throughput, simple and rapid mode to analyze the serum metabolome. Despite this technique not enabling the identification of metabolites, it allowed to identify molecular fingerprints associated to each patient group, while leading to a good predictive model, based on principal component analysis-LDA, with a sensitivity and specificity of 100% and 90%, respectively. Therefore, both analytical techniques presented complementary characteristics, that should be further explored for metabolome characterization and application as for biomarkers discovery for medical diagnosis and prognosis.publishersversionpublishe

The Impact of the Serum Extraction Protocol on Metabolomic Profiling Using UPLC-MS/MS and FTIR Spectroscopy

Funding Information: This research was funded by Fundação para a Ciência e a Tecnologia (FCT), Grants DSAIPA/DS/0117/2020 and RNEM-LISBOA-01-0145-FEDER-022125 (Portuguese Mass Spectrometry Network). The Centro de Química Estrutural is a Research Unit funded by FCT through projects UIDB/00100/2020 and UIDP/00100/2020. The Institute of Molecular Sciences is an Associate Laboratory funded by FCT through project LA/P/0056/2020. Publisher Copyright: © 2023 The Authors. Published by American Chemical Society.Biofluid metabolomics is a very appealing tool to increase the knowledge associated with pathophysiological mechanisms leading to better and new therapies and biomarkers for disease diagnosis and prognosis. However, due to the complex process of metabolome analysis, including the metabolome isolation method and the platform used to analyze it, there are diverse factors that affect metabolomics output. In the present work, the impact of two protocols to extract the serum metabolome, one using methanol and another using a mixture of methanol, acetonitrile, and water, was evaluated. The metabolome was analyzed by ultraperformance liquid chromatography associated with tandem mass spectrometry (UPLC-MS/MS), based on reverse-phase and hydrophobic chromatographic separations, and Fourier transform infrared (FTIR) spectroscopy. The two extraction protocols of the metabolome were compared over the analytical platforms (UPLC-MS/MS and FTIR spectroscopy) concerning the number of features, the type of features, common features, and the reproducibility of extraction replicas and analytical replicas. The ability of the extraction protocols to predict the survivability of critically ill patients hospitalized at an intensive care unit was also evaluated. The FTIR spectroscopy platform was compared to the UPLC-MS/MS platform and, despite not identifying metabolites and consequently not contributing as much as UPLC-MS/MS in terms of information concerning metabolic information, it enabled the comparison of the two extraction protocols as well as the development of very good predictive models of patient’s survivability, such as the UPLC-MS/MS platform. Furthermore, FTIR spectroscopy is based on much simpler procedures and is rapid, economic, and applicable in the high-throughput mode, i.e., enabling the simultaneous analysis of hundreds of samples in the microliter range in a couple of hours. Therefore, FTIR spectroscopy represents a very interesting complementary technique not only to optimize processes as the metabolome isolation but also for obtaining biomarkers such as those for disease prognosis.publishersversionpublishe

Multiple-clone infections of Plasmodium vivax: definition of a panel of markers for molecular epidemiology

Submitted by Nuzia Santos ([email protected]) on 2016-02-29T17:46:50Z No. of bitstreams: 1 Multiple-clone infections of Plasmodium.pdf: 5467763 bytes, checksum: b4719a5dd04db8f670d04a87ecc9303f (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2016-02-29T17:50:22Z (GMT) No. of bitstreams: 1 Multiple-clone infections of Plasmodium.pdf: 5467763 bytes, checksum: b4719a5dd04db8f670d04a87ecc9303f (MD5)Made available in DSpace on 2016-02-29T17:50:22Z (GMT). No. of bitstreams: 1 Multiple-clone infections of Plasmodium.pdf: 5467763 bytes, checksum: b4719a5dd04db8f670d04a87ecc9303f (MD5) Previous issue date: 2015Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, BrasilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, BrasilUniversidade Federal de Mato Grosso. Hospital Julio Muller. Cuiabá, MT, BrasilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, BrasilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, BrasilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, BrasilBACKGROUND: Plasmodium vivax infections commonly contain multiple genetically distinct parasite clones. The detection of multiple-clone infections depends on several factors, such as the accuracy of the genotyping method, and the type and number of the molecular markers analysed. Characterizing the multiplicity of infection has broad implications that range from population genetic studies of the parasite to malaria treatment and control. This study compared and evaluated the efficiency of neutral and non-neutral markers that are widely used in studies of molecular epidemiology to detect the multiplicity of P. vivax infection. METHODS: The performance of six markers was evaluated using 11 mixtures of DNA with well-defined proportions of two different parasite genotypes for each marker. These mixtures were generated by mixing cloned PCR products or patient-derived genomic DNA. In addition, 51 samples of natural infections from the Brazil were genotyped for all markers. The PCR-capillary electrophoresis-based method was used to permit direct comparisons among the markers. The criteria for differentiating minor peaks from artifacts were also evaluated. RESULTS: The analysis of DNA mixtures showed that the tandem repeat MN21 and the polymorphic blocks 2 (msp1B2) and 10 (msp1B10) of merozoite surface protein-1 allowed for the estimation of the expected ratio of both alleles in the majority of preparations. Nevertheless, msp1B2 was not able to detect the majority of multiple-clone infections in field samples; it identified only 6 % of these infections. The merozoite surface protein-3 alpha and microsatellites (PvMS6 and PvMS7) did not accurately estimate the relative clonal proportions in artificial mixtures, but the microsatellites performed well in detecting natural multiple-clone infections. Notably, the use of a less stringent criterion to score rare alleles significantly increased the sensitivity of the detection of multi-clonal infections. CONCLUSIONS: Depending on the type of marker used, a considerable amplification bias was observed, which may have serious implications for the characterization of the complexity of a P. vivax infection. Based on the performance of markers in artificial mixtures of DNA and natural infections, a minimum panel of four genetic markers (PvMS6, PvMS7, MN21, and msp1B10) was defined, and these markers are highly informative regarding the genetic variability of P. vivax populations

Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumonia

ObjectiveCommunity-acquired pneumonia is an important cause of morbidity in childhood, but the detection of its causative agent remains a diagnostic challenge. The authors aimed to evaluate the role of the chest radiograph to identify cases of community-aquired pneumonia caused by typical bacteria.MethodsThe frequency of infection by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis was compared in non-hospitalized children with clinical diagnosis of community acquired pneumonia aged 2–59 months with or without radiological confirmation (n = 249 and 366, respectively). Infection by S. pneumoniae was diagnosed by the detection of a serological response against at least one of eight pneumococcal proteins (defined as an increase ≥2-fold in the IgG levels against Ply, CbpA, PspA1 and PspA2, PhtD, StkP-C, and PcsB-N, or an increase ≥1.5-fold against PcpA). Infection by H. influenzae and M. catarrhalis was defined as an increase ≥2-fold on the levels of microbe-specific IgG.ResultsChildren with radiologically confirmed pneumonia had higher rates of infection by S. pneumoniae. The presence of pneumococcal infection increased the odds of having radiologically confirmed pneumonia by 2.8 times (95% CI: 1.8–4.3). The negative predictive value of the normal chest radiograph for infection by S. pneumoniae was 86.3% (95% CI: 82.4–89.7%). There was no difference on the rates of infection by H. influenzae and M. catarrhalis between children with community-acquired pneumonia with and without radiological confirmation.ConclusionsAmong children with clinical diagnosis of community-acquired pneumonia submitted to chest radiograph, those with radiologically confirmed pneumonia present a higher rate of infection by S. pneumoniae when compared with those with a normal chest radiograph.</p