Cardiovascular risk rate in hypertensive patients attended in primary health care units: the influence of pharmaceutical care

Cardiovascular complications are relevant due to their frequency and severity on the hypertension scenario. Studies refer Pharmaceutical Care (PC) as capable of decreasing cardiovascular risk rate (%CVR) on hypertensive patients. This study aimed to investigate, through a randomized clinical assay, the influence of PC service on the %CVR of hypertensive patients assisted in a health primary care unit from Fortaleza-Ceará. Two study groups were formed: i. Intervention Group (IG), which received orientation about taking medicines, actions aiming to prevent/solve medicine interactions and adverse effects and non-pharmacological interventions for 9 months and, ii. Control Group (CG), which received traditional assistance of the unit and was monitored during the same period. It was observed a statistically significant reduction on %CVR (10.76 to 7.86; p=0.04) and systolic blood pressure levels (SBP) (137.69 to 131.54; p<0.01) in the IG, while, in the CG, there was no significant alteration. 151 Drug Related Problem (DRP) were identified and it was realized 124 pharmaceutical interventions, with 89.2% of them resulting on solution/prevention of the problem. Our findings indicated that the inclusion of the PC service in the hypertensive health assistance was more effective at the %CVR and the SBP reduction in comparison to the traditional assistance offered

Seguimiento farmacoterapéutico en pacientes hospitalizados en tratamiento con fentanilo transdérmico

Pain is the most frequent reason of consultation in pi mary care centres. Approximately, half of the populatio suffers from pain crisis at some time in the year, and or third of those suffers from chronic pain. The aims of th study are to describe the incidence and types of drug th rapy problems (DTP), understood as negative clinical ou comes from antinociceptive therapy with transdermal fetanyl in hospitalized patients, the pharmacist interventions, their acceptance by the clinicians and their resolution. As well as to compare the incidence of DTP, of pharmacist interventions, their acceptance and resolution according to the following variables: clinical service and oncologic diagnostic or not. Material and method: Evaluation and detection of DTP in patients who initiate treatment with transdermal fentanyl (TF) in a third level hospital. The follow-up to the patients was during 7 days or longer up to resolution of the DTP. For the assessment of the pain perception the Visual Analogic Scale (VAS) was used. Results: 30 patients (129 patients/day) were studied. A total of 51 DTP were detected. The DTP incidence in patients with non-oncologic pain has been major (p<0.05). The DTP types from major to minor incidence were DTP 1: 53% (the patient suffers from a health problem as a consequence of not receiving the medication that he needs), DTP 3: 15.6% (the patient suffers from a health problem as a consequence of a non-quantitative ineffectiveness of the medication), DTP 4: 15.6% (the patient suffers from a health problem as a consequence of a quantitative ineffectiveness of the medication), DTP 6: 7.8% (the patient suffers from a health problem as a consequence of a quantitative safety problem of a medicine), DTP 2: 5.8% (the patient suffers from a health problem as a consequence of receiving a medicine that he does not need) and DTP 5: 2% (the patient suffers from a health problem as a consequence of a non-quantitative safety problem of a medicine). The most common reason was that the rescue analgesic therapy was not prescribed. 45 interventions were realized. The global acceptance of the recommendations was of 84.45%. From 35 accepted interventions, 34 (97.14%) achieved to solve the PRM. Conclusions: They are prevalent DTP in analgesic therapy and to avoid them a pharmacotherapy follow-up is necessary. There would be necessary the achievement of studies including a higher number of patients and with a longer follow-up period; then there might detect other DTP that were not possible in this case.Objetivo: El dolor es una de las causas de consulta más frecuente en los centros de atención primaria. Aproximadamente la mitad de la población sufre crisis de dolor alguna vez al año, y un tercio de la misma sufre dolor crónico. Los objetivos del estudio son describir la incidencia y tipos de problemas relacionados con los medicamentos (PRM) de la terapia antiálgica con fentanilo transdérmico en pacientes hospitalizados, las intervenciones farmacéuticas realizadas, su aceptación por parte de los clínicos y su resolución. También comparar la incidencia de PRM, de intervenciones farmacéuticas, su aceptación y resolución según las variables: servicio clínico y diagnóstico, oncológico o no. Material y método: Evaluación y detección de PRM en pacientes que inician tratamiento con fentanilo transdérmico (FT) en un hospital de tercer nivel. El seguimiento de los pacientes fue de 7 días o superior hasta resolución de los PRM. Para la valoración del dolor se utilizó la Escala Visual Analógica (EVA). Resultados: Se estudiaron 30 pacientes, 129 pacientes-día. Se detectaron un total de 51 PRM. La incidencia de PRM ha sido mayor en pacientes con dolor de origen no oncológico (p<0,05). Los tipos de PRM de mayor a menor incidencia fueron PRM 1: 53% (no usa los medicamentos que necesita), PRM 3: 15,6% (usa un medicamento mal seleccionado), PRM 4: 15,6% (usa una dosis, pauta y/o duración inferior a la que necesita), PRM 6: 7,8% (usa un medicamento que le provoca una reacción adversa), PRM 2: 5,8% (el paciente usa medicamentos que no necesita) y PRM 5: 2% (el paciente usa una dosis, pauta y/o duración superior a la que necesita). La causa más común fue que no estaba prescrita la terapia analgésica de rescate. Se realizaron 45 intervenciones para resolver los PRM. La aceptación global de las recomendaciones fue del 84,45%. De un total de 35 intervenciones aceptadas, 34 (97,14%) consiguieron resolver el PRM. Conclusiones: La prevalencia de PRM es alta en la terapia analgésica y para conseguir evitarlos es necesario un seguimiento farmacoterapéutico del mismo. Para poder detectar otros PRM sería necesario realizar otros estudios con un seguimiento y población mayor

Cauliflower mosaic virus protein P6‐TAV plays a major role in alteration of aphid vector feeding behaviour but not performance on infected Arabidopsis

International audienceEmerging evidence suggests that viral infection modifies host plant traits that in turn alter behaviour and performance of vectors colonizing the plants in a way conducive for transmission of both nonpersistent and persistent viruses. Similar evidence for semipersistent viruses like cauliflower mosaic virus (CaMV) is scarce. Here we compared the effects of Arabidopsis infection with mild (CM) and severe (JI) CaMV isolates on the feeding behaviour (recorded by the electrical penetration graph technique) and fecundity of the aphid vector Myzus persicae. Compared to mock-inoculated plants, feeding behaviour was altered similarly on CM- and JI-infected plants, but only aphids on JI-infected plants had reduced fecundity. To evaluate the role of the multifunctional CaMV protein P6-TAV, aphid feeding behaviour and fecundity were tested on transgenic Arabidopsis plants expressing wild-type (wt) and mutant versions of P6-TAV. In contrast to viral infection, aphid fecundity was unchanged on all transgenic lines, suggesting that other viral factors compromise fecundity. Aphid feeding behaviour was modified on wt P6-CM-, but not on wt P6-JI-expressing plants. Analysis of plants expressing P6 mutants identified N-terminal P6 domains contributing to modification of feeding behaviour. Taken together, we show that CaMV infection can modify both aphid fecundity and feeding behaviour and that P6 is only involved in the latter

Virus infection mediates the effects of elevated CO2 on plants and vectors

Atmospheric carbon dioxide (CO(2)) concentration has increased significantly and is projected to double by 2100. To increase current food production levels, understanding how pests and diseases respond to future climate driven by increasing CO(2) is imperative. We investigated the effects of elevated CO(2) (eCO(2)) on the interactions among wheat (cv. Yitpi), Barley yellow dwarf virus and an important pest and virus vector, the bird cherry-oat aphid (Rhopalosiphum padi), by examining aphid life history, feeding behavior and plant physiology and biochemistry. Our results showed for the first time that virus infection can mediate effects of eCO(2) on plants and pathogen vectors. Changes in plant N concentration influenced aphid life history and behavior, and N concentration was affected by virus infection under eCO(2). We observed a reduction in aphid population size and increased feeding damage on noninfected plants under eCO(2) but no changes to population and feeding on virus-infected plants irrespective of CO(2) treatment. We expect potentially lower future aphid populations on noninfected plants but no change or increased aphid populations on virus-infected plants therefore subsequent virus spread. Our findings underscore the complexity of interactions between plants, insects and viruses under future climate with implications for plant disease epidemiology and crop production

Tomatoes

IPM has been developed and successfully applied in greenhouse tomatoes in several regions of the world since the 1970s. As an alternative to the exclusive application of pesticides, the cornerstone of this strategy is to use Natural Enemies (NE) to control some of the crop’s key pests (whiteflies, tomato leafminer) and other pests (spider mites, dipteran leafminers, thrips, aphids and noctuid moths). Along with the development of varieties with reduced susceptibility to viral diseases transmitted by insects, such as TYLCV, TICV, ToCV and ToTV (by whiteflies), TSWV (by thrips) and PVY (by aphids), management of these problems in many affected areas has been enhanced by the use of screens in greenhouses and the use of NE to reduce vector populations region-wide (both inside and outside greenhouses). Until recently, fungicides were the only available solution for control of airborne diseases (Botrytis, Oidium, Phytophtora and Alternaria) and soilborne diseases (Verticillium, Fusarium, Rhizoctonia). A number of biological products and biostimulants now available offer a more sustainable solution, but there is yet no effective solution to some pest problems, such as russet mites, and their presence limits wider application of the programme