Development of nanoemulsions containing penciclovir for herpes simplex treatment and a liquid chromatographic method to drug assessment in porcine skin layers

A successful formulation (penciclovir hydrogel nanoemulsion - HN) to be used in transdermal drug delivery route to treat herpes simplex virus was developed and an analytical method to quantify penciclovir (PCV) in porcine ear skin was stablished and validated. PCV nanoemulsions were prepared by high pressure homogenization and presented spherical mean droplet size 180 nm. The association efficiency and zeta potential were 87% and– 27 mV, respectively. The bioanalytical method developed showed specificity for the interferences from the skin matrixes (epidermis and dermis) and the linearity was in the range 0.1 – 25 μg/mL of drug, The mean recovery data for the three levels tested were 95.2% for the epidermis and 97.3% for the dermis and adequate results were obtained for repeatability and inter-day precision.  In vitro percutaneous absorption studies with the PCV nanoemulsion and a market cream were conducted employing the porcine skin.The cumulative amounts of PCV permeated from cream and HN, 8 h after dosing, were 2.60 and 4.15 μg/cm², respectively, representing a quite higher flux and a much higher permeability coefficient for the developed formulation. It can be concluded that HN provide a good skin targeting effect and may be a promising carrier for topical delivery of penciclovir

Allergic reactions to asparaginase : retrospective cohort study in pediatric patients with acute lymphoid leukemia

Introduction To assess the frequency of allergic reactions to asparaginase (ASP) and possible risk factors for reactions in a cohort of pediatric patients. Method The study was performed based on retrospective data from patients under acute lymphoid leukemia treatment in a general university hospital located in southern Brazil. Information on patients who used ASP from 2010 to 2017 was collected. Allergic reactions were identified in electronic medical records. Results Among the 98 patients included in the study, 16 (16.3 %) experienced an allergic reaction to native l-asparaginase (L-ASP). Of the 22 patients (22.4 %) that received only intravenous (IV) administration of l-ASP, 10 (62.5 %) had allergic reactions, while 48 patients (49 %) received intramuscular (IM) administration and 28 (28.6 %) received IV and IM administrations. The occurrence of allergic reactions differed between the groups (p <  0.001), and IV administration was associated with allergic reactions. Association was also observed between the severity of the reaction and the route of administration, with the IM route associated with grade 2 and IV route associated with grade 3. Occurrence of allergic reactions was higher when the commercial formulation of l-ASP, Leuginase®, was used (p =  0.0009 in the analysis per patient and p =  0.0003 in the analysis per administration). Conclusions The IV administration and commercial Leuginase® presentation were associated with more allergic reactions in the study population, which corroborates the findings in the literature. The IV route was also associated with higher severity of reactions in the present study

Um brinde à diversidade! / A toast to diversity!

Pensar o fazer humano em Terapia Ocupacional é caminhar por um território de diversidades. Conceitos e opiniões ora se complementam ora nem tanto, divergindo entre os terapeutas que se lançam à tentativa de explicar esta relação. Anos de história se passaram e vimos a emergência de questionamentos e inquietações acerca de como e onde temos ancorado nossa Terapia Ocupacional. Ao comemorarmos o centenário da Terapia Ocupacional, recordamos os referenciais teórico-metodológicos que nortearam e norteiam as práticas profissionais nos diferentes contextos. Sendo os terapeutas ocupacionais defensores do respeito às diferenças, convidamos a todos para um brinde à diversidade! To think about human doing in Occupational Therapy is to walk through a territory of diversities. Concepts and opinions now complement each other, not so much, diverging among the therapists who try to explain this relationship. Years of history have passed and we have seen the emergence of questions and concerns about how and where we have anchored our Occupational Therapy. As we commemorate the centennial of Occupational Therapy, we recall the theoretical and methodological references that guided and guide professional practices in different contexts. As occupational therapists advocate respect for differences, we invite everyone to a toast to diversity!Keywords: Knowledge; Professional practice; Occupational therapy. Pensar en hacer humano en Terapia Ocupacional es caminar por un territorio de diversidades. Los conceptos y las opiniones ya se complementan tanto, divergiendo entre los terapeutas que se lanzan al intento de explicar esta relación. Años de historia se pasaron y vimos la emergencia de cuestionamientos e inquietudes acerca de cómo y dónde hemos anclado nuestra Terapia Ocupacional. Al conmemoramos el centenario de la Terapia Ocupacional, recordamos los referentes teórico-metodológicos que guiaron y orientan las prácticas profesionales en los diferentes contextos. Siendo los terapeutas ocupacionales defensores del respeto a las diferencias, invitamos a todos a un brindis a la diversidad! Palabras claves: Conocimiento; Práctica profesional; Terapia ocupacional

Estudo exploratório da adesão de pacientes em início de terapia antirretroviral num hospital universitário de Porto Alegre

Introdução: No Brasil, desde 1996, o Sistema Único de Saúde distribui medicamentos antirretrovirais (ARV) gratuitamente para os portadores do vírus da imunodeficiência humana (HIV). Em Porto Alegre, a Farmácia de Programas Especiais do Hospital de Clínicas de Porto Alegre (FAPE-HCPA) dispensa esses medicamentos. O tratamento com antirretrovirais é complexo e o sucesso da terapia está associado com a adesão dos pacientes. O objetivo principal do estudo foi avaliar a adesão das pessoas vivendo com HIV/AIDS em início de tratamento antirretroviral que retiram os medicamentos na FAPE-HCPA e fazem acompanhamento médico no Hospital de Clínicas de Porto Alegre. Métodos: Realizou-se um estudo observacional, retrospectivo, exploratório, com análise de prontuários e da dispensação de ARV pelo SICLOM. Foram incluídos no estudo pacientes que iniciariam o tratamento nos anos de 2014 e 2015. Os dados de exames laboratoriais foram coletados do prontuário eletrônico e os dados de frequência de dispensação dos medicamentos no SICLOM. O paciente foi considerado aderente se apresentou registro de retiradas adequadas dos ARV e carga viral indetectável em até seis meses após o início do tratamento. Resultados: Dos 244 pacientes incluídos no estudo, 136 (56%) eram do sexo masculino e 108 (44%) do sexo feminino e a idade média encontrada foi 41,2 anos. Observou-se que 65% dos pacientes aderiram ao tratamento. Entre os não aderentes, 61% apresentaram retiradas irregulares dos antirretrovirais e carga viral indetectável. Conclusão: A maioria dos pacientes incluídos no estudo foi considerada aderente ao tratamento antirretroviral. Ainda assim, um terço dos pacientes foram considerados não aderentes. O farmacêutico apresenta papel fundamental na identificação dos indivíduos não aderentes e na busca de estratégias que possam contribuir para uma melhor adesão.Introduction: In Brazil, since 1996, the Unified Health System (SUS) dispenses free antiretroviral drugs (ARV) to patients with the human immunodeficiency virus (HIV). In Porto Alegre, it is the Special Programs Pharmacy of the Hospital de Clínicas de Porto Alegre (FAPE-HCPA) that dispenses these drugs. The antiretroviral treatment is complex and its success is associated with the patients’ adherence to it. The main objective of this study was to evaluate the HIV patients’ adherence at the beginning of the antiretroviral treatment that receive the ARV from the FAPE-HCPA, and that attend follow-up appointments at Hospital de Clínicas de Porto Alegre. Methods: An observational, retrospective, exploratory study was carried out, and the patients’ records and the registers of ARV distribution by the SICLOM system were analyzed. Patients that began their treatment in 2014 and 2015 were included in the study. Labs data were extracted from the patients’ electronic files and the frequency of drug distribution was obtained from SICLOM. Patients were considered adherent to the treatment when ARV collection was regularly registered and their viral load was undetectable up to six months after the beginning of the treatment. Results: 244 patients were included in the study of which 136 (56%) were male and 108 (44%) female. The average age was 41,2 years old. 65% of the patients were considered adherent to the treatment, and among the non-adherent ones, 61% presented irregular collection of the ARV and undetectable viral load. Conclusions: Most of the patients included in the study were adherent to the antiretroviral treatment. Despite that, a third of the patients was considered non-adherent to it. Pharmacists have a fundamental role in the identification of the non-adherent patients as well as in the search of strategies that may contribute to a better adherence to the antiretroviral treatment

Estudo exploratório da adesão de pacientes em início de terapia antirretroviral num hospital universitário de Porto Alegre

Introdução: No Brasil, desde 1996, o Sistema Único de Saúde distribui medicamentos antirretrovirais (ARV) gratuitamente para os portadores do vírus da imunodeficiência humana (HIV). Em Porto Alegre, a Farmácia de Programas Especiais do Hospital de Clínicas de Porto Alegre (FAPE-HCPA) dispensa esses medicamentos. O tratamento com antirretrovirais é complexo e o sucesso da terapia está associado com a adesão dos pacientes. O objetivo principal do estudo foi avaliar a adesão das pessoas vivendo com HIV/AIDS em início de tratamento antirretroviral que retiram os medicamentos na FAPE-HCPA e fazem acompanhamento médico no Hospital de Clínicas de Porto Alegre. Métodos: Realizou-se um estudo observacional, retrospectivo, exploratório, com análise de prontuários e da dispensação de ARV pelo SICLOM. Foram incluídos no estudo pacientes que iniciariam o tratamento nos anos de 2014 e 2015. Os dados de exames laboratoriais foram coletados do prontuário eletrônico e os dados de frequência de dispensação dos medicamentos no SICLOM. O paciente foi considerado aderente se apresentou registro de retiradas adequadas dos ARV e carga viral indetectável em até seis meses após o início do tratamento. Resultados: Dos 244 pacientes incluídos no estudo, 136 (56%) eram do sexo masculino e 108 (44%) do sexo feminino e a idade média encontrada foi 41,2 anos. Observou-se que 65% dos pacientes aderiram ao tratamento. Entre os não aderentes, 61% apresentaram retiradas irregulares dos antirretrovirais e carga viral indetectável. Conclusão: A maioria dos pacientes incluídos no estudo foi considerada aderente ao tratamento antirretroviral. Ainda assim, um terço dos pacientes foram considerados não aderentes. O farmacêutico apresenta papel fundamental na identificação dos indivíduos não aderentes e na busca de estratégias que possam contribuir para uma melhor adesão.Introduction: In Brazil, since 1996, the Unified Health System (SUS) dispenses free antiretroviral drugs (ARV) to patients with the human immunodeficiency virus (HIV). In Porto Alegre, it is the Special Programs Pharmacy of the Hospital de Clínicas de Porto Alegre (FAPE-HCPA) that dispenses these drugs. The antiretroviral treatment is complex and its success is associated with the patients’ adherence to it. The main objective of this study was to evaluate the HIV patients’ adherence at the beginning of the antiretroviral treatment that receive the ARV from the FAPE-HCPA, and that attend follow-up appointments at Hospital de Clínicas de Porto Alegre. Methods: An observational, retrospective, exploratory study was carried out, and the patients’ records and the registers of ARV distribution by the SICLOM system were analyzed. Patients that began their treatment in 2014 and 2015 were included in the study. Labs data were extracted from the patients’ electronic files and the frequency of drug distribution was obtained from SICLOM. Patients were considered adherent to the treatment when ARV collection was regularly registered and their viral load was undetectable up to six months after the beginning of the treatment. Results: 244 patients were included in the study of which 136 (56%) were male and 108 (44%) female. The average age was 41,2 years old. 65% of the patients were considered adherent to the treatment, and among the non-adherent ones, 61% presented irregular collection of the ARV and undetectable viral load. Conclusions: Most of the patients included in the study were adherent to the antiretroviral treatment. Despite that, a third of the patients was considered non-adherent to it. Pharmacists have a fundamental role in the identification of the non-adherent patients as well as in the search of strategies that may contribute to a better adherence to the antiretroviral treatment