Redesigning the advanced pharmacy practice experiential education from hospital to home: A COVID-19 scenario

Introduction: During the 2020 COVID-19 pandemic, suspension of many educational activities occurred to mitigate the risks of infection spread. For pharmacy students in their internship year, many efforts have been made to move their experiential training to a virtual platform without compromising learning outcomes. Objectives: Redesign the advanced pharmacy practice experience (APPE) to remote learning without compromising the learning outcomes; Develop an appropriate teaching modality/strategy and assessment method for remote APPE; To drive the change in experiential education by providing guidance for other pharmacy schools dealing with similar situations. Restructured APPE: Eighty-seven interns were switched to an online internship with five specialties based on the availability of the preceptors, namely internal medicine, infectious diseases, oncology, total parenteral nutrition, and psychiatry. Experiential education activities such as drug information questions, case presentations, and clinical pharmacy topic discussions took place on virtual platforms. Student assessment was done using adjusted rubrics to suit the online platforms. Student feedback was taken using an online questionnaire and was mostly positive, indicating that they improved their clinical pharmacy knowledge. Conclusion: The authors highlighted the various restructuring modalities and learning methods used for different clinical rotations to achieve the learning outcomes in difficult situations. In future, the authors plan to work with their colleagues in other health colleges to adapt their practices together

The karyotype of three Brazilian Terrarana frogs (Amphibia, Anura) with evidence of a new Barycholos species

A recent substantial rearrangement of the 882 described eleutherodactyline frog species has considerably improved the understanding of their systematics. Nevertheless, many taxonomic aspects of the South American eleutherodactyline species remain unknown and require further investigation using morphological, cytogenetic and molecular approaches. In this work, the karyotypes of the Brazilian species Ischnocnema juipoca (Atibaia and Campos do Jordão, SP), Barycholos cf. ternetzi (Uberlândia, MG, and Porto Nacional, TO), and Pristimantis crepitans (Chapada dos Guimarães and São Vicente, MT) were analyzed using Giemsa staining, Ag-NOR labeling, and C-banding techniques. All individuals had a diploid number of 22 chromosomes, but the Fundamental Numbers were different among species. The herein described low chromosome number of Pristimantis crepitans is unique within this genus, suggesting that cytogenetically this species is not closely related either to its congeneric species or to Ischnocnema. In addition, karyotype differences, mainly in the NOR position, clearly distinguished the two Barycholos populations, besides indicating the existence of a so far undescribed species in this genus. A taxonomic review could clarify the systematic position of P. crepitans and verify the hypothetic new Barycholos species

Atitudes de enfermeiros de hospital geral frente às características pessoais do paciente alcoolista

Estudo exploratório que objetivou verificar as atitudes de enfermeiros de hospital geral frente às características pessoais de alcoolista. Na coleta de dados, utilizou-se a subescala IV da Seamon-Mannello Scale , a amostra constituiu-se de 171 enfermeiros de um hospital universitário do Estado de São Paulo. Os resultados evidenciaram que mais da metade da amostra (52,4%) possui experiência profissional com alcoolistas, sendo estes percebidos pelos participantes, como uma pessoa infeliz, solitária, sensível, que duvida de seu próprio valor e apresenta severas dificuldades emocionais. Concluiu-se que as atitudes desses enfermeiros frente às características pessoais do paciente alcoolista tendem a ser positivas e sugere-se que maior atenção seja dada ao treinamento desse profissional para reconhecimento e abordagem do alcoolista em hospital geral

Bilateral adrenal histoplasmosis in an immunocompetent man Histoplasmose adrenal bilateral em um homem imunocompetente

Histoplasmosis is a fungal disease that is endemic in Brazil. It may present as chronic pulmonary infection or in disseminated form. Disseminated histoplasmosis frequently affects the adrenal gland; however, unilateral involvement in immunosuppressed patients is the usual presentation. We report a case of an elderly immunocompetent male with history of weight loss, fever and bilateral adrenal mass who was successfully treated with itraconazole.<br>Histoplasmose é uma doença fúngica endêmica no Brasil que pode se apresentar como infecção pulmonar crônica ou na forma disseminada. A histoplasmose disseminada freqüentemente acomete a glândula adrenal; entretanto, ocorre mais em pacientes imunossuprimidos e de forma unilateral. Relatamos um caso de um homem idoso imunocompetente com história de perda de peso, febre e massa adrenal bilateral que foi tratada com itraconazol, com sucesso