Padrões de prescrição, dispensação e comercialização de metilfenidato

OBJETIVO Analisar padrões e requisitos legais do consumo de metilfenidato. MÉTODOS Estudo transversal realizado em Belo Horizonte, MG, em 2006. Foram analisados dados de notificações de receitas de metilfenidato e de balanços de vendas de medicamentos – psicoativos e outros – sujeitos a controle especial. Determinou-se a dose diária definida, a dose diária prescrita, o período médio de prescrição e de dispensação, bem como a distribuição regional das vendas desse medicamento no município. Foram estimados, ainda, os gastos com a aquisição do medicamento e analisado o perfil de consumo individual do fármaco por meio da Curva de Lorenz. RESULTADOS Os dados dos balanços mensais de comercialização de psicotrópicos cobriram toda a comercialização notificada do fármaco, enquanto aqueles coletados nas notificações de receita cobriram 50,6% das farmácias que o comercializaram, incluindo aquelas de maior volume de venda. O consumo de metilfenidato foi 0,37 DDD/1.000 habitantes/dia. As vendas concentraram-se em áreas mais desenvolvidas e as formulações farmacêuticas de liberação não controlada foram as mais prescritas. A prescrição e a dispensação com dosagens >; 30 mg/dia e período de tratamento >; 30 dias apresentaram valores em torno de 20,0% em algumas regiões da cidade. CONCLUSÕES O consumo de metilfenidato apresentou-se elevado no município, maior em áreas mais favorecidas economicamente e predominando o consumo de formulações com maior risco de abuso. Tanto a prescrição quanto a dispensação apresentaram características não compatíveis com as recomendações farmacoterapêuticas e determinações legais. O controle de venda do fármaco deve ser monitorado e a farmacoterapia das alterações comportamentais amplamente rediscutida em concordância com os conceitos do uso de medicamentos com qualidade.OBJECTIVE To analyze the patterns and legal requirements of methylphenidate consumption. METHODS We conducted a cross-sectional study of the data from prescription notification forms and balance lists of drugs sales – psychoactive and others – subject to special control in the fifth largest city of Brazil, in 2006. We determined the defined and prescribed daily doses, the average prescription and dispensation periods, and the regional sales distribution in the municipality. In addition, we estimated the costs of drug acquisition and analyzed the individual drug consumption profile using the Lorenz curve. RESULTS The balance lists data covered all notified sales of the drug while data from prescription notification forms covered 50.6% of the pharmacies that sold it, including those with the highest sales volumes. Total methylphenidate consumption was 0.37 DDD/1,000 inhabitants/day. Sales were concentrated in more developed areas, and regular-release tablets were the most commonly prescribed pharmaceutical formulation. In some regions of the city, approximately 20.0% of the prescriptions and dispensation exceeded 30 mg/day and 30 days of treatment. CONCLUSIONS Methylphenidate was widely consumed in the municipality and mainly in the most developed areas. Of note, the consumption of formulations with the higher abuse risk was the most predominant. Both its prescription and dispensation contrasted with current pharmacotherapeutic recommendations and legal requirements. Therefore, the commercialization of methylphenidate should be monitored more closely, and its use in the treatment of behavioral changes of psychological disorders needs to be discussed in detail, in line with the concepts of the quality use of medicines

Biología de poblaciones de especies simpátricas de Caprella (Amphipoda: Caprellidae) en un bosque de algas tropicales

The population biology of the three sympatric species of caprellids (Caprella danilevskii, C. equilibra and C. scaura) associated with a Sargassum bed was studied in the northern coast of São Paulo state, Brazil. Samplings were carried out monthly from October 2010 to February 2012. In each month, 25 fronds of Sargassum were randomly collected through snorkelling. The caprellids were identified, counted, classified by sex and separated into size classes. Caprella danilevskii was the most abundant species, with 14939 specimens recorded. The body size of males was larger than that of females for C. danilevskii and C. equilibra, and the sex ratio was skewed toward males for all species. The size-frequency distribution was polymodal for C. danilevskii and C. scaura and bimodal for C. equilibra. Mature males of C. scaura and C. equilibra were recorded in all size classes. The last size classes (from 8.3–9.4 to 12.7–13.8 mm) were dominated by mature males. Mature and ovigerous females were more frequent in intermediate size classes. Significant temporal variations were recorded for the three species with higher densities in spring and summer that are related to higher algal biomass; but other environmental factors are certainly important for explaining caprellid density variation.Se estudió la biología poblacional de las tres especies simpátricas de caprélidos (Caprella danilevskii, C. equilibra y C. scaura) asociadas a un lecho de Sargassum en la costa norte del estado de São Paulo, Brasil. Los muestreos se realizaron mensualmente desde octubre de 2010 hasta febrero de 2012. En cada mes, se recolectaron al azar 25 frondas de Sargassum a través de snorkel. Los caprélidos fueron identificados, contados, clasificados por sexo y separados en clases de tamaño. Caprella danilevskii fue la especie más abundante, con 14939 ejemplares registrados. El tamaño corporal de los machos fue mayor que el de las hembras para C. danilevskii y C. equilibra y la proporción de sexos se inclinó hacia los machos para todas las especies. La distribución de frecuencia de tamaño fue polimodal para C. danilevskii y C. scaura y bimodal para C. equilibra. Se registraron machos maduros de C. scaura y C. equilibra en todas las clases de tamaño. Las últimas clases de tamaño (de 8,3–9,4 a 12,7–13,8 mm) estuvieron dominadas por machos maduros. Las hembras maduras y ovígeras fueron más frecuentes en clases de tamaño intermedio. Se registraron variaciones temporales significativas para las tres especies con mayores densidades en primavera y verano que están relacionadas con una mayor biomasa de algas; pero otros factores ambientales son ciertamente importantes para explicar la variación de la densidad de los caprélidos

Produção monográfica: significados e dificuldades na visão dos estudantes

A produção monográfica é um meio de inserir o aluno da graduação na pesquisa científica, tornando-o responsável por gerar conhecimento e ser sujeito ativo no seu processo de formação (Severino, 2007; Demo, 2011). A problemática desta pesquisa consiste no seguinte questionamento: que significados são atribuídos pelos estudantes à elaboração da monografia?  Esta investigação justifica-se pela inexistência de pesquisas que tratem das percepções dos alunos de Secretariado Executivo sobre o tema, sendo relevante conhecer tais percepções, uma vez que a monografia não é um componente obrigatório para a conclusão da graduação na área, e estudos que evidenciem tais percepções podem contribuir para maior interesse dos estudantes de graduação na pesquisa científica. O objetivo geral consiste em compreender o significado da produção monográfica para os egressos do curso de bacharelado em Secretariado Executivo da Universidade Federal do Ceará [UFC]. No que se refere aos aspectos metodológicos, trata-se de uma pesquisa qualitativa e descritiva. A técnica de coleta de dados empregada foi questionário, e a análise foi realizada por meio da análise de conteúdo. A abordagem teórica contempla estudos da Educação que discutem a formação acadêmica e os estudos sobre pesquisa em Secretariado. Os sujeitos apontaram dificuldades de ordem pessoal e institucional, mas estas parecem não comprometer a produção monográfica. Concluiu-se que o trabalho monográfico impacta positivamente na satisfação dos estudantes, contribuindo tanto para o seu desenvolvimento intelectual quanto pessoal. Ademais, esses trabalhos fomentam e enriquecessem as pesquisas na área secretarial

Profile of Service Use and Barriers to Access to Care among Brazilian Children and Adolescents with Autism Spectrum Disorders

Delayed diagnosis and a lack of adequate care for people with autism spectrum disorder (ASD) are related to worse outcomes and quality of life. This study aimed to identify the profile of service use, barriers to access care, and factors related to those barriers in Brazilian families with children with ASD. A total of 927 families with children with ASD (3-17 years) from five Brazilian regions completed an online version of the Caregivers Needs Survey. Results showed that the most used services were behavioral interventions and pharmacotherapy, while the most used professionals were neurologists, nutritionists, speech therapists, psychiatrists, psychologists, and pediatricians. The main barriers included waiting lists, costs, and the absence of services or treatment. Service use varied according to age, the region of residence, type of health care system used, and the parents/caregivers\u27 education. Access to behavioral interventions was more frequent among users of the private system/health insurance and families whose caregivers had higher education. The absence of specialized services/treatments was less frequent among residents of state capitals and families whose caregivers had higher levels of education. This study highlights how families with children/adolescents with ASD in Brazil face significant barriers to access care related to sociodemographic factors

Genetic ablation of inositol 1,4,5-Trisphosphate receptor type 2 (IP3R2) fails to modify disease progression in a mouse model of Spinocerebellar Ataxia type 3

Spinocerebellar ataxia type 3 (SCA3) is a rare neurodegenerative disease caused by an abnormal polyglutamine expansion within the ataxin-3 protein (ATXN3). This leads to neurodegeneration of specific brain and spinal cord regions, resulting in a progressive loss of motor function. Despite neuronal death, non-neuronal cells, including astrocytes, are also involved in SCA3 pathogenesis. Astrogliosis is a common pathological feature in SCA3 patients and animal models of the disease. However, the contribution of astrocytes to SCA3 is not clearly defined. Inositol 1,4,5-trisphosphate receptor type 2 (IP3R2) is the predominant IP3R in mediating astrocyte somatic calcium signals, and genetically ablation of IP3R2 has been widely used to study astrocyte function. Here, we aimed to investigate the relevance of IP3R2 in the onset and progression of SCA3. For this, we tested whether IP3R2 depletion and the consecutive suppression of global astrocytic calcium signalling would lead to marked changes in the behavioral phenotype of a SCA3 mouse model, the CMVMJD135 transgenic line. This was achieved by crossing IP3R2 null mice with the CMVMJD135 mouse model and performing a longitudinal behavioral characterization of these mice using well-established motor-related function tests. Our results demonstrate that IP3R2 deletion in astrocytes does not modify SCA3 progression.This work has been funded by National funds, through the Foundation for Science and Technology (FCT)—project UIDB/50026/2020 and UIDP/50026/2020, PTDC/NEUNMC/3648/2014 and COMPETE-FEDER (POCI-01-0145-FEDER-016818); fellowships to DCG (2021.08121.BD), DMF (SFRH/BD/147947/2019), JSC (SFRH/BD/140624/2018), ANC (SFRH/BPD/118779/2016), AVF (UMINHO/BIL-CNCG/2022/11), SGG (SFRH/BD/101298/2014), and JFV (2020.05109.BD); FCT Scientific Employment Stimulus (CEEC)—Individual Call position to SDS (CEECIND/00685/2020); grants from the Bial Foundation (037/18) and “the la Caixa” Foundation (LCF/PR/HR21/52410024) to JFO; and by the projects NORTE-01-0145-FEDER-000013 and NORTE-01-0145-FEDER-000023, supported by the Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). It was also supported by grants from the ICVS Scientific Microscopy Platform, a member of the national infrastructure PPBI—Portuguese Platform of Bioimaging (PPBI-POCI-01-0145-FEDER-022122 and national funds through the Foundation for Science and Technology (FCT)

Hypoalbuminemia as a risk factor for thromboembolic events in inflammatory bowel disease inpatients

Background/Aims Inflammatory bowel disease (IBD) are chronic entities characterized by local and systemic inflammation and may be associated with thrombosis. The aim of this study was to identify the prevalence of thromboembolic events (TEE) in hospitalized IBD patients and identify risk factors for their occurrence. Methods This retrospective, single-center study included patients treated at a Brazilian IBD referral unit between 2004 and 2014. Patients hospitalized for more than 48 hours due to active IBD and who did not receive prophylaxis for TEE during hospitalization were included. Patients were allocated to 2 groups: those with TEE up to 30 days or at the time of hospitalization (TEE-group) and patients without TEE (control-group). Clinical and laboratory characteristics were evaluated. Results Of 53 patients evaluated, 69,8% with Crohn’s disease (CD) and 30.2% with ulcerative colitis (UC). The prevalence of TEE 30 days before or during hospitalization was 15.1%, with 10.8% in CD and 25% in UC. In the TEE group, mean serum albumin was 2.06 g/dL versus 3.30 g/dL in the control group. Patients with albumin levels below 2.95 g/dL (43.18%) had a higher risk of developing TEE (relative risk, 1.72; 95% confidence interval, 1.17–2.53) (P<0.001). Conclusions Albumin levels were significantly lower in patients with TEE, and hypoalbuminemia was considered a risk factor for the development of TEE in this population

A contribuição do farmacêutico para a promoção do acesso e uso racional de medicamentos essenciais no SUS

Resumo O objetivo deste artigo é descrever o processo da inserção do farmacêutico na equipe de uma Unidade Básica de Saúde e os resultados na promoção do acesso e uso racional de medicamentos. Trata-se de estudo descritivo, transversal, realizado em unidade de atenção primária do município de São Paulo. As atividades do farmacêutico foram avaliadas em relação à estruturação e organização do serviço, melhoria do padrão de prescrição médica, elaboração de método de orientação e implantação de serviços farmacêuticos clínicos. A análise estatística foi realizada empregando o teste Qui-Quadrado de Pearson, com nível de significância de 5%, e o ODDs Ratio, quando comparados os períodos anterior e posterior à intervenções e resultados entre os anos de 2010 e 2011. A atuação do farmacêutico apresentou resultados estatisticamente significativos na redução da falta de medicamentos; melhora da qualidade da prescrição (com aumento do número de prescrições atendidas); redução do número de medicamentos prescritos entre os pacientes em seguimento farmacoterapêutico; e, comparando-se os anos 2010 e 2011, as recomendações de mudanças na farmacoterapia passaram a ter maior nível de aceitação. O farmacêutico contribuiu efetivamente para o acesso e a promoção do uso racional de medicamentos

Preclinical Evidence Supporting Early Initiation of Citalopram Treatment in Machado-Joseph Disease

Spinocerebellar ataxias are dominantly inherited neurodegenerative disorders with no disease-modifying treatment. We previously identified the selective serotonin reuptake inhibitor citalopram as a safe and effective drug to be repurposed for Machado-Joseph disease. Pre-symptomatic treatment of transgenic (CMVMJD135) mice strikingly ameliorated mutant ataxin-3 (ATXN3) pathogenesis. Here, we asked whether citalopram treatment initiated at a post-symptomatic age would still show efficacy. We used a cohort of CMVMJD135 mice that shows increased phenotypic severity and faster disease progression (CMVMJD135hi) compared to the mice used in the first trial. Groups of hemizygous CMVMJD135hi mice were orally treated with citalopram. Behavior, protein analysis, and pathology assessment were performed blindly to treatment. Our results show that even when initiated after symptom onset, treatment of CMVMJD135hi mice with citalopram ameliorated motor coordination and balance, attenuating disease progression, albeit to a lesser extent than that seen with pre-symptomatic treatment initiation. There was no impact on ATXN3 aggregation, which contrasts with the robust reduction in ATXN3-positive inclusions observed in CMVMJD135 mice, when treated pre-symptomatically. Post-symptomatic treatment of CMVMJD135hi mice revealed, however, a limited neuroprotective effect by showing a tendency to repair cerebellar calbindin staining, and to increase the number of motor neurons and of NeuN-positive cells in certain brain regions. While supporting that early initiation of treatment with citalopram leads to a marked increase in efficacy, these results strengthen our previous observation that modulation of serotonergic signaling by citalopram is a promising therapeutic approach for Machado-Joseph disease even after symptom onset.European Regional Development Funds (FEDER), through the Competitiveness Factors Operational Programme (COMPETE), and by National funds, through the Foundation for Science and Technology (FCT), under the scope of the project POCI-01-0145-FEDER-007038. This article has been developed under the scope of the project NORTE-01-0145-FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the FEDER. This work was also supported by FCT and COMPETE through the projects [PTDC/SAU-GMG/112617/2009] (to PM) and [EXPL/BIM-MEC/0239/2012] (to AT-C), by FCT through the project [POCI-01-0145-FEDER-016818 (PTDC/NEU-NMC/3648/2014)] (to PM), by National Ataxia foundation (to PM and to AT-C), and by Ataxia UK (to PM). SE, SD-S, SO, and AT-C were supported by the FCT individual fellowships, SFRH/BD/78554/2011, SFRH/BD/78388/2011, PD/BD/127818/2016, and SFRH/BPD/102317/2014, respectively. FCT fellowships are co-financed by POPH, QREN, Governo da República Portuguesa, and EU/FSEinfo:eu-repo/semantics/publishedVersio

Artistas sobre outras Obras

Propõe-se neste número uma estética da materialidade, em cada um dos quinze artigos aqui reunidos. Há nas propostas artísticas a expansão estética que se alarga com tranquilidade a partir da materialidade das obras de arte. As matérias suportam a arte, o seu pensamento, a sua estética. A relação com o público está em permanente adiamento e, ao mesmo tempo, renovação. As matérias, enunciadas pelos artistas, suportam o seu próprio resgate, na possibilidade de uma relação. O espectador, o novo curador, segue em construção no processo.info:eu-repo/semantics/publishedVersio