Assist?ncia farmac?utica a pacientes oncol?gicos em uso de anticorpos monoclonais em um hospital de refer?ncia do Oeste de Santa Catarina

Introduction: The increase in the incidence of cancer, related to issues such as changes in lifestyle, demographic profile and increased life expectancy, raises a series of questions about new treatments and their impact, both on the quality / prognosis of the patient and on the cost to the Public Health System. The present study aims to characterize pharmaceutical assistance in the use of monoclonal antibodies, mainly related to adverse effects and the route of acquisition of these medications. Objectives: To describe the use of immunobiologicals with regard to the form of acquisition, regulation and judicialization, adverse effects and causes of interruption of therapy. In addition to the characterization of cancer patients and the main neoplasms and monoclonal antibodies used in the treatment of these patients. Methods: The study is a retrospective cross-sectional study, by consulting data from medical records in the sectors of Oncology and Hospital Pharmacy, from the period from August 1, 2017 to July 31, 2019, at Associa??o Lenoir Vargas Ferreira - Hospital Regional do Oeste - Chapec?-SC, with the sample consisting of 169 patients. Results: The studied population was mostly female (n = 115). The main neoplasms found were breast (n = 64, 36.16%), lymphomas (n = 53, 29.94%) and multiple plasmacytoma / plasmacytoma melanoma (n = 25, 14.12%). The most used mABs were trastuzumab (n = 65, 35.71%) and rituximab (n = 54, 29.67%). Four forms of drug acquisition were observed, with SUS (n = 110, 60.44%) and judicial (n = 65, 35.71%) being those with the highest percentage 60.3% of the patients had no adverse effect on therapy, but among those who did, the main ones were vomiting and nausea, asthenia, diarrhea, pain, neutropenia and mucositis. Adverse effects / toxicity (n = 15), lack of medication (n = 11) and delay in release (n = 10) are the most common causes of treatment interruption. Conclusion: The selectivity of therapies with mABs causes adverse effects to be minimized or even extinguished, which, together with increased survival, justifies their use. MABs not made available by SUS are demanded by the population, who resort to judicial measures to obtain their treatment by the Union, state or municipality. This form of acquisition implies questions related to the financial privilege of some, which favors them in obtaining such drugs. This justifies the importance of public policies to encourage the medical, scientific, social and legal community to send reviews with clinical evidence to CONITEC to approve the incorporation of these technologies in SUS.Introdu??o: O aumento da incid?ncia de c?ncer, relacionado a quest?es como mudan?as nos h?bitos de vida, perfil demogr?fico e aumento da expectativa de vida, levanta uma s?rie de questionamentos sobre novos tratamentos e seu impacto, tanto na qualidade / progn?stico do paciente, quanto no custo ao sistema p?blico de sa?de. O presente estudo visa caracterizar a assist?ncia farmac?utica no uso de anticorpos monoclonais principalmente relacionado aos efeitos adversos e a via de aquisi??o dessas medica??es. Objetivos: Descrever a utiliza??o de imunobiol?gicos no que tange ? forma de aquisi??o, regula??o e judicializa??o, efeitos adversos e causas de interrup??o da terapia. Al?m da caracteriza??o dos pacientes com c?ncer e das principais neoplasias e anticorpos monoclonais utilizados nos tratamentos desses pacientes. Metodologia: O estudo ? do tipo transversal retrospectivo, por meio da consulta a dados dos prontu?rios nos setores de Oncologia e Farm?cia Hospitalar, do per?odo de 1 de agosto de 2017 at? 31 de julho de 2019, na Associa??o Lenoir Vargas Ferreira - Hospital Regional do Oeste - Chapec?-SC, sendo a amostra composta por 169 pacientes. Resultados: A popula??o estudada foi majoritariamente feminina (n=115). As principais neoplasias encontradas foram de mama (n=64, 36,16%), linfomas (n=53, 29,94%) e melanoma m?ltiplo de plasm?cito/ plasmocitoma (n=25, 14,12%). Os mABs mais utilizados foram o trastuzumabe (n=65, 35,71%) e rituximabe (n=54, 29,67%). Foram observadas quatro formas de aquisi??o dos f?rmacos, sendo via SUS (n=110, 60,44%) e judicial (n=65, 35,71%) as de maior porcentagem. 60,3% dos pacientes n?o apresentaram efeito adverso ? terapia, mas dentre os que apresentaram os principais foram v?mitos e n?useas, astenia, diarreia, dor, neutropenia e mucosite. Efeitos adversos/ toxicidade (n=15), falta de medicamento (n=11) e atraso na libera??o (n=10) s?o as causas mais comuns de interrup??o do tratamento. Conclus?o: A seletividade das terapias com mABs faz com que os efeitos adversos sejam minimizados ou at? extintos, o que, associado ao aumento de sobrevida, justifica seu uso. Os mABs n?o disponibilizados pelo SUS s?o demandados pela popula??o, que recorrem a medidas judiciais para conseguirem seu tratamento pela Uni?o, estado ou munic?pio. Essa forma de aquisi??o implica em questionamentos relacionados ao privil?gio financeiro de alguns, o que os favorece na obten??o de tais medicamentos. Isso justifica a import?ncia de pol?ticas p?blicas incentivarem a comunidade m?dica, cient?fica, social e jur?dica a enviarem revis?es com evid?ncias cl?nicas ? CONITEC para aprovar a incorpora??o de novas tecnologias em sa?de no SUS

Prevalence of Hepatitis B, C, HIV and syphilis markers among refugees in Bari, Italy

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to assess the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) serological markers and the prevalence of VDRL positive subjects in a population of refugees of various nationalities, living in the Asylum Seeker Centre in Bari Palese, Southern Italy.</p> <p>Methods</p> <p>The study was carried out in the period May-July 2008 and recruited only voluntarily enrolled healthy refugees. HBsAg, anti-HBc, anti-HCV and anti-HIV virus antibodies were detected. VDRL syphilis screening was also carried out on the serum samples.</p> <p>Results</p> <p>A total of 529 refugees, 442 males and 87 females, aged between 7 and 52 years, were studied. Of these, 510 were from Africa and 19 from Asia.</p> <p>Forty-four individuals (8.3%) were HBsAg positive and 241 (45.6%) were anti-HBc positive. A total of 24 (4.5%) individuals were anti-HCV positive. Eight asylum seekers (1.5%) were HIV positive. VDRL tests were performed on 269 subjects and 4 (1.5%) were positive. 12.3% of the study population had serological markers of chronic and transmissible infections with potential blood-borne or sexual transmission.</p> <p>Conclusions</p> <p>In Italy, a suitable protocol is necessary for the early diagnosis of infectious diseases on entering Asylum Centres, so allowing the adoption of prevention measures to safeguard the health of the individuals, the residents and workers in the Centres and the general population.</p

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

Sex-Differences in the Pattern of Comorbidities, Functional Independence, and Mortality in Elderly Inpatients: Evidence from the RePoSI Register

Background: The RePoSi study has provided data on comorbidities, polypharmacy, and sex dimorphism in hospitalised elderly patients. Methods: We retrospectively analysed data collected from the 2010, 2012, 2014, and 2016 data sets of the RePoSi register. The aim of this study was to explore the sex-differences and to validate the multivariate model in the entire dataset with an expanded follow-up at 1 year. Results: Among 4714 patients, 51% were women and 49% were men. The disease distribution showed that diabetes, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, and malignancy were more frequent in men but that hypertension, anaemia, osteoarthritis, depression, and diverticulitis disease were more common in women. Severity and comorbidity indexes according to the Cumulative Illness Rating Scale (CIRS-s and CIRS-c) were higher in men, while cognitive impairment, mood disorders, and disability in daily life measured by the Barthel Index (BI) were worse in women. In the multivariate analysis, BI, CIRS, and malignancy significantly increased the risk of death in men at the 1-year follow-up, while age was independently associated with mortality in women. Conclusions: Our study highlighted the relevance and the validity of our previous predictive model in the identification of sex dimorphism in hospitalised elderly patients underscoring the need of sex-personalised health-care

Arrival Directions of Cosmic Rays above 32 EeV from Phase One of the Pierre Auger Observatory

A promising energy range to look for angular correlations between cosmic rays of extragalactic origin and their sources is at the highest energies, above a few tens of EeV (1 EeV equivalent to 10^(18) eV). Despite the flux of these particles being extremely low, the area of similar to 3000 km^(2) covered at the Pierre Auger Observatory, and the 17 yr data-taking period of the Phase 1 of its operations, have enabled us to measure the arrival directions of more than 2600 ultra-high-energy cosmic rays above 32 EeV. We publish this data set, the largest available at such energies from an integrated exposure of 122,000 km^(2) sr yr, and search it for anisotropies over the 3.4 pi steradians covered with the Observatory. Evidence for a deviation in excess of isotropy at intermediate angular scales, with similar to 15 degrees Gaussian spread or similar to 25 degrees top-hat radius, is obtained at the 4 sigma significance level for cosmic-ray energies above similar to 40 EeV

Search for Ultra-high-energy Photons from Gravitational Wave Sources with the Pierre Auger Observatory

A search for time-directional coincidences of ultra-high-energy (UHE) photons above 10 EeV with gravitational wave (GW) events from the LIGO/Virgo runs O1 to O3 is conducted with the Pierre Auger Observatory. Due to the distinctive properties of photon interactions and to the background expected from hadronic showers, a subset of the most interesting GW events is selected based on their localization quality and distance. Time periods of 1000 s around and 1 day after the GW events are analyzed. No coincidences are observed. Upper limits on the UHE photon fluence from a GW event are derived that are typically at &amp; SIM;7 MeV cm(-2) (time period 1000 s) and &amp; SIM;35 MeV cm(-2) (time period 1 day). Due to the proximity of the binary neutron star merger GW170817, the energy of the source transferred into UHE photons above 40 EeV is constrained to be less than 20% of its total GW energy. These are the first limits on UHE photons from GW sources