Type B adverse drug reactions reported by an immunoallergology department

Objective: Characterization of the adverse drug reactions (ADR) reported by the immunoallergology department (IAD), Centro Hospitalar de São João (Porto), to the Northern Pharmacovigilance Centre (NPC). Methods: An observational, descriptive and retrospective study was conducted, based in a spontaneous report system. Participants were all the patients from the IAD, with suspected ADR, reported to NPC by specialists after the study was completed. Results: Studied population had a median age of 41 years, with the predominance of the female gender (73.2%). Allergic rhinitis and asthma were the most frequent comorbidities. All studied ADR were type B, 89.6% were serious, 86.4% unexpected and 2.6% associated with drugs that presented less than 2 years in the market. The most represented drug classes were the non-steroidal anti-inflammatory drugs (NSAIDs) (52.6%) and antibiotics (25.2%). Skin symptoms represented 61.2% of the reported complaints. About 52.9% of these ADR occurred in less than one hour after intake. The most frequent ADR treatment at the time of the reaction was drug interruption (86.2%), followed by the prescription of anti-histamines (42.2%). Conclusions: Reported ADR to NPC by the Drug Alert Unit were mainly serious, unexpected, associated with NSAIDs and antibiotics and related with marketing authorization medicines older than two years. These results could be very useful to develop strategies to prevent the clinical and economic consequences of ADR.publishe

Does the problem begin at the beginning? Medical students' knowledge and beliefs regarding antibiotics and resistance: a systematic review

Studies have detected that prescribers display gaps in knowledge and inappropriate attitudes regarding antibiotics and resistances, but it is not known whether these are generated during professional practice or derive from the undergraduate stage of their education. Accordingly, the aim of this study was to identify medical students' knowledge, beliefs and attitudes regarding antibiotic use and antibiotic resistance, and whether these change over the course of their time at medical school.publishe

New generalized nonspherical black hole solutions

We present numerical evidence for the existence of several types of static black hole solutions with a nonspherical event horizon topology in $d\geq 6$ spacetime dimensions. These asymptotically flat configurations are found for a specific metric ansatz and can be viewed as higher dimensional counterparts of the $d=5$ static black rings, dirings and black Saturn. Similar to that case, they are supported against collapse by conical singularities. The issue of rotating generalizations of these solutions is also considered.Comment: 47 pages, 11 figures, some comments adde

Estudo da composição de fitoquímicos bioactivos em plantas medicinais portuguesas

O presente estudo teve como objetivo determinar os teores de fitoquímicos em três espécies vegetais nativas de Portugal - erva-cidreira (Melissa officinalis L.), camomila (Matricaria chamomilla L.) e tília (Tilia cordata Mill.) - , através da quantificação dos compostos fenólicos totais, flavonoides totais, proantocianidinas (taninos totais) e carotenoides totais. Foi também avaliada a possível correlação entre a atividade antioxidante (in vitro) e o efeito sinérgico entre os diferentes fitoquímicos presentes, através do método do radical livre DPPH. Os extratos aquosos apresentaram diferenças significativas (p<0.05) entre todos os fitoquímicos estudados. A erva-cidreira apresentou maiores concentrações em fenólicos totais (258.1 mg.100g-1) e flavonoides totais (686.4 mg.100g-1), verificando-se uma correlação positiva entre estes compostos e o seu poder antioxidante (65%). A camomila foi a planta medicinal com maiores teores em taninos (37.0 mg.100g-1), compostos reconhecidos pelo seu poder adstringente e propriedades digestivas. Todas as plantas apresentaram atividade antioxidante, superior à amostra controlo, com valores compreendidos entre 8.5% e 65% para a tília e erva-cidreira, respetivamente. Este estudo prova que as plantas medicinais portuguesas são uma fonte rica em compostos bioativos para a aplicação nas indústrias alimentares e farmacêuticas.info:eu-repo/semantics/publishedVersio

Type B adverse drug reactions reported by an immunoallergology department

Objective: Characterization of the adverse drug reactions (ADR) reported by the immunoallergology department (IAD), Centro Hospitalar de São João (Porto), to the Northern Pharmacovigilance Centre (NPC). Methods: An observational, descriptive and retrospective study was conducted, based in a spontaneous report system. Participants were all the patients from the IAD, with suspected ADR, reported to NPC by specialists after the study was completed. Results: Studied population had a median age of 41 years, with the predominance of the female gender (73.2%). Allergic rhinitis and asthma were the most frequent comorbidities. All studied ADR were type B, 89.6% were serious, 86.4% unexpected and 2.6% associated with drugs that presented less than 2 years in the market. The most represented drug classes were the non-steroidal anti-inflammatory drugs (NSAIDs) (52.6%) and antibiotics (25.2%). Skin symptoms represented 61.2% of the reported complaints. About 52.9% of these ADR occurred in less than one hour after intake. The most frequent ADR treatment at the time of the reaction was drug interruption (86.2%), followed by the prescription of anti-histamines (42.2%). Conclusions: Reported ADR to NPC by the Drug Alert Unit were mainly serious, unexpected, associated with NSAIDs and antibiotics and related with marketing authorization medicines older than two years. These results could be very useful to develop strategies to prevent the clinical and economic consequences of ADR

Operationalisation for Portugal of the EU(7)-PIM List for identification of potentially inappropriate medicines in older adults

Em 2015 foi publicada a lista EU(7)-PIM, que identifica medicamentos potencialmente inapropriados na população idosa e resultou de um consenso de peritos de sete países europeus. Portugal não fez parte deste grupo, pelo que na sua origem não foi adaptada para a realidade portuguesa. Com este trabalho pretendemos elaborar uma lista de medicamentos potencialmente inapropriados adaptada à realidade dos medicamentos comercializados em Portugal, através da operacionalização da lista EU(7)-PIM para a realidade nacional, avaliar a adequabilidade do seu uso na prática clínica.In 2015, the EU(7)-PIM List was published, which identifies potentially inappropriate medicines in older patients and resulted from a consensus of experts from seven European countries. Portugal was not part of this group, so it was not originally adapted to the Portuguese reality. With this work, we intend to elaborate a list of potentially inappropriate medicines adapted to the reality of medicines marketed in Portugal, through the operationalization of the EU(7)-PIM List for the national reality and to evaluate the adequacy of its use for clinical practice.publishe

Outpatient atorvastatin use and severe COVID‐19 outcomes: A population‐based study

Evidence of the effect of statins on patients with coronavirus disease (2019) COVID-19 is inconsistent. The aim of this study was to evaluate the association between chronic use of statins—both overall and by active ingredient—and severe outcomes of COVID-19 (risk of hospitalization and mortality), progression to severe outcomes, and susceptibility to the virus. We conducted a population-based case–control study with data from electronic records to assess the risk of (1) hospitalization: cases were patients admitted due to COVID-19 and controls were subjects without COVID-19; (2) mortality: cases were hospitalized patients who died due to COVID-19 and controls were subjects without COVID-19; (3) progression: cases were hospitalized COVID-19 subjects and controls were nonhospitalized COVID-19 patients; and (4) susceptibility: cases were patients with COVID-19 (both hospitalized and nonhospitalized) and controls were subjects without COVID-19. We collected data on 2821 hospitalized cases, 26 996 nonhospitalized cases, and 52 318 controls. Chronic use of atorvastatin was associated with a decreased risk of hospitalization (adjusted odds ratios [aOR] = 0.83; 95% confidence interval [CI]: 0.74–0.92) and mortality (aOR = 0.70; 95% CI: 0.53–0.93), attributable in part to a lower risk of susceptibility to the virus (aOR = 0.91; 95% CI: 0.86–0.96). Simvastatin was associated with a reduced risk of mortality (aOR = 0.59; 95% CI: 0.40–0.87). The wide degree of heterogeneity observed in the estimated odds ratios (ORs) of the different statins suggests that there is no class effect. The results of this real-world study suggest that chronic use of atorvastatin (and to a lesser degree, of simvastatin) is associated with a decrease in risk of severe COVID-19 outcomesThe authors should like to thank the SERGAS General Healthcare Directorate for furnishing the data needed to conduct this study, DXC Technology for its work in extracting the study data, and Michael Benedict for reviewing and revising the English. This study was sponsored by the Carlos III Institute of Health via the “COV20/00470” project (cofunded by the European Regional Development Fund, “A way to make Europe”)S