POTENCIAIS INTERAÇÕES MEDICAMENTOSAS EM UM CENTRO DE ATENDIMENTO PSICOSSOCIAL (CAPS) DO CENTRO-OESTE.

Introdução e objetivos: As altas taxas de prescrição de psicofármacos nos Centros de Atenção Psicossocial (CAPS)1, associada aos seus elevados índices de interações medicamentosas2 exigem a investigação da terapia farmacoterapêutica e potencialidades que possam comprometer o quadro clínico das pessoas com transtornos mentais3. Assim almeja-se identificar e relacionar a gravidade das principais interações medicamentosas entre usuários de um CAPS situado no interior do centro-oeste do Brasil. Metodologia: Estudo observacional transversal, com dados secundários em prontuário de usuários do sistema semi-intensivo, realizado no mês de novembro de 2014, aplicando-se a ferramenta Micromedex® Solutions. Aprovação Comitê de Ética 523.834/14. Resultados e discussões: Analisou-se 228 prontuários, que identificou a prescrição de 669 medicamentos, com prevalência de psicofármacos (86,09%). Os esquemas terapêuticos individuais abordaram 181 (79,39%) multiterapias, com ausência de interações em 31 (17,12%) destas, enquanto 150 (82,88%) apresentaram de 1 (4%) a 11 (1,33%) interações, resultando 370 no total e média aproximada de 2,09 interações por prescrição médica individual. Quanto a gravidade, evidenciou-se 6 (1,62%) casos de contraindicação, todos resultante da associação da ziprazidona com outros fármacos (prometazina, olanzapina, haloperidol, fluoxetina). Ainda, 264 (71,35%) foram consideradas importantes, 85 (22,97%) moderadas e apenas 15 (4,06%) relatadas como interações secundárias, indicando uma interação leve de menor relevância clínica. O risco de prolongamento do intervalo QT esteve presente em 156 (42,16%) das interações, resultado este contribuinte para a afirmação da correlação positiva entre o número de psicotrópicos usados e o aumento da dispersão do QT4. Conclusões: Os resultados demonstrados revelam a necessidade da intervenção farmacêutica no serviço de atenção à saúde mental, com uma participação mais efetiva do profissional farmacêutico no acompanhamento da terapêutica destes pacientes, frente ao quantitativo de interações medicamentosas e suas gravidades evidenciadas

Phosphate supplementation withdrawal during dry season for Nelore range cows

O objetivo deste trabalho foi avaliar o desempenho reprodutivo de vacas Nelore em pastos de capim-marandu, após a retirada do fosfato bicálcico da mistura mineral, na estação seca. Sessenta matrizes receberam, durante seis anos, mistura mineral completa na estação chuvosa. Na estação seca, os tratamentos consistiram de: mistura mineral completa (MMC); MMC sem fosfato bicálcico (MM); e MM + concentrado. As pastagens foram manejadas de forma a não limitar a disponibilidade de matéria seca. A retirada do fosfato bicálcico do suplemento mineral, durante a estação seca, não prejudicou o desempenho reprodutivo de vacas, avaliado pela taxa de prenhez, intervalo de partos e retorno da atividade cíclica ovariana. Vacas que receberam concentrado na estação seca pariram em melhor condição corporal; vacas primíparas arraçoadas apresentaram menor número de dias vazios do que as vacas primíparas dos demais tratamentos. A retirada do fosfato bicálcico suplementar, fonte de fósforo e cálcio, na estação seca, não prejudica o desempenho de vacas multíparas em pastejo de capim-marandu.The objective of this work was to evaluate the reproductive performance of Nelore cows at 'Marandu' palisade grass paddocks, after dicalcium phosphate withdrawal from the mineral supplement in the dry season. Sixty breeding cows received, during six years, a complete mineral mixture in the wet season. In the dry season, the treatments consisted of: a complete mineral mixture (MMC); MMC without dicalcium phosphate (MM); and MM plus a concentrate. Pastures were managed in order to allow for adequate dry matter availability. The removal of dicalcium phosphate from the mineral supplement, during the dry season, did not affect the animal reproduction performance which was evaluated as pregnancy rates, delivery intervals and return of oestrous cycles. Cows receiving concentrate in the dry season had higher body score at delivery; primiparous cows which fed concentrate showed a lower number of days open, in comparison to the primiparous ones of the other treatments. Dicalcium phosphate withdrawal from the mineral supplement, source of phosphorus and calcium, during the dry season, does not affect the reproductive performance of multiparous range cows grazing 'Marandu' palisade grass

Urinary incontinence related to perineal muscle strength in the first trimester of pregnancy: cross-sectional study

Objective To analyze pelvic floor muscle strength (PFMS), urinary continence and quality of life related to urinary incontinence (UI) of women in the first trimester of pregnancy. Method Cross-sectional study with a sample of 500 women who started prenatal care in a complementary healthcare facility in Guarulhos, state of São Paulo, from 2012 and 2013. Pelvic floor muscle strength was evaluated through perineometry. The pregnant women who presented UI answered the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Results It was found that maternal age (OR=1.06; CI95% 1.02-1.11) and prior UI (OR=15.12; 95%CI 8.19-27.92) are the variables that, in tandem, best explain the occurrence of UI at the beginning of pregnancy. The mean score on the ICIQ-SF was 8.2 (SD=3.9), considered a moderate impact on quality of life. Conclusion Older pregnant women with prior UI are more likely to have UI in the first trimester of pregnancy.
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Antifungal drug susceptibility profile of Pichia anomala isolates from patients presenting with nosocomial fungemia

In vitro susceptibility of 58 isolates of Pichia anomala to five antifungal drugs using two broth microdilution methods (CLSI and EUCAST) was analyzed. Low susceptibility to itraconazole was observed. Fluconazole, voriconazole, amphotericin B, and caspofungin showed good antifungal activity, although relatively high drug concentrations were necessary to inhibit the isolates.Inst Adolfo Lutz Registro, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilUniv Estadual Campinas, Fac Med Sci, Div Infect Dis, Campinas, SP, BrazilUniv Catolica Argentina, Fac Med, Buenos Aires, DF, ArgentinaUniv São Paulo, Hosp Clin, Lab Clin Micorbiol, São Paulo, BrazilUniv São Paulo, Hosp Clin, Hosp Infect Control Dept, LIM 54, São Paulo, BrazilHosp Sirio Libanes, São Paulo, BrazilUniv Fed Rio de Janeiro, Dept Internal Med, Rio de Janeiro, BrazilUniv São Paulo, Hosp Clin, Dept Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilWeb of Scienc

Recurrent Implantation Failure: The Role of Anatomical Causes

Recurrent implantation failure (RIF) is one of the great challenges of current reproductive medicine. The term refers to the failure of repeated transfers of embryos of good morphological quality. Embryo implantation is a crucial moment in in vitro fertilization (IVF) treatments. A successful pregnancy depends on a synchronized interaction between a good quality embryo and a receptive endometrium. Its failure may be a consequence of embryo quality, anatomical or immunological factors. The anatomic causes constitute an important factor for RIF, although they are usually manageable. Fibroids, polyps and adhesions that develop after a surgical procedure or infection can hamper the embryo - endometrium attachment process. In addition, Mullerian abnormalities and hydrosalpinx can cause a negative impact on implantation rates and should also be taken into account in patients with RIF. In this chapter, we will address the main anatomical causes that may impact the implantation rates of patients undergoing IVF, as well as recommendations on management and its treatment

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio