ATENÇÃO FARMACÊUTICA NO CONTEXTO DO TRATAMENTO DE TABAGISTAS:: ESTUDO DE CASO

Medicamentos são substâncias químicas que, quando em doses terapêuticas, atuam no organismo contribuindo para homeostase. Em contrapartida, sabe-se que a associação de dois ou mais fármacos pode acarretar alterações em seu mecanismo de atuação, conduzindo a riscos de toxicidade acompanhados de prejuízos à saúde por meio das interações medicamentosas. Objetiva-se estudar a atenção farmacêutica no contexto do tratamento de tabagistas. Na presente pesquisa foi realizado seguimento farmacoterapêutico de um paciente atendido em grupo de tratamento de tabagistas do município de Campina Grande, Paraíba. O tabagista em tratamento voluntário, sexo masculino, 52 anos, infartado, usuário dos medicamentos trimetazidina, bissulfato de clopidogrel, ácido acetilsalicílico, atorvastatina cálcica, oxalato de escitalopram, ramipril e succinato de metoprolol. Foi prescrito Bupropiona para tratamento do tabagismo. No acompanhamento da evolução foi utilizado o método Dáder, participação em grupos de apoio para resolução dos Problemas Relacionados a Medicamentos (PRMs) e aprimoramento da prática de atenção farmacêutica. Observaram-se riscos à saúde decorrentes da interação entre fármacos, fazendo-se necessárias estratégias que proporcionem segurança à utilização dos mesmos. Foi suspensa bupropiona e realizada a abordagem cognitiva comportamental. No relato, o tabagista em tratamento recebeu orientações por meio da atenção farmacêutica fortalecendo e promovendo adesão ao tratamento sem utilização da medicação prescrita para tratamento de tabagistas. Conclui-se que a atenção farmacêutica tem potencial para se tornar indispensável no âmbito da saúde em virtude de promover saúde por realizar observação qualificada da atuação do

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

Dependência psicológica de Benzodiazepínicos: Psychological dependence on Benzodiazepines

O crescente aumento do seu uso no começo do século XXI, os ansiolíticos vêm se tornando a “porta de fuga” para nova e também velha geração. Geração essa, que cada vez mais vem sendo consumida por distúrbios de ansiedade, insônia e quadros depressivos de forma exponencial. (Faculdade de Ciências Farmacêuticas de Ribeirão Preto – 2019). Este trabalho, avalia o uso e possível dependência psicológica dos benzodiazepínicos, a partir de um levantamento bibliográfico de forma sistemática de pesquisas dentro da literatura científica acerca do assunto.&nbsp

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 understanding 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,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 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 underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities 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 organism 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 neglected 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 lost

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Caracterização clinicopatológica de carcinoma papilífero de tireoide em crianças e adolescentes: uma série de casos

Introdução: Carcinoma diferenciado da tireoide é raro em crianças e adolescentes. Contudo, apesar do bom prognóstico, geralmente exibe na sua apresentação um comportamento mais agressivo quando comparado à população adulta, com presença de invasão tumoral, multifocalidade, metástases locorregionais e à distância. Objetivo: Descrever os aspectos clinicopatológicos de pacientes pediátricos (≤ 14 anos de idade) diagnosticados com carcinoma diferenciado da tireoide em serviço de referência na cidade de Salvador, Bahia. Metodologia: Foram revisados os prontuários de nove pacientes submetidos à tireoidectomia no Serviço de Cirurgia Cabeça e Pescoço do Hospital São Rafael, entre 2003-2009. Resultados: A idade ao diagnóstico dos pacientes variou de 11 a 14 anos. Houve predominância do sexo feminino (2:1). Dois pacientes tinham história familiar de câncer de tireoide (22,2%). Nódulo tireoidiano foi a manifestação inicial mais frequente (44,4%). Todos os pacientes foram submetidos à tireoidectomia total. Houve comprometimento dos linfonodos cervicais em seis pacientes (66,6%). Tamanho médio dos tumores foi de 26,3 mm. Todos os pacientes eram portadores de carcinoma papilífero da tireoide ao exame anatomopatológico, sendo a forma clássica o subtipo histológico predominante. Bilateralidade foi observada em quatro pacientes (44,4%) e apenas dois apresentaram extensão extratireoidiana (22,2%). Foi observado a presença de metástases pulmonares em três pacientes (33,3%). Houve recorrência um paciente. Conclusão: Os achados sugerem que pacientes pediátricos com carcinoma diferenciado da tireoide possuem uma apresentação inicial mais agressiva, com presença de metástases linfonodais e à distância. Tireoidectomia total seguida de esvaziamento cervical é indicada para o tratamento primário do câncer de tireoide pediátrico

Association between BRAF (V600E) mutation and clinicopathological features of papillary thyroid carcinoma: a Brazilian single-centre case series

ABSTRACT Objectives: We aimed to investigate the prevalence of the BRAF (V600E) mutation in consecutive cases of papillary thyroid carcinoma (PTC) in patients diagnosed and treated at the Hospital Sao Rafael (Salvador, BA, Brazil) and evaluate its association with clinical and pathological characteristics of PTC. Subjects and methods: We retrospectively enrolled in the study a total of 43 consecutive PTC patients who underwent total thyroidectomy. We performed DNA extraction from formalin-fixed paraffin-embedded (FFPE) tumour tissue samples. Polymerase chain reaction (PCR) and direct sequencing were used to determine BRAF (V600E) mutation status. Univariate and multivariate logistic regression analyses were employed to identify independent associations. Results: The prevalence of BRAF (V600E) mutation was 65.1% (28/43). A high frequency of older patients (p value: 0.004) was observed among the BRAF-mutated PTC group and, in contrast, a low frequency of concurrent Hashimoto's thyroiditis (HT) (p value: 0.011) was noted. Multivariate analysis confirmed that older age (OR: 1.15; 95% CI: 1.00 – 1.33; p value: 0.047) and HT (OR: 0.05; 95% CI: 0.006-0.40; p value: 0.005) were independent factors associated with BRAF (V600E) mutation. Conclusion: We found a high prevalence of BRAF (V600E) mutation in PTC cases. Older age and no concurrent HT were independently associated with BRAF (V600E) mutation

An international survey of screening and management of hypothyroidism during pregnancy in Latin America

OBJECTIVE: To determine how endocrinologists in Latin America deal with clinical case scenarios related to hypothyroidism and pregnancy. MATERIALS AND METHODS: In January 2013, we sent an electronic questionnaire on current practice relating to management of hypothyroidism in pregnancy to 856 members of the Latin American Thyroid Society (LATS) who manage pregnant patients with thyroid disease. Subsequently, we have analyzed responses from physician members. RESULTS: Two hundred and ninety-three responders represent clinicians from 13 countries. All were directly involved in the management of maternal hypothyroidism and 90.7% were endocrinologists. The recommendation of a starting dose of L-thyoxine for a woman diagnosed with overt hypothyroidism in pregnancy, preconception management of euthyroid women with known thyroid autoimmunity and approach related to ovarian hyperstimulation in women with thyroid peroxidase antibodies were widely variable. For women with known hypothyroidism, 34.6% of responders would increase L-thyroxine dose by 30-50% as soon as pregnancy is confirmed. With regard to screening, 42.7% of responders perform universal evaluation and 70% recommend TSH < 2.5 mUI/L in the first trimester and TSH < 3 mUI/L in the second and third trimester as target results in known hypothyroid pregnant women. CONCLUSION: Deficiencies in diagnosis and management of hypothyroidism during pregnancy were observed in our survey, highlighting the need for improvement of specialist education and quality of care offered to patients with thyroid disease during pregnancy in Latin America.This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text

Resumos em andamento - Saúde Coletiva

Resumos em andamento - Saúde Coletiv