AUTOMEDICAÇÃO ENTRE PROFISSIONAIS DA SAÚDE

RESUMO O presente estudo teve como objetivo identificar as evidências disponíveis na literatura sobre automedicação em profissionais da saúde. Realizou-se revisão integrativa da literatura com buscas na Base de Dados de Enfermagem (BDEnf), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Pubmed, SCOPUS, Web of Science, Biblioteca Virtual em Saúde Brasil (BVS) e no portal de periódicos Scientific Eletronic Library Online (SciELO). Foram selecionados 19 artigos que atenderam aos critérios de inclusão, sendo a maioria classificada com nível de evidência 6 (n=17). A análise dos artigos permitiu identificar que a automedicação é prática frequente e aceita entre profissionais da saúde, com destaque para a categoria médica, mencionados na maioria das publicações (n=8) e com as maiores prevalências. O consumo de fármacos que não exigem prescrição foi acentuado em farmacêuticos e profissionais de enfermagem. A prevalência mostrou-se maior em profissionais mais jovens e com mais escolaridade. O sintoma que mais estimulou a automedicação foi a dor de cabeça e os medicamentos mais usados foram os analgésicos. A análise realizada permitiu identificar lacunas relacionadas à compreensão dos aspectos laborais associados à automedicação e os efeitos dessa prática sobre a saúde dos profissionais. É necessário identificar medidas que controlem essa prática a fim de preservar a saúde dos trabalhadores da área da saúde

Automedicación entre profesionales de la salud

O presente estudo teve como objetivo identificar as evidências disponíveis na literatura sobre automedicação em profissionais da saúde. Realizouse revisão integrativa da literatura com buscas na Base de Dados de Enfermagem (BDEnf), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Pubmed, SCOPUS, Web of Science, Biblioteca Virtual em Saúde Brasil (BVS) e no portal de periódicos Scientific Eletronic Library Online (SciELO). Foram selecionados 19 artigos que atenderam aos critérios de inclusão, sendo a maioria classificada com nível de evidência 6 (n=17). A análise dos artigos permitiu identificar que a automedicação é prática frequente e aceita entre profissionais da saúde, com destaque para a categoria médica, mencionados na maioria das publicações (n=8) e com as maiores prevalências. O consumo de fármacos que não exigem prescrição foi acentuado em farmacêuticos e profissionais de enfermagem. A prevalência mostrou-se maior em profissionais mais jovens e com mais escolaridade. O sintoma que mais estimulou a automedicação foi a dor de cabeça e os medicamentos mais usados foram os analgésicos. A análise realizada permitiu identificar lacunas relacionadas à compreensão dos aspectos laborais associados à automedicação e os efeitos dessa prática sobre a saúde dos profissionais. É necessário identificar medidas que controlem essa prática a fim de preservar a saúde dos trabalhadores da área da saúde.This study aimed to get to know the available evidence in the national and international literature about self-medication among health professionals. An integrative revision was carried out based on research data from Nursing Data (BDEnf), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Latin-American Literature and from Caribbean in Health Science (LILACS), Pubmed, SCOPUS, Web of Science, Health Virtual Library Brazil (BVS) and the portal of journals Scientific Electronic Library Online (SciELO). Nineteen articles considered inclusive according to criteria of inclusiveness were selected, and the majority was classified with evidence levels 6 (n=17). The articles’ analyses supported the assertion that self-medication is a frequent practice among health professionals, especially those in the medical area, presenting a greater number of publications (n=8) and the greatest susceptibility. The consumption of drugs not requiring medical prescription was high among pharmaceutical and nursing professionals. Greater susceptibility was shown among younger professionals and those with higher school education. The symptom identified as a great stimulator for the use of drugs was a headache and painkillers were the most frequently used drugs. Such analysis allowed us to spot gaps in the understanding of the labor aspects associated with self-medication and the effects of such practice upon the health of professionals. It is necessary to identify measures that control this practice so as to maintain the health of health professionals.El presente estudio tuvo como objetivo conocer las evidencias disponibles en la literatura nacional e internacional sobre automedicación en profesionales de la salud. Se llevó a cabo una revisión integradora de la literatura con búsquedas en la Base de Datos de Enfermería (BDEnf), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Pubmed, SCOPUS, Web of Science, Biblioteca Virtual em Saúde Brasil (BVS) y en el portal de publicaciones Scientific Eletronic Library Online (SciELO). Fueron seleccionados 19 artículos que cumplían los criterios de inclusión, la mayoría de nivel de evidencia 6 (n = 17). El análisis de los artículos permitió identificar que la automedicación es una práctica común y aceptada entre los profesionales de la salud, principalmente entre los médicos, se en la mayoría de las publicaciones (n=8) con mayor prevalencia. El consumo de medicamentos que no requieren receta fue superior entre farmacéuticos y enfermeros. La prevalencia fue mayor en individuos más jóvenes y con estudios superiores. El síntoma que más estimuló la automedicación fue el dolor de cabeza, y los fármacos más utilizados fueron los analgésicos. El análisis permitió identificar carencia de información sobre la comprensión de los aspectos laborales asociados a la automedicación y los efectos de esa práctica sobre la salud de los profesionales. Es necesario identificar medidas que permitan controlar esta práctica con el fin de preservar la salud de los trabajadores del área de la salud

Expression and Modulation of the Intermediate- Conductance Ca2+-Activated K+ Channel in Glioblastoma GL-15 Cells

We report here the expression and properties of the intermediate-conductance Ca2+-activated K+ (IKCa) channel in the GL-15 human glioblastoma cell line. Macroscopi

The Anti-Arthritic Efficacy of Khellin Loaded in Ascorbyl Decanoate Nanovesicles after an Intra-Articular Administration

Osteoarthritis is the most widespread joint-affecting disease. The management of persistent pain remains inadequate and demands new therapeutic strategies. In this study, we explored the pain relieving and protective properties of a single intra-articular (i.a.) injection of khellin loaded in nanovesicles (K-Ves) based on ascorbyl decanoate plus phosphatidylcholine in a rat model of osteoarthritis (OA) induced by monosodium iodoacetate (MIA) treatment. The developed nanovesicles (approximately 136 nm) had a narrow size distribution (PdI 0.26), a good recovery (about 80%) and a worthy encapsulation efficiency (about 70%) with a ζ-potential of about −40 mV. The stability of K-Ves was assessed in simulated synovial fluid. Seven days after the articular damage with MIA, both K-Ves and a suspension of khellin (K, 50 μL) were i.a. injected. K-Ves significantly counteracted MIA-induced hypersensitivity to mechanical noxious (paw pressure test) and non-noxious stimuli (von Frey test) and significantly reduced the postural unbalance related to spontaneous pain (incapacitance test) and the motor alterations (beam balance test) 7 and 14 days after the i.a. injection. K was partially active only on day 7 after the treatment. The histology emphasized the improvement of several morphological factors in MIA plus K-Ves-treated animals. In conclusion, K-Ves could be successfully used for the local treatment of osteoarthritis

HPRTSardinia: a new point mutation causing HPRT deficiency without Lesch–Nyhan disease

AbstractHypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency always causing hyperuricemia presents various degrees of neurological manifestations, the most severe which is Lesch–Nyhan syndrome. The HPRT gene is situated in the region Xq26-q27.2 and consists of 9 exons. At least 300 different mutations at different sites in the HPRT coding region from exon 1 to exon 9 have been identified. A new mutation in the HPRT gene has been determined in one patient with complete deficiency of erythrocyte activity, with hyperuricemia and gout but without Lesch–Nyhan disease. Analysis of cultured fibroblasts revealed minimal residual HPRT activity mainly when guanine was the substrate. Genomic DNA sequencing demonstrated patient's mother heterozygosity for the mutation and no mutation in her brother. The mutation consists in a C→T transversion at cDNA base 463 (C463T) in exon 6, resulting in proline to serine substitution at codon 155 (P155S). This mutation had not been reported previously and has been designated HPRTSardinia. The mutation identified in this patient allows some expression of functional enzyme in nucleated cells such as fibroblasts, indicating that such cell type may add further information to conventional blood analysis. A multicentre survey gathering patients with variant neurological forms could contribute to understand the pathophysiology of the neurobehavioral symptoms of HPRT deficiency

Influenza A/H1N1/2009 virus - experience of the clinical microbiology laboratory of the "L. Sacco" University Hospital in Milan

In the spring of 2009, a new variant of influenza A/H1N1 virus that had never been isolated before, was identified. From April 27 to December 31, 2009 the respiratory samples of 974 patients, obtained from suspected cases of pandemic influenza A virus infection, were analyzed at the Clinical Microbiology Laboratory of the "L. Sacco" University Hospital in Milan. The diagnosis of influenza A/H1N1 infection was performed initially through the use of different molecular biological methods: Seeplex® RV12 ACE Detection (Seegene), NUCLISENS® EASYQ® INFLUENZA A/B (bioMérieux), Influenza A/B Q-PCR Alert (Nanogen) running in parallel with rRT-PCR (CDC) to confirm the positivity to the new influenza virus, then was used a single specific test, Fast set H1N1v (Arrow Diagnostics). Retrospective study of data showed that 293 (30.1%) patients were positive for the new strain of influenza A/H1N1 virus and 8 (0.8%) for influenza A other than H1N1 virus.The distribution of influenza A/H1N1 cases showed two peaks, one on July (62.9%) and the other one on October (36%), moreover we observed that 155 patients (53%) out of 293 positive for influenza A/H1N1 virus aged under 20 years old. The first positivity peak was found in travelers and the second one, occurred 2-3 months prior to the classic seasonal epidemic influenza, was attributed to autochthonous cases , by which the virus had spread worldwide. The highest proportion of cases were among subjects aged from 0 to 20 years and, over this age the positivity rate decreased proportionally with increasing age, in agreement with data reported in other countries

Sudden Unexpected Deaths and Vaccinations during the First Two Years of Life in Italy: A Case Series Study

Background The signal of an association between vaccination in the second year of life with a hexavalent vaccine and sudden unexpected deaths (SUD) in the two days following vaccination was reported in Germany in 2003. A study to establish whether the immunisation with hexavalent vaccines increased the short term risk of SUD in infants was conducted in Italy. Methodology/Principal Findings The reference population comprises around 3 million infants vaccinated in Italy in the study period 1999–2004 (1.5 million received hexavalent vaccines). Events of SUD in infants aged 1–23 months were identified through the death certificates. Vaccination history was retrieved from immunisation registries. Association between immunisation and death was assessed adopting a case series design focusing on the risk periods 0–1, 0–7, and 0–14 days after immunisation. Among the 604 infants who died of SUD, 244 (40%) had received at least one vaccination. Four deaths occurred within two days from vaccination with the hexavalent vaccines (RR = 1.5; 95% CI 0.6 to 4.2). The RRs for the risk periods 0–7 and 0–14 were 2.0 (95% CI 1.2 to 3.5) and 1.5 (95% CI 0.9 to 2.4). The increased risk was limited to the first dose (RR = 2.2; 95% CI 1.1 to 4.4), whereas no increase was observed for the second and third doses combined. Conclusions The RRs of SUD for any vaccines and any risk periods, even when greater than 1, were almost an order of magnitude lower than the estimates in Germany. The limited increase in RRs found in Italy appears confined to the first dose and may be partly explained by a residual uncontrolled confounding effect of age

Carriers of ADAMTS13 Rare Variants Are at High Risk of Life-Threatening COVID-19

Thrombosis of small and large vessels is reported as a key player in COVID-19 severity. However, host genetic determinants of this susceptibility are still unclear. Congenital Thrombotic Thrombocytopenic Purpura is a severe autosomal recessive disorder characterized by uncleaved ultra-large vWF and thrombotic microangiopathy, frequently triggered by infections. Carriers are reported to be asymptomatic. Exome analysis of about 3000 SARS-CoV-2 infected subjects of different severities, belonging to the GEN-COVID cohort, revealed the specific role of vWF cleaving enzyme ADAMTS13 (A disintegrin-like and metalloprotease with thrombospondin type 1 motif, 13). We report here that ultra-rare variants in a heterozygous state lead to a rare form of COVID-19 characterized by hyper-inflammation signs, which segregates in families as an autosomal dominant disorder conditioned by SARS-CoV-2 infection, sex, and age. This has clinical relevance due to the availability of drugs such as Caplacizumab, which inhibits vWF-platelet interaction, and Crizanlizumab, which, by inhibiting P-selectin binding to its ligands, prevents leukocyte recruitment and platelet aggregation at the site of vascular damage