Prevalência de síndrome metabólica (SM) em usuários de antipsicóticos

-OBJETIVOS: São descritos diversos transtornos metabólicos, associados ao uso de antipsicóticos, sugerindo interface com o quadro de síndrome metabólica (SM). O objetivo do presente estudo é determinar a freqüência dos componentes da SM, em indivíduos com diagnóstico prévio de esquizofrenia, usuários de medicação antipsicótica, verificando possível relação entre uso o dessas drogas e a SM. MATERIAL E MÉTODOS: Foram estudados 64 indivíduos sendo 28 usuários de antipsicóticos típicos (grupo 1), 17 usuários de antipsicóticos atípicos (grupo 2) e 19 como grupo controle (grupo 3). Cada indivíduo foi submetido à avaliação clínica, avaliação do nível de atividade física e às dosagens de glicose, colesterol total e HDL, triglicérides, insulina e leptina. RESULTADOS: As médias dos parâmetros clínicos foram: idade, 37±10 anos, 35±7 anos e 37±10 anos; circunferência abdominal, 97±15cm, 93±12cm e 86±14cm (p<0,05); IMC 26,3±3,7kg/m2 , 25,1±4,0kg/m2, 24,5±4,9kg/m2; PAS 119±21mmHg; 112±15mmHg e 120±19mmHg e PAD 79±14mmHg; 70±9mmHg e 77±14mmHg, nos grupos 1, 2 e 3, respectivamente. Foram considerados sedentários 90,6% dos indivíduos do grupo 1, 59,2% do grupo 2 e 49,7%, do grupo 3. As médias dos exames laboratoriais foram colesterol total: 185± 31mg/dl, 170±42mg/dl e 169±25mg/dl; colesterol HDL:42±12mg/dl, 43±15mg/dl, 51±13mg/dl (p<0,05), triglicérides: 161±105mg/dl, 119±60mg/dl e 114±84mg/dl, glicose: 90±15mg/dl, 86±10mg/dl e 89±16mg/dl, HOMA-index: 1,5± 1,1, 1,5±1,0, 1,2 ±0,8 e leptina 2,5±1,7mg/dl, 2,3± 1,5mg/dl, 3,3± 2,1mg/dl (NS), nos grupos 1, 2 e 3, respectivamente. A prevalência de SM foi 33%, 20% e 25%, nos grupos 1, 2 e 3, respectivamente. DISCUSSÃO: Na maioria dos parâmetros, não se encontrou diferença significativa entre os grupos, todavia observou-se perfil metabólico mais desfavorável, no grupo 1. Diferença significativa nos níveis de HDL colesterol e na circunferência abdominal bem como maior prevalência de SM em usuários de antipsicóticos típicos sugerem possível relação desses transtornos metabólicos e o uso desse tipo de droga. Todavia, existe a possibilidade de que o sedentarismo e o ganho de peso que estão ligados à doença psiquiátrica de base e não o tipo de tratamento em si possam ser a causa do transtorno metabólico. CONCLUSÃO: Os achados sugerem que usuários de antipsicóticos apresentam maior prevalência de SM. A ampliação do número de indivíduos avaliados poderá esclarecer a possível relação entre o tipo de medicação anti-psicótica e a SM

Building an antimicrobial stewardship program: A narrative of six years under the Donabedian perspective

Introduction: Antimicrobial resistance (AMR) is increasing and represents one of the world’s major challenges. AMR increase morbimortality, length of hospital stay and costs. Antimicrobial Stewardship Programs (ASP) are one of the key strategies to promote the rational use of antimicrobials since AMR is mostly driven by antimicrobial consumption.Objective: To describe the ASP implementation in a teaching hospital from the perspective of Donabedian quality assessment and the Brazilian regulatory requirements.Method: This was a descriptive study with secondary data collection, including document review of the ASP. The study setting was a general public 392-bed hospital. The ASP activities were performed by the hospital infection control committee (HICC), hospital pharmacy (HP) and diagnostic support laboratory (DSL). The description of the three services mainly involved in the ASP was based on a quality assessment model involving the dimensions of “structure”, “process” and “result” proposed by Donabedian. The distribution among dimensions was guided by the checklist of essential elements of the ASP that compose the Brazilian regulatory requirements. The checklist was applied in July, 2022, and the ASP results described from 2016 to 2021.Results: ASP actions have been gradually implemented since 2008 with the implementation of HICC and improved over the years. Regarding structure, the investments in technology were mapped, quantifying 26 computers and three software programs employed to computerize the ASP processes performed in specific physical areas by HICC, HP and DSL. Institutional guidelines used by HICC, HP and DSL guided clinical practices to operationalize ASP. The evaluation metrics improved for 10 indicators and worsened for four indicators. From the 60 items composing the checklist, the hospital met the requirements in 73.3% of the items (n = 44).Conclusion: This study described the implementation of ASP in a teaching hospital, applying the Donabedian perspective. Although the hospital still does not have a classic ASP model, there were investments to improve structure, processes and results, aiming to comply with international guidelines. A high proportion of key elements of ASP in the hospital were followed according to the Brazilian regulatory requirements. Aspects related to antimicrobial consumption and the emergence of microbial resistance deserve further investigations

Frequency and characteristics of diarrhoeagenic Escherichia coli strains isolated from children with and without diarrhoea in Rio de Janeiro, Brazil

The frequency of diarrhoeagenic Escherichia coli (DEC) strains was investigated in 253 children up to 3 years old, with (patient group, PG, 199 children) and without (control group, CG, 54 children) diarrhoea, living in Rio de Janeiro, Brazil. DEC strains were detected in 70 (27.6%) children, including 54 (27.1%) with diarrhoea and 16 (29.6%) without diarrhoea. Enteroaggregative E. coli (EAEC) was the most frequent DEC category, accounting for 14.6% of the isolates in the PG and for 11.1% in the CG. E. coli strains carrying enteropathogenic E. coli (EPEC) virulence markers showed higher incidence in the CG (12.9%) than in the PG (8.0%). E. coli strains belonging to non-classical, EPEC groups that carried eae only or eae and bfpA, designated as attaching-effacing E. coli (AEEC) were the most frequent (79.1%). Simultaneous presence of multiple EPEC virulence factors (EAF/eae/bfpA) were only detected among strains isolated from the PG. Enterotoxigenic E. coli (ETEC) strains were isolated from 5.5% of the children in the CG and from 3.5% of those in the PG. Most of the ETEC isolates were LT-probe positive (70%) and none carried both LT-I and ST-I probe sequences. One enteroinvasive E. coli (EIEC) strain was recovered from a child with diarrhoea. No stx-probe positive E. coli strains were detected. Overall, DEC strains were not found to be significantly associated with diarrhoea (p > 0.05). However, the higher incidence of EAEC, the most frequent DEC category, among children with diarrhoea, suggests a potential role of EAEC as an important enteric pathogen in the community investigated. (C) 2003 the British Infection Society. Published by Elsevier B.V. All rights reserved.Escola Nacl Saude Publica, Fdn Oswaldo Cruz, Lab Epidemiol Mol, BR-148060 Rio de Janeiro, RJ, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, SP, BrazilUniv Estado Rio de Janeiro, Rio de Janeiro, RJ, BrazilInst Adolfo Lutz Registro, São Paulo, SP, BrazilUniv Fed Rio de Janeiro, Rio de Janeiro, RJ, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, SP, BrazilWeb of Scienc

ENTREVISTA COM MARIA HELENA VIEIRA-ABRAHÃO: SOBRE FORMAÇÃO DE PROFESSORES E ENSINO-APRENDIZAGEM DE LÍNGUA INGLESA

Esta entrevista foi concedida ao PIBID-UNEMAT, Subprojeto de Letras - Língua Inglesa e realizada na data de 04 de outubro de 2013 pelos alunos-bolsistas, supervisoras e coordenadora de área. Nossos sinceros agradecimentos à professora que muito gentilmente compartilhou sua sabedoria com um sorriso sincero

Nachhaltige unterirdische Raumplanung für die Energiewende und Spätfolgen des Bergbaus : Konsequenzen aus dem Garzweiler-Urteil des BVerfG

Chlorophenylpiperazines (CPP) are psychotropic drugs used in nightclub parties and are frequently used in a state of sleep deprivation, a condition which can potentiate the effects of psychoactive drugs. This study aimed to investigate the effects of sleep deprivation and sleep rebound (RB) on anxiety-like measures in mCPP-treated mice using the open field test. We first optimized our procedure by performing dose-effect curves and examining different pretreatment times in naïve male Swiss mice. Subsequently, a separate cohort of mice underwent paradoxical sleep deprivation (PSD) for 24 or 48h. In the last experiment, immediately after the 24h-PSD period, mice received an injection of saline or mCPP, but their general activity was quantified in the open field only after the RB period (24 or 48h). The dose of 5mgmL(-1) of mCPP was the most effective at decreasing rearing behavior, with peak effects 15min after injection. PSD decreased locomotion and rearing behaviors, thereby inhibiting a further impairment induced by mCPP. Plasma concentrations of mCPP were significantly higher in PSD 48h animals compared to the non-PSD control group. Twenty-four hours of RB combined with mCPP administration produced a slight reduction in locomotion. Our results show that mCPP was able to significantly change the behavior of naïve, PSD, and RB mice. When combined with sleep deprivation, there was a higher availability of drug in plasma levels. Taken together, our results suggest that sleep loss can enhance the behavioral effects of the potent psychoactive drug, mCPP, even after a period of rebound sleep.4970-