Evaluation of adherence to treatment by patients seen in a psychosocial care center in northeastern Brazil

No tratamento de desordens mentais, a não-adesão ao tratamento ocorre em cerca de 50% dos casos e é responsável por inúmeros prejuízos, além de ser a principal causa de morbidade psiquiátrica. O presente estudo objetivou avaliar a adesão ao tratamento medicamentoso de pacientes atendidos em um Centro de Atenção Psicossocial (CAPS) no Nordeste do Brasil. A avaliação da adesão ao tratamento foi feita através dos testes de Haynes-Sackett e Morisky-Green-Levine. Todos os pacientes cadastrados no CAPS foram incluídos no estudo (n = 101). Observou-se que apenas 11,88% dos pacientes aderiram ao tratamento medicamentoso. As principais razões para o não uso dos medicamentos foram: esquecimento (68,83%), sentir-se mal após a ingestão de medicamentos (54,22%), não ter dinheiro para comprar medicamentos (43,83%), não encontrar os medicamentos no serviço público de saúde (39,94%) e medo dos danos causados pelos medicamentos (28,90%). Além disso, observou-se que 85,1% dos pacientes não conheciam suas doenças, 88,1% não conheciam seus tratamentos, 86,4% não se sentiam bem quando usavam medicamentos e 88,1% usavam os medicamentos incorretamente. Os resultados demonstram que a falta de informação sobre doenças e medicamentos, os danos decorrentes da terapia medicamentosa e o baixo acesso aos medicamentos comprometem a adesão ao tratamento e, consequentemente, a eficácia do tratamento.In the treatment of mental disorders, nonadherence to medication, the main cause of psychiatric morbidity, is observed in about 50% of the cases and is responsible for numerous losses. This study evaluated adherence to drug treatment by patients seen in a Psychosocial Care Center (CAPS) in northeastern Brazil. Adherence to treatment was evaluated using the Haynes-Sackett and Morisky-Green-Levine tests. All patients registered in the CAPS were included in the study (n= 101). Only 11.88% of the patients adhered to drug treatment. The main reasons not to use medication were: oblivion (68.83%), feeling unwell after taking the medication (54.22%), not having money to buy the medication (43.83%), not finding the medication in the public health service (39.94%) and fear of harm that might be caused by the drug (28.90%). Furthermore, 85.1% of the patients did not know their diseases, 88.1% did not know their treatment, 86.4% did not feel good when they took their medication, and 88.1% took their medication incorrectly. The results revealed that the lack of information about diseases and drugs used, the nuisance posed by drug therapy and the low access to medications reduce adherence to treatment and, consequently, treatment effectiveness

COVID-19 Mortality and Case-Fatality Rates in Sergipe State, Northeast Brazil, From April to June 2020

Information on how coronavirus disease 2019 (COVID-19) mortality is related to population characteristics in low- and middle-income countries is still limited. We described the deaths from COVID-19 in Sergipe state, Northeast Brazil, from April 2 to June 27, 2020. For this purpose, we conducted a study composed of (i) a case series study of all deaths due to COVID-19 and (ii) a population-based study to verify the behavior of the mortality and case-fatality rates (CFR) related to COVID-19. Data from 605 deaths due to COVID-19 were used to describe the characteristics of individuals with the disease, as well as the differences in gender, age, and comorbidities. Additionally, population data were extracted to estimate the mortality and CFR by population stratum. We also performed an adjusted CFR analysis including a time lag of 14 days between the onset of symptoms and reporting deaths. Of the 605 patients included in this study, 321 (53.1%) were males and the median age was 67.0 years. Most patients (n = 447, 73.9%) who died from COVID-19 had at least one pre-existing clinical condition. The mortality rate was 29.3 deaths per 100,000 inhabitants and the crude CRF was 2.6% (95% CI 2.4–2.8). CFR was higher in males (3.1%, 95% CI 2.8–3.4; p < 0.001) and people aged =60 years (14.2%, 95% CI 13.0–15.6; p = 0.042). About 25% of patients died during the first 24-h post-hospital admission. The adjusted CFR for a 14-day time lag was ~2-fold higher than the crude CFR over the study period.We dedicated this article to all health professionals who are facing COVID-19. This study was part of the EpiSERGIPE project. NM thanks the Portuguese Foundation for Science and Technology under the Horizon 2020 Program (PTDC/PSI-GER/280 76/2017)

Volatile constituents and behavioral change induced by Cymbopogon winterianus leaf essential oil in rodents

Cymbopogon winterianus Jowitt (‘Java citronella’) is an important essential oil yielding aromatic grass cultivated in India and Brazil and its volatile essential oils extracted from its leaves are used in perfumery, cosmetics, pharmaceuticals and flavoring industries. However, there is no report on any psychopharmacological study of C. winterianus leaf essential oil (LEO) available to date. In this study, the pharmacological effects of the LEO were investigated in animal models and its phytochemical analyses. GC-MS analysis showed a mixture of monoterpenes, as citronellal (36.19%), geraniol (32.82%) and citronellol (11.37%). LEO exhibited an inhibitory effect on the locomotor activity of mice, an antinociceptive effect by increasing the reaction time in the writhing and capsaicin tests. All doses induced a significant increase in the sleeping time of animals not having modified however, the latency. The LEO did not alter the remaining time of the animals on the rota-rod apparatus. These results suggest a possible central effect.Key words: Cymbopogon winterianus, essential oil, CNS, behavioral effects, analgesic

A Systematic Review for Anti-Inflammatory Property of Clusiaceae Family: A Preclinical Approach

Background. Clusiaceae family (sensu lato) is extensively used in ethnomedicine for treating a number of disease conditions which include cancer, inflammation, and infection. The aim of this review is to report the pharmacological potential of plants of Clusiaceae family with the anti-inflammatory activity in animal experiments. Methods. A systematic review about experiments investigating anti-inflammatory activity of Clusiaceae family was carried out by searching bibliographic databases such as Medline, Scopus and Embase. In this update, the search terms were “anti-inflammatory agents,” “Clusiaceae,” and “animals, laboratory.” Results. A total of 255 publications with plants this family were identified. From the initial 255 studies, a total of 21 studies were selected for the final analysis. Studies with genera Allanblackia, Clusia, Garcinia or Rheedia, and Hypericum showed significant anti-inflammatory activity. The findings include a decrease of total leukocytes, a number of neutrophils, total protein concentration, granuloma formation, and paw or ear edema formation. Other interesting findings included decreased of the MPO activity, and inflammatory mediators such as NF-κB and iNOS expression, PGE2 and Il-1β levels and a decrease in chronic inflammation. Conclusion. The data reported suggests the anti-inflammatory effect potential of Clusiaceae family in animal experiments

Flavonoids: Promising Natural Products for Treatment of Skin Cancer (Melanoma)

Melanoma, which is the most malignant skin cancer type, has got one of the fastest increasing incidence rates of all cancer types in the world. When belatedly diagnosed, melanoma is extremely invasive and metastatic. Although there are effective drugs used to treat melanoma, some cell lines have proven resistant to chemotherapy. In this context, several research groups on natural products have investigated the anticancer effect of new natural molecules in the treatment of melanoma. Flavonoids have shown to play an important role in chemoprevention and inhibition of the proliferation, migration, and invasion of melanoma cells. In this chapter, we present a systematic review performed through a literature search over a period of 20 years, using specialized databases. Analysis of all selected manuscripts demonstrated that at least 97 flavonoids have already been investigated for the treatment of melanoma using in vitro or in vivo models. Most of the bioactive flavonoids belong to the classes of flavones (38.0%), flavonols (17.5%), or isoflavonoids (17.5%). Apigenin, diosmin, fisetin, luteolin, and quercetin were considered as the most studied flavonoids for melanoma treatment. In general, flavonoids have shown to be a promising source of molecules with great potential for the treatment of melanoma

Carvacrol, (-)-borneol and citral reduce convulsant activity in rodents

Carvacrol, a monoterpenic phenol present in essential oils of the Labiatae family, has been used through the ages as a source of flavor in food and for medicinal purposes. Borneol is a monoterpene found in several species of Artemisia and Dipterocarpaceae, used for anxiety, pain and anesthesia in traditional Chinese. Citral, a mixture of two geometrical isomers (neral and geranial), is one of the most important compounds in some citrus oils and has central nervous system (CNS) properties. The anticonvulsant effect of carvacrol (CARV), (-)-borneol (BOR) and citral (CIT) was investigated in two animal models of epilepsy. Mice were pretreated with CARV, BOR or CIT (50, 100, and 200 mg/kg, i.p.) 30 min before pentylenetetrazole (PTZ) or maximal electroshock (MES) tests, the two most important animal epilepsy tests. The latency for development of convulsions and protection percentage was recorded. In order to investigate the involvement of GABAergic system, flumazenil was utilized. These monoterpenes, CARV in a higher, but not in a lower dose (p &lt; 0.001), BOR and CIT in all doses (p &lt; 0.05 or p &lt; 0.001), were capable of promoting an increase of latency for the development of convulsions induced by PTZ. Additionally, these compounds were efficient in preventing the tonic convulsions (p &lt; 0.05) induced by MES. However, the GABAergic neurotransmitter system might be involved, at least in BOR effects. Henceforth, our results suggest that CARV, BOR and CIT possess anticonvulsant activity effect against PTZ-induced convulsions and MES.Key words: Carvacrol, (-)-borneol, citral, anticonvulsant activit

Natural Products as Promising Pharmacological Tools for the Management of Fibromyalgia Symptoms – A Review

Fibromyalgia (FM) is the second most common rheumatologic disorder, affecting 5% of the world population, and has a serious effect on the quality of life of patients, as well as an economic impact through lost workdays. This pain syndrome is a common cause of chronic widespread pain and is characterized by reduced pressure pain thresholds with hyperalgesia and allodynia, nonrestorative sleep, fatigue, cognitive dysfunction, and mood disturbances. The pharmacological treatment strategies for FM include the use of antidepressants, calcium channel modulators, muscle relaxants, and analgesics but have shown limited efficacy and therapeutic adherence. Thus, researchers have been seeking potential substances (new chemical entities or through drug repositioning) that could be used for FM treatment. In this context, natural products (NPs) have been shown to be promising pharmacological tools due to the variety of their pharmacological activity and the number of molecular sites available as possible active targets. Recent clinical and preclinical studies have been conducted to verify the possible applicability of NPs such as essential oils (EOs), plants extracts, terpenes, sapogenins, and alkaloids in the treatment of FM. The results have shown that natural products have an analgesic effect in different animal models of FM, probably by activation of inhibitory descending pathways, such as the periaqueductal gray and rostroventromedial medulla. Natural products and their secondary metabolites could therefore be a promising source for FM management. However, translational studies that seek to validate the preclinical studies are scarce, incipient, and lacking an approach focused on the traditional pharmaceutical market

Acute effects of a typical rhythmic gymnastic training session on physiological parameters in Olympic athletes

The aim of this study was to evaluate the effects of a day with two separate training sessions (morning and afternoon) of rhythmic gymnastics on erythrocytes, leukocytes, muscle damage, oxidative stress, and hydration of Brazilian team [age 17.7 (±1.1) years; body height 165 (±0.5) cm; body mass 49.7 (±4.2) kg]. Heart rate and session-ratings of perceived exertion were used to monitor training intensity. Blood samples were collected immediately before (M1) and after (M2) the training day for analyzing erythrocytes, leukocytes, plasma creatine kinase activity, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, ferric reducing ability plasma, thyroid-stimulating hormone, and free T4. Saliva was collected for cortisol analysis. After 24 hours rest (M3), blood collection was performed to analyze creatine kinase and lactate dehydrogenase. The moderate-intensity training day induced significant elevations of total leukocytes (5,163.3 to 9,617.8), lymphocytes (1,752.7 to 2,729.7), neutrophils (2,873.9 to 6,163.6), monocytes (255.7 to 519.1), platelets (280,000.0 to 300,666.7), aspartate aminotransferase (13.1 to 25.6), lactate dehydrogenase (102.5 to 249.1), thyroid-stimulating hormone (1.0 to 3.2), and ferric reducing ability plasma (136.8 to 165.4), as well as significant reductions in red cells (4,691,111.1 to 4,497,777.8), hematocrit (42.1 to 39.3), and hemoglobin (12.9 to 12.5) at M2. There were also significant increases in creatine kinase (144.2 to 519.3) and lactate dehydrogenase (102.5 to 538.2) at M3. The average dehydration rate was 1.3%. A moderate-intensity day of training in rhythmic gymnastics of 8h21min duration caused hemolysis, leukocytosis, muscle damage, redox status perturbations, and insufficient hydration status. These findings show that athletes are exposed to physiological vulnerabilities that can possibly harm their performance and health

Atividade antinociceptiva e estudo toxicológico de extrato aquoso de Egletes viscosa Lessa (Asteraceae)

Egletes viscosa Less (Asteraceae), popularmente conhecida como "macela" ou "macela-da-terra", é uma planta largamente usada na medicina popular devido as suas propriedades: anti-inflamatória, bactericida, antidiarréica, mio-relaxante, anti-espasmódica, antinociceptiva, digestiva e anti-viral. Análise fitoquímica do extrato aquoso da Egletes viscosa (AEEV) mostrou elevada presença de flavonóides. Este estudo examinou o potencial antinociceptivo do AEEV em roedores usando diferentes concentrações (100, 200 and 400 mg/kg, p.o.). Os resultados mostraram significante efeito antinociceptivo quando testadas as doses (200 mg/kg-pEgletes viscosa Less (Asteraceae), popularly known as "macela" or "macela-da-terra", is a plant widely used in popular medicine due to its anti-inflammatory, bactericidal, antidiarrhoea, mio-relaxant, antispasmodic, antinociceptive, digestive, and anti-viral properties. Phytochemical screening of aqueous extract of Egletes viscosa (AEEV) revealed the high presence of flavonoids. This study examined the oral antinociceptive potential of AEEV in rodents using different concentrations (100, 200, and 400 mg/kg, p.o.). The results showed significant antinociceptive action when tested in writhing (200 and 400 mg/kg-

Prospecção tecnológica do uso da prata contra microorganismos nocivos em sistemas de água

A água, apesar de hoje ser um elemento indispensável à vida, é também uma fonte de contaminação e veículo de transmissão de doenças. As pesquisas e tecnologias realizadas para tratamento de água são inúmeras e tornam-se uma preocupação constante dos pesquisadores. Nesse contexto, um elemento estudado e com seus efeitos antimicrobianos bem conhecidos é a prata (Ag). Assim, esse estudo objetivou a realização de uma prospecção tecnológica nas bases patentearias nacional e mundial, a fim de caracterizar as pesquisas que estão sendo realizadas com o uso da prata nesse meio. O estudo mostrou um acentuado avanço tecnológico na área de tratamento de água, sendo os Estados Unidos o país que mais deposita patentes. Entretanto, quando a pesquisa refere-se à tratamento de água com prata, o número de patentes é extremamente reduzido, tornando o seu uso uma lacuna tecnológica a ser explorada