Knowledge about aids and drugs among undergraduate students in a higher education institution in the state of Paraná El conocimiento sobre sida y drogas entre alumnos de graduación de una institución de enseñanza superior en el estado de Paraná Conhecimento sobre aids e drogas entre alunos de graduação de uma instituição de ensino superior do estado do Paraná

The main objective of this study was to measure the knowledge of undergraduate nursing students about Acquired Immunodeficiency Syndrome (AIDS) and drugs. The study was carried out in 2007 with a random sample of 289 undergraduate students at a State University in the Northwest of Paraná, Brazil. The students self-applied a questionnaire validated by experts. Questions were divided into three levels of complexity: low, average and high. The level of correct answers was higher in the questions of low complexity, diminishing as the questions' complexity increased. Thirteen percent of questions concerning risk factors and vulnerability to HIV infection among injection drug users (IDU) and biological material for diagnosis of AIDS was correctly answered by 90% of students. Students possessed knowledge concerning AIDS and drugs, however such knowledge was considered insufficient, showing lack of information and gaps in education with a dissociation of interdisciplinary and inter-curricular content.<br>Este trabajo tuvo como principal objetivo investigar el conocimiento de universitarios sobre el síndrome de inmunodeficiencia adquirida (SIDA) y drogas. La investigación se realizó en el año 2007 a partir de una muestra aleatoria de 289 alumnos de los cursos de graduación de una facultad estatal de la región noroeste de Paraná, en Brasil. Los alumnos respondieron un cuestionario auto aplicable, validado por especialistas del área. Las preguntas fueron divididas en tres niveles de complejidad: baja, media y alta. El índice de aciertos de los alumnos fue mayor en las preguntas de baja complejidad, disminuyendo con el aumento del grado de complejidad. El índice de 90% de aciertos ocurrió en 13% de las preguntas, que se referían a los factores de riesgo y vulnerabilidad para la infección por el virus de la inmunodeficiencia humana (HIV) en usuarios de drogas inyectables (UDI) y el material biológico para el diagnóstico de SIDA. Los alumnos poseían conocimientos sobre SIDA y drogas, sin embargo, este es insuficiente, demostrando falta de información y vacíos en la enseñanza, con disociación de contenidos interdisciplinares e intercurriculares.<br>Este trabalho teve como principal objetivo investigar o conhecimento de universitários sobre a síndrome de imunodeficiência adquirida (AIDS) e drogas. Realizou-se a pesquisa no ano 2007 a partir de amostra aleatória de 289 alunos dos cursos de graduação de uma faculdade estadual da região noroeste do Paraná. Os alunos responderam um questionário autoaplicável, validado por especialistas na área. As questões foram divididas em três níveis: baixa, média e alta complexidade. O índice de acertos dos alunos foi maior nas questões de baixa complexidade, diminuindo com o aumento do grau de complexidade. O índice de 90% de acertos ocorreu em 13% das questões, que se referiam aos fatores de risco e vulnerabilidade para a infecção pelo vírus da imunodeficiência humana (HIV) em usuários de drogas injetáveis (UDI) e o material biológico para o diagnóstico de AIDS. Os alunos possuíam conhecimento sobre AIDS e drogas, porém, insuficiente, demonstrando falta de informação e lacunas no ensino, com dissociação de conteúdos interdisciplinares e intercurriculares

Population pharmacokinetics of (R)-, (S)- and rac-methadone in methadone maintenance patients

The definitive version is available at www.blackwell-synergy.com.AIM: To construct a population pharmacokinetic model for methadone enantiomers in the setting of methadone maintenance treatment for opioid dependence. METHODS: A population pharmacokinetic model was developed using P-Pharm software for rac-, (R)- and (S)-methadone using data (8–13 plasma samples per subject) obtained from 59 methadone maintenance patients during one interdosing interval at steady state. The patients were randomly assigned to either a development (n = 38) or a validation dataset (n = 21). The model was refined by inclusion of all subjects to construct a final basic model, which was used to construct a covariate model. RESULTS: A population-based two-compartment open model with first-order absorption and lag time was developed and validated for all analytes. The population geometric mean (coefficient of variation) of maximum a posteriori probability Bayesian estimated values for clearance, terminal half-life and volume of distribution at steady-state of the active (R)-enantiomer were 8.7 (42%) l h1, 51 (45%) h and 597 (45%) l, respectively. For all analytes, the volume of the central compartment was decreased with increasing plasma α1-acid glycoprotein concentration and was lower in females, while the delay in absorption was longer at higher doses. No covariates were identified for apparent oral clearance. The apparent oral clearance of (R)-methadone (geometric mean ratio; 95% confidence interval) was 105% (99, 110), that of (S)-methadone (P = 0.19), while (R)-methadone Vc/F (154%; 151, 157), Vdss /F (173%; 164, 183), t1/2 (162%; 153, 172) and mean residence time (166%; 156, 176) were significantly greater (P < 0.0001) than for (S)-methadone. The population pharmacokinetic models were able to predict accurately oral clearance values from limited (one or two samples) blood sampling protocols. CONCLUSIONS: The substantial stereoselectivity in methadone disposition reinforces the potential for misinterpretation of racemic methadone disposition data. The marked interindividual variability in (R)-methadone clearance, with no covariates identified, highlights the need for alternative methods to determine an individual's metabolic clearance. The ability to predict (R)-methadone clearance from one to two blood samples at steady state may prove clinically useful if a drug–drug interaction or poor adherence are suspected and guide the prescriber in deciding if a client's request for a dose increase is warranted or whether an alternative opioid would be more appropriate.David J. R. Foster, Andrew A. Somogyi, Jason M. White and Felix Bochne

Revisitando o desmame precoce através de recortes da história Revisando el destete precoz a través de recortes de la historia Revisiting early weaning through historical analysis

A ação básica de saúde requer estratégia direcionada quanto à tomada de consciência da importância do aleitamento materno, principalmente para redução da morbi-mortalidade infantil. A história da amamentação mostra um hiato sobre como os povos lidaram com o desmame precoce. Objetiva-se, neste estudo, revisitar o desmame precoce através de recortes históricos. A revisão bibliográfica foi a estratégia utilizada para este estudo. A amostra constou de livros, monografias, teses, dissertações, textos publicados em revistas científicas e artigos captados via Internet, no período de 1978 a 1998, os quais retratam histórias desde a época mitológica até os séculos atuais. A revisão apontou que o desmame é sócio-culturalmente construído e determinado e que a mulher, para manter o aleitamento materno, necessita não só de suporte/apoio familiar e social, mas também governamental.<br>La acción básica de salud requiere estrategias dirigidas hacia la toma de conciencia de la importancia del amamantamiento materno principalmente para la disminución de la morbi-mortalidad infantil. La historia del amamantamiento muestra un vacío acerca de cómo los pueblos lidiaron con el destete precoz. El presente estudio pretende revisar el destete precoz a través de recortes históricos. La revisión bibliográfica fue la estrategia utilizada para el estudio. La muestra estuvo compuesta por libros, monografías, tesis, disertaciones, textos publicados en las revistas científicas capturados a través de Internet en el periodo de 1978 a 1998, los cuales retratan la historia desde la época mitológica hasta los siglos más actuales. La revisión mostró que el destete es socialmente construido y determinado y que la mujer para mantener la lactancia materna necesita no solo de soporte familiar y social si no también del apoyo gubernamental.<br>Basic health actions require strategies towards awareness development concerning the importance of breastfeeding, particuarly aiming at the reduction of child morbi-mortality The history of breastfeeding presents a gap of information about how people have dealt with early weanin. This study aimed at revisiting early weaning the historical analysis of breastfeeding. The literture review methodology was used. The samples consisted of books, monographs, theses, dissertations, texts published in scientific journals and scientific articles obtained through the internet in the period of 1978 to 1998. These sources portray stories from mythological times up to this day. The review pointed out that weaning is socially and culturally constructed and determined and that, in order to maintain breastfeeding, women require not only social and family support, but also governmental support