20 research outputs found
Aspects of self-medication in Brazil
INTRODUÇÃO: Os dados apresentados fazem parte de um estudo multicêntrico sobre automedicação na América Latina realizado pela Organização Mundial de Saúde (OMS). Objetivou-se traçar um perfil da automedicação através da análise da procura de medicamentos em farmácias sem prescrição médica ou aconselhamento do farmacêutico/balconista. MATERIAL E MÉTODO: As especialidades farmacêuticas foram classificadas pelo código "Anatomical Therapeutical Classification" e analisadas sob quatro aspectos qualitativos: valor intrínseco, essencialidade (lista da OMS e Relação Nacional de Medicamentos Essenciais (RENAME), combinação em dose fixa e necessidade de prescrição médica. RESULTADOS: Foram solicitadas 5.332 especialidades farmacêuticas (785 diferentes princípios ativos), sendo 49,5% combinações em dose fixas, 53,0% de valor intrínseco não elevado, 44,1% sujeitos a prescrição médica, 71,0% não essenciais e 40,0% baseados em prescrições médicas anteriores. Os medicamentos mais solicitados foram analgésicos (17,3%), descongestionantes nasais (7,0%), antiinflamatório/antireumático e antiinfecciosos de uso sistêmico, ambos com 5,6%. CONCLUSÕES: Os dados sugerem que a automedicação no Brasil reflete as carências e hábitos da população, é consideravelmente influenciada pela prescrição médica e tem a sua qualidade prejudicada pela baixa seletividade do mercado farmacêutico.INTRODUCTION: The data presented are part of a World Health Organization (WHO) multicenter study of self-medication in Latin America. Brazilian sites included: Belo Horizonte, Fortaleza, the city of S. Paulo and outlying locations. The objective was to characterize self-medication practices by analyzing drugs sought by consumers in pharmacies without a physician's prescription. MATERIAL AND METHOD: Drugs were classified according to the Anatomic Therapeutic Classification codes, and analyzed with respect to 1) intrinsic value; 2) recognition as an essential drug (by either WHO or Brazil); 3) number of active ingredients; and 4) requirement for prescription. RESULTS: Five thousand, three hundred and thirty-two (5,332) different drugs, with 785 distinct active ingredients were sought. Of these, 49.5% were fixed dose combinations, 53.0% were of little intrinsic value, 44,1% required a physician's prescription, 71.0% were not essential drugs, and 40.0% of requests were based on prior prescriptions from the physician. The drugs most requested were analgesics (17.3%), nasal descongestants (7.0%), antirheumatic anti-inflamatory drugs (5.6%), and systemic anti-infective drugs (5.6%). CONCLUSIONS: Self-medication in Brazil reflects the needs and habits of the population. It is strongly influenced by physician's-prescribing habits and by the inadequate selectivity of the Brazilian pharmaceutical market
Análise da atividade e gasto fisiológico dos catadores de resíduos sólidos: a percepção da terapia ocupacional
The world’s transformation in the market has been causing changes in the working class. As those changes have come, the market calls for a high capacity from the workers. Due to that, the unemployment rate has increased and induced a new type of class worker: the Recyclable Material Collectors. In this job, the role of the collector is to return the materials to their commodity chain, and to accomplish this, two methods of collecting are used: one with a truck and the other with a manual collector car. This is one type of occupation which has an extenuating work time, where the worker is exposed to a high ergonomic risk. This study, which was labored from a quantitative and qualitative approach to exploratory method and field research, is intended to compare which collecting technique can be less weariness to the worker. To the purpose of comparison of the physiological work weight, the participants used the Polar FT7 frequency counter, which generated, in graphic form, the performance of the collector in both methods. According to the values presented, was concluded that three of the four participants had a higher physiological weariness by using the manual car collecting approach, concluding that this method is the one that brings most effort to the worker. Considering the results obtained in this research, it was possible to observe that the use of the manual car causes a higher damage to the health of the recyclable material collector.A transformação no mundo do trabalho tem causado mudanças no perfil da classe
trabalhadora. Cada vez mais, o mercado de trabalho requer exigências e, como decorrência
disso, a taxa de desemprego aumentou e fez surgir uma nova profissão, a de Catadores de
Materiais Recicláveis. A função do catador é a de devolver os materiais à sua cadeia
produtiva e, para isso, existem dois métodos de coleta: com o caminhão e com o carro manual
de coleta. Essa é uma profissão que possui jornadas de trabalho extenuantes, nas quais o
trabalhador está exposto a riscos ergonômicos. Esse estudo foi elaborado a partir de uma
abordagem quantitativa e qualitativa de método explorátorio e pesquisa de campo; pretende
comparar qual método de coleta causa menos desgaste ao trabalhador. Para fins de
comparação da carga fisiológica do trabalho, os participantes utilizaram o frequencímetro
Polar FT7 que gerou, em forma de gráfico, o desempenho do catador em ambos os métodos
de coleta. De acordo com os valores expostos, avaliou-se que, dos 4 participantes, 3
apresentaram um maior desgaste fisiológico no método de coleta com o carro manual, sendo
esta a forma pela qual o trabalhador realiza mais esforços. Considerando os resultados obtidos
nessa pesquisa, foi possível observar que o uso do carro manual de coleta causa um maior
prejuízo à saúde do catador de materiais recicláveis
Inventory and distribution of Oligochaeta (Annelida, Clitellata) in first-order streams in preserved areas of the state of Minas Gerais, Brazil
Broadband Multi-wavelength Properties of M87 during the 2017 Event Horizon Telescope Campaign
Abstract: In 2017, the Event Horizon Telescope (EHT) Collaboration succeeded in capturing the first direct image of the center of the M87 galaxy. The asymmetric ring morphology and size are consistent with theoretical expectations for a weakly accreting supermassive black hole of mass ∼6.5 × 109 M ⊙. The EHTC also partnered with several international facilities in space and on the ground, to arrange an extensive, quasi-simultaneous multi-wavelength campaign. This Letter presents the results and analysis of this campaign, as well as the multi-wavelength data as a legacy data repository. We captured M87 in a historically low state, and the core flux dominates over HST-1 at high energies, making it possible to combine core flux constraints with the more spatially precise very long baseline interferometry data. We present the most complete simultaneous multi-wavelength spectrum of the active nucleus to date, and discuss the complexity and caveats of combining data from different spatial scales into one broadband spectrum. We apply two heuristic, isotropic leptonic single-zone models to provide insight into the basic source properties, but conclude that a structured jet is necessary to explain M87’s spectrum. We can exclude that the simultaneous γ-ray emission is produced via inverse Compton emission in the same region producing the EHT mm-band emission, and further conclude that the γ-rays can only be produced in the inner jets (inward of HST-1) if there are strongly particle-dominated regions. Direct synchrotron emission from accelerated protons and secondaries cannot yet be excluded
Laboratory observations on predator–prey interactions between the bearded fireworm ( Hermodice carunculata
Oligochaeta (Annelida: Clitellata) em córregos de baixa ordem do Parque Estadual de Campos do Jordão (São Paulo - Brasil)
Incidence, risk factors, and predictors of outcome of candidemia. Survey in 2 Italian university hospitals.
In recent decades, Candida spp. emerged as the fourth most common cause of nosocomial bloodstream infections. The incidence of candidemia was 0.13 per 100 persons. Eighty-three cases (61%) of candidemia were due to Candida albicans and 53 (39%) to nonalbicans Candida spp. Twelve strains of Candida (9%) had shown in vitro resistance to fluconazole, 5 (4%) to itraconazole, 2 (1.5%) to voriconazole, 12 (9%) to 5-flucytosine, and 1 (0.7%) to amphotericin B. Multivariate logistic regression analysis of risk factors showed that length of hospitalization, presence of a central venous catheter, previous episodes of candidemia or bacteremia, parenteral nutrition, and chronic renal failure were variables independently associated with the development of candidemia. Multivariate logistic regression analysis of prognostic indicators showed that the independent variables associated with poor prognosis were inadequate initial therapy (P < .001) and high APACHE III score (P = .004). The inadequate initial therapy associated with mortality indicates the need for additional investigations to define high-risk patients for beneficial antifungal prophylaxis
Predictors of choice of initial antifungal treatment in intraabdominal candidiasis
IAC Study Investigators: F. Ansaldi, C. Scarparo, A. Diaz-Martin, I. Palacios-Garcia, C. Rosin, B. Almirante, G. Baldin, A. Vena, E. Bouza, V. de Egea, C. Tascini, F. Menichetti, E. Tagliaferri, M. Sanguinetti, A. Mesini, G. Sganga, M. Busetti, T. Pumarola, M. T. Martin, S. A. Nouér, T. Pelaez, E. Raise, S. Grandesso, V. Del Bono, P. Esteves, C. Trucchi, A. Sartor, G. De Pascale, B. Posteraro, C. Scarparo, P. Esteves.Intraabdominal candidiasis (IAC) is the second most frequent form of invasive candidiasis, and is associated with high mortality rates. This study aims to identify current practices in initial antifungal treatment (IAT) in a real-world scenario and to define the predictors of the choice of echinocandins or azoles in IAC episodes. Secondary analysis was performed of a multinational retrospective cohort at 13 teaching hospitals in four countries (Italy, Greece, Spain and Brazil), over a 3-year period (2011–2013). IAC was identified in 481 patients, 323 of whom received antifungal therapy (classified as the treatment group). After excluding 13 patients given amphotericin B, the treatment group was further divided into the echinocandin group (209 patients; 64.7%) and the azole group (101 patients; 32.3%). Median APACHE II scores were significantly higher in the echinocandin group (p 0.013), but IAT did not differ significantly with regard to the Candida species involved. Logistic multivariate stepwise regression analysis, adjusted for centre effect, identified septic shock (adjusted OR (aOR) 1.54), APACHE II >15 (aOR 1.16) and presence in surgical ward at diagnosis (aOR 1.16) as the top three independent variables associated with an empirical echinocandin regimen. No differences in 30-day mortality were observed between groups. Echinocandin regimen was the first choice for IAT in patients with IAC. No statistical differences in mortality were observed between regimens, but echinocandins were administered to patients with more severe disease. Some disagreements were identified between current clinical guidelines and prescription of antifungals for IAC at the bedside, so further educational measures are required to optimize therapies.MB serves on scientific advisory boards for Pfizer Inc, Merck Serono and Astellas Pharma Inc.; has received funding for travel or speaker honoraria from Pfizer Inc., Merck Serono, Gilead Sciences, Teva Inc. and Astellas Pharma Inc. ALC serves on scientific advisory boards for MSD and has received funding for continuing education programmes from Pfizer Inc., Gilead Sciences, United Medical, MSD and Astellas Pharma Inc. CT has been paid for lectures on behalf of Pfizer, Novartis, MSD, AstraZeneca, Zambon and Astellas