Fitovigilância: avaliação das interações e reações adversas de fitoterápicos no mercado

Introduction: The use of medicinal plants as active plant pharmaceutical ingredients (APPIs) as well as the use of herbal medicines and their associations with other herbal medicines and synthetic active pharmaceutical ingredients (API) can result in interactions that affect the efficacy and safe use of these. The main means of reporting adverse drug reactions (ADR) is voluntary, which makes the identification and monitoring of these ADRs difficult and portrays the importance of pharmacovigilance in our country, highlighting the need to strengthen the culture of reporting adverse drug events (ADE). Objective: To analyze the occurrence of ADR related to the simultaneous use of five herbal medicines with other synthetics, describing possible synthetic APPI-API interactions. Method: A literature search was carried out on synthetic APPI-API interactions and their notifications of ADR by the main pharmacovigilance systems in the world. Results: The main interaction mechanisms between synthetic APPI-API involve the metabolism by enzymes of the CYP450 family or the action of efflux transporters such as P-gp. In addition, a large part of phytotherapeutic AEM may not be being notified, generating possible underreporting of this information in the world. Conclusions: On ADR containing APPI from Ginkgo biloba, Hypericum perforatum, Matricaria recutita, Allium sativum and Zingiber officinale, 7,571 were reported worldwide, classified by continent, in the period 1971 to August 2021, as well as the list of plant species on the list of RENISUS that have reported effects on CYP enzymes (1A2, 2C9, 2C19, 2D6 and 3A4), levels of GSH, UGT and P-gp activity.Introdução: O uso de plantas medicinais como insumos farmacêuticos ativos vegetais (IFAV), bem como o uso de fitoterápicos e suas associações com outros medicamentos fitoterápicos e os insumos farmacêuticos ativos (IFA) sintéticos, pode resultar em interações que afetem a eficácia e o uso seguro desses. O principal meio de notificações de reação adversa a medicamento (RAM) é a voluntária, o que dificulta a identificação e o monitoramento dessas RAM e retrata a importância da farmacovigilância em nosso país, realçando a necessidade de fortalecimento da cultura de notificação de eventos adversos a medicamentos (EAM). Objetivo: Analisar a ocorrência de RAM relacionada ao uso simultâneo de cinco fitoterápicos a outros sintéticos, descrevendo as possíveis interações IFAV-IFA sintéticos. Método: Foi realizada pesquisa bibliográfica sobre as interações IFAV-IFA sintéticos e suas notificações de RAM pelos principais sistemas de farmacovigilância do mundo. Resultados: Os principais mecanismos de interação entre IFAV-IFA sintéticos envolvem a metabolização pelas enzimas da família CYP450 ou a ação de transportadores de efluxo como a gp-P. Além disso, grande parte dos EAM fitoterápicos podem não estar sendo notificados, gerando possível subnotificação dessas informações no mundo. Conclusões: Sobre RAM contendo IFAV de Ginkgo biloba, Hypericum perforatum, Matricaria recutita, Allium sativum e Zingiber officinale, foram relatados 7.571 no mundo, classificados por continente, no período de 1971 a agosto de 2021, bem como lista de espécies vegetais da lista do Renisus que apresentam efeitos relatados nas enzimas CYP (1A2, 2C9, 2C19, 2D6 e 3A4), níveis de GSH, UGT e atividade da gp-P.

O PCB e a modernização midiática: propostas para a análise das relações entre comunistas e a televisão nos anos 1970

This article aims to discuss the participation of the Brazilian Communist Party (PCB), through its militants in a specific context of modernization media - the changing profile of the Brazilian television in the 1970s – that coincided with the “institutionalization” of Communists in government bodies and media organizations. We will analyze the relationship between professional artists and intellectuals with the Communist television, to not only ask whether this process was “infiltration” or if there was “co-option” but to highlight how they were ambiguous and mutually constitutive articulations such existing political practices, ie showing the dialectic between them.Este artigo tem o objetivo de discutir a participação do Partido Comunista Brasileiro (PCB), por meio de seus militantes, numa específica conjuntura de modernização midiática – a mudança de perfil da televisão brasileira na década de 1970 –, fato que coincidiu com a “institucionalização” de comunistas em órgãos estatais e nas organizações midiáticas. Analisaremos as relações profissionais entre intelectuais e artistas comunistas e a televisão, a fim de indagar até que ponto esse processo pode ser compreendido em torno da dicotomia “infiltração” ou “cooptação”, destacando como foram ambíguas e mutuamente constitutivas as articulações existentes entre tais práticas políticas, ou seja, mostrando a dialética entre elas. Este artículo tiene por objeto analizar la participación del Partido Comunista Brasileño (PCB), a través de sus militantes en un contexto específico de modernización de los medios de comunicación - el perfil cambiante de la televisión brasileña en la década de 1970 - que coincidió la “institucionalización” los comunistas en los órganos de gobierno y medios de comunicación. Vamos a analizar la relación entre artistas profesionales y los intelectuales con la televisión comunista, no sólo para preguntar si este proceso fue la “infiltración” o si hubo “cooptación”, pero para destacar la forma en que eran ambiguas y mutuamente constitutiva articulaciones tales prácticas políticas existentes, es decir, que muestra la dialéctica entre ellos

O PCB e a modernização midiática: propostas para a análise das relações entre comunistas e a televisão nos anos 1970

This article aims to discuss the participation of the Brazilian Communist Party (PCB), through its militants in a specific context of modernization media - the changing profile of the Brazilian television in the 1970s – that coincided with the “institutionalization” of Communists in government bodies and media organizations. We will analyze the relationship between professional artists and intellectuals with the Communist television, to not only ask whether this process was “infiltration” or if there was “co-option” but to highlight how they were ambiguous and mutually constitutive articulations such existing political practices, ie showing the dialectic between them.Este artículo tiene por objeto analizar la participación del Partido Comunista Brasileño (PCB), a través de sus militantes en un contexto específico de modernización de los medios de comunicación - el perfil cambiante de la televisión brasileña en la década de 1970 - que coincidió la “institucionalización” los comunistas en los órganos de gobierno y medios de comunicación. Vamos a analizar la relación entre artistas profesionales y los intelectuales con la televisión comunista, no sólo para preguntar si este proceso fue la “infiltración” o si hubo “cooptación”, pero para destacar la forma en que eran ambiguas y mutuamente constitutiva articulaciones tales prácticas políticas existentes, es decir, que muestra la dialéctica entre ellos.Este artigo tem o objetivo de discutir a participação do Partido Comunista Brasileiro (PCB), por meio de seus militantes, numa específica conjuntura de modernização midiática – a mudança de perfil da televisão brasileira na década de 1970 –, fato que coincidiu com a “institucionalização” de comunistas em órgãos estatais e nas organizações midiáticas. Analisaremos as relações profissionais entre intelectuais e artistas comunistas e a televisão, a fim de indagar até que ponto esse processo pode ser compreendido em torno da dicotomia “infiltração” ou “cooptação”, destacando como foram ambíguas e mutuamente constitutivas as articulações existentes entre tais práticas políticas, ou seja, mostrando a dialética entre elas.

Determinants of HIV late presentation among men who have sex with men in Portugal (2014–2019): who’s being left behind?

IntroductionHIV late presentation (LP) remains excessive in Europe. We aimed to analyze the factors associated with late presentation in the MSM population newly diagnosed with HIV in Portugal between 2014 and 2019.MethodsWe included 391 newly HIV-1 diagnosed Men who have Sex with Men (MSM), from the BESTHOPE project, in 17 countrywide Portuguese hospitals. The data included clinical and socio-behavioral questionnaires and the viral genomic sequence obtained in the drug resistance test before starting antiretrovirals (ARVs). HIV-1 subtypes and epidemiological surveillance mutations were determined using different bioinformatics tools. Logistic regression was used to estimate the association between predictor variables and late presentation (LP).ResultsThe median age was 31 years, 51% had a current income between 501–1,000 euros, 28% were migrants. 21% had never been tested for HIV before diagnosis, with 42.3% of MSM presenting LP. 60% were infected with subtype B strains. In the multivariate regression, increased age at diagnosis, higher income, lower frequency of screening, STI ever diagnosed and higher viral load were associated with LP.ConclusionOur study suggests that specific subgroups of the MSM population, such older MSM, with higher income and lower HIV testing frequency, are not being targeted by community and clinical screening services. Overall, targeted public health measures should be strengthened toward these subgroups, through strengthened primary care testing, expanded access to PrEP, information and promotion of HIV self-testing and more inclusive and accessible health services

Characterization of a large cluster of HIV-1 A1 infections detected in Portugal and connected to several Western European countries

HIV-1 subtypes associate with differences in transmission and disease progression. Thus, the existence of geographic hotspots of subtype diversity deepens the complexity of HIV-1/AIDS control. The already high subtype diversity in Portugal seems to be increasing due to infections with sub-subtype A1 virus. We performed phylogenetic analysis of 65 A1 sequences newly obtained from 14 Portuguese hospitals and 425 closely related database sequences. 80% of the A1 Portuguese isolates gathered in a main phylogenetic clade (MA1). Six transmission clusters were identified in MA1, encompassing isolates from Portugal, Spain, France, and United Kingdom. The most common transmission route identified was men who have sex with men. The origin of the MA1 was linked to Greece, with the first introduction to Portugal dating back to 1996 (95% HPD: 1993.6-1999.2). Individuals infected with MA1 virus revealed lower viral loads and higher CD4+ T-cell counts in comparison with those infected by subtype B. The expanding A1 clusters in Portugal are connected to other European countries and share a recent common ancestor with the Greek A1 outbreak. The recent expansion of this HIV-1 subtype might be related to a slower disease progression leading to a population level delay in its diagnostic.Supported by FEDER, COMPETE, and FCT by the projects NORTE-01-0145-FEDER-000013, POCI-01-0145-FEDER-007038 and IF/00474/2014; FCT PhD scholarship PDE/BDE/113599/2015; FCT contract FCT IF/00474/2014; European Funds through grant BEST HOPE (project funded through HIVERA, grant 249697) and by FCT PTDC/DTP-EPI/7066/2014. Global Health and Tropical Medicine Center are funded through FCT (UID/Multi/04413/2013). We would like to acknowledge all the patients and health care professionals from the Portuguese hospitals that contributed in some way to this study

Extraprensa. Cultura e comunicação na América Latina (Edição Especial sep 2019)

A revista Extraprensa é um periódico destinado à publicação da produção científica nas áreas da cultura e da comunicação no Brasil e América Latina, abrangendo temas como a diversidade cultural, cidadania, expressões das culturas populares, artes, mídias alternativas, epistemologia e metodologia em cultura e comunicação

Data_Sheet_1_Determinants of HIV late presentation among men who have sex with men in Portugal (2014–2019): who’s being left behind?.docx

IntroductionHIV late presentation (LP) remains excessive in Europe. We aimed to analyze the factors associated with late presentation in the MSM population newly diagnosed with HIV in Portugal between 2014 and 2019.MethodsWe included 391 newly HIV-1 diagnosed Men who have Sex with Men (MSM), from the BESTHOPE project, in 17 countrywide Portuguese hospitals. The data included clinical and socio-behavioral questionnaires and the viral genomic sequence obtained in the drug resistance test before starting antiretrovirals (ARVs). HIV-1 subtypes and epidemiological surveillance mutations were determined using different bioinformatics tools. Logistic regression was used to estimate the association between predictor variables and late presentation (LP).ResultsThe median age was 31 years, 51% had a current income between 501–1,000 euros, 28% were migrants. 21% had never been tested for HIV before diagnosis, with 42.3% of MSM presenting LP. 60% were infected with subtype B strains. In the multivariate regression, increased age at diagnosis, higher income, lower frequency of screening, STI ever diagnosed and higher viral load were associated with LP.ConclusionOur study suggests that specific subgroups of the MSM population, such older MSM, with higher income and lower HIV testing frequency, are not being targeted by community and clinical screening services. Overall, targeted public health measures should be strengthened toward these subgroups, through strengthened primary care testing, expanded access to PrEP, information and promotion of HIV self-testing and more inclusive and accessible health services.</p

Data_Sheet_1_Determinants of HIV late presentation among men who have sex with men in Portugal (2014–2019): who’s being left behind?.docx

IntroductionHIV late presentation (LP) remains excessive in Europe. We aimed to analyze the factors associated with late presentation in the MSM population newly diagnosed with HIV in Portugal between 2014 and 2019.MethodsWe included 391 newly HIV-1 diagnosed Men who have Sex with Men (MSM), from the BESTHOPE project, in 17 countrywide Portuguese hospitals. The data included clinical and socio-behavioral questionnaires and the viral genomic sequence obtained in the drug resistance test before starting antiretrovirals (ARVs). HIV-1 subtypes and epidemiological surveillance mutations were determined using different bioinformatics tools. Logistic regression was used to estimate the association between predictor variables and late presentation (LP).ResultsThe median age was 31 years, 51% had a current income between 501–1,000 euros, 28% were migrants. 21% had never been tested for HIV before diagnosis, with 42.3% of MSM presenting LP. 60% were infected with subtype B strains. In the multivariate regression, increased age at diagnosis, higher income, lower frequency of screening, STI ever diagnosed and higher viral load were associated with LP.ConclusionOur study suggests that specific subgroups of the MSM population, such older MSM, with higher income and lower HIV testing frequency, are not being targeted by community and clinical screening services. Overall, targeted public health measures should be strengthened toward these subgroups, through strengthened primary care testing, expanded access to PrEP, information and promotion of HIV self-testing and more inclusive and accessible health services.</p