Inappropriate medication use among the elderly: a systematic review of administrative databases

<p>Abstract</p> <p>Background</p> <p>Inappropriate medication use (IMU) by elderly people is a public health problem associated with adverse effects on health. There are a number of methods for identifying IMU, some involving clinical judgment and others, consensually generated lists of drugs to be avoided. This review aims to describe studies that used information from insurance company and social security administrative databases to assess IMU among community-dwelling elderly and to present the risk factors most often associated with IMU.</p> <p>Methods</p> <p>The paper search was conducted in Medline and Embase, using descriptors combined with free terms in the title or abstract. The limits applied were: publication date from January 1990 to June 2010, species (human) and publication type (excluding editorials, letters and reviews). Excluded were: case studies; studies in hospitals, nursing homes, or hospital emergency departments; studies of specific drugs or groups of drugs; studies exclusively of subgroups of ill, frail elderly or rural populations. Additional studies were identified from reference lists. Data were selected and extracted after independent reading by two of the authors, with disagreements resolved by a third author. The primary outcome assessed was prevalence of IMU, defined as the proportion of elderly who received at least one inappropriate medication.</p> <p>Results</p> <p>Of the 628 studies, 19 met the inclusion criteria, 78.9% of them conducted in the USA. All papers included used explicit criteria of inappropriateness, most commonly Beers criteria (73.7%) in their three versions (1991, 1997 and 2002). Other methods used included Zhan, which is derived from on Beers criteria and was applied in 21% of the papers selected. The study found that prevalence of IMU ranged from 11.5% to 62.5%. Only 68.4% of the studies included examined inappropriate use-related factors, the most important being female sex, advanced age and larger number of drugs.</p> <p>Conclusions</p> <p>The results show that the prevalence of IMU among community-dwelling elderly is high and depends partly on the method used to evaluate improper use. Besides the diversity of methods, other factors, such as patient sex, age and number of drugs used concurrently, appear to have influenced the estimates of IMU.</p

O papel das mutações na compreensão da genética do milho.

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Anotação funcional de sequências com BLAST2GO.

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Diferentes dosagens de manipueira e urina de vaca no manejo de Meloidogyne javanica em mudas de aceroleira.

A aceroleira (Malpighia emaginata Sessé & Moc. ex DC.) é cultivada comercialmente, principalmente, na região Nordeste, onde concentra-se a maior parte da produção brasileira. Em levantamentos realizados nessa região, identificou-se o gênero Meloidogyne sp. (nematóide das galhas) como principal problema fitossanitário na cultura devido à dificuldade de manejo. Os danos causados nas raízes, formação de galhas, são frequentemente confundidos por sintomas de deficiências nutricionais ou outras doenças na parte aérea da planta. Estratégias de manejo não químicas como a utilização de resíduos orgânicos e agroindustriais, a exemplo da manipueira, farelo de mamona, raspas secas de mandioca, urina de vaca, dentre outros, se bem manejadas possuem potencial para agir como fertilizantes e/ou potencial para agir como biocidas. Desta forma, este trabalho teve o objetivo de avaliar e identificar dosagens nematicidas e/ou fertilizantes de resíduos agroindustriais em mudas de aceroleira infestadas pelo nematóide das galhas.PDF. 072

Elasticity of Ingestive Behaviour and Intake in Sheep Associated with Food Diversity on Plurispecific Swards

Animals on heterogeneous swards generally opt for a varied diet. This may stimulate their intake, unless searching constraints limit intake rate (Champion et al., 1998). However the management of plurispecific swards presents a risk of overgrazing the preferred species and undergrazing the less-preferred species. This study aimed to test the effect of type of diversity and type of management on the elasticity of ingestive behaviour and intake in sheep

Composição florística e estrutura de remanescentes de Chaco florestado no Pantanal brasileiro.

O Chaco, de grande biodiversidade e endemismo, tem sido pouco estudado no Brasil, o que dificulta sua conservação e uso sustentável. Assim, o presente estudo objetivou descrever a composição florística e estrutural de três remanescentes de Chaco florestado no Pantanal brasileiro. The Chaco, a vegetation with great biodiversity and endemism, has not been intensively studied in Brazil and, because of that, conservation and sustainable use become a tough tasks. The study aimed to describe the floristic composition and the structure of three fragments of Chaco forest in the Brazilian Pantanal