Conhecimento sobre hipertensão arterial e fatores associados à não adesão à farmacoterapia

OBJECTIVES: to identify the degree of knowledge of people with hypertension concerning the disease and to verify the factors associated with the non-adherence to anti-hypertensive drug therapy. METHOD: Cross sectional study, involving 422 people. Data collection took place at their homes, between December 2011 and March 2012, through interviews using the following instruments: Medication Adherence Questionnaire (MAQ-Q), Medication Regimen Complexity Index (MRCI) and a guide with questions related to sociodemographic profile, satisfaction with healthcare service and knowledge about the disease. RESULTS: 42.6% did not adhere to the drug therapy and 17.7% had poor knowledge about the disease. Factors associated with the non-adherence were: complex drug therapy, poor knowledge about the disease and dissatisfaction with the healthcare service. CONCLUSION: The findings reinforce that the complex drug therapy prescriptions, little knowledge about the disease and dissatisfaction with the healthcare service have influence on the process of non-adherence to anti-hypertensive drug therapy.OBJETIVOS: identificar el nivel de conocimiento de personas con hipertensión arterial acerca de la enfermedad y verificar los factores asociados a la no adhesión a la farmacoterapia antihipertensiva. MÉTODO: estudio transversal realizado en 422 individuos. Los datos fueron recolectados en los domicilios, entre diciembre de 2011 y marzo de 2012, por medio de entrevistas utilizando los instrumentos: Cuestionario de Adhesión a Medicamentos (CAM-Q), Índice de Complejidad de la Farmacoterapia y un guión con preguntas relativas al perfil sociodemográfico, satisfacción con el servicio de salud y conocimiento sobre la enfermedad. RESULTADOS: 42,6% no adherían a la farmacoterapia y 17,7% poseían conocimiento insatisfactorio sobre la enfermedad. Los factores asociados a la no adhesión fueron: farmacoterapia compleja, conocimiento insatisfactorio sobre la enfermedad e insatisfacción con el servicio de salud. CONCLUSIÓN: Los hallazgos refuerzan que prescripciones farmacológicas complejas, poco conocimiento sobre la enfermedad e insatisfacción con el servicio de salud influyen en el proceso de la no adhesión al tratamiento medicamentoso antihipertensivo.OBJETIVOS: identificar o nível de conhecimento de pessoas com hipertensão arterial acerca da doença e verificar os fatores associados à não adesão à farmacoterapia anti-hipertensiva. MÉTODO: estudo transversal, realizado com 422 indivíduos. Os dados foram coletados nos domicílios, entre dezembro de 2011 e março de 2012, por meio de entrevistas, utilizando os instrumentos: Questionário de Adesão a Medicamentos, Índice de Complexidade da Farmacoterapia e um roteiro com questões relativas ao perfil sociodemográfico, satisfação com o serviço de saúde e conhecimento sobre a doença. RESULTADOS: 42,6% não aderiram à farmacoterapia e 17,7% possuíam conhecimento insatisfatório sobre a doença. Os fatores associados à não adesão foram: farmacoterapia complexa, conhecimento insatisfatório sobre a doença e insatisfação com o serviço de saúde. CONCLUSÃO: os achados reforçam que prescrições farmacológicas complexas, pouco conhecimento sobre a doença e insatisfação com o serviço de saúde influenciam no processo de não adesão ao tratamento medicamentoso anti-hipertensivo

Detecting Network Communities: An Application to Phylogenetic Analysis

This paper proposes a new method to identify communities in generally weighted complex networks and apply it to phylogenetic analysis. In this case, weights correspond to the similarity indexes among protein sequences, which can be used for network construction so that the network structure can be analyzed to recover phylogenetically useful information from its properties. The analyses discussed here are mainly based on the modular character of protein similarity networks, explored through the Newman-Girvan algorithm, with the help of the neighborhood matrix . The most relevant networks are found when the network topology changes abruptly revealing distinct modules related to the sets of organisms to which the proteins belong. Sound biological information can be retrieved by the computational routines used in the network approach, without using biological assumptions other than those incorporated by BLAST. Usually, all the main bacterial phyla and, in some cases, also some bacterial classes corresponded totally (100%) or to a great extent (>70%) to the modules. We checked for internal consistency in the obtained results, and we scored close to 84% of matches for community pertinence when comparisons between the results were performed. To illustrate how to use the network-based method, we employed data for enzymes involved in the chitin metabolic pathway that are present in more than 100 organisms from an original data set containing 1,695 organisms, downloaded from GenBank on May 19, 2007. A preliminary comparison between the outcomes of the network-based method and the results of methods based on Bayesian, distance, likelihood, and parsimony criteria suggests that the former is as reliable as these commonly used methods. We conclude that the network-based method can be used as a powerful tool for retrieving modularity information from weighted networks, which is useful for phylogenetic analysis

Modulatory effects of Tabebuia impetiginosa (Lamiales, Bignoniaceae) on doxorubicin-induced somatic mutation and recombination in Drosophila melanogaster

The wing Somatic Mutation and Recombination Test (SMART) in D. melanogaster was used to study genotoxicity of the medicinal plant Tabebuia impetiginosa. Lapachol (naphthoquinone) and β-lapachone (quinone) are the two main chemical constituents of T. impetiginosa. These compounds have several biological properties. They induce apoptosis by generating oxygen-reactive species, thereby inhibiting topoisomerases (I and II) or inducing other enzymes dependent on NAD(P)H:quinone oxidoreductase 1, thus affecting cell cycle checkpoints. The SMART was used in the standard (ST) version, which has normal levels of cytochrome P450 (CYP) enzymes, to check the direct action of this compound, and in the high bioactivation (HB) version, which has a high constitutive level of CYP enzymes, to check for indirect action in three different T. impetiginosa concentrations (10%, 20% or 40% w/w). It was observed that T. impetiginosa alone did not modify the spontaneous frequencies of mutant spots in either cross. The negative results observed prompted us to study this phytotherapeuticum in association with the reference mutagen doxorubicin (DXR). In co-treated series, T. impetiginosa was toxic in both crosses at higher concentration, whereas in the HB cross, it induced a considerable potentiating effect (from ~24.0 to ~95.0%) on DXR genotoxity. Therefore, further research is needed to determine the possible risks associated with the exposure of living organisms to this complex mixture

Network Geometry and Complexity

(28 pages, 11 figures)Higher order networks are able to characterize data as different as functional brain networks, protein interaction networks and social networks beyond the framework of pairwise interactions. Most notably higher order networks include simplicial complexes formed not only by nodes and links but also by triangles, tetrahedra, etc. More in general, higher-order networks can be cell-complexes formed by gluing convex polytopes along their faces. Interestingly, higher order networks have a natural geometric interpretation and therefore constitute a natural way to explore the discrete network geometry of complex networks. Here we investigate the rich interplay between emergent network geometry of higher order networks and their complexity in the framework of a non-equilibrium model called Network Geometry with Flavor. This model, originally proposed for capturing the evolution of simplicial complexes, is here extended to cell-complexes formed by subsequently gluing different copies of an arbitrary regular polytope. We reveal the interplay between complexity and geometry of the higher order networks generated by the model by studying the emergent community structure and the degree distribution as a function of the regular polytope forming its building blocks. Additionally, we discuss the underlying hyperbolic nature of the emergent geometry and we relate the spectral dimension of the higher-order network to the dimension and nature of its building blocks

Chiral squaramide-catalyzed asymmetric synthesis of pyranones and pyranonaphthoquinones via cascade reactions of 1,3-dicarbonyls with Morita-Baylis-Hillman acetates of nitroalkenes

Cascade reactions of 1,3-dicarbonyls with Morita-Baylis-Hillman acetates of nitroalkenes using a quinine derived chiral squaramide organocatalyst led to the formation of pyranones and pyranonaphthoquinones in good to excellent yields and high diastereo-and enantioselectivities. Representative examples of the reaction scale-up with a much lower catalyst loading without an appreciable loss of selectivities and synthetic transformations of the products are also reported here. The compounds described herein for the first time were evaluated against the infective bloodstream form of Trypanosoma cruzi, the etiological agent of Chagas disease, since the structures are related to bioactive alpha-lapachones

Imidazoles from nitroallylic acetates and alpha-bromonitroalkenes with amidines: synthesis and trypanocidal activity studies

Cascade reactions of amidines with nitroallylic acetates and alpha-bromonitroalkenes provide potentially bioactive imidazoles in good to excellent yields in most cases. While 2,4-disubstituted imidazol-5-yl acetates are formed in the first case, 2,4-disubstituted imidazoles, bearing no substituent at position 5, are the products in the second case. These two series of imidazoles, viz. 2,4,5-trisubstituted and 2,4-disubstituted, were screened for their activity against the protozoan parasite Trypanosoma cruzi which is responsible for Chagas disease. As many as three compounds were as active as the standard benznidazole and two others were 2-3-fold more active highlighting the potential of substituted imidazoles, easily accessible from nitroalkenes, as possible anti-parasitic agents

Strategies towards potent trypanocidal drugs: Application of Rh-catalyzed [2 + 2 + 2] cycloadditions, sulfonyl phthalide annulation and nitroalkene reactions for the synthesis of substituted quinones and their evaluation against Trypanosoma cruzi

Rhodium-catalyzed [2 + 2 + 2] cycloadditions, sulfonyl phthalide annulations and nitroalkene reactions have been employed for the synthesis of 56 quinone-based compounds. These were evaluated against Trypanosoma cruzi, the parasite that causes Chagas disease. The reactions described here are part of a program that aims to utilize modern, versatile and efficient synthetic methods for the one or two step preparation of trypanocidal compounds. We have identified 9 compounds with potent activity against the parasite; 3 of these were 30-fold more potent than benznidazole (Bz), a drug used for the treatment of Chagas disease. This article provides a comprehensive outline of reactions involving over 120 compounds aimed at the discovery of new quinone-based frameworks with activity against T. cruzi