Pharmaceutical consultation as a tool to improve health outcomes for patients with type 2 diabetes

Neste estudo, desenvolvemos e avaliamos um programa de consulta farmacêutica (PCF) visando melhorar o tratamento de pacientes diabéticos tipo 2 (PDT2) e reduzir os fatores de risco de complicações diabéticas com possibilidade de aplicação em outras doenças crônicas. Para alcançar este propósito, PDT2 recebendo tratamento médico convencional, apresentando glicemia de jejum &gt; 140 mg/dl e/ou hemoglobina glicada &gt;7% foram selecionados. O PCF inclui estratégias obtidas a partir do método de Dader, do modelo de cuidados farmacêuticos PWDT (Pharmacist's Workup of Drug Therapy method), do método SOAP (Subjective data, Objective data, Assessment, and Plan of care) e conceitos baseados em um modelo de cuidados em enfermagem. O PCF avaliou o estilo de vida, farmacoterapia e seu monitoramento através de exames laboratoriais, sinais vitais e antropometria. Estes procedimentos foram repetidos a cada 4 meses durante 1 ano. Os dados obtidos em cada consulta possibilitaram oferecer educação focada no estilo de vida e uso de medicamentos. Para os 50 pacientes que concluiram o PCF houve redução da glicemia (P < 0.0001), hemoglobina glicada (P = 0.0022), colesterolemia (P = 0.0072), triacilgliceridemia (P= 0.0204) e pressão arterial (P < 0.0001). O aumento da concordância e a correção dos problemas relacionados a medicamentos contribuíram para melhoria do tratamento. Assim, podemos concluir que o PCF foi adequado para melhorar a saúde de PDT2 ao reduzir fatores de risco de complicações diabéticas.This study develops and evaluates a pharmaceutical consultation program (PCP) to improve treatment for Type 2 diabetes patients (T2DP) and reduce risk factors for diabetic complications with possible application in other chronic diseases. We recruited T2DP receiving conventional medical treatment but with fasting glycemia &gt;140mg/dl and/or glycated hemoglobin &gt;7%. The PCP includes strategies obtained from Dader's method, the PWDT (Pharmacist's Workup of Drug Therapy method) model of pharmaceutical care, the SOAP (Subjective data, Objective data, Assessment, and Plan of care) method, and concepts based on a nursing care model. The PCP evaluated lifestyle, pharmacotherapy and monitoring it using laboratory tests, vital signs, and anthropometry. These procedures were repeated every 4 months for 1 year. Data obtained in each consultation were used to provide patient education focusing on healthy lifestyles and medications. Fifty patients completed the PCP. There were reductions in glycemia (

Risk factors in patients with type 2 diabetes mellitus

El objetivo de este estudio fue verificar los factores de riesgo de las complicaciones de la diabetes mellitus tipo 2, por medio del levantamiento de datos sociodemográficos, hábitos de salud, perfil antropométrico y bioquímico, de pacientes diabéticos tipo 2 atendidos en una Unidad Básica de Salud en la ciudad de Maringá, Paraná. Fueron entrevistados y evaluados 66 pacientes con más de 50 años; 56 eran del sexo femenino. Se verificó una elevada presencia de factores de riesgo cardiovascular en los pacientes investigados: sobrepeso y obesidad, hipertensión, dislipidemia, sedentarismo y dieta no saludable. Los resultados indican la necesidad de la implantación de programas de intervención multidisciplinares en unidades básicas de la salud asociada a prácticas educativas, estimulando la adopción de una dieta saludable y la práctica de actividad física regular para estos pacientes.O objetivo deste estudo foi verificar os fatores de risco das complicações do diabetes mellitus tipo 2, por meio de levantamento de dados sociodemográficos, hábitos de saúde, perfil antropométrico e bioquímico de pacientes diabéticos tipo 2, atendidos em Unidade Básica de Saúde, na cidade de Maringá, Paraná. Foram entrevistados e avaliados 66 pacientes acima de 50 anos, sendo 56 do sexo feminino. Verificou-se elevada prevalência de fatores de risco cardiovascular nos pacientes investigados: sobrepeso e obesidade, hipertensão, dislipidemia, sedentarismo e dieta não saudável. Os resultados indicam a necessidade da implantação de programas de intervenção multidisciplinares em unidades básicas de saúde, associados a práticas educativas, estimulando a adoção de dieta saudável e a prática de atividade física regular para esses pacientes.This study was carried out to evaluate the risk factors of type 2 diabetic patients through sociodemographic data, habits of health, anthropometric and biochemist profiles, assisted at a basic public health care unit in Maringá, Paraná. Sixty-six patients, 56 women aged over than 50 years-old were interviewed. High prevalence factors for cardiovascular risk were observed, such as: overweight and obesity, hypertension, dyslipidemia, sedentariness and inadequate diet. Data suggested the need for multidisciplinary intervention programs in health care units associated to educative programs, adjusted diet intake and regular physical activity for these diabetic patients

An evaluation of generic medicines availability in pharmacies and drugstores in Maringá (PR) and comparison of their prices in relation with the similars and the references

O debate sobre a implementação de genéricos vem sendo realizado no Brasil desde 1976. Entretanto, somente em 1991, foi elaborado um projeto, visando à implantação dos medicamentos genéricos. A lei nº 9787 ("Lei dos genéricos") só foi publicada no Diário Oficial da União em 11 de fevereiro de 1999. Os objetivos deste trabalho foram verificar a disponibilidade de medicamentos genéricos em farmácias e drogarias, bem como comparar os preços destes medicamentos em relação aos similares e aos de referência. Verificou-se a disponibilidade dos medicamentos genéricos em 22 farmácias e drogarias do município de Maringá, estado do Paraná, de 30 de outubro a 22 de novembro de 2002. Dos 222 princípios ativos disponibilizados no Brasil como genéricos, foram encontrados 71 (32%). Os medicamentos genéricos não sujeitos a controle especial são em média 42% mais baratos do que os de referência e 15% mais baratos que os similares. Os medicamentos genéricos de venda controlada com tarja vermelha são, em média, 36% mais baratos que os de referência e 12% mais baratos que os similares. Os medicamentos genéricos com tarja preta são, em média, 37% mais baratos que os de referência e 14% mais baratos que os similares.The discussion about the implementation of generics has being carried trough since 1976 in Brazil. However, just in 1991 a project which proposes the implantation of generic medicines has been elaborated. The Law 9787 (called Law of the Generic medicines) has been only published in Diário Oficial da União in February 11th, 1999. The objectives of this work had been to verify generic medicine availability in pharmacies and drugstores, as well as comparing their prices in relation with the similars and the references. The generic availability was verified in 22 pharmacies and drugstores in Maringá city, state of Paraná, from October, 30th to November, 20th ,2002. In a total of 222 active principles available in Brazil as generic, 71 (32%) had been found. Those generic medicines sold not under special control are in average 42% cheaper than the reference and 15% cheaper than the similar ones. Those generic medicines with red label, sold under special control, are in average 36% cheaper than the reference and 12% cheaper than the similar ones. The generic medicines with black label are 37% cheaper than the reference and 14% cheaper than the similars ones

Effect of aerobic physical exercise on the lipid profile in type 2 diabetic elderly women attended in a basic health unit in Maringá, Paraná State, Brazil

<p></p><p>ABSTRACT This study aims to evaluate the influence of a physical exercise program on the lipid profile in type 2 diabetic elderly women. The patients were selected from a Basic Unit of Health (Mandacaru - NIS II, Maringá, Paraná), that attends 200 type 2 diabetic subjects. Among these patients, 40 women aged 60 years or more were randomically selected. The sample was distributed in two groups of 20 patients each: the Trained Group (TG), that received nutritional instructions and participated in supervised sessions of aerobic physical exercise; Control Group (CG), that received only nutritional instructions. The exercises were applied three times a week, one hour each session. Results showed that the adopted protocol promoted a significant reduction in triglycerides levels (pre-test = 190 ± 76,67 and post-test = 125,33 ± 45,82 mg/dL, p<0,05) and also in the LDL-cholesterol (pre-test = 147,98 ± 29,98 and post-test = 122,24 ± 17,61 mg/dL, p<0,05) for the TG. Therefore, we concluded that the adopted exercise program improved the lipid profile in type 2 diabetic elderly women , showing the importance of practicing oriented physical activity in health primary units.</p><p></p

Natural green coating inhibits adhesion of clinically important bacteria

Despite many advances, biomaterial-associated infections continue to be a major clinical problem. In order to minimize bacterial adhesion, material surface modifications are currently being investigated and natural products possess large potential for the design of innovative surface coatings. We report the bioguided phytochemical investigation of Pityrocarpa moniliformis and the characterization of tannins by mass spectrometry. It was demonstrated that B-type linked proanthocyanidins-coated surfaces, here termed Green coatings, reduced Gram-positive bacterial adhesion and supported mammalian cell spreading. The proposed mechanism of bacterial attachment inhibition is based on electrostatic repulsion, high hydrophilicity and the steric hindrance provided by the coating that blocks bacterium-substratum interactions. This work shows the applicability of a prototype Green-coated surface that aims to promote necessary mammalian tissue compatibility, while reducing bacterial colonization

L’origine grecque de la démocratie

Despite many advances, biomaterial-associated infections continue to be a major clinical problem. In order to minimize bacterial adhesion, material surface modifications are currently being investigated and natural products possess large potential for the design of innovative surface coatings. We report the bioguided phytochemical investigation of Pityrocarpa moniliformis and the characterization of tannins by mass spectrometry. It was demonstrated that B-type linked proanthocyanidins-coated surfaces, here termed Green coatings, reduced Gram-positive bacterial adhesion and supported mammalian cell spreading. The proposed mechanism of bacterial attachment inhibition is based on electrostatic repulsion, high hydrophilicity and the steric hindrance provided by the coating that blocks bacterium-substratum interactions. This work shows the applicability of a prototype Green-coated surface that aims to promote necessary mammalian tissue compatibility, while reducing bacterial colonization