Role of community pharmacy and pharmacists in self-care in Brazil

Global healthcare systems, including the National Health System in Brazil - one of the largest public models in the world -, continue to evolve, as well as populations' health needs, currently shaped by individuals feeling a greater desire to manage their own health. Self-care practices are part of several public policies and clinical guidelines in Brazil including the National Policy on Complementary and Integrative Practices, the National AIDS Control Program, the National Policy for Women's Health, and the Guidelines for Care of People with Chronic Diseases. There are over 100,700 community pharmacies, in the country (89.2% privately owned) employing 234,300 pharmacists, representing an important delivery point for self-care, as they are the first point of access to care for most patients. Self-medication is a common practice in Brazil (prevalence rates of self-medication ranging from 16.1% to 35.0%), especially with non-prescription/over-the-counter medicinal products (65.0%). In fact, these products represent over 25% of the volume marketed of medicines, summing revenues of USD 1.9 billion per year. Studies demonstrated a positive budget impact as important savings for the National Health System due to reductions in unnecessary medical appointments and loss of working days. In addition to minor ailments management, other self-care services provided by community pharmacies that are frequently sought by Brazilian citizens (20-25% of cases) are smoking cessation and weight management (costs per service ranging from around USD 5.00-12.00). However, pharmacy services are not yet as fully integrated in Brazil to the same extent as in other countries. Barriers such as standardization of processes (from services' design, implementation, and evaluation in practice), pharmacist remuneration for the provision of services and the amount to be charged for the service are still a matter of controversy. For more rapid and sustainable advances in these practices, communication among various stakeholders, professional practice and healthcare regulations, standardization of services, and financing of self-care (both publicly and privately) are urgently needed. This paper provides an overview of some self-care services provided by community pharmacies in Brazil and calls attention to the ongoing challenges to move the National Health system forward.info:eu-repo/semantics/publishedVersio

Revisão sistemática com meta-análise da eficácia e segurança de novos antipsicóticos para o tratamento da equizofrenia

Orientador : Prof. Dr. Roberto PontaroloCoorientadora : Profª. Drª. Astrid Wiens SouzaDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Ciências Farmacêuticas. Defesa: Curitiba, 16/10/2015Inclui referências : f. 138-154;168-170;179-182Área de concentração: Insumos, medicamentos e correlatosResumo: A esquizofrenia é uma doença mental crônica e deteriorativa, com grande impacto na qualidade de vida dos pacientes, afetando cerca de 24 milhões de pessoas em todo o mundo. O tratamento da doença se baseia no uso da classe dos antipsicóticos. Porém, a busca por estratégias cada vez mais eficazes e seguras leva ao desenvolvimento de novos fármacos, aumentando ainda mais o leque de opções terapêuticas. Nesse contexto, é importante avaliar, por meio da Saúde Baseada em Evidências, os riscos e benefícios da disponibilização de tecnologias à população, a fim de gerar dados científicos passíveis de guiar tomadas de decisão por profissionais e gestores de saúde. Assim, o objetivo deste estudo foi realizar uma avaliação e comparação de evidências primárias e secundárias sobre a eficácia e segurança de antipsicóticos para o tratamento da esquizofrenia. Foi realizada uma revisão sistemática (RS) de ensaios clínicos randomizados (ECRs) de nove novos potenciais fármacos (asenapina, blonanserin, iloperidona, loxapina inalável, lurasidona, nitroprussiato de sódio, perospirona, pimavanserin e sertindol) aliada a uma overview (revisão sistemática de revisões sistemáticas) dos principais antipsicóticos já bem estabelecidos e comercializados (como haloperidol, risperidona, clozapina, entre outros). Para tanto, as buscas foram conduzidas nas bases MEDLINE (PUBMED), Cochrane Library, SCIELO, Scopus, International Pharmaceutical Abstracts, Lilacs e Web of Science, junto com busca manual. Para a RS foram encontrados 2024 registros, dos quais 29 contemplaram os critérios de inclusão (n=7487). As análises estatísticas foram conduzidas da maneira convencional (meta-análises) e também por mixed treatment comparison (MTC), uma vez que poucos estudos head-to-head foram encontrados. Os principais resultados evidenciam que alguns fármacos novos (asenapina e lurasidona) apresentam-se superiores ao placebo em termos de eficácia e tolerabilidade, porém poucas diferenças estatisticamente significativas entre os fármacos foram observadas. Além disso, poucos estudos foram encontrados para alguns ativos (como blonanserin e perospirona), demonstrando a ausência de evidências que favoreça a sua implantação em protocolos e guias de tratamento. Já para a overview, foram encontrados 1067 registros dos quais 42 foram incluídos nas análises. A qualidade metodológica das revisões publicadas apresentou uma pontuação média de 7,28 na ferramenta AMSTAR, sendo considerada moderada. Os resultados evidenciam que antipsicóticos atípicos (2ª geração) como risperidona, olanzapina e quetiapina apresentam maior eficácia sobre os típicos (1ª geração) como haloperidol e clorpromazina, e tendem a ser a primeira escolha em diretrizes internacionais, devendo essa realidade ser ajustada para países como Brasil. Por fim, de modo geral, os resultados apresentados nesse trabalho podem contribuir para elaboração de protocolos clínicos na medida em que aumentam a qualidade e quantidade de evidências disponíveis sobre terapias para esquizofrenia. Sugere-se ainda que análises farmacoeconômicas sejam incorporadas ao estudo, a fim de se definir melhores relações custo-efetividade que contribuam para tomadas de decisão em saúde. Palavras-chave: Antipsicóticos. Esquizofrenia. Meta-análise. Revisão sistemática.Abstract: Schizophrenia is a chronic and damaging mental disease that affects about 24 million people worldwide and has great impact on patient's quality of life. The therapeutic treatment of the disease relies on the use of antipsychotic drugs. However, the search for more effective and safer treatments leads to the development of new drugs, which increases the range of therapeutic options. In this context, Evidence-Based Medicine stands as as important tool to assess the risks and benefits of available technologies in order to create scientific data that could support decision-making. Hence, the aim of this study was to assess primary and secondary evidences about the efficacy and safety of antipsychotic drugs for schizophrenia. A systematic review (SR) of randomized controlled trials (RCTs) of nine potential drugs (asenapine, blonanserin, iloperidone, inhaled loxapine, lurasidone, sodium nitroprusside, perospirone, pimavanserin and sertindole) was performed. Moreover an overview of SR of the main well established antipsychotic (e.g. haloperidol, risperidone, clozapine) was conducted. The search was conducted in MEDLINE (PubMed), Cochrane Library, SciELO, Scopus, International Pharmaceutical Abstracts, Lilacs and Web of Science, along with handsearching. For the SR initially 2024 records were found. After screening, 29 studies remained (n=7487). Apart from traditional pairwise meta-analyses, mixed treatment comparisons (MTC) were also performed since only few head-to-head studies were found. The main results showed that some of the new drugs (asenapine, lurasidone) are superior to placebo in efficacy and tolerability outcomes. However, between drugs few statistically significant differences were observed. In addition, few studies for some of the drugs were reached (e.g. blonanserin, perospirone). This lack of evidence do not support their implementation in protocols or treatment guidelines. Concerning the overview, 1067 records were found of which 42 were included in the analyses. The overall score of methodological quality assessment through AMSTAR tool for the published revisions was considered moderate (7.28). The main results showed that 2nd generation antipsychotics (atypical drugs) such as risperidone, olanzapine and quetiapine have better profile than typical drugs (1st generation) (e.g. haloperidol and chlorpromazine). Thus, atypical drugs stand as the first therapeutic choice in international guidelines. Countries like Brazil should consider adjusting its clinical protocols. Finally, our results can contribute to development of clinical guidelines as they increase the amount of available quality of evidence on schizophrenia therapies. We also suggest the incorporation of further pharmacoeconomic analyzes into this study in order to provide cost-effectiveness comparisons that should help decision-making. Key-words: Antipsychotic drugs. Schizophrenia. Meta-analyses. Systematic review

Mapping the characteristics of network meta-analyses on antithrombotic therapies: an overview and critical appraisal

Objectives: A large number of network meta-analyses (NMAs) in the field of cardiac disease are available, yet the scientific literature lacks an updated straightforward synthesis of this evidence to ground the decision-making process. We aimed to map and critically appraise NMAs on antithrombotic therapies used as treatment or prophylaxis of cardiac diseases and cardiac surgical procedures. Methods: A systematic review of systematic reviews with meta-analysis was conducted following Cochrane Collaboration and Joanna Briggs recommendations (PROSPERO-CRD2020166468). Searches to identify NMAs meeting the eligibility criteria of this study were performed in PubMed and Scopus (Jan-2022). NMAs characteristics including metadata, statistical models’ description, and main pooled results were collected. The methodological quality of NMAs was evaluated using the PRISMA-NMA checklist and AMSTAR-2 tools. Descriptive statistical analyses with categorical variables reported as frequencies and continuous variables as the median and interquartile range (IQR) were performed (SPSS-Statistics v.25.0). Results: Overall, n=88 NMAs published between 2007-2022 were identified. The most evaluated clinical condition was atrial fibrillation (n=57; 64.7%); around one-third of the studies (38.6%) assessed cardiac surgical procedures. Only 28.4% NMAs had a registered study protocol. Fifty NMAs (56.8%) were published by authors from one single country China the most frequently. A median of 14 primary studies (IQR 5-20.75) (mostly randomized clinical trials) were included per NMA. A median of 40 (IQR 24-84.25) indirect meta-analyses per study were found. At least one network diagram for a given outcome was provided by 68 (77.2%) studies, yet only 22 (25.6%) performed treatment ranking analyses. Conflict of interest declarations and study funding were informed by 34 (38.6%) and 38 (43.2%) NMAs, respectively. Conclusions: Although there is a widespread of NMA-type studies assessing different antithrombotic agents for different cardiac conditions, the lack of standardized conduction and reporting of NMAs (poor-moderate methodological quality) may limit their comparison and results implementation into clinical practice.info:eu-repo/semantics/publishedVersio

A aprendizagem de paralelismo, concorrência e perpendicularidade de retas relacionada aos deslocamentos e localização espacial de pessoas cegas

O trabalho apresenta uma investigação relativa à questão: estudantes com deficiência visual utilizam ou referem conhecimentos de geometria aprendidos na escola ao se deslocar e se localizar no espaço? Foram realizadas duas entrevistas exploratórias semiestruturadas e uma caminhada pela quadra ao redor da instituição de ensino na coleta de dados. A primeira entrevista foi realizada com sete professores da disciplina de Orientação e Mobilidade de três estudantes cegos congênitos que frequentam escolas comuns e participantes da segunda entrevista e da caminhada. Os professores evidenciaram que os conhecimentos essenciais para a compreensão das técnicas de Orientação e Mobilidade estão relacionados à compreensão do espaço que rodeia os estudantes, aos conceitos de geometria como paralelismo, perpendicularidade, concorrência, figuras geométricas planas, ângulos e medidas e à utilização do corpo como um sistema de referência de lateralidade e direcionalidade. Enfatizaram que é papel da escola proporcionar essas competências. Os estudantes referiram poucos conhecimentos e os utilizaram de modo intuitivo: ideia do giro em relação ao conhecimento sobre ângulos, lateralidade, diagonal e a forma plana retangular. A pesquisa evidenciou a importância de trabalhar conteúdos geométricos que possibilitem aprendizagens e noções espaciais efetivas a estes com deficiência visual inclusos em salas de aula regulares

How many manuscripts should I peer review per year?

Peer review provides the foundation for the scholarly publishing system. The conventional peer review system consists of using authors of articles as reviewers for other colleagues' manuscripts in a collaborative-basis system. However, authors complain about a theoretical overwhelming number of invitations to peer review. It seems that authors feel that they are invited to review many more manuscripts than they should when taking into account their participation in the scholarly publishing system. The high number of scientific journals and the existence of predatory journals were reported as potential causes of this excessive number of reviews required. In this editorial, we demonstrate that the number of reviewers required to publish a given number of articles depends exclusively on the journals' rejection rate and the number of reviewers intended per manuscript. Several initiatives to overcome the peer review crises are suggested

Publication delay in pharmacy practice journals: a comparative analysis

Introduction: Articles published in scientific journals are a valuable source of information and the main system to communicate research results. Authors frequently complain about the long duration of the editorial process, which includes time of external peer-review, layout formatting, and metadata indexing. Differences in the duration of these processes between areas have not been sufficiently explored. Aim: To evaluate the duration of the publication process in pharmacy practice journals compared with other scientific disciplines. Methods: From 67 pharmacy practice journals previously identified, 33 indexed in PubMed were selected for data collection. Metadata of all articles published between 2009-2018 were extracted from PubMed. To create a comparison group of randomly selected articles, the first PMIDs of each year between 2009-2018 were identified. Four lag times for the different steps of the publication and indexing process were calculated: Total publication lag (days between ‘submission date’ and ‘online publication date’), acceptance lag (days between ‘submission date’ and ‘acceptance date’), lead lag (days between ‘acceptance date’ and ‘online publication date’), and indexing lag (days between ‘online publication date’ and ‘Entry date’). Impact Factor (IF) and CiteScore data were also collected. Statistical analyzes were performed in SPSS v20 and RStudio v1.2. Results: The 33 pharmacy practice journals published a total of 26,256 articles. CiteScore of 25 journals was calculated with mean of 1.34 (SD 0.90); only 8 journals have IF (mean 2.135; SD 0.681). In the comparison group, 5,622 different journals published 23,888 articles with a median of 2 articles per journal (IQR 1-5). CiteScore was calculated for 4,879 of these journals, with mean of 2.61 (SD 2.64); 3,853 journals have IF (mean 3.337; SD 0.811). Comparison journals presented higher report rates for all the editorial process dates than pharmacy practice journals: submission OR=0.9 (IC95% 0.76-0.82), acceptance OR=0.86 (0.83-089), and Online publication OR=0.001 (0.0006-0.002). Acceptance lag was not different between pharmacy practice and comparison group (93 vs. 97 days), while small differences existed in lead lag (15 vs. 25 days; Cohen`s d=0.279). However, a greater difference was found in indexing lag (12 vs. 4 days; Cohen`s d=0.703). The analyses of pharmacy practice journals showed important variability in acceptance lag (range 13 to 290 days). Open access pharmacy practice journals presented a lower acceptance lag than subscription ones (74 vs. 126 days). Acceptance lag showed no association with CiteScore in both group of journals (p>0.05). The IF presented a significant inverse association, but with no effect size, with the acceptance lag, in both groups (p<0.001). Discussion: Although the average acceptance lag of pharmacy practice journals was similar to a generic comparison group, huge variability exists between these journals. While authors may consider the smaller acceptance lag as a good characteristic, literature suggests risks associated to fraudulent peer-review. Conclusions: About 95 days since submission are required to have an article accepted, whether in pharmacy practice or in comparison groups of biomedical journals.info:eu-repo/semantics/publishedVersio

Limitations and perceived delays for diagnosis and staging of lung cancer in Portugal: A nationwide survey analysis

Background: We aimed to identify the perception of physicians on the limitations and delays for diagnosing, staging and treatment of lung cancer in Portugal. Methods: Portuguese physicians were invited to participate an electronic survey (Feb-Apr-2020). Descriptive statistical analyses were performed, with categorical variables reported as absolute and relative frequencies, and continuous variables with non-normal distribution as median and interquartile range (IQR). The association between categorical variables was assessed through Pearson's chi-square test. Mann-Whitney test was used to compare categorical and continuous variables (Stata v.15.0). Results: Sixty-one physicians participated in the study (45 pulmonologists, 16 oncologists), with n = 26 exclusively assisting lung cancer patients. Most experts work in public hospitals (90.16%) in Lisbon (36.07%). During the last semester of 2019, responders performed a median of 85 (IQR 55-140) diagnoses of lung cancer. Factors preventing faster referral to the specialty included poor articulation between services (60.0%) and patients low economic/cultural level (44.26%). Obtaining National Drugs Authority authorization was one of the main reasons (75.41%) for delaying the begin of treatment. The cumulative lag-time from patients' admission until treatment ranged from 42-61 days. Experts believe that the time to diagnosis could be optimized in around 11.05 days [IQR 9.61-12.50]. Most physicians (88.52%) started treatment before biomarkers results motivated by performance status deterioration (65.57%) or high tumor burden (52.46%). Clinicians exclusively assisting lung cancer cases reported fewer delays for obtaining authorization for biomarkers analysis (p = 0.023). Higher waiting times for surgery (p = 0.001), radiotherapy (p = 0.004), immunotherapy (p = 0.003) were reported by professionals from public hospitals. Conclusions: Physicians believe that is possible to reduce delays in all stages of lung cancer diagnosis with further efforts from multidisciplinary teams and hospital administration.his work was supported by AstraZeneca. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscripinfo:eu-repo/semantics/publishedVersio

Comparative efficacy and safety of pharmacological interventions for managing sickle cell disease complications in children and adolescents: a systematic review with network meta-analyses

Objectives: Sickle cell disease (SCD), an inherited hemoglobinopathy that causes anemia, severe pain, and vaso-occlusive crisis (VOC), is currently recognized as a global public health concern, being the leading cause of pediatric stroke. Our aim was to synthesize the evidence on the efficacy and safety of interventions for managing SCD in this population. Methods: A systematic review with searches in PubMed, Scopus, and Web of Science was performed (April-2022). Randomized controlled trials comparing disease-modifying agents in SCD patients under 18 years old were included. For each outcome of interest, data were pooled by means of Bayesian network meta-analyses with the surface under the cumulative ranking curve analyses (SUCRA). Results were reported as odds ratio (OR) with 95% credibility intervals (CrI). Results: Seventeen trials (1982-2022) mostly from African countries (65%) and North America (53%), assessing the effect of different interventions’ regimens (hydroxyurea [n=6 trials], L-arginine [n=3], antiplatelets [n=2], immunotherapy/monoclonal antibodies [n=2], sulfates [n=2], docosahexaenoic acid [n=1], niprisan [n=1]) and placebo were included. No statistical differences among treatments were found for the main outcomes. SUCRA revealed that immunotherapy/monoclonal antibodies and hydroxyurea 20 mg/kg are potentially more effective against acute chest syndrome (83% and 76% probabilities, respectively), VOC (71% and 80%, respectively) and needing of transfusions (72% and 75%, respectively), while L-arginine (100-200 mg/kg) and placebo were more prone to these events. Although therapies were overall considered safe, antiplatelet and sulfates may lead to more discontinuations and severe adverse events (uncertainty evidence). Results were similar between age subgroups (<10 years vs. 10-19 years). Conclusions: The available evidence on the effect of drugs on managing SCD in children and adolescents is insufficient and weak. No clear definition for some outcomes exists. Hydroxyurea may remain the standard of care for this population, however, long-term well-designed, and well-reported trials comparing new immunotherapy/monoclonal antibodies should be performed.info:eu-repo/semantics/publishedVersio

Mapeando objetivamente as revistas de Farmácia

Introdução: Mapa da ciência é uma representação espacial de como as disciplinas, as áreas do conhecimento, as especialidades, as revistas científicas e, individualmente, os artigos ou os autores estão relacionados entre si. A Farmácia, como área do conhecimento, por englobar características de caráter tecnológico, analítico e assistencial, apresenta ainda uma imprecisão sobre as suas subdivisões em disciplinas e especialidades. Objetivos: Mapear as subdivisões da área da Farmácia a partir dos artigos publicados em revistas científicas. Método: As revistas ativas (dezembro 2016), com publicações em inglês e cujos títulos apresentassem um ou mais termos relacionados à área (pharmacy, pharmaceutica*, pharmacist, pharmacotherapy) foram coletadas das bases Web of Science, Scopus, MEDLINE e PubMed Central. Os títulos de todos os artigos publicados (2006-2016) nas revistas incluídas foram compilados e organizados de acordo com a revista de origem em um corpus único para análise textual (Iramuteq 0.7 alpha 2). Foram conduzidas: análise lexicográfica para determinação dos segmentos de texto (ST) e frequência das palavras; classificação hierárquica descendente (CHD) para categorização das palavras e revistas em grupos lexicais semelhantes; e análise fatorial correspondente (AFC) para obtenção de gráficos bi e trimedimensionais. Qui-quadrado (X2) e p-value foram utilizados como medidas estatísticas de frequência e significância. Resultados: Foram encontradas inicialmente 209 revistas, das quais 161 foram selecionadas. Após a coleta de dados, obtivemos 148.081 títulos de artigos, com média de 919,7±1.069,2 artigos por revista. Na análise lexicográfica, 34.394 ST foram analisados com aproveitamento satisfatório (74,82%). Emergiram 65.070 palavras distintas. Através da CHD foi gerado dendrograma com cinco classes lexicais distintas. As classes foram separadas em duas ramificações principais: subcorpus A (classes 1 e 2); e subcorpus B (classes 3, 4 e 5). As palavras e a revista mais representativas para as classes foram: patient, treatment, therapy, EXP_OP_PHARMACOTHERAPY (p<0,0001) – Classe 1; pharmacy, pharmacist, medication, INT_J_CLIN_PHARM (p<0,0001) – Classe 2; release, formulation, tablet, DRUG_DEVELOP_IND_PHARM (p<0,0001) – Classe 3; activity, extract, synthesis, CHEM_PHARM_BULLETIN (p<0,0001) – Classe 4; cell, expression, human, BIO_PHARM_BULLETIN (p<0,0001) – Classe 5. A AFC gerou dois planos cartesianos (palavras e revistas) que demonstraram clara separação entre o subcorpus A e B, porém, sem clara distinção entre as classes pertencentes ao mesmo subcorpus. Discussão: As análises dos artigos publicados nas revistas do campo de Farmácia nos últimos 10 anos demonstraram uma nítida separação entre duas grandes áreas: Farmácia Clínica (subcorpus A) e Farmácia Básica (subcorpus B). A partir das palavras mais relevantes foi possível identificar as seguintes classes lexicais: 1. Farmacoterapia; 2. Farmácia Prática; 3. Tecnologia Farmacêutica; 4. Farmácia Analítica/Química Farmacêutica; 5. Farmacologia experimental/Biofarmácia. Algumas bases de indexação e vários índices pelos quais se avalia o desempenho de investigadores consideram a Farmácia como uma área única, ignorando as diferenças encontradas nesta análise. Semelhante a outras áreas, é expectável a existência de padrões de publicação e citação diferentes entre as subáreas que justificam a necessidade da subdivisão do campo da Farmácia nas cinco categorias identificadas. Conclusões: Através de um método objetivo de análise textual dos títulos dos artigos científicos foi possível demonstrar a distinção existente no campo da Farmácia entre dois grandes subcorpus e cinco subáreas que a compõem.Introduction: A science map is a spatial representation of how disciplines, areas of knowledge, specialties, scientific journals, and individually articles or authors are related to each other. Pharmacy, as an area of knowledge, encompasses both technological, analytical and assistance features, which renders imprecise its subdivisions into disciplines and specialties. Main purpose: To map the subdivisions of the Pharmacy area from articles published in scientific journals. Methods: Active journals (December 2016) with publications in English and whose titles exhibited one or more related-terms (pharmacy, pharmaceutica*, pharmacist, pharmacotherapy) were collected from the Web of Science, Scopus, Medline and PubMed Central databases. The titles of all published articles (2006-2016) of the included journals were gathered according to the journal’s source into a single corpus for textual analyses (Iramuteq 0.7 alpha 2). The following analyses were conducted: lexicographic analysis to determine the text segments (ST) and frequency of words; Descending Hierarchical Classification (DHC) to categorize words and journals into similar lexical groups; and Factorial Correspondence Analyses (FCA) to obtain bi and tri-dimensional graphs. Chi-square (X2) and p-value were used as statistical measures of frequency and significance. Results: Initially 209 journals were found, of which 161 were selected. After data collection, 148,081 article’s titles were obtained, with an average of 919.7±1069.2 articles per journal. In the lexicographic analysis, 34,394 ST were analyzed with a satisfactory performance (74.82%). We found 65,070 different words. The DHC generated a dendrogram with five distinct lexical classes. The classes were separated into two main branches: subcorpus A (classes 1 and 2); and subcorpus B (3, 4 and 5). The most representative words and journals for each class were: patient, treatment, therapy, Exp_Op_Pharmacotherapy (p<0.0001) – Class 1; pharmacy, pharmacist, medication, Int_J_Clin_Pharm (p<0.0001) – Class 2; release, formulation, tablet, Drug_Develop_Ind_Pharm (p<0.0001) – Class 3; activity, extract, synthesis, Chem_Pharm_Bulletin (p<0.0001) – Class 4; cell, expression, human, Bio_Pharm_Bulletin (p<0.0001) – Class 5. The two Cartesian planes (words and journals) obtained in the FCA showed a clear separation between subcorpus A and B, but without clear distinction between the classes of the same subcorpus. Discussion: The analyses of the articles published in the Pharmacy journals in the last 10 years highlighted a clear separation between two major areas: Clinical Pharmacy (subcorpus A) and Basic Pharmacy (subcorpus B). The following lexical classes were identified from the most relevant words: 1. Pharmacotherapy; 2. Pharmacy Practice; 3. Pharmaceutical Technology; 4. Analytical Pharmacy/Pharmaceutical Chemistry; 5. Experimental Pharmacology/Biopharmacy. Some indexing bases and several indices by which the performance of researchers are evaluated, consider Pharmacy as a single area, ignoring the differences found in these analyses. Similar to other areas, different publication and citation patterns are expected to exist among subareas, which justify the need to subdivide the Pharmacy field into the five identified categories. Conclusions: Through an objective method of textual analysis of the titles of the scientific articles, it was possible to demonstrate the distinction between two major subcorpus with five sub-areas that compose the Pharmacy field.info:eu-repo/semantics/publishedVersio

The role of benralizumab in eosinophilic immune dysfunctions: a case report-based literature review

In the past years, the knowledge of eosinophils playing a primary pathophysiologic role in several associated conditions has led to the development of biologics targeting therapies aiming at normalizing the immune response, reducing chronic inflammation, and preventing tissue damage. To better illustrate the potential relationship between different eosinophilic immune dysfunctions and the effects of biological therapies in this scenario, here, we present a case of a 63-year-old male first referred to our department in 2018 with a diagnosis of asthma, polyposis, and rhinosinusitis and presenting a suspicion of nonsteroidal anti-inflammatory drugs' allergy. He also had a past medical history of eosinophilic gastroenteritis/duodenitis (eosinophilia counts >50 cells/high-power field HPF). The use of multiple courses of corticosteroid therapy failed to completely control these conditions. In October 2019, after starting benralizumab (an antibody directed against the alpha chain of the IL-5 cytokine receptor) as an add-on treatment for severe eosinophilic asthma, important clinical improvements were reported both in the respiratory (no asthma exacerbations) and gastrointestinal systems (eosinophilia count 0 cells/HPF). The patient's quality of life also increased. Since June 2020, systemic corticosteroid therapy was reduced without worsening gastrointestinal symptoms or eosinophilic inflammation. This case warns of the importance of early recognition and appropriate individualized treatment of eosinophilic immune dysfunctions and suggests the conduction of further larger studies on the use of benralizumab in gastrointestinal syndromes aiming at better understanding its relying mechanisms of action in the intestinal mucosa.info:eu-repo/semantics/publishedVersio