Erros de distribuição em dose unitária: tipos e causas

Os erros de medicação são um problema de saúde pública com uma repercussão económica importante, afectando a qualidade de vida dos utentes e os custos em saúde. Ao nível da farmácia hospitalar, “que tem como principal função a dispensa dos medicamentos aos doentes de acordo com a prescrição médica, nas quantidades e especificações solicitadas, de forma segura e no prazo requerido, promovendo o uso seguro e racional do medicamento,” o erro de distribuição é definido como a discrepância entre a ordem prescrita pelo médico e o atendimento dessa ordem, podendo gerar oportunidades de erros de administração. Os erros classificam-se em função da etapa do circuito do medicamento em que ocorrem: prescrição, distribuição e administração. A distribuição de medicamentos em sistema de dose unitária (DMDU) está descrita como imperativo para aumentar a segurança no circuito do medicamento, prevendo uma distribuição diária de medicamentos, em dose individual unitária, para um período de 24 horas. Sempre que possível, a DMDU deverá apoiar-se em equipamentos semi-automáticos, para redução dos erros. Sendo a qualidade e segurança uma preocupação crescente e uma prioridade dos sistemas de saúde, os profissionais de saúde devem intervir activamente na melhoria dos sistemas de utilização dos medicamentos para garantir a segurança do doente. Consequentemente, vários estudos têm sido desenvolvidos para verificar os tipos de erros mais frequentes em farmácia hospitalar. Objectivo do estudo: identificar os principais erros de distribuição em dose unitária descritos na literatura nos últimos 5 anos e as suas causas, através de uma revisão sistemática

Multi-frequency multimode modulated technology as a clean, fast, and sustainable process to recover antioxidants from a coffee by-product

Coffee chaff is a major coffee roasting by-product that could be valued as a source of antioxidants. In the present work, we compared classic, but optimized, solid-liquid extraction conditions with a new concept, namely, the Multi-frequency Multimode Modulated (MMM) vibration technique. The extracts obtained by both methods were analysed and compared in relation to several parameters, namely, phenolics profile (by HPLC/DAD), 5-caffeoylquinic acid content, total phenolics content, and Ferric Reducing Antioxidant Power. Compared to an optimized solid-liquid extraction (using a hydroethanolic solvent (1:1) at 40 °C for 60 min), the acoustic probe allowed a higher recovery of antioxidants in only 10 min and using only water as extraction solvent. Moreover, the effects that arise from the acoustic cavitation in the medium allowed the suppression of the sample preparation step (grinding). These results show that this type of technology can be of high interest to recover antioxidants from natural matrices, in a green, fast and very efficient way.info:eu-repo/semantics/publishedVersio

Organic versus conventional tomatoes: Influence on physicochemical parameters, bioactive compounds and sensorial attributes

The effect of organic and conventional agricultural systems on the physicochemical parameters, bioactive compounds content, and sensorial attributes of tomatoes (‘‘Redondo’’ cultivar) was studied. The influence on phytochemicals distribution among peel, pulp and seeds was also accessed. Organic tomatoes were richer in lycopene (+20%), vitamin C (+30%), total phenolics (+24%) and flavonoids (+21%) and had higher (+6%) in vitro antioxidant activity. In the conventional fruits, lycopene was mainly concentrated in the pulp, whereas in the organic ones, the peel and seeds contained high levels of bioactive compounds. Only the phenolic compounds had a similar distribution among the different fractions of both types of tomatoes. Furthermore, a sensorial analysis indicated that organic farming improved the gustative properties of this tomato cultivar

Phenylketonuria: Protein content and amino acids profile of dishes for phenylketonuric patients. The relevance of phenylalanine

Phenylketonuria is an inborn error of metabolism, involving, in most cases, a deficient activity of phenylalanine hydroxylase. Neonatal diagnosis and a prompt special diet (low phenylalanine and natural-protein restricted diets) are essential to the treatment. The lack of data concerning phenylalanine contents of processed foodstuffs is an additional limitation for an already very restrictive diet. Our goals were to quantify protein (Kjeldahl method) and amino acid (18) content (HPLC/fluorescence) in 16 dishes specifically conceived for phenylketonuric patients, and compare the most relevant results with those of several international food composition databases. As might be expected, all the meals contained low protein levels (0.67–3.15 g/100 g) with the highest ones occurring in boiled rice and potatoes. These foods also contained the highest amounts of phenylalanine (158.51 and 62.65 mg/100 g, respectively). In contrast to the other amino acids, it was possible to predict phenylalanine content based on protein alone. Slight deviations were observed when comparing results with the different food composition databases

Valorizing coffee silverskin based on its phytochemicals and antidiabetic potential: from lab to a pilot scale

This study investigates the possibility of valorizing coffee silverskin through the recovery of its bioactive compounds using a sustainable extraction method that could be industrially applied. For that, aqueous extracts were prepared using ultrasonic-assisted extraction (laboratorial scale) and, for comparison, a scale-up of the process was developed using the Multi-frequency Multimode Modulated technology. A concentration procedure at the pilot scale was also tested. The three types of extracts obtained were characterized regarding caffeine and chlorogenic acids contents, and the effects on intestinal glucose and fructose uptake (including sugar transporters expression) in human intestinal epithelial (Caco-2) cells were ascertained. The phytochemical contents of the extracts prepared at the laboratory and pilot scale were comparable (caffeine: 27.7 vs. 29.6 mg/g freeze-dried extract; 3-, 4-, and 5-caffeoylquinic acids: 0.19 vs. 0.31, 0.15 vs. 0.42, and 1.04 vs. 1.98 mg/g, respectively; 4- and 5- feruloylquinic acids: 0.39 vs. 0.43 and 1.05 vs. 1.32 mg/g, respectively). Slight differences were noticed according to the extracts preparation steps, but in general, all the extracts promoted significant inhibitions of [1,2-3H(N)]-deoxy-D-glucose and 14C-D-fructose uptake, which resulted mainly from a decrease on the facilitative glucose transporter 2 (GLUT2) and sodium-glucose linked transporter 1 (SGLT1) genes expression but not on the expression of the facilitative glucose transporter 5 (GLUT5) gene. Moreover, a synergistic effect of caffeine and 5-caffeoylquinic acid on sugars uptake was found. The results clearly show that the Multi-frequency Multimode Modulated technology is a viable option to be applied at an industrial level to recover bioactive components from silverskin and obtain extracts with antidiabetic potential that could be used to develop functional food products or dietary supplements.The open access publication fee of this paper was funded by the AgriFood XXI I&D&I project (NORTE-01-0145-FEDER-000041) cofinanced by European Regional Development Fund (ERDF) through the NORTE 2020 (Programa Operacional Regional do Norte 2014/2020)

Trimetilaminúria (Síndroma de odor a peixe) uma doença subestimada: espectro mutacional da população portuguesa

Pretende-se com este trabalho divulgar a capacidade instalada de estudo desta doença, esclarecer a etiologia de casos investigados e tentar correlacionar o genótipo/fenótipo da doença, minimizando os impactos psicossociais que esta patologia acarreta. Por outro lado, pretende-se também alertar para a necessidade do estudo desta patologia de uma forma integrada com a farmacogenética, uma vez que certos genótipos poderão condicionar a atuação de um determinado fármaco

Integrating Science, Technology, Engineering and Mathematics contents through PBL in an Industrial Engineering and Management first year program

Paper aims: This paper presents teachers and students perspectives of integration Science, Technology, Engineering and Mathematics (STEM) courses contents into the first year of Industrial Engineering and Management (IEM) program through Project-Based Learning (PBL). Originality: These perspectives provide strategies that IEM teachers could use to challenge students to apply STEM contents to design a product and its production system by developing a semester interdisciplinary project. Research method: Grounded on project deliveries and an on-line questionnaire, the teachers and students' work and perceptions were analysed in order to understand and to evaluate the effectiveness of such strategies. Main findings: Results pointed out a general satisfaction of the teachers with the way teams integrate the STEM contents to design the production system and the product and students proud of their projects. Implications for theory and practice: PBL is recognized as an active learning methodology that engages students in their own learning process and allows them to realize the relevance of all courses and the role of each to design a product/production system. Nevertheless, is fundamental a good knowledge of the PBL process to achieve this.This work has been supported by FCT – Fundação para a Ciência e Tecnologia within the Project Scope: UID/CEC/00319/201

Water-sediment physicochemical dynamics in a large reservoir in the Mediterranean region under multiple stressors

Nowadays, the Mediterranean freshwater systems face the threat of water scarcity, along with multiple other stressors (e.g., organic and inorganic contamination, geomorphological alterations, invasive species), leading to the impairment of their ecosystem services. All these stressors have been speeding up, due to climate variability and land cover/land use changes, turning them into a big challenge for the water management plans. The present study analyses the physicochemical and phytoplankton biomass (chlorophyll-a) dynamics of a large reservoir, in the Mediterranean region (Alqueva reservoir, Southern Portugal), under diverse meteorological conditions and land cover/land use real scenarios (2017 and 2018). The most important stressors were identified and the necessary tools and information for a more effective management plan were provided. Changes in these parameters were further related to the observed variations in the meteorological conditions and in the land cover/land use. The increase in nutrients and ions in the water column, and of potentially toxic metals in the sediment, were more obvious in periods of severe drought. Further, the enhancement of nutrients concentrations, potentially caused by the intensification of agricultural activities, may indicate an increased risk of water eutrophication. The results highlight that a holistic approach is essential for a better water resources management strategy

Targeting specific nutrient deficiencies in proteinrestricted diets: some practical facts in PKU dietary management

Among aminoacidopathies, phenylketonuria (PKU) is the most prevalent one. Early diagnosis in the neonatal period with a prompt nutritional therapy (low natural-protein and phenylalanine diet, supplemented with phenylalanine-free amino acid mixtures and special low-protein foods) remains the mainstay of the treatment. Data considering nutrient contents of cooked dishes is lacking. In this study, fourteen dishes specifically prepared for PKU individuals were analysed, regarding the lipid profile and iron and zinc contents. These dishes are poor sources of essential nutrients like Fe, Zn or n-3 fatty acids, reinforcing the need for adequate supplementation to cover individual patients’ needs. This study can contribute to a more accurate adjustment of PKU diets and supplementation in order to prevent eventual nutritional deficiencies. This study contributes to a better understanding of nutrient intake from PKU patients’ meals, showing the need for dietary supplementation

End-user assessment of an innovative clothing-based sensor developed for pressure injury prevention: a mixed-method study

This study aimed to evaluate a clothing prototype that incorporates sensors for the evaluation of pressure, temperature, and humidity for the prevention of pressure injuries, namely regarding physical and comfort requirements. A mixed-method approach was used with concurrent quantitative and qualitative data triangulation. A structured questionnaire was applied before a focus group of experts to evaluate the sensor prototypes. Data were analyzed using descriptive and inferential statistics and the discourse of the collective subject, followed by method integration and meta-inferences. Nine nurses, experts in this topic, aged 32.66 ± 6.28 years and with a time of profession of 10.88 ± 6.19 years, participated in the study. Prototype A presented low evaluation in stiffness (1.56 ± 1.01) and roughness (2.11 ± 1.17). Prototype B showed smaller values in dimension (2.77 ± 0.83) and stiffness (3.00 ± 1.22). Embroidery was assessed as inadequate in terms of stiffness (1.88 ± 1.05) and roughness (2.44 ± 1.01). The results from the questionnaires and focus groups’ show low adequacy as to stiffness, roughness, and comfort. The participants highlighted the need for improvements regarding stiffness and comfort, suggesting new proposals for the development of sensors for clothing. The main conclusions are that Prototype A presented the lowest average scores relative to rigidity (1.56 ± 1.01), considered inadequate. This dimension of Prototype B was evaluated as slightly adequate (2.77 ± 0.83). The rigidity (1.88 ± 1.05) of Prototype A + B + embroidery was evaluated as inadequate. The prototype revealed clothing sensors with low adequacy regarding the physical requirements, such as stiffness or roughness. Improvements are needed regarding the stiffness and roughness for the safety and comfort characteristics of the device evaluated.The 4NoPressure project was co-financed by the Operational Program for Competitiveness and Internationalization (COMPETE 2020) under the PORTUGAL 2020 Partnership Agreement, with support from the European Regional Development Fund (ERDF), reference number POCI-01-0247- FEDER-039869