Vitamin D deficiency and acute respiratory infections among brazilian children

The prescription of antibiotics worldwide remains large, especially in children. The lack of accurate diagnoses leads to overuse of these drugs, increasing bacterial resistance. A large number of studies have shown that another important factor in the onset of upper respiratory infections (URI) is inadequate intake of nutrients for these children, especially vitamins A, C and D. This study aimed to understand the use of antibiotics and the profile of nutrient intake in children diagnosed with URI. During 12 months, a survey (24 h dietary recall) was applied in 131 parents of children using antibiotics. The results showed antibiotic prescriptions for viral infections (37 %), pointing out incorrect prescriptions. The presence of URI was directly related to the lack of intake of vitamins, especially A and D. Countries with poor sources of these vitamins (fish oil), in regular diet, should increase the dietary supplementation of vitamins to diminish the appearance of URIs.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Differing myocardial response to a single session of hemodialysis in end-stage renal disease with and without type 2 diabetes mellitus and coronary artery disease

BACKGROUND: Though hemodialysis (HD) acutely improves cardiac function, the impact of background diseases like coronary artery disease (CAD) and Type 2 diabetes (DM) in the setting of end-stage renal disease (ESRD) is not known. Tissue velocity echocardiography (TVE) offers a fast choice to follow changes in myocardial function after HD in ESRD with concomitant DM and /or CAD. METHODS: 46 subjects (17 with ESRD, Group 1; 15 with DM, Group 2; 14 with DM+CAD, Group 3) underwent standard and TVE prior to and shortly after HD. Besides standard Doppler variables, regional myocardial systolic and diastolic velocities, as well as systolic strain rate were post processed. RESULTS: Compared with pre-HD, post-HD body weight (kg) significantly decreased in all the three groups (51 ± 9 vs. 48 ± 8, 62 ± 10 vs.59 ± 10, and 61 ± 9 vs. 58 ± 9 respectively; all p < 0.01). Left ventricular end diastolic dimensions (mm) also decreased post- HD (46 ± 5 vs. 42 ± 7, 53 ± 7 vs. 50 ± 7, 51 ± 7 vs. 47 ± 8 respectively; all p < 0.01). Regional longitudinal peak systolic velocity in septum (cm/s) significantly increased post-HD in Group 1(5.7 ± 1.6 vs. 7.2 ± 2.3; p < 0.001) while remained unchanged in the other two groups. Similar trends were noted in other left ventricular walls. When the myocardial velocities (cm/s) were computed globally, the improvement was seen only in Group 1 (6.3 ± 1.5 vs. 7.9 ± 2.0; p < 0.001). Global early regional diastolic velocity (cm/s) improved in Group 1, remained unchanged in Group 2, while significantly decreased in Group 3(-5.9 ± 1.3 vs. -4.1 ± 1.8; p < 0.01). Global systolic strain rate (1/sec) increased in the first 2 Groups but remained unchanged (-0.87 ± 0.4 vs. -0.94 ± 0.3; p = ns) in Group 3. CONCLUSION: A single HD session improves LV function only in ESRD without coexistent DM and/or CAD. The present data suggest that not only dialysis-dependent changes in loading conditions but also co-existent background diseases determine the myocardial response to HD

A influência da margem de lucro na comercialização de medicamentos

&lt;p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: normal; text-align: justify; mso-layout-grid-align: none;"&gt; Este trabalho pretende identificar a variação da margem de lucro a partir da comparação entre o preço real de compra e o preço máximo ao consumidor de medicamentos de referência, genéricos e similares, e estabelecer a relação entre este parâmetro e a comercialização de medicamentos, sob o ponto de vista ético e legal. A amostra foi composta por 14 fármacos, 295 especialidades, sendo 14 medicamentos de referência, 112 genéricos e 169 similares. Para a análise dos dados foi calculada a margem de lucro de cada medicamento. Os medicamentos similares foram divididos em dois grupos, A e B, considerando as semelhanças na margem de lucro. Para avaliar a diferença de preço que o consumidor pode pagar ao optar por um dos produtos contendo o mesmo fármaco, na mesma apresentação, calculou-se a porcentagem de variação do preço máximo ao consumidor entre a especialidade mais cara e a mais barata. A margem de lucro observada situa-se entre 44 e 57% (referência); 98-199% (genéricos); 49-57% (similares A) e 147-236% (similares B). Os resultados obtidos e as reflexões apresentadas destacam a importância do governo no controle da qualidade e na regulação do mercado farmacêutico brasileiro, e o que se pode constatar indiretamente é que as regras de comercialização, muitas vezes, se contrapõem aos compromissos social, ético e legal necessários para caracterizar as farmácias e drogarias como estabelecimentos de saúde. Palavras-chave: preço de medicamentos; comercialização de medicamentos; vigilância sanitária; medicamento genérico. &lt;/p&gt

Obesity: A New Adverse Effect of Antibiotics?

Since the introduction of antibiotics, they have been used freely, with their prescription occurring almost always when they were not necessary. The other major form of contact between humans and antibiotics, now unintentionally, is with the large amount of these drugs in the environment and in our food. The relationship between antibiotic use and the development of obesity has become increasingly evident and apparent in humans, with some authors clearly establishing the relationship between the large-scale use of antibiotics in the past 70 years and the “epidemic” of obesity that has occurred in parallel, almost as an adverse epidemiological effect. In the research effort entertained herein, a correlation between the use and abuse of antibiotics and the onset of obesity was investigated

Phenobarbital Pharmacological Findings on the Nerve-Muscle Basis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Phenobarbital and carbamazepine are antiepileptic drugs that act at the nervous central system by different mechanisms of action. In this work we investigated the pharmacological effects of these drugs on mouse phrenic nerve-diaphragm preparations through the myographic technique. Carbamazepine (0.105, 1.05, 2.1 and 4.2 mM, n = 8, 6, 6 and 6, respectively), induced a dose-dependent neuromuscular blockade, under indirect or direct muscle stimulation and the neurotransmission was reestablished after washing. Conversely, phenobarbital caused an unexpected facilitatory effect, under several formulations, such as the acid-extracted commercial tablets (1.05, 2.1 and 4.2 mM, n = 7, 6 and 7, respectively), commercial phenobarbital solution (4.2 mM, n = 7) or its correspondent pure active ingredient (4.2 and 2.1 mM, n = 6 each). Only at a higher concentration the acid-extracted phenobarbital performed a neuromuscular blockade (8.4 mM, n = 10). The different responses between carbamazepine (paralysis) and phenobarbital (facilitatory effect) evidentiated a new effect for phenobarbital until now concealed at the neuromuscular junction and may involve the glutamatergic regulation, since its role as an acethyl-choline co-transmitter in motoneurons was already established.282211218Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)PROBIC/UNISOFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [04/09705-8

Phenobarbital Pharmacological Findings On The Nerve-muscle Basis

Phenobarbital and carbamazepine are antiepileptic drugs that act at the nervous central system by different mechanisms of action. In this work we investigated the pharmacological effects of these drugs on mouse phrenic nerve-diaphragm preparations through the myographic technique. Carbamazepine (0.105, 1.05, 2.1 and 4.2 mM, n = 8, 6, 6 and 6, respectively), induced a dose-dependent neuromuscular blockade, under indirect or direct muscle stimulation and the neurotransmission was reestablished after washing. Conversely, phenobarbital caused an unexpected facilitatory effect, under several formulations, such as the acid-extracted commercial tablets (1.05, 2.1 and 4.2 mM, n = 7, 6 and 7, respectively), commercial phenobarbital solution (4.2 mM, n = 7) or its correspondent pure active ingredient (4.2 and 2.1 mM, n = 6 each). Only at a higher concentration the acid-extracted phenobarbital performed a neuromuscular blockade (8.4 mM, n = 10). 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Editorial : new horizons in health-promoting: from methods to implementation science

New technologies with the potential to improve population health are being continually introduced through research and innovation. To improve care with available resources, it is necessary to promote the most cost-effective technologies, respecting organizational, social and ethical issues. This can be a concern in recent years with the growth in pharmaceutical expenditure being driven by new medicines for complex diseases, including cancer and orphan diseases, often though with limited health gain (Cohen, 2017; Luzzatto et al., 2018; Moreira et al., 2021; Godman et al., 2021c). This calls for greater evidence-based approaches to healthcare especially in countries with universal healthcare systems faced with rising costs and continued unmet need (Camargo et al., 2016; Fulone et al., 2016; Godman et al., 2021b)