ABSTRACT
O objetivo deste estudo foi determinar a taxa de adesão à farmacoterapia e identificar os fatores que interferem nesta taxa em pacientes idosos atendidos em uma Unidade Básica de Saúde (UBS) no município de Salto Grande, São Paulo. Foram recrutados 120 pacientes idosos para participar de estudo transversal, desenvolvido no período de maio a setembro de 2009. Foi aplicado questionário para determinar a taxa de adesão (MMAS-8) e identificar as características sócio-econômicas, de saúde autorreferidas, da farmacoterapia utilizada e da satisfação dos pacientes com os serviços de saúde da UBS estudada. Um total de 102 pacientes completo o estudo, sendo que a maioria dos indivíduos apresentou taxa de adesão insatisfatória (14,7% alta adesão, 48,0% adesão média e 37,3% baixa adesão). Apresentaram forte correlação com adesão, satisfação com os serviços de saúde (r= 0,884; p < 0,0001) e o Índice de Complexidade da Farmacoterapia (ICFT) (r= - 0,705; p < 0,001). O número de medicamentos consumidos (r= - 0,604; p < 0,001), número de doenças relatadas (r = - 0,604; p < 0,001) e número de moradores por residência (r= 0,428; p < 0,001) apresentaram correlação intermediária com adesão. Foi encontrada uma correlação fraca entre adesão e escolaridade (r= 0,263; p < 0,001), raça (r= 0,090; p < 0,001), sexo (r= 0,080; p < 0,001), renda familiar (r= 0,054; p < 0,001) e idade (r= -0,090; p < 0,001). Esses resultados indicam que a população estudada não adere adequadamente à farmacoterapia, com forte influência da satisfação dos pacientes com os serviços de saúde e ICFT nesses resultados.
The aim of this study was to determine the rate of adherence to pharmacotherapy and to identify the factors that interfere with this adherence in elderly patients attended at a local Health Center (BHU) in Salto Grande, a country town in Sao Paulo. One hundred and twenty patients were recruited to participate in a cross-sectional study, conducted from May to September 2009. A questionnaire was used to determine the adherence rate (MMAS-8) and to identify the socio-economic factors, health condition (self-reported), medication used and satisfaction of the patients with the health services provided at the BHU. A total of 102 patients completed the study, most of whom showed unsatisfactory adherence rates (14.7% high adherence, 48.0% mean adherence and 37.3% poor adherence). Adherence was strongly correlated with patient satisfaction with health services (r= 0.884; p < 0.0001) and the Medication Regimen Complexity Index (MRCI) (r= - 0.705; p < 0.001). The number of drugs consumed (r = - 0.604, p <0.001), number of reported diseases (r = - 0.604, p <0.001) and number of residents per house (r = 0.428, p <0.001) showed intermediate correlation with intermediate adherence. Weak correlation was found between adherence and education level (r = 0.263, p <0.001), race (r = 0.090, p <0.001), sex (r = 0.080, p <0.001), family income (r = 0.054, p <0.001 ) and age (r = -0.090, p <0.001). These results indicate that the population does not adhere adequately to medication prescribed at the BHU and that patients? satisfaction with health services and the MRCI influence these results strongly.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Health of the ElderlyABSTRACT
Torque Teno virus (TTV) is an infectious agent of worldwide distribution isolated by the first time as the agent of an acute post-transfusion hepatitis in a patient in Japan. It has been classified into a new floating genus called Anellovirus. Recent studies showed that TTV can also be identified in serum specimens obtained from domesticated farm animals and from non-human primates. To better understand the relationship between TTV and their hosts, a study to detect virus in the serum and whole blood of Brazilian non-human primates and in the plasm of chickens was performed by applying the PCR-UTR-A technique, followed by a genomic sequence and phylogenetic analysis. By nested-PCR-UTR, the DNA of TTV was detected in sera from 4 (5.3 percent) of 75 Cebus apella, 2 (40 percent) of 5 Alouatafusca, 1 (20 percent) of 5 Alouata caraya, 1 (5.2 percent) of 19 Callithrixpenicilata, 1 (4 percent) of 25 Callithrixjacchus, 1 (20 percent) of 5 Saimiri sciureus and 1 (25 percent) of 4 Leontopithecus chrysomelas. Phylogenetic analysis revealed that sequences detected in 8 samples clustered with TTV sequences So-TTV2 (Sagüínus oedipus) and At-TTV3 (Aotes Trivirgatus). Three sequences showed similarity with a human Torque Teno Minivirus (TLMV). TTV ORF2 DNA was detected in one sera sample and one whole blood sample of non-human primates and in one plasm sample of chicken. Phylogenetic analysis revealed that the sequences amplified by the ORF2 region show no difference between human, non-human primates and chicken. This is the first report of TTV in Brazilian new world non-human primates and chicken.
Torque Teno virus (TTV) es una agente infeccioso de distribución mundial, aislado por primera vez como el agente de una hepatitis aguda posterior a la transfusión de un paciente en Japón. Se ha clasificado en un nuevo género flotante llamado Anellovirus. Recientes estudios han demostrado que TTV también puede ser identificado en el suero de especímenes obtenidos desde granjas de animales domésticos y desde primates no humanos. Para entender mejor la relación entre la TTV y sus huéspedes, fue realizado un estudio para detectar el virus en el suero y la sangre de primates no humanos brasileños y en el plasma de pollos mediante la aplicación de la técnica PCR-UTR-A, seguida de una secuencia genómica y análisis filogenético. Por medio de PCR-UTR-anidado, el ADN de TTV fue detectado en sueros de 4 de 75 (5,3 por ciento)Cebus apella, 2 de 5 (40 por ciento) Alouata fusca, 1 de 5 (20 por ciento) de Alouata caraya, 1 de 19 (5,2 por ciento) de Callithrixpenicilata, 1 de 25 (4 por ciento) Callithrixjacchus, 1 de 5 (20 por ciento) de Saimiri sciureus y 1 de 4 (25 por ciento) de Leontopithecus chrysomelas. El análisis filogenético reveló secuencias detectadas en 8 muestras agrupadas con TTV secuencias So-TTV2 (Sagüínus oedipus) y At-TTV3 (Aotes Trivirgatus). Tres secuencias mostraron similitud con el Torque Teno Minivirus humano (TLMV). Fue detectado TTV ORF2 ADN en una muestra de suero y una muestra de sangre de primates no-humanos y en una muestra de plasma de pollo. El análisis filogenético reveló que las secuencias amplificadas por la región ORF2 no muestran ninguna diferencia entre humanos, primates no humanos y pollos. Este es el primer informe de nuevos TTV en primates-no humanos brasileños y en pollos.
Subject(s)
Animals , Poultry Diseases/virology , Primate Diseases/virology , DNA Virus Infections/genetics , DNA Virus Infections/veterinary , Torque teno virus/isolation & purification , DNA, Viral/genetics , Amino Acid Sequence , Brazil , Poultry Diseases/genetics , Primate Diseases/genetics , Genome, Viral , DNA Virus Infections/virology , Phylogeny , Polymerase Chain Reaction , Chickens/virology , Primates/virology , Sequence Analysis, DNA , Torque teno virus/genetics , Untranslated RegionsABSTRACT
Torque teno virus (TTV) is a recently discovered DNA virus that was originally isolated from a Japanese patient (initials, TT) with post-transfusion hepatitis of unknown aetiology. TTV is an circular DNA virus classified recently together with related Torque teño minivirus, into a new genus called Anellovirus. Infection TTV has been detected in a range of non-human primates as well as domestic animals. The purpose of this study was to search TTV in the serum and total blood of Brazilian monkeys and in plasma of domestic chickens by seminested PCR of coding region (N22), followed by a genomic sequence and phylogenetic analysis. No serum sample was amplified. TTV DNA was detected in total blood from 3 (4 percent) out of 75 brown-capuchin (Cebus apella) and from 1 (25 percent) out of 4 golden-headed lion-tamarin (Leontopithecus chrysomelas). Phylogenetic analysis revealed that one sample showed similarity with one sequence of the cotton top tamarin (Saguinus oedipus) (So-TTV2) and with one of the douroucoulis (ão tes trivirgatus) (At-TTV3). Two samples showed similarity with a human Torque Teño Mini Virus (TLMV). The other sample clustered with one sequence of the chimpanzee (Pt-TTV6) and with the human TTV strain TA278. The plasma chicken samples tested were all negative. The amino acid sequences reported in this study are the first obtained in Brazil from total blood of non-human primates naturally infected by TTV.
Torque teno virus (TTV) es un virus de ADN recientemente descubierto que fue inicialmente aislado de un paciente japonés (iniciales TT) después de la transfusión de hepatitis de etiología desconocida. TTV es un virus de ADN circular recientemente clasificado junto con los torque teno minivirus, en un nuevo género llamado Anellovirus. La infección de TTV se ha detectado en una serie de primates no humanos, así como animales domésticos. El objetivo de este estudio fue buscar TTV en el suero y sangre total de monos de Brasil y en el plasma de pollos domésticos, por seminested PCR de la región de codificación (N22), seguido de una secuencia genómica y el análisis filogenético. Las muestras que no eran suero fueron amplificadas. TTV DNA se detectó en sangre total de 3 (4 por ciento) de un total de 75 capuchinos de cabeza dura (Cebus apella) y de 1 (25 por ciento) de un total de 4 tití- león de cabeza dorada (Leontopithecus chrysomelas). El análisis filogenético demostró que una muestra presentaba similitud con una secuencia de Saguinus Edipo (So-TTV2) y con una de Aotes trivirgatus (A-TTV3). Dos muestras mostraron similitud con un torque teno mini virus (TLMV) humano. La otra muestra agrupada con una secuencia de los chimpancés (PT-TTV6) y con el TTV humanos cepa TA278. El análisis de las muestras de plasma de pollo fueron negativas Las secuencias de aminoácidos que se reportan en este estudio son las primeras obtenidas en Brasil de sangre de primates no humanos infectados naturalmente por TTV.