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1.
Rev. APS ; 25(1): 120-153, 25/07/2022.
Article in Portuguese | LILACS | ID: biblio-1393488

ABSTRACT

Visando contribuir para o fortalecimento do uso adequado de fitoterápicos na Atenção Primária à Saúde (APS), este estudo apresenta resultados de pesquisa exploratório-descritiva que buscou avaliar o risco associado ao uso de plantas medicinais. Foi realizado um levantamento etnobotânico e etnofarmacológico junto à população da área de abrangência de uma Unidade de Saúde da Família (USF) rural localizada em um município da região Sul do Brasil. Em 80,65% dos domicílios visitados, verificou-se que o uso terapêutico de plantas medicinais estava associado a medicamentos de uso contínuo, e 51,61% dos entrevistados relataram não comunicar o uso de plantas medicinais ao profissional de saúde. 58,33% das espécies identificadas apresentaram possíveis riscos, contraindicações ou toxicidade, e 35,83% apresentaram possíveis interações com medicamentos convencionais de acordo com a literatura consultada. Discute-se sobre os riscos associados ao uso dessas plantas nessa população, e apresentam-se sugestões e orientações para minimizar esses riscos.


To contribute to the strengthening of the appropriate use of herbal medicines in primary health care, this study presents the results of exploratory and descriptive research which sought to assess the risk associated with the use of medicinal plants. It was realized an ethnobotanical and ethnopharmacological survey, carried out with the population of the areacovered by a rural Family Health Care Unit located in a county in the South region of Brazil. In 80.65% of the households visited, it was found that the therapeutic use of medicinal plants was associated with continuous-use medications, and 51.61% of the interviewees reported not communicating the use of medicinal plants to the health professional. 58.33% of the identified species presented possible risks, contraindications, or toxicity, and 35.83% presented possible interactions with conventional drugs according to the literature consulted. It discusses the risks associated with the use of these plants in this population and offers suggestions and guidelines to minimize these risks.


Subject(s)
Plants, Medicinal , Primary Health Care
2.
Acta sci., Health sci ; 44: e56764, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367790

ABSTRACT

The aim of this study was to investigate possible factors related to antiretroviral therapy (ART) that contribute to the understanding of the highest rate of Aids detection on the coast of the state of Paraná, a port region identified administratively as the 1stRegional Health Division (1stHD) in the state of Paraná. Data on the sociodemographic profile of the population undergoing antiretroviral treatment (ART), medication changes, dropout of therapy, proportion of the population undergoing treatment and viral load were obtained through computerized systems. Between July 1, 2018 and June 31, 2019, 1,393 people were on ART in the 1stRS. Of these, 57.6% were male. During this period, 110 people started ART with a predominance of the age group between 30 and 39 years old. ART was switched for169 people and 211 patient dropouts were detected. The proportion of people diagnosed with HIV without treatment (gap) is still high, however 92.7% people on ART have suppressed viral load. It can be concluded that the lower educational level of the population undergoing treatment, the late diagnosis of those infected and the treatment gapprobably contribute to the highest rate of Aids detection in the 1stRS.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Acquired Immunodeficiency Syndrome/epidemiology , Pharmacoepidemiology/methods , Anti-Retroviral Agents/therapeutic use , Sociodemographic Factors , Brazil/epidemiology , Incidence , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/drug therapy , Health Strategies , Viral Load
3.
Acta sci., Health sci ; 44: e53630, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367783

ABSTRACT

The aim of this study was to investigate adverse reactions to Dolutegravir, a drug recently made available by the Unified Health System (SUS) for treating HIV infections. The frequency, severity and sex distribution of adverse reactions to Dolutegravir were identified over the first 18 months of its availability in users in the state of Paraná. Information was obtained through the pharmacovigilance questionnaire prepared by the Ministry of Health, accessed through the Logistics Control System for Medicines(SICLOM). During the study period, dolutegravirwas dispensed to 9,865 patients in the state. However, 9,207 users (93.3%) answered the pharmacovigilance questionnaire. Among them, 1.75% reported 279 adverse reactions. This population was composed mainly of male people (69.57%), in the ratio of 2.29 men for each woman, white (67.08%), aged between 20 and 29 years (26.71%), single (45.34%) and with education between 8 and 11 years of study (41.61%). Gastrointestinal (36.92%) and nervous system (14.34%) disorders were the most prevalent. 77.78% adverse reactions were considered non-serious by users. It can be concluded that dolutegravirhad a low prevalence of adverse reactions in users in the state of Paraná, demonstrating to be safe for use by the population in therapy against HIV, in accordance with clinical trials.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , HIV Infections/drug therapy , HIV Integrase Inhibitors/adverse effects , Anti-Retroviral Agents/adverse effects , Anti-Retroviral Agents/pharmacology , Pharmacovigilance , Unified Health System , Severity of Illness Index , Sex Distribution , HIV Integrase Inhibitors/therapeutic use , Anti-Retroviral Agents/therapeutic use
4.
Rev. bras. promoç. saúde (Impr.) ; 34(1): 1-10, 17/02/2021.
Article in English, Portuguese | LILACS | ID: biblio-1343983

ABSTRACT

Objetivo: Identificar o perfil da população que buscou a Profilaxia Pré-Exposição ao HIV (PrEP) no Paraná e, entre os usuários da PrEP, avaliar modificações nos comportamentos de risco de adquirir infecções sexualmente transmissíveis (IST's), além de alterações nos exames laboratoriais de monitoramento. Métodos: Coorte retrospectiva com dados secundários obtidos do Sistema de Controle Logístico de Medicamentos acessados em 2018 e 2019. Investigou-se o perfil sociodemográfico da população que buscou a PrEP, de forma a correlacioná-lo aos segmentos prioritários para o uso do medicamento profilático. Entre os usuários, avaliaram-se dados comportamentais, testes diagnósticos para IST's, funções renal e hepática referentes a diferentes momentos no decorrer do uso. Os resultados comparados deram-se por meio dos testes Wilcoxon e Exato de Fisher. Resultados: 255 pessoas buscaram a PrEP. Predominaram-se o sexo masculino (92,28%), homossexuais (78,04%), de 20 a 39 anos (83,53%), brancos (71,76%), com 12 ou mais anos de estudo (74,90%). Para uso da PrEP elegeram-se 188 pessoas. Entre estas, durante o uso, observou-se aumento de práticas sexuais sem preservativo (p=0,012), diminuição no número de parceiros e do consumo de álcool (p=0,001), aumento da atividade de enzimas hepáticas ALT/AST (p=0,018), sem diferença no diagnóstico do HIV e outras IST's. Conclusão: Homens que fazem sexo com homens predominaram na busca pela profilaxia. Entre os usuários da PrEP, apesar do aumento de práticas sexuais desprotegidas, não houve aumento do diagnóstico de IST's no período do estudo. O medicamento da PrEP demonstrou bom perfil de segurança nos exames laboratoriais de seguimento.


Objective: To identify the profile of the population that sought HIV Pre-Exposure Prophylaxis (PrEP) in Paraná; and assess, among PrEP users, changes in risk behaviors for acquiring sexually transmitted infections (STIs) as well as changes in monitoring laboratory tests. Methods: Retrospective cohort with secondary data obtained from the Drug Logistics Control System accessed in 2018 and 2019. The sociodemographic profile of the population that sought PrEP was investigated to correlate it with priority segments for the use of prophylactic medication. Among users, behavioral data, diagnostic tests for STIs, kidney, and liver functions were evaluated at different times during use. The results were compared using the Wilcoxon and Fisher's Exact tests. Results: 255 people sought PrEP. Males predominated (92.28%), homosexuals (78.04%), from 20 to 39 years old (83.53%),white people (71.76%), with 12 or more years of schooling (74.90%). For the use of PrEP, 188 people were elected. Among them, during the usage, was noticed an increase in sexual practices without a condom (p=0.012), a decrease in the number of partners and alcohol consumption (p=0.001), an increase in the activity of liver enzymes ALT/AST (p=0.018), with no difference in the diagnosis of HIV and other STI's. Conclusion: Men who have sex with men predominated in the search for prophylaxis. Among PrEP users, despite the increase in unprotected sexual practices, there was no increase in the diagnosis of STIs during the study period; PrEP drugs showed a good safety profile in follow-up laboratory tests.


Objetivo: Identificar el perfil de la población que fue en busca de la Profilaxis pre-exposición al VIH (PrEP) en Paraná y, de entre los usuarios de la PrEP, evaluar los cambios de conducta de riesgo para tener infecciones de transmisión sexual (ITS) además de las alteraciones de las pruebas de laboratorios para el monitoreo. Métodos: Cohorte retrospectiva con datos secundarios del Sistema de Control Logístico de Medicamentos con acceso en 2018 y 2019. Se investigó el perfil sociodemográfico de la población que fue en busca de la PrEP, para correlacionarlo con los segmentos prioritarios para el uso del medicamento profiláctico. De los usuarios se ha evaluado los datos comportamentales, las pruebas de diagnósticos para las ITS, las funciones renales y hepática referente a distintos momentos durante el uso. Los resultados comparados se han dado a través de las pruebas de Wilcoxon y el Exacta de Fisher. Resultados: 255 personas han buscado la PrEP. Hubo el predominio para el sexo masculino (92,28%), homosexuales (78,04%), entre los 20 y 39 años (83,53%), blancos (71,76%), con 12 o más años de estudio (74,90%). Se há elegido 188 personas para el uso de la PrEP. De entre ellas, durante el uso, se observó el aumento de las prácticas sexuales sin condón (p=0,012), la disminución del número de compañeros y del consumo del alcohol (p=0,001), el aumento de la actividad de enzimas hepáticas ALT/AST (p=0,018), sin diferencia en el diagnóstico del VIH y de otras ITS. Conclusión: Los hombres que tienen sexo con hombres prevalecieron para la búsqueda de la profilaxis. De entre los usuarios de la PrEP, a pesar del aumento de las prácticas sexuales sin protección no hubo el aumento del diagnóstico de ITS en el período del estudio. El medicamento de la PrEP demostró un perfil bueno de seguridad en las pruebas de laboratorios de seguimiento.


Subject(s)
HIV , Pre-Exposure Prophylaxis , Population Health , Synthetic Drugs
5.
Einstein (Säo Paulo) ; 19: eAO5800, 2021. tab, graf
Article in English | LILACS | ID: biblio-1350699

ABSTRACT

ABSTRACT Objective: To characterize the sociodemographic profile of the population undergoing antiretroviral treatment in the state of Paraná, Brazil, to investigate the proportion of people undergoing treatment among all those diagnosed, and to analyze the proportion of patients with suppressed viral load in different regions of the state. Methods: Observational descriptive and analytical study carried out with information referring to the period from January 2018 to January 2019. Data were obtained from the Sistema Informatizado de Monitoramento Clínico das Pessoas Vivendo com HIV/AIDS [Computerized System for Clinical Monitoring of People Living with HIV/AIDS] and Sistema de Controle Logístico de Medicamentos[Drug Supply Control System]. The proportion of people on antiretroviral treatment in the state and the proportion of patients with viral load ≤1,000 copies/mL and ≤50 copies/mL were calculated. The results were compared with the corresponding parameters of the World Health Organization goal 90-90-90. Results: The state of Paraná managed to reach the second and third parameters of the 90-90-90 goal of the World Health Organization. Among those diagnosed, 93.12% were on antiretroviral treatment, and 90.0% of them had a viral load below 50 copies of viral RNA/mL of blood, indicating virologic success. Conclusion: The health policy aimed at the population living with HIV/AIDS, and the health services available in Paraná have been successful in parameters relevant to the control of the epidemic. However, it is necessary to ensure the diagnosis of people infected with HIV in the population.


RESUMO Objetivo: Caracterizar o perfil sociodemográfico da população em tratamento antirretroviral no estado do Paraná, investigar a proporção de pessoas em tratamento entre todos os diagnosticados e analisar a proporção de pacientes com carga viral suprimida nas diferentes regiões do estado. Métodos: Estudo observacional descritivo e analítico realizado com informações referentes ao período de janeiro de 2018 a janeiro de 2019. Os dados foram obtidos do Sistema Informatizado de Monitoramento Clínico das Pessoas Vivendo com HIV/AIDS e do Sistema de Controle Logístico de Medicamentos. Foram calculadas as proporções de pessoas em tratamento antirretroviral no estado e de pacientes com carga viral ≤1.000 cópias/mL e ≤50 cópias/mL. Os resultados foram comparados com os parâmetros correspondentes da meta 90-90-90 da Organização Mundial da Saúde. Resultados: O estado do Paraná alcançou o segundo e o terceiro parâmetros da meta 90-90-90 da Organização Mundial da Saúde. Entre os diagnosticados, 93,12% encontravam-se em tratamento antirretroviral, e 90,0% destes apresentavam carga viral abaixo 50 cópias do RNA viral/mL de sangue, indicando sucesso virológico. Conclusão: A política de saúde voltada à população vivendo com HIV/AIDS e os serviços de saúde disponibilizados no Paraná têm obtido êxito em parâmetros relevantes para o controle da epidemia. Entretanto, é necessário assegurar o diagnóstico das pessoas infectadas por HIV na população.


Subject(s)
Humans , HIV Infections/drug therapy , Anti-HIV Agents/therapeutic use , Brazil , RNA, Viral , Viral Load , Antiretroviral Therapy, Highly Active , Anti-Retroviral Agents/therapeutic use
6.
Einstein (Säo Paulo) ; 18: eAO4995, 2020. tab, graf
Article in English | LILACS | ID: biblio-1090037

ABSTRACT

ABSTRACT Objective To describe antiretroviral treatment regimens prescribed and their compliance with the Clinical Protocol and Therapy Guidelines of the Ministry of Health for the management of HIV infection. Methods Observational and descriptive study. Secondary data of the state of Paraná (Brazil) on drugs, treatment regimens, lines of treatment and number of individuals on treatment, from January to June 2018, were accessed at the Antiretroviral Agents Logistic Control System. Combinations of antiretroviral drugs (treatment regimens) were compared according to the current Clinical Protocol and Therapy Guidelines and non-compliances were classified and quantified. Results In Paraná, 35,127 individuals with HIV were treated with 253 different treatment regimens. Of the prescribed regimens, 19.1% were first-line, 27.4% second-line and 48.5% third-line. Among non-compliances, the most prevalent were absence of association of protease inhibitors and ritonavir (42.8%), low efficacy triple therapy (36.9%), double therapy (26.1%), monotherapy (20.3%), and triple therapy of nucleoside analog reverse transcriptase inhibitors (17.1%). Conclusion Most individuals receiving HIV treatment in the state of Paraná are on treatment regimens established in the current Clinical Protocol and Therapy Guidelines, which contributes to successful therapy. However, associations not provided by the current Clinical Protocol and Therapy Guidelines were identified in the initial treatment lines, which could lead to ineffectiveness, virologic failure and viral resistance.


RESUMO Objetivo Descrever esquemas terapêuticos de antirretrovirais prescritos e sua conformidade com o Protocolo Clínico e Diretrizes Terapêuticas, do Ministério da Saúde, para manejo da infecção pelo HIV. Métodos Estudo observacional e descritivo. Os dados do estado do Paraná sobre medicamentos que compõem os esquemas terapêuticos, linhas de tratamento e número de pessoas em uso destes foram acessados no Sistema de Controle Logístico de Medicamentos Antirretrovirais no período de janeiro a junho de 2018. As combinações de antirretrovirais (esquemas terapêuticos) foram comparadas conforme o Protocolo Clínico e Diretrizes Terapêuticas vigente, e as inconformidades foram categorizadas e quantificadas. Resultados No Paraná, 35.127 pessoas com HIV foram tratadas com 253 esquemas terapêuticos distintos. Dentre os esquemas prescritos, 19,1% eram de primeira linha, 27,4% de segunda linha e 48,5% de terceira linha. Nas inconformidades, predominaram a não associação entre inibidores da protease e ritonavir (42,8%), terapia tripla de baixa eficiência (36,9%), terapia dupla (26,1%), monoterapia (20,3%) e terapia tripla de inibidores da transcriptase reversa análogos de nucleosídeos (17,1%). Conclusão Maior parte das pessoas em tratamento do HIV no Paraná utilizam esquemas terapêuticos previstos no Protocolo Clínico e Diretrizes Terapêuticas vigente, o que contribui para o sucesso terapêutico. Entretanto, associações não previstas foram identificadas nas linhas de tratamento iniciais, podendo ocasionar inefetividade, falha virológica e resistência viral.


Subject(s)
Humans , Clinical Protocols/standards , Guideline Adherence/standards , Anti-Retroviral Agents/administration & dosage , Brazil , HIV Infections/drug therapy , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/therapeutic use , Guideline Adherence/statistics & numerical data , Anti-Retroviral Agents/therapeutic use , Drug Therapy, Combination/standards , Drug Therapy, Combination/statistics & numerical data , Medication Adherence/statistics & numerical data
7.
Einstein (Säo Paulo) ; 18: eGS4442, 2020. tab, graf
Article in English | LILACS | ID: biblio-1039730

ABSTRACT

ABSTRACT Objective To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease. Methods We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center. Results Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage. Conclusion Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.


RESUMO Objetivo Analisar as demandas judiciais do brometo de tiotrópio para tratar a doença pulmonar obstrutiva crônica. Métodos Foram considerados dados secundários dos sistemas gerenciais de assistência farmacêutica, disponibilizados pelo Centro de Medicamentos do Paraná. Resultados Ações civis públicas e ações ordinárias, de procedimento comum, entre outras, foram as mais praticadas pelos pacientes para obter o medicamento. Duas Regionais de Saúde do Paraná (Londrina e Umuarama) concentraram mais de 50% das ações. Quanto à especialidade dos médicos prescritores, 33,8% eram pneumologistas. Verificou-se discreto impacto financeiro do brometo de tiotrópio nos gastos gerais com medicamentos pelo Centro de Medicamentos do Paraná. Entretanto, também houve relevante impacto financeiro individual, pois uma unidade do medicamento consome 38% do salário mínimo. Conclusão O estudo aponta para a necessidade de incorporação deste medicamento da classe broncodilatadores anticolinérgicos de longa duração, no Sistema Único de Saúde.


Subject(s)
Humans , Bronchodilator Agents/economics , Drugs, Essential/supply & distribution , Pulmonary Disease, Chronic Obstructive/economics , Judicial Role , Tiotropium Bromide/economics , Health Services Needs and Demand/legislation & jurisprudence , Time Factors , Brazil , Retrospective Studies , Statistics, Nonparametric , Drugs, Essential/economics , Pulmonary Disease, Chronic Obstructive/drug therapy , Health Services Accessibility/economics , Health Services Accessibility/legislation & jurisprudence , Health Services Accessibility/trends , Health Services Needs and Demand/economics , Health Services Needs and Demand/trends , National Health Programs
8.
Einstein (Säo Paulo) ; 18: eAO5029, 2020. tab
Article in English | LILACS | ID: biblio-1039733

ABSTRACT

ABSTRACT Objective To characterize the use of the drug misoprostol for treatment of postpartum hemorrhage in pregnant women. Methods A descriptive observational study was carried out with secondary data from pregnant women who used misoprostol to treat postpartum hemorrhage in a reference public maternity, from July 2015 to June 2017. Clinical and sociodemographic profiles of pregnant women, how misoprostol was used and success rate in controling postpartum hemorrhage were characterized. Results A total of 717 prescriptions of misoprostol were identified. Of these, 10% were for treatment of postpartum hemorrhage. The majority of pregnant women were young adults, married, with complete high school education, white, residing in urban areas, multiparous (68.1%) and 25% had previous cesarean sections. The mean gestational age was 39 weeks and 51.4% had a cesarean section. There was prophylactic use of oxytocin in 47.2% of women. Treatment of postpartum hemorrhage was successful in 84.7% of women. Of these, 79.2% also used oxytocin and 54.2% methylergonovine. Only 13.5% of pregnant women had less than five prenatal visits, and the main cause of postpartum hemorrhage was uterine atony. There were 13 complications after hemorrhage, 15.3% required blood transfusion and there was one case of maternal death. Conclusion Misoprostol showed to be effective and safe for treating postpartum hemorrhage.


RESUMO Objetivo Caracterizar o uso do medicamento misoprostol para o tratamento da hemorragia pós-parto em gestantes. Métodos Estudo observacional descritivo realizado por meio de dados secundários de gestantes que fizeram uso do misoprostol para tratamento da hemorragia pós-parto em maternidade pública de referência, no período de julho de 2015 a junho de 2017. Caracterizaram-se os perfis clínico e sociodemográfico das gestantes, o padrão de utilização do misoprostol e sua taxa de sucesso no controle da hemorragia pós-parto. Resultados Foram identificadas 717 prescrições do misoprostol. Destas, 10% foram para tratamento da hemorragia pós-parto. Predominaram gestantes adultas jovens, casadas, com Ensino Médio completo, raça branca, da região urbana, multíparas (68,1%) e 25% apresentavam cesáreas prévias. A idade gestacional média foi 39 semanas e 51,4% das gestantes tiveram parto cesárea. Houve uso profilático de ocitocina em 47,2% das mulheres. O tratamento da hemorragia pós-parto eve sucesso em 84,7% das gestantes que usaram misoprostol. Destas, 79,2% também usaram ocitocina e 54,2% metilergometrina. Apenas 13,5% das gestantes tiveram menos de cinco consultas de pré-natal, e a principal causa da hemorragia pós-parto foi atonia uterina. Foram registrados 13 casos de complicações após a hemorragia, 15,3% necessitaram de hemotransfusão e houve um caso de óbito materno. Conclusão O misoprostol demonstrou ser efetivo e seguro para o tratamento da hemorragia pós-parto.


Subject(s)
Humans , Pregnancy , Adult , Young Adult , Oxytocics/therapeutic use , Misoprostol/therapeutic use , Postpartum Hemorrhage/drug therapy , Oxytocin/therapeutic use , Cross-Sectional Studies , Gestational Age , Methylergonovine/therapeutic use
9.
ABCS health sci ; 43(3): 136-140, 20 dez. 2018. graf
Article in Portuguese | LILACS | ID: biblio-967911

ABSTRACT

INTRODUÇÃO: Com o propósito de estimular a adesão aos antirretrovirais e minimizar os riscos de resistência a estes medicamentos, o Ministério da Saúde (MS) passou a disponibilizar o medicamento 3 em 1, uma coformulação de tenofovir (300 mg), lamivudina (300 mg) e efavirenz (600 mg), o qual inova com uso de um único comprimido diário. OBJETIVO: Estimar a adesão aos medicamentos antirretrovirais da primeira linha de tratamento contra o HIV. MÉTODOS: Verificação da frequência dos retornos mensais de pacientes a um dispensário dos medicamentos antirretrovirais fornecidos pelo MS. RESULTADOS: Os pacientes em tratamento com o medicamento 3 em 1 foram mais assíduos e retornaram com frequência 65% maior ao dispensário. CONCLUSÃO: Com a introdução do 3 em 1 confirma-se que a simplificação de esquemas terapêuticos é uma medida que facilita a adesão ao tratamento. Isso gera a expectativa de manter por mais tempo os indivíduos em uso da primeira linha de tratamento, retardando a necessidade de recorrer a outras linhas terapêuticas mais onerosas, com maior número de medicamentos e riscos associados.


INTRODUCTION: In order to stimulate adherence to antiretrovirals and minimize the risks of viral mutations and resistance to these drugs, the Ministry of Health (MS) started providing the 3-in-1 drug, a co-formulation of tenofovir (300 mg), lamivudine (300 mg) and efavirenz (600 mg), which innovates by the use of a single daily tablet. OBJECTIVE: Estimating the adherence to antiretroviral drugs in the first line of HIV treatment. METHODS: Verification of the frequency of monthly patient returns to a dispensary of antiretroviral drugs provided by MS. RESULTS: Patients treated with the 3-in-1 medication were more assiduous and returned 65% higher at the dispensary. CONCLUSION: The introduction of 3-in-1 confirms that the simplification of therapeutic schemes is a measure that facilitates adherence to treatment. This generates the expectation of keeping individuals in the first line of treatment longer, delaying the need to resort to other more expensive therapeutic lines, with a higher number of drugs and associated risks.


Subject(s)
Humans , HIV/drug effects , Anti-Retroviral Agents/administration & dosage , Anti-Retroviral Agents/pharmacology , Medication Adherence , Medication Adherence/statistics & numerical data , Treatment Adherence and Compliance/statistics & numerical data
10.
ABCS health sci ; 43(2): 69-76, 02 ago. 2018. ilus, tab, graf
Article in Portuguese | LILACS | ID: biblio-908967

ABSTRACT

INTRODUÇÃO: O transplante de células-tronco hematopoéticas (TCTH) é a única alternativa para o tratamento de algumas doenças. Entretanto, identifica-se escassez de estudos na população brasileira. OBJETIVO: Caracterizar o perfil dos pacientes submetidos ao TCTH no Hospital de Clínicas da Universidade Federal do Paraná (HC/UFPR), entre 2011 e 2015, com base em variáveis demográficas, diagnóstico, duração da internação, e a taxa de mortalidade na instituição. MÉTODOS: Pesquisa de séries temporais baseada em dados do Sistema de Informações Hospitalares. Avaliou-se a tendência na distribuição das proporções ao longo dos anos por meio do teste de Cochran­Armitage e da regressão binomial negativa. A presença de Autocorrelação seriada foi testada pelo teste de Durbin-Watson. RESULTADOS: De 2011-2015 o Paraná foi responsável por 9,2% dos TCTH realizados no Brasil. O HC/UFPR foi responsável por 46,0% destes procedimentos realizados no Paraná. Não foram observadas variações significativas na distribuição das variáveis sexo (p=0,788) e número de TCTH (p=0,213). 59,5% dos pacientes residiam no PR, 49,4% tinham entre 0 e 17 anos, 79,9% eram brancos, e 63,5% do sexo masculino. O TCTH alogênico foi o mais realizado (88,5%). 58,5% permaneceram internados de 31 a 60 dias (média=37,6 dias). 9,1% foram a óbito. A anemia aplástica adquirida foi a doença base mais frequente (31,9%). CONCLUSÃO: O TCTH é um procedimento de alto custo e complexidade. O estudo e a compreensão dos fatores determinantes para o seu sucesso são de extrema importância para o melhor planejamento, estimativa de risco e elaboração de políticas públicas de saúde.


INTRODUCTION: Hematopoietic stem cell transplantation (HSCT) is the only alternative for the treatment of some diseases. However, there is a shortage of studies in Brazilian population. OBJECTIVE: To identify the profile of patients submitted to HSCT at the Hospital de Clínicas da Universidade Federal do Paraná (HC/UFPR), between 2011 and 2015, based on demographic variables, diagnosis, duration of hospitalization and the mortality ration in the institution. METHODS: Time Series Studies research based on data from the Hospital Information System. The trend in the distribution of proportions over the years was evaluated through Cochran­Armitage test and negative binomial regression. The presence of serial autocorrelation was tested by the Durbin­Watson test. RESULTS: From 2011-2015 Paraná was responsible for 9.2% of HSCT performed in Brazil. HC/UFPR accounted for 46.0% of these procedures performed in Paraná. There were no significant variations in the sex distribution (p=0.788) and number of HSCT (p=0.213). 59.5% of the patients were from PR, 49.4% were between 0 and 17 years old, 79.9% were white, and 63.5% were male. The allogeneic HSCT was the most performed procedure (88.5%). 58.5% were hospitalized from 31 to 60 days (mean=37.6 days). 9.1% died. Acquired aplastic anemia was the most common underlying disease (31.9%). CONCLUSION: HSCT is a procedure of high cost and complexity. The study and the understanding of the determinants of its success are of extreme importance for the best planning, risk estimation and elaboration of public health policies.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Time Series Studies , Hematopoietic Stem Cell Transplantation , Anemia, Aplastic/epidemiology , Hospitals, Public , Hospitals, University
11.
Bol. latinoam. Caribe plantas med. aromát ; 17(3): 238-248, mayo 2018. tab
Article in English | LILACS | ID: biblio-915320

ABSTRACT

The present article studied the use of industrialized phytotherapies by patients attended at the basic health units in Pinhais county, located in the metropolitan region of Curitiba, Paraná, Brazil. This is a quantitative, observational and cross-sectional study that was conducted by semi-structured questionnaire interviews that were used as a data collection instrument. The population sample consisted of 267 patients from basic health care organizations. Regardless of gender or age, 56.2% of the interviewed participants reported using industrialized herbal medicines, of which 21.3% acquired their drugs from drugstores from around the county. Patients reported positive results using industrialized herbal medicines (89.33%), of whom women were predominant, making up (80%) (p<0.05). Among the drugs used by all the patients, "guaco" syrup was the most frequent (34%). The present study demonstrates the good acceptance by patients of treatments that involve integrative practices, such as herbal medicine, but when a drug has a vegetal origin, the idea that these products do not cause adverse effects persists.


El presente articulo se estudio el uso de hierbas medicinales procesadas por pacientes tratados en unidades básicas de salud del município de Pinhais, en la región metropolitana de Curitiba, Paraná, Brasil. Se trata de un estudio cuantitativo, observacional y transversal, realizado por medio de entrevistas que utilizan como instrumento de recolección de datos un cuestionario semi-estructurado. La población de la muestra consistió en 267 pacientes de atención básica a la salud. Independiente del sexo o de la edad, 56.2% de los entrevistados relató hacer uso de fitoterápicos industrializados, siendo que de los 21.3% hizo la adquisición en las farmacias de las unidades de salud del municipio. Los pacientes reportaron resultados positivos con el tratamiento realizado con fitoterápicos industrializados (89.33%). Entre ellos predominan las mujeres (80%) (p<0.05). Entre los medicamentos citados por los pacientes, el jarabe de guaco se mostró el más frecuente (34%). El presente estudio demuestra la buena aceptación por parte de los pacientes en realizar tratamientos que implican prácticas integrativas como la fitoterapia, pero, por poseer origen vegetal, todavía existe la idea de que estos productos no tienen la capacidad de causar efectos adversos.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Plants, Medicinal , Primary Health Care , Complementary Therapies , Drug Industry , Phytotherapy , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Observational Studies as Topic
12.
Rev. Inst. Adolfo Lutz ; (77): 1-9, 2018. tab, graf
Article in Portuguese | LILACS, SES-SP, SESSP-ACVSES, SESSP-IALPROD, SES-SP, SESSP-IALACERVO | ID: biblio-982812

ABSTRACT

The reduction of the incidence of water-borne diseases is achieved with the diffusion of the useof chlorination techniques. However, in spite of the benefits of this disinfection method,the reactions of chlorine with the natural organic matter occurring in the water induce theproduction of disinfection by products such as trihalomethanes. These products have already beenassociated with the incidence of some cancers types. Considering that in the Brazilian legislation,it is not mandatory measuring and controlling the occurrence of trihalomethanes at the exitand during the water distribution to the consumer. This study aimed at analyzing the relationshipbetween chlorination and its by products. Thus, this project evaluated the concentrations oftrihalomethanes in water collected at different points of supply in the municipality of Colombo,Paraná, Brazil, during the period from November 2015 to February 2016. Chromatographicmethods were employed, besides the spreadsheets provided by the Health Surveillance ofColombo for comparison. The found values were tabulated and they were compared with thelimits established by the Brazilian Ministry of Health- Ordinance No 05/2017. The results confirmedthat the values of those provided by the concessionaire responsible for the city water treatmentand supply, and being within the standards determined by the legislation.


A redução da incidência de doenças transmitidas pela água foi alcançada com a difusão douso de técnicas de cloração. Apesar dos benefícios desse método de desinfecção, as reações decloro com a matéria orgânica natural presente na água levam à formação de subprodutos dedesinfecção como trihalometanos. Esses produtos já foram associados à incidência de algunstipos de câncer em animais, e muitas vezes podem ser detectados em água tratada e fornecidapara o consumo. Pela legislação brasileira não é obrigatório efetuar o monitoramento detrihalometanos após o tratamento e distribuição de água. Frente a este problema, este estudoteve como objetivo avaliar as concentrações de trihalometanos em água coletada em diferentespontos de abastecimento no município de Colombo, PR, Brasil, durante o período de novembrode 2015 a fevereiro de 2016. Utilizou-se método cromatográfico para as análises, além deplanilhas fornecidas pela Vigilância Sanitária de Colombo. Todos os valores foram comparadoscom os limites estabelecidos na Portaria de Consolidação Nº 05/2017 do Ministério da Saúde.Os resultados confirmaram que os valores de trihalometanos fornecidos pela concessionária,responsável pelo tratamento e fornecimento de água na cidade, atendem aos parâmetros legais.


Subject(s)
Chromatography, Gas , Water Disinfection , Chlorides , Drinking Water , Trihalomethanes
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