ABSTRACT
OBJECTIVES: The aim of this study was to develop a strategy to identify adverse drug events associated with drug-drug interactions by analyzing the prescriptions of critically ill patients. METHODS: This retrospective study included HIV/AIDS patients who were admitted to an intensive care unit between November 2006 and September 2008. Data were collected in two stages. In the first stage, three prescriptions administered throughout the entire duration of these patients' hospitalization were reviewed, with the Micromedex database used to search for potential drug-drug interactions. In the second stage, a search for adverse drug events in all available medical, nursing and laboratory records was performed. The probability that a drug-drug interaction caused each adverse drug events was assessed using the Naranjo algorithm. RESULTS: A total of 186 drug prescriptions of 62 HIV/AIDS patients were analyzed. There were 331 potential drug-drug interactions, and 9% of these potential interactions resulted in adverse drug events in 16 patients; these adverse drug events included treatment failure (16.7%) and adverse reactions (83.3%). Most of the adverse drug reactions were classified as possible based on the Naranjo algorithm. CONCLUSIONS: The approach used in this study allowed for the detection of adverse drug events related to 9% of the potential drug-drug interactions that were identified; these adverse drug events affected 26% of the study population. With the monitoring of adverse drug events based on prescriptions, a combination of the evaluation of potential drug-drug interactions by clinical pharmacy services and the monitoring of critically ill patients is an effective strategy that can be used as a complementary tool for safety assessments and the prevention of adverse drug events.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Feline Acquired Immunodeficiency Syndrome/drug therapy , Feline Acquired Immunodeficiency Syndrome/epidemiology , Drug-Related Side Effects and Adverse Reactions/diagnosis , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug Prescriptions , Brazil/epidemiology , Retrospective Studies , Risk Factors , Databases, Factual , Feline Acquired Immunodeficiency Syndrome/complications , Drug Monitoring/methods , Critical Illness/therapy , Critical Illness/epidemiology , Treatment Failure , Antirheumatic Agents/adverse effects , Drug Interactions , Drug-Related Side Effects and Adverse Reactions/prevention & control , Intensive Care UnitsABSTRACT
Summary Objective: To investigate the prevalence of overweight, abdominal obesity and associated factors in people living with HIV/AIDS (PLWHA). Method: Cross-sectional study with 270 PLWHA. A questionnaire was applied to investigate sociodemographic, clinical and lifestyle characteristics. Weight, height and waist circumference were measured. BMI ≥25 kg/m2 was considered overweight, while abdominal obesity referred to waist circumference ≥102 cm for men and ≥88 cm for women. The authors used multiple Poisson regression with 5% significance level. Results: The prevalence of overweight and abdominal obesity was 33.7% and 12.6%, respectively, referring to 37.9% of women and 5.7% of men (p<0.001). Overweight was associated with age of 40-49 years and ≥50 years, non-use of ARV therapy, and lower tertile of consumption of risk foods. Abdominal obesity was associated with: female gender, age of 40-49 years and ≥50 years, income greater than four times the minimum wage, and CD4+ lymphocyte count >350 cells/mm3. Conclusion: There was a high prevalence of overweight and abdominal obesity associated with sociodemographic and clinical conditions, and consumption of risk foods. This scenario indicates the need for reorientation of the health care focus in this population.
Resumo Objetivo: investigar em pessoas vivendo com HIV/aids (PVHA) a prevalência de excesso de peso, obesidade abdominal e fatores associados. Método: estudo transversal com 270 PVHA. Aplicou-se questionário para investigar características sociodemográficas, clínicas e estilo de vida. Coletaram-se peso, altura e circunferência de cintura. Consideraram-se excesso de peso o IMC ≥25 kg/m2 e obesidade abdominal a circunferência de cintura ≥102 cm para homens e ≥88 cm para mulheres. Utilizou-se regressão de Poisson múltipla com nível de significância de 5%. Resultados: a prevalência de excesso de peso foi de 33,7% e de obesidade abdominal foi de 12,6%, sendo 37,9% nas mulheres e 5,7% nos homens (p<0,001). Excesso de peso foi associado com idade de 40 a 49 anos e ≥50 anos, não uso de terapia antirretroviral (TARV) e menor tercil de consumo de alimentos de risco. Obesidade abdominal se associou com sexo feminino, idade de 40 a 49 anos e ≥50 anos, renda própria maior que quatros salários mínimos e contagem de linfócitos T CD4+ >350 células/mm3. Conclusão: constatou-se elevada prevalência de excesso de peso e obesidade abdominal, associados a condições sociodemográficas, clínicas e consumo de alimentos de risco. Esse panorama sinaliza a necessidade de reorientação do foco de atenção à saúde dessa população.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Feline Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/epidemiology , Overweight/complications , Overweight/epidemiology , Obesity, Abdominal/complications , Obesity, Abdominal/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Body Mass Index , Comorbidity , Sex Factors , Epidemiologic Methods , Age Factors , Waist Circumference , Middle AgedABSTRACT
Se utilizaron 100 sueros de gatos provenientes de la ciudad de La Plata y alrededores con el fin de determinar la relación entre la infección con FIV y la infección con T. gondii. Los sueros se analizaron para determinar anticuerpos anti-FIV y anti-T. gondii por las pruebas de inmunobloting e inmunofluorescencia indirecta, respectivamente. Para el análisis de los resultados los sueros se clasificaron en cuatro grupos según presentaran o no anticuerpos anti-FIV y anti-T. gondii (Tox): Grupo 1) FIV+ Tox+; Grupo 2) FIV+ Tox-; Grupo 3) FIV- Tox+; Grupo 4) FIV- Tox-. Se establecieron tres categorías por grupo con respecto a los signos clínicos de los gatos estudiados. El porcentaje de sueros positivos a FIV y a T. gondii (34,5 por ciento, 19/55) fue significativamente mayor que el porcentaje de sueros positivos a FIV y negativos a T. gondii (17,7 por ciento, 8/45; p < 0,05, prueba exacta de Fisher). Los títulos de anticuerpos anti T. gondii fueron significativamente mayores en el Grupo 1 con respecto al Grupo 3. La distribución de los signos clínicos fue significativamente diferente entre los 4 grupos. El porcentaje de animales con signos clínicos potencialmente compatibles con FIV y/o toxoplasmosis fue: Grupo 1: 57,9 por ciento, Grupo 2: 75 por ciento; Grupo 3: 48,6 por ciento y Grupo 4: 27 por ciento. Los resultados del presente trabajo indican la asociación entre la infección con el FIV y la infección con T. gondii