Spatial analysis of a case of reverse logistics of medicines in community pharmacies in Brazil - a preliminary study

Background: The reverse logistics of medicines consists of the logistical procedure of collection, transport, storage, treatment and final disposal of post-consumer or expired waste. Medicines can be toxic to the environment and affect the health of citizens of the territory. Community pharmacies, as a health facility, play a key role in this process. Objectives: Define the spatial analysis and cases of reverse logistics of medicines in community pharmacies in Brazil. Methods: This is a cross-sectional study, and the research covered the medicines collected by 400 community pharmacies in the period from 2020 to 2022. To obtain the data, the medicines were collected, weighed, segregated and the weight released on a dedicated waste management platform. All regions of Brazil subject to georeferencing were processed using the free software Geographic Information System (QGIS). Data were expressed as median and range or as frequency of occurrence. Chi-square t-test and Fisher's exact test were used to compare variables. The accepted significance level was 5%. Results: Of the five existing regions in Brazil, only three had records of reverse medication logistics. 4,519.74 Kg of products were collected, and the North region of Brazil was responsible for 69.1% of the collection. In the spatial analysis, it was possible to perceive a difference between the areas of concentration of the RDL, that is, locations where collections were carried out in the period from 2020 to 2022. Conclusion: The present study preliminarily analyzed the reverse logistics of medicines in Brazil. The data obtained can contribute to the knowledge of this area and to the strengthening of the process. Thus, these places must exercise a task force for the educational process of the population about the risks of incorrect disposal of medicines and that this could harm the environment, economic aspects of society, food and the entire context that involves health and well-being. of citizens (AU)

Performing rapid metabolite tests (IgG-IgM) for SARS-CoV-2 infection in community pharmacies: A cross sectional-study from Brazil

Background: Immunochromatographic rapid tests in pharmacies allow the discovery of specific antibodies against SARS-CoV-2 or viral antigens and provide a broader and more effective screening of the virus. However, in many countries, this process is still not well defined. In this sense, the perception of pharmacists about these screening practices presents an overview of how the service is being carried out in the country. Objective: This study was to evaluate the performance of rapid immunochromatographic tests and their clinical results in community pharmacies in northern Brazil. Method: A retrospective study was carried out between May 2020 and December 2021 in community pharmacies in the northern region of Brazil. Participants were 18 years of age or older, of both sexes, who spontaneously sought the SARS-CoV-2 rapid testing service at pharmacies located in the municipality of Belem and who had had close contact with the virus or symptoms infection-related. Data were expressed as median and range or as frequency of occurrence. Chi-square t-test and Fisher’s exact test were used to compare variables. The accepted significance level was 5%. This study was approved by the Research Ethics Committee (number: 4,865,206). Results: A total of 78,849 patients were recruited into the study. Most patients, 37,847 (48%), were tested antibody positive for SARS-CoV-2. There were no severe signs and symptoms of the disease. The results showed the great demand for carrying out the rapid test in pharmacies and these places could contribute to the understanding of this health establishment, to curb the speed of SARS-CoV-2 dissemination. (AU)

Endophytic fungus Phomopsis sp. as a source of 3-nitropropionic acid with larvicidal activity against Aedes aegypti (Linnaeus 1762, Diptera: Culicidae).

BACKGROUND: Aedes aegypti is the primary vector of viruses, such as Zika, chikungunya, yellow fever, and dengue. In this context, a biomonitored chemical study was conducted to evaluate the activity of the crude extract of the endophytic fungus Phomopsis sp. against the larvae of Aedes aegypti. METHODS: Crude extract, fractions, and isolated substances were evaluated in in-vitro assays against third-stage larvae of Aedes aegypti. RESULTS: We isolated 3-nitropropionic acid with an LC50 of 15.172 ppm and LC90 of 18.178 ppm after 24 hours of larval exposure. CONCLUSIONS: The results indicated that 3-nitropropionic acid exerted larvicidal activity.

Analysis of the clinical practice of the pharmacist in a community pharmacy: A Cross-sectional Study from Brazil.

Background: The pharmaceutical profession has experienced renewals over time. In community pharmacies, pharmaceutical services contribute to the public health system in Brazil. The development of these tasks, in collaboration with professionals from the multidisciplinary team, demonstrates the involvement with the well-being, health and improvement of the patient's life. Objectives: This study aimed to identify the professional practice of pharmacists, their understandings and attitudes towards clinical practice in community pharmacies in northern Brazil. Methods: This is a cross-sectional descriptive study, based on a questionnaire carried out with pharmacists for seven months in the municipality of Belém, in the state of Pará. Data were expressed using descriptive statistics and the results were shown as a percentage. Results: 182 pharmacists participated. Females were predominant (80.2%) and the average age of participants was 34.2 years. 77.4% graduated from private institutions and 59.3% already have a specialization. 38.4% hold the position of technical director. 50.5% of respondents say that community pharmacies have a reserved place for service. The most used clinical services were pharmacotherapy review (89.5%), health education (60.9%), dispensing (34%), therapeutic monitoring (25.8%) and pharmacotherapeutic follow-up (4.9%). In the study, it was realized that community pharmacies should not be seen as a commercial place but rather as a health care facility. Conclusions: Therefore, these establishments must adapt at a structural and professional level, to meet an increasingly growing demand of a population in need of services offered with quality health care.

Oxidative stress induction by crude extract of Xylaria sp. triggers lethality in the larvae of Aedes aegypti (Diptera: Culicidae).

BACKGROUND: Aedes aegypti is currently controlled with synthetic larvicides; however, mosquitoes have become highly resistant to these larvicides and difficult to eradicate. Studies have shown that insecticides derived from fungal extracts have various mechanisms of action that reduce the risk of resistance in these mosquitoes. One possible mechanism is uncontrolled production of reactive oxygen species (ROS) in the larvae, which can cause changes at the cellular level. Thus, the crude extract of Xylaria sp. was evaluated to investigate the oxidative effect of this extract in A. aegypti larvae by quantifying the oxidative damage to proteins and lipids. METHODS: The larvicidal potential of the crude extract of Xylaria sp. Was evaluated, and the extract was subsequently tested in human lung fibroblasts for cytotoxicity and ROS production. ROS level was quantified in the larvae that were killed following exposure to the extract in the larvicide test. RESULTS: The crude extract of Xylaria sp. Caused cytotoxicity and induced ROS production in human lung fibroblasts and A. aegypti larvae, respectively. In the larvicide trial, the extract showed an LC50 of 264.456 ppm and an LC90 of 364.307 ppm, and was thus considered active. The extract showed greater oxidative damage to lipids and proteins, with LC90 values of 24.7 µmol MDA/L and 14.6278 ×10-3 nmol carbonyl/ mg protein, respectively. CONCLUSIONS: Crude extracts of Xylaria sp. induced oxidative stress that may have caused the mortality of A. aegypti larvae.

Analysis of the clinical practice of the pharmacist in a community pharmacy: A Cross-sectional Study from Brazil

Background: The pharmaceutical profession has experienced renewals over time. In community pharmacies, pharmaceutical services contribute to the public health system in Brazil. The development of these tasks, in collaboration with professionals from the multidisciplinary team, demonstrates the involvement with the well-being, health and improvement of the patient’s life. Objectives: This study aimed to identify the professional practice of pharmacists, their understandings and attitudes towards clinical practice in community pharmacies in northern Brazil. Methods: This is a cross-sectional descriptive study, based on a questionnaire carried out with pharmacists for seven months in the municipality of Belém, in the state of Pará. Data were expressed using descriptive statistics and the results were shown as a percentage. Results: 182 pharmacists participated. Females were predominant (80.2%) and the average age of participants was 34.2 years. 77.4% graduated from private institutions and 59.3% already have a specialization. 38.4% hold the position of technical director. 50.5% of respondents say that community pharmacies have a reserved place for service. The most used clinical services were pharmacotherapy review (89.5%), health education (60.9%), dispensing (34%), therapeutic monitoring (25.8%) and pharmacotherapeutic follow-up (4.9%). In the study, it was realized that community pharmacies should not be seen as a commercial place but rather as a health care facility. Conclusions: Therefore, these establishments must adapt at a structural and professional level, to meet an increasingly growing demand of a population in need of services offered with quality health care. (AU)

Endophytic fungus Phomopsis sp. as a source of 3-nitropropionic acid with larvicidal activity against Aedes aegypti (Linnaeus 1762, Diptera: Culicidae)

ABSTRACT Background: Aedes aegypti is the primary vector of viruses, such as Zika, chikungunya, yellow fever, and dengue. In this context, a biomonitored chemical study was conducted to evaluate the activity of the crude extract of the endophytic fungus Phomopsis sp. against the larvae of Aedes aegypti. Methods: Crude extract, fractions, and isolated substances were evaluated in in-vitro assays against third-stage larvae of Aedes aegypti. Results: We isolated 3-nitropropionic acid with an LC50 of 15.172 ppm and LC90 of 18.178 ppm after 24 hours of larval exposure. Conclusions: The results indicated that 3-nitropropionic acid exerted larvicidal activity.

Oxidative stress induction by crude extract of Xylaria sp. triggers lethality in the larvae of Aedes aegypti (Diptera: Culicidae)

ABSTRACT Background: Aedes aegypti is currently controlled with synthetic larvicides; however, mosquitoes have become highly resistant to these larvicides and difficult to eradicate. Studies have shown that insecticides derived from fungal extracts have various mechanisms of action that reduce the risk of resistance in these mosquitoes. One possible mechanism is uncontrolled production of reactive oxygen species (ROS) in the larvae, which can cause changes at the cellular level. Thus, the crude extract of Xylaria sp. was evaluated to investigate the oxidative effect of this extract in A. aegypti larvae by quantifying the oxidative damage to proteins and lipids. Methods: The larvicidal potential of the crude extract of Xylaria sp. Was evaluated, and the extract was subsequently tested in human lung fibroblasts for cytotoxicity and ROS production. ROS level was quantified in the larvae that were killed following exposure to the extract in the larvicide test. Results: The crude extract of Xylaria sp. Caused cytotoxicity and induced ROS production in human lung fibroblasts and A. aegypti larvae, respectively. In the larvicide trial, the extract showed an LC50 of 264.456 ppm and an LC90 of 364.307 ppm, and was thus considered active. The extract showed greater oxidative damage to lipids and proteins, with LC90 values of 24.7 µmol MDA/L and 14.6278 ×10-3 nmol carbonyl/ mg protein, respectively. Conclusions: Crude extracts of Xylaria sp. induced oxidative stress that may have caused the mortality of A. aegypti larvae.

Characterization of ßN-Octadecanoyl-5-hydroxytryptamide Anti-Inflammatory Effect.

BACKGROUND: N-octadecanoyl-5-hydroxytryptamide (C18-5HT) is an amide that can be obtained by the coupling of serotonin and octadecanoic acid. This study aims to characterize the in vivo and in vitro anti-inflammatory activity of C18-5HT. METHODS: A subcutaneous air pouch model (SAP) was used. The exudates were collected from SAP after carrageenan injection to assess cell migration and inflammatory mediators production. RAW 264.7 cells were used for in vitro assays. RESULTS: C18-5HT significantly inhibited leukocyte migration into the SAP as well as nitric oxide (NO) and cytokines production and protein extravasation. We also observed an reduction in some cytokines and an increase in IL-10 production. Assays conducted with RAW 264.7 cells indicated that C18-5HT inhibited NO and cytokine produced. CONCLUSIONS: Taken together, our data suggest that C18-5HT presents a significant effect in different cell types (leukocytes collected from exudate, mainly polumorphonuclear leukocytes and cell culture macrophages) and is a promising compound for further studies for the development of a new anti-inflammatory drug.

Cuidado a famílias com pessoas em condições crônicas na atenção primária à saúde: revisão integrativa / Cuidado a familias con personas en condiciones crónicas en la atención primaria a la salud: revisión integradora / Care for families with people with chronic conditions in primary health care: integrative review

RESUMO Objetivo: Identificar o cuidado a famílias com pessoas em condições crônicas na Atenção Primária à Saúde, por meio de uma revisão integrativa da literatura. Método: Trata-se de revisão integrativa que incluiu artigos publicados no período de 2010 a 2020, identificados nas bases de dados: Literatura Internacional em Ciências da Saúde, Literatura Latino Americana e do Caribe em Ciências da Saúde e Banco de Dados em Enfermagem. Foram utilizados descritores "atenção primária à saúde" AND "família" AND "doenças crônicas" e "atenção primária à saúde" AND "condições crônicas" AND "cuidado". Resultados: Emergiram categorias temáticas: Promoção da Saúde na perspectiva do cuidado às famílias com pessoas em condições crônicas; Relação entre família de pessoas em condições crônicas e profissionais de saúde; e Potencialidades e desafios para a efetivação do cuidado às famílias com pessoas em condições crônicas. A promoção da saúde surgiu como ferramenta do cuidado, destacando-se a visita domiciliar. Evidenciaram-se fragilidade de aproximação das equipes de saúde com as famílias, prevalência do ideário curativista e acesso fragilizado aos serviços de saúde. Considerações finais: Os achados deste estudo são importantes para Enfermagem para fomento de políticas públicas voltadas ao cuidado das famílias com pessoas em condições crônicas na Atenção Primária à Saúde.

RESUMEN Objetivo: identificar el cuidado a familias con personas en condiciones crónicas en la Atención Primaria de Salud, por medio de una revisión integradora de la literatura. Método: se trata de una revisión integradora que incluyó artículos publicados en el período de 2010 a 2020, identificados en las bases de datos: Literatura Internacional en Ciencias de la Salud, Literatura Latino Americana y del Caribe en Ciencias de la Salud y Banco de Datos en Enfermería. Fueron utilizados descriptores "atenção primária à saúde" AND "família" AND "doenças crônicas" y "atenção primária à saúde" AND "condições crônicas" AND "cuidado". Resultados: surgieron categorías temáticas: Promoción de la Salud en la perspectiva del cuidado a las familias con personas en condiciones crónicas; Relación entre familia de personas en condiciones crónicas y profesionales de salud; y Potencialidades y desafíos para la realización del cuidado a las familias con personas en condiciones crónicas. La promoción de la salud surgió como herramienta del cuidado, destacándose la visita domiciliaria. Se evidenciaron fragilidad de aproximación de los equipos de salud con las familias, prevalencia del ideario curativista y acceso debilitado a los servicios de salud. Consideraciones finales: los hallazgos de este estudio son importantes para la Enfermería para el fomento de políticas públicas dirigidas al cuidado de las familias con personas en condiciones crónicas en la Atención Primaria de Salud.

ABSTRACT Objective: To identify care for families with people with chronic conditions in Primary Health Care, through an integrative literature review. Method: This is an integrative review that included articles published from 2010 to 2020, identified in the databases: International Literature in Health Sciences, Latin American and Caribbean Literature in Health Sciences and Database in Nursing. The keywords "primary health care" AND "family" AND "chronic diseases" and "primary health care" AND "chronic conditions" AND "care" were used. Results: Thematic categories emerged: Health Promotion from the perspective of caring for families with people with chronic conditions; Relationship between family of people with chronic conditions and health professionals; and Potentials and challenges for effective care for families with people with chronic conditions. Health promotion emerged as a care tool, with emphasis on home visits. There was a weakness in the approximation of the health teams with the families, the prevalence of the curative ideology and weakened access to health services. Final considerations: The findings of this study are important for nursing to promote public policies aimed at the care of families with people with chronic conditions in Primary Health Care.

Endophytic Fungi in the Fight Against Neglected Tropical Diseases.

Neglected tropical diseases are a serious global public health problem and they are one of the main causes of mortality and morbidity, especially in underdeveloped countries. These diseases have several implications for health and they are considered a priority in global eradication programs for disease control. The aim of this mini-review is to report recent studies on the fight against neglected diseases, namely dengue fever, chikungunya, zika, malaria protozoa, Chagas disease, leishmaniasis, schistosomiasis helminths, filariasis, and tuberculosis bacteria using extracts and isolated substances of endophytic fungi based on their bioactivity profiles in relation to these diseases.

Potencialidades e desafios na realização de oficinas educativas com adolescentes / Potentials and challenges in carrying out educational workshops with adolescents

Objetivo: identificar os fatores potencializadores, as dificuldades e desafios na realização das oficinas educativas com adolescentes. Metodologia: pesquisa descritiva, com abordagem qualitativa,desenvolvida junto ao Projeto Flor do Mandacaru. A coleta de dados ocorreu nos meses de maio a junho de 2015.Foi realizada uma busca em todos os documentos e registros existentes no Projeto Flor do Mandacaru sobre as oficinas e aplicado um questionário aos profissionais do serviço. Os dados foram considerados por meio da análise temática proposta por Minayo. Resultados: identificou-se que o Projeto Flor do Mandacaru utiliza nove técnicas diferentes para desenvolver atividades de educação em saúde. A escolha da técnica se dá de acordo com a idade do público alvo e o tema que será discutido. A partir da análise das informações, emergiram quatro categorias temáticas: singularidades do trabalho com adolescentes, recursos para o desenvolvimento das oficinas, escola como espaço para promoção da saúde e o desafio da inter e multiprofissionalidade nas oficinas com os adolescentes. Conclusão: observou-se que o Projeto Flor do Mandacaru dispõe de metodologias diversas em sua atuação junto aos adolescentes. Isto se torna importante, pois à medida que o adolescente vive novas experiências, ele necessita de novas formas de abordagem.

Objective: identify the potential factors, difficulties and challenges in the realization of educational workshops with adolescents. Methodology: adescriptive research, with a qualitative approach, developed with the Mandacaru Flower Project. Data collection took place from May to June 2015. A search of all the documents and records in the Mandacaru Flower Project about the workshops was carried out and a questionnaire was applied to service professionals. The data were analyzed through the thematic analysis proposed by Minayo. Results: it was identified that the Mandacaru Flower Project uses nine different techniques to develop health education activities. The choice of technique is made according to the age of the target audience and the topic that will be discussed. From the analysis of the questionnaire emerged four thematic categories being: peculiarities of the work with adolescents, resources for the development of workshops, school as a space for promoting health and the challenge of inter and multiprofessionality in workshops with adolescents. Conclusion: it was observed that the Mandacaru Flower Project has a diversified methodology for working with adolescents. This becomes important because as the adolescent experiences new experiences he needs new approaches.

Xylarenones C-E from an endophytic fungus isolated from Alibertia macrophylla.

Xylarenones C-E (2-4), three new eremophilane sesquiterpenes, have been isolated from solid substrate cultures of a Camarops-like endophytic fungus isolated from Alibertia macrophylla. The structures were elucidated by analysis of spectroscopic data. Compounds were evaluated in subtilisin and pepsin protease assays, and compound 2 showed potent inhibitory activity against both proteases.