RESUMO
Adherence to pharmacological treatment for hypertension is considered a key factor in guaranteeing successful therapy outcomes. Knowledge of the disease, its complications, as well as the need for changes in lifestyle, call for patient motivation and continuous interactive education. The evidence regarding the beneficial effects of changes in life style by hypertensive individuals in reducing the complications of the disease, as well as in its prevention are indisputable. However, the challenges posed by patient adherence to treatment prescribed by doctors remain. The aim of this study was to assess blood pressure levels together with degree of adherence to pharmacological treatment with Enalapril Maleate by means of the Morisky-Green Test, in hypertensive patients who were users of a School Pharmacy. Of the 102 patients interviewed, 65.7 percent had controlled blood pressure, but only 36.3 percent indicated total compliance with the pharmacological treatment. The Morisky-Green test proved ineffective in associating controlled blood pressure levels and positive attitudes toward taking antihypertensive medicines.
A adesão ao tratamento farmacológico da hipertensão arterial sistêmica é considerada uma das etapas essenciais para a garantia do seu sucesso. Para tanto, o conhecimento da doença, suas complicações e necessidade de mudanças em relação ao estilo de vida, requer do paciente, além da motivação, a educação contínua e de modo compartilhado. A evidência quanto aos efeitos benéficos da mudança do estilo de vida pelo portador de hipertensão na redução das complicações desta doença, bem como em sua prevenção, já não são mais questionados, porém o desafio continua residindo na adesão do indivíduo ao padrão de tratamento prescrito pelo médico. Este estudo teve como objetivo avaliar os níveis de pressão arterial, assim como o nível de adesão ao tratamento farmacológico com maleato de enalapril de pacientes portadores de hipertensão arterial, usuários de uma Farmácia Escola, através do Teste de Morisky e Green. Dos 102 pacientes entrevistados, 65,7 por cento apresentaram níveis pressóricos controlados, porém apenas 36,3 por cento indicaram níveis de adesão total à terapêutica farmacológica. O teste de Morisky e Green não foi eficiente para relacionar níveis de pressão arterial controlado e atitude positiva frente à tomada do medicamento anti-hipertensivo fornecido.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adesão à Medicação/estatística & dados numéricos , Faculdades de Farmácia , Hipertensão , Epidemiologia Descritiva , Estudos Observacionais como Assunto , Demografia , Interpretação Estatística de DadosRESUMO
The recombinant histidine-rich protein II (HRPII) from Plasmodium falciparum was shown to bind actin and phosphatidylinositol 4,5-bisphosphate (PIP(2)) in vitro in a pH-dependent manner, very similar to hisactophilin, an actin-binding protein from ameba. Binding of HRPII to actin and PIP(2) occurred at pH 6.0 and 6.5, but not above pH 7.0. Circular dichroism (CD) spectroscopy confirmed that HRPII interacts with actin at pH below 7.0, as judged by the changes induced in the secondary structure of the HRPII/actin mixture. Further CD analysis demonstrated that HRPII adopts a predominantly alpha-helical conformation with anionic micelles of PIP(2) and SDS, but not with neutral micelles of phosphatidylcholine (PC), a feature that is common to many actin-binding proteins involved in cytoskeleton remodeling. Similarly to hisactophilin, a GFP-HRPII fusion protein shuttled from the cytoplasm to the nucleus of HeLa cells as the cellular pH was lowered from 8.0 to 6.0. HeLa cells transfected with the HRPII gene showed increased levels of histidine-rich proteins (HRPs) in the soluble cell fraction at pH 8.0. At pH 6.0, however, HRPs were detected mainly in the insoluble cell fraction. Interestingly, we found that HRPII binds to human erythrocyte membranes at pH 6.0 and 6.5 but not at pH above 7.0. Our results point to remarkable similarities between HRPII, hisactophilin, and actin-binding proteins. Possible roles of the HRPII during Plasmodium infection are discussed in the light of these findings.
