Conhecimento de Mulheres acerca do Exame Papanicolaou / Women's Knowledge about Papanicolaou Test / El Conocimiento de las Mujeres sobre el examen de Papanicolaou

O exame preventivo do câncer do colo uterino (PCCU) permite a análise morfológica do tecido do colo do útero para identificação de alterações em células isoladas ou em pequenos grupos. Mediante as dificuldades enfrentadas pelo enfermeiro, a problemática deste trabalho é a baixa procura de mulheres por serviços de saúde para realizar o rastreamento com o exame preventivo. Objetivo: Analisar as produções científicas publicadas no Brasil sobre o conhecimento de mulheres acerca do PCCU. Método: Revisão integrativa da literatura. Para a construção do estudo, buscaram-se publicações científicas indexadas na base de dados LILACS, MEDLINE e BDENF. Os critérios de inclusão definidos para a seleção dos documentos foram artigos originais, nos idiomas português e inglês, disponíveis na íntegra, de acesso gratuito, publicados de 2017 a 2021. Resultados: Foram encontrados 71 artigos e, após serem aplicados os critérios de exclusão, apenas 14 artigos foram incluídos na amostra do estudo categorizados em três eixos temáticos: o primeiro apresenta o conhecimento sobre o PCCU, o segundo, os fatores relacionados à não adesão, e o terceiro, a cobertura para a realização do PCCU na prática da enfermagem. Conclusão: Os baixos níveis de informação e a má comunicação contribuem para a não adesão ao exame. Desse modo, para maximizar a adesão das pacientes, recomenda-se que a equipe de enfermagem modifique a abordagem sobre a realização dos exames preventivos

The Papanicolaou test allows the morphological analysis of the tissue to identify changes in isolated cells or in small groups. Given the difficulties faced by nurses, the low demand of women for health services to submit to screening preventive exams is a limitation of the study. Objective: To analyze scientific productions published in Brazil on women's knowledge about cervix cancer screening (CCS). Method: Integrative Literature Review. Scientific publications indexed at the LILACS, MEDLINE and BDENF databases were searched. The inclusion criteria were free, fully available original articles published in Portuguese and English published from 2017 to 2021. Results: 71 articles were found, and after the exclusion criteria were applied, only 14 articles remained categorized into three thematic axes, the first addresses women's knowledge about CCS; the second, factors related to non-adherence and the third, the challenges nursing professionals face regarding the coverage for CCS. Conclusion: Low levels of information and poor communication contribute to non-adherence. Therefore, to maximize patient adherence, nursing professionals should change the approach to CCS.

El examen preventivo del cáncer del cuello uterino (PCCU) permite el análisis morfológico del tejido del cérvix para identificar cambios en células aisladas o en pequeños grupos. Ante las dificultades que enfrentan las enfermeras, el problema de este trabajo es la baja demanda de las mujeres de los servicios de salud para realizar despistajes con exámenes preventivos. Objetivo: Analizar las producciones científicas publicadas en el Brasil sobre el conocimiento de las mujeres sobre el PCCU. Método: Revisión integradora de la literatura. Para construir el estudio se buscaron publicaciones científicas indexadas en las bases de datos LILACS, MEDLINE y BDENF. Los criterios de inclusión definidos para la selección de documentos fueron artículos originales, en portugués e inglés, disponibles en su totalidad, de acceso gratuito, publicados entre 2017 y 2021. Resultados: Se encontraron 71 artículos, y tras aplicar los criterios de exclusión, solamente 14 artículos fueron considerados en la muestra del estudio categorizados en tres ejes temáticos: el primero presenta el conocimiento sobre el PCCU; el segundo, los factores relacionados a la falta de compromiso; y el tercero, la cobertura para la realización del PCCU en la práctica de la enfermería. Conclusión: Los bajos niveles de información y la mala comunicación contribuyen al incumplimiento del examen. Por lo tanto, para maximizar el compromiso de la paciente, se recomienda cambios en la forma en que el equipo de enfermería realiza los exámenes preventivos.

Correlation between chest computed tomography findings and pulmonary function test results in the post-recovery phase of COVID-19.

OBJECTIVE: The radiological and functional lung sequelae in COVID-19 survivors remain unclear. We compared the chest computed tomography findings of COVID-19 patients with normal and abnormal pulmonary function test results in the post-recovery phase. METHODS: The data of consecutive patients who underwent pulmonary function tests and chest computed tomography within 14 days after recovery from COVID-19 at two medical centers between May and October 2020 were collected retrospectively. Two thoracic radiologists who were blinded to the clinical information and pulmonary function test results classified the patients according to the computed tomography features, evidence of fibrotic-like changes, and semi-quantitative quantification of the extent of pulmonary abnormalities. The clinical characteristics and computed tomography findings of patients with normal pulmonary function test results were compared with those of patients with abnormal results. RESULTS: A total of 101 COVID-19 survivors, comprising 48 ambulatory and 53 hospitalized patients, were included at a median of 95 days from initial symptom onset. Computed tomography revealed fibrotic-like changes in 10.9% of patients. A reduction in the diffusion capacity of carbon monoxide was the most common lung function abnormality (19.8%). Abnormal diffusion capacity of carbon monoxide was associated with the presence and extension of lung opacities on chest computed tomography scans and fibrotic pulmonary abnormalities. The sensitivity, specificity, and accuracy of reduced diffusion capacity of carbon monoxide for detecting fibrotic-like pulmonary changes on chest computed tomography scans were 72.7%, 87.8%, and 86.1%, respectively. CONCLUSION: Our study suggests that the presence of an abnormal diffusion capacity of carbon monoxide in the post-recovery phase of COVID-19 is associated with a greater risk of long-term parenchymal lung disease, as evidenced by the presence of fibrotic-like changes on chest computed tomography scans, such as traction bronchiectasis and architectural distortion.

Correlation between chest computed tomography findings and pulmonary function test results in the post-recovery phase of COVID-19

ABSTRACT Objective The radiological and functional lung sequelae in COVID-19 survivors remain unclear. We compared the chest computed tomography findings of COVID-19 patients with normal and abnormal pulmonary function test results in the post-recovery phase. Methods The data of consecutive patients who underwent pulmonary function tests and chest computed tomography within 14 days after recovery from COVID-19 at two medical centers between May and October 2020 were collected retrospectively. Two thoracic radiologists who were blinded to the clinical information and pulmonary function test results classified the patients according to the computed tomography features, evidence of fibrotic-like changes, and semi-quantitative quantification of the extent of pulmonary abnormalities. The clinical characteristics and computed tomography findings of patients with normal pulmonary function test results were compared with those of patients with abnormal results. Results A total of 101 COVID-19 survivors, comprising 48 ambulatory and 53 hospitalized patients, were included at a median of 95 days from initial symptom onset. Computed tomography revealed fibrotic-like changes in 10.9% of patients. A reduction in the diffusion capacity of carbon monoxide was the most common lung function abnormality (19.8%). Abnormal diffusion capacity of carbon monoxide was associated with the presence and extension of lung opacities on chest computed tomography scans and fibrotic pulmonary abnormalities. The sensitivity, specificity, and accuracy of reduced diffusion capacity of carbon monoxide for detecting fibrotic-like pulmonary changes on chest computed tomography scans were 72.7%, 87.8%, and 86.1%, respectively. Conclusion Our study suggests that the presence of an abnormal diffusion capacity of carbon monoxide in the post-recovery phase of COVID-19 is associated with a greater risk of long-term parenchymal lung disease, as evidenced by the presence of fibrotic-like changes on chest computed tomography scans, such as traction bronchiectasis and architectural distortion.

Adolescentes grávidas que experienciaram o nascimento prematuro: percepções acerca do cuidado pré-natal / Adolescentes embarazadas que experimentaron un nacimiento prematuro: percepciones acerca del cuidado prenatal / Pregnant adolescents who experienced premature birth: perceptions about prenatal care

Resumo Objetivo conhecer os significados atribuídos ao pré-natal por adolescentes que pariram prematuramente e seus alcances ao parto e nascimento. Método estudo qualitativo que adotou o Interacionismo Simbólico e a Análise de Conteúdo Temática como referenciais teóricos e metodológicos e a entrevista aberta como instrumento de coleta de dados. Onze adolescentes residentes em um município do interior paulista integraram o estudo ao longo do ano de 2018. Resultados as adolescentes apontaram relações limitadas com os profissionais com obstáculos ao desenvolvimento da autonomia para as questões da gestação, parto e nascimento, assim como para o estabelecimento do apoio social. Emergiram três categorias temáticas: 'Início do pré-natal: reflexões e projeções futuras'; 'Insuficiências na atenção pré-natal' e '(Des) acolhimento no parto e nascimento'. Conclusão conhecer os significados atribuídos ao pré-natal por adolescentes que pariram prematuramente favoreceu apontamentos ao atitudinal do profissional em relação à consideração da adolescente enquanto indivíduo que direciona o cuidado por meio de seu lugar de fala e no exercício dos seus direitos no sentido de promover uma experiência positiva e qualificar o pré-natal.

Resumen Objetivo conocer los significados atribuidos a la atención prenatal por las adolescentes que dieron a luz prematuramente y su alcance durante el parto y el nacimiento. Método estudio cualitativo que adoptó el Interaccionismo Simbólico y el Análisis de Contenido Temático como referenciales teóricos y metodológicos y la entrevista abierta como instrumento de recolección de datos. Once adolescentes residentes en una ciudad del interior de São Paulo participaron del estudio a lo largo de 2018. Resultados las adolescentes señalaron relaciones limitadas con profesionales con obstáculos al desarrollo de la autonomía para los temas de embarazo, parto y nacimiento, así como para el establecimiento de apoyo social. Surgieron tres categorías temáticas: 'Inicio de la atención prenatal: reflexiones y proyecciones de futuro'; 'Insuficiencias en la atención prenatal' y '(Des) acogida en el parto y el nacimiento'. Conclusión conocer los significados atribuidos a la atención prenatal por las adolescentes que dieron a luz prematuramente favoreció la actitud del profesional de considerar a la adolescente como un individuo que dirige el cuidado a través de su lugar de expresión y en el ejercicio de sus derechos para promover una experiencia positiva y calificar el prenatal.

Abstract Objective to know the meanings attributed to prenatal care by adolescents who gave birth prematurely and their reaches to labor and birth. Method qualitative study that adopted the Symbolic Interactionism and Thematic Content Analysis as theoretical and methodological references and the open interview as a data collection tool. Eleven adolescents living in a municipality in the interior of São Paulo integrated the study throughout the year 2018. Results the adolescents pointed out limited relationships with professionals with obstacles to the development of autonomy for the issues of pregnancy, delivery and birth, as well as for the establishment of social support. Three thematic categories emerged: 'Beginning of prenatal care: reflections and future projections'; 'Insufficiencies in prenatal care' and '(un) welcoming in labor and birth'. Conclusion knowing the meanings attributed to prenatal care by adolescents who gave birth prematurely, favored points to the attitudinal of the professional regarding the consideration of the adolescent as an individual who directs care through her place of speech and in the exercise of her rights in order to promote a positive experience and qualify prenatal care.

Evaluation of process indicators of a medication review service between pharmacists and physicians.

RATIONALE, AIMS AND OBJECTIVES: Literature have showed inconclusive or contradictory results regarding medication review services effectiveness in optimizing process indicators. Thus, this study aimed to evaluate the process indicators of a medication review service between pharmacists and physicians. METHOD: This quasi-experimental study was conducted between March 2013 and February 2014 with patients who were receiving care in a medication review service in a teaching hospital in northeastern Brazil. The main process indicators were number of pharmaceutical consultations; identification and resolution of drug-related problems (DRP) and pharmaceutical interventions that were classified according to type and degree of acceptance. Descriptive statistics were used to report data. The statistical significance of the association between variables was evaluated using the Mantel-Haenszel chi-square test. The 95% confidence interval was considered, and differences were deemed statistically significant if P ≤ .05. RESULTS: A total of 146 patients attended the medication review service. The number of consultations per patient ranged from one to five (2.1 ± 1.1). The service identified 366 DRP, most of which were indication (67.5%). Patients who had four to five pharmaceutical consultations were 1.14 times more likely to have their DRP identified (χ2 = 33.83, P < .0001). Of the DRP identified, 183 (42.33%) were resolved. Patients who had between one and two pharmaceutical consultations were 1.22 times more likely not to have their DRP resolved compared with the group with more than three consultations (χ2 = 3.44, P < .05). Of the 173 pharmaceutical interventions made to the medical students and physicians, the majority (98.7%) was accepted. CONCLUSION: The collaborative medication review service optimized the process indicators. Drug-related problems identification and resolution required more than three pharmaceutical consultations. Most of the pharmaceutical interventions were accepted by prescribers. Thus, collaborative medication review services may be fundamental to the construction of more effective and safe health systems.

Evaluation of students' attitudes towards pharmacist-physician collaboration in Brazil

Objective: To measure undergraduate pharmacy and medical students' collaborative attitudes regarding Pharmacist-Physician collaboration. Methods: A cross-sectional descriptive study was conducted from September 2016 to February 2017 in Northeast Brazil. Pharmacy and medical students from the first and the last year of courses were invited to complete Portuguese version of Scale of Attitudes Toward Pharmacist-Physician Collaboration (SATP2C). Descriptive and comparative analyses were performed using IBM SPSS (22 version). Differences were considered significant when p<0.05. Results: Three hundred seventy students completed the SATP2C. Overall, the students had positive attitudes towards physician-pharmacist collaboration. There was no significant correlation between age and score (p=0.79). Women showed a more positive collaborative attitude than men (53.1, SD=6.8 vs. 55.1, SD=6.3). Pharmacy students had a higher score than medical students (57.5, SD=4.7, vs. 51.1, SD=6.4). The first-year medical students had a higher score than last-year medical students (52.3, SD=6.0 vs. 49.5, SD=6.6; p<0.007). There was no significant difference in the attitudes between the first and last year pharmacy students (p<0.007). Conclusions: Pharmacy and medical students showed positive attitudes towards physician-pharmacist collaboration. However, pharmacy students presented more collaborative attitudes than medical ones. Additionally, the first-year medical students had more collaborative attitudes than last-year medical students. Studies should be conducted to provide recommendations to improve interprofessional education efforts to further enhance the positive attitudes toward physician-pharmacist collaboration

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Use of Tc-rCRP as a target for lytic antibody titration after experimental Trypanosoma cruzi infection.

Experimental Chagas disease has been used as a model to identify several host/parasite interaction factors involved in immune responses to Trypanosoma cruzi infection. One of the factors inherent to this parasite is the complement regulatory protein (Tc-CRP), a major epitope that induces production of lytic antibodies during T. cruzi infections. Previous studies have evaluated the function of Tc-CRP as an antigenic marker via ELISAs, which demonstrated high sensitivity and specificity when compared to other methods. Therefore, this study aimed to assess and compare the levels of lytic antibodies induced by this protein following experimental infection using different T. cruzi strains. Our results demonstrated that infections induced by strains isolated from vectors resulted in subpatent parasitaemia and low reactivity, as assessed by Tc-rCRP ELISAs. On the other hand, mice inoculated with T. cruzi strains isolated from patients developed patent parasitaemia, and presented elevated lytic antibodies titres, as measured by Tc-rCRP ELISA. In addition, comparison between different mouse lineages demonstrated that Balb/c mice were more reactive than C57BL/6 mice in almost all types of infections, except those infected by the AQ-4 strain. Parasites from the Hel strain generated the greatest lytic antibody response in all evaluated models. Therefore, application of sensitive techniques for monitoring immune responses would enable us to establish growth curves for lytic antibodies during the course of the infection, and allow us to discriminate between T. cruzi strains that originate from different hosts.

Evaluation of students' attitudes towards pharmacist-physician collaboration in Brazil.

OBJECTIVE: To measure undergraduate pharmacy and medical students' collaborative attitudes regarding Pharmacist-Physician collaboration. METHODS: A cross-sectional descriptive study was conducted from September 2016 to February 2017 in Northeast Brazil. Pharmacy and medical students from the first and the last year of courses were invited to complete Portuguese version of Scale of Attitudes Toward Pharmacist-Physician Collaboration (SATP2C). Descriptive and comparative analyses were performed using IBM SPSS (22 version). Differences were considered significant when p<0.05. RESULTS: Three hundred seventy students completed the SATP2C. Overall, the students had positive attitudes towards physician-pharmacist collaboration. There was no significant correlation between age and score (p=0.79). Women showed a more positive collaborative attitude than men (53.1, SD=6.8 vs. 55.1, SD=6.3). Pharmacy students had a higher score than medical students (57.5, SD=4.7, vs. 51.1, SD=6.4). The first-year medical students had a higher score than last-year medical students (52.3, SD=6.0 vs. 49.5, SD=6.6; p<0.007). There was no significant difference in the attitudes between the first and last year pharmacy students (p<0.007). CONCLUSIONS: Pharmacy and medical students showed positive attitudes towards physician-pharmacist collaboration. However, pharmacy students presented more collaborative attitudes than medical ones. Additionally, the first-year medical students had more collaborative attitudes than last-year medical students. Studies should be conducted to provide recommendations to improve interprofessional education efforts to further enhance the positive attitudes toward physician-pharmacist collaboration.

Cross-cultural adaptation and validation to Brazil of the scale of attitudes toward physician-pharmacists collaboration.

BACKGROUND: Despite the increasing complexity of medication therapies and the expansion of pharmaceutical clinical services to optimize patient care working in collaboration with physicians. In this sense, interdisciplinary education has been encouraged. However, no instrument is available to measure attitudes toward collaborative relationships. OBJECTIVE: To translate, cross-cultural adaptation and validation an instrument to measure collaboration attitudes toward students of medicine/pharmacy and physicians/pharmacists. METHODS: The process of cross-cultural adaptation was carried out using international recommendations and was performed from January 2014 to April 2015. The instrument under consideration was translated and re-translated. A panel of experts compared the generated documents and the translation was evaluated for 20 undergraduate students of Pharmacy, 20 undergraduate students of Medicine and professionals (20 pharmacists and 20 physicians). RESULTS: The process of cross-cultural translation and validation result in the Portuguese version. Modifications to the grammatical structures were made in order to establish a cross-cultural similarity between the English and Portuguese versions. Regarding the evaluation of the expert panel, six questions required modifications. CONCLUSIONS: Psychometric evaluation demonstrated and confirmed the validity of the Brazilian-Portuguese version to assess collaborative attitudes among pharmacists and physicians. Moreover, the scale can be used to evaluate undergraduates and postgraduates and foster the development of teaching methods that promote comprehensive attitudes in patient care.

Cross-cultural adaptation and validation to Brazil of the scale of attitudes toward physician-pharmacists collaboration

Background: Despite the increasing complexity of medication therapies and the expansion of pharmaceutical clinical services to optimize patient care working in collaboration with physicians. In this sense, interdisciplinary education has been encouraged. However, no instrument is available to measure attitudes toward collaborative relationships. Objective: To translate, cross-cultural adaptation and validation an instrument to measure collaboration attitudes toward students of medicine/pharmacy and physicians/pharmacists. Methods: The process of cross-cultural adaptation was carried out using international recommendations and was performed from January 2014 to April 2015. The instrument under consideration was translated and re-translated. A panel of experts compared the generated documents and the translation was evaluated for 20 undergraduate students of Pharmacy, 20 undergraduate students of Medicine and professionals (20 pharmacists and 20 physicians). Results: The process of cross-cultural translation and validation result in the Portuguese version. Modifications to the grammatical structures were made in order to establish a cross-cultural similarity between the English and Portuguese versions. Regarding the evaluation of the expert panel, six questions required modifications. Conclusions: Psychometric evaluation demonstrated and confirmed the validity of the Brazilian-Portuguese version to assess collaborative attitudes among pharmacists and physicians. Moreover, the scale can be used to evaluate undergraduates and postgraduates and foster the development of teaching methods that promote comprehensive attitudes in patient care (AU)

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Establishment, Implementation, and Consolidation of Clinical Pharmacy Services in Community Pharmacies: Perceptions of a Group of Pharmacists.

When pharmacists incorporate clinical practice into their routine, barriers and facilitators influence the implementation of patient care services. Three focus groups were conducted with 11 pharmacists who were working for the Farmácia Popular do Brasil program on the establishment, implementation, and consolidation of clinical pharmacy services. The perception of the pharmacists in Brazil about the program was that it facilitated access to health care and medication. The distance between neighboring cities made it difficult for patients to return for services. Lack of staff training created a lack of communication skills and knowledge. The pharmacists wanted to have increased technical support, skill development opportunities, and monitoring of researchers who assessed progress of the service. Pharmacists overcame many of their insecurities and felt more proactive and committed to quality service. Positive experiences in service implementations have shown that it is possible to develop a model of clinical services in community pharmacies.

Correlation between the virulence of T. cruzi strains, complement regulatory protein expression levels, and the ability to elicit lytic antibody production.

Trypanosoma cruzi trypomastigotes are able to resist lysis via the complement system, which involves many surface proteins including the complement regulatory protein (CRP). To examine the diversity in CRP recognition among strains of T. cruzi, the expression levels of the translated protein on trypomastigote surfaces were analyzed by flow cytometry, and associations between protein expression and the biological behavior of these strains, especially the ability to induce lytic antibodies in animal models, were assessed. The highly virulent T. cruzi strains Ninoa, INC-5, and Colombiana and the less virulent strains CL-Brener, LGB-231, and JG were used in the experiments. An expression profile analysis showed that the Colombiana and INC-5 strains have higher translated protein levels and induced higher production of antibodies in mice than the other strains. Our results indicated that there are differences in the surface expression of CRP between parasite strains, with a tendency for the most virulent strains to have higher expression levels. Combined, these results contribute to a better understanding of CRP functions and the complexity of host-parasite interactions, considering the large number of virulence factors involved in the process.

The Driving of Immune Response by Th1 Adjuvants in Immunization of Mice with Trypanosoma cruzi marinkellei Elicits a Controversial Infection Control.

In previous studies, we have demonstrated that inoculation with a Trypanosoma cruzi marinkellei (avirulent RM1 strain) was able to reduce parasitemia in mice challenged with T. cruzi, although it was not able to prevent histopathological lesions. Th1 response stimulation by immunization is necessary for T. cruzi infection control, but the resistance is also dependent on immunoregulatory mechanisms, which can be induced by adjuvants. Thus, we evaluated whether inoculation of T. cruzi marinkellei associated with administration of different adjuvants would be capable of inducing different patterns of immune response to maximize the immune response against T. cruzi (virulent Romildo strain) infection. Two hundred eighty nonisogenic mice were divided into 14 groups according to the immunization scheme and the subsequent challenge with virulent Romildo T. cruzi strain. Nonimmunized groups and animals inoculated without adjuvants were also included. Immune protection was not observed with Th2 adjuvants (incomplete Freund's adjuvant [IFA] and Alum) due to high parasitemia. Th1/Th2-polarizing adjuvants also did not induce immune protection because inulin was unable to maintain survival, and immune-stimulating complexes induced intense inflammatory processes. Animals sensitized with RM1 strain without adjuvants were able to reduce parasitemia, increase survival, and protect against severe histological lesions, followed by adequate cytokine stimulation. Finally, our results demonstrate that the early and balanced IFN-γ production becomes critical to promote protection and that Th1 adjuvant elicited a controversial infection control due to increased histopathological damage. Therefore, the host's immunomodulation remains one of the most important challenges in the research for effective protection against T. cruzi infection. Similarly, the identification of protective antigens in the RM1 strain of T. cruzi marinkellei may contribute to further studies on vaccine development against human Chagas disease.

Medication wrong-route administrations in relation to medical prescriptions.

This study analyzes the influence of medical prescriptions' writing on the occurrence of medication errors in the medical wards of five Brazilian hospitals. This descriptive study used data obtained from a multicenter study conducted in 2005. The population was composed of 1,425 medication errors and the sample included 92 routes through which medication was wrongly administered. The pharmacological classes most frequently involved in errors were cardiovascular agents (31.5%), medication that acts on the nervous system (23.9%), and on the digestive system and metabolism (13.0%). In relation to the prescription items that may have contributed to such errors, we verified that 91.3% of prescriptions contained acronyms and abbreviations; patient information was missing in 22.8%, and 4.3% did not include the date and were effaced. Medication wrong-route administrations are common in Brazilian hospitals and around the world. It is well established that these situations may result in severe adverse events for patients, including death.

Medication wrong-route administrations in relation to medical prescriptions / Administração de medicamentos, em vias diferentes das prescritas, relacionada à prescrição médica / Administración de medicamentos en vías diferentes de las indicadas en la prescripción médica

This study analyzes the influence of medical prescriptions' writing on the occurrence of medication errors in the medical wards of five Brazilian hospitals. This descriptive study used data obtained from a multicenter study conducted in 2005. The population was composed of 1,425 medication errors and the sample included 92 routes through which medication was wrongly administered. The pharmacological classes most frequently involved in errors were cardiovascular agents (31.5 percent), medication that acts on the nervous system (23.9 percent), and on the digestive system and metabolism (13.0 percent). In relation to the prescription items that may have contributed to such errors, we verified that 91.3 percent of prescriptions contained acronyms and abbreviations; patient information was missing in 22.8 percent, and 4.3 percent did not include the date and were effaced. Medication wrong-route administrations are common in Brazilian hospitals and around the world. It is well established that these situations may result in severe adverse events for patients, including death.

O objetivo foi analisar a influência da redação da prescrição médica nos erros de via de administração, ocorridos em enfermaria de clínica médica de cinco hospitais brasileiros. Estudo descritivo que utilizou dados de pesquisa multicêntrica, realizada em 2005. A população foi composta por 1.425 erros de medicação e a amostra por 92 erros de via. As classes farmacológicas mais envolvidas no erro foram as cardiovasculares (31,5 por cento), drogas que atuam no sistema nervoso (23,9 por cento) e no sistema digestório e metabolismo (13,0 por cento). No que diz respeito aos itens da prescrição médica, que poderiam ter contribuído com os erros de via, verificou-se que 91,3 por cento das prescrições continham siglas/abreviaturas, 22,8 por cento não continham dados do paciente e 4,3 por cento não apresentavam data e continham rasuras. Erros de via são frequentes nos hospitais brasileiros e ao redor do mundo, e se sabe que essas situações podem resultar em eventos adversos severos aos pacientes, incluindo morte.

El objetivo fue analizar la influencia de la redacción de la prescripción médica en los errores de vía de administración ocurridos en la enfermería de clínica médica de cinco hospitales brasileños. Se trata de un estudio descriptivo que utilizó datos de investigación multicéntrica realizada en 2005. La población fue compuesta por 1.425 errores de medicación y la muestra por 92 errores de vía. Las clases farmacológicas más envueltas en el error fueron: 1) las cardiovasculares (31,5 por ciento), 2) las drogas que actúan en el sistema nervioso (23,9 por ciento), y 3) las que actúan en el sistema digestivo y metabolismo (13,0 por ciento). En lo que se refiere a los ítems de la prescripción médica que podrían haber contribuido con los errores de vía, se verificó que 91,3 por ciento de las prescripciones contenían siglas/abreviaturas; 22,8 por ciento no contenían datos del paciente, y 4,3 por ciento no presentaban fecha y contenían raspados. Errores de vía son frecuentes en los hospitales brasileños y alrededor del mundo y se sabe que estas situaciones pueden resultar en eventos adversos severos en los pacientes, incluyendo la muerte.

[The influence of the advertising in the medication use in a group of elderly attended in a primary health care unit in Aracaju (Sergipe, Brasil)]. / Influência da propaganda na utilização de medicamentos em um grupo de idosos atendidos em uma unidade básica de saúde em Aracaju (SE, Brasil).

The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the user's health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73%) has at least a chronic health condition and 73.9% consumed regularly at least one medication. 17.8% of the sample informed to use medication motivated by publicity influence; 2.2% had considered that the medication never cause damages and 6.5% believed that always it makes well. In this study, correlations have been made and demonstrated that those who presented a higher level of consumption influenced by advertising also think that drugs used are always beneficial and vice versa (p= 0.04). The data showed that part of elderly suffered influence of advertisement to medication use, and are not conscious of risks involved.

Influência da propaganda na utilização de medicamentos em um grupo de idosos atendidos em uma unidade básica de saúde em Aracaju (SE, Brasil) / The influence of the advertising in the medication use in a group of elderly attended in a primary health care unit in Aracaju (Sergipe, Brasil)

O crescimento da população idosa brasileira tem levado a uma maior tendência ao uso de medicamentos. A sua utilização inadequada pode ser induzida por vários fatores, dentre eles a propaganda, podendo trazer danos à saúde do usuário. O objetivo do estudo foi avaliar a influência da propaganda no consumo de medicamentos por um grupo de idosos atendidos em unidade básica de saúde de Aracaju, Sergipe. No período de abril a junho de 2007, um grupo de 230 idosos, com idade acima de 60 anos, de ambos os gêneros, foi entrevistado. A maioria dos entrevistados (73 por cento) possuía pelo menos uma doença crônica e 73,9 por cento consumiam pelo menos um medicamento regularmente. Do total de entrevistados, 17,8 por cento da amostra relataram utilizar medicamentos por influência da propaganda; 2,2 por cento consideraram que os medicamentos veiculados na mídia nunca fazem mal e 6,5 por cento acreditavam que eles sempre fazem bem. No estudo, correlações foram feitas e demonstraram que quem mais consome medicamentos influenciados pela propaganda também considera que eles sempre fazem bem e vice-versa (p= 0,04). Os dados revelaram que parte dos idosos sofreu influência da propaganda no consumo de medicamentos, não levando em consideração os riscos que estes poderiam causar.

The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the user's health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73 percent) has at least a chronic health condition and 73.9 percent consumed regularly at least one medication. 17.8 percent of the sample informed to use medication motivated by publicity influence; 2.2 percent had considered that the medication never cause damages and 6.5 percent believed that always it makes well. In this study, correlations have been made and demonstrated that those who presented a higher level of consumption influenced by advertising also think that drugs used are always beneficial and vice versa (p= 0.04). The data showed that part of elderly suffered influence of advertisement to medication use, and are not conscious of risks involved.

A percepção de farmacêuticos acerca da possibilidade de implantação da atenção farmacêutica na prática profissional / The pharmacists` perceptions on possibilities of pharmaceutical care implantation in the professional practice

O objetivo deste estudo foi compreender o ponto de vista de farmacêuticos sobre as possibilidades de implantação da Atenção Farmacêutica em farmácias e drogarias. A investigação teve abordagem qualitativa, sendo os sujeitos farmacêuticos de um município do interior paulista. Os dados foram coletados por meio de entrevistas semi-estruturadas e analisados por meio da análise de conteúdo temático, com base nos pressupostos da Teoria Fundamentada em Dados, que possibilitou o agrupamento por categorias, de acordo com a similitude. Emergiram as seguintes categorias de análise: Conceituando a Atenção Farmacêutica como atividade de aconselhamento ao paciente; Necessidade de capacitação para a prática da Atenção Farmacêutica; Falta de condições de trabalho para o desempenho das ações de Atenção Farmacêutica; Pouca receptividade da população para receber cuidados farmacêuticos; Atenção Farmacêutica como possibilidade de resgate do papel do farmacêutico. As falas revelaram que os profissionais não se sentem aptos ou capacitados para o exercício da Atenção Farmacêutica. A falta de tempo e de receptividade do público são apontadas como importantes barreiras. No entanto a Atenção Farmacêutica é vista como caminho para resgatar o papel do farmacêutico na sociedade. Preliminarmente, este estudo demonstra a necessidade de um maior investimento em estratégias voltadas à formação dos profissionais. Também deve ser buscado melhor entendimento acerca da aceitação do público para os cuidados farmacêuticos e dos mecanismos capazes de promover a interação deste profissional com a população.

The aim of this study was to understand the pharmacists’ point of view on the possibilities of implantation of Pharmaceutical Care in pharmacies. The approach of research was qualitative and the participants were pharmacists from a small city in the state of São Paulo, Brazil. Data were collected through semi-structured interviews and analyzed using content analysis, based on the assumptions of Grounded Theory, which allowed the grouping by categories according to their similarity. There was obtained the following categories: Conceptualizing Pharmaceutical Care as an activity of patient counseling; training needs for the Pharmaceutical Care practice; lack of working conditions for the Pharmaceutical Care practice; little receptivity of people to receive Pharmaceutical Care, Pharmaceutical Care as a possibility for rescue the pharmacist’ role. The interviews revealed that professionals do not feel ready or able to practice Pharmaceutical Care. The lack of time and public acceptance are cited as major barriers. However, Pharmaceutical Care is considered as a solution for rescuing the role of the pharmacist in society. Preliminarily, this study demonstrates the need for greater investment in strategies for the professionals training. It should also be better understanding the public acceptance for Pharmaceutical Care and the mechanisms to promote the professional-population interaction.

Errors in medicine administration - profile of medicines: knowing and preventing / Perfil de medicamentos envolvidos com erros de administração: conhecer para prevenir / Perfil de medicamentos envueltos en errores de administración: conocer para prevenir

OBJECTIVES: To describe the pharmacological characteristics of medicines involved in administration errors and determine the frequency of errors with potentially dangerous medicines and low therapeutic index, in clinical units of five teaching hospitals, in Brazil. METHODS: Multicentric study, descriptive and exploratory, using the non-participant observation technique (during the administration of 4958 doses of medicines) and the anatomical therapeutic chemical classification (ATC). RESULTS: Of that total, 1500 administration errors were identified (30.3 percent). The administration of pharmacological groups - ATC (cardiovascular system, nervous system, alimentary tract and metabolism system and anti-infectives for systemic use) showed a higher frequency of errors. In 13.0 percent of errors were involved potentially dangerous medicines and in 12.2 percent medicines with low therapeutic index. CONCLUSION: The knowledge of the pharmacological profile could be an important strategy to be used in the prevention medication errors in health institutions.

OBJETIVOS: Descrever as características farmacológicas dos medicamentos envolvidos em erros de administração e determinar a frequência desses erros com medicamentos potencialmente perigosos e de baixo índice terapêutico em unidades de clínica médica de cinco hospitais de ensino brasileiros. MÉTODOS: Estudo multicêntrico, descritivo/exploratório utilizando a técnica de observação não participante durante a administração de 4958 doses de medicamentos e a classificação anatômica terapêutica química (ATC). RESULTADOS: Dentre esse total, foram identificados 1500 erros de administração de medicamentos (30,3 por cento). A administração dos fármacos dos grupos ATC - sistema cardiovascular, sistema nervoso, trato alimentar e metabolismo e antinfecciosos de uso sistêmico apresentou maior frequência de erros. Em 13,0 por cento dos erros estavam envolvidos medicamentos potencialmente perigosos e em 12,2 por cento medicamentos de baixo índice terapêutico. CONCLUSÃO: O conhecimento do perfil farmacológico pode ser uma importante estratégia a ser utilizada na prevenção de erros de medicação em instituições de saúde.

OBJETIVOS: Describir las características farmacológicas de los medicamentos envueltos en errores de administración y determinar la frecuencia de esos errores en medicamentos potencialmente peligrosos y en los de bajo índice terapéutico, en unidades de clínica médica de cinco hospitales de enseñanza brasileños. MÉTODOS: Estudio multicéntrico, descriptivo-exploratorio utilizando la técnica de observación no participante (durante la administración de 4.958 dosis de medicamentos) y la clasificación anatómica terapéutica química (ATC). RESULTADOS: Fueron identificados 1500 errores de administración de medicamentos (30,3 por ciento). La administración de los fármacos de los grupos ATC (sistema cardiovascular, sistema nervioso, sistema digestivo y metabolismo, y, anti-infecciosos) de uso sistémico presentó mayor frecuencia de errores. En 13,0 por ciento de los errores estaban envueltos medicamentos potencialmente peligrosos y en 12,2 por ciento medicamentos de bajo índice terapéutico. CONCLUSIÓN: El conocimiento del perfil farmacológico puede ser una importante estrategia para prevenir los errores de medicación en las instituciones de salud.

Compreendendo os significados das interações entre profissionais de saúde e idosos usuários de medicamentos / Understanding the meanings of the interactions between health care professionals and elderly users of the medicine

O presente trabalho visa compreender e analisar os significados das interações entre profissionais de saúde (médicos e farmacêuticos) e idosos portadores de condições crônicas de saúde, na perspectiva dos usuários de medicamentos. O estudo foi realizado em uma unidade de saúde do Município de Ribeirão Preto, em agosto de 2003. Esta análise secundária teve como referencial o Interacionismo Simbólico e os dados das entrevistas gravadas, no trabalho original, foram submetidos à análise temática de conteúdo. Os temas que emergiram demonstram que a ambivalência simbólica das interações permite diversas interpretações que vão desde o distanciamento e falta de confiança até a liberdade de expressão e o diálogo com o profissional de saúde. Compreender tais interações pode ser fundamental para melhorar o entendimento do processo saúde-doença, otimizar os cuidados à saúde e garantir o uso racional dos medicamentos.

The present work aims at understanding and analyzing the meanings of the interactions between health care professionals (doctors and pharmacists) and elderly with chronic heath conditions, in the perspective of the medicine users. The study was carried out a primary healthcare unit in Ribeirão Preto (SP), Brazil, in August 2003. This secondary analysis had as referencial the Symbolic Interacionism and the data of the recorded interviews, in the original work, had been submitted to the thematic analysis of content. The subjects that had emerged demonstrate that symbolic ambivalence of the interactions allows diverse interpretations that go since the distance and the lack of confidence until the liberty of speech and the dialogue with the health care professionals. Understanding such interactions can be basic to improve the agreement of the process health-illness, to optimize the cares to the health and to guarantee the rational use of medicines.

El presente trabajo visa comprender y analizar los significados de las interaciones entre profesionales de la salud (médicos y farmacéuticos) y ancianos portadores de condiciones crónicas de salud, en la perspectiva de los usuarios de medicamentos. El estudio fue realizado en una unidad de atención primaria de salud en Ribeirão Preto (SP), Brasil, en agosto de 2003. Este análisis secundario tuvo como referencial el Interacionismo Simbólico y los datos de las entrevistas grabadas, en el trabajo original, fueron sometidos al análisis temático de contenido. Los temas que emergieron demuestran que la ambivalencia simbólica de las interaciones permite diversas interpretaciones que van desde el distanciamiento y la falta de confianza hasta la libertad de expresión y el diálogo con el profesional de la salud. Comprender tal interación puede ser fundamental para mejorar el entendimiento del proceso salud-enfermedad, optimizar los cuidados de la salud y garantizar el uso racional de los medicamentos.