RESUMO
Metal-rich fumes emitted during ore smelting contribute to widespread anthropogenic contamination. Environmental archives (such as lake sediments) record fallouts deposited on lake and terrestrial surfaces during ancient mining and smelting activities. However, very few is known about the potential buffering effect of soils upon which metal falls out, prior to be released through runoff and or/erosion, hence leading to pervasive contamination fluxes long after the ceasing of metallurgical activities. Here we aim at assessing this long-term remobilisation in a mountainous catchment area. Lake sediments and soils were collected 7 km upward a 200-year-old historic mine. The PbAg mine of Peisey-Nancroix was operated between the 17th and the 19th centuries with a documented smelting period of 80 years. In lake sediments, the total Pb content varies from 29 mg.kg-1 prior smelting to 148 mg.kg-1 during ore smelting. Pb isotopes in lake sediments and soils provide evidence of anthropogenic Pb from the local ore (206Pb/207Pb = 1.173; 208Pb/206Pb = 2.094) during and after smelting, suggesting anthropogenic Pb remobilisation for 200 years. The accumulation rates of anthropogenic Pb calculated in lake sediments after the smelting period confirm such a remobilisation. Despite a decrease in this accumulation rate through time, soils still contain significant stocks of anthropogenic Pb (54-89 % of PbANTH). The distribution of present-day anthropogenic Pb in the catchment area depends mainly on topographic characteristics. Coupling lake sediments and soils investigations is thus necessary to constrain the long-term persistence and remobilisation of a diffuse contamination related to mining activities.
RESUMO
Abstract This study examined the effects of pharmacist interventions for patients with advanced prostate cancer. A pre-post study was conducted between October 2014 and August 2017 in a community pharmacy in Brazil for outpatients with advanced prostate cancer, aged ≥ 18 years, using cyproterone acetate and/or goserelin. The patients had face-to-face meetings with a pharmacist who dispensed antiandrogenic drugs and performed interventions aimed at solving and/or preventing drug-therapy problems. Primary outcomes regarding prostate-specific antigen (PSA) and testosterone levels were compared at 0, 6, and 12 months, whereas secondary outcomes-medication adherence and quality of life-were compared at baseline and at the 12-month follow-up. Medication adherence was assessed using the Morisky-Green test, and quality of life was measured by the Medical Outcomes Study 36-item Short Form (SF-36) and the Functional Assessment of Cancer Therapy-Prostate (FACT-P). The analysis included 20 patients; 311 drug-therapy problems were identified and most of them were related to adverse reactions (78.5%). The most common adverse reactions were reduced libido, erectile dysfunction, hyperglycemia, fatigue, and gynecomastia. Testosterone levels significantly decreased at 6 months, and PSA levels at 6 and 12 months. No significant changes in adherence were noted at the end of the study. A significant increase in the "pain" domain and an improvement trend in the "physical aspects" and "vitality" domains were observed based on the SF-36 instrument. The findings show that pharmacist interventions were able to improve PSA and testosterone levels, and some domains of quality of life of patients.
RESUMO
Background The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria is used to identify instances of potentially inappropriate prescribing in a patient's medication regimen. Objective To determine the prevalence and predictors of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among elderly patients at hospital discharge. Setting A university hospital medical clinic in Brazil. Method Discharge prescriptions were examined using the STOPP/START criteria. Subjects were inpatients aged ≥60 years receiving at least one medication prior to hospitalization and with a history of cardiovascular disease. The prevalence of PIMs and PPOs was determined and a multivariable binary regression analysis was performed to identify independent predictors associated with PIMs or PPOs. Main outcome measure Prevalence of PIMs and PPOs. Results Of the 230 subjects, 13.9% were prescribed at least one PIM. The most frequently prescribed PIMs were glibenclamide or chlorpropamide prescribed for type 2 diabetes mellitus (31.0%), and aspirin at doses >150 mg/day (14.3%). Ninety patients had at least one PPO (39.1%). The most prevalent PPOs were statins (29.8%) and antiplatelet therapy (13.7%) for diabetes mellitus when coexisting major cardiovascular risk factors were present. No predictors for PIMs were found. In contrast, diabetes was a risk factor while dyslipidaemia was a protective factor for PPOs. Conclusion PIMs and PPOs commonly occur with elderly people at hospital discharge. Diabetes and dyslipidaemia were significantly associated with PPOs. Our findings show the need for interventions to reduce potentially inappropriate prescribing, such as a pharmacist medication review process at hospital discharge.
