Utilization of machine learning for dengue case screening.

Dengue causes approximately 10.000 deaths and 100 million symptomatic infections annually worldwide, making it a significant public health concern. To address this, artificial intelligence tools like machine learning can play a crucial role in developing more effective strategies for control, diagnosis, and treatment. This study identifies relevant variables for the screening of dengue cases through machine learning models and evaluates the accuracy of the models. Data from reported dengue cases in the states of Rio de Janeiro and Minas Gerais for the years 2016 and 2019 were obtained through the National Notifiable Diseases Surveillance System (SINAN). The mutual information technique was used to assess which variables were most related to laboratory-confirmed dengue cases. Next, a random selection of 10,000 confirmed cases and 10,000 discarded cases was performed, and the dataset was divided into training (70%) and testing (30%). Machine learning models were then tested to classify the cases. It was found that the logistic regression model with 10 variables (gender, age, fever, myalgia, headache, vomiting, nausea, back pain, rash, retro-orbital pain) and the Decision Tree and Multilayer Perceptron (MLP) models achieved the best results in decision metrics, with an accuracy of 98%. Therefore, a tree-based model would be suitable for building an application and implementing it on smartphones. This resource would be available to healthcare professionals such as doctors and nurses.

Analysis of notified drug poisoning among children in Santa Catarina state, 2016-2020.

OBJECTIVE: The aim of this study was to analyze the incidence of drug poisoning in children registered in the Santa Catarina Information and Toxicological Assistance Center between 2016 and 2020. METHODS: This observational epidemiological study, with a historical cohort design, was carried out from reported cases of drug poisoning in children aged 0-12 years. Census sampling was used to collect data. RESULTS: There were 4839 reported cases of drug poisoning among children in the State of Santa Catarina in the surveyed period, with an average annual incidence rate of 6 cases/1000 live births. The median age was 3 years. Most cases of poisoning occurred among girls aged 0-3 years by accidental ingestion of drugs at home. There was a predominance of signs and symptoms affecting the nervous system; only a small portion required hospitalization. Most cases were considered mild poisoning with a favorable outcome. No deaths were recorded. There was a tendency of increasing cases over time, however not significant. There is a predominance of incident cases in the Great West of the state, followed by the Midwest and Serra Catarinense regions. CONCLUSIONS: Drug poisoning in children is predominant in early childhood, mainly caused by accidental ingestion of drugs at home. These findings highlight the importance of preventive and educational measures among family members and caregivers.

Analysis of notified drug poisoning among children in Santa Catarina state, 2016-2020 / Análise das intoxicações medicamentosas notificadas em crianças no estado de Santa Catarina, 2016-2020

ABSTRACT Objective: The aim of this study was to analyze the incidence of drug poisoning in children registered in the Santa Catarina Information and Toxicological Assistance Center between 2016 and 2020. Methods: This observational epidemiological study, with a historical cohort design, was carried out from reported cases of drug poisoning in children aged 0-12 years. Census sampling was used to collect data. Results: There were 4839 reported cases of drug poisoning among children in the State of Santa Catarina in the surveyed period, with an average annual incidence rate of 6 cases/1000 live births. The median age was 3 years. Most cases of poisoning occurred among girls aged 0-3 years by accidental ingestion of drugs at home. There was a predominance of signs and symptoms affecting the nervous system; only a small portion required hospitalization. Most cases were considered mild poisoning with a favorable outcome. No deaths were recorded. There was a tendency of increasing cases over time, however not significant. There is a predominance of incident cases in the Great West of the state, followed by the Midwest and Serra Catarinense regions. Conclusions: Drug poisoning in children is predominant in early childhood, mainly caused by accidental ingestion of drugs at home. These findings highlight the importance of preventive and educational measures among family members and caregivers.

RESUMO Objetivo: Analisar a incidência das intoxicações medicamentosas em crianças registradas no Centro de Informação e Assistência Toxicológica de Santa Catarina entre os anos de 2016 e 2020. Métodos: Estudo epidemiológico observacional, com delineamento de coorte histórica. Foi realizado com base nos casos notificados de intoxicação por medicamentos em crianças de zero a 12 anos. A amostra foi do tipo censo. Resultados: Foram notificadas 4.839 intoxicações medicamentosas em crianças no Estado de Santa Catarina no período, com taxa de incidência média anual de 6 casos/mil nascidos vivos. A idade apresentou mediana de três anos. A maioria (51,5%) dos casos de intoxicação ocorreu entre meninas, até os três anos de idade, de causa acidental, por exposição oral e no domicílio. Houve predomínio de sinais e sintomas que afetaram o sistema nervoso e apenas uma pequena parcela (6,2%) necessitou de hospitalização. A maioria dos casos (65,6%) foi considerada intoxicação leve com evolução favorável. Nenhum óbito foi registrado. Houve tendência de aumento dos casos ao longo do tempo, porém não significativo. Observa-se predomínio de casos incidentes no Grande Oeste, seguido do Meio-Oeste e Serra Catarinense. Conclusões: As intoxicações medicamentosas em crianças predominam na primeira infância, de forma acidental, sendo o ambiente doméstico o principal local. Esses achados destacam a importância de intensificar medidas preventivas e educativas entre familiares e cuidadores de crianças.

Use of tracking drugs for the search of intra-hospital adverse reactions: a pharmacovigilance study.

OBJECTIVE: To estimate the incidence of potential in-hospital adverse reactions  with the use of alert drugs in a general hospital in southern Brazil. Method: Cross-sectional study, carried out in a hospital in southern Brazil. The  electronic medical records (TASY®) of patients hospitalized between January  and August 2020, who were prescribed one of the drugs earmarked for  tracking adverse drug reactions, were evaluated: the drugs included  flumazenil, fexofenadine hydrochloride, naloxone, promethazine, diphenhydramine and loperamide. RESULTS: A total of 13,476 medical records were reviewed and 204 (1.5%)  were included in the study in which tracker use was indicated in the management of adverse drug reactions. In this study a total of 18 different signs or symptoms were found in medical records, with  pruritus/hyperemia/urticaria being the most reported symptoms (n = 76).  Among the drug classes that caused most adverse drug reactions, opioids were  the most mentioned (n = 44). It should be noted that in 49 medical  records the information on which drug caused the adverse events was not  reported. Regarding the cause of hospitalization of patients who used  creening drugs, cancer was the most frequent (n = 37). CONCLUSIONS: This study indicates that the use of trackers can be a tool to  estimate the occurrence of adverse drug reactions and to establish adverse  events related to the use of medications, which should be reported to the  pharmacovigilance service, with a view to patient safety.

OBJETIVO: Estimar la incidencia de potenciales reacciones adversas intrahospitalarias con el uso de prescripciones alertantes en un  hospital general del sur de Brasil.Método: Estudio transversal, realizado en un hospital del sur de Brasil. Se  evaluaron las historias clínicas electrónicas (TASY®) de los pacientes hospitalizados entre enero y agosto de 2020, a los que se les  prescribió uno de los medicamentos destinados al seguimiento de reacciones  adversas a medicamentos: los medicamentos incluían flumazenil, clorhidrato de fexofenadina, naloxona, prometazina, difenhidramina y  loperamida. RESULTADOS: Se revisaron 13.476 historias clínicas y se incluyeron 204 (1,5%) en el estudio en el que se indicó el uso de prescripciones alertantes en  el manejo de reacciones adversas a medicamentos. En este estudio se  encontró un total de 18 signos o síntomas diferentes en las historias clínicas,  siendo el prurito, la hiperemia y la urticaria los síntomas más reportados (n =  76). Entre las clases de fármacos que causaron la mayoría de las reacciones  adversas a medicamentos, los opioides fueron los más mencionados (n = 44).  Cabe señalar que en 49 historias clínicas no se reportó la información sobre  qué fármaco causó los eventos adversos. En cuanto a la causa de  hospitalización de los pacientes que utilizaron prescripciones alertantes, el  cáncer fue la más frecuente (n = 37). Conclusiones: Este estudio indica que el uso de alertadores puede ser una  herramienta para estimar la incidencia de reacciones adversas a medicamentos y establecer eventos adversos relacionados con el uso de medicamentos, los cuales deben ser reportados al servicio de  armacovigilancia, con miras a la seguridad del paciente.

Validation of a computerized decision support system to review pharmacotherapy treatment: scheduling guidelines.

BACKGROUND: The review of pharmacotherapy can be conceptualized as a service in which the drugs used by the patient are reviewed to control the risks as well as to improve the results of the drug therapy, detecting, solving, and preventing issues associated with the drug, readjusting the doses and times (schedule) so that the treatment is not incompatible or in duplicity. METHODS: The aim of the study was to validate an intelligent information system, which was developed to assist the scheduling activity in the pharmacotherapy review. The system used the concept of Genetic Algorithms. To validate the system, hypothetical cases were elaborated considering various aspects of pharmacotherapy such as underdose, overdose, drug interactions and contraindications. These cases were tested in the system and were also analyzed by pharmaceutical experts with clinical and research experience in the pharmacotherapy review process. The degree of agreement between the assessments of the appointments carried out by the pharmaceutical specialists and by the system were measured using the Kappa index with a 95% confidence interval. RESULTS: In detecting errors and make propositions, the system was able to identify 80% of errors, with pharmaceutical experts identifying between 20 and 70% of errors. In relation the results of kappa between the cases, the system had 87,3% of concordance, whereas the best pharmaceutical expert had 75,5% of concordance, considering the correct answer. CONCLUSION: It can be concluded that with the methodology used, the investigation met the objectives and confirmed the system is effective for pharmaceutical review process. There are indications that the system can help in the Pharmacotherapy review process, being able to find prescription errors as well as to establish times for the use of medications according to the patient's routine.

Uso de fármacos alertantes para la detecciónde reacciones adversas intrahospitalarias: estudio de farmacovigilancia / Use of tracking drugs for the search of intra-hospital adverse reactions: a pharmacovigilance study

Objetivo: Estimar la incidencia de potenciales reacciones adversasintrahospitalarias con el uso de prescripciones alertantes en un hospitalgeneral del sur de Brasil.Método: Estudio transversal, realizado en un hospital del sur de Brasil.Se evaluaron las historias clínicas electrónicas (TASY®) de los pacienteshospitalizados entre enero y agosto de 2020, a los que se les prescribióuno de los medicamentos destinados al seguimiento de reacciones adversasa medicamentos: los medicamentos incluían flumazenil, clorhidratode fexofenadina, naloxona, prometazina, difenhidramina y loperamida.Resultados: Se revisaron 13.476 historias clínicas y se incluyeron 204 (1,5%)en el estudio en el que se indicó el uso de prescripciones alertantes en elmanejo de reacciones adversas a medicamentos. En este estudio se encontró untotal de 18 signos o síntomas diferentes en las historias clínicas, siendo el prurito,la hiperemia y la urticaria los síntomas más reportados (n = 76). Entre las clasesde fármacos que causaron la mayoría de las reacciones adversas a medicamentos,los opioides fueron los más mencionados (n = 44). Cabe señalar queen 49 historias clínicas no se reportó la información sobre qué fármaco causólos eventos adversos. En cuanto a la causa de hospitalización de los pacientesque utilizaron prescripciones alertantes, el cáncer fue la más frecuente (n = 37). Conclusiones: Este estudio indica que el uso de alertadores puede seruna herramienta para estimar la incidencia de reacciones adversas a medicamentosy establecer eventos adversos relacionados con el uso demedicamentos, los cuales deben ser reportados al servicio de farmacovigilancia,con miras a la seguridad del paciente.

Objective: To estimate the incidence of potential in-hospital adversereactions with the use of alert drugs in a general hospital in southernBrazil.Method: Cross-sectional study, carried out in a hospital in southernBrazil. The electronic medical records (TASY®) of patients hospitalizedbetween January and August 2020, who were prescribed one of thedrugs earmarked for tracking adverse drug reactions, were evaluated:the drugs included flumazenil, fexofenadine hydrochloride, naloxone, promethazine,diphenhydramine and loperamide.Results: A total of 13,476 medical records were reviewed and 204(1.5%) were included in the study in which tracker use was indicated in themanagement of adverse drug reactions. In this study a total of 18 differentsigns or symptoms were found in medical records, with pruritus/hyperemia/urticaria being the most reported symptoms (n = 76). Among the drugclasses that caused most adverse drug reactions, opioids were the mostmentioned (n = 44). It should be noted that in 49 medical records theinformation on which drug caused the adverse events was not reported.Regarding the cause of hospitalization of patients who used screeningdrugs, cancer was the most frequent (n = 37). Conclusions: This study indicates that the use of trackers can be a toolto estimate the occurrence of adverse drug reactions and to establishadverse events related to the use of medications, which should be reportedto the pharmacovigilance service, with a view to patient safety.

Medication discrepancies in a hospital in Southern Brazil: the importance of medication reconciliation for patient safety

Medication discrepancies are of great concern in hospitals because they pose risks to patients and increase health care costs. The aim of this study was to estimate the prevalence of inconsistent medication prescriptions to adult patients admitted to a hospital in southern Santa Catarina, Brazil. This was a patient safety study on patients recruited between November 2015 and June 2016. The participants were interviewed and had their medical records reviewed. Discrepant medications were considered those that did not match between the list of medicines taken at home and the prescribed drugs for treatment in a hospital setting. Of the 394 patients included, 98.5% took continuous-use medications at home, with an average of 5.5 medications per patient. Discrepancies totaled 80.2%, The independent variables associated with the discrepancies were systemic arterial hypertension, hypercholesterolemia, vascular disease, number of medications taken at home, and poor documentation of the medications in the medical record. Findings from this study allowed us to conclude there was a high rate of prescription medication misuse. Medication reconciliation is crucial in reducing these errors. Pharmacists can help reduce these medication-related errors and the associated risks and complications.

Perfil e adequação do uso de antibacterianos em crianças internadas em hospital geral no sul do brasil / Profile and appropriate use of antibiotics among children in a general hospital in southern brazil

RESUMO Objetivo: Verificar o perfil e a adequabilidade do uso de antibacterianos em crianças hospitalizadas. Métodos: Estudo transversal. Foi feita a análise de todas as crianças que utilizaram antibacterianos durante a internação de janeiro a dezembro de 2015, em um hospital filantrópico de direito privado de grande porte no sul do Brasil. As informações foram obtidas por revisão dos prontuários e incluíram dados demográficos (idade, sexo, raça e peso corporal) e clínicos (motivo da internação, uso deantibacterianos e desfecho clínico). Utilizou-se estatística descritiva. Resultados: Dos 318 pacientes incluídos, 61,3% eram do sexo masculino. A faixa etária variou de 2 a 11 anos (média: 5,8±2,9 anos de idade). A prevalência do uso de antibacterianos foi de 24,4% considerando o total de 1.346 crianças que foram hospitalizadas. O tempo de internação apresentou mediana de quatro dias. O principal motivo de internação foi clínico e o antibacteriano mais prescrito foi a cefazolina, sendo a via intravenosa predominante. Em relação ao uso de antibacterianos, 62,2% apresentaram prescrições de antibacterianos consideradas adequadas. A subdosagem e a superdosagem tiveram, respectivamente, os valores de 11,7 e 14,6% dos pacientes incluídos. Quanto aos intervalos de administração, 8% foram caracterizados com intervalos longos e 3,5%, curtos. Conclusões: Apesar de a prevalência encontrada do uso de antibacterianos nas crianças hospitalizadas não ser tão elevada, parte considerável da amostra apresentou inadequabilidade quanto ao uso desse tipo de medicamento, se considerados a dose e o intervalo de utilização. Esses dados são motivo de preocupação para o desenvolvimento de resistência bacteriana e ocorrência de reações adversas.

ABSTRACT Objective: To examine the profile and appropriate use of antibiotics among hospitalized children. Methods: A cross-sectional study was conducted with children who had taken antibiotics during hospitalization in a private philanthropic hospital in Southern Brazil, from January to December 2015. The data were obtained by reviewing medical records, encompassing demographic data (age, gender, ethnicity, and body weight) and clinical data (causes of hospitalization, use of antibiotics, and clinical outcome). Descriptive statistics was used to present the data. Results: Of the 318 participants included in the study, 61.3% were male patients. The age range varied between 2 and 11 years, with mean age of 5.8±2.9 years. The prevalence of antibiotics was 24.4% out of the 1,346 hospitalized children. Median hospital stay was four days. The main cause of hospitalization was clinical instability, and the most commonly prescribed antibiotics was Cefazolin, mostly administered intravenously. Regarding the administration of antibiotics, 62.2% were adequately prescribed, even though underdose was 11.7%, and overdose was 14.6% in the studied patients. Antibiotic administration intervals were characterized as long in 8% of cases, and short in 3.5% of cases. Conclusions: Although the prevalence of antibiotics among hospitalized children was not that high, a considerable part of the sample presented inadequacy regarding the dosage and range of use. These data raise concerns about bacterial resistance and adverse reactions.

PROFILE AND APPROPRIATE USE OF ANTIBIOTICS AMONG CHILDREN IN A GENERAL HOSPITAL IN SOUTHERN BRAZIL. / PERFIL E ADEQUAÇÃO DO USO DE ANTIBACTERIANOS EM CRIANÇAS INTERNADAS EM HOSPITAL GERAL NO SUL DO BRASIL.

OBJECTIVE: To examine the profile and appropriate use of antibiotics among hospitalized children. METHODS: A cross-sectional study was conducted with children who had taken antibiotics during hospitalization in a private philanthropic hospital in Southern Brazil, from January to December 2015. The data were obtained by reviewing medical records, encompassing demographic data (age, gender, ethnicity, and body weight) and clinical data (causes of hospitalization, use of antibiotics, and clinical outcome). Descriptive statistics was used to present the data. RESULTS: Of the 318 participants included in the study, 61.3% were male patients. The age range varied between 2 and 11 years, with mean age of 5.8±2.9 years. The prevalence of antibiotics was 24.4% out of the 1,346 hospitalized children. Median hospital stay was four days. The main cause of hospitalization was clinical instability, and the most commonly prescribed antibiotics was Cefazolin, mostly administered intravenously. Regarding the administration of antibiotics, 62.2% were adequately prescribed, even though underdose was 11.7%, and overdose was 14.6% in the studied patients. Antibiotic administration intervals were characterized as long in 8% of cases, and short in 3.5% of cases. CONCLUSIONS: Although the prevalence of antibiotics among hospitalized children was not that high, a considerable part of the sample presented inadequacy regarding the dosage and range of use. These data raise concerns about bacterial resistance and adverse reactions.

OBJETIVO: Verificar o perfil e a adequabilidade do uso de antibacterianos em crianças hospitalizadas. MÉTODOS: Estudo transversal. Foi feita a análise de todas as crianças que utilizaram antibacterianos durante a internação de janeiro a dezembro de 2015, em um hospital filantrópico de direito privado de grande porte no sul do Brasil. As informações foram obtidas por revisão dos prontuários e incluíram dados demográficos (idade, sexo, raça e peso corporal) e clínicos (motivo da internação, uso deantibacterianos e desfecho clínico). Utilizou-se estatística descritiva. RESULTADOS: Dos 318 pacientes incluídos, 61,3% eram do sexo masculino. A faixa etária variou de 2 a 11 anos (média: 5,8±2,9 anos de idade). A prevalência do uso de antibacterianos foi de 24,4% considerando o total de 1.346 crianças que foram hospitalizadas. O tempo de internação apresentou mediana de quatro dias. O principal motivo de internação foi clínico e o antibacteriano mais prescrito foi a cefazolina, sendo a via intravenosa predominante. Em relação ao uso de antibacterianos, 62,2% apresentaram prescrições de antibacterianos consideradas adequadas. A subdosagem e a superdosagem tiveram, respectivamente, os valores de 11,7 e 14,6% dos pacientes incluídos. Quanto aos intervalos de administração, 8% foram caracterizados com intervalos longos e 3,5%, curtos. CONCLUSÕES: Apesar de a prevalência encontrada do uso de antibacterianos nas crianças hospitalizadas não ser tão elevada, parte considerável da amostra apresentou inadequabilidade quanto ao uso desse tipo de medicamento, se considerados a dose e o intervalo de utilização. Esses dados são motivo de preocupação para o desenvolvimento de resistência bacteriana e ocorrência de reações adversas.

Assessing the overall medication use by elderly people in a Brazilian hospital using the start/stopp criteria version 2

To estimate the frequency of the use of medicines listed in the Screening Tool to Alert Doctors to the Right Treatment (START) and Screening Tool of Older Person's Prescriptions (STOPP) criteria version 2 among the elderly. A cross-sectional study was conducted on elderly who were attended in medical clinic and cardiology sectors in a hospital in southern Brazil attended at a hospital from February through September 2016. A data-collection tool was used to obtain information on variables, such as demographic and clinical data, and medications used before and during the hospitalization period. The adequacy of the medicines taken was examined with regard to omission (START) or inappropriate use (STOPP). This study was approved by the Research Ethics Committee of the University of Southern Santa Catarina. A total of 307 subjects were included in the final sample. The mean age was 75.2 years (SD = 8; range 65-102). Of the total, 93.5% had had at least one potential prescribing omission (PPO) listed in the START criteria, whereas 95.4% used at least one medicine of the STOPP criteria. PPO was significantly associated with lower mean age (74.9 years, SD = 7.9 versus 79.0 years, SD = 8.8) among the elderly who did not have PPOs detected by the START criteria (p-value=0.03). Furthermore, PPO was associated with longer hospital stay (18 versus 9 days; p-value=0.03). This study revealed inadequate prescription affecting 99.3% of the participating patients. To the best of our knowledge, this was the first to use the START and STOPP criteria, version 2, in Brazil.

Perfil das vítimas de acidentes de trânsito atendidas pelo serviço integrado de atendimento ao trauma em Curitiba e Região Metropolitana / Profile of the victims of transit accidents attended by the integrated service of trauma at Curitiba and metropolitan region

Objetivo: descrever características epidemiológicas das vítimas de acidentes de trânsito atendidas pelo SIATE no município de Curitiba e Região Metropolitana, no período de 2004 a 2013. Métodos: pesquisa descritiva retrospectiva, com utilização de dados obtidos de fonte secundária, compreendendo o período entre 01/01/2004 a 31/12/2013. Foram incluídos, dados referentes à solicitação de Atendimento Pré-Hospitalar do SIATE Curitiba e região metropolitana, que incluem situações de acidentes de trânsito. Resultados: O número total de ocorrências no período foi de 176.186, com 200.159 vítimas atendidas. O ano com maior proporção de acidentes de trânsito foi 2011 (64,17%), havendo uma tendência a queda no número de ocorrências, bem como de acidentes de trânsito, ao longo dos anos. Dentre os acidentes de trânsito, a grande maioria foi de baixa gravidade: 113.299 (98,34%).Conclusão: Traçou-se o perfil epidemiológico e, dentre outras informações, conclui-se que a mortalidade por acidentes de trânsito vem diminuindo ao longo dos anos

Objective: to describe the epidemiological characteristics of the victims of traffic accidents attended by SIATE in the city of Curitiba and Metropolitan Region, from 2004 to 2013. Methods: retrospective descriptive research, using data obtained from a secondary source, comprising the period between 01 / 01/2004 to 12/31/2013. Data concerning the request for Pre-hospital Care of SIATE Curitiba and metropolitan region were included, will all the situations of traffic accidents. Results: The total number of occurrences in the period was 176,186, with 200,159 victims attended. The year with the highest proportion of traffic accidents was in 2011 (64.17%), with a tendency to decrease in the number of occurrences, as well as traffic accidents, over the years. Among the traffic accidents, the majority were of low severity: 113,299 (98.34%). Conclusion: The epidemiological profile was drawn and, among other information, it is concluded that the mortality due to traffic accidents has been decreasing over the years

Influência do gênero nos efeitos adversos provocados por antineoplásicos em pacientes oncológicos atendidos em um hospital do sul catarinense / Gender influence on the adverse effects caused by antineoplastics in oncological patients of a hospital in the south of santa catarina

OBJETIVO: Verificar a ocorrência de efeitos adversos causados pelo uso de antineoplásicos e sua relação com o gênero. MÉTODOS: Estudo transversal de análise das evoluções médicas descritas em prontuários de pacientes em uso de antineoplásicos (n=200) na unidade de oncologia de um hospital da região sul do país, no ano de 2015. A análise dos prontuários foi feita através da utilização do algoritmo de Naranjo, algoritmo esse que determina a causalidade das Reações Adversas a Medicamentos (RAM). RESULTADOS: No sexo feminino, a maioria das pesquisadas apresentou a doença na faixa etária de 31-60 anos (56,25%), já no sexo masculino houve predominância do aparecimento na faixa etária maior do que 60 anos (73,86%). Com relação às reações adversas descritas nos prontuários, o sexo feminino apresentou uma prevalência 30% maior (p=0,025). Em relação à frequência de RAM, no sexo feminino houve uma maior prevalência de reações no sistema gastrointestinal (73,6%), enquanto o sexo masculino apresentou maior prevalência no sistema tegumentar (19,7%). DISCUSSÃO: Foram observadas diferenças entre os gêneros quanto às reações adversas relacionadas ao uso de antineoplásicos, com maior prevalência no sexo feminino e relacionadas ao sistema gastrointestinal.

OBJECTIVE: To verify the occurrence of adverse effects caused by the use of antineoplastic agents and their relationship with the gender. METHODS: A cross-sectional study of the medical evolution through of the use of the Naranjo algorithm, which determines the causality of Adverse Drug Reactions (ADRs). RESULTS: In the female sex, the majority of those surveyed presented the disease in the age group of 31-60 years (56.25%), whereas in the male sex there was a higher frequency in the age group over 60 years old (73.86%). With regard to the adverse reactions described in the charts, the female sex presented a 30% higher prevalence (p = 0.025). Regarding to the frequency of ADRs, in females there was a higher prevalence of reactions in the gastrointestinal system (73.6%), while males had a higher prevalence in the tegumentary system (19.7%). DISCUSSION: It was observed differences between genders regarding the adverse reactions related to the antineoplastics use, with more prevalence in female and related to gastrointestinal system.

Structured Pyramidal Neural Networks.

The Pyramidal Neural Networks (PNN) are an example of a successful recently proposed model inspired by the human visual system and deep learning theory. PNNs are applied to computer vision and based on the concept of receptive fields. This paper proposes a variation of PNN, named here as Structured Pyramidal Neural Network (SPNN). SPNN has self-adaptive variable receptive fields, while the original PNNs rely on the same size for the fields of all neurons, which limits the model since it is not possible to put more computing resources in a particular region of the image. Another limitation of the original approach is the need to define values for a reasonable number of parameters, which can turn difficult the application of PNNs in contexts in which the user does not have experience. On the other hand, SPNN has a fewer number of parameters. Its structure is determined using a novel method with Delaunay Triangulation and k-means clustering. SPNN achieved better results than PNNs and similar performance when compared to Convolutional Neural Network (CNN) and Support Vector Machine (SVM), but using lower memory capacity and processing time.

Diagnóstico da busca de reações adversas a medicamentos nas diferentes fases da pesquisa clínica / A diagnosis on the search of drug adverse reactions in the different stages of clinical research

Com o aumento do número de reações adversas a medicamentos, faz-se necessária a monitorização adequada dos medicamentos durante seu desenvolvimento e após a comercialização, papel desempenhado pela farmacovigilância.

It was observed that none of the documents investigated dealt with the search for adverse reactions to drugs during all the stages of clinical research. Theauthors explored these reactions only in phase IV or pharmacovigilance.

Deposição óssea de cálcio e fósforo, densidade radiográfica e desenvolvimento corporal em potros alimentados com minerais orgânicos / Bone deposition of calcium and phosphorus, radiographic density and body development in foals fed with organic minerals

Foi avaliado o efeito da inclusão de minerais orgânicos na alimentação de potros sobre a concentração ossea de cálcio e fósforo, densitometria óssea e variáveis de desempenho de desenvolvimento e crescimento corporal. Foram utilizados dez potros com peso de 240,7 +- 30,2 kg e idade de 10 de 10 +- 0,15 meses, distribuidos em delineamento inteiramente casualizado, em dois tratamentos: dieta formulada com fonte de minerais na forma orgânica ou inorgânica. A dieta foi composta de 40% de volumoso e 60% de concentrado, à qual foi adicionada mistura mineral na forma orgânica ou inorgãnica na quantidade de 3% do concentrado.Não foi observado efeito das fontes minerais orgãnicas durante 90 dias, quando comparada aos potros alimentados com minerais em forma. Os animais alimentados com minerais organicos aprosentaram maior ganho de peso médio e diario em relação aos animais alimentados com com minerais inorgânicos. O uso de minerais em forma orgânico aumenta a densidade e o ganho de peso dos potrosem fase de crescimento.

This study examined the effect of organic minerals in foals diet evaluating the concentration of bone calcium and phosphorus, bone densitometry and growth and development performance variables. Ten horses weighing 240.7 ± 30.2 kg and 10 ± 0.15 months were used in the study, with two treatments: basal diet with minerals in organic or inorganic forms. The diet was composed of 40% forage and 60% concentrate, which was added as mineral mixture in organic or inorganic quantity of 3% of the concentrate. No effect of mineral sources was observed on bone deposition of calcium and phosphorus. At 90 days, the bone density of foals fed with minerals in organic form was higher than that observed in animals fed with minerals in the inorganic form. Animals fed with organic minerals showed greater weight increase compared to animals fed ino.

Avaliação da qualidade de comprimidos de propranolol e enalapril distribuídos no sistema público de saúde em uma cidade do sul do Brasil / Evaluation of the quality of propranolol and enalapril tablets supplied in the public health system in a southern Brazilian city

A aquisição de medicamentos no serviço público de saúde brasileiro através de licitação com critério de menor preço gera preocupação com a qualidade dos produtos distribuídos à população. O objetivo deste trabalho foi avaliar a qualidade dos comprimidos de Enalapril 10 mg e Propranolol 40 mg adquiridos através de processo licitatório e distribuídos na rede pública de saúde de um município catarinense durante o período de um ano. Foram analisados: o aspecto visual, o peso médio, a friabilidade, o teor de fármaco e o tempo de dissolução. De um total de sete lotes, cinco apresentaram desvio da qualidade. Encontraram-se irregularidades no aspecto visual, peso médio, friabilidade e teor de princípio ativo. A avaliação dos medicamentos além de assegurar que os medicamentos dispensados na rede pública possuem qualidade e que podem ser utilizados com segurança pelos pacientes é também uma ferramenta para a qualificação de fornecedores e um subsídio para o aprimoramento do processo licitatório. Sugere-se a implantação de um sistema de gestão da qualidade que inclua a qualificação de fornecedores, o aperfeiçoamento do processo de licitação, incluindo especificações claras sobre a qualidade dos medicamentos adquiridos, bem como o monitoramento da qualidade integrado a ações de farmacovigilância.

The acquisition of medication by the Brazilian public health service through bidding processes based on the lowest price criterion is a source of concern with respect to the quality of the products offered to the population. The scope of this work was to evaluate the quality of Enalapril 10 mg and Propranolol 40 mg tablets bought via the bidding process and supplied by the public health system in a city in the state of Santa Catarina, Brasil, over the course of a year. The visual aspect, weight variation, friability, drug content and dissolving time were analyzed. Out of seven lots, five presented quality deviation. Irregularities were found in the visual aspect, weight variation, friability and active ingredient. The evaluation of the quality of medication, besides ensuring the quality of the products supplied by the health system and safe usage by patients, is also a tool to evaluate medical supply companies and ensure the enhancement of the bidding process. The implementation of a management system that includes the evaluation of medical supply companies, improvement of the bidding process with clear specifications about the quality of the medicines bought are all recommended to ensure product safety.

[Evaluation of the quality of propranolol and enalapril tablets supplied in the public health system in a southern Brazilian city]. / Avaliação da qualidade de comprimidos de propranolol e enalapril distribuídos no sistema público de saúde em uma cidade do sul do Brasil.

The acquisition of medication by the Brazilian public health service through bidding processes based on the lowest price criterion is a source of concern with respect to the quality of the products offered to the population. The scope of this work was to evaluate the quality of Enalapril 10 mg and Propranolol 40 mg tablets bought via the bidding process and supplied by the public health system in a city in the state of Santa Catarina, Brasil, over the course of a year. The visual aspect, weight variation, friability, drug content and dissolving time were analyzed. Out of seven lots, five presented quality deviation. Irregularities were found in the visual aspect, weight variation, friability and active ingredient. The evaluation of the quality of medication, besides ensuring the quality of the products supplied by the health system and safe usage by patients, is also a tool to evaluate medical supply companies and ensure the enhancement of the bidding process. The implementation of a management system that includes the evaluation of medical supply companies, improvement of the bidding process with clear specifications about the quality of the medicines bought are all recommended to ensure product safety.

Preanesthesia evaluation and reduction of preoperative care costs.

BACKGROUND AND OBJECTIVES: Preanesthesia evaluation (PAE) is fundamental in the preparation of a surgical patient. Among its advantages is the reduction of preoperative care costs. Although prior studies had observed this benefit, it is not clear whether it can be taken into consideration among us. The objective of the present study was to compare the costs of preoperative care performed by the surgeon with estimated costs based on PAE. In parallel, we compared the American Society of Anesthesiologists (ASA) physical status classification determined by the anesthesiologist with that estimated by other specialists. METHODS: Two hundred patients scheduled for elective surgery or diagnostic procedures whose preoperative care was made by the surgeon underwent PAE after hospital admission. The anesthesiologist determined which ancillary exams or referrals necessary for each patient. The number and cost of ancillary exams or referrals requested by the anesthesiologist were compared with those of the preoperative preparation. The ASA classification according to the anesthesiologist was also compared to that of the physician in charge of the consultation. RESULTS: Out of 1,075 ancillary exams performed, 55.8% were not indicated, which corresponded to 50.8% of the total cost of exams. The anesthesiologist considered that 37 patients (18.5%) did not require exams. The cost of surgeon-oriented preoperative care was higher than that based on the preanesthesia evaluation and this difference in costs was statistically significant (p < 0.01). In 9.3% of the patients discordance in ASA classification according to the specialist was observed. CONCLUSIONS: Preoperative care based on judicious preanesthesia evaluation can result in significant reduction in costs when compared to that oriented by the surgeon. Good concordance in ASA classification was observed.

Avaliação pré-anestésica e redução dos custos do preparo pré-operatório / Preanesthesia evaluation and reduction of preoperative care costs / Evaluación preanestésica y reducción de los costes de la preparación del preoperatorio

JUSTIFICATIVA E OBJETIVOS: A avaliação pré-anestésica (APA) é fundamental no preparo do paciente cirúrgico. Entre suas muitas vantagens, destaca-se a redução dos custos com o preparo pré-operatório. Embora estudos prévios tenham constatado esse benefício, não é certo que ele se aplique adequadamente em nosso meio. O objetivo deste estudo foi comparar os custos do preparo pré-operatório realizado pelo cirurgião com os custos estimados a partir da APA. Paralelamente, comparou-se a classificação do estado físico da American Society of Anesthesiologists (ASA) determinada pelo anestesiologista ou por outros especialistas. MÉTODO: Duzentos pacientes candidatos a procedimentos cirúrgicos ou diagnósticos eletivos, cujo preparo pré-operatório foi orientado pelo cirurgião, foram submetidos à APA após internação hospitalar. O anestesiologista determinou os exames complementares ou as consultas especializadas e necessárias a cada paciente. Foram comparados o número e os custos dos exames ou consultas indicados pelo anestesiologista com aqueles realizados no preparo pré-operatório. Comparou-se também a classificação da ASA determinada pelo anestesiologista ou pelo médico que realizou a consulta especializada. RESULTADOS: Dos 1.075 exames complementares realizados, 55,8 por cento não estavam indicados, o que equivaleu a uma fração de 50,8 por cento do custo total com exames. O anestesiologista considerou que 37 pacientes (18,5 por cento) não precisariam realizar exames. O custo do preparo orientado pelo cirurgião foi 25,11 por cento maior do que o custo estimado a partir da avaliação pré-anestésica, sendo essa diferença estatisticamente significante (p < 0,01). Houve discordância na classificação da ASA em 9,3 por cento dos pacientes avaliados pelo especialista. CONCLUSÕES: O preparo pré-operatório baseado na avaliação pré-anestésica criteriosa pode resultar em significativa redução dos custos quando comparado ao preparo orientado pelo cirurgião. Observou-se boa concordância na determinação do escore da ASA.

BACKGROUND AND OBJECTIVES: Preanesthesia evaluation (PAE) is fundamental in the preparation of a surgical patient. Among its advantages is the reduction of preoperative care costs. Although prior studies had observed this benefit, it is not clear whether it can be taken into consideration among us. The objective of the present study was to compare the costs of preoperative care performed by the surgeon with estimated costs based on PAE. In parallel, we compared the American Society of Anesthesiologists (ASA) physical status classification determined by the anesthesiologist with that estimated by other specialists. METHODS: Two hundred patients scheduled for elective surgery or diagnostic procedures whose preoperative care was made by the surgeon underwent PAE after hospital admission. The anesthesiologist determined which ancillary exams or referrals necessary for each patient. The number and cost of ancillary exams or referrals requested by the anesthesiologist were compared with those of the preoperative preparation. The ASA classification according to the anesthesiologist was also compared to that of the physician in charge of the consultation. RESULTS: Out of 1,075 ancillary exams performed, 55.8 percent were not indicated, which corresponded to 50.8 percent of the total cost of exams. The anesthesiologist considered that 37 patients (18.5 percent) did not require exams. The cost of surgeon-oriented preoperative care was higher than that based on the preanesthesia evaluation and this difference in costs was statistically significant (p < 0.01). In 9.3 percent of the patients discordance in ASA classification according to the specialist was observed. CONCLUSIONS: Preoperative care based on judicious preanesthesia evaluation can result in significant reduction in costs when compared to that oriented by the surgeon. Good concordance in ASA classification was observed.

JUSTIFICATIVA Y OBJETIVOS: La evaluación preanestésica (EPA), es fundamental para la preparación del paciente quirúrgico. Entre sus muchas ventajas tenemos la reducción de los costes con la preparación del preoperatorio. Aunque algunos estudios previos hayan constatado ese beneficio, no es correcto decir que él se pueda aplicar adecuadamente a nuestro medio. El objetivo de este estudio fue comparar los costes de la preparación del preoperatorio realizado por el cirujano con los costes estimados a partir de la EPA. En paralelo, comparamos la clasificación del estado físico de la American Society of Anesthesiologists (ASA) determinada por el anestesiólogo o por otros especialistas. MÉTODO: Doscientos pacientes candidatos a procedimientos quirúrgicos o diagnósticos electivos, cuya preparación preoperatoria estuvo orientada por el cirujano, se sometieron a la EPA después de su ingreso. El anestesiólogo determinó los exámenes complementarios o las consultas especializadas pertinentes para cada paciente. Se comparó el número y los costes de los exámenes o consultas indicados por el anestesiólogo con los realizados durante la preparación del preoperatorio. También comparamos la clasificación de la ASA determinada por el anestesiólogo o por el médico que realizó la consulta especializada. RESULTADOS: De los 1.075 exámenes complementarios realizados 55,8 por ciento no estaban indicados, lo que equivalió a una fracción de un 50,8 por ciento del coste total con los exámenes. El anestesiólogo consideró que 37 pacientes (18,5 por ciento) no necesitarían realizar exámenes. El coste de la preparación orientada por el cirujano fue un 25,11 por ciento mayor que el coste estimado a partir de la evaluación preanestésica, siendo ésa la diferencia entre los costes estadísticamente significantes: (p < 0,01). Se registró una discordancia en la clasificación de la ASA en 9,3 por ciento de los pacientes evaluados por el experto. CONCLUSIONES: La preparación del preoperatorio con base en la evaluación preanestésica de criterio puede resultar en una significativa reducción de los costes cuando se le compara a la preparación orientada por el cirujano. Se observó una buena concordancia en la determinación de la puntuación de la ASA.

Uma boa relação entre sogra e nora pode ser possível? / Is a good relation between in-laws possible?

O presente trabalho tem por objetivo a reflexão sobre questões ligadas ao relacionamento sogra/nora na contemporaneidade, com embasamento em revisão bibliográfica. Essa relação é considerada uma das mais conflituadas entre as díades familiares. Trata-se de um tema amplo e complexo e que permite um olhar sob várias perspectivas. Porém, este texto, se propõe a focar questões que influenciam a construção dessa relação, tais como o papel da mulher ao longo da história, questões de poder e gênero, a família de origem e o ciclo de vida familiar.

The present paper aims to reflect about issues related to mother-in-law and daughter-in-law relationship, based on literature review. This relation is considered the most conflicted among the family dyads. The subject is wide and complex, allowing to be looked from different perspectives. However, the focus of this paper is to discuss issues influencing the construction of this relationship, such as, female roles throughout history, power and gender issues, family life cycle and family of origin.