RESUMO
BACKGROUND: Prenatal alcohol exposure (PAE) has serious physical consequences for children such as behavioral disabilities, growth disorders, neuromuscular problems, impaired motor coordination, and decreased muscle tone. However, it is not known whether loss of muscle strength occurs, and which interventions will effectively mitigate physical PAE impairments. We aimed to investigate whether physical alteration persists during adolescence and whether exercise is an effective intervention. RESULTS: Using paradigms to evaluate different physical qualities, we described that early adolescent PAE animals have significant alterations in agility and strength, without alterations in balance and coordination compared to CTRL animals. We evaluated the effectiveness of 3 different exercise protocols for 4 weeks: Enrichment environment (EE), Endurance exercise (EEX), and Resistance exercise (REX). The enriched environment significantly improved the strength in the PAE group but not in the CTRL group whose strength parameters were maintained even during exercise. Resistance exercise showed the greatest benefits in gaining strength, and endurance exercise did not. CONCLUSION: PAE induced a significant decrease in strength compared to CTRL in PND21. Resistance exercise is the most effective to reverse the effects of PAE on muscular strength. Our data suggests that individualized, scheduled, and supervised training of resistance is more beneficial than endurance or enriched environment exercise for adolescents FASD.
Assuntos
Modelos Animais de Doenças , Transtornos do Espectro Alcoólico Fetal , Força Muscular , Condicionamento Físico Animal , Transtornos do Espectro Alcoólico Fetal/fisiopatologia , Transtornos do Espectro Alcoólico Fetal/prevenção & controle , Animais , Condicionamento Físico Animal/fisiologia , Feminino , Força Muscular/fisiologia , Gravidez , Masculino , Ratos , Efeitos Tardios da Exposição Pré-Natal , Ratos WistarRESUMO
OBJECTIVE: Determining hospital admissions prevalence associated with problems related to medicines in the emergency services of high complexity hospital; performing the pertinent pharmaceutical interventions. METHOD: Descriptive observational cross-sectional study. The medical records of the patients admitted to the emergency services were reviewed. Those that reported hospitalization due to problems related to medication were selected. These were classified according to the Third Consensus of Granada adaptation. A pharma-therapeutic profile was made to hospitalized patients; performing the necessary pharmaceutical interventions to avoid future medication related problems. RESULTS: 3.8% of patients were included in the study. The problems related to medications had a preventability of 87.7% and the most frequent were those of need with 42.2%. A pharma-therapeutic profile was done to hospitalized patients (137). 150 pharmaceutical interventions were done, which had an acceptance of 95.3%. The most intervened risk was administering an unnecessary medication 62.7%. CONCLUSIONS: Lack of supervision and analysis of problems related to medication could cause therapeutic approach failure, therefore, health and life quality improvement of the patients is not achieve. The pharmaceutical chemist plays a fundamental role in the health care of patients, helping to the prevention and proper use of medicines. The Pharmaceutical Care program proves that it provides an invaluable contribution to public health service by improving the pharmacological safety of treatments, reducing costs and public health problems.
Objetivo: Determinar la prevalencia de ingresos hospitalarios asociados a problemas relacionados con medicamentos en los servicios de urgencias de un hospital de alta complejidad, realizando las intervenciones farmacéuticas pertinentes.Método: Estudio observacional descriptivo de corte transversal. Se revisaron las historias clínicas de pacientes que ingresaron en los servicios de urgencias, seleccionando aquellas que reportaban ingresos por problemas relacionados con medicamentos. Estas se clasificaron según la adaptación del Tercer Consenso de Granada. Se realizó un perfil farmacoterapéutico a los pacientes hospitalizados y se establecieron las intervenciones farmacéuticas necesarias para evitar futuros problemas relacionados con medicamentos.Resultados: El 3,8% de los pacientes fueron incluidos en el estudio. Los problemas relacionados con medicamentos tuvieron una evitabilidad del 87,7% y los más frecuentes fueron los de necesidad, con un 42,2%. Se realizó un perfil farmacoterapéutico a los pacientes hospitalizados (137) y se llevaron a cabo 150 intervenciones farmacéuticas, las cuales fueron aceptadas en un 95,3%. El riesgo más intervenido fue administrar un medicamento innecesario (62,7%).Conclusiones: La falta de supervisión y análisis de problemas relacionados con los medicamentos podría ocasionar el fracaso del abordaje terapéutico y la no consecución de la mejoría de la salud y la calidad de vida de los pacientes. El químico farmacéutico cumple un papel fundamental en el cuidado de la salud de los pacientes, ayudando desde la prevención y el uso adecuado de los medicamentos. El programa de Atención Farmacéutica demuestra que brinda un aporte inestimable al servicio de la salud pública al mejorar la farmacoseguridad de los tratamientos, disminuyendo costes y problemas de salud pública.
Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/terapia , Serviço Hospitalar de Emergência/organização & administração , Admissão do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Assistência Farmacêutica , Serviço de Farmácia Hospitalar/organização & administração , Prevalência , Adulto JovemRESUMO
Introducción y objetivo: se desconocen la experiencia y el conocimiento con los que cuenta el personal médico del medio en el manejo de los anticoagulantes orales directos. Se pretende describir el uso de estos medicamentos en los pacientes atendidos en el Hospital Pablo Tobón Uribe y evaluar el nivel de conocimientos al respecto en los profesionales de la misma institución. Materiales y métodos: estudio de corte transversal en el período comprendido entre enero del 2012 y enero del 2013. Para recolectar la información se utilizaron dos estrategias: el análisis de las historias clínicas pertinentes y la evaluación de conocimientos sobre la prescripción y el uso de anticoagulantes orales directos en el grupo de especialistas facultados. Resultados: en el análisis se incluyeron 114 historias; el rivaroxaban fue el medicamento prescrito con mayor frecuencia (87%) seguido del dabigatrán (13%). La principal indicación fue la profilaxis en cirugía ortopédica (69%). Entre los especialistas evaluados, el promedio de respuestas acertadas fue del 67% sin diferencias aparentes entre los mismos. Conclusión: el rivaroxaban se prescribió con mayor frecuencia que el dabigatrán; sin embargo, este hallazgo no parece asociarse con un conocimiento médico claro y suficiente acerca de estos medicamentos. No se encontraron reportes de eventos adversos asociados al uso de los mismos.
Introduction and objective: The experience and knowledge concerning the use of direct oral anticoagulants among specialists in Medellin, Colombia, are not known. Our goal was to describe the use of these drugs in patients treated at Hospital Pablo Tobón Uribe and to assess the level of knowledge regarding this issue in professionals from this institution. Materials and methods: Cross sectional study conducted between January 2012 and January 2013. Two strategies to collect information were used, namely: Analysis of relevant medical records and evaluation of knowledge about the appropriate use and prescription of direct oral anticoagulants in the group of medical specialists. Results: 114 records were included in the analysis; rivaroxaban was the most frequently prescribed drug (87%) followed by dabigatran (13%). The main indication was prophylaxis in orthopedic surgery (69%). Average of correct answers among the different specialists evaluated was 67% with no apparent difference between them. Conclusion: rivaroxaban was prescribed more often than dabigatran; however, this fact does not appear to be associated with a clear and sufficient medical knowledge about these drugs. No reports of adverse events associated with this therapy were found.
Introdução e objetivo: desconhecem-se a experiência e o conhecimento com os que conta o pessoal médico do meio no manejo dos anticoagulantes orais diretos. Pretende-se descrever o uso destes medicamentos nos pacientes atendidos no Hospital Pablo Tobón Uribe e avaliar o nível de conhecimentos com respeito aos profissionais da mesma instituição. Materiais e métodos: estudo de corte transversal no período compreendido entre janeiro do 2012 e janeiro do 2013. Para coletar a informação se utilizaram duas estratégias: a análise das histórias clínicas pertinentes e a avaliação de conhecimentos sobre a prescrição e o uso de anticoagulantes orais diretos no grupo de especialistas facultados. Resultados: na análise se incluíram 114 histórias; o Rivaroxabana foi o medicamento prescrito com maior frequência (87%) seguido do Dabigatran (13%). A principal indicação foi a profilaxia em cirurgia ortopédica (69%). Entre os especialistas avaliados, a média de respostas acertadas foi de 67% sem diferenças aparentes entre os mesmos. Conclusão: o Rivaroxabana se prescreveu com maior frequência do que o Dabigatran; no entanto, este achado não parece associar-se com um conhecimento médico claro e suficiente a respeito destes medicamentos. Não se encontraram reportes de eventos adversos sócios ao uso dos mesmos.
Assuntos
Humanos , Adulto , Médicos , Administração Oral , Competência Clínica , Prescrições , Anticoagulantes , Epidemiologia Descritiva , Estudos RetrospectivosRESUMO
INTRODUCTION: The melanocortin system plays an important role in energy homeostasis. Mice genetically deficient in the melanocortin-3 receptor gene have a normal body weight with increased body fat, mild hypophagia compared to wild-type mice. In humans, Thr6Lys and Val81Ile variants of the melanocortin-3 receptor gene (MC3R) have been associated with childhood obesity, higher BMI Z-score and elevated body fat percentage compared to non-carriers. The aim of this study is to assess the association in adults between allelic variants of MC3R with weight loss induced by energy-restricted diets. SUBJECTS AND METHODS: This research is based on the NUGENOB study, a trial conducted to assess weight loss during a 10-week dietary intervention involving two different hypo-energetic (high-fat and low-fat) diets. A total of 760 obese patients were genotyped for 10 single nucleotide polymorphisms covering the single exon of MC3R gene and its flanking regions, including the missense variants Thr6Lys and Val81Ile. Linear mixed models and haplotype-based analysis were carried out to assess the potential association between genetic polymorphisms and differential weight loss, fat mass loss, waist change and resting energy expenditure changes. RESULTS: No differences in drop-out rate were found by MC3R genotypes. The rs6014646 polymorphism was significantly associated with weight loss using co-dominant (pâ=â0.04) and dominant models (pâ=â0.03). These p-values were not statistically significant after strict control for multiple testing. Haplotype-based multivariate analysis using permutations showed that rs3827103-rs1543873 (pâ=â0.06), rs6014646-rs6024730 (pâ=â0.05) and rs3746619-rs3827103 (pâ=â0.10) displayed near-statistical significant results in relation to weight loss. No other significant associations or gene*diet interactions were detected for weight loss, fat mass loss, waist change and resting energy expenditure changes. CONCLUSION: The study provided overall sufficient evidence to support that there is no major effect of genetic variants of MC3R and differential weight loss after a 10-week dietary intervention with hypo-energetic diets in obese Europeans.