Use of therapeutic outcomes monitoring method for performing of pharmaceutical care in oncology patients

This study aimed to implement pharmaceutical care using the therapeutic outcome monitoring (TOM) method for pharmacotherapeutic follow-up of oncological patients. This was a prospective longitudinal study involving patients undergoing oral chemotherapy. The study environment was an outpatient pharmacy at a tertiary-level oncology hospital. Ninety patients who received oral chemotherapy were evaluated, and 27 patients were followed up in accordance with the exclusion criteria and acceptability of participation in the study. The patients were predominantly diagnosed with gynecological tumors, with a mean age of 57.56 ± 13.06. The average consumption of drugs per patient was 4.63 ± 4.85, and more than 55% of patients had undergone oral antineoplastic therapy for more than a year. The main therapeutic groups used were drugs that acted on the gastrointestinal tract and metabolism (34%). All patients had at least one drug-related problem (DRP). In total, 133 DRP were identified. Approximately 33% of patients had DRPs related to antineoplastic therapy; non-adherence, incorrect administration, and the probability of adverse events were among the frequently reported DRPs. We identified 43 negative outcomes associated with medication (NOM), with untreated health problems (47%) and non-quantitative insecurity (30%) being the most frequently reported. 81 pharmaceutical interventions were performed, and 96% were accepted. The main errors avoided with the interventions were untreated health problems, misuse, and interruptions associated with medication administration. The TOM method effectively achieved the desired results of therapy, improving the use of medicines, and thus increasing patient safety. </jats:p

Pontos de vista e conhecimentos dos sinais indicativos de depressão entre acadêmicos de enfermagem Puntos de vista y conocimientos de los signos indicativos de depresión entre estudiantes de enfermeria Undergraduate nursing students' knowledge and viewpoints on depression

Objetivou-se identificar pontos de vista, conhecimento e sinais de depressão entre graduandos de Enfermagem. Quatro instru-mentos foram utilizados para a coleta dos dados: A - Pontos de Vista Sobre Depressão; B - Conhecimento Sobre Depressão; C - Inventário de Beck; D - Escala de Zung. A análise quantitativa descritiva somou-se às reflexões qualitativas. Os alunos demonstraram que têm interesse e freqüentaram cursos de saúde mental; 65,4% tiveram altos escores de acordo com os pontos de vista 61,5% e têm ótimo conhecimento sobre depressão. Nas duas escalas de depressão verificou-se a existência de depressão moderada em um aluno. Nas respostas individuais, observa-se a falta de experiência dos alunos, preconceitos e informações equivocadas.<br>El presente estudio tuvo como objetivo identificar puntos de vista, conocimiento y signos de depresión entre estudiantes de Enfermería. Fueron utilizados cuatro instrumentos para la recolección de los datos: A - Puntos de Vista Sobre Depresión; B - Conocimiento Sobre Depre-sión; C - Inventario de Beck; D - Escala de Zung. El análisis cuantitativo descriptivo se sumó a las reflexiones cualitativas. Los alumnos demostraron que tienen interés y frecuentaron cursos de salud mental; 65.4% tuvieron altos escores de acuerdo con los puntos de vista esperados de depresión; 61.5% tienen óptimo conocimiento sobre el tema. En las dos escalas de depresión se verificó la existencia de depresión moderada en un alumno. En las respuestas individuales, se observa falta de experiencia de los alumnos, prejuicios e informaciones equivocadas.<br>This study aimed at identifying viewpoints, knowledge and indicative signs of depression among nursing students. Four instruments were used for data collection: A - Viewpoints on Depression; B - Knowledge on Depression; C - Beck's Inventory and D - Zung's Scale. The descriptive quantitative analysis added to qualitative reflections. Students showed that they were interested and that they had attended courses on mental health; 65.4% had high scores according to the expected viewpoints for depression; 61.5% showed excellent knowledge concerning depression. Two scales of depression showed moderate depression in one student. On basis of individuals responses, the students' lack of experience, some prejudice or erroneous information were observed

Fluoxetine Inhibits Inflammatory Response and Bone Loss in a Rat Model of Ligature-Induced Periodontitis

Background: Fluoxetine, a selective serotonin reuptake inhibitor, has been found recently to possess anti-inflammatory properties. The present study investigates the effects of fluoxetine on inflammatory tissue destruction in a rat model of ligature-induced periodontal disease.Methods: Thirty male Wistar rats were randomly assigned into three groups (n = 10 animals per group): 1) control rats (without ligature); 2) rats with ligature + placebo (saline; oral gavage); and 3) rats with ligature + fluoxetine (20 mg/kg/day in saline; oral gavage). Histologic analyses were performed on the furcation region and mesial aspect of mandibular first molars of rats sacrificed at 15 days after ligature-induced periodontal disease. Reverse transcription-polymerase chain reaction and zymography were performed to analyze the mRNA expression of interleukin (IL)-1 beta, cyclooxygenase (COX)-2, matrix metalloproteinase (MMP)-9 and inducible nitric oxide synthase and the MMP-9 activity, respectively, in gingival tissues samples.Results: Compared to the ligature + placebo group, alveolar bone loss was reduced in the fluoxetine group (P <0.05), and the amount of collagen fibers in the gingival tissue was maintained. Moreover, in gingival tissue sampled 3 days after ligature attachment, fluoxetine administration reduced IL-1 beta and COX-2 mRNA expression. Fluoxetine downregulated MMP-9 activity, without affecting MMP-9 mRNA expression induced by ligature, compared to the ligature + placebo group (P <0.05). These data suggest that fluoxetine suppressed proinflammatory responses, as well as proteolytic enzyme activity, induced by ligature.Conclusion: In the present study, fluoxetine suppresses the inflammatory response and protects against periodontal bone resorption and destruction of collagen fibers, suggesting that fluoxetine can constitute a promising therapeutic approach for periodontal diseases. J Periodontol 2012;83:664-671.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)National Institutes of Health/National Institute of Dental and Craniofacial ResearchUniv Estadual Campinas, Piracicaba Dent Sch, Dept Physiol Sci, BR-13414903 Piracicaba, SP, BrazilUniv Taubate, Dept Oral Biol, São Paulo, BrazilUniv Estadual Paulista UNESP, Sch Dent Sao Jose dos Campos, Dept Biosci & Oral Diag, São Paulo, BrazilForsyth Inst, Dept Immunol, Cambridge, MA USAHarvard Univ, Sch Dent Med, Dept Oral Med Infect & Immun, Boston, MA 02115 USAUniv Estadual Paulista UNESP, Sch Dent Sao Jose dos Campos, Dept Biosci & Oral Diag, São Paulo, BrazilFAPESP: 08/00566-6CAPES: 4073/08-8NIH/NIDCR: DE-018499NIH/NIDCR: DE-01991

Qualidade de vida de pacientes com câncer colorretal em uso de suplementação dietética com fungos Agaricus sylvaticus após seis meses de segmento: ensaio clínico aleatorizado e placebo-controlado Quality of life of patients with colorectal cancer on dietary supplementation with Agaricus sylvaticus fungus: after six months of segment: randomized and placebo-controlled clinical trial

INTRODUÇÃO: O câncer gastrointestinal compromete a qualidade de vida devido às alterações fisiológicas, metabólicas e psicológicas. Fungos medicinais podem melhorar a qualidade de vida de pacientes com câncer. OBJETIVO: Avaliar os efeitos da suplementação dietética com fungos Agaricus sylvaticus na qualidade de vida de pacientes com câncer colorretal em fase pós-operatória. METODOLOGIA: Ensaio clínico randomizado, duplo-cego, placebo-controlado, realizado no Hospital de Base do Distrito Federal. Amostra constituída por 56 pacientes (24 homens e 32 mulheres), estádios I, II e III, separados em grupos placebo e Agaricus sylvaticus (30mg/kg/dia), e acompanhados por um período de seis meses. Para avaliar os indicadores da qualidade de vida foram utilizados um formulário-padrão e uma anamnese dirigida-padrão. Os resultados foram analisados de forma qualitativa e descritiva, utilizando os programas Microsoft Excel 2003 e Epi Info 2004. RESULTADOS: Após seis meses de tratamento, observou-se, no grupo Agaricus sylvaticus, aumento da adesão à prática de atividade física, melhora da disposição e do humor, redução das queixas de dores e das alterações do sono como insônia e noites mal dormidas comparado com o grupo placebo. CONCLUSÃO: Os resultados sugerem que a suplementação dietética com Agaricus sylvaticus pode melhorar a qualidade de vida de pacientes no pós-operatório de câncer colorretal.<br>INTRODUCTION: Gastrointestinal cancer jeopardizes the quality of life through physiological, metabolic and psychological alterations. Medicinal fungus may boost the quality of life of patients with cancer. OBJECTIVE: To evaluate the effects of the dietary supplementation with Agaricus sylvaticus fungus in relation to the quality of life in patients with colorectal cancer during post-surgery phase. METHODOLOGY: Randomized, double-blind, placebo-controlled clinical trial carried out at the Federal District Hospital - Brazil, for six months. Samples of 56 enrolled patients (24 men and 32 women), stadiums phase I, II and III, separated as placebo and Agaricus sylvaticus (30mg/kg/day) supplemented groups: In order to evaluate indicators for quality of life, it was used form-standard and direct anamnese-standard. The method of analysis for results was qualitative and descriptive, using the Microsoft Excel 2003 and Epi Info 2004 programs. RESULTS: After six months of treatment, it was observed an increase of adhesion to physical activity; improved disposition and good mood, reduction of complaints, pains, and alterations of sleep such as insomnia and bad nights of sleep when Agaricus sylvaticus and placebo groups were compared. CONCLUSION: The results suggest that the dietary supplementation with Agaricus sylvaticus may improve the quality of life of patients with colorectal adenocarcinoma in post-surgery phase