DEFAR - Artigos publicados em periódicos
URI permanente para esta coleçãohttp://www.hml.repositorio.ufop.br/handle/123456789/531
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Item Immune response in acute respiratory syndrome induced by the new coronavirus.(2021) Paula Júnior, Waldemar de; Freitas, Carina Silva de; Lima Neto, Francisco Ferreira de; Santana, Nathália Alves; Soares, Nathália Zenaide Durães; Fonseca, Vitória Louise Mendes; Nascimento, Renata Cristina Rezende Macedo do; Guimarães, Andrea GrabeCoronaviruses (CoVs) belong to the family Coronaviridae, which are enveloped and have a single-stranded RNA genome. The new coronavirus (SARS-CoV-2) is the seventh known coronavirus that can infect humans and cause serious illness, such as acute respiratory syndrome. The coronaviruses already identified have contributed to the understanding of the clinical manifestations caused by SARS- CoV-2, as well as their associations with the immune system. The aim of the present study was to carry out a narrative review of the literature on the host’s immune response to infection by the new coronavirus. The review contains basic and summarized information on the main mechanisms involved in the immune response to SARS-CoV-2. The characteristics of the infection were considered according to the following: from the initial contact with the host through binding to angiotensin-converting enzyme 2 (ACE-2); the recognition of the pathogen by innate immunity cells; its containment mechanisms, including the production of effector cytokines and chemokines important in the development of the inflammatory process; and the participation of the complement system until the activation of the adaptive immune response. The probable occurrence of a host dysfunctional immune response and the escape mechanisms of the virus were also addressed. Despite numerous studies on the pathogenesis of SARS-CoV-2 infection, knowledge about the host’s immune response in COVID-19 is not fully understood. The present work established the relationship between the new coronavirus and the immune system, but further studies are needed for all the mechanisms of the process to be elucidated.Item Inteligência regulatória de tecnologias de saúde na Grécia.(2022) Barbosa, Mariana Michel; Zampirolli, Carolina Dias; Zuppo, Isabella de Figueiredo; Nascimento, Renata Cristina Rezende Macedo do; Kritikou, Persefoni; Acúrcio, Francisco de Assis; Teodoro, Juliana AlvaresA Grécia possui um sistema de saúde público e universal, o Serviço Nacional de Saúde (ESY), com cobertura de seguro obrigatório (IKA) para todos os trabalhadores (empregados ou autônomos). Além disso, os individuos podem ter, voluntariamente, seguro privado. A EOPYY (Organização nacional para provisão de serviços de saúde), a única responsável pela aquisição de serviços de saúde financiados por recursos públicos baseados nas contribuições do Fundo Nacional de Seguridade Social (EFKA) e do orçamento estadual. Há um número limitado de medicamentos fornecidos exclusivamente pelo sistema público de saúde, gratuitamente (farmácias EOPYY), como os medicamentos de alto custo. Além desses, a população pode comprar qualquer medicamento que deseje. National Organization for Medicines (EOF) é a autoridade regulatória e responsável também pela farmacovigilância de medicamentos, produtos médicos, de beleza e medicamentos veterinários. Em 2011, os processos de precificação e reembolso foram separados, sendo que a precificação ocorre após a autorização de comercialização, em seguida, é permitida a análise para reembolso pelo seguro social de saúde com a inclusão numa lista positiva. A precificação de novos produtos farmacêuticos segue um sistema de referenciamento externo de preços, onde o preço de fábrica máximo para medicamentos sob patente é definido pela média dos três menores preços para o mesmo medicamento nos países da União Européia (UE), sendo essa mesma regra aplicada para medicamentos biológicos e biossimilares. Medicamentos genéricos são precificados pela média dos três menores preços praticados na UE ou pela redução em 50% do preço em relação ao período em que o medicamento estava sob patente. Assim, os preços máximos dos medicamentos genéricos são fixados em 65% do preço do respectivo produto de referência. Em 2018, a Avaliação de Tecnologias em Saúde (ATS) foi introduzida no país para avaliar medicamentos e emitir recomendações ao Ministério da Saúde sobre a inclusão ou remoção de produtos da Lista Positiva. Como o processo de ATS ainda está sendo implementado, acredita-se que nos próximos anos, o país terá a oportunidade de aprimorar a implementação dessas técnicas, tendo como um dos grandes desafios a vinculação dos resultados das ATS com as orientações clínicas.Item Public programs for essential medicine access in a small municipality : a cross-sectional analysis.(2022) Chaves, Zeó Jaime Lacerda; Silva, Luiz Sérgio; Nascimento, Renata Cristina Rezende Macedo doBackground: Public programs that provide access to essential medications have played an important role in the care of hypertensive and diabetic patients. However, access in small municipalities has been poorly studied. Objective: To describe the sociodemographic profile and the medication and health service usage of patients with systemic arterial hypertension and/or diabetes mellitus in a small municipality who use the public medication access programs Health has no Price (Saúde Não Tem Preço - SNTP) and the Minas Pharmacy Network. Methods: This cross-sectional study with 341 participants was conducted in 2019. Home interviews were conducted using a standardized, semi-structured questionnaire. The data are expressed as absolute and relative frequencies, and Pearson's chi-square test was used for comparisons between proportions (α = 5%). Results: Most of the participants (70.68%) had hypertension only, 11.14% had diabetes only, and 18.18% had both. Regarding the origin of the hypertension medications, 82.67% were provided by the Minas Pharmacy Network and/or SNTP programs. Regarding oral hypoglycemic agents and insulins, 88.61% were provided by the Minas Pharmacy Network and/or SNTP. Most participants were female (63.1%), at least 65 years of age (50.30%), non- White (66.96%), resided in an urban area (67.16%), were illiterate or had a low education level (89.94%), and had a maximum income ≤ 2 times the federal minimum salary (89.19%). Overall user perception was significantly better for SNTP (p=0.010). Conclusion: The results of this study indicate that programs which provide access to essential medications are important sources of hypertension and diabetes medications in the study area, especially for people with low incomes.Item Prevalence and factors associated with anxiety among university students of health sciences in Brazil : findings and implications.(2021) Alves, Júlia Vasconcelos de Sá; Paula, Waléria de; Netto, Patrícia Ribeiro Rezende; Godman, Brian; Nascimento, Renata Cristina Rezende Macedo do; Vital, Wendel CouraObjective: The aim was to evaluate the prevalence and factors associated with anxiety disorders among university students of health sciences at Federal University of Ouro Preto, Brazil. Methods: A cross-sectional study between March to June 2019. Data were collected through a self-administered questionnaire including sociodemographic, academic, family and behavioral issues. The Beck Anxiety Inventory was used to assess anxiety. Estimates were obtained through the prevalence ratio and Poisson multivariate analysis. Results: Four hundred and ninety-three students participated with a mean age of 23.1 and predominantly women (79.9%). All students had some degree of anxiety, with the frequency of the severe, moderate and mild forms being 28.0%, 29.8% and 27.0%, respectively. The factors associated with anxiety included having suffered psychological and/or physical violence in childhood, having suicidal thoughts, having a deceased parent, living with parents, being dissatisfied with the course and being in the exam period. Conclusions: The prevalence of anxiety was high in our study and family problems prior to entering university seem to significantly influence the degree of anxiety, which may compromise the student’s academic and social performance.Item Strategies to improve antimicrobial utilization with a special focus on developing countries.(2021) Godman, Brian; Nascimento, Renata Cristina Rezende Macedo do; Seaton, Ronald AndrewAntimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, na- tionally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up.Item The current situation regarding long-acting insulin analogues including biosimilars among African, Asian, European, and South American countries : findings and implications for the future.(2021) Godman, Brian; Nascimento, Renata Cristina Rezende Macedo do; Jakovljevic, MihajloBackground: Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers. Objective: To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin analogue biosimilars to benefit all key stakeholders. Our approach: Multiple approaches including assessing the utilisation, expenditure and prices of insulins, including biosimilar insulin glargine, across multiple continents and countries. Results: There was considerable variation in the use of long-acting insulin analogues as a percentage of all insulins prescribed and dispensed across countries and continents. This ranged from limited use of long-acting insulin analogues among African countries compared to routine funding and use across Europe in view of their perceived benefits. Increasing use was also seen among Asian countries including Bangladesh and India for similar reasons. However, concerns with costs and value limited their use across Africa, Brazil and Pakistan. There was though limited use of biosimilar insulin glargine 100 IU/ml compared with other recent biosimilars especially among European countries and Korea. This was principally driven by small price differences in reality between the originator and biosimilars coupled with increasing use of the patented 300 IU/ml formulation. A number of activities were identified to enhance future biosimilar use. These included only reimbursing biosimilar long-acting insulin analogues, introducing prescribing targets and increasing competition among manufacturers including stimulating local production. Conclusions: There are concerns with the availability and use of insulin glargine biosimilars despite lower costs. This can be addressed by multiple activities.Item A new Brazilian regional scenario of Type 2 diabetes risk in the next ten years.(2021) Nascimento, Lúbia Guaima; Nascimento, Renata Cristina Rezende Macedo do; Frade, Josélia Cintya Quintão Pena; Pinheiro, Eliete Bachrany; Ferreira, Wesley Magno; Reis, Janice Sepúlveda; Melo, Karla Fabiana Santana de; Pontarolo, Roberto; Lenzi, Mônica Soares Amaral; Almeida, José Vanilton de; João, Walter Jorge; Pedrosa, Hermelinda Cordeiro; Correr, Cassyano Januário; Vital, Wendel CouraAims: According to a recent national diabetes screening performed by our group in 2018, 18.4% of the Brazilians were found to have high blood glucose. The objective of the present study was to estimate the risk of developing type 2 DM (T2DM) in the next ten years in Brazilian population. Methods: A cross-sectional study was carried out in community pharmacies across Brazil, in 2018, where pharmacists applied the FINDRISC questionnaire to estimate the population’s risk of developing T2DM within a ten-year period. Results: The study included 977 pharmacists from 345 municipalities distributed across the five geograph- ical regions of Brazil. Of the 17,580 people evaluated, the South region was found to have the highest frequency (59.6%) among people at very low and/or low risk of developing T2DM, while the North region, the most underserved, presented the highest and/or very highest T2DM risk (24.1%). The factors that mostly and importantly impacted these regional differences were body mass index; the highest daily consumption of vegetables and fruits; history of high blood glucose and family history of T1DM/T2DM. Conclusion: These results showed an impressive change of direction concerning diabetes numbers between the most underserved region in public health care and one of the most developed and best organized regions concerning health assistance, the North and the South, respectively.Item COVID-19 in medium-sized municipalities in the 14 health macro-regions of Minas Gerais, Brazil.(2021) Paula Júnior, Waldemar de; Nascimento, Renata Cristina Rezende Macedo do; Matiles, R.S.; Lima Neto, Francisco Ferreira de; Leles, Michel C. R.; Guimarães, H. N.; Guimarães, Andrea GrabeThe present study focused on the scenario of confirmed cases of SARS-CoV-2 infection in the state of Minas Gerais (MG), Brazil, from March 2020 to March 2021. We evaluated the evolution of COVID-19 prevalence and death in one municipality from each of the 14 health macro-regions of MG state. Socio-demographic characteristics and variables related to the municipalities were analyzed. The raw dataset used in this study was freely sourced from the website Brasil.io. From the raw dataset, two time series were extracted: the cumulative confirmed cases of COVID-19 and cumulative death counts, and they were compared to the state data using a nowcasting approach. In order to make time series comparisons possible, all data was normalized per 100,000 inhabitants. When analyzing in light of colored wave code interventions initiated in August 2020 in MG, for the majority of the municipalities, there was an absence of clear influence on prevalence and deaths. The national holidays in the first semester of 2020 had a small impact on the COVID-19 prevalence of the municipalities, but the holidays in the second semester of 2020 and beginning of 2021 caused important impacts on COVID-19 prevalence. The low number of ICU beds in some municipalities contributed to the higher number of deaths. The analysis showed here is expected to contribute to the improvement of decision making of the MG government, as it opened a huge possibility to have the total macro-regions and state data analyzed.Item Prezado autor : quais os critérios de qualidade para publicação de um protocolo de prática clínica?(2021) Melo, Angelita Cristine; Silva, Mario Jorge Sobreira da; Nascimento, Renata Cristina Rezende Macedo doItem História em quadrinhos como ferramenta para o ensino e aprendizagem sobre o novo coronavírus.(2021) Paula Júnior, Waldemar de; Lima Neto, Francisco Ferreira de; Soares, Nathália Zenaide Durães; Fonseca, Vitória Louise Mendes; Nascimento, Renata Cristina Rezende Macedo do; Guimarães, Andrea GrabeO objetivo deste trabalho foi desenvolver uma história em quadrinhos, exemplo de metodologia ativa de ensino, relacionando sistema imunológico e o novo coronavírus, para potencializar o processo de ensino-aprendizagem. Possui, ainda, a finalidade de levar o leitor ao aprendizado científico e ao conhecimento de mundo, para que ele reflita em novas perspectivas. Foi elaborada uma história em quadrinhos (HQ) simulando a infecção pelo SARS-CoV-2 em um organismo humano. Foram enumerados os constituintes do sistema imunológico (macrófago, linfócito B, linfócito T citotóxico, linfócito T helper, célula natural killer, célula dendrítica, neutrófilo, eosinófilo, basófilo, IgA, IgG, IgM, citocinas e sistema complemento) capazes de atuar nessa infecção. As respostas imunológicas e os mecanismos de ação dos componentes do sistema imunológico foram relacionados com a infecção provocada pelo novo coronavírus. Foi utilizada uma linguagem acessível a pessoas de todas as idades e diferentes graus de instrução. A HQ produzida pode representar resultado positivo no aprendizado do conteúdo de imunologia associado ao novo coronavírus ou potencializar informações já adquiridas. Para os autores, foram observadas habilidades como iniciativa, trabalho em equipe, além da capacidade de comunicação e de síntese. O presente trabalho pode ser utilizado associado a outras metodologias ativas de aprendizagem e, sobretudo, servir de inspiração para que novas abordagens educacionais sobre o novo coronavírus sejam criadas.