Objective:To describe and analyze the pharmaceutical orientation given at hospital discharge of transplant patients.Methods:This was a cross-sectional, descriptive and retrospective study that used records of orientation given by the clinical pharmacist in the inpatients unit of the Kidney and Liver Transplant Department, at Hospital Universitário Walter Cantídio, in the city of Fortaleza (CE), Brazil, from January to July, 2014. The following variables recorded at the Clinical Pharmacy Database were analyzed according to their significance and clinical outcomes: pharmaceutical orientation at hospital discharge, drug-related problems and negative outcomes associated with medication, and pharmaceutical interventions performed.Results:The first post-transplant hospital discharge involved the entire multidisciplinary team and the pharmacist was responsible for orienting about drug therapy. The mean hospital discharges/month with pharmaceutical orientation during the study period was 10.6±1.3, totaling 74 orientations. The prescribed drug therapy had a mean of 9.1±2.7 medications per patient. Fifty-nine drug-related problems were identified, in which 67.8% were related to non-prescription of medication needed, resulting in 89.8% of risk of negative outcomes associated with medications due to untreated health problems. The request for inclusion of drugs (66.1%) was the main intervention, and 49.2% of the medications had some action in the digestive tract or metabolism. All interventions were classified as appropriate, and 86.4% of them we able to prevent negative outcomes.Conclusion:Upon discharge of a transplanted patient, the orientation given by the clinical pharmacist together with the multidisciplinary team is important to avoid negative outcomes associated with drug therapy, assuring medication reconciliation and patient safety.

ObjectiveTo describe and evaluate the pharmacotherapeutic follow-up by a clinical pharmacist in an intensive care unit.MethodsA descriptive and cross-sectional study carried out from August to October 2016. The data were collected through a form, and pharmacotherapeutic follow-up conducted by a clinical pharmacist at the respiratory intensive care unit of a tertiary hospital. The problems recorded in the prescriptions were quantified, classified and evaluated according to severity; the recommendations made by the pharmacist were analyzed considering the impact on pharmacotherapy. The medications involved in the problems were classified according to the Anatomical Therapeutic Chemical Classification System.ResultsForty-six patients were followed up and 192 pharmacotherapy-related problems were registered. The most prevalent problems were missing information on the prescription (33.16%), and those with minor severity (37.5%). Of the recommendations made to optimize pharmacotherapy, 92.7% were accepted, particularly those on inclusion of infusion time (16.67%), and dose appropriateness (13.02%), with greater impact on toxicity (53.6%). Antimicrobials, in general, for systemic use were drug class most often related to problems in pharmacotherapy (53%).ConclusionPharmacotherapeutic follow-up conducted by a pharmacist in a respiratory intensive care unit was able to detect problems in drug therapy and to make clinically relevant recommendations.

No abstract

Objetivo: Analisar a influência da complexidade da farmacoterapia (CFT) na adesão ao tratamento imunossupressor. Métodos: Trata-se de um estudo analítico, observacional e transversal, baseado nos registros do atendimento farmacêutico de pacientes transplantados renais de um hospital universitário (Fortaleza/Ceará). A CFT foi avaliada em consulta farmacêutica no período de janeiro a julho/2014, utilizando-se o Índice de Complexidade da Farmacoterapia (ICFT). A análise da adesão foi realizada através do nível sérico dos inibidores da calcineurina e imTor. Resultados: Analisou-se o acompanhamento de 36 pacientes: sendo 52,78% (n=19) homens; 27,80% (n=10) entre 41 e 50 anos; 41,70% (n=15) com ensino fundamental incompleto e 72,22% (n=26) possuíam cuidador. A média de medicamentos foi nove e de pontos no ICFT foi de 50,94. O ICFT máximo foi registrado na faixa de 31-60 dias pós-transplante. Analisando o nível sérico dos imunossupressores, observou-se prevalência de pacientes classificados como “não aderentes” maior no período menor de 60 dias pós-transplante. Conclusão: Concluiu-se que no pós-transplante renal a adesão dos pacientes ao tratamento imunossupressor aumenta com a diminuição da CFT, sendo necessária uma maior e melhor orientação dos pacientes no inicio do pós-transplante.

A descriptive and prospective study was conducted on the pharmaceutical care in the post-transplant outpatient clinic of Hospital Universitario Walter Cantidio of Universidade Federal do Ceará (HUWC/UFC), in Fortaleza- Ceará in the period of April to October of 2011. The aim of the present study was to describe the pharmaceutical interventions performed in a Pharmaceutical Care service structured in the liver and kidney transplant outpatient clinic of an academic hospital. The Pharmaceutical interventions (PI) were classified according to Sabater et al.(2005), with significance based on Riba et al.(2000) and the Negative Outcomes associated with Medication (NOM) established at the Third Consensus of Granada. Statistical analyses were performed using the Epi Info v.3.5.1 program and hypothesis tests were done with the SigmaPlot v.10.0 program. A chi-squared (X²) test was utilized for statistical analysis of the sample. A total of 97 patients were followed, where 54 problems related to medications were identified and 139 PI performed. The main PI were in education of the patient about treatment (n=111; 80%) (p<0.05), while the significance of all interventions were appropriate, where 83.4% (n=116) of PI performed in the study period were shown to be "significant" (p<0.05). Through pharmaceutical care, the pharmacist is capable of monitoring the pharmacotherapeutic treatment and intervening when necessary, while being part of the multiprofessional team caring for the transplant patient.

No abstract

Emotion regulation relies on cognitive processing, but the foundational cognitive control mechanisms engaged remain unclear. The process model of emotion regulation posits that different strategies occur at different points in time, with antecedent strategies occurring early and response-focused strategies later in the affective timecourse, with cognitive processing supporting these strategies following a similar timecourse. In parallel, the Dual Mechanisms of Control (DMC) theoretical framework (Braver, 2012; Braver, Gray, &amp; Burgess, 2007; Chiew &amp; Braver, 2017) proposes that cognitive control operates via two temporally-distinct modes: anticipatory preparation to perform cognitive tasks (proactive), and momentary engagement in cognitive tasks as they arise (reactive). However, empirical investigations of the role of proactive and reactive control in emotion regulation have been limited. In this paper, we summarize and integrate these two theoretical perspectives. We first posit that any emotion regulation strategy may take place either early or late in the affective timecourse, depending on whether it is proactively or reactively enacted. We next provide examples of different strategies from the process model and their engagement in both control modes. In addition, we discuss how strategic dependence on the downstream emotional stimulus and response could further affect the timecourse and cognitive load of emotion regulation strategies. We conclude by discussing how controlling for timing in future research designs may clarify how populations with reduced cognitive control may demonstrate intact emotion regulation (i.e., through greater reliance on reactive strategies), and how incorporation of the DMC perspective may inform applied emotion regulation interventions for clinical populations.

Currently, there is no known cure for neurodegenerative disease. However, the available therapies aim to manage some of the symptoms of the disease. Human neurodegenerative diseases are a heterogeneous group of illnesses characterized by progressive loss of neuronal cells and nervous system dysfunction related to several mechanisms such as protein aggregation, neuroinflammation, oxidative stress, and neurotransmission dysfunction. Neuroprotective compounds are essential in the prevention and management of neurodegenerative diseases. This review will focus on the neurodegeneration mechanisms and the compounds (proteins, polyunsaturated fatty acids (PUFAs), polysaccharides, carotenoids, phycobiliproteins, phenolic compounds, among others) present in seaweeds that have shown in vivo and in vitro neuroprotective activity. Additionally, it will cover the recent findings on the neuroprotective effects of bioactive compounds from macroalgae, with a focus on their biological potential and possible mechanism of action, including microbiota modulation. Furthermore, gastrointestinal digestion, absorption, and bioavailability will be discussed. Moreover, the clinical trials using seaweed-based drugs or extracts to treat neurodegenerative disorders will be presented, showing the real potential and limitations that a specific metabolite or extract may have as a new therapeutic agent considering the recent approval of a seaweed-based drug to treat Alzheimer’s disease.