The aim of this study was to evaluate the physico-chemical and biocompatibility characteristics of two different hydroxyapatites. Physical and chemical properties were analyzed using granulometric analysis, scanning electron microscopy (SEM), X-ray energy-dispersion (EDX), X-ray fuorescence (XRF) and X-ray diffraction (XRD). Biomaterials were implanted into the subcutaneous tissue on the dorsum of 36 Wistar rats, divided into the following groups: Group 1 - Gen-Ox (natural); Group 2 - HA-U (synthetic) and Group 3 - Control (Sham). After 15 and 30 days, 6 animals/period were sacrificed and the subcutaneous tissue was taken for histological and histometric analysis, giving consideration to inflammatory reaction and granule area. The granulometric test results showed a mean granule diameter of 161.6 microm (min = 19.0 microm; max = 498.0 microm) and 48.7 microm (min = 7.0 microm; max = 256.0 microm) for groups 1 and 2 respectively. Analysis with SEM demonstrated irregular and sharp-edge particles in group 1 (3332.8 +/- 274.3 microm(2)) and irregular and rounded particles in group 2 (1320.8 +/- 83.0 microm(2)) (P < 0.0001; Student's t test). EDX and XRF revealed calcium, carbon, oxygen, sodium and phosphorus in both groups. XRD indicated that both biomaterials were pure and crystalline. There was a statistically significant difference in granule area between the two groups after 15 days (P = 0.022; Student's t-test). After 15 days, an increased inflammatory response was seen in group 2 (P < 0.0001; ANOVA and Tukey's post hoc test) whereas it was more pronounced in group 1 after 30 days (P < 0.0001; ANOVA and Tukey's post hoc test). It was concluded that these biomaterials have similar physical, chemical and biocompatibility characteristics.
Glycemic control in patients with diabetes mellitus type 1 (DM1) reduces the risk of complications but requires a rigorous health care routine. Thus, diabetes education is central to increasing treatment compliance and self-care practices. This study aimed to evaluate the quality of life (QoL) and glycemic control of DM1 patients being treated with insulin analogs and receiving medication review with followup. This was a transversal study that included 110 patients registered at the 3 rd Health Regional of Ponta Grossa-PR, aged ≥ 18 years, and receiving pharmaceutical care for at least 1 year. The Diabetes Quality of Life Measure (DQOL)-Brazil was used to evaluate QoL. The data were statistically analyzed using SPSS version 17.0 with 95% confidence levels. Of the 110 patients, 58.2% were women. The average age was 33.7 years (±10.5), and the average glycated hemoglobin (HbA1c) value was 8% (±1.4). The mean total DQOL-Brazil score was 2.11 (95% confidence interval, 2.02 -2.21). All DQOL-Brazil scores were lower in patients with HbA1c ≤ 8%, indicating a better QoL. Good glycemic control, thus, appears to have a positive influence on the QoL, and pharmaceutical interventions are able to contribute to the achievement of therapeutic targets.Uniterms: Diabetes mellitus type 1/treatment. Diabetes mellitus type 1/treatment/quality of life. Pharmaceutical care. Insulin analogs. Pharmacotherapy follow-up. INTRODUCTIONDiabetes mellitus (DM) is a group of metabolic d i s o r d e r s p r i m a r i l y c h a r a c t e r i z e d b y c h r o n i c hyperglycemia. High glycemic levels are associated with micro-and macrovascular complications leading to damage to, and failure of organs such as the eyes (retinopathy), kidneys (nephropathy), nerves (neuropathy), heart, and blood vessels (ADA, 2016; Braga de Souza et al., 2015;Gross et al., 2002).According to the Diabetes Control and Complications Trial (DCCT), the risk of developing chronic complications is higher in patients with chronically high glycated hemoglobin (HbA1c) levels, and the risk gradually increases with HbA1c levels greater than 7% (Pimazoni Netto et al., 2009). The American Diabetes Association (ADA) defines an HbA1c value < 7% as the acceptable limit for diabetes control. With good glycemic control, patients can be symptom-free, and prevent acute and chronic complications (ADA, 2016;UKPDS, 1999;DCCT, 1988).DM is a chronic condition that requires daily self-care throughout life and has a negative impact on the subjective perception of the quality of life (QoL). However, daily treatment is fundamental to DM control and decreases the risk of complications (Debaty et al., 2008;Wood-Dauphinee, 1999). DM1 therapy includes intensive care demands such as daily blood glucose monitoring, multiple insulin injections, and specific dietary and physical activity recommendations (ADA, 2016). Not understanding all these recommendations and a lack of compliance to treatment leads to a poor glycemic control that can cause severe hyper-or hypoglycemia episodes and chronic complicat...
Diabetes mellitus (DM) é um grupo heterogêneo de distúrbios metabólicos que apresenta em comum a hiperglicemia. Diabetes mellitus tipo 1 (DM1) é o resultado de uma destruição seletiva de células beta pancreáticas, o que acarreta uma deficiência de insulina. O objetivo deste trabalho foi realizar o Acompanhamento Farmacoterapêutico individualizado a paciente adolescente portador de DM1, que faz uso de análogos de insulina e que apresenta controle glicêmico insatisfatório. O acompanhamento foi realizado através de visitas domiciliares visando à educação integral da família e do paciente, orientações quanto às técnicas da utilização adequada dos análogos de insulina, hábitos alimentares, bem como o incentivo às medidas não farmacológicas do tratamento, buscando a promoção a saúde e melhoria da qualidade de vida, na tentativa de reduzir os riscos das complicações de diabetes a longo prazo. Os dados foram coletados através do registro dos valores glicêmicos diários por meio do automonitoramento, bem como dos resultados de exames laboratoriais de glicemia de jejum e hemoglobina glicada (HbA1c). Após o acompanhamento, observou-se uma redução na média da glicemia capilar e nos valores das glicemias plasmáticas de jejum, embora os valores de HbA1c do início e do final do acompanhamento não denotem alterações significativas. O resultado desse trabalho reflete a dificuldade da adesão efetiva e melhora clínica de pacientes adolescentes insulinizados, mesmo com a participação do farmacêutico.
Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects many people worldwide and is the most common inflammatory joint disease of autoimmune origin. In Brazil, the treatment for RA is guided by clinical protocols and therapeutic guidelines. This work aims to investigate the profile of patients with RA through the analysis of sociodemographic, clinical, and pharmacotherapy data. A cross-sectional and descriptive study was carried out in the Specialized Component of Pharmaceutical Services (CEAF) in Ponta Grossa, Paraná, Brazil. Patients with RA that received regular pharmacological therapy were included. Most were female, adults between 40 and 59 years old, and exhibited a disease activity score classified as remission. The majority of patients in remission of disease utilized at least a conventional synthetic diseasemodifying antirheumatic drug (csDMARD) or biological synthetic disease-modifying antirheumatic drug (bDMARD) in monotherapy or associated with other drugs. The treatment costs were high, mainly by utilizing bDMARDs followed by csDMARDs. Most patients exhibited adequate control of disease progression, and fortunately, only a few cases of drug-related problems were identified. This profile is associated with the therapeutic guidelines for RA treatment in Brazil. The SUS has an important role in guaranteeing high-cost drugs access by health judicialization and access to multidisciplinary health professionals for patients with RA.
Introdução: Diabetes mellitus é uma epidemia mundial. Considerado um dos principais problemas de saúde pública do país, conhecer como vivem os diabéticos é de grande importância para a introdução de diretrizes que possam contribuir para um controle glicêmico adequado, melhorando a qualidade de vida desses indivíduos. Objetivos: Avaliar a qualidade de vida de pacientes com diabetes mellitus tipo 1 (DM1) tratados com insulina convencional NPH e Regular. Metodologia: Trata-se de um estudo observacional, retrospectivo e transversal. Foram entrevistados 44 pacientes com DM1 que faziam uso de insulina convencional. A qualidade de vida foi avaliada por meio do instrumento DQOL-
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