Daniel Tenório da Silva

Integrated Monitoring of Mola mola Behaviour in Space and Time.

Over the last decade, ocean sunfish movements have been monitored worldwide using various satellite tracking methods. This study reports the near-real time monitoring of fine-scale (< 10 m) behaviour of sunfish. The study was conducted in southern Portugal in May 2014 and involved satellite tags and underwater and surface robotic vehicles to measure both the movements and the contextual environment of the fish. A total of four individuals were tracked using custom-made GPS satellite tags providing geolocation estimates of fine-scale resolution. These accurate positions further informed sunfish areas of restricted search (ARS), which were directly correlated to steep thermal frontal zones. Simultaneously, and for two different occasions, an Autonomous Underwater Vehicle (AUV) video-recorded the path of the tracked fish and detected buoyant particles in the water column. Importantly, the densities of these particles were also directly correlated to steep thermal gradients. Thus, both sunfish foraging behaviour (ARS) and possibly prey densities, were found to be influenced by analogous environmental conditions. In addition, the dynamic structure of the water transited by the tracked individuals was described by a Lagrangian modelling approach. The model informed the distribution of zooplankton in the region, both horizontally and in the water column, and the resultant simulated densities positively correlated with sunfish ARS behaviour estimator (rs = 0.184, p<0.001). The model also revealed that tracked fish opportunistically displace with respect to subsurface current flow. Thus, we show how physical forcing and current structure provide a rationale for a predator’s fine-scale behaviour observed over a two weeks in May 2014.

ANALYSIS OF RESEARCH QUALITY REGARDING PHARMACEUTICAL INTERVENTION IN ELDERLY RESIDENTS OF LONG-TERM CARE FACILITIES: A SYSTEMATIC REVIEW

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Author Contributions: Kitchen T: initial draft of manuscript, critical revision of manuscript. Coles R and Smith A: conception and design, critical revision of manuscript. Baglioni P: critical revision of manuscript, management of patient. Okosieme OE: conception and design, management of patient, critical revision and final draft of manuscript. Sponsor’s Role: None.

Conceptualizing and measuring potentially inappropriate drug therapy.

Elderly people are the principal consumers of prescription drugs. The more the medication used by the patient, the greater the likelihood there is of the patient being subjected to potentially inappropriate drug therapy (PIDT). PIDT has been measured in the literature with both implicit and explicit tools. The purpose of this review was to assess the use of tools to detect PIDT in various studies and to determine which terms are used to refer to PIDT in practice.

An analysis of the quality of studies that evaluate potentially inappropriate drug therapy

In the elderly population, increased predisposition to chronic diseases and consequent use of various medications increases the chances of using a potentially inappropriate drug therapy. The purpose of this review was to analyze research that uses tools to study potentially inappropriate drug therapy through the strengthening the reporting of observational studies in epidemiology (STROBE) initiative. A systematic review was undertaken between February and March, 2013. The studies were selected from different combinations of the Medicines controlled vocabulary thesaurus (MESH) terms - “aged,” “elderly,” “inappropriate prescribing,” and “drug utilization” in English, Spanish and Portuguese, in the Literatura Latino-Americana e do Caribe em Ciencias da Saude, PubMed, Scopus, and Web of Science databases. The papers that satisfied the inclusion criteria for data extraction were examined regarding the following variables: country, sample size, duration, type of study, practice scenario, study limitations and fulfillment of the items proposed by the STROBE initiative. At the end of the selection process, 119 articles met the specific criteria. The US had the highest number of publications in this area. The samples observed were heterogeneous, ranging from patient to database samples, and most studies were cross-sectional. The most frequently used study practice scenarios were hospitals or outpatient clinics. No article completely met the STROBE criteria. It was found that potentially inappropriate drug therapy is studied primarily in developed countries, which reinforces the need for further studies in developing countries. These findings should guide future research in this subject area, providing a more complete approach on aspects related to the use of medications by this specific population. Key words: Potentially inappropriate drug therapy, inappropriate prescribing, elderly, study quality assessment.

Quality analysis of research on the use of benzodiazepines by elderly patients in the emergency room:a systematic review

PurposeTo analyze the quality of research on the use of benzodiazepines (BZDs) in the emergency room by the elderly population through the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative.MethodsA systematic review was carried out according to the following steps: (1) identification of studies, in which studies were selected from different combinations of the descriptors “elderly–aged,” “benzodiazepines,” and “emergency room” in the EMBASE–MEDLINE, SciELO, Scopus, and Web of Science databases; (2) evaluation of studies, in which the title, abstract, and full text of the studies were assessed; (3) evaluation of the methodological quality of the studies. The criteria used were those included in the STROBE recommendations.ResultsAt the end of the selection process, only six articles were identified which met the specific criteria. The sample sizes in these studies varied from 118 to 1,611 patients. More than half (4) of the studies did not describe the type of design used, whereas all collected demographic data and analyzed details on the use of BZDs, such as type administered and/or its relationship to the symptoms, were shown. No article fully complied with the STROBE criteria.ConclusionsThis review shows a lack of methodological quality in the studies performed to date that have evaluated the use of BZDs in elderly patients in emergency rooms. These findings should guide future research in this subject area, providing a more complete approach on aspects related to the use of medications by this specific population.

Evaluation of pharmacotherapy complexity in residents of long-term care facilities: a cross-sectional descriptive study

BackgroundPolypharmacy is a reality in long-term care facilities. However, number of medications used by the patient should not be the only predictor of a complex pharmacotherapy. Although the level of complexity of pharmacotherapy is considered an important factor that may lead to side effects, there are few studies in this field. The aim of this study was to evaluate the complexity of pharmacotherapy in residents of three long-term care facilities.MethodsA cross-sectional study was performed to evaluate the complexity of pharmacotherapy using the protocols laid out in the Medication Regimen Complexity Index instrument in three long-term care facilities in northeastern Brazil. As a secondary result, potential drug interactions, potentially inappropriate medications, medication duplication, and polypharmacy were evaluated. After the assessment, the association among these variables and the Medication Regimen Complexity Index was performed.ResultsIn this study, there was a higher prevalence of women (64.4%) with a high mean age among the study population of 81.8 (±9.7) years. The complexity of pharmacotherapy obtained a mean of 15.1 points (±9.8), with a minimum of 2 and a maximum of 59. The highest levels of complexity were associated with dose frequency, with a mean of 5.5 (±3.6), followed by additional instructions of use averaging 4.9 (±3.7) and by the dosage forms averaging 4.6 (±3.0).ConclusionsThe present study evaluated some factors that complicate the pharmacotherapy of geriatric patients. Although polypharmacy was implicated as a factor directly related to complexity, other indicators such as drug interactions, potentially inappropriate medications, and therapeutic duplication can also make the use of pharmacotherapy in such patients more difficult.

Medication Regimen Complexity Measured by MRCI: A Systematic Review to Identify Health Outcomes

Objective: To perform a systematic review to identify health outcomes related to medication regimen complexity as measured by the Medication Regimen Complexity Index (MRCI) instrument. Data Sources: Cochrane Library, LILACS, PubMed, Scopus, EMBASE, Open Thesis, and Web of Science were searched from January 1, 2004, until April 02, 2018, using the following search terms: outcome assessment, drug therapy, and Medication Regimen Complexity Index and their synonyms in different combinations. Study Selection and Data Extraction: Studies that used the MRCI instrument to measure medication regimen complexity and related it to clinical, humanistic, and/or economic outcomes were evaluated. Two reviewers independently carried out the analysis of the titles, abstracts, and complete texts according to the eligibility criteria, performed data extraction, and evaluated study quality. Data Synthesis: A total of 23 studies met the inclusion criteria; 18 health outcomes related to medication regimen complexity were found. The health outcomes most influenced by medication regimen complexity were hospital readmission, medication adherence, hospitalization, adverse drug events, and emergency sector visit. Only one study related medication regimen complexity with humanistic outcomes, and no study related medication regimen complexity to economic outcomes. Most of the studies were of good methodological quality. Relevance to Patient Care and Clinical Practice: Health care professionals should pay attention to medication regimen complexity of the patients because this may influence health outcomes. Conclusion: This study identified some health outcomes that may be influenced by medication regimen complexity: hospitalization, hospital readmission, and medication adherence were more prevalent, showing a significant association between MRCI increase and these health outcomes.

Technical Evaluation of Eye Drops Instillation: A Systematic Review

Objective: Assess the profile of eye drops in patients with eye diseases. Methods: Studies available in the scientific literature were identified without any time limits using the databases Embase-Medline, Scielo, Scopus and Web of Knowledge. The selected studies were compared with the following inclusion criteria: (i) if the study evaluated the eye drop instillation, (ii) if the study involved participation of patients with eye diseases. Results: Twelve studies met the inclusion criteria. Of them, 83.33% evaluated the technique of eye drop instillation in patients with glaucoma, 8.33% in patients with eye diseases and 8.33% in patients with cataract after undergoing surgery to correct. 41.66% of studies have chosen to record a video of patients to analyze the technique of instilling eye drops and 41.66% did not describe the/esearch location. Regarding the type of study, 75% had the design as prospective cross-sectional, 8.33% prospective open label study, 8.33% intervention study and 8.33% study called masked trial. Although studies evaluate the technique of eye drop instillation, only 8.33% describe in the article the reference in the literature used to evaluate patients. 50% of articles acknowledged some sort of bias or limitation. Conclusion: The limitations inherent in these types of studies should guide future research.

Effect of salt stress on the activity of bromelain in pineapple plants grown In vitro

Bromelain is a collective name for proteolytic enzymes or proteases (natural proteolytic enzymatic complex) found in tissues including stems, fruit and leaves of the pineapple (Ananas comosus var. comosus) and of other plant species of the family Bromeliaceae (KUMAR, 2011). Is a bioactive agent possessing remarkable therapeutic properties such as reversible inhibition of platelet aggregation, relief from bronchitis, sinusitis and enhanced absorption of drugs, particularly of antibiotics (BHUI et al., 2009). Although Brazil is a major producer of pineapple, occupying the first position in 2010 worldwide with a production of 1.5 million tons of fruit, the salt stress, deleterious alterations observed in plants grown in saline conditions, which occur due to intoxication by ions and decline of supply of water and nutrients to the plant (LI et al., 2010), is main factor limiting growth and productivity of plants since it causes metabolic responses in plants, affecting and compromising all important processes such as photosynthesis, changes in levels and protein synthesis and activity enzymes, as well as in the synthesis of lipid metabolism and energy (PIZA et al., 2003). Thus, the objective of this research was to evaluate the influence of salt stress on the activity of bromelain in pineapple plants (Ananas comosus L. Merril) cv. Perola cultured in vitro.

Evaluation of production of xanthan gum utilizing the corn cob liquor as a carbon source in different strains of Xanthomonas campestres

Background The xanthan gum production has been growing significantly. It is estimated an annual increase by about 5 to 10%. The production needs a carbon source in fermentation media and are commonly employed as glucose or sucrose, which accounts for about 50% of the cost of production. Therefore the use of agro-industrial residues, such as corn cob for the production of xanthan gum becomes suggestive, as such residues are abundant. Waste when processed becomes a rich source of carbon, nutrients and salts. Thus this study aims to use hemicellulose fractions, derived from agro-industrial residues.