Gil Sevalho

Atenção Farmacêutica: fundamentação conceitual e crítica para um modelo brasileiro

The Pharmaceutical Care concepts were analyzed from their origins in the United States and the later contributions which came from Spain and from the effort of sistematization by the World Health Organization to understand the processs that has been happening in Brasil. After the abandon of the communitarian pharmacy, the Brazilian pharmacists hope that this new model of practicing is the way to get back his/her social role. The philosophy which directs the Pharmaceutical Care, having the focus on patient, in our understanding, must support philosophical and conceptually the rebuilding of pharmaceutical practicing in Brazil in order to get back the lost relation between the pharmacist and patient at communitarian pharmacy.

Tempos históricos, tempos físicos, tempos epidemiológicos: prováveis contribuiçöes de Fernand Braudel e Ilya Prigogine ao pensamento epidemiológico

The text is an approach on time as a scientific category in epidemiology. Considering the aphorism time-place-person, time is pointed out as an element with little theoretical concern, despite its presence in main epidemiological concepts. While a topic connected to important changes in other disciplines, such as history, geography, biology and physics, time represents an interesting point of view to the interdisciplinary dialogue and its relevance for a critical knowledge in epidemiology. To argue about this idea, the historical and physical time constructions of Fernand Braudel and Ilya Prigogine are presented. These time theoretical constructions are compared with a probable epidemiological time. Finally, using the emerging infectious diseases as an example, some considerations are made about an apparent epistemological inadequacy of the epidemiological time to recognize the social and historical aspects involved in the complexity of the disease expressions in human populations.

The use of nonsteroidal anti-inflammatory drugs and the occurrence of gastric lesions among patients undergoing upper endoscopy in a university hospital in Brazil

BACKGROUND Nonsteroidal anti-inflammatory drugs are widely used in Brazil in spite of the known risks associated with their use, but investigation of their side effects conducted in this country has been far from sufficient. This study investigates the use of NSAIDs among patients undergoing upper endoscopy in the Hospital das Clínicas of the Federal University of Minas Gerais and the association of this use with the endoscopic diagnosis of gastric erosions, gastric erosions with hematin pigmentation, and gastric ulcer. METHODS The cross-sectional methodological approach was used; 533 patients aged 17 or older were interviewed, between June and December, 2000. Data were submitted to bivariate and multivariate analyses. RESULTS More than two thirds of the interviewed population reported the use of nonsteroidal anti-inflammatory drugs in a period of 1 month before the upper endoscopy. The most used nonsteroidal anti-inflammatory drugs were acetylsalicylic acid and diclofenac. An association was clearly shown between the use of these drugs and the occurrence of the studied lesions, with the latter attaining significance. There was also a significant association between nonsteroidal anti-inflammatory drugs use for a period greater than 15 days and the occurrence of the gastric lesions, with a higher odds ratio than for the other comparisons. CONCLUSIONS The results suggest that nonsteroidal anti-inflammatory drugs have a significant association with the occurrence of the gastric lesions and point to the need of further study of this issue in Brazil.

Prevalência e fatores associados ao uso de antiinflamatórios não-esteróides por pacientes submetidos a endoscopia digestiva alta, Belo Horizonte, Minas Gerais, 2000

OBJETIVO: Determinar a prevalencia e os fatores associados ao uso de AINE por pacientes submetidos a endoscopia digestiva alta no Hospital das Clinicas da UFMG. METODOS: Estudo transversal de uma amostra de 533 pacientes com idade igual ou superior a 17 anos, com endoscopia previamente marcada na Secao de Endoscopia do Hospital das Clinicas da Universidade Federal de Minas Gerais. Os dados foram coletados por meio de entrevistas. Foram considerados quatro grupos de variaveis exploratorias: sociodemograficas, relacionadas aos habitos de vida, relacionadas a historia de morbidades e relacionadas ao uso de medicamentos. Os dados foram submetidos as analises estatisticas bivariada e multivariada. RESULTADOS E CONCLUSOES: Entre os entrevistados, 34,1% relataram algum uso de AINE no periodo de 1 mes anterior a realizacao da endoscopia. Os AINE mais utilizados foram o acido acetilsalicilico e o diclofenaco. Os fatores associados ao uso de AINE foram: sexo feminino (OR = 2,07; IC 95% = 1,28-3,34), renda igual ou superior a 3 salarios minimos (OR = 3,20; IC 95% = 1,74-5,90), uso de alcool (OR = 2,43; IC 95% = 1,39-4,24), presenca de sintomas gastrintestinais (OR = 1,82; IC 95% = 1,18-2,80), uso regular de 4 ou mais medicamentos (OR = 4,33; IC 95% = 2,49-7,54) e historia previa de ulcera e/ou hemorragia digestiva (OR = 0,40; IC 95% = 0,22-0,75). Estes resultados mostram semelhancas aos observados em paises desenvolvidos. Alem disso, alertam para a necessidade de maior atencao por profissionais de saude para com os subgrupos de uso evidenciados.