Rita de Cássia Padula Alves Vieira

Evaluation of inadequate anti-retroviral treatment in patients with HIV/AIDS

INTRODUCTION Since the emergence of antiretroviral therapy, the survival of patients infected with human immunodeficiency virus has increased. Non-adherence to this therapy is directly related to treatment failure, which allows the emergence of resistant viral strains. METHODS A retrospective descriptive study of the antiretroviral dispensing records of 229 patients from the Center for Health Care, University Hospital, Federal University of Juiz de Fora, Brazil, was conducted between January and December 2009. RESULTS The study aimed to evaluate patient compliance and determine if there was an association between non-adherence and the therapy. Among these patients, 63.8% were men with an average age of 44.0 ± 9.9 years. The most used treatment was a combination of 2 nucleoside reverse transcriptase inhibitors with 1 non-nucleoside reverse transcriptase inhibitor (55.5%) or with 2 protease inhibitors (28.8%). It was found that patients taking lopinavir/ritonavir with zidovudine and lamivudine had a greater frequency of inadequate treatment than those taking atazanavir with zidovudine and lamivudine (85% and 83.3%, respectively). Moreover, when the combination of zidovudine/ lamivudine was used, the patients were less compliant (χ² = 4.468, 1 degree of freedom, p = 0.035). CONCLUSIONS The majority of patients failed to correctly adhere to their treatment; therefore, it is necessary to implement strategies that lead to improved compliance, thus ensuring therapeutic efficacy and increased patient survival.

Análise retrospectiva das intoxicações admitidas no hospital universitário da UFJF no período 2000-2004

Poisonings may have their consequences minimized by the acquisition of knowledge concerning its etiologies, evolutions and means of prevention. In Brazil, the progressive increase of toxic emergencies justifies the acquisition and analysis of regional and decentralized data concerning toxic emergencies. The aim of this retrospective and descriptive study was to evaluate data on the toxicology occurrence registered at the University Hospital/UFJF from 2000 to 2004. Data were collected using a structured instrument which comprised: age range, gender, profession, average hospitalization time, etiology and possible reasons for the intoxication, drug categories, where the patients live and the most important exposure route to the poisonous agent. The possible relationship among the data was also examined. The profile found for poisoning in the 50 cases analyzed, was that accidents are more common from 0 to 5 years old (24%) and male gender (68%), the majority of the cases happened in the city of Juiz de Fora (78%) and oral exposure. The most important poisonous agents were found to be the psychotropics (60%). Definition of a profile helps promoting educative activities and expands poisoning prevention campaigns by public health agencies. Therefore, these facts strengthen the importance of an Information Service net to prevent and reduce intoxications and the irrational use of drugs.

Assistência farmacêutica no Sistema Único de Saúde (SUS): percepções de graduandos em Farmácia

Este estudo teve como objetivo compreender as percepcoes de graduandos em farmacia de uma universidade publica brasileira sobre a Assistencia Farmaceutica (AF) no Sistema Unico de Saude, frente ao atual contexto politico e educacional em saude, com a perspectiva de incrementar a discussao sobre a formacao para esta area. Foram realizadas entrevistas semi-estruturadas com estudantes do ultimo ano letivo, sendo os resultados interpretados a partir da analise tematica de conteudo. Verificou-se que apesar de alguns avancos, as percepcoes partilhadas demonstram a lacuna existente na formacao para a atuacao em AF, considerada em processo de construcao, indicando a necessidade de desenvolvimento de estrategias metodologicas de ensino mais adequadas, de diversificacao dos cenarios de ensino-aprendizagem nos servicos de saude, bem como de maiores esforcos de gestores, profissionais de saude e docentes.

Percepção do paciente portador de glaucoma e os diferentes tipos de tratamento (clínico versus cirúrgico)

Objective: To identify the meaning and impact on their quality of life of having glaucoma and to understand the patients’ perception on the different types of treatment (medical or surgical). Methods: Through a qualitative research, focus groups were conducted with patients in clinical treatment (group 1) and patients who underwent glaucoma surgery in both eyes and were without medication (group 2). The responses were analyzed using the technique of content analysis. Results: Fear of blindness and lack of information about the disease were the most cited issues in relation to how it is like to having glaucoma. Medication costs, impact of drops on patients’ daily lives and the side effects were the main points discussed in relation to medical treatment. All patients in the surgical group preferred the current situation (without medication) when compared to the need for chronic use of medication. In the two groups, both glaucoma and its treatment had a profound impact on people, not only from a psychological standpoint, but also affecting their daily lives. Patients operated on for glaucoma appear to have less impact on their daily lives, but the concern about the disease persists. Conclusion: We identified the most significant negative aspects of glaucoma and its treatment from patients’ perspectives. Confidence in the correct indication of the type of treatment, clinical or surgical, and a solid relationship between the patient the doctor are determining factors for extra peace of mind of patients being treated for glaucoma.