A fitoterapia e o uso de plantas medicinais fazem parte da prática da medicina popular, que complementa o tratamento usualmente empregado para a população de menor renda. O trabalho analisou o conhecimento de gestores e profissionais de saúde que atuam na atenção primária (APS), sobre fitoterapia, nos municípios de Cascavel e Foz do Iguaçu, Paraná. Entre fevereiro e julho de 2009, realizou-se estudo exploratório, descritivo, qualitativo, empregando entrevistas e questionário estruturado. Um gestor relatou interesse na implantação do programa, os demais profissionais entrevistados não receberam formação sobre o tema durante a graduação ou nas Unidades Básicas de Saúde (UBS) onde trabalham. Seis profissionais (60%) relataram ter acesso às informações sobre fitoterapia através do conhecimento popular, uma (10%) formação na UBS, dois (20%) através de periódicos, quatro (40%) através de meio de comunicação e quatro citaram mais que uma das opções. Em Foz do Iguaçu, nas UBS onde a terapêutica foi introduzida, os profissionais não foram consultados antes de sua implantação. Para instituir a fitoterapia nas UBS desses dois municípios é necessário capacitar os profissionais quanto ao tema, desde o cultivo até a prescrição, melhorando o uso racional desses medicamentos.

OBJETIVO: Avaliar a qualidade do uso de medicamentos através da análise do padrão do uso, do grau de concordância com listas de medicamentos essenciais, do valor terapêutico e das interações medicamentosas encontradas entre mulheres com mais de 60 anos. MÉTODOS: Foram pesquisadas 634 mulheres que freqüentam a Universidade Aberta da Terceira Idade da Universidade do Estado do Rio de Janeiro. Os dados foram coletados através de questionário padronizado e testado. As variáveis utilizadas foram relativas aos medicamentos e a seu modo de utilização. As unidades de análise foram o medicamento e o indivíduo. RESULTADOS: Das 634 mulheres estudadas, 9,1% não tomam qualquer tipo de medicamento. A média de medicamentos consumidos foi de 4,0 por mulher. Das 2.510 especialidades farmacêuticas citadas, há 538 princípios ativos diferentes. Cerca de 26% dos medicamentos são concordantes com as recomendações da Organização Mundial da Saúde, e 17%, com as da Relação Nacional de Medicamentos Essenciais. Cerca de 17% dos medicamentos são inadequados para o uso. No que diz respeito a redundâncias, 14,1% das mulheres podem sofrer conseqüências decorrentes desse evento. Quanto às interações medicamentosas, 15,5% das entrevistadas estão expostas às principais interações. CONCLUSÕES: Os dados sugerem que o padrão do uso dos medicamentos entre as idosas é bastante influenciado pela prescrição médica e que sua qualidade é prejudicada pela baixa seletividade do mercado farmacêutico.

Acute lymphoblastic leukemia (ALL) is the cancer with the highest incidence in childhood and adolescence, and pharmacotherapy is the primary form of treatment. A systematic review of the efficacy and safety of polyethylene glycol (PEG)-asparaginase in acute lymphoblastic leukemia therapy in children and adolescents was conducted to compare it with native Escherichia coli L-asparaginase. PubMed, Web of Science, Science Direct, Cochrane Library, Scopus, LILACS (Latin American and Caribbean Health Sciences Literature) and EMBASE databases were selected. The following outcomes were analyzed: complete remission of the disease, event-free survival, overall survival, anti-asparaginase antibody level, hypersensitivity reactions, asparaginase and asparagine serum levels, number of postdiagnosis events, and overall mortality. Five randomized controlled trials were included. Analysis of the quality of evidence and risk of bias was performed using the Cochrane recommendation tool and the GRADE system. The assessment results suggest that the level of certainty on the technology addressed is relatively weak from a methodological point of view. Evidence is insufficient to assess the effects on health outcomes because of the limited number and power of studies and important flaws in their design or conduct in classifying PEG-asparaginase as a superior drug or not, in the pharmacotherapy of ALL in children and adolescents. PEG-asparaginase can be used as a substitute for native E. coli L-asparaginase, demonstrating similar efficacy and safety. The study may help decision-makers in the public health system to offer a more in-depth judgment on the therapeutic alternatives used to treat this neoplasm in children and adolescents.

Background: Pharmacists’ participation in health care within multi-disciplinary teams in Humanitarian Assistance (HA) shall be encouraged. Limited literature exists on their role in the humanitarian context. The objective of this paper is to evidence the skill-specific, comprehensive core competencies that pharmacists must demonstrate working in humanitarian interventions.Methods: The literature search laid the groundwork for the development of interview guides and further analysis of the data. Semi-structured interviews were conducted with expatriate pharmacists and medical coordinators, all of whom have worked in the field of HA. The interviews were recorded, transcribed, and analyzed using a content analysis methodology.Results: Three pharmacists and three medical coordinators were interviewed, who had worked in a combined 32 humanitarian missions. The main functions of pharmacists were focused on stock management and supply of medicinal products. However, pharmacists in HA did not perform many functions related to the provision of effective medication therapy management (MTM). A core competency framework for pharmacists working in the humanitarian field was created, which reflects the personal and technical competencies that are essential to work in HA.Conclusion: Self-management in a pressured and changing environment, the ability to adapt to changing situations, and planning, prioritizing, and performing tasks well under pressure are the skills required for pharmacists and for any other humanitarian health worker. The results highlight great efforts being dedicated to pharmaceutical product supply and management by pharmacists working in HA. Vardanyan H , Mosegui GBG , Miranda ES . Skills and core competencies of pharmacists in humanitarian assistance. Prehosp Disaster Med. 2018;33(3):266–272.

Functional foods are generally defined as foods that, due to their physiologically active substances, benefit health in addition to providing basic nourishment. As Brazilian legislation does not provide a definition for functional foods, the only possible actions is to claim that some foods have functional health proprieties. Based on a review of legislation, this paper discusses not only the lack of transparency in relation to the categories of products classified as foods and medicinal plants, but also the interactions and contradictions of functional food product legislation. Products may be classified either within the "New Food/or Ingredient category" or as "Bioactive Substances or Isolated Probiotics with Functional Properties and/ or Health Claims". Products such as garlic can also be classified into multiple food categories and as medicinal plants. Intersections in food legislation, especially with respect to functional and new food products, lead to misunderstandings and even omissions on the part of Brazilian National Sanitary Surveillance Agency (ANVISA). Moreover, health claims on food product labels can make distinction between foods and medicines difficult for consumers. In Brazil, clearer rules for the industry are necessary so that the consumer is not deceived by false cure promises.

Introduction: Respiratory diseases (RD) are an important public health problem. Their burden has not been comprehensively evaluated in South America (SA). This study describes the burden of acute respiratory infections (ARIs) in SA in 2019. Methodology: This is an exploratory, population-based study with a quantitative approach to incidence, mortality, and Disability-adjusted life years (DALYs) by standardized age group among the 12 countries. Measurements were captured through the Institute for Health Metrics and Evaluation (IHME) website. It used the Burden Study Global Disease, Injury and Risk Factors (GBD) 2019 assessment. Correlation analyses were performed. Results: The age-standardized incidence rate per 1,00,000 people for lower respiratory infections (LRIs) is lowest in Chile (3,902) and highest in Peru (9,997). For upper respiratory infections (URIs), Bolivia (2,25,826) had the lowest rates, while Brazil (3,16,667) and Colombia (3,06,302) had the highest. Standardized mortality rates for LRI were lowest in Colombia (15.10) and highest in Bolivia (80.53). Bolivia had the highest standardized DALY rate (2,083), while Uruguay had the lowest (468). Upper ARI had lower incidence rates than lower ARI. The lowest DALY rates were in Suriname (82) and the highest were in Brazil (111). There is a correlation between sociodemographic and economic health indicators and the standardized rates of incidence and DALY in the upper ARIs. Conclusions: The present paper provides comprehensive ARI burden estimates for the region. The substantial incidence and considerable mortality and DALYs are noteworthy and lead to reflections on preventive measures such as rational use of antibiotics and deeper epidemiological investigations.