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Resumo Este artigo investiga possíveis analogias entre a escuta e o olhar do documentarista Eduardo Coutinho e a atenção psicológica psicanaliticamente orientada. A filmografia de Eduardo Coutinho questiona a simples dualidade entre realidade e ficção. Também a psicanálise questiona essa dualidade, a partir de noções como realidade psíquica e realidade material, por exemplo. Freud chegou a afirmar que o aparelho psíquico se constitui enquanto ficção, problematizando os limites entre a realidade objetiva e o vivido. Em uma situação de análise, é por meio da associação livre por parte do paciente e da escuta interessada que acredita na verdade do sujeito por parte do analista que podem ocorrer transformações, de modo que representações sejam modificadas, situações traumáticas elaboradas, o sofrimento dirimido. Nesse caso, tanto a atenção psicológica quanto a de Eduardo Coutinho estariam atestando a existência dos sujeitos por meio de uma abertura radical à alteridade e tomando a existência também em sua vertente ficcional.

Poly (ADP-Ribose) polymerase inhibitors (PARPi) have emerged as a targeted therapy in cancer treatment with promising results in various types of cancer. This work aims to investigate the profile of adverse drug reactions (ADRs) associated with PARPi through the reports provided by the Eudravigilance (EV) database. We also intend to analyze the potential association of peripheral neuropathy to PARPi. Data on individual case safety reports (ICSRs) were obtained by accessing the European spontaneous reporting system via the EV website. A total of 12,762 ICSRs were collected from the EV database. Serious cases of nervous system disorders were analyzed providing strong evidence that peripheral neuropathy was reported in a higher frequency in patients treated with niraparib. Most cases reported a not recovered/not resolved outcome and involved drug withdrawal. However, several studies suggest that PARPi attenuate chemotherapy-induced painful neuropathy. Unexpected ADRs such as peripheral neuropathy may also occur, mostly in patients taking niraparib. Further pharmacovigilance studies should be conducted in this area to clarify with more precision the toxicity profile of these drugs.

Adverse drug reactions (ADRs) are responsible for almost 5% of hospital admissions, making it necessary to implement different pharmacovigilance strategies. The additional monitoring (AM) concept has been highlighted and intended to increase the number of suspected ADRs reported, namely in medicines with limited safety data. A prospective, descriptive study of active pharmacovigilance (AP) was conducted between 2019 and 2021 in the Local Health Unit of Matosinhos (LHUM) (Porto, Portugal). A model of AP for medicines under AM, namely oral antineoplastic agents, was designed. Follow-up consultations were performed, and adverse events (AEs) data were collected. The overall response to the treatment was evaluated through the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. A total of 52 patients were included in the study, and 14 antineoplastic drugs under AM were analyzed. Of the total number of patients included, only 29 developed at least one type of toxicity. Hematological disorders were the most reported suspected ADR. However, only four patients interrupted their treatment due to toxicity. After 12 months of treatment, most patients had disease progression, which was the main reason for therapy discontinuation. This AP model played an important role in the early detection of AEs and, consequently, contributed to better management of them. Increasing the number of suspected ADR reports is crucial for drugs with limited safety data.

Dapagliflozin, a sodium–glucose cotransporter 2 inhibitor (SGLT2i), has shown demonstrated benefits for renal and cardiovascular outcomes in large clinical trials. However, short-term concerns regarding its impact on renal function and electrolyte balance exist. This study aimed to evaluate the short-term effects of dapagliflozin on renal function and electrolyte balance in patients newly prescribed the medication. A retrospective analysis of 246 patients who initiated dapagliflozin therapy was conducted. Serum creatinine, sodium, and potassium levels were measured at baseline (before dapagliflozin) and 5–8 days after initiation (endpoint). A Wilcoxon signed-rank test, Pearson’s chi-square test, and Fischer’s exact test were used for the data analysis. Glycemia and sodium levels were significantly higher at the baseline compared to the endpoint (p < 0.001). Conversely, creatinine and potassium levels were significantly higher at the endpoint than at the baseline (p < 0.001). The prevalence of hyponatremia and hyperkalemia were increased at the endpoint (17.5% vs. 10.2% and 16.7% vs. 8.9%, respectively). Although not statistically significant, a trend towards increased hyponatremia with the co-administration of furosemide was observed (p = 0.089). No significant association was found between potassium-sparing medications (p > 0.05) and hyperkalemia, except for angiotensin receptor blockers (p = 0.017). The combination of dapagliflozin and furosemide significantly increased the risk of acute kidney injury (AKI) at the endpoint (p = 0.006). Age, gender, and chronic kidney disease status did not significantly influence the occurrence of AKI, hyponatremia, or hyperkalemia (p > 0.05). These findings emphasize the importance of the close monitoring of renal function and electrolyte balance, particularly in the early stages of dapagliflozin therapy, especially in patients receiving diuretics or renin–angiotensin–aldosterone system inhibitors.

Complementary and alternative medicine (CAM) has been fronted as an alternative due to its potential for holistic treatment. Many CAMs are plant-derived, including algae and mushrooms that have been used widely in many parts of the world, where they are regarded as biological response modifiers. The purpose of this article was to review the role of mushrooms as an adjuvant in conventional therapies, to reveal the therapeutic substances of mushrooms as an adjuvant in conventional therapies, to bring together the available scientific data on the medical effects of mushrooms in oncology, and verify its efficacy and safety. A literature search was conducted in September 2021 on the MEDLINE-PubMed and Cochrane databases to identify relevant randomized controlled trials or clinical trials studies addressing the use of whole mushroom formulations as complementary therapy during conventional cancer treatment.: The findings from the present study suggest that mushrooms may act as a potentiator of host defense mechanisms and decrease adverse events for patients with cancer undergoing conventional therapies. New protocols to conduct clinical trials are needed to elucidate the possible active mechanisms and clinical benefits of these fungi in various types of cancer.

Cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors are a recent targeted therapy approved for patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2 negative (HER2−) advanced breast cancer. Abemaciclib, palbociclib and ribociclib demonstrated great efficacy and safety during clinical studies. However, differences in their adverse-event profiles have been observed. This work aims to describe the suspected adverse drug reactions (ADRs), such as leukopenia and thrombocytopenia, reported for each CDK4/6 inhibitor in the EudraVigilance (EV) database. Data on individual case safety reports (ICSRs) were obtained by accessing the European spontaneous reporting system via the EV website. Information on concomitant drug therapy, including fulvestrant, letrozole, anastrozole and exemestane, was also analyzed. A total of 1611 ICSRs were collected from the EV database. Most reports of palbociclib and ribociclib were classified as serious cases for both suspected leukopenia and thrombocytopenia ADRs. However, most patients had their leukopenia and thrombocytopenia recovered/resolved. On the contrary, reports of abemaciclib were mostly characterized as non-serious cases. Abemaciclib and palbociclib were often combined with fulvestrant, while ribociclib was generally associated with letrozole. Pharmacovigilance studies are crucial for the early identification of potential ADRs and to better differentiate the toxicity profile of the different CDK4/6 inhibitors, particularly in a real-world setting.

Ethics and morals are concepts simultaneously immersed today in two phenomena that contradict each other. On the one hand, the scientific literature assumes a total separation and distinction between them. On the other hand, they remain, currently but indiscriminately, used as synonyms. Now, what we defend in this exercise of reflection is that both this contradiction and the separation itself constitute the most explicit result of a truly profound and thus crucial crisis — or inversion — of values, adding that the contradiction derives from the separation itself engineered in the intellectual world; which, in turn, has as its ultimate manifestations the social turmoil and the set of demands for justice that multiply in the various fields of activity throughout society. In this sense, always resorting to classical authors and contributions distant from the modernists and postmodernists who commit this fracture, the thesis is concluded by suggesting that, in order to assume and resolve what turns out to be a psychosocial tension, it will always be, somehow, necessary to recover the civilizational pillars that bring together the various dimensions rooted in the complexity of reality; logic which is embodied, after all, in the very etymological genetics that fuse ethics and morals.

Type 2 diabetes mellitus (T2DM) is closely associated with other pathologies, which may require complex therapeutic approaches. We aim to characterize the clinical and pharmacological profile of T2DM patients admitted to an emergency department. Patients aged ≥65 years and who were already using at least one antidiabetic drug were included in this analysis. Blood glycemia, creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and hemoglobin were analyzed for each patient, as well as personal pathological history, diagnosis(s) at admission, and antidiabetic drugs used before. Outcome variables were analyzed using Pearson’s Chi-Square, Fisher’s exact test, and linear regression test. In total, 420 patients were randomly selected (48.6% male and 51.4% female). Patients with family support showed a lower incidence of high glycemia at admission (p = 0.016). Higher blood creatinine levels were associated with higher blood glycemia (p = 0.005), and hyperuricemia (HU) (p = 0.001), as well as HU, was associated with a higher incidence of acute cardiovascular diseases (ACD) (p = 0.007). Hemoglobin levels are lower with age (p = 0.0001), creatinine (p = 0.009), and female gender (p = 0.03). The lower the AST/ALT ratio, the higher the glycemia at admission (p < 0.0001). Obese patients with (p = 0.021) or without (p = 0.027) concomitant dyslipidemia had a higher incidence of ACD. Insulin (p = 0.003) and glucagon-like peptide-1 agonists (GLP1 RA) (p = 0.023) were associated with a higher incidence of decompensated heart failure, while sulfonylureas (p = 0.009), metformin-associated with dipeptidyl peptidase-4 inhibitors (DPP4i) (p = 0.029) or to a sulfonylurea (p = 0.003) with a lower incidence. Metformin, in monotherapy or associated with DPP4i, was associated with a lower incidence of acute kidney injury (p = 0.017) or acute chronic kidney injury (p = 0.014). SGLT2i monotherapy (p = 0.0003), associated with metformin (p = 0.026) or with DPP4i (p = 0.007), as well as insulin and sulfonylurea association (p = 0.026), were associated with hydroelectrolytic disorders, unlike GLP1 RA (p = 0.017), DPP4i associated with insulin (p = 0.034) or with a GLP1 RA (p = 0.003). Insulin was mainly used by autonomous and institutionalized patients (p = 0.0008), while metformin (p = 0.003) and GLP1 RA (p < 0.0001) were used by autonomous patients. Sulfonylureas were mostly used by male patients (p = 0.027), while SGLT2 (p = 0.0004) and GLP1 RA (p < 0.0001) were mostly used by patients within the age group 65–85 years. Sulfonylureas (p = 0.008), insulin associated with metformin (p = 0.040) or with a sulfonylurea (p = 0.048), as well as DPP4i and sulfonylurea association (p = 0.031), were associated with higher blood glycemia. T2DM patients are characterized by great heterogeneity from a clinical point of view presenting with several associated comorbidities, so the pharmacotherapeutic approach must consider all aspects that may affect disease progression.

O consumo abusivo de substâncias psicoativas (SPA) está associado a prejuízos no funcionamento das áreas frontais, especificamente do córtex pré-frontal sendo de grande importância o entendimento e descrição das alterações comportamentais, emocionais e cognitivas visando diagnóstico bem como prever o curso de tratamento adequado através da investigação neuropsicológica. Este trabalho teve o objetivo de identificar quais os impactos neuropsicológicos em decorrência do uso abusivo de substâncias psicoativas e analisar de que forma esses prejuízos influenciam no tratamento da dependência de substâncias psicoativas. A partir dos artigos analisados foi possível identificar a importância da avaliação neuropsicológica para o diagnóstico prognóstico do uso de substâncias psicoativas, além de identificar as alterações corticais (de córtex pré-frontal) afetadas pelo uso indevido de SPA bem como reflexo dessas alterações no desempenho e comportamento dos usuários de SPA. A realização desta pesquisa permite apontar que compreender esse contexto tem impacto direto no tratamento uma vez que as intervenções devem observar as capacidades e necessidades individuais dos usuários dos serviços de atenção objetivando a adesão ao tratamento e remissão dos sintomas.

Type 2 diabetes mellitus is one of the main chronic diseases worldwide, with a significant impact on public health. Behavioral changes are an important step in disease prevention and management, so the way in which individuals adapt their lifestyle to new circumstances will undoubtedly be a predictor of the success of the treatments instituted, contributing to a reduction in the morbidity and mortality that may be associated with them. It is essential to prepare and educate all diabetic patients on the importance of changing behavioral patterns in relation to the disease, with health professionals assuming an extremely important role in this area, both from a pharmacological and non-pharmacological point of view, and also ensuring the monitoring of the progress of these measures. Diabetes is a chronic disease that requires a high self-management capacity on the part of patients in order to achieve success in treating the disease, and non-adherence to therapy or non-compliance with the previously defined plan, together with an erratic lifestyle, will contribute to failure in controlling the disease. The lower adherence to pharmacological and non-pharmacological treatment in diabetes is mainly correlated to socio-economic aspects, lower health literacy, the side effects associated with the use of antidiabetic therapy or even the concomitant use of several drugs. This article consists of a narrative review that aims to synthesize the findings published in the literature, retrieved by searching databases, manuals, previously published scientific articles and official texts, following the methodology of the Scale for Assessment of Narrative Review Articles (SANRA). We aim to address the importance of behavioral sciences in the treatment of diabetes, in order to assess behavior factors and barriers for behavior changes that have an impact on the therapeutic and non-therapeutic optimization in patients with type 2 diabetes mellitus control.

Janus associated kinases inhibitors are a new strategy for the treatment of different clinical conditions like immunologic, inflammatory and oncology disorders. The aim of this study was to perform a review of all Janus associated kinases inhibitors available in national and international pharmaceutical market, their therapeutic indications and adverse effects, and the potential indications for investigation of those already available in the pharmaceutical market. It was also performed a review of the main new Janus associated kinases inhibitors that are still in clinical research. A literature review was conducted by consulting the summary of product characteristics of Janus associated kinases inhibitors available in the pharmaceutical market and a research in the bibliographic database PubMed using the terms «JAK inhibitors», «Janus associated kinases inhibitors» and «Janus kinases inhibitors». Ninety-five publications were included in the present review, published from January 2014 to January 2015. Drug databases of the European Medicines Agency and United States Food and Drug Administration were also consulted to search for Janus associated kinases inhibitors authorized in clinical practice. Currently, ruxolitinib and tofacitinib are available in the pharmaceutical market and oclatinib is approved as a veterinary medicinal product. Both drugs approved for human use have major adverse effects at hematological and immunological levels, which enhance the importance of the pharmacist’s role in the monitoring of patients involved in these treatments. However, several molecules are in pre-clinical and clinical studies trying to prove its potential in the treatment of several immunologic, inflammatory and oncology disorders. Thus, it is still necessary to deepen the knowledge in this area in order to overcome the risks of therapy with these agents. These risks weighed against the benefits of its clinical use have compromised the progress of various Janus associated kinases inhibitors with therapeutic potential.

By increasing the activity of the immune system, immune checkpoint inhibitors (ICPI) can have adverse inflammatory effects, which are referred to as immune-related adverse effects (irAEs). In this review, we present the recommendations for the appropriate identification and treatment of irAEs associated with ICPI to increase the safety and effectiveness of therapy with these immuno-oncological drugs. Several guidelines to manage irAEs adopted by different American and European societies in the field of oncology were identified. A narrative review of the several strategies adopted to manage irAEs was performed. With close clinical surveillance, ICPI can be used even in patients who have mild irAEs. Moderate to severe events require early detection and appropriate treatment, particularly in patients with a history of transplantation or pre-existing autoimmune disease. In most cases, adverse reactions can be treated with the interruption of treatment and/or supportive therapy, which includes, in serious adverse reactions, the administration of immunosuppressants. The identification and treatment of irAEs in the early stages may allow patients to resume therapy with ICPI. This review is an instrument to support healthcare professionals involved in the treatment and monitoring of patients who are administered ICPI, contributing to the timely identification and management of irAEs.

Background: Type 2 diabetes mellitus is a chronic disease that is reaching epidemic proportions worldwide. It is imperative to adopt an integrated strategy, which involves a close collaboration between the patient and a multidisciplinary team of which pharmacists should be integral elements. Objective: This work aims to identify and summarize the main effects of interventions carried out by clinical pharmacists in the management of patients with type 2 diabetes, considering clinical, humanistic and economic outcomes. Methods: PubMed and Cochrane Central Register of Controlled Trials were searched for randomized controlled trials assessing the effectiveness of such interventions compared with usual care that took place in hospitals or outpatient facilities. Results: This review included 39 studies, involving a total of 5,474 participants. Beneficial effects were observed on various clinical outcomes such as glycemia, blood pressure, lipid profile, body mass index and coronary heart disease risk. For the following parameters, the range for the difference in change from baseline to final follow-up between the intervention and control groups was: HbA1c, -0.05% to -2.1%; systolic blood pressure, +3.45 mmHg to -10.6 mmHg; total cholesterol, +10.06 mg/dL to -32.48 mg/dL; body mass index, +0.6 kg/m2 to -1.94 kg/m2; and coronary heart disease risk, -3.0% and -12.0% (among the studies that used Framinghan prediction method). The effect on medication adherence and health-related quality of life was also positive. In the studies that performed an economic evaluation, the interventions proved to be economically viable. Conclusions: These findings support and encourage the integration of clinical pharmacists into multidisciplinary teams, underlining their role in improving the management of type 2 diabetes.

Os inibidores das Janus Associated Kinases (JAK) são uma estratégia recente direcionada para o tratamento de diversas patologias como a artrite reumatoide, a psoríase, a alopecia areata e diversos tipos de cancro. Contudo, estes medicamentos estão associados a reações adversas graves, estando subentendida a importância da monitorização farmacoterapêutica dos doentes submetidos a estes tratamentos. O objetivo do estudo foi efetuar uma revisão dos diferentes inibidores das JAK aprovados no mercado nacional e internacional, as suas indicações terapêuticas e efeitos adversos, bem como as potenciais indicações em investigação dos inibidores das JAK já introduzidos no mercado farmacêutico. Foi, também, efetuada uma revisão dos principais inibidores das JAK que se encontram em investigação clínica. Efetuou-se uma revisão bibliográfica do Resumo das Características do Medicamento (RCM) dos inibidores das JAK disponíveis no mercado farmacêutico, bem como uma pesquisa na base de dados eletrónica da PubMed, recorrendo aos termos «JAK inhibitors», «Janus Associated Kinases inhibitors» e «Janus Kinases inhibitors». Foram considerados os artigos publicados desde janeiro de 2014 até janeiro de 2015, tendo sido incluídos 92 artigos na revisão efetuada. Foram também consultadas as bases de dados da European Medicines Agency (EMA) e da United States Food and Drug Administration (FDA) de forma a identificar os inibidores das JAK autorizados na prática clínica. Atualmente, apenas o ruxolitinib e o tofacitinib estão disponíveis no mercado farmacêutico, subsistindo, ainda, a aprovação do oclatinib enquanto medicamento de uso veterinário. Ambos os fármacos de uso humano apresentam efeitos adversos major ao nível hematológico e imunológico, facto que reforça a importância do papel do farmacêutico no acompanhamento dos doentes implicados nestes tratamentos. Encontram-se em estudos pré-clínicos e clínicos inúmeras moléculas que tentam provar o seu potencial no tratamento de diversas patologias de natureza autoimune, inflamatória e oncológica. Desta forma, é, ainda, necessário aprofundar o conhecimento nesta área por forma a ultrapassar os riscos inerentes à terapia com estes agentes, riscos esses que, contrabalançados com os benefícios do seu uso clínico, têm comprometido o avanço de diversos inibidores das JAK com potencial terapêutico demonstrado.

Este estudio tuvo como objetivo determinar la prevalencia de consumo de sustancias psicoactivas en los adolescentes de la escuela secundaria en la ciudad de Maceió, estado de Alagoas. Este fue un estudio transversal. La muestra fue compuesta por 407 estudiantes y el estudio fue conducido en cuatro escuelas públicas y tres privadas. Los participantes respondieron a un cuestionario sociodemográfico y a una encuesta sobre el uso de sustancias psicoactivas. El alcohol fue la sustancia más consumida en los cinco modos de uso: la vida, año, mes, consumo frecuente y consumo intenso. El uso en la vida era más frecuente en los adolescentes del sexo masculino y estudiantes de escuelas privadas. La investigación analiza la necesidad de llevar a cabo proyectos de prevención de drogas y promoción de la salud

The discovery of mutations in tyrosine kinases (TKs) involved in the pathogenesis of many diseases, particularly oncological, encouraged the investigation of inhibitors of tyrosine kinases (ITKs) as therapeutic strategies. The aim of this study was to perform a review of the different ITKs available in the national and international markets, their therapeutic indications, and their potential directions in research. It was also a revision of the main ITKs which are currently being evaluated in various stages of clinical trials. We conducted a literature search in the PubMed electronic database using the term “tyrosine kinase inhibitors” and 219 publications were included in the present review, published from August 2011 to July 2012. We also consulted the databases of the Portuguese National Authority of Medicines and Health Products, IP (INFARMED), the European Medicines Agency (EMA) and the United States Food and Drug Administration (FDA). Presently there are 14 ITKs approved by FDA. In Portugal there are 13 ITKs with marketing authorization (MA), and bosutinib currently in the authorization phase. There are ITKs approved for the treatment of chronic myeloid leukemia, acute lymphoblastic leukemia, carcinoma of non-small-cell lung cancer, renal cell carcinoma, hepatocellular carcinoma, breast cancer, gastrointestinal stromal tumor, pancreatic neuroendocrine carcinoma, thyroid carcinoma, myelofibrosis and soft tissue sarcomas. ITKs are under investigation for other potential indications such as autoimmune diseases, namely rheumatoid arthritis and psoriasis, among others. Because there is a wide variety of TKs and not all of them are yet studied, more research is needed so that other potential therapeutic targets can be discovered in the future. The TKs are therefore a promising therapeutic target, which makes the ITKs a pharmacological class with great clinical potential.

El crack se volvió, en las últimas décadas, una problemática de salud pública, en la sociedad brasileña. Esta investigación tuvo como objetivo verificar las representaciones de la recaída en dependientes de crack a la luz de la teoría de Moscovici. El estudio fue realizado con seis participantes, que estaban en tratamiento de dependencia química en una residencia terapéutica. Para recogida de datos fue utilizada una entrevista-semiestructurada, el tratamiento de los datos fue hecho con el Análisis de Contenido. Los resultados apuntan la dificultad de que los entrevistados sobrepasen la desintoxicación y la meta de la abstinencia. Se concluye que la idealización de la meta de la abstinencia es indisociable de la constante amenaza de recaída, representada como cualquier consumo de substancia psicoactiva durante o después del tratamiento.

The pregnancy is the first cause of internments (66%) in young women with age of 10 the 19 years in net SUS and the AIDS has been responsible for the potential years of lost life between young. In this study, one searched to identify the perception of this risk between adolescents in relation to AIDS and the risk factors related to sexual practice without protection. For this, one selected 32 adolescents, distributed in two pertaining groups to the classroom and the two to Classroom D, as specifications of the Abep. The method used for collection and analysis of data was the Focal Group. The pointed results as cause of this practical demonstrated little chance for this practice and restricted use of the protection information that had. The told consequences had been HIV/DST and precocious pregnancy. The presented factors of protection involved to prevent the sex and to select partners.

El embarazo es la principal causa de hospitalizaciones (66%) niñas en edades comprendidas entre 10 a 19 años en la red del SUS, y el SIDA se ha encargado de años potenciales de vida perdidos entre los jóvenes. En este estudio se buscó identificar la percepción de los adolescentes en relación a la contaminación de SIDA y los factores de riesgo asociados a la práctica sexual sin protección. Para ello, recogió 32 adolescentes, distribuidos en dos grupos pertenecientes a la clase A y dos de clase D, según especificaciones de Abep. El método utilizado para la recolección y análisis de datos fue la Coordinadora de Grupo. Los resultados de relieve como una de las causas de esta práctica mostró pocas oportunidades de tener relaciones sexuales y el uso de la información restringido exclusivamente a proteger la bodega. Las consecuencias fueron notificados de VIH/ETS y los embarazos precoces. Los factores de protección para evitar la participación de los profesionales del sexo y seleccionar socios.

As fosfodiesterases dos nucleótidos cíclicos (PDE) são enzimas que regulam os níveis celulares dos segundos mensageiros adenosina 3´,5´-monofosfato cíclico (AMPc) e de guanosina 3´,5´-monofosfato cíclico (GMPc) através do controlo das suas taxas de degradação. O aumento dos níveis intracelulares de AMPc e GMPc, através da inibição das PDE, constitui uma estratégia extremamente útil para a obtenção de diversos efeitos farmacológicos com aplicação clínica relevante. A diferente distribuição tecidular e celular e a grande diversidade na estrutura, regulação e função das isoenzimas de PDE permitem o desenvolvimento de inibidores seletivos para cada uma das isoenzimas, dotados de grande interesse farmacológico. Neste artigo é feita uma revisão dos diferentes inibidores das PDE disponíveis no mercado farmacêutico nacional e internacional e das suas aplicações na terapêutica farmacológica. É ainda feita uma abordagem dos principais inibidores das PDE que se encontram atualmente em fase de investigação, bem como do potencial terapêutico da inibição de determinadas PDE. Foi efetuada uma revisão da literatura científica, através da pesquisa bibliográfica na PubMed, utilizando os termos «cyclic nucleotide phosphodiesterases» e «phosphodiesterase inhibitors», para a obtenção de referências bibliográficas publicadas desde 1998 até ao momento atual. Foram ainda consultadas as bases de dados de medicamentos da Autoridade Nacional do Medicamento e Produtos de Saúde, I. P. (INFARMED), da European Medicines Agency (EMA) e da Food and Drug Administration (FDA) para pesquisa dos inibidores das PDE autorizados para utilização na prática clínica. Atualmente, encontram-se disponíveis no mercado farmacêutico mundial 15 inibidores seletivos das PDE, utilizados como cardiotónicos, relaxantes do músculo liso vascular e brônquico, antitrombóticos, anti-inflamatórios e antidepressivos. Os inibidores das PDE disponíveis em maior número são os inibidores das famílias 3 e 5, mas existem muitos outros inibidores seletivos com interesse na terapêutica farmacológica e um número considerável de fármacos em fase de desenvolvimento para utilização clínica.

O objetivo deste estudo foi relacionar ansiedade e consumo de substâncias psicoativas em adolescentes da cidade de Maceió, Alagoas. Trata-se de um estudo descritivo, transversal, com 407 estudantes de 14 a 18 anos. Para coleta de dados foi utilizado um questionário sociodemográfico, escala de ansiedade do adolescente e um questionário sobre o consumo de substâncias psicoativas. Fez-se a análise através do teste Qui-quadrado e exato de Fisher. O álcool foi a substância lícita mais consumida, e o solvente, a ilícita mais consumida. Os participantes apresentaram maior percentual no nível moderado: 28%. O uso na vida de solventes (p=0,037) e energéticos (p=0,023), o uso no ano de cigarro (p=0,043) e álcool (p=0,007) e o uso frequente de álcool (p

O objetivo deste estudo foi descrever e discutir a experiência dos dirigentes de instituições que dão assistência a dependentes de drogas no Vale do Paraíba, São Paulo, Brasil. Trata-se de pesquisa qualitativa e exploratória com dez dirigentes de instituições de assistência em dependência química. Foram realizadas entrevistas semidirigidas e o material transcrito foi submetido à análise de conteúdo. Encontrou-se que há falta de profissionais especializados e de equipes interdisciplinares da área de saúde, bem como de planejamento e funcionamento das instituições. Observou-se a presença de atividades de cunho religioso pautadas pelo discurso de ajuda ao próximo e a valorização de tarefas direcionadas ao trabalho, a disciplina e a espiritualidade. Conclui-se que é importante os dirigentes de instituições que prestam atendimento a dependentes de drogas desenvolverem ou mesmo adquirirem formação para trabalhar no complexo campo da reabilitação dessa população clínica, habitualmente estigmatizada e excluída.

Esta pesquisa foi realizada com profissionais de Saúde Mental, de diversas formações de nível universitário que atendem drogadependentes nas cidades de Taubaté e São José dos Campos, localizadas no Vale do Paraíba, Estado de São Paulo. Investigaramse características relativas à formação, atuação e alguns dos pontos de vista e observações destes profissionais sobre a experiência de atendimento a pacientes que apresentam transtornos relacionados a substâncias. Os diálogos com os entrevistados indicaram que há insatisfação com os resultados obtidos e com as condições de trabalho. Praticamente não há cursos de reciclagem, controle de eficácia, ou follow-up. A improvisação e o uso de técnicas ecléticas predominam sobre as intervenções definidas e avaliadas sistematicamente. A experiência assistencial é dominante em relação à de pesquisa, ou de atualização da literatura científica especializada.