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In prostate cancer (PCa), androgens upregulate tumorigenesis, whereas in benign tissue, the revival of androgen receptor (AR) signaling suppresses aggressive behaviors, suggesting therapeutic potential. Dogs, natural PCa models, often lack AR in PCa. We restored AR in dog PCa to investigate resultant characteristics. Three AR-null canine PCa lines (1508, Leo, 1258) were transfected with canine wild-type AR and treated with dihydrotestosterone (DHT). In 1508, AR restoration decreased clonogenicity (p = 0.03), viability (p = 0.004), migration (p = 0.03), invasion (p = 0.01), and increased expression of the tumor suppressor NKX3.1, an AR transcriptional target (p = 0.001). In Leo, AR decreased clonogenicity (p = 0.04) and the expression of another AR transcriptional target FOLH1 (p < 0.001) and increased the expression of NKX3.1 (p = 0.01). In 1258, AR increased migration (p = 0.006) and invasion (p = 0.03). Epithelial-mesenchymal transition (EMT) marker (Vimentin, N-cadherin, SNAIL1) expression increased with AR restoration in Leo and 1258 but not 1508; siRNA vimentin knockdown abrogated AR-induced 1258 migration only. Overall, 1508 showed AR-mediated tumor suppression; AR affected proliferation in Leo but not migration or invasion; and EMT and AR regulated migration and invasion in 1258 but not proliferation. This study highlights the heterogeneous nature of PCa in dogs and cell line-specific effects of AR abrogation on aggressive behaviors.

Abstract Background Canine mammary tumours (CMT) are among the most common types of tumours in female dogs. Diagnosis currently requires invasive tissue biopsies and histological analysis. Tumour cells shed extracellular vesicles (EVs) containing RNAs and proteins with potential for liquid biopsy diagnostics. We aimed to identify CMT subtype-specific proteome profiles by comparing the proteomes of EVs isolated from epithelial cell lines derived from morphologically normal canine mammary tissue, adenomas, and carcinomas. Methods Whole-cell protein lysates (WCLs) and EV-lysates were obtained from five canine mammary cell lines: MTH53A (non-neoplastic); ZMTH3 (adenoma); MTH52C (simple carcinoma); 1305, DT1406TB (complex carcinoma); and their proteins identified by LC-MS/MS analyses. Gene Ontology analysis was performed on differentially abundant proteins from each group to identify up- and down-regulated biological processes. To establish CMT subtype-specific proteomic profiles, weighted gene correlation network analysis (WGCNA) was carried out. Results WCL and EVs displayed distinct protein abundance signatures while still showing the same increase in adhesion, migration, and motility-related proteins in carcinoma-derived cell lines, and of RNA processing and RNA splicing factors in the adenoma cell line. WGCNA identified CMT stage-specific co-abundant EV proteins, allowing the identification of adenoma and carcinoma EV signatures not seen in WCLs. Conclusions EVs from CMT cell lines exhibit distinct protein profiles reflecting malignancy state, allowing us to identify potential biomarkers for canine mammary carcinomas, such as biglycan. Our dataset could therefore potentially serve as a basis for the development of a less invasive clinical diagnostic tool for the characterisation of CMT.

Este é um estudo transversal com coleta de dados retrospectiva que analisou 356 pacientes internados em hospital universitário referência em casos graves por COVID-19 no período temporal da primeira e segunda onda no Rio Grande do Sul, Brasil. A mortalidade foi o desfecho de interesse e variáveis significativas foram submetidas à regressão de Poisson. Noventa e nove (27,8%) pacientes tiveram óbito como desfecho. Baixa escolaridade, admissão em mal estado geral, desnutrição, ausência de diagnóstico prévio de COVID-19, apresentar outros sintomas que não gripais ou respiratórios e ter polifarmácia foram mais frequentes nos pacientes que morreram. Foram encontradas taxa de filtração glomerular reduzida, D-Dímero, proteína C reativa, uréia e Razão Normalizada Internacional elevadas quando da admissão hospitalar dos pacientes que morreram. Não foram encontradas diferenças nos óbitos entre os períodos da pandemia. Após análise multivariada, os fatores relacionados ao óbito, em ordem decrescente de prevalência, foram institucionalização, ventilação mecânica prolongada (>21 dias) e por até 21 dias, alta Razão Normalizada Internacional na admissão, idade acima de 65 anos, necessidade de diálise e insuficiência respiratória aguda. Os resultados auxiliam no conhecimento do comportamento da doença e fornecem subsídios para treinamento e alocação de recursos em cenários de demandas exponenciais de atendimento, como surtos e epidemias.

Parturition in dogs is subjected to complex hormonal regulation, with the involvement of prostaglandin F2α (PGF2α) still not fully understood. To investigate uterine inertia (UI), the most prevalent maternal reason for dystocia in the bitch, a better understanding of undisturbed uterine, especially myometrial function, is crucial. Our aim was to gain deeper insights into the role of PGF2α in the canine parturient myometrium. Uterine biopsies were obtained during medically indicated cesarean sections. To test for stimulatory effects of PGF2α in vitro, circular and longitudinal myometrial layer tissue strips were challenged with 50 pM, 0.5 µM, and 50 µM PGF2α. Prostaglandin-endoperoxide synthase 2 (PTGS2) and PGF2α-receptor (PTGFR) mRNA expressions were compared between primary UI (PUI) and obstructive dystocia (OD) samples in isolated parturient myometrium. PTGFR protein expression was assessed in full thickness uterine samples. PGF2α concentrations were analyzed in canine interplacental tissue around term. In the organ bath, the contractile response to PGF2α was limited to the circular layer at the highest dosage. Correspondingly, PTGFR immunohistochemical staining was significantly stronger in the circular layer (p ≤ 0.01). PTGS2 gene expression did not differ between PUI and OD, whereas PTGFR gene expression could not be quantified. Local uterine PGF2α concentrations correlated negatively with serum P4 levels and were the highest during prepartum luteolysis while being significantly lower in PUI. Conclusively, despite the significant increase in local PGF2α concentrations at birth, confirming the interplacental tissue as a production site, our results suggest that PGF2α might affect uterine contractility during labor, mainly indirectly.

Objective: to estimate the prevalence of medication-induced delirium and drug-related problems (DRP) in older people hospitalized in intensive care unit (ICU). Methods: A systematic review were conducted in PubMed, EMBASE, LILACS, Ageline, Web of Science, and Cochrane databases (until March 2023). Clinical trials and observational studies that investigated the contribution of medication in the occurrence of delirium and compared with critically ill older patients (aged≥65 years old) without the syndrome were included. We excluded emergency departments, medical wards, primary and secondary healthcare levels, patients with delirium tremens; metabolic encephalopathy; dementia; palliative care; and brain metastasis. The references were entered into Rayyan QCRI. Two pairs of reviewers selected the articles, extracted data, and assessed the risk of bias (ROBINS-I). Results: Of 12,492 studies retrieved, after de-duplication exclusion (n=6,025), title/abstract (n=6,467) and full reading (n=286), two met the inclusion criteria. Both were observational (cohort), developed in high-income countries, with high level of risk of bias (overall). The frequency of delirium and subsyndromal delirium was 15.8% to 33.9%. Independent risk factors were the exposure of opioids and use of corticosteroids. Delirium increased the length of hospital stay in ICU, and the mechanical ventilation. Conclusion: Further studies are necessary to understand the DRP and characteristics of pharmacotherapy associated with delirium in critically ill older people. Adverse drug reactions and deliriogenic load seem to contribute to the occurrence of syndrome.

Introdução: Minimizar desperdícios, garantindo o controle e uso adequado de medicamentos é um dos desafios do profissional farmacêutico no âmbito hospitalar. Como os medicamentos representam um dos maiores custos hospitalares, a revisão de processos para assegurar o consumo racional, seguro e sustentável de medicamentos é desafiador e de extrema importância. Em 2022, o serviço de farmácia em conjunto com o serviço de hemodinâmica do hospital universitário do sul do Brasil realizou o redesenho do fluxo de medicamentos para a unidade. Objetivos: Descrever a reestruturação da gestão de medicamentos no serviço de hemodinâmica e analisar o consumo de medicamentos antes e após reestruturação dos processos de trabalho. Material e Método: Estudo descritivo com coleta de dados retrospectiva. A análise contemplou 30 medicamentos de maior consumo na hemodinâmica nos períodos de novembro/2021 a abril/2022 (período pré) e novembro/2022 a abril/2023 (período pós). Resultados: A reestruturação do atendimento foi realizada por equipe multiprofissional composta por farmacêuticos, médicos e enfermeiros. Realizou-se a padronização do quantitativo máximo de medicamentos em sala cirúrgica com base no consumo histórico e a reposição passou a ocorrer de forma diária por sala. A composição dos kits foi readequada e a sala de recuperação passou a ser atendida através de correio pneumático, eliminando a etapa de deslocamento da enfermagem. Dos 30 medicamentos analisados, 21 (70%) apresentaram redução de consumo, 1 (3,3%) não teve o consumo alterado e 7 (23,3%) apresentaram aumento de consumo em comparação ao período pré. Seis meses após implantação, houve redução de 21,74% (n=2304) do consumo total dos medicamentos analisados, gerando uma economia de 14,9% e, em valor, R$ 20.917,53. Os medicamentos que apresentaram maior redução no consumo foram, em ordem decrescente: morfina (-88,6%), remifentanil (-86,0%), midazolam (-84,8%), diazepam (-81,8%), fentanil (-76,1%), propofol (-74,1%), tiopental (-55,0%) e dipirona (-46,8%). Os medicamentos que apresentaram aumento de consumo, em ordem crescente, foram: cefazolina (1,6%), clonidina (3,2%), nitroglicerina (4,5%), dexametasona (12,6%), hidrocortisona (13,6%), metaraminol (17,1%) e adrenalina (38,1%). Discussão e Conclusões: A partir da análise preliminar de dados de consumo, observa-se que, em seis meses de implantação da gestão dos estoques por um farmacêutico, com a alteração do processo de dispensação e reposição de estoque no serviço de hemodinâmica, houve importante redução de consumo de diversos medicamentos, além de otimização do serviço de enfermagem. A alteração na gestão da cadeia medicamentosa no serviço de hemodinâmica, através do redesenho de processos relacionados à dispensação e disponibilização de medicamentos no setor agregou maior segurança no controle de estoque, redução de desperdícios, racionalidade no e benefício econômico à instituição em virtude da redução no consumo de alguns fármacos.

Introdução: Na pandemia de COVID-19, uma gama variada de medicamentos foi sendo noticiada pela mídia e divulgada em publicações científicas como potenciais tratamentos para o coronavírus, causando o uso indiscriminado de medicamentos para tratamento, manejo e prevenção dos sintomas da doença. Objetivos: Descrever a farmacoterapia no cenário domiciliar e hospitalar dos pacientes que foram hospitalizados por COVID-19 por tempo igual ou superior a 48h entre março de 2020 a setembro de 2021 em hospital universitário de alta complexidade. Material e Método: Estudo transversal com coleta de dados retrospectiva analisou o prontuário eletrônico de 356 pacientes internados em hospital universitário referência no atendimento de casos graves por COVID-19 na primeira e segunda onda no Rio Grande do Sul, Brasil. Resultados: A amostra foi composta por 56,5% (n=201) homens e 43,5% (n=155) mulheres, com mediana de 62 anos. Destes, 40,2% (n=143) internaram na primeira onda de COVID-19 e 59,8% (n=213) na segunda, e 27,8% (n=99) vieram a óbito. Ao todo, 34,8% (n=124) dos pacientes utilizaram algum medicamento para a COVID-19 antes da internação, sendo azitromicina (67,7%), amoxicilina+clavulanato (27,4%), prednisona (21,7%), ivermectina (15,3%) e dexametasona (15,3%) os mais utilizados. Foi identificado o uso crônico de 179 medicamentos por 71,6% (n=255) dos pacientes, sendo mais prevalente entre as mulheres 78,0% (n=121) e 28,1% (n=100) apresentavam polifarmácia. Os medicamentos crônicos mais utilizados foram losartana (23,9%), metformina (22,7%), sinvastatina (22,7%), omeprazol (21,9%) e anlodipino (21,1%). Na internação, os medicamentos mais prescritos na emergência foram dipirona (88,6%), dexametasona (69,0%), enoxaparina (61,5%), amoxicilina+clavulanato (53,7%), metoclopramida (35,8%), azitromicina (35,1%) e omeprazol (29,3%). Na terapia intensiva, a maior frequência de prescrição foi entre os medicamentos dipirona (75,8%), fentanil (62,5%), omeprazol (61,6%), midazolam (58,9%), noradrenalina (57,0%) e dexametasona (56,1%). Em leito de enfermaria, dipirona (83,3%), enoxaparina (63,4%), omeprazol (54,1%), dexametasona (51,8%), heparina (38,5%) e metoclopramida (35,2%) foram os medicamentos mais prescritos. Discussão e Conclusões: O uso por um terço dos pacientes de medicamentos off label para tratar ou prevenir a COVID-19 entre a primeira e segunda onda refletem o cenário incentivado pelas mídias sociais e por autoridades governamentais no contexto brasileiro. O uso de medicamentos na internação hospitalar demonstra a complexidade do cuidado e gravidade do paciente com COVID-19. Este estudo caracteriza o cenário de utilização de medicamentos no contexto ambulatorial e hospitalar pela população que necessitou de internação hospitalar por COVID-19 durante a primeira e segunda onda no RS, trazendo oportunidades para o estabelecimento de estratégias para o uso racional de medicamentos e fornecendo subsídios para auxiliar os gestores de saúde em cenários de escassez de suprimentos e demandas exponenciais de atendimento.

Chronic asymptomatic idiopathic orchitis (CAO) is an important but neglected cause of acquired infertility due to non-obstructive azoospermia (NOA) in male dogs. The similarity of the pathophysiology in infertile dogs and men supports the dog's suitability as a possible animal model for studying human diseases causing disruption of spermatogenesis and evaluating the role of spermatogonial stem cells (SSCs) as a new therapeutic approach to restore or recover fertility in cases of CAO. To investigate the survival of resilient stem cells, the expression of the protein gene product (PGP9.5), deleted in azoospermia like (DAZL), foxo transcription factor 1 (FOXO1) and tyrosine-kinase receptor (C-Kit) were evaluated in healthy and CAO-affected canine testes. Our data confirmed the presence of all investigated germ cell markers at mRNA and protein levels. In addition, we postulate a specific expression pattern of FOXO1 and C-Kit in undifferentiated and differentiating spermatogonia, respectively, whereas DAZL and PGP9.5 expressions were confirmed in the entire spermatogonial population. Furthermore, this is the first study revealing a significant reduction of PGP9.5, DAZL, and FOXO1 in CAO at protein and/or gene expression level indicating a severe disruption of spermatogenesis. This means that chronic asymptomatic inflammatory changes in CAO testis are accompanied by a significant loss of SSCs. Notwithstanding, our data confirm the survival of putative stem cells with the potential of self-renewal and differentiation and lay the groundwork for further research into stem cell-based therapeutic options to reinitialize spermatogenesis in canine CAO-affected patients.

Abstract Background Dogs with degenerative mitral valve disease are commonly presented to small animal clinicians. Diagnosis, clinical staging, and therapeutic design are based on a combination of clinical examination, radiography, and echocardiography. To support diagnosis and clinical monitoring, a multi-marker-based approach would be conceivable. The aim of this study was to investigate the suitability of Galectin-3 and interleukin-1 receptor-like 1 protein (ST2) in dogs with degenerative mitral valve disease in accordance with N-terminal-prohormone-B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI). For this purpose, serum concentrations of Galectin-3 and ST2 of 64 dogs with different stages of mitral valve disease and 21 dogs without cardiac disease were analyzed at the first examination and six months later. Echocardiography, blood cell count and clinical chemistry were performed and established biomarkers NT-proBNP and cTnI were measured additionally. Differences in the biomarker concentrations between all groups at both timepoints and the change in biomarker concentrations from first to second evaluation was investigated. Furthermore, correlations of each biomarker, between biomarkers and echocardiographic measurements, were calculated. Finally, the receiver-operating characteristic curve and the area under the curve analysis were performed to differentiate between disease stages and controls. Results Serum concentrations of Galectin-3 and ST2 were not statistically different between canine patients in the respective stages of mitral valve disease or in comparison to dogs in the control group at any timepoint. A significant increase in ST2 concentrations from the baseline to the follow-up examination was observed in dogs classified as stage B1 and the control group. The concentrations of NT-proBNP and cTnI in stage C dogs were significantly increased in comparison to the other groups. Conclusions In this study, no relation between Galectin-3 and ST2 levels to the presence or stage of mitral valve disease could be detected. Nevertheless, considering the increase in ST2 concentrations from the first to second measurement, its value on monitoring disease progress could be feasible. In agreement with previous studies, NT-proBNP and cTnI have once more proven their utility in assessing disease severity. The approach of examining new cardiac biomarkers in dogs is still worth pursuing.

Abstract Background Canine prostate adenocarcinoma (PAC) and transitional cell carcinoma (TCC) are typically characterized by metastasis and chemoresistance. Cell lines are important model systems for developing new therapeutic strategies. However, as they adapt to culturing conditions and undergo clonal selection, they can diverge from the tissue from which they were originally derived. Therefore, a comprehensive characterization of cell lines and their original tissues is paramount. Methods This study compared the transcriptomes of nine canine cell lines derived from PAC, PAC metastasis and TCC to their respective original primary tumor or metastasis tissues. Special interests were laid on cell culture-related differences, epithelial to mesenchymal transition (EMT), the prostate and bladder cancer pathways, therapeutic targets in the PI3K-AKT signaling pathway and genes correlated with chemoresistance towards doxorubicin and carboplatin. Results Independent analyses for PAC, PAC metastasis and TCC revealed 1743, 3941 and 463 genes, respectively, differentially expressed in the cell lines relative to their original tissues (DEGs). While genes associated with tumor microenvironment were mostly downregulated in the cell lines, patient-specific EMT features were conserved. Furthermore, examination of the prostate and bladder cancer pathways revealed extensive concordance between cell lines and tissues. Interestingly, all cell lines preserved downstream PI3K-AKT signaling, but each featured a unique therapeutic target signature. Additionally, resistance towards doxorubicin was associated with G2/M cell cycle transition and cell membrane biosynthesis, while carboplatin resistance correlated with histone, m- and tRNA processing. Conclusion Comparative whole-transcriptome profiling of cell lines and their original tissues identifies models with conserved therapeutic target expression. Moreover, it is useful for selecting suitable negative controls, i.e., cell lines lacking therapeutic target expression, increasing the transfer efficiency from in vitro to primary neoplasias for new therapeutic protocols. In summary, the dataset presented here constitutes a rich resource for canine prostate and bladder cancer research.

In pregnant bitches, the response to oxytocin and denaverine hydrochloride in dystocia management is usually poor. To better understand the effect of both drugs on myometrial contractility, the circular and longitudinal muscle layers were examined in an organ bath. For each layer, three myometrial strips were stimulated twice, each with one of three oxytocin concentrations. The effect of denaverine hydrochloride was studied once in direct combination with oxytocin and alone with subsequent oxytocin administration. Contractions were recorded and evaluated for average amplitude, mean force, area under the curve (AUC), and frequency. Effects of different treatments were analyzed and compared within and between layers. In the circular layer, oxytocin significantly increased amplitude and mean force compared to untreated controls regardless of stimulation cycles or concentrations. In both layers, high oxytocin concentrations caused tonic contractions, while the lowest concentration created regular rhythmic contractions. Longitudinal layer tissue responded to oxytocin with a significantly decreased contractility when stimulated twice, presumably a sign of desensitization. Denaverine hydrochloride neither affected oxytocin induced contractions nor showed a priming effect to subsequent oxytocin. Thus, no benefit of denaverine hydrochloride on myometrial contractility was found in the organ bath. Our results suggest a better efficiency of low-dose oxytocin in canine dystocia management.

Introdução: A atuação do farmacêutico no atendimento da população indígena ainda é pouco explorada no Brasil. Em 2016, foi realizado o curso de capacitação em parceira com o Ministério da Saúde e a Universidade Federal do Rio Grande do Sul para profissionais farmacêuticos atuantes na saúde indígena neuronal atender as necessidades e as especificidades desta população específica. Uma das etapas do curso foi a simulação da dispensação de medicamentos como forma de aprimoramento e consolidação dos conhecimentos. Objetivos: Avaliar os resultados das simulações de dispensação de medicamentos para o paciente indígena. Métodos:Estudo transversal e retrospectivo que avaliou como gravações das simulações de dispensação de medicamentos a pacientes médios de formulário específico. Resultados: A pontuação geral dos participantes variou de 2,4 a 8,3 pontos, de uma pontuação máxima de 10 pontos. Os casos de infecção pediátrica foram os que relatam o pior desempenho entre os participantes. A média de tempo para realização da dispensação foi de 8,8 minutos. Em relação ao conhecimento técnico, os alunos independentes uma média de 4,4 pontos. Conclusão:O baixo desempenho dos participantes nas simulações refletidas o despreparo dos farmacêuticos para realizarem a dispensação de medicamentos a pacientes indígenas. As limitações quanto às barreiras linguísticas e culturais foram identificados de forma marcante na avaliação das simulações.

An important approach in tumor therapy is combining substances with different action mechanisms aiming to enhance the antineoplastic effect, decrease the therapeutic dosage, and avoid resistance mechanisms. Moreover, evaluating compounds already approved for the treatment of non-neoplastic diseases is promising for new antineoplastic therapies. Sodium dichloroacetate (DCA) reactivates oxidative phosphorylation in the cancer cell mitochondria, reducing apoptosis resistance in cancer cells. Furthermore, metformin inhibits the proliferation of tumor cells and CD133+ cancer -stem-like cells. In the present study, we evaluated the independent and synergistic effect of metformin and DCA on the metabolic activity, cell proliferation, and apoptosis of a canine prostate adenocarcinoma (Adcarc1258) and a transitional cell carcinoma cell line (TCC1506) in comparison to a primary canine fibroblast culture. Determining metformin uptake in tumor cells was performed by quantitative HPLC. Depending on the dosage, metformin as a single agent inhibited the metabolic activity and cell proliferation of the tumor cells, showing only minor effects on the fibroblasts. Furthermore, 1 mM metformin increased apoptosis over 96 h in the tumor cell lines but not in fibroblasts. Additionally, metformin uptake into the tumor cells in vitro was measurable by quantitative HPLC. Synergistic effects for the combination therapy were observed in both neoplastic cell lines as well as in the fibroblasts. Based on these results, metformin might be a promising therapeutic agent for canine urogenital tumors. Further studies on kinetics, toxicology, bioavailability, and application of metformin in dogs are necessary.

Canine prostate adenocarcinoma (PAC) and transitional cell carcinoma (TCC) of prostate and urinary bladder are highly invasive and metastatic tumors of closely neighbored organs. Cell lines are valuable tools to investigate tumor mechanisms and therapeutic approaches in vitro. PAC in dogs is infrequent, difficult to differentiate from TCC and usually characterized by poor prognosis, enhancing the value of the few available cell lines. However, as cell lines adapt to culturing conditions, a thorough characterization, ideally compared to original tissue, is indispensable. Herein, six canine PAC cell lines and three TCC cell lines were profiled by immunophenotype in comparison to respective original tumor tissues. Three of the six PAC cell lines were derived from primary tumor and metastases of the same patient. Further, two of the three TCC cell lines were derived from TCCs invading into or originating from the prostate. Cell biologic parameters as doubling times and chemoresistances to commonly used drugs in cancer treatment (doxorubicin, carboplatin and meloxicam) were assessed. All cell lines were immunohistochemically close to the respective original tissue. Compared to primary tumor cell lines, metastasis-derived cell lines were more chemoresistant to doxorubicin, but equally susceptive to carboplatin treatment. Two cell lines were multiresistant. COX-2 enzyme activity was demonstrated in all cell lines. However, meloxicam inhibited prostaglandin E2 production in only seven of nine cell lines and did neither influence metabolic activity, nor proliferation. The characterized nine cell lines represent excellent tools to investigate PAC as well as TCC in prostate and urinary bladder of the dog. Furthermore, the profiled paired cell lines from PAC primary tumor and metastasis provide the unique opportunity to investigate metastasis-associated changes PAC cells undergo in tumor progression. The combination of nine differently chemoresistant PAC and TCC cell lines resembles the heterogeneity of canine lower urinary tract cancer.

To describe pharmacotherapy in the home and hospital setting and the association with clinical-demographic characteristics of patients hospitalized with COVID-19. Observational, cross-sectional study with retrospective data collection. The variables of interest were medications for COVID-19, chronically used, and used during hospital admission. Non-parametric tests were used to compare and correlate the variables, and the statistical significance adopted was 5%. It was identified that 34.8% of patients used some medication for COVID-19 before hospitalization, and 71.6% (n=255) were undergoing chronic treatments. Azithromycin was the most used medication for COVID-19, and 28.1% of patients had polypharmacy. Days of hospitalization (p=<0.001) and intensive care (p=<0.001) had a strong correlation with the number of medications used. Higher education, impaired renal function, comorbidities, and polypharmacy were associated with the profile of previous users of medications for COVID-19. Intensive care and death were related to a higher number of medications used than other patients. [ABSTRACT FROM AUTHOR]

Background: Aiming to facilitate the drug dispensing process and patient counseling, specific professional skills are required. The knowledge, skills and attitudes involved in this process can be improved. From 2012 to 2015, a nationwide course was held, in partnership with the Ministry of Health and the Federal University of Rio Grande do Sul (UFRGS) – Brazil, to train pharmacists working in primary health care through the development of their clinical and communication skills. One of the steps in this process involved the simulation of the drug dispensing process and patient counseling. Objective: To evaluate the performance of pharmacists in drug dispensing and counseling through patient simulation role-playing held in a face-to-face meeting at the end of a training course. Methods: A cross-sectional and retrospective study with analysis of patient simulation recordings and data collection using an assessment instrument with scores ranging from 0 to 10 points to assess pharmacist's behavior, skills, and technical knowledge. Results: Participants presented poor-to-regular performance, with median scores equal to or lower than six. The median time of the drug dispensing simulation was five minutes and the patient counseling was eight minutes. Pharmacists had better scores in the simulation of asthma cases. In drug dispensing, 99.5% of pharmacists had difficulty checking the patient's time availability, 98.5% did not know how to use the devices, and 94.7% did not advise the patient on what to do if they forgot to take a dose. In patient counseling simulation, 1.18% of pharmacists remembered to advise on what do with medication leftovers, and 50.6% asked questions that induced the patient's responses. Conclusions: The low-to-regular performance showed that pharmacists had difficulties at improving their skills in the performance of complete and effective drug dispensing and patient counseling.

Farmacoeconomia é a aplicação da economia ao estudo dos medicamentos, otimizando os gastos financeiros sem prejuízo ao tratamento do paciente. Diferentes estudos farmacoeconômicos podem ser empregados, sendo que os principais são: minimização de custo, análise custo-utilidade, custo-benefício e custo-efetividade. O objetivo deste estudo foi realizar uma revisão dos conceitos de farmacoeconomia e dos estudos farmacoeconômicos, apresentando suas principais características e exemplos de aplicabilidade no âmbito hospitalar. Foi realizado um levantamento bibliográfico nas bases de dados do Scielo, Lilacs e Medline, selecionando 16 artigos no período de janeiro a março de 2014, publicados em inglês, português e espanhol. A escassez e limitação de recursos dos hospitais públicos brasileiros aliado ao envelhecimento populacional torna a farmacoeconomia uma importante ferramenta para a tomada de decisão quanto aos recursos farmacológicos, permitindo a escolha da melhor opção de tratamento ao paciente, adequada à possibilidade de custeio do hospital.