RESUMO Objetivo: Descrever como aplicativos de smartphone podem contribuir para o gerenciamento de quadros de epilepsia em crianças e adolescentes. Fontes de dados: Trata-se de uma revisão integrativa realizada nas bases de dados Medline; PubMed e SciELO, com base nos descritores “epilepsy” e “smartphone”. Foram incluídos estudos originais publicados entre 2017–2023 em português ou inglês que respondessem à pergunta de investigação. Teses e dissertações, estudos duplicados, revisões de literatura e estudos que não responderam à questão de pesquisa foram excluídos. Síntese dos dados: Foram localizados 178 estudos, dos quais seis foram selecionados para compor esta revisão. A amostra incluiu 731 participantes (631 infantojuvenis com epilepsia e 100 cuidadores). Os aplicativos permitem a coleta da frequência de convulsões; momento e o tipo de crise; lembretes para a administração de medicamentos; e informações sobre a qualidade do sono, sendo capazes de armazenar esses dados para profissionais da saúde, cuidadores e usuários acompanharem a evolução do quadro. Conclusões: O uso de aplicativos no manejo das convulsões de crianças e adolescentes com epilepsia apresenta resultados promissores ao promoverem um monitoramento contínuo e personalizado. Novos estudos são necessários para otimizar os resultados benéficos e superar desafios. Objetivo Tratase Trata se Medline SciELO epilepsy “epilepsy smartphone. . “smartphone” 20172023 2017 2023 2017–202 investigação dissertações duplicados excluídos 17 73 631 (63 10 cuidadores. cuidadores) crise medicamentos sono saúde quadro Conclusões personalizado desafios “smartphone 2017202 201 202 2017–20 1 7 63 (6 201720 20 2017–2 6 ( 20172 2 2017–

ABSTRACT Objective: To describe how smartphone applications can contribute to the management of epilepsy in children and adolescents. Data source: This is an integrative review conducted on the Medline, PubMed, and SciELO databases, based on the descriptors “epilepsy” and “smartphone.” Original studies published between 2017–2023 in Portuguese or English that addressed the research question were included. Theses and dissertations, duplicate studies, literature reviews, and studies that did not answer the research question were excluded. Data synthesis: A total of 178 studies were located, of which six were selected for this review. The sample included 731 participants (631 children and adolescents with epilepsy and 100 caregivers). The applications allow for the collection of seizure frequency; timing and type of crisis; reminders for medication administration; and information about sleep quality. They can store these data for healthcare professionals, caregivers, and users to monitor the progress of the condition. Conclusions: The use of applications in managing seizures in children and adolescents with epilepsy shows promising results by promoting continuous and personalized monitoring. Further studies are needed to optimize beneficial outcomes and overcome challenges. Objective source Medline PubMed databases “epilepsy smartphone. “smartphone. 20172023 2017 2023 2017–202 dissertations reviews excluded synthesis 17 located 73 631 (63 10 caregivers. caregivers . caregivers) frequency crisis administration quality professionals condition Conclusions monitoring challenges “smartphone 2017202 201 202 2017–20 1 7 63 (6 201720 20 2017–2 6 ( 20172 2 2017–

Resumen El objetivo del presente artículo es presentar un material de archivo inédito que da cuenta de las relaciones incipientes entre la Monarquía Hispánica y el Imperio Ming en los albores del siglo XVII. Se trata de tres cartas de Diego de Pantoja, el pionero de habla hispana en China, en las que se despliegan concepciones religioso-políticas alternativas a otros testimonios iberoamericanos de la época en las Indias Orientales. Este estudio emplea un método basado en tres pasos: la transcripción de las cartas, su contextualización historiográfica y la explicación de sus elementos geopolíticamente relevantes. El estudio tiene como resultado destacar la importancia de la figura de Pantoja para las relaciones internacionales en el ámbito del Pacífico, tanto en el pasado como en la actualidad. El aporte principal es traer a la luz un testimonio perteneciente a los orígenes del intercambio cultural acontecido entre el mundo chino y el hispanohablante que sirve como base para el entendimiento diplomático, el diálogo político y el desarrollo económico del presente.

Abstract The objective of this paper is to offer unpublished archival material with an account of the nascent relations between the Hispanic Monarchy and the Ming Empire at the dawn of the 17th century. These are three letters from Diego de Pantoja, the Spanish-speaking pioneer in China, with a series of religious-political conceptions whose character is alternative to other Ibero-American testimonies of the time in the East Indies. This study uses a method based on three steps: the transcription of the letters, their historiographical contextualization, and the explanation of their geopolitically relevant elements. As a result of this process, this study highlights the importance of the figure of Pantoja for international relations in the Pacific area, both in the past and the present. The main contribution is to bring to light a testimony from the origins of the cultural exchange between the Chinese and Spanish-speaking world that serves as a basis for diplomatic understanding, political dialogue, and economic development of the present.

Abstract The objective was to evaluate the dry matter (DM) accumulation by component, yield, and nutritional composition of forage of four corn hybrids harvested at 121, 128, 135 and 142 d after sowing. In each harvest, five plants were randomly taken and separated into their components (stem, leaves, grain, cob, bracts, and tassel) and DM was determined; chemical composition and in-situ digestibility were analyzed in a composite sample of a whole plant. The accumulation of grain in the total DM increased from 35.8 to 43.9 % from 121 to 142 d to harvest, respectively, and diluted the other components, especially the proportion of stem and leaves, which decreased inversely proportional to the accumulation of grain. Total DM content differed between hybrids, from 3.8 and up to 8.3 percentage units on the same days to harvest. Nonetheless, the hybrid did not affect DM yield or grain production, increasing by 2.1 and 1.4 t ha-1 between harvests, respectively. NDF content decreased and starch increased (both linearly), affecting net energy for lactation, which increased from 1.49 to 1.56 Mcal kg-1 from 121 to 142 d to harvest, respectively. The interaction between days to harvest and hybrid affected starch content, which was 5.2 units higher in a hybrid with similar NFC and NDF content than its counterparts. DM, NDF and starch digestibilities were affected by the hybrid, but not by the days to harvest.

Resumen El objetivo fue evaluar la acumulación de materia seca (MS) por componente, rendimiento y composición nutricional del forraje de cuatro híbridos de maíz cosechados a 121, 128, 135 y 142 días después de la siembra. En cada cosecha, se tomaron al azar cinco plantas y se separaron en sus componentes (tallo, hojas, grano, olote, brácteas y espiga) y se determinó la MS; en una muestra compuesta de planta completa se analizó la composición química y digestibilidad in situ. La acumulación de grano en la MS total se incrementó de 35.8 a 43.9 % de los 121 a 142 días a cosecha, respectivamente, y diluyó a los demás componentes, sobre todo la proporción de tallo y de hojas, que decrecieron inversamente proporcional a la acumulación de grano. El contenido de MS total difirió entre híbridos de 3.8 y hasta 8.3 unidades porcentuales a mismos días a cosecha. Sin embargo, el híbrido no afectó el rendimiento de MS ni la producción de grano incrementándose 2.1 y 1.4 t ha-1 entre cosecha, respectivamente. El contenido de FDN disminuyó y el almidón se incrementó (ambos linealmente), afectando la energía neta de lactancia que aumentó de 1.49 a 1.56 Mcal kg-1 de los 121 a 142 días a cosecha, respectivamente. La interacción entre días a cosecha e híbrido afectó el contenido de almidón, el cual fue 5.2 unidades superior en un híbrido con similar contenido de CNF y FDN que sus contrapartes. Las digestibilidades de la MS, de la FDN y del almidón fueron afectadas por el híbrido, pero no por los días a cosecha.

Abstract: Vascular rings are unusual congenital malformations. Among them, double aortic arch (DAA) is often difficult to diagnose due to its low incidence of symptoms. DAA can be associated with tracheal or esophageal compression and, in severe cases, could require tracheal intubation or chronic use of a nasogastric tube. This scenario favors the development of aortotracheal fistulas (ATF) or aortoe-sophageal fistulas (AEF). Objective: To present a clinical case with an unusual association of DAA with ATF and to reinforce the importance of maintaining high diagnostic suspicion in patients with massive aerodigestive bleeding without an obvious source. Clinical Case: A 32-week preterm newborn who required prolonged mechanical ventilation and presented intermittent episodes of massive oropharyngeal bleeding with hemodynamic compromise associated with lower airway obstruction without pulmonary hemorrhage. The patient underwent upper endoscopy and exploratory laparotomy without evidence of bleeding. Flexible nasopharyngolaryngoscopy and direct laryngoscopy also showed no abnormalities. A CT angiography showed complete DAA with indentation of the left dominant arch over the trachea, without severe stenosis or evidence of a fistula. AEF was suspected, so exploratory surgery was considered. However, the patient died before surgery due to a massive pulmonary hemorrhage. The autopsy revealed the presence of ATF. Conclusions: In patients with massive aerodigestive bleeding without an obvious source, the presence of DAA and possible AEF/ ATF should be considered. Imaging studies have a poor performance for this diagnosis, so surgery should be considered for diagnosis and treatment in these patients.

Resumen: Los anillos vasculares son malformaciones congénitas infrecuentes. Dentro de ellas, el doble arco aórtico (DAA) suele ser de difícil diagnóstico debido a su baja incidencia de síntomas. El DAA puede asociarse a compresión traqueal o esofágica y en casos severos, requerir intubación traqueal o uso crónico de sonda nasogástrica. Esto último, favorece el desarrollo de fístulas aortotraqueales (FAT) y/o aortoesofágicas (FAE). Objetivo: Presentar un caso con una inusual asociación de DAA con FAT y reforzar la importancia de mantener una alta sospecha diagnóstica en pacientes con hemorragia aerodigestiva masiva sin foco evidente. Caso Clínico: Se presenta caso de RNPT de 32 semanas de gestación que requirió ventilación mecánica prolongada con episodios intermitentes de hemorragia orofaríngea masiva, con compromiso hemodinámico, asociado a obstrucción de vía aérea inferior sin hemorragia pulmonar. Endoscopía digestiva alta y laparotomía exploradora sin evidencia de sangrado. Nasofaringolaringoscopía flexible y laringoscopía directa tampoco detectaron anomalías. Angiotomografía computada demostró DAA completo con indentación de arco dominante izquierdo sobre tráquea, sin estenosis severa ni evidencia de fístula. Se sospechó FAE y se planteó exploración quirúrgica. Sin embargo, el paciente falleció previo al procedimiento por hemorragia pulmonar masiva. La autopsia demostró la presencia de FAT. Conclusiones: En pacientes con hemorragia aerodigestiva masiva sin foco evidente se debe considerar la presencia de un DAA y posible FAE/FAT. Los estudios imagenológicos no tienen buen rendimiento para este diagnóstico, por lo que debe considerarse la cirugía como parte del proceso diagnóstico y tratamiento.

Resumen: Los anillos vasculares son malformaciones congénitas infrecuentes. Dentro de ellas, el doble arco aórtico (DAA) suele ser de difícil diagnóstico debido a su baja incidencia de síntomas. El DAA puede asociarse a compresión traqueal o esofágica y en casos severos, requerir intubación traqueal o uso crónico de sonda nasogástrica. Esto último, favorece el desarrollo de fístulas aortotraqueales (FAT) y/o aortoesofágicas (FAE). Objetivo: Presentar un caso con una inusual asociación de DAA con FAT y reforzar la importancia de mantener una alta sospecha diagnóstica en pacientes con hemorragia aerodigestiva masiva sin foco evidente. Caso Clínico: Se presenta caso de RNPT de 32 semanas de gestación que requirió ventilación mecánica prolongada con episodios intermitentes de hemorragia orofaríngea masiva, con compromiso hemodinámico, asociado a obstrucción de vía aérea inferior sin hemorragia pulmonar. Endoscopía digestiva alta y laparotomía exploradora sin evidencia de sangrado. Nasofaringolaringoscopía flexible y laringoscopía directa tampoco detectaron anomalías. Angiotomografía computada demostró DAA completo con indentación de arco dominante izquierdo sobre tráquea, sin estenosis severa ni evidencia de fístula. Se sospechó FAE y se planteó exploración quirúrgica. Sin embargo, el paciente falleció previo al procedimiento por hemorragia pulmonar masiva. La autopsia demostró la presencia de FAT. Conclusiones: En pacientes con hemorragia aerodigestiva masiva sin foco evidente se debe considerar la presencia de un DAA y posible FAE/FAT. Los estudios imagenológicos no tienen buen rendimiento para este diagnóstico, por lo que debe considerarse la cirugía como parte del proceso diagnóstico y tratamiento.

Abstract: Vascular rings are unusual congenital malformations. Among them, double aortic arch (DAA) is often difficult to diagnose due to its low incidence of symptoms. DAA can be associated with tracheal or esophageal compression and, in severe cases, could require tracheal intubation or chronic use of a nasogastric tube. This scenario favors the development of aortotracheal fistulas (ATF) or aortoe-sophageal fistulas (AEF). Objective: To present a clinical case with an unusual association of DAA with ATF and to reinforce the importance of maintaining high diagnostic suspicion in patients with massive aerodigestive bleeding without an obvious source. Clinical Case: A 32-week preterm newborn who required prolonged mechanical ventilation and presented intermittent episodes of massive oropharyngeal bleeding with hemodynamic compromise associated with lower airway obstruction without pulmonary hemorrhage. The patient underwent upper endoscopy and exploratory laparotomy without evidence of bleeding. Flexible nasopharyngolaryngoscopy and direct laryngoscopy also showed no abnormalities. A CT angiography showed complete DAA with indentation of the left dominant arch over the trachea, without severe stenosis or evidence of a fistula. AEF was suspected, so exploratory surgery was considered. However, the patient died before surgery due to a massive pulmonary hemorrhage. The autopsy revealed the presence of ATF. Conclusions: In patients with massive aerodigestive bleeding without an obvious source, the presence of DAA and possible AEF/ ATF should be considered. Imaging studies have a poor performance for this diagnosis, so surgery should be considered for diagnosis and treatment in these patients.

Resumo A prescrição farmacêutica avança no mundo, com diferentes países regulando a prática. No Brasil, essa regulação ocorreu em 2013, porém são escassas as informações sobre sua inserção no cotidiano do exercício farmacêutico. Este estudo objetivou analisar a prescrição farmacêutica no município de Vitória-ES, Brasil, e os fatores que influenciam na adesão da prática. Trata-se de um estudo qualitativo com 20 farmacêuticos e 10 gestores de farmácias comunitárias públicas e privadas, realizado a partir de entrevistas, com posterior análise de conteúdo temática para apreender percepções e opiniões. Os farmacêuticos desta pesquisa não prescreviam. Farmacêuticos e gestores identificaram facilitadores para a implementação da atividade, com destaque para os fatores: infraestrutura; fácil acesso ao farmacêutico; e boa receptividade à prescrição. Como barreiras, os fatores foram: número insuficiente de recursos humanos; falta de estímulo institucional à prescrição; e fatores individuais. Além da observação da não execução da prescrição farmacêutica, este estudo trouxe uma oportunidade para identificar elementos que podem estar contribuindo para que o exercício dessa atividade não seja realizado nas farmácias comunitárias. Adaptar rotinas ou contratar pessoal se mostraram as principais modificações necessárias. Paralelamente, ações destinadas a qualificar a formação por meio da educação permanente também se apresentam como necessárias.

Abstract Pharmacist prescribing advances in the world with different countries regulating this activity. In Brazil, this regulation took place in 2013, but there is little information about its insertion in the routine of pharmacist practice. This study aimed to analyze the pharmacist prescribing in the city of Vitória, Espírito Santo state, Brazil, and the factors that influence adherence to the practice. This is a qualitative study based on interviews with 20 pharmacists and 10 managers of public and private community drugstores with subsequent content analysis to apprehend perceptions and opinions. The pharmacists in this research did not prescribe. Pharmacists and managers identified facilitators for the implementation of the activity, highlighting the following factors: infrastructure; easy access to the pharmacist; and good receptivity to the prescription. As barriers, the factors were insufficient number of human resources; lack of institutional stimulus to prescribing; and individual factors. In addition to the observation of non-execution of pharmacist prescribing, this study provided an opportunity to identify elements that may contribute to the non-existence of this activity in community drugstores. Adapting routines or hiring staff were the main necessary changes. At the same time, actions aimed at qualifying training through permanent education are also necessary.

ABSTRACT This article analyses the validity evidence based on the internal structure and reliability of the 12-item Herth Hope Index in a sample of 1255 inhabitants of the city of Arequipa (46.3% men and 53.7% women), located in the south of Peru. Five models were tested by confirmatory factor analysis and, based on the results, comparisons were made according to sex and age. The results suggest a two-factor structure similar to that reported in a sample from Lima. These factors are Optimism and Agencies. Regarding reliability, the first factor obtained adequate levels of internal consistency through McDonald's Omega test and Cronbach's Alpha test; while the second factor obtained low but acceptable levels of reliability with both tests. Likewise, no gender differences were recorded, although there were differences with respect to age in the agency dimension, given the results of low reliability in this dimension, it is suggested to take these results with caution.

RESUMEN El presente artículo analiza la evidencia de validez basada en la estructura interna y la confiabilidad del Índice de Esperanza de Herth de 12 reactivos en una muestra de 1255 habitantes de la ciudad de Arequipa (46.3% hombres y 53.7% mujeres), ubicada al sur de Perú. Se pusieron a prueba cinco modelos mediante análisis factorial confirmatorio y sobre la base de los resultados, se realizaron comparaciones en función del sexo y la edad. Los resultados sugieren una estructura de dos factores similar a la reportada en una muestra de Lima. Estos factores son Optimismo y Agencias. Con respecto a la confiabilidad, el primer factor obtuvo adecuados niveles de consistencia interna mediante la prueba Omega de McDonald y la prueba Alfa de Cronbach, mientras que el segundo factor obtuvo niveles bajos pero aceptables de confiabilidad con ambas pruebas. Asimismo, no se registraron diferencias en función del sexo, aunque sí con respecto a la edad en la dimensión de agencias, pero dados los resultados de baja confiabilidad en esta dimensión, se sugiere tomar estos resultados con cautela.

RESUMEN Objetivo. Evaluar la implementación de estrategias de la iniciativa HEARTS en una comunidad de la República Bolivariana de Venezuela. Métodos. Estudio cuasiexperimental, con la evaluación de la cascada de cuidado, factores impulsores e índices de madurez y desempeño cuatro meses después de la implementación de la iniciativa HEARTS en la comunidad La Marroquina en 52 pacientes con hipertensión (HTA). Los datos se procesaron en el programa SPSS® versión 25.0. Se aplicaron las pruebas t-Student y de ji cuadrado para determinar la significancia estadística. Resultados. Completaron los cuatro meses de seguimiento 50 pacientes, 63,5% con baja escolaridad y estrato socioeconómico bajo o muy bajo. Al inicio, 11,5% estaba controlado, y 40,4% inició con monoterapia. Al cuarto mes, 100% de las personas hipertensas recibieron el diagnóstico, 92% recibió tratamiento y 52% alcanzó la meta de control de HTA. El 72% recibía terapia combinada. De las personas hipertensas, 70% mantenía cifras de presión arterial <140/90 mmHg. El índice de madurez alcanzó nivel 4 de 5, y el índice de desempeño se clasificó en incipiente. Conclusión. Este trabajo muestra, en un corto tiempo, un buen índice de madurez en la implementación de un protocolo estandarizado de diagnóstico, tratamiento y seguimiento de la HTA en una población rural, por parte de personal médico y no médico supervisado, que mejora las tasas de diagnóstico, tratamiento y control en los hipertensos, y empieza a mostrar su desempeño. El mantenimiento de esta iniciativa tendrá un gran impacto en la salud de esta población. Se recomienda su implementación como política de salud pública nacional.

ABSTRACT Objective. To evaluate the implementation of HEARTS strategies in a community in the Bolivarian Republic of Venezuela. Methods. Quasi-experimental study evaluating the cascade of care, driving factors, and maturity and performance indicators four months after implementation of the HEARTS initiative in 52 patients with high blood pressure (BP) in the community of La Marroquina. The data were processed using SPSS® Statistics, version 25.0. Student’s t-distribution and chi-square tests were applied to determine statistical significance. Results. Fifty patients, 63.5% of them with a low educational level and low or very low socioeconomic status, completed the four-month monitoring period. At baseline, 11.5% had controlled BP and 40.4% initiated monotherapy. By the fourth month, 100% of patients with high BP had been diagnosed, 92% had received treatment, and 52% had achieved control of their BP. Seventy-two percent were receiving combined therapy. Seventy percent of the hypertensive individuals maintained blood pressure levels <140/90 mmHg. The maturity index score was 4 of 5, and the performance index was classified as incipient. Conclusion. This work shows that, in a short time, a good maturity index was achieved through the implementation, by medical and supervised non-medical personnel, of a standardized protocol for diagnosis, treatment, and monitoring of high blood pressure in a rural population. Rates of diagnosis, treatment, and BP control improved, with incipient performance results. Sustaining this initiative will have a major impact on the health of this population. Its implementation as a national public health policy is recommended.

RESUMO Objetivo. Avaliar a implementação das estratégias da iniciativa HEARTS em uma comunidade da República Bolivariana da Venezuela. Métodos. Estudo quase-experimental que avaliou a cascata de cuidados, fatores determinantes e índices de maturidade e desempenho quatro meses após a implementação da iniciativa HEARTS na comunidade de La Marroquina, Venezuela. Foram avaliados 52 pacientes com hipertensão arterial. A análise estatística foi realizada no software SPSS®, versão 25.0. O teste t de Student e o teste qui-quadrado foram usados para determinar a significância estatística. Resultados. Cinquenta pacientes completaram o acompanhamento de quatro meses. Desses, 63,5% tinham baixa escolaridade e nível socioeconômico baixo ou muito baixo. No início do estudo, 11,5% apresentavam doença controlada e 40,4% estavam em monoterapia. No quarto mês, 100% dos pacientes com hipertensão arterial haviam sido diagnosticados, 92% haviam recebido tratamento, 52% haviam atingido a meta de controle da hipertensão e 72% estavam recebendo terapia combinada. Dos pacientes com hipertensão, 70% mantinham níveis pressóricos <140 × 90 mmHg. O índice de maturidade foi avaliado como nível 4 (de 5), e o desempenho foi classificado como incipiente. Conclusão. Este estudo demonstra, após pouco tempo, um bom índice de maturidade na implementação de um protocolo padronizado de diagnóstico, tratamento e acompanhamento da hipertensão arterial em uma população rural atendida por pessoal médico e não médico supervisionado. Observa-se melhoria das taxas de diagnóstico, tratamento e controle dos pacientes com hipertensão, demonstrando de forma incipiente seu desempenho. Dar continuidade a essa iniciativa terá uma repercussão importante na saúde dessa população. Recomendando-se que a iniciativa seja implementada como política nacional de saúde pública.

RESUMO Este estudo teve como objetivo construir e validar o Modelo Lógico (ML) da prescrição farmacêutica no Brasil. Caracteriza-se como um estudo de avaliabilidade, com utilização de técnicas quantiqualitativas. Para a construção da primeira versão do ML, utilizaram-se informações disponibilizadas em documentos oficiais, literatura científica e informantes-chave. Para validação, empregou-se a técnica de Delphi, com 19 especialistas que analisaram a pertinência e a relevância dos itens propostos, no período entre março e outubro de 2022. O ML apresentou, ao final, oito itens do elemento estrutura, 13 itens do elemento atividades, oito itens do elemento resultados intermediários e quatro itens do elemento impacto. Da versão original à final, houve relativamente poucas modificações realizadas a partir da contribuição dos especialistas, resultado dos altos níveis de consenso alcançados nas análises de pertinência e relevância. O ML validado apresenta plausibilidade de execução nas relações estabelecidas entre os elementos de atividades e de resultados, identificação da essencialidade no campo da estrutura e vislumbre dos resultados de sua execução em longo prazo, que incluem a promoção do uso racional de medicamentos, a expansão da atividade do farmacêutico no cuidado à saúde, melhoria da qualidade de vida do paciente e racionalização de custos ao Sistema Único de Saúde.

ABSTRACT This study aimed to build and validate the Logical Model (LM) of pharmacist prescribing in Brazil. It is characterized as an evaluability study, using quantitative and qualitative techniques. To construct the first version of the LM, information made available by official documents, scientific literature and key informants was used. For validation, the Delphi technique was used, with 19 experts who analyzed the pertinence and relevance of the proposed items, in the period between March and October 2022. The LM presented, in the end, eight items from the structure element, 13 items from the activities element, eight items from the intermediate results element and four items from the impact element. From the original to the final version, there were relatively few modifications made based on the contributions of experts, a result of the high levels of consensus achieved in the pertinence and relevance analyses. The validated LM presents plausibility of execution in the relationships established between the elements of activities and results, identification of the essentiality in the field of structure and a glimpse of the results of its long-term execution, which include the promotion of the rational use of medicines, the expansion of the pharmacist’s activity in health care, improving the patient’s quality of life and rationalizing costs for the Unified Health System.

Resumo A prescrição farmacêutica avança no mundo, com diferentes países regulando a prática. No Brasil, essa regulação ocorreu em 2013, porém são escassas as informações sobre sua inserção no cotidiano do exercício farmacêutico. Este estudo objetivou analisar a prescrição farmacêutica no município de Vitória-ES, Brasil, e os fatores que influenciam na adesão da prática. Trata-se de um estudo qualitativo com 20 farmacêuticos e 10 gestores de farmácias comunitárias públicas e privadas, realizado a partir de entrevistas, com posterior análise de conteúdo temática para apreender percepções e opiniões. Os farmacêuticos desta pesquisa não prescreviam. Farmacêuticos e gestores identificaram facilitadores para a implementação da atividade, com destaque para os fatores: infraestrutura; fácil acesso ao farmacêutico; e boa receptividade à prescrição. Como barreiras, os fatores foram: número insuficiente de recursos humanos; falta de estímulo institucional à prescrição; e fatores individuais. Além da observação da não execução da prescrição farmacêutica, este estudo trouxe uma oportunidade para identificar elementos que podem estar contribuindo para que o exercício dessa atividade não seja realizado nas farmácias comunitárias. Adaptar rotinas ou contratar pessoal se mostraram as principais modificações necessárias. Paralelamente, ações destinadas a qualificar a formação por meio da educação permanente também se apresentam como necessárias. mundo prática Brasil 2013 farmacêutico VitóriaES, VitóriaES Vitória ES, ES Vitória-ES Tratase Trata 2 1 privadas entrevistas opiniões prescreviam infraestrutura barreiras foram humanos individuais necessárias Paralelamente 201

Abstract Pharmacist prescribing advances in the world with different countries regulating this activity. In Brazil, this regulation took place in 2013, but there is little information about its insertion in the routine of pharmacist practice. This study aimed to analyze the pharmacist prescribing in the city of Vitória, Espírito Santo state, Brazil, and the factors that influence adherence to the practice. This is a qualitative study based on interviews with 20 pharmacists and 10 managers of public and private community drugstores with subsequent content analysis to apprehend perceptions and opinions. The pharmacists in this research did not prescribe. Pharmacists and managers identified facilitators for the implementation of the activity, highlighting the following factors: infrastructure; easy access to the pharmacist; and good receptivity to the prescription. As barriers, the factors were insufficient number of human resources; lack of institutional stimulus to prescribing; and individual factors. In addition to the observation of non-execution of pharmacist prescribing, this study provided an opportunity to identify elements that may contribute to the non-existence of this activity in community drugstores. Adapting routines or hiring staff were the main necessary changes. At the same time, actions aimed at qualifying training through permanent education are also necessary. Brazil 2013 practice Vitória state 2 1 opinions prescribe infrastructure prescription barriers resources nonexecution non execution nonexistence existence changes time 201

Resumo As larvas de Oestrus ovis são parasitas obrigatórios de vertebrados e causam miíase cavitária (estrose) em ovinos e caprinos. Também é relatada como uma zoonose que causa oftalmomíase e miíase nasofaríngea. Apesar de relativamente comum no Brasil, os estudos epidemiológicos sobre O. ovis são escassos. Considerando que a infestação é influenciada pelo clima e biomas da região estudada, objetivou-se investigar a prevalência sazonal de O. ovis entre ovinos abatidos na região norte do estado de Mato Grosso, Brasil. Foram coletadas cabeças de ovinos (n=697) abatidos em frigorífico do município de Terra Nova do Norte (novembro de 2011 a novembro de 2013) para contagem, catalogação e identificação das larvas encontradas no trato respiratório superior. No geral, 45,77% (319/697) dos animais estavam infestados com 2.412 larvas recuperadas, das quais 96,89% (2.337/2.412) foram identificadas em nível de espécie como O. ovis. As variações sazonais na prevalência variaram de 41% (primavera) a 56% (verão); no entanto, não foi observada correlação entre prevalência e estação do ano, umidade média ou temperatura. Conclui-se que o parasitismo por O. ovis em ovinos na área estudada ocorre durante todo o ano, considerando a ocorrência de larvas (L1, L2 e L3) ao longo do ano, provavelmente devido às condições ambientais da área. estrose (estrose caprinos nasofaríngea Brasil O escassos objetivouse objetivou se Grosso n=697 n697 n 697 (n=697 201 2013 contagem superior geral 4577 45 77 45,77 319/697 319697 319 (319/697 2412 2 412 2.41 recuperadas 9689 96 89 96,89 2.337/2.412 23372412 337 (2.337/2.412 41 primavera (primavera 56 verão (verão) entanto ano temperatura Concluise Conclui L1, L1 L (L1 L3 n=69 n69 69 (n=69 20 457 4 7 45,7 319/69 31969 31 (319/69 241 2.4 968 9 8 96,8 2.337/2.41 2337241 33 (2.337/2.41 5 (verão (L n=6 n6 6 (n=6 45, 319/6 3196 3 (319/6 24 2. 96, 2.337/2.4 233724 (2.337/2.4 n= (n= 319/ (319/ 2.337/2. 23372 (2.337/2. (n (319 2.337/2 2337 (2.337/2 (31 2.337/ 233 (2.337/ (3 2.337 23 (2.337 ( 2.33 (2.33 2.3 (2.3 (2. (2

Abstract Oestrus ovis larvae are obligate parasites of vertebrates and cause cavitary myiasis (oestrosis) in sheep and goats. It is also reported as a zoonosis causing ophthalmomyiasis and nasopharyngeal myiasis. Despite being relatively common in Brazil, epidemiological studies on O. ovis are scarce. Considering that the infestation is influenced by the climate and biomes of the studied region, we aimed to investigate the seasonal prevalence of O. ovis among slaughtered sheep in the northern region of the state of Mato Grosso, Brazil. The heads of sheep (n=697) slaughtered at a slaughterhouse in the municipality of Terra Nova do Norte (November 2011 to November 2013) were collected to count, catalog, and identify the larvae found in the upper respiratory tract. Overall, 45.77% (319/697) of the animals were infested with 2,412 recovered larvae, 96.89% (2,337/2,412) of which were identified at the species level as O. ovis. Seasonal variations in prevalence ranged from 41% (spring) to 56% (summer); however, no correlation was observed between prevalence and season, mean humidity, or temperature. In conclusion, parasitism by O. ovis in sheep in the studied area, occurs year-round, considering the occurrence of larvae (L1, L2, and L3) throughout the year, probably because of the area's environmental conditions. oestrosis (oestrosis goats Brazil O scarce Grosso n=697 n697 n 697 (n=697 201 2013 count catalog tract Overall 4577 45 77 45.77 319/697 319697 319 (319/697 2412 2 412 2,41 9689 96 89 96.89 2,337/2,412 23372412 337 (2,337/2,412 41 spring (spring 56 summer (summer) however season humidity temperature conclusion area yearround, yearround year round, round year-round L1, L1 L (L1 L2 L3 areas s conditions n=69 n69 69 (n=69 20 457 4 7 45.7 319/69 31969 31 (319/69 241 2,4 968 9 8 96.8 2,337/2,41 2337241 33 (2,337/2,41 5 (summer (L n=6 n6 6 (n=6 45. 319/6 3196 3 (319/6 24 2, 96. 2,337/2,4 233724 (2,337/2,4 n= (n= 319/ (319/ 2,337/2, 23372 (2,337/2, (n (319 2,337/2 2337 (2,337/2 (31 2,337/ 233 (2,337/ (3 2,337 23 (2,337 ( 2,33 (2,33 2,3 (2,3 (2, (2

Abstract One of the crucial aspects to be considered for successful in vitro production (IVP) of embryos is the composition of the various media used throughout the stages of this reproductive biotechnology. The cell culture media employed should fulfill the metabolic requirements of both gametes during oocyte maturation and sperm development, as well as the embryo during its initial cell divisions. Most IVP protocols incorporate blood serum into the media composition as a source of hormones, proteins, growth factors, and nutrients. Numerous studies have suggested Platelet-Rich Plasma (PRP) as a substitute for fetal sera in cell culture, particularly for stem cells. Therefore, the objective of this study is to assess the potential use of PRP as a replacement for fetal bovine serum (FBS) during oocyte maturation for in vitro production of bovine embryos. During in vitro maturation (IVM), cumulus-oocyte complexes (COCs) were allocated into the following experimental groups: Group G1 (IVM medium with 5% PRP); Group G2 (MIV medium with 5% PRP and 5% SFB); Group G3 (MIV medium with 5% SFB); and Group G4 (MIV medium without either PRP or SFB). Subsequently, the cumulus-oocyte complexes were fertilized with semen from a single bull, and the resulting zygotes were cultured for seven days. Cleavage and blastocyst formation rates were assessed on days 2 and 7 of embryonic development, respectively. The quality of matured COCs was also evaluated by analyzing the gene expression of HSP70, an important protein associated with cellular stress. The results demonstrated that there were no significant differences among the experimental groups in terms of embryo production rates, both in the initial cleavage stages and blastocyst formation (except for the G4 group, which exhibited a lower blastocyst formation rate on D7, as expected). This indicates that PRP could be a cost-effective alternative to SFB in the IVP of embryos. (IVP biotechnology development divisions hormones proteins factors nutrients PlateletRich Platelet Rich (PRP cells Therefore FBS (FBS IVM, IVM , (IVM) cumulusoocyte cumulus (COCs G 5 PRP) MIV SFB) SFB. . Subsequently bull respectively HSP70 HSP stress except group D7 D expected. expected expected) costeffective cost effective HSP7

Abstract Several countries and non-governmental organizations have discussed the use of animals in industry and biomedical areas. This work shows the progression of animal’ rights for scientific purposes in Brazil and how Brazilian Councils have advanced to follow worldwide regulations. Since the first rules about animals’ usage in Ireland in 1635, the British Cruelty to Animals Act in 1876, and the Brazilian animal protection rules in 1924 and 1934, most worldwide actions culminated in the Universal Declaration of Animal Rights (1978). In 1979, the Brazilian Law 6.638 displayed directives for didactic-scientific practice of vivisection. In 2008, the Arouca Law 11.794 filled regulatory gaps and created the National Council for the Control of Animal Experimentation (CONCEA). In 2014, the CONCEA incorporated the 3R’s philosophy and recognized substitute techniques, but only in 2023 it prohibited vertebrate animals in scientific research, development and control of personal hygiene products, cosmetics and perfumes. It is clear current Brazilian and international rules are unable to cover all aspects of animal wellbeing, even for regulations of commercial issues. Certainly, innovative tools, as organ-on-chip, in vitro techniques and bioinformatical advancements will provide a crucial animal welfare and new laws will minimize animal pain and distress, including for disregarded invertebrates. nongovernmental non governmental areas 1635 1876 192 1934 1978. 1978 . (1978) 1979 6638 6 638 6.63 didacticscientific didactic vivisection 2008 11794 11 794 11.79 CONCEA. (CONCEA) 2014 3Rs Rs 3R s R 202 research products perfumes wellbeing issues Certainly tools organonchip, organonchip organ on chip, chip organ-on-chip distress invertebrates 163 187 19 193 197 (1978 663 63 6.6 200 1179 1 79 11.7 (CONCEA 201 20 16 18 (197 66 6. 117 7 11. 2 (19 (1 (

Abstract Sjogren’s disease (SjD) is an autoimmune disease that is characterized not only by the sicca symptoms it causes but also by its systemic nature, which is capable of several and not yet fully understood extraglandular manifestations. To gain a clearer understanding of these manifestations as well as a better practical approach, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of the extraglandular manifestations present in ESSDAI (EULAR Sjogren´s syndrome disease activity index), followed by a voting panel with recommendations for clinical practice. This publication is complementary to others already published and covers cutaneous and hematological manifestations, with prevalence data generated by a meta-analysis of 13 clinical or laboratory manifestations and 6 clinical management recommendations. Sjogrens Sjogren s SjD (SjD nature approach metaanalysis meta analysis EULAR index, index , index) practice 1

Resumo Objetivo Investigar a prevalência de polifarmácia e os seus fatores associados no espaço da Atenção Primária à Saúde em Caicó (RN, Brasil). Método Trata-se de um estudo de prevalência de abordagem quantitativa com amostra final de 295 pessoas idosas. Resultados A prevalência de polifarmácia foi de 22%. A maioria dos participantes tinha entre 60 e 79 anos (76%), cor parda (50,5%), era casada (43,1%), ensino fundamental incompleto (60,3%) e renda entre um e três salários-mínimos (74,2%). Os fármacos mais utilizados foram os bloqueadores dos receptores de angiotensina (26,1%), as estatinas (20,3%) e os diuréticos tiazídicos (19,3%). O modelo de regressão logística multivariada mostrou que a polifarmácia se associa com diabetes mellitus, hipertensão arterial sistêmica, transtorno de ansiedade generalizada, gastrite, insuficiência cardíaca, doença arterial coronariana e idade acima de 80 anos. Conclusão A polifarmácia é uma condição de alta prevalência, fortemente associada ao aumento da idade, do tipo e do número de comorbidades. A problemática aponta para a necessidade de fortalecer ações e políticas de promoção da saúde, educação profissional permanente, fortalecimento do trabalho em equipe e prestação de cuidado longitudinal e em rede, em vista do risco iatrogênico do uso de muitos medicamentos por parte dos idosos. RN, RN (RN Brasil. Brasil . Brasil) Tratase Trata 29 idosas 22 22% 6 7 76%, 76 76% , (76%) 50,5%, 505 50,5% 50 5 (50,5%) 43,1%, 431 43,1% 43 1 (43,1%) 60,3% 603 3 (60,3% saláriosmínimos salários mínimos 74,2%. 742 74,2% 74 2 (74,2%) 26,1%, 261 26,1% 26 (26,1%) 20,3% 203 20 (20,3% 19,3%. 193 19,3% 19 (19,3%) mellitus sistêmica generalizada gastrite cardíaca 8 comorbidades saúde permanente rede idosos (76% 50,5 (50,5% 43,1 4 (43,1% 60,3 (60,3 74,2 (74,2% 26,1 (26,1% 20,3 (20,3 19,3 (19,3% (76 50, (50,5 43, (43,1 60, (60, 74, (74,2 26, (26,1 20, (20, 19, (19,3 (7 (50, (43, (60 (74, (26, (20 (19, ( (50 (43 (6 (74 (26 (2 (19 (5 (4 (1

Abstract Objective To investigate the prevalence of polypharmacy and its associated factors in the Primary Care setting of Caicó city (Rio Grande do Norte state, Brazil). Method A quantitative prevalence study of 295 older adults was conducted. Results The prevalence of polypharmacy was 22%. Participants were predominantly aged 60-79 years (76%), brown (50.5%), married (43.1%), educated to primary (incomplete) level (60.3%) and had an income of 1-3 minimum wages (74.2%). The most used medications were angiotensin-receptor blockers (26.1%), statins (20.3%) and thiazide diuretics (19.3%). The multivariate logistic regression model showed that polypharmacy was associated with diabetes mellitus, systemic arterial hypertension, generalized anxiety disorder, gastritis, heart failure, coronary artery disease and age >80 years. Conclusion Polypharmacy prevalence was high and strongly associated with advanced age and number and type of comorbidity. These results highlight the need for greater health promotion actions and policies, continuous professional education, enhanced team work and longitudinal systemic care provision to address the iatrogenic risk of use of multiple medications by older adults. Rio state Brazil. Brazil . Brazil) 29 conducted 22 22% 6079 60 79 60-7 76%, 76 76% , (76%) 50.5%, 505 50.5% 50 5 (50.5%) 43.1%, 431 43.1% 43 1 (43.1%) incomplete (incomplete 60.3% 603 3 (60.3% 13 1- 74.2%. 742 74.2% 74 2 (74.2%) angiotensinreceptor angiotensin receptor 26.1%, 261 26.1% 26 (26.1%) 20.3% 203 20 (20.3% 19.3%. 193 19.3% 19 (19.3%) mellitus hypertension disorder gastritis failure 80 >8 comorbidity policies education 607 6 7 60- (76% 50.5 (50.5% 43.1 4 (43.1% 60.3 (60.3 74.2 (74.2% 26.1 (26.1% 20.3 (20.3 19.3 (19.3% 8 > (76 50. (50.5 43. (43.1 60. (60. 74. (74.2 26. (26.1 20. (20. 19. (19.3 (7 (50. (43. (60 (74. (26. (20 (19. ( (50 (43 (6 (74 (26 (2 (19 (5 (4 (1