The role of irrigated areas for the spread of schistosomiasis is of worldwide concern. The aim of the present study was to investigate the spatial distribution of the intermediate snail host Biomphalaria in an area highly endemic for schistosomiasis due to Schistosoma mansoni, evaluating the relationship between irrigation and types of natural water sources on one hand, and the influence of place and time of water exposure on the intensity of human infection on the other. A geographical information system (GIS) was used to map the distribution of the intermediate snail hosts in Ilha das Flores, Sergipe, Brazil, combined with a clinical/epidemiological survey. We observed a direct correlation between the intensity of human infection with S. mansoni and irrigation projects. Malacological studies to identify snail species and infection rates showed that B. glabrata is the main species responsible for human schistosomiasis in the municipality, but that B. straminea also plays a role. Our results provide evidence for a competitive selection between the two snail species in rice fields with a predominance of B. glabrata in irrigation systems and B. straminea in natural water sources.

Objetivo: Realizar a avaliação de prescrições de oxigenoterapia de pacientes sob cuidados clínicos internados em um hospital de ensino de Sergipe. Métodos: Trata-se de um estudo transversal, descritivo, retrospectivo e quantitativo, no qual foram avaliados os prontuários e prescrições de 28 pacientes em uso de oxigênio (O2) internados entre os meses de março a junho de 2021. Os pacientes foram avaliados quanto à indicação de O2 e saturação de oxigênio (SatO2) inicial, e as prescrições quanto à inclusão do O2 na prescrição, saturação alvo, dispositivo de entrega do O2 e fluxo inicial ou concentração de O2 inicial inspirada. Após a coleta dos dados foi formado um painel de especialistas composto por pneumologista, fisioterapeutas e farmacêuticas para avaliar os achados e sugerirem intervenções a serem realizadas. Resultados: Dos pacientes avaliados, 89,3% tinham indicação de oxigenoterapia, mas 72,4% dos prontuários não apresentavam informação sobre SatO2 inicial. Da amostra analisada, 53,6% não tinham O2 prescrito, 75,0% não apresentavam meta de SatO2, 42,9% não apresentavam o dispositivo de entrega de O2, e 67,9% não continham o fluxo inicial ou concentração inspirada de O2 inicial. Além disso, o cateter nasal foi o dispositivo mais prescrito (85,2%). O painel de especialistas sugeriu nove intervenções para serem realizadas, que envolveram desde a realização de treinamentos com os profissionais envolvidos em todo o processo de uso do oxigênio medicinal, até a modificação do modelo de prescrição médica atual para atender aos requisitos necessários para uma prescrição de oxigênio adequada, com o intuito de promover a prática do uso racional de oxigênio e adequações no processo de trabalho. Conclusão: O estudo demonstrou que a maioria dos itens avaliados nas prescrições de oxigênio apresentavam não-conformidades diante das recomendações internacionais. Estes achados justificam a realização de intervenções junto à equipe assistencial.

This is a case series study to evaluate immunological markers associated with schistosomiasis advanced fibrosis, including 69 patients from an endemic area from the State of Sergipe and from the Hepatology Service of the University Hospital in Sergipe, Brazil. Hepatic fibrosis was classified based on Niamey protocol for ultrasonography (US). Immune response to Schistosoma mansoni antigens was evaluated by stimulating peripheral blood mononuclear cells (PBMCs) from these patients with either adult worm (SWAP—10 μg/ml) or egg (SEA—10 μg/ml) antigens or purified protein derivative of turberculin (PPD—10 μg/ml) or phytohemagglutinin (PHA—1 μg/ml) for 72 h. The levels of IFN-γ, TNF-α, IL-5, IL-10, and IL-17 were measured in these supernatants by ELISA and IL-9 by Luminex. Single nucleotide polymorphisms in IL-17, IL10, and CD209 genes were genotyped using TaqMan probe by qPCR. Higher levels of IL-9, IL-10, and IL-17 were found in PBMC supernatants of patients with advanced hepatic fibrosis. Direct correlations were detected between IL-9 and IL-17 levels with US spleen sizes, portal vein diameters, and periportal thickening. The CD209 rs2287886 AG polymorphism patients produce higher IL-17 levels. Together, these data suggest a role of these cytokines in the immunopathogenesis of advanced fibrosis in human schistosomiasis.

Objective: To characterize compliance with good practices in medical gas management in federal teaching hospitals in Brazil. Methods: A cross-sectional survey-type study, designed to perform a situational diagnosis of the pharmacy services in 40 federal teaching hospitals in Brazil linked to the Brazilian Hospital Services Company, with respect to compliance with good practices in gas management, through the application of the ABPGasMed 1.0 instrument. This instrument consists of 54 compliance standards divided into two sections (structure and process). The characterization of research participants and hospitals, and the classification of hospitals in terms of performance categories were expressed as absolute and relative values. Chi-square tests of independence were performed to investigate the association between the hospital’s performance category and the hospital’s geographic region and size. Results: In total, 87.5% of the invited hospitals participated in the study, and only 27.59% of the hospitals had a pharmacist responsible for medicinal gases. Pharmacovigilance was performed by pharmacists in 20.59% of the hospitals. Analyzing the hospitals by region of the country and size, statistically significant associations were found between the general classification of hospitals and the geographic region (x2(8)=18.936, p= 0.015), as well as the classification of the hospital and structure and size (x2(9)= 20.373, p= 0.016). Analyses of the adjusted standardized residues returned an association between the southeastern region and the satisfactory performance category when analyzing the entire instrument, and between the excellent performance category in the structure section and size of a small hospital. Conclusion: In most of the hospitals studied, management of medicinal gases did not show the desired performance, which indicates the need to comply with current healthcare legislations and improve the provided services. It is believed that compliance rates may evolve training of healthcare team members, with an emphasis on the pharmacist.

BACKGROUND The clinical activities developed by pharmacists in a hospital environment can improve health outcomes and generate savings for hospitals. However, to determine whether pharmaceutical interventions are cost effective, it is essential to define a method according to which cost-effectiveness is intended to be measured. In addition, the quality of economic assessments and the amount of information present in systematic reviews in the literature make it difficult to analyze the effects of this intervention. OBJECTIVE This paper aims to provide an overview of systematic reviews on the pharmacoeconomic impact of the performance of pharmaceutical care in hospitals. METHODS A systematic search of the Cochrane Library databases, PubMed or MEDLINE, LILACS, Scopus, Web of Science, Google Scholar, and Open Thesis will be performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The search will involve the use of keywords determined using the Medical Subject Headings database to define the search terms and include the following terms: “pharmacoeconomics,” “pharmaceutical care,” and “hospital.” The study designs to be included will be systematic reviews of good quality. Studies will be included that address pharmacoeconomics; studies that evaluated pharmaceutical care in hospitals; and studies published in Portuguese, English, or Spanish. The primary outcome sought in the systematic reviews will be the cost ratio in monetary units and the outcomes in monetary or natural units. The secondary economic outcomes considered will be determined based on factors associated with the drugs and translated into benefit, efficacy, or utility. RESULTS It is intended to start this overview in January 2023. Thus far, only previous searches have been carried out to contextualize the theme and build the protocol. CONCLUSIONS This overview will determine the pharmacoeconomic impact of pharmaceutical care interventions in the hospital environment. In addition, this study will point out which clinical outcomes in natural units are impacted by the performance of pharmaceutical care and the strengths and limitations of each approach. It will also identify gaps in the literature and areas for future work. CLINICALTRIAL PROSPERO CRD42019140665; https://tinyurl.com/bddwnz43