A higher number of SARS-COV-2 infections in quilombola communities than in the local population in Brazil

The historical and social vulnerability of quilombola communities in Brazil can make them especially fragile in the face of COVID-19, considering that several individuals have precarious health systems and inadequate access to water. This work aimed to characterize the frequency of SARS-COV-2 infections and the presence of IgM and IgG SARS-CoV-2 antibodies in quilombola populations and their relationship with the presence of risk factors or preexisting chronic diseases in the quilombola communities. We analyzed the sociodemographic and clinical characteristics, serological status, comorbidities, and symptoms of 1,994 individuals (478 males and 1,536 females) from 18 Brazilian municipalities in the State of Sergipe of quilombola communities, which were evaluated at different epidemiological weeks, starting at the 32nd (August 6th) and ending at the 40th (October 3rd) epidemiological week. More than 70% of studied families live in rural areas and they have an extreme poverty social status. Although we found a higher number of SARS-COV-2 infections in quilombola communities than in the local population, their SARS-CoV-2 reactivity and IgM and IgG positivity varied across the communities investigated. Arterial hypertension was the most risk factor, being found in 27.8% of the individuals (9.5% in stage 1, 10.8% in stage 2, and 7.5% in stage 3). The most common COVID-19 symptoms and comorbidities were headache, runny nose, flu, and dyslipidemia. However, most individuals were asymptomatic (79.9%). Our data indicate that mass testing must be incorporated into public policy to improve the health care system available to quilombola populations during a future pandemic or epidemic.

The effectiveness of propolis extract in reducing dentin hypersensitivity: A systematic review

OBJECTIVE

This systematic review was performed to evaluate the effectiveness of propolis on dentin hypersensitivity reduction.

DESIGN

The search was conducted in Pubmed, Scopus, Web of science, Latin American and Caribbean Health Sciences Literature data base (Lilacs), Brazilian Library in Dentistry (BBO), Embase, and Cochrane Library aiming to identify relevant randomized clinical trials that evaluated the effect of propolis on dentin hypersensitivity. The Cochrane Collaboration tool was used for assessing the risk of bias.

RESULTS

From the total of 63 articles found in the search, six clinical trials were selected. All studies reported that propolis was more effective in reducing hypersensitivity than the placebo. No side effects were observed.

CONCLUSIONS

Overall, propolis extract can be considered an effective, safe and low-cost alternative to reduce the dentin hypersensitivity.

Challenges to the consolidation of pharmacovigilance practices in Brazil: limitations of the hospital pharmacist

Aims:

The aim of this study was to present the needs of hospital pharmacists in pharmacovigilance practices.

Methods:

This study has a cross-sectional design and was carried out with hospital pharmacists in Brazil. The sample was obtained by voluntary recruitment. Pharmacists who worked at Brazilian hospitals and were registered in their respective regulatory councils were invited to participate in the present study. A personalized questionnaire was developed by the authors and was electronically filled out by the respondents on the platform ‘Google forms’. The questionnaire was nationally available on the digital platform of the Pharmacy Federal Council, the Brazilian Society of Hospital Pharmacy and Health Services, four Pharmacy regional councils and the social network farmacêuticoclínico^®. Quantitative variables were analyzed by mean and standard deviation. The qualitative variables were analyzed by means of absolute and relative frequency. Difficulties related to pharmacovigilance activities are presented in an Ishikawa diagram in the Supplemental Material online.

Results:

Of the 27 federative units of Brazil, we obtained answers from pharmacists located in 85.2% (n = 23) of them. Among the pharmacovigilance practices developed by Brazilian pharmacists, the adverse drug reaction investigation (55.4%) and notification activities (47.0%) were worthy of note. Numerous difficulties were reported by the pharmacists, highlighting the difficulty in monitoring the medication and imputation of causality (27.7%). After categorizing the difficulties reported, it was observed that the category ‘people involved’ (45.1%) stood out from the others.

Conclusion:

This study pointed out numerous challenges to pharmacovigilance practices involving pharmacists in Brazil. It is believed that the correction of certain difficulties may impact on the better consolidation of pharmacovigilance activities in the country. However, regulatory agencies at all hierarchical levels of pharmacovigilance must work together to make it possible.

Plain language Summary

Challenges to the consolidation of pharmacovigilance

This is a study that seeks to present the needs of Brazilian hospital pharmacists in relation to pharmacovigilance activities. Through online interviews, pharmacists answered a questionnaire, presented the pharmacovigilance activities they develop and expressed their anxieties and difficulties for the development of these activities. With this study, it was concluded that numerous activities of active search, investigation and notification of adverse drug reaction are developed by Brazilian pharmacists. However, each pharmacist performs a different method of pharmacovigilance. In addition, it was observed that among the interviewees there was a perception of insufficient professional training and a shortage of professionals to assist in pharmacovigilance activities. These were the main difficulties reported. Therefore, the search for models or agile solutions to solve problems involving adverse drug reactions seems necessary for a better consolidation of pharmacovigilance services in Brazil.

Controle de qualidade físico-químico e caracterização fitoquímica das principais plantas medicinais comercializadas na feira-livre de Lagarto-SE

Segundo a Organização Mundial de Saúde (OMS), as plantas medicinais contribuem para a promoção da saúde, prevenção de doenças reabilitação e cura. Neste contexto, o presente estudo buscou realizar a caracterização físico – químico e fitoquímico das plantas medicinais mais comercializadas na feira – livre de Lagarto, munícipio do estado de Sergipe. As plantas medicinais mais comercializadas foram Plectranthus barbatus Andrews (boldo) 40%, Lippia alba (Mill.) N. E. Brown (erva cidreira) 25% e Pimpinella anisum L. (erva doce) 20%. Foi possível constatar os grupos dos compostos químicos provenientes do metabolismo secundário das plantas de cada espécie estudada com a ausência de alguns compostos descritos na literatura. Com relação a caracterização fitoquímica a espécie vegetal do boldo estava em sua maior parte dentro dos padrões estabelecidos pela farmacopeia, contudo as outras plantas medicinais ainda não estão incluídas na farmacopeia. Os testes realizados são vitais para o controle de qualidade, proporcionando segurança para os usuários, além de fornecer dados para futuros estudos para a padronização e desenvolvimento de novos fármacos.

Acute and sub-acute oral toxicity of Brazilian red propolis in rats

ETHNOPHARMACOLOGICAL RELEVANCE

Propolis is a bee product widely used in folk medicine due to its numerous pharmacological properties. However, samples from different regions can differ in chemical composition, effectiveness, and side effects. Despite the widespread use of Brazilian red propolis, which is an isoflavone-rich variety, its toxicity has not been carefully studied.

AIMS OF THE STUDY

To assess the acute and sub-acute toxicity of the hydroethanolic extract of red propolis (HERP) administered orally to rats.

MATERIALS AND METHODS

HERP for the acute (300mg/kg) and sub-acute (10, 100 and 200mg/kg) toxicity studies was administered orally to rats according to OECD Guidelines 420 and 407, respectively. Clinical signs were identified, and hematological and biochemical analyses were performed. Water and food uptake as well as body and organ weights of animals were recorded.

RESULTS AND CONCLUSIONS

The acute study revealed no lethal effects at 300mg/kg of HERP, but toxic signs were observed, as HERP had an LD50 of more than 300mg/kg, indicating a warning. The most toxic signals in sub-acute studies were observed in males at a dose of 200mg/kg HERP. These results suggest estrogen-like activity, possibly from the isoflavones in HERP.

Use of herbal medicines by elderly patients: A systematic review

OBJECTIVES

We aimed to survey the published literature for articles that describe the use of herbal supplements by elderly patients and to summarize important aspects of selected studies, including most commonly used supplements, study type, study location, and potential hazards of herbal supplement use.

METHODS

Literature searches were conducted on three scientific/medical databases: Medline, Web of Science, and Scopus. Search results were examined for articles involving the use of herbal products in the elderly population that met selection criteria.

RESULTS

Initial searches yielded 1297 articles. Of these original results, only 16 met specific selection criteria. Twelve (75%) of studies identified were performed in North America. Nine studies (56.25%) were conducted in the United States. Seven of the studies were cross-sectional (43.8%). The most commonly reported were gingko biloba, garlic, ginseng, aloe vera, chamomile, spearmint, and ginger. Of these, gingko and garlic are the most commonly used among community-dwelling elderly. Both of these supplements have the potential to interact with anticoagulants and produce bruising or bleeding problems.

CONCLUSIONS

The use of herbal supplements is common among the elderly, a population that takes a disproportionate share of prescription medications compared to that taken by younger populations. Among the problems uncovered by these studies was a lack of dialog between medical professionals and patients about the use of herbal supplements. Prescribers need to consider the use of herbal supplements and discuss the matter with their elderly patients when making decisions about pharmacological treatments.

Antinociceptive action and redox properties of citronellal, an essential oil present in lemongrass

Citronellal (CT) is a monoterpenoid and the major constituent of the mixture of terpenoids that give the citronella oil its lemon scent. Citronella oil is widely used around the world for various purposes and is mainly obtained from plants of the Cymbopogon genus, which are known as "lemongrass." Considering these plants have been used worldwide for various medicinal purposes, the interest of researchers to understand the biological activities of monoterpenoids related to the Cymbopogon genus has been increasing. In the present work, we investigated the antinociceptive action and the redox properties of CT. Our results indicate that intraperitoneal injection of CT was effective in reducing nociceptive face-rubbing behavior in both phases of the formalin test, which was also naloxone-sensitive. CT also evoked antinociceptive response in the capsaicin and glutamate tests. The total radical-trapping antioxidant parameter and total antioxidant reactivity assays indicate that CT at doses of 0.1 and 1 mg/mL exerts a significant antioxidant activity, which is probably related to its ability to scavenge superoxide and nitric oxide, but not H(2)O(2) or hydroxyl radicals, as evaluated separately by specific in vitro tests. These results show for the first time the antinociceptive potential of CT and indicate that the antioxidant properties of this compound may rely on its mechanism of biological actions because CT-containing natural products are used to treat various diseases related to oxidative stress and reactive species.

Antioxidant Activities and Free Radical Scavenging Potential of Bauhinia microstachya (RADDI) MACBR. (Caesalpinaceae) Extracts Linked to Their Polyphenol Content

Aqueous and hydro-ethanolic extracts of Bauhinia microstachya leaves (AEBM and HEBM) were investigated for their phenolic content and phytochemical profile (by spectrophotometry and HPLC), and for their antioxidant activities and free radical scavenging potential in different in vitro systems (TRAP, TEAC, TBARS, nitric oxide, superoxide and hydroxyl radical). HEBM presented a 27.4% higher content of phenolics when compared to AEBM and a distinct phytochemical profile was observed. Our work suggests that both extracts have potent antioxidant activities and that their antioxidant capacity and efficiency vary according to the radical-generating system. In general, HEBM was more effective than AEBM in avoiding ROS-generating damage and in scavenging the various radicals formed. Nevertheless, when results were normalized to total phenolic content, a different profile of antioxidant activities and free radical scavenging potential was observed, particularly against oxidative lipid damage and superoxide radical. B. microstachya extracts may be considered an interesting source of natural antioxidants as well as other phenolic-rich plants.