Browsing by Issue Date, starting with "2019-06-17"
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- Inhaled Therapy-Associated Adverse Reactions in Obstructive Respiratory DiseasesPublication . Fonseca, Willy Anselmo Ribeiro; Barata, Luís Manuel Taborda; Monteiro, Cristina Sofia de JesusIntroduction: Obstructive lung diseases (OLDs) include asthma, chronic obstructive pulmonary disease (COPD), and asthma/COPD overlap (ACO). OLDs therapy includes medications that are administered through inhalation devices belonging to the following classes: corticosteroids, ?2-adrenergic receptor agonists and muscarinic receptor antagonists. Certain adverse drug reactions (ADRs) associated with this therapy have been reported in pre-marketing clinical trials and case reports. However, there are few post-marketing surveillance studies focused on suspected ADRs spontaneously reported to the Pharmacovigilance system, and none has been published in Portugal. Objectives: To characterise spontaneous reports (SRs) of suspected ADRs associated with OLDs inhaled therapy received by the Portuguese Pharmacovigilance System (PPS), from 2007 to 2017. Materials and methods: Retrospective observational study based on the analysis of suspected ADRs spontaneously reported to the PPS, associated with 20 inhalers of the following classes: LAMA (long-acting muscarinic antagonists), SAMA (short acting muscarinic antagonists), SABA (short-acting ?2 agonists) and LABA (long-acting ?2 agonists), ICS (inhaled corticosteroids), LAMA / LABA combination, SAMA / SABA combination and ICS / LABA combination. SRs were evaluated according to the demographic characteristics of the patients, pharmacological classes of suspected drugs, type and seriousness of suspected ADRs. Results: 230 SRs were analysed, accounting for a total of 599 suspected ADRs. There was a trend towards an increase in the number of notifications over the years under study, with the average being 2 SRs per 1000 inhabitants with one OLD per year. The ICS/LABA combination obtained the highest frequency in both SRs (n = 74, 32.2%) and in ADRs (n = 196, 32.7%). There was a slight predominance in men (SR n = 118, 51.3%) and non-elderly adults were the most affected age group (SR n = 90, 39.1%). The majority of SRs were classified as being serious (n = 162, 70.4%). In total, "respiratory, thoracic and mediastinal diseases" ADRs were the most reported ones (n = 117, 19.5%), with "dyspnoea" being the most frequent one (n = 29; 4.8%). There were many cases of medication errors associated with symptoms and exacerbations, and also cases of SABAs overdose. Conclusions: Most of the SRs were associated with controller medications and classified as being serious. Most of the reactions were expected, with the authorities' recommendation being to review those not expected to update the drug safety profile. The present data confirm the existence of errors in the use of inhalation devices, which are associated with suboptimal levels of therapeutic effect and, therefore, ineffective control of the diseases. The data also indicate the existence of overuse of relieving medication.
- Interactions of Phenolic Compounds with OvalbuminPublication . Vapor, Alcides; Tomaz, Cândida T.; Mendonça, AntónioOvalbumin (OVA) is the major protein in egg white and can cause allergy mainly in infants and young children [1]. Egg allergy is an IgE mediated reaction and is one the most common food allergies. So far, the avoidance of the egg has been the unique way to prevent this allergy [2]. It is well known that phenolic compounds can bind to proteins promoting structural and functional changes. In this work, the interactions between OVA and the phenolic compounds were studied through spectroscopic techniques (fluorescence, circular dichroism (CD), Fourier transform infrared spectroscopy (FTIR)) and docking. OVA solutions were incubated at different temperatures and times, with different phenolic compounds prepared with the same buffer solution (Gallic, Caffeic, Ferulic, Chlorogenic and Tannic Acids, Resveratrol and Quercetin). Results indicate that OVA's structure was affected by the binding of phenolic compounds. CD and FTIR experiments showed changes in the secondary structure of OVA, originated by the conversion of α-helix into β-sheets [1]. Fluorescence spectra demonstrated that phenolics are quenchers of fluorescent aminoacids (Tyrosine, Phenylalanine and Tryptophan) meaning that interactions occur directly or near these aminoacids. Fluorescence results also suggest that these interactions are electrostatic and thermodynamically favorable (∆G<0). Docking studies showed that the tested phenolic compounds can interact directly with OVA epitopes, or with its neighbors, thus avoiding the IgE binding. Therefore, the phenolic compounds can be used as a strategy for reducing egg allergy in foods.
- Gastroenterite Vírica em Idade PediátricaPublication . Lasca, Andreia Pinto; Maio, António Gonçalves Candeias da GuerraA gastroenterite é definida como uma inflamação da mucosa do trato gastrointestinal, caracterizada clinicamente por diarreia de início súbito, podendo ser acompanhada por náuseas, vómitos, febre ou dores abdominais. A diarreia geralmente é autolimitada e resolve em poucos dias. Trata-se de uma patologia frequente em idade pediátrica, principalmente durante os primeiros anos de vida, representando a segunda causa mais frequente de internamento em Pediatria. Os agentes mais comumente associados à gastroenterite infeciosa diferem de acordo com a faixa etária, a região geográfica e o tipo de diarreia. A maioria das gastroenterites são devidas a vírus entéricos, podendo ser também causada por infeções bacterianas ou protozoárias. Menos frequentemente, a diarreia aguda poderá ser parte integrante de uma infeção sistémica ou emergência cirúrgica. Dentro das causas víricas, os agentes mais frequentes são o rotavírus (principal agente etiológico), norovírus, adenovírus entérico, astrovírus e sapovírus. Entre as medidas de prevenção da gastroenterite aguda estão incluídas a vacinação contra o rotavírus (o que tem aumentado a incidência de outros vírus), lavagem das mãos com água e sabão, troca adequada das fraldas, desinfeção de água obtida de fontes inseguras, exclusão de crianças sintomáticas de infantários ou escolas e precauções de contacto para crianças hospitalizadas. Tendo em conta a importância desta patologia e sua frequência, bem com os gastos em saúde associados, fez-se uma revisão bibliográfica atualizada para compreender melhor a epidemiologia da doença, a sua etiologia, fisiopatologia, vias de contágio, principais fatores de risco, terapêutica e medidas preventivas a adotar para evitar a aquisição e transmissão interpessoal da doença.