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Canabidiol para controle glicêmico em Diabetes Mellitus: uma revisão sistemática e meta-análise

2026-02-26T00:00:00Z

Título: Canabidiol para controle glicêmico em Diabetes Mellitus: uma revisão sistemática e meta-análise Autor(es): Souza, Jessiane Bispo de Abstract: The loss of pancreatic beta cell function, associated with insulin resistance, contributes to the persistent hyperglycemia characteristic of Diabetes Mellitus (DM). This glycemic dysregulation promotes alterations in biochemical markers, such as HbA1c, fasting and postprandial blood glucose, and insulin levels. Although pharmacotherapy is essential for the management of DM, its adverse effects, mainly gastrointestinal and hypoglycemic, can compromise adherence to treatment. In this scenario, cannabidiol (CBD), a phytocannabinoid derived from Cannabis sativa, has demonstrated great therapeutic potential for various conditions, including epilepsy, chronic pain, and DM. Therefore, this systematic review sought to analyze evidence on the use of CBD in the control of hyperglycemia. The search in four databases identified 856 articles, of which 15 studies were selected, 14 preclinical and 1 clinical. Nine preclinical studies demonstrated a reduction in glucose levels, possibly associated with modulation of the endocannabinoid system, especially in the inhibition of anandamide degradation and consequent stimulation of canonical and non-canonical receptors that are also part of metabolic control. A meta-analysis of 14 in vivo studies indicated that CBD significantly decreased blood glucose levels. The studies presented a risk of bias ranging from low to moderate. It is concluded that CBD shows potential for controlling hyperglycemia, although further preclinical and clinical studies are needed to elucidate the mechanisms involved in regulating blood glucose levels and thus guide new therapeutic approaches and research on the subject, serving as supporting material for possible clinical applications.

A questão étnico-racial na formação farmacêutica: uma análise curricular das Instituições Federais de Ensino Superior Brasileiras

2023-08-18T00:00:00Z

Título: A questão étnico-racial na formação farmacêutica: uma análise curricular das Instituições Federais de Ensino Superior Brasileiras Autor(es): Cavalcante, Nayara Costa

Cuidado farmacêutico em pacientes com artrite reumatoide

2024-12-06T00:00:00Z

Título: Cuidado farmacêutico em pacientes com artrite reumatoide Autor(es): Costa, Alana Teles Abstract: Rheumatoid arthritis (RA) is a systemic autoimmune disease whose management involves complex therapies, often associated with polypharmacy and drug-related problems. The involvement of pharmacists within the multidisciplinary healthcare team may enhance the effectiveness and safety of treatment. Therefore, the objective of this study was to evaluate the effect of pharmaceutical care on patients with RA. This study was conducted in three complementary stages. Initially, a systematic review was performed to address the central question: “What is the effect of pharmaceutical care in patients with RA, and how is this care being delivered?” The protocol was registered in PROSPERO (CRD42020133705). Subsequently, a pilot randomized controlled trial (RCT), approved by the research ethics committee and registered under number RBR-8494rf7, was conducted to evaluate the effect of pharmaceutical care in patients with RA attending a rheumatology outpatient clinic in Brazil. Finally, considering that approximately 25% of patients with RA have renal impairment, the third stage consisted of a systematic review on the pharmacokinetics and dose adjustment of antimicrobials in patients undergoing renal replacement therapy (RRT). This protocol was also registered in PROSPERO (CRD42024532462). The systematic review on pharmaceutical care in patients with RA identified a total of 3,078 titles. Six met the predefined criteria and were included, comprising a total of 337 patients with RA. All six RCTs presented some limitations, and only one was classified as having a low risk of bias. In 66.6% of these studies, the intervention consisted of a short-term service focused on health education. When the intervention was remote and short-term, improvements in pharmacotherapy adherence reached up to 8% (P < 0.05). In contrast, when a comprehensive pharmacotherapeutic follow-up service was provided, adherence improved by up to 59% (p=0.002). Pharmaceutical interventions were also associated with significant improvements in beliefs about medicines, patient satisfaction, reductions in drug-related problems, and treatment costs. In the RCT conducted in the second stage, a total of 14 patients with RA were included, with seven allocated to each group. The medication review service, delivered by pharmacists using a hybrid model, demonstrated a statistically significant benefit for the intervention group compared with the control group regarding pharmacotherapy adherence (p=0.041) and drug-related problems (p=0.019). No significant differences were observed in quality of life, pain, or satisfaction with care. The systematic review on antimicrobial pharmacokinetics and dosing in patients undergoing RRT identified 488 titles. Thirty-two met the predefined criteria and were included, encompassing a total of 1,641 patients. Of the 31 included studies, 22 were classified as high quality, three as moderate, and seven as low quality. Most studies indicated that dose adjustments of currently used antimicrobials are required in patients undergoing RRT to ensure effectiveness and safety. These studies recommended regular therapeutic drug monitoring to achieve therapeutic targets and reduce mortality rates. Overall, the results demonstrate that pharmaceutical care, delivered in face-to-face, remote, or hybrid formats, has a significant positive impact on patients with RA. Additionally, the findings provide important context and deeper insights into essential aspects of safer and more personalized clinical pharmacy practice for the subpopulation undergoing RRT.

Fatores responsáveis pela prevalência global das geohelmintíases: uma overview de revisões sistemáticas

2019-08-23T00:00:00Z

Título: Fatores responsáveis pela prevalência global das geohelmintíases: uma overview de revisões sistemáticas Autor(es): Ramos Neto, Adelson Ferreira Abstract: It is estimated that more than 1.5 billion people are infected with at least one soiltrasmitted helminth. Although the prevalence of geohelminthiasis and its associatedfactors have been studied over the years, this parasitosis is classified by the WorldHealth Organization (WHO) as Neglected Tropical Disease. Systematic review studieson the subject collect information on infection rates and associated factors in severalcountries. The objective of this overview of systematic reviews is to discuss howenvironmental factors, host-related risk factors, and control strategies influence theprevalence of soil-transmitted helminths in different regions of the world. The followingdatabases were used: LILACS, PubMed, Web of Knowlegde, Embase and TheCochrane Library and Clinical Trials (gray literature). In each of these databases thefollowing descriptors were used: helminths, geohelminths, soil-transmitted helminths, epidemiology, prevalence, Ascaris lumbricoides, Trichuris trichiura, Necatoramericanus, Ancylostoma duodenale, systematic review. Systematic reviews wereincluded, with or without meta-analysis, published until December 2017 and theinclusion criteria were: (i) to present a clear research question and eligibility criteriaused for the selection of the studies; (ii) describe all the sources of information in thesearch and the keywords used; (iii) present the number of studies found in the sources ofinformation and included in the final sample of the systematic review. The evaluation ofthe quality of the studies was done using the AMSTAR tool (Assessing theMethodological Quality of Systematic Reviews). The initial results of the bibliographicsearch identified 1,448 articles of which 125 were excluded by simultaneous indexing intwo or more databases. After review reviews, 17 met the inclusion criteria and wereused in this overview. Factors such as climate, MDA (Mass Drug Administration), WASH (Water, Sanitation and Hygiene) access, shoe use and nutritional status wereconsidered to be the main culprits for the prevalence rate of geohelminthiases. AlthoughWHO strategies to reduce the prevalence of geohelminthias have a positive short-termeffect, it is necessary to understand other aspects, such as socioeconomic and culturalfactors, to achieve satisfactory rates of prevalence.