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

Fri, 18 Aug 2023 00:00:00 GMT

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

Fri, 06 Dec 2024 00:00:00 GMT

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

Fri, 23 Aug 2019 00:00:00 GMT

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.

Desempenho dos métodos de Kato-Katz e Helmintex para o diagnóstico da esquistossomose mansoni em área endêmica no Estado de Sergipe

Fri, 22 Sep 2023 00:00:00 GMT

Título: Desempenho dos métodos de Kato-Katz e Helmintex para o diagnóstico da esquistossomose mansoni em área endêmica no Estado de Sergipe Autor(es): Menezes, Daniel Lima Abstract: Schistosomiasis is a parasitic infection caused by the helminth Schistosoma mansoni and represents a serious public health problem in tropical regions, affecting more than 250 million people worldwide. In Sergipe, the disease is endemic and affects more than 65% of the state's municipalities. The Schistosomiasis Control Program (SCP) uses the Kato-Katz (KK) method for population screening, as recommended by the World Health Organization, but there is growing evidence for the sensitivity limitations associated with KK, especially in areas with low parasite loads. Helmintex (HTX) is a sensitive egg detection method based on the magnetic properties of S. mansoni eggs and their isolation in a magnetic field. The aim of this study is to evaluate both KK and HTX in an endemic area for schistosomiasis in Sergipe, Areia Branca, located in the municipality of Pacatuba. Individuals from six years older who signed the term of consent and/or free and informed assent and who provided fecal samples in sufficient quantity to carry out the tests participated in the project. At the end, the results were delivered to the population and all positive individuals were treated. A total of 234 individual fecal samples were delivered and two KK thick smears were prepared and evaluated for each sample. A total of 30g of each fecal sample was processed by the HTX method. Eggs were detected in 80 (34.18%) of the participants. Twenty-three (9.83%) samples were positive by the KK method and 77 (32.91%) by the HTX method. A total of 95.7% (22/23) of the positive samples in the KK method had mild infections and only one individual (4.3%) had a moderate infection (108 OPG, eggs per gram of feces). The age of the sampled population ranged from six to 97 years, with a mean of 35.5 ± 18.1 years. There was no statistical relationship between infection and age (KK vs. AGE -0.442; HTX vs. AGE - 0.543). More than half of the participants were female (56.98%). The gender variable showed that men were more likely to become infected, according to KK (PR: 2.91) and HTX (PR: 1.79) data. The sensitivity of KK was 28.8% while that of HTX was 96.2%. The ROC curve showed that the probability of detecting schistosomiasis is higher with Helmintex (0.98) than with Kato-Katz (0.64). A HTX detects 3.3x more PPV and 25% more NPV. Public policies are necessary to change the panorama of neglected diseases, especially in the control of schistosomiasis in endemic areas.