Ana Cyra dos Santos Lucas

This systematic review and meta-analysis aimed to synthesise the evidence on the association between sense of coherence (SOC) and the utilisation of dental services among children and adolescents. Children and adolescents aged 0–18 years and/or their parents were included. The outcome was utilisation of dental services (regular attendance and preventive-oriented use), in relation to individual or parental SOC (assessed using the SOC-13 instrument). This systematic review (PROSPERO No CRD42024626799) was conducted in accordance with the PRISMA guidelines. A comprehensive search of electronic databases (PubMed, Web of Science, EMBASE, LILACS, Scopus, and APA PsycINFO), and grey literature was conducted on January 14, 2025, and updated on September 30, 2025. No language restrictions were applied. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Meta-analyses using random-effects were performed. Eleven studies (one cohort study and ten cross-sectional studies) were included. Of these, 10 were eligible for meta-analysis. The pooled results showed a significant association between higher parents’ SOC and more regular use and preventive-oriented utilisation of dental services among children and adolescents. No statistically significant association was observed between adolescents’ SOC and dental service utilisation. Considerable heterogeneity was identified across studies. In conclusion, higher parental SOC was associated with more regular dental attendance and preventive dental care patterns during childhood and adolescence. These results underscore the relevance of psychosocial determinants within the family context and support public health strategies that incorporate family-centred and salutogenic approaches to promote preventive oral health behaviours.

Objetivo: identificar as evidências científicas sobre as práticas de cuidado em saúde com pessoas idosas acamadas na Atenção Domiciliar (AD). Métodos: protocolo de revisão de escopo, desenvolvido conforme a metodologia do Joanna Briggs Institute, registrado com o DOI 10.17605/OSF.IO/YTNM9. Será adotada a estratégia PCC: População (pessoas idosas acamadas em assistência na APS), Conceito (práticas de cuidado em saúde por profissionais da APS) e Contexto (Atenção Domiciliar) do objeto a ser pesquisado. A busca será realizada em cinco bases científicas de dados e na literatura cinzenta, mediante equação de busca. A seleção do material acerca da temática será realizada com auxílio do Rayyan®. Resultados: fluxo de seleção de artigos será apresentado na forma de diagrama e os resultados da revisão serão apresentados por meio de análise estatística descritiva, utilizando de tabelas e figuras. Considerações finais: espera-se fornecer um panorama sobre o atendimento de pessoas idosas acamadas em domicílio.

Background: Pharmacist-led clinical services play a crucial role in the care of people living with HIV (PLWH), contributing to adherence, therapeutic optimization, and improved health outcomes. This scoping review aimed to map and describe pharmacist-led services for PLWH, including service types, locations, outcomes, and geographic distribution. Methods: A comprehensive literature search was conducted in Medline/PubMed, Scopus, Web of Science, Lilacs, ProQuest, and LA Referencia, covering studies from 1986 onward, with no language restrictions. Eligible studies addressed PLWH on antiretroviral therapy receiving pharmacist-led services in outpatient, hospital, or home-based settings. The review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. Results: Of the 8,864 records identified, 146 studies met the inclusion criteria. Most were conducted in North America (51.9%) and Europe (21.8%). Study designs included observational (48.9%), interventional (42.8%), and review articles (9.6%). Research output increased over the past two decades, with publication peaks in 2009, 2014, and 2018. Outpatient clinics were the most frequent setting (n=98), followed by hospitals (n=41) and home care (n=2). Most studies occurred in urban areas (n=129). Common services included medication therapy review (68.0%), health education (61.9%), and pharmacotherapeutic follow-up (61.2%). Less frequent services included medication reconciliation, chronic disease management, dispensing, screening, and therapeutic drug monitoring. Services were primarily delivered by pharmacists alone, with some collaboration with physicians or nurses. Conclusion: This review highlights the growing interest in pharmacist-led services for PLWH and offers a foundation for future studies by identifying established areas and research gaps.

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multiorgan inflammatory involvement and a mortality rate that is 2.6-fold higher than individuals of the same age and sex in the general population. Approximately 50% of patients with SLE develop renal impairment (lupus nephritis). Delayed diagnosis of lupus nephritis is associated with a higher risk of progression to end-stage renal disease, the need for replacement therapy, and mortality. The initial clinical manifestations of lupus nephritis are often discrete or absent and are usually detected through complementary tests. Although widely used in clinical practice, their accuracy is limited. A great scientific effort has been exerted towards searching for new, more sensitive, and specific biomarkers in recent years. Some systematic reviews have individually evaluated new serum and urinary biomarkers tested in patients with lupus nephritis. This overview aimed to summarize systematic reviews on the accuracy of novel serum and urinary biomarkers for diagnosing lupus nephritis in patients with SLE, discussing how our results can guide the clinical management of the disease and the direction of research in this area. Methods: The research question is “What is the accuracy of the new serum and urinary biomarkers studied for the diagnosis of LN in patients with SLE?”. We searched for systematic reviews of observational studies evaluating the diagnostic accuracy of new serum or urinary biomarkers of lupus nephritis. The following databases were included: PubMed, EMBASE, BIREME/LILACS, Scopus, Web of Science, and Cochrane, including gray literature found via Google Scholar and PROQUEST. Two authors assessed the reviews for inclusion, data extraction, and assessment of the risk of bias (ROBIS tool). Results: Ten SRs on the diagnostic accuracy of new serum and urinary BMs in LN were selected. The SRs evaluated 7 distinct BMs: (a) antibodies (anti-Sm, anti-RNP, and anti-C1q), (b) cytokines (TWEAK and MCP-1), (c) a chemokine (IP-10), and (d) an acute phase glycoprotein (NGAL), in a total of 20 review arms (9 that analyzed serum BMs, and 12 that analyzed BMs in urine). The population evaluated in the primary studies was predominantly adults. Two SRs included strictly adults, 5 reviews also included studies in the paediatric population, and 4 did not report the age groups. The results of the evaluation with the ROBIS tool showed that most of the reviews had a low overall risk of bias. Conclusions: There are 10 SRs of evidence relating to the diagnostic accuracy of serum and urinary biomarkers for lupus nephritis. Among the BMs evaluated, anti-C1q, urinary MCP-1, TWEAK, and NGAL stood out, highlighting the need for additional research, especially on LN diagnostic panels, and attempting to address methodological issues within diagnostic accuracy research. This would allow for a better understanding of their usefulness and possibly validate their clinical use in the future. Registration: This project is registered on the International Prospective Registry of Systematic Reviews (PROSPERO) database (CRD42020196693).

Este estudo tem por objetivo descrever a organização do cuidado especialmente direcionado a condições crônicas por equipes da Estratégia Saúde Família no estado do Amazonas e região Amazônica, Brasil. Trata-se de pesquisa avaliativa baseada em observação em unidades básicas de saúde e entrevistas com profissionais. Os resultados indicam alta rotatividade de profissionais, baixa disponibilidade de insumos indispensáveis ao atendimento; organização fragmentária do cuidado; limitado uso de protocolos, planejamento e programação baseados em critérios de risco e vulnerabilidade. A situação reflete-se em falta de longitunidalidade e integralidade do cuidado, pautado em demanda espontânea e voltado às queixas clínicas

Foi realizado um levantamento sobre uso de psicotrópicos entre estudantes da Faculdade de Ciências da Saúde da Universidade Federal do Amazonas, Manaus, Brasil, em uma amostra de 521 alunos. O "uso na vida" de álcool foi relatado por 87,7% dos estudantes (IC95%: 85,34-90,06) e o de tabaco por 30,7% (IC 95%: 27,39-34,01), sendo o último maior entre estudantes do sexo masculino (39,7%; IC95%: 33,33-46,01). As substâncias ilegais mais usadas foram: solventes (11,9%; IC95%: 9,57-14,23), maconha (9,4%; IC95%: 7,30-11,50), anfetamínicos e ansiolíticos (ambos com 9,2%; IC95%: 7,12-11,28), cocaína (2,1%; IC95%: 1,07- 3,13) e alucinógenos (1,2%; IC95%: 0,42-1,98). O principal motivo relatado para o uso de drogas ilegais foi a curiosidade. O "uso na vida" de esteróides anabolizantes foi citado por 2,1% dos estudantes. O uso abusivo de álcool nos últimos 30 dias foi relatado por 12,4% dos universitários. Entre os eventos ocorridos após a ingestão de bebidas alcoólicas, os estudantes citaram envolvimento em briga (4,7%), acidentes (2,4%), faltaà escola (33,7%), falta ao trabalho (11,8%) e condução de veículos (47,3%). A opinião sobre as drogas e o padrão de uso dos estudantes não diferem muito dos estudos semelhantes em outras regiões do Brasil.

Methadone elimination half-life was determined in 18 patients under maintenance treatments and found to range from 2.05 to 49.6 h. A study of potential correlations between this parameter and the presence of concomitant drugs, inhibitors or inducers of cytochrome P450, revealed an increase or decrease of methadone elimination half-life, respectively. Twenty-four-hour urinary excretion of methadone was determined in three patients, who were found to release 22.3-49.8% of the dose taken. The amount excreted varied with the chemical form (unaltered drug or its main metabolite) in the three cases. No statistically significant correlation was found between urine pH and the elimination half-life (p < 0.50).

Solid-phase microextraction (SPME) with a 100-µm polydimethylsiloxane film fiber was applied to the determination of methadone and 2-ethylidine-3,3-diphenylpyrrolidine (EDDP) by GC-MS in human saliva and compared with liquid-liquid extraction. A shorter extraction time of 30 min with the fiber was obtained, speeding up the total analysis time. Linearity was found for SPME from 0.05 to 2.0 µg/mL (r = 0.9976 for methadone; r = 0.9988 for EDDP) with precision between 0.7 and 4.3% for saliva spiked with 0.2 and 1.5 µg/mL of methadone and EDDP. The limit of detection using SPME was 0.04 Ég/mL for methadone and 0.008 µg/mL for EDDP. Analytical recoveries of SPME and liquid-liquid extraction ranged from 98.8 to 103.6%. The use of deuterated internal standard by both methods have yielded comparable results. Thus, the SPME method is highly accurate, precise, and useful for determination of methadone and EDDP in saliva.

A simple, rapid method for the determination of methadone and its metabofite 2-ethylene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) in plasma using solid-phase microextraction (SPME) and gas chromatography-mass spectrometry is proposed. A 100-µm polydimethylsiloxane film fiber was exposed by immersion for 30 min in a diluted plasma solution (1:4 with buffer pH 9) containing both compounds and an internal standard (proadifen). Calibration curves were linear over the concentration range 50–2000 ng/mL. The analysis time was 45 min per sample. The determination of methadone and EDDP was subject to no interference. The performance of SPME was compared with that of liquid-liquid extraction, obtaining lower limits of detection for EDDP. The method using the two extraction procedures was applied to 10 plasma samples from methadone-treated patients.