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ObjectiveTo assess the effect of pharmacist interventions on glycemic control in type 2 diabetic patients and to examine factors that could explain the variation across studies.MethodsA comprehensive literature search was performed in PubMed, Scopus, and LILACS databases for randomized controlled trials (RCTs) published up to July 2015. The search strategy included the use of MeSH terms or text words related to pharmacist interventions, type 2 diabetes, and randomized controlled trials. RCTs published in English, Portuguese, or Spanish that evaluated the effect of pharmacist intervention on glycemic control in type 2 diabetic outpatients were included. Two independent authors executed study selection, data extraction, and risk of bias assessment. Mean differences in glycosylated hemoglobin (HbA1c) were estimated using random-effect models, and heterogeneity was evaluated by subgroup and meta-regression analyses.ResultsThe literature search yielded 963 records of potential interest, of which 30 were included in the systematic review and 22 in the meta-analysis. Most of these RCTs were conducted in the United States in patients in outpatient clinics using face-to-face contact only. All RCTs performed patient education, and most executed the medication review. The appraised sample showed uncertain or high risk of bias in most of the items evaluated, resulting in low-quality studies. In comparison with usual care, pharmacist interventions were associated with significant reductions in HbA1c levels (-8.5% [95% CI: -1.06, -0.65]; P < 0.0001; I2 = 67.3%). Subgroup analysis indicated differences of heterogeneity by country, baseline HbA1c levels, setting, intervention frequency, and random allocation. Age and HbA1c levels partly explained the variability across studies by meta-regression.ConclusionsOur findings confirmed that pharmacist interventions improve glycemic control in patients with type 2 diabetes compared with usual care and suggest that younger patients or with higher baseline HbA1c levels may be the main beneficiaries of pharmacist care.Protocol PROSPERO Registration NumberCRD42014007457

Abstract Background Since the start of the new Coronavirus (COVID-19) outbreak in December 2019, pharmacists worldwide are playing a key role adopting innovative strategies to minimize the adverse impact of the pandemic. Objectives To identify and describe core services provided by the pharmacist during the COVID-19 pandemic. Methods A literature search was performed in MEDLINE, Embase, Scopus, and LILACS for studies published between December 1st, 2019 and May 20th, 2020 without language restriction. Studies that reported services provided by pharmacists during the COVID-19 pandemic were included. Two independent authors performed study selection and data extraction with a consensus process. The pharmacist's intervention identified in the included studies were described based on key domains in the DEPICT v.2. Results A total of 1,189 records were identified, of which 11 studies fully met the eligibility criteria. Most of them were conducted in the United States of America (n=4) and China (n=4). The most common type of publication were letters (n=4) describing the workplace of the pharmacist in hospitals (n=8). These findings showed the different roles of pharmacists during the COVID-19 pandemic, such as disease prevention and infection control, adequate storage and drug supply, patient care and support for healthcare professionals. Pharmacists' interventions were mostly conducted for healthcare professionals and patients (n=7), through one-to-one contact (n=11), telephone (n=6) or video conference (n=5). The pharmacists' main responsibility was to provide drug information for healthcare professionals (n=7) as well as patient counseling (n=8). Conclusions A reasonable number of studies that described the role of the pharmacists during the COVID-19 pandemic were found. All studies reported actions taken by pharmacists, although without providing a satisfactory description. Thus, future research with more detailed description as well as an evaluation of the impact of pharmacist intervention is needed in order to guide future actions in this and-or other pandemic. Keywords: COVID-19; pharmacists; pharmaceutical services; review

Aripiprazole exhibited efficacy similar to that of other antipsychotic drugs and a better safety profile than that of typical (i.e., less some extrapyramidal side effects) and atypical (i.e., less metabolic changes) antipsychotic drugs.

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Introdução: A medida fundamental de isolamento social tomada pelas autoridades sanitárias internacionais para conter o avanço da pandemia de COVID-19 traz consequências no campo econômico e social. Dentre elas se destaca o aumento da miséria e da fome, comprometendo a garantia da Segurança Alimentar e Nutricional. Dentre programas existentes na agenda pública como forma de amenizar as consequências da fome, se ressalta o Programa Nacional de Alimentação Escolar. Objetivo: Este trabalho busca problematizar, por meio de reflexões teóricas e críticas, a contribuição do Programa Nacional de Alimentação Escolar na garantia da segurança alimentar e nutricional dos estudantes brasileiros no período da pandemia da COVID--19. Resultado: Um debate teórico sobre o direito em questão foi apresentado, ressaltando a análise da alimentação escolar como um potencial para manutenção da segurança alimentar dos milhares de estudantes beneficiários. No contexto da pandemia, o programa de alimentação escolar apresenta mudanças na sua legislação como resposta as adaptações na sua forma operacionalização. Conclusão:Reforça-se a importância da sociedade civil organizada em defesa das políticas públicas de segurança alimentar, em especial no apoio e sustentabilidade programa de alimentação escolar, bem como no papel do Estado como protagonista do combate à fome e da redução da miséria no país, assumindo o fortalecimento das políticas sociais existentes.Introdução: A medida fundamental de isolamento social tomada pelas autoridades sanitárias internacionais para conter o avanço da pandemia de Covid-19 traz consequências no campo econômico e social. Dentre elas se destaca o aumento da miséria e da fome, comprometendo a garantia da Segurança Alimentar e Nutricional. Dentre programas existentes na agenda pública como forma de amenizar as consequências da fome, ressalta-se o Programa Nacional de Alimentação Escolar. Objetivo: Este trabalho busca problematizar, por meio de reflexões críticas, a contribuição do Programa Nacional de Alimentação Escolar na garantia da segurança alimentar e nutricional dos estudantes brasileiros no período da pandemia da Covid-19. Resultado: Um debate crítico sobre o direito em questão foi apresentado, ressaltando a análise da alimentação escolar como um potencial para manutenção da segurança alimentar dos milhares de estudantes beneficiários. No contexto da pandemia, o programa de alimentação escolar apresenta mudanças na sua legislação como resposta às adaptações na sua operacionalização. Conclusão: Reforça-se a importância da sociedade civil organizada em defesa das políticas públicas de segurança alimentar e nutricional, em especial no apoio do programa de alimentação escolar, bem como no papel do Estado como protagonista do combate à fome e da redução da miséria no país, assumindo o fortalecimento das políticas sociais existentes.

Therapeutic monitoring of the antibiotic vancomycin is important to achieve specific plasma concentration and prevent toxic effects. Several assays have been described for vancomycin determination in clinical practice, but high-performance liquid chromatography is still considered the gold standard for the quantification of vancomycin. In this study, we developed a new and rapid high-performance liquid chromatography method requiring 50 μL of plasma for the quantification of vancomycin. Acetonitrile was used for processing plasma by protein precipitation (1:2.5). Isocratic chromatographic analysis was carried out on a C18 silica-based (2.7 μm) column with the mobile phase containing 20 mM ammonium acetate/formic acid buffer (pH 4.0):methanol 88:12 (v/v). A diode array detector was used for UV detection at 240 nm. This method was validated according to the Brazilian Health Surveillance Agency legislation and International Conference on Harmonization guidelines. The measurement range was 1-100 μg/mL, analysis time was 8 min, and intermediate precision was <12%, supporting the present method as a fast, simple, and effective alternative for therapeutic monitoring of vancomycin.