Atherosclerotic cardiovascular disease (ASCVD), affects approximately 18.6 million individuals worldwide and poses a significant healthcare related challenge. Despite the established efficacy of both high-intensity statin monotherapy (HIS) and moderate-intensity statin plus ezetimibe (MIS+EZT) in ASCVD management, the optimal treatment strategy remains unclear. A thorough literature study was conducted across PubMed, Embase, and the Cochrane databases, focusing on studies that compared the effects of moderate-intensity statins plus ezetimibe with high-intensity statin monotherapy in ASCVD patients. In the 13 included studies, involving 8,592 patients, 4,525 (52.67 %) of which received moderate-intensity statin plus ezetimibe treatment. The follow-up period ranged from 4 to 156 weeks, with participant ages varying LDL-C from 55.2 to 71 years old. Analysis revealed significant MIS+EZT-associated with greater percentages of patients achieved the goal in Low-Density Lipoprotein (LDL-C) < 70 (Odds Ratio (OR) 1.76; 95 % CI [1.26; 2.45]; p = 0.001; I² = 73 %), LDL-C reduction (Mean Difference (MD) -5.05 mg/dL; 95 % CI [-9.02;-1.07]; p < 0.013; I² = 56 %;); Total Cholesterol reduction (MD -7.91 mg/ dL; 95 % CI [-14.90; -0.91]; p < 0.027; I² = 60 %); Triglycerides reduction (MD -8.20 mg/ dL; 95 % CI [-13.05; -3.35]; p < 0.001; I² = 2 %;); There was no statistical difference between groups in Drug Adverse reaction (Risk Ratio (RR) 1.19; 95 % CI [0.79; 1.78]; p = 0.404; I² = 0 %); and Drug intolerance (RR 0.78; 95 % CI [0.32; 1.92]; p = 0.584; I² = 35 %). This meta-analysis highlights the effectiveness of MIS+EZT in improving significant lipid profile components for ASCVD patients, as can been seen through the greater percentage of patients achieving the LDL-C < 70 mg/dL target and lower LDL-C, total cholesterol and triglycerides levels. Importantly, there were no significant differences in the occurrence of overall adverse events and adverse drug reactions between the two groups.

A violência sexual contra crianças e adolescentes (VSCA) é uma epidemia, que segue trazendo inúmeras consequências para a saúde individual e coletiva. Devido ao agravamento da pandemia, desencadeada pelo vírus SARS-CoV-2, e a fundamentalidade da determinação de medidas restritivas que se iniciaram em março de 2020, evidenciou-se um aumento na vulnerabilidade das vítimas, que se mantiveram distantes de agentes de sua rede de apoio principal, as escolas. Objetivo: Analisar o agravamento dos casos de VSCA durante a pandemia de COVID-19 no Brasil. Metodologia: Revisão sistemática de caráter qualitativo e exploratório, seguindo o protocolo PRISMA. Resultados: Demonstraram que dentre as vítimas de 0 até 9 anos, as meninas representam 77%, já entre 10 e 19 anos, o sexo feminino (SF) corresponde por 91% dos registros, ou seja, 86,9% das vítimas de abuso sexual infantil são meninas. Quanto aos autores, 85,2% eram conhecidos das vítimas e 96,3% eram do sexo masculino – parentes, pessoas próximas com livre acesso às crianças o que dificultam ainda mais o processo de denúncia. Conclusão: O aumento dos casos é evidente no Brasil, principalmente em crianças e adolescentes do SF, e que o isolamento social limitou a possibilidade de as vítimas acionarem as redes de apoio. Frisa-se que identificação dos grupos vulneráveis e a proteção destes, só ocorre através da sua notificação e do desenvolvimento de políticas públicas em todas as esferas – saúde, assistência social, educação, segurança pública etc. – e é claro, da sociedade civil.

Background: Donanemab, a monoclonal antibody targeting amyloid-β (Aβ) plaques, has shown the ability to reduce cerebral amyloid burden in early Alzheimer's disease (AD). However, uncertainties remain regarding its clinical relevance, particularly in relation to tau pathology, APOE ε4 genotype, and methodological limitations in existing trials. Objective: To conduct a systematic review and exploratory meta-analysis to evaluate the efficacy, safety, and tolerability of donanemab in patients with mild to moderate AD. Methods: We conducted a systematic review and exploratory meta-analysis following PRISMA guidelines. Randomized controlled trials comparing donanemab to placebo in individuals aged ≥65 years with biomarker-confirmed mild to moderate AD were included. Outcomes included cognitive measures (ADAS-Cog13, MMSE, CDR-SB, iADRS, ADCS-iADL) and adverse events (ARIA-E, ARIA-H, infusion reactions, discontinuations). Random-effects models were used to estimate pooled mean difference (MD) or risk ratio (RR) with 95% confidence intervals. Subgroup analyses were performed by baseline tau burden and APOE ε4 genotype. Results: Three trials (n = 2054) were included. Donanemab modestly reduced cognitive decline compared to placebo: ADAS-Cog13 (MD, −1.86), CDR-SB (MD, −0.36), MMSE (MD, 0.64), and iADRS (MD, 3.19), with similar effects across tau subgroups. The risk of ARIA-E was markedly increased (RR, 12.39), especially among APOE ε4 homozygotes. Infusion reactions (RR, 11.90) and discontinuations (RR, 3.22) were also more frequent. Conclusions: Donanemab demonstrated modest cognitive benefits, the clinical significance of which remains uncertain. Independent, longer-term trials with rigorous methodology and active comparators are warranted to more clearly define its therapeutic value in the treatment of AD.