The low health literacy in Latin America and the Caribbean: a systematic review and meta-analysis.

BACKGROUND: Health literacy (HL) impacts people's health and well-being. In Latin America and the Caribbean (LAC), there are no general estimates of the prevalence of low HL. This study aimed to estimate the prevalence of low HL among citizens of LAC and identify the tools used to measure it. METHODS: We included observational studies quantifying the prevalence of low HL in people living in LAC. We searched PubMed, CINAHL, EMBASE, ERIC, LILACS, PsycINFO, Redalyc, SciELO, Web of Science, PQDT, and the reference lists of the included studies in June 2023. Two reviewers independently conducted the selection, extraction, and risk of bias assessment using the JBI Critical Appraisal Tools. Meta-analysis of proportions using random effects models was used to summarize the prevalence of low HL estimated. This prevalence was measured in each study using different classification methods: word recognition items, reading and numeracy comprehension items, and self-reported comprehension items. RESULTS: Eighty four studies involving 23,914 participants from 15 countries were included. We identified 23 tools to assess HL, and most of the studies were carried out in health services. The pooled prevalence of low HL were 44.02% (95%CI: 36.12-52.24) for reading and numeracy comprehension items, 50.62% (95%CI: 41.82-59.39) for word recognition items, and 41.73% (95%CI: 31.76-52.43) for self-reported comprehension items. CONCLUSION: Despite the variability in the prevalence of low HL and a diversity of tools, the average of low HL is of concern. Almost half of the participants in the included studies have low HL. Most of the studies targeted users of healthcare services. Further research investigating the prevalence of low HL in the general population and actions focused on health education, communication, and information are necessary. TRIAL REGISTRATION: PROSPERO (CRD42021250286).

The effect of different levothyroxine administration regimens on thyroid hormone levels: a systematic review, pairwise, and network meta-analysis.

INTRODUCTION: This systematic review aimed to compare the effect of alternative levothyroxine administration regimens on thyroid hormone levels and patient-reported outcomes (PROs) among adults with hypothyroidism. METHODS: We searched PubMed, Embase, CENTRAL, CINAHL, LILACS, SciELO, Scopus, Web of Science, OpenGrey, ProQuest, ClinicalTrials.gov, and ICTRP from inception to May/2023 for randomized controlled trials (RCTs). We assessed the risk of bias with Cochrane Risk of Bias 2.0 tool. We analyzed TSH levels by pairwise and network meta-analyses (NMA). The FT4 levels and PROs were qualitatively assessed. RESULTS: We included 14 RCTs (906 participants) comparing different regimens, as bedtime vs. before breakfast. A total of 12 RCTs were at high risk of bias. Seven RCTs were included in the TSH meta-analysis, where the mean difference (MD) and 95% confidence interval (CI) were as follows: bedtime vs before breakfast (4 RCTs) 0.69 (-1.67-3.04), I2 = 92%, very low certainty evidence; weekly dose vs before breakfast (2 RCTs) 1.68 (0.94-2.41), I2 = 0%, low certainty evidence; and at breakfast vs before breakfast (1 RCT) 0.65 (-1.11-2.41), very low certainty evidence. The NMA showed no evidence of differences in TSH level with different regimens. CONCLUSION: The evidence is insufficient to determine the most effective levothyroxine administration regimen for hypothyroidism. SYSTEMATIC REVIEW REGISTRATION: PROSPERO - CRD42021279375.

Antidiabetic effects of Olea europaea L. leaves in diabetic rats induced by high-fat diet and low-dose streptozotocin.

ETHNOPHARMACOLOGICAL RELEVANCE: Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia, insulin resistance, and dyslipidemia. It has broad occurrence worldwide, affecting millions of people, and can cause serious complications. The olive (Olea europaea L.) has important pharmacological functions, including anti-inflammatory, antioxidant, and hypoglycemic activities. Olive leaves are used in traditional medicine for diabetes and hypertension. AIM OF THE STUDY: To evaluate the effect of the ethanolic extract of olive leaves (EEOL) on the metabolism of rats with diabetes induced by a high-fat diet and low dose of streptozotocin (STZ). MATERIALS AND METHODS: Male Wistar rats were either given normal feed or a high-fat diet (70% standard laboratory feed, 15% sucrose, 10% lard and 5% yolk powder) for four weeks, followed by administration of STZ (35 mg/kg, via ip). Animals with fasting glucose levels above 200 mg/dL were considered diabetic. Animals were divided into 5 groups, which received ethanol (10 mL/kg), metformin (250 mg/kg), or EEOL at doses of 200 and 400 mg/kg during 10 weeks by oral gavage. Blood samples were used to measure hematological and biochemical parameters, and kidneys were removed for posterior analysis. Body weight was recorded weekly. RESULTS: A significant decrease in body weight was observed among diabetic animals treated with ethanol and EEOL compared to the control group. Moreover, animals treated with EEOL showed an improvement in glucose levels and in levels of inflammatory and metabolic markers when compared to diabetic animals. CONCLUSIONS: The results indicate a potential anti-diabetic activity of olive leaves, however more studies are needed to validate clinical effects.

Acute toxicity and antimicrobial activity of leaf tincture Baccharis trimera (Less).

BACKGROUND: The present study aimed to evaluate the possible acute oral toxicity of Baccharistrimera leaf dye as well as its antimicrobial activity. METHOD: Organization for Economic co-operation and development (OECD) 423 was used to assess acute oral toxicity and as per protocol a dose of 2000 mg/kg of tincture was administered to Wistar rats, male and female, and observed for 14 days. Biochemical and hematological analyzes were performed with sample collected of rat. The dye was evaluated for antimicrobial activity by agar diffusion and microdilution methods, which allow to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) and antibiofilm potential. RESULTS: The results showed that there was no loss of animals and no significant changes in hematological and biochemical parameters after oral administration of 2000 mg/kg of tincture and was considered safe by the OECD, classified as category 5. The dyeing also showed an important antimicrobial activity against gram positive and gram negative bacteria also significantly decreased the microbial biofilm. CONCLUSION: The tincture of B.trimera leaf when given orally once can be considered safe and has a relevant antimicrobial potential that should be elucidated in subsequent research.