The effect of high-intensity interval training on post-exercise oxygen consumption: a meta-analysis / Efecto del entrenamiento de intervalos de alta intensidad sobre el consumo de oxígeno después delejercicio: metaanálisis / Efeito do treinamento intervalado de alta intensidade sobre o consumo de oxigênio depois do exercício: metanálise

ABSTRACT Introduction: The objective of this study was to present a systematic review and meta-analysis to compare total excess post-exercise oxygen consumption (EPOC) for two training intervention models in healthy individuals, and the secondary objective was to understand whether oxygen consumption after exercise could really promote a meaningful help. Design: To design a meta-analysis review to compare two training intervention models (experimental: high-intensity interval training; and control: continuous moderate-intensity) and their effects on total EPOC in healthy individuals. Participants: Seventeen studies were considered to be of good methodological quality and with a low risk of bias. Methods: Literature searches were performed using the electronic databases with no restriction on year of publication. The keywords used were obtained by consulting Mesh Terms (PubMed) and DeCS (BIREME Health Science Descriptors). Results: The present study findings showed a tendency (random-effects model: 0.87, 95%-CI [0.35,1.38], I2=73%, p<0.01) to increase EPOC when measured following high-intensity interval training. Conclusions: Our study focused on the analysis of high- and moderate-intensity oxygen uptake results following exercise. Despite the growing popularity of high-intensity interval training, we found that the acute and chronic benefits remain limited. We understand that the lack of a standard protocol and standard training variables provides limited consensus to determine the magnitude of the EPOC. We suggest that longitudinal experimental studies may provide more robust conclusions. Another confounding factor in the studies investigated was the magnitude (time in minutes) of VO2 measurements when assessing EPOC. Measurement times ranged from 60 min to 720 min. Longitudinal studies and controlled experimental designs would facilitate more precise measurements and correct subject numbers would provide accurate effect sizes. Systematic reviewb of Level II studies.

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RESUMO Introdução: O objetivo deste estudo foi apresentar uma revisão sistemática e metanálise para comparar os efeitos de dois modelos de intervenção de treinamento sobre o consumo excessivo de oxigênio pós-exercício (EPOC) em indivíduos saudáveis em treinamento, e o objetivo secundário foi entender se o consumo de oxigênio depois de exercício realmente pode proporcionar ajuda substancial. Objetivo: Elaborar uma revisão de metanálise para comparar um modelo de treinamento de duas intervenções (experimental: treinamento intervalado de alta intensidade, e controle: contínuo de intensidade moderada) e o efeito sobre o EPOC total em indivíduos saudáveis. Participantes: Os 17 estudos foram considerados de boa qualidade metodológica e baixo risco de viés. Métodos: As buscas bibliográficas foram realizadas nos bancos de dados eletrônicos sem restrição de ano de publicação. Os descritores usados foram obtidos em MeSH (PubMed) e DeCS (Descritores em Ciências da Saúde da BIREME). Resultados: Os achados do presente estudo mostraram uma tendência (modelo de efeitos aleatórios: 0,87, IC 95% [0,35;1,38], I ² = 73%, p < 0,01) de aumento do EPOC quando as medidas foram realizadas depois de treinamento intervalado de alta intensidade. Conclusões: Nosso estudo concentrou-se na análise dos resultados de alta e moderada intensidade no consumo de oxigênio depois do exercício. Apesar da crescente popularidade do treinamento intervalado de alta intensidade, descobrimos que os benefícios agudos e crônicos permanecem limitados. Entendemos que a falta de um protocolo e variáveis padronizadas de treinamento fornecem consenso limitado para determinar a magnitude do EPOC. Sugerimos que estudos experimentais longitudinais podem fornecer conclusões mais robustas. Outro fator de confusão nos estudos investigados foi a magnitude (tempo em minutos) das medidas do VO2na avaliação do EPOC. Os tempos de medição variaram de 60 a 720 min. Estudos longitudinais e projetos experimentais controlados facilitariam medições mais precisas e números corretos de indivíduos forneceriam tamanhos de efeito precisos. Nível de evidência II; Revisão sistemáticabde Estudos.

Accuracy of Doppler ultrasound in the diagnosis of giant cell arteritis: a systematic review and meta-analysis

Abstract Background Giant cell arteritis (GCA) is the most common primary systemic vasculitis in people 50 years of age and over, and it is considered a medical emergency due to the potential risk of permanent visual loss. Color Doppler ultrasound (CDU) of the temporal arteries is a rapid, noninvasive method to diagnose GCA. This study aims to determine the diagnostic accuracy of the halo sign in temporal arteries by CDU in people with suspected GCA. Methods The systematic literature review included the search for publications in the following electronic databases: PubMed, Embase, CENTRAL, LILACS, WHO ICTRP, ClinicalTrials.gov, gray literature up to December 2022, and no date or language restrictions were applied. We analyzed studies including patients over 50 years of age with suspected GCA evaluating CDU of temporal arteries as a diagnostic tool against clinical diagnosis as a standard reference. Paper titles and abstracts were selected by two investigators independently for all available records. The quality of the studies was assessed using the Quality of Diagnostic Accuracy Studies tool (QUADAS-2) and the R software (version 4.2.1) was used for data analysis. The protocol of this review is registered with PROSPERO (CRD42016033079). Results Twenty-two studies including 2893 participants with suspected GCA who underwent temporal artery CDU were evaluated. The primary analysis results showed a sensitivity of 0.76 [95% confidence interval (95 CI) 0.69-0.81] and specificity of 0.93 (95 CI 0.89-0.95) when the halo sign was compared to clinical diagnosis. The sensitivity value of 0.84 (95 CI 0.72-0.92) and specificity of 0.95 (95 CI 0.88-0.98) were found in five studies involving 1037 participants that analyzed the halo sign and temporal artery compression sign. A sensitivity of 0.86 (95 CI 0.78-0.91) and specificity of 0.95 (95 CI 0.89-0.98) were found in four studies with 603 participants where the halo sign was evaluated CDU on temporal and axillary arteries. Conclusion The detection of the halo sign by CDU of temporal arteries has good accuracy for the diagnosis of cranial GCA. The compression sign in temporal arteries and the addition of axillary arteries assessment improves the diagnostic performance of CDU for GCA. Trial registration PROSPERO CRD42016046860.

Duplex ultrasound for diagnosing symptomatic carotid stenosis in the extracranial segments.

BACKGROUND: Carotid artery stenosis is an important cause of stroke and transient ischemic attack. Correctly and rapidly identifying patients with symptomatic carotid artery stenosis is essential for adequate treatment with early cerebral revascularization. Doubts about the diagnostic value regarding the accuracy of duplex ultrasound (DUS) and the possibility of using DUS as the single diagnostic test before carotid revascularization are still debated. OBJECTIVES: To estimate the accuracy of DUS in individuals with symptomatic carotid stenosis verified by either digital subtraction angiography (DSA), computed tomography angiography (CTA), or magnetic resonance angiography (MRA). SEARCH METHODS: We searched CRDTAS, CENTRAL, MEDLINE (Ovid), Embase (Ovid), ISI Web of Science, HTA, DARE, and LILACS up to 15 February 2021. We handsearched the reference lists of all included studies and other relevant publications and contacted experts in the field to identify additional studies or unpublished data. SELECTION CRITERIA: We included studies assessing DUS accuracy against an acceptable reference standard (DSA, MRA, or CTA) in symptomatic patients. We considered the classification of carotid stenosis with DUS defined with validated duplex velocity criteria, and the NASCET criteria for carotid stenosis measures on DSA, MRA, and CTA. We excluded studies that included < 70% of symptomatic patients; the time between the index test and the reference standard was longer than four weeks or not described, or that presented no objective criteria to estimate carotid stenosis. DATA COLLECTION AND ANALYSIS: The review authors independently screened articles, extracted data, and assessed the risk of bias and applicability concerns using the QUADAS-2 domain list. We extracted data with an effort to complete a 2 × 2 table (true positives, true negatives, false positives, and false negatives) for each of the different categories of carotid stenosis and reference standards. We produced forest plots and summary receiver operating characteristic (ROC) plots to summarize the data. Where meta-analysis was possible, we used a bivariate meta-analysis model. MAIN RESULTS: We identified 25,087 unique studies, of which 22 were deemed eligible for inclusion (4957 carotid arteries). The risk of bias varied considerably across the studies, and studies were generally of moderate to low quality. We narratively described the results without meta-analysis in seven studies in which the criteria used to determine stenosis were too different from the duplex velocity criteria proposed in our protocol or studies that provided insufficient data to complete a 2 × 2 table for at least in one category of stenosis. Nine studies (2770 carotid arteries) presented DUS versus DSA results for 70% to 99% carotid artery stenosis, and two (685 carotid arteries) presented results from DUS versus CTA in this category. Seven studies presented results for occlusion with DSA as the reference standard and three with CTA as the reference standard. Five studies compared DUS versus DSA for 50% to 99% carotid artery stenosis. Only one study presented results from 50% to 69% carotid artery stenosis. For DUS versus DSA, for < 50% carotid artery stenosis, the summary sensitivity was 0.63 (95% confidence interval [CI] 0.48 to 0.76) and the summary specificity was 0.99 (95% CI 0.96 to 0.99); for the 50% to 69% range, only one study was included and meta-analysis not performed; for the 50% to 99% range, the summary sensitivity was 0.97 (95% CI 0.95 to 0.98) and the summary specificity was 0.70 (95% CI 0.67 to 0.73); for the 70% to 99% range, the summary sensitivity was 0.85 (95% CI 0.77 to 0.91) and the summary specificity was 0.98 (95% CI 0.74 to 0.90); for occlusion, the summary sensitivity was 0.91 (95% CI 0.81 to 0.97) and the summary specificity was 0.95 (95% CI 0.76 to 0.99). For sensitivity analyses, excluding studies in which participants were selected based on the presence of occlusion on DUS had an impact on specificity: 0.98 (95% CI 0.97 to 0.99). For DUS versus CTA, we found two studies in the range of 70% to 99%; the sensitivity varied from 0.57 to 0.94 and the specificity varied from 0.87 to 0.98. For occlusion, the summary sensitivity was 0.95 (95% CI 0.80 to 0.99) and the summary specificity was 0.91 (95% CI 0.09 to 0.99). For DUS versus MRA, there was one study with results for 50% to 99% carotid artery stenosis, with a sensitivity of 0.88 (95% CI 0.70 to 0.98) and specificity of 0.60 (95% CI 0.15 to 0.95); in the 70% to 99% range, two studies were included, with sensitivity that varied from 0.54 to 0.99 and specificity that varied from 0.78 to 0.89. We could perform only a few of the proposed sensitivity analyses because of the small number of studies included. AUTHORS' CONCLUSIONS: This review provides evidence that the diagnostic accuracy of DUS is high, especially at discriminating between the presence or absence of significant carotid artery stenosis (< 50% or 50% to 99%). This evidence, plus its less invasive nature, supports the early use of DUS for the detection of carotid artery stenosis. The accuracy for 70% to 99% carotid artery stenosis and occlusion is high. Clinicians should exercise caution when using DUS as the single preoperative diagnostic method, and the limitations should be considered. There was little evidence of the accuracy of DUS when compared with CTA or MRA. The results of this review should be interpreted with caution because they are based on studies of low methodological quality, mainly due to the patient selection method. Methodological problems in participant inclusion criteria from the studies discussed above apparently influenced an overestimated estimate of prevalence values. Most of the studies included failed to precisely describe inclusion criteria and previous testing. Future diagnostic accuracy studies should include direct comparisons of the various modalities of diagnostic tests (mainly DUS, CTA, and MRA) for carotid artery stenosis since DSA is no longer considered to be the best method for diagnosing carotid stenosis and less invasive tests are now used as reference standards in clinical practice. Also, for future studies, the participant inclusion criteria require careful attention.

Mineralocorticoid receptor antagonists for chronic central serous chorioretinopathy: systematic review and meta-analyses.

BACKGROUND: Mineralocorticoid receptor antagonists (MRAs) are widely used for chronic central serous chorioretinopathy (cCSCR), but their effectiveness remains unclear. This research was conducted to evaluate the efficacy of this drugs for cCSCR. METHODS: This is a review of randomized clinical trials (RCT) comparing MRAs to placebo in adults with cCSCR, using the effects of MRAs on best-corrected visual acuity (BCVA) and adverse events as primary outcomes and the effects of MRAs on anatomical parameters as secondary outcomes: central subfield thickness (CST), subretinal fluid height (SFH) and central choroidal thickness (CCT). Our all-language online search included Medline (via PubMed), Central, Embase, Lilacs, Ibecs, and RCT registers platforms, as late as May 2021. We used the Cochrane risk-of-bias tool (version 2) to assess the methodological quality of each study and synthesized the results in meta-analyses using a random-effects model. RESULTS: The search identified 302 records, five of which were eligible, totaling 225 cCSCR patients (aged 45-62 years; M/F ratio 3.1:1) treated for 1 to 12 months with spironolactone (50 mg/day) or eplerenone (50 mg/day) vs. placebo. Moderate-certainty evidence suggests MRAs result in little to no improvement in BCVA compared to placebo (SMD 0.22; 95% CI - 0.04 to 0.48; studies = 5; comparisons = 6; participants = 218; I2 = 0%). Very low-certainty evidence suggests that, when compared to placebo, MRAs have a very uncertain impact on adverse effects (no meta-analysis was performed), and CST (MD 18.1; 95% CI - 113.04 to 76.84; participants = 145; studies = 2; I2 = 68%). MRAs also result in little to no difference in SFH (SMD - 0.35; 95% CI - 0.95 to 0.26; studies = 5; comparisons = 6; participants = 221; I2 = 76%; moderate certainty) and CCT (MD - 21.23; 95% CI - 64.69 to 22.24; participants = 206; studies = 4; comparisons = 5; I2 = 85%; low certainty). CONCLUSION: MRAs have little to no effect on BCVA. Evidence for adverse events and CST is very uncertain. MRAs also have little to no effect on SFH and CCT. These findings should be considered when prescribing MRAs for cCSCR. This research was previous registration in the PROSPERO platform (CRD42020182601).

Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis.

This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.

Study of anesthetics for euthanasia in rats and mice: A systematic review and meta-analysis on the impact upon biological outcomes (SAFE-RM).

AIM: To summarize the knowledge on the effect of anesthetics employed right before euthanasia on biological outcomes. DATA SOURCE: A systematic review of the literature to find studies with isoflurane, ketamine, halothane, pentobarbital, or thiopental just before euthanasia of laboratory rats or mice. STUDY SELECTION: Controlled studies with quantitative data available. DATA EXTRACTION: The search, data extraction, and risk of bias (RoB) were performed independently by two reviewers using a structured form. For each outcome, an effect size (ES) was calculated relative to the control group. Meta-analysis was performed using robust variance meta-regression for hierarchical data structures, with adjustment for small samples. DATA SYNTHESIS: We included 20 studies with 407 biological outcomes (110 unique). RoB analysis indicated that 87.5% of the domains evaluated showed unclear risk, 2% high risk, and 10.5% low risk. The effect size for all anesthetics considered together was 0.99 (CI95% = 0.75-1.23; p < 0.0001). Sub-analyses indicate high effect sizes for pentobarbital (1.14; CI95% = 0.75-1.52; p < 0.0001), and isoflurane (1.01; CI95% = 0.58-1.44; p = 0.0005) but not for ketamine (1.49; CI95% = -7.95-10.9; p = 0.295). CONCLUSION: We showed that anesthetics interfere differently with the majority of the outcomes assessed. However, our data did not support the use of one anesthetic over others or even the killing without anesthetics. We conclude that outcomes cannot be compared among studies without considering the killing method. This protocol was registered at Prospero (CRD42019119520). FUNDING: There was no direct funding for this research.

Comparison of the printed and online administration of the Behavioral Regulation in Exercise Questionnaire (BREQ-2).

OBJECTIVE: To compare the traditional printed form of the Behavioral Regulation in Exercise Questionnaire with a proposed online form in terms of validity, reliability, and applicability. METHODS: A crossover design study was conducted with 157 undergraduate students. Half of the sample answered the printed questionnaire first and then answered the online questionnaire 7 days later, while the other half of the sample did the inverse. Cronbach's alpha was used to analyze the internal consistency of both the online and printed questionnaires. The construct validity was analyzed by confirmatory factor analysis, using a weighted least square mean and adjusted variance estimation and oblique rotation. The quality of the model was tested with fit indices. RESULTS: The confirmatory factor analysis showed the 19-item structure with five factors: χ2 of 230.718; degrees of freedom of 142; χ2/degrees of freedom of 1.625; comparative fit index of 0.978 and root mean square error of approximation of 0.073. All items presented factorial loads above 0.5. There was also excellent consistency between the formats of administration in all dimensions, with Cronbach's alpha values above 0.70. The stability between the formats of administration varied between 0.78 (95%CI: 0.69-0.85) and 0.84 (95%CI: 0.77-0.89), suggesting desirable confidence between both formats of administration. CONCLUSION: The five-factor model of the online Behavioral Regulation in Exercise Questionnaire shows internal consistency both in terms of the scale dimensions as well as in terms of the total items.

Acute Behavior of Oxygen Consumption, Lactate Concentrations, and Energy Expenditure During Resistance Training: Comparisons Among Three Intensities.

Purpose: This study aimed to compare the oxygen consumption, lactate concentrations, and energy expenditure using three different intensities during the resistance training sessions. Methods: A total of 15 men (22.9 ± 2.61 years) experienced in resistance training underwent 3 sessions composed of 8 exercises (chest press, pec deck, squat, lat pull-down, biceps curl, triceps extension, hamstring curl, and crunch machine), which were applied in the same order. The weight lifted differed among the sessions [high session: 6 sets of 5 repetitions at 90% of 1-repetition maximum (1-RM); intermediary session: 3 sets of 10 repetitions at 75% of 1-RM; and low session: 2 sets of 15 repetitions at 60% of 1-RM]. The oxygen consumption (VO2)-during and after (excess post-exercise oxygen consumption (EPOC)) the session, blood lactate concentration, and energy expenditure (i.e., the sum of aerobic and anaerobic contributions, respectively) were assessed. Results: The VO2 significantly decreased in the function of the weight lifting (F (2.28) = 17.02; p < 0.01; η G 2 = 0.32). However, the aerobic contributions significantly increase in the function of the weight lifting (F (2.28) = 79.18; p < 0.01; η G 2 = 0.75). The anaerobic contributions were not different among the sessions (p > 0.05; η G 2 < 0.01). Thus, the total energy expenditure during the session (kcal) significantly increased in the function of the weight lifting (F (2.28) = 86.68; p < 0.01; η G 2 = 0.75). The energy expenditure expressed in time unit (kcal·min-1) was higher in low session than in high session (F (2.28) = 6.20; p < 0.01; η G 2 = 0.15). Conclusion: The weight lifted during resistance training-induced different physiological responses, which induced higher energy expenditure per unit of time during the low session.

Comparison of the printed and online administration of the Behavioral Regulation in Exercise Questionnaire (BREQ-2) / Comparação da administração impressa e on-line do Behavioral Regulation in Exercise Questionnaire (BREQ-2)

ABSTRACT Objective: To compare the traditional printed form of the Behavioral Regulation in Exercise Questionnaire with a proposed online form in terms of validity, reliability, and applicability. Methods: A crossover design study was conducted with 157 undergraduate students. Half of the sample answered the printed questionnaire first and then answered the online questionnaire 7 days later, while the other half of the sample did the inverse. Cronbach's alpha was used to analyze the internal consistency of both the online and printed questionnaires. The construct validity was analyzed by confirmatory factor analysis, using a weighted least square mean and adjusted variance estimation and oblique rotation. The quality of the model was tested with fit indices. Results: The confirmatory factor analysis showed the 19-item structure with five factors: χ2 of 230.718; degrees of freedom of 142; χ2/degrees of freedom of 1.625; comparative fit index of 0.978 and root mean square error of approximation of 0.073. All items presented factorial loads above 0.5. There was also excellent consistency between the formats of administration in all dimensions, with Cronbach's alpha values above 0.70. The stability between the formats of administration varied between 0.78 (95%CI: 0.69-0.85) and 0.84 (95%CI: 0.77-0.89), suggesting desirable confidence between both formats of administration. Conclusion: The five-factor model of the online Behavioral Regulation in Exercise Questionnaire shows internal consistency both in terms of the scale dimensions as well as in terms of the total items.

RESUMO Objetivo: Comparar a forma tradicional impressa do Behavioral Regulation in Exercise Questionnaire com uma proposta de formulário on-line, em termos de validade, confiabilidade e aplicabilidade. Métodos: Estudo de delineamento cruzado (crossover) realizado com 157 estudantes universitários de graduação. Metade da amostra respondeu primeiro ao questionário impresso e, 7 dias depois, ao questionário on-line, enquanto a outra metade da amostra fez o inverso. O coeficiente alfa de Cronbach foi usado para analisar a consistência interna dos questionários on-line e impressos. A validade de construção foi verificada por análise fatorial confirmatória, utilizando-se um estimador de mínimos quadrados ajustados pela média e variância e rotação oblíqua. A qualidade do modelo foi testada com índices de ajuste. Resultados: A análise fatorial confirmatória mostrou a estrutura de 19 itens com cinco fatores: χ2 de 230,718; graus de liberdade de 142; χ2/grau de liberdade de 1,625; índice de ajuste comparativo de 0,978 e raiz do erro quadrático médio de aproximação de 0,073. Todos os itens apresentaram cargas fatoriais acima de 0,5. Também houve excelente consistência entre os formatos de administração em todas as dimensões, com valores de alfa de Cronbach acima de 0,70. A estabilidade entre os formatos de administração variou entre 0,78 (IC95%: 0,69-0,85) e 0,84 (IC95%: 0,77-0,89), sugerindo confiança desejável entre os dois formatos de administração. Conclusão: O modelo de cinco fatores do Behavioral Regulation in Exercise Questionnaire on-line apresenta consistência interna tanto em relação às dimensões da escala quanto em relação ao total de itens.

Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis / Prevalência de lesões dentárias traumáticas em crianças e adolescentes brasileiros: uma revisão sistemática e metanálise / Prevalencia de lesiones dentales traumáticas en niños brasileños y adolescentes: una revisión sistemática y metaanálisis

Abstract: This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.

Resumo: O estudo buscou investigar a prevalência de trauma dentário em crianças e adolescentes brasileiros. Foi realizada uma revisão sistemática em oito bases de dados: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations e OpenThesis. Foram incluídos apenas estudos de prevalência que usavam métodos de amostragem probabilística, sem limitação de ano ou idioma de publicação. Para avaliar o risco individual de viés, foram utilizadas as ferramentas de avaliação crítica da JBI para estudos de prevalência. Os estudos individuais foram combinados na metanálise com o uso do modelo de efeitos aleatórios. A heterogeneidade entre os estudos foi analisada pelas estatísticas Q de Cochran e I-quadrado. A análise de metarregressão foi realizada para avaliar as fontes de heterogeneidade. A abordagem GRADE avaliou a certeza das evidências entre os estudos incluídos. A busca resultou em 2.069 registros, dos quais 36 foram incluídos no estudo. Os estudos elegíveis foram publicados entre 2000 e 2021, com uma amostra total de 40.194 crianças e adolescentes. A maioria dos estudos (75%) teve baixo risco de viés. Nos dentes permanentes, a prevalência de trauma dentário foi de 21% (IC95%: 16,0; 26,0) e nos dentes decíduos foi de 35% (IC95%: 26,0; 44,0). A prevalência de trauma dentário foi mais alta no sexo masculino que no feminino, para ambas as dentições. Com base na baixa certeza, a prevalência das lesões dentárias traumáticas em crianças e adolescentes brasileiros é mais alta que no resto do mundo, tanto nos dentes decíduos quanto nos permanentes. Além disso, a prevalência de trauma dentário é mais alta em meninos que em meninas.

Resumen: Este estudio tuvo como meta investigar la prevalencia de trauma dental en niños y adolescentes brasileños. Se realizó una revisión sistemática considerando ocho bases de datos: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations y OpenThesis. Solamente se incluyeron estudios de prevalencia que usaron un método de muestreo probabilístico, sin restricción sobre el año o lengua de publicación. Se usó las herramientas de evaluación crítica del JBI para estudios de prevalencia studies para evaluar el riesgo individual de sesgo. Los estudios individuales se combinaron en metaanálisis, usando un modelo de efectos aleatorios. La heterogeneidad entre los estudios se analizó mediante las estadísticas de Cochran Q e I-cuadrado. Se realizó un análisis de meta-regresión para evaluar las fuentes de heterogeneidad. El enfoque GRADE evaluó la certidumbre de evidencia a través de los estudios incluidos. La búsqueda resultó en 2.069 registros, de los cuales treinta y seis se incluyeron en el estudio. Los estudios elegibles se publicaron entre 2000 y 2021, con una muestra total de 40.194 niños y adolescentes. La mayoría de los estudios (75%) tenían un bajo riesgo de sesgo. En los dientes permanentes la prevalencia de trauma dental fue 21% (IC95%: 16,0; 26,0) y en los dientes deciduos la prevalencia de trauma dental fue 35% (IC95%: 26,0; 44,0). La prevalencia trauma dental entre niños fue más alta que entre niñas en ambas denticiones. Basado en una baja certidumbre, la prevalencia de lesiones traumáticas dentales en niños y adolescentes brasileños es más alta que la encontrada en el resto del mundo, tanto en dientes deciduos como en dientes permanentes. Asimismo, la prevalencia de trauma dental entre niños es más alta que entre niñas.

COVID-19 and patients with immune-mediated inflammatory diseases undergoing pharmacological treatments: a rapid living systematic review.

BACKGROUND: Patients with immune-mediated inflammatory diseases (IMID) are at increased risk of infection. OBJECTIVE: To assess whether patients undergoing pharmacological treatment for IMID present higher risk of worse outcomes when diagnosed with COVID-19. DESIGN AND SETTING: Rapid systematic review conducted in the medical school of the Federal University of São Paulo (SP), Brazil. METHODS: We searched CENTRAL, MEDLINE, EMBASE, LILACS, SCOPUS, Web of Science, L·OVE, ClinicalTrials.gov and WHO-ICTRP for studies evaluating patients diagnosed with COVID-19 who were undergoing pharmacological treatment for IMID. Two authors selected studies, extracted data and assessed risk of bias and certainty of evidence, following the Cochrane recommendations. RESULTS: We identified 1,498 references, from which one cohort study was included. This compared patients with and without rheumatic diseases (RD) who all had been diagnosed with COVID-19. Those with RD seemed to have higher chances of hospitalization and mortality, but no statistical difference was detected between the groups: hospitalization: odds ratio (OR) 1.17; 95% confidence interval (CI) 0.6 to 2.29; mortality rate: OR 1.53; 95% CI 0.33 to 7.11 (very low certainty of evidence). Patients with RD were three times more likely to require admission to intensive care units (ICUs), with invasive mechanical ventilation (IMV), than those without RD: OR 3.72; 95% CI 1.35 to 10.26 (for both outcomes; very low certainty of evidence). CONCLUSION: Patients undergoing pharmacological treatment for IMID seem to present higher chances of requiring admission to ICUs, with IMV. Additional high-quality studies are needed to analyze the effects of different treatments for IMID.

Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol.

INTRODUCTION: Heart transplantation is the gold standard treatment for selected patients with end-stage heart failure. Although this procedure can improve quality and prolong life expectancy, several of these patients persist with decreased exercise tolerance. Evidence suggests that exercise training can bring multifactorial benefits to heart transplant (HTx) recipients. However, it is unclear that exercise modality should be preferred. Therefore, the aim of this systematic review and network meta-analysis is to compare the efficacy and safety of different training modalities in HTx recipients. METHODS AND ANALYSIS: We will perform a comprehensive literature search in PubMed/MEDLINE, Embase, The Cochrane Library, CINAHL, Scopus, SportDISCUS, Web of Science Core Collection and PEDro from inception until November 2020. Two registries (ClinicalTrials.gov and REBEC) will also be searched for potential results in unpublished studies. There will be no restriction on language, date of publication, publication status or sample size. We will include randomised controlled trials enrolling adult HTx recipients with the presence of at least one exercise training group, which might be compared with another training modality and/or a non-exercise control group for a minimum of 4 weeks of intervention. The primary outcomes will be peak oxygen consumption and occurrence of adverse events. As secondary outcomes, the interaction between pulmonary ventilation, pulmonary perfusion and cardiac output, oxygen uptake efficiency slope, heart rate response, oxygen pulse, peak blood pressure and peak subjective perception of effort. In addition, we will evaluate the 6 min walking distance, health-related quality of life, endothelial function, muscle strength, body fat percentage and lean mass. Risk of bias will be assessed using the Cochrane RoB V.2.0 tool, and we plan to use the Confidence in Network Meta-Analysis tool to assess confidence in the results. All materials (raw data, processed data, statistical code and outputs) will be shared in a public repository. ETHICS AND DISSEMINATION: Given the nature of this study, no ethical approval will be required. We believe that the findings of this study may show which is the most efficacious and safe physical training modality for HTx recipients. The completed systematic review and network meta-analysis will be submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020191192.

COVID-19 and patients with immune-mediated inflammatory diseases undergoing pharmacological treatments: a rapid living systematic review

ABSTRACT BACKGROUND: Patients with immune-mediated inflammatory diseases (IMID) are at increased risk of infection. OBJECTIVE: To assess whether patients undergoing pharmacological treatment for IMID present higher risk of worse outcomes when diagnosed with COVID-19. DESIGN AND SETTING: Rapid systematic review conducted in the medical school of the Federal University of São Paulo (SP), Brazil. METHODS: We searched CENTRAL, MEDLINE, EMBASE, LILACS, SCOPUS, Web of Science, L·OVE, ClinicalTrials.gov and WHO-ICTRP for studies evaluating patients diagnosed with COVID-19 who were undergoing pharmacological treatment for IMID. Two authors selected studies, extracted data and assessed risk of bias and certainty of evidence, following the Cochrane recommendations. RESULTS: We identified 1,498 references, from which one cohort study was included. This compared patients with and without rheumatic diseases (RD) who all had been diagnosed with COVID-19. Those with RD seemed to have higher chances of hospitalization and mortality, but no statistical difference was detected between the groups: hospitalization: odds ratio (OR) 1.17; 95% confidence interval (CI) 0.6 to 2.29; mortality rate: OR 1.53; 95% CI 0.33 to 7.11 (very low certainty of evidence). Patients with RD were three times more likely to require admission to intensive care units (ICUs), with invasive mechanical ventilation (IMV), than those without RD: OR 3.72; 95% CI 1.35 to 10.26 (for both outcomes; very low certainty of evidence). CONCLUSION: Patients undergoing pharmacological treatment for IMID seem to present higher chances of requiring admission to ICUs, with IMV. Additional high-quality studies are needed to analyze the effects of different treatments for IMID.

Correlation between chronic low back pain and female sexual function / Correlação entre a lombalgia crônica e a função sexual feminina / Correlación entre la lumbalgia crónica y la función sexual femenina

ABSTRACT Objective To correlate chronic low back pain with female sexual function. Methods This is a cross-sectional study. Thirty-two women aged between 18 and 44 years old, with body mass index (BMI) between 18.5 kg/m2 and 29.9 kg/m2, with a medical diagnosis of chronic low back pain and sexually active in the last six months were selected. The patients underwent a physical therapy evaluation and responded to two questionnaires: the Roland-Morris Disability Questionnaire and the Female Sexual Quotient (QS-F). Pearson's correlation test was used to assess the impact of chronic low back pain on sexual activity. Results The mean age was 30.31 years old (±.7.10) and the mean BMI was 24.54 Kg/m2 (±3.06). The mean Roland-Morris Disability Questionnaire score was 5.2 ( ± 3.28), indicating that the patients did not have significant disability. The mean QS-F score was 60.37 (±14.48), classified as "unfavorable to normal". The correlation test showed a low correlation between chronic low back pain and female sexual function (r = 0.027). Conclusion There was a low correlation between chronic low back pain and female sexual function in the study population, but the moderate correlation between the "comfort" domain and the Roland-Morris Disability Questionnaire score was significant. Level of evidence II ; Cross-sectional clinical study.

RESUMO Objetivo Correlacionar a lombalgia crônica com a função sexual feminina. Métodos Trata-se de um estudo transversal. Foram selecionadas 32 mulheres com faixa etária entre 18 e 44 anos, com Índice de Massa Corporal (IMC) entre 18,5 kg/m2 e 29,9 kg/m2, diagnóstico médico de lombalgia crônica e sexualmente ativas nos últimos seis meses. As pacientes foram submetidas a uma única avaliação fisioterapêutica e responderam a dois instrumentos: Questionário de Incapacidade Roland-Morris e Quociente Sexual - versão feminina (QS-F). Para a avaliação do impacto da lombalgia crônica na função sexual foi utilizada a correlação de Pearson. Resultados A média de idade foi de 30,31 anos (± 7,10) e a do IMC foi de 24,54 Kg/m2 (± 3,06). A média da pontuação do Questionário de Incapacidade Roland-Morris foi de 5,2 (± 3,28), representando que as pacientes não tinham incapacidade significante. A pontuação do QS-F foi de 60,37 (± 14,48), classificada como "desfavorável a regular" quanto à função sexual feminina. O teste de correlação demonstrou que houve baixa correlação entre a lombalgia crônica e a função sexual feminina (r = 0,027). Conclusões Houve baixa correlação entre a lombalgia crônica e a função sexual feminina na população estudada, porém a correlação moderada entre o domínio "conforto" e o escore do Questionário de Incapacidade Roland-Morris foi significativa. Nível de evidência II ; Estudo clínico descritivo transversal.

RESUMEN Objetivo Correlacionar la lumbalgia crónica con la función sexual femenina. Métodos Se trata de un estudio transversal. Se seleccionaron 32 mujeres con edades entre 18 y 44 años, con Índice de Masa Corporal (IMC) entre 18,5 kg/m2 y 29,9 kg/m2, diagnóstico médico de lumbalgia crónica y sexualmente activas en los últimos seis meses. Las pacientes fueron sometidas a una única evaluación fisioterapéutica y respondieron a dos instrumentos: Cuestionario de Discapacidad Roland-Morris y por el Cociente Sexual - versión femenina (QS-F). Para la evaluación del impacto de la lumbalgia crónica en la función sexual se utilizó la correlación de Pearson. Resultados El promedio de edad fue de 30,31 años (± 7,10) y la del IMC fue de 24,54 kg/m2 (± 3,06). El promedio de la puntuación del Cuestionario de Discapacidad Roland-Morris fue de 5,2 (± 3,28), representando que las pacientes no tenían incapacidad significativa. La puntuación del QS-F fue de 60,37 (± 14,48), clasificada como "desfavorable a regular" en cuanto a la función sexual femenina. El test de correlación demostró que hubo baja correlación entre la lumbalgia crónica y la función sexual femenina (r = 0,027). Conclusiones Hubo baja correlación entre la lumbalgia crónica y la función sexual femenina en la población estudiada, sin embargo la correlación moderada entre el dominio "comodidad" y el score del Cuestionario de Discapacidad Roland-Morris fue significativa. Nivel de evidencia II ; Estudio clínico transversal.

SARS-CoV-2 and arbovirus infection: a rapid systematic review

ABSTRACT BACKGROUND: The numbers of cases of arboviral diseases have increased in tropical and subtropical regions while the coronavirus disease (COVID-19) pandemic overwhelms healthcare systems worldwide. The clinical manifestations of arboviral diseases, especially dengue fever, can be very similar to COVID-19, and misdiagnoses are still a reality. In the meantime, outcomes for patients and healthcare systems in situations of possible syndemic have not yet been clarified. OBJECTIVE: We set out to conduct a systematic review to understand and summarize the evidence relating to clinical manifestations, disease severity and prognoses among patients coinfected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and arboviruses. METHODS: We conducted a rapid systematic review with meta-analysis, on prospective and retrospective cohorts, case-control studies and case series of patients with confirmed diagnoses of SARS-CoV-2 and arboviral infection. We followed the Cochrane Handbook recommendations. We searched EMBASE, MEDLINE, Cochrane Library, LILACS, Scopus and Web of Science to identify published, ongoing and unpublished studies. We planned to extract data and assess the risk of bias and the certainty of evidence of the studies included, using the Quality in Prognosis Studies tool and the Grading of Recommendations Assessment. RESULTS: We were able to retrieve 2,407 citations using the search strategy, but none of the studies fulfilled the inclusion criteria. CONCLUSION: The clinical presentations, disease severity and prognoses of patients coinfected with SARS-CoV-2 and arboviruses remain unclear. Further prospective studies are necessary in order to provide useful information for clinical decision-making processes. Protocol registration number in the PROSPERO database: CRD42020183460

SARS-CoV-2 and arbovirus infection: a rapid systematic review.

BACKGROUND: The numbers of cases of arboviral diseases have increased in tropical and subtropical regions while the coronavirus disease (COVID-19) pandemic overwhelms healthcare systems worldwide. The clinical manifestations of arboviral diseases, especially dengue fever, can be very similar to COVID-19, and misdiagnoses are still a reality. In the meantime, outcomes for patients and healthcare systems in situations of possible syndemic have not yet been clarified. OBJECTIVE: We set out to conduct a systematic review to understand and summarize the evidence relating to clinical manifestations, disease severity and prognoses among patients coinfected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and arboviruses. METHODS: We conducted a rapid systematic review with meta-analysis, on prospective and retrospective cohorts, case-control studies and case series of patients with confirmed diagnoses of SARS-CoV-2 and arboviral infection. We followed the Cochrane Handbook recommendations. We searched EMBASE, MEDLINE, Cochrane Library, LILACS, Scopus and Web of Science to identify published, ongoing and unpublished studies. We planned to extract data and assess the risk of bias and the certainty of evidence of the studies included, using the Quality in Prognosis Studies tool and the Grading of Recommendations Assessment. RESULTS: We were able to retrieve 2,407 citations using the search strategy, but none of the studies fulfilled the inclusion criteria. CONCLUSION: The clinical presentations, disease severity and prognoses of patients coinfected with SARS-CoV-2 and arboviruses remain unclear. Further prospective studies are necessary in order to provide useful information for clinical decision-making processes. PROTOCOL REGISTRATION NUMBER IN THE PROSPERO DATABASE: CRD42020183460.

Reliability of questionnaire The International Fitness Scale: a systematic review and meta-analysis.

Objective To perform a systematic literature review and meta-analysis to investigate the reliability of The International Fitness Scale questionnaire for assessing overall physical fitness and related components. Methods PubMed®, BIREME, SciELO, EMBASE, SPORTDiscus, LILACS and Cochrane databases were searched using the following search terms: "The International Fitness Scale", "International Fitness Scale" and "IFIS". Article selection and data extraction were performed according to the following eligibility criteria: reliability and/or validity study of the measure tools of The International Fitness Scale; adoption of the The International Fitness Scale as a reference criterion (gold standard) and being an original article. Quality of the study was considered based on Assessment of Reliability Studies. Data analysis used Kappa coefficient of agreement, Cochran and the Higgins I2 test. Sensitivity analysis was conducted using the withdrawal model. Results A total of seven articles were included in the analysis. Test-retest reliability coefficients ranged from 0.40 to 0.99, with most studies achieving values ≥0.60, indicative of moderate to substantial reliability. Conclusion In spite of appropriate test-retest scores attributed to most reliability indicators, heterogeneity among the studies remained high. Therefore, further studies with low risk of bias are needed to support the reliability of the self-reported The International Fitness Scale.

Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis.

A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%-99%; n = 4410), cough (61%, 95% CI 39%-81%; n = 3985), muscle aches and/or fatigue (36%, 95% CI 18%-55%; n = 3778), dyspnea (26%, 95% CI 12%-41%; n = 3700), headache in 12% (95% CI 4%-23%, n = 3598 patients), sore throat in 10% (95% CI 5%-17%, n = 1387) and gastrointestinal symptoms in 9% (95% CI 3%-17%, n = 1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 109/L, 95% CI 0.83-1.03 × 109/L, n = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54-45.91 mg/dL; n = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%-1.0%; n = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.

Can Enhanced Techniques Improve the Diagnostic Accuracy of Transvaginal Sonography and Magnetic Resonance Imaging for Rectosigmoid Endometriosis? A Systematic Review and Meta-analysis.

OBJECTIVE: Our aim was to perform a systematic review and meta-analysis of the most commonly used examinations for rectosigmoid lesions of deeply infiltrating endometriosis, transvaginal sonography (TVS) and magnetic resonance imaging (MRI), to compare their diagnostic accuracy and enhanced or non-enhanced techniques. METHODS: A systematic search was performed until March 2018 without time or language restrictions. Eligibility criteria included studies that compared the accuracy of TVS and MRI for diagnosis of rectosigmoid endometriosis. The quality of the studies was assessed by means of Quality Assessment of Diagnostic Accuracy Studies-2 and Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Bivariate and hierarchical analysis were performed. The difference in the accuracy of TVS and MRI was tested, and heterogeneity was addressed by means of meta-regression, sensitivity, or subgroup analysis. RESULTS: A total of 1754 studies were screened; 105 studies were eligible, and 11 studies were included in the meta-analysis. Overall pooled sensitivity, specificity, and area under the receiver operating characteristic curve were 0.80, 0.94, and 0.95, respectively. The measures for MRI were 0.82, 0.94, and 0.95, respectively. There was no statistical difference between the accuracy values of TVS and MRI (P = 0.90). The use of bowel preparation and vaginal contrast could enhance the accuracy of MRI. Along with rectosigmoid prevalence, bowel and vaginal contrast explained a significant proportion of the statistical heterogeneity. CONCLUSIONS: Both TVS and MRI showed high diagnostic accuracy for rectosigmoid deeply infiltrating endometriosis lesions. There is no strong evidence suggesting that the two diagnostic methods might differ in specificity or sensitivity, but enhanced techniques may increase the accuracy measures.

Can intensity in strength training change caloric expenditure? Systematic review and meta-analysis.

INTRODUCTION: Strength training (ST) is considered an important strategy for maintaining body weight, as it promotes an increase in total energy expenditure (EE). However, the combination and manipulation of variables (intensity and volume) allow for different training adaptations. However, it remains unclear as to what is the most important variable between volume or intensity for example number of sets, repetitions, or total load for maximizing EE during ST. Several studies have analyzed the EE response in ST, but still unclear the variable is able to increase EE in the ST. OBJECTIVE: This review aimed to investigate the effect of ST on EE in adults using a systematic literature review and subsequent meta-analysis. METHODS: The search was performed on the electronic databases using the following keywords: strength training (resistance training; strength training; strength training method) and energy expenditure (energy metabolism; energy expenditure; caloric expenditure, caloric cost) with 'AND' and 'OR' combination. Manual searches of references were also conducted for additional relevant studies. After evaluating the inclusion and exclusion criteria, the selected studies were analysed according to strength training methods and the training variables used to measure EE. RESULTS: We identified two ST methods from the literature review: circuit training (CT) and traditional training (TT). Meta-analysis showed a significant effect on EE increase, which favour TT when compared with CT [-0·99 (95%CI: -1·96, -0·02), P<0·01] with I2 of 89% (P<0·01). After adjusting for bias risk, no significant differences were found in EE associated with intensity [-0·40, 95% CI (0·98, 0·18), P = 0·18). CONCLUSION: The present review and meta-analysis indicated that the intensity of exercise does not seem to be associated with an increase of EE in ST.