Preconditioning by Moderate-Intensity Exercise Prevents Gentamicin-Induced Acute Kidney Injury.

A strict correlation among proximal tubule epithelial cell dysfunction, proteinuria, and modulation of the Renin-Angiotensin System and Kalikrein-Kinin System are crucial factors in the pathogenesis of Acute Kidney Injury (AKI). In this study, we investigated the potential protective effect of preconditioning by moderate-intensity aerobic exercise on gentamicin-induced AKI. Male Wistar rats were submitted to a moderate-intensity treadmill exercise protocol for 8 weeks, and then injected with 80 mg/kg/day s.c. gentamicin for 5 consecutive days. Four groups were generated: 1) NT+SAL (control); 2) NT+AKI (non-trained with AKI); 3) T+SAL (trained); and 4) T+AKI (trained with AKI). The NT+AKI group presented: 1) impairment in glomerular function parameters; 2) increased fractional excretion of Na + , K + , and water; 4) proteinuria and increased urinary γ-glutamyl transferase activity (a marker of tubular injury) accompanied by acute tubular necrosis; 5) an increased renal angiotensin-converting enzyme and bradykinin B1 receptor mRNA expression. Interestingly, the preconditioning by moderate-intensity aerobic exercise attenuated all alterations observed in gentamicin-induced AKI (T+AKI group). Taken together, our results show that the preconditioning by moderate-intensity aerobic exercise ameliorates the development of gentamicin-induced AKI. Our findings help to expand the current knowledge regarding the effect of physical exercise on kidneys during physiological and pathological conditions.

Constrains in the articulation between profession, family, and personal life: a case study of the Portuguese police (PSP).

The dangers and stresses of a police officer's career cause physical and psychological distress which in turn cause considerable challenges for the integration of professional, family, and personal life. This study focuses on the conditions that influence this articulation between the personal, family, and professional lives of Portuguese Police (PSP) officers. A questionnaire survey was applied to 414 police officers from 11 divisions of COMETLIS. At the empirical level, several models were tested to assess the articulation between the professional, family, and personal lives of police officers. The results highlight the influence of having young children, elderly people or other dependents living in the family home, as well as the employee's age, on the job's interaction with professional life. At a professional level, the variables shift work, professional category, years of service and working away from home were identified by the officers as conditioning factors in the work-family-personal life balance. Sex differences in the articulation of professional, family, and personal life were also observed.

Impact of Production Systems on the Levels of Vitamin E, ß-Carotene, and Cholesterol in the Liver of Cattle Raised in the Eastern Amazon.

The nutritional composition of bovine liver, particularly in terms of vitamins E, ß-carotene, and cholesterol concentration, is significantly influenced by the cattle-rearing system and diet. This study aimed to elucidate the impact of four predominant cattle-rearing systems in the Eastern Amazon region on the vitamin E, ß-carotene content, and cholesterol levels in bovine liver during the rainy season. Liver-tissue samples were collected from 48 cattle, with twelve specimens representing each rearing system. The systems encompassed two native pastures located in flood-prone areas, cultivated pastures on upland terrain and a confinement-rearing system. Our findings indicate that, when considering all rearing systems collectively, there were no significant differences in the levels of vitamins and cholesterol in the liver tissues (p > 0.05). However, a marked disparity in cholesterol levels emerged when comparing intensive rearing systems to extensive ones, with the former demonstrating notably higher concentrations (p = 0.01). Additionally, the intensive rearing system was associated with elevated levels of ß-carotene (p < 0.01), α-tocopherol (p = 0.01), and ß-tocopherol (p = 0.01) relative to the extensive systems. No significant variations were observed amongst the different extensive systems (p > 0.05). These results suggest that, while all rearing systems yielded liver tissues with typical concentrations of vitamins and cholesterol, the intensive rearing system led to a higher accumulation of certain vitamin compounds. This study highlights the substantial nutritional implications of different cattle-rearing systems in the Eastern Amazon and provides valuable insights for developing dietary strategies to optimize the nutritional quality of bovine liver. Therefore, the generated results are groundbreaking in the Eastern Amazon, Brazil, and inspire the development of new research projects to address other demands in this field and achieve additional outcomes.

Impact of rearing systems in the Eastern Amazon on cholesterol, ß-carotene and vitamin E homologues in steer.

Introduction: The quality of meat, with a focus on compounds important for human health, is directly related to the rearing systems in which the animals are produced. The search for a balanced diet, with an emphasis on low cholesterol and adequate levels of vitamins, aligns with society's emphasis on healthy eating, directly correlated with the importance of the offer made by producers for the cattle's diet. Objective and methodology: The objective was to verify the impact of different rearing systems, in the Eastern Amazon, during the rainy season, on the concentrations of vitamins (A, E) and cholesterol in the muscle (Longissimus lumborum) of crossbred Nelore cattle, castrated, aged between 24 and 36 months, and weighing between 410 and 628 kg. Twelve animals, from each of the three pasture rearing systems: native pasture in flooded areas of Monte Alegre; native pasture in a flooded area of Santa Cruz do Arari; and pasture cultivated on dry land in São Miguel do Guamá, all located in Pará, Brazil-were sampled in commercial slaughterhouses. Results: A notable influence was observed in the concentrations of ß-carotene (p < 0.01), α-Tocopherol (p = 0.02), ß-Tocopherol (p < 0.01) and the combined sum of ß-Tocotrienol and γ-Tocopherol (p < 0.01), as well as δ-Tocopherol (p < 0.01) when contrasting extensive with intensive systems (confinement). However, there was a difference in the content of vitamins and cholesterol between the isolated extensive systems, or between the four rearing systems (p > 0.05). Extensive systems, mainly in Monte Alegre, demonstrated greater amounts of α-Tocopherol and δ-Tocopherol. Conclusion: On the other hand, the intensive system exhibited higher levels of other investigated compounds, clarifying the nutritional variations generated by different livestock rearing practices in the region. Therefore, the results obtained are innovative in the Eastern Amazon, Brazil, in addition to inspiring the development of new research to meet other demands in this field, and achieve additional results, such as determining which meat, coming from cattle in production systems in the country, presents the better compositional quality of vitamins and lipids.

Comparison of home-based rehabilitation and a centre-based exercise in terms of functional capacity, muscle oxygenation and quality of life in people with peripheral arterial disease: a protocol for a randomised controlled trial.

INTRODUCTION: Peripheral arterial disease (PAD) is increasingly prevalent, and supervised physical exercise programmes are recommended as the first-line treatment. However, these programmes are underused. Alternative delivery models may be able to expand treatment coverage. The objective of this study was to compare a home-based exercise programme (HBEP) and a centre-based exercise (CBE) in terms of their effects on functional capacity, peripheral muscle oxygenation and quality of life in individuals with PAD. METHODS AND ANALYSIS: This single-blind, parallel randomised clinical trial will consist of two groups: HBEP and CBE. A qualitative analysis will be carried out to investigate acceptability and satisfaction. The primary outcome will be functional capacity, assessed by the incremental shuttle walk test. Secondary outcomes will include functional capacity, assessed by a treadmill walking test; peripheral muscle oxygenation and quality of life; and self-reported functional impairment, risk factors, morbidity, level of physical activity, adherence, acceptability and satisfaction. The intervention protocols will consist of 12 weeks of intermittent walking until claudication symptoms, three times a week. Participants randomly assigned to the CBE group will participate in supervised face-to-face sessions. The HBEP group will perform exercises at home with remote supervision, monitored by a pedometer and heart rate monitor, and subjective perception of effort during each session will be recorded by participants in a training diary; follow-up will be conducted by telephone calls. Statistical analyses will follow the intention-to-treat principle. Participants allocated to the HBEP group will be interviewed about their experience of remote treatment using a qualitative approach. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Ethics Committee of the Universidade Federal de Minas Gerais. The results will be disseminated in a peer-reviewed journal and presented at international congresses. This research has the potential to improve the care of people with PAD because if home-based rehabilitation demonstrates effectiveness, it could be considered an alternative or support resource to the usual centre-based treatment models, expanding access, coverage and participation in vascular physiotherapy TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/rg/RBR-97vy9n7 on 14 April 2022.

Tecnologias educacionais direcionadas ao aleitamento materno produzidas na pós-graduação em enfermagem brasileira / Educational technologies directed to breastfeeding produced in brazilian nursing graduate / Tecnologías educativas orientadas a la lactancia materna producidas en programas de posgrado en enfermería brasileños

Objetivo: Conhecer as tecnologias educacionais voltadas à prática do aleitamento materno desenvolvidas por enfermeiros. Método: Revisão Integrativa realizada nas bases de dados da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e Biblioteca Digital Brasileira de Teses e Dissertações, em dezembro de 2021. Inicialmente foram identificados 313 trabalhos, após aplicados critérios de inclusão e exclusão foram selecionados 13 estudos para a amostra. Resultados: Verificou-se as seguintes tecnologias: álbum seriado, iconografia 3D, rádio, telefone, literatura de cordel, websites e simuladores realísticos de baixa fidelidade. Os estudos visaram desenvolver, avaliar ou validar tecnologias educacionais voltadas para o aleitamento materno no que diz respeito aos benefícios quando se trata do manejo correto. Conclusão: As tecnologias educacionais têm sido alvo no desenvolvimento de pesquisas em Enfermagem, contribuindo para a promoção do aleitamento materno, beneficiando mães e bebês e dinamizando o processo de cuidar.

Objective: To learn about educational technologies related to breastfeeding practice. Methods: Integrative Review conducted in the Coordination for the Improvement of Higher Education Personnel (CAPES) and Brazilian Digital Library of Theses and Dissertations (BDTD) databases, from December 2019 to December 2021. Initially, 313 studies were identified, and after applying the inclusion and exclusion criteria, 13 studies were selected for the sample. Results: The following technologies were verified: serialized album, 3D iconography, radio, telephone, string literature, websites, and low fidelity realistic simulators. The studies aimed to develop, evaluate, or validate educational technologies focused on breastfeeding with regard to the benefits when it comes to the correct management. Conclusion: Educational technologies have been a target in the development of nursing research, contributing to the promotion of breastfeeding, benefiting mothers and babies and streamlining the care process.

Objetivo: Conocer las tecnologías educativas orientadas a la práctica de la lactancia materna. Métodos: revisión integradora realizada en las bases de datos Coordinación para el Perfeccionamiento del Personal de Educación Superior (CAPES) y la Biblioteca Digital Brasileña de Tesis y Disertaciones (BDTD), desde diciembre de 2019 hasta diciembre de 2021. Inicialmente se identificaron 313 estudios, luego de aplicar los criterios de inclusión y exclusión, se seleccionaron 13 estudios para la muestra. Resultados: se verificaron las siguientes tecnologías: álbum en serie, iconografía 3D, radio, teléfono, literatura de cuerdas, sitios web y simuladores realistas de baja fidelidad. Los estudios tuvieron como objetivo desarrollar, evaluar o validar tecnologías educativas orientadas a la lactancia materna en cuanto a beneficios en cuanto a un correcto manejo se refiere. Conclusión: Las tecnologías educativas han sido un objetivo en el desarrollo de la investigación en enfermería, contribuyendo a la promoción de la lactancia materna, beneficiando a madres y bebés y agilizando el proceso de atención.

Acute outcomes of acupuncture and dry needling over peripheral acute fatigue in untrained healthy volunteers: A randomized controlled clinical trial.

Peripheral acute fatigue (PAF) is defined as when the skeletal muscle is incapable of generating power. We aimed to investigate the acute effects of traditional Chinese acupuncture (TCA) and dry needling (DN) over PAF induced on the biceps brachii of untrained healthy volunteers. We conducted a randomized, single-blind controlled clinical trial. All volunteers (n = 45) underwent fatigue induction protocols repeated before and after treatment with TCA (TCA group; TCAg; n = 15), DN (DN group; DNg; n = 15), and rest (control group; Cg; n = 15). Assessments of PAF, skin temperature, and exercise time occur before and after each event: 1st fatigue induction (FI), treatment, and 2nd FI. We used repeated measures ANOVA adjusted with Bonferroni post hoc test to determine any change in tested variables (PAF-VAS, PAF-EMG, and skin temperature) at different time points compared to the baseline. Paired Samples t-test was used for the variable exercise times. All statistical tests considered' the significance level at p ≤ 0,05. There was no difference between groups in acute fatigue recovery (p = 0.19). All intragroup analyses were significant (p ≤ 0.05) and all volunteers show a reduction in fatigue perception after treatment (p ≤ 0,05), however, exercise time did not ameliorate after TCA or DN (p > 0.77). A single session of TCA and, DN can equally reduce fatigue, temperature, and exercise time over PAF induced on biceps brachii of untrained healthy volunteers.

Irrigation Strategies with Controlled Water Deficit in Two Production Cycles of Cotton.

Water scarcity is one of the main abiotic factors that limit agricultural production. In this sense, the identification of genotypes tolerant to water deficit associated with irrigation management strategies is extremely important. In this context, the objective of this study was to evaluate the morphology, production, water consumption, and water use efficiency of colored fiber cotton genotypes submitted to irrigation strategies with a water deficit in the phenological phases. Two experiments were conducted in succession. In the first experiment, a randomized block design was used in a 3 × 7 factorial scheme, corresponding to three colored cotton genotypes (BRS Rubi, BRS Jade, and BRS Safira) in seven irrigation management strategies with 40% of the real evapotranspiration (ETr) varying the phenological stages. In the second experiment, the same design was used in a 3 × 10 factorial arrangement (genotypes × irrigation management strategies). The water deficit in the vegetative phase can be used in the first year of cotton cultivation. Among the genotypes, 'BRS Jade' is the most tolerant to water deficit in terms of phytomass accumulation and fiber production.

Deferoxamine Interference in Fibro-inflammation: Additional Action in Control of Obese Adipose Tissue Dysfunction.

INTRODUCTION: Several studies demonstrated that deferoxamine, an iron chelator, can improve inflammatory alterations in adipose tissue induced by obesity. Obesity alterations in adipose tissue are also associated with tissue remodeling, and deferoxamine has anti-fibrosis action previously described in sites like the skin and liver. METHODS: In this work, we analyzed deferoxamine effects on adipose tissue fibro-inflammation during obesity induced by diet in mice. in vitro approaches with fibroblasts and macrophages were also carried out to elucidate deferoxamine activity. RESULTS: Our results demonstrated that in addition to exerting anti-inflammatory effects, reducing the cytokine production in adipose tissue of obese mice and by human monocyte differentiated in macrophage in vitro, deferoxamine can alter metalloproteinases expression and extracellular matrix production in vivo and in vitro. CONCLUSION: Deferoxamine could be an alternative to control fibro-inflammation in obese adipose tissue, contributing to the metabolic improvements previously described.

Establishing a core dossier for multiple regulatory submissions: a case study in the Latin America region.

The Latin America region comprises several countries that do not follow harmonized regulatory requirements for drug product (DP) marketing authorization applications (MAA), resulting in customized registration dossiers for each country. Here, we established a core dossier for multiple MAA in the Latin America region by examining the similarities between regulatory requirements and reconciling their potential discrepancies through discussions among all national regulatory representatives. The core dossier was used in the submission of a new small molecule, NME1, to nine markets. Assessment of the process included the time to submission; the timing, number, and complexity of questions received; and timing of final national regulatory agencies (NRA) evaluation decisions. The core dossier resulted in an accelerated submission timeline for most markets and earlier receipt of NRA queries from some markets, compared with projections. One round of queries of a low or medium complexity was received from all agencies. The receipt of final NRA evaluation decisions was also accelerated in most markets, compared with the best-case approval timeframes. The core dossier approach was also evaluated against the standard submission of a similar small molecule, NME2. In contrast to the core dossier submission of NME1, a second round of questions, and high-complexity questions were received from two markets for NME2. In conclusion, a core dossier has the potential to simplify the regulatory process for both reviewers and applicants in regions that do not share harmonized regulatory requirements, with a consequential acceleration of DP approvals.

Variation in sociodemographic, clinical and functional characteristics of patients with chronic venous insufficiency in a single public health center.

OBJECTIVES: Describe and analyze the sociodemographic, clinical and functional characteristics of individuals with chronic venous insufficiency (CVI) and compare the clinical severity with levels of mobility. METHODS: Exploratory cross-sectional study in a single public health center. The study cohort comprised 99 individuals. INTERVENTIONS: Clinical, sociodemographic and physical activity level questionnaires were applied; we also evaluated ankle amplitude and sural triceps function. Descriptive statistics, independent t test and one-way ANOVA with post hoc Least Significant Difference (LSD) were performed. RESULTS: Ninety-nine participants (87.9% woman) with an average age with an average age of 60.6 ± 14 years who where recruited to the study. The cohort was composed of individuals were moderately active, 80% exhibited symptoms of the disease and approximately 40% reported reduced mobility. Individuals who had reduced mobility and less physical activity showed reduced ankle amplitude and muscle function (p <0.05). CONCLUSION: CVI impacts on functional capacity, even in individuals with less severe disease.

Acute Effect of a Half-Marathon over the Muscular Function and Electromyographic Activity of the Pelvic Floor in Female Runners with or without Urinary Incontinence: A Pilot Study.

OBJECTIVE: to verify the acute effect of running a half marathon on pelvic floor muscle (PFM) function and electromyographic (EMG) activity in female runners with and without urinary incontinence. METHODS: This is a cross-sectional pilot study. The sample was divided into two groups: runners with urinary incontinence (with UI) and runners without urinary incontinence (without UI). A semi-structured form and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI-SF) were used for data collection. The EMG and PFM function were evaluated using the PERFECT method before and immediately after running a half marathon. RESULTS: A total of 14 runners were included (8 with UI; 6 without UI). Runners with and without UI did not show significant differences for EMG and PERFECT. The acute effects of the half marathon on runners without UI were reduced PFM function in terms of strength (p = 0.00), reduced endurance (p = 0.02), and reduced repetition (p = 0.03), and an increase in EMG measured by the median frequency (p = 0.02). Runners with UI showed reduced PFM function in terms of strength (p = 0.05) and repetition (p = 0.01). CONCLUSION: there was no difference in the acute effects of the half marathon on PFM function and EMG in women with and without UI.

Use of the SARC-F Score as an Aid in Fragility Fractures Prevention.

Objective The present study aimed to relate the strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) score with the presence or absence of fragility fracture in the population over 60 years of age. Methods The risk of sarcopenia was determined through the application of the SARC-F questionnaire, and the patients were divided into 2 groups, according to the occurrence or not of fragility fracture (n = 100). Results Thirty-two cases of distal radius fractures and eighteen cases of proximal femur fractures were identified. A higher score on the SARC-F is determinant between having or not a fragility fracture, estimating that for each point in the score there is a 70% increase in the chance of a patient having a fracture, regardless of age, gender, and body mass index (BMI). Conclusion There was a direct correlation between a higher score on the SARC-F and an increase in the chance of fragility fracture.

Effects of mat Pilates on older adult women with knee osteoarthritis: A randomized controlled trial.

INTRODUCTION: Osteoarthritis is the most common joint disorder in the world and its incidence is rising, and one of the most frequent causes of pain, loss of function and disability in adults. AIM: The aim of this study was to evaluate the effects of Mat Pilates on health status, pain, stiffness, and functionality of older adult women with knee osteoarthritis (KOA). METHODS: A randomized-controlled trial to preliminarily test an intervention protocol of Mat Pilates in older women with KOA on health status, pain, stiffness, and functionality. This study included 41 volunteers with age over 40 years, which mean was 52.1 ± 8.9 years, and were allocated into Mat Pilates and control groups. The protocol was developed to be performed in 60 min, twice a week; the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Medical Outcomes Study 36 (SF-36) were used to assess pain, to evaluate functionality and stiffness. RESULTS: The Mat Pilates group significantly improved the functional capacity assessed by SF-36 (33.12 ± 22.03 to 69.37 ± 22.43, p < 0.05), and by WOMAC (29.75 ± 6.92 to 9.75 ± 9.35, p < 0.05). The pain domain also improved in Mat Pilates group assessed by SF-36 (39.50 ± 12.89 to 71.75 ± 18.66, p < 0.05) and by WOMAC (8.00 ± 2.56 to 2.75 ± 3.01, p < 0.05). The total score of WOMAC (41.75 ± 10.39 to 14.25 ± 13.88, p < 0.05), and the general health status assessed by SF-36 (59.44 ± 18.07 to 82.75 ± 12.03, p < 0.05) only improved for Mat Pilates group. No differences were observed in outcomes for the control group in both questionnaires. CONCLUSION: Our results show that Mat Pilates protocol can improve the health status, pain, and functionality of older women with KOA.

Use of the SARC-F Score as an Aid in Fragility Fractures Prevention / O uso do escore SARC-F como auxiliar na prevenção de fraturas por fragilidade

Abstract Objective The present study aimed to relate the strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) score with the presence or absence of fragility fracture in the population over 60 years of age. Methods The risk of sarcopenia was determined through the application of the SARC-F questionnaire, and the patients were divided into 2 groups, according to the occurrence or not of fragility fracture (n = 100). Results Thirty-two cases of distal radius fractures and eighteen cases of proximal femur fractures were identified. A higher score on the SARC-F is determinant between having or not a fragility fracture, estimating that for each point in the score there is a 70% increase in the chance of a patient having a fracture, regardless of age, gender, and body mass index (BMI). Conclusion There was a direct correlation between a higher score on the SARC-F and an increase in the chance of fragility fracture.

Resumo Objetivo O presente estudo teve como objetivo relacionar o escore strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) com a presença ou não de fratura por fragilidade na população acima de 60 anos. Métodos O risco de sarcopenia foi determinado por meio da aplicação do questionário SARC-F, sendo os pacientes divididos em 2 grupos, de acordo com a ocorrência ou não de fratura por fragilidade (n = 100). Resultados Foram levantados 32 casos de fratura de rádio distal e 18 casos de fratura de fêmur proximal. Uma maior pontuação no SARC-F determina bem entre ter ou não ter fratura por fragilidade, estimando que a cada ponto a mais no escore há um acréscimo de 70% na chance de o paciente ter fratura, independentemente da idade, sexo e índice de massa corporal (IMC). Conclusão Houve correlação direta entre uma maior pontuação no SARC-F e aumento na chance de fratura por fragilidade.

Endophytic species of Induratia from coffee and carqueja plants from Brazil and its potential for the biological control of toxicogenic fungi on coffee beans by means of antimicrobial volatiles.

Several endophytic fungi have been reported to have produced bioactive metabolites. Some of them, including the Induratia species, have the capacity to emit volatile compounds with antimicrobial properties with broad spectrum against human and plant pathogens. The present study aimed to prospect the Induratia species producing volatile organic compounds (VOCs), in carqueja plants used in alternative medicine and coffee plants in Brazil. A total of 11 fungal isolates producing volatile metabolites were obtained by a parallel growth technique, using I. alba 620 as a reference strain. Phylogenetic relationships revealed the presence of at least three distinct species, I. coffeana, I. yucatanensis, and Induratia sp. SPME/GC/MS analyses of the VOCs in the headspace above the mycelium from Induratia species cultured for 10 days on PDA revealed the volatile profile emitted by I. coffeana CCF 572, I. coffeana COAD 2055, I. yucatanensis COAD 2062, and Induratia sp. COAD 2059. Volatile organic compounds produced by I. coffeana isolates presented antimicrobial activity against Aspergillus ochraceus, A. sclerotiorum, A. elegans, A. foetidus, A. flavus, A. tamari, A. tubingensis, A. sydowii, A. niger, A. caespitosus, A. versicolor, and A. expansum, sometimes by decreasing the growth rate or, mainly, by fully inhibiting colony growth. Fifty-eight percent of the target species died after 6 days of exposure to VOCs emitted by I. coffeana CCF 572. In addition, VOCs emitted by the same fungus inhibited the growth in A. ochraceus inoculated into coffee beans, which indicates that plants which have I. coffeana as an endophyte may be protected from attacks by this plant pathogen.

Effectiveness of Biofeedback in Individuals with Awake Bruxism Compared to Other Types of Treatment: A Systematic Review.

Excessive masticatory muscle activity is generally present in awake bruxism, which is related to increased anxiety and stress. It has been hypothesized that biofeedback could potentially manage awake bruxism, however, its effectiveness has not been empirically analyzed in a systematic manner. Therefore, this systematic review was designed to determine the effectiveness of biofeedback compared to other therapies in adults with awake bruxism. Extensive searches in five databases looking for randomized controlled trials (RCTs) that included biofeedback to manage awake bruxism were targeted. The risk of bias (RoB) assessment was conducted using the Cochrane RoB-2 tool. Overall, four studies were included in this systematic review, all of which used the electromyographic activity of the masticatory muscles during the day and night as the main endpoint. Auditory and visual biofeedback could reduce the excessive level of masticatory muscle activity in a few days of intervention. The majority of the included studies had a high RoB and only one study had a low RoB. The standardization of the biofeedback protocols was also inconsistent, which makes it difficult to establish the ideal protocol for the use of biofeedback in awake bruxism. Thus, it is proposed that future studies seek to reduce methodological risks and obtain more robust samples.

Atuação da terapia ocupacional no treino de atividade de vida diária com pacientes acometidos pela COVID-19 em enfermarias de um hospital universitário / Occupational Therapy intervention in the training of activities of daily living with patients affected by COVID-19 in inpatient units of a university hospital

Resumo Introdução A Covid-19 acarreta comprometimentos multissistêmicos, ocasionando prejuízos funcionais, principalmente voltados às Atividades de Vida Diária (AVDs), sendo imprescindível a atuação do terapeuta ocupacional no processo de reabilitação. Objetivo Analisar a proporção de treino de AVDs e as principais atividades treinadas com pacientes com Covid-19. Método Trata-se de um estudo documental realizado em um hospital universitário da região sudeste do Brasil. Foram analisados registros da terapia ocupacional em prontuário eletrônico de pacientes internados em enfermarias de Covid-19, entre junho de 2020 e janeiro de 2021. Resultados A prevalência de atendimentos terapêuticos ocupacionais foi de 53,1%. Os pacientes atendidos estavam restritos ao leito, com maior dependência para as AVDs e mais tempo de hospitalização. Foram realizados 413 atendimentos no total, sendo que a média por paciente foi de três, o mínimo de um e o máximo de 15. A proporção do treino de AVDs foi de 76,9%. As AVDs mais treinadas foram alimentação (96,8%), higiene pessoal (93,9%) e mobilidade funcional (59,8%). Conclusão O desenvolvimento deste estudo promoveu a discussão da análise multidimensional cuidadosa, realizada por terapeutas ocupacionais para efetuar o treino de AVDs com pacientes diagnosticados com Covid-19, internados em enfermarias. Ademais, trouxe resultados importantes relacionados ao perfil dos pacientes atendidos, às proporções das intervenções voltadas ao treino de AVDs e aos elementos que nortearam essa prática.

Abstract Introduction COVID-19 causes multisystemic compromises, resulting in functional impairments, mainly related to the Activities of Daily Living (ADLs). Therefore, the occupational therapist is one of the professionals needed to favor the rehabilitation process. Objective To analyze the proportion of ADLs training and the main activities that were trained with patients with COVID-19. Method This is a documental study developed in a teaching hospital in the southeast region of Brazil. Occupational therapy records were analyzed in electronic medical records of patients admitted to COVID-19 infirmaries between June 2020 and January 2021. Results The prevalence of occupational therapy attendances was 53.1%. The patients who were prioritized were those restricted to bed, with worse functionality and longer hospital stay. In all, 413 attendances were performed; the average per patient was three, the minimum was one, and the maximum was 15. The proportion of ADLs training was 76.9%. The most trained activities in the infirmaries by the occupational therapy team were feeding (96.8%), personal hygiene (93.9%), and functional mobility (59.8%). Conclusion The development of this study promoted the discussion of the careful multidimensional analysis performed by occupational therapists to carry out ADLs training with patients diagnosed with Covid-19 hospitalized in wards. Furthermore, it brought important results related to the profile of the patients seen, the proportions of interventions aimed at ADLs training and the elements that guided this practice.

Biofeedback no controle do bruxismo: uma revisão de escopo / Biofeedback for the control of bruxism: a scoping review

Objetivo: Compreender como os diversos tipos de biofeedback agem, e se são eficazes no controle do bruxismo do sono e vigília. Métodos: trata-se de uma revisão de escopo, com busca em três bases de dados, Medline (Pubmed e BVS), PEDRo e Cochrane, e redigida de acordo com as diretrizes do PRISMA-ScR. Resultados: Foram encontradas 595 referências. Após a remoção das duplicatas e da aplicação dos critérios de elegibilidade, trinta e cinco artigos foram incluídos. A maioria investigou o bruxismo do sono e o uso de placas orais integradas a sistemas de biofeedback, principalmente através de estímulos exteroceptivos. Na maioria dos artigos, o biofeedback foi efetivo a curto prazo para o bruxismo do sono, reduzindo a duração dos episódios, mas não alterando o número de episódios do bruxismo, mas com retorno aos níveis do pré-tratamento. O uso do biofeedback foi mais efetivo para o bruxismo de vigília e nos estudos que investigaram ambos os tipos de bruxismo, mas, com o uso do biofeedback apenas no período diurno, foi possível observar uma redução tanto nos eventos do bruxismo de vigília como nos do sono. Conclusão: A maioria das pesquisas se utilizou do biofeedback por meio de estímulo exteroceptivo, com reforço negativo a um estímulo aversivo; poucos estudos utilizaram o biofeedback com o propósito de condicionamento motor ou de mudança comportamental, sendo esses mais eficazes, mesmo após a retirada do estímulo.

Aim:To comprehend the functioning of various biofeedback types and their effectiveness in controlling sleep and awake bruxism. Methods: This is a scoping review, conducted in three databases: Medline (Pubmed and VHL), PEDRo, and Cochrane, and was written according to PRISMA-ScR guidelines. Results: Our study found 595 references; after removing duplicates and applying the eligibility criteria, thirty-five articles were included. Most studies examined the effectiveness of biofeedback systems that integrated oral splints, primarily through the use of exteroceptive stimuli, to manage sleep bruxism. Although biofeedback was found to reduce the duration of bruxism episodes in the short term in most articles, it did not significantly change the number of episodes, which reverted to pre-treatment levels. The use of biofeedback was more effective for awake bruxism. Moreover, in the studies that investigated both types of bruxism, but with the use of biofeedback only during the day, it was possible to observe a reduction in both the events of awake and sleep bruxism. Conclusion: Most studies used biofeedback with negative reinforcement through exteroceptive stimulation to an aversive stimulus. Few studies use biofeedback for motor conditioning or behavioral change. The latter approaches proved to be more effective, even after discontinuing the stimulus.

The impact of post-COVID multicomponent rehabilitation / O impacto da reabilitação com multicomponentes no pós-COVID

Abstract Introduction Post-COVID-19 syndrome is characterized by chronic fatigue and myalgia, among other symptoms, which can limit activities of daily living. Physical therapy protocols with multicomponent exercises combine strength, resistance, balance and gait, producing sig-nificant improvements in functional mobility. Objective Evaluate whether multicomponent rehabilitation is effective in improving functional mobility and quality of life in individuals with post-COVID-19 syndrome. Methods Randomized controlled trial with 59 volunteers, divided into an intervention (IG) and control group (CG), all of whom underwent initial assessment (T0). The IG performed 24 sessions over 12 weeks and the CG did not undergo training. Functional mobility was analyzed using the 6-minute walk test (6MWT) and the Berg balance scale, while the SF-36 questionnaire assessed quality of life. Results In the 6MWT, the IG covered 464.40 + 81.26 meters (T0) and 518.60 + 82.68 meters (T4). The IG Berg scale scores were 48.00 + 4.00 (T0) and 51.90 + 4.26 (T4). In terms of quality of life, the IG obtained mean scores of 96.26 + 10.14 (T0) and 102.60 + 5.53 (T4). None of these measures was statistically significant. Conclusion Individuals who underwent the multicomponent phys-iotherapy protocol showed statistically nonsignificant increases in the variables studied.

Resumo Introdução A síndrome pós-COVID-19 caracteriza-se por fadiga crônica, mialgia, entre outros sintomas que podem causar limitações na realização das atividades de vida diária. Protocolos de fisioterapia com exercício de multicomponentes combinam força, resistência, equi-líbrio e marcha, e produzem melhorias significativas na mobilidade funcional. Objetivo Avaliar se a reabilitação de multicomponentes é eficaz em promover melhora na mobilidade funcional e qualidade de vida em indivíduos com síndrome pós-COVID-19. Métodos Ensaio clínico randomizado, controlado, realizado com 59 voluntários, divididos em grupo intervenção (GI) e grupo controle (GC). Todos fizeram avaliação inicial (T0); GI realizou 24 sessões durante 12 semanas e GC não realizou treinamento. A análise da mobilidade funcional foi realizada através do teste de caminhada de 6 minutos (TC6m) e da escala de equilíbrio de Berg. O questionário SF-36 avaliou a qualidade de vida. Resultados A distância percorrida no TC6m pelo GI foi de 464,40 + 81,26 metros (T0) e de 518,60 + 82,68 metros (T4). A pontuação na escala de Berg do GI foi de 48,00 + 4,00 (T0) e de 51,90 + 4,26 (T4). Na qualidade de vida, GI apresentou escore com média de 96,26 + 10,14 (T0) e 102,60 + 5,53 (T4). Nenhuma destas medidas foram estatisticamente significantes. Conclusão Os indivíduos que foram submetidos ao protocolo fisioterapêutico de multicomponentes apresentaram incrementos nas variáveis estudadas sem significância estatística.