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Braz. j. biol ; 83: e249209, 2023.
Artículo en Inglés | LILACS, VETINDEX | ID: biblio-1339360


Abstract Alo vera is a centenary remedy use for minor wounds and burns, but its mechanism of wound healing has not been know since. This article will evaluate and gather evidence of the effectiveness and safety of the use of aloe vera in the treatment of burns. A systematic review was carried out on the databases: MEDLINE, LILACS, DECS, SCIELO, in the last 7 years, with the descriptors: "Aloe", "Burns" and "treatment". 16 articles were found. After using the exclusion criteria; research in non-humans and literature review; 5 articles were selected. The article Teplick et al. (2018) performed an in vitro clinical experiment in A. Vera solution, and demonstrated that there was proliferation and cell migration of human skin fibroblasts and keratinocytes, in addition to being protective in the death of keratonocytes. That is, it accelerates the healing of wounds. Muangman et al. (2016), evaluated 50 patients with 20% of the total body surface area burned with second-degree burns, between 18-60 years old, with half of the group receiving gauze dressings with soft paraffin containing 0.5% chlorhexidine acetate and the other half receiving polyester dressings containing extracts of medicinal plants mainly Aloe Vera. It had positive results, a higher healing speed and shorter hospital stay compared to the control group. Hwang et al. (2015) investigated the antioxidant effects of different extracts from 2,4,6,8,12 months of Aloe Vera. And the 6-month concentrated extract of 0.25 mg / mL had a higher content of flavonoids (9.750 mg catechin equivalent / g extract) and polyphenols (23.375 mg gallic acid equivalent / g extract) and the greater ferric reducing antioxidant power (0.047 mM equivalent ferrous sulfate / mg extract), that is, greater potential for free radical scavenging and also a protective effect against oxidative stress induced by tert-butyl hydroperoxide (t-BHP), suggesting evidence of a bioactive potential of A. vera . However, in the article Kolacz et al. (2014) suggested as an alternative treatment the use of Aloe Vera dressing in combination with honey, lanolin, olive oil, wheat germ oil, marshmallow root, wormwood, comfrey root, white oak bark, lobelia inflata, glycerin vegetable oil, beeswax and myrrh, without obtaining significant and conclusive results that would allow the conventional treatment of burns to be subsidized. Finally, in the article by Zurita and Gallegos (2017), it carried out a descriptive cross-sectional study with 321 people, both sexes between 17-76 years of age, of an inductive nature, exploring the experience of this population and their behavioral attitudes regarding the treatment of dermatoses. Aloe vera had 13.8% cited by individuals in the treatment of acne and 33.6% in the treatment of burns. Even with evidence that suggests the efficacy in the treatment of burns with the use of Aloe Vera extract, further clinical trials with larger sample space on the use of Aloe vera dressings in medium burns are suggested for further conclusions.

Resumo Alo vera é um remédio centenário usado para pequenas feridas e queimaduras, mas seu mecanismo de cicatrização de feridas não foi conhecido desde então. Este artigo avaliará e reunirá evidências da eficácia e segurança do uso de aloe vera no tratamento de queimaduras. Realizada revisão Sistemática nas bases de dados: MEDLINE, LILACS, DECS, SCIELO, nos últimos 7 anos, com os descritores: "Aloe", "Burns" and "treatment". Foram encontrados 16 trabalhos. Após utilizarmos os critérios de exclusão; pesquisa em nao humanos e revisão da literatura ; foram selecionados 5 artigos. O artigo Teplick et al. (2018) realizou um experimento clinico in vitro em solução de A. Vera, e demonstrou que houve proliferação e migração celular de fibroblastos e queratinócitos de pele humana, além de ser protetor na morte de queratonócitos. Ou seja, acelera a cicatrização das feridas. Já Muangman et al. (2016), avaliou 50 pacientes com 20% do total da área superficial corporal queimada com queimaduras de segundo grau, entre 18-60 anos, tendo metade do grupo como controle recebendo curativos de gaze com parafina mole contendo 0,5% acetado de clorexidina e a outra metade recebendo curativos com poliéster contendo extratos de plantas medicinais principalmente Aloe Vera. Teve resultados positivos, uma maior velocidade de cicatrização e menor tempo de internação comparado ao grupo controle. Já Hwang et al. (2015) investigou os efeitos antioxidante de diferentes extratos de 2,4,6,8,12 meses da Aloe Vera. E o extrato com 6 meses concentrado de 0,25 mg/mL teve maior teor de flavanóides (9,750 mg equivalente catequina / g extrato) e polifenóis (23,375 mg equivalente ácido gálico / g extrato) e o maior poder antioxidante redutor férrico (0,047 mM de sulfato ferroso equivalente / extrato mg), ou seja, maior potencial de eliminação de radicais livres e também efeito proteror contra o estresse oxidativo induzido por hidroperóxido de terc-butila (t-BHP), sugerindo indícios de um potencial bioativo da A. vera. Porém, no artigo Kolacz et al. (2014) sugeriu como tratamento alternativo o uso do curativo com Aloe Vera em conjunto de mel, lanolina, azeite de oliva, óleo de gérmen de trigo, raiz de marshmallow, absinto, raiz de confrei, casca de carvalho branco, lobelia inflata, glicerina vegetal, cera de abelha e mirra, não obtendo resultados significativos e conclusivos que permitam subsidiar o tratamento convencional das queimaduras. Por fim, no artigo de Zurita and Gallegos (2017), realizou um estudo descritivo transversal com 321 pessoas, ambos os sexos entre 17-76 anos, de natureza indutiva, explorando a vivência dessa população e suas atitudes comportamentais quanto ao tratamento de dermatoses. Aloe vera teve 13,8% citada pelos indivíduos no tratamento de acne e 33,6% no tratamento de queimaduras. Mesmo tendo evidências que sugerem a eficácia no tratamento de queimaduras com o uso do extrato da Aloe Vera, sugere-se mais ensaios clínicos com espaço amostral maior sobre o uso de curativos de Aloe vera em médio queimados para maiores conclusões.

Humanos , Plantas Medicinales , Quemaduras/tratamiento farmacológico , Aloe , Cicatrización de Heridas , Extractos Vegetales/uso terapéutico , Extractos Vegetales/farmacología , Estudios Transversales
Neural Regen Res ; 18(2): 299-305, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35900407


Currently, there is no cure for traumatic spinal cord injury but one therapeutic approach showing promise is gene therapy. In this systematic review and meta-analysis, we aim to assess the efficacy of gene therapies in pre-clinical models of spinal cord injury and the risk of bias. In this meta-analysis, registered at PROSPERO (Registration ID: CRD42020185008), we identified relevant controlled in vivo studies published in English by searching the PubMed, Web of Science, and Embase databases. No restrictions of the year of publication were applied and the last literature search was conducted on August 3, 2020. We then conducted a random-effects meta-analysis using the restricted maximum likelihood estimator. A total of 71 studies met our inclusion criteria and were included in the systematic review. Our results showed that overall, gene therapies were associated with improvements in locomotor score (standardized mean difference [SMD]: 2.07, 95% confidence interval [CI]: 1.68-2.47, Tau2 = 2.13, I2 = 83.6%) and axonal regrowth (SMD: 2.78, 95% CI: 1.92-3.65, Tau2 = 4.13, I2 = 85.5%). There was significant asymmetry in the funnel plots of both outcome measures indicating the presence of publication bias. We used a modified CAMARADES (Collaborative Approach to Meta-Analysis and Review of Animal Data in Experimental Studies) checklist to assess the risk of bias, finding that the median score was 4 (IQR: 3-5). In particular, reports of allocation concealment and sample size calculations were lacking. In conclusion, gene therapies are showing promise as therapies for spinal cord injury repair, but there is no consensus on which gene or genes should be targeted.

J Healthy Eat Act Living ; 1(3): 127-141, 2023 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-35935885


Active travel to school is one way youths can incorporate physical activity into their daily schedule. It is unclear the extent to which active travel to school is systematically monitored at local, state, or national levels. To determine the scope of active travel to school surveillance in the US and Canada and catalog the types of measures captured, we conducted a systematic review of peer-reviewed literature documenting active travel to school surveillance published from 2004 to February 2018. A study was included if it addressed children's school travel mode across two or more time periods in the US or Canada. Criteria were applied to determine whether a data source was considered an active travel to school surveillance system. We identified 15 unique data sources; 4 of these met our surveillance system criteria. One system is conducted in the US, is nationally representative, and occurs every 5-8 years. Three are conducted in Canada, are limited geographically to regions and provinces, and are administered with greater frequency (e.g., 2-year cycles). School travel mode was the primary measure assessed, most commonly through parent report. None of the systems collected data on school policies or program supports related to active travel to school. We concluded that incorporating questions related to active travel to school behaviors into existing surveillance systems, as well as maintaining them over time, would enable more consistent monitoring. Concurrently capturing behavioral information along with related environmental, policy, and program supports may inform efforts to promote active travel to school.

Int Arch Occup Environ Health ; 95(3): 559-571, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35220487


OBJECTIVE: Estimate the effort-reward imbalance prevalence (ERI) among physicians. METHODS: A systematic review was conducted from 2005 to 2019 using PRISMA guidelines on the PubMed and EBSCOhost search engines. Data were classified according to the ERI definition used by the authors. A meta-analysis was performed on effort and reward scores and on ERI prevalence rates. RESULTS: Out of 3787 results, we selected 41 studies. The physicians' ERI prevalence rate ranged from 3.50 to 96.9%. The standardized pooled effort mean score was 58.5 for effort and 48.9 for a reward out of 100, respectively. The overall combined ERI rate (when the ratio between effort and reward scores was above 1) was 40.2% among 21,939 practitioners (31.7% in the working European population). ERI rate was 70.2% using a four-point Likert scale and 21.1% using a five-point Likert scale. The highest rate (96.9%) was observed among German rural general practitioners and the lowest rate (3.50%) among Swiss hospital practitioners. The low percentage of variability (I2 = 27%) attributed to effort scores heterogeneity between studies suggested that this dimension is not discriminant in the physician ERI assessment. The high heterogeneity in reward scores (I2 = 83%) indicated that this dimension is sensible in ERI assessment among physicians. The number of items used did not appear as a significant source of heterogeneity. CONCLUSION: Physician job ERI appeared to be higher than in the working population. Studying each dimension and item indicators could help improve psychosocial risk prevention.

Satisfacción en el Trabajo , Médicos , Humanos , Médicos/psicología , Prevalencia , Recompensa , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Carga de Trabajo/psicología
Comput Math Methods Med ; 2022: 2935992, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35341003


Background: To evaluate the clinical effects and safety of glucocorticoids for patients with nonarteritic anterior ischemic optic neuropathy (NAION). Methods: The databases MEDLINE, Embase, PubMed, Cochrane Database, and Web of Science were used to search for the relevant studies, and full-text articles that reported on the evaluation of glucocorticoids vs. no-treatment or placebo for patients with NAION. Review Manager 5.4 was used to estimate the pooled effects of the results among selected studies. Forest plots, funnel plots, and Begg's rank correlation were also performed on the included articles. Results: A total of 983 patients were contained in the 9 studies that satisfied the eligibility criteria. The meta-analysis showed that, compared with the control group, the glucocorticoid group had significantly improved the VA (MD: -0.25, 95% CI [-0.45, -0.05], P = 0.02), VF (MD: -0.50, 95% CI [-0.94, -0.07], P = 0.02), and RNFL (MD: -14.10, 95% CI [-26.41, -1.79], P = 0.02) in NAION patients and had a high improvement rate of VA (RR 1.31, 95% CI [1.12, 1.52], P = 0.0005). No significant publication bias was observed in our study. Discussion. Our research preliminarily confirmed the effectiveness of glucocorticoids for NAION treatment, but more high-quality RCTs focusing on the hormone adverse reactions should be performed to verify our conclusions.

Glucocorticoides , Neuropatía Óptica Isquémica , Glucocorticoides/uso terapéutico , Humanos , Neuropatía Óptica Isquémica/tratamiento farmacológico
Mol Hum Reprod ; 28(1)2022 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-34954800


Sperm DNA damage is considered a predictive factor for the clinical outcomes of patients undergoing ART. Laboratory evidence suggests that zygotes and developing embryos have adopted specific response and repair mechanisms to repair DNA damage of paternal origin. We have conducted a systematic review in accordance with guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify and review the maternal mechanisms used to respond and repair sperm DNA damage during early embryonic development, how these mechanisms operate and their potential clinical implications. The literature search was conducted in Ovid MEDLINE and Embase databases until May 2021. Out of 6297 articles initially identified, 36 studies were found to be relevant through cross referencing and were fully extracted. The collective evidence in human and animal models indicate that the early embryo has the capacity to repair DNA damage within sperm by activating maternally driven mechanisms throughout embryonic development. However, this capacity is limited and likely declines with age. The link between age and decreased DNA repair capacity could explain decreased oocyte quality in older women, poor reproductive outcomes in idiopathic cases and patients who present high sperm DNA damage. Ultimately, further understanding mechanisms underlying the maternal repair of sperm DNA damage could lead to the development of targeted therapies to decrease sperm DNA damage, improved oocyte quality to combat incoming DNA insults or lead to development of methodologies to identify individual spermatozoa without DNA damage.

Daño del ADN , Reparación del ADN , Anciano , Animales , Daño del ADN/genética , Reparación del ADN/genética , Desarrollo Embrionario/genética , Femenino , Humanos , Masculino , Oocitos/fisiología , Embarazo , Espermatozoides/fisiología
Clin Neurol Neurosurg ; 213: 107134, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35078087


OBJECTIVE: This study intends to systematically evaluate the efficacy and safety of donepezil for improving cognitive function in patients with mild cognitive impairment (MCI), and to provide evidence-based foundation for donepezil in MCI treatment. METHODS: We searched in PubMed, Embase, Cochrane Library, Clinical, Web of Science, CQVIP, and CNKI databases, and then we summarized the interventional and observational studies on the use of donepezil for improving the cognitive function of MCI patients. The literature was collected according to the inclusion criteria for data extraction. We evaluated the quality of the selected literature and used Stata 15.0 for meta-analysis. RESULTS: A total of 12 randomized controlled trials (RCTs) and 5 non-randomized concurrent controlled trials (CCTs) were included, and a total of 2847 patients were included. In terms of efficacy, meta-analysis showed that donepezil could significantly improve the MMSE (SMD: 0.85, 95%CI: 0.40-1.31) and MoCA (SMD: 1.88, 95%CI: 0.32-3.45) scores of MCI patients. Donepezil could not significantly reduce ADAS-cog score, nor could it significantly delay disease progression. The quality of the evidence was low overall. In terms of safety, donepezil could significantly increase the risk of adverse reactions such as nausea, vomiting, diarrhea in patients with MCI. CONCLUSION: Donepezil can improve the cognitive function of MCI patients to a certain extent. However, there is no trend of significantly delaying the progression of the disease, and it is easy to lead to the occurrence of adverse reactions.

Disfunción Cognitiva , Nootrópicos , Cognición , Disfunción Cognitiva/tratamiento farmacológico , Bases de Datos Factuales , Donepezilo/efectos adversos , Humanos , Nootrópicos/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto
Eur J Prev Cardiol ; 28(18): 2001-2009, 2022 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33624058


AIM: The 2018 American Heart Association/American College of Cardiology/Multi-Society Cholesterol Guidelines recommended the addition of non-statins to statin therapy for high-risk secondary prevention patients above a low-density lipoprotein cholesterol (LDL-C) threshold of ≥70 mg/dL (1.8 mmol/L). We compared effectiveness and safety of treatment to achieve lower (<70) vs. higher (≥70 mg/dL) LDL-C among patients receiving intensive lipid-lowering therapy (statins alone or plus ezetimibe or proprotein convertase subtilisin/kexin type 9 inhibitors). METHODS AND RESULTS: Eleven randomized controlled trials (130 070 patients), comparing intensive vs. less-intensive lipid-lowering therapy, with follow-up ≥6 months and sample size ≥1000 patients were selected. Meta-analysis was reported as random effects risk ratios (RRs) [95% confidence intervals] and absolute risk differences (ARDs) as incident cases per 1000 person-years. The median LDL-C levels achieved in lower LDL-C vs. higher LDL-C groups were 62 and 103 mg/dL, respectively. At median follow-up of 2 years, the lower LDL-C vs. higher LDL-C group was associated with significant reduction in all-cause mortality [ARD -1.56; RR 0.94 (0.89-1.00)], cardiovascular mortality [ARD -1.49; RR 0.90 (0.81-1.00)], and reduced risk of myocardial infarction, cerebrovascular events, revascularization, and major adverse cardiovascular events (MACE). These benefits were achieved without increasing the risk of incident cancer, diabetes mellitus, or haemorrhagic stroke. All-cause mortality benefit in lower LDL-C group was limited to statin therapy and those with higher baseline LDL-C (≥100 mg/dL). However, the RR reduction in ischaemic and safety endpoints was independent of baseline LDL-C or drug therapy. CONCLUSION: This meta-analysis showed that treatment to achieve LDL-C levels below 70 mg/dL using intensive lipid-lowering therapy can safely reduce the risk of mortality and MACE.

Anticolesterolemiantes , Enfermedades Cardiovasculares , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Infarto del Miocardio , Anticolesterolemiantes/efectos adversos , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/tratamiento farmacológico , Enfermedades Cardiovasculares/prevención & control , Colesterol , LDL-Colesterol , Ezetimiba/uso terapéutico , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Infarto del Miocardio/prevención & control
Horm Metab Res ; 54(2): 94-103, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35130570


Glycated hemoglobin (HbA1c) variability is emerging as an indicator of long-term glycemic control, which may play a significant role during vascular complications. We conducted a systematic review and meta-analysis to assess the association between the scope of HbA1c variability and vascular complications in patients with type 2 diabetes mellitus. PubMed and Embase were searched for studies that evaluated the association of HbA1c variability with vascular complications in patients with type 2 diabetes. Two reviewers independently completed data extraction. Random-effects meta-analysis was conducted with stratification according to the type of vascular complications. Nine studies were eligible for inclusion in our systematic review and meta-analysis. Six studies evaluated the impact of the standard deviation of HbA1c (HbA1c-SD) on cardiovascular events and showed an association of HbA1c-SD with cardiovascular events (HR: 1.25, 95% CI 1.18-1.32, 5 studies). Six studies evaluated renal disease associated with HbA1c-SD and showed that HbA1c-SD was correlated with an increased risk of renal disease (HR: 1.19, 95% CI 1.13-1.24). Two studies evaluated HbA1c-SD and the risk of retinopathy and showed that no significant association was found between retinopathy and HbA1c-SD (HR 1.08, 95% CI 0.92-125). For HbA1c-SD ranging from 0.6 to 0.8%, HbA1c-SD was associated with an increased risk of cardiovascular events (HR: 1.25, 95% CI 1.15-1.35) and renal disease (HR: 1.16, 95% CI 1.11-1.22). For individuals with index HbA1c variability greater than or equal to 0.6%, HbA1c variability was significantly associated with vascular complications in patients with type 2 diabetes mellitus.

Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Glucemia/análisis , Enfermedades Cardiovasculares/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Hemoglobina A Glucada/análisis , Humanos , Estudios Prospectivos
Front Pharmacol ; 13: 841782, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35370685


Pharmaceutical interest in the human intestinal microbiota has increased considerably, because of the increasing number of studies linking the human intestinal microbial ecology to an increasing number of non-communicable diseases. Many efforts at modulating the gut microbiota have been made using probiotics, prebiotics and recently postbiotics. However, there are other, still little-explored opportunities from a pharmaceutical point of view, which appear promising to obtain modifications of the microbiota structure and functions. This review summarizes all in vitro, in vivo and clinical studies demonstrating the possibility to positively modulate the intestinal microbiota by using probiotics, prebiotics, postbiotics, essential oils, fungus and officinal plants. For the future, clinical studies investigating the ability to impact the intestinal microbiota especially by using fungus, officinal and aromatic plants or their extracts are required. This knowledge could lead to effective microbiome modulations that might support the pharmacological therapy of most non-communicable diseases in a near future.

Ann R Coll Surg Engl ; 104(4): 242-248, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34931532


BACKGROUND: Online resources are a fundamental source of healthcare information due to the increasing popularity of the internet. Ensuring accuracy and reliability of websites is crucial to improving patient education and enhancing patient outcomes. Inguinal hernia repair is the most commonly performed general surgical procedure worldwide. This study analyses the quality of online patient information about inguinal hernia repair using the Modified Ensuring Quality Information for Patients (EQIP) tool. METHODS: A systematic review of online information on inguinal hernia repair was conducted using four search terms: 'inguinal hernia', 'groin hernia', 'inguinal hernia repair' and 'inguinoscrotal hernia'. The top 100 websites for each term identified using Google were assessed using the modified EQIP tool (score 0-36). Websites for the paediatric population or intended for medical professional use were excluded from analysis. FINDINGS: A total of 142 websites were eligible for analysis, 52.8% originating from the UK. The median EQIP score for all websites was 17/36 (interquartile range 14-21). The median EQIP scores for content, identification and structure were 8/18, 2/8 and 8/12, respectively. Complications of inguinal hernia repair were included in 46.5% of websites, with only 9.2% providing complication rates and 14.1% providing information on how complications are handled. CONCLUSION: This study highlights that the current quality of online patient information on inguinal hernia repair is poor, with minimal information available on complications, hindering patients' ability to make informed decisions regarding their healthcare. To improve patient education, there is an immediate need for improved quality online resources to meet international standards.

Hernia Inguinal , Niño , Hernia Inguinal/cirugía , Herniorrafia/métodos , Humanos , Reproducibilidad de los Resultados
Ann R Coll Surg Engl ; 104(4): 249-256, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34928718


INTRODUCTION: Multiple traumatic rib fractures are associated with significant morbidity and mortality. The last decade has seen a significant increase in rates of surgical fixation for both flail and non-flail rib fractures; the evidence for this has come from largely retrospective studies. The aim of this meta-analysis was to compare the efficacy of this approach with that of non-operative management. METHODS: A systematic search of the literature was performed to identify randomised controlled trials (RCTs) comparing surgical stabilisation to non-operative management. Both flail and non-flail injuries were included. RESULTS: Five RCTs reported the results of 286 patients. Only one study assessed non-flail fractures. The studies were heterogenic in nature and of mixed quality. Surgical stabilisation was associated with a reduction in pneumonia (RR 0.46, 95% confidence intervals (CI) 0.29 to 0.73, I2=42%, p=0.001). The duration of mechanical ventilation (mean difference (MD) -6.3, 95% CI -12.16 to -0.43, I2=95%, p=0.05) and critical care length of stay was also shorter after surgery (mean difference -6.46 days, 95% CI 9.73 to -3.19, p<0.001); however, the overall length of stay in hospital was not (MD -7.18, 95% CI -15.63 to -1.28, I2=94%, p=0.1). No study demonstrated a significant reduction in mortality (RR 0.54, 95% CI 0.18 to 1.8, I2=0%, p=0.28). CONCLUSIONS: Surgical stabilisation of rib fractures is associated with some improved clinical outcomes. Further large RCTs are still needed to confirm if there is also a survival benefit.

Tórax Paradójico , Fracturas de las Costillas , Heridas no Penetrantes , Tórax Paradójico/cirugía , Humanos , Tiempo de Internación , Ensayos Clínicos Controlados Aleatorios como Asunto , Respiración Artificial , Fracturas de las Costillas/cirugía , Heridas no Penetrantes/complicaciones , Heridas no Penetrantes/cirugía
Front Psychiatry ; 13: 833865, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35370861


Objective: This paper used meta-regression to analyze the heterogenous factors contributing to the prevalence rate of mental health symptoms of the general and frontline healthcare workers (HCWs) in China under the COVID-19 crisis. Method: We systematically searched PubMed, Embase, Web of Science, and Medrxiv and pooled data using random-effects meta-analyses to estimate the prevalence rates, and ran meta-regression to tease out the key sources of the heterogeneity. Results: The meta-regression results uncovered several predictors of the heterogeneity in prevalence rates among published studies, including severity (e.g., above severe vs. above moderate, p < 0.01; above moderate vs. above mild, p < 0.01), type of mental symptoms (PTSD vs. anxiety, p = 0.04), population (frontline vs. general HCWs, p < 0.01), sampling location (Wuhan vs. Non-Wuhan, p = 0.04), and study quality (p = 0.04). Conclusion: The meta-regression findings provide evidence on the factors contributing to the prevalence rate of mental health symptoms of the general and frontline healthcare workers (HCWs) to guide future research and evidence-based medicine in several specific directions. Systematic Review Registration:, identifier: CRD42020220592.

Front Oncol ; 12: 868031, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35372002


In advanced prostate cancer, access to recent diagnostic tissue samples is restricted and this affects the analysis of the association of evolving biomarkers such as AR-V7 with metastatic castrate resistance. Liquid biopsies are emerging as alternative analytes. To clarify clinical value of AR-V7 detection from liquid biopsies, here we performed a meta-analysis on the prognostic and predictive value of androgen receptor variant 7 (AR-V7) detected from liquid biopsy for patients with prostate cancer (PC), three databases, the Embase, Medline, and Scopus were searched up to September 2021. A total of 37 studies were included. The effects of liquid biopsy AR-V7 status on overall survival (OS), radiographic progression-free survival (PFS), and prostate-specific antigen (PSA)-PFS were calculated with RevMan 5.3 software. AR-V7 positivity detected in liquid biopsy significantly associates with worse OS, PFS, and PSA-PFS (P <0.00001). A subgroup analysis of patients treated with androgen receptor signaling inhibitors (ARSi such as abiraterone and enzalutamide) showed a significant association of AR-V7 positivity with poorer OS, PFS, and PSA-PFS. A statistically significant association with OS was also found in taxane-treated patients (P = 0.04), but not for PFS (P = 0.21) or PSA-PFS (P = 0.93). For AR-V7 positive patients, taxane treatment has better OS outcomes than ARSi (P = 0.01). Study quality, publication bias and sensitivity analysis were integrated in the assessment. Our data show that liquid biopsy AR-V7 is a clinically useful biomarker that is associated with poor outcomes of ARSi-treated castrate resistant PC (CRPC) patients and thus has the potential to guide patient management and also to stratify patients for clinical trials. More studies on chemotherapy-treated patients are warranted. Systematic Review Registration: PROSPERO, CRD42021239353.

Braz. j. oral sci ; 21: e226252, jan.-dez. 2022. ilus
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1366526


Universal health coverage is a global target included in the United Nations Sustainable Development Goals agenda for 2030. Healthcare in Brazil has universal coverage through the Unified Health System (SUS), which guarantees health as basic right to the Brazilian population. Considering the principles of SUS, public oral healthcare management is a huge challenge. Aim: To identify good management practices for quality care adopted by local public oral healthcare managers and teams around Brazil. Methods: This study was registered with PROSPERO (CRD42017051639). Five databases (PubMed, Embase, Web of Science, Scopus and Lilacs) as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines. Results:A total of 30,895 references were initially found, which were evaluated according to the defined eligibility criteria. Twenty qualitative studies, eight surveys and two mixed-model studies were selected. The practices (codes) were organized into three main groups (families), and the Frequency of the Effect Size (FES) of each code was calculated. Among the 20 codes identified, the most relevant ones were: Diagnosis and Health Planning (FES=80%) and Family Health Strategy(FES=66,7). The Intensity of the Effect Size of each study was also calculated to demonstrate the individual contribution of each study to the conclusions. Conclusion: The evidence emerging from this review showed that healthcare diagnosis, planning, and performance based on the family health strategy principles were the most relevant practices adopted by public oral healthcare managers in Brazil. The widespread adoption of these practices could lead to improved oral healthcare provision and management in Brazil

Humanos , Sistema Único de Salud , Atención Odontológica , Gestión en Salud , Política de Salud , Brasil
Braz. j. oral sci ; 21: e226351, jan.-dez. 2022. ilus
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1355010


Aim: This study aimed to assess the reporting characteristics of systematic review abstracts published in the proceedings of the Sociedade Brasileira de Pesquisa Odontológica (SBPqO) meeting. Methods: We selected abstracts published in the SBPqO meeting proceedings of 2019 and 2020, mentioning that a systematic review was conducted in the title, objective or methods sections. One researcher performed the screening and the data extraction after a pilot test training. The following data were extracted: affiliation of the primary author, dental specialization, the term "systematic review" mentioned in the title, reporting of the objective, reporting of eligibility criteria, reporting of information sources, reporting of the number of included studies and if a meta-analysis was performed. A descriptive analysis of the data was performed with data summarized as frequencies. Results: We included 235 abstracts. A total of 20 studies were from the Universidade de Uberlândia (8.5%), and the main specialization was Restorative and Esthetic Dentistry, with 47 studies (20%). Most of the studies mentioned the term "systematic review" in the title (n=219; 93.2%) and reported the objective (n=231; 98.3%). A great majority of studies did not report the eligibility criteria (n=97; 41.3%) or it was classified as unclear (n=96; 40.8%). The great majority of studies only reported the databases searched (n=103; 43.8%) or databases and date of search (n=74; 31.5%). Most of the studies reported the number of included studies (n=204; 86.8%). Conclusion: Based on this study, the reporting characteristics of systematic review abstracts published in the proceedings of the SBPqO meeting are satisfactory. However, there is room for improvement

Congresos como Asunto , Investigación Dental/estadística & datos numéricos , Indización y Redacción de Resúmenes , Informe de Investigación , Revisiones Sistemáticas como Asunto
J. Health Biol. Sci. (Online) ; 10(1): 1-7, 01/jan./2022. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1361637


Aim: to identify which complications and prognosis of diabetic patients, hospitalized, who acquired COVID-19, through a systematic review. Methods: a systematic review based on the PRISMA flowchart, including cohort studies, available in Portuguese, English, Spanish, French, and Mandarin, published from 2019 to 2020, using the PICOS strategy, in the databases: PubMed, Web of Science, Scielo, Lilacs, Scopus and Science Direct, which in addition to the inclusion criteria after questionnaires to assess methodological quality and risk of bias. Results: of the 811 articles researched, 6 were included in this research. These studies showed that patients with COVID-19 and higher DM with worse prognosis, spent more time in the ICU, constantly needed indifference, greater complications when related to other comorbidities, high mortality rate, and glycemic control associated with advanced age directly affected patients. Outcomes even of non-diabetic subjects. Conclusion: this review identified the severity of the pathophysiological association is related to older age and biochemical and inflammatory factors linked to the two pathogens and that these subjects are more prone to specialized hospital care, which, however, result in high rates of hospital mortality.

Objetivo: identificar quais complicações e prognósticos dos pacientes diabéticos, internados, que adquiriram COVID-19, por meio de uma revisão sistemática. Métodos: foi realizada uma revisão sistemática baseada no fluxograma PRISMA, incluindo estudos de coorte, disponíveis em português, inglês, espanhol, francês e mandarim, publicados de 2019 a 2020, utilizando a estratégia PICOS, nas bases de dados: PubMed, Web of Science, Scielo, Lilacs, Scopus e Sciece Direct. Além dos critérios de inclusão passam por questionários para avaliar a qualidade metodológica e risco de viés. Resultados: dos 811 artigos pesquisados, 6 foram incluídos nesta pesquisa. Esses estudos mostraram que pacientes com COVID-19 e DM apresentam pior prognóstico, maior permanência em UTI, necessidade constante de ventilação invasiva, maiores complicações quando relacionadas a outras comorbidades, elevado índice de mortalidade, e o controle glicêmico associado à idade avançada afetavam diretamente os desfechos inclusive de pacientes não diabéticos. Conclusão: esta revisão identificou que a gravidade da associação fisiopatológica está relacionada à idade mais avançada e aos fatores bioquímicos e inflamatórios ligados aos dois patógenos e que esses sujeitos são mais propensos ao atendimento hospitalar especializado, o que, no entanto, resulta em altas taxas de mortalidade hospitalar.

COVID-19 , Estrategias de Salud , Mortalidad Hospitalaria , Diabetes Mellitus , Control Glucémico
Rev. bras. med. esporte ; 28(5): 602-608, Set.-Oct. 2022. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1376684


ABSTRACT Introduction: Vitamin E supplementation may protect against exercise-induced muscle damage (EIMD) through possible inhibition of free radical formation and cell membrane stabilization. However, there is no systematic review of this topic. This fact maintains academic stalemates that may have a resolution. Objective: This systematic review with meta-analysis aims to provide a comprehensive literature review on the hypothesis of the benefit of vitamin E supplementation on oxidative stress and muscle damage induced by aerobic exercise. Methods: A random-effects model was used, weighted mean difference (WMD) and 95% confidence interval (CI) were applied to estimate the overall effect. Results: The results revealed a significant effect of vitamin E supplementation on reducing creatine kinase (CK) and lactate dehydrogenase (LDH). In addition, a subgroup analysis resulted in a significant decrease in CK concentrations in trials with immediate and <24 hours post-exercise CK measurement; <1000 at daily vitamin E intake; ≤1 at weekly intake; 1 at six weeks and >6 weeks experimental duration, studies on aerobic exercise and training were part of the crossover study. Conclusion: Vitamin E can be seen as a priority agent for recovery from muscle damage. Evidence Level II; Therapeutic Studies - Investigating the results.

RESUMO Introdução: A suplementação de vitamina E pode ter um efeito protetor contra danos musculares induzidos pelo exercício (EIMD) através da possível inibição da formação radical livre e estabilização da membrana celular. Todavia, não há uma revisão sistemática sobre esse tema. Tal fato mantém empasses acadêmicos que podem ter uma resolução. Objetivo: Esta revisão sistemática com meta-análise objetiva fornecer uma análise bibliográfica abrangente na hipótese do benefício na suplementação de vitaminas E sobre o estresse oxidativo e os danos musculares induzidos pelo pelo exercício aeróbico. Métodos: Foi utilizado um modelo com efeitos aleatórios, diferença média ponderada (ADM) e intervalo de confiança de 95% (IC) foram aplicados para estimar o efeito geral. Resultados: Os resultados revelaram um efeito significativo da suplementação de vitamina E na redução da creatina-quinase (CK) e lactato-desidrogenase (LDH). Além disso, uma análise do subgrupo resultou em uma diminuição significativa das concentrações de CK em ensaios com medição imediata e <24 horas de CK após o exercício; <1000 no consumo diário de vitamina E; ≤1 no consumo semanal; 1 em 6 semanas e >6 semanas de duração experimental, estudos sobre exercício aeróbico e treinamento fizeram parte do estudo cruzado. Conclusão: A vitamina E pode ser vista como um agente prioritário de recuperação de danos musculares. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción: La suplementación con vitamina E puede tener un efecto protector contra el daño muscular inducido por el ejercicio (EIMD) a través de la posible inhibición de la formación de radicales libres y la estabilización de la membrana celular. Sin embargo, no existe ninguna revisión sistemática sobre este tema. Este hecho mantiene un impasse académico que puede tener resolución. Objetivo: Esta revisión sistemática con meta-análisis tiene como objetivo proporcionar una amplia revisión de la literatura sobre la hipótesis del beneficio de la suplementación con vitamina E sobre el estrés oxidativo y el daño muscular inducido por el ejercicio aeróbico. Métodos: Se utilizó un modelo de efectos aleatorios, se aplicó la diferencia de medias ponderada (DMP) y el intervalo de confianza (IC) del 95% para estimar el efecto global. Resultados: Los resultados revelaron un efecto significativo de la suplementación con vitamina E en la reducción de la creatina quinasa (CK) y la lactato deshidrogenasa (LDH). Además, un análisis de subgrupos dio como resultado una disminución significativa de las concentraciones de CK en los ensayos con medición de CK inmediata y <24 horas después del ejercicio; <1000 en la ingesta diaria de vitamina E; ≤1 en la ingesta semanal; 1 en 6 semanas y >6 semanas de duración experimental, los estudios sobre el ejercicio aeróbico y el entrenamiento formaron parte del estudio cruzado. Conclusión: La vitamina E puede resultar un agente prioritario para la recuperación del daño muscular. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Rev. bras. med. esporte ; 28(5): 595-601, Set.-Oct. 2022. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1376689


ABSTRACT Introduction: The β-hydroxy β-methyl butyrate (HMB) is an amino acid leucine metabolite with several ergogenic benefits. It is known that it can benefit testosterone and cortisol concentration in athletes. However, no systematic review and meta-analysis has focused on the effects of HMB supplementation on testosterone and cortisol in trained athletes. Objectives: The meta-analysis evaluates the effect of HMB supplementation on testosterone and cortisol in trained athletes and verifies conflicting results between studies. Methods: A systemic review was performed in Scopus, Medline, and Google scholar databases of articles published until August 2021. The Cochrane Collaboration tool was used to assess the risk of bias and assess the quality of the studies. Random effects model, weighted mean difference (WMD), and 95% confidence interval (CI) were used to estimate the overall effect. Results: Although the meta-analysis showed that HMB consumption does not alter cortisol and testosterone concentration, subgroup analysis based on exercise type exhibited a significant decrease in cortisol concentration in resistance training exercises (P<0.05) and a significant increase in testosterone concentration in combined aerobic and anaerobic sports (P<0.05). Conclusion: The results indicate that HMB supplementation in athletes can reduce cortisol concentration in endurance exercise and increase testosterone concentration in combined aerobic and anaerobic exercise. Evidence Level II; Therapeutic Studies - Investigating the results.

RESUMO Introdução: o β-hidroxi β-metilbutirato (HMB) é um metabólito de aminoácido leucina e tem vários benefícios ergogênicos. Sabe-se que ela pode beneficiar a concentração de testosterona e cortisol em atletas. Porém, nenhuma revisão sistemática e meta-análise focou-se nos efeitos que a suplementação de HMB provoca sobre testosterona e cortisol em atletas treinados. Objetivos: A meta-análise tem como objetivo avaliar o efeito de suplementação de HMB na testosterona e cortisol em atletas treinados, além de verificar resultados contraditórios entre estudos. Métodos: Foi feita uma revisão sistêmica nas bases Scopus, Medline e Google scholar dos artigos publicados até agosto de 2021. A ferramenta de colaboração Cochrane foi utilizada para avaliar o risco de viés e também para avaliar a qualidade dos estudos. Modelo de efeitos aleatórios, diferença média ponderada (ADM) e intervalo de confiança de 95% (IC) foram utilizados para estimar o efeito geral. Resultados: Embora a meta-análise tenha evidenciado que o consumo de HMB não altere a concentração de cortisol e testosterona, a análise do subgrupo com base no tipo de exercício exibiu uma diminuição significativa na concentração do cortisol nos exercícios de treinamento de resistência (P<0,05) e um aumento significativo na concentração de testosterona em esportes combinados aeróbicos e anaeróbicos (P<0,05). Conclusão: Os resultados indicam que a suplementação de HMB em atletas pode reduzir a concentração de cortisol em exercícios de resistência e aumentar a concentração de testosterona em exercícios aeróbicos e anaeróbicos combinados. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción: El β-hidroxi-β-metilbutirato (HMB) es un metabolito del aminoácido leucina y tiene varios beneficios ergogénicos. Está comprobado que puede beneficiar la concentración de testosterona y cortisol en los deportistas. Sin embargo, ninguna revisión sistemática y meta-análisis se ha centrado en los efectos que la suplementación con HMB provoca en la testosterona y el cortisol en atletas entrenados. Objetivos: El meta-análisis tiene como objetivo evaluar el efecto de la suplementación con HMB sobre la testosterona y el cortisol en atletas entrenados, y verificar los resultados contradictorios entre los estudios. Métodos: Se realizó una revisión sistémica en las bases de datos Scopus, Medline y Google scholar de los artículos publicados hasta agosto de 2021. Se utilizó la herramienta de colaboración Cochrane para evaluar el riesgo de sesgo y también para evaluar la calidad de los estudios. Se utilizó un modelo de efectos aleatorios, una diferencia de medias ponderada (DMP) y un intervalo de confianza (IC) del 95% para estimar el efecto global. Resultados: Aunque el meta-análisis mostró que el consumo de HMB no altera la concentración de cortisol y testosterona, el análisis de subgrupos basado en el tipo de ejercicio mostró una disminución significativa de la concentración de cortisol en los ejercicios de entrenamiento de resistencia (P<0,05) y un aumento significativo de la concentración de testosterona en los deportes aeróbicos y anaeróbicos combinados (P<0,05). Conclusión: Los resultados indican que la suplementación con HMB en los atletas puede reducir la concentración de cortisol en el ejercicio de resistencia y aumentar la concentración de testosterona en el ejercicio aeróbico y anaeróbico combinado. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Psychol Trauma ; 2022 Aug 04.
Artículo en Inglés | MEDLINE | ID: mdl-35925693


OBJECTIVE: This systematic review of the literature aims to systematize the current knowledge on psychological treatments implemented with trafficked children and adults, specifically exploring their effect on the mental health recovery of victims. Integrating this information is an important step to informing practice, as well as examining gaps in the literature and enlightening future research. METHOD: A systematic search was conducted of five electronic databases for journal articles published until October 2019. This study followed the protocol based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Moher et al., 2009) recommendations. RESULTS: The search yielded six articles for inclusion in the review. Evidence for the efficacy of interventions to increase the mental health recovery of victims is inconclusive as most studies presented a range of methodology limitations, which in turn are related to difficulties with causal inferences and low external validity. CONCLUSION: There is a need for further research in this area to increase informed practices and interventions with human trafficking victims. Implications for practice and research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).