[Effects of front-of-package nutritional labeling of food and beverages: synopsis of systematic reviewsEfeitos da rotulagem nutricional frontal de alimentos e bebidas: sumário de estudos de revisão sistemática]. / Efectos del etiquetado nutricional frontal de alimentos y bebidas: sinopsis de revisiones sistemáticas.

OBJECTIVES: Synthesize available information on the effects of front-of-package nutritional labeling on choice, purchase, and consumption of food and beverages, and nutritional status of consumers, and identify factors that influence its effectiveness. METHODS: A synopsis of systematic reviews was carried out following PRISMA recommendations. A literature search was performed in MEDLINE (PubMed), Cochrane Library, LILACS, EBSCOhost, and Scopus, limited to studies published in Spanish or English with no restrictions on date of publication. Methodological quality was evaluated using AMSTAR 2. RESULTS: Seven systematic reviews were included. Front-of-package labeling facilitated healthy food choices and had a variable effect on consumption and purchase dimensions. No systematic review evaluated effects on nutritional status. Cost and flavor, eating habits, educational level, and dominant information processing systems in the consumer influenced labeling effectiveness. Most of the systematic reviews showed methodological limitations and critically low confidence levels. CONCLUSIONS: Front-of-package labeling had a positive effect on healthy food choices, with variable results on purchase and consumption dimensions. Local studies with adequate methodological quality are needed to identify the most effective labeling format in each country. Implementation of labeling as public health policy should be accompanied by strategies to improve access to healthy foods, promote physical activity, and provide nutrition education to consumers.

OBJETIVOS: Sumarizar os dados disponíveis referentes ao efeito da rotulagem nutricional frontal na escolha, compra e consumo de alimentos e bebidas e no estado nutricional dos consumidores e identificar os fatores que influenciam a efetividade desta medida. MÉTODOS: Foi realizado um sumário de estudos de revisão sistemática segundo as recomendações PRISMA. Foi feita uma busca da literatura nas bases de dados MEDLINE (PubMed), Cochrane Library, LILACS, EBSCOhost e Scopus de estudos publicados em espanhol ou inglês, sem restrição de data de publicação. A qualidade metodológica foi avaliada com o uso da ferramenta AMSTAR 2. RESULTADOS: Sete estudos de revisão sistemática foram selecionados. A rotulagem frontal facilitou a escolha de alimentos saudáveis e teve um efeito variável nas dimensões de consumo e compra. Nenhum estudo avaliou o efeito no estado nutricional. Custo e sabor, hábitos alimentares, nível educacional e sistemas dominantes de processamento de informação do consumidor tiveram influência na efetividade desta medida. Os estudos de revisão apresentaram, na sua maioria, limitações metodológicas e um grau de confiança criticamente baixo. CONCLUSÕES: A rotulagem nutricional frontal teve efeito positivo na escolha de alimentos saudáveis, com resultados variáveis nas dimensões de compra e consumo. É preciso realizar estudos locais com qualidade metodológica adequada para identificar o formato de rotulagem mais efetivo em cada país. A implementação desta medida como política de saúde pública deve ser acompanhada por estratégias para melhorar o acesso a alimentos saudáveis, promover a atividade física e proporcionar educação nutricional aos consumidores.

The roadmap to transcatheter aortic valve implantation.

Nearly 300 years after the first description of aortic valve obstruction, it has taken less than two decades of randomized clinical trials (RCTs) for transcatheter aortic valve implantation (TAVI) to become a recognized strategy for patients with aortic stenosis. The high density of recent publications makes it easy to ignore the history that led to the development of this procedure. Knowing the evolution of a diagnostic or therapeutic technique improves critical reasoning, prevents repeated mistakes, paves the way for future research and contributes to an insightful perspective on the subject. Nevertheless, it should not overshadow the findings of recently published RCTs, which still are the mainstay of clinical practice. In this timeline review, the authors aim to recap the development of TAVI, combining the pathophysiology of aortic stenosis and the initial concept of TAVI with the roadmap of clinical trials that led to the generalization of the TAVI procedure.

Nursing interventions for adult patients undergoing cancer cardiotoxic therapy: Scoping review.

PURPOSE: To identify nursing interventions for the management of adult patients undergoing cardiotoxic oncologic therapy. METHODS: This scoping review was performed in accordance with the JBI guidelines. The literature search took place between July and August 2022. Studies examining interventions for the management of adult cancer patients undergoing cardiotoxic therapy were included. The characteristics and results of the studies were synthesized and analyzed in a narrative way. FINDINGS: In the nine included studies, it was verified that the interventions were implemented to guide the actions of the health team in general rather than specifically nursing staff. Nine nursing interventions related to the Classification of Nursing Interventions were included. CONCLUSIONS: The nursing interventions identified focused on rigorous cardiovascular surveillance, risk assessment, and actions to identify and mitigate cardiotoxicity. IMPLICATIONS FOR NURSING PRACTICE: It is believed that the implementation of the identified nursing interventions will lead to evidence-based nursing practice and will contribute to the development of care products and processes that assess the cardiological risks and cardiotoxicity.

OBJETIVO: Identificar as intervenções de enfermagem no manejo de pacientes adultos submetidos à terapia oncológica cardiotóxica. MÉTODOS: Revisão de escopo seguindo a JBI. A busca da literatura ocorreu entre julho e agosto de 2022. Foram incluídos estudos que abordam intervenções para o manejo de pacientes adultos oncológicos submetidos à terapia cardiotóxica. As características e resultados foram sintetizados e analisados de forma narrativa. RESULTADOS: Nos nove estudos incluídos, verificou-se que as intervenções foram direcionadas às ações da equipe de saúde, em geral, e não àquelas específicas da enfermagem. A partir da literatura, foram identificadas nove intervenções de enfermagem relacionadas à Classificação das Intervenções de Enfermagem. CONCLUSÕES: As intervenções de enfermagem identificadas direcionaram-se para vigilância cardiovascular rigorosa, avaliação de risco e ações para identificar e mitigar a cardiotoxicidade. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Acredita-se que a implementação das intervenções identificadas proporcionará uma prática de enfermagem baseada em evidências e contribuirá para o desenvolvimento de produtos e processos assistenciais que avaliem os riscos cardiológicos e a cardiotoxicidade.

What is the role of septal myectomy in aortic stenosis?

Asymmetric basal septal hypertrophy is present in 10% of patients with hemodynamic significant aortic valve stenosis. From the surgeon's standpoint, it represents a dilemma as it may be implicated in suboptimal short and long-term results after aortic valve replacement (AVR), but also heighten unwarranted complications at the time of surgical correction. To provide insight about the usefulness and safety of concomitant septal myectomy in this setting, we performed a literature review searching Medline from its inception to November 2020 using the Pubmed interface. Only five low evidence retrospective analyses, comprising a total of <200 patients undergoing AVR with concomitant septal myectomy, were found in the literature. In summary, routine myectomy, in the presence of suspected or directly visualized asymmetric septal hypertrophy on echocardiogram during AVR, seems to be a safe procedure, with all authors reporting a low rate or absence of complications. Overall, myectomy in this setting is associated with superior echocardiographic results concerning surrogates of LV remodelling (LVM; LVM index; LVM/height) and diastolic function (E/E'), suggesting some benefit for hemodynamic outcomes. However, to what extent hemodynamic improvement is exclusively attributable to myectomy is uncertain, as is, the clinical significance of such an improvement, with similar short and mid-term survival rates being reported.

Effect of vitamin D supplements on left ventricular ejection fraction in patients with heart failure: A systematic review and meta-analysis of randomized controlled trials.

Cardiovascular diseases (CVD) are the most common cause of death worldwide. Among CVDs, heart failure (HF) is known to be the most common cause of hospitalization in patients over 65. Despite all proposed treatments for CVDs, mortality and morbidity still remain high. There are controversial reports available on vitamin D efficacy in patients with HF. In this systematic review and meta-analysis, we aimed to investigate whether vitamin D is effective at enhancing ejection fraction (EF) in patients with HF. We performed a systematic search across different databases (PubMed, SCOPUS, Web of Science, EMBASE, SciELO and Google Scholar) up to 1 Jan 2020 without any language or location limitations. Our suggested Population/Intervention/Comparison/Outcome/Type of study (PICOT) was P: patients with HF, I: vitamin D, C: placebo or no treatment, O: EF and T: clinical trials. To achieve the highest sensitivity, only keywords associate with P and I were selected for the search query. A total number of 5397 primary studies were found, of which 13 were elected for data synthesis. Clinical trials were published and available since 2005 up to 2019 and a total number of 1215 patients were included. Our results showed that vitamin D can significantly enhance left ventricular EF in HF patients by 3.304% (95% confidence interval [CI] 0.954, 5.654, p=0.006). Based on our observations, we conclude that before conducting a large number of high quality clinical trials and further meta-analysis, vitamin D should be prescribed to all patients with HF.

[Epidemiology of perioperative cardiac arrest and mortality in Brazil: a systematic review]. / Epidemiologia de parada cardíaca e de mortalidade perioperatória no Brasil: revisão sistemática.

BACKGROUND AND OBJECTIVES: The perioperative cardiac arrest (CA) and mortality rates in Brazil, a developing country, are higher than in developed countries. The hypothesis of this review was that knowledge of the epidemiology of perioperative CA and mortality in Brazil enables the comparison with developed countries. The systematic review aimed to verify, in studies conducted in Brazil, the epidemiology of perioperative CA and mortality. METHOD AND RESULTS: A search strategy was carried out on different databases (PubMed, EMBASE, SciELO and LILACS) to identify observational studies that reported perioperative CA and/or mortality up to 48 hours postoperatively in Brazil. The primary outcomes were data on epidemiology of perioperative CA and mortality. In 8 Brazilian studies, there was a higher occurrence of perioperative CA and mortality in males; in extremes of age; in patients in worse physical status according to the American Society of Anesthesiologists (ASA); in emergency surgeries; in general anesthesia; and in cardiac, thoracic, vascular, abdominal and neurological surgeries. The patient's disease/condition was the main triggering factor, with sepsis and trauma as the main causes. CONCLUSIONS: The epidemiology of both perioperative CA and mortality events reported in Brazilian studies does not show important differences and, in general, is similar to studies in developed countries. However, sepsis represents one of the major causes of perioperative CA and mortality in Brazilian studies, contrasting with studies in developed countries in which sepsis is a secondary cause.

Study of the brainstem auditory evoked potential with speech stimulus in the pediatric population with and without oral language disorders: a systematic review.

INTRODUCTION: The brainstem auditory evoked potential with speech stimulus, BAEP-speech, has been applied to observe how speech sounds are manifested in the brainstem. This tool can be used in children to assess central auditory processing, allowing preventive and early interventions. OBJECTIVE: To assess the results found in the brainstem auditory evoked potential with speech stimulus in the pediatric population with and without oral language disorders, through a systematic literature review. METHOD: The search was carried out in the scientific databases Portal BVS, Pubmed, Lilacs, Medline, Scielo and Web of Science, OpenGrey.eu, DissOnline, OpenDoar, OAIster and The New York Academy of Medicine. A systematic literature review was performed using the descriptors: auditory evoked potentials, children and their synonyms, combined by the Boolean operators AND and OR. The search filter "age: child" was used. The studies were independently read by peers and, in case of disagreement regarding the inclusion of studies, a third researcher was consulted. Original case-control articles that performed BAEP-speech without competitive noise, carried out in the pediatric population without and with oral language disorders, were included. RESULT: 14 articles published between 2008 and 2019 were included in this review. Methodological variability was observed in the exam, with the syllable / da / being the most frequently used as the stimulus. When performing the average of the groups, it was observed that the population with specific language disorders showed greater latency delays in the sustained portion, lower amplitude values and VA complex slope. The group with phonological disorders had higher values in the transient portion of the responses. CONCLUSION: Children with language disorders of different etiologies have different patterns of BAEP-speech responses when compared to children with typical development.

[Patent blue V dye anaphylaxis: a case report and literature review]. / Anafilaxia por corante azul patente V: relato de caso e revisão da literatura.

BACKGROUND: Anaphylaxis is a constant perioperative concern due to the exposure to several agents capable of inducing hypersensitivity reactions. Patent blue V (PBV), also known as Sulfan Blue, a synthetic dye used in sentinel node research in breast surgery, is responsible for 0.6% of reported anaphylactic conditions. We present a case of a 49-year-old female patient who underwent left breast tumorectomy with sentinel lymph node staging using PBV and experienced an anaphylactic reaction. METHODS: We conducted a literature search through PubMed for case reports, case series, reviews, and systematic reviews since 2005 with the keywords "anaphylaxis" and "patent blue". We then included articles found in these publications' reference sections. RESULTS: We found 12 relevant publications regarding this topic. The main findings are summarized, with information regarding the clinical presentation, management, and investigation protocol. Hypotension is the most common clinical manifestation. The presentation is usually delayed when compared with anaphylaxis from other agents, and cutaneous manifestations are occasionally absent. Patients may have had previous exposure to the dye, used also as a food, clothes and drug colorant. CONCLUSION: The diagnosis of anaphylaxis in patients under sedation or general anesthesia may be difficult due to particularities of the perioperative context. According to the published literature, the presentation of the reaction is similar in most cases and a heightened clinical sense is key to address the situation appropriately. Finding the agent responsible for the allergic reaction is of paramount importance to prevent future episodes.

[Noninvasive hemoglobin monitoring in clinical trials: a systematic review and meta-analysis]. / Monitorização não invasiva da hemoglobina em ensaios clínicos: uma revisão sistemática e metanálise.

BACKGROUND AND OBJECTIVES: The measurement of Hb by co-oximetry is an innovative technique that offers efficiency and agility in the processing of information regarding the measurement of Hemoglobin concentration (Hb) obtained through continuous, non-invasive and rapid monitoring. Because of this attribute, it avoids unnecessary exposures of the patient to invasive procedures by allowing a reduction in the number of blood samples for evaluation and other unnecessary therapies. It also helps to make decisions about the need for transfusion and how to handle it. The objective of this study is to compare the performance offered to obtain Hb values between the Masimo Corporation (Irvine, CA, USA) instrument and the standard gold tool (laboratory examination). CONTENTS: The study corresponds to a systematic review followed by meta-analysis, which included fully registered full-text clinical trials published from 1990 to 2018. PubMed, Cochrane, Medline, Embase and Web of Science databases were investigated. The mean overall difference found between the non-invasive and invasive methods of hemoglobin monitoring was 0.23 (95% CI -0.16, 0.62), that is, it did not present statistical significance (p = 0.250). The results of the analysis of heterogeneity within and between the studies indicated high levels of inconsistency (Q = 461.63, p < 0.0001, I2 = 98%), method for Hb values. CONCLUSIONS: Although the mean difference between noninvasive measurements of Hb and the gold standard method is small, the co-oximeter can be used as a non-invasive "trend" monitor in detecting unexpected responses at Hb levels.

Does topical application of tranexamic acid reduce intraoperative bleeding in sinus surgery during general anesthesia?

INTRODUCTION: Tranexamic acid is a hemostatic agent, which inhibits fibrin degradation, which may be beneficial in controlling bleeding during surgery. OBJECTIVES: The purpose of this study was to provide a meta-analysis and review of the effects of tranexamic acid on hemorrhage and surgical fields and side effects on patients during endoscopic sinus surgery. METHODS: Two authors independently searched six databases (Medline, Scopus, Embase, Web of Science, Google Scholar and Cochrane library) from the start of article collection until July 2018. Postoperative complications such as intraoperative bleeding, operative time, hypotension, nausea, vomiting, and coagulation profile were included in the analysis of tranexamic acid (Treatment Group) and placebo (Control Group) during the operation. RESULTS: The amount of blood loss during surgery was statistically lower in the treatment group compared to the placebo group, and the surgical field quality was statistically higher in the treatment group than in the placebo group. On the other hand, there was no significant difference in operation time, hemodynamics, or coagulation profile between groups. In addition, tranexamic acid had no significant effect on vomiting and thrombosis compared to the Control Group. CONCLUSION: This meta-analysis has shown that topical administration of tranexamic acid can reduce the amount of bleeding during surgery and improve the overall quality of the surgery. Hemodynamic instability during surgery, vomiting after surgery, or abnormal clotting profile were not reported. Additional studies are needed to confirm the results of this study because there are fewer studies.

[Association between peripheral perfusion, microcirculation and mortality in sepsis: a systematic review]. / Associação entre perfusão periférica, microcirculação e mortalidade em sepse: uma revisão sistemática.

Although increasing evidence supports the monitoring of peripheral perfusion in septic patients, no systematic review has been undertaken to explore the strength of association between poor perfusion assessed in microcirculation of peripheral tissues and mortality. A search of the most important databases was carried out to find articles published until February 2018 that met the criteria of this study using different keywords: sepsis, mortality, prognosis, microcirculation and peripheral perfusion. The inclusion criteria were studies that assessed association between peripheral perfusion/microcirculation and mortality in sepsis. The exclusion criteria adopted were: review articles, animal/pre-clinical studies, meta-analyzes, abstracts, annals of congress, editorials, letters, case-reports, duplicate and articles that did not present abstracts and/or had no text. In the 26 articles were chosen in which 2465 patients with sepsis were evaluated using at least one recognized method for monitoring peripheral perfusion. The review demonstrated a heterogeneous critically ill group with a mortality-rate between 3% and 71% (median=37% [28%-43%]). The most commonly used methods for measurement were Near-Infrared Spectroscopy (NIRS) (7 articles) and Sidestream Dark-Field (SDF) imaging (5 articles). The vascular bed most studied was the sublingual/buccal microcirculation (8 articles), followed by fingertip (4 articles). The majority of the studies (23 articles) demonstrated a clear relationship between poor peripheral perfusion and mortality. In conclusion, the diagnosis of hypoperfusion/microcirculatory abnormalities in peripheral non-vital organs was associated with increased mortality. However, additional studies must be undertaken to verify if this association can be considered a marker of the gravity or a trigger factor for organ failure in sepsis.

Perfil e fatores relacionados à sífilis gestacional: revisão integrativa / Profile and factors related to gestational syphilis: integrative review

A sífilis consiste em um grave problema de saúde pública e na gestação pode acarretar complicações para a gestante e recém-nascido. Objetivou-se descrever os principais fatores associados aos casos de sífilis gestacional em brasileiras relatados na literatura. Trata-se de revisão integrativa de artigos publicados entre 2014 e 2023 nas bases de dados BVS, Scielo e PubMed. Utilizou-se os descritores sífilis, gestação e epidemiologia nos idiomas português, inglês e espanhol, aplicando os operadores booleanos AND e OR. Após análise com base nos critérios de inclusão e exclusão e questão norteadora resultou amostra final de vinte artigos. Os resultados demonstraram que há tendência crescente na incidência de sífilis gestacional, além disso, ser jovem, raça não branca, baixas escolaridade e renda estão associados aos casos. A assistência inadequada no pré-natal e não tratamento do parceiro provocam aumento dos casos de sífilis congênita. Conclui-se que é necessário maior destaque para a temática a fim de integrar os serviços de saúde, melhorar os fluxos, acolhimento e assistência, fortalecendo assim, as ações voltadas para prevenção, controle e redução dos casos de sífilis gestacional.

Syphilis is a serious public health problem and during pregnancy it can cause complications for the pregnant woman and newborn. The objective was to describe the main factors associated with cases of gestational syphilis in Brazilian women reported in the literature. This is an integrative review of articles published between 2014 and 2023 in the VHL, Scielo and PubMed databases. The descriptors syphilis, pregnancy and epidemiology were used in Portuguese, English and Spanish, applying the Boolean operators AND and OR. After analysis based on the inclusion and exclusion criteria and guiding question, the final sample of twenty articles resulted. The results demonstrated that there is an increasing trend in the incidence of gestational syphilis, in addition, being young, non-white race, low education and income are associated with cases. Inadequate prenatal care and non-treatment of the partner cause an increase in cases of congenital syphilis. It is concluded that greater emphasis is needed on the topic in order to integrate health services, improve flows, reception and assistance, thus strengthening actions aimed at preventing, controlling and reducing cases of gestational syphilis.

Range of motion after bone block procedures for shoulder instability: systematic review / Arco de movimento após bloqueio ósseo para instabilidade do ombro: revisão sistemática

ABSTRACT Objective: to determine the surgical indications for glenoid bone grafting associated with better postoperative ranges of motion. Methods: This systematic review was conducted according to PRISMA. The included studies were subdivided according to the criteria used to indicate glenoid bone graft surgery: group for radiological indications only (Group R), group for radiological indications associated with clinical indications (Group R + C), and group for arthroscopic indications (Group A). The extracted and evaluated data were the range of motion of the shoulder. Results: in the electronic search conducted in October 2022, 1567 articles were selected. After applying the inclusion criteria, 14 articles were selected for the systematic review. Regarding the ranges of motion, group A had the highest number of statistically positive results together with group R. Group A showed positive results in elevation parameters, loss of lateral rotation in adduction, and medial rotation in abduction. Group R showed positive results in lateral rotation in adduction and loss of lateral rotation in adduction. On the other hand, Group R + C was the one that presented the highest number of statistically negative results, in the following parameters: elevation, lateral rotation in abduction, loss of lateral rotation in adduction, and medial rotation in abduction. Conclusion: the subgroups presented variable results in the evaluated parameters; however, the groups with arthroscopic and radiological indications showed the highest number of positive results, with the latter group showing the best results regarding lateral rotation. Level of Evidence II, Systematic Reviews.

RESUMO Objetivo: Determinar as indicações cirúrgicas de enxertia óssea da glenoide associadas aos melhores arcos de movimento no pós-operatório. Métodos: De acordo com o Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 14 artigos de um total de 1.567, selecionados em busca eletrônica, foram escolhidos para a revisão sistemática. Os estudos incluídos foram subdivididos de acordo com os critérios de indicação da cirurgia: indicações somente radiológicas (grupo R), indicações radiológicas associadas a indicações clínicas (grupo R + C) e indicações artroscópicas (grupo A). Os dados avaliados foram os arcos de movimento do ombro. Resultados: Em relação aos arcos de movimento, os grupos que apresentaram a maior quantidade de resultados estatisticamente positivos foram o A - parâmetros elevação, perda de rotação lateral em adução e rotação medial em abdução - e o R - parâmetros rotação lateral em adução e perda de rotação lateral em adução. O grupo R + C apresentou a maior quantidade de resultados estatisticamente negativos nos parâmetros elevação, rotação lateral em abdução, perda de rotação lateral em adução e rotação medial em abdução. Conclusão: Os grupos de indicações artroscópicas e radiológicas apresentaram a maior quantidade de resultados positivos, sendo que o último apresentou os melhores resultados em relação à rotação lateral. Nível de Evidência II, Revisão Sistemática.

Influence the number of touches on physical and physiological responses during small-sided soccer games / Influência do número de toques na bola nas respostas físicas e fisiológicas durante pequenos jogos de futebol

ABSTRACT The objective of the present review was to analyze the effects of the number of touches on the ball, in the physical and physiological responses during small soccer games. Electronic searches were carried out in the databases: "Web of Science", "Scopus" and "PubMed", using the descriptors "Small-sided games"; "Intensity"; "Touches"; "Soccer"; "Soccer players"; "Modified rules". The PICO strategy was used and the group of words was combined in pairs or trios, using the OR and AND connectors. Only articles published between 2010 and 2022 were considered. The following were excluded: (a) annals and supplements of scientific events, (b) reviews, editorial and instrument validation articles, and (c) studies with women. Of 578 studies, 9 were selected and analyzed. In general, the adoption of the limit rule for touching the ball increased the physiological responses, although discrepancies were observed between the studies regarding the physical responses, we must consider the methodological differences between the studies. We conclude that manipulating the number of touches allowed per ball possession influences players' physiological responses. Specifically, higher intensity is expected in SSGs with fewer ball touches allowed. On the other hand, physical responses are not influenced by this rule.

RESUMO O objetivo da presente revisão foi analisar os efeitos do número de toques na bola, nas respostas físicas e fisiológicas de durante pequenos jogos de futebol. Foram realizadas buscas eletrônicas nas bases de dados: "Web of Science", "Scopus" e "PubMed", utilizando os descritores "Small-sided games"; "Intensity"; "Touches"; "Soccer"; "Soccer players"; "Modified rules". A estratégia PICO foi utilizada e o grupo de palavras foi combinado em duplas ou trios, utilizando os conectores OR e AND. Foram considerados apenas os artigos publicados entre 2010 e 2022. Foram excluídos: (a) anais e suplementos de eventos científicos, (b) revisões, artigos editoriais e de validação de instrumentos, e (c) estudos com mulheres. De 578 estudos, 9 foram selecionados e analisados. De um modo geral, a adoção da regra de limite de toques na bola aumentou as respostas fisiológicas, embora tenham sido observadas discrepâncias entre os estudos quanto as respostas físicas, devemos considerar as diferenças metodológicas entre os estudos. Concluímos que manipular o número de toques de bola permitidos por posse de bola influencia as respostas fisiológicas dos jogadores. Especificamente, maior intensidade é esperada em SSGs com menos toques de bola permitidos. Por outro lado, as respostas físicas não são influenciadas por esta regra.

Evidências acerca do brincar no hospital na perspectiva do familiar da criança: revisão integrativa / Evidence about playing in the hospital from the perspective of the child's family: integrative review / Evidencias sobre jugar en el hospital desde la perspectiva de la familia del niño: revisión integrativa

Objetivo: identificar estudos na literatura nacional e internacional acerca do brincar no hospital na perspectiva do familiar da criança. Método: revisão Integrativa realizada no período de março a maio de 2022, nas fontes de informações: Scielo; LILACS e BDENF via BVS; MEDLINE via PUBMED; Scopus e o Google Scholar como estratégia adicional. Foram incluídos artigos originais, nos idiomas inglês, português e espanhol; sem recorte temporal; e que tivessem como participantes familiares e/ou acompanhantes de crianças hospitalizadas. Resultados: as famílias reconhecem o brincar como promotor na redução da ansiedade das crianças frente aos procedimentos invasivos, além de auxiliar no enfrentamento da hospitalização e na melhora do humor e comportamento delas. Também destacaram a brinquedoteca hospitalar como um importante espaço que promove distração e continuidade do desenvolvimento. Conclusão: a partir da perspectiva dos familiares acerca do brincar, a equipe de enfermagem deve incentiva-las serem coparticipante dessa atividade durante a hospitalização da criança.

Objective: to identify studies in the national and international literature about playing in the hospital from the perspective of the child's family. Method: integrative review carried out from March to May 2022, in the information sources: Scielo; LILACS and BDENF via VHL; MEDLINE via PUBMED; Scopus and Google Scholar as an additional strategy. Original articles in English, Portuguese and Spanish were included; no temporal clipping; and that had family members and/or companions of hospitalized children as participants. Results: families recognize playing as a promoter in reducing children's anxiety in the face of invasive procedures, as well as helping to cope with hospitalization and improving their mood and behavior. They also highlighted the hospital toy library as an important space that promotes distraction and continuity of development. Conclusion: from the perspective of family members about playing, the nursing team should encourage them to be a co-participant in this activity during the child's hospitalization.

Objetivos:identificar estudios en la literatura nacional e internacional sobre el juego en el hospital desde la perspectiva de la familia del niño. Método: revisión integradora realizada de marzo a mayo de 2022, en las fuentes de información: Scielo; LILACS y BDENF vía BVS; MEDLINE vía PUBMED; Scopus y Google Scholar como estrategia adicional. Se incluyeron artículos originales en inglés, portugués y español; sin recorte temporal; y que tuvo como participantes a familiares y/o acompañantes de niños hospitalizados. Resultados: las familias reconocen jugar como un promotor en la reducción de la ansiedad de los niños frente a los procedimientos invasivos, además de ayudar a sobrellevar la hospitalización y mejorar su estado de ánimo y comportamiento. También destacaron la ludoteca del hospital como un espacio importante que promueve la distracción y la continuidad del desarrollo. Conclusión: desde la perspectiva de los familiares sobre el juego, el equipo de enfermería debe incentivarlos a ser copartícipes de esa actividad durante la hospitalización del niño.

Nutritional interventions in children and adolescents with cerebral palsy: systematic review / Intervenções nutricionais em crianças e adolescentes com paralisia cerebral: revisão sistemática

ABSTRACT Objective: To systematically review the literature in search of the most suitable and effective nutritional interventions and indications for the nutritional treatment of children and adolescents with cerebral palsy (CP). Data source: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were selected from seven databases (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Studies from a pediatric group (0 to 18 years old) diagnosed with CP were included and the search strategy included the descriptors: "children" OR "childhood" AND "nutritional therapy" OR "nutritional intervention" OR "nutrition" OR "nutritional support" OR "diet" AND "cerebral palsy" OR "cerebral injury". Methodological quality was assessed using the checklist for cross-sectional analytical studies, the Newcastle-Ottawa scale or the Cochrane Collaboration tool for clinical trials. Data synthesis: Fifteen studies (n=658) published from 1990 to 2020 met the inclusion criteria. All of them had a low risk of bias. The data showed that children and adolescents with CP have worse nutritional status than those normally developed. Those who received hypercaloric and hyperprotein nutritional supplementation benefited from its use. Studies indicate that enteral nutrition should be considered when nutritional needs are not met by the oral diet, especially in cases where oral motor functions are impaired. In addition, there was a direct relationship between the consistency of food, the level of motor function and nutritional status. Conclusions: Children and adolescents with CP have a greater risk of malnutrition. The use of nutritional supplementation may help with weight gain. In addition, enteral nutrition and modification of food texture have been used to improve the nutritional status of this group.

RESUMO Objetivo: Revisar sistematicamente a literatura em busca das intervenções e indicações nutricionais mais adequadas e eficazes para o tratamento nutricional de crianças e adolescentes com paralisia cerebral (PC). Fontes de dados: Esta revisão foi conduzida de acordo com as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses — PRISMA. Os artigos foram selecionados em sete bases de dados (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Foram incluídos estudos de um grupo pediátrico (zero a 18 anos) com diagnóstico de PC e a estratégia de busca incluiu os descritores: "children" OR "childhood" AND "nutritional therapy" OR "nutritional intervention" OR "nutrition" OR "nutritional support" OR "diet" AND "cerebral palsy" OR "cerebral injury". A qualidade metodológica foi avaliada utilizando a lista de verificação para estudos transversais analíticos, escala Newcastle-Ottawa ou ferramenta da Cochrane Collaboration, para ensaios clínicos. Síntese dos dados: Quinze estudos (n=658) publicados de 1990 a 2020 preencheram os critérios de inclusão. Todos tiveram baixo risco de viés. Os dados mostraram que crianças e adolescentes com PC apresentam pior estado nutricional do que os normalmente desenvolvidos. Aqueles que receberam suplementação nutricional hipercalórica e hiperproteica beneficiaram-se de seu uso. Estudos demonstram que a nutrição enteral deve ser considerada quando as necessidades nutricionais não são supridas pela dieta oral, principalmente nos casos em que as funções oromotoras estão prejudicadas. Além disso, houve relação direta entre a consistência dos alimentos, o nível de função motora e o estado nutricional. Conclusões: Crianças e adolescentes com PC têm maior risco de desnutrição. O uso de suplementação nutricional pode auxiliar no ganho de peso desses pacientes. Além disso, a nutrição enteral e a modificação da textura dos alimentos têm sido artifícios utilizados para a melhora do estado nutricional neste grupo.

Telessaúde no Brasil: uma revisão de escopo / Telehealth in Brazil: a scoping review / Telesalud en Brasil: una revisión de alcance

Este artigo buscou conhecer o desenvolvimento da telessaúde no Brasil, desde a sua efetivação e ampliação a partir das publicações científicas sobre o tema pela implementação do Programa Nacional de Telessaúde Brasil Redes em 2007. Esta é uma revisão de escopo de estudos indexados nas bases Medical Literature Analysis and Retrieval System Online (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (SciELO) de 2007 a 2022 que abordaram ações de telessaúde. Incluíram-se 177 estudos, publicados majoritariamente nos anos de 2021 e 2020. Ações de telessaúde foram realizadas especialmente nas regiões Sudeste e Sul, sendo o telediagnóstico e teleconsultoria as mais realizadas. A medicina foi a área em que as ações de telessaúde foram mais frequentes (54,80%), focadas principalmente na saúde em geral e na cardiologia (38,42% e 19,21% respectivamente). Conclui-se que a telessaúde no Brasil tem avançado, especialmente após a pandemia da covid-19, que deflagrou a necessidade da ampliação desses serviços. As regiões Sudeste e Sul têm ofertado o maior número de serviços, sendo o telediagnóstico e a teleconsultoria os mais frequentes, especialmente na atenção primária.

This scoping review discusses the development of telehealth in Brazil from its implementation by the Brasil Redes National Telehealth Program in 2007 and expansion based on scientific publications on the topic indexed on the Medical Literature Analysis and Retrieval System Online (Medline), Latin American and Caribbean Health Sciences Literature (Lilacs) and Scientific Electronic Library Online (SciELO) from 2007 to 2022. A total of 177 studies were included, mostly published in 2021 and 2020. Telehealth actions were conducted especially in Southeastern and Southern Brazil, mostly by telediagnosis and teleconsultation. Telehealth actions were most frequent in medicine (54.80%), mainly focused on General Health and cardiology (38.42% and 19.21%, respectively). Telehealth in Brazil has advanced, especially after the COVID-19 pandemic, as it triggered the need to expand these services. Southeastern and Southern Brazil have offered the largest number of services, with telediagnosis and teleconsultation in primary care being the most frequent.

Este estudio pretendió comprender el desarrollo de la telesalud en Brasil desde la implementación y expansión de publicaciones científicas sobre la implementación del Programa Nacional de Telesalud Brasil Redes en 2007. Esta es una revisión de alcance de estudios indexados en las siguientes bases de datos: Medical Literature Analysis and Retrievel System Online (Medline), Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs) y Scientific Electronic Library Online (SciELO), publicados entre 2007 y 2022, que abordaron acciones de telesalud. Se incluyeron 177 estudios, en su mayoría publicados en los años 2020 y 2021. Se realizaron acciones de telesalud especialmente en las regiones Sudeste y Sur, y entre las más realizadas se destacaron el telediagnóstico y la teleconsulta. La medicina fue el área en que se concentraron las acciones de telesalud más frecuentes (54,80%), enfocadas principalmente en salud general y cardiología (38,42% y 19,21%, respectivamente). Se concluyó que hubo un avance en la telesalud en Brasil, especialmente con la pandemia del COVID-19, ya que despertó la necesidad de ampliar estos servicios. Las regiones Sudeste y Sur han ofrecido la mayor cantidad de servicios, y el telediagnóstico y la teleconsulta fueron los más frecuentes, especialmente en la atención primaria.

Qualidade de vida de portadores de neurofibromatose tipo 1: um protocolo de revisão de escopo / Quality of life of type 1 neurofibromatosis patients: a scoping review protocol

OBJETIVO: Mapear conceitos, achados e limitações acerca da qualidade de vida de crianças, adolescentes e adultos jovens portadores de neurofibromatose tipo 1. MÉTODO: Trata-se de um protocolo de revisão de escopo baseado nas diretrizes do Joanna Briggs Institute (JBI). A busca de dados será realizada nas plataformas PubMed/MEDLINE, EMBASE, Web of Science, Lilacs, CINAHL, Open Grey e Google Scholar. Os manuscritos encontrados serão organizados através da ferramenta Rayyan para identificação e exclusão de duplicatas. Na sequência, os artigos e demais materiais seguirão na mesma ferramenta para triagem e seleção de estudos elegíveis por dois pesquisadores independentes, sendo esse processo todo descrito em um fluxograma adaptado do Checklist PRISMA-ScR. Os dados extraídos dos manuscritos elegíveis serão apresentados em tabelas, quadros e fluxogramas, conforme pertinente. Os dados serão discutidos e inter-relacionados, com a finalidade de identificar potencialidades e limitações acerca do tema de pesquisa.

OBJECTIVE: To map concepts, findings, and limitations related to quality of life in children, adolescents, and young adults with neurofibromatosis type 1. METHOD: This is a scoping review protocol based on Joanna Briggs Institute (JBI) guidelines. Data searches will be conducted on PubMed/MEDLINE, EMBASE, Web of Science, Lilacs, CINAHL, Open Grey, and Google Scholar. The retrieved manuscripts will be organized using the Rayyan tool for duplicate identification and removal. Subsequently, the articles and other materials will be processed in the same tool for screening and selecting eligible studies by two independent researchers, and this entire process will be described in a flowchart adapted from the PRISMA-ScR checklist. As appropriate, data extracted from eligible manuscripts will be presented in tables, figures, and flowcharts. The data will be discussed and correlated to identify potential strengths and limitations related to the research topic.

Construções de masculinidades entre pessoas moradoras de rua: uma revisão de escopo / Constructions of masculinity among homeless persons: a scoping review

Resumo Nesta revisão objetivou-se investigar e sintetizar o que há na literatura científica sobre as relações entre as masculinidades e as pessoas moradoras de rua, com enfoque em relações sociais, trajetória e processo saúde-doença. Foi feita uma busca sistemática em dez bases de dados com os descritores: "Masculinities", "Hegemonic Masculinities", "Gender Identity" e "Homeless Persons", "Homeless, Roofless" e "Houseless". Obteve-se 2.459 resultados, com 25 referências finais após aplicação dos critérios de inclusão e exclusão, compostas em grande parte por estudos internacionais. Identificou-se seis temas-chave: Masculinidade enquanto prática performativa nas ruas, Masculinidades e relações de violência nas ruas, Masculinidades entre homens moradores de rua: percepções de liberdade e encarceramento, Paternidade dos homens moradores de rua, Estigmas e deságios no processo de busca pela masculinidade hegemônica nas ruas e Masculinidades como determinante social de saúde nas ruas. A revisão aborda as influências das masculinidades entre a População Moradora de Rua (PMR), destacando sua transversalidade nas vivências e atitudes do grupo, e explora a relação entre masculinidades e violência, os desafios na paternidade e os estigmas ligados à condição de vida nas ruas e impactos na saúde. Conclui-se que as normas sociais relacionadas ao masculino atuam como uma forma de se adaptar as vidas nas ruas, mas influenciam negativamente no processo saúde-doença da PMR, em especial dos homens.

Abstract This study aimed to investigate and synthesize the scientific literature regarding the relationships between masculinities and individuals experiencing homelessness by focusing on social relationships, life trajectories, and the health-disease process. A systematic search was conducted in 10 databases using the following descriptors: "Masculinities," "Hegemonic Masculinities," "Gender Identity," "Homeless Persons," "Homeless, Roofless," and "Houseless." In total, 2459 results were retrieved. Overall, 25 studies remained after the application of inclusion and exclusion criteria, most of which were international studies. This study identified six key themes: 1) Masculinity as a performative practice on the streets, 2) Masculinities and relationships of violence on the streets, 3) Masculinities among men experiencing homelessness: perceptions of freedom and imprisonment, 4) Fatherhood among men experiencing homelessness, 5) Stigmas and challenges in the pursuit of hegemonic masculinity on the streets, and 6) Masculinities as a social determinant of health on the streets. This review addresses the influences of masculinities on individuals experiencing homelessness, emphasizing the cross-cutting nature of these ideals in the experiences and attitudes of this group. It explores the relationship between masculinities and violence, as well as addressing challenges in fatherhood. It highlights stigmas linked to the condition of being homeless that impact health and quality of life. It is concluded that social norms related to masculinity act negatively as social determinants of health for the homeless population, especially men.

Integridade na pesquisa: ética profissional dos cientistas - O papel do Comitê de Integridade na Pesquisa do Instituto Adolfo Lutz / Research integrity: professional ethics of scientists - The role of the Research Integrity Committee at the Adolfo Lutz Institute

O Comitê de Integridade na Pesquisa do Instituto Adolfo Lutz (CIPIAL), com o objetivo de promover a cultura da integridade científica como um dos valores fundamentais defendidos pela instituição nas suas atividades de pesquisa, considera relevante compartilhar com a comunidade científica a sua implantação, destacando o seu papel no gerenciamento deste tema na instituição. Após a publicação de seu regimento, de acordo com as suas competências primordiais, o CIPIAL elaborou e publicou o Código de Boas Práticas Científicas do IAL com o objetivo de definir as políticas de integridade para orientar os profissionais envolvidos com a pesquisa. (AU)

The Research Integrity Committee of the Adolfo Lutz Institute (CIPIAL), with the aim of promoting the culture of scientific integrity as one of the fundamental values defended by the institution in its research activities, considers it relevant to share its implementation with the scientific community, highlighting its role in managing this issue at the institution. Following the publication of its rules and regulations, in accordance with its core competencies, CIPIAL drew up and published the IAL Code of Good Scientific Practice with the aim of defining integrity policies to guide professionals involved in research. (AU)