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Nakajima E, Moon FH, Junior NC, Macedo CR, de Souza AWS, Iared W. Accuracy of Doppler ultrasound in the diagnosis of giant cell arteritis: a systematic review and meta-analysis. Adv Rheumatol 2023; 63:5. [PMID: 36755336 DOI: 10.1186/s42358-023-00286-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/29/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Giant cell arteritis (GCA) is the most common primary systemic vasculitis in people 50 years of age and over, and it is considered a medical emergency due to the potential risk of permanent visual loss. Color Doppler ultrasound (CDU) of the temporal arteries is a rapid, noninvasive method to diagnose GCA. This study aims to determine the diagnostic accuracy of the halo sign in temporal arteries by CDU in people with suspected GCA. METHODS The systematic literature review included the search for publications in the following electronic databases: PubMed, Embase, CENTRAL, LILACS, WHO ICTRP, ClinicalTrials.gov, gray literature up to December 2022, and no date or language restrictions were applied. We analyzed studies including patients over 50 years of age with suspected GCA evaluating CDU of temporal arteries as a diagnostic tool against clinical diagnosis as a standard reference. Paper titles and abstracts were selected by two investigators independently for all available records. The quality of the studies was assessed using the Quality of Diagnostic Accuracy Studies tool (QUADAS-2) and the R software (version 4.2.1) was used for data analysis. The protocol of this review is registered with PROSPERO (CRD42016033079). RESULTS Twenty-two studies including 2893 participants with suspected GCA who underwent temporal artery CDU were evaluated. The primary analysis results showed a sensitivity of 0.76 [95% confidence interval (95 CI) 0.69-0.81] and specificity of 0.93 (95 CI 0.89-0.95) when the halo sign was compared to clinical diagnosis. The sensitivity value of 0.84 (95 CI 0.72-0.92) and specificity of 0.95 (95 CI 0.88-0.98) were found in five studies involving 1037 participants that analyzed the halo sign and temporal artery compression sign. A sensitivity of 0.86 (95 CI 0.78-0.91) and specificity of 0.95 (95 CI 0.89-0.98) were found in four studies with 603 participants where the halo sign was evaluated CDU on temporal and axillary arteries. CONCLUSION The detection of the halo sign by CDU of temporal arteries has good accuracy for the diagnosis of cranial GCA. The compression sign in temporal arteries and the addition of axillary arteries assessment improves the diagnostic performance of CDU for GCA. TRIAL REGISTRATION PROSPERO CRD42016046860.
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Affiliation(s)
- Eliza Nakajima
- Department of Evidence-Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Napoleão de Barros, 865, São Paulo, 04024-002, Brazil.,Division of Vascular and Endovascular Surgery, Department of Surgery, Escola Paulista de Medicina - Universidade Federal de Sao Paulo, Rua Borges Lagoa, 754, Sao Paulo, 04038-002, Brazil
| | - Francisca Hatta Moon
- Division of Vascular and Endovascular Surgery, Department of Surgery, Escola Paulista de Medicina - Universidade Federal de Sao Paulo, Rua Borges Lagoa, 754, Sao Paulo, 04038-002, Brazil
| | - Nelson Carvas Junior
- Department of Evidence-Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Napoleão de Barros, 865, São Paulo, 04024-002, Brazil
| | - Cristiane Rufino Macedo
- Department of Evidence-Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Napoleão de Barros, 865, São Paulo, 04024-002, Brazil
| | - Alexandre Wagner Silva de Souza
- Rheumatology Division, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua dos Otonis, 863, São Paulo, SP, 04025-002, Brazil.
| | - Wagner Iared
- Department of Evidence-Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Napoleão de Barros, 865, São Paulo, 04024-002, Brazil
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Belli-Marin JFC, Bocchi EA, Ayub-Ferreira S, Junior NC, Guimarães GV. Effects of β-blocker therapy on exercise oscillatory ventilation in reduced ejection fraction heart failure patients: A case series study. Biomed Pharmacother 2022; 152:113106. [PMID: 35665667 DOI: 10.1016/j.biopha.2022.113106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/03/2022] [Accepted: 05/10/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Exercise oscillatory ventilation (EOV) is an abnormal breathing pattern that occurs in ~20% of patients with heart failure (HF) and is associated with poor prognosis and exercise intolerance. β-blockers (βb) are prescribed for most HF patients; however, their effect on EOV remains unclear. We evaluated the effect of βb on EOV in HF patients with reduced ejection fraction (HFrEF). METHODS Fifteen patients diagnosed with HF, ejection fraction < 45%, aged from 18 to 65 years, were included before starting βb therapy. Patients underwent clinical evaluation, cardiopulmonary exercise testing, echocardiography, laboratory exams (norepinephrine levels, B type natriuretic peptide) at baseline and after βb therapy optimized for six months. Presence of exercise oscillatory breathing was determined by two experienced observers who were blinded to the moment of the test (pre or post). RESULTS Fifteen patients (1 female), aged 49.5 ± 2.5 years, with HFrEF, NYHA I-III enrolled in the study. The etiologies of the HFrEF were idiopathic (n = 8) and hypertensive (n = 7). LVEF increased after βb therapy from 25.9 ± 2.5% to 33 ± 2.6%, P = 0.02; peak VO2 did not significantly change (21.8 ± 1.7 vs 24.7 ± 1.9, P = 0.4); VE/VCO2 slope changed from 32.1 ± 10.6-27.5 ± 9.1, P = 0.03. Before βb initiation, nine patients (60%) had EOV, but only two (13%) did after optimized therapy. McNemar test was used to evaluate the significance of the association between the two moments (P = 0.02). CONCLUSION In patients with HF, medical therapy with βb can reverse EOV. This may explain why these patients experience symptom improvement after βb therapy.
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Affiliation(s)
| | - Edimar Alcides Bocchi
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Silvia Ayub-Ferreira
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Nelson Carvas Junior
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Guilherme Veiga Guimarães
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
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Cassola N, Baptista-Silva JC, Nakano LC, Flumignan CD, Sesso R, Vasconcelos V, Carvas Junior N, Flumignan RL. Duplex ultrasound for diagnosing symptomatic carotid stenosis in the extracranial segments. Cochrane Database Syst Rev 2022; 7:CD013172. [PMID: 35815652 PMCID: PMC9272405 DOI: 10.1002/14651858.cd013172.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Carotid artery stenosis is an important cause of stroke and transient ischemic attack. Correctly and rapidly identifying patients with symptomatic carotid artery stenosis is essential for adequate treatment with early cerebral revascularization. Doubts about the diagnostic value regarding the accuracy of duplex ultrasound (DUS) and the possibility of using DUS as the single diagnostic test before carotid revascularization are still debated. OBJECTIVES To estimate the accuracy of DUS in individuals with symptomatic carotid stenosis verified by either digital subtraction angiography (DSA), computed tomography angiography (CTA), or magnetic resonance angiography (MRA). SEARCH METHODS We searched CRDTAS, CENTRAL, MEDLINE (Ovid), Embase (Ovid), ISI Web of Science, HTA, DARE, and LILACS up to 15 February 2021. We handsearched the reference lists of all included studies and other relevant publications and contacted experts in the field to identify additional studies or unpublished data. SELECTION CRITERIA We included studies assessing DUS accuracy against an acceptable reference standard (DSA, MRA, or CTA) in symptomatic patients. We considered the classification of carotid stenosis with DUS defined with validated duplex velocity criteria, and the NASCET criteria for carotid stenosis measures on DSA, MRA, and CTA. We excluded studies that included < 70% of symptomatic patients; the time between the index test and the reference standard was longer than four weeks or not described, or that presented no objective criteria to estimate carotid stenosis. DATA COLLECTION AND ANALYSIS The review authors independently screened articles, extracted data, and assessed the risk of bias and applicability concerns using the QUADAS-2 domain list. We extracted data with an effort to complete a 2 × 2 table (true positives, true negatives, false positives, and false negatives) for each of the different categories of carotid stenosis and reference standards. We produced forest plots and summary receiver operating characteristic (ROC) plots to summarize the data. Where meta-analysis was possible, we used a bivariate meta-analysis model. MAIN RESULTS We identified 25,087 unique studies, of which 22 were deemed eligible for inclusion (4957 carotid arteries). The risk of bias varied considerably across the studies, and studies were generally of moderate to low quality. We narratively described the results without meta-analysis in seven studies in which the criteria used to determine stenosis were too different from the duplex velocity criteria proposed in our protocol or studies that provided insufficient data to complete a 2 × 2 table for at least in one category of stenosis. Nine studies (2770 carotid arteries) presented DUS versus DSA results for 70% to 99% carotid artery stenosis, and two (685 carotid arteries) presented results from DUS versus CTA in this category. Seven studies presented results for occlusion with DSA as the reference standard and three with CTA as the reference standard. Five studies compared DUS versus DSA for 50% to 99% carotid artery stenosis. Only one study presented results from 50% to 69% carotid artery stenosis. For DUS versus DSA, for < 50% carotid artery stenosis, the summary sensitivity was 0.63 (95% confidence interval [CI] 0.48 to 0.76) and the summary specificity was 0.99 (95% CI 0.96 to 0.99); for the 50% to 69% range, only one study was included and meta-analysis not performed; for the 50% to 99% range, the summary sensitivity was 0.97 (95% CI 0.95 to 0.98) and the summary specificity was 0.70 (95% CI 0.67 to 0.73); for the 70% to 99% range, the summary sensitivity was 0.85 (95% CI 0.77 to 0.91) and the summary specificity was 0.98 (95% CI 0.74 to 0.90); for occlusion, the summary sensitivity was 0.91 (95% CI 0.81 to 0.97) and the summary specificity was 0.95 (95% CI 0.76 to 0.99). For sensitivity analyses, excluding studies in which participants were selected based on the presence of occlusion on DUS had an impact on specificity: 0.98 (95% CI 0.97 to 0.99). For DUS versus CTA, we found two studies in the range of 70% to 99%; the sensitivity varied from 0.57 to 0.94 and the specificity varied from 0.87 to 0.98. For occlusion, the summary sensitivity was 0.95 (95% CI 0.80 to 0.99) and the summary specificity was 0.91 (95% CI 0.09 to 0.99). For DUS versus MRA, there was one study with results for 50% to 99% carotid artery stenosis, with a sensitivity of 0.88 (95% CI 0.70 to 0.98) and specificity of 0.60 (95% CI 0.15 to 0.95); in the 70% to 99% range, two studies were included, with sensitivity that varied from 0.54 to 0.99 and specificity that varied from 0.78 to 0.89. We could perform only a few of the proposed sensitivity analyses because of the small number of studies included. AUTHORS' CONCLUSIONS This review provides evidence that the diagnostic accuracy of DUS is high, especially at discriminating between the presence or absence of significant carotid artery stenosis (< 50% or 50% to 99%). This evidence, plus its less invasive nature, supports the early use of DUS for the detection of carotid artery stenosis. The accuracy for 70% to 99% carotid artery stenosis and occlusion is high. Clinicians should exercise caution when using DUS as the single preoperative diagnostic method, and the limitations should be considered. There was little evidence of the accuracy of DUS when compared with CTA or MRA. The results of this review should be interpreted with caution because they are based on studies of low methodological quality, mainly due to the patient selection method. Methodological problems in participant inclusion criteria from the studies discussed above apparently influenced an overestimated estimate of prevalence values. Most of the studies included failed to precisely describe inclusion criteria and previous testing. Future diagnostic accuracy studies should include direct comparisons of the various modalities of diagnostic tests (mainly DUS, CTA, and MRA) for carotid artery stenosis since DSA is no longer considered to be the best method for diagnosing carotid stenosis and less invasive tests are now used as reference standards in clinical practice. Also, for future studies, the participant inclusion criteria require careful attention.
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Affiliation(s)
- Nicolle Cassola
- Department of Surgery, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Jose Cc Baptista-Silva
- Evidence Based Medicine, Cochrane Brazil, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luis Cu Nakano
- Department of Surgery, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Carolina Dq Flumignan
- Department of Surgery, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ricardo Sesso
- Department of Medicine, Division of Nefrology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Vladimir Vasconcelos
- Department of Surgery, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Nelson Carvas Junior
- Evidence-Based Health Post-Graduation Program, Universidade Federal de São Paulo; Cochrane Brazil; Department of Physiotherapy, Universidade Paulista, São Paulo, Brazil
| | - Ronald Lg Flumignan
- Department of Surgery, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
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Felipe CQ, Biancardi AL, Civile VT, Carvas Junior N, Serracarbassa PD, Koike MK. Mineralocorticoid receptor antagonists for chronic central serous chorioretinopathy: systematic review and meta-analyses. Int J Retina Vitreous 2022; 8:34. [PMID: 35672807 PMCID: PMC9172176 DOI: 10.1186/s40942-022-00385-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mineralocorticoid receptor antagonists (MRAs) are widely used for chronic central serous chorioretinopathy (cCSCR), but their effectiveness remains unclear. This research was conducted to evaluate the efficacy of this drugs for cCSCR. METHODS This is a review of randomized clinical trials (RCT) comparing MRAs to placebo in adults with cCSCR, using the effects of MRAs on best-corrected visual acuity (BCVA) and adverse events as primary outcomes and the effects of MRAs on anatomical parameters as secondary outcomes: central subfield thickness (CST), subretinal fluid height (SFH) and central choroidal thickness (CCT). Our all-language online search included Medline (via PubMed), Central, Embase, Lilacs, Ibecs, and RCT registers platforms, as late as May 2021. We used the Cochrane risk-of-bias tool (version 2) to assess the methodological quality of each study and synthesized the results in meta-analyses using a random-effects model. RESULTS The search identified 302 records, five of which were eligible, totaling 225 cCSCR patients (aged 45-62 years; M/F ratio 3.1:1) treated for 1 to 12 months with spironolactone (50 mg/day) or eplerenone (50 mg/day) vs. placebo. Moderate-certainty evidence suggests MRAs result in little to no improvement in BCVA compared to placebo (SMD 0.22; 95% CI - 0.04 to 0.48; studies = 5; comparisons = 6; participants = 218; I2 = 0%). Very low-certainty evidence suggests that, when compared to placebo, MRAs have a very uncertain impact on adverse effects (no meta-analysis was performed), and CST (MD 18.1; 95% CI - 113.04 to 76.84; participants = 145; studies = 2; I2 = 68%). MRAs also result in little to no difference in SFH (SMD - 0.35; 95% CI - 0.95 to 0.26; studies = 5; comparisons = 6; participants = 221; I2 = 76%; moderate certainty) and CCT (MD - 21.23; 95% CI - 64.69 to 22.24; participants = 206; studies = 4; comparisons = 5; I2 = 85%; low certainty). CONCLUSION MRAs have little to no effect on BCVA. Evidence for adverse events and CST is very uncertain. MRAs also have little to no effect on SFH and CCT. These findings should be considered when prescribing MRAs for cCSCR. This research was previous registration in the PROSPERO platform (CRD42020182601).
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Affiliation(s)
- Camila Q. Felipe
- Postgraduate Program in Health Sciences, Institute of Medical Care for Civil Servants in the State of São Paulo (IAMSPE), São Paulo, Brazil
| | - Ana Luiza Biancardi
- Laboratory of Infectious Diseases in Ophthalmology, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Vinicius T. Civile
- Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Nelson Carvas Junior
- Cochrane Brazil and Department of Physiotherapy, Paulista University, São Paulo, Brazil
| | | | - Marcia K. Koike
- Postgraduate Program in Health Sciences, IAMSPE and Laboratory of Medical Investigation 51 (LIM-51), University of São Paulo, São Paulo, Brazil
- Postgraduate Program in Health Sciences of the Institute of Medical Care for Civil Servants in the State of São Paulo (IAMSPE), Avenida Ibirapuera 981, 2 andar, Vila Clementino, São Paulo, SP CEP 04029-000 Brazil
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Vieira WDA, Pecorari VGA, Figueiredo-de-Almeida R, Carvas Junior N, Vargas-Neto J, Santos ECA, Gomes BPFDA, Almeida JFAD, de-Jesus-Soares A. Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis. CAD SAUDE PUBLICA 2021; 37:e00015920. [PMID: 34909926 DOI: 10.1590/0102-311x00015920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/06/2021] [Indexed: 12/24/2022] Open
Abstract
This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.
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Affiliation(s)
| | | | | | | | - Júlio Vargas-Neto
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, Brasil
| | | | | | | | - Adriana de-Jesus-Soares
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, Brasil
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João GA, Almeida GPL, Tavares LD, Kalva-Filho CA, Carvas Junior N, Pontes FL, Baker JS, Bocalini DS, Figueira AJ. Acute Behavior of Oxygen Consumption, Lactate Concentrations, and Energy Expenditure During Resistance Training: Comparisons Among Three Intensities. Front Sports Act Living 2021; 3:797604. [PMID: 34977570 PMCID: PMC8714826 DOI: 10.3389/fspor.2021.797604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/15/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose: This study aimed to compare the oxygen consumption, lactate concentrations, and energy expenditure using three different intensities during the resistance training sessions. Methods: A total of 15 men (22.9 ± 2.61 years) experienced in resistance training underwent 3 sessions composed of 8 exercises (chest press, pec deck, squat, lat pull-down, biceps curl, triceps extension, hamstring curl, and crunch machine), which were applied in the same order. The weight lifted differed among the sessions [high session: 6 sets of 5 repetitions at 90% of 1-repetition maximum (1-RM); intermediary session: 3 sets of 10 repetitions at 75% of 1-RM; and low session: 2 sets of 15 repetitions at 60% of 1-RM]. The oxygen consumption (VO2)—during and after (excess post-exercise oxygen consumption (EPOC)) the session, blood lactate concentration, and energy expenditure (i.e., the sum of aerobic and anaerobic contributions, respectively) were assessed. Results: The VO2 significantly decreased in the function of the weight lifting (F(2.28) = 17.02; p < 0.01; ηG2 = 0.32). However, the aerobic contributions significantly increase in the function of the weight lifting (F(2.28) = 79.18; p < 0.01; ηG2 = 0.75). The anaerobic contributions were not different among the sessions (p > 0.05; ηG2 < 0.01). Thus, the total energy expenditure during the session (kcal) significantly increased in the function of the weight lifting (F(2.28) = 86.68; p < 0.01; ηG2 = 0.75). The energy expenditure expressed in time unit (kcal·min−1) was higher in low session than in high session (F(2.28) = 6.20; p < 0.01; ηG2 = 0.15). Conclusion: The weight lifted during resistance training-induced different physiological responses, which induced higher energy expenditure per unit of time during the low session.
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Affiliation(s)
- Gustavo A. João
- Department of Exercise Physiology Laboratory, Metropolitanas Unidas College, São Paulo, Brazil
- Department of Translational Physiology Laboratory, São Judas Tadeu University, São Paulo, Brazil
| | - Gustavo P. L. Almeida
- Department of Translational Physiology Laboratory, São Judas Tadeu University, São Paulo, Brazil
- *Correspondence: Gustavo P. L. Almeida
| | - Lucas D. Tavares
- Department of Exercise Physiology Laboratory, Metropolitanas Unidas College, São Paulo, Brazil
- Laboratory of Neuromuscular Adaptations to Strength Training, University of São Paulo, São Paulo, Brazil
| | - Carlos Augusto Kalva-Filho
- Laboratory of Applied Sports Science, Institute of Physical Education and Sports, Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Nelson Carvas Junior
- Department of Evidence-Based Health, Brazilian Cochrane Center, University Federal de São Paulo, São Paulo, Brazil
| | - Francisco L. Pontes
- Physical Activity and Aging Laboratory, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Danilo S. Bocalini
- Experimental Physiology and Biochemistry Laboratory, Physical Education and Sport Center of Federal University of Espírito Santo, Vitoria, Brazil
| | - Aylton J. Figueira
- Department of Translational Physiology Laboratory, São Judas Tadeu University, São Paulo, Brazil
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Alexandre DJA, Ramalho GS, Civile VT, Carvas Junior N, Cury Fernandes MB, Cacione DG, Trevisani VFM. Telerehabilitation versus conventional face-to-face land-based exercises following hip or knee arthroplasty. Hippokratia 2021. [DOI: 10.1002/14651858.cd014931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Dângelo JA Alexandre
- Physical Therapy Department; National Institute of Traumatology and Orthopaedics (INTO / Ministry of Health - Brazil); Rio de Janeiro Brazil
| | | | - Vinicius T Civile
- Evidence-Based Health Post-Graduation Program, Universidade Federal de São Paulo; Cochrane Brazil; Department of Physiotherapy, Universidade Paulista; Sao Paulo Brazil
| | | | - Marco Bernardo Cury Fernandes
- The Centre for Hip Surgery; National Institute of Traumatology and Orthopaedics (INTO / Ministry of Health - Brazil); Rio de Janeiro Brazil
| | - Daniel G Cacione
- Division of Vascular and Endovascular Surgery, Department of Surgery; UNIFESP - Escola Paulista de Medicina; São Paulo Brazil
| | - Virginia FM Trevisani
- Medicina de Urgência and Rheumatology; Escola Paulista de Medicina, Universidade Federal de São Paulo and Universidade de Santo Amaro; São Paulo Brazil
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Tobar Leitão SA, Soares DDS, Carvas Junior N, Zimmer R, Ludwig NF, Andrades M. Study of anesthetics for euthanasia in rats and mice: A systematic review and meta-analysis on the impact upon biological outcomes (SAFE-RM). Life Sci 2021; 284:119916. [PMID: 34480936 DOI: 10.1016/j.lfs.2021.119916] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 12/09/2022]
Abstract
AIM To summarize the knowledge on the effect of anesthetics employed right before euthanasia on biological outcomes. DATA SOURCE A systematic review of the literature to find studies with isoflurane, ketamine, halothane, pentobarbital, or thiopental just before euthanasia of laboratory rats or mice. STUDY SELECTION Controlled studies with quantitative data available. DATA EXTRACTION The search, data extraction, and risk of bias (RoB) were performed independently by two reviewers using a structured form. For each outcome, an effect size (ES) was calculated relative to the control group. Meta-analysis was performed using robust variance meta-regression for hierarchical data structures, with adjustment for small samples. DATA SYNTHESIS We included 20 studies with 407 biological outcomes (110 unique). RoB analysis indicated that 87.5% of the domains evaluated showed unclear risk, 2% high risk, and 10.5% low risk. The effect size for all anesthetics considered together was 0.99 (CI95% = 0.75-1.23; p < 0.0001). Sub-analyses indicate high effect sizes for pentobarbital (1.14; CI95% = 0.75-1.52; p < 0.0001), and isoflurane (1.01; CI95% = 0.58-1.44; p = 0.0005) but not for ketamine (1.49; CI95% = -7.95-10.9; p = 0.295). CONCLUSION We showed that anesthetics interfere differently with the majority of the outcomes assessed. However, our data did not support the use of one anesthetic over others or even the killing without anesthetics. We conclude that outcomes cannot be compared among studies without considering the killing method. This protocol was registered at Prospero (CRD42019119520). FUNDING There was no direct funding for this research.
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Affiliation(s)
- Santiago Alonso Tobar Leitão
- Postgraduate Program in Cardiology and Cardiovascular Science, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-903 Porto Alegre, RS, Brazil; Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350 - sala 12113, 90035-903 Porto Alegre, RS, Brazil
| | - Douglas Dos Santos Soares
- Postgraduate Program in Cardiology and Cardiovascular Science, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-903 Porto Alegre, RS, Brazil; Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350 - sala 12113, 90035-903 Porto Alegre, RS, Brazil
| | - Nelson Carvas Junior
- Department of Evidence-Based Health, UNIFESP, Rua Isabel Schmidt, 349, São Paulo 04743-030, Brazil
| | - Rafael Zimmer
- Postgraduate Program in Medical Science, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-903 Porto Alegre, RS, Brazil
| | - Nataniel Floriano Ludwig
- Postgraduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500, 91501-970 Porto Alegre, RS, Brazil
| | - Michael Andrades
- Postgraduate Program in Cardiology and Cardiovascular Science, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 90035-903 Porto Alegre, RS, Brazil; Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350 - sala 12113, 90035-903 Porto Alegre, RS, Brazil.
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Carvas Junior N, Gomes IC, Valassi JMR, Anunciação L, Freitas-Dias RD, Koike MK. Comparison of the printed and online administration of the Behavioral Regulation in Exercise Questionnaire (BREQ-2). Einstein (Sao Paulo) 2021; 19:eAO6088. [PMID: 34346988 PMCID: PMC8302226 DOI: 10.31744/einstein_journal/2021ao6088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 02/05/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the traditional printed form of the Behavioral Regulation in Exercise Questionnaire with a proposed online form in terms of validity, reliability, and applicability. METHODS A crossover design study was conducted with 157 undergraduate students. Half of the sample answered the printed questionnaire first and then answered the online questionnaire 7 days later, while the other half of the sample did the inverse. Cronbach's alpha was used to analyze the internal consistency of both the online and printed questionnaires. The construct validity was analyzed by confirmatory factor analysis, using a weighted least square mean and adjusted variance estimation and oblique rotation. The quality of the model was tested with fit indices. RESULTS The confirmatory factor analysis showed the 19-item structure with five factors: χ2 of 230.718; degrees of freedom of 142; χ2/degrees of freedom of 1.625; comparative fit index of 0.978 and root mean square error of approximation of 0.073. All items presented factorial loads above 0.5. There was also excellent consistency between the formats of administration in all dimensions, with Cronbach's alpha values above 0.70. The stability between the formats of administration varied between 0.78 (95%CI: 0.69-0.85) and 0.84 (95%CI: 0.77-0.89), suggesting desirable confidence between both formats of administration. CONCLUSION The five-factor model of the online Behavioral Regulation in Exercise Questionnaire shows internal consistency both in terms of the scale dimensions as well as in terms of the total items.
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Affiliation(s)
- Nelson Carvas Junior
- Instituto de Assistência Médica ao Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
| | | | | | - Luís Anunciação
- Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Marcia Kiyomi Koike
- Instituto de Assistência Médica ao Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
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de Lima JB, Soares DDS, Ferrari F, Carvas Junior N, Carvalho G, Tobar Leitão SA, Goldraich LA, Clausell N, Stein R. Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol. BMJ Open 2020; 10:e044975. [PMID: 33376184 PMCID: PMC7778772 DOI: 10.1136/bmjopen-2020-044975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Heart transplantation is the gold standard treatment for selected patients with end-stage heart failure. Although this procedure can improve quality and prolong life expectancy, several of these patients persist with decreased exercise tolerance. Evidence suggests that exercise training can bring multifactorial benefits to heart transplant (HTx) recipients. However, it is unclear that exercise modality should be preferred. Therefore, the aim of this systematic review and network meta-analysis is to compare the efficacy and safety of different training modalities in HTx recipients. METHODS AND ANALYSIS We will perform a comprehensive literature search in PubMed/MEDLINE, Embase, The Cochrane Library, CINAHL, Scopus, SportDISCUS, Web of Science Core Collection and PEDro from inception until November 2020. Two registries (ClinicalTrials.gov and REBEC) will also be searched for potential results in unpublished studies. There will be no restriction on language, date of publication, publication status or sample size. We will include randomised controlled trials enrolling adult HTx recipients with the presence of at least one exercise training group, which might be compared with another training modality and/or a non-exercise control group for a minimum of 4 weeks of intervention. The primary outcomes will be peak oxygen consumption and occurrence of adverse events. As secondary outcomes, the interaction between pulmonary ventilation, pulmonary perfusion and cardiac output, oxygen uptake efficiency slope, heart rate response, oxygen pulse, peak blood pressure and peak subjective perception of effort. In addition, we will evaluate the 6 min walking distance, health-related quality of life, endothelial function, muscle strength, body fat percentage and lean mass. Risk of bias will be assessed using the Cochrane RoB V.2.0 tool, and we plan to use the Confidence in Network Meta-Analysis tool to assess confidence in the results. All materials (raw data, processed data, statistical code and outputs) will be shared in a public repository. ETHICS AND DISSEMINATION Given the nature of this study, no ethical approval will be required. We believe that the findings of this study may show which is the most efficacious and safe physical training modality for HTx recipients. The completed systematic review and network meta-analysis will be submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020191192.
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Affiliation(s)
- Juliana Beust de Lima
- Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Exercise Cardiology Research Group, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Interdisciplinary Research Group in Translational Cardiology, Clinical Research Center, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Douglas Dos Santos Soares
- Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Interdisciplinary Research Group in Translational Cardiology, Clinical Research Center, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Filipe Ferrari
- Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Exercise Cardiology Research Group, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Interdisciplinary Research Group in Translational Cardiology, Clinical Research Center, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Nelson Carvas Junior
- Department of Evidence-Based Health, Brazilian Cochrane Center, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Gabriel Carvalho
- Exercise Cardiology Research Group, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Santiago Alonso Tobar Leitão
- Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Interdisciplinary Research Group in Translational Cardiology, Clinical Research Center, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Lívia Adams Goldraich
- Interdisciplinary Research Group in Translational Cardiology, Clinical Research Center, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Heart Failure and Cardiac Transplant Unit, Cardiology Division, Hospital das Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Nadine Clausell
- Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Interdisciplinary Research Group in Translational Cardiology, Clinical Research Center, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Heart Failure and Cardiac Transplant Unit, Cardiology Division, Hospital das Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Associate Professor, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ricardo Stein
- Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Exercise Cardiology Research Group, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Interdisciplinary Research Group in Translational Cardiology, Clinical Research Center, Hospital das Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Associate Professor, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Pereira DDA, Correia Júnior JL, Carvas Junior N, Freitas-Dias RD. Reliability of questionnaire The International Fitness Scale: a systematic review and meta-analysis. Einstein (Sao Paulo) 2020; 18:eRW5232. [PMID: 32725055 PMCID: PMC7394011 DOI: 10.31744/einstein_journal/2020rw5232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/29/2019] [Indexed: 11/21/2022] Open
Abstract
Objective To perform a systematic literature review and meta-analysis to investigate the reliability of The International Fitness Scale questionnaire for assessing overall physical fitness and related components. Methods PubMed®, BIREME, SciELO, EMBASE, SPORTDiscus, LILACS and Cochrane databases were searched using the following search terms: “The International Fitness Scale”, “International Fitness Scale” and “IFIS”. Article selection and data extraction were performed according to the following eligibility criteria: reliability and/or validity study of the measure tools of The International Fitness Scale; adoption of the The International Fitness Scale as a reference criterion (gold standard) and being an original article. Quality of the study was considered based on Assessment of Reliability Studies. Data analysis used Kappa coefficient of agreement, Cochran and the Higgins I2 test. Sensitivity analysis was conducted using the withdrawal model. Results A total of seven articles were included in the analysis. Test-retest reliability coefficients ranged from 0.40 to 0.99, with most studies achieving values ≥0.60, indicative of moderate to substantial reliability. Conclusion In spite of appropriate test-retest scores attributed to most reliability indicators, heterogeneity among the studies remained high. Therefore, further studies with low risk of bias are needed to support the reliability of the self-reported The International Fitness Scale.
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Affiliation(s)
- Débora de Almeida Pereira
- Graduate Program in Adolescent Medicine - Determinants of Health in Adolescents, Universidade de Pernambuco, Camaragibe, PE, Brazil
| | | | | | - Ricardo de Freitas-Dias
- Graduate Program in Adolescent Medicine - Determinants of Health in Adolescents, Universidade de Pernambuco, Camaragibe, PE, Brazil
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Viveiro LAP, Gomes GCV, Bacha JMR, Carvas Junior N, Kallas ME, Reis M, Jacob Filho W, Pompeu JE. Reliability, Validity, and Ability to Identity Fall Status of the Berg Balance Scale, Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest in Older Adults Who Live in Nursing Homes. J Geriatr Phys Ther 2020; 42:E45-E54. [PMID: 30407272 DOI: 10.1519/jpt.0000000000000215] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE In any given year, 28% to 35% of older adults experience falls. In nursing home environments, the annual rate of falls increases to 30% to 50%. Our objective was to verify and compare the reliability, validity, and ability to identify falls of the Berg Balance Scale (BBS), Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest for older adults who live in nursing homes. METHODS This was a cross-sectional study. Older adults (n = 49; aged 62-90 years; mean = 77.8; standard deviation = 7.2) were recruited from a nonprofit nursing home. All participants were assessed by 2 physiotherapists using the BBS, BESTest, Mini-BESTest, and Brief-BESTest. The interrater and test-retest (7-14 days) reliability were assessed using intraclass correlation coefficients (ICCs [2, 1]). Minimal detectable changes at the 95% confidence level were established. To analyze each test's ability to identify fall status, we used receiver operating characteristic (ROC) curves, whose statistical significance we verified using the area under the ROC curve (AUC) and respective 95% confidence intervals (CIs). The diagnostic likelihood ratios (positive and negative) and 95% CI were used to verify posttest probability. We used Fagan's nomogram to show the posttest probability of each balance test. Validity was assessed using kappa coefficients and the prevalence-adjusted bias-adjusted kappa (PABAK). RESULTS Interrater and test-retest reliability for the total scores were good to excellent across all 4 tests (ICC interrater value = 0.992-0.994 and ICC test-retest value = 0.886-0.945). All tests were also able to identify fall status (AUC = 0.712-0.762) and were in good agreement with each other (kappa coefficient for individuals with fall risk = 0.679-0.957 and individuals with no fall risk = 0.135-0.143; PABAK = 83.7%-98%). CONCLUSION All balance tests presented similar reliability, reproducibility, and validity. This suggests that any of these tests can be used in clinical practice. However, the Brief-BESTest is the quickest and easiest test to perform.
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Affiliation(s)
- Larissa Alamino Pereira Viveiro
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Gisele Cristine Vieira Gomes
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Jéssica Maria Ribeiro Bacha
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Nelson Carvas Junior
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Marina Esteves Kallas
- Departamento de Geriatria, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Muriel Reis
- Departamento de Geriatria, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Wilson Jacob Filho
- Departamento de Geriatria, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - José Eduardo Pompeu
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
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Domingues de Freitas C, Costa DA, Junior NC, Civile VT. Effects of the pilates method on kinesiophobia associated with chronic non-specific low back pain: Systematic review and meta-analysis. J Bodyw Mov Ther 2020; 24:300-306. [PMID: 32826004 DOI: 10.1016/j.jbmt.2020.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 12/11/2019] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Patients with chronic low back pain with higher levels of kinesiophobia have a 41% greater risk of developing a physical disability. The kinesiophobia model suggests that patients fear movements because of pain, associating movement with worsening of their state. Studies that apply the Pilates method for chronic low back pain achieve positive results in reducing pain and disability, and moderate results regarding kinesiophobia. OBJECTIVE The purpose of this review is to evaluate the effects of the Pilates method on kinesiophobia associated with chronic non-specific low back pain. SEARCH METHODS The following databases were searched from August to October 2018: MEDLINE, PEDro, SciELO, LILACS and the Cochrane Database of Systematic Reviews (CENTRAL), without restriction of language and year of publication. SELECTION CRITERIA Randomized clinical trials assessing the effectiveness of the Pilates method in the treatment of kinesiophobia in patients with chronic non-specific low back pain. DATA COLLECTION AND ANALYSIS Two authors independently selected the studies, assessed the risk of bias and extracted data. A third author was consulted in case of disagreements. The primary outcome was kinesiophobia as evaluated by the Tampa scale. RESULTS Our electronic searches resulted in 314 studies; 288 studies were excluded and 27 were selected for reading in full-text. Five articles were included in this review and four in the meta-analysis. CONCLUSION There is a favorable effect of the Pilates method compared to minimal intervention or no treatment in reducing kinesiophobia associated with chronic non-specific low back pain, with a moderate quality of evidence. DESCRIPTORS Low Back Pain, Exercise Movement Techniques, Exercises, Pilates-Based.
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Affiliation(s)
| | | | - Nelson Carvas Junior
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Universidade Paulista (UNIP), Brazil
| | - Vinicius Tassoni Civile
- Universidade Metodista de São Paulo for Universidade Federal de São Paulo (UNIFESP), Universidade Paulista (UNIP), Brazil
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Pereira AMG, Brizon VSC, Carvas Junior N, de Carvalho MDSR, Cuvero EM, Buehler AM, Pereira TDV, Lopes RGC. Can Enhanced Techniques Improve the Diagnostic Accuracy of Transvaginal Sonography and Magnetic Resonance Imaging for Rectosigmoid Endometriosis? A Systematic Review and Meta-analysis. Journal of Obstetrics and Gynaecology Canada 2020; 42:488-499.e4. [DOI: 10.1016/j.jogc.2019.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 11/29/2022]
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Silva DVD, Andrusaitis SF, Fernandes LG, Melo TBD, Carvas Junior N, Brech GC. Prevalência de idade e gênero e sua correspondência com os setores de fisioterapia ambulatorial de um instituto de ortopedia e traumatologia de referência da cidade de São Paulo. Fisioter Pesqui 2019. [DOI: 10.1590/1809-2950/18026426042019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Independentemente da natureza dos acidentes que ocorrem diariamente, as consequências frequentemente exigem reabilitação especializada. Este estudo pretende verificar qual setor de fisioterapia ambulatorial de um instituto de ortopedia e traumatologia apresenta maior prevalência de fichas de encaminhamento para atendimento. Além disso, pretende verificar qual gênero predomina e qual é a relação entre as faixas etárias e os setores de fisioterapia ambulatorial de um hospital de referência da cidade de São Paulo. Trata-se de um estudo prospectivo realizado entre março e dezembro de 2016 com uma amostra de 1507 fichas de encaminhamento ao Ambulatório de Fisioterapia do Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. O estudo mostrou que o setor Trauma em Fisioterapia Ambulatorial apresenta maior quantidade de fichas de encaminhamento, que o gênero masculino foi predominante e que há uma correspondência das relações entre diferentes faixas etárias e os setores de Fisioterapia Ambulatorial.
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João GA, Rodriguez D, Tavares LD, Carvas Junior N, Miranda ML, Reis VM, Bocalini DS, Baker JS, Figueira AJ. Can intensity in strength training change caloric expenditure? Systematic review and meta-analysis. Clin Physiol Funct Imaging 2019; 40:55-66. [PMID: 31674141 DOI: 10.1111/cpf.12604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 08/24/2019] [Accepted: 10/24/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Strength training (ST) is considered an important strategy for maintaining body weight, as it promotes an increase in total energy expenditure (EE). However, the combination and manipulation of variables (intensity and volume) allow for different training adaptations. However, it remains unclear as to what is the most important variable between volume or intensity for example number of sets, repetitions, or total load for maximizing EE during ST. Several studies have analyzed the EE response in ST, but still unclear the variable is able to increase EE in the ST. OBJECTIVE This review aimed to investigate the effect of ST on EE in adults using a systematic literature review and subsequent meta-analysis. METHODS The search was performed on the electronic databases using the following keywords: strength training (resistance training; strength training; strength training method) and energy expenditure (energy metabolism; energy expenditure; caloric expenditure, caloric cost) with 'AND' and 'OR' combination. Manual searches of references were also conducted for additional relevant studies. After evaluating the inclusion and exclusion criteria, the selected studies were analysed according to strength training methods and the training variables used to measure EE. RESULTS We identified two ST methods from the literature review: circuit training (CT) and traditional training (TT). Meta-analysis showed a significant effect on EE increase, which favour TT when compared with CT [-0·99 (95%CI: -1·96, -0·02), P<0·01] with I2 of 89% (P<0·01). After adjusting for bias risk, no significant differences were found in EE associated with intensity [-0·40, 95% CI (0·98, 0·18), P = 0·18). CONCLUSION The present review and meta-analysis indicated that the intensity of exercise does not seem to be associated with an increase of EE in ST.
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Affiliation(s)
- Gustavo Allegretti João
- Translational Exercise Physiology Laboratory, São Paulo, Brazil.,Metropolitanas Unidas Faculty, São Paulo, Brazil
| | | | | | - Nelson Carvas Junior
- Ibirapuera University, São Paulo, Brazil.,Institute of São Paulo Medical Assistance State, São Paulo, Brazil
| | | | - Victor M Reis
- Research Center in Sport Sciences, Health Sciences & Human Development, University of Trás-os-Montes & Alto Douro, Vila Real, Portugal
| | - Danilo Sales Bocalini
- Experimental Physiology and Biochemistry Laboratory of Physical Education and Sport Center, Federal University of Espiríto Santo, Vitória, Brazil
| | - Julien S Baker
- Department of Sport and Physical Education, Faculty of Social Sciences, Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Valassi JMR, Carvas Junior N, Matsura Shirassu M, de Paula KE, Atkinson ER, Koike MK. Factors Associated With Medication Adherence In Elderly Retired Outpatients In São Paulo, Brazil. Patient Prefer Adherence 2019; 13:1619-1628. [PMID: 31686788 PMCID: PMC6777441 DOI: 10.2147/ppa.s208026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 09/01/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To evaluate medication adherence and associated socioeconomic factors in elderly Brazilians. METHODOLOGY This observational study was conducted with 159 elderly retired in an outpatient clinic in the city of São Paulo. Treatment adherence was assessed with the questions from the Morisky Green Levine Medication Adherence Questionnaire, and medications were classified using the Anatomical Therapeutic Chemical system. Statistical tests and adjusted Poisson regression models were used to analyze variables. RESULTS The study population was mostly female (67.5%), had an average age of, and took an average of 6.5 medications per day. The most commonly used drugs were agents acting on the renin-angiotensin system (67.9%), statins (62.3%), antithrombotic agents (48.4%), and biguanides (37.1%) for the treatment of hypertension (76.7%), dyslipidemia (54.1%), and diabetes (47.8%). The rate of adherence was below 60% in the groups of participants that were analyzed except for the high household income category, which had a rate of 75.8%. CONCLUSION Medication adherence among the elderly was low in all categories except for the high household income category, a relevant finding that will help to understand medication adherence patterns in elderly Brazilians.
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Affiliation(s)
| | - Nelson Carvas Junior
- Health Sciences Department, Institute for Medical Assistance to State Public Servants, São Paulo, Brazil
| | - Mirian Matsura Shirassu
- Health Sciences Department, Institute for Medical Assistance to State Public Servants, São Paulo, Brazil
| | - Kaleo Eduardo de Paula
- Health Sciences Department, Institute for Medical Assistance to State Public Servants, São Paulo, Brazil
| | | | - Marcia Kiyomi Koike
- Health Sciences Department, Institute for Medical Assistance to State Public Servants, São Paulo, Brazil
- Emergency Medicine Department, Medical School, University of São Paulo, São Paulo, Brazil
- Correspondence: Marcia Kiyomi Koike Programa de Pós-Graduação em Ciências da Saúde. Instituto de Assistência Médica ao Servidor Público Estadual (IAMSPE), Brasil Av. Ibirapuera, 981 - 2º andar, Vila Clementino, São Paulo/SPCEP: 04029-000, BrazilTel +55 11 9 9964-8421 Email
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Gomes GCV, Simões MDS, Lin SM, Bacha JMR, Viveiro LAP, Varise EM, Carvas Junior N, Lange B, Jacob Filho W, Pompeu JE. Feasibility, safety, acceptability, and functional outcomes of playing Nintendo Wii Fit PlusTM for frail older adults: A randomized feasibility clinical trial. Maturitas 2018; 118:20-28. [DOI: 10.1016/j.maturitas.2018.10.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/17/2018] [Accepted: 10/01/2018] [Indexed: 10/28/2022]
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Brandão SMG, Issa VS, Ayub-Ferreira SM, Storer S, Gonçalves BG, Santos VG, Carvas Junior N, Guimarães GV, Bocchi EA. Reverse auction: a potential strategy for reduction of pharmacological therapy cost. Arq Bras Cardiol 2015. [PMID: 26200898 PMCID: PMC4592175 DOI: 10.5935/abc.20150076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Polypharmacy is a significant economic burden. Objective We tested whether using reverse auction (RA) as compared with commercial pharmacy
(CP) to purchase medicine results in lower pharmaceutical costs for heart failure
(HF) and heart transplantation (HT) outpatients. Methods We compared the costs via RA versus CP in 808 HF and 147 HT patients followed from
2009 through 2011, and evaluated the influence of clinical and demographic
variables on cost. Results The monthly cost per patient for HF drugs acquired via RA was $10.15 (IQ
3.51-40.22) versus $161.76 (IQ 86.05‑340.15) via CP; for HT, those costs were
$393.08 (IQ 124.74-774.76) and $1,207.70 (IQ 604.48-2,499.97), respectively. Conclusion RA may reduce the cost of prescription drugs for HF and HT, potentially making HF
treatment more accessible. Clinical characteristics can influence the cost and
benefits of RA. RA may be a new health policy strategy to reduce costs of
prescribed medications for HF and HT patients, reducing the economic burden of
treatment.
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Affiliation(s)
| | - Victor Sarli Issa
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR
| | | | - Samantha Storer
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, BR
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Fernandes Silva MM, Bacal F, Roque JM, Teixeira-Neto IS, Carvas Junior N, Bocchi EA, Guimarães GV. Age-Related Maximum Heart Rate Among Ischemic and Nonischemic Heart Failure Patients Receiving β-Blockade Therapy. J Card Fail 2012; 18:831-6. [DOI: 10.1016/j.cardfail.2012.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 10/01/2012] [Accepted: 10/02/2012] [Indexed: 01/08/2023]
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