Search

Este estudo objetivou identificar e caracterizar as tendências das teses e dissertações brasileiras acerca da utilização das práticas integrativas e complementares no controle da hipertensão arterial sistêmica. Revisão narrativa, resultante de uma busca realizada no Catálogo de Teses e Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, no mês de julho de 2020, sem recorte temporal, utilizando quatro estratégias de busca. Após uma revisão independente, por dois pesquisadores, 11 estudos foram avaliados criticamente. As práticas mais pesquisadas foram yoga e acupuntura, além destas, o Lian Gong, Qigong, a meditação e a auriculoterapia mostraram efeitos positivos na redução da pressão arterial, mas evidenciaram a necessidade de pesquisas com outras parcelas da população ou com metodologias mais robustas, visto as limitações identificadas no cegamento, randomização e baixo número de participantes. Identificou-se lacuna no conhecimento e limitações desta ciência em conceber métodos mais adequados aos estudos com práticas integrativas e complementares. This study aimed to identify and characterize the trends of Brazilian theses and dissertations about the use of integrative and complementary practices in the control of systemic arterial hypertension. Narrative review, resulting from a search conducted in the Catalog of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel, in the month of July 2020, without time frame, using four search strategies. After an independent review by two researchers, 11 studies were critically evaluated. The most researched practices were yoga and acupuncture, in addition to these, Lian Gong, Qigong, meditation and auriculotherapy showed positive effects in reducing blood pressure, but evidenced the need for research with other parts of the population or with more robust methodologies, since the limitations identified in blinding, randomization and low number of participants. A gap was identified in the knowledge and limitations of this science in devising more adequate methods for studies with integrative and complementary practices. Este estudio tuvo como objetivo identificar y caracterizar las tendencias de las tesis y disertaciones brasileñas sobre el uso de prácticas integradoras y complementarias en el control de la hipertensión arterial sistémica. Revisión narrativa, resultado de una búsqueda realizada en el Catálogo de Tesis y Disertaciones de la Coordinación para el Perfeccionamiento del Personal de Educación Superior, en el mes de julio de 2020, sin marco temporal, utilizando cuatro estrategias de búsqueda. Después de una revisión independiente de dos investigadores, se evaluaron críticamente 11 estudios. Las prácticas más investigadas fueron el yoga y la acupuntura, además de estas, Lian Gong, Qigong, meditación y auriculoterapia mostraron efectos positivos en la reducción de la presión arterial, pero evidenciaron la necesidad de investigar con otros sectores de la población o con metodologías más robustas, ya que el limitaciones identificadas en el cegamiento, la asignación al azar y el bajo número de participantes. Se identificó una brecha en el conocimiento y limitaciones de esta ciencia para idear métodos más adecuados para estudios con prácticas integradoras y complementarias

Ziel der Studie In Deutschland unterscheiden sich die Behandlungspfade von frisch Querschnittgelähmten in Abhängigkeit von intrinsisch-krankheitsspezifischen und extrinsischen Faktoren erheblich. Welche dieser Faktoren mit einem verbesserten Outcome, weniger Folgekomplikationen und stationären Wiederaufnahmen assoziiert sind, ist bis heute nicht bekannt. Daher soll das deutschlandweite, patientenzentrierte, webbasierte ParaReg-Register implementiert werden, um langfristig eine bessere Qualität der Patientenversorgung, Planung der Behandlungspfade und Kosteneffizienz zu erreichen. Methodik In der Konzeptionierungsphase 2017/18 wurde das Datenmodell des Registers vom ParaReg-Leitungskomitee in einem iterativen Prozess zusammen mit dem erweiterten Vorstand der Deutschsprachigen Medizinischen Gesellschaft für Paraplegiologie e.V. (DMGP) und Patientenvertretern entwickelt. In ParaReg werden soziale und medizinische Routinedaten zusammen mit international etablierten neurologischen, funktionellen und partizipationsbezogenen Scores dokumentiert. Die Vergabe einer eindeutigen Patienten-ID erlaubt lebenslang eine zentrumsübergreifende Dokumentation von stationären Aufenthalten in einem der 27 in Deutschland in der DMGP organisierten Querschnittzentren. Das ParaReg-Datenschutzkonzept und die Patienteninformation/-einwilligung orientieren sich an den um DSGVO-relevante Aspekte erweiterten Vorlagen des Open Source Registers für seltene Erkrankungen (OSSE). Ergebnisse In der 2019 begonnenen Realisierungsphase wurde die informationstechnische Infrastruktur gemäß des klinischen ID-Management-Moduls der Technologie- und Methodenplattform für die vernetzte medizinische Forschung e.V. (TMF) umgesetzt. Parallel wurden die rechtlich-ethischen Voraussetzungen für den Registerbetrieb unter der Schirmherrschaft der DMGP geschaffen. In das Datenschutzkonzept sind die Empfehlungen der Arbeitsgruppe Datenschutz der TMF eingeflossen. Basierend auf den Rückmeldungen aus der Alpha-Testphase mit Eingabe der Aufenthaltsdaten von 40 Patienten wurde die Ergonomie der elektronischen Eingabeformulare speziell für mobile Eingabegeräte verbessert. Schlussfolgerung Mit Abschluss der monozentrischen Alpha-Testphase hat die multizentrische Datenerhebung an 5 DMGP-Querschnittzentren begonnen. Die Nachhaltigkeit von ParaReg ist durch die strukturelle und finanzielle Unterstützung durch die DMGP auch nach Auslaufen der Förderung durch das Bundesministerium für Bildung und Forschung (BMBF) gesichert.

SUMMARYPrimary motor cortex (M1) has been thought to form a continuous somatotopic homunculus extending down precentral gyrus from foot to face representations1,2. The motor homunculus has remained a textbook pillar of functional neuroanatomy, despite evidence for concentric functional zones3and maps of complex actions4. Using our highest precision functional magnetic resonance imaging (fMRI) data and methods, we discovered that the classic homunculus is interrupted by regions with sharpy distinct connectivity, structure, and function, alternating with effector-specific (foot, hand, mouth) areas. These inter-effector regions exhibit decreased cortical thickness and strong functional connectivity to each other, and to prefrontal, insular, and subcortical regions of the Cingulo-opercular network (CON), critical for executive action5and physiological control6, arousal7, and processing of errors8and pain9. This interdigitation of action control-linked and motor effector regions was independently verified in the three largest fMRI datasets. Macaque and pediatric (newborn, infant, child) precision fMRI revealed potential cross-species analogues and developmental precursors of the inter-effector system. An extensive battery of motor and action fMRI tasks documented concentric somatotopies for each effector, separated by the CON-linked inter-effector regions. The inter-effector regions lacked movement specificity and co-activated during action planning (coordination of hands and feet), and axial body movement (e.g., abdomen, eyebrows). These results, together with prior work demonstrating stimulation-evoked complex actions4and connectivity to internal organs (e.g., adrenal medulla)10, suggest that M1 is punctuated by an integrative system for implementing whole-body action plans. Thus, two parallel systems intertwine in motor cortex to form an integrate-isolate pattern: effector-specific regions (foot, hand, mouth) for isolating fine motor control, and a mind-body interface (MBI) for the integrative whole-organism coordination of goals, physiology, and body movement.

Objective To analyze the effect of lavender essential oil associated with massage on spinal pain levels in obese women. Methods The sample included 49 obese women, between 20 and 60 years of age, randomly assigned to three groups: control (n=15), intervention (n=19) and placebo (n=15). The intervention and placebo groups were submitted to eight 35-minute sessions, twice a week for one month, but the essential oil of Lavandula angustifolia was used only in the intervention group. A placebo was used for the placebo group and the control group received no intervention. Pain levels were measured before and after the intervention using the Visual Analog Scale. Results There was a significant decrease in total spinal pain (p=0.004), in the cervical region (p=0.003) and in the lumbar region (p=0.008) in the intervention group. Conclusion Lavender essential oil had a positive impact on the reduction of pain in the spine of obese women, as well as in the specific areas of the cervical and lumbar regions compared to the control and placebo groups. Level of evidence I; Randomized clinical trial. RESUMO Objetivo Analisar o efeito do óleo essencial de lavanda associado à massagem nos níveis de dor na coluna em mulheres obesas. Métodos A amostra incluiu 49 mulheres obesas com idades entre 20 e 60 anos, randomizadas em três grupos: controle (n = 15), intervenção (n = 19) e placebo (n = 15). Os grupos intervenção e placebo foram submetidos a oito sessões com duração de 35 minutos, duas vezes por semana durante um mês, sendo que o óleo essencial de Lavandula angustifolia foi usado apenas no grupo intervenção. Um placebo foi usado para o grupo placebo e o grupo controle não recebeu intervenção. Os níveis de dor foram medidos antes e depois da intervenção pela Escala Visual Analógica. Resultados Houve diminuição significativa da dor total na coluna (p = 0,004), na região cervical (p = 0,003) e na região lombar (p = 0,008) no grupo intervenção. Conclusão O óleo essencial de lavanda teve impacto positivo na redução da dor na coluna de mulheres obesas, bem como em áreas específicas das regiões cervical e lombar em comparação com os grupos controle e placebo. Nível de evidência I; Ensaio clínico randomizado. RESUMEN Objetivo Analizar el efecto del aceite esencial de lavanda asociado al masaje sobre los niveles de dolor espinal en mujeres obesas. Métodos La muestra incluyó a 49 mujeres obesas con edades de 20 a 60 años, distribuidas aleatoriamente en tres grupos: control (n = 15), intervención (n = 19) y placebo (n = 15). Los grupos intervención y placebo se sometieron a ocho sesiones con 35 minutos de duración, dos veces por semana durante un mes, utilizándose el aceite esencial de Lavandula angustifolia solo en el grupo intervención. Para el grupo placebo se utilizó un placebo y el grupo control no recibió ninguna intervención. Los niveles de dolor se midieron antes y después de la intervención, utilizando la Escala Visual Analógica. Resultados Hubo una disminución significativa del dolor total en la columna (p = 0,004), en la región cervical (p = 0,003) y en la región lumbar (p = 0,008) en el grupo intervención. Conclusión El aceite esencial de lavanda tuvo un impacto positivo en la reducción del dolor de columna vertebral en mujeres obesas, así como en las áreas específicas de las regiones cervical y lumbar en comparación con los grupos control y placebo. Nivel de evidencia I; Ensayo clínico aleatorizado.

Vitamins are essential micronutrients with key roles in many biological pathways relevant to sepsis. Some of these relevant biological mechanisms include antioxidant and anti-inflammatory effects, protein and hormone synthesis, energy generation, and regulation of gene transcription. Moreover, relative vitamin deficiencies in plasma are common during sepsis and vitamin therapy has been associated with improved outcomes in some adult and pediatric studies. High-dose intravenous vitamin C has been the vitamin therapy most extensively studied in adult patients with sepsis and septic shock. This includes three randomized control trials (RCTs) as monotherapy with a total of 219 patients showing significant reduction in organ dysfunction and lower mortality when compared to placebo, and five RCTs as a combination therapy with thiamine and hydrocortisone with a total of 1134 patients showing no difference in clinical outcomes. Likewise, the evidence for the role of other vitamins in sepsis remains mixed. In this narrative review, we present the preclinical, clinical, and safety evidence of the most studied vitamins in sepsis, including vitamin C, thiamine (i.e., vitamin B1), and vitamin D. We also present the relevant evidence of the other vitamins that have been studied in sepsis and critical illness in both children and adults, including vitamins A, B2, B6, B12, and E. Impact Vitamins are key effectors in many biological processes relevant to sepsis. We present the preclinical, clinical, and safety evidence of the most studied vitamins in pediatric sepsis. Designing response-adaptive platform trials may help fill in knowledge gaps regarding vitamin use for critical illness and association with clinical outcomes.