Navegando por Palavras-chave "systematic review"

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    Anorexia nervosa treatment from the patient perspective: A metasynthesis of qualitative studies
    (Dowden Health Media, 2009-02-01) Espindola, Cybele Ribeiro; Blay, Sergio Luis [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: Anorexia nervosa is a complex condition that brings great challenges at each stage of treatment. This study aims to organize the body of information available in qualitative studies about the treatment of anorexia nervosa through a systematic literature review and metasynthesis.METHODS: Searches were carried out on the following databases for the years 1990 to 2005: PubMed, ISI, PsycINFO, EMBASE, LILACS, and SciELO from 1990 to 2005. A meta-ethnographic approach was used to synthesize the data through second-order and third-order interpretations.RESULTS: The search revealed 3415 studies, of which 16 were selected. Two concepts for second-order interpretation emerged from the process: (1) the process of change (phases of recovery, factors favoring recovery, factors limiting recovery) and (2) perception of the treatment modalities. From the second-order categories, a third-order category was derived-reconciliation, in which personal and environmental acceptance have a central role.CONCLUSIONS: Recovery from anorexia nervosa, as a very complex process, goes well beyond conventional treatment. Self-acceptance, determination, and spirituality are equally important elements.
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    Antidepressants versus placebo for the treatment of bulimia nervosa: a systematic review
    (Blackwell Science Asia, 2000-04-01) Bacaltchuk, Josué [UNIFESP]; Hay, P.; Mari, J. J.; Universidade Federal de São Paulo (UNIFESP); Univ Adelaide
    Objective: the objective of this study was to valuate the effectiveness, tolerability and acceptability of various classes of antidepressants compared with placebo in the treatment of bulimia nervosa.Method: A meta-analysis including 16 randomised controlled trials and 1300 bulimic patients was performed. Dichotomous outcomes were analysed by calculating relative risks, and continuous outcomes by calculating effect sizes. Methodological quality, heterogeneity in the results and selective publication were assessed.Results: Short-term remission in bulimic symptoms was statistically more likely on antidepressants than placebo (Relative Risk = 0.88, 95% CI = 0.83-0.94, p < 0.0001). Drop-out rates were high but no statistical difference was found between treatment groups (34.6% and 31.4% for drug and placebo; RR = 1.03, 95% CI = 0.80-1.32, p = 0.8). No difference in efficacy could be demonstrated among different classes of antidepressants.Conclusions: the use of a single antidepressant agent was clinically effective for the treatment of bulimia nervosa when compared with placebo, with an overall greater remission rate and a higher rate of drop-outs. No differential effect regarding efficacy and tolerability among the various classes of antidepressants could be demonstrated.
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    Cannabinoids for nausea and vomiting related to chemotherapy: Overview of systematic reviews
    (Wiley, 2018) Schussel, Victor [UNIFESP]; Kenzo, Lucas [UNIFESP]; Santos, Andreia [UNIFESP]; Bueno, Julia [UNIFESP]; Yoshimura, Ellen [UNIFESP]; Latorraca, Carolina de Oliveira Cruz [UNIFESP]; Pachito, Daniela Vianna [UNIFESP]; Riera, Rachel [UNIFESP]
    Nausea and vomiting are common and distressing adverse events of chemotherapy. This review focuses on the findings and quality of systematic reviews (SRs) of cannabinoids for chemotherapy-induced nausea and vomiting (CINV). Review of SRs, a systematic literature search, was conducted in several electronic databases and included SRs evaluating cannabinoids for CINV in cancer patients. Methodological quality and quality of reporting were evaluated by AMSTAR and PRISMA, respectively. Initial search retrieved 2,206 records, and 5 SRs were included. On the basis of findings of the sole SR judged as high methodological quality, cannabinoids seem to be more effective than placebo, equal to prochlorperazine for reducing CINV, and to be preferred by patients. The response to different combinations of antiemetic agents seems to be equal to 1 antiemetic alone. The average of AMSTAR score was 5, and the average of PRISMA score was 13.2. Cannabinoids represent a valuable option for treating CINV, despite the adverse events related to treatment, such as drowsiness and cognitive impairment. There is no good quality evidence to recommend or not the use of cannabinoids for CINV. More studies are still needed to evaluate the effectiveness of cannabinoids when compared with modern antiemetics.
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    Combination of antidepressants and psychological treatments for bulimia nervosa: a systematic review
    (Munksgaard Int Publ Ltd, 2000-04-01) Bacaltchuk, Josué [UNIFESP]; Trefiglio, R. P.; Oliveira, I. R.; Hay, P.; Lima, M. S.; Mari, J. J.; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Bahia (UFBA); Univ Adelaide; Fed Univ Pelotas
    Background: This review assessed the effect of a combination of antidepressants plus psychological approaches compared to each single treatment for bulimia nervosa.Method: Trials were included in two meta-analyses: single antidepressants versus combination and single psychological approaches versus combination. Methodological quality and homogeneity of results were assessed. Dichotomous outcomes were analysed by calculating relative risks (RR).Results: Five trials were included in meta-analysis I and 7 in meta-analysis 2. Remission rates were 42% for combination versus 23% for antidepressants (RR = 1.38; 95% CI = 0.98-1.93; P = 0.06) and 36% for psychological approaches compared to 49% for combination (RR = 1.21; P = 0.03). Drop-out rates were 16% for psychological approaches and 30% for combination (RR = 0.57; 95% CI = 0.38-0.088; P = 0.11).Conclusion: Efficacy of combined treatments was superior to single approaches. When antidepressants were combined to treatment, acceptability of psychological approaches was significantly reduced.
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    Comparação das técnicas para redução da luxação anterior do ombro: uma revisão sistemática
    (Universidade Federal de São Paulo (UNIFESP), 2016-12-09) Lara, Paulo Henrique Schmidt [UNIFESP]; Tamaoki, Marcel Jun Sugawara Tamaoki [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: The shoulder is regarded as the most commonly dislocated major joint in the human body. There are many methods of reduction, but there are few studies that compare efficiency, safety and reliability of these techniques. Objective: To compare the methods of reduction of the anterior dislocation of the shoulder. Method: Systematic review of randomized controlled clinical trials that compared two or more methods of reduction of the anterior dislocation of the shoulder. Studies were identified and selected from databases on the internet (Medline, Embase, Lilacs and Cochrane Virtual Library). A manual search for studies in journals and books was performed. The primary outcomes were failure rate, pain and reduction time. Secondary outcomes were: complications rate, length of stay in the Emergency Department, pain after 10 and 30 minutes and on discharge. Results: The search strategy resulted in 964 studies, and 7 studies were chosen. With respect to failure rate, FARES technique showed statistically significant results. With relation to pain during reduction and reduction time, when traction-countertraction and Kocher techniques were compared to the other techniques, there were statistically significant results in favour of the other techniques. Conclusion: There is no enough evidence to establish which is the best method of reduction of the anterior dislocation of the shoulder. Old methods such as traction-countertraction and Kocher showed negative results when compared to other techniques in outcomes as reduction time, pain during reduction and failure rate.
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    Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials
    (Federacao Brasileira Soc Ginecologia & Obstetricia-Febrasgo, 2016) Moroni, Rafael Mendes; Magnani, Pedro Sergio; Haddad, Jorge Milhem; Castro, Rodrigo de Aquino [UNIFESP]; Brito, Luiz Gustavo Oliveira
    We performed a systematic review and meta-analysis of randomized controlled trials that studied the conservative management of stress urinary incontinence (SUI). There were 1058 results after the initial searches, from which 37 studies were eligible according to previously determined inclusion criteria. For the primary outcomes, pelvic floor muscle training (PFMT) was more efficacious than no treatment in improving incontinence-specific quality of life (QoL) scales (SMD = -1.24SDs; CI 95% = -1.77 to -0.71SDs). However, its effect on pad tests was imprecise. Combining biofeedback with PFMT had an uncertain effect on QoL (MD = -4.4 points; CI 95% = -16.69 to 7.89 points), but better results on the pad test, although with elevated heterogeneity (MD = 0.9g; 95% CI = 0.71 to 1,10g); group PFMT was not less efficacious than individual treatment, and home PFMT was not consistently worse than supervised PFMT. Both intravaginal and superficial electrical stimulation (IES and SES) were better than no treatment for QoL and pad test. Vaginal cones had mixed results. The association of IES with PFMT may improve the efficacy of the latter for QoL and pad test, but the results of individual studies were not consistent. Thus, there is evidence of the use of PFMT on the treatment of SUI, with and without biofeedback.
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    Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials
    (Federacao Brasileira Soc Ginecologia & Obstetricia-Febrasgo, 2016) Moroni, Rafael Mendes; Magnani, Pedro Sergio; Haddad, Jorge Milhem; Castro, Rodrigo de Aquino [UNIFESP]; Brito, Luiz Gustavo Oliveira
    We performed a systematic review and meta-analysis of randomized controlled trials that studied the conservative management of stress urinary incontinence (SUI). There were 1058 results after the initial searches, from which 37 studies were eligible according to previously determined inclusion criteria. For the primary outcomes, pelvic floor muscle training (PFMT) was more efficacious than no treatment in improving incontinence-specific quality of life (QoL) scales (SMD = -1.24SDs; CI 95% = -1.77 to -0.71SDs). However, its effect on pad tests was imprecise. Combining biofeedback with PFMT had an uncertain effect on QoL (MD = -4.4 points; CI 95% = -16.69 to 7.89 points), but better results on the pad test, although with elevated heterogeneity (MD = 0.9g; 95% CI = 0.71 to 1,10g); group PFMT was not less efficacious than individual treatment, and home PFMT was not consistently worse than supervised PFMT. Both intravaginal and superficial electrical stimulation (IES and SES) were better than no treatment for QoL and pad test. Vaginal cones had mixed results. The association of IES with PFMT may improve the efficacy of the latter for QoL and pad test, but the results of individual studies were not consistent. Thus, there is evidence of the use of PFMT on the treatment of SUI, with and without biofeedback.
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    Efeito do uso de pistas externas nos parâmetros de marcha de pacientes com doença de Parkinson: Revisão sistemática
    (Universidade Federal de São Paulo (UNIFESP), 2014) Rocha, Priscila Alves [UNIFESP]; Ferraz, Henrique Ballalai [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    A doenca de Parkinson e uma das doencas neurologicas mais prevalentes. Diversos deficits motores estao presentes nestes pacientes, entre eles os disturbios da marcha e equilibrio. Alem das terapias convencionais, tem se utilizado com frequencia, pistas (tambem chamados de feedback extrinseco) para melhora destes deficits. Objetivos: Avaliar a efetividade e seguranca do uso de pistas na marcha de pacientes com Doenca de Parkinson. Assim como verificar se a mudanca na marcha provocada auxilia na melhora da qualidade de vida e do desempenho psicomotor, e diminuicao do freezing. Por fim, com os objetivos anteriores respondidos, analisar qual tipo de pista externa provoca ganhos mais expressivos em todos os desfechos analisados. Metodos de busca: As bases de dados eletronicas analisadas foram: Cochrane Library, Pubmed, Embase, Lilacs, Pedro, e Sumsearch. Tambem foram analisados artigos das referencias bibliograficas dos artigos coletados, assim como busca manual nas Revistas Movement Disorders e Physical Therapy, alem de anais de congressos principalmente da Movement Disorders Society. As seguintes palavras chaves foram utilizadas: Parkinson disease, feedback, biofeedback, neurofeedback, psychology biofeedback, cue, cues, cueing, rehabilitation, physical therapy, physiotherapy, exercise, locomotion, gait, neurologic gait disorders, optical flow field, visual, auditory, sensory, tactile. Criterios de inclusao: Ensaios clinicos randomizados e quasi randomizados que analisaram marcha, freezing, qualidade de vida e desempenho psicomotor foram analisados. Coleta e analise de dados: Os dados destes estudos foram analisados por meio de um formulario padronizado por dois revisores. Resultados: Dos 259 artigos localizados, apenas sete estudos se enquadraram nos criterios de inclusao e de qualidade metodologica desta revisao. Deste total, dois estudos utilizaram pistas visuais, dois pistas auditivas, um analisou o uso de instrucoes verbais, um utilizou pistas combinadas e por fim, um utilizou pistas sensoriais (proprioceptivas). Em geral, o uso de pistas resultou em melhoras no comprimento do passo (p < 0,0001), velocidade (p < 0,00001), cadencia (p < 0,001), comprimento da passada (p < 0,00001). As pistas visuais provocaram melhorias significantes na velocidade (p < 0,00001), cadencia (p < 0,00001) e comprimento do passo (p = 0,0004), enquanto as auditivas foram efetivas no aumento do comprimento do passo (p = 0,03) e velocidade (p < 0,00001); o estudo incluido que avaliou o uso da instrucao verbal apenas analisou comprimento do passo, porem, esta intervencao nao mostrou diferenca estatisticamente significante para este desfecho (p = 0,16). A pista sensorial (proprioceptiva) mostrou beneficios significantes na velocidade (p = 0,01), cadencia e comprimento da passada (p < 0,00001), enquanto que com o uso de pistas combinadas (visual + auditiva) houve maiores ganhos na UPDRS III (p = 0,009) do que na velocidade (p = 0,01). Conclusao: Esta revisao sistematica apresenta nivel de evidencia 1A, com base na classificacao de oOxford Centre for Evidence-based Medicineo. Conclui-se que o uso de pistas externas e efetivo para a melhora dos parametros de marcha de pacientes com Doenca de Parkinson, havendo melhora do freezing, do desempenho psicomotor avaliados pelo FOGQ e UPDRS III, respectivamente
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    Efetividade das intervenções psicossociais no tratamento dos transtornos alimentares: overview das revisões sistemáticas Cochrane
    (Universidade Federal de São Paulo (UNIFESP), 2013-09-25) Costa, Marcelle Barrueco [UNIFESP]; Melnik, Tamara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background:.The Overviews of Systematic Reviews (SRs) are devoloped by The Cochrane Collaboration in order to compile the results of multiple SRs for specific clinical condition. There are 5 SRs of psychosocial interventions for one or more Eating Disorders (EDs) published in The Cochrane Library up to now. Due to the high rate of relapse, chronicity and the possibility of migration of a type of Eating Disorder to another, a single document that presents the scientific evidence on psychosocial interventions can facilitate the decision making in health. Objective: To conduct an Overview of Cochrane Systematic Reviews on the effectiveness of psychosocial interventions in treatment of EDs. Methods: We performed a critical evaluation of all Cochrane Systematic Reviews (CSRs) published in The Cochrane Library about psychosocial interventions for EDs. The AMSTAR instrument with 11 items was used for evaluate the quality of included SRs. Results: Five CSRs were included (90 studies, 5487 participants), as shown in the Table 1. The main outcome analyzed was symptomatic remission. The categories of EDs were analyzed separately (Anorexia Nervosa (AN); Bulimia Nervosa (BN); Binge Eating (BED); (EDs). All 5 CSRs were assessed as high quality according to the AMSTAR. Conclusions: Current evidences suggest that for AN, Family Therapy may be effective for younger patients; For BN and BED, Cognitive Behavior Therapy is effective and your combination with antidepressants too, despite likely side effects; For BED, self-help may be effective as first step and less for BN also. However, are required further studies with larger samples, which analyses treatments according to ages, chronicity of disease, psychiatric comorbidities (especially anxiety and depression) and subtypes of EDs. Furthermore, preventive and promotional strategies are needed as well as the dissemination of knowledge on EDs for health professionals in general.
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    Efetividade e segurança dos fibratos no diabetes mellitus tipo 2: protocolo de revisão sistemática
    (Universidade Federal de São Paulo (UNIFESP), 2014-09-24) Bonates, Milla Canicali [UNIFESP]; Silva, Cristiane Rufino da Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The type 2 diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Type 2 diabetes is the predominant form of disease, accounting for 90% of cases globally. The cardiovascular disease (CVD) is the main cause of morbidity and mortality in people with type 2 diabetes and correction of diabetic dyslipidemia might be the most important factor in reducing cardiac risk. Dyslipidemia in patients with T2DM is characterized by high triglyceride levels, low HDL-cholesterol levels, and a preponderance of small, dense, LDL-cholesterol particles. Although the statins have been shown to significantly reduce LDL-cholesterol levels, they do not specifically address the high triglyceride levels and low HDL-cholesterol levels observed in diabetic patients, both of which have been shown to be independent predictors for occurrence of adverse cardiovascular events. The fibrates are lipid-lowering medications and their major effects are to lower serum triglycerides and to raise HDL-cholesterol concentrations. Although the fibrates favorably affect two of the fundamental abnormalities of diabetic dyslipidemia, the net of CVD effects of this class of drugs remain uncertain. A systematic review of the literature is obligatory to define how effective and safe is the fibrates for the cardiovascular disease prevention in type 2 diabetes mellitus. Objective: To assess the effects of fibrates on people with type 2 diabetes mellitus. Systematic review with Cochrane methodology. Search strategy: Databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, databases of ongoing trials, hand searched reference lists of published articles and conference meetings. Pharmaceutical companies and authors of published articles were contacted. There was no language restriction. Selection criteria: Randomized controlled trials (RCT) of placebo-controlled or active comparator studies of fibrates in adults with type 2 diabetes mellitus. Data collection & analysis: Data abstraction and quality assessment was performed independently by three investigators according to predetermined criteria and the results were compared to determine the degree of agreement. Quality evaluation was done using the criteria of methodological quality described in Cochrane Handbook. Continuous outcome measures were pooled using weighted mean differences (WMD). Dichotomous outcome measures were pooled using random effects model and results were expressed as relative risks (RR).
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    Efficacy of theophylline in people with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis
    (W B Saunders Co Ltd, 2005-02-01) Ram, Felix SF; Jardim, José Roberto; Atallah, Álvaro Nagib [UNIFESP]; Castro, Aldemar Araujo [UNIFESP]; Mazzini, Renato Coimbra [UNIFESP]; Goldstein, Roger; Lacasse, Yves; Cendon Filha, Sônia Perez [UNIFESP]; Natl Collaborating Ctr Womens & Childrens Hlth; Universidade Federal de São Paulo (UNIFESP); Emergency Med Div; Fed Univ Alagoas; Univ Toronto; Univ Laval
    Objectives: To determine the efficacy of oral theophylline compared with placebo in people with stable chronic obstructive pulmonary disease (COPD).Methods: Systematic review of randomized-controlled trials comparing oral Theophylline; with placebo for a minimum of 7 days in people with stable COPD.Results: Twenty randomized-controlled trials were included in this review. the Meta-analysis; following outcomes showed significant improvement with theophylline compared with placebo: FEV, and FVC both improved with theophylline (weighted mean difference [WMD] 0.10 L; 95% confidence interval [95% CI] 0.04-0.16 and WMD 0.21 L; 95% CI 0.10-0.32, respectively). VO2 max also improved with theophylline (WMD 195.27mL/ min; 95% Cl 112.71-277.83), as did PaO2 and PaCO2 (WMD 3.18mmHg;,95% Cl 1.23-5.13 and WMD -2.36mmHg; 95% Cl -3.52 to -1.21, respectively). Patients preferred theophylline over placebo (relative risk 2.27; 95% Cl 1.26-4.11). Theophylline increased the risk of nausea compared with placebo (RR 7.67; 95% Cl 1.47-39.94).Conclusion: This review has shown that theophylline still has a role in the management of stable COPD, and is preferred by patients over placebo. However, the benefits of theophylline in stable COPD have to be weighed against the risk of adverse effects. (C) 2004 Elsevier B.V. All rights reserved.
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    Eficácia da suplementação oral de zinco no tratamento do zumbido: revisão sistemática de ensaios clínicos randomizados pela metodologia da colaboração cochrane
    (Universidade Federal de São Paulo (UNIFESP), 2013-11-27) Person, Osmar Clayton [UNIFESP]; Torloni, Maria Regina Torloni [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Zinc is an important oligoelement involved in several physiological functions including central neurotransmission. Abnormal zinc physiology has been associated with the onset of tinnitus and systematic administration of zinc has been tested as an alternative treatment for this disorder by several investigators over the last decades. Objectives: To assess the effectiveness and safety of oral zinc supplementation in the treatment of tinnitus. Methods: We conducted systematic searches for randomised controlled trials, in August 2013, that compared zinc supplementation versus placebo for tinnitus in adults (18 years and over). Four electronic databases were searched for relevant studies (Cochrane Central Register of Controlled Trials – CENTRAL- from inception to 2013, PUBMED (1966-2013), EMBASE (1974-2013) and LILACS (1982-2013). There were no language, publication year or publication status restrictions. Two researches independently extracted data and assessed the quality of the studies. Results: Three trials involving a total of 276 patients were included. The quality of these trials in general was moderate. All studies assessed the effect of zinc supplementation on improvement of tinnitus. Tinnitus loudness was evaluated only in two studies (228 patients). There is difference between the groups treated with zinc and placebo (RR=2,32; CI 95% 1,17,4,60) for improvement of tinnitus. For tinnitus loudness, there is no differences between the groups treated and control (MD-0,77; CI 95% -6,35,4,81). Conclusions: Statistical analyses indicate improvement of tinnitus in patients treated with zinc. However, due to small number of trials, the evidence is limited and should be taken with caution. For tinnitus loudness there is no evidence of improvement with zinc supplementation. 8
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    Espectroscopia no FTIR: uma aplicabilidade na área de saúde
    (Universidade Federal de São Paulo (UNIFESP), 2016-09-30) Neves, Karina Ferreira [UNIFESP]; Alves, Maria Teresa de Seixas Alves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: The main goal of this study is through the technique of spectroscopy vibrational molecular in the medium infrared, check the technique potential at the healthcare area. Results: We could observe that this analyses technique can map complex biological samples trough the interaction of eletromagnetic radiation with the substance, determining the energy levels of atoms and molecules, and lastly finding the biochemical composition of the sample. Based in biochemical?s information contained in the FTIR?s images, it is possible generate images of spacial distribution of several components of one specific sample ( like DNA proteins, collagen, among others) with high level of spacial resolution. A great advantage are that are not necessary large and complexes preparations of the samples. Conclusions: The Fourier Transform in Medium Infrared (FTIR) allows the global analysis of the samples with an resolution at the celular level and recently studies have showed that the image generated by the FTIR allows to view the biological?s distribution of multiples molecules of interest to analysis of tissues without pre-analytical modifications of the sample by coloration, as well as, information of the molecular?s structure. So, multiples markers can be identified from the generation of these images trough the FTIR, besides the, exact discrimination of healthy tissues and tumoral tissues; which accordingly leads us to consider the technique as a molecular histopathological tool
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    Estratégia de busca sensibilizada e filtros metodológicos para identificação de ensaios clínicos na base de dados LILACS
    (Universidade Federal de São Paulo (UNIFESP), 2015-12-31) Puga, Maria Eduarda dos Santos [UNIFESP]; Atallah, Alvaro Nagib Atallah [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Sensible search strategy and methodological filters to identify clinical trials on LILACS database Background: The identification and selection of studies are steps to build Systematic Reviews that should be invested. It is fundamental that the search strategy allows finding all relevant studies efficiently to answer with efficacy the formulated question. Objective: To design a group of procedures (guideline) to recover information from LILACS database, through a highly sensible search strategy design formatted for the iAHx interface, added to methodological search filters highly sensible and validated to identify the study design Randomized Clinical Trial (RCT). Methods: Analytical cross-sectional accuracy study. A systematic search was conducted in the literature and we used the Relative Recall methodology for the gold standard nucleus. Results: studies selected through inclusion and exclusion criteria; Methodological search filters to identify RCTs in LILACS – two studies (02) were selected for translation and assessment (Castro AA., 1997 e Manriquez JJ., 2008); Instrument and methodology to assess search filters as an alternative for gold standard (Hand search). Five (05) eligible studies (Robertson, 1969; Sampson, M. 2006; Hoogendan, 2009; Damarell, 2011; Beynon, 2013) a methodology relative recall. For the gold standard nucleus, 286 RCTs or quasi-RCTs were extracted from Cochrane Systematic Reviews and were divided as 88 included and 198 excluded studies composing the standard nucleus through the alternative methodology (relative recall). Four filters were validated, two of them were existing and published in the literature and although they were not translated to the actual database interface use, (Castro and Manriquez), their sensibility was 84% and 92%, respectively. Two filters were proposed by the authors Puga/Atallah 1 and 2 and reached 97% of sensibility and excellent performance on its validation. The best performance filter was Puga/Atallah 2. Conclusion: The Guideline availability to develop high sensibility search strategies. In addition, the Methodological Search Filter Puga/Atallah 2 presented the best performance. We can adopt LILACS as mandatory base for reviewers from Brazil and Latin America.
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    Gestational tissue inflammatory biomarkers at term labor: Asystematic review of literature
    (Wiley, 2018) Hadley, Emily E.; Richardson, Lauren S.; Torloni, Maria R. [UNIFESP]; Menon, Ramkumar
    Parturition at term is characterized by inflammatory overload in both feto-maternal tissues. Despite the large number of individual studies on changes in inflammatory biomarkers linked to labor, a comprehensive profile of them in each of the uterine compartments is not available to better understand their mechanistic contributions to labor. This systematic review investigated the pro- and anti-inflammatory biomarkers reported in intra-uterine tissues (amnion, chorion, decidua, placenta, and myometrium) at term labor. We conducted a systematic review of studies on pro- and anti-inflammatory biomarkers (mRNA and/or protein) reported in feto-maternal tissues during normal human term labor, published in English (1980-2016), in 3 electronic data bases. From a total of 3712 citations, 172 were included for final review. Each tissue expresses a unique set of biomarkers at the time of term labor, but there is significant overlap between tissues. All tissues had IL-6, IL-8, IL-1, COX-2, PGE-2, TNF-, and hCAP18 in common at term labor. Common and unique inflammatory biomarkers are expressed in various feto-maternal compartments at term labor. Increase in pro-inflammatory markers in all gestational tissue signifies their harmonious functional role in promoting labor. Anti-inflammatory markers at term labor are hardly reported.
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    Levodopa for idiopathic restless legs syndrome: Evidence based review
    (Wiley-Blackwell, 2007-10-15) Conti, Cristiane Fiquene; De Oliveira, Marcio Moyses; Andriolo, Regis Bruni; Saconato, Humberto; Atallah, Alvaro Nagib; Valbuza, Juliana Spelta; De Carvalho, Luciane Bizari Coin; Do Prado, Gilmar Fernandes; Universidade Federal de São Paulo (UNIFESP)
    Restless legs syndrome (RLS) is a sensory motor disorder characterized by a distressing urge to move the legs and sometimes also other parts of the body usually accompanied by a marked sense of discomfort or pain in the leg or other affected body part. the prevalence of RLS is estimated at 2.7 to 5% of adults and it is more common in women. the treatment of RLS with levodopa has been reported thus a systematic synthesis of evidence is necessary to evaluate the effectiveness and safety of levodopa for RLS. Systematic review of randomized or quasi-randomized, double blind trials on levodopa. Relief of restless legs symptoms marked on a validated scale, subjective sleep quality, sleep quality measured by night polysomnography and actigraphy, quality of life measured by subjective measures, adverse events associated with the treatments. Nine eligible clinical trials were included. the subjective analyses of these studies showed contradictory results, although the objective analyses showed that treatment group had a statistically significant improvement of periodic leg movement (PLM) index, favoring the treatment group. the most commonly adverse event seen was gastrointestinal symptoms. the short-term treatment with levodopa was demonstrated effective and safety for PLM, but there was only few trials assessing long-term treatment and the augmentation phenomenon in RLS. Further long-term randomized controlled trials using standard follow-up measurements as the International RLS Study Group Rating Scale are necessary. (C) 2007 Movement Disorder Society.
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    Mannitol for acute stroke
    (Lippincott Williams & Wilkins, 2008-02-01) Bereczki, Daniel; Liu, Ming; Prado, Gilmar Fernandes do [UNIFESP]; Fekete, Istvan; Semmelweis Univ; Univ Debrecen; Sichuan Univ; Universidade Federal de São Paulo (UNIFESP)
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    The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs
    (Sage Publications Ltd, 2017) Brosseau, Lucie; Taki, Jade; Desjardins, Brigit; Thevenot, Odette; Fransen, Marlene; Wells, George A.; Imoto, Aline Mizusaki [UNIFESP]; Toupin-April, Karine; Westby, Marie; Alvarez Gallardo, Inmaculada C.; Gifford, Wendy; Laferriere, Lucie; Rahman, Prinon; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Shallwani, Shirin Mehdi; Aburub, Ala'; Bennell, Kim L.; Van der Esch, Martin; Simic, Milena; McConnell, Sara; Harmer, Alison; Kenny, Glen P.; Paterson, Gail; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; McLean, Linda
    Objective: To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis. Methods: A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, D-) was used, based on statistical significance (P < 0.5) and clinical importance (15% improvement). Results: The four high-quality studies identified demonstrated that various mind-body exercise programs are promising for improving the management of knee osteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical function (Grade C+). Tai Chi Qigong demonstrated significant improvement for quality of life (Grade B), pain relief (Grade C+) and physical function (Grade C+). Sun style Tai Chi gave significant improvement for pain relief (Grade B) and physical function (Grade B). Conclusion: Mind-body exercises are promising approaches to reduce pain, as well as to improve physical function and quality of life for individuals with knee osteoarthritis.
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    The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part three: aerobic exercise programs
    (Sage Publications Ltd, 2017) Brosseau, Lucie; Taki, Jade; Desjardins, Brigit; Thevenot, Odette; Fransen, Marlene; Wells, George A.; Imoto, Aline Mizusaki [UNIFESP]; Toupin-April, Karine; Westby, Marie; Alvarez Gallardo, Inmaculada C.; Gifford, Wendy; Laferriere, Lucie; Rahman, Prinon; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Shallwani, Shirin Mehdi; Aburub, Ala'; Bennell, Kim L.; Van der Esch, Martin; Simic, Milena; McConnell, Sara; Harmer, Alison; Kenny, Glen P.; Paterson, Gail; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; McLean, Linda
    Objectives: To identify effective aerobic exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. Methods: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) was used, based on statistical significance (P < 0.5) and clinical importance (15% improvement). Results: The five high-quality studies included demonstrated that various aerobic training exercises are generally effective for improving knee osteoarthritis within a 12-week period. An aerobic exercise program demonstrated significant improvement for pain relief (Grade B), physical function (Grade B) and quality of life (Grade C+). Aerobic exercise in combination with strengthening exercises showed significant improvement for pain relief (3 Grade A) and physical function (2 Grade A, 2 Grade B). Conclusion: A short-term aerobic exercise program with/without muscle strengthening exercises is promising for reducing pain, improving physical function and quality of life for individuals with knee osteoarthritis.
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    The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs
    (Sage Publications Ltd, 2017) Brosseau, Lucie; Taki, Jade; Desjardins, Brigit; Thevenot, Odette; Fransen, Marlene; Wells, George A.; Imoto, Aline Mizusaki [UNIFESP]; Toupin-April, Karine; Westby, Marie; Alvarez Gallardo, Inmaculada C.; Gifford, Wendy; Laferriere, Lucie; Rahman, Prinon; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Shallwani, Shirin Mehdi; Aburub, Ala'; Bennell, Kim L.; Van der Esch, Martin; Simic, Milena; McConnell, Sara; Harmer, Alison; Kenny, Glen P.; Paterson, Gail; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; McLean, Linda
    Objective: To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. Methods: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+ or D-) was based on statistical significance (p<0.5) and clinical importance (15% improvement). Results: The 26 high-quality studies identified demonstrated that various strengthening exercise programs with/without other types of therapeutic exercises are generally effective for improving knee osteoarthritis management within a six-month period. Strengthening exercise programs demonstrated a significant improvement for pain relief (four Grade A, ten Grade B, two Grade C+), physical function (four Grade A, eight Grade B) and quality of life (three Grade B). Strengthening in combination with other types of exercises (coordination, balance, functional) showed a significant improvement in pain relief (three Grade A, 11 Grade B, eight Grade C+), physical function (two Grade A, four Grade B, three Grade C+) and quality of life (one Grade A, one Grade C+). Conclusion: There are a variety of choices for strengthening exercise programs with positive recommendations for healthcare professionals and knee osteoarthritis patients. There is a need to develop combined behavioral and muscle-strengthening strategies to improve long-term maintenance of regular strengthening exercise programs.