O papel da fisioterapia no tratamento das cefaleias: revisão de literatura

2016 ◽  
pp. 33-42
Author(s):  
Débora Wanderley ◽  
Joaquim José de Souza Costa Neto ◽  
Marcelo Moraes Valença ◽  
Daniella Araújo de Oliveira
Keyword(s):  
Controlled Trials ◽  
Cochrane Central Register ◽  
Central Register

A intolerância aos movimentos, incapacidade do pescoço e alterações nos músculos pericranianos são aspectos que podem interferir durante as crises de migrânea. A presença destes achados tornou a fisioterapia uma modalidade terapêutica alternativa para as cefaleias. Assim, as desordens estruturais e comportamentais musculares podem promover modificações na biomecânica da cabeça e região cervical, bem como limitações na mobilidade cervical no paciente com cefaleia, as quais podem ser tratadas por meio de diferentes modalidades fisioterapêuticas. O objetivo deste estudo foi revisar as publicações mais relevantes sobre o papel da fisioterapia no tratamento das cefaleias, a fim de fundamentar e direcionar o tratamento não farmacológico destes pacientes. Foi feito um levantamento da literatura, entre setembro/2015 e maio/2016, nas bases de dados MEDLINE/ PubMed, LILACS e Cochrane Central Register of Controlled Trials - CENTRAL, buscando ensaios clínicos randomizados e quasi randomizados sobre o tema. Os descritores do MeSH/DeCS utilizados foram: 'cefaleia', 'modalidades de fisioterapia', e seus equivalentes em inglês. Foram identificados 589 artigos, dos quais 19 foram incluídos, segundo os critérios de elegibilidade. De acordo com os resultados dos estudos avaliados, a fisioterapia promove melhora da cefaleia, dos sintomas associados e das disfunções musculoesqueléticas relacionadas. Entre as modalidades utilizadas estão correção postural, mobilização da coluna, alongamento muscular, técnicas de relaxamento, massagem, exercícios ativos ou passivos, entre outras. Devido à baixa qualidade metodológica da maioria dos estudos, são necessários novos ensaios controlados e randomizados, baseados nos critérios diagnósticos da ICHD, utilizando protocolos descritos de maneira mais detalhada e reprodutível, incluindo a avaliação de efeitos adversos.

Functional cortical changes associated with shoulder instability – a systematic review

2021 ◽  
pp. 175857322110190
Author(s):  
Morissa F Livett ◽  
Deborah Williams ◽  
Hayley Potter ◽  
Melinda Cairns
Keyword(s):  
Systematic Review ◽  
Joint Instability ◽  
Glenohumeral Joint ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Cortical Function ◽  
High Quality Research ◽  
Central Register ◽  
Rehabilitative Measures ◽  
Randomised Controlled

Background Glenohumeral joint instability is associated with structural deficits and/or alterations in sensory and motor processing; however, a proportion of patients with glenohumeral joint instability fail to respond to surgical and rehabilitative measures. This systematic review aimed to establish if functional cortical changes occur in patients with glenohumeral joint instability. Methods AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline, PEDro, Pubmed, PsychINFO and Scopus were searched from inception to 17 March 2021. Randomised controlled trials and non-randomised trials were included and quality was appraised using the Downs and Black tool. Results One thousand two hundred seventy-nine records were identified of which five were included in the review. All studies showed altered cortical function when comparing instability patients with healthy controls and included areas associated with higher cortical functions. Discussion The findings of this systematic review offer some insight as to why interventions addressing peripheral pathoanatomical factors in patients with glenohumeral joint instability may fail in some cases due to functional cortical changes. However, data are of moderate to high risk of bias. Further high-quality research is required to ascertain the degree of functional cortical changes associated with the type and duration of glenohumeral joint instability.

Reducción de eventos cardiovasculares de Lomitapida versus Estatinas en pacientes con diagnóstico de hipercolesterolemia familiar. Protocolo de revisión sistemática.

10.52011/0097 ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Maritza Auxiliadora Torres Valdez ◽  
Lorena Alexandra Muñoz Avila ◽  
Carlos Enrique Ortega Espinoza ◽  
Franklin Geovany Mora Bravo ◽  
Diego Fernando Barzallo Zeas
Keyword(s):  
Controlled Trials ◽  
Cochrane Central Register ◽  
Electronic Library ◽  
Central Register ◽  
Revisión Sistemática

Introducción: La hipercolesterolemia familiar (HF) un trastorno genético autosómico dominante que produce hipercolesterolemia y desarrollo prematuro de enfermedades cardiovasculares. Las estatinas han sido el medicamento de elección en estos pacientes, sin embargo, un buen porcentaje de pacientes no pueden alcanzar sus objetivos terapéuticas con las dosis máximas recomendadas por lo que la Lomitapida se podría establecer como una nueva alternativa de tratamiento. Objetivo: El objetivo de esta revisión sistemática es determinar si la Lomitapida reduce los eventos cardiovasculares en pacientes con diagnóstico de Hipercolesterolemia familiar comparado con estatinas. Métodos: Se incluirán ensayos controlados aleatorios (ECA) y cuasialeatorios de pacientes con diagnóstico de HF. Las medidas de resultado primarias: 1. Niveles de LDL, HDL pos tratamiento. 2. Presencia de eventos cardiovasculares. Las búsquedas electrónicas se realizarán en PUBMED, The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE y Scientific electronic library (Scielo). La evaluación del riesgo de sesgo se utilizará la herramienta de Cochrane. Las medidas del efecto del tratamiento serán las diferencias de medias (DM) y los intervalos de confianza (IC) del 95%. La evaluación de heterogeneidad se realizará mediante la inspección visual del diagrama de embudo. La evaluación de la calidad de la evidencia se realizará usando la evaluación GRADE.

scholarly journals Meta-Analysis: Randomized Trials of Lactobacillus plantarum on Immune Regulation Over the Last Decades

2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Zhao ◽  
Chuantao Peng ◽  
Hafiz Arbab Sakandar ◽  
Lai-Yu Kwok ◽  
Wenyi Zhang
Keyword(s):  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Central Register ◽  
Tnf Α ◽  
Ifn Γ ◽  
The Mean ◽  
Regulatory Effects ◽  
Mean Differences ◽  
Necrosis Factor

Lactobacillus (L.) plantarum strains, belong to lactic acid bacteria group, are considered indispensable probiotics. Here, we performed meta-analysis to evaluate the regulatory effects of L. plantarum on the immunity during clinical trials. This meta-analysis was conducted by searching across four most common literature databases, namely, Cochrane Central Register of Controlled Trials, Web of Science, Embase, and PubMed. Clinical trial articles that met the inclusion and exclusion criteria were analyzed by Review Manager (version 5.3). p-value < 0.05 of the total effect was considered statistically significant. Finally, total of 677 references were retrieved, among which six references and 18 randomized controlled trials were included in the meta-analysis. The mean differences observed at 95% confidence interval: interleukin (IL)-4, −0.48 pg/mL (−0.79 to −0.17; p < 0.05); IL-10, 9.88 pg/mL (6.52 to 13.2; p < 0.05); tumor necrosis factor (TNF)-α, −2.34 pg/mL (−3.5 to −1.19; p < 0.05); interferon (IFN)-γ, −0.99 pg/mL (−1.56 to −0.41; p < 0.05). Therefore, meta-analysis results suggested that L. plantarum could promote host immunity by regulating pro-inflammatory and anti-inflammatory cytokines.

scholarly journals Azithromycin in patients with Covid-19; a systematic review and metanalysis

2021 ◽  
Author(s):  
Luis Ayerbe ◽  
Ivo Forgnone ◽  
Carlos Risco-Risco ◽  
Maria Perez-Pinar ◽  
Salma Ayis
Keyword(s):  
Systematic Review ◽  
Clinical Severity ◽  
Future Research ◽  
Controlled Trials ◽  
Clinical Settings ◽  
Cochrane Central Register ◽  
Random Effects Models ◽  
Central Register ◽  
Significant Difference ◽  
Observational Design

Background: Azithromycin (AZM) has been widely used in the management of Covid-19. However, the evidence on its actual effects remains disperse and difficult to apply in clinical settings. This systematic review and metanalysis summarizes the studies on the beneficial and adverse effect of AZM in patients with Covid-19. Methods: The PRISMA 2020 statement criteria were followed. Randomized controlled trials (RCTs) and observational studies comparing clinical outcomes of patients treated, and not treated, with AZM, indexed until the 5th of July 2021, were searched in PubMed, Embase, The Web of Science, Scopus, The Cochrane Central Register of Controlled Trials, and MedRXivs. We used Random-effects models to estimate pooled effect size from aggregate data. Results: The initial search produced 4950 results. Finally, 16 studies, five RCTs and 11 with an observational design, with a total of 22984 patients, were included. The metanalysis showed no difference in mortality for those treated, or not, with AZM, OR: 0.95 (0.79-1.13). There was also no significant difference for those treated, and not, with AZM in need for hospital admission or time to admission from ambulatory settings, clinical severity, need for intensive care, or adverse effects. Conclusions: These results presented in this review do not support the use of AZM in the management of Covid-19. They also show that any harm caused to the patient who received it is unlikely. Future research on treatment for patients with Covid-19 may need to focus on other drugs

scholarly journals Desenvolvimento de transtornos mentais relacionados à úlcera venosa: revisão sistemática

2019 ◽  
Vol 11 (16) ◽  
pp. e1417
Author(s):  
Adriana Souza Szpalher
Keyword(s):  
Controlled Trials ◽  
Cochrane Central Register ◽  
National Library ◽  
Electronic Library ◽  
Central Register

Objetivo: Avaliar o desenvolvimento de transtornos psicológicos relacionados à presença de úlcera venosa de perna (UVP). Métodos: revisão sistemática em julho de 2019 com metodologia de Donato H e Donato M (2019) e Recomendação PRISMA para responder à questão: há desenvolvimento de transtornos psicológicos relacionados à UVP? Incluídos estudos originais, sem delimitação temporal, em português, inglês e espanhol, nas Bases US National Library of Medicine (PubMed), Biblioteca Virtual de Saúde (BVS), The Cochrane Central Register of Controlled Trials (CENTRAL) abrangendo a Base eletrônica editora Elsevier (EMBASE), Scientific Electronic Library Online (SciELO) e Health Evidence. Resultados: A busca retornou 256 estudos, após análise completa foram excluídos 248 por não atenderem a metodologia e objetivo, resultando em 8 estudos, prevalecendo em inglês. 816 indivíduos foram avaliados, predominando como transtorno mental a depressão. Houve diversidade quanto ao Tipo de estudo. Considerações finais: há pouca produção relacionada à temática e não foi encontrada revisão sistemática. Sugerem-se estudos que aprofundem o impacto dos transtornos psicológicos na UVP, enfatizando os níveis citológico e histológico. Acredita-se que pesquisas futuras trarão reflexões acerca da importância do atendimento psicológico e psiquiátrico, associado à promoção de atividades de bem-estar e do convívio social.

scholarly journals Fluid resuscitation in paediatric burns: how do we get it right? A systematic review of the evidence

2018 ◽  
Vol 104 (3) ◽  
pp. 280-285 ◽  
Author(s):  
Christopher Stutchfield ◽  
Anna Davies ◽  
Amber Young
Keyword(s):  
Systematic Review ◽  
Fluid Resuscitation ◽  
Primary Data ◽  
Controlled Trials ◽  
Burn Shock ◽  
Cochrane Central Register ◽  
Study Protocols ◽  
Central Register ◽  
Affect Patient Outcome ◽  
Randomised Controlled

BackgroundOptimal fluid resuscitation in children with major burns is crucial to prevent or minimise burn shock and prevent complications of over-resuscitation.ObjectivesTo identify studies using endpoints to guide fluid resuscitation in children with burns, review the range of reported endpoint targets and assess whether there is evidence that targeted endpoints impact on outcome.DesignSystematic review.MethodsMedline, Embase, Cinahl and the Cochrane Central Register of Controlled Trials databases were searched with no restrictions on study design or date. Search terms combined burns, fluid resuscitation, endpoints, goal-directed therapy and related synonyms. Studies reporting primary data regarding children with burns (<16 years) and targeting fluid resuscitation endpoints were included. Data were extracted using a proforma and the results were narratively reviewed.ResultsFollowing screening of 777 unique references, 7 studies fulfilled the inclusion criteria. Four studies were exclusively paediatric. Six studies used urine output (UO) as the primary endpoint. Of these, one set a minimum UO threshold, while the remainder targeted a range from 0.5–1.0 mL/kg/hour to 2–3 mL/kg/hour. No studies compared different UO targets. Heterogeneous study protocols and outcomes precluded comparison between the UO targets. One study targeted invasive haemodynamic variables, but this did not significantly affect patient outcome.ConclusionsFew studies have researched resuscitation endpoints for children with burns. Those that have done so have investigated heterogeneous endpoints and endpoint targets. There is a need for future randomised controlled trials to identify optimal endpoints with which to target fluid resuscitation in children with burns.

The safety of restrictive fluid therapy for major abdominal surgery: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Ping Li ◽  
Sheng-Wen Wu ◽  
Dong-Fang Ge ◽  
Zai-Rong Tang ◽  
Cong-Chao Ma ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Fluid Therapy ◽  
Enhanced Recovery ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Major Abdominal Surgery ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Central Register ◽  
Clinical Trials Registry

Abstract Background: Restrictive fluid therapy is essential to enhanced recovery after surgery. A meta-analysis was conducted to explore the safety of restrictive fluid therapy for major abdominal surgery and compare it with liberal fluid therapy. Methodology : We searched MEDLINE, the Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs), the WHO International Clinical Trials Registry Platform, and EMBASE in which restrictive and liberal fluid therapies were compared. Data on complications, anastomotic leaks, and wound infections were extracted. Results: Eleven RCTs comparing the two therapies were included. Compared with liberal fluid therapy, restrictive fluid therapy lowered the risk of complications and cardiopulmonary dysfunction and had similar rates of mortality, anastomotic leak, pneumonia and would infection. But increased kidney injury was also observed in restrictive fluid therapy. Conclusion: Restrictive fluid therapy is safe but may have potential dangers, so caution is warranted in its application.

scholarly journals Efficacy of pharmacological therapies in patients with IBS with diarrhoea or mixed stool pattern: systematic review and network meta-analysis

Gut ◽  
2019 ◽  
Vol 69 (1) ◽  
pp. 74-82 ◽  
Author(s):  
Christopher J Black ◽  
Nicholas E Burr ◽  
Michael Camilleri ◽  
David L Earnest ◽  
Eamonn MM Quigley ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Meta Analysis ◽  
Composite Endpoint ◽  
Response To Therapy ◽  
Stool Consistency ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Once Daily ◽  
Central Register ◽  
Randomised Controlled

ObjectiveOver half of patients with IBS have either diarrhoea (IBS-D) or a mixed stool pattern (IBS-M). The relative efficacy of licenced pharmacological therapies is unclear in the absence of head-to-head trials. We conducted a network meta-analysis to resolve this uncertainty.DesignWe searched MEDLINE, Embase, Embase Classic, the Cochrane central register of controlled trials, and Clinicaltrials.gov through January 2019 to identify randomised controlled trials (RCTs) assessing the efficacy of licenced pharmacological therapies (alosetron, eluxadoline, ramosetron and rifaximin) in adults with IBS-D or IBS-M. Trials included in the analysis reported a dichotomous assessment of overall response to therapy, and data were pooled using a random effects model. Efficacy and safety of all pharmacological therapies were reported as a pooled relative risk with 95% CIs to summarise the effect of each comparison tested. Treatments were ranked according to their p score.ResultsWe identified 18 eligible RCTs (seven alosetron, five ramosetron, two rifaximin and four eluxadoline), containing 9844 patients. All were superior to placebo for the treatment of IBS-D or IBS-M at 12 weeks, according to the Food and Drug Administration (FDA)-recommended endpoint for trials in IBS. Alosetron 1 mg twice daily was ranked first for efficacy, based on the FDA-recommended composite endpoint of improvement in both abdominal pain and stool consistency, effect on global symptoms of IBS and effect on stool consistency. Ramosetron 2.5µg once daily was ranked first for effect on abdominal pain. Total numbers of adverse events were significantly greater with alosetron 1 mg twice daily and ramosetron 2.5µg once daily, compared with placebo. Rifaximin 550 mg three times daily ranked first for safety. Constipation was significantly more common with all drugs, except rifaximin 550 mg three times daily.ConclusionIn a network meta-analysis of RCTs of pharmacological therapies for IBS-D and IBS-M, we found all drugs to be superior to placebo, but alosetron and ramosetron appeared to be the most effective.

scholarly journals Should Finasteride Be Routinely Given Preoperatively for TURP?

ISRN Urology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
O. M. Aboumarzouk ◽  
M. Z. Aslam ◽  
A. Wedderburn ◽  
K. Turner ◽  
O. Hughes ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Vascular Endothelial ◽  
Central Register ◽  
Language Restriction ◽  
Randomised Controlled ◽  
Endothelial Growth Factor

Objective. The aim of the review was to compare the use of finasteride to placebo in patients undergoing TURP procedures. Material & Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966–November 2011), EMBASE (1980–November 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles, and abstracts from conference proceedings without language restriction for studies comparing finasteride to placebo patients needing TURPs. Results. Four randomised controlled trials were included comparing finasteride to a placebo. A meta-analysis was not conducted due to the disparity present in the results between the studies. Three of the studies found that finasteride could reduce either intra- or postoperative bleeding after TURP. One study found finasteride to significantly lower the microvessel density (MVD) and vascular endothelial growth factor (VEGF). None of the studies reported any long-term complications related to either the medication or the procedure. Conclusion. finasteride reduces bleeding either during or after TURP.

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