Brazilian oral herbal medication for osteoarthritis: a systematic review protocol

Abstract Background Osteoarthritis affects 1 % of the world’s population and is the most common cause of musculoskeletal impairment in the elderly. Herbal medications are commonly used in Brazil to manage symptoms associated with osteoarthritis, and some of them are financed by the Brazilian government; however, the effectiveness of most of these agents is uncertain. The aim was to systematically review the efficacy and safety of 13 oral herbal medications used in Brazil for the treatment of osteoarthritis. Methods Randomized clinical trials eligible for our systematic review will enroll adults with osteoarthritis treated by a Brazilian herbal medication or a control group (placebo or active control). Using terms to include all forms of osteoarthritis combined with herbal medications, we will search the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CINAHL; Web of Science; Health Star; AMED, the database of the Cochrane Complementary Medicine Field, LILACS; CAB abstracts, Clinical trial.gov, WHO trials registry, and Bank of Brazil Thesis (CAPES), to 31 January 2016, without restrictions concerning language or status of publication. Outcomes of interest include the following: symptom relief (e.g., pain), adverse events (gastrointestinal bleeding, epigastric pain, nausea, and allergic reactions), discontinuation due to adverse events, quality of life, and the satisfaction with the treatment. Dichotomous data will be summarized as risk ratios; continuous data will be given as standard average differences with 95 % confidence intervals. A team of reviewers will assess each citation independently for eligibility and in duplicate it. For eligible studies, the same reviewers will perform data extraction, bias risk assessment, and determination of the overall quality of evidence for each of the outcomes using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification system. Discussion This is the first study that will evaluate the use of herbal medications used in Brazil for the treatment of pain caused by osteoarthritis. The results could guide prescribers in decision-making in clinical practice, to inform the patients with pain caused by osteoarthritis in relation to effective and safe treatment options and to inform the managers of the public health system which of the plants could actually be financed by the Brazilian government. Systematic review registration PROSPERO 4201501979

Revista Materia

En este trabajo se exploró el comportamiento y los mecanismos de daño de un panel laminado compuesto a partir de materiales poliméricos y cerámicos, ante el impacto de un proyectil metálico. Se realizó el diseño de un sistema con la cara de impacto en material cerámico (SiC), con respaldo elaborado en polietileno de peso molecular ultra alto (UHMWPE), placas elaboradas con geometría cuadrada de 200 mm de lado y 5 mm de espesor, y cortes de tejido polimérico con iguales dimensiones de área. Se tomó como referencia el montaje de la norma (NIJ) Standard 0101.06 para el ensayo a impacto balístico; en el material cerámico se identificó la formación de cráter, fracturas y delaminación como mecanismos de falla predominantes, utilizando microscopia óptica y de barrido; en el material polimérico se observó fibrilación, torsión, fusión de fibras, delaminación y deformación cónica y posteriormente se analizaron las muestras empleando los modelos de balance de energía cinética de "Morye, Smith y de Retch e Ipson". El resultado evidenció que el arreglo con mayor influencia para disipar energía, es el panel elaborado con doble placa cerámica (SiC) y doble capa de tejido polimérico como respaldo