Eficácia da quick massage no tratamento das dores osteomusculares de funcionários administrativos:

Introdução: A ocorrência de dores osteomusculares pode estar relacionada à atividade executada pelo trabalhador, constituindo um grave problema humano e econômico em todo o país na medida em que a diminuição da eficácia do trabalho está atrelada aos distúrbios osteomusculares relacionados ao trabalho. Objetivo: Este estudo objetivou avaliar os benefícios da quick massage nas queixas de dores osteomusculares de funcionários administrativos de uma instituição escolar. Método: Trata-se de estudo piloto com 12 participantes, divididos em dois grupos que receberam uma (G1) ou duas (G2) sessões semanais de quick massage por oito semanas, avaliados em três momentos. Resultados: Os participantes de ambos os grupos relataram dor durante a jornada de trabalho, com destaque para as regiões corporais de pescoço, lombar e dorsal. Houve redução dos sintomas quando comparadas as avaliações realizadas na primeira e na oitava semana de intervenção, sem diferenças significativas na frequência de aplicação da quick massage. Conclusões: Independentemente da frequência oferecida, a quick massage é um recurso benéfico para a redução de dor em trabalhadores administrativos

Pharmaceutical policies : effects of policies regulating drug marketing

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. Main objective To assess the effects of policies that regulate drug promotion on drug utilization, coverage or access, healthcare utilization, patient outcomes, adverse events and costs. Secondary objective(s) To assess whether the effects of policies that regulate drug promotion to patients/consumers, healthcare professionals, regulators and third-party payers differ according to drug class, clinical indication, target groups and country (high-, middle- or low-income countries)

A influência do membro superior na marcha de indivíduos com hemiparesia: revisão

A compreensão da influência do membro superior na marcha de indivíduos hemiparéticos é de extrema importância. Sendo assim, o trabalho objetivou-se no estudo da importância que o membro superior tem na marcha de pacientes após acidente vascular encefálico (AVE). Foi realizada uma revisão bibliográfica na qual buscou-se artigos científicos nas bases de dados, LILACS, BIREME, SciELO e Cochrane. A pesquisa levou em consideração trabalhos publicados no período de 2002 a 2014. De acordo com os artigos encontrados, concluiu-se que a biomecânica da marcha está diretamente relacionada ao membro superior, sendo assim, qualquer disfunção poderá alterar a marcha de pacientes após AVE

Use of IMMPACT domains in clinical trials of acupuncture for chronic pain: A methodological survey.

Acupuncture is one of the therapeutic resources used for the management of chronic pain. Variability in outcome measurements in randomized clinical trials of non-oncologic chronic pain (RCT-NOCP) generates inconsistencies in determining effects of treatments. The objective of this survey was to assess the adherence to the recommendations made by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) in the measurement of RCT-NOCP of acupuncture. This methodological research made a systematic search for eligible studies from different sources of information. Eligible studies included those with number of patients ≥100, who randomized and allocated patients with chronic non-oncologic pain to be treated with acupuncture or with "sham" acupuncture, or non-acupuncture. This research included the recommendations for IMMPACT in the measurement of RCT-NOCP: presence of outcomes pain, physical function, emotional state and improvement perception of patient, the source of the outcome information pain and the tools used to measure such domains. From a total of 1,386 studies, 24 were included in this survey. Eleven studies presented low risk of bias. Pain outcome was measured in 23 studies, physical function in 22 studies, emotional state in 14 studies and improvement perception of patient in one study. As for the pain outcome, the patient was the information source in 50% of the studies. The measurement tools recommended for IMMPACT were included in eight studies (35%) that evaluated pain, one study that evaluated the emotional state (7%), and one study that evaluated the improvement perception and satisfaction of patient. It was observed that studies which did not adhere to the recommendations had more favorable results for acupuncture in the outcome pain. This study concludes that randomized clinical trials that used acupuncture to manage chronic pain failed to adhere to IMMPACT recommendations. Clinical societies and IMMPACT do not share the same recommendations. This fact reflects in the diversity of outcomes and instruments adopted in the studies, making it difficult to compare the results

Use of second-generation antipsychotics in autism spectrum disorder: a systematic review and meta-analysis protocol

Introduction Atypical antipsychotics have been studied to treat autism spectrum disorder (ASD). However, like little is known about whether these drugs are effective and safe when compared in controlled and non-controlled settings. This study aims to assess the efficacy and safety of second-generation antipsychotics in ASD in randomised controlled trials (RCT) and observational studies.Methods and analysis This systematic review will include RCT and prospective cohorts evaluating second-generation antipsychotics in people 5 years and older diagnosed with ASD. Searches will be conducted in Medline, Embase, Cochrane Library, Epistemonikos, Lilacs, CINAHL, PsycINFO, trial registries and grey literature databases without restriction on publication status, year of publication and language. The primary outcomes will be symptoms of aggressive behaviour, quality of life for the individual or their careers, and discontinuation or dropouts/withdrawals of antipsychotics due to adverse events. The secondary outcomes are other not serious adverse events and adherence to pharmacotherapy. Selection, data extraction, and quality assessment will be performed by pairs of reviewers, independently. The Risk of Bias 2 (RoB 2) and Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-I) tools will be used to assess the risk of bias in the included studies. If appropriate, a meta-analysis and network meta-analysis will be conducted to synthesise the results. The overall quality of the evidence for each outcome will be determined by the Recommendation, Assessment, Development and Evaluation approach.Ethics and dissemination This study will systematically summarise the existing evidence evaluating the use of second-generation antipsychotics for treating ASD, in controlled and uncontrolled studies. The results of this review will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration number CRD42022353795

Factors Associated with the Magnitude Of acUpuncture treatment effectS (FAMOUS): a meta-epidemiological study of acupuncture randomised controlled trials

Objective To identify factors and assess to what extent they impact the magnitude of the treatment effect of acupuncture therapies across therapeutic areas.Data source Medline, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc, between 2015 and 2019.Study selection The inclusion criteria were trials with a total number of randomised patients larger than 100, at least one patient-important outcome and one of two sets of comparisons.Data analysis The potential independent variables were identified by reviewing relevant literature and consulting with experts. We conducted meta-regression analyses with standardised mean difference (SMD) as effect estimate for the dependent variable. The analyses included univariable meta-regression and multivariable meta-regression using a three-level robust mixed model.Results 1304 effect estimates from 584 acupuncture randomised controlled trials (RCTs) were analysed. The multivariable analyses contained 15 independent variables . In the multivariable analysis, the following produced larger treatment effects of large magnitude (>0.4): quality of life (difference of adjusted SMDs 0.51, 95% CI 0.24 to 0.77), or pain (0.48, 95% CI 0.27 to 0.69), or function (0.41, 95% CI 0.21 to 0.61) vs major events. The following produced larger treatment effects of moderate magnitude (0.2–0.4): single-centred vs multicentred RCTs (0.38, 95% CI 0.10 to 0.66); penetration acupuncture vs non-penetration types of acupuncture (0.34, 95% CI 0.15 to 0.53); non-pain symptoms vs major events (0.32, 95% CI 0.12 to 0.52). The following produced larger treatment effects of small magnitude (<0.2): high vs low frequency treatment sessions (0.19, 95% CI 0.03 to 0.35); pain vs non-pain symptoms (0.16, 95% CI 0.04 to 0.27); unreported vs reported funding (0.12, 95% CI 0 to 0.25).Conclusion Patients, clinicians and policy-makers should consider penetrating over non-penetrating acupuncture and more frequent treatment sessions when feasible and acceptable. When designing future acupuncture RCTs, trialists should consider factors that impact acupuncture treatment effects