IX Conferência Internacional sobre Bibliotecas e Repositórios Digitais da América Latina BIREDIAL – ISTEC : Anais das sessões temáticas

Em sua nona edição, a Conferência Internacional sobre Bibliotecas e Repositórios Digitais da América Latina foi realizada na Universidade Nove de Julho, em São Paulo, Brasil, durante os dias 30 e 31 de julho e 01 e 02 de agosto de 2019 e foi organizada pela Universidade Federal de São Paulo (UNIFESP), Universidade Federal do ABC (UFABC), Instituto de Pesquisas Energéticas e Nucleares (IPEN) e Instituto Tecnológico de Aeronáutica (ITA), com a colaboração LibLink do Consórcio Ibero-Americano para a Educação em Ciência e Tecnologia (ISTEC). A Conferência Internacional BIREDIAL-ISTEC dedica-se a compartilhar o conhecimento a uma ampla comunidade universitária e de diferentes disciplinas de conhecimento, comprometidas com a iniciativa de acesso aberto. O objetivo do evento é expor, discutir em analisar as questões que envolvem a iniciativa: materiais para acesso aberto, o problema especial dos dados pesquisa, provisão, preservação e disseminação de obras, atenção aos direitos autorais e reprodutibilidade da investigação, capacitação dos recursos humanos para a gestão em plataformas digitais em acesso aberto.Universidade Federal de São Paul

IX Conferência Internacional sobre Bibliotecas e Repositórios Digitais da América Latina BIREDIAL – ISTEC : Anais das sessões temáticas

Em sua nona edição, a Conferência Internacional sobre Bibliotecas e Repositórios Digitais da América Latina foi realizada na Universidade Nove de Julho, em São Paulo, Brasil, durante os dias 30 e 31 de julho e 01 e 02 de agosto de 2019 e foi organizada pela Universidade Federal de São Paulo (UNIFESP), Universidade Federal do ABC (UFABC), Instituto de Pesquisas Energéticas e Nucleares (IPEN) e Instituto Tecnológico de Aeronáutica (ITA), com a colaboração LibLink do Consórcio Ibero-Americano para a Educação em Ciência e Tecnologia (ISTEC). A Conferência Internacional BIREDIAL-ISTEC dedica-se a compartilhar o conhecimento a uma ampla comunidade universitária e de diferentes disciplinas de conhecimento, comprometidas com a iniciativa de acesso aberto. O objetivo do evento é expor, discutir em analisar as questões que envolvem a iniciativa: materiais para acesso aberto, o problema especial dos dados pesquisa, provisão, preservação e disseminação de obras, atenção aos direitos autorais e reprodutibilidade da investigação, capacitação dos recursos humanos para a gestão em plataformas digitais em acesso aberto.Universidade Federal de São Paul

IX Conferência Internacional sobre Bibliotecas e Repositórios Digitais da América Latina BIREDIAL – ISTEC : Anais das sessões temáticas

Em sua nona edição, a Conferência Internacional sobre Bibliotecas e Repositórios Digitais da América Latina foi realizada na Universidade Nove de Julho, em São Paulo, Brasil, durante os dias 30 e 31 de julho e 01 e 02 de agosto de 2019 e foi organizada pela Universidade Federal de São Paulo (UNIFESP), Universidade Federal do ABC (UFABC), Instituto de Pesquisas Energéticas e Nucleares (IPEN) e Instituto Tecnológico de Aeronáutica (ITA), com a colaboração LibLink do Consórcio Ibero-Americano para a Educação em Ciência e Tecnologia (ISTEC). A Conferência Internacional BIREDIAL-ISTEC dedica-se a compartilhar o conhecimento a uma ampla comunidade universitária e de diferentes disciplinas de conhecimento, comprometidas com a iniciativa de acesso aberto. O objetivo do evento é expor, discutir em analisar as questões que envolvem a iniciativa: materiais para acesso aberto, o problema especial dos dados pesquisa, provisão, preservação e disseminação de obras, atenção aos direitos autorais e reprodutibilidade da investigação, capacitação dos recursos humanos para a gestão em plataformas digitais em acesso aberto.Universidade Federal de São Paul

Eficácia e segurança dos antipsicóticos atípicos (quetiapina, risperidona, aripiprazol, paliperidona) em comparação com um placebo ou medicamentos antipsicóticos típicos no tratamento da esquizofrenia refratária: overview de revisão sistemática

CONTEXT AND OBJECTIVE: According to some cohort studies, the prevalence of refractory schizophrenia (RS) is 20-40%. Our aim was to evaluate the effectiveness and safety of aripiprazole, paliperidone, quetiapine and risperidone for treating RS. METHODS: This was a critical appraisal of Cochrane reviews published in the Cochrane Library, supplemented with reference to more recent randomized controlled trials (RCTs) on RS. The following databases were searched: Medical Literature Analysis and Retrieval System Online (Medline) (1966-2009), Controlled Trials of the Cochrane Collaboration (2009, Issue 2), Embase (Excerpta Medica) (1980-2009), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) (1982-2009). There was no language restriction. Randomized controlled trials, systematic reviews and meta-analyses evaluating atypical antipsychotics for treating RS were included. RESULTS: Seven Cochrane systematic reviews and 10 additional RCTs were included in this review. The data generally showed minor differences between the atypical antipsychotics evaluated and typical antipsychotics, regarding improvement in disease symptoms, despite better adherence to treatment with atypical antipsychotics. Risperidone was specifically evaluated in patients with RS in one of the systematic reviews included, with favorable outcomes, but without definitive superiority compared with other drugs of proven efficacy, like amisulpride, clozapine and olanzapine. CONCLUSIONS: The findings underscore the difficulty in treating these patients, with high dropout rates and treatment patterns of modest improvement in assessments of effectiveness. Atypical antipsychotics have advantages over typical antipsychotics mainly through their better safety profile, which leads to better adherence to treatment. A combination of antipsychotics may also be an option for some refractory patients.CONTEXTO E OBJETIVO: De acordo com alguns estudos de coorte, a prevalência da esquizofrenia refratária (ER) está entre 20-40%. Nosso objetivo foi avaliar a efetividade e segurança de aripiprazol, paliperidona, quetiapina e risperidona no tratamento da esquizofrenia refratária. MÉTODOS: Avaliação crítica das revisões Cochrane publicadas na Biblioteca Cochrane e complementação com referências de ensaios clínicos randomizados (ECRs) mais atualizados sobre ER. As seguintes bases de dados foram pesquisadas: Medline (Medical Literature Analysis and Retrieval System Online) (1966-2009), Ensaios Controlados da Colaboração Cochrane (2009, edição 2), Embase (Excerpta Database) (1980-2009), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) (1982-2009). Não houve restrição a idiomas. Ensaios clínicos randomizados, revisões sistemáticas e metanálises que avaliaram antipsicóticos atípicos no tratamento da esquizofrenia refratária foram incluídos. RESULTADOS: Sete revisões sistemáticas Cochrane e 10 ECRs complementares foram incluídos nessa revisão. No geral os dados demonstram pequenas diferenças entre os antipsicóticos atípicos avaliados e os típicos na melhora dos sintomas da doença, apesar da melhor adesão ao tratamento com os atípicos. A risperidona foi avaliada especificamente em pacientes com esquizofrenia refratária em uma das revisões sistemáticas incluídas, a qual demonstrou desfechos favoráveis, porém não definitivos quando comparada a drogas também com eficácia comprovada como amisulprida, clozapina e olanzapina. CONCLUSÕES: Os dados reforçam a dificuldade de tratar esses pacientes, com elevadas taxas de desistência do tratamento e padrões de melhora modestos nas avaliações de eficácia. Os antipsicóticos atípicos têm vantagens sobre os típicos principalmente pelo melhor perfil de segurança, o que leva a melhor adesão ao tratamento. A associação de antipsicóticos também pode ser uma opção em alguns pacientes refratários ao tratamento.Universidade Federal de São Paulo (UNIFESP) Brazilian Cochrane CenterUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Brazilian Cochrane CenterUNIFESP, Brazilian Cochrane CenterUNIFESP, EPM, Brazilian Cochrane CenterSciEL

Zinc supplementation for tinnitus

Background Tinnitus is the perception of sound without external acoustic stimuli. Patients with severe tinnitus may have physical and psychological complaints and their tinnitus can cause deterioration in their quality of life. At present no specific therapy for tinnitus has been found to be satisfactory in all patients. In recent decades, a number of reports have suggested that oral zinc supplementation may be effective in the management of tinnitus. Since zinc has a role in cochlear physiology and in the synapses of the auditory system, there is a plausible mechanism of action for this treatment. Objectives To evaluate the effectiveness and safety of oral zinc supplementation in the management of patients with tinnitus. Search methods The Cochrane ENT Information Specialist searched the ENT Trials Register; Central Register of Controlled Trials (CENTRAL 2016, Issue 6); PubMed; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 14 July 2016. Selection criteria Randomised controlled trials comparing zinc supplementation versus placebo in adults (18 years and over) with tinnitus. Data collection and analysis We used the standard methodological procedures recommended by Cochrane. Our primary outcome measures were improvement in tinnitus severity and disability, measured by a validated tinnitus‐specific questionnaire, and adverse effects. Secondary outcomes were quality of life, change in socioeconomic impact associated with work, change in anxiety and depression disorders, change in psychoacoustic parameters, change in tinnitus loudness, change in overall severity of tinnitus and change in thresholds on pure tone audiometry. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics. Main results We included three trials involving a total of 209 participants. The studies were at moderate to high risk of bias. All included studies had differences in participant selection criteria, length of follow‐up and outcome measurement, precluding a meta‐analysis. The participants were all adults over 18 years with subjective tinnitus, but one study conducted in 2013 (n = 109) included only elderly patients. Improvement in tinnitus severity and disability Only the study in elderly patients used a validated instrument (Tinnitus Handicap Questionnaire) for this primary outcome. The authors of this cross‐over study did not report the results of the two phases separately and found no significant differences in the proportion of patients reporting tinnitus improvement at four months of follow‐up: 5% (5/93) versus 2% (2/94) in the zinc and placebo groups, respectively (risk ratio (RR) 2.53, 95% confidence interval (CI) 0.50 to 12.70; very low‐quality evidence). None of the included studies reported any significant adverse effects. Secondary outcomes For the secondary outcome change in tinnitus loudness, one study reported no significant difference between the zinc and placebo groups after eight weeks: mean difference in tinnitus loudness ‐9.71 dB (95% CI ‐25.53 to 6.11; very low‐quality evidence). Another study also measured tinnitus loudness but used a 0‐ to 100‐point scale. The authors of this second study reported no significant difference between the zinc and placebo groups after four months: mean difference in tinnitus loudness rating scores 0.50 (95% CI ‐5.08 to 6.08; very low‐quality evidence). Two studies used unvalidated instruments to assess tinnitus severity. One (with 50 participants) reported the severity of tinnitus using a non‐validated scale (0 to 7 points) and found no significant difference in subjective tinnitus scores between the zinc and placebo groups at the end of eight weeks of follow‐up (mean difference (MD) ‐1.41, 95% CI ‐2.97 to 0.15; very low‐quality evidence). A third trial (n = 50) also evaluated the improvement of tinnitus using a non‐validated instrument (a 0 to 10 scale: 10 = severe and unbearable tinnitus). In this study, after eight weeks there was no difference in the proportion of patients with improvement in their tinnitus, 8.7% (2/23) treated with zinc versus 8% (2/25) of those who received a placebo (RR 1.09, 95% CI 0.17 to 7.10, very low‐quality evidence). None of the included studies reported any of our other secondary outcomes (quality of life, change in socioeconomic impact associated with work, change in anxiety and depression disorders, change in psychoacoustic parameters or change in thresholds on pure tone audiometry). Authors' conclusions We found no evidence that the use of oral zinc supplementation improves symptoms in adults with tinnitus.National Institute for Health Research, UKMedicina, Medical School, Universidade Federal de São Paulo, Rua Pedro de Toledo, 598, São Paulo, São Paulo, 04039-001, BrazilBrazilian Cochrane Centre, Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde, São Paulo, BrazilMedicine and Evidence Based Medicine, Universidade Federal de São Paulo, São Paulo, BrazilMedicina, Medical School, Universidade Federal de São Paulo, Rua Pedro de Toledo, 598, São Paulo, São Paulo, 04039-001, BrazilMedicine and Evidence Based Medicine, Universidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Uso de albumina como fator de risco para mortalidade intra-hospitalar em pacientes portadores de queimaduras no Brasil: coorte histórica não concorrente

CONTEXT AND OBJECTIVE: Among burn patients, it is common to use colloidal substances under the justification that it is necessary to correct the oncotic pressure of the plasma, thereby reducing the edema in the burnt area and the hypotension. The aim here was to assess the risk of hospital mortality, comparing the use of albumin and crystalloid solutions for these patients. DESIGN AND SETTING: Non-concurrent historical cohort study at Faculdade de Medicina de Marília; within the Postgraduate program on Internal and Therapeutic Medicine, Universidade Federal de São Paulo (UNIFESP); and at the Brazilian Cochrane Center. METHODS: Burn patients hospitalized between 2000 and 2001, with registration in the Hospital Information System, who received albumin, were compared with those who received other types of volume replacement. The primary outcome was the hospital mortality rate. The data were collected from files within the Datasus software. RESULTS: 39,684 patients were included: 24,116 patients with moderate burns and 15,566 patients with major burns. Among the men treated with albumin, the odds ratio for the risk of death was 20.58 (95% confidence interval, CI: 11.28-37.54) for moderate burns and 6.24 (CI 5.22-7.45) for major burns. Among the women, this risk was 40.97 for moderate burns (CI 21.71-77.30) and 7.35 for major burns (CI 5.99-9.01). The strength of the association between the use of albumin and the risk of death was maintained for the other characteristics studied, with statistical significance. CONCLUSION: The use of albumin among patients with moderate and major burns was associated with considerably increased mortality.CONTEXTO E OBJETIVO: Em pacientes queimados é comum o uso de substâncias coloidais sob justificativa de que é necessário corrigir a pressão oncótica do plasma, reduzindo o edema na área queimada e a hipotensão. O objetivo foi avaliar o risco de mortalidade hospitalar, comparando o uso de albumina e soluções cristaloides para esses pacientes. TIPO DE ESTUDO E LOCAL: Estudo coorte histórico não concorrente na Faculdade de Medicina de Marília, no Programa de Pós-Graduação em Medicina Interna e Terapêutica da Universidade Federal de São Paulo (UNIFESP) e no Centro Cochrane do Brasil. MÉTODOS: Pacientes queimados hospitalizados entre 2000 e 2001, registrados no Sistema de Informações Hospitalares e que receberam albumina foram comparados com aqueles que receberam outros tipos de reposição volêmica. O desfecho primário foi a taxa de mortalidade hospitalar. Os dados foram coletados dos arquivos do programa Datasus. RESULTADOS: Foram incluídos 39.684 pacientes: sendo 24.116 pacientes com queimaduras moderadas e 15.566 pacientes com queimaduras graves. Entre os homens tratados com albumina, o odds ratio para o risco de morte foi 20,58 (intervalo de confiança IC 95% 11,28-37,54) para queimaduras moderadas e 6,24 (IC 5,22-7,45) para queimaduras graves. Entre as mulheres, esse risco foi de 40,97 para queimaduras moderadas (IC 21,71-77,30) e 7,35 para queimaduras graves (IC 5,99-9,01). A força da associação entre o uso de albumina e o risco de morte foi mantida para as outras características estudadas, com significância estatística. CONCLUSÃO: O uso de albumina entre pacientes com queimaduras moderadas e graves foi associado a aumento considerável da mortalidade.Faculdade de Medicina de MaríliaUniversidade Federal de UberlândiaBrazilian Cochrane CenterUniversidade Federal de São Paulo (UNIFESP) Department of Emergency and Evidence-Based MedicineUNIFESP, Department of Emergency and Evidence-Based MedicineSciEL

Estratégias governamentais não medicamentosas para COVID-19 - Scoping review

Background and objectives: The new coronavirus pandemic has so far caused around 3 million deaths worldwide and significant changes in the population's routine. Social distancing, the use of masks and general restrictions are advocated by governments as mandatory non-drug primary strategies, which must be incorporated into society for a long time. The present study aimed to evaluate the effectiveness of governmental non-drug strategies for COVID-19. Study design: This is a scoping review. Methodology: Search for studies at Medline / PUBMED, at the Cochrane Library and at EMBASE. DECS descriptors were used and there were no geographical and temporal restrictions on publications. The inclusion criteria involved human studies covering exposure to governmental non-drug strategies, with social distance, the use of masks and lockdown being a priority. Results: The search strategy retrieved 365 citations and, of these, 9 studies were included in this review. Discussion: Most studies involve observational studies and suggest that social distance, lockdown and the use of facial masks can reduce the incidence of new cases of COVID-19. Conclusion: The strategies of physical distance, lockdown and the use of facial masks had a beneficial result in most of the studies analyzed, contributing to the reduction of new cases of COVID-19.Contextualização e objetivos: A pandemia do novo coronavírus causou até o momento cerca de 3 milhões de mortes no mundo e mudanças significativas na rotina da população. O distanciamento social, o uso de máscaras e as restrições gerais são preconizadas pelos governos como estratégias primárias obrigatórias não medicamentosas, que devem ser incorporadas à sociedade por muito tempo. O presente estudo teve como objetivo avaliar a eficácia das estratégias governamentais não medicamentosas para COVID-19. Desenho de estudo: Trata-se de scoping review. Metodologia: Procedeu-se à busca por estudos no Medline/PUBMED, na Cochrane Library e na EMBASE. Foram utilizados descritores do DECS e não houve restrição geográfica e temporal das publicações. Os critérios de inclusão envolveram estudos em humanos abrangendo a exposição às estratégias governamentais não medicamentosas, sendo prioridade o distanciamento social, o uso de máscaras e o lockdown. Resultados: A estratégia de busca recuperou 365 citações e, destas, 9 estudos foram incluídos nessa revisão. Discussão: A maioria dos estudos envolve estudos observacionais e sugerem que o distanciamento social, o lockdown e o uso de máscaras faciais podem reduzir a incidência de novos casos de COVID-19. Conclusão: As estratégias de distanciamento físico, de lockdown e o uso de máscaras faciais apresentaram resultado benéfico na maioria dos estudos analisados, contribuindo para a redução de novos casos de COVID-19

Bioidentical hormones for women with vasomotor symptoms

Background Various hormone therapies (HT) are available to treat menopausal vasomotor symptoms. Bioidentical hormones are chemically identical to those produced by the human body, and several types are well-tested and available on prescription. Many women have opted for bioidentical hormone therapy (BHT) on the assumption that it is safer than other forms of HT. We evaluated the evidence. Objectives To determine the effectiveness and safety of bioidentical hormones compared to placebo or non-bioidentical hormones for the relief of vasomotor symptoms. Search methods In July 2015 we searched the Cochrane Central Register of Controlled Trials, PubMed, Embase, Literatura Latino-Americana e do Caribe em Ciencias da Saude (LILACS), registers of ongoing trials and the reference lists of articles retrieved. Selection criteria Randomised controlled trials (RCTs) comparing bioidentical hormone therapy (BHT) versus placebo or non-bioidentical hormones. Data collection and analysis We used standard methodological procedures expected by the Cochrane Collaboration. Our primary outcome was vasomotor symptoms (hot flushes and night sweats). We evaluated the overall quality of the evidence using Grading of Recommendations Assessment, Development and Evaluation criteria (GRADE). Main results We included 23 RCTs (5779 participants). Most studies (20/23) included only women with moderate to severe hot flushes. All studies compared unopposed 17 beta-estradiol (beta-estradiol) versus placebo or conjugated equine estrogens (CEE). None of the studies reported night sweats as a separate outcome. BHT patch versus placebo Frequency of hot flushes Four RCTs reported data suitable for analysis. There were fewer hot flushes in the BHT group, with a moderate to large effect size (SMD -0.68, 95% CI -0.83 to -0.53, four RCTs, 793 women, I-2 = 67%, low quality evidence). There was moderate heterogeneity, but a consistent direction of effect. Seven RCTs reported data unsuitable for analysisall reported a benefit in the intervention group. Symptom intensity Two RCTs reported analysable data. Measured on a 0-100 visual analogue scale (VAS), hot flush intensity was lower in the BHT group (MD -19.94 points, 95% CI -24.86 to -15.02, two RCTs, 393 women, I-2 = 54%, low quality evidence). There was moderate heterogeneity, but a consistent direction of effect. Adverse effects Adverse events (such as headache, vaginal bleeding, breast tenderness and skin reactions) were more common in the intervention group (odds ratio (OR) 2.14, 95% CI 1.29 to 3.54, 9 RCTs, 1822 women, I-2 = 73%, low quality evidence). There was moderate heterogeneity, but a consistent direction of effect. In one study, five women in the intervention group developed endometrial hyperplasia. BHT gel versus placebo Hot flush frequency Three RCTs reported this outcome, but the data were unsuitable for analysis. All reported a benefit in the BHT group. Adverse effects Adverse events were more common in the BHT group (OR 1.41, 95% CI 1.09 to 1.83, 3 RCTs, 1086 women, I-2 = 0%, moderate quality evidence). Oral BHT versus placebo Hot flush frequency Two studies reported analysable data. There were fewer hot flushes in the BHT group, with a moderate to large effect size (SMD -0.80, 95% CI -1.03 to -0.57, two RCTs, 356 women, I-2 = 14%, low quality evidence). Adverse effects There was no evidence of a difference between the groups (OR 1.28, 95% CI 0.84 to 1.96, 3 RCTs, 433 women, I-2 = 0%, low quality evidence). Topical BHT emulsion versus placebo Hot flush frequency One study with data unsuitable for analysis reported a benefit in the intervention group. Adverse effects There was no evidence of a difference between the groups (OR 1.46, 95% CI 0.80 to 2.66, one RCT, 200 women, low quality evidence). Intranasal BHT versus placebo Hot flush frequency Only one study reported analysable data. There were fewer hot flushes per day in the BHT group (MD -3.04 95% CI -4.05 to -2.03, one study, 458 women, moderate quality evidence) Adverse effects Adverse events (such as headache, breast tenderness, arthralgia and nausea) were more common in the intervention group (OR 1.96, 95% CI 1.26 to 3.03, one RCT, 458 women, moderate quality evidence). Subgroup analyses Subgroup analyses by dose of BHT suggested that higher doses of BHT may be associated with more effectiveness but also higher risk of adverse effects. BHT patch versus 0.625 mg CEE Two RCTs reported this comparison, but the data were unsuitable for analysis. Hot flush frequency Both RCTs reported no evidence of a difference between the groups. Adverse effects Findings were inconsistent. In one comparison (0.1 mg BHT versus CEE), breast pain and vaginal bleeding were more frequent in the BHT group. Oral BHT versus 0.625 mg CEE Hot flush frequency One study with data unsuitable for analysis reported no evidence of a difference between the groups. Adverse effects There was no evidence of a difference between the groups (OR 1.20, 95% CI 0.50 to 2.87, one RCT, 103 women, very low quality evidence). Authors' conclusions There was low to moderate quality evidence that BHT in various forms and doses is more effective than placebo for treating moderate to severe menopausal hot flushes. There was low to moderate quality evidence of higher rates of adverse effects such as headache, vaginal bleeding, breast tenderness and skin reactions in the BHT group. There was some evidence to suggest that higher doses of BHT are associated with greater effectiveness but also with higher risk of adverse effects. Although all the included studies used unopposed estrogen, it is recommended best practice to use progestogen therapy in women with a uterus taking estrogen in order to avoid endometrial hyperplasia, regardless of the source of the estrogen. No data are yet available about the safety of BHT with regard to long-term outcomes such as heart attack, stroke and breast cancer. There was no good evidence of a difference in effectiveness between BHT and CEE, and findings with regard to adverse effects were inconsistent. The quality of the evidence was too low to reach any firm conclusions. The main limitations in the quality of the evidence were study risk of bias (mainly due to poor reporting of methods), imprecision and lack of data suitable for analysis.Brazilian Cochrane Centre, BrazilSchool of Sciences of Health/FEPECS, Management of educational evaluation, Brasília, BrazilCentro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde, Brazilian Cochrane Centre, São Paulo, São Paulo, BrazilUniversity of Auckland, Department of Obstetrics and Gynaecology, Auckland, New ZealandUniversidade Federal de São Paulo, Emergency Medicine and Evidence Based Medicine, São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, Emergency Medicine and Evidence Based Medicine, São Paulo, São Paulo, BrazilWeb of Scienc