Comparative effects of fractional radiofrequency and microneedling on the genitalia of postmenopausal women: Histological and clinical changes

Objectives: The authors aimed to evaluate clinical and histological changes induced by Fractional Radiofrequency (FRF) and microneedling in vulvar tissue. Methods: Thirty postmenopausal women were randomly divided into G1 (FRF) and G2 (microneedling) groups. Sub-ablative FRF was executed using disposable fractionated electrodes with an intensity of 8 mJ. Microneedling was performed using a derma roller system. The authors evaluated before and after treatment using the Vaginal Laxity Questionnaire (VLQ), EuroQol Five-Dimensional (EQ-5D) questionnaire, and the Blatt and Kupperman Menopausal Index (BKMI). Additionally, the authors performed biopsies of the labia majora for histological analysis pre- and post-treatment. Data were expressed as mean (± standard deviation). A paired t-test was used for intra-group comparison (pre- and post-treatment), with an independent t-test used to compare intergroup data (both pre- and post-treatment). Results: In the G1 group, the VLQ values showed differences compared to the pre-treatment values with the data obtained 60 days after the beginning of the sessions (p = 0.01). Similarly, the data changes of the G2 group proved to be significant (p = 0.001) across the same time interval. In comparing the groups, VLQ values were not different (p > 0.05). Regarding histological analysis, FRF demonstrated improvement concerning the number of fibroblasts, blood vessels, and fatty degeneration (p < 0.05) compared to the control. Additionally, FRF and microneedling samples showed higher type III collagen and vimentin expression in the immunohistochemical analysis (p < 0.05). Conclusions: The therapies were found to be effective in treating the flaccidity of the female external genitalia. Additionally, histological changes were observed after interventions suggesting collagen remodeling

Impact of microablative fractional radiofrequency on the vaginal health, microbiota, and cellularity of postmenopausal women

OBJECTIVES: We aimed to evaluate the effectiveness of microablative fractional radiofrequency (MAFRF) in the non-hormonal treatment of genitourinary syndrome of menopause. METHODS: We examined the cases of 55 postmenopausal women before and after treatment with regard to their vaginal health index (VHI), vaginal microbiota, vaginal pH, and cell maturation. Three applications of MAFRF were performed in the vagina/vaginal introitus. During the treatment, six vaginal smears were obtained and stained with the Papanicolaou stain for determining the degree of cell maturation and with Gram stain for classification of vaginal flora, as per the criteria of Spiegel and Amsel. For vaginal pH determination, pH indicator strips were applied against the vaginal wall. Statistical analysis was performed using SPSS for Windows (version 17.0). Data were reported as mean±standard deviation. The differences were analyzed using the statistical method of generalized estimation equations with autoregressive correlation structure ‘‘1’’ and robust standard errors. RESULTS: The mean age was 59.8±4.2 years, and the mean time of menopause was 15.4±4.5 years. After treatment, there was an increase in the percentage of Lactobacillus spp. (po0.001). Consequently, there was a progressive decrease in vaginal pH during the treatment (po0.001). Regarding cell maturation, there was a decrease in the percentage of parabasal cells (p=0.001) and an increase in the rate of superficial cells (po0.001). Additionally, there was an improvement in the VHI index. The mean VHI values before and after treatment were 13.2±5.6 and 22.5±3.7, respectively (po0.001). CONCLUSION: MAFRF treatment is well tolerated and leads to improvement in the vaginal microenvironment

Drug therapies for obstructive sleep apnoea: a systematic review and meta-analysis protocol

Introduction Obstructive sleep apnoea (OSA) is a common disorder that can affect the quality of life and increase the risk for psychiatric, neurological and cardiometabolic diseases. Despite the significant burden, it poses on health and well-being, there is a lack of evidence regarding the use of drug therapies in these patients. This work aims to evaluate the efficacy and safety of pharmacological treatment alternatives for patients with OSA.Methods and analysis Databases, including PubMed, Embase, Web of Science, SciELO, LILACS, Scopus, Cochrane Register of Controlled Trials and ClinicalTrials.gov, will be used for the search. A search strategy was developed to retrieve clinical trials that have evaluated polysomnographic primary outcome (Apnoea-Hypopnoea index) and secondary outcomes (eg, daytime sleepiness, adverse events) of any drug therapy used for OSA. No date or language restrictions will be applied. Two authors will independently select the studies meeting the inclusion criteria by screening the title, abstract and full text. Data will be extracted, and the risk of bias will be evaluated using the Cochrane Risk of Bias Tool. Review Manager V.5.4.1 will be used for data synthesis. The Grading of Recommendation Assessment, Development and Evaluation will be used to assess the strength of the evidence.Ethics and dissemination As a review of published data, it is not necessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration number CRD42022362639

Impact of SARS-CoV-2 (COVID-19) on pregnancy: a systematic review and meta-analysis protocol

Introduction The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has been growing at an accelerating rate, and has become a public health emergency. Pregnant women and their fetuses are susceptible to viral infection, and outcomes in this population need to be investigated.Methods and analysis PubMed, Web of Science, Embase, CINAHAL, Latin American and Caribbean Health Sciences Literature, clinicaltrials.gov, SCOPUS, Google Scholar and Cochrane Central Controlled Trials Registry will be searched for observational studies (cohort and control cases) published from December 2019 to present. This systematic review and meta-analysis will include studies of pregnant women at any gestational stage diagnosed with COVID-19. The primary outcomes will be maternal and foetal morbidity and mortality. Three independent reviewers will select the studies and extract data from the original publications. The risk of bias will be assessed using the Newcastle-Ottawa Scale for observational studies. To evaluate the strength of evidence from the included data, we will use Grading of Recommendation Assessment, Development, and Evaluation method. Data synthesis will be performed using Review Manager software V.5.2.3. To assess heterogeneity, we will compute the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogenous.Ethics and dissemination This study will be a review of the published data, and thus it is not necessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration number PROSPERO 2020: CRD42020181519

Antifungal (oral and vaginal) therapy for recurrent vulvovaginal candidiasis: a systematic review protocol

Introduction Vulvovaginal candidiasis (VVC) is frequent in women worldwide and usually responds rapidly to topical or oral antifungal therapy. However, some women develop recurrent vulvovaginal candidiasis (RVVC), which is arbitrarily defined as four or more episodes every year. RVVC is a debilitating, long-term condition that can severely affect the quality of life of women. Most VVC is diagnosed and treated empirically and women frequently self-treat with over-the-counter medications that could contribute to an increase in the antifungal resistance. The effective treatment of RVVC has been a challenge in daily clinical practice. This review aims to assess the efficacy of antifungal agents administered orally or intravaginally for the treatment of RVVC, in order to define clinical practices that will impact on the reduction of the morbidity and antifungal resistance. Methods and analysis A comprehensive search of the following databases will be carried out: PubMed, Embase, Scopus, Web of Science, Scientific Electronic Library Online (SciELO), the Cochrane Central Register of Controlled Trials (CENTRAL), Biblioteca Virtual em Saude (Virtual Health Library)/Biblioteca Regional de Medicina (Regional Library of Medicine) (BVS/BIREME), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and in the clinical trials databases (www. trialscentral. org; www. controlled-trials. com; www. clinicaltrials. gov). The risk of bias will be assessed according to the Cochrane Risk of Bias tool. We will perform data synthesis using the Review Manager (RevMan) software V. 5.2.3. To assess heterogeneity, we will compute the I2 statistic. Ethics and dissemination This study will be a review of published data and it is not necessary to obtain ethical approval. Findings of this systematic review will be published in a peer-reviewed journal

Mobile applications for sexual encounters accessed by men who have sex with men: Information on sexually transmitted infection

We evaluated existing mobile applications (apps) on both Android and iOS (Apple) platforms that are used by men who have sex with men (MSM) to obtain sexual encounters. The word “gay” was used to search for apps in the Apple and Google Play virtual stores. The 10 most downloaded apps were analysed concerning safe sexual practices (SSP) messages. Out of 245 apps selected, 213 were evaluated — 102 for Android and 111 for iOS. Mostly social networks were accessed by MSM of which 112 allow access to people aged 14 and over. Most of the apps could be downloaded in more than two languages. Of the 10 most downloaded and evaluated apps, 5 had no HIV/STI and SSP messages, only 3 contained HIV/STI and SSP messages, and 2 had information about one or the other. Several social networking apps are available, however, there is no information on HIV/STI in the most accessed apps. Keywords: men who have sex with men, mobile app, sex education, sexual health, sexually transmitted infection

Use of dating sites and applications by women and their risk of sexually transmitted infections: a systematic review and meta-analysis protocol

Introduction The use of social networks has been increasing worldwide. Mobile websites and applications (apps) allow people to network more quickly and have more partners for sex. This can facilitate risky sexual behaviours, such as having multiple partners and unprotected sex, which can lead to a higher incidence of sexually transmitted infections. This systematic review/meta-analysis will assess the effects of the use of dating sites and apps by women on their level of engagement in risky sexual behaviours and their incidence of sexually transmitted infections.Methods and analysis The Cochrane Central Controlled Trials Registry, ClinicalTrials.gov, MEDLINE, Embase, SciELO, Web of Science, Scopus and Cumulative Index to Nursing & Allied Health Literature will be searched for cross-sectional studies, clinical trials and observational studies published between January 1990 and July 2020. This systematic review and meta-analysis will include studies investigating the use of mobile apps by women, risky sexual behaviour and sexually transmitted infections. The outcome will be an increase in new cases of sexually transmitted infections and HIV among women using dating sites and apps. Three independent reviewers will select the studies and extract data from the original articles. The risk of bias will be assessed using the Cochrane risk of bias tool and Risk Of Bias in Non-randomized Studies of Interventions. Data synthesis will be performed using Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will compute the I2 statistic. In addition, a quantitative synthesis will be carried out if the included studies are sufficiently homogeneous.Ethics and dissemination This study will be a review of the published data, and thus ethical approval is not required. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration number CRD42019120494

Heparin versus 0.9% sodium chloride intermittent flushing for preventing occlusion in newborns with peripherally inserted central catheters: A systematic review protocol.

BackgroundMechanical factors are primary complications that justify early removal of a peripherally inserted central catheter, and thrombotic catheter occlusion is the most critical mechanical complication associated with loss of device functionality. Studies have investigated these factors in adult patients, but findings are not directly applicable to newborns. Therefore, systematic reviews focusing on this population are necessary for consolidated evidence to aid clinical practice.AimsThis study aims to evaluate the efficacy of intermittent heparin washing versus 0.9% sodium chloride solution for preventing occlusion in newborns with peripherally inserted central catheters.MethodsWe will use the PubMed, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and Clinical Trial Databases for article search, without language or publication periods restrictions. Randomized clinical trials evaluating the use of intermittent heparin washing versus 0.9% sodium chloride solution in newborns with peripherally inserted central venous catheters will be included. The primary outcome will be peripherally inserted central catheter occlusion. Two reviewers will independently screen the studies, based on the inclusion criteria, extract the data for each included study and assess the risk of bias using the Cochrane risk of bias tool. The data will be synthesized using the Review Manager software (RevMan 5.4.1). To classify the strength of the evidence of results, we will use the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE). The review was registered with PROSPERO (registration number CRD42021281509).Expected resultsWe expect that this study would reveal the best method for preventing catheter occlusion in newborns with peripherally inserted central catheters

Effect of in the Management of Nausea and Vomiting Induced by Treatment With Cisplatin Associated With Radiotherapy: A Randomized Controlled Trial

Objective: evaluate the efficacy of Zingiber Officinale in the management of nausea and vomiting induced by treatment with cisplatin associated with radiotherapy in patients with uterine cervical neoplasms. Methods: a triple-blind, randomized, placebo-controlled trial. Interventions: Comparing the effects of ginger with institutional antiemetic therapy (ondansetron with dexamethasone). Patients with cervical cancer who started treatment with cisplatin with an indication of 40 mg/m² associated with radiotherapy, aged over 18 years, and with the ability to tolerate swallowing a capsule were recruited and equally allocated (1:1:1) into 3 groups of 16 patients each (the ginger capsules 250 mg group, ginger capsules 500 mg group, and placebo group). Nausea and vomiting were measured on baseline, 7 days after the first dose of medication and every seven consecutive days during a treatment break. Results: The 250 mg ginger group had an 8.0% greater chance of experiencing nausea within 24 h after the chemotherapy infusion than the placebo group, although there is no statistical significance ( P  = .92986). The 500 mg ginger group showed a 63.9% reduction in nausea under the same conditions ( P  = .40460). No change was detected in the occurrence of nausea episodes during the 6 weeks ( P  = .8664) or between the groups ( P  = .2817). No change was detected in acute or late vomiting during the 6 weeks ( P  = .3510) or between the groups ( P  = .8500 and P  = .5389, respectively). Conclusion: Ginger supplementation does not reduce the intensity of acute and late nausea and vomiting. REBEC (RBR-47yx6p9)

Prevalence of Burnout Syndrome and other psychiatric disorders among health professionals during the COVID-19 pandemic: A systematic review and meta-analysis protocol.

IntroductionStudies carried out during previous pandemics revealed an increase in the prevalence of Burnout Syndrome and other psychiatric disorders among health professionals. A high prevalence of psychiatric disorders is also observed in some health categories, during the COVID-19 pandemic.ObjectiveThis systematic review/meta-analysis study aims to assess the prevalence of Burnout Syndrome and other psychiatric disorders (depression, anxiety, stress, and insomnia) among health care professionals and other support professionals during the COVID-19 pandemic.Inclusion criteriaObservational studies published from December 2019, without language restrictions in which the prevalence of Burnout Syndrome and other psychiatric disorders among health professionals during the COVID-19 pandemic will be assessed.MethodsPubMed, Web of Science, Embase, CINAHAL, PsycINFO, LILACS, SCOPUS, and The Cochrane Library will be searched for eligible studies. Two reviewers will independently screen and select studies, assess methodological quality, and extract data. A meta-analysis will be performed, if possible, and the Grading of Recommendations Assessment Development and Evaluation (GRADE).Ethics and disclosureThis study will use secondary data. Thus, there is no need for submission to the ethics committee. The results of this systematic review will be published in a journal after a peer-review process.Trial registrationSystematic review registration number: CRD42020212036