Community wide interventions for increasing physical activity

Univ Fed Sao Paulo, Discipline Emergency Med & Evidence Based Med, Sao Paulo, BrazilUniv Santo Amaro, Discipline Rheumatol, Sao Paulo, BrazilUniv Fed Sao Paulo, Discipline Emergency Med & Evidence Based Med, Sao Paulo, BrazilWeb of Scienc

Quadriceps strengthening exercises are effective in improving pain, function and quality of life in patients with osteoarthritis of the knee

OBJECTIVE: The purpose of this research was to verify the effectiveness of an eight-week quadriceps strengthening program on pain, function and quality of life of patients with knee osteoarthritis. METHODS: A hundred patients were randomized into two groups: 1- Exercise Group (ExG) and 2- Orientation Group. The Timed Up and Go (TUG) test, the Numerical Rating Scale (NRS) and the Short Form-36 were used for the assessment. RESULTS: Eighty-one patients completed the survey. According to the intention to treat (ITT) analysis, there was statistically significant difference in ExG compared to OG in all the variables assessed. CONCLUSION: The program quadriceps strengthening exercises applied in this randomized clinical trial was effective in improving pain, function and quality of life of patients with knee osteoarthritis. Level of Evidence I, Randomized Clinical Trial.OBJETIVO: Verificar o efeito de um programa de fortalecimento de quadríceps com duração de oito semanas na dor, função e qualidade de vida de pacientes com osteoartrite do joelho. MÉTODOS: Cem pacientes foram randomizados em dois grupos: 1- Grupo Exercício (GEx) e 2 - Grupo Orientação (GO). O teste Timed Up and Go (TUG), a Escala Numérica de Dor (END) e o questionário SF-36 foram utilizados para a avaliação. RESULTADOS: Oitenta e um pacientes completaram a pesquisa. Considerando a análise por intenção de tratar, houve melhora estatisticamente significante no GEx quando comparado ao GO em todas as variáveis avaliadas. CONCLUSÃO: O programa de exercícios de fortalecimento do quadríceps por nós aplicado foi efetivo na melhora da dor, função e qualidade de vida de pacientes com osteoartrite do joelho. Nível de Evidência I, Ensaio Clínico Randomizado.Universidade Federal de São Paulo (UNIFESP) Departamento de Medicina Interna e TerapêuticaUNIFESP, Depto. de Medicina Interna e TerapêuticaSciEL

A estimulação elétrica neuromuscular é efetiva na melhora da dor, função e atividades de vida diária de pacientes com osteoartrite do joelho? Ensaio clínico randomizado

CONTEXT AND OBJECTIVE Neuromuscular electrical stimulation (NMES) has been used in rehabilitation protocols for patients suffering from muscle weakness resulting from knee osteoarthritis. The purpose of the present study was to assess the effectiveness of an eight-week treatment program of NMES combined with exercises, for improving pain and function among patients with knee osteoarthritis. DESIGN AND SETTING Randomized clinical trial at Interlagos Specialty Ambulatory Clinic, São Paulo, Brazil. METHODS One hundred were randomized into two groups: NMES group and control group. The following evaluation measurements were used: numerical pain scale from 0 to 10, timed up and go (TUG) test, Lequesne index and activities of daily living (ADL) scale. RESULTS Eighty-two patients completed the study. From intention-to-treat (ITT) analysis comparing the groups, the NMES group showed a statistically significant improvement in relation to the control group, regarding pain intensity (difference between means: 1.67 [0.31 to 3.02]; P = 0.01), Lequesne index (difference between means: 1.98 [0.15 to 3.79]; P = 0.03) and ADL scale (difference between means: -11.23 [-19.88 to -2.57]; P = 0.01). CONCLUSION NMES, within a rehabilitation protocol for patients with knee osteoarthritis, is effective for improving pain, function and activities of daily living, in comparison with a group that received an orientation program. CLINICAL TRIAL REGISTRATION ACTRN012607000357459.CONTEXTO E OBJETIVO A estimulação elétrica neuromuscular (EENM) tem sido incluída em protocolos de reabilitação de pacientes com fraqueza muscular decorrente da osteoartrite do joelho. O objetivo do presente estudo foi determinar a efetividade de um tratamento de oito semanas de EENM combinado com exercícios na melhora da dor e função em pacientes com osteoartrite do joelho. TIPO DE ESTUDO E LOCAL Ensaio clínico randomizado realizado no Ambulatório de Especialidades de Interlagos, São Paulo, Brasil. MÉTODOS Cem pacientes foram randomizados em dois grupos: Grupo EENM (GEENM) e grupo controle (GC). As medidas de avaliação utilizadas foram: escala numérica de dor (END) 0 a 10, teste timed up and go (TUG), índice de Lequesne e escala de atividades de vida diária (EAVD). RESULTADOS Oitenta e dois pacientes completaram a pesquisa. Por meio da análise por intenção de tratar, na comparação entre grupos, o GEENM apresentou melhora estatisticamente significante em comparação ao GC na redução da dor (diferença entre as médias: 1,67 [0,31; 3,02], P = 0,01), no índice de Lequesne (diferença entre as médias: 1,98 [0,15; 3,79] e na EAVD (diferença entre as médias: -11,23 [-19,88; -2,57], P = 0,01). CONCLUSÃO A EENM, quando inserida em um protocolo de reabilitação para pacientes com osteoartrite do joelho, é efetiva na redução da dor, melhora da função e das atividades de vida diária quando comparada a um grupo submetido a programa de orientação. REGISTRO DE ENSAIO CLÍNICO ACTRN012607000357459.Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Department of Movement SciencesUniversidade de Santo Amaro (Unisa)UNIFESP, Department of Movement SciencesSciEL

Vena cava thrombosis associated with nephrotic syndrome in the puerperal gestational cycle

CONTEXT: The puerperal gestational cycle is accompanied by a state of physiological hypercoagulability. Thromboembolic phenomena may occur at this time. OBJECTIVE: To report on a clinic case involving a patient that presented a family history of thromboembolism and developed deep vein thrombosis in a lower limb and vena cava thrombosis during the puerperal gestational cycle, displaying nephrotic syndrome as the main complication. DESIGN: Case report.CONTEXTO: A gestação é acompanhada de um estado fisiológico de hipercoagulabilidade. Fenômenos de Trombose podem ocorrer. OBJETIVO: Relatar um caso clínico envolvendo uma paciente que apresentava história importante de trombifilia familiar, e que desenvolveu trombose venosa profunda no membro inferior e trombose da veia cava durante o ciclo gravídico-puerperal, apresentando síndrome nefrótica como principal complicação. TIPO DE ESTUDO: Relato de caso.Universidade de Santo AmaroUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Discipline of RheumatologyUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Head of the Discipline of Urgent MedicineUniversidade de Santo Amaro Discipline of RheumatologyUNIFESP, EPM, Discipline of RheumatologyUNIFESP, EPM, Head of the Discipline of Urgent MedicineSciEL

SARS-COV-2 AND ARBOVIRUS INFECTIONS: PROTOCOL FOR A RAPID LIVING SYSTEMATIC REVIEW

Context and objective: While cases of COVID-19 disease increase daily worldwide, outbreaks of arboviral infections have affected health systems of countries in tropical regions. The outcomes for patients and health systems of a possible syndemic are not clarified yet. Thus, we aim to systematically review the literature searching for evidence that describes the clinical presentation, severity and prognostic of SARS-CoV-2 and Arboviral coinfection. Design and setting: Protocol for a rapid living systematic review, that will follow the Cochrane Handbook for Systematic Reviews recommendations. We will include prospective and retrospective cohort, case-control studies and case series of patients with confirmed diagnosis of SARS-CoV-2 and Arboviral infection. We will perform the search strategy with no language restrictions on Medline via PubMed, Embase via Elsevier, Cochrane Library - Cochrane Central Register of Controlled Trials (CENTRAL), Portal Regional BVS - LILACS, Scopus and WebOfScience to identify published, ongoing, and unpublished studies. The selection and extraction will be performed by two authors. We will perform the critical appraisal of included studies with the Newcastle-Ottawa Scale and the certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).   &nbsp