O que sabemos sobre aptidão física, atividade física e exercícios para jovens com doença falciforme? Um estudo de revisão

A doença falciforme é o resultado de uma alteração na síntese da hemoglobina que passa a ter o formato de foice. Os impactos dessa modificação comprometem o organismo, reduzindo o desempenho físico e a tolerância ao esforço físico. O objetivo deste estudo foi verificar a produção do conhecimento sobre aptidão física, atividade física e exercícios físicos para crianças e adolescentes com doença falciforme no período entre 2004 a 2019. A busca foi feita nas bases Scientific Electronic Library Online, (Scielo), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Sistema Online de Busca e Análise de Literatura Médica (Pubmed) no período de 2004 a 2019. Foram utilizados os Descritores em Ciência da Saúde (DeCS) doença falciforme, aptidão física, atividade física, exercício físico, crianças e adolescentes e na língua inglesa (MeSHs) Sickle Cell Disease, Physical Fitness, Physical Activity, Exercise, Exercise Therapy, Physical Endurance, Children, Adolescents. 12 artigos foram selecionados para a leitura na íntegra. A maioria dos estudos mostrou que crianças e adolescentes com doença falciforme apresentaram baixos níveis de atividade física e gasto energético quando comparados aos indivíduos saudáveis. O mesmo foi observado em relação a aptidão física com redução de força e flexibilidade. A produção do conhecimento ainda não esclareceu quais os critérios de acompanhamento para a realização de esforços físicos com segurança para essa população

EXPERIENCE REPORT OF THE RESEARCH WITH YOUNG PEOPLE WITH SICKLE CELL DISEASE FROM FEIRA DE SANTANA-BAHIA

No Brasil, onde o racismo mata indiscriminadamente, ocupamos sem dúvida o patamar de um número de óbitos alarmantes, seja por arma de fogo, pelas mãos do estado, de fome e da falta de atendimento e assistência básica de saúde. A doença falciforme (DF) não é uma doença rara e nos compete a visibilidade dos índices em Feira de Santana. Objetivo: relatar a experiência de uma pesquisa de doutorado que avaliou a aptidão física e biomarcadores em crianças e adolescentes com DF no município de Feira de Santana. Resultados: 30 jovens participaram e todos se autodeclararam pretos e pardos, com renda familiar de até dois salários-mínimos mensais. O desempenho na avaliação da caminhada foi considerado moderadamente reduzido para 50%, normal para 33,3% e gravemente alterado para 16,7% dos participantes. Os testes motores também apresentaram níveis abaixo das referências para indivíduos sem a doença na mesma faixa etária: 80% fracos para força de membros superiores; 75% fracos para força de membros inferiores e 90% fracos para agilidade. Conclusão: A baixa renda das famílias que pertencem à população negra, revelaram a situação de pobreza e as dificuldades para se dirigirem ao centro de referência. Condições clínicas desfavoráveis como baixa saturação periférica de oxigênio em repouso e palidez também foram verificadas. A observação mais marcante foi o relato de fome de algumas famílias. Mesmo enfrentando a distância e as dificuldades para chegarem ao centro de saúde no dia das avaliações, mães e crianças revelaram que não tinham se alimentado até o momento da pesquisa.In Brazil, where racism kills indiscriminately, we undoubtedly occupy the level of an alarming number of deaths, whether by firearms, at the hands of the state, hunger and lack of care and basic health care. Sickle cell disease (SCD) is not a rare disease, and it is up to us to make the indexes visible in Feira de Santana. Objective: to report the experience of a doctoral research that evaluated physical fitness and biomarkers in children and adolescents with SCD in the city of Feira de Santana. Results: 30 young people participated, and all declared themselves to be black and brown, with a family income of up to two monthly minimum wages. Performance in the walking assessment was considered moderately reduced for 50%, normal for 33.3% and severely altered for 16.7% of the participants. Motor tests also showed levels below the references for individuals without the disease in the same age group: 80% were weak for upper limb strength; 75% weak for lower limb strength and 90% weak for agility. Conclusion: The low income of families belonging to the black population revealed the situation of poverty and the difficulties in going to the reference center. Unfavorable clinical conditions such as low peripheral oxygen saturation at rest and pallor were also observed. The most striking observation was the report of hunger by some families. Even facing the distance and the difficulties to reach in the evaluations, mothers and children revealed that they had not eaten until the time of the research

AVANÇOS RECENTES NO DIAGNÓSTICO PRECOCE DO CÂNCER DE PULMÃO: UMA ANÁLISE DE REVISÕES SISTEMÁTICAS

The high mortality rate from lung cancer, the leading cause of cancer death in Brazil, highlights the urgent need for effective screening and early diagnosis policies. Late detection, often in advanced stages, compromises treatment options. The aim of this study was to reflect on the importance of recent advances in the early diagnosis of lung cancer. A systematic literature review was carried out using the Scielo, Lilacs and Medline databases. After a qualitative analysis of the results, it was concluded that early identification of the disease allows for more effective therapeutic interventions, resulting in greater survival and better clinical outcomes for patients.A alta taxa de mortalidade pelo câncer de pulmão, principal causa de óbito por câncer no Brasil, ressalta a urgência de políticas efetivas de rastreamento e diagnóstico precoce. A detecção tardia, frequentemente nos estágios avançados, compromete as opções de tratamento. Este estudo teve como objetivo refletir sobre a importância do avanços recentes no diagnóstico precoce do câncer de pulmão. Para isso, foi desenvolvida uma revisão sistemática da literatura, utilizando as bases de dados Scielo, Lilacs e Medline. Após análise qualitativa dos resultados, concluiu-se que a identificação precoce da doença permite intervenções terapêuticas mais eficazes, resultando em maior sobrevida e melhores resultados clínicos para os pacientes

Eficácia de intervenções imunomoduladoras para o tratamento da Esclerose Lateral Amiotrófica (ELA)

A esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa que afeta as células nervosas responsáveis pelo controle dos músculos voluntários, resultando em fraqueza muscular e atrofia. Nesse contexto, as intervenções imunomoduladoras têm como objetivo modular a resposta imune do organismo, ao reduzir a inflamação e possibilitar a neuroproteção, a partir do uso de anticorpos monoclonais, inibidores de citocinas e moduladores do sistema imunológico. No entanto, a eficácia de tais intervenções no tratamento da ELA ainda é incerta. Nesse sentido, o presente estudo tem como objetivo analisar a eficácia de intervenções imunomoduladoras para o tratamento da esclerose lateral amiotrófica. Para isso, foram selecionados cinco artigos que abordavam sobre a sua eficácia, por meio de uma estratégia de busca com recorte temporal entre 2017 e 2023, nas bases de dados PubMed (Medline), Cochrane Library e Embase. As intervenções imunomoduladoras, como o uso de inibidores de citocinas, têm demonstrado eficácia no tratamento da esclerose lateral amiotrófica (ELA). Além disso, há evidências de que a inflamação crônica pode estar envolvida em sua patogênese, o que sugere que a modulação do sistema imunológico pode ser uma abordagem terapêutica promissora. Em estudos clínicos recentes, a terapia com inibidores de citocinas mostrou-se capaz de reduzir a progressão da doença e melhorar a qualidade de vida dos pacientes com ELA. Ademais, há evidências que o uso de células-tronco pode melhorar o status funcional em pacientes com a doença. Entretanto, são necessários mais estudos, como ensaios clínicos randomizados e revisões sistemáticas com meta-análises, a fim de ratificar a eficácia das estratégias imunomoduladoras para a patologia

Disability Assessment in people with Chronic Illness: a scoping review protocol

The objective of this review is to understand the ways in which the assessment of disability in adults with chronic disease is being carried out. In view of the relevance of chronic diseases for Public Health today, the need to know the limitations caused by these diseases is evident

INSEGURANÇA ALIMENTAR E NUTRICIONAL ENTRE ADULTOS COM DOENÇA FALCIFORME: UM PROTOCOLO DE REVISÃO DE ESCOPO

Scoping Review to investigative the causes and manifestations of food and nutrition insecurity in adults with sickle cell disease. Method: scoping review of the developed following the recommendations proposed by the JBI manual. The search sources will be: SCIELO, LILACS (BVS), MEDLINE via PubMed, COCHRANE LIBRARY (Wiley), CINAHL (Ebsco), SCOPUS (Elsevier), Web of Science Core Collection (Clarivate Analytics), EMBASE (Elsevier), theses and dissertations will be analyzed in the databases of Google Scholar and Periodical Portal of the Coordination for the Improvement of Higher Education Personnel (CAPES, DART-E theses Europe; OATD - Open Access Theses and Dissertations, Canadian Theses and Dissertations Portal, Database of African Theses and Dissertations and Research (DATAD-R). Publications will be selected by two independent reviewers and disagreements will be analyzed by a third reviewer. For analysis of references (remove duplications, organization, inclusion and exclusion according to the adopted inclusion criteria) we will use EndNote Web 20 (Clarivate Analytics, PA, USA) and Rayyan Data will be extracted with the help of an instrument developed by the reviewers and the results will be presented through charts, flowcharts and narrative synthesis. This review will follow the recommendations proposed by the JBI methodology for the same and will use the Preferred Reporting Items for Scope Reviews (PRISMA-ScR) extension as a reporting guideline. A preliminary review was carried out in March 2023 using the terms Medical Subject Headings (MeSH): “nutrition” and “sickle cell disease” in the databases of PUBMED and CINAHL and PROSPERO, Pubmed and OSF for knowledge of the subject and identification of studies of scoping review with the same phenomenon, but no protocol with the present theme was foun

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author

Neotropical ornithology: Reckoning with historical assumptions, removing systemic barriers, and reimagining the future

A major barrier to advancing ornithology is the systemic exclusion of professionals from the Global South. A recent special feature, Advances in Neotropical Ornithology, and a shortfalls analysis therein, unintentionally followed a long-standing pattern of highlighting individuals, knowledge, and views from the Global North, while largely omitting the perspectives of people based within the Neotropics. Here, we review current strengths and opportunities in the practice of Neotropical ornithology. Further, we discuss problems with assessing the state of Neotropical ornithology through a northern lens, including discovery narratives, incomplete (and biased) understanding of history and advances, and the promotion of agendas that, while currently popular in the north, may not fit the needs and realities of Neotropical research. We argue that future advances in Neotropical ornithology will critically depend on identifying and addressing the systemic barriers that hold back ornithologists who live and work in the Neotropics: unreliable and limited funding, exclusion from international research leadership, restricted dissemination of knowledge (e.g., through language hegemony and citation bias), and logistical barriers. Moving forward, we must examine and acknowledge the colonial roots of our discipline, and explicitly promote anti-colonial agendas for research, training, and conservation. We invite our colleagues within and beyond the Neotropics to join us in creating new models of governance that establish research priorities with vigorous participation of ornithologists and communities within the Neotropical region. To include a diversity of perspectives, we must systemically address discrimination and bias rooted in the socioeconomic class system, anti-Blackness, anti-Brownness, anti-Indigeneity, misogyny, homophobia, tokenism, and ableism. Instead of seeking individual excellence and rewarding top-down leadership, institutions in the North and South can promote collective leadership. In adopting these approaches, we, ornithologists, will join a community of researchers across academia building new paradigms that can reconcile our relationships and transform science. Spanish and Portuguese translations are available in the Supplementary Material.• Research conducted by ornithologists living and working in Latin America and the Caribbean has been historically and systemically excluded from global scientific paradigms, ultimately holding back ornithology as a discipline.• To avoid replicating systems of exclusion in ornithology, authors, editors, reviewers, journals, scientific societies, and research institutions need to interrupt long-held assumptions, improve research practices, and change policies around funding and publication.• To advance Neotropical ornithology and conserve birds across the Americas, institutions should invest directly in basic field biology research, reward collective leadership, and strengthen funding and professional development opportunities for people affected by current research policies.Peer reviewe