COVID-19 pandemic information on Brazilian websites: credibility, coverage, and agreement with World Health Organization. Quality of COVID-19 online information in Brazil

SUMMARY OBJECTIVE: To assess the credibility and the quality content of COVID-19 pandemic information on Brazilian websites. METHODS: We performed Google searches and screened the first 45 websites. The websites were categorized as academic, commercial, government, hospital, media, nongovernmental organizations, and professionals. The credibility was assessed by JAMA benchmark criteria and HONCODE. A checklist with WHO information about COVID-19 was developed to assess the quality content. For each website, the level of agreement with WHO information was categorized into "total," "partial," or "disagreement". RESULTS: A total of 20 websites were analyzed. None of the websites had HONCODE certification. Six websites (30%) met none of the four JAMA criteria and only one website (5%) fulfilled all the four criteria. Only 11 out of 20 websites showed overall coverage >50% for the checklist. Overall, 70% (14/20) of the websites had at least 50% total agreement with WHO items. The government websites presented more disagreement with the WHO items than media websites in the overall quality content analysis. CONCLUSION: The COVID-19 information on Brazilian websites have a moderate-to-low credibility and quality, particularly on the government websites.

Acute effects of physiotherapeutic respiratory maneuvers in critically ill patients with craniocerebral trauma

OBJECTIVE: To evaluate the effects of physiotherapeutic respiratory maneuvers on cerebral and cardiovascular hemodynamics and blood gas variables. METHOD: A descriptive, longitudinal, prospective, nonrandomized clinical trial that included 20 critical patients with severe craniocerebral trauma who were receiving mechanical ventilation and who were admitted to the intensive care unit. Each patient was subjected to the physiotherapeutic maneuvers of vibrocompression and increased manual expiratory flow (5 minutes on each hemithorax), along with subsequent airway suctioning with prior instillation of saline solution, hyperinflation and hyperoxygenation. Variables related to cardiovascular and cerebral hemodynamics and blood gas variables were recorded after each vibrocompression, increased manual expiratory flow and airway suctioning maneuver and 10 minutes after the end of airway suctioning. RESULTS: The hemodynamic and blood gas variables were maintained during vibrocompression and increased manual expiratory flow maneuvers; however, there were increases in mean arterial pressure, intracranial pressure, heart rate, pulmonary arterial pressure and pulmonary capillary pressure during airway suctioning. All of the values returned to baseline 10 minutes after the end of airway suctioning. CONCLUSION: Respiratory physiotherapy can be safely performed on patients with severe craniocerebral trauma. Additional caution must be taken when performing airway suctioning because this technique alters cerebral and cardiovascular hemodynamics, even in sedated and paralyzed patients. .