Suicidal ideation and suicide attempts among students aged 12 to 24 after the lifting of COVID-19 restrictions in China: prevalence and associated factors.

Objective: To investigate the prevalence and associated factors of suicidal ideation and suicide attempts among adolescent and young adults in China from December 14, 2022 to February 28, 2023, when COVID-19 restrictions were lifted. Methods: Students in middle and high schools and colleges and universities in the province of Sichuan, China were asked to complete on-line cross-sectional surveys. Information was collected about sociodemographics, experiences related to the COVID-19 pandemic, suicidal ideation and suicide attempts. Participants also filled out the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 and the Social Support Rate Scale surveys. Factors associated with suicidal ideation or suicide attempts were explored using logistic regression. Results: Of the 82,873 respondents (aged 12 to 24 years), 21,292 (25.7%) reported having thought of suicide at least once in their lifetime, 10,382 (12.5%) reported having thought about suicide within the previous 12 months, and 1,123 (1.4%) reported having attempted it within the previous 12 months. Risk of lifetime suicidal ideation was higher among middle school students than among older students. Risk of suicidal ideation and risk of suicide attempts correlated directly with severity of symptoms of depression and anxiety, and inversely with level of social support. Greater risk of suicidal ideation and suicidal attempts was associated with: being female, living in an urban environment, attending a boarding school, currently being in love, having parents who divorced or remarried, having parents who exhibit non-authoritative parenting behavior, having higher family income, having been COVID-19 infected, having been quarantined for a long time, and being dissatisfied with one's education. Conclusions: Suicidal ideation and suicide attempts remain prevalent among young people in China. The potential associated factors identified in our study may be useful for targeting appropriate psychosocial interventions and developing mental health policies.

"Back Health 24/7/365"-A Novel, Comprehensive "One Size Fits All" Workplace Health Promotion Intervention for Occupational Back Health among Hospital Employees.

BACKGROUND: Projects for workplace health promotion (WHP) for back pain traditionally focus exclusively on work-related but not on leisure-time stress on the spine. We developed a comprehensive WHP project on the back health of hospital workers regardless of the physical characteristics of their work and compared its effects on sedentary and physically active hospital workers. METHODS: Study assessments were carried out before and six months after participation in the WHP intervention. The primary outcome parameter was back pain (Oswestry Disability Index, ODI). Anxiety (Generalized Anxiety Disorder-7), work ability (Work Ability Index), depression (Patient Health Questionnaire-9), stress (Perceived Stress Scale-10), and quality of life (Short Form-36) were assessed via questionnaires as secondary outcome parameters. Physical performance was measured via the 30 seconds Sit-to-Stand test (30secSTS). RESULTS: Sixty-eight healthcare workers with non-specific back pain were included in the evaluation study of the WHP project "Back Health 24/7/365". After six months, back pain, physical performance, and self-perceived physical functioning (SF-36 Physical Functioning subscale) improved significantly in both groups. Not a single parameter showed an interaction effect with the group allocation. CONCLUSIONS: A comprehensive WHP-intervention showed significant positive effects on hospital workers regardless of the physical characteristics of their work.

Paralumbar compartment syndrome, a rare sequela of deadlifting: a case report and review of current literature.

BACKGROUND: Compartment syndrome is a well-known phenomenon that is most commonly reported in the extremities. However, paralumbar compartment syndrome is rarely described in available literature. The authors present a case of paralumbar compartment syndrome after high intensity deadlifting. CASE PRESENTATION: 53-year-old male who presented with progressively worsening low back pain and paresthesias one day after high-intensity deadlifting. Laboratory testing found the patient to be in rhabdomyolysis; he was admitted for intravenous fluid resuscitation and pain control. Orthopedics was consulted, and Magnetic Resonance Imaging revealed significant paravertebral edema and loss of muscle striation. Given the patient's lack of improvement with intravenous and oral pain control, clinical and radiographic findings, there was significant concern for acute paralumbar compartment syndrome. The patient subsequently underwent urgent fasciotomy of bilateral paralumbar musculature with delayed closure. CONCLUSION: Given the paucity of literature on paralumbar compartment syndrome, the authors' goal is to promote awareness of the diagnosis, as it should be included in the differential diagnosis of intractable back pain after high exertional exercise. The current literature suggests that operative cases of paralumbar compartment syndromes have a higher rate of return to pre-operative function compared to those treated non-operatively. This case report further supports this notion. The authors recommend further study into this phenomenon, given its potential to result in persistent chronic exertional pain and irreversible tissue damage.

Local Gate Enhanced Correlated Phases in Twisted Monolayer-Bilayer Graphene.

Manipulating the flat band degeneracy and thus getting the correlated insulating phases has been an ideal thread for realizing the exotic quantum phenomenon in the moiré system. To achieve this goal, the delicately tuned twist angle and a substantial displacement field (D) are rigorously requested. Here, we report our scanning tunneling microscope (STM) work on reaching these correlated insulating states in twisted monolayer-bilayer graphene through a decorated tip. It acts as a local top gate, leading to an enhanced local D, and enables us to fully lift the 8-fold degeneracy of the flat bands. With the aid of this technique, we further expand the correlated insulating states into a more tolerant twist angle that is down to 0.92°. Moreover, the correlated insulating phases in the hole-doping regime are realized. Our tip decoration method allows us to integrate the STM study with the high displacement field for the correlated phases in the twisted moiré systems.

A Rare Case of a Spontaneous Thoracic Epidural Hematoma in a Young Male Weightlifter.

Spontaneous spinal epidural hematoma (SSEH) is the accumulation of blood in the epidural space of the spinal cord. Acute SSEH is a rare phenomenon that presents with a wide variety of neurologic symptoms and most often is a surgical emergency. We present a previously healthy 34-year-old male with sudden onset progressive weakness and tingling in the right lower extremity that progressed to the left lower extremity while bench pressing weights, resulting in complete lower extremity paralysis. Magnetic resonance imaging (MRI) revealed a 3.0 cm extradural mass centered in the dorsal and left lateral canal. After a T1-T4 hemilaminectomy was performed which was followed by inpatient rehabilitation, the patient had a favorable outcome improving from The American Spinal Injury Association Impairment Scale (AIS) grade A, complete impairment, to AIS grade C, incomplete impairment on discharge. Initially, the patient had complete motor and sensory paralysis below the level of T4, and upon discharge, the patient was able to attain modified independence in activities of daily living, mobility, and transfer. Due to the lack of risk factors for SSEH in this patient, the etiology is most likely related to the Valsalva maneuver while weightlifting. Lesions in the thoracic region with rapid progression of neurologic symptoms are indicators of poor prognosis, so this case highlights the importance of prompt recognition and intervention for improved outcomes to prevent devastating neurologic defects.

A narrative-style review of non-surgical rhinoplasty: Indications, outcomes, and limitations.

The aim of this narrative-style review was to evaluate non-surgical rhinoplasty in terms of indications, outcomes, and limitations. Both 'PubMed' and 'Science Direct' were reviewed by all authors, in order to reach consensus with regard to the chosen studies. Studies published from 1980 to 2023 were searched using the key terms "non-surgical rhinoplasty", "dermal filler", "thread lifting", and "botulinum toxin", and relevant papers were selected. Non-surgical rhinoplasty refers to the use of injectable temporary fillers to augment selected areas of the nose, in order to achieve improved appearance or function in select patients. It includes the use of dermal fillers, thread lifting, and botulinum toxin injections. The perfect dermal filler would be inexpensive, safe, painless to inject, hypoallergenic, and long lasting. In addition, it should produce consistent and predictable results, feel natural under the skin, take little time to inject, be ready to use, exert no downtime on the patient, and have a low risk of complications. Regions of the nose treated with filler injections include the frontonasal angle, dorsum, nasolabial angle, and columella. Thread lifting and botulinum toxin injection are the other methods of non-surgical rhinoplasty. Dermal fillers, thread lifting, and botulinum toxin injections can be used as non-surgical rhinoplasty. Dermal fillers and botulinum neurotoxin can be used alongside each other to allow minimally invasive resculpting of the nasal region and midface, compensating for a reduction in tissue volume and the formation of rhytides.

Thread Lifting Materials: A Review of Its Difference in Terms of Technical and Mechanical Perspective.

Thread lifting involves the use of slender materials, reminiscent of threads, for aesthetic procedures. These materials are distinct from traditional sutures and vary in composition, purpose, and performance. The introduction delves into the literal and material significance of threads, establishing the broad concept of thread lifting materials. The article revisits the evolution of thread lifting materials, emphasizing the preexistence of cog threads for tissue manipulation before their widespread adoption in plastic surgery. Observations regarding the efficacy and longevity of absorbable versus non-absorbable threads are discussed, stressing the efficiency of high-quality absorbable cog threads. The conclusion underlines the proliferation of thread lifting materials beyond PDO, highlighting the importance of considering multiple factors beyond duration when selecting threads for lifting procedures.

Impact of the width and shape of the sliding board on design evaluation.

This study aimed to investigate how width affects the design evaluation of sliding boards with a new shape. Ten caregivers at a senior facility evaluated five types of boards every two weeks. The new shape board received high ratings as the width increased, with a SUS (System Usability Scale) score of 68.5 points (95% CI 60.6-76.4). Compared to the traditional rectangular board, which had a width of 250 mm and a thickness of 5 mm, the new shape board (with a central width of 163 mm and a thickness of 8 mm) received higher ratings by 0.68 points (95% CI 0.31-1.05)using a paired comparison method. The results of a quantitative study on the usability of sliding boards from the perspective of caregivers indicated that for similar board shapes with a length of 650 mm and a thickness of 8 mm, the evaluation increases as the width increases in the range of 130 mm to 163 mm at the center.

An intelligent wireless channel corrupted image-denoising framework using symmetric convolution-based heuristic assisted residual attention network.

Image denoising is one of the significant approaches for extracting valuable information in the required images without any errors. During the process of image transmission in the wireless medium, a wide variety of noise is presented to affect the image quality. For efficient analysis, an effective denoising approach is needed to enhance the quality of the images. The main scope of this research paper is to correct errors and remove the effects of channel degradation. A corrupted image denoising approach is developed in wireless channels to eliminate the bugs. The required images are gathered from wireless channels at the receiver end. Initially, the collected images are decomposed into several regions using Adaptive Lifting Wavelet Transform (ALWT) and then the "Symmetric Convolution-based Residual Attention Network (SC-RAN)" is employed, where the residual images are obtained by separating the clean image from the noisy images. The parameters present are optimized using Hybrid Energy Golden Tortoise Beetle Optimizer (HEGTBO) to maximize efficiency. The image denoising is performed over the obtained residual images and noisy images to get the final denoised images. The numerical findings of the developed model attain 31.69% regarding PSNR metrics. Thus, the analysis of the developed model shows significant improvement.

The effects of an upper limb exoskeleton on gait performance and stability.

Upper limb exoskeletons (ULEs) are emerging as workplace tools to alleviate workload and prevent work-related musculoskeletal disorders during lifting tasks. However, their introduction raises concerns about potential instability and increased fall risk for workers. This study investigates gait performance and stability parameters implications of ULE use. Fifteen participants performed a carrying task with different loads (0, 5, 10, 15 kg), both with and without the use of an ULE. Spatiotemporal gait parameters, Required Coefficient of Friction (RCoF), Minimum Foot Clearance (MFC), and Margin of Stability (MoS) were analysed. The findings indicate that while the ULE does not significantly alter most gait parameters or slip risk, it may negatively impact trip risk. Furthermore, while mediolateral stability remains unaffected, anteroposterior stability is compromised by ULE usage. These insights are critical for ensuring the safe implementation of ULEs in occupational settings.

Real-World Study of Definisse Threads for Facial Reshaping in Indian Patients: REDEFINE FACE Study.

INTRODUCTION: In recent years, thread lifting has gained popularity as a less invasive cosmetic surgery. It helps raise and realign sagging tissue. The newest thread type for thread lifting procedure is poly-lactic acid-polycaprolactone (PLCL) Definisse threads (RELIFE S.r.l., Florence, Italy). These are fourth-generation absorbable suspended barbed threads. Their double action involves an immediate elevating impact through mechanical action and, over time, the promotion of histological rejuvenating activity through inducing fibroblasts and the synthesis of elastin, hyaluronic acid, and collagen. OBJECTIVES: The REDEFINE FACE study assessed the effectiveness and tolerance of Definisse threads in a real-world setting for facial reshaping in patients in India. METHODS: This multicenter, retrospective observational research included patients treated with Definisse threads for face contouring. RESULTS: Three hundred seventeen patients with a mean follow-up of 4.9 months and an average age of 48.6 years participated in the study. All patients underwent thread lifts using either a single or a combination of Definisse thread reshaping techniques. The Global Aesthetic Improvement Scale for Physicians and Subjects (PGAIS and SGAIS) reported improvement instantly following the treatment (mean score- 3.23 and 3.18, respectively). Improvements continued to enhance during the follow-up visits (mean score- 4.09 and 4.03, respectively). Following the procedure, 96% of patients on the PGAIS and SGAIS exhibited enhancement. Most procedure-related side effects were minor and went away on their own in a few days without the need for proactive care. CONCLUSION: The results of this real-world analysis showed that the latest Definisse threads effectively achieve facial reshaping on patients in India and have both immediate and long-term effects. Treatment was generally well tolerated, and no patient experienced serious adverse events.

Restricting lumbar spine flexion redistributes and changes total mechanical energy expenditure during lifting.

Minimizing lumbar spine flexion during lifting requires greater lower extremity joint motion. However, the effects of these kinematic changes on lumbar and lower extremity joint kinetics are unknown. Further, it is unclear whether the distribution of biomechanical demands throughout the lumbar spine and lower extremity during lumbar spine flexion restricted lifting are modulated by task factors like lift origin height and object mass. This study examined the influence of restricting lumbar spine flexion during lifting on the distribution of biomechanical demands, operationalized as mechanical energy expenditure (MEE), across the lumbar spine and lower extremity joints during lifting tasks. Twenty participants performed a series of lifting tasks that varied by lift origin height, object mass and presence or absence of lumbar spine motion restricting harness. MEE was quantified for the lumbar spine and lower extremity joints and summed across all joints to represent the total MEE. Distributions of MEE were compared across combinations of the three task factors. Total MEE was greater when lifting with restricted spine motion (p < 0.001). MEE was redistributed away from the lumbar spine and predominantly to the hips in the spine restricted conditions (p < 0.001). The nature and magnitude of this effect was modulated by lift origin height for the lumbar spine (p < 0.001) and hips (p < 0.001). Findings demonstrated that biomechanical demands can be shifted from the lumbar spine to the lower extremity when lifting with restricted spine flexion, which might help mitigate overuse injuries through coordinative variability.

New evidence for the sensorimotor mismatch theory of weight perception and the size-weight illusion.

The size-weight illusion is a phenomenon where a smaller object is perceived heavier than an equally weighted larger object. The sensorimotor mismatch theory proposed that this illusion occurs because of a mismatch between efferent motor commands and afferent sensory feedback received when lifting large and small objects (i.e., the application of too little and too much lifting force, respectively). This explanation has been undermined by studies demonstrating a separation between the perceived weight of objects and the lifting forces that are applied on them. However, this research suffers from inconsistencies in the choice of lifting force measures reported. Therefore, we examined the contribution of sensorimotor mismatch in the perception of weight in the size-weight illusion and in non-size-weight illusion stimuli and evaluated the use of a lifting force aggregate measure comprising the four most common lifting force measures used in previous research. In doing so, the sensorimotor mismatch theory was mostly supported. In a size-weight illusion experiment, the lifting forces correlated with weight perception and, contrary to some earlier research, did not adapt over time. In a non-size-weight illusion experiment, switches between lifting light and heavy objects resulted in perceiving the weight of these objects differently compared to no switch trials, which mirrored differences in the manner participants applied forces on the objects. Additionally, we reveal that our force aggregate measure can allow for a more sensitive and objective examination of the effects of lifting forces on objects.

Combined endoscopic mucosal resection and full-thickness resection for large colorectal polyps: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Combined endoscopic mucosal resection (EMR) with endoscopic Full thickness resection (EFTR) is an emerging technique that has been developed to target colorectal polyps larger than 2 cm. We performed a systematic review and meta-analysis to evaluate this technique for the resection of large colorectal lesions. METHODS: We conducted a comprehensive search of multiple electronic databases from inception through August 2023, to identify studies that reported on hybrid FTR. A random-effects model was employed to calculate the overall pooled technical success, macroscopic complete resection, free vertical margins resection rate, adverse events, and recurrence on follow up. RESULTS: A total of 8 Study arms with 244 patients (30% women) were included in the analysis. The pooled technical success rate was 97% (95% CI 88%-100%, I2 = 79.93%). The pooled rate of macroscopic complete resection was achieved in 95% (95% CI 90%-99%, I2 = 49.98) with a free vertical margins resection rate 88% (95% CI, 78%-96%, I2 = 63.32). The overall adverse events rate was 2% (95% CI 0%-5%, I2 = 11.64) and recurrence rate of 6% (95% CI 2%-12%, I2=20.32). CONCLUSION: Combined EMR with EFTR is effective and safe for resecting large, and complex colorectal adenomas, offering a good alternative for high surgical risk patients. Regional heterogeneity was observed, indicating that outcomes may be impacted by differences in operator expertise and industry training certification across regions. Comparative studies that directly compare combined EMR with EFTR against alternative methods such as ESD and surgical resection are needed.

Modification of the Revised National Institute for Occupational Safety and Health (NIOSH) Lifting Equation to Determine the Individual Manual Lifting Risk in Malaysia's Manufacturing Industry.

INTRODUCTION: The National Institute for Occupational Safety and Health (NIOSH) established the Revised NIOSH Lifting Equation (RNLE) for manual lifting risk assessment. The objectives of this study were to determine the characteristics of physical factors using the RNLE and to explore additional factors to RNLE by modifying it to an Individual Lifting Equation (ILE). METHODS: This cross-sectional study was conducted in the manufacturing industry of three states in Malaysia among manual lifting workers. A questionnaire was administered, which comprised the sociodemographic characteristics and Nordic Musculoskeletal Questionnaire (NMQ) assessing low back pain (LBP). The RNLE dataset includes a load constant and six manual lifting variables collected from observational ergonomic risk assessment. The RNLE was modified to ILE by incorporating age, gender, and BMI. The equations' Lifting Index (LI) computed provides an overall manual lifting risk estimate. RESULTS: There were 165 participants, with a mean age of 28 years, and 108 (65.5%) were male. Most participants had a BMI within the normal range (60 (36.4%)) or were classified as overweight (54 (32.7%)). The lifting horizontal location showed the highest risk estimates, with the lowest mean multiplier value of 0.55. In contrast, age and BMI had the lowest risk estimates, with mean multiplier values of 0.99 and 0.98, respectively. Among the participants, LI values of one or less, indicating very low risk, were observed in 58 (35.1%) for RNLE and 39 (23.6%) for ILE. Additionally, RNLE and ILE showed figures of 11 (6.7%) and 20 (12.1%), respectively, signifying a very high risk of LI exceeding three. CONCLUSION: Studying the lifting factors and equation multipliers from RNLE is critical for evaluating the risk estimates of manual lifting. Exploring the ILE based on individual characteristics is appropriate to support the ergonomic program. Further study is needed to validate the ILE as an accurate screening tool for determining LBP risk estimates.

Water-Responsive Self-Contractive Silk-Based Skin Anti-Aging Tensioners with Customizable Biofunctions.

Skin anti-aging treatments have become increasingly popular. Currently, the prevalent treatment method involves implanting skin tension regulation threads (skin lifting threads) under the skin, and radiofrequency treatments. In this study, inspired by the natural supercontraction of spider silk, the molecular structure of silk fibroin fibers is modulated into an oriented configuration. This modification endows silk proteins with water-responsive self-contraction capabilities, leading to the development of innovative self-contracting silk-based skin tensioners (SSSTs). To align with clinical requirements, skin tension regulation materials are functionalized by testing for their self-contraction, near-infrared laser heating function, and bacteriostatic properties. The SSSTs exhibited remarkable self-contraction properties, drug-loading and sustained-release capabilities, notable antibacterial effects, controllable degradation, and good biocompatibility. Moreover, the near-infrared light heating function effectively increased subcutaneous temperature, demonstrating its potential for enhancing and prolonging skin lifting effects. Therefore, SSSTs can be applied for skin tension regulation to improve and delay skin aging. The results may pave the way for novel strategies in skin rejuvenation, with broad implications for the field of skin anti-aging.

Use of a wearable electromyography armband to detect lift-lower tasks and classify hand loads.

We used an armband with embedded surface electromyography (sEMG) electrodes, together with machine-learning (ML) models, to automatically detect lifting-lowering activities and classify hand loads. Nine healthy participants (4 male and 5 female) completed simulated lifting-lowering tasks in various conditions and with two different hand loads (2.3 and 6.8 kg). We compared three sEMG signal feature sets (i.e., time, frequency, and a combination of both domains) and three ML classifiers (i.e., Random Forest, Support Vector Machine, and Logistic Regression). Both Random Forest and Support Vector Machine models, using either time-domain or time- and frequency-domain features, yielded the best performance in detecting lifts, with respective accuracies of 79.2% (start) and 86.7% (end). Similarly, both ML models yielded the highest accuracy (80.9%) in classifying the two hand loads, regardless of the sEMG features used, emphasizing the potential of sEMG armbands for assessing exposure and risks in occupational lifting tasks.

Efficient nitrogen removal from municipal wastewater using an integrated fixed-film activated sludge process in a novel air-lifting loop reactor: A pilot-scale demonstration.

A novel air-lifting loop reactor combines anoxic, oxic, and settling zones to achieve organic and nutrient removal, as well as solid-liquid separation. To address sludge settling ability and operation stability issues caused by low dissolved oxygen in aerobic zones, this study proposes using modified polypropylene carriers to establish a fixed-film activated sludge (IFAS) system. A pilot-scale demonstration of the IFAS-based air-lifting loop reactor is conducted, and the results show successful operation for approximately 300 days. The pilot-scale reactor achieves a maximum aerobic granulation ratio of 16% in the bulk liquid. The IFAS system contributes to efficient removal of organic matter (96%) and nitrogen (94%) by facilitating simultaneous nitrification and denitrification, as well as fast solid-liquid separation with a low sludge volume index of 34 mL/g. Microbial analysis reveals enrichment of functional bacteria involved in nitrification, denitrification, and flocculation throughout the operation process.

Patient Repositioning during Hospitalization and Prevention of Pressure Ulcers: a Narrative Review / Reposicionamiento de pacientes en hospitalización y prevención de úlceras por presión: una revisión narrativa / Reposicionamento de pacientes na internação e prevenção de úlceras por pressão: uma revisão narrativa

Objective. This article presents a literature review to explore and analyze the current situation of pressure ulcers or lesions or decubitus ulcers, pathophysiological, epidemiological aspects, and risk factors. The progress in evidence of the effectiveness of preventive repositioning in the appearance of these lesions in vulnerable hospitalized patients is also evaluated. Methods. Databases were reviewed in non-systematic manner, including the Cochrane Wounds Specialized Register; Medline, Scopus, PubMed, the Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, SciELO, and Lilacs. The general search terms included [pressure ulcers or pressure lesions or decubitus ulcers] and [prevention or preventive] and [repositioning or positioning or position changes or postural change] and [patient at risk or vulnerable] and [hospitalized or ICU or intensive care]. Systematic literature reviews, randomized clinical trials, observational studies, cost-effectiveness and qualitative studies in English or Spanish were included. Results. Although globally, the incidence, prevalence, and years of disability associated to these lesions has diminished between 1990 and 2019, the high impact on health persists. Evidence found on the effectiveness of repositioning in preventing pressure ulcers and health associated costs has been evaluated with certainty between low and very low, as a result of conducting research with serious methodological limitations that report results with high inaccuracy. Conclusion.The findings reported present that these lesions persist at hospital level and continue being a global social and health problem with high impact on health budgets. Likewise, there is a need to develop greater quality research on prevention strategies, such as repositioning, which validate their effectiveness, and justify their use.

Objetivo. Este artículo presenta una revisión de la literatura con el objetivo de explorar y analizar la situación actual de las úlceras o lesiones por presión o úlceras por decúbito, aspectos fisiopatológicos, epidemiológicos, y factores de riesgo. Se evalúa además el progreso en la evidencia de la eficacia del reposicionamiento preventivo en la aparición de estas lesiones en pacientes vulnerables hospitalizados. Métodos. Se revisaron bases de datos de forma no sistemática, incluyendo The Cochrane Wounds Specialised Register; Medline, Scopus, PubMed, the Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, Scielo, y Lilacs. Los términos de búsqueda generales incluyeron [úlceras por presión o lesiones por presión o úlceras por decúbito] y [prevención o preventivo] y [reposicionamiento o posicionamiento o cambios de posición o cambio postural] y [paciente en riesgo o vulnerable] y [hospitalizado o UCI o cuidados intensivos]. Se incluyeron revisiones sistemáticas de la literatura, ensayos clínicos aleatorizados, estudios observacionales, estudios de costo-efectividad y cualitativos en idioma inglés o español. Resultados. Aunque globalmente la incidencia, prevalencia y años de incapacidad asociado a estas lesiones ha disminuido entre 1990 y 2019, el impacto en salud persiste de forma elevada. La evidencia encontrada sobre la eficacia del reposicionamiento en prevención de úlceras por presión y costos asociados en salud ha sido evaluada con certeza entre baja y muy baja, como resultado de la realización de investigaciones con serias limitaciones metodológicas que reportan resultados con alta imprecisión. Conclusión.Los hallazgos reportados presentan que estas lesiones persisten a nivel hospitalario y continúan siendo un problema social y de salud mundial con alto impacto en los presupuestos en salud. Así mismo se presenta la necesidad de desarrollar mayor investigación de calidad en estrategias preventivas como el reposicionamiento, que validen su eficacia, y justifiquen su utilización.

Objetivo. Este artigo apresenta uma revisão da literatura com o objetivo de explorar e analisar a situação atual das úlceras por pressão ou úlceras de decúbito, os aspectos fisiopatológicos e epidemiológicos e os fatores de risco. Também avalia o progresso na evidência da eficácia do reposicionamento preventivo no desenvolvimento dessas lesões em pacientes hospitalizados vulneráveis. Métodos.Foram revisados bancos de dados não específicos do local, incluindo The Cochrane Wounds Specialised Register; Medline, Scopus, PubMed, Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, Scielo e Lilacs. Os termos gerais de pesquisa incluíram [úlceras de pressão ou lesões por pressão ou úlceras de pressão ou úlceras de decúbito] e [prevenção ou preventivo] e [reposicionamento ou posicionamento ou mudanças de posição ou mudança postural] e [paciente em risco ou vulnerável] e [hospitalizado ou UTI ou terapia intensiva]. Foram incluídas revisões sistemáticas da literatura, ensaios clínicos randomizados, estudos observacionais, estudos de custo-efetividade e qualitativos em inglês ou espanhol. Resultados. Embora, em geral, a incidência, a prevalência e os anos de incapacidade associados a essas lesões tenham diminuído entre 1990 e 2019, o impacto na saúde continua alto. As evidências encontradas sobre a eficácia do reposicionamento na prevenção de úlceras por pressão e os custos de saúde associados foram avaliadas com certeza baixa a muito baixa, como resultado de pesquisas com sérias limitações metodológicas que relataram resultados altamente imprecisos. Conclusão. Os resultados relatados mostram que essas lesões persistem em nível hospitalar e continuam a ser um problema social e de saúde global com alto impacto nos orçamentos de saúde. Também há necessidade de mais pesquisas de qualidade sobre estratégias preventivas, como o reposicionamento, para validar sua eficácia e justificar seu uso.