RESVECH 2.0: cross-cultural adaptation for Brazil, reliability and validity for the evaluation of venous ulcers.

OBJECTIVES: to cross-culturally adapt the scale Resultados en la valoración y evolución de la cicatrización de las heridas - RESVECH 2.0 for Brazilian Portuguese; to estimate the internal consistency and construct and criterion validity of the scale in the evaluation of venous ulcers. METHODS: methodological study, based on international guidelines for studies of this type. Wounds were evaluated using the RESVECH 2.0 and Pressure Ulcer Scale of Healing 3.0 (PUSH). Descriptive analysis, confirmatory factor analysis, Cronbach's alpha and Spearman's correlation (p<0.05) were used. RESULTS: 12 nurses and 77 people with 153 venous ulcers participated in the study. The translation was successful, the proposed factor model was validated, and Cronbach 's alpha = 0.832 (95%CI, 0.780-0.880) and correlation coefficient (RESVECH 2.0 and PUSH 3.0) = 0.74 were obtained. CONCLUSIONS: the adaptation of RESVECH 2.0 to Brazilian Portuguese is robust. Reliability and validity show compatibility for use in the country in the evaluation of venous ulcers.

Effectiveness of Epidermal Growth Factor Loaded Carboxymethylcellulose (EGF-CMC) Hydrogel in Biofilm Formation in Wounds of Diabetic Patients: A Randomized Clinical Trial.

Diabetic patients frequently develop wounds, which can be colonized by bacteria, mainly Staphylococcus aureus and Pseudomonas aeruginosa, with the ability to form biofilms. This study aimed to evaluate the colonization and biofilm formation of Staphylococcus aureus and Pseudomonas aeruginosa in chronic wounds of diabetic patients treated with a bioactive dressing (EGF-CMC), which consisted of a 2% carboxymethylcellulose (CMC) hydrogel loaded with epidermal growth factor (EGF). This randomized clinical trial was conducted with 25 participants: 14 treated with EGF-CMC hydrogel and 11 treated with CMC hydrogel for 12 weeks. Participants with type 2 diabetes mellitus were selected. All had diabetic foot ulcers or chronic venous ulcers. Swab collections were performed on weeks 1, 6, and 12. The laboratory analyses included the identification of strains, microbial quantification, virulence gene investigation, and the evaluation of biofilm formation. In total, 13 S. aureus strains and 15 P. aeruginosa strains were isolated. There were no statistically significant differences regarding bacterial loads and virulence genes. However, EGF-CMC-hydrogel-treated wounds were colonized by strains with lower biofilm formation abilities. The probability of isolating biofilm-producing strains from CMC-hydrogel-treated wounds was 83% greater than the probability of isolating biofilm-producing strains from EGF-CMC-treated wounds.

Tratamentos tópicos para prevenção da radiodermatite em pacientes oncológicos: um protocolo de revisão de escopo / Topical treatments for the prevention of radiodermatitis in cancer patients: a scoping review protocol

OBJETIVO: Mapear as evidências disponíveis sobre os tratamentos tópicos utilizados na prevenção da radiodermatite no paciente oncológico. MÉTODO: Protocolo de revisão de escopo seguindo a metodologia do Joanna Briggs Institute (JBI). A estratégia de busca subdivide-se em três etapas utilizando os bancos de dados MEDLINE, CINAHL, LILACS, Web of Science (WoS) e literatura cinzenta (teses, dissertações, guidelines, opiniões de especialistas e material de divulgação de empresas detentoras de produtos), sem restrição de idioma ou temporal. A seleção dos artigos será realizada por dois revisores independentes e a extração de dados se dará através de um formulário construído para esse propósito. Os dados extraídos serão apresentados em diagramas ou tabelas, alinhados com o objetivo dessa revisão de escopo, concluindo com um resumo narrativo.

OBJECTIVE: To map the available evidence on topical treatments used to prevent radiodermatitis in cancer patients. METHOD: Scoping review protocol developed following the Joanna Briggs Institute (JBI) methodology. The search strategy is subdivided into three steps using the MEDLINE, CINAHL, LILACS, Web of Science (WoS), and grey literature databases (theses, dissertations, guidelines, expert opinions, and promotional material from companies that own specific products), with no language or time restriction. Two independent reviewers will select articles, and data extraction will take place through a form built for this purpose. The extracted data will be presented in diagrams or tables, aligned with the objective of this scoping review, closing with a narrative synthesis.

Polihexametilenobiguanida versus solução salina na carga microbiana em feridas: protocolo de revisão sistemática / Polyhexamethylene biguanide versus saline on microbial load in wounds: a systematic review protocol

OBJETIVO: Analisar a efetividade de Polihexametileno Biguanida (PHMB), comparado à solução salina na carga microbiana de pacientes com feridas. MÉTODO: Protocolo de revisão sistemática, construído segundo o Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), de acordo com metodologia do Joanna Briggs Institute (JBI). Os estudos serão avaliados por dois pesquisadores independentes, nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados de Enfermagem (BDENF), Sistema Online de Busca e Análise de Literatura Médica (MEDLINE)e Excerpta Medica Database (Embase). As pesquisas a serem incluídas serão aquelas publicadas em português, inglês ou espanhol e a busca não definirá recorte temporal. Serão desconsiderados estudos em animais ou in vitro, revisões, cartas ao editor ou estudos de casos. Após a seleção dos estudos, a extração de dados ocorrerá de maneira sistemática e os registros correspondentes serão feitos de forma narrativa e tabular.

OBJECTIVE: To analyze the effectiveness of polyhexamethylene biguanide (PHMB) compared to saline on the microbial load of wounds. METHOD: Systematic review protocol, built according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the Joanna Briggs Institute's (JBI) methodology. Studies will be evaluated by two independent researchers in the following databases: Latin America and the Caribbean Literature on Health Sciences (LILACS), Nursing Database (BDENF), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Excerpta Medica Database (Embase). Studies published in Portuguese, English, or Spanish will be included, and the search will not be restricted by publication date. Animal or in vitro studies, reviews, letters to the editor, and case studies will be excluded. After selecting studies, data extraction will take place systematically, and the corresponding records will be presented in a narrative and tabular way.

Translation and cross-cultural adaptation of the ABC taxonomy for medication adherence into Portuguese - Updating patients into people.

BACKGROUND: The Ascertaining Barriers to Compliance (ABC) taxonomy for describing medication adherence was created in 2012, aiming to standardize terms and definitions in research and practice. The taxonomy comprises seven terms and definitions. Originally developed in English, subsequently translated into French and German, is currently being translated to Portuguese, Spanish, Czech, Romanian and Italian, aiming to promote its global use and overcome cultural barriers. OBJECTIVES: To cross-culturally translate the ABC taxonomy into Portuguese for Portugal and Brazil. METHODS: A systematic literature search was conducted to identify published taxonomy terms and definitions in Portuguese, and to identify panelists in medication adherence. Initial mapping of terms and definitions retrieved was scrutinized by the research team to build an e-survey. The e-survey was piloted and then sent to panelists in both countries seeking consensus using a three-round Delphi method. Consensus was defined as ≥ 85% for round 1 and ≥ 75% for round 2. Terms with agreement <10% were dropped between rounds. In round 3, terms and definitions reaching agreement between 50 and 75% were classified as moderate consensus,>75-95% as consensus and >95% as strong consensus. RESULTS: A total of 778 studies were identified and 84 included, enabling the extraction of 154 terms and 32 definitions. In round 1, 164 panelists participated, 115 in round 2 and 99 in the round 3. Consensus was achieved in both countries for all seven terms and definitions, although with varying intensity of agreement. The term "Management of adherence" and the definition of "Discontinuation" obtained moderate consensus in both countries. CONCLUSIONS: A unified and unique ABC taxonomy in Portuguese was possible to develop for use in Portugal and in Brazil. Its use will harmonize and standardize the terms and definitions used in clinical practice and research.

RESVECH 2.0: cross-cultural adaptation for Brazil, reliability and validity for the evaluation of venous ulcers / RESVECH 2.0: adaptación transcultural para Brasil, fiabilidad y validez para evaluar úlceras varicosas / RESVECH 2.0: adaptação transcultural para o Brasil, confiabilidade e validade para avaliação de úlceras venosas

ABSTRACT Objectives: to cross-culturally adapt the scale Resultados en la valoración y evolución de la cicatrización de las heridas - RESVECH 2.0 for Brazilian Portuguese; to estimate the internal consistency and construct and criterion validity of the scale in the evaluation of venous ulcers. Methods: methodological study, based on international guidelines for studies of this type. Wounds were evaluated using the RESVECH 2.0 and Pressure Ulcer Scale of Healing 3.0 (PUSH). Descriptive analysis, confirmatory factor analysis, Cronbach's alpha and Spearman's correlation (p<0.05) were used. Results: 12 nurses and 77 people with 153 venous ulcers participated in the study. The translation was successful, the proposed factor model was validated, and Cronbach 's alpha = 0.832 (95%CI, 0.780-0.880) and correlation coefficient (RESVECH 2.0 and PUSH 3.0) = 0.74 were obtained. Conclusions: the adaptation of RESVECH 2.0 to Brazilian Portuguese is robust. Reliability and validity show compatibility for use in the country in the evaluation of venous ulcers.

RESUMEN Objetivos: adaptar transculturalmente la escala "Resultados en la valoración y evolución de la cicatrización de heridas", RESVECH 2.0 al portugués de Brasil; estimar su consistencia interna, validez de constructo y de criterio para su utilización en úlceras varicosas. Métodos: es un estudio metodológico, basado en directivas internacionales sobre investigaciones de esta naturaleza. Se evaluaron las heridas por medio de la RESVECH 2.0 y de la Escala de Cicatrización de Úlceras por Presión 3.0 (PUSH). Se llevó a cabo con análisis descriptivo, análisis factorial confirmatorio, alfa de Cronbach y correlación de Spearman (p<0,05). Resultados: participaron 12 enfermeros y 77 personas que tenían 153 úlceras venosas. La traducción fue exitosa, el modelo factorial propuesto fue validado, el alfa de Cronbach = 0,832 (95%CI=0,780-0,880) y el coeficiente de correlación (RESVECH 2.0 y PUSH 3.0) = 0,74. Conclusiones: la adaptación de la RESVECH 2.0 al portugués brasileño es sólida. La fiabilidad y la validez demuestran la compatibilidad para su utilización en el país en la evaluación de las úlceras varicosas.

RESUMO Objetivos: adaptar transculturalmente a escala Resultados en la valoración y evolución de la cicatrización de las heridas - RESVECH 2.0 para o português do Brasil; estimar sua consistência interna, validade de construto e de critério para utilização em úlceras venosas. Métodos: estudo metodológico, baseado em diretrizes internacionais para estudos dessa natureza. Realizou-se avaliação das feridas por meio da RESVECH 2.0 e da Pressure Ulcer Scale of Healing 3.0 (PUSH). Empregou-se análise descritiva, análise fatorial confirmatória, alfa de Cronbach e correlação de Spearman (p<0,05). Resultados: participaram 12 enfermeiros e 77 pessoas com 153 úlceras venosas. A tradução foi bem-sucedida, o modelo fatorial proposto foi validado, obteve-se alfa de Cronbach = 0,832 (IC95%=0,780-0,880) e coeficiente de correlação (RESVECH 2.0 e PUSH 3.0) = 0,74. Conclusões: a adaptação da RESVECH 2.0 para o português do Brasil é robusta. A confiabilidade e validade evidenciam compatibilidade para utilização no país e avaliação de úlceras venosas.

RESVECH 2.0: cross-cultural adaptation for Brazil, reliability and validity for the evaluation of venous ulcers / RESVECH 2.0: adaptación transcultural para Brasil, fiabilidad y validez para evaluar úlceras varicosas / RESVECH 2.0: adaptação transcultural para o Brasil, confiabilidade e validade para avaliação de úlceras venosas

ABSTRACT Objectives: to cross-culturally adapt the scale Resultados en la valoración y evolución de la cicatrización de las heridas - RESVECH 2.0 for Brazilian Portuguese; to estimate the internal consistency and construct and criterion validity of the scale in the evaluation of venous ulcers. Methods: methodological study, based on international guidelines for studies of this type. Wounds were evaluated using the RESVECH 2.0 and Pressure Ulcer Scale of Healing 3.0 (PUSH). Descriptive analysis, confirmatory factor analysis, Cronbach's alpha and Spearman's correlation (p<0.05) were used. Results: 12 nurses and 77 people with 153 venous ulcers participated in the study. The translation was successful, the proposed factor model was validated, and Cronbach 's alpha = 0.832 (95%CI, 0.780-0.880) and correlation coefficient (RESVECH 2.0 and PUSH 3.0) = 0.74 were obtained. Conclusions: the adaptation of RESVECH 2.0 to Brazilian Portuguese is robust. Reliability and validity show compatibility for use in the country in the evaluation of venous ulcers.

RESUMEN Objetivos: adaptar transculturalmente la escala "Resultados en la valoración y evolución de la cicatrización de heridas", RESVECH 2.0 al portugués de Brasil; estimar su consistencia interna, validez de constructo y de criterio para su utilización en úlceras varicosas. Métodos: es un estudio metodológico, basado en directivas internacionales sobre investigaciones de esta naturaleza. Se evaluaron las heridas por medio de la RESVECH 2.0 y de la Escala de Cicatrización de Úlceras por Presión 3.0 (PUSH). Se llevó a cabo con análisis descriptivo, análisis factorial confirmatorio, alfa de Cronbach y correlación de Spearman (p<0,05). Resultados: participaron 12 enfermeros y 77 personas que tenían 153 úlceras venosas. La traducción fue exitosa, el modelo factorial propuesto fue validado, el alfa de Cronbach = 0,832 (95%CI=0,780-0,880) y el coeficiente de correlación (RESVECH 2.0 y PUSH 3.0) = 0,74. Conclusiones: la adaptación de la RESVECH 2.0 al portugués brasileño es sólida. La fiabilidad y la validez demuestran la compatibilidad para su utilización en el país en la evaluación de las úlceras varicosas.

RESUMO Objetivos: adaptar transculturalmente a escala Resultados en la valoración y evolución de la cicatrización de las heridas - RESVECH 2.0 para o português do Brasil; estimar sua consistência interna, validade de construto e de critério para utilização em úlceras venosas. Métodos: estudo metodológico, baseado em diretrizes internacionais para estudos dessa natureza. Realizou-se avaliação das feridas por meio da RESVECH 2.0 e da Pressure Ulcer Scale of Healing 3.0 (PUSH). Empregou-se análise descritiva, análise fatorial confirmatória, alfa de Cronbach e correlação de Spearman (p<0,05). Resultados: participaram 12 enfermeiros e 77 pessoas com 153 úlceras venosas. A tradução foi bem-sucedida, o modelo fatorial proposto foi validado, obteve-se alfa de Cronbach = 0,832 (IC95%=0,780-0,880) e coeficiente de correlação (RESVECH 2.0 e PUSH 3.0) = 0,74. Conclusões: a adaptação da RESVECH 2.0 para o português do Brasil é robusta. A confiabilidade e validade evidenciam compatibilidade para utilização no país e avaliação de úlceras venosas.

DETERMINANTE SOCIAL EM SAÚDE E ÚLCERA DO PÉ DIABÉTICO: PROTOCOLO DE REVISÃO DE ESCOPO / SOCIAL DETERMINANT IN HEALTH AND DIABETIC FOOT ULCER: SCOPE REVIEW PROTOCOL / DETERMINANTE SOCIAL EN SALUD Y ÚLCERA DE PIE DIABÉTICO: PROTOCOLO DE REVISIÓN DEL ALCANCE

Objetivo: apresentar a sistematização de um protocolo de scoping review para mapear e descrever os determinantes sociais da saúde, propostos pela Organização Mundial da Saúde, presentes em adultos com úlcera do pé diabético. Método: Será utilizada uma estratégia de busca em três etapas. As bases de dados utilizadas são LILACS (Portal BVS), IBECS (Portal BVS), BDENF (Portal BVS), ColecionaSUS (Portal BVS). MEDLINE (PUBMED), Pubmed Central (PMC). Embase (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), CINAHL (EBSCO). As fontes de estudos não publicados e literatura cinzenta a serem pesquisadas incluem o portal de literatura cinzenta Scielo (Science.gov) e o banco de dados colaborativo e multilíngue Epistemonikos (Epistemonikos). Portal de Periódicos Capes nas bases de dados: Embase (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), Cumulative Index to Nursing and Allied Health Literature ­ Cinahl, Academic Search Premier - ASP, Academic Source, Open Dissertations e SocINDEX com Texto Completo (EBSCO). Portal da revista Scientific Electronic Library Online (Scielo), Science. As listas de referência de estudos elegíveis serão pesquisadas. O portal de periódicos Scielo (Science.gov) e o banco de dados colaborativo e multilíngue Epistemonikos serão pesquisados por literatura inédita. Será extraído os dados de acordo com as características do estudo e da publicação e classificará os determinantes de acordo com os conceitos da Organização Mundial da Saúde

Objective: to present the systematization of a scoping review protocol to map and describe the social determinants of health, proposed by the World Health Organization, present in adults with diabetic foot ulcers. Method: A three-step search strategy will be used. The databases used are LILACS (VHL Portal), IBECS (VHL Portal), BDENF (VHL Portal), ColecionaSUS (VHL Portal). MEDLINE (PUBMED), Pubmed Central (PMC). Embase (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), CINAHL (EBSCO). Sources of unpublished studies and gray literature to be searched include the gray literature portal Scielo (Science.gov) and the multilingual collaborative database Epistemonikos (Epistemonikos). Portal de Periódicos Capes in the databases: Embase (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), Cumulative Index to Nursing and Allied Health Literature ­Cinahl, Academic Search Premier -ASP, Academic Source, Open Dissertations and SocINDEX with Full Text (EBSCO). Portal of Scientific Electronic Library Online (Scielo), Science. Reference lists of eligible studies will be searched. The journal portal Scielo (Science.gov) and the collaborative multilingual database Epistemonikos will be searched for unpublished literature. Data will be extracted according to the characteristics of the study and publication and the determinants will be classified according to the concepts of the World Health Organizationt

Objetivo: presentar la sistematización de un protocolo de revisión de alcance para mapear y describir los determinantes sociales de la salud, propuesto por la Organización Mundial de la Salud, presentes en adultos con úlceras del pie diabético. Las bases de datos utilizadas son LILACS (Portal BVS), IBECS (Portal BVS), BDENF (Portal BVS), ColecionaSUS (Portal BVS). MEDLINE (PUBMED), Pubmed Central (PMC). Embase (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), CINAHL (EBSCO). Las fuentes de estudios no publicados y literatura gris que se buscarán incluyen el portal de literatura gris Scielo (Science.gov) y la base de datos colaborativa multilingüe Epistemonikos (Epistemonikos). Portal de Periódicos Capes en las bases de datos: Embase (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), Cumulative Index to Nursing and Allied Health Literature ­Cinahl, Academic Search Premier -ASP, Academic Source, Open Dissertations y SocINDEX con texto completo (EBSCO). Portal de Biblioteca Científica Electrónica en Línea (Scielo), Ciencia. Se buscarán las listas de referencias de los estudios elegibles. Se buscará literatura no publicada en el portal de revistas Scielo (Science.gov) y en la base de datos multilingüe colaborativa Epistemonikos. Los datos se extraerán según las características del estudio y publicación y los determinantes se clasificarán según los conceptos de la Organización Mundial de la Salud

Brazilian practice guidelines for stroke rehabilitation: Part II.

The Brazilian Practice Guidelines for Stroke Rehabilitation - Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderência ao uso de medicamentos, cuidados paliativos, o futuro da reabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

Implementation of an innovative model of community nursing for older adults based on Buurtzorg principles: a scoping review protocol.

OBJECTIVE: The objective of this review is to map the international evidence on the implementation of the Buurtzorg model of community nursing practice for the care of older adults. We will describe where and how it has been used, and the challenges and facilitators of implementing this model of care. INTRODUCTION: The challenges of aging have mobilized health systems around the world to replace the current facility- and disease-centered care model with integrated patient-centered care models. The Buurtzorg model provides autonomy to nurses, who, in turn, empower patients in need-based and self-reliant care. INCLUSION CRITERIA: We will consider both published and unpublished studies and reports exploring the process of implementing the Buurtzorg community nursing model for the care of older adults (65 years and older) internationally, in all settings. Concepts of interest will include where the model has been used, how the model has been implemented, and what challenges and facilitators were reported. METHODS: We will implement a three-step search strategy to locate both published and unpublished primary studies, theses, dissertations, book chapters, and text and opinion reports using the following databases: MEDLINE, LILACS, Cochrane CENTRAL, CINAHL, Web of Science, Google Scholar, Embase, Scopus, ProQuest Dissertations and Theses Global, and the official Buurtzorg website. We will present the search strategy in a PRISMA flow diagram. Data will be extracted using Excel spreadsheets and then analyzed narratively. Extracted data will be quantitatively pooled in tables using descriptive statistics to synthesize the characteristics of the reports and sample, followed by a qualitative summary of how the Buurtzorg model has been used, and the challenges and facilitators of implementing this care model.

Cicatrização de feridas diabéticas com fator de crescimento epidérmico: revisão integrativa / Healing of diabetic wounds with epidemic growth factor: integrative review / Curación de heridas diabéticas con factor de crecimiento epidérmico: revisión integrativa

Objetivo: Analisar as produções científicas sobre a efetividade do Fator de crescimento epitelial recombinante humano na cicatrização de feridas diabéticas. Métodos: Trata-se de uma revisão sistemática da literatura, a busca foi realizada nas bases de dados: Pubmed; Scopus e Lilacs. Resultados: Foram selecionados 21 artigos, sendo a maioria estudos experimentais (48%). A cicatrização completa de lesões tratadas com Fator de crescimento epitelial recombinante humano foi relatada por 17 artigos (81%). O aumento do tecido de granulação foi relatado em nove publicações (43%). Da mesma maneira, a diminuição da área da lesão foi descrita em dois artigos incluídos (10%). Duas publicações descrevem a diminuição do número de amputações e do estresse oxidativo e 62% dos artigos abordaram eventos adversos associados ao uso do produto (13/21), dos quais foram prioritários a ocorrência de tremores, dor local, calafrios, náuseas, infecção superficial, sensação de queimação e hematomas, considerados eventos adversos leves. Apenas um estudo apresentou a ocorrência de dor no peito como evento adverso grave. Conclusão: O fator de crescimento epitelial recombinante humano é indicado para uso tópico no tratamento de feridas diabéticas, evidenciando boa eficácia, porém mais estudos clínicos devem ser desenvolvidos. (AU)

Objective: To analyse the scientific studies of Human recombinant epithelial growth factor for the healing of diabetic wounds. Methods: A thorough review of the literature was performed in the following databases: PubMed, Scopus and LILACS. Results: 21 articles were selected, most studies were experimental (48%). Complete healing of Human recombinant epithelial growth factor-treated lesions has been reported by 17 articles (81%). Increased granulation tissue has been reported in nine publications (43%). Similarly, the reduction of the lesion area was described in two included articles (10%). Two publication describes the decrease in the number of amputations and oxidative stress and 62% of the articles addressed adverse events associated with the use of the product (13/21), of which the occurrence of tremors, local pain, chills, nausea, superficial infection, burning sensation and bruising were considered priority, considered adverse events light. Only one study showed chest pain as a serious adverse event. Conclusion: Although Human recombinant epithelial growth factor is indicated for topical use in the treatment of diabetic wounds and demonstrates good efficacy, more clinical studies should be developed. (AU)

Objetivo: Analizar la producción científica sobre la efectividad de Factor de crecimiento epitelial humano recombinante en la curación de heridas diabéticas. Métodos: Esta es una revisión sistemática de la literatura, la búsqueda se realizó en las bases de datos: Pubmed; Scopus y lilas. Resultados: Se seleccionaron 21 artículos. La mayoría de los estudios fueron experimentales (48%). 17 artículos informaron sobre la curación completa de lesiones tratadas con factor de crecimiento epitelial humano recombinante (81%). El aumento en el tejido de granulación se informó en nueve publicaciones (43%). Asimismo, se utilizó una reducción en el área de la lesión en dos artículos incluidos (10%). Dos publicaciones describen una disminución en el número de amputaciones y estrés oxidativo y el 62% de los artículos abordaron eventos adversos asociados con el uso del producto (13/21), que son las prioridades prioritarias en la aparición de temblores, dolor local, escalofríos, náuseas, infección superficial, sensación de ardor y hematomas, reflejos de eventos adversos leves. Solo un estudio muestra la aparición de dolor torácico como un evento adverso grave. Conclusión: Factor de crecimiento epitelial humano recombinante está indicado para uso tópico en el tratamiento de heridas diabéticas, mostrando buena eficacia, pero se deben desarrollar más estudios clínicos. (AU)

rhEGF-Loaded Hydrogel in the Treatment of Chronic Wounds in Patients with Diabetes: Clinical Cases.

The aim of the study was to evaluate the healing process of chronic wounds treated with carboxymethylcellulose loaded with recombinant human epidermal growth factor in patients with diabetes. The case series consisted of 10 patients treated at the university hospital for 12 weeks. Data were analyzed using SPSS version 22.0. according to the intention to treat the principle, without the loss or exclusion of the participants. The sample consisted of 70% (7/10) males with a mean age of 61.9 years (±9.4); all (100%) had diabetes mellitus and 70% (7/10) had systolic hypertension associated with diabetes mellitus. Sixty percent (6/10) presented lesions of diabetic etiology and 40% (4/10) presented lesions of venous etiology; 70% (7/10) had had lesions for less than 5 years. The mean glycated hemoglobin was 7.8% (±2.7%), while the mean ankle-arm index (AAI) was 0.94 (±0.21). The mean initial area of all wounds was 13.4 cm², and the mean final area was 7.8 cm2, with a reduction rate of 28.9% over the 12 weeks of treatment. The reduction rate of diabetic ulcers was higher (33.4%) than that of venous ulcers (22.1%). Regarding the type of tissue, there was an increase in granulation and epithelialization, and a decrease in slough and the amount of exudate that were statistically significant (p = 0.021). No participant had severe or local adverse events during the study period. Epidermal growth factor was effective in the treatment of chronic wounds, especially diabetic ulcers, resulting in the reduction of the wound area and the improvement of tissue and exudate quality.

Brazilian Academy of Neurology practice guidelines for stroke rehabilitation: part I.

The Guidelines for Stroke Rehabilitation are the result of a joint effort by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology aiming to guide professionals involved in the rehabilitation process to reduce functional disability and increase individual autonomy. Members of the group participated in web discussion forums with predefined themes, followed by videoconference meetings in which issues were discussed, leading to a consensus. These guidelines, divided into two parts, focus on the implications of recent clinical trials, systematic reviews, and meta-analyses in stroke rehabilitation literature. The main objective was to guide physicians, physiotherapists, speech therapists, occupational therapists, nurses, nutritionists, and other professionals involved in post-stroke care. Recommendations and levels of evidence were adapted according to the currently available literature. Part I discusses topics on rehabilitation in the acute phase, as well as prevention and management of frequent conditions and comorbidities after stroke.

Brazilian practice guidelines for stroke rehabilitation: part II / Diretrizes brasileiras para reabilitação no acidente vascular cerebral: parte II

Abstract The Brazilian Practice Guidelines for Stroke Rehabilitation - Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

Resumo As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderênciaao usode medicamentos, cuidados paliativos,ofuturodareabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

Brazilian Academy of Neurology practice guidelines for stroke rehabilitation: part I / Diretrizes da Academia Brasileira de Neurologia para reabilitação do acidente vascular cerebral: parte I

ABSTRACT The Guidelines for Stroke Rehabilitation are the result of a joint effort by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology aiming to guide professionals involved in the rehabilitation process to reduce functional disability and increase individual autonomy. Members of the group participated in web discussion forums with predefined themes, followed by videoconference meetings in which issues were discussed, leading to a consensus. These guidelines, divided into two parts, focus on the implications of recent clinical trials, systematic reviews, and meta-analyses in stroke rehabilitation literature. The main objective was to guide physicians, physiotherapists, speech therapists, occupational therapists, nurses, nutritionists, and other professionals involved in post-stroke care. Recommendations and levels of evidence were adapted according to the currently available literature. Part I discusses topics on rehabilitation in the acute phase, as well as prevention and management of frequent conditions and comorbidities after stroke.

RESUMO As Diretrizes Brasileiras para Reabilitação do AVC são fruto de um esforço conjunto do Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia com o objetivo de orientar os profissionais envolvidos no processo de reabilitação para a redução da incapacidade funcional e aumento da autonomia dos indivíduos. Membros do grupo acima participaram de fóruns de discussão na web com pré-temas, seguidos de reuniões por videoconferência em que as controvérsias foram discutidas, levando a um consenso. Essas diretrizes, divididas em duas partes, focam as implicações de recentes ensaios clínicos, revisões sistemáticas e metanálises sobre reabilitação do AVC. O objetivo principal é servir de orientação a médicos, fisioterapeutas, fonoaudiólogos, terapeutas ocupacionais, enfermeiros, nutricionistas e demais profissionais envolvidos no cuidado pós-AVC. As recomendações e níveis de evidência foram adaptados de acordo com a literatura disponível atualmente. Aqui é apresentada a Parte I sobre tópicos de reabilitação na fase aguda, prevenção e tratamento de doenças e comorbidades frequentes após o AVC.

Construct validity and reliability of the leg ulcer measurement tool scale adapted for brazil / Validez de constructo y confiabilidad de la escala leg ulcer measurement tool adaptada a brasil / Validade de construto e confiabilidade da escala leg ulcer measurement tool adaptada para o brasil

ABSTRACT Objective: to validate the Portuguese version of the Leg Ulcer Measurement Tool regarding construct and reliability. Method: this is a methodological research study. Data collection was conducted between January and July 2019. A total of 105 participants were included for construct validation and internal consistency and, of these, 50 were selected for intra-observer stability. For the analysis of construct validity, factor analysis was performed; for internal consistency, Cronbach's alpha coefficient was calculated, and for stability, the intraclass correlation coefficient. Results: A total of 12items were confirmed for the Brazilian reality, meeting all the theoretical requirements of the factor analysis model. As for the internal consistency (reliability) analysis, the Cronbach's alpha coefficient values (α=0.711) showed that the set of items that make up the scale measures the same characteristics and presents internal consistency. In the global stability analysis (ICC=0.823), the Leg Ulcer Measurement Tool test and retest scores presented good agreement, showing that the adapted scale is stable. Conclusion: the Leg Ulcer Measurement Tool scale adapted to the Portuguese language contains 12 items, with scores varying from 0 to 4 and, thus, produces a score from 0 to 48 points. It presents construct validity analyzed by means of factor analysis and reliability in terms of internal consistency and stability.

RESUMEN Objetivo: validar el constructo y la confiabilidad de la versión en portugués de la escala Leg Ulcer Measurement Tool. Método: investigación metodológica. La recolección de datos tuvo lugar entre enero y julio de 2019. Se incluyó a 105 participantes para la validación del constructo y la consistencia interna y, de ellos, 50 para la estabilidad intraobservador. Para el análisis de validez de constructo, se realizó un análisis factorial; para la consistencia interna, se calculó el coeficiente alfa de Cronbach y, para la estabilidad, el coeficiente de correlación intraclase. Resultados: se confirmaron 12 ítems para la realidad brasileña, cumpliendo con todos los requisitos teóricos del modelo de análisis factorial. En relación con el análisis de la consistencia interna (confiabilidad), los valores del coeficiente alfa de Cronbach (α=0,711) demostraron que el conjunto de ítems que componen la escala mide las mismas características y presenta consistencia interna. En el análisis de la estabilidad global (ICC=0,823), las puntuaciones test-retest de la escala Leg Ulcer Measurement Tool presentaron buena concordancia, demostrando así que la escalaadaptada es estable. Conclusión: la escala Leg Ulcer Measurement Tool adaptada para el idioma portuguéscontiene 12 ítems, con valores de 0 a 4 y, por lo tanto, genera una puntuación que varía entre 0 y 48 puntos. Presenta validez de constructo, la cual se analizó por medio del análisis factorial y confiabilidad en términos de consistencia interna y estabilidad.

RESUMO Objetivo: validar o construto e a confiabilidade da versão em português da escala Leg Ulcer Measurement Tool. Método: trata-se de uma pesquisa metodológica. A coleta de dados foi realizada entre janeiro e julho de 2019. Foram incluídos 105 participantes para a validação de construto e consistência interna e, desses, 50 participantes para a estabilidade intraobservador. Para a análise de validade de construto, foi realizada a análise fatorial; para a consistência interna, foi calculado o coeficiente alfa de Cronbach e para a estabilidade, o coeficiente de correlação intraclasse. Resultados: foram confirmados 12 itens para a realidade brasileira, cumprindo todas as exigências teóricas do modelo da análise fatorial. Quanto à análise da consistência interna (confiabilidade), os valores do coeficiente de alfa de Cronbach (α=0,711) demonstraram que o conjunto de itens que compõem a escala mede as mesmas características e apresenta consistência interna. Na análise da estabilidade global (ICC=0,823), os escores da Leg Ulcer Measurement Tool no teste e reteste apresentaram boa concordância, demonstrando que a escalaadaptada é estável. Conclusão: A escala Leg Ulcer Measurement Tool adaptada para a língua portuguesa contém 12 itens, com pontuação de 0 a 4, e produz, assim, um escore que varia de 0 a 48 pontos. Apresenta validade de construto analisada pela análise fatorial e confiabilidade em termos de consistência interna e estabilidade.

The presence of anemia in patients with leg ulcer: laboratory test / La presencia de anemia en pacientes con úlcera de la pierna: prueba de laboratorio / Presença de anemia em pacientes com úlcera da perna: testes laboratoriais

ABSTRACT Objective: To evaluate the presence of anemia in patients with chronic lower limb ulcers based on profile and hematometric indices. Method: This is a cross-sectional study carried out in a university hospital in Rio de Janeiro. The sample was composed of 64 participants with lower limb ulcers and evolution time greater than 12 weeks. Data was collected between May/2016 and December/2017 from hematological analyses, records from medical records, and wound assessment form. Results: 36 (56.2%) were male; 38 (59.4%) between 60 and 80 years old; 56 (87.5%) with chronic diseases and 52 (81.2%) with venous ulcers. 6 years mean of active ulceration. Anemia was detected in 36 (56.2%), 27 (75%) of which were normochromic and normocytic; 14 (38.8%) had deficiency anemia recorded in their medical chart. Conclusion: The low hemoglobin concentration is recurrent among the participants characterizing an anemia condition, whose profile reveals congruence to the anemia of chronic disease.

RESUMEN Objetivo: Evaluar la presencia de anemia en pacientes con úlceras crónicas de miembros inferiores desde el perfil e índices hematimétricos Método: Este estudio seccional transcurrió en un hospital universitario de Río de Janeiro, con una muestra de 64 participantes con úlceras en los miembros inferiores y tiempo de evolución superior a 12 semanas. Los datos se recopilaron entre mayo/2016 y diciembre/2017 investigando los análisis hematológicos, registros en las historias clínicas y formularios de evaluación de la herida. Resultados: 36 (56,2%) eran hombres; 38 (59,4%) tenían entre 60 y 80 años; 56 (87,5%) padecían de enfermedades crónicas y 52 (81,2%), de úlceras venosas. El promedio era de 6 años de úlcera activa. Se detectó anemia en 36 (56,2%), siendo que en 27 (75%) era normocrómica/normocítica; 14 (38,8%) presentaban anemia carencial registrada en la historia clínica. Conclusión: La baja concentración de hemoglobina es recurrente entre los participantes caracterizando un cuadro de anemia que coincide con el de anemia de enfermedad crónica.

RESUMO Objetivo: Avaliar a presença de anemia em pacientes com úlceras crônicas de membros inferiores a partir do perfil e dos índices hematimétricos. Método: Estudo seccional realizado em um hospital universitário do Rio de Janeiro. Amostra composta por 64 participantes com úlceras de membros inferiores e tempo de evolução maior que 12 semanas. Dados coletados entre maio/2016 e dezembro/2017, a partir de análises hematológicas, registros nos prontuários e em formulário de avaliação da ferida. Resultados: 36 (56,2%) eram do sexo masculino; 38 (59,4%) entre 60 e 80 anos; 56 (87,5%) com doenças crônicas e 52 (81,2%) com úlceras venosas. Média de 6 anos de úlcera ativa. Detectou-se anemia em 36 (56,2%), sendo 27 (75%) normocrômica e normocítica; 14 (38,8%) apresentavam anemia carencial registrada em prontuário. Conclusão: A baixa concentração de hemoglobina é recorrente entre os participantes, caracterizando um quadro de anemia cujo perfil revela congruência ao da anemia da doença crônica.

The presence of anemia in patients with leg ulcer: laboratory test.

OBJECTIVE: To evaluate the presence of anemia in patients with chronic lower limb ulcers based on profile and hematometric indices. METHOD: This is a cross-sectional study carried out in a university hospital in Rio de Janeiro. The sample was composed of 64 participants with lower limb ulcers and evolution time greater than 12 weeks. Data was collected between May/2016 and December/2017 from hematological analyses, records from medical records, and wound assessment form. RESULTS: 36 (56.2%) were male; 38 (59.4%) between 60 and 80 years old; 56 (87.5%) with chronic diseases and 52 (81.2%) with venous ulcers. 6 years mean of active ulceration. Anemia was detected in 36 (56.2%), 27 (75%) of which were normochromic and normocytic; 14 (38.8%) had deficiency anemia recorded in their medical chart. CONCLUSION: The low hemoglobin concentration is recurrent among the participants characterizing an anemia condition, whose profile reveals congruence to the anemia of chronic disease.

Effectiveness of a synthetic human recombinant epidermal growth factor in diabetic patients wound healing: Pilot, double-blind, randomized clinical controlled trial.

To investigate whether the addition of human recombinant epidermal growth factor (h-EGF) to 2% carboxymethyl cellulose gel is more effective in diabetic wound healing than standard treatment, a pilot, double-blind, randomized and controlled clinical trial with therapeutic intervention was performed at a university hospital. The sample consisted of 25 patients (14 in the intervention group that used rh-EGF and 11 in the control group that used 2% carboxymethyl cellulose gel). Data were tabulated in SPSS and analysed by intention to treat, without loss or exclusion of participants. Twenty-five subjects participated with a mean age of 60.6 years, a predominance of males in both groups and 100% prevalence of type-2 diabetes. Within 12 weeks, complete wound healing occurred in three ulcers in the intervention group versus one ulcer in the control group. The percent reduction in the wound area was significantly higher in the intervention group than in the control group (p = 0.049). Concerning the types of tissue, an increase in granulation and epithelial tissue and a reduction in exudate levels were observed in both groups. Decreased slough occurred only in the intervention group. No participant experienced serious or local adverse events during the study period. This study shows that h-EGF is effective, with a statistically significant reduction in wound area, improvement of tissue quality, and safe treatment of chronic wounds. In addition, this study demonstrated that blinding of participants during research using h-EGF is feasible.

Blood Cell Count and the Presence or Absence of Infection in Venous Ulcers Treated With Platelet-Rich Plasma.

INTRODUCTION: In general, chronic wounds are colonized by bacteria; however, when microorganisms start to multiply at higher levels, wounds can become infected, causing prolongation of the inflammatory phase and retardation of collagen synthesis and epithelialization. OBJECTIVE: The objective of this study was to evaluate the presence of infection in venous ulcers after 12 weeks of treatment with autologous platelet-rich plasma (PRP) and determine global white blood cell counts. MATERIALS AND METHODS: This case series study involved a sequential sample of 17 patients with venous ulcers treated with PRP for 12 weeks. Descriptive and inferential statistical analysis was performed using the McNemar test and χ² test. RESULTS: At baseline, 10 patients (58.8%) had wound infection. During the sixth week of treatment with PRP, only 3 patients (17.6%) continued to exhibit wound infection. After 12 weeks of PRP treatment, only 1 patient (5.9%) continued to exhibit wound infection. McNemar and χ² tests used to assess the presence of infection in the intervention group produced a P value of .0039 for a comparison of baseline and week 6 and a P value of .0078 for a comparison of baseline and week 12. These results demonstrated significant differences from baseline at both 6 weeks and 12 weeks of treatment, with greater significance at 12 weeks. There was no relationship between global white blood cell count and the presence of infection. CONCLUSION: After intervention with PRP, 94% of patients experienced improvement concerning the infection of ulcers.