Cross-Cultural Adaptation and Measurement Properties Analysis of the Brazilian Portuguese Version of the ICIQ-VS.

INTRODUCTION AND HYPOTHESIS: The high prevalence of pelvic floor disorders in women requires assessments using validated instruments. We aimed to translate, cross-culturally adapt to Brazilian Portuguese, and analyze the measurement properties of the International Consultation on Incontinence Questionnaire Vaginal Symptoms Module (ICIQ-VS-Br). METHODS: Participants were Brazilian women older than 18 years presenting vulvovaginal symptoms according to the Vulvovaginal Symptoms Questionnaire (VSQ-Br). The development of the ICIQ-VS-Br included the steps of translation, synthesis, back-translation, expert meeting, and pre-test. We analyzed construct validity by correlating the ICIQ-VS-Br and VSQ-Br. The participants answered the ICIQ-VS-Br the second time 7 to 10 days after the first response. We measured test-retest reliability using intraclass correlation coefficient (ICC), internal consistency using Cronbach's alpha, and construct validity using Pearson's correlation coefficient. RESULTS: The study included 313 women. Reproducibility was analyzed for the three subscales of the ICIQ-VS-Br, resulting in an ICC of 0.92 (95% CI 0.89 to 0.94) for "vaginal symptoms," 0.85 (95% CI 0.78 to 0.89) for "sexual matters," and 0.87 (95% CI 0.81 to 0.91) for "quality of life." Construct validity showed a moderate correlation between ICIQ-VS-Br and VSQ-Br, confirming our hypotheses. CONCLUSIONS: The ICIQ-VS-Br demonstrated validity and reproducibility, indicating that the instrument can be used in scientific research and clinical practice.

The Brazilian Portuguese version of the ICIQ-FLUTSsex: cross-cultural adaptation and measurement property analysis.

INTRODUCTION AND HYPOTHESIS: The worldwide prevalence of sexual dysfunction in women is high; therefore, an adequate assessment of this condition is necessary, with instruments validated for the Brazilian population. The aim was to translate and adapt the International Consultation on Incontinence Questionnaire Female Sexual Matters Associated with Lower Urinary Tract Symptoms into Brazilian Portuguese (ICIQ-FLUTSsex-Br) and analyze its measurement properties. METHODS: We recruited Brazilian women, literate, over 18 years old, who had had sexual intercourse in the last 4 weeks and had urinary loss. The translation and cross-cultural adaptation were performed following five stages: translation, synthesis, back translation, expert committee review, and pre-test. Measurement properties were analyzed using SPSS software, as follows: test-retest reliability using the intraclass correlation coefficient (ICC); construct validity using Pearson's correlation coefficient, by correlating the ICIQ-FLUTSsex-Br with the Female Sexual Function Index (FSFI) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). RESULTS: A total of 328 women participated in the study. The reproducibility was 0.88, the standard error of measurement was 0.29, and the minimal detectable change was 0.80 (95% CI). Moderate correlations were found between the total scores of the ICIQ-FLUTSsex and PISQ-12 questionnaires (0.54, p<0.01), confirming the hypotheses outlined. Weak correlations were also found for comparisons between the FSFI and ICIQ-FLUTSsex total scores (-0.56, p<0.01) and the PISQ-12 question about fear of incontinence hindering sexual intercourse (0.26, p<0.01). CONCLUSION: The Portuguese-language version of the ICIQ-FLUTSsex-Br showed validity and reproducibility, making it a tool to be used in research and clinical practice by health professionals in Brazil.

Impacts of Social Isolation on the Physical and Mental Health of Older Adults During Quarantine: A Systematic Review.

OBJECTIVES: To systematically review articles that reported the impacts of social isolation on the physical and mental health of healthy older adults during the coronavirus disease 2019 (Covid-19) quarantine. METHODS: Electronic search was performed in PubMed, EMBASE, Web of Science, Scopus, and BIREME databases. It included cohort and cross-sectional studies published between January 2020 and January 2022 which evaluated the impacts of social isolation on the physical and mental health of older adults during quarantine. The study was registered in PROSPERO (CRD42021269720). RESULTS: Out of 8,505 studies identified, 17 met the inclusion criteria, with moderate to excellent quality. The majority of the older population perceived changes in their physical and mental health. Impacts differed in cohorts according to sex, age group, income, social participation, exercising before and during confinement, and living alone or with other people. CONCLUSIONS: The long period of social isolation dictated by the COVID-19 pandemic caused changes in most older adults`, reducing levels of physical activity and/or generating depression, anxiety, fear, and mood problems. Follow-up studies are necessary to observe the evolution of these impacts. CLINICAL IMPLICATIONS: Public policies must be developed to promote the emotional and physical health of the older adult population in the post-pandemic period.

Vitamin C-based regimens for sepsis and septic shock: Systematic review and meta-analysis of randomized clinical trials.

PURPOSE: to critically appraise and synthesize the evidence on the effects of vitamin C-based regimens for patients with sepsis or septic shock. METHODS: a broad search was performed on May 2021 to identify randomized clinical trials (RCTs) assessing vitamin C-based regimens as adjuvant therapy for adults with sepsis or septic shock. We used the Cochrane Risk of Bias table to assess the methodological quality of the included RCTs and the GRADE approach to evaluate the evidence certainty. RESULTS: We included 20 RCTs (2124 participants). Evidence from low to very low certainty showed that vitamin C compared to placebo may reduce all-cause mortality up to 28 days (relative risk [RR] 0.60, 95% confidence interval (CI) 0.45 to 0.80, 4 RCTs, 335 participants). Considering the other comparisons (vitamin C alone or combined with thiamine and/or hydrocortisone, compared to placebo, standard care or hydrocortisone), there were a little to no difference or very uncertain evidence for adverse events, SOFA score, ICU length of stay, acute kidney injury, mechanical ventilation- and vasoactive drugs-free days up to 28 days. CONCLUSION: Further RCTs with higher methodological quality, an increased number of participants and assessing clinically relevant outcomes are needed to provide better decision-making guidance. PROSPERO REGISTER: CRD42021251786.

The Effect of Priming on Outcomes of Task-Oriented Training for the Upper Extremity in Chronic Stroke: A Systematic Review and Meta-analysis.

Background. Priming results in a type of implicit memory that prepares the brain for a more plastic response, thereby changing behavior. New evidence in neurorehabilitation points to the use of priming interventions to optimize functional gains of the upper extremity in poststroke individuals. Objective. To determine the effects of priming on task-oriented training on upper extremity outcomes (body function and activity) in chronic stroke. Methods. The PubMed, CINAHL, Web of Science, EMBASE, and PEDro databases were searched in October 2019. Outcome data were pooled into categories of measures considering the International Classification Functional (ICF) classifications of body function and activity. Means and standard deviations for each group were used to determine group effect sizes by calculating mean differences (MDs) and 95% confidence intervals via a fixed effects model. Heterogeneity among the included studies for each factor evaluated was measured using the I2 statistic. Results. Thirty-six studies with 814 patients undergoing various types of task-oriented training were included in the analysis. Of these studies, 17 were associated with stimulation priming, 12 with sensory priming, 4 with movement priming, and 3 with action observation priming. Stimulation priming showed moderate-quality evidence of body function. Only the Wolf Motor Function Test (time) in the activity domain showed low-quality evidence. However, gains in motor function and in use of extremity members were measured by the Fugl-Meyer Assessment (UE-FMA). Regarding sensory priming, we found moderate-quality evidence and effect size for UE-FMA, corresponding to the body function domain (MD 4.77, 95% CI 3.25-6.29, Z = 6.15, P < .0001), and for the Action Research Arm Test, corresponding to the activity domain (MD 7.47, 95% CI 4.52-10.42, Z = 4.96, P < .0001). Despite the low-quality evidence, we found an effect size (MD 8.64, 95% CI 10.85-16.43, Z = 2.17, P = .003) in movement priming. Evidence for action observation priming was inconclusive. Conclusion. Combining priming and task-oriented training for the upper extremities of chronic stroke patients can be a promising intervention strategy. Studies that identify which priming techniques combined with task-oriented training for upper extremity function in chronic stroke yield effective outcomes in each ICF domain are needed and may be beneficial for the recovery of upper extremities poststroke.