ABSTRACT BACKGROUND: Use of the web for radiological education is an obvious application. Many computer-based teaching materials have been developed over recent years, and e-learning is becoming increasingly popular in medical schools. OBJECTIVE: To assess whether the effectiveness of distance-learning and/or e-learning, m-learning and web-based methods are equivalent to traditional methods. DESIGN AND SETTING: Systematic review of comparative studies of teaching techniques guided by Best Evidence Medical Education. METHODS: A search was carried out in the MEDLINE, EMBASE, Cochrane Library, Tripdatabase, CINAHL and LILACS online databases in April 2020, for original publications in all languages. The following MeSH terms were used: Ultrasonography; Teleradiology; Telemedicine; Education, Medical; Teaching; and Simulation Training; along with the terms e-learning, m-learning and web-based. All eligible studies were assessed using the Kirkpatrick model and Buckley's quality indicators. RESULTS: The search in the databases and a manual search resulted in 4549 articles, of which 16 had sufficient methodological quality for their inclusion. From analysis of these data, it was observed that teaching of ultrasonography using telemedicine methods is similar to the traditional method, except for venous access procedures, for which the studies did not show agreement. CONCLUSION: We found that learning via telemedicine methodologies presents great acceptance among students, besides demonstrating quality similar to the traditional method. Thus, at least at the moment, this has the capacity to serve as an important adjunct in the teaching of ultrasonography. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/CGUPA at the OPENSCIENCE Framework.

ABSTRACT BACKGROUND: The speed of the spread of coronavirus disease 2019 (COVID-19) has put enormous pressure on hospitals and other healthcare facilities. This, together with blockages in several countries, has hindered the availability and accessibility of the necessary personal protective equipment (PPE). OBJECTIVE: To identify, systematically evaluate and summarize the available scientific evidence on the efficacy, safety, safe use and reuse of PPE for healthcare professionals, for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN AND SETTING: Systematic review of studies analyzing products for disinfecting and enabling reuse of PPE for coronavirus within the evidence-based health program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, SCOPUS, Web of Science and LILACS databases, for articles published up to November 30, 2020. RESULTS: Ten studies were selected. These analyzed the use of N95, surgical and cotton masks, face shields, flexible enclosures with plastic covers or polycarbonate intubation boxes and plastic curtains; and also PPE disinfection using several substances. CONCLUSION: Combined use of a face shield with a N95 mask proved to be superior to other associations for protecting healthcare workers. Some products are useful for disinfecting PPE, such as 70% ethanol, 0.1% sodium hypochlorite and a mixture of quaternary ammonium and H2O2, and hydrogen peroxide. Ultraviolet light and dry heat at 70 °C can be used to decontaminate N95 masks. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/4V5FD at the OPENSCIENCE Framework.

ABSTRACT BACKGROUND: Teleradiology consists of electronic transmission of radiological images from one location to another, including between countries, for interpretation and/or consultation. It is one of the most successful applications of telemedicine. Combining this methodology with ultrasound (called telesonography) can accelerate the process of making diagnoses. Despite this rationale, the quality of the evidence about the effectiveness and accuracy of teleradiology remains unknown. OBJECTIVE: To review the literature on the evidence that exists regarding use of telemedicine for ultrasound in situations of synchronous transmission. DESIGN AND SETTING: Narrative review conducted within the evidence-based health program at a federal university in São Paulo (SP), Brazil. METHODS: A search of the literature was carried out in April 2020, in the online databases MEDLINE, EMBASE, Cochrane Library, Tripdatabase, CINAHL and LILACS, for original publications in all languages. The reference lists of the studies included and the main reviews on the subject were also evaluated. RESULTS: We included ten studies that assessed procedures performed by different healthcare professionals, always with a doctor experienced in ultrasound as a distant mentor. Among these, only one study assessed disease diagnoses in relation to real patients. CONCLUSIONS: Despite the promising position of telesonography within telemedicine, no studies with reasonable methodological quality have yet been conducted to demonstrate its effectiveness.

Resumo Objetivo Avaliar a qualidade metodológica das revisões sistemáticas para tratamento cirúrgico e não cirúrgico de indivíduos com síndrome do manguito rotador; comparar, através do instrumento Assessingthemethodologicalqualityofsystematic reviews(AMSTAR, na sigla em inglês), a qualidade dos estudos encontrados nas bases de dados Cochrane Library, PubMed (Publisher Medline), EMBASE e Qinsight. Métodos Trata-se de um estudo transversal descritivo e comparativo, em que dois autores independentes analisaram, por meio do instrumento AMSTAR, a qualidade metodológica das revisões sistemáticas Cochrane e nãoCochrane sobre tratamento de indivíduos com diagnóstico de síndrome do manguito rotador. Resultados 76 revisões sistemáticas foram avaliadas pelo instrumento AMSTAR. O escore médio geral foi de 6,1(±2,1) e a média por base de dados foi 9,1(±0,9) para as revisões Cochrane e 5,7(±1,8) para as não Cochrane. O item de menor pontuação do AMSTAR foi 11, relacionada à exibição dos conflitos de interesse da publicação. Em uma análise comparativa do escore da variável final, houve uma diferença estatística entre os estudos Cochrane e nãoCochrane. Conclusão De acordo com o presenteestudo, revisões sistemáticas utilizando a metodologia Cochrane têm uma melhor qualidade metodológica em comparação com estudos nãoCochrane sobre o tratamento de disfunções do manguito rotador.

Abstract Objective To evaluate the methodological quality of systematic reviews for the surgical and nonsurgical treatment of individuals with rotator cuff syndrome; to compare, through the Assessing the methodological quality of systematic reviews (AMSTAR) instrument, the quality of studies found in the Cochrane Library, PubMed (Publisher Medline), EMBASE andQinsightdatabases. Methods This is a descriptive and comparative cross-sectional study, in which two independent authors analyzed, through the AMSTAR instrument, the methodological quality of Cochrane and non-Cochrane systematic reviews on the treatment of individuals diagnosed with rotator cuff syndrome. Results A total of 76 systematic reviews were evaluated by the AMSTAR instrument. The overall mean score was 6.1 (±2.1) and the mean per database was 9.1 (±0.9) for the Cochrane reviews and 5.7 (±1.8) for the non-Cochrane reviews. The lowest-scoring item of AMSTAR was 11, related to the display of the conflict of interests of the publication. In a comparative analysis of the final variable score, there was a statistical difference between the Cochrane and non-Cochrane studies. Conclusion According to the present study, systematic reviews using the Cochrane methodology have a better methodological quality compared to non-Cochrane studies on the treatment of rotator cuff dysfunctions.

BACKGROUND: Computed tomography (CT) accounts for 13% of all radiological examinations in the United States and 40-70% of the radiation that patients receive. Even with the advent of magnetic resonance imaging (MRI), CT continues to be the gold standard for diagnosing bone fractures. There is uncertainty as to whether CT with a low radiation dose has a fracture detection rate similar to that of standard-dose CT. OBJECTIVE: To determine the detection rate of low-dose radiation CT and standard-dose radiation CT for fractures, in patients with suspected fractures. DESIGN AND SETTING: Systematic review of comparative studies on diagnostic accuracy within the evidence-based health program at a federal university in São Paulo (SP), Brazil. METHODS: We searched the electronic databases Cochrane Library, MEDLINE, EMBASE and LILACS up to June 29, 2020, for studies evaluating the detection rates of low-dose CT and standard-dose CT for diagnosing bone fractures. The Research Triangle Institute (RTI) item bank tool was used for methodological quality evaluation. RESULTS: The fracture detection rate according to the number of bones evaluated, using CT with low-dose radiation was 20.3%, while with standard-dose radiation it was 19.2%, and the difference between the methods was not significant. The fracture detection rate according to the number of patients, using CT with low-dose radiation was 56.0%, while with standard-dose radiation it was 58.7%, and this difference between the methods was not significant, either. CONCLUSION: CT with low-dose radiation presented detection rates similar to those of CT with standard-dose radiation, regardless of the bones evaluated. REGISTRATION NUMBER: CRD42019148491 at the PROSPERO database.

ABSTRACT BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with higher prevalence among women aged between 30 and 50 years and general prevalence of 1% worldwide. Interventions promoting improvement of quality of life for individuals with RA are required. Tai Chi appears to be a low-cost alternative, with studies showing positive results from this technique. However, regarding aspects of RA such as pain and sensitivity, studies remain inconclusive. OBJECTIVES: To compare the effectiveness of the Tai Chi method for treating patients diagnosed with rheumatoid arthritis, among systematic reviews. DESIGN AND SETTING: Overview of systematic reviews with Cochrane and non-Cochrane methodology. METHODS: Systematic reviews involving quasi-randomized and randomized clinical trials (RCTs) on use of Tai Chi, with no restrictions regarding the date and language of publication, were included. RESULTS: Three systematic reviews were included. The effects of Tai Chi associated with education and stretching exercises versus education and stretching were evaluated in these reviews. They showed that improvements in the variables of mood, depression and functional index were associated with use of Tai Chi. CONCLUSIONS: The findings suggest that clinical improvement was achieved, although not statistically significant with regard to pain and disease pattern, as assessed using the ACR20 measurement. Improvements relating to disability and quality of life were also seen. There was a low level of evidence and therefore caution in data analysis is recommended. The three studies included showed poor reliability for providing an accurate and complete summary of use of Tai Chi among people diagnosed with rheumatoid arthritis. PROSPERO: CRD42019125501.

Abstract Background: Diet plays a critical role in Systemic Lupus Erythematosus (SLE) patients, impacting on the microbiota composition and, consequently, on the immune response. The objective was to analyze and verify the diet effect on SLE patients. Methods: This is a systematic review performed at the Evidences-based Health Lab, Escola Superior em Ciências da Saúde, Brasília (DF), Brazil. In March, 2021, five databases, and grey literature, through JSTOR, Open Grey, and Google Scholar were searched. Randomized Clinical Trials in which SLE patients with calorie restricted, low glycemic index or other diet involving the joint adequacy of these aspects, compared with placebo or different types of diet, were included. Results: It was identified in the databases 758 articles; 132 were duplicated; 616 references were screened, and 604 were excluded. After reading the title and abstract, 12 articles were included for full-text reading. After the full-text reading, three studies were included for quantitative analysis. The diet improved the quality of life at 6 (MD 16.30; 5.91;26.69) and 12 weeks (MD 14.60; 0.88;28.32). The GRADE was used to evaluate the quality of evidence. Conclusion: There is low evidence that the diet has a positive impact on the quality of life of SLE patients. Trial registration PROSPERO—CRD4202012208.

Resumo O objetivo deste estudo foi compreender a construção da trajetória de jogadores de futebol profissional da seleção brasileira. Foram entrevistados seis jogadores de futebol, do gênero masculino, que faziam parte da equipe principal de clubes que disputam a primeira divisão do Campeonato Brasileiro. Critério de inclusão: mínimo de dois anos como jogador profissional e pelo menos uma convocação pela seleção brasileira de futebol. Os atletas foram entrevistados individualmente. A partir da análise das entrevistas, constatou-se que o futebol se apresenta como tema central em suas vidas e que a família tem um papel importante no contexto do esporte. A importância das habilidades psicológicas é confirmada para aqueles que atingiram a elite do futebol profissional e a seleção brasileira. A compreensão da trajetória esportiva de atletas da elite constitui um tema de grande relevância para o avanço da ciência do esporte.

Abstract This study looked into the construction of the professional trajectories of players from Brazil’s national soccer team. Interviews were conducted with six male players who were part of the first team of clubs that play in the first division of the Brazilian Championship. Inclusion criteria: minimum of two years as a professional player and at least one call-up to the Brazilian national team. Athletes were interviewed individually. According to the analysis of the interviews, soccer is a central theme in their lives, and their families play important roles in the sports context. The importance of psychological skills for those who reach the elite of professional soccer and the Brazilian team is confirmed. Understanding the trajectories of elite athletes in sports is important for the advancement of sports science.

Resumen El objetivo de este estudio es comprender la construcción de la trayectoria de futbolistas profesionales de la selección brasileña. Entrevistamos a seis futbolistas, de género masculino, que formaban parte del equipo principal de clubes que compiten en la primera división del Campeonato Brasileño. Criterios de inclusión: mínimo de dos años como jugador profesional y al menos una convocatoria para la Selección Brasileña de Fútbol. Los atletas fueron entrevistados individualmente. A partir del análisis de las entrevistas, se constató que el fútbol es un tema central en sus vidas y que la familia juega un papel importante en el contexto del deporte. La importancia de las habilidades psicológicas se confirma para aquellos que alcanzaron la élite del fútbol profesional y la selección brasileña. Comprender la trayectoria deportiva de los deportistas de élite es un tema de gran relevancia para el avance de la ciencia del deporte.

ABSTRACT BACKGROUND: Faced with a pandemic, all healthcare actions need to reflect best practices, in order to avoid high transmissibility, complications and even hospitalizations. For hospital environments, the products recommended and authorized by regulatory institutions for environmental cleaning and disinfection need to be highly effective. OBJECTIVE: To identify, systematically evaluate and summarize the best available scientific evidence on environmental cleaning to prevent COVID-19 infection. DESIGN AND SETTING: A systematic review of studies analyzing cleaning products that inactivate coronavirus, conducted within the evidence-based health program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL and LILACS databases, for articles published up to May 27, 2020, relating to studies evaluating cleaning products that inactivate coronavirus in the environment. RESULTS: Seven studies were selected. These analyzed use of 70% alcohol, detergent, detergent containing iodine, household bleach, sodium hypochlorite, hydrogen peroxide, chlorine dioxide, glutaraldehyde, ultraviolet irradiation and plasma air purifier. The effectiveness of treating sewage with sodium hypochlorite and chlorine dioxide was also evaluated. CONCLUSION: Disinfection of environments, especially those in ordinary use, such as bathrooms, needs to be done constantly. Viral inactivation was achieved using chlorine-based disinfectants, alcohol, detergents, glutaraldehyde, iodine-containing detergents, hydrogen peroxide compounds and household bleaches. Alcohol showed efficient immediate activity. In sewage, sodium hypochlorite had better action than chlorine dioxide. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/YC5P4 in the Open Science Framework.

ABSTRACT BACKGROUND: A positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) for SARS CoV-2, from nasopharyngeal swabs, is the current gold standard diagnostic test for this virus and has sensitivity of 60-70%. Some studies have demonstrated a significant number of false-negative RT-PCR tests while displaying significant tomographic findings, in the early days of symptoms of COVID-19. OBJECTIVE: To compare accuracy between RT-PCR and computed tomography (CT) for detecting COVID-19 in the first week of its symptoms during the pandemic. DESIGN AND SETTING: Systematic review of comparative studies of diagnostic accuracy within the Evidence-based Health Program of a federal university in São Paulo (SP), Brazil. METHODS: A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL and LILACS databases, for articles published up to June 6, 2020, relating to studies evaluating the diagnostic accuracy of RT-PCR and chest CT for COVID-19 diagnoses. The QUADAS 2 tool was used for methodological quality evaluation. RESULTS: In total, 1204 patients with COVID-19 were evaluated; 1045 had tomographic findings while 755 showed positive RT-PCR for COVID-19. RT-PCR demonstrated 81.4% sensitivity, 100% specificity and 92.3% accuracy. Chest CT demonstrated 95.3% sensitivity, 43.8% specificity and 63.3% accuracy. CONCLUSION: The high sensitivity and detection rates shown by CT demonstrate that this technique has a high degree of importance in the early stages of the disease. During an outbreak, the higher prevalence of the condition increases the positive predictive value of CT. REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/UNGHA in the Open Science Framework.

Resumo O objetivo deste estudo foi determinar a acurácia diagnóstica da ultrassonografia e da eletroneuromiografia para o diagnóstico da fasciculação e comparar suas taxas de detecção. Foram realizadas buscas nas bases de dados eletrônicas Cochrane Library, MEDLINE, Embase e Lilacs, para estudos que avaliam a acurácia diagnóstica e as taxas de detecção da ultrassonografia e eletroneuromiografia. As ferramentas Quality Assessment of Diagnostic Accuracy Studies, versão 2, e RTI item bank foram utilizadas para avaliação da qualidade do método. A ultrassonografia, tanto de 10 s quanto de 30 s, apresentou taxa de detecção superior à eletroneuromiografia em todos os músculos avaliados. A avaliação da taxa de detecção por pacientes não apresentou diferença significativa entre a ultrassonografia de 10 s e 30 s. A acurácia da ultrassonografia de 10 s nos músculos foi de 70%, enquanto nos pacientes foi de 85%. Já na ultrassonografia de 30 s, a acurácia nos pacientes foi de 82%. A ultrassonografia apresentou taxas de detecção superiores à eletroneuromiografia, independentemente do tempo de sua avaliação e dos músculos avaliados.

Abstract The objective of this study was to determine the diagnostic accuracy of ultrasound and electromyography for the detection of fasciculation in patients with amyotrophic lateral sclerosis and to compare detection rates between the two methods. By searching the Cochrane Library, MEDLINE, Excerpta Medica, and Latin-American and Caribbean Health Sciences Literature databases, we identified studies evaluating the diagnostic accuracy and fasciculation detection rates of ultrasound and electromyography. The Quality Assessment of Diagnostic Accuracy Studies, version 2, and RTI item bank tools were used for the evaluation of methodological quality. Ultrasound, for 10 s or 30 s, had a higher detection rate than did electromyography in all muscles evaluated. The overall detection rate (in patients) did not differ significantly between ultrasound for 10 s and ultrasound for 30 s. The accuracy of ultrasound for 10 s was 70% in muscles and 85% in patients. The accuracy of ultrasound for 30 s was 82% in patients. Ultrasound provided detection rates superior to those achieved with electromyography, independent of the examination time and muscles evaluated.

Abstract Objective To identify evidences regarding infection by SARS-CoV-2 and deaths of healthcare workers and related-risk factors. Methods We conducted a systematic review by searching the following databases SCOPUS, VHL Regional Portal, PubMed and Embase. We included studies on infection and death of healthcare workers who delivery care for COVID-19 patients. There were no restriction on date of publication, idiom, or type of study. The search was conducted until April 14, 2020. Results A total of 28 articles were selected. Most mentioned risk factors were: scarcity, inadequate use or non-usage of personal protective equipment, work overload, close contact with potentially infected patients and/or coworkers, risk for aerosol-generating procedures, late diagnosis and inadequate air renovation. According to each country, the number of infected workers ranged from 1,716 to 17,306. Concerning deaths, there are data of up to 605 healthcare workers who died of COVID-19 all over the world. Evidences found were editorials, cross-sectional, and cohort studies. Conclusion Studies identified showed high number of infection and deaths among healthcare workers. Overload of health system was a significant factor.

Resumen Objetivo Identificar evidencias sobre la infección por SARS-CoV-2 y muerte de profesionales de la salud y factores de riesgo relacionados. Métodos Se realizó una revisión sistemática en busca de artículos en las bases de datos Scopus, Portal Regional de la BVS, Pubmed y Embase, relacionados con la infección y muerte de profesionales de la salud involucrados en el tratamiento de pacientes con COVID-19. No hubo restricción respecto a la fecha de publicación, idioma ni tipo de estudio. Para la búsqueda se consideraron publicaciones hasta el 14 de abril de 2020. Resultados Se incluyeron 28 artículos. Los factores de riesgo más mencionados fueron: escasez, uso inadecuado o falta de uso de equipos de protección individual; sobrecarga de trabajo; contacto cercano con pacientes o compañeros de trabajo potencialmente contaminados; procedimientos con riesgo generador de aerosoles; diagnóstico tardío y renovación inadecuada del aire interior. El número de profesionales infectados varió de 1.716 a 17.306, de acuerdo con cada país. Respecto a las muertes, hay datos de 605 profesionales fallecidos en todo el mundo. La evidencia se encontró en editoriales, estudios transversales y de cohorte. Conclusión Las evidencias identificadas demuestran un alto número de profesionales infectados y fallecidos, y la sobrecarga del sistema de salud es un factor significativo.

Resumo Objetivo Identificar as evidências quanto à infecção pelo SARS-CoV-2 e óbitos dos profissionais de saúde e fatores de risco relacionados. Métodos Realizou-se uma revisão sistemática buscando-se artigos nas bases de dados Scopus, Portal Regional da BVS, Pubmed e Embase, relacionados à infecção e óbito de profissionais da saúde envolvidos no tratamento de pacientes com a COVID-19. Não houve restrição quanto a data de publicação, idioma ou tipo de estudo. Para a busca foi considerado publicações até 14 de abril de 2020. Resultados Foram incluídos 28 artigos. Os fatores de risco mais citados foram: escassez, uso inadequado ou não uso de equipamentos de proteção individual, sobrecarga de trabalho, contato próximo com pacientes e/ou colegas de trabalho potencialmente contaminados, procedimento com risco de geração de aerossol, diagnóstico tardio e renovação de ar ambiente inadequado. De acordo com cada país, o número de profissionais infectados variou de 1.716 a 17.306. Quanto aos óbitos, existem dados de até 605 profissionais falecidos no mundo inteiro. As evidências encontradas são editoriais, estudos transversais e de coorte. Conclusão As evidências identificadas demonstram um alto número de profissionais infectados e que foram a óbito, sendo a sobrecarga do sistema de saúde um fator significativo.

Resumo Objetivo Identificar as evidências quanto à infecção pelo SARS-CoV-2 e óbitos dos profissionais de saúde e fatores de risco relacionados. Métodos Realizou-se uma revisão sistemática buscando-se artigos nas bases de dados Scopus, Portal Regional da BVS, Pubmed e Embase, relacionados à infecção e óbito de profissionais da saúde envolvidos no tratamento de pacientes com a COVID-19. Não houve restrição quanto a data de publicação, idioma ou tipo de estudo. Para a busca foi considerado publicações até 14 de abril de 2020. Resultados Foram incluídos 28 artigos. Os fatores de risco mais citados foram: escassez, uso inadequado ou não uso de equipamentos de proteção individual, sobrecarga de trabalho, contato próximo com pacientes e/ou colegas de trabalho potencialmente contaminados, procedimento com risco de geração de aerossol, diagnóstico tardio e renovação de ar ambiente inadequado. De acordo com cada país, o número de profissionais infectados variou de 1.716 a 17.306. Quanto aos óbitos, existem dados de até 605 profissionais falecidos no mundo inteiro. As evidências encontradas são editoriais, estudos transversais e de coorte. Conclusão As evidências identificadas demonstram um alto número de profissionais infectados e que foram a óbito, sendo a sobrecarga do sistema de saúde um fator significativo.

Abstract Objective To identify evidences regarding infection by SARS-CoV-2 and deaths of healthcare workers and related-risk factors. Methods We conducted a systematic review by searching the following databases SCOPUS, VHL Regional Portal, PubMed and Embase. We included studies on infection and death of healthcare workers who delivery care for COVID-19 patients. There were no restriction on date of publication, idiom, or type of study. The search was conducted until April 14, 2020. Results A total of 28 articles were selected. Most mentioned risk factors were: scarcity, inadequate use or non-usage of personal protective equipment, work overload, close contact with potentially infected patients and/or coworkers, risk for aerosol-generating procedures, late diagnosis and inadequate air renovation. According to each country, the number of infected workers ranged from 1,716 to 17,306. Concerning deaths, there are data of up to 605 healthcare workers who died of COVID-19 all over the world. Evidences found were editorials, cross-sectional, and cohort studies. Conclusion Studies identified showed high number of infection and deaths among healthcare workers. Overload of health system was a significant factor.

Resumen Objetivo Identificar evidencias sobre la infección por SARS-CoV-2 y muerte de profesionales de la salud y factores de riesgo relacionados. Métodos Se realizó una revisión sistemática en busca de artículos en las bases de datos Scopus, Portal Regional de la BVS, Pubmed y Embase, relacionados con la infección y muerte de profesionales de la salud involucrados en el tratamiento de pacientes con COVID-19. No hubo restricción respecto a la fecha de publicación, idioma ni tipo de estudio. Para la búsqueda se consideraron publicaciones hasta el 14 de abril de 2020. Resultados Se incluyeron 28 artículos. Los factores de riesgo más mencionados fueron: escasez, uso inadecuado o falta de uso de equipos de protección individual; sobrecarga de trabajo; contacto cercano con pacientes o compañeros de trabajo potencialmente contaminados; procedimientos con riesgo generador de aerosoles; diagnóstico tardío y renovación inadecuada del aire interior. El número de profesionales infectados varió de 1.716 a 17.306, de acuerdo con cada país. Respecto a las muertes, hay datos de 605 profesionales fallecidos en todo el mundo. La evidencia se encontró en editoriales, estudios transversales y de cohorte. Conclusión Las evidencias identificadas demuestran un alto número de profesionales infectados y fallecidos, y la sobrecarga del sistema de salud es un factor significativo.

Resumo Objetivo Identificar, avaliar sistematicamente e sumarizar as melhores evidências científicas disponíveis sobre a eficácia e a segurança das máscaras de tecido para a comunidade. Métodos Foram consultadas as bases de dados Cochrane, PUBMED, EMBASE, LILACS e a literatura cinzenta por meio do Opengrey . Também foi realizada busca nas referências bibliográficas dos estudos primários e secundários identificados. Não houve restrição de idioma, nem período de tempo. Foram incluídos todos os artigos que tenham como objetivo verificar a eficácia e segurança do uso de máscaras de tecido como proteção contra a transmissão viral, bem como estudos laboratoriais que avaliassem barreiras de contenção de partículas. Foram excluídos os estudos que envolvessem o uso de máscaras por profissionais de saúde. Dois avaliadores independentes selecionaram os estudos e as discrepâncias foram resolvidas por um terceiro avaliador. Resultados Após o processo de seleção, não foram localizados estudos clínicos randomizados envolvendo máscaras de tecidos para a população em geral. Incluímos sete estudos que avaliaram diferentes tecidos no bloqueio de gotículas de nível laboratorial e um estudo de revisão. Conclusão O uso de máscara de tecido possibilita uma barreira às gotículas quando comparada a nenhuma máscara. A máscara é um recurso adicional na prevenção e deve sempre ser associada à etiqueta respiratória, higienização das mãos, distanciamento social e isolamento dos casos.

Abstract Objective To identify, systematically review, and summarize the best scientific evidence available on the efficacy and safety of homemade cloth face masks for the community. Methods The search was conducted using the Cochrane, PUBMED, EMBASE, and LILACS databases, as well as grey literature, using Opengrey . A search was also conducted using references from primary and secondary studies that were found. No language or time period restrictions were applied. All papers that objective was to check efficacy and safety of the use of cloth face masks as protection against viral transmission were included, as well as laboratory studies assessing barriers against particles. We excluded studies approaching the use of face masks by healthcare providers. Two independent reviewers selected the studies, and discrepancies were decided by a third reviewer. Results No randomized clinical trials involving cloth face masks for the general population were found. Seven studies assessing different types of cloth to prevent the penetration of droplets at a laboratory level and a review study were included. Conclusion Using cloth face masks provides a barrier against droplets when compared with not using any face masks. The face mask is an additional preventive mesuare and must be used along with respiratory etiquette, hand hygiene, social distancing, and isolation of cases.

Resumen Objetivo Identificar, evaluar sistemáticamente y resumir las mejores evidencias científicas disponibles sobre la eficacia y la seguridad de las mascarillas caseras para la comunidad. Métodos Se consultaron las bases de datos Cochrane, PUBMED, EMBASE, LILACS y literatura gris por medio de Opengrey. También se realizó búsqueda en las referencias bibliográficas de los estudios primarios y secundarios identificados. No hubo restricción de idioma ni período de tiempo. Se incluyeron todos los artículos que tuvieran como objetivo verificar la eficacia y seguridad del uso de mascarillas caseras como protección contra la transmisión viral, así como estudios de laboratorio que evaluaran barreras de contención de partículas. Se excluyeron los estudios que abarcaran el uso de mascarillas por profesionales de la salud. Dos evaluadores independientes seleccionaron los estudios y las discrepancias fueron resueltas por un tercer evaluador. Resultados Luego del proceso de selección, no se localizaron estudios clínicos aleatorizados que incluyeran mascarillas caseras para la población en general. Incluimos siete estudios que evaluaron diferentes telas para el bloqueo de gotas de nivel de laboratorio y un estudio de revisión. Conclusión El uso de mascarillas caseras permite una barrera para las gotas al compararlo con ninguna mascarilla. La mascarilla es un recurso adicional en la prevención y siempre debe estar asociada a la etiqueta respiratoria, higienización de manos, distanciamiento social y aislamiento de casos.