ABSTRACT Purpose: This study aimed to determine whether early-stage intraocular pressure can be modulated using a thermal face mask. Methods: In this prospective clinical study, healthy participants were randomized on a 1:1:1 allocation ratio to three mask groups: hypothermic (G1), normothermic (G2), and hyperthermic (G3). After randomization, 108 eyes from 108 participants were submitted to clinical evaluations, including measurement of initial intraocular pressure (T1). The thermal mask was then applied for 10 minutes, followed by a second evaluation of intraocular pressure (T2) and assessment of any side effects. Results: The hypothermic group (G1) showed a significant reduction in mean intraocular pressure between T1 (16.97 ± 2.59 mmHg) and T2 (14.97 ± 2.44 mmHg) (p<0.001). G2 showed no significant pressure difference between T1 (16.50 ± 2.55 mmHg) and T2 (17.00 ± 2.29 mmHg) (p=0.054). G3 showed a significant increase in pressure from T1 (16.53 ± 2.69 mmHg) to T2 (18.58 ± 2.95 mmHg) (p<0.001). At T1, there was no difference between the three study groups (p=0.823), but at T2, the mean values of G3 were significantly higher than those of G1 and G2 (p<0.00). Conclusion: Temperature was shown to significantly modify intraocular pressure. Thermal masks allow the application of temperature in a controlled, reproducible manner. Further studies are needed to assess the duration of these effects and whether they are reproducible in patients with pathologies that affect intraocular pressure. Purpose earlystage early stage Methods 111 1 1:1: G1, G , G2, (G2) G3. . (G3) randomization evaluations T1. T (T1) minutes (T2 Results (G1 16.97 1697 16 97 (16.9 259 2 59 2.5 mmHg 14.97 1497 14 (14.9 244 44 2.4 p<0.001. p0001 p p<0.001 0 001 (p<0.001) 16.50 1650 50 (16.5 255 55 17.00 1700 17 00 (17.0 229 29 2.2 p=0.054. p0054 p=0.054 054 (p=0.054) 16.53 1653 53 269 69 2.6 18.58 1858 18 58 (18.5 295 95 2.9 p=0.823, p0823 p=0.823 823 (p=0.823) p<0.00. p000 p<0.00 (p<0.00) Conclusion controlled manner 11 1:1 (G2 (G3 (T1 (T (G 16.9 169 9 (16. 25 5 2. 14.9 149 (14. 24 4 (p<0.001 16.5 165 17.0 170 (17. 22 p005 p=0.05 05 (p=0.054 26 6 18.5 185 (18. p082 p=0.82 82 (p=0.823 p00 p<0.0 (p<0.00 1: 16. (16 14. (14 17. (17 p=0.0 (p=0.05 18. (18 p08 p=0.8 8 (p=0.82 p0 p<0. (p<0.0 (1 p=0. (p=0.0 (p=0.8 p<0 (p<0. ( p=0 (p=0. p< (p<0 p= (p=0 (p< (p= (p

Resumen Objetivo: recopilar información de factores de riesgo de la enfermedad arterial coronaria en población adulta evidenciados mediante estudios de aleatorización mendeliana. Métodos: de acuerdo con las recomendaciones de la escala para la Evaluación de Artículos de Revisión Narrativa (SANRA), se realizó una revisión desde el usuario de la Universidad Militar Nueva Granada en las bases de datos de PubMed, EMBASE y BIREME. Resultados: se obtuvieron 757 artículos, luego se aplicaron los criterios de inclusión y exclusión, y se eligieron 29 artículos en los que se investiga la asociación de la enfermedad arterial coronaria con la apolipoproteína B, colesterol LDL, triglicéridos, colesterol total, apolipoproteina C3, proteína de transferencia de ésteres de colesterol, HDL, omega 6, lipoproteína (a), obesidad, hemoglobina A1C, diabetes mellitus tipo 2, glucosa en ayunas, inicio del hábito de fumar, presión arterial, hormona paratiroidea sérica, niveles de fosfato sérico, enfermedad del hígado graso no alcohólico, síndrome de ovario poliquístico, globulina fijadora de hormonas sexuales, testosterona, filoquinona circulante, proteína gla de la matriz inactiva, antioxidantes circulantes derivados de la dieta, glicina, homocisteína, ácido úrico, marcadores inflamatorios, hemoglobina, hematocrito y recuento de glóbulos rojos. Conclusión: esta revisión sugiere nuevos estudios con información genética colombiana para respaldar los factores de riesgo aquí presentados, teniendo en cuenta que en ninguno de los estudios evaluados se utilizó información genética latinoamericana, lo cual puede limitar la extrapolación de los resultados.

Summary: Objective: To compile information on risk factors for coronary artery disease in the adult population evidenced by Mendelian randomization studies.. Methods: A search was carried out from the user of the Nueva Granada Military University in the databases of PubMed, EMBASE and BIREME and a narrative review of the literature was carried out in accordance with the recommendations of the scale for the Evaluation of Narrative Review Articles (SANRA). Results: 757 articles were obtained, after the application of inclusion and exclusion criteria, 29 articles were chosen that investigated the association of apolipoprotein B, LDL cholesterol, triglycerides, total cholesterol, apolipoprotein C3, cholesterol ester transfer protein, HDL, omega 6, lipoprotein (a), obesity, hemoglobin A1C, type 2 diabetes mellitus, fasting glucose, smoking initiation, blood pressure, serum parathyroid hormone, serum phosphate levels, non-alcoholic fatty liver disease, polycystic ovary syndrome , sex hormone-binding globulin, testosterone, circulating phylloquinone, inactive matrix protein gla, circulating dietary-derived antioxidants, glycine, homocysteine, uric acid, inflammatory markers, hemoglobin, hematocrit, and red blood cell count, with coronary artery disease. Conclusion: This review suggests new studies with Colombian genetic information to support the risk factors presented here, considering that none of the studies evaluated used Latin American genetic information, which may limit the extrapolation of the results.

Abstract Background Recently, it was demonstrated that allopurinol, a xanthine oxidase inhibitor, has cardiovascular and anti-ischaemic properties and may be a metabolic antianginal agent option.Objective: The objective of this study was to evaluate the antianginal effect of allopurinol as a third drug for patients with stable coronary artery disease (CAD). Methods This was a randomized clinical trial between 2018 and 2020 including patients with CAD who maintained angina despite initial optimization with beta-blockers and calcium channel blockers. The individuals were randomized 1:1 to 300 mg of allopurinol twice daily or 35 mg of trimetazidine twice daily. The main outcome was the difference in the angina frequency domain of the Seattle Angina Questionnaire (SAQ-AF). A probability (p) value < 0.05 was considered statistically significant. Results A hundred and eight patients were included in the randomization phase, with 54 (50%) in the allopurinol group and 54 (50%) in the trimetazidine group. Six (5.6%) individuals, 3 from each group, were lost to follow-up for the primary outcome. In the allopurinol and trimetazidine groups, the median SAQ-AF scores were 50 (30.0 to 70.0) and 50 (21.3 to 78.3), respectively. In both groups, the SAQ-AF score improved, but the median of the difference compared to baseline was lower in the allopurinol group (10 [0 to 30] versus 20 [10 to 40]; p < 0.001), as was the mean of the difference in the total SAQ score (12.8 ± 17.8 versus 21.2 ± 15.9; p = 0.014). Conclusion Both allopurinol and trimetazidine improved the control of angina symptoms; however, trimetazidine presented a greater gain compared to baseline. Brazilian Registry of Clinical Trials - Registration Number RBR-5kh98y Recently inhibitor antiischaemic anti ischaemic option.Objective optionObjective option Objective CAD. . (CAD) 201 202 betablockers beta blockers 11 1 1: 30 SAQAF. SAQAF AF (SAQ-AF) (p 005 0 05 0.0 significant phase 5 50% (50% 5.6% 56 6 (5.6% followup follow up groups 30.0 (30. 70.0 700 70 21.3 213 21 (21. 78.3, 783 78.3 , 78 78.3) respectively 10 (1 [ 2 [1 40 40] 0.001, 0001 0.001 001 0.001) 12.8 128 12 8 (12. 178 17 17. 212 21. 15.9 159 15 9 0.014. 0014 0.014 014 0.014) symptoms however RBR5kh98y RBRkhy RBR 5kh98y kh y (CAD (SAQ-AF 00 0. (50 5.6 (5.6 30. (30 70. 7 (21 78. ( 4 000 0.00 12. (12 15. 0.01 01 khy (5 5. (5. (3 (2

Resumo Fundamento Recentemente, foi demonstrado que o alopurinol, um inibidor da xantina oxidase, possui propriedades cardiovasculares e anti-isquêmicas e pode ser uma opção de agente antianginoso metabólico. Objetivo O objetivo do presente estudo foi avaliar o efeito antianginoso do alopurinol como terceiro medicamento para pacientes com doença arterial coronariana (DAC) estável. Métodos Trata-se de um ensaio clínico randomizado entre 2018 e 2020 incluindo pacientes com DAC que mantiveram angina apesar da otimização inicial com betabloqueadores e bloqueadores dos canais de cálcio. Os indivíduos foram randomizados 1:1 para 300 mg de alopurinol 2 vezes ao dia ou 35 mg de trimetazidina 2 vezes ao dia. O desfecho principal foi a diferença no domínio da frequência da angina do Questionário de Angina de Seattle (QAS-FA). Foram considerados estatisticamente significativos valores de probabilidade (p) < 0,05. Resultados Foram incluídos 108 pacientes na fase de randomização, com 54 (50%) no grupo alopurinol e 54 (50%) no grupo trimetazidina. Seis (5,6%) indivíduos, 3 de cada grupo, foram perdidos no seguimento para o desfecho primário. Nos grupos de alopurinol e trimetazidina, as pontuações medianas do QAS-FA foram 50 (30,0 a 70,0) e 50 (21,3 a 78,3), respectivamente. Em ambos os grupos, a pontuação do QAS-FA melhorou, mas a mediana da diferença em relação à linha de base foi menor no grupo alopurinol (10 [0 a 30] versus 20 [10 a 40]; p < 0,001), assim como a média da diferença na pontuação total do QAS (12,8 ± 17,8 versus 21,2 ± 15,9; p = 0,014). Conclusão Tanto o alopurinol quanto a trimetazidina melhoraram o controle dos sintomas de angina; no entanto, a trimetazidina apresentou um ganho maior em relação à linha de base. Registro Brasileiro de Ensaios Clínicos – Número de Registro RBR-5kh98y Recentemente oxidase antiisquêmicas anti isquêmicas metabólico (DAC estável Tratase Trata se 201 202 cálcio 11 1 1: 30 QASFA. QASFA FA . (QAS-FA) (p 005 0 05 0,05 10 randomização 5 50% (50% 5,6% 56 6 (5,6% primário 30,0 (30, 70,0 700 70 21,3 213 21 (21, 78,3, 783 78,3 , 78 78,3) respectivamente melhorou (1 [ [1 40 40] 0,001, 0001 0,001 001 0,001) 12,8 128 12 8 (12, 178 17 17, 212 21, 15,9 159 15 9 0,014. 0014 0,014 014 0,014) entanto RBR5kh98y RBRkhy RBR 5kh98y kh y (QAS-FA 00 0,0 (50 5,6 (5,6 30, (30 70, 7 (21 78, ( 4 000 0,00 12, (12 15, 0,01 01 khy 0, (5 5, (5, (3 (2

Abstract Objective To compare the functional outcomes of anterior cruciate ligament (ACL) reconstruction with hamstring autograft (HA) through the all-inside (AI) technique with adjustable-loop cortical Endobutton (Smith & Nephew, Watford, Hertfordshire, England) on the sides of the femur and tibia and through the outside-in (OI) technique using an interference screw on the tibial side and a cortical Endobutton on the femoral side. Materials and Methods The present is a double-blinded randomized controlled trial (RCT) of 44 patients undergoing arthroscopic ACL reconstruction from February 2019 to February 2022 in a tertiary care hospital. As per computer-based randomization, the patients were distributed into two groups: the AI and OI groups. Both groups were evaluated for 12 months using the Visual Analog Scale (VAS), the Lysholm Knee Scoring Scale, and part I (pain score) and part II (function score) of the Knee Society Score (KSS). Results On postoperative day 2,the VAS score was significantly higher in the OI group (p = 0.0001), but insignificant (p = 0.807) at 6 weeks. At 3, 6, and 12 months of follow-up, the score on the Lysholm Knee Scoring Scale was significantly higher (p = 0.001) in the AI group. At 6 months, both parts of the KSS showed a significant difference, with the AI group presenting a better outcome (p = 0.04). However, at 12 months, the AI group presented a better score on part I of the KSS, but no differences were observed regarding part II. Conclusion In a follow-up of 12 months, the patients submitted to the AI technique presented better outcome scores and pain relief than those submitted to the OI technique. (ACL HA (HA allinside all inside (AI adjustableloop adjustable loop Smith Nephew Watford Hertfordshire England outsidein outside (OI doubleblinded double blinded RCT (RCT 4 201 202 hospital computerbased computer based randomization 1 VAS, , (VAS) function KSS. . (KSS) 2the 2 p 0.0001, 00001 0.0001 0 0001 0.0001) 0.807 0807 807 weeks 3 followup, followup follow up, up 0.001 001 difference 0.04. 004 0.04 04 0.04) However 20 (VAS (KSS 0000 0.000 000 0.80 080 80 0.00 00 0.0 0.8 08 8 0.

Resumo Objetivo Comparar os resultados funcionais da reconstrução do ligamento cruzado anterior (LCA) com autoenxerto de isquiotibiais pela técnica all-inside (AI) com Endobutton (Smith & Nephew, Watford, Hertfordshire, Inglaterra) cortical de alça ajustável nos lados do fêmur e da tíbia e pela técnica outside-in (OI) com parafuso de interferência no lado tibial e Endobutton cortical no lado femoral. Métodos Trata-se de um ensaio clínico controlado, randomizado e duplo-cego com 44 pacientes submetidos à reconstrução artroscópica do LCA de fevereiro de 2019 a fevereiro de 2022 em um hospital de cuidados terciários. De acordo com a randomização por computador, os pacientes foram distribuídos em dois grupos: AI e OI. Ambos os grupos foram avaliados durante 12 meses pela Escala Visual Analógica (EVA), a Escala de Pontuação do Joelho de Lysholm e pela parte I (pontuação de dor) e a parte II (pontuação de função) da escala Knee Society Score (KSS). Resultados No segundo dia de pós-operatório, a pontuação média na EVA foi significativamente maior no grupo OI (p = 0,0001), mas insignificante (p 0,807) às 6 semanas. Aos 3, 6 e 12 meses de acompanhamento, a pontuação na Escala de Lysholm (p = 0,001) foi significativamente maior no grupo AI. Aos 6 meses, ambas as partes da KSS apresentam uma diferença significativa, com o grupo AI apresentando um desfecho melhor (p = 0,04). No entanto, aos 12 meses, o grupo AI apresentou uma pontuação melhor na parte I da KSS, mas não foram observadas diferenças na parte II. Conclusão Em um acompanhamento de 12 meses, os pacientes submetidos à técnica AI apresentaram melhores pontuações de desfecho e alívio da dor do que aqueles submetidos à técnica OI. (LCA allinside all inside (AI Smith Nephew Watford Hertfordshire Inglaterra outsidein outside in (OI femoral Tratase Trata se controlado duplocego duplo cego 4 201 202 terciários computador 1 EVA, , (EVA) função KSS. . (KSS) pósoperatório, pósoperatório pós operatório, operatório pós-operatório p 0,0001, 00001 0,0001 0 0001 0,0001) 0,807 0807 807 semanas 3 0,001 001 significativa 0,04. 004 0,04 04 0,04) entanto 20 (EVA (KSS 0000 0,000 000 0,80 080 80 0,00 00 0,0 2 0,8 08 8 0,

ABSTRACT Background: Parasacral Transcutaneous Electrical Nerve Stimulation (PTENS) is a treatment used in enuresis refractory to first-line treatment. This review aimed to evaluate the effectiveness of PTENS in treating monosymptomatic enuresis (MNE) in children and adolescents. Methods: The study followed the Preferred Reporting Items for Systematic (PRISMA) guidelines. The search was carried out in the following databases: MEDLINE (via PubMed), Web of Science, SCOPUS, Central Cochrane Library and Physiotherapy Evidence Database (PEDro). The selected studies were randomized clinical trials (RCTs). The "Risk of Bias tool for randomized trials" and the "Risk of Bias VISualization" were used to analyze the risk of bias. Results: Of the 624 studies selected, four RCTs were eligible. Three included 146 children and adolescents aged between six and 16.3 years and used similar PTENS protocols with a frequency of 10 Hz, pulse duration of 700 µs and 20 minutes three times/week. One study enrolled 52 patients aged seven to 14 years used PTENS at home, with a pulse duration of 200 µs and 20 to 60 minutes twice/day. Risk of bias was observed in three studies due to results’ randomization and measurement. Two studies showed a partial response with a reduction in wet nights, one a complete response in 27% of patients, and one showed no improvement. Conclusion: PTENS reduces wet nights’ frequency but does not cure them, except in 27% of patients in one study. Limited RCTs and data heterogeneity are limitations. Background (PTENS firstline first line MNE (MNE Methods PRISMA (PRISMA guidelines databases via PubMed, PubMed , PubMed) Science SCOPUS PEDro. PEDro . (PEDro) RCTs. (RCTs) VISualization Results 62 eligible 163 16 3 16. 1 Hz 70 2 timesweek times week times/week 5 home 6 twiceday twice day twice/day results measurement nights 27 improvement Conclusion them limitations (PEDro (RCTs 7

Abstract Introduction. Vitamin D is required for bone and mineral metabolism and participates in the regulation of the immune response. It is also linked to several chronic diseases and conditions, usually in populations of European descent. Brazil presents a high prevalence of vitamin D deficiency and insufficiency despite the widespread availability of sunlight in the country. Thus, it is important to investigate the role of vitamin D as a risk factor for disease and to establish causal relationships between vitamin D levels and health-related outcomes in the Brazilian population. Objective. To examine genetic variants identified as determinants of serum vitamin D in genome-wide association studies of European populations and check whether the same associations are present in Brazil. If so, these single nucleotide polymorphisms (SNPs) could be developed locally as proxies to use in genetically informed causal inference methods, such as Mendelian randomization. Materials and methods. We extracted SNPs associated with vitamin D from the genome-wide association studies catalog. We did a literature search to select papers ascertaining these variants and vitamin D concentrations in Brazil. Results. GC was the gene with the strongest association with vitamin D levels, in agreement with existing findings in European populations. However, VDR was the most investigated gene, regardless of its non-existing association with vitamin D in the genomewide association studies. Conclusions. More research is needed to validate sound proxies for vitamin D levels in Brazil, for example, prioritizing GC rather than VDR.

Resemen Introducción. La vitamina D es necesaria para el metabolismo óseo y mineral, y participa en la regulación de la respuesta inmunitaria. También está relacionada con enfermedades crónicas en poblaciones europeas. En Brasil, existe una prevalencia elevada de deficiencia e insuficiencia de vitamina D, a pesar de la amplia disponibilidad de luz solar. Por lo tanto, es importante investigar el papel de la vitamina D como factor de riesgo de diversas enfermedades y establecer relaciones causales entre los niveles de vitamina D y los problemas de salud en la población brasileña. Objetivo. Examinar variantes genéticas relacionadas con la vitamina D sérica en estudios de asociación genómica de poblaciones europeas y comprobar si estas mismas están presentes en Brasil. De ser así, estos SNPs podrían utilizarse como proxies en métodos de inferencia causal, tales como la aleatorización mendeliana. Materiales y métodos. A partir del catálogo de estudios de asociación de genoma completo se extrajeron SNPs relacionados con los niveles de vitamina D. Luego se hizo una búsqueda bibliográfica para identificar los artículos que evaluaran estos SNPs y la concentración de vitamina D en Brasil. Resultados. GC fue el gen más fuertemente asociado con los niveles de vitamina D, en concordancia con los resultados existentes en poblaciones europeas. Sin embargo, el gen VDR fue el más investigado, aunque no esté vinculado con la vitamina D en los estudios de asociación de genoma completo. Conclusiones. Se necesita más investigación para validar proxies genéticos de los niveles de vitamina D en Brasil y se recomienda priorizar el gen GC en lugar de VDR.

Abstract The incidences of periodontitis and osteoporosis are rising worldwide. Observational studies have shown that periodontitis is associated with increased risk of osteoporosis. We performed a Mendelian randomization (MR) study to genetically investigate the causality of periodontitis on osteoporosis. We explored the causal effect of periodontitis on osteoporosis by MR analysis. A total of 9 single nucleotide polymorphisms (SNP) were related to periodontitis. The primary approach in this MR analysis was the inverse variance-weighted (IVW) method. Simple median, weighted median, and penalized weighted median were used to analyze sensitivity. The fixed-effect IVW model and random-effect IVW model showed no significant causal effect of genetically predicted periodontitis on the risk of osteoporosis (OR=1.032; 95%CI: 0.923-1.153; P=0.574; OR=1.032; 95%CI: 0.920-1.158; P=0.588, respectively). Similar results were observed in simple mode (OR=1.031; 95%CI: 0.780-1.361, P=0.835), weighted mode (OR=1.120; 95%CI: 0.944-1.328, P=0.229), simple median (OR=1.003; 95%CI: 0.839-1.197, P=0.977), weighted median (OR=1.078; 95%CI: 0.921-1.262, P=0.346), penalized weight median (OR 1.078; 95%CI: 0.919-1.264, P=0.351), and MR-Egger method (OR=1.360; 95%CI: 0.998-1.853, P=0.092). There was no heterogeneity in the IVW and MR-Egger analyses (Q=7.454, P=0.489 and Q=3.901, P=0.791, respectively). MR-Egger regression revealed no evidence of a pleiotropic influence through genetic variants (intercept: -0.004; P=0.101). The leave-one-out sensitivity analysis indicated no driven influence of any individual SNP on the association between periodontitis and osteoporosis. The Mendelian randomization analysis did not show a significant detrimental effect of periodontitis on the risk of osteoporosis. worldwide (MR (SNP varianceweighted variance (IVW fixedeffect fixed randomeffect random OR=1.032 OR1032 OR 1 032 (OR=1.032 95%CI 95CI CI 95 0.9231.153 09231153 0.923 1.153 0 923 153 0.923-1.153 P=0.574 P0574 P 574 0.9201.158 09201158 0.920 1.158 920 158 0.920-1.158 P0588 588 P=0.588 respectively. respectively . respectively) OR=1.031 OR1031 031 (OR=1.031 0.7801.361, 07801361 0.780 1.361, 780 361 0.780-1.361 P=0.835, P0835 P=0.835 , 835 P=0.835) OR=1.120 OR1120 120 (OR=1.120 0.9441.328, 09441328 0.944 1.328, 944 328 0.944-1.328 P=0.229, P0229 P=0.229 229 P=0.229) OR=1.003 OR1003 003 (OR=1.003 0.8391.197, 08391197 0.839 1.197, 839 197 0.839-1.197 P=0.977, P0977 P=0.977 977 P=0.977) OR=1.078 OR1078 078 (OR=1.078 0.9211.262, 09211262 0.921 1.262, 921 262 0.921-1.262 P=0.346, P0346 P=0.346 346 P=0.346) 1.078 1078 0.9191.264, 09191264 0.919 1.264, 919 264 0.919-1.264 P=0.351, P0351 P=0.351 351 P=0.351) MREgger Egger OR=1.360 OR1360 360 (OR=1.360 0.9981.853, 09981853 0.998 1.853, 998 853 0.998-1.853 P=0.092. P0092 P=0.092 092 P=0.092) Q=7.454, Q7454 Q 7 454 (Q=7.454 P0489 489 P=0.48 Q3901 3 901 Q=3.901 P0791 791 P=0.791 intercept (intercept 0.004 0004 004 -0.004 P=0.101. P0101 P=0.101 101 P=0.101) leaveoneout leave one out OR=1.03 OR103 03 (OR=1.03 9231 0.9231.15 0923115 0923 0.92 1153 1.15 92 15 0.923-1.15 P=0.57 P057 57 9201 0.9201.15 0920115 0920 1158 0.920-1.15 P058 58 P=0.58 7801 0.7801.361 0780136 0780 0.78 1361 1.361 78 36 0.780-1.36 P083 P=0.83 83 OR=1.12 OR112 12 (OR=1.12 9441 0.9441.328 0944132 0944 0.94 1328 1.328 94 32 0.944-1.32 P022 P=0.22 22 OR=1.00 OR100 00 (OR=1.00 8391 0.8391.197 0839119 0839 0.83 1197 1.197 19 0.839-1.19 P097 P=0.97 97 OR=1.07 OR107 07 (OR=1.07 9211 0.9211.262 0921126 0921 1262 1.262 26 0.921-1.26 P034 P=0.34 34 1.07 107 9191 0.9191.264 0919126 0919 0.91 1264 1.264 91 0.919-1.26 P035 P=0.35 35 OR=1.36 OR136 (OR=1.36 9981 0.9981.853 0998185 0998 0.99 1853 1.853 99 85 0.998-1.85 P009 P=0.09 09 Q=7.454 Q745 45 (Q=7.45 P048 48 P=0.4 Q390 90 Q=3.90 P079 79 P=0.79 0.00 000 -0.00 P010 P=0.10 10 OR=1.0 OR10 (OR=1.0 0.9231.1 092311 0.9 115 1.1 0.923-1.1 P=0.5 P05 5 0.9201.1 092011 0.920-1.1 0.7801.36 078013 0.7 136 1.36 0.780-1.3 P08 P=0.8 8 OR=1.1 OR11 (OR=1.1 0.9441.32 094413 094 132 1.32 0.944-1.3 P02 P=0.2 2 0.8391.19 083911 083 0.8 119 1.19 0.839-1.1 P09 P=0.9 0.9211.26 092112 126 1.26 0.921-1.2 P03 P=0.3 1.0 0.9191.26 091912 091 0.919-1.2 OR=1.3 OR13 (OR=1.3 0.9981.85 099818 099 185 1.85 0.998-1.8 P00 P=0.0 Q=7.45 Q74 4 (Q=7.4 P04 P=0. Q39 Q=3.9 P07 P=0.7 0.0 -0.0 P01 P=0.1 OR=1. OR1 (OR=1. 0.9231. 09231 0. 11 1. 0.923-1. P0 0.9201. 09201 0.920-1. 0.7801.3 07801 13 1.3 0.780-1. 0.9441.3 09441 0.944-1. 0.8391.1 08391 08 0.839-1. 0.9211.2 09211 1.2 0.921-1. 0.9191.2 09191 0.919-1. 0.9981.8 09981 18 1.8 0.998-1. Q=7.4 Q7 (Q=7. P=0 Q3 Q=3. -0. OR=1 (OR=1 0.9231 0.923-1 0.9201 0.920-1 0.7801. 0.780-1 0.9441. 0.944-1 0.8391. 0.839-1 0.9211. 0.921-1 0.9191. 0.919-1 0.9981. 0.998-1 Q=7. (Q=7 P= Q=3 -0 OR= (OR= 0.923- 0.920- 0.7801 0.780- 0.9441 0.944- 0.8391 0.839- 0.9211 0.921- 0.9191 0.919- 0.9981 0.998- Q=7 (Q= Q= - (Q

Abstract Objective To assess the effectiveness of a Reiki protocol on anxiety levels in the preoperative period of cardiac surgery. Methods This is a controlled and randomized clinical trial carried out in a university reference hospital in cardiology between June and December 2021. Chunk randomization and allocation by draw with opaque sealed envelopes were carried out in two groups: Control (n=44; not subjected to intervention); and Intervention (n=44; submitted to two Reiki sessions three days before and the day before surgery). The main outcomes (anxiety, well-being and muscle tension) were assessed across sessions using a mixed effects model. To assess the effect size, partial eta squared (η2p) values were calculated. Results Differences in anxiety scores (+2.7 points more than the control), well-being (-0.78) and muscle tension (1.27) were determined, being considered statistically significant (p<0.001). In analyzing the effect size, the experiment better distinguished the variation in the anxiety variable (η2p=0.74) than in the other two variables (η2p=0.14; η2p=0.23). Conclusion The study offers favorable evidence for the effectiveness of Reiki in controlling preoperative anxiety after cardiac surgery. Brazilian Clinical Trials Registry: RBR-2nhgvn6 surgery 2021 groups n=44 n44 n 44 (n=44 intervention intervention) . surgery) anxiety, (anxiety wellbeing well model size η2p ηp η p (η2p calculated +2.7 27 2 7 (+2. control, control , control) 0.78 078 0 78 (-0.78 1.27 127 1 (1.27 determined p<0.001. p0001 p<0.001 001 (p<0.001) η2p=0.74 η2p074 74 (η2p=0.74 η2p=0.14 η2p014 14 (η2p=0.14 η2p=0.23. η2p023 η2p=0.23 23 η2p=0.23) Registry RBR2nhgvn6 RBRnhgvn RBR 2nhgvn6 nhgvn RBR-2nhgvn 202 n=4 n4 4 (n=4 +2. (+2 0.7 07 (-0.7 1.2 12 (1.2 p000 p<0.00 00 (p<0.001 η2p=0.7 η2p07 (η2p=0.7 η2p=0.1 η2p01 (η2p=0.1 η2p02 η2p=0.2 RBR2nhgvn 2nhgvn 20 n= (n= +2 (+ 0. (-0. 1. (1. p00 p<0.0 (p<0.00 η2p=0. η2p0 (η2p=0. (n + ( (-0 (1 p0 p<0. (p<0.0 η2p=0 (η2p=0 (- p<0 (p<0. η2p= (η2p= p< (p<0 (p< (p

Resumo Objetivo Avaliar a efetividade de um protocolo de Reiki nos níveis de ansiedade no período pré-operatório de cirurgia cardíaca. Métodos Ensaio clínico controlado e randomizado realizado em um hospital universitário de referência em cardiologia entre junho e dezembro de 2021. Foi realizada randomização em bloco e alocação por sorteio com envelopes selados opacos em dois grupos: Controle (n=44; não submetido a intervenção) e Intervenção (n=44; submetido a duas sessões de Reiki três dias antes e na véspera da cirurgia). Os desfechos principais (ansiedade, bem-estar e tensão muscular) foram avaliados ao longo das sessões usando um modelo de efeitos mistos. Para avaliar o tamanho do efeito foram calculados os valores parciais de eta quadrado (η2p). Resultados Foram determinadas as diferenças nos escores de ansiedade (+2,7 pontos a mais para o controle), bem-estar (-0,78) e tensão muscular (1,27), sendo consideradas estatisticamente significativas (p<0,001). Na análise do tamanho do efeito, o experimento distinguiu melhor a variação na variável ansiedade (η2p=0,74) que nas outras duas variáveis (η2p=0,14; η2p=0,23). Conclusão O estudo oferece evidência favorável para efetividade do Reiki no controle da ansiedade pré-operatória de cirurgia cardíaca. préoperatório pré operatório cardíaca 2021 grupos n=44 n44 n 44 (n=44 intervenção cirurgia. . cirurgia) ansiedade, (ansiedade bemestar bem estar mistos η2p. η2p ηp η p (η2p) +2,7 27 2 7 (+2, controle, , controle) 0,78 078 0 78 (-0,78 1,27, 127 1,27 1 (1,27) p<0,001. p0001 p<0,001 001 (p<0,001) η2p=0,74 η2p074 74 (η2p=0,74 η2p=0,14 η2p014 14 (η2p=0,14 η2p=0,23. η2p023 η2p=0,23 23 η2p=0,23) préoperatória operatória 202 n=4 n4 4 (n=4 (η2p +2, (+2 0,7 07 (-0,7 12 1,2 (1,27 p000 p<0,00 00 (p<0,001 η2p=0,7 η2p07 (η2p=0,7 η2p=0,1 η2p01 (η2p=0,1 η2p02 η2p=0,2 20 n= (n= +2 (+ 0, (-0, 1, (1,2 p00 p<0,0 (p<0,00 η2p=0, η2p0 (η2p=0, (n + ( (-0 (1, p0 p<0, (p<0,0 η2p=0 (η2p=0 (- (1 p<0 (p<0, η2p= (η2p= p< (p<0 (p< (p

Resumen Objetivo Evaluar la efectividad de un protocolo de reiki en los niveles de ansiedad en el período preoperatorio de cirugías cardíacas. Métodos Ensayo clínico controlado y aleatorizado, realizado en un hospital universitario de referencia en cardiología entre junio y diciembre de 2021. La aleatorización se realizó por bloques y la asignación por sorteo con sobres cerrados opacos en dos grupos: Control (n=44, sin intervención) y Experimental (n=44, sometidos a dos sesiones de reiki, una tres días antes y otra en la víspera de la cirugía). Los criterios de valoración principales (ansiedad, bienestar y tensión muscular) fueron evaluados a lo largo de las sesiones, mediante un modelo de efectos mixtos. Para evaluar el tamaño del efecto se calcularon los valores parciales de eta cuadrado (η2p). Resultados Se observaron diferencias en la puntuación de ansiedad (+2,7 puntos más en el grupo de control), bienestar (-0,78) y tensión muscular (1,27), consideradas estadísticamente significativas (p<0,001). En el análisis del tamaño del efecto, el estudio percibió mejor la variación en la variable ansiedad (η2p=0,74) que en las otras dos variables (η2p=0,14; η2p=0,23). Cirugía El estudio ofrece evidencias favorables para la efectividad del reiki en el control de la ansiedad preoperatoria de cirugías cardíacas. Registro Brasileiro de Ensaios Clínicos: RBR-2nhgvn6 cardíacas aleatorizado 2021 grupos n=44, n44 n 44 (n=44 intervención cirugía. cirugía . cirugía) ansiedad, (ansiedad mixtos η2p. η2p ηp η p (η2p) +2,7 27 2 7 (+2, control, , control) 0,78 078 0 78 (-0,78 1,27, 127 1,27 1 (1,27) p<0,001. p0001 p<0,001 001 (p<0,001) η2p=0,74 η2p074 74 (η2p=0,74 η2p=0,14 η2p014 14 (η2p=0,14 η2p=0,23. η2p023 η2p=0,23 23 η2p=0,23) Clínicos RBR2nhgvn6 RBRnhgvn RBR 2nhgvn6 nhgvn RBR-2nhgvn 202 n=44 n4 4 (n=4 (η2p +2, (+2 0,7 07 (-0,7 12 1,2 (1,27 p000 p<0,00 00 (p<0,001 η2p=0,7 η2p07 (η2p=0,7 η2p=0,1 η2p01 (η2p=0,1 η2p02 η2p=0,2 RBR2nhgvn 2nhgvn 20 n=4 (n= +2 (+ 0, (-0, 1, (1,2 p00 p<0,0 (p<0,00 η2p=0, η2p0 (η2p=0, n= (n + ( (-0 (1, p0 p<0, (p<0,0 η2p=0 (η2p=0 (- (1 p<0 (p<0, η2p= (η2p= p< (p<0 (p< (p

Abstract Background: End-stage renal diseases patients have a high risk of postoperative nausea and vomiting (PONV), which is multifactorial and need acute attention after renal transplantation for a successful outcome in term of an uneventful postoperative period. The study was done to compare the efficacy of palonosetron and ondansetron in preventing early and late-onset PONV in live donor renal transplantation recipients (LDRT). Methods: The prospective randomized double-blinded study was done on 112 consecutive patients planned for live donor renal transplantation. Patients of both sexes in the age group of 18-60 years were randomly divided into two groups: Group O (Ondansetron) and Group P (Palonosetron) with 56 patients in each group by computer-generated randomization. The study drug was administered intravenously (IV) slowly over 30 seconds, one hour before extubation. Postoperatively, the patients were accessed for PONV at 6, 24, and 72 hours using the Visual Analogue Scale (VAS) nausea score and PONV intensity scale. Results: The incidence of PONV in the study was found to be 30.35%. There was significant difference in incidence of PONV between Group P and Group O at 6 hours (12.5% vs. 32.1%, p = 0.013) and 72 hours (1.8% vs. 33.9%, p < 0.001), but insignificant difference at 24 hours (1.8% vs. 10.7%, p = 0.113). VAS-nausea score was significantly lower in Group P as compared to Group O at a time point of 24 hours (45.54 ± 12.64 vs. 51.96 ± 14.70, p = 0.015) and 72 hours (39.11 ± 10.32 vs. 45.7 ± 15.12, p = 0.015). Conclusion: Palonosetron is clinically superior to ondansetron in preventing early and delayed onset postoperative nausea and vomiting in live-related renal transplant recipients. Background Endstage End stage PONV, , (PONV) period lateonset late LDRT. LDRT . (LDRT) Methods doubleblinded double blinded 11 1860 18 60 18-6 groups Ondansetron (Ondansetron (Palonosetron 5 computergenerated computer generated randomization IV (IV 3 seconds extubation Postoperatively 7 VAS (VAS scale Results 3035 35 30.35% 12.5% 125 12 (12.5 vs 321 32 1 32.1% 0.013 0013 0 013 1.8% 8 (1.8 339 33 9 33.9% 0.001, 0001 0.001 001 0.001) 2 107 10 10.7% 0.113. 0113 0.113 113 0.113) VASnausea 45.54 4554 45 54 (45.5 1264 64 12.6 5196 51 96 51.9 1470 14 70 14.70 0.015 0015 015 39.11 3911 39 (39.1 1032 10.3 457 45. 1512 15 15.12 0.015. Conclusion liverelated related (PONV (LDRT 186 18- 303 30.35 12.5 (12. 32.1 0.01 01 1.8 (1. 33.9 000 0.00 00 10.7 011 0.11 45.5 455 4 (45. 126 12. 519 51. 147 14.7 39.1 391 (39. 103 10. 151 15.1 30.3 (12 32. 0.0 1. (1 33. 0.1 (45 14. 39. (39 15. 30. 0. ( (4 (3

SUMMARY OBJECTIVE: In our study, we aimed to compare the effect of standard rapid sequence intubation protocol and the application of rocuronium priming technique on the procedure time and hemodynamic profile. METHODS: Patients who applied to the emergency department and needed rapid sequence intubation were included in our study, which we conducted with a randomized controlled design. Randomization in the study was made according to the order of arrival of the cases. Rapid sequence intubation was performed in the standard group. In the priming group, 10% of the rocuronium dose was administered approximately 3 min before the induction agent. Intubation time, amount of drug used, vital signs, and end-tidal CO2 level before and after intubation used to confirm intubation were recorded. RESULTS: A total of 52 patients were included in the study, of which 26 patients were included in the standard group and 26 patients in the priming group. While intubation time was 121.2±21.9 s in the standard group, it was calculated as 68.4±11.6 s in the priming group (p<0.001). While the mean arterial pressure was 58.3±26.6 mmHg in the standard group after intubation, it was 80.6±21.1 mmHg in the priming group (p=0.002). CONCLUSION: It was observed that priming with rocuronium shortened the intubation time and preserved the hemodynamic profile better. Clinical Trial Registration Number: NCT05343702. OBJECTIVE METHODS design cases 10 agent signs endtidal end tidal CO recorded RESULTS 5 2 1212219 121 21 9 121.2±21. 684116 68 4 11 6 68.4±11. p<0.001. p0001 p p<0.001 . 0 001 (p<0.001) 583266 58 58.3±26. 806211 80 1 80.6±21. p=0.002. p0002 p=0.002 002 (p=0.002) CONCLUSION better Number NCT05343702 NCT 121221 12 121.2±21 68411 68.4±11 p000 p<0.00 00 (p<0.001 58326 58.3±26 80621 8 80.6±21 p=0.00 (p=0.002 NCT0534370 12122 121.2±2 6841 68.4±1 p00 p<0.0 (p<0.00 5832 58.3±2 8062 80.6±2 p=0.0 (p=0.00 NCT053437 1212 121.2± 684 68.4± p0 p<0. (p<0.0 583 58.3± 806 80.6± p=0. (p=0.0 NCT05343 121.2 68.4 p<0 (p<0. 58.3 80.6 p=0 (p=0. NCT0534 121. 68. p< (p<0 58. 80. p= (p=0 NCT053 (p< (p= NCT05 (p NCT0

Objective: To ascertain whether sociodemographic and health-related characteristics known from previous research to have a substantive impact on recovery from depression modified the effect of a digital intervention designed to improve depressive symptoms (CONEMO). Methods: The CONEMO study consisted of two randomized controlled trials, one conducted in Lima, Peru, and one in São Paulo, Brazil. As a secondary trial plan analysis, mixed logistic regression was used to explore interactions between the treatment arm and subgroups of interest defined by characteristics measured before randomization – suicidal ideation, race/color, age, gender, income, type of mobile phone, alcohol misuse, tobacco use, and diabetes/hypertension – in both trials. We estimated interaction effects between the treatment group and these subgroup factors for the secondary outcomes using linear mixed regression models. Results: Increased effects of the CONEMO intervention on the primary outcome (reduction of at least 50% in depressive symptom scores at 3-month follow-up) were observed among older and wealthier participants in the Lima trial (p = 0.030 and p = 0.001, respectively). Conclusion: There was no evidence of such differential effects in São Paulo, and no evidence of impact of any other secondary outcomes in either trial. Clinical trial registration: NCT02846662 (São Paulo, Brazil – SP), NCT03026426 (Lima, Peru – LI). Funded by the U.S. National Institute of Mental Health (grant U19MH098780). Objective healthrelated health related CONEMO. . (CONEMO) Methods trials Paulo analysis ideation racecolor race color race/color age gender income phone misuse use diabeteshypertension diabetes hypertension models Results reduction 50 3month month 3 followup follow up follow-up 0030 0 030 0.03 0001 001 0.001 respectively. respectively respectively) Conclusion registration NCT NCT0284666 SP, SP , SP) NCT0302642 (Lima LI. LI LI) US U S U.S grant U19MH098780. U19MH098780 UMH MH U19MH098780) (CONEMO 5 003 03 0.0 000 00 0.00 NCT028466 NCT030264 U19MH09878 0. NCT02846 NCT03026 U19MH0987 NCT0284 NCT0302 U19MH098 NCT028 NCT030 U19MH09 NCT02 NCT03 U19MH0 NCT0 U19MH

ABSTRACT Objective To evaluate and compare the efficacy of high-flow nasal cannula treatment and that of bilevel positive airway pressure treatment as respiratory physiotherapy interventions for pediatric patients who are hospitalized because of asthma exacerbation. Methods During a randomized clinical trial, treatment was performed using a high-flow nasal cannula and bilevel positive airway pressure for hospitalized children with asthma. After randomization, data regarding lung function, vital signs, and severity scores (pulmonary index, pediatric asthma severity, and pediatric asthma scores) were collected. Results Fifty patients were included in this study (25 in the Bilevel Group and 25 in the high-flow nasal cannula group). After 45 minutes of therapy, an improvement in the forced expiratory volume in 1 second was observed. The high-flow nasal cannula group required fewer days of oxygen (O2) use, used fewer bronchodilators (number of salbutamol puffs), and required shorter hospitalization periods than the Bilevel Group (6.1±1.9 versus 4.3±1.3 days; 95% confidence interval, -5.0 to -0.6) Conclusion A high-flow nasal cannula is a viable option for the treatment of asthma exacerbation because it can reduce the hospitalization period and the need for O2 and bronchodilators. Additionally, it is a safe and comfortable treatment modality that is as effective as bilevel positive airway pressure. ClinicalTrials.gov Identifier: NCT04033666. highflow high flow trial randomization function signs pulmonary index collected (2 2 group. . group) 4 therapy observed O (O2 use number puffs, puffs , puffs) 6.1±1.9 6119 6 9 (6.1±1. 4313 3 4.3±1. 95 interval 5.0 50 5 0 -5. 0.6 06 -0.6 Additionally ClinicalTrialsgov ClinicalTrials gov Identifier NCT04033666 NCT ( (O 6.1±1. 611 (6.1±1 431 4.3±1 5. -5 0. -0. NCT0403366 6.1±1 61 (6.1± 43 4.3± - -0 NCT040336 6.1± (6.1 4.3 NCT04033 6.1 (6. 4. NCT0403 6. (6 NCT040 NCT04 NCT0

Abstract Aim: Using Mendelian Randomization (MR) analysis to investigate the potential causal association between Inflammatory Bowel Disease (IBD) and the occurrence of parenteral malignancies, in order to provide some reference for the parenteral malignancy prevention in patients with IBD. Methods: This was a two-sample MR study based on independent genetic variants strongly linked to IBD selected from the Genome-Wide Association Study (GWAS) meta-analysis carried out by the International Inflammatory Bowel Disease Genetics Consortium (IIBDGC). Parenteral malignancy cases and controls were obtained from the FinnGen consortium and the UK Biobank (UKB) release data. Inverse Variance Weighted (IVW), weighted median, MR-Egger, and strength test (F) were utilized to explore the causal association of IBD with parenteral malignancies. In addition, Cochran’s Q statistic was performed to quantify the heterogeneity of Instrumental Variables (IVs). Results: The estimates of IVW showed that patients with IBD had higher odds of diffuse large B-cell lymphoma (OR = 1.2450, 95% CI: 1.0311‒1.5034). UC had potential causal associations with non-melanoma skin cancer (all p < 0.05), melanoma (OR = 1.0280, 95% CI: 0.9860‒1.0718), and skin cancer (OR = 1.0004, 95% CI: 1.0001‒1.0006). Also, having CD was associated with higher odds of non-melanoma skin cancer (all p < 0.05) and skin cancer (OR = 1.0287, 95% CI: 1.0022‒1.0559). In addition, results of pleiotropy and heterogeneity tests indicated these results are relatively robust. Conclusions: IBD has potential causal associations with diffuse large B-cell lymphoma and skin cancers, which may provide some information on the prevention of parenteral malignancies in patients with IBD. Moreover, further studies are needed to explore the specific mechanisms of the effect of IBD on skin cancers. Aim (MR (IBD Methods twosample two sample GenomeWide Genome Wide GWAS (GWAS metaanalysis meta IIBDGC. IIBDGC . (IIBDGC) UKB (UKB data IVW, , (IVW) median MREgger, MREgger Egger, Egger MR-Egger F (F addition Cochrans Cochran s IVs. IVs (IVs) Results Bcell B cell OR 12450 1 2450 1.2450 95 CI 1.0311‒1.5034. 1031115034 1.0311‒1.5034 0311 5034 1.0311‒1.5034) nonmelanoma non all 0.05, 005 0.05 0 05 10280 0280 1.0280 0.9860‒1.0718, 0986010718 0.9860‒1.0718 9860 0718 0.9860‒1.0718) 10004 0004 1.0004 1.0001‒1.0006. 1000110006 1.0001‒1.0006 0001 0006 1.0001‒1.0006) Also 10287 0287 1.0287 1.0022‒1.0559. 1002210559 1.0022‒1.0559 0022 0559 1.0022‒1.0559) robust Conclusions cancers Moreover (IIBDGC (IVW (IVs 1245 245 1.245 9 103111503 1.0311‒1.503 031 503 00 0.0 1028 028 1.028 098601071 0.9860‒1.071 986 071 1000 000 1.000 100011000 1.0001‒1.000 100221055 1.0022‒1.055 002 055 124 24 1.24 10311150 1.0311‒1.50 03 50 0. 102 02 1.02 09860107 0.9860‒1.07 98 07 100 1.00 10001100 1.0001‒1.00 10022105 1.0022‒1.05 12 2 1.2 1031115 1.0311‒1.5 5 10 1.0 0986010 0.9860‒1.0 1000110 1.0001‒1.0 1002210 1.0022‒1.0 1. 103111 1.0311‒1. 098601 0.9860‒1. 100011 1.0001‒1. 100221 1.0022‒1. 10311 1.0311‒1 09860 0.9860‒1 10001 1.0001‒1 10022 1.0022‒1 1031 1.0311‒ 0986 0.9860‒ 1.0001‒ 1002 1.0022‒ 103 1.0311 098 0.9860 1.0001 1.0022 1.031 09 0.986 1.002 1.03 0.98 0.9

Abstract Objective: This narrative review explores alternative non-antibiotic antimicrobial agents for CRS management in adults. Methods: Alternative antimicrobial agents using EPOS 2020 guidelines as reference were selected, and articles dated from 2003 to 2022 in English, Portuguese, or Spanish using PubMed and EMBASE databases. The parameters analyzed included study design, evidence level, population characteristics, CRS characteristics, interventions, outcomes, sample size, randomization, blinding, and side effects. Reviews, unrelated contexts,in vitro experiments, and duplicates were excluded. Results: 148 articles were screened; 19 articles were selected for analysis. Randomized controlled trials and cohort studies assessing non-antibiotic antimicrobial treatments for CRS were included. Xylitol demonstrated effectiveness in reducing CRS symptoms, particularly SNOT-22 scores, surpassing saline irrigation benefits. Manuka honey showed potential microbiological benefits in recalcitrant CRS, but symptomatic and endoscopic improvements remained inconclusive. Baby shampoo irrigation improved nasal mucociliary clearance and postoperative outcomes. Colloidal silver nasal irrigation showed limited efficacy in reducing CRS symptoms or endoscopic scores. Povidone-Iodine (PI) nasal irrigation yielded mixed results, with varying effects on culture negativity and SNOT-20 scores. Bacteriophage treatment exhibited promise in decreasing specific bacterial strains and cytokine levels. Conclusion: Non-antibiotic antimicrobial therapies, including xylitol, manuka honey, baby shampoo, colloidal silver, PI, bacteriophages, lactoferrin, and carrageenan offer potential alternatives forCRS in adult patients. Xylitol, baby shampoo, and PI presented benefits in improving symptoms and nasal endoscopic scores, however, the number of studies is limited for conclusive recommendations and safety assessments. CRS management should adopt a comprehensive approach, particularly for non-infectious or immune-related cases, moving beyond antibiotics. Antibiotics should be reserved for confirmed bacterial infections. Overall, this review shows the importance of exploring non-antibiotic therapies to enhance the management of CRS. © 2024 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier España, S.L.U. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/). Objective nonantibiotic non antibiotic adults Methods 202 200 English Portuguese databases design level characteristics interventions outcomes size randomization blinding Reviews contextsin contexts experiments excluded Results 14 screened 1 analysis SNOT22 SNOT 22 SNOT-2 scores inconclusive PovidoneIodine Povidone Iodine (PI results SNOT20 20 levels Conclusion Nonantibiotic Non xylitol bacteriophages lactoferrin patients however assessments approach noninfectious infectious immunerelated immune related cases antibiotics infections Overall CérvicoFacial. CérvicoFacial Cérvico Facial. Facial Cérvico-Facial España SLU S L U S.L.U https//creativecommons.org/licenses/by/4.0/. httpscreativecommonsorglicensesby40 httpscreativecommonsorglicensesby https //creativecommons.org/licenses/by/4.0/ . creativecommons org licenses 4 0 (https://creativecommons.org/licenses/by/4.0/) SNOT2 2 SNOT- https//creativecommons.org/licenses/by/4.0/ httpscreativecommonsorglicensesby4 creativecommonsorglicensesby40 creativecommonsorglicensesby //creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/ https//creativecommons.org/licenses/by/4.0 creativecommonsorglicensesby4 //creativecommons.org/licenses/by/4. (https://creativecommons.org/licenses/by/4.0 https//creativecommons.org/licenses/by/4. //creativecommons.org/licenses/by/4 (https://creativecommons.org/licenses/by/4. https//creativecommons.org/licenses/by/4 //creativecommons.org/licenses/by/ (https://creativecommons.org/licenses/by/4 https//creativecommons.org/licenses/by/ //creativecommons.org/licenses/by (https://creativecommons.org/licenses/by/ https//creativecommons.org/licenses/by (https://creativecommons.org/licenses/by

Abstract The objective of this study was to evaluate the effects of different protocols combining cyanocobalamin and butaphosphan on metabolic markers and milk production by Holstein cows postpartum. We used 154 multiparous cows housed in a free-stall system and divided into five groups, using the number of lactations and the probable date of calving as randomization criteria. The animals received intramuscular applications of a 100 mg/mL butaphosphan and 0.05 mg/mL cyanocobalamin combination. The treatment was delivered in a volume of 1 mL for every 20 Kg of body weight on varying treatment days as follows: treatment 1 (T1), on delivery day (day 0) (n=36); T2, days 0 and 3 (n = 31); T3: days 0 and 7 (n = 30); T4: days 0, 3 and 7 (n = 28). The control group (CG) received saline solution on days 0, 3 and 7 (n = 29). Blood samples were collected for metabolite evaluation on days 0, 7, 21 and 30. Milk production was recorded once a week for up to 98 lactation days. T4 elicited higher average milk production (25.87±0.34 kg/day; P < 0.001) than all other groups. Administering butaphosphan and cyanocobalamin on days 0, 3 and 7 postpartum increased milk production and improved energy and liver metabolism in the animals. 15 freestall free stall groups criteria 10 mgmL mg 005 05 0.0 combination 2 follows T1, T1 T , (T1) n=36 n36 n 36 (n=36) T2 31 31) T3 30 30) 28. 28 . 28) CG (CG 29. 29 29) 9 25.87±0.34 2587034 25 87 34 (25.87±0.3 kg/day kgday kg 0.001 0001 001 00 0. (T1 n=3 n3 (n=36 25.87±0.3 258703 8 (25.87±0. 0.00 000 (T n= (n=3 25.87±0. 25870 (25.87±0 (n= 25.87±0 2587 (25.87± 25.87± 258 (25.87 25.87 (25.8 25.8 (25. 25. (25 (2 (

Resumo O objetivo deste estudo foi avaliar os efeitos de diferentes protocolos de administração da associação de cianocobalamina e butafosfan no pós-parto recente de vacas da raça Holandesa sobre marcadores metabólicos e produção de leite. Foram utilizadas 154 vacas da raça Holandesa, multíparas, mantidas em sistema Free-stall e divididas em cinco grupos, utilizando como critérios de randomização o número de lactações e a data provável do parto. Os animais receberam aplicações por via intramuscular após o parto da associação de 100 mg/mL de butafosfan e 0,05 mg/mL de cianocobalamina, em volume de 1mL para cada 20 kg de peso vivo, variando apenas os dias de aplicação: T1: no dia do parto (dia 0) (n=36); T2: dias 0 e 3 (n = 31); T3: dias 0 e 7 (n = 30); T4: dias 0, 3 e 7 (n = 28). O grupo controle (GC) recebeu solução fisiológica nos dias 0, 3 e 7 (n = 29). As amostras de sangue foram coletadas para avaliação de metabólitos nos dias 0, 7, 21 e 30 pós-parto. A produção de leite foi registrada uma vez por semana até 98 dias em lactação. Observou-se que o grupo T4 apresentou a média de produção de leite maior (25,87±0,34 kg/dia; P < 0,001) do que os demais grupos. O protocolo com a administração da associação de butafosfan e cianocobalamina aplicado nos dias 0, 3 e 7 pós-parto foi o mais eficiente em relação a produção de leite e contribuiu para um melhor metabolismo energético e hepático dos animais. pósparto pós 15 multíparas Freestall Free stall grupos 10 mgmL mg mL 005 05 0,0 2 vivo aplicação T1 T n=36 n36 n 36 (n=36) T2 31 31) T3 30) 28. 28 . 28) GC (GC 29. 29 29) pósparto. 9 lactação Observouse Observou se 25,87±0,34 2587034 25 87 34 (25,87±0,3 kg/dia kgdia 0,001 0001 001 1 00 n=3 n3 (n=36 25,87±0,3 258703 8 (25,87±0, 0,00 000 n= (n=3 25,87±0, 25870 (25,87±0 (n= 25,87±0 2587 (25,87± 25,87± 258 (25,87 25,87 (25,8 25,8 (25, 25, (25 (2 (