uchinok@ccf.org / Background Randomized controlled trials (RCTs) of endovascular therapy for acute ischemic stroke have had inconsistent results. We evaluated the efficacy and safety of endovascular therapy in published RCTs. Methods We performed a systematic review of RCTs of endovascular therapy with thrombolytic or mechanical reperfusion compared with interventions without endovascular therapy. Primary outcome was the frequency of good functional outcome (modified Rankin scale (mRS) of 0-2 at 90 days) and secondary outcomes were mortality at 90 days and symptomatic intracranial hemorrhage (sICH). Random-effects meta-analysis was performed and the Cochrane risk of bias assessment was used to evaluate quality of evidence. Results Ten studies involving 1,612 subjects were included. Endovascular therapy was not significantly associated with good functional outcome (Relative Risk [RR] =1.17; 95% CI, 0.97 to 1.42; p=0.10 and Absolute Risk Difference [ARD] =7%; 95%CI -0.1% to 14%; p=0.05); heterogeneity was moderate among studies (I2=30%). Mortality was unchanged with endovascular therapy (RR=0.92; 95 % CI, 0.75 to 1.13; p=0.45) and there was no difference in sICH (RR=1.20; 95 % CI, 0.79 to 1.82; p=0.39). The quality of evidence was low for all outcomes and the recommendation is weak for the use of endovascular therapy as per GRADE methodology. Conclusions Intra-arterial therapy did not show significant increase in good outcomes and no changes in either mortality or sICH in patients with acute ischemic stroke. We need further RCTs with better design and quality to evaluate the true efficacy of endovascular therapy.

Bariatric surgery is becoming a more common solution for weight loss in individuals with severe obesity. Much attention has been placed on negative surgery outcomes, specifically on psychosocial predictors of post-surgical weight regain and development of psychopathology. Literature on obesity suggests that eating in response to emotional cues is related to the obesity epidemic. The current review identifies all research in the literature that focuses on emotionality and emotional characteristics in bariatric surgery patients and the predicted negative impact on the surgery process from pre-surgical evaluation to post-surgical follow-up. The review was conducted following PRISMA guidelines for systematic reviews. Six articles were identified in the literature meeting all review criteria, specifically focusing on emotionality in bariatric surgery patients. Results suggest high rates of emotional instability, impulsivity, and difficulty in identifying emotions in bariatric surgery patients, which could have adverse effects on the bariatric surgery process. Authors suggest that these components of emotionality may lead to negative effects following surgery, specifically concerning post-surgical dietary restrictions and weight regain. These findings suggest that further research needs to be done in the area of emotionality and bariatric surgery. Authors infer that high rates of emotional instability, impulsivity, and inability to identify emotions may have significant implications for screening and intervention; however, limitations in these studies indicate a need for further research on emotionality in bariatric surgery patients, particularly the impact of emotionality on surgery outcomes.

Objective A systematic review and meta-analysis was conducted to assess the efficacy of low-sodium salt substitutes (LSSS) as a potential intervention to reduce cardiovascular (CV) diseases. Methods Five engines and ClinicalTrials.gov were searched from inception to May 2018. Randomised controlled trials (RCTs) enrolling adult hypertensive or general populations that compared detected hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), overall mortality, stroke and other CV risk factors in those receiving LSSS versus regular salt were included. Effects were expressed as risk ratios or mean differences (MD) and their 95% CIs. Quality of evidence assessment followed GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. Results 21 RCTs (15 in hypertensive (n=2016), 2 in normotensive (n=163) and 4 in mixed populations (n=5224)) were evaluated. LSSS formulations were heterogeneous. Effects were similar across hypertensive, normotensive and mixed populations. LSSS decreased SBP (MD-7.81 mm Hg, 95% CI-9.47 to-6.15, p<0.00001) and DBP (MD-3.96 mm Hg, 95% CI-5.17 to-2.74, p<0.00001) compared with control. Significant increases in urinary potassium (MD 11.46 mmol/day, 95% CI 8.36 to 14.55, p<0.00001) and calcium excretion (MD 2.39 mmol/day, 95% CI 0.52 to 4.26, p=0.01) and decreases in urinary sodium excretion (MD-35.82 mmol/day, 95% CI-57.35 to-14.29, p=0.001) were observed. Differences in detected hypertension, overall mortality, total cholesterol, triglycerides, glucose or BMI were not significant. Quality of evidence was low to very low for most of outcomes. Conclusions LSSS significantly decreased SBP and DBP. There was no effect for detected hypertension, overall mortality and intermediate outcomes. Large, long-term RCTs are necessary to clarify salt substitute effects on clinical outcomes. / Wellcome Trust / Revisión por pares

Yes / Immunization against common childhood diseases is an important strategy as it is critical for reducing the global child morbidity and mortality. This review explores the perceptions of parents and HCWs toward childhood immunization. The PRISMA guideline was used to search and include the studies. Relevant electronic databases were systemically searched for the years ranging from 2000 to 2021 to identify studies reported in English. Themes were then identified using thematic analysis. A total of 44 studies met the review criteria and were summarized and categorized into 4 themes: barriers to immunization, parental knowledge, attitude and behavior (KAB), health system factors and HCWs’ KAB. This review found that immunization decision-making is a complex process. Parental KAB leads to immunization decisions. HCWs were also noted to be the trusted sources of immunization information. Further research can be conducted on how to improve parents’ perceptions of immunization and immunization practices.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-20T17:13:19Z No. of bitstreams: 1 mariacandidavianapereira.pdf: 1195378 bytes, checksum: a2f7c0b973a329febe8388d5aaef8588 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T18:41:12Z (GMT) No. of bitstreams: 1 mariacandidavianapereira.pdf: 1195378 bytes, checksum: a2f7c0b973a329febe8388d5aaef8588 (MD5) / Made available in DSpace on 2016-01-25T18:41:12Z (GMT). No. of bitstreams: 1 mariacandidavianapereira.pdf: 1195378 bytes, checksum: a2f7c0b973a329febe8388d5aaef8588 (MD5) Previous issue date: 2014-08-12 / Essa dissertação tem o objetivo de analisar as estratégias de acessibilidade oferecidas aos alunos com deficiência para a participação no Avalia BH – avaliação externa de Belo Horizonte. Foi realizada uma pesquisa acerca da apropriação pelas escolas municipais do documento orientador enviado às mesmas pela Secretaria Municipal de Educação. Conduziu-se e uma revisão de literatura com autores que trabalham a inclusão escolar como Mantoan, Sassaki, Mazzotta, bem como um estudo sobre Avaliações Externas e em Larga Escala baseado em Lima, Gadotti e Dalben. Investigou-se, detalhadamente, os diversos cadernos das avaliações sistêmicas que o Município participa a fim de compreender qual a orientação é oferecida para o cumprimento da legislação referente à inclusão. Também foram realizadas entrevistas com a Coordenadora do Núcleo de Inclusão Escolar da Pessoa com Deficiência da Secretaria de Educação de Belo Horizonte e com professores que atuam na gestão de quatro regionais da cidade com vistas a compreender a percepção destes atores sobre a apropriação dos documentos orientadores e como se dá na prática a acessibilidade dos alunos com deficiência no Avalia BH. Por fim, o trabalho propõe um Plano de Ação Educacional que tem como objetivo potencializar e qualificar a acessibilidade dos alunos com deficiência para participarem do Avalia BH. / This dissertation aims to analyze the strategies of accessibility offered to students with disabilities to participate in Avalia BH - external evaluation of Belo Horizonte. A research about the appropriation of results by local schools of the guidance document sent to them by the Municipal Education was held. It was conducted a literatura review with authors who work with school inclusion such as Mantoan, Sassaki, Mazzotta well as a study on External evoluation and in Large Scale based on Lima, Gadotti e Dalben. It was investigated, in detail, the various schedules of systemic reviews that the City participates in order to understand which orientation is offered for the enforcement of legislation concerning the inclusion.Interviews with the Coordinator of Núcleo de Inclusão Escolar da Pessoa com Deficiência da Secretaria de Educação de Belo Horizonte and teachers who work in four Regional offices was conducted in order to understand the perception of these actors on the appropriation of results of the guiding documents and also to understand how the practical accessibility of students with disabilities in Avalia BH is. Finally, the dissertation proposes a Educational Action Plan which aims to potentialize and qualify the accessibility of students with disabilities to participate in the Avalia BH.