Introduction: Early mobilization has shown significant benefits in the rehabilitation of critically ill patients, including improved muscle strength, prevention of physical deconditioning, and reduced hospital length of stay. However, its safety in neurocritical patients, such as those with strokes, traumatic brain injuries, and postsurgical brain surgeries, remains uncertain. This study aims to map and examine the available evidence on the safety of early mobilization in adult neurocritical patients. Methods: A scoping review was conducted following PRISMA‐SCR guidelines and the Joanna Briggs Institute (JBI) methodology. The research question focused on the safety of early mobilization in neurocritical patients, considering adverse events, neurological changes, hemodynamic changes, and respiratory changes. A comprehensive search was performed in databases such as PubMed, BVS–LILACS, Ovid MEDLINE, and ScienceDirect, using specific search strategies. The selected studies were assessed for methodological quality using JBI tools. Results: Of 1310 identified articles, 25 were included in the review. These studies comprised randomized controlled trials, prospective observational studies, retrospective studies, and pre‐ and postimplementation intervention studies. The review found that early mobilization in neurocritical patients is generally safe, with a low incidence of severe adverse events, and does not increase the risk of vasospasm, and most complications were manageable with protocol adjustments and continuous monitoring. Conclusion: Early mobilization in neurocritical patients has been shown to be potentially safe under specific conditions, without a significant increase in severe complications when properly monitored. However, the available evidence is limited by the heterogeneity of protocols and study designs, emphasizing the need for further research. The importance of tailoring mobilization protocols to each patient and ensuring continuous monitoring is highlighted. Additional studies with larger sample sizes are needed to fully understand the associated risks and optimize mobilization strategies.
Plasmodium falciparum malaria remains a major cause of morbidity and mortality, particularly in endemic regions. We report the case of a 21-year-old male with recent travel to an endemic area (Guapi, Colombia), who presented with febrile symptoms, severe respiratory distress, and oxygen saturation below 75%, necessitating orotracheal intubation. During the procedure, he developed pulseless electrical activity cardiac arrest, achieving return of spontaneous circulation after advanced resuscitation. Diagnosis was confirmed by thick blood smear, demonstrating P. falciparum infection. The patient progressed to multiorgan failure, including acute respiratory distress syndrome with capillary leak pulmonary edema, refractory distributive shock, acute kidney injury with severe hyperkalemia, and consumptive thrombocytopenia. Management included invasive mechanical ventilation, vasopressor support, sedation-analgesia, neuromuscular blockade, methylene blue, unsuccessful hemodialysis due to hemorrhagic complications, and platelet transfusions. Despite these interventions, the patient experienced a second cardiac arrest and died. This case highlights the severity and rapid progression of severe malaria with multisystem involvement, underscoring the critical importance of early diagnosis and intensive multidisciplinary management. It also emphasizes the need for preventive strategies for travelers to endemic areas and the development of clinical protocols to improve outcomes in complicated malaria.
Background/Objective: Cancer significantly impairs physical function and quality of life. Exercise has gained recognition as a therapeutic strategy; however, its long-term efficacy in terms of multidimensional outcomes in patients with cancer remains underexplored. This review aimed to evaluate and summarize the available evidence regarding the effects of multicomponent exercise programs on pain and psychosocial outcomes in individuals with cancer. Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42022321183). Comprehensive searches were performed in MEDLINE, OVID, LILACS, Scopus, PEDro, OTseeker, The Cochrane Library, EBSCO, and Google Scholar, without date restrictions. Search terms included “exercise” and “cancer.” Only randomized controlled trials (RCTs) were included. Methodological quality and risk of bias were assessed using the PEDro scale. Results: Sixteen randomized controlled trials met the inclusion criteria. Multicomponent exercise programs combining aerobic, resistance, and flexibility training significantly improved muscle strength, balance, and quality of life. Several studies reported meaningful reductions in pain intensity and interference, whereas others found no significant changes. Overall, exercise interventions demonstrated superior effects compared with usual care or educational controls across physical and psychosocial outcomes. Conclusions: Multicomponent exercise is a safe and feasible intervention for adults with cancer, including those with advanced disease or complex clinical profiles. Evidence supports consistent benefits in physical function and quality of life, with partially consistent yet favorable effects on pain. Programs integrating multiple exercise modalities appear most effective and should be considered as part of comprehensive oncological care to enhance therapeutic outcomes and long-term well-being.
Background/Objectives: Mental disorders such as anxiety, schizophrenia, and depression are linked to alterations in neuroplasticity and neuroprotection within the central nervous system. While conventional drugs are widely used, medicinal plants are emerging as a promising alternative due to their potential therapeutic effects on neuronal function. This study aimed to explore and analyze the impact of medicinal plants on neuroplasticity and neuroprotection in relation to mental disorders using biomodels. Methods: Data were collected from Scopus, Dimensions, and PubMed by using the search terms “Medicinal plants”, “Neuronal Plasticity”, and “Mental Disorder” in accordance with the guidelines of the PRISMA checklist. Results: A total of twenty-three relevant studies were selected to investigate the association between medicinal plants and mental disorders, focusing on factors such as administered doses and the modulation of neurotransmitters in the context of neuroplasticity and neuroprotection. This review highlights the complexity of study designs, target populations, and methodologies. Of the studies, 86% investigated depression, while 13% focused on anxiety. Regarding neurotransmitter modulation, 47% found that medicinal plants influenced serotonin levels, followed by 27% which found that they affected dopamine; according to the remaining studies, medicinal plants impacted norepinephrine, GABA, and acetylcholine. These findings emphasize the importance of precise dosing and neurotransmitter modulation, suggesting that targeted interactions with neural systems may help clarify the specific effects of these plants on mental health. Conclusions: Research on the effects of medicinal plants on psychiatric disorders in animal models suggests their potential to support neuroplasticity and neuroprotection. Positive impacts on mental health are indicated through the modulation of cytokines, neurotransmitters, and specific signaling pathways.
Background/Objectives: We will describe the early mobilization protocols applied to critically ill pediatric patients in PICUs, analyzing the strategies employed, the tools used, and the barriers perceived by the healthcare team during their implementation. Methods: The scoping review followed the guidelines established by PRISMA-ScR. A search was conducted across five electronic databases: PubMed, Scopus, Web of Science, Dimensions AI, and ScienceDirect. Articles published in English that focused on pediatric patients aged 0 to 18 years were included. Results: A total of 3508 records were initially identified, of which 3422 articles were evaluated after duplicate removal. Subsequently, 12 studies that met the inclusion criteria were included. The methodological quality of the studies was mostly adequate, with 71.43% achieving scores between eight and nine on the Newcastle–Ottawa scale and 50% of the randomized clinical trials obtaining the maximum score of 7/7 on the Jadad scale. The interventions analyzed, including active bed mobility, bed cycling, and virtual reality, showed positive results in terms of feasibility and safety. The most frequently reported barriers to mobilization were hemodynamic instability, excessive sedation, pain, and lack of personnel and equipment. Conclusions: Early mobilization in pediatric PICUs is linked to improvements in mobility, reduced hospital stays, and shorter mechanical ventilation duration. However, its implementation is limited by barriers such as hemodynamic instability, excessive sedation, and lack of personnel and equipment. Further research is needed to establish uniform protocols, reduce these barriers, and optimize their effectiveness.
This paper aims to investigate and analyze the correlation between diaphragmatic parameters through ultrasonography and sports performance in various sports disciplines. This systematic review followed the PRISMA methodology. The search strategy was applied in the Medline database through Ovid, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials, and Open Gray. Clinical trials, cohort, case–control, and cross-sectional studies were included, and animal experiments were excluded. A total of 388 studies were identified. After removing duplicates and screening titles and abstracts, sixteen studies were selected for full review, and six were included in the qualitative analysis. The results demonstrated a positive correlation between diaphragm excursion and thickness during inspiration with the anaerobic power, highlighting their importance in high-intensity performance. Additionally, one study reported a positive correlation between diaphragm thickness and aerobic power, suggesting the need for further research. The impact of inspiratory muscle training in Paralympic athletes was also evaluated, providing valuable insights into diaphragmatic adaptation in disabled populations. Ultrasonography is a feasible tool for evaluating the structure and function of the diaphragm, the main element of the respiratory process during sports practice. Its use could contribute to the evaluation and planning of sports training and be a possible indicator of performance improvement.
About Me
Research Professor., Phys., MSc., PhD(s)
Basical Medical Sciences
Line of Research: Clinical Physiology and Pathophysiology
Research Professor., Phys., MSc., PhD(s)
Basical Medical Sciences
Line of Research: Clinical Physiology and Pathophysiology