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/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.

Background and Aims: Telerehabilitation is essential for the recovery of post-COVID-19 patients, improving exercise tolerance, dyspnea, functional capacity, and daily activity performance. This study aimed to describe telerehabilitation protocols specifically designed for individuals with post-COVID-19 sequelae. Materials and Methods: A systematic review was conducted with registration number CRD42023423678, based on searches developed in the following databases: ScienceDirect, Scopus, Dimensions.ai and PubMed, using keywords such as “telerehabilitation” and “COVID-19”. The final search date was July 2024. The selection of studies involved an initial calibration process, followed by independent filtering by the researchers. The selection criteria were applied prior to critical appraisal, data extraction, and the risk of bias assessment. Results: After reviewing 405 full-text papers, 14 articles were included that focused on telerehabilitation interventions for post-COVID-19 patients. These interventions were designed for remote delivery and included exercise protocols, vital sign monitoring, and virtual supervision by physical therapists. The studies reported improvements in physical function, muscle performance, lung capacity, and psychological outcomes. Significant gains were observed in strength, mobility, and functional capacity, as well as reductions in dyspnea, fatigue, and improvements in quality of life, particularly in social domains. Intervention protocols included aerobic, strength, and respiratory exercises, monitored using tools such as heart rate monitors and smartphones. Conclusions: Telerehabilitation positively impacts lung volumes, pulmonary capacities, dyspnea reduction, functionality, muscle performance, and independence in post-COVID-19 patients.

The lung microbiota is integral to maintaining microenvironmental homeostasis, influencing immune regulation, host defense against pathogens, and overall respiratory health. The dynamic interplay among the lung microbiota emphasizes their significance in shaping the respiratory milieu and potential impact on diverse pulmonary affections. This investigation aimed to identify the effects of invasive mechanical ventilation on the lung microbiome. Materials and Methods: A systematic review was conducted with registration number CRD42023461618, based on a search of PubMed, SCOPUS, and Web of Science databases, in line with the PRISMA guidelines. To achieve this, “(mechanical ventilation) AND (microbiota)” was used as the search term, replicable across all databases. The closing date of the search was 12 March 2025, and the evidence was scored using the MINORS scale. Results: A total of 16 studies were included, with patients aged 13.6 months to 76 years, predominantly male (64.2%). Common ICU admission diagnoses requiring invasive mechanical ventilation (IMV) included pneumonia, acute respiratory failure, and COVID-19. IMV was associated with reduced lung microbiota diversity and an increased prevalence of pathogenic bacteria, including Prevotella, Streptococcus, Staphylococcus, Pseudomonas, and Acinetobacter. The most frequently used antibiotics were cephalosporins, aminoglycosides, and penicillins. IMV-induced pulmonary dysbiosis correlated with higher infection risk and mortality, particularly in pneumonia and COVID-19 cases. Factors such as antimicrobial therapy, enteral nutrition, and systemic inflammation contributed to these alterations. Conclusions: Invasive mechanical ventilation has been associated with the development of alterations in the respiratory microbiome, resulting in reduced diversity of lung microorganisms.