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.

Inhaled corticosteroids (ICSs) are widely used to manage chronic respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), and human immunodeficiency virus (HIV). However, prolonged use of ICS is associated with the development of oropharyngeal candidiasis, a fungal infection primarily caused by Candida albicans, due to local immunosuppression in the oral cavity. The incidence of oropharyngeal candidiasis varies depending on geographic region, patient age, and comorbidities, with immunocompromised individuals, those with diabetes, and the elderly being particularly vulnerable. Key risk factors include high ICS doses, poor oral hygiene, and improper use of inhalers. Prevention is the cornerstone of managing oropharyngeal candidiasis associated with the chronic use of inhaled corticosteroids. Patient education on proper inhaler technique and oral hygiene is essential to reduce the risk of fungal overgrowth in the oral cavity. Additional preventive strategies include the use of spacers, mouth rinsing after inhalation, and proper denture care. In cases where these measures fail to prevent the infection, prompt detection and early intervention are crucial to prevent progression or recurrence. This narrative review aims to analyze the most effective prophylactic measures to prevent oropharyngeal candidiasis associated with the chronic use of inhaled corticosteroids, emphasizing patient education, oral hygiene, and proper use of inhalation devices.

Pulmonary complications can arise due to trauma, postoperative conditions, or as sequelae of diseases such as COVID-19. To help patients restore lung functionality, most undergo lung re-expansion physiotherapy using a Respiratory Incentive Spirometer. However, currently available Respiratory Incentive Spirometers do not allow for quantitative tracking of performance during inspiration exercises, require physiotherapist supervision to ensure exercise quality, and show low treatment adherence. To address these limitations, we developed UBICU, an assistive product for lung re-expansion physiotherapy. UBICU includes a flow measurement device, an app with a video game interface to motivate exercise performance, and cloud-based software for the remote prescription and evaluation of physiotherapy. We conducted a quasi-experimental study with a sample of 30 healthy individuals, aged 18 to 65 years and balanced by age and sex. We assessed pulmonary ventilation distribution before, during, and after using two flow respiratory incentive spirometers, UBICU and TriFlo, with electrical impedance tomography. Our findings indicate that UBICU provides accurate and reliable measurements of pulmonary ventilation distribution, showing statistically significant improvements after use (p < 0.01), validating its effectiveness as a respiratory incentive spirometer. To evaluate the usability of the video game component, we conducted a perception survey, achieving an acceptance rating above 5 on a scale of 0 to 6. Notably, UBICU was shown to favor lung re-expansion more effectively than the traditional TriFlo mechanical system.

Introduction: Hyperkalemia is a potentially life-threatening condition that requires prompt intervention to prevent cardiac complications. While insulin and glucose administration remains a cornerstone of treatment, inhaled β2-adrenergic agonists have been proposed as a complementary or alternative strategy, particularly in emergency settings. This scoping review aimed to describe the utility of inhaled β2-agonists in lowering serum potassium levels in adult patients. Methods: A scoping review was conducted following the PRISMA-ScR guidelines and the Joanna Briggs Institute methodology. Experimental studies published within the past ten years evaluating the use of inhaled β2-agonists in adult patients with hyperkalemia were included. Five studies were analyzed (three randomized controlled trials and three quasi-experimental studies), assessing dosage, route of administration, magnitude of potassium reduction, and reported adverse events. Results: Most studies used nebulized salbutamol at a dose of 10 mg, with observed reductions in serum potassium ranging from 0.62 to 1.636 mEq/L, and a peak effect between 1 and 4 hours post-administration. One study also reported the use of levalbuterol. The most common adverse effects were tachycardia, dizziness, and mild hyperglycemia, all of which were clinically manageable. Efficacy was demonstrated in both patients with chronic kidney disease and in individuals with normal renal function. Conclusion: Inhaled β2-agonists, particularly nebulized salbutamol, represent an effective and safe therapeutic option for the acute reduction of serum potassium in adults with hyperkalemia. Their rapid onset of action and applicability across various patient profiles make them a valuable tool in emergency settings, especially where immediate access to advanced therapies such as dialysis is limited. Further research is warranted to evaluate long-term outcomes, safety in patients with cardiovascular comorbidities, and optimal dosing strategies.

Background: Sudden cardiac death (SCD) is a rare but devastating event in the sports setting, often affecting apparently healthy and physically active individuals. Although regular physical activity is widely promoted as a protective factor against cardiovascular disease, cases of SCD continue to be reported not only in elite athletes but also in amateur and recreational athletes, who frequently lack systematic cardiovascular screening. Objective: To map the available evidence on the most prevalent cardiovascular diseases and the associated risk factors related to sudden cardiac death in amateur athletes. Methods: A scoping review was conducted following the PRISMA-ScR guidelines and the methodological framework proposed by the Joanna Briggs Institute (JBI). The research question was structured using the PCC framework (Population: amateur athletes aged ≥18 years; Concept: cardiovascular diseases and associated risk factors; Context: sudden cardiac death). Systematic searches were performed in PubMed, Scopus, SciELO, and Springer, with no restrictions on publication date and including studies published in English, Spanish, and Portuguese. Study selection, data extraction, and methodological quality assessment were independently performed by two reviewers, with disagreements resolved by a third reviewer. Methodological quality was assessed using JBI critical appraisal tools for observational cohort studies. Results: A total of 1,807 records were identified, of which five observational studies met the inclusion criteria. The most frequently reported cause of SCD in amateur athletes was hypertrophic cardiomyopathy, followed by atherosclerotic coronary artery disease—particularly in athletes older than 35 years—and myocarditis, mainly in younger individuals with recent respiratory infections. Football was the sport most commonly associated with SCD events. The main risk factors identified included male sex, intense physical exertion, traditional cardiovascular risk factors (smoking, hypertension, dyslipidemia, prior myocardial infarction, and coronary stenosis), family history of premature coronary disease, and the absence of early cardiopulmonary resuscitation or defibrillation at the event site. Overall methodological quality ranged from moderate to high. Conclusion: Sudden cardiac death in amateur athletes is predominantly associated with underlying cardiovascular diseases, particularly hypertrophic cardiomyopathy, and with a combination of modifiable and non-modifiable risk factors. These findings highlight that SCD is not exclusive to elite sports and underscore the need for preventive strategies in amateur athletes, including cardiovascular screening, risk factor control, education in cardiopulmonary resuscitation, and availability of automated external defibrillators in sports settings.