Patrícia dos Santos Vigário

Background: Shrinking lung syndrome (SLS) is a rare manifestation of systemic lupus erythematosus (SLE) lacking standardized management. This systematic review summarizes the current evidence on therapeutic interventions and clinical outcomes. Methods: Following PRISMA guidelines, we searched six databases (e.g., PubMed, Scopus, and Web of Science) for studies on adult SLS patients published up to January 2026. Methodological quality was assessed using JBI tools. Results: Forty studies (111 patients) were included (30 case reports and 10 case series); 87.5% presented a low risk of bias. There was a marked female predominance (91%), with a mean age of 33.5 ± 9.8 years. All patients showed a restrictive pattern (forced vital capacity: 47–52%). Glucocorticoids were the mainstay of therapy (95–96%). Rituximab emerged as an effective primary biologic for refractory cases. Non-pharmacological interventions, such as inspiratory muscle training and non-invasive ventilation, improved diaphragmatic strength. Although symptomatic resolution occurred in 75–95% of patients, complete functional recovery (normalization of pulmonary function tests) was achieved in only 20–23% of patients. Mortality directly attributed to SLS was low (2–5.5%). Conclusions: Early glucocorticoid therapy remains essential, but complete functional recovery is rare, with 80% of patients maintaining chronic restriction. For refractory cases, multidisciplinary care integrating rituximab and respiratory rehabilitation should be considered to optimize functional outcomes.

This study aimed to evaluate body composition, quality of life, and depression risk in women with polycystic ovary syndrome (PCOS) compared to women without PCOS. This prospective, cross-sectional study assessed quality of life (QoL) and depressive symptoms in women with polycystic ovary syndrome (PCOS) compared with controls with and without overweight or obesity. Assessments included body composition, QoL, health-related quality of life (HRQoL), and depressive symptoms. Participants without PCOS were divided into two groups according to BMI: < 25 kg/m² [median age 30 years (27-33)] and ≥ 25 kg/m² [median age 32 years (29-35)]. The study included 47 women with polycystic ovary syndrome (PCOS) phenotypes A and B. The median age was 29 years (25-35), and the median body mass index (BMI) was 32.08 kg/m² (28.48-36.40). Women with PCOS showed a higher risk of depression (24% with moderate to severe risk) compared with women without PCOS, both with and without overweight or obesity (5% and 3%, respectively). Additionally, women with PCOS consistently reported lower QoL and HRQoL scores, particularly in the physical, environmental, and overall QoL domains, as well as in functional capacity, pain, general health status, vitality, emotional well-being, and mental health domains of HRQoL. Based on these findings, we concluded that body composition does not appear to be a determining factor for increased risk of depressive symptoms or poorer perceptions of QoL and HRQoL in women with PCOS.

Background: Exercise training is a cornerstone in managing type 2 diabetes mellitus (T2DM), yet direct comparisons between combined aerobic–resistance training (A + R) and high-intensity interval training (HIIT) across clinical and patient-reported outcomes remain limited. Objective: To compare the effects of A + R and HIIT on insulin resistance, glycaemic control, body composition, physical function, and quality of life in adults with T2DM, relative to standard care. Design and participants: A single-centre, randomised controlled trial involving 90 participants with T2DM (aged 30–65 years), allocated to A + R, HIIT, or control groups. Interventions: A + R consisted of moderate-intensity aerobic and resistance exercises, while HIIT comprised structured interval sessions. Both programs were delivered 3–5 times weekly for 12 weeks. The control group received usual care without structured exercise. Measurements: Primary outcomes included fasting insulin (FI), Glycosylated Hemoglobin (HbA1c), and insulin resistance (HOMA-IR). Secondary outcomes included fasting glucose (FG), 6-minute walk distance (6MWD), subcutaneous and visceral fat, muscle mass, and WHOQOL-BREF domains. Results: Compared with control, the HIIT group showed a greater reduction in fasting glucose (Mean Difference [MD] −29.1 mg/dL; 95% CI −41.2 to −17.0) and the A+R group also improved (MD −20.6 mg/dL; 95% CI −31.0 to −10.2). HbA1c was lower versus control in both HIIT (MD −3.35%; 95% CI −4.11 to −2.58) and A+R (MD −3.33%; 95% CI −4.03 to −2.62). Fasting insulin decreased relative to control in HIIT (MD −7.16 mIU/L; 95% CI −10.04 to −4.28) and A+R (MD −8.87 mIU/L; 95% CI −11.77 to −5.97). HOMA-IR improved versus control in A+R (MD −2.33; 95% CI −3.63 to −1.03) with a non-significant trend in HIIT (MD −1.17; 95% CI −2.47 to 0.13). Functional capacity (6-minute walk distance) increased versus control in HIIT (MD +178.9 m; 95% CI 130.5 to 227.4) and A+R (MD +233.6 m; 95% CI 191.8 to 275.5). Body composition favored both interventions: fat-free mass increased (HIIT MD +7.54 kg; 95% CI 4.71 to 10.36; A+R MD +5.96 kg; 95% CI 3.06 to 8.86) while subcutaneous fat (HIIT MD −7.16%; 95% CI −9.33 to −4.99; A+R MD −8.37%; 95% CI −10.65 to −6.09) and visceral fat (HIIT MD −4.70%; 95% CI −5.93 to −3.47; A+R MD −4.58%; 95% CI −5.86 to −3.31) were reduced. Quality of life improved across domains versus control in both groups (e.g., physical domain: HIIT MD +10.29; 95% CI 4.06 to 16.51; A+R MD +13.77; 95% CI 6.62 to 20.91). All results were derived from covariate-adjusted mixed models with multiple comparison corrections (Benjamini–Hochberg FDR, q = 0.05; Bonferroni-adjusted α = 0.002). Limitations: Findings are limited to adherent participants, and generalizability is restricted to those without advanced complications. The 12-week duration precludes assessment of long-term sustainability. Conclusion: Both HIIT and A+R significantly improved metabolic, functional, and psychosocial outcomes compared with control. HIIT yielded greater benefits for fasting glucose and muscle mass, while A+R conferred broader improvements in HbA1c, fat reduction, and quality of life. These findings support tailoring exercise prescriptions to therapeutic goals and highlight the complementary roles of HIIT and A+R in routine diabetes care. Clinical trial registration: The trial is registered with the Clinical Trial Registry of India (reference no: CTRI/2022/04/041762).

In martial arts, heart rate variability (HRV) measurements can potentially be used to assess injury risk and susceptibility to fatigue. Muay Thai uses the Frequency Speed of Kick Test (FSKT) to measure kick speed, but it is unknown whether better fitness results in improved autonomic function and body composition, which may affect athletic performance and recovery. We aimed to evaluate the correlations between FSKT, HRV, and body composition measures in amateur Muay Thai fighters. This is a cross-sectional study with 37 Muay Thai fighters. They underwent FSKT-10s and multiple FSKT to measure the kick fatigue index (KFI). In addition, body composition was assessed using bioelectrical impedance analysis and HRV using a heart rate monitor. When comparing the values before and during the FSKT-10s, there was a decrease in the percentage of interval differences of consecutive successive NN intervals greater than 50 ms (pNN50), approximate entropy, and parasympathetic nervous system (PNS) index, with an increase in the sympathetic nervous system (SNS) index. The number of kicks assessed by FSKT-10s positively correlated with fat-free mass (FFM) and low frequency (LF) of the HRV assessment. The KFI correlated negatively with the FFM and PNS index, and positively with the LF and SNS index. When amateur Muay Thai fighters perform the FSKT-10s, there is an acute effect on autonomic modulation with increased sympathetic activation and vagal withdrawal. FFM and sympathetic activation are related to performance and susceptibility to fatigue. These results indicate the importance of assessing HRV in Muay Thai fighters to improve performance.

O presente levantamento bibliográfico teve como objetivo analisar o papel do artesanato sustentável na promoção do desenvolvimento socioeconômico em comunidades locais brasileiras. Para tal, foram consultadas as bases de dados Scientific Electronic Library Online (Scielo), Domínio Público, Periódicos CAPES e Google Acadêmico, utilizando as seguintes palavras-chave em uma busca avançada: “artesanato sustentável”, “artesãos” e “desenvolvimento sustentável”. Como resultados, constatou-se que os desafios a serem superados pelos artesãos de comunidades locais brasileiras para que o desempenho de seus ofícios se dê de forma sustentável com vistas ao desenvolvimento socioeconômico são muitos, e incluem a falta de incentivo governamental, a necessidade de fortalecimento das políticas públicas, e a ausência de comprometimento da coletividade no trato com a produção artesanal. Dessa forma, os resultados aqui encontrados podem contribuir para discussões e reflexões acerca das políticas públicas atuais, assim como o desenvolvimento de práticas que promovam o equilíbrio entre crescimento econômico, bem-estar social e sustentabilidade ambiental nas comunidades locais brasileiras. Por fim, é oportuno destacar que este tema está relacionado direta e indiretamente aos Objetivos de Desenvolvimento Sustentável (ODS) números 1, 8, 11, 12, 15 e 17 da Agenda 2030 das Nações Unidas (ONU) em prol de um mundo mais justo e sustentável.

Introdução: O câncer de colo de útero é o terceiro tipo de câncer mais comum entre mulheres no Brasil. Esse tipo de câncer está fortemente associado à infecção crônica pelos subtipos cancerígenos do Papilomavírus Humano (HPV), sendo o HPV-16 e o HPV-18 responsáveis por cerca de 70% dos casos. A detecção precoce da doença é crucial para reduzir sua gravidade e, nesse sentido, a Atenção Primária à Saúde desempenha um papel fundamental com destaque para os enfermeiros. Objetivo: Compreender a prática da enfermagem no rastreamento do câncer de colo de útero na Atenção Primária à Saúde, no Município de Itaguaí no Estado do Rio de Janeiro. Método: Participaram do estudo 17 enfermeiros atuantes no município, responsáveis pela coleta de esfregaço cérvico-vaginal. Os dados foram coletados através de questionário de perfil sociodemográfico e entrevistas semiestruturadas. Resultados: O estudo evidenciou a importância do papel dos enfermeiros na captação de mulheres para o rastreamento do câncer de colo uterino, na realização da consulta de enfermagem ginecológica e no acompanhamento das pacientes com exames alterados. No entanto, os desafios enfrentados pelos profissionais, como a falta de estrutura adequada e a insuficiência de recursos humanos, limitam a qualidade do serviço prestado. Conclusão: Investir na capacitação dos enfermeiros responsáveis pela realização do rastreamento do câncer de colo uterino, na melhoria da infraestrutura das unidades de saúde e na ampliação da equipe de profissionais é fundamental para aprimorar o cuidado com as mulheres e contribuir para o diagnóstico precoce do câncer do colo do útero.

Introdução: O câncer de colo de útero é o terceiro tipo de câncer mais comum entre mulheres no Brasil. Esse tipo de câncer está fortemente associado à infecção crônica pelos subtipos cancerígenos do Papilomavírus Humano (HPV), sendo o HPV-16 e o HPV-18 responsáveis por cerca de 70% dos casos. A detecção precoce da doença é crucial para reduzir sua gravidade e, nesse sentido, a Atenção Primária à Saúde desempenha um papel fundamental com destaque para os enfermeiros. Objetivo: Compreender a prática da enfermagem no rastreamento do câncer de colo de útero na Atenção Primária à Saúde, no Município de Itaguaí no Estado do Rio de Janeiro. Método: Participaram do estudo 17 enfermeiros atuantes no município, responsáveis pela coleta de esfregaço cérvico-vaginal. Os dados foram coletados através de questionário de perfil sociodemográfico e entrevistas semiestruturadas. Resultados: O estudo evidenciou a importância do papel dos enfermeiros na captação de mulheres para o rastreamento do câncer de colo uterino, na realização da consulta de enfermagem ginecológica e no acompanhamento das pacientes com exames alterados. No entanto, os desafios enfrentados pelos profissionais, como a falta de estrutura adequada e a insuficiência de recursos humanos, limitam a qualidade do serviço prestado. Conclusão: Investir na capacitação dos enfermeiros responsáveis pela realização do rastreamento do câncer de colo uterino, na melhoria da infraestrutura das unidades de saúde e na ampliação da equipe de profissionais é fundamental para aprimorar o cuidado com as mulheres e contribuir para o diagnóstico precoce do câncer do colo do útero.

Introdução: A estimativa do consumo de oxigênio de pico (VO2pico) deve incluir variáveis que representem as características da população avaliada. Objetivo: Examinar a associação de variáveis antropométricas, de esforço cardiorrespiratório e de características específicas da lesão medular (LM) com o VO2pico em homens. Métodos: Estudo observacional seccional com nove homens com LM alta incompleta: tetraplegia (grupo TETRA) e 08 com LM baixa completa: paraplegia (grupo PARA). A aptidão cardiorrespiratória foi avaliada pelo teste cardiopulmonar de esforço em cicloergômetro para membros superiores, sendo considerados no pico do esforço: VO2pico (L/min), carga (w) e frequência cardíaca (bpm). Para a composição corporal foram considerados: somatório de 4 dobras cutâneas (mm), massa corporal total (kg) e perímetro muscular de braço (cm). Como variável relativa à LM foi considerado o nível/ altura da LM (grupo). Um modelo de regressão linear multivariado com método “Backward” (α=5%) foi feito para a determinação do VO2pico (IBM SPSS 27.0). Resultados: As variáveis antropométricas consideradas não se correlacionaram com o VO2pico. A análise multivariada resultou no modelo F(2,14) = 25,25; p<0,001; R2=0,783, com a equação: VO2pico=0,134+0,256* grupo (TETRA=0; PARA=1)+0,014*carga (w), sendo a carga a variável mais importante para a determinação do VO2pico. Conclusão: Neste estudo preliminar, a carga e a altura/nível da LM foram as variáveis que melhor determinaram o VO2pico, enquanto as variáveis antropométricas não se correlacionaram com o VO2pico.

Context: Wheelchair Power Soccer (WPS) is the only team sport that allows the participation of people with severe physical disabilities who require the daily use of motorized wheelchairs. These individuals may live with chronic pain due to the characteristics of the disabilities and treatments, interfering with their health and limiting their participation in sports. Objectives: To investigate the prevalence of musculoskeletal pain and its relationship with mood in WPS players and to analyze the incidence of traumatic injuries during a championship. Methods: A prospective, longitudinal study was carried out on 30 WPS athletes (93.33% male) with a mean (SD) (range) age of 22.37 (9.79) (47) years. Data collection was performed during a South American WPS Championship lasting 3 days, with: investigation of the presence of musculoskeletal pain and mood through a questionnaire; investigation of the occurrence of traumatic injuries through match observation; and confirmation of the occurrence of traumatic injuries through access to medical department records. Results: About 30% (n = 9/30) of the sample presented some pain on the day of evaluation, with an intensity of 5.67 (3.35) (10) points on the visual analog scale. The most common regions of pain were the lower back (13.3%, n = 4/30), thoracic (10%; n = 3/30), and cervical (10%; n = 3/30) areas of the spine. A total of 46.7% (n = 14/30) reported pain in the month before data collection but of less intensity (2.56 [4] [10] points), the most common regions being the lower limbs (20%; n = 6/30) and cervical spine (20%; n = 6/30). Among the between-group comparisons (ie, participants with pain vs without pain), no relationship was observed between mood state and pain. No traumatic injuries were identified during the competition. Conclusion: The presence of musculoskeletal pain was common in WPS players, but it was not related to mood. As no traumatic injuries were observed during the championship, this modality seems to be safe for people with physical disabilities in general.