Anna Quialheiro

Background: Pre-pregnancy obesity and GDM increase maternal–fetal oxidative stress, but their consequences for women’s health and child development are still unclear. Objectives: This paper describes the methodological design, recruitment strategy, data collection methods, and baseline characteristics of the Gerar Cohort, a prospective longitudinal study designed to investigate the relationship between pre-pregnancy obesity and gestational diabetes mellitus (GDM) with oxidative stress biomarkers and their effects on maternal and child health outcomes through 12 months postpartum. Methods: Women were recruited early in their prenatal care in a city in Southern Brazil. Sociodemographic and clinical data, as well as blood samples, were collected each trimester. At childbirth, umbilical cord blood and placental tissue were collected. Children were followed up until 12 months of age, with blood collection at 4 and 12 months. The study was approved by the Research Ethics Committee. Results: A total of 189 women were recruited in the first trimester; 136 were followed up until the third trimester; 23 pregnancy losses were recorded. Pre-gestational obesity was observed in 24.3% (95% CI 18.4–31.1), and 27% (95% CI 20.8–33.9) of women were diagnosed with gestational diabetes mellitus. Fifty-nine umbilical cord blood samples and 61 placental fragments were collected. In the children’s follow-up, 71 children were taken for ophthalmological examination at 1 month of age; 60 attended the pediatric consultation at 4 months; 56 children attended the neurological evaluation at 6 months and 50 at 12 months. Conclusions: The Gerar Cohort successfully implemented its recruitment and biospecimen collection procedures within public healthcare services.

Immobility Syndrome – Consequences of Lower Limb Unloading. A Systematic Literature Review

Arthrogenic muscle inhibition (AMI) following ACL injury or reconstruction is a common issue that affects muscle activation and functional recovery. Thus, the objective of this study was to systematize the literature on the effects of physiotherapy interventions in the rehabilitation of AMI after ACL injury or reconstruction. A systematic review was conducted following the PRISMA guidelines. The risk of bias was evaluated using the PEDro scale and the Cochrane risk of bias tool. Searches were performed in the PubMed, Google Scholar, Cochrane Library, and EMBASE databases. Randomized controlled trials involving patients with ACL injuries or ACL reconstruction were included. Twenty studies were included. Fifteen evaluated the effects of exercise, showing significant improvement. Seven studies examined electrotherapy, with neuromuscular electrical stimulation and high-frequency therapy combined with exercise showing improvements in muscle strength, pain, and joint range of motion. Nine studies explored interventions like motor imagery, cryotherapy, taping, and vibration. When performed before exercise, motor imagery and cryotherapy improved cortical activity and muscle recovery. Kinesio taping reduced edema and pain better than exercise alone. Vibration showed inconsistent results across three studies. Methodological quality varied between 5 and 8 on the PEDro scale, with moderate-to-low risk of bias. Structured exercise should be the first-line intervention, but combining it with other therapies enhances rehabilitation. The study protocol was registered in the PROSPERO database (CRD42023425510).