Browsing by Author "Ferreira, Maria"
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- Umbrella review on the possible use of Ivermectin in the treatment of COVID-19Publication . Reis, Mariana; Ferreira, Maria; Pedro, Sílvia; Ferraz Oliveira, Rita; Moreira, FernandoThe urgency to find treatment and prophylactic measures for COVID-19, motivated the use of drugs usually indicated in other pathologies, such as Ivermectin (commonly used as antiparasitic). The main objective of this study was to evaluate the potential use of ivermectin in the treatment of COVID-19, and to identify its mechanism of action and dosing regimen regarding this particular indication. To perform this umbrella review, a bibliographic search was carried out in the Pubmed, LILACS, SciELO and Wiley Online Library databases using the terms "Ivermectin AND COVID-19" and "Ivermectin AND SARS-CoV-2". Only articles published between January 2020 and March 2022 written in English or Portuguese and configured in review or meta-analysis formats, were considered. The selection of the articles returned in the initial search (n=1609), resulted from the analysis of the titles and abstracts, and was performed after elimination of duplicates. Studies addressing the pharmacology, pharmacokinetics and/or pharmacotherapy of ivermectin in the treatment of COVID-19 were considered eligible. Twenty-six articles that met the inclusion criteria were selected. In patients with COVID-19, Ivermectin presented as main clinical result a decrease in mortality. Although there are several proposed mechanisms, the antiviral mechanism against SARS-COV-2 may be multimodal. Some of the studies demonstrated that the IC50 value of Ivermectin required to inhibit the replication process of the SARS-CoV-2 virus is much higher than the maximum plasma concentration reached after administration of approved doses. However, administration via inhalation or with nanotechnology may be promising, according to some reviews, as it would increase the concentration of ivermectin at the site of action. Preliminary studies using ivermectin in COVID-19 patients reported nausea, vomiting and increased circulating liver enzymes among the main side effects. The small samples used in the various studies and the nonspecification of the administered dose are the main limitations of humanstudies. Most reviews suggest that further studies are needed to prove that tolerable doses of ivermectin may be effective in the treatment of SARS-CoV-2. It should also be noted that the potential benefit associated with treatment with ivermectin does not outweigh or decrease the relevance of vaccination.
- O uso do smartphone na avaliação do risco de queda associado ao envelhecimentoPublication . Ferreira, Maria; Melo, Cristina ArgelIntrodução: O declínio do equilíbrio, da força dos membros inferiores e o medo de cair são fatores de risco de queda associados ao envelhecimento e a sua avaliação pode ser realizada pelo teste One Leg Standing (OLS), Sit to Stand (STS) e pela Falls Eficacy Scale (FES), respetivamente. As aplicações para smartphone constituem uma alternativa para a avaliação dos fatores de risco de queda no envelhecimento. Objetivo: Analisar a capacidade de uma aplicação para smartphone na avaliação dos testes STS, OLS e FES. Metodologia: Realizou-se um estudo analítico numa amostra de 27 voluntários com idade ≥ 60 anos. Realizaram-se os testes STS, OLS e a FES (versão iconográfica, apresentada no smartphone). Os dados foram recolhidos simultaneamente por um smartphone e pelo Qualisys Motion Capture Systems associado a uma plataforma de forças. Foi utilizado o r de Pearson ou Spearman para analisar as possíveis correlações. Resultados: No STS obteve-se uma correlação muito forte (rp=0.97) no número de repetições de ciclos Sit Stand Sit (SLS) e forte na duração média do SLS (rp=0.85) e das subfases Sit to Stand (rp=0.69) e Stand to Sit (rp=0.778), com p<0.001. As medidas de inclinação do tronco apresentaram correlações fortes, com exceção do ângulo inicial (p≥0.05). No OLS, verificou-se uma correlação moderada entre o deslocamento do centro de pressão peak to peak médio-lateral (rs=0.45; p=0.017) e antero-posterior (rs=0.39; p=0.046), root mean square médio-lateral (rs=0.39; p=0.046) e antero-posterior (rs=0.46; p=0.017) e área do estatocinesiograma (rs=0.45; p=0.018). Na FES obteve-se uma correlação moderada em três categorias: ‘tomar banho/duche’ (rs=0.49; p=0.010), ‘deitar/levantar da cama (rs=0.43; p=0.024) e ‘chegar aos armários’ (rs=0.38; p=0.050). Conclusão: A aplicação para smartphone parece avaliar corretamente os ciclos e a variação da inclinação do tronco no STS, porém parece necessitar de ser reajustada na FES e na velocidade do deslocamento do centro de pressão, no OLS.