Stimulation of the P6 Acupuncture Point for Prophylaxis of Nausea and Vomiting in Pregnant Women Submitted to Cesarean Section: A Blinded Clinical Trial

In pregnant women subjected to spinal anesthesia for a Cesarean section, episodes of nausea and vomiting are common both during and following surgery. Acupuncture for the prophylaxis and treatment of these complications has been gaining in popularity due to its low cost, simplicity, absence of side effects and confirmed efficacy. This study investigated the efficacy of stimulating the P6 acupoint in conjunction with the use of dexamethasone as prophylaxis for nausea and vomiting in pregnant women submitted to spinal anesthesia for a Cesarean section. The patients (n = 100) were randomly distributed into two groups. In the first group (n = 50), a site located one centimeter laterally from P6 was stimulated. This is not a true acupuncture point (sham acupuncture). In the second group (n = 50), P6 was stimulated. In both groups, 4 mg of dexamethasone were administered intravenously. A questionnaire was used to obtain information on the occurrence of nausea and vomiting during surgery and in the first 12 hours postpartum. The chi-square test and Fisher’s exact test were used to assess differences between the groups. Age and physical status were similar in both groups. The incidence of nausea during surgery was 32% (n = 16) in the control group and 22% (n = 11) in the P6 group (p > 0.05). In the first 12 hours following surgery, nausea occurred in 16% of the women in the control group (n = 6) and in 4% in the P6 group (n = 4) (p = 0.045). The incidence of vomiting in the control group was 12% (n = 6) during surgery and 10% (n = 5) in the postoperative period compared to 8% (n = 4) and 4% (n = 2), respectively, in the P6 group (p > 0.05). Although these differences were not statistically significant with the exception of the incidence of nausea in the first 12 hours postpartum, a reduction occurred in the incidence of all the outcomes evaluated in the P6 group.

Contraceptive Continuation, Pregnancy and Abortion Rate Two Years after Post Abortion Counselling

Objectives: To estimate the contraceptive use rate, pregnancy and abortion rate two years after post abortion counselling. Methods: In this current paper we conducted a cross-sectional study from September to December 2011 among women who participated of original randomized trial. In this study 118 women who had been allocated in the group that received the personalized contraceptive counselling and 103 women who had been allocated in the group that received standard counselling service were contacted by phone. The analyzed variables were the use of contraceptive methods, reasons for not using them, satisfaction in used method, and occurrence of pregnancy and abortion. Results: The pregnancy rate was lower in the personalized counselling group (p = 0.022), whereas abortion (p = 0.543) and contraceptive use rate (p = 0.270) had no difference between groups. The overall contraceptive use rate was high in both groups and the injectable method use rate was higher in personalized counselling group (p?= 0.004). Conclusions: Two years after the intervention the pregnancy rate was lower in personalized counselling group. The contraceptive use rate had no difference between the groups, except for the injectable which the use rate was higher in the personalized counselling group. These results could be encouraging because the intervention improved the uptake of one of the long-acting methods of contraception.

Physical fitness level and the risk of severe COVID-19:A systematic review

To verify systematically the association between the status of physical fitness and the risk of severe Coronavirus disease 2019(COVID-19).This systematic review is in accordance with the Preferred Reporting Items for Systematic Review and Meta Analyses(PRISMA)statement and the eligibility criteria followed the Population,Intervention,Comparison,Outcomes and Study(PICOS)recommendation.PubMed,Embase,SciELO and Cochrane electronic databases were searched.All studies that explored the relationship between the pattern of physical fitness and COVID-19 adverse outcomes(hospitalization,intensive care unit admission,intubation,or mortality),were selected.The quality of the studies was assessed by the specific scale of the Newcastle-Ottawa Scale.A total of seven observational studies were identified in this systematic review;13468 patients were included in one case-control study,two cohort studies,and four cross-sectional studies.All studies reported an inverse association between high physical fitness and severe COVID-19(hospitalization,intensive care admission,or mortality).Only some studies reported comorbidities,especially obesity and cardiovascular disorders,but the results remained unchanged after controlling for comorbidities.The quality of the seven studies included was moderate according to the Newcastle-Ottawa Quality Assessment Scale.The methodological heterogeneity of the studies included did not allow a meta-analysis of the findings.In conclusion,higher physical fitness levels were associated with lower risk of hospitalization,intensive care admissions,and mortality rates among patients with COVID-19.