Introduction: Creatine is important in providing energy for the resynthesis of adenosine triphosphate (ATP) and in the deposition of intracellular energy, being present mainly in muscle fibers and in the brain. Supplementation with exogenous creatine can be used in neurodegenerative disorders that are related to bioenergetic deficits in the etiology and progression of the disease. Objective: Highlight the neuroprotective mechanisms of creatine supplementation in neurodegenerative diseases. Methods: In April 2021, a search was carried out on MEDLINE, with the descriptors: “Creatine” and “Neuroprotection”; and its variations, obtained in MeSH. Studies published in the last five years were included. Results: Of the 122 articles found, four were used in this work. They concluded that creatine supplementation contributes to brain bioenergetics by increasing phosphocreatine deposits, restoring mitochondrial functions and decreasing susceptibility to apoptosis. In addition, creatine intake shortly after the diagnosis of Huntington’s and Parkinson’s Diseases can be used as a complementary therapy, because improve performance in tasks of memory and intelligence. Finally, it buffers cellular concentrations of ATP, being a possible therapeutic strategy to delay or stop neurodegeneration diseases. Conclusion: Creatine promote important neuroprotective effect, but further studies on the subject are needed.

Introduction: Stroke was responsible for 139.4 million cases of global disability in 2019, many of which require rehabilitation. Telerehabilitation has emerged as a promising remote therapy aimed at improving the deficits resulting from stroke. Objective: To compare the benefits of telerehabilitation with the usual methods of rehabilitation in post-stroke patients. Methodology: In April 2021, a literature review including systematic reviews of studies in humans, available in full and published in the last 5 years was executed on MedLine using the descriptors “stroke”, “telerehabilitation” and their MeSH variations. Results: The first selected article revealed that post-stroke telerehabilitation resulted in less expenses and was associated with comparable improvements to the standard treatment group in the recovery of motor deficits, cortical dysfunction and depression. The second review concluded that telerehabilitation was equal to or greater than usual rehabilitation for improvements in daily living and psychological status and restoration of quality of life and motor performance. The third study found that telerehabilitation achieved similar results to face-to-face therapy and usual care on improving daily life. The fourth article reinforced the benefits of telerehabilitation on several outcomes, although current evidence is limited. Conclusion: Telerehabilitation can be an adequate alternative to the care of post-stroke patients, however, further studies are needed to establish the benefits it provides.

Introduction: Sleep disorders are one of the main complaints of women in transition from menopause, with a prevalence between 40% and 56%. However, regardless of the etiology, it is essential to assess the symptoms of insomnia in the context of menopause, as well as physical and mental health. Objective: To investigate the relationship between the transition from menopause to the causes of insomnia. Methodology: In April 2021, a literature review was carried out on MedLine using the descriptors “insomnia”, “menopause” and their respective synonyms, published in the last 5 years and available in full. Results: 157 articles were found, 4 of which were used in making this work. The precise mechanism of vasomotor symptoms is little known, but the hypothesis is that it results from a disturbance of the temperature regulating system in the hypothalamus, triggered by a decline in estrogen. Longitudinal data show that women with moderate to severe hot flashes are almost three times more likely to report frequent nighttime awakenings compared to women without hot flashes (HF). Conclusion: Therefore, HF is an important aspect of insomnia in the transition from menopause and is strongly associated with reports of interrupted sleep.

INTRODUÇÃO: O espectro da infecção do SARS-CoV-2 é amplo e predomina o acometimento respiratório. Estudos recentes, no entanto, têm demonstrado cada vez mais o acometimento extra respiratório, incluindo alterações neurológicas diversas. A presente revisão discorre sobre as principais manifestações neurológicas decorrentes da infecção por SARS-CoV-2 e suas consequências para os infectados. METODOLOGIA: Trata-se de uma revisão integrativa da literatura. As bases de dados utilizadas foram MEDLINE/PubMed, Scielo e LILACS. Os seguintes descritores foram utilizados: “Neurological manifestations”, “COVID-19” e “Neurological symptoms”. RESULTADOS: No mundo foram reportadas diversas manifestações neurológicas como as centrais (cefaleia, tontura, convulsões, meningite/encefalite, déficit cognitivo, AVC), periféricas  (analgesia, anosmia) e musculoesqueléticas. As mais frequentemente observadas foram tontura e cefaléia. DISCUSSÃO: O mecanismo de neuro invasão ainda não está totalmente esclarecido, mas as evidências mostram que se deve haver lesão direta, imunomediada ou decorrente de hipóxia, além de eventos secundários relacionados a distúrbios sistêmicos, como sepse, hiperpirexia  hipercoagulabilidade etc. A agressividade dos sintomas pode variar desde as mais leves até predispor manifestações graves como doenças cerebrovasculares agudas. CONCLUSÃO: As  manifestações neurológicas apresentaram-se sob diferentes formas e ainda são necessários mais  ensaios clínicos para analisar a fisiopatologia do SARS-CoV-2 no sistema nervoso, assim como suas consequências tardias.

Background:Variations in genes codifying target structures in the nociceptive pathway can result in pain attenuation or increase.Objective:Investigate the genetic polymorphism influence in the individual pain threshold. Methods: Search on PubMed with the terms “genetic”, “pain” and its synonyms published in the last 10 years. Results:The subjective and individual mechanisms of pain aren’t completely understood, but genetic susceptibility is one of the hypothesis to explain these differences.The KCNK18 gene influences the synaptic transmission by producing potassium channel protein that equalizes resting membrane potential, calcineurin activated and inhibited by arachidonic acid. This gene was found more frequently in migraine individuals. The COMT gene increase the sensibility to pain by met-enkephalins reduction and/or catecholamine elevation. Its activity’s reduced in fibromyalgia patients. However, the OPRM1 gene, an opioid receptor, was found in individuals with a higher pain threshold.Furthermore, studies with human cell culture shows the analgesic role of the gene A118G, by its greater binding affinity for β-endorphin.It is associated with more effective endorphinergic endogenous pain inhibition. Conclusion:Researches indicates a striking participation of genetic polymorphism in pain mechanisms. The knowledge about genetic variables on pain perception can contribute to the development of individualized analgesic protocols and therapeutic strategies, accordantly to the patient genetic profile. This evolution becomes fundamental in a population that tend to the indiscriminate use of analgesics.