Mobilization of critically ill patients admitted to intensive care units should be performed based on safety criteria. The aim of the present review was to establish which safety criteria are most often used to start early mobilization for patients under mechanical ventilation admitted to intensive care units. Articles were searched in the PubMed, PEDro, LILACS, Cochrane and CINAHL databases; randomized and quasi-randomized clinical trials, cohort studies, comparative studies with or without simultaneous controls, case series with 10 or more consecutive cases and descriptive studies were included. The same was performed regarding prospective, retrospective or cross-sectional studies where safety criteria to start early mobilization should be described in the Methods section. Two reviewers independently selected potentially eligible studies according to the established inclusion criteria, extracted data and assessed the studies' methodological quality. Narrative description was employed in data analysis to summarize the characteristics and results of the included studies; safety criteria were categorized as follows: cardiovascular, respiratory, neurological, orthopedic and other. A total of 37 articles were considered eligible. Cardiovascular safety criteria exhibited the largest number of variables. However, respiratory safety criteria exhibited higher concordance among studies. There was greater divergence among the authors regarding neurological criteria. There is a need to reinforce the recognition of the safety criteria used to start early mobilization for critically ill patients; the parameters and variables found might contribute to inclusion into service routines so as to start, make progress and guide clinical practice.

Introduction: Breast cancer has a high prevalence among women. It is known that breast cancer survivors can undergo a several alterations due to the treatment, including sexual dysfunction. Objective: This study aimed to determine the incidence of sexual dysfunction in women after breast cancer surgery, and assess the relationship between sexual dysfunctions and pelvic floor muscles (PFM) contraction, as well to verify if hormone therapy caused long-term occurrence of PFM weakness or sexual dysfunction. Methods: The sample was composed by 26 women with 48.4 ± 6.8 years which using hormone therapy treatment at least six months. Data on sexual dysfunction were collected through the Female Sexual Function Index- FSFI questionnaire and a section composed by demographic information. Furthermore, the PFM contraction was assessed using the PERFECT scale. Results: The results demonstrated a high rate of sexual dysfunction (64.3%) and a weak PFM contraction (2.31±1.3) among the women. In addition, a long-term hormone therapy had a negative association with PFM endurance and with the orgasm and satisfaction domains of the FSFI questionnaire. Conclusion: women using hormone therapy after breast cancer surgery had a high rate of sexual dysfunction and the long-term treatment of hormone treatment can be associated with a worsening of orgasm and sexual satisfaction in these women. Also, the use at long-term of hormone therapy had a negative association with the PFM endurance.

Cirrhosis causes systemic and metabolic changes that culminate in various complications, such as compromised pulmonary function, ascites, hepatic encephalopathy, weight loss, and muscle weakness with significant physical function limitations. Our aim is to evaluate the effects of training with neuromuscular electrical stimulation (NMES) on the muscular and functional capacity of patients with cirrhosis classified as Child-Pugh B and C. A total of 72 patients diagnosed with cirrhosis will be recruited and randomized to perform an NMES protocol for 50 minutes, 3 times a week, for 4 weeks. The evaluations will be performed at the beginning and after 12 sessions, and patients will be submitted to a pulmonary function test, an ultrasound evaluation of the rectus femoris, an evaluation of peripheral muscle strength, a submaximal exercise capacity test associated with an evaluation of peripheral tissue oxygenation, a quality of life evaluation, and orientation about monitoring daily physical activities. The evaluators and patients will be blinded to the allocation of the groups. Training Group will be treated with the following parameters: frequency of 50 Hz, pulse width of 400 μs, rise and fall times of 2 s, and on:off 1:1; Sham Group: 5 Hz, 100 μs, on:off 1:3. The data will be analyzed using the principles of the intention to treat. This study provides health professionals with information on the benefits of this intervention. In this way, we believe that the results of this study could stimulate the use of NMES as a way of rehabilitating patients with more severe cirrhosis, with the objective of improving these patients’ functional independence.