Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals

The physiological benefits of applying blood flow restriction (BFR) in isolation or in the presence of physical exercise have been widely documented in the scientific literature. Most investigations carried out under controlled laboratory conditions have found the technique to be safe. However, few...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Medicine (Baltimore) 2021-05, Vol.100 (18), p.e25794-e25794
Hauptverfasser: de Queiros, Victor Sabino, Dantas, Matheus, Neto, Gabriel Rodrigues, da Silva, Luiz Felipe, Assis, Marina Gonçalves, Almeida-Neto, Paulo Francisco, Dantas, Paulo Moreira Silva, Cabral, Breno Guilherme de Araújo Tinôco
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page e25794
container_issue 18
container_start_page e25794
container_title Medicine (Baltimore)
container_volume 100
creator de Queiros, Victor Sabino
Dantas, Matheus
Neto, Gabriel Rodrigues
da Silva, Luiz Felipe
Assis, Marina Gonçalves
Almeida-Neto, Paulo Francisco
Dantas, Paulo Moreira Silva
Cabral, Breno Guilherme de Araújo Tinôco
description The physiological benefits of applying blood flow restriction (BFR) in isolation or in the presence of physical exercise have been widely documented in the scientific literature. Most investigations carried out under controlled laboratory conditions have found the technique to be safe. However, few studies have analyzed the use of the technique in clinical settings.To analyze how the BFR technique has been applied by professionals working in the clinical area and the prevalence of side effects (SEs) resulting from the use of this technique.This is a cross-sectional study. A total of 136 Brazilian professionals who perform some function related to physical rehabilitation, sports science, or physical conditioning participated in this study. Participants answered a self-administered online questionnaire consisting of 21 questions related to the professional profile and methodological aspects and SEs of the BFR technique.Professionals reported applying the BFR technique on individuals from different age groups from youth (≤18 years; 3.5%) to older adults (60-80 years; 30.7%), but mainly on people within the age group of 20 to 29 years (74.6%). A total of 99.1% of the professionals coupled the BFR technique with resistance exercise. Their main goals were muscle hypertrophy and physical rehabilitation. The majority (60.9%) of interviewees reported using BFR in durations of less than 5 minutes and the pressure used was mainly determined through the values of brachial blood pressure and arterial occlusion. Moreover, 92% of professionals declared observing at least 1 SE resulting from the BFR technique. Most professionals observed tingling (71.2%) and delayed onset of muscle soreness (55.8%). Rhabdomyolysis, fainting, and subcutaneous hemorrhaging were reported less frequently (1.9%, 3.8%, and 4.8%, respectively).Our findings indicate that the prescription of blood flow restriction technique results in minimal serious side effects when it is done in a proper clinical environment and follows the proposed recommendations found in relevant scientific literature.
doi_str_mv 10.1097/MD.0000000000025794
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8104249</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2522618433</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3554-f0502c495aa01b7ddf0839b2195de208ec5c2920ba1ad83d54e9aec32180e49b3</originalsourceid><addsrcrecordid>eNpdkU1v1DAQhi0EokvbX4CEfOSS4s8k5oC0asuH1KoXOFuOM2YN3jjYSVf77_FmS4H6MtY77zxjzyD0mpILSlTz7vbqgvw9TDZKPEMrKnldSVWL52h1UKtGNeIEvcr5ByGUN0y8RCecK1kQ9Qrt1-MYvDWTjwM2Q4-z7wGDc2CnjKPDXYixxy7EHU6Qp-TtYp3Abgb_a4b3eI1tijlXGZaUCbjI-XAdjE-A85zuYX9gjSk6yHkx5TP0wpUA5w_xFH37eP318nN1c_fpy-X6prJcSlE5IgmzQkljCO2avnek5apjVMkeGGnBSssUI52hpm95LwUoA5Yz2hIQquOn6MORO87dFnoLw5RM0GPyW5P2Ohqv_88MfqO_x3vdUiKYUAXw9gGQ4vIzvfXZQghmgDhnzSRjNW0F58XKj9ZlIgncYxtK9GFp-vZKP11aqXrz7wsfa_5sqRjE0bCLYYKUf4Z5B0lvwIRps_AKh1WMMFqm1ZCqKLXgvwH67KWQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2522618433</pqid></control><display><type>article</type><title>Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Wolters Kluwer Open Health</source><source>IngentaConnect Free/Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>de Queiros, Victor Sabino ; Dantas, Matheus ; Neto, Gabriel Rodrigues ; da Silva, Luiz Felipe ; Assis, Marina Gonçalves ; Almeida-Neto, Paulo Francisco ; Dantas, Paulo Moreira Silva ; Cabral, Breno Guilherme de Araújo Tinôco</creator><creatorcontrib>de Queiros, Victor Sabino ; Dantas, Matheus ; Neto, Gabriel Rodrigues ; da Silva, Luiz Felipe ; Assis, Marina Gonçalves ; Almeida-Neto, Paulo Francisco ; Dantas, Paulo Moreira Silva ; Cabral, Breno Guilherme de Araújo Tinôco</creatorcontrib><description>The physiological benefits of applying blood flow restriction (BFR) in isolation or in the presence of physical exercise have been widely documented in the scientific literature. Most investigations carried out under controlled laboratory conditions have found the technique to be safe. However, few studies have analyzed the use of the technique in clinical settings.To analyze how the BFR technique has been applied by professionals working in the clinical area and the prevalence of side effects (SEs) resulting from the use of this technique.This is a cross-sectional study. A total of 136 Brazilian professionals who perform some function related to physical rehabilitation, sports science, or physical conditioning participated in this study. Participants answered a self-administered online questionnaire consisting of 21 questions related to the professional profile and methodological aspects and SEs of the BFR technique.Professionals reported applying the BFR technique on individuals from different age groups from youth (≤18 years; 3.5%) to older adults (60-80 years; 30.7%), but mainly on people within the age group of 20 to 29 years (74.6%). A total of 99.1% of the professionals coupled the BFR technique with resistance exercise. Their main goals were muscle hypertrophy and physical rehabilitation. The majority (60.9%) of interviewees reported using BFR in durations of less than 5 minutes and the pressure used was mainly determined through the values of brachial blood pressure and arterial occlusion. Moreover, 92% of professionals declared observing at least 1 SE resulting from the BFR technique. Most professionals observed tingling (71.2%) and delayed onset of muscle soreness (55.8%). Rhabdomyolysis, fainting, and subcutaneous hemorrhaging were reported less frequently (1.9%, 3.8%, and 4.8%, respectively).Our findings indicate that the prescription of blood flow restriction technique results in minimal serious side effects when it is done in a proper clinical environment and follows the proposed recommendations found in relevant scientific literature.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000025794</identifier><identifier>PMID: 33950976</identifier><language>eng</language><publisher>United States: Lippincott Williams &amp; Wilkins</publisher><subject>Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Brazil - epidemiology ; Cross-Sectional Studies ; Female ; Health Personnel - statistics &amp; numerical data ; Hematoma - epidemiology ; Hematoma - etiology ; Humans ; Hypertrophy - physiopathology ; Hypertrophy - therapy ; Male ; Middle Aged ; Muscle, Skeletal - blood supply ; Muscle, Skeletal - pathology ; Observational Study ; Practice Patterns, Physicians' - statistics &amp; numerical data ; Pressure ; Regional Blood Flow - physiology ; Resistance Training - adverse effects ; Resistance Training - methods ; Resistance Training - statistics &amp; numerical data ; Rhabdomyolysis - epidemiology ; Rhabdomyolysis - etiology ; Surveys and Questionnaires - statistics &amp; numerical data ; Syncope - epidemiology ; Syncope - etiology ; Time Factors ; Young Adult</subject><ispartof>Medicine (Baltimore), 2021-05, Vol.100 (18), p.e25794-e25794</ispartof><rights>Lippincott Williams &amp; Wilkins</rights><rights>Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3554-f0502c495aa01b7ddf0839b2195de208ec5c2920ba1ad83d54e9aec32180e49b3</cites><orcidid>0000-0003-4117-0295</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104249/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104249/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33950976$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Queiros, Victor Sabino</creatorcontrib><creatorcontrib>Dantas, Matheus</creatorcontrib><creatorcontrib>Neto, Gabriel Rodrigues</creatorcontrib><creatorcontrib>da Silva, Luiz Felipe</creatorcontrib><creatorcontrib>Assis, Marina Gonçalves</creatorcontrib><creatorcontrib>Almeida-Neto, Paulo Francisco</creatorcontrib><creatorcontrib>Dantas, Paulo Moreira Silva</creatorcontrib><creatorcontrib>Cabral, Breno Guilherme de Araújo Tinôco</creatorcontrib><title>Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>The physiological benefits of applying blood flow restriction (BFR) in isolation or in the presence of physical exercise have been widely documented in the scientific literature. Most investigations carried out under controlled laboratory conditions have found the technique to be safe. However, few studies have analyzed the use of the technique in clinical settings.To analyze how the BFR technique has been applied by professionals working in the clinical area and the prevalence of side effects (SEs) resulting from the use of this technique.This is a cross-sectional study. A total of 136 Brazilian professionals who perform some function related to physical rehabilitation, sports science, or physical conditioning participated in this study. Participants answered a self-administered online questionnaire consisting of 21 questions related to the professional profile and methodological aspects and SEs of the BFR technique.Professionals reported applying the BFR technique on individuals from different age groups from youth (≤18 years; 3.5%) to older adults (60-80 years; 30.7%), but mainly on people within the age group of 20 to 29 years (74.6%). A total of 99.1% of the professionals coupled the BFR technique with resistance exercise. Their main goals were muscle hypertrophy and physical rehabilitation. The majority (60.9%) of interviewees reported using BFR in durations of less than 5 minutes and the pressure used was mainly determined through the values of brachial blood pressure and arterial occlusion. Moreover, 92% of professionals declared observing at least 1 SE resulting from the BFR technique. Most professionals observed tingling (71.2%) and delayed onset of muscle soreness (55.8%). Rhabdomyolysis, fainting, and subcutaneous hemorrhaging were reported less frequently (1.9%, 3.8%, and 4.8%, respectively).Our findings indicate that the prescription of blood flow restriction technique results in minimal serious side effects when it is done in a proper clinical environment and follows the proposed recommendations found in relevant scientific literature.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brazil - epidemiology</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Health Personnel - statistics &amp; numerical data</subject><subject>Hematoma - epidemiology</subject><subject>Hematoma - etiology</subject><subject>Humans</subject><subject>Hypertrophy - physiopathology</subject><subject>Hypertrophy - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Muscle, Skeletal - blood supply</subject><subject>Muscle, Skeletal - pathology</subject><subject>Observational Study</subject><subject>Practice Patterns, Physicians' - statistics &amp; numerical data</subject><subject>Pressure</subject><subject>Regional Blood Flow - physiology</subject><subject>Resistance Training - adverse effects</subject><subject>Resistance Training - methods</subject><subject>Resistance Training - statistics &amp; numerical data</subject><subject>Rhabdomyolysis - epidemiology</subject><subject>Rhabdomyolysis - etiology</subject><subject>Surveys and Questionnaires - statistics &amp; numerical data</subject><subject>Syncope - epidemiology</subject><subject>Syncope - etiology</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1v1DAQhi0EokvbX4CEfOSS4s8k5oC0asuH1KoXOFuOM2YN3jjYSVf77_FmS4H6MtY77zxjzyD0mpILSlTz7vbqgvw9TDZKPEMrKnldSVWL52h1UKtGNeIEvcr5ByGUN0y8RCecK1kQ9Qrt1-MYvDWTjwM2Q4-z7wGDc2CnjKPDXYixxy7EHU6Qp-TtYp3Abgb_a4b3eI1tijlXGZaUCbjI-XAdjE-A85zuYX9gjSk6yHkx5TP0wpUA5w_xFH37eP318nN1c_fpy-X6prJcSlE5IgmzQkljCO2avnek5apjVMkeGGnBSssUI52hpm95LwUoA5Yz2hIQquOn6MORO87dFnoLw5RM0GPyW5P2Ohqv_88MfqO_x3vdUiKYUAXw9gGQ4vIzvfXZQghmgDhnzSRjNW0F58XKj9ZlIgncYxtK9GFp-vZKP11aqXrz7wsfa_5sqRjE0bCLYYKUf4Z5B0lvwIRps_AKh1WMMFqm1ZCqKLXgvwH67KWQ</recordid><startdate>20210507</startdate><enddate>20210507</enddate><creator>de Queiros, Victor Sabino</creator><creator>Dantas, Matheus</creator><creator>Neto, Gabriel Rodrigues</creator><creator>da Silva, Luiz Felipe</creator><creator>Assis, Marina Gonçalves</creator><creator>Almeida-Neto, Paulo Francisco</creator><creator>Dantas, Paulo Moreira Silva</creator><creator>Cabral, Breno Guilherme de Araújo Tinôco</creator><general>Lippincott Williams &amp; Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4117-0295</orcidid></search><sort><creationdate>20210507</creationdate><title>Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals</title><author>de Queiros, Victor Sabino ; Dantas, Matheus ; Neto, Gabriel Rodrigues ; da Silva, Luiz Felipe ; Assis, Marina Gonçalves ; Almeida-Neto, Paulo Francisco ; Dantas, Paulo Moreira Silva ; Cabral, Breno Guilherme de Araújo Tinôco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3554-f0502c495aa01b7ddf0839b2195de208ec5c2920ba1ad83d54e9aec32180e49b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brazil - epidemiology</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Health Personnel - statistics &amp; numerical data</topic><topic>Hematoma - epidemiology</topic><topic>Hematoma - etiology</topic><topic>Humans</topic><topic>Hypertrophy - physiopathology</topic><topic>Hypertrophy - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Muscle, Skeletal - blood supply</topic><topic>Muscle, Skeletal - pathology</topic><topic>Observational Study</topic><topic>Practice Patterns, Physicians' - statistics &amp; numerical data</topic><topic>Pressure</topic><topic>Regional Blood Flow - physiology</topic><topic>Resistance Training - adverse effects</topic><topic>Resistance Training - methods</topic><topic>Resistance Training - statistics &amp; numerical data</topic><topic>Rhabdomyolysis - epidemiology</topic><topic>Rhabdomyolysis - etiology</topic><topic>Surveys and Questionnaires - statistics &amp; numerical data</topic><topic>Syncope - epidemiology</topic><topic>Syncope - etiology</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Queiros, Victor Sabino</creatorcontrib><creatorcontrib>Dantas, Matheus</creatorcontrib><creatorcontrib>Neto, Gabriel Rodrigues</creatorcontrib><creatorcontrib>da Silva, Luiz Felipe</creatorcontrib><creatorcontrib>Assis, Marina Gonçalves</creatorcontrib><creatorcontrib>Almeida-Neto, Paulo Francisco</creatorcontrib><creatorcontrib>Dantas, Paulo Moreira Silva</creatorcontrib><creatorcontrib>Cabral, Breno Guilherme de Araújo Tinôco</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Queiros, Victor Sabino</au><au>Dantas, Matheus</au><au>Neto, Gabriel Rodrigues</au><au>da Silva, Luiz Felipe</au><au>Assis, Marina Gonçalves</au><au>Almeida-Neto, Paulo Francisco</au><au>Dantas, Paulo Moreira Silva</au><au>Cabral, Breno Guilherme de Araújo Tinôco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2021-05-07</date><risdate>2021</risdate><volume>100</volume><issue>18</issue><spage>e25794</spage><epage>e25794</epage><pages>e25794-e25794</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>The physiological benefits of applying blood flow restriction (BFR) in isolation or in the presence of physical exercise have been widely documented in the scientific literature. Most investigations carried out under controlled laboratory conditions have found the technique to be safe. However, few studies have analyzed the use of the technique in clinical settings.To analyze how the BFR technique has been applied by professionals working in the clinical area and the prevalence of side effects (SEs) resulting from the use of this technique.This is a cross-sectional study. A total of 136 Brazilian professionals who perform some function related to physical rehabilitation, sports science, or physical conditioning participated in this study. Participants answered a self-administered online questionnaire consisting of 21 questions related to the professional profile and methodological aspects and SEs of the BFR technique.Professionals reported applying the BFR technique on individuals from different age groups from youth (≤18 years; 3.5%) to older adults (60-80 years; 30.7%), but mainly on people within the age group of 20 to 29 years (74.6%). A total of 99.1% of the professionals coupled the BFR technique with resistance exercise. Their main goals were muscle hypertrophy and physical rehabilitation. The majority (60.9%) of interviewees reported using BFR in durations of less than 5 minutes and the pressure used was mainly determined through the values of brachial blood pressure and arterial occlusion. Moreover, 92% of professionals declared observing at least 1 SE resulting from the BFR technique. Most professionals observed tingling (71.2%) and delayed onset of muscle soreness (55.8%). Rhabdomyolysis, fainting, and subcutaneous hemorrhaging were reported less frequently (1.9%, 3.8%, and 4.8%, respectively).Our findings indicate that the prescription of blood flow restriction technique results in minimal serious side effects when it is done in a proper clinical environment and follows the proposed recommendations found in relevant scientific literature.</abstract><cop>United States</cop><pub>Lippincott Williams &amp; Wilkins</pub><pmid>33950976</pmid><doi>10.1097/MD.0000000000025794</doi><orcidid>https://orcid.org/0000-0003-4117-0295</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0025-7974
ispartof Medicine (Baltimore), 2021-05, Vol.100 (18), p.e25794-e25794
issn 0025-7974
1536-5964
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8104249
source MEDLINE; DOAJ Directory of Open Access Journals; Wolters Kluwer Open Health; IngentaConnect Free/Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection
subjects Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Brazil - epidemiology
Cross-Sectional Studies
Female
Health Personnel - statistics & numerical data
Hematoma - epidemiology
Hematoma - etiology
Humans
Hypertrophy - physiopathology
Hypertrophy - therapy
Male
Middle Aged
Muscle, Skeletal - blood supply
Muscle, Skeletal - pathology
Observational Study
Practice Patterns, Physicians' - statistics & numerical data
Pressure
Regional Blood Flow - physiology
Resistance Training - adverse effects
Resistance Training - methods
Resistance Training - statistics & numerical data
Rhabdomyolysis - epidemiology
Rhabdomyolysis - etiology
Surveys and Questionnaires - statistics & numerical data
Syncope - epidemiology
Syncope - etiology
Time Factors
Young Adult
title Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T08%3A28%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Application%20and%20side%20effects%20of%20blood%20flow%20restriction%20technique:%20A%20cross-sectional%20questionnaire%20survey%20of%20professionals&rft.jtitle=Medicine%20(Baltimore)&rft.au=de%20Queiros,%20Victor%20Sabino&rft.date=2021-05-07&rft.volume=100&rft.issue=18&rft.spage=e25794&rft.epage=e25794&rft.pages=e25794-e25794&rft.issn=0025-7974&rft.eissn=1536-5964&rft_id=info:doi/10.1097/MD.0000000000025794&rft_dat=%3Cproquest_pubme%3E2522618433%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2522618433&rft_id=info:pmid/33950976&rfr_iscdi=true