Introduction: The effects of aerobic exercise on the immune system are not yet fully defined in the scientific literature. This fact demonstrates the need to investigate its influence on existing immunological markers by classifying and quantifying their acute and chronic effects. Objective: To investigate the effects of acute and chronic aerobic exercise on inflammatory markers of healthy adults. Methods: This study is a systematic review according to PRISMA recommendations. The following databases were searched: MEDLINE (via PubMed), Science Direct, Scopus, Web of Science, SciELO, Bireme and Cochrane Library, and article references. The last search was performed in March 2019. We included randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) investigating the acute and chronic effects of aerobic exercise on immune markers in healthy male and female adults aged 20 to 45 years, without restrictions in language or year of publication. Two authors independently analyzed the studies by reading the titles, abstracts, and full texts. Risk of Study bias was analyzed using Cochrane's Risk of Bias Tool. Outcomes: We included 15 studies in this systematic review, 13 of which were acute intervention and 2 were chronic, with 296 participants, 196 men and 100 women all being healthy individuals. It was observed that the acute intervention promotes changes in most immunological markers, while the chronic intervention interferes with a smaller proportion, this being in lymphocyte subpopulations. In the evaluation of quality, it was found that most studies did not present a high risk of bias in the evaluated aspects, but an unclear related risk of bias was observed, requiring a more careful analysis. Conclusion: Thus, it can be concluded that the evidence indicates that acute and chronic interventions may modify most immune markers, but aspects such as gender, contraceptive pill use in women, physical capacity of the investigated individuals, environment, and type and intensity of the exercises may interfere with these markers as well as the data analysis. Therefore, this review suggests that further research is needed to contribute to the confirmation and estimation of results.

Objective Development and internal validation of a clinical tool for assessment of the risk of adverse drug reactions (ADR) in hospitalized patients. Methodology Nested case-control study in an open cohort of all patients admitted to a general hospital. Cases of ADR were matched to two controls. Eighty four patient variables collected at the time of the ADR were analyzed by conditional logistic regression. Multivariate logistic regression with clustering of cases in a random sample of 2/3 of the cases and respective controls, with baseline odds-ratio corrected with an estimate of ADR incidence, was used to obtain regression coefficients for each risk factor and to develop a risk score. The clinical tool was validated in the remaining 1/3 observations. The study was approved by the institution’s research ethics committee. Results In the 8060 hospitalized patients, ADR occurred in 343 (5.31%), who were matched to 686 controls. Fourteen variables were identified as independent risk factors of ADR: female, past history of ADR, heart rate ≥72 bpm, systolic blood pressure≥148 mmHg, diastolic blood pressure <79 mmHg, diabetes mellitus, serum urea ≥ 67 mg/dL, serum sodium ≥141 mmol/L, serum potassium ≥4.9 mmol/L, main diagnosis of neoplasia, prescription of ≥3 ATC class B drugs, prescription of ATC class R drugs, prescription of intravenous drugs and ≥ 6 oral drugs. In the validation sample, the ADR risk tool based on those variables showed sensitivity 61%, specificity 73% and area under the ROC curve 0.73. Conclusion We report a clinical tool for ADR risk stratification in patients hospitalized in general wards based on 14 variables.

OBJECTIVES:Inflammatory molecules play a role in the development of atherosclerosis, which is the primary origin of cardiovascular disorders. However, to the best of our knowledge, no study has attempted to investigate the relationship between these circulating molecules and the prediction of cardiovascular risk. The present study aimed to investigate the relationships of vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin and matrix metalloproteinase 9 serum concentrations with the extent of coronary lesions.METHODS:Seventy-four individuals who were undergoing coronary angiography for the first time for diagnostic purposes were enrolled in this study. The extent of the coronary lesion was assessed using the Friesinger Index, and subjects were classified into four groups: no lesions, minor lesions, intermediate lesions and major lesions. Serum biochemical parameters and serum concentrations of vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin and matrix metalloproteinase 9 were analyzed.RESULTS:The vascular cell adhesion molecule-1 concentration was higher than 876 ng/mL in individuals with intermediate and major lesions (p<0.001 and p=0.020, respectively). Moreover, logistic regression analysis showed that these patients had an increased risk of having an intermediate lesion (p=0.007). Interestingly, all individuals with major lesions had vascular cell adhesion molecule-1 concentrations higher than 876 ng/mL. No association was found between the concentrations of the other proteins and the Friesinger Index.CONCLUSIONS:Serum vascular cell adhesion molecule-1 may be associated with the extent of coronary lesions. Moreover, it may represent an alternative to improve the cardiovascular risk classification in patients without acute coronary syndrome.

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Background: Polycystic ovary syndrome (PCOS) affects reproductive-aged women and is associated with increased prevalence of serious clinical problems including: reproductive implications, metabolic dysfunction, and cardiovascular risk. Physical activity offers several health benefits for women with PCOS. The aim of this systematic review was to synthesize evidence on the effect of different types of exercise on reproductive function and body composition for women with PCOS.Methods: This was a systematic review and meta-analysis of randomized controlled trials (RCTs) following recommended review methods. We searched 6 databases: Cumulative Index of Nursing and Allied Health Literature; Embase; MEDLINE (via Ovid); PubMed; Sport Discus; and Web of Science; and we developed search strategies using a combination of Medical Subject Headings terms and text words related to exercise interventions for women with PCOS. There was no restriction on language or publication year. The search was conducted on April 16, 2019 and updated on November 15, 2019. Two authors independently screened citations, determined risk of bias and quality of evidence with Grading of Recommendations Assessment, Development and Evaluation. We conducted meta-analyses following recommended guidelines, and report results using standardized mean difference (SMD).Results: Ten RCTs (n = 533) were included in this review. Studies tested the following interventions: aerobic, resistance, and combined (aerobic/resistance) training programs. Most studies were small (average 32, range 15-124 participants), and of relatively short duration (8-32 weeks). There was high heterogeneity for outcomes of reproductive function (menstrual cycle, ovulation, and fertility). We noted low certainty evidence for little to no effect of exercise on reproductive hormones and moderate certainty evidence that aerobic exercise reduced body mass index (BMI) in women with PCOS: BMI SMD À0.35, 95% confidence interval À0.56 to À0.14, P = .001. Conclusion:For women with PCOS, evidence is limited to discern the effect of exercise on major health outcomes (e.g., reproductive function). There is moderate certainty evidence that aerobic exercise alone is beneficial for reducing BMI in women with PCOS. Future studies should be conducted with longer duration, larger sample sizes, and should provide detailed information on menstrual cycle and fertility outcomes.PROSPERO Systematic review registration: 2017 CRD42017058869.

The aim of this descriptive study was to correlate the level of pain with the quality of life in 261 people living with HIV/AIDS. Mild pain/no pain was reported by 47.5% of subjects, 24.1% reported moderate pain, and 28.4% reported severe pain; pain levels were correlated with gender (p = 0.02), health status (p < 0.001), perception (p < 0.001), and stage of infection (p = 0.005). Being female represented a risk factor for moderate (p < 0.001) and intense pain (p = 0.004). Poor health represented a risk for moderate (p < 0.038) and intense pain (p = 0.005). Being young was a factor of protection for moderate pain (21-30 years, p = 0.046; 41-50 years, p = 0.023; and 51-60 years, p < 0.030). The low quality of life averages was identified and correlated with pain in all evaluated domains (p < 0.001). The risk factors for moderate and severe pain were a low level of independence (p = 0.004) and compromised social relations (p = 0.029), respectively. Psychological control behaved as a protection factor for moderate pain (p = 0.011), and bad physical domain proved to be a protection factor for severe pain (p = 0.007). The level of pain is a negative impact on the quality of life of people with HIV/AIDS.

The aim of this study was to synthesize the evidence on the effects of active video games (AVGs) on mental health, physical fitness and body composition of children and adolescents. A search was conducted in the following databases: PubMed; MEDLINE (by Ovid); SportDiscus, Cochrane library systematic reviews (CENTRAL) and EMBASE with no language restrictions during October 2020. Reviews on the use of AVGs were included in the study. We use the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) scale to analyze the methodological quality of the studies. Seventeen systematic reviews and meta-analyzes were included on the effects of AVGs with 30 to 4728 children and adolescents of both sexes with ages ranging from 6 to 19 years. In five studies, the population was overweight or obese. Regarding the quality, 12 studies were of moderate quality, two had high quality, two had low quality and one showed very low quality. The analyzed data indicate that the use of AVGs with a frequency of 1 to 3 times a week with durations of between 10 and 90 min per day shows positive effects on mental health and physical functioning. There was moderate quality evidence that AVGs can result in benefits for self-esteem, increased energy expenditure, physical activity and reduced body mass index in children and adolescents who used AVGs in the home environment. Further research is needed on this tool to help in the process of social isolation and consequently in promoting health and well-being.

The training improved the strength, the functionality and reduces the pain on the shoulder of the people with paraplegia.