Cardiorespiratory abnormalities in ICU survivors of COVID-19 with postacute sequelae of SARS-CoV-2 infection are unrelated to invasive mechanical ventilation.

Postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) often leads to exertional intolerance and reduced exercise capacity, particularly in individuals previously admitted to an intensive care unit (ICU). However, the impact of invasive mechanical ventilation (IMV) on PASC-associated cardiorespiratory abnormalities during exercise remains poorly understood. This single-center, cross-sectional study aimed to gather knowledge on this topic. Fifty-two patients with PASC recruited ∼6 mo after ICU discharge were clustered based on their need for IMV (PASC + IMV, n = 27) or noninvasive support therapy (PASC + NIS, n = 25). Patients underwent pulmonary function and cardiopulmonary exercise testing (CPX) and were compared with a reference group (CONTROL, n = 19) comprising individuals of both sexes with similar age, comorbidities, and physical activity levels but without a history of COVID-19 illness. Individuals with PASC, irrespective of support therapy, presented with higher rates of cardiorespiratory abnormalities than CONTROL, especially dysfunctional breathing patterns, dynamic hyperinflation, reduced oxygen uptake and oxygen pulse, and blunted heart rate recovery (all P < 0.05). Only the rate of abnormal oxygen pulse was greater among PASC + IMV group than PASC + NIS group (P = 0.05). Mean estimates for all CPX variables were comparable between PASC + IMV and PASC + NIS groups (all P > 0.05). These findings indicate significant involvement of both central and peripheral factors, leading to exertional intolerance in individuals with PASC previously admitted to the ICU, regardless of their need for IMV.NEW & NOTEWORTHY We found cardiorespiratory abnormalities in ICU survivors of severe-to-critical COVID-19 with PASC to be independent of IMV need. Overall, both group of patients experienced dysfunctional breathing patterns, dynamic hyperinflation, lower oxygen uptake and oxygen pulse, and blunted heart rate responses to CPX. PASC seems to impact exertional tolerance and exercise capacity due to ventilatory inefficiency, impaired aerobic metabolism, and potential systolic and autonomic dysfunction, all of these irrespective of support therapy during ICU stay.

Association between ultra-processed food and flavonoid intakes in a nationally representative sample of the US population.

Consumption of ultra-processed food (UPF) has been associated with several chronic diseases and poor diet quality. It is reasonable to speculate that the consumption of UPF negatively associates with flavonoid dietary intake; however, this assumption has not been previously examined. The present study aims to assess association between the dietary contribution of UPF and flavonoid intake in the US population aged 0 years and above. We performed a cross-sectional analysis of dietary data collected by 24-h recalls from 7640 participants participating in the National Health and Nutrition Examination Survey 2017-2018. Foods were classified according to the Nova classification system. The updated US Department of Agriculture (USDA) Database for the Flavonoid Content of Selected Foods (Release 3.3) database was used to estimate total and six classes of flavonoid intakes. Flavonoid intakes were compared across quintiles of dietary contribution of UPF (% of total energy intake) using linear regression models. The total and five out of six class flavonoid intakes decreased between 50 and 70 % across extreme quintiles of the dietary contribution of UPF (Pfor linear trend < 0·001); only isoflavones increased by over 260 %. Our findings suggest that consumption of UPF is associated with lower total and five of six class flavonoid intakes and with higher isoflavone intakes, supporting previous evidence of the negative impact of UPF consumption on the overall quality of the diet and health outcomes.

Sleep quality is a predictor of muscle mass, strength, quality of life, anxiety and depression in older adults with obesity.

We aimed to investigate associations between sleep quality with selected quantitative and qualitative parameters of health in older individuals with obesity. Cross-sectional assessment (n = 95 men/women; ≥ 65 years; BMI ≥ 30 kg/m2) of sleep quality, body composition, handgrip strength, quality-of-life, anxiety/depression. Mean PSQI score was 6.3. Poor sleepers (n = 49) presented lower appendicular lean mass (ALM) (16.2 vs 17.8 kg; p = 0.0273), ALM/BMI (0.47 vs 0.53 kg/BMI; p = 0.0085), fat mass (48.6 vs 46.6%; p = 0.0464), handgrip strength (19.7 vs 22.0 kgf; p = 0.0542) and handgrip/BMI (0.57 vs 0.66 kgf/BMI; p = 0.0242) than good sleepers. They also had higher anxiety (8.6 vs 5.6; p = 0.0100) and depression (4.8 vs 3.2; p = 0.0197) scores, worse health-related quality-of-life and lower scores in mental (62.8 vs 73.0; p = 0.0223) and physical (52.9 vs 67.3; p = 0.0015) domains. Adjusted models showed that PSQI was negatively associated with ALM (ß = - 0.13, 95% CI - 0.25; - 0.01) and health-related quality of life on physical (ß = - 2.76, 95% CI - 3.82; - 1.70) and mental (ß = - 2.25, 95% CI - 3.38; - 1.12) domains, and positively associated with anxiety (ß = 0.57; 95% CI 0.26; 0.87) and depression (ß = 0.31; 95% CI 0.13; 0.49). Poor sleep quality associates with impaired selected quantitative and qualitative parameters of health. Additionally, sleep quality was shown as an independent predictor of ALM, health-related quality-of-life, anxiety and depression in older individuals with obesity.

Disordered Eating Attitudes and Food Choice Motives Among Individuals Who Follow a Vegan Diet in Brazil.

Importance: It remains controversial whether adhering to a vegan diet may be associated with a higher prevalence of disordered eating. Also, main food choice motives and their association with disordered eating in this population are still unknown. Objective: To determine the association between disordered eating attitudes and food choice motives of individuals who follow a vegan diet. Design, Setting, and Participants: This is a cross-sectional online survey conducted between September 2021 and January 2023. Individuals of both sexes, aged 18 years or older, following a vegan diet for at least 6 months, currently living in Brazil were recruited through advertisements on social media. Exposure: Adherence to a vegan diet and food choice motives. Main Outcomes and Measures: Disordered eating attitudes and food choice motives. Results: Nine hundred seventy-one participants completed the online survey. Median (IQR) age and BMI of participants was 29 (24-36) years and 22.6 (20.3-24.9), respectively, and 800 participants (82.4%) were female. Most participants (908 respondents [94%]) were categorized with the lowest level of disturbed eating attitudes. "Need and hunger," "liking," "health," "habits," and "natural concerns" were the most important food choice motives in this population, while "affect regulation," "social norms," and "social image" were the less important ones. Adjusted models showed that "liking," "need and hunger," and "health" were associated with lower levels of disordered eating attitudes, while "price," "pleasure," "sociability," "traditional eating," "visual appeal," "social norms," "social image," "weight control," and "affect regulation" were associated with higher levels of disordered eating attitudes. Conclusions and Relevance: In this cross-sectional study, as opposed to previous suggestions, levels of disordered eating were very low among vegans, although certain food choice motives were associated with disordered eating attitudes. Understanding the motivations of adhering to diets that may impose restrictions, which include vegan diets, may help tailor interventions focused on promoting healthy eating and preventing or treating disordered eating.

Factors Associated with Cardiorespiratory Fitness in Breast Cancer Survivors from the State of Santa Catarina, Brazil: Cross-Sectional Study

Introduction: Oxygen consumption (VO2 ) is indicative of cardiorespiratory fitness (CRF) and lower levels are related to a higher risk of total mortality among individuals with cancer whose therapy can have adverse consequences on the cardiovascular system. Objective: To examine the associations of patient-reported sociodemographic, clinical, anthropometric outcomes and functional variables with CRF in 69 women (55±10 years) and to identify whether walking is a predictor of peak VO2 variation in this population with breast cancer (BC). Method: Female BC survivors receiving hormone therapy after two types of surgery (breast-conserving and mastectomy) underwent a CRF test on a cycle ergometer to measure peak VO2 . A questionnaire containing sociodemographic, clinical data, patient reported outcomes (PROs) (depressive symptoms, sleep quality, fatigue, body image) and self-reported walking and tests to measure body fat percentage, waist circumference, flexibility and shoulder range of motion (RoM) were performed. Results: Unemployment and retirement were associated with low CRF, as was the use of aromatase inhibitors instead of tamoxifen. Depressive symptoms, worse body image, greater waist circumference, less flexibility and shoulder RoM were also associated with low CRF. Walking duration, controlled for age and body mass index (BMI), is a 13% predictor of peak VO2 variance in this sample. Conclusion: These factors must be considered in understanding the CRF profile of BC survivors. As walking was a predictor of peak VO2 variance, it should be recommended as a type of physical activity for patients with BC using hormone therapy.

Introdução: O consumo de oxigênio (VO2 ) é indicativo de aptidão cardiorrespiratória (ACR), e níveis mais baixos estão relacionados a um maior risco de mortalidade total entre indivíduos com câncer cuja terapia pode ter consequências adversas no sistema cardiovascular. Objetivo: Examinar as associações de desfechos sociodemográficos, clínicos, antropométricos relatados pelo paciente e variáveis funcionais com a ACR de 69 mulheres (55±10 anos), e identificar se a caminhada é um preditor de variação do pico de VO2 nessa população com câncer de mama (CM). Método: Mulheres sobreviventes de CM recebendo terapia hormonal após dois tipos de cirurgias (conservadora e mastectomia) realizaram um teste de ACR em cicloergômetro para medir o VO2 pico. Um questionário contendo dados sociodemográficos e clínicos; resultados relatados pelos pacientes (RRP) (sintomas depressivos, qualidade do sono, fadiga, imagem corporal); caminhada autorreferida; e testes para medir o percentual de gordura, circunferência da cintura, flexibilidade e amplitude do movimento ADM do ombro foram realizados. Resultados: Desemprego e aposentadoria foram associados à baixa ACR, assim como o uso de inibidores de aromatase ao invés de tamoxifeno. Sintomas depressivos, pior imagem corporal, maior circunferência da cintura, menor flexibilidade e ADM do ombro também foram associados à baixa ACR. A duração da caminhada, controlada por idade e índice de massa corporal (IMC), é um preditor de 13% da variância do VO2 pico nesta amostra. Conclusão: Tais fatores devem ser considerados na compreensão do perfil de ACR de sobreviventes de CM. Como a caminhada foi um preditor da variância do VO2 pico, deve ser recomendada atividade física para pacientes com CM em uso de hormonioterapia.

Introducción: El consumo de oxígeno (VO2 ) es indicativo de aptitud cardiorrespiratoria (ACR) y los niveles más bajos se relacionan con un mayor riesgo de mortalidad total entre las personas con cáncer cuya terapia puede tener consecuencias adversas sobre el sistema cardiovascular. Objetivo: Examinar las asociaciones de los resultados sociodemográficos, clínicos, antropométricos y variables funcionales informados por las pacientes con la ACR en 69 mujeres (55±10 años) e identificar si caminar es un predictor de la variación del VO2 máximo en esta población con cáncer de mama (CM). Método: Mujeres sobrevivientes de CM que recibieron terapia hormonal después de dos tipos de cirugía (conservadora y mastectomía) se sometieron a una prueba de ACR en un cicloergómetro para medir el VO2 máximo. Se aplicó un cuestionario que contenía datos sociodemográficos, clínicos, resultados informados por los pacientes (RIP) (síntomas depresivos, calidad del sueño, fatiga, imagen corporal) y caminata autoinformada y pruebas para medir el porcentaje de grasa corporal, la circunferencia de la cintura, la flexibilidad y el rango de movimiento (RoM) del hombro. Resultados: El desempleo y la jubilación se asociaron con una baja ACR, al igual que el uso de inhibidores de la aromatasa en lugar de tamoxifeno. Síntomas depresivos, peor imagen corporal, mayor perímetro de cintura, menor flexibilidad y RoM de los hombros también se asociaron con una baja ACR. La duración de la caminata, controlada por edad e índice de masa corporal (IMC), es un predictor del 13% de la variación del VO2 pico en esta muestra. Conclusión: Estos factores deben ser considerados para comprender el perfil de ACR de los sobrevivientes de CM. Como la caminata fue un predictor de la variación del VO2 pico, debe recomendarse actividad física para pacientes con CM en terapia hormonal.

A 6-month, double-blind, placebo-controlled, randomized trial to evaluate the effect of Eurycoma longifolia (Tongkat Ali) and concurrent training on erectile function and testosterone levels in androgen deficiency of aging males (ADAM).

BACKGROUND: Androgen deficiency of aging males (ADAM) largely manifests as sexual symptoms. Erectile dysfunction is one of the most common symptoms of ADAM. AIM: To ascertain the effect of concurrent training and supplementation with Eurycoma longifolia on erectile function and testosterone levels in men with ADAM, and the association of erectile function with levels of total testosterone. METHODS: 6-month, randomized, double-blind, placebo-controlled four-arm clinical. 45 men (47.38 ± 5.03 years) were randomized into 4 groups (G1: control + placebo; G2: control + Eurycoma longifolia; G3: concurrent training + placebo; G4: concurrent training + Eurycoma longifolia). 22 received a 200 mg supplement of Eurycoma longifolia and 23 underwent the intervention with concurrent training, 3 times a week for 60 min at progressive intensity. OUTCOMES: International Index of Erectile Function (IIEF-5), Aging Male Scale (AMS) and total testosterone. RESULTS: Erectile function demonstrated improvements in both interventions; however, the most significant results were obtained by men allocated to concurrent training + Eurycoma longifolia. CLINICAL IMPLICATIONS: A 200 mg supplement of Eurycoma longifolia and the practice of concurrent training for 6 months significantly improved the erectile function of men with ADAM. STRENGTHS & LIMITATIONS: The study's design stands out as a strength, in addition to the six-month intervention. The main limitation is the study not having groups that used only Eurycoma longifolia and only concurrent training. CONCLUSION: The combination of Eurycoma longifolia and concurrent training improved erectile function and increased total testosterone levels in men with ADAM.

Exercise associated or not to the intake of Eurycoma longifolia improves strength and cardiorespiratory fitness in men with androgen deficiency.

This study aims to analyze the effects of a concurrent training (CT) associated with Eurycoma longifolia (EL) supplementation on the muscle strength, cardiorespiratory fitness, and symptomatology score of men with the androgen deficiency of aging male (ADAM). Forty-five subjects (47.6 ± 5.2 years) were included in the study. The randomized, double-blinded, placebo controlled clinical trial lasted for 6 months. Participants were randomized into four groups, control (C; n = 12); EL (n = 11); CT (n = 11); and CT + EL (n = 11). Along this period, the isokinetic peak torque of the knee extensors increased in the CT (14%) and CT + EL (17%) groups (p = 0.040; p = 0.006, respectively), while the isokinetic peak torque of knee flexion increased in the CT + EL group only (p < 0.05). For all participants, testosterone levels were correlated with isokinetic peak torque of knee extension (r = 0.517, p = 0.001) and flexion (r = 0.362, p = 0.028). Subjects of the CT (27.3%) and CT + EL (36.1%) groups decreased the symptomatology of ADAM (p = 0.005). This study demonstrated the benefits of CT and EL consumption as a non-pharmacological treatment for ADAM.

The impact of brazilian samba on parkinson's disease: analysis by the disease subtypes / O impacto do samba brasileiro na doença de parkinson: análise através dos subtipos da doença / El impacto del samba brasileño en la enfermedad de parkinson: análisis a través de los subtipos de la enfermedad

ABSTRACT Introduction: People with Parkinson's disease constantly have low levels of physical activity. Dancing has become increasingly important for treating the disease and can help improve non-motor symptoms. Objective: To analyze the influence of Brazilian samba on the non-motor symptoms of PD according to TD and PGID subtypes. Methods: A 12-week, non-randomized clinical trial, through comparison with a control group. The 23 individuals who agreed to participate in the activities formed the experimental group (EG) and the 24 individuals who opted not to participate in the Brazilian samba classes comprised the control group (CG). A questionnaire was applied, composed of validated instruments. Mini Mental State Examination - MMSE; HY - Disability Scale; Unified Parkinson's Disease Rating Scale - UPDRS 1 and total values; Parkinson's Disease Questionnaire - PDQ-39, Parkinson's Disease Sleep Scale - PDSS; Beck Depression Inventory - BDI; Fatigue Severity Scale - FSS and Magnitude of Perceived Changes. Results: After the twelve weeks of intervention, it was observed that the EG showed improvement in the scores of all the tests. The comparison between groups, however, indicated a significant difference in the post-UPDRS1 period in which the EG presented improvement in cognitive impairment, while the CG presented a deficit in these values. The results of the division between disease subtypes show a greater change in the values between individuals of the TD group, when comparing the EG with the CG. For the EG, the greatest difference between pre- and post- intervention was fatigue. Conclusion: There was a positive trend in all the variables studied after the application of the protocol. This demonstrates that interventions such as dance may have greater effects on non-motor symptoms, depending on the expected progression of the disease. The scarcity of studies that use this approach in their analyses may explain the lack of evidence in this symptomatology related to dance. Level of evidence II; Therapeutic studies - Investigating the results of treatment.

RESUMO Introdução: As pessoas com doença de Parkinson constantemente apresentam baixos níveis de atividade física. A dança tem se tornado cada vez mais importante para o tratamento da doença e pode ajudar a melhorar os sintomas não motores. Objetivo: Analisar a influência do samba brasileiro nos sintomas não motores da DP, segundo os subtipos TD e PGID. Métodos: Ensaio clínico não randomizado com duração de 12 semanas por meio de comparação com grupo controle. Os 23 indivíduos que aceitaram participar das atividades formaram o grupo experimental (GE) e os 24 indivíduos que optaram por não participar das aulas de dança brasileira formaram o grupo controle (GC). Um questionário foi aplicado, composto por instrumentos validados: Mini Exame do Estado Mental - MEEM; HY - Escala de Grau de Incapacidade; Escala Unificada de Avaliação da Doença de Parkinson - UPDRS 1 e valores totais; Questionário sobre a Doença de Parkinson - PDQ-39; Escala de Sono para a Doença de Parkinson - PDSS; Inventário de Depressão de Beck - BDI; Escala de Severidade de Fadiga - FSS e Magnitude das Alterações Percebidas. Resultados: Após doze semanas de intervenção, observou-se que o GE apresentou melhora nos escores de todos os testes. A comparação entre os grupos, no entanto, indicou uma diferença significativa no período pós-UPDRS1 em que o GE apresentou melhora no comprometimento cognitivo, enquanto o GC apresentou déficit nesses valores. Os resultados da divisão entre os subtipos da doença apresentam uma maior mudança nos valores entre os indivíduos do grupo TD ao comparar o GE com o GC. Em relação ao GE, a maior diferença entre a pré e pós-intervenção foi relacionada à fadiga. Conclusão: Houve tendência positiva em todas as variáveis estudadas após a aplicação do protocolo. Isso demonstra que intervenções como a dança podem ter maiores efeitos sobre os sintomas não motores, dependendo da progressão esperada da doença. A escassez de estudos que utilizam essa abordagem em suas análises pode explicar a falta de evidências nessa sintomatologia relacionadas à dança. Nível de evidência II; Estudos terapêuticos-Investigação dos resultados do tratamento.

RESUMEN Introducción: Las personas con enfermedad de Parkinson constantemente presentan bajos niveles de actividad física. La danza se ha vuelto cada vez más importante para el tratamiento de la enfermedad y puede ayudar a mejorar los síntomas no motores. Objetivo: Analizar la influencia del samba brasileño en los síntomas no motores de la EP, según los subtipos TD y PGID. Métodos: Ensayo clínico no aleatorizado con duración de 12 semanas, por medio de comparación con grupo control. Los 23 individuos que aceptaron participar en las actividades formaron el grupo experimental (GE) y los 24 individuos que optaron por no participar en las clases de danza brasileña formaron el grupo control (GC). Fue aplicado un cuestionario, compuesto por instrumentos validados: Mini Examen del Estado Mental - MEEM; HY - Escala del Grado de Incapacidad; Escala unificada de evaluación de la Enfermedad de Parkinson - UPDRS 1 y valores totales; Cuestionario sobre la Enfermedad de Parkinson - PDQ-39; Escala de Sueño de la Enfermedad de Parkinson - PDSS; Inventario de Depresión de Beck - BDI; Escala de Severidad de la Fatiga - FSS y Magnitud de las Alteraciones Percibidas. Resultados: Después de doce semanas de intervención, se observó que el GE presentó una mejora en los puntajes de todos los tests. La comparación entre los grupos, sin embargo, indicó una diferencia significativa en el período post-UPDRS1 en que el GE presentó una mejora en el compromiso cognitivo, mientras que el GC presentó déficit en esos valores. Los resultados de la división entre los subtipos de la enfermedad presentan un mayor cambio en los valores entre los individuos del grupo TD al comparar el GE con el GC. Con relación al GE, la mayor diferencia encontrada entre la pre y post intervención fue relacionada a la fatiga. Conclusión: Hubo tendencia positiva en todas las variables estudiadas después de la aplicación del protocolo. Eso demuestra que intervenciones como la danza pueden tener mayores efectos sobre los síntomas no motores, dependiendo de la progresión esperada de la enfermedad. La escasez de estudios que utilizan ese abordaje en sus análisis, puede explicar la falta de evidencias en esa sintomatología cuando relacionadas a la danza. Nivel de evidencia II; Estudios terapéuticos - Investigación de los resultados del tratamiento.

Effect of physical exercise on the cardiorespiratory fitness of men-A systematic review and meta-analysis.

This systematic review and meta-analysis analyzes the effect of physical exercise on the cardiorespiratory fitness of men according to type, intensity and duration of intervention, using data from randomized clinical trials; it also seeks to verify the dose-response relationship between duration and intensity of exercise and level of fitness. Databases were searched for reports of relevant studies. A methodological evaluation was carried out. In the statistical analysis, mean, standard deviation and sample size of each group were used. The mean age of the participants was 48.2 ±â€¯17.1 years. The effect on men's VO2 (a measure of cardiovascular fitness) of five to 120 weeks of exercise of moderate to vigorous intensity was found to be a change of 10.190 L/min-1. A meta-regression analysis did not reveal significant results. A positive effect on VO2 of men of different age groups was observed after aerobic and resistance exercise interventions, indicating the beneficial effects of exercise on cardiorespiratory fitness.

Concurrent training protocol for men with androgen deficiency in the aging male: a randomized clinical trial.

BACKGROUND: The androgen deficiency in the aging male (ADAM) affects physical, sexual, and psychological aspects with characteristics symptoms of middle-aged men. The practice of regular physical activity and physical exercise can attenuate these symptoms. The aim of this randomized clinical trial is to propose a physical exercise protocol based on concurrent training for middle-aged men with ADAM. METHOD: Randomized clinical trial with a 6-month intervention will randomly divided into two groups: experimental group (EG) and control group (CG). Four evaluations will be carried out, (1) pre-intervention; (2) in the first month of intervention; (3) in the third month of intervention; (4) post-intervention, evaluating: physical, psychological, sexual, and hormonal aspects. The intervention protocol with concurrent training will have duration of 6 months; frequency of 3 times weekly, with 60 min per session. The two-way ANOVA test will be used for the inter-group and intra-group comparisons with repeated measurements, and also Sydak's comparison test. CONCLUSION: This protocol was developed with the intent of easing the symptoms of ADAM. In addition, it is believed that the concurrent training protocol could be capable to recover hormonal, physical, psychological, and sexual aspect of middle-aged men with ADAM.