Investigation of the involvement of platelet-activating factor in the control of hypertension by aerobic training. A randomized controlled trial.

Although studies have demonstrated the effectiveness of exercise in controlling systemic arterial hypertension (SAH), the mechanisms involved in this effect are still poorly understood. Thus, this study investigated the impact of aerobic training on the relationship between platelet-activating factor (PAF) circulating levels and blood pressure in hypertensives. Seventy-seven hypertensive subjects were enrolled in this randomized controlled trial (age 66.51 ± 7.53 years, body mass 76.17 ± 14.19 kg). Participants were randomized to two groups: the intervention group (IG, n = 36), composed of hypertensive individuals submitted to an aerobic training protocol, and the control group (CG, n = 41), composed of non-exercised hypertensives. Body mass index, arterial blood pressure, quality of life, respiratory muscle strength, and functional capacity were assessed before and after 12 weeks. PAF and plasma cytokine levels were also evaluated respectively by liquid chromatography coupled with mass spectrometry and enzyme-linked immunosorbent assay. Aerobic training promoted a significant reduction in blood pressure while functional capacity, expiratory muscle strength, and quality of life, PAFC16:0 and PAFC18:1 plasma levels were increased in comparison to the CG (p < 0.05). In addition, multiple correlation analysis indicated a positive correlation [F (3.19) = 6.322; p = 0.001; R2adjusted = 0.499] between PAFC16:0 levels and expiratory muscle strength after aerobic training. Taken together, our findings indicate that PAF may be involved in the indirect mechanisms that control SAH, being mainly associated with increased respiratory muscle strength in hypertensive subjects undergoing aerobic training.

The impact of the COVID-19 pandemic on neuropsychiatric and sleep disorders, and quality of life in individuals with neurodegenerative and demyelinating diseases: a systematic review and meta-analysis of observational studies.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has affected the mental health, sleep and quality of life, especially in individuals with chronic disease. Therefore, the purpose of this systematic review and meta-analysis was to investigate the impact of the COVID-19 pandemic on neuropsychiatric disorders (depression, anxiety, stress), sleep disorders (sleep quality, insomnia) and quality of life in individuals with Parkinson's disease (PD), Multiple Sclerosis (MS) and Alzheimer's disease (AD) compared to healthy controls. METHODS: Seven databases (Medline, Embase, ScienceDirect, Web of Science, The Cochrane Library, Scielo and Lilacs) were searched between March 2020 and December 2022. Observational studies (i.e., cross-sectional, case-control, cohort) were included. GRADE approach was used to assess the quality of evidence and strength of the recommendation. Effect size was calculated using standardized mean differences (SMD; random effects model). A customized Downs and Black checklist was used to assess the risk of bias. RESULTS: Eighteen studies (PD = 7, MS = 11) were included. A total of 627 individuals with PD (healthy controls = 857) and 3923 individuals with MS (healthy controls = 2432) were analyzed. Twelve studies (PD = 4, MS = 8) were included in the meta-analysis. Individuals with PD had significantly elevated levels of depression (very low evidence, SMD = 0.40, p = 0.04) and stress (very low evidence, SMD = 0.60, p < 0.0001). There was no difference in anxiety (p = 0.08). Individuals with MS had significantly higher levels of depression (very low evidence, SMD = 0.73, p = 0.007) and stress (low evidence, SMD = 0.69, p = 0.03) and low quality of life (very low evidence, SMD = 0.77, p = 0.006). There was no difference in anxiety (p = 0.05) and sleep quality (p = 0.13). It was not possible to synthesize evidence in individuals with AD and sleep disorder (insomnia). CONCLUSION: In general, the COVID-19 pandemic negatively impacted individuals with PD and MS. Individuals with PD showed significantly higher levels of depression and stress; and individuals with MS presented significantly higher depression and stress levels, as well as significantly lower quality of life when compared to healthy controls. Further studies are needed to investigate the impact of the COVID-19 pandemic in individuals with AD.

Factors associated with functional capacity in the elderly enrolled in the Family Health Strategy. / Fatores associados a capacidade funcional de idosos adscritos à Estratégia de Saúde da Família.

The study investigated the prevalence of functional capacity decline and its associated factors in the older people enrolled in the Family Health Strategy (ESF) in a city in the south of Minas Gerais. This is an observational, cross-sectional, population-based study with 406 elderly (70.49 years ± 6.77). The functional capacity was evaluated by the Short Physical Performance Battery (SPPB), and its associated factors were evaluated by a structured questionnaire including sociodemographic, economic, clinical and physical aspects. The analysis of plasma levels of inflammatory mediators was performed by the ELISA method. Multiple linear regression was used for the analyses (p < 0.05). The prevalence of functional decline in the sample was 57.6% and factors associated with functional capacity were advanced age, female gender, number of medications, depressive symptoms, high plasma concentrations of the soluble receptor of tumor necrosis factor alpha 1 (sTNFR1) and low handgrip strength. The results demonstrated that functional capacity was associated with a network of multidimensional factors. This study contributes to the practice of ESF professionals by indicating the main factors that can guide actions to promote and prevent the decline of functional capacity in the elderly population.

O estudo investigou a prevalência de declínio da capacidade funcional e seus fatores associados em idosos adscritos à Estratégia Saúde da Família (ESF), em um município do sul de Minas Gerais. Estudo observacional, transversal, de base populacional, com 406 idosos. A capacidade funcional foi avaliada pelo Short Physical Performance Battery (SPPB); seus fatores associados foram avaliados por um questionário estruturado incluindo aspectos sociodemográficos, econômicos, clínicos e físicos. Concentrações de mediadores inflamatórios foram dosadas pelo método de Elisa ("Enzyme-Linked Immunosorbent Assay"). Regressão linear múltipla foi usada para as análises (p < 0,05). A prevalência de declínio funcional na amostra foi de 57,6% e os fatores associados à capacidade funcional foram: idade avançada, sexo feminino, número de medicamentos, sintomas depressivos, elevadas concentrações plasmáticas de receptor solúvel 1 do fator de necrose tumoral alfa (sTNFR1) e baixa força de preensão palmar. Os resultados mostraram que a capacidade funcional foi associada a uma rede de fatores multidimensionais. O presente estudo contribui para a prática de profissionais na ESF ao apontar os principais fatores que podem nortear as ações de promoção e prevenção do declínio da capacidade funcional na população idosa.

Fatores associados a capacidade funcional de idosos adscritos à Estratégia de Saúde da Família / Factors associated with functional capacity in the elderly enrolled in the Family Health Strategy

Resumo O estudo investigou a prevalência de declínio da capacidade funcional e seus fatores associados em idosos adscritos à Estratégia Saúde da Família (ESF), em um município do sul de Minas Gerais. Estudo observacional, transversal, de base populacional, com 406 idosos. A capacidade funcional foi avaliada pelo Short Physical Performance Battery (SPPB); seus fatores associados foram avaliados por um questionário estruturado incluindo aspectos sociodemográficos, econômicos, clínicos e físicos. Concentrações de mediadores inflamatórios foram dosadas pelo método de Elisa ("Enzyme-Linked Immunosorbent Assay"). Regressão linear múltipla foi usada para as análises (p < 0,05). A prevalência de declínio funcional na amostra foi de 57,6% e os fatores associados à capacidade funcional foram: idade avançada, sexo feminino, número de medicamentos, sintomas depressivos, elevadas concentrações plasmáticas de receptor solúvel 1 do fator de necrose tumoral alfa (sTNFR1) e baixa força de preensão palmar. Os resultados mostraram que a capacidade funcional foi associada a uma rede de fatores multidimensionais. O presente estudo contribui para a prática de profissionais na ESF ao apontar os principais fatores que podem nortear as ações de promoção e prevenção do declínio da capacidade funcional na população idosa.

Abstract The study investigated the prevalence of functional capacity decline and its associated factors in the older people enrolled in the Family Health Strategy (ESF) in a city in the south of Minas Gerais. This is an observational, cross-sectional, population-based study with 406 elderly (70.49 years ± 6.77). The functional capacity was evaluated by the Short Physical Performance Battery (SPPB), and its associated factors were evaluated by a structured questionnaire including sociodemographic, economic, clinical and physical aspects. The analysis of plasma levels of inflammatory mediators was performed by the ELISA method. Multiple linear regression was used for the analyses (p < 0.05). The prevalence of functional decline in the sample was 57.6% and factors associated with functional capacity were advanced age, female gender, number of medications, depressive symptoms, high plasma concentrations of the soluble receptor of tumor necrosis factor alpha 1 (sTNFR1) and low handgrip strength. The results demonstrated that functional capacity was associated with a network of multidimensional factors. This study contributes to the practice of ESF professionals by indicating the main factors that can guide actions to promote and prevent the decline of functional capacity in the elderly population.