Distinct Adverse Reactions to mRNA, Inactivated Virus, and Adenovirus Vector COVID-19 Vaccines: Insights from a Cohort Study on Atopic and Non-Atopic Subjects in Brazil.

The emergence of COVID-19 caused by SARS-CoV-2 prompted an unprecedented global response to develop vaccines at an accelerated pace. Messenger RNA (mRNA) and adenovirus vector vaccines emerged as the frontrunners in global immunization efforts, significantly reducing hospitalization, severity, and mortality, supplemented by inactivated virus-based vaccines in developing countries. However, concerns regarding adverse effects, including allergic reactions, have been raised. This study aimed to investigate the adverse effects following COVID-19 vaccination, particularly in atopic and non-atopic individuals. A cohort of 305 volunteers receiving BNT162, ChAdOx1, or CoronaVac vaccines were assessed based on a Skin Prick Test (SPT), specific IgE levels, and clinical history of asthma and rhinitis. Adverse effects were self-reported and scored across the different vaccination shots. The results indicated a notable presence of mild adverse effects following the first and third doses, regardless of vaccine type. ChAdOx1 recipients experienced more adverse effects compared to those receiving BNT162 and CoronaVac, including headaches, muscle pain, fever, chills, nausea, and flu-like symptoms. Atopic individuals receiving ChAdOx1 reported more adverse effects, such as muscle pain, fever, and chills, compared to non-atopic individuals. Conversely, headaches were more frequently reported in non-atopic individuals receiving BNT162 compared to atopic individuals. No anaphylaxis or allergic reactions were reported, indicating valuable evidence supporting the safety of COVID-19 vaccination in individuals with respiratory allergies. This study highlights the importance of understanding vaccine-related adverse effects, particularly in vulnerable populations, to inform vaccination strategies and address safety concerns in global immunization campaigns.

Why Physical Activity Should Be Considered in Clinical Trials for COVID-19 Vaccines: A Focus on Risk Groups.

Since the World Health Organization declared the global COVID-19 state of emergency in early 2020, several vaccine candidates have emerged to control SARS-CoV-2, and some of them have been approved and implemented in vaccination campaigns worldwide. Although clinical trials for these vaccines have been carried out using highly controlled methods with accurate immunological tests, clinical questionnaires did not include questions concerning the physical activity profile among volunteers. It has been well established that physical activity plays a pivotal role in the immune response after vaccination, led by the activation of cytokines, antibodies, and cells. This concept should have been considered when evaluating the efficacy of COVID-19 vaccine candidates, particularly in elderly and obese people. Here, we discuss data from the literature providing strong evidence regarding the importance of analyzing physical activity parameters to improve the accuracy of clinical trials on assessing the efficacy of vaccine candidates.

Physical activity learning by medical students: the current picture in Brazil / Aprendizagem sobre atividade física por estudantes de Medicina: a situação hoje no Brasil

Abstract: Introduction: Physical activity is essential for preventing and treating many diseases. Although physicians are the most influential health professionals in advising their patients on the benefits of physical activity, most medical degree programs in Brazil do not seem to include physical activity topics in their curricula. Objective: This study aimed to investigate physical activity topics on active medical curricula in Brazil. Method: The research was conducted separately in April 2015 and February 2019 using a governmental resource, the e-MEC system, and search in internet databases. Data were split into categories according to the type of enrollment (mandatory or optional) of the courses that have subjects or thematic modules with topics on physical activity, type of activities (theoretical, practical, or theoretical-practical), and emphasis on the content (health, performance, or health and performance). Results: Of the 223 medical curricula compiled in 2015 and 286 in 2019, respectively, only 24 (10.8%) and 19 (6.7%) had at least one subject or thematic module concerning physical activity with emphasis on health. Conclusion: In Brazil, the number of undergraduate medical curricula covering physical activity topics is still small and suffered a reduction between 2015 and 2019, which should warn medical education institutions about the need to include physical activity longitudinally distributed contents, with theoretical and - if possible - practical approaches, and emphasis on health promotion and treatment of diseases, in mandatory curricular units.

Resumo: Introdução: A atividade física é essencial para prevenir e tratar muitas doenças. Embora os médicos sejam os profissionais de saúde que mais influenciam a orientação de seus pacientes sobre os benefícios da atividade física, a maioria dos programas de graduação em Medicina no Brasil parece não incluir tópicos sobre atividade física em seus currículos. Objetivo: Este estudo teve como objetivo investigar a presença de tópicos sobre atividade física nos currículos médicos ativos no Brasil. Método: A pesquisa foi realizada separadamente em abril de 2015 e fevereiro de 2019, utilizando um recurso governamental, o sistema e-MEC, e pesquisa em bancos de dados da internet. Os dados foram divididos em categorias, de acordo com a condição de matrícula (obrigatória ou opcional) dos cursos com disciplinas ou módulos temáticos contendo tópicos sobre atividade física, tipo de atividades (teóricas, práticas ou teórico-práticas) e ênfase no conteúdo (saúde, desempenho ou saúde e desempenho). Resultado: Dos 223 currículos médicos compilados em 2015 e 286 em 2019, respectivamente, apenas 24 (10,8%) e 19 (6,7%) apresentaram pelo menos uma disciplina ou módulo temático contendo tópico sobre atividade física com ênfase em saúde. Conclusão: No Brasil, o número de currículos de graduação em Medicina contemplando tópicos de atividade física ainda é pequeno e sofreu uma redução entre 2015 e 2019, o que deve servir de alerta para as instituições de ensino médico quanto à necessidade de inclusão de conteúdos longitudinalmente distribuídos sobre atividade física, com abordagens teórica e, se possível, prática, e com ênfase na promoção da saúde e no tratamento de doenças, em unidades curriculares obrigatórias.

Relationship between anthropometric indicators and risk factors for cardiovascular disease in adults and older adults of Rio Branco, Acre.

OBJECTIVE: To analyze the association between anthropometric variables and cardiovascular risk factors in adults and older adults of Rio Branco, Acre. METHODS: A population-based cross-sectional study with 641 adults and 957 older adults was conducted. The statistical analyses consisted of the distribution of anthropometric variables according to the cardiovascular risk factors by frequency and dispersion measures. Pearson's correlation coefficient and prevalence ratios (PR) were estimated with their respective 95% confidence intervals (95%CI) using the SPSS ® version 20.0. RESULTS: Moderate correlations were obtained in adult men for waist-hip ratio and total cholesterol (r = 0.486; p < 0.001) and for waist-hip and triglyceride ratios (r = 0.484; p < 0.001). The highest prevalence of hypertension and diabetes in adults were observed in men; in the older adults, the prevalence of hypertension was above 65% in both sexes. The prevalence of dyslipidemia was above 78% in obese adults and older adults. When analyzing the associations, a higher strength of association was found between arterial hypertension and waist-to-stature ratio (PR = 13.42; 95%CI 12.58-14.31) and body mass index greater than 30 kg/m 2 (PR = 6.61; 95%CI 6.34-6.89) in adult men. In the analysis of diabetes, the waist-hip ratio presented greater robustness in the association for women (PR = 7.53; 95%CI 6.92-8.20) and men (PR = 9.79; 95%CI 9.14-10.49). CONCLUSION: Anthropometric variables are important predictors of cardiovascular risk; however, their assessments should be performed independently, according to sex and age group.

Relationship between anthropometric indicators and risk factors for cardiovascular disease in adults and older adults of Rio Branco, Acre / Relação de indicadores antropométricos com fatores de risco para doença cardiovascular em adultos e idosos de Rio Branco, Acre

ABSTRACT OBJECTIVE To analyze the association between anthropometric variables and cardiovascular risk factors in adults and older adults of Rio Branco, Acre. METHODS A population-based cross-sectional study with 641 adults and 957 older adults was conducted. The statistical analyses consisted of the distribution of anthropometric variables according to the cardiovascular risk factors by frequency and dispersion measures. Pearson's correlation coefficient and prevalence ratios (PR) were estimated with their respective 95% confidence intervals (95%CI) using the SPSS ® version 20.0. RESULTS Moderate correlations were obtained in adult men for waist-hip ratio and total cholesterol (r = 0.486; p < 0.001) and for waist-hip and triglyceride ratios (r = 0.484; p < 0.001). The highest prevalence of hypertension and diabetes in adults were observed in men; in the older adults, the prevalence of hypertension was above 65% in both sexes. The prevalence of dyslipidemia was above 78% in obese adults and older adults. When analyzing the associations, a higher strength of association was found between arterial hypertension and waist-to-stature ratio (PR = 13.42; 95%CI 12.58-14.31) and body mass index greater than 30 kg/m 2 (PR = 6.61; 95%CI 6.34-6.89) in adult men. In the analysis of diabetes, the waist-hip ratio presented greater robustness in the association for women (PR = 7.53; 95%CI 6.92-8.20) and men (PR = 9.79; 95%CI 9.14-10.49). CONCLUSION Anthropometric variables are important predictors of cardiovascular risk; however, their assessments should be performed independently, according to sex and age group.

RESUMO OBJETIVO Analisar a associação entre variáveis antropométricas e os fatores de risco cardiovascular na população de adultos e idosos de Rio Branco, Acre. MÉTODOS Estudo transversal de base populacional com 641 adultos e 957 idosos. As análises estatísticas consistiram na distribuição das variáveis antropométricas segundo os fatores de risco cardiovascular por medidas de frequência e dispersão. Foram calculadas a correlação de Pearson e razões de prevalência (RP) com seus respectivos intervalos de confiança de 95% (IC5%), empregando as rotinas do SPSS ® versão 20.0. RESULTADOS Correlações moderadas foram obtidas nos adultos homens para relação cintura-quadril e colesterol total (r = 0,486; p < 0,001) e para relação cintura-quadril e triglicerídeos (r = 0,484; p < 0,001). As maiores prevalências de hipertensão arterial e diabetes nos adultos foram observadas nos homens; já nos idosos, as prevalências de hipertensão ficaram acima de 65% em ambos os sexos. As prevalências de dislipidemia ficaram acima de 78% nos indivíduos obesos adultos e idosos. Ao analisar as associações, constatou-se maior força de associação entre hipertensão arterial e relação cintura-estatura (RP = 13,42; IC95% 12,58-14,31) e com índice de massa corporal maior que 30 kg/m 2 (RP = 6,61; IC95% 6,34-6,89) nos homens adultos. Na análise para diabetes, a relação cintura-quadril apresentou maior robustez na associação para mulheres (RP = 7,53; IC95% 6,92-8,20) e homens (RP = 9,79; IC95% 9,14-10,49). CONCLUSÃO As variáveis antropométricas são importantes preditores de risco cardiovascular; no entanto, suas avaliações devem ser feitas de forma independente, segundo sexo e grupo etário.

Depression, Hematologic Parameters, and Blood Levels of Vitamin B12 in Patients With Laryngopharyngeal Reflux Under Use of Proton Pump Inhibitors.

OBJECTIVE: The objective of this study was to evaluate and correlate hematologic indices, vitamin B12 levels, and depression in patients with suspected laryngopharyngeal reflux (LPR) treated with proton pump inhibitor (PPI). METHODS: This was a prospective study with a population (n = 23) consisted of patients with suspected LPR and treated with 2 daily doses of Omeprazole 40 mg (80 mg or full dose). The study volunteers performed a complete blood count and vitamin B12 dosage before and after 3 and 6 months of treatment, as well as depression screening using the Center of Epidemiologic Studies-Depression (CES-D) questionnaire before and after 6 months of treatment. Scores greater than 16 were considered as suggestive of depression. RESULTS: The mean score on the CES-D scale of study participants at baseline significantly decreased after 6 months of treatment. A significant decrease was observed in the red blood cells count (RBC) after 6 months in relation to 3 months. Significant increases in mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were observed from 3 months to 6 months in this study. Vitamin B12 levels increased significantly between baseline and after 6 months of treatment. CONCLUSION: Decreased scores on the CES-D scale were associated with increased MCV values, with no association with vitamin B12 levels. However, vitamin B12 levels also increased significantly after 6 months of treatment with PPI.

Effects of combined and resistance training on the inflammatory profile in breast cancer survivors: A systematic review.

OBJECTIVE: The present systematic review aimed to verify the effect of resistance and combined training on the inflammatory profile of breast cancer survivors. DESIGN: The searches were made on the platforms PsycINFO, PubMed, Cochrane, Science Direct and Scopus, from 1996 to 2017, using the keywords: cancer survivors, cancer treatment, cancer patients, breast cancer, inflammation, inflammatory profile, immune function, resistance training, strength training, weight training, physical activity, concurrent training and combined training. References of selected articles were also considered. Seven studies fulfilled the criteria adopted for analysis. RESULTS: None of these studies have shown reduced inflammatory markers in breast cancer survivors undergoing combined or isolated resistance training. CONCLUSIONS: It is not yet possible to conclude which resistance and/or combination training protocol is capable of improving the short-term inflammatory profile in this population. Future studies should seek to establish how structural training variables (intensity, volume, density, intra- and inter-series recovery, among others) act on anti-inflammatory processes in breast cancer survivors.

Comparação do estado nutricional em crianças de cinco a dez anos de idade beneficiárias do Programa de transferência de dinheiro condicional nos Estados do Acre e do Rio Grande do Sul, Brasil / Comparison of the nutritional status in children aged 5 to 10 years old on the Conditional Cash Transfer Programme in the States of Acre and Rio Grande do Sul, Brazil

INTRODUCTION: In recent years, there has been a reduction in cases of malnutrition in Brazil but this has been accompanied with an increase in the overweight and obesity rates. These changes, together with others, such as changes in eating patterns and lifestyle, characterise the process of nutritional transition. OBJECTIVE: We aimed to compare the prevalence of nutritional status of beneficiary children of the Bolsa Família Program (PBF) in the states of Acre and Rio Grande do Sul, Brazil, and to analyse the changes in the anthropometric profile of these children during 5 years. METHODS: This is an ecological study using secondary data from the Food and Nutrition Surveillance System (SISVAN) and Bolsa Família Department of SUS (DATASUS), which assessed the nutritional status of children over 5 years and under 10 years benefiting from the PBF in the years 2011 to 2015 in the states of Acre and Rio Grande do Sul. The sample consisted of 94,865 children from Acre and 342,462 children from Rio Grande do Sul. The Body Mass Index was used to classify the nutritional status. RESULTS: The mean prevalence of eutrophic children aged 5 to 10 years in Acre was 70.42% and was 61.28% in Rio Grande do Sul. Overweight was 13.06% in Acre and 19.48% in Rio Grande do Sul. Obesity was 5.08% in Acre and 9.36% in Rio Grande do Sul. Severe obesity was 4.02% in Acre and 6.92% in Rio Grande do Sul. CONCLUSION: Overweight and obesity in children benefiting from the PBF has been growing in the last 5 years, notably in the state of Rio Grande do Sul. This is possibly due to the fact that the nutritional transition is at a more advanced stage here than in Acre State.

INTRODUÇÃO: No Brasil tem-se observado que houve uma redução nos casos de desnutrição nos últimos anos, porém acompanhado a esse decréscimo houve um aumento em relação às taxas de sobrepeso e obesidade. Essas mudanças em conjunto com outras como alteração dos padrões alimentares e o estilo de vida caracterizam o processo de transição nutricional. OBJETIVO: Comparar as prevalências do perfil nutricional de crianças beneficiárias do Programa Bolsa Família dos estados do Acre e do Rio Grande do Sul, assim como analisar mudanças no perfil antropométrico dessas crianças por período de cinco anos. MÉTODO: Trata-se de estudo ecológico utilizando dados secundários do Sistema de Vigilância Alimentar e Nutricional (SISVAN) e Bolsa Família do Departamento de Informática do SUS (DATASUS), no qual foi avaliado o estado nutricional de crianças maiores de cinco anos e menores de dez anos beneficiárias do Programa Bolsa Família (PBF) no ano de 2011 a 2015 nos estados do Acre e Rio Grande do Sul. A amostra constituiu de 94.865 crianças do Acre e 342.462 crianças do Rio Grande do Sul. Para classificar o estado nutricional utilizou-se o Índice de Massa Corporal/idade. RESULTADOS: A média da prevalência de eutrofia de crianças na faixa etária cinco a dez anos beneficiárias no Acre foi de 70,42% e 61,28% no Rio Grande do Sul; o sobrepeso foi de 13,06% no Acre e 19,48% no Rio Grande do Sul; a obesidade 5,08% no Acre e 9,36% no Rio Grande do Sul; e a obesidade grave 4,02% no Acre e 6,92% no Rio Grande do Sul. CONCLUSÃO: O sobrepeso e obesidade em crianças beneficiárias do PBF tem crescido nos últimos cinco anos, notadamente no estado do Rio Grande do Sul possivelmente pelo fato da transição nutricional já estar em um estágio mais avançado do que no Estado Acre.

Total protein of whole saliva as a biomarker of anaerobic threshold.

Saliva provides a convenient and noninvasive matrix for assessing specific physiological parameters, including some biomarkers of exercise. We investigated whether the total protein concentration of whole saliva (TPWS) would reflect the anaerobic threshold during an incremental exercise test. After a warm-up period, 13 nonsmoking men performed a maximum incremental exercise on a cycle ergometer. Blood and stimulated saliva were collected during the test. The TPWS anaerobic threshold (PAT) was determined using the Dmax method. The PAT was correlated with the blood lactate anaerobic threshold (AT; r = .93, p < .05). No significant difference (p = .16) was observed between PAT and AT. Thus, TPWS provides a convenient and noninvasive matrix for determining the anaerobic threshold during incremental exercise tests.