Empathy and psychological concerns among medical students in Brazil during the COVID-19 pandemic.

OBJECTIVE: Being in direct contact with COVID-19 patients for long periods increases the risk of infection among frontline workers. The purpose of this study was to identify levels of empathy and psychological concern among medical students during the COVID-19 pandemic. METHODS: An online cross-sectional study was conducted among medical interns divided into two groups: those who worked on the frontline (n = 87) and those who did not (n = 63) during the COVID pandemic. The students completed the Interpersonal Reactivity Index, Maslach Burnout Inventory, Perceived Stress Scale, and Patient Health Questionnaire. RESULTS: The majority of respondents were women (70.7%), and the mean age was 25.45 ± 3.93 years. In unadjusted analyses, those who worked with COVID-19 patients had a higher level of empathy, stress, burnout symptoms, and depressive symptoms. In the logistic regression analyses, students who worked on the frontline during the COVID-19 pandemic had a higher level of empathy (OR: 1.27; 95% CI: 1.16-1.14), higher perceived stress levels (OR: 1.21; 95% CI: 1.05-1.39), and greater burnout symptoms (OR: 1.19; 95% CI: 1.10-1.30). CONCLUSION: Medical students in the internship period who worked on the frontline during the COVID-19 pandemic had more psychological concerns and higher levels of empathy compared to those who did not work on the frontline.

Daily Undulating Periodization Is More Effective Than Nonperiodized Training on Maximal Strength, Aerobic Capacity, and TCD4+ Cell Count in People Living With HIV.

ABSTRACT: Soares, VL, Soares, WF, Zanetti, HR, Neves, FF, Silva-Vergara, ML, and Mendes, EL. Daily undulating periodization is more effective than nonperiodized training on maximal strength, aerobic capacity, and TCD4+ cell count in people living with HIV. J Strength Cond Res 36(6): 1738-1748, 2022-The aim of this study was to evaluate the effects of daily undulating periodization (DUP) and nonperiodized training (NPT) programs on maximal muscle strength, body composition, aerobic capacity, muscle power, and immune markers in people living with HIV (PLWHIV). A total of 41 PLWHIV were randomly assigned to control (CON [n = 15]), DUP (n = 13), and NPT (n = 13) groups. The DUP and NPT groups performed combined training 3 times a week on nonconsecutive days during 12 weeks, whereas the CON group was asked to maintain their current level of activity. After the 12-week training program, DUP produced greater gains in muscle strength (except for bench press), V̇o2peak, and muscle power than NPT (p < 0.05). Compared to CON, the training groups showed significantly (p < 0.05) increased muscle strength (DUP = 31.0 ± 13.9 kg; NPT = 17.7 ± 9.2 kg; CON = -0.3 ± 1.5 kg), fat-free mass (DUP = 1.9 ± 1.5 kg; NPT = 1.4 ± 1.9 kg; CON = -0.1 ± 1.2 kg), and metabolic equivalent (DUP = 2.3 ± 1.3; NPT = 1.8 ± 1.9), and decreased body fat mass (DUP = -2.1 ± 1.6 kg; NPT = -1.4 ± 1.5 kg; CON = 0.1 ± 0.2) and functional aerobic impairment (DUP = -35.9 ± 17.0%; NPT = -25.8 ± 22.0%; CON = 0.8 ± 3.0%). There was an increase in TCD4+ cells only in the DUP group (p < 0.05). The training effect generally provided a positive correlation between change in leg press strength (r = 0.393, p < 0.05), triceps pulley strength (r = 0.417, p < 0.05), lat pull-down strength (r = 0.459, p < 0.05), and muscle power (r = 0.324, p < 0.05) with changing CD4 + lymphocyte count. Daily undulating periodization protocol showed to be safe, applicable, and more efficient for increasing strength, aerobic capacity, and TCD4+ cells compared to NPT in PLWHIV.

Isometric handgrip exercise training reduces resting systolic blood pressure but does not interfere with diastolic blood pressure and heart rate variability in hypertensive subjects: a systematic review and meta-analysis of randomized clinical trials.

To evaluate the effects of isometric handgrip exercise training (IHET) on blood pressure and heart rate variability in hypertensive subjects. Five databases were searched for randomized clinical trials in English, Spanish, or Portuguese evaluating the effect of IHET vs. no exercise on blood pressure (systolic and/or diastolic) and/or heart rate variability (low frequency [LF], high frequency [HF], and/or LF/HF ratio) through December 2020. Random-effects meta-analyses of mean differences (MDs) and/or standardized mean differences (SMDs) with 95% confidence intervals (CIs) were performed. Five trials were selected (n = 324 hypertensive subjects), whose durations ranged from 8 to 10 weeks. Compared to no exercise, IHET reduced systolic blood pressure (MD -8.11 mmHg, 95% CI -11.7 to -4.53, p < 0.001) but did not affect diastolic blood pressure (MD -2.75 mmHg, 95% CI -9.47-3.96, p = 0.42), LF (SMD -0.14, 95% CI -0.65-0.37, p = 0.59), HF (SMD 0.38, 95% CI -0.14-0.89, p = 0.15), or the LF/HF ratio (SMD -0.22, 95% CI -0.95-0.52, p = 0.57). IHET performed for 8-10 weeks had a positive effect on resting systolic blood pressure but did not interfere with diastolic blood pressure or heart rate variability in hypertensive subjects. These data should be interpreted with caution since all volunteers included in the studies were clinically medicated and their blood pressure was controlled.

Influence of sleep quality on medical students' academic performance / Influência da qualidade do sono no desempenho acadêmico de estudantes de medicina

Objective: To identify the main factors affecting medical stu- dents' sleep quality and the probable relationship between sleep and academic performance throughout the course. Methods: A cross-sectional qualitative study was carried out at a private higher education institution in the city of Araguari (MG), Brazil. The sample consisted of 110 regularly enrolled medical students. A sociodemographic questionnaire and the Pittsburgh Sleep Quality Index Questionnaire were applied. Statistical analy- sis was performed using the one way analysis of variance test with the post-hoc Tukey test, two way analysis of variance Test, and Student's t-test. Results: Out of the 105 students analyzed, 19.04% (n=20) were classified as "good" sleepers and 80.95% (n=85) as "poor" sleepers. No statistically significant difference was observed between the Pittsburgh Sleep Quality Index Questionnaire scores and the students' grades averages or the students' academic terms. Conclusion: The majority of the students was classified as "poor" sleepers. The use of ener- getic substances and the female sex were the two significant factors that may affect sleep quality. There was no relationship between sleep quality and academic performance.

Objetivo: Identificar os principais fatores que afetam a qualidade do sono de acadêmicos de medicina e a provável relação entre o sono e o desempenho escolar ao longo do curso. Métodos: Estudo transversal de cunho qualiquantitativo realizado em uma institui- ção privada de ensino superior da cidade de Araguari (MG). A amostra foi constituída de 110 acadêmicos do curso de medi- cina regularmente matriculados. Aplicaram-se um questioná- rio sociodemográfico e o Questionário Índice de Qualidade de Sono de Pittsburgh. A análise estatística foi realizada pelo teste de análise de variância one way com post-hoc de Tukey, teste de análise de variância two way e teste t Student. Resultados: Dos 105 estudantes analisados, 19,05% (n=20) foram classificados como bons dormidores e 80,95% (n=85) como maus dormidores. Não houve diferença significativa entre o escore do Questioná- rio Índice de Qualidade de Sono de Pittsburgh e as médias de notas semestrais, tampouco entre o escore do questionário e os períodos letivos. Conclusão: A maioria dos acadêmicos foi clas- sificada como maus dormidores. Uso de substâncias energéticas e sexo feminino foram os fatores significativos que podem afetar a qualidade do sono. Não houve relação entre a qualidade do sono e o desempenho acadêmico.

Effects of Exercise Training and Statin Use in People Living with Human Immunodeficiency Virus with Dyslipidemia.

PURPOSE: To evaluate the effects of the combination of exercise training (ET) and statins in people living with human immunodeficiency virus. METHODS: This was a randomized, double-blind, placebo-controlled clinical trial. Eighty-three people living with human immunodeficiency virus were assigned to either placebo (PL), statins (STA), PL + ET (PLET) or STA + ET (STAET) groups. Volunteers assigned to STA and STAET groups were administered 10 mg of rosuvastatin, whereas the PL and PLET groups were administered a placebo. The PLET and STAET groups performed ET three times a week. Before and after the 12-wk follow-up, the volunteers underwent to anthropometric assessment and blood collection to evaluate lipid profile, cardiovascular markers, inflammatory profile; a Doppler ultrasound examination, muscle strength (MS) and cardiorespiratory fitness (CF) tests were performed. RESULTS: There was a decrease in total cholesterol, triglycerides, low-density lipoprotein, C-reactive protein, fibrinogen, interleukin (IL)-1ß and right carotid intima-media thickness in the STA, PLET, and STAET groups compared with PL group (P < 0.001). Furthermore, there was a decrease in total cholesterol, triglycerides, low-density lipoprotein, IL-1ß, IL-6, and IL-8 levels and in left and right carotid intima-media thickness and an increase in HDL-c levels in the STAET groups compared with the STA (P ≤ 0.001) and PLET groups (P ≤ 0.001). There was an increase in IL-10 levels, peak-systolic velocity, end-diastolic velocity, wall shear rate in the PLET and STAET groups compared with the PL (P ≤ 0.001) and STA groups (P ≤ 0.001). The PLET and STAET groups reduced body fat mass, body fat percentage and increased lean body mass, MS and CF compared with PL (P ≤ 0.001) and STA (P ≤ 0.001) groups. CONCLUSIONS: The combination of ET and statins is useful to enhance lipid and inflammatory profiles, reduce cardiovascular disease markers, and improve Doppler ultrasound findings, MS and CF in people living with HIV.

Using the medicine ball throw test to predict upper limb muscle power: validity evidence / Teste do arremesso de bola medicinal para predizer potência muscular de membros superiores: evidências de validade

Abstract Muscle power is the product of muscle force and velocity, which translates into the ability to produce force in a short time interval. Periodic evaluations of strength and power, coupled with training strategies for these capacities, are of great value to athletes and multi-sports coaches, since they are key determinants for team success. Specifically, in rugby, where passing is a predominant and determinant element of sporting success, few field tests are available for assessing upper limb muscle power. The purpose of this point of view is to correct the upper limb power prediction equation previously published by our group and to highlight its concepts and applicability in sports, especially in rugby.

Resumo Potência muscular é o produto entre força e velocidade, que se traduz na capacidade de produzir força em um curto intervalo de tempo. Avaliações periódicas de força e potência, combinadas a estratégias de treinamento para essas capacidades, são de grande valor para atletas e treinadores multi-esportivos, pois são determinantes para o sucesso da equipe. Especificamente no rugby, onde o passe é elemento predominante e determinante do sucesso esportivo, poucos testes de campo estão disponíveis para avaliar força muscular de membro superior. O objetivo deste ponto de vista é corrigir a equação de predição de potência do membro superior previamente publicada pelo nosso grupo e destacar seus conceitos e aplicabilidade nos esportes, especialmente no rugby.

Influence of sleep quality on academic performance of medical students / Influência da qualidade do sono no desempenho acadêmico de estudantes de medicina

Objective: To know the prevalence of "poor" sleepers among medical students, to identify the main factors affecting sleep quality in this population, and the probable relationship between sleep and academic performance throughout the course. Methods: This is a cross-sectional qualitative and quantitative study carried out at a higher education private institution in the city of Araguari (MG) Brazil. The sample consisted of 110 medical students. A sociodemographic questionnaire and the Pittsburgh Sleep Quality Index were applied. Statistical analysis was performed using ANOVA one-way test with the post-hoc Tukey test, two-way ANOVA test and Student's t test. Results: Of the 105 students analyzed, 19.05% (n=20) were classified as "good" sleepers, and 80.95% (n=85) as poor sleepers. No statistically significant difference was observed between the Pittsburgh Sleep Quality Index scores and the students' grade averages or the students' academic terms. Conclusion: The majority of the students was classified as poor sleepers. The consumption of energetic substances and the female sex were the two significant factors that could affect sleep quality. There was no relationship between sleep quality and academic performance.

Objetivo: Conhecer a prevalência de maus dormidores, identificar os principais fatores que afetam a qualidade do sono dessa população e a provável relação entre o sono e o desempenho escolar ao longo do curso de medicina. Métodos: Estudo transversal de cunho qualiquantitativo, realizado em uma instituição privada de Ensino Superior da cidade de Araguari (MG). A amostra foi constituída de 110 acadêmicos do curso de medicina regularmente matriculados. Aplicaram-se um questionário sociodemográfico e o Índice de Qualidade do Sono de Pittsburgh. A análise estatística foi realizada pelo ANOVA one-way com post-hoc de Tukey, teste ANOVA two-way e teste t de Student. Resultados: Dos 105 estudantes analisados, 19,05% (n=20) foram classificados como bons dormidores e 80,95% (n=85) como maus dormidores. Não houve diferença significativa entre o escore do Índice de Qualidade do Sono de Pittsburgh e as médias de notas semestrais, tampouco entre o escore do Índice de Qualidade do Sono de Pittsburgh e os períodos letivos. Conclusão: A maioria dos acadêmicos foi classificada como maus dormidores. O uso de substâncias energéticas e o sexo feminino foram os fatores significativos que podem afetar a qualidade do sono. Não houve relação entre a qualidade do sono e o desempenho acadêmico.

Respostas cardiovasculares ao treino resistido com diferentes níveis de oclusão vascular / Cardiovascular responses to resistance training with different vascular oclusion levels

: O treino com oclusão vascular (OV) tem sido amplamente utilizado devido a seus benefícios. No entanto, ainda permanecem escassos os estudos em relação às respostas cardiovasculares a este tipo de treino. O objetivo deste estudo foi verificar as respostas hemodinâmicas e trabalho do miocárdio com diferentes níveis de oclusão vascular no exercício de extensão unilateral de joelho. Recrutamos 14 voluntários e estes foram submetidos a um protocolo de três séries de 15 repetições com 30% de uma repetição máxima no exercício de extensão unilateral de joelho com diferentes níveis de OV, sendo eles: sem oclusão (SO), oclusão parcial (OP) e oclusão total (OT). A pressão arterial sistólica (PAS) e frequência cardíaca (FC) foram verificadas em repouso e ao final de cada série do protocolo. A análise de variância de duas entradas com post hoc de Bonferroni foi utilizado para verificar diferença entre os tipos de oclusão, tendo nível de significância quando p<0.05. Observou-se diferença da PAS, FC e duploproduto (DP) entre as séries e o repouso (p<0,001). Independentemente do tipo de execução, a PAS, FC e DP foram maiores na 2ª e 3ª séries comparadas à 1ª. A OP e OT proporcionaram maiores valores de PAS na 3ª série comparada à 2ª série (p= 0,036; p=0,025). Por fim, houve diferença na 3ª série entre a OT e SO (p= 0,01). O presente estudo conclui que a sobrecarga cardiovascular tem relação direta com o volume de exercício e o nível de oclusão....(AU)

Vascular occlusion (VO) training has been widely used because of its benefits. However, there are still few studies regarding cardiovascular responses to this type of training. The objective of this study was to verify hemodynamics responses and myocardial workload with different occlusion levels on unilateral knee extension exercise. We recruited 14 volunteers and were submitted to a protocol of three series of 15 repetitions with 30% of a maximal repetition in the exercise of with different levels of OV, being: no occlusion (NO), partial occlusion (PO) and total occlusion (TO). Systolic blood pressure (SBP) and heart rate (HR) were checked at rest and at the end of each protocol series. Bonferroni post hoc twoway analysis of variance was used to verify the difference between occlusion types, with significance level when p <0.05. A difference of SBP, HR and double-product (DP) between series and rest was observed (p<0.001). Regardless of the type of execution, SBP, HR and DP were higher in the 2nd and 3rd grades compared to the 1st. The PO and TO provided higher SBP values in the 3rd grade compared to the 2nd grade (p = 0.036, p = 0.025). Finally, there was a difference in the 3rd grade between TO and NO (p =0.01). It's concluded that the cardiovascular overload has direct relation with exercise volume and occlusion level....(AU)

Comportamento sedentário em adolescentes: prevalência e fatores associados / Sedentary behavior in adolescents: prevalence and associated factors

Este estudo objetivou determinar a prevalência do comportamento sedentário (CS) e analisar os fatores sociodemográfi cos, comportamentais, de hábitos alimentares e de saúde associados em adolescentes. Este é um estudo transversal de base populacional escolar com participação de 1.009 adolescentes (55,0% do sexo feminino) de 14 a 19 anos das escolas públicas e privadas do município de Uberaba, Minas Gerais, Brasil. O CS foi estimado pelo tempo sedentário de tela (assistir TV + jogar videogame + uso de computador) ≥ 2 h/dia. Empregou-se a regressão logística hierárquica para analisar os fatores sociodemográfi cos (sexo, idade, situação de estágio/trabalho, renda familiar, turno e série de estudo), comportamentais e de hábitos alimentares (atividade física no lazer, participação nas aulas de Educação Física, consumo de frutas, frituras e refrigerantes) e de saúde (IMC, autopercepção do sono e da saúde) associados ao CS. A prevalência do CS foi de 81,6% (IC95%: 78,8 - 84,4) sendo maior entre o sexo masculino (84,9%; IC95%: 82,6 - 87,2) do que no feminino (78,6%; IC95%: 75,9 - 81,3, p = 0,018). Na análise ajustada, apresentaram maiores chances de CS: o sexo masculino (OR = 1,78; IC95%: 1,23 - 2,56), aqueles do 1º ano (OR = 1,89; IC95%: 1,22 -2,94) e 2º ano de estudo (OR = 1,97; IC95%: 1,22 -3,17), não ter vínculo de estágio/trabalho (OR = 2,23; IC95%: 1,54 -3,23) e menor consumo de frutas (OR = 1,43; IC95%: 1,01 - 2,14). A prevalência do CS foi alta e o sexo, a série de estudo, a situação de estágio/trabalho e o hábito alimentar foram fatores associados. Os adolescentes aqui identificados com maiores chances de apresentarem CS representam potenciais grupos para intervenções que objetivem a redução do entretenimento sedentário baseado em tela, seja em casa, na escola e no ambiente de estágio/trabalho....(AU)

The purpose of this study was to determine the prevalence of sedentary behavior (SB) and to analyze the sociodemographic, behavioral, eating habits and health associated factors in adolescents. This is a cross-sectional population-based study involving 1,009 adolescents (55.0% females) aged 14 to 19 from public and private schools in Uberaba, Minas Gerais, Brazil. SB was estimated by sedentary screen time (watch TV + play videogame + computer use) ≥ 2 h/day. The hierarchical logistic regression was used to analyze sociodemographic factors (sex, age, internship/work status, family income, shifts and study series), behavioral and eating habits (physical activity in leisure, participation in Physical Education classes, consumption of fruits, fried foods and soft drinks) and health (BMI, self-perception of sleep and health) associated with SB. The prevalence of SB was 81.6% (95%CI: 78.8 - 84.4), higher among males (84.9%; 95%CI: 82.6 - 87.2) than females (78.6%, 95% CI: 75.9-81.3, p = 0.018). Adjusted regression analyses showed SB higher to male (OR = 1.78, 95%CI: 1.23 - 2.56), in the 1st class (OR = 1.89, 95% CI: 1.22 - (OR = 1.97, 95% CI: 1.22 -3.17), not have internship/work (OR = 2.23, 95%CI: 1.54 -3.23) and lower fruit intake (OR = 1.43, 95% CI: 1.01 - 2.14). The prevalence of SB was high. The sex, study series, internship/ work status and eating habits were associated factors. The adolescents here identifi ed as being more likely to SB represent potential groups for interventions that aim to reduce screen-based sedentary entertainment, whether at home, at school or in the work / internship environment....(AU)

Cardiovascular complications of HIV / Complicações cardiovasculares do HIV

With the advent of the antiretroviral therapy (ART), people infected with HIV are experiencing a significant increase in life expectancy. However, as this population ages, the morbidity and mortality due to events not related to HIV infection and/or treatment become increasingly clear. Cardiovascular diseases are among the major causes of death, and, thus, understanding the factors that trigger this situation is necessary. This review article will assess how the intrinsic and extrinsic factors related to HIV, ART and the associated risk factors can aid the epidemiological transition of mortality in this population. Moreover, we will present the studies on the epidemiology and pathogenesis of each clinical condition related to HIV-infected individuals, in addition to introducing the major markers of cardiovascular disease in this population. Finally, we will point the main issues to be addressed by health professionals for an adequate prognosis

High-density lipoprotein-cholesterol functionality and metabolic syndrome: Protocol for review and meta-analysis.

INTRODUCTION: The prevalence of metabolic syndrome (MetS) and MetS-related stroke is set to increase dramatically in coming decades. MetS is a complex disease that includes endothelial dysfunction, insulin resistance, diabetes, hypertension, ectopic obesity, and dyslipidaemia and an increased risk of cardiovascular events. One function of high-density lipoprotein (HDL) cholesterol (HDL-C) is the cholesterol-efflux pathway, which is the pathway where cholesterol is removed from macrophages within the arterial walls back into the bloodstream and out to the liver. As one of the key functions of HDL, their hypothesis was that if they could measure HDL-C-efflux capacity, they would have a better handle on the role of HDL in atherosclerosis. However, there are no systematic analyses or well-conducted meta-analyses to evaluate the relationship between HDL-C functionality and MetS. The aim of this study is to examine this association of HDL-C functionality with MetS in different ages and sex. METHODS AND ANALYSIS: The update systematic review and meta-analysis will be conducted using published studies that will be identified from electronic databases (i.e., PubMed, EMBASE, Web of Science, and Google Scholar). Studies that examined the association between HDL-C functionality and MetS; focused on cohort, case-control, and cross-sectional studies; were conducted among in adults aged 40 to 70 years; provided sufficient data for calculating odds ratio or relative risk with a 95% confidence interval; were published as original articles written in English or other languages; and have been published until January 2018 will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted based on discussions among investigators. ETHICS AND DISSEMINATION: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. TRIAL REGISTRATION NUMBER: PROSPERO (CRD42018083465).

High-density lipoprotein-cholesterol functionality and metabolic syndrome: Protocol for review and meta-analysis

INTRODUCTION: The prevalence of metabolic syndrome (MetS) and MetS-related stroke is set to increase dramatically in coming decades. MetS is a complex disease that includes endothelial dysfunction, insulin resistance, diabetes, hypertension, ectopic obesity, and dyslipidaemia and an increased risk of cardiovascular events. One function of high-density lipoprotein (HDL) cholesterol (HDL-C) is the cholesterol-efflux pathway, which is the pathway where cholesterol is removed from macrophages within the arterial walls back into the bloodstream and out to the liver. As one of the key functions of HDL, their hypothesis was that if they could measure HDL-C-efflux capacity, they would have a better handle on the role of HDL in atherosclerosis. However, there are no systematic analyses or well-conducted meta-analyses to evaluate the relationship between HDL-C functionality and MetS. The aim of this study is to examine this association of HDL-C functionality with MetS in different ages and sex. METHODS AND ANALYSIS: The update systematic review and meta-analysis will be conducted using published studies that will be identified from electronic databases (i.e., PubMed, EMBASE, Web of Science, and Google Scholar). Studies that examined the association between HDL-C functionality and MetS; focused on cohort, case-control, and cross-sectional studies; were conducted among in adults aged 40 to 70 years; provided sufficient data for calculating odds ratio or relative risk with a 95% confidence interval; were published as original articles written in English or other languages; and have been published until January 2018 will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted based on discussions among investigators.

Triad of the Ischemic Cardiovascular Disease in People Living with HIV? Association Between Risk Factors, HIV Infection, and Use of Antiretroviral Therapy.

PURPOSE OF REVIEW: This review is focused on cardiovascular risk factors in HIV-infected people. RECENT FINDINGS: Antiretroviral therapy (ART) has significantly increased the life expectancy of HIV-infected people. Thus, this population has experienced non-HIV-related diseases, mainly cardiovascular diseases. Thus, in our review, we intend to understand the cardiovascular risk factors that trigger this situation. We have demonstrated that both ART and traditional cardiovascular risk factors contribute to the development of cardiovascular disease in HIV-infected people. Thus, it becomes important to stratify the risk factors to reduce this scenario.

Statins in adult patients with HIV: Protocol for a systematic review and network meta-analysis.

BACKGROUND: Patients with HIV have been found to suffer from lipid abnormalities, including elevated levels of total and LDL-cholesterol as well as triglyceride levels. Abnormal lipid levels are associated with an increased risk of developing cardiovascular diseases, which are significant causes of mortality among the general population. Therefore, the objective of the current study is to conduct a systematic review with network meta-analysis to compare the effects of statins classes on HIV patients. METHODS: Randomized clinical trials (RCTs) and observational studies published in English up to 31 December 2017, and which include direct and/or indirect evidence, will be included. Studies will be retrieved by searching four electronic databases and cross-referencing. Dual selection and abstraction of data will occur. The primary outcome will all-cause mortality, new event of acute myocardial infarction, stroke (hemorrhagic and ischemic), hospitalization for acute coronary syndrome and urgent revascularization procedures and cardiovascular mortality. Secondary outcomes will be assessment of the differences in change of total cholesterol (TC), low-density lipoprotein (LDL-C), apolipoprotein B (ApoB), high density lipoprotein (HDL-C). Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument for RCTs and the Strengthening the Reporting of Observational Studies in Epidemiology instrument for observational studies. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of statins that reduce cardiovascular mortality in HIV patients. A revised version of the Cochrane Risk of Bias tool (RoB 2.0) will be used to assess the risk of bias in eligible RCTs. Results will be synthesized and analyzed using network meta-analysis (NMA). Overall strength of the evidence and publication bias will be evaluated. Subgroup and sensitivity analysis will also be performed. RESULTS AND CONCLUSION: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. The evidence will determine which combination of interventions are most promising for current practice and further investigation. TRIAL REGISTRATION NUMBER: PROSPERO (CRD42017072996).

Epicardial adipose tissue and carotid artery disease: Protocol for systematic review and meta-analysis.

BACKGROUND: Atherosclerosis is now widely recognized as a multifactorial disease with outcomes that arise from complex factors such as plaque components, blood flow, and inflammation. Epicardial adipose tissue (EAT) is a metabolically active fat depot, abundant in proinflammatory cytokines, and has been correlated with the extent and severity of carotid artery disease (CD). The locations most frequently affected by carotid atherosclerosis are the proximal internal carotid artery (ie, the origin) and the common carotid artery bifurcation. Progression of atheromatous plaque at the carotid bifurcation results in luminal narrowing, often accompanied by ulceration. However, there are no systematic analyses or well-conducted meta-analyses to evaluate the relationship between EAT and CD. The aim of this study is to examine this association of EAT with CD in different ages and sex. METHODS: This systematic review and meta-analysis will be conducted using published studies that will be identified from electronic databases (ie, PubMed, EMBASE, Web of Science, and Google Scholar. Studies that (1) examined the association between EAT and CD, (2) focus on cohort, case-control and cross-sectional studies, (3) will conducted among in adults aged 40 to 70 years, (4) provided sufficient data for calculating ORs or relative risk with a 95% CI, (5) will published as original articles written in English or other languages, and (6) have been published until January 2018 will be included. Study selection, data collection, quality assessment and statistical syntheses will be conducted based on discussions among investigators. RESULTS: We propose the current protocol to evaluate the evaluation of EAT with ED. CONCLUSION: This systematic review will not need ethical approval, because it does not involve human beings. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. ETHICS AND DISSEMINATION: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. TRIAL REGISTRATION NUMBER: PROSPERO (CRD42018083458).

Epicardial adipose tissue and metabolic syndrome: An update protocol for systematic review and meta-analysis.

BACKGROUND: The prevalence of metabolic syndrome (MetS) and MetS-related stroke is set to increase dramatically in coming decades. MetS is a complex disease that includes endothelial dysfunction, insulin resistance, diabetes, hypertension, ectopic obesity, and dyslipidaemia, and an increased risk of cardiovascular events. However, there are no systematic analyses, or well-conducted meta-analyses to evaluate the relationship between epicardial adipose tissue (EAT) and (MetS). The aim of this study is to examine this association of EAT with MetS in different ages and sex. METHODS: The update systematic review, and meta-analysis will be conducted using published studies that will be identified from electronic databases (ie, PubMed, EMBASE, Web of Science, and Google Scholar. Studies that firstly, examined the association between EAT and MetS, secondly, focus on cohort, case-control, and cross-sectional studies, thirdly, were conducted among in adults aged between 40 and 70 years, fourth, provided sufficient data for calculating ORs or relative risk with a 95% CI, fifth, were published as original articles written in English or other languages, and sixth, have been published until January year 2018 will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted based on discussions among investigators. RESULTS: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. This study will provide a high quality synthesis on the association of EAT and MetS. CONCLUSION: This systematic review will provide evidence to assess whether there is a strong association of EAT and MetS, and its components.

Metabolic syndrome and risk of stroke: Protocol for an update systematic review and meta-analysis.

INTRODUCTION: The metabolic syndrome is composed of several cardiovascular risk factors and has a high prevalence throughout the world. However, there are no systematic analyses or well-conducted meta-analyses to evaluate the relationship between metabolic syndrome and stroke. The aim of this study is to examine this association of metabolic syndrome with stroke in different ages and sex. METHODS AND ANALYSIS: The update systematic review and meta-analysis will be conducted using published studies that will be identified from electronic databases (i.e., PubMed, EMBASE, Web of Science, and Google Scholar. Studies that examined the association between metabolic syndrome and stroke, had a longitudinal or prospective cohort design, were conducted among in adults aged 40 to 70 years, provided sufficient data for calculating ORs or relative risk with a 95% CI, were published as original articles written in English or other languages, and have been published until December 2017 will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted based on discussions among investigators. ETHICS AND DISSEMINATION: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. The findings from this study could be useful for assessing metabolic syndrome risk factors in stroke, and determining approaches for prevention of stroke in the future.

Epicardial adipose tissue and metabolic syndrome An update protocol for systematic review and meta-analysis

BACKGROUND: The prevalence of metabolic syndrome (MetS) and MetS-related stroke is set to increase dramatically in coming decades. MetS is a complex disease that includes endothelial dysfunction, insulin resistance, diabetes, hypertension, ectopic obesity, and dyslipidaemia, and an increased risk of cardiovascular events. However, there are no systematic analyses, or well conducted meta-analyses to evaluate the relationship between epicardial adipose tissue (EAT) and (MetS). The aim of this study is to examine this association of EAT with MetS in different ages and sex. METHODS: The update systematic review, and meta-analysis will be conducted using published studies that will be identified from electronic databases (ie, PubMed, EMBASE, Web of Science, and Google Scholar. Studies that firstly, examined the association between EAT and MetS, secondly, focus on cohort, case-control, and cross-sectional studies, thirdly, were conducted among in adults aged between 40 and 70 years, fourth, provided sufficient data for calculating ORs or relative risk with a 95% CI, fifth, were published as original articles written in English or other languages, and sixth, have been published until January year 2018 will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted based on discussions among investigators. RESULTS: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. This study will provide a high quality synthesis on the association of EAT and MetS. CONCLUSION: This systematic review will provide evidence to assess whether there is a strong association of EAT and MetS, and its components.

Statins in adult patients with HIV Protocol for a systematic review and network meta-analysis

BACKGROUND: Patients with HIV have been found to suffer from lipid abnormalities, including elevated levels of total and LDL cholesterol as well as triglyceride levels. Abnormal lipid levels are associated with an increased risk of developing cardiovascular diseases, which are significant causes of mortality among the general population. Therefore, the objective of the current study is to conduct a systematic review with network meta-analysis to compare the effects of statins classes on HIV patients. METHODS: Randomized clinical trials (RCTs) and observational studies published in English up to 31 December 2017, and which include direct and/or indirect evidence, will be included. Studies will be retrieved by searching four electronic databases and cross referencing. Dual selection and abstraction of data will occur. The primary outcome will all-cause mortality, new event of acute myocardial infarction, stroke (hemorrhagic and ischemic), hospitalization for acute coronary syndrome and urgent revascularization procedures and cardiovascular mortality. Secondary outcomes will be assessment of the differences in change of total cholesterol (TC), low-density lipoprotein (LDL-C), apolipoprotein B (ApoB), high density lipoprotein (HDL-C). Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument for RCTs and the Strengthening the Reporting of Observational Studies in Epidemiology instrument for observational studies. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of statins that reduce cardiovascular mortality in HIV patients. A revised version of the Cochrane Risk of Bias tool (RoB 2.0) will be used to assess the risk of bias in eligible RCTs. Results will be synthesized and analyzed using network meta-analysis (NMA). Overall strength of the evidence and publication bias will be evaluated. Subgroup and sensitivity analysis will also be performed. RESULTS AND CONCLUSION: Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. The evidence will determine which combination of interventions are most promising for current practice and further investigation.