Acute hemodynamic responses from low-load resistance exercise with blood flow restriction in young and older individuals: A systematic review and meta-analysis of cross-over trials.

OBJECTIVE: To summarize the existing evidence on the acute response of low-load (LL) resistance exercise (RE) with blood flow restriction (BFR) on hemodynamic parameters. DATA SOURCES: MEDLINE (via PubMed), EMBASE (via Scopus), SPORTDiscus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science and MedRxiv databases were searched from inception to February 2022. REVIEW METHODS: Cross-over trials investigating the acute effect of LLRE + BFR versus passive (no exercise) and active control methods (LLRE or HLRE) on heart rate (HR), systolic (SBP), diastolic (DBP) and mean (MBP) blood pressure responses. RESULTS: The quality of the studies was assessed using the PEDro scale, risk of bias using the RoB 2.0 tool for cross-over trials and certainty of the evidence using the GRADE method. A total of 15 randomized cross-over studies with 466 participants were eligible for analyses. Our data showed that LLRE + BFR increases all hemodynamic parameters compared to passive control, but not compared to conventional resistance exercise. Subgroup analysis did not demonstrate any differences between LLRE + BFR and low- (LL) or high-load (HL) resistance exercise protocols. Studies including younger volunteers presented higher chronotropic responses (HR) than those with older volunteers. CONCLUSIONS: Despite causing notable hemodynamic responses compared to no exercise, the short-term LL resistance exercise with BFR modulates all hemodynamic parameters HR, SBP, DBP and MBP, similarly to a conventional resistance exercise protocol, whether at low or high-intensity. The chronotropic response is slightly higher in younger healthy individuals despite the similarity regarding pressure parameters.

Frequência de esfregaços cérvico-vaginais anormais em adolescentes e adultas: revisão de 308.630 casos / Frequency of abnormal uterine cervix smears from adolescents and adult women: review of 308.630 cases

No presente trabalho, estudamos a frequência de achados de esfregaços anormais pelo exame de Papanicolaou nas populações de adolescentes (idade <=21 anos)e adulta (>21 anos) atendidas pelo Setor de Citologia do Instituto Adolfo Lutz-Programa de Prevenção do Câncer de Colo Uterino nos últimos seis anos (1996 a 2001). Verificamos que a frequência destes achados vem aumentando gradativamente em ambas as populações, sendo sempre mais alta nas adolescentes (1,7 por cento, 2,3 por cento, 1,8 por cento, 1,3 por cento, 2,6 por cento e 4,2 por cento respectivamente). Nas mulheres adultas, as lesões também sobreram progressivo aumento com o passar dos anos, com ocorrência de 1,2 por cento, 1,3 por cento, 1,0 por cento, 0,9 por cento, 1,6 por cento e 2,5 por cento respectivamente. A análise estatística mostrou uma tendência linear de aumento de frequência de exames anormais em ambos os grupos sendo maior nas adolescentes. Acrescendo os dados dos quatro anos precedentes (1992 a 1995) de estudo similar, publicado anteriormente, envolvendo o mesmo tipo de populações, as diferenças foram ainda mais notáveis com relação aos anos posteriores: de 1992 a 1995, a frequência de lesões na população de adolescentes foi de 0,45 por cento, 0,95 por cento, 1,12 por cento e 2,10 por cento, e na população de adultas, 0,44 por cento, 0,72 por cento, 0,87 por cento e 1,18 por cento respectivamente. Uma vez que a progressão das lesões para câncer cervical se dá em um período médio de dez anos, é de grande importância que a população mais jovem, sexualmente ativa, também seja monitorada pelos Programas de Prevenção de Câncer do Colo Uterino. (AU)

The aim of the present study was to ascertain the frequency of abnormal PAP smears(ASCUS, AGUS, SILs and carcinoma) in two populations that search for the Program of Cervical CancerPrevention of the Public Health Services of São Paulo State (Brazil) in the last six years (1996 to 2001):adolescents (up to the age of 21 years) and adults (over 21 years). The samples were examined at Divisionof Pathology of Adolfo Lutz Institute. The frequency of uterine cervix lesions is increasing constantly inboth populations but mainly in adolescents (1.7%, 2.3%, 1.8%, 1.3% 2.6% and 4.2% respectively). Theadult women also have showed a progressive increasing of the lesions during the period studied: 1.2%,1.3%, 1.0%, 0.9%,1.6% and 2.5%, respectively. The addition of data of four anterior years (1992 a1995) of a similar study previously published, involving the same type of populations, the differences werestill further notable if compared to the posterior years: from 1992 a 1995, the frequency of lesions in theadolescent population was 0,45%, 0,95%, 1,12% e 2,10%, and in the adult population was 0,44%, 0,72%,0,87% e 1,18%, respectively.Statistical analysis showed a tendency of linear increase in frequency of abnormal PAP smears in bothgroups, being greater in the adolescent group. Since the progression of intraepithelial lesions to invasivecancer may occur in a period of ten years, the younger sexually active population should be monitored byregular programs for uterine cervix cancer detection. (AU)