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Introduction: Understanding the epidemiology and cost implications of acute bacterial meningitis is crucial for effective health planning, timely treatment implementation, and comprehensive patient support measures, as well as for determining appropriate hospital expenses. Therefore, we conducted an analysis of hospitalization cases for bacterial meningitis in Brazil from January 2008 to December 2019. Methods: This is a descriptive ecological study that utilized the Hospital Information System of Brazil's National Unified Health System (SIH/SUS) database. The variables included sex, region, age group, hospitalizations, deaths, lethality rate, and hospital service expenses. The data were tabulated to focus specifically on the epidemiological aspect of bacterial meningitis. Results: During the study period, there were 20,207 hospitalizations for bacterial meningitis in Brazil. Men accounted for a higher number of cases, with 11,690 (57.67%), while women had a higher lethality rate of 10.64%. The Southeast region had the highest percentage of both hospitalizations (45.78%) and deaths (46.42%). Bacterial meningitis remains an important cause of morbidity and mortality, particularly in children under 5 years of age. Notably, the elderly and the Northeast region showed higher rates of lethality. The total expenditure on hospital services exceeded 43 million in Brazilian real, with the highest expenditure observed in 2019 and the lowest in 2011. Conclusion: A higher prevalence of the disease was observed in males, in children under 1-year-old and in the southeast region. Hospital expenditures were found to be substantial and increasing over time, underscoring the significance of early diagnosis and the promotion of vaccination campaigns.
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As the older population grows, there is an increasing interest in understanding how physical exercise can counteract the changes seen with aging. The benefits of exercise to general health, and especially to the cardiovascular system, have been a topic of discussion for decades. However, there is still a need to elucidate the effects of training programs on the cerebrovascular blood velocity in older people. This systematic review and meta-analysis aimed to investigate the effect of physical exercise on the cerebral blood velocity in older people (PROSPERO CRD42019136305). A search was performed on PubMed, Web of Science, EBSCO, ScienceDirect, and Scopus from the inception of this study to October 2023, retrieving 493 results, of which 26 were included, analyzing more than 1000 participants. An overall moderate risk of bias was found for the studies using the Cochrane risk-of-bias tools for randomized and non-randomized clinical trials. The pooled results of randomized trials showed that older people who underwent physical exercise presented a statistically significant increase in cerebral blood velocity (3.58; 95%CI = 0.51, 6.65; p = 0.02). This result indicates that physical exercise is important to help maintain cerebral health in older adults.
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This crossover study explored the acute effect of a session of high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) on middle cerebral artery (MCA) variables such as cerebral blood velocity, pulsatility index (PI) and resistivity index (RI) through transcranial Doppler (TCD), and cognitive function (CF - verbal fluency and Digit Span) in healthy young adults. Participants (26 healthy young adults, 13 women, 24 ± 3 years) underwent two different randomized exercise sessions: (1) MICT (60 % heart rate reserve, HRR) and (2) HIIT (80 % HRR). MCA velocity, PI, RI, CF, and serum lactate were measured immediately before and after the sessions. HIIT demonstrated improved executive function/semantic fluency (20 %, p = 0.019), while both MICT and HIIT increased lactate (625 %, HIIT, p < 0.001, and 238 %, MICT, p < 0.001). Other assessments remained stable, except for reduced PI (p = 0.029) and RI (p = 0.023) after MICT, with no significant difference (pre-post for HIIT-MICT). Notably, cognition improvement correlated with lactate increase in HIIT (ρ = 0.436; p < 0.001). Executive function/semantic fluency increased after HIIT relative to MICT. The findings show that there are no systematic out-of-normal changes in the cerebrovascular circulation of clinically healthy adults undergoing HIIT and MICT.
