Stress symptoms occur in patients undergoing chemotherapy treatment independently of the level of physical activity.

The cancer patient is undergoing a set of procedures that affect the physical and psychological balance, which can generate stressful situations in the organism. In turn, physical activity helps to treat stress, promoting well-being and reducing anxiety. Our study aimed to verify the influence of physical activity practice on stress symptoms in patients undergoing oncological chemotherapy treatment. For this, we used Lipp's Inventory of Stress Symptoms (ISSL) and the International Physical Activity Questionnaire (IPAQ) in 56 patients with cancer. Our data show that 45.4% of the participants exhibited stress scores, of which, 21.8% were at near to exhaustion, and 23.6% at exhaustion. We observed that 30% of them are considered sufficiently active, 25% insufficiently active, 45% sedentary. No association was observed between physical activity and stress. These findings indicate that stress symptoms occur in patients undergoing chemotherapy treatment regardless of the level of physical activity.

Healthy lifestyle as predictors of common mental disorder during coronavirus disease.

OBJECTIVE: The objective of the present study was to verify the indication of common mental disorder and changes in healthy lifestyle among individuals affected by coronavirus disease, as well as to evaluate if changes in healthy lifestyle are predictors of common mental disorder. METHODS: This descriptive, cross-sectional study employed an exploratory approach and quantitative methodology, using the Self-Reporting Questionnaire to assess the indication of common mental disorder and questions regarding healthy lifestyle during the pandemic. RESULTS: A total of 280 individuals affected by coronavirus disease, aged 18 years and above, participated in the study. The average indication for common mental disorder was 5.0±5.34. The average age was characterized by adults (41.24±14.03 years), with the majority being women (57.9%), White (51.4%), and those in stable relationships (55.7%). Worsening sleep quality (ß==6.327; p<0.001) was the main predictor of common mental disorder, followed by female gender (ß==2.814; p<0.001) and worsening dietary habits (ß==2.227; p<0.012). CONCLUSION: These factors should be considered in the assessment of individuals affected by coronavirus disease to provide comprehensive care.

Healthy lifestyle as predictors of common mental disorder during coronavirus disease

SUMMARY OBJECTIVE: The objective of the present study was to verify the indication of common mental disorder and changes in healthy lifestyle among individuals affected by coronavirus disease, as well as to evaluate if changes in healthy lifestyle are predictors of common mental disorder. METHODS: This descriptive, cross-sectional study employed an exploratory approach and quantitative methodology, using the Self-Reporting Questionnaire to assess the indication of common mental disorder and questions regarding healthy lifestyle during the pandemic. RESULTS: A total of 280 individuals affected by coronavirus disease, aged 18 years and above, participated in the study. The average indication for common mental disorder was 5.0±5.34. The average age was characterized by adults (41.24±14.03 years), with the majority being women (57.9%), White (51.4%), and those in stable relationships (55.7%). Worsening sleep quality (β==6.327; p<0.001) was the main predictor of common mental disorder, followed by female gender (β==2.814; p<0.001) and worsening dietary habits (β==2.227; p<0.012). CONCLUSION: These factors should be considered in the assessment of individuals affected by coronavirus disease to provide comprehensive care.

Late effects of caffeine use on sleep of infants born prematurely / Efeitos tardios do uso de cafeína no sono de crianças nascidas prematuras

ABSTRACT Objective: This study aimed to evaluate whether the therapeutic use of caffeine for premature newborns is associated with changes in sleep habits and the presence of obstructive sleep apnea in childhood. Methods: This is a cross-sectional single-center study in which the caretakers of 87 children aged 5-10 years, born full-term or preterm, treated or not with caffeine in the neonatal period, answered questionnaires to screen for obstructive sleep apnea (Pediatric Obstructive Sleep Apnea Screening Tool [PosaST]) and to characterize the sleep habits (Children's Sleep Habits Questionnaire [CSHQ]) of their children. ANOVA and linear regression tests were performed to verify possible differences between the groups. Results: Children born prematurely who were treated with caffeine woke up significantly later on weekdays than those born at term (09h±00h58 and 07h43±1h15, respectively, p=0.022) and had longer total daily sleep time also compared to those born at term (10h24±1h08 and 09h29±1h08, respectively, p<0.001). There was no significant difference between the three groups in overall PosaST and CSHQ scores. Conclusions: Caffeine use in the neonatal period did not impair sleep habits later in life and did not lead to increased obstructive sleep apnea scores in prematurely born children compared to those born at term.

RESUMO Objetivo: Avaliar se o uso terapêutico de cafeína para recém-nascidos prematuros se associa a alterações nos hábitos de sono e à presença de apneia obstrutiva do sono na infância. Métodos: Este é um estudo unicêntrico transversal no qual os responsáveis por 87 crianças com idades entre cinco e dez anos, nascidas a termo ou pré-termo e tratadas ou não com cafeína no período neonatal responderam a questionários para triagem de apneia obstrutiva do sono (Pediatric Obstructive Sleep Apnea Screening Tool - PosaST) e para a caracterização dos hábitos de sono (Children's Sleep Habits Questionnaire - CSHQ) de seus filhos. Foram realizados testes de variância (ANOVA) e de regressão linear para verificar possíveis diferenças entre os grupos. Resultados: As crianças nascidas prematuras que foram tratadas com cafeína acordaram significativamente mais tarde nos dias de semana do que as nascidas a termo (09h±00h58 e 07h43±1h15, respectivamente, p=0,022) e tiveram maior tempo total de sono diário também comparadas às nascidas a termo (10h24±1h08 e 09h29±1h08, respectivamente, p<0,001). Não houve diferença significativa entre os três grupos na pontuação geral dos questionários PosaST e CSHQ. Conclusões: O uso de cafeína no período neonatal não prejudicou tardiamente os hábitos de sono e não levou ao aumento dos escores de apneia obstrutiva do sono de crianças nascidas prematuras quando comparadas com crianças nascidas a termo.

Evidence of whole-body vibration exercises on body composition changes in older individuals: a systematic review and meta-analysis.

Introduction: The aging process is associated with changes in body composition, including fat gain and skeletal muscle loss from middle age onward. Moreover, increased risk of functional decline and the development of chronic diseases are also related to aging. Objective: This systematic review and meta-analysis aimed to evaluate the effects of whole-body vibration exercise (WBVE), as a physical exercise, on body composition in people over 60 years of age. Methods: Searches were performed on PubMed, Scopus, Web of Science, and Embase. Only randomized clinical trials evaluating the effects of WBVE on body composition in older individuals were considered. The methodological quality of the studies involved was assessed using the Physiotherapy Evidence Database (PEDro) scale, recommendations from the Cochrane Collaboration were used to assess risk of bias, and quality of evidence was assessed using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology. RevMan 5.4 was used to calculate standardized mean differences and confidence intervals of 95% (CIs). Results: Eight studies were included in this review with a mean methodological quality score of 7.5, which is considered high quality on the PEDro scale. The included studies suggest that more robust research with protocols and well-designed comparison groups is required to better assess changes in the body composition of older individuals through WBVE. Quantitative results were calculated, with differences in weighted means, differences in standardized means, and 95% confidence intervals (CIs). Conclusion: WBVE evaluated by the studies included in this review did not demonstrate improvements in body composition, and no significant effect of WBVE was found on fat mass with standardized differences (SD = -1.92; 95% CI: -4.81 to -0.98; p = 0.19), lean mass with standardized mean differences (SMD = 0.06 CI 95% [-0.21; -0.33]; p = 0.67), or skeletal muscle mass with standardized differences (SD = 0.10; CI 95% [-1.62; 1.83]; p = 0.91). Therefore, to date, there is lack of adequate evidence to state that WBVE can benefit the body composition of men and women over 60 years of age. However, further studies are required to better understand the physiological impacts of WBVE on body composition. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#myprosperoCRD42021248871, identifier CRD42021248871.

Photodynamic inactivation by hypericin-P123 on azole-resistant isolates of the Trichophyton rubrum complex as planktonic cells and biofilm.

INTRODUCTION: The Trichophyton rubrum complex comprises the majority of dermatophyte fungi (DM) responsible for chronic cases of onychomycosis, which is treated with oral or topical antifungals. However, owing to antifungal resistance, alternative therapies, such as photodynamic therapy (PDT), are needed. This study investigated the frequency of the T. rubrum species complex in onychomycosis cases in the northwestern region of Paraná state, Brazil, and evaluated the efficacy of (PDT) using P123-encapsulated hypericin (Hyp-P123) on clinical isolates of T. rubrum in the planktonic cell and biofilm forms. MATERIAL AND METHODS: The frequency of the T. rubrum complex in onychomycosis cases from 2017 to 2021 was evaluated through a data survey of records from the Laboratory of Medical Mycology (LEPAC) of the State University of Maringa (UEM). To determine the effect of PDT-Hyp-P123 on planktonic cells of T. rubrum isolates, 1 × 105 conidia/mL were treated with ten different concentrations of Hyp-P123 and then irradiated with 37.8 J/cm2. Antibiofilm activity of PDT-Hyp-P123 was tested against T. rubrum biofilm in the adhesion phase (3 h), evaluated 72 h after irradiation (37.8 J/cm2), and the mature biofilm (72 h), evaluated immediately after irradiation. In this context, three different parameters were evaluated: cell viability, metabolic activity and total biomass. RESULTS: The T. rubrum species complex was the most frequently isolated DM in onychomycosis cases (approximately 80 %). A significant reduction in fungal growth was observed for 75 % of the clinical isolates tested with a concentration from 0.19 µmol/L Hyp-P123, and 56.25 % had complete inhibition of fungal growth (fungicidal action); while all isolates were azole-resistant. The biofilm of T. rubrum isolates (TR0022 and TR0870) was inactivated in both the adhesion phase and the mature biofilm. CONCLUSION: PDT-Hyp-P123 had antifungal and antibiofilm activity on T. rubrum, which is an important dermatophyte responsible for onychomycosis cases.

An Experimental Approach to Induce Trips in Lower-Limb Amputees.

Reestablishing balance after a trip is challenging for lower-limb amputees and often results in a fall. The effectiveness of reestablishing balance following a trip depends on factors such as amputation level (transtibial or transfemoral) or which limb is tripped (prosthetic or sound/lead or trailing). Understanding the recovery responses can help identify strategies to avoid a trip becoming a fall and what trip-response functionality could be designed into a prosthesis. This study presents an experimental approach for inducing unexpected trips in individuals with amputation. Tripping was manually triggered by activating an electromagnetic device to raisea polypropylene wire to obstruct (bring to a near halt) theswinging limb during its mid-swing phase. A safety harness attached to a ceiling rail ensured participants did not hit the ground if they failed to reestablish balance following the trip (i.e., it prevented a fall from occurring). One transtibial amputee completed repeated walking trials in which a trip was induced around 1 out of 15 times to avoid it being anticipated. 3D kinematics were determined via two smartphones (60Hz) using the OpenCap software, highlighting that the experimental approach induced meaningful tripping/recovery responses dependent on which limb was tripped (prosthetic or sound). The presented methodology avoids using a rigid obstacle, potentially reducing the risk of injuries, and is inexpensive and easy to set up. Importantly it permits a trip to be unexpectedly introduced during the mid-swing phase of the gait and hence provides an approach for identifying real-world trip recovery responses. When tripping the sound limb, participants could 'disentangle' from the trip-wire (post-trip) by plantarflexing the ankle, but such action was not possible when tripping the prosthetic limb.

Use of new recombinant proteins for ovarian stimulation in ruminants.

Currently, gonadotropin products (follicle stimulating hormone, FSH, and luteinizing hormone, LH) used in animal reproduction are produced by extraction and purification from abattoir-derived pituitary glands. This method, relying on animal-derived materials, carries the potential risk of hormone contamination and pathogen transmission. Additionally, chorionic gonadotropins are extracted from the blood of pregnant mares (equine chorionic gonadotropin; eCG) or the urine of pregnant women (human chorionic gonadotropin; hCG). However, recent advancements have introduced recombinant gonadotropins for assisted animal reproduction therapies. The traditional use of FSH for superovulation has limitations, including labor requirements and variability in superovulation response, affecting the success of in vivo (SOV) and in vitro (OPU/IVEP) embryo production. FSH treatment for superstimulation before OPU can promote the growth of a homogenous follicular population and the recovery of competent oocytes suitable for IVEP procedures. At present, a single injection of a preparation of long-acting bovine recombinant FSH (rFSH) produced similar superovulation responses resulting in the production of good-quality in vivo and in vitro embryos. Furthermore, the treatment with eCG at FTAI protocol has demonstrated its efficacy in promoting follicular growth, ovulation, and P/AI, mainly in heifers and anestrous cows. Currently, treatment with recombinant glycoproteins with eCG-like activity (r-eCG) have shown promising results in increasing follicular growth, ovulation, and P/AI in cows submitted to P4/E2 -based protocols. Bovine somatotropin (bST) is a naturally occurring hormone found in cows. Recombinant bovine somatotropin (rbST), produced through genetic engineering techniques, has shown potential in enhancing reproductive outcomes in ruminants. Treatment with rbST has been found to improve P/IA, increase donor embryo production, and enhance P/ET in recipients. The use of recombinant hormones allows to produce non-animal-derived products, offering several advantages in assisted reproductive technologies for ruminants. This advancement opens up new possibilities for improving reproductive efficiency and success rates in the field of animal reproduction.

Encephalopathy Caused by Human Parvovirus B19 Genotype 1 Associated with Haemophilus influenzae Meningitis in a Newborn.

Parvovirus B19 infection is associated with a wide range of clinical manifestations, from asymptomatic to severe neurological disorders. Its major clinical symptoms, fever and rash, are common to multiple viruses, and laboratory tests to detect B19 are frequently not available. Thus, the impact of B19 on public health remains unclear. We report the case of a 38-day old girl admitted to São Paulo Clinical Hospital, Brazil, with an initial diagnosis of bacterial meningitis, seizures, and acute hydrocephalus. Antibiotic therapy was maintained for one week after admission and discontinued after negative laboratory results were obtained. Nine days after symptoms onset, a cerebral spinal fluid (CSF) sample revealed persistent pleocytosis. The complete B19 complete genome was subsequently identified in her CSF by a metagenomic next-generation sequencing approach. This report highlights the possible involvement of B19 in the occurrence of acute neurological manifestations and emphasizes that its possible involvement might be better revealed by the use of metagenomic technology to detect viral agents in clinical situations of unknown or uncertain etiology.

What We Know about Euterpe Genus and Neuroprotection: A Scoping Review.

The Euterpe genus (mainly Euterpe oleracea Martius, Euterpe precatoria Martius, and Euterpe edulis Martius) has recently gained commercial and scientific notoriety due to the high nutritional value of its fruits, which are rich in polyphenols (phenolic acids and anthocyanins) and have potent antioxidant activity. These characteristics have contributed to the increased number of neuropharmacological evaluations of the three species over the last 10 years, especially açaí of the species Euterpe oleracea Martius. The fruits of the three species exert neuroprotective effects through the modulation of inflammatory and oxidative pathways and other mechanisms, including the inhibition of the mTOR pathway and protection of the blood-brain barrier, all of them intimately involved in several neuropathologies. Thus, a better understanding of the neuropharmacological properties of these three species may open new paths for the development of therapeutic tools aimed at preventing and treating a variety of neurological conditions.

Successful nonsurgical treatment of type II dens invaginatus with 5 root canals using a self-adjusting file: a case report.

The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.

Chest physiotherapy techniques administered by certified specialists to hospitalized patients with COVID-19 in Brazil: A look towards future practice.

BACKGROUND: Chest physiotherapy for hospitalized patients with COVID-19 has been poorly reported. Although recommendations were published to guide physiotherapists, practice might have differed depending on education and training. OBJECTIVE: To analyze the differences in chest physiotherapy applied for hospitalized patients with COVID-19 between certified specialists and non-certified specialists. METHODS: An online questionnaire survey was developed for physiotherapists involved in the management of hospitalized patients with COVID-19. The questionnaire inquired about professional information and characteristics of physiotherapy practice. RESULTS: There were 485 respondents, yielding a completion rate of 76%. Of these, 61 were certified specialists and 424 non-certified specialists. The certified specialists were older, had more years of professional experience, were more qualified, and had better job conditions. For mechanically ventilated patients, the certified specialists used the ventilator hyperinflation maneuver more frequently (50.4% vs 35.1%, p = 0.005), and the hard/brief expiratory rib cage compression (ERCC) (26.9% vs 48.3%, p = 0.016), soft/long ERCC (25.2% vs 39.1%, p = 0.047), and manual chest compression-decompression (MCCD) maneuver (22.4% vs 35.6%, p = 0.001) less often. For spontaneously breathing patients, the certified specialists used the active cycle of breathing technique (30.8% vs 67.1%, p<0.001), autogenic drainage (7.7% vs 20.7%, p = 0.017), and MCCD maneuver (23.1% vs 41.4%, p = 0.018) less frequently. CONCLUSIONS: Certified specialists with higher levels of expertise seem to prefer the use of chest physiotherapy techniques that are applied with the mechanical ventilator over manual techniques. Furthermore, they use techniques that could potentially increase the work of breathing less frequently, mitigating the risk of exacerbating respiratory conditions in patients with COVID-19.

Whole-Body Vibration Exercise Improves the Functionality in Postmenopausal Women: A Systematic Review.

Background: Menopause is a natural phase in a woman's aging process. Menopause leads to the decrease of the estrogen levels, and in consequence the functionality worsening. Physical exercise can improve the functionality of postmenopausal woman. This review aimed to assess the effect of whole-body vibration exercise (WBVE) on the functionality of postmenopausal women. Methods: PRISMA guideline were used. Only English language were considered. Searches were conducted using relevant keywords for papers prior to Sep 16th, 2021, in Embase, Pubmed, The Cochrane Library, PED-ro, SPORTDiscus, Scopus, Web of Science and CINAHL databases. Results: Eight articles were selected to be in this systematic review. The mean score of methodological quality was moderate, the risk of bias was low for two studies, high for four studies, and unclear for two studies. The level of evidence of the studies was II. Improvements on muscle strength, jump, balance and maximum trunk flexion strength in the post menopause woman were reported. Conclusion: This systematic review demonstrated the functionality increase in postmenopausal women through WBVE. WBVE has been recommended as a non-pharmacological option relevant to postmenopausal management, helping to control the decline in bone density and symptoms related to osteoporosis and sarcopenia. However, further studies are needed to reinforce these findings.

Effectiveness of Using the FreeStyle Libre® System for Monitoring Blood Glucose during the COVID-19 Pandemic in Diabetic Individuals: Systematic Review.

BACKGROUND: Artificial Intelligence (AI) is an area of computer science/engineering that is aiming to spread technological systems. The COVID-19 pandemic caused economic and public health turbulence around the world. Among the many possibilities for using AI in the medical field is FreeStyle Libre® (FSL), which uses a disposable sensor inserted into the user's arm, and a touchscreen device/reader is used to scan and retrieve other continuous monitoring of glucose (CMG) readings. The aim of this systematic review is to summarize the effectiveness of FSL blood glucose monitoring during the COVID-19 pandemic. METHODS: This systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) and was registered in the international prospective register of systematic reviews (PROSPERO: CRD42022340562). The inclusion criteria considered studies involving the use of the FSL device during the COVID-19 pandemic and published in English. No publication date restrictions were set. The exclusion criteria were abstracts, systematic reviews, studies with patients with other diseases, monitoring with other equipment, patients with COVID-19, and bariatrics patients. Seven databases were searched (PubMed, Scopus, Embase, Web of Science, Scielo, PEDro and Cochrane Library). The ACROBAT-NRSI tool (A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies) was used to evaluate the risk of bias in the selected articles. RESULTS: A total of 113 articles were found. Sixty-four were excluded because they were duplicates, 39 were excluded after reading the titles and abstracts, and twenty articles were considered for full reading. Of the 10 articles analyzed, four articles were excluded because they did not meet the inclusion criteria. Thus, six articles were included in the current systematic review. It was observed that among the selected articles, only two were classified as having serious risk of bias. It was shown that FSL had a positive impact on glycemic control and on reducing the number of individuals with hypoglycemia. CONCLUSION: The findings suggest that the implementation of FSL during COVID-19 confinement in this population can be confidently stated to have been effective in diabetes mellitus patients.

Analysis of salivary flow rate, biochemical composition, and redox status in orchiectomized spontaneously hypertensive rats.

OBJECTIVE: This study aimed to analyze the salivary flow rate, biochemical composition, and redox status in orchiectomized spontaneously hypertensive rats (SHR) compared to normotensive Wistar rats. DESIGN: Thirty-two young adult male SHR and Wistar (3-months-old) rats were randomly distributed into four groups; either castrated bilaterally (ORX) or underwent fictitious surgery (SHAM) as Wistar-SHAM, Wistar-ORX, SHR-SHAM, and SHR-ORX. Two months beyond castration, pilocarpine-induced salivary secretion was collected from 5-month-old rats to analyze salivary flow rate, pH, buffer capacity, total protein, amylase, calcium, phosphate, sodium, potassium, chloride, thiobarbituric acid reactive substances (TBARs), carbonyl protein, nitrite, and total antioxidant capacity. RESULTS: The salivary flow rate was higher in the Wistar-ORX compared to the Wistar-SHAM group, while remaining similar between the SHR-SHAM and SHR-ORX groups. ORX did not affect pH and salivary buffer capacity in both strains. However, salivary total protein and amylase were significantly reduced in the Wistar-ORX and SHR-ORX compared to the respective SHAM groups. In both ORX groups, salivary total antioxidant capacity and carbonylated protein were increased, while lipid oxidative damage (TBARs) and nitrite concentration were higher only in the Wistar-ORX than in the Wistar-SHAM group. In the Wistar-ORX and SHR-ORX, the salivary calcium, phosphate, and chloride were increased while no change was detected in the SHAM groups. Only salivary buffering capacity, calcium, and chloride in the SHR-ORX adjusted to values similar to Wistar-SHAM group. CONCLUSION: Hypertensive phenotype mitigated the orchiectomy-induced salivary dysfunction, since the disturbances were restricted to alterations in the salivary biochemical composition and redox state.

Effects of whole-body vibration exercise on sleep disorders, body composition and clinical parameters in down syndrome children: A study protocol for a randomized cross-over trial.

Down-syndrome (DS) the most common genetic disorder worldwide. Whole-body-vibration-exercise (WBVE) has been recommended for individuals with DS. To verify the efficacy of WBVE on sleep disorders, body-composition (BC) and clinical parameters of children with DS. It is a randomized cross-over-trial. Children with DS, 5-12 years, both-genders will be selected. The sleep disorders will be evaluated by the "Infant sleep questionnaire Reimão and Lefevre" and by the "Sleep disturbance scale in children". The BC will be measure by bioimpedance and the skin temperature using infrared-thermography. WBVE will be performed seating in an ancillary-chair or sitting on the base of the vibrating platform, with 2.5 mm, 5Hz. Each session (5 series, 30-seconds on vibration, 1-minute of rest). It is expected improvement responses on sleep, BC and some clinical parameters. It is expected that this WBVE protocol will bring important clinical contributions for children with DS.

Genetic Ablation and Pharmacological Blockade of Bradykinin B1 Receptor Unveiled a Detrimental Role for the Kinin System in Chagas Disease Cardiomyopathy.

Chagas disease, the parasitic infection caused by Trypanosoma cruzi, afflicts about 6 million people in Latin America. Here, we investigated the hypothesis that T. cruzi may fuel heart parasitism by activating B1R, a G protein-coupled (brady) kinin receptor whose expression is upregulated in inflamed tissues. Studies in WT and B1R-/- mice showed that T. cruzi DNA levels (15 days post infection-dpi) were sharply reduced in the transgenic heart. FACS analysis revealed that frequencies of proinflammatory neutrophils and monocytes were diminished in B1R-/- hearts whereas CK-MB activity (60 dpi) was exclusively detected in B1R+/+ sera. Since chronic myocarditis and heart fibrosis (90 dpi) were markedly attenuated in the transgenic mice, we sought to determine whether a pharmacological blockade of the des-Arg9-bradykinin (DABK)/B1R pathway might alleviate chagasic cardiomyopathy. Using C57BL/6 mice acutely infected by a myotropic T. cruzi strain (Colombian), we found that daily treatment (15-60 dpi) with R-954 (B1R antagonist) reduced heart parasitism and blunted cardiac injury. Extending R-954 treatment to the chronic phase (120-160 dpi), we verified that B1R targeting (i) decreased mortality indexes, (ii) mitigated chronic myocarditis, and (iii) ameliorated heart conduction disturbances. Collectively, our study suggests that a pharmacological blockade of the proinflammatory KKS/DABK/B1R pathway is cardioprotective in acute and chronic Chagas disease.

Effects of Whole-Body Vibration Exercise on Athletes with Ankle Instability: A Systematic Review.

OBJECTIVE: Chronic Ankle Instability (CAI) or Functional Ankle Instability (FAI) is a condition characterized by laxity and mechanical instability in the ankle joint. This instability interferes with the activities and physical-functional parameters of athletes, which leads to repetitive ankle sprains. The current systematic review was carried out to identify the effects of whole-body vibration exercise (WBVE) in athletes with CAI. METHODS: We conducted electronic searches in Pubmed, the Cochrane Library, Embase, Web of Science, Scopus, Science Direct, Allied Health Literature (CINAHL) and Academic Search Premier (ASP) (EBSCO) databases on 26 February 2022. Registers were identified, and studies were selected for inclusion according to the eligibility criteria. The methodological quality was assessed by the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Seven studies were included with a mean methodological quality score of 5.85, considered 'regular' quality on the PEDro scale. WBVE interventions in athletes with CAI showed that this exercise contributes to a better response on parameters of neuromuscular performance, muscle strength and consequently in balance and postural control, variables that are for the management of CAI. CONCLUSION: WBVE interventions in sports modalities promote physiological responses that may lead to positive effects in several parameters. The protocols proposed in each modality can be carried out in practice and are considered effective additional exercise and training methods beyond traditional types of training for athletes. However, more studies are needed on athletes with this condition, with specific protocols, to highlight the possible physiological and physical-functional responses. Protocol study registration: PROSPERO (CRD42020204434).

Effects of the Whole-Body Vibration Exercise on Sleep Disorders, Body Temperature, Body Composition, Tone, and Clinical Parameters in a Child with Down Syndrome Who Underwent Total Atrioventricular Septal Defect Surgery: A Case-Report.

BACKGROUND: The health and developmental issues of people with Down syndrome (DS) are complex and are associated with many medical, psychological, and social problems from childhood through into adulthood. DS children have an increased risk of multiorgan comorbidities, including congenital heart disease. Atrioventricular septal defect (AVSD) is a congenital heart malformation that often occurs in DS people. AIM: Physical activity and exercise are recommended for patients with cardiovascular disease and are considered to be the gold standard of cardiac rehabilitation. Whole-body vibration exercise (WBVE) is considered a form of exercises. The aim of this case report is to show the effects of WBVE on sleep disturbances, body temperature, body composition, tone, and clinical parameters in a child with DS with corrected total AVSD. The subject is a 10-year-old girl, with free-type DS, who underwent surgery to correct a total AVSD at 6 months. She underwent periodic cardiological monitoring and was released to perform any type of physical exercise, including WBVE. WBVE improved sleep quality and body composition. CONCLUSION: WBVE leads to physiological effects that benefit the DS child.

Evidence of Use of Whole-Body Vibration in Individuals with Metabolic Syndrome: A Systematic Review and Meta-Analysis.

(1) Background: Metabolic syndrome (MSy) is defined by a constellation of interconnected physiological, biochemical, clinical, and metabolic factors that directly increase the risk of cardiovascular disease. This systematic review with meta-analysis was conducted to assess the effects of whole-body vibration exercise (WBVE) in metabolic syndrome (MSy) individuals. (2) Methods: An electronic search in Pubmed, Embase, Scopus, Web of Science, ScienceDirect, PEDro, and CINAHL databases in December 2022 was performed. Data regarding the included studies were extracted. The level of evidence, the methodological quality, and the risk of bias of each selected publication were individually evaluated. (3) Results: Eight studies were included in the systematic review and four studies in the meta-analysis, with a mean methodological quality score on the Physiotherapy Evidence Database (PEDro scale) of 5.6, considered "fair" quality. The qualitative results suggested positive effects of the systemic vibration therapy in relevant outcomes, such as quality of life, functionality, pain level, trunk flexibility, cardiovascular responses (blood pressure and heart rate), neuromuscular activation, range of motion of the knees, rating of perceived exertion, and body composition. The quantitative results, with weighted mean differences, standard mean differences, and 95% confidence intervals (CIs), were calculated. Conclusions: WBVE may be an alternative capable of interfering with physical-mainly for flexibility with weighted mean differences (1.70; 95% CI 0.15, 3.25; n = 39)-functional, psychosocial, neuromuscular, emotional parameters, and consequently contribute to improvements in metabolic health and reduce the cardiovascular risk factor in MSy individuals. Nevertheless, further additional studies are required to understand the long-term effects of WBVE on MSy and its complications in a better way. Protocol study registration was as follows: PROSPERO (CRD 42020187319).