Sleep quality of adult recreational cannabis users: a systematic review of literature.

INTRODUCTION: Human sleep is fundamental for the proper occurrence of organic functions. Hence, the lack of sleep can impair cognitive function, resulting in emotional problems, memory changes and disease onset. However, it is worth noting that sleep is influenced by outside factors, such as drug use. In this sense, the aim of this work is to analyze studies that had as their research object the influence of recreational marijuana on the sleep quality of adults. METHODS: A high-sensitivity research was conducted in databases (Biblioteca Virtual em Saúde, Medline via Pubmed, Cochrane, Embase, Web of Science and Scopus) using descriptors linked to marijuana and sleep habits. RESULTS: Eighteen studies from four countries were included with a total sample size of 29,858 participants. It was identified that marijuana affects sleep characteristics-such as latency and duration-with these changes being more evident in users who make greater use of marijuana and in those who started premature use. CONCLUSIONS: It was observed that most articles demonstrated a detrimental effect of recreational cannabis use on the quality of sleep in adults.

Autonomic modulation of heart rate during physical activity in pregnant women: A systematic review of literature.

BACKGROUND: There are important physiological changes in the heart rate autonomic modulation in pregnant women and these changes may affect the way their bodies respond to exercise stimulus. The objective of this review is to verify the physical exercise influence on autonomic modulation of heart rate in pregnant women. METHODS: This study is a Systematic Review. The electronic databases used to search for the studies were Cochrane Library, MEDLINE via PUBMED, Regional Health Portal and EMBASE. Experimental studies that evaluated heart-rate variability in pregnant women practicing physical exercises were included. And articles that addressed only fetal heart-rate variability, case reports, congress abstracts, clinical trial protocols without results, preprints, and gray literature were excluded. There were no language or publication year restrictions. The descriptors used in the Search were Cardiac Chronotropism, Sympathetic Nervous System, Pregnancy, and Physical Exercise. For statistical analysis, the fixed effect model was used. RESULTS: A total of 3106 articles were found, and 12 studies were included, which 5 were nonrandomized clinical trials, 4 were randomized clinical trials, and 3 were cross-sectional studies. Three hundred and four pregnant women were included in the studies. The application of physical exercise was varied, but in general they used aerobic exercises and with increased variability of the heart rate and reflex on the autonomic modulation of heart rate. CONCLUSION: Most studies demonstrate benefits heart rate in pregnant women, but limited research makes it hard to compare specific types of exercise and larger studies are needed to identify the best exercise.

Risk factors for falls in older adults with diabetes mellitus: systematic review and meta-analysis.

AIM: To identify risk factors for falls in older adults with Type 2 Diabetes Mellitus (T2DM). METHODS: The eligible studies identified factors associated with the risk of falls in older adults with T2DM. We searched PubMed, Cinahl, Web of Science, Scopus, and the Cochrane Library databases. The review has been updated and the last review date was November 30, 2023 (CRD42020193461). RESULTS: Twelve studies met the inclusion criteria, and eight studies were included in the meta-analysis. These studies included a total of 40,778 older adults with T2DM, aged 60 to 101 years. The risk of developing the outcome falls in older adults with T2DM is 63% higher compared to the risk in older adults without T2DM (HR 1.63; 95% CI [1.30 - 2.05]). The overall chance of falling in older adults with T2DM is 59% higher than that of non-diabetic older adults (OR 1.59; 95% CI [1.36 -1.87]), and in older adults with T2DM who take insulin the chance of falling is 162% higher (OR 2.62; 95% CI [1.87 - 3.65]). No results on diabetic polyneuropathy were found in the studies. CONCLUSION: Older adults with T2DM present a higher risk of falls compared to non-diabetics. Among the included older adults with T2DM, the most important factor associated with a higher risk of falls was insulin use. TRIAL REGISTRATION: Registered in the International Prospective Register of Systematic Reviews (CRD42020193461).

Effects of Home-Based Electrical Stimulation on Plasma Cytokines Profile, Redox Biomarkers, and Metalloproteinases in the Heart Failure with Reduced Ejection Fraction: A Randomized Trial.

Background: Low-frequency electrical stimulation (LFES) is an adjuvant method for heart failure (HF) patients with restrictions to start an exercise. However, the impact on molecular changes in circulating is unknown. We investigated the effects of 10 weeks of home-based LFES on plasma cytokines profile, redox biomarkers, metalloproteinases (MMPs) activity, and exercise performance in HF patients. Methods: Twenty-four HF patients (52.45 ± 9.15 years) with reduced ejection fraction (HFrEF) (EF < 40%), were randomly assigned to a home-based LFES or sham protocol. Plasma cytokines profile was assessed through interleukins, interferon-gamma, and tumor necrosis factor levels. Oxidative stress was evaluated through ferric reducing antioxidant power, thiobarbituric acid-reactive substances, and inducible nitric oxide synthase. The MMPs activity were analyzed by zymography. Cardiorespiratory capacity and muscle strength were evaluated by cardiopulmonary test and isokinetic. Results: LFES was able to increase the active-MMP2 activity post compared to pre-training (0.057 to 0.163, p = 0.0001), while it decreased the active-MMP9 (0.135 to 0.093, p = 0.02). However, it did not elicit changes in cytokines, redox biomarkers, or exercise performance (p > 0.05). Conclusion: LFES protocol is a promising intervention to modulate MMPs activity in HFrEF patients, although with limited functional effects. These preliminary responses may help the muscle to adapt to future mechanical demands dynamically.

The impact of heart failure on the sexual response cycle: A systematic review.

BACKGROUND: Heart failure (HF) is the most prevalent disease among chronic diseases and has been associated with a high prevalence of erectile dysfunction (ED). OBJECTIVE: this study aims to analyze research that has as its object of study the sexual activity of patients with HF. METHODS: A high-sensitivity search was performed in databases (PUBMED via MEDLINE, Cochrane, EMBASE, Web of Science, SCOPUS AND CINAHL) using descriptors linked to sexuality and heart failure. RESULTS: Fifteen studies from 7 countries with a total sample of 6244 participants were included. CONCLUSION: It was identified that patients with HF have alterations in their sexual activities, which are more common in males. Among men, it was noticed that the most reported sexual disorder was erectile dysfunction.

Acute and Time-Course Effects of Osteopathic Manipulative Treatment on Vascular and Autonomic Function in Patients With Heart Failure: A Randomized Trial.

OBJECTIVE: The purposed of this study was to valuate the effect of osteopathic manipulative treatment (OMT) on flow-mediated dilation and heart rate variability of patients with heart failure. BACKGROUND: Osteopathic manipulative treatment modulates both the vascular and autonomic nervous system (ANS) in healthy volunteers. However, the acute and time-course effects of the OMT on patients with an overactive ANS remain unclear. METHODS: This randomized controlled trial study included 20 patients with heart failure aged 50 to 60 years, allocated to a single session of OMT (base of the skull, retromaxillary region, heart, and thoracic duct) or sham. Flow-mediated dilation (FMD) at the brachial artery, hemodynamic measures, and heart rate variability were assessed in 3 periods (baseline, immediately after the intervention, and after 15 minutes). Multivariate analysis of variance procedure was used to compare intervention and periods. RESULTS: The OMT group had a greater FMD modulation compared with the sham (FMD,% =  9.5 vs. -5.6, 95% confidence interval (CI): [6.6, -12.35] vs. [-14.25, 2.8]; p = 0.001) and grater peak diameter (PD, mm =  0.77 vs -0.16 mm, 95% CI: [0.31,-1.24] vs [-0.63, 0.29]; P =  0.001), suggesting an important acute and time-course vascular effect from OMT. We also found some relevant heart rate variability modulation after 15 minutes from OMT: high frequency (HF, ms2 = 295 vs -354, 95% CI: [144.2, -769]; P = .001) and low frequency (LF, ms2) = 670 vs 775, 95% CI: [-98, 3591]; P = .001), suggesting a time-course ANS modulation after OMT. CONCLUSIONS: Osteopathic manipulative treatment was effective at increasing brachial blood flow and stimulating the vagal system in patients with heart failure. Moreover, vascular changes seem to precede the autonomic modulation.

Physical exercise and quality of life in patients with prostate cancer: systematic review and meta-analysis.

BACKGROUND: Prostate cancer leads to worse quality of life due to treatment and consequences of disease; benefits of physical exercise remain unclear on the improvement of quality of life in this population. The aim of this study is to evaluate the effectiveness of physical exercise in improving quality of life in patients with prostate cancer. METHODS: A systematic review and meta-analysis was carried out. For the search of studies, we used electronics databases such as Cochrane Library, MEDLINE via PUBMED, Regional Health Portal, and EMBASE, without language restrictions or year of publication. The descriptors used were as follows: "prostatic neoplasms," "exercise," and "quality of life." The risk analysis of bias in the meta-analysis was based on the Cochrane Collaboration Tool. For statistical analysis, the fixed effects model was used. Randomized controlled trials were included, which had a sample of patients with stage I-IV prostate cancer and that the intervention was aerobic physical exercise (AE) or resistance physical exercise (RE) or combined AE and RE. RESULTS: Five thousand six hundred nineteen studies were identified, but only 12 studies were selected. The quality of life of the patients was measured using instruments (SF 36, EORTC, AQoL-8D, IPSS and FACT-P), which served to divide the studies in groups where they presented the same instrument used. The analysis carried out shows that the quality of life of patients with prostate cancer submitted to aerobic training regimens had a protective effect in relation to the others. CONCLUSION: Most studies show an improvement in the quality of life of patients when they practice physical exercise, perceived by increasing the score of the instrument in question. However, methodological and heterogeneous differences between the studies increase the analysis bias.

Physical Exercise and Quality of Life of Patients Diagnosed with Colorectal Cancer: Systematic Literature Review.

BACKGROUND: Colorectal cancer decrease quality of life, due to treatment and disease, and physical exercise can improve the quality of life of patients with cancer, but it is still uncertain whether physical exercise can improve quality of life in these patients. AIM: To determine if there is an improvement in the quality of life in patients diagnosed with colorectal cancer undergoing physical exercise. METHODS: A systematic literature review was carried out; non-randomized clinical trials of any year were included from PubMed, Embase, Cochrane, and VHL platforms, without specific language delimitation, and analyzed the influence of physical exercise on the quality of life of patients diagnosed with colorectal cancer, and for analysis of bias, the Cochrane Manual for the Development of Systematic Intervention Reviews was used. RESULTS: Four studies were analyzed in full to produce the results; of these, three intervened with unsupervised aerobic exercises and one with semi-supervised aerobic exercises, all used the FACT-C as a questionnaire to assess quality of life, some even used FACT-G and/or SF-12, and only one author found significance values in the variables of physical well-being, emotional well-being, and functional well-being of the questionnaire, compared with the control group. CONCLUSION: There were no significant increases in the quality of life of patients diagnosed with colorectal cancer compared with the control group.

A systematic review of the prevalence of anxiety symptoms during coronavirus epidemics.

Coronavirus pandemics causes systemic and mainly pulmonary changes. We assessed the prevalence of generalized anxiety disorder (GAD) in pandemic survivors and the general population. Papers indexed by MEDLINE/PubMed, The Cochrane, Embase, Lilacs, Scielo, Psycoinfo, and Pepsic databases were searched to April 2020, using GAD and Coronavirus (CoV) infection as keywords. Sixteen studies with 25,779 participants in eight countries were included. A 46% pooled prevalence of anxiety symptoms (95% CI 33.9-58.2%) was found with significant evidence of between-study heterogeneity (Q = 154953, I2 = 99.99%, p < 0.001). Age and sex were not found to be significant moderators for anxiety symptoms. Intervention programs for anxiety symptoms are highly recommended.

Noninvasive ventilation improves the cardiovascular response and fatigability during resistance exercise in patients with heart failure.

PURPOSE: Noninvasive ventilation may improve cardiovascular function and exercise performance. We evaluated the physiologic impact of noninvasive ventilation during isokinetic knee extension resistance exercise in patients with heart failure. METHODS: This clinical trial included 10 male compensated patients with ischemic heart failure (age, 57 ± 9.1 years; ejection fraction, 28.5 ± 5.8%). Subjects underwent 2 bouts of exercise on an isokinetic dynamometer, separated by 72 hours of rest. The resistance exercise was concentric knee extension, at a speed of 60°/s. Five sets of 10 repetitions were performed during the 2 exercise bouts, and each set was separated by 2 minutes of rest. Subjects were administered either bilevel positive airway pressure ventilation (BV) or sham ventilation 20 minutes before and during the 2 exercise sessions in a randomized fashion. Heart rate, systolic blood pressure, and diastolic blood pressure were measured at rest, during exercise, and into recovery. Changes in peak torque (ΔPT), total work (ΔTW), and power (ΔPw) between the fifth and first sets were also measured. RESULTS: Compared with the sham intervention, BV significantly decreased heart rate, systolic blood pressure, and diastolic blood pressure at rest and during exercise (P < .01). There were no significant differences in these variables during recovery. Bi-level positive airway pressure ventilation also significantly reduced ΔPT, ΔTW, and ΔPw compared with the sham intervention (P < .01). CONCLUSIONS: Bi-level positive airway pressure ventilation significantly improved the cardiovascular response and fatigability during resistance exercise in patients with heart failure. These results suggest that use of BV during exercise training may be beneficial in this population with chronic disease.