Jerri Luiz Ribeiro

Introduction: Systemic sclerosis (SSc) often leads to decreased muscle strength and mass, impairing physical performance and causing disability. Interventions with resistance exercise (RE) is an effective non-pharmacological approach to mitigate these issues. This systematic review aims to evaluate the effects of interventions with RE on muscle strength, muscle mass, physical performance, physical disability, and quality of life (QOL) in SSc patients, as well as to assess its adherence and safety. Methods: A systematic review and meta-analysis were conducted based on a PICOS framework: Patient = Systemic Sclerosis; Intervention = Resistance exercise; Study design = Randomized clinical trials. Searches were performed across MEDLINE (PubMed), PMC, Web of Science, Cochrane Library, LILACS, and EMBASE up to January 2025. Results: Ten randomized clinical trials, including 422 participants (~85% female), were eligible for analysis. Participants’ ages ranged from 42 to 64 years, with body mass indices between 22.5 and 28.0 kg/m². The intervention period was standardized to 12 weeks. Interventions with RE significantly improved muscle strength (SMD = 2.76 kg; 95% CI, 1.32 to 4.20; p = 0.0002) and functional disability (SMD = −0.47; 95% CI, −0.93 to −0.00; p = 0.05) compared to controls. Interventions with RE also showed superiority in the physical component of QOL (SMD = 0.42; 95% CI, 0.04 to 0.81; p = 0.03). Although enhanced physical performance was observed, statistical pooling was not possible due to limited data. Interventions with RE had a low incidence of adverse events, but data on disease progression and adherence were insufficient. Conclusion: Interventions with RE benefits muscle strength, physical function, and QOL in SSc patients, though optimal protocols and adherence strategies need further investigation. More robust studies are required to refine training methods and enhance clinical trial designs.

Background: Prolonged postprandial hyperlipemia (PPL) and hyperglycemia (PPG) are important risk factors for the development of cardiovascular disease. Although physical exercise improves lipid profile and glucose tolerance, thus reducing cardiovascular risk, the effects of fasting exercise in adolescents need to be investigated. Objective: To investigate the effects of different intensities of fasted aerobic exercise on the magnitude of PPL and glycemic responses to isocaloric meals in adolescents. Methods: A randomized crossover clinical trial in which 13 healthy and eutrophic adolescents, aged 14.5 ± 1.3 years, performed three interventions (washout period = 7 days): 45 minutes of rest (REST); 45 minutes of moderate-intensity fasting (MI); and a calorie-matched high-intensity aerobic exercise session (HI). Subjects were serially assessed for blood triglycerides, cholesterol, and glucose levels. Results: Regarding PPL, the MI protocol induced triglycerides reductions compared to REST only at 105 min (70.1 ± 10.3 vs 95.4 ± 30.2; p=0.006) and compared to both HI and REST at 135 min (68.4 ± 14.4 vs 91.5 ± 24.9 vs 93.7 ± 21.2 p<0.02). No differences in iAUC were observed. Conclusion: The present study shows that calorie-matched moderate and high-intensity fasting aerobic exercise has no acute effect on PPL responsiveness in adolescents.

Introduction: Aerobic protocols and exercises are sought with less overload and that produce gains similar to traditional exercises. Therefore, understanding the changes that occur in incremental test with blood flow restriction(Tmax-BFR) and without blood flow restriction(Tmax-TRAD) is fundamental. Objective: To compare the responses of speeds, ventilatory thresholds(VT), maximum oxygen uptake(VO2max), blood lactate([la]), heart rate(HR) and Borg scale of Tmax-BFR vs. Tmax-TRAD. Methods: In this crossover study, non-athlete men who were submitted to two tests conditions(Tmax-BFR and Tmax-TRAD) were included. Data were analyzed using Generalized Estimating Equations and Bonferroni test. Values p<0.05 were considered significant. Results: Five men were included(Age:22.6±1.1years). The 1stVT, 2ndVT and VO2max were similar in both conditions. However, Tmax-BFR has reached 1stVT(Tmax-TRAD, 9.0±0.7km/h; Tmax-BFR, 8.2±0.5km/h), 2ndVT(Tmax-TRAD, 13.8±1.6km/h; Tmax-BFR, 11.6±1.8km/h) and VO2max(Tmax-TRAD, 15.6±2.9km/h; Tmax-BFR, 13.0±2.1km/h) at significantly lower speeds when compared to Tmax-TRAD(p<0.0001). HR at 2ndVT(Tmax-TRAD, 189.2±20.7bpm; Tmax-BFR, 173.2±10.6bpm; p=0.014) and Maximum HR(Tmax-TRAD, 203.6±14.9bpm; TBFR, 178.8±9.7bpm; p<0.0001) were higher in Tmax-TRAD. The Tmax-BFR showed higher levels of [la] when compared to Tmax-TRAD for 1stVT(p=0.019) and 2ndVT(p=0.005). Conclusion: There was a reduction in speed of 1stVT, 2ndVT and VO2max, as well as lower cardiac effort in the 2ndVT and HR at the end of the test in the Tmax-BFR condition.

Este artigo analisa a participação do Brasil no sistema Arcu-Sul e a visão dos atores brasileiros sobre o processo de acreditação no Mercosul. O sistema tem como objetivo estabelecer critérios regionais de qualidade da educação superior no Mercosul. Foram realizadas entrevistas com atores brasileiros que participam do processo de acreditação desse sistema. Os resultados destacam que o Brasil tem um grande protagonismo, e, para alguns atores, o processo de acreditação ocorre de forma plena no país; contudo, os dados apontam que o Brasil coloca entraves para o funcionamento do sistema. Nessa perspecti- va, nota-se que a participação do Brasil no sistema Arcu-Sul é de grande destaque e pode contribuir para a garantia de qualidade na região.

A metodologia coaching é utilizada para o desenvolvimento de pessoas nas dimensões profissional e pessoal, valendo-se do apoio ao processo de reflexão, aprendizado e ação para alcançar metas. Objetivo: estudara aplicação da metodologia coaching no tratamento da obesidade. Metodologia: estudou-se dificuldades para o tratamento da obesidade e possíveis estratégias de tratamento através desta metodologia. Resultados: (1) a obesidade atualmente é problema de saúde pública considerado uma epidemia mundial, sendo uma doença multifatorial; (2) o obeso tem pressa para emagrecer e a maior dificuldade está em manter sua motivação para continuar o tratamento em médio e longo prazo; (3) o coaching pode fazer parte de um programa multidisciplinar, atuando fortemente na mudança comportamental. Conclusão: a metodologia coaching está sendo utilizada com êxito por profissionais de diferentes dimensões da área da saúde, podendo, como ficouclaro, ser adaptada conforme a prática do profissional que a utiliza no tratamento da obesidade.

Summary: The purpose of this study was to compare the peripheral expression of natural killers and CCR5 in a session of low‐intensity strength training with vascular occlusion and in high‐intensity training. Young males were randomized into session groups of a high‐intensity strength training (HI) and a session group of low‐intensity strength training with vascular occlusion (LI‐BFR). The exercise session consisted in knee extension and bicep curl in 80% 1RM (HI) and 30% 1RM (LI‐BFR) with equalized volumes. Blood collection was made before, immediately after and 24 h after each training session. Immunophenotyping was carried out through CD195+ (CCR5) e CD3‐CD16+CD56+ (NK) in peripheral blood and analysed by flow cytometry and presented in frequency (%). Peripheral frequency of NK cells showed no significant difference in LI‐BFR group in time effect, while a gradual reduction of NK cells was identified in HI group in before‐24 h postexercise and after‐24 h postexercise comparison. However, significant differences have been found in relative change of NK cells immediately after exercise between sessions. In addition, HI and LI‐BFR groups showed a significant reduction in the cells expressed CCR5 during 24 h postsession compared to the postsession, but CCR5 also differed when comparing before‐24 h after session in the HI group. No differences were observed amongst the groups. LIO induced CCR5 response similar to the HI session, while the NK cells remained in similar frequency during the studied moments in LI‐BFR, but not in HI group, suggesting that local hypoxia created by the blood flow restriction was able to prevent a change in the frequency of peripheral cells and a possible immunosuppression.

The need to study cardiovascular diseases (CVD) has become more and more relevant as their prevalence has increased over the years. An intact endothelial wall is essential to vascular health. Certain factors are responsible for maintaining this tissue intact, including nitric oxide (NO), which provokes dilation of blood vessels in response to shear stress. Expression of the endothelial nitric oxide synthase (eNOS) enzyme, which produces nitric oxide in response to increases in blood flow, is of fundamental importance to maintenance of the vascular system. When this enzyme is inhibited, nitric oxide production is reduced, causing endothelial dysfunction. Since C-reactive protein inhibits production of nitric oxide by the eNOS enzyme, it is one of the causes of endothelial dysfunction and cardiovascular events. The objective of the present study was to review scientific articles in the literature related to the subject 'inflammatory markers and endothelial function'. A wide-ranging review of the current literature was conducted, using systematic analysis of bibliographic references indexed in PubMed, Scielo, Medline and LILACS database, for the years 1992 to 2013. The studies reviewed show that increases in inflammation causes reductions in NO and increases in cardiovascular events. Increased inflammation is associated with higher incidence of cardiovascular diseases.