Acute Specific Effects of Caffeine-containing Energy Drink on Different Physical Performances in Resistance-trained Men

International Journal of Exercise Science 11(4): 260-268, 2018. Caffeine containing energy drink (ED) is frequently used as ergogenic aid, but its effect on performance need more investigation. Thus, the aim of this study was to analyze the effects of acute ingestion of an ED on the physical performance of resistance-trained men subjected to successive tests in the same experimental protocol. Fifteen resistance-trained males (21.0 ± 0.3 yrs; 177.4 ± 1.8 cm; 79.6 ± 1.8 kg) ingested 2.5 mg caffeine per kg of body weight (619.5 ± 14.6 mL of ED) or a placebo in a double-blind randomized cross-over design. Physical performance was randomized for the maximum repetition tests (80% 1RM) in the bench press exercise and unilateral knee extension (dominant leg), maximal isometric hand-grip test in both hands, standing long jump and repeated sprint ability test. The paired Student-t test showed that ED intake increased performance compared to the placebo for the number of repetitions in the unilateral knee extension test of the dominant leg (11.5 ± 0.9 reps vs 9.5 ± 0.8 reps; P = 0.001) and bench press (10.2 ± 0.4 reps vs 8.1 ± 0.5 reps; P = 0.01); and also increased isometric strength in the hand-grip maximal test in the right (53.7 ± 1.5 kg vs. 47.7 ± 1.6 kg; P = 0.02) and left hand (52.9 ± 1.5 kg vs. 45.9 ± 1.3 kg; P = 0.02). In conclusion, acute ingestion of ED increased performance only in specific strength tests in resistance-trained men

Poor Sleep quality and health-related quality of life impact in adolescents with and without chronic immunosuppressive conditions during COVID-19 quarantine

OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included 305 adolescents with chronic immunocompromised conditions and 82 healthy adolescents. Online surveys were completed, which included questions on socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and the following validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), and Pediatric Outcome Data Collection Instrument (PODCI). RESULTS: The median current age [14 (10-18) vs. 15 (10-18) years, p=0.847] and frequency of female sex (62% vs. 58%, p=0.571) were similar in adolescents with chronic conditions compared with healthy adolescents. The frequency of poor sleep quality was similar in both groups (38% vs. 48%, p=0.118). Logistic regression analysis, including both healthy adolescents and adolescents with chronic conditions (n=387), demonstrated that self-reported increase in screen time (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.3-6.8; p=0.008) and intrafamilial violence report (OR 2.1; 95% CI 1.2-3.5; p=0.008) were independently associated with poor sleep quality in these adolescents. However, the PODCI global function score was associated with a lower OR for poor sleep quality (OR 0.97; 95% CI 0.94-0.99; p=0.001). Further logistic regression, including only adolescents with chronic conditions (n=305), demonstrated that self-reported increase in screen time (OR 3.1; 95% CI 1.4-6.8; p=0.006) and intrafamilial violence report (OR 2.0; 95% CI 1.2-3.4; p=0.011) remained independently associated with poor quality of sleep, whereas a lower PODCI global function score was associated with a lower OR for sleep quality (OR 0.96; 95% CI 0.94-0.98; p<0.001). CONCLUSION: Self-reported increases in screen time and intrafamilial violence report impacted sleep quality in both healthy adolescents and those with chronic conditions. Decreased health-related quality of life was observed in adolescents with poor sleep quality

Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital

OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19

Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic

Objective: To assess factors associated with emotional changes and Hyperactivity/Inattention (HI) motivated by COVID-19 quarantine in adolescents with immunocompromising diseases. Methods: A cross-sectional study included 343 adolescents with immunocompromising diseases and 108 healthy adolescents. Online questionnaires were answered including socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and validated surveys: Strengths and Difficulties Questionnaire (SDQ), Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0). Results: The frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were similar to those of healthy subjects (110/343 [32%] vs. 38/108 [35%], p = 0.548), as well as abnormal hyperactivity/inattention SDQ scores (79/343 [23%] vs. 29/108 [27%], p = 0.417). Logistic regression analysis of independent variables associated with abnormal emotional scores from adolescents with chronic diseases showed: female sex (Odds Ratio [OR = 3.76]; 95% Confidence Interval (95% CI) 2.00‒7.05; p < 0.001), poor sleep quality (OR = 2.05; 95% CI 1.08‒3.88; p = 0.028) and intrafamilial violence during pandemic (OR = 2.17; 95% CI 1.12‒4.19; p = 0.021) as independently associated with abnormal emotional scores, whereas total PedsQL score was inversely associated with abnormal emotional scores (OR = 0.95; 95% CI 0.93‒0.96; p < 0.0001). Logistic regression analysis associated with abnormal HI scores from patients evidenced that total PedsQL score (OR = 0.97; 95% CI 0.95‒0.99; p = 0.010], changes in medical appointments during the pandemic (OR = 0.39; 95% CI 0.19-0.79; p = 0.021), and reliable COVID-19 information (OR = 0.35; 95% CI 0.16‒0.77; p = 0.026) remained inversely associated with abnormal HI scores. Conclusion: The present study showed emotional and HI disturbances in adolescents with chronic immunosuppressive diseases during the COVID-19 pandemic. It reinforces the need to promptly implement a longitudinal program to protect the mental health of adolescents with and without chronic illnesses during future pandemics

Health-related quality of life and functionality in primary caregiver of surviving pediatric COVID-19

ObjectivesTo prospectively assess health-related quality of life (HRQoL), global functionality, and disability in primary caregivers of surviving children and adolescents after COVID-19.MethodsA longitudinal observational study was carried out on primary caregivers of surviving pediatric post-COVID-19 patients (n = 51) and subjects without COVID-19 (n = 60). EuroQol five-dimension five-level questionnaire (EQ-5D-5L) and 12-question WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) were answered for both groups. The univariate regression analysis was carried out using SPSS (v 20) and significance was established at 5%.ResultsThe median duration between COVID-19 diagnosis in children and adolescents and longitudinal follow-up visits was 4.4 months (0.8–10.7). The median age of children and adolescents caregivers with laboratory-confirmed COVID-19 was similar to primary caregivers of subjects without laboratory-confirmed COVID-19 [43.2 (31.6–60.9) vs. 41.5 (21.6–54.8) years, p = 0.08], as well as similar female sex (p = 1.00), level of schooling (p = 0.11), social assistance program (p = 0.28), family income/month U$ (p = 0.25) and the number of household’s members in the residence (p = 0.68). The frequency of slight to extreme problems (level ≥ 2) of the pain/discomfort domain according to EQ-5D-5L score was significantly higher in the former group [74% vs. 52.5%, p = 0.03, OR = 2.57 (1.14–5.96)]. The frequency of disability according to WHODAS 2.0 total score was similar to those without disability and unknown (p = 0.79); however, with a very high disability in both groups (72.5% and 78.3%). Further analysis of primary caregivers of children and adolescents with post-COVID-19 condition (PCC) [n = 12/51 (23%)] compared to those without PCC [n = 39/51(77%)] revealed no differences between demographic data, EQ-5D-5L and WHODAS 2.0 scores in both groups (p > 0.05).ConclusionWe longitudinally demonstrated that pain/discomfort were predominantly reported in approximately 75% of primary caregiver of COVID-19 patients, with high disability in approximately three-quarters of both caregiver groups. These data emphasized the prospective and systematic caregiver burden evaluation relevance of pediatric COVID-19

Effects of exercise training on systemic and arterial wall inflammation in childhood-onset Takayasu arteritis: a randomized, multicenter, controlled trial study

Introdução: A arterite de Takayasu de início juvenil (ATJ) é uma vasculite inflamatória crônica que afeta artérias de grande e médio calibres predispondo esses pacientes à um elevado risco cardiovascular. Sabe-se que o exercício físico é capaz de melhorar a inflamação e a saúde cardiovascular em uma variedade de doenças, entretanto, estudos controlados e randomizados avaliando esses possíveis efeitos na ATJ são escassos. O principal objetivo deste estudo foi investigar os potenciais efeitos terapêuticos do exercício na ATJ. Métodos: Este estudo foi dividido em duas grandes partes. Em um primeiro momento, comparamos transversalmente pacientes com ATJ vs. controles saudáveis. Para o estudo longitudinal, foram recrutados 17 pacientes diagnosticados com ATJ atendidos regularmente em três ambulatórios de reumatologia pediátrica da cidade de São Paulo. Os pacientes foram avaliados no período pré e após 12 semanas de um programa de treinamento físico (TF) realizado em casa. Os desfechos primários foram: avaliar a inflamação sistêmica através das concentrações séricas de marcadores pró e anti-inflamatórios e avaliar a inflamação da parede arterial através da [18F] fluoro- deoxy-D-glucose positron emission tomography/magnetic resonance imaging [FDG- PET/MRI]). Composição corporal, avaliação clínica global, capacidade aeróbia, força e funcionalidade, qualidade de vida e nível de atividade física foram avaliados como desfechos secundários. Este estudo foi registrado e aprovado na plataforma ClinicalTrials, sob o número NCT03494062. Resultados: Transversalmente, os pacientes com ATJ apresentaram piora da capacidade aeróbica, função autonômica, baixos níveis de atividade física, valores maiores de massa gorda, redução da massa magra e óssea, piora da sensibilidade à insulina e qualidade de vida quando comparadas a seus pares saudáveis (todos, P <= 0,05). Após o período de 12 semanas, houve uma redução na distribuição de artérias classificadas como grau III (i.e., inflamação grave), enquanto que o grupo sem treinamento físico demonstrou um aumento da frequência das artérias classificadas no mesmo grau (P = 0,014). Também houve diminuição da inflamação no arco aórtico (P = 0,002) e na artéria subclávia esquerda (P = 0,029) foi mais acentuada nos pacientes treinados vs. não treinados. Além disso, pacientes do grupo TF apresentaram redução da gordura visceral, melhora da força muscular, funcionalidade e vitalidade, avaliada pelo SF-36 (todos P <= 0,05). Conclusão: Os pacientes com ATJ apresentaram uma piora geral de fatores relacionados à saúde, entretanto, o exercício físico foi capaz de contrapor muitos desses malefícios, melhorando a inflamação arterial, a gordura visceral, os níveis de atividade física, a funcionalidade e a vitalidade. O exercício físico emerge como uma estratégia importante para o tratamento de pacientes com ATJBackground: Childhood-onset Takayasu arteritis (c-TA) is an inflammatory vasculitis predisposing to a high risk of morbidity and mortality. No randomized controlled trial has been conducted in c-TA, precluding evidence-based treatment recommendations. Exercise has the potential to improve inflammation and cardiovascular health, but evidence remains scant in c-TA. The main objective of this study was to investigate the potential therapeutic effects of exercise in c-TA. Methods: This is a two-part study involving a cross-sectional comparison between c-TA and healthy controls, followed by a 12-week, multicenter, randomized controlled trial conducted in Sao Paulo (Brazil), between November 2017 and March 2019, to test the effects of a home-based, exercise intervention vs. standard of care in patients with c-TA (n = 17). The primary outcomes were arterial inflammation, assessed by [18F] fluoro- deoxy-D-glucose positron emission tomography/magnetic resonance imaging [FDG-PET/MRI]) and systemic inflammatory markers. Secondary outcomes included body composition, physical activity levels, physical capacity, cardiometabolic risk factors, disease-related parameters, and quality of life. This trial was registered at ClinicalTrials,gov number NCT03494062. Findings: In the cross-sectional comparison, c-TA patients showed worse physical capacity, physical activity levels, autonomic function, fat, lean and bone mass, insulin sensitivity, and quality of life vs. controls (P <= 0,05). Findings from randomized clinical trial showed that exercised patients experienced a reduction in the frequency of vessel segments with severe inflammation, whereas the non-exercised patients had an opposite response (P = 0,007). Decreased inflammation in aortic arch (P = 0,002) and left subclavian artery (P = 0,029) were more pronounced in the exercised vs. non-exercised patients. Greater improvements in visceral fat, steps per day, muscle function, strength, and vitality were also observed in the exercised vs. no exercised patients (all P <= 0,05). Interpretation: c-TA patients showed worse overall health-related factors, but exercise improved arterial inflammation, visceral fat, physical activity levels, functionality, and vitality. Exercise arises as a valuable, evidence-based intervention to treat c-TA patient