Abstract We critically analyzed clinical trials performed with chloroquine (CQ) and hydroxychloroquine (HCQ) with or without macrolides during the first wave of COVID-19 and discussed the design and limitations of peer-reviewed studies from January to July 2020. Seventeen studies were eligible for the discussion. CQ and HCQ did not demonstrate clinical advantages that justified their inclusion in therapeutic regimens of free prescription for treatment or prophylactic purposes, as suggested by health authorities, including in Brazil, during the first wave. Around August 2020, robust data had already indicated that pharmacological effects of CQ, HCQ and macrolides as anti-SARS-CoV-2 molecules were limited to in vitro conditions and largely based on retrospective trials with low quality and weak internal validity, which made evidence superficial for decision-making. Up to that point, most randomized and nonrandomized clinical trials did not reveal beneficial effects of CQ or HCQ with or without macrolides to reduce lethality, rate of intubation, days of hospitalization, respiratory support/mechanical ventilation requirements, duration, type and number of symptoms, and death and were unsuccessful in increasing virus elimination and/or days alive in hospitalized or ambulatory patients with COVID-19. In addition, many studies have demonstrated that side effects are more common in CQ-or HCQ-treated patients. (CQ (HCQ COVID19 COVID 19 COVID-1 peerreviewed peer reviewed 2020 discussion purposes authorities Brazil antiSARSCoV2 antiSARSCoV anti SARS CoV 2 anti-SARS-CoV- validity decisionmaking. decisionmaking decision making. making decision-making point lethality intubation hospitalization supportmechanical support mechanical requirements duration symptoms andor COVID19. 19. addition CQor HCQtreated treated COVID1 1 COVID- 202 anti-SARS-CoV 20

Abstract Aim: Exercise elicits adaptations in several physiological systems, such as the gastrointestinal tract. We evaluated the effects of an acute strength exercise (acute-SE) on gastric satiety and its correlation with creatinine kinase (CK), lactate, and plasma cytokine levels in humans. Methods: Anthropometric parameters, body composition, muscular strength, and satiety (drink test protocol) at rest and exercise were assessed. Results: In the squat, bench press, and T-bar row exercises, we observed a significant decrease (p<0.05) in muscular strength in the second, third, and fourth sets compared with that in the first set. Compared with rest, we observed a significant increase (p<0.05) in CK and lactate levels after acute-SE. In the drink test, acute-SE significantly increased (p <0.05) the total intake, calories ingested, and a total time of ingestion. Concerning cytokines, there was a significant increase (p<0.05) after acute-SE of IL-1β and IL-6 levels at the beginning of the test and a decrease in IL-6, -10, -13, and TNF-α levels after acute-SE at the end of the test (p<0.05). There was a correlation between CK, lactate, and total intake after acute-SE (p<0.05) as well as between IL-6, 13, TNF-α, and volume ingested in the last score of the drink test after acute-SE (p<0.05). Conclusion: Acute-SE decreases satiety associated with changes in lactate, CK, and plasma cytokine levels in healthy humans.

Objectives: To estimate the prevalence of obesity, overweight, abdominal obesity and high blood pressure in a sample of adolescents from a low-income city in Brazil and to estimate the relationship with the socioeconomic status of the family, the education level of the family provider and the type of school. Methods: This cross-sectional study randomly sampled 1,014 adolescents (54.8% girls), between 14-19 years of age, attending high school from Imperatriz (MA). The outcomes of this study were: obesity and overweight, abdominal obesity and high blood pressure (systolic and/or diastolic). The independent variables were: socioeconomic status (SES) of the family, education level of the family provider (ELFP) and type of school. The confounding variables were: gender, age and physical activity level. Prevalence was estimated, and the association between the endpoints and the independent variables was analyzed using a prevalence ratio (PR), with a 95% confidence interval, estimated by Poisson regression. Results: The overall prevalence of obesity was 3.8%, overweight, 13.1%, abdominal obesity, 22.7% and high blood pressure, 21.3%. The adjusted analysis indicated that girls with high SES showed an increased likelihood to be overweight (PR=1.71 [95% IC: 1.13-2.87]), while private school boys had an increased likelihood of obesity (PR=1.79 [95% CI: 1.04-3.08]) and abdominal obesity (PR =1.64 [95% CI: 1.06-2.54]). Conclusion: The prevalence of CVDR is high in adolescents from this low-income region. Boys from private schools are more likely to have obesity and abdominal obesity, and girls with high SES are more likely to be overweight.

Objetivos: Estimar la prevalencia de obesidad y sobrepeso, obesidad abdominal y hipertensión arterial en una muestra de adolescentes pertenecientes a una ciudad de baja renta en Brasil y su relación con el nivel socioeconómico, nivel educativo de lo responsable de la familia y tipo de escuela. Métodos: Estudio transversal con una muestra de 1014 adolescentes (54,8% chicas), con edades entre 14-19 años, estudiantes de las escuelas de la ciudad de Imperatriz (Brasil), seleccionadas por un muestreo aleatorio. Las variables dependientes evaluadas son: obesidad general y sobrepeso, obesidad abdominal, y tensión arterial alta (sistólica y/o diastólica). Las variables independientes son: nivel socioeconómico de la familia (NSO), el nivel de educación de lo responsable de la familia (NERF) y tipo de escuela. Las variables de confusión son: sexo, edad y nivel de actividad física. La prevalencia fue estimada, y la asociación entre las variables dependientes y las variables independientes se analizaron mediante razón de prevalencia (RP), con intervalo de confianza (IC) del 95%, estimado por la regresión de Poisson. Resultados: La prevalencia de la obesidad general fue de 3,8%, sobrepeso 13,1%, obesidad abdominal 22,7% y la tesión arterial alta 21,3%. Las análisis ajustadas indicaron que las chicas con NSO alto tienen mayor probabilidad de tener sobrepeso (RP=1,71 [IC95%: 1,13 a 2,87]), y chicos de las escuelas privadas tienen más probabilidad de tener obesidad (RP=1,79 [IC95%: 1.04- 3,08]) y obesidad abdominal (RP=1,64 [IC95%: 1,06 a 2,54]). Conclusión: La prevalencia de los FRC es alta en adolescentes de una región de baja renta. Los chicos de las escuelas privadas son más propensos a tener obesidad y obesidad abdominal, y las chicas con NSO alto son más propensas a tener sobrepeso.

O tecido adiposo branco (WAT) é considerado um órgão endócrino, que, em excesso, é capaz de controlar o metabolismo, pela ação de moléculas biologicamente ativas. A produção desregulada destas substâncias pela disfunção do tecido adiposo pode contribuir para as complicações presentes na obesidade. As pesquisas atuais têm esclarecido fatores e mecanismos envolvidos na atuação de substâncias pró e anti-inflamatórias na modulação da inflamação e da resistência à insulina. Em indivíduos obesos, as moléculas pró-inflamatórias produzidas pelo tecido adiposo têm sido implicadas como fator contribuinte para o desenvolvimento da resistência à insulina e aumento do risco de doença cardiovascular. Por outro lado, as moléculas com ação anti-inflamatória, que atuam na melhora da sensibilidade à insulina, têm sua produção reduzida. O desequilíbrio entre essas substâncias contribui de forma significativa para as desordens metabólicas presente em indivíduos obesos. Assim, esta revisão visa a trazer informações atualizadas sobre a atuação de moléculas secretadas pelo tecido adiposo.

White adipose tissue (WAT) is considered an endocrine organ. When present in excess, WAT can influence metabolism via biologically active molecules. Following unregulated production of such molecules, adipose tissue dysfunction results, contributing to complications associated with obesity. Previous studies have implicated pro- and anti-inflammatory substances in the regulation of inflammatory response and in the development of insulin resistance. In obese individuals, pro-inflammatory molecules produced by adipose tissue contribute to the development of insulin resistance and increased risk of cardiovascular disease. On the other hand, the molecules with anti-inflammatory action, that have been associated with the improvement of insulin sensitivity, have your decreased production. Imbalance of these substances contributes significantly to metabolic disorders found in obese individuals. The current review aims to provide updated information regarding the activity of biomolecules produced by WAT.

Estudos in vivo e in vitro verificaram que dietas hiperprotéicas influenciam a síntese protéica e regulam vários processos celulares. O papel dos aminoácidos como substrato para a síntese de proteínas já está bem evidenciado na literatura, porém as formas como esses aminoácidos modulam a etapa da transcrição e regulam a tradução do RNAm, pela via de sinalização dependente da mTOR, ainda não estão totalmente esclarecidas. Tem-se verificado que a mTOR é uma proteína responsável por ativar uma cascata de eventos bioquímicos intracelulares que culminam na ativação do processo de tradução protéica. Dentre todos os aminoácidos, a leucina é a mais eficaz em estimular a síntese protéica, reduzir a proteólise e, portanto, favorecer o balanço nitrogenado positivo, possivelmente por favorecer a ativação desta proteína. Além disso, este aminoácido estimula direta e indiretamente a síntese e a secreção de insulina, e, assim, aumenta as propriedades anabólicas celulares. Nesse sentido, a presente revisão tem como objetivo identificar o papel da leucina na modulação da síntese protéica e abordar aspectos metabólicos relacionados a este aminoácido.

In vivo and in vitro studies have demonstrated that high protein diets affect both protein synthesis and regulation of several cellular processes. The role of amino acids as substrate for protein synthesis has been established in the literature. However, the mechanism by which these amino acids modulate transcription and regulate the mRNA translation via mTOR-dependent signaling pathway has yet to be fully determined. It has been verified that mTOR is a protein responsible for activating a cascade of biochemical intracellular events which result in the activation of the protein translation process. Of the aminoacids, leucine is the most effective in stimulating protein synthesis and reducing proteolysis. Therefore, it promotes a positive nitrogen balance, possibly by favoring the activation of this protein. This amino acid also directly and indirectly stimulates the synthesis and secretion of insulin, enhancing its anabolic cellular effects. Therefore, this review aimed to identify the role of leucine in protein synthesis modulation and to discuss the metabolic aspects related to this aminoacid.

O objetivo do trabalho foi avaliar o efeito do tratamento com undecanoato de testosterona (UT) combinado ao treinamento físico moderado sobre ciclo estral, peso corporal, estruturas do sistema reprodutor, comportamento motor e morfologia hepática e renal em ratas. Ratas Wistar (180 a 250 g) foram divididas em: sedentárias + UT (S+UT), treinadas + UT (T+UT), sedentárias + veículo (S+V), treinadas + veículo (T+V). As ratas nadaram 50 min/dia com sobrecarga de ~5% do peso corporal por 4 semanas. Durante o período de treinamento foi realizado acompanhamento diário do peso corporal (PC) e do ciclo estral (CE) pelo esfregaço vaginal. O UT (15 mg/kg s.c.) foi administrado 3x/semana durante 4 semanas. Ao final foram avaliados comportamento motor, pesos e alterações histopatológicas de alguns órgãos. O grupo T+UT apresentou PC maior na quarta semana do que na primeira, com pesos corporais maiores que os grupos S+V e S+UT. Houve interrupção no CE e redução do peso dos ovários nos animais tratados com UT. Houve aumento do peso relativo do coração, nos grupos T+V e T+UT, e do peso relativo dos rins, no grupo T+UT. A análise histopatológica revelou congestão periportal e focos isolados de necrose hepática nas ratas com UT. O UT combinado com treinamento produziu supressão do ciclo estral, atrofia ovariana, necrose hepática, hipertrofia cardíaca e redução da atividade motora.

The aim of the work was evaluate the effects of testosterone undecanoate (TU) treatment combined with moderate physical training on: the estrous cycle, body weight (BW), motor behavior (MB), and the morphohistology of the reproductive system, the liver and kidney in rats. Female Wistar rats (180 g - 250 g) were divided as follows: sedentary + TU (S + TU), trained + TU (T + TU), sedentary + vehicle (S + V), trained + vehicle (T + V). The rats swam 50 min/Day, strapped with a 5% BW load, for 4 weeks. During this training, (BW) was monitored daily as well as the estrous cycle (EC) by vaginal smear. The TU (15 mg/kg s.c) was administered 3 times/week for 4 weeks. At the end of the study, data on MB, BW and morphohistopathological changes in viscera were compiled. The (T + TU) group had on average, a higher (BW) in the fourth week compared to the first week, and (BW) higher than (S + V) and (S + TU) groups. We noted an interruption in the EC and a decrease in weight of ovaries in animals treated with TU. In addition, there was an increase in the relative weight of the heart in groups (T + V) and (T+ TU), and kidneys in group (T + TU). Histopathological analysis showed periportal congestion and isolated foci of hepatic necrosis in rats with TU. Thus, TU combined with training abolished the EC, promoted ovarian atrophy, liver necrosis, cardiac hypertrophy and a decrease in motor activity.

Recentes estudos, relativos aos efeitos do exercício físico e da restrição energética, têm relatado diversos benefícios sobre fatores metabólicos e de risco cardiovascular relacionados à síndrome metabólica (SM). Esta revisão aborda os aspectos mais recentes dos efeitos do exercício físico sobre as principais patologias associadas à SM: obesidade, resistência à insulina, diabetes mellitus tipo 2 (DM2), dislipidemia e hipertensão. Embora estudos randomizados e controlados que avaliam a prevenção e o tratamento da SM sejam escassos, pesquisas controladas indicam fortes evidências de que mudanças no estilo de vida, incluindo a pratica de exercício físico regular e restrição energética, sejam eficazes na prevenção e tratamento de DM2 em indivíduos com sobrepeso e com tolerância à glicose diminuída. No mesmo sentido, estudos epidemiológicos sugerem que a prática regular de exercício físico previne DM2 e doenças cardiovasculares. Com base nas atuais recomendações, preconiza-se o aumento do volume total de exercício físico com intensidade moderada, na busca da boa condição cardiorrespiratória e muscular e da diminuição da massa gorda, com conseqüente aumento da proteção contra fatores associados ao desenvolvimento da síndrome metabólica.

Recent studies of the effects of physical exercise and caloric restriction have found several benefits on the metabolic and cardiovascular risk factors related to metabolic syndrome (MS). This review examines the current state of knowledge of the effects of physical exercise on the main pathologies associated with MS: obesity, insulin resistance, type 2 diabetes mellitus (DM2), dyslipidemias and hypertension. Although there are only a few randomized and controlled studies that evaluated the prevention and treatment of MS, strong evidence from controlled studies indicates that lifestyle changes that include regular physical exercise and caloric restriction are effective in preventing and treating DM2 in overweight individuals with reduced glucose tolerance. Likewise, epidemiologic studies suggest that regular physical exercise prevents the development of DM2 and cardiovascular disease. Based on current recommendations, it is important to increase the level of physical exercise at a moderate intensity to achieve good cardiorespiratory and muscular conditions and to promote fat mass reduction, with consequent reductions of risk of developing metabolic syndrome.