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  1. Article ; Online: Effect of physical activity and exercise on telomere length: Systematic review with meta-analysis.

    Valente, Cristina / Andrade, Renato / Alvarez, Luis / Rebelo-Marques, Alexandre / Stamatakis, Emmanuel / Espregueira-Mendes, João

    Journal of the American Geriatrics Society

    2021  Volume 69, Issue 11, Page(s) 3285–3300

    Abstract: Purpose: To compare a physically active lifestyle or structured exercise program to physically inactive lifestyle or control groups on telomere length (TL).: Method: We searched PubMed, EMBASE, Cochrane Library, and Open Gray databases up to March 31, ...

    Abstract Purpose: To compare a physically active lifestyle or structured exercise program to physically inactive lifestyle or control groups on telomere length (TL).
    Method: We searched PubMed, EMBASE, Cochrane Library, and Open Gray databases up to March 31, 2020. We calculated standardized mean differences (SMD) with 95% confidence intervals (CI) of TL comparing physically active to physically inactive individuals and exercise intervention to control groups. Risk of bias was judged using the Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) for physical activity (PA) studies and the Cochrane risk-of-bias (RoB2) for exercise intervention studies. Certainty of evidence was judged using Grading of Recommendations Assessment, Development and Evaluation (GRADE).
    Results: We included 30 studies (24 assessing the effects of PA and 6 assessing the effects of exercise interventions) comprising 7418 individuals. Physically active individuals had longer telomeres (SMD = 0.70, 95% CI 0.12-1.28, very-low certainty), especially in middle-aged individuals (SMD = 0.90, 95% CI 0.08-1.72, very-low certainty) and when considering only athletes (SMD = 0.54, 95% CI 0.18-0.90, very-low certainty). Trim-and-fill analyses revealed that most of the pooled effects were overestimated. Exercise interventions did not yield any significant effect on TL.
    Conclusion: There is very-low certainty that physically active individuals have longer telomeres with a moderate effect, but this effect is probably overestimated.
    MeSH term(s) Bias ; Exercise/physiology ; Humans ; Sedentary Behavior ; Telomere/physiology
    Language English
    Publishing date 2021-06-23
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 80363-7
    ISSN 1532-5415 ; 0002-8614
    ISSN (online) 1532-5415
    ISSN 0002-8614
    DOI 10.1111/jgs.17334
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  2. Article ; Online: Therapeutics That Can Potentially Replicate or Augment the Anti-Aging Effects of Physical Exercise.

    De Sousa Lages, Adriana / Lopes, Valentim / Horta, João / Espregueira-Mendes, João / Andrade, Renato / Rebelo-Marques, Alexandre

    International journal of molecular sciences

    2022  Volume 23, Issue 17

    Abstract: Globally, better health care access and social conditions ensured a significant increase in the life expectancy of the population. There is, however, a clear increase in the incidence of age-related diseases which, besides affecting the social and ... ...

    Abstract Globally, better health care access and social conditions ensured a significant increase in the life expectancy of the population. There is, however, a clear increase in the incidence of age-related diseases which, besides affecting the social and economic sustainability of countries and regions around the globe, leads to a decrease in the individual's quality of life. There is an urgent need for interventions that can reverse, or at least prevent and delay, the age-associated pathological deterioration. Within this line, this narrative review aims to assess updated evidence that explores the potential therapeutic targets that can mimic or complement the recognized anti-aging effects of physical exercise. We considered pertinent to review the anti-aging effects of the following drugs and supplements: Rapamycin and Rapamycin analogues (Rapalogs); Metformin; 2-deoxy-D-glucose; Somatostatin analogues; Pegvisomant; Trametinib; Spermidine; Fisetin; Quercetin; Navitoclax; TA-65; Resveratrol; Melatonin; Curcumin; Rhodiola rosea and Caffeine. The current scientific evidence on the anti-aging effect of these drugs and supplements is still scarce and no recommendation of their generalized use can be made at this stage. Further studies are warranted to determine which therapies display a geroprotective effect and are capable of emulating the benefits of physical exercise.
    MeSH term(s) Exercise ; Longevity ; Quality of Life ; Sirolimus/pharmacology
    Chemical Substances Sirolimus (W36ZG6FT64)
    Language English
    Publishing date 2022-09-01
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms23179957
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  3. Article ; Online: European Portuguese Language and Cultural Validation of the Chronic Obstructive Pulmonary Disease Assessment Test.

    Pimenta Valério, Margarida / Ribeiro, Soraia / Seiça Cardoso, Carlos / Machado, João / Costa, José / Rodrigues, Cidália / Rebelo-Marques, Alexandre

    Acta medica portuguesa

    2022  Volume 35, Issue 10, Page(s) 738–742

    Abstract: Introduction: The chronic obstructive pulmonary disease assessment test (CAT) is a self-administered questionnaire that measures health-related quality of life. GOLD proposes using this questionnaire, since it provides thorough coverage of the impact of ...

    Abstract Introduction: The chronic obstructive pulmonary disease assessment test (CAT) is a self-administered questionnaire that measures health-related quality of life. GOLD proposes using this questionnaire, since it provides thorough coverage of the impact of chronic obstructive pulmonary disease (COPD) on well-being. This questionnaire has been widely used in daily clinical practice in Portugal, but it lacks validation for European Portuguese. The aim of this study was to carry out the cultural adaptation and validation of the CAT questionnaire so that the most appropriate version can be made available to Portuguese researchers and clinicians.
    Material and methods: A cross-sectional descriptive study was performed involving 65 patients with COPD aged 40 years or older. CAT and the previously validated Portuguese-language version of the Clinical Questionnaire for COPD were applied between January 2019 and June 2019. The agreement between the two questionnaires was determined with Kappa agreement with a 95% confidence interval. Spearman correlation was used to find the correlation between two scores.
    Results: The 65 patients included in the study were observed in a hospital-based pulmonology clinic [aged 68 ± 7 years; forced expiratory volume in 1 sec (FEV1) 49.86% ± 16.5% predicted]. CAT correlated significantly with all the domains and the overall score of the CCQ (0.47 < r < 0.75; p < 0.001). The bilingual patient interclass correlation coefficient was 0.922; Pearson's r = 0.928; p < 0.001. The Cronbach's alpha coefficient was 0.96 (p < 0.001).
    Conclusion: The European Portuguese version of the COPD Assessment Test is a valid instrument for measurement of health-related quality of life in COPD patients. The use of validated questionnaires is of great importance since it generates reliable and reproducible evidence for use either in research or clinical practice.
    MeSH term(s) Humans ; Language ; Translations ; Quality of Life ; Portugal ; Cross-Sectional Studies ; Reproducibility of Results ; Surveys and Questionnaires ; Pulmonary Disease, Chronic Obstructive/diagnosis
    Language English
    Publishing date 2022-10-03
    Publishing country Portugal
    Document type Journal Article
    ZDB-ID 603078-6
    ISSN 1646-0758 ; 0870-399X
    ISSN (online) 1646-0758
    ISSN 0870-399X
    DOI 10.20344/amp.15343
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  4. Article ; Online: Menstrual pattern and contraceptive choices of Portuguese athletes.

    Coutinho, Filipa Mendes / Rebelo-Marques, Alexandre / Andrade, Renato / Espregueira-Mendes, João / Bombas, Teresa / Moura, Paulo

    The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception

    2021  Volume 26, Issue 3, Page(s) 240–245

    Abstract: Objectives: Menstrual symptoms are commonly cited barriers to physical activity in women. Delay or avoidance of menstruation through hormonal contraceptives may mitigate those barriers. Our purpose is to identify the uterine bleeding patterns of ... ...

    Abstract Objectives: Menstrual symptoms are commonly cited barriers to physical activity in women. Delay or avoidance of menstruation through hormonal contraceptives may mitigate those barriers. Our purpose is to identify the uterine bleeding patterns of Portuguese athletes, their contraceptive choices and the impact of contraceptive methods in sports performance. We aim also to compare the outcomes between users and non-users of contraception.
    Methods: Observational, descriptive and comparative study based on a customised self-assessment online survey aimed at Portuguese athletes. Athletes had to be at least 16 years old and competing at a national, international or professional level.
    Results: A total of 256 athletes from 18 modalities were eligible. The mean age was 29 years and the mean age of menarche was 12.8 years. Monthly bleeding pattern was prevailing and 50% presented dysmenorrhoea. More than 85% experience fluctuations in sports performance throughout the month. The majority (71.5%) used contraceptive methods. Only 16% believed that contraception decreased sports performance. Contraceptive users exhibit a lower mean body mass index, blood loss and percentage of dysmenorrhoea than the non-users.
    Conclusion: Most athletes had the perception that performance varies throughout the month. The majority of participants do not report amenorrhoea and have monthly menses. The use of contraceptive methods is reportedly high, benefit cycle control and apparently without any physical inconvenience.
    MeSH term(s) Adolescent ; Adult ; Athletes/psychology ; Athletic Performance ; Choice Behavior ; Contraception ; Contraceptive Agents/administration & dosage ; Female ; Humans ; Menstrual Cycle ; Menstruation/physiology ; Middle Aged ; Portugal ; Young Adult
    Chemical Substances Contraceptive Agents
    Language English
    Publishing date 2021-02-22
    Publishing country England
    Document type Comparative Study ; Journal Article ; Observational Study
    ZDB-ID 1397560-2
    ISSN 1473-0782 ; 1362-5187
    ISSN (online) 1473-0782
    ISSN 1362-5187
    DOI 10.1080/13625187.2021.1879780
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  5. Article ; Online: Confirmatory Evaluation of the Modified Medical Research Council Questionnaire for Assessment of Dyspnea in Patients with Chronic Obstructive Pulmonary Disease in Portugal.

    Ribeiro, Soraia / Cardoso, Carlos Seiça / Valério, Margarida / Machado, João / Costa, José / Rodrigues, Cidália / Rebelo-Marques, Alexandre

    Acta medica portuguesa

    2021  Volume 35, Issue 2, Page(s) 89–93

    Abstract: Introduction: The Modified British Medical Research Council Questionnaire is considered an adequate and simple measure of breathlessness in chronic obstructive pulmonary disease. It is widely used in clinical practice in Portugal, but it still lacks ... ...

    Abstract Introduction: The Modified British Medical Research Council Questionnaire is considered an adequate and simple measure of breathlessness in chronic obstructive pulmonary disease. It is widely used in clinical practice in Portugal, but it still lacks confirmatory evaluation for the Portuguese setting. The aim of this study was to perform a cultural adaptation and validation of the Modified British Medical Research Council Questionnaire so that its most suitable version can be made available to researchers and clinicians in Portugal.
    Material and methods: We performed a cross-sectional descriptive study involving patients with chronic obstructive pulmonary disease aged 40 years or older. We applied the Modified British Medical Research Council Questionnaire and the previously validated Portuguese-language version of the clinical questionnaire for chronic obstructive pulmonary disease between January and June 2019. We determined the agreement between the two questionnaires with kappa agreement, with a 95% confidence interval, and we used Spearman correlation to find a correlation between two scores.
    Results: The study included 65 patients managed in a hospital pulmonology clinic (aged 68 ± 7 years; with predicted FEV1 of 49.86% ± 16.5%). The Modified British Medical Research Council scale correlated significantly with all the domains and the overall score of the clinical questionnaire for chronic obstructive pulmonary disease (0.46 < r < 0.68; p < 0.001). In bilingual patients, interclass correlation coefficient was 0.912 (p < 0.001).
    Discussion: Our study showed that the Portuguese-language version of the Modified British Medical Research Council Questionnaire is feasible and externally valid when compared with a traditional and previously validated instrument.
    Conclusion: The Portuguese version of the Modified British Medical Research Council Questionnaire is a valid instrument for measurement of breathlessness in chronic obstructive pulmonary disease.
    MeSH term(s) Adult ; Aged ; Biomedical Research ; Cross-Sectional Studies ; Dyspnea/diagnosis ; Dyspnea/etiology ; Humans ; Middle Aged ; Portugal ; Pulmonary Disease, Chronic Obstructive/complications ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Quality of Life ; Reproducibility of Results ; Surveys and Questionnaires
    Language English
    Publishing date 2021-04-19
    Publishing country Portugal
    Document type Journal Article
    ZDB-ID 603078-6
    ISSN 1646-0758 ; 0870-399X
    ISSN (online) 1646-0758
    ISSN 0870-399X
    DOI 10.20344/amp.15208
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  6. Article ; Online: Is the Acute: Chronic Workload Ratio (ACWR) Associated with Risk of Time-Loss Injury in Professional Team Sports? A Systematic Review of Methodology, Variables and Injury Risk in Practical Situations.

    Andrade, Renato / Wik, Eirik Halvorsen / Rebelo-Marques, Alexandre / Blanch, Peter / Whiteley, Rodney / Espregueira-Mendes, João / Gabbett, Tim J

    Sports medicine (Auckland, N.Z.)

    2020  Volume 50, Issue 9, Page(s) 1613–1635

    Abstract: Background: The acute: chronic workload ratio (ACWR) is an index of the acute workload relative to the cumulative chronic workloads. The monitoring of physical workloads using the ACWR has emerged and been hypothesized as a useful tool for coaches and ... ...

    Abstract Background: The acute: chronic workload ratio (ACWR) is an index of the acute workload relative to the cumulative chronic workloads. The monitoring of physical workloads using the ACWR has emerged and been hypothesized as a useful tool for coaches and athletes to optimize performance while aiming to reduce the risk of potentially preventable load-driven injuries.
    Objectives: Our goal was to describe characteristics of the ACWR and investigate the association of the ACWR with the risk of time-loss injuries in adult elite team sport athletes.
    Data sources: PubMed, EMBASE and grey literature databases; inception to May 2019.
    Eligibility criteria: Longitudinal studies that assess the relationship of the ACWR and time-loss injury risk in adult professional or elite team sports.
    Methods: We summarized the population characteristics, workload metrics and ACWR calculation methods. For each workload metric, we plotted the risk estimates for the ACWR in isolation, or when combined with chronic workloads. Methodological quality was assessed using a modified version of the Downs and Black scale.
    Results: Twenty studies comprising 2375 injuries from 1234 athletes (all males and mean age of 24 years) from different sports were included. Internal (65%) and external loads (70%) were collected in more than half of the studies and the session-rating of perceived exertion and total distance were the most commonly collected metrics. The ACWR was commonly calculated using the coupled method (95%), 1:4 weekly blocks (95%) and subsequent week injury lag (80%). There were 14 different binning methods with almost none of the studies using the same binning categories.
    Conclusion: The majority of studies suggest that athletes are at greater risk of sustaining a time-loss injury when the ACWR is higher relative to a lower or moderate ACWR. The heterogenous methodological approaches not only reflect the wide range of sports studied and the differing demands of these activities, but also limit the strength of recommendations.
    Prospero registration number: CRD42017067585.
    MeSH term(s) Adult ; Athletic Injuries/epidemiology ; Humans ; Male ; Risk Factors ; Team Sports ; Workload ; Young Adult
    Language English
    Publishing date 2020-06-22
    Publishing country New Zealand
    Document type Journal Article ; Systematic Review
    ZDB-ID 605911-9
    ISSN 1179-2035 ; 0112-1642
    ISSN (online) 1179-2035
    ISSN 0112-1642
    DOI 10.1007/s40279-020-01308-6
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  7. Article ; Online: Author Reply to "Regarding 'Identification of Normal and Injured Anterolateral Ligaments of the Knee: A Systematic Review of Magnetic Resonance Imaging Studies'".

    Andrade, Renato / Rebelo-Marques, Alexandre / Bastos, Ricardo / Zaffagnini, Stefano / Seil, Romain / Ayeni, Olufemi R / Espregueira-Mendes, João

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2019  Volume 35, Issue 8, Page(s) 2258–2260

    MeSH term(s) Knee Joint ; Ligaments, Articular ; Magnetic Resonance Imaging
    Language English
    Publishing date 2019-08-08
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2019.05.041
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  8. Article ; Online: Identification of Normal and Injured Anterolateral Ligaments of the Knee: A Systematic Review of Magnetic Resonance Imaging Studies.

    Andrade, Renato / Rebelo-Marques, Alexandre / Bastos, Ricardo / Zaffagnini, Stefano / Seil, Romain / Ayeni, Olufemi R / Espregueira-Mendes, João

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2019  Volume 35, Issue 5, Page(s) 1594–1613.e1

    Abstract: Purpose: To identify the normal and injured magnetic resonance imaging appearance of the anterolateral ligament (ALL).: Methods: A systematic review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) ... ...

    Abstract Purpose: To identify the normal and injured magnetic resonance imaging appearance of the anterolateral ligament (ALL).
    Methods: A systematic review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed and Cochrane Library electronic databases were used to search for studies that reported the imaging outcomes of the appearance of the ALL. Two authors performed the searches in duplicate up to April 30, 2018, and interobserver agreement was calculated. The methodologic quality of included articles was assessed using an adaptation of the Arrivé methodologic quality scale for clinical studies of radiologic examinations.
    Results: From the original 270 records, a total of 24 studies (κ = 0.94) comprising 2,427 knees in 2,388 patients (mean age, 33.3 years; 66% male patients; 63% with anterior cruciate ligament [ACL] injury) were included. The ALL appeared in 51% to 100% of all assessed knees (71%-100% in ACL-injured knees and 64%-97% in uninjured knees) and was injured in 11% to 79% of ACL-injured knees. Reliability rates varied considerably (0.04-1.0 for intraobserver and 0.143-1.0 for interobserver agreement), and the entire portion of the ligament was often not seen. The tibial insertion was seen in 21% to 96% of cases, followed by the meniscal (range, 0%-100%) and femoral (range, 0%-90%) insertions. The mean methodologic quality score was 5.1 ± 1.8 out of a possible score of 9.
    Conclusions: High variability was found in the identification of normal and injured ALL definition methods and the respective magnetic resonance imaging findings. Reliability rates varied considerably, and the entire portion of the ligament was often not seen.
    Level of evidence: Level IV, systematic review of Level II to IV studies.
    MeSH term(s) Anterior Cruciate Ligament/diagnostic imaging ; Anterior Cruciate Ligament Injuries/diagnostic imaging ; Femur/diagnostic imaging ; Humans ; Knee Joint/diagnostic imaging ; Magnetic Resonance Imaging ; Meniscus/diagnostic imaging ; Observer Variation ; Radiography ; Reproducibility of Results
    Language English
    Publishing date 2019-04-15
    Publishing country United States
    Document type Journal Article ; Systematic Review
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2018.10.120
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  9. Article ; Online: Late-Night Salivary Cortisol: Cut-Off Definition and Diagnostic Accuracy for Cushing's Syndrome in a Portuguese Population.

    Lages, Adriana Sousa / Frade, João Gonçalo / Oliveira, Diana / Paiva, Isabel / Oliveira, Patrícia / Rebelo-Marques, Alexandre / Carrilho, Francisco

    Acta medica portuguesa

    2019  Volume 32, Issue 5, Page(s) 381–387

    Abstract: Introduction: Diagnosis of Cushing's syndrome remains a challenge in clinical endocrinology. Even though late-night salivary cortisol is used as screening tool, individualized cut-off levels for each population must be defined.: Material and methods: ...

    Abstract Introduction: Diagnosis of Cushing's syndrome remains a challenge in clinical endocrinology. Even though late-night salivary cortisol is used as screening tool, individualized cut-off levels for each population must be defined.
    Material and methods: Three groups of subjects were studied: normal subjects, suspected and proven Cushing's syndrome. Salivary cortisol was measured using an automated electrochemiluminescence assay. The functional sensitivity of the assay is 0.018 μg/dL. The diagnostic cut-off level was defined by Receiver Operating Characteristic curve and Youden's J index.
    Results: We studied 127 subjects: 57 healthy volunteers, 39 patients with suspected and 31 with proven Cushing's syndrome. 2.5th - 97.5th percentile of the late-night salivary cortisol concentrations in normal subjects was 0.054 to 0.1827 μg/dL. Receiver Operating Characteristic curve analysis showed an area under the curve of 0.9881 (p < 0.0001). A cut-off point of 0.1 μg/dL provided a sensitivity of 96.77% (95% CI 83.3 - 99.92%) and specificity of 91.23% (95% CI 80.7 - 97.09%). There was a significant correlation between latenight salivary cortisol and late-night serum cortisol (R = 0.6977; p < 0.0001) and urinary free cortisol (R = 0.5404; p = 0.0025) in proven Cushing's syndrome group.
    Discussion: The mean ± SD late-night salivary cortisol concentration in patients with proven Cushing's syndrome (0.6798 ± 0.52 μg/ dL) was significantly higher (p < 0.0001). In our population, the late-night salivary cortisol cut-off was 0.1 μg/dL with high sensitivity and specificity.
    Conclusion: Late-night salivary cortisol has excellent diagnostic accuracy, making it a highly reliable, noninvasive, screening tool for outpatient assessment. Given its convenience and diagnostic accuracy, late-night salivary cortisol may be added to other traditional screening tests on hypercortisolism.
    MeSH term(s) Adult ; Aged ; Area Under Curve ; Biomarkers/analysis ; Cushing Syndrome/diagnosis ; Female ; Healthy Volunteers ; Humans ; Hydrocortisone/analysis ; Luminescent Measurements/methods ; Male ; Middle Aged ; ROC Curve ; Reference Values ; Saliva/chemistry ; Sensitivity and Specificity ; Time Factors
    Chemical Substances Biomarkers ; Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2019-05-31
    Publishing country Portugal
    Document type Journal Article
    ZDB-ID 603078-6
    ISSN 1646-0758 ; 0870-399X
    ISSN (online) 1646-0758
    ISSN 0870-399X
    DOI 10.20344/amp.11265
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  10. Article: Aging Hallmarks: The Benefits of Physical Exercise.

    Rebelo-Marques, Alexandre / De Sousa Lages, Adriana / Andrade, Renato / Ribeiro, Carlos Fontes / Mota-Pinto, Anabela / Carrilho, Francisco / Espregueira-Mendes, João

    Frontiers in endocrinology

    2018  Volume 9, Page(s) 258

    Abstract: World population has been continuously increasing and progressively aging. Aging is characterized by a complex and intraindividual process associated with nine major cellular and molecular hallmarks, namely, genomic instability, telomere attrition, ... ...

    Abstract World population has been continuously increasing and progressively aging. Aging is characterized by a complex and intraindividual process associated with nine major cellular and molecular hallmarks, namely, genomic instability, telomere attrition, epigenetic alterations, a loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication. This review exposes the positive antiaging impact of physical exercise at the cellular level, highlighting its specific role in attenuating the aging effects of each hallmark. Exercise should be seen as a polypill, which improves the health-related quality of life and functional capabilities while mitigating physiological changes and comorbidities associated with aging. To achieve a framework of effective physical exercise interventions on aging, further research on its benefits and the most effective strategies is encouraged.
    Language English
    Publishing date 2018-05-25
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2018.00258
    Database MEDical Literature Analysis and Retrieval System OnLINE

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