Bullying is defined as a set of intentional aggressions practiced in an unequal power relationship, bringing numerous psychological, physical, social, and learning consequences for the individual. In addition, it affects 43% of children and youth in Brazil, according to the UN. In view of this wide scope, it must be combated in order to provide a better quality of life for students. The aim of the project is to collect data on the number of aggressors and victims, the most frequent locations, the most affected gender, the most common age, the most frequent type of bullying, as well as its effect on the lives of young people. The project's methodology is based on dynamics for the establishment of bonds and questionnaires for the collection of data on the students' experience in relation to bullying. The results obtained showed that more than half revealed that they had already suffered bullying, indicating that there is the presence of this bully in this age group. Furthermore, they suggested that the stimulus of empathy in children reflected positively on their lives and on society as a whole. Therefore, the need to encourage respect since childhood is concluded, in order to minimize these practices and their consequences. Keywords: Bullying. Empathy. Education.

Significance: Obesity is a multifactorial disease with many risks to public health, with 39.6% of American adults and 18.5% of young people obese. Brazil ranks fifth in the world rankings, with about 18 million people. In this scenario, melatonin has evidenced an important function in the regulation of energy metabolism. Information gap: What is the real influence of melatonin supplementation on obesity and T2DM control? Objective: A systematic review of the physiological and endocrine aspects of melatonin was performed, as well as to analyze the real impact of its use for the treatment of obesity and type 2 diabetes in humans. Methods: 51 studies were selected to make up the textual part of the manuscript and 44 to make the Meta-analysis. The PRISMA rules followed. Results and Conclusion: Many studies have shown the importance of melatonin in various diseases, especially obesity, T2DM and metabolic syndrome. Human studies have shown that the use of melatonin is simple, safe, and has no side effects. Nevertheless, intervention studies using this hormone in obese or diabetic patients do not yet have a consensus on supplementation. Keywords: Melatonin. Obesity. Metabolism. Type 2 diabetes. Clinical study.

Introduction: In the scenario of cardiovascular disease (CVD), the WHO reported in 2017 that there are about 21.7 million deaths, of which more than ten million are due to atherosclerotic coronary disease. In Brazil, CVD is responsible for about 384 thousand deaths per year. Arterial access for coronary angiography and percutaneous coronary interventions has addressed the change from the transfemoral to the transradial (TRA) pathway, as this presents fewer complications, especially the distal transradial pathway (dTRA) in the anatomical snuffbox. Objective: To carry out a systematic review of the main snuffbox approaches. Methods: Review papers, systematic reviews, prospective studies, retrospective studies, clinical trials, and case reports were selected. The MeSH Terms were the Radial artery. Catheterization. Percutaneous coronary intervention. Of the total of 105 articles found, 23 studies were selected, following the rules of PRISMA. Results: The studies analyzed showed that dTRA is a reliable, safe, effective and comfortable route. The position of the arm during the intervention is comfortable for the patient, who does not need to expose the palm side of the arm while flexing the arm towards the operator. The studies also reported that there is a low rate of obstruction of the distal radial artery. There is also early hemostasis, low risk of hematoma formation, low level of pain perceived by patients, reduced risk of compartment syndrome, saving the radial artery for possible future myocardial revascularization grafting, and the operator's ability to work at a safe distance of the radiation source. The average success rate in the studies analyzed was 97%. The average rate of occlusion of the distal radial artery was 0.5%. Other complications at the access site were hematoma (0.2%), pulsatile hematoma (<0.1%), infection (0.1%), dissection (0.1%), arteriovenous fistula (<0.1%) . Conclusion: Distal radial access is a reliable, safe, effective, and comfortable route for cardiovascular interventions. They have a less arterial obstruction and short hemostasis. The main disadvantage is the difficulty in cannulation. However, more randomized studies and meta-analysis are needed to establish a guideline. Keywords: Transradial artery. Distal transradial artery. Left distal transradial artery. Catheterization. Percutaneous coronary intervention.  

Objective: This study measured the cortisol levels of professional athletes during a CrossFit® championship. Then, it evaluated the physiological response caused by cortisol. Increased cortisol levels may interfere with the athletes’ performance and muscle recovery. Materials and Methods: A prospective observational cross-sectional study was performed with a sample of eight female professional athletes, aged between 20 and 34 years, enrolled in the 2017 Brazil CrossFit Championship (TCB), held in Valinhos, state of Sao Paulo, Brazil.  The salivary samples were obtained during the three days of the championship in two different moments: in the morning, before athletes’ warm-up, and 15 minutes after the last workout of each day. Results: Before warming up, the mean values of salivary cortisol were 15.9 ng/mL, 13.2 ng/mL, and 13.1 ng/mL, respectively. After the last workout, the mean values for cortisol were 6.4 ng/mL, 9.6 ng/mL, and 7.1 ng/mL, respectively. A statistically significant difference was found on the first day of competition.  The results presented the expected diurnal cycle of this hormone.  Conclusion: CrossFit® is a sport that alternates medium- to high-intensity exercises, including gymnastics, metabolic conditioning, and weight lifting. This competitive sport presents a variability of stressors, which may increase cortisol production and secretion according to different studies. This study found that the physiological stress of a CrossFit® championship affects the production of cortisol and increases the stimulation of the hypothalamic axis. However, the normal cortisol secretion response suggests a physiological adaptation or alteration in the cortisol receptor in the athletes studied.  Further studies carried out with a larger sample are necessary to assess these neuroendocrine changes.Keywords: CrossFit®. Cortisol. Physical activity. Women.

Introduction: The number of disabilities due to age is expected to double by 2060. In this scenario, the development of sarcopenia is an important risk factor for the development of frailty, loss of independence and physical disability in the elderly and is associated with lower survival in critically ill patients. In this sense, the decline in fat-free mass correlates with the decline associated with the age of growth hormone (GH) secretion. Thus, GH secretagogue (MK-677) as the first orally active ghrelin mimetic may increase pulsatile GH secretion in the elderly. Objective: The main objectives were to determine whether oral MK-677 in healthy elderly would increase GH and IGF-I levels, prevent the decline of FFM and decrease abdominal visceral fat (AVF) with acceptable tolerability. Methods: A total of 18 articles were found involving MK-677, GH secretagogue, sarcopenia, insulin-like growth factor-1, safety, and efficacy. Initially, it was held the existing exclusion title and duplications following the interest described in this work. After this process, 5 articles were included and discussed in this study. The present study was elaborated according to the rules of systematic review- PRISMA (Transparent reporting of systematic reviews and meta-analysis- http://www.prisma-statement.org/). Results: In a clinical study, MK-677 neutralized three important factors contributing to the development of sarcopenia, which is reduced GH secretion, fat-free mass loss, and inadequate food intake. A recent study looked at the safety and efficacy of the oral GH secretagogue (MK-677) in humans, showing that MK-677 promotes pulsatile GH release that is subject to negative feedback and may prevent supra-therapeutic levels. of GH and its sequelae. Available studies indicate that MK-677 is well tolerated, however, there is a bias in decreased insulin sensitivity. There were no adverse effects attributable to MK-677. However, MK-677 had an unfavorable safety profile in individuals with congestive heart failure. Conclusion: The most confirmed sarcopenia treatment methods are nutritional overfeeding and resistance training, but studies have shown that supplementation with MK-677 can significantly reduce three important factors contributing to the development of sarcopenia, which is reduced secretion. GH loss, fat-free mass loss, and inadequate food intake, safely and effectively. However, it is imperative to increase randomized clinical trials to establish a consensus treatment. Keywords: MK-677. Ibutamoren. GH secretagogue. Sarcopenia. Elderly.

INTRODUCTION: Obesity is an important health condition that is related to high rates of morbidity and mortality. Bariatric surgery, although effective, has limited indications and may pose a risk of early and late postoperative complications, one of which is related to the gastric retaining ring, such as erosion, sliding of the device, and food intolerance. One of the modalities used in the endoscopic treatment of ring extraction is the use of stents, which represents a minimally invasive, safe, and effective alternative to the detriment of surgical treatment. OBJECTIVE: To characterize the modalities of endoscopic treatment using Stents for the treatment of complications associated with the retaining ring in the postoperative period of bariatric surgery and to determine the success rate of the different methods of endoscopic treatment. METHODS: The present study will follow an international model of systematic review and meta-analysis, following the rules of PRISMA. The search strategies for this systematic review will be based on the keywords (MeSH Terms) “Obesity. Endoscopy. Bariatric surgery. Gastric Bypass. Stents ”, with publications between 2010 and 2020, in order to analyze more recent scientific publications. Meta-analysis: A common descriptive statistical analysis will be carried out, obtaining the values of total N, mean, standard deviation, confidence interval (CI), and percentage (frequency) for all predictors. The One-Way test (ANOVA) will be applied, adopting the α level less than 0.05 with a statistically significant difference for the 95% CI. The value of R-sq (I2) will be analyzed to discover the inaccuracy or heterogeneity of the analyzes. The S factor will indicate the standard deviation between the data points and the adjusted values.  Keywords: Obesity. Endoscopy. Bariatric surgery. Gastric Bypass. Stent.

Background: Endoscopic methods, especially the intragastric balloon (IGB), have been shown to be effective for the treatment of excess weight. This study aimed to assess the tolerance, complications and efficacy of excess weight treatment with a non-adjustable IGB during 6 months. Methods: A total of 5,874 patients treated with a liquid filled IGB (600-700mL) and followed up by a multidisciplinary team were evaluated.  Participants presented an initial body mass index (BMI) ≥25 kg/m2 and were stratified according to sex and degree of overweight (pre-obesity and obesity grade I, II and III).  Results: The incidence of complications was 7.32% (n=430): 6.10% (n=357) early IGB removal, 0.20% (n=12) gas production inside the balloon, 0.54% (n=32) leakage, 0.32% (n=19) pregnancy, 0.07% (n=4) gastric perforation, 0.05% (n=3) upper digestive bleeding,  0.01% (n=1) Wernick Korsakoff syndrome due to excessive vomiting, 0.02% each (n=1) pancreatitis and esophagus perforation. The 5,444 remaining patients (4081 women, 38±38years) presented a weight loss of 19.13±8.86kg and a BMI decreased significantly (p<0.0001) (36.94±5.67 vs. 30.08±5.06 kg/m2). The % total weight loss (%TWL) was 18.42±7.25% and % excess weight loss (%EWL) 65.66±36.24%. The treatment success rate (%TWL≥10%) was 85%. The %EWL was higher in the pre-obese group (122.19%), followed by obesity grades I (76.67%), II (56.01%) and III (45.45%), with p<0.0001 for each group. %EWL was higher in women (69.71%) than in men (53.39), with p<0.0001 for each group. There was also a statistical difference between the TWL and EWL groups, with p<0.001 for all analyzes. Conclusion: Endoscopic IGB treatment for excess weight is an excellent therapeutic option for patients with different degrees of overweight. Keywords: Intragastric balloon. Orbera balloon. Bariatric endoscopy. Endoscopic. Obesity treatment.

COVID-19 disease is associated with a high inflammatory load that can induce vascular inflammation, myocarditis, and cardiac arrhythmias. Mortality from COVID-19  disease in 2019 is strongly associated with cardiovascular disease, diabetes, and hypertension. These disorders share the underlying pathophysiology related to the renin-angiotensin system (SARS). Cardiovascular disease and SARS pharmacological inhibition increase ACE2 levels, which can increase coronavirus virulence in the lung and heart. On the other hand, there is evidence that coronavirus infection can decrease ACE2, leading to toxic over-accumulation of angiotensin II, which induces acute respiratory distress syndrome and fulminant myocarditis. In addition, there is scientific evidence that SARS-CoV-2 can bind chemically to the heme group of hemoglobin and thus cause the release of iron ions (Fe2+ and Fe3+) that can damage tissues, including the lungs and heart. Another important information is that the heme group is produced by mitochondria and, in this case, the oral or intramuscular use of Coenzyme Q10 (ubiquinone) is strongly recommended, as it stimulates the increase in mitochondrial production. Therefore, the use of chelators of iron ions is notorious, as well as the administration of Coenzyme Q10 as a treatment for patients infected with SARS-CoV-2. Keywords: SARS-CoV-2. Cardiovascular diseases. Heme group. Iron ions. Mitochondrial production.

Introduction: On March 11, 2020, the World Health Organization (WHO) declared the coronavirus outbreak (COVID-19) to be pandemic. By March 16, 2020, 139 countries were affected. In this situation, the Scientific Societies decided to prepare this Contingency Plan to guide the response of health services. 4,088,848 COVID-19 cases and 283,153 deaths were confirmed worldwide. Recent data presented by the Ministry of Health in Brazil show that 177,589 cases of coronavirus and 72,597 recovered people have already been registered. However, nursing homes usually are not counted in these statistical data, as people usually die in the Istitution. Thus, developing a monitoring program in medical services, such as in nursing homes for eldery people (NHE) with ideal care for possible patients infected with COVID-19, is essential to increase the protection of the most vulnerable, as well as professionals of health. Objective:  To present the monitoring program of the Nursing homes in the city of São José do Rio Preto/SP, by Faceres Medica School, as an important strategy to identify, control and allocate patients infected by COVID-19. Methods:. All the NHE registered in the city council were raised , with data such as head nurse name, number of beds available and number of inpatients . According to the program's action plan, telephone calls was made daily by trained medical students with a professor tuition to all institutions and information was provided by the head nurse. Thus, when a resident or employee has symptoms, he was removed and tested for SARS-CoV-2. Subsequently, epidemiological surveillance was communicated and the case was monitored. Final Considerations: According to the world literature, elderly patients with COVID- 19 are more likely to progress to severe disease. Therefore, extensive measures to reduce the transmission of COVID-19 from person to person are being implemented to control the current outbreak. The monitoring program at the NHE proposed in the present study aims to collaborate in this regard, especially to the most vulnerable.