Universidade Federal de Roraima

Anabolic-androgenic steroids (AAS) are widely used by resistance-trained athletes, but their effects on cardiac structure and function remain uncertain.

To assess the impact of AAS on cardiac structure and function using echocardiography.

We performed a systematic review and meta-analysis to assess the effects of AAS on echocardiographic parameters in athletes, using a random-effects model and Review Manager 5.4.1.

We included 35 studies with 2000 male individuals (834 resistance-trained athletes using AAS vs 754 resistance-trained non-users vs 412 sedentary controls; mean age 32 years). Compared with non-users of AAS, AAS users was associated with a decrease in left ventricular (LV) ejection fraction (MD -2.25 %; 95 % CI -3.41 to -1.09; p < 0.01), and global longitudinal strain (GLS) (MD 3.34 %; 95 % CI 2.93 to 3.76; p < 0.01). Athletes who used AAS also had an increased septal wall thickness (MD 1.24 mm; 95 % CI 0.79 to 1.69; p < 0.01), posterior wall thickness (MD 1.09 mm; 95 % CI 0.70 to 1.48; p < 0.01) and LV mass (MD 13.29 g; 95 % CI 6.25 to 20.33; p < 0.01). LV end-diastolic diameter was also higher among AAS users (MD 1.09 mm; 95 % CI 0.44 to 1.73; p < 0.01).

Among athletes, AAS was associated with a significant decrease in LV ejection fraction and GLS, alongside with increased septal and posterior wall thickness, LV mass, and end-diastolic diameter compared with athletes who do not use AAS. These findings suggest adverse cardiac remodeling in AAS users, highlighting the potential harmful cardiovascular effects of steroid use in athletes.

The use of electronic cigarettes has increased markedly over the past decade, particularly among young adults, representing a growing public health concern. Pharmacological interventions for the cessation of vaping are thus limited. This meta-analysis assessed the efficacy and safety of varenicline compared with that of placebo in vaping cessation.

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following the Cochrane Collaboration and PRISMA guidelines. The PubMed, Embase, and Cochrane databases were searched until April 2025. The outcomes included continuous abstinence, seven-day point prevalence abstinence at the end of treatment and follow-up, and adverse events, including nausea and vivid dreams.

Three RCTs comprising 355 participants were included. Varenicline significantly increased seven-day point-prevalence abstinence at the end of treatment (RR, 2.30; 95 % CI, 1.64-3.24) and at follow-up (RR, 2.14; 95 % CI, 1.47-3.10) and improved continuous abstinence rates (RR, 2.71; 95 % CI, 1.48-4.99). The overall incidence of adverse events did not differ significantly between the groups (RR: 1.49; 95 % CI: 0.68-3.25). However, nausea (RR: 2.35; 95 % CI 1.77-3.13) and vivid dreams (RR: 2.56; 95 % CI 1.59-4.11) were more frequent among patients receiving varenicline treatment CONCLUSION: Varenicline improved vaping cessation rates compared to placebo and was generally well tolerated, despite a higher incidence of nausea and vivid dreams.

Relapsed B-cell acute lymphoblastic leukemia (B-ALL) remains a therapeutic challenge, particularly in children, adolescents, and young adults. Blinatumomab, a bispecific T-cell engager targeting CD19-positive leukemic cells, has emerged as an alternative to conventional chemotherapy in post-induction consolidation. This meta-analysis aimed to evaluate its impact on survival outcomes, relapse rates, and treatment-related toxicities.

A systematic review and meta-analysis were conducted following PRISMA guidelines. Randomized controlled trials (RCTs) comparing blinatumomab to chemotherapy as post-induction consolidation therapy in children, adolescents, and young adults with first relapse of standard-risk B-ALL were included. Primary outcomes were disease-free survival (DFS) and overall survival (OS). Secondary outcomes included cumulative incidence of relapse, measurable residual disease (MRD) negativity, hematopoietic stem cell transplantation (HSCT) eligibility, and treatment-related toxicities. Effect sizes were estimated using hazard ratios (HR) and risk ratios (RR) with 95% confidence intervals (CI).

Four RCTs including 703 patients were analyzed. Blinatumomab was associated with improved disease-free survival (DFS) (HR 0.59; 95% CI, 0.42-0.81) and OS (HR 0.57; 95% CI, 0.43-0.76), as well as a lower cumulative incidence of relapse (HR 0.26; 95% CI, 0.16-0.41). Referral for HSCT was more frequent in the blinatumomab group (RR 1.43; 95% CI, 1.10-1.85). Furthermore, blinatumomab was associated with a higher rate of measurable residual disease (MRD) negativity at the end of the first consolidation cycle (RR 1.96; 95% CI, 1.40-2.76).

Blinatumomab improved survival outcomes and increased the proportion of patients referred for HSCT, supporting its role as post-induction consolidation therapy for relapsed B-ALL in paediatric and young adult populations.