Renoprotective mechanisms of exercise training against acute and chronic renal diseases - A perspective based on experimental studies.

Regular exercise training can lead to several health benefits, reduce mortality risk, and increase life expectancy. On the other hand, a sedentary lifestyle is a known risk factor for chronic diseases and increased mortality. Acute kidney injury (AKI) and chronic kidney disease (CKD) represent a significant global health problem, affecting millions of people worldwide. The progression from AKI to CKD is well-recognized in the literature, and exercise training has emerged as a potential renoprotective strategy. Thus, this article aims to review the main molecular mechanisms underlying the renoprotective actions of exercise training in the context of AKI and CKD, focusing on its antioxidative, anti-inflammatory, anti-apoptotic, anti-fibrotic, and autophagy regulatory effects. For that, bibliographical research was carried out in Medline/PubMed and Scielo databases. Although the pathophysiological mechanisms involved in renal diseases are not fully understood, experimental studies demonstrate that oxidative stress, inflammation, apoptosis, and dysregulation of fibrotic and autophagic processes play central roles in the development of tissue damage. Increasing evidence has suggested that exercise can beneficially modulate these mechanisms, potentially becoming a safe and effective non-pharmacological strategy for kidney health protection and promotion. Thus, the evidence base discussed in this review suggests that an adequate training program emerges as a valuable tool for preserving renal function in experimental animals, mainly through the production of antioxidant enzymes, nitric oxide (NO), irisin, IL-10, and IL-11. Future research can continue to explore these mechanisms to develop specific guidelines for the prescription of exercise training in different populations of patients with kidney diseases.

Decision Making in Health Management during Crisis: A Case Study Based on Epidemiological Curves of China and Italy against COVID-19.

In December 2019, a new infectious respiratory disease called COVID-19 was identified in Wuhan, Hubei province, in China and quickly reached pandemic status in March 2020, in uncertain and frightening situation. The objective of this study was to analyze the epidemiological curves from the fight against COVID-19 in China and Italy, establishing parameters that can assist with the decisions of health-planning managers. This study was conducted using the principles of the grounded theory methodology and a practical method of comparison between the real and ideal curves, based on the contamination and death data by SARS-CoV-2 in China and Italy. For this purpose, we built graphs, including parameters, such as, among others, amplitude, height, saturation point, acceleration, lethality, event, risk, and efficiency. The results of our study showed that China exhibited amplitude and height of the active contamination and death curve 2 times smaller than those of Italy which exhibited several saturations. It was investigated that Italy presented a qualitative risk of 5-6, whereas for China it was 4. According to the parameters, China and Italy presented health management that was able to reduce the impact caused by the virus. The implementation of adequate health management with these practical tools can guide perception of the crisis critical levels, avoiding major disasters. We intend to continue to validate the method in the analysis of data from Brazil and the USA.