ABSTRACT
Introduction: During the COVID-19 pandemic, international organizations recommended regular physical exercise to maintain physical and mental health during confinement, however, it is an emerging disease, the evidence is not conclusive regarding the relationship between a physical inactivity and the risk of serious outcomes in patients with COVID-19, therefore, it is essential to identify the contribution of the type of physical exercise modality and the contribution to the immune system. Objective: To demonstrate the immunological response of different physical exercise modality in the population between 18 and 84 years of age, the population identified with the highest number of confirmed cases of COVID-19, in the report n°198 of the World Health Organization. Materials and methods: A review of the literature was carried out between Central Pubmed, Google Scholar and Scielo from January 2016 to December 2021. Results: Of the selected articles, it was possible to identify the main benefits in the immune response with both modalities of physical exercise (aerobic and/or resistance) in the target population. Conclusion: At present, the benefits on the immune response in patients with COVID-19 are completely unknown, which is why it is essential to identify the contribution on the immune response in different modalities of physical exercise in the population between 18-84 years of age.
Introducción: Durante la pandemia de COVID-19, organismos internacionales recomendaron ejercicio físico regular para mantener la salud física y mental durante el confinamiento, sin embargo, al tratarse de una enfermedad emergente, la evidencia no es concluyente en relación a una inactividad física y el riesgo de desenlaces graves en estos pacientes con COVID-19. Es fundamental identificar el aporte del tipo de modalidad de ejercicio físico al sistema inmunológico. Objetivo: Demostrar la respuesta inmunológica de las diferentes modalidades de ejercicio físico en la población de 18 a 84 años, población identificada con mayor número de casos confirmados de COVID-19, en el informe n°198 de la Organización Mundial de la Salud. Materiales y métodos: Revisión de la literatura entre Pubmed Central, Google Scholar y Scielo (enero de 2016 - diciembre de 2021). Resultados: De los artículos seleccionados se identificó los principales beneficios en la respuesta inmune con ambas modalidades de ejercicio físico (aeróbico y/o resistencia) en dicha población. Conclusión: En la actualidad se desconoce por completo los beneficios sobre la respuesta inmune en pacientes con COVID-19, por ello, es fundamental identificar el aporte sobre la respuesta inmune en diferentes modalidades de ejercicio físico en la población entre 18-84 años de edad.
Subject(s)
Humans , Exercise , Health , Resistance Training , Sedentary Behavior , Endurance Training , ImmunityABSTRACT
BACKGROUND: Antimicrobial resistance of bacterial pathogens is an increasing clinical problem and alternative approaches to antibiotic chemotherapy are needed. One of these approaches is the use of lytic bacterial viruses known as phage therapy. We aimed to assess the efficacy of phage therapy in preclinical animal models of bacterial infection. METHODS: In this systematic review and meta-analysis, MEDLINE/Ovid, Embase/Ovid, CINAHL/EbscoHOST, Web of Science/Wiley, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar were searched from inception to Sept 30, 2021. Studies assessing phage efficacy in animal models were included. Only studies that assessed the efficacy of phage therapy in treating established bacterial infections in terms of survival and bacterial abundance or density were included. Studies reporting only in-vitro or ex-vivo results and those with incomplete information were excluded. Risk-of-bias assessment was performed using the Systematic Review Centre for Laboratory Animal Experimentation tool. The main endpoints were animal survival and tissue bacterial burden, which were reported using pooled odds ratios (ORs) and mean differences with random-effects models. The I2 measure and its 95% CI were also calculated. This study is registered with PROSPERO, CRD42022311309. FINDINGS: Of the 5084 references screened, 124 studies fulfilled the selection criteria. Risk of bias was high for 70 (56%) of the 124 included studies; therefore, only studies classified as having a low-to-moderate risk of bias were considered for quantitative data synthesis (n=32). Phage therapy was associated with significantly improved survival at 24 h in systemic infection models (OR 0·08 [95% CI 0·03 to 0·20]; I2=55% [95% CI 8 to 77]), skin infection (OR 0·08 [0·04 to 0·19]; I2â=â0% [0 to 79]), and pneumonia models (OR 0·13 [0·06 to 0·31]; I2=0% [0 to 68]) when compared with placebo. Animals with skin infections (mean difference -2·66 [95% CI -3·17 to -2·16]; I2â=â95% [90 to 96]) and those with pneumonia (mean difference -3·35 [-6·00 to -0·69]; I2â=â99% [98 to 99]) treated with phage therapy had significantly lower tissue bacterial loads at 5â±â2 days of follow-up compared with placebo. INTERPRETATION: Phage therapy significantly improved animal survival and reduced organ bacterial loads compared with placebo in preclinical animal models. However, high heterogeneity was observed in some comparisons. More evidence is needed to identify the factors influencing phage therapy performance to improve future clinical application. FUNDING: Swiss National Foundation and Swiss Heart Foundation.
Subject(s)
Bacterial Infections , Phage Therapy , Humans , Bacterial Infections/therapy , Anti-Bacterial Agents/therapeutic useABSTRACT
INTRODUCTION: The main route of transmission of SARS-CoV-2 is the upper respiratory tract via cell membranes, including angiotensin-converting enzyme 2 (ACE2) and transmembrane host-associated serine protease transmembrane serine protease 2 (TMPRSS2). Both enzymes present in the nasal epithelium are the first direct point of contact for SARS-CoV-2. In this sense, the mucosal immune mechanisms of the upper respiratory tract, including immunoglobulin A (IgA), could be enhanced by physical exercise and be the first defense mechanism against the transmission and infection of SARS-CoV-2. AREAS COVERED: The authors reviewed recent biomedical literature available in databases related to the effects of exercise and training modalities on IgA concentration levels in the upper respiratory tract in different populations. EXPERT OPINION: According to the biomedical literature reviewed, physical exercise can decrease or improve the level of IgA concentrations. However, it is important to take into account factors such as training load, recovery during the exercise session and between training, as well as the exercise modality. Furthermore, the characteristics of the target population should be taken into account to maximize the adaptive immune response to adequately strengthen the upper respiratory tract and potentially be a barrier against SARS-CoV-2 infection.
Subject(s)
COVID-19 , SARS-CoV-2 , Exercise , Humans , Immunoglobulin A , Peptidyl-Dipeptidase A/metabolism , Respiratory SystemABSTRACT
BACKGROUND: Chronic Chagas cardiomyopathy (CCM) is ranked among heart failure etiologies with the highest mortality rates. CCM is characterized by alterations in left ventricular function with a typical and unique pattern of myocardial involvement. Left ventricle longitudinal speckle tracking strain is emerging as an important additive method for evaluating left ventricular function and risk of future cardiovascular events. This systematic review aimed to characterize the left ventricle (LV) longitudinal strain by speckle tracking patterns in the different stages of Chagas disease, compared to healthy controls. METHODS: Searches in Medline, EMBASE, and LILACS databases (from inception to 20 May 2021) were performed. Articles written in any language that assessed patients with Chagas disease and reported any measures derived from the left ventricular strain by speckle tracking were included. Two reviewers independently selected the studies, extracted the data, and assessed the quality of evidence. Standardized mean differences (SMD) were pooled using random-effects meta-analyses. RESULTS: Of 1044 references, ten studies, including a total of 1222 participants (CCM: 477; indeterminate form: 444; healthy controls: 301), fulfilled the selection criteria and were included in the final analysis. Patients with CCM had a significantly higher mean global longitudinal strain (GLS) value than indeterminate form (IF) patients (SMD 1.253; 95% CI 0.53, 1.98. I2 = 94%), while no significant difference was observed between IF patients and healthy controls (SMD 0.197; 95% CI -0.19, 0.59. I2 = 80%). Segmental strain analyses revealed that patients with the IF form of CD had significantly worse strain values in the basal-inferoseptal (SMD 0.49; 95% CI 0.24, 0.74. I2: 24%), and mid-inferoseptal (SMD 0.28; 95% CI 0.05, 0.50. I2: 10%) segments compared to healthy controls. CONCLUSIONS: Our results suggest different levels of functional derangements in myocardial function across different stages of Chagas disease. Further research is needed to assess the prognostic role of LV longitudinal strain and other measures derived from speckle tracking in CD patients regarding progression to cardiomyopathy and clinical outcomes prediction.
ABSTRACT
El ectima gangrenoso es una manifestación cutánea de infección por Pseudomonas que lleva a confusión diagnóstica y que puede tener consecuencias devastadoras para el paciente y aun llevarlo a la muerte. Se presenta el caso de un niño sano de 2 meses de edad con aparición de lesiones en el 5º dedo del pie sin compromiso sistémico que correspondía a ectima gangrenoso por P. aeruginosa, diagnosticado por lámpara de Wood y a la buena y rápida respuesta del paciente al tratamiento antibiótico específico. Este caso es típico de la variedad localizada, sin neutropenia y sin septicemia, que se puede observar en pacientes sanos.
Ecthyma gangrenosum is a cutaneous manifestation of Pseudomonas infection that confusing to diagnose due to similarities with other pathologies and that can have devastating consequences for the patient and even cause death. A case of a healthy infant with lesions in the 5th toe without systemic compromise corresponding to ecthyma gangrenosum caused by P. aeruginosa, diagnosed by Wood lamp and the patients good fast answer to the specific antibiotic treatment. This case is typical of the local variety without neutropenia nor septicemia, as observed in healthy patients.
