Impact of aerobic and resistance training on fatigue, quality of life, and physical activity in prostate cancer patients: a systematic review and meta-analysis.

BACKGROUND: Prostate cancer (PCa) is a prevalent cancer with significant morbidity and mortality rates. In most cases, prostate cancer remains asymptomatic until advanced disease manifests with symptoms, such as benign prostate hyperplasia (BPH). Timely detection and better management have improved overall survival in patients with prostate cancer, and fatigue, reduced physical activity, and impaired quality of life (QoL) remain major challenges that impact daily life. OBJECTIVE: This study aimed to systematically review and conduct a meta-analysis to evaluate the impact of aerobic and resistance training on fatigue, quality of life, and physical activity in prostate cancer patients undergoing treatment. MATERIAL METHODS: A comprehensive literature search was conducted using the PubMed, Cochrane Library, and clinicaltrials.gov databases, adhering to the PRISMA guidelines. Twenty studies, involving 1393 participants, were included in the final analysis. The inclusion criteria were Studies that evaluated the effects of exercise interventions relative to passive controls in patients with prostate cancer were included. The primary outcomes of interest were fatigue, QoL, and PA.. Data from eligible studies were extracted, and a meta-analysis was performed using RevMan 5.40. RESULTS: Twenty studies met our inclusion criteria. Data Analysis of the included studies demonstrated a significant improvement in quality of life among prostate cancer patients in the exercise group compared to the control group (SMD=0.20, 95% CI=0.07 to 0.34, P=0.003). However, there was no significant association between exercise and fatigue (SMD=0.07, 95% CI=-0.13, 0.26, P=0.51). Sensitivity analysis did not alter these findings. Regarding physical activity outcomes, the control group exhibited superior performance in the 400-meter walk test (P<0.05). No significant associations were found between exercise and the 6-meter walk test or up-and-go time. CONCLUSION: This systematic review revealed that aerobic and resistance training enhance the quality of life of patients with prostate cancer, although it has a limited impact on fatigue and physical activity levels. These findings advocate a shift in clinical practice and positioning exercise as a core component of comprehensive cancer care. Tailoring exercise regimens according to individual patient needs and treatment stages should become the norm in treatment planning. This approach goes beyond physical wellness and addresses the psychological and emotional facets of cancer management. Moreover, there is an evident need for further research to develop holistic exercise interventions that effectively address the complex dynamics of fatigue, physical activity, and QoL in this patient group.

Small airway disease in post-acute COVID-19 syndrome, a non-conventional approach in three years follow-up of a patient with long COVID: a case report.

BACKGROUND: Small airways disease (SAD), a novel finding described in post-acute COVID-19 patients, should be suspected when respiratory symptoms continue, air trapping persists on expiratory CT scans, and imaging findings fail to improve despite objectively better conventional pulmonary function test (PFT) parameters. The forced oscillation technique (FOT) and Multiple breathing washout (MBW) are both very sensitive methods for detecting anomalies in the peripheral airways. CASE PRESENTATION: We discuss the case of a 60-year-old Hispanic patient who had severe COVID-19 pneumonia and developed dyspnea, fatigue, and limited daily activity a year later. The PFTs revealed restrictive lung disease, as seen by significant diffusing capacity of the lungs for carbon monoxide (DLCO) decrease, severe desaturation, and poor 6-min walk test (6MWT) performance. The patient was treated with lowering corticosteroids as well as pulmonary rehabilitation (PR). During the 24-month follow-up, the dyspnea and fatigue persisted. On PFTs, 6MWT performance and restricted pattern improved slightly, but MBW discovered significant ventilatory inhomogeneity. FOT revealed substantial peripheral airway obstructive abnormalities. On CT scans, air trapping and ground-glass opacities (GGO) improved somewhat. The patient used a bronchodilator twice a day and low-dose inhaled corticosteroids (160 µg of budesonide and 4.5 µg of formoterol fumarate dihydrate) for nine months. PR sessions were resuming. The restricting parameters were stabilized and the DLCO had normalized after 36 months, with a 6MWT performance of 87% but significant desaturation. The CT scan revealed traction bronchiectasis, low GGO, and persistent air trapping. Without normalization, FOT and MBW scores improved, indicating small airway disease. CONCLUSIONS: The necessity of integrating these tests when detecting SAD is emphasized in our paper. This article lays the foundation for future research into the best ways to manage and monitor SAD in post-acute COVID-19 patients.

Anaphylaxis after prick-to-prick skin test to seafood allergy: A rare adverse event.

Allergies to seafood are common all over the world. The prick-to-pricktest is used to diagnose allergic reactions. In this article, a femalepatient suffered an anaphylactic reaction 5 minutes following a Prick-to-Prick skin test. Therefore, it is important to stratify, recognize and treatthe anaphylactic reaction promptly.

Pulmonary Evaluation of Post-COVID-19 Patients: An Ecuadorian Experience.

Background: Despite the growing concerns related to the potential of long-term pulmonary sequelae due to COVID-19, data about intermediate and long-term changes in the respiratory function of patients who recover is relatively sparse, particularly in developing countries. Objectives: To assess the characteristics and pulmonary function at follow-up in a sample of Ecuadorian patients that recovered from the virus. Methods: We conducted a cross-sectional study that included 43 patients after symptomatic COVID infection, who were evaluated by spirometry, single breath DLCO, and 6MWT. For statistical analysis we performed point biserial correlations, and chi squared tests. Results: Overall, 30.3% of patients (n = 13) reported persistent symptoms, with fatigue being the most common (23.3%, n = 10). Around 34.9% (n = 15) of the sample had a restrictive spirometry pattern, 18.6% (n = 8) had an abnormally decreased adjusted DLCO. A restrictive spirometry pattern was associated with an abnormally low adjusted DLCO (χ2(2) = 11,979, p = 0.001). Conclusion: We found that a considerable proportion of patients presented with persistent symptoms and alterations in pulmonary function following COVID-19, mainly a restrictive respiratory pattern and abnormally low DLCO. Further studies are needed to determine which patients may benefit from the follow-up with specific pulmonary function tests.

Current Needs Assessment for Using Lung Clearance Index for Asthma in Clinical Practice.

PURPOSE OF REVIEW: Asthma pathophysiology has shown that remodeling of the bronchial airways mainly affects the small rather than large airways. The severity of asthma is conventionally measured by forced expiratory volume 1 (FEV1) but this maneuver is insensitive to changes in distal airways with smaller diameter. The aim of this review is to evaluate the current evidence supporting LCI as a clinical tool for assessing small airways disease in asthma patients, as well as whether it is useful as a treatment response parameter in severe therapy-resistant asthma (STRA) patients. RECENT FINDINGS: There is an increasing need for novel tests that can assess distal airway disease in asthma. Lung Clearance Index (LCI) may be a useful test for assessing more severe airway obstruction and the persistence of small airway disease. LCI measurement has been shown to be more sensitive than spirometry in cystic fibrosis (CF), but its clinical utility in asthma has not been thoroughly investigated. LCI abnormalities may be a sensitive marker for the persistence of small distal airway disease and may be associated with a more severe asthma endotype unresponsive to inhaled glucocorticoids. There is a need to identify other lung function tests for asthma that can identify early airway remodeling while simultaneously measuring the rate of lung function impairment. When compared to other conventional methods, multiple-breath washout (MBW) measures the lung clearance index (LCI), a more sensitive predictor of early airway disease that is feasible to perform in children. The goal of this review is to evaluate the current evidence of LCI as a clinical tool in asthma patients.

[Skin reactions to the Pfizer-BioNTech vaccine for COVID-19. An Ecuadorian experience]. / Reacciones cutáneas a la vacuna Pfizer-BioNTech contra COVID-19. Una experiencia ecuatoriana.

OBJETIVE: To assess cutaneous reactions after Pfizer-BioNTech COVID-19 vaccine administration. METHODS: A cross-sectional observational study was carried out in health workers belonging to the city of Guayaquil-Ecuador, from March to May 2021. The participants were contacted through a local registry established by the Universidad Espíritu Santo. Frequencies and percentages were used to represent the proportions of nominal variables, while the mean and standard deviation were used for continuous data, given a normal sample distribution. RESULTS: Local skin reactions were the most frequent, and included redness, edema, and itching. On the other hand, delayed large local skin reactions (generalized rash and pruritus, angioedema, urticaria, eczema, petechiae) were rare and occurred in less than 1.4% of participants, (95% CI = 0.69-1.00). Finally, we did not find cases of anaphylaxis or other life-threatening reactions requiring urgent attention after vaccination. CONCLUSIONS: Our findings suggest that local skin reactions occur in a minority of recipients and are often mild and self-limited.

OBJECTIVO: Evaluar las reacciones cutáneas tras la administración de la vacuna COVID-19 de Pfizer-BioNTech. MÉTODOS: Se realizó un estudio observacional transversal en trabajadores de la salud, pertenecientes a la ciudad de Guayaquil-Ecuador, de marzo a mayo de 2021. Los participantes fueron contactados a través de un registro local establecido por la Universidad Espíritu Santo. Se utilizaron frecuencias y porcentajes para representar las proporciones de las variables nominales, mientras que la media y la desviación estándar se usaron para datos continuos, dada la distribución de muestra normal. RESULTADOS: Las reacciones cutáneas locales fueron las más frecuentes e incluyeron enrojecimiento, edema y prurito. Por otro lado, las reacciones cutáneas locales grandes retardadas (exantema y prurito generalizados, angioedema, urticaria, eccema y petequias) fueron raras y ocurrieron en menos de 1.4 % de los participantes, (IC 95 % = 0.69-1.00). Finalmente, no encontramos casos de anafilaxia u otras reacciones potencialmente mortales que requieran atención urgente después de la vacunación. CONCLUSIONES: Nuestros hallazgos sugieren que las reacciones cutáneas locales ocurren en una minoría de personas y que a menudo son leves y autolimitadas.

Adverse reactions following COVID-19 vaccination: An Ecuadorian experience.

BACKGROUND: Limited large-scale studies have been conducted to investigate the adverse effects of COVID-19 vaccine in Latin America, particularly among the healthcare worker (HCW) population in Ecuador. The objective of this study was to assess a cohort of Ecuadorian healthcare workers for adverse reactions following vaccination with the Pfizer-BioNTech vaccine. METHODS: We conducted an observational cross-sectional study to assess the potential adverse reactions to the Pfizer-BioNTech COVID-19 vaccine among a sample of healthcare workers (HCWs) in the city of Guayaquil, Ecuador, from March to May 2021. RESULTS: The sample comprised 1291 patients, with a mean age of 39.3 years (SD, 13.5). In general, 79% (N = 1020) of participants presented an adverse effect of any type at first dose, while 75.1% (N = 969) did so at the second dose. Pain at the puncture site was the most common adverse effect overall after either the first (68.4%) and second (55.6%) dose. Regarding anaphylaxis, no participant developed the condition after the first dose, and only 0.2% (N = 2) developing it at the second dose. No fatalities were reported. CONCLUSION: Our findings suggest that adverse reactions following COVID-19 vaccination with the Pfizer-BioNTech vaccine are relatively common, albeit often mild and self-limited. Consistent with the literature there were few cases of anaphylaxis, and no deaths that could be attributed to the inoculation with the vaccine. We hope our findings can help to reassure the public that benefits of vaccination highly outweigh the risks and contribute to the effort of reducing vaccine hesitancy among those who are concerned about the safety and potential side effects.

Follow-up of two cases of suspected interstitial lung disease following severe COVID-19 infection shows persistent changes in imaging and lung function.

Physicians are observing persisting symptoms and unexpected organ dysfunction after severe COVID-19. In this report, we present the follow-up of two cases of suspected interstitial lung disease following the viral infection. Up to the last month of follow-up, both patients presented with persistent changes in imaging and pulmonary function tests.

Coronavirus Disease 2019 in Children: Is It Really Mild?

Coronavirus disease 2019 pandemic has spread rapidly to the world. The disease can vary from mild cases to severe respiratory distress; this may increase rapidly and overwhelm the pediatric intensive care units. Lately, there have been various reports about a de novo multisystem inflammatory syndrome in children or pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 infection. We classified the disease into 2 spectrums: the acute phase in severely ill patients and the postinflammatory phase. Neither of them could be classified as mild because there is enough evidence that supports a wide range of complications. The goals of this brief review were to summarize available literature and to give some awareness about the current status of the coronavirus disease 2019 in the severely ill patients during the active phase and postinflammatory phase.