Effects of cardiorespiratory rehabilitation program on submaximal exercise in patients with long-COVID-19 conditions: a systematic review of randomized controlled trials and recommendations for future studies.

INTRODUCTION: Long-COVID-19 patients (LC19Ps) often experience cardiovascular and respiratory complications. Cardiorespiratory rehabilitation programs (CRRPs) have emerged as promising interventions to enhance exercise capacity in this population. This systematic review aimed to assess the impact of CRRPs on submaximal exercise performance, specifically the 6-minute walk test (6MWT) outcomes, in LC19Ps through an analysis of available randomized controlled trials (RCTs). METHODS: A systematic search was conducted in PubMed/Medline and Scopus to identify relevant RCTs. Six RCTs meeting inclusion criteria were included in this review, investigating the effects of CRRPs on 6MWT outcomes in LC19Ps. RESULTS: The findings from the included RCTs provide compelling evidence supporting the effectiveness of CRRPs in improving submaximal exercise performance in LC19Ps. These results underscore the potential of CRRPs to enhance submaximal exercise capacity and overall functional well-being in this population. However, future research is imperative to determine optimal CRRPs, including duration, intensity, and specific intervention components. Additionally, the long-term sustainability and durability of CRRP-induced improvements warrant further exploration. Future studies should prioritize patient-centric outcomes and address potential implementation barriers. CONCLUSION: CRRPs show promise in ameliorating submaximal exercise performance among LC19Ps. Further research is needed to refine these programs and ensure their lasting impact on this patient group. SYSTEMATIC REVIEW REGISTRATION: https://doi.org/10.17605/OSF.IO/HMN38. [Figure: see text].

ChatGPT for Sample-Size Calculation in Sports Medicine and Exercise Sciences: A Cautionary Note.

PURPOSE: To investigate the accuracy of ChatGPT (Chat generative pretrained transformer), a large language model, in calculating sample size for sport-sciences and sports-medicine research studies. METHODS: We conducted an analysis on 4 published papers (ie, examples 1-4) encompassing various study designs and approaches for calculating sample size in 3 sport-science and -medicine journals, including 3 randomized controlled trials and 1 survey paper. We provided ChatGPT with all necessary data such as mean, percentage SD, normal deviates (Zα/2 and Z1-ß), and study design. Prompting from 1 example has subsequently been reused to gain insights into the reproducibility of the ChatGPT response. RESULTS: ChatGPT correctly calculated the sample size for 1 randomized controlled trial but failed in the remaining 3 examples, including the incorrect identification of the formula in one example of a survey paper. After interaction with ChatGPT, the correct sample size was obtained for the survey paper. Intriguingly, when the prompt from Example 3 was reused, ChatGPT provided a completely different sample size than its initial response. CONCLUSIONS: While the use of artificial-intelligence tools holds great promise, it should be noted that it might lead to errors and inconsistencies in sample-size calculations even when the tool is fed with the necessary correct information. As artificial-intelligence technology continues to advance and learn from human feedback, there is hope for improvement in sample-size calculation and other research tasks. However, it is important for scientists to exercise caution in utilizing these tools. Future studies should assess more advanced/powerful versions of this tool (ie, ChatGPT4).

Effect of Pre-Meal Metformin With or Without an Acute Exercise Bout on Postprandial Lipemic and Glycemic Responses in Metabolic Syndrome Patients: A Randomized, Open Label, Crossover Study.

INTRODUCTION: Both exercise and pre-meal metformin could lower postprandial glucose and lipid profiles. AIMS: To explore whether pre-meal metformin administration is superior to metformin administration with the meal in reducing postprandial lipid and glucose metabolism, and whether its combination with exercise confer superior benefits in metabolic syndrome patients. MATERIALS AND METHODS: In a randomized crossover design, 15 metabolic syndrome patients were assigned to 6 sequences including 3 experimental conditions: metformin administration with a test meal (met-meal), metformin administration 30 min prior to a test meal (pre-meal-met) with or without an exercise bout designed to expend 700 Kcal at 60% VO2 peak performed the evening just before pre-meal-met condition. Only 13 participants (3 males, 10 females; age: 46 ± 9.86, HbA1c: 6.23 ± 0.36) were included in the final analysis. RESULTS: Postprandial triglyceridemia was unaffected by any condition (all P > .05). However, both pre-meal-met (-7.1%, P = .009) and pre-meal-metx (-8.2%, P = .013) significantly reduced total cholesterol AUC with no significant differences between the two latter condition (P = .616). Similarly, LDL-cholesterol levels were significantly lower during both pre-meal-met (-10.1%, P = .013) and pre-meal-metx (-10.7%, P = .021) compared to met-meal with no difference between latter conditions (P = .822). Plasma glucose AUC was significantly reduced by pre-meal-metx compared to both pre-meal-met (-7.5%, P = .045) and met-meal (-8%, P = .03). Insulin AUC was significantly lower during pre-meal-metx compared to met-meal (-36.4%, P = .044). CONCLUSIONS: Metformin administration 30 minutes prior to meal seems to exert favorable effects on postprandial TC and LDL-Cholesterol levels compared to its administration with meal. Addition of one exercise bout only improved postprandial glycemia and insulinemia. TRIAL REGISTRY: Pan African clinical trial registry, Identifier PACTR202203690920424.

A fortuitous discovery of a neurofibroma in a female patient with type 1 neurofibromatosis: a case report.

Neurofibromatosis type 1 (NF1) is a neurocutaneous condition with an autosomal dominant pattern of inheritance. This congenital disease is characterized by a wide spectrum of clinical manifestations and degree of severity. This case report describes a female patient in her early 20s who presented with a complaint of lumbosciatica-like pain evolving for several months. The condition initially escaped the attention of clinicians until a lumbar computed tomography scan and spinal magnetic resonance imaging were performed. The patient was then transferred to the general surgery department, where a clinical diagnosis of NF1 was established. The clinical manifestations were specific for this disease, including café-au-lait macules, plexiform neurofibroma, and a history of neurofibromatosis in her mother. The patient underwent surgical resection of the neurofibroma, which resulted in a favorable outcome. However, 2 years later, a new mass attached to the second lumbar spinal nerve was revealed by a follow-up computed tomography scan. Long-term and close follow-up of NF1 is required because of the high risk of malignancy and recurrence in NF1 patients.

Sedentary behavior, exercise and COVID-19: immune and metabolic implications in obesity and its comorbidities.

Many reports showed a dramatic decrease in the levels of physical activity during the current pandemic of SARS-CoV-2. This has substantial immune and metabolic implications, especially in those at risk or with metabolic diseases including individuals with obesity and Type 2 diabetes. In this study we discussed the route from physical inactivity to immune and metabolic aberrancies; focusing on how insulin resistance could represent an adaptive mechanism to the low physical activity levels and on how such an adaptive mechanism could shift to a pathognomonic feature of metabolic diseases, creating a vicious circle of immune and metabolic aberrancies. We provide a theoretical framework to the severe immunopathology of COVID-19 in patients with metabolic diseases. We finally discuss the idea of exercise as a potential adjuvant against COVID-19 and emphasize how even interrupting prolonged periods of sitting with short time breaks of very light activity could be a feasible strategy to limit the deleterious effects of the outbreak.