Cardiac ischemia reperfusion injury (IRI) occurs when the myocardium is revascularized after an episode of limited or absent blood supply. Many changes, including free radical production, calcium overload, protease activation, altered membrane lipids and leukocyte activation, contribute to IRI-induced myocardium damage. Aerobic exercise is the only countermeasure against IRI that can be sustained on a regular basis in clinical practice. Interestingly, both short-term (3-5 days) and long-term (several weeks) exercise increase myocardial tolerance, reduce infarct size area and arrhythmias induced by IRI. Exercise protects the heart against IRI in a biphasic manner. The early phase of cardioprotection occurs between 30 min and 3 h following an acute exercise bout, whilst the late phase is achieved within 24 h after the exercise bout and persists for several days. As for the exercise intensity, although controversial data exists, it is feasible that the amount of cardioprotection is proportional to exercise intensity and only achieved above a critical threshold. It is known that aerobic exercise produces a cardioprotective phenotype, however the mechanisms responsible for this phenomenon remain unclear. Apparently, aerobic exercise-induced preconditioning is dependent on several factors that work together to protect the heart. Altered nitric oxide (NO) signaling, increased levels of heat shock proteins (HSPs), enhanced function of ATP-sensitive potassium channels, increased activation of opioids system, and enhanced antioxidant capacity may contribute to exercise-induced cardioprotection. Much has been discovered from animal models involving exercise-induced cardioprotection against cardiac IRI, however translating these findings to clinical practice still represents the major challenge in this field.
A COVID-19 consolidou-se como a principal pandemia dos últimos cem anos, tornando-se a principal causa de morte no Brasil e no mundo. Os sistemas de saúde, bem como as fontes de financiamento de pesquisas científicas voltaram seus holofotes para desenvolver estratégias de prevenção da disseminação do vírus Sars-Cov 2 e tratamento da COVID-19. Nesse cenário, o uso de máscaras para prevenir o contágio foi uma das principais estratégias adotadas pelos governos e sistemas de saúde. Apesar de estudos comprovarem a eficácia dessa metodologia para prevenir a infecção por vírus respiratórios, a segurança do seu uso não foi amplamente testada na população, de forma que grupos de risco não foram identificados. Assim, esse artigo se propõe a discutir a segurança do uso de máscaras pelas pessoas com epilepsia, que comprovadamente apresentam propensão a sofrer crises quando submetidos a alterações da fisiologia respiratória.
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