In mid-March 2020, all rehabilitation centers in Rio de Janeiro closed as a strategy to contain the progress of COVID-19. Patients who went through the acute phase of disease noticed the need for rehabilitation follow-up, at that time was impossible to perform presently. The objective of this study was to verify whether a pulmonary rehabilitation program through videoconference could improve patients' exercise capacity after the acute phase of COVID-19. METHOD: We prospectively evaluated 196 subjects during the post-acute phase of COVID-19, without requiring ICU admission and they were divided into two groups. The Control Group (CG) with 92 subjects receiving no non-drug intervention for six weeks, and the Intervention Group (IG) with 104 subjects that performed a low-intensity Pulmonary Rehabilitation Program (PRP) during 6 weeks, held at home, with a weekly session by videoconference. As all the protocol was performed trough videoconference, the exercise capacity was assessed through 30 seconds sit-to-stand test (STS), the fatigue sensation after the exercise using 10-points Borg Scale, and the Physical Activity in Daily Life (PADL) assessed using a cell phone application that measures moves you in steps/day. RESULTS: The IG after the six weeks of PRP, achieved a significant increase in the STS and PADL, and an important decrease in the sensation of fatigue after exercise (p <0.05). The control group does not present a significant improvement in AFVD and STS and does not show improvement in the fatigue sensation. CONCLUSION: Our findings reinforce the importance of evaluating and offering a low-intensity program for patients after the acute phase of COVID-19, that in this population presented improvement in exercise capacity, AFVD, and feeling of fatigue after 6 weeks, compared to subjects who did not perform a PRP and they did not achieve this improvement after that time.

Due to the severity of infections caused by P. aeruginosa and the limitations in treatment, it is necessary to find new therapeutic alternatives. Thus, the use of silver nanoparticles (AgNPs) is a viable alternative because of their potential actions in the combat of microorganisms, showing efficacy against Gram-positive and Gram-negative bacteria, including multidrug-resistant microorganisms (MDR). In this sense, the aim of this work was to conduct a literature review related to the antibacterial and antibiofilm activity of AgNPs against antibiotic-sensitive and multidrug-resistant Pseudomonas aeruginosa strains. The AgNPs are promising for future applications, which may match the clinical need for effective antibiotic therapy. The size of AgNPs is a crucial element to determine the therapeutic activity of nanoparticles, since smaller particles present a larger surface area of contact with the microorganism, affecting their vital functioning. AgNPs adhere to the cytoplasmic membrane and cell wall of microorganisms, causing disruption, penetrating the cell, interacting with cellular structures and biomolecules, and inducing the generation of reactive oxygen species and free radicals. Studies describe the antimicrobial activity of AgNPs at minimum inhibitory concentration (MIC) between 1 and 200 μg/mL against susceptible and MDR P. aeruginosa strains. These studies have also shown antibiofilm activity through disruption of biofilm structure, and oxidative stress, inhibiting biofilm growth at concentrations between 1 and 600 μg/mL of AgNPs. This study evidences the advance of AgNPs as an antibacterial and antibiofilm agent against Pseudomonas aeruginosa strains, demonstrating to be an extremely promising approach to the development of new antimicrobial systems.

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Antimicrobial resistance (AMR) represents a critical obstacle to public health worldwide, due to the high incidence of strains resistant to available antibiotic therapies. In recent years, there has been a significant increase in the prevalence of resistant epidemic strains, associated with this, public health authorities have been alarmed about a possible scenario of uncontrolled dissemination of these microorganisms and the difficulty in interrupting their transmission, as nosocomial pathogens with resistance profiles previously considered sporadic. They become frequent bacteria in the community. In addition, therapy for infections caused by these pathogens is based on broad-spectrum antibiotic therapy, which favors an increase in the tolerance of remaining bacterial cells and is commonly associated with a poor prognosis. In this review, we present the current status of epidemic strains of methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococcus (VRE), MDR Mycobacterium tuberculosis , extended-spectrum β-lactamase-producing Enterobacterales (ESBL), Klebsiella pneumoniae carbapenemase (KPC), and—New Delhi Metallo-beta-lactamase-producing Pseudomonas aeruginosa (NDM).

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: In response to the global outbreak caused by SARS-CoV-2, this article aims to propose the development of nanosystems for the delivery of hydroxychloroquine in the respiratory system to the treatment of COVID-19. Performed a descriptive literature review, using the descriptors "COVID-19", "Nanotechnology", "Respiratory Syndrome" and "Hydroxychloroquine", in the PubMed, ScienceDirect and SciElo databases. After analyzing the articles according to the inclusion and exclusion criteria, they were divided into 3 sessions: Coronavirus: definitions, classifications and epidemiology, pharmacological aspects of hydroxychloroquine and pharmaceutical nanotechnology in targeting of drugs. We used 131 articles published until July 18, 2020. Hydroxychloroquine seems to promote a reduction in viral load, in vivo studies, preventing the entry of SARS-CoV-2 into lung cells, and the safety of its administration is questioned due to the toxic effects that it can develop, such as retinopathy, hypoglycemia and even cardiotoxicity. Nanosystems for the delivery of drugs in the respiratory system may be a viable alternative for the administration of hydroxychloroquine, which may enhance the therapeutic effect of the drug with a consequent decrease in its toxicity, providing greater safety for implementation in the clinic in the treatment of COVID-19.

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