Acute effects of a typical rhythmic gymnastic training session on physiological parameters in Olympic athletes

The aim of this study was to evaluate the effects of a day with two separate training sessions (morning and afternoon) of rhythmic gymnastics on erythrocytes, leukocytes, muscle damage, oxidative stress, and hydration of Brazilian team [age 17.7 (±1.1) years; body height 165 (±0.5) cm; body mass 49.7 (±4.2) kg]. Heart rate and session-ratings of perceived exertion were used to monitor training intensity. Blood samples were collected immediately before (M1) and after (M2) the training day for analyzing erythrocytes, leukocytes, plasma creatine kinase activity, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, ferric reducing ability plasma, thyroid-stimulating hormone, and free T4. Saliva was collected for cortisol analysis. After 24 hours rest (M3), blood collection was performed to analyze creatine kinase and lactate dehydrogenase. The moderate-intensity training day induced significant elevations of total leukocytes (5,163.3 to 9,617.8), lymphocytes (1,752.7 to 2,729.7), neutrophils (2,873.9 to 6,163.6), monocytes (255.7 to 519.1), platelets (280,000.0 to 300,666.7), aspartate aminotransferase (13.1 to 25.6), lactate dehydrogenase (102.5 to 249.1), thyroid-stimulating hormone (1.0 to 3.2), and ferric reducing ability plasma (136.8 to 165.4), as well as significant reductions in red cells (4,691,111.1 to 4,497,777.8), hematocrit (42.1 to 39.3), and hemoglobin (12.9 to 12.5) at M2. There were also significant increases in creatine kinase (144.2 to 519.3) and lactate dehydrogenase (102.5 to 538.2) at M3. The average dehydration rate was 1.3%. A moderate-intensity day of training in rhythmic gymnastics of 8h21min duration caused hemolysis, leukocytosis, muscle damage, redox status perturbations, and insufficient hydration status. These findings show that athletes are exposed to physiological vulnerabilities that can possibly harm their performance and health.

Predominance of the SARS-CoV-2 Lineage P.1 and Its Sublineage P.1.2 in Patients from the Metropolitan Region of Porto Alegre, Southern Brazil in March 2021

Almost a year after the COVID-19 pandemic had begun, new lineages (B.1.1.7, B.1.351, P.1, and B.1.617.2) associated with enhanced transmissibility, immunity evasion, and mortality were identified in the United Kingdom, South Africa, and Brazil. The previous most prevalent lineages in the state of Rio Grande do Sul (RS, Southern Brazil), B.1.1.28 and B.1.1.33, were rapidly replaced by P.1 and P.2, two B.1.1.28-derived lineages harboring the E484K mutation. To perform a genomic characterization from the metropolitan region of Porto Alegre, we sequenced viral samples to: (i) identify the prevalence of SARS-CoV-2 lineages in the region, the state, and bordering countries/regions; (ii) characterize the mutation spectra; (iii) hypothesize viral dispersal routes by using phylogenetic and phylogeographic approaches. We found that 96.4% of the samples belonged to the P.1 lineage and approximately 20% of them were assigned as the novel P.1.2, a P.1-derived sublineage harboring signature substitutions recently described in other Brazilian states and foreign countries. Moreover, sequences from this study were allocated in distinct branches of the P.1 phylogeny, suggesting multiple introductions in RS and placing this state as a potential diffusion core of P.1-derived clades and the emergence of P.1.2. It is uncertain whether the emergence of P.1.2 and other P.1 clades is related to clinical or epidemiological consequences. However, the clear signs of molecular diversity from the recently introduced P.1 warrant further genomic surveillance.

Proxalutamide Reduces the Rate of Hospitalization for COVID-19 Male Outpatients: A Randomized Double-Blinded Placebo-Controlled Trial

Antiandrogens have demonstrated a protective effect for COVOD-19 patients in observational and interventional studies. The goal of this study was to determine if proxalutamide, an androgen receptor antagonist, could be an effective treatment for men with COVID-19 in an outpatient setting. A randomized, double-blinded, placebo-controlled clinical trial was conducted at two outpatient centers (Brasilia, Brazil). Patients were recruited from October 21 to December 24, 2020 (clinicaltrials.gov number, NCT04446429). Male patients with confirmed COVID-19 but not requiring hospitalization (COVID-19 8-point ordinal scale <3) were administered proxalutamide 200 mg/day or placebo for up to 7 days. The primary endpoint was hospitalization rate at 30 days post-randomization. A total of 268 men were randomized in a 1:1 ratio. 134 patients receiving proxalutamide and 134 receiving placebo were included in the intention-to-treat analysis. The 30-day hospitalization rate was 2.2% in men taking proxalutamide compared to 26% in placebo, P < 0.001. The 30-day hospitalization risk ratio was 0.09; 95% confidence interval (CI) 0.03-0.27. Patients in the proxalutamide arm more frequently reported gastrointestinal adverse events, however, no patient discontinued treatment. In placebo group, 6 patients were lost during follow-up, and 2 patients died from acute respiratory distress syndrome. Here we demonstrate the hospitalization rate in proxalutamide treated men was reduced by 91% compared to usual care.

Remission of Severe Myasthenia Gravis After Massive-Dose Vitamin D Treatment

BACKGROUND

Vitamin D has been shown to be related to autoimmune diseases, such as multiple sclerosis and psoriasis. Correlations have been reported between vitamin D levels and prevalence and severity of other autoimmune disorders, and also between vitamin D therapy and disease improvement and remission.

CASE REPORT

This is a case report of a patient with severe and refractory myasthenia gravis (MG) who followed a "high-dose vitamin D treatment", a massive-dose treatment (80,000 to 120,000 IU/day) promoted by a medical center in Brazil (but still not proven), and she had her first complete remission after this type of treatment with increased vitamin D serum levels (400 to 700 ng/mL).

CONCLUSIONS

This case report may reinforce the reported correlation between vitamin D level and disease severity and introduces a possible new use for vitamin D as a potential target for treating autoimmune diseases. We recommend large, double-blind, placebo-controlled, randomized studies using high-dose vitamin D treatment for refractory autoimmune diseases to reliably assess this pharmacotherapy target for these diseases.