Macrolide-Clarithromycin Task-Force for the Treatment and Prophylaxis of Covid-19 as a Single Agent

SARS-CoV-2 is a novel RNA coronavirus responsible of a deadly pandemic: the clinical illness COVID-19. With only one authorized drug for emergency use in critically ill patients: Remdesivir, there is not any other approved drug or vaccine yet with proven potential to overcome this infection. We exposed here many scientific evidences to support our novel idea that a macrolide, basically Clarithromycin, could be effective as a single agent for treatment and prophylaxis of COVID-19. Clarithromycin could change the history of this pandemic. It could reduce the costs of treatment and the potential adverse effects when combining more than one drug such as with Hydroxychloroquine. Clarithromycin treatment and prophylaxis as a single agent could be much more simple, safe and cheaper as giving Chloroquine or Hydroxychloroquine alone or in combination with Azithromycin as well as other therapeutic options.

Phase Ⅰ of cardiac rehabilitation:A new challenge for evidence based physiotherapy

Cardiac rehabilitation protocols applied during the inhospital phase(phaseⅠ)are subjective and their results are contested when evaluated considering what should be the three basic principles of exercise prescription:specificity,overload and reversibility.In this review,we focus on the problems associated with the models of exercise prescription applied at this early stage in-hospital and adopted today,especially the lack of clinical studies demonstrating its effectiveness.Moreover,we present the concept of"periodization"as a useful tool in the search for better results.

Benefit of stem cells and skeletal myoblast cells in dilated cardiomyopathies

Although some authors suggest that there is mitotic division in the heart,most cardiomyocytes do not have the capacity to regenerate after myocardial infarction and when this occurs there is a deterioration of contractile function,and if the area of infarction is extensive ventricular remodeling may occur,leading to the development of heart failure.Cell transplantation into the myocardium with the goal of recovery of cardiac function has been extensively studied in recent years. The effects of cell therapy are based directly on the cell type used and the type of cardiac pathology.For myocardial ischemia in the hibernating myocardium, bone marrow cells have functional benefits,however these results in transmural fibrosis are not evident. In these cases there is a benefit of implantation with skeletal myoblasts,for treating the underlying cause of disease,the loss of cell contractility.

Preclinical stem cell therapy in Chagas Disease: Perspectives for future research

Chagas cardiomyopathy still remains a challenging problem that is responsible for high morbidity and mortality in Central and Latin America. Chagas disease disrupts blood microcirculation via various autoimmune mechanisms, causing loss of cardiomyocytes and severe impairment of heart function. Different cell types and delivery approaches in Chagas Disease have been studied in both preclinical models and clinical trials. The main objective of this article is to clarify the reasons why the benefits that have been seen with cell therapy in preclinical models fail to translate to the clinical setting. This can be explained by crucial differences between the cellular types and pathophysiological mechanisms of the disease, as well as the differences between human patients and animal models. We discuss examples that demonstrate how the results from preclinical trials might have overestimated the efficacy of myocardial regeneration therapies. Future research should focus, not only on studying the best cell type to use but, very importantly, understanding the levels of safety and cellular interaction that can elicit efficient therapeutic effects in human tissue. Addressing the challenges associated with future research may ensure the success of stem cell therapy in improving preclinical models and the treatment of Chagas disease.

Amniotic membrane as a potent source of stem cells and a matrix for engineering heart tissue

Existing therapies for the treatment of chronic heart failure still have some limitations and there is a pressing need for the development of new therapeutic modalities. The amniotic membrane has been used for the treatment of various diseases, such as conjunctive defects;however, the mechanisms behind its repair functions are still unclear. Regenerative medicine is seeking newer alternatives and among them, biomaterials have emerged in recent years for developing and manipulating molecules, cells, tissues or organs grown in laboratories in order to replace human body parts. Many such materials have been used for this purpose, either synthetically or biologically, in order to provide new medical devices. This review provides a wider view of the regeneration potential of the use of amniotic membrane as a potential biomaterial to facilitate the implementation of new research in surgical procedures. Amniotic membrane appears to be an alternative source of stem cells as well as an excellent biomaterial for cell-based therapeutic applications in engineering heart tissue.

In vitro differentiation capacity of human breastmilk stem cells:A systematic review

BACKGROUND Mesenchymal stem cells are pluripotent cells that have the ability to generate cells from a cell line or in other cell types from different tissues but from the same origin.Although those cells have more limited differentiation capacity than embryonic stem cells,they are easily obtained from somatic tissue and can be grown in large quantities.This characteristic of undifferentiated stem cells differentiating into different cell lines arouses strategies in regenerative medicine for the treatment of different diseases such as neurodegenerative diseases.AIM To evaluate the cell differentiation capacity of human breastmilk stem cells for the three germ layers by a systematic review.METHODS The searched databases were PubMed,EMBASE,OVID,and COCHRANE LIBRARY,published between 2007 and 2018 in the English language.All were in vitro studies for analysis of the"cell differentiation potential"in the literature using the keywords“human breastmilk,”“stem cells,”and keywords combined with the Boolean operator“NOT”were used to exclude those articles that had the word“CANCER”and their respective synonyms,which were previously consulted according to medical subject heading terms.PRISMA 2009 guidelines were followed in this study.RESULTS A total of 315 titles and abstracts of articles were examined.From these,21 were in common with more than one database,leaving 294 articles for analysis.Of that total,five publications met the inclusion criteria.When analyzing the publications,it was demonstrated that human breastmilk stem cells have a high cellular plasticity,exhibiting the ability to generate cells of all three germ layers,endoderm,mesoderm,and ectoderm,demonstrating their stemness.Those cells expressed the genes,TRA-1-60/81,octamer-binding transcription factor 4,and NANOG,of which NANOG,a critical regulator for self-renewal and maintenance,was the most highly expressed.Those cells have the ability to differentiate in vitro into adipocytes,chondrocytes,osteocytes,oligodendrocytes,astrocytes,and neurons as well hepatocytes,β-pancreatic cells,and cardiomyocytes.CONCLUSION Although the literature has been scarce,the pluripotentiality of these cells represents great potential for tissue engineering and cellular therapy.Further studies for safe clinical translation are needed.