RESUMO
Introducción. Las distrofias musculares son un grupo heterogéneo de trastornos genéticos degenerativos del músculo que comparten características clínicas de debilidad muscular. Recientemente, la actividad física ha vuelto a ser posicionada como una intervención clave en esta población, sin embargo, no existe consenso terapéutico relativo a la prescripción de ejercicio. Junto con describir los principales tipos de distrofias musculares del adulto, el objetivo de esta revisión es describir los efectos clínicos y eventos adversos del ejercicio y la actividad física en las personas adultas con distrofias musculares. Método. Se realizó una revisión narrativa con enfoque cuantitativo en las bases de datos PubMed, Scielo, Scopus y Biblioteca Cochrane Plus utilizando las palabras claves en inglés "muscular dystrophy", "muscular dystrophies", "physical activity", "exercise" y, en español, "distrofia muscular", "distrofias musculares", "actividad física" y "ejercicio" con estudios hasta la fecha. Se seleccionaron siete ensayos controlados aleatorios y un metaanálisis para su revisión. Resultados. En los ocho estudios seleccionados se presentan los outcomes respecto a la fuerza muscular, capacidad aeróbica, capacidades funcionales, dolor, fatiga y efectos adversos. Se presentan resultados que muestran que las intervenciones en modalidad de entrenamiento de fuerza, aeróbica o ambas pueden tener mejoras y/o no tener efecto significativo en sus resultados. Asimismo, ningún estudio mostró efectos negativos y/o deletéreos posteriores a las intervenciones realizadas. Conclusiones. La realización de actividad física en las diversas distrofias musculares prevalentes en el adulto presenta efectos clínicos positivos y/o nulos, sin embargo, se requiere de estudios que aporten una mayor calidad de evidencia.
Introduction. Muscular dystrophies are a heterogeneous group of genetic degenerative muscle disorders that share clinical characteristics of muscle weakness. Recently, physical activity has been positioned as a key intervention in this population. However, there is no therapeutic consensus regarding the exercise prescription. Along with describing the main types of adult muscular dystrophies, this review aims to describe the clinical effects and adverse events of exercise and physical activity in adults with muscular dystrophies. Method. A narrative review with a quantitative approach was carried out in the PubMed, Scielo, Scopus and Cochrane Plus Library databases using the keywords in English "muscular dystrophy", "muscular dystrophies", "physical activity", "exercise" and in Spanish "distrofia muscular", "distrofias musculares", "actividad física" and "ejercicio" with studies to date. Seven randomized controlled trials and one meta-analysis were selected for review. Results. In the eight selected studies, the outcomes regarding muscle strength, aerobic capacity, functional capacities, pain, fatigue, and adverse effects are presented. Results show that interventions in strength training, aerobic training, or both may have improvements and/or not have a significant effect on their results. Likewise, no study showed adverse and/or harmful effects after the interventions were carried out. Conclusions. The performance of physical activity in the various muscular dystrophies prevalent in adults has positive and/or null clinical effects. However, studies that provide a higher quality of evidence are required.
RESUMO
Paraquat, a non-selective bipyridyl pesticide, is one of the leading causes of death from intoxication in many parts of Asia and America. It is the second most sold herbicide worldwide, being widely used in Chile. Its ingestion generates toxicity due to the release of superoxide radicals, mainly affecting kidneys, lungs and liver. There is no antidote available. We report a 31 years old male who ingested Paraquat for suicidal purposes. He developed an acute renal and hepatic failure and a rapidly progressive severe respiratory failure with images compatible with acute pulmonary fibrosis. No response to immunosuppressive treatment was observed. He died eight days after admission. The use of cyclophosphamide associated with glucocorticoids could lower risk of death the in these patients, although the pathophysiology of respiratory failure is still under study.