Background: Local hyperthermia is recommended for the treatment of patients with fixed cutaneous sporotrichosis, though the effectiveness and mechanisms of action remain elusive. While neutrophils represent the main inflammatory cells associated with sporotrichosis lesions, the issue of whether hyperthermia is involved with interactions between neutrophils and Sporothrix globosa remains unclear. Objective: To evaluate the effect of local hyperthermia on sporotrichosis and determine whether local hyperthermia involves effects of neutrophils against Sporothrix. Methods: For the in vivo study, mice were infected with yeast cells of S. globosa followed by treatment with local hyperthermia. In vitro, an isolated Sporothrix strain was co-cultured with or without neutrophils and subjected under different temperatures. Immunofluorescence was used to assess the formation of neutrophil extracellular trap (NETs) were formed under these different culture conditions and the number of fungi colony forming units were compared. Results: Hyperthermia was significantly more effective in clearing the lesions in the mouse model, as compared to sham treatment. Neutrophils failed to exert any fungicidal effects against S. globosa in response to hyperthermia. Moreover, NETs were formed after interaction with S. globosa, and the percentage of NETs formed was not significantly different at 41 o C or 37 o C. Conclusion: While hyperthermia could serve as an effective therapy for fixed cutaneous sporotrichosis, this ability does not involve the formation of NETs. (Ann Dermatol 33(1) 37∼45, 2021
The stress management program is not considered as a part of routine cardiac rehabilitation due to the lack of consensus and inconsistencies in the studies detailing the relation between stress and coronary artery disease. The current meta-analysis is intended to determine the effectiveness of stress management in cardiac rehabilitation. The published literature studies until December 2020 were extracted from various databases and eligible studies were selected based on the inclusion and exclusion criteria. Quality assessment of the selected studies was carried out using Jadad. The literature search of various databases yielded 154 studies and 9 were selected based on the inclusion/exclusion criteria. On the Jadad scale, 6 studies obtained a score of 3, whereas the remaining studies obtained a score of 2. Funnel plot findings reported no publication bias. The result of the meta-analysis showed a persistent improvement in Beck depression inventory-2, hospital anxiety scale and hospital depression scale in subjects who had undergone various stress management interventions. The meta-analysis corroborates the benefits of stress management training in cardiac rehabilitation and underscores the need to adopt a stress management program in routine cardiac care.
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