Vitamins C, B3, and E are the most important antioxidants because of their ability to penetrate the skin through their small molecular weight.52 The water-soluble, heat-labile local L-ascorbic acid (vitamin C) in concentrations between 5 and 15% was proven to have a skin anti-aging effect by inducing the production of Col-1, and Col-3, as well as enzymes important for the production of collagen, and inhibitors of matrixmetalloproteinase (MMP) 1 (collagenase 1).43,53 Clinical studies have proven that the antioxidative protection is higher with the combination of vitamins C and E than with the vitamin C or E alone.54,55 Niacinamide (vitamin B3) regulates cell metabolism and regeneration, and it is used in 5% concentration as an anti-aging agent.56 In some studies, improvement of skin elasticity, erythema and pigmentations after 3 mo of topical treatment has been observed.52,54 Vitamin E (α-tocopherol) used as a component of skin products has anti-inflammatory and antiproliferative effects in concentrations between 2 and 20%. It acts by smoothing the skin and increasing the ability of the stratum corneum to maintain its humidity, to accelerate the epithelialization, and contribute to photoprotection of the skin. The effects are not as strong as with vitamins C and B3.57
Vitamin A (retinol) and its derivates (retinaldehyde and tretinoin) are also a group of agents with antioxidant effects. They can induce the biosynthesis of collagen and reduce the expression of MMP 1 (collagenase 1). Retinol is, at the moment, the substance that is most often used as an anti-aging compound and, compared with tretinoin, causes less skin irritation.59,60 It has been shown that retinol has positive effects not only on extrinsic but also on intrinsic skin aging and has a strong positive effect on collagen metabolism.60,61 Tretinoin, a nonaromatic retinoid of the first generation, is approved for application as an anti-aging treatment in a concentration of 0.05% in the United States. It has been shown to be able to reduce the signs of UV-induced early skin aging, such as wrinkles, loss of skin elasticity and pigmentation.
Laser resurfacing has been shown to be effective in counteracting photoaging through entire epidermal ablation, collagen shrinkage, stimulation of neocollagenesis, extensive dermal remodeling, regeneration of cellular organelles and intercellular attachments100 but parallelly, results in long recovery time are associated with risks of severe long lasting side effects, such as persistent erythema, hypo- or hyperpigmentation, infection or scarring.101-104
Recently, fractionated CO2-, erbium glass or erbium-YAG lasers have been introduced to reduce downtime and side effects.105 These devices emit light in a pixilated fashion onto the skin, producing an array of microthermal zones in the dermis.105-108 The controlled thermal stress to the epidermis and the dermal compartment is followed by a wound healing response ultimately leading to re-epithelization and dermal remodeling.109
Monopolar RF is a noninvasive way to obtain skin tightening39 and immediate collagen contraction with a single treatment. Unlike lasers, the RF technology produces electric current, which generates heat through resistance in the dermis and as deep as the subcutaneous fat.78 Unfortunately there is a lack of long-term studies of efficacy and analysis of side effects for the skin using this method of skin rejuvenation.
The World Health Organization and the American College of Sports Medicine have issued evidence-based recommendations indicating that the beneficial effects of exercise in most adults are indisputable and that the benefits far outweigh the risks 2 3.
Pregnant women who were sedentary before pregnancy should follow a more gradual progression of exercise. Although an upper level of safe exercise intensity has not been established, women who were regular exercisers before pregnancy and who have uncomplicated, healthy pregnancies should be able to engage in high-intensity exercise programs, such as jogging and aerobics, with no adverse effects. High-intensity or prolonged exercise in excess of 45 minutes can lead to hypoglycemia; therefore, adequate caloric intake before exercise, or limiting the intensity or length of the exercise session, is essential to minimize this risk 55.
Pregnant women with obesity should be encouraged to engage in a healthy lifestyle modification in pregnancy that includes physical activities and judicious diets 5. Women should start with low-intensity, short periods of exercise and gradually increase the period or intensity of exercise as they are able. In recent studies examining the effects of exercise among pregnant women with obesity, women assigned to exercise demonstrated modest reductions in weight gain and no adverse outcomes 45 63.
Vigorous-intensity exercise completed into the third trimester appears to be safe for most healthy pregnancies. Further research is needed on the effects of vigorous-intensity exercise in the first and second trimesters and of exercise intensity exceeding 90% of maximum heart rate 64. Competitive athletes require frequent and close supervision because they tend to maintain a more strenuous training schedule throughout pregnancy and resume high-intensity training postpartum sooner than other women. Such athletes should pay particular attention to avoiding hyperthermia, maintaining proper hydration, and sustaining adequate caloric intake to prevent weight loss, which may adversely affect fetal growth.
Several reviews have determined that there is no credible evidence to prescribe bed rest in pregnancy for the prevention of preterm labor, and it should not be routinely recommended 65 66. Patients prescribed prolonged bed rest or restricted physical activity are at risk of venous thromboembolism, bone demineralization, and deconditioning. There are no studies documenting an improvement in outcomes in women at risk for preterm birth who are placed on activity restriction, including bed rest, and there are multiple studies documenting untoward effects of routine activity restriction on the mother and family, including negative psychosocial effects. Activity restriction should not be prescribed routinely as a treatment to reduce preterm birth 67. Additionally, there is no evidence that bed rest reduces preeclampsia risk, and it should not be routinely recommended for the primary prevention of preeclampsia and its complications 68.
Table 2. Statistics of all involved fixed effects terms of the linear mixed effect analysis for the final models (model #3), separated by the two tested dependent variables %correct (percentage of correct emotion classifications) and confidence (for correct emotion classifications).
CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.
The world is currently in the grips of the coronavirus disease (COVID-19) pandemic, caused by the SARS-CoV-2 virus, which has mutated to allow human-to-human spread. Infection can cause fever, dry cough, fatigue, severe pneumonia, respiratory distress syndrome and in some instances death. COVID-19 affects the immune system by producing a systemic inflammatory response, or cytokine release syndrome. Patients with COVID-19 have shown a high level of pro-inflammatory cytokines and chemokines. There are currently no effective anti-SARS-CoV-2 viral drugs or vaccines. COVID-19 disproportionately affects the elderly, both directly, and through a number of significant age-related comorbidities. Undoubtedly, nutrition is a key determinant of maintaining good health. Key dietary components such as vitamins C, D, E, zinc, selenium and the omega 3 fatty acids have well-established immunomodulatory effects, with benefits in infectious disease. Some of these nutrients have also been shown to have a potential role in the management of COVID-19. In this paper, evidence surrounding the role of these dietary components in immunity as well as their specific effect in COVID-19 patients are discussed. In addition, how supplementation of these nutrients may be used as therapeutic modalities potentially to decrease the morbidity and mortality rates of patients with COVID-19 is discussed.
Laboratory Testing: Before pesticides are registered bythe U.S. EPA, they must undergo laboratory testing forshort-term (acute) and long-term (chronic) health effects.Laboratory animals are purposely given high enough dosesto cause toxic effects. These tests help scientists judge howthese chemicals might affect humans, domestic animals,and wildlife in cases of overexposure.
Reference Dose (RfD): The RfD is an estimate of the quantity ofchemical that a person could be exposed to every day for the restof their life with no appreciable risk of adverse health effects. Thereference dose is typically measured in milligrams (mg) of chemicalper kilogram (kg) of body weight per day.
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