Clinical and Physiological Variables in Patients with Post-COVID-19 Condition and Persistent Fatigue.

Background/Objectives: Post-COVID-19 condition can manifest through various symptoms such as dyspnea, cognitive disturbances, and fatigue, with mechanisms related to these symptoms, particularly those related to fatigue, still requiring further clarification. Therefore, our aim was to assess the clinical and physiological variables in patients with post-COVID-19 condition and persistent fatigue. Methods: After one year post-COVID-19 infection, the patients underwent a comprehensive evaluation, including a complete blood count, a metabolic panel, complete spirometry, and assessments of dyspnea, quality of life, anxiety and depression, physical capacity, body composition, muscle strength, comorbidities, and medications. The participants were categorized into two groups: G1-fatigue and G2-non-fatigue. Results: Seventy-seven patients (53% female; 55 ± 11.8 years) were included, 37 in G1 and 40 in G2. As for clinical markers and symptoms of illness, in those with persistent fatigue symptoms, a greater sensation of dyspnea [BDI score: 7.5 (6-9) vs. 12 (9-12), p < 0.001; mMRC score: 1 (1-2) vs. 0 (0-1), p = 0.002], worse quality of life [SGRQ total score: 1404 (1007-1897) vs. 497 (274-985); p < 0.001], higher levels of anxiety [HADS-A score: 8 (5-9) vs. 3 (0.5-4); p < 0.001], and a reduction in peripheral and inspiratory muscle strength [handgrip strength: 34 (28-40) vs. 40 (30-46.5) kgf, p = 0.044; MIP: -81 ± 31 vs. -111 ± 33 mmHg, p < 0.001)] were observed. Conclusions: Those with persistent fatigue exhibited a greater sensation of dyspnea, higher levels of anxiety, reduced peripheral and inspiratory muscle strength, and a greater impairment of quality of life. The severity of fatigue was influenced by the worsening quality of life, heightened anxiety levels, and decreased peripheral muscle strength. Additionally, the worse quality of life was associated with a higher sensation of dyspnea, lower muscle strength, and reduced physical capacity.

Relationship of scapular dyskinesis with the pattern of activation of periescapular muscles during exercise / Relação da discinese scapular com o padrão de ativação dos músculos periescapulares durante exercicios

abstract The aim of the present study was to analyze the activation pattern of the serratus anterior (SA), upper trapezius (UT), and lower trapezius (LT) muscles during periscapular exercises in individuals with and without ED, and to identify which proposed exercise presents greater activation of the periscapular muscles. Fourteen women, aged between 18 and 30 years, participated in this study, divided into a control group (n = 8) and a dyskinesis group (n = 8). The determination of the presence of ED was performed according to the analysis of scapular movement during arm elevation, using the yes/no classification. To evaluate muscle activation, electromyography signals of the SA, UT, and LT muscles were collected during exercise. The exercise protocol was composed of three repetitions of the exercises: punch up, wall slide, and scaption. The results showed that the ED group showed less activation of the AS and TT than the control group. During the scaption and wall slide exercises, the DE group showed less activation of the AS in relation to those without DE. There was no difference in muscle activation between the exercises. That individuals with dyskinesis have less activation of the muscles that control scapular mechanics and that the type of exercise did not influence the activation of the periscapular muscles.

resumo O objetivo do presente estudo foi analisar o padrão de ativação dos músculos serrátil anterior (SA), trapézio superior (TS) e trapézio inferior (TI) durante exercícios periescapulares em indivíduos com e sem DE, e identificar qual exercício propostos apresenta maior ativação da musculatura periescapular. Participaram deste estudo 14 mulheres, com idade entre 18 e 30 anos, divididas em grupo controle (n = 8) e grupo discinese (n=8). A determinação da presença de DE foi realizada de acordo com a análise do movimento da escápula durante elevação do braço, usando a classificação sim/não. Para avaliação da ativação muscular, sinais eletromiográficos dos músculos SA, TS e TI foram coletados durante o exercício. O protocolo de exercício foi composto por três repetições dos exercícios: punch up, wall slide e scaption. Os resultados mostraram que o grupo DE apresentou menor ativação do SA e TI em relação ao grupo controle. Durante os exercícios scaption e wall slide, o grupo DE apresentou menor ativação do SA em relação àqueles sem DE. Não houve diferença na ativação muscular entre os exercícios. Concluímos que indivíduos com discinese apresentam menor ativação dos músculos que controlam a mecânica da escápula e que o tipo de exercício não influenciou na ativação da musculatura periescapular.

The perception of territory and personal space invasion among hospitalized patients.

OBJECTIVES: 1) To identify the patient's perception of invasion of territorial and personal space and 2) to evaluate whether personal characteristics, housing conditions and characteristics of the hospital unit affect this perception. METHODS: Analytical, cross-sectional and quantitative study. An adapted version of the "Anxiety Due to Territory and Space Intrusion Questionnaire" was applied with patients hospitalized in the internal medicine and maternity wards and in the ward for patients with private health insurance of a university hospital in the state of São Paulo. RESULTS: The sample consisted of 300 patients. The mean total score of the questionnaire administered was 143.58 (SD = 18.88). The mean subscale scores for territorial space and personal space invasion were 89.10 (SD = 15.29) and 54.48 (SD = 10.58), respectively. The invasion of territorial space differed significantly between patients with and without children (p = 0.02) and for the number of people living in the residence (p < 0.01). CONCLUSIONS: Attitudes of the nursing staff, such as touching the patient's possessions without permission and exposing the patient, caused discomfort and violated patient privacy. Patients who were lonelier and had more privacy at home perceived greater invasion of their territorial space by the nursing professionals.

[Gestational weight gain and birth weight of the newborn: a cross-sectional study in Jundiaí, São Paulo, Brazil]. / Ganho de peso gestacional e peso ao nascer do concepto: estudo transversal na região de Jundiaí, São Paulo, Brasil.

The aim of this study was to determine the prevalence of overweight, pre-pregnancy and gestational obesity and verify the association with the birth weight of the newborn. A descriptive cross-sectional study was conducted with 712 pregnant women admitted for delivery at the School of Medicine of Jundiaí hospital. The variables studied were socio-demographics, pregnancy, pre-pregnancy weight, prenatal care, total gestational weight gain and birth weight of the newborn. The majority (99.7%) had a pre-natal and 84.6% > 6 visits. The prevalence of pre-pregnancy overweight was 34.7%, and excessive total weight gain was 36.9%. A significant association was observed between the pregnant women's BMI classification and the newborn's weight (NB) classification and between total weight gain classification of the mother and the newborn's weight classification. In pregnant women with excessive weight a higher prevalence of newborns with appropriate weight was observed. In contrast, women with insufficient weight gain had 2.15 times higher risk of underweight newborns and 2.85 times higher risk of low weight newborns. Although a significant percentage of overweight pregnant women was observed, this influenced the insufficient weight of the pregnant woman though not the birth weight of the newborns.

Ganho de peso gestacional e peso ao nascer do concepto: estudo transversal na região de Jundiaí, São Paulo, Brasil / Gestational weight gain and birth weight of the newborn: a cross-sectional study in Jundiaí, São Paulo, Brazil

O objetivo deste estudo foi determinar a prevalência de sobrepeso e obesidade pré-gravídica e gestacional e verificar a associação com o peso ao nascer do concepto. Estudo descritivo, transversal, quantitativo, realizado com 712 gestantes internadas para o parto no hospital da Faculdade de Medicina de Jundiaí. Variáveis estudadas: perfil sociodemográfico, gestacional, peso pré-gravídico, assistência pré-natal, ganho de peso gestacional total e peso ao nascer do concepto. A maioria (99,7%) realizou pré-natal, 84,6% > seis consultas. Prevalência de excesso de peso pré-gravídico (34,7%) e de ganho de peso total excessivo (36,9%). Associação significativa foi observada entre classificação do IMC inicial da gestante e classificação do peso do recém-nascido (RN) e entre classificação do ganho de peso total da gestante e classificação do peso do RN. Nas gestantes com peso excessivo observou-se maior prevalência de RN com peso adequado, em contrapartida, gestantes com ganho de peso insuficiente tiveram 2,15 vezes mais risco de RN com peso insuficiente e 2,85 vezes mais risco de RN com baixo peso. Conclui-se que embora observado importante percentual de gestantes com excesso de peso, este, não influenciou no peso ao nascer do concepto e sim, o peso insuficiente da gestante.

The aim of this study was to determine the prevalence of overweight, pre-pregnancy and gestational obesity and verify the association with the birth weight of the newborn. A descriptive cross-sectional study was conducted with 712 pregnant women admitted for delivery at the School of Medicine of Jundiaí hospital. The variables studied were socio-demographics, pregnancy, pre-pregnancy weight, prenatal care, total gestational weight gain and birth weight of the newborn. The majority (99.7%) had a pre-natal and 84.6% > 6 visits. The prevalence of pre-pregnancy overweight was 34.7%, and excessive total weight gain was 36.9%. A significant association was observed between the pregnant women's BMI classification and the newborn's weight (NB) classification and between total weight gain classification of the mother and the newborn's weight classification. In pregnant women with excessive weight a higher prevalence of newborns with appropriate weight was observed. In contrast, women with insufficient weight gain had 2.15 times higher risk of underweight newborns and 2.85 times higher risk of low weight newborns. Although a significant percentage of overweight pregnant women was observed, this influenced the insufficient weight of the pregnant woman though not the birth weight of the newborns.