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2.
PLoS Med ; 18(9): e1003777, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34582457

RESUMO

BACKGROUND: Rapid detection, isolation, and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict COVID-19 and investigated whether predictive symptoms differ between the B.1.1.7 (Alpha) lineage (predominating as of April 2021 in the US, UK, and elsewhere) and wild type. METHODS AND FINDINGS: We obtained throat and nose swabs with valid SARS-CoV-2 PCR test results from 1,147,370 volunteers aged 5 years and above (6,450 positive cases) in the REal-time Assessment of Community Transmission-1 (REACT-1) study. This study involved repeated community-based random surveys of prevalence in England (study rounds 2 to 8, June 2020 to January 2021, response rates 22%-27%). Participants were asked about symptoms occurring in the week prior to testing. Viral genome sequencing was carried out for PCR-positive samples with N-gene cycle threshold value < 34 (N = 1,079) in round 8 (January 2021). In univariate analysis, all 26 surveyed symptoms were associated with PCR positivity compared with non-symptomatic people. Stability selection (1,000 penalized logistic regression models with 50% subsampling) among people reporting at least 1 symptom identified 7 symptoms as jointly and positively predictive of PCR positivity in rounds 2-7 (June to December 2020): loss or change of sense of smell, loss or change of sense of taste, fever, new persistent cough, chills, appetite loss, and muscle aches. The resulting model (rounds 2-7) predicted PCR positivity in round 8 with area under the curve (AUC) of 0.77. The same 7 symptoms were selected as jointly predictive of B.1.1.7 infection in round 8, although when comparing B.1.1.7 with wild type, new persistent cough and sore throat were more predictive of B.1.1.7 infection while loss or change of sense of smell was more predictive of the wild type. The main limitations of our study are (i) potential participation bias despite random sampling of named individuals from the National Health Service register and weighting designed to achieve a representative sample of the population of England and (ii) the necessary reliance on self-reported symptoms, which may be prone to recall bias and may therefore lead to biased estimates of symptom prevalence in England. CONCLUSIONS: Where testing capacity is limited, it is important to use tests in the most efficient way possible. We identified a set of 7 symptoms that, when considered together, maximize detection of COVID-19 in the community, including infection with the B.1.1.7 lineage.


Assuntos
COVID-19/complicações , COVID-19/diagnóstico , Modelos Biológicos , Ageusia/diagnóstico , Ageusia/etiologia , Ageusia/virologia , Anosmia/diagnóstico , Anosmia/etiologia , Anosmia/virologia , Apetite , Área Sob a Curva , COVID-19/virologia , Calafrios/diagnóstico , Calafrios/etiologia , Calafrios/virologia , Controle de Doenças Transmissíveis , Tosse/diagnóstico , Tosse/etiologia , Tosse/virologia , Inglaterra , Reações Falso-Positivas , Feminino , Febre/diagnóstico , Febre/etiologia , Febre/virologia , Humanos , Masculino , Programas de Rastreamento , Mialgia/diagnóstico , Mialgia/etiologia , Mialgia/virologia , Faringite/diagnóstico , Faringite/etiologia , Faringite/virologia , Reação em Cadeia da Polimerase , SARS-CoV-2/genética , Medicina Estatal
3.
JAMA Netw Open ; 4(9): e2127403, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34586367

RESUMO

Importance: The long-term health outcomes and symptom burden of COVID-19 remain largely unclear. Objective: To evaluate health outcomes of COVID-19 survivors 1 year after hospital discharge and to identify associated risk factors. Design, Setting, and Participants: This retrospective, multicenter cohort study was conducted at 2 designated hospitals, Huoshenshan Hospital and Taikang Tongji Hospital, both in Wuhan, China. All adult patients with COVID-19 discharged between February 12 and April 10, 2020, were screened for eligibility. Of a consecutive sample of 3988 discharged patients, 1555 were excluded (796 declined to participate and 759 were unable to be contacted) and the remaining 2433 patients were enrolled. All patients were interviewed via telephone from March 1 to March 20, 2021. Statistical analysis was performed from March 28 to April 18, 2021. Exposures: COVID-19. Main Outcomes and Measures: All patients participated in telephone interviews using a series of questionnaires for evaluation of symptoms, along with a chronic obstructive pulmonary disease (COPD) assessment test (CAT). Logistic regression models were used to evaluate risk factors for fatigue, dyspnea, symptom burden, or higher CAT scores. Results: Of 2433 patients at 1-year follow-up, 1205 (49.5%) were men and 680 (27.9%) were categorized into the severe disease group as defined by the World Health Organization guideline; the median (IQR) age was 60.0 (49.0-68.0) years. In total, 1095 patients (45.0%) reported at least 1 symptom. The most common symptoms included fatigue, sweating, chest tightness, anxiety, and myalgia. Older age (odds ratio [OR], 1.02; 95% CI, 1.01-1.02; P < .001), female sex (OR, 1.27; 95% CI, 1.06-1.52; P = .008), and severe disease during hospital stay (OR, 1.43; 95% CI, 1.18-1.74; P < .001) were associated with higher risks of fatigue. Older age (OR, 1.02; 95% CI, 1.01-1.03; P < .001) and severe disease (OR, 1.51; 95% CI, 1.14-1.99; P = .004) were associated with higher risks of having at least 3 symptoms. The median (IQR) CAT score was 2 (0-4), and a total of 161 patients (6.6%) had a CAT score of at least 10. Severe disease (OR, 1.84; 95% CI, 1.31-2.58; P < .001) and coexisting cerebrovascular diseases (OR, 1.95; 95% CI, 1.07-3.54; P = .03) were independent risk factors for CAT scores of at least 10. Conclusions and Relevance: This study found that patients with COVID-19 with severe disease during hospitalization had more postinfection symptoms and higher CAT scores.


Assuntos
COVID-19/complicações , Hospitais , Alta do Paciente , Doença Pulmonar Obstrutiva Crônica/etiologia , Índice de Gravidade de Doença , Sobreviventes , Idoso , Ansiedade/etiologia , China , Cidades , Dispneia/etiologia , Fadiga/etiologia , Feminino , Hospitalização , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Mialgia/etiologia , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Inquéritos e Questionários
5.
J Microbiol ; 59(10): 941-948, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34382150

RESUMO

Several follow-up studies have found that COVID-19 (coronavirus disease 2019) patients had persistent symptoms after discharge. Gut microbiota play an important role in human health and immune responses. Therefore, this study investigated the gut microbiota of recovered COVID-19 patients and the correlations between gut microbiota and persistent symptoms after discharge. Stool samples were collected from 15 recovered healthcare workers (HCWs) with COVID-19 at three months after discharge, in addition, stool samples were collected from 14 healthy controls (HCs) to perform 16S rRNA gene sequencing between May and July 2020. Compared with HCs, recovered HCWs had reduced bacterial diversity at three months after discharge, with a significantly higher relative abundance of opportunistic pathogens, and a significantly lower relative abundance of beneficial bacteria. In addition, Escherichia unclassified was positively correlated with persistent symptoms at three months after discharge, including fatigue (r = 0.567, p = 0.028), chest tightness after activity (r = 0.687, p = 0.005), and myalgia (r = 0.523, p = 0.045). Intestinibacter bartlettii was positively correlated with anorexia (r = 0.629, p = 0.012) and fatigue (r = 0.545, p = 0.036). However, Faecalibacterium prausnitzii was negatively correlated with chest tightness after activity (r = -0.591, p = 0.02), and Intestinimonas butyriciproducens was negatively correlated with cough (r = -0.635, p = 0.011). In conclusion, the gut microbiota of recovered HCWs with COVID-19 at three months after discharge was different from that of HCs, and altered gut microbiota was correlated with persistent symptoms after discharge, highlighting that gut microbiota may play an important role in the recovery of patients with COVID-19.


Assuntos
Bactérias/isolamento & purificação , COVID-19/complicações , COVID-19/microbiologia , Microbioma Gastrointestinal , Adulto , Bactérias/classificação , Bactérias/genética , COVID-19/terapia , COVID-19/virologia , Fadiga/etiologia , Fadiga/microbiologia , Fezes/microbiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Mialgia/etiologia , Mialgia/microbiologia , Alta do Paciente , Filogenia , Sobreviventes/estatística & dados numéricos
6.
Nutrients ; 13(7)2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34371824

RESUMO

Delayed-onset muscle soreness (DOMS) is associated with increases in acute inflammatory and biochemical markers, muscle swelling, pain, and reduced functional performance. This study aimed to investigate the preventative effects of crocodile blood supplementation on DOMS induced by eccentric exercise. Sixteen healthy males were randomly allocated to either a crocodile blood (CB, n = 8) or a placebo (PL, n = 8) treatment. Participants receiving the CB treatment consumed four capsules of freeze-dried CB powder (1 g day-1) over 18 days. Participants receiving the other treatment were administered a placebo over the same period. An eccentric exercise protocol was performed, and functional performance, visual analogue scale (VAS)-measured pain, knee range of movement (ROM), thigh circumference (swelling), and cytokines, enzymes, and biochemical parameters were assessed immediately after exercise as well as after 24 h, 48 h, and 72 h. CB supplementation could significantly maintain maximum voluntary isometric contraction (MVIC) at 24 h (p = 0.001) and 48 h after exercise (p = 0.001) when comparing values at different times for the CB group. In the CB group, thigh circumference decreased only immediately after eccentric exercise (p = 0.031) in comparison with pre-eccentric exercise values. An 18-day supplementation (1 g day-1) of crocodile blood does aid in the maintenance of functional performance and muscle swelling after eccentric exercise. Our data indicate that 1 g day-1 of crocodile blood supplementation should be safe for human consumption.


Assuntos
Jacarés e Crocodilos/sangue , Suplementos Nutricionais , Exercício Físico/fisiologia , Doenças Musculares/prevenção & controle , Mialgia/prevenção & controle , Animais , Biomarcadores/análise , Método Duplo-Cego , Edema/etiologia , Edema/fisiopatologia , Edema/prevenção & controle , Voluntários Saudáveis , Humanos , Contração Isométrica/efeitos dos fármacos , Masculino , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/fisiopatologia , Doenças Musculares/etiologia , Doenças Musculares/fisiopatologia , Mialgia/etiologia , Mialgia/fisiopatologia , Medição da Dor , Desempenho Físico Funcional , Amplitude de Movimento Articular/efeitos dos fármacos , Adulto Jovem
7.
Nutrients ; 13(8)2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34445035

RESUMO

BACKGROUND: Blackcurrant is rich in anthocyanins that may protect against exercise-induced muscle damage (EIMD) and facilitate a faster recovery of muscle function. We examined the effects of New Zealand blackcurrant (NZBC) extract on indices of muscle damage and recovery following a bout of strenuous isokinetic resistance exercise. METHODS: Using a double-blind, randomised, placebo controlled, parallel design, twenty-seven healthy participants received either a 3 g·day-1 NZBC extract (n = 14) or the placebo (PLA) (n = 13) for 8 days prior to and 4 days following 60 strenuous concentric and eccentric contractions of the biceps brachii muscle on an isokinetic dynamometer. Muscle soreness (using a visual analogue scale), maximal voluntary contraction (MVC), range of motion (ROM) and blood creatine kinase (CK) were assessed before (0 h) and after (24, 48, 72 and 96 h) exercise. RESULTS: Consumption of NZBC extract resulted in faster recovery of baseline MVC (p = 0.04), attenuated muscle soreness at 24 h (NZBC: 21 ± 10 mm vs. PLA: 40 ± 23 mm, p = 0.02) and 48 h (NZBC: 22 ± 17 vs. PLA: 44 ± 26 mm, p = 0.03) and serum CK concentration at 96 h (NZBC: 635 ± 921 UL vs. PLA: 4021 ± 4319 UL, p = 0.04) following EIMD. CONCLUSIONS: Consumption of NZBC extract prior to and following a bout of eccentric exercise attenuates muscle damage and improves functional recovery. These findings are of practical importance in recreationally active and potentially athletic populations, who may benefit from accelerated recovery following EIMD.


Assuntos
Frutas , Contração Muscular , Músculo Esquelético/efeitos dos fármacos , Mialgia/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Treinamento de Força/efeitos adversos , Ribes , Adulto , Biomarcadores/sangue , Creatina Quinase Forma MM/sangue , Método Duplo-Cego , Inglaterra , Feminino , Frutas/química , Humanos , Masculino , Músculo Esquelético/fisiopatologia , Mialgia/diagnóstico , Mialgia/etiologia , Mialgia/fisiopatologia , Medição da Dor , Extratos Vegetais/efeitos adversos , Extratos Vegetais/isolamento & purificação , Recuperação de Função Fisiológica , Ribes/química , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
8.
J Korean Med Sci ; 36(34): e245, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34463066

RESUMO

Since February 26, 2021, when vaccination against coronavirus disease 2019 (COVID-19) began in South Korea, patients who visited the Korea University Guro Hospital with suspected adverse events after COVID-19 vaccination were monitored actively with interest. We encountered five unusual cases of polyarthralgia and myalgia syndrome in patients who received the ChAdOx1 nCOV-19 (AstraZeneca) vaccine. The patients (median age 67 years) were not previously diagnosed with arthropathy and rheumatologic diseases. They developed fever, myalgia, joint pain, and swelling three to seven days after vaccination. The symptoms persisted for up to 47 days despite antipyretic treatment. Arthralgia occurred in multiple joints, including small and large joints. A whole-body Technetium-99m methylene diphosphonate bone scan revealed unusual uptakes in the affected joints. Non-steroidal anti-inflammatory drugs with or without prednisolone relieved the symptoms of all patients. Further monitoring is required to clarify the long-term prognosis of this syndrome.


Assuntos
Artralgia/etiologia , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Mialgia/etiologia , Vacinação/efeitos adversos , Adulto , Idoso , Antipsicóticos/uso terapêutico , Artralgia/tratamento farmacológico , COVID-19/virologia , Feminino , Humanos , Articulações/diagnóstico por imagem , Articulações/patologia , Mialgia/tratamento farmacológico , República da Coreia , SARS-CoV-2/isolamento & purificação , Tomografia Computadorizada por Raios X
9.
Am J Physiol Regul Integr Comp Physiol ; 321(2): R238-R249, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34189949

RESUMO

Neuromuscular (NM), cardiorespiratory, and perceptual responses to maximal-graded exercise using different amounts of active muscle mass remain unclear. We hypothesized that during dynamic exercise, peripheral NM fatigue (declined twitch force) and muscle pain would be greater using smaller muscle mass, whereas central fatigue (declined voluntary activation) and ventilatory variables would be greater using larger muscle mass. Twelve males (29.8 ± 4.7 years) performed two ramp-incremental cycling tests until task failure: 1) single-leg (SL) with 10 W·min-1 ramp and 2) double-leg (DL) with 20 W·min-1 ramp. NM fatigue was assessed at baseline, task failure (post), and after 1, 4, and 8 min of recovery. Cardiorespiratory and perceptual variables [i.e., ratings of perceived exertion (RPE), pain, and dyspnea] were measured throughout cycling. Exercise duration was similar between sessions (SL: 857.7 ± 263.6 s; DL: 855.0 ± 218.8 s; P = 0.923), and higher absolute peak power output was attained in DL (SL: 163.2 ± 43.8 W; DL: 307.0 ± 72.0 W; P < 0.001). Although central fatigue did not differ between conditions (SL: -6.6 ± 6.5%; DL: -3.5 ± 4.8%; P = 0.091), maximal voluntary contraction (SL: -41.6 ± 10.9%; DL: -33.7 ± 8.5%; P = 0.032) and single twitch forces (SL: -59.4 ± 18.8%; DL: -46.2 ± 16.2%; P = 0.003) declined more following SL. DL elicited higher peak oxygen uptake (SL: 42.1 ± 10.0 mL·kg-1·min-1; DL: 50.3 ± 9.3 mL·kg-1·min-1; P < 0.001), ventilation (SL: 137.1 ± 38.1 L·min-1; DL: 171.5 ± 33.2 L·min-1; P < 0.001), and heart rate (SL: 167 ± 21 bpm; DL: 187 ± 8 bpm; P = 0.005). Dyspnea (P = 0.025) was higher in DL; however, RPE (P = 0.005) and pain (P < 0.001) were higher in SL. These results suggest that interplay between NM, cardiorespiratory, and perceptual determinants of exercise performance during ramp-incremental cycling to task failure is muscle mass dependent.


Assuntos
Ciclismo , Aptidão Cardiorrespiratória , Contração Muscular , Fadiga Muscular , Músculo Esquelético/inervação , Resistência Física , Potenciais de Ação , Adulto , Humanos , Masculino , Mialgia/etiologia , Mialgia/fisiopatologia , Fatores de Tempo , Volição
10.
Medicine (Baltimore) ; 100(24): e26371, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128896

RESUMO

ABSTRACT: Most patients with coronavirus disease 2019 (COVID-19) have mild to moderate illness not requiring hospitalization. However, no study has detailed the evolution of symptoms in the first month of illness.At our institution, we conducted remote (telephone and video) visits for all adult outpatients diagnosed with COVID-19 within 24 h of a positive nasopharyngeal polymerase chain test for SARS-CoV-2. We repeated regular video visits at 7, 14, and 28 days after the positive test, retrospectively reviewed the prospective data collected in the remote visits, and constructed a week by week profile of clinical illness, through week 4 of illness.We reviewed the courses of 458 symptomatic patients diagnosed between March 12, 2020, and June 22, 2020, and characterized their weekly courses. Common initial symptoms included fever, headache, cough, and chest pain, which frequently persisted through week 3 or longer. Upper respiratory or gastrointestinal symptoms were much shorter lived, present primarily in week 1. Anosmia/ageusia peaked in weeks 2 to 3. Emergency department visits were frequent, with 128 visits in the 423 patients who were not hospitalized and 48 visits among the 35 outpatients (7.6%) who were eventually hospitalized (2 subsequently died). By the fourth week, 28.9% said their illness had completely resolved. After the 4-week follow up, 20 (4.7%) of the 423 nonhospitalized patients had further medical evaluation and management for subacute or chronic COVID-19 symptoms.Mild to moderate outpatient COVID-19 is a prolonged illness, with evolving symptoms commonly lasting into the fourth week of illness.


Assuntos
Assistência Ambulatorial , COVID-19/complicações , COVID-19/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anosmia/etiologia , COVID-19/diagnóstico , Dor no Peito/etiologia , Tosse/etiologia , Dispneia/etiologia , Serviço Hospitalar de Emergência , Fadiga/etiologia , Feminino , Febre/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Mialgia/etiologia , Estudos Retrospectivos , SARS-CoV-2 , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
11.
Clin Drug Investig ; 41(7): 639-645, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34110614

RESUMO

BACKGROUND AND OBJECTIVE: Omecamtiv mecarbil (OM) is a cardiac myosin activator under clinical development for the treatment of heart failure. Two modified-release (MR) novel OM minitablet formulations were developed to support the planned investigation of chronic heart failure in pediatric patients. The primary objective of this study was to determine the bioavailability of the minitablets relative to the adult matrix MR formulation tablets. METHODS: In a randomized, 5-period, crossover study, 20 healthy subjects received each of the following treatments orally: one 25-mg adult matrix MR tablet, 25 1-mg slow-release minitablets, 25 1-mg fast-release minitablets, six 1-mg slow-release minitablets, or six 1-mg fast-release minitablets after an overnight fast of at least 10 h with a minimum washout of 7 days between treatments. Blood samples were collected for up to 168 h. OM pharmacokinetic parameters were estimated using non-compartmental methods. RESULTS: When OM was administered as 25 1-mg OM slow-release minitablets, AUClast, AUCinf, and Cmax were 0.998-, 1.00-, and 1.29-fold of a single 25-mg OM matrix MR tablet, respectively. When OM was administered as 25 1-mg OM fast-release minitablets, AUClast, AUCinf, and Cmax were 1.26-, 1.25-, and 2.21-fold of a single 25-mg OM matrix MR tablet, respectively. The slow- and fast-release minitablets display approximately dose-proportional pharmacokinetics. There were no serious adverse events or treatment-emergent adverse events leading to discontinuation from the study. CONCLUSIONS: Relative bioavailability of slow-release minitablets was demonstrated to be similar to the adult matrix MR formulation.


Assuntos
Preparações de Ação Retardada/química , Comprimidos/química , Ureia/análogos & derivados , Administração Oral , Adolescente , Adulto , Disponibilidade Biológica , Estudos Cross-Over , Composição de Medicamentos , Feminino , Meia-Vida , Voluntários Saudáveis , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Mialgia/etiologia , Ureia/efeitos adversos , Ureia/sangue , Ureia/farmacocinética , Ureia/uso terapêutico , Adulto Jovem
12.
Rheumatol Int ; 41(7): 1263-1271, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33978818

RESUMO

To describe the rheumatic and musculoskeletal symptoms at hospitalization as well as their persistence/severity after discharge with coronavirus disease 2019 (COVID-19) and to identify whether age, sex, body mass index (BMI), and length of hospital stay are associated with persistence of these symptoms. In this single-center cohort study, comprising 300 participants, two phone interviews were conducted (2-week and 1-month after hospitalization) and symptoms were queried with a standardized form. This form included musculoskeletal symptoms and other COVID-19 symptoms. Considering all symptoms (musculoskeletal and other), 100.0%, 86.7%, and 72.0% of patients reported one or more symptoms, at hospitalization, 2-week, and 1-month, respectively. Considering only musculoskeletal symptoms, 92.3%, 72.7%, and 56.3% of patients reported any musculoskeletal symptom at hospitalization, 2-week, and 1-month, respectively. The musculoskeletal symptoms were fatigue (44.3% of patients reported), back pain (22.7%), arthralgia (22.0%), myalgia (21.0%), low back pain (16.3%), and neck pain (10.3%); the other symptoms were shortness of breath (26.3%), loss of taste (15.0%), cough (14.0%), loss of smell (12.3%), loss of appetite (10.3%), headache (8.7%), sore throat (3.0%), diarrhea (1.3%), dizziness (1.3%), and fever (0.3%) at 1-month. Increasing BMI was associated with higher odds of persistence of fatigue (OR: 1.08, 1.03 to 1.13), myalgia (OR: 1.08, 1.01 to 1.14), and arthralgia (OR: 1.07, 1.02 to 1.14, p = 0.012) at 1-month. Nearly three-quarters reported one or more symptoms, with more than half of patients reported any musculoskeletal symptom at 1 month. The most common musculoskeletal symptom was fatigue, followed by back pain, arthralgia, myalgia, low back pain, and neck pain. The persistence of fatigue, myalgia, and arthralgia was related to BMI. The study results increase our understanding of the spectrum of COVID-19, which, in turn, may lead to more efficient and better care for COVID-19 survivors.


Assuntos
Artralgia/etiologia , Dor nas Costas/etiologia , COVID-19/complicações , Fadiga/etiologia , Mialgia/etiologia , SARS-CoV-2 , Adulto , Idoso , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas , Alta do Paciente , Estudos Prospectivos
13.
Int J Mol Sci ; 22(7)2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33810365

RESUMO

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a persistent and unexplained pathological state characterized by exertional and severely debilitating fatigue, with/without infectious or neuropsychiatric symptoms, and with a minimum duration of 6 consecutive months. Its pathogenesis is not fully understood. There are no firmly established diagnostic biomarkers or treatment, due to incomplete understanding of the etiology of ME/CFS and diagnostic uncertainty. Establishing a biomarker for the objective diagnosis is urgently needed to treat a lot of patients. Recently, research on ME/CFS using metabolome analysis methods has been increasing. Here, we overview recent findings concerning the metabolic features in patients with ME/CFS and the animal models which contribute to the development of diagnostic biomarkers for ME/CFS and its treatment. In addition, we discuss future perspectives of studies on ME/CFS.


Assuntos
Biomarcadores/metabolismo , Encefalite/diagnóstico , Síndrome de Fadiga Crônica/diagnóstico , Mialgia/diagnóstico , Animais , Modelos Animais de Doenças , Encefalite/etiologia , Síndrome de Fadiga Crônica/etiologia , Humanos , Metaboloma , Metabolômica , Mialgia/etiologia , Ratos , Ratos Sprague-Dawley , Ratos Wistar
14.
J Indian Prosthodont Soc ; 21(1): 81-87, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33835072

RESUMO

Aim: The purpose was to evaluate the morphological variations of the condyle in patients presenting with myalgia associated with and without clicking of temporomandibular joint (TMJ) and its possible effect on the contour and height. Setting and Design: Cross sectional study. Material and Methods: A total of 60 patients comprising of 20 patients with myalgia, 20 patients with myalgia associated with clicking of TMJ, and a control group of 20 patients without any signs and symptoms of temporomandibular disorder were selected for purpose of the study. Using a digital panoramic radiograph, the contour of the condyle was evaluated for shape, condylar height (CH), and condylar asymmetry. Statistical Analyses Used: Chi-square test, One- way ANOVA. Results: Rounded contour of the condyle was the most prevalent shape of the condyle amongst the three groups. There was a significant decrease in mean right and left CH in subjects with myalgia (0.71 cm and 0.73 cm) and subjects with myalgia associated with clicking (0.65 cm and 0.62 cm) compared to control group subjects. There was also an increase in the mean asymmetry index in subjects with myalgia presenting with clicking (2.362 ± 1.4) and without clicking (1.388 ± 2.1) (P < 0.05). Conclusion: Within the limitations of the current study, round contour of the condyle is the most common variant. Subjects with myalgia showed a significant reduction in condyle height. Condyle contour, height, and asymmetry may not predispose the joint for clicking.


Assuntos
Côndilo Mandibular , Mialgia , Estudos Transversais , Humanos , Índia/epidemiologia , Côndilo Mandibular/diagnóstico por imagem , Mialgia/etiologia , Articulação Temporomandibular
15.
Med Sci Monit ; 27: e930447, 2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33854028

RESUMO

BACKGROUND The present study was designed to reveal the trajectory of self-reported somatic symptom burden and sleep quality over time in patients with COVID-19 and to identify prognostic factors for greater somatic symptom burden and sleep disturbance. MATERIAL AND METHODS Seventy-four patients with COVID-19 were prospectively followed for longitudinal assessment of somatic symptom burden and sleep quality. We used the 8-item Somatic Symptom Scale (SSS-8) and the modified Medical Research Council (mMRC) scale for somatic symptom burden and the Pittsburgh Sleep Quality Index for sleep quality investigation. Univariate and multivariate analyses were performed to identify independent factors associated with somatic symptom burden and sleep quality. RESULTS Although the degree of physical discomfort and sleep quality issues tended to decline during self-quarantine, patients still experienced these problems to a certain degree. Univariate and multivariate analyses showed that SSS-8 scores at admission (relative risk [RR] 1.234, 95% CI 1.075-1.417, P=0.003) and mMRC scores at discharge (RR 2.420, 95% CI 1.251-4.682, P=0.009) were 2 independent prognostic indicators of somatic symptom burden. In addition, muscle pain as a chief complaint (RR 4.682, 95% CI 1.247-17.580, P<0.022) and history of use of hypnotic drugs (RR 0.148, 95% CI 0.029-0.749, P<0.019) were 2 independent indicators of patient sleep quality during hospitalization. CONCLUSIONS To the best of our knowledge, the present study was the first dynamic assessment of the somatic symptom burden and sleep quality in patients with COVID-19 during hospitalization and quarantine after discharge. Patients with high somatic symptom burden at admission, especially muscle pain as the chief complaint, are prone to having a higher physical burden and more sleep disturbance at discharge.


Assuntos
COVID-19/complicações , Efeitos Psicossociais da Doença , Sintomas Inexplicáveis , Mialgia/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Adulto , Idoso , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , China/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Mialgia/diagnóstico , Mialgia/etiologia , Mialgia/fisiopatologia , Admissão do Paciente/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Prognóstico , Estudos Prospectivos , Quarentena/estatística & dados numéricos , Medição de Risco/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , Autorrelato/estatística & dados numéricos , Índice de Gravidade de Doença , Sono/fisiologia , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/etiologia
16.
Nutrients ; 13(3)2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33807745

RESUMO

We assessed whether a protein supplementation protocol could attenuate running-induced muscle soreness and other muscle damage markers compared to iso-caloric placebo supplementation. A double-blind randomized controlled trial was performed among 323 recreational runners (age 44 ± 11 years, 56% men) participating in a 15-km road race. Participants received milk protein or carbohydrate supplementation, for three consecutive days post-race. Habitual protein intake was assessed using 24 h recalls. Race characteristics were determined and muscle soreness was assessed with the Brief Pain Inventory at baseline and 1-3 days post-race. In a subgroup (n = 149) muscle soreness was measured with a strain gauge algometer and creatine kinase (CK) and lactate dehydrogenase (LDH) concentrations were measured. At baseline, no group-differences were observed for habitual protein intake (protein group: 79.9 ± 26.5 g/d versus placebo group: 82.0 ± 26.8 g/d, p = 0.49) and muscle soreness (protein: 0.45 ± 1.08 versus placebo: 0.44 ± 1.14, p = 0.96). Subjects completed the race with a running speed of 12 ± 2 km/h. With the Intention-to-Treat analysis no between-group differences were observed in reported muscle soreness. With the per-protocol analysis, however, the protein group reported higher muscle soreness 24 h post-race compared to the placebo group (2.96 ± 2.27 versus 2.46 ± 2.38, p = 0.039) and a lower pressure muscle pain threshold in the protein group compared to the placebo group (71.8 ± 30.0 N versus 83.9 ± 27.9 N, p = 0.019). No differences were found in concentrations of CK and LDH post-race between groups. Post-exercise protein supplementation is not more preferable than carbohydrate supplementation to reduce muscle soreness or other damage markers in recreational athletes with mostly a sufficient baseline protein intake running a 15-km road race.


Assuntos
Carboidratos da Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Suplementos Nutricionais , Mialgia/prevenção & controle , Corrida/fisiologia , Adulto , Biomarcadores/sangue , Creatina Quinase/sangue , Método Duplo-Cego , Feminino , Humanos , Análise de Intenção de Tratamento , L-Lactato Desidrogenase/sangue , Masculino , Mialgia/sangue , Mialgia/etiologia , Limiar da Dor
17.
Rev. andal. med. deporte ; 14(1): 3-7, mar. 2021. tab, graf, ilus
Artigo em Inglês | IBECS | ID: ibc-200372

RESUMO

OBJECTIVE: The purpose of the present study was to examine the effect of kinesio taping on calf pain in healthy runners immediately after a half marathon. METHOD: A sample of 13 runner volunteers was recruited in a half marathon. Calf pain measurements were taken at baseline and 10-15 minutes after competition. Kinesio tape was applied to the calf of runners the evening before the competition, only on one leg, with the contralateral leg acting as a control. RESULTS: The results of the repeated measures ANOVA in the leg differences on pain values did not show statistically significant differences (p = 0.515). However, the effect size after the race could be an indication that kinesio tape might be useful (g = - 0.37) and that studies with the sample calculated would be necessary (n = 61). CONCLUSIONS: When kinesio tape was applied to healthy half marathon runners, the data did not disclose whether the tape could lead to control calf pain produced by the competition


OBJETIVO: El propósito del presente estudio fue examinar el efecto del vendaje neuromuscular sobre el dolor de la pantorrilla en corredores sanos inmediatamente después de una media maratón. MÉTODO: Una muestra de 13 corredores voluntarios fue reclutada en una media maratón. Las mediciones de dolor de las pantorrillas se tomaron al inicio y 10-15 minutos después de la competición. El vendaje neuromuscular se aplicó en la pantorrilla de los corredores la noche anterior a la competencia, sólo en una pierna, con la pierna contralateral actuando como control. RESULTADOS: Los resultados del ANOVA de medidas repetidas sobre las diferencias en los valores de dolor en las piernas no mostraron diferencias estadísticamente significativas (p = 0.515). Sin embargo, el tamaño del efecto después de la carrera podría ser un indicio de la utilidad del vendaje (g = - 0.37) y de que estudios con la muestra calculada son necesarios (n = 61). CONCLUSIONES: Cuando el vendaje neuromuscular se aplicó a los corredores de medio maratón sanos, los datos no revelaron si podría controlar el dolor de las pantorrillas producido por la competición


OBJETIVO: O objetivo do presente estudo foi examinar o efeito da bandagem neuromuscular na dor na panturrilha em corredores saudáveis ​​imediatamente após uma meia maratona. MÉTODO: Uma amostra de 13 corredores voluntários foi recrutada para uma meia maratona. As medições da dor na panturrilha foram feitas no início e 10-15 minutos após a competição. A bandagem neuromuscular foi aplicada na panturrilha dos corredores na noite anterior à competição, apenas em uma perna, com a perna contralateral atuando como controle. RESULTADOS: Os resultados da ANOVA de medidas repetidas sobre as diferenças nos valores de dor nas pernas não mostraram diferenças estatisticamente significativas (p = 0,515). Porém, o tamanho do efeito após a corrida pode ser um indicativo da utilidade da bandagem (g = - 0,37) e que estudos com a amostra calculada são necessários (n = 61). CONCLUSÕES: Quando a bandagem neuromuscular foi aplicada em corredores saudáveis ​​de meia maratona, os dados não revelaram se ela poderia controlar a dor na panturrilha produzida pela competição


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Fita Atlética , Dor/reabilitação , Atletas , Projetos Piloto , Esforço Físico/fisiologia , Corrida/lesões , Mialgia/reabilitação , Medição da Dor , Análise de Variância , Mialgia/etiologia
18.
J Child Neurol ; 36(10): 853-866, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33646895

RESUMO

INTRODUCTION: Although multiple neurologic manifestations associated with SARS-CoV-2 infection have been described in adults, there is little information about those presented in children. Here, we described neurologic manifestations associated with COVID-19 in the pediatric population. METHODS: Retrospective case series report. We included patients younger than 18 years, admitted with confirmed SARS-CoV-2 infection and neurologic manifestations at our hospital in Santiago, Chile. Demographics, clinical presentations, laboratory results, radiologic and neurophysiological studies, treatment, and outcome features were described. Cases were described based on whether they presented with predominantly central or peripheral neurologic involvement. RESULTS: Thirteen of 90 (14.4%) patients admitted with confirmed infection presented with new-onset neurologic symptoms and 4 patients showed epilepsy exacerbation. Neurologic manifestations ranged from mild (headache, muscle weakness, anosmia, ageusia), to severe (status epilepticus, Guillain-Barré syndrome, encephalopathy, demyelinating events). CONCLUSIONS: We found a wide range of neurologic manifestations in children with confirmed SARS-CoV-2 infection. In general, neurologic symptoms were resolved as the systemic presentation subsided. It is essential to recognize and report the main neurologic manifestations related to this new infectious disease in the pediatric population. More evidence is needed to establish the specific causality of nervous system involvement.


Assuntos
COVID-19/complicações , Tontura/etiologia , Encefalite/etiologia , Cefaleia/etiologia , Mialgia/etiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos
19.
J Int Soc Sports Nutr ; 18(1): 18, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33648546

RESUMO

BACKGROUND: We previously showed 8-week of fish oil supplementation attenuated muscle damage. However, the effect of a shorter period of fish oil supplementation is unclear. The present study investigated the effect of fish oil, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), for 4 weeks on muscular damage caused by eccentric contractions (ECCs) of the elbow flexors. METHODS: Twenty-two untrained men were recruited in this double-blind, placebo-controlled, parallel design study and the subjects were randomly assigned to the EPA and DHA group (EPA and DHA, n = 11) and placebo group (PL, n = 11). They consumed either EPA 600 mg and DHA 260 mg per day or placebo supplement for 4 weeks prior to exercise. Subjects performed 60 ECCs at 100 % maximal voluntary contraction (MVC) using a dumbbell. Changes in MVC torque, range of motion (ROM), upper arm circumference, muscle soreness, echo intensity, muscle thickness, serum creatine kinase (CK), and interleukin-6 (IL-6) were assessed before exercise; immediately after exercise; and 1, 2, 3, and 5 days after exercise. RESULTS: ROM was significantly higher in the EPA and DHA group than in the PL group immediately after performing ECCs (p < 0.05). No differences between groups were observed in terms of MVC torque, upper arm circumference, muscle soreness, echo intensity, and thickness. A significant difference was observed in serum CK 3 days after ECCs (p < 0.05). CONCLUSIONS: We concluded that shorter period EPA and DHA supplementation benefits joint flexibility and protection of muscle fiber following ECCs.


Assuntos
Suplementos Nutricionais , Ácidos Docosa-Hexaenoicos/farmacologia , Ácido Eicosapentaenoico/farmacologia , Óleos de Peixe/farmacologia , Contração Isométrica , Mialgia/prevenção & controle , Ácido 8,11,14-Eicosatrienoico/sangue , Ácido Araquidônico/sangue , Braço/anatomia & histologia , Braço/diagnóstico por imagem , Creatina Quinase/sangue , Ácidos Docosa-Hexaenoicos/administração & dosagem , Ácidos Docosa-Hexaenoicos/sangue , Ácido Eicosapentaenoico/administração & dosagem , Ácido Eicosapentaenoico/sangue , Articulação do Cotovelo/fisiologia , Ácidos Graxos Insaturados/sangue , Óleos de Peixe/administração & dosagem , Óleos de Peixe/química , Humanos , Interleucina-6/sangue , Masculino , Mialgia/etiologia , Placebos/administração & dosagem , Placebos/farmacologia , Amplitude de Movimento Articular/efeitos dos fármacos , Amplitude de Movimento Articular/fisiologia , Fatores de Tempo , Torque , Adulto Jovem
20.
Acta Otolaryngol ; 141(6): 615-620, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33733988

RESUMO

BACKGROUND: There is no clinical instrument evaluating symptoms of COVID-19. OBJECTIVE: To develop a clinical instrument for evaluating symptoms of COVID-19 mild-to-moderate forms. METHODS: COVID-19 patients were recruited from EpiCURA Hospital (Belgium). They completed the COVID-19 Symptom Index (CSI) twice to assess the test-retest reliability. The internal consistency was evaluated with Cronbach's alpha. CSI was completed by healthy subjects to assess the internal validity. Patients completed CSI 6 weeks after the COVID-19 resolution to evaluate the responsiveness to change. RESULTS: Ninety-four COVID-19 patients and 55 healthy individuals completed the evaluations. Symptoms associated with the higher severity score were fatigue, headache and myalgia. The Cronbach's alpha value was 0.801, indicating high internal consistency. The test-retest reliability was adequate (rs = 0.535, p = .001). The correlation between CSI total score and SNOT-22 was high (rs = 0.782; p < .001), supporting a high external validity. COVID-19 patients reported significant higher CSI score than healthy individuals, suggesting an adequate internal validity. The mean CSI significantly decreased after the COVID-19 resolution, supporting a high responsiveness to change property. CONCLUSION AND SIGNIFICANCE: The CSI is a reliable and valid patient reported outcome questionnaire for the evaluation of symptom severity of COVID-19 patients.


Assuntos
COVID-19/diagnóstico , Índice de Gravidade de Doença , Avaliação de Sintomas , Adulto , Estudos de Casos e Controles , Fadiga/etiologia , Feminino , Cefaleia/etiologia , Humanos , Masculino , Mialgia/etiologia , Reprodutibilidade dos Testes
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