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Background and Objectives: Among the extra-pulmonary manifestations of COVID-19, neuromuscular signs and symptoms are frequent. We aimed to assess the correlation between neuromuscular abnormalities (electrophysiological) and mobility measures (Berg Balance Scale and Timed-Up-and-Go test) twice, at least 6 weeks after hospital discharge and 6 months later, taking into account cognitive performance, nutrition, muscle strength, and submaximal exercise capacity. Materials and Methods: 43 patients (51.4 ± 9.3 years old) accepted to participate in the study; they had a dyspnea score ≤ 3 (Borg scale), and no history of neurology/neuromuscular/orthopedic disorders, but high frequency of overweight/obesity and weight loss during hospital stay. The two evaluations included physical examination, cognitive assessment, nutritional evaluation, muscle strength (hand-grip and quadriceps dynamometry), electromyography, Barthel Index, Six-Minute- Walk-Test (6MWT), Berg Balance Scale and Timed-Up-and-Go test. Bivariate and repeated measures covariance analyses were performed (significance level of 0.05). Results: Electrophysiological abnormalities were evident in 67% of the patients, which were associated with diminished performance on the 6MWT, the Berg Balance Scale and the Timed-Up-and-Go test. At each evaluation and between evaluations, scores on the Berg Balance Scale were related to the body mass index (BMI) at hospital admission and the 6MWT (MANCoVA R ≥ 0.62, p = 0.0001), while the time to perform the Timed-Up-and-Go test was related to the electrophysiological abnormalities, weight loss during hospital stay, sex, handgrip strength, and the 6MWT (MANCoVA, R ≥ 0.62, p < 0.0001). We concluded that, after hospital discharge, patients with moderate to severe COVID-19 may have neuromuscular abnormalities that can be related to BMI/weight loss, and contribute to mobility decrease. In patients with moderate to severe COVID-19 and high BMI/ large weight loss, neuromuscular and intended mobility assessments could be required to provide early rehabilitation. Apart from the 6MWT, handgrip dynamometry and the Timed-Up-and-Go test were useful tools to quickly assess fitness and mobility.
Assuntos
COVID-19 , Equilíbrio Postural , Humanos , Adulto , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia , Força da Mão , COVID-19/complicações , Estudos de Tempo e Movimento , Peso Corporal , Redução de PesoRESUMO
The ecancer 'Choosing Wisely' conference was held for the first time in Latin America in Santa Cruz, Bolivia. The event had more than 150 registered attendees in addition to 22 speakers from different countries and different specialities in the field of oncology, who presented topics on prevention, oncological surgery, clinical oncology and palliative care, in order to demonstrate the current evidence of how to approach a patient in daily clinical practice based on the human resources, materials and drugs available, trying to offer the maximum benefit to the patient based on current scientific evidence. In addition to addressing issues of vital importance in breast cancer, during the 2 days of the event, updated information generated in recent years was presented, the results of which will change clinical practice. All the experts were in favour of developing strategies and methods that help us to properly select treatments to optimise resources and reduce the economic toxicity of the most modern and current treatments. This conference was an event of vital importance because it was the first face-to-face event for ecancer and the physicians after difficult years due to COVID-19.
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A better understanding of fitness costs and insecticide resistance reversion has practical applications for improving resistance management approaches. The coffee leaf miner, Leucoptera coffeella, is one of the most important coffee pests worldwide. Chlorpyrifos is still used to control L. coffeella despite studies showing resistance in this pest. The current study investigated the fitness costs and reversion of resistance to chlorpyrifos in L. coffeella populations in coffee. The control failure of this insecticide was evaluated in 15 field populations. Selection of resistant and susceptible L. coffeella (G1-G10), with and without chlorpyrifos exposure, was evaluated. The following parameters were investigated: consumed leaf area, adult longevity, number of eggs per female, and egg viability. The present study showed control failures of chlorpyrifos and low (< 31-folds) to high levels (> 80-folds) of resistance in all field populations tested. The resistant population showed less fitness than the susceptible population. The fitness of the resistant population decreased significantly after 10 generations of chlorpyrifos selection. Specifically, the number of eggs per female, larvae hatched, and adult longevity were reduced by factors of 5, 2.3 and 3, respectively. Furthermore, the chlorpyrifos-resistant L. coffeella population consumed more than the susceptible population. Therefore, we concluded that non-exposing L. coffeella populations to chlorpyrifos insecticide leads to rapid reversion of resistance and susceptibility. In addition, resistant populations show reduced reproductive fitness and longevity, while consuming more, probably to meet greater metabolic demands.