Background: Simplified field tests have gained increasing interest for the assessment of functional capacity in patients with post-COVID-19 condition; however, direct comparisons of functional performance and physiological responses between the 1-min sit-to-stand test (1MSTST) and the 6-min walk test (6MWT) remain limited. This study aimed to examine the associations between the two tests by evaluating functional performance, cardiopulmonary responses, oxygen desaturation, perceived exertion, and peripheral muscle strength. Furthermore, we explored whether the 1MSTST can be used as a complementary assessment, particularly within telerehabilitation pathways and in contexts where resource-intensive testing is not feasible. Methods: We conducted a cross-sectional observational study of adults recovering from moderate to severe COVID-19 between May and July 2021. Participants performed both the 1MSTST and 6MWT on the same day. Functional performance, peak heart rate, nadir peripheral oxygen saturation (SpO2), perceived exertion, and handgrip dynamometry were recorded. Associations between test performances were assessed using correlation and partial correlation analyses, including adjustment for peripheral muscle strength. Results: Fifty-four patients were included. A moderate correlation was observed between 1MSTST repetitions and 6MWT distance (Spearman’s ρ = 0.47, p < 0.001), which was attenuated after adjustment for muscle strength and demographic variables. Peak heart rate and nadir SpO2 responses were strongly correlated between tests (r = 0.75 and ρ = 0.83, respectively; both p < 0.001), with no significant differences in magnitude. Exercise-induced oxygen desaturation (≥4% SpO2 drop) occurred at similar frequencies during both tests. Perceived exertion increased similarly following the 1MSTST and the 6MWT. Conclusions: In post-COVID-19 patients, the 1 min sit-to-stand test shows moderate concordance with the 6 min walk test for functional performance and strong agreement in cardiopulmonary responses. These findings suggest that the two tests assess overlapping but distinct aspects of functional capacity. This supports the use of the 1MSTST as a pragmatic complementary assessment when standard walking tests are not feasible, particularly within telerehabilitation pathways, primary care, and resource-limited settings.
26 September 2024 in International Journal of Innovative Research in Medical Science
We present a case of Q fever in a 77-year-old autonomous male with a complex medical history. The patient, immunocompromised due to azathioprine and prednisolone use for myasthenia gravis, also suffered from diabetes mellitus, heart failure, and severe asthma. Despite no history of animal contact or travel to endemic regions, the patient developed flu-like symptoms followed by high fever and prostration. Multiple courses of antibiotics were administered without clinical improvement, and cultures of blood, urine, and stool were negative. Serological testing for Coxiella burnetii confirmed the diagnosis, with positive IgG and IgM phase II antibodies. The patient received doxycycline therapy and experienced rapid clinical improvement, with sustained apyrexy and no recurrence of symptoms at a 2-week follow-up. This case highlights the diagnostic challenges of Q fever, particularly in immunocompromised individuals with multiple comorbidities. Despite the absence of typical exposure history, serological testing was crucial for confirming the diagnosis. The timely initiation of doxycycline therapy was essential for a favourable outcome.
1 November 2024 in International Journal of Innovative Research in Medical Science
An 80-year-old male, autonomous, with a history of cardiovascular risk factors, underwent aortic bioprosthesis placement for symptomatic severe aortic stenosis. He presented with acute bacterial endocarditis of the aortic valve prosthesis caused by methicillin-resistant Staphylococcus epidermidis (MRSE). The patient also had a pacemaker for atrial fibrillation and required catheter replacement due to infectious vegetation. Admitted one year after a previous episode of bacterial endocarditis, he exhibited fever of unknown origin, prostration, anorexia, and elevated inflammatory markers. Empirical treatment was initiated with ceftriaxone, gentamicin, and vancomycin. Hemocultures revealed Candida metapsilosis, leading to the addition of caspofungin. Transesophageal echocardiography showed vegetations on the bioprosthesis but none on the pacemaker catheter. He spent 103 days in the hospital, including intensive care for renal dysfunction. Following persistent fungemia, antifungal therapy was switched to liposomal amphotericin B. Haemocultures were sterilized 38 days after treatment initiation. The patient was discharged on lifelong itraconazole, with no periprosthetic complications, highlighting a rare case of recurrent fungal endocarditis following bacterial infection.