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Sample records for sarcopenia etiology clinical

  1. Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives.

    Science.gov (United States)

    Rolland, Y; Czerwinski, S; Abellan Van Kan, G; Morley, J E; Cesari, M; Onder, G; Woo, J; Baumgartner, R; Pillard, F; Boirie, Y; Chumlea, W M C; Vellas, B

    2008-01-01

    Sarcopenia is a loss of muscle protein mass and loss of muscle function. It occurs with increasing age, being a major component in the development of frailty. Current knowledge on its assessment, etiology, pathogenesis, consequences and future perspectives are reported in the present review. On-going and future clinical trials on sarcopenia may radically change our preventive and therapeutic approaches of mobility disability in older people.

  2. Sarcopenia: origins and clinical relevance

    Science.gov (United States)

    To a considerable extent, the advent of the term sarcopenia has contributed to the focus on this important condition and its effects on the quality of life and care of older persons. It is hoped that the advances in our understanding of the etiology and treatment of sarcopenia will further contribut...

  3. [Clinical consequences of sarcopenia].

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    Serra Rexach, J A

    2006-05-01

    The concept of sarcopenia implies loss of muscle mass and function. It is a condition that accompanies aging, although it not always has clinical consequences. It is produced by many factors: nervous system (loss of alpha motor units in the spinal cord), muscular (loss of muscle quality and mass), humoral (decrease in anabolic hormones such as testosterone, estrogens, GH, and increase of several interleukines), and life style (physical activity). The main clinical consequences of sarcopenia relate with functional independence. Thus, the sarcopenic elderly has greater difficulty walking, or do it more slowly, climbing up stairs, or doing basic daily living activities. These difficulties increase the risk for falls and, thus, fractures. They also affect bone formation, glucose tolerance, and body temperature regulation. Besides, dependency is a mortality risk factor.

  4. Sarcopenia.

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    Woo, Jean

    2017-08-01

    Sarcopenia refers to age-related muscle loss, defined using a combination of appendicular muscle mass, muscle strength, and physical performance measures. The pathogenesis depends on a balance between positive and negative regulators of muscle growth. Sarcopenia increases the risk for falls, fractures, dependency, use of hospital services, institutionalization, poor quality of life, and mortality. In clinical practice, brief screening tools, such as the 5-item SARC-F score, may be useful. Although pharmacologic treatments are actively being studied, the current mainstay consists of optimizing nutrition status, in particular protein and vitamin D status, and resistance exercises. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Sarcopenia in Alcoholic Liver Disease: Clinical and Molecular Advances.

    Science.gov (United States)

    Dasarathy, Jaividhya; McCullough, Arthur J; Dasarathy, Srinivasan

    2017-08-01

    Despite advances in treatment of alcohol use disorders that focus on increasing abstinence and reducing recidivism, alcoholic liver disease (ALD) is projected to be the major cause of cirrhosis and its complications. Malnutrition is recognized as the most frequent complication in ALD, and despite the high clinical significance, there are no effective therapies to reverse malnutrition in ALD. Malnutrition is a relatively imprecise term, and sarcopenia or skeletal muscle loss, the major component of malnutrition, is primarily responsible for the adverse clinical consequences in patients with liver disease. It is, therefore, critical to define the specific abnormality (sarcopenia) rather than malnutrition in ALD, so that therapies targeting sarcopenia can be developed. Skeletal muscle mass is maintained by a balance between protein synthesis and proteolysis. Both direct effects of ethanol (EtOH) and its metabolites on the skeletal muscle and the consequences of liver disease result in disturbed proteostasis (protein homeostasis) and consequent sarcopenia. Once cirrhosis develops in patients with ALD, abstinence is unlikely to be effective in completely reversing sarcopenia, as other contributors including hyperammonemia, hormonal, and cytokine abnormalities aggravate sarcopenia and maintain a state of anabolic resistance initiated by EtOH. Cirrhosis is also a state of accelerated starvation, with increased gluconeogenesis that requires amino acid diversion from signaling and substrate functions. Novel therapeutic options are being recognized that are likely to supplant the current "deficiency replacement" approach and instead focus on specific molecular perturbations, given the increasing availability of small molecules that can target specific signaling components. Myostatin antagonists, leucine supplementation, and mitochondrial protective agents are currently in various stages of evaluation in preclinical studies to prevent and reverse sarcopenia, in cirrhosis in

  6. Defining sarcopenia

    Science.gov (United States)

    Currently there is no standardized definition of sarcopenia. This hampers the clinical management of sarcopenia and retards the development and regulatory approval of interventions to reduce the progression of this common and debilitating condition in the elderly. Nine definitions of sarcopenia have...

  7. Implications of ICD-10 for Sarcopenia Clinical Practice and Clinical Trials: Report by the International Conference on Frailty and Sarcopenia Research Task Force.

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    Vellas, B; Fielding, R A; Bens, C; Bernabei, R; Cawthon, P M; Cederholm, T; Cruz-Jentoft, A J; Del Signore, S; Donahue, S; Morley, J; Pahor, M; Reginster, J-Y; Rodriguez Mañas, L; Rolland, Y; Roubenoff, R; Sinclair, A; Cesari, M

    2018-01-01

    Establishment of an ICD-10-CM code for sarcopenia in 2016 was an important step towards reaching international consensus on the need for a nosological framework of age-related skeletal muscle decline. The International Conference on Frailty and Sarcopenia Research Task Force met in April 2017 to discuss the meaning, significance, and barriers to the implementation of the new code as well as strategies to accelerate development of new therapies. Analyses by the Sarcopenia Definitions and Outcomes Consortium are underway to develop quantitative definitions of sarcopenia. A consensus conference is planned to evaluate this analysis. The Task Force also discussed lessons learned from sarcopenia trials that could be applied to future trials, as well as lessons from the osteoporosis field, a clinical condition with many constructs similar to sarcopenia and for which ad hoc treatments have been developed and approved by regulatory agencies.

  8. Sarcopenia: An Undiagnosed Condition in Older Adults. Current Consensus Definition: Prevalence, Etiology, and Consequences

    Science.gov (United States)

    2012-01-01

    Sarcopenia, the age associated loss of skeletal muscle mass and function, has considerable societal consequences for the development of frailty, disability and health care planning. A group of geriatricians and scientists from academia and industry met in Rome, Italy on November 18, 2009 to arrive at a consensus definition of sarcopenia. The current consensus definition was approved unanimously by the meeting participants and is as follows: Sarcopenia is defined as the age-associated loss of skeletal muscle mass and function. The causes of sarcopenia are multi-factorial and can include disuse, altered endocrine function, chronic diseases, inflammation, insulin resistance, and nutritional deficiencies. While cachexia may be a component of sarcopenia, the two conditions are not the same. The diagnosis of sarcopenia should be considered in all older patients who present with observed declines in physical function, strength, or overall health. Sarcopenia should specifically be considered in patients who are bedridden, cannot independently rise from a chair, or who have a measured gait speed less that 1.0 m·s−1. Patients who meet these criteria should further undergo body composition assessment using dual energy x-ray absorptiometry (DXA) with sarcopenia being defined using currently validated definitions. A diagnosis of sarcopenia is consistent with a gait speed of less than 1 m·s−1 and an objectively measured low muscle mass (eg: appendicular mass relative to ht2 that is ≤ 7.23 kg/ m2 in men ≤ 5.67 kg/ m2 in men). Sarcopenia is a highly prevalent condition in older persons that leads to disability, hospitalization and death. PMID:21527165

  9. [Transdisciplinary Approach for Sarcopenia. Clinical significance of sarcopenia in the patients with chronic liver disease].

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    Shirabe, Ken; Harimoto, Norifumi; Ikegami, Toru; Yoshizumi, Tomoharu; Itoh, Shinji; Takeishi, Kazuki; Toshima, Takeo; Kimura, Kohichi; Matsumoto, Yoshihiro; Bekki, Yuki; Imai, Daisuke; Yamashita, Yoichi; Kawanaka, Hirofumi; Maehara, Yoshihiko

    2014-10-01

    Recently, many studies of the patients with chronic liver disease have focused on sarcopenia. In the patients with chronic liver disease, sarcopenia occurs, because of advanced liver failure and hepatocellular carcinoma (HCC) . In both diseases, sarcopenia is an important prognostic factor. Thus, sarcopenia has been reported to be a predictor for recurrence of HCC and early mortality after liver transplantation. In the patients with HCC, the mechanism of sarcopenia is unknown. In the patients with endostea liver failure, muscle compensates energy breakdown of the liver and muscle atrophy occurs. Further research is necessary to clarify whether nutritional support and muscle training prevent from sarcopenia and as a result, improve survival of the patients with chronic liver disease.

  10. Polypharmacy as a Risk Factor for Clinically Relevant Sarcopenia: Results From the Berlin Aging Study II.

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    König, Maximilian; Spira, Dominik; Demuth, Ilja; Steinhagen-Thiessen, Elisabeth; Norman, Kristina

    2017-12-12

    Sarcopenia affects more than 10% of older adults. Next to age-associated physiologic changes, diseases like diabetes or inflammatory, neurological, malignant and endocrine disorders may contribute to the development of sarcopenia. Likewise, polypharmacy, i.e., multiple drug use, is common among older adults. Although the two conditions frequently co-occur, the association of polypharmacy with sarcopenia has not yet been examined. We investigated the association of polypharmacy and sarcopenia in a large cohort of community-dwelling older adults (60-84 years). Thousand five hundred and two participants from the Berlin Aging Study II were included. Polypharmacy was defined as concurrent use of 5 or more drugs (prescription and nonprescription). Body composition was assessed with dual-energy X-ray absorptiometry, and appendicular lean mass (ALM) was calculated as sum of the four limbs' lean mass. Sarcopenia was defined as low ALM-to-body mass index (BMI)-ratio using validated sex-specific cutoffs. Mean age was 68.7 ± 3.7 years, 50.7% were female. The median (interquartile range) number of drugs was 2 (1-4); 21.1% of subjects reported regular use of ≥5 drugs. Subjects with polypharmacy were more often sarcopenic according to the applied ALM/BMI-cutoffs (16.3% vs 6.9%, p sarcopenia (odds ratio = 2.24, 95% confidence interval [CI] = 1.33-3.75). Polypharmacy is associated with clinically relevant sarcopenia, as assessed by a low ALM/BMI.

  11. Consecuencias clínicas de la sarcopenia Clinical consequences of sarcopenia

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    J. A. Serra Rexah

    2006-01-01

    El concepto de sarcopenia implica pérdida de masa y potencia muscular. Es un hecho que acompaña al envejecimiento aunque no siempre tiene consecuencias clínicas.Se produce por multitud de factores: sistema nervioso (pérdida de unidades motoras alfa de la médula espinal), musculares (pérdida de la calidad y masa muscular), humorales (descenso de hormonas anabolizantes como testosterona, estrógenos y GH y aumento de distintas interleukinas) y de estilo de vida (actividad física).Las principales...

  12. Sarcopenia associada ao envelhecimento: aspectos etiológicos e opções terapêuticas Sarcopenia and aging: etiological aspects and therapeutic options

    Directory of Open Access Journals (Sweden)

    Tatiana Alves de Araujo Silva

    2006-12-01

    Full Text Available A prevalência de incapacidade e dependência funcional é maior em idosos e está intimamente associada à redução da massa muscular, que ocorre, até mesmo, em indivíduos saudáveis. A sarcopenia parece decorrer da interação complexa de distúrbios da inervação, diminuição de hormônios, aumento de mediadores inflamatórios e alterações da ingestão protéico-calórica que ocorrem durante o envelhecimento. A perda de massa e força muscular é responsável pela redução de mobilidade e aumento da incapacidade funcional e dependência. Quando associada à fragilidade, esta perda gera custos econômicos e sociais. Neste artigo, pretende-se avaliar aspectos relacionados à gênese da sarcopenia, bem como analisar possíveis opções terapêuticas e de prevenção.The high prevalence of inability and functional dependence is an important problem in elderly people. It is closely related with aging decrease of lean muscle mass that occurs even in healthy subjects. Skeletal muscle mass deficiency, or sarcopenia, results from complex interactions between innervations disturbances, hormones deficiency, inflammatory cytokines and restriction in caloric-proteic ingestion. Loss of skeletal muscle mass and strength results in disability and functional dependency that are associated to frailty in many elderly people. These conditions represent enormous economic and social budget. In this article, we evaluate pathogenesis of sarcopenia and discuss potential therapies.

  13. Clinically Relevant Cut-off Points for the Diagnosis of Sarcopenia in Older Korean People.

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    Choe, Yu-Ri; Joh, Ju-Youn; Kim, Yeon-Pyo

    2017-11-09

    The optimal criteria applied to older Korean people have not been defined. We aimed to define clinically relevant cut-off points for older Korean people and to compare the predictive validity with other definitions of sarcopenia. Nine hundred and sixteen older Koreans (≥65 years) were included in this cross-sectional observational study. We used conditional inference tree analysis to determine cut-off points for height-adjusted grip strength (GS) and appendicular skeletal muscle mass (ASM), for use in the diagnosis of sarcopenia. We then compared the Korean sarcopenia criteria with the Foundation for the National Institutes of Health and Asian Working Group for Sarcopenia criteria, using frailty, assessed with the Korean Frailty Index, as an outcome variable. For men, a residual GS (GSre) of ≤ 0.25 was defined as weak, and a residual ASM (ASMre) of ≤ 1.29 was defined as low. Corresponding cut-off points for women were a GSre of ≤ 0.17 and an ASMre of ≤ 0.69. GSre and ASMre values were adjusted for height. In logistic regression analysis with new cut-off points, the adjusted odds ratios for pre-frail or frail status in the sarcopenia group were 3.23 (95% confidence interval [CI] 1.33-7.83) for the men and 1.74 (95% CI 0.91-3.35) for the women. In receiver operating characteristic curve analysis, the unadjusted area under the curve for Korean sarcopenia criteria in men and women were 0.653 and 0.608, respectively (p sarcopenia in older Korean people.

  14. Mitochondrial dysfunction and sarcopenia of aging: from signaling pathways to clinical trials

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    Marzetti, Emanuele; Calvani, Riccardo; Cesari, Matteo; Buford, Thomas W.; Lorenzi, Maria; Behnke, Bradley J.; Leeuwenburgh, Christiaan

    2013-01-01

    Sarcopenia, the age-related loss of muscle mass and function, imposes a dramatic burden on individuals and society. The development of preventive and therapeutic strategies against sarcopenia is therefore perceived as an urgent need by health professionals and has instigated intensive research on the pathophysiology of this syndrome. The pathogenesis of sarcopenia is multifaceted and encompasses lifestyle habits, systemic factors (e.g., chronic inflammation and hormonal alterations), local environment perturbations (e.g., vascular dysfunction), and intramuscular specific processes. In this scenario, derangements in skeletal myocyte mitochondrial function are recognized as major factors contributing to the age-dependent muscle degeneration. In this review, we summarize prominent findings and controversial issues on the contribution of specific mitochondrial processes – including oxidative stress, quality control mechanisms and apoptotic signaling – on the development of sarcopenia. Extramuscular alterations accompanying the aging process with a potential impact on myocyte mitochondrial function are also discussed. We conclude with presenting methodological and safety considerations for the design of clinical trials targeting mitochondrial dysfunction to treat sarcopenia. Special emphasis is placed on the importance of monitoring the effects of an intervention on muscle mitochondrial function and identifying the optimal target population for the trial. PMID:23845738

  15. Chloracne. Clinical manifestations and etiology

    Energy Technology Data Exchange (ETDEWEB)

    Zugerman, C. (Northwestern Univ., Chicago, IL (USA))

    1990-01-01

    Chloracne is a rare but important acneiform eruption often associated with the ingestion of chlorinated phenolic agents such as dioxins with subsequent toxicity from these chemicals. Clinically, chloracne can be distinguished from acne vulgaris by the distribution and appearance of the lesions and by taking a detailed history. In some instances, it may be associated with particularly xerotic skin, pigmentation, follicular hyperkeratosis, conjunctivitis, and actinic elastosis. Histologically, the primary lesion is a follicular plug containing keratinous material. Chloracne is difficult if not impossible to treat adequately and once present, may persist for years. Consequently, good hygiene, safe manufacturing processes so that no inhalation or skin contact is possible, and the elimination of atmospheric contamination are all necessary in the prevention of this potentially debilitating disease.34 references.

  16. Sarcopenia and cachexia in the era of obesity: clinical and nutritional impact.

    Science.gov (United States)

    Prado, C M; Cushen, S J; Orsso, C E; Ryan, A M

    2016-05-01

    Our understanding of body composition (BC) variability in contemporary populations has significantly increased with the use of imaging techniques. Abnormal BC such as sarcopenia (low muscle mass) and obesity (excess adipose tissue) are predictors of poorer prognosis in a variety of conditions or clinical situations. As a catabolic illness, a defining feature of cancer is muscle loss. Although the conceptual model of wasting in cancer is typically conceived as involuntary weight loss leading to low body weight, recent studies have shown that both sarcopenia and cachexia can be present with obesity. The combination of low muscle and high adipose tissue (sarcopenic obesity) is an emerging abnormal BC phenotype prevalent across the body weight, and hence BMI spectra. Sarcopenia and sarcopenic obesity in cancer are in most instances occult conditions, which have been independently associated with higher incidence of chemotherapy toxicity, shorter time to tumour progression, poorer outcomes of surgery, physical impairment and shorter survival. Although the mechanisms are yet to be fully understood, the associations with poorer clinical outcomes emphasise the value of nutritional assessment as well as the need to develop appropriate interventions to countermeasure abnormal BC. Sarcopenia and sarcopenic obesity create diverse nutritional requirements, highlighting the compelling need for a more comprehensive and differentiated understanding of energy and protein requirements in this heterogeneous population.

  17. The impact of sleep on age-related sarcopenia: Possible connections and clinical implications.

    Science.gov (United States)

    Piovezan, Ronaldo D; Abucham, Julio; Dos Santos, Ronaldo Vagner Thomatieli; Mello, Marco Tulio; Tufik, Sergio; Poyares, Dalva

    2015-09-01

    Sarcopenia is a geriatric condition that comprises declined skeletal muscle mass, strength and function, leading to the risk of multiple adverse outcomes, including death. Its pathophysiology involves neuroendocrine and inflammatory factors, unfavorable nutritional habits and low physical activity. Sleep may play a role in muscle protein metabolism, although this hypothesis has not been studied extensively. Reductions in duration and quality of sleep and increases in prevalence of circadian rhythm and sleep disorders with age favor proteolysis, modify body composition and increase the risk of insulin resistance, all of which have been associated with sarcopenia. Data on the effects of age-related slow-wave sleep decline, circadian rhythm disruptions and obstructive sleep apnea (OSA) on hypothalamic-pituitary-adrenal (HPA), hypothalamic-pituitary-gonadal (HPG), somatotropic axes, and glucose metabolism indicate that sleep disorder interventions may affect muscle loss. Recent research associating OSA with the risk of conditions closely related to the sarcopenia process, such as frailty and sleep quality impairment, indirectly suggest that sleep can influence skeletal muscle decline in the elderly. Several protein synthesis and degradation pathways are mediated by growth hormone (GH), insulin-like growth factor-1 (IGF-1), testosterone, cortisol and insulin, which act on the cellular and molecular levels to increase or reestablish muscle fiber, strength and function. Age-related sleep problems potentially interfere intracellularly by inhibiting anabolic hormone cascades and enhancing catabolic pathways in the skeletal muscle. Specific physical exercises combined or not with nutritional recommendations are the current treatment options for sarcopenia. Clinical studies testing exogenous administration of anabolic hormones have not yielded adequate safety profiles. Therapeutic approaches targeting sleep disturbances to normalize circadian rhythms and sleep homeostasis may

  18. Clinical Definitions of Sarcopenia and Risk of Hospitalization in Community-Dwelling Older Men: The Osteoporotic Fractures in Men Study.

    Science.gov (United States)

    Cawthon, Peggy M; Lui, Li-Yung; Taylor, Brent C; McCulloch, Charles E; Cauley, Jane A; Lapidus, Jodi; Orwoll, Eric; Ensrud, Kristine E

    2017-10-01

    The association between various definitions of sarcopenia and hospitalization has not been evaluated in community-dwelling older men. We used data from 1,516 participants at Visit 3 of the Osteoporotic Fractures in Men (MrOS) study who also had linked Medicare Fee-For-Service Claims data available. We examined the association between several sarcopenia definitions (International Working Group, European Working Group for Sarcopenia in Older Persons, Foundation for the NIH Sarcopenia Project, Baumgartner, and Newman) and hospitalization, using two-part ("hurdle") models, adjusted for age, clinical center, functional limitations, self-reported health, comorbidity, and cognitive function. Predictors included sarcopenia status (the summary definitions and the components of slowness, weakness, and/or lean mass); outcomes included hospitalization and cumulative inpatient days/year in the 3 years following the Visit 3 exam. After accounting for confounding factors, none of the summary definitions or the definition components (slowness, weakness, or low lean mass) were associated with likelihood of hospitalization, the rate ratio of inpatient days among those hospitalized, or the mean rate of inpatient days amongst all participants. Sarcopenia was not associated hospitalization in community-dwelling older men. These results provide further evidence that current sarcopenia definitions are unlikely to identify those who are most likely to have greater hospitalization.

  19. Sarcopenia, a Neurogenic Syndrome?

    Directory of Open Access Journals (Sweden)

    Ping Kwan

    2013-01-01

    Full Text Available Sarcopenia is an aging-associated condition, which is currently characterized by the loss of muscle mass and muscle strength. However, there is no consensus regarding its characterization hitherto. As the world older adult population is on the rise, the impact of sarcopenia becomes greater. Due to the lack of effective treatments, sarcopenia is still a persisting problem among the global older adults and should not be overlooked. As a result, it is vital to investigate deeper into the mechanism underlying the pathogenesis of sarcopenia in order to develop more effective therapeutic interventions and to inscribe a more uniform characterization. The etiology of sarcopenia is currently found to be multifactorial, and most of the pharmacological researches are focused on the muscular factors in aging. Although the complete mechanism underlying the development of sarcopenia is still waiting to be elucidated, we propose in this article that the primary trigger of sarcopenia may be neurogenic in origin based on the intimate relationship between the nervous and muscular system, namely, the motor neuron and its underlying muscle fibers. Both of them are affected by the cellular environment and their physiological activity.

  20. Pathogenesis and Management of Sarcopenia.

    Science.gov (United States)

    Dhillon, Robinder J S; Hasni, Sarfaraz

    2017-02-01

    Sarcopenia represents a loss of muscle strength and mass in older individuals. Sarcopenia in the elderly has now become a major focus of research and public policy debate due to its impact on morbidity, mortality, and health care expenditure. Despite its clinical importance, sarcopenia remains under-recognized and poorly managed in routine clinical practice. This is, in part, due to a lack of available diagnostic testing and uniform diagnostic criteria. The management of sarcopenia is primarily focused on physical therapy for muscle strengthening and gait training. There are no pharmacologic agents for the treatment of sarcopenia. Published by Elsevier Inc.

  1. Papilledema: epidemiology, etiology, and clinical management

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    Rigi M

    2015-08-01

    Full Text Available Mohammed Rigi,1 Sumayya J Almarzouqi,2 Michael L Morgan,2 Andrew G Lee2–4 1Robert Cizik Eye Clinic, University of Texas, 2Department of Ophthalmology, Houston Methodist Hospital, Blanton Eye Institute, 3Baylor College of Medicine, 4Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, Houston, UTMB Galveston, UT MD Anderson Cancer Center, Houston, TX, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA Abstract: Papilledema is optic disc swelling due to high intracranial pressure. Possible conditions causing high intracranial pressure and papilledema include intracerebral mass lesions, cerebral hemorrhage, head trauma, meningitis, hydrocephalus, spinal cord lesions, impairment of cerebral sinus drainage, anomalies of the cranium, and idiopathic intracranial hypertension (IIH. Irrespective of the cause, visual loss is the feared morbidity of papilledema, and the main mechanism of optic nerve damage is intraneuronal ischemia secondary to axoplasmic flow stasis. Treatment is directed at correcting the underlying cause. In cases where there is no other identifiable cause for intracranial hypertension (ie, IIH the available options include both medical and surgical modalities. Weight loss and diuretics remain the mainstays for treatment of IIH, and surgery is typically reserved for patients who fail, are intolerant to, or non-compliant with maximum medical therapy. Keywords: papilledema, intracranial hypertension, idiopathic intracranial hypertension, epidemiology, papilledema management, papilledema etiology, acetazolamide, optic nerve sheath fenestration, ventriculoperitoneal shunt, lumboperitoneal shunt, venous sinus stenting

  2. Clinical Implications of Sarcopenia on Decreased Bone Density in Men With COPD.

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    Hwang, Ji An; Kim, Young Sam; Leem, Ah Young; Park, Moo Suk; Kim, Se Kyu; Chang, Joon; Jung, Ji Ye

    2017-05-01

    Sarcopenia and osteoporosis are systemic features of COPD. The present study investigated the association between sarcopenia and osteopenia/osteoporosis and the factors associated with low bone mineral density (BMD) in men with COPD. Data from 777 men with COPD who underwent both pulmonary function test and dual-energy x-ray absorptiometry were extracted from the Korean National Health and Nutritional Examination Survey database between 2008 and 2011. Sarcopenia was assessed with the appendicular skeletal mass index (ASMI) and osteopenia/osteoporosis with the T-score. As the severity of airflow limitation increased, the prevalence of sarcopenia increased (P trend  sarcopenia became severe, the prevalence of osteopenia/osteoporosis increased (P trend  Sarcopenia was independently associated with an increased risk of low BMD in men with COPD (OR, 2.31; 95% CI, 1.53-3.46; P Sarcopenia is closely correlated with osteopenia/osteoporosis in men with COPD. Moreover, different factors are associated with low BMD according to the presence/absence of sarcopenia in that population. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  3. Sarcopenia and nutrition.

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    Laviano, Alessandro; Gori, Chiara; Rianda, Serena

    2014-01-01

    Preserving or restoring adequate nutritional status is a key factor to delay the onset of chronic diseases and to accelerate recovery from acute illnesses. In particular, consistent and robust data show the loss of muscle mass, that is, sarcopenia, is clinically relevant since it is closely related to increased morbidity and mortality in healthy individuals and patients. Sarcopenia is defined as the age-related loss of muscle mass and function. International study groups have recently proposed separate definitions and diagnostic criteria for sarcopenia. Unfortunately, the rate of agreement in assessing the prevalence of sarcopenia is just fair, which highlights the need for a common effort to harmonize definitions and diagnostic criteria. Sarcopenia should be distinct from myopenia, which is the disease-associated loss of muscle mass, although in clinical practice it may be impossible to separate them (i.e., in old cancer patients). The pathogenesis of sarcopenia is complex and multifactorial. Consequently, its treatment should target the different factors involved, including quantitatively and qualitatively inappropriate food intake and reduced physical activity. © 2014 Elsevier Inc. All rights reserved.

  4. Clinical impact of sarcopenia on prognosis in pancreatic ductal adenocarcinoma: A retrospective cohort study.

    Science.gov (United States)

    Ninomiya, Go; Fujii, Tsutomu; Yamada, Suguru; Yabusaki, Norimitsu; Suzuki, Kojiro; Iwata, Naoki; Kanda, Mitsuro; Hayashi, Masamichi; Tanaka, Chie; Nakayama, Goro; Sugimoto, Hiroyuki; Koike, Masahiko; Fujiwara, Michitaka; Kodera, Yasuhiro

    2017-03-01

    To investigate the impact of the body composition such as skeletal muscle, visceral fat and body mass index (BMI) on patients with resected pancreatic ductal adenocarcinoma (PDAC). A total of 265 patients who underwent curative surgery for PDAC were examined in this study. The total skeletal muscle and fat tissue areas were evaluated in a single image obtained at the third lumber vertebra during a preoperative computed tomography (CT) scan. The patients were assigned to either the sarcopenia or non-sarcopenia group based on their skeletal muscle index (SMI) and classified into high visceral fat area (H-VFA) or low VFA (L-VFA) groups. The association of clinicopathological features and prognosis with the body composition were statistically analyzed. There were 170 patients (64.2%) with sarcopenia. The median survival time (MST) was 23.7 months for sarcopenia patients and 25.8 months for patients without sarcopenia. The MST was 24.4 months for H-VFA patients and 25.8 months for L-VFA patients. However, sarcopenia patients with BMI ≥22 exhibited significantly poorer survival than patients without sarcopenia (MST: 19.2 vs. 35.4 months, P = 0.025). There was a significant difference between patients with and without sarcopenia who did not receive chemotherapy (5-year survival rate: 0% vs. 68.3%, P = 0.003). The multivariate analysis revealed that tumor size, positive dissected peripancreatic tissue margin, and sarcopenia were independent prognostic factors. Sarcopenia is an independent prognostic factor in PDAC patients with a BMI ≥22. Therefore, evaluating skeletal muscle mass may be a simple and useful approach for predicting patient prognosis. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  5. [Acute hepatitis of unspecified etiology: etiological structure and clinical-laboratory characteristics].

    Science.gov (United States)

    Iushchuk, N D; Tsyganova, E V; Znoĭko, O O; Karetkina, G N; Solonin, S A; Mikhaĭlov, M I; Isaguliants, M G; Petrova, T V; Kashirin, V I; Cheshik, D S

    2009-01-01

    The straight line nucleic acids detection method of viruses and wide spectrum of virus antigens immunodiagnostics in acute hepatitis of unknown etiology patients has allowed verifying the diagnosis at 19% cases (a viral hepatitis A, C or E). Results of research do not allow to consider hepatotropic viruses HGV, TTV, PV B19, EBV, CMV, HHV 1, 2, 6 and 8 type, NV-F as etiological agents at the majority of patients of investigated group, and the data of the anamnesis and a clinical and laboratory picture of a current of disease does not allow to exclude at 29.4% of patients a drug-induced hepatitis. Despite detailed molecular-biological and immunological inspection of patients, at 37.9% of acute hepatitis of unknown etiology patients it was not possible to establish a connection with hepatitis and defined etiological factor (the infectious agent).

  6. Prevalence and Clinical Correlates of Sarcopenia, Identified According to the EWGSOP Definition and Diagnostic Algorithm, in Hospitalized Older People: The GLISTEN Study.

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    Bianchi, Lara; Abete, Pasquale; Bellelli, Giuseppe; Bo, Mario; Cherubini, Antonio; Corica, Francesco; Di Bari, Mauro; Maggio, Marcello; Manca, Giovanna Maria; Rizzo, Maria Rosaria; Rossi, Andrea P; Landi, Francesco; Volpato, Stefano

    2017-10-12

    Prevalence of sarcopenia is substantial in most geriatrics settings, but estimates vary greatly across studies because of difference in population characteristics, diagnostic criteria, and methods used to assess muscle mass, muscle strength, and physical performance. We investigated the feasibility of the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm assessment in hospitalized older adults and analyzed prevalence and clinical correlates of sarcopenia. Cross-sectional analysis of 655 participants enrolled in a multicenter observational study of older adults admitted to 12 acute hospital wards in Italy. Sarcopenia was assessed as low skeletal mass index (kg/m2) plus either low handgrip strength or low walking speed (EWGSOP criteria). Skeletal muscle mass was estimated using bioimpedance analysis. Of the 655 patients (age 81.0 ± 6.8 years; women 51.9%) enrolled in the study, 275 (40.2%) were not able to perform the 4-m walking test because of medical problems. The overall prevalence of sarcopenia on hospital admission was 34.7% (95% confidence interval 28-37) and it steeply increased with aging (p sarcopenia on hospital admission were older and were more likely to be male and to have congestive heart failure, cerebrovascular disease, and severe basic activities of daily living disability. The prevalence of sarcopenia was inversely correlated with body mass index. Based on EWGSOP criteria, prevalence of sarcopenia is extremely high among older adults on admission to acute hospital wards. Older age, male gender, congestive heart failure, cerebrovascular disease, severe activities of daily living disability, and body mass index were the clinical variables significantly associated with the presence of sarcopenia.

  7. Bulimia: clinical characteristics, development, and etiology.

    Science.gov (United States)

    Kirkley, B G

    1986-04-01

    Bulimia is characterized by recurrent episodes of binge eating and severe self-deprecation, often accompanied by self-induced vomiting and/or laxative abuse. It is most often found among young women in their late teens to mid-30s. Estimates of the disorder's prevalence vary widely, depending on the diagnostic criteria used, but usually range from 5% to 20% of college age women. Binge eating typically begins in late adolescence, frequently after a period of dieting to lose weight. Self-induced vomiting usually follows the onset of binge eating by about a year. To date, theories of the disorder's etiology have included several biological models, a psychosocial model, and a biopsychosocial model. The biological models proposed have viewed bulimia as a form of biological depression, neurological disturbance, or metabolic disturbance. The psychosocial model suggests that society's pressure on young women for extreme thinness leads to excessive dietary restraint, deprivation, and, paradoxically, binge eating. The presence of anxiety or depression exacerbates the process. The biopsychosocial model appears to be the most promising. It proposes that young women with biological predispositions toward overweight, depression, or metabolic disturbance are particularly vulnerable to social pressure for thinness, the binge eating that may result from excessive dieting, and, hence, bulimia. The complex nature of bulimia suggests that a multidisciplinary team approach treatment is appropriate.

  8. Bilateral Vestibular Hypofunction: Insights in Etiologies, Clinical Subtypes, and Diagnostics.

    Science.gov (United States)

    Lucieer, F; Vonk, P; Guinand, N; Stokroos, R; Kingma, H; van de Berg, Raymond

    2016-01-01

    To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH) and the value of diagnostic tools in the diagnostic process of BVH. A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised (1) imbalance and/or oscillopsia during locomotion and (2) summated slow phase velocity of nystagmus of less than 20°/s during bithermal caloric tests. The definite etiology of BVH was determined in 47% of the cases and the probable etiology in 22%. In 31%, the etiology of BVH remained idiopathic. BVH resulted from more than 20 different etiologies. In the idiopathic group, the percentage of migraine was significantly higher compared to the non-idiopathic group (50 versus 11%, p development of BVH. The distribution of etiologies of BVH probably depends on the clinical setting. In the diagnostic process of BVH, the routine use of some blood tests can be reconsidered and a low-threshold use of audiometry and cerebral imaging is advised. The torsion swing test is not the "gold standard" for diagnosing BVH due to its lack of sensitivity. Future diagnostic criteria of BVH should consist of standardized vestibular tests combined with a history that is congruent with the vestibular findings.

  9. [Narcolepsy: etiology, clinical features, diagnosis and treatment].

    Science.gov (United States)

    Zawilska, Jolanta B; Woldan-Tambor, Agata; Płocka, Anna; Kużajska, Katarzyna; Wojcieszak, Jakub

    2012-10-24

     Narcolepsy is a chronic hypersomnia characterized by excessive daytime sleepiness (EDS) and manifestations of disrupted rapid eye movement sleep stage (cataplexy, sleep paralysis, and hypnagogic/hypnopompic hallucinations). Mechanisms underlying narcolepsy are not fully understood. Experimental data indicate that the disease is caused by a loss of hypocretin neurons in the hypothalamus, likely due to an autoimmune process triggered by environmental factors in susceptible individuals. Most patients with narcolepsy and cataplexy have very low hypocretin-1 levels in the cerebrospinal fluid. An appropriate clinical history, polysomnogram, and multiple sleep latency test are necessary for diagnosis of the disease. Additionally, two biological markers, i.e., cerebrospinal fluid hypocretin-1 levels and expression of the DQB1*0602 gene, are used. The treatment of narcolepsy is aimed at the different symptoms that the patient manifests. Excessive daytime sleepiness is treated with psychostimulants (amphetamine-like, modafinil and armodafinil). Cataplexy is treated with sodium oxybate (GHB), tricyclic antidepressants, or selective serotonin and noradrenaline reuptake inhibitors. Sleep paralysis, hallucinations, and fragmented sleep may be treated with sodium oxybate. Patients with narcolepsy should follow proper sleep hygiene and avoid strong emotions.

  10. Narcolepsy: etiology, clinical features, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Jolanta B. Zawilska

    2012-10-01

    Full Text Available [u][/u] Narcolepsy is a chronic hypersomnia characterized by excessive daytime sleepiness (EDS and manifestations of disrupted rapid eye movement sleep stage (cataplexy, sleep paralysis, and hypnagogic/hypnopompic hallucinations. Mechanisms underlying narcolepsy are not fully understood. Experimental data indicate that the disease is caused by a loss of hypocretin neurons in the hypothalamus, likely due to an autoimmune process triggered by environmental factors in susceptible individuals. Most patients with narcolepsy and cataplexy have very low hypocretin-1 levels in the cerebrospinal fluid. An appropriate clinical history, polysomnogram, and multiple sleep latency test are necessary for diagnosis of the disease. Additionally, two biological markers, i.e., cerebrospinal fluid hypocretin-1 levels and expression of the DQB1*0602 gene, are used. The treatment of narcolepsy is aimed at the different symptoms that the patient manifests. Excessive daytime sleepiness is treated with psychostimulants (amphetamine-like, modafinil and armodafinil. Cataplexy is treated with sodium oxybate (GHB, tricyclic antidepressants, or selective serotonin and noradrenaline reuptake inhibitors. Sleep paralysis, hallucinations, and fragmented sleep may be treated with sodium oxybate. Patients with narcolepsy should follow proper sleep hygiene and avoid strong emotions.

  11. Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia

    Science.gov (United States)

    PURPOSE: Sarcopenia is an age related muscle condition which is frequently a precursor of frailty, mobility disability and premature death. It has a high prevalence in older populations and presents a considerable social and economic burden. Potential treatments are under development but, as yet, no...

  12. [Transdisciplinary approach for sarcopenia. Sarcopenic Dysphagia].

    Science.gov (United States)

    Wakabayashi, Hidetaka

    2014-10-01

    Sarcopenic dysphagia is difficulty swallowing due to sarcopenia of generalized skeletal muscles and swallowing muscles. Presbyphagia refers to age-related changes in the swallowing mechanism in the elderly associated with a frailty in swallowing. Presbyphagia is different from dysphagia. The most common cause of dysphagia is stroke. However, sarcopenic dysphagia may be common in the elderly with sarcopenia and dysphagia. Frail elderly with aspiration pneumonia can simultaneously experience activity-, disease-, and nutrition-related sarcopenia of generalized skeletal muscles and swallowing muscles, resulting in the development of sarcopenic dysphagia. Consensus diagnostic criteria for sarcopenic dysphagia were proposed at the 19th Annual Meeting of the Japanese Society of Dysphagia Rehabilitation. The concept of rehabilitation nutrition as a combination of both rehabilitation and nutrition care management is useful for treatment of sarcopenic dysphagia. Therapy for sarcopenic dysphagia includes dysphagia rehabilitation, nutrition improvement and sarcopenia treatment. The core components of dysphagia rehabilitation are oral health care, rehabilitative techniques, and food modification. Nutrition improvement is important, because malnutrition contributes to the etiology of secondary sarcopenia and sarcopenic dysphagia. Assessment of the multi-factorial causes of primary and secondary sarcopenia is important because rehabilitation nutrition for sarcopenia differs depending on its etiology. Treatment of age-related sarcopenia should include resistance training and dietary supplements of amino acids. Therapy for activity-related sarcopenia includes reduced bed rest time and early mobilization and physical activity. Treatment for disease-related sarcopenia requires therapies for advanced organ failure, inflammatory disease, or malignancy, while therapy for nutrition-related sarcopenia involves appropriate nutrition management to increase muscle mass.

  13. [Transdisciplinary Approach for Sarcopenia. Physical activity and sarcopenia].

    Science.gov (United States)

    Muraki, Shigeyuki

    2014-10-01

    With the goal of establishing epidemiologic indexes to evaluate the clinical evidence for developing a disease-modifying treatment of bone and joint diseases including sarcopenia, we set up a large-scale nationwide cohort study called ROAD (Research on Osteoarthritis/osteoporosis Against Disability) in 2005. We established muscle strength and volume indexes stratified according to gender and age strata. We also clarified the prevalence of sarcopenia and its association with osteoarthritis, pain, and exercise in middle-aged individuals. In addition, we showed that unipedal standing exercise and squatting are effective methods to prevent sarcopenia.

  14. Bilateral vestibular hypofunction: Insights in etiologies, clinical subtypes and diagnostics

    Directory of Open Access Journals (Sweden)

    F. eLucieer

    2016-03-01

    Full Text Available Objective:To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH and the value of diagnostic tools in the diagnostic process of BVH.Materials and methods: A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised 1 imbalance and/or oscillopsia during locomotion, and 2 summated slow phase velocity of nystagmus of less than 20 degrees per second during bithermal caloric tests.Results:The definite etiology of BVH was determined in 47% of the cases and the probable etiology in 22%. In 31%, the etiology of BVH remained idiopathic. BVH resulted from more than 20 different etiologies. In the idiopathic group, the percentage of migraine was significantly higher compared to the non-idiopathic group (50% versus 11%, p<0.001. Among all patients, 23.4% were known with autoimmune disorders in their medical history. All 4 clinical subtypes (recurrent vertigo with BVH, rapidly progressive BVH, slowly progressive BVH and slowly progressive BVH with ataxia were found in this population. Slowly progressive BVH with ataxia comprised only 4.5% of the cases. The head impulse test was abnormal in 94% of the cases. The torsion swing test was abnormal in 66%. Bilateral normal hearing to moderate hearing loss was found in 49%. Blood tests did not often contribute to the determination of the etiology of the disease. Abnormal cerebral imaging was found in 21 patients.Conclusion:BVH is a heterogeneous condition with various etiologies and clinical characteristics. Migraine seems to play a significant role in idiopathic BVH and auto-immunity could be a modulating factor in the development of BVH. The distribution of etiologies of BVH probably depends on the clinical setting. In the diagnostic process of BVH, the routine use of some blood tests can be reconsidered and a low-threshold use of audiometry and cerebral imaging is

  15. SARCOPENIA: DESIGNING PHASE IIB TRIALS

    Science.gov (United States)

    CHUMLEA, WM.C.; CESARI, M.; EVANS, W.J.; FERRUCCI, L.; FIELDING, R.A.; PAHOR, M.; STUDENSKI, S.; VELLAS, B.

    2012-01-01

    Sarcopenia is the age-related involuntary loss of skeletal muscle mass and functionality that can lead to the development of disability, frailty and increased health care costs. The development of interventions aimed at preventing and/or treating sarcopenia is complex, requiring the adoption of assumptions and standards that are not well established scientifically or clinically. A number of investigators and clinicians (both from academia and industry) met in Rome (Italy) in 2009 to develop a consensus definition of sarcopenia. Subsequently, in Albuquerque (New Mexico, USA) in 2010, the same group met again to consider the complex issues necessary for designing Phase II clinical trials for sarcopenia. Current clinical trial data indicate that fat-free mass (FFM) parameters are responsive to physical activity/nutritional treatment modalities over short time periods, but pharmacological trials of sarcopenia have yet to show significant efficacy. In order to conduct a clinical trial within a reasonable time frame, groups that model or display accelerated aging and loss of FFM are necessary. Few studies have used acceptable designs for testing treatment effects, sample sizes or primary outcomes that could provide interpretable findings or effects across studies. Dual energy x ray absorptiometry (DXA) is the measure of choice for assessing FFM, but sufficient time is needed for changes to be detected accurately and reliably. A tool set that would allow clinical, basic and epidemiological research on sarcopenia to advance rapidly toward diagnosis and treatment phases should be those reflecting function and strength. PMID:21623466

  16. Clinical Assessment of Sarcopenia and Changes in Body Composition During Neoadjuvant Chemotherapy for Esophageal Cancer.

    Science.gov (United States)

    Miyata, Hiroshi; Sugimura, Keijiro; Motoori, Masaaki; Fujiwara, Yoshiyuki; Omori, Takeshi; Yanagimoto, Yoshitomo; Ohue, Masayuki; Yasui, Masayoshi; Miyoshi, Norikatsu; Tomokuni, Akira; Akita, Hirofumi; Kobayashi, Shogo; Takahashi, Hidenori; Yano, Masahiko

    2017-06-01

    The aim of this study was to assess changes in body composition during neoadjuvant chemotherapy (NAC) and investigate whether chemotherapy-related toxicities affect body composition in patients with esophageal cancer. In ninety-four patients who underwent NAC for esophageal cancer, body composition was assessed before and after NAC. Associations between the incidence of toxicities and change in body composition during NAC were investigated. Forty-four (46.8%) and 50 (53.2%) out of 94 patients were defined as having sarcopenia before and after NAC, respectively. There was no significant difference in the incidence of any toxicity pre-treatment between patients with sarcopenia and those without sarcopenia. No significant reduction in skeletal muscle mass or fat mass was observed in the patients during NAC (p=0.501 and p=0.072). However, patients who experienced grade 4 neutropenia or febrile neutropenia during NAC showed a significantly larger decrease in change of skeletal muscle mass compared to patients who did not experience those toxicities (p=0.013 and 0.036, respectively). The incidence of serious adverse events such as febrile neutropenia and grade 4 neutropenia is associated with a significant reduction of skeletal muscle mass during NAC. We should make an effort to reduce the incidence of adverse events in order to maintain an appropriate body composition during NAC. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  17. Bilateral vestibular hypofunction: Insights in etiologies, clinical subtypes and diagnostics

    OpenAIRE

    F. eLucieer; P. eVonk; N. eGuinand; R. eStokroos; H. eKingma; R. evan de Berg

    2016-01-01

    Objective:To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH) and the value of diagnostic tools in the diagnostic process of BVH.Materials and methods: A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised 1) imbalance and/or oscillopsia during locomotion, and 2) summated slow phase velocity of nystagmus of less than 20 degrees per second ...

  18. Bilateral Vestibular Hypofunction: Insights in Etiologies, Clinical Subtypes, and Diagnostics

    OpenAIRE

    Lucieer, F.; Vonk, P.; Guinand, N; Stokroos, R.; Kingma, H.; van de Berg, Raymond

    2016-01-01

    Objective To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH) and the value of diagnostic tools in the diagnostic process of BVH. Materials and methods A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised (1) imbalance and/or oscillopsia during locomotion and (2) summated slow phase velocity of nystagmus of less than 20°/s duri...

  19. Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yip, Connie [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); National Cancer Centre, Department of Radiation Oncology, Singapore (Singapore); Imaging 2, Level 1, Lambeth Wing, St Thomas' Hospital, London (United Kingdom); Goh, Vicky [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Davies, Andrew; Gossage, James; Mason, Robert [Guy' s and St Thomas' NHS Foundation Trust, Department of Upper Gastrointestinal and General Surgery, London (United Kingdom); Mitchell-Hay, Rosalind; Griffin, Nyree [Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Hynes, Orla [Department of Dietetics, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Maisey, Nick; Ross, Paul; Gaya, Andrew [Department of Oncology, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Landau, David B. [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Department of Oncology, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Cook, Gary J. [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom)

    2014-05-15

    Sarcopenia and changes in body composition following neoadjuvant chemotherapy (NAC) may affect clinical outcome. We assessed the associations between CT body composition changes following NAC and outcomes in oesophageal cancer. A total of 35 patients who received NAC followed by oesophagectomy, and underwent CT assessment pre- and post-NAC were included. Fat mass (FM), fat-free mass (FFM), subcutaneous fat to muscle ratio (FMR) and visceral to subcutaneous adipose tissue ratio (VA/SA) were derived from CT. Changes in FM, FFM, FMR, VA/SA and sarcopenia were correlated to chemotherapy dose reductions, postoperative complications, length of hospital stay (LOS), circumferential resection margin (CRM), pathological chemotherapy response, disease-free survival (DFS) and overall survival (OS). Nine (26 %) patients were sarcopenic before NAC and this increased to 15 (43 %) after NAC. Average weight loss was 3.7 % ± 6.4 (SD) in comparison to FM index (-1.2 ± 4.2), FFM index (-4.6 ± 6.8), FMR (-1.2 ± 24.3) and VA/SA (-62.3 ± 12.7). Changes in FM index (p = 0.022), FMR (p = 0.028), VA/SA (p = 0.024) and weight (p = 0.007) were significant univariable factors for CRM status. There was no significant association between changes in body composition and survival. Loss of FM, differential loss of VA/SA and skeletal muscle were associated with risk of CRM positivity. (orig.)

  20. Pilonidal sinus disease - Etiological factors, pathogenesis and clinical features

    Directory of Open Access Journals (Sweden)

    Kazim Duman

    2016-12-01

    Full Text Available and lsquo;Pilonidal sinus' disease, which is most commonly seen in reproductive populations, such as young adults - mostly in males who are in their twenties - is actually a controversial disease in that there is no consensus on its many facets. It is sometimes seen as an infected abscess draining from an opening or a lesion extending to the perineum. It may also present as a draining fistula opening to skin. In terms of etiological factors, various theories (main theories being congenital and acquired have been established since it was first described, no universal understanding achieved. A long and significant post-operative care period with different lengths of recovery depending on the type of operation are quite prevalent with regards to recurrence and complication status. In order to prevent recurrence and improve the quality of life, etiological and predisposing factors as well as clinical features of sacrococcygeal pilonidal disease should be well known, a detailed differential diagnosis should be made, and a suitable and timely intervention should be performed. It was aimed here to explain the etiological factors, pathogenesis and clinical features of the disease that may present with various clinical symptoms. [Arch Clin Exp Surg 2016; 5(4.000: 228-232

  1. [Transdisciplinary Approach for Sarcopenia. Sarcopenia and atherosclerosis].

    Science.gov (United States)

    Kohara, Katsuhiko

    2014-10-01

    Risk factors for sarcopenia, including aging, inflammation, oxidative stress, and sedentary life style, are also known as risks for atherosclerosis. Sarcopenia and atherosclerosis relate each other. We found that sarcopenia, especially sarcopenic visceral obesity in male subjects, was associated with higher arterial stiffness and central blood pressure. We also observed that leptin resistance may underlie the link between sarcopenia, sarcopenic obesity and atherosclerosis. In epidemiological studies, it has been demonstrated sarcopenic indices were associated with cardiovascular death. These findings indicate that sarcopenia could be regarded as risk factor for atherosclerosis and cardiovascular events.

  2. Halitosis: an overview of epidemiology, etiology and clinical management

    Directory of Open Access Journals (Sweden)

    Cassiano Kuchenbecker Rösing

    2011-10-01

    Full Text Available Halitosis is an unpleasant condition that causes social restraint. Studies worldwide indicate a high prevalence of moderate halitosis, whereas severe cases are restricted to around 5% of the populations. The etiological chain of halitosis relates to the presence of odoriferous substances in exhaled air, especially the volatile sulphur compounds (VSC produced by bacteria. The organoleptic diagnosis is the gold standard and clinical management includes oral approaches, especially periodontal treatment and oral hygiene instructions, including the tongue. When oral strategies are not successful, referral to physicians is warranted.

  3. Sarcopenia and Postoperative Complication Risk in Gastrointestinal Surgical Oncology

    DEFF Research Database (Denmark)

    Simonsen, Casper; de Heer, Pieter; Bjerre, Eik D

    2018-01-01

    across stratification by sarcopenia criteria, assessment methods, study quality, and diagnoses. CONCLUSIONS: Sarcopenia was associated with an increased risk of complications after gastrointestinal tumor resection, but lack of methodological consensus hampers the interpretation and clinical utilization......OBJECTIVE: The aim of the study was to evaluate sarcopenia as a predictor of postoperative risk of major and total complications after surgery for gastrointestinal cancer. BACKGROUND: Sarcopenia is associated with poor survival in gastrointestinal cancer patients, but the role of sarcopenia...... used to estimate the pooled risk ratio for postoperative complications by Clavien-Dindo grade (total complications: grade ≥2; major complications: grade ≥3) in patients with sarcopenia versus patients without sarcopenia. Stratified analyses were performed by sarcopenia criteria, cutoff level...

  4. Considerations concerning the definition of sarcopenia

    Science.gov (United States)

    In this commentary, we describe the sarcopenia spectrum that results in frailty and consider the impact of several components of the frailty definition on its global prevalence. We review proposed operational definitions of sarcopenia the extent to which they have been shown to predict hard clinical...

  5. Clinical features and etiology of retinal vasculitis in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Supanut Apinyawasisuk

    2013-01-01

    Full Text Available Purpose: To report on the clinical features and etiology of patients with retinal vasculitis (RV. Materials and Methods: We reviewed medical records of 47 patients (75 affected eyes diagnosed with RV. Clinical presentations, ocular complications, associated systemic diseases, and treatment regimens were registered. Results: Etiology of RV included infectious causes in 10/47, (21% while an association with systemic and/or ocular non-infectious disorders was noted in 22/47 (47%. Eales′ disease and Behcet′s disease represented the most common clinical entities in non-infectious group while tuberculosis-associated RV was diagnosed in 6/10 (60% among those with infectious disorders. RV was bilateral in 28/47 (60% patients. Retinal veins were most commonly affected (72%, 34/47. Involvement of arteries was present in 12/47 (25% and was associated with viral infections and Behcet′s disease. Ocular complications developed in 60/75 (80% eyes. The most common complications were elevated intraocular pressure and/or glaucoma (33/75, 44%. Retinal detachment, vitreous hemorrhage, and cystoid macular edema developed in similar percentages (15%. Conclusions: RV in Thailand manifested mostly in male patients, was typically bilateral and involved mostly veins. Involvement of arteries was observed in patients with viral infections and Behcet′s disease. Tuberculosis was the most common infectious cause.

  6. Sarcopenia and frailty in chronic respiratory disease.

    Science.gov (United States)

    Bone, Anna E; Hepgul, Nilay; Kon, Samantha; Maddocks, Matthew

    2017-02-01

    Sarcopenia and frailty are geriatric syndromes characterized by multisystem decline, which are related to and reflected by markers of skeletal muscle dysfunction. In older people, sarcopenia and frailty have been used for risk stratification, to predict adverse outcomes and to prompt intervention aimed at preventing decline in those at greatest risk. In this review, we examine sarcopenia and frailty in the context of chronic respiratory disease, providing an overview of the common assessments tools and studies to date in the field. We contrast assessments of sarcopenia, which consider muscle mass and function, with assessments of frailty, which often additionally consider social, cognitive and psychological domains. Frailty is emerging as an important syndrome in respiratory disease, being strongly associated with poor outcome. We also unpick the relationship between sarcopenia, frailty and skeletal muscle dysfunction in chronic respiratory disease and reveal these as interlinked but distinct clinical phenotypes. Suggested areas for future work include the application of sarcopenia and frailty models to restrictive diseases and population-based samples, prospective prognostic assessments of sarcopenia and frailty in relation to common multidimensional indices, plus the investigation of exercise, nutritional and pharmacological strategies to prevent or treat sarcopenia and frailty in chronic respiratory disease.

  7. PERICARDITIS: ETIOLOGY, CLASSIFICATION, CLINIC, DIAGNOSTICS, TREATMENT. PART II

    Directory of Open Access Journals (Sweden)

    A.B. Sugak

    2009-01-01

    Full Text Available Pericarditis maybe caused by different agents: viruses, bacteria, tuberculosis, and it may be autoimmune. All these types of diseases have similar clinical signs, but differ by prevalence, prognosis and medical tactics. Due to achievements of radial methods of visualization, molecular biology, and immunology, we have an opportunity to provide early specific diagnostics and etiological treatment of inflammatory diseases of pericardium. The second part of lecture presents main principles of differential diagnostics of specific types of pericarditis, gives characteristics of several often accruing types of disease, and describes treatment and tactics of management of patients with pericarditis.Key words: children, pericarditis.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(3:76-81

  8. Dysfunction of the hypothalamus: etiology, clinical picture, diagnosis, treatment (guidelines

    Directory of Open Access Journals (Sweden)

    V.I. Botsyurko

    2017-05-01

    Full Text Available In the hypothalamus, there are nuclei of autonomic nervous system, as well endocrine system, and vitally important centers — of hunger, saturation, thermoregulation, sleep and wakefulness. Under the influence of traumatic brain injuries, neuroinfections and poisons, this complex integral system is often disturbed causing dysfunction of the hypothalamus. The prepared guidelines observe questions of the etiology, pathogenesis, clinical picture, diagnosis and treatment of hypothalamic dysfunction. In terms of therapy, a main emphasis is put on physiological approaches to the normalization of hypothalamic disorders. Particular attention is paid to the formulation of diagnosis according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems that has a significant importance for the regulation of statistical statements. Guidelines are intended for endocrinologists, neuropathologists, cardiologists, general practitioners and family doctors.

  9. Molecular mechanisms and therapeutic interventions in sarcopenia

    Directory of Open Access Journals (Sweden)

    Sung Sup Park

    2017-09-01

    Full Text Available Sarcopenia is the degenerative loss of muscle mass and function with aging. Recently sarcopenia was recognized as a clinical disease by the International Classification of Disease, 10th revision, Clinical Modification. An imbalance between protein synthesis and degradation causes a gradual loss of muscle mass, resulting in a decline of muscle function as a progress of sarcopenia. Many mechanisms involved in the onset of sarcopenia include age-related factors as well as activity-, disease-, and nutrition-related factors. The stage of sarcopenia reflecting the severity of conditions assists clinical management of sarcopenia. It is important that systemic descriptions of the disease conditions include age, sex, and other environmental risk factors as well as levels of physical function. To develop a new therapeutic intervention needed is the detailed understanding of molecular and cellular mechanisms by which apoptosis, autophagy, atrophy, and hypertrophy occur in the muscle stem cells, myotubes, and/or neuromuscular junction. The new strategy to managing sarcopenia will be signal-modulating small molecules, natural compounds, repurposing of old drugs, and muscle-specific microRNAs.

  10. Tools in the assessment of sarcopenia

    Science.gov (United States)

    Cooper, C; Fielding, R; Visser, M; van Loon, LJ; Rolland, Y; Orwoll, E; Reid, K; Boonen, S; Dere, W; Epstein, S; Mitlak, B; Tsouderos, Y; Sayer, AA; Rizzoli, R; Reginster, JY; Kanis, JA

    2013-01-01

    Summary This review provides a framework for development of an operational definition of sarcopenia and of the potential endpoints that might be adopted in clinical trials among older adults. Introduction While the clinical relevance of sarcopenia is widely recognized, there is currently no universally accepted definition of the disorder. The development of interventions to alter the natural history of sarcopenia also requires consensus on the most appropriate endpoints for determining outcomes of clinical importance which might be utilised in intervention studies. Methods and results We review current approaches to the definition of sarcopenia, and the methods used for the assessment of various aspects of physical function in older people. The potential endpoints of muscle mass, muscle strength, muscle power and muscle fatigue, as well as the relationships between them, are explored with reference to the availability and practicality of the available methods for measuring these endpoints in clinical trials. Conclusions Based on current evidence, none of the four potential outcomes in question is sufficiently comprehensive to recommend as a uniform single outcome in randomised clinical trials. We propose that sarcopenia may be optimally defined (for the purposes of clinical trial inclusion criteria, as well as epidemiological studies) using a combination of measures of muscle mass and physical performance. The choice of outcome measures for clinical trials in sarcopenia is more difficult; co-primary outcomes, tailored to the specific intervention in question, may be the best way forward in this difficult but clinically important area. PMID:23842964

  11. Chronic urticaria in children: Etiologies, Clinical Manifestations, Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Javad Ghaffari

    2013-06-01

    Full Text Available Chronic urticaria is defined as a skin disease with central induration (wheal and erythema formation around it (flare that appears at least twice a week and remains at least for 6 weeks continually. The incidence of urticaria in children is about 0.1-3%. Most cases of chronic urticaria occur in children between 6-11 years. Autoimmune and allergy immaturity is one of the reasons of lower incidence of chronic urticaria in younger children. Quality of life impairment in children with urticaria has been known to be similar to diseases with severe atopic dermatitis, epilepsy, diabetes mellitus and asthma. There are several causes for chronic urticaria in children in different reports. In most of cases the known etiologic agents are varies from 21 to 83%. Overall, infectious causes of chronic urticaria in children are more common and obvious than other in adults .In most cases, the cause of chronic urticaria are idiopathic or autoimmune. Urticaria severity divided to mild, moderate and severe was based on the number of wheals and severity of pruritus. Diagnosis of chronic urticaria is based on a good history and physical examination. The treatment of chronic urticaria is a patient education that is to remove the triggering and aggravating agents, resolving and treating of the known disease and the use of various medicines based on the history and clinical findings. The first medical therapeutics lines in children are anti-histamines, beta-blocker H1 and new generation of non-sedating agents.

  12. Sarcopenia correlates with systemic inflammation in COPD.

    Science.gov (United States)

    Byun, Min Kwang; Cho, Eun Na; Chang, Joon; Ahn, Chul Min; Kim, Hyung Jung

    2017-01-01

    Muscle wasting and chronic inflammation are predominant features of patients with COPD. Systemic inflammation is associated with an accelerated decline in lung function. In this study, the prevalence of sarcopenia and the relationships between sarcopenia and systemic inflammations in patients with stable COPD were investigated. In a cross-sectional design, muscle strength and muscle mass were measured by handgrip strength (HGS) and bioelectrical impedance analysis in 80 patients with stable COPD. Patients (≥40 years old) diagnosed with COPD were recruited from outpatient clinics, and then COPD stages were classified. Sarcopenia was defined as the presence of both low muscle strength (by HGS) and low muscle mass (skeletal muscle mass index [SMMI]). Levels of circulating inflammatory biomarkers (IL-6 and high-sensitivity TNFα [hsTNFα]) were measured. Sarcopenia was prevalent in 20 (25%) patients. Patients with sarcopenia were older, had lower body mass index, and a higher percentage of cardiovascular diseases. In addition, they had significantly higher modified Medical Research Council scores and lower 6-minute walk distance than those without sarcopenia. HGS was significantly correlated with age, modified Medical Research Council score, and COPD Assessment Test scores. Both HGS and SMMI had associations with IL-6 and hsTNFα (HGS, r =-0.35, P =0.002; SMMI, r =-0.246, P =0.044) level. In multivariate analysis, old age, lower body mass index, presence of cardiovascular comorbidities, and higher hsTNFα levels were significant determinants for sarcopenia in patients with stable COPD. Sarcopenia is very common in patients with stable COPD, and is associated with more severe dyspnea-scale scores and lower exercise tolerance. Systemic inflammation could be an important contributor to sarcopenia in the stable COPD population.

  13. Etiological Analysis of Neurodevelopmental Disabilities: Single-Center Eight-Year Clinical Experience in South China

    Directory of Open Access Journals (Sweden)

    Li Guo

    2011-01-01

    Full Text Available Etiology determination of neurodevelopmental disabilities (NDDs currently remains a worldwide common challenge on child health. We herein reported the etiology distribution feature in a cohort of 285 Chinese patients with NDDs. Although concrete NDD etiologies in 48.4% of the total patients could not be identified, genetic diseases (with the proportion of 35.8% in the total cases including inborn errors of metabolism (IEM and congenital dysmorphic diseases, constituted the commonest etiology category for NDDs in this study. The two key experimental technologies in pediatric metabolomics, gas chromatography-mass spectrometry (GC-MS, and tandem mass spectrometry (MS-MS, proved to be substantially helpful for the exploration of the NDD etiologies in this clinical investigation. The findings in this paper provided latest epidemiologic information on the etiology distribution of NDDs in Chinese, and the syndromic NDDs caused by citrin deficiency and the novel chromosomal karyotype, respectively, further expanded the etiology spectrum of NDDs.

  14. Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy.

    Science.gov (United States)

    Takagi, Kosei; Yoshida, Ryuichi; Yagi, Takahito; Umeda, Yuzo; Nobuoka, Daisuke; Kuise, Takashi; Fujiwara, Toshiyoshi

    2017-05-26

    Recently, skeletal muscle depletion (sarcopenia) has been reported to influence postoperative outcomes after certain procedures. This study investigated the impact of sarcopenia on postoperative outcomes following pancreaticoduodenectomy (PD). We performed a retrospective study of consecutive patients (n = 219) who underwent PD at our institution between January 2007 and May 2013. Sarcopenia was evaluated using preoperative computed tomography. We evaluated postoperative outcomes and the influence of sarcopenia on short-term outcomes, especially infectious complications. Subsequently, multivariate analysis was used to assess the impact of prognostic factors (including sarcopenia) on postoperative infections. The mortality, major complication, and infectious complication rates for all patients were 1.4%, 16.4%, and 47.0%, respectively. Fifty-five patients met the criteria for sarcopenia. Sarcopenia was significantly associated with a higher incidence of in-hospital mortality (P = 0.004) and infectious complications (P sarcopenia (odds ratio = 3.43; P Sarcopenia is an independent preoperative predictor of infectious complications after PD. Clinical assessment combined with sarcopenia may be helpful for understanding the risk of postoperative outcomes and determining perioperative management strategies.

  15. Prevalence of and interventions for sarcopenia in ageing adults - a systematic review report of the international sarcopenia initiative (EWGSOP and IWGS)

    Science.gov (United States)

    Objective: to examine the clinical evidence reporting the prevalence of sarcopenia and the effect of nutrition and exercise interventions from studies using the consensus definition of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). Methods: PubMed and Dial...

  16. Etiology and clinical management of adult meningitis in Indonesia

    NARCIS (Netherlands)

    Rizal Ganiem, A.

    2013-01-01

    This thesis consists of 8 chapters and addresses the etiology, diagnosis, outcome and treatment of adult meningitis in Indonesia. The studies were conducted in Hasan Sadikin Hospital, Bandung, the referral hospital for West Java province, Indonesia between December 2006 and August 2012. In a

  17. [FEATURES OF CLINICAL COURSE OF INFECTIOUS MONONUCLEOSIS IN CHILDREN DEPENDENT ON ETIOLOGY].

    Science.gov (United States)

    Kharchenko, Iu P; Zarets'ka, A V; Slobodnichenko, L M; Iurchenko, I V

    2015-01-01

    The article highlights the clinical features of infectious mononucleosis in children (based on the analysis of the data for children of different ages treated in Odessa clinical hospital of infectious diseases in connection with infectious mononucleosis) based on etiological factors.

  18. Sarcopenia in daily practice: assessment and management.

    Science.gov (United States)

    Beaudart, Charlotte; McCloskey, Eugène; Bruyère, Olivier; Cesari, Matteo; Rolland, Yves; Rizzoli, René; Araujo de Carvalho, Islène; Amuthavalli Thiyagarajan, Jotheeswaran; Bautmans, Ivan; Bertière, Marie-Claude; Brandi, Maria Luisa; Al-Daghri, Nasser M; Burlet, Nansa; Cavalier, Etienne; Cerreta, Francesca; Cherubini, Antonio; Fielding, Roger; Gielen, Evelien; Landi, Francesco; Petermans, Jean; Reginster, Jean-Yves; Visser, Marjolein; Kanis, John; Cooper, Cyrus

    2016-10-05

    Sarcopenia is increasingly recognized as a correlate of ageing and is associated with increased likelihood of adverse outcomes including falls, fractures, frailty and mortality. Several tools have been recommended to assess muscle mass, muscle strength and physical performance in clinical trials. Whilst these tools have proven to be accurate and reliable in investigational settings, many are not easily applied to daily practice. This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were afterwards organized for the whole group to make amendments and discuss further recommendations. This paper proposes some user-friendly and inexpensive methods that can be used to assess sarcopenia in real-life settings. Healthcare providers, particularly in primary care, should consider an assessment of sarcopenia in individuals at increased risk; suggested tools for assessing risk include the Red Flag Method, the SARC-F questionnaire, the SMI method or different prediction equations. Management of sarcopenia should primarily be patient centered and involve the combination of both resistance and endurance based activity programmes with or without dietary interventions. Development of a number of pharmacological interventions is also in progress. Assessment of sarcopenia in individuals with risk factors, symptoms and/or conditions exposing them to the risk of disability will become particularly important in the near future.

  19. The definition of sarcopenia

    NARCIS (Netherlands)

    Bijlsma, Astrid Y.

    2013-01-01

    Sarcopenia in old age has been associated with a higher mortality, poor physical functioning, poor outcome of surgery and higher drug toxicity. There is no general consensus on the definition of sarcopenia. The aim of the research presented in this thesis was to assess the implications of the use of

  20. Focal foveal atrophy of unknown etiology: Clinical pictures and possible underlying causes

    Directory of Open Access Journals (Sweden)

    Tzu-Yun Kao

    2015-03-01

    Conclusion: This is the first report of clinical presentations for patients with focal foveal atrophy of unknown etiology. OCT aided in the diagnosis and assessment of the degree of retinal structural abnormalities, but the real etiology of foveal atrophy remains unclear.

  1. Nutrition, frailty, and sarcopenia.

    Science.gov (United States)

    Cruz-Jentoft, Alfonso J; Kiesswetter, Eva; Drey, Michael; Sieber, Cornel C

    2017-02-01

    Frailty and sarcopenia are important concepts in the quest to prevent physical dependence, as geriatrics are shifting towards identifications of early stages of disability. Definitions of both sarcopenia and frailty are still developing, and both concepts clearly overlap in their physical aspects. Malnutrition (both undernutrition and obesity) plays a key role in the pathogenesis of frailty and sarcopenia. The quality of the diet along the lifespan has a close relation with the incidence of both entities, and nutritional interventions may be able to reduce the incidence or revert either of them. This brief review explores the role of energy and protein intake and other key nutrients on muscle function. Nutrition may be a key element of multimodal interventions for frailty and sarcopenia. The results of the "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" (SPRINTT) trial will offer key insights on the effect of such interventions in frail, sarcopenic older individuals.

  2. SARCOPENIA: AN ENDOCRINE DISORDER?

    Science.gov (United States)

    McKee, Alexis; Morley, John E; Matsumoto, Alvin M; Vinik, Aaron

    2017-09-01

    Sarcopenia is defined as low muscle function (walking speed or grip strength) in the presence of low muscle mass. A simple screening test-the SARC-F-is available to identify persons with sarcopenia. The major endocrine causes of sarcopenia are diabetes mellitus and male hypogonadism. Other causes are decreased physical activity, loss of motor neuron units, weight loss, inflammatory cytokines, reduced blood flow to muscles, very low 25(OH) vitamin D levels, and decreased growth hormone and insulin-like growth factor 1. Treatment for sarcopenia includes resistance and aerobic exercise, leucine-enriched essential amino acids, and vitamin D. In hypogonadal males, testosterone improves muscle mass, strength, and function. Selective androgen receptor molecules and anti-myostatin activin II receptor molecules are under development as possible treatments for sarcopenia. COPD = chronic obstructive pulmonary disease DHEA = dehydroepiandrosterone IGF-1 = insulin-like growth factor 1 GH = growth hormone mTOR = mammalian target of rapamycin SARM = selective androgen receptor molecule.

  3. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation.

    Science.gov (United States)

    Varol, Sefer; Ozdemir, Hasan Huseyin; Akil, Esref; Arslan, Demet; Aluclu, M Ufuk; Demir, Caner F; Yucel, Yavuz

    2015-12-01

    Facial diplegia (FD) is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. The study was performed retrospectively and included 17 patients with a diagnosis of FD. Patients were diagnosed with Guillain-Barré syndrome (GBS) (11), Bickerstaff's brainstem encephalitis (1), neurosarcoidosis (1), non-Hodgkin's Lymphoma (1), tuberculous meningitis (1) herpes simplex reactivation (1) and idiopathic (1). In addition, two patients had developed FD during pregnancy. Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

  4. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation

    Directory of Open Access Journals (Sweden)

    Sefer Varol

    2015-12-01

    Full Text Available ABSTRACT Objective Facial diplegia (FD is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS (11, Bickerstaff’s brainstem encephalitis (1, neurosarcoidosis (1, non-Hodgkin’s Lymphoma (1, tuberculous meningitis (1 herpes simplex reactivation (1 and idiopathic (1. In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

  5. The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients

    NARCIS (Netherlands)

    Reijnierse, E.M.; Trappenburg, M.C.; Leter, M.J.; Blauw, G. J.; van Bokhorst-de van der Schueren, M.A.E.; Meskers, C.G.M.; Maier, A.B.

    2015-01-01

    Objectives: Diagnostic criteria for sarcopenia include measures of muscle mass, muscle strength and physical performance. Consensus on the definition of sarcopenia has not been reached yet. To improve insight into the most clinically valid definition of sarcopenia, this study aimed to compare the

  6. Zoonotic bacterial meningitis in adults: clinical characteristics, etiology, treatment and outcome

    NARCIS (Netherlands)

    van Samkar, A.

    2016-01-01

    In this thesis, we describe the clinical characteristics, etiology, treatment and outcome of zoonotic bacterial meningitis. Each chapter describes meningitis patients infected by a specific zoonotic pathogen, such as Streptococcus equi, Streptococcuis suis, Capnocytophaga canimorsus, Campylobacter

  7. Sarcopenia: what should a pharmacist know?

    Directory of Open Access Journals (Sweden)

    Alfonso J. Cruz-Jentoft

    2017-07-01

    Full Text Available Sarcopenia (or muscle insufficiency is a geriatric syndrome characterized by a progressive and generalized loss of skeletal muscle mass and function which has adverse consequences, particularly physical disability, falls and death. It can develop slowly, as a chronic condition that emerges over many years, or acutely, generally due to immobilization associated with an acute disease. The physiopathology of sarcopenia is complex, and affects both the muscle and its neurological and hormonal regulation. The prevalence of sarcopenia increases with age and in certain healthcare settings (nursing homes, hospitals, rehabilitation centres. Its diagnosis is based on the documentation of a low muscle mass associated with low muscle strength and/or low physical performance. Once confirmed, a syndromic approach is needed, based on a comprehensive geriatric assessment in order to determine its causes and prepare a treatment plan which addresses the treatment of symptoms as well as the etiology. Prevention of sarcopenia starts in the adult age, through the promotion of adequate nutritional habits, an increase in physical activity and, ideally, resistance exercise. Sarcopenia treatment must necessarily include resistance exercises (that can be associated with other types of exercise and an improvement in diet, increasing protein intake up to 1.2-1.5 g/kg/day and covering caloric requirements. In some cases, this will require the use of nutritional supplements, which can contain leucine, beta-hydroxy beta-methylbutyrate acid (HMB and vitamin D, in order to optimize its effects on the muscle. There are still no medications available to treat sarcopenia

  8. Improving Clinical Outcome in the Nutritional Management of Sarcopenia at the National Center for Geriatric Health and Research Institute (NCGH-RI), Philippines.

    Science.gov (United States)

    Ramos, Miguel A

    2015-01-01

    Background: One of the National Center for Geriatric Health-Research Institute (NCGH-RI) mission is to be the leader in innovative health care approaches to improve the quality of life of the Senior Citizens in the country, and one of its strategies to attain its mission is to look into at how it can promote clinical outcomes in conditions that are prevalent in this population. One such condition that has been identified is "Sarcopenia" which up to this point has been the subject of intensive research both in basic and clinical levels. However, it is still not part of the daily routine clinical experience of medical providers both in the ambulatory or out-patient and acute or in-patient encounter. To achieve this, the NCHG-RI has included it in the screening for geriatric syndromes using the Comprehensive Geriatric Assessment (CGA).

  9. Biomarkers for sarcopenia: reductionism vs. complexity.

    Science.gov (United States)

    Calvani, Riccardo; Picca, Anna; Cesari, Matteo; Tosato, Matteo; Marini, Federico; Manes-Gravina, Ester; Bernabei, Roberto; Landi, Francesco; Marzetti, Emanuele

    2017-05-15

    Sarcopenia, the progressive and generalized loss of muscle mass and strength/function, is a major health issue in older adults, given its high prevalence and the burdensome clinical ramifications. The absence of a unified operational definition for sarcopenia has hampered its full appreciation by healthcare providers, researchers and policy-makers. At the same time, this unresolved debate and the complexity of musculoskeletal aging pose major challenges to the identification of clinically meaningful biomarkers. This review summarizes the current knowledge on biological markers for sarcopenia, including a critical appraisal of traditional procedures for biomarker development in the field of muscle aging. As an alternative approach, we illustrate the potential advantages of biomarker discovery procedures based on multivariate methodologies. Relevant examples of multidimensional biomarker modeling are provided with an emphasis on its clinical and research application. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. [Effusive pericarditis: clinical and etiological aspects in Lomé].

    Science.gov (United States)

    Pio, M; Afassinou, Y M; Pessinaba, S; Mossi, K E; Kotosso, A; Baragou, S; Akue, E G; Ephoevi-Ga, A M; Atta, B; Ehlan, K E; Damorou, F

    2016-01-01

    to describe the course and the etiologic, prognostic, and therapeutic aspects of effusive pericarditis (EP) in Togo. MATERIAL ANDMETHODS: Prospective and longitudinal study conducted at the cardiology department of Sylvanus Olympio Teaching Hospital of Lome from February 1, 2011, to January 31, 2014, of patients hospitalized for EP, confirmed by Doppler echocardiography. The study included 38 patients. The hospital incidence rate of EP was 2.0%. The mean age was 42.5 ± 14.9 years (range: 16 to 73 years) with a sex ratio of 0.7. Exertional dyspnea, poor general condition, chest pain, and fever were the main symptoms. Pericardial effusion was abundant in 24 patients (63%). The Koch bacillus was identified on direct examination in five patients (13%) and only from sputum. HIV serology was positive in 18 patients (47%). Pericardial fluid was collected from 24 patients (63%). Pathology examinations of pericardial tissue found nonspecific inflammation in 5 patients and pericardial tuberculosis in 7. The causes of EP were: tuberculous (55%), idiopathic (16%), bacterial (8%), HIV-related (5%), uremic (5%), neoplastic (5%), lupus (3%), and rheumatic (3%). EFP is a frequent, serious, even deadly disease in Africa because of the HIV-AIDS pandemic. Treatment depends on the cause, most often tuberculosis.

  11. Osteoporosis and Sarcopenia in Older Age

    Science.gov (United States)

    Edwards, MH; Dennison, EM; Sayer, A Aihie; Fielding, R; Cooper, C

    2015-01-01

    Osteoporosis and sarcopenia are common in older age and associated with significant morbidity and mortality. Consequently, they are both attended by a considerable socioeconomic burden. Osteoporosis was defined by the World Health Organisation (WHO) in 1994 as a bone mineral density of less than 2.5 standard deviations below the sex-specific young adult mean and this characterisation has been adopted globally. Subsequently, a further step forward was taken when bone mineral density was incorporated into fracture risk prediction algorithms, such as the Fracture Risk Assessment Tool (FRAX®) also developed by the WHO. In contrast, for sarcopenia there have been several diagnostic criteria suggested, initially relating to low muscle mass alone and more recently low muscle mass and muscle function. However, none of these have been universally accepted. This has led to difficulties in accurately delineating the burden of disease, exploring geographic differences, and recruiting appropriate subjects to clinical trials. There is also uncertainty about how improvement in sarcopenia should be measured in pharmaceutical trials. Reasons for these difficulties including the number of facets of muscle health available, e.g. mass, strength, function, and performance, and the various clinical outcomes to which sarcopenia can be related such as falls, fracture, disability and premature mortality. It is imperative that a universal definition of sarcopenia is reached soon to facilitate greater progress in research into this debilitating condition. PMID:25886902

  12. Significance of Sarcopenia Evaluation in Acute Decompensated Heart Failure.

    Science.gov (United States)

    Tsuchida, Keiichi; Fujihara, Yuki; Hiroki, Jiro; Hakamata, Takahiro; Sakai, Ryohei; Nishida, Kota; Sudo, Koji; Tanaka, Komei; Hosaka, Yukio; Takahashi, Kazuyoshi; Oda, Hirotaka

    2018-01-27

    In patients with chronic heart failure (HF), the clinical importance of sarcopenia has been recognized in relation to disease severity, reduced exercise capacity, and adverse clinical outcome. Nevertheless, its impact on acute decompensated heart failure (ADHF) is still poorly understood. Dual-energy X-ray absorptiometry (DXA) is a technique for quantitatively analyzing muscle mass and the degree of sarcopenia. Fat-free mass index (FFMI) is a noninvasive and easily applicable marker of muscle mass.This was a prospective observational cohort study comprising 38 consecutive patients hospitalized for ADHF. Sarcopenia, derived from DXA, was defined as a skeletal muscle mass index (SMI) two standard deviations below the mean for healthy young subjects. FFMI (kg/m 2 ) was calculated as 7.38 + 0.02908 × urinary creatinine (mg/day) divided by the square of height (m 2 ).Sarcopenia was present in 52.6% of study patients. B-type natriuretic peptide (BNP) levels were significantly higher in ADHF patients with sarcopenia than in those without sarcopenia (1666 versus 429 pg/mL, P sarcopenia as a predictor of higher BNP level (OR = 18.4; 95% CI, 1.86-181.27; P = 0.013).Sarcopenia is associated with increased disease severity in ADHF. SMI based on DXA is potentially superior to FFMI in terms of predicting the degree of severity, but FFMI is also associated with ADHF severity.

  13. Sarcopenia and sarcopenic obesity.

    Science.gov (United States)

    Choi, Kyung Mook

    2016-11-01

    Sarcopenia is an age-associated loss of muscle mass and decline in muscle strength; it is common in older adults and is associated with significant morbidity and mortality. Despite its prevalence, there is currently no universally adopted definition of sarcopenia. In addition to low muscle mass measurements, recent research has recognized the importance of muscle strength and physical performance. Aging induces changes in body composition, such as an increase in visceral fat and reduced muscle mass. Recently, the new concept of sarcopenic obesity has emerged, reflecting a combination of sarcopenia and obesity. The rapidly increasing prevalence and serious consequences of sarcopenic obesity are recognized as a critical public health risk in the aging society. Sarcopenia and obesity share several pathophysiological mechanisms, and they may potentiate each other. The present paper reviews the definitions and techniques used to measure sarcopenia, as well as the health outcomes of sarcopenic obesity. It also highlights the role of diminished muscle mass and strength in cardiometabolic disease mortality. Additional research may be needed to promote the identification and management of sarcopenia and sarcopenic obesity in the elderly population.

  14. Genetic etiology and clinical consequences of complete and incomplete achromatopsia

    NARCIS (Netherlands)

    Thiadens, A.A.H.J.; Slingerland, N.W.; Roosing, S.; Schooneveld, M.J. van; Lith-Verhoeven, J.J. van; Moll-Ramirez, N.G. van; Born, L.I. van den; Hoyng, C.B.; Cremers, F.P.M.; Klaver, C.C.

    2009-01-01

    OBJECTIVE: To investigate the genetic causes of complete and incomplete achromatopsia (ACHM) and assess the association between disease-causing mutations, phenotype at diagnosis, and visual prognosis. DESIGN: Clinic-based, longitudinal, multicenter study. PARTICIPANTS: Probands with complete ACHM (n

  15. Microbial etiology and clinical characteristics of distributive shock.

    Science.gov (United States)

    Bamberger, D M; Gurley, M B

    1994-05-01

    Although septic shock may be the most common cause of distributive shock, to our knowledge, no studies have defined the likelihood and type of infection among patients with distributive shock. We performed a retrospective study of 100 consecutive patients who were admitted to a city-county hospital with hemodynamic evidence of distributive shock. Forty-nine of 100 patients with distributive shock had microbiological documentation of infection. Six patients had clinical evidence of infection without microbiological documentation. Forty-five patients had no microbiological or clinical evidence of infection. Among patients with microbiologically documented infections, the incidence of infection due to aerobic gram-positive cocci equaled the incidence of infection due to aerobic gram-negative bacilli. Clinical parameters, such as the criteria for the systemic inflammatory response syndrome, were not useful in distinguishing the group with infections from the group without infections. In conclusion, many patients with distributive shock do not have evidence of infection.

  16. PERIVENTRICULAR LEUCOMALACIA: ETIOLOGY, PATHOGENESIS, CLINICAL SIGNS, OUTCOMES COMMENTS ON THE ARTICLE E.F. YUSUPOVA, D.D. GAYNETDINOVA «PERIVENTRICULAR LEUCOMALACIA: ETIOLOGY, PATHOGENESIS, CLINICAL SIGNS, OUTCOMES»

    Directory of Open Access Journals (Sweden)

    E.F. Yusupova

    2010-01-01

    Full Text Available The problem of perinatal periventricular brain lesions in newborns, playing leading role in forming of disability and disadaptation of nervous system, is discussed in this article. Authors present literature data on periventricular leucomalacia: modern information on etiology and pathogenesis, morphology, clinical symptoms and outcomes.Key words: periventricular leucomalacia, infantile cerebral paralysis, perinatal lesions of brain.(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4:68-72

  17. [EBOLA HEMORRHAGIC FEVER; ETIOLOGY, EPIDEMIOLOGY, PATHOGENESIS, AND CLINICAL SYMPTOMS].

    Science.gov (United States)

    Zhdanov, K W; Zakharenko, S M; Kovalenko, A N; Semenov, A V; Fusin, A Ya

    2015-01-01

    The data on the prevalence of disease caused by Ebola virus, biological features of its pathogen, character of the epidemiological process, pathogenesis and clinical symptoms are presented. The disease is characterized by suppression of protective immunological mechanisms and systemic inflammatory reaction accounting for the lesions of vascular endothelium, hemostatic and immune systems. It eventually leads to polyorgan insufficiency and severe shock. Lethality amounts to 50%.

  18. Strokes in the subinsular territory: clinical, topographical, and etiological patterns.

    Science.gov (United States)

    Kumral, Emre; Ozdemirkiran, Tolga; Alper, Yaprak

    2004-12-28

    The authors studied 11 patients with subinsular stroke (subIS) located in a deep border zone between lenticulostriate arteries and small insular cortical penetrating branches of the middle cerebral artery. The typical clinical features of subIS were motor deficits (11 patients), sensory disturbances (6 patients), transcortical motor aphasia and hypophonia (2 patients), and transient dysphagia at stroke onset (5 patients). Large artery disease and cardioembolic mechanisms may give rise to subIS by hemodynamic mechanisms.

  19. Clinical course, genetic etiology, and visual outcome in cone and cone-rod dystrophy

    NARCIS (Netherlands)

    Thiadens, A.A.; Phan, T.M.; Zekveld-Vroon, R.C.; Leroy, B.P.; Born, L.I. van den; Hoyng, C.B.; Klaver, C.C.; Writing Committee for the Cone Disorders Study Group, C.; Roosing, S.; Pott, J.W.; van Schooneveld, M.J.; van Moll-Ramirez, N.; van Genderen, M.M.; Boon, C.J.F.; Hollander, A.I. den; Bergen, A.A.; De Baere, E.; Cremers, F.P.; Lotery, A.J.

    2012-01-01

    OBJECTIVE: To evaluate the clinical course, genetic etiology, and visual prognosis in patients with cone dystrophy (CD) and cone-rod dystrophy (CRD). DESIGN: Clinic-based, longitudinal, multicenter study. PARTICIPANTS: Consecutive probands with CD (N = 98), CRD (N = 83), and affected relatives (N =

  20. Clinical Course, Genetic Etiology, and Visual Outcome in Cone and Cone-Rod Dystrophy

    NARCIS (Netherlands)

    Thiadens, Alberta A. H. J.; Phan, T. My Lan; Zekveld-Vroon, Renate C.; Leroy, Bart P.; van den Born, L. Ingeborgh; Hoyng, Carel B.; Klaver, Caroline C. W.; Roosing, Susanne; Pott, Jan-Willem R.; van Schooneveld, Mary J.; van Moll-Ramirez, Norka; van Genderen, Maria M.; Boon, Camiel J. F.; den Hollander, Anneke I.; Bergen, Arthur A. B.; De Baere, Elfride; Cremers, Frans P. M.; Lotery, Andrew J.

    Objective: To evaluate the clinical course, genetic etiology, and visual prognosis in patients with cone dystrophy (CD) and cone-rod dystrophy (CRD). Design: Clinic-based, longitudinal, multicenter study. Participants: Consecutive probands with CD (N = 98), CRD (N = 83), and affected relatives (N =

  1. Rationale for Antioxidant Supplementation in Sarcopenia

    Directory of Open Access Journals (Sweden)

    Francesco Cerullo

    2012-01-01

    Full Text Available Sarcopenia is an age-related clinical condition characterized by the progressive loss of motor units and wasting of muscle fibers resulting in decreased muscle function. The molecular mechanisms leading to sarcopenia are not completely identified, but the increased oxidative damage occurring in muscle cells during the course of aging represents one of the most accepted underlying pathways. In fact, skeletal muscle is a highly oxygenated tissue and the generation of reactive oxygen species is particularly enhanced in both contracting and at rest conditions. It has been suggested that oral antioxidant supplementation may contribute at reducing indices of oxidative stress both in animal and human models by reinforcing the natural endogenous defenses. Aim of the present paper is to discuss present evidence related to possible benefits of oral antioxidants in the prevention and treatment of sarcopenia.

  2. Intracranial Hypertension in Children: Etiologies, Clinical Features, and Outcome.

    Science.gov (United States)

    Masri, Amira; Jaafar, Amani; Noman, Rasha; Gharaibeh, Almutez; Ababneh, Osama H

    2015-10-01

    This retrospective study aimed to describe the clinical presentations, possible causes, and outcomes of children with idiopathic intracranial hypertension who presented to the authors' clinic. The mean age at onset of symptoms in the authors' cohort of 19 children was 6 years (range: 7 months to 12 years). Most patients (90%) were under 11 years old and (84.2%) symptomatic. The probable cause was identified in 7/19 (37.0%) patients. The most common cause was vitamin D deficiency (26.3%). Other associated probably coincidental comorbidities included sinusitis (5/19, 26.3%), hypophosphatasia (1/19), Pyle disease (1/19), and measles vaccine (1/19). Apart from 2 patients who required lumboperitoneal shunt, the cerebrospinal fluid pressure returned to normal in all patients within a period of 6 weeks to 1 year (average, 5 months). Of those who followed up with the authors' ophthalmologist, 30.7% developed optic atrophy or pallor; 75% of these patients had previous ocular comorbidities. © The Author(s) 2015.

  3. Clinical and etiologic evaluation of the children with chronic urticaria.

    Science.gov (United States)

    Azkur, Dilek; Civelek, Ersoy; Toyran, Mge; Msrlolu, Emine Dibek; Erkoolu, Mustafa; Kaya, Ayenur; Vezir, Emine; Gini, Tayfur; Akan, Ayegl; Kocaba, Can Naci

    2016-11-01

    Chronic urticaria (CU) is a skin disorder defined as daily or almost daily exhibition of pruritic and transient wheals that last for 6 weeks. CU is divided into two subtypes: chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU). To evaluate the clinical features, possible causes, associated findings, and laboratory results of different subtypes of CU in children according to a new classification. In this study, we evaluated the clinical features, laboratory investigations, and provocation tests of children with different subtypes of CU according to a new classification. Two hundred and twenty-two children (59.9% girls) were enrolled in the study. Of the study patients, 59.9% and 40.1% were diagnosed as having CSU and CIndU, respectively. Antithyroid antibody levels were positive in 7.1% of the patients with CSU, 32.8% of the children had positive 14C-urea breath test results, and 6.5% of the patients had positive stool examination results for parasites. Autologous serum skin test results were positive in 53.5% of the patients with CSU. Of the patients with CIndU, 77.5% had symptomatic dermographism, 16.8% had cold urticaria, 2.2% had cholinergic urticaria, 2.2% had solar urticaria, and 1.1% had aquagenic urticaria. Children with CSU represent the majority of patients with CU, and more than a half of these patients might have autoimmune urticaria. Symptomatic dermographism was the most common type of CIndU.

  4. Clinical presentation and etiology of osteomalacia/rickets in adolescents

    Directory of Open Access Journals (Sweden)

    Mohammad A Hazzazi

    2013-01-01

    Full Text Available This study was conducted to determine the causes and clinical presentations of osteomalacia/rickets in adolescents seen at the King Abdulaziz Medical City (KAMC, Riyadh. Because osteomalacia and rickets constitute the same entity, the term osteomalacia will be used for future discussion. A retrospective file review was performed on all adolescents (10-16 years with osteomalacia, defined as alkaline phosphatase levels ≥500 IU/L, seen at the KAMC, Riyadh, from 2000 to 2006. We recorded the signs and symptoms, dietary history and amount of sun exposure at presentation. A total of 135 patients were found to fit the inclusion criteria for the study. Of them, 57 had nutritional causes, with a mean age of 13.2 years, and included 32 females. At diagnosis, 22 patients were found to have bone pain, 10 had bone deformities, eight had pathological fractures and 17 were asymptomatic. Secondary causes for osteomalacia were found in 59 cases who had liver and renal disease and in 19 other patients who were on medications such as anticonvulsants and steroids, which are known to cause osteomalacia. Our study indicates that osteomalacia is a significant health burden that deserves special attention. Bone pain is the most common presenting symptom at diagnosis. Because of the high risk of osteomalacia associated with the use of anticonvulsants and steroids, it is advised that all patients on these drugs should be routinely screened for secondary osteomalacia.

  5. Narcolepsy: clinical approach to etiology, diagnosis, and treatment.

    Science.gov (United States)

    Koziorynska, Ewa I; Rodriguez, Alcibiades J

    2011-01-01

    Narcolepsy is a neurologic disorder characterized by excessive daytime sleepiness and manifestations of disrupted rapid eye movement sleep stage. The pathologic hallmark is loss of hypocretin neurons in the hypothalamus likely triggered by environmental factors in a susceptible individual. Patients with narcolepsy, in addition to excessive daytime sleepiness, can present with cataplexy, sleep paralysis, sleep fragmentation, and hypnagogic/hypnopompic hallucinations. Approximately 60% to 90% of patients with narcolepsy have cataplexy, characterized by sudden loss of muscle tone. Only 15% of patients manifest all of these symptoms together. Narcolepsy can be misdiagnosed as a psychiatric disorder or even epilepsy. An appropriate clinical history, polysomnogram, Multiple Sleep Latency Test, and, at times, cerebrospinal fluid hypocretin levels are necessary for diagnosis. The treatment of narcolepsy is aimed toward the different symptoms that the patient manifests. Excessive daytime sleepiness is treated with amphetamine-like or non-amphetamine-like stimulants. Cataplexy is treated with sodium oxybate, tricyclic antidepressants, or selective serotonin and norepinephrine reuptake inhibitors. Sleep paralysis, hallucinations, and fragmented sleep may be treated with benzodiazepine hypnotics or sodium oxybate. Patients with narcolepsy should avoid sleep deprivation, sleep at regular hours, and, if possible, schedule routine napping.

  6. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

    Science.gov (United States)

    Valour, Florent; Sénéchal, Agathe; Dupieux, Céline; Karsenty, Judith; Lustig, Sébastien; Breton, Pierre; Gleizal, Arnaud; Boussel, Loïc; Laurent, Frédéric; Braun, Evelyne; Chidiac, Christian; Ader, Florence; Ferry, Tristan

    2014-01-01

    Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. Physicians must be aware of typical clinical presentations (such as cervicofacial actinomycosis following dental focus of infection, pelvic actinomycosis in women with an intrauterine device, and pulmonary actinomycosis in smokers with poor dental hygiene), but also that actinomycosis may mimic the malignancy process in various anatomical sites. Bacterial cultures and pathology are the cornerstone of diagnosis, but particular conditions are required in order to get the correct diagnosis. Prolonged bacterial cultures in anaerobic conditions are necessary to identify the bacterium and typical microscopic findings include necrosis with yellowish sulfur granules and filamentous Gram-positive fungal-like pathogens. Patients with actinomycosis require prolonged (6- to 12-month) high doses (to facilitate the drug penetration in abscess and in infected tissues) of penicillin G or amoxicillin, but the duration of antimicrobial therapy could probably be shortened to 3 months in patients in whom optimal surgical resection of infected tissues has been performed. Preventive measures, such as reduction of alcohol abuse and improvement of dental hygiene, may limit occurrence of pulmonary, cervicofacial, and central nervous system actinomycosis. In women, intrauterine devices must be changed every 5 years in order to limit the occurrence of pelvic actinomycosis. PMID:25045274

  7. Impact of sarcopenia in the management of urological cancer patients.

    Science.gov (United States)

    Fukushima, Hiroshi; Koga, Fumitaka

    2017-05-01

    Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, develops as a consequence of the progression of cancer cachexia. Recent studies suggest that sarcopenia may be used as a biomarker in the management of patients with several cancers. Areas covered: In this article, the authors review 1) the methods to simply and optimally evaluate and define sarcopenia using computed tomography images in daily clinical practice and 2) the impact of sarcopenia in the management of urological cancers, specifically focusing on the usefulness in predicting treatment-related complications and prognosis. The authors also discuss the prognostic importance of changes in skeletal muscle mass in the course of treatment and the potential roles of nutritional support and exercise to prevent progression of sarcopenia. Expert commentary: Sarcopenia is associated with treatment-related complications and unfavorable prognosis in urological cancer patients. Nutritional support and exercise might be helpful in improving sarcopenia. The impact of these interventions on clinical outcomes would be elucidated by ongoing or future clinical studies.

  8. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

    Directory of Open Access Journals (Sweden)

    Valour F

    2014-07-01

    Full Text Available Florent Valour,1–3 Agathe Sénéchal,1,2 Céline Dupieux,2–4 Judith Karsenty,1,2 Sébastien Lustig,2,5 Pierre Breton,2,6 Arnaud Gleizal,2,7 Loïc Boussel,2,8,9 Frédéric Laurent,2–4 Evelyne Braun,1 Christian Chidiac,1–3 Florence Ader,1–3 Tristan Ferry1–3 1Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 2Université Claude Bernard Lyon 1, Lyon, France; 3Centre International de Recherche en Infectiologie, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France; 4Laboratoire de Bactériologie, Centre de Biologie du Nord, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 5Chirurgie Orthopédique, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 6Stomatologie et Chirurgie Maxillo-faciale, Hospices Civils de Lyon, Groupement Hospitalier Sud, Lyon, France; 7Chirurgie Maxillo-faciale, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 8Radiologie, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; 9Creatis, CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon, Lyon, France Abstract: Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. Physicians must be aware of typical clinical presentations (such as cervicofacial actinomycosis following dental focus of infection, pelvic actinomycosis in women with an intrauterine device, and pulmonary actinomycosis in smokers with poor dental hygiene, but also that actinomycosis may mimic the malignancy process in various anatomical sites. Bacterial cultures and pathology are the cornerstone of diagnosis, but particular conditions are required in order to get the correct diagnosis. Prolonged bacterial cultures in anaerobic conditions are necessary to identify the bacterium and typical microscopic findings include necrosis with

  9. Etiology of aseptic meningitis and clinical characteristics in immune-competent adults.

    Science.gov (United States)

    Han, Su-Hyun; Choi, Hye-Yeon; Kim, Jeong-Min; Park, Kwang-Ryul; Youn, Young Chul; Shin, Hae-Won

    2016-01-01

    Viral meningitis is the most common cause of aseptic meningitis. Use of the polymerase chain reaction (PCR) has increased the ability to determine the etiology of viral meningitis. This study used PCR analysis to evaluate the etiology of aseptic meningitis in 177 previously healthy adults over a 5-year period, as well as analyzing the clinical characteristics, cerebrospinal fluid (CSF) findings, and prognosis according to each etiology. The most frequent cause of aseptic meningitis was enterovirus (EV), followed by varicella zoster virus (VZV). Patients with EV meningitis were significantly younger than those with VZV meningitis. The percentage of lymphocytes in white blood cell counts and protein concentrations in the CSF differed significantly among patients with EV, VZV and meningitis of undetermined etiology. Younger age and lower percentage of lymphocyte and protein level in CSF analysis may be suggestive of EV meningitis. Further prospective studies are warranted to identify the correlations between the clinical characteristics and the etiologies of meningitis. © 2015 Wiley Periodicals, Inc.

  10. Physical activity and sarcopenia.

    Science.gov (United States)

    Pillard, Fabien; Laoudj-Chenivesse, Dalila; Carnac, Gilles; Mercier, Jacques; Rami, Jacques; Rivière, Daniel; Rolland, Yves

    2011-08-01

    Physical activity can be a valuable countermeasure to sarcopenia in its treatment and prevention. In considering physical training strategies for sarcopenic subjects, it is critical to consider personal and environmental obstacles to access opportunities for physical activity for any patient with chronic disease. This article presents an overview of current knowledge of the effects of physical training on muscle function and the physical activity recommended for sarcopenic patients. So that this countermeasure strategy can be applied in practice, the authors propose a standardized protocol for prescribing physical activity in chronic diseases such as sarcopenia. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Bacterial etiology of sexually transmitted infections at a STI clinic in ...

    African Journals Online (AJOL)

    Bacterial etiology of sexually transmitted infections at a STI clinic in Ghana; use of multiplex real time PCR. Augustina A Sylverken, Ellis Owusu-Dabo, Denis D Yar, Samson P Salifu, Nana Yaa Awua-Boateng, John H Amuasi, Portia B Okyere, Thomas Agyarko-Poku ...

  12. Recent Advances in Sarcopenia Research in Asia: 2016 Update From the Asian Working Group for Sarcopenia.

    Science.gov (United States)

    Chen, Liang-Kung; Lee, Wei-Ju; Peng, Li-Ning; Liu, Li-Kuo; Arai, Hidenori; Akishita, Masahiro

    2016-08-01

    Sarcopenia was recently classified a geriatric syndrome and is a major challenge to healthy aging. Affected patients tend to have worse clinical outcomes and higher mortality than those without sarcopenia. Although there is general agreement on the principal diagnostic characteristics, initial thresholds for muscle mass, strength, and physical performance were based on data from populations of predominantly Europid ancestry and may not apply worldwide. The Asian Working Group for Sarcopenia (AWGS) issued regional consensus guidelines in 2014, and many more research studies from Asia have since been published; this review summarizes recent progress. The prevalence of sarcopenia estimated by the AWGS criteria ranges between 4.1% and 11.5% of the general older population; however, prevalence rates were higher in Asian studies that used European Working Group on Sarcopenia in Older People cut-offs. Risk factors include age, sex, heart disease, hyperlipidemia, daily alcohol consumption, and low protein or vitamin intake; physical activity is protective. Adjusting skeletal muscle mass by weight rather than height is better in showing the effect of older age in sarcopenia and identifying sarcopenic obesity; however, some Asian studies found no significant skeletal muscle loss, and muscle strength might be a better indicator. Although AWGS 2014 diagnostic cut-offs were generally well accepted, some may require further revision in light of conflicting evidence from some studies. The importance of sarcopenia in diverse therapeutic areas is increasingly evident, with strong research interest in sarcopenic obesity and the setting of malignancy. Pharmacologic interventions have been unsatisfactory, and the core management strategies remain physical exercise and nutritional supplementation; however, further research is required to determine the most beneficial approaches. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc

  13. Oral Lichen Planus: Clinical Features, Etiology, Treatment and Management; A Review of Literature

    Directory of Open Access Journals (Sweden)

    Marzieh Boorghani

    2010-03-01

    Full Text Available Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for two forms of OLP; therefore, follow-up should be considered. There are many unestablished etiological factors for OLP and some different treatment modalities are based on etiology. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. We have used review papers, case reports, cohort studies, and case-and-control studies published from 1985 to 2010 to prepare this review of literature.

  14. Consequences of sarcopenia.

    NARCIS (Netherlands)

    Visser, M.; Schaap, L.A.

    2011-01-01

    This article describes the relationship of sarcopenia and dynapenia with three important outcomes in aging research: functional status, falls, and mortality. The data from epidemiologic studies conducted in large samples of older men and women suggest that muscle functioning, as indicated by muscle

  15. Sarcopenia and fragility fractures.

    Science.gov (United States)

    Cederholm, T; Cruz-Jentoft, A J; Maggi, S

    2013-02-01

    Sarcopenia, a reduction in muscle mass and muscle function, is considered one of the hallmarks of the aging process. Current views consider sarcopenia as the consequence of multiple medical, behavioural and environmental factors that characterize aged individuals. Likewise bone fragility is known to depend on several pathogenetic mechanisms leading to bone mass loss and reduction of bone strength. Muscle weakness, fear of falls, falls and subsequent fractures are associated to concurrent sarcopenia and osteoporosis and lead to restricted mobility, loss of autonomy and reduced life expectancy. The skeletal and the muscular organ systems are tightly intertwined: the strongest mechanical forces applied to bones are, indeed, those created by muscle contractions that condition bone density, strength, and microarchitecture. Not surprising, therefore, the decrease in muscle strength leads to lower bone strength. The degenerative processes leading to osteoporosis and sarcopenia show many common pathogenic pathways, like the sensitivity to reduced anabolic hormone secretion, increased inflammatory cytokine activity and reduced physical activity. Thus they may also respond to the same kind of treatments. Basic is life-style interventions related to exercise and nutrition. Sufficient vitamin D levels are of importance for both bone and muscle, primarily provided by sun exposure at younger age, and by supplementation at older age. Resistance training several times per week is crucial, and to be effective adequate access to energy and proteins is necessary.

  16. Serum markers of inflammation and oxidative stress in sarcopenia.

    Science.gov (United States)

    Can, Busra; Kara, Ozgur; Kizilarslanoglu, Muhammet Cemal; Arik, Gunes; Aycicek, Gozde Sengul; Sumer, Fatih; Civelek, Ramazan; Demirtas, Canan; Ulger, Zekeriya

    2017-08-01

    Sarcopenia is a geriatric syndrome characterized by the presence of low muscle mass and function. Possible mechanisms underlying sarcopenia include oxidative stress and elevation of inflammatory cytokines. The aim of the study was to evaluate the relationship between sarcopenia and biomarkers that may be involved in its pathogenesis and hence early detection. A total of 72 patients (36 sarcopenic and 36 non-sarcopenic) were included in the study. An experienced geriatric team applied comprehensive geriatric assessment to all patients. Anthropometric measures, gait speed and handgrip strength were recorded. Bioelectrical impedance analysis was used to assess skeletal muscle mass. In addition to routine clinical laboratory tests, serum adiponectin, thioredoxin-1 and pentraxin-3 levels were measured. Sarcopenia was defined according to the European Working Group on Sarcopenia in older Adults as the presence of low muscle mass and low muscle function or muscle performance. Sarcopenic patients were more likely to be functionally dependent and had lower scores on comprehensive geriatric assessment tools. Erythrocyte sedimentation rate (ESR) and C-reactive protein levels were significantly higher in the sarcopenic group. There was no significant difference in serum levels of thioredoxin-1 and pentraxin-3. Sarcopenic patients had lower levels of hemoglobin, albumin, total protein, calcium, triglycerides, uric acid and adiponectin (p sarcopenia whereas ESR was positively correlated. The present study demonstrated an association of sarcopenia with inflammatory markers CRP, ESR and adiponectin. Long-term prospective studies are warranted to confirm the relationship between markers oxidative stress and age related muscle decline.

  17. Clinical and radiographic predictors of the etiology of pulmonary nodules in HIV-infected patients.

    Science.gov (United States)

    Jasmer, R M; Edinburgh, K J; Thompson, A; Gotway, M B; Creasman, J M; Webb, W R; Huang, L

    2000-04-01

    To determine the etiology and the clinical and radiographic predictors of the etiology of pulmonary nodules in a group of HIV-infected patients. Retrospective analysis. A large urban hospital in San Francisco, CA. HIV-infected patients evaluated at San Francisco General Hospital from June 1, 1993, through December 31, 1997, having one or more pulmonary nodules on chest CT. Three physicians reviewed medical records for clinical data and final diagnoses. Three chest radiologists blinded to clinical data reviewed chest CTs. Univariate and multivariate analyses were performed to determine clinical and radiographic predictors of having an opportunistic infection and the specific diagnoses of bacterial pneumonia and tuberculosis. Eighty seven of 242 patients (36%) had one or more pulmonary nodules on chest CT. Among these 87 patients, opportunistic infections were the underlying etiology in 57 patients; bacterial pneumonia (30 patients) and tuberculosis (14 patients) were the most common infections identified. Multivariate analysis identified fever, cough, and size of nodules < 1 cm on chest CT as independent predictors of having an opportunistic infection. Furthermore, a history of bacterial pneumonia, symptoms for 1 to 7 days, and size of nodules < 1 cm on CT independently predicted a diagnosis of bacterial pneumonia; a history of homelessness, weight loss, and lymphadenopathy on CT independently predicted a diagnosis of tuberculosis. In HIV-infected patients having one or more pulmonary nodules on chest CT scan, opportunistic infections are the most common cause. Specific clinical and radiographic features can suggest particular opportunistic infections.

  18. Research on the premotor symptoms of Parkinson's disease: clinical and etiological implications.

    Science.gov (United States)

    Chen, Honglei; Burton, Edward A; Ross, G Webster; Huang, Xuemei; Savica, Rodolfo; Abbott, Robert D; Ascherio, Alberto; Caviness, John N; Gao, Xiang; Gray, Kimberly A; Hong, Jau-Shyong; Kamel, Freya; Jennings, Danna; Kirshner, Annette; Lawler, Cindy; Liu, Rui; Miller, Gary W; Nussbaum, Robert; Peddada, Shyamal D; Rick, Amy Comstock; Ritz, Beate; Siderowf, Andrew D; Tanner, Caroline M; Tröster, Alexander I; Zhang, Jing

    2013-01-01

    The etiology and natural history of Parkinson's disease (PD) are not well understood. Some non-motor symptoms such as hyposmia, rapid eye movement sleep behavior disorder, and constipation may develop during the prodromal stage of PD and precede PD diagnosis by years. We examined the promise and pitfalls of research on premotor symptoms of PD and developed priorities and strategies to understand their clinical and etiological implications. This review was based on a workshop, Parkinson's Disease Premotor Symptom Symposium, held 7-8 June 2012 at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina. Research on premotor symptoms of PD may offer an excellent opportunity to characterize high-risk populations and to better understand PD etiology. Such research may lead to evaluation of novel etiological hypotheses such as the possibility that environmental toxicants or viruses may initiate PD pathogenesis in the gastrointestinal tract or olfactory bulb. At present, our understanding of premotor symptoms of PD is in its infancy and faces many obstacles. These symptoms are often not specific to PD and have low positive predictive value for early PD diagnosis. Further, the pathological bases and biological mechanisms of these premotor symptoms and their relevance to PD pathogenesis are poorly understood. This is an emerging research area with important data gaps to be filled. Future research is needed to understand the prevalence of multiple premotor symptoms and their etiological relevance to PD. Animal experiments and mechanistic studies will further understanding of the biology of these premotor symptoms and test novel etiological hypothesis.

  19. Advantages of dietary, exercise-related, and therapeutic interventions to prevent and treat sarcopenia in adult patients: an update

    Directory of Open Access Journals (Sweden)

    DL Waters

    2010-09-01

    Full Text Available DL Waters1, RN Baumgartner2, PJ Garry3, B Vellas41Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; 2Department of Epidemiology and Population Health, University of Louisville, Louisville, Kentucky, USA; 3Department of Pathology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA; 4Department of Internal Medicine and Geriatric Medicine, University Hospital Center of Toulouse, Gerontopole, Toulouse, FranceAbstract: Sarcopenia is the loss of skeletal muscle mass and function with aging. Although the term sarcopenia was first coined in 1989, its etiology is still poorly understood. Moreover, a consensus for defining sarcopenia continues to elude us. Sarcopenic changes in the muscle include losses in muscle fiber quantity and quality, alpha-motor neurons, protein synthesis rates, and anabolic and sex hormone production. Other factors include basal metabolic rate, increased protein dietary requirements, and chronic inflammation secondary to age-related changes in cytokines and oxidative stress. These changes lead to decreased overall physical functioning, increased frailty, falls risk, and ultimately the loss of independent living. Because the intertwining relationships of these factors are complex, effective treatment options are still under investigation. The published data on sarcopenia are vast, and this review is not intended to be exhaustive. The aim of this review is to provide an update on the current knowledge of the definition, etiology, consequences, and current clinical trials that may help address this pressing public health problem for our aging populations.Keywords: aging, muscle loss, nutrition, physical activity

  20. Bioelectrical impedance analysis for diagnosing sarcopenia and cachexia: what are we really estimating?

    Science.gov (United States)

    Gonzalez, Maria Cristina; Heymsfield, Steven B

    2017-04-01

    As reference methods are not available for identifying low skeletal muscle mass in clinical practice, the European Group on Sarcopenia in Older People the Asian Working Group for Sarcopenia and the International Consensus for Cancer Cachexia guidelines accept bioelectrical impedance analysis (BIA) as an option for sarcopenia and cachexia assessment. Using different BIA equations, several components that represent 'muscularity' can be assessed. Total skeletal muscle mass or appendicular skeletal muscle mass normalized in relation to height (skeletal muscle mass index or appendicular skeletal muscle index, respectively) is the most common term used in the consensus. These terms are similar, but they should not be used as synonymous. Both terms can be used to define sarcopenia, but adequate equations and cut-off values should be used according to the studied population. However, there is a disagreement between the sarcopenia definition assessed by using BIA from the European Group on Sarcopenia in Older People and Cachexia Consensus, and this can lead to an overestimation of sarcopenia and, consequently, cachexia. An effort should be made to standardize the terminology employed by the Societies to define low muscularity and sarcopenia by using BIA. Future validation studies may show the need for specific cut-off values for each population using this method. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

  1. Research on the Premotor Symptoms of Parkinson’s Disease: Clinical and Etiological Implications

    Science.gov (United States)

    Burton, Edward A.; Ross, G. Webster; Huang, Xuemei; Savica, Rodolfo; Abbott, Robert D.; Ascherio, Alberto; Caviness, John N.; Gao, Xiang; Gray, Kimberly A.; Hong, Jau-Shyong; Kamel, Freya; Jennings, Danna; Kirshner, Annette; Lawler, Cindy; Liu, Rui; Miller, Gary W.; Nussbaum, Robert; Peddada, Shyamal D.; Rick, Amy Comstock; Ritz, Beate; Siderowf, Andrew D.; Tanner, Caroline M.; Tröster, Alexander I.; Zhang, Jing

    2013-01-01

    Background: The etiology and natural history of Parkinson’s disease (PD) are not well understood. Some non-motor symptoms such as hyposmia, rapid eye movement sleep behavior disorder, and constipation may develop during the prodromal stage of PD and precede PD diagnosis by years. Objectives: We examined the promise and pitfalls of research on premotor symptoms of PD and developed priorities and strategies to understand their clinical and etiological implications. Methods: This review was based on a workshop, Parkinson’s Disease Premotor Symptom Symposium, held 7–8 June 2012 at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina. Discussion: Research on premotor symptoms of PD may offer an excellent opportunity to characterize high-risk populations and to better understand PD etiology. Such research may lead to evaluation of novel etiological hypotheses such as the possibility that environmental toxicants or viruses may initiate PD pathogenesis in the gastrointestinal tract or olfactory bulb. At present, our understanding of premotor symptoms of PD is in its infancy and faces many obstacles. These symptoms are often not specific to PD and have low positive predictive value for early PD diagnosis. Further, the pathological bases and biological mechanisms of these premotor symptoms and their relevance to PD pathogenesis are poorly understood. Conclusion: This is an emerging research area with important data gaps to be filled. Future research is needed to understand the prevalence of multiple premotor symptoms and their etiological relevance to PD. Animal experiments and mechanistic studies will further understanding of the biology of these premotor symptoms and test novel etiological hypothesis. Citation: Chen H, Burton EA, Ross GW, Huang X, Savica R, Abbott RD, Ascherio A, Caviness JN, Gao X, Gray KA, Hong JS, Kamel F, Jennings D, Kirshner A, Lawler C, Liu R, Miller GW, Nussbaum R, Peddada SD, Comstock Rick A, Ritz

  2. Clinical presentation and pharmacotherapy response in social anxiety disorder: The effect of etiological beliefs.

    Science.gov (United States)

    Cohen, Jonah N; Potter, Carrie M; Drabick, Deborah A G; Blanco, Carlos; Schneier, Franklin R; Liebowitz, Michael R; Heimberg, Richard G

    2015-07-30

    Therapies for social anxiety disorder (SAD) leave many patients symptomatic at the end of treatment and little is known about predictors of treatment response. This study investigated the predictive relationship of patients' etiological attributions to initial clinical features and response to pharmacotherapy. One hundred thirty-seven individuals seeking treatment for SAD received 12 weeks of open treatment with paroxetine. Participants completed the Attributions for the Etiology of Social Anxiety Scale at baseline in addition to measures of social anxiety and depression at baseline and over the course of treatment. A latent class analysis suggested four profiles of etiological beliefs about one's SAD that may be characterized as: Familial Factors, Need to be Liked, Bad Social Experiences, and Diffuse Beliefs. Patients in the more psychosocially-driven classes, Need to be Liked and Bad Social Experiences, had the most severe social anxiety and depression at baseline. Patients in the Familial Factors class, who attributed their SAD to genetic, biological, and early life experiences, had the most rapid response to paroxetine.These results highlight the effect of biological and genetically-oriented etiological beliefs on pharmacological intervention, have implications for person-specific treatment selection, and identify potential points of intervention to augment treatment response. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Clinical Presentation and Pharmacotherapy Response in Social Anxiety Disorder: The Effect of Etiological Beliefs

    Science.gov (United States)

    Cohen, Jonah N.; Potter, Carrie M.; Drabick, Deborah A.G.; Blanco, Carlos; Schneier, Franklin R.; Liebowitz, Michael R.; Heimberg, Richard G.

    2015-01-01

    Therapies for social anxiety disorder (SAD) leave many patients symptomatic at the end of treatment and little is known about predictors of treatment response. This study investigated the predictive relationship of patients’ etiological attributions to initial clinical features and response to pharmacotherapy. Methods One hundred thirty-seven individuals seeking treatment for SAD received 12 weeks of open treatment with paroxetine. Participants completed the Attributions for the Etiology of Social Anxiety Scale at baseline in addition to measures of social anxiety and depression at baseline and over the course of treatment. Results A latent class analysis suggested four profiles of etiological beliefs about one’s SAD that may be characterized as: Familial Factors, Need to be Liked, Bad Social Experiences, and Diffuse Beliefs. Patients in the more psychosocially-driven classes, Need to be Liked and Bad Social Experiences, had the most severe social anxiety and depression at baseline. Patients in the Familial Factors class, who attributed their SAD to genetic, biological, and early life experiences, had the most rapid response to paroxetine. Conclusions These results highlight the effect of biological and genetically-oriented etiological beliefs on pharmacological intervention, have implications for person-specific treatment selection, and identify potential points of intervention to augment treatment response. PMID:25920804

  4. SARCOPENIA: DIAGNOSIS, STAGES AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Pasca Luminita Aurelia

    2015-02-01

    Full Text Available Sarcopenia is defined as the age-related loss of skeletal muscle mass and decline of function. The causes of sarcopenia are multi-factorial. The diagnosis of sarcopenia should be considered in all older patients who present with declines in physical function, because of potential consequences for the development of frailty and disability. There are numerous techniques to assess muscle mass, muscle strength and physical performance. Treatment consists of nutritional (macro- and micronutrients and physical activity (resistance exercise regimens adapted to person. There is an emerging role for testosterone and anabolic steroids in severe sarcopenia.

  5. Zoonotic bacterial meningitis in adults: clinical characteristics, etiology, treatment and outcome

    OpenAIRE

    van Samkar, A.

    2016-01-01

    In this thesis, we describe the clinical characteristics, etiology, treatment and outcome of zoonotic bacterial meningitis. Each chapter describes meningitis patients infected by a specific zoonotic pathogen, such as Streptococcus equi, Streptococcuis suis, Capnocytophaga canimorsus, Campylobacter fetus and Leptospira. We combine cases identified in a nationwide prospective cohort study of adult bacterial meningitis patients with a literature review on meningitis caused by each zoonotic patho...

  6. Etiological classification and clinical assessment of children and adolescents with disorders of sex development.

    Science.gov (United States)

    Erdoğan, Sema; Kara, Cengiz; Uçaktürk, Ahmet; Aydın, Murat

    2011-01-01

    In 2006, the Lawson Wilkins Pediatric Endocrine Society (LWPES) and the European Society for Paediatric Endocrinology (ESPE) published a consensus statement on management of intersex disorders. The aim of our study was to determine the etiological distribution of disorders of sex development (DSD) according to the new DSD classification system and to evaluate the clinical features of DSDs in our patient cohort. We retrospectively reviewed the records of patients followed up during the past three years. The subjects were divided into three etiologic groups according to their karyotypes. The definite diagnoses in each subgroup were established by clinical and laboratory investigations including abdominopelvic imaging as well as basal and stimulated hormone measurements. Molecular genetic testing, except for CYP21A2 gene, could not be performed. Out of a total of 95 patients, 26 had sex chromosome DSD, 45 had 46,XY DSD and 24 had 46,XX DSD. The most common causes of DSDs were Turner's syndrome (TS), congenital adrenal hyperplasia (CAH) and androgen insensitivity syndrome (AIS). There was a wide variation in age of presentation ranging from 1 day to 17.5 years with a mean of 6.5±6.5 years. The most frequent complaints at presentation were ambiguous genitalia, isolated perineal hypospadias and short stature. The results of our study demonstrate that the new DSD classification system leads to a major change in the distribution of etiological diagnoses of DSDs, which is exemplified by the significant frequencies of TS and vanishing testes syndrome. This alteration expands the clinical spectrum and increases the mean age at diagnosis. However, the most common causes of ambiguous genitalia, such as CAH and AIS, remain unchanged. Further studies using molecular genetic analyses are needed to give a more precise distribution of etiologies of DSDs, especially in 46,XY patients. ©Journal of Clinical Research in Pediatric Endocrinology, Published by Galenos Publishing.

  7. Sarcopenia: an overview on current definitions, diagnosis and treatment.

    Science.gov (United States)

    Landi, Francesco; Calvani, Riccardo; Cesari, Matteo; Tosato, Matteo; Martone, Anna Maria; Ortolani, Elena; Savera, Giulia; Salini, Sara; Sisto, Alex N; Picca, Anna; Marzetti, Emanuele

    2017-06-06

    Sarcopenia, the progressive and generalized loss of skeletal muscle mass and strength/function associated with aging, increases the risk of a vast array of adverse health outcomes, including falls, morbidity, loss of independence, disability, and mortality. As such, sarcopenia poses a huge socioeconomic burden in developed countries. The development and implementation of effective interventions against sarcopenia is therefore a public health priority. A preliminary, fundamental step in such a process entails the agreement of researchers, healthcare professionals and policy-makers around a unique operational definition of sarcopenia. This will facilitate the framing of a definite clinical entity to be incorporated in standard practice, the understanding of the underlying pathophysiology, and the identification of biological targets for drug development. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  8. Biomarkers of sarcopenia in clincal trials recommendations from the international working group on sarcopenia

    Science.gov (United States)

    Sarcopenia, the age-related skeletal muscle decline, is associated with relevant clinical and socioeconomic negative outcomes in older persons. The study of this phenomenon and the development of preventive/therapeutic strategies represent public health priorities. The present document reports the r...

  9. Estudio sobre prevalencia de la sarcopenia en una unidad de pacientes crónicos

    OpenAIRE

    Moral Moral, Pedro

    2013-01-01

    La sarcopenia es un trastorno complejo, de etiología multifactorial que consta de la pérdida de masa corporal junto con una disminución de la fuerza y del rendimiento físico. Este estudio he evaluado la prevalencia de la sarcopenia en una población de 205 pacientes hospitalizados en una unidad de crónicos del Hospital La Fe de Valencia. También se ha evaluado la posible relación de la sarcopenia con otros factores como la comorbilidad, la discapacidad, la desnutrición, la disfagia orofaringea...

  10. Sarcopenia: designing phase IIb trials: international working group on sarcopenia

    Science.gov (United States)

    Sarcopenia is the age-related involuntary loss of skeletal muscle mass and functionality that can lead to the development of disability, frailty and increased health care costs. The development of interventions aimed at preventing and/or treating sarcopenia is complex, requiring the adoption of assu...

  11. [Transdisciplinary Approach for Sarcopenia. Sarcopenia and Locomotive syndrome].

    Science.gov (United States)

    Endo, Naoto

    2014-10-01

    Locomotive syndrome refers to a condition under which the elderly has transfer-difficulties by problems of the locomotive organs. Sarcopenia and osteoporosis are a cause of care requirement and bedridden status. To evaluate and manage these disabled elderly with osteoporosis or sarcopenia, multidisciplinary approach is important.

  12. Reclassification of clinical sleep disorders using traditional models of syndromic, neuroanatomic, pathophysiological and etiological diagnosis.

    Science.gov (United States)

    Spitzer, A Robert

    2014-09-01

    Existing classifications of central nervous system sleep disorders do not often provide tools to diagnose the majority of patients complaining of sleep-related symptoms, nor always guide effective treatment. I present a novel classification system that completely separates clinical syndromes from anatomical localization, pathophysiology, and etiology. The clinical syndrome I present can describe the majority of patients, but can be fractionated into individual subgroups for further study. By then separating the anatomy and physiology from the symptoms, an avenue of research becomes available to study the different possible structures that regulate sleep, that may be damaged and cause syndromes of sleep dysfunction. Some of these may produce symptoms that overlap with narcolepsy and some may be distinct. Because the clinical syndrome should be distinguished from anatomy or physiology, I have proposed the term narcoleptiform syndrome for the clinical syndrome. The model also clearly separates etiology from anatomy in a classical neurological manner. This allows etiology, localization and symptoms to be studied separately. It is likely that different etiologies may produce damage in areas that produce similar syndromes. For example, in this model, different causes of damage to the orexin nucleus would result in the same clinical syndrome. This reinforces the concept of studying anatomy, symptoms and etiology separately. By studying the relationship of syndromes or symptoms to anatomic localization and pathophysiology, it should be possible to test novel approaches to treatment based on different underlying structure or function. For example, patients with lesions in the ventrolateral preoptic nucleus or the thalamic intralaminar nuclei may both present with insomnia symptoms but need different treatment; or they might present with symptoms overlapping narcolepsy (a narcoleptiform syndrome) yet need different treatment. In some cases, a single treatment may cross over

  13. Peak muscle mass in young men and sarcopenia in the ageing male

    DEFF Research Database (Denmark)

    Nielsen, Morten Frost Munk; Nielsen, T L; Brixen, K

    2015-01-01

    The prevalence of sarcopenia increases with age. The diagnosis of sarcopenia relies in part on normative data on muscle mass, but these data are lacking. This study provides population-based reference data on muscle mass in young men, and these results may be used clinically for the diagnosis...... of sarcopenia in men. INTRODUCTION: The ageing population increases the prevalence of sarcopenia. Estimation of normative data on muscle mass in young men during the peak of anabolic hormones is necessary for the diagnosis of sarcopenia in ageing males. The purposes of this study were to provide population......-based reference data on lean body mass (LBM) in young men during the time of peak levels of GH/IGF-1 and testosterone and further to apply the reference data on a population-based sample of men aged 60-74 years to estimate the prevalence of sarcopenia. METHODS: This is a cross-sectional, population-based single...

  14. Infertility etiologies are genetically and clinically linked with other diseases in single meta-diseases.

    Science.gov (United States)

    Tarín, Juan J; García-Pérez, Miguel A; Hamatani, Toshio; Cano, Antonio

    2015-04-15

    The present review aims to ascertain whether different infertility etiologies share particular genes and/or molecular pathways with other pathologies and are associated with distinct and particular risks of later-life morbidity and mortality. In order to reach this aim, we use two different sources of information: (1) a public web server named DiseaseConnect ( http://disease-connect.org ) focused on the analysis of common genes and molecular mechanisms shared by diseases by integrating comprehensive omics and literature data; and (2) a literature search directed to find clinical comorbid relationships of infertility etiologies with only those diseases appearing after infertility is manifested. This literature search is performed because DiseaseConnect web server does not discriminate between pathologies emerging before, concomitantly or after infertility is manifested. Data show that different infertility etiologies not only share particular genes and/or molecular pathways with other pathologies but they have distinct clinical relationships with other diseases appearing after infertility is manifested. In particular, (1) testicular and high-grade prostate cancer in male infertility; (2) non-fatal stroke and endometrial cancer, and likely non-fatal coronary heart disease and ovarian cancer in polycystic ovary syndrome; (3) osteoporosis, psychosexual dysfunction, mood disorders and dementia in premature ovarian failure; (4) breast and ovarian cancer in carriers of BRCA1/2 mutations in diminished ovarian reserve; (5) clear cell and endometrioid histologic subtypes of invasive ovarian cancer, and likely low-grade serous invasive ovarian cancer, melanoma and non-Hodgkin lymphoma in endometriosis; and (6) endometrial and ovarian cancer in idiopathic infertility. The present data endorse the principle that the occurrence of a disease (in our case infertility) is non-random in the population and suggest that different infertility etiologies are genetically and clinically

  15. The Etiology and Clinical Features of Anaphylaxis in a developing country: A nationwide survey in Turkey.

    Science.gov (United States)

    Civelek, Ersoy; Erkoçoğlu, Mustafa; Akan, Ayşegül; Özcan, Celal; Kaya, Ayşenur; Vezir, Emine; Giniş, Tayfur; Azkur, Dilek; Toyran, Müge; Tokaç, Mahmut; Kocabaş, Can Naci

    2017-12-01

    Despite the increasing frequency of anaphylaxis, there is inadequate information on the etiology and clinical features in various countries, regions and age groups, especially in developing countries. Our aim is to assess the etiology and clinical findings of anaphylaxis in Turkey. Gathering reliable data about the etiology and clinical findings of anaphylaxis in the general population will decrease the related morbidity and mortality. We obtained the names and phone numbers of individuals who had been prescribed an epinephrine auto-injector with a diagnosis of anaphylaxis from ministry of health. Demographic data, clinical history of the first episode of anaphylaxis including the triggering agent, clinical findings, course of hospitalization, and the management of anaphylaxis were obtained by phone survey. A total of 843 patients with a mean age of 21.4±17.3 years were evaluated. There was a significant male predominance among children younger than 10 years of age but a female predominance in older subjects. The most common causes of anaphylaxis were foods(40.1%) in children and bee venom(60.8%) in adults. The biphasic reaction rate was 4.3% and the median length of stay at an emergency department was 4.0 hours. Almost 60% of the patients had recurrent anaphylaxis episodes. Only 10.7% of the cases were prescribed an epinephrine auto-injector at their first anaphylaxis episode and only 59.2% of the patients were referred to an allergist during discharge from the emergency department. In Turkey, bee venom was the most common cause of anaphylaxis, followed by food and drug. While more than a half of patients reported recurrent attacks; only 10% had been prescribed epinephrine auto-injector kit after their first episode. Strategies to improve the anaphyalxis management are therefore urgently required.

  16. The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients

    Science.gov (United States)

    Reijnierse, Esmee M.; Trappenburg, Marijke C.; Leter, Morena J.; Blauw, Gerard Jan; de van der Schueren, Marian A. E.; Meskers, Carel G. M.; Maier, Andrea B.

    2015-01-01

    Objectives Diagnostic criteria for sarcopenia include measures of muscle mass, muscle strength and physical performance. Consensus on the definition of sarcopenia has not been reached yet. To improve insight into the most clinically valid definition of sarcopenia, this study aimed to compare the association between parameters of malnutrition, as a risk factor in sarcopenia, and diagnostic measures of sarcopenia in geriatric outpatients. Material and Methods This study is based on data from a cross-sectional study conducted in a geriatric outpatient clinic including 185 geriatric outpatients (mean age 82 years). Parameters of malnutrition included risk of malnutrition (assessed by the Short Nutritional Assessment Questionnaire), loss of appetite, unintentional weight loss and underweight (body mass index malnutrition (independent variables) and diagnostic measures of sarcopenia (dependent variables) were analysed using multivariate linear regression models adjusted for age, body mass, fat mass and height in separate models. Results None of the parameters of malnutrition was consistently associated with diagnostic measures of sarcopenia. The strongest associations were found for both relative and absolute muscle mass; less stronger associations were found for muscle strength and physical performance. Underweight (p = malnutrition relate differently to diagnostic measures of sarcopenia in geriatric outpatients. The association between parameters of malnutrition and diagnostic measures of sarcopenia was strongest for both relative and absolute muscle mass, while less strong associations were found with muscle strength and physical performance. PMID:26284368

  17. Clinical Profile, Etiology, and Outcome of Infantile Ocular Trauma: A Developing Country Perspective.

    Science.gov (United States)

    Shah, Vedang D; Uddaraju, Madhu; Singh, Amitabh; Das, Rashmi Ranjan

    2017-06-20

    The aim of this article was to study the clinical profile, etiology, and outcome of infantile ocular trauma in a developing country setting. A retrospective study on corneal trauma in infants (≤12 months old) was undertaken in a tertiary care hospital during a 2-year period. An analysis of clinical profile, etiology, microbiological profile, clinical course, and outcome was studied. Seventy-six infants were included. Approximately 69% presented within 24 hours of injury. The common presentations were inability to open the eyelids, redness of eyes, and watering. Self-infliction by child's hand (49%) was found to be the main cause of corneal trauma. Corneal abrasion was seen in 34 cases (45%), isolated epithelial defects were seen in 30%, and infective keratitis was seen in 25%. Infection was found in 14 cases (fungal filaments in 7 and gram-positive cocci in 7). Only 36 infants followed up regularly in the hospital. All the infants following up in the hospital recovered in due course. Infantile ocular trauma is a common morbidity that is underreported. Self-infliction by child's hand was found to be the main cause of corneal trauma. Cases presenting early and following up regularly till recovery have a favorable clinical course with good outcome. A high loss to follow-up indicates that awareness needs to be created among the caregivers.

  18. Congenital Upper Eyelid Coloboma: Embryologic, Nomenclatorial, Nosologic, Etiologic, Pathogenetic, Epidemiologic, Clinical, and Management Perspectives

    Science.gov (United States)

    Abdulhafez, Mohamed H.; Fouad, Yousef A.

    2015-01-01

    Purpose: To review the recent literature and describe the authors’ experience with congenital upper eyelid coloboma. Methods: In this review, we will summarize the embryologic and etiopathogenetic bases of congenital upper eyelid coloboma, and study the published clinical reports. We will also attempt to briefly shed some light on the rarer syndromic curiosities associated with upper eyelid coloboma. Results: Congenital upper eyelid colobomas are one of the few nontraumatic oculoplastic emergencies that may occasionally present in the first few days of life with a corneal ulcer and may even present with impending perforation. They can present with or without corneopalpebral adhesions, may be isolated findings or a part of a larger spectrum of congenital anomalies as in the case of Fraser syndrome or Goldenhar syndrome, or could be associated with other rare curiosities that could challenge the clinician with a huge diagnostic dilemma. Conclusions: Existing literature dealing with congenital colobomas of the upper eyelid is fraught with nosologic problems, confusing etiologies, and overlapping clinical features. We attempted to clarify the salient clinical features, outline the management principles, and until a time in the not-so-distant future where advances in molecular genetic testing would help redefine the etiology and the diverse clinical spectrum of genetic diseases associated with upper eyelid colobomas, we propose a simplified classification scheme based on the relation of the coloboma to the cornea, the presence or absence of systemic features, and all the syndromic and nonsyndromic associations of congenital coloboma of the upper eyelid known today. PMID:25419956

  19. [The etiological, clinical and prognosis of diarrhea occurs during AIDS in to hospital in Bamako].

    Science.gov (United States)

    Dao, S; Oumar, A A; Doumbia, S; Goita, D; Boushab, M; Maiga, I I; Bougoudogo, F

    2007-01-01

    Its was a descriptive survey achieved in the service of the infectious and tropical illnesses of the teaching hospital of the "Point G" from 31 December 2002 to 30 June 2004 was about the analysis of 76 files. Its goal was to determine the clinical, etiological and prognostic aspects, of the diarrhea during the AIDS. The oral-pharyngeal candidiasis (50%), the deshydratation (60,5%), the fever (67,5%) and the thinning (77,6%) were associated to the diarrhoea frequently. Cholera syndrome was (52.6%), dysenteric syndrome was (36.8%) and the diarrhea syndrome was (10.5%). According to the etiological aspect, the parasites were founded in 51,3 % of cases, bacteria 9,2 % of cases, and fungus 5,3%. Any pathogen hasn't been founded in 34,2% of cases. Cyptosporidium parvum (15,8 %), and Isospora Belli (11,8%) was the most common parasites founded, but some unusual pathogens as: Entamoeba hystolitica, Trichomonas intestinalis , Giardia intestinalis , Shistosoma mansoni , Dicrococelium dendriticum, Trichostrongylus were present . The most common bacteria were Escherichia coli 5,3%. The fungus family was represented by Candida albicans . The lethality rate was 46,1%. The etiology of diarrhea occurs during aids is variable and include opportunistic and non opportunistic. The fatality rate remains incised because the delay of care and the poverty of the patients.

  20. Presbyphagia and Sarcopenic Dysphagia: Association between Aging, Sarcopenia, and Deglutition Disorders.

    Science.gov (United States)

    Wakabayashi, H

    2014-01-01

    Presbyphagia refers to age-related changes in the swallowing mechanism in the elderly associated with a frailty in swallowing. Presbyphagia is different from dysphagia. Sarcopenic dysphagia is difficulty swallowing due to sarcopenia of generalized skeletal muscles and swallowing muscles. Age-related loss of swallowing muscle mass becomes evident in the geniohyoid muscle and tongue. Elderly subjects with both sarcopenia and dysphagia may have not only disease-related dysphagia but also sarcopenic dysphagia. In cases of aspiration pneumonia, deterioration in activity-, disease-, and nutrition-related sarcopenia of generalized skeletal muscles and swallowing muscles may develop into sarcopenic dysphagia. Assessment of sarcopenic dysphagia includes evaluation of both dysphagia and sarcopenia. The 10-item Eating Assessment Tool (EAT-10) and a water test combined with pulse oximetry are useful for dysphagia screening. Assessment of the multi-factorial causes of sarcopenia including nutritional review is important, because rehabilitation of sarcopenic dysphagia differs depending on its etiology. Consensus diagnostic criteria for sarcopenic dysphagia were proposed at the 19th Annual Meeting of the Japanese Society of Dysphagia Rehabilitation. Rehabilitation for sarcopenic dysphagia includes treatment of both dysphagia and sarcopenia. The core components of dysphagia rehabilitation are oral health care, rehabilitative techniques, and food modification. The causes of adult malnutrition may also contribute to the etiology of secondary sarcopenia and sarcopenic dysphagia. Therefore, nutrition management is indispensable for sarcopenic dysphagia rehabilitation. In cases of sarcopenia with numerous complicating causes, treatment should include pharmaceutical therapies for age-related sarcopenia and comorbid chronic diseases, resistance training, early ambulation, nutrition management, protein and amino acid supplementation, and non-smoking.

  1. Comorbidity in pediatric bipolar disorder: prevalence, clinical impact, etiology and treatment.

    Science.gov (United States)

    Frías, Álvaro; Palma, Cárol; Farriols, Núria

    2015-03-15

    Research on pediatric bipolar disorder (PBD) is providing a plethora of empirical findings regarding its comorbidity. We addressed this question through a systematic review concerning the prevalence, clinical impact, etiology and treatment of main comorbid disorders involved. A comprehensive database search was performed from 1990 to August 2014. Overall, 167 studies fulfilled the inclusion criteria. Bipolar youth tend to suffer from comorbid disorders, with highest weighted mean prevalence rate arising from anxiety disorders (54%), followed by attention deficit hyperactivity disorder (ADHD) (48%), disruptive behavior disorders (31%), and substance use disorders (SUD) (31%). Furthermore, evidence indicates that ADHD and anxiety disorders negatively affect the symptomatology, neurocognitive profile, clinical course and the global functioning of PBD. Likewise, several theories have been posited to explain comorbidity rates in PBD, specifically common risk factors, one disorder being a risk factor for the other and nosological artefacts. Lastly, randomized controlled trials highlight a stronger therapeutic response to stimulants and atomoxetine (vs. placebo) as adjunctive interventions for comorbid ADHD symptoms. In addition, research focused on the treatment of other comorbid disorders postulates some benefits from mood stabilizers and/or SGA. Epidemiologic follow-up studies are needed to avoid the risk of nosological artefacts. Likewise, more research is needed on pervasive developmental disorders and anxiety disorders, especially regarding their etiology and treatment. Psychiatric comorbidity is highly prevalent and is associated with a deleterious clinical effect on pediatric bipolarity. Different etiological pathways may explain the presence of these comorbid disorders among bipolar youth. Standardized treatments are providing ongoing data regarding their effectiveness for these comorbidities among bipolar youth. Copyright © 2014 Elsevier B.V. All rights

  2. Sarcopenia e envelhecimento

    OpenAIRE

    Brás, Rafael Duarte

    2014-01-01

    Trabalho final de mestrado integrado em Medicina (Geriatria), apresentado á Faculdade de Medicina da Universidade de Coimbra Sarcopenia pode ser considerada uma síndrome geriátrica caracterizada por perda de massa muscular e força e/ou performance física sendo que é necessário a documentação de dois dos três critérios anteriormente citados para se estabelecer o diagnóstico. Esta condição pode ter consequências muito graves, como é exemplo a síndrome de fragilidade no idoso. Atualmente a...

  3. Sarcopenia With Limited Mobility: An International Consensus

    Science.gov (United States)

    Morley, John E.; Abbatecola, Angela Marie; Argiles, Josep M.; Baracos, Vickie; Bauer, Juergen; Bhasin, Shalender; Cederholm, Tommy; Stewart Coats, Andrew J.; Cummings, Steven R.; Evans, William J.; Fearon, Kenneth; Ferrucci, Luigi; Fielding, Roger A.; Guralnik, Jack M.; Harris, Tamara B.; Inui, Akio; Kalantar-Zadeh, Kamyar; Kirwan, Bridget-Anne; Mantovani, Giovanni; Muscaritoli, Maurizio; Newman, Anne B.; Rossi-Fanelli, Filippo; Rosano, Giuseppe M. C.; Roubenoff, Ronenn; Schambelan, Morris; Sokol, Gerald H.; Storer, Thomas W.; Vellas, Bruno; von Haehling, Stephan; Yeh, Shing-Shing; Anker, Stefan D.

    2016-01-01

    A consensus conference convened by the Society of Sarcopenia, Cachexia and Wasting Disorders has concluded that “Sarcopenia, ie, reduced muscle mass, with limited mobility” should be considered an important clinical entity and that most older persons should be screened for this condition. “Sarcopenia with limited mobility” is defined as a person with muscle loss whose walking speed is equal to or less than 1 m/s or who walks less than 400 m during a 6-minute walk, and who has a lean appendicular mass corrected for height squared of 2 standard deviations or more below the mean of healthy persons between 20 and 30 years of age of the same ethnic group. The limitation in mobility should not clearly be a result of otherwise defined specific diseases of muscle, peripheral vascular disease with intermittent claudication, central and peripheral nervous system disorders, or cachexia. Clinically significant interventions are defined as an increase in the 6-minute walk of at least 50 meters or an increase of walking speed of at least 0.1 m/s. “A word is not a crystal, transparent and unchanged; it is the skin of a living thought and may vary greatly in color and content according to the circumstances and the time when it is used.”—Oliver Wendell Holmes PMID:21640657

  4. Extrahepatic portal biliopathy: proposed etiology on the basis of anatomic and clinical features.

    Science.gov (United States)

    Walser, Eric M; Runyan, Brandon R; Heckman, Michael G; Bridges, Mellena D; Willingham, Darrin L; Paz-Fumagalli, Ricardo; Nguyen, Justin H

    2011-01-01

    To compare the anatomic and clinical features in patients with chronic portal vein thrombosis (PVT) to determine why some patients develop portal biliopathy (PB) while most do not and propose an etiology for PB. This project satisfied HIPAA regulations and received institutional review board approval for a retrospective review without the need for consent. From 100 patients with PVT, 60 were extracted who had chronic, nonmalignant PVT, after exclusion of those with sclerosing cholangitis, liver transplants, choledocholithiasis, or portosystemic shunts. Clinical and imaging data from 19 patients with biliary dilatation (PB group) were compared with data from 41 patients without biliary dilatation (no-PB group). Statistical analysis was performed with the Fisher exact test for categorical variables or the Wilcoxon rank-sum test for numerical and ordered categorical variables. P values of .05 or less were considered to indicate a significant difference. The etiology of PVT differed between the groups (P < .001); cirrhosis was infrequently seen in the PB group (two of 19, 11%) but was common in the no-PB group (31 of 41, 76%). Only two of 33 (6%) patients with cirrhosis and PVT had PB. Extension of PVT into the mesenteric veins was significantly more common in the PB group (18 of 19, 95%) than in the no-PB group (one of 41, 2%) (P < .001). Compared with the no-PB group, patients in the PB group had more acute angulation of the bile duct (median, 110° vs 128°; P = .008), less frequent gastroesophageal varices (three of 19 [16%] vs 20 of 41 [49%], P = .021), and a smaller mean coronary vein diameter (median, 5 vs 6 mm; P = .014). Noncirrhotic patients with hypercoagulable states tend to develop PB when PVT extends to the splenomesenteric veins. A possible etiology is the formation of specific peribiliary venous pathways responsible for bile duct compression and tethering. © RSNA, 2010.

  5. Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management

    Science.gov (United States)

    Gupta, Sonia; Jawanda, Manveen Kaur

    2015-01-01

    The mouth is a mirror of health or disease, a sentinel or early warning system. The oral cavity might well be thought as a window to the body because oral manifestations accompany many systemic diseases. In many instances, oral involvement precedes the appearance of other symptoms or lesions at other locations. Oral lichen planus (OLP) is a chronic mucocutaneous disorder of stratified squamous epithelium of uncertain etiology that affects oral and genital mucous membranes, skin, nails, and scalp. LP is estimated to affect 0.5% to 2.0% of the general population. This disease has most often been reported in middle-aged patients with 30-60 years of age and is more common in females than in males. The disease seems to be mediated by an antigen-specific mechanism, activating cytotoxic T cells, and non-specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. A proper understanding of the pathogenesis, clinical presentation, diagnosis of the disease becomes important for providing the right treatment. This article discusses the prevalence, etiology, clinical features, oral manifestations, diagnosis, complications and treatment of oral LP. PMID:26120146

  6. Clinical Profile and Etiology of Diabetes Mellitus With Onset at Less Than 6 Months of Age

    Directory of Open Access Journals (Sweden)

    Joseph J. Valamparampil

    2009-12-01

    Full Text Available The aim of this study was to determine the clinical profile and etiology of diabetes mellitus (DM with onset at < 6 months of age. All children aged < 6 months diagnosed with DM at a tertiary referral center between 2005 and 2008 were included in the study. Three cases of DM with onset at < 6 months of age were identified. All patients were female and of the same ethnic origin, with nonconsanguineous parents. Intrauterine growth retardation was noted in all three patients, and diabetic ketoacidosis and hypertriglyceridemia in two of the three. Blood samples from all three patients and their parents were analyzed for mutations in the KCNJ11 gene (inwardly-rectifying potassium channel, subfamily J, member 11 gene; OMIM 600937. A heterozygous de novo mutation in the KCNJ11 gene was detected in one patient, which confirmed the diagnosis of permanent neonatal DM. Neither C-peptide secretion nor circulating islet cell antibodies were detected in any patient during diagnosis, but C-peptide elevation was detected in the patient with permanent neonatal DM after treatment with sulfonylurea. One infant had clinical and immunological evidence of congenital cytomegalovirus infection while the diabetes in another case was postulated to be syndromic. DM within the first 6 months of life is a rare condition with various etiologies. The high prevalence of Kir6.2 mutations in neonatal diabetes means that all children < 6 months of age diagnosed with diabetes should be tested for Kir6.2 mutations at diagnosis.

  7. Sarcopenia and post-hospital outcomes in older adults: A longitudinal study.

    Science.gov (United States)

    Pérez-Zepeda, Mario Ulises; Sgaravatti, Aldo; Dent, Elsa

    Sarcopenia poses a significant problem for older adults, yet very little is known about this medical condition in the hospital setting. The aims of this hospital-based study were to determine: (i) the prevalence of sarcopenia; (ii) factors associated with sarcopenia; and (iii) the association of sarcopenia with adverse clinical outcomes post-hospitalisation. This is a longitudinal analysis of consecutive patients aged ≥70 years admitted to a Geriatric Management and Evaluation Unit (GEMU) ward. Sarcopenia was classified using the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm, which included: handgrip strength, gait speed, and muscle mass using Bioelectrical Impedance Analysis (BIA). Outcomes were assessed at 12-months post-hospital discharge, and included both mortality and admission to a hospital Emergency Department (ED). Kaplan-Meier methods were used to estimate survival, with Cox proportion hazard models then applied. All regression analyses controlled for age, sex, and co-morbidity. 172 patients (72% female) with a mean (SD) age of 85.2 (6.4) years were included. Sarcopenia was present in 69 (40.1%) of patients. Patients with sarcopenia were twice as likely to die in the 12-months post-hospitalisation (HR, 95% CI=2.23, 1.15-4.34), but did not have an increased likelihood of ED admission. Sarcopenia showed an independent association with 12-month post-hospital mortality in older adults. With the new recognition of sarcopenia as a medical condition with its own unique ICD-10-CM code, awareness and diagnosis of sarcopenia in clinical settings is paramount. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. [Neonatal convulsions in health care. I. Incidence, etiology and clinical aspects].

    Science.gov (United States)

    Carrascosa, M C; Mariínez-Gutiérrez, A; Onsurbe, I; Vázquez, M S; Catalán, B; Tébar, R

    1996-10-01

    To determine the incidence, etiology and course of neonatal convulsions in the Albacete Health District between 1991 and 1993. A descriptive study of retrospective cohorts. 12,427 new born babies in the province of Albacete. The Hospital General de Albacete looks after a population of 376,071 inhabitants, attends 82% of the births in this area and its Neonatology Department is the only one in the province. Incidence: we found 25 new born babies (RN) with neonatal convulsions: absolute incidence (IA) in live RN0/00.; IA in live full-term RN (RNI) 1.4(0/00); IA in preterm RN (RNPT) 13.4(0/00) and in immature RN (with a gestational age of hipocalcemia and hypothermia, which do not leave sequelae after treatment. Also when methods of clinical inclusion/EEG are used, evaluating only the epileptic phenomena, convulsive crises with minimal clinical signs are observed.

  9. Quality of Life in Sarcopenia and Frailty

    Science.gov (United States)

    Rizzoli, René; Reginster, Jean-Yves; Arnal, Jean-François; Bautmans, Ivan; Beaudart, Charlotte; Bischoff-Ferrari, Heike; Biver, Emmanuel; Boonen, Steven; Brandi, Maria-Luisa; Chines, Arkadi; Cooper, Cyrus; Epstein, Sol; Fielding, Roger A.; Goodpaster, Bret; Kanis, John A.; Kaufman, Jean-Marc; Laslop, Andrea; Malafarina, Vincenzo; Mañas, Leocadio Rodriguez; Mitlak, Bruce H.; Oreffo, Richard O.; Petermans, Jean; Reid, Kieran; Rolland, Yves; Sayer, Avan Aihie; Tsouderos, Yannis; Visser, Marjolein; Bruyère, Olivier

    2013-01-01

    The reduced muscle mass and impaired muscle performance that defines sarcopenia in older individuals is associated with increased risk of physical limitation and a variety of chronic diseases. It may also contribute to clinical frailty. A gradual erosion of quality of life (QoL) has been evidenced in these individuals, although much of this research has been done using generic QoL instruments, particularly the SF-36, which may not be ideal in older populations with significant comorbidities. This review and report of an expert meeting, presents the current definitions of these geriatric syndromes (sarcopenia and frailty). It then briefly summarises QoL concepts and specificities in older populations, examines the relevant domains of QoL and what is known concerning QoL decline with these conditions. It calls for a clearer definition of the construct of disability and argues that a disease-specific QoL instrument for sarcopenia/frailty would be an asset for future research and discusses whether there are available and validated components that could be used to this end and whether the psychometric properties of these instruments are sufficiently tested. It calls also for an approach using utility weighting to provide some cost estimates and suggests that a time trade off study could be appropriate. PMID:23828275

  10. Clinical and etiological profile of epilepsy in elderly: a hospital-based study from rural India.

    Science.gov (United States)

    Verma, Archana; Kumar, Alok

    2017-03-01

    To determine the clinical profile and etiology of epilepsy in elderly patients in rural population of India which is in a phase of demographic transition with steadily growing geriatric population. A cross-sectional, prospective, hospital-based clinicoepidemiological study was performed from October 2014 to November 2015. Patients having onset of epilepsy after 60 years were incorporated in the study. We excluded the acute symptomatic seizures. One hundred and ten patients were enrolled and were divided into three standard subgroups: subgroup A (aged 60-70), subgroup B (aged 71-80), and subgroup C (aged 81-90). Out of 110 patients, 72 (65.45%) were male and 38 (34.54%) were female. The most common etiology was cerebrovascular disease (46.36%), followed by focal cerebral calcifications single or multiple (11.81%), tumors (9.09%), trauma (6.36%) dementias (6.36%) and unknown (16.63%). In our study, the frequency of epilepsy decreases with advancing age which was 77.27% in group A (less than 70 years), 16.36% in group B and 6.36% in group C (70-90 years).The most common type of seizure in the group studied was focal 59.09% followed by generalized seizures 37.27%. Hypertension was the most common co-morbidity found in 40 (36.36%) patients. The present study proposes that epilepsy in the elderly patients have etiological relationship with stroke, focal cerebral calcifications, tumors and dementias. CNS infections account for a significant number of cases of remote symptomatic epilepsy in elderly in our region where neurocysticercosis is endemic.

  11. Clinical, Etiologic, and Histopathologic Features of Stevens-Johnson Syndrome During an 8-Year Period at Mayo Clinic

    Science.gov (United States)

    Wetter, David A.; Camilleri, Michael J.

    2010-01-01

    OBJECTIVE: To examine clinical, etiologic, and histologic features of Stevens-Johnson syndrome and to identify possible correlates of clinical disease severity related to etiologic and histopathologic findings. PATIENTS AND METHODS: This is a retrospective review of patients seen at Mayo Clinic between January 1, 2000, and December 31, 2007. RESULTS: Of 27 patients (mean age, 28.1 years), 22 (81%) had involvement of 2 or more mucous membranes, and 19 (70%) had ocular involvement. Medications, most commonly antibiotics and anticonvulsants, were causative in 20 patients. Mycoplasma pneumoniae infection caused 6 of the 27 cases. Corticosteroids were the most common systemic therapy. No patients with mycoplasma-induced Stevens-Johnson syndrome had internal organ involvement or required treatment in the intensive care unit, in contrast to 4 patients each in the drug-induced group. Three patients had chronic ocular sequelae, and 1 died of complications. Biopsy specimens from 13 patients (48%) showed epidermal necrosis (8 patients), basal vacuolar change (10 patients), and subepidermal bullae (10 patients). Biopsy specimens from 11 patients displayed moderate or dense dermal infiltrate. Histologic features in drug-induced cases included individual necrotic keratinocytes, dense dermal infiltrate, red blood cell extravasation, pigment incontinence, parakeratosis, and substantial eosinophils or neutrophils. CONCLUSION: Our clinical and etiologic findings corroborate those in previous reports. M pneumoniae—induced Stevens-Johnson syndrome manifested less severely than its drug-induced counterpart. The limited number of biopsies precludes unequivocal demonstration of histopathologic differences between drug-induced and M pneumoniae—induced Stevens-Johnson syndrome. PMID:20118388

  12. Revisiting of etiology, clinical picture and diagnosis of the Kleine-Levin syndrome.

    Directory of Open Access Journals (Sweden)

    Ulyanova О.V.

    2017-03-01

    Full Text Available Objective: to draw the attention to the Kleine - Levin syndrome (SKL, a rare, poorly understood disease, not only in Russia but throughout the world. We analyzed the case of the 23-year old patient M, with the Kleine — Levin syndrome. SKL belongs to the group of recurrent hypersomnia and is characterized by long bouts of sleep lasting an average of 10-14 days, beginning with the imperative and difficulty awakening. During bouts of sleep observed unusual behavior of patients: hyperphagia; hypersexuality in males; irritability, restlessness, impaired mental activity; aggression; feeling of unreality of it all; confusion, hallucinatory episodes and depression in females. During wakefulness, marked dyspho-ria, emotional stupefaction, loss of memory. The syndrome develops in 4 times more often in men than in women, aged 12-25 years. Etiological factors: brain tumor, head trauma, metabolic disorders, acute infectious diseases with fever. Often the development of the syndrome is preceded by hyperemia and hypothalamic-pituitary dysfunction. The article discussed the etiology, diagnosis, and possible combinations of clinical manifestations in SKL.

  13. Exercise and Protein Intake: A Synergistic Approach against Sarcopenia.

    Science.gov (United States)

    Martone, Anna Maria; Marzetti, Emanuele; Calvani, Riccardo; Picca, Anna; Tosato, Matteo; Santoro, Luca; Di Giorgio, Angela; Nesci, Antonio; Sisto, Alex; Santoliquido, Angelo; Landi, Francesco

    2017-01-01

    Sarcopenia, the age-dependent loss of muscle mass and function/strength, is increasingly recognized as a major risk factor for adverse outcomes in frail older people. As such, the skeletal muscle is a relevant target for interventions aimed at preventing or postponing the occurrence of negative health-related events in late life. The association among physical inactivity, insufficient intake of energy and protein, and poor muscle health in older adults suggests that physical exercise and targeted nutritional supplementation may offer substantial therapeutic gain against sarcopenia and its negative correlates. This view is supported by observational studies as well as by small-scale clinical trials. In this review, we summarize the available evidence on the beneficial effects of behavioral interventions on sarcopenia. We also briefly describe how the knowledge gathered so far has been used to design the "Sarcopenia and Physical fRailty IN older people: multicomponenT Treatment strategies" (SPRINTT) project. The randomized clinical trial conducted within SPRINTT will provide robust evidence on the effectiveness of exercise and nutrition at preventing negative outcomes associated with sarcopenia and physical frailty.

  14. Relationship Between Sarcopenia and Albuminuria

    Science.gov (United States)

    Kim, Tae Nyun; Lee, Eun Ju; Hong, Jae Won; Kim, Jung Min; Won, Jong Chul; Kim, Mi Kyung; Noh, Jung Hyun; Ko, Kyung Soo; Rhee, Byoung Doo; Kim, Dong-Jun

    2016-01-01

    Abstract Studies have shown that albuminuria, obesity, and sarcopenia may share pathophysiological processes related to cardiovascular disease risk. Their direct relationships, however, have not been examined. This study investigated the association between albuminuria and sarcopenia in a representative fraction of the Korean population. Of the 10,589 people who participated in the 2011 Korea National Health and Nutrition Examination Survey, 2158 participants aged over 19 years had been tested for albumin-to-creatinine ratio and for body composition data using dual-energy x-ray absorptiometry. Albuminuria was defined as an albumin-to-creatinine ratio ≥30 mg/g. Sarcopenia was defined as a skeletal muscle index (SMI) (SMI (%) = total appendicular skeletal muscle mass [kg]/weight [kg] × 100) of less than 1 standard deviation (SD) (grade 1) or 2 SD (grade 2) below the sex-specific mean for a younger reference group. The prevalence of albuminuria was higher in those with grade 2 sarcopenia than in those with a normal SMI or grade 1 sarcopenia (33.3% versus 8.4% and 8.9%; P albuminuria than in those with the upper tertile of normoalbuminuria. In addition, multiple logistic regression analysis showed the odds ratio for albuminuria risk in the grade 2 sarcopenia group was 2.93 (95% confidence interval [CI], 1.46–5.88), compared with normal SMI after adjusting for potential confounding factors, including the presence of obesity, diabetes, and hypertension. Moreover, individuals with albuminuria had an odds ratio of 3.39 (95% [confidence interval], 1.38–8.37) for grade 2 sarcopenia compared with those in the lowest tertile of normoalbuminuria. This is the first study to demonstrate that individuals with sarcopenia exhibited increased risk of albuminuria and vice versa. PMID:26817888

  15. Etiology and clinical profile of childhood optic nerve atrophy at a tertiary eye care center in South India

    OpenAIRE

    Chinta, Supriya; Wallang, Batriti S; Sachdeva, Virender; Gupta, Amit; Patil-Chhablani, Preeti; Kekunnaya, Ramesh

    2014-01-01

    Background: Optic nerve atrophy is an important ophthalmological sign that may be associated with serious systemic conditions having a significant bearing on the overall morbidity of the child. Studies specific to etiology of childhood optic atrophy are scarce, this being the first such study from India to the best of our knowledge. Aim: The aim was to analyze the clinical features and etiology of diagnosed cases of optic nerve atrophy in children

  16. The diagnosis of sarcopenia is mainly driven by muscle mass in hemodialysis patients.

    Science.gov (United States)

    Bataille, Stanislas; Serveaux, Marianne; Carreno, Elisa; Pedinielli, Nathalie; Darmon, Patrice; Robert, Alain

    2016-10-22

    Sarcopenia is a well-known complication of protein energy wasting in hemodialysis patients. Its diagnosis requires measurements of muscle mass and muscle function. Few studies have reported its prevalence in hemodialysis patients. In this study, we report the prevalence of sarcopenia in this population and evaluate the performance of other parameters for its diagnosis. In this observational cross-sectional study, data from hemodialysis patients from our nephrology department were recorded. Body composition measured by bioimpedancemetry analysis and muscle strength measured by handgrip were recorded. Normal values for sarcopenia were those recommended by the European Working Group on Sarcopenia in Older People (EWGSOP). The median age (interquartile range) of the 111 patients was 77.5 (70.8-84.8) years. A large majority of 88.3% (n = 98) of patients had a low muscle strength; a low muscle mass index was present in 33.3% (n = 37) of the population. Finally, 31.5% (n = 35) of patients had sarcopenia. These latter were older, had longer dialysis vintage, lower BMI, mid-arm circumference and mid-leg circumference, and a lower prealbumin. The best parameter predicting sarcopenia was BMI (ROC curve AUC of 0.79 [0.68-0.91] (p < 0.001) in men and 0.81 [0.68-0.93] (p = 0.003) in women). Mid-arm circumference predicted sarcopenia, but was less accurate than BMI. Mid-leg circumference predicted sarcopenia only in men. Predialysis creatinine or creatinine index could not predict sarcopenia. We report a 31.5% prevalence of sarcopenia in hemodialysis patients. The diagnosis of sarcopenia was mainly driven by muscle mass measurement because muscle strength is low in the large majority of hemodialysis patients. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  17. Screening for sarcopenia in obesity

    Science.gov (United States)

    Sammarco, R.; Marra, M.; Montagnese, C.; De Rosa, E.; Onufrio, M.; Amato, V.; Santarpia, L.; De Caprio, C.; Contaldo, F.; Pasanisi, F.

    2013-04-01

    Sarcopenia is a progressive and generalized loss of skeletal muscle mass (SM) and function which can also be found in obese adults. The aim of the study was to evaluate the prevalence of sarcopenia in 1 245 obese women (18 - 67 years, weight 114.7±24.5 kg; BMI 44.1±9.2 fat mass 49.0±6.2%) from Southern Italy. Body composition was evaluated by bioimpedance analysis (BIA) and SM calculated by using Janssen's equation; therefore the sex-specific cut-off points of percentage skeletal muscle index were used. The whole population was divided in two age groups: A (18-40 years; n. 808; weight 115.4±23.5 kg; BMI 43.8±8.8 kg/m2) and B (41-67 years; n. 438; weight 113.4±26.3 kg; BMI 44.8±9.9 kg/m2). In all the sample there was 2.7% moderate and 0.6% severe sarcopenia; in group A, 1.9% moderate and 0.6% severe sarcopenia whilst in group B 4.3% moderate and 0.7% severe sarcopenia. The results of our study suggest that, based on a screening examination by BIA, moderate/severe sarcopenia can be detected in an unselected middle-aged obese population. Further studies are required to clarify the diagnosis with functional tests.

  18. Strength and function response to clinical interventions of older women categorized by weakness and low lean mass using classifications from the Foundation for the National Institute of Health sarcopenia project.

    Science.gov (United States)

    Fragala, Maren S; Dam, Thuy-Tien L; Barber, Vanessa; Judge, James O; Studenski, Stephanie A; Cawthon, Peggy M; McLean, Robert R; Harris, Tamara B; Ferrucci, Luigi; Guralnik, Jack M; Kiel, Douglas P; Kritchevsky, Stephen B; Shardell, Michelle D; Vassileva, Maria T; Kenny, Anne M

    2015-02-01

    The Foundation for the National Institutes of Health Sarcopenia Project developed data-driven cut-points for clinically meaningful weakness and low lean body mass. This analysis describes strength and function response to interventions based on these classifications. In data from four intervention studies, 378 postmenopausal women with baseline and 6-month data were evaluated for change in grip strength, appendicular lean mass corrected for body mass index, leg strength and power, and short physical performance battery (SPPB). Clinical interventions included hormones, exercise, and nutritional supplementation. Differences in outcomes were evaluated between (i) those with and without weakness and (ii) those with weakness and low lean mass or with one but not the other. We stratified analyses by slowness (walking speed ≤ 0.8 m/s) and by treatment assignment. The women (72±7 years; body mass index of 26±5kg/m(2)) were weak (33%), had low lean mass (14%), or both (6%). Those with weakness increased grip strength, lost less leg power, and gained SPPB score (p interventions for frailty. Thus, results suggest that muscle weakness, as defined by the Foundation for the National Institutes of Health Sarcopenia Project, appears to be a treatable symptom. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Common Ground? The Concordance of Sarcopenia and Frailty Definitions

    NARCIS (Netherlands)

    Reijnierse, Esmee M.; Trappenburg, Marijke C.; Blauw, Gerard Jan; Verlaan, Sjors; de van der Schueren, Marian A.E.; Meskers, Carel G.M.; Maier, Andrea B.

    2016-01-01

    Objectives: This study aimed to explore the concordance between definitions of sarcopenia and frailty in a clinically relevant population of geriatric outpatients. Design: Data were retrieved from a cross-sectional study. Setting: The study was performed in a geriatric outpatient clinic of a

  20. Risk of Fracture in Women with Sarcopenia, Low Bone Mass, or Both.

    Science.gov (United States)

    Harris, Rebekah; Chang, Yuefang; Beavers, Kristen; Laddu-Patel, Deepika; Bea, Jennifer; Johnson, Karen; LeBoff, Meryl; Womack, Catherine; Wallace, Robert; Li, Wenjun; Crandall, Carolyn; Cauley, Jane

    2017-12-01

    To determine whether women with sarcopenia and low bone mineral density (BMD) are at greater risk of clinical fractures than those with sarcopenia or low BMD alone. Women's Health Initiative (WHI) Observational and Clinical trials. Three U.S. clinical centers (Pittsburgh, PA; Birmingham, AL; Phoenix/Tucson, AZ). Women (mean age 63.3 ± 0.07) with BMD measurements (N = 10,937). Sarcopenia was defined as appendicular lean mass values corrected for height and fat mass. Low BMD was defined as a femoral neck T-score less than -1.0 based on the Third National Health and Nutrition Examination Survey reference database for white women. Cox proportional hazards analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). We followed women for incident fractures over a median of 15.9 years. Participants were classified into mutually exclusive groups based on BMD and sarcopenia status: normal BMD and no sarcopenia (n = 3,857, 35%), sarcopenia alone (n = 774, 7%), low BMD alone (n = 4,907, 45%), and low BMD and sarcopenia (n = 1,399, 13%). Women with low BMD, with (HR = 1.72, 95% CI = 1.44-2.06) or without sarcopenia (HR = 1.58, 95% CI = 1.37-1.83), had greater risk of fracture than women with normal BMD; the difference remained statistically significant after adjustment for important covariates. Women with low BMD, with (HR = 2.78, 95% CI = 1.78-4.30 and without (HR = 2.42, 95% CI = 1.63-3.59) sarcopenia had higher risk of hip fractures. Women with sarcopenia alone had similar HRs to women with normal BMD. Compared to women with normal BMD. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  1. Sarcopenia and functionality in elderly inpatient

    National Research Council Canada - National Science Library

    Chávez-Moreno, Diana Victoria; Infante-Sierra, Héctor; Serralde-Zúñiga, Aurora E

    2015-01-01

    Sarcopenia is a geriatric syndrome associated with adverse events. The aim of the present study was to assess the sarcopenia prevalence and its association with the functionality in elderly inpatient...

  2. Pulmonary thromboembolic disease – clinical and etiological aspects in internal medicine department

    Directory of Open Access Journals (Sweden)

    Mazilu Laura

    2015-05-01

    Full Text Available Background: Pulmonary embolism (PE represents the third most frequent vascular disease following acute myocardial ischemic disease and stroke. It is a common and potentially lethal disease. Aim: We observed etiological spectrum, clinical aspects and diagnostic tests for patients with PE. Material and methods: Retrospective observational study that included 53 patients diagnosed with PE between 01.01.2009- 31.12.2013. We followed epidemiological aspects, risk factors, clinical manifestations and methods for positive diagnosis. Results: 53 patients which represents 0.66% from the patients admitted in our department (n=8,011, were diagnosed with PE. The main risk factor for PE was malignancy (n=16. Twenty patients with PE presented deep venous thrombosis (DVT and 12 patients arterial thrombosis (AT. Main clinical syndromes of patients with PE were pulmonary infarction (n=32, isolated dyspnea (n=11 and circulatory collapse (n=10. A lot of paraclinical investigation sustained positive diagnosis,mainly by high performance techniques. Four cases were diagnosed postmortem.

  3. Lesiones medulares no traumáticas: etiología, demografía y clínica Nontraumatic spinal cord injury: etiology, demography and clinics

    Directory of Open Access Journals (Sweden)

    Asencio Quintana-Gonzales

    2011-12-01

    Full Text Available Se realizó un estudio retrospectivo y descriptivo en 210 pacientes hospitalizados con lesión medular del Instituto Nacional de Rehabilitación (INR, Callao-Perú (2000-2006 para conocer la etiología, características clínicas y socio-demográficas de los pacientes con lesiones medulares no traumáticas (LMNT. Se encontró una prevalencia de 27 % para LMNT siendo la edad promedio al inicio de la lesión 32,0 años; siendo varones el 50,5 %, y el 41,9 % tuvieron educación secundaría, el nivel de pobreza alcanzó el 90,5 %. Predominó la etiología infecciosa (viral y bacteriana en 37,6 %, con un 11,9 % de infección por HTLVI. No obstante ser el INR un centro de referencia, nuestros resultados son preliminares, siendo necesario realizar mayores estudios para proponer estrategias de prevención y control, dado el alto costo del tratamiento integral de rehabilitación en estos pacientes.We performed a retrospective and descriptive cross-sectional; study in 210 hospitalized patients with spinal cord injury at the National Institute of Rehabilitation (INR, Callao, Peru from 2000-2006. The goal was to describe etiology, and clinical and socio-demographic characteristics of non traumatic spinal cord injuries (LMNT. We found a prevalence of 27 % for LMNT, average age at onset of 32.0 years, male gender 50.5 %, and secondary education completed in 41.9 %, poverty 90.5 %. The infectious etiology (viral and bacterial was predominant in 37.6 %, with 11.9 infected with HTLVI. Although the INR is a reference center, the findings can’t be generalized because it isn’t a representative sample of the Peruvian population, further studies are necessary to propose strategies for prevention and control, considering the high cost of integral rehabilitation treatment in these patients.

  4. Pathophysiology of major depressive disorder: mechanisms involved in etiology are not associated with clinical progression.

    Science.gov (United States)

    Verduijn, J; Milaneschi, Y; Schoevers, R A; van Hemert, A M; Beekman, A T F; Penninx, B W J H

    2015-09-29

    Meta-analyses support the involvement of different pathophysiological mechanisms (inflammation, hypothalamic-pituitary (HPA)-axis, neurotrophic growth and vitamin D) in major depressive disorder (MDD). However, it remains unknown whether dysregulations in these mechanisms are more pronounced when MDD progresses toward multiple episodes and/or chronicity. We hypothesized that four central pathophysiological mechanisms of MDD are not only involved in etiology, but also associated with clinical disease progression. Therefore, we expected to find increasingly more dysregulation across consecutive stages of MDD progression. The sample from the Netherlands Study of Depression and Anxiety (18-65 years) consisted of 230 controls and 2333 participants assigned to a clinical staging model categorizing MDD in eight stages (0, 1A, 1B, 2, 3A, 3B, 3C and 4), from familial risk at MDD (stage 0) to chronic MDD (stage 4). Analyses of covariance examined whether pathophysiological mechanism markers (interleukin (IL)-6, C-reactive protein (CRP), cortisol, brain-derived neurotrophic factor and vitamin D) showed a linear trend across controls, those at risk for MDD (stages 0, 1A and 1B), and those with full-threshold MDD (stages 2, 3A, 3B, 3C and 4). Subsequently, pathophysiological differences across separate stages within those at risk and with full-threshold MDD were examined. A linear increase of inflammatory markers (CRP P=0.026; IL-6 P=0.090), cortisol (P=0.025) and decrease of vitamin D (P<0.001) was found across the entire sample (for example, from controls to those at risk and those with full-threshold MDD). Significant trends of dysregulations across stages were present in analyses focusing on at-risk individuals (IL-6 P=0.050; cortisol P=0.008; vitamin D P<0.001); however, no linear trends were found in dysregulations for any of the mechanisms across more progressive stages of full-threshold MDD. Our results support that the examined pathophysiological mechanisms are

  5. Morgellons disease: Analysis of a population with clinically confirmed microscopic subcutaneous fibers of unknown etiology.

    Science.gov (United States)

    Savely, Virginia R; Stricker, Raphael B

    2010-05-13

    Morgellons disease is a controversial illness in which patients complain of stinging, burning, and biting sensations under the skin. Unusual subcutaneous fibers are the unique objective finding. The etiology of Morgellons disease is unknown, and diagnostic criteria have yet to be established. Our goal was to identify prevalent symptoms in patients with clinically confirmed subcutaneous fibers in order to develop a case definition for Morgellons disease. Patients with subcutaneous fibers observed on physical examination (designated as the fiber group) were evaluated using a data extraction tool that measured clinical and demographic characteristics. The prevalence of symptoms common to the fiber group was then compared with the prevalence of these symptoms in patients with Lyme disease and no complaints of skin fibers. The fiber group consisted of 122 patients. Significant findings in this group were an association with tick-borne diseases and hypothyroidism, high numbers from two states (Texas and California), high prevalence in middle-aged Caucasian women, and an increased prevalence of smoking and substance abuse. Although depression was noted in 29% of the fiber patients, pre-existing delusional disease was not reported. After adjusting for nonspecific symptoms, the most common symptoms reported in the fiber group were: crawling sensations under the skin; spontaneously appearing, slow-healing lesions; hyperpigmented scars when lesions heal; intense pruritus; seed-like objects, black specks, or "fuzz balls" in lesions or on intact skin; fine, thread-like fibers of varying colors in lesions and intact skin; lesions containing thick, tough, translucent fibers that are highly resistant to extraction; and a sensation of something trying to penetrate the skin from the inside out. This study of the largest clinical cohort reported to date provides the basis for an accurate and clinically useful case definition for Morgellons disease.

  6. Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Gaeun Kim

    Full Text Available Sarcopenia is a common syndrome in chronic diseases such as liver cirrhosis. The association between sarcopenia and outcomes, such as complications and survival has recently been described in various patient groups. However, study results remain inconclusive. Therefore, the aim of this study was to systematically review the impact of sarcopenia on outcome in patients with cirrhosis.We conducted a systematic review (SR and meta-analysis (MA on the impact of sarcopenia on outcome in liver cirrhosis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Of the 312 studies identified, 20 were eligible according to our inclusion criteria. Most of the studies used CT to diagnose sarcopenia. Two studies used bioelectrical impedance analysis (BIA, 10 studies used skeletal muscle index (SMI and 8 studies used total psoas muscle area (TPA. Seven studies included Asian participants and the remaining 13 studies included Western participants. The prevalence rate of sarcopenia among participants was mean 48.1%, and appeared more among men with a rate of 61.6% whereas the rate was 36% for women. With respect to clinical outcomes, patients with sarcopenia had poorer survival rates and an increased risk of complications such as infection compared to those without sarcopenia. According to the analysis of race subgroup, Asians had a HR 2.45 (95% confidence interval (CI = 1.44-4.16, P = 0.001 of mortality whereas Westerners had a HR 1.45 (95% CI = 1.002-2.09, P<0.05.Based on this SR and MA, the presence of sarcopenia is related to a poor prognosis and occurrence of cirrhotic complications and could be used for risk assessment. Moreover, Asian participants had higher mortality related to sarcopenia compared to the Western participants.

  7. Towards a definition of sarcopenia--results from epidemiologic studies

    NARCIS (Netherlands)

    Visser, M.

    2009-01-01

    The age-related loss of muscle mass, also called sarcopenia, is receiving increasing attention in aging research. While the concept is frequently being used in research settings and introduced to clinical settings, thus far no consensus on its definition has been established. This article provides

  8. Severe Drug Hypersensitivity Reactions: Clinical Pattern, Diagnosis, Etiology and Therapeutic Options.

    Science.gov (United States)

    Paulmann, Maren; Mockenhaupt, Maja

    2016-01-01

    Severe cutaneous adverse reactions (SCAR) are known for a high morbidity and mortality. They may be life-threatening for the affected patient and difficult to accomplish for the patient's family and the treating physician. Such conditions include not only bullous reactions like toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), but also acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia and systemic symptoms (DRESS). Since clinical pattern, etiology, prognosis and treatment differ among these severe skin reactions, a clear diagnosis based on a comprehensive clinical examination, skin biopsy, and specific laboratory tests is necessary. Because most of these reactions are caused by drug intake, a thorough history of medication use has to be obtained. However, there are cases with an infectious or idiopathic cause. In any case it is crucial to identify the most likely cause and rapidly discontinue the inducing agent, if a drug cause is suspected. This is associated with the patient`s prognosis which is often poor for bullous reaction. In addition, patient's age, underlying conditions, and the extent of skin detachment play a major role in terms of prognosis. Severe cutaneous adverse reactions are T-cell-mediated reactions, and certain alleles of human leukocyte antigens (HLA) are involved in the activation of T-cells with cytotoxic effect. The therapeutic options depend on the clinical diagnosis. For all reactions a symptomatic and adequate supportive therapy is necessary, in some cases a systemic immunomodulating therapy can be useful. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  9. Usefulness of clinical data and rapid diagnostic tests to identify bacterial etiology in adult respiratory infections

    Directory of Open Access Journals (Sweden)

    Pilar Toledano-Sierra

    2015-01-01

    Full Text Available Respiratory tract infections are a common complaint and most of them, such as common cold and laryngitis, are viral in origin, so antibiotic use should be exceptional. However, there are other respiratory tract infections (sinusitis, pharyngitis, lower respiratory tract infections, and exacerbations of chronic obstructive pulmonary disease where a bacterial etiology is responsible for a non-negligible percentage, and antibiotics are often empirically indicated. The aim of the study is to identify the strength of the data obtained from the symptoms, physical examination and rapid diagnostic methods in respiratory infections in which antibiotic use is frequently proposed in order to improve diagnosis and influence the decision to prescribe these drugs. The review concludes that history, physical examination and rapid tests are useful to guide the need for antibiotic treatment in diseases such as acute sinusitis, acute pharyngitis, exacerbation of lower respiratory tract infection and chronic obstructive pulmonary disease. However, no isolated data is accurate enough by itself to confirm or rule out the need for antibiotics. Therefore, clinical prediction rules bring together history and physical examination, thereby improving the accuracy of the decision to indicate or not antibiotics.

  10. [Prevalence of sarcopenia in geriatric outpatients and nursing homes. The ELLI study].

    Science.gov (United States)

    Osuna-Pozo, Carmen María; Serra-Rexach, José Antonio; Viña, José; Gómez-Cabrera, María del Carmen; Salvá, Antoni; Ruiz, Domingo; Masanes, Ferrán; Lopez-Soto, Alfonso; Formiga, Francesc; Cuesta, Federico; Cruz-Jentoft, Alfonso

    2014-01-01

    There are few systematic studies on the prevalence of sarcopenia using the new diagnostic criteria in different geriatric care settings. To estimate the prevalence of sarcopenia, using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria in older subjects living in nursing homes and in those who attend geriatric outpatient clinics. A single country multicentre study in two samples of older subjects: patients cared for in outpatient geriatric clinics, and individuals living in nursing homes. Data collected will include demographic variables, medical history, medication, geriatric syndromes, functional status (assessment of basic and instrumental activities of daily living), mobility, cognitive status, comorbidity, quality of life, nutritional status, and laboratory parameters. For the diagnosis of sarcopenia, 4m walking speed, handgrip strength, and body composition measured by bioelectrical impedance analysis will be assessed. Using the EWGSOP algorithm, the prevalence of sarcopenia in an elderly Spanish population will be estimated. In addition, concordance and correlation between the three parameters included in the definition (muscle mass, muscle strength, and physical performance) will be analysed, using the different existing cut-off points, and examining the diagnostic accuracy of each. Finally, demographic, anthropometric and functional data that define subjects with sarcopenia will be investigated. The ELLI study should improve knowledge on the prevalence and characteristics of sarcopenia in older people in our population. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

  11. A study on etiologic agents and clinical manifestations of dermatophytosis in Yazd, Iran

    Science.gov (United States)

    Rashidian, S; Falahati, M; Kordbacheh, P; Mahmoudi, M; Safara, M; Sadeghi Tafti, H; Mahmoudi, S; Zaini, F

    2015-01-01

    Background and Purpose: Dermatophytosis is one of the most common infections of skin, hair, and nails, caused by a group of keratinophilic fungi known as dermatophytes. Species identification of these fungi is of great significance from epidemiological and therapeutic points of view. The objective of the present study was to investigate dermatophytosis and its causative agents in patients, referring to the Central Mycology Laboratory of Yazd University of Medical Sciences, Yazd, Iran. Materials and Methods: In total, 139 clinically suspected cases of dermatophytosis were examined during 12 months from February 2014 to February 2015. Skin scrapings were assessed through direct microscopic examinations and culture studies. Dermatophyte isolates were identified based on colony morphology on potato dextrose agar and dermatophyte test medium, nutritional requirements, urease and hair perforation tests, and microscopic characteristics on slide cultures. Results: Dermatophytosis was mycologically confirmed in 26 (18.70%) out of 139 cases. Although there was a statistically insignificant difference between male and female subjects, men were dominantly affected. Infection was significantly common in the age group of ≤ 29 years (P<0.043). The most common clinical manifestation of dermatophytosis was tinea corporis (69.2%), followed by tinea cruris (15.4%), tinea manuum (11.5%), and tinea pedis (3.8%). Trichophyton mentagrophytes complex was the main etiologic agent (38.5%), followed by T. rubrum (23%), T. violaceum (15.5%), T. verrucosum (11.5%), Microsporum canis (7.7%), and Epidermophyton floccosum (3.8%). Conclusion: In comparison with previous research, epidemiology of dermatophytosis has changed in Yazd over the past decades. Therefore, periodical investigations on the epidemiological aspects of this infection are required for efficient control and prevention of this cutaneous dermatophytic disease. PMID:28681000

  12. Viral etiology and clinical profiles of children with severe acute respiratory infections in China.

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    Chen Zhang

    Full Text Available No comprehensive analysis is available on the viral etiology and clinical characterization among children with severe acute respiratory infection (SARI in China during 2009 H1N1 pandemic and post-pandemic period.Cohort of 370 hospitalized children (1 to 72 months with SARI from May 2008 to March 2010 was enrolled in this study. Nasopharyngeal aspirate (NPA specimens were tested by a commercial assay for 18 respiratory viral targets. The viral distribution and its association with clinical character were statistically analyzed.Viral pathogen was detected in 350 (94.29% of children with SARI. Overall, the most popular viruses were: enterovirus/rhinovirus (EV/RV (54.05%, respiratory syncytial virus (RSV (51.08%, human bocavirus (BoCA (33.78%, human parainfluenzaviruse type 3 (PIV3 (15.41%, and adenovirus (ADV (12.97%. Pandemic H1N1 was the dominant influenza virus (IFV but was only detected in 20 (5.41% of children. Moreover, detection rate of RSV and human metapneumovirus (hMPV among suburb participants were significantly higher than that of urban area (P<0.05. Incidence of VSARI among suburb participants was also significant higher, especially among those of 24 to 59 months group (P<0.05.Piconaviruses (EV/RV and paramyxoviruses are the most popular viral pathogens among children with SARI in this study. RSV and hMPV significantly increase the risk of SARI, especially in children younger than 24 months. Higher incidence of VSARI and more susceptibilities to RSV and hMPV infections were found in suburban patients.

  13. [Transdisciplinary Approach for Sarcopenia. Effect of nutritional support for the prevention of sarcopenia].

    Science.gov (United States)

    Nishioka, Hiroaki

    2014-10-01

    Sarcopenia is defined as the age-related loss of muscle mass and function. Sarcopenia is closely related with decreased physical function, fall, bone fracture, osteoporosis, and insulin resistance, which lead to increased morbidity and mortality in elderly people. The pathogenesis of sarcopenia is complex and multifactorial, which remains not to be fully understood. Inappropriate food intake and reduced physical activity are known to increase the risk of developing sarcopenia. Resistance training and nutritional support have been shown to be an effective intervention for prevention of sarcopenia. Protein, especially branched chain amino acid, and vitamin D have been reported to improve sarcopenia. The intervention together with nutrition and exercise are more effective.

  14. Morgellons disease: Analysis of a population with clinically confirmed microscopic subcutaneous fibers of unknown etiology

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    Virginia R Savely

    2010-05-01

    Full Text Available Virginia R Savely1, Raphael B Stricker21TBD Medical Associates, San Francisco, CA, USA; 2International Lyme and Associated Diseases Society, Bethesda, MD, USABackground: Morgellons disease is a controversial illness in which patients complain of stinging, burning, and biting sensations under the skin. Unusual subcutaneous fibers are the unique objective finding. The etiology of Morgellons disease is unknown, and diagnostic criteria have yet to be established. Our goal was to identify prevalent symptoms in patients with clinically confirmed subcutaneous fibers in order to develop a case definition for Morgellons disease.Methods: Patients with subcutaneous fibers observed on physical examination (designated as the fiber group were evaluated using a data extraction tool that measured clinical and demographic characteristics. The prevalence of symptoms common to the fiber group was then compared with the prevalence of these symptoms in patients with Lyme disease and no complaints of skin fibers.Results: The fiber group consisted of 122 patients. Significant findings in this group were an association with tick-borne diseases and hypothyroidism, high numbers from two states (Texas and California, high prevalence in middle-aged Caucasian women, and an increased prevalence of smoking and substance abuse. Although depression was noted in 29% of the fiber patients, pre-existing delusional disease was not reported. After adjusting for nonspecific symptoms, the most common symptoms reported in the fiber group were: crawling sensations under the skin; spontaneously appearing, slow-healing lesions; hyperpigmented scars when lesions heal; intense pruritus; seed-like objects, black specks, or “fuzz balls” in lesions or on intact skin; fine, thread-like fibers of varying colors in lesions and intact skin; lesions containing thick, tough, translucent fibers that are highly resistant to extraction; and a sensation of something trying to penetrate the skin from

  15. Lack of knowledge and availability of diagnostic equipment could hinder the diagnosis of sarcopenia and its management

    NARCIS (Netherlands)

    Reijnierse, Esmee M.; De Van Der Schueren, Marian A.E.; Trappenburg, Marijke C.; Doves, Marjan; Meskers, Carel G.M.; Maier, Andrea B.

    2017-01-01

    Objectives: Sarcopenia is an emerging clinical challenge in an ageing population and is associated with serious negative health outcomes. This study aimed to assess the current state of the art regarding the knowledge about the concept of sarcopenia and practice of the diagnostic strategy and

  16. Ageing well: a review of sarcopenia and frailty.

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    Keevil, Victoria L; Romero-Ortuno, Roman

    2015-11-01

    'Ageing well' has been declared a global health priority by the World Health Organisation and the role of sarcopenia and frailty in late-life health is receiving increasing attention. Frailty is the decline in an individual's homeostatic function, strength and physiologic reserves leading to increased vulnerability, while sarcopenia describes the loss of muscle mass and function with age. The conceptual definitions of these conditions have been widely agreed but there is a lack of consensus on how to measure them. We review the different operational definitions described in the literature and the evidence that, whatever definition used, the prevalence and clinical impact of these conditions is high. We also consider the commonality of low physical function to both conditions, a feature which could provide a pragmatic way forward in terms of identifying those at risk. Objective measures of physical function such as usual walking speed are simple and feasible measures, extensively validated against health outcomes. Additionally, clinical applications of sarcopenia and frailty are reviewed with particular consideration to their potential role in the management of older people undergoing surgery. Frailty appears to outperform traditional anaesthetic and surgical risk scores in terms of its association with post-operative complications, length of hospital stay, institutionalisation and mortality. However, even within this sub-specialty area there is wide variation in the approaches used to measure frailty and there is an urgent need for studies to utilise established, validated and reproducible methods to identify sarcopenia and frailty in their study participants, in order to expedite scientific development.

  17. Contribution of diagnostic tests for the etiological assessment of uveitis, data from the ULISSE study (Uveitis: Clinical and medicoeconomic evaluation of a standardized strategy of the etiological diagnosis).

    Science.gov (United States)

    Grumet, Pierre; Kodjikian, Laurent; de Parisot, Audrey; Errera, Marie-Hélène; Sedira, Neila; Heron, Emmanuel; Pérard, Laurent; Cornut, Pierre-Loïc; Schneider, Christelle; Rivière, Sophie; Ollé, Priscille; Pugnet, Grégory; Cathébras, Pascal; Manoli, Pierre; Bodaghi, Bahram; Saadoun, David; Baillif, Stéphanie; Tieulie, Nathalie; Andre, Marc; Chiambaretta, Frédéric; Bonin, Nicolas; Bielefeld, Philip; Bron, Alain; Mouriaux, Frédéric; Bienvenu, Boris; Vicente, Stéphanie; Bin, Sylvie; Labetoulle, Marc; Broussolle, Christiane; Jamilloux, Yvan; Decullier, Evelyne; Sève, Pascal

    2018-02-07

    ULISSE is the only study that prospectively assessed the efficiency of a standardized strategy, compared to an open strategy for the etiologic diagnosis of uveitis. Our aim was to evaluate the diagnostic yield of the tests prescribed in the ULISSE study to clarify their relevance. ULISSE is a non-inferiority, prospective, multicenter and cluster randomized study. The standardized strategy is a two-steps strategy: in the first step, common standard tests were performed, and in the second step, tests were guided by the clinical and anatomic type of uveitis. We reported the relevance of the diagnostic tests used in the standardized strategy, as well as the profitability of the tests that were prescribed to more than twenty patients in each group. Based on diagnostic criteria, either an ophthalmologist, or an internist, established the profitability of a test by considering whether the test lead to a diagnosis or not. Among the 676 patients included (standardized 303; open 373), a diagnosis was made for 152 (50.4%) in the standardized group and 203 (54.4%) in the open group. The most common entities were HLA-B27 associated uveitis (22%), spondyloarthritis (11%), sarcoidosis (18%), tuberculosis (10.7%) and herpes virus infections (8.5%). Among the first step's systematic tests, tuberculin skin test was the most contributive investigation (17.1%), followed by chest X-ray (8.4%), C reactive protein and ESR (6.6% and 5.1%), complete blood count (2.2%) and VDRL (2.0%). The second step's most often contributive tests were: HLA B27 (56.3%), chest-CT (30.3%) and angiotensin converting enzyme (ACE) (16.5%). HLA B27 and ACE were significantly more contributive in the standardized group than in the open group. Immunological tests were never contributive. Among the free investigations, or among the investigations guided by clinical or paraclinical findings, the most often contributive tests were: Quantiferon® (24%), electrophoresis of serum protein (7.8%) and sacroiliac imagery

  18. [Transdisciplinary Approach for Sarcopenia. Appication of selective androgen receptor modulator to the therapy of sarcopenia].

    Science.gov (United States)

    Yanase, Toshihiko; Tanabe, Makito; Nomiyama, Takashi

    2014-10-01

    The research to develop a drug, so called selective androgen receptor modulator (SARM) , which shows beneficial androgenic action on bone and muscle, but hardly possesses the stimulatory action on prostate has been making a progress. However, no drug is available in the market at present. Most of such drugs are developed, aiming at the application to age-related muscle reduction (sarcopenia) and osteoporosis. Recently, in a clinical trial of SARM (enbosarm) administration to healthy elderly men, a promising data showing the increase of lean body mass and physical function has been reported. Future clinical applications of SARMs are expected.

  19. Relationships between 25(OH)D concentration, sarcopenia and HOMA-IR in postmenopausal Korean women.

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    Lee, J H; Kim, S; Kim, M K; Yun, B H; Cho, S; Choi, Y S; Lee, B S; Seo, S K

    2018-02-01

    Sarcopenia and insulin resistance are common co-morbidities in the elderly and are known to be associated with vitamin D deficiency. However, no previous studies have investigated interactions between all three of these factors. We aimed to investigate the relationship between 25-hydroxyvitamin D concentration, sarcopenia, and insulin resistance in postmenopausal Korean women. This study used data from the Korea National Health and Nutrition Examination Survey 2008-2011. Participants were 3744 postmenopausal Korean women. Sarcopenia was defined as appendicular skeletal muscle mass divided by body weight >1 standard deviation below the mean for women aged 20-40 years. The serum 25-hydroxyvitamin D and fasting insulin levels were measured, and insulin resistance was calculated using the formula: fasting plasma glucose (mg/dl) × fasting insulin (mIU/l)/405. We found a strong inverse association between 25-hydroxyvitamin D concentration and sarcopenia in postmenopausal Korean women (p = 0.0009). There was also a significant association between sarcopenia and insulin resistance, independent of vitamin D and obesity status (p D concentration and insulin resistance. In the subgroup analysis, insulin resistance was found to be determined by sarcopenic rather than vitamin D status. Sarcopenia was associated with both insulin resistance and 25-hydroxyvitamin D concentration in postmenopausal Korean women, regardless of obesity status. However, 25-hydroxyvitamin D concentration was not associated with insulin resistance. Sarcopenia is therefore of greater clinical importance due to its close relationship with insulin resistance.

  20. Association of Fatigue With Sarcopenia and its Elements: A Secondary Analysis of SABE-Bogotá.

    Science.gov (United States)

    Patino-Hernandez, Daniela; David-Pardo, David Gabriel; Borda, Miguel Germán; Pérez-Zepeda, Mario Ulises; Cano-Gutiérrez, Carlos

    2017-01-01

    Objective: Sarcopenia, fatigue, and depression are associated with higher mortality rates and adverse outcomes in the aging population. Understanding the association among clinical variables, mainly symptoms, is important for screening and appropriately managing these conditions. The aim of this article is to evaluate the association among sarcopenia and its elements with depression and fatigue. Method: We used cross-sectional data from 2012 SABE ( Salud, Bienestar y Envejecimiento )-Bogotá study, which included 2,000 participants of ages ≥60 years. Sarcopenia and its elements were taken as the dependent variable, while fatigue and depression were the main independent variables. We tested the association among these through multiple logistic regression models, which were fitted for each dependent variable and adjusted for confounding variables. Results: Our findings showed that gait speed was associated with fatigue (adjusted odds ratio [OR] = 1.41, 95% confidence interval [CI] = [1.05, 1.90], p = .02) as well as abnormal handgrip strength (adjusted OR = 1.40, 95% CI = [1.02, 1.93], p = .04). No other associations were significant. Conclusion: While sarcopenia and fatigue are not associated, two of the sarcopenia-defining variables are associated with fatigue; this suggests that lack of sarcopenia does not exclude undesirable outcomes related to fatigue in aging adults. Also, the lack of association between sarcopenia-defining elements and depression demonstrates that depression and fatigue are different concepts.

  1. Sarcopenia and liver transplant: The relevance of too little muscle mass

    Science.gov (United States)

    Kallwitz, Eric R

    2015-01-01

    Loss of muscle mass and function is a common occurrence in both patients with decompensated cirrhosis and those undergoing liver transplantation. Sarcopenia is associated with morbidity and mortality before and after liver transplantation. The ability of skeletal muscle mass to recover after transplant is questionable, and long term adverse events associated with persistent sarcopenia have not been well studied. Limited data is available examining mechanisms by which decreased muscle mass might develop. It is not clear which interventions might reduce the prevalence of sarcopenia and associated health burdens. However, measures to either decrease portal hypertension or improve nutrition appear to have benefit. Research on sarcopenia in the liver transplant setting is hampered by differing methodology to quantify muscle mass and varied thresholds determining the presence of sarcopenia. One area highlighted in this review is the heterogeneity used when defining sarcopenia. The health consequences, clinical course and potential pathophysiologic mechanisms of sarcopenia in the setting of cirrhosis and liver transplantation are further discussed. PMID:26494955

  2. Association of Fatigue With Sarcopenia and its Elements: A Secondary Analysis of SABE-Bogotá

    Science.gov (United States)

    Patino-Hernandez, Daniela; David-Pardo, David Gabriel; Borda, Miguel Germán; Pérez-Zepeda, Mario Ulises; Cano-Gutiérrez, Carlos

    2017-01-01

    Objective: Sarcopenia, fatigue, and depression are associated with higher mortality rates and adverse outcomes in the aging population. Understanding the association among clinical variables, mainly symptoms, is important for screening and appropriately managing these conditions. The aim of this article is to evaluate the association among sarcopenia and its elements with depression and fatigue. Method: We used cross-sectional data from 2012 SABE (Salud, Bienestar y Envejecimiento)-Bogotá study, which included 2,000 participants of ages ≥60 years. Sarcopenia and its elements were taken as the dependent variable, while fatigue and depression were the main independent variables. We tested the association among these through multiple logistic regression models, which were fitted for each dependent variable and adjusted for confounding variables. Results: Our findings showed that gait speed was associated with fatigue (adjusted odds ratio [OR] = 1.41, 95% confidence interval [CI] = [1.05, 1.90], p = .02) as well as abnormal handgrip strength (adjusted OR = 1.40, 95% CI = [1.02, 1.93], p = .04). No other associations were significant. Conclusion: While sarcopenia and fatigue are not associated, two of the sarcopenia-defining variables are associated with fatigue; this suggests that lack of sarcopenia does not exclude undesirable outcomes related to fatigue in aging adults. Also, the lack of association between sarcopenia-defining elements and depression demonstrates that depression and fatigue are different concepts. PMID:28474000

  3. Peripheral muscle abnormalities in cystic fibrosis: Etiology, clinical implications and response to therapeutic interventions.

    Science.gov (United States)

    Gruet, Mathieu; Troosters, Thierry; Verges, Samuel

    2017-09-01

    Peripheral muscle dysfunction is an important systemic consequence of cystic fibrosis (CF) with major clinical implications, such as exercise intolerance and reduced quality of life. Evidence is now accumulating that lack of physical activity is unlikely to be the sole explanation for peripheral muscle dysfunction of patients with CF. Particularly, the demonstration of CFTR expression in both murine and human skeletal muscle suggests the potential implication of intrinsic CF-related factors. By combining data from both human and animal models, this review describes CF peripheral muscle abnormalities and critically reviews the advances in understanding the impact of the underlying mechanisms. We also describe how peripheral muscles respond to intervention in this population. Methodological concerns and directions for future research are also considered. Peripheral muscle atrophy and weakness is prevalent in patients with CF and associated with reduced aerobic and anaerobic performances. Further investigations are however needed to confirm alterations in peripheral muscle endurance and fatigability. Physical inactivity is probably the major contributor of peripheral muscle abnormalities in patients with CF with mild-to-moderate phenotypes. However, the relative influence of additional factors (e.g. inflammation, metabolic abnormalities) probably increases with disease severity making specific and individualized interventions necessary in severe patients. Exercise training is the most effective intervention to address peripheral muscle dysfunction but other strategies, such as neuromuscular electrical stimulation and nutritional or hormonal supplementation may be of interest in some patients. Investigations are needed to determine whether pharmacological interventions such as CFTR modulators are effective to address this condition. To better elucidate the etiology of peripheral muscle dysfunction in CF, future studies should combine measurements at the cellular level

  4. The etiology of extensive pleural effusions with troublesome clinical course among children

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    Luís Marcelo Inaco Cirino

    Full Text Available CONTEXT: In São Paulo, pneumonia is the main infectious cause of death among children. Parapneumonic pleural effusion is a possible complication and has to be treated surgically when the patient does not respond to antibiotics. OBJECTIVE: Assessment of the etiology of complicated parapneumonic pleural effusions that needed surgical intervention. TYPE OF STUDY: Retrospective study. SETTING: University hospital of the University of São Paulo. METHOD: Analysis of 4,000 files on children hospitalized with pneumonia from November 1986 to November 1996 had shown that 115 of these children presented a total of 117 cases of pleural empyema that required surgical procedures. The children's clinical condition was assessed in relation to radiological findings and to their nutrition and immunization status. Previous antimicrobial therapy and pleural effusion bacterioscopy were also evaluated. RESULTS: Streptococcus pneumoniae was the agent found most commonly, as frequently in blood cultures as in pleural effusions. DISCUSSION: Data on vaccination coverage, birth weight and nutritional status are analyzed and compared to other publications. We observed that pleural effusion has a high potential for discomfort, and in most cases it is not a complication of the first pulmonary disease episode. Previous use of antibiotics interfered with culture positivity. The agent most frequently found was Streptococcus pneumoniae, which is in accordance with the findings from other authors. Nonetheless, the antibiotics used to treat the patients after the procedure were the same used in non-complicated pneumonias, which has led us to conclude that the worse outcome in this cases was not due to drug resistance. CONCLUSION: The bacteriological profile in our series of complicated pneumonia cases was similar to what has been described for non-complicated pneumonia cases. Future studies will be necessary to determine why these children presented a worse outcome.

  5. Uncommon and Neglected Venezuelan Viral Diseases: Etiologic Agents, Physiopathological, Clinical and Epidemiological Characteristics

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    Juan C. Gabaldon-Figueira

    2015-10-01

    Full Text Available Abstract (english Viral infectious diseases are common in Venezuela, influenza, dengue, yellow fever, HIV infection, viral Hepatitis, chikungunya fever and many others represent public health problems in the country and therefore, have been well documented. However, other rarer and even unique or lethal viral illnesses present in Venezuela are usually poorly understood or even unknown. This review described Venezuelan Hemorrhagic Fever, Venezuelan Equine Encephalitis, Hantavirus Infections and Mayaro fever, named as neglected diseases, emphasizing the etiologic agents and their most relevant pathogenic mechanisms, clinical and epidemiological characteristics. Although there is not an official report about the re-emergence of these diseases, falling living standards and unsanitary conditions, together with limited accessibility to hygiene products and medical supplies, put us on alert about the re-emergence of these neglected diseases. Resumen (español Las enfermedades infecciosas virales son comunes en Venezuela, influenza, dengue, fiebre amarilla, infección por VIH, hepatitis viral, fiebre chikungunya y muchas otras representan problemas de salud pública en el país y por lo tanto, han sido bien documentadas. Sin embargo, otras enfermedades virales más raras e incluso únicas y letales presentes en Venezuela son generalmente poco estudiadas y hasta desconocidas. Esta revisión describe alguna de estas enfermedades olvidadas tales como la fiebre hemorrágica venezolana, la encefalitis equina venezolana, las infecciones por hantavirus y la fiebre de Mayaro, haciendo hincapié en los agentes etiológicos y en sus mecanismos patogénicos más relevantes, características clínicas y epidemiológicas. Aunque no hay informes oficiales sobre el resurgimiento de estas enfermedades, la caída de los niveles de vida y las condiciones insalubres, junto con el acceso limitado a los productos de higiene y suministros médicos, debe alertar sobre el

  6. Sarcopenia e envelhecimento

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    Tatiane da Silva Pícoli

    Full Text Available INTRODUÇÃO: O envelhecimento está ligado ao grupo de alterações do desenvolvimento que ocorrem nos últimos anos de vida e está associado a alterações profundas na composição corporal. Essa perda relacionada à idade foi denominada "sarcopenia". OBJETIVOS: Avaliar a força muscular no processo de envelhecimento e identificar as variações entre os músculos do abdômen, membros superiores e inferiores. MATERIAIS E MÉTODOS: Participaram deste estudo 48 indivíduos, que foram divididos em quatro grupos de acordo com a faixa etária: (G1 11 a 18 anos, (G2 20 a 26 anos, (G3 45 a 60 anos e (G4 66-82 anos. Os instrumentos de avaliação utilizados foram: 1 esfigmomanômetro (EM - para análise da força de flexores e extensores da articulação do joelho; 2 flexão de tronco em decúbito dorsal - para avaliação da força dos músculos abdominais (graus 0 a 5; 3 dinamômetro Jamar - para avaliação da força de preensão palmar; e 4 dinamômetro Preston Pinch Gauge - para avaliação da força na pinça dos dedos (polegar e indicador. RESULTADOS: Foi observado crescente incremento da força muscular de membros inferiores e superiores com o avançar da idade (G1, G2 e G3 e significativa diminuição da força muscular em todos os segmentos avaliados no G4 quando comparado com o G3. Foi observada importante variação entre a força muscular dos segmentos avaliados e a idade. O trabalho sugere que a diminuição da força muscular torna-se evidente a partir da sexta década de vida, e que esta apresenta variações entre os músculos do abdômen, membros superiores e inferiores.

  7. Decreased tongue pressure is associated with sarcopenia and sarcopenic dysphagia in the elderly.

    Science.gov (United States)

    Maeda, Keisuke; Akagi, Junji

    2015-02-01

    The aim of this study was to clarify the association between tongue pressure and factors related to sarcopenia such as aging, activities of daily living, nutritional state, and dysphagia. One-hundred-and-four patients without a history of treatment of stroke and without a diagnosis of neurodegenerative disease (36 men and 68 women), with a mean age of 84.1 ± 5.6 years, hospitalized from May 2013 to June 2013 were included in this study. Maximum voluntary tongue pressure against the palate (MTP) was measured by a device consisting of a disposable oral balloon probe. Nutritional and anthropometric parameters such as serum albumin concentration, Mini-Nutritional Assessment short form (MNA-SF), body mass index, arm muscle area (AMA), and others and presence of sarcopenia and dysphagia were analyzed to evaluate their relationships. Correlation analysis and univariate or multivariate analysis were performed. Simple correlation analysis showed that MTP correlated with Barthel index (BI), MNA-SF, serum albumin concentration, body mass index, and AMA. Univariate and multivariate analysis showed that sarcopenia, BI, MNA-SF, and age were the independent explanatory factors for decreased MTP, and the propensity score for dysphagia, including causes of primary or secondary sarcopenia, and the presence of sarcopenia were significantly associated with the presence of dysphagia. Decreased MTP and dysphagia were related to sarcopenia or the causes of sarcopenia in the studied population. Furthermore, the clinical condition of sarcopenic dysphagia may be partially interpreted as the presence of sarcopenia and causal factors for sarcopenia.

  8. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS)

    Science.gov (United States)

    Cruz-Jentoft, Alfonso J.; Landi, Francesco; Schneider, Stéphane M.; Zúñiga, Clemente; Arai, Hidenori; Boirie, Yves; Chen, Liang-Kung; Fielding, Roger A.; Martin, Finbarr C.; Michel, Jean-Pierre; Sieber, Cornel; Stout, Jeffrey R.; Studenski, Stephanie A.; Vellas, Bruno; Woo, Jean; Zamboni, Mauro; Cederholm, Tommy

    2014-01-01

    Objective: to examine the clinical evidence reporting the prevalence of sarcopenia and the effect of nutrition and exercise interventions from studies using the consensus definition of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). Methods: PubMed and Dialog databases were searched (January 2000–October 2013) using pre-defined search terms. Prevalence studies and intervention studies investigating muscle mass plus strength or function outcome measures using the EWGSOP definition of sarcopenia, in well-defined populations of adults aged ≥50 years were selected. Results: prevalence of sarcopenia was, with regional and age-related variations, 1–29% in community-dwelling populations, 14–33% in long-term care populations and 10% in the only acute hospital-care population examined. Moderate quality evidence suggests that exercise interventions improve muscle strength and physical performance. The results of nutrition interventions are equivocal due to the low number of studies and heterogeneous study design. Essential amino acid (EAA) supplements, including ∼2.5 g of leucine, and β-hydroxy β-methylbutyric acid (HMB) supplements, show some effects in improving muscle mass and function parameters. Protein supplements have not shown consistent benefits on muscle mass and function. Conclusion: prevalence of sarcopenia is substantial in most geriatric settings. Well-designed, standardised studies evaluating exercise or nutrition interventions are needed before treatment guidelines can be developed. Physicians should screen for sarcopenia in both community and geriatric settings, with diagnosis based on muscle mass and function. Supervised resistance exercise is recommended for individuals with sarcopenia. EAA (with leucine) and HMB may improve muscle outcomes. PMID:25241753

  9. Borderlines between sarcopenia and mild late-onset muscle disease

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    Johanna ePalmio

    2014-09-01

    Full Text Available Numerous natural or disease-related alterations occur in different tissues of the body with advancing age. Sarcopenia is defined as age-related decrease of muscle mass and strength beginning in mid-adulthood and accelerating in people older than 60 years. Pathophysiology of sarcopenia involves both neural and muscle dependent mechanisms and is enhanced by multiple factors. Aged muscles show loss in fiber number, fiber atrophy and gradual increase in the number of ragged red fibers and cytochrome c oxidase-negative fibers. Generalized loss of muscle tissue and increased amount of intramuscular fat is seen on muscle imaging. However, the degree of these changes vary greatly between individuals and the distinction between normal age-related weakening of muscle strength and clinically significant muscle disease is not always obvious. Because some of the genetic myopathies can present at a very late age and be mild in severity, the correct diagnosis is easily missed. We highlight this difficult borderline zone between sarcopenia and muscle disease by two examples: LGMD1D and myotonic dystrophy type 2. Muscle MRI is a useful tool to help differentiate myopathies from sarcopenia and to reach the correct diagnosis also in the elderly.

  10. Sarcopenia is a novel poor prognostic factor in male patients with pathological Stage I non-small cell lung cancer.

    Science.gov (United States)

    Tsukioka, Takuma; Nishiyama, Noritoshi; Izumi, Nobuhiro; Mizuguchi, Shinjiro; Komatsu, Hiroaki; Okada, Satoshi; Toda, Michihito; Hara, Kantaro; Ito, Ryuichi; Shibata, Toshihiko

    2017-04-01

    Sarcopenia is the progressive loss of muscle mass and strength, and has a risk of adverse outcomes such as disability, poor quality of life and death. As prognosis depends not only on disease aggressiveness, but also on a patient's physical condition, sarcopenia can predict survival in patients with various cancer types. However, its effects on postoperative prognosis in patients with localized non-small cell lung cancers (NSCLC) have never been reported. We retrospectively investigated 215 male patients with pathological Stage I NSCLC. L3 muscle index is defined as the cross-section area of muscle at the third lumbar vertebra level, normalized for height, and is a clinical measurement of sarcopenia. We then investigated the effect of preoperative sarcopenia on their postoperative prognosis. Our 215 subjects included 30 patients with sarcopenia. Sarcopenia was significantly associated with body mass index, nutritional condition, serum CYFRA 21-1 level and pathological stage, but not with preoperative respiratory function or performance status. Frequency of postoperative complications, length of postoperative hospital stay, thoracic drainage period or causes of death were not correlated with the presence of sarcopenia. The sarcopenia group had a significantly shorter median overall survival (32 months) than the no-sarcopenia group. Sarcopenia might not affect short-term outcomes in patients with early-stage lung cancer. Sarcopenia was a predictor of poor prognosis in male patients with Stage I NSCLC. As sarcopenic patients with NSCLC patients are at risk for significantly worse outcomes, their treatments require careful planning, even for those with Stage I disease.

  11. Sarcopenia and chemotherapy-mediated toxicity.

    Science.gov (United States)

    Vega, Maria Cecília Monteiro Dela; Laviano, Alessandro; Pimentel, Gustavo Duarte

    2016-01-01

    This narrative review focuses on the role of sarcopenia and chemotherapy-induced toxicity in cancer patients. Consistent evidence shows that sarcopenia in cancer patients leads to decreased overall survival by influencing treatment discontinuation and dose reduction. Therefore, sarcopenia should be considered a robust prognostic factor of negative outcome as well as a determinant of increased healthcare costs. RESUMO Esta revisão narrativa descreve o papel da sarcopenia e a toxicidade mediada pela quimioterapia em pacientes com câncer. Diversas evidências consistentes mostram que a sarcopenia em pacientes com câncer induz à menor sobrevida global, por influenciar na interrupção do tratamento e na redução da dose. Portanto, a sarcopenia pode ser considerada um importante fator de prognóstico de desfecho negativo, além de um determinante de maiores custos em saúde.

  12. A cytogenetic study of nonpolymalformed patients with mental retardation of clinically undefined etiology: application of a high resolution banding technique.

    OpenAIRE

    Kikkawa,Kiyoshi; Narahara,Kouji; Kimoto,Hiroshi

    1989-01-01

    We performed a cytogenetic study on 140 nonpolymalformed patients with mental retardation of clinically undefined origin, using a high resolution banding technique, to determine how much chromosome abnormalities contribute to the etiology of this condition. A total of 15 patients (10.7%) were found to have autosomal or sex chromosomal abnormalities. Autosomal abnormalities included partial monosomy (5 cases), reciprocal translocation (one case), 13/14 robertsonian translocation (3 cases), unb...

  13. Populations and outcome measures used in ongoing research in sarcopenia.

    Science.gov (United States)

    Peña Ordóñez, Gloria Gabriela; Bustamante Montes, Lilia Patricia; Ramírez Duran, Ninfa; Sánchez Castellano, Carmen; Cruz-Jentoft, Alfonso J

    2017-08-01

    Sarcopenia research may be hampered by the heterogeneity of populations and outcome measures used in clinical studies. The aim of this study was to describe the inclusion/exclusion criteria and outcome measures used in ongoing research in sarcopenia. All active intervention studies registered in the World Health Organization with the keyword sarcopenia were included. Study design, type of intervention, inclusion/exclusion criteria and outcome measures were registered and classified. In April 2014, 151 studies on sarcopenia were registered in the WHO database. One hundred twenty-three were intervention studies. Most trials (94.3 %) were single centre and randomized (93.5 %), 51.2 % were double blind. Nutritional interventions (36.6 %), physical exercise (12.2 %) or both (19.5 %) were the most common interventions tested. Only 54.4 % included subjects of both genders, and 46.3 % had an upper age limit. Definition of the target populations was heterogeneous, with 57.7 % including healthy subjects and none using recent definitions of sarcopenia. Lifestyle and the degree of physical activity of subjects were not described or considered in most cases (79.7 %). Subjects with cardiovascular, neuropsychiatric or metabolic disorders and those with physical disability were usually excluded. Muscle mass and muscle strength were the primary outcome variables in 28.5 and 29.5 % of studies and physical performance in 19.5 %, but only 4.1 % used the three variables used the three of them. An additional 26.8 % used biological outcome variables. Little information and agreement existed in the way muscle and physical performance parameters were measured. We found a large heterogeneity in trial design, definition of populations and outcome measures in present research.

  14. Morgellons disease: Analysis of a population with clinically confirmed microscopic subcutaneous fibers of unknown etiology

    OpenAIRE

    Virginia R Savely; Raphael B Stricker

    2010-01-01

    Virginia R Savely1, Raphael B Stricker21TBD Medical Associates, San Francisco, CA, USA; 2International Lyme and Associated Diseases Society, Bethesda, MD, USABackground: Morgellons disease is a controversial illness in which patients complain of stinging, burning, and biting sensations under the skin. Unusual subcutaneous fibers are the unique objective finding. The etiology of Morgellons disease is unknown, and diagnostic criteria have yet to be established. Our goal was to identify prevalen...

  15. Cephalic arch stenosis in dialysis patients: review of clinical relevance, anatomy, current theories on etiology and management.

    Science.gov (United States)

    Sivananthan, Gajan; Menashe, Leo; Halin, Neil J

    2014-01-01

    Arteriovenous hemodialysis fistulas (AVFs) serve as a lifeline for many individuals with end-stage renal failure. A common cause of AVF failure is cephalic arch stenosis. Its high prevalence compounded with its resistance to treatment makes cephalic arch stenosis important to understand. Proposed etiologies include altered flow in a fistulized cephalic vein, external compression by fascia, the unique morphology of the cephalic arch, large number of valves in the cephalic outflow tract and biochemical changes that accompany renal failure. Management options are also in debate and include angioplasty, cutting balloon angioplasty, bare metal stents, stent grafts and surgical techniques including flow reduction with minimally invasive banding as well as more invasive venovenostomy with transposition surgeries for refractory cases. In this review, the evidence for the clinical relevance of cephalic arch stenosis, its etiology and management are summarized.

  16. Sarcopenia is an independent risk factor for non-alcoholic steatohepatitis and significant fibrosis.

    Science.gov (United States)

    Koo, Bo Kyung; Kim, Donghee; Joo, Sae Kyung; Kim, Jung Ho; Chang, Mee Soo; Kim, Byeong Gwan; Lee, Kook Lae; Kim, Won

    2017-01-01

    We explored whether sarcopenia is associated with the histological severity of non-alcoholic fatty liver disease (NAFLD), especially non-alcoholic steatohepatitis (NASH) and significant fibrosis. In a biopsy-proven NAFLD cohort, the appendicular skeletal muscle mass (ASM) was measured. Sarcopenia was defined as a ASM/body weight (ASM%) value beyond two standard deviations below the mean for healthy young adults. Among the entire set of 309 subjects, the prevalence of sarcopenia in subjects without NAFLD, with non-alcoholic fatty liver (NAFL), and with NASH were 8.7%, 17.9%, and 35.0%, respectively (psarcopenia than in those without (45.7% vs. 24.7%; psarcopenia was associated with NAFLD (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.58-9.25), which became insignificant after adjustment for body mass index (BMI), diabetes, and hypertension. Among NAFLD subjects, subjects with sarcopenia were more likely to have NASH than those without sarcopenia through a multivariate analysis adjusted for age, gender, BMI, hypertension, diabetes, and smoking status (OR, 2.28; 95% CI, 1.21-4.30), and this finding was obtained even after adjustment for insulin resistance (OR, 2.30; 95% CI, 1.08-4.93). Sarcopenia was also associated with significant fibrosis independent of BMI and insulin resistance (OR, 2.05; 95% CI, 1.01-4.16). In this large biopsy-proven NAFLD cohort, sarcopenia was significantly associated with NASH and significant fibrosis. Low muscle mass was found to be associated with histological severity in non-alcoholic fatty liver disease, and sarcopenia was significantly associated with non-alcoholic steatohepatitis and significant fibrosis, independent of obesity, inflammation, and insulin resistance. Clinical trial number: NCT 02206841. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  17. Etiology and clinical profile of childhood optic nerve atrophy at a tertiary eye care center in South India

    Directory of Open Access Journals (Sweden)

    Supriya Chinta

    2014-01-01

    Full Text Available Background: Optic nerve atrophy is an important ophthalmological sign that may be associated with serious systemic conditions having a significant bearing on the overall morbidity of the child. Studies specific to etiology of childhood optic atrophy are scarce, this being the first such study from India to the best of our knowledge. Aim: The aim was to analyze the clinical features and etiology of diagnosed cases of optic nerve atrophy in children <16 years of age. Materials and Methods: Retrospective review of records of children diagnosed with optic nerve atrophy between the ages of 0 and 16 years from 2006 to 2011. Results: A total of 324 children (583 eyes were identified. Among these 160 (49% presented with defective vision, 71 (22% with strabismus, 18 (6% with only nystagmus. Rest had a combination of two or three of the above symptoms. Sixty-five patients (20% had a unilateral affection. Hypoxic ischemic encephalopathy seen in 133 patients (41% was the most frequent cause of childhood optic atrophy, followed by idiopathic in 98 (30%, hydrocephalus in 24 (7%, compressive etiology in 18 (5%, infective in 19 (6%, congenital in 6 (2%, inflammatory in 5 (2% patients, respectively. Conclusion: Hypoxic ischemic encephalopathy appears to be the most common cause of optic atrophy in children in this series. The most common presenting complaint was defective vision.

  18. Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer

    Science.gov (United States)

    Zhuang, Cheng-Le; Huang, Dong-Dong; Pang, Wen-Yang; Zhou, Chong-Jun; Wang, Su-Lin; Lou, Neng; Ma, Liang-Liang; Yu, Zhen; Shen, Xian

    2016-01-01

    Abstract Currently, the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated. Moreover, the association between sarcopenia and postoperative complications remains controversial. This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer. From December 2008 to April 2013, the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospectively. Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis. Skeletal muscle mass was determined by abdominal (computed tomography) CT scan, and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification. Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed. A total of 937 patients were included in this study, and 389 (41.5%) patients were sarcopenic based on the diagnostic cut-off values (34.9 cm2/m2 for women and 40.8 cm2/m2 for men). Sarcopenia was an independent risk factor for severe postoperative complications (OR = 3.010, P sarcopenia did not show significant association with operative mortality. Moreover, sarcopenia was an independent predictor for poorer overall survival (HR = 1.653, P sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer. Moreover, sarcopenia is independently associated with overall and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. PMID:27043677

  19. Sarcopenia and sarcopenic leg as potential risk factors for acute osteoporotic vertebral fracture among older women.

    Science.gov (United States)

    Hida, Tetsuro; Shimokata, Hiroshi; Sakai, Yoshihito; Ito, Sadayuki; Matsui, Yasumoto; Takemura, Marie; Kasai, Takehiro; Ishiguro, Naoki; Harada, Atsushi

    2016-11-01

    Sarcopenia-related falls and fractures among women with osteoporosis are becoming an emerging problem because of rapid aging worldwide. We aimed to investigate the association between sarcopenia, given by the muscle mass of the arms and legs, and osteoporotic vertebral fracture (OVF) among female patients. This cross-sectional study examined 216 women with fresh OVF (OVF group) diagnosed by magnetic resonance imaging and 1,608 women from an outpatient clinic who did not have a OVF [non-fracture (NF) group]. We performed whole-body dual-energy X-ray absorptiometry to analyze body composition, including skeletal muscle mass index (SMI; lean mass/height 2 ) and bone mineral density (BMD). We used stepwise logistic regression analysis to determine the risk factors associated with OVF. After controlling for age, the OVF group showed lower appendicular SMI (5.62 vs. 5.97 kg/m 2 , P sarcopenia (42.3 vs. 25.9 %, P sarcopenia were independent risk factors for acute OVF in multivariate analysis (odds ratio = 1.4, P = 0.002; odds ratio = 1.96, P sarcopenia and lower leg muscle mass among patients with acute OVF compared with patients who did not have an OVF. These results suggest that sarcopenia may be a risk factor for OVF.

  20. Sarcopenia and sarcopenic obesity in patients with complex abdominal wall hernias.

    Science.gov (United States)

    Rinaldi, John M; Geletzke, Abby K; Phillips, Brett E; Miller, Jamie; Dykes, Thomas M; Soybel, David I

    2016-11-01

    Chronic muscle wasting, or sarcopenia, has been associated with poor-health outcomes after major surgical procedures. Here, we explore the utility of CT-generated determinations of sarcopenia as markers of risk in patients undergoing evaluation for complex ventral hernia repair. In 148 successive patients being evaluated for complex ventral hernia repair, CT scans were analyzed retrospectively for attributes of the hernia and indices of core-muscle mass, correlating them with preoperative clinical/laboratory profiles and outcomes in 82 patients who had undergone surgery. Prevalence of sarcopenia, and sarcopenia corrected for obesity, was 26% and 20% respectively. Sarcopenia was associated with age, some laboratory indicators, and increased hospital length of stay but not with a higher likelihood of surgical site occurrence. Obesity may obscure the value of sarcopenia as a marker of metabolic disturbance and postoperative outcome. Image-based measurements of core-muscle mass should be used with caution as predictors of risk in similar surgical populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies.

    Science.gov (United States)

    Murphy, Meghan K; MacBarb, Regina F; Wong, Mark E; Athanasiou, Kyriacos A

    2013-01-01

    Temporomandibular disorders (TMD) are a class of degenerative musculoskeletal conditions associated with morphologic and functional deformities that affect up to 25% of the population, but their etiology and progression are poorly understood and, as a result, treatment options are limited. In up to 70% of cases, TMD are accompanied by malpositioning of the temporomandibular joint (TMJ) disc, termed "internal derangement." Although the onset is not well characterized, correlations between internal derangement and osteoarthritic change have been identified. Because of the complex and unique nature of each TMD case, diagnosis requires patient-specific analysis accompanied by various diagnostic modalities. Likewise, treatment requires customized plans to address the specific characteristics of each patient's disease. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic approaches that can restore joint functionality while responding to changes in the joint have become a necessity. One such approach, tissue engineering, which may be capable of integration and adaptation in the TMJ, carries significant potential for the development of repair and replacement tissues. The following review presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc. An analysis of native tissue characterization to assist clinicians in identifying tissue engineering objectives and validation metrics for restoring healthy and functional structures of the TMJ is followed by a discussion of current trends in tissue engineering.

  2. Temporomandibular Joint Disorders: A Review of Etiology, Clinical Management, and Tissue Engineering Strategies

    Science.gov (United States)

    Murphy, Meghan K.; MacBarb, Regina F.; Wong, Mark E.; Athanasiou, Kyriacos A.

    2015-01-01

    Epidemiology reports state temporomandibular joint disorders (TMD) affect up to 25% of the population, yet their etiology and progression are poorly understood. As a result, treatment options are limited and fail to meet the long-term demands of the relatively young patient population. TMD are a class of degenerative musculoskeletal conditions associated with morphological and functional deformities. In up to 70% of cases, TMD are accompanied by malpositioning of the TMJ disc, termed “internal derangement.” Though onset is not well characterized, correlations between internal derangement and osteoarthritic change have been identified. Due to the complex and unique nature of each TMD case, diagnosis requires patient-specific analysis accompanied by various diagnostic modalities. Likewise, treatment requires customized plans to address the specific characteristics of each patient’s disease. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic approaches capable of restoring joint functionality while responding to changes in the joint have become a necessity. Capable of integration and adaptation in the TMJ, one such approach, tissue engineering, carries significant potential in the development of repair and replacement tissues. The following review presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc. Preceding the current trends in tissue engineering is an analysis of native tissue characterization, toward identifying tissue engineering objectives and validation metrics for restoring healthy and functional structures of the TMJ. PMID:24278954

  3. Modern going near setting of medical physical culture taking into account etiology, type, form, degree and clinical displays of scoliotic illness for children

    Directory of Open Access Journals (Sweden)

    Olga Peshkova

    2015-12-01

    Full Text Available Authors in the article are consider the basic going near setting of medical physical culture at scoliostic illness of І–ІІ degree for children taking into account a type, form, etiology, degree and clinical displays. Purpose: to describe the modern going near setting of medical physical culture taking into account etiology, type, form, degree and clinical displays of scoliostic illness for children. Material and Methods: analysis of the modern special literature on issue of physical rehabilitation of children at scoliostic illness; analysis of medical cards. Results: description of scoliosis is given on an etiologic sign, form, type, degrees and clinical displays. The features of methods of medical physical culture are presented taking into account the afore-named signs of scoliotic illness. Conclusions: setting of facilities and forms of medical physical culture at scoliotic illness depends on etiology, form and type of scoliosis, degree and clinical displays of disease

  4. Clinical and radiographic predictors of the etiology of computed tomography-diagnosed intrathoracic lymphadenopathy in HIV-infected patients.

    Science.gov (United States)

    Jasmer, Robert M; Gotway, Michael B; Creasman, Jennifer M; Webb, W Richard; Edinburgh, Keith J; Huang, Laurence

    2002-11-01

    In HIV-infected patients with intrathoracic lymphadenopathy, it is not known whether clinical and radiographic findings are useful in predicting a specific diagnosis. We determined the etiology and predictors of the etiology of computed tomography (CT)-diagnosed intrathoracic lymphadenopathy in HIV-infected patients evaluated from June 1993 through April 1999. Multivariate analyses were performed to determine clinical and radiographic predictors of the three most common diagnoses. Of 318 patients, 110 (35%) had lymphadenopathy on chest CT. Among these 110 patients, tuberculosis/nontuberculous mycobacterial disease ( = 31), bacterial pneumonia ( = 26), and lymphoma ( = 21) were the most common diagnoses. Multivariate analysis identified cough and necrosis of lymph nodes on chest CT as independent predictors of tuberculosis/nontuberculous mycobacterial disease. African-American race, symptoms for 1 to 7 days, dyspnea, and presence of airways disease on chest CT were independent predictors of bacterial pneumonia; symptoms for >7 days, absence of cough, and absence of pulmonary nodules on CT independently predicted lymphoma. Intrathoracic lymphadenopathy is a frequent chest CT finding in HIV-infected patients. Opportunistic infections and lymphoma are the most common causes, and specific clinical and radiographic features can suggest these particular diagnoses.

  5. Sarcopenia in patients with chronic kidney disease not yet on dialysis: Analysis of the prevalence and associated factors

    Science.gov (United States)

    Oliveira, Dílmerson; Barbosa, Sérgio Ribeiro; Corrêa, José Otávio do Amaral; Colugnati, Fernando Antônio Basile; Mansur, Henrique Novais; Fernandes, Natália Maria da Silva; Bastos, Marcus Gomes

    2017-01-01

    Introduction Sarcopenia is a chronic condition that is associated with aging and characterized by a reduction of muscle mass, strength, and function. Sarcopenia is prevalent in patients with chronic kidney disease (CKD) and associated with increased morbidity and mortality, as well as cardiovascular complications. Objectives To investigate the prevalence of sarcopenia in patients with CKD not yet on dialysis and its correlation with clinical and laboratory variables and inflammatory markers. Methods A total of 100 patients of both sexes aged over 18 were evaluated. Sarcopenia was defined using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) and of the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project. Sociodemographic and clinical data, activities of daily living, functional capacity, and physical activity were also evaluated. Inflammation was assessed by the serum levels of high-sensitivity C-reactive protein (hsCRP) and interleukin (IL) 4 and 6. Results The prevalence of sarcopenia was 11.9% and 28.7% using the EWGSOP and FNIH criteria, respectively. Sarcopenia was more prevalent in the more advanced stages of CKD (34.5% in stages 2 and 3A; and 65.5% in stages 3B, 4, and 5) and associated with worse performance in activities of daily living (p = 0.049), lower walking speeds (p sarcopenia had lower functional capacity (p = 0.012) and higher prevalence of physical inactivity (p = 0.041) compared with patients without sarcopenia. After adjustment for confounding variables, sarcopenia was still significantly correlated with walking speed (p = 0.004) and BMI (p = 0.002). HsCRP levels were inversely correlated with appendicular lean mass adjusted for BMI (p = 0.007) and were also positively associated with BMI (p = 0.001). IL4 levels were positively correlated with walking speed (p = 0.007) and lean mass in the lower limbs (p = 0.022). Conclusions Sarcopenia is common in patients with CKD, particularly in the

  6. The clinical impact of the detection of potential etiologic pathogens of community-acquired pneumonia.

    Science.gov (United States)

    Gelfer, Gita; Leggett, James; Myers, Jillian; Wang, Luan; Gilbert, David N

    2015-12-01

    The etiology of community-acquired pneumonia (CAP) is determined in less than half of the patients based on cultures of sputum and blood plus testing urine for the antigens of Streptococcus pneumoniae and Legionella pneumophila. This study added nasal polymerase chain reaction (PCR) probes for S. pneumoniae, Staphylococcus aureus, and respiratory viruses. Serum procalcitonin (PCT) levels were measured. Pathogens were identified in 78% of the patients. For detection of viruses, patients were randomized to either a 5-virus laboratory-generated PCR bundle or the 17-virus FilmArray PCR platform. The FilmArray PCR platform detected more viruses than the laboratory-generated bundle and did so in less than 2 hours. There were fewer days of antibiotic therapy, P = 0.003, in CAP patients with viral infections and a low serum PCT levels. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Etiology of Genital Ulcer Disease in Male Patients Attending a Sexually Transmitted Diseases Clinic: First Assessment in Cuba.

    Science.gov (United States)

    Noda, Angel A; Blanco, Orestes; Correa, Consuelo; Pérez, Lissette; Kourí, Vivian; Rodríguez, Islay

    2016-08-01

    Sexually transmitted diseases (STDs) and in particular genital ulcer disease (GUD) have a major impact on morbidity and mortality in developing countries. The World Health Organization recommends the use of syndromic guidelines for the treatment of sexually transmitted infections (STIs) in resource-constrained countries. Surveillance of autochthonous etiologies provides epidemiological information contributing to the prevention and treatment of STIs. We investigated the etiology and factors associated with GUD among male patients attending a STD clinic in Havana, Cuba. Swabs from genital ulcers of 113 male patients, collected from May 2012 to June 2015, were analyzed using PCR for herpes simplex virus types 1 and 2, Treponema pallidum, Haemophilus ducreyi, and Chlamydia trachomatis. We also investigated the clinical and epidemiological characteristics associated with the presence of these pathogens in GUD. At least one of the pathogens was detected in 70% of patients. The occurrence of the pathogens was herpes simplex virus type 2 (HSV-2) (51.3%), T. pallidum (29.2%), and C. trachomatis (1.8%). Co-infections occurred as follows: T. pallidum-HSV-2 (10.6%), C. trachomatis-HSV-2 (0.9%) and C. trachomatis-T. pallidum (0.9%). Herpes simplex virus type 1 and H. ducreyi were not detected. Ages 15 to 40 years, HIV-positive serostatus, and no condom use were significant risk factors for the presence of HSV-2 in genital ulcers. Our preliminary results highlight the predominance of HSV-2 and T. pallidum as the leading GUD etiologies in the study population and identified risk factors associated with HSV-2. This information should help to inform guidelines for better management of GUD in Havana, Cuba.

  8. Searching for a relevant definition of sarcopenia: results from the cross-sectional EPIDOS study

    Science.gov (United States)

    Dupuy, Charlotte; Lauwers-Cances, Valérie; Guyonnet, Sophie; Gentil, Catherine; Abellan Van Kan, Gabor; Beauchet, Olivier; Schott, Anne-Marie; Vellas, Bruno; Rolland, Yves

    2015-01-01

    Background The diversity of definitions proposed for sarcopenia has been rarely tested in the same population, and so far, their clinical utilities for predicting physical difficulties could not be clearly understood. Our objective is to report the prevalence of sarcopenia and the characteristics of sarcopenic community-dwelling older women according to the different definitions of sarcopenia currently proposed. We also assessed these definitions for their incremental predictive value over currently standard predictors for some self-reported difficulties in physical function and knee extension strength. Methods Cross-sectional analysis included data from 3025 non-disabled women aged 75 years or older without previous history of hip fracture from the inclusion visit of the EPIDémiologie de l'OStéoporose study. A total body composition evaluation was available for 2725 women. Sarcopenia was defined using six different definitions of sarcopenia based on different muscle mass, gait speed, and grip strength cut-offs. Self-reported difficulties in physical function and knee extension strength were collected. Logistic regression and multiple linear regression models were built for each physical dysfunction, and the predictive capacity of sarcopenia (one model for each definition) was studied using the C-statistic, the net reclassification index, or adjusted R2. Results The estimated prevalence of sarcopenia ranged from 3.3–20.0%. Only 85 participants (3.1%) were identified having sarcopenia according to all definitions. All definitions were, to some degree, associated with self-reported difficulties in physical function and knee extension strength, but none improved the predictive ability of the self-reported difficulties in physical function. Conversely, all definitions accounted for a small but significant amount of explained variation for predicting knee extension strength. Conclusions Prevalence of sarcopenia varies widely depending on the definition adopted

  9. [Rehabilitation prognosis of aphasias of various etiologies with reference to clinical, neurolinguistic and computerized tomography findings].

    Science.gov (United States)

    Mezger, G; Busch, G

    1988-05-01

    To obtain further insights into the rehabilitation outlook in different baseline conditions, a comparison was made of data and treatment outcomes in 92 patients having aphasias of different etiology and disease duration. Rating as "improved" was contingent on significant changes in at least 2 subtests of the AAT (Aachener Aphasietest), which is a fairly stringent requirement. This criterion was met by some 35% of the patients overall, independent of their age; the percentage increased to 45% in case of treatment onset during the first year, while in later onset, significant improvement was achieved in 15% only. Aphasic syndromes secondary to hemorrhage, trauma, tumors, or infections, usually are less severe than the predominant classical syndromes, i.e. Global, Broca and Wernicke aphasia, caused by ischemic stroke. CT lesion size did not yield any definite information. Minor improvements below the required significance levels, and, above all, gains in communication performance, i.e. further consolidation, could be achieved by appropriate management even after the crucial initial year, which, however, does not imply any fundamental changes in the rehabilitation prognosis as such.

  10. The burden of poofs: criminal pathology, clinical scrutiny, and homosexual etiology in queer cinema.

    Science.gov (United States)

    Wahlert, Lance

    2013-06-01

    Given the resurgence of scientific studies on the etiology of homosexuality in the wake of the AIDS epidemic, this article considers the effects these studies had on contemporaneous queer filmmakers. By using the subject of criminality as a way to talk about homosexual causality, queer films of the 1990s illustrate that contemporary scientific studies on homosexuality were historically and politically situated in relation to cultural anxieties about other forms of deviance. This article focuses on films that dissect the hetero-normative tendency to amalgamate forms of deviance in order to distinguish between the diseased and the healthy. Such products of New Queer Cinema highlight this amalgamation of criminality and homosexuality in order to challenge demands by the LGBT community of the 1980s and 1990s for "more positive images" in film. This article argues that queer filmmakers have manipulated the image of the queer criminal to usurp the medical tendency to biologize and pathologize the notion of queer transgression. In such a way, queer films that enthusiastically dramatize the queer outlaw perpetuate myths about homosexuality in order to dissect and discredit them.

  11. ACUTE POISONING WITH BENZODIAZEPINES AND OTHER HYPNOTICS: ETIOLOGIC CAUSE, SEX/AGE DISTRIBUTION AND CLINICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Petko Marinov

    2016-11-01

    Full Text Available Purpose: Poisoning with drugs occupies a leading position among the causes of acute intoxications. Etiological distribution of medicated poisoning in different countries, even if they are adjacent, is different. In the most studies it was reported that the highest incidence of poisoning is with benzodiazepines or other psychoactive drugs. A retrospective analysis of acute poisoning with benzodiazepines and other hypnotic drugs in the Varna region for 25 years period – from 1991 to 2015 was carried out. Material and Methods: The number of patients who received hospital treatment after poisoning with benzodiazepines is 1741, and those with other hypnotics is 293, representing respectively 26.37% and 4.44% of all drug intoxications. Results: The share of poisoning with benzodiazepines and hypnotics compared to all acute intoxications is 11.66%. They are more common in women – 1566 (77%. Men are 468 (23%, the ratio of men to women was 3.34:1. The largest number of intoxications is in the age group up to 24 years - 1123 (55.2%, and only 4.1% of patients over 60 years. Intentional suicide attempts are 1896 (93.2%. Death is registered in 8 (0.4% patients.

  12. Sarcopenia and malnutrition in acutely ill hospitalized elderly: Prevalence and outcomes.

    Science.gov (United States)

    Cerri, Anna Paola; Bellelli, Giuseppe; Mazzone, Andrea; Pittella, Francesca; Landi, Francesco; Zambon, Antonella; Annoni, Giorgio

    2015-08-01

    Data about the prevalence of sarcopenia among hospitalized patients is lacking and it is unclear whether the diagnostic criteria commonly used in community-dwellers is applicable in acutely ill subjects. The aims of this report are: (i) to assess the prevalence of sarcopenia among hospitalized patients; (ii) to assess whether the European Working Group on Sarcopenia in Older People (EWGSOP) criteria are applicable in an acute care setting; and (iii) to assess the mortality rate at 3 months. 103 patients admitted to the Acute Geriatric Clinic were enrolled. Inclusion criteria were: age ≥65 years and malnutrition or risk of malnutrition, according to the Mini Nutritional Assessment Short Form. Sarcopenia was diagnosed using the EWGSOP criteria by means of bioimpedance analysis, handgrip strength and gait speed, within 72 h of admission. Information on deaths was obtained by telephone interview at 3 months following discharge. Sarcopenia was diagnosed in 22 patients (21.4%). Twenty-three patients (22.3%) were not able to perform the gait speed and/or the handgrip strength because bedridden or requiring intensive treatments. In this group, a definite diagnosis of sarcopenia was not possible, lacking at least one EWGSOP criteria. Eleven (10.7%) patients died within the 3 months post-discharge period. Kaplan-Meier survival curves showed that sarcopenic patients died significantly more frequently than others (log-rank p ≤ 0.001). In a population of hospitalized elderly malnourished or at risk of malnutrition, sarcopenia is highly prevalent and associated with an increased risk to die in the short-term. Furthermore, the EWGSOP criteria cannot be satisfactorily applied in a relevant proportion of patients. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  13. Etiology of Spastic Diplegia

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    J Gordon Millichap

    2006-05-01

    Full Text Available The clinical and etiologic profile of spastic diplegia was studied in a retrospective chart review of 54 patients diagnosed during a 12-year period at Montreal Children’s Hospital, Quebec, Canada.

  14. Etiology and body area of injuries in young female dancers presenting to sports medicine clinic: A comparison by age group.

    Science.gov (United States)

    Stracciolini, Andrea; Yin, Amy X; Sugimoto, Dai

    2015-11-01

    Improving knowledge regarding injuries sustained by pediatric dancers is important in order to better understand injury risk. The aim of this study is to analyze dance injury etiology and body area by age in a cohort of young female dancers presenting to a pediatric sports/dance medicine clinic. The cross-sectional epidemiological study of a 5% probability sample of dancers evaluated between 1/1/2000 and 12/31/2009 with a musculoskeletal injury requiring physician evaluation. A total of 2,133 charts were reviewed from which 171 female dancers 8-17 years old (mean age 14.7 years) were identified. Data were stratified by age, injury body area, type, and etiology. Fisher's exact test was used to determine statistical significance. Injuries sustained by dancers in the younger age category (hip/spine/upper extremity (6.7%). In comparison, dancers in the older age group (≥ 12 years) had a large proportion of injuries to the foot-ankle/lower leg/knee (67.3%) as well, but had a notably larger fraction of injuries to the thigh-hip/spine/upper extremity (32.7%; p = 0.04). Approximately two-thirds of the injuries sustained in the younger age group (injuries in the older age group (≥ 12 years) were roughly half bony and half soft tissue (51.3% and 48.7%, respectively; p = 0.29). Most injuries were overuse in etiology for both younger and older age groups (86.7% and 82.1%, respectively; p = 1.00). Through puberty, there was a decline in the injuries to the foot-ankle/lower leg/knee. Conversely, there was an increase in the thigh/hip-pelvis/spine/upper extremity injuries through growth. Injuries to young female dancers in this study cohort were mostly categorized as overuse in etiology, and differed by the age group and the body area. Increased information regarding dance injuries can help guide future injury prevention efforts.

  15. Inflammatory choroidal neovascularization in Indian eyes: Etiology, clinical features, and outcomes to anti-vascular endothelial growth factor

    Directory of Open Access Journals (Sweden)

    Rupak Roy

    2017-01-01

    Full Text Available Background and Objectives: The aim was to study the clinical profile of inflammatory choroidal neovascularization (CNV and its treatment response to intravitreal bevacizumab or ranibizumab on pro re nata (PRN basis in Indian eyes. Materials and Methods: This was a retrospective case series of consecutive patients with inflammatory CNV treated with anti-vascular endothelial growth factor (anti-VEGF in a tertiary eye care center in Eastern India between 2009 and 2014. The data about clinical features, investigations, treatment, and outcomes were obtained from the medical records. We included patients with active inflammatory CNV but with no evidence of inflammation and were treated with anti-VEGF alone, with a minimum follow-up of 6 months. Main outcome measures were a clinical and etiological profile of inflammatory CNV in Indian eyes and their response to treatment. Results: Thirty eyes of 28 patients were included in the study. The mean follow-up was 17.93 ± 14.28 months (range 6–53 months. In our cohort, seven (23.33% eyes had inflammatory CNV secondary to idiopathic choroiditis, four (13.33% eyes had toxoplasmosis, idiopathic panuveitis, and Vogt Koyanaki Harada's disease each. Three (10% eyes had geographic helicoid peripapillary choroidopathy and tubercular choroiditis each. Remaining two (6.66% eyes had punctate inner choroidopathy, while multifocal choroiditis with panuveitis, resolved endogenous endophthalmitis and Hansen's diseases were the etiology in one (3.33% case of inflammatory CNV each. The mean number of injections were 2.76 (range 1–5. Among thirty eyes of inflammatory CNV, 16 (53.3% eyes showed improvement, eight (26.6% maintained the same vision, whereas six (20% eyes showed deterioration of vision. Interpretations and Conclusion: Idiopathic choroiditis was the most common cause of inflammatory CNV and PRN intravitreal anti-VEGF (ranibizumab or bevacizumab appears to have effective treatment response.

  16. Inflammatory choroidal neovascularization in Indian eyes: Etiology, clinical features, and outcomes to anti-vascular endothelial growth factor

    Science.gov (United States)

    Roy, Rupak; Saurabh, Kumar; Bansal, Aditya; Kumar, Amitabh; Majumdar, Anindya Kishore; Paul, Swakshyar Saumya

    2017-01-01

    Background and Objectives: The aim was to study the clinical profile of inflammatory choroidal neovascularization (CNV) and its treatment response to intravitreal bevacizumab or ranibizumab on pro re nata (PRN) basis in Indian eyes. Materials and Methods: This was a retrospective case series of consecutive patients with inflammatory CNV treated with anti-vascular endothelial growth factor (anti-VEGF) in a tertiary eye care center in Eastern India between 2009 and 2014. The data about clinical features, investigations, treatment, and outcomes were obtained from the medical records. We included patients with active inflammatory CNV but with no evidence of inflammation and were treated with anti-VEGF alone, with a minimum follow-up of 6 months. Main outcome measures were a clinical and etiological profile of inflammatory CNV in Indian eyes and their response to treatment. Results: Thirty eyes of 28 patients were included in the study. The mean follow-up was 17.93 ± 14.28 months (range 6–53 months). In our cohort, seven (23.33%) eyes had inflammatory CNV secondary to idiopathic choroiditis, four (13.33%) eyes had toxoplasmosis, idiopathic panuveitis, and Vogt Koyanaki Harada's disease each. Three (10%) eyes had geographic helicoid peripapillary choroidopathy and tubercular choroiditis each. Remaining two (6.66%) eyes had punctate inner choroidopathy, while multifocal choroiditis with panuveitis, resolved endogenous endophthalmitis and Hansen's diseases were the etiology in one (3.33%) case of inflammatory CNV each. The mean number of injections were 2.76 (range 1–5). Among thirty eyes of inflammatory CNV, 16 (53.3%) eyes showed improvement, eight (26.6%) maintained the same vision, whereas six (20%) eyes showed deterioration of vision. Interpretations and Conclusion: Idiopathic choroiditis was the most common cause of inflammatory CNV and PRN intravitreal anti-VEGF (ranibizumab or bevacizumab) appears to have effective treatment response. PMID:28513493

  17. Budd–Chiari Syndrome in Young Chinese: Clinical Characteristics, Etiology and Outcome of Recanalization from a Single Center

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    Zhou, Wen-Jie, E-mail: 776260859@qq.com; Cui, Yan-Feng, E-mail: cuiyanfeng366@126.com; Zu, Mao-Heng, E-mail: cjr.zumaoheng@vip.163.com; Zhang, Qing-Qiao, E-mail: 1427286069@qq.com; Xu, Hao, E-mail: xuhao585@yeah.net [Affiliated Hospital of Xuzhou Medical College, Department of Interventional Radiology (China)

    2016-04-15

    PurposeWe aimed to characterize the clinical profile, etiology, and outcomes of young Chinese patients with Budd–Chiari syndrome treated with recanalization.MethodsA total of 35 consecutive young patients (≤25 years of age) with primary Budd–Chiari syndrome treated with recanalization at our center were enrolled in this study between March 2011 and December 2014. Data on baseline information, etiology tests, therapeutic recanalization strategies, and follow-up were collected.ResultsThe most common clinical feature was ascites, present in 33 cases (94 %). Hepatic vein obstruction was present in 60 % (21/35) of patients, inferior vena cava obstruction in 3 % (1/35), and combined obstruction in 37 % (13/35). The most common risk factor for thrombosis was hyperhomocysteinemia (14/35, 40 %). Recanalization was technically successful in 32 of 35 patients (91 %), and clinically successful in 28 of these 32 patients (88 %). The cumulative 1- and 3-year primary patency rates were 75.2 and 54.3 %, respectively. The cumulative 1- and 3-year secondary patency rates were 89.3 and 89.3 %, respectively. The cumulative 1- and 3-year survival rates were 96.9 and 93.8 %, respectively.ConclusionIn this study, the most common type of lesion was hepatic vein obstruction, the most common thrombotic risk factor was hyperhomocysteinemia, and recanalization resulted in good mid-term outcomes in young Chinese patients with Budd–Chiari syndrome.

  18. Factors associated with sarcopenia in institutionalized elderly.

    Science.gov (United States)

    Mesquita, Alice Ferreira; Silva, Emanuelle Cruz da; Eickemberg, Michaela; Roriz, Anna Karla Carneiro; Barreto-Medeiros, Jairza Maria; Ramos, Lílian Barbosa

    2017-03-30

    The sarcopenia is a negative aspect for the health of the elderly, increased the risk for disease and mortality. Additionally can contributes greatly to functional reducing capacity and quality of life. To identify the prevalence and factors associated with sarcopenia in institutionalized elderly. This is a cross-sectional study, conducted with 216 elderly people, aged ≥ 60 years, of both sexes, residents in long-term care facilities in Salvador-Bahia, Brazil. To identify sarcopenia was used the skeletal muscle Index. Covariates were considered: gender, age, time of institutionalization, type of institution, body mass index and functional capacity. The Association between sarcopenia and covariates was evaluated using the Poisson regression model with robust variance. The prevalence of sarcopenia in the elderly was 72.2% and this condition was associated with male sex (PR = 1,33; CI 95% = 1,081,65), thinness (PR = 1,29; CI 95% = 1,16-1,43) and obesity (PR = 0,37; CI 95% = 0,23-0,61). The prevalence of sarcopenia was high among the elderly living in long-term institutions, especially among men. Elderly with thinness showed greater impairment of muscle reserves, while the state of obesity was protective.

  19. Relationship Between Sarcopenia and Frailty in the Toledo Study of Healthy Aging: A Population Based Cross-Sectional Study.

    Science.gov (United States)

    Davies, B; García, F; Ara, I; Artalejo, F Rodríguez; Rodriguez-Mañas, L; Walter, S

    2017-10-24

    .4), and sFNIH (OR = 6.63, 95% CI =3.5, 12.53). Frailty and sarcopenia are distinct but related conditions. Sarcopenia is not a useful clinical biomarker of frailty, but its absence might be useful to exclude frailty. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  20. Dislocation of preformed antibiotic-loaded cement spacers (Spacer-G): etiological factors and clinical prognosis.

    Science.gov (United States)

    Bori, Guillem; García-Oltra, Ester; Soriano, Alex; Rios, José; Gallart, Xavier; Garcia, Sebastian

    2014-05-01

    This study assesses the factors associated with the dislocation of the Spacer-G and its clinical prognosis. Seventy-four spacers were reviewed. Acetabular bone defects, proximal femoral cementation of the spacer and its relationship to the size of the head spacer were not associated with dislocation. The only variable that it was possible to associate with dislocation was when the previous stem, prior to the spacer placement, was a cemented stem. In patients who experienced a dislocation, infection was not cured during the interim period more frequently than patients who had not experienced a dislocation (P = 0.001) and the final clinical hip evaluation was also worse (P dislocation and its consequences. © 2014.

  1. Pancreatic Cancer: Review of Etiology, Clinical Features, Diagnostic Procedures, Treatment and Mesothelin Role

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    Darmawan, Guntur; Simadibrata, Marcellus

    2011-01-01

    Pancreatic cancer is one with high mortality cancer in the world. Ninety percent of pancreatic cancer is pancreatic adenocarcinoma. Various factors is associated with an increased risk of pancreatic cancer including age, sex, race, genetic, history of chronic pancreatitis, diabetes mellitus, gallstone, obesity, Helicobacter pylori infection, smoking, diet, and polution exposure. A lot of cases were diagnosed in late stadium due to non-specific early clinical symptoms, and also, until now, the...

  2. [The etiological and clinical characteristics of hospitalized children with hand, foot and mouth disease in Beijing in 2013].

    Science.gov (United States)

    Gu, Hongyan; Liu, Zhida; Zhang, Ling; Chen, Yong; Yang, Siyuan; Zhang, Weiyan; Li, Xingwang

    2015-06-01

    To investigate the etiology of hand, foot and mouth disease (HFMD) in Beijing during 2013, and study the clinical characteristics of HFMD caused by the main serotypes of enterovirus in the study. Clinical data and 128 stool samples were collected from 128 hospitalized children with HFMD in Beijing Ditan Hospital during 2013. One step RT-PCR method was used for enterovirus genotyping to investigate the etiology of HFMD. Clinical characteristics of HFMD caused by the main serotypes of enterovirus were analyzed. And VP1 segments of the main virus were amplified to construct phylogenetic tree for the phylogenetic analysis. A total of 128 hospitalized children with HFMD were included. HFMD was more likely developed in children under 2 years of age (81.6%, 102/125); 11 different enteroviruses were genotyped, with a total enterovirus positive rate of 76.6% (98/128); the positive rate of coxsackievirus A6 (CA6), 43.0% ( 55/128), was the highest, followed by enterovirus 71 (EV71), accounting for 14.8% (19/128). HFMD caused by CA6 was atypical, the rashes of which involved the perioral, trunk, limbs, face and neck (47%, 26/55), besides the common parts. Of the 55 cases caused by CA6, 6 children had clinical manifestations of nervous system involvement, one of whom even displayed type 2 respiratory failure. Mental status change more likely to occur in EV71-infected children than in CA6-infected ones (42% (8/19) vs. 11% (6/55) (χ(2)=7.041, P=0.008)); 13 children displayed onychomadesis, including 12 CA6 cases (23%, 12/53) and 1 CA10 cases (17%, 1/6), in the convalescence of hand, foot and mouth disease, and the correlation between onychomadesis and CA6 infection was significant (χ(2)=9.297, P=0.002). Phylogenetic analysis of 33 CA6 VP1 showed that the CA6 isolates of this study were highly similar to that of Taiwan and the nucleotide similarity was 95.91%-98.89%. CA6 was the major pathogen of hospitalized children with hand, foot and mouth disease in Beijing during 2013

  3. Clinical Pearls: Etiologies of Superscan Appearance on Fluorine-18-Fludeoxyglucose Positron Emission Tomography-Computed Tomography.

    Science.gov (United States)

    Manov, John Joseph; Roth, Patrick J; Kuker, Russ

    2017-01-01

    The term "superscan" usually refers to a characteristic pattern on skeletal scintigraphy consisting of symmetrically intense and diffuse radiotracer uptake in the skeleton with absent or diminished visualization of the genitourinary system and soft tissues. Superscans and superscan-like appearances have also been described on fluorine-18-fludeoxyglucose positron emission tomography-computed tomography (18-F-FDG PET/CT). We review reported cases of 18-F-FDG PET/CT superscans and propose criteria for differentiating pathologic superscans from physiologic causes. Knowledge of the 18-F-FDG PET/CT superscan, its reported pathologic causes, its benign imitators, and its clinical implications is important to the nuclear medicine physician or radiologist specializing in the interpretation of nuclear studies to avoid several diagnostic pitfalls.

  4. Etiologic Agents and Diseases Found Associated with Clinical Aspergillosis in Falcons

    Directory of Open Access Journals (Sweden)

    Walter Tarello

    2011-01-01

    Full Text Available The aim of this study was to describe parasitological, microbiological, and pathological findings associated with the isolation of Aspergillus species in 94 clinically diseased captive falcons from Dubai. Concomitant agents and/or diseases were identified in 64 cases, causing either single (=36 or multiple coinfections (=28. Diagnoses found more often in association with aspergillosis were chronic fatigue and immune dysfunction syndrome (CFIDS (=29, Caryospora sp. (=16, Serratospiculum seurati infestation (=14, cestodiasis (=6, bumblefoot (=5, trematodosis due to Strigea falconispalumbi (=5, trichomoniasis (=4, Babesia shortti (=4, Mannheimia (Pastorella haemolytica (=4, interstitial hepatitis (=4, Escherichia coli (=3, and Clostridium perfringens enterotoxemia (=2. Compared with a control group of 2000 diseased falcons without evidence of aspergillosis, the prevalence of Babesia shortti, CFIDS, Mannheimia (Pastorella haemolytica, Escherichia coli, and falcon herpes virus infection was conspicuously higher in association with aspergillosis. These entities may be considered suitable candidates as predisposing factors for the mycosis.

  5. [Dens invaginatus--its etiology, incidence and clinical characteristics (I). A review].

    Science.gov (United States)

    Hülsmann, M

    1995-01-01

    Dens invaginatus is a rare malformation of teeth, showing a broad spectrum of morphological variations. A genetical determination cannot be excluded. The incidence of dental invaginations cannot be determined exactly, the data from different investigations range from 0.25% to 10%. The majority of epidemiological studies present an incidence of more than 2%. Most affected are maxillary lateral incisors, bilateral occurrence is not uncommon (43%). The aetiology of dens invaginatus is still not entirely known. Most probably the invagination has its origin in a deep folding of the foramen caecum during tooth development which in some cases may even result in a second apical foramen. The invagination presents a predisposition for carious lesions, often resulting in early pulp necrosis and apical periodontitis. Endodontic therapy may present several complications due to complex morphology of the root canal system of teeth with invaginations. The paper reviews the different theories on the aetiology of dens invaginatus, classifications, incidence and clinical aspects of this malformation.

  6. Acute Drug Overdose: Clinical Profile, Etiologic Spectrum and Determinants of Duration of Intensive Medical Treatment

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    B Jayakrishnan

    2012-11-01

    Full Text Available Objectives: Acute drug overdosing is an important cause of organ dysfunction and metabolic derangements and the patients often require intensive care. This study aims to determine the clinical pattern of severe drug overdose as well as the factors influencing the duration of intensive care.Methods: The clinical characteristics and course of consecutive adult patients admitted with a diagnosis of acute drug poisoning in the ICU of a tertiary hospital in Oman from January 2007 to December 2008 were reviewed retrospectively from the electronic case records.Results: Acute drug poisoning (n=29 constituted 3.9% of admissions to the ICU. Mean age was 29.38±7.9 years. They were brought in by their relatives (72% or the state services (24%. Accidental poisoning was noted in 21 patients (72% and suicidal overdosing in 6 (21%. The commonest drug was an opioid (65.5%. Glasgow Coma Scale score of ≤8 was recorded in 18 (62.1%. Sixty two percent of patients required mechanical ventilation. The prominent complications were hypotension in 9 (31%, pulmonary in 19 (65.5%, hepatic in 18 (62.1% and renal in 12 (41.4% patients. The major electrolytes abnormalities were low bicarbonate in 11 (37.9%, hyponatremia in 5 (17.2% and hypokalemia in 4 (13.8%. Patients stayed in the ICU for 1 to 20 days (median-2 days. Factors associated with a longer ICU stay included hypotension upon arrival (p=0.048 and the need for mechanical ventilation on the first (p=0.001 and second (p=0.001 days of hospitalization. There was no mortality.Conclusion: Early and prompt intensive medical therapy in acute drug poisoning can favorably influence the outcome. In addition, the presence of hypotension and requirement of mechanical ventilation on the first two days of hospitalization were responsible for prolonged ICU stay.

  7. Current review of the SarQoL®: a health-related quality of life questionnaire specific to sarcopenia.

    Science.gov (United States)

    Beaudart, Charlotte; Reginster, Jean-Yves; Geerinck, Anton; Locquet, Médéa; Bruyère, Olivier

    2017-08-01

    Sarcopenia, defined by a progressive and generalized loss of muscle mass and muscle function, is associated with many harmful clinical consequences. Several studies have reported the impact of sarcopenia on health-related quality of life (HRQoL) using generic quality of life (QoL) questionnaires. The results of these observational studies are quite heterogenous. Indeed, generic tools may not be able to detect subtle effects of sarcopenia on QoL. Recently, a sarcopenia-specific HRQoL questionnaire was developed and validated in a population of sarcopenic subjects to more accurately assess the impact of sarcopenia on QoL. Areas covered: The purpose of this review is to present evidence regarding the impact of sarcopenia on QoL and to introduce a new specific HRQoL questionnaire, the SarQoL®. Expert commentary: The self-administered SarQoL®, initially developed in French, comprises 55 items translated into 22 questions. The questionnaire has been shown to be understandable, valid, consistent, and reliable and can therefore be recommended for clinical and research purposes. The questionnaire is now available in 11 different languages with another 20 translations in progress. The instrument's sensitivity to change still needs to be assessed in future longitudinal studies.

  8. [Porcine stress syndrome and PSE meat: clinical symptoms, pathogenesis, etiology and animal rights aspects].

    Science.gov (United States)

    Wendt, M; Bickhardt, K; Herzog, A; Fischer, A; Martens, H; Richter, T

    2000-05-01

    A review is given about the clinical symptoms, pathogenesis and aetiology of the porcine stress syndrome, furthermore aspects of animal welfare are discussed. The current breeding programmes of pig industry in Germany in many cases include animals with a mutation of the ryanodine-receptor (RYR-1)-gene--homozygous or heterozygous. This situation is the result of an intensive breeding of pigs during the last decades with the intention of increased lean carcass content and corresponding proceeds. The homozygous pigs are more stress susceptible (porcine stress syndrome) and produce meat of poor quality (PSE), which is also the case to some extend in heterozygous animals. The clinical symptoms of this muscle disease are characterised by a deficit of oxygen and a rapid glycolysis accompanied by a production of lactic acid and acidosis primarily in II B white muscle fibres. There is no doubt that a very close causal relation exists between the mutation of the RYR-1 and the porcine stress syndrome as well as the poor meat quality. The present knowledge of this disease, the genetic background, the physiology and pathophysiology of the mutation of the RYR-1 leads to the imperative conclusion to eliminate this mutated RYR-1 by selection of healthy pigs, which has been done successfully in other countries with important pig production. This conclusion is also supported by simple economic reasons because fertility, reproduction and daily weight gain are significantly reduced in stress susceptible pigs. Furthermore, it should be emphasised that regular breeding with the mutated RYR-1 is also a matter of animal welfare. The evident correlation between the mutated RYR-1 and the porcine stress syndrome, which includes degeneration of the muscle, pain and even life threatening malignant hyperthermia, can easily lead to the accusation in the public that diseased animals are used for pig meat production. Consequently, the authors would like to urge the breeding companies and the

  9. On the Etiology of Listening Difficulties in Noise Despite Clinically Normal Audiograms.

    Science.gov (United States)

    Pienkowski, Martin

    Many people with difficulties following conversations in noisy settings have "clinically normal" audiograms, that is, tone thresholds better than 20 dB HL from 0.1 to 8 kHz. This review summarizes the possible causes of such difficulties, and examines established as well as promising new psychoacoustic and electrophysiologic approaches to differentiate between them. Deficits at the level of the auditory periphery are possible even if thresholds remain around 0 dB HL, and become probable when they reach 10 to 20 dB HL. Extending the audiogram beyond 8 kHz can identify early signs of noise-induced trauma to the vulnerable basal turn of the cochlea, and might point to "hidden" losses at lower frequencies that could compromise speech reception in noise. Listening difficulties can also be a consequence of impaired central auditory processing, resulting from lesions affecting the auditory brainstem or cortex, or from abnormal patterns of sound input during developmental sensitive periods and even in adulthood. Such auditory processing disorders should be distinguished from (cognitive) linguistic deficits, and from problems with attention or working memory that may not be specific to the auditory modality. Improved diagnosis of the causes of listening difficulties in noise should lead to better treatment outcomes, by optimizing auditory training procedures to the specific deficits of individual patients, for example.

  10. Sarcopenia and the syndrome of frailty

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Gupta

    2016-01-01

    Full Text Available Sarcopenia is the process of loss of body mass, specifically the musculoskeletal tissue, with age, which ultimately leads to a syndrome of clinical entity poorly defined as frailty. It is probably as old as humanity itself. Functionally, frailty is described as a syndrome characterized by a progressive decrease in the body's reserve and declining resistance to stressors, possibly because of declining capacity of multiple physiologic systems resulting in higher vulnerability morbidity and mortality. Ayurveda also mentions morbidity occurring with advancing age and various options for its management. Elixirs are recommended in Ayurveda, popularly called ‘rasayana’, for recovery from the symptoms of frailty. Worldwide, because of the wide demographic profile, the process of ageing exerts its effects on geriatric populations at different ages. Europeans were the first to paraphrase the word frailty for the ageing process. With better medical care and nutrition, a substantial subset of populations survives longer than 60 years or longer worldwide. The most relevant aspect of the recognition of syndrome of frailty is that the process is, to some extent, reversible, provided that adequate attention is paid and a timely intervention is performed for the needy subset of population, which is likely to improve the quality of life markedly, besides resulting in an increased life span.

  11. New onset seizures: Etiology and co-relation of clinical features with computerized tomography and electroencephalography

    Directory of Open Access Journals (Sweden)

    V Muralidhar

    2015-01-01

    Full Text Available Aims and Objective: To establish whether the reported episode was a seizure, to determine the cause of seizure by identifying the risk factors, lab, radiological and electroencephalography (EEG evaluation to determine any underlying structural abnormality and to decide whether anti-epileptics therapy is essential. Settings and Design: This was a descriptive study. Materials and Methods: (1 Source of data - All the patients with inclusion criteria attending to the medicine outpatient department (OPD/wards. Sample size = 50 cases. (2 Study subjects - Inclusion criteria: All patients >15 years age group presenting in medicine OPD/wards with the first episode of seizure. Exclusion criteria: Seizures on treatment and head injury. Methods of Collection of Data: Each patient was subjected to the detailed evaluation including history, precipitating factors, and symptomatology recorded accordingly. History of hypertension, diabetes mellitus, tuberculosis (TB was enquired into. Family history of epilepsy, TB was recorded. Complete clinical evaluation and thorough investigations-complete blood count, urine examination, blood urea nitrogen, random blood sugar, chest X-ray, computerized tomography (CT scan and EEG were done for all patients in the inclusion criteria. Anti-epileptics were started if either CT/EEG was abnormal, rest of the patients were not given anti-epileptics. Follow-up was done for 6 months, and any recurrence of seizures was noted. The data collected from cases in the inclusion criteria were recorded in a Master chart. Data analysis was done using appropriate statistical tests and graphs. Results and Conclusions: Peak incidence of new onset seizure was second to third decade (25 cases; 50%, max cases <25 years, male: Female ratio of 2.12:1, duration of seizure <5 min (30 cases; 60%, evidence of TB = 6 cases (12%, alcohol intake = 5 cases (10%, developmental delay = 3 cases (6%, family history = 3 cases (6%, old cerebro-vascular accident

  12. Burden, etiology and predictors of visual impairment among children attending Mulago National Referral Hospital eye clinic, Uganda.

    Science.gov (United States)

    Kinengyere, Patience; Kizito, Samuel; Kiggundu, John Baptist; Ampaire, Anne; Wabulembo, Geoffrey

    2017-09-01

    Childhood visual impairment (CVI) has not been given due attention. Knowledge of CVI is important in planning preventive measures. The aim of this study was determine the prevalence, etiology and the factors associated with childhood visual impairment among the children attending the eye clinic in Mulago National Referral Hospital. This was a cross sectional hospital based study among 318 children attending the Mulago Hospital eye clinic between January 2015 to March 2015. Ocular and general history was taken and patient examination done. The data generated was entered by Epidata and analyzed by STATA 12. The prevalence of CVI was 42.14%, 134 patients with 49 patients (15.41%) having moderate visual impairment, 45 patients (14.15%) having severe visual impairment and 40 patients (12.58%) presenting with blindness. Significant predictors included; increasing age, delayed developmental milestones and having abnormal corneal, refractive and fundus findings. There is a high burden of visual impairment among children in Uganda. It is vital to screen all the children presenting to hospital for visual impairment. Majority of the causes of the visual impairment are preventable.

  13. Novel Intriguing Strategies Attenuating to Sarcopenia

    Directory of Open Access Journals (Sweden)

    Kunihiro Sakuma

    2012-01-01

    Full Text Available Sarcopenia, the age-related loss of skeletal muscle mass, is characterized by a deterioration of muscle quantity and quality leading to a gradual slowing of movement, a decline in strength and power, increased risk of fall-related injury, and, often, frailty. Since sarcopenia is largely attributed to various molecular mediators affecting fiber size, mitochondrial homeostasis, and apoptosis, the mechanisms responsible for these deleterious changes present numerous therapeutic targets for drug discovery. Resistance training combined with amino acid-containing supplements is often utilized to prevent age-related muscle wasting and weakness. In this review, we summarize more recent therapeutic strategies (myostatin or proteasome inhibition, supplementation with eicosapentaenoic acid (EPA or ursolic acid, etc. for counteracting sarcopenia. Myostatin inhibitor is the most advanced research with a Phase I/II trial in muscular dystrophy but does not try the possibility for attenuating sarcopenia. EPA and ursolic acid seem to be effective as therapeutic agents, because they attenuate the degenerative symptoms of muscular dystrophy and cachexic muscle. The activation of peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α in skeletal muscle by exercise and/or unknown supplementation would be an intriguing approach to attenuating sarcopenia. In contrast, muscle loss with age may not be influenced positively by treatment with a proteasome inhibitor or antioxidant.

  14. Association of Sasang Constitutional Type with Sarcopenia

    Directory of Open Access Journals (Sweden)

    Seung Ku Lee

    2015-01-01

    Full Text Available Sasang constitutional medicine (SCM is a unique Korean traditional medicine that classifies human beings as four distinct types named Sasang constitutional types (SCTs, based on physiologic, physical, and psychological traits. Accumulating evidence has demonstrated that specific constitutional types are associated with chronic diseases, but no study has investigated the relationship between SCTs and sarcopenia. The aim of this study was to examine the association in a large population-based study. Data from 1,204 participants who completed questionnaires for life style, anthropometric evaluation, and biochemical analysis were analyzed. Classification of the SCTs was done using an integrated diagnostic method. Sarcopenia was defined as appendicular skeletal muscle mass/height2 less than one standard deviation below the gender-specific normal mean of a younger group. Dual-energy X-ray absorptiometry was used to assess whole body composition. The prevalence of sarcopenia was 8.6% in the Tae-eum (TE type, 44.7% in the So-eum (SE type, and 20.7% in the So-yang (SY type. Multivariate analysis revealed that the SE and SY types had 9.22 (5.06–16.81; P<0.0001 and 2.90 (1.76–4.76; P<0.0001 greater odds of sarcopenia compared to the TE type, respectively. Our results show that the SE and SY types are significantly associated with increased prevalence of sarcopenia.

  15. Defining sarcopenia : The impact of different diagnostic criteria on the prevalence of sarcopenia in a large middle aged cohort

    NARCIS (Netherlands)

    Bijlsma, A. Y.; Meskers, C. G M; Ling, C. H Y; Narici, M.; Kurrle, S. E.; Cameron, I. D.; Westendorp, R. G J; Maier, A. B.

    Sarcopenia, low muscle mass, is an increasing problem in our ageing society. The prevalence of sarcopenia varies extremely between elderly cohorts ranging from 7% to over 50%. Without consensus on the definition of sarcopenia, a variety of diagnostic criteria are being used. We assessed the degree

  16. Sarcopenia, Osteoporosis and Its Complications

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    V.V. Povoroznyuk

    2017-03-01

    Full Text Available Today, the significant attention of scientists is paid to the study of associative changes in muscle and bone tissue with age. The reduction of muscle mass and its function is associated with reduced bone mineral density, increased risk of falls, deterioration in the quality of life, functionality and increased patient mortality. However, there is a small number of studies that have examined the relationship between sarcopenia and osteoporotic fractures. The aim of research: to study the particularities of body composition, structural and functional state of bone in women aged 65 and older depending on the presence of vertebral deformations. We have examined 171 women aged 65–89 years. Depending on the presence of vertebral deformations, the patients were divided into two groups: A — 105 women without vertebral deformations, B — 66 women with vertebral deformations. Lean and fat masses, bone mineral density and trabecular bone score, lateral vertebral assessment were performed by dual X-ray absorptiometry (Prodigy, GEHC Lunar, Madison, WI, USA. We determined that patients with vertebral deformations as compared to the women without deformations had significantly lower indices of bone mineral density, trabecular bone score, lean and fat masses (p < 0.05. The incidence of presarcopenia (reduced lean mass in women with vertebral deformations was 14.6 %, in women without vertebral deformations — 2.2 %.

  17. Sarcopenia in overweight and obese patients is a predictive factor for postoperative complication in gastric cancer: A prospective study.

    Science.gov (United States)

    Lou, N; Chi, C-H; Chen, X-D; Zhou, C-J; Wang, S-L; Zhuang, C-L; Shen, X

    2017-01-01

    Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. This study aims to explore the prevalence of sarcopenia in overweight and obese gastric cancer (GC) patients and figured out the impacts of sarcopenia on the postoperative complication of overweight and obese GC patients. According to the recommended body-mass index (BMI) for Asian populations by WHO, we conducted a prospective study of overweight and obese gastric cancer patients (BMI ≥ 23 kg/m(2)) under curative gastrectomy from August 2014 to December 2015. Including lumbar skeletal muscle index, handgrip strength and gait speed as the sarcopenic components were measured before surgery. Patients were followed up after gastrectomy to gain the actual clinical outcomes. Factors contributing to postoperative complications were analyzed by univariate and multivariate analysis. Total of 206 overweight or obese patients were enrolled in this study, 14 patients were diagnosed sarcopenia and were demonstrated having significantly association with higher risk of postoperative complications, higher hospital costs, and higher rate of 30-days readmission compared with the non-sarcopenic ones. On the basis of univariate and multivariate analysis, sarcopenia was an independent risk factor for postoperative complication of overweight and obese patients with gastric cancer (P = 0.002). Sarcopenia is an independent predictor of postoperative complications in overweight or obese patients with gastric cancer after radical gastrectomy. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  18. The Challenge of Appropriate Identification and Treatment of Starvation, Sarcopenia, and Cachexia: A Survey of Australian Dietitians

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    Alison Yaxley

    2011-01-01

    Full Text Available Malnutrition is an umbrella term that includes starvation, sarcopenia, and cachexia; however, differentiating between these terms is infrequent in clinical practice. Given that the effectiveness of treatment depends on the aetiology of unintentional weight loss, it is important that clinicians are aware of the defining characteristics. The aim of this study was to determine whether Australian dietitians understand and use the terms starvation, sarcopenia, and cachexia and provide targeted treatment strategies accordingly. Members of the Dietitians Association of Australia were surveyed to gain information on practices and attitudes to diagnosis and treatment of adult malnutrition. In addition, three case studies were provided to examine understanding of starvation, sarcopenia, and cachexia. 221 dietitians accessed the survey. 81 respondents (43% indicated the use of at least one alternate term (starvation, sarcopenia, and/or cachexia. Muscle wasting was the most commonly used diagnostic criterion. High-energy high-protein diet was the most common therapy prescribed. Correct diagnoses for case studies were recorded by 6% of respondents for starvation, 46% for sarcopenia, and 21% for cachexia. There is a need for increased awareness of the existence of starvation, sarcopenia, and cachexia amongst Australian dietitians and research into appropriate methods of identification and treatment for each condition.

  19. Seizures and epilepsy in elderly patients of an urban area of Iran: clinical manifestation, differential diagnosis, etiology, and epilepsy subtypes.

    Science.gov (United States)

    Tabatabaei, Sayed Shahaboddin; Delbari, Ahmad; Salman-Roghani, Reza; Shahgholi, Leili; Fadayevatan, Reza; Mokhber, Naghmeh; Lokk, Johan

    2013-08-01

    The incidences of seizures and epilepsy in the population show a peak after 60 years of age. Due to the lack of reported clinical aspects of seizure and epilepsy in the older patients in our region in Iran, this study was conducted to describe the clinical manifestation, etiology, differential diagnosis, and epilepsy subtypes of epilepsy and seizure. A cross-sectional retrospective study was performed on all consecutively elderly seizure and epilepsy patients, referred to the Epilepsy Association in the city of Qom, Iran over a 10-year period. A total of 466 patients aged >60 years were admitted. 31 % of the patients had epilepsy or seizure and 69 % of them had non-epileptic events. The most prevalent differential diagnoses in the beginning were syncope and cardiovascular disorders. The most frequent clinical symptom of epilepsy was generalized tonic-clonic seizures (75 %). The most common cause of seizure was systemic metabolic disorder (27 %). In epileptic elderly patients, no cause was ascertained for 38 % and the most frequently observed pathological factors were cerebrovascular diseases, which accounted for 24 %. The most common type of epileptic seizure was generalized epileptic seizures (75 %). 10 % of elderly epileptic patients suffered from status epilepticus, which was primarily caused by anoxia. Despite the rising rate and potentially profound physical and psychosocial effects of seizures and epilepsy, these disorders have received surprisingly little research focus and attention in Iran. Referring older patients to a specialist or a specialist epilepsy center allows speedy assessment, appropriate investigation and treatment, and less likely to miss the diagnosis.

  20. Sarcopenia is associated with an increased inflammatory response to surgery in colorectal cancer

    NARCIS (Netherlands)

    Reisinger, Kostan W.; Derikx, Joep P. M.; van Vugt, Jeroen L. A.; Von Meyenfeldt, Maarten F.; Hulsewé, Karel W.; Olde Damink, Steven W. M.; Stoot, Jan H. M. B.; Poeze, Martijn

    2016-01-01

    Background & aims: Sarcopenia in gastrointestinal cancer has been associated with poor clinical outcome after surgery. The effect of low muscle mass on the inflammatory response to surgery has not been investigated, however skeletal muscle wasting in the context of cachexia is associated with a

  1. Frequency of Macroprolactinemia in Hyperprolactinemic Women Presenting with Menstrual Irregularities, Galactorrhea, and/or Infertility: Etiology and Clinical Manifestations

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    Alfredo Leaños-Miranda

    2013-01-01

    Full Text Available Aim. To determine the frequency of macroprolactinemia, its etiology, and the clinical manifestations in patients with hyperprolactinemia presenting with menstrual irregularities, galactorrhea, and/or infertility who were attended by the gynecology-endocrinology service. Methods. In a cross-sectional study, 326 hyperprolactinemic women were tested for serum prolactin (PRL concentrations before and after chromatographic separation (gel filtration and affinity with protein G and extraction of free PRL with polyethylene glycol (PEG. Results. Sera from 57 patients (17.5% were found to have macroprolactinemia. The presence of macroprolactinemia was attributable to anti-PRL autoantibodies in 54 (94.7% patients. The median serum PRL levels were similar in patients with or without macroprolactinemia (42.0 versus 38.1 ng/mL. In contrast, patients with macroprolactinemia had lower serum-free PRL levels (median 9.2 versus 31.7 ng/mL, . Patients without macroprolactinemia had a higher frequency of galactorrhea and abnormal pituitary imagine findings (. Conclusions. We can conclude that macroprolactinemia should be considered as a benign variant, and it must be ruled out in women presenting with menstrual irregularities, galactorrhea, and/or infertility in order to investigate other causes different than hyperprolactinemia. Serum PRL precipitated with PEG is a convenient and simple procedure to screen for the presence of macroprolactinemia.

  2. The Definition of Pneumonia, the Assessment of Severity, and Clinical Standardization in the Pneumonia Etiology Research for Child Health Study

    Science.gov (United States)

    Wonodi, Chizoba; Moïsi, Jennifer C.; Deloria-Knoll, Maria; DeLuca, Andrea N.; Karron, Ruth A.; Bhat, Niranjan; Murdoch, David R.; Crawley, Jane; Levine, Orin S.; O’Brien, Katherine L.; Feikin, Daniel R.

    2012-01-01

    To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization’s classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1–59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing. PMID:22403224

  3. Etiology, clinical features and outcomes of pre-engraftment and post-engraftment bloodstream infection in hematopoietic SCT recipients.

    Science.gov (United States)

    Gudiol, C; Garcia-Vidal, C; Arnan, M; Sánchez-Ortega, I; Patiño, B; Duarte, R; Carratalà, J

    2014-06-01

    We conducted an observational study to assess the etiology, clinical features and outcomes of bloodstream infection (BSI) in 172 hematopoietic SCT (HCST) recipients. One hundred episodes of BSI in the pre-engraftment period (early onset) were compared with 89 episodes in the post-engraftment phase (late onset). More patients with late-onset BSI received an allogeneic HSCT, had GVHD and had received corticosteroids, whereas patients with early-onset BSI were more likely to have neutropenia, severe mucositis and a central venous catheter (CVC) in place. CVC was the most frequent site of infection, followed by an endogenous source. Pneumonia and gastrointestinal infection were particularly frequent in late-onset BSI, whereas mucositis was more frequent in the early-onset group. Gram-positive organisms predominated over Gram negatives. Streptococcus pneumoniae was more frequent in patients with late-onset BSI. Patients with late-onset BSI presented worse outcomes regarding septic shock, intensive care unit admission and early and overall case-fatality rates. Early-onset BSI was mainly related to the presence of neutropenia, mucositis and CVC, whereas late-onset BSI mainly affected severely immunosuppressed allogeneic HSCT recipients with GVHD and corticosteroids. Late-onset BSI caused high case-fatality rates. BSI due to S. pneumoniae was especially frequent late after transplantation. The development of better vaccination strategies is needed.

  4. Nutrition and sarcopenia: evidence for an interaction.

    Science.gov (United States)

    Millward, D Joe

    2012-11-01

    Nutritional interventions that might influence sarcopenia, as indicated by literature reporting on sarcopenia per se as well as dynapenia and frailty, are reviewed in relation to potential physiological aetiological factors, i.e. inactivity, anabolic resistance, inflammation, acidosis and vitamin D deficiency. As sarcopenia occurs in physically active and presumably well-nourished populations, it is argued that a simple nutritional aetiology is unlikely and unequivocal evidence for any nutritional influence is extremely limited. Dietary protein is probably the most widely researched nutrient but only for frailty is there one study showing evidence of an aetiological influence and most intervention studies with protein or amino acids have proved ineffective with only a very few exceptions. Fish oil has been shown to attenuate anabolic resistance of muscle protein synthesis in one study. There is limited evidence for a protective influence of antioxidants and inducers of phase 2 proteins on sarcopenia, dynapenia and anabolic resistance in human and animal studies. Also fruit and vegetables may protect against acidosis-induced sarcopenia through their provision of dietary potassium. While severe vitamin D deficiency is associated with dynapenia and sarcopenia, the evidence for a beneficial influence of increasing vitamin D status above the severe deficiency level is limited and controversial, especially in men. On this basis there is insufficient evidence for any more specific nutritional advice than that contained in the general healthy lifestyle-healthy diet message: i.e. avoiding inactivity and low intakes of food energy and nutrients and maintain an active lifestyle with a diet providing a rich supply of fruit and vegetables and frequent oily fish.

  5. Unsatisfactory knowledge and use of terminology regarding malnutrition, starvation, cachexia and sarcopenia among dietitians.

    Science.gov (United States)

    Ter Beek, Lies; Vanhauwaert, Erika; Slinde, Frode; Orrevall, Ylva; Henriksen, Christine; Johansson, Madelene; Vereecken, Carine; Rothenberg, Elisabet; Jager-Wittenaar, Harriët

    2016-12-01

    Clinical signs of malnutrition, starvation, cachexia and sarcopenia overlap, as they all imply muscle wasting to a various extent. However, the underlying mechanisms differ fundamentally and therefore distinction between these phenomena has therapeutic and prognostic implications. We aimed to determine whether dietitians in selected European countries have 'sufficient knowledge' regarding malnutrition, starvation, cachexia and sarcopenia, and use these terms in their daily clinical work. An anonymous online survey was performed among dietitians in Belgium, the Netherlands, Norway and Sweden. 'Sufficient knowledge' was defined as having mentioned at least two of the three common domains of malnutrition according to ESPEN definition of malnutrition (2011): 'nutritional balance', 'body composition' and 'functionality and clinical outcome', and a correct answer to three cases on starvation, cachexia and sarcopenia. Chi-square test was used to analyse differences in experience, work place and number of malnourished patients treated between dietitians with 'sufficient knowledge' vs. 'less sufficient knowledge'. 712/7186 responded to the questionnaire, of which data of 369 dietitians were included in the analysis (5%). The term 'malnutrition' is being used in clinical practice by 88% of the respondents. Starvation, cachexia and sarcopenia is being used by 3%, 30% and 12% respectively. The cases on starvation, cachexia and sarcopenia were correctly identified by 58%, 43% and 74% respectively. 13% of the respondents had 'sufficient knowledge'. 31% of the respondents identified all cases correctly. The proportion of respondents with 'sufficient knowledge' was significantly higher in those working in a hospital or in municipality (16%, P cachexia and sarcopenia is unsatisfactory (13%). The terms starvation, cachexia and sarcopenia are not often used by dietitians in daily clinical work. As only one-third (31%) of dietitians identified all cases correctly, the results of this

  6. Recurrent erythema multiforme: clinical characteristics, etiologic associations, and treatment in a series of 48 patients at Mayo Clinic, 2000 to 2007.

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    Wetter, David A; Davis, Mark D P

    2010-01-01

    Recurrent erythema multiforme (EM) is a condition of substantial morbidity. Our efforts toward the etiologic attribution and treatment of recurrent EM have been less fruitful than those previously described. We sought to further characterize clinical characteristics, etiologic associations, and treatment of recurrent EM. We conducted a retrospective review of patients with recurrent EM seen between 2000 and 2007. Of 48 patients (mean age at disease onset, 36.4 years), 28 (58%) were female (mean duration of recurrent EM, 6 years). Thirty (63%) patients had oral involvement. Herpes simplex virus caused recurrent EM in 11 (23%) patients, and the cause remained unknown in 28 (58%). In all, 37 (77%) patients received systemic corticosteroids, 33 (69%) received continuous antiviral treatment, and 23 (48%) used immunosuppressive or anti-inflammatory agents. Sixteen of 33 patients receiving continuous antiviral treatment had either partial or complete disease suppression. Patients had varied responses to immunosuppressants, with mycophenolate mofetil providing partial or complete response in 6 of 8 patients. Features of recalcitrant cases included clinicians' inability to identify a specific cause, lack of improvement with continuous antiviral therapy, severe oral involvement, extensive corticosteroid therapy, and immunosuppressive therapy (two or more agents). This study is retrospective. More than half of patients in this study did not have an identifiable cause for recurrent EM, and herpes simplex virus was found less frequently than reported in previous studies. Response to systemic treatments, including continuous antivirals and immunosuppressants, was varied and often times suboptimal.

  7. PROSPECTIVE STUDY OF ETIOLOGY, CLINICAL PROFILE AND OUTCOME IN PATIENTS WITH FEVER, JAUNDICE AND ACUTE KIDNEY INJURY

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    Pradeep

    2015-09-01

    Full Text Available OBJECTIVE: To study etiology, risk factors, various clinical and lab parameters and outcome of patients presenting with fever, jaundice and acute kidney injury. MATERIALS AND METHODS : An open prospective study was done on 100 patients presented with triad of fever, jaundice and acute kidney injury (AKI in the Depar tment of Medicine of G R Medical College and JA Group of Hospitals, Gwalior, MP from September 2011 to November 2012. Patients having temperature more than >100 0 F, serum creatinine ≥1.3 mg/dL or a 50 % increase from baseline or a reduction in urine output (documented oliguria of 6 hours, serum bilirubin >1.8 mg/dL were included in the study. A detailed history, clinical examination and investigations were done to find the cause of these derangements and all the patients were managed acc ordingly. RESULTS: A total 100 patients were included in study out of which 70% were males. Out of 100 patients, 50% were of septicemia, 34% were having malaria, 12% had acute pancreatitis and 4% patients were of dengue. Out of 50 septicemia patients, 35(7 0% were male, out of which 11(31.42% were of 56 - 65 years of age. Out of 17 deaths, 13(76% were males. Among total death, 11(22% were in septicemia followed by 5(14.70% in malaria patients. CONCLUSION: Many infectious and non - infectious diseases like malaria, septicemia, acute pancreatitis, dengue fever etc. can present with fever, jaundice and deranged renal functions. This triad of presentation is associated wi th high morbidity and mortality and the advanced age, male gender presences of anemia were the risk factors for high mortality. AKI occurs most commonly in association with P. falciparum malaria. Early diagnosis and prompt management including dialysis can reduce mortality and expedite recovery of renal function

  8. An evaluation of the usefulness of consensus definitions of sarcopenia in older men: results from the observational Osteoporotic Fractures in Men (MrOS) cohort study

    Science.gov (United States)

    Cawthon, Peggy M; Blackwell, Terri L; Cauley, Jane; Kado, Deborah M; Barrett-Connor, Elizabeth; Lee, Christine G; Hoffman, Andrew R; Nevitt, Michael M; Stefanick, Marcia L; Lane, Nancy E; Ensrud, Kristine E; Cummings, Steven R; Orwoll, Eric S

    2016-01-01

    Background Recently, several consensus definitions for sarcopenia have been developed. Objective To evaluate the associations and discriminative ability of definitions of sarcopenia against clinical outcomes. Design Osteoporotic Fractures in Men study Setting Six clinical centers Participants 5,934 community-dwelling men aged ≥65 yrs Measurements Sarcopenia definitions evaluated were: International Working Group (IWG), European Working Group for Sarcopenia in Older Persons (EWGSOP), Foundation for the NIH (FNIH) Sarcopenia, Baumgartner, and Newman. Recurrent falls were defined as ≥2 self-reported falls in the year after baseline (N=694, 11.9%). Incident hip fractures (N=207, 3.5 %) and deaths (N=2003, 34.1%) were confirmed by central review of medical records over 9.8 years. Self-reported functional limitations were assessed at baseline and again 4.6 years later. Logistic regression or proportional hazards models estimated associations between sarcopenia and falls, hip fractures or death. The discriminative ability of the sarcopenia definitions (compared to referent models) for these outcomes was evaluated with areas under the receiver operator curve (AUCs) or C-statistics. Referent models included age alone for falls, function limitations and mortality, and age and BMD for hip fractures. Results The association between sarcopenia by the various definitions and risk of falls, functional limitations, and hip fractures was variable; all definitions were associated with increased mortality risk. However, none of the definitions materially changed discrimination based on AUC and C-statistic when compared to referent models (change ≤1% in all models). Conclusions Sarcopenia definitions as currently constructed did not consistently improve prediction of clinical outcomes in relatively healthy older men. PMID:26502831

  9. Sarcopenia and its relationship with osteoarthritis: risk factor or direct consequence?

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    Papalia, R; Zampogna, B; Torre, G; Lanotte, A; Vasta, S; Albo, E; Tecame, A; Denaro, V

    2014-06-01

    The aim of this review is to evaluate the clinical role of sarcopenia in patients affected by osteoarthritis (OA) of major joints. An online database research was performed, in order to retrieve all articles investigating the relationship between sarcopenia and OA. No peer-reviewed journal was excluded. Papers in English, French, Spanish and Italian language were considered. After consulting the full-text article, five studies have been included in the review. Of the five studies included, four are prospective studies and only one is a cross-sectional study which retrieved data retrospectively. A total of 4,231 patients, presenting a mean age of 62.0 years, were studied. Three studies evaluated only female subjects. Weight, height and body mass index were reported in all the articles. Knee OA has been assessed using the Kellgren-Lawrence grading system and the American college of rheumatology criteria. Alterations of the lean body mass on body weight ratio have been reported to be as a significant predictive parameter in two studies. Relationship between radiographic OA and an increase in the leg lean mass has been observed in one study. We cannot support neither the thesis of a direct effect of sarcopenia on OA development nor the opposite relation, because the up-to-date literature lacks basic science studies concerning these topics. The absence of clinical studies regarding measurements and tools to compare sarcopenia and OA do not allow to definitely clarify this relationship.

  10. Diagnostic criteria for sarcopenia and physical performance

    NARCIS (Netherlands)

    Bijlsma, A.Y.; Meskers, C.G.M.; van den Eshof, N.; Westendorp, R.G.; Sipila, S.; Stenroth, L.; Sillanpaa, E.; McPhee, J.S.; Jones, D.A.; Narici, M.V.; Gapeyeva, H.; Paasuke, M.; Voit, T.; Barnouin, Y.; Hogrel, J.Y.; Butler-Browne, G.; Maier, A.B.

    2014-01-01

    Relative and absolute muscle mass and muscle strength are used as diagnostic criteria for sarcopenia.We aimed to assess which diagnostic criteria are most associated with physical performance in 180 young (18-30 years) and 281 healthy old participants (69-81 years) of the European study MYOAGE.

  11. Sarcopenia in community-dwelling persons over 60 years of age from a northern spanish city: relationship between diagnostic criteria and association with the functional performance.

    Science.gov (United States)

    Patiño Villada, Fredy Alonso; Arboleda Franco, Santiago Adolfo; de Paz Fernández, José Antonio

    2015-05-01

    Sarcopenia is a recognized problem in older people. Currently, its diagnosis goes beyond a simple loss of muscle mass. The aim of this study was to determine the frequency of sarcopenia, defined by the European Working Group on Sarcopenia in Older People (EWGSOP), in independent persons over 60 years of age from a northern Spanish city. In addition, this study compared the diagnostic criteria for sarcopenia and assessed the differences in functional performance according to them. A cross-sectional study was carried out on 258 members of community centers of both genders. Body composition was assessed with dual-energy X-ray absorptiometry. Appendicular lean mass index (App LMI), hand grip strength (HGS), and 8 foot up-and-go test (8f-UG) were used to diagnose sarcopenia. The frequency of sarcopenia was 2.4% (n=6). In women, the App LMI was correlated with HGS (r= 0.164, pdefinition, the frequency of sarcopenia was low in a group of individuals over 60 years of age from a northern Spanish city. In clinical practice, greater emphasis should be placed on the decrease in muscle strength and functional performance rather than on low muscle mass alone. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  12. [Less frequent etiology in uveitis].

    Science.gov (United States)

    Ignat, F; Preda, M; Perovic, I

    2001-01-01

    This material intends to present three clinical observations regarding the uveitis etiology, that is represented by the association of some etiological factors less known: Toxoplasma gondii, Listeria monocytogenes, Leptospira icterohaemorrhagiae. The uveitis described here have been severe in the fast evolution and with trends of reappearence. This work demonstrates that the strict etiological antibacteria and antiparasite therapy is not enough and only corticotherapy is able to fight against the accentuated inflammatory phenomena that go along with type of uveitis.

  13. Clinical, Etiological and Therapeutic Features of Jaw-opening and Jaw-closing Oromandibular Dystonias: A Decade of Experience at a Single Treatment Center

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    Pedro Gonzalez-Alegre

    2014-04-01

    Full Text Available Background: Dystonia is a heterogeneous hyperkinetic disorder. The anatomical location of the dystonia helps clinicians guide their evaluation and treatment plan. When dystonia involves masticatory, lingual, and pharyngeal muscles, it is referred to as oromandibular dystonia (OMD.Methods: We identified patients diagnosed with OMD in a Movement Disorders Clinic and Laryngeal Movement Disorders Clinic from a single institution. Demographic, etiological, clinical, and therapeutic information was retrospectively reviewed for patients with jaw‐opening (O‐OMD and jaw‐closing (C‐OMD OMD.Results: Twenty‐seven patients were included. Their average age of onset was in the sixth decade of life and there was a female predominance. Etiological factors linked in this study to OMD included a family history of dystonia or essential tremor, occupation, cerebellar disease, a dental disorder, and tardive syndrome. Clinically, patients with C‐OMD presented with more prominent feeding difficulties, but seemed to respond better to therapy than those with O‐OMD. In addition to the known benefits of botulinum toxin therapy, patients who described sensory tricks obtained benefit from the use of customized dental prosthesis.Discussion: This works provides useful information on potential etiological factors for OMD and its response to therapy, and highlights the potential benefit of dental prosthesis for the treatment of OMD.

  14. Nutritional problems in older adults with Alzheimer’s disease: Risk of malnutrition and sarcopenia

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    Danielle Rodrigues LECHETA

    Full Text Available ABSTRACT Objective Understand the nutritional problems and detect the presence of sarcopenia in older adults with Alzheimer’s disease. Methods Descriptive cross-sectional study carried out among elderly patients with Alzheimer’s disease receiving care at the Unidade de Saúde de Atenção ao Idoso (Elderly Care Unit in a capital city in Southern Brazil between November 2010 and July 2011. The Clinical Dementia Rating scale was used for the evaluation of staging severity of dementia. Participants’ nutritional status was classified using The Mini Nutritional Assessment. The following tests were used to diagnose sarcopenia: bioelectrical impedance, hand grip strength, and the Timed Up and Go test. Anthropometric measurements and laboratory tests (hemoglobin, lymphocytes, serum albumin, and total cholesterol were performed. Results Ninety-six older adults (mean age of 78 years were evaluated. It was observed prevalence of mild Alzheimer’s disease in 54.2% of the participants; 55.2% were at risk of malnutrition; unintentional weight loss was observed in 64.6%, 55.3% had lower number of lymphocytes, and 43.7% had severe sarcopenia. Conclusion The prevalence of risk of malnutrition and sarcopenia is high among older adults with Alzheimer’s disease. Future studies should focus on the evaluation of nutritional interventions aimed at maintaining the nutritional status and muscle mass in these individuals.

  15. Skeletal muscle mass and quality: evolution of modern measurement concepts in the context of sarcopenia.

    Science.gov (United States)

    Heymsfield, Steven B; Gonzalez, M Cristina; Lu, Jianhua; Jia, Guang; Zheng, Jolene

    2015-11-01

    The first reports of accurate skeletal muscle mass measurement in human subjects appeared at about the same time as introduction of the sarcopenia concept in the late 1980s. Since then these methods, computed tomography and MRI, have been used to gain insights into older (i.e. anthropometry and urinary markers) and more recently developed and refined methods (ultrasound, bioimpedance analysis and dual-energy X-ray absorptiometry) of quantifying regional and total body skeletal muscle mass. The objective of this review is to describe the evolution of these methods and their continued development in the context of sarcopenia evaluation and treatment. Advances in these technologies are described with a focus on additional quantifiable measures that relate to muscle composition and 'quality'. The integration of these collective evaluations with strength and physical performance indices is highlighted with linkages to evaluation of sarcopenia and the spectrum of related disorders such as sarcopenic obesity, cachexia and frailty. Our findings show that currently available methods and those in development are capable of non-invasively extending measures from solely 'mass' to quality evaluations that promise to close the gaps now recognised between skeletal muscle mass and muscle function, morbidity and mortality. As the largest tissue compartment in most adults, skeletal muscle mass and aspects of muscle composition can now be evaluated by a wide array of technologies that provide important new research and clinical opportunities aligned with the growing interest in the spectrum of conditions associated with sarcopenia.

  16. The definition of pneumonia, the assessment of severity, and clinical standardization in the Pneumonia Etiology Research for Child Health study

    NARCIS (Netherlands)

    Scott, J. Anthony G.; Wonodi, Chizoba; Moïsi, Jennifer C.; Deloria-Knoll, Maria; DeLuca, Andrea N.; Karron, Ruth A.; Bhat, Niranjan; Murdoch, David R.; Crawley, Jane; Levine, Orin S.; O'Brien, Katherine L.; Feikin, Daniel R.; Black, Robert E.; Bhutta, Zulfiqar A.; Campbell, Harry; Cherian, Thomas; Crook, Derrick W.; de Jong, Menno D.; Dowell, Scott F.; Graham, Stephen M.; Klugman, Keith P.; Lanata, Claudio F.; Madhi, Shabir A.; Martin, Paul; Nataro, James P.; Piazza, Franco M.; Qazi, Shamim A.; Zar, Heather J.

    2012-01-01

    To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization's classification of severe/very

  17. Sarcopenia and physical activity in older male cardiac patients.

    Science.gov (United States)

    Izawa, Kazuhiro P; Watanabe, Satoshi; Oka, Koichiro; Kasahara, Yusuke; Morio, Yuji; Hiraki, Koji; Hirano, Yasuyuki; Omori, Yutaka; Suzuki, Norio; Kida, Keisuke; Suzuki, Kengo; Akashi, Yoshihiro J

    2016-11-01

    There is little information on the association of sarcopenia with physical activity in elderly cardiac patients. This study determined differences in physical activity and cutoff values for physical activity according to the presence or absence of sarcopenia in elderly male cardiac patients. Sixty-seven consecutive men aged ≥65 years with cardiac disease were enrolled. We defined sarcopenia using the European Working Group on Sarcopenia in Older People algorithm. Patients were divided into the sarcopenia group (n=25) and the non-sarcopenia group (n=42). In the patients with and without sarcopenia of physical activities were evaluated to determine cutoff values of physical activity. After adjusting for patient characteristics, both the average daily number of steps (3361.43±793.23 vs. 5991.55±583.57 steps, P=0.021) and the average daily energy expenditure of physical activity (71.84±22.19 vs. 154.57±16.18kcal, P=0.009) were significantly lower in the sarcopenia versus non-sarcopenia group. Receiver-operating characteristic analysis identified a cutoff value for steps of physical activity of 3551.80steps/day for 1 week, with a sensitivity of 0.73 and 1-specificity of 0.44 and a cutoff value for energy expenditure of physical activity of 85.17kcal/day for 1 week, with a sensitivity of 0.73 and 1-specificity of 0.27. Physical activity in the male cardiac patients with sarcopenia was significantly lower than that in those without sarcopenia. The cutoff values reported here may be useful values to aid in the identification of elderly male cardiac patients with sarcopenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. [Transdisciplinary Approach for Sarcopenia. Sarcopenia : definition and the criteria for Asian elderly people].

    Science.gov (United States)

    Yuki, Atsumu; Ando, Fujiko; Shimokata, Hiroshi

    2014-10-01

    Sarcopenia is a syndrome characterized by loss of skeletal muscle mass and function (strength and physical performance) with a risk of adverse outcomes. Asian criteria have been decided recently by the Asia Working Group for Sarcopenia (AWGS) . AWGS defined sarcopenia as low skeletal muscle mass plus low muscle strength and/or low physical performance based on the previous reports. AWGS recommend cutoff values for muscle mass (7.0 kg/m(2) for men and 5.4 kg/m(2) for women by using dual X-ray absorptiometry, and 7.0 kg/m(2) for men and 5.7 kg/m(2) for women by using bioelectrical impedance analysis) , handgrip strength (<26 kg for men and <18 kg for women) , and usual gait speed (<0.8 m/s) . The prevalence of sarcopenia in Japanese elderly men and women diagnosed using Asian criteria was 9.6% and 7.7%, respectively. The estimated number of prevalent cases of sarcopenia in Japanese elderly men and women was approximately 1.3 million and 1.4 million, respectively.

  19. Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults.

    Science.gov (United States)

    Scott, D; Hayes, A; Sanders, K M; Aitken, D; Ebeling, P R; Jones, G

    2014-01-01

    Sarcopenia may be diagnosed in the clinic using operational definitions based on low muscle mass or function. This prospective, population-based study revealed that sex-specific associations may exist between operational definitions of sarcopenia and falls in community-dwelling middle-aged and older adults. The objective of this study is to verify associations between sarcopenia and falls risk and to determine changes in sarcopenia prevalence over 5 years in middle-aged and older men and women according to different anthropometric and performance-based operational definitions. N = 681 volunteers (48% female; mean ± SD age 61.4 ± 7.0 years) participated in baseline and follow-up assessments (mean 5.1 ± 0.5 years later). Appendicular lean mass (ALM) was assessed by dual-energy X-ray absorptiometry, hand grip (HGS) and lower-limb (LLS) strength were assessed by dynamometry, and falls risk was determined using the physiological profile assessment. Anthropometric definitions (ALM/height squared [ALM-H], ALM/weight × 100 and a residuals method [ALM-R]) and performance-based definitions (HGS, LLS and upper- and lower-limb muscle quality [LMQ]) of sarcopenia were examined. The lowest 20% of the sex-specific distribution for each definition at baseline was classified as sarcopenia. Sarcopenia prevalence increased after 5 years for all operational definitions except ALM-H (men: -4.0%; women: -5.5%). Men classified with sarcopenia according to anthropometric definitions, and women classified with sarcopenia according to performance-based definitions, had significant increases in falls risk over 5 years (all P < 0.05) compared to individuals without sarcopenia. Significant sex interactions were observed for ALM-R, LLS and LMQ (all P < 0.05) definitions. Sarcopenia prevalence generally increases at a higher rate when assessed using performance-based definitions. Sarcopenia is associated with increases in falls risk over 5 years in community-dwelling middle-aged and older

  20. Sarcopenia and body composition in diabetic Charcot osteoarthropathy

    DEFF Research Database (Denmark)

    Jansen, Rasmus Bo; Christensen, Tomas Møller; Bülow, Jens

    2015-01-01

    BACKGROUND: Treatment of Charcot osteoarthropathy (COA) requires restricted walking and offloading for several months, which lead to fat re-distribution and increased sarcopenia. OBJECTIVES/AIM: To investigate whether subjects with COA have an altered body composition compared to controls. METHODS....../total body fat distribution ratios. RESULTS: Sarcopenia frequency was higher in the total population with diabetes overall (9-40%), compared to normal materials. Using two different models for correlating appendicular lean mass to sarcopenia, there were no differences in sarcopenia-rates between the groups...

  1. Sarcopenia and Visceral Obesity in Esophageal and Gastric Cancer

    Science.gov (United States)

    2017-02-17

    Esophageal Cancer; Gastric Cancer; Sarcopenia; Sarcopenic Obesity; Obesity; Visceral Obesity; Quality of Life; Surgery; Complication of Treatment; Chemotherapeutic Toxicity; Physical Activity; Oncology

  2. Factors Affecting Sarcopenia in Korean Adults by Age Groups.

    Science.gov (United States)

    Bae, Eun-Jung; Kim, Yun-Hee

    2017-06-01

    This study aimed to investigate factors affecting sarcopenia in different age groups among Korean adults aged 20 years or older. In this secondary analysis, data were collected from records for 17,968, participants who participated in the Korea National Health and Nutrition Examination Survey during 2008-2011. Data were analyzed using multiple logistic regression to determine the associated factors of sarcopenia by age groups. The prevalence of sarcopenia increased significantly with age. Physical activity, blood pressure, waist circumference, triglycerides, vitamin D level were found to be factors significantly associated with sarcopenia in all age groups. Total energy intake was found to be a factor that is significantly associated with sarcopenia among the adults aged 20-39 years. Fasting glucose, suicidal ideation, perceived health status, mobility problem, pain/discomfort, total energy intake were found to be factors associated with sarcopenia in the adults aged 40-64 years. Sex, residential area, smoking, drinking, fasting glucose, osteoarthritis, fall experience, usual activity problem, protein intake were factors associated with sarcopenia in the adults over 65 years of age. The findings show that sarcopenia in adults and the associated factors were different by age groups. Thus, these factors should be considered in the development of intervention programs for the care and prevention of sarcopenia, and such programs should be modified according to different age groups.

  3. Accuracy of the Timed Up and Go test for predicting sarcopenia in elderly hospitalized patients

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    Bruno Prata Martinez

    2015-05-01

    Full Text Available OBJECTIVES: The ability of the Timed Up and Go test to predict sarcopenia has not been evaluated previously. The objective of this study was to evaluate the accuracy of the Timed Up and Go test for predicting sarcopenia in elderly hospitalized patients. METHODS: This cross-sectional study analyzed 68 elderly patients (≥60 years of age in a private hospital in the city of Salvador-BA, Brazil, between the 1st and 5th day of hospitalization. The predictive variable was the Timed Up and Go test score, and the outcome of interest was the presence of sarcopenia (reduced muscle mass associated with a reduction in handgrip strength and/or weak physical performance in a 6-m gait-speed test. After the descriptive data analyses, the sensitivity, specificity and accuracy of a test using the predictive variable to predict the presence of sarcopenia were calculated. RESULTS: In total, 68 elderly individuals, with a mean age 70.4±7.7 years, were evaluated. The subjects had a Charlson Comorbidity Index score of 5.35±1.97. Most (64.7% of the subjects had a clinical admission profile; the main reasons for hospitalization were cardiovascular disorders (22.1%, pneumonia (19.1% and abdominal disorders (10.2%. The frequency of sarcopenia in the sample was 22.1%, and the mean length of time spent performing the Timed Up and Go test was 10.02±5.38 s. A time longer than or equal to a cutoff of 10.85 s on the Timed Up and Go test predicted sarcopenia with a sensitivity of 67% and a specificity of 88.7%. The accuracy of this cutoff for the Timed Up and Go test was good (0.80; IC=0.66-0.94; p=0.002. CONCLUSION: The Timed Up and Go test was shown to be a predictor of sarcopenia in elderly hospitalized patients.

  4. The Combination of Physical Exercise with Muscle-Directed Antioxidants to Counteract Sarcopenia: A Biomedical Rationale for Pleiotropic Treatment with Creatine and Coenzyme Q10

    Directory of Open Access Journals (Sweden)

    Michele Guescini

    2017-01-01

    Full Text Available Sarcopenia represents an increasing public health risk due to the rapid aging of the world’s population. It is characterized by both low muscle mass and function and is associated with mobility disorders, increased risk of falls and fractures, loss of independence, disabilities, and increased risk of death. Despite the urgency of the problem, the development of treatments for sarcopenia has lagged. Increased reactive oxygen species (ROS production and decreased antioxidant (AO defences seem to be important factors contributing to muscle impairment. Studies have been conducted to verify whether physical exercise and/or AOs could prevent and/or delay sarcopenia through a normalization of the etiologically relevant ROS imbalance. Despite the strong rationale, the results obtained were contradictory, particularly with regard to the effects of the tested AOs. A possible explanation might be that not all the agents included in the general heading of “AOs” could fulfill the requisites to counteract the complex series of events causing/accelerating sarcopenia: the combination of the muscle-directed antioxidants creatine and coenzyme Q10 with physical exercise as a biomedical rationale for pleiotropic prevention and/or treatment of sarcopenia is discussed.

  5. Sarcopenia Screened by the SARC-F Questionnaire and Physical Performances of Elderly Women: A Cross-Sectional Study.

    Science.gov (United States)

    Rolland, Yves; Dupuy, Charlotte; Abellan Van Kan, Gabor; Cesari, Matteo; Vellas, Bruno; Faruch, Marie; Dray, Cedric; de Souto Barreto, Philipe

    2017-10-01

    Screening for sarcopenia in daily practice can be challenging. Our objective was to explore whether the SARC-F questionnaire is a valid screening tool for sarcopenia (defined by the Foundation for the National Institutes of Health [FNIH] criteria). Moreover, we evaluated the physical performance of older women according to the SARC-F questionnaire. Cross-sectional study. Data from the Toulouse and Lyon EPIDémiologie de l'OStéoporose study (EPIDOS) on 3025 women living in the community (mean age: 80.5 ± 3.9 years), without a previous history of hip fracture, were assessed. The SARC-F self-report questionnaire score ranges from 0 to 10: a score ≥4 defines sarcopenia. The FNIH criteria uses handgrip strength (GS) and appendicular lean mass (ALM; assessed by DXA) divided by body mass index (BMI) to define sarcopenia. Outcome measures were the following performance-based tests: knee-extension strength, 6-m gait speed, and a repeated chair-stand test. The associations of sarcopenia with performance-based tests was examined using bootstrap multiple linear-regression models; adjusted R(2) determined the percentage variation for each outcome explained by the model. Prevalence of sarcopenia was 16.7% (n = 504) according to the SARC-F questionnaire and 1.8% (n = 49) using the FNIH criteria. Sensibility and specificity of the SARC-F to diagnose sarcopenia (defined by FNIH criteria) were 34% and 85%, respectively. Sarcopenic women defined by SARC-F had significantly lower physical performance than nonsarcopenic women. The SARC-F improved the ability to predict poor physical performance. The validity of the SARC-F questionnaire to screen for sarcopenia, when compared with the FNIH criteria, was limited. However, sarcopenia defined by the SARC-F questionnaire substantially improved the predictive value of clinical characteristics of patients to predict poor physical performance. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine

  6. Association Between Sarcopenia and Metabolic Syndrome in Cancer Survivors.

    Science.gov (United States)

    Lee, Su Jung; Kim, Nam Cho

    Advanced cancer treatments have improved survival from cancer, but the incidence of cardiovascular disease in survivors has recently increased. Sarcopenia and metabolic syndrome (MetS) are related to cancer survival, and sarcopenia is an emerging risk factor for cardiovascular disease. However, evidence of a relationship between sarcopenia and MetS in cancer survivors is lacking. The aims of this study were to determine the prevalence of sarcopenia and MetS in cancer survivors and to investigate independent predictors of MetS in cancer survivors. From the fourth and fifth Korea National Health and Nutritional Exam Survey (2008-2011), 798 consecutive cancer survivors were analyzed. Sarcopenia was defined as the appendicular skeletal muscle mass divided by weight less than 1 SD below the sex-specific healthy population aged 20 to 39 years. Metabolic syndrome was defined using the National Cholesterol Education Program definition. Among 798 cancer survivors, the prevalence rates of sarcopenia and MetS were 23.1% and 30.0%, respectively. Survivors with sarcopenia were more likely to have a higher waist circumference, body mass index, triglyceride level, and blood pressure and to have a lower high-density lipoprotein cholesterol level compared with those without sarcopenia. In multivariable analysis, sarcopenia was an independent predictor of MetS (odds ratio, 2.76; 95% confidence interval, 1.92-3.97). In addition, age and type of cancer were independent predictors of MetS. Sarcopenia was associated with an increased prevalence of MetS in cancer survivors. Interventions to prevent sarcopenia may be necessary to improve cardiovascular outcome in cancer survivors.

  7. The SARC-F Questionnaire: Diagnostic Overlap with Established Sarcopenia Definitions in Older German Men with Sarcopenia.

    Science.gov (United States)

    Kemmler, Wolfgang; Sieber, Cornel; Freiberger, Ellen; von Stengel, Simon

    2017-01-01

    The high relevance of sarcopenia for the aging societies of most developed nations is emphasized by its recent inclusion in the ICD-10-CM (M62.84). However, diagnosing sarcopenia is a daunting task. Apart from varying definitions, the proper assessment of recognized sarcopenia criteria is time and cost consuming. A short and inexpensive screening tool may thus be welcome for clinicians and others working in the area of gerontology. Recently, a simple questionnaire was provided (SARC-F) that may adequately realize this aim. The purpose of this study is to compare established sarcopenia definitions (European Working Group on Sarcopenia in Older People [EWGSOP], Foundation National Institute of Health [FNIH], International Working Group on Sarcopenia [IWGS]) with the SARC-F. Our hypothesis was that the diagnostic overlap between the SARC-F and sarcopenia as determined by these recognized definitions was too low to reliably diagnose sarcopenia. Seventy-four community-dwelling German men aged 70 years and older with established sarcopenia according to EWGSOP and/or FNIH and/or IWGS were screened with the SARC-F questionnaire. Applying the definitions of EWGSOP, IWGS, and FNIH, 66.2, 43.2, and 50% of the cohort were classified sarcopenic, respectively. The SARC-F identified 33.5% of the cohort as sarcopenic. The predictive power of the SARC-F increased when men were classified as sarcopenic according to 2 (57.1%) or all (78.8%) sarcopenia definitions. The diagnostic overlap with the 3 sarcopenia definitions varied between 38.8% (SARC-F-FNIH) and 54.1% (SARC-F-IWGS). In comparison, the overlap of diagnosed sarcopenia ranged from 27.0% (FNIH-IWGS) to 49.0% (IWGS-EWGSOP) among the definitions themselves. Only 12.2% of the men met all 3 sarcopenia definitions. The diagnostic overlap with respect to sensitivity of the SARC-F and present sarcopenia definitions was at least as high as the range of the diagnostic overlap of these approaches themselves. Thus, although the

  8. PREVALENCE OF SARCOPENIA IN ELDERLY PATIENTS ON HEMODIALYSIS.

    Directory of Open Access Journals (Sweden)

    Fernando Lamarca

    2012-06-01

    In conclusion, sarcopenia is highly prevalent in elderly HD patients and the inflammatory profile of sarcopenic and non-sarcopenic patients is similar. In addition, these results show that sarcopenia does not exclude the occurrence of increased adiposity, as shown by the elevated frequency of obesity and abdominal obesity in the elderly sarcopenic group.

  9. Transition to Sarcopenia and Determinants of Transitions in Older Adults: A Population-Based Study

    NARCIS (Netherlands)

    Murphy, R.A.; Ip, E.H.; Zhang, Q.; Boudreau, R.M.; Cawthon, P.M.; Newman, A.B.; Tylavsky, F.A.; Visser, M.; Goodpaster, B.H.; Harris, T.B.

    2014-01-01

    Background. Diagnostic criteria for sarcopenia from appendicular lean mass (ALM), strength, and performance have been proposed, but little is known regarding the progression of sarcopenia. We examined the time course of sarcopenia and determinants of transitioning toward and away from sarcopenia.

  10. Pharmacological intervention in frailty and sarcopenia: report by the International Conference on Frailty and Sarcopenia Research Task Force

    Science.gov (United States)

    Sarcopenia and frailty often co-exist and both have physical function impairment as a core component. Yet despite the urgency of the problem, the development of pharmaceutical therapies for sarcopenia and frailty has lagged, in part because of the lack of consensus definitions for the two conditions...

  11. Regulation of satellite cell function in sarcopenia

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    Stephen E Alway

    2014-09-01

    Full Text Available The mechanisms contributing to sarcopenia include reduced satellite cell (myogenic stem cell function that is impacted by the environment (niche of these cells. Satellite cell function is affected by oxidative stress, which is elevated in aged muscles, and this along with changes in largely unknown systemic factors, likely contribute to the manner in which satellite cells respond to stressors such as exercise, disuse or rehabilitation in sarcopenic muscles. Nutritional intervention provides one therapeutic strategy to improve the satellite cell niche and systemic factors, with the goal of improving satellite cell function in aging muscles. Although many elderly persons consume various nutraceuticals with the hope of improving health, most of these compounds have not been thoroughly tested, and the impacts that they might have on sarcopenia, and satellite cell function are not clear. This review discusses data pertaining to the satellite cell responses and function in aging skeletal muscle, and the impact that three compounds: resveratrol, green tea catechins and β-Hydroxy-β-methylbutyrate have on regulating satellite cell function and therefore contributing to reducing sarcopenia or improving muscle mass after disuse in aging. The data suggest that these nutraceutical compounds improve satellite cell function during rehabilitative loading in animal models of aging after disuse (i.e., muscle regeneration. While these compounds have not been rigorously tested in humans, the data from animal models of aging provide a strong basis for conducting additional focused work to determine if these or other nutraceuticals can offset the muscle losses, or improve regeneration in sarcopenic muscles of older humans via improving satellite cell function.

  12. Prognostic Indication of Sarcopenia for Wound Complication After Total Laryngectomy.

    Science.gov (United States)

    Achim, Virginie; Bash, Jasper; Mowery, Alia; Guimaraes, Alexander R; Li, Ryan; Schindler, Josh; Wax, Mark; Andersen, Peter; Clayburgh, Daniel

    2017-04-27

    Postoperative wound complications after total laryngectomy (TL) increase hospital stay, costs, and delay adjuvant therapy when indicated. Recently, sarcopenia has been identified as a predictor of postoperative complications in patients undergoing major surgery but has not been assessed in head and neck surgery patients. To determine the incidence of sarcopenia in patients with squamous cell carcinoma (SCC) undergoing TL and evaluate its association with the development of postoperative wound complications. Retrospective medical chart review of 70 patients with SCC who underwent TL with cross-sectional abdominal imaging obtained preoperatively from 2004 to 2016 in a tertiary care hospital. Patients were determined to have sarcopenia present if the skeletal muscle index was calculated to be less than 38.5 cm2/m2 for women and 52.4 cm2/m2 for men. Demographic data included age, sex, smoking history, Charlson Comorbidity Index (CCI) score, prior radiation history, tumor stage, body mass index (BMI), and preoperative albumin levels. Measurements of abdominal wall and paraspinal musculature at the cross-sectional L3 vertebral body were performed, normalized for height, and compared with previously defined sex-specific cutoff values to identify sarcopenia. Postoperative complications including all complications, wound-related complications, and pharyngo-cutaneous fistula (PCF) were determined. Sarcopenia was identified preoperatively in 54 (77%) patients. There was not a significant difference between the sarcopenia group and the nonsarcopenia group for any data except BMI (Cohen d = 1; 95% CI, 0.41-1.57) and preoperative albumin levels (Cohen d = 0.69; 95% CI, 0.11-1.25). Of 70 patients, 13 (24%) in the sarcopenia group developed a PCF compared with 0 (0%) without sarcopenia (OR, 1.32; 95% CI, 1.13-1.53). Similarly, 35 (50%) patients in the sarcopenia group developed a wound complication compared with 2 (13%) in the nonsarcopenia group (OR, 7.54; 95% CI, 1

  13. Clinical findings and prognosis of patients hospitalized for acute decompensated heart failure: Analysis of the influence of Chagas etiology and ventricular function

    Science.gov (United States)

    Moreira, Henry Fukuda; Ayub-Ferreira, Silvia Moreira; Conceição-Souza, Germano Emilio; Salemi, Vera Maria Cury; Chizzola, Paulo Roberto; Oliveira, Mucio Tavares; Lage, Silvia Helena Gelas; Bocchi, Edimar Alcides; Issa, Victor Sarli

    2018-01-01

    Aims Explore the association between clinical findings and prognosis in patients with acute decompensated heart failure (ADHF) and analyze the influence of etiology on clinical presentation and prognosis. Methods and results Prospective cohort of 500 patients admitted with ADHF from Aug/2013-Feb/2016; patients were predominantly male (61.8%), median age was 58 (IQ25-75% 47–66 years); etiology was dilated cardiomyopathy in 141 (28.2%), ischemic heart disease in 137 (27.4%), and Chagas heart disease in 113 (22.6%). Patients who died (154 [30.8%]) or underwent heart transplantation (53[10.6%]) were younger (56 years [IQ25-75% 45–64 vs 60 years, IQ25-75% 49–67], P = 0.032), more frequently admitted for cardiogenic shock (20.3% vs 6.8%, Pheart transplant was higher among patients with Chagas (50.5%). Conclusions A physical exam may identify patients at higher risk in a contemporaneous population. Our findings support specific therapies targeted at Chagas patients in the setting of ADHF. PMID:29432453

  14. Sarcopenia in diabetic nephropathy: a cross-sectional study.

    Science.gov (United States)

    Çeliker, Meral; Selçuk, Mustafa Yavuz; Olt, Serdar

    2018-01-01

    To investigate the relationship between sarcopenia and diabetic nephropathy. 56 diabetic patients without complications, 50 diabetic patients with nephropathy, 53 healthy controls included in this present study. Demographic characteristics such as sex, age, anthropometric measurements such as weight, body mass index [BMI], hip circumference, waist circumference and upper arm circumference were measured. Sarcopenia diagnosis was based on European Working Group on Sarcopenia in Older People [EWGSOP] criteria which consist of hand grip strength, 6-meter walking test and muscle mass. The frequency of sarcopenia increased gradually from 15,1% in healthy control group to 21,4% in the diabetes group, and 34% in diabetic nephropathy group (X2 for trend, p=0.029),. The frequency of sarcopenia was similar in diabetes and diabetic nephropathy group. However, the frequency of sarcopenia was higher in diabetic nephropathy than healthy controls (OR=2.89, CI [1.11-7.51] in logistic regression). In the present study, the prevalence of sarcopenia was higher in patients with diabetic nephropathy compared to healty co`ntrols.

  15. Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015.

    Directory of Open Access Journals (Sweden)

    Kay M Tomashek

    2017-09-01

    Full Text Available Identifying etiologies of acute febrile illnesses (AFI is challenging due to non-specific presentation and limited availability of diagnostics. Prospective AFI studies provide a methodology to describe the syndrome by age and etiology, findings that can be used to develop case definitions and multiplexed diagnostics to optimize management. We conducted a 3-year prospective AFI study in Puerto Rico. Patients with fever ≤7 days were offered enrollment, and clinical data and specimens were collected at enrollment and upon discharge or follow-up. Blood and oro-nasopharyngeal specimens were tested by RT-PCR and immunodiagnostic methods for infection with dengue viruses (DENV 1-4, chikungunya virus (CHIKV, influenza A and B viruses (FLU A/B, 12 other respiratory viruses (ORV, enterovirus, Leptospira spp., and Burkholderia pseudomallei. Clinical presentation and laboratory findings of participants infected with DENV were compared to those infected with CHIKV, FLU A/B, and ORV. Clinical predictors of laboratory-positive dengue compared to all other AFI etiologies were determined by age and day post-illness onset (DPO at presentation. Of 8,996 participants enrolled from May 7, 2012 through May 6, 2015, more than half (54.8%, 4,930 had a pathogen detected. Pathogens most frequently detected were CHIKV (1,635, 18.2%, FLU A/B (1,074, 11.9%, DENV 1-4 (970, 10.8%, and ORV (904, 10.3%. Participants with DENV infection presented later and a higher proportion were hospitalized than those with other diagnoses (46.7% versus 27.3% with ORV, 18.8% with FLU A/B, and 11.2% with CHIKV. Predictors of dengue in participants presenting <3 DPO included leukopenia, thrombocytopenia, headache, eye pain, nausea, and dizziness, while negative predictors were irritability and rhinorrhea. Predictors of dengue in participants presenting 3-5 DPO were leukopenia, thrombocytopenia, facial/neck erythema, nausea, eye pain, signs of poor circulation, and diarrhea; presence of

  16. Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015.

    Science.gov (United States)

    Tomashek, Kay M; Lorenzi, Olga D; Andújar-Pérez, Doris A; Torres-Velásquez, Brenda C; Hunsperger, Elizabeth A; Munoz-Jordan, Jorge Luis; Perez-Padilla, Janice; Rivera, Aidsa; Gonzalez-Zeno, Gladys E; Sharp, Tyler M; Galloway, Renee L; Glass Elrod, Mindy; Mathis, Demetrius L; Oberste, M Steven; Nix, W Allan; Henderson, Elizabeth; McQuiston, Jennifer; Singleton, Joseph; Kato, Cecilia; García Gubern, Carlos; Santiago-Rivera, William; Cruz-Correa, Jesús; Muns-Sosa, Robert; Ortiz-Rivera, Juan D; Jiménez, Gerson; Galarza, Ivonne E; Horiuchi, Kalanthe; Margolis, Harold S; Alvarado, Luisa I

    2017-09-01

    Identifying etiologies of acute febrile illnesses (AFI) is challenging due to non-specific presentation and limited availability of diagnostics. Prospective AFI studies provide a methodology to describe the syndrome by age and etiology, findings that can be used to develop case definitions and multiplexed diagnostics to optimize management. We conducted a 3-year prospective AFI study in Puerto Rico. Patients with fever ≤7 days were offered enrollment, and clinical data and specimens were collected at enrollment and upon discharge or follow-up. Blood and oro-nasopharyngeal specimens were tested by RT-PCR and immunodiagnostic methods for infection with dengue viruses (DENV) 1-4, chikungunya virus (CHIKV), influenza A and B viruses (FLU A/B), 12 other respiratory viruses (ORV), enterovirus, Leptospira spp., and Burkholderia pseudomallei. Clinical presentation and laboratory findings of participants infected with DENV were compared to those infected with CHIKV, FLU A/B, and ORV. Clinical predictors of laboratory-positive dengue compared to all other AFI etiologies were determined by age and day post-illness onset (DPO) at presentation. Of 8,996 participants enrolled from May 7, 2012 through May 6, 2015, more than half (54.8%, 4,930) had a pathogen detected. Pathogens most frequently detected were CHIKV (1,635, 18.2%), FLU A/B (1,074, 11.9%), DENV 1-4 (970, 10.8%), and ORV (904, 10.3%). Participants with DENV infection presented later and a higher proportion were hospitalized than those with other diagnoses (46.7% versus 27.3% with ORV, 18.8% with FLU A/B, and 11.2% with CHIKV). Predictors of dengue in participants presenting dengue in participants presenting 3-5 DPO were leukopenia, thrombocytopenia, facial/neck erythema, nausea, eye pain, signs of poor circulation, and diarrhea; presence of rhinorrhea, cough, and red conjunctiva predicted non-dengue AFI. By enrolling febrile patients at clinical presentation, we identified unbiased predictors of laboratory

  17. Mecanismos de perda muscular da sarcopenia Mechanisms of muscle wasting in sarcopenia

    Directory of Open Access Journals (Sweden)

    Vivian de Oliveira Nunes Teixeira

    2012-04-01

    Full Text Available Cerca de 66% dos pacientes com artrite reumatoide (AR apresentam significativa perda de massa celular, denominada caquexia reumatoide, predominantemente de músculo esquelético (sarcopenia reumatoide. A sarcopenia é caracterizada por perda de massa muscular associada a prejuízos de função. Pacientes com AR apresentam uma redução significativa na força muscular, causada pela perda de proteínas musculares, alterando sua funcionalidade. As diversas condições que levam à perda de massa muscular envolvem distintas cascatas de sinalização intracelular, que podem levar: (i à morte celular programada (apoptose; (ii ao aumento da degradação proteica, por meio de autofagia, de proteases dependentes de cálcio (calpaínas e caspases e do sistema proteossomo; e (iii à diminuição da ativação das células-satélite responsáveis pela regeneração muscular. Este artigo tem como objetivo revisar esses mecanismos gerais de sarcopenia e seu envolvimento na AR. O melhor conhecimento desses mecanismos pode levar ao desenvolvimento de terapias inovadoras para essa debilitante complicação.Approximately 66% of the patients with rheumatoid arthritis (RA have significant loss of cell mass (rheumatoid cachexia, mainly of skeletal muscle (rheumatoid sarcopenia. Sarcopenia is defined as muscle wasting associated with functional impairment. Patients with RA possess significant reduction in muscle strength, caused by muscle protein wasting, and loss of functionality. Various conditions leading to muscle wasting involve different pathways of intracellular signaling that trigger: (i programmed cell death (apoptosis; (ii increased protein degradation through autophagy, calcium-dependent proteases (calpains and caspases, and proteasome system; (iii decreased satellite cell activation, responsible for muscle regeneration. This article aimed at reviewing these general mechanisms of sarcopenia and their involvement in RA. Greater knowledge of these

  18. Alveolar process fractures in the permanent dentition. Part 1. Etiology and clinical characteristics. A retrospective analysis of 299 cases involving 815 teeth

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva

    2015-01-01

    AIM: To describe the etiology and clinical characteristics of alveolar process fractures treated in a regional trauma clinic. MATERIAL AND METHOD: The study is a retrospective descriptive analysis of 299 patients (180 males, 119 females; 815 permanent teeth) diagnosed with fractures of the alveolar...... frequently in the mandible (26%). The majority of the fractures involved only two teeth (57%) but occasionally involved up to seven teeth. The age at fracture ranged from 5 to 90 years; alveolar process fractures occurred most frequently between 15 and 25 years of age (43%). Concomitant soft tissue injuries...... were present in 73%. The most frequent location of the mandibular fracture line was along the periodontal ligament of the canine and in the sagittal suture between the two central maxillary incisors. This pattern appears to correlate with weak zones in the jaws. CONCLUSION: In conclusion, alveolar...

  19. Sarcopenia in children with perforated appendicitis.

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    López, Joseph J; Cooper, Jennifer N; Albert, Brett; Adler, Brent; King, Denis; Minneci, Peter C

    2017-12-01

    Decreased skeletal muscle mass, or sarcopenia, has been shown to be associated with worse postoperative recovery and a higher risk of complications in adult surgical patients. We hypothesized that pediatric patients with complicated appendicitis may experience sarcopenic changes over the course of their treatment. The medical records and computed tomography scans of 36 pediatric complex appendicitis patients who had both preoperative and postoperative computerized tomography scans at our hospital were reviewed. Changes in psoas muscle area were examined using linear mixed models with random patient-level intercept and time effects. The median change in body mass index among all patients from admission to discharge was -0.8 kg/m 2 (interquartile range: -1.3 to -0.2). The mean percentage change in psoas muscle area per day over the course of appendicitis-related treatment was -0.81% (95% confidence interval: -1.12 to -0.50) (P  0.10 for all interactions). Our data suggest that pediatric patients with complex appendicitis experience sarcopenic changes during their hospital admission. Given previous reports that sarcopenia is a significant predictor of worse surgical outcomes, more investigation is warranted to assess whether these changes are associated with postsurgical complications and to evaluate potential interventions that may prevent these changes. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Assessment of Lean Mass and Physical Performance in Sarcopenia.

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    Cawthon, Peggy M

    2015-01-01

    This review provides a description of the assessment of lean mass and physical performance with particular attention to how these measures are used in the context of sarcopenia, in both research and clinical settings. One of the most common methods to estimate muscle mass is whole-body dual-energy X-ray absorptiometry (DXA). DXA estimates the total amount of lean tissue but does not directly measure muscle mass. Appendicular lean mass (ALM), derived from DXA scans, is the sum of the lean tissue in the arms and legs. ALM alone, or scaled to height squared (ALM/height(2)) or body mass index (ALM/body mass index), is the most common metric used as an approximation of muscle mass in sarcopenia research. Other methods to assess muscle mass include central or peripheral quantitative computed tomography (to determine muscle cross-sectional area and muscle density, a marker of fat i nfiltration into the muscle); magnetic resonance (to assess muscle cross-sectional area and volume); and bioelectrical impedance analysis (to determine fat-free mass). Many approaches to objectively measuring physical performance have been used in sarcopenia research. Muscle strength is often measured: Grip strength is very inexpensive and straightforward to assess, whereas assessment of lower extremity strength is more difficult. However, lower extremity strength may be a more relevant measure than grip strength in the context of mobility outcomes. Dynamic physical performance is also widely measured in research settings and may be emerging as a routine assessment in clinical care. The most widely used measure of physical performance is walking speed over a short distance, usually 3-6 m. Other measures of objective physical performance include the Short Physical Performance Battery that includes gait speed, ability and time to rise from a chair 5 times, and static balance tests; and the Timed Up and Go test that measures the time to rise from a chair and walk a short distance. Finally, longer

  1. Sarcopenia and frailty in older patients with diabetes mellitus.

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    Umegaki, Hiroyuki

    2016-03-01

    Sarcopenia is defined as age-associated loss of muscle mass and function, and is frequently accompanied by diabetes mellitus (DM) in older adults. Some of the mechanisms of the development of sarcopenia including insulin resistance, chronic inflammation and mitochondrial dysfunction are also associated with the pathogenesis of DM. Sarcopenia provides the basis for frailty, which is a state that is highly vulnerable to stressors, and can lead to disability, dependency and mortality, and older DM patients are often in a state of frailty. Given the background of an increasing number of older DM patients, the screening and early detection of sarcopenia/frailty and appropriate intervention would be expected to improve the prognosis and quality of life in older patients. © 2016 Japan Geriatrics Society.

  2. Therapies for sarcopenia and regeneration of old skeletal muscles: more a case of old tissue architecture than old stem cells.

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    Grounds, Miranda D

    2014-01-01

    Age related loss of skeletal muscle mass and function (sarcopenia) reduces independence and the quality of life for individuals, and leads to falls and fractures with escalating health costs for the rapidly aging human population. Thus there is much interest in developing interventions to reduce sarcopenia. One area that has attracted recent attention is the proposed use of myogenic stem cells to improve regeneration of old muscles. This mini-review challenges the fundamental need for myogenic stem cell therapy for sarcopenia. It presents evidence that demonstrates the excellent capacity of myogenic stem cells from very old rodent and human muscles to form new muscles after experimental myofiber necrosis. The many factors required for successful muscle regeneration are considered with a strong focus on integration of components of old muscle bioarchitecture. The fundamental role of satellite cells in homeostasis of normal aging muscles and the incidence of endogenous regeneration in old muscles is questioned. These issues, combined with problems for clinical myogenic stem cell therapies for severe muscle diseases, raise fundamental concerns about the justification for myogenic stem cell therapy for sarcopenia.

  3. Sarcopenia and its determinants among Iranian elderly (SARIR: study protocol

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    Hashemi Rezvan

    2012-11-01

    Full Text Available Abstract Background The elderly populations increase in world because of improved health status in communities, so health and independency of seniors has become and will be one of the main priorities of public health systems. Ageing have been associated with changes in body composition, including loss of muscle mass, loss of bone mass and increase fat mass. Involuntary age related loss of muscle mass, sarcopenia,has been linked to functional impairment and physical disability. Several definitions for sarcopenia have been presented based on the method of measuring body composition, but an internationally accepted definition doesn’t presently exist yet. In 2010, the European working group on sarcopenia developed a new definition for sarcopenia according to measure muscle mass and muscle function. Several studies have been done about sarcopenia in world, but to our knowledge this study is the first in Iran which is one of the largest countries of the Middle East that faces a fast growing elderly population. The aim of this study is to evaluate sarcopenia and related risk factors in Iran according new definition of sarcopenia. Methods This study will be conducted in two phase among elderly men and women over 55 years in the 6th district of TehranThe first phase will be a population-based cross-sectional study to determine the frequency of sarcopenia in the study population, and to conduct case finding for the second phase. The second phase will be a case–control study to comparison the metabolic and inflammatory factors in sarcopenic and non sarcopenic groups. The association between sarcopenia and major dietary pattern will be evaluated using factor analysis. Conclusion This study is the first study that evaluates sarcopenia and its risk factor in Iranian elderlies. We discuss details of how we collect the data and appropriate instruments to measure muscle mass, muscle power and muscle strength, and suitable cut- off to define sarcopenia in

  4. Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

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    Felipe Torres Pacheco

    2015-05-01

    Full Text Available Objective The potential of computed tomography angiography (CTA was assessed for early determination of stroke subtypes in a Brazilian cohort of patients with stroke. Method From July 2011 to July 2013, we selected patients with suspected hyperacute stroke (< 6 hours. Intracranial and cervical arteries were scrutinized on CTA and their imaging features were correlated with concurrent subtype of stroke. Results Stroke was documented in 50/106 selected patients (47.2% based on both clinical grounds and imaging follow-up (stroke group, with statistically significant arterial stenosis and vulnerable plaques on CTA. Intracranial large artery disease was demonstrated in 34% of patients in the stroke group. Partial territorial infarct prevailed (86% while artery-to-artery embolization was the most common stroke mechanism (52%. Conclusion Multidetector CTA was useful for the etiologic work-up of hyperacute ischemic stroke and facilitated the knowledge about the topographic pattern of brain infarct in accordance with its causative mechanism.

  5. Sarcopenia in type 2 diabetes mellitus (review and own observations

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    O.A. Goncharova

    2017-03-01

    Full Text Available Background. A review of the literature on sarcopenia syndrome presents its definition, classifications and etiological factors. The main attention is paid to the correlation between sarcopenia and carbohydrate metabolism, in particular, between glycogen content and insulin sensitivity. The publications dealing with the mechanisms of influence of physical activity (short-term and long-term on carbohydrate metabolism are analyzed. It is emphasized that today there is an evidence base on the role of skeletal muscles in maintaining glucose homeostasis, which justifies the importance of physical activity for the prevention of type 2 diabetes mellitus (DM and monitoring such patients. Our observations were carried out to compare the frequency of the increase in the percentage of fat tissue (FT and the reduction in muscle tissue in patients with different body mass index (BMI and the effects of type 2 DM on these indicators. Materials and methods. A bioimpedance study was performed in 114 patients with type 2 DM aged 52.3 ± 1.7 years and 110 persons of the same age without type 2 DM (control group. Results. In all those surveyed with overweight and obesity, the age norms of percentage of FT were increased, regardless of the presence or absence of type 2 DM. At normal body weight in the control group in almost half of the examinees (52.0 %, there was an increase in the specific weight of the FT, and in the presence of type 2 DM, this index was significantly higher (94.1 %. This suggests that exceeding the age norms for the percentage of FT in persons with normal body weight can be regarded as a risk factor for type 2 DM. Conclusions. The incidence of a decrease in the specific weight of FT in the control group was 8.0 % in normal body weight, 20.0 % — in overweight and 80.0 % — in obesity that indicates the significance of the problem of sarcopenia, primarily in persons with obesity. Against the background of type 2 DM, these rates were

  6. Assessing the Risk of Sarcopenia in the Elderly: The Mini Sarcopenia Risk Assessment (MSRA) Questionnaire.

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    Rossi, A P; Micciolo, R; Rubele, S; Fantin, F; Caliari, C; Zoico, E; Mazzali, G; Ferrari, E; Volpato, S; Zamboni, M

    2017-01-01

    to validate the MSRA questionnaire proposed as prescreening tool for sarcopenia, in a population of community-dwelling elderly subjects. observational study. community dwelling elderly subjects. 274 community dwelling elderly subjects, 177 women and 97 men, aged 66-78 years. Based on EWGSOP diagnostic criteria subjects were classified as sarcopenic and non-sarcopenic. The Mini Sarcopenia Risk Assessment (MSRA) questionnaire, is composed of seven questions and investigates anamnestic and nutritional characteristics related to risk of sarcopenia onset (age, protein and dairy products consumption, number of meals per day, physical activity level, number of hospitalizations and weight loss in the last year). 33.5% of the study population, were classified as sarcopenic. With the 7-item MSRA score, subjects with a score of 30 or less, had a 4-fold greater risk of being sarcopenic than subjects with a score higher than 30 (OR:4.20;95% CI:2.26-8.06); area under the ROC curve was 0.786 (95% CI:0.725-0.847). In a logistic regression, considering as dependent variable the probability of being sarcopenic, and as independent variables the 7 items of the questionnaire, two items (number of meals and milk and dairy products consumption) showed non-significant diagnostic power. A 5-item score was then derived and the area under the ROC curve was 0.789 (95% IC:0.728-0.851). Taking into account the cost of false positive and false negative costs and the prevalence of sarcopenia, the "optimal" threshold of the original MSRA score (based on 7 items) is 30, with a sensitivity of 0.804 and a specificity of 0.505, while the "optimal" threshold of the MSRA score based on 5 items, is 45, with a sensitivity of 0.804 and a specificity of 0.604. this preliminary study shows that the MSRA questionnaire is predictive of sarcopenia and can be suggested as prescreening instrument to detect this condition. The use of a short form of the MSRA questionnaire improves the capacity to identify

  7. Etiologic Factors in Erythema Nodosum

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    Mehmet Ali Gürer

    2008-12-01

    Full Text Available Background and Design: Erythema nodosum (EN is the most common type of inflammatory nodules. Etiologic factors that lead to EN show a wide spectrum including drugs, infections, malignant and inflammatory diseases. The aim of our study was to investigate frequency of etiologic factors, clinical and laboratory findings of EN patients treated in our clinic, and to identify whether these findings were predictive for a specific etiology in these patients or not. Material and Method: A total of 72 patients diagnosed with EN in our clinic during the period 2003-2007 were included. Results: Patients were divided into two groups with regard to their etiologies. Group I was consisting of 30 cases (41.6% in whom no underlying disease or precipitating factor were found and Group II was consisting of 42 cases (58.4% in whom an etiologic factor was identified. Infections (n=24 were the most common identified etiologic factors followed by Behcet's disease (BD, drugs, pregnancy, and sarcoidosis. Statistical analysis revealed no difference according to age and sex characteristics, localization of disease, and the presence of fever and arthralgia as accompanying findings between the groups (p>0.05. The duration of disease was longer in Group II and patients in Group II were found to have more frequently >1 attack of EN, culture positivity and elevated ASO level when compared with that of Group I (p0.05.Conclusion: Infections, BD and drugs were the most frequently detected etiologic factors in our study. Our results revealed that the localization of lesions and laboratory findings like elevated ESR and CRP, leukocytosis, and anemia were not predictors of secondary EN, and that a further search for an underlying disease is necessary in patients having relapsing EN with a long disease duration. (Turkderm 2008; 42: 113-7

  8. Novel Insights on Nutrient Management of Sarcopenia in Elderly

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    Mariangela Rondanelli

    2015-01-01

    Full Text Available Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of muscle mass and strength. The more rationale approach to delay the progression of sarcopenia is based on the combination of proper nutrition, possibly associated with the use of dietary supplements and a regular exercise program. We performed a narrative literature review to evaluate the till-now evidence regarding (1 the metabolic and nutritional correlates of sarcopenia; (2 the optimum diet therapy for the treatment of these abnormalities. This review included 67 eligible studies. In addition to the well recognized link between adequate intake of proteins/amino acids and sarcopenia, the recent literature underlines that in sarcopenic elderly subjects there is an unbalance in vitamin D synthesis and in omega-6/omega-3 PUFA ratio. Given the detrimental effect of these metabolic abnormalities, a change in the lifestyle must be the cornerstone in the treatment of sarcopenia. The optimum diet therapy for the sarcopenia treatment must aim at achieving specific metabolic goals, which must be reached through accession of the elderly to specific personalized dietary program aimed at achieving and/or maintaining muscle mass; increasing their intake of fish (4 times/week or taking omega-3 PUFA supplements; taking vitamin D supplementation, if there are low serum levels.

  9. Prevalence of sarcopenia in a media and long stay Unit.

    Science.gov (United States)

    Rubio-Maicas, C; Duarte-Alfonso, E; Beseler-Soto, M R; Moreno-Muñoz, I; Moral-Moral, P; Merino-Torres, J F

    2014-01-01

    Sarcopenia is characterized by the loss of skeletal muscle mass and strength and represents a risk factor for frailty, loss of independence and physical disabilities. This study aimed to assess the prevalence of sarcopenia in a population of patients admitted to a media and long-stay unit. Descriptive, cross-sectional observational study that included 166 patients over 18 years who were admitted consecutively for a year to palliative care, convalescence or rehabilitation. Administrative and anthropometric data were recorded. Sarcopenia detection was performed by assessing the strength in the scapular and pelvic girdle muscles, grip strength in the hands, muscle mass and physical functional capacity. The overall prevalence of sarcopenia was 77.6%. Most patients had severe sarcopenia (91.2%), with reduced levels of the 3 assessed parameters: muscle strength (88.2%), muscle mass (85.5%) and physical performance (94.70%). The prevalence of sarcopenia in patients admitted to our media and long-stay unit is higher than that reported in noninstitutionalized populations, and often has a significant degree of severity. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  10. [Transdisciplinary Approach for Sarcopenia. The application of life style diseases-animal models to the research for sarcopenia].

    Science.gov (United States)

    Sugimoto, Ken; Rakugi, Hiromi

    2014-10-01

    Sarcopenia can be developed based on loss of skeletal muscle mass induced by various age-related factors, and suitable animal models must be needed to elucidate the mechanism of sarcopenia. Since loss of skeletal muscle mass is observed earlier in the elderly with lifestyle-related diseases than in the health elderly, animal models for lifestyle-related diseases can be applicable to the research for sarcopenia. Several reports using animal models for diabetes or specific diet-fed animals show that insulin resistance, hyperglycemia, increase of glucocorticoids, low-grade inflammation and accumulation of advanced glycation end products (AGEs) can accelerate loss of skeletal muscle mass. Thus, the application of these animal models to further investigations on prevention or intervention for sarcopenia will be widely expected.

  11. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition.

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    Bahat, Gulistan; Tufan, Asli; Tufan, Fatih; Kilic, Cihan; Akpinar, Timur Selçuk; Kose, Murat; Erten, Nilgun; Karan, Mehmet Akif; Cruz-Jentoft, Alfonso J

    2016-12-01

    The reported prevalence of sarcopenia ranges widely depending on its definition criterion. European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria. This definition recommends using normative data of the study population rather than other reference populations. We aimed to define the reference cut-off values for muscle mass, muscle strength and calf circumference in Turkey in order to improve general applicability of EWGSOP criteria. Healthy young adults between 18 and 39 years of age with no known chronic disease or chronic drug usage were included in our study to serve as reference population for assessing muscle mass. Community-dwelling older outpatients were prospectively recruited from the geriatrics outpatient clinics of a university hospital for assessing hand grip strength and calf circumference. Body composition was assessed by bioimpedance analysis. Muscle strength was assessed measuring hand grip strength with a Jamar hand dynamometer. The cut-off thresholds for muscle mass were defined as the mean-2SD of the values of the young reference study population; for grip strength were calculated from ROC analyses using cut-off values that predicted gait speed < 0.8 m/s; and for calf circumference were calculated from ROC analyses using cut-off values that predicted low muscle mass. The young reference group included a total of 301 participants (187 male, 114 female; mean age: 26.5 ± 4.6 years). The cut-off thresholds for skeletal muscle mass indexes were 9.2 kg/m(2) and 7.4 kg/m(2) in males and females, respectively. The older community dwelling group included 406 subjects (123 male, 283 female, mean age: 76.6 ± 6.7 years). The cut-off thresholds for hand grip strength were 32 kg and 22 kg for males and females. The cut-off threshold for calf circumference was 33 cm for both males and females. The cut-off thresholds for muscle mass, grip strength and calf

  12. Adherence to a standardized protocol for measuring grip strength and appropriate cut-off values in adults over 65 years with sarcopenia: a systematic review protocol.

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    Fox, Benjamin; Henwood, Tim; Schaap, Laura; Bruyère, Olivier; Reginster, Jean-Yves; Beaudart, Charlotte; Buckinx, Fanny; Roberts, Helen; Cooper, Cyrus; Cherubini, Antonio; dellʼAquilla, Giuseppina; Maggio, Marcello; Volpato, Stefano

    2015-10-01

    The objective of this review is to examine the use of grip strength analysis in well and unwell populations in adults 65 years and over as a tool to establish muscle strength in sarcopenia.More specifically, the main review question is:1. What protocol, if any, is most commonly used among older adults with sarcopenia and does this match the standardized protocol suggested in 2011 by Roberts et al.1?Secondary review questions are:2. What are the reported cut-off values being used to determine sarcopenia in older adults, with consideration for ethnic and gender variability?3. Is grip strength, as a tool to measure muscle strength, suitable for people with common comorbidities and geriatric syndromes, such as osteoarthritis, often associated with sarcopenia? Sarcopenia, a commonly used concept in geriatrics and gerontology, is characterized by a loss of muscle mass, muscle strength and/or physical functioning. Prevalence rates vary between 1-39% in community dwelling older populations and 14-33% in long-term care populations. Several epidemiological studies have shown the association of sarcopenia with adverse health outcomes such as falls, disability, hospitalization and mortality. Originally, sarcopenia refers to the loss of muscle mass with aging, which was later complemented with loss of muscle strength and physical functioning.In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) reported a consensus definition of sarcopenia, which included measurement of low muscle mass and low muscle function (strength or physical performance). This consensus definition can be used to identify sarcopenia patients in clinical practice and to select individuals for clinical trials. Well-designed clinical trials could ultimately lead to effective treatment and prevention strategies for sarcopenia. Since the publication of the consensus report, many studies have adopted this definition, which could potentially lead to better comparison of results between

  13. STEVENS-JOHNSON SYNDROME — TOXIC EPIDERMAL NECTROLYSIS IN CHILDREN. PART I. DETERMINATION, ETIOLOGY, PATHOGENESIS, CLINICAL MANIFESTATIONS, SYSTEMIC TREATMENT

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    V.F. Zhernosek

    2011-01-01

    Full Text Available Part I of the literature review provides modern terminology and classification of Stevens-Johnson syndrome (SJS and toxic epidermal necrolysis (TEN, which is now considered different ways of treating the single pathological process induced in children by infections, drugs, malignant and autoimmune diseases. It illustrates in detail the latest data on pathogenesis, describes clinical manifestations of both scenarios and their transition forms. Special emphasis is made on the organisation of care for patients with SJS and TEN. It details various aspects of systemic therapy.Key words: Stevens-Johnson syndrome, toxic epidermal necrolysis, systemic treatment, children.

  14. Validation of the Korean Version of the SARC-F Questionnaire to Assess Sarcopenia: Korean Frailty and Aging Cohort Study.

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    Kim, Sunyoung; Kim, Miji; Won, Chang Won

    2017-08-23

    The SARC-F is a simple sarcopenia screening tool comprising 5 assessment items: strength, assistance walking, rising from a chair, climbing stairs, and falls. The present study aimed to examine the validation of the Korean version of SARC-F for elderly individuals residing in communities. From the first year baseline data of Korean Frailty and Aging Cohort Study, a total of 1222 elderly individuals (70 years and older) who met the study's selection criteria were included in the analysis. The SARC-F was translated into the Korean language in a culturally responsive way. The total score was calculated by adding the scores on the 5 items. The participants were divided into 2 groups according to the total score (SARC-F F ≥4), and its correlations with various factors including walking speed, hand grip, ability to perform everyday activities, and health-related quality of life, were examined by sex. In addition, the tool's validity was analyzed by comparing it with the European, international, and Asian sarcopenia working group diagnostic criteria for sarcopenia. The prevalence of sarcopenia according to the SARC-F was 4.2% in among men and 15.3% in women. The sensitivity of the SARC-F was low compared with the European, international, and Asian criteria of sarcopenia [male (M): 11%-60%, female (F): 28%-34%]. However, SARC-F showed a high specificity (M: 96.6%-98%, F: 85%-87.7%) and a high negative predictive value (M: 89.2%-99.3%, F: 88.5%-98.4%). The participants in the SARC-F ≥4 group had poorer grip strength, slower walking speed, poorer physical performance, poorer cognitive function, and a lower quality of life (a high EuroQol-5 dimension score) than the participants in the SARC-F F showed a high specificity and high negative predictive value. As such, the tool is useful for briefly ruling out sarcopenia in a clinical setting. In addition, diagnosis of sarcopenia using the SARC-F was found to be associated with physical performance, cognitive function, and

  15. Etiology and clinical characterization of respiratory virus infections in adult patients attending an emergency department in Beijing.

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    Xiaoyan Yu

    Full Text Available BACKGROUND: Acute respiratory tract infections (ARTIs represent a serious global health burden. To date, few reports have addressed the prevalence of respiratory viruses (RVs in adults with ARTIs attending an emergency department (ED. Therefore, the potential impact of respiratory virus infections on such patients remains unknown. METHODOLOGY/PRINCIPAL FINDINGS: To determine the epidemiological and clinical profiles of common and recently discovered respiratory viruses in adults with ARTIs attending an ED in Beijing, a 1-year consecutive study was conducted from May, 2010, to April, 2011. Nose and throat swab samples from 416 ARTI patients were checked for 13 respiratory viruses using multiple reverse transcription polymerase chain reaction(RT-PCR assays for common respiratory viruses, including influenza viruses (Flu A, B, and adenoviruses (ADVs, picornaviruses (PICs, respiratory syncytial virus (RSV, parainfluenza viruses (PIVs 1-3, combined with real-time RT-PCR for human metapneumovirus (HMPV and human coronaviruses (HCoVs, -OC43, -229E, -NL63, and -HKU1. Viral pathogens were detected in 52.88% (220/416 of patient samples, and 7.21% (30/416 of patients tested positive for more than one virus. PICs (17.79% were the dominant agents detected, followed by FluA (16.11%, HCoVs (11.78%, and ADV (11.30%. HMPV, PIVs, and FluB were also detected (<3%, but not RSV. The total prevalence and the dominant virus infections detected differed significantly between ours and a previous report. Co-infection rates were high for HCoV-229E (12/39, 30.76%, PIC (22/74, 29.73%, ADV (12/47, 25.53% and FluA (15/67, 22.39%. Different patterns of clinical symptoms were associated with different respiratory viruses. CONCLUSIONS: The pattern of RV involvement in adults with ARTIs attending an ED in China differs from that previously reported. The high prevalence of viruses (PIC, FluA, HCoVs and ADV reported here strongly highlight the need for the development of safe and

  16. Clinical and Etiological Characteristics of Atypical Hand-Foot-and-Mouth Disease in Children from Chongqing, China: A Retrospective Study

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    Xiang Yan

    2015-01-01

    Full Text Available Background. Hand-foot-and-mouth disease (HFMD is a disease that had similar manifestations to chickenpox, impetigo, and measles, which is easy to misdiagnose and subsequently causes delayed therapy and subsequent epidemic. To date, no study has been conducted to report the clinical and epidemiological characteristics of atypical HFMD. Methods. 64 children with atypical HFMD out of 887 HFMD children were recruited, stool was collected, and viral VP1 was detected. Results. The atypical HFMD accounted for 7.2% of total HFMD in the same period (64/887 and there were two peaks in its prevalence in nonepidemic seasons. Ten children (15.6% had manifestations of neurologic involvement, of whom 4 (6.3% were diagnosed with severe HFMD and 1 with critically severe HFMD, but all recovered smoothly. Onychomadesis and desquamation were found in 14 patients (21.9% and 15 patients (23.4%, respectively. The most common pathogen was coxsackievirus A6 (CV-A6 which accounted for 67.2%, followed by nontypable enterovirus (26.6%, enterovirus 71 (EV-A71 (4.7%, and coxsackievirus A16 (A16 (1.5%. Conclusions. Atypical HFMD has seasonal prevalence. The manifestations of neurologic involvement in atypical HFMD are mild and usually have a good prognosis. CV-A6 is a major pathogen causing atypical HFMD, but not a major pathogen in Chongqing, China.

  17. Clinical and Etiological Characteristics of Atypical Hand-Foot-and-Mouth Disease in Children from Chongqing, China: A Retrospective Study.

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    Yan, Xiang; Zhang, Zhen-Zhen; Yang, Zhen-Hua; Zhu, Chao-Min; Hu, Yun-Ge; Liu, Quan-Bo

    2015-01-01

    Hand-foot-and-mouth disease (HFMD) is a disease that had similar manifestations to chickenpox, impetigo, and measles, which is easy to misdiagnose and subsequently causes delayed therapy and subsequent epidemic. To date, no study has been conducted to report the clinical and epidemiological characteristics of atypical HFMD. 64 children with atypical HFMD out of 887 HFMD children were recruited, stool was collected, and viral VP1 was detected. The atypical HFMD accounted for 7.2% of total HFMD in the same period (64/887) and there were two peaks in its prevalence in nonepidemic seasons. Ten children (15.6%) had manifestations of neurologic involvement, of whom 4 (6.3%) were diagnosed with severe HFMD and 1 with critically severe HFMD, but all recovered smoothly. Onychomadesis and desquamation were found in 14 patients (21.9%) and 15 patients (23.4%), respectively. The most common pathogen was coxsackievirus A6 (CV-A6) which accounted for 67.2%, followed by nontypable enterovirus (26.6%), enterovirus 71 (EV-A71) (4.7%), and coxsackievirus A16 (A16) (1.5%). Atypical HFMD has seasonal prevalence. The manifestations of neurologic involvement in atypical HFMD are mild and usually have a good prognosis. CV-A6 is a major pathogen causing atypical HFMD, but not a major pathogen in Chongqing, China.

  18. Sarcopenia and Health Care Utilization in Older Women

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    Lui, Li-Yung; McCulloch, Charles E.; Cauley, Jane A.; Paudel, Misti L.; Taylor, Brent; Schousboe, John T.; Ensrud, Kristine E.

    2017-01-01

    Background: Although there are several consensus definitions of sarcopenia, their association with health care utilization has not been studied. Methods: We included women from the prospective Study of Osteoporotic Fractures with complete assessment of sarcopenia by several definitions at the Study of Osteoporotic Fractures Year 10 (Y10) exam (1997–1998) who also had available data from Medicare Fee- For-Service Claims (N = 566) or Kaiser Encounter data (N = 194). Sarcopenia definitions evaluated were: International Working Group, European Working Group for Sarcopenia in Older Persons, Foundation for the NIH Sarcopenia Project, Baumgartner, and Newman. Hurdle models and logistic regression were used to assess the relation between sarcopenia status (the summary definition and the components of slowness, weakness and/or lean mass) and outcomes that included hospitalizations, cumulative inpatient days/year, short-term (part A paid) skilled nursing facility stay in the 3 years following the Y10 visit. Results: None of the consensus definitions, nor the definition components of weakness or low lean mass, was associated with increased risk of hospitalization or greater likelihood of short-term skilled nursing facility stay. Women with slowness by any criterion definition were about 50% more likely to be hospitalized; had a greater rate of hospitalization days amongst those hospitalized; and had 1.8 to 2.1 times greater likelihood of a short-term skilled nursing facility stay than women without slowness. There was the suggestion of a protective association of low lean mass by the various criterion definitions on short-term skilled nursing facility stay. Conclusion: Estimated effects of sarcopenia on health care utilization were negligible. However, slowness was associated with greater health care utilization. PMID:27402050

  19. Vitamin E in Sarcopenia: Current Evidences on Its Role in Prevention and Treatment

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    Khor, Shy Cian; Abdul Karim, Norwahidah; Wan Ngah, Wan Zurinah; Mohd Yusof, Yasmin Anum; Makpol, Suzana

    2014-01-01

    Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS) can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vita...

  20. Etiology, seasonality, and clinical characteristics of respiratory viruses in children with respiratory tract infections in Eastern India (Bhubaneswar, Odisha).

    Science.gov (United States)

    Panda, Swagatika; Mohakud, Nirmal Kumar; Suar, Mrutyunjay; Kumar, Subrat

    2017-03-01

    Acute respiratory tract infections (ARTIs) are a leading cause of morbidity and mortality in young children in low and middle income countries. To analyse the overall burden of respiratory viruses responsible for ARTIs in paediatrics population in eastern India, this study was performed. Clinical information, demographic information and nasal/oral swabs were collected from 332 paediatric patients (aged from 1 month to 12 years old) with the symptoms of ARTI, enrolled from the outpatient department from Nov 2012 to Oct 2014. Multiplex PCR was performed to detect eight respiratory viral pathogens. Seasonal, as well as age-wise prevalence of respiratory viruses was analysed. Of these 332 cases, 32.53% (108/332) were positive for at least one pathogen. Human rhinovirus (HRV) was the most frequently detected pathogen (24.7%, 82/332) followed by respiratory syncytial virus (RSV) (4.22%, 14/332), PIV (2.11%, 7/332), and hMPV (2.11%, 7/332). Single infection was detected in 92.6% (100/108) of positive cases. Respiratory virus infections showed seasonal variation, with peaks during the rainy season followed by winter season, and were most common in patients under 1 year of age. Phylogenetic analysis of HMPV positive samples confirmed the circulation of A2 subgroup in the study area. The present study is first of its kind and adds to our knowledge of the epidemiological characteristics of these common respiratory viruses among patients with ARTIs in the study area. J. Med. Virol. 89:553-558, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. [Transdisciplinary Approach for Sarcopenia. Sarcopenia and physical disability in older adults].

    Science.gov (United States)

    Ikezoe, Tome

    2014-10-01

    We investigated the effects of age on muscle atrophy and the relationship of locomotor ability with the sarcopenia in trunk and lower-limb muscle using ultrasound. Age-related muscle atrophy in elderly women was greatest for the psoas major and internal oblique muscles among the trunk and lower limb muscles. The age-related decline in gluteus medius muscle was closely associated with daily physical activity. Physical disability influenced muscle atrophy in the trunk and lower limbs, especially in the quadriceps femoris, soleus, transversus abdominis and lumbar multifidus muscles among elderly women. These findings may be a useful guideline for muscle strength training to prevent physical disability in the elderly people.

  2. The Effect of Sarcopenia on Outcomes in Geriatric Blunt Trauma.

    Science.gov (United States)

    Malekpour, Mahdi; Bridgham, Kelly; Jaap, Kathryn; Erwin, Ryan; Widom, Kenneth; Rapp, Megan; Leonard, Diane; Baro, Susan; Dove, James; Hunsinger, Marie; Blansfield, Joseph; Shabahang, Mohsen; Torres, Denise; Wild, Jeffrey

    2017-11-01

    Elderly patients are at a higher risk of morbidity and mortality after trauma, which is reflected through higher frailty indices. Data collection using existing frailty indices is often not possible because of brain injury, dementia, or inability to communicate with the patient. Sarcopenia is a reliable objective measure for frailty that can be readily assessed in CT imaging. In this study, we aimed to evaluate the effect of sarcopenia on the outcomes of geriatric blunt trauma patients. Left psoas area (LPA) was measured at the level of the third lumbar vertebra on the axial CT images. LPA was normalized for height (LPA mm2/m2) and after stratification by gender, sarcopenia was defined as LPA measurements in the lowest quartile. A total of 1175 patients consisting of 597 males and 578 females were studied. LPAs below 242.6 mm2/m2 in males and below 187.8 mm2/m2 in females were considered to be sarcopenic. We found sarcopenia in 149 males and 145 females. In multivariate analysis, sarcopenia was associated with a higher risk of in-hospital mortality (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.01-2.56) and a higher risk of discharge to less favorable destinations (OR: 1.42, 95% CI: 1.05-1.97). Lastly, sarcopenic patients had an increased risk of prolonged hospitalization (hazard ratio: 1.21, 95% CI: 1.04-1.40).

  3. Sarcopenia and androgens: A link between pathology and treatment

    Directory of Open Access Journals (Sweden)

    Carla eBasualto-Alarcón

    2014-12-01

    Full Text Available Sarcopenia, the age-related loss of skeletal muscle mass and function, is becoming more prevalent as the lifespan continues to increase in most populations. As sarcopenia is highly disabling, being associated with increased risk of dependence, falls, fractures, weakness, disability, and death, development of approaches to its prevention and treatment are required. Androgens are the main physiologic anabolic steroid hormones and normal testosterone levels are necessary for a range of developmental and biological processes, including maintenance of muscle mass. Testosterone concentrations decline as age increase, suggesting that low plasma testosterone levels can cause or accelerate muscle- and age-related diseases, as sarcopenia. Currently, there is increasing interest on the anabolic properties of testosterone for therapeutic use in muscle diseases including sarcopenia. However, the pathophysiological mechanisms underlying this muscle syndrome and its relationship with plasma level of androgens are not completely understood. This review discusses the recent findings regarding sarcopenia, the intrinsic and extrinsic mechanisms involved in the onset and progression of this disease and the treatment approaches that have been developed based on testosterone deficiency and their implications.

  4. An etiological model of perfectionism.

    Directory of Open Access Journals (Sweden)

    Gayle K Maloney

    Full Text Available OBJECTIVE: Perfectionism has been recognized as a transdiagnostic factor that is relevant to anxiety disorders, eating disorders and depression. Despite the importance of perfectionism in psychopathology to date there has been no empirical test of an etiological model of perfectionism. METHOD: The present study aimed to address the paucity of research on the etiology of perfectionism by developing and testing an etiological model using a sample of 311 clients seeking treatment. RESULTS: Structural equation modeling showed a direct relationship between high Parental Expectations and Criticism, and Perfectionism. There was also an indirect relationship between Parental Bonding and Perfectionism that was mediated by core schemas of disconnection and rejection. Finally, it was found that Neuroticism had both an indirect relationship, which was mediated by core schemas, and a direct relationship with perfectionism. CONCLUSIONS: The study provided the first direct test of an etiological model of perfectionism to date. Clinical implications include investigating whether the inclusion of etiological factors in the understanding and treatment of perfectionism is effective.

  5. Is there a relation between pre-sarcopenia, sarcopenia, cachexia and osteoporosis in patients with ankylosing spondylitis?

    Science.gov (United States)

    El Maghraoui, Abdellah; Ebo'o, François Bertin; Sadni, Siham; Majjad, Abderrahim; Hamza, Toufik; Mounach, Aziza

    2016-07-11

    Osteoporosis is a well-known complication of ankylosing spondylitis (AS). However, data about body composition modifications and muscle performance showed conflicting results. The aim of the study was to determine the prevalence and risk factors of pre-sarcopenia, sarcopenia and cachexia in patients with AS and analyze its relationship with bone loss and symptomatic and severity parameters of the disease. Sixty-seven consecutive male patients with AS (mean age of 40.9 ± 11.0 years) and 67 healthy controls were studied. Body composition and bone mineral density (BMD) scans were obtained using DXA. The fat-free mass index (FFMI; fat-free mass divided by height squared) and the percent of fat mass (%FM) were calculated. Pre-sarcopenia was defined by low skeletal muscle mass (SMI 10 s) and cachexia by a BMI 5 mg/l, SMI cachexia, and osteoporosis prevalences were (50.4, 34.3, 11.9, and 16.0) respectively. Patients had a mean 3 kg significant decrease in FFM and a 1 kg/m(2) decrease in appendicular mass vs. healthy controls. Pre-sarcopenia, sarcopenia and cachexia were significantly associated to higher BASDAI levels and low BMD. Our study showed that men with AS had a statistically significant reduction in total and appendicular lean mass that is related to higher disease activity and significantly associated to bone loss.

  6. Sarcopenia and the Analysis of Body Composition12

    Science.gov (United States)

    Ribeiro, Sandra M. L.; Kehayias, Joseph J.

    2014-01-01

    Reduction of lean mass is a primary body composition change associated with aging. Because many factors contribute to lean mass reduction, the problem has been given various names depending on the proposed cause, such as “age-related sarcopenia,” “dynapenia,” “myopenia,” “sarcopenic obesity,” or simply “sarcopenia.” There is currently no consensus on how to best diagnose the reduction of lean mass and its consequences on health. We propose that simple body composition methods can be used to indirectly evaluate sarcopenia, provided that those techniques are validated against the “quality of lean” criterion that associates muscle mass and metabolic function with the components of fat-free mass. Promising field methods include the use of stable isotopes for the evaluation of water compartments and new approaches to bioelectrical impedance analysis, which is also associated with the monitoring of water homeostasis. PMID:24829472

  7. Etiology of parkinsonism in a Brazilian movement disorders clinic Etiologia de parkinsonismo em uma clínica brasileira de distúrbios do movimento

    Directory of Open Access Journals (Sweden)

    FRANCISCO CARDOSO

    1998-06-01

    Full Text Available OBJECTIVE: The aim of the present study is to investigate whether there are geographic differences in the etiology of parkinsonism (PA. BACKGROUND: 72% of patients with PA evaluated at movement disorders clinics in the Northern Hemisphere are diagnosed with Parkinson's disease (PD. Data regarding other regions are not available. METHODS: We reviewed the charts of all patients with PA seen at the Federal University of Minas Gerais Movement Disorders Clinic from July 1993 through October 1995. PA was diagnosed by the presence of at least two of the following: rest tremor, bradykinesia, rigidity, and postural instability. The different etiologies were diagnosed based on standard clinical criteria RESULTS: During the period of the study, PA was recognized in 338 subjects. The following clinical diagnoses were made: PD (68.9%, drug-induced PA (DIP (13.3%, vascular PA (4.7%, Progressive supranuclear palsy (PSP (2%, multiple system atrophy (MSA (1.8%, others (9.7%. Cinnarizine, haloperidol and flunarizine were the commonest drugs related to DIP. CONCLUSIONS: Similarly to other studies, PD accounts for about 70% of PA patients. However, there are differences between our results and previous series. DIP is much more common in the present series. This may be accounted for a more liberal use of antidopaminergic drugs in our environment, especially Calcium channel blockers. The lower frequency of MSA and PSP in our study may reflect a short follow-up, since many patients initially diagnosed with PD later are found to have Parkinson-plus syndromes.OBJETIVO: O objetivo deste estudo é investigar se há diferenças geográficas na etiologia de parkinsonismo (PA. PANORAMA: 72% dos pacientes com PA avaliados em Clínicas de Distúrbios do Movimento no hemisfério norte são diagnosticados com doença de Parkinson (DP. Dados a respeito de outras regiões não se encontram disponíveis. MÉTODOS: Nós revisamos os prontuários de todos pacientes com PA vistos na

  8. Human immunodeficiency virus infection and its association with sarcopenia

    Directory of Open Access Journals (Sweden)

    Lauro Ferreira da Silva Pinto Neto

    Full Text Available Abstract Presarcopenia and sarcopenia were evaluated in HIV-infected individuals and in healthy elderly controls according to the consensus definitions of the European Working Group on Sarcopenia in Older People. Bioelectrical impedance, a hydraulic hand dynamometer, and gait speed were used to evaluate muscle mass, muscle strength, and physical performance, respectively. Adjusted and unadjusted binary logistic regression predicted the risk of sarcopenia. Predictor contribution was assessed by the Wald test. Significance was established at p ≤ 0.05. The HIV-infected group consisted of 33 patients on treatment (42.4% women; mean age 59 ± 7 years; mean BMI 25 ± 6 kg/m2; viral load undetectable in 30 cases. The HIV-uninfected group consisted of 60 individuals (71.7% women; mean age 70 ± 7 years; mean BMI 28 ± 6 kg/m2. Of the controls, 4 (6.7% individuals had presarcopenia and 4 (6.7% sarcopenia compared to 4 (12.1% and 8 (24.2%, respectively, in the HIV-infected group. The HIV-infected patients had a 4.95 higher risk (95% CI: 1.34–18.23 for sarcopenia compared to the controls. It should be pointed out that the control group was on average 10 years older. This risk increased further (RR = 5.20; 95% CI: 1.40–19.20 after adjusting for age and BMI. HIV-infected patients were shown to be at a greater risk of sarcopenia, an indicator of frailty, even following adjustment for age and BMI.

  9. Clinical characteristics of Q fever and etiology of community-acquired pneumonia in a tropical region of southern Taiwan: a prospective observational study.

    Directory of Open Access Journals (Sweden)

    Chung-Hsu Lai

    Full Text Available The clinical characteristics of Q fever are poorly identified in the tropics. Fever with pneumonia or hepatitis are the dominant presentations of acute Q fever, which exhibits geographic variability. In southern Taiwan, which is located in a tropical region, the role of Q fever in community-acquired pneumonia (CAP has never been investigated.During the study period, May 2012 to April 2013, 166 cases of adult CAP and 15 cases of acute Q fever were prospectively investigated. Cultures of clinical specimens, urine antigen tests for Streptococcus pneumoniae and Legionella pneumophila, and paired serologic assessments for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Q fever (Coxiella burnetii were used for identifying pathogens associated with CAP. From April 2004 to April 2013 (the pre-study period, 122 cases of acute Q fever were also included retrospectively for analysis. The geographic distribution of Q fever and CAP cases was similar. Q fever cases were identified in warmer seasons and younger ages than CAP. Based on multivariate analysis, male gender, chills, thrombocytopenia, and elevated liver enzymes were independent characteristics associated with Q fever. In patients with Q fever, 95% and 13.5% of cases presented with hepatitis and pneumonia, respectively. Twelve (7.2% cases of CAP were seropositive for C. burnetii antibodies, but none of them had acute Q fever. Among CAP cases, 22.9% had a CURB-65 score ≧2, and 45.8% had identifiable pathogens. Haemophilus parainfluenzae (14.5%, S. pneumoniae (6.6%, Pseudomonas aeruginosa (4.8%, and Klebsiella pneumoniae (3.0% were the most common pathogens identified by cultures or urine antigen tests. Moreover, M. pneumoniae, C. pneumoniae, and co-infection with 2 pathogens accounted for 9.0%, 7.8%, and 1.8%, respectively.In southern Taiwan, Q fever is an endemic disease with hepatitis as the major presentation and is not a common etiology of CAP.

  10. The endocrine system and sarcopenia: potential therapeutic benefits.

    Science.gov (United States)

    McIntire, Kevin L; Hoffman, Andrew R

    2011-12-01

    Age related muscle loss, known as sarcopenia, is a major factor in disability, loss of mobility and quality of life in the elderly. There are many proposed mechanisms of age-related muscle loss that include the endocrine system. A variety of hormones regulate growth, development and metabolism throughout the lifespan. Hormone activity may change with age as a result of reduced hormone secretion or decreased tissue responsiveness. This review will focus on the complex interplay between the endocrine system, aging and skeletal muscle and will present possible benefits of therapeutic interventions for sarcopenia.

  11. Sarcopenia em idosos institucionalizados: prevalência e fatores associados

    OpenAIRE

    Mesquita, Alice Ferreira

    2015-01-01

    A sarcopenia é um importante fator a ser controlado para promover qualidade de vida e capacidade funcional em idosos, principalmente em caso de institucionalização. Objetivo: Avaliar a prevalência de sarcopenia e os fatores associados em idosos institucionalizados. Materiais e Métodos: Estudo transversal, realizado com 216 idosos (60 anos ou mais), de ambos os sexos, residentes em 29 instituições de longa permanência, na cidade de Salvador- BA, Brasil. O índice de massa corporal foi utilizado...

  12. Evaluation of sarcopenia in patients with distal radius fractures.

    Science.gov (United States)

    Roh, Young Hak; Koh, Young Do; Noh, Jung Ho; Gong, Hyun Sik; Baek, Goo Hyun

    2017-12-01

    Sarcopenia is more prevalent in patients with distal radius fracture (DRF) than in age- and sex-matched controls. Lower appendicular mass index in men and weaker grip strength in both men and women increase the likelihood of DRF. Sarcopenia is a core component of physical frailty that predisposes older people to falls and negatively impacts the activities of daily living. The objectives of this study were to compare the prevalence of sarcopenia in patients with DRF with that in age- and sex-matched controls without DRF; and evaluate the association between sarcopenia and the occurrence of DRF. We prospectively recruited 132 patients over 50 years of age who sustained DRF due to fall and 132 age- and sex-matched controls without DRF. A definition of sarcopenia was based on the consensus of the Asian Working Group for Sarcopenia. Sarcopenic components including appendicular lean body mass, grip strength, and gait speed were compared between the two groups. Other factors assessed for the occurrence of DRF were age, gender, body mass index (BMI), lumbar, and hip bone mineral density (BMD) values. A conditional logistic regression analysis was conducted to evaluate the associations between sarcopenia and the occurrence of DRF. A total of 39 (30%) of 132 DRF patients were sarcopenic, whereas 23 (17%) of the 132 controls were within the sarcopenic criteria (p = 0.048). The patient group had significantly lower lean body mass and weaker grip strength than those of the control group. However, there was no significant difference in gait speed between the two groups. According to regression analysis, lower appendicular mass index in men was associated with an increased incidence of DRF (odds ratio [OR] = 0.84, 95% confidence interval [CI] = 0.72, 0.95) while weaker grip strength and lower total hip BMD values were associated with the occurrence of DRF in both men (OR = 0.77, 95% CI = 0.63, 0.92; and OR = 0.79, 95% CI = 0.64, 0.94, respectively) and women (OR

  13. Etiologija in klinična slika duševne manjrazvitosti pri otrocih: Etiology and clinical features of mental retardation in children:

    OpenAIRE

    Bon, Jurij

    1998-01-01

    Children with mental retardation constitute a group with special medical needs. There are several hundrede known etiological (mostly biomedical) factors, that can influence the development of a child's brain. We experience the changes in their prevalence rates, mainly because of improvements in health care. There is more than one etiological factor present in more than half of mentally retarded children. We are recognizing the role of psychosocial factors in development of borderline and mild...

  14. Exercise and physical activity for patients with end-stage liver disease: Improving functional status and sarcopenia while on the transplant waiting list.

    Science.gov (United States)

    Duarte-Rojo, Andrés; Ruiz-Margáin, Astrid; Montaño-Loza, Aldo J; Macías-Rodríguez, Ricardo U; Ferrando, Arny; Kim, W Ray

    2018-01-01

    Sarcopenia and physical deconditioning are frequent complications in patients with cirrhosis and end-stage liver disease (ESLD). They are the end result of impaired dietary intake, chronic inflammation, altered macronutrient and micronutrient metabolism, and low physical activity. Frailty is the end result of prolonged sarcopenia and physical deconditioning. It severely affects a patient's functional status and presents in approximately 1 in 5 patients on the liver transplantation waiting list. Sarcopenia, poor physical fitness/cardiopulmonary endurance (CPE), and frailty are all associated with increased mortality in ESLD. Clinical trials addressing the usefulness of exercise in patients with cirrhosis have shown that it improves the metabolic syndrome, sarcopenia, CPE, health-related quality of life, and hepatic venous pressure gradient. Although evidence on the benefits of exercise on clinical outcomes derived from large clinical trials is still missing, based on existing literature from multiple medical subspecialties, we believe that an exercise program coupled to a tailored nutritional intervention benefits both cardiopulmonary and musculoskeletal functions, ultimately translating into improved functional status, sense of well-being, and possibly less complications from portal hypertension. In conclusion, although supervised exercise training is the prevailing approach to manage ESLD patients, such intervention is not sustainable or feasible for most patients. Innovative home-based physical activity interventions may be able to effectively reach a larger number of patients. Liver Transplantation 24 122-139 2018 AASLD. © 2017 by the American Association for the Study of Liver Diseases.

  15. Caracterização etiológica e clínica das neurites ópticas infecciosas Etiological and clinical characteristics of infectious optic neuritis

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    Marco Aurélio Lana-Peixoto

    1997-06-01

    clinical features to look up features which could be used to distinct them from the demyelinating optic neuritis (DON which have a well-known tendency to convert to multiple sclerosis. Bilateral involvement was found in 23 patients (45.1 %, simultaneously in 18 cases. Sex distribution was 2M:1F. The ages ranged from 1 to 82 years (median 34.8; 1/3 of the patients were younger than 20 and 1/3 were 50 years of age or older. Syphilis was found in 19 patients being the single most common etiology, whereas viral infetions were found in 41.2% of the cases. Visual acuity was severely damaged in most patients and was worse than 20/200 in 57.3% of the involved eyes. Color vision was affected in 91.8%. Visual field defects were found in 92.2%, with predominance of the central defects (40.7%. The optic disc was abnormal in 90.5% of the eyes. This study clearly demonstrates that ION and DON have distinct epidemiological and clinical features. The awareness of these differences may help clinicians to follow different paths for the correct diagnosis and appropriate treatment and prognostic orientation of their patients.

  16. Behçet's disease: A comprehensive review with a focus on epidemiology, etiology and clinical features, and management of mucocutaneous lesions.

    Science.gov (United States)

    Alpsoy, Erkan

    2016-06-01

    Behçet's disease (BD) is a chronic, relapsing, inflammatory multisystem disease of unknown etiology. Oral ulcers, genital ulcers, cutaneous lesions, and ocular and articular involvement are the most frequent features of the disease. Mucocutaneous lesions are considered hallmarks of the disease, and often precede other manifestations. Therefore, their recognition may permit earlier diagnosis and treatment with beneficial results for prognosis. BD is particularly prevalent in "Silk Route" populations but has a global distribution. The disease usually starts around the third or fourth decade of life. Sex distribution is roughly equal. The diagnosis is based on clinical criteria, as there is no pathognomonic test. Genetic factors have been investigated extensively, and association with human leukocyte antigen (HLA)-B51 is still known as the strongest genetic susceptibility factor. The T-helper 17 and interleukin (IL)-17 pathways are active, and play an important role, particularly in acute attacks of BD. Neutrophil activity is increased in BD, and the affected organs show a significant neutrophil and lymphocyte infiltration. HLA-B51 association and increased IL-17 response are thought to play a role in neutrophil activation. Treatment is mainly based on the suppression of inflammatory attacks of the disease using immunomodulatory and immunosuppressive agents. Although treatment has become much more effective in recent years with the introduction of newer drugs, BD is still associated with considerable morbidity and increased mortality. Male sex, younger age of onset and increased number of organs involved at the diagnosis are associated with a more severe disease and, therefore, require more aggressive treatment. © 2016 Japanese Dermatological Association.

  17. [Transdisciplinary Approach for Sarcopenia. Physical activity and exercise training for prevention and treatment of sarcopenia].

    Science.gov (United States)

    Okura, Tomohiro

    2014-10-01

    The general outline of an exercise prescription for older adults with sarcopenia is aimed at improving their muscle strength and walking ability and increasing their muscle mass. Various types of resistance training (RT) can effectively increase muscle mass and strength even when the older individual's body weight is the only load and no special instruments such as expensive machines or heavy dumbbells are used. To effectively increase muscle mass and strength, individuals must perform at least one to two RT exercises on both the upper and lower extremities and the trunk two to three times per week for more than three months. Gait training is essential for improving walking ability. Although aerobic exercises typically contain gait training, they require an exercise intensity of greater than 60% of maximum oxygen uptake to effectively improve walking ability. In addition, we should remember that the effect of exercise training is maintained only by continuing the exercise program regularly over the long-term.

  18. The role of physical activity in counteracting age-related sarcopenia and cancer cachexia: A brief literature review

    Directory of Open Access Journals (Sweden)

    Scalabrin Mattia

    2016-01-01

    Full Text Available Muscle tissue plays several important health functions . In addition to the important mechanical functions, it represents the biggest reserve of body proteins and it is also able to produce several myokines that are able to induce important beneficial effects, through the interaction with different organs. The loss of muscle mass has a tremendous impact on health and it is not surprising that a great interest has raised on two degenerative, irreversible and unstoppable conditions known as sarcopenia and cachexia. Sarcopenia, the age-related loss of muscle mass, is not a disease or a syndrome, it is not even a medical sign sometimes. Indeed, a general consensus among scientists does not exist regarding the definition and the identification criteria of this condition. On the other hand, cachexia is a wasting syndrome characterized by an uncontrolled and unstoppable loss of muscle mass, associated with fatigue and weakness. It is often associated with a disease like cancer, AIDS, Chronic Obstructive Pulmonary Disease (COPD, multiple sclerosis, tuberculosis etc. Given the complexity of these muscle conditions and considering that during aging and cancer there is an increased risk of comorbidities, regular physical activity might be a crucial point to be carefully evaluated on a single patient basis. The aim of this review is to highlight the impact on society and the etiology of sarcopenia and cancer cachexia, with particular regard to the role played by physical activity in preventing and counteracting these muscle-wasting conditions, focusing attention also on the limitation factors that must be considered during the prescription of physical activity to sarcopenic and cachectic patients.

  19. Current nutritional recommendations and novel dietary strategies to manage sarcopenia.

    Science.gov (United States)

    Calvani, Riccardo; Miccheli, Alfredo; Landi, Francesco; Bossola, Maurizio; Cesari, Matteo; Leeuwenburgh, Christiaan; Sieber, Cornel C; Bernabei, Roberto; Marzetti, Emanuele

    2013-01-01

    Sarcopenia, the loss of skeletal muscle mass and function that occurs with aging, is associated with increased risk for several adverse health outcomes, including frailty, disability, falls, loss of independent living, and mortality. At present, no pharmacological treatment exists that is able to definitely halt the progression of sarcopenia. Likewise, no pharmacological remedies are yet available to prevent the onset of age-related muscle wasting. In this scenario, the combination of nutritional interventions and physical exercise appears to be the most effective strategy presently available for the management of sarcopenia. The purposes of this review are to summarize the current knowledge on the role of nutrition as a countermeasure for sarcopenia, illustrate the mechanisms of action of relevant dietary agents on the aging muscle, and introduce novel nutritional strategies that may help preserve muscle mass and function into old age. Issues related to the identification of the optimal timing of nutritional interventions in the context of primary and secondary prevention are also discussed. Finally, the prospect of elaborating personalized dietary and physical exercise recommendations through the implementation of integrated, high-throughput analytic approaches is illustrated.

  20. Current nutritional recommendations and novel dietary strategies to manage sarcopenia

    Science.gov (United States)

    Calvani, Riccardo; Miccheli, Alfredo; Landi, Francesco; Bossola, Maurizio; Cesari, Matteo; Leeuwenburgh, Christiaan; Sieber, Cornel C.; Bernabei, Roberto; Marzetti, Emanuele

    2015-01-01

    Sarcopenia, the loss of skeletal muscle mass and function that occurs with aging, is associated with increased risk for several adverse health outcomes, including frailty, disability, falls, loss of independent living, and mortality. At present, no pharmacological treatment exists that is able to definitely halt the progression of sarcopenia. Likewise, no pharmacological remedies are yet available to prevent the onset of age-related muscle wasting. In this scenario, the combination of nutritional interventions and physical exercise appears to be the most effective strategy presently available for the management of sarcopenia. The purposes of this review are to summarize the current knowledge on the role of nutrition as a countermeasure for sarcopenia, illustrate the mechanisms of action of relevant dietary agents on the aging muscle, and introduce novel nutritional strategies that may help preserve muscle mass and function into old age. Issues related to the identification of the optimal timing of nutritional interventions in the context of primary and secondary prevention are also discussed. Finally, the prospect of elaborating personalized dietary and physical exercise recommendations through the implementation of integrated, high-throughput analytic approaches is illustrated. PMID:26082911

  1. Role and potential mechanisms of anabolic resistance in sarcopenia

    Science.gov (United States)

    There is a pressing need to understand the aging process to better cope with its associated physical and societal costs. The age-related muscle wasting known as sarcopenia is a major contributor to the problems faced by the elderly. By hindering mobility and reducing strength, it greatly diminishes ...

  2. Prevalence of sarcopenia and its association with socioeconomic ...

    African Journals Online (AJOL)

    Background: Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It imposes significant costs on health care systems. Socioeconomic status is also the root cause of healthy challenges among the elderly. Therefore, investigating the association between ...

  3. Chronology of age-related disease definitions : Osteoporosis and sarcopenia

    NARCIS (Netherlands)

    Bijlsma, A. Y.; Meskers, C. G.M.; Westendorp, R. G.J.; Maier, A. B.

    Low muscle mass at older age has been associated with functional impairments, cognitive decline and mortality. The term sarcopenia, coined in 1988, has been used interchangeably to describe low muscle mass, strength, and function. Without a well defined definition, results of studies using the term

  4. Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.

    Science.gov (United States)

    Park, Youn Su; Kim, Ji Won; Kim, Byeong Gwan; Lee, Kook Lae; Lee, Jae Kyung; Kim, Joo Sung; Koh, Seong-Joon

    2017-04-01

    Although sarcopenia is associated with an increased risk for mortality after the curative resection of colorectal cancer, its influence on the development of advanced colonic neoplasia remains unclear. This study included 1270 subjects aged 40 years or older evaluated with first-time screening colonoscopy at Seoul National University Boramae Health Care Center from January 2010 to February 2015. Skeletal muscle mass was measured with a body composition analyzer (direct segmental multifrequency bioelectrical impedance analysis method). Multiple logistic regression analysis was performed to determine whether sarcopenia is associated with advanced colorectal neoplasia. Of 1270 subjects, 139 (10.9%) were categorized into the sarcopenia group and 1131 (89.1%) into the non-sarcopenia group. In the non-sarcopenia group, 55 subjects (4.9%) had advanced colorectal neoplasia. However, in the sarcopenia group, 19 subjects (13.7%) had advanced colorectal neoplasia, including 1 subject with invasive colorectal cancer (0.7%). In addition, subjects with sarcopenia had a higher prevalence of advanced adenoma (P sarcopenia. According to the multiple logistic regression analysis adjusted for variable confounders, age (odds ratio 1.062, 95% confidence interval 1.032-1.093; P sarcopenia (odds ratio 2.347, 95% confidence interval 1.311-4.202; P = 0.004) were associated with an advanced colorectal neoplasia. Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.

  5. A path model of sarcopenia on bone mass loss in elderly subjects.

    Science.gov (United States)

    Rondanelli, M; Guido, D; Opizzi, A; Faliva, M A; Perna, S; Grassi, M

    2014-01-01

    Aging is associated with decreases in muscle mass, strength, power (sarcopenia) and bone mineral density (BMD). The aims of this study were to investigate in elderly the role of sarcopenia on BMD loss by a path model, including adiposity, inflammation, and malnutrition associations. Body composition and BMD were measured by dual X-ray absorptiometry in 159 elderly subjects (52 male/107 female; mean age 80.3 yrs). Muscle strength was determined with dynamometer. Serum albumin and PCR were also assessed. Structural equations examined the effect of sarcopenia (measured by Relative Skeletal Muscle Mass, Total Muscle Mass, Handgrip, Muscle Quality Score) on osteoporosis (measured by Vertebral and Femoral T-scores) in a latent variable model including adiposity (measured by Total Fat Mass, BMI, Ginoid/Android Fat), inflammation (PCR), and malnutrition (serum albumin). The sarcopenia assumed a role of moderator in the adiposity-osteoporosis relationship. Specifically, increasing the sarcopenia, the relationship adiposity-osteoporosis (β: -0.58) decrease in intensity. Adiposity also influences sarcopenia (β: -0.18). Malnutrition affects the inflammatory and the adiposity states (β: +0.61, and β: -0.30, respectively), while not influencing the sarcopenia. Thus, adiposity has a role as a mediator of the effect of malnutrition on both sarcopenia and osteoporosis. Malnutrition decreases adiposity; decreasing adiposity, in turn, increase the sarcopenia and osteoporosis. This study suggests such as in a group of elderly sarcopenia affects the link between adiposity and BMD, but not have a pure independent effect on osteoporosis.

  6. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study

    NARCIS (Netherlands)

    Murdoch, David R.; Corey, G. Ralph; Hoen, Bruno; Miró, José M.; Fowler, Vance G.; Bayer, Arnold S.; Karchmer, Adolf W.; Olaison, Lars; Pappas, Paul A.; Moreillon, Philippe; Chambers, Stephen T.; Chu, Vivian H.; Falcó, Vicenç; Holland, David J.; Jones, Philip; Klein, John L.; Raymond, Nigel J.; Read, Kerry M.; Tripodi, Marie Francoise; Utili, Riccardo; Wang, Andrew; Woods, Christopher W.; Cabell, Christopher H.; Gordon, David; Devi, Uma; Spelman, Denis; van der Meer, Jan T. M.; Kauffman, Carol; Bradley, Suzanne; Armstrong, William; Giannitsioti, Efthymia; Giamarellou, Helen; Lerakis, Stamatios; del Rio, Ana; Moreno, Asuncion; Mestres, Carlos A.; Ninot, Carlos A.; Pare, Carlos; de la Maria, Cristina Garcia; Armero, Yolanda; de Lazzari, Elisa; Marco, Francesc; Gatell, Jose M.; Almela, Manel; Azqueta, Manuel; Sitges, Marta; Claramonte, Xavier; Jiménez-Expósito, Maria Jesús; de Benito, Natividad; Ramirez, Jose; Perez, Noel; Miro, José M.; Almirante, Benito; Fernandez-Hidalgo, Nuria; de Vera, Pablo Rodriguez; Tornos, Pilar; Falco, Vicenç; Sidani, Nisreen; Kanj-Sharara, Souha; Kanafani, Zeina; Raglio, Annibale; Goglio, Antonio; Gnecchi, Fabrizio; Suter, Fredy; Valsecchi, Grazia; Rizzi, Marco; Ravasio, Veronica; Chirouze, Catherine; Leroy, Joel; Plesiat, Patrick; Bernard, Yvette; Casey, Anna; Lambert, Peter; Watkin, Richard; Elliott, Tom; Patel, Mukesh; Dismukes, William; Pan, Angelo; Caros, Giampiero; Mathiron, Amel Brahim; Tribouilloy, Christophe; Goissen, Thomas; Delahaye, Armelle; Delahaye, Francois; Vandenesch, Francois; Vizzotti, Carla; Nacinovich, Francisco M.; Marin, Marcelo; Trivi, Marcelo; Lombardero, Martin; Cortes, Claudia; Casabé, José Horacio; Altclas, Javier; Kogan, Silvia; Clara, Liliana; Sanchez, Marisa; Commerford, Anita; Hansa, Cass; Deetlefs, Eduan; Ntsekhe, Mpiko; Commerford, Patrick; Wray, Dannah; Steed, Lisa L.; Church, Preston; Cantey, Robert; Morris, Arthur; Lang, Selwyn; Kotsanas, Despina; Korman, Tony M.; Peterson, Gail; Purcell, Jon; Southern, Paul M.; Shah, Manisha; Bedimo, Roger; Reddy, Arjun; Levine, Donald; Dhar, Gaurav; Hanlon-Feeney, Alanna; Hannan, Margaret; Kelly, Sinead; Sexton, Daniel J.; Benjamin, Daniel J.; McDonald, Jay R.; Federspiel, Jeff; Engemann, John J.; Reller, Barth; Drew, Laura; Caram, L. B.; Stryjewski, Martin; Morpeth, Susan; Lalani, Tahaniyat; Mazaheri, Bahram; Neuerburg, Carl; Naber, Christoph; Athan, Eugene; Henry, Margaret; Harris, Owen; Alestig, Eric; Wikstrom, Lotta; Snygg-Martin, Ulrika; Francis, Johnson; Venugopal, K.; Nair, Lathi; Thomas, Vinod; Chaiworramukkun, Jaruwan; Pachirat, Orathai; Chetchotisakd, Ploenchan; Suwanich, Tewan; Kamarulzaman, Adeeba; Tamin, Syahidah Syed; Premru, Manica Mueller; Logar, Mateja; Lejko-Zupanc, Tatjana; Orezzi, Christina; Bouz, Emilio; Rodríguez-Créixems, Marta; Marín, Mercedes; Fernández, Miguel; Muñoz, Patricia; Fernández, Rocío; Ramallo, Victor; Raoult, Didier; Thuny, Franck; Habib, Gilbert; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Chipigina, Natalia; Kirill, Ozerecky; Vinogradova, Tatiana; Kulichenko, Vadim P.; Butkevich, O. M.; Lion, Christine; Selton-Suty, Christine; Coyard, Hélène; Doco-Lecompte, Thanh; Iarussi, Diana; Durante-Mangoni, Emanuele; Ragone, Enrico; Dialetto, Giovanni; Casillo, Roberta; Kumar, A. Sampath; Sharma, Gautam; Dickerman, Stuart A.; Street, Alan; Eisen, Damon Peter; McBryde, Emma Sue; Grigg, Leeanne; Abrutyn, Elias; Michelet, Christian; Tattevin, Pierre; Donnio, Pierre Yves; Fortes, Claudio Querido; Edathodu, Jameela; Al-Hegelan, Mashael; Font, Bernat; Anguera, Ignasi; Guma, Joan Raimon; Cereceda, M.; Oyonarte, Miguel J.; Mella, Rodrigo Montagna; Garcia, Patricia; Jones, Sandra Braun; Ramos, Auristela Isabel de Oliveira; Paiva, Marcelo Goulart; Tranchesi, Regina Aparecida de Medeiros; Woon, Lok Ley; Lum, Luh-Nah; Tan, Ru-San; Rees, David; Kornecny, Pam; Lawrence, Richard; Dever, Robyn; Post, Jeffrey; Ryan, Suzanne; Harkness, John; Feneley, Michael; Rubinstein, Ethan; Strahilewitz, Jacob; Ionac, Adina; Mornos, Cristian; Dragulescu, Stefan; Forno, Davide; Cecchi, Enrico; de Rosa, Francesco; Imazio, Massimo; Trinchero, Rita; Wiesbauer, Franz; Gattringer, Rainer; Deans, Greg; Andrasevic, Arjana Tambic; Barsic, Bruno; Klinar, Igor; Vincelj, Josip; Bukovski, Suzana; Krajinovic, Vladimir; Stafford, Judy; Baloch, Khaula; Redick, Thomas; Harding, Tina; Corey, Ralph; Durack, David T.; Eykyn, Susannah

    2009-01-01

    BACKGROUND: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. METHODS: Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25

  7. Prevalence and incidence of sarcopenia in the very old: findings from the Newcastle 85+ Study.

    Science.gov (United States)

    Dodds, Richard Matthew; Granic, Antoneta; Davies, Karen; Kirkwood, Thomas B L; Jagger, Carol; Sayer, Avan Aihie

    2017-04-01

    Recognition that an older person has sarcopenia is important because this condition is linked to a range of adverse outcomes. Sarcopenia becomes increasingly common with age, and yet there are few data concerning its descriptive epidemiology in the very old (aged 85 years and above). Our aims were to describe risk factors for sarcopenia and estimate its prevalence and incidence in a British sample of the very old. We used data from two waves (2006/07 and 2009/10) of the Newcastle 85+ Study, a cohort born in 1921 and registered with a Newcastle/North Tyneside general practice. We assessed sarcopenia status using the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Grip strength was measured using a Takei digital dynamometer (Takei Scientific Instruments Ltd., Niigata, Japan), gait speed was calculated from the Timed Up and Go test, and lean mass was estimated using a Tanita-305 body fat analyzer. We used logistic regression to examine associations between risk factors for prevalent sarcopenia at baseline and incident sarcopenia at follow-up. European Working Group on Sarcopenia in Older People sarcopenia was present in 21% of participants at baseline [149/719 participants, mean age 85.5 (0.4) years]. Many participants had either slow gait speed or weak grip strength (74.3%), and hence measurement of muscle mass was frequently indicated by the EWGSOP definition. Incidence data were available for 302 participants, and the incident rate was 3.7 cases per 100 person years at risk. Low Standardized Mini-Mental State Examination, lower occupational social class, and shorter duration of education were associated with sarcopenia at baseline, while low muscle mass was associated with incident sarcopenia. Low body mass index (BMI) was a risk factor for both in a graded fashion, with each unit decrease associated with increased odds of prevalent [odds ratio (OR) 1.29, 95% confidence interval (CI): 1.21, 1.37] and incident (OR 1.20, 95% CI: 1.08, 1

  8. Markers of sarcopenia quantified by computed tomography predict adverse long-term outcome in patients with resected oesophageal or gastro-oesophageal junction cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tamandl, Dietmar; Baltzer, Pascal A.; Ba-Ssalamah, Ahmed [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Comprehensive Cancer Center GET-Unit, Vienna (Austria); Paireder, Matthias; Asari, Reza; Schoppmann, Sebastian F. [Medical University of Vienna, Department of Surgery, Upper-GI-Service, Comprehensive Cancer Center GET-Unit, Vienna (Austria)

    2016-05-15

    To assess the impact of sarcopenia and alterations in body composition parameters (BCPs) on survival after surgery for oesophageal and gastro-oesophageal junction cancer (OC). 200 consecutive patients who underwent resection for OC between 2006 and 2013 were selected. Preoperative CTs were used to assess markers of sarcopenia and body composition (total muscle area [TMA], fat-free mass index [FFMi], fat mass index [FMi], subcutaneous, visceral and retrorenal fat [RRF], muscle attenuation). Cox regression was used to assess the primary outcome parameter of overall survival (OS) after surgery. 130 patients (65 %) had sarcopenia based on preoperative CT examinations. Sarcopenic patients showed impaired survival compared to non-sarcopenic individuals (hazard ratio [HR] 1.87, 95 % confidence interval [CI] 1.15-3.03, p = 0.011). Furthermore, low skeletal muscle attenuation (HR 1.91, 95 % CI 1.12-3.28, p = 0.019) and increased FMi (HR 3.47, 95 % CI 1.27-9.50, p = 0.016) were associated with impaired outcome. In the multivariate analysis, including a composite score (CSS) of those three parameters and clinical variables, only CSS, T-stage and surgical resection margin remained significant predictors of OS. Patients who show signs of sarcopenia and alterations in BCPs on preoperative CT images have impaired long-term outcome after surgery for OC. (orig.)

  9. Contact vitiligo: etiology and treatment

    Directory of Open Access Journals (Sweden)

    Singh P

    2003-01-01

    Full Text Available Fifty patients of contact vitiligo were studied. EtiologicaI agents of contact vitiligo were identified by clinical history, distribution of lesions and patch testing with suspected material. All patients were advised to avoid the suspected agent and treated with PUVASOL and topical steroid. Out of 50 patients (Male 8%, Female 92% age 14-60 years., etiological agent of contact vitiligo was found to be sticking bindi alone in 24 (48%, while bindi along with other etiological agents were found to be purse, foot wear, plastic watch strap, lipstick and tooth paste in 14 ( 28% cases. 14 (28% patients also had disseminated lesions of vitiligo along with contact vitiligo. Positive reaction with patch testing was observed in 18 (36% while depigmentation was seen in 4 ( 8% cases. We observed that response of treatment was better in patients with shorter duration of disease while poor response was seen in patients with longer duration of disease.

  10. ETIOLOGY OF THE BOVINE CLINICAL MASTITIS IN GOIÂNIA ETIOLOGIA DA MASTITE CLÍNICA BOVINA NA BACIA LEITEIRA DE GOIÂNIA

    Directory of Open Access Journals (Sweden)

    Paulo César Moreira

    2007-09-01

    Full Text Available

    There is an estimate that the mastitis in dairy herds causes production losses between 5 and 35%, equivalent from 85 to 500 million dollars per year. 231 milk samples from 231 cows on different stages of lactation, with clinic mastitis, from 35 farms of Goiânia, were analyzed in order to map the pathogens implicated in these process and to discover the microorganisms with major prevalence. All the samples had positive growth. The principal agents were Staphylococcus coagulase positive (32.90%, Streptococcus sp. (22.07%, Pseudomonas sp. (12.12%, Enterobacter sp. (10.38%, Corynebacterium sp. (8.65%, Escherichia coli (8.22%, Bacillus sp. (8.22%, Proteus sp. (6.49%, Klebsiella sp. (4.32% and Staphylococcus coagulase negative (3.46%. The Nocardia genus was isolated in 0.86% of the cases.

    KEY-WORDS: Bovine mastitis; etiology; isolated microorganisms.

    Estima-se que a presença de mastite bovina em rebanhos produtores provoque perdas de produção entre 5 e 35%, o que equivale de 85 a 500 milhões de dólares ao ano. Com o objetivo de mapear os patógenos envolvidos nesse processo e evidenciar os microrganismos com maior freqüência foram examinadas amostras de leite de 231 vacas, em diferentes estágios de lactação, que apresentaram sinais de mastite clínica e eram pertencentes a 35 propriedades rurais da bacia leiteira de Goiânia. Todas as amostras tiveram crescimento bacteriano positivo. Os principais agentes isolados foram o Staphylococcus coagulase positiva (32,90%, Streptococcus sp. (22,07%, Pseudomonas sp. (12,12%, Enterobacter sp. (10,38%, Corynebacterium sp. (8,65%, Escherichia coli (8,22%, Bacillus sp. (8,22%,

  11. Consequences of sarcopenia among nursing home residents at long-term follow-up.

    Science.gov (United States)

    Henwood, Tim; Hassan, Bothaina; Swinton, Paul; Senior, Hugh; Keogh, Justin

    The consequences of and transition into sarcopenia with long-term survival was investigated in the nursing home setting. Eligible residents from 11 nursing homes were followed-up 18-months after their assessment for sarcopenia using the European Working Group on Sarcopenia in Older People criteria, with other demographic, physical and cognitive health measures collected. Of the 102 older adults who consented at baseline, 22 had died and 58 agreed to participate at follow-up, 51.7% of whom had sarcopenic. Sarcopenia at baseline was associated with a depression (p sarcopenia is high and increases with long-term survival in end-of-life care. However, the risk of sarcopenia-related mortality is not as great as from increasing age alone. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. [Etiology and diagnosis of intellectual disability].

    Science.gov (United States)

    Yang, Pu; Gui, Bao-Heng; Wu, Ling-Qian

    2015-06-01

    Intellectual disability, occurring in 1%-3% of the general population, is a common disease of the nervous system in children. Since diverse genetic and environmental factors contribute to its pathogenesis, the etiological diagnosis of intellectual disability is challenging with respect to the selection of diagnostic tests. It is important to determine the etiology of intellectual disability for the assessment of prognosis, treatment and the family plan. This paper summarizes the research progress in etiology and diagnosis for intellectual disability and introduces the recommended clinical genetics diagnostic approach from the American Academy of Pediatrics.

  13. Sarcopenia and impairment in cognitive and physical performance

    Directory of Open Access Journals (Sweden)

    Tolea MI

    2015-03-01

    Full Text Available Magdalena I Tolea,1 James E Galvin1–3 1Alzheimer’s Disease Center, Department of Neurology, 2Department of Psychiatry, 3Department of Population Health, New York University School of Medicine, New York, NY, USA Background: Whether older adults with sarcopenia who underperform controls on tests of physical performance and cognition also have a higher likelihood of combined cognitive-physical impairment is not clear. We assessed the impact of sarcopenia on impairment in both aspects of functionality and the relative contribution of its components, muscle mass and strength.Methods: Two hundred and twenty-three community-dwelling adults aged 40 years and older (mean age =68.1±10.6 years; 65% female were recruited and underwent physical functionality, anthropometry, and cognitive testing. Participants with low muscle mass were categorized as pre-sarcopenic; those with low muscle mass and muscle strength as sarcopenic; those with higher muscle mass and low muscle strength only were categorized as non-sarcopenic and were compared on risk of cognitive impairment (Montreal Cognitive Assessment <26; Ascertaining Dementia 8 ≥2, physical impairment (Mini Physical Performance Test <12, both, or neither by ordinal logistic regression. Results: Compared to controls, those with sarcopenia were six times more likely to have combined cognitive impairment/physical impairment with a fully adjusted model showing a three-fold increased odds ratio. The results were consistent across different measures of global cognition (odds ratio =3.46, 95% confidence interval =1.07–11.45 for the Montreal Cognitive Assessment; odds ratio =3.61, 95% confidence interval =1.11–11.72 for Ascertaining Dementia 8. Pre-sarcopenic participants were not different from controls. The effect of sarcopenia on cognition is related to low muscle strength rather than low muscle mass. Conclusion: Individuals with sarcopenia are not only more likely to have single but also to have dual

  14. Prevalence of Sarcopenia and Its Association with Socioeconomic Status among the Elderly in Tehran

    OpenAIRE

    Dorosty, Ahmadreza; Arero, Godana; Chamar, Maryam; Tavakoli, Sogand

    2016-01-01

    Background Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It imposes significant costs on health care systems. Socioeconomic status is also the root cause of healthy challenges among the elderly. Therefore, investigating the association between sarcopenia and socioeconomic status is very important to improve healthy ageing of the elderly. The aim of this study was to investigate the prevalence of sarcopenia and its association ...

  15. Sarcopenia and frailty in chronic respiratory disease:Lessons from gerontology

    OpenAIRE

    Bone, Anna E.; Hepgul, Nilay; Kon, Samantha; Maddocks, Matthew

    2016-01-01

    Sarcopenia and frailty are geriatric syndromes characterized by multisystem decline, which are related to and reflected by markers of skeletal muscle dysfunction. In older people, sarcopenia and frailty have been used for risk stratification, to predict adverse outcomes and to prompt intervention aimed at preventing decline in those at greatest risk. In this review, we examine sarcopenia and frailty in the context of chronic respiratory disease, providing an overview of the common assessments...

  16. Efficacy and Safety of On-Demand Use of 2 Treatments Designed for Different Etiologies of Female Sexual Interest/Arousal Disorder: 3 Randomized Clinical Trials.

    Science.gov (United States)

    Tuiten, Adriaan; van Rooij, Kim; Bloemers, Jos; Eisenegger, Christoph; van Honk, Jack; Kessels, Rob; Kingsberg, Sheryl; Derogatis, Leonard R; de Leede, Leo; Gerritsen, Jeroen; Koppeschaar, Hans P F; Olivier, Berend; Everaerd, Walter; Frijlink, Henderik W; Höhle, Daniël; de Lange, Robert P J; Böcker, Koen B E; Pfaus, James G

    2018-02-01

     = 0.99, 95% CI = 0.17-1.82, P = .019) and monotherapies (B: Δ = 1.52, 95% CI = 0.57-2.46, P = .002; T: Δ = 0.98, 95% CI = 0.17-1.78, P = .018). Secondary end points followed this pattern of results. The most common drug-related side effects were flushing (T + S treatment, 3%; T + B treatment, 2%), headache (placebo treatment, 2%; T + S treatment, 9%), dizziness (T + B treatment, 3%), and nausea (T + S treatment, 3%; T + B treatment, 2%). T + S and T + B are promising treatments for women with FSIAD. The data were collected in 3 well-designed randomized clinical trials that tested multiple doses in a substantial number of women. The influence of T + S and T + B on distress and the potentially sustained improvements after medication cessation were not investigated. T + S and T + B are well tolerated and safe and significantly increase the number of SSEs in different FSIAD subgroups. Tuiten A, van Rooij K, Bloemers J, et al. Efficacy and Safety of On-Demand Use of 2 Treatments Designed for Different Etiologies of Female Sexual Interest/Arousal Disorder: 3 Randomized Clinical Trials. J Sex Med 2018;15:201-216. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Sarcopenia is associated with disability status-results from the KORA-Age study.

    Science.gov (United States)

    Phillips, A; Strobl, R; Vogt, S; Ladwig, K-H; Thorand, B; Grill, E

    2017-07-01

    We estimated the prevalence of sarcopenia and its impact on disability in older people. Sarcopenia was found to contribute to higher disability scores. However, our study was not able to show any influence of sarcopenia on the rate of functional decline. This directs attention to an accurate diagnosis of sarcopenia as the onset may be influenced, but its rate may not. The objectives of this study using data from a population-based cohort were to estimate the prevalence of sarcopenia in older people in Germany and to test the hypothesis that sarcopenia is associated with disability in older adults. Cross-sectional (n = 927) and longitudinal analyses (n = 859) of participants aged ≥65 years at baseline from southern Germany enrolled in the Cooperative Health Research in the Region Augsburg (KORA)-Age study (2009-2012). Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm which includes the presence of both low muscle mass and low muscle function (strength or performance). Disability status was measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI). The presence of disability was defined as HAQ-DI >0. Directed acyclic graphs (DAGs) were constructed to identify potential confounders. The effect of sarcopenia on disability was analyzed using linear mixed effect models with disability values as a continuous outcome. The overall prevalence of sarcopenia was 5.7% (men 4.0%, women 7.5%) and increased with age. The 3-year incidence of disability was 32.7%. After adjustment for potential confounders, presence of sarcopenia was significantly associated with higher disability scores (0.142 [confidence interval 0.029-0.254]). The prevalence of sarcopenia is consistent with estimates from other European studies using this algorithm. Our results suggest that sarcopenia can contribute to higher disability scores in older adults. However, our study was not able to show any influence of sarcopenia on the

  18. Sarcopenia Adversely Impacts Postoperative Complications Following Resection or Transplantation in Patients with Primary Liver Tumors

    Science.gov (United States)

    Valero, Vicente; Amini, Neda; Spolverato, Gaya; Weiss, Matthew J.; Hirose, Kenzo; Dagher, Nabil N.; Wolfgang, Christopher L.; Cameron, Andrew A.; Philosophe, Benjamin; Kamel, Ihab R.

    2015-01-01

    Background Sarcopenia is a surrogate marker of patient frailty that estimates the physiologic reserve of an individual patient. We sought to investigate the impact of sarcopenia on short- and long-term outcomes in patients having undergone surgical intervention for primary hepatic malignancies. Methods Ninety-six patients who underwent hepatic resection or liver transplantation for HCC or ICC at the John Hopkins Hospital between 2000 and 2013 met inclusion criteria. Sarcopenia was assessed by the measurement of total psoas major volume (TPV) and total psoas area (TPA). The impact of sarcopenia on perioperative complications and survival was assessed. Results Mean age was 61.9 years and most patients were men (61.4 %). Mean adjusted TPV was lower in women (23.3 cm3/m) versus men (34.9 cm3/m) (Psarcopenia. The incidence of a postoperative complication was 40.4 % among patients with sarcopenia versus 18.4 % among patients who did not have sarcopenia (P=0.01). Of note, all Clavien grade ≥3 complications (n=11, 23.4 %) occurred in the sarcopenic group. On multivariable analysis, the presence of sarcopenia was an independent predictive factor of postoperative complications (OR=3.06). Sarcopenia was not associated with long-term survival (HR=1.23; P=0.51). Conclusions Sarcopenia, as assessed by TPV, was an independent factor predictive of postoperative complications following surgical intervention for primary hepatic malignancies. PMID:25389056

  19. Cancer cachexia, sarcopenia and biochemical markers in patients with advanced non-small cell lung cancer-chemotherapy toxicity and prognostic value.

    Science.gov (United States)

    Srdic, Drazena; Plestina, Sanja; Sverko-Peternac, Ana; Nikolac, Nora; Simundic, Ana-Maria; Samarzija, Miroslav

    2016-11-01

    demonstrated statistically significant difference (p = 0.020, p = 0.040, p = 0.003). Cachexia and sarcopenia were not found to be predictors of chemotoxicity nor was time to tumor progression. On the contrary, albumin concentration with established cutoff point of 37.5 g/L was clearly proved as the predictive factor of both chemotoxicity (OR (95 % CI) = 0.85; p cachexia and sarcopenia are. This approach in clinical settings can be used to guide the choice of oncologic treatment.

  20. Etiology of Inguinal Hernias

    DEFF Research Database (Denmark)

    Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral...... with patients with lateral hernias. However, connective tissue alteration may play a role in development of both subtypes. Inguinal hernias have a hereditary component with a complex inheritance pattern, and inguinal hernia susceptible genes have been identified that also are involved in connective tissue...... homeostasis. CONCLUSION: The etiology of lateral and medial hernias are at least partly different, but the final explanations are still lacking on certain areas. Further investigations of inguinal hernia genes may explain the altered connective tissue observed in patients with inguinal hernias. The precise...

  1. Recent genetic discoveries in osteoporosis, sarcopenia and obesity.

    Science.gov (United States)

    Urano, Tomohiko; Inoue, Satoshi

    2015-01-01

    Osteoporosis is a skeletal disorder characterized by low bone mineral density (BMD) and an increased susceptibility to fractures. Evidence from genetic studies indicates that BMD, a complex quantitative trait with a normal distribution, is genetically controlled. Genome-wide association studies (GWAS) as well as studies using candidate gene approaches have identified single-nucleotide polymorphisms (SNPs) that are associated with BMD, osteoporosis and osteoporotic fractures. These SNPs have been mapped close to or within genes including those encoding WNT/β-catenin signaling proteins. Understanding the genetics of osteoporosis will help to identify novel candidates for diagnostic and therapeutic targets. Genetic factors are also important for the development of sarcopenia, which is characterized by a loss of lean body mass, and obesity, which is characterized by high fat mass. Hence, in this review, we discuss the genetic factors, identified by genetic studies, which regulate the body components related to osteoporosis, sarcopenia, and obesity.

  2. Sarcopenia and sarcopenic obesity in patients with muscular dystrophy

    Directory of Open Access Journals (Sweden)

    Luciano eMerlini

    2014-10-01

    Full Text Available Aging sarcopenia and muscular dystrophy are two conditions characterized by lower skeletal muscle quantity, lower muscle strength, and lower physical performance. Aging is associated with a peculiar alteration in body composition called sarcopenic obesity characterized by a decrease in lean body mass and increase in fat mass. To evaluate the presence of sarcopenia and obesity in a cohort of adult patients with muscular dystrophy we have used the measurement techniques considered golden standard for sarcopenia that is for muscle mass dual energy X-ray absorptiometry (DXA, for muscle strength hand held dynamometry, and for physical performance gait speed. The study involved 14 adult patients with different types of muscular dystrophy. We were able to demonstrate that all patient were sarcopenic-obese. We showed in fact that all were sarcopenic based on appendicular lean, fat & bone free, mass index (ALMI. In addition all resulted obese according to the % of body fat determined by DXA in contrast with their body mass index ranging from underweight to obese. Skeletal muscle mass determined by DXA was markedly reduced in all patients and correlated with residual muscle strength determined by hand held dynamometry, and physical performances determined by gait speed and respiratory function. Finally we showed that ALMI was the best linear explicator of muscle strength and physical function. Altogether, our study suggest the relevance of a proper evaluation of body composition in muscular dystrophy and we propose to use, both in research and practice, the measurement techniques that has already been demonstrated effective in aging sarcopenia.

  3. The influence of sarcopenia on survival and surgical complications in ovarian cancer patients undergoing primary debulking surgery

    NARCIS (Netherlands)

    Rutten, I.J.; Ubachs, J.; Kruitwagen, R.F.P.M.; Dijk, D.P. van; Beets-Tan, R.G.; Massuger, L.F.A.G.; Oude Damink, S.W.; Gorp, T. Van

    2017-01-01

    BACKGROUND: Sarcopenia, severe skeletal muscle loss, has been identified as a prognostic factor in various malignancies. This study aims to investigate whether sarcopenia is associated with overall survival (OS) and surgical complications in patients with advanced ovarian cancer undergoing primary

  4. The Etiology of Giftedness

    Science.gov (United States)

    Thompson, Lee Anne; Oehlert, Jeremy

    2010-01-01

    Many theories of giftedness either explicitly or implicitly acknowledge the role of genetic influences; yet, empirical work has not been able to establish the impact that genes have specifically on gifted behavior. In contrast, a great deal of research has been targeted at understanding the etiology of individual differences in general and…

  5. Sarcopenia in patients with hip fracture: A multicenter cross-sectional study.

    Science.gov (United States)

    Steihaug, Ole Martin; Gjesdal, Clara Gram; Bogen, Bård; Kristoffersen, Målfrid Holen; Lien, Gunhild; Ranhoff, Anette Hylen

    2017-01-01

    Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities. A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score. Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0]. Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility.

  6. Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Steffl M

    2017-05-01

    Full Text Available Michal Steffl,1 Richard W Bohannon,2 Lenka Sontakova,1 James J Tufano,1 Kate Shiells,3 Iva Holmerova3 1Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University Prague, Prague, Czech Republic; 2Department of Physical Therapy, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC, USA; 3Faculty of Humanities, Centre of Gerontology, Charles University Prague, Prague, Czech Republic Abstract: Physical activity (PA has been identified as beneficial for many diseases and health disorders, including sarcopenia. The positive influence of PA interventions on sarcopenia has been described previously on many occasions. Current reviews on the topic include studies with varied PA interventions for sarcopenia; nevertheless, no systematic review exploring the effects of PA in general on sarcopenia has been published. The main aim of this study was to explore the relationship between PA and sarcopenia in older people on the basis of cross-sectional and cohort studies. We searched PubMed, Scopus, EBSCOhost, and ScienceDirect for articles addressing the relationship between PA and sarcopenia. Twenty-five articles were ultimately included in the qualitative and quantitative syntheses. A statistically significant association between PA and sarcopenia was documented in most of the studies, as well as the protective role of PA against sarcopenia development. Furthermore, the meta-analysis indicated that PA reduces the odds of acquiring sarcopenia in later life (odds ratio [OR] =0.45; 95% confidence interval [CI] 0.37–0.55. The results of this systematic review and meta-analysis confirm the beneficial influence of PA in general for the prevention of sarcopenia. Keywords: aging, sarcopenia, physical activity 

  7. The Impact of Sarcopenia on Survival and Complications in Surgical Oncology: A Review of the Current Literature

    Science.gov (United States)

    JOGLEKAR, SAVITA; NAU, PETER N.; MEZHIR, JAMES J.

    2016-01-01

    Sarcopenia is the subclinical loss of skeletal muscle and strength and has been extensively studied in both the cancer and surgical literature. Specifically, sarcopenia has gained significant recognition as an important prognostic factor for both complications and survival in cancer patients. Herein, we review the current literature to date highlighting the specific impact of sarcopenia in patients undergoing oncologic procedures. PMID:26310812

  8. Associations of sarcopenia definitions, and their components, with the incidence of recurrent falling and fractures; the Longitudinal Aging Study Amsterdam

    NARCIS (Netherlands)

    Schaap, Laura A; van Schoor, Natasja M; Lips, Paul; Visser, Marjolein

    2017-01-01

    Background: The aim was to investigate the associations of sarcopenia as defined by European Working Group on Sarcopenia in Older People (EWGSOP) and Foundation for the National Institutes of Health (FNIH) Sarcopenia Project, and their underlying components, with the incidence of recurrent falling

  9. Sarcopenia in the prognosis of cirrhosis: Going beyond the MELD score

    Science.gov (United States)

    Kim, Hee Yeon; Jang, Jeong Won

    2015-01-01

    Estimating the prognosis of patients with cirrhosis remains challenging, because the natural history of cirrhosis varies according to the cause, presence of portal hypertension, liver synthetic function, and the reversibility of underlying disease. Conventional prognostic scoring systems, including the Child-Turcotte-Pugh score or model for end-stage liver diseases are widely used; however, revised models have been introduced to improve prognostic performance. Although sarcopenia is one of the most common complications related to survival of patients with cirrhosis, the newly proposed prognostic models lack a nutritional status evaluation of patients. This is reflected by the lack of an optimal index for sarcopenia in terms of objectivity, reproducibility, practicality, and prognostic performance, and of a consensus definition for sarcopenia in patients with cirrhosis in whom ascites and edema may interfere with body composition analysis. Quantifying skeletal muscle mass using cross-sectional abdominal imaging is a promising tool for assessing sarcopenia. As radiological imaging provides direct visualization of body composition, it is useful to evaluate sarcopenia in patients with cirrhosis whose body mass index, anthropometric measurements, or biochemical markers are inaccurate on a nutritional assessment. Sarcopenia defined by cross-sectional imaging-based muscular assessment is prevalent and predicts mortality in patients with cirrhosis. Sarcopenia alone or in combination with conventional prognostic systems shows promise for a cirrhosis prognosis. Including an objective assessment of sarcopenia with conventional scores to optimize the outcome prediction for patients with cirrhosis needs further research. PMID:26167066

  10. Prevalence and Associated Factors of Sarcopenia in Older Adults with Intellectual Disabilities

    Science.gov (United States)

    Bastiaanse, Luc P.; Hilgenkamp, Thessa I. M.; Echteld, Michael A.; Evenhuis, Heleen M.

    2012-01-01

    Sarcopenia is defined as a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength. It has hardly been studied in older people with intellectual disabilities (ID). In this study 884 persons with borderline to profound ID aged 50 years and over, were investigated to determine the prevalence of sarcopenia in…

  11. [Etiology of affective disorders].

    Science.gov (United States)

    Shinohara, M; Kariya, T

    1994-05-01

    We discussed mainly neurochemical etiology of affective disorders (A.D.). Neurochemically, decreased 5-HT uptake in the platelet, increased 5-HT2 receptor in the platelet and cortex of suicides, increased beta receptor in the brains of suicide, functional abnormality of alpha 2 receptor in clonidine, DMI test, GABAB receptor up-regulation after chronic administration of antidepressants and mood stabilizers, participation of neuropeptide Y, and abnormality of HPA axis were recognized. Moreover, we referred to the importance of psychosocial and genetic factors. As for the etiology of A.D., while predisposition and environment participate, the method of participation will be different in subtypes. Frailty to stress in a broad sense, however is commonly seen in A.D. Though psychosocial factors are important, the physical condition, which involves fatigue, cannot be ignored. And, it is the most important that the biological and genetical factors which cause A.D., in the face of stimuli, must first be elucidated.

  12. The association between delirium and sarcopenia in older adult patients admitted to acute geriatrics units: Results from the GLISTEN multicenter observational study.

    Science.gov (United States)

    Bellelli, Giuseppe; Zambon, Antonella; Volpato, Stefano; Abete, Pasquale; Bianchi, Lara; Bo, Mario; Cherubini, Antonio; Corica, Francesco; Di Bari, Mauro; Maggio, Marcello; Manca, Giovanna Maria; Rizzo, Maria Rosaria; Rossi, Andrea; Landi, Francesco

    2017-09-05

    To date, studies assessing the relationship between sarcopenia and delirium, two of the most common geriatric syndromes, are lacking. We sought to explore this association by investigating the co-occurrence of these two conditions and the independent association between them in a population of hospitalized older adults. Cross-sectional multicenter analysis of older adults consecutively admitted to 12 acute geriatric units (AGUs). Sarcopenia was assessed upon admission by evaluating the presence of low skeletal mass index (kg/m2), and either low handgrip strength or low walking speed (European Working Group on Sarcopenia in Older People, EWGSOP criteria). Skeletal muscle mass was estimated using bioimpedance analysis. Participants underwent a comprehensive geriatric assessment upon admission; information concerning demographics, cognition (Short Portable Status Mental Questionnaire, SPMSQ) functional (Instrumental Activities of Daily Living, IADL and Basic-Activities of Daily Living, BADL), and health status (Charlson Index and specific diseases) was evaluated. The presence of delirium upon admission was ascertained as an explicit clinical diagnosis recorded by the researcher of each centre on the data form. All association estimates were reported as Prevalence Ratios (PRs) and 95% confidence intervals (CIs), using a Cox hazard proportional regression model with robust variance and constant time. Of the 588 analyzed patients (mean age = 80.9 ± 6.8, 53.2% females), 199 (33.8%) had sarcopenia upon admission to the AGU. According to a multivariable Cox regression, delirium upon admission (PR 1.66, 95% CI: 1.12-2.45), IADL total score (PR 0.93, 95% CI: 0.87-0.98), Body Mass Index values (BMI) ranging from 18.5 to 25.0 (PR 1.70, 95% CI: 1.33-2.18), BMI values >18.5 (PR 2.53, 95% CI: 1.81-3.53), previous stroke (PR 1.51, 95% CI: 1.10-2.07) and chronic heart failure (CHF) (PR 1.31, 95% CI: 1.02-1.68) were significantly and independently associated with sarcopenia upon

  13. High prevalence of sarcopenia among binge drinking elderly women: a nationwide population-based study.

    Science.gov (United States)

    Yoo, Jun-Il; Ha, Yong-Chan; Lee, Young-Kyun; Hana-Choi; Yoo, Moon-Jib; Koo, Kyung-Hoi

    2017-05-30

    Alcohol consumption is considered a risk factor for sarcopenia, but the association between alcohol consumption and the prevalence of sarcopenia has not been evaluated in detail. This study was to identify the relationship between alcohol drinking patterns and the prevalence of sarcopenia in the elderly Korean population. The cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. Participants were excluded if they were under the age of 65, or if data was not available regarding skeletal muscle mass or dietary intake. After these exclusions, a total of 4020 participants (men: 1698; women: 2322) were analyzed in the present study. Sarcopenia is defined according to the criteria for the Asia Working Group for Sarcopenia (AWGS). Binge drinking was defined as consuming ≥5 standard alcoholic drinks (≥4 drinks for women) consecutively on one occasion. This data was subcategorized into two groups based on presence of binge drinking: Social drinking (≤1 time/month) and binge drinking (>1 time/month). Women binge drinkers with weekly or daily consumption had 2.8 times higher prevalence of sarcopenia than social drinkers (Odds Ratio [OR] = 2.84; 95% Confidence Interval [CI] = 1.12-7.29). However, there were no associations between binge drinkers and sarcopenia in men. After adjusting for age, body mass index (BMI), energy intake, moderate physical activity, and energy intake, women binge drinkers with weekly or daily alcohol consumption had 3.9 times higher prevalence of sarcopenia than social drinkers (OR = 3.88; 95% CI = 1.33-11.36). The prevalence of sarcopenia in elderly women was related to binge drinking frequency and amounts of drinking after adjusting for covariates. Elderly Korean women who binge drink once or more per week may be associated with sarcopenia, as seen with the observed 3.9 times higher prevalence compared to social drinkers.

  14. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) "cachexia-anorexia in chronic wasting diseases" and "nutrition in geriatrics".

    Science.gov (United States)

    Muscaritoli, M; Anker, S D; Argilés, J; Aversa, Z; Bauer, J M; Biolo, G; Boirie, Y; Bosaeus, I; Cederholm, T; Costelli, P; Fearon, K C; Laviano, A; Maggio, M; Rossi Fanelli, F; Schneider, S M; Schols, A; Sieber, C C

    2010-04-01

    Chronic diseases as well as aging are frequently associated with deterioration of nutritional status, loss muscle mass and function (i.e. sarcopenia), impaired quality of life and increased risk for morbidity and mortality. Although simple and effective tools for the accurate screening, diagnosis and treatment of malnutrition have been developed during the recent years, its prevalence still remains disappointingly high and its impact on morbidity, mortality and quality of life clinically significant. Based on these premises, the Special Interest Group (SIG) on cachexia-anorexia in chronic wasting diseases was created within ESPEN with the aim of developing and spreading the knowledge on the basic and clinical aspects of cachexia and anorexia as well as of increasing the awareness of cachexia among health professionals and care givers. The definition, the assessment and the staging of cachexia, were identified as a priority by the SIG. This consensus paper reports the definition of cachexia, pre-cachexia and sarcopenia as well as the criteria for the differentiation between cachexia and other conditions associated with sarcopenia, which have been developed in cooperation with the ESPEN SIG on nutrition in geriatrics. Copyright 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  15. Severe Sarcopenia and Increased Fat Stores in Pediatric Patients With Liver, Kidney, or Intestine Failure.

    Science.gov (United States)

    Mangus, Richard S; Bush, Weston J; Miller, Christina; Kubal, Chandrashekhar A

    2017-11-01

    Malnutrition and wasting predict clinical outcomes in children with severe chronic illness. Objectively calculated malnutrition in children with end-stage organ failure has not been well studied. This analysis compares children with kidney, liver or intestine failure to healthy controls to quantitate the disparity in muscle and fat stores. Children younger than 19 years with end-stage liver, kidney, or intestine failure and with pretransplant computed tomography (CT) imaging were selected from the transplant database. Age- and sex-matched healthy controls were selected from the trauma database. Measures of nutrition status included a scaled scoring of core muscle mass, and visceral and subcutaneous fat stores. Analysis was conducted using the pooled and individually matched subject-control differences. There were 81 subjects included in the final analysis (liver [n = 35], kidney [n = 20], and intestine [n = 26]). Children with end-stage liver disease had a 23% reduction in muscle mass, a 69% increase in visceral fat, and a 29% increase in subcutaneous fat. End-stage renal disease patients had a 19% reduction in muscle mass and a 258% increase in subcutaneous fat. Intestine failure patients had a 24% reduction in muscle mass, a 30% increase in visceral fat, and a 46% increase in subcutaneous fat. These results demonstrate significant sarcopenia and increased fat stores in end-stage organ failure patients, which supports the idea of an active physiologic mechanism to store fat while losing muscle mass. Sarcopenia may be related to total protein loss from a catabolic state, or from decreased synthesis (liver), wasting (kidney), or malabsorption (intestine).

  16. Association between sarcopenia and nutritional status and physical activity among community-dwelling Chinese adults aged 60 years and older.

    Science.gov (United States)

    Hai, Shan; Cao, Li; Wang, Hui; Zhou, Jianghua; Liu, Ping; Yang, Ying; Hao, Qiukui; Dong, Birong

    2017-11-01

    The aim of the present study was to examine the association between sarcopenia and nutritional status and physical activity among community-dwelling Chinese people aged 60 years and older. This study was carried out on 836 community-dwelling Chinese individuals aged ≥60 years to evaluate sarcopenia using the Asian Working Group for Sarcopenia criteria. Sociodemographic characteristics and lifestyle habits were collected using a general questionnaire. Nutritional status was assessed using the Mini Nutritional Assessment and biochemical parameters, whereas physical activity was assessed using the long form of the International Physical Activity Questionnaire. In addition, univariate and multivariate analysis was used to analyze the association between sarcopenia with nutritional status and physical activity. The total prevalence rate of sarcopenia was 10.5%, 47 (11.3%) men and 41 (9.7%) women who were classified as sarcopenia. The prevalence of sarcopenia was significantly lower among the participants of normal nutrition status. Compared with the participants with sarcopenia, those without sarcopenia had higher levels of prealbumin (P Nutritional Assessment score (adjusted OR 0.769, 95% CI 0.689-0.859, P older was high. There was a significant association between sarcopenia and nutritional status, but not with physical activity, based on a questionnaire. Further studies should evaluate whether maintaining a good nutritional status might be effective in lowering the risk of sarcopenia. Geriatr Gerontol Int 2017; 17: 1959-1966. © 2017 Japan Geriatrics Society.

  17. Sarcopenia among patients receiving hemodialysis: weighing the evidence.

    Science.gov (United States)

    Kittiskulnam, Piyawan; Carrero, Juan J; Chertow, Glenn M; Kaysen, George A; Delgado, Cynthia; Johansen, Kirsten L

    2017-02-01

    There is no consensus on how best to define low muscle mass in patients with end-stage renal disease. Use of muscle mass normalized to height-squared has been suggested by geriatric societies but may underestimate sarcopenia, particularly in the setting of excess adiposity. We compared four definitions of low muscle mass in a prevalent hemodialysis cohort. ACTIVE/ADIPOSE enrolled prevalent patients receiving hemodialysis from the San Francisco and Atlanta areas from June 2009 to August 2011. Whole-body muscle mass was estimated using bioelectrical impedance spectroscopy, performed before a midweek dialysis session (n = 645; age 56.7 ± 14.5 years, 41% women). We defined low muscle mass as muscle mass of 2SD or more below sex-specific bioelectrical impedance spectroscopy-derived means for young adults (18-49 years) from National Health and Nutrition Examination Survey and indexed to height2 , body weight (percentage), body surface area (BSA) by the DuBois formula, or Quételet's body mass index (BMI). We compared prevalence of low muscle mass among the four methods and assessed their correlation with strength and physical performance. The prevalence of low muscle mass ranged from 8 to 32%. Muscle mass indexed to height2 classified the smallest percentage of patients as having low muscle mass, particularly among women, whereas indexing by BSA classified the largest percentage. Low muscle mass/height2 was present almost exclusively among normal or underweight patients, whereas indexing to body weight and BMI classified more overweight and obese patients as having low muscle mass. Handgrip strength was lower among those with low muscle mass by all methods except height2 . Handgrip strength was directly and modestly correlated with muscle mass normalized by percentage of body weight, BSA, and BMI (ρ = 0.43, 0.56, and, 0.64, respectively) and less so with muscle/height2 (ρ = 0.31, P grip strength among patients with low vs. normal muscle mass was

  18. Etiological relationships in atopy

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; Kyvik, Kirsten Ohm; Backer, Vibeke

    2008-01-01

    respiratory allergic symptoms, that is, asthma and hay fever, to be between .47 and .95. Furthermore, atopic traits share a portion of their genetic determinants with other complex disorders like obesity and behavioral traits. A correlation of about .3 and .34 has been reported between genes associated...... with asthma and obesity, and between genes associated with asthma and depression, respectively. We emphasize that multivariate methods applied to twin studies, especially when genetic marker information is available, provide a valuable framework within which complex etiological mechanisms underlying atopy can...

  19. Association between sarcopenia with lifestyle and family function among community-dwelling Chinese aged 60 years and older.

    Science.gov (United States)

    Hai, Shan; Wang, Hui; Cao, Li; Liu, Ping; Zhou, Jianghua; Yang, Ying; Dong, Birong

    2017-08-18

    Sarcopenia is defined as the age-related decline in skeletal muscle mass and function. The risk factors and causes of sarcopenia must be identified to develop prevention and treatment strategies for this syndrome. Our aim was to examine the association between sarcopenia with lifestyle and family function among community-dwelling Chinese people aged 60 years and older. We conducted this study to evaluate sarcopenia among 834 community-dwelling Chinese individuals aged ≥60 years using the Asian Working Group for Sarcopenia (AWGS) criteria. The sociodemographic characteristics, food consumption patterns, habits of smoking, and alcohol consumption of the participants were collected using a general questionnaire, whereas physical activity was assessed using the International Physical Activity Questionnaire (IPAQ; long-form version). Family function was assessed using the Family APGAR scale. In addition, the association of sarcopenia with lifestyle and family function was examined using univariate and multivariate analyses. The total prevalence rate of sarcopenia was 10.6%. Female participants with sarcopenia had a lower frequency per week of nut consumption than those without sarcopenia (p consumption patterns of those with sarcopenia versus those without sarcopenia were not significant. Among the participants, the mean Family APGAR score was 8 (standard deviation [SD] = 0.92). For both sexes, participants with sarcopenia had lower family function scores than those without sarcopenia. In the multivariate model, after adjustment for all covariates, frequency per week of nut consumption (adjusted OR 0.724, 95% CI 0.532-0.985, P function. Further studies should evaluate if adequate intake of nuts and a well-functioning family may be effective in lowering the risk of sarcopenia.

  20. Associations of Sarcopenia and Sarcopenic Obesity With Metabolic Syndrome Considering Both Muscle Mass and Muscle Strength

    Science.gov (United States)

    2016-01-01

    Objectives: We investigated the associations of sarcopenia-defined both in terms of muscle mass and muscle strength-and sarcopenic obesity with metabolic syndrome. Methods: Secondary data pertaining to 309 subjects (85 men and 224 women) were collected from participants in exercise programs at a health center in a suburban area. Muscle mass was measured using bioelectrical impedance analysis, and muscle strength was measured via handgrip strength. Sarcopenia based on muscle mass alone was defined as a weight-adjusted skeletal muscle mass index more than two standard deviations below the mean of a sex-specific young reference group (class II sarcopenia). Two cut-off values for low handgrip strength were used: the first criteria were sarcopenia and being in the two highest quintiles of total body fat percentage among the subjects. The associations of sarcopenia and sarcopenic obesity with metabolic syndrome were evaluated using logistic regression models. Results: The age-adjusted risk ratios (RRs) of metabolic syndrome being compared in people with or without sarcopenia defined in terms of muscle mass were 1.25 (95% confidence interval [CI], 1.06 to 1.47, p=0.008) in men and 1.12 (95% CI, 1.06 to 1.19, psarcopenia defined in terms of muscle mass and sarcopenic obesity with metabolic syndrome were statistically significant in both men and women. Therefore, sarcopenia and sarcopenic obesity must be considered as part of the community-based management of non-communicable diseases. PMID:26841883

  1. White blood cell counts, insulin resistance, vitamin D levels and sarcopenia in Korean elderly men.

    Science.gov (United States)

    Kim, Sang-Hwan; Kwon, Hyun Seok; Hwang, Hee-Jin

    2017-05-01

    Sarcopenia is a major determinant of frailty, disability and mortality in the elderly. Whether low-grade inflammation, insulin resistance and vitamin D are independently associated with sarcopenia remains unclear. In our study, sarcopenia was defined as an appendicular skeletal muscle mass divided by height squared (ASM/Ht 2 ) that was sarcopenia in Korean elderly men aged more than 65 years was 11.2%. ASM/Ht 2 were positively associated with vitamin D levels, but negatively associated with white blood cell counts and HOMA-IR by multiple regression analysis. After adjustment for covariables, sarcopenia was associated with the highest quartile of WBC counts (OR = 2.93, 95% CI = 1.21-7.14) and the highest quartile of serum vitamin D levels (OR = 0.38, 95% CI = 0.15-0.95). In conclusion, the study findings suggest that higher WBC counts and lower vitamin D levels are independently associated with the presence of sarcopenia in community-dwelling elderly men. They also provide a basis for further studies of the complex immune-endocrine network in sarcopenia.

  2. Obesity, sarcopenia, sarcopenic obesity and reduced mobility in Brazilian older people aged 80 years and over.

    Science.gov (United States)

    Santos, Vanessa Ribeiro Dos; Gomes, Igor Conterato; Bueno, Denise Rodrigues; Christofaro, Diego Giulliano Destro; Freitas, Ismael Forte; Gobbo, Luis Alberto

    2017-01-01

    To analyze which abnormalities in body composition (obesity, sarcopenia or sarcopenic obesity) are related to reduced mobility in older people aged 80 years and older. The sample included 116 subjects aged 80 years and older. The body composition was measured using dual-energy X-ray absorptiometry (DXA) and mobility was assessed by motor tests. The χ2 test was used to analyze the proportion of older people with sarcopenia, obesity and sarcopenic obesity based on sex as well as to indicate an association between obesity, sarcopenia, sarcopenic obesity and mobility. Binary logistic regression, adjusted for the variables (sex and osteoarticular diseases), was used to express the magnitude of these associations. One-way analysis of variance was used to compare the mobility of four groups (Normal, Obesity, Sarcopenia and Sarcopenic Obesity). The Sarcopenia Group had lower performance in the lower limbs strength test and in sum of two tests compared with Obesity and Normal Groups. Older people with sarcopenia had higher chance of reduced mobility (OR: 3.44; 95%CI: 1.12-10.52). Older people aged 80 years and older with sarcopenia have more chance for reduction in mobility.

  3. One size may not fit all: anti-aging therapies and sarcopenia.

    Science.gov (United States)

    Burks, Tyesha N; Cohn, Ronald D

    2011-12-01

    Sarcopenia refers to age-related loss of muscle mass and function. Several age-related changes occur in skeletal muscle including a decrease in myofiber size and number and a diminished ability of satellite cells to activate and proliferate upon injury leading to impaired muscle remodeling. Although the molecular mechanisms underlying sarcopenia are unknown, it is tempting to hypothesize that interplay between biological and environmental factors cooperate in a positive feedback cycle contributing to the progression of sarcopenia. Indeed many essential biological mechanisms such as apoptosis and autophagy and critical signaling pathways involved in skeletal muscle homeostasis are altered during aging and have been linked to loss of muscle mass. Moreover, the environmental effects of the sedentary lifestyle of older people further promote and contribute the loss of muscle mass. There are currently no widely accepted therapeutic strategies to halt or reverse the progression of sarcopenia. Caloric restriction has been shown to be beneficial as a sarcopenia and aging antagonist. Such results have made the search for caloric restriction mimetics (CRM) a priority. However given the mechanisms of action, some of the currently investigated CRMs may not combat sarcopenia. Thus, sarcopenia may represent a unique phenotypic feature of aging that requires specific and individually tailored therapeutic strategies.

  4. The Relationship of Sleep Duration with Obesity and Sarcopenia in Community-Dwelling Older Adults.

    Science.gov (United States)

    Chien, Meng-Yueh; Wang, Li-Ying; Chen, Hsi-Chung

    2015-01-01

    Numerous studies have reported the relationship between sleep duration and obesity in elderly adults; however, little is known about the relationship of sleep duration and sarcopenia. We examined the relationship of sleep duration with obesity and sarcopenia in community-dwelling older adults. A total of 488 community-dwelling adults (224 men and 264 women) aged ≥65 years were included in the analysis. Self-reported sleep duration and anthropometric data were collected. Skeletal muscle mass was estimated using the predicted equation from a bioelectrical impedance analysis measurement. Obesity and sarcopenia were defined according to the body mass index and the skeletal muscle mass index, respectively. The association between sleep duration and sarcopenia exhibited a U shape in older adults. Compared to adults with 6-8 h of sleep, adults with sleep had a nearly 3-fold increased likelihood of sarcopenia (odds ratio, OR: 2.76, 95% confidence interval, CI: 1.28-5.96), while adults with ≥8 h of sleep had a nearly 2-fold increased risk of sarcopenia (OR: 1.89, 95% CI: 1.01-3.54). Older adults with a sleep duration obesity (OR: 2.15, 95% CI: 1.08-4.30). After gender stratification, the association between obesity and short sleep duration was more robust in women. There were significant associations of sleep duration with either obesity or sarcopenia in community-dwelling older adults. Gender differences in these associations were also observed.

  5. [FAI - concept and etiology].

    Science.gov (United States)

    Leunig, M; Ganz, R

    2009-05-01

    Femoroacetabular impingement (FAI), a recently proposed mechanical concept regarding the development of osteoarthritis (OA) of the hip, is gaining increased acceptance. Both osseous deformity and use of the hip may result in hip damage. Osseous deformities are seen on the acetabular (pincer) or the femoral (cam) side of the hip, leading to characteristic alterations of the acetabular rim. Cam FAI is found in 20-30-year-old athletic men, revealing deep cartilage avulsions from the acetabular rim while the labrum is frequently intact. In pincer FAI, found in 30-40-year-old women, the labrum is frequently significantly destroyed with only minor damage to the acetabular rim. Professional or athletic impact activities can trigger even mild FAI deformities to become symptomatic. For some FAI deformities, the etiologies are known, but for most of them the exact causes are unknown. An improved understanding of the etiology of FAI and its role in the development of hip OA might lead to a reduction in the prevalence of so-called primary OA of the hip.

  6. The Potential of β-Hydroxy-β-Methylbutyrate as a New Strategy for the Management of Sarcopenia and Sarcopenic Obesity.

    Science.gov (United States)

    Rossi, Andrea P; D'Introno, Alessia; Rubele, Sofia; Caliari, Cesare; Gattazzo, Stefano; Zoico, Elena; Mazzali, Gloria; Fantin, Francesco; Zamboni, Mauro

    2017-10-31

    Sarcopenia is defined as an age-related loss of skeletal muscle mass and function and is recognized as a major clinical problem for older people. Essential amino acid supplementation, particularly β-hydroxy-β-methylbutyrate (HMB), a metabolite of leucine that is produced in skeletal muscle, has been evaluated in several studies as a nutritional approach to enhancing muscle protein synthesis in healthy or frail elderly subjects. Studies performed in in vitro conditions show that HMB may be effective in the treatment of muscle wasting, increasing myogenesis, reducing muscle apoptosis, and having a positive effect on muscle protein turnover; however, studies of the effects of HMB conducted in old animals have reported conflicting results. Clinical trials performed in older adults confirm that HMB can attenuate the progression of sarcopenia in elderly subjects. HMB supplementation results in an increase in skeletal muscle mass and strength in the elderly and its effect is even greater when combined with physical exercise. The role of HMB in sarcopenic obesity management is still under debate and a general lack of intervention studies in this population must be recognized. In conclusion, HMB appears to be effective for enhancing muscle mass and strength in the elderly. Less certain is the role of HMB supplementation in reducing fat mass and, thus, in the treatment of sarcopenic obesity.

  7. Sarcopenia in patients undergoing maintenance hemodialysis: incidence rate, risk factors and its effect on survival risk.

    Science.gov (United States)

    Ren, Hongqi; Gong, Dehua; Jia, Fengyu; Xu, Bin; Liu, Zhihong

    2016-01-01

    Sarcopenia is a degenerative syndrome mainly characterized by the atrophy of skeletal muscle, along with the decrease of muscle strength and function. However, there are currently few studies concerning sarcopenia in patients undergoing maintenance hemodialysis dialysis (MHD). This study was aimed to investigate the incidence of sarcopenia in MHD patients and its influencing factors, as well as its impact on survival risk. All 131 MHD patients enrolled in our study were tested with bioelectrical impedance analysis (BIA) and grip strength. Demographic data was collected and anthropometric measurement and laboratory examination were conducted. The total incidence of sarcopenia within the 131 MHD patients was 13.7% and the incidence of sarcopenia in patients over 60 years was 33.3%. The dialysis duration, with or without diabetes, serum phosphorus and pre-albumin levels of sarcopenic patients were significantly different from those of non-sarcopenicones; the modified quantitative subjective global assessment (MQSGA) scores of sarcopenic patients were higher than those without sarcopenia. Multivariate analysis showed that dialysis duration, diabetes and serum phosphorus level were independent risk factors for sarcopenia in MHD patients. Kaplan-Meier survival analysis showed a one-year survival of 88.9% in sarcopenic patients, which was significantly lower than non-sarcopenic patients. The incidence of sarcopenia in MHD patients was high and increased gradually with age. Dialysis duration, diabetes, serum phosphorus level and malnutrition predisposed the patients to sarcopenia. One-year follow-up found that the mortality risk of sarcopenic patients was higher than that of non-sarcopenic patients.

  8. Basis for Sarcopenia Screening With the SARC-CalF in Nursing Homes.

    Science.gov (United States)

    Urzi, Felicita; Šimunič, Boštjan; Buzan, Elena

    2017-11-01

    Sarcopenia is a major health problem of the older population. The European Working Group on Sarcopenia in Older People (EWGSOP) developed diagnostic criteria for diagnosis of sarcopenia that require assessing muscle mass and strength or physical performance. Recently, however, a rapid screening method SARC-CalF was developed. The aim of the present study was to validate the SARC-CalF test using EWGSOP sarcopenia diagnostic criteria in a sample of nursing home residents. Cross-sectional study. A sample of 80 nursing home residents [30% of men; mean age 84.3 (7.9) years]. Sarcopenia was determined as proposed by the EWGSOP diagnostic criteria, whereby muscle mass was measured by bioelectrical impedance, muscle strength by handgrip strength, and physical performance by usual gait speed and a Short Physical Performance Battery score. Sarcopenia was also assessed by the SARC-CalF screening test. A total of 38.7% of sarcopenia was evaluated using EWGSOP diagnostic criteria and 36.2% using the SARC-CalF test. The SARC-CalF demonstrated a sensitivity level of 77.4% and specificity of 89.8%. The area under the receiver operating characteristic curves of SARC-CalF test was 0.84 (95% confidence interval 0.74, 0.94). SARC-CalF could be a useful screening test for sarcopenia in nursing home residents. The incorporation of the test as a basis for sarcopenia screening will provide additional value to current nursing home preventive measures. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  9. Sarcopenia is an independent risk factor of dysphagia in hospitalized older people.

    Science.gov (United States)

    Maeda, Keisuke; Akagi, Junji

    2016-04-01

    Sarcopenia can cause varying physical function disorders, including dysphagia. Malnutrition, a potential result of dysphagia, can also cause sarcopenia. However, the association between sarcopenia and dysphagia is not fully understood, despite evidence suggesting correlations between deglutition disorders and degenerative loss of muscle mass. The present study investigated the prevalence of dysphagia among patients with sarcopenia, and the association between the two conditions. We included 224 older adults (mean age 82.5 ± 8.4 years; 37.9% men). Individuals who had a stroke or other diseases that could directly cause dysphagia were excluded. Logistic regression analyses were carried out after adjusting for potential causes of sarcopenia, including malnutrition, a low activity of daily living levels and aging, to investigate the relationship between the skeletal muscle index (SMI), prevalence of sarcopenia diagnosed based on a low SMI and grip strength, and swallowing functions. The Mini-Nutritional Assessment short form was used to assess their nutritional status, and the Barthel Index was used to evaluate their activities of daily living. The prevalences of sarcopenia and dysphagia were 76.8% and 30.0%, respectively. Multivariate analysis showed that Barthel Index, SMI and presence of sarcopenia were significant independent factors for the prevalence of dysphagia, after adjusting for sex, age and nutritional status. Furthermore, subgroup analysis showed that SMI in males, and both hand-grip strength and SMI in females were lower in dysphagic subjects than in non-dysphagic subjects (P ≤ 0.01). Sarcopenia was an independent risk factor for dysphagia among older individuals. However, further studies are required to define causality. © 2015 Japan Geriatrics Society.

  10. Sarcopenia, sarcopenic obesity and inflammation: Results from the 1999-2004 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Batsis, John A; Mackenzie, Todd A; Jones, Jonathan D; Lopez-Jimenez, Francisco; Bartels, Stephen J

    2016-12-01

    The Foundation for the National Institutes of Health Sarcopenia Project validated cutpoints for appendicular lean mass (ALM) to identify individuals at risk for functional impairment. Recognizing possible underlying mechanisms between adipose tissue and muscle, we sought to apply the recent definitions and determine the relationship with markers of glucose homeostasis and inflammation in individuals with sarcopenia and sarcopenic obesity. The National Health and Nutrition Examination Surveys 1999-2004 were used to identify 4984 adults aged ≥60 years with DEXA measures. Sarcopenia was defined using ALM (mensarcopenia and obesity by body fat (men ≥25%, women ≥35%). We assessed the association between ALM and ALM:BMI with inflammatory and markers of glucose homeostasis, both as continuous variables but also classifying as having sarcopenic obesity or not after adjusting for confounding variables including pro-inflammatory chronic diseases such as diabetes and cancer. Mean age was 71.1 years (56.5%) females. Prevalence of sarcopenia and sarcopenic obesity were (ALM definition: 29.9 and 24.4%; ALM:BMI definition: 23.0 and 22.7%). There were significant associations with ALM and ln C-reactive protein (β = 0.0287; p = 0.001), fibrinogen (β = 0.519; p < 0.001), and HOMA-IR (β = 0.359; p < 0.001). Using ALM:BMI, significant associations were observed with ln CRP (β = -2.58; p = 0.001), fibrinogen (β = -124.2; p < 0.001), and HOMA-IR (β = -6.63; p < 0.001). Sarcopenic obesity using the ALM:BMI definition demonstrated significant associations with CRP (β = 0.422; p < 0.001), fibrinogen (β = 22.5; p < 0.001), but not HOMA-IR (β = 1.19; p = 0.13). Strong associations with seen with increased levels of fibrinogen and CRP with sarcopenic obesity (ALM:BMI definition) that persisted after adjusting for diabetes and cancer. Biologically plausible associations exist between ALM:BMI and inflammation and HOMA-IR that were not observed

  11. The Intriguing Regulators of Muscle Mass in Sarcopenia and Muscular Dystrophy

    Science.gov (United States)

    Sakuma, Kunihiro; Aoi, Wataru; Yamaguchi, Akihiko

    2014-01-01

    Recent advances in our understanding of the biology of muscle have led to new interest in the pharmacological treatment of muscle wasting. Loss of muscle mass and increased intramuscular fibrosis occur in both sarcopenia and muscular dystrophy. Several regulators (mammalian target of rapamycin, serum response factor, atrogin-1, myostatin, etc.) seem to modulate protein synthesis and degradation or transcription of muscle-specific genes during both sarcopenia and muscular dystrophy. This review provides an overview of the adaptive changes in several regulators of muscle mass in both sarcopenia and muscular dystrophy. PMID:25221510

  12. The association between sarcopenia and functional outcomes among older patients with hip fracture undergoing in-hospital rehabilitation.

    Science.gov (United States)

    Landi, F; Calvani, R; Ortolani, E; Salini, S; Martone, A M; Santoro, L; Santoliquido, A; Sisto, A; Picca, A; Marzetti, E

    2017-05-01

    This study evaluates the prevalence of sarcopenia among older people admitted to a rehabilitation unit after hip fracture and the association between sarcopenia and functional outcomes. The results show that sarcopenia had a negative impact on functional recovery. The assessment of sarcopenia among older adults receiving rehabilitation programs is crucial. Sarcopenia is a highly prevalent geriatric syndrome associated with adverse outcomes, including falls, disability, institutionalization, and mortality. Few studies assessed sarcopenia among older adults receiving rehabilitation programs. Patients aged 70 years or more consecutively admitted to in-hospital rehabilitation programs that had suffered from hip fracture entered the study. Sarcopenia was defined according to the Foundation for National Institutes of Health (FNIH) criteria. Multivariable linear regression models were used to analyze the association between the sarcopenia and functional recovery. The recruited population was composed of 127 patients, with a mean age of 81.3 ± 4.8 years, predominantly females (64.6%). Using the criteria proposed by the FNIH, patients with a diagnosis of sarcopenia were 43 (33.9%). After adjustment for potential confounders, participants with sarcopenia had a significant increased risk of incomplete functional recovery compared with non-sarcopenic patients (OR 3.07, 95% CI 1.07-8.75). Compared with participants without sarcopenia, those with sarcopenia showed lower Barthel index scores at the time of discharge from the rehabilitation unit (69.2 versus 58.9, respectively; p sarcopenia among older adults receiving rehabilitation programs to assist in the development of personalized treatment plans aimed at improving functional outcomes.

  13. Cut-off points of quadriceps strength, declines and relationships of sarcopenia-related variables among Thai community-dwelling older adults.

    Science.gov (United States)

    Assantachai, Prasert; Muangpaisan, Weerasak; Intalapaporn, Somboon; Sitthichai, Kobkul; Udompunturak, Suthipol

    2014-02-01

    To define quadriceps strength cut-off points for both sexes to be used in the working diagnosis of sarcopenia in older Asian people, and to investigate the age-related declines of sarcopenia-related variables and correlations between those variables among community-dwelling older adults. The present 3-year prospective study was a part of the Bangkok Longitudinal Study by Siriraj Hospital for Older Men and Women. Data on 2149 participants aged ≥ 60 years were included in this analysis. The quadriceps strength cut-off points, identified based on mobility decline over 2 years of follow up, were 18.0 kg for men and 16.0 kg for women. When these cut-off points were applied to the whole population aged ≥ 60 years (n = 950), the low quadriceps strength group had poorer results on all clinical variables when compared with the normal quadriceps strength group. Although nearly all of the sarcopenia-related variables declined over 2 years of follow up in both older men and women, more significant differences between age groups were seen in older women. Quadriceps strength had the highest degree of correlation with total lean body mass in all age groups (r = 0.550-0.584, P cut-off points of 18.0 kg for older men and 16.0 kg for older women would be useful as a muscle strength measurement for use in any diagnostic algorithm; for example, sarcopenia diagnosis in older Asian people. © 2014 Japan Geriatrics Society.

  14. Biochemical Pathways of Sarcopenia and Their Modulation by Physical Exercise: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Mohammad Mosaferi Ziaaldini

    2017-10-01

    Full Text Available Aging is a complex process characterized by progressive multisystem derangement predisposing individuals to increased risk of developing negative health outcomes. Sarcopenia is the age-related decline of muscle mass and function/strength and represents a highly prevalent correlate of aging. Several factors have been indicated to play a role in the onset and progression of sarcopenia; however, its pathophysiology is still unclear. Physical exercise is to date one of the few strategies able to improve muscle health in old age through multiple metabolic and transcriptional adaptations. Although the benefits of different exercise modalities on the function and structure of aged myocytes is acknowledged, the cellular and molecular mechanisms underlying such effects are not yet fully identified. Here, we briefly overview the current knowledge on the biochemical pathways associated with the onset and progression of sarcopenia. We subsequently describe the effects of exercise on relevant signaling pathways involved in sarcopenia pathophysiology.

  15. Frailty and sarcopenia in Bogotá: results from the SABE Bogotá Study.

    Science.gov (United States)

    Samper-Ternent, Rafael; Reyes-Ortiz, Carlos; Ottenbacher, Kenneth J; Cano, Carlos A

    2017-04-01

    Latin American countries like Colombia are experiencing a unique aging process due to a mixed epidemiological regime of communicable and non-communicable diseases. To estimate the prevalence of frailty and sarcopenia among older adults in Colombia and identify variables associated with these conditions. Data come from the "Salud Bienestar y Envejecimiento" (SABE) Bogotá Study, a cross-sectional study conducted in 2012 in Bogotá, Colombia. Sociodemographic, health, cognitive and anthropometric measures were collected from 2000 community-dwelling adults aged 60 years and older. Frailty variable was created using the Fried phenotype and sarcopenia following the European Working Group on Sarcopenia in Older People algorithm. Logistic regression analyses were used to identify factors associated with frailty and sarcopenia. A total of 135 older adults are frail (9.4 %), while 166 have sarcopenia (11.5 %). Older age and female gender have a significant association with both conditions (Frailty: Age OR 1.05, 95 % CI 1.03-1.06, Gender OR 1.44, 95 % CI 1.12-1.84; Sarcopenia: Age 1.04, 95 % CI 1.02-1.07, Gender OR 1.51, 95 % CI 1.05-2.17). Depression was also significantly associated with frailty (OR 1.17, 95 % CI 1.12-1.22), while smoking was significantly associated with sarcopenia (OR 2.38, 95 % CI 1.29-4.37). Finally, higher function, measured by independence in IADL (Instrumental Activities of Daily Living) was significantly associated with less frailty (OR 0.74, 95 % CI 0.64-0.86). Education, higher number of comorbidities, better MMSE score, activities of daily living disability and alcohol consumption were not significantly associated with frailty or sarcopenia. Frailty, sarcopenia and multimorbidity are overlapping, yet distinct conditions in this sample. There are potentially reversible factors that are associated with frailty and sarcopenia in this sample. Future studies need to analyze the best way to prevent these conditions, and examine individuals

  16. Sarcopenia in Peripheral Arterial Disease: Prevalence and Impact on Functional Status.

    Science.gov (United States)

    Addison, Odessa; Prior, Steven J; Kundi, Rishi; Serra, Monica C; Katzel, Leslie I; Gardner, Andrew W; Ryan, Alice S

    2017-11-11

    To determine the prevalence of sarcopenia in older men with peripheral arterial disease (PAD) and to compare to a subset of the group to age, race, sex, and body mass index (BMI)-matched non-PAD control counterparts. We also sought to compare the functional status of those with PAD with and without sarcopenia. Cohort study. A Veterans Affairs medical center. Sedentary, community dwelling men age 50+ years with a confirmed diagnosis of PAD (N=108; 44% black; BMI 27.8 ± 0.4 kg/m2; ABI:0.62 ± 0.01; mean ±SEM). Not applicable. Dual-energy x-ray absorptiometry scans were used to assess appendicular lean mass (ALM) and determine the prevalence of sarcopenia by ALM/height2 (ALM/ht2). Treadmill tests were used to determine claudication onset time (COT), peak walking time (PWT), and claudication recovery time (CRT). Six-minute walk distance (6MWD) was also measured. Sarcopenia prevalence in our PAD cohort was 25%. The PAD subset (N=42) matched with control counterparts for race, sex, age, and BMI had higher prevalence rates compared with their non-PAD counter parts (23.8% vs 2.4%, P<0.05). Individuals with sarcopenia (N=28) had lower 6MWD (p<0.05; 326± 18.8 vs 380 ± 9.7 meters) and higher CRT (p<0.05; 592 ± 98 vs 395 ± 29 seconds) compared to individuals with PAD but without sarcopenia (N=80). There was no difference in COT or PWT between the PAD groups. Men with PAD demonstrate a high prevalence of sarcopenia. Those with sarcopenia and PAD demonstrate decreased mobility function. Copyright © 2017. Published by Elsevier Inc.

  17. Prevalence and Determinant Factors of Sarcopenia in Patients With Type 2 Diabetes

    OpenAIRE

    Kim, Tae Nyun; Park, Man Sik; Yang, Sae Jeong; Yoo, Hye Jin; Kang, Hyun Joo; Song, Wook; Seo, Ji A.; Kim, Sin Gon; Kim, Nan Hee; Baik, Sei Hyun; Choi, Dong Seop; Choi, Kyung Mook

    2010-01-01

    OBJECTIVE We examined prevalence of sarcopenia in Korean patients with type 2 diabetes and compared body compositional parameters between subjects with and without type 2 diabetes. RESEARCH DESIGN AND METHODS The Korean Sarcopenic Obesity Study (KSOS) included 810 subjects (414 patients with diabetes and 396 control subjects) who were examined using dual-energy X-ray absorptiometry. Prevalence of sarcopenia was defined using the skeletal muscle index (SMI). RESULTS Prevalence in patients with...

  18. The Future Prevalence of Sarcopenia in Europe: A Claim for Public Health Action.

    Science.gov (United States)

    Ethgen, O; Beaudart, C; Buckinx, F; Bruyère, O; Reginster, J Y

    2017-03-01

    Sarcopenia is a major public health issue. To convince health policy makers of the emergency to invest in the sarcopenia field, it is of critical importance to produce reliable figures of the expected burden of sarcopenia in the coming years. Age- and gender-specific population projections were retrieved until 2045 from the Eurostat online database (28 European countries). Age- and gender-specific prevalences of sarcopenia were interpolated from a study that compared prevalence estimates according to the different diagnostic cutoffs of the EWGSOP proposed definition. The reported prevalence estimates were interpolated between 65 and 100 years. Interpolated age- and gender-specific estimates of sarcopenia prevalence were then applied to population projections until 2045. Using the definition providing the lowest prevalence estimates, the number of individuals with sarcopenia would rise in Europe from 10,869,527 in 2016 to 18,735,173 in 2045 (a 72.4% increase). This corresponds to an overall prevalence of sarcopenia in the elderly rising from 11.1% in 2016 to 12.9% in 2045. With the definition providing the highest prevalence estimates, the number of individuals with sarcopenia would rise from 19,740,527 in 2016 to 32,338,990 in 2045 (a 63.8% increase), corresponding to overall prevalence rates in the elderly of 20.2% and 22.3% for 2016 and 2045, respectively. We showed that the number of sarcopenic patients will dramatically increase in the next 30 years, making consequences of muscle wasting a major public health issue.

  19. Sarcopenia is associated with albuminuria independently of hypertension and diabetes: KNHANES 2008-2011.

    Science.gov (United States)

    Han, Eugene; Lee, Yong-Ho; Kim, Gyuri; Kim, So Ra; Lee, Byung-Wan; Kang, Eun Seok; Ahn, Chul Woo; Cha, Bong-Soo

    2016-10-01

    Although sarcopenia is associated with metabolic disorders, its influence on albuminuria has not been determined. The aim of this study was to identify the relationship between sarcopenia and albuminuria in the general population. This was a population-based, cross-sectional study using a nationally representative sample of 2326 subjects aged ≥20years from the Korea National Health and Nutrition Examination Surveys of 2008-2011. Appendicular skeletal muscle (ASM) measured by dual-energy X-ray absorptiometry was used to assess sarcopenia, which was defined as ASM divided by body mass index, as recommended by the international consensus meeting of the National Institutes of Health. Albuminuria was defined as an albumin-to-creatinine ratio of ≥30mg/g using random spot urine samples. A total of 385 (16.5%) subjects were classified as having albuminuria. Sarcopenic subjects showed a higher proportion of albuminuria than subjects without sarcopenia (odds ratios [ORs]=2.17-3.26, all Palbuminuria risk was comparable between insulin-sensitive subjects with sarcopenia and insulin-resistant subjects with preserved muscle mass. A multiple logistic regression analysis also demonstrated that sarcopenia was independently associated with albuminuria (OR=1.61, 95% confidence interval [CI]=1.04-2.48, Palbuminuria remained strong in the elderly population (ORs=1.80-2.68, Palbuminuria was much higher in sarcopenic obese subjects than in other groups (OR=4.90, 95% CI=3.23-7.43, Palbuminuria independent of hypertension, diabetes, and metabolic syndrome. Sarcopenia and obesity had a synergistic impact on the increased risk of albuminuria. This suggests that sarcopenic obesity as well as sarcopenia alone may be considered as novel risk factors for albuminuria. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Relationship Between Sarcopenia and Albuminuria: The 2011 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Kim, Tae Nyun; Lee, Eun Ju; Hong, Jae Won; Kim, Jung Min; Won, Jong Chul; Kim, Mi Kyung; Noh, Jung Hyun; Ko, Kyung Soo; Rhee, Byoung Doo; Kim, Dong-Jun

    2016-01-01

    Studies have shown that albuminuria, obesity, and sarcopenia may share pathophysiological processes related to cardiovascular disease risk. Their direct relationships, however, have not been examined. This study investigated the association between albuminuria and sarcopenia in a representative fraction of the Korean population.Of the 10,589 people who participated in the 2011 Korea National Health and Nutrition Examination Survey, 2158 participants aged over 19 years had been tested for albumin-to-creatinine ratio and for body composition data using dual-energy x-ray absorptiometry. Albuminuria was defined as an albumin-to-creatinine ratio ≥30 mg/g. Sarcopenia was defined as a skeletal muscle index (SMI) (SMI (%) = total appendicular skeletal muscle mass [kg]/weight [kg] × 100) of less than 1 standard deviation (SD) (grade 1) or 2 SD (grade 2) below the sex-specific mean for a younger reference group.The prevalence of albuminuria was higher in those with grade 2 sarcopenia than in those with a normal SMI or grade 1 sarcopenia (33.3% versus 8.4% and 8.9%; P albuminuria than in those with the upper tertile of normoalbuminuria. In addition, multiple logistic regression analysis showed the odds ratio for albuminuria risk in the grade 2 sarcopenia group was 2.93 (95% confidence interval [CI], 1.46-5.88), compared with normal SMI after adjusting for potential confounding factors, including the presence of obesity, diabetes, and hypertension. Moreover, individuals with albuminuria had an odds ratio of 3.39 (95% [confidence interval], 1.38-8.37) for grade 2 sarcopenia compared with those in the lowest tertile of normoalbuminuria.This is the first study to demonstrate that individuals with sarcopenia exhibited increased risk of albuminuria and vice versa.

  1. A study on relationship between elderly sarcopenia and inflammatory factors IL-6 and TNF-α.

    Science.gov (United States)

    Bian, Ai-Lin; Hu, Hui-Ying; Rong, Yu-Dong; Wang, Jian; Wang, Jun-Xiong; Zhou, Xin-Zi

    2017-07-12

    This report aims to study the relationship between sarcopenia of elderly in community and inflammatory factors IL-6 and TNF-α. A total of 441 elders who undertook physical examinations were included into this study. The age of these subjects were >60, in which 235 subjects were male and 206 subjects were female. According to the diagnostic standards of sarcopenia set by EWGSOP and AWGS, these subjects were divided into two groups: sarcopenia, and non-sarcopenia groups. The living habits, disease status, biochemical indexes, and levels of IL-6 and TNF-α of these subjects were investigated. The morbidity rate of sarcopenia was 17.02% in male subjects and 18.9% in female subjects. In elderly subjects >80 years old, morbidity rate was 25.3% in male subjects and 35.1% in female subjects. The history of smoking in patients with sarcopenia was long, and their regular exercise history was short (P TNF-α levels between these two groups were statistically significant (P TNF-α levels, and ALB was negatively correlated to IL-6; while BMI and VFA were positively correlated to TNF-α levels, and SMM, HDL-C, Hb, HG were negatively correlated to IL-6 level (P TNF-α, while VFA was the independent risk factor of IL-6. The onset of sarcopenia was associated with poor exercise habits, disease history, and nutritional status. The emergence of sarcopenia was accompanied by increased levels of inflammation factors TNF-α and IL-6. Plasma albumin, BMI, and VFA were inflammatory factor predictors of TNF and IL-6.

  2. Risk Factors Associated with Chronic Kidney Disease of Unknown Etiology (CKDu): A Study of Patients from an Occupational Health Clinic in Rural Nicaragua

    OpenAIRE

    Jimenez, Krystal Alicia

    2016-01-01

    Contrary to the conventional definition of CKD that is observed in developed countries, studies on CKD in developing countries demonstrate an atypical presentation of the disease, referenced as CKD of unknown origin (CKDu). CKD rates have been exponentially increasing in Nicaragua, particularly in sugarcane workers. This study assesses risk factors associated with this atypical presentation of CKD in patients from an occupational health clinic in rural Nicaragua. This was a cross-sectional st...

  3. Sarcopenia in hiding: The risk and consequence of underestimating muscle dysfunction in nonalcoholic steatohepatitis.

    Science.gov (United States)

    Bhanji, Rahima A; Narayanan, Praveena; Allen, Alina M; Malhi, Harmeet; Watt, Kymberly D

    2017-12-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Up to one third of individuals with NAFLD will develop nonalcoholic steatohepatitis (NASH), which is associated with progression to cirrhosis and is rapidly becoming the leading indication for liver transplantation. Sarcopenia is defined as a progressive and generalized loss of skeletal muscle mass, strength, and function. It is observed in up to 60% of patients with end-stage liver disease and portends a poor prognosis. Recent studies have shown that sarcopenia is a novel risk factor for developing NAFLD. Pathophysiological mechanisms relating sarcopenia and NASH may include insulin resistance (IR) and increased inflammation. IR leads to accumulation of triglycerides in both muscle tissue and the liver. It also exacerbates proteolysis and leads to muscle depletion. Chronic inflammation leads to liver injury and progression of fibrosis. The inflammatory milieu also stimulates protein catabolism. Viewing skeletal muscle as an endocrine organ that secretes various salutary myokines may help us understand its role in the development of steatosis. A better understanding of the pathophysiology will aid in developing physical and pharmacological therapeutic interventions. In this review, we will explore the complex inter-relationships between sarcopenia and NASH. We will discuss the impact of sarcopenia in patients with NASH and therapeutic options for the management of sarcopenia. (Hepatology 2017;66:2055-2065). © 2017 by the American Association for the Study of Liver Diseases.

  4. Intramuscular Adipose Tissue, Sarcopenia, and Mobility Function in Older Individuals

    Directory of Open Access Journals (Sweden)

    Robin L. Marcus

    2012-01-01

    Full Text Available Objective. Intramuscular adipose tissue (IMAT and sarcopenia may adversely impact mobility function and physical activity. This study determined the association of locomotor muscle structure and function with mobility function in older adults. Method. 109 older adults with a variety of comorbid disease conditions were examined for thigh muscle composition via MRI, knee extensor strength via isometric dynamometry, and mobility function. The contribution of strength, quadriceps lean tissue, and IMAT to explaining the variability in mobility function was examined using multivariate linear regression models. Results. The predictors as a group contributed 27–45% of the variance in all outcome measures; however, IMAT contributed between 8–15% of the variance in all four mobility variables, while lean explained only 5% variance in only one mobility measure. Conclusions. Thigh IMAT, a newly identified muscle impairment appears to be a potent muscle variable related to the ability of older adults to move about in their community.

  5. The influence of sarcopenia on survival and surgical complications in ovarian cancer patients undergoing primary debulking surgery.

    Science.gov (United States)

    Rutten, I J G; Ubachs, J; Kruitwagen, R F P M; van Dijk, D P J; Beets-Tan, R G H; Massuger, L F A G; Olde Damink, S W M; Van Gorp, T

    2017-04-01

    Sarcopenia, severe skeletal muscle loss, has been identified as a prognostic factor in various malignancies. This study aims to investigate whether sarcopenia is associated with overall survival (OS) and surgical complications in patients with advanced ovarian cancer undergoing primary debulking surgery (PDS). Ovarian cancer patients (n = 216) treated with PDS were enrolled retrospectively. Total skeletal muscle surface area was measured on axial computed tomography at the level of the third lumbar vertebra. Optimum stratification was used to find the optimal skeletal muscle index cut-off to define sarcopenia (≤38.73 cm 2 /m 2 ). Cox-regression and Kaplan-Meier analysis were used to analyse the relationship between sarcopenia and OS. The effect of sarcopenia on the development of major surgical complications was studied with logistic regression. Kaplan-Meier analysis showed a significant survival disadvantage for patients with sarcopenia compared to patients without sarcopenia (p = 0.010). Sarcopenia univariably predicted OS (HR 1.536 (95% CI 1.105-2.134), p = 0.011) but was not significant in multivariable Cox-regression analysis (HR 1.362 (95% CI 0.968-1.916), p = 0.076). Significant predictors for OS in multivariable Cox-regression analysis were complete PDS, treatment in a specialised centre and the development of major complications. Sarcopenia was not predictive of major complications. Sarcopenia was not predictive of OS or major complications in ovarian cancer patients undergoing primary debulking surgery. However a strong trend towards a survival disadvantage for patients with sarcopenia was seen. Future prospective studies should focus on interventions to prevent or reverse sarcopenia and possibly increase ovarian cancer survival. Complete cytoreduction remains the strongest predictor of ovarian cancer survival. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights

  6. Association of anorexia with sarcopenia in a community-dwelling elderly population: results from the ilSIRENTE study.

    Science.gov (United States)

    Landi, Francesco; Liperoti, Rosa; Russo, Andrea; Giovannini, Silvia; Tosato, Matteo; Barillaro, Christian; Capoluongo, Ettore; Bernabei, Roberto; Onder, Graziano

    2013-04-01

    There is increasing evidence that anorexia of aging can cause physical and mental impairment. The aim of the present study was to evaluate the relationship between anorexia and sarcopenia in elderly persons aged 80 years or older. Data are from the baseline evaluation of 354 subjects enrolled in the ilSIRENTE study. The ilSIRENTE study is a prospective cohort study performed in the mountain community living in the Sirente geographic area (L'Aquila, Abruzzo) in Central Italy. We defined anorexia as the presence of loss of appetite and/or lower food intake. According to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, diagnosis of sarcopenia required the documentation of low muscle mass plus the documentation of either low muscle strength or low physical performance. The relationship between anorexia and sarcopenia was estimated by deriving odds ratios from the multiple logistic regression models considering sarcopenia as the dependent variable. Nearly 21 % of the study sample showed symptoms of anorexia. Using the EWGSOP-suggested algorithm, 103 subjects (29.1 %) with sarcopenia were identified. Thirty-four (46.6 %) participants were affected by sarcopenia among subjects with anorexia compared to 69 subjects [24.6 %] without anorexia (p anorexia had a higher risk of sarcopenia compared with non-anorexic subjects (HR 1.88, 95 % CI 1.01-3.51). Anorexia is common among community-dwelling older subjects in Italy. Our results suggest that among old-old subjects, anorexia is independently associated with sarcopenia.

  7. Burden, etiology and predictors of visual impairment among children ...

    African Journals Online (AJOL)

    . Knowledge of CVI is important in planning preventive measures. The aim of this study was determine the prevalence, etiology and the factors associated with childhood visual impairment among the children attending the eye clinic in Mulago ...

  8. Oropharyngeal Dysphagia: neurogenic etiology and manifestation.

    Science.gov (United States)

    Sebastian, Swapna; Nair, Prem G; Thomas, Philip; Tyagi, Amit Kumar

    2015-03-01

    To determine the type, severity and manifestation of dysphagia in patients with neurogenic etiology. Clinical documentation was done on the different etiologies, its manifestation, assessment findings and management strategies taken for patients with neurogenic oropharyngeal dysphagia who were referred for assessment and management of dysphagia over a period of three months in a tertiary care teaching hospital. Flexible endoscopic examination was done in all the patients. The severity of dysphagia in these patients were graded based on Gugging Swallowing Screen (GUSS). A total of 53 patients with neurogenic oropharyngeal dysphagia were evaluated by an otolaryngologist and a speech language pathologist over a period of three months. The grading of severity based on GUSS for these patients were done. There were 30 patients with recurrent laryngeal nerve injury due to various etiologies, one patient with Neurofibroma-vestibular schwanoma who underwent surgical excision, 16 patients with stroke, two patients with traumatic brain injury, two patients with Parkinsonism and two patients with myasthenia gravis. The manifestation of dysphagia was mainly in the form of prolonged masticatory time, oral transit time, and increased number of swallows required for each bolus, cricopharyngeal spasms and aspiration. Among the dysphagia patients with neurogenic etiology, dysphagia is manifested with a gradual onset and is found to have a progressive course in degenerative disorders. Morbidity and mortality may be reduced with early identification and management of neurogenic dysphagia.

  9. INTUSSUSCEPTION - A RARE ETIOLOGY

    Directory of Open Access Journals (Sweden)

    Mariana Branco

    2017-02-01

    Discussion / Conclusions: The clinical case described is intended to alert to the importance of investigating an underlying disease in some children and adolescents with intussusception. In this case the study led to the diagnosis of cystic fibrosis

  10. THE ETIOLOGIC PATTERNS IN MICROCEPHALY WITH MENTAL RETARDATION

    OpenAIRE

    Prasad, K.M.R.; Girimaji, S.R.; Manjunatha, K.R.; Khanna, Neelam; Rao, B.S.S.; Ravi, V.; MURTHY, R. SRINIVASA; Vani, K.R.

    1995-01-01

    Microcephaly with mental retardation forms a distinct subgroup among mentally retarded individuals. The paucity of studies on the etiology of this condition in India made the investigators to study this population. It HTO aimed to study the demographic and clinical characteristics, and the etiologic pattern in children with microcepltaly and mental retardation The sample consisted of 82 children who were examined by detailed clinical assessment and a battery of investigations. A definite etio...

  11. [Infectious mononucleosis: etiology, immunological variants, methods of correction].

    Science.gov (United States)

    Gordeets, A V; Savina, O G; Beniova, S N; Chernikova, A A

    2011-01-01

    Clinical options of infectious mononucleosis course depending on infecting agent etiology are presented for Epstein-Barr virus (EBV), cytomegalovirus (CMV), mono and mixed forms of the disease. Examined cytokine profiles demonstrate analogous changes of serum cytokines in the acute stage of the disease irrespective of etiological factors. Data show that it is important and useful clinically and immunologically to include immunomodulators--in particular, cycloferon--info a complex therapy of different types of mononucleosis.

  12. Syncope: epidemiology, etiology and prognosis.

    Directory of Open Access Journals (Sweden)

    Rose M F Lisboa Da Silva

    2014-12-01

    Full Text Available Syncope is a common medical problem, with a frequency between 15% and 39%. In the general population, the annual number episodes are 18.1 to 39.7 per 1000 patients, with similar incidence between genders. The first report of the incidence of syncope is 6.2 per 1000 person-years. However, there is a significant increase in the incidence of syncope after 70 years of age with rate annual 19.5 per thousand individuals after 80 years. It presents a recurrence rate of 35% and 29% of physical injury. Among the causes of syncope, the mediated neural reflex, known as neurocardiogenic or vasovagal syncope, is the most frequent. The others are of cardiac origin, orthostatic hypotension, carotid sinus hypersensitivity, neurological and endocrinological causes and psychiatric disorders. The diagnosis of syncope can be made by clinical method associated with the electrocardiogram in up 50% of patients. Its prognosis is determined by the underlying etiology specifically the presence and severity of cardiac disease. The annual mortality can reach between 18 and 33% if cardiac cause, and between 0 and 12% if the noncardiac cause. Thus, it is imperative to identify its cause and risk stratification for positive impact in reducing morbidity and mortality.

  13. Advances in data assessment. Application to the etiology of nausea reported during chemotherapy, concerns about significance testing, and opportunities in clinical trials.

    Science.gov (United States)

    Morrow, G R; Black, P M; Dudgeon, D J

    1991-02-01

    inferential statistics, they offer advantages in terms of data exploration and understanding relationships within data sets that are not clearly addressed by other methods. They are potentially valuable alternatives worthy of exploration. Finally, we discuss issues of interim analyses and multiple endpoint assessment for clinical trials.

  14. Prevalence of sarcopenia and associated factors in the healthy older adults of the Peruvian Andes.

    Science.gov (United States)

    Tramontano, Alessandra; Veronese, Nicola; Sergi, Giuseppe; Manzato, Enzo; Rodriguez-Hurtado, Diana; Maggi, Stefania; Trevisan, Caterina; De Zaiacomo, Francesca; Giantin, Valter

    To assess the prevalence of sarcopenia and associated factors in a population of older people living in a rural area of the Peruvian Andes. The study concerned 222 people aged ≥65 years. Sarcopenia was diagnosed on the basis of skeletal muscle mass, measured using bioimpedance analysis, and gait speed, measured with the 4-m walking test, as recommended by the International Working Group on sarcopenia. Self-reported physical activity, the Short Physical Performance Battery, and the Six-Minute Walking Test also contributed information on participants' physical performance status. Disabilities were investigated by assessing participants' self-reported difficulties in performing one or more basic or instrumental activities of daily living. The prevalence of sarcopenia was 17.6%. Compared with participants without sarcopenia, individuals who were found sarcopenic were significantly older, female and were less frequently farmers, had fewer children, had a worse nutritional status, a significantly lower physical performance, and higher levels of disability in the instrumental activities of daily living. After adjusting for potential confounders, age, female sex, a low body mass index, a self-reported low physical activity level, a worse Six-Minute Walking Test scores, and a low number of children were significantly associated with sarcopenia. The prevalence of sarcopenia seems to be quite high among community-dwelling older subjects in the Peruvian Andes. Age, female sex, a low body mass index, little physical activity, a poor Six-Minute Walking Test scores, and a low number of children could be associated with this condition. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Sarcopenia is closely associated with pancreatic exocrine insufficiency in patients with pancreatic disease.

    Science.gov (United States)

    Shintakuya, Ryuta; Uemura, Kenichiro; Murakami, Yoshiaki; Kondo, Naru; Nakagawa, Naoya; Urabe, Kazuhide; Okano, Keisuke; Awai, Kazuo; Higaki, Toru; Sueda, Taijiro

    The loss of skeletal muscle mass (sarcopenia) is associated with the poor prognosis of pancreatic cancer. It has been reported pancreatic exocrine insufficiency (PEI) is associated with serum nutritional markers in chronic pancreatitis. However, there has been no report about the relationship between sarcopenia and PEI. The aim of this study is to determine whether body composition, including skeletal muscle (SM), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), intramuscular adipose tissue content (IMAC), and serum nutritional markers are associated with pancreatic exocrine function in patients with pancreatic disease. Data were collected prospectively on 132 patients with pancreatic disease. SM, SAT, VAT and IMAC were assessed by computed tomography. Patients underwent a 13 C-labeled mixed triglyceride breath test to measure pancreatic exocrine function. Serum nutritional markers were measured at the same time of 13 C-labeled mixed triglyceride breath test. Patients were stratified by quartiles according to each body component, and for each component the lowest group was defined as the lowest quartile, treating men and women separately. The lowest group for SM was defined as sarcopenia. PEI was defined as a percentage 13 CO 2 cumulative dose at 7 h below 5%. Sarcopenia was associated with PEI in both men (P sarcopenia (P = 0.001) and serum albumin (P = 0.058) were associated with PEI. On multivariate analysis, only sarcopenia remained independently associated with PEI (P Sarcopenia is independently associated with PEI in patients with pancreatic disease. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  16. Etiology of hypercoagulable state in women with recurrent fetal loss without other causes of miscarriage from Southern Italy: new clinical target for antithrombotic therapy

    Directory of Open Access Journals (Sweden)

    Maristella D’Uva

    2008-10-01

    other causes of miscarriage women affected by RPL should be tested for thrombophilia. Our data demonstrated 78% of women with one or combined thrombophilic conditions. Differences with previous studies should be related to difference in the inclusion and exclusion criteria and ethnic background. Because these patients often also show a hypercoagulable state, it an antithrombotic treatment before and during pregnancy may improve their clinical outcome (ie, secondary prevention of miscarriage and primary thromboprophylaxis.Keywords: recurrent pregnancy loss, late pregnancy loss, thrombophilia, hypercoagulable state, hyperhomocysteinemia, factor V Leiden, prothrombin, antithrombotic drugs

  17. The Etiology of Primary Hyperhidrosis

    DEFF Research Database (Denmark)

    Hashmonai, Moshe; Cameron, Alan E.P.; Connery, Cliff P.

    2017-01-01

    Purpose: Primary hyperhidrosis is a pathological disorder of unknown etiology, affecting 0.6-5% of the population, and causing severe functional and social handicaps. As the etiology is unknown, it is not possible to treat the root cause. Recently some differences between affected and non......-affected people have been reported. The aim of this review is to summarize these new etiological data. Methods: Search of the literature was performed in the PubMed/Medline Database and pertinent articles were retrieved and reviewed. Additional publications were obtained from the references of these articles...... of patients with hyperhidrosis has been reported. Conclusions: Despite these accumulated data, the etiology of primary hyperhidrosis remains obscure. Nevertheless, three main lines for future research seem to be delineated: genetics, histological observations, and enzymatic studies....

  18. Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study.

    Science.gov (United States)

    Yang, Ming; Hu, Xiaoyi; Wang, Haozhong; Zhang, Lei; Hao, Qiukui; Dong, Birong

    2017-04-01

    The aim of this study is to assess the prevalence of sarcopenia and investigate the associations between sarcopenia and long-term mortality and readmission in a population of elderly inpatients in acute care wards. We conducted a prospective observational study in the acute care wards of a teaching hospital in western China. The muscle mass was estimated according to a previously validated anthropometric equation. Handgrip strength was measured with a handheld dynamometer, and physical performance was measured via a 4 m walking test. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia. The survival status and readmission information were obtained via telephone interviews at 12, 24, and 36 months during the 3 year follow-up period following the baseline investigation. Two hundred and eighty-eight participants (mean age: 81.1 ± 6.6 years) were included. Forty-nine participants (17.0%) were identified as having sarcopenia. This condition was similar in men and women (16.9% vs. 17.5%, respectively, P = 0.915). During the 3 year follow-up period, 49 men (22.7%) and 9 women (16.4%) died (P = 0.307). The mortality of sarcopenic participants was significantly increased compared with non-sarcopenic participants (40.8% vs. 17.1%, respectively, P sarcopenia was an independent predictor of 3 year mortality (adjusted hazard ratio: 2.49; 95% confidential interval: 1.25-4.95) and readmission (adjusted hazard ratio: 1.81; 95% confidential interval: 1.17-2.80). Sarcopenia, which is evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable to predict hospital readmission and long-term mortality in elderly patients in acute care wards. © 2016 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

  19. Sarcopenia: a new predictor of postoperative complications for elderly gastric cancer patients who underwent radical gastrectomy.

    Science.gov (United States)

    Zhou, Chong-Jun; Zhang, Feng-Min; Zhang, Fei-Yu; Yu, Zhen; Chen, Xiao-Lei; Shen, Xian; Zhuang, Cheng-Le; Chen, Xiao-Xi

    2017-05-01

    A geriatric assessment is needed to identify high-risk elderly patients with gastric cancer. However, the current geriatric assessment has been considered to be either time-consuming or subjective. The present study aimed to investigate the predictive effect of sarcopenia on the postoperative complications for elderly patients who underwent radical gastrectomy. We conducted a prospective study of patients who underwent radical gastrectomy from August 2014 to December 2015. Computed tomography-assessed lumbar skeletal muscle, handgrip strength, and gait speed were measured to define sarcopenia. Sarcopenia was present in 69 of 240 patients (28.8%) and was associated with lower body mass index, lower serum albumin, lower hemoglobin, and higher nutritional risk screening 2002 scores. Postoperative complications significantly increased in the sarcopenic patients (49.3% versus 24.6%, P sarcopenia (odds ratio: 2.959, 95% CI: 1.629-5.373, P Sarcopenia, presented as a new geriatric assessment factor, was a strong and independent risk factor for postoperative complications of elderly patients with gastric cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Acute Sarcopenia Secondary to Hospitalisation - An Emerging Condition Affecting Older Adults

    Science.gov (United States)

    Welch, Carly; K. Hassan-Smith, Zaki; A. Greig, Carolyn; M. Lord, Janet; A. Jackson, Thomas

    2018-01-01

    There has been increasing interest and research into sarcopenia in community-dwelling older adults since the European Working Group on Sarcopenia in Older People (EWGSOP) agreed a consensus definition in 2010. Sarcopenia has been defined as loss of muscle mass with loss of muscle function (strength or physical performance), with measurements two Standard Deviations (SDs) below the mean of a young reference population. This definition does not necessitate longitudinal measurements, or the absence of acute illness and diagnosis can be made from single measurements. We hypothesise that hospitalisation, due to a combination of acute inflammatory burden and muscle disuse, leads to an acute decline in muscle mass and function and may lead to some individuals meeting criteria for sarcopenia, acutely, based on the EWGSOP definition. This may be partially recoverable or may lead to increased risk of developing sarcopenia long-term. We have denoted the term “acute sarcopenia” to refer to acute loss of muscle mass and function associated with hospitalisation. This review discusses some of the current available research in this context and also identifies some of the knowledge gaps and potential areas for future research. PMID:29392090

  1. Sarcopenia and Physical Function in Middle-Aged and Older Stroke Survivors.

    Science.gov (United States)

    Ryan, Alice S; Ivey, Frederick M; Serra, Monica C; Hartstein, Joseph; Hafer-Macko, Charlene E

    2017-03-01

    To determine the prevalence of sarcopenia in stroke survivors using different methodologies, and compare a subset of the stroke group to age-, sex-, and body mass index (BMI)-matched nonstroke control counterparts. Cohort study. A Veterans Affairs medical center and a university hospital. Mild to moderately disabled participants >6 months after onset of stroke aged 40 to 84 years (N=190, 61% men, 57% African American; mean BMI ± SEM, 29±1kg/m 2 ). Not applicable. Dual-energy x-ray absorptiometry scans to assess appendicular lean mass (ALM). Rates of sarcopenia were determined using 4 established methods: (1) ALM/height 2 (ALM/ht 2 ); (2) European Working Group on Sarcopenia in Older Persons; (3) International Working Group on Sarcopenia; and (4) ALM/BMI. Sarcopenia prevalence in our stroke cohort ranged between 14% and 18%. The stroke survivor subset (n=38) matched one-for-one with control counterparts for race, sex, age ±4 years and BMI ±2.5kg/m 2 had higher prevalence rates compared with their nonstroke counterparts (13.2% vs 5.3%, Psarcopenia when considering age, sex, and race compared with nonstroke individuals. Published by Elsevier Inc.

  2. Frailty and sarcopenia: The potential role of an aged immune system.

    Science.gov (United States)

    Wilson, Daisy; Jackson, Thomas; Sapey, Elizabeth; Lord, Janet M

    2017-07-01

    Frailty is a common negative consequence of ageing. Sarcopenia, the syndrome of loss of muscle mass, quality and strength, is more common in older adults and has been considered a precursor syndrome or the physical manifestation of frailty. The pathophysiology of both syndromes is incompletely described with multiple causes, inter-relationships and complex pathways proposed. Age-associated changes to the immune system (both immunesenescence, the decline in immune function with ageing, and inflammageing, a state of chronic inflammation) have been suggested as contributors to sarcopenia and frailty but a direct causative role remains to be established. Frailty, sarcopenia and immunesenescence are commonly described in older adults but are not ubiquitous to ageing. There is evidence that all three conditions are reversible and all three appear to share common inflammatory drivers. It is unclear whether frailty, sarcopenia and immunesenescence are separate entities that co-occur due to coincidental or potentially confounding factors, or whether they are more intimately linked by the same underlying cellular mechanisms. This review explores these possibilities focusing on innate immunity, and in particular associations with neutrophil dysfunction, inflammation and known mechanisms described to date. Furthermore, we consider whether the age-related decline in immune cell function (such as neutrophil migration), increased inflammation and the dysregulation of the phosphoinositide 3-kinase (PI3K)-Akt pathway in neutrophils could contribute pathogenically to sarcopenia and frailty. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  3. The Impact of Low Muscle Mass Definition on the Prevalence of Sarcopenia in Older Australians

    Directory of Open Access Journals (Sweden)

    Solomon Yu

    2014-01-01

    Full Text Available Background. Sarcopenia is the presence of low muscle mass and low muscle function. The aim of this study was to establish cutoffs for low muscle mass using three published methods and to compare the prevalence of sarcopenia in older Australians. Methods. Gender specific cutoffs levels were identified for low muscle mass using three different methods. Low grip strength was determined using established cutoffs of <30 kg for men and <20 kg for women to estimate the prevalence of sarcopenia. Results. Gender specific cutoffs levels for low muscle mass identified were (a <6.89 kg/m2 for men and <4.32 kg/m2 for women, <2 standard deviation (SD of a young reference population; (b <7.36 kg/m2 for men and <5.81 kg/m2 for women from the lowest 20% percentile of the older group; and (c <−2.15 for men and <−1.42 for women from the lowest 20% of the residuals of linear regressions of appendicular skeletal mass, adjusted for fat mass and height. Prevalence of sarcopenia in older (65 years and older people by these three methods for men was 2.5%, 6.2%, and 6.4% and for women 0.3%, 9.3%, and 8.5%, respectively. Conclusions. Sarcopenia is common but consensus on the best method to confirm low muscle mass is required.

  4. Coffee treatment prevents the progression of sarcopenia in aged mice in vivo and in vitro.

    Science.gov (United States)

    Guo, Yinting; Niu, Kaijun; Okazaki, Tatsuma; Wu, Hongmei; Yoshikawa, Takeo; Ohrui, Takashi; Furukawa, Katsutoshi; Ichinose, Masakazu; Yanai, Kazuhiko; Arai, Hiroyuki; Huang, Guowei; Nagatomi, Ryoichi

    2014-02-01

    Sarcopenia is characterized by the age-related loss of muscle mass and strength, which results in higher mortality in aged people. One of the mechanisms of the sarcopenia is the loss in the function and number of muscle satellite cells. Chronic low-grade inflammation plays a central role in the pathogenesis of age-related sarcopenia. Accumulating evidence suggests that coffee, one of the most widely consumed beverages in the world, has potential pharmacological benefits such as anti-inflammatory and anti-oxidant effects. Since these effects may improve sarcopenia and the functions of satellite cells, we examined the effects of coffee on the skeletal muscles in an animal model using aged mice. In vivo, coffee treatment attenuated the decrease in the muscle weight and grip strength, increased the regenerating capacity of injured muscles, and decreased the serum pro-inflammatory mediator levels compared to controls. In vitro, using satellite cells isolated from aged mice, coffee treatment increased the cell proliferation rate, augmented the cell cycle, and increased the activation level of Akt intra-cellular signaling pathway compared to controls. These findings suggest that the coffee treatment had a beneficial effect on age-related sarcopenia. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Evaluation of protein intake and physical activity associated with sarcopenia in the elderly

    Directory of Open Access Journals (Sweden)

    Gloria Gabriela Peña-Ordóñez

    2015-10-01

    Full Text Available Introduction: The aim of this study was to determine the association between protein intake and physical activity with sarcopenia of the elderly. Older people are a vulnerable group and are easily reflected in their nutritional status, most do not cover their nutritional requirements and are physically inactive. A protein intake <1.2 g/kg/day and a low level of physical activity (<3.5 MET are factors associated with sarcopenia. Material and Methods: Observational, analytical, prospective, case-control study. Sampling was done for convenience in patients over 60 years of service outpatient Medical Center Adolfo Lopez Mateos, Toluca, Mexico. Questionnaires were used to determine protein intake and physical activity, and diagnostic tests for Sarcopenia (percentage of muscle mass, strength and speed Manual operation. 115 subjects were enrolled but 110 (55 cases and 55 controls were included. Results: The odds ratio (OR of the variables was obtained, finding that for every gram of total protein intake of 3% reduces the risk of sarcopenia and per unit of percent fat increases the risk by 20%. No statistically significant difference was found in physical activity, there is homogeneity between cases and controls regarding MET consumed. Conclusions: Protein intake is a protective factor against sarcopenia and excessive accumulation of fat is a risk factor for this disorder. It is important to further investigate the relationship between the two in older adults.

  6. Sarcopenia is a risk factor for complications and an independent predictor of hospital length of stay in trauma patients.

    Science.gov (United States)

    DeAndrade, James; Pedersen, Mark; Garcia, Luis; Nau, Peter

    2018-01-01

    Sarcopenia is an independent risk factor for adverse outcomes in critically ill patients. The impact of sarcopenia on morbidity and length of stay in a trauma population has not been completely defined. This project evaluated the influence of sarcopenia on patients admitted to the trauma service. A retrospective review of 778 patients presenting as a trauma alert at a single institution from 2012-2014 was completed. Records were abstracted for comorbidities and hospital complications. The Hounsfield Unit Area Calculation was collected from admission computed tomography scans. Criteria for sarcopenia were based on the lowest 25th percentile of muscle density measurements. Relationships to patient outcomes were evaluated by univariate and multivariable regression or analyses of variance, when applicable. A total of 432 (55.6%) patients suffered a complication. Sarcopenia was associated with overall complications (P sarcopenia into a novel length of stay calculator showed increased prognostic ability for prolonged length of stay over Abbreviated Injury Scale alone (P = 0.0002). Sarcopenia is an independent risk factor for adverse outcomes and increased length of stay in trauma patients. Prognostic algorithms incorporating sarcopenia better predict hospital length of stay. Identification of patients at risk may allow for targeted interventions early in the patient's hospital course. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Sarcopenia: Prevalence, and Impact on Operative and Oncologic Outcomes in the Multimodal Management of Locally Advanced Esophageal Cancer.

    Science.gov (United States)

    Elliott, Jessie A; Doyle, Suzanne L; Murphy, Conor F; King, Sinead; Guinan, Emer M; Beddy, Peter; Ravi, Narayanasamy; Reynolds, John V

    2017-11-01

    The aim of this article was to study the prevalence and significance of sarcopenia in the multimodal management of locally advanced esophageal cancer (LAEC), and to assess its independent impact on operative and oncologic outcomes. Sarcopenia in cancer may confer negative outcomes, but its prevalence and impact on modern multimodal regimens for LAEC have not been systematically studied. Two hundred fifty-two consecutive patients were studied. Lean body mass (LBM), skeletal muscle index (SMI), and fat mass (FM) were determined pre-treatment, preoperatively, and 1 year postoperatively. Sarcopenia was defined by computed tomography (CT) at L3 as SMI Sarcopenia increased (P = 0.02) from 16% at diagnosis to 31% post-neoadjuvant therapy, with loss of LBM (-3.0 ± 5.4 kg, P sarcopenia was associated with CCI (P = 0.043), and CDC ≥IIIb (P = 0.003). PPCs occurred in 36% nonsarcopenic versus 55% sarcopenic patients (P = 0.01). Sarcopenia did not impact disease-specific (P = 0.14) or overall survival (P = 0.11) after resection. At 1 year, 35% had sarcopenia, significantly associated with pre-treatment BMI (P = 0.013) but not complications (P = 0.20). Sarcopenia increases through multimodal therapy, is associated with an increased risk of major postoperative complications, and is prevalent in survivorship. These data highlight a potentially modifiable marker of risk that should be assessed and targeted in modern multimodal care pathways.

  8. Pedophilia: Clinical Features, Etiology and Treatment

    Directory of Open Access Journals (Sweden)

    Ayten Erdogan

    2010-08-01

    Full Text Available There is a growing recognition that child sexual abuse is a critical public health problem. Child sexual abusement is not a medical diagnosis and is not necessarily a term synonymous with pedophilia. According to DSM-IV, a pedophile is an individual who fantasizes about, is sexually aroused by, or experiences sexual urges toward prepubescent children (generally <13 years for a period of at least 6 months. It is difficult to estimate the true prevalence of pedophilia because few pedophiles voluntarily seek treatment. Most of the available data are based on individuals who have become involved with the legal system. Most individuals who engage in pedophilia are male. When compared with other sex offenders, pedophiles are in the older adult age range (age, 40-70 years. Pedophiles may engage in a wide range of sexual acts with children. These activities includes exposing themselves to children, looking at naked children, masturbating in the presence of children, physical contact, rubbing, fondling a child, engaging in oral sex, or penetration of the mouth, anus, and/or vagina. Generally, pedophiles do not use force to have children engage in these activities but instead rely on various forms of psychic manipulation and desensitization. People with pedophilia use internet to be a vehicle capable of meeting their needs: obtaining information, monitoring and contacting victims, developing fantasy, overcoming inhibitions, avoiding apprehension, and communicating with other offenders. The compulsive-aggressive trait is more pronounced in people with pedophilia. Generally they plan the sexual offending with the intention of relieving internal pressures or urges. Pedophiles generally experience feelings of inferiority, isolation or loneliness, low self-esteem, internal dysphoria, and emotional immaturity. There are likely multiple factors and multiple pathways involved in the development of pedophilia. Since there has been no treatment method that can alter the pedophile’s sexual orientation toward children, much of the focus of pedophilic treatment is on stopping further offenses against children. The combination of pharmacologic and behavioral treatment coupled with close legal supervision appears to help reduce the risk of repeated offense. Currently chemical castration; testosterone suppression by antiandrogenic therapy is a popular treatment option. Effective prevention is most effective means to manage the sexual abusement of children. For primary prevention and treatment, it is necessary to know the characteristics of pedophilia and understand the factors that lead to the development of the pedophilic tendencies.

  9. Urticarial vasculitis: etiologies and clinical course.

    Science.gov (United States)

    Kulthanan, Kanokvalai; Cheepsomsong, Meethawee; Jiamton, Sukhum

    2009-01-01

    Out of 64 patients diagnosed with urticarial vasculitis (UV), 49 (76.6%) presented with their first attack of UV. The others experienced recurrent attacks with a mean number of 3.3 past recurrences. Fifteen patients had angioedema (23.4%) and 16 (25%) suffered systemic involvement. The most common abnormal laboratory finding was an increased erythrocyte sedimentation rate. Six of 62 patients (9.7%) had decreased C3 levels. A cause could be identified in 19 patients (29.7%). The most common identified cause was infection; other causes included drugs, malignancy and systemic lupus erythematosus (SLE). The prevalence of immunoreactant deposits in the skin lesions measured by DIF was 54.7% (35 of 64 patients). The median disease duration of each episode was 85 days. The probability that patients were free of symptoms within one year was 70%. Patients with an idiopathic cause had a statistically significant longer course duration of each episode than the group with upper respiratory tract infection. Compared to reports from Westem countries, our patients seemed to have less severe symptoms and a lower percentage of hypocomplementemic UV and SLE.

  10. Aging of the endocrine system and its potential impact on sarcopenia.

    Science.gov (United States)

    Vitale, Giovanni; Cesari, Matteo; Mari, Daniela

    2016-11-01

    Sarcopenia, occurring as a primary consequence of aging, is a progressive generalized decline of skeletal muscle mass, strength and function. The pathophysiology of sarcopenia is complex and multifactorial. One major cause of muscle mass and strength loss with aging appears to be the alteration in hormonal networks involved in the inflammatory processes, muscle regeneration and protein synthesis. This review describes the recent findings concerning the role of the aging on the endocrine system in the development of sarcopenia. We also report the benefits and safety of hormone replacement therapy in elderly subjects and discuss future perspectives in the therapy and prevention of skeletal muscle aging. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  11. Publication trends in cachexia and sarcopenia in elderly heart failure patients.

    Science.gov (United States)

    Springer, Jochen; Anker, Stefan D

    2016-12-01

    The loss of skeletal mass - sarcopenia and cachexia - is considered to be a major contributor to morbidity and mortality in chronic heart failure (CHF). Unfortunately, sarcopenia is generally considered to be a geriatric syndrome, but not necessarily seen as a comorbidity in CHF, even though it has a wide range of adverse health outcomes. While there were 15,574 publication with the title word "heart failure" in PubMed in the 5‑year period from 1 June 2011 to 31 May 2016, only 22 or 71 publications were found with the search combination "sarcopenia" or "cachexia" (title word) and "heart failure" (all fields), respectively. This shows very clearly that loss of muscle quality and function due to heart failure is still an underappreciated problem in the medical field.

  12. Association between sarcopenia and quality of life in quilombola elderly in Brazil

    Directory of Open Access Journals (Sweden)

    Silva Neto LS

    2016-04-01

    Full Text Available Luiz Sinésio Silva Neto,1–3 Margô GO Karnikowski,2 Neila B Osório,3 Leonardo C Pereira,2 Marcilio B Mendes,1 Dayani Galato,2 Liana B Gomide Matheus,4 João Paulo C Matheus2,4 1School of Medicine, Federal University of Tocantins, Palmas, Tocantins, 2Graduate Program in Health Sciences and Technology, Ceilândia College, University of Brasilia, Federal District, 3Graduate Program in Education, Federal University of Tocantins, Palmas, Tocantins, 4School of Physiotherapy, Ceilândia College, University of Brasília, Federal District, Brazil Introduction: Currently, there is no single consensual definition of sarcopenia in the literature. This creates a challenge for the evaluation of its prevalence and its direct or indirect impact on the quality of life of elderly populations of different races and ethnicities. Furthermore, no studies as yet have analyzed these variables in populations of elderly subjects of the "quilombola" ethnic group. Objective: We aimed to verify the association between sarcopenia and quality of life in quilombola elderly using the Baumgartner and the European Working Group on Sarcopenia in Older People (EWGSOP criteria. Methods: This was a cross-sectional study of 70 male and female participants (mean age: 65.58±6.67 years. Quality of life was evaluated using the multidimensional 36-item Short-Form Health Survey (SF-36 of the Medical Outcomes Study. Sarcopenia was diagnosed according to the Baumgartner cutoff for appendicular skeletal muscle mass and the criteria recommended by the EWGSOP. Muscle mass and fat mass percentages were analyzed by dual-energy X-ray absorptiometry, while handgrip strength (HGS was evaluated using a hand-held dynamometer. Physical performance was assessed through a gait speed test. Results: The prevalence of sarcopenia was 15% according to the Baumgartner cutoff and 10% according to EWGSOP criteria. Quilombola elderly classified as physically active or very active were at least six times less

  13. Motor Unit Changes Seen With Skeletal Muscle Sarcopenia in Oldest Old Rats

    Science.gov (United States)

    Kung, Theodore A.; van der Meulen, Jack H.; Urbanchek, Melanie G.; Kuzon, William M.; Faulkner, John A.

    2014-01-01

    Sarcopenia leads to many changes in skeletal muscle that contribute to atrophy, force deficits, and subsequent frailty. The purpose of this study was to characterize motor unit remodeling related to sarcopenia seen in extreme old age. Whole extensor digitorum longus muscle and motor unit contractile properties were measured in 19 adult (11–13 months) and 12 oldest old (36–37 months) Brown-Norway rats. Compared with adults, oldest old rats had significantly fewer motor units per muscle, smaller muscle cross-sectional area, and lower muscle specific force. However, mean motor unit force generation was similar between the two groups due to an increase in innervation ratio by the oldest old rats. These findings suggest that even in extreme old age both fast- and slow-twitch motor units maintain the ability to undergo motor unit remodeling that offsets some effects of sarcopenia. PMID:24077596

  14. Spectrum of etiologies causing hydrometrocolpos.

    Science.gov (United States)

    Cerrah Celayir, Aysenur; Kurt, Gökmen; Sahin, Ceyhan; Cici, Inanç

    2013-01-01

    Hydrometrocolpos (HMC) develops as a result of vaginal outflow obstruction and the accumulation of secretions. It might be secondary to persistent cloaca, urogenital sinus, some syndromes, presence of the vaginal septum, vaginal atresia, and imperforate hymen. Each of them has different treatment options and follow-up protocols. This study was performed to identify the etiology and the related management of patients with HMC. A descriptive series of patients with HMC managed in our hospital between 2004 and 2011 is being presented. The medical record of these patients was analyzed for etiology, management, and outcome. Eight patients with HMC were managed during 7 years at our department. Underlying etiologies included urogenital sinus (n=3), and 1 each of imperforate hymen, transverse vaginal septum, Herlyn-Werner-Wunderlich syndrome, persistent cloaca, and a variant of the cloaca. Four patients were prenatally diagnosed. The patient with imperforate hymen was managed successfully with incision and drainage. Abdominal vaginostomy was done in three patients with urogenital sinus as initial procedure. In patient with persistent cloaca, a colostomy and abdominal vaginostomy were performed. Patient with cloaca variant died due to persistent acidosis and salt wasting. HMC may have different etiological factors which may dictate different surgical management. Etiology of HMC can be as simple as imperforate hymen to the most severe cloacal malformations.

  15. Pediatric Dental Trauma:Wide Horizon of Ignored Etiological Factors

    OpenAIRE

    Anegundi, Rajesh T; Patil, Shruthi B.; M, Shubha; Havale, Raghavendra

    2010-01-01

    Trauma of the oral and peroral structures are one of the most common and frequent complaints after dental caries with which a child is being referred to a dental clinic. As an emergency, we tend to treat the injuries without understanding or neglecting the cause of trauma. The different possible etiological factors are unnoticed, not revealed or not noted while taking the history of the patient. Sometimes negligence of the etiology by the dentist himself or the accompanying person could influ...

  16. Sarcopenia Is Risk Factor for Development of Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt Placement.

    Science.gov (United States)

    Nardelli, Silvia; Lattanzi, Barbara; Torrisi, Sabrina; Greco, Francesca; Farcomeni, Alessio; Gioia, Stefania; Merli, Manuela; Riggio, Oliviero

    2017-06-01

    Hepatic encephalopathy (HE) is an important complication in patients with cirrhosis who received transjugular intrahepatic portosystemic shunts (TIPS). We investigated whether a decrease in muscle mass was associated independently with the occurrence of HE after TIPS. We performed a prospective study of 46 consecutive patients with cirrhosis (mean age, 58.6 ± 9.1 y; mean model for end-stage liver disease score, 11.3 ± 3.3; mean Child-Pugh score, 7.6 ± 1.5) who received TIPS from January 2013 through December 2014 at a tertiary center in Rome, Italy. All patients underwent computed tomography analysis at the level of the third lumbar vertebrae to determine the skeletal muscle index; sarcopenia was defined by sex-specific cut-off values. We estimated the incidence of the first episode of HE after TIPS, taking into account the competing risk nature of the data (death or liver transplantation). Twenty-six patients (57%) were found to have sarcopenia. Twenty-one patients (46%) developed overt HE in the 7 ± 9 months after TIPS placement; all of these patients were sarcopenic, according to the skeletal muscle index. Of the 25 patients without HE after TIPS, only 5 had sarcopenia. In multivariate analysis, model for end-stage liver disease score (subdistribution hazard ratio, 1.16; 95% confidence interval, 1.01-1.34; P = .043) and sarcopenia (subdistribution hazard ratio, 31.3; 95% confidence interval, 4.5-218.07; P Sarcopenia should be considered in selecting patients for TIPS therapy. Nutritional status should be evaluated in patients with sarcopenia before TIPS placement, which might reduce the incidence of HE. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  17. Sarcopenia is a predictor of outcomes in very elderly patients undergoing emergency surgery.

    Science.gov (United States)

    Du, Yang; Karvellas, Constantine J; Baracos, Vickie; Williams, David C; Khadaroo, Rachel G

    2014-09-01

    With the increasing aging population, the number of very elderly patients (age ≥80 years) undergoing emergency operations is increasing. Evaluating patient-specific risk factors for postoperative morbidity and mortality in the acute care surgery setting is crucial to improving outcomes. We hypothesize that sarcopenia, a severe depletion of skeletal muscles, is a predictor of morbidity and mortality in very elderly patients undergoing emergency surgery. A total of 170 patients older than the age of 80 underwent emergency surgery between 2008 and 2010 at a tertiary care facility; 100 of these patients had abdominal computed tomography images within 30 days of the operation that were adequate for the assessment of sarcopenia. The impact of sarcopenia on the operative outcomes was evaluated using both univariate and multivariate analysis. The mean patient age was 84 years, with an in-hospital mortality of 18%. Sarcopenia was present in 73% of patients. More sarcopenic patients had postoperative complications (45% sarcopenic versus 15% nonsarcopenic, P = .005) and more died in hospital (23 vs 4%, P = .037). There were no differences in duration of stay or requirement for intensive care unit postoperatively. After we controlled for confounding factors, increasing skeletal muscle index (per incremental cm(2)/m(2)) was associated with decreased in-hospital mortality (odds ratio ∼0.834, 95% confidence interval 0.731-0.952, P = .007) in multivariate analysis. Sarcopenia was independently predictive of greater complication rates, discharge disposition, and in-hospital mortality in the very elderly emergency surgery population. Using sarcopenia as an objective tool to identify high-risk patients would be beneficial in developing tailored preventative strategies and potentially resource allocation in the future. Copyright © 2014 Mosby, Inc. All rights reserved.

  18. Diagnóstico de la sarcopenia en pacientes con fractura por fragilidad de cadera

    OpenAIRE

    Díez de Baldeón Chicón, Pilar María; Villanueva Fernández, Eva

    2017-01-01

    La fractura de cadera se trata de un grave problema en la población anciana. La presencia de sarcopenia, entendida como la pérdida involuntaria de fuerza, masa y función muscular esquelética debida al envejecimiento, está estrechamente relacionada con la fractura de cadera, lo que determina una evolución desfavorable en los supervivientes, de los cuales tan sólo la mitad recuperará su estado funcional previo. Determinar la relación entre el estado de sarcopenia prefractura y la...

  19. Sarcopenia increases risk of long-term mortality in elderly patients undergoing emergency abdominal surgery.

    Science.gov (United States)

    Rangel, Erika L; Rios-Diaz, Arturo J; Uyeda, Jennifer W; Castillo-Angeles, Manuel; Cooper, Zara; Olufajo, Olubode A; Salim, Ali; Sodickson, Aaron D

    2017-12-01

    Frailty is associated with poor surgical outcomes in elderly patients but is difficult to measure in the emergency setting. Sarcopenia, or the loss of lean muscle mass, is a surrogate for frailty and can be measured using cross-sectional imaging. We sought to determine the impact of sarcopenia on 1-year mortality after emergency abdominal surgery in elderly patients. Sarcopenia was assessed in patients 70 years or older who underwent emergency abdominal surgery at a single hospital from 2006 to 2011. Average bilateral psoas muscle cross-sectional area at L3, normalized for height (Total Psoas Index [TPI]), was calculated using computed tomography. Sarcopenia was defined as TPI in the lowest sex-specific quartile. Primary outcome was mortality at 1 year. Secondary outcomes were in-hospital mortality and mortality at 30, 90, and 180 days. The association of sarcopenia with mortality was assessed using Cox proportional hazards regression and model performance judged using Harrell's C-statistic. Two hundred ninety-seven of 390 emergency abdominal surgery patients had preoperative imaging and height. The median age was 79 years, and 1-year mortality was 32%. Sarcopenic and nonsarcopenic patients were comparable in age, sex, race, comorbidities, American Society of Anesthesiologists classification, procedure urgency and type, operative severity, and need for discharge to a nursing facility. Sarcopenic patients had lower body mass index, greater need for intensive care, and longer hospital length of stay (p Sarcopenia was independently associated with increased in-hospital mortality (risk ratio, 2.6; 95% confidence interval [CI], 1.6-3.7) and mortality at 30 days (hazard ratio [HR], 3.7; 95% CI, 1.9-7.4), 90 days (HR, 3.3; 95% CI, 1.8-6.0), 180 days (HR, 2.5; 95% CI, 1.4-4.4), and 1 year (HR, 2.4; 95% CI, 1.4-3.9). Sarcopenia is associated with increased risk of mortality over 1 year in elderly patients undergoing emergency abdominal surgery. Sarcopenia defined by TPI is

  20. [Analysis of elderly outpatients in relation to nutritional status, sarcopenia, renal function, and bone density].

    Science.gov (United States)

    Salmaso, Franciany Viana; Vigário, Patrícia dos Santos; Mendonça, Laura Maria Carvalho de; Madeira, Miguel; Vieira Netto, Leonardo; Guimarães, Marcela Rodrigues Moreira; Farias, Maria Lucia Fleiuss de

    2014-04-01

    To evaluate relationships between nutritional status, sarcopenia and osteoporosis in older women. We studied 44 women, 67-94 years, by mini-nutritional assessment (MAN), glomerular filtration corr. 1.73 m(2), body mass index (BMI), arm circumference and calf (CP and CB), bone mineral density and body composition, DXA (fat mass MG; lean MM). We gauge sarcopenia: IMM MM = MSS + MIS/height(2). We used the Pearson correlation coefficient, p nutritional status and body composition; and major influences on BMD were nutritional status and fat mass.

  1. [Transdisciplinary Approach for Sarcopenia. The effects of exercise on skeletal muscle hypertrophy and satellite cells].

    Science.gov (United States)

    Fujimaki, Shin; Takemasa, Tohru; Kuwabara, Tomoko

    2014-10-01

    Skeletal muscle has a high degree of plasticity. The mass of skeletal muscle maintains owing to muscle protein synthesis and the regeneration by satellite cells. Skeletal muscle atrophy with aging (sarcopenia) is developed by decline of muscle protein synthesis and dysfunction of satellite cells. It is urgently necessary for today's highly aged society to elucidate the mechanism of sarcopenia and to establish prevention measure. This review shows that the positive effects of "exercise" on muscle protein synthesis and satellite cell function including their main molecular mechanism.

  2. Spoken language outcomes after hemispherectomy: factoring in etiology.

    Science.gov (United States)

    Curtiss, S; de Bode, S; Mathern, G W

    2001-12-01

    We analyzed postsurgery linguistic outcomes of 43 hemispherectomy patients operated on at UCLA. We rated spoken language (Spoken Language Rank, SLR) on a scale from 0 (no language) to 6 (mature grammar) and examined the effects of side of resection/damage, age at surgery/seizure onset, seizure control postsurgery, and etiology on language development. Etiology was defined as developmental (cortical dysplasia and prenatal stroke) and acquired pathology (Rasmussen's encephalitis and postnatal stroke). We found that clinical variables were predictive of language outcomes only when they were considered within distinct etiology groups. Specifically, children with developmental etiologies had lower SLRs than those with acquired pathologies (p =.0006); age factors correlated positively with higher SLRs only for children with acquired etiologies (p =.0006); right-sided resections led to higher SLRs only for the acquired group (p =.0008); and postsurgery seizure control correlated positively with SLR only for those with developmental etiologies (p =.0047). We argue that the variables considered are not independent predictors of spoken language outcome posthemispherectomy but should be viewed instead as characteristics of etiology. Copyright 2001 Elsevier Science.

  3. Sarcopenia as a Determinant of Blood Pressure in Older Koreans: Findings from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2008–2010

    Science.gov (United States)

    Kwon, Hyuk-Sang; Ko, Seung-Hyun; Lee, Seung-Hwan; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Kim, Mee Kyoung; Park, Yong-Moon

    2014-01-01

    Background Blood pressure (BP) is directly and causally associated with body size in the general population. Whether muscle mass is an important factor that determines BP remains unclear. Objective To investigate whether sarcopenia is associated with hypertension in older Koreans. Participants We surveyed 2,099 males and 2,747 females aged 60 years or older. Measurements Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight (ASM/Wt) that was sarcopenia. Hypertension was defined as a systolic BP (SBP) ≥140 mmHg, a diastolic BP (DBP) ≥90 mmHg, or a self-reported current use of antihypertensive medications. Results The overall prevalence of hypertension in the four groups was as follows 49.7% for non-obese non-sarcopenia, 60.9% for non-obese sarcopenia, 66.2% for obese non-sarcopenia and 74.7% for obese sarcopenia. After adjustment for age, gender, regular activity, current smoking and alcohol use, the odds ratio (OR) for having hypertension was 1.5 (95% confidence interval (CI) = 1.23–1.84) in subjects in the non-obese sarcopenia group, 2.08 (95% CI = 1.68–2.57) in the obese non-sarcopenia group and 3.0 (95% CI = 2.48–3.63) in the obese sarcopenia group, compared with the non-obese non-sarcopenia group (p for trend sarcopenia. The association between sarcopenia and hypertension was more robust in the subjects with diabetes mellitus. Conclusion Body composition beyond BMI has a considerable impact on hypertension in elderly Koreans. Subjects with sarcopenic obesity appear to have a greater risk of hypertension than simply obese or sarcopenia subjects. PMID:24489804

  4. Etiology, evaluation, and management of xerostomia.

    Science.gov (United States)

    Millsop, Jillian W; Wang, Elizabeth A; Fazel, Nasim

    Xerostomia is defined as the complaint of oral dryness. It is a condition that primarily affects older adults and can have a significant negative effect on one's quality of life. Patients with xerostomia often do not have objective signs of hyposalivation. The underlying etiology of xerostomia includes a variety of systemic diseases and local factors. Our aim is to provide a comprehensive review of the differential diagnosis, evaluation, and management of xerostomia. Prompt diagnosis and management can alleviate the clinical manifestations of this debilitating condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Ankle osteoarthritis: etiology, diagnostics, and classification.

    Science.gov (United States)

    Barg, Alexej; Pagenstert, Geert I; Hügle, Thomas; Gloyer, Marcel; Wiewiorski, Martin; Henninger, Heath B; Valderrabano, Victor

    2013-09-01

    Osteoarthritis (OA) is defined as the syndrome of joint pain and dysfunction caused by substantial joint degeneration. In general, OA is the most common joint disease and is one of the most frequent and symptomatic health problems for middle-aged and older people: OA disables more than 10% of people who are older than 60 years. This article reviews the etiology of ankle OA, and describes the onset and development of posttraumatic ankle OA, the most common form of OA in the tibiotalar joint. Various methods of clinical and radiographic assessment are described in detail. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Etiology of pediatric acute liver failure

    Directory of Open Access Journals (Sweden)

    GUO Jing

    2017-10-01

    Full Text Available Pediatric acute liver failure (PALF is a complex syndrome with rapid progression, and the cause of PALF is age-dependent. This article analyzes the common causes of PALF in clinical practice, including infection factors, inherited metabolic factors, poisoning and drugs, abnormal perfusion, and autoimmune diseases, among which infection factors are the most common cause. With the improvement in diagnosis and treatment techniques, the diagnostic rate of PALF caused by inherited metabolic diseases and autoimmune diseases keeps increasing. Due to the small number of PALF patients, there lacks experience in etiological diagnosis. This article summarizes related reports, in order to provide a reference for screening the causes of PALF.

  7. [CONSISTENCY OF MINI NUTRITIONAL ASSESSMENT TO IDENTIFY SARCOPENIA IN OLDER ADULTS IN NURSING HOMES IN BOGOTA, COLOMBIA].

    Science.gov (United States)

    Díaz Muñoz, Gustavo Alfonso; Cárdenas Zuluaga, Diana María; Mesa Jimenez, Alfonso

    2015-07-01

    malnutrition and sarcopenia, which have similar physiological mechanisms and are both responsible for adverse health outcomes, are highly prevalent in the elderly. to measure the consistency of the MNA with the diagnosis of sarcopenia in older adults. cross-sectional study of consistency in four nursing homes in Bogotá. The nutritional screening and nutritional assessment were made with the Mini Nutritional Assessment in its long form; the diagnosis of sarcopenia was done with the algorithm and the breakpoints of the European Consensus (EWGSOP). Pearson Chi2, Mann-Whitney and consistency by Cohen's kappa coefficient. we included 108 patients, 62% women, mean age 80.4 years (SD 7.7). The prevalence of sarcopenia, malnutrition and risk of malnutrition were 38.9%, 33.3% and 2.8% respectively. The concordance of the MNA with the diagnosis of sarcopenia was slight (kappa 0.1908 95% CI 0.0025 to 0.3791, p < 0.05) CONCLUSION: MNA shows mild concordance to identify sarcopenia, suggesting that it is not an appropriate tool for the diagnosis of sarcopenia in older institutionalized adults. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  8. Prevalence of Sarcopenia and Its Relationship with Sites of Fragility Fractures in Elderly Chinese Men and Women.

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    Wei Hong

    Full Text Available Sarcopenia might be associated with bone fragility in elderly individuals. This study aimed to investigate the prevalence of sarcopenia and its association with fragility fracture sites in elderly Chinese patients.Patients (322 men and 435 women aged 65-94 years and with a history of fragility fractures in the ankle, wrist, vertebrae or hip, and healthy men (n = 1263 and women (n = 1057 aged 65-92 years without a history of fractures were enrolled. Whole-body dual energy X-ray absorptiometry was used to analyze skeletal muscle mass index (SMI, fat mass and bone mineral density. Sarcopenia was defined as SMI less than two standard deviations below the mean of a young reference group.Sarcopenia occurrence varied with fracture location. Sarcopenia was more common in females with vertebral and hip fractures and in men with hip and ankle fractures than in the non-fracture group. Sarcopenia was significantly more prevalent in men with wrist, hip and ankle fractures than in women. SMI was correlated with BMD in different fracture groups. Logistic regression analyses revealed that lower SMI was associated with an increased risk of hip fracture both in men and women and ankle fracture in men.Sarcopenia may be an independent risk factor for hip and ankle fractures in men, and for hip fractures in women.

  9. Association between leukocyte count and sarcopenia in postmenopausal women: The Korean National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Chung, Tae-Ha; Shim, Jae-Yong; Lee, Yong-Jae

    2016-02-01

    To investigate the association between leukocyte counts and sarcopenia according in postmenopausal women. Cross-sectional study. We examined the relationship between leukocyte counts and sarcopenia in 2152 post-menopausal Korean women who participated in the 2010-2011 Korean National Health Examination and Nutrition Survey. Sarcopenia was defined as an appendicular skeletal muscle mass (ASM) divided by weight (%) that was greater than 1SD below the mean of young adults. The odds ratios (ORs) for sarcopenia were calculated using multiple logistic regression across leukocyte count quartiles (Q1:≤4710, Q2:4720-5600, Q3:5610-6600, and Q4:≥6610cells/μL) after adjusting for confounding variables. The prevalence of sarcopenia gradually increased in accordance with leukocyte quartiles. Compared with the lowest quartile of leukocyte counts, the corresponding OR (95% CI) of the highest quartile of leukocyte counts for sarcopenia was 2.41 (1.12-5.22) after adjusting for age, waist circumference, cigarette smoking, alcohol intake, regular exercise, blood pressure, fasting plasma glucose, triglyceride, and HDL-cholesterol. Leukocyte counts were positively related to a higher risk of sarcopenia in postmenopausal women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Predictive Values of the New Sarcopenia Index by the Foundation for the National Institutes of Health Sarcopenia Project for Mortality among Older Korean Adults

    Science.gov (United States)

    Kim, Jung Hee; Moon, Jae Hoon; Choi, Sung Hee; Lim, Soo; Lim, Jae-Young; Kim, Ki Woong; Park, Kyong Soo; Jang, Hak Chul

    2016-01-01

    Objective We evaluated the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project’s recommended criteria for sarcopenia’s association with mortality among older Korean adults. Methods We conducted a community-based prospective cohort study which included 560 (285 men and 275 women) older Korean adults aged ≥65 years. Muscle mass (appendicular skeletal muscle mass-to-body mass index ratio (ASM/BMI)), handgrip strength, and walking velocity were evaluated in association with all-cause mortality during 6-year follow-up. Both the lowest quintile for each parameter (ethnic-specific cutoff) and FNIH-recommended values were used as cutoffs. Results Forty men (14.0%) and 21 women (7.6%) died during 6-year follow-up. The deceased subjects were older and had lower ASM, handgrip strength, and walking velocity. Sarcopenia defined by both low lean mass and weakness had a 4.13 (95% CI, 1.69–10.11) times higher risk of death, and sarcopenia defined by a combination of low lean mass, weakness, and slowness had a 9.56 (3.16–28.90) times higher risk of death after adjusting for covariates in men. However, these significant associations were not observed in women. In terms of cutoffs of each parameter, using the lowest quintile showed better predictive values in mortality than using the FNIH-recommended values. Moreover, new muscle mass index, ASM/BMI, provided better prognostic values than ASM/height2 in all associations. Conclusions New sarcopenia definition by FNIH was better able to predict 6-year mortality among Korean men. Moreover, ethnic-specific cutoffs, the lowest quintile for each parameter, predicted the higher risk of mortality than the FNIH-recommended values. PMID:27832145

  11. Critical analysis of vestibular rehabilitation outcome according to dizziness etiology.

    Science.gov (United States)

    Bittar, Roseli Saraiva Moreira; Pedalini, Maria Elisabete Bovino; Ramalho, Jeanne Oiticica; Yoshimura, Ricardo

    2007-01-01

    Vestibular rehabilitation (VR) is an excellent therapy for dizziness patients. However, despite well managed, sometimes results are not suitable. evaluate VR outcome between patients according to dizziness etiology. Retrospective review of medical records. Patients records were analyzed between January 2002 and December 2004. As for inclusion criteria, patients should have had finished VR therapy and an established diagnosis. Patients were included in three VR outcome groups and compared according to etiology. according to VR outcome 13 patients had no improvement, 24 had partial improvement and 22 complete improvement. The main etiologies were cervical syndrome, trauma, metabolic disorders, central nervous system disorders, anxiety and mood disorders, autoimmune disease and orthostatic intolerance. Patients with metabolic disorders showed better VR outcome than the others. VR therapy combined with clinical etiology treatment is an excellent approach for dizziness patients.

  12. Etiologia, manifestações clínicas e alterações presentes nas crianças respiradoras orais Etiology, clinical manifestations and concurrent findings in mouth-breathing children

    Directory of Open Access Journals (Sweden)

    Rubens Rafael Abreu

    2008-12-01

    Full Text Available OBJETIVO: Investigar a etiologia, as principais manifestações clínicas e as alterações presentes em crianças de 3 a 9 anos, respiradoras orais, residentes na região urbana de Abaeté (MG. MÉTODOS: Estudo com amostra aleatória representativa da população do município de 23.596 habitantes. Clinicamente, foram consideradas respiradoras orais as crianças que roncavam, dormiam com a boca aberta, babavam no travesseiro e apresentavam queixas de obstrução nasal freqüente ou intermitente. As crianças com diagnóstico clínico de respirador oral foram submetidas a endoscopia nasal, teste alérgico cutâneo e raio X do cavum, hemograma, contagem de eosinófilos, dosagem de IgE total e parasitológico de fezes. Os dados foram analisados utilizando o programa SPSS® versão 10.5. RESULTADOS: As principais causas da respiração oral foram: rinite alérgica (81,4%, hipertrofia de adenóides (79,2%, hipertrofia de amígdalas (12,6% e desvio obstrutivo do septo nasal (1,0%. As principais manifestações clínicas do respirador oral foram: dormir com a boca aberta (86%, roncar (79%, coçar o nariz (77%, babar no travesseiro (62%, dificuldade respiratória noturna ou sono agitado (62%, obstrução nasal (49% e irritabilidade durante o dia (43%. CONCLUSÃO: Algumas manifestações clínicas são muito freqüentes na criança respiradora oral. Essas manifestações devem ser reconhecidas e consideradas no diagnóstico clínico da respiração oral.OBJECTIVE: To investigate the etiology, main clinical manifestations and other concurrent findings in mouth-breathing children aged 3 to 9 years and resident in the urban area of Abaeté (MG, Brazil. METHODS: This study was based on a representative random sample of the town population, of 23,596 inhabitants. Clinical diagnosis of mouth-breathing was defined as a combination of snoring, sleeping with mouth open, drooling on the pillow and frequent or intermittent nasal obstruction. Children with a

  13. Association of vegetables and fruits consumption with sarcopenia in older adults: the Fourth Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Kim, Jinhee; Lee, Yunhwan; Kye, Seunghee; Chung, Yoon-Sok; Kim, Kwang-Min

    2015-01-01

    several studies have found nutrients, including antioxidants, to be associated with sarcopenia. However, whether specific foods, such as vegetables and fruits, are associated with sarcopenia has not been studied. to examine the association of the frequency of vegetables and fruits consumption with sarcopenia in older people. this study used cross-sectional data from the Fourth Korea National Health and Nutrition Examination Survey in 2008-09. Subjects were community-dwelling 823 men and 1,089 women aged ≥65 years. Frequency of food group consumption was obtained by using the food frequency questionnaire. Body composition was measured with the dual-energy X-ray absorptiometry and sarcopenia was defined as appendicular lean mass adjusted for height and fat mass. Logistic regression was used to assess the association of the frequency of food group consumption with sarcopenia, controlling for sociodemographics and health-related variables. dietary intake of vegetables, fruits and both vegetables and fruits was associated with a significantly reduced risk of sarcopenia after controlling for covariates in men (P = 0.026 for trend, P = 0.012 for trend, P = 0.003 for trend, respectively). Men in the highest quintile, compared with those in the lowest quintile, of vegetables [odds ratio (OR) = 0.48; 95% confidence interval (CI): 0.24-0.95], fruits (OR = 0.30; 95% CI: 0.13-0.70) and vegetables and fruits consumption (OR = 0.32; 95% CI: 0.16-0.67) demonstrated a lower risk of sarcopenia. In women, high consumption of fruits demonstrated a lower risk of sarcopenia (OR = 0.39; 95% CI: 0.18-0.83). frequent vegetables and fruits consumption was inversely associated with sarcopenia in older adults. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Etiological study of microcytic hypochromic anemia

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    S Kafle

    2016-09-01

    Full Text Available Background: Microcytic hypochromic anemia is a distinct morphologic subtype of anemia with well- de ned etiology and treatment. The objective of this study was to determine the etiology and frequency of microcytic hypochromic anemia. Materials and Methods: This cross-sectional observational study was conducted at Kathmandu Medical College Teaching Hospital. One hundred cases of microcytic hypochromic anemia were included. Relevant clinical history, hemogram, reticulocyte count, iron pro les were documented in a proforma. Bone marrow aspiration and hemoglobin electrophoresis was conducted when required. Data was analysed by Microsoft SPSS 16 windows. Result: Iron de ciency was the commonest etiology (49%. Dysfunctional uterine bleeding (20.8% was the commonest cause of iron de ciency, malignancy (24.3% was the commonest cause of anemia of chronic disease. Mean value of Mean Corpuscular Volume was lowest in hemolytic anemia (71.0 . Mean Red cell Distribution Width was normal (14.0% in hemolytic anemia but was raised in other types. Mean serum iron was reduced in iron de ciency anemia (32.2μg/dl and chronic disease (34.8μg/dl, normal in hemolytic anemia (83μg/dl and raised in sideroblastic anemia (295μg/dl. Mean serum ferritin was reduced in iron de ciency anemia (7.6ng/ml, raised in chronic disease (158.6ng/ml and normal in hemolytic anemia (99.2ng/ml. Serum ferritin was normal in sideroblastic anemia (93ng/ml. Mean Total Iron Binding Capacity was raised in iron de ciency anemia (458μg/dl and normal in other microcytic hypochromic anemias. Conclusion: Diagnosis of microcytic hypochromic anemia requires a standardized approach which includes clinical details, hemogram, peripheral blood smear, reticulocyte count, iron pro le, hemoglobin electrophoresis and bone marrow examination. 

  15. Criteria for early etiological diagnosis of serous meningitis in children

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    Лариса Анатольевна Ходак

    2015-06-01

    Full Text Available To improve early etiological diagnosis of serous meningitis in children, the differential diagnostic algorithms have been developed.Methods. 220 children with serous meningitis(SM aged 1 to 17 years were divided into 3 groups depending on the etiological factor: 1 enterovirus SM (n=130; 2 herpesvirus SM (n=14; 3 enterovirus SM combined with persistent herpes virus infection (n=76. In the alternative groups of patients (in all combinations, the differential diagnostic significance of clinical and laboratory parameters has been evaluated by means of Wald–Genkin heterogeneous sequential procedure. All studied traits were divided into gradations and then differential diagnostic coefficients (DC and diagnostic information (I were obtained separately for the clinical indicators, CSF indicators and full blood count. The indicators were distributed in the descending order of their self-descriptiveness that, in future, taking into account the most significant of them, allowed to form a generalized diagnostic algorithms in each comparison group.Results. Differential algorithmic diagnosis is obtained by means of algebraic summation of DC until the diagnostic threshold is reached. For 95 percent confidence level, the threshold sum is DK≥13,0. Etiologic diagnosis of SM involves the use of all three algorithms, that is, differentiation is conducted between SM herpesvirus, enterovirus etiology and SM enterovirus etiology in combination with persistent herpes virus infection. When reaching the diagnostic threshold in favor of certain etiology, the appropriate diagnosis is made. In case the diagnostic threshold for two etiological factors is reached, the final diagnosis is formulated on the basis of the differential diagnosis data.Conclusions. The developed algorithms of early etiological diagnosis of SM in children are highly reliable (≥95% and minimize the number of indicators required for diagnosis with a given level of reliability

  16. Vitamin E in sarcopenia: current evidences on its role in prevention and treatment.

    Science.gov (United States)

    Khor, Shy Cian; Abdul Karim, Norwahidah; Ngah, Wan Zurinah Wan; Yusof, Yasmin Anum Mohd; Makpol, Suzana

    2014-01-01

    Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS) can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vitamin E is a lipid soluble vitamin, with potent antioxidant properties and current evidence suggesting a role in the modulation of signaling pathways. Previous studies have shown its possible beneficial effects on aging and age-related diseases. Although there are evidences suggesting an association between vitamin E and muscle health, they are still inconclusive compared to other more extensively studied chronic diseases such as neurodegenerative diseases and cardiovascular diseases. Therefore, we reviewed the role of vitamin E and its potential protective mechanisms on muscle health based on previous and current in vitro and in vivo studies.

  17. The impact of sarcopenia on the response to a physical activity intervention in older adults

    Science.gov (United States)

    To determine if the changes observed in the Short Physical Performance Battery (SPPB) after a physical activity or health education intervention are influenced by sarcopenia status at baseline. Data were obtained from the Lifestyles for Interventions and Independence for Elders Pilot Study, a RCT th...

  18. Vitamin E in Sarcopenia: Current Evidences on Its Role in Prevention and Treatment

    Directory of Open Access Journals (Sweden)

    Shy Cian Khor

    2014-01-01

    Full Text Available Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vitamin E is a lipid soluble vitamin, with potent antioxidant properties and current evidence suggesting a role in the modulation of signaling pathways. Previous studies have shown its possible beneficial effects on aging and age-related diseases. Although there are evidences suggesting an association between vitamin E and muscle health, they are still inconclusive compared to other more extensively studied chronic diseases such as neurodegenerative diseases and cardiovascular diseases. Therefore, we reviewed the role of vitamin E and its potential protective mechanisms on muscle health based on previous and current in vitro and in vivo studies.

  19. Impact of a multidisciplinary rehabilitation nutrition team on evaluating sarcopenia, cachexia and practice of rehabilitation nutrition.

    Science.gov (United States)

    Kokura, Yoji; Wakabayashi, Hidetaka; Maeda, Keisuke; Nishioka, Shinta; Nakahara, Saori

    2017-01-01

    To determine whether the presence of a multidisciplinary rehabilitation nutrition team affects sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. A cross-sectional study using online questionnaire among members of the Japanese Association of Rehabilitation Nutrition (JARN) was conducted. Questions were related to sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. 677 (14.7%) questionnaires were analysed. 44.5% reported that their institution employed a rehabilitation nutrition team, 20.2% conducted rehabilitation nutrition rounds and 26.1% conducted rehabilitation nutrition meetings. A total of 51.7%, 69.7%, 69.0% and 17.8% measured muscle mass, muscle strength, physical function and cachexia, respectively. For those with a rehabilitation nutrition team, 63.5%, 80.7%, 82.4% and 22.9% measured muscle mass, muscle strength, physical function and cachexia, respectively, whereas 46.7%, 78.0% and 78.1% of the respondents reported implementation of nutrition planning strategies in consideration of energy accumulation, rehabilitation training in consideration of nutritional status and use of dietary supplements, respectively. Multivariate logistic regression analysis showed that the use of a rehabilitation nutrition team independently affected sarcopenia evaluation and practice of rehabilitation nutrition but not cachexia evaluation. The presence of a multidisciplinary rehabilitation nutrition team increased the frequency of sarcopenia evaluation and practice of rehabilitation nutrition. J. Med. Invest. 64: 140-145, February, 2017.

  20. Association Between Sarcopenia and Nutritional Status in Older Adults: A Systematic Literature Review.

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    Eglseer, Doris; Eminovic, Sandra; Lohrmann, Christa

    2016-07-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Association Between Sarcopenia and Nutritional Status in Older Adults: A Systematic Literature Review" found on pages 33-41, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until June 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe the geriatric syndrome of sarcopenia. 2. Identify the outcome of the

  1. Etiological approach to chronic urticaria

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    Krupa Shankar D

    2010-01-01

    Full Text Available Background: In 1769, William Cullen introduced the word "urticaria" (transient edematous papules, plaque with itching. Urticaria affects 15-25% of people at least once in their life time. It is a clinical reaction pattern triggered by many factors causing the liberation of vasoactive substances such as histamine, prostaglandins and kinins. Urticaria is classified according to its duration into acute (< 6 weeks duration and chronic (>6 weeks duration. Various clinical investigations may be initiated to diagnosis the cause. Aims: To evaluate the types of chronic urticaria with reference to etiology from history and investigations . Materials and Methods: A total of 150 patients with chronic urticaria of more than six weeks were studied. Autologous serum skin test (ASST was performed after physical urticarias were excluded. Standard batteries of tests were performed after ASST in all patients; and other specific investigations were done where necessary. Skin prick test was done in idiopathic urticaria. Results: The study sample consisted of 62 male and 88 female patients with a mean age of 21-40 years. About 50% of patients showed an ASST positive reaction, 3.9% were positive for antinuclear antibody (ANA, IgE titer was elevated in 37%, H. pylori antibodies was positive in 26.7%. Thyroid antibodies were positive in 6.2%. Giardia and entamoeba histolytica was reported in 3.3% on routine stool examination and on urinalysis 8% had elevated WBC counts; 12% showed para nasal sinusitis, with maxillary sinusitis of 7.3%. Random blood sugar was high in 5.3%. Four patients had ASOM, two had positive KOH mount for dermatophytes, abdominal USG showed cholecystitis in two patients. Recurrent tonsillitis was noted in two patients. Urticaria following intake of NSAIDs was observed in four patients and with oral contraceptive pills in one patient. Contact urticaria to condom (latex was seen in one patient. Cholinergic (4.7% and dermographic (4.7% urticaria were

  2. Epilepsy in the tropics: Emerging etiologies.

    Science.gov (United States)

    Carrizosa Moog, Jaime; Kakooza-Mwesige, Angelina; Tan, Chong Tin

    2017-01-01

    Epilepsy is considered by the World Health Organization a public health priority with more than 50 million human beings affected by the disease. More than 80% of persons with epilepsy live in low and middle income countries and most of them in tropical areas. Several emerging, re-emerging and neglected diseases are symptomatic etiologies that jointly contribute to the enormous global burden of epilepsy. Besides the clinical strengths to reduce diagnostic and treatment gaps, other strategies in social, economic, cultural, educational and health policies are needed to prevent and treat appropriately vulnerable and affected persons with epilepsy. From the public health point of view, several of those strategies could be more effective in reducing the incidence and burden of the disease than the clinical approach of diagnosis and treatment. Special attention has to be given to stigma reduction and promotion of human rights. Several aspects mentioned in this abstract slip away the scope of the article, but it is a remainder to approach epilepsy in an inter- and transdisciplinary manner, an integral and pertinent approach needed and requested in tropical counties. The article focuses only on emergent and re-emergent etiologies of epilepsy in the tropics like malaria, HIV, neurocysticercosis, viral encephalitis and traumatic brain injury. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Sarcopenia as an Independent Risk Factor for Decreased BMD in COPD Patients: Korean National Health and Nutrition Examination Surveys IV and V (2008-2011)

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    Lee, Dong-Won; Choi, Eun-Young

    2016-01-01

    Background A decrease in bone mineral density (BMD) is a systemic consequence of chronic obstructive pulmonary disease (COPD). Past reports have rarely examined any correlation between sarcopenia and BMD. We investigated the relationship cross-sectionally between the presence of sarcopenia and BMD reduction in COPD patients. Methods COPD patients aged 50 or older with qualifying spirometry and dual-energy X-ray absorptiometry data were from participants in the Korean National Health and Nutrition Examination Surveys IV and V (2008–2011). Results There were 286 (33.3%) subjects in the sarcopenia group and 572 (66.7%) in the non-sarcopenia group. The sarcopenia group had lower T-scores than the non-sarcopenia group (femur: -0.73±0.88 vs. -0.18±0.97, p sarcopenia group and 45.6% and 13.3% in the non-sarcopenia group (both p sarcopenia associated with increased the risk of osteopenia, osteoporosis, and a low BMD (OR = 3.227, 95% CI = 2.125–4.899, p sarcopenia was associated with increased the risk for decreased BMD in COPD. PMID:27749901

  4. Sarcopenia in older mice is characterized by a decreased anabolic response to a protein meal.

    Science.gov (United States)

    van Dijk, Miriam; Nagel, Jolanda; Dijk, Francina J; Salles, Jerôme; Verlaan, Sjors; Walrand, Stephane; van Norren, Klaske; Luiking, Yvette

    Ageing is associated with sarcopenia, a progressive decline of skeletal muscle mass, muscle quality and muscle function. Reduced sensitivity of older muscles to respond to anabolic stimuli, i.e. anabolic resistance, is part of the underlying mechanisms. Although, muscle parameters have been studied in mice of various ages/strains; the aim was to study if mice display similar deteriorating processes as human ageing. Therefore, 10,16,21 and 25 months-old C57BL6/6J male mice were studied to measure parameters of sarcopenia and factors contributing to its pathophysiology, with the aim of characterizing sarcopenia in old mice. Muscle mass of the hind limb was lower in 25 as compared to 10 month-old mice. A significant decrease in physical daily activity, muscle grip strength and ex vivo muscle maximal force production was observed in 25 compared to 10 month-old mice. The muscle anabolic response to a single protein meal showed increased muscle protein synthesis in young, but not in old mice, indicative to anabolic resistance. However, by increasing the protein content in meals, anabolic resistance could be overcome, similar as in human elderly. Additionally, aged mice showed higher fasted insulin and hepatic malondialdehyde (MDA) levels (=marker oxidative stress). This study shows clear characteristics of sarcopenia that coincide with anabolic resistance, insulin resistance and oxidative stress in 25 month-old C57/BL6 male mice, similar to human ageing. Furthermore, similar decline in muscle mass, strength and function was observed in this aged-mice-model. These observations offer potential for the future to explore in old mice the effects of interventions targeting sarcopenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. THE ETIOLOGY OF BACTERIAL VAGINOSIS

    Science.gov (United States)

    Turovskiy, Yevgeniy; Noll, Katia Sutyak; Chikindas, Michael L.

    2011-01-01

    Bacterial vaginosis (BV) is the most common vaginal infection among women of childbearing age. This condition is notorious for causing severe complications related to the reproductive health of women. Five decades of intense research established many risk factors for acquisition of BV, however due to the complexity of BV and due to lack of a reliable animal model for this condition, its exact etiology remains elusive. In this manuscript we use a historical perspective to critically review the development of major theories on the etiology of BV, ultimately implicating BV-related pathogens, healthy vaginal microbiota, bacteriophages and the immune response of the host. None of these theories on their own can reliably explain the epidemiological data. Instead, BV is caused by a complex interaction of multiple factors, which include the numerous components of the vaginal microbial ecosystem and their human host. Many of these factors are yet to be characterized because a clear understanding of their relative contribution to the etiology of BV is pivotal to formulation of an effective treatment for and prophylaxis of this condition. PMID:21332897

  6. Características etiológicas, clínicas y sociodemográficas de la diarrea aguda en Venezuela Etiological, clinical, and sociodemographic characteristics of acute diarrhea in Venezuela

    Directory of Open Access Journals (Sweden)

    María I. Urrestarazu

    1999-09-01

    Full Text Available En cuatro ciudades de Venezuela se llevó a cabo un estudio para evaluar las características epidemiológicas, clínicas y etiológicas de la diarrea aguda en niños menores de 5 años. Entre junio de 1993 y mayo de 1995 se estudiaron 2 552 niños con diarrea y 793 controles que fueron atendidos en el hospital. Para el análisis estadístico de los resultados se empleó la prueba exacta de Fisher. Los rotavirus fueron los agentes más importantes, tanto por su frecuencia (30% como por su asociación con la deshidratación (58%. Le siguieron en importancia Campylobacter spp. (13% y Escherichia coli serogrupos O clásicos (9%, pero su asociación con la diarrea solo fue estadísticamente significativa en los niños menores de 3 meses, hecho de particular importancia desde el punto de vista del tratamiento. Se confirmó la importancia de la edad como factor determinante de la prevalencia y gravedad de la diarrea.In four cities of Venezuela a study was carried out to evaluate the epidemiological, clinical, and etiological characteristics of acute diarrhea in children under 5 years of age. The study was done between June 1993 and May 1995 and involved children who were seen in a hospital, 2 552 with diarrhea and 793 controls. The Fisher exact test was used for the statistical analysis of the results. Rotaviruses were the most important agents, both in terms of their frequency (30% and their association with dehydration (58%. Following in importance were Campylobacter spp. (13% and Escherichia coli classical O serogroups (9%, but their association with diarrhea was only statistically significant among children less than 3 months old, a fact that is particularly important from the standpoint of treatment. The importance of age was confirmed as a determining factor in the prevalence and severity of diarrhea.

  7. Terminology, epidemiology, etiology, and pathophysiology of nocturia.

    Science.gov (United States)

    Van Kerrebroeck, Philip; Andersson, Karl-Erik

    2014-04-01

    Nocturia, awaking from sleep to void, has a negative impact on health and well-being. Nocturia affects men and women and is more prevalent among the elderly. More than two nocturnal voids is considered to be a clinically meaningful threshold associated with significant negative outcomes for health and well-being, and the timing of awakening has a significant bearing on the negative consequences of nocturia. Several serious underlying pathophysiologic conditions may be associated with nocturia. A thorough history and assessment of number and times of voids, void volume, and fluid intake is essential for determining the etiology of a patient's nocturia. With data obtained from the frequency-volume chart (FVC), which is used to collect quantitative voiding data, a patient's nocturia may be classified as global polyuria, nocturnal polyuria, reduced bladder capacity, or a combination of these categories. Global polyuria is defined as 24-hr urinary output that exceeds 40 ml/kg body weight and results in increased 24-hr urinary frequency. Nocturnal polyuria is defined as more than 20% of daily urine output at night in young patients and more than 33% in elderly patients. Reduced bladder capacity may be a result of idiopathic or neurogenic detrusor overactivity, bladder outlet obstruction, or reduced nocturnal bladder capacity. The pathophysiology underlying the findings of the FVC falls into five main categories: global polyuria, nocturnal polyuria, reduced bladder capacity, sleep disorders, and circadian clock disorders. This review discusses the epidemiology, etiology, and pathophysiology of nocturia. © 2014 Wiley Periodicals, Inc.

  8. Thrombocytosis. Etiologic analysis of 663 patients.

    Science.gov (United States)

    Yohannan, M D; Higgy, K E; al-Mashhadani, S A; Santhosh-Kumar, C R

    1994-06-01

    Six hundred sixty-three children aged 1 to 16 years with thrombocytosis (defined as a platelet count of more than 500 x 10(9)/L) seen in a university hospital over a 1-year period were studied prospectively for etiology. The causes of thrombocytosis were infection (30.6%), hemolytic anemia (19.3%), tissue damage (15.2%), rebound thrombocytosis (14.8%), chronic inflammation (4.1%), renal disorders (4.1%), and malignancy (2%). Thrombocytosis associated with multiple, simultaneous causative factors was seen in 3.3% of cases. Among all patients with infections, osteomyelitis and septic arthritis were associated with higher platelet counts than other infections (P Thrombocytosis secondary to infections was significantly more common in children under 5 years of age, whereas chronic inflammation, malignancy, and renal disorders were more common causes of thrombocytosis in children over 5 years of age. Thrombocytosis of 1 million or more platelets was seen in 13 (2%) children. No thrombocytosis-related complications were seen in any children, and none required any specific treatment. Thrombocytosis is a frequent finding in children. It is due to a variety of etiologic factors and is of little clinical discriminatory value. It is often due to an acute-phase phenomenon in response to infection, tissue damage, blood loss, or anemia, and is rarely due to malignancy.

  9. Etiology of liver cirrhosis in Mexico.

    Science.gov (United States)

    Méndez-Sánchez, Nahum; Aguilar-Ramírez, Juan R; Reyes, Angel; Dehesa, Margarita; Juórez, Alberto; Castñeda, Beatriz; Sánchez-Avila, Francisco; Poo, Jorge L; Guevara González, Luis; Lizardi, Javier; Valdovinos, Miguel A; Uribe, Misael; Contreras, Ana M; Tirado, Patricia; Aguirre, Jesús; Rivera-Benítez, Cesar; Santiago-Santiago, Ramón; Bosques-Padilla, Francisco; Muñoz, Linda; Guerroro, Arnoldo; Ramos, Mayra; Rodríguez-Hernández, Heriberto; Jacobo-Karam, Jannett

    2004-01-01

    In the last decades it has been suggested that the main cause of liver cirrhosis in Mexico is alcohol. Currently in Western countries hepatitis C virus stage liver disease and liver transplantation. In Mexico, we have no data relative to the etiology of liver cirrhosis. The aim of this study was to investigate the main causes of liver cirrhosis in Mexico. Eight hospitals located in different areas of the country were invited to participate in this study. Those hospitals provide health care to different social classes of the country. The inclusion criteria were the presence of either an histological or a clinical and biochemical diagnosis of liver cirrhosis. A total 1,486 cases were included in this study. The etiology of liver cirrhosis was alcohol in 587 (39.5%), HCV 544 (36.6%), cryptogenic 154 (10.4%), PBC 84 (5.7%), HBV 75 (5.0%) and other 42 (2.8%). There was no statistical difference between alcohol and HCV. We conclude that the main causes of liver cirrhosis in Mexico are alcohol and HCV.

  10. THE ETIOLOGIC PATTERNS IN MICROCEPHALY WITH MENTAL RETARDATION

    Science.gov (United States)

    Prasad, K.M.R.; Girimaji, S.R.; Manjunatha, K.R.; Khanna, Neelam; Rao, B.S.S.; Ravi, V.; Murthy, R. Srinivasa; Vani, K.R.

    1995-01-01

    Microcephaly with mental retardation forms a distinct subgroup among mentally retarded individuals. The paucity of studies on the etiology of this condition in India made the investigators to study this population. It HTO aimed to study the demographic and clinical characteristics, and the etiologic pattern in children with microcepltaly and mental retardation The sample consisted of 82 children who were examined by detailed clinical assessment and a battery of investigations. A definite etiology could be found in 56% of children which have been grouped into prenatal embryonic, prenatal maternal/environmental, and birth and neonatal causes. Non-genetic causes were the most common. The prenatal etiology constituted nearly twice that of birth and neonatal causes. Majority of the etiologic factors were preventable. The role of socio-environmental factors has been discussed As a group, the neurological disorders were found to be the most commonly associated medical condition. Malnutrition, specially of severe degree, was significantly associated with this group compared to the general population. The study findings indicate that there is a significant place for prevention. PMID:21743719

  11. Etiological factors of preterm delivery

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    Elvira Brkičević

    2013-09-01

    Full Text Available Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. Preterm birth is a major course of neonatal morbidity and mortality, the incidence of premature delivery in developedcountries is 5 to 9%. Aims of this study were to determine the common etiological factors for preterm delivery, most common weeks of gestation for pretern delivery, and most commom way of delivery for preterm delivery.Methods: The study included 600 patients divided into two groups, experimental group (included 300 preterm delivered pregnant women, control group (included 300 term delivered women.Results: The incidence of preterm delivery in pregnant women younger than 18 years was 4.4%, and in pregnant women older than 35 years was 14%. 44.6 % of preterm delivered women at the experimentalgroup had lower education. In the experimental group burdened obstetrical history had 29%, 17.2% had a preterm delivery, 35.6% had a premature rupture of membranes, 15% had a preterm delivery before32 weeks of gestation, 12.4% between 32-33.6 weeks of gestation, while 72.6% of deliveries were between 34- 36.6 weeks of gestation. Multiple pregnancy as an etiological factor was present in 10.07% ofcases. Extragenital diseases were present in 10.4%. In the experimental group there were 29%, while in the control group there were 15% subjects with burdened obstetrical history.Conclusions: Preterm birth more often occurs in a pregnant women younger than 18 and older than 35 years, and in a pregnant women of lower educational degree. Preterm delivery in the most commoncases was fi nished in period from 34 to 36.6 weeks of gestation. The most common etiological factor of preterm delivery in the experimental group was preterm rupture of membranes and idiopathic pretermdelivery.

  12. Etiology of Nasal Bone Fractures.

    Science.gov (United States)

    Hwang, Kun; Ki, So Jung; Ko, Sang Hyun

    2017-05-01

    The aim of this study was to perform a systematic review of the etiology of nasal bone fractures (NBFs).In PubMed (500 titles) and Scopus (272), the search terms "nasal bone fracture" AND "etiology OR cause" were used. Among the 772 titles, 137 were duplicated and excluded. The 552 titles were excluded and 83 abstracts were read. Subsequently, 42 abstracts were excluded and 41 full articles providing data on etiologies of NBFs were reviewed. Finally, 26 papers were incorporated into this analysis.The causes of NBFs were different between adults and children. In adults, the most frequent causes were fights (36.3%), traffic accidents (20.8%), sports (15.3%), and falls (13.4%). In children, the most frequent causes were sports (59.3%), fights (10.8%), traffic accidents (8.3%), collisions (5.0%), and falls (3.3%). It is noticeable that fights, traffic accidents, and falls were more frequent in adults than in children, although sports and collisions were more frequent in children than in adults (P causes of NBFs varied geographically. Fights were the most frequent cause in Asia (36.7%), South America (46.5%), and Europe (40.8%). In North America, however, traffic accidents were the most frequent cause (33.6%), followed by fights (20.7%) and sports (17.3%). Among the sports injuries, ball-related sports were the most frequent cause (84.2%). Fighting-related sports (6.4%) contributed to relatively small proportion of NBFs.In efforts to prevent NBFs in children, sports injuries should be primarily considered. Restraining devices such as seatbelts are needed to prevent NBFs caused by traffic accidents, especially in North America.

  13. Intrathoracic neoplasia: Epidemiology and etiology

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1992-05-01

    Neoplasms of the thorax encompass those derived from the thoracic wall, trachea, mediastinum, lungs and pleura. They represent a wide variety of lesions including benign and malignant tumors arising from many tissues. The large surface area, 60 to 90 m{sup 2} in man, represented by the respiratory epithelium and associated thoracic structures are ideal targets for carcinogens carried by inspired air. The topic of discussion in this report is the epidemiology, etiology, and mechanisms of spontaneous intrathoracic neoplasia in animals and man. Much of what we know or suspect about thoracic neoplasia in animals has been extrapolated from experimentally-induced neoplasms.

  14. Impact Total Psoas Volume on Short- and Long-Term Outcomes in Patients Undergoing Curative Resection for Pancreatic Adenocarcinoma: a New Tool to Assess Sarcopenia

    Science.gov (United States)

    Amini, Neda; Spolverato, Gaya; Gupta, Rohan; Margonis, Georgios A.; Kim, Yuhree; Wagner, Doris; Rezaee, Neda; Weiss, Matthew J.; Wolfgang, Christopher L.; Makary, Martin M.; Kamel, Ihab R.; Pawlik, Timothy M.

    2016-01-01

    Background While sarcopenia is typically defined using total psoas area (TPA), characterizing sarcopenia using only a single axial cross-sectional image may be inadequate. We sought to evaluate total psoas volume (TPV) as a new tool to define sarcopenia and compare patient outcomes relative to TPA and TPV. Method Sarcopenia was assessed in 763 patients who underwent pancreatectomy for pancreatic adenocarcinoma between 1996 and 2014. It was defined as the TPA and TPV in the lowest sex-specific quartile. The impact of sarcopenia defined by TPA and TPV on overall morbidity and mortality was assessed using multivariable analysis. Result Median TPA and TPV were both lower in women versus men (both Psarcopenia was not associated with higher risk of postoperative complications (OR 1.06; P=0.72), sarcopenia defined by TPV was associated with morbidity (OR 1.79; P=0.002). On multivariable analysis, TPV-sarcopenia remained independently associated with an increased risk of postoperative complications (OR 1.69; P=0.006), as well as long-term survival (HR 1.46; P=0.006). Conclusion The use of TPV to define sarcopenia was associated with both short- and long-term outcomes following resection of pancreatic cancer. Assessment of the entire volume of the psoas muscle (TPV) may be a better means to define sarcopenia rather than a single axial image. PMID:25925237

  15. The relationship between sarcopenia,undernutrition, physical mobility and basic activities of daily living in a group of elderly women of Mexico City.

    Science.gov (United States)

    Velázquez Alva, María del Consuelo; Irigoyen Camacho, Maria Esther; Delgadillo Velázquez, Jaime; Lazarevich, Irina

    2013-01-01

    Sarcopenia is a geriatric syndrome, which affects the functional status and mobility of individuals. To identify the prevalence of sarcopenia and undernutrition, and to assess the association between sarcopenia and mobility, and sarcopenia and basic activities of daily living (ADL) in a group of elderly women. A cross-sectional study was performed in patients attending a geriatric service at a government hospital in Mexico City. Sarcopenia was identified applying Baumgartner's equation by obtaining skeletal muscle mass index (SMI) and undernutrition was diagnosed using mini-nutritional assessment instrument (MNA). The SENECA questionnaire and Katz index were used to evaluate mobility and ADL, respectively. lineal regression models were constructed fitting SMI as a dependent variable and SENECA, and ADL scores as independent variables, adjusted for age. 90 women with a mean age of 78.2 (± 6.8) were studied. Undernutrition was identified in 15.5% of the patients. The prevalence of sarcopenia was 41.1%. Patients with sarcopenia presented a high prevalence of undernutrition (p elder women with sarcopenia had a higher prevalence of undernutrition. Sarcopenia was associated with difficulties in mobility, particularly difficulties in climbing stairs. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  16. Anterior cruciate ligament injuries: etiology and prevention.

    Science.gov (United States)

    Brophy, Robert H; Silvers, Holly J; Mandelbaum, Bert R

    2010-03-01

    The relatively high risk of noncontact anterior cruciate ligament (ACL) rupture among female athletes has been a major impetus for investigation into the etiology of this injury. A number of risk factors have been identified, both internal and external to the athlete, including neuromuscular, anatomical, hormonal, shoe-surface interaction, and environmental, such as weather. The anatomic and neuromuscular risk factors, often gender related, are the focus of most ACL injury prevention programs. Although studies have shown that biomechanic- centered prevention programs can reduce the risk of ACL injury, many questions remain unanswered. More research is needed to increase our understanding of the risk factors for ACL injury; how injury prevention programs work and can the clinical application of such programs be optimized.

  17. Sarcopenia or muscle modifications in neurologic diseases: a lexical or patophysiological difference?

    Science.gov (United States)

    Carda, S; Cisari, C; Invernizzi, M

    2013-02-01

    Sarcopenia is a condition characterized by a decrease in muscle mass and function (strength and mobility) that is frequently observed in the elderly. In people with paresis and altered mobility due to central nervous system (CNS) diseases, this definition then may not be applicable. In CNS diseases, mainly stroke and spinal cord injury, different and specific patterns of muscle loss and muscle changes have been described, due to denervation, disuse atrophy, spasticity and myosteatosis. The main observations available about these phenomena in CNS diseases are reviewed, and a broad view on the specific physiopathological mechanisms is also described. Moreover, a description of the potential pharmacological targets and treatment strategies (physical and nutritional) is provided. Since sarcopenia of the elderly and muscle modifications and muscle atrophy in CNS diseases have different mechanisms, it is probable that they do not respond equally to the same treatments.

  18. Etiology research on different types of uveitis

    Directory of Open Access Journals (Sweden)

    Zhe Yang

    2016-05-01

    Full Text Available AIM:To analysis and discuss etiology of different types of uveitis. METHODS:We selected 60 patients(120 eyeswith uveitis treated in our hospital from June 2012 to June 2015. All patients examined by the same uveitis specialist with unified standards. According to international standards, uveitis was customized into:anterior uveitis(AU, intermediate uveitis(IU, posterior uveitis(PU, panuveitis(PanU. Age, gender, type of uveitis and causes of the disease were analyzed. RESULTS:Through the analysis of the etiology and clinical types of patients, the main types were idiopathic(26 cases, 21.7%, VKH syndrome(18 cases, 15.0%, HLA-B27 related(14 cases, 11.7%, viral(12 cases, 10.0%, Fuchs syndrome(8 cases, 6.7%, Behcet's disease(8 eyes, 6.7%, diabetes(6 eyes, 5.0%, syphilis(6 eyes, 5.0%, Posner-Schlossman syndrome(6 eyes, 5.0%, juvenile chronic arthritis(4 eyes, 3.3%, sympathetic ophthalmia(4 eyes,3.3%, traumatic(2 eyes, 1.7%, sarcoid(2 eyes, 1.7%, endophthalmitis(2 eyes, 1.7%and others(2 eyes, 1.7%. By the observation for different types uveitis, the main cause of AU was idiopathic, followed by HLA-B27-related and viral; for PanU, it was VKH syndrome, idiopathic ones and Behcet's disease; for PU, it was idiopathic, then viral; for IU, it was idiopathic. CONCLUSION:Through observation and analysis for clinical patients, male patients were more than female; idiopathic, caused by VKH syndrome, viral and Behcet's disease are the common types of uveitis.

  19. Considering the benefits of egg consumption for older people at risk of sarcopenia.

    Science.gov (United States)

    Smith, Alison; Gray, Juliet

    2016-06-01

    Sarcopenia is an important health issue for older people. It is closely linked with frailty and malnutrition and can significantly reduce both health and quality of life for those affected. Sarcopenic decline in muscle mass can start as early as the fourth and fifth decade of life, so the maintenance of muscle mass throughout adulthood, through regular physical activity and a balanced diet, should be an important consideration in reducing the risk of sarcopenia in older age. Maintaining regular exercise throughout older age remains key to the treatment of sarcopenia, as does an adequate intake of nutrients, including high-quality protein and vitamin D. A significant proportion of older people fail to meet the recommended requirements for protein; it has also been suggested that the requirements in existing recommendations could be higher. Evidence is emerging that an adequate intake of protein at each meal may be required to optimise muscle synthesis in older people. Eggs are an inexpensive, widely available and easily digestible source of high-quality protein and contain a significant proportion of leucine, an amino acid that is important for muscle synthesis, as well as many other nutrients of significance for older people, including vitamin D and omega-3 fatty acids. For many older people, eggs are a familiar and acceptable protein food at breakfast and other meals. Encouraging both those approaching older age and older people to include eggs more frequently, as part of a healthy, balanced diet and in addition to physical activity, could help them maintain their muscle strength and function, thereby preserving their functional capacity and reducing morbidity, mortality and healthcare costs associated with sarcopenia.

  20. Sarcopenia no envelhecimento: alterações funcionais, estruturais e bioquímicas

    OpenAIRE

    Zhong, S; Chen, CN; Thompson, LV

    2007-01-01

    Aging is associated with a progressive decline of muscle mass, strength, and quality, a condition described as sarcopenia of aging. Despite the significance of skeletal muscle atrophy, the mechanisms responsible for the deterioration of muscle performance are only partially understood. The purpose of this review is to highlight cellular, molecular and biochemical changes that contribute to age-related muscle weakness.O envelhecimento está associado ao declínio progressivo da massa, força, e q...

  1. Sarcopenia and cachexia evaluation in different healthcare settings: a questionnaire survey of health professionals.

    Science.gov (United States)

    Nakahara, Saori; Wakabayashi, Hidetaka; Maeda, Keisuke; Nishioka, Shinta; Kokura, Yoji

    2018-01-01

    The rates of sarcopenia and cachexia evaluations by different occupational groups at different settings are unclear. The objectives are to evaluate and compare the relative use of sarcopenia and cachexia evaluations among dietitians and associated healthcare professionals in a diverse range of settings. Participants were 4,621 members from the Japanese Association of Rehabilitation Nutrition. Settings included acute general wards, convalescent rehabilitation wards, long-term care wards, homecare service, and other settings. A questionnaire-based cross-sectional study was performed to evaluate assessments for sarcopenia and cachexia among dietitians and other professionals. Multiple comparisons based on Bonferroni method and logistic regression analysis were used. 718 (15.5%) answered the questionnaire. Data from 683 valid questionnaires were analyzed. Muscle strength, muscle mass, physical function, and cachexia were assessed by 53.4%, 51.1%, 53.4%, and 17.4% of dietitians. At convalescent rehabilitation wards, these rates were 81.8%, 62.0%, 82.5%, and 14.0%. The use of muscle strength and physical function evaluations was significantly lower among dietitians than among physical therapists and occupational therapists. The use of muscle mass and cachexia evaluations was not significantly different among the occupations. The use of muscle mass and strength evaluations was significantly higher in convalescent rehabilitation wards than in acute general wards, long-term care wards and facilities, and other settings, but not in homecare services. Cachexia evaluations were not significantly different between all settings. Raising the awareness of cachexia and sarcopenia among dietitians is a key issue, which should be addressed.

  2. Comprehensive proteome analysis of human skeletal muscle in cachexia and sarcopenia: a pilot study.

    Science.gov (United States)

    Ebhardt, H Alexander; Degen, Simone; Tadini, Valentina; Schilb, Alain; Johns, Neil; Greig, Carolyn A; Fearon, Kenneth C H; Aebersold, Ruedi; Jacobi, Carsten

    2017-08-01

    Cancer cachexia (cancer-induced muscle wasting) is found in a subgroup of cancer patients leaving the patients with a poor prognosis for survival due to a lower tolerance of the chemotherapeutic drug. The cause of the muscle wasting in these patients is not fully understood, and no predictive biomarker exists to identify these patients early on. Skeletal muscle loss is an inevitable consequence of advancing age. As cancer frequently occurs in old age, identifying and differentiating the molecular mechanisms mediating muscle wasting in cancer cachexia vs. age-related sarcopenia are a challenge. However, the ability to distinguish between them is critical for early intervention, and simple measures of body weight may not be sufficiently sensitive to detect cachexia early. We used a range of omics approaches: (i) undepleted proteome was quantified using advanced high mass accuracy mass spectrometers in SWATH-MS acquisition mode; (ii) phospho epitopes were quantified using protein arrays; and (iii) morphology was assessed using fluorescent microscopy. We quantified the soluble proteome of muscle biopsies from cancer cachexia patients and compared them with cohorts of cancer patients and healthy individuals with and without age-related muscle loss (aka age-related sarcopenia). Comparing the proteomes of these cohorts, we quantified changes in muscle contractile myosins and energy metabolism allowing for a clear identification of cachexia patients. In an in vitro time lapse experiment, we mimicked cancer cachexia and identified signal transduction pathways governing cell fusion to play a pivotal role in preventing muscle regeneration. The work presented here lays the foundation for further understanding of muscle wasting diseases and holds the promise of overcoming ambiguous weight loss as a measure for defining cachexia to be replaced by a precise protein signature. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on

  3. Effects of a Vitamin D and Leucine-Enriched Whey Protein Nutritional Supplement on Measures of Sarcopenia in Older Adults, the PROVIDE Study: A Randomized, Double-Blind, Placebo-Controlled Trial

    NARCIS (Netherlands)

    Bauer, J.M.; Verlaan, S.; Bautmans, I.; Brandt, K.; Donini, L.M.; Maggio, M.; McMurdo, M.E.T.; Mets, T.; Seal, C.; Wijers, S.L.; Ceda, G.P.; De Vito, G.; Donders, G.; Drey, M.; Greig, C.; Holmback, U.; Narici, M.; McPhee, J.; Poggiogalle, E.; Power, D.; Scafoglieri, A.; Schultz, R.; Sieber, C.C.; Cederholm, T.

    2015-01-01

    Background: Age-related losses of muscle mass, strength, and function (sarcopenia) pose significant threats to physical performance, independence, and quality of life. Nutritional supplementation could positively influence aspects of sarcopenia and thereby prevent mobility disability. Objective: To

  4. The etiology of vocal fold nodules in adults.

    Science.gov (United States)

    Karkos, Petros D; McCormick, Maxwell

    2009-12-01

    To review the recent literature on the etiology and pathophysiology of vocal fold nodules in adults. Research regarding the etiology of vocal nodules over the past 2 years supports previous thinking regarding the central role of voice misuse, overuse, and phonatory trauma. Advanced modeling techniques have helped elucidate mechanisms by which this may occur such as vibration-induced rise in capillary pressures and varying fluid dynamics in the layered vocal fold structure. Contributory roles of personality traits, reflux, and allergy have also been hypothesized. Current research supports long-held beliefs that phonatory trauma is a central cause of vocal fold nodule formation. Innovative basic science research has unraveled mechanisms of traumatic damage and clinical research continues to identify crucial lifestyle behavior and contributing comorbid conditions that play a role in the pathogenesis of vocal fold nodules. The multifactorial etiology of vocal fold nodules requires a comprehensive history to identify contributing factors and a multidisciplinary approach to optimize treatment outcome.

  5. Etiology of Sarcoidosis: Does Infection Play a Role?

    Science.gov (United States)

    Saidha, Shiv; Sotirchos, Elias S.; Eckstein, Christopher

    2012-01-01

    Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology, which is known to affect multiple organ systems including the lungs, heart, skin, central nervous system, and eyes, among others. For this reason, sarcoidosis represents a systemic medical disorder that is clinically relevant to multiple medical sub-specialties. Despite extensive research, the etiology of sarcoidosis has yet to be elucidated, although most evidence supports that the pathogenetic mechanism of sarcoidosis is an aberrant immune response, driven by an unidentified antigen (or antigens) in genetically susceptible individuals. Multiple candidate etiologic agents, including microbial organisms and environmental agents, have been investigated, but study results are inconclusive. In this review, we describe the known histologic and immunologic features of sarcoidosis and discuss the evidence supporting a role for infectious processes in the pathogenesis of sarcoidosis. PMID:22461752

  6. Muscle wasting and sarcopenia in heart failure and beyond: update 2017.

    Science.gov (United States)

    Springer, Jochen; Springer, Joshua-I; Anker, Stefan D

    2017-11-01

    Sarcopenia (loss of muscle mass and muscle function) is a strong predictor of frailty, disability and mortality in older persons and may also occur in obese subjects. The prevalence of sarcopenia is increased in patients suffering from chronic heart failure. However, there are currently few therapy options. The main intervention is resistance exercise, either alone or in combination with nutritional support, which seems to enhance the beneficial effects of training. Also, testosterone has been shown to increased muscle power and function; however, a possible limitation is the side effects of testosterone. Other investigational drugs include selective androgen receptor modulators, growth hormone, IGF-1, compounds targeting myostatin signaling, which have their own set of side effects. There are abundant prospective targets for improving muscle function in the elderly with or without chronic heart failure, and the continuing development of new treatment strategies and compounds for sarcopenia and cardiac cachexia makes this field an exciting one. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

  7. Physical activity and exercise as countermeasures to physical frailty and sarcopenia.

    Science.gov (United States)

    Marzetti, Emanuele; Calvani, Riccardo; Tosato, Matteo; Cesari, Matteo; Di Bari, Mauro; Cherubini, Antonio; Broccatelli, Marianna; Savera, Giulia; D'Elia, Mariaelena; Pahor, Marco; Bernabei, Roberto; Landi, Francesco

    2017-02-01

    The identification of cost-effective interventions that improve the health status and prevent disability in old age is one of the most important public health challenges. Regular physical activity is the only intervention that has consistently been shown to improve functional health and energy balance and to reduce the risk of cardiovascular disease, stroke, diabetes, several cancers, depression and falls. In advanced age, physical activity is also effective at mitigating sarcopenia, restoring robustness, and preventing/delaying the development of disability. On the other hand, physical inactivity is recognized as one of the leading causes of several chronic degenerative diseases and is also a major contributing factor to sarcopenia and functional disability. This compelling evidence has prompted the World Health Organization to recommend engaging in regular physical activity throughout one's life course. The present review summarizes the available evidence in support of physical activity as a remedy against physical frailty and sarcopenia. The relevant pathways through which the benefits of physical activity are conveyed are also discussed.

  8. Dietary Patterns and Sarcopenia in an Urban African American and White Population in the United States

    Science.gov (United States)

    KUCZMARSKI, MARIE FANELLI; MASON, MARC A.; BEYDOUN, MAY A.; ALLEGRO, DEANNE; ZONDERMAN, ALAN B.; EVANS, MICHELE K.

    2015-01-01

    The primary objective of this cross-sectional study was to characterize dietary patterns of African Americans and Whites, 30 to 64 years, examined in the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Other objectives of the study were to evaluate micronutrient adequacy of each pattern and to determine the association of diet with sarcopenia. Cluster analysis was used to determine patterns and mean adequacy ratio (MAR) to determine adequacy of 15 micmnutrients. Ten clusters were identified: sandwich, sweet drink, pizza, poultry, frozen meal, dessert, alcoholic drink, bread, starchy vegetables, and pasta/rice dish. MAR ranged from 69 for the sweet drink cluster to 82 for the pasta/rice dish cluster. Sarcopenia was present in 6.4% of the sample, ranging from 1.5% in the poultry cluster to 14.1% in the alcoholic drink cluster. This study is the first to report an association between diet and sarcopenia in people younger than 65 years. The identification of presarcopenia has important implications for dietary interventions that might delay age-associated loss of lean mass. PMID:24224938

  9. Metabolic syndrome, sarcopenia and role of sex and age: cross-sectional analysis of Kashiwa cohort study.

    Directory of Open Access Journals (Sweden)

    Shinya Ishii

    Full Text Available Recent epidemiological evidence suggests that effects of cardiovascular risk factors may vary depending on sex and age. In this study, we assessed the associations of metabolic syndrome (MetS with sarcopenia and its components in older adults, and examined whether the associations vary by sex and age. We also tested if any one of the MetS components could explain the associations. We conducted a cross-sectional analysis of the baseline data from the cohort study conducted in Kashiwa city, Chiba, Japan in 2012 which included 1971 functionally-independent, community-dwelling Japanese adults aged 65 years or older (977 men, 994 women. Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. MetS was defined based on the National Cholesterol Education Program's Adult Treatment Panel-III criteria. The prevalence of sarcopenia was 14.2% in men and 22.1% in women, while the prevalence of MetS was 43.6% in men and 28.9% in women. After adjustment for potential confounders, MetS was positively associated with sarcopenia in men aged 65 to 74 years (odds ratio 5.5; 95% confidence interval 1.9-15.9 but not in older men or women. Among the sarcopenia components, MetS was associated with lower muscle mass and grip strength, particularly in men aged 65 to 74 years. The associations of MetS with sarcopenia and its components were mainly driven by abdominal obesity regardless of sex or age. In conclusion, MetS is positively associated with sarcopenia in older men. The association is modified by sex and age, but abdominal obesity is the main contributor to the association across sex and age.

  10. Relationships between sarcopenia and household status and locomotive syndrome in a community-dwelling elderly women in Japan.

    Science.gov (United States)

    Momoki, Chika; Habu, Daiki; Ogura, Juri; Tada, Arisa; Hasei, Ai; Sakurai, Kotone; Watanabe, Hatsumi

    2017-01-01

    The aim of the present study was to identify factors associated with sarcopenia in community-dwelling elderly women in Japan. A total of 186 women aged over 65 years attending preventive care classes were enrolled in the study. Muscle mass was assessed using bioelectrical impedance analysis. Sarcopenia was defined as low muscle mass and low muscle strength in accord with the consensus report of the Asian Working Group for Sarcopenia. Data regarding household status (living alone, with a spouse, or with children and/or grandchildren), calf circumference and the presence of locomotive syndrome were obtained, as well as dietary variety score, Tokyo Metropolitan Institute of Gerontology Index of Competence and Mini-Nutritional Assessment short form, and 10-item Eating Assessment Tool scores. Sarcopenia was identified in 21.0% of participants. Participants with sarcopenia were older, had a lower body mass index and calf circumference, and were more likely to have locomotive syndrome, and living with children and/or grandchildren. In multivariate analysis, age, body mass index Japan Geriatrics Society.

  11. The most effective factors to offset sarcopenia and obesity in the older Korean: Physical activity, vitamin D, and protein intake.

    Science.gov (United States)

    Oh, Chorong; Jeon, Byeong Hwan; Reid Storm, Shaun Nicholas; Jho, Sunkug; No, Jae-Kyung

    2017-01-01

    The aim of this study was to evaluate the effects of the types and levels of physical activity in conjunction with protein intake and vitamin D on sarcopenia and obesity status in an elderly population. Study participants (N = 4452) were ages ≥60 y and included 1929 men and 2523 women who completed a body composition analysis with a dual energy x-ray absorptiometry and provided health and dietary data. Higher appendicular skeletal muscle mass/weight was observed in the non-obese group, although obese participants had greater weights. The non-obese sarcopenia subgroup showed health problems related to insulin resistance and metabolic-related factors compared with the nonsarcopenic group. The total metabolic equivalent was significantly different in both obese categories, regardless of sarcopenic status. The prevalence of obesity, sarcopenia, and sarcopenic obesity relatively increased with a diet deficient of protein intake and vitamin D. These data suggest that sarcopenia had a significant association with metabolic-related factors; physical activity, especially vigorous activity; and protein intake and vitamin D levels in a non-obese elderly population. Therefore, maintaining healthy body weight by means of resistance exercise and enhanced protein intake and vitamin D may help offset sarcopenia in this age group. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. The Effect of Physiological Stimuli on Sarcopenia; Impact of Notch and Wnt Signaling on Impaired Aged Skeletal Muscle Repair

    Science.gov (United States)

    Arthur, Susan Tsivitse; Cooley, Ian D.

    2012-01-01

    The age-related loss of skeletal muscle mass and function that is associated with sarcopenia can result in ultimate consequences such as decreased quality of life. The causes of sarcopenia are multifactorial and include environmental and biological factors. The purpose of this review is to synthesize what the literature reveals in regards to the cellular regulation of sarcopenia, including impaired muscle regenerative capacity in the aged, and to discuss if physiological stimuli have the potential to slow the loss of myogenic potential that is associated with sarcopenia. In addition, this review article will discuss the effect of aging on Notch and Wnt signaling, and whether physiological stimuli have the ability to restore Notch and Wnt signaling resulting in rejuvenated aged muscle repair. The intention of this summary is to bring awareness to the benefits of consistent physiological stimulus (exercise) to combating sarcopenia as well as proclaiming the usefulness of contraction-induced injury models to studying the effects of local and systemic influences on aged myogenic capability. PMID:22701343

  13. Estimation of prevalence of sarcopenia by using a new bioelectrical impedance analysis in Chinese community-dwelling elderly people.

    Science.gov (United States)

    Wang, Hui; Hai, Shan; Cao, Li; Zhou, Jianghua; Liu, Ping; Dong, Bi-Rong

    2016-12-28

    The aim of the present study was to validate the usefulness of the new octapolar multifrequency bioelectrical impedance analysis (BIA) for assessment of appendicular skeletal muscle mass (ASM) by comparing it with that of dual-energy X-ray absorptiometry (DXA) and to investigate the prevalence of sarcopenia in Chinese community-dwelling elderly according to Asian Working Group for Sarcopenia (AWGS) definition. A cross-sectional study was conducted in communities of Chengdu, China. A total of 944 community-dwelling elderly adults aged ≥60 years were included. ASM was measured by using DXA as a criterion method to validate a standing eight-electrode multifrequency BIA (InBody 720), followed by a further estimation of the prevalence of sarcopenia according the AWGS definition. In the Bland-Altman analysis, no significant difference was found between DXA and BIA based on the ASM measurements. The prevalence of AWGS-defined sarcopenia was 12.5% in the elderly women and 8.2% in the elderly men. BIA is suitable for body composition monitoring (ASM) in elderly Chinese as a fast, noninvasive, and convenient method; therefore, it may be a better choice in large epidemiological studies in the Chinese population. The prevalence of AWGS-defined sarcopenia was approximately 10.4% and increased with age in the Chinese community-dwelling elderly in this study.

  14. [Detection and evaluation of the role of sarcopenia in elderly patients with cancer treated with chemotherapy. ONCOSARCO project].

    Science.gov (United States)

    Molina Garrido, Maria José; Guillén Ponce, Carmen; Fernández Félix, Borja Manuel; Muñoz Sánchez, Maria Del Mar; Soriano Rodríguez, Maria Del Carmen; Olaverri Hernández, Amaya; Santiago Crespo, Jose Antonio

    To develop a predictive model of toxicity to chemotherapy in elderly patients with cancer, using the variables associated with sarcopenia, and to identify which of these parameters, sarcopenia or frailty, is the best predictor of toxicity to chemotherapy in the elderly. A prospective observational study with patients ≥70 years treated with chemotherapy in the Cancer Unit for the Elderly, in the Medical Oncology Section of the Hospital Virgen de la Luz de Cuenca. The following tests will be performed by each patient before chemotherapy: muscle strength (handgrip, cylindrical handgrip, pinch gauge, hip flexion, knee extension), muscle mass (skeletal muscle mass index), and physical function (gait speed and 5STS test). The occurrence of severe toxicity will be recorded over a period of 4 months of chemotherapy treatment. It will be evaluated, using logistic regression analysis, whether sarcopenia (defined by the European Working Group on Sarcopenia in Older People) or frailty (defined by the phenotype of frailty) is the best predictor of chemotherapy toxicity. Using a multinomial logistic regression analysis, we will try to create the first model to predict toxicity to chemotherapy in elderly patients with diagnosis of cancer, based on the definition of sarcopenia. It is expected that the final analysis of this project will be useful to detect predictive factors of toxicity to chemotherapy in elderly patients with cancer. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Causas de epilepsia tardia em uma clínica de epilepsia do Estado de Santa Catarina Etiologies of late-onset epilepsy in an epilepsy clinic of Santa Catarina - Southern Brazil

    Directory of Open Access Journals (Sweden)

    MARCELO RIGATTI

    1999-09-01

    Full Text Available OBJETIVO: Identificar em nossa sociedade as etiologias mais prováveis de epilepsia iniciada após os 18 anos de idade. MÉTODO: Estudo retrospectivo e descritivo na CME/SUS de Florianópolis de 1990 à 1998, analisando 120 prontuários de pacientes com epilepsia tardia, isto é, aqueles que iniciaram suas crises epilépticas dos 18 anos em diante. As variáveis coletadas foram: idade da primeira crise, etiologias prováveis, história mórbida familiar. RESULTADOS: A prevalência encontrada para epilepsia tardia foi 29,48%.Epilepsias parciais sintomáticas foram majoritárias e as etiologias mais frequentes e relevantes encontradas foram: cisticercose com cerca de 20%, trauma crânio encefálico com 15%, convulsão febril na infância com 5% e 35% da amostra foi classificada como idiopática. CONCLUSÃO: prevalência de epilepsia de início tardio em nossa sociedade é 29,48%, cifra ligeiramente superior à relatada em países desenvolvidos (25%. Muito provavelmente, esta diferença é consequência do caráter epidêmico de cisticercose entre nós. Além disso, trauma crânio encefálico e crises febris são etiologias comuns. Profilaxia de epilepsia é viável e urgentemente necessária em nosso Estado.OBJECTIVE: To identify the most common etiologies of late-onset epilepsy in our society. METHOD: Retrospective and descriptive study in the CME/SUS of Florianópolis from 1990 to 1998, evaluating 120 handbooks of patients with late-onset epilepsy, that is, those that had initiated epileptic seizures of the 18 years in ahead. The collected variables were: age of the first seizure, etiologies and morbid familial history. RESULTS: The prevalence rate found for late-onset epilepsy was 29.48%. Most of the sample had partial symptomatic epilepsy and the most frequent and important were: cysticercosis with 20%, head trauma with 15%, febrile convulsions in infancy with 5% and 35% were classified as idiopatic. CONCLUSION: Prevalence of late

  16. Sarcopenia as a determinant of blood pressure in older Koreans: findings from the Korea National Health and Nutrition Examination Surveys (KNHANES 2008-2010.

    Directory of Open Access Journals (Sweden)

    Kyungdo Han

    Full Text Available BACKGROUND: Blood pressure (BP is directly and causally associated with body size in the general population. Whether muscle mass is an important factor that determines BP remains unclear. OBJECTIVE: To investigate whether sarcopenia is associated with hypertension in older Koreans. PARTICIPANTS: We surveyed 2,099 males and 2,747 females aged 60 years or older. MEASUREMENTS: Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight (ASM/Wt that was <1 SD below the gender-specific mean for young adults. Obesity was defined as a body mass index (BMI ≥ 25 kg/m(2. Subjects were divided into four groups based on presence or absence of obesity or sarcopenia. Hypertension was defined as a systolic BP (SBP ≥ 140 mmHg, a diastolic BP (DBP ≥ 90 mmHg, or a self-reported current use of antihypertensive medications. RESULTS: The overall prevalence of hypertension in the four groups was as follows 49.7% for non-obese non-sarcopenia, 60.9% for non-obese sarcopenia, 66.2% for obese non-sarcopenia and 74.7% for obese sarcopenia. After adjustment for age, gender, regular activity, current smoking and alcohol use, the odds ratio (OR for having hypertension was 1.5 (95% confidence interval (CI = 1.23-1.84 in subjects in the non-obese sarcopenia group, 2.08 (95% CI = 1.68-2.57 in the obese non-sarcopenia group and 3.0 (95% CI = 2.48-3.63 in the obese sarcopenia group, compared with the non-obese non-sarcopenia group (p for trend <0.001. Controlling further for body weight and waist circumference did not change the association between hypertension and sarcopenia. The association between sarcopenia and hypertension was more robust in the subjects with diabetes mellitus. CONCLUSION: Body composition beyond BMI has a considerable impact on hypertension in elderly Koreans. Subjects with sarcopenic obesity appear to have a greater risk of hypertension than simply obese or sarcopenia subjects.

  17. Priapism: etiology, pathophysiology and management

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    Van Der Horst C.

    2003-01-01

    Full Text Available The understanding of erectile physiology has improved the prompt diagnosis and treatment of priapism. Priapism is defined as prolonged and persistent erection of the penis without sexual stimulation and failure to subside despite orgasm. Numerous etiologies of this condition are considered. Among others a disturbed detumescence mechanism, which may due to excess release of contractile neurotransmitters, obstruction of draining venules, malfunction of the intrinsic detumescence mechanism or prolonged relaxation of intracavernosal smooth muscle are postulated. Treatment of priapism varies from a conservative medical to a drastic surgical approach. Two main types of priapism; veno-occlusive low flow (ischemic and arterial high flow (non-ischemic, must be distinguished to choose the correct treatment option for each type. Patient history, physical examination, penile hemodynamics and corporeal metabolic blood quality provides distinction between a static or dynamic pathology. Priapism can be treated effectively with intracavernous vasoconstrictive agents or surgical shunting. Alternative options, such as intracavernous injection of methylene blue (MB or selective penile arterial embolization (SPEA, for the management of high and low flow priapism are described and a survey on current treatment modalities is given.

  18. Melasma. Etiologic and therapeutic considerations.

    Science.gov (United States)

    Grimes, P E

    1995-12-01

    Melasma is a common acquired symmetric hypermelanosis characterized by irregular light- to gray-brown macules and patches involving sun-exposed areas of skin. Etiologic factors in the pathogenesis of melasma include genetic influences, exposure to UV radiation, pregnancy, hormonal therapies, cosmetics, phototoxic drugs, and antiseizure medications. Melasma is often a therapeutically challenging disease, and current treatments include hypopigmenting agents, chemical peels, and lasers. Hypopigmenting agents include phenolic and nonphenolic derivatives. Phenolic agents include hydroquinone and hydroquinone combination preparations. Despite controversies regarding the issue of hydroquinone-induced ochronosis, hydroquinone remains the most effective topically applied bleaching agent approved by the Food and Drug Administration for the treatment of melasma. Nonphenolic bleaching agents include tretinoin and azelaic acid. Superficial, medium, and deep chemical peels are more often used in lighter-complexioned patients. Such peels should be used with caution in blacks. Although lasers have demonstrated significant efficacy in the treatment of a variety of hyperpigmentary disorders, their precise efficacy and place in the therapy of melasma have yet to be established. In the hierarchy of therapies for melasma, the treating physician must consider the devastating psychosocial impact of pigmentary imperfections within the realm of the benefits and risks associated with each treatment.

  19. Cervicogenic vertigo: etiology, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Elham Tavanai

    2013-07-01

    Full Text Available Background and Aim: Cervicogenic dizziness is induced by a specific neck position and the earth’s gravity has no effect on provoking of it. The precise incidence of cervicogenic dizziness is not certain but, 20-58% of patients following sudden head injuries experience its symptoms . In this article, the etiology, diagnosis and treatment of cervicogenic vertigo is discussed. Methods: At first, articles of cervicogenic dizziness from electronic databases of Google scholar , PubMed, Scopus, Ovid and CINAHL were searched from 1987 up to 2012. Then, the articles in them vertigo, disequilibrium or nystagmus were consistent with neck disorders were searched. Conclusion: Articles with title of cervicogenic vertigo (cervical vertigo were limited. Clinical researches about cervicogenic vertigo up to now implicate on several points; all signify that we cannot diagnose it certainly and there is not any specific single test for that. Recently, smooth pursuit neck torsion test (SPNTT has introduced for diagnosis of cervicogenic vertigo that is not valid yet. There is no protocol for diagnosis of cervicogenic vertigo and diagnosis is often based on limited clinical experiences of clinicians. Physiotherapy, medication and manual therapies are options for treatment but there is no distinct and effective treatment for it and in just one article, a combination of treatments for cervicogenic vertigo as a protocol has recommended.

  20. Frequência etiológica da hipertensão pulmonar em ambulatório de referência na Bahia Frecuencia etiológica de la hipertensión pulmonar en un ambulatorio de referencia en Bahia Etiological frequency of pulmonary hypertension in a reference outpatient clinic in Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Cesar Machado

    2009-12-01

    etiologies, with possible geographic influences; however, few studies have described the etiological frequency of PH, especially in our country. It is not clear whether there is an association between etiology and pulmonary pressure level or symptom intensity. OBJECTIVES: 1 to describe the etiological prevalence of PH in the state of Bahia, Brazil; 2 to evaluate whether the etiology is a determinant factor for the pulmonary pressure level; 3 to evaluate whether the etiology is a determinant factor for functional class; 4 to identify the other predictors of pulmonary pressure level and functional class. METHODS: The present was an observational, cross-sectional study that analyzed individuals with PH treated at the Magalhaes Neto Outpatient Clinic, between June 2005 and December 2007. PH was defined as pulmonary artery systolic pressure (PASP > 40 mmHg measure at the echocardiogram. Patients with chronic obstructive pulmonary disease or ventricular disease were excluded from the study. RESULTS: A total of 48 patients with PASP = 86 ± 24 mmHg were studied. Regarding the etiology, 42% of the patients were classified as idiopathic, followed by 25% as schistosomatic, 19% as congenital cardiopathy and 10% of chronic pulmonary embolism. A longer time of disease predicted higher pressures in patients with cardiopathy. Individuals with schistosomiasis had the best functional performance when compared to the others (456 ± 58 vs. 299 ± 138 meters, p=0.005. The schistosomatic etiology and younger age presented better functional class. CONCLUSIONS: 1 the idiopathic classification is the most prevalent, with schistosomiasis being the most frequent specific cause in our country; 2 patients with schistosomatic etiology and of younger age present better functional class. 3 the congenital cardiopathy results in a higher pressure level in the pulmonary artery, probably due to the longer duration of the disease.

  1. Sarcopenia exacerbates obesity-associated insulin resistance and dysglycemia: findings from the National Health and Nutrition Examination Survey III.

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    Preethi Srikanthan

    2010-05-01

    Full Text Available Sarcopenia often co-exists with obesity, and may have additive effects on insulin resistance. Sarcopenic obese individuals could be at increased risk for type 2 diabetes. We performed a study to determine whether sarcopenia is associated with impairment in insulin sensitivity and glucose homeostasis in obese and non-obese individuals.We performed a cross-sectional analysis of National Health and Nutrition Examination Survey III data utilizing subjects of 20 years or older, non-pregnant (N = 14,528. Sarcopenia was identified from bioelectrical impedance measurement of muscle mass. Obesity was identified from body mass index. Outcomes were homeostasis model assessment of insulin resistance (HOMA IR, glycosylated hemoglobin level (HbA1C, and prevalence of pre-diabetes (6.0≤ HbA1C<6.5 and not on medication and type 2 diabetes. Covariates in multiple regression were age, educational level, ethnicity and sex.Sarcopenia was associated with insulin resistance in non-obese (HOMA IR ratio 1.39, 95% confidence interval (CI 1.26 to 1.52 and obese individuals (HOMA-IR ratio 1.16, 95% CI 1.12 to 1.18. Sarcopenia was associated with dysglycemia in obese individuals (HbA1C ratio 1.021, 95% CI 1.011 to 1.043 but not in non-obese individuals. Associations were stronger in those under 60 years of age. We acknowledge that the cross-sectional study design limits our ability to draw causal inferences.Sarcopenia, independent of obesity, is associated with adverse glucose metabolism, and the association is strongest in individuals under 60 years of age, which suggests that low muscle mass may be an early predictor of diabetes susceptibility. Given the increasing prevalence of obesity, further research is urgently needed to develop interventions to prevent sarcopenic obesity and its metabolic consequences.

  2. [Transdisciplinary Approach for Sarcopenia. Molecular mechanism of sarcopenia : The role of skeletal muscle niche component SPARC in the regulation of myogenesis and adipogenesis and its alteration with age].

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    Nakamura, Katsuyuki; Yamanouchi, Keitaro; Nishihara, Masugi

    2014-10-01

    Sarcopenia, an age-related decline in skeletal muscle mass and strength, causes the decline of the quality of life in the elderly. The age-related alteration in the differentiation potency of satellite cells, myogenic tissue specific stem cells in skeletal muscle, and preadipocytes in skeletal muscle is possibly involved in the disruption of homeostasis in skeletal muscle. The differentiation of the cells is affected by the microenvironment surrounding the cells, called niche. Here, we focused on SPARC (secreted protein acidic and rich in cysteine) as a secreted glycoprotein existing in the niche. We review the roles of SPARC on the differentiation of satellite cells and preadipocytes in the muscle and their alteration with age.

  3. International Retrospective Comparison of Inpatient Rehabilitation for Patients With Spinal Cord Dysfunction : Differences According to Etiology

    NARCIS (Netherlands)

    New, Peter Wayne; Reeves, Ronald K.; Smith, Eimear; Eriks-Hoogland, Inge; Gupta, Anupam; Scivoletto, Giorgio; Townson, Andrea; Maurizio, Belci; Post, Marcel. W.

    Objectives: To describe and compare epidemiologic characteristics and clinical outcomes of patients with nontraumatic spinal cord dysfunction according to etiology. Design: Retrospective, multicenter open-cohort case series. Setting: Spinal rehabilitation units (SRUs) in 9 countries. Participants:

  4. International Retrospective Comparison of Inpatient Rehabilitation for Patients With Spinal Cord Dysfunction : Differences According to Etiology

    NARCIS (Netherlands)

    New, P.W.; Reeves, Ron; Smith, Einar; Eriks-Hoogland, I.E.; Gupta, A.; Scivoletto, G.; Townson, A.; Maurizio, B.; Post, MWM

    Objectives To describe and compare epidemiologic characteristics and clinical outcomes of patients with nontraumatic spinal cord dysfunction according to etiology. Design Retrospective, multicenter open-cohort case series. Setting Spinal rehabilitation units (SRUs) in 9 countries. Participants

  5. The "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" (SPRINTT) randomized controlled trial: design and methods.

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    Landi, Francesco; Cesari, Matteo; Calvani, Riccardo; Cherubini, Antonio; Di Bari, Mauro; Bejuit, Raphael; Mshid, Jerome; Andrieu, Sandrine; Sinclair, Alan J; Sieber, Cornel C; Vellas, Bruno; Topinkova, Eva; Strandberg, Timo; Rodriguez-Manas, Leocadio; Lattanzio, Fabrizia; Pahor, Marco; Roubenoff, Ronenn; Cruz-Jentoft, Alfonso J; Bernabei, Roberto; Marzetti, Emanuele

    2017-02-01

    The sustainability of health and social care systems is threatened by a growing population of older persons with heterogeneous needs related to multimorbidity, frailty, and increased risk of functional impairment. Since disability is difficult to reverse in old age and is extremely burdensome for individuals and society, novel strategies should be devised to preserve adequate levels of function and independence in late life. The development of mobility disability, an early event in the disablement process, precedes and predicts more severe forms of inability. Its prevention is, therefore, critical to impede the transition to overt disability. For this reason, the Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT) project is conducting a randomized controlled trial (RCT) to test a multicomponent intervention (MCI) specifically designed to prevent mobility disability in high-risk older persons. SPRINTT is a phase III, multicenter RCT aimed at comparing the efficacy of a MCI, based on long-term structured physical activity, nutritional counseling/dietary intervention, and an information and communication technology intervention, versus a healthy aging lifestyle education program designed to prevent mobility disability in 1500 older persons with physical frailty and sarcopenia who will be followed for up to 36 months. The primary outcome of the SPRINTT trial is mobility disability, operationalized as the inability to walk for 400 m within 15 min, without sitting, help of another person, or the use of a walker. Secondary outcomes include changes in muscle mass and strength, persistent mobility disability, falls and injurious falls, disability in activities of daily living, nutritional status, cognition, mood, the use of healthcare resources, cost-effectiveness analysis, quality of life, and mortality rate. SPRINTT results are expected to promote significant advancements in the management of frail older persons at high risk

  6. Prevalência de sarcopenia em idosos: resultados de estudos transversais amplos em diferentes países

    OpenAIRE

    Diz,Juliano Bergamaschine Mata; Queiroz,Bárbara Zille de; Tavares,Leonardo Barbosa; Pereira, Leani Souza Máximo

    2015-01-01

    ResumoA sarcopenia caracteriza-se pela perda generalizada e progressiva da força e massa muscular esquelética com o envelhecimento. Com o aumento da população idosa em ritmo acelerado em todo o mundo, torna-se necessário o maior entendimento dos fenômenos associados ao processo de envelhecimento. Portanto, descrever a frequência e distribuição desses fenômenos, tal como a sarcopenia, é um passo fundamental para se conhecer os componentes atrelados a sua ocorrência e promover a assistência à s...

  7. Sarcopenia Screened With SARC-F Questionnaire Is Associated With Quality of Life and 4-Year Mortality.

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    Wu, Tai-Yin; Liaw, Chen-Kun; Chen, Fang-Chun; Kuo, Kuan-Liang; Chie, Wei-Chu; Yang, Rong-Sen

    2016-12-01

    There is no gold standard in diagnosing sarcopenia. We aimed to assess the validity of screening sarcopenia using SARC-F (sluggishness, assistance in walking, rise from a chair, climb stairs, falls). Prospective cohort study. Community hospital in Taiwan. Community-dwelling senior citizens. Participants were interviewed with a structured questionnaire annually. The questionnaire items were recoded into the 5 items of SARC-F (sluggishness, assistance in walking, rise from a chair, climb stairs, falls). In the baseline year, a subgroup was tested for grip strength and body composition. Healthcare utilization and mortality were based on self-report and hospital records. Our main outcome was 4-year mortality. Secondary outcomes included hospitalization, emergency care use, and quality of life (QOL) measured using the CASP-12 scale (control, autonomy, self-realization, pleasure (control, autonomy, self-realization, pressure). There were 670 participants. The mean age was 76.1 (standard deviation 6.36). One-half were men (n = 340, 50.7%). The prevalence of sarcopenia was 6.1% (n = 41). SARC-F scores were inversely associated with grip strength (P = .001) and skeletal muscle composition (P = .045). Participants with sarcopenia were mostly women (P = .005) and older (P sarcopenia was associated with 1- to 4-year mortalities (P = .033, .001, .001, sarcopenia [odds ratio (OR) 7.35, 95% confidence interval (CI) 2.67-20.18], age (OR 1.19, 95% CI 1.09-1.29 for each year), and taking vitamin D supplements (OR 0.29, 95% CI 0.11-0.74) were factors associated with mortality. Sarcopenia screened using SARC-F was associated with subsequent QOL, overall hospitalization, overall emergency care use, and 4-year mortality. SARC-F can serve as a quick screening tool of sarcopenia. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  8. The Relationship between Sarcopenia and Systemic Inflammatory Response for Cancer Cachexia in Small Cell Lung Cancer.

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    Eun Young Kim

    Full Text Available The prognostic significance of sarcopenia, an important component of cancer cachexia, has been demonstrated in oncologic patients. Catabolic drivers have been suggested to be key features of cancer cachexia.To determine the relationship between systemic inflammatory markers and CT-determined muscle mass in patients with SCLC.Cross-sectional muscle areas were evaluated at the level of the third lumbar vertebra (L3 using baseline CT images in 186 SCLC patients. Sarcopenia was defined as a L3 muscle index (L3MI, muscle area at L3/height2 of < 55 cm2/m2 for men and of < 39 cm2/m2 for women. Systemic inflammatory markers investigated included serum white blood cell count (WBC, neutrophil: lymphocyte ratio (NLR, C-reactive protein (CRP, and albumin.Mean L3MI was 47.9 ± 9.7 cm2/m2 for men and 41.6 ± 7.0 cm2/m2 for women. Sarcopenia was present in 128 patients (68.8%, and sarcopenic patients had significant serum lymphocyte counts and albumin levels (p = 0.002 and 0.041, respectively, and higher NLRs and CRP levels (p = 0.011 and 0.026 than non-sarcopenic patients. Multivariable analysis revealed that CRP independently predicted L3MI (β = -0.208; 95% CI, -0.415 to -0.002; p = 0.048, along with gender and BMI (p values < 0.001 and performance status (p = 0.010.The present study confirms a significant linear relationship exists between CT-determined muscle mass and CRP in SCLC patients. This association might provide a better understanding of the mechanism of cancer cachexia.

  9. Sarcopenia is a predictive factor for intestinal resection in admitted patients with Crohn's disease.

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    Shigeki Bamba

    Full Text Available The relationship between skeletal muscle volume and the prognosis of patients with inflammatory bowel disease (IBD remains undetermined. We conducted a retrospective study of 72 IBD patient