{"title":"Long-chain fatty acids in sarcopenia patients with cardiovascular diseases: importance of n-9 monounsaturated fatty acids","authors":"Atsushi Katoh, Hisao Ikeda, Yoshihisa Matsushima, Motoki Sasaki, Norihito Okina, Hiroshi Niiyama, Haruhito Harada, Yasuhiro Nishiyama, Hisashi Kai","doi":"10.1002/crt2.27","DOIUrl":"https://doi.org/10.1002/crt2.27","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Long-chain fatty acids are essential components of the cellular energy supply, cellular membranes, and autacoid synthesis. It has been suggested that long-chain fatty acids might be involved in the pathophysiology underlying sarcopenia. We investigated the association between sarcopenia and serum long-chain fatty acid profile in patients with cardiovascular diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively investigated 308 cardiovascular patients [age: 72 ± 12 (mean ± SD), 174 male patients] admitted to our hospital. All patients were evaluated by sarcopenia diagnostic tests and serum free fatty acid analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-seven patients (25%) were diagnosed with sarcopenia. Serum fatty acid weight percentages of nervonic acid and erucic acid were elevated in patients with sarcopenia compared with those without. Nervonic acid, which was an independent factor for sarcopenia in binary logistics regression analysis (<i>B</i> = 2.559, <i>p</i> < 0.001), correlated negatively with skeletal muscle index (<i>r</i> = −0.331, <i>p</i> < 0.001), gait speed (<i>r</i> = −0.387, <i>p</i> < 0.001), and handgrip strength (<i>r</i> = −0.372, <i>p</i> < 0.001). These significant relationships were confirmed in subgroup analyses stratified by age and gender. In receiver operating characteristic curve analysis, the cut-off of nervonic acid weight percentage for diagnosis of sarcopenia was 1.37% with a sensitivity and specificity of 76.6% and 65.1%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nervonic acid, an n-9 monounsaturated fatty acid, might serve as a new marker for sarcopenia in patients with cardiovascular diseases. Further studies with larger patient numbers will be needed to determine the roles of long-chain fatty acids in sarcopenia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 4","pages":"121-128"},"PeriodicalIF":0.0,"publicationDate":"2020-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.27","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72168387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Denervation-induced loss of skeletal muscle mass influences immune homeostasis and accelerates the disease progression of lupus nephritis","authors":"Shuang Liu, Takeshi Kiyoi, Erika Takemasa, Masaki Mogi","doi":"10.1002/crt2.26","DOIUrl":"10.1002/crt2.26","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with systemic autoimmune disease are predisposed to developing sarcopenia associated with their underlying proinflammatory condition and a decrease in motility. How sarcopenic status affects disease progression remains unknown. The present study explored the influence of denervation-induced sarcopenia on immune homeostasis and investigated related biological pathways that might be important for future disease management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A denervation-induced skeletal muscle loss model was established, and the function of the immune system was evaluated. Immune cell proportions and cytokine levels in peripheral blood and atrophied skeletal muscle were profiled. We examined store-operated Ca<sup>2+</sup> entry and mitochondrial function in immune cells. MRL/lpr mice were used to evaluate the influence of denervation-induced sarcopenia on autoimmune progression in lupus nephritis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with splenocyte fractions obtained from sham mice, proportions of CD4<sup>+</sup> cells, CD8<sup>+</sup> cells, CD19<sup>+</sup>CD20<sup>−</sup> cells, CD49b<sup>+</sup>NK46<sup>+</sup> cells, CD4<sup>+</sup>IL-4<sup>+</sup> cells, and CD4<sup>+</sup>FoxP3<sup>+</sup> cells were significantly decreased, whereas CD19<sup>+</sup>CD20<sup>+</sup> cells, CD4<sup>+</sup>IFN-γ<sup>+</sup> cells, and CD4<sup>+</sup>IL17<sup>+</sup> cells were markedly increased in sciatic nerve axotomy (SNA) mice. The serum cytokine profile indicated that SNA significantly increased the protein expressions of IL-12p70 (<i>P</i> = 0.014), IL-17A (<i>P</i> = 0.007), and IFN-γ (<i>P</i> < 0.001). In SNA mice, there was an 18.74% decrease in peak Ca<sup>2+</sup> influx (<i>P</i> < 0.001) and an 18.22% decrease in initial Ca<sup>2+</sup> influx (<i>P</i> < 0.001) rates in peripheral T cells compared with sham mice. Mitochondrial respiration was significantly reduced in peripheral T cells from SNA mice compared with sham mice. SNA substantially promoted disease progression in lupus model mice demonstrated by the results of proteinuria monitoring, serum levels of blood urea nitrogen, and kidney histological scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The loss of skeletal muscle impaired mitochondrial respiration and activation in T cells and influenced the balance of T helper cell subsets. Therefore, denervation-induced sarcopenia might promote the progression of autoimmune diseases, such as lupus nephritis, and enhance Th1/Th17 functions. These resul","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 4","pages":"108-120"},"PeriodicalIF":0.0,"publicationDate":"2020-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.26","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45585513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tanvir Abbass, Ross D. Dolan, Paul G. Horgan, Donald C. McMillan
{"title":"The relationship between systemic inflammation, body composition and clinical outcomes in patients with operable colorectal cancer at low and medium to high nutritional risk","authors":"Tanvir Abbass, Ross D. Dolan, Paul G. Horgan, Donald C. McMillan","doi":"10.1002/crt2.25","DOIUrl":"10.1002/crt2.25","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In accordance with European Society of Parenteral and Enteral Nutrition guidelines, the combination of malnutrition universal screening tool (MUST), systemic inflammation [modified Glasgow prognostic score (mGPS)] and body composition [skeletal muscle index (SMI) and skeletal muscle density (SMD)] were examined in relation to clinical outcomes in patients undergoing surgery for colorectal cancer (CRC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected for stages I–III CRC patients from prospectively maintained data base at the academic department of surgery, Glasgow Royal Infirmary. From the initial sample of 1046, pre-admission MUST score was available in 984 patients. The classification into low malnutrition risk (MUST = 0, <i>n</i> = 810) and moderate to high malnutrition risk (MUST 1 to ≥2, <i>n</i> = 174) groups and their relationship to systemic inflammatory response and body composition (SMI and SMD) with clinical outcomes were examined using univariate and multivariate analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with those patients at low nutrition risk (MUST = 0), patients at moderate to high malnutrition risk (MUST 1 to ≥2) had an elevated mGPS (<i>P</i> < 0.001), neutrophil lymphocyte ratio (NLR) (<i>P</i> < 0.001), low SMI (<i>P</i> ≤ 0.001) and low SMD (<i>P</i> = 0.015). MUST was an important prognostic factor for length of hospital stay (<i>P</i> < 0.001) and 3 years overall survival (<i>P</i> < 0.001).</p>\u0000 \u0000 <p>In low malnutrition risk patients (MUST = 0), those who were systemically inflammed (mGPS 1/2, <i>n</i> = 187), had an elevated NLR (<i>P</i> < 0.001), low SMI (<i>P</i> < 0.001), low SMD (<i>P</i> < 0.01), increased post-operative complications (<i>P</i> < 0.05), longer hospital stay >7 days (<i>P</i> < 0.001), and poorer 3 years survival (<i>P</i> < 0.05) compared with those who were not systemically inflamed. On multivariate analysis, American Society of Anaesthesiologist (ASA) score (<i>P</i> < 0.05) and mGPS (<i>P</i> < 0.05) were independently associated with increased risk of clinical complications. ASA, mGPS, and NLR were independently associated with prolonged hospital stay (<i>P</i> < 0.05, <i>P</i> < 0.05, and <i>P</i> < 0.001, respectively). ASA, tumour, node, metastasis stage, and mGPS were independently associated with overall survival (<i>P</i> < 0.01, <i>P</i> < 0.001, and <i>P</i> < 0.05, respectively).</p>\u0000 \u0000 <p>In medium-risk to high-risk patients (MUST = 1/2), those who were systemically inflamed (mGPS 1/2, <i>n</i> = ","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 4","pages":"99-107"},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.25","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45283604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophia X. Sui, Kara L. Holloway-Kew, Natalie K. Hyde, Lana J. Williams, Monica C. Tembo, Sarah Leach, Julie A. Pasco
{"title":"Definition-specific prevalence estimates for sarcopenia in an Australian population: the Geelong Osteoporosis Study","authors":"Sophia X. Sui, Kara L. Holloway-Kew, Natalie K. Hyde, Lana J. Williams, Monica C. Tembo, Sarah Leach, Julie A. Pasco","doi":"10.1002/crt2.22","DOIUrl":"10.1002/crt2.22","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to compare prevalence estimates for sarcopenia in an Australian sample of older men and women by using different criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women (<i>n</i> = 323) and men (<i>n</i> = 342) aged 60–96 years from the Geelong Osteoporosis Study were included. Handgrip strength (HGS) was measured by dynamometer (Jamar or Vernier) and appendicular lean mass (ALM) by whole-body densitometry (Lunar). Sarcopenia definitions included European Working Group on Sarcopenia in Older People (EWGSOP) 1, EWGSOP2, and US Foundation for the National Institutes of Health (FNIH). Sarcopenia was identified as low HGS and low ALM/height<sup>2</sup> or low muscle performance, and low HGS and low ALM/body mass index (BMI). Prevalence estimates were standardized to the Australian population and agreement between definitions assessed using the Cohen kappa statistic (<i>κ</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Low HGS was identified in 13.7–29.9% of women and 2.1–14.1% of men. Low ALM/height<sup>2</sup> was identified in 7.1–11.8% of women and 6.0–8.4% of men, while 21.7% of women and 21.1% of men had low ALM/BMI. Mean age-standardized prevalence estimates for sarcopenia were 5.9% (95% confidence interval 3.4–8.4) for women and 2.9% (1.9–4.0) for men (EWGSOP1), 2.3% (1.1–3.4) for women and 0.5% (0.2–0.9) for men (EWGSOP2), and 4.0% (2.1–5.8) for women and 1.1% (0.6–1.5) for men (FNIH). There was moderate agreement between EWGSOP1 and EWGSOP2 (<i>κ</i> = 0.58 women, 0.30 men) and poor agreement between FNIH and EWGSOP1 (<i>κ</i> = 0.16 women, 0.12 men) and EWGSOP2 (<i>κ</i> = 0.19 women, 0 men).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sarcopenia prevalence differed according to definition applied. Point estimates for sarcopenia prevalence according to EWGSOP2 identified fewer individuals than EWGSOP1, with FNIH estimates between the two; however, there were overlapping 95% confidence intervals across definitions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 4","pages":"89-98"},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.22","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44252191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reduced muscle strength of knee extensors is a risk factor for silent lacunar infarcts among Japanese elderly people: the Bunkyo Health Study","authors":"Yuki Someya, Yoshifumi Tamura, Hideyoshi Kaga, Daisuke Sugimoto, Satoshi Kadowaki, Ruriko Suzuki, Shigeki Aoki, Nobutaka Hattori, Yumiko Motoi, Kazunori Shimada, Hiroyuki Daida, Muneaki Ishijima, Kazuo Kaneko, Shuko Nojiri, Ryuzo Kawamori, Hirotaka Watada","doi":"10.1002/crt2.24","DOIUrl":"10.1002/crt2.24","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Silent lacunar infarcts (SLIs) are often incidentally diagnosed by brain magnetic resonance imaging in elderly people and are associated with the future onset of stroke, dementia, and frailty. While decreased muscle strength was reported as a risk factor for stroke, it is still unclear whether it also predisposes to SLI. In this study, we investigated the association between muscle strength and SLI in elderly subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The subjects were 1536 elderly people aged 65–84 years without previous stroke events, living in an urban area of Tokyo, Japan, and recruited in the Bunkyo Health Study. Lacunar infarcts were defined by brain magnetic resonance imaging. Muscle strength of the knee extensors was measured using a dynamometer. After categorizing subjects by age and sex, we divided them into three groups based on muscle strength tertiles (High, Medium, and Low) and investigated the association between muscle strength and SLI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean subject age was 73.0 ± 5.4 years, and 58.9% were female. The prevalence of SLI was 16.4% and was inversely associated with muscle strength (High, 12.3%; Medium, 17.7%; and Low, 19.3%; <i>P</i> for trend 0.003). After multivariate adjustment, the odds ratio for SLI was increased in the Medium and Low groups compared with the High group (High, 1.00 [reference]; Medium, 1.42 [95% confidence interval: 0.98–2.04]; and Low: 1.48 [1.02–2.14]), and the linear trend across the three groups was significant (<i>P</i> for trend 0.043).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Reduced knee extensor muscle strength is associated with SLI among Japanese elderly, independently of other established risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 3","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2020-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.24","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45984788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Significance of fluid retention, body mass index, and weight loss in patients with advanced cancer","authors":"Koji Amano, Isseki Maeda, Hiroto Ishiki, Tomofumi Miura, Yutaka Hatano, Kiyofumi Oya, Akihiro Sakashita, Satoko Ito, Yusuke Hiratsuka, Tatsuya Morita, Masanori Mori","doi":"10.1002/crt2.23","DOIUrl":"10.1002/crt2.23","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Few studies have investigated the relationship between body mass index (BMI) and mortality or evaluated the prognostic validity of a grading system incorporating BMI and weight loss in Asian cancer patients. We conducted a study to investigate characteristics according to BMI and to confirm the prognostic validity of BMI and the grading system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study involved a secondary analysis of a prospective cohort study. Subjects were divided into six BMI groups and five grades according to the grading system. Characteristics were compared between the six groups. We conducted time-to-event analyses using the Kaplan–Meier method, log-rank test, and univariate and multivariate Cox regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1094 patients were classified into six BMI groups: <17 (<i>n</i> = 244), 17–18.4 (<i>n</i> = 211), 18.5–19.9 (<i>n</i> = 192), 20–21.9 (<i>n</i> = 196), 22–24.9 (<i>n</i> = 161), and 25 ≤ (<i>n</i> = 90). Regarding oedema, the prevalence increased with BMI, being 70% the 25 ≤ group. The prevalence of pleural effusion and ascites were the highest in the 25 ≤ group. Median survival ranged between 18 and 22 days in the six groups. No significant differences were observed in survival rates among the six BMI groups (log rank <i>P</i> = 0.83). No significant differences were observed in survival rates among the five grades (log rank <i>P</i> = 0.25).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of fluid retention is high in patients with advanced cancer. BMI and weight loss appear to lose their prognostic significance among them.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 3","pages":"69-78"},"PeriodicalIF":0.0,"publicationDate":"2020-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.23","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42418153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Higher disease activity and lower renal function in patients with rheumatoid arthritis are associated with loss of muscle mass: results from a long-term follow-up study","authors":"Shinichi Nogi, Atsushi Hashimoto, Shigeto Tohma, Toshihiro Matsui","doi":"10.1002/crt2.21","DOIUrl":"10.1002/crt2.21","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Muscle mass or strength is an important factor of activities of daily living in patients with rheumatoid arthritis (RA). However, there are few reports analysing the long-term change in muscle mass in these patients. The aim of this study was to examine the relationship of patient's background or disease activity of RA with change in muscle mass after 7 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Muscle mass was measured in 101 female patients with RA in 2010. Among them, 79 patients underwent remeasurements in 2017. We examined the relationship between muscle mass at baseline in 2010 or changes in muscle mass (i.e., the difference between 2010 and 2017 or the ratio of 2017 to 2010) and the patients' background, disease activity of RA, treatment, or renal function. Logistic regression analysis was used to explore the factors associated with loss of muscle mass. Muscle mass was evaluated by bioelectrical impedance analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline in 2010, the age (mean ± SD) of 101 patients was 62.6 ± 9.8 years. Muscle mass measurements in 2010 showed a significantly negative correlation with patient age (<i>r</i> = −0.361, <i>p</i> < 0.001), Modified Health Assessment Questionnaire (mHAQ) (<i>r</i> = −0.461, <i>p</i> < 0.001), and Disease Activity Score (DAS)28-CRP (<i>r</i> = −0.249, <i>p</i> = 0.013). Mean (±SD) muscle mass was not significantly different between 2010 (32.5 ± 3.4 kg) and 2017 (32.1 ± 3.8 kg). Changes in muscle mass (the difference or ratio) were negatively correlated with the mean value of DAS28-CRP for 7 years (<i>r</i> = −0.281, <i>p</i> = 0.012 or <i>r</i> = −0.298, <i>p</i> = 0.010, respectively) and positively correlated with the estimated glomerular filtration rate (eGFR). However, they were not correlated with the use of glucocorticoids, age, or mHAQ. Logistic regression analysis showed that a mean DAS28-CRP value for 7 years >2.6 (odds ratio (OR): 3.49; 95% confidence interval (CI): 1.2–11.1; <i>p</i> = 0.028) and eGFR≤80 in 2010 (OR: 3.42; 95% CI: 1.2–11.1; <i>p</i> = 0.030) was significantly associated with >5% loss of muscle mass after 7 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with higher disease activity of RA and lower renal function exhibited a tendency toward loss of muscle mass after 7 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 3","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2020-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.21","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43132258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Koji Amano, Yutaka Hatano, Yoshinobu Matsuda, Isseki Maeda, Hiroto Ishiki, Tomofumi Miura, Kengo Imai, Tetsuo Hori, Yosuke Matsuda, Hiromi Funaki, Kozue Suzuki, Masanori Mori, Tatsuya Morita, the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) investigator
{"title":"C-reactive protein, delirium, and other psychological symptoms among patients with advanced cancer","authors":"Koji Amano, Yutaka Hatano, Yoshinobu Matsuda, Isseki Maeda, Hiroto Ishiki, Tomofumi Miura, Kengo Imai, Tetsuo Hori, Yosuke Matsuda, Hiromi Funaki, Kozue Suzuki, Masanori Mori, Tatsuya Morita, the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) investigator","doi":"10.1002/crt2.12","DOIUrl":"10.1002/crt2.12","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It remains unclear whether a relationship exists between elevated C-reactive protein (CRP) levels and delirium. The primary aim was to investigate the relationship between CRP and delirium in advanced cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a multicenter prospective cohort study conducted in palliative care units. At baseline, the physicians diagnosed delirium. On the seventh day, they evaluated whether new delirium had occurred. Subjects were divided into four groups according to CRP levels. We assessed the associations between CRP levels and proportions of delirium. To evaluate the relationship between CRP and delirium, adjusted odd ratios (ORs) and 95% confidence intervals (CIs) were calculated in the logistic models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1896 patients, 1354 patients were eligible for analyses. We classified them into four groups: low (CRP < 1 mg/dl) (<i>n</i> = 170), moderate (1 ≤ CRP < 5 mg/dl) (<i>n</i> = 453), high (5 ≤ CRP < 10 mg/dl) (<i>n</i> = 334), and very high (10 mg/dl ≤ CRP) (<i>n</i> = 397). The incidence of delirium significantly increased with increasing CRP levels (<i>P</i> = 0.02). In model 1, significantly higher adjusted ORs than in the low CRP group were observed in the high CRP and very high CRP groups (1.63 [95% CI 1.06–2.50], <i>P</i> = 0.03; 1.72 [95% CI 1.13–2.62], <i>P</i> = 0.01, respectively). In model 2, a significantly higher adjusted OR than in the low CRP group was observed in the very high CRP group (1.61 [95% CI 1.05–2.45], <i>P</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Relationships existed between elevated CRP levels and delirium.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 2","pages":"42-51"},"PeriodicalIF":0.0,"publicationDate":"2020-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45211278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Takashi Abe, Ricardo B. Viana, Vickie Wong, Zachary W. Bell, Robert W. Spitz, Yujiro Yamada, Robert S. Thiebaud, Jeremy P. Loenneke
{"title":"The influence of training variables on lingual strength and swallowing in adults with and without dysphagia","authors":"Takashi Abe, Ricardo B. Viana, Vickie Wong, Zachary W. Bell, Robert W. Spitz, Yujiro Yamada, Robert S. Thiebaud, Jeremy P. Loenneke","doi":"10.1002/crt2.11","DOIUrl":"10.1002/crt2.11","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Swallowing disorders (dysphagia) occur in a large proportion of individuals over the age of 60. The improvement of tongue strength by resistance exercise is postulated to be directly related to lingual-palatal pressure generation and bolus propulsion into the pharynx during swallowing. To the best of our knowledge, however, there is no evidence-based discussion evaluating the strength training variables of the tongue for improving tongue strength maximally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To solve this problem, we reviewed the relationships between different resistance training variables (i.e. training period, intensity, duration of muscle contraction, volume, and frequency) and the change in muscle strength in the lingual muscle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our findings show that tongue strength training may improve anterior and posterior tongue strength in both healthy adults and patients with dysphagia. Anterior and posterior tongue strength gradually increased and did not reach a plateau after at least 8 weeks of training. Data for other variables were insufficient to draw clear conclusions. Available data suggest that a training intensity of 60–100% of maximum tongue strength, a contraction time of 2–3 s, a total number of 90–120 repetitions per day, and a training frequency of three times per week appears to result in an improvement in maximal isometric tongue elevation strength in adults with and without dysphagia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Future studies are warranted to better determine if there are dose–response relationships in tongue strength training in healthy adults and patients with dysphagia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 2","pages":"29-41"},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47747827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zachary L. Chaplow, Brian C. Focht, Alexander R. Lucas, Elizabeth Grainger, Christina Simpson, Jackie Buell, Ciaran M. Fairman, Jennifer M. Thomas-Ahner, Jessica Bowman, Victoria R. DeScenza, J. Paul Monk, Amir Mortazavi, Steven K. Clinton
{"title":"Effects of a lifestyle intervention on body composition in prostate cancer patients on androgen deprivation therapy","authors":"Zachary L. Chaplow, Brian C. Focht, Alexander R. Lucas, Elizabeth Grainger, Christina Simpson, Jackie Buell, Ciaran M. Fairman, Jennifer M. Thomas-Ahner, Jessica Bowman, Victoria R. DeScenza, J. Paul Monk, Amir Mortazavi, Steven K. Clinton","doi":"10.1002/crt2.13","DOIUrl":"10.1002/crt2.13","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Exercise and dietary (EX+D) interventions could represent an optimal treatment for attenuating or reversing adverse effects of androgen deprivation therapy (ADT) in prostate cancer (PCa) patients. The Individualized Diet and Exercise Adherence-Pilot (IDEA-P) trial compared the effects of an EX+D intervention relative to standard-of-care (SC) treatment among PCa patients undergoing ADT. The present study evaluated the effects of the EX+D intervention on body composition (BC) obtained via dual-energy X-ray absorptiometry (DXA) in a subsample of IDEA-P patients. A secondary objective was to explore the association of adiposity and lean mass with mobility performance and strength.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Complete DXA data were acquired from a subsample of 22 PCa patients (EX+D: <i>n</i> = 13; SC: <i>n</i> = 9) at baseline and 3 month follow-up. Intention-to-treat analysis included data from 30 participants (<i>M</i> age = 66.28; SD = 7.79) with baseline DXA assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Intention-to-treat analysis revealed EX+D resulted in significant improvements in fat mass (<i>P</i> = 0.022), per cent fat mass (<i>P</i> = 0.028), trunk fat mass (<i>P</i> = 0.017), fat mass/lean mass (<i>P</i> = 0.040), and per cent lean mass (<i>P</i> = 0.026) vs. SC. EX+D also resulted in more favourable changes in appendicular lean mass/body mass (<i>d</i> = 0.59). Select BC outcomes were also significantly correlated with mobility performance and strength (<i>P</i> < 0.05) at 3 month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings suggest the EX+D intervention resulted in superior preservation of lean tissue and improvement in adiposity relative to SC treatment. Results underscore the utility of implementing EX+D interventions for preserving muscle mass and reducing adiposity in PCa patients undergoing ADT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"5 2","pages":"52-60"},"PeriodicalIF":0.0,"publicationDate":"2020-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9432850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40344005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}