RESUMO
Intensive Care Unit-acquired weakness (ICU-AW) is a common complication that significantly impedes patient recovery. In the study, we investigated the correlation between early serum myoglobin levels in patients with septic shock due to pneumonia, and the incidence of ICU-AW, duration of mechanical ventilation, and prognosis. Patients were classified based on the development of ICU-AW within the first 10 days of ICU admission. We measured serum myoglobin levels upon ICU entry, and analyzed demographic data, APACHE II scores, use of mechanical ventilation, and clinical outcomes, including mortality and duration of mechanical ventilation. The results indicated significantly elevated serum myoglobin levels in the ICU-AW group, correlated with prolonged mechanical ventilation and increased mortality. ROC analysis revealed myoglobin as a promising biomarker for predicting ICU-AW, with an area under the curve of 0.843 (95% CI: 0.819~0.867), demonstrating a sensitivity of 76.00% and specificity of 82.30%. These findings underscored serum myoglobin as a predictive biomarker for early ICU-AW in septic shock patients, highlighting its potential to guide clinical decision-making.
Assuntos
Biomarcadores , Unidades de Terapia Intensiva , Debilidade Muscular , Mioglobina , Choque Séptico , Feminino , Humanos , Masculino , APACHE , Biomarcadores/sangue , Incidência , Debilidade Muscular/sangue , Mioglobina/sangue , Prognóstico , Respiração Artificial , Curva ROC , Choque Séptico/sangueRESUMO
AIM: Intrahepatic cholestasis of pregnancy (ICP) is considered a high-risk condition because it may have serious consequences for the fetus health. ICP is characterized by the accumulation of bile acids in maternal serum which contribute to an imbalance between the production of reactive oxygen species and the antioxidant defenses increasing the oxidative stress experienced by the fetus. Previously, it was reported a significant decrease in plasma coenzyme Q10 (CoQ10) in women with ICP. CoQ10 is a redox substance integrated in the mitochondrial respiratory chain and is recognized as a potent antioxidant playing an intrinsic role against oxidative damage. The objective of the present study was to investigate the levels of CoQ10 in umbilical cord blood during normal pregnancy and in those complicated with ICP, all of them compared to the maternal ones. METHODS: CoQ10 levels and bile acid levels in maternal and umbilical cord blood levels during normal pregnancies (n=23) and in those complicated with ICP (n=13), were investigated. RESULTS: A significant decrease in neonate CoQ10 levels corrected by cholesterol (0.105±0.010 vs. 0.069±0.011, P<0.05, normal pregnancy vs. ICP, respectively), together with an increase of total serum bile acids (2.10±0.02 vs. 7.60±2.30, P<0.05, normal pregnancy vs. ICP, respectively) was observed. CONCLUSIONS: A fetus from an ICP mother is exposed to a greater risk derived from oxidative damage. The recognition of CoQ10 deficiency is important since it could be the starting point for a new and safe intervention strategy which can establish CoQ10 as a promising candidate to prevent the risk of oxidative stress.
Assuntos
Ataxia/sangue , Ácidos e Sais Biliares/sangue , Colestase Intra-Hepática/sangue , Sangue Fetal/química , Doenças Mitocondriais/sangue , Debilidade Muscular/sangue , Complicações na Gravidez/sangue , Ubiquinona/análogos & derivados , Ubiquinona/deficiência , Adulto , Ataxia/diagnóstico , Biomarcadores/sangue , Peso ao Nascer , Colesterol/sangue , Ácido Cólico/sangue , Estudos Transversais , Feminino , Feto/metabolismo , Idade Gestacional , Humanos , Recém-Nascido , Doenças Mitocondriais/diagnóstico , Debilidade Muscular/diagnóstico , Oxirredução , Estresse Oxidativo , Gravidez , Estudos Prospectivos , Espécies Reativas de Oxigênio/metabolismo , Ubiquinona/sangue , Adulto JovemRESUMO
OBJECTIVES: The aim of this study was to investigate the frequency of frailty and the association of vitamin D levels and the frailty phenotype among non-geriatric dialysis patients. METHOD: Seventy-four stable, chronic hemodialysis patients from the hemodialysis unit of the hospital were enrolled in the study. The patients' medical histories and laboratory findings were obtained from the medical records of the dialysis unit. Serum parathyroid hormone and 25-hydroxy vitamin D levels were determined using chemiluminometric immunoassays. Frailty was defined by Fried et al. as a phenotype; shrinking, weakness, self-reported exhaustion, decreased activity and slowed walking speed were evaluated. RESULTS: Forty-one (55%) of the patients were males. The patients were divided into 3 groups according to frailty scores: 39 (53%) patients were frail, 6 (8%) patients were intermediately frail, and 28 (39%) patients were normal. Significant differences were found for 25-hydroxy vitamin D and hemoglobin levels among the groups; however, no differences were observed in body mass index, comorbidities, sex, marital status, education, disease and dialysis durations, or parathyroid hormone, creatinine, serum calcium, phosphorus, and potassium levels. CONCLUSIONS: Weakness and slowness are serious outcomes of both vitamin D deficiency and frailty, and vitamin D deficiency has been associated with increased risks of decreased physical activity, falls, fractures and death in postmenopausal women and older men. Although studies on frailty have focused on older adults, growing evidence indicates that the frailty phenotype is becoming a factor associated with poor health outcomes in non-geriatric populations with chronic disease.
Assuntos
Fragilidade/sangue , Fenótipo , Diálise Renal/estatística & dados numéricos , Vitamina D/sangue , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Disparidades nos Níveis de Saúde , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/sangue , Hormônio Paratireóideo/sangue , Insuficiência Renal Crônica/sangue , Vitamina D/análogos & derivados , Adulto JovemRESUMO
OBJECTIVES: The aim of this study was to investigate the frequency of frailty and the association of vitamin D levels and the frailty phenotype among non-geriatric dialysis patients. METHOD: Seventy-four stable, chronic hemodialysis patients from the hemodialysis unit of the hospital were enrolled in the study. The patients' medical histories and laboratory findings were obtained from the medical records of the dialysis unit. Serum parathyroid hormone and 25-hydroxy vitamin D levels were determined using chemiluminometric immunoassays. Frailty was defined by Fried et al. as a phenotype; shrinking, weakness, self-reported exhaustion, decreased activity and slowed walking speed were evaluated. RESULTS: Forty-one (55%) of the patients were males. The patients were divided into 3 groups according to frailty scores: 39 (53%) patients were frail, 6 (8%) patients were intermediately frail, and 28 (39%) patients were normal. Significant differences were found for 25-hydroxy vitamin D and hemoglobin levels among the groups; however, no differences were observed in body mass index, comorbidities, sex, marital status, education, disease and dialysis durations, or parathyroid hormone, creatinine, serum calcium, phosphorus, and potassium levels. CONCLUSIONS: Weakness and slowness are serious outcomes of both vitamin D deficiency and frailty, and vitamin D deficiency has been associated with increased risks of decreased physical activity, falls, fractures and death in postmenopausal women and older men. Although studies on frailty have focused on older adults, growing evidence indicates that the frailty phenotype is becoming a factor associated with poor health outcomes in non-geriatric populations with chronic disease.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Fenótipo , Vitamina D/sangue , Diálise Renal/estatística & dados numéricos , Fragilidade/sangue , Hormônio Paratireóideo/sangue , Vitamina D/análogos & derivados , Hemoglobinas/análise , Estudos Transversais , Debilidade Muscular/sangue , Disparidades nos Níveis de Saúde , Insuficiência Renal Crônica/sangueRESUMO
BACKGROUND: Muscle weakness and 25-hydroxyvitamin D (25(OH)D) deficiency have been associated with adverse outcomes among older adults. However, little is known about the relationship between clinically relevant muscle weakness and 25(OH)D levels in Ecuador. AIMS: To examine the prevalence of muscle weakness and its association with 25(OH)D status among subjects aged 60 years and older in Ecuador. METHODS: The present study was based on data from 2205 participants in the first National Survey of Health, Wellbeing, and Aging. The Foundation for the National Institute of Health Sarcopenia Project criteria was used to examine muscle weakness prevalence rates. Gender-specific general linear and logistic regression models adjusted for potential confounders were created to compare mean 25(OH)D concentrations and 25(OH)D deficiency across muscle strength categories, respectively. RESULTS: An estimated 32.2% of women and 33.4% of men had evidence of clinically relevant muscle weakness in Ecuador. In general, increased muscle weakness prevalence rates were present among Indigenous, residents in the rural Andes Mountains, underweight subjects, and those with a sedentary lifestyle. Muscle strength was significantly and directly correlated with mean 25(OH)D levels. After controlling for potential confounders, 25(OH)D deficiency prevalence rates were 31 and 43% higher among men and women with muscle weakness than those with normal strength, respectively. CONCLUSIONS: One-third of older adults nationwide had evidence of muscle weakness. While the present study found a significant correlation between muscle strength and 25(OH)D concentrations, further research is needed to examine whether optimizing 25(OH)D levels may improve muscle weakness among older adults.
Assuntos
Força Muscular/fisiologia , Debilidade Muscular/epidemiologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Equador/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/sangue , Debilidade Muscular/complicações , Prevalência , População Rural , Distribuição por Sexo , Vitamina D/sangue , Deficiência de Vitamina D/complicações , VitaminasRESUMO
The aim of this study was to investigate the association between systemic inflammatory mediators and peripheral muscle mass and strength in COPD patients. Fifty-five patients (69% male; age: 64±9 years) with mild/very severe COPD (defined as forced expiratory volume in the first second [FEV1] =54%±23%) were evaluated. We evaluated serum concentrations of IL-8, CRP, and TNF-α. Peripheral muscle mass was evaluated by computerized tomography (CT); midthigh cross-sectional muscle area (MTCSA) and midarm cross-sectional muscle area (MACSA) were obtained. Quadriceps, triceps, and biceps strength were assessed through the determination of the one-repetition maximum. The multiple regression results, adjusted for age, sex, and FEV1%, showed positive significant association between MTCSA and leg extension (0.35 [0.16, 0.55]; P=0.001), between MACSA and triceps pulley (0.45 [0.31, 0.58]; P=0.001), and between MACSA and biceps curl (0.34 [0.22, 0.47]; P=0.001). Plasma TNF-α was negatively associated with leg extension (-3.09 [-5.99, -0.18]; P=0.04) and triceps pulley (-1.31 [-2.35, -0.28]; P=0.01), while plasma CRP presented negative association with biceps curl (-0.06 [-0.11, -0.01]; P=0.02). Our results showed negative association between peripheral muscle mass (evaluated by CT) and muscle strength and that systemic inflammation has a negative influence in the strength of specific groups of muscles in individuals with stable COPD. This is the first study showing association between systemic inflammatory markers and strength in upper limb muscles.
Assuntos
Proteína C-Reativa/análise , Mediadores da Inflamação/sangue , Força Muscular , Debilidade Muscular/etiologia , Músculo Esquelético , Doença Pulmonar Obstrutiva Crônica/complicações , Sarcopenia/etiologia , Fator de Necrose Tumoral alfa/sangue , Idoso , Biomarcadores/sangue , Feminino , Volume Expiratório Forçado , Humanos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/sangue , Debilidade Muscular/diagnóstico , Debilidade Muscular/fisiopatologia , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiopatologia , Estado Nutricional , Tamanho do Órgão , Doença Pulmonar Obstrutiva Crônica/sangue , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Músculo Quadríceps/fisiopatologia , Sarcopenia/sangue , Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Capacidade VitalRESUMO
Coenzyme Q10 (CoQ10) is an important cofactor in the mitochondrial respiratory chain and a potent endogenous antioxidant. CoQ10 deficiency is often associated with numerous diseases, and patients can benefit from CoQ10 supplementation, being more effective when diagnosed and treated early. Due to the increased interest in CoQ10 deficiency, several methods for CoQ10 analysis from plasmatic, muscular, fibroblast, and platelet matrices have been developed. These sampling techniques are not only highly invasive but also too traumatic for periodic clinical monitoring. In the present work, we describe the development and validation of a novel non-invasive sampling method for quantification of CoQ10 in buccal mucosa cells (BMCs) by microHPLC. This method is suitable for using in a routine laboratory and useful for sampling patients in pediatry. CoQ10 correlation was demonstrated between BMCs and plasma levels (Spearman r, 0.4540; p < 0.001). The proposed method is amenable to be applied in the post treatment monitoring, especially in pediatric patients as a non-invasive sample collection. More studies are needed to assess whether this determination could be used for diagnosis and if this matrix could replace the traditional ones.
Assuntos
Ataxia/diagnóstico , Cromatografia Líquida de Alta Pressão/métodos , Doenças Mitocondriais/diagnóstico , Mucosa Bucal/citologia , Debilidade Muscular/diagnóstico , Ubiquinona/análogos & derivados , Ubiquinona/deficiência , Adulto , Ataxia/sangue , Criança , Humanos , Limite de Detecção , Doenças Mitocondriais/sangue , Debilidade Muscular/sangue , Ubiquinona/análise , Ubiquinona/sangueRESUMO
BACKGROUND: Vitamin D insufficiency is common in elderly adults, and leads to secondary hyperparathyroidism, bone loss, muscle weakness, and osteoporotic fractures. OBJECTIVE: To evaluate the relation between vitamin D nutritional status and muscle function and muscle strength in women aged over 65 years. METHODS: Fifty-four postmenopausal women from Buenos Aires (latitude 34° S), average age (X±DS) 71±4, were included in the study. Determinations of serum calcium, phosphate, 25 hydroxyvitamin D (25OHD), intact parathormone (iPTH) and calciuria / creatininuria ratio in 24-hour urine samples were performed. Muscle function was assessed by means of walking-speed test, standing balance, and sit-to-stand tests. Lower extremity muscle strength was determined using a manual dynamometer. RESULTS: 25OHD levels ≥20 ng/ml were found to be associated with better lower extremity muscle function and strength. Forty- six % of participants had 25OHD levels ≥20 ng/ml. Women with 25OHD levels ≥20 ng/ml scored higher on the muscle function tests (11.2±0.9 vs.10.0±2.1; p<0.003) and had stronger knee extensor (13.4±2.7 vs.11.6±2.5 Kg.; p<0.03) and hip abductor (8.3±2.7 vs. 7.3±3.1 Kg; p<0.04) muscles; strength of their hip flexors tended to be higher but did not reach significantly different values (17.0±3.3 vs. 15.4±2.8 Kg.; 0.1>p>0.05). Negative correlation was observed between iPTH and muscle function (r= -0.436; p<0.02). CONCLUSION: 25OHD levels ≥20 ng/ml are needed for a better muscle function and strength. Assessing vitamin D nutritional status in adults aged ≥ 65 years would allow correcting hypovitaminosis D and improve muscle function and strength.
Assuntos
Extremidade Inferior/fisiologia , Força Muscular/fisiologia , Debilidade Muscular/prevenção & controle , Músculo Esquelético/fisiologia , Estado Nutricional , Deficiência de Vitamina D/fisiopatologia , Vitamina D/análogos & derivados , Idoso , Feminino , Avaliação Geriátrica , Humanos , Movimento , Debilidade Muscular/sangue , Músculo Esquelético/fisiopatologia , Hormônio Paratireóideo/sangue , Aptidão Física , Pós-Menopausa , Equilíbrio Postural , Prevalência , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , CaminhadaRESUMO
Se informa sobre doce miembros de una familia colombiana con esta rara enfermedad.El objeto es un paciente de 19 anos, quien presentaba debilidad muscular generalizada luego de exposicion al frio y a ejercicio intenso. Ocho miembros de la familia fueron estudiados directamente por el autor.Las caracteristicas clinicas fueron fascies inexpresiva, hipertrofia gemelar, debilidad muscular proximal, rigidez de las manos luego de exposicion al agua fria y paralisis generalizada con o sin exposicion al frio. Se describen asi mismo, las pruebas diagnosticas, la biopsia muscular y el tratamiento