Objective. Muscle quality has received considerable attention within the literature due to its influence on health and performance. However, it has been assessed by various measures (e.g. ultrasound imaging, normalized strength), contributing to a lack of a consensus definition. The purpose of this study was to investigate the association between common muscle quality measures vastus lateralis echo intensity (EI) and peak torque (PT) and power (PP) normalized to thigh lean mass (TLM) and thigh fat mass (TFM).Approach. https://www.selleckchem.com/products/WP1130.html Participants' (n = 39; age = 32.7 ± 8.2 years; %BF = 24.1% ±8.1%) whole body and leg composition was assessed via dual-energy x-ray absorptiometry and custom thigh analyses. Subcutaneous fat-corrected muscle EI was assessed via ultrasonography. Maximal PT and PP of the dominant leg extensors were examined on a calibrated dynamometer and were normalized to both TLM and TFM, respectively. Pearson product-moment correlations were used to examine the associations between EI and PT/TLM, PT/TFM, PP/TLM, and PP/TFM.Main results. Greater muscle EI was significantly related with lower PT/TFM and PP/TFM (r = -0.74 to -0.70,P less then 0.001), but unrelated to PT/TLM or PP/TLM (P ≥ 0.205).Significance. These findings suggest that ultrasound imaging (muscle EI) and normalized strength and power may not be used interchangeably to define muscle quality, and muscle EI may be more sensitive to the adiposity of the limb than TLM. Future research should consider using separate and consistent definitions when referring to imaging-derived or normalized strength and power values of muscle quality.Objective. The aim of this study was to investigate methods for measuring the cardiac efficiency (CE) and internal work (IW) of the left ventricle via reconstructed impedance cardiography (RICG).Approach.On the basis of the physiological context and Bernoulli's equation in physics, methods of measuring the CE and IW were proposed. The CE, IW, internal work index (IWI), and other data from 180 healthy adults and 144 patients with cardiovascular disease were measured.Main results. The CE of 180 healthy adults was 22.5 ± 2.2%, and the IWI was 22.3 ± 5.2 J l-1m-2. CE decreased with age, and the CE of the younger group (23.5 ± 1.9%) was larger than that of the older group (21.5 ± 1.9%),P less then 0.01. The IWI increased with age, and the IWI of the younger group (19.0 ± 3.8 J l-1m-2) was smaller than that of the older group (24.8 ± 4.3 J l-1m-2),P less then 0.01. There were no significant difference in CE (22.4 ± 2.2% and 22.6 ± 2.2%) or in the IWI (21.9 ± 5.1 J l-1m-2and 22.6 ± 5.2 J l-1m-2) between the male and female groups. The CEs and IWIs of patients with hypertension, coronary heart disease, and heart failure were 17.4 ± 2.4% and 41.8 ± 15.6 J l-1m-2, 17.6 ± 3.0% and 35.1 ± 10.4 J l-1m-2, and 15.8 ± 3.5% and 42.1 ± 15.6 J l-1m-2, respectively. These CEs were all smaller than that (21.6 ± 2.0%) of the healthy contrast groupP less then 0.01, while the IWIs were all larger than that (24.6 ± 4.8 J l-1m-2) of the healthy contrast group,P less then 0.01.Significance.The CEs and IWIs measured in this study may reflect physiological changes in healthy humans and pathogenic conditions in patients with cardiovascular disease.
Middle meningeal artery (MMA) embolization is a promising treatment strategy for chronic subdural hematomas (cSDHs). However, studies comparing MMA embolization and conventional therapy (surgical intervention and conservative management) are limited. The authors aimed to compare MMA embolization versus conventional therapy for cSDHs using a propensity-adjusted analysis.
A retrospective study of all patients with cSDH who presented to a large tertiary center over a 2-year period was performed. MMA embolization was compared with surgical intervention and conservative management. Neurological outcome was assessed using the modified Rankin Scale (mRS). A propensity-adjusted analysis compared MMA embolization versus surgery and conservative management for all individual cSDHs. Primary outcomes included change in hematoma diameter, treatment failure, and complete resolution at last follow-up.
A total of 231 patients with cSDH met the inclusion criteria. Of these, 35 (15%) were treated using MMA embolization, a greater extent of hematoma volume reduction with fewer treatment failures than conventional therapy.
This propensity-adjusted analysis suggests that MMA embolization for cSDH is associated with a greater extent of hematoma volume reduction with fewer treatment failures than conventional therapy.
Endovascular thrombectomy (EVT) and tissue plasminogen activator (tPA) are effective ischemic stroke treatments in the initial treatment window. In the extended treatment window, these treatments may offer benefit, but CT and MR perfusion may be necessary to determine patient eligibility. Many hospitals do not have access to advanced imaging tools or EVT capability, and further patient care would require transfer to a facility with these capabilities. To assist transfer decisions, the authors developed risk indices that could identify patients eligible for extended-window EVT or tPA.
The authors retrospectively identified stroke patients who had concurrent CTA and perfusion and evaluated three potential outcomes that would suggest a benefit from patient transfer. The first outcome was large-vessel occlusion (LVO) and target mismatch (TM) in patients 5-23 hours from last known normal (LKN). The second outcome was TM in patients 5-15 hours from LKN with known LVO. The third outcome was TM in patients 4.5-12in patients with confirmed LVO or a less stringent tissue mismatch (TM < 1.2) cutoff. Larger patient registries should be used to validate and improve the predictive ability of these models.
Despite the limited sample size, compared with perfusion-based examinations, the clinical variables identified in this study accurately predicted which stroke patients would have salvageable penumbra (C statistic 71%-86%) in a range of clinical scenarios and treatment cutoffs. This prediction improved (C statistic 85%-86%) when utilized in patients with confirmed LVO or a less stringent tissue mismatch (TM less then 1.2) cutoff. Larger patient registries should be used to validate and improve the predictive ability of these models.
Objective. Muscle quality has received considerable attention within the literature due to its influence on health and performance. However, it has been assessed by various measures (e.g. ultrasound imaging, normalized strength), contributing to a lack of a consensus definition. The purpose of this study was to investigate the association between common muscle quality measures vastus lateralis echo intensity (EI) and peak torque (PT) and power (PP) normalized to thigh lean mass (TLM) and thigh fat mass (TFM).Approach. https://www.selleckchem.com/products/WP1130.html Participants' (n = 39; age = 32.7 ± 8.2 years; %BF = 24.1% ±8.1%) whole body and leg composition was assessed via dual-energy x-ray absorptiometry and custom thigh analyses. Subcutaneous fat-corrected muscle EI was assessed via ultrasonography. Maximal PT and PP of the dominant leg extensors were examined on a calibrated dynamometer and were normalized to both TLM and TFM, respectively. Pearson product-moment correlations were used to examine the associations between EI and PT/TLM, PT/TFM, PP/TLM, and PP/TFM.Main results. Greater muscle EI was significantly related with lower PT/TFM and PP/TFM (r = -0.74 to -0.70,P less then 0.001), but unrelated to PT/TLM or PP/TLM (P ≥ 0.205).Significance. These findings suggest that ultrasound imaging (muscle EI) and normalized strength and power may not be used interchangeably to define muscle quality, and muscle EI may be more sensitive to the adiposity of the limb than TLM. Future research should consider using separate and consistent definitions when referring to imaging-derived or normalized strength and power values of muscle quality.Objective. The aim of this study was to investigate methods for measuring the cardiac efficiency (CE) and internal work (IW) of the left ventricle via reconstructed impedance cardiography (RICG).Approach.On the basis of the physiological context and Bernoulli's equation in physics, methods of measuring the CE and IW were proposed. The CE, IW, internal work index (IWI), and other data from 180 healthy adults and 144 patients with cardiovascular disease were measured.Main results. The CE of 180 healthy adults was 22.5 ± 2.2%, and the IWI was 22.3 ± 5.2 J l-1m-2. CE decreased with age, and the CE of the younger group (23.5 ± 1.9%) was larger than that of the older group (21.5 ± 1.9%),P less then 0.01. The IWI increased with age, and the IWI of the younger group (19.0 ± 3.8 J l-1m-2) was smaller than that of the older group (24.8 ± 4.3 J l-1m-2),P less then 0.01. There were no significant difference in CE (22.4 ± 2.2% and 22.6 ± 2.2%) or in the IWI (21.9 ± 5.1 J l-1m-2and 22.6 ± 5.2 J l-1m-2) between the male and female groups. The CEs and IWIs of patients with hypertension, coronary heart disease, and heart failure were 17.4 ± 2.4% and 41.8 ± 15.6 J l-1m-2, 17.6 ± 3.0% and 35.1 ± 10.4 J l-1m-2, and 15.8 ± 3.5% and 42.1 ± 15.6 J l-1m-2, respectively. These CEs were all smaller than that (21.6 ± 2.0%) of the healthy contrast groupP less then 0.01, while the IWIs were all larger than that (24.6 ± 4.8 J l-1m-2) of the healthy contrast group,P less then 0.01.Significance.The CEs and IWIs measured in this study may reflect physiological changes in healthy humans and pathogenic conditions in patients with cardiovascular disease.
Middle meningeal artery (MMA) embolization is a promising treatment strategy for chronic subdural hematomas (cSDHs). However, studies comparing MMA embolization and conventional therapy (surgical intervention and conservative management) are limited. The authors aimed to compare MMA embolization versus conventional therapy for cSDHs using a propensity-adjusted analysis.
A retrospective study of all patients with cSDH who presented to a large tertiary center over a 2-year period was performed. MMA embolization was compared with surgical intervention and conservative management. Neurological outcome was assessed using the modified Rankin Scale (mRS). A propensity-adjusted analysis compared MMA embolization versus surgery and conservative management for all individual cSDHs. Primary outcomes included change in hematoma diameter, treatment failure, and complete resolution at last follow-up.
A total of 231 patients with cSDH met the inclusion criteria. Of these, 35 (15%) were treated using MMA embolization, a greater extent of hematoma volume reduction with fewer treatment failures than conventional therapy.
This propensity-adjusted analysis suggests that MMA embolization for cSDH is associated with a greater extent of hematoma volume reduction with fewer treatment failures than conventional therapy.
Endovascular thrombectomy (EVT) and tissue plasminogen activator (tPA) are effective ischemic stroke treatments in the initial treatment window. In the extended treatment window, these treatments may offer benefit, but CT and MR perfusion may be necessary to determine patient eligibility. Many hospitals do not have access to advanced imaging tools or EVT capability, and further patient care would require transfer to a facility with these capabilities. To assist transfer decisions, the authors developed risk indices that could identify patients eligible for extended-window EVT or tPA.
The authors retrospectively identified stroke patients who had concurrent CTA and perfusion and evaluated three potential outcomes that would suggest a benefit from patient transfer. The first outcome was large-vessel occlusion (LVO) and target mismatch (TM) in patients 5-23 hours from last known normal (LKN). The second outcome was TM in patients 5-15 hours from LKN with known LVO. The third outcome was TM in patients 4.5-12in patients with confirmed LVO or a less stringent tissue mismatch (TM < 1.2) cutoff. Larger patient registries should be used to validate and improve the predictive ability of these models.
Despite the limited sample size, compared with perfusion-based examinations, the clinical variables identified in this study accurately predicted which stroke patients would have salvageable penumbra (C statistic 71%-86%) in a range of clinical scenarios and treatment cutoffs. This prediction improved (C statistic 85%-86%) when utilized in patients with confirmed LVO or a less stringent tissue mismatch (TM less then 1.2) cutoff. Larger patient registries should be used to validate and improve the predictive ability of these models.
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