Weak psoas and spine extensors potentially predispose to hip fracture

2020 ◽  
pp. 112070002090433
Author(s):  
Keong-Hwan Kim ◽  
Jun Hee Lee ◽  
Eic Ju Lim

Introduction: We performed a computed tomography analysis of muscle composition characteristics in hip fracture patients and non-hip fracture controls. Methods: In total, 43 patients (9 men, 34 women) were included in the hip fracture group, matched 1 to 1 with non-hip fracture controls. Muscle cross-sectional areas were measured in axial CT scan at the body level of the 4th lumbar vertebra (L4), intervertebral disc level between the 5th lumbar vertebra and the 1st sacral vertebra (L5-S1) and just below level of the lesser trochanter (LT). Attenuation was also evaluated through the mean Hounsfield unit (HU) in these areas. Results: The cross-sectional area per weight (CSA/Wt, mm2/kg) of psoas muscle and extensor muscles of the spine showed a significant difference between the 2 groups at both L4 (9.7 vs. 12.4, p  < 0.001 and 26.3 vs. 29.2, p  = 0.025) and L5-S1 (9.6 vs. 11.5, p  = 0.001 and 8.8 vs. 10.3, p  = 0.041) levels. In addition, the HU of these muscles differed significantly between the 2 groups at both L4 (33.3 vs. 47.6, p  < 0.001 and 13.7 vs. 30.2, p  < 0.001) and L5-S1 (39.7 vs. 52.6, p  < 0.001 and 3.8 vs. 15.1, p  = 0.012) levels. There was no difference in abdominal wall, gluteal, or thigh compartment musculature between the groups. Conclusions: Poorer quantity and quality of psoas muscle and extensor muscles of the spine rather than whole body muscles may contribute to falls and were characteristic features of the hip fracture patients in this series. These findings should be considered when recommending a preventive exercise and rehabilitation protocol.

2018 ◽  
Vol 1 (2) ◽  
pp. 114
Author(s):  
Wahdaniah Wahdaniah ◽  
Sri Tumpuk

Abstract: Routine blood examination is the earliest blood test or screening test to determine the diagnosis of an abnormality. Blood easily froze if it is outside the body and can be prevented by the addition of anticoagulants, one of which Ethylene Diamine Tetra Acetate (EDTA). Currently available vacuum tubes containing EDTA anticoagulants in the form of K2EDTA and K3EDTA. K3EDTA is usually a salt that has better stability than other EDTA salts because it shows a pH approaching a blood pH of about 6.4. The purpose of this research is to know the difference of erythrocyte index results include MCH, MCV and MCHC using K3EDTA anticoagulant with K2EDTA. This research is a cross sectional design. This study used venous blood samples mixed with K2EDTA anticoagulant and venous blood mixed with K3EDTA anticoagulants, each of 30 samples. Data were collected and analyzed using paired different test. Based on data analysis that has been done on MCH examination, p value <0,05 then there is a significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value. Then on the examination of MCV and MCHC obtained p value <0.05 then there is no significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value.Abstrak: Pemeriksaan darah rutin merupakan pemeriksaan darah yang paling awal atau screening test untuk mengetahui diagnosis suatu kelainan. Darah mudah membeku jika berada diluar tubuh dan bisa dicegah dengan penambahan antikoagulan, salah satunya Ethylene Diamine Tetra Acetate (EDTA). Dewasa ini telah tersedia tabung vakum yang sudah berisi antikoagulan EDTA dalam bentuk  K2EDTA dan  K3EDTA. K3EDTA  biasanya berupa garam yang mempunyai stabilitas yang lebih baik dari garam EDTA yang lain karena menunjukkan pH yang mendekati pH darah yaitu sekitar 6,4. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan hasil indeks eritrosit meliputi MCH, MCV dan MCHC menggunakan antikoagulan K3EDTA dengan K2EDTA. Penelitian ini merupakan penelitian dengan desain cross sectional. Penelitian ini menggunakan sampel darah vena yang dicampur dengan antikoagulan K2EDTA dan darah vena yang dicampur dengan antikoagulan K3EDTA, masing-masing sebanyak 30 sampel. Data dikumpulkan dan dianalisis menggunakan uji beda berpasangan. Berdasarkan analisis data yang telah dilakukan pada pemeriksaan MCH didapatkan nilai p < 0,05 maka ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit. Kemudian pada pemeriksaan MCV dan MCHC didapatkan nilai p < 0,05 maka tidak ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit.


2021 ◽  
Vol 17 (3) ◽  
pp. 422-430
Author(s):  
Federico Massini ◽  
Lars Ebert ◽  
Garyfalia Ampanozi ◽  
Sabine Franckenberg ◽  
Lena Benz ◽  
...  

AbstractEvidence acquisition, interpretation and preservation are essential parts of forensic case work that make a standardized documentation process fundamental. The most commonly used method for the documentation and interpretation of superficial wounds is a combination of two modalities: two-dimensional (2D) photography for evidence preservation and real-life examination for wound analysis. As technologies continue to develop, 2D photography is being enhanced with three-dimensional (3D) documentation technology. In our study, we compared the real-life examination of superficial wounds using four different technical documentation and visualization methods.To test the different methods, a mannequin was equipped with several injury stickers, and then the different methods were applied. A total of 42 artificial injury stickers were documented in regard to orientation, form, color, size, wound borders, wound corners and suspected mechanism of injury for the injury mechanism. As the gold standard, superficial wounds were visually examined by two board-certified forensic pathologists directly on the mannequin. These results were compared to an examination using standard 2D forensic photography; 2D photography using the multicamera system Botscan©, which included predefined viewing positions all around the body; and 3D photogrammetric reconstruction based on images visualized both on screen and in a virtual reality (VR) using a head-mounted display (HMD).The results of the gold standard examination showed that the two forensic pathologists had an inter-reader agreement ranging from 69% for the orientation and 11% for the size of the wounds. A substantial portion of the direct visual documentation showed only a partial overlap, especially for the items of size and color, thereby prohibiting the statistical comparison of these two items. A forest plot analysis of the remaining six items showed no significant difference between the methods. We found that among the forensic pathologists, there was high variability regarding the vocabulary used for the description of wound morphology, which complicated the exact comparison of the two documentations of the same wound.There were no significant differences for any of the four methods compared to the gold standard, thereby challenging the role of real-life examination and 2D photography as the most reliable documentation approaches. Further studies with real injuries are necessary to support our evaluation that technical examination methods involving multicamera systems and 3D visualization for whole-body examination might be a valid alternative in future forensic documentation.


2021 ◽  
Vol 100 (5) ◽  
pp. 203-208
Author(s):  
Sh.K. Salikhov ◽  
◽  
D.Z. Alieva ◽  
U.A. Magomedova ◽  
S.О. Abdulkadyrova ◽  
...  

The aim of the study is to determine the role of geochemical factors (the content of Mg, K, Ca, Zn, Pb in soils and natural waters of the plain zone of Dagestan) in the prevalence of essential arterial hypertension (EAH) among the population of children. Materials and methods of research: an observational cross-sectional (one-step) study of the prevalence of EAH in the child population was carried out. The prevalence rates of EAH among children in the plain zone of the Republic of Dagestan are calculated for 100,000 children 0–17 years old, without taking into account gender differences. The content of elements (Mg, K, Ca, Zn, Pb) in the environment (soil, natural waters) was determined by atomic absorption spectroscopy. Results: one-way analysis of variance (One-Way ANOVA) of indicators of the content of metals (Mg, K, Ca, Zn, Pb) in the regions and objects (soils, natural waters) of the study revealed a statistically significant difference in the data (for soils: F=81,06772, p<0,0002; for natural waters: F=58,86451, p<0,00001). The dependence of children's EAH on the content of chemical elements in the objects of the biosphere of Dagestan was determined, which was expressed in an increase in the number of patients with EAH when Pb content exceeded (r=+ 0,576, r=+ 0,759) and with the decrease of Mg (r=–0,668, r=–0,173), K (r=–0,440, r=–0,636), Ca (r=–0,693, r=–0,533), Zn (r=–0,051, r=–0,827) in soils and natural waters. Conclusion: when assessing the pathogenesis of EAH in the population of children, the content of Mg, K, Ca, Zn, Pb in soil and water should be taken into account, since these microelements, entering the body with water and food, affect the elemental status of child's body.


2021 ◽  
Vol 8 (3) ◽  
pp. 147-152
Author(s):  
Mosmi Lomi ◽  
Jonathan Daniel M

Determining gender is one of the most important procedure in forensics. Teeth are made of the most enduring mineralized tissues in the body, as such, they have an extraordinary resistance to putrefaction and the effects of external agents (physical, thermal, mechanical, chemical or biological) which makes them invaluable material for anthropological, genetic, odontologic and forensic examinations.i)To assess the degree of sexual dimorphism in maxillary canine using maxillary canine index, maxillary first molar and central incisor using mesiodistal (MD) and buccolingual/buccopalatal (BL) dimensions of the crown. ii) To determine the accuracy of maxillary canine index, first molar and central incisor dimensions (mesiodistal and buccolingual/buccopalatal) in determining sex.This study consisted of total 30 participants (males=15, females=15) of age group ranging from 20 to 35 yrs. Measurement of dimensions of selected teeth were performed on maxillary cast using digital Vernier caliper, resolution 0.01mm. Data thus obtained were analyzed statistically.The mean values of all the measurements in males were greater than females. There was statistical significant difference in mean value of bucco-lingual width of molar, mesiodistal width of canine (on left side, right side and average) and the inter-canine distance between males and females. The buccolingual width of molar showed the highest % of sexual dimorphism (5.33%) and the mesiodistal width of molar showed the least % of dimorphism (0.7%). Bucco-lingual width of molar posed the highest prediction accuracy for gender determination. We conclude that buccolingual width of maxillary first molar can be used to predict the gender when only teeth of maxillary arch are available for forensic examination.


2021 ◽  
Author(s):  
Shima Salehi ◽  
Rozita Hosseini Shamsabadi ◽  
Hassan Otukesh ◽  
Reza Shiari ◽  
Monir Sharafi

Abstract Background: Lupus is an inflammatory and autoimmune disease that involves various tissues and organs of the body. Identification of diagnostic elements to rapid identification of seronegative lupus cases is very important in order to prevent morbidity and progression of disease. This study aimed to compare clinical and laboratory findings of seropositive cases with seronegative lupus patients. Methods: This cross-sectional analytic study was performed on 43 children (17 seronegative and 26 seropositive) with lupus who were admitted to Ali Asghar Hospital during 2007-2017. Seropositive patients had anti-nuclear antibody (ANA) titration >1/80, while seronegative patients had ANA titration <1/80 (at the time of disease diagnosis). Clinical and laboratory findings were compared between two groups.Results: Serositis in patients with ANA- was significantly higher than ANA+ (41.17% vs. 23.07%; p = 0.042). ANA- group had higher autoimmune disease history than ANA+ group (42.85% vs. 15.0%; p = 0.041). The family history of the disease in the ANA- group was greater than ANA+ group (50% vs. 23.52%). The percentage of hypertensive patients in ANA- group was higher than ANA+ group (52.94% vs. 26.92%; p = 0.037). Neurologic symptoms in ANA+ and ANA- groups were 38.46% and 17.64%, respectively (p = 0.043). The frequency of patients with thrombocytopenia in ANA+ group was significantly greater than ANA- group (32% vs. 12.5%; p=0.041). There was no significant difference in other clinical and laboratory findings between two groups. Conclusion: Seronegative lupus patients had higher percentage of musculoskeletal symptoms, autoimmune disease history, familial history of disease, and hypertension, while neurological and thrombocytopenia symptoms were higher in seropositive patients compared to seronegative cases. Therefore, evaluation of these factors can be helpful to diagnosis of seronegative patients.


Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5629
Author(s):  
Yusuke Sugino ◽  
Takeshi Sasaki ◽  
Manabu Kato ◽  
Satoru Masui ◽  
Kouhei Nishikawa ◽  
...  

Radical cystectomy (RC) is the standard treatment for patients with advanced bladder cancer. Since RC is a highly invasive procedure, the surgical indications in an aging society must be carefully judged. In recent years, the concept of “frailty” has been attracting attention as a term used to describe fragility due to aging. We focused on the psoas muscle Hounsfield unit (PMHU) and analyzed its appropriateness as a prognostic factor together with other clinical factors in patients after RC. We retrospectively analyzed the preoperative prognostic factors in 177 patients with bladder cancer who underwent RC between 2008 and 2020. Preoperative non-contrast computed tomography axial image at the third lumbar vertebral level was used to measure the mean Hounsfield unit (HU) and cross-sectional area (mm2) of the psoas muscle. Univariate analysis showed significant differences in age, sex, clinical T stage, and PMHU. In multivariate analysis using the Cox proportional hazards model, age (hazard ratio (HR) = 1.734), sex (HR = 2.116), cT stage (HR = 1.665), and PMHU (HR = 1.758) were significant predictors for overall survival. Furthermore, using these four predictors, it was possible to stratify the prognosis of patients after RC. Finally, PMHU was useful as a simple and significant preoperative factor that correlated with prognosis after RC.


2021 ◽  
Vol 3 (2) ◽  
pp. 105-108
Author(s):  
Jamshid Ayatollahi ◽  
◽  
Abolhasan Halvani ◽  
Mohammadhesam Gharaei Khezri ◽  
Hossein Shahcheraghi ◽  
...  

Introduction: Tuberculosis infection caused by Mycobacterium tuberculosis is one of the most common infectious diseases, especially in countries such as Iran. The course of treatment and the number of drugs used vary depending on the severity of the disease and the parts of the body involved. The resistant tuberculosis to treatment has increased in recent years. Thus, this study was conducted to investigate the frequency distribution of response to treatment of patients with tuberculosis in Sirjan, Iran. Methods: This descriptive cross-sectional study investigated all patients with tuberculosis in Sirjan city who had referred to health centers during the years 2011-2019. The data collection tool was a pre-prepared checklist that included information on age, sex, sputum smear results, sputum culture results, diabetes, patients' nationality, drug side effects, and response to treatment. Finally, data was entered into SPSS version 22, and analyzed. Results: In this study, the overall response rate was 83% and the mortality rate was 10%. Between the frequency distribution of response to treatment in terms of gender, age, sputum smear results, sputum culture results, patients' nationality and diabetes was not statistically significant difference. Also, no statistically significant difference was found between the frequency distribution of pulmonary TB treatment response in terms of drug allergy, drug hepatitis and other drug side effects. Conclusion: According to results, can be concluded that none of the variables: age, sex, smear and culture result, and history of diabetes have no an effect on response to treatment and mortality of tuberculosis.


2021 ◽  
Vol 8 (04) ◽  
pp. 204-207
Author(s):  
Shreyansh Talera ◽  
Saurabh Singhal ◽  
Nishant Wadhera ◽  
Mayank Arora ◽  
Ravi Pratap

BACKGROUND WHO has declared Coronavirus disease 2019 (Covid-19) as a pandemic. Covid-19 leads to sickness and death. Human serum albumin (HSA) is the most common circulating protein in the body having oncotic as well as non-oncotic properties. The role of albumin in death among Covid-19 subjects, especially in this part of the country has not been frequently reported. The aim of the study was to analyse the role of serum albumin level as prognostic marker for Covid-19 positive patients. METHODS The present study was conducted in the department of Medicine at Chhatrapati Shivaji Subharti Hospital, Subharti Medical College, Meerut, UP. The study comprised of 100 subjects who were Covid positive from May 2020 to July 2020. A detailed explanation was given to all the participating respondents regarding the study and their contribution to it. Covid-19 was diagnosed on the basis of the WHO interim guidelines. A questionnaire was prepared to collect the patients’ demographic profile. Patients date of admission and discharge was recorded along with the outcome i.e., whether patient expired or survived. Patients’ diagnosis was identified along with the comorbidity (if present). Laboratory investigations comprised of CBC and serum albumin detection. Data so collected was tabulated in an excel sheet, under the guidance of statistician. Collected data was analysed using Statistical Package for the Social Sciences (SPSS) software version 24 and the tests used were t test and Fisher’s exact test and the level of significance was set at p < 0.05. RESULTS The study comprised of 100 subjects, out of which 45 were males and 55 were females. The overall mean age of the study subjects was 37.52 years. In our study, mortality was 35.29 %, 9.33 % and 85.7 % of the subjects having Covid-19+ type 2 diabetes (T2DM), only Covid-19 and Covid-19+ hypertension respectively with statistically significant difference as p < 0.05. Albumin level was significantly lower in expired patients (2.99) as compared to survivors (3.85) as p < 0.05. Hospital stay was also higher in expired patients. CONCLUSIONS Covid-19 patients had low serum albumin levels and that might play a role in the survival of patient. KEYWORDS Covid-19, Mortality, Albumin


2020 ◽  
Author(s):  
Sung Yoon Jung ◽  
Hyeon Jun Kim ◽  
Kyu Taek Oh

Abstract Background:This study assessed the changes in hip muscles by comparing the preoperative and postoperative CT scan results between patients with intertrochanteric versus femoral neck fractures. Methods:48 patients who received surgical treatment for intertrochanteric or femoral neck fractures from February 2013 to February 2019 and underwent pelvic computed tomography(CT) preoperative and postoperatively aged 65 and older with a minimum follow-up of 1 year were included. The subjects were divided into two groups: 26 patients with intertrochanteric fracture and 22 patients with femoral neck fracture. We measured the cross-sectional area(CSA) and attenuation of the gluteus medius(G.med), gluteus minimus(G.min), iliopsoas(IP), and rectus femoris(RF) on the contralateral side. Patient basic data were collected from medial records including sex, age, height, weight, BMI, BMD, Harris hip score (HHS), and length of follow-up until the final visit. Results: There was no significant difference in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up until the final visit between two groups. The femoral neck fracture group had significantly larger CSA and cross-sectional area per weight(CSA/Wt) of the G.med and G.min(G.med CSA, CSA/wt preoperative 1995.29 vs 1713.64, 38.87 vs 32.74; postoperative 2144.98 vs 1815.56, 37.48 vs 32.78/G.min preoperative 745.22 vs 566.59, 14.32 vs 10.96; postoperative 764.39 vs 619.17, 14.78 vs 11.25). On the contrary, the intertrochanteric fracture group had significantly greater CSA and CSA/Wt of the IP and RF(IP preoperative 810.86 vs 661.88, 17.73 vs 9.42; postoperative 681.98 vs 571.32, 12.68 vs 9.88/RF preoperative 503.66 vs 386.72, 9.42 vs 7.23; postoperative 426.24 vs 349.31, 7.17 vs 5.23). HHS related with function had no significant correlation with postoperative CSA and CSA/Wt. There was no significant difference in attenuation between two groups. All subjects had a significant decrease of muscle attenuation postoperatively.Conclusions: The CSA of the hip abductor(G.med and G.min) was significantly larger in the femoral neck fracture group, while the CSA of the hip flexor(IP and RF) was significantly higher in the intertrochanteric fracture group. Based on these findings, choosing the rehabilitation program suitable for the fracture site is expected to be beneficial in hip fracture rehabilitation.


2020 ◽  
Vol 8 (1) ◽  
pp. 51
Author(s):  
La Mani ◽  
Siti Fatimah-Muis ◽  
Apoina Kartini

Background: Stunted overweight is associated with mild chronic inflammation. The state of inflammation will increase the expression of hepcidin, which affects the iron status of the body, besides the intake of protein, iron, and vitamin C.Objective: To analyze the correlation of hepcidin levels and food intake (protein, iron, vitamin C) with serum transferrin receptors (sTfR) and hemoglobin in stunted overweight adolescents.Method: The design of research was cross-sectional. The subjects were 64 adolescents stunted overweight aged 15-18 years in four high/vocational schools in the Banyumanik District, Semarang City. Measurement the level of hepcidin and sTfR was using the ELISA method and haemoglobin was using Cyanomethemoglobin method. Data on protein, iron, vitamin C intake was using the SQ-FFQ method. Bivariate analysis was using Pearson and Spearman correlation test then followed by multiple linear regression analysis.Results: The result showed that 89.1% subjects had adequate intake of protein, 54.7% subjects had low intake of vitamin C, 76.6% subjects had low intake of iron. Hepcidin levels in all subjects were 100% normal. There were 7.8% subjects with a low sTfR and 7.8% with a low haemoglobin level. Statistic test showed there was correlation between hepcidin with haemoglobin and sTfR (p1 = 0,010 r1 = -0,319, p2 = 0,001, r2 = 0,569). From food intake, only intake iron was correlated with haemoglobin but not with sTfR. There was significant difference between the mean of haemoglobin and sTfR among girls and boys. Further analysis, showed that only hepcidin was a weak negative determinant for sTfR (R2 = 0,120). The determinant factors for haemoglobin were gender (p=0,001) and hepcidin (p =0,004) with the value of R2 = 0,577.Conclusion: Hepcidin correlated with sTfR and haemoglobin while iron intake only correlated with hemoglobin.


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