scholarly journals Evaluation of the mechanisms of sarcopenia in chronic inflammatory disease: protocol for a prospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amritpal Dhaliwal ◽  
Felicity R. Williams ◽  
Jonathan I. Quinlan ◽  
Sophie L. Allen ◽  
Carolyn Greig ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Inflammatory Disease ◽  
Prospective Cohort ◽  
Inflammatory Diseases ◽  
Chronic Inflammatory Disease ◽  
Assessment Model ◽  
Chronic Inflammatory Diseases ◽  
Link Type ◽  
Disease Specific

Abstract Background Several chronic inflammatory diseases co-exist with and accelerate sarcopenia (reduction in muscle strength, function and mass) and negatively impact on both morbidity and mortality. There is currently limited research on the extent of sarcopenia in such conditions, how to accurately assess it and whether there are generic or disease-specific mechanisms driving sarcopenia. Therefore, this study aims to identify potential mechanisms driving sarcopenia within chronic inflammatory disease via a multi-modal approach; in an attempt to help define potential interventions for future use. Methods This prospective cohort study will consist of a multi-modal assessment of sarcopenia and its underlying mechanisms. Recruitment will target three chronic inflammatory diseases: chronic liver disease (CLD) (n=50), with a subset of NAFLD (n=20), inflammatory bowel disease (IBD) (n=50) and rheumatoid arthritis (RA) (n=50) both before and after therapeutic intervention. In addition, 20 age and sex matched healthy individuals will be recruited for comparison. Participants will undergo 4 assessment visits at weeks 0, 2, 12 and 24. Visits will consist of the following assessments: blood tests, anthropometrics, functional assessment, quadriceps muscle imaging, actigraphy, quality of life questionnaires, food diary collection and muscle biopsy of the vastus lateralis (at weeks 2 and 24 only). In addition, stool and urine samples will be collected for future microbiome and metabolomics analysis. Discussion This is the first study to use a multi-modal assessment model to phenotype sarcopenia in these chronic inflammatory diseases. We hope to identify generic as well as disease-specific mechanisms driving sarcopenia. We appreciate that these cohorts do require separate standards of care treatments which limit comparison between groups. Ethics and dissemination The study is approved by the Health Research Authority - West Midlands Solihull Research Ethics Service Committee Authority (REC reference: 18/WM/0167). Recruitment commenced in January 2019 and will continue until July 2021. The study was halted in March 2020 and again in January 2021 with the COVID-19 pandemic. The findings will be disseminated through peer-reviewed publications and conference presentations. All data will be stored on a secure server. Trial registration ClinicalTrials.gov Identifier: NCT04734496

scholarly journals Impact of red and processed meat and fibre intake on treatment outcomes among patients with chronic inflammatory diseases: protocol for a prospective cohort study of prognostic factors and personalised medicine

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018166 ◽  
Author(s):  
Robin Christensen ◽  
Berit L Heitmann ◽  
Karina Winther Andersen ◽  
Ole Haagen Nielsen ◽  
Signe Bek Sørensen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Treatment Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Inflammatory Diseases ◽  
Personalised Medicine ◽  
Lifestyle Factors ◽  
Chronic Inflammatory Diseases

IntroductionChronic inflammatory diseases (CIDs) are frequently treated with biological medications, specifically tumour necrosis factor inhibitors (TNFi)). These medications inhibit the pro-inflammatory molecule TNF alpha, which has been strongly implicated in the aetiology of these diseases. Up to one-third of patients do not, however, respond to biologics, and lifestyle factors are assumed to affect treatment outcomes. Little is known about the effects of dietary lifestyle as a prognostic factor that may enable personalised medicine. The primary outcome of this multidisciplinary collaborative study will be to identify dietary lifestyle factors that support optimal treatment outcomes.Methods and analysisThis prospective cohort study will enrol 320 patients with CID who are prescribed a TNFi between June 2017 and March 2019. Included among the patients with CID will be patients with inflammatory bowel disease (Crohn’s disease and ulcerative colitis), rheumatic disorders (rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis), inflammatory skin diseases (psoriasis, hidradenitis suppurativa) and non-infectious uveitis. At baseline (pretreatment), patient characteristics will be assessed using patient-reported outcome measures, clinical assessments of disease activity, quality of life and lifestyle, in addition to registry data on comorbidity and concomitant medication(s). In accordance with current Danish standards, follow-up will be conducted 14–16 weeks after treatment initiation. For each disease, evaluation of successful treatment response will be based on established primary and secondary endpoints, including disease-specific core outcome sets. The major outcome of the analyses will be to detect variability in treatment effectiveness between patients with different lifestyle characteristics.Ethics and disseminationThe principle goal of this project is to improve the quality of life of patients suffering from CID by providing evidence to support dietary and other lifestyle recommendations that may improve clinical outcomes. The study is approved by the Ethics Committee (S-20160124) and the Danish Data Protecting Agency (2008-58-035). Study findings will be disseminated through peer-reviewed journals, patient associations and presentations at international conferences.Trial registration numberNCT03173144; Pre-results.

Inter-observer reliability of a risk assessment model for venous thromboembolism in acutely-ill medical hospitalized patients: Results from a prospective cohort study

2021 ◽  
pp. 026835552110212
Author(s):  
Cassia RL Ferreira ◽  
Marcos de Bastos ◽  
Mirella L Diniz ◽  
Renan A Mancini ◽  
Yan S Raposo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Risk Classification ◽  
Assessment Model ◽  
Kappa Statistics ◽  
Medical Patients ◽  
Observer Reliability

Objectives To analyze the inter-observer reliability of risk for venous thromboembolism (VTE) in a population of adult acutely-ill medical patients. Methods In this prospective cohort study, we collected risk factors and risk classification for VTE using RAM IMPROVE7. Kappa statistics was used to evaluate inter-observer reliability between lead clinicians and trained researchers. We evaluated occurrence of VTE in patients with mismatched classification. Results We included 2,380 patients, median age 70 years (interquartile range [IQR], 58-79), 56.2% female. Adjusted Kappa for VTE risk factors ranged from substantial (0.64, 95% confidence interval [CI], 0.61-0.67) for “immobilization”, to almost perfect (0.98; 95% CI 0.97-0.99) for “thrombophilia”; risk classification was 0.64 (95% CI 0.60-0.67). Divergent risk classification occurred in 434 patients (18.2%) of whom seven (1.6%) developed VTE. Conclusion Despite substantial to almost perfect reliability between observers for risk factors and risk classification, lead clinicians tended to underestimate the risk for VTE.

scholarly journals The Biological Efficacy of Natural Products against Acute and Chronic Inflammatory Diseases in the Oral Region

Medicines ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. 122 ◽  
Author(s):  
Toshiaki Ara ◽  
Sachie Nakatani ◽  
Kenji Kobata ◽  
Norio Sogawa ◽  
Chiharu Sogawa
Keyword(s):  
Natural Products ◽  
Inflammatory Disease ◽  
Alveolar Bone ◽  
Inflammatory Diseases ◽  
Herbal Medicines ◽  
Chronic Inflammatory Disease ◽  
Chronic Inflammatory Diseases ◽  
Oral Region ◽  
Biological Efficacy ◽  
Clinical Conditions

The oral inflammatory diseases are divided into two types: acute and chronic inflammatory diseases. In this review, we summarize the biological efficacy of herbal medicine, natural products, and their active ingredients against acute and chronic inflammatory diseases in the oral region, especially stomatitis and periodontitis. We review the effects of herbal medicines and a biscoclaurin alkaloid preparation, cepharamthin, as a therapy against stomatitis, an acute inflammatory disease. We also summarize the effects of herbal medicines and natural products against periodontitis, a chronic inflammatory disease, and one of its clinical conditions, alveolar bone resorption. Recent studies show that several herbal medicines such as kakkonto and ninjinto reduce LPS-induced PGE 2 production by human gingival fibroblasts. Among herbs constituting these herbal medicines, shokyo (Zingiberis Rhizoma) and kankyo (Zingiberis Processum Rhizoma) strongly reduce PGE 2 production. Moreover, anti-osteoclast activity has been observed in some natural products with anti-inflammatory effects used against rheumatoid arthritis such as carotenoids, flavonoids, limonoids, and polyphenols. These herbal medicines and natural products could be useful for treating oral inflammatory diseases.

scholarly journals Impact of red meat, processed meat and fibre intake on risk of late-onset chronic inflammatory diseases: prospective cohort study on lifestyle factors using the Danish ‘Diet, Cancer and Health’ cohort (PROCID-DCH):protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024555 ◽  
Author(s):  
Nathalie Fogh Rasmussen ◽  
Katrine Hass Rubin ◽  
Maria Stougaard ◽  
Anne Tjønneland ◽  
Egon Stenager ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cohort Study ◽  
Prospective Cohort ◽  
Disease Risk ◽  
Late Onset ◽  
Inflammatory Diseases ◽  
Red Meat ◽  
Processed Meat ◽  
Chronic Inflammatory Diseases

IntroductionChronic inflammatory diseases (CIDs) (Crohn’s disease, ulcerative colitis, psoriasis, psoriatic arthritis, rheumatoid arthritis and multiple sclerosis) are diseases of the immune system that have some shared genetic and environmental predisposing factors, but still few studies have investigated the effects of lifestyle on disease risk of several CIDs. The primary aim of this prospective cohort study is to investigate the impact of fibre, red meat and processed meat on risk of late-onset CID, with the perspective that results of this study can contribute in supporting future diet recommendations for effective personalised prevention.Methods and analysisThe study will use data from 57 053 persons from the prospective Danish cohort study ‘Diet, Cancer and Health’ together with National Health Registry data. The follow-up period is from December 1993 to December 2018. Questionnaire data on diet and lifestyle were collected at entry to the Diet, Cancer and Health study. The outcome CID is defined as having a diagnosis of one of the CIDs registered in the National Patient Registry or, for multiple sclerosis, in the Danish Multiple Sclerosis Registry during follow-up and being treated with a drug used for the specific disease. The major outcome of the analyses will be to detect variability in risk of late onset of any CID and, if power allows, disease risk of late onset of each CID diagnosis between persons with different fibre and red meat, and processed meat intake. The outcome will be adjusted for age, sex, body mass index, physical activity, energy, alcohol, fermented dairy products, education, smoking status, hormone replacement therapy and comorbidity.Ethics and disseminationThe study is approved by the Danish Data Protection Agency (2012-58-0018). The core study is an open register-based cohort study. The study does not need approval from the Ethics committee or Institutional Review Board by Danish law. Study findings will be disseminated through peer-reviewed journals, patient associations and presentations at international conferences.Trial registration numberNCT03456206; Post-results.

scholarly journals Biomarkers for length of hospital stay, changes in muscle mass, strength and physical function in older medical patients: protocol for the Copenhagen PROTECT study—a prospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042786
Author(s):  
Rikke S Kamper ◽  
Martin Schultz ◽  
Sofie K Hansen ◽  
Helle Andersen ◽  
Anette Ekmann ◽  
...  
Keyword(s):  
Body Composition ◽  
Cohort Study ◽  
Muscle Strength ◽  
Physical Function ◽  
Muscle Mass ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Medical Patients ◽  
Link Type ◽  
Protect Study

IntroductionSarcopenia is generally used to describe the age-related loss of muscle mass and strength believed to play a major role in the pathogenesis of physical frailty and functional impairment that may occur with old age. The knowledge surrounding the prevalence and determinants of sarcopenia in older medical patients is scarce, and it is unknown whether specific biomarkers can predict physical deconditioning during hospitalisation. We hypothesise that a combination of clinical, functional and circulating biomarkers can serve as a risk stratification tool and can (i) identify older acutely ill medical patients at risk of prolonged hospital stays and (ii) predict changes in muscle mass, muscle strength and function during hospitalisation.Method and analysisThe Copenhagen PROTECT study is a prospective cohort study consisting of acutely ill older medical patients admitted to the acute medical ward at Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark. Assessments are performed within 24 hours of admission and include blood samples, body composition, muscle strength, physical function and questionnaires. A subgroup of patients transferred to the Geriatric Department are included in a smaller geriatric cohort and have additional assessments at discharge to evaluate the relative change in circulating biomarker concentrations, body composition, muscle strength and physical function during hospitalisation. Enrolment commenced 4 November 2019, and proceeds until August 2021.Ethics and disseminationThe study protocol has been approved by the local ethics committee of Copenhagen and Frederiksberg (H-19039214) and the Danish Data Protection Agency (P-2019-239) and all experimental procedures were performed in accordance with the Declaration of Helsinki. Findings from the project, regardless of the outcome, will be published in relevant peer-reviewed scientific journals in online (www.clinicaltrials.gov).Trial registration numberNCT04151108

scholarly journals A prospective cohort study of self-reported computerised medical history taking for acute chest pain: protocol of the CLEOS-Chest Pain Danderyd Study (CLEOS-CPDS)

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031871
Author(s):  
Helge Brandberg ◽  
Thomas Kahan ◽  
Jonas Spaak ◽  
Kay Sundberg ◽  
Sabine Koch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Chest Pain ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Acute Chest Pain ◽  
Risk Scores ◽  
History Taking ◽  
Link Type ◽  
Medical Histories ◽  
The Impact

IntroductionManagement of acute chest pain focuses on diagnosis or safe rule-out of an acute coronary syndrome (ACS). We aim to determine the additional value of self-reported computerised history taking (CHT).Methods and analysisProspective cohort study design with self-reported, medical histories collected by a CHT programme (Clinical Expert Operating System, CLEOS) using a tablet. Women and men presenting with acute chest pain to the emergency department at Danderyd University Hospital (Stockholm, Sweden) are eligible. CHT will be compared with standard history taking for completeness of data required to calculate ACS risk scores such as History, ECG, Age, Risk factors and Troponin (HEART), Global Registry of Acute Coronary Events (GRACE), and Thrombolysis in Myocardial Infarction (TIMI). Clinical outcomes will be extracted from hospital electronic health records and national registries. The CLEOS-Chest Pain Danderyd Study project includes (1) a feasibility study of CHT, (2) a validation study of CHT as compared with standard history taking, (3) a paired diagnostic accuracy study using data from CHT and established risk scores, (4) a clinical utility study to evaluate the impact of CHT on the management of chest pain and the use of resources, and (5) data mining, aiming to generate an improved risk score for ACS. Primary outcomes will be analysed after 1000 patients, but to allow for subgroup analysis, the study intends to recruit 2000 or more patients. This ongoing project may lead to new and more effective ways for collecting thorough, accurate medical histories with important implications for clinical practice.Ethics and disseminationThis study has been reviewed and approved by the Stockholm Regional Ethical Committee (now Swedish Ethical Review Authority). Results will be published, regardless of the outcome, in peer-reviewed international scientific journals.Trial registration numberThis study is registered athttps://www.clinicaltrials.gov(unique identifier:NCT03439449).

scholarly journals Editorial Expression of Concern: Exposure to Magnetic Field Non-Ionizing Radiation and the Risk of Miscarriage: A Prospective Cohort Study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
De-Kun Li ◽  
Hong Chen ◽  
Jeannette R. Ferber ◽  
Roxana Odouli ◽  
Charles Quesenberry
Keyword(s):  
Magnetic Field ◽  
Cohort Study ◽  
Ionizing Radiation ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Link Type

Editor's Note: an editorial expression of Concern for this article has been published and is available at 10.1038/s41598-021-85479-w

scholarly journals End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kevin Ki-Wai Ho ◽  
Lawrence Chun-Man Lau ◽  
Wai-Wang Chau ◽  
Queena Poon ◽  
Kwong-Yin Chung ◽  
...  
Keyword(s):  
Cohort Study ◽  
Muscle Strength ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Knee Arthroplasty ◽  
Prospective Cohort ◽  
Secondary Outcome ◽  
Link Type ◽  
End Stage

Abstract Background Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a one-year post-operative period. Methods This prospective cohort study was conducted between 2015 to 2018 at our hospital. Patients with end-stage OA of the knee waiting for TKA were recruited into the study. Primary outcome measures were change in muscle strength, mass and function. Secondary outcome measures were quality of life (QOL) measurements for pain, psychological and physical health. Results Fifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects was comparable (67.89 ± 7.07 vs. 67.92 ± 6.85; p = 0.99), but sarcopenic subjects had a lower body mass index (BMI) (25.64 ± 2.64 vs. 28.57 ± 4.04; p = 0.01). There was a statistically significant improvement in walking speed (10.24 ± 5.35 vs. 7.69 ± 2.68, p < 0.01) and muscle strength in both sarcopenic and non-sarcopenic patients after TKA. This was accompanied by an improvement trend in muscle mass in all subjects. There was no change in handgrip power before and after TKA and subsequent follow-up (19.31 ± 5.92 vs. 18.98 ± 6.37 vs. 19.36 ± 7.66; p = 0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27 ± 15.98 vs. 20.65 ± 15.24 vs. 16.65 ± 18.13) and SF12v2 (PCS: 33.06 ± 8.55 vs. 38.96 ± 8.01 vs. 40.67 ± 7.93) revealed progressive significant improvement (both comparisons p ≤ 0.01). Further analysis with the IPAQ also found increased engagement of high-intensity activities. Conclusions This study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon, but both sarcopenic and non-sarcopenic OA patients achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects. Trial registration Registry: ClinicalTrials.gov, Registration number: NCT03579329. Date of registration: 6 July 2018. Retrospectively registered.

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