ELECTROMYOGRAPHY (EMG): A BIO-MEDICAL TECHNIQUE USED FOR ACQUIRING DATA DURING MASTICATION OF FOOD

The main objective of this study was to understand the technique of Electromyography. In this technique activities of muscles were governed on the basis of generated my electrical signals. Electromyography instrumentation consists of data acquisition unit, Universal interface module, Connector, adaptor and software. Various parameters like chew number, mastication time, total burst duration, total muscle activity, burst duration, inter burst duration, cycle time, muscle activity and amplitude were used for analyzing the data acquired during mastication of food at entire mastication, per chew and at three different stages (early, middle and late) of mastication.

The Association of Serum Circulating Neuropeptide Q and Chemerin Levels with Cardiometabolic Risk Factors among Patients with Metabolic Syndrome

The potential involvement of neuropeptide Q (NPQ) and chemerin (CHEM) in metabolic disorders is yet to be fully elucidated. The aim of this study was to evaluate serum concentrations of NPQ and CHEM and to establish their relationship with cardiometabolic risk factors among individuals with metabolic syndrome. A total of 66 patients with metabolic syndrome (MetS) and 83 healthy volunteers (non-MetS) underwent biochemical, blood pressure, and anthropometric measurements. The concentration of NPQ in the MetS group was significantly lower (0.47 (0.34 ; 0.54) vs. 0.52 (0.43 ; 0.60) ng/mL, p = 0.015) than in non-MetS, while there were no differences in CHEM level. In the entire study population, we observed several negative correlations between NPQ concentration and waist-hip ratio (WHR), visceral adipose tissue, diastolic blood pressure (DBP), triglycerides (TG) along with a positive correlation with high-density lipoprotein (HDL), total muscle mass, and CHEM. Moreover, a negative correlation was observed in the MetS group between NPQ and glycemia. CHEM showed no significant correlations with cardiometabolic risk factors in the study population. In a multiple regression model, the total muscle mass proved to be an independent factor determining NPQ concentration in the population (p < 0.00000001, R2adj = 28.6%). NPQ seems to protect against metabolic disorders correlated with obesity. Thus, it is worth considering NPQ level as a candidate protective biomarker of metabolic syndrome complications.

Comparison of Muscle Mass, Total Body Water and Total Body Protein in Type II Diabetics with Healthy Matched Adults by Bioelectrical Impedance Analysis

Background: Bioelectrical impedance analysis (BIA) is a new and rapid technique to validate body composition. Several studies have used this technique to evaluate body compositions, such as muscle mass, in diabetic patients, but the results are very different. This may due the differences between diabetic patients and control group. Therefore, this study aimed to compare the muscle mass of diabetic patients with healthy matched adults using the BIA method. Methods: This descriptive cross-sectional study was conducted on 928 diabetic patients and 928 healthy individuals selected based on gender, age, height, weight, and closeness to demographic conditions. Body composition was measured by the BIA technique. Total body water, muscle mass in the trunk, legs, hands, and total body protein were measured by this method. The data were analyzed using t-test, paired t-test, and one-way ANOVA methods. Results: Diabetic women aged 50-60 years showed that their body weight, total protein, total muscle, right-hand muscle mass, left-hand muscle mass, right foot muscle mass, left foot muscle mass, and trunk muscle mass were higher than healthy matched women, and the differences were significant. Conclusion: Diabetic women aged 50-60 years showed the most significant difference compared to other age groups. It seems that diabetes along with the changes in humeral status in this age group due to menopause affected their body weight, total muscle mass, hand and leg muscles, and trunk muscles mass, and total body protein compared to healthy matched women. However, diabetic men showed no significant difference in the studied variables compared to healthy male subjects.

Salvage of Infected Cardiac Implantable Electrical Devices with Subpectoral Plane Pocket Revision

Introduction Infection of cardiac implantable electrical devices (CIEDs) may lead to serious complications. Complete CIED explantation is expensive, requires expertise, not free from complications, and may not be an option in patients with device dependence. Aim To highlight that carefully selected infected CIEDs can be salvaged by placing the device in a subpectoral pocket below the pectoralis major muscle. We conducted a retrospective descriptive observational study. Material and Methods Twelve patients (10 male and two female) with erosion, exposure or infection of infraclavicular, subcutaneously placed CIED were treated over a 30-month period between July 2018 and December 2020. The technique involved debridement and excision of a peridevice capsule, creating a subpectoral pocket beneath the pectoralis major muscle, and placing the CIED in a new pocket with total muscle coverage and closure of skin without tension. Results Twelve patients (m = 10; f = 2) with a mean age of 65 years (range, 46–82 years) presented with infection of CIED within 9 months of implantation. None had sepsis or endocarditis. In nine patients, CIEDs were successfully salvaged with relocation to subpectoral pocket. Mean follow-up was 20 months (range, 8–30 months). Three out of 12 developed reinfection that ultimately required CIED explantation. There was no mortality. Conclusion In the absence of sepsis or endocarditis, infected CIEDs may be attempted at salvage by subpectoral pocket placement. This obviates the need for potentially risky explantation or replacement of expensive CIEDs.

Associations Between Lipoprotein Subfractions and Area and Density of Abdominal Muscle and Intermuscular Adipose Tissue: The Multi-Ethnic Study of Atherosclerosis

Skeletal muscle quantity and quality decrease with older age, which is partly attributed to ectopic fat infiltration and has negative metabolic consequences. To inform efforts to preserve skeletal muscle with aging, a better understanding of biologic correlates of quantity and quality of muscle and intermuscular adipose tissue (IMAT) is needed. We used targeted lipidomics of lipoprotein subfractions among 947 Multi-Ethnic Study of Atherosclerosis participants to provide a detailed metabolic characterization of area and density of abdominal muscle and IMAT. Serum lipoprotein subfractions were measured at the first visit using 1H-Nuclear Magnetic Resonance spectroscopy. Muscle and IMAT area (cm2) and density (Hounsfield units) were estimated at visit 2 or 3 using computed tomography of the total abdominal, locomotion (psoas), and stabilization (paraspinal, oblique, rectus abdominis) muscles. We identified lipoprotein subfractions associated with body composition using linear regression adjusting for demographics, lifestyle, and multiple comparisons. Among 105 lipoprotein subfractions, 24 were associated with total muscle area (absolute standardized regression coefficient range: 0.07–0.10, p-values ≤ 0.002), whereas none were associated with total muscle density. When examining muscle subgroups, 25 lipoprotein subfractions were associated with stabilization muscle area, with associations strongest among the obliques. For total IMAT area, there were 27 significant associations with lipoprotein subfractions (absolute standardized regression coefficient range: 0.09–0.13, p-values ≤ 0.002). Specifically, 27 lipoprotein subfractions were associated with stabilization IMAT area, with associations strongest among the oblique and rectus abdominis muscles. For total IMAT density, there were 39 significant associations with lipoprotein subfractions (absolute standardized regression coefficient range: 0.10–0.19, p-values ≤ 0.003). Specifically, 28 and 33 lipoprotein subfractions were associated with IMAT density of locomotion and stabilization (statistically driven by obliques) muscles, respectively. Higher VLDL (cholesterol, unesterified cholesterol, phospholipids, triglycerides, and apolipoprotein B) and lower HDL (cholesterol and unesterified cholesterol) were associated with higher muscle area, higher IMAT area, and lower IMAT density. Several associations between lipoprotein subfractions and abdominal muscle area and IMAT area and density were strongest among the stabilization muscles, particularly the obliques, illustrating the importance of examining muscle groups separately. Future work is needed to determine whether the observed associations indicate a lipoprotein profile contributing to worse skeletal muscle with fat infiltration.

Soft-tissue vibration and damping response to footwear changes across a wide range of anthropometrics in running

Different factors were shown to alter the vibration characteristics of soft-tissue compartments during running. Changing pre-heel strike muscle activation or changing footwear conditions represents two possibilities to influence the vibration response via frequency shift or altered damping. Associated with the study of muscle pre-tuning is the difficulty in quantifying clean experimental data for the acceleration of soft-tissue compartments and muscle activities in heterogeneous populations. The purpose of this study was to determine the vibration and pre-tuning response to footwear across a wide range of participants during running and establish and describe groups formed according to the damping coefficient. 32 subjects were used for further analysis. The subjects ran at a self-selected speed (5 min) on a treadmill in two different shoes (soft & hard), while soft-tissue accelerations and muscle activation at the gastrocnemius medialis were quantified. Damping coefficients, total muscle intensity and dominant vibration frequencies were determined. Anthropometrics and skinfold measurements of the lower limbs were obtained. According to the damping coefficient response to the footwear intervention, three groups were formed, with most runners (n = 20) showing less damping in the hard shoe. Total muscle intensity, anthropometrics, and dominant vibration frequency across footwear were not different for these three groups. Most runners (84.4%) used the strategy of adjusting the damping coefficients significantly when switching footwear. Despite damping being the preferred adjustment to changes in footwear, muscle pre-tuning might not be the only mechanism to influence damping as previously suggested. Future studies should focus on the subject-specific composition of soft-tissue compartments to elucidate their contribution to vibrations.

Strength normalized to muscle volume rather than body weight is more accurate for assessing knee strength following anterior cruciate ligament reconstruction

BACKGROUND: Knee strength weakness is a major problem frequently observed in patients during postoperative rehabilitation following anterior cruciate ligament reconstruction (ACLR). OBJECTIVE: To investigate whether knee strength normalized to muscle volume could better detect side-to-side differences than that normalized to body weight following ACLR. METHOD: This study included 17 patients who had undergone primary ACLR (11.6 ± 2.3 months). Body weight and total muscle volume were measured using a bioelectrical impedance analysis composition scale. Isokinetic knee extension and flexion moment were measured at 60∘/s and 180∘/s, respectively. Bivariate correlation analysis was used to examine correlations between body composition and knee strength. Differences in knee strength between the operated and unoperated legs were analyzed using a paired t-test, which calculated the effect size. RESULTS: There was a significant correlation between knee strength and body weight (r= 0.53–0.67); however, a stronger correlation was observed between knee strength and total muscle volume (ρ= 0.80–0.87). The effect size was larger for knee strength expressed as % total muscle volume than for knee strength expressed as % body weight. CONCLUSION: Strength expressed as % total muscle volume may be more accurate than that expressed as % body weight for detecting side-to-side differences in knee strength following ACLR.

Is age-related worsening in ovarian cancer prognosis linked to changes in body composition and pharmacokinetics?

e17553 Background: The prognosis of ovarian cancer worsens markedly with age. Yet few data are available to explain this phenomenon. Two hypotheses can be made. Changes in pharmacokinetics and treatment tolerance limit the dosing of chemotherapy. And/or changes in tumor and host-tumor biology limit treatment efficacy. Methods: We conducted a prospective cohort study of women with stage III/IV high-grade serous ovarian cancers treated with neoadjuvant intravenous carboplatin(C) AUC 5 every 3 weeks and paclitaxel(P) dosed either weekly at 80 mg/m2 or every 3 weeks at 175 mg/m2. Body composition was assessed using baseline CT scans at the L3 level. Total muscle mass, total fat mass, skeletal muscle index (SMI) and fat index were computed. Plasma concentrations were collected at pre-established time points for both C1D1 of C and P and concentration-time data was analyzed by non-compartmental methods. Area under the curve (AUC)0-INF, volume of distribution(Vd), clearance (Cl), half-life, and mean residence time were calculated. Free C concentrations were determined in plasma ultrafiltrate and assayed, along with P plasma concentrations, by liquid chromatography-tandem mass spectrometry. Toxicity was assessed as first cycle nadir ANC and G4 hematologic(H) or grade 3-4 non-hematologic(NH) toxicity by CTCAE 4.0 criteria over a 3 cycles follow-up. The correlation between continuous measures was assessed by Spearman correlation coefficient, and the association with toxicity was evaluated by Wilcoxon rank sum test. Results: Seventeen patients, ages 38 to 86 (median 61) were eligible. All patients but one received 3 cycles of chemotherapy and median dose intensity was 100% (range 33.3-100%). Mean 1st cycle nadir ANC was 1.29 (range 0.06-9.0). 10/17 (59%) patients experienced G4 H and/or G3-4 NH toxicity. SMI was associated with C AUC (r -0.50, p < 0.05), and both total muscle (r = 0.61) and total fat (r = 0.53) were associated with C Vd. We did not find a correlation of P pharmacokinetics with body composition. A lower SMI was associated with 1st cycle G4H toxicity (p = 0.02), while C AUC had a borderline trend only (p = 0.15). Age was associated with a lower Vd (r -0.63, p = 0.009) and Cl (r -0.67, p = 0.004) of C. There was no significant age trend in the body composition parameters. Conclusions: Neoadjuvant treatment delivery was high in an academic setting. Toxicity appeared driven by low skeletal muscle index, in part via affecting carboplatin pharmacokinetics, and showed no significant age trend. The explanation for age-related changes in prognosis is more likely to lay with changes in tumor and host-tumor biology, which are being analyzed.

RESULTS OF STUDY OF THE HYPOGLOSSAL NERVE FUNCTIONS IN PATIENTS AFTER HYPOGLOSSAL-FACIAL ANASTOMOSIS

Hypoglossal-facial anastomosis is a common method of restoring and/or replacing lost facial nerve function. At the same time, there are works that compare functional disorders of the XII pair of cranial nerves that arise in patients with various types of hypoglossal-facial anastomosis, which, in turn, indicates the rather great importance of this problem, as well as the need for further research. There are several modifications of the hypoglossal-facial anastomosis, which differ significantly, including the effect on the function of the tongue muscles. An important instrumental method for studying the function of the hypoglossal nerve is electromyography, namely, the determination of the total evoked potentials of the tongue muscles. In order to study complications in the form of dysfunction of the tongue muscles due to hypoglossal-facial anastomosis, a comparative analysis of the data of the tongue electromyography in patients after performing these interventions was carried out. Materials and methods. The study included 55 patients with chronic suppurative otitis media, with tumors of the cerebello-pontine angle (acoustic and vestibular schwannomas, tumors of the jugular glomus) complicated by a lesion of the facial nerve. In the main group of patients (20 patients), the original technique of the modified hypoglossal-facial anastomosis was used to restore the facial nerve function. Patients (n=35) in the control group underwent a classic hypoglossal-facial anastomosis. Results. As can be seen from the above data, when comparing the tongue muscles contraction amplitude 3, 6 and 12 months after the formation of the hypoglossal-facial anastomosis, a statistically significant decrease in this indicator is observed on the side of performing the hypoglossal-facial anastomosis in comparison with the intact side at all stages of the study (p <0.05) (p <0.05) (p <0.01), respectively. When comparing the indicators of the total muscle response in patients after using the modified and classical methods of XII-VII anastomosis, there was a statistically significant increase in the compound muscle response of the tongue in the main group - by an average of 10.94% (p <0.05). Conclusion. Performing hypoglossal-facial anastomosis leads to gross dysfunction of the hypoglossal nerve on the side of the intervention, manifested in the form of a significant decrease in the amplitude of muscle contraction according to electromyography of the tongue. The use of the modified technique of XII-VII anastomosis provided the restoration of the total muscle potential of the tongue by 8.82% after 3 months, by 8.7% – after 6 months. and by 15.38% – after 12 months after surgery in comparison with the group where the classic hypoglossal-facial anastomosis was performed.