Computed tomography-based skeletal muscle and adipose tissue attenuation: Variations by age, sex, and muscle

OBJECTIVE

This study aimed to investigate how skeletal muscle attenuation and adipose tissue (AT) attenuation of the quadriceps, hamstrings, paraspinal muscle groups and the psoas muscle vary according to the targeted muscles, sex, and age.

DESIGN

Population-based cross-sectional study.

SETTING

Community-dwelling old population in Reykjavik, Iceland.

SUBJECTS

A total of 5331 older adults (42.8% women), aged 66-96 years from the Age, Gene/Environment Susceptibility (AGES)- Reykjavik Study, who participated in the baseline visit (between 2002 and 2006) and had valid thigh and abdominal computed tomography (CT) scans were studied.

METHODS

Muscle attenuation and AT attenuation of the quadriceps, hamstrings, paraspinal muscle groups and the psoas muscle were determined using CT. Linear mixed model analysis of variance was performed for each sex, with skeletal muscle or AT attenuation as the dependent variable.

RESULTS

Muscle attenuation decreased, and AT attenuation increased with age in both sexes, and these differences were specific for each muscle, although not in all age groups. Age-related differences in muscle and AT attenuation varied with specific muscle. In general, for both sexes, skeletal muscle attenuation of the hamstrings declined more than average with age. Men and women displayed a different pattern in the age differences in AT attenuation for each muscle.

CONCLUSIONS

Our data support the hypotheses that skeletal muscle attenuation decreases, and AT attenuation increases with aging. In addition, our data add new evidence, supporting that age-related differences in skeletal muscle and AT attenuation vary between muscles.

Sleep Indices and Cardiac Autonomic Activity Responses during an International Tournament in a Youth National Soccer Team

This study aimed to describe habitual sleep and nocturnal cardiac autonomic activity (CAA), and their relationship with training/match load in male youth soccer players during an international tournament. Eighteen elite male youth soccer players (aged 14.8 ± 0.3 years; mean ± SD) participated in the study. Sleep indices were measured using wrist actigraphy, and heart rate (HR) monitors were used to measure CAA during night-sleep throughout 5 consecutive days. Training and match loads were characterized using the session-rating of perceived exertion (s-RPE). During the five nights 8 to 17 players slept less than <8 h and only one to two players had a sleep efficiency <75%. Players' sleep duration coefficient of variation (CV) ranged between 4 and 17%. Nocturnal heart rate variability (HRV) indices for the time-domain analyses ranged from 3.8 (95% confidence interval, 3.6; 4.0) to 4.1 ln[ms] (3.9; 4.3) and for the frequency-domain analyses ranged from 5.9 (5.6; 6.5) to 6.6 (6.3; 7.4). Time-domain HRV CV ranged from 3 to 10% and frequency-domain HRV ranged from 2 to 12%. A moderate within-subjects correlation was found between s-RPE and sleep duration [r = -0.41 (-0.62; -0.14); p = 0.003]. The present findings suggest that youth soccer players slept less than the recommended during the international tournament, and sleep duration was negatively associated with training/match load.

Dead-end stomach: a giant and pedunculated gastric pyloric gland adenoma conditioning gastric outlet obstruction and anemia

We present the case of a 69-year-old female undergoing esophagogastroduodenoscopy for iron-deficiency anemia investigation. She reported intermittent bloating, nausea and vomiting. A pedunculated polyp was identified arising from the greater curvature of the middle gastric body, with a long fibroelastic stalk (30mm) and a 60mm congestive head that prolapsed towards the pyloric ring, causing a complete gastric outlet obstruction (GOO). An en-block polypectomy was performed. An intraprocedural oozing bleeding from a large visible vessel at the residual stalk was managed using endoloop®. Histo-immunohistochemistry showed a R0-resection of a mixed-type gastric pyloric gland adenoma (PGA) positive for MUC-5AC and MUC-6 mucins, in a surrounding H. pylori-negative non-atrophic chronic gastritis. She became asymptomatic with anemia resolution. Adenomas account for up to 10% of gastric polyps. Histologically, they are categorized into intestinal, foveolar, pyloric and oxyntic types (1). PGA is a rare subtype, accounting for less than 3% of all gastric polyps (2). PGAs are usually solitary at gastric body, and occur in association with autoimmune gastritis, H. pylori and chemical gastritis (2). A normal background gastric mucosa has also been described (35.8%) (3). PGAs are devoid of apical mucin cap and label by both MUC-5AC and MUC-6 (2). Choi et al. (3) defined three PGA immunohistochemical phenotypes: pure pyloric-type (25.4%), with strong MUC-6 expression; predominant foveolar-type (3%), with MUC-5AC diffuse expression but ≤10% of MUC-6 expression and no foveolar differentiation; and mixed-type (61.2%), with variable MUC-5AC/MUC-6 expression. Most PGAs are asymptomatic, but clinically significant because of their potential for malignant transformation (12-47%) and complications, including gastrointestinal bleeding and obstruction (1, 3). GOO is rare, causing intermittent symptoms by polyp intussusception (ball-valve-syndrome) (4, 5). PGA management is challenging, depending on size, morphology and location. This case illustrates a successful endoscopic resection as a minimally invasive procedure of a doubly complicated PGA.

Endoscopic extraction of a retained Kehr's T-tube fragment

A 55-year-old male underwent a liver transplantation due to alcoholic cirrhosis. Three years later, a re-transplantation was performed due to refractory biliary strictures related to ischemic cholangiopathy.

Can Tracking Data Help in Assessing Interpersonal Contact Exposure in Team Sports during the COVID-19 Pandemic?

During the COVID-19 pandemic, the temporary closure of physical activity and sports facilities, and the generalized cancellation or postponement of sports events have a massive impact on social and economic development. In this study, we explored the feasibility of using tracking data from a football match to assess interpersonal contact between individuals by calculating two measures of respiratory exposure. The dynamic tracking positioning of all players and referees during one international football match was analyzed. For each individual, two measures of respiratory exposure were calculated, based on the 2 m interpersonal distance recommendations for contact tracing for COVID-19 control. Overall, individuals spent a median of 0.12 mm:ss (IQR = 0.45 mm:ss) exposed to interpersonal contact of fewer than 2 m from others. The highest value of exposure was observed between two players of opposing teams (6.35 mm:ss). The results suggest that tracking data can be used to assess respiratory exposure to interpersonal contact in team sports, such as football. The measures of exposure calculated can be used to the prompt identification of high-risk contacts of COVID-19 cases during a match or a training session, but also the risk stratification of different sports and physical activities.

Potential of 2-Chloro-N-(4-fluoro-3-nitrophenyl)acetamide Against Klebsiella pneumoniae and In Vitro Toxicity Analysis

Klebsiella pneumoniae causes a wide range of community and nosocomial infections. The high capacity of this pathogen to acquire resistance drugs makes it necessary to develop therapeutic alternatives, discovering new antibacterial molecules. Acetamides are molecules that have several biological activities. However, there are no reports on the activity of 2-chloro-N-(4-fluoro-3-nitrophenyl)acetamide. Based on this, this study aimed to investigate the in vitro antibacterial activity of this molecule on K. pneumoniae, evaluating whether the presence of the chloro atom improves this effect. Then, analyzing its antibacterial action more thoroughly, as well as its cytotoxic and pharmacokinetic profile, in order to contribute to future studies for the viability of a new antibacterial drug. It was shown that the substance has good potential against K. pneumoniae and the chloro atom is responsible for improving this activity, stabilizing the molecule in the target enzyme at the site. The substance possibly acts on penicillin-binding protein, promoting cell lysis. The analysis of cytotoxicity and mutagenicity shows favorable results for future in vivo toxicological tests to be carried out, with the aim of investigating the potential of this molecule. In addition, the substance showed an excellent pharmacokinetic profile, indicating good parameters for oral use.

The Arrowhead Agility Test: Reliability, Minimum Detectable Change, and Practical Applications in Soccer Players

Rago, V, Brito, J, Figueiredo, P, Ermidis, G, Barreira, D, and Rebelo, A. The arrowhead agility test: Reliability, minimum detectable change, and practical applications in soccer players. J Strength Cond Res 34(2): 483-494, 2020-Four independent studies were conducted to examine the utility of the arrowhead agility test (AAT) to measure change of direction (COD) capacity in soccer players, specifically, (a) intersession reliability and minimum detectable change (n = 24); (b) power-dependent abilities associated with AAT performance (n = 56); and (c) fatigue sensitivity (n = 20); differences between competitive levels and age groups (n = 264). Irrespective of the AAT outcome measure (skillful side, less-skillful side, sum of both), intersession reliability and the ability to detect changes in performance were good (ICC = 0.80-0.83; CV = 1.25-2.21%; smallest worthwhile change, 0.06-0.12 >SEM, 0.01-0.03) except for the asymmetry index. A 15-m sprint explained a significant amount of variance in COD (p < 0.01; R = 0.42). Arrowhead agility test performance did not change from the prematch toward half time (p = 0.21). However, reduced COD performance was observed after an intense period in the second half and after the game, compared with prematch and half-time performance (p < 0.05; effect size [ES] = -0.85 to 0.42). Irrespective of age group, national players were more agile than regional players (p < 0.05; ES = -1.97 to -0.36). Moreover, independently of their competitive level, senior and U18 players had a better performance than U16 (p < 0.05; ES = -2.33 to -0.84), whereas no significant differences were observed between senior and U18. Percentiles were also reported in the results. The AAT is reliable to measure COD in soccer players. The test may simultaneously encompass 15-m sprint testing but should be implemented independently to countermovement jump. Furthermore, the test is sensitive to match-induced fatigue during the second half and discriminates players from different competitive levels.

School-based soccer practice is an effective strategy to improve cardiovascular and metabolic risk factors in overweight children

We examined the effects of a 6-month school-based soccer programme on cardiovascular (CV) and metabolic risk factors in overweight children. Methods: 40 boys [8-12 years; body mass index (BMI) >2 standard deviations of WHO reference values] participated in complementary school-based physical education classes (two sessions per week, 45-90 min each). The participants were divided into a soccer group (SG; n = 20) and a control group (CG; n = 20). The SG intervention involved 3 extra-curricular school-based soccer sessions per week, 60-90 min each. The intervention lasted for 6-months. All measurements were taken at baseline and after 6-months. From baseline to 6-months, the SG significantly improved (p < .05) BMI z-score, waist circumference, waist-to-height ratio, percentage of fat mass, percentage of fat-free mass, diastolic blood pressure, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol, but no such improvements were observed for the CG. After the intervention, the prevalence of soccer participants with normal waist-to-height ratio (30 vs. 5%; p = .037), systolic blood pressure (90 vs. 55%; p = .039), total cholesterol (80 vs. 65%; p = .035) and LDL-C (90 vs. 75%; p = .012) were significantly higher than at baseline. The findings suggest that a 6-month school-based soccer intervention program represents an effective strategy to reduce CV and metabolic risk factors in overweight children prepared to take part in a soccer program.

Antibacterial and Antibiofilm Activity of Myrtenol against Staphylococcus aureus

The increase in Staphylococcus aureus resistance to conventional antibacterials and persistent infections related to biofilms, as well as the low availability of new antibacterial drugs, has made the development of new therapeutic alternatives necessary. Medicinal plants are one of the main sources of bioactive molecules and myrtenol is a natural product with several biological activities, although its antimicrobial activity is little explored. Based on this, the objective of this study was to evaluate the antibacterial activity of myrtenol against S. aureus, determining the minimum inhibitory and bactericidal concentrations (MIC and MBC), investigating the possible molecular target through the analysis of molecular docking. It also aimed to evaluate the effect of its combination with antibacterial drugs and its activity against S. aureus biofilms, in addition to performing an in silico analysis of its pharmacokinetic parameters. Myrtenol showed MIC and MBC of 128 µg/mL (bactericidal action) and probably acts by interfering with the synthesis of the bacterial cell wall. The effects of the association with antibacterials demonstrate favorable results. Myrtenol has remarkable antibiofilm activity and in silico results indicate a good pharmacokinetic profile, which make myrtenol a potential drug candidate for the treatment of infections caused by S. aureus.

Football can tackle type 2 diabetes: a systematic review of the health effects of recreational football practice in individuals with prediabetes and type 2 diabetes

This work aimed to summarize the health effects of recreational football practice in individuals with prediabetes and type 2 diabetes (T2D), through a systematic review. An electronic search was performed in PubMed, Scopus, Web of Science, LILACS and list of references of the available reviews, until July 2019. Studies were eligible if they included any form of football practice, in patients diagnosed with prediabetes or T2D. After recreational football practice, participants with prediabetes or T2D improved fasting glucose, total and LDL cholesterol, triglycerides, body mass, body fat percentage, waist circumference, blood pressure, and maximal oxygen uptake. Further benefits were found in fat-free mass and resting heart rate for participants with prediabetes, and in glycated haemoglobin, body mass index and fat mass in individuals with T2D. This systematic review showed promising benefits of recreational football practice on both the prevention and control of T2D and related cardiovascular risk.

Small Bowel Enteroscopy - A Joint Clinical Guideline from the Spanish and Portuguese Small Bowel Study Groups

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.

Does exergaming drive future physical activity and sport intentions?

We studied how usability and playability of sport exergames affect future intentions of participation in physical activity or actual sport. We employed questionnaires to measure participants' enjoyment, usability, game-experience, and future intentions of physical activity and real sport. We compared the outcomes based on players' gender, previous real-swimming, and exergame experience. Psychological parameters were not different between groups but players without exergame experience enjoyed the game more. Physical activity intentions increased for all participants but not swimming intentions. The limitations of current gaming systems and their effects on players' gaming experience and intentions are discussed.

Comparing the Continuous Geboes Score With the Robarts Histopathology Index: Definitions of Histological Remission and Response and their Relation to Faecal Calprotectin Levels

BACKGROUND AND AIMS

The histological status of ulcerative colitis [UC] patients in clinical and endoscopic remission has gained space as an important prognostic marker and a key component of disease monitoring. Our main aims were to compare two histological indexes-the continuous Geboes score [GS] and the Robarts Histopathology index [RHI]-regarding their definitions of histological remission and response, and the ability of faecal calprotectin [FC] levels to discriminate between these statuses.

METHODS

This was an analysis of three prospective cohorts including 422 patients previously enrolled in other studies.

RESULTS

The two continuous scores [GS and RHI] were shown to be significantly correlated [correlation coefficient of 0.806, p < 0.001] and particularly close regarding their definition of histological response: 95% and 88% of all patients classified as having/not having [respectively] histological response according to RHI also did so according to GS. Moreover, median FC levels in patients with histological response were lower than those in patients without histological response [GS: 73.00 vs 525.00, p < 0.001; RHI: 73.50 vs 510.00, p < 0.001]; a similar trend was observed when FC levels of patients in histological remission were compared to those of patients with histological activity [GS: 76.00 vs 228.00, p < 0.001; RHI: 73.50 vs 467.00, p < 0.001]. FC levels allowed us to exclude the absence of histological remission [according to RHI] and absence of histological response [according to RHI and GS], with negative predictive values varying from 82% to 96%. However, optimization of the FC cut-off to exclude the absence of histological remission, as for the continuous GS, falls within values that resemble those of the healthy population.

CONCLUSION

The continuous GS and RHI histological scores are strongly correlated in their definitions of histological response. An absence of histological remission could only be excluded at physiological levels of FC.

Bioenergetics and Biomechanics of Handcycling at Submaximal Speeds in Athletes with a Spinal Cord Injury

BACKGROUND

A study aimed at comparing bioenergetics and biomechanical parameters between athletes with tetraplegia and paraplegia riding race handbikes at submaximal speeds in ecological conditions.

METHODS

Five athletes with tetraplegia (C6-T1, 43 ± 6 yrs, 63 ± 14 kg) and 12 athletes with paraplegia (T4-S5, 44 ± 7 yrs, 72 ± 12 kg) rode their handbikes at submaximal speeds under metabolic measurements. A deceleration method (coasting down) was applied to calculate the rolling resistance and frontal picture of each participant was taken to calculate air resistance. The net overall Mechanical Efficiency (Eff) was calculated by dividing external mechanical work to the corresponding Metabolic Power.

RESULTS

Athletes with tetraplegia reached a lower aerobic speed (4.7 ± 0.6 m s^-1 vs. 7.1 ± 0.9 m s^-1, P = 0.001) and Mechanical Power (54 ± 15 W vs. 111 ± 25 W, P = 0.001) compared with athletes with paraplegia. The metabolic cost was around 1 J kg^-1 m^-1 for both groups. The Eff values (17 ± 2% vs. 19 ± 3%, P = 0.262) suggested that the handbike is an efficient assisted locomotion device.

CONCLUSION

Handbikers with tetraplegia showed lower aerobic performances but a similar metabolic cost compared with handbikers with paraplegia at submaximal speeds in ecological conditions.