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Saketkoo LA, Russell AM, Patterson KC, Obi ON, Drent M. Sarcoidosis and frailty: recognizing factors that foster holistic resilience. Curr Opin Pulm Med 2023:00063198-990000000-00099. [PMID: 37522560 DOI: 10.1097/mcp.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE OF REVIEW Sarcoidosis is a multiorgan system disease exerting significant impact on biophysical, social, psychological and emotional well-being. Mortality and disability correlate to accessible, timely, expert care for sarcoidosis and its related complications. Across health conditions, positive healthcare interactions and interventions can rehabilitate unfavourable factors tied to concepts of 'frailty'. Here, we set out to introduce concepts related to frailty and their impact in the context of sarcoidosis. RECENT FINDINGS Studies examining frailty across other multiorgan and single organ-based diseases that mirror organ involvement in sarcoidosis demonstrate findings that bear relevance in sarcoidosis. Namely, factors predisposing a person to frailty are a multifactorial phenomenon which are also reflected in the lived experience of sarcoidosis; and that early diagnosis, intervention and prevention may alter a course towards more favourable health outcomes. SUMMARY Factors predisposing to frailty in other health conditions may also signal a risk in sarcoidosis. In turn, proactive health preservation - regardless of age - may lead to improved biopsychosocial reserve and health-related quality of life. Fortifying holistic resilience in sarcoidosis is anticipated to reduce risk of the occurrence and prolongation of health-related complications, and facilitate swifter recovery from biophysical complications as well as from psychosocial and emotional stressors.
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Affiliation(s)
- Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center
- University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs
- Louisiana State University School of Medicine, Section of Pulmonary Medicine
- Tulane University School of Medicine, Undergraduate Honors Department, New Orleans, Louisiana, USA
| | - Anne-Marie Russell
- Exeter Respiratory Innovations Center, University of Exeter, Exeter
- Royal Devon and Exeter NHS Foundation Trust, Devon
- Imperial College Healthcare NHS Trust, London
| | - Karen C Patterson
- Brighton & Sussex Medical School, Department of Clinical & Experimental Medicine, Falmer, UK
| | - Ogugua Ndili Obi
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Marjolein Drent
- Interstitial Lung Diseases (ILD) Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein
- Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht
- ILD CARE Foundation Research Team, Ede, The Netherlands
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Manganotti P, Buoite Stella A, Ajcevic M, di Girolamo FG, Biolo G, Franchi MV, Monti E, Sirago G, Marusic U, Simunic B, Narici MV, Pisot R. Peripheral nerve adaptations to 10 days of horizontal bed rest in healthy young adult males. Am J Physiol Regul Integr Comp Physiol 2021; 321:R495-R503. [PMID: 34318712 DOI: 10.1152/ajpregu.00146.2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Space analogs, such as bed rest, are used to reproduce microgravity-induced morphological and physiological changes and can be used as clinical models of prolonged inactivity. Nevertheless, nonuniform decreases in muscle mass and function have been frequently reported, and peripheral nerve adaptations have been poorly studied, although some of these mechanisms may be explained. Ten young healthy males (18-33 yr) underwent 10 days of horizontal bed rest. Peripheral neurophysiological assessments were performed bilaterally for the dominant (DL) and nondominant upper and lower limbs (N-DL) on the 1st and 10th day of bed rest, including ultrasound of the median, deep peroneal nerve (DPN), and common fibular nerve (CFN) , as well as a complete nerve conduction study (NCS) of the upper and lower limbs. Consistently, reduced F waves, suggesting peripheral nerve dysfunction, of both the peroneal (DL: P = 0.005, N-DL: P = 0.013) and tibial nerves (DL: P = 0.037, N-DL: P = 0.005) were found bilaterally, whereas no changes were observed in nerve ultrasound or other parameters of the NCS of both the upper and lower limbs. In these young healthy males, only the F waves, known to respond to postural changes, were significantly affected by short-term bed rest. These preliminary results suggest that during simulated microgravity, most changes occur at the muscle or central nervous system level. Since the assessment of F waves is common in clinical neurophysiological examinations, caution should be used when testing individuals after prolonged immobility.
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Affiliation(s)
- Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Alex Buoite Stella
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Milos Ajcevic
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital of Trieste, University of Trieste, Trieste, Italy.,Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Filippo Giorgio di Girolamo
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Gianni Biolo
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Elena Monti
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Giuseppe Sirago
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Uros Marusic
- Science and Research Center Koper, Institute for Kinesiology Research, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - European Center Maribor, Maribor, Slovenia
| | - Bostjan Simunic
- Science and Research Center Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Marco V Narici
- Department of Biomedical Sciences, University of Padova, Padova, Italy.,Science and Research Center Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Rado Pisot
- Science and Research Center Koper, Institute for Kinesiology Research, Koper, Slovenia
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