A new possible marker: can pennation angle defined by ultrasound predict the frailty?

BACKGROUND: Frailty indicates older people who are vulnerable to stressors. The relation between ultrasonographic parameters of muscle and frailty among older people has yet to be investigated. AIMS: The aim of the study is to investigate the relationship between frailty and the ultrasonographic measurements of the rectus femoris muscle (RFM). METHODS: This cross-sectional study included 301 participants who were ≥65 years. The FRAIL questionnaire assessed frailty. The thickness, cross-sectional area (CSA), fascicle length, pennation angle (PA), stiffness, and echogenicity of RFM were assessed by ultrasound. The accuracy of parameters in predicting the frailty was evaluated by ROC analysis. RESULTS: Of all 301 participants, 24.6% were frail. Pre-frail and frail participants had significantly lower thickness (p = 0.002), CSA (p = 0.009), and fascicle length (p = 0.043) of RFM compared to robust. PA was significantly lowest in frails (p < 0.001). The multivariate logistic regression analysis showed that PA values lower than 10.65 degrees were an independent predictor of frailty (OR = 0.83, 95% Cl: 0.70-0.97, p = 0.019). Results of ROC analysis demonstrated a satisfactory result between the PA and frailty (AUC = 0.692, p < 0.001). DISCUSSION: Thickness, CSA, and PA of RFM were found to be lower in frail subjects, which may indicate the changes in muscle structure in frailty. Among all parameters, lower PA values were independent predictors of frailty. These findings may indicate a novel ultrasound-based method in frailty, that is more objective and unrelated to the cross-sectional evaluation. CONCLUSIONS: Ultrasonographic measurements of RFM, especially the lower PA may predict frailty in older people. As an objective and quantitative method, PA may be used to define frailty with acceptable sensitivity.

The relationship between sarcopenia, sarcopenia related quality of life and ultrasound findings of the rectus femoris muscle in older outpatients.

PURPOSE: Skeletal muscle ultrasonography stands out as a promising method for detecting sarcopenia. We aimed to evaluate the relationship between sarcopenia, sarcopenia related quality of life and US findings of the Rectus Femoris muscle. METHODS: A total of 300 older individuals were included in this cross-sectional study. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People 2 criteria. Rectus F muscle thickness, cross-sectional area, fascicle length, pennation angle, stiffness and echogenicity were measured by an experienced radiologist using a B-mode US device. Quality of life was determined with the Sarcopenia- Quality of life questionnaire. Correlation analysis, receiver operating analysis, sensitivity and specificity analysis were performed. RESULTS: The median age of participants was 72. 191 (63.9%) and 109 (36.1%) of the participants were male and female, respectively. The prevalence of sarcopenia was 15.6%. Fascicle length, cross-sectional area and thickness showed the highest sensitivity (81%) and specificity (87%) for men. Fascicle length and pennation angle showed the highest sensitivity (87%) and specificity (66%) for women. Rectus Femoris ultrasound parameters differed across SarQoL quartiles, and higher Sarcopenia- Quality of life scores were associated with better ultrasound parameters. All ultrasound parameters had positive correlations with Sarcopenia- Quality of life. CONCLUSION: Different Rectus Femoris ultrasound parameters are useful for detecting sarcopenia according to gender. A combination of these parameters can increase diagnosis accuracy. Ultrasound parameters are associated with sarcopenia related quality of life.

Prevalence of COVID-19 in 10,000 samples from 7853 patients in Eastern Turkey by positive real-time PCR.

Aim: COVID-19, caused by SARS-CoV-2, started in December 2019 and has spread across the world. Materials & methods: We analyzed real-time PCR results of 10,000 samples from 2 April to 30 May 2020 in three neighbor cities located in the East of Turkey. The final study population was 7853 cases, after excluding screening tests. Results: Real-time PCR was performed to detect the SARS-CoV-2-specific RNA-dependent-RNA-polymerase gene fragment. The number of total positive samples out of 7853 were 487; however, the number of nonrepeating positive patient was 373 (4.8%). Cough and fever were the most common symptoms in positive cases. Conclusion: Epidemiologic studies should be performed about the prevalence of SARS-CoV-2 infection to better understand the effect of the virus across the world.

The influence of genotype on disease severity and concomitant diseases in familial Mediterranean fever patients.

OBJECTIVES: To evaluate differences between the patients with familial Mediterranean fever (FMF) with homozygous (Hom), heterozygous (Het) and compound heterozygous (cHet) MEFV mutations in terms of clinical features and severity of the disease, as well as frequency of concomitant disorders, without focusing on Exon 10 mutations. METHODS: The patients with FMF were diagnosed using the Tel-Hashomer diagnostic criteria. The presence of MEFV mutations was investigated in exons 2,3,5 and 10 by multiplex-PCR reverse hybridisation method. All the patients were questioned for the presence of concurrent disorders, and the medical records of these patients were revised retrospectively. RESULTS: 259 unrelated patients (female: 143, male: 116; mean age: 33.5±12 years) were included in this study. Hom and Het mutations were found in 79 (31.9%) and 88 (35.6%) patients with FMF, respectively. cHet mutations were found in 68 (27.5%) FMF patients. Early onset and early diagnosis of FMF were found in Hom group compared to Het and compound Het groups. The number of the patients with a higher severity score was significantly higher in Hom group (n=40, 50.6%) than Het (n=12, 13.6%) and cHet groups (n=10, 14.7%), (p<0.0001). No significant differences were found between the groups in terms of clinical features, except for erysipelas like erythema (ELE) (Hom group: 69.6% vs. Het group 37.5%, p<0.0001). Amyloidosis and concomitant disorders were found in 22 FMF patients with Hom MEFV mutations, 16 FMF patients with heterozygous mutations, 7 FMF patients with cHet mutations. CONCLUSIONS: While the presence of homozygous mutations creates tendency for a severe disease phenotype, the development of concomitant disorders seems to be independent of homozygous mutations.