Strong association between sarcopenic obesity and non-alcoholic fatty liver disease: An observational study with ISarcoPRM algorithm.

BACKGROUND: In recent times, sarcopenia and non-alcoholic fatty liver disease (NAFLD) have garnered widespread attention in public health. Nevertheless, the relationship between sarcopenia and NAFLD remains uncertain. This study investigated the association between NAFLD and sarcopenia in the elderly population. METHODS: In this cross-sectional study, 1099 adults aged 60 and older participated. The participants were classified based on their body composition, and the International Society of Physical and Rehabilitation Medicine's diagnostic algorithm (ISarcoPRM) was utilized to diagnose sarcopenia, while the fatty liver index was utilized to diagnose NAFLD. Binary logistic regression analysis determined the correlation between NAFLD and sarcopenia. RESULTS: Of the 1099 participants, 213 (58.2 %) males and 480 (65.5 %) females were afflicted with NAFLD. After adjusting for other clinical factors, exercise was found to decrease the likelihood of NAFLD in females (but not in males) by approximately 70 % [relative risk (RR): 0.312, 95 % confidence interval (CI): 0.182-0.547]. In addition, sarcopenia was not discerned as a risk factor for NAFLD in either gender (both p > 0.05). However, obesity increased the likelihood of NAFLD in males by 27.5 (95 % CI: 10.4-73.1) and in females by 28.1 (95 % CI: 17.1-46.4), and sarcopenic obesity increased the likelihood of NAFLD by 49.5 (95 % CI: 11.1-219.1) in males and 35.5 (95 % CI: 18.5-68.2) in females (all p < 0.001). CONCLUSION: Our study suggests that sarcopenia is not a risk factor for NAFLD in non-obese elderly subjects. However, a strong association was observed between obesity, especially sarcopenic obesity, and NAFLD. Regular physical activity seems protective for NAFLD in older females.

The Surgical Outcome of Standard Lobectomy Versus Sleeve Lobectomy in Patients with Non-small Cell Lung Cancer: Propensity Score Matching.

OBJECTIVES: In this study, we aimed to compare the patients who underwent standard or sleeve lobectomy for non-small cell lung cancer in terms of postoperative outcomes, prognostic factors and overall survival. METHODS: Between January 2002 and January 2020, the patients with squamous cell carcinoma or adenocarcinoma, who underwent standard lobectomy or sleeve lobectomy by thoracotomy in our clinic were retrospectively analyzed. Standard and sleeve groups were compared after propensity score matching in terms of age, comorbidity, T status, N status and pathological stage. Primary outcomes were morbitidy and mortality, while secondary outcome was overall survival. RESULTS: The study included 476 patients and sleeve lobectomy was performed in 196 (41.1%) patients. Multivariable analysis revealed that age over 61 years (p = 0.003 and p = 0.005, respectively), forced expiratory volume in first second below 84% (p = 0.013 and p = 0.205, respectively) and the presence of perineural invasion (p = 0.052 and p = 0.001, respectively) were poor prognostic factors in the standard lobectomy and the sleeve groups. The propensity matching analysis included 276 patients (138 sleeve lobectomy and 138 standard lobectomy). Complications were occured in 96 (69.6%) and 92 (66.7%) patients in the standard and sleeve groups, respectively (p = 0.605). Three (2.2%) patients in the standard group and five (3.6%) patients in the sleeve group died in 90 days postoperatively (p = 0.723). CONCLUSIONS: Bronchial sleeve lobectomy is a safe procedure that can be applied in oncologically suitable cases without causing higher mortality than standard lobectomies.

"Prompt" for PREEMPT: Dotting the I's and Crossing the T's With Ultrasound.

The management of chronic migraine (CM) underwent a significant shift with the introduction of onabotulinumtoxin A (BoNT-A) injections following the landmark PREEMPT trial in 2010. Despite its efficacy, the existing injection protocol lacks precision, prompting a call for revision in light of modern ultrasound (US)-guided techniques. This article highlights the potential of US-guided injections to enhance accuracy, safety, and efficacy in CM treatment. By providing real-time visualization and addressing anatomical variations, US guidance offers a promising avenue for optimizing BoNT-A delivery, minimizing adverse effects, and ensuring therapeutic success.

Potential Survival Benefit of Upfront Surgery for Lung Tumors Unconfirmed but Highly Suspicious for Stage I Lung Cancer.

Background: Patients with early-stage lung tumors that are highly suspicious for malignancy typically undergo a preoperative diagnostic workup, primarily through bronchoscopy or transthoracic biopsy. Those without a preoperative diagnosis may alternatively be treated with upfront surgery, contingent upon the potential for intraoperative diagnosis. Previous studies have yielded conflicting results regarding the impact of upfront surgery on the survival of these patients. Our study aimed to elucidate the effect of upfront surgery on the survival outcomes of patients undergoing surgery for early-stage lung cancer without a preoperative diagnosis. Methods: We analyzed the survival rate of 158 consecutive patients who underwent pulmonary resection for stage I lung cancer, either with or without a preoperative diagnosis. Results: A total of 86 patients (54%) underwent upfront surgery. This approach positively impacted both disease-free survival (p=0.031) and overall survival (p=0.017). However, no significant differences were observed across subgroups based on sex, smoking status, forced expiratory volume in 1 second, histologic tumor size, or histologic subtype. Univariate analysis identified upfront surgery (p=0.020), age (p=0.002), maximum standardized uptake value (SUVmax) exceeding 7 (p=0.001), and histological tumor size greater than 20 mm (p=0.009) as independent predictors. However, multivariate analysis indicated that only SUVmax greater than 7 (p=0.011) was a significant predictor of unfavorable survival. Conclusion: Upfront surgery does not appear to confer a survival advantage in patients with stage I lung cancer undergoing surgical intervention.

Novel Mutation in the HSD17B10 Gene Accompanied by Dysmorphic Findings in Female Patients.

Introduction: Hydroxysteroid 17-beta dehydrogenase type 10 (HSD10) protein is a mitochondrial enzyme. Multisystemic involvement occurs in HSD10 deficiency as in other mitochondrial diseases. HSD10 deficiency (disease) is rare. Less than 40 index cases have been reported so far. A female patient is even rarer because of X-linked transmission. Five index female cases have been reported. Case Presentation: We report a three-year-old female patient who was investigated due to microcephaly and global developmental delay. She had significant dysmorphic findings. The tiglylglycine peak was detected in urinary organic acid analysis. Other metabolic investigations and laboratory tests were unremarkable. Mild cerebral atrophy, mild ventricular dilation, thin corpus callosum, and an increase in T2 signal in the globus pallidus were revealed at brain magnetic resonance imaging. Heterozygous novel mutation in the HSD17B10 gene was found by whole-exome sequencing (WES) analysis. We started isoleucine-restricted diet and a "cocktail" of the mitochondrial vitamin. Discussion/Conclusion: We will see HSD10 disease patients more frequently with the increasing use of WES and genetic panels. Thus, different findings and phenotypes of the HSD10 disease will be revealed.

Parsonage Turner syndrome after needle electromyography: a needle in a haystack.

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Comparison of closed percutaneous screw reduction versus open reduction and internal fixation in the treatment of frontal sinus fractures: A retrospective study.

The aim of this study was to compare closed percutaneous screw reduction to traditional open reduction-internal fixation (OR-IF) for the treatment of anterior table fractures. Both groups were evaluated in terms of operative variables, complications, and treatment success. Of 32 patients included, 19 patients underwent OR-IF, while 13 underwent percutaneous screw reduction. The median operative time, length of hospital stays, and treatment cost of the OR-IF group were 100 min (range 60-130), 4 days (range 3-9), and $727 (range $642-$1291), respectively. The same variables for the closed reduction group were 30 min (range 20-40), 2 days (range 1-2), and $303 (range $252-$349), respectively. The closed reduction group exhibited a shorter operative time (p< 0.001), reduced length of hospital stays (p< 0.001), lower treatment cost (p< 0.001), and a lower complication rate (p = 0.025) compared to the OR-IF group. Late-term outcomes in both groups showed no visible contour changes or step deformities. In conclusion, the percutaneous screw reduction technique is a safe and effective option with minimal morbidity in the treatment of frontal sinus anterior table fractures. Therefore, traditional OR-IF should be reserved for fractures that are not suitable for reduction using minimally invasive techniques.