Evaluation of bilateral acromiohumeral distance on magnetic resonance imaging and radiography in patients with unilateral rotator cuff tears.

INTRODUCTION: The aim of this study was to evaluate the difference in the acromiohumeral distance (AHD) between the shoulders with full-thickness rotator cuff tear and contralateral healthy shoulders of the same patients on magnetic resonance imaging (MRI) and radiograph. MATERIALS AND METHODS: We included 49 patients with unilateral full-thickness rotator cuff tears. The mean age of the patients (29 women and 20 men) was 54.57 ± 7.10 years. The shoulders were divided into those with a full-thickness rotator cuff tear and healthy shoulders. The mean AHDs on radiograph and MRI were calculated by two radiologists experienced in the musculoskeletal system. Shoulders with rotator cuff tears on coronal plane and sagittal MRI were divided into 3 (Patte I, II, III) and 4 subgroups (S: superior, AS: anterosuperior, PS: posterosuperior, APS: anteroposterosuperior), respectively. The relationship between the groups and the subgroups was statistically investigated. RESULTS: The mean AHDs on radiograph were 6.93 and 9.11 mm and on MRI were 5.94 and 7.46 mm in the patient and control groups, respectively. The mean AHDs were 6.47, 6.03, and 4.95 mm in Patte I, II, and III, respectively. The difference between the subgroups was statistically significant. According to the sagittal plane topography, the mean AHDs (mm) were 6.39, 6.44, 5.8, and 4.6 mm in the superiorly, anterosuperiorly, posterosuperiorly, and anteroposterosuperiorly localized lesions, respectively. The relationship between S and AS was not statistically significant, and those between S and PS, AS and PS, S and APS, and PS and APS were significant. CONCLUSIONS: In patients with unilateral full-thickness rotator cuff tear, AHD narrowing was observed on the törnekler side after evaluating the bilateral acromiohumeral distance on MRI and radiograph. AHD was significantly reduced by increasing the degree of supraspinatus tendon retraction in the coronal plane MRI and by the posterosuperior and anteroposterosuperior location of the rotator cuff tear in the sagittal plane MRI.

Psoas Muscle Area Measured with Computed Tomography at Admission to Intensive Care Unit: Prediction of In-Hospital Mortality in Patients with Pulmonary Embolism.

AIM: Sarcopenia, a core component of physical frailty, is an independent risk factor for suboptimal health outcomes in hospitalized patients, especially in the intensive care patients. Psoas muscle areas can be assessed to identify sarcopenia. The aim of this study was to determine the prognostic value of psoas muscle area measured with CT for the prediction of in-hospital mortality in patients with pulmonary embolism at admission to the intensive care unit. METHODS: Patients with an admission abdominal computed tomography scan and requiring intensive care unit (ICU) stay were reviewed. Selected clinical data of patients admitted to intensive care unit for the management of pulmonary embolism were collected. Using CT scan images at the level of L3 vertebra, the psoas muscle area value was obtained by dividing the sum of the right and left psoas muscle areas into the body surface area. RESULTS: In-hospital mortality rate was 22.5% in 89 patients. The pulmonary embolism patients with in-hospital mortality had higher PESI and lower value of psoas muscle area, in addition to the lower systolic blood pressure and arterial oxygen saturation at admission. The increase in the value of psoas muscle area is associated with a decrease in the rate of in-hospital mortality. In patients with in-hospital mortality related to pulmonary embolism, the higher PESI and the lower value of psoas muscle area were considered in accordance with the outcome of patients. CONCLUSIONS: For the prediction of in-hospital mortality risk in patients with pulmonary embolism managed in intensive care unit, the psoas muscle area value has a merit to be used among the routine diagnostic procedures after further studies conducted with different severity of pulmonary embolism.

The Relation between Sarcopenia and Mortality in Patients at Intensive Care Unit.

BACKGROUND AND AIM: Psoas muscle area (PMA) can reflect the status of skeletal muscle in the whole body. It has been also reported that decreased PMA was associated with postoperative mortality or morbidity after several surgical procedures. In this study, we aimed to investigate the relation between PMA and mortality in all age groups in intensive care unit (UNIT). MATERIALS AND METHOD: The study consists of 362 consecutive patients. The demographic characteristics of patients, indications for ICU hospitalization, laboratory parameters, and clinical parameters consist of mortality and length of stay, and surgery history was obtained from intensive care archive records. RESULTS: The mean age was 61.2 ± 18.2 years, and the percentage of female was 33.3%. The mean duration of stay was 10.3 ± 24.4 days. Exitus ratio, partial healing, and healing were 25%, 70%, and 5%, respectively. The mean right, left, and total PMA were 8.7 ± 3.6, 8.9 ± 3.4, and 17.6 ± 6.9, respectively. The left and total PMA averages of the nonoperation patients were statistically significantly lower (p = 0.021 p = 0.043). The mean PMA between the ex and recovered patients were statistically significantly lower (p = 0.001, p = 0.001, p < 0.001). Dyspnoea, renal insufficiency, COPD, transfusion rate, operation rate, ventilator needy, and mean duration of hospitalization were statistically significant higher in patients with exitus. There is a significant difference in operation types, anesthesia type, and clinic rates. CONCLUSION: Our data suggest that sarcopenia can be used to risk stratification in ICU patients. Future studies may use this technique to individualize postoperative interventions that may reduce the risk for an adverse discharge disposition related to critical illness, such as early mobilization, optimized nutritional support, and reduction of sedation and opioid dose.