A nomogram to predict the risk of sarcopenia in older people.

The burden of sarcopenia is increasing worldwide. However, most cases of sarcopenia are undiagnosed due to the lack of simple screening tools. This study aimed to develop and validate an individualized and simple nomogram for predicting sarcopenia in older adults. A total of 180 medical examination populations aged ≥60 years were enrolled in this study. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. The primary data were randomly divided into training and validation sets. Univariate logistic regression analysis was performed to select the risk factors of sarcopenia, which were subjected to the least absolute shrinkage and selection operator for feature selection. A nomogram was established using multivariate logistic regression analysis by incorporating the features selected in the least absolute shrinkage and selection operator regression model. The discrimination and calibration of the predictive model were verified by the concordance index, receiver operating characteristic curve, and calibration curve. In this study, 55 cases of sarcopenia were available. Risk predictors included age, albumin, blood urea nitrogen, grip strength, and calf circumference. The model had good discrimination and calibration capabilities. concordance index was 0.92 (95% confidence interval: 0.84-1.00), and the area under the receiver operating characteristic curve was 0.92 (95% confidence interval: 0.83-1.00) in the validation set. The Hosmer-Lemeshow test had a P value of .94. The predictive model in this study will be a clinically useful tool for predicting the risk of sarcopenia, and it will facilitate earlier detection and therapeutic intervention for sarcopenia.

Hemophagocytic Lymphohistiocytosis Associated with Synergistic Defects of AP3B1 and ATM Genes: A Case Report and Literature Review.

Hemophagocytic lymphohistiocytosis (HLH) is an overwhelming immune system activation that manifests as hyperinflammation and life-threatening multiple organ failure. However, the clinical manifestations of the systemic inflammatory response in sepsis and fulminant cytokine storm caused by HLH macrophage activation are very similar and difficult to distinguish. HLH triggered by two novel gene defects manifesting with multiorgan dysfunction syndrome (MODS) and distributive shock has not been reported. A 14-year-old male patient was hospitalized with a high fever, his condition deteriorated rapidly, accompanied by cytopenia, shock, and MODS, and he was subsequently transferred to our intensive care unit (ICU) for symptomatic and organ-supportive treatments. Laboratory indicators of cytopenia, hypofibrinogenemia, hypertriglyceridemia, hyperferritinemia, high soluble CD25, low natural killer (NK) cell cytotoxicity, and hemophagocytosis in the bone marrow confirmed the diagnosis of HLH. Molecular genetic analysis revealed that two novel heterozygous gene mutations in AP3B1 (c.3197 C > T) and ATM (c.8077 G > T) might have accounted for the onset. After treatment, the patient's condition successfully improved. This case report demonstrates the timely determination of underlying triggers and critical care supports (supportive and etiological treatment) of HLH related to the improved outcome.