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1.
BMC Geriatr ; 24(1): 674, 2024 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-39127641

RESUMEN

BACKGROUND: Calf circumference is currently recommended as a case-finding marker for sarcopenia, but its usefulness has not been determined in chronic pain conditions. Therefore, the present study aimed to evaluate the predictive performance of calf circumference in diagnosing sarcopenia in older patients with chronic low back pain. METHODS: Ambulatory adult patients aged ≥ 65 years with chronic low back pain were enrolled. A diagnosis of sarcopenia was established based on the criteria outlined by the Asian Working Group for Sarcopenia in 2019. Patient demographics, pain-related factors, clinical factors, and sarcopenia-related measurements were compared between non-sarcopenic and sarcopenic patients. Linear regression analysis was used to evaluate the correlation of calf circumference with muscle mass, strength, and physical performance. Also, a receiver operating characteristic curve analysis for calf circumference in predicting sarcopenia was conducted; and area under the curve (AUC) values, along with their corresponding 95% confidence intervals (CI), were calculated. RESULTS: Data from 592 patients were included in the analysis. Eighty-five patients were diagnosed with sarcopenia (14.3%), 71 of whom had severe sarcopenia (11.9%). A higher prevalence of sarcopenia was observed in female patients (9.0% vs. 16.7%, p = 0.016). After adjusting for age, BMI, and comorbidities, calf circumference correlated positively with muscle mass but not with muscle strength and physical performance. The AUC values for sarcopenia were 0.754 (95% CI = 0.636-0.871, p = 0.001) in males and 0.721 (95% CI = 0.657-0.786, p < 0.001) in females. The cut-offs for calf circumference in predicting sarcopenia were 34 cm (sensitivity 67.1%, specificity 70.6%) in males, and 31 cm (sensitivity 82.5%, specificity 51.5%) in females. CONCLUSIONS: Even though sex differences in its predictive value for sarcopenia should be considered, our findings suggest that calf circumference can be used as an indicator for predicting muscle mass and may serve as a potential marker for identifying sarcopenia in older patients with chronic low back pain.


Asunto(s)
Pierna , Dolor de la Región Lumbar , Sarcopenia , Humanos , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Masculino , Femenino , Anciano , Estudios Transversales , Estudios Retrospectivos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/epidemiología , Dolor Crónico/diagnóstico , Dolor Crónico/epidemiología , Fuerza Muscular/fisiología , Anciano de 80 o más Años , Valor Predictivo de las Pruebas , Músculo Esquelético/patología , Músculo Esquelético/fisiopatología
2.
Clin Anat ; 2024 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-38984441

RESUMEN

The articular branch (Arb) from the common fibular nerve (CFN) plays a pivotal role in procedures such as genicular nerve blocks since it extensively innervates the anterolateral knee joint. It remains unclear whether the Arb can be classified as purely sensory, and understanding its axonal composition is critical to prevent muscle weakness during nerve blocks. We conducted a histological analysis on six cadaveric nerve specimens (four males and two females; mean age at death, 81.3 years old). The axonal composition of the main trunk of the CFN, the deep and superficial fibular nerves (DFN and SFN), and the Arb was verified through double immunofluorescence labeling with antibodies against neurofilament 200 and choline acetyltransferase. We revealed that the DFN contains motor and sensory fascicles that serve the anterior muscular compartment of the leg, including the fibularis longus and the first web space of the foot. Moreover, we showed that the SFN includes a major sensory branch innervating the skin of the lateral leg and the dorsum of the foot and a minor motor branch for the lateral muscular compartment of the leg. Furthermore, we demonstrated that the Abr contains a major sensory branch that targets the infrapatellar fat pad, the knee joint, and a minor motor branch innervating the superior part of the anterior muscular compartment of the leg. Thus, our study proves that the Arb is a motor-sensory mixed nerve, suggesting that an Arb block may significantly weaken the anterior leg muscles.

3.
Appl Radiat Isot ; 210: 111341, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38744039

RESUMEN

We developed a novel quadratic resampling method for summing up γ-ray spectra with different calibration parameters. We investigated a long-term environmental background γ-ray spectrum by summing up 114 spectra measured using a 30% HPGe detector between 2017 and 2021. Gain variations in different measurement periods shift γ-ray peak positions by a fractional pulse-height bin size up to around 2 keV. The resampling method was applied to measure low-level background γ-ray peaks in the γ-ray spectrum in a wide energy range from 50 keV to 3 MeV. We additionally document temporal variations in the activities of major γ-ray peaks, such as 40K (1461 keV), 208Tl (2615 keV), and other typical nuclides, along with contributions from cosmic rays. The normal distribution of γ-ray background count rates, as evidenced by quantile-quantile plots, indicates consistent data collection throughout the measurement period. Consequently, we assert that the quadratic resampling method for accumulating γ-ray spectra surpasses the linear method (Bossew, 2005) in various aspects.

4.
Sci Transl Med ; 16(742): eadj0395, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38598615

RESUMEN

Chronic primary pain conditions (CPPCs) affect over 100 million Americans, predominantly women. They remain ineffectively treated, in large part because of a lack of valid animal models with translational relevance. Here, we characterized a CPPC mouse model that integrated clinically relevant genetic (catechol-O-methyltransferase; COMT knockdown) and environmental (stress and injury) factors. Compared with wild-type mice, Comt+/- mice undergoing repeated swim stress and molar extraction surgery intervention exhibited pronounced multisite body pain and depressive-like behavior lasting >3 months. Comt+/- mice undergoing the intervention also exhibited enhanced activity of primary afferent nociceptors innervating hindpaw and low back sites and increased plasma concentrations of norepinephrine and pro-inflammatory cytokines interleukin-6 (IL-6) and IL-17A. The pain and depressive-like behavior were of greater magnitude and longer duration (≥12 months) in females versus males. Furthermore, increases in anxiety-like behavior and IL-6 were female-specific. The effect of COMT genotype × stress interactions on pain, IL-6, and IL-17A was validated in a cohort of 549 patients with CPPCs, demonstrating clinical relevance. Last, we assessed the predictive validity of the model for analgesic screening and found that it successfully predicted the lack of efficacy of minocycline and the CB2 agonist GW842166X, which were effective in spared nerve injury and complete Freund's adjuvant models, respectively, but failed in clinical trials. Yet, pain in the CPPC model was alleviated by the beta-3 adrenergic antagonist SR59230A. Thus, the CPPC mouse model reliably recapitulates clinically and biologically relevant features of CPPCs and may be implemented to test underlying mechanisms and find new therapeutics.


Asunto(s)
Dolor Crónico , Ratas , Masculino , Humanos , Femenino , Ratones , Animales , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/genética , Catecol O-Metiltransferasa/genética , Interleucina-17 , Interleucina-6 , Ratas Sprague-Dawley
5.
Qual Life Res ; 33(7): 1905-1913, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38642220

RESUMEN

PURPOSE: Understanding the influence of frailty on health-related quality of life (HRQoL) in older individuals experiencing chronic low back pain can provide valuable insights into the impact of frailty. Therefore, the aim of our study is to assess how different frailty statuses among older outpatients with chronic low back pain affect their HRQoL. METHODS: Patients aged 60 and above with chronic low back pain were recruited from March 2022 to February 2023. Frailty was assessed via the frailty phenotype questionnaire, and HRQoL was evaluated using the EQ-5D-5L. Multiple regression models were used to explore the influence of frailty status on the EQ-5D-5L index and EQ-VAS. Logistic regression was used to determine odds ratios for the impact of frailty status on belonging to the lowest EQ-5D-5L index quartile. RESULTS: A total of 1,054 participants were classified into robust (29.8%), pre-frail (47.7%), and frail (22.5%) groups. Frailty was significantly associated with declining HRQoL. Pre-frail and frail statuses were inversely linked to the EQ-5D-5L index, with significantly higher odds of scoring in the lowest quartile compared to robust individuals. Stratification analysis identified sex as an effect modifier, emphasizing a more substantial association between frailty and the lowest EQ-5D-5L index quartile in female patients. CONCLUSIONS: A significant association exists between frailty and reduced HRQoL in patients with chronic low back pain. This association was predominant in female patients. Furthermore, considering the dynamic nature of frailty, early detection and effective interventions targeting pre-frailty are essential to delaying the transition to full frailty and improving HRQoL.


Asunto(s)
Dolor de la Región Lumbar , Calidad de Vida , Humanos , Dolor de la Región Lumbar/psicología , Femenino , Masculino , Anciano , Estudios Retrospectivos , Persona de Mediana Edad , Encuestas y Cuestionarios , Anciano de 80 o más Años , Anciano Frágil/psicología , Dolor Crónico/psicología , Fragilidad/psicología
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