Identification of factors associated with sarcopenic obesity development: Literature review and expert panel voting.

Sarcopenic obesity (SO) is defined as the combination of excess fat mass (obesity) and low skeletal muscle mass and function (sarcopenia). The identification and classification of factors related to SO would favor better prevention and diagnosis. The present article aimed to (i) define a list of factors related with SO based on literature analysis, (ii) identify clinical conditions linked with SO development from literature search and (iii) evaluate their relevance and the potential research gaps by consulting an expert panel. From 4746 articles screened, 240 articles were selected for extraction of the factors associated with SO. Factors were classified according to their frequency in the literature. Clinical conditions were also recorded. Then, they were evaluated by a panel of expert for evaluation of their relevance in SO development. Experts also suggested additional factors. Thirty-nine unique factors were extracted from the papers and additional eleven factors suggested by a panel of experts in the SO field. The frequency in the literature showed insulin resistance, dyslipidemia, lack of exercise training, inflammation and hypertension as the most frequent factors associated with SO whereas experts ranked low spontaneous physical activity, protein and energy intakes, low exercise training and aging as the most important. Although literature and expert panel presented some differences, this first list of associated factors could help to identify patients at risk of SO. Further work is needed to confirm the contribution of factors associated with SO among the population overtime or in randomized controlled trials to demonstrate causality.

Depression Severity as a Risk Factor of Sarcopenic Obesity in Morbidly Obese Patients.

SETTING: Etiopathogenic factors of physical disability in obesity are numerous, underestimated and not sought in the non-geriatric population. Amongst these factors, depression may favor the development of sarcopenic obesity by reducing strength and physical performance even in the absence of overt muscle loss. Objectives and participants: To study the link between depression status and muscle functional disorders (dynapenia) in a population of adult subjects with severe and morbid obesity. MEASUREMENTS: Patients were assessed for body composition, grip strength, the Short Physical Performances Battery test (SPPB), for depression according to the Beck II score as well as for metabolic parameters through biological tests. RESULTS: In 373 obese subjects (mean age 44 ± 13y and BMI 43 ± 6 kg/m²), the prevalence of depression was 53% with 18% having mild depression, 18% moderate depression and 16% severe depression. Depression was significantly related to dynapenia: 62% of dynapenic (D) patients suffered from depression compared to 50% of non-dynapenic (ND) patients (p = 0.036). The Beck questionnaire score for D patients was 20 ± 13 and 15 ± 10 for ND patients (p = 0.001). The depression intensity was significantly correlated with dynapenia with D patients having a higher severe depression degree than ND patients (30% versus 11%; p < 0.0001). Fat-free to fat mass ratio was also significantly correlated with dynapenia (p = 0.01). In multivariate analysis, the presence of depression was twice as likely to be associated with dynapenia. CONCLUSIONS: Depression is associated with a reduction of muscle function in severe obesity in relation to its severity and to changes in fat to fat-free mass, suggesting that screening and prevention of sarcopenic obesity should be considered in adult obese patients with depression.

The motor function measure to study limitation of activity in children and adults with Charcot-Marie-Tooth disease.

OBJECTIVE: To study the applicability and responsiveness of the motor function measure (total score and sub-scores D1, D2 and D3) in patients with Charcot-Marie-Tooth disease. PATIENTS AND METHODS: Two hundred and thirty-three patients aged 4-86 years were included in the descriptive study. Scores and sub-scores were analyzed by age and by disease subtypes. Sensitivity to change (responsiveness) was estimated in patients having had at least two evaluations with at least six months between the first and the second. RESULTS: Motor function measure scores decrease with age, especially sub-scores D1 and D3. There were no significant differences between the scores according to type of Charcot-Marie-Tooth disease. The scores were significantly higher for ambulatory than for non-ambulatory patients. Significant responsiveness was demonstrated only in type 2 Charcot-Marie-Tooth disease. DISCUSSION/CONCLUSIONS: Our results suggest that, especially for D1 and D3 sub-scores, the motor function measure is a reliable and valid outcome measure that can be usefully applied in longitudinal follow-up. Studies of longer duration could demonstrate its responsiveness in other Charcot-Marie-Tooth disease subtypes.

Acquired visual field defects rehabilitation: critical review and perspectives.

Visual field deficit (VFD) is one of the most commonly observed symptoms following brain injury. Persistent VFD and defective exploratory oculomotor scanning patterns often cause severe impairment in daily activities, particularly as regards visual exploration and reading. Homonymous hemianopia is consequently a powerful negative predictor of patient outcome. In spite of these quantitative and qualitative factors, there currently exists no consensus on rehabilitative therapy and treatment. Different approaches have nevertheless been developed, all of them having one therapeutic principle in common; repeated practice of a specific visual task, with the hope/expectation that improved performance will extend to a wide range of ecologically useful visual functions. The four main available methods aim at replacing part of the intact visual field with part of the damaged visual field (optical therapy using prisms), at partially restoring the lost visual field region (restorative therapies), at stimulating detection capacities in the blind field (stimulation or blindsight) or at substituting for the lost region by reorganizing the control of visual information processing and eye movements (compensatory therapies). This review explores the key data relative to these different approaches in terms of behavioral or imagery results. It also aims at critically analyzing the advantages and limits of each one. The importance of strict assessment in terms of deficiencies or disabilities is underlined. Finally, upon consideration of these data taken as a whole, it is suggested that efficient treatment would probably have to associate general components and more specific elements, according to what may be done with regard to other aspects of cognitive rehabilitation.

Functionalization of hydrocolloids: principal component analysis applied to the study of correlations between parameters describing the consistency of hydrogels.

This work was part of a pure research project on the functionalization of three families of hydrocolloids: cellulose derivatives, carrageenates, and alginates. Principal component analysis (PCA), a powerful statistical method, was used to demonstrate the relations existing among these different parameters that describe the consistency of hydrogels and their spreadability. This approach therefore provides a basis for modeling hydrogel consistency. PCA also afforded a classification of hydrogels that demonstrated the remarkable adhesiveness of very stiff gels based on cellulose derivatives and sodium or potassium alginates. The corresponding semi-fluid gels and all the gels based on carrageenates and mixed sodium-calcium alginates, whatever their spreadability, were found to be very poorly adhesive. Generalized to all the many colloids currently marketed, this approach can be used to set up a databank for the formulation of mucoadhesive excipients.

Procyanidins from tormentil: antioxidant properties towards lipoperoxidation and anti-elastase activity.

Procyanidins extracted from the rhizomes of Potentilla tormentilla were fractionated according to their degree of polymerization by chromatography on Sephadex LH20. Dimers and trimers displayed the highest anti-radical activity towards lipoperoxidation. Pentamers and hexamers possessed the most marked anti-elastase properties.

Tannins from Hamamelis virginiana: identification of proanthocyanidins and hamamelitannin quantification in leaf, bark, and stem extracts.

The tannins in leaf, bark, and stem extracts of HAMAMELIS VIRGINIANA were analyzed. Four proanthocyanidins were isolated by HPLC. One was a procyanidin polymer containing only one type of flavanol unit; the other three were polymers of procyanidin and prodelphinidin containing two types of flavanol units. A method of assay of hamamelitannin showed the bark extract to be 31 times richer in hamamelitannin than the leaf extract and 87 times richer than the stem extract.

Lack of cardiovascular effects of delta-9-tetrahydrocannabinol in chemically denervated men.

We have previously reported that 25 micrograms/kg of intravenous (i.v.) delta-9-tetrahydrocannabinol (delta-9-THC) produces marked increases in heart rate, prolongation of left ventricular ejection time corrected for heart rate (LVETc), and a shortening of the pre-ejection period in normal volunteers. Beta-adrenergic blockade partially attenuates these responses. To elucidate further the mechanism of action of delta-9-THC, we gave 10 normal volunteers 0.1 mg/kg of i.v. propranolol and 2 mg of i.v. atropine before they received 25 micrograms/kg of i.v. delta-9-THC. Systolic time intervals were compared in the denervated subjects before and after delta-9-THC. Post delta-9-THC responses were measured at a time approximating peak psychologic high. Mean +/- SEM heart rate before and after delta-9-THC was 89 +/- 4 and 87 +/- 3 beats/min (NS); mean +/- SEM pre-ejection period before and after delta-9-TCH was 107 +/- 5 and 109 +/- 4 ms (NS); and mean +/- SEM LVETc before and after delta-9-THC was 433 +/- 6 and 429 +/- 6 ms (NS). Since previous denervation of our subjects with atropine and propranolol totally abolished changes in heart rate and systolic time intervals, the cardiac effects of delta-9-THC appear to be mediated totally via the autonomic nervous system, probably reflecting direct central nervous system stimulation.

[Comparison of exogenous cell fusion induced by a wild and two mutant strains of sheep Visna virus]. / Etude comparée de la fusion cellulaire exogène induite in vitro par une souche standard du virus Visna du Mouton et par deux variants.

Exogen cell fusion induced in vitro by a wild strain of Visna virus of Sheep is compared with two mutant strains isolated from the precedent. One of them produces large plaques in vitro (strain LPF), and the other produces small plaques (strain SPF). These strains behave in different ways according to infection multiplicity, type of cells, temperature and timing of fusing activity. Taking the wild strain K 796 as a base of reference, the strain SPF seems to have a higher rate fusing activity and the strain LPF lower rate of fusing activity.

[Kinetics and ultrastructure of sheep fibroblast fusion induced by polyethylene glycol. Comparison with endogenous cell fusion induced by Visna virus]. / Etude cinétique et ultrastructurale de la fusion de fibroblastes de mouton induite par le polyéthylène-glycol. Comparaison avec la fusion cellulaire endogène induite par le virus Visna.

The authors compare the fusion of sheep fibroblasts induced by low multiplicities of infection using visna virus and by high concentrations of polyethylene-glycol. In the case of Visna virus cell fusion is of the endogenous type, while fusion induced by polyethylene-glycol is of the exogenous type. The ultrastructural features are discussed for each type of cell fusion. The main differences between the two systems involve the intracellular microfilaments and Golgi apparatus.