The trajectory of patient-reported outcomes and minimal clinically important differences in isolated and polytraumatic pelvis and acetabular fractures.

PURPOSE: Patient-reported minimal clinically important differences (MCID) provide a standard to compare clinical outcomes. The purpose of this study was to calculate the MCID of PROMIS Physical Function (PF), Pain Interference (PI), Anxiety (AX), and Depression (DEP) scores in patients with pelvis and/or acetabular fractures. METHODS: All patients with operatively treated pelvic and/or acetabular fractures were identified. Patients were categorized as either only pelvis and/or acetabular fractures (PA) or polytrauma (PT). PROMIS PF, PI, AX, and DEP scores were evaluated at 3-month, 6-month, and 12-month intervals. Distribution-based MCID and anchor-based MCID were calculated for the overall cohort, PA, and PT groups. RESULTS: The overall distribution-based MCIDs were PF (5.19), PI (3.97), AX (4.33), and DEP (4.41). The overall anchor-based MCIDs were PF (7.18), PI (8.03), AX (5.85), DEP (5.00). The percentage of patients achieving MCID for AX was 39.8-54% at 3 months and 32.7-56% at 12 months. The percentage of patients achieving MCID for DEP was 35.7-39.3% at 3 months and 32.1-35.7% at 12 months. The PT group had worse PROMIS PF scores than the PA group at all time points [post-operative, 3-month, 6-month, and 12-month scores, (28.3 (6.3) vs. 26.8 (6.8) P = 0.016), (38.1 (9.2) vs. 35.0 (8.7) P = 0.037), (42.8 (8.2) vs. 39 (9.6) P = 0.015), (46.2 (9.7) vs. 41.2 (9.7) P = 0.011)]. CONCLUSION: An overall MCID for PROMIS PF was 5.19-7.18, PROMIS PI 3.97-8.03, PROMIS AX of 4.33-5.85, and PROMIS DEP of 4.41-5.00. The PT group had worse PROMIS PF at all time points. The percentage of patients achieving MCID for AX and DEP plateaued at 3 months post-operatively. LEVEL OF EVIDENCE: Level IV.

Association of Hepatic Steatosis with Adipose and Muscle Mass and Distribution in Children.

Background: Pediatric studies have shown associations between hepatic steatosis and total body fat, visceral fat, and lean mass. However, these associations have not been assessed simultaneously, leaving their relative importance unknown. Objective: To evaluate associations between hepatic steatosis and total-body adiposity, visceral adiposity, and lean mass in children. Method: In children at risk for fatty liver, hepatic steatosis, adipose, and lean mass were estimated with magnetic resonance imaging and dual-energy X-ray absorptiometry. Results: Two hundred twenty-seven children with mean age 12.1 years had mean percent body fat of 38.9% and mean liver fat of 8.4%. Liver fat was positively associated with total-body adiposity, visceral adiposity, and lean mass (P < 0.001), and negatively associated with lean mass percentage (P < 0.001). After weight adjustment, liver fat was only positively associated with measures of central adiposity (P < 0.001). Visceral adiposity also had the strongest association with liver fat (P < 0.001). Conclusions: In children, hepatic steatosis is more strongly associated with visceral adiposity than total adiposity, and the association of lean mass is not independent of weight or fat mass. These relationships may help guide the choice of future interventions to target hepatic steatosis.

Effects of Compound Active Peptides on Protecting Liver and Intestinal Epithelial Cells from Damages and Preventing Hyperglycemia.

Active peptides have good effectiveness in controlling or preventing many diseases. Compound active peptides (CAP) obtained from animal, plant, and sea food proteins were used in this study to explore their effects on antioxidation, anti-inflammation, and antihyperglycemia in vitro and in vivo. The results demonstrated that 10 µg/mL CAP could increase cell viability (P < 0.05) and decrease reactive oxygen species (ROS) levels and cell apoptosis (P < 0.05) when WRL68 cells were induced by H2O2 for 6 h. Moreover, incubation with 20 µg/mL CAP for 6 h significantly increased cell viability and Bcl-2 expression level (P < 0.05) and decreased expression levels of IL-6, IL-8, TNF-α, Bax, and Caspase 3 and the ratio of Bax/Bcl-2 (P < 0.05) when swine jejunal epithelial cells (IPEC-J2) were induced by deoxynivalenol (DON). In addition, adding CAP individually or combined with Liuweidihuang pills (LDP, Chinese medicine) and low-dose glibenclamide could lower blood glucose levels in alloxan-induced hyperglycemic model mice. These results suggested that CAP was probably a beneficial ingredient for alleviating H2O2-induced oxidative stress and DON-induced cell inflammation and apoptosis and preventing hyperglycemia.