ChatGPT in forensic sciences: a new Pandora's box with advantages and challenges to pay attention.

ChatGPT is a variant of the generative pre-trained transformer (GPT) language model that uses large amounts of text-based training data and a transformer architecture to generate human-like text adjusted to the received prompts. ChatGPT presents several advantages in forensic sciences, namely, constituting a virtual assistant to aid lawyers, judges, and victims in managing and interpreting forensic expert data. But what would happen if ChatGPT began to be used to produce forensic expertise reports? Despite its potential applications, the use of ChatGPT and other Large Language Models and artificial intelligence tools in forensic writing also poses ethical and legal concerns, which are discussed in this perspective together with some expected future perspectives.

Drug Overdose-Induced Coma Blisters: Pathophysiology and Clinical and Forensic Diagnosis.

BACKGROUND: Coma blisters or coma bullae are bullous lesions that have been associated with cases of drug overdose-induced coma. Previous history of suicide attempt by administering benzodiazepines, barbiturates, ethanol, antipsychotics, antidepressants or opioids have been particularly implicated. Patients may present also painful deep skin and soft tissue involvement, edema and functional impairment. The pathophysiology remains unknown and lesions are usually self-limited and typically resolve without scarring. OBJECTIVE: This work aims to fully review the state of the art regarding the causes pathophysiology, diagnosis and treatment of drug overdose-induced coma blisters. CONCLUSION: Coma blisters are a benign, self-limiting condition that should be suspected in patients who develop pressure blisters several hours after an altered state of consciousness.

L-Threonine Supplementation During Colitis Onset Delays Disease Recovery.

Dietary nutrients have emerged as potential therapeutic adjuncts for inflammatory bowel disease (IBD) given their impact on intestinal homeostasis through the modulation of immune response, gut microbiota composition and epithelial barrier stability. Several nutrients have already been associated with a protective phenotype. Yet, there is a lack of knowledge toward the most promising ones as well as the most adequate phase of action. To unveil the most prominent therapy candidates we characterized the colon metabolic profile during colitis development. We have observed a twofold decrease in threonine levels in mice subjected to DSS-induced colitis. We then assessed the effect of threonine supplementation in the beginning of the inflammatory process (DSS + Thr) or when inflammation is already established (DSS + Thr D8). Colitis progression was similar between the treated groups and control colitic mice, yet threonine had a surprisingly detrimental effect when administered in the beginning of the disease, with mice displaying a delayed recovery when compared to control mice and mice supplemented with threonine after day 8. Although no major changes were found in their metabolic profile, DSS + Thr mice displayed altered expression in mucin-encoding genes, as well as in goblet cell counts, unveiling an impaired ability to produce mucus. Moreover, IL-22 secretion was decreased in DSS + Thr mice when compared to DSS + Thr D8 mice. Overall, these results suggest that supplementation with threonine during colitis induction impact goblet cell number and delays the recovery period. This reinforces the importance of a deeper understanding regarding threonine supplementation in IBD.

Do virtual reality games improve mobility skills and balance measurements in community-dwelling older adults? Systematic review and meta-analysis.

OBJECTIVE: To summarize evidence on the effectiveness of virtual reality games and conventional therapy or no-intervention for fall prevention in the elderly. DATA SOURCES: An electronic data search (last searched December 2016) was performed on 10 databases (Web of Science, EMBASE, PUBMED, CINAHL, LILACS, SPORTDiscus, Cochrane Library, Scopus, SciELO, PEDro) and retained only randomized controlled trials. REVIEW METHOD: Sample characteristics and intervention parameters were compared, focusing on clinical homogeneity of demographic characteristics, type/duration of interventions, outcomes (balance, reaction time, mobility, lower limb strength and fear of falling) and low risk of bias. Based on homogeneity, a meta-analysis was considered. Two independent reviewers assessed the risk of bias. RESULTS: A total of 28 studies met the inclusion criteria and were appraised ( n: 1121 elderly participants). We found that virtual reality games presented positive effects on balance and fear of falling compared with no-intervention. Virtual reality games were also superior to conventional interventions for balance improvements and fear of falling. The six studies included in the meta-analysis demonstrated that virtual reality games significantly improved mobility and balance after 3-6 and 8-12 weeks of intervention when compared with no-intervention. The risk of bias revealed that less than one-third of the studies correctly described the random sequence generation and allocation concealment procedures. CONCLUSION: Our review suggests positive clinical effects of virtual reality games for balance and mobility improvements compared with no-treatment and conventional interventions. However, owing to the high risk of bias and large variability of intervention protocols, the evidence remains inconclusive and further research is warranted.

Fatal Intoxications in the North of Portugal: 12 Years of Retrospective Analysis.

BACKGROUND: Fatal intoxications are a topic of great relevance in today's society. They typically occur by accidental or voluntary ingestion, but its characterization by a forensic perspective was not fully explored. OBJECTIVE: This study retrospectively reviews fatal intoxication cases autopsied at the northern forensic medicine services of Portugal, between 2001 and 2013. METHOD: For this purpose, we analyzed postmortem forensic medical reports with positive qualitative analysis for xenobiotics. RESULTS: A total of 27,778 autopsy reports were analyzed, of which 1,269 cases fulfilled the selection criteria, representing 4.6% of total number of individuals autopsied during the period under analysis. Men were involved in most of the cases (73.8%) and most individuals were adults with ages between 36 and 65 years old (57.0%). The highest incidences were medicines (22.9%) and alcohol (15.8%), followed by their association. Cases of fatal intoxications involving opioids come on fifth place (5.8%) namely due to accidental overdoses. Moreover, intoxications appeared as the leading cause of death in reports concerning accidental etiology, with drugs and alcohol associations having a great expression. CONCLUSION: Due to morbidity and relevant number of fatal cases, risk prevention measures, such as public health policies should be implemented to reduce the number of intoxications.

Body Composition is Strongly Associated With Cardiorespiratory Fitness in a Large Brazilian Military Firefighter Cohort: The Brazilian Firefighters Study.

Firefighting is associated with high-level physical demands and requires appropriate physical fitness. Considering that obesity has been correlated with decreased cardiorespiratory fitness (CRF) and that the prevalence of obesity may also be elevated within firefighters (FF), we analyzed the association between CRF and body composition (BC) in Brazilian military FF. We assessed 4,237 male FF (18-49 years) who performed a physical fitness test that included BC and CRF. Body composition was assessed by body mass index (BMI), body adiposity index (BAI), body fat percentage (BF%), and waist circumference (WC). CRF was assessed by the 12-minute Cooper test. Comparisons of VO2max between the BC categories were analyzed using the Mann-Whitney test, and the analysis was adjusted for age using the General Linear Model. The Spearman test was used for correlation analysis and the odds ratio (OR) was calculated to assess the odds of the unfit group (≤ 12 metabolic equivalents [METs]) for poor BC. Statistically significant differences were considered when p ≤ 0.05. Considering the BMI categories, 8 volunteers (0.2%) were underweight, 1,306 (30.8%) were normal weight, 2,301 (54.3%) were overweight, and 622 (14.7%) were obese. The VO2max was negatively correlated with age (rs = -0.21), BMI (rs = -0.45), WC (rs = -0.50), and BAI (rs = -0.35) (p < 0.001). Cardiorespiratory fitness was lower in the obese compared with the nonobese for all age categories (-3.8 ml · kg(-1) · min(-1); p < 0.001) and for all BC indices (-4.5 ml · kg(-1) · min(-1); p < 0.001). The OR of the unfit group having poor BC in all indices varied from 2.9 to 8.1 (p < 0.001). Despite the metabolically healthy obesity phenomenon, we found a strong association between CRF and BC irrespective of age and the BC method (BMI, BAI, WC, or BF%). These findings may aid in improving FF training programs with a focus on health and performance.

Interleukin-1ß genotype and circulating levels in cancer patients: metastatic status and pain perception.

OBJECTIVES: Proinflammatory cytokines released during inflammation can cause hyperexcitability in pain transmission neurons, leading to hyperalgesia and allodynia. Polymorphisms in interleukin 1 (IL-1) family of genes (IL1A, IL1B) and in IL-1 receptor antagonist (IL-1Ra, coded by IL1RN) may therefore induce alterations in cytokine levels/effects and pain related response. Our purpose was to investigate the influence of polymorphisms in IL1A/B/RN on cytokine serum levels and its correlation with pain intensity, performance status, adverse effects, metastases and breakthrough pain in Caucasian cancer patients. DESIGN AND METHODS: Serum IL-1α/ß levels of 74 cancer patients were measured by competitive enzyme immunosorbent assay. All patients were also genotyped for the polymorphisms in IL1A (rs17561), IL1B (rs1143634) and IL1RN (rs419598) with Real-Time PCR. Results were then correlated to the appearance of bone or CNS metastases and several pain-related parameters. RESULTS: IL-1ß rs1143634 homozygous for T allele were associated with lower levels of IL1-ß (p=0.032, Mann-Whitney test) and presented a trend for lower levels of pain (p=0.06, Fisher's Exact Test). Also, IL1-ß levels were related with cancer onset status, since a four-fold increase probability of metastatic disease was observed in high IL-1ß individuals (OR=4.074, p=0.010, Pearson χ(2) test). Among the female patients presenting metastatic disease and carriers of the TT genotype we observed a trend to lower levels of IL1-ß (p=0.053, Pearson χ(2) test). CONCLUSIONS: Our results indicate that genetic variation at IL1-ß gene may influence serum levels of IL1-ß, with proportional consequences in cancer-related pain.

Cumulative mitoxantrone-induced haematological and hepatic adverse effects in a subchronic in vivo study.

Mitoxantrone (MTX) is an antineoplastic agent that can induce hepato- and haematotoxicity. This work aimed to investigate the occurrence of cumulative early and late MTX-induced hepatic and haematological disturbances in an vivo model. A control group and two groups treated with three cycles of 2.5 mg/kg MTX at days 0, 10 and 20 were formed. One of the treated groups suffered euthanasia on day 22 (MTX22) to evaluate early MTX toxic effects, while the other suffered euthanasia on day 48 (MTX48), to allow the evaluation of MTX late effects. An early immunosuppression with a drop in the IgG levels was observed, causing a slight decrease in the plasma total protein content. The early bone marrow depression was followed by signs of recovery in MTX48. The genotoxic potential of MTX was demonstrated by the presence of several micronuclei in MTX22 leucocytes. Increases in plasma iron and cholesterol levels in the MTX22 rats were observed, while in both groups increases in the unconjugated bilirubin, C4 complement, and decreases in the triglycerides, alanine aminotransferase, alkaline phosphatase and transferrin were found in plasma samples. On MTX 48, the liver histology showed more hepatotoxic signs, the hepatic levels of reduced and oxidized glutathione were increased, and ATP hepatic levels were decreased. However, the hepatic total protein levels were decreased only in the livers of MTX22 group. Results demonstrated the MTX genotoxic effects, haemato- and direct hepatotoxicity. While the haematological toxicity is ameliorated with time, the same was not observed in the hepatic injury.

Alleged biological father incest: a forensic approach.

Paternal incest is one of the most serious forms of intrafamilial sexual abuse with clinical, social, and legal relevance. A retrospective study was performed, based on forensic reports and judicial decisions of alleged cases of biological paternal incest of victims under 18 years old (n = 215) from 2003 to 2008. Results highlight that in a relevant number of cases: victims were female; the abuse begun at an early age with reiteration; the alleged perpetrator presented a history of sexual crimes against children; sexual practices were physically poorly intrusive, which associated with a forensic medical evaluation performed more than 72 h after the abuse, explain partially the absence of physical injuries or other evidence-these last aspects are different from extrafamilial cases. In conclusion, observations about paternal incest are likely to exacerbate the psychosocial consequences of the abuse and may explain the difficulty and delay in detect and disclose these cases. Few cases were legally prosecuted and convicted.

Association between polymorphisms in the TRHR gene, fat-free mass, and muscle strength in older women.

A previous genome-wide association study suggested that polymorphisms in the thyrotrophin-releasing hormone receptor (TRHR) gene contribute to fat-free mass (FFM) variation. The aim of the present study was to examine the association between polymorphisms in the TRHR gene with FFM and muscle strength in older women. Volunteers (n = 241; age = 66.65 ± 5.5 years) underwent quadriceps strength assessment using isokinetics and fat-free mass by dual-energy X-ray absorptiometry. TRHR polymorphisms and ancestry-informative markers were genotyped through standard procedures. No significant difference was observed for rs7832552. Regarding the rs16892496, ANCOVA revealed that appendicular fat-free mass (AFFM) and relative AFFM were significantly different between groups (p = 0.04 and p = 0.05, respectively). Individuals carrying A/A and A/C genotypes respectively showed, on average, an extra 1 kg and 900 g of AFFM when compared to C/C genotype carriers. Also, the C/C genotype group presented a significantly higher chance to have reduced muscle strength. The observations presented here provide further evidence that the rs16892496 polymorphism in the TRHR gene may play a role in FFM variation. Moreover, the results bring the novel insight that this genetic variant can present a modest contribution to muscle strength in older women.

Acute and chronic effects of resistive exercise on blood pressure in hypertensive elderly women.

The purpose of this study was to investigate postexercise hypotension (PEH) during a 4-month period of resistance training in hypertensive elderly women. Sixty-four women were divided into 2 groups: an experimental group (EG), which performed resistance training, and a control group (CG) that did not practice any exercise. The EG carried out the following steps: (a) 3 weeks of exercise adaptation and 1 repetition maximum (1RM) test (month 1); (b) resistance exercise at 60% 1RM (month 2); (c) resistance exercise at 70% 1RM (month 3); (d) resistance exercise at 80% 1RM (month 4); and (e) PEH analyses at the end of each month. Measurements of systolic (SBP) and diastolic blood pressure (DBP) were calculated each 5 minutes during a 20-minute resting period before the sessions and each 15 minutes during 1 hour of post-session recovery. Analysis of covariance for repeated measures showed a reduction in SBP of about 14 mm Hg (p ≤ 0.05) and in DBP of 3.6 mm Hg (p ≤ 0.05) between resting values after the training period. In the EG group, SBP showed acute PEH during months 2 and 3, whereas DBP showed acute PEH during months 2 and 4. The CG did not show acute PEH or variations during the 4-month period. Postexercise hypotension occurrence and chronic reduction of resting blood pressure observed in the EG may have a protective effect on the cardiovascular system of the study participants.

High molecular mass proteomics analyses of left ventricle from rats subjected to differential swimming training.

BACKGROUND: Regular exercises are commonly described as an important factor in health improvement, being directly related to contractile force development in cardiac cells.In order to evaluate the links between swimming exercise intensity and cardiac adaptation by using high molecular mass proteomics, isogenic Wistar rats were divided into four groups: one control (CG) and three training groups (TG's), with low, moderate and high intensity of exercises.In order to evaluate the links between swimming exercise intensity and cardiac adaptation by using high molecular mass proteomics, isogenic Wistar rats were divided into four groups: one control (CG) and three training groups (TG's), with low, moderate and high intensity of exercises. RESULTS: Findings here reported demonstrated clear morphologic alterations, significant cellular injury and increased energy supplies at high exercise intensities. α-MyHC, as well proteins associated with mitochondrial oxidative metabolism were shown to be improved. α-MyHC expression increase 1.2 fold in high intensity training group when compared with control group. α-MyHC was also evaluated by real-time PCR showing a clear expression correlation with protein synthesis data increase in 8.48 fold in high intensity training group. Other myofibrillar protein, troponin , appear only in high intensity group, corroborating the cellular injury data. High molecular masses proteins such as MRS2 and NADH dehydrogenase, involved in metabolic pathways also demonstrate increase expression, respectily 1.5 and 1.3 fold, in response to high intensity exercise. CONCLUSIONS: High intensity exercise demonstrated an increase expression in some high molecular masses myofibrilar proteins, α-MyHC and troponin. Furthermore this intensity also lead a significant increase of other high molecular masses proteins such as MRS2 and NADH dehydrogenase in comparison to low and moderate intensities. However, high intensity exercise also represented a significant degree of cellular injury, when compared with the individuals submitted to low and moderate intensities.

Effects of a physical activity governmental health programme on the quality of life of elderly people.

BACKGROUND: The population ageing occurring worldwide resulted in multiple researches on sedentary ageing and quality of life. PURPOSE: To verify the effects of a physical activity programme on the quality of life (QOL) of elderly individuals served by a governmental health programme. DESIGN: Descriptive inquiry research. METHODS: Randomly distributing 70 elderly individuals in a control group (n=35; mean±SD 69.80±8.05 years) and an experimental group (n=35; 68.66±5.93 years) plus QOL evaluation via WHOQOL-Old. RESULTS: The experimental group showed significant best results on the post-test by repeated-measures ANOVA on sensorial functioning (Δ%=0.022%, p=0. 0001), social participation (Δ%=0.012%, p=0.013), perceptions of death and dying (Δ%=0.04%, p=0.009), intimacy (Δ%=0.059%, p=0.05), and total score (Δ%=0.001, p=0.000). CONCLUSIONS: Sensorial functioning, social participation, perceptions of death and dying, and intimacy play an important role in the positive relationship between physical activity and QOL.

The influence of the level of physical activity and human development in the quality of life in survivors of stroke.

BACKGROUND: The association between physical activity and quality of life in stroke survivors has not been analyzed within a framework related to the human development index. This study aimed to identify differences in physical activity level and in the quality of life of stroke survivors in two cities differing in economic aspects of the human development index. METHODS: Two groups of subjects who had suffered a stroke at least a year prior to testing and showed hemiplegia or hemiparesis were studied: a group from Belo Horizonte (BH) with 48 people (51.5 ± 8.7 years) and one from Montes Claros (MC) with 29 subjects (55.4 ± 8.1 years). Subsequently, regardless of location, the groups were divided into Active and Insufficiently Active so their difference in terms of quality of life could be analyzed. RESULTS: There were no significant differences between BH and MCG when it came to four dimensions of physical health that were evaluated (physical functioning, physical aspect, pain and health status) or in the following four dimensions of mental health status (vitality, social aspect, emotional aspect and mental health). However, significantly higher mean values were found in Active when compared with Insufficiently Active individuals in various measures of physical health (physical functioning 56.2 ± 4.4 vs. 47.4 ± 6.9; physical aspect 66.5 ± 6.5 vs. 59.1 ± 6.7; pain 55.9 ± 6.2 vs. 47.7 ± 6.0; health status 67.2 ± 4.2 vs. 56.6 ± 7.8) (arbitrary units), and mental health (vitality 60.9 ± 6.8 vs. 54.1 ± 7.2; social aspect 60.4 ± 7.1 vs. 54.2 ± 7.4; emotional aspect 64.0 ± 5.5 vs. 58.1 ± 6.9; mental health status 66.2 ± 5.5 vs. 58.4 ± 7.5) (arbitrary units). CONCLUSIONS: Despite the difference between the cities concerning HDI values, no significant differences in quality of life were found between BH and MCG. However, the Active group showed significantly better results, confirming the importance of active lifestyle to enhance quality of life in stroke survivors.

Effects of 24 weeks of progressive resistance training on knee extensors peak torque and fat-free mass in older women.

This study examined the effects of resistance training (RT) on knee extensor peak torque (KEPT) and fat-free mass (FFM) in older women. Seventy-eight volunteers (67.1 ± 5.9 years old) underwent 24 weeks of progressive RT (RTG) while 76 (67.4 ± 5.9 years old) were studied as controls (CG). Dominant knee extension peak torque was assessed using an isokinetic dynamometer (Biodex System 3) and FFM measurements were performed by dual-energy x-ray absorptiometry. Muscle strength and FFM were evaluated before and after the intervention in all volunteers. Participants in the RTG trained major muscle groups 3 times per week during 24 weeks. Training load was kept at 60% of 1 repetition maximum in the first 4 weeks, 70% in the following 4 weeks, and 80% in the remaining 16 weeks, with repetitions, respectively, decreasing from 12, 10, and 8. A Split-plot analysis of variance was performed to examine between- and within-group differences, and the level of significance was accepted at p ≤ 0.05. It was observed that the RTG showed significant increases in KEPT (from 89.9 ± 21.8 to 102.8 ± 22.6 N·m; p < 0.05) and FFM (from 36.4 ± 4.0 to 37.1 ± 4.2 kg, p < 0.05). Appendicular FFM was also significantly increased after the intervention period in the RTG (13.9 ± 1.8 to 14.2 ± 1.9 kg, p < 0.05). None of these changes were observed for the CG. Consistent with the literature, it is concluded that a progressive RT program promotes not only increases in muscle strength, as evaluated by an isokinetic dynamometer, but also in FFM as evaluated by the DXA, in elderly women.

Genetic heterogeneity of self-reported ancestry groups in an admixed Brazilian population.

BACKGROUND: Population stratification is the main source of spurious results and poor reproducibility in genetic association findings. Population heterogeneity can be controlled for by grouping individuals in ethnic clusters; however, in admixed populations, there is evidence that such proxies do not provide efficient stratification control. The aim of this study was to evaluate the relation of self-reported with genetic ancestry and the statistical risk of grouping an admixed sample based on self-reported ancestry. METHODS: A questionnaire that included an item on self-reported ancestry was completed by 189 female volunteers from an admixed Brazilian population. Individual genetic ancestry was then determined by genotyping ancestry informative markers. RESULTS: Self-reported ancestry was classified as white, intermediate, and black. The mean difference among self-reported groups was significant for European and African, but not Amerindian, genetic ancestry. Pairwise fixation index analysis revealed a significant difference among groups. However, the increase in the chance of type 1 error was estimated to be 14%. CONCLUSIONS: Self-reporting of ancestry was not an appropriate methodology to cluster groups in a Brazilian population, due to high variance at the individual level. Ancestry informative markers are more useful for quantitative measurement of biological ancestry.

Estudo comparativo da função do assoalho pélvico em mulheres continentes e incontinentes na pós menopausa / Comparative study of pelvic floor function in continent and incontinent postmenopausal women

CONTEXTUALIZAÇÃO: A incontinência urinária (IU) é de causa multifatorial, sendo atribuída, em parte, à fraqueza da musculatura do assoalho pélvico. Apesar de ser subestimada por muitas mulheres, a avaliação funcional do assoalho pélvico (AFA) pode contribuir para um correto diagnóstico e terapêutica adequada. OBJETIVOS: Comparar a função muscular do assoalho pélvico em mulheres continentes e incontinentes na pós menopausa como fator diagnóstico no tratamento da IU. MÉTODOS: A partir da investigação dos sintomas urinários, 153 mulheres (idade X=66,7±5,4) foram separadas em dois grupos (G1 incontinentes e G2 assintomáticas). Após análise dos critérios de inclusão, as mulheres foram submetidas à AFA por meio da palpação bidigital (classificação de Contreras Ortis, 1994) e à quantificação da pressão de contração perineal por meio do perineômetro (PERINA 996-2® QUARK). RESULTADOS: Observou-se prevalência de IU (54,9 por cento) na amostra estudada, sendo a incontinência urinária de esforço (IUE) (41,7 por cento) o tipo mais presente. Em relação aos sintomas urinários, como a frequência miccional diurna (p=0,004) e noturna (p=0,02), o grupo G1 apresentou um valor significativamente mais alto. A AFA mostrou resultados similares durante a palpação e o perineômetro, com diferenças significativas (p<0,001) entre os dois grupos. Utilizou-se estatística descritiva, teste t de Student para amostras independentes, medidas de prevalência e análise de variância (one-way ANOVA), seguida do post hoc de Bonferroni (p<0,05). O software Statistical Package for the Social Sciences (SPSS) versão 10,0 (SPSS, Chicago, IL) foi utilizado para realização de todas as análises. CONCLUSÕES: A palpação e o perineômetro se mostraram eficientes na avaliação da força e pressão de contração desse grupo muscular.

BACKGROUND: Urinary incontinence (UI) is multifactorial and attributed, in part, to weakness of the pelvic floor muscles. Despite being underestimated by many women, a functional pelvic floor assessment (FPA) may contribute to a correct diagnosis and appropriate treatment. OBJECTIVES: To compare the function of pelvic floor muscles in continent and incontinent postmenopausal women as a diagnostic factor in UI treatment. METHODS: Based on the investigation of urinary symptoms, 153 women (age X=66.7±5.4) were divided into two groups (G1-incontinent and G2-continent). After analysis of the inclusion criteria, the women were submitted to FPA by means of bidigital palpation according to Contreras Ortiz (1994) and quantification of perineal strength with a perineometer (PERINA 996-2 QUARK®). RESULTS: There was prevalence of UI (54.9 percent) in the sample, with stress urinary incontinence (41.7 percent) as the most common. Regarding urinary symptoms such as diurnal (p=0.004) and nocturnal (p=0.02) voiding frequency, G1 had a significantly higher value. The FPA found similar results via palpation and the perineometer, with significant differences (p<0.001) between the two groups. We used descriptive statistics, the Student t test for independent samples, measures of prevalence and one-way ANOVA, followed by Bonferroni's post-hoc test (p<0.05). The software Statistical Package for the Social Sciences (SPSS) version 10.0 (SPSS, Chicago, IL) was used to perform all tests. CONCLUSIONS: Palpation and the perineometer were efficient forms of assessing the force and pressure of the muscle contractions of this muscle group.

Fat-free mass, strength, and sarcopenia are related to bone mineral density in older women.

This study examined the association between fat-free mass (FFM) and muscle strength with bone mineral density (BMD), and compared the BMD values between sarcopenic and nonsarcopenic older women. After the exclusion criteria were applied, a total of 246 volunteers (age: 66.51+/-6.37 yr) participated in the analysis. Subjects underwent FFM and BMD evaluation by dual-energy X-ray absorptiometry and quadriceps strength by an isokinetic dynamometer. To address the potential for confounding by height, FFM values were considered relative to body height squared. For fat mass correction, fat-adjusted FFM was calculated. Individuals were classified as sarcopenic if their appendicular FFM was less than 5.45 kg/m2. All the evaluated FFM indexes were significantly correlated with the measured BMD sites. Sarcopenic individuals presented significantly lower whole body and trochanter BMD, and were significantly more prone to have low BMD. Muscle strength was also correlated with BMD sites; however, when it was expressed relative to body weight, the significance disappeared. Nevertheless, volunteers with low relative strength had higher risk of having low trochanter BMD. It can be concluded, in older women, that FFM is significantly correlated with BMD independently of height and fat mass. Muscle strength was also correlated with BMD, although the correlation was weaker when corrected for body weight. Finally, sarcopenic elderly women were more likely to have low BMD and muscle strength.