Risultati per: Sarcopenia: la prevenzione, il sospetto, la diagnosi e le azioni per il medico di medicina generale

Oncologi, più vaccinazioni e screening. Parte una campagna di sensibilizzazione

Alessandro Vespignani: «siamo in una fase di accelerazione esponenziale che è vissuta in una scala temporale che non ha precedenti. Quindi, per evitare di creare un’altra generazione di medici incapaci di usare questi strumenti, l’urgenza di rivedere la formazione è ora, tra 5 anni sarà tardi»

Ecdc-Oms, 22.995 casi nel 2022; 767 i decessi dovuti all’Aids

Misura oggettive differenze nel cervello con immagini risonanza

Misura oggettive differenze nel cervello con immagini risonanza

Sosterrà i giovani ricercatori. Focus sulla neuroinfiammazione

Donelli, permette diagnosi precoci e terapie più tempestive

Endocrinologi, 16 anni di vita in meno senza gestione ottimale

Non adottandole il corpo più vecchio di 4 anni rispetto all’età

Circulation, Volume 148, Issue Suppl_1, Page A16118-A16118, November 6, 2023. Introduction:Aging is the leading risk factor for multiple chronic diseases especially cardio and cerebrovascular and for a decline in physical and mental function. Progressive stiffening arterial wall, cognitive impairment and sarcopenia are hallmarks of aging. Due to the pleiotropic actions that have been discovered in vitamin D (VD), which include vascular ,muscular and cognitive effects, we hypothesized that VD3 supplementation might decrease vascular stiffness and could have beneficial effect on mental status and sarcopenia in a frailty elderly population.Methods:We randomized 42 residents (78±6.5 yo; 24 females) from a public geriatric institution, to receive either 100,000 IU of VD3 or placebo (P) every 15 days for 6 months. Arterial stiffness (AS) was evaluated through central systolic pressure (cSYS), central pulse pressure (cPP), and the augmentation index (AIx) a measure of systemic AS derived from the ascending aortic pressure waveform; using Uscom® device. Cognitive function was evaluated using the Clock-Drawing Test (CDT), which is simple and effective for this population. Skeletal muscle strength/sarcopenia, were assess with the up and go test (UGT), muscle strength with hydraulic dynamometer, body mass index (BMI) and mini-nutritional assessment (MNA) test.Results:VD group showed a statistically significant decrease in AS vs P. VD Δ cSYS -12.3 mmHg, Δ cPP -6.7 mmHg mmHg and Δ AIx -17.8 %, for all three parameters: p

Circulation, Volume 148, Issue Suppl_1, Page A13076-A13076, November 6, 2023. Background:The Geriatric Nutrition Risk Index (GNRI) is a simple nutritional assessment tool used in elderly patients. Sarcopenia, defined as reduced muscle mass strength, is widely prevalent in patients with advanced heart failure, and has been associated with worse clinical outcomes including post-transplant infections and mortality but is not routinely assessed. The relationship between GNRI and sarcopenia in advanced heart failure patients undergoing cardiac transplantation has not been well-established.Aims/Hypotheses:The primary outcome was to determine if GNRI was associated with sarcopenia as diagnosed using pectoralis muscle area index. We hypothesize that patients with a higher nutritional risk (GNRI < 92) will have higher rates of sarcopenia.Methods:Patients who underwent cardiac transplantation from January 2018 to June 2022 and who underwent preoperative chest CT scans were included. GNRI was calculated using albumin, height and weight on the day of transplant. Previous literature has defined malnutrition status as a GNRI < 92. The primary outcome was sarcopenia which was diagnosed as pectoralis muscle area index in the lowest sex-specific tertile.Results:172 patients were included in the primary analysis and were stratified into high (GNRI92) nutritional risk. Patients with high nutritional risk had a lower BMI than those with low nutritional risk. Patients with high nutritional risk were more likely to meet criteria for sarcopenia than those with low risk (56.5% vs 28.9%, p=0.02). Additionally, patients with high nutritional risk had a longer hospital length of stay at their index hospitalization than patients with low nutritional risk (29 vs 22 days, p=0.03). There were no significant differences by nutritional risk in outcomes of rehospitalizations, days alive and out of the hospital, or death.Conclusions:Lower GNRI (higher nutritional risk) was associated with a greater prevalence of sarcopenia in patients undergoing cardiac transplantation. This index may represent a simple screening tool utilizing readily available data to ascertain sarcopenia in patients with advanced heart failure.

Circulation, Volume 148, Issue Suppl_1, Page A11787-A11787, November 6, 2023. Introduction:Sarcopenia, or reduced muscle mass and function, is underdiagnosed in advanced heart failure and is not routinely assessed. In patients receiving a left ventricular assist device (LVAD), preoperative sarcopenia, defined using CT-derived pectoralis muscle area index (muscle area indexed to height), was an independent predictor of post-operative mortality. The association between preoperative sarcopenia and outcomes after cardiac transplantation is unknown.Aims/Hypotheses:The primary aim was to determine if preoperative sarcopenia, diagnosed using pectoralis muscle area index, is an independent predictor of days alive & out of the hospital at 1-year post-cardiac transplant. We hypothesize that patients with preoperative sarcopenia will have fewer days alive & out of the hospital compared to those without.Methods:Patients who underwent cardiac transplantation from January 2018 to June 2022 with available preoperative chest CT scans (68% of total cohort) were included. Sarcopenia was diagnosed as pectoralis muscle area index in the lowest sex-specific tertile (male < 5.7 cm2/m2; female < 4.4 cm2/m2). The primary endpoint was days alive & out of the hospital at 1-year post-transplant.Results:172 patients were included of whom 32.7% met criteria for sarcopenia. Patients with sarcopenia were more likely white with lower body mass index (BMI) (23.5 vs 27.7 kg/m2). Patients with sarcopenia had fewer days alive & out of the hospital compared to those without, with a median difference of 16.5 days (320.5 vs. 337 days, p=0.004). Patients with sarcopenia had a longer index hospitalization (28.5 vs. 22 days) and were more likely to be discharged to a facility other than home (40.4% vs. 12.3%). In a linear regression model, sarcopenia was a significant univariable and the strongest multivariable predictor of days alive & out of the hospital at 1-year when controlling for diabetes status (β = -14.4, 95% CI -28, -1.2, p = 0.032).Conclusions:Preoperative sarcopenia, diagnosed using pectoralis muscle area index, is an independent predictor of poor outcomes after cardiac transplant. This parameter is easily measurable from commonly obtained preoperative CT scans and may be considered in the transplant evaluation as a marker of risk.

Circulation, Volume 148, Issue Suppl_1, Page A17932-A17932, November 6, 2023. Background:Sarcopenia and smoking are independently associated with worse heart failure (HF) outcomes; therefore, their combined effect is likely even more detrimental.Research Questions:We studied the impact of sarcopenia and smoking on outcomes in patients admitted for acute decompensated HF (ADHF).Methods:We conducted a retrospective cohort study of 406 consecutive patients hospitalized at our tertiary care center for ADHF from 2017 to 2020 with computed tomography of the chest one month before the discharge date. Semi-automatic measurements were made at T12 (Figure 1A) and adjusted for height squared to obtain skeletal muscle index (SMI). To compare survival, patients were divided into four groups: nonsarcopenic nonsmokers (controls, 22.4%), sarcopenic nonsmokers (10.6%), nonsarcopenic smokers (44.3%), and sarcopenic smokers (22.7%). Sarcopenia was the lowest sex-stratified SMI tertile (cutoffs of 29.6 cm2/m2in males and 25.7 cm2/m2in females), and smokers were those who had ever smoked.Results:The mean admission age of our cohort was 70±14 years, 44.3% were female, and 67.0% had a smoking history (191 former and 81 active). Compared to nonsmokers, patients with a smoking history had more COPD (53.3% vs. 18.7%, p