Decreased Muscle Strength Research Articles

Analyze the Effect of Steel Waste on Performance Characteristics of Concrete

This cross-sectional study investigates the immediate impact of occupational stress on short-term heart rate variability (HRV) and muscle strength among 200 construction workers in Chennai. The Perceived Stress Scale (PSS) was employed to assess stress levels, while HRV was measured using a portable ECG device, focusing on time-domain (RMSSD) and frequency-domain (HF Power) parameters. Muscle strength was evaluated using a MicroFET 2 dynamometer. Pearson correlation and multivariate regression analyses were applied to determine the associations between stress, HRV, and muscle strength, adjusting for confounding factors such as age, body mass index (BMI), and work duration. Results revealed a significant negative correlation between perceived stress and both HRV indices (RMSSD: r=-0.45, p<0.01; HF Power: r=-0.50, p<0.01) as well as muscle strength (r=-0.40, p<0.01). Higher stress levels were associated with reduced HRV and diminished muscle strength. Regression analyses confirmed that stress independently predicted lower HRV (RMSSD: ?=-0.35, p<0.01; HF Power: ?=-0.42, p<0.01) and decreased muscle strength (?=-0.32, p<0.01). These findings suggest that elevated stress negatively impacts both cardiovascular and muscular functioning, potentially increasing the health risks among construction workers. The study highlights the importance of implementing stress management interventions to improve both the physical well-being and productivity of workers in the construction industry.

Muscular strength, endothelial function and cognitive disorders: state of the art.

In recent years, the ageing population has increasingly grown. This process carries a range of pathophysiological changes involving alterations in the skeletal muscle, vascular endothelium and brain function, becoming an important risk factor for developing cognitive disorders and cardiovascular diseases. With ageing, there is a decrease in muscle mass and muscle strength, and a relationship between muscle strength decrease and cognitive decline has been shown. Lower handgrip strength has been linked to memory impairment, lower global cognitive function, decreased attention and reduced visuospatial abilities in the elderly, but understanding of the underlying mechanisms that explain the link between altered skeletal muscle function and structure, endothelial dysfunction, and the role of endothelial dysfunction in the onset of cognitive disorders has been scarcely explored. This review aims to detail the cellular and molecular mechanisms by which the progressive changes associated with ageing can alter healthy skeletal muscle and endothelial function, creating an environment of oxidative stress, inflammation and mitochondrial dysfunction. These changes can lead to reduced muscle strength, and the secretion of detrimental endothelial factors, resulting in endothelial dysfunction, blood-brain barrier disruption, and damage to neurons and microglia, ultimately accelerating the onset of cognitive disorders in the elderly. In addition, we aimed to describe the mechanisms that potentially explain how preserving muscular function with resistance training could prevent brain function deterioration, including the production of different factors that allow an improved endothelial function, haemodynamic parameters and brain plasticity, ultimately delaying the onset of cognitive impairment and chronic diseases.

Epidermal growth factor receptor contributes to indirect regulation of skeletal muscle mass by androgen.

Androgen is widely acknowledged to regulate skeletal muscle mass. However, the specific mechanism driving muscle atrophy resulting from androgen deficiency remains elusive. Systemic androgen receptor knockout (ARKO) mice exhibit reduction in both muscle strength and muscle mass while skeletal muscle fiber specific ARKO mice have decreased muscle strength without affecting skeletal muscle mass in the limbs. Therefore, androgens may indirectly regulate skeletal muscle mass through effects on non-myofibers. Considering this, our investigation focused on blood fluid factors that might play a role in the regulation of skeletal muscle mass under the influence of androgens. Using a male mouse model of sham, orchidectomy and DHT replacement, mass spectrometry for serum samples of each group identified epidermal growth factor receptor (EGFR) as a candidate protein involving the regulation of skeletal muscle mass affected by androgens. Egfr expression in both liver and epididymal white adipose tissue correlated with androgen levels. Furthermore, Egfr expression in these tissues was predominantly elevated in male compared to female mice. Interestingly, male mice exhibited significantly elevated serum EGFR concentrations compared to their female counterparts, suggesting a connection with androgen levels. Treatment of EGFR to C2C12 cells promoted phosphorylation of AKT and its downstream S6K, and enhanced the protein synthesis in vitro. Furthermore, the administration of EGFR to female mice revealed a potential role in promoting an increase in skeletal muscle mass. These findings collectively enhance our understanding of the complex interplay among androgens, EGFR, and the regulation of skeletal muscle mass.

Examination of Gait Characteristics Related to Sarcopenia in Community-Dwelling Older Adults: A Study Focusing on Plantar Pressure.

Sarcopenia is a condition characterized by a decrease in skeletal muscle mass and strength with age, which results in a lower gait speed. Decreased gait speed in older individuals with sarcopenia can lead to adverse events such as falls and mortality. It is a major health issue; several studies have investigated gait speed in sarcopenia. However, plantar pressure has not been sufficiently evaluated. Plantar pressure facilitates gait analysis, including gait speed, and plays an important role in preventing adverse events such as falls and mortality. Therefore, the current study aimed to validate gait characteristics, including plantar pressure in community-dwelling older adults with sarcopenia. The current study included community-dwelling Japanese adults aged ≥60 years who participated in health checkups between 2013 and 2018. Sarcopenia was diagnosed by measuring muscle mass and strength based on clinical definition (nonsarcopenia: n = 7662; probable sarcopenia: n = 1208; and sarcopenia: n = 477). Gait parameters (including gait speed, relative plantar pressure, cadence, stride length, step length, step width and foot angle) were measured at a comfortable speed using a computerized electronic walkway. Gait parameters between groups were compared via an analysis of covariance adjusted for age and BMI. In addition, post hoc analyses were performed with Bonferroni correction. The sarcopenia and probable sarcopenia groups had a significantly lower gait speed than the nonsarcopenia group (p < 0.01). Further, the sarcopenia and probable sarcopenia groups had a significantly lower forefoot plantar pressure, stride length and cadence than the nonsarcopenia group (all p < 0.01). When comparing, the sarcopenia group had a greater medial plantar pressure, step length, and foot angle and a lower lateral plantar pressure, cadence, and step width than the probable sarcopenia group (all p < 0.01). The sarcopenia, probable sarcopenia and nonsarcopenia groups differed concerning gait characteristics, including plantar pressure. It is thought that exercise instruction that takes into account walking characteristics is important for probable sarcopenia and sarcopenia.

Association of low muscle strength with incident pneumonia in older patients with heart failure.

Patients with heart failure (HF) are at an increased risk of developing pneumonia, leading to a high mortality. A decrease in muscle strength due to aging or concomitant disease may contribute to the development of pneumonia in older adults. We sought to investigate the relationship between low muscle strength and pneumonia incidence in older patients hospitalized for worsening HF. We carried out a sub-analysis of the FRAGILE-HF, a prospective multicenter observational study, including 1266 consecutive older (≥65 years) patients hospitalized with HF (mean age 80.2±7.8 years; 57.4% male; left ventricular ejection fraction 46±17%) and information of incident pneumonia observed after discharge. Patients were followed up for two years post-discharge. A total of 88 patients (7.0%) developed pneumonia after discharge, with an incidence of 42.7 per 1,000 person-years. A total of 893 patients with low muscle strength, defined as handgrip strength <28kg for men and <18kg for women according to international criteria, were more likely to develop pneumonia than those with normal muscle strength (p <0.001; log-rank test). Low muscle strength was a significant predictor of incident pneumonia (adjusted hazard ratio with 95% confidence interval: 2.65 [1.31-5.35], p=0.007). Furthermore, the mortality rates were 43.2% in patients who developed pneumonia and 19.3% in those who did not, indicating a heightened risk of death following the onset of pneumonia (adjusted hazard ratio: 4.25 [2.91-6.19], p<0.001). In older patients hospitalized for HF, low muscle strength was associated with incident pneumonia after discharge.

Brain abscess caused by Streptococcus pyogenes with atypical symptoms: a case report and literature review

BackgroundStreptococcus pyogenes is a common gram-positive bacterium, belonging to group A Streptococcus (GAS), and is responsible for causing a range of clinical conditions. Brain abscess caused by GAS is uncommon in pediatric infectious diseases, and GAS brain abscess without acute infectious symptoms has been rarely reported.Case presentationWe present a case of one GAS brain abscess in a previously healthy child with unusual clinical manifestations of decreased muscle strength in the left limbs. The right frontal lobe mass lesion was resected using a microscope-based neuronavigation system. A sole defectively beta-hemolytic Streptococcus pyogenes was isolated from the lesion. The patient’s peripheral blood whole-exome and the pathogen’s whole-genome sequencing were performed respectively, revealing a heterozygous mutation in the interferon regulatory factor-8 (IRF8) gene in the patient and lack of hyaluronic acid capsules in Streptococcus pyogenes (genotype emm22). The patient eventually recovered after prompt surgical drainage of the abscess and appropriate antibiotic treatment.ConclusionsIt is important to pay attention to Streptococcus pyogenes brain abscesses with mild clinical manifestations. Upon reviewing all the cases of pediatric GAS brain abscess reported in the published literature, we discovered that early diagnosis and treatment are crucial factors that impact the prognosis of GAS brain abscess.

Modern views on the diagnosis of sarcopenia in patients with diffuse liver diseases

Currently, the term sarcopenia is primarily understood as a decrease in muscle strength as a key characteristic of sarcopenia, taking into account that the most unfavorable clinical outcomes occur in patients with a combination of impaired muscle strength and function. In particular, grip strength combined with evaluation of the end-stage liver disease (MELD) model is the best predictive model among widely used methods for diagnosing sarcopenia in patients with cirrhosis of the liver. Given that muscle mass does not always correlate well with muscle strength or function in the population of patients with cirrhosis of the liver, there is a need for a comprehensive diagnosis of sarcopenia based on a combination of functional research methods with modern instrumental methods. The presented review article highlights current information on the diagnosis of sarcopenia in patients with chronic diffuse liver diseases. Aspects of antrometric methods, functional tests, methods for evaluating muscle strength and mass, and physical performance are reflected. Special attention is paid to the advantages of modern methods of instrumental diagnosis of sarcopenia in patients with diffuse liver diseases. The advantages and disadvantages of each of the methods of instrumental diagnostics are noted.

GABA Prevents Sarcopenia by Regulation of Muscle Protein Degradation and Inflammaging in 23- to 25-Month-Old Female Mice.

Sarcopenia is the gradual decrease in skeletal muscle mass, strength and function in elderly individuals. Gamma-aminobutyric acid (GABA) is a neurotransmitter naturally produced from glutamate by the enzyme glutamic acid decarboxylase. Age-related decline in GABA is linked to age-related motor and sensory decline and seems to affect sarcopenia, yet no detailed study has been conducted. In this study, we aimed to investigate the effect of GABA on improving sarcopenia by suppressing muscle protein degradation through supplementing decreased GABA in old mice. GABA (10 or 30 mg/kg/day) was orally administered daily to young (3 months) and old (21-23 months) C57BL/6 mice for 7 weeks. The body weight and grip strength of the mice were measured weekly at the same time. After sacrificing the mice, the quadriceps and gastrocnemius muscles were excised from their hind limbs, and the spleen and serum were collected. Histological, biochemical and molecular analyses were conducted in various experiments. The administration of GABA increased muscle strength (+41%, +70% compared to the aged mouse control group, GABA at doses of 10 or 30 mg/kg/day respectively, p < 0.05) and muscle mass (quadriceps: +28%, +46%; gastrocnemius: +12%, +19%, p < 0.05) in old mice. This increase was accompanied by a cross-sectional area (CSA) increase in the quadriceps and gastrocnemius muscle (p < 0.05). The administration of GABA increased IGF-1 levels in serum (p < 0.05), leading to the activation of muscle protein synthesis. We found that GABA inhibits sarcopenia by regulating muscle protein degradation through the activation of Akt/mTOR/FoxO3a signalling pathways. GABA also regulates inflammaging, which is a hallmark of age-related muscle atrophy. There was a significant increase in the F4/80 + CD11b + total macrophage ratio in gastrocnemius and spleen, especially the M1 macrophage ratio increased in old mice. However, GABA administration was effective in suppressing M1 macrophages (gastrocnemius: -40%, - 53%; spleen: -22%, -26%, p < 0.05). Pro-inflammatory cytokines such as TNF-α and IL-6, primarily secreted by M1 macrophages, are also decreased by treatment with GABA (TNF-α: -24%, -27%; IL-6: -45%, -59%, p < 0.05). Together, this study demonstrates the importance of GABA in maintaining muscle and low-chronic inflammation during ageing. We suggest that GABA shows potential as a substance that can effectively address sarcopenia and enhance the overall lifespan and well-being of older individuals.

Astragalus polysaccharide/carboxymethyl chitosan/sodium alginate based electroconductive hydrogels for diabetic wound healing and muscle function assessment

Natural polysaccharides with excellent biocompatibility are considered ideal materials for repairing diabetic foot ulcer. However, diabetic foot ulcer is often accompanied by decreased muscle function, even resulting in muscle atrophy. During wound repair, monitoring muscle function at the wound site in real time can identify the decreased muscle strength timely, which is crucial for precise wound rehabilitation. Nevertheless, the majority of hydrogels are primarily utilized for wound healing and lack the capability for electromyography monitoring.Here, we designed a multinetwork hydrogel composed of astragalus polysaccharide, chitosan, and sodium alginate and internally embedded conductive PPy-PDA-MnO2 nanoparticles (P-NPs) loaded with resveratrol (Res) for wound repair and muscle function assessment. The intrinsic hypoglycemic and anti-inflammatory properties of astragalus polysaccharides, combined with the antioxidative and proangiogenic functions of Res, synergistically facilitate wound healing. The multinetwork structure affords the hydrogel excellent mechanical properties. Furthermore, the addition of conductive NPs not only improves the mechanical performance of the hydrogel but also confers electrical conductivity. The conductive hydrogel acts as an epidermal electrode which can be utilized for monitoring of electromyography signals. This novel approach for treating diabetic wounds ultimately achieves improved wound repair and muscle function assessment, carrying out a monitoring-guided safe and accurate wound repair.

Osteoporosis

Osteoporosis, the most prevalent bone disease, increases an individual's risk of fractures. Various factors, such as a past history of fractures, smoking, alcohol consumption, use of steroid medications, genetic background, and physical activity level, are associated with fracture risk. Notably, reduced physical activity should be emphasized for patients with brain or other neurological disorders, as impaired body balance and decreased muscle strength contribute to falls and fractures. The emergence of many effective treatments for osteoporosis has enabled patient-tailored treatments. Even physicians who do not specialize in osteoporosis, such as neurosurgeons, are expected to assess patient condition, estimate the risk of osteoporosis or fractures, and consult specialists when necessary.

Effectiveness of Propioceptive Neuromuscular Facilitation in Improving Walking Quality in Post-Stroke Patients at Haji General Hospital Medan

Nationally, the prevalence of stroke in Indonesia in 2018 was 10.9 per mile, an increase compared to 2013 which was 7 per mile. Stroke is the second leading cause of death and the third leading cause of disability in the world. Two-thirds of stroke events occur in developing countries. Weakness and decreased muscle strength in stroke sufferers occur on one side of the limb, however, in the trunk muscles, weakness occurs on both sides, resulting in limited trunk rotation and difficulty in maintaining balance and gait). Propioceptive Neuromuscular Facilitation (PNF) is a physiotherapy intervention method that can be used to improve the quality of walking in stroke patients. This method can improve proprioceptor function by stimulating it in muscles and tendons. PNF also improves muscle strength, flexibility, and balance). Description of respondent data was carried out using univariate analysis to determine the frequency of age, weight, height, gender, paralyzed side and Wisconsin values ??before and after the intervention for both groups. Bivariate test to compare the average WGS value after treatment with before treatment in both the PNF group and the conventional group and compare the average difference between the PNF group and the conventional group. The average value of the difference before and after the intervention in the PNF group was 1.75 with a standard deviation of ± 0.463, while in the conventional group the average value of the difference before and after the intervention was 0.63 with a standard deviation of ± 0.518. Statistical tests using the Wilcoxon rink test between the two groups obtained a p-value of 0.024, which is smaller than 0.05, which means there is a significant difference between the PNF intervention group and the Conventional intervention group.

Effectiveness of Adding Strengthening Lower Extremity Exercise on Gait Speed of Hajj Pilgrims Who Receive Walking Aerobic Exercises

Background: In the Hajj pilgrimage, the daily activities of Hajj Pilgrims also require good walking skills. Walking is the most common physical activities. Individuals with limited mobility have been found to have greater energy costs related to daily life tasks. Resistance training is a type of exercise that can increase muscular speed, power, strength, hypertrophy, and coordination. The decreased muscle strength leads to decrease in walking ability. Objective: Researchers want to compare that adding strengthening lower extremity exercise can improve the gait speed on Hajj Pilgrims more than control group who receive walking aerobic exercise only. Methods: A randomized controlled trial was used for this research. There were 36 participants divided into an 18-person intervention group and an 18-person control group. The groups received walking aerobic exercises five times a week and the intervention group were added strengthening lower extremity exercise twice a week. A 4-meter gait speed test was used to evaluate gait speed both pre- and post- a six-week course of intervention. Results: After six weeks, there was a significant increase in gait speed in both the intervention group (p=0.000) and the control group (p=0.000). There’s no significant difference between the interventions of each group (0.86 ± 0.58) compared to the control group. (0.87 ± 0.66) (p=0.968). Conclusion: Walking aerobic exercise and adding strengthening lower extremity exercise can increase gait speed significantly. However, walking aerobic exercise with or without strengthening lower extremity exercise addition there is an increase in gait speed.

Investigation of the playing digital games on shoulder flexibility, muscle strength and reaction speed in volleyball players.

Esports is a natural extension of digital games. Digital games provide a platform for players to showcase their skills, thereby forming the foundation of e-sports. These two domains continuously support each other, demonstrating significant growth in popularity and establishing a solid presence in the competitive landscape. Digital games require high levels of attention, strategy, reflexes, and coordination, offering pathways to reach the pinnacle of competition. The benefits derived from digital games enhance the ability to perform effectively under stress, making them crucial for both physical and mental performance. This study investigates the effects of digital gaming on the physical performance, shoulder flexibility, muscle strength and reaction speed of female volleyball players. A total of 50 female volleyball players took part, who were divided into two groups based on their digital playing habits: Group 1 consisted of female players who played video games for at least 4 h per day in the last 6 months, while Group 2 included those who played <4 h per day. In the study, the Activ5© Handheld Digital Dynamometer was used to measure the strength of the shoulder muscles during various movements, including flexion, hyperextension, abduction, internal rotation and external rotation. In addition, the BlazePod™ trainer device was used to assess reaction times. The results showed that volleyball players who frequently played digitally showed significant improvements in shoulder flexibility, especially in flexion of the non-dominant side. In addition, these players showed faster reaction times than those who played less frequently. However, a significant decrease in hyperextension muscle strength was observed in the group that frequently played digital games. The study highlights that while digital games can improve certain physical skills such as reaction speed and shoulder flexibility, they can also contribute to muscular imbalances or a decrease in muscle strength in certain areas. These findings suggest potential benefits for volleyball players, particularly in movements that require quick reflexes and flexibility, such as serving and spiking. However, the results also raise concerns about potential negative effects on muscle strength and posture, highlighting the need for balanced training programs to mitigate these effects. Further research is needed to investigate the long-term effects of digital games on athletic performance and physical health.

A Cross-Sectional Study on the Effect of Stress on Short-Term Heart Rate Variability and Muscle Strength Among Construction Site Workers

This cross-sectional study investigates the immediate impact of occupational stress on short-term heart rate variability (HRV) and muscle strength among 200 construction workers in Chennai. The Perceived Stress Scale (PSS) was employed to assess stress levels, while HRV was measured using a portable ECG device, focusing on time-domain (RMSSD) and frequency-domain (HF Power) parameters. Muscle strength was evaluated using a MicroFET 2 dynamometer. Pearson correlation and multivariate regression analyses were applied to determine the associations between stress, HRV, and muscle strength, adjusting for confounding factors such as age, body mass index (BMI), and work duration. Results revealed a significant negative correlation between perceived stress and both HRV indices (RMSSD: r=-0.45, p&lt;0.01; HF Power: r=-0.50, p&lt;0.01) as well as muscle strength (r=-0.40, p&lt;0.01). Higher stress levels were associated with reduced HRV and diminished muscle strength. Regression analyses confirmed that stress independently predicted lower HRV (RMSSD: ?=-0.35, p&lt;0.01; HF Power: ?=-0.42, p&lt;0.01) and decreased muscle strength (?=-0.32, p&lt;0.01). These findings suggest that elevated stress negatively impacts both cardiovascular and muscular functioning, potentially increasing the health risks among construction workers. The study highlights the importance of implementing stress management interventions to improve both the physical well-being and productivity of workers in the construction industry.

Short-term exercise counteracts accelerated ageing impacts on physical performance and liver health in mice.

Senescence impairs liver physiology, mitochondrial function and circadian regulation, resulting in systemic metabolic dysregulation. Given the limited research on the effects of combined exercise on an ageing liver, this study aimed to evaluate its impact on liver metabolism, circadian rhythms and mitochondrial function in senescence-accelerated mouse-prone 8 (SAMP8) and senescence-accelerated mouse-resistant 1 (SAMR1) mice. Histological, reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunoblotting analyses were conducted, supplemented by transcriptomic data sets and AML12 hepatocyte studies. Sedentary SAMP8 mice exhibited decreased muscle strength, reduced mitochondrial complex I levels and increased lipid droplet accumulation. In contrast, combined exercise mitigated muscle strength loss, upregulated proteins involved in mitochondrial complexes (CIII, CIV, CV) and increased Bmal1 messenger RNA (mRNA) expression in the liver. These molecular adaptations are associated with healthier liver phenotypes and may influence metabolic function and cellular longevity. Notably, elevated lipid content in aged mice was reduced post-exercise, indicating liver benefits even after a relatively short intervention. The combined exercise regimen did not improve aerobic capacity, likely due to the low volume and brief duration of running. Moreover, no significant effects were observed in SAMR1 mice, possibly because the training intensity was insufficient for younger, healthier animals. These findings underscore the potential of combined strength and endurance exercise to attenuate age-related liver dysfunction, particularly in ageing populations.

Assessment of the effect of solid herbal extract of primula veris l on the physical performance of rats after chronic alcohol intoxication

The aim of this study was to evaluate the effect of solid herbal extract of Primula Veris L. and comparison drugs phenotropil and mildronate on the physical performance of female rats after chronic alcohol intoxication (CAI). CAI was modeled by replacing drinking water for 6 months with a 10 % solution of ethyl alcohol with sucrose (50 g/l). At the age of 16 months, the “Rotarod performance test”, “The horizontal rope walking test” and “Forced swim test with weight load” were performed. After CAI, rats show a deterioration in coordination and motor activity, a decrease in muscle strength and aerobic-anaerobic endurance. Solid herbal extract of Primula Veris L., phenotropil and mildronate contributed to an increase in the physical performance of animals after CAI.

Justification of the effective sequence of group fitness classes with second mature women (45-55 years old)

This article deals with issues that are aimed at the organization of strength training. First of all, it is necessary to note significant differences between women and men in terms of strength. In women, they are 15-20% lower than in men. Women have a lower tendency to gain muscle mass. This is primarily related to the hormonal background, since the male hormone testosterone is responsible for the growth of muscle mass, and its amount in the body of women is many times smaller than that of men. At the same time, women's ability to display strength indicators of leg muscles is close to men's. Experts in age-related physiology note that at the age of 40-45, reverse processes begin in a woman's body. The main metabolism slows down, the productivity of various organs and systems decreases, the possibility of various pathological processes, chronic diseases, etc. increases. In connection with the decrease in the hormonal background, negative changes are observed in all organs and systems of the body. Blood pressure often rises, a tendency to osteoporosis appears, fat metabolism is disturbed, which often leads to an increase in body fat. There are significant changes in the respiratory system, the vital capacity of the lungs decreases, the mobility of the chest decreases. After 40 years, there is a significant decrease in muscle strength in women. The elasticity of muscles, tendons, and joint performance is lost. At the same time, muscle tone decreases, which leads to negative changes in posture.

Bioelectrical impedance analysis–derived phase angle predicts possible Sarcopenia in patients on maintenance hemodialysis: a retrospective study

BackgroundThe prevalence of possible sarcopenia is notably high among maintenance hemodialysis (MHD) patients. Possible sarcopenia, defined as a decrease in muscle strength and/or somatic function, is an early and reversible condition between non-sarcopenic and sarcopenia, and early recognition and intervention for possible sarcopenia is important for preventing adverse outcomes and improving the quality of life of these patients. This study aimed to establish a simple and effective model for screening and identifying MHD patients at high risk of possible sarcopenia by using 50 kHz-Whole Body Phase Angle (PhA), with a specific focus on gender differences.MethodsThis prospective cross-sectional study was conducted from September to December 2023 at the Wenjiang Hemodialysis Center in the Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China. A total of 244 MHD patients, including 130 males and 114 females, were enrolled. Data were collected prospectively, including demographic information and physical measurements. All participants provided informed consent before enrollment. Measurements were taken post-dialysis to ensure consistency. The whole-body phase angle was measured using the InBody S10 device, grip strength was measured using an electronic grip strength tester, and physical function was assessed by the Short Physical Performance Battery (SPPB). The Skeletal Muscle Index (SMI) was also calculated.ResultsA total of 244 patients receiving hemodialysis were enrolled in this study. Among these, 109 patients were categorized as non-sarcopenic, 111 as having possible sarcopenia, and 24 as sarcopenic. The prevalence of sarcopenia among MHD patients is 9.8%, while the prevalence of possible sarcopenia is 45.5%. The receiver operating characteristic (ROC) curve analysis showed that for male patients, the AUC of PhA for predicting possible sarcopenia was 0.798, with a sensitivity of 80.36%, specificity of 69.70%, and a cutoff value of 6.20°. For female patients, the AUC of PhA was 0.701, with a sensitivity of 70.91% and specificity of 62.79%, and a cutoff value of 5.70°.ConclusionsPhA may be a useful and simple predictor of the risk of possible sarcopenia in MHD patients, and more research is needed to further promote the use of PhA in possible sarcopenia.

"Y appearance" infarction: caused by essential thrombocythemia.

Essential thrombocythemia (ET) is a myeloproliferative malignancy caused by the excessive proliferation of megakaryocytes in the bone marrow, resulting in the overproduction of peripheral platelets. ET can lead to thrombotic events, such as ischemic stroke (IS), though it is a rare cause of IS. Bilateral medial medullary infarction (BMMI), also known as "Y appearance" infarction due to its distinctive imaging morphology, is a rare clinical subtype of IS which typically has a poor prognosis and a high mortality rate. Herein, we report the case of a 43-year-old male with a history of ET. The patient's platelet count was poorly controlled, and he did not receive regular treatment. After developing symptoms such as dizziness, dysphagia, choking on water, slurred speech, blurred vision, and bilateral limb numbness. Head magnetic resonance imaging revealed a "Y appearance" infarction in the bilateral medial medulla. After admission, the patient was administered intravenous antiplatelet therapy with tirofiban. However, when he was switched to oral aspirin after three days, he experienced decreased muscle strength and worsening symptoms. Therefore, tirofiban was continued for 14 days. Upon discharge, the patient experienced residual limb numbness. His National Institutes of Health Stroke Scale score was 1, Modified Rankin Scale score was 0, and platelet count had decreased to the normal range. During the 9-month follow-up period after discharge, the patient still had only mild limb numbness. Our report presents a special case of "Y appearance" infarction due to ET. Owing to fluctuations in the patient's condition, he received long-term high-dose tirofiban, which ultimately led to a significant improvement in his symptoms.

6556 Does Autoimmune Hashimoto’s Hypothyroidism Mask the Diagnosis of Ehlers-Danlos-Syndrome?

Abstract Disclosure: S. Azmat: None. U. Rafat: None. J.L. Gilden: None. Does Autoimmune Hashimoto’s Hypothyroidism Mask the Diagnosis of Ehlers-Danlos Syndrome? Background: Hypothyroidism is well-known to be associated with muscle weakness and fatigue. There are other etiologies for decreased muscle tone such as Ehlers-Danlos syndrome (EDS) which is group of connective tissue disorders characterized by joint hypermobility, skin hyperextensibility and tissue fragility. Other rheumatological and cardiac conditions associated with this syndrome can pose diagnostic challenges. We present case of 32-year-old female presenting with facial muscle weakness and newly diagnosed Hashimoto’s hypothyroidism. We highlight importance of keeping EDS as another differential in patients with muscle weakness allowing for accurate, prompt diagnosis and treatment to be done in timely manner. Case Description: A 32-year-old female professional musician was referred to Endocrine for mouth muscles weakness and decreasing ability to play her French Horn wind instrument with vocal dystonia and the question of whether these were symptoms of hypothyroidism. She was noted to have mild thyroid enlargement and abnormal thyroid function tests with positive thyroid antibodies. Initial TSH was 7.506 uIU/mL(0.55-4.78), free T4 0.9 ng/dL (0.76-1.46), peroxidase antibody = 96,061U/mL (0-60) and thyroglobulin of 134.9 U/mL (0-60). She also reported low energy, intermittent difficulty swallowing and decreased muscle strength. There was no prior personal and family history of hypo/hyperthyroidism or any other disorders. VS were normal, physical exam showe d no thyromegaly, reflexes revealed objective decrease but normal muscle strength. The skin was noted to be hyperextensible with passive hyperextension of fifth metacarpophalangeal joint beyond 90 degrees, thumb to flexor aspect of forearm and elbows bilaterally with positive Beighton criteria for EDS. She later admitted to intermittent palpitations and easy bruising. Subsequent lab tests were negative ANA, anti-mitochondrial, PCEL and striated muscles antibodies. Additionally she had normal IGA, PTH, AM cortisol- ACTH, vitamin B12 levels with negative 21 hydroxylases antibodies and celiac titers. She was started on levothyroxine 25 mcg and recommended for Cardiology evaluation and genetic testing. Physiotherapy was started. Upon six months follow-up she clinically felt better with improved muscle strength, swallowing and energy level. Repeat lab testing showed improved TSH of 2.67 uIU/mL(0.55-4.78) with free T4 of 1.0 ng/dL (0.76-1.46). Conclusion: This case demonstrates that although muscle weakness can be symptom of hypothyroidism one must evaluate all patients for other possible causes. We highlight importance of keeping EDS as a differential especially in female patients with muscle weakness. Though history and physical exam is crucial allowing for prompt diagnosis and treatment for other conditions. Presentation: 6/1/2024