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Background and Objective: Cancer is a deadly disease with high mortality rates in developing countries. A recent preclinical study found promising results in treating hepatocellular carcinoma (HCC) by combining acetylsalicylic acid (ASA) and ascorbate (AS), which might offer a safer alternative to expensive clinical chemotherapeutics; however, the impact of this combination on other tumors remains unexplored. Therefore, this study aims to investigate the effectiveness of combining ASA and AS in treating Ehrlich solid tumors. Methods: Eighty female Swiss albino mice were divided into eight groups (10 mice/group): four healthy groups (healthy, AS, ASA, and AS+ASA) and four groups with carcinoma (Ehrlich ascites carcinoma [EAC], EAC+AS, EAC+ASA, and EAC+AS+ASA). AS was injected intraperitoneally (4 g/kg) daily for 10 days, whereas ASA was ingested orally at 60 mg/kg/day for 10 days. Carcinoma was induced by subcutaneous injection of 1×106 EAC cells/mouse once. Treatment of carcinoma started after 10 days of tumor inoculation. Blood, livers, and tumors were obtained, and tumor weights, volumes, and levels of hemoglobin, aminotransferases, albumin, bilirubin, urea, creatinine, lipid profile, malondialdehyde, nitric oxide, glutathione, catalase, total antioxidant capacity, lactate dehydrogenase, and creatine kinase were estimated. The percentage increase in lifespan was also assessed. Results: Tumor treatment alleviated tumor burden. Tumor size was reduced, lifespan increased, organs (liver, kidney, and heart) functions adjusted, hemoglobin, lipid profile improved, and oxidative stress decreased. Combining ASA with AS showed more effective antitumor effects than only ASA or AS alone. Conclusion: After more validation research, combining ASA with AS may provide benefit in cancer treatment. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate troponin I, creatine kinase isoenzyme, and the new Japanese Severity Score(JSS) for predicting Severe Acute Pancreatitis-Associated myocardial Injury(SACI). Patients and Methods: This retrospective study included 136 patients with Severe Acute Pancreatitis, hospitalized in grade-III hospital from June 1, 2015, to October 31, 2022; selected using convenience sampling method and divided into SACI occurrence (n =34) and SACI non-occurrence (n =102) groups. New JSS evaluated predictive value of each SACI index. Binary logistic regression model compared risk factors and constructed a prediction model. Area under receiver operating characteristic curve (AUC) and Hosmer–Lemeshow goodness of fit test evaluated model's prediction efficiency and calibration ability. Results: The incidence of SACI was 25%. Univariate analysis found that troponin I and creatine kinase isoenzyme were significantly different (P < 0.05) and independent risk factors for SACI. The new JSS, troponin I, and creatine kinase isoenzyme were included in the prediction model. The prediction model had a good calibration ability, and its predicted value and the actual observed value were not significantly different (Hosmer–Lemeshow χ 2 = 5.408, P = 0.368). AUC of the model was 0.803 (95% CI: 0.689– 0.918), and the optimal threshold of the prediction model was 0.318 with the maximum Youden index (0.488). The AUC for internal validation was 0.788 (95% CI: 0.657– 0.876), and external validation was 0.761 (95% CI: 0.622– 0.832). Conclusion: Troponin I and creatine kinase isoenzymes combined with the new JSS have a high predictive value for SACI, improving the early prediction and treatment of at-risk patients. [ABSTRACT FROM AUTHOR]

The nature of brain redox metabolism in health, aging, and disease remains to be fully established. Reversible oxidations, to disulfide bonds, of closely spaced (vicinal) protein thiols underlie the catalytic maintenance of redox homeostasis by redoxin enzymes, including thioredoxin peroxidases (peroxiredoxins), and have been implicated in redox buffering and regulation. We propose that non-peroxidase proteins containing vicinal thiols that are responsive to physiological redox perturbations may serve as intrinsic probes of brain redox metabolism. Using redox phenylarsine oxide (PAO)-affinity chromatography, we report that PAO-binding vicinal thiols on creatine kinase B and alpha-enolase from healthy rat brains were preferentially oxidized compared to other selected proteins, including neuron-specific (gamma) enolase, under conditions designed to trap in vivo protein thiol redox states. Moreover, measures of the extents of oxidations of vicinal thiols on total protein, and on creatine kinase B and alpha-enolase, showed that vicinal thiol-linked redox states were stable over the lifespan of rats and revealed a transient reductive shift in these redox couples following decapitation-induced global ischemia. Finally, formation of disulfide-linked complexes between peroxiredoxin-2 and brain proteins was demonstrated on redox blots, supporting a link between protein vicinal thiol redox states and the peroxidase activities of peroxiredoxins. The implications of these findings with respect to underappreciated aspects of brain redox metabolism in health, aging, and ischemia are discussed. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effects of high-altitude living low-altitude training on the athletic performance and metabolic indexes of adolescent boxers by using a hypobaric cabin to simulate hypoxia in high-altitude environments. Male adolescent boxers (n = 16; control: n = 8, living and training at low altitude [LOLO]; experimental: n = 8, living at high altitude and training at low altitude [HILO]). The study period was 5 weeks (35 days) for both groups: baseline, week 1, week 2, week 3, week 4, and week 5 (post-training) representing the time point prior to, the first week, second week, third week, fourth week, and the week after training. Participants in the experimental group, slept in a high-altitude environment (2000m) simulated using an altitude-training hypobaric cabin. Blood indexes (erythrocyte count, hemoglobin, hematocrit, blood urea, creatine kinase), functional indexes (longitudinal jump, grip strength, eyes-closed one-foot standing, selective reaction time, 30-second sit-ups, 30-second push-ups, 30-second squats), and endurance indexes (lactate threshold, power) were assessed. In the HILO group, with respect to baseline, erythrocyte count, hemoglobin level, and hematocrit level increased (week 1); hemoglobin level remained high (week 2), decreased (week 3), and increased (week 4). Blood urea concentration increased to 6.11 ± 0.59 mmol/L in week 2 (P < 0.05); creatine kinase concentration increased to 310.75 ± 112. 21 U/L in week 3 (P < 0.01). Upper and lower limb strength increased in week 5, while the number of squats performed in 30 seconds (lower limb strength) decreased 6.87% in week 4 (P < 0.05), and the grip strength (upper limb strength) decreased 11.35% in week 4 (P < 0.05). The lactate threshold of the experimental group increased. Adolescent boxers who lived in high-altitude conditions and trained in low-altitude conditions for 4 weeks exhibited improved blood oxygen transport capacity, upper limb strength, and speed endurance, which indicate that exercise ability improved. [ABSTRACT FROM AUTHOR]

Background: Traditional Chinese Medicine (TCM) has been used in the treatment of anthracycline (ANTs)-induced cardiotoxicity. This meta-analysis aims to evaluate systematically the efficacy and safety of TCM combined with dexrazoxane (DRZ) on cardiotoxicity caused by ANTs. Materials and Methods: Retrieval of the China National Knowledge Infrastructure (CNKI), WAN FANG DATA, Chinese Biomedical Database (CBM), Cochrane Library, and PubMed was conducted through various methods. The meta-analysis was registered on PROSPERO (Registration ID: CRD42023435324). A randomized controlled trial (RCT) of TCM in combination with DRZ to avert cardiotoxicity caused by ANTs was compiled. The efficacy and safety of TCM Combined with DRZ, the cardiotoxicity induced by ANTs was synthesized and discussed, along with the outcomes of cardiac troponin T (cTnT), cardiac troponin I (cTnI), brain natriuretic peptide (BNP), creatine kinase isoenzymes (CK-MB), creatine kinase (CK), left ventricular ejection fraction (LVEF), electrocardiogram (ECG) abnormalities, and the incidence of adverse reactions. RevMan 5.3 was used for meta-analysis. Results: A total of 10 RCTs with 746 patients were included. The pooled results showed that TCM combined with DRZ treatment decreased significantly the incidence of ECG abnormalities (RR = 0.47, 95% CI [0.32,0.70], p = 0.0001), the level of cTnT (MD = −7.16, 95% CI [−8.31, −6.02], p< 0.001), CK (MD = −14.94, 95% CI [−22.91, −6.97], p< 0.001), cTnI (MD = −0.10, 95% CI [−0.14, −0.06], p< 0.001), BNP (MD = −33.66, 95% CI [−36.95, −30.37], p< 0.001), CK-MB (MD = −5.93, 95% CI [−8.16, −3.70], p< 0.001). However, there was no significant change in LVEF in the experimental group compared with the control group (MD = 4.81, 95% CI [−02.99, 12.21], p = 0.23). Moreover, adverse events have no significant difference between the two groups as well (RR = 0.60, 95% CI [0.31, 1.15], p = 0.13). Conclusion: This meta-analysis revealed TCM combined with DRZ appears to be able to improve the efficacy of cardiotoxicity caused by ANTs, but the included studies were of poor quality, and high-quality RCTs would be preferred for future studies. [ABSTRACT FROM AUTHOR]

Introduction: Musculoskeletal injuries are widespread causes of sport injuries. Ordinary therapy is inadequate for rapid healing. So, in this study, the therapeutic effects of platelet rich plasma (PRP) were investigated as it is simple, efficient, and minimally invasive, and lessen recovery time. Materials and Methods: Fifty-four adult male albino rats, were categorizes into four groups: Group I (control group). Group II had a crush injury to the right gastrocnemius muscle, then sacrificed after 2 hours. Group III received no treatment and were subdivided into subgroups III A and III B, each includes 6 rats sacrificed after 7 and 14 days, respectively. Group IV, were injected immediately after injury by 0.1 ml PRP in injury site, then were subdivided into subgroups IV A and IV B, each includes 6 rats sacrificed after 7 and 14 days, respectively. Blood samples were analyzed for serum creatine phosphokinase (CPK) level. Sections from the middle part of the right gastrocnemius muscle were processed for histological assessment using H. and E., Masson trichrome stain, immunohistochemical staining for myogenin immunoreactivity, in addition to semithin and ultra-thin sections for light and electron microscopic examination, followed by morphometric and statistical studies. Results: Sections of group II showed disorganized, fragmented, discontinued, and tapering muscle fibers, disrupted Z discs at focal areas and giant disfigured mitochondria. The CPK level and mean number of myogenin immunoreactive nuclei and mean area percent of fibrous tissue were elevated, while the mean diameter of muscle fibers was decreased versus the control. Group III showed partial improvement, significant decrease in CPK level and increase in mean area percent of fibrous tissue, mean number of myogenin immunoreactive nuclei and in fiber diameter. Group IV showed prominent improvement. Conclusion: Platelet rich plasma could enhance repair of acutely crushed skeletal muscle and accelerate the healing process with minimal fibrosis. [ABSTRACT FROM AUTHOR]

Glycogen storage disorder (GSD) type IIIa is a rare inherited genetic disorder affecting liver and muscle tissue. Liver transplantation (LT) improves metabolic control, but muscle involvement persists. We report the case of a 31-year-old man who underwent orthotopic LT for end-stage liver disease caused by GSD type IIIa. After LT, he developed worsening clinical signs of myopathy, along with exponentially increasing levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and creatine kinase. Liver-related elevations of AST and ALT were excluded through liver biopsy and endoscopic cholangiography; consequently, AST and ALT elevations were attributed to the underlying muscle involvement. Exacerbation of muscle disease after LT could be attributed to restoration of liver glycogen metabolism after LT, leading to increased glucose accumulation in muscle cells, where the gene defect persists. A dietary intervention with a high-protein, ketogenic diet was initiated but did not lead to significant improvement of myalgia. LT exacerbated muscle disease in a patient with GSD type IIIa. Patients should be counseled about this possible side effect of LT in GSD type IIIa. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis aim to analyze the effects of ingesting non-steroidal anti-inflammatory drugs (NSAIDs) on physical performance, muscle strength, and muscle damage in three different moments: immediately, 24 and 48 h after resistance exercise practice. Relevant studies were researched in three databases (PubMed, Web of Science and SPORTDiscus) in April 2023. After excluding duplicates, the decision to include or exclude studies was made by two independent investigators in the following steps: (I) the study title; (II) the study abstract; and (III) the complete study manuscript. The following characteristics were recorded: (I) first author, (II) year of publication, (III) sample size, (IV) method of NSAIDs administration, (V) exercise protocol, and (VI) analyzed variable results. The studies selected were divided into trials that evaluated the effects of NSAIDs ingestion on performance indices of resistance exercise, endurance exercise and resistance training. The meta-analysis, based only on resistance exercises, revealed that both performance and muscle strength were similar between placebo or NSAID treatment immediately and 24 h after resistance exercise practice. An ergolytic effect was found 48 hours after resistance exercise (mean effect size (ES) = −0.42; 95% CI: −0.71, −0.12; p = 0.132), as well as reduced muscle strength (ES = −0.50; 95% CI: −0.83, −0.16; p = 0.072). Additionally, NSAID use did not prevent muscle waste as seen by the unchanged CK plasma concentration at all timetables. The data of the present meta-analysis indicate that NSAID use is ineffective in improving resistance performance and muscle strength, as well as exercise recovery. When considering the practical application of using NSAIDs to improve exercise capacity and strength gains, the present data supports that consumption of analgesic drugs as an endurance performance enhancer or as a muscle anabolic must not be recommended. [ABSTRACT FROM AUTHOR]

Background: Mitochondrial creatine kinase (MtCK) plays a pivotal role in cellular energy metabolism, exhibiting enhanced expression in various tumors, including colorectal cancer (CRC). Creatine kinase mitochondrial 2 (CKMT2) is a subtype of MtCK; however, its clinical significance, biological functions, and underlying molecular mechanisms in CRC remain elusive. Methods: We employed immunohistochemical staining to discern the expression of CKMT2 in CRC and adjacent nontumor tissues of patients. The correlation between CKMT2 levels and clinical pathological factors was assessed. Additionally, we evaluated the association between CKMT2 and the prognosis of CRC patients using Kaplan-Meier survival curves and Cox regression analysis. Meanwhile, quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expression levels of CKMT2 in different CRC cell lines. Finally, we explored the biological functions and potential molecular mechanisms of CKMT2 in CRC cells through various techniques, including qRT-PCR, cell culture, cell transfection, western blot, Transwell chamber assays, flow cytometry, and co-immunoprecipitation. Results: We found that CKMT2 was significantly overexpressed in CRC tissues compared with adjacent nontumor tissues. The expression of CKMT2 is correlated with pathological types, tumor size, distant metastasis, and survival in CRC patients. Importantly, CKMT2 emerged as an independent prognostic factor through Cox regression analysis. Experimental downregulation of CKMT2 expression in CRC cell lines inhibited the migration and promoted apoptosis of these cells. Furthermore, we identified a novel role for CKMT2 in promoting aerobic glycolysis in CRC cells through interaction with lactate dehydrogenase B (LDHB). Conclusion: In this study, we found the elevated expression of CKMT2 in CRC, and it was a robust prognostic indicator in CRC patients. CKMT2 regulates glucose metabolism via amplifying the Warburg effect through interaction with LDHB, which promotes the growth and progression of CRC. These insights unveil a novel regulatory mechanism by which CKMT2 influences CRC and provide promising targets for future CRC therapeutic interventions. [ABSTRACT FROM AUTHOR]

The primary aim of the present investigation was to compare the acute physiological and perceptual responses between two modes of interval training using a randomized crossover design. More specifically, eleven young adult participants (23 ± 4 years, 77 ± 13 kg, 178 ± 7 cm) performed two protocols: one composed of whole-body calisthenics exercises and another on a cycle ergometer. Both protocols encompassed eight 20 s bouts at intensities equivalent to all-out (HIIT-WB) and 170% of the maximal power output (HIIT-C), respectively, interspersed with 10 s of passive rest. The peak and average heart rate, the rating of perceived effort, and blood lactate, creatine kinase, and lactate dehydrogenase concentrations were measured. Aside from blood lactate (HIIT-WB = 9.4 ± 1.8 mmo/L; HIIT-C = 12.5 ± 2.5 mmol/L, p < 0.05) and the rating of perceived exertion (HIIT-WB = 8.8 ± 0.9; HIIT-C = 9.6 ± 0.5, p < 0.05), physiological responses did not significantly differ between protocols (all p > 0.05), with high average heart rate values (HIIT-WB = 86 ± 6% HRmax; HIIT-C = 87 ± 4% HRmax) and a low magnitude of muscle damage, as inferred by CK and LDH concentrations (HIIT-WB = 205.9 ± 56.3 and 203.5 ± 72.4 U/L; HIIT-C = 234.5 ± 77.1 and 155.1 ± 65.3 U/L), respectively. It can be concluded that both protocols elicit vigorous heart rate responses and a low magnitude of muscle damage and, therefore, appear as viable alternatives to improve aerobic fitness. The inclusion of a whole-body HIIT protocol may be an interesting alternative for training prescription in relation to more common interval training protocols. [ABSTRACT FROM AUTHOR]

Left ventricular systolic dysfunction (LVSD) is a cardiac involvement that is the leading cause of death among patients with systemic sclerosis (SSc). We aimed to define the clinical course and predictors of LVSD among SSc patients. We conducted a cohort study among adult patients with SSc who were followed up from 2013 to 2020. Semiparametric Cox regression analysis with robust clustering by cohort identification number was used to evaluate the predictors of LVSD. Among the 3, 987 person-years, LVSD was defined in 35 of 419 SSc patients for an incidence of 0.88 per 100 person-years. The median duration of the disease was 8.5 (interquartile range (IQR) 4.9–12.9) years. Every 1-point increase in the modified Rodnan skin score (mRSS) and salt and pepper skin were strong predictors of LVSD, with a respective adjusted hazard ratio (HR) of 1.05 and 3.17. During follow-up, 26 cases (74.3%) had unimproved LVSD. The strong predictors of the unimprovement of LVSD were every 1-point increase in mRSS (HR 1.05), every 1 mg increase in prednisolone treatment (HR 1.05), and every 1 U/L increase in creatine kinase (CK) (HR 1.001). Mycophenolate treatment was a protective factor against the unimprovement of LVSD in SSc (HR 0.15). LVSD was frequently found in patients with diffuse cutaneous SSc, and in most cases, it remained unimproved during follow-up. High mRSS, steroid use, and high CK levels were predictors of unimproved LVSD, whereas mycophenolate treatment might prevent the progression of LVSD. Steroids should be prescribed with caution in patients with longer disease duration. [ABSTRACT FROM AUTHOR]

Purpose: Although traumatic rhabdomyolysis (TR) is shown to be associated with acute kidney injury (AKI), there are no large prospective epidemiological studies, interventional trials, official guidelines outlining the appropriate investigation, monitoring, and treatment on this poorly understood condition. We aimed to establish the contemporary epidemiology and describe current practices for TR to power future higher quality studies. We hypothesised that investigation and monitoring occur in an ad hoc fashion. Material and methods: We conducted a 1-year retrospective cohort study of all patients > 16 years of age, with an ISS > 12 and, admitted to a level 1 trauma centre. Demographics, initial vital signs, admission laboratory values, and daily creatinine kinase (CK) values were collected. The primary outcome was TR (defined by CK > 5000 IU), secondary outcomes included AKI (KDIGO criteria), mortality, multiple organ failure, length of stay, and need for renal replacement therapy (RRT). Results: 586 patients met inclusion criteria and 15 patients (2.56%) developed TR. CK testing occurred in 78 (13.1%) patients with 29 (37.7%) of these having values followed until downtrending. AKI occurred in 63 (10.8%) patients within the entire study population. Among those with TR, nine (60%) patients developed AKI. Patients with TR had higher ISS (median 29 vs 18) and mortality (26.7% vs 8.9%). Discussion: Whilst TR appears rare without liberal screening, it is strongly associated with AKI. Given the poor outcomes, standardised monitoring, and liberal testing of CK could be justified in trauma patients with higher injury severity. This epidemiological data can help to define study populations and power future multicentre prospective studies on this infrequent yet morbid condition. [ABSTRACT FROM AUTHOR]

Objective: To explore the epidemiology and risk factors associated with the development of pressure ulcers (PUs) in patients receiving prone positioning (PP) ventilatory therapy; to compare the inflammatory status of patients who develop PUs with those who do not; and to describe the experience and useful findings that have allowed us to improve the management of these patients to reduce the incidence of PUs. Method: An observational, descriptive and longitudinal study was conducted, where sociodemographic and laboratory data were collected from patients who were hospitalised and required PP ventilatory therapy in critical care areas (CCA) during the months of May–October 2020. Results: From the total number of patients who required PP during their CCA stay (n=240), 202 (84.2%) developed a PU. The four most frequent areas where a PU appeared were: the head and neck (n=115); the pinna (n=21); the torso (n=21); and the lower limbs (n=21). Patients who developed PU were more frequently males with higher initial levels of creatinine phosphokinase and ferritin. The incidence for each month of follow-up decreased from 8.3% to 5.8%. Conclusion: Regardless of the intervention, a multidisciplinary approach is required to optimise the prevention and treatment of these wounds. While PUs are often the result of other medical conditions or poor health status in general, the vast majority of PUs are avoidable. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the relationship between creatine kinase (CK) concentration following official matches and the risk of subsequent muscle injury in professional male football (soccer) players. Blood samples were collected on the second post-match day for CK analysis over four consecutive seasons in a professional football club. Players were then followed for five days to observe any occurrence of indirect muscle injury (structural or functional in nature). Players exposed to at least 45 minutes in two consecutive matches within seven days were considered valid cases for analysis. Eighty players participated in the study, generating 1,656 cases eligible for analysis, of which 229 resulted in muscle injuries. The hamstrings were the most frequently injured muscle group (54%), followed by the adductor (21%), triceps surae (19%), quadriceps (5%), and psoas (1%). While CK concentration was higher in muscle injury cases [783 ± 507 U/L (95%CI, 717 to 849; min–max, 105–2,800)] compared with uninjured cases [688 ± 446 U/L (95%CI, 665 to 711; min–max, 100–2,950)], it was not an accurate predictor of subsequent muscle injury risk in professional football players (sensitivity = 56%; specificity = 55%; odds ratio = 1.00; area under curve = 0.557). CK concentration on the second post-match day cannot be used to effectively screen subsequent muscle injury risk in professional male football players. [ABSTRACT FROM AUTHOR]

Aim: Despite numerous reports of various neurological symptoms observed in Coronavirus disease-2019 (COVID-19) disease, the role of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) in the neuropathogenesis and tropism of the central nervous system (CNS) has yet to be fully elucidated. In this study, we evaluated the development of CNS damage related to the severity of COVID-19 pneumonia with creatine kinase BB (CK-BB) serum levels. Material and Methods: The study included 55 patients hospitalized in the intensive care unit diagnosed with severe COVID-19 pneumonia, 79 in the inpatient service diagnosed with milder COVID-19 pneumonia, and 39 healthy volunteers. CK-BB levels were measured using a quantitative sandwich enzyme immunoassay technique with an Enzyme-Linked Immunosorbent Assay kit. Detection of SARS-CoV-2 was performed by real time-polymerase chain reaction from the respiratory tract (nasopharyngeal swab) according to current guidelines. Results: While markers that were shown to predict disease severity were higher in patients with severe COVID-19 pneumonia compared with patients with milder pneumonia and the control group, serum levels of the neurological damage marker CK-BB were found to be similar between the groups [respectively 6.84 (5.05-16.2), 7.48 (4.7-22.5), 6.7 (3.8-16.2), p>0.005]. In addition, there was no difference in serum CK-BB levels between patients who developed neurological symptoms and those who did not [respectively 6.78 (5.07-17.21), 7.43 (4.7-22.5), p>0.005]. Conclusion: In COVID-19 pneumonia, serum CK-BB levels do not increase with disease severity and the development of neurological symptoms. [ABSTRACT FROM AUTHOR]

BACKGROUND: Immune checkpoint inhibitors (ICIs) are approved for multiple cancers but can result in ICI-associated myocarditis, an infrequent but life-threatening condition. Elevations in cardiac biomarkers, specifically troponin-I (cTnI), troponin-T (cTnT), and creatine kinase (CK), are used for diagnosis. However, the association between temporal elevations of these biomarkers with disease trajectory and outcomes has not been established. METHODS: We analyzed the diagnostic accuracy and prognostic performances of cTnI, cTnT, and CK in patients with ICI myocarditis (n=60) through 1-year follow-up in 2 cardio-oncology units (APHP Sorbonne, Paris, France and Heidelberg, Germany). A total of 1751 (1 cTnT assay type), 920 (4 cTnI assay types), and 1191 CK sampling time points were available. Major adverse cardiomyotoxic events (MACE) were defined as heart failure, ventricular arrhythmia, atrioventricular or sinus block requiring pacemaker, respiratory muscle failure requiring mechanical ventilation, and sudden cardiac death. Diagnostic performance of cTnI and cTnT was also assessed in an international ICI myocarditis registry. RESULTS: Within 72 hours of admission, cTnT, cTnI, and CK were increased compared with upper reference limits (URLs) in 56 of 57 (98%), 37 of 42 ([88%] P=0.03 versus cTnT), and 43 of 57 ([75%] P

PurposeThis brief report aimed to characterize inter-individual training responses following a single session of high-intense whole-body electromyostimulation (WB-EMS) using markers of muscle damage over a period of 72 h.MethodsTwelve healthy individuals (5 men, 7 women; 32.0 ± 7 years) participated in a single 20-minute high-intensity WB-EMS training session. Markers of muscle damage, creatine kinase (CK) and myoglobin (Mb), were assessed before and immediately after training, as well as at 1.5, 3, 24, 48 and 72 h post-exercise. Lactate levels were determined pre- and post-exercise.ResultsOverall, WB-EMS induced significant CK elevations, peaking at 72 h (18.358 ± 21.380 U/L; p

Key Clinical Message MDMA and cocaine can result in acute onset rhabdomyolysis. However, delayed onset rhabdomyolysis and its pathophysiology is of concern Early therapeutic intervention improves prognosis. Such cases should be promptly referred and managed in centers equipped with critical care and renal replacement therapy.

ObjectiveTo investigate the incidence of myocardial injury in children with critically ill children without primary cardiac disease and the association between elevated cardiac troponin I (cTnl) and creatine kinase MB (CK-MB) concentrations and disease progression and prognosis to guide early treatment.MethodsThe serum cTnI and CK-MB concentrations of 292 children with critically ill children without primary cardiac disease in Yantai Yuhuangding Hospital between January 2021 and January 2024 were retrospectively analyzed within 24 h after entering the Pediatric Intensive Care Unit (PICU). The children were divided into normal and abnormal groups according to the myocardial marker results. The abnormal group was further divided into the cTnI-elevated, CK-MB-elevated, single-elevated (cTnI- or CK-MB-elevated) and double-elevated (cTnI- and CK-MB-elevated) groups. The differences in the clinical indicators and their relationships with prognosis for the groups were compared.ResultsThe incidence of myocardial injury among the critically ill children without primary cardiac disease was 55.1%. The incidence of myocardial injury in children with infectious diarrhea combined with moderate and severe dehydration reached 85.19%. The pediatric critical illness score; frequency of use of vasoactive drugs; hypotension, shock, heart failure, respiratory failure, and multiple organ dysfunction syndrome; and mortality indexes differed significantly for the normal and abnormal myocardial marker groups (P

Background: Almonds promote cardiometabolic health benefits; however, the ergogenic effect of almond supplementation on exercise recovery is less explored. Objectives: We evaluated the impacts of raw, shelled, almonds on pain, muscle force production, and biochemical indices of muscle damage and inflammation during recovery from eccentrically biased exercise. Methods: Using a randomized, crossover design, 26 healthy adults (37 ± 6 y) ran downhill (–10%) for 30 min at a heart rate corresponding to 65%–70% of maximal oxygen consumption followed by 3-d recovery periods after 8-wk adaptations to either ALMOND (2 oz/d) or isocaloric pretzel (CONTROL) feedings. Volunteers consumed the study food immediately following the run and each day during recovery. Fasted blood samples were collected, and pain and muscle function were tested before the downhill run and over 72 h of recovery. Results: Downhill running elicited moderate muscle damage (Time: P < 0.001; η2 = 0.395) with creatine kinase (CK) peaking after 24 h (CONTROL: Δ + 180% from baseline compared with ALMOND: Δ + 171% from baseline). CK was reduced after 72 h in ALMOND (Δ – 50% from peak; P < 0.05) but not CONTROL (Δ – 33% from peak; P > 0.05). Maximal torque at 120°/s of flexion was greater (Trial: P = 0.004; η2 = 0.315) in ALMOND compared with CONTROL at 24 h (Δ + 12% between trials; P < 0.05) and 72 h (Δ + 9% between trials; P < 0.05) timepoints. Pain during maximal contraction was lower (Trial: P < 0.026; η2 = 0.225) in ALMOND compared with CONTROL after 24 h (Δ – 37% between trials; P < 0.05) and 48 h (Δ – 33% between trials; P < 0.05). No differences (P > 0.05) in vertical jump force, C-reactive protein concentrations, myoglobin concentrations, and total antioxidant capacity were observed between trials. Conclusions: This study demonstrates that 2.0 oz/d of almonds modestly reduces pain, better maintains muscle strength, and reduces the CK response to eccentric-based exercise. This apparent effect of almond ingestion on exercise recovery has the potential to promote increased exercise adherence, which should be investigated in future studies.This trial was registered at the clinicaltrials.gov as NCT04787718.

Background: CK-MB is a subtype of creatine kinase isoenzyme, mainly present in myocardial tissue. When myocardial tissue damage is severe, CK-MB is released into the blood, and the serum level significantly increases, which is an important indicator for diagnosing acute myocardial infarction. Methods: We reported a case of pseudo-elevation of CK-MB without acute myocardial infarction. Results: The immunosuppressive assay showed that the activity of CK-MB isoenzyme was 903.0 U/L, which was significantly increased. The patient underwent examinations such as cardiac ultrasound and coronary artery imaging, and no obvious abnormalities were found. Suspected interference, CK-MB was measured using mass immunoassay, and the result was 1.96 ng/mL, which is within the normal range. Conclusions: When the CK-MB level (immunosuppressive assay) abnormally increases but clinical examination does not support the diagnosis of acute myocardial infarction, laboratory personnel should be aware of the shortcomings of this method and use mass immunoassay to detect CK-MB to eliminate interference, and avoid unnecessary examinations and treatments for patients due to inaccurate results. [ABSTRACT FROM AUTHOR]

This document is a systematic review of randomized controlled trials (RCTs) that assess the risk of myopathy and hepatotoxicity in patients with cancer receiving statin therapy. Statins are commonly used to lower cholesterol and reduce the risk of cardiovascular events. The review found that the risk of severe transaminitis or clinically relevant myopathy events in patients with cancer receiving statin therapy is very low. However, the study acknowledges limitations such as a small number of patients and short follow-up periods. Overall, the data suggest that statin therapy is generally safe for patients with cancer, but individual patient factors should also be considered. [Extracted from the article]

Electrical muscle stimulation (EMS) training has been recognized as an effective modality for improving body composition, enhancing body strength, and facilitating injury recovery. However, individuals who are new to EMS training and those with certain chronic diseases should exercise caution due to the increased risk of rhabdomyolysis. This case report describes the occurrence of rhabdomyolysis and gluteal compartment syndrome following a single session of EMS training in a 46-year-old Caucasian female professional athlete. The patient was successfully managed with intensive intravenous fluid therapy and sodium bicarbonate supplementation, along with close monitoring of electrolytes and renal function. Electrical muscle stimulation training poses an increased risk of severe complications in individuals with chronic diseases and myopathy. Therefore, careful subject selection is required for EMS training in individuals with chronic diseases and myopathy to prevent common side effects. For individuals trying EMS training for the first time, it is recommended to avoid high-frequency EMS exercises. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the classification performance of a new method to individualize reference ranges for biomarkers of muscle recovery in elite handball. Methods: In a longitudinal observational study, creatine kinase (CK) and urea levels were assessed in 16 male elite handball players during the 2019–20 preseason. Blood samples were collected at prespecified time points when players were considered either recovered or nonrecovered. Initially, linear mixed-effects models were calculated, as outlined in the study design, to examine the effect of recovery status on CK and urea levels. Finally, a fixed-effect model was calculated for urea based on the law of parsimony. Individualized reference ranges were calculated using a recently published algorithm. To investigate whether the individualized approach resulted in a more accurate classification of recovery status (recovered or nonrecovered), it was compared with a group-based approach derived from the same data set, utilizing predefined error rates. Results: Linear mixed-effects models showed a large effect of recovery status on CK (P <.001, d = 3.49) and a small effect on urea (P =.018, d = 0.382). In contrast to CK (P =.017), urea had no significant interindividual variation. Hence, individualization was examined only for CK. The numerical decrease in both CK error rates by the individualized approach was significant for the test-pass error rate (P =.0196, ϕ =.19). Conclusions: Our findings underscore the critical role of CK for monitoring in team sports such as handball. The observed improvement in CK error rates suggests a promising opportunity to individualize biochemical monitoring, although further studies encompassing larger sample sizes are warranted. [ABSTRACT FROM AUTHOR]

Introduction Fracture of the proximal femur is common in elderly patients, in fact threatening their lives. Age-related sarcopenia may be involved in the imbalance resulting in the injury. Handy and readily accessible biochemical tests would be useful to assess the musculoskeletal system condition in daily practice. The aim of the study was to determine whether there is any relation between muscle decay and fracture of the proximal femur and to assess bone quality in elderly patients. Material and methods In the study 22 patients who represented the treatment group were hospitalized due to proximal femur fracture. Eighteen patients from the control group with no fracture in their history were admitted to the Internal Medicine Department. Anyone treated for osteoporosis, immune disease affecting protein balance, neoplasm, mental illness, heart failure, or myocardial infarction was excluded from the study. In every case a blood sample from an elbow vein was drawn, collected in EDTA-K2 tubes, and then centrifuged to separate plasma from the whole blood. Subsequently, the concentrations of C-terminal cross-linked telopeptide of type I collagen (CTX-I), sex hormone binding globulin (SHBG) and creatine kinase (CK) in plasma were determined using commercial enzyme-linked immunosorbent assays. Results The CK plasma concentration differed between the patient groups (p = 0.011). The SHBG plasma concentration was significantly higher in the treatment group (p = 0.006), whereas a slight difference in CTX-I plasma concentration between the groups was found (p = 0.038). No significant correlations between plasma CK, SHBG or CTX-I were found (p > 0.05). Conclusions Creatine kinase is actually not an appropriate marker for the clinical assessment of muscle tissue quality in patients with or at risk of proximal femur fracture. Analyzing the quality of bone tissue, we can conclude it was poorer in patients with proximal femur fracture than in the control group.

Objective To explore the effect of moderate fatty liver on cardiac function in orthotopic autologous liver transplantation model rats. Methods Sixty SPF-grade healthy male SD rats were randomly divided into three groups (20 rats in each group). Group A was fed ordinary diet for 6 weeks and underwent laparotomy followed by separation of the blood vessels and ligaments around the liver and abdominal closure; group B was fed ordinary diet for 6 weeks and underwent orthotopic autologous liver transplantation; group C was fed high-fat diet for 6 weeks and underwent orthotopic autologous liver transplantation. The body mass, liver wet mass, liver index, and serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) after 6 weeks of feeding, as well as intraoperative blood pressure, pulse rate, respiratory rate, proportion of arrhythmia occurring in the new liver stage, and serum levels of lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (α-HBDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and high-sensitivity cardiac troponin (hs-cTn) at 0, 5, 10, and 60 min in the new liver stage were compared. Results The body mass, liver wet mass, liver index, and serum AST and ALT levels, as well as intraoperative systolic blood pressure, diastolic blood pressure, pulse rate, respiratory rate, and proportion of arrhythmia occurring in the new liver stage in group C were significantly higher than those in groups A and B (F=36.40-4 060.54,χ2 =10.91,P0.05). The serum levels of LDH, α-HBDH, CK, CK-MB, and hs-cTn at different time points in the new liver stage were significantly higher in group C than in groups A and B (F=14.11-1 057.08,P

Abstract Objectives This study aimed to evaluate the prognostic significance of postoperative Creatine Kinase type M and B (CK-MB) to total Creatine Kinase (CK) ratio (CK-MB/CK) in colorectal cancer (CRC) patients after radical resection. Methods This was a single-center retrospective cohort analysis. Subjects were stage I-III CRC patients hospitalized in Sichuan Cancer Hospital from January 2017 to May 2021. Patients were divided into abnormal group and normal group according to whether the CK-MB/CK ratio was abnormal after surgery. Through a comparative analysis of clinical data, laboratory test results, and prognosis differences between the two groups, we aimed to uncover the potential relationship between abnormal CK-MB > CK results and CRC patients. To gauge the impact of CK-MB/CK on overall survival (OS) and disease-free survival (DFS), we employed the multivariable COX regression and LASSO regression analysis. Additionally, Spearman correlation analysis, logistic regression, and receiver-operating characteristic (ROC) curve analysis were conducted to assess the predictive value of the CK-MB/CK ratio for postoperative liver metastasis. Results Cox regression analysis revealed that the CK-MB/CK ratio was a stable risk factors for OS (HR = 3.82, p

Objective To explore the histomorphology and related indicators in a rat model of skeletal muscle injury in an artificial experimental chamber as special environment in Northwest China to stimulate a hot and dry desert environment in order to screen the evaluation indicators of skeletal muscle injury in a hot and dry environment. Methods Eighteen male SD rats (8 weeks old) were randomly divided into blank control group (room temperature, free movement), room temperature exercise group, and hot and dry exercise group, with 6 rats in each group.After the rats were subjected to adaptation training for 3 d (a 3-D exercise treadmill, speed: 16 m/min, slope: -16°, time: 5~10 min), the rats in the 2 exercise groups were subjected to a treadmill once per day at a speed of 19.3 m/min and a slope of-16° till the end of exhaustion, and those in the hot and dry exercise group were housed in an artificial experimental chamber at a temperature of (40±1)℃, a humidity of (10±2)%.After 6 d of continuous exercise, the rat soleus muscle tissue was taken to observe the pathological changes, and the serum samples were detected for skeletal muscle injury markers, inflammatory factors, oxidative stress related factors, hormones and other related indicators. Results When compared with the blank control group and the room temperature exercise group, the hot and dry exercise group had significantly higher concentrations of creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and myotype creatine kinase (CK-MM)(P < 0.05), elevated contents of TNF-α, IL-1β and IL-6(P < 0.05), raised malondialdehyde (MDA) content and lower superoxide dismutase (SOD) activity (P < 0.05), lower testosterone (T) but higher corticosterone (Cort) levels and thus lower testosterone/corticosterone (T/Cort) ratio (P < 0.05).The markers of skeletal muscle injury, CK, CK-MB and CK-MM were positively correlated with the pro-inflammatory cytokines, TNF-α, IL-1β and IL-6(P < 0.05), positively with the antioxidant indicator MDA but negatively with SOD (P < 0.05), and positively correlated with Cort level and negatively with T level and T/Cort ratio (P < 0.05). Conclusion A stable rat model of skeletal muscle injury in a hot and dry desert environment is successfully constructed.The severity of skeletal muscle injury is greater in rats in a hot and dry desert environment than those in a normal temperature environment.TNF-α and IL-1β are found to be indirect indicators to evaluate skeletal muscle injury in the environment.

Abstract Background Significant elevation of creatine kinase levels (above three digits) and leucocytosis in the absence of muscle rigidity, tremors, or autonomic dysfunction can pose a real challenge in the context of antipsychotic treatment as an early herald of neuroleptic malignant syndrome. Case presentation We present here two cases of adult male patients of Black British heritage, ages 51 years and 28 years, respectively. Both received a diagnosis of schizoaffective disorder and presented with massive increase of creatine kinase blood level after aripiprazole depot administration, one with pernicious increase associated with silent neuroleptic malignant syndrome, and the second with asymptomatic benign enzyme elevation. Conclusion Though aripiprazole use is less likely to cause neuroleptic malignant syndrome, on rare occasions it can produce massive symptomatic or asymptomatic increase in serum creatine kinase enzyme levels, raising the need for close monitoring, especially at the initial doses of the drug.

Abstract Background Branched-chain amino acid (BCAA) supplementation is one of the most popular strategies used by the general population and athletes to reduce muscle soreness and accelerate the recovery process of muscle damage biomarkers after an intense exercise or training session. Objectives This systematic review and meta-analysis investigated the effects of BCAA supplementation on muscle damage biomarkers and muscle soreness after exercise-induced muscle damage (EIMD). Methods The systematic literature search for randomized controlled trials was conducted using seven databases, up to September 13th, 2022. The eligibility criteria for selecting studies were as follows: studies performed on healthy active participants, using BCAA at least once, controlled with a placebo or control group, performing resistance or endurance exercises, and followed up at least once post-EIMD. The methodological quality of the studies was assessed using the “SIGN RCT checklist”. Random-effects meta-analyses were processed to compute the standardized mean difference (Hedges’ g). Meta-regression analyses were completed with daily and total dosage and supplementation as continuous moderator variables. Results Of the 18 studies included in this meta-analysis, 13 were of high quality and five were of acceptable quality. Our results revealed BCAA supplementation elicits a significant effect on reducing creatine kinase (CK) levels immediately (g = − 0.44; p = 0.006) and 72 h (g = − 0.99; p = 0.002), but not 24 h, 48 h, and 96 h post-EIMD. Additionally, a significant effect on delayed onset of muscle soreness (DOMS) was identified at 24 h (g = − 1.34; p

Abstract Background Congenital muscular dystrophies (CMDs) are genetically and clinically heterogeneous inherited conditions. Onset is typically within the first year of life. Most CMDs are autosomal recessive, except for de novo dominant mutations in LMNA‐related muscular dystrophy and some collagen‐6‐associated disorders. Results CMD is characterized by progressive muscular weakness, hypotonia, multiple contractures with a variable degree, spinal stiffness, delay in motor milestones acquisition, and histologically dystrophic lesions. Also, some forms of CMD may feature structural and myelination abnormalities on brain magnetic resonance imaging, intellectual impairment, and structural abnormalities of the eye. Muscle biopsy specimens exhibit a dystrophic pattern, but the appearance is quite variable depending on the different stages and severity of the disorder. The prevalence of CMD is estimated to be one in 100 000 people. Over the last few years, with advances in molecular genetic diagnostics, knowledge about neuromuscular disorders, particularly CMDs, has increased dramatically. Thus, the incidence may be higher than originally thought. Conclusion This article reviews the recent achievements related to the clinical, diagnostic, pathogenic, and therapeutic aspects of CMDs.

Purpose: The authors investigated whether far-infrared radiation (FIR) lamp therapy would reduce muscle damage and enhance recovery from multiple soccer-match-related running activities. Methods: Twenty-four elite female soccer players (20–24 y) were assigned into a FIR or a sham treatment group (n = 12/group). They performed a daily 90-minute Loughborough Intermittent Shuttle Test (LIST) for 6 consecutive days. Maximal voluntary contraction torque of the knee extensors (KEs) and flexors, muscle soreness, plasma creatine kinase activity, countermovement jump, and several other performance measures (eg, 30-m dash, Yo-Yo Intermittent Recovery Test Level 1) were taken before the first LIST, 1 hour after each LIST, and 24, 48, 72, 96, and 120 hours after the last LIST. All participants received a 30-minute FIR or sham treatment on KEs and knee flexors, respectively, at 2 hour after each LIST and 25, 49, 73, and 97 hours after the last LIST. Results: All measures changed significantly (P <.05) at 1 hour after the first LIST without difference (P >.05) between groups. Maximal voluntary contraction torque (eg, the largest decrease of KE for FIR: 13% [4%], sham: 25% [5%]), countermovement jump height (4% [3%] vs 14% [4%]), and other performance measures (eg, Yo-Yo Intermittent Recovery Test: 11% [5%] vs 26% [5%]) decreased less, and peak muscle soreness (eg, KE: 26 [9] vs 51 [18] mm) and plasma creatine kinase activity (172 [32] vs 1289 [610] IU/L) were smaller for the FIR than for the sham group (P <.05), and they returned to the baseline earlier (P <.05) for the FIR group. Conclusions: These results suggest that the FIR therapy provided potent effects on reducing accumulated muscle damage and enhancing recovery. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the relationships between the recovery kinetics experienced by professional football players and noncontact injury. Methods: A cohort of 46 professional football players (age 24.2 [4.7] y) from the same team (French Ligue 1) was monitored each day between matches when the team played twice a week. The recovery monitoring procedure was implemented after 38 matches and included some questionnaires: duration of sleep, Hooper scale (quality of sleep, level of stress, fatigue, and muscle soreness), perceived recovery status scale, creatine kinase concentrations, a countermovement jump, and an isometric force test. Noncontact injuries were collected during these periods. Results: Noncontact injuries were associated with perceived fatigue and muscle soreness 2 days (relative risk [RR] = 1.89 and 1.48, respectively) and 3 days following the matches (RR = 2.08 and 2.08, respectively). An increase of sleep quantity during the 2 nights following a match was significantly associated with a lower RR (RR = 0.65), as well as a lower decrement score on the isometric force test on each of the 3 days after the matches (RR = 0.97, RR = 0.99, and RR = 0.97, respectively). No other association was reported for the variables sleep quality, stress, perceived recovery, creatine kinase concentrations, countermovement jump, and noncontact injuries. Conclusion: During a congested schedule, implementing a recovery monitoring protocol including questionnaires about fatigue, muscle soreness, quantity of sleep, and a physical test of isometric force could help practitioners prevent injuries. [ABSTRACT FROM AUTHOR]

Aims. This study aimed to analyze the effects of the surgery preparation time on patient outcomes. Background. Postoperative complications have a decisive effect on postoperative survival. The anesthesia time is a crucial determinant of such complications. Competent operating room nurses can shorten the surgery preparation time, which is the time from when anesthesia is first administered to the making of the surgical incision. The shortening of this preparation time can shorten the anesthesia time and may reduce postoperative complications. However, discussion of this preparation time is insufficient. Therefore, this study analyzed the effect of the surgery preparation time on patient outcomes. Methods. From electronic health records data, this retrospective cohort study used the data of 1,944 patients who had been immediately admitted to the ICU after their surgery between 2017 and 2020. The patients were divided into two groups: ≥30 minutes preparation time and <30 minutes preparation time groups. We performed chi-squared tests and t-tests to determine differences in preoperation, intraoperation, and postoperation characteristics of the patients and patient outcomes based on the surgery preparation time. Furthermore, we performed a multiple logistic regression by including 12 adjusted variables to determine the influence of the surgery preparation time on patient outcomes. Results. Among the 1,944 patients, 820 were in the ≥30 minutes preparation time group and 1,124 in the <30 minutes preparation time group. The multiple logistic regression analysis showed that the surgery preparation time affects alertness (OR = 1.44; 95% CI: [1.09, 1.90]), ventilator application (OR = 1.32; 95% CI: [1.03, 1.70]), and length of stay in the ICU (OR = 1.69; 95% CI [1.16, 2.47]). Conclusions. The surgery preparation time affects postoperative patient outcomes. The competence of operating room nurses is the most essential aspect of the surgery preparation time. Implications for Nursing Management. It is important to analyze operating room nurses' tasks, standardize the tasks, and educate nurses according to their experience level to reduce the surgery preparation time and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Strenuous exercise in traditional polo matches creates enormous stress on horses. Hematological and physiological measures may vary across different field-play positions. This study aimed to investigate the effort intensity and the impact of exertion on hematology and heart rate variability (HRV) in polo ponies with different positions. Thirty-two ponies, divided equally into eight teams, were studied. Each comprises forwards (number 1), midfielders (numbers 2 and 3), and defenders (number 4). Team pairs played the first chukka in four low-goal polo matches. Percent maximum heart rate (%HRmax), indicating ponies' effort intensity, was classified into five zones, including zones 1 (<70%), 2 (70–80%), 3 (80–90%), 4 (90–95%) and 5 (>95%). Hematological and HRV parameters were determined before, immediately after, and at 30-minute intervals for 180 minutes after chukkas; HRV variables were also obtained during warm-up and exercise periods. Results indicated that the number two ponies spent more time in zone 4 (p < 0.05) but less in zone 2 (p < 0.01) than the number four ponies. Cortisol levels increased immediately and 30 minutes afterward (p < 0.0001 for both) and then returned to baseline 60–90 minutes after exertion. Other measures (Hct, Hb, RBC, WBC, neutrophils, and CK enzyme) increased immediately (p < 0.0001 for all) and lasted at least 180 minutes after exertion (p < 0.05–0.0001). HRV decreased during the chukka until approximately 90 minutes afterward (p < 0.05–0.0001). The stress index increased during the chukka and declined to baseline at 60 minutes in number 1–3 ponies but lasted 90 minutes in those at number four. Effort intensity distribution differed among field-play positions. Decreased HRV indicated reduced parasympathetic activity during exercise, extending to 90 minutes after exertion in polo ponies. Defenders seem to experience more stress than those in other positions. [ABSTRACT FROM AUTHOR]

Background: The development and course of myocardial infarction with non-obstructive coronary artery (MINOCA) disease is still not fully understood. In this study, we aimed to examine the baseline characteristics of in-hospital outcomes and long-term outcomes of a cohort of troponin-positive patients without obstructive coronary artery disease based on different left ventricular ejection fractions (LVEFs). Methods and results: We included a cohort of 254 patients (mean age: 64 (50.8–75.3) years, 120 females) with suspected myocardial infarction and no obstructive coronary artery disease (MINOCA) in our institutional database between 2010 and 2021. Among these patients, 170 had LVEF ≥ 50% (84 females, 49.4%), 31 patients had LVEF 40–49% (15 females, 48.4%), and 53 patients had LVEF < 40% (20 females, 37.7%). The mean age in the LVEF ≥ 50% group was 61.5 (48–73) years, in the LVEF 40–49% group was 67 (57–78) years, and in the LVEF < 40% group was 68 (56–75.5) years (p = 0.05). The mean troponin value was highest in the LVEF < 40% group, at 3.8 (1.7–4.6) µg/L, and lowest in the LVEF ≥ 50% group, at 1.1 (0.5–2.1) µg/L (p = 0.05). Creatine Phosphokinase (CK) levels were highest in the LVEF ≥ 50% group (156 (89.5–256)) and lowest in the LVEF 40–49% group (127 (73–256)) (p < 0.05), while the mean BNP value was lowest in the LVEF ≥ 50% group (98 (48–278) pg/mL) and highest in the <40% group (793 (238.3–2247.5) pg/mL) (p = 0.001). Adverse in-hospital cardiovascular events were highest in the LVEF < 40% group compared to the LVEF 40–49% group and the LVEF ≥ 50% group (56% vs. 55% vs. 27%; p < 0.001). Over a follow-up period of 6.2 ± 3.1 years, the all-cause mortality was higher in the LVEF < 40% group compared to the LVEF 40–49% group and the LVEF ≥ 50% group. Among the different factors, LVEF < 40% and LVEF 40–49% were associated with an increased risk of in-hospital cardiovascular events in the multivariable Cox regression analysis. Conclusions: LVEF has different impacts on in-hospital cardiovascular events in this cohort. Furthermore, LVEF influences long-term all-cause mortality. [ABSTRACT FROM AUTHOR]

Simple Summary: Wooden breast myopathy is an abnormality that affects heavyweight, rapidly growing broilers' breast muscle. The understanding of the exact cause of this muscle pathology remains incomplete, necessitating further investigation. Blood biochemical analysis is used to diagnose pathologies and understand disease processes. Therefore, the objective of this research was to determine and compare the changes in the blood serum biochemical parameters of broilers without myopathy and those affected by myopathy. Blood samples were collected from male and female 43-day-old broilers with an average live weight of 2.98–3.09 kg. The research results showed that birds with wooden breast had higher levels of creatine kinase, potassium, and alanine aminotransferase. Increased alanine aminotransferase indicated possible liver injury alongside wooden breast myopathy. Elevated creatine kinase and potassium suggested muscle damage, indicating CK as a potential biomarker for WB. Wooden breast (WB) myopathy is a pathology of the pectoralis major muscle. Wooden breast is caused by multiple factors. The exact etiopathogenesis of this myodegenerative pathology is still unclear. Fast-growing commercial lines of broilers that are selected for high breast muscle yields are more susceptible to this myopathy. The biochemical analysis of blood is used to diagnose pathologies and understand disease processes. Therefore, the objective of this research was to determine and compare the changes in the blood serum biochemical parameters of Ross 308 chicken broilers without myopathy and those affected by WB myopathy. Blood samples were collected from male and female Ross 308 broilers that were 43 days old, with an average live weight of 2.98–3.09 kg. Representative blood samples were selected from broilers with WB (n = 33) and without WB (n = 33). In the laboratory, the blood was centrifugated, and biochemical tests were performed with an automated computerized biochemistry analyzer. The research results showed that broilers with WB had elevated blood serum levels of creatine kinase (CK) (p = 0.018), potassium (p = 0.010), and alanine aminotransferase (ALT) (p = 0.012). In conclusion, elevated serum levels of CK and potassium indicated that skeletal muscle cells were damaged. Moreover, increased ALT levels suggested a possible association between WB myopathy and liver damage. Additionally, these research findings underscore the diagnostic significance of CK and hint at its potential as a WB biomarker. [ABSTRACT FROM AUTHOR]

BACKGROUND: Ischemic postconditioning is one of the effective ways to reduce ischemia-reperfusion injury and has been more and more widely used in clinical practice in recent years, but its specific molecular mechanism has yet to be studied. OBJECTIVE: To investigate the role and mechanism of piRNA-005854 in the aging cardiomyocytes caused by hypoxic postconditioning. METHODS: In vitro, cardiomyocytes were administered 8 mg/mL D-galactose for 9 days to induce their aging. β-Galactosidase staining was used to observe the aging of cardiomyocytes. Senescent cells were treated with hypoxia/reoxygenation and hypoxic postconditioning. ELISA was utilized to detect changes in myocardial injury markers creatine kinase isoenzyme MB and lactate dehydrogenase levels. Western blot assay was applied to detect the expression changes of autophagy-related proteins LC3II, p62, ULK1 and phosphorylated ULK1 in aging cardiomyocytes. qRT-PCR was employed to determine the expression level of piRNA-005854. piRNA-005854 inhibitor and piRNA-005854 mimics were transferred into aging cardiomyocytes and followed with hypoxic postconditioning. Western blot assay was used to examine the expression of LC3II, p62, ULK1 and phosphorylated ULK1. RESULTS AND CONCLUSION: (1) D-galactose induced obvious senescence of cardiomyocytes 9 days later. (2) Compared with the normoxia group, creatine kinase isoenzyme MB and lactate dehydrogenase levels increased in the hypoxia/reoxygenation group (P < 0.01); LC3 II/I expression was increased; p62 expression was decreased; ULK1 phosphorylation level was increased, and piRNA-005854 expression was increased (P < 0.01). (3) Compared with the hypoxia/ reoxygenation group, creatine kinase isoenzyme MB and lactate dehydrogenase levels significantly reduced in the hypoxic postconditioning group (P < 0.01); LC3 II/I expression significantly decreased (P < 0.05); p62 expression increased (P < 0.01); ULK1 phosphorylation level decreased (P < 0.05), and piRNA-005854 expression decreased (P < 0.01). (4) After transfection of piRNA-005854 inhibitor, LC3II/I expression was decreased (P < 0.01); the expression of p62 was increased significantly (P < 0.05); the phosphorylation level of ULK1 was decreased significantly (P < 0.01). After transfection of piRNA-005854 mimics, LC3II/ I expression was increased significantly; the expression of p62 was decreased, and the phosphorylation level of ULK1 was increased significantly (P < 0.01). (5) The results show that piRNA-005854-mediated reduction of ULK1-dependent autophagy level is a possible mechanism that hypoxic postconditioning exerts its protective effect on aging cardiomyocytes. [ABSTRACT FROM AUTHOR]

Background: Febrile seizures (FS) are the most common seizure disorder in children and a common neurologic complication in children with coronavirus disease 2019 (COVID-19). This study aimed to identify differences in clinical characteristics and disease burden between FS with and without COVID-19. Materials and methods: We conducted a retrospective analysis of medical data at our hospital from December 2019 to July 2023, focusing on hospitalized patients under the age of 14 diagnosed with FS who underwent COVID-19 polymerase chain reaction (PCR) testing. Descriptive statistics and analysis of variance were employed to compare the COVID-19 and non-COVID-19 groups in terms of clinical characteristics and disease burden. Results: A total of 514 patients were included, with 106 testing positive for COVID-19 and 408 testing negative. Patients with COVID-19 were older (34.87 ± 6.16 vs. 28.61 ± 11.35 months, P < 0.001) and had a higher proportion of males (79.2% vs. 62.3%, P = 0.001). The COVID-19 group had longer seizure durations (4.57 ± 4.38 vs. 3.22 ± 2.91 min, P = 0.006) and more complex FS (25.5% vs. 15.9%, P = 0.022). Laboratory tests showed lower lymphocyte counts in the COVID-19 group (1.87 ± 1.48 vs. 2.75 ± 1.51 × 103/µL, P < 0.001) and higher creatine kinase levels (158.49 ± 82.89 vs. 110.89 ± 56.11 U/L, P < 0.001). No significant differences were found in hospital costs, length of hospitalization, and intensive care unit admissions. Conclusion: Clinicians should be knowledgeable about the distinct clinical characteristics of FS in children with COVID-19. Despite distinct features, the prognosis remains favorable and does not require excessive intervention. Ongoing monitoring and research are needed to fully understand the impact of COVID-19 on FS and optimize management strategies. [ABSTRACT FROM AUTHOR]

Suspected adverse drug reactions (ADRs) during treatment with clozapine often prompt therapeutic drug monitoring (TDM) in clinical practice. Currently, there is no official recommendation for pharmacogenetic (PGx) testing in the context of clozapine therapy. In this case report, we demonstrate and discuss the challenges of interpreting PGx and TDM results highlighting the possibilities and limitations of both analytical methods. A 36-year-old male patient with catatonic schizophrenia was treated with clozapine. He experienced multiple hospitalizations due to elevated creatine kinase (CK) levels (up to 9000 U/L, reference range: 30-200 U/L). With no other medical explanation found, physicians suspected clozapine-induced ADRs. However, plasma levels of clozapine were consistently low or subtherapeutic upon admission, prompting us to conduct a PGx analysis and retrospectively review the patient's TDM data, progress notes, and discharge reports. We investigated two possible hypotheses to explain the symptoms despite low clozapine plasma levels: Hypothesis i. suggested the formation and accumulation of a reactive intermediate metabolite due to increased activity in cytochrome P450 3A5 and reduced activity in glutathione S-transferases 1, leading to myotoxicity. Hypothesis ii. proposed under-treatment with clozapine, resulting in ineffective clozapine levels, leading to a rebound effect with increased catatonic symptoms and CK levels. After considering both data sources (PGx and TDM), hypothesis ii. appeared more plausible. By comprehensively assessing all available TDM measurements and examining them in temporal correlation with the drug dose and clinical symptoms, we observed that CK levels normalized when clozapine plasma levels were raised to the therapeutic range. This was achieved through hospitalization and closely monitored clozapine intake. Therefore, we concluded that the symptoms were not an ADR due to altered clozapine metabolism but rather the result of under-treatment. Interpreting TDM and PGx results requires caution. Relying solely on isolated PGx or single TDM values can result in misinterpretation of drug reactions. We recommend considering the comprehensive patient history, including treatment, dosages, laboratory values, clinic visits, and medication adherence. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the outcomes of unilateral biportal endoscopy, unilateral laminectomy bilateral decompression (UBE-ULBD), and open lumbar decompression (OLD) in patients with lumbar epidural lipomatosis (LEL). Methods: This prospective observational study was conducted fromMarch 2019 to May 2022 and encompassed 33 patients with LEL who underwent lumbar decompression. The study included 15 cases of UBE-ULBD decompression and 18 cases of open decompression, which were followed up for 1 year. The baseline characteristics, initial clinical manifestations, and surgical details [including estimated blood loss (EBL) and preoperative complications] of all patients were recorded. Radiographic evaluation included the cross-sectional area (CSA) of the thecal sac and paraspinal muscles on MRI. Clinical results were analyzed using the Short Form-36 Score (SF-36), the Numeric Pain Rating Scale (NRS) for lumbar and leg pain, creatine kinase, the Roland and Morris Disability Questionnaire (RMDQ), and the Oswestry Disability Index (ODI). Results: The dural sac CSA increased considerably at the 1-year postoperative follow-up in both groups (p < 0.001). The operative duration in the OLD group (48.2±7.2min) was shorter than that in the UBE-ULBD group (67.7±6.3min, p< 0.001). The OLD group (97.2 ± 19.8mL) was associated with more EBL than the UBE-ULBD group (40.6 ± 13.6mL, p < 0.001). The duration of hospitalization in the OLD group (5.4 ± 1.3 days) was significantly longer compared with the UBE-ULBD group (3.5 ± 1.2 days, p < 0.01). The SF-36, NRS, RMDQ, and ODI scores improved in both groups postoperatively (p < 0.001). Serum creatine kinase values in the UBE-ULBD group (101.7 ± 15.5) were significantly lower than those in the OLD group (330.8 ± 28.1 U/L) 1 day after surgery (p < 0.001). The degree of paraspinal muscle atrophy in the UBE-ULBD group (4.81 ± 1.94) was significantly lower than that in the OLD group (12.15 ± 6.99) at 1 year (p < 0.001). Conclusion: UBE-ULBD and OLD demonstrated comparable clinical outcomes in treating LEL. However, UBE-ULBD surgery was associated with shorter hospital stays, lower rates of incision infection, lighter paravertebral muscle injury, and lower EBL than OLD surgery. Consequently, UBE-ULBD can be recommended in patients with LEL if conservative treatment fails. [ABSTRACT FROM AUTHOR]

Duchenne muscular dystrophy (DMD) is an intractable X-linked muscular dystrophy caused by mutations in the DMD gene. While many animal models have been used to study the disease, translating findings to humans has been challenging. Microminipigs, with their pronounced physiological similarity to humans and notably compact size amongst pig models, could offer a more representative model for human diseases. Here, we accomplished precise DMD modification in microminipigs by co-injecting embryos with Cas9 protein and a single-guide RNA targeting exon 23 of DMD. The DMD-edited microminipigs exhibited pronounced clinical phenotypes, including perturbed locomotion and body-wide skeletal muscle weakness and atrophy, alongside augmented serum creatine kinase levels. Muscle weakness was observed as of one month of age, respiratory and cardiac dysfunctions emerged by the sixth month, and the maximum lifespan was 29.9 months. Histopathological evaluations confirmed dystrophin deficiency and pronounced dystrophic pathology in the skeletal and myocardial tissues, demonstrating that these animals are an unprecedented model for studying human DMD. The model stands as a distinct and crucial tool in biomedical research, offering deep understanding of disease progression and enhancing therapeutic assessments, with potential to influence forthcoming treatment approaches. The authors present DMD-edited microminipigs showing severe Duchenne muscular dystrophy symptoms; their human-like physiology and small size make them ideal for developing new treatments. [ABSTRACT FROM AUTHOR]

Purposes: Due to the morphological diversity of deformities, technical difficulties, improperly designed components, and so on, THA remains a challenging task in dysplastic hips, especially in highly dislocated hips. The purpose of this study was to comprehensively evaluate the clinical outcomes of robot-assisted THA in patients with DDH through a large cohort study, including the precision of acetabular cup positioning, indicators of inflammatory response, indicators of muscle damage, and complications. Methods: We retrospectively analyzed patients with DDH who underwent THA in our prospectively constructed joint registry between August 2018 and August 2022. Finally, 147 manual THAs and 147 robotic-assisted THAs were included in the final analysis. Patient demographics, indicators of inflammation, indicators of muscle damage, operative time, Harris hip scores (HHS), and forgotten joint score (FJS) were recorded for analysis. The precision of the positioning of the acetabular component was assessed with plain radiographs. Results: In the Crowe II/III groups, the reconstructed center of rotation (COR) in the robotic-assisted group was closer to the anatomical COR with less variation than the manual group (absolute horizontal distances of COR 3.5 ± 2.8 vs. 5.4 ± 4.9 mm, p < 0.05; absolute vertical distances of COR 6.4 ± 4.1 vs. 11.7 ± 8.2 mm, p = 0.001). For all Crowe subtypes, the robotic-assisted THA significantly increased the proportion of acetabular cups located in the safety zone within 5° (all p < 0.05). Interleukin-6 and creatine kinase levels were slightly lower and significantly different in the robotic-assisted group at three days postoperatively (all p < 0.05). Conclusions: Compared to the manual technique, the robot-assisted technique improved the precision and reproducibility of acetabular component positioning, particularly in DDH patients with Crowe types II/III. The robotic-assisted technique did not increase operative time, bleeding, complications, or revision rates, and had a slighter early inflammatory response and muscle damage. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the risk factors for death in anti-melanoma differentiation–associated protein-5-positive dermatomyositis-associated interstitial lung disease (ILD). Methods: Studies were identified by searching PubMed, Embase, Web of Science, and Cochrane Library. We calculated pooled risk ratios (RRs) or standardized mean differences (SMDs) and 95% confidence intervals (CIs) using random-effects models. Results: Twenty studies were selected. Factors that may increase death risk included older age (SMD: 0.62, 95% CI: 0.42–0.81), elevated Krebs von den Lungen-6 (SMD: 0.66, 95% CI: 0.47–0.86), lactate dehydrogenase (SMD: 0.87, 95% CI: 0.72–1.02), C-reactive protein (SMD: 0.62, 95% CI: 0.44–0.80), ferritin (SMD: 0.93, 95% CI: 0.71–1.15), creatine kinase (SMD: 0.28, 95% CI: 0.13–0.44), neutrophil (SMD: 0.34, 95% CI: 0.04–0.64), neutrophil-to-lymphocyte ratio (SMD: 0.52, 95% CI: 0.24–0.79), aspartate aminotransferase (SMD: 0.70, 95% CI: 0.45–0.94), shorter disease duration (SMD: −0.44, 95% CI: −0.67 to −0.21), rapidly progressive ILD (RR: 4.08, 95% CI: 3.01–5.54), fever (RR: 1.98, 95% CI: 1.46–2.69), dyspnoea (RR: 1.63, 95% CI: 1.32–2.02), and anti-Ro52 antibody positive (RR: 1.28, 95% CI: 1.11–1.49). Female (RR: 0.86, 95% CI: 0.78–0.94), increased albumin (SMD: −1.20, 95% CI: −1.76 to −0.64), lymphocyte (SMD: −0.49, 95% CI: −0.67 to −0.30), and arthralgia (RR: 0.53, 95% CI: 0.37–0.78) were protective factors. Conclusion: Older age, shorter disease duration, rapidly progressive ILD, fever, dyspnoea, anti-Ro52 antibody positive, and some inflammatory markers were risk factors for death in patients with anti-melanoma differentiation–associated protein-5-positive dermatomyositis-associated ILD. [ABSTRACT FROM AUTHOR]

Biomarkers for depression in patients with acute coronary syndrome (ACS) have not been identified. This study evaluated multiple serum biomarkers for depressive disorders after ACS. Thirteen serum biomarkers associated with seven functional systems, along with sociodemographic/clinical characteristics, were evaluated in 969 patients within 2 weeks after ACS onset (acute phase). In total, 711 patients were evaluated for depressive disorder using DSM-IV criteria 1 year later (chronic phase). Logistic regression was used for the analysis. Depressive disorders were observed in 378 patients (39.0%) in the acute phase of ACS and 183 patients (25.7%) in the chronic phase. The weighted scores of five serum biomarkers (high-sensitivity C-reactive protein, interleukin-6, homocysteine, troponin I, and creatine kinase-MB) were significantly associated with depressive disorder diagnosis in the acute phase, and the weighted scores of three other biomarkers (tumor necrosis factor-alpha, interleukin-1 beta, and homocysteine) were significantly associated with depressive disorders in the chronic phase, in a dose-dependent manner after adjusting for relevant covariates (all P -values <0.001). The combination of several serum biomarkers exhibited robust associations with depressive disorders in both the acute and chronic phases of ACS. • Biomarkers for depression in acute coronary syndrome (ACS) have not been determined. • Combination of hsCPR, IL-6, homocysteine, troponin I, CK-MB predicted depression at acute phase. • Combination of TNF-α, IL-1β, homocysteine predicted depression at chronic phase. • Multiple serum biomarkers improved identification of depression in ACS. [ABSTRACT FROM AUTHOR]