RESUMO
OBJECTIVES: Patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) have a higher risk of falls than those receiving other therapies for haematological disorders. This study aimed to investigate the impact of pretransplant lower extremity muscle strength (LEMS) on post-transplant falls. METHODS: In this retrospective cohort study, patients aged ≥18 years who underwent allo-HSCT were included. All data were extracted from medical records. LEMS was defined as the knee extension force measured by a handheld dynamometer divided by the patient's weight. The receiver operating characteristic (ROC) curve was used to calculate the optimal LEMS cut-off value for prediction of falls. Patients were categorised into low and normal LEMS groups based on the cut-off value. The impact of pretransplant LEMS on post-transplant falls was analysed using a Cox proportional hazards model. RESULTS: In total, 101 patients were analysed. During the observation period, falls occurred in 32 patients (31.7%). The ROC curve analysis results showed that the optimal LEMS cut-off value for prediction of falls was 45.4% per body weight. In multivariate analysis, pretransplant low LEMS was a significant predictor of falls in model 1 with patient characteristics as a confounding factor and model 2 with medications-inducing falls as a confounding factor, respectively (model 1: HR 3.23, 95% CI 1.37 to 7.64; model 2: HR 2.82, 95% CI 1.20 to 6.59). CONCLUSIONS: Pretransplant LEMS was a significant predictor of post-transplant falls. The results of this study may help to prevent falls in patients undergoing allo-HSCT.
RESUMO
Many studies have examined the metabolic pathway of selenium (Se) compounds in Se-accumulating plants (hereafter "Se accumulators") when the plants are exposed to inorganic Se, such as selenite and selenate. However, if we were to consider Se circulation in the biosphere, the metabolism of organic Se, in particular, selenometabolites of animals and plants, in plants should be elucidated. In this study, Brassica rapa var. peruviridis, a known Se accumulator, was hydroponically cultivated and then exposed to selenometabolites of animals and plants, such as methyl-2-acetamido-2-deoxy-1-seleno-ß-d-galactopyranoside (selenosugar, SeSug), trimethylselenonium (TMSe), selenomethionine (SeMet), and Se-methylselenocysteine (MeSeCys). Then, the metabolic pathway of the organic Se compounds/selenometabolites in B. rapa var. peruviridis was investigated by speciation analysis. Two selenometabolites were detected in the roots when the plant was exposed to SeMet, MeSeCys, and SeSug. They were assigned to S-(methylseleno)-glutathione and MeSeCys using electrospray tandem mass spectrometry (ESI-MS-MS) and HPLC-inductively coupled plasma mass spectrometry (ICP-MS). Contrary to SeMet, MeSeCys, and SeSug, TMSe was not metabolized even if it was more efficiently incorporated into the roots than the other Se compounds. The identified metabolites enabled us to propose a metabolic pathway for the organic Se metabolites except TMSe in the plant roots: a monomethylseleno moiety (CH3Se-) commonly existing in SeMet, MeSeCys, and SeSug was cleaved off and conjugated with GSH, and then the CH3Se group was transferred to O-acetylserine to form MeSeCys.
