The Significance of Dual-Energy X-ray Absorptiometry (DXA) Examination in Cushing's Syndrome-A Systematic Review.

In recent years, the usefulness of dual-energy X-ray absorptiometry (DXA) as a valuable complementary method of assessing the content and distribution of adipose and lean tissue as well as bone mineral density and estimating the risk of fractures has been increasingly confirmed. The diagnosis and treatment of Cushing's syndrome remain challenging, and monitoring the effects of treatment is often necessary. DXA tests offer a potential solution to many problems related to the availability of a quick, detailed, and reliable analysis of changes in the content and distribution of individual body composition components. The article discusses total body DXA scans (FMI, VAT, ALMI), lumbar spine scans (VFA, TBS), and osteoporosis scans (BMD, T-score, Z-score)-all are of potential interest in Cushing's syndrome. The article discusses the use of the most important indicators obtained from a DXA test (FMI, VAT, ALMI, BMD, T-score, Z-score, VFA, TBS) and their clinical significance in Cushing's syndrome was verified. The literature from the last decade was used for the study, available in MEDLINE, Web of Science, and ScienceDirect.

Assessment of muscle fatigue in multiple sclerosis patients in electromyographic examinations.

BACKGROUND: Although surface electromyography (sEMG) is the method used to assess muscle fatigue in patients with multiple sclerosis (PwMS), no pattern of signal change has been established. The differences shown in the parameters of other neurophysiological tests between PwMS and control groups (CG) suggest the differentiation of the sEMG signal. AIM: The purpose of the study was to verify potential differences in the fatigue sEMG signal in PwMS compared to CG. DESIGN: Cross-sectional study. SETTING: Chair and Department of Functional Diagnostics and Physical Medicine. POPULATION: A randomised group of patients diagnosed with MS (30, 20-41 years). A random sample of young, healthy adults (median 28, 20-39 years). METHODS: Measurement of sEMG was performed from extensor carpi radialis (ECR) and FCR (flexor carpi radialis) during 60-80% of maximum voluntary contraction (MVC) of extension and then flexion for 60sec, accordance with the fatigue protocol in Research XP Master Edition software (v. 1.08.27). RESULTS: Root mean square amplitude (ARMS) were lower for muscle in the PwMS compared to the CG (ECR P=0.0001, FCU P<0.0001). In the CG, the ARMS value increases during fatigue contraction (ECR P=0.0003, FCU P<0.0001), while in the PwMS) the ARMS value decreases (ECR: P<0.0001, FCU P<0.0001. CONCLUSIONS: The PwMS show an opposite pattern of preservation of the absolute value of ARMS during prolonged contraction to fatigue, compared with healthy subjects. CLINICAL REHABILITATION IMPACT: The results are important for clinical trials using sEMG to assess fatigue in PwMS. Knowledge of the differences in the time domain changes in sEMG signal between healthy subjects and PwMS is crucial for correctly interpreting the results.

Direct Effect of Local Cryotherapy on Muscle Stimulation, Pain and Strength in Male Office Workers with Lateral Epicondylitis, Non-Randomized Clinical Trial Study.

Background: Local cryotherapy (LC) is one of the physiotherapeutic methods used in the conservative treatment of lateral epicondylitis (LE). The aim of the study was to verify the direct effect of a single LC procedure on the clinical symptoms of lateral epicondylitis enthesopathy (pain, pain free grip, PFG) and its effect on the bioelectrical properties of the wrist extensor muscles at rest, on maximal contraction and isometric contraction during fatigue. Methods: The study group was 28 men (35.4 ± 6.13 years) with confirmed unilateral epicondylitis. The performed procedures included the assessment of pain (visual analogue scale, VAS), PFG and ARMS (root-mean-square amplitude) and mean frequencies (MNF) of the sEMG signal before (T0) and after (T1) LC on the side with enthesopathy (ECRE) and without enthesopathy (ECRN/E). Results: There was an increase in the ARMS values of the signals recorded during rest and MVC from the ECR muscles both with and without enthesopathy (p = 0.0001, p = 0.006), an increased PFG after LC only on the side with LE (p < 0.0001) and decreased pain (p < 0.0001). During isometric fatigue contraction, a higher ARMS on both the ECRE side (p < 0.0001) and the ECRN/E side (p < 0.0001) was observed after LC treatment, and a lower MNF was observed on both the ECRN/E side (p < 0.0001) and the ECRE side (p < 0.0001) after LC. Conclusions: LC reduces the pain and increases PFG and muscle excitation expressed by ARMS and seems to delay muscle fatigue.

Thermal Imaging of Exercise-Associated Skin Temperature Changes in Swimmers Subjected to 2-min Intensive Exercise on a VASA Swim Bench Ergometer.

An important element of swimming training is the improvement of muscle strength and the technique of swimming movements on dry land. The heat generated by the muscles involved in the effort contributes to a change in the temperature of the skin surface, which can be assessed by the IRT method. The aim of the study was to assess the symmetry and dynamics of changes in surface temperatures of selected areas of the body in swimmers after exercise on a swimming ergometer with the use of IRT. A total of 12 swimmers (aged 19 ± 1.3 years) completed a two-minute stress test (front crawl swimming movements) using a VASA Swim Ergometer, with a load of 5. Using an IRT camera (FLIR E60), postexercise changes in back and upper limbs surface temperature in relation to the resting values were observed. After exercise, the temperature value of all assessed areas decreased, apparently in the area of the back and the back of the arms, returning to the baseline values after 12 min of observation. There was no asymmetry in mean temperature values between the right and left upper limbs. IRT is a noninvasive and sensitive tool for the individual analysis of changes in body surface temperature in swimmers after training on dry land.

Assessment of the Dynamics of Temperature Changes in the Knee Joint Area in Response to Selected Cooling Agents in Thermographic Tests.

Although local cryotherapy (LC) is performed with various cooling agents (CAg) such as ice, water, and gasses, in clinical practice, it is mostly performed with cooling gasses. Presently, LC with cooling gasses is very popular but the inference about the thermal (stimulus) effect on the tissues is mainly based on research carried out using ice packs. The proposed objective of the study was to evaluate the dynamics of temperature changes in the knee joint area in response to a 3-min exposure to liquid nitrogen vapors (LNVs), cold air (CA) and ice bag (IB). The study group included 23 healthy volunteers with an average age of 26.67 ± 4.56. The exposed (ROIE) and contralateral (ROINE) areas of the knee joint after exposure to CAg were observed. Immediately after 3 min of LC, the ROIE temperature dropped by 10.11 ± 0.91 °C after LNV, 7.59 ± 0.14 °C after IB and 6.76 ± 1.3 °C after CA. Significant tissue cooling was maintained up to 15 min after LNV (p < 0.01), 10 min after IB (p < 0.05) and 5 min after CA (p < 0.05). LC causes significant temperature changes both in ROIE and ROINE. The greatest cooling potential was demonstrated for LNV and the lowest for CA.

Adaptive changes in muscle activity after cryotherapy treatment: Potential mechanism for improvement the functional state in patients with multiple sclerosis.

BACKGROUND: The available literature lacks data about the influence of whole body cryotherapy (WBC) on muscle activity in patients with sclerosis multiplex (MS). OBJECTIVE: Assessment of the influence of the 20 WBC series on the surface electromyography (sEMG) signal and the relationship between it and the functional state in patients with MS. METHODS: The study group was 114 of MS patients (aged 45.24±11.88yr.,) which 74 of them received 20 of WBC. An assessment was made of: the hand grip (HGS), Timed 25-Foot Walk, Fatigue Severity Scale, sEMG signal from the dominant limb. RESULTS: After a series of 20 WBC: in the rest electromyograms, an increase of extensor carpi radialis (ECR) and a decrease of flexor carpi radialis (FCR) amplitude were demonstrated (non-normalized signal ECR p = 0.0001); significant differences in sEMG rest signals between ECR and FCR have decreased; for voluntary contraction in both assessed antagonistic muscle amplitude was significantly decreased (p = 0.0005; p = 0.0316, p = 0.0185); an increase of HGS (p < 0.001); gait improvement (p = 0.001); decrease fatigue (p = 0.024). No significant changes were observed in the control group. CONCLUSIONS: Series of 20 WBC improves the functional state and reduces fatigue in patients with MS, which may be due to adaptive changes in bioelectrical muscle activity.

The Role of Iron Metabolism in Fatigue, Depression, and Quality of Life in Multiple Sclerosis Patients.

Multiple sclerosis (MS) is a chronic inflammatory disease of autoimmune origin for which there is currently no available cure. In the course of MS, next to neurological disorders, patients often present with chronic fatigue syndrome and depressive disorders, which impact on their daily function and quality of life. The aim of study was to analyse the relationship between serum parameters of iron metabolism and the severity of fatigue, depressive symptoms, and quality of life in MS patients. METHODS: The study sample consisted of 90 people with a diagnosis of multiple sclerosis, age range 19-67 years, whose functional status evaluated using the Expanded Disability Status Scale in 90% of the participants did not exceed 3.5 points. Venous blood samples were collected for blood cell count determination and for the purposes of obtaining serum analysed for the concentrations of iron, ferritin, transferrin, transferrin saturation, unsaturated iron binding capacity (UIBC), and total iron binding capacity (TIBC). The participants were also evaluated according to the Fatigue Severity Scale, Beck Depression Inventory, and Functional Assessment of Multiple Sclerosis. RESULTS: Ferritin levels were significantly correlated with the severity of depressive symptoms (r = -0.22; p = 0.04) and quality of life assessment (r = 0.22; p = 0.04) in the MS patients. Moreover, the severity of fatigue and depressive symptoms was significantly linked to a deterioration in quality of life. CONCLUSIONS: Ferritin deficiency in MS patients is associated with an exacerbation of depressive disorders and a decline in quality of life. Symptoms of fatigue in MS patients are inversely proportional to mood and quality of life.

Changes in the bioelectric activity of the trapezius muscle following the thermal effect of red light and infrared radiation.

BACKGROUND: The therapeutic effects of visible light and infrared is especially often used in physiotherapy. OBJECTIVE: The purpose of this study was to determine the effect of exposure to radiation on the motor units activity. METHODS: The study included 29 volunteers of whom the spontaneous and voluntary bioelectric activity of the trapezius muscle was evaluated using surface electromyography (value of average amplitude and frequency), before and immediately after a 15-minute irradiation. Additionally, the range of motion of the cervical spine and trigger points pain sensitivity to the pressure were assessed. RESULTS: No statistically significant changes in the pain sensitivity threshold and the range of motion after the irradiation was applied. On the other hand, a 15-minute exposure to radiation induced an increase in the value of average amplitude of rest-related as well as exercise-related potentials and an increase in the average value of frequency of the right side biopotentials at rest and of both sides for active elevation. CONCLUSIONS: Infrared radiation and visible red light have a stimulating effect on the muscle ability to develop active contraction. It is proposed that the observed changes are associated with the thermal effect of radiation as well as with the so-called extra-visual effects.

Serum Adiponectin and Leptin Concentrations in Relation to Body Fat Distribution, Hematological Indices and Lipid Profile in Humans.

The purpose of the study was to evaluate the relationship between serum adiponectin and leptin concentrations and body composition, hematological indices and lipid profile parameters in adults. The study involved 95 volunteers (BMI from 23.3 to 53 kg/m²). Anthropometric parameters were measured: body weight and height, waist and hip circumference, waist-to-hip ratio, body fat mass (BMF), subcutaneous and visceral fat mass (SFM, VFM), lean body mass (LBM), skeletal muscle mass (SMM). In serum we determined adiponectin and leptin concentrations, extracellular hemoglobin, total bilirubin, as well as lipid metabolism (TCh, HDL-Ch, LDL-Ch, TG). Mean adipokine levels were significantly higher in women (p ≤ 0.01), adiponectin significantly negatively correlated with body height and weight, systolic blood pressure and absolute LBM and SMM values. The same relation was observed for erythroid system indicators and lipid indicators. A positive correlation was exceptionally found between adiponectin and HDL-Ch. LEP negatively correlated with some percentage rates (%LBM, %SMM). Only in women, we observed a positive correlation between LEP and body weight, BMI and WHR. Studies on ADPN and the ADPN/LEP ratio as a valuable complementary diagnostic element in the prediction and prevention of cardiovascular diseases need to be continued.