Irish Journal of Medical Science最新文献

Background: The Glittre activity of daily living (TGlittre) is a functional test that aligns with daily tasks, clinically useful, and is well-tolerated by patients.

Aims: The study aimed to establish the cut-off point for TGlittre test corresponding to the six-minute walk test (6MWT) threshold value of 400 m for determining impaired functional status in heart failure (HF) cases.

Methods: In the cross-sectional study, seventy-eight HF cases (mean age:63.61±11.55, 67.9 % male, LVEF: 35.41±7.60 %, NYHA FC II: 62.8%, FCIII: 37.2%) performed the 6MWT and TGlittre test in a random order. Also, each patient was administered with the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Minnesota Living with Heart Failure Questionnaire (MLHF-Q) questionnaires. The cut-off value for the TGlittre test was determined with Receiver operating characteristics analysis.

Results: The equivalent TGlittre cut-off for the <400 m 6MWT threshold was 5.05 minutes (sensitivity: 88%, specificity: 81%, and area under the curve: 0.92(95 % confidence interval 0.87-0.98). The participants performing ≥5.05 minutes had lower levels of physical activity and higher MLHF-Q scores. Furthermore, the most of them were in NYHA FCIII (51.2%), and the mean LVEF % (33.12±7.75) was lower in this group.

Conclusion: 5.05 minutes is a sensitive and specific cut-off point for TGlittre test in identifying impaired functional status in HF populations. The determined cut-off point also indicates a deterioration in the clinical features of the cases. This study suggests the TGlittre test as a clinically useful, objective, test for determining functional status in the HF population, including elderly patients.

Background: Field-based contact sports, including American football and rugby are among those with the highest sport-related concussion (SRC) rates. Regarding SRC treatment, gradual return-to-play (RTP) protocols are commonly used, however variability in RTP protocols between sporting bodies and scholastic institutions makes accurately interpreting published SRC severity data difficult.

Aims: Compare SRC recovery times, RTP protocols, and mandated sit-out period duration among adult amateur contact field sports.

Methods: MEDLINE, CINAHL Complete, SPORTDiscus, APA PsycInfo, and APA PsycArticles were searched on May 13th, 2024. Eligibility criteria included (1) published in English in a peer-reviewed journal from 2015 to 2024, (2) adult population, (3) amateur, field-based contact sport athlete population, (4) diagnosed and/or suspected SRC, and (5) recovery time (days/weeks) data available.

Results: 19/6085 (< 1%) studies comprising 58 datasets met all inclusion criteria. The studies comprised American football (10/19, 52.6%), field-hockey (5/19, 26.3%), lacrosse (9/19, 47.4%), ladies gaelic football (1/19, 5.3%), rugby (8/19, 42.1%), soccer (10/19, 52.6%), and sprint football (1/19, 5.2%). Mandated sit-out periods ranged from 0 to 21 days across sports, and RTP protocol durations ranged from 5 to 21 days. The most common RTP protocol duration was 7 days (n = 31/58), and mandated sit-out period was no same-day return (n = 25/58). Field hockey had the longest reported SRC recovery duration (34 days), and rugby had the longest mandated sit-out period (21 days).

Conclusion: Recovery time following concussion in contact sports should be interpreted in light of sport type, mandated sit-out policies, and RTP protocols. Empirical evidence should drive decisions in RTP protocols and sit-out periods, which are currently inconsistent between sports.

Objective: The Figure-8 Walk Test (F8WT) is a standardized clinical assessment used to evaluate walking performance, including straight walking and maneuvering around obstacles, as required in daily life. The aim of this study was to establish reference values for the F8WT in healthy adults.

Methods: A total of 1,145 healthy Turkish adults participated in this cross-sectional study. Individuals aged ≥ 18 years who were able to walk independently without assistive devices were included. Participants with a history of neurological, musculoskeletal, or cardiopulmonary disorders affecting gait, recent lower extremity injury or surgery, or cognitive impairment were excluded. The F8WT was administered, and anthropometric as well as sociodemographic parameters were recorded.

Results: The 25th, 25th-75th, and > 75th percentiles were classified as low, average, and high fall risk for both men and women based on F8WT performance. For men, < 3.06 s indicated low fall risk, 3.06-9.34 s indicated average fall risk, and 9.34-22.31 s indicated high fall risk. For women, < 2.41 s indicated low fall risk, 2.41-8.43 s indicated average fall risk, and 8.43-16.06 s indicated high fall risk. Statistically significant differences were observed between men and women in terms of age, height, body weight, and body mass index (BMI) (p < 0.01). In the overall sample, F8WT performance was significantly correlated with age (r = 0.575, p < 0.001), height (r = -0.145, p < 0.001), weight (r = 0.242, p < 0.001), and BMI (r = 0.359, p < 0.001).

Conclusion: This study provides reference values for the F8WT according to age and sex in healthy adults. Women demonstrated shorter F8WT completion times than men, and test duration increased with advancing age.

Clinical trial number: NCT06314347.

Backround: While low-carbohydrate/high-protein diets are common for rapid weight loss, their controversial side effects warrant investigation.

Aims: This study aimed to examine age- and duration-dependent effects of high-protein diets on the liver and kidneys of adult (6 months) and elderly (18 months) rats.

Methods: Thirty-two male Wistar albino rats were divided into four groups: Adult Standard, Adult High-Protein, Elderly Standard, and Elderly High-Protein. After one month, we collected kidney and liver samples for histological analysis and biochemical assessment of MDA and GSH levels.  RESULTS: High-protein diets severely affected the kidneys of both adult and elderly rats. The livers also exhibited moderate degenerative changes. We found a significant increase in MDA levels, indicating lipid peroxidation. Additionally, hepatic and renal GSH levels significantly increased in elderly rats on a high-protein diet, suggesting a metabolic response to oxidative stress.  CONCLUSION: Our findings suggest that high-protein diets should be applied very cautiously, especially in elderly individuals and those with existing kidney disorders.