Myopenia—a new universal term for muscle wasting

A universal term describing the presence of clinically relevant muscle wasting that warrants medical intervention is required. The term sarcopenia might be used in this context. However, common use now means that sarcopenia is more often regarded as synonymous with age-associated muscle wasting in the elderly. We suggest the term “myopenia” to indicate the presence of clinically relevant muscle wasting due to any illness and at any age. This term would translate well into any language and is sufficiently specific if appropriately defined. We suggest to define myopenia as a clinically relevant degree of muscle wasting that is associated either with impaired functional capacity and/or with increased risk of morbidity or mortality. The precise cut-points to define myopenia may be different in various diseases. Myopenia could be diagnosed when a certain degree of muscle wasting over time has occurred (for instance, at least 5% in 6–12 months) or when muscle mass is below a certain threshold level (for instance, the <5th centile of healthy 30-year-olds or a fat-free mass index <16 kg/m2 for men and <15 kg/m2 for women). Future studies need to refine these in a disease-specific manner and link them to degrees of functional impairment that are clinically relevant and/or to degrees of risk of morbid or fatal events

eine kritische Analyse

Haehling Von Lanzenauer, Christoph, Huesmann, Monika (2002): Der Ausbreitungsprozess des Managementinstrumentes TQM. Journal of Natural History 36: 1259-1260, DOI: 10.17169/fudocs_document_000000000504, URL: http://dx.doi.org/10.17169/fudocs_document_00000000050

The obesity paradox in chronic disease: facts and numbers

Body size, particularly large, is a matter of concern among the lay public. Whether this is justified depends upon the state of health and should be judged individually. For patients with established chronic disease, there is sufficient evidence to support the benefits of large body size, i.e., the obesity paradox. This uniform finding is shared over a variety of cardiovascular, pulmonary, and renal diseases and is counterintuitive to the current concepts on ideal body weight. The scientific community has to increase the awareness about differences for optimal body size in health and disease. Simultaneously, clinicians have to be aware about body weight dynamics implications and should interpret the changes in the context of an underlying disease in order to implement the best available management

Diabetes mellitus, cachexia and obesity in heart failure: rationale and design of the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF)

Background: Chronic heart failure (CHF) is increasing in prevalence. Patients with CHF usually have co-morbid conditions, but these have been subjected to little research and consequently there is a paucity of guidance on how to manage them. Obesity and diabetes mellitus are common antecedents of CHF and often complicate management and influence outcome. Cachexia is an ominous and often missed sign in patients with CHF. Methods: This manuscript describes the rationale and the design of Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF), a prospective, multicentre, multinational, longitudinal, pathophysiological evaluation study, which is being conducted in 11 centres across six countries in the European Union and in Russia. We aim to recruit >1,600 patients with CHF due to various common aetiologies, irrespective of left ventricular ejection fraction, and with or without co-morbidities at study entry. In addition, >300 patients with type 2 diabetes mellitus without CHF and >150 healthy subjects will serve as control groups. Participants will be systematically investigated at annual intervals for up to 48 months. Additional investigations focusing on cellular and subcellular mechanisms, adipose and skeletal muscle tissue, and in endothelial progenitor cells will be performed in selected subgroups. Conclusions: SICA-HF will provide insights into common co-morbidities in CHF with a specific emphasis on diabetes mellitus and body mass. This will provide a more thorough pathophysiological understanding of the complexity of CHF that will help develop therapies tailored to manage specific co-morbidities. © 2010 The Author(s)

Developing an Optimal Repair-Replacement Strategy for Pallets

The problem of determining when to repair and when to replace failing equipment is a concern of management of productive resources. Inefficient management due to the use of non-optimal repair-replacement policies can have significant financial implications. The purpose of this paper is to describe the problem, analysis and results of a study which is concerned with determining the optimal repair-replacement strategy for an organization managing a large number of wooden pallets.Supported in part by the U.S. Army Research Office (Durham) under Contract No. DAHC04-73-C-0032