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Background: Accurate quantification of bone, muscle, and their components is still an unmet need in the musculoskeletal field. Current methods to quantify tissue volumes in 3D images are expensive, labor-intensive, and time-consuming; thus, a reliable, valid, and quick application is highly needed.Methods: Tissue Compass is a standalone software for semiautomatic segmentation and automatic quantification of musculoskeletal organs. To validate the software, cross-sectional micro-CT scans images of rat femur (n=19), and CT images of hip and abdomen (n=100) from the Osteoporotic Fractures in Men (MrOS) Study were used to quantify bone, hematopoietic marrow (HBM), and marrow adipose tissue (MAT) using commercial manual software as a comparator. Also, abdominal CT scans (n=100) were used to quantify psoas muscle volumes and intermuscular adipose tissue (IMAT) using the same software. We calculated Pearson's correlation coefficients, individual intra-class correlation coefficients (ICC), and Bland-Altman limits of agreement together with Bland-Altman plots to show the inter- and intra-observer agreement between Tissue Compass and commercially available software.Results: In the animal study, the agreement between Tissue Compass and commercial software was r>0.93 and ICC>0.93 for rat femur measurements. Bland-Altman limits of agreement was -720.89 (-1.5e+04, 13074.00) for MAT, 4421.11 (-1.8e+04, 27149.73) for HBM and -6073.32 (-2.9e+04, 16388.37) for bone. The inter-observer agreement for QCT human study between two observers was r>0.99 and ICC>0.99. Bland-Altman limits of agreement was 0.01 (-0.07, 0.10) for MAT in hip, 0.02 (-0.08, 0.12) for HBM in hip, 0.05 (-0.15, 0.25) for bone in hip, 0.02 (-0.18, 0.22) for MAT in L1, 0.00 (-0.16, 0.16) for HBM in L1, 0.02 (-0.23, 0.27) for bone in L1. The intra-observer agreement for QCT human study between two applications was r>0.997 and ICC>0.99. Bland-Altman limits of agreement was 0.03 (-0.13, 0.20) for MAT in hip, 0.05 (-0.08, 0.18) for HBM in hip, 0.05 (-0.24, 0.34) for bone in hip, -0.02 (-0.34, 0.31) for MAT in L1, -0.14 (-0.44, 0.17) for HBM in L1, -0.29 (-0.62, 0.05) for bone in L1, 0.03 (-0.08, 0.15) for IMAT in psoas, and 0.02 (-0.35, 0.38) for muscle in psoas. Conclusion: Compared to a conventional application, Tissue Compass demonstrated high accuracy and non-inferiority while also facilitating easier analyses. Tissue Compass could become the tool of choice to diagnose tissue loss/gain syndromes in the future by requiring a small number of CT sections to detect tissue volumes and fat infiltration.

Purpose The objective of this study was to compare the effects of 12 weeks of resistance training combined with either 5:2 intermittent fasting or continuous energy restriction on body composition, muscle size and quality, and upper and lower body strength. Methods Untrained individuals undertook 12 weeks of resistance training plus either continuous energy restriction [20% daily energy restriction (CERT)] or 5:2 intermittent fasting [~ 70% energy restriction 2 days/week, euenergetic consumption 5 days/week (IFT)], with both groups prescribed a mean of ≥ 1.4 g of protein per kilogram of body weight per day. Participants completed 2 supervised resistance and 1 unsupervised aerobic/resistance training combination session per week. Changes in lean body mass (LBM), thigh muscle size and quality, strength and dietary intake were assessed. Results Thirty-four participants completed the study (CERT = 17, IFT = 17). LBM was significantly increased (+ 3.7%, p p p Conclusion When combined with resistance training and moderate protein intake, continuous energy restriction and 5:2 intermittent fasting resulted in similar improvements in body composition, muscle quality, and strength. ACTRN: ACTRN12620000920998, September 2020, retrospectively registered.

This narrative review provides a summary introduction to the relationship between stroke and physical and cognitive frailty syndromes and the neuro-inflammatory similarities (including inflammaging) between the two. The review argues the potential effects of Post COVID-19 Neurological Syndrome (PCNS, also known as Long COVID) with similar pathophysiology. Many patients who have suffered from acute stroke experience long-lasting symptoms affecting several organs including fatigue, brain fog, reduced physical activity, loss of energy, and loss of cognitive reserve, culminating in the loss of independence and poor quality of life. This is very similar to the emerging reports of PCNS from different parts of the world. Stroke, particularly in older adults with comorbidities appears to impact the health and welfare of patients by reducing central neuronal input and neuromuscular function, with muscular atrophy and neuropsychiatric complications. The cumulative effects can potentially lead to a range of physical and cognitive frailty syndromes, which, in many cases may be attributed to persistent, maladapted, low grade, chronic inflammation. Meanwhile, post-COVID-19 Neurological Syndrome (also known as Long COVID Syndrome) appears to share a similar trajectory, adding further urgency for investigations into the mechanisms underlying this constellation of symptoms.

Purpose: The prevalence of musculoskeletal tissue loss syndromes (osteoporosis and sarcopenia), as well as obesity and their combinations, is on the rise. Previous reports indicate mid-thigh dual-energy x-ray absorptiometry (DXA) is well-suited for the simultaneous assessment of bone, muscle, and fat mass in a single scan.Methods: Using DXA images of 1322 community-dwelling adults (57% women, age 58.2 ± 15.6 SD), bone, lean and fat mass were quantified in five regions of interest (ROIs): a) a 2.6 cm; and b) a 13 cm thick slice of mid-thigh; c) whole thigh; d) whole calf; and e) forearm. Conventional indices of tissue mass i.e. appendicular lean mass, hip, and spine bone mineral density (BMD) and total, gynoid and android fat mass, were also calculated. Their associations with muscle strength (handgrip strength) and performance (timed-up-and-go [TUG] and gait speed), as well as falls and fractures, were investigated.Results: Lean mass in all ROIs was well-correlated with outcomes, and according to regression analyses, lean mass explained two-thirds, a third and a quarter of the variability in the handgrip strength (r2= 0.63 to 0.64, p2= 0.34 to 0.37, p2= 0.25 to 0.27, pp=0.029). In all assessed ROIs, BMD was associated with the number of incident fractures within five years (OR= 0.72 to 0.93, p=0.034 to 2.Conclusion: Compared to the conventional indices and four other ROIs, mid-thigh tissue masses were associated with markers of muscle performance. Mid-thigh BMD and lean mass were superior and showed more consistent and more robust associations with adverse outcomes (falls and fractures), particularly in the older population.

Malnutrition is highly prevalent in older persons with dementia. Therefore, strong predictors of malnutrition in this population are crucial to initiating early interventions. This study evaluates the association between the probability of having malnutrition with the muscle volume and intramuscular fat (iMAT) of the masseter and the tongue in magnetic resonance imaging (MRI) of community-dwelling older persons diagnosed with mild dementia followed up for 5 years. This is a longitudinal study conducted in the western part of Norway. Muscle volume and iMAT of the tongue and masseter were computed from structural head MRI obtained from 65 participants of the Dementia Study of Western Norway using Slice-O-Matic software for segmentation. Malnutrition was assessed using the Global Leadership Initiative on Malnutrition Index. Linear mixed models were conducted. Having malnutrition at baseline was associated with lower muscle volume (odds ratio [OR] 0.60, standard error [SE] 0.20; p = .010) and higher iMAT (OR 3.31, SE 0.46; p = .010) in the tongue. At 5 years follow-up, those with lower muscle volume (OR 0.55, SE 0.20; p = .002) and higher iMAT (OR 2.52, SE 0.40; p = .022) in the tongue had a higher probability of presenting malnutrition. The masseter iMAT and volume were not associated with malnutrition in any of the adjusted models. In people diagnosed with mild dementia, tongue muscle volume and iMAT were associated with baseline malnutrition and the probability of developing malnutrition in a 5-year trajectory. In the masseter, there were no significant associations after adjustments.

Introduction: Increased adiposity and reduced lean mass are prevalent in Fontan patients and could be impactful because of the reliance on the peripheral muscle pump and the importance of favourable pulmonary physiology in univentricular physiology. The current study aimed to determine the impact of body fat and lean mass on the risk of adverse outcomes in Fontan patients. Methods: Patients with dual-energy X-ray absorptiometry (DXA) scans from the Australian and New Zealand Fontan Registry were included; they had been consecutively recruited for 2 previous cohort studies. Regression analysis was used to characterize the association between body composition and the composite endpoint of Fontan failure (which included death, transplantation, New York Heart Association (NYHA) functional class III/IV, protein-losing enteropathy, and plastic bronchitis) and development of moderate or worse ventricular dysfunction. Results: 131 DXA scans were analyzed, with mean follow-up of 2.5 (SD 2.2) years after DXA. Mean body fat percentage (%BF) was 29% (SD 10) with 48% having increased adiposity compared with local reference data. Mean appendicular lean mass index (ALMI) z-score was -1.5 (SD 1.1); one third of patients had skeletal muscle deficiency (defined as ALMI z-score between -1 and -2) and another third had Fontan-associated myopenia (defined as ALMI z-score &lt -2). Nine patients reached the composite endpoint during the follow-up period. Age and %BF were predictors of the endpoint in univariable regression (age: HR 1.09 per year, 95% CI 1.02-1.17, p = 0.01; %BF: HR 1.08, 95% CI 1.01-1.17, p = 0.03). On multivariable regression, %BF remained a significant predictor with every 1% increase conferring an 9% increased risk (HR 1.09, 95% CI 1.00-1.19; p = 0.045). ALMI was not a predictor of the endpoint (HR 1.40, 95% CI 0.71-2.76, p = 0.33). However, all patients who experienced a Fontan failure event (n=4) concurrently had increased adiposity and skeletal muscle deficiency. Conclusions: Increased adiposity is associated with increased risk for adverse clinical outcomes. Appropriate lifestyle interventions to optimise body composition should be an important aspect of routine care in this population.

ObjectiveWe aimed to investigate the skeletal phenotype of Winnie mouse model of spontaneous chronic colitis, which carries a mutation in the Muc2 gene and closely replicates IBD symptoms and pathophysiology. These mice have a high level of gut-derived serotonin (GDS), a potent osteoblastogenesis inhibitor. We explored the underlying mechanisms of bone loss associated with chronic intestinal inflammation.DesignWinnie male and female mice prior to colitis onset (6 weeks old) and progression (14 and 24 weeks) were compared to age- and sex-matched C57BL/6 controls. We assessed bone quality (static and dynamic histomorphometry, micro-CT, 3-point bending), intestinal inflammation (lipocalin-2), GDS levels, serum levels of calcium, phosphorus and vitamin D, ex vivo bone marrow analysis and molecular mechanisms inhibiting osteoblastogenesis.ResultsSignificant deterioration in trabecular and cortical microarchitecture, reductions in bone formation, mineral apposition rate, bone volume, osteoid volume and bone strength were observed in Winnie mice compared to C57BL/6 controls. Decreased osteoblast and increased osteoclast numbers were prominent in Winnie mice. We report for the first time that elevated GDS cross-talks with molecular pathways to inhibit bone formation in Winnie mice. Increased expression of 5-HTR1B and FOXO1 mRNAs, dissociation of FOXO1/CREB1 complex and association of FOXO1 with ATF4, promoting the transcriptional activity of FOXO1, results in suppression of osteoblast proliferation in Winnie mice compared to controls.ConclusionThese findings open avenues for the development of targeted therapies for IBD-related bone loss.Significance of this studyWhat is already known on this subject?- Osteoporosis is a common extraintestinal manifestation of inflammatory bowel disease (IBD).- Currently available treatments are not effective for IBD-associated bone loss.- The mechanisms of bone loss are poorly understood. A major limitation has been the lack of an appropriate animal model for IBD-associated bone loss.What are the new findings?- We report for the first-time the skeletal phenotype in Winnie mouse model of IBD- This study presents a novel mechanism of IBD-associated bone loss, involving elevated gut-derived serotonin crosstalk with molecular pathways inhibiting bone formation.How might it impact on clinical practice in the foreseeable future- These findings open avenues for the development of targeted therapies for IBD-related bone loss.

Background Sarcopenia is defined as the age-related loss of muscle mass, strength, and physical performance. The original European Working Group on Sarcopenia in Older Persons (EWGSOP1) definition, and its revision (EWGSOP2), provide new cut-points and alternate measures for sarcopenia diagnosis. However, sarcopenia is rarely diagnosed in clinical settings owing to its labor-intensive diagnostic process. Given the Short Physical Performance Battery (SPPB) is a quick, easily administrable, and objective measure of muscle strength and physical performance, both of which are key components of sarcopenia, this study examined the diagnostic value of the SPPB for this muscle disease. Methods A cross-sectional analysis of 294 community-dwelling older persons (≥65 years) was conducted. Appendicular lean body mass [(ALM) divided by height squared (ALM/h2)], muscle strength (handgrip/sit to stand), and physical performance [gait speed, timed up and go (TUG) and SPPB] were assessed using validated procedures, while participants were diagnosed with sarcopenia following the EWGSOP1 and EWGSOP2 criteria. Diagnostic ability of the SPPB independently and combined with ALM/h2 for sarcopenia was determined using area under the curve (AUC). Potential cut-points were identified, and sensitivity and specificity calculated. Results Prevalence of sarcopenia ranged from 4 to 16% depending on the definition. The SPPB demonstrated moderate (AUC = 0.644–0.770) value in diagnosing sarcopenia, and a cut-point of ≤8points in SPPB performance resulted in high sensitivity (82–100%) but low specificity (36–41%) for diagnosing those with severe sarcopenia. Conclusions The SPPB displayed acceptable value in diagnosing older adults with severe sarcopenia. Moreover, the high sensitivity of the SPPB when using the cut-point of ≤8 suggests it may be a favorable screening tool for sarcopenia in clinical settings where ALM measurements are not available.

BACKGROUND Bone and muscle are closely linked anatomically, biochemically, and metabolically. Acute exercise affects both bone and muscle, implying a crosstalk between the two systems. However, how these two systems communicate is still largely unknown. We will explore the role of undercarboxylated osteocalcin (ucOC) in this crosstalk. ucOC is involved in glucose metabolism and has a potential role in muscle maintenance and metabolism. OBJECTIVE The proposed trial will determine if circulating ucOC levels in older adults at baseline and following acute exercise are associated with parameters of muscle function and if the ucOC response to exercise varies between older adults with low muscle quality and those with normal or high muscle quality. METHODS A total of 54 men and women aged 60 years or older with no history of diabetes and warfarin and vitamin K use will be recruited. Screening tests will be performed, including those for functional, anthropometric, and clinical presentation. On the basis of muscle quality, a combined equation of lean mass (leg appendicular skeletal muscle mass in kg) and strength (leg press; one-repetition maximum), participants will be stratified into a high or low muscle function group and randomized into the controlled crossover acute intervention. Three visits will be performed approximately 7 days apart, and acute aerobic exercise, acute resistance exercise, and a control session (rest) will be completed in any order. Our primary outcome for this study is the effect of acute exercise on ucOC in older adults with low muscle function and those with high muscle function. RESULTS The trial is active and ongoing. Recruitment began in February 2018, and 38 participants have completed the study as of May 26, 2019. CONCLUSIONS This study will provide novel insights into bone and muscle crosstalk in older adults, potentially identifying new clinical biomarkers and mechanistic targets for drug treatments for sarcopenia and other related musculoskeletal conditions. CLINICALTRIAL Australia New Zealand Clinical Trials Registry ACTRN12618001756213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375925. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/18777

Marrow (MAT) and subcutaneous (SAT) adipose tissues display different metabolic profiles and varying associations with aging, bone density, and fracture risk. Using a non-invasive imaging methodology, we aimed to investigate the associations between MAT, SAT, and visceral fat (VAT) with bone volume, bone remodeling markers, insulin resistance, and circulating inflammatory mediators in a population of older men. In this cross-sectional study, 96 healthy men (mean age 67 ± 5.5) were assessed for anthropometric parameters, body composition, serum biochemistry, and inflammatory panel. Using single-energy computed tomography images, MAT (in L2 and L3 and both hips), VAT, and SAT (at the level of L2-L3 and L4-L5) were measured employing Slice-O-Matic software (Tomovision), which enables specific tissue demarcation applying previously reported Hounsfield unit thresholds. MAT volume was similar in all anatomical sites and independent of BMI. In all femoral regions of interest (ROIs) there was a strong negative association between bone and MAT volumes (r = - 0.840 to - 0.972, p

OBJECTIVES: Because of the nature of the Fontan physiology, patients are at an increased risk of thromboembolic complications. As such, warfarin or aspirin is generally prescribed lifelong for thromboprophylaxis. This study aimed to compare long-term rates of cerebrovascular injury, thrombosis, bleeding, bone mineral density, and quality of life in people living with Fontan circulation receiving warfarin compared with aspirin. METHODS: This was a multicenter study of a selected cohort from the Australia and New Zealand Fontan population. Participants underwent cerebral magnetic resonance imaging to detect the presence of cerebrovascular injury (n = 84) and dual-energy X-ray absorptiometry to assess bone mineral density (n = 120). Bleeding (n = 100) and quality of life (n = 90) were assessed using validated questionnaires: Warfarin and Aspirin Bleeding assessment tool and Pediatric Quality of Life Inventory, respectively. RESULTS: Stroke was detected in 33 participants (39%), with only 7 (6%) being clinically symptomatic. There was no association between stroke and Fontan type or thromboprophylaxis type. Microhemorrhage and white matter injury were detected in most participants (96% and 86%, respectively), regardless of thromboprophylaxis type. Bleeding rates were high in both groups; however, bleeding was more frequent in the warfarin group. Bone mineral density was reduced in our cohort compared with the general population; however, this was further attenuated in the warfarin group. Quality of life was similar between the warfarin and aspirin groups. Home international normalized ratio monitoring was associated with better quality of life scores in the warfarin group. CONCLUSIONS: Cerebrovascular injury is a frequent occurrence in the Australia and New Zealand Fontan population regardless of thromboprophylaxis type. No benefit of long-term warfarin prophylaxis could be demonstrated over aspirin; however, consideration must be given to important clinical features such as cardiac function and lung function. Furthermore, the association of reduced bone health in children receiving warfarin warrants further mechanistic studies.

Background Bone and muscle are closely linked anatomically, biochemically, and metabolically. Acute exercise affects both bone and muscle, implying a crosstalk between the two systems. However, how these two systems communicate is still largely unknown. We will explore the role of undercarboxylated osteocalcin (ucOC) in this crosstalk. ucOC is involved in glucose metabolism and has a potential role in muscle maintenance and metabolism. Objective The proposed trial will determine if circulating ucOC levels in older adults at baseline and following acute exercise are associated with parameters of muscle function and if the ucOC response to exercise varies between older adults with low muscle quality and those with normal or high muscle quality. Methods A total of 54 men and women aged 60 years or older with no history of diabetes and warfarin and vitamin K use will be recruited. Screening tests will be performed, including those for functional, anthropometric, and clinical presentation. On the basis of muscle quality, a combined equation of lean mass (leg appendicular skeletal muscle mass in kg) and strength (leg press; one-repetition maximum), participants will be stratified into a high or low muscle function group and randomized into the controlled crossover acute intervention. Three visits will be performed approximately 7 days apart, and acute aerobic exercise, acute resistance exercise, and a control session (rest) will be completed in any order. Our primary outcome for this study is the effect of acute exercise on ucOC in older adults with low muscle function and those with high muscle function. Results The trial is active and ongoing. Recruitment began in February 2018, and 38 participants have completed the study as of May 26, 2019. Conclusions This study will provide novel insights into bone and muscle crosstalk in older adults, potentially identifying new clinical biomarkers and mechanistic targets for drug treatments for sarcopenia and other related musculoskeletal conditions. Trial Registration Australia New Zealand Clinical Trials Registry ACTRN12618001756213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375925. International Registered Report Identifier (IRRID) DERR1-10.2196/18777

Detecting the genera and species of gastrointestinal (GI) nematode infections in faecal samples obtained from cattle requires the incubation of faeces ('larval culture') followed by identification of the third-stage larvae that are harvested after 10-14days. Substantial research in the development of PCR-based methods for the rapid and specific identification GI nematodes has been conducted for small ruminants, whilst only few such assays have been developed for cattle. In the present paper we describe the development of an automated, robotic PCR platform for the detection and genus and/or species-specific identification of GI nematodes from bovine faecal samples. This test was then validated using samples from different regions of three countries (Australia, Belgium and Scotland). The PCR platform was found to be highly sensitive and specific for the identification of the important GI nematodes in naturally infected cattle (both estimates >90%). The PCR platform can also estimate the percentage of genera or species present in a mixed-species infection, and was found superior to larval culture in terms of speed (1-2days versus 1-2 weeks for culture), sensitivity and specificity. The PCR was simple to use and the operator requires no knowledge or experience to identify the nematodes present, compared to larval culture where even experienced operators can make substantial errors due to considerable overlap in the published characteristics of key species.

This is a case report of unusual lesions caused by Thelazia gulosa in cattle. After several ineffective treatments of suspected infectious keratoconjunctivitis in calves and cows, T. gulosa was found associated with retrobulbar granuloma-like masses. The masses with multiple digit-like protrusions on conjunctival surface ejected multiple worms on firm pressure on clinical examination. Samples of tissues that contained worms were surgically removed, fixed in ethanol and submitted to the parasitology and histopathology labs for morphological identification of worms and the nature of the tissue masses, respectively. The infestation was present only in young calves (

Understanding how changes in nutritional status influence musculoskeletal recovery after falling remains unclear. We explored associations between changes in nutritional status and musculoskeletal health in 106 community-dwelling older adults aged &ge, 65 years, who attended the Falls and Fractures Clinic at Sunshine Hospital in St Albans, Australia after falling. At baseline and after 6 months, individuals were assessed for Mini Nutritional Assessment (MNA&reg, ), grip strength, gait speed, Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and bone turnover marker levels. Associations were examined using multiple linear regression, adjusted for baseline covariates and post-fall care plans. Over 6 months, the prevalence of malnutrition or risk thereof decreased from 29% to 15% using MNA &lt, 24/30. Specifically, 20 individuals (19%) improved, 7 (7%) deteriorated, and 73 (69%) maintained nutritional status, including 65 (61%) who remained well-nourished and 8 (8%) who remained malnourished/at risk. A 1-point increase in MNA score over 6 months was associated with an increase of 0.20 points (95% confidence interval 0.10, 0.31, p &lt, 0.001) in SPPB score. Improvement in nutritional status was associated with improvement in physical performance, providing a basis for interventional studies to ascertain causality and evaluate nutritional models of care for post-fall functional recovery in older adults.

Purpose: Marrow adipose tissue (MAT) expansion and associated lipotoxicity are important drivers of age-related bone loss and hematopoietic bone marrow (HBM) atrophy. Fish oil and borage oil (rich in ω3 fatty acids) can partially prevent aged-related bone loss in SAMP8 mice. However, whether preservation of bone mass in this progeria model is associated with MAT volumes remains unknown. Results: MAT volume fraction (MAT%) showed a negative association with hematopoietic bone marrow (HBM%;r=-0.836, p9 /group) were allocated into 4 categories and fed a control ration, FO-, sunflower oil (SFO)- and borage oil-enriched diets for lifetime. Femurs were scanned using microcomputed tomography (μCT) and bone, MAT, and HBM volumes were determined using an image analysis software.

Context Androgen deprivation therapy (ADT) for prostate cancer (PCa) leads to a selective loss of leg muscle function during walking. Rodent models of ADT have demonstrated that the levator ani is exquisitely androgen sensitive. Objective To determine whether the high androgen responsiveness of the levator ani muscle documented in rodents is evolutionarily conserved and ADT is associated with a selective loss in leg muscle volume. Design Prospective longitudinal case-control study. Setting Tertiary referral hospital. Participants Thirty-four men newly beginning ADT and 29 age-matched controls with PCa. Main outcome measures The muscle volumes in liters of the levator ani and primary muscles involved in walking (iliopsoas, quadriceps, gluteus maximus, gluteus medius, calf). Results Compared with controls, during a 12-month period, men receiving ADT experienced a mean reduction in total testosterone from 14.1 to 0.4 nmol/L and demonstrated greater decreases in levator ani [mean adjusted difference (MAD), -0.005 L; 95% CI, -0.007 to -0.002; P = 0.002; -16% of initial median value], gluteus maximus (MAD, -0.032 L; 95% CI, -0.063 to -0.002; P = 0.017; -5% of initial median value), iliopsoas (MAD, -0.005 L; 95% CI, -0.001 to 0.000; P = 0.013; -5% of initial median value), and quadriceps (MAD, -0.050 L; 95% CI, -0.088 to -0.012; P = 0.031; -3% of initial median value). No substantial differences were observed in the gluteus medius and calf muscles. Conclusions The androgen responsiveness of the levator ani appears to be evolutionarily conserved in humans. ADT selectively decreases the volume of muscles that support body weight. Interventional strategies to reduce ADT-related sarcopenia and sexual dysfunction should assess whether targeting these muscle groups, including the pelvic floor, will improve clinical outcomes.

Longevity, the increase in the ageing population and a lifestyle of minimal physical activity come with a hefty price. Consequently, two diseases are increasingly becoming a concern for the welfare of patients and the health industry: osteoporosis and sarcopenia. These conditions are usually interrelated through several mechanisms and metabolic pathways, and comprise a syndrome called osteosarcopenia.As patients with osteosarcopenia represent an important subset of frail individuals at higher risk of institutionalisation, falls and fractures, the aim of this review is to further familiarise general practitioners with osteosarcopenia as a new geriatric syndrome that requires early diagnosis and effective therapeutic interventions.The most important aspects of osteosarcopenia are discussed here. These include pathogenesis, prevalence, diagnostic criteria, management and follow-up. Finally, the role of multidisciplinary clinics for the care of patients with osteosarcopenia is discussed in brief.

Osteosarcopenia is a newly defined geriatric syndrome with serious consequences in the older population. Therefore, early identification of this syndrome and accurate prediction of poor outcomes and response to treatment are crucial. However, the diagnostic methods for sarcopenia and osteoporosis have several limitations. In this review, we briefly discuss the pathogenesis of osteosarcopenia in the light of new discoveries on the importance of local lipotoxicity induced by intramuscular and marrow fat. We also discuss the current and possible future diagnostic methods for osteosarcopenia focusing on the identification and quantification of tissue-embedded fat.

Objective—To evaluate the effect of parenteral administration of ivermectin and erythromycin on abomasal emptying rate in suckling calves. Animals—6 male Holstein-Friesian calves < 15 days old. Procedures—In a crossover study, calves were administered each of 3 treatments (control treatment, 2 mL of saline [0.9% NaCl] solution, IM; erythromycin, 8.8 mg/kg, IM; and ivermectin, 200 μg/kg, IV). Thirty minutes later, calves were bottle-fed 2 L of fresh cow's milk containing acetaminophen (50 mg/kg). Blood samples were collected from a jugular vein at various periods after suckling of milk. Abomasal emptying rate was assessed by use of the time to pharmacokinetically determined maximal plasma acetaminophen concentration. Results—Administration of erythromycin and ivermectin caused a significant increase in abomasal emptying rate, compared with results for the control treatment, as determined on the basis of time to maximal plasma acetaminophen concentration. Conclusions and Clinical Relevance—Parenteral administration of erythromycin and ivermectin increased the abomasal emptying rate. The macrolide erythromycin can be an effective prokinetic agent in calves and other animals. Ivermectin is classified as a macrolide but has a number of structural differences from erythromycin. The clinical importance of a slight increase in abomasal emptying rate after IV administration of ivermectin remains to be determined because ivermectin is only labeled for SC, oral, and topical administration.