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We carried out a randomized, clinical trial in adults of both sexes with metabolic syndrome (MS) to assess the efficacy of high-intensity, low-volume interval training (HIIT) compared to moderate-intensity continuous training (MICT) on insulin resistance (IR), muscle mass, muscle activation, and serum musclin. Fasting glycemia, insulinemia, and glycated haemoglobin were determined by conventional methods, IR by Homeostatic model assessment (HOMA), lean mass by Dual-Energy X-ray Absorptiometry, muscle activation through carnosine by Proton Magnetic Resonance Spectroscopy, and musclin by Enzyme-Linked ImmunoSorbent Assay before and after a supervised, three-times/week, 12-week treadmill programme. HIIT (n = 29) consisted of six intervals with one-minute, high-intensity phases at 90% of peak oxygen consumption (VO2peak). MICT (n = 31) trained at 60% of VO2peak for 30 min. Patients had a mean age of 50.8 ± 6.0 years, body mass index of 30.6 ± 4.0 kg/m2, and VO2peak of 29.0 ± 6.3 mL.kg−1.min−1. Compared to MICT, HIIT was not superior at reducing Ln HOMA-IR (adjusted mean difference: 0.083 [95%CI − 0.092 to 0.257]), carnosine or musclin or at increasing thigh lean mass. HIIT increased carnosine by 0.66 mmol/kg.ww (95% CI 0.08–1.24) after intervention. Both interventions reduced IR, body fat percentage and increased total lean mass/height2 and VO2peak. Musclin showed a non-significant reduction with a small effect size after both interventions. Compared to MICT, HIIT is not superior at reducing IR, carnosine or musclin or at increasing skeletal muscle mass in adults with MS. Both training types improved IR, muscle mass and body composition. NCT03087721, March 22nd, 2017. NCT03087721. Registered March 22nd, 2017.

Background: We studied whether musclin function in humans is related to glycemic control, body composition, and cardiorespiratory capacity.Methods: A cross-sectional study was performed in sedentary adults with or without metabolic syndrome (MS). Serum musclin was measured by enzyme-linked immunosorbent assay. Insulin resistance (IR) was evaluated by the homeostatic model assessment (HOMA-IR). Body composition was determined by dual-energy X-ray absorptiometry and muscle composition by measuring carnosine in the thigh, a surrogate of fiber types, through proton magnetic resonance spectroscopy. Cardiorespiratory capacity was assessed through direct ergospirometry.Results: The control (n=29) and MS (n=61) groups were comparable in age (51.5±6.5 years old vs. 50.7±6.1 years old), sex (72.4% vs. 70.5% women), total lean mass (58.5%±7.4% vs. 57.3%±6.8%), and peak oxygen consumption (VOpeak) (31.0±5.8 mL O2./kg.min vs. 29.2±6.3 mL O2/kg.min). Individuals with MS had higher body mass index (BMI) (30.6±4.0 kg/m2 vs. 27.4± 3.6 kg/m2), HOMA-IR (3.5 [95% confidence interval, CI, 2.9 to 4.6] vs. 1.7 [95% CI, 1.1 to 2.0]), and musclin (206.7 pg/mL [95% CI, 122.7 to 387.8] vs. 111.1 pg/mL [95% CI, 63.2 to 218.5]) values than controls (P˂0.05). Musclin showed a significant relationship with HOMA-IR (β=0.23; 95% CI, 0.12 to 0.33; P˂0.01), but not with VOpeak, in multiple linear regression models adjusted for age, sex, fat mass, lean mass, and physical activity. Musclin was significantly associated with insulin, glycemia, visceral fat, and regional muscle mass, but not with BMI, VCO2peak, maximum heart rate, maximum time of work, or carnosine.Conclusion: In humans, musclin positively correlates with insulinemia, IR, and a body composition profile with high visceral adiposity and lean mass, but low body fat percentage. Musclin is not related to BMI or cardiorespiratory capacity.

The diagnosis of pyogenic liver abscess (PLA) represents a challenge for physicians due to their association with multiple pre-existing conditions. Its incidence varies between 2.3 and 17.59 per 100 000 inhabitants per year,1–3 and in hospitalised patients, it is 8–22 cases per 100 000 hospital admissions.4 Usually occurs in Caucasian men between 50 and 60 years old.5 Risk factors include diabetes mellitus, bacteraemia of non-hepatic origin, immunosuppression, cirrhosis and a history of solid organ transplantation or splenectomy.6–8 Those microorganisms commonly found are specified in table 1. Generally, they are polymicrobial, although single bacteria can be isolated and, in up to 30% of cases, no infectious agent is identified.9 View this table: Table 1 Main microorganisms involved in the aetiology of pyogenic liver abscess Escherichia coli had been considered the bacterium responsible for the largest number of cases of pyogenic abscesses in the world;10–12 however, it has been found that in Asian countries Klebsiella pneumoniae is one of the main aetiologies,13–15 and its presentation is monomicrobial, usually generates severe clinical conditions due to the hypervirulence and is not related to hepatobiliary diseases.16 17 An invasive syndrome has then been described by serotypes K1 and K2 that are associated with bacteraemia, necrotising fasciitis, endophthalmitis, meningitis and cerebral asbcesses.8 18 PLA can also occur in fungal coinfection by Candida spp., which affects patients with haematological malignancies, and Cryptococcus spp., which has been found in immunosuppressed patients by the HIV, solid organ transplants and primary immunodeficiencies.8 The clinical manifestations are abdominal pain, fever, jaundice, weight loss and chills, similar to an unknown origin fever, sepsis and acute abdomen. The classic triad characterised by fever, jaundice and abdominal pain in the right hypochondrium is only present in 10% of patients; fever is the most frequent symptom, followed by abdominal pain that …