BioMed, Volume 1, Issue 1 (December 2021) – 2 articles

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Review
Physical Frailty/Sarcopenia as a Key Predisposing Factor to Coronavirus Disease 2019 (COVID-19) and Its Complications in Older Adults
BioMed 2021, 1(1), 11-40; https://0-doi-org.brum.beds.ac.uk/10.3390/biomed1010002 - 29 Jul 2021
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Abstract
The tremendously rising numbers of aged populations are associated with a heightened risk for motor and functional declines. Sarcopenia is an active age-related process that involves progressive losses of skeletal muscle mass, muscle strength, and muscle function. Muscle failure is a major cause [...] Read more.
The tremendously rising numbers of aged populations are associated with a heightened risk for motor and functional declines. Sarcopenia is an active age-related process that involves progressive losses of skeletal muscle mass, muscle strength, and muscle function. Muscle failure is a major cause of frailty, disability, falls, hospitalization, dependency, institutionalization, and low quality of life in older seniors. Therefore, sarcopenia considerably heightens the annual cost of care worldwide. This narrative review elaborates on sarcopenia as a deleterious condition in old age while spotting the light on its association with the coronavirus disease 2019 (COVID-19). It discusses its pathophysiology and the most possible options for preventing and treating sarcopenia. The literature shows that the dynamic of sarcopenia is complex, involving multifaceted physiological alterations relevant to aging, unhealthy behaviors (e.g., undernutrition or inadequate dietary intake and physical inactivity/immobility or sedentary lifestyle), and multiple pathogenic conditions such as metabolic, inflammatory, and endocrinal disorders. Frail individuals express nutritional deficiencies, immune deficit, oxidative stress, metabolic alterations, gut microbial alterations, neurological insult, etc. Such physiological dysfunctions are closely linked to increased vulnerability to COVID-19 among older adults and people with non-communicable diseases such as diabetes mellitus, cardiovascular disorders, and obesity. Available studies report higher occurrence of severe COVID-19 and COVID-19-related complications (ICU admission, mechanical ventilation, and in-hospital mortality) among frail compared with non-frail and prefrail individuals. Effective pharmacological treatments of sarcopenia are not currently available. However, physical activity and nutritional interventions (e.g., fast digestive proteins, vitamin D, and natural products such as bee products) may prevent the development of sarcopenia in early stages of the disease or limit disease progress. Such interventions may also lower vulnerability to COVID-19. Full article
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Systematic Review
Does the Current State of Evidence Justify the Broad Use of Cross-Links in Dorsal Instrumentation? A Systematic Review
BioMed 2021, 1(1), 1-10; https://0-doi-org.brum.beds.ac.uk/10.3390/biomed1010001 - 29 Mar 2021
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Abstract
Cross-links increase the stability of screw-rod systems in biomechanical testing. The aim of this systemic review was to find evidence pertaining to the additional benefit of the implantation of cross-links in clinical practice in regard to different spinal diseases. Therefore, a systematic literature [...] Read more.
Cross-links increase the stability of screw-rod systems in biomechanical testing. The aim of this systemic review was to find evidence pertaining to the additional benefit of the implantation of cross-links in clinical practice in regard to different spinal diseases. Therefore, a systematic literature analysis of two online databases was performed according to the PRISMA statement. Inclusion criteria were prospective and retrospective studies investigating the use of cross-links in dorsal instrumentation. Biomechanical studies and case series were excluded. A total of seven retrospective studies remained for final full-text evaluation. In total, two studies each address the use of cross-links in adolescent idiopathic scoliosis, neuromuscular scoliosis or atlantoaxial fusion, one study in congenital scoliosis. In atlantoaxial fusion the additional use of cross-links may provide earlier bony fusion. In surgical treatment for pediatric scoliosis the additional use of cross-links does not provide additional benefit. Radiological outcome and complication rate did not differ in between groups. No study addressed the use of cross-links in short- or long-segment fusion due to degenerative or traumatic disorders of the spine. There is a deficiency in published literature towards the impact of cross-links in spinal surgery. The current clinical evidence data do not confirm the biomechanical advantages of cross-links in clinical practice. Further studies are needed to warrant the use of cross-links in the future. Full article
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