Although the age-dependent loss of muscle mass and strength, sarcopenia, is an inevitable process, its onset and progression are not well established. Here we defined the onset and the progression of sarcopenia in a healthy aging animal model, Fisher 344×Brown Norway rats. Vastus lateralis, rectus femoris, and vastus medialis muscles (three of the quadriceps muscles) were analyzed at 5 months of age and at 3-month intervals between 12 and 39 months of age. We found an age-dependent decline in muscle mass and fiber number and an increase in fiber atrophy and nonmuscle tissue. Significant changes of fiber number and muscle mass were not observed until very late in life (30–33 months) and were concurrent, whereas fiber cross-sectional area (CSA) gradually declined from maximum CSA (24 months). Sarcopenic declines identified between 30 and 36 months did not continue to 39 months, possibly due to the increased proportion of type I fibers.
The first year after LT remains a high-risk period for unplanned readmissions regardless of pretransplantation diagnosis. Readmissions soon after discharge at index hospitalization and multiple readmissions are associated with an increased risk of mortality.
Infants undergoing congenital heart surgery (CHS) with cardiopulmonary bypass (CPB) are at risk of acute kidney injury (AKI) and fluid overload. We hypothesized that placement of a passive peritoneal drain (PPD) can improve postoperative fluid output in such infants. We analyzed 115 consecutive patients, age birth to 60 days, admitted to the PICU after CHS with CPB between 2012 and 2018. Patients who needed postoperative ECMO were excluded. Linear and logistic regression models compared postoperative fluid balances, diuretics administration, AKI, vasoactive-inotropic scores (VIS), time intubated, and length of stay after adjusting for pre/operative predictors including STAT category, bypass time, age, weight, and open chest status. PPD patients had higher STAT category (
p
= 0.001), longer CPB times (
p
= 0.001), and higher VIS on POD 1–3 (
p
≤ 0.005 daily). PPD patients also had higher AKI rates (
p
= 0.01) that did not reach significance in multivariable modeling. There were no postoperative deaths. Postoperative hours of intubation, hospital length of stay, and POD 1–5 fluid intake did not differ between groups. Over POD 1–5, PPD use accounted for 48.8 mL/kg increased fluid output (95% CI [2.2, 95.4],
p
= 0.043) and 3.41 mg/kg less furosemide administered (95% CI [1.69, 5.14],
p
< 0.001). No PPD complications were observed. Although PPD placement did not affect end-outcomes, it was used in higher acuity patients. PPD placement is associated with improved fluid output despite lower diuretic administration and may be a useful postoperative fluid management adjunct in some complex CHS patients.
Definitive quantitation of mitochondrial DNA (mtDNA) and mtDNA deletion mutation abundances would help clarify the role of mtDNA instability in aging. To more accurately quantify mtDNA, we applied the emerging technique of digital polymerase chain reaction to individual muscle fibers and muscle homogenates from aged rodents. Individual fiber mtDNA content correlated with fiber type and decreased with age. We adapted a digital polymerase chain reaction deletion assay that was accurate in mixing experiments to a mutation frequency of 0.03% and quantitated an age-induced increase in deletion frequency from rat muscle homogenates. Importantly, the deletion frequency measured in muscle homogenates strongly correlated with electron transport chain-deficient fiber abundance determined by histochemical analyses. These data clarify the temporal accumulation of mtDNA deletions that lead to electron chain-deficient fibers, a process culminating in muscle fiber loss.
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