Background: Sarcopenia and Frailty are syndromes that affect the clinical outcomes of patients suffering from a wide range of diseases. The use of Computed Tomography (CT) is well established for Sarcopenia evaluation via estimation of the Skeletal Muscle Index (SMI) at the level of the third lumbar vertebra (L3SMI). Nevertheless, the association of more readily available biomarkers of Sarcopenia and clinical outcomes is desired. Recent studies have associated low Alanine amino-transferase ALT (SGPT) levels with Sarcopenia and frailty. The current study aimed to establish the association between low L3SMI and the aforementioned indices of Sarcopenia, frailty and poor clinical outcomes. Methods: A cohort study of patients admitted to the internal medicine department at a tertiary medical center. Sarcopenia was determined as L3SMI, lower than 53 cm2/m2 in men and 41 cm2/m2 in women. Clinical and mortality data was collected from the medical record. Results: Of the 187 patients recruited (mean age 70.4 ± 9.2, 59% males), 116 (62%) had Sarcopenia, based on L3SMI values. Sarcopenic patients were older, predominantly male, had lower BMI, lower mid-arm muscle circumference (MAMC) and low ALT values upon admission. L3SMI values significantly correlated with age and MAMC among males (R = −0.38, p < 0.001, R = 0.35, p < 0.001, respectively). Sarcopenia was associated with higher, one-year mortality (HR = 2.60, 95% CI 1.06–6.37, p = 0.036) and shorter all-time survival (HR = 2.91, 95% CI 1.35–6.29, p = 0.007). The association with all-time survival remained after adjusting for age and sex (HR = 2.38, 95% CI 1.07–5.29, p = 0.034). Conclusion: As defined by low L3SMI value, Sarcopenia is a poor prognostic factor for the general internal ward patient population. As part of personalized medicine, physicians may benefit from measuring L3SMI value, as indicated by commonly performed CT scans, to objectively assess their patient’s risk of suffering from Sarcopenia and frailty-associated complications.
Two critical factors that influence the accuracy of an impression include the proper manipulation of the impression materials and the technique used to make the impression. The purpose of this study was to clinically evaluate the effect of different mixing techniques on the accuracy of vinyl polysiloxane (VPS) impressions by assessing metal framework fit of fixed partial restorations. The study included 92 consecutive patients diagnosed with partial edentulism and treated with fixed partial denture restorations. The mixing technique was one of the two following mixing methods: hand mixing technique (45 patients), with the putty material mixed according to the manufacturer’s instructions; or mechanical mixing technique (47 patients), with the putty material mixed by a Pentamix device. Under both mixing methods, vinyl polysiloxane was used as the impression material. Two impression techniques were randomly used by the operators (One/Two-stage putty –wash impression techniques). The accuracy of the metal framework restorations was tested clinically and radiologically, resulting in significant statistical difference (p = 0.04) between different mixing techniques. The mechanical mixing produced more accurate restorations (metal framework misfit only in 14.9% of patients vs. hand mixing 31.1%). Regarding the impression techniques, the two-stage impression technique was found to be significantly more accurate (p = 0.04), resulting in 14.6% ill-fitted metal frameworks vs. 31.8%, in the one-stage technique. It can be concluded that mechanical mixing yields more accurate impressions leading to more accurate restorations, especially when combined with two-stage impression technique.
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