Systemic Inflammatory Response Syndrome is Associated with Hematoma Expansion in Intracerebral Hemorrhage

ObjectivesSystemic inflammatory response syndrome (SIRS) and hematoma expansion are independently associated with worse outcomes after intracerebral hemorrhage (ICH), but the relationship between SIRS and hematoma expansion remains unclear.Materials and methodsWe performed a retrospective review of patients admitted to our hospital from 2013 to 2020 with primary spontaneous ICH with at least two head CTs within the first 24 hours. The relationship between SIRS and hematoma expansion, defined as ≥6 mL or ≥33% growth between the first and second scan, was assessed using univariable and multivariable regression analysis. We assessed the relationship of hematoma expansion and SIRS on discharge mRS using mediation analysis.ResultsOf 149 patients with ICH, 83 (56%; mean age 67±16; 41% female) met inclusion criteria. Of those, 44 (53%) had SIRS. Admission systolic blood pressure (SBP), temperature, antiplatelet use, platelet count, initial hematoma volume and rates of infection did not differ between groups (all p>0.05). Hematoma expansion occurred in 15/83 (18%) patients, 12 (80%) of whom also had SIRS. SIRS was significantly associated with hematoma expansion (OR 4.5, 95% CI 1.16 - 17.39, p= 0.02) on univariable analysis. The association remained statistically significant after adjusting for admission SBP and initial hematoma volume (OR 5.72, 95% CI 1.40 – 23.41, p= 0.02). There was a significant indirect effect of SIRS on discharge mRS through hematoma expansion. A significantly greater percentage of patients with SIRS had mRS 4-6 at discharge (59 vs 33%, p=0.02).ConclusionSIRS is associated with hematoma expansion of ICH within the first 24 hours, and hematoma expansion mediates the effect of SIRS on poor outcome.     

Relationship between vastus lateralis muscle ultrasound echography,knee extensors rate of torque development,and jump height in professional soccer athletes

Purpose

This study aimed to investigate the relationship between knee extensors maximum voluntary contraction (MVC) torque and rate of torque development (RTD) with jump performance and with echography intensity (EI) from the vastus lateralis muscle (VL).

Methods

We assessed the MVC torque and RTD from knee extensors by a standard isokinetic device from 16 male professional soccer players (25.5?±?3.9 years). Counter-movement jump (CMJ) and squat jump (SJ) height were calculated from their flight times. EI was determined from VL ultrasound images’ grayscale histogram acquired in the middle of the tight. Correlation between variables was investigated by the Pearson correlation coefficient.

Results

We observed a VL EI of 26.4?±?7.8 a.u., and the SJ and CMJ heights were 36.0?±?3.0 and 36.2?±?4.1 cm, respectively. There was a significant correlation between the MVC torque and absolute late-phase RTD (r?=?0.67 and 0.76—RTD₂₀₀ and RTD₂₅₀, respectively), between the CMJ height and absolute RTD₅₀ (r?=?0.50), and between the normalized early-phase RTD and SJ height (r?=?0.53–0.60—RTD₅₀ and RTD₁₅₀). Additionally, normalized RTD₂₀₀ (r?=?? 0.51) and RTD₂₅₀ (r?=?? 0.56) were negatively correlated with EI.

Conclusions

Such results suggest that athletes with the ability to produce torque explosively in the very beginning (between 50 and 150 ms) of knee extension can jump higher. Also, the muscle quality assessed by the VL IE seems to be more important to maximum strength and later periods of torque rise (>?200 ms).