Effect of branched-chain amino acid supplementation and exercise on quadriceps muscle quantity and quality in patients with cirrhosis as assessed by ultrasonography: A randomized controlled trial.

Background/aim: Sarcopenia and myosteatosis are common in patients with cirrhosis. The study aimed to evaluate efficacy of ultrasound to monitor muscle status during branched-chain amino acid (BCAA) supplementation and/or muscle exercise interventional approaches.

Patients And Methods: A randomized controlled study, included 220 liver cirrhosis patients with Child- Pugh B and C, randomized into a control group (55 patients) received only the standard care, and interventional groups (165 patients) equally distributed into three subgroups, in addition to standard care, they received BCAA, programmed exercise, or BCAA and programmed exercise.

Ultrasonographic assessment of muscle layer thickness and its relation to patient outcome in a medical intensive care unit.

Aim: Low skeletal muscle mass in ICU patients is associated with poor clinical outcome. Ultrasonography is a noninvasive method that can measure muscle thickness at the bedside. We aimed at studying the relation of the ultrasonography measured muscle layer thickness (MLT) at time of ICU admission with the patients' outcome namely mortality, duration of mechanical ventilation (MV) and ICU length of stay (LOS).

Associations of measured resting energy expenditure with predictive equations, NUTRIC score, and patient outcomes.

Background: Indirect calorimetry is the reference method for measuring resting energy expenditure (REE), but the necessary equipment and technical expertise are not always available. Meanwhile, the NUTrition Risk in the Critically ill (NUTRIC) scale is designed to identify patients who would benefit from nutrition therapy, but no data are available regarding the association of NUTRIC scores with REE. Several predictive formulas are available as alternatives to indirect calorimetry for calculation of energy requirements, but they have not been compared in a homogeneous group of critically ill patients.

Unusual cause of pericardial effusion.

A 65-year-old Egyptian lady suffering from non-alcoholic liver cirrhosis was referred to our unit for evaluation of a massive pericardial effusion. Few weeks before presentation, she suffered from progressive abdominal distention and dyspnoea. She denied fever, rigors or other cardiorespiratory symptoms.