Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.914
Filtrar
1.
Orv Hetil ; 162(1): 3-12, 2021 01 03.
Artículo en Húngaro | MEDLINE | ID: mdl-33388736

RESUMEN

Összefoglaló. A sarcopenia progresszív, generalizált vázizombetegség az izomtömeg fogyásával és az izomfunkció romlásával, számos szövodménnyel, rossz prognózissal. A sarcopeniát eredetileg életkorfüggo, idosekben jelentkezo kórképnek írták le (primaer sarcopenia). Késobb derült ki, hogy fiatal- és középkorú személyeknél is elofordul, különbözo betegségekhez társulva (secundaer sarcopenia). A közlemény áttekintést ad a betegség patofiziológiájáról, a fizikai inaktivitás, az inzulinrezisztencia, a krónikus gyulladás, a citokinek, hepatokinek és miokinek szerepérol az izomkárosodásban, valamint az izom, a zsírszövet és a máj funkcionális kapcsolatairól nem alkoholos zsírmájban és cirrhosisban. A diagnózis felállítását számos funkcionális próba, illetve vizsgálóeljárás teszi lehetové. Az izomero-csökkenés igazolása a legfontosabb paraméter (kézszorító ero). Az izomtömegvesztést kettos energiájú röntgenabszorpciometria, bioelektromosimpedancia-analízis, komputertomográfia vagy mágneses rezonanciás képalkotó vizsgálat mutathatja ki, megerosítve a kórismét, a fizikai teljesítmény csökkenése pedig a sarcopenia súlyosságát jelzi. A sarcopenia kezelése és a progresszió prevenciója a fiatalkorban elkezdett és élethosszig tartó rendszeres fizikai aktivitáson, a protein-kalória túltápláláson és a gyógyszeres terápián alapul, beleértve a D-vitamin és a tesztoszteron pótlását, az elágazó láncú aminosavak és az L-karnitin adását. Másodlagos sarcopeniában az alapbetegség kezelése is szükséges. Orv Hetil. 2021; 162(1): 3-12. Summary. Sarcopenia is a progressive, generalized skeletal muscle disease with the loss of muscle mass and function, associated with adverse outcomes and poor prognosis. Sarcopenia first was regarded as an age-related disorder of older people (primary sarcopenia). Later it turned out that it can also occur in young age due to a range of chronic disorders such as cancer, anorexia or malnutrition (secondary sarcopenia). This paper overviews the pathophysiology of sarcopenia and the factors involved in the muscle mass loss, i.e., physical inactivity, insulin resistance, low-grade chronic inflammation, hepatokines and myokines. The basic feature is the imbalance between proteolysis and protein synthesis that leads to muscle atrophy. We discuss the relationship between liver, muscle and adipose tissue in non-alcoholic fatty liver disease and cirrhosis. To diagnose sarcopenia, there are a range of tests and tools that measure muscle strength and muscle mass as well as physical performance. The low muscle strength (hand grip strength) is the primary parameter of the diagnosis, the best measure of muscle function. The loss of skeletal muscle mass assessed by dual-energy X-ray absorptiometry, bioelectric impedance analysis, computer tomography, or magnetic resonance imaging confirms diagnosis, while the decrease in physical performance reflects severe sarcopenia. For the treatment and prevention of progression, the most important is the regular physical activity started from early adulthood, and healthy diet containing protein-calorie hyperalimentation. In addition, a pharmacotherapy with the supplementation of vitamin D and testosterone, furthermore, the administration of L-carnitine and branched-chain amino acids can be recommended. In the case of secondary sarcopenia, the underlying disease also requires treatment. Orv Hetil. 2021; 162(1): 3-12.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Músculo Esquelético/diagnóstico por imagen , Sarcopenia , Vitamina D/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Fuerza de la Mano , Humanos , Sarcopenia/diagnóstico , Sarcopenia/fisiopatología , Sarcopenia/terapia
2.
Anticancer Res ; 41(1): 9-20, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33419795

RESUMEN

The evaluation of the whole skeletal muscle area at the level of the third lumbar vertebra on computed tomography (CT) scans has often detected loss of skeletal muscle mass, defined as sarcopenia, and reduced skeletal muscle radiation attenuation (SMRA) in patients with different malignancies. Baseline sarcopenia has been detected in 33.3%-51.8% of patients with advanced cervical cancer, 33.6%-50% of those with endometrial cancer, and 11%-64% of those with advanced ovarian cancer. We reviewed the literature data on the clinical relevance of CT-assessed skeletal muscle status in gynecological malignancies. Overall, baseline skeletal muscle index and SMRA have an uncertain prognostic relevance, whereas their changes during treatment usually correlate with progression-free survival and overall survival. Multicenter clinical trials are strongly warranted to assess the effects of pharmacological agents and physical exercise in the management of skeletal muscle damage in patients with gynecological cancer.


Asunto(s)
Neoplasias de los Genitales Femeninos/diagnóstico , Neoplasias de los Genitales Femeninos/mortalidad , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/patología , Tomografía Computarizada por Rayos X , Biomarcadores , Femenino , Neoplasias de los Genitales Femeninos/radioterapia , Humanos , Músculo Esquelético/efectos de la radiación , Clasificación del Tumor , Estadificación de Neoplasias , Tamaño de los Órganos , Especificidad de Órganos , Pronóstico , Tomografía Computarizada por Rayos X/métodos
3.
Respir Res ; 22(1): 18, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33451329

RESUMEN

BACKGROUND: Physical inactivity due to cachexia and muscle wasting is well recognized as a sign of poor prognosis in chronic obstructive pulmonary disease (COPD). However, there have been no reports on the relationship between trunk muscle measurements and energy expenditure parameters, such as the total energy expenditure (TEE) and physical activity level (PAL), in COPD. In this study, we investigated the associations of computed tomography (CT)-derived muscle area and density measurements with clinical parameters, including TEE and PAL, in patients with or at risk for COPD, and examined whether these muscle measurements serve as an indicator of TEE and PAL. METHODS: The study population consisted of 36 male patients with (n = 28, stage 1-4) and at risk for (n = 8) COPD aged over 50 years. TEE was measured by the doubly labeled water method, and PAL was calculated as the TEE/basal metabolic rate estimated by the indirect method. The cross-sectional areas and densities of the pectoralis muscles, rectus abdominis muscles, and erector spinae muscles were measured. We evaluated the relationship between these muscle measurements and clinical outcomes, including body composition, lung function, muscle strength, TEE, and PAL. RESULTS: All the muscle areas were significantly associated with TEE, severity of emphysema, and body composition indices such as body mass index, fat-free mass, and trunk muscle mass. All trunk muscle densities were correlated with PAL. The product of the rectus abdominis muscle area and density showed the highest association with TEE (r = 0.732) and PAL (r = 0.578). Several trunk muscle measurements showed significant correlations with maximal inspiratory and expiratory pressures, indicating their roles in respiration. CONCLUSIONS: CT-derived measurements for trunk muscles are helpful in evaluating physical status and function in patients with or at risk for COPD. Particularly, trunk muscle evaluation may be a useful marker reflecting TEE and PAL.


Asunto(s)
Metabolismo Energético/fisiología , Fuerza Muscular/fisiología , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/fisiología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Anciano , Ejercicio Físico/fisiología , Femenino , Volumen Espiratorio Forzado/fisiología , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Factores de Riesgo
5.
Clin Imaging ; 69: 374-379, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33075596

RESUMEN

INTRODUCTION: Mobile wad of Henry (MOH) is a preferred surgical term used to describe the lateral compartment muscles of the forearm consisting of brachioradialis, extensor carpi radialis longus and brevis. The lesions in this compartment are uncommon. In this paper, we describe the largest series of the MOH lesions including their demographics, imaging appearances and importance of surgical anatomy whilst managing MOH lesions via radiological or surgical interventions. METHODS: A retrospective search of oncology database for lesions in MOH at our tertiary orthopaedic oncology institute was performed for the last 12 years (2007-2019) after obtaining institutional review board approval. We further analyse data to obtain further clarity of various neoplasms occurring at this particular anatomical site. RESULTS: We identified 28 patients with MOH lesions with an age range of 8 to 84 years and a male predominance. Imaging-wise, majority of lesions were benign following characteristics of lipomatous tumours, lipomas being the commonest. Other relatively uncommon benign lesions were nodular fasciitis, myositis ossificans and brachioradialis muscle injury; whereas aggressive MOH soft tissue neoplasms included synovial sarcoma and fibrohistiocytoma. CONCLUSION: Although majority of MOH lesions are benign, one needs to be aware of spectrum containing uncommon benign and aggressive MOH lesions. When posed with dilemma, the MOH lesions require multidisciplinary approach with close collaboration of the radiologist, the surgeon and the pathologist to decide further management.


Asunto(s)
Codo , Antebrazo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Demografía , Antebrazo/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Músculo Esquelético/diagnóstico por imagen , Estudios Retrospectivos , Adulto Joven
6.
Am J Sports Med ; 49(2): 346-352, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33315467

RESUMEN

BACKGROUND: Biceps tenodesis is a common treatment for proximal long head of biceps (LHB) tendon pathology. To maintain biceps strength and contour and minimize cramping, restoration of muscle-length tension and appropriate positioning of the tenodesis is key. Little is known about the biceps musculotendinous junction (MTJ) anatomy, especially in relation to the overlying pectoralis major tendon (PMT), which is a commonly used landmark for tenodesis positioning. PURPOSE: To characterize the in vivo topographic anatomy of the LHB tendon, in particular the MTJ relative to the PMT, using a novel axial proton-density magnetic resonance imaging (MRI) sequence. STUDY DESIGN: Descriptive laboratory study. METHODS: In total, 45 patients having a shoulder MRI for symptoms unrelated to their biceps tendon or rotator cuff were prospectively recruited. There were 33 men and 12 women, with a mean age of 37 ± 13 years (range, 18-59 years). All patients underwent routine shoulder MRI scans with an additional axial proton density sequence examining the LHB tendon and its MTJ. Three independent observers reviewed each MRI scan, and measurements were obtained for (1) MTJ length, (2) the distance between the proximal MTJ and the superior border of the PMT (MTJ-S), (3) the distance between the distal MTJ to the inferior border of the PMT, and (4) the width of the PMT. RESULTS: The average position of the MTJ-S was 5.9 ± 10.8 mm distal to the superior border of the PMT. The mean MTJ length was 32.5 ± 8.3 mm and the width of the PMT was 28.0 ± 7.3 mm. We found no significant correlation between patient age, height, sex, or body mass index and any of the biceps measurements. We observed wide variability of the MTJ-S position and identified 3 distinct types of biceps MTJ: type 1, MTJ-S above the PMT; type 2, MTJ-S between 0 and 10 mm below the superior border of the PMT; and type 3, MTJ-S >10 mm distal to the superior PMT. CONCLUSION: In this study, the in vivo anatomy of the LHB tendon is characterized relative to the PMT using a novel MRI sequence. The results demonstrate wide variability in the position of the MTJ relative to the PMT, which can be classified into 3 distinct subtypes or zones relative to the superior border of the PMT. Understanding this potentially allows for accurate and anatomic placement of the biceps tendon for tenodesis. CLINICAL RELEVANCE: To our knowledge, this is the first study to radiologically analyze the in vivo topographic anatomy of the LHB tendon and its MTJ. The results of this study provide more detailed understanding of the variability of the biceps MTJ, thus allowing for more accurate placement of the biceps tendon during tenodesis.


Asunto(s)
Músculo Esquelético/anatomía & histología , Músculo Esquelético/diagnóstico por imagen , Tendones/anatomía & histología , Tendones/diagnóstico por imagen , Tenodesis , Adolescente , Adulto , Brazo , Artroscopía , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tendones/cirugía , Adulto Joven
7.
Magn Reson Imaging ; 75: 72-88, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32979516

RESUMEN

PURPOSE: To compare three anisotropic acquisition schemes and three compressed sensing (CS) approaches for accelerated tissue sodium concentration (TSC) quantification using 23Na MRI at 7 T. MATERIALS AND METHODS: Three anisotropic 3D-radial acquisition sequences were evaluated using simulations, phantom- and in vivo TSC measurements: An anisotropic density-adapted 3D-radial sequence (3DPR-C), a 3D acquisition-weighted density-adapted stack-of-stars sampling scheme (SOS) and a SOS approach with golden-ratio rotation (SOS-GR). Eight healthy volunteers were examined at a 7 Tesla MRI system. TSC measurements of the calf were conducted with a nominal spatial resolution of Δx = (3.0 × 3.0 × 15.0) mm3 and a field of view of (156.0 × 156.0 × 240.0) mm3 for multiple undersampling factors (USF). Three CS reconstructions were evaluated: Total variation CS (TV-CS), 3D dictionary-learning compressed sensing (3D-DLCS) and TV-CS with a block matching prior (TV-BL-CS). Results of the simulations and measurements were compared to a simulated ground truth (GT) or a fully sampled reference measurement (FS), respectively. The deviation of the mean TSC evaluated in multiple ROI (mEGT/FS) and the normalized root-mean-squared error (NRMSE) for simulations were evaluated for CS and NUFFT reconstructions. RESULTS: In simulations, the SOS-GR yielded the lowest NRMSE and mEGT (< 4%) with NUFFT for an acquisition time (TA) of less than 2 min. CS further improved the results. In simulations and measurements, the best TSC quantification results were obtained with 3D-DLCS and SOS-GR (lowest NRMSE, mEGT < 2.6% in simulations, mEGT < 10.7% for phantom measurements and mEFS < 6% in vivo) with an USF = 4.1 (TA < 2 min). TV-CS showed no or only slight improvements to NUFFT. The results of TV-BL-CS were similar to 3D-DLCS. DISCUSSION: The TA for TSC measurements could be reduced to less than 2 min by using adapted sequences such as SOS-GR and CS reconstruction approaches such as 3D-DLCS or TV-BL-CS, while the quantitative accuracy stays comparable to a fully sampled NUFFT reconstruction (approx. 8 min TA). In future, the lower TA could improve clinical applicability of TSC measurements.


Asunto(s)
Imagenología Tridimensional/métodos , Imagen por Resonancia Magnética , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/metabolismo , Sodio/metabolismo , Adulto , Anisotropía , Humanos , Masculino , Fantasmas de Imagen , Factores de Tiempo
8.
J Vis Exp ; (166)2020 12 14.
Artículo en Inglés | MEDLINE | ID: mdl-33369599

RESUMEN

Muscle fascicle length, which is commonly measured in vivo using traditional ultrasound, is an important parameter defining a muscle's force generating capacity. However, over 90% of all upper limb muscles and 85% of all lower limb muscles have optimal fascicle lengths longer than the field-of-view of common traditional ultrasound (T-US) probes. A newer, less frequently adopted method called extended field-of-view ultrasound (EFOV-US) can enable direct measurement of fascicles longer than the field-of-view of a single T-US image. This method, which automatically fits together a sequence of T-US images from a dynamic scan, has been demonstrated to be valid and reliable for obtaining muscle fascicle lengths in vivo. Despite the numerous skeletal muscles with long fascicles and the validity of the EFOV-US method for making measurements of such fascicles, few published studies have utilized this method. In this study, we demonstrate both how to implement the EFOV-US method to obtain high quality musculoskeletal images and how to quantify fascicle lengths from those images. We expect that this demonstration will encourage the use of the EFOV-US method to increase the pool of muscles, both in healthy and impaired populations, for which we have in vivo muscle fascicle length data.


Asunto(s)
Procesamiento de Imagen Asistido por Computador/normas , Músculo Esquelético/anatomía & histología , Músculo Esquelético/diagnóstico por imagen , Ultrasonografía/normas , Algoritmos , Humanos
9.
Apunts, Med. esport (Internet) ; 55(208): 153-156, oct.-dic. 2020. ilus
Artículo en Inglés | IBECS | ID: ibc-197959

RESUMEN

INTRODUCTION: Muscular hernias in the lower limb are a rare entity that have seldom been described in the literature, from 1929 about 200 cases of muscle hernias have been described. CASE: Here, we present a case of tibialis anterior muscle hernia and discuss the aetiology behind the same. Furthermore, we attempt to amalgamate existing knowledge to provide some guidance for investigation and management of this important diagnostic consideration. CONCLUSION: Lower limb hernias are rare but should be considered as a differential for unidentified lower limb swellings. There is no clear consensus in literature about treatment, so every case must be individualized


OBJETIVOS/INTRODUCCIÓN: Las hernias musculares son raras, donde se evidencian con más frecuencia son en las extremidades inferiores siendo el tibial anterior el músculo más afectado. En este artículo describimos un caso de hernia muscular de tibial anterior y su evolución clinica, además de revisión de la literatura actual sobre el tema. MATERIAL Y MÉTODOS: Paciente de 34 años, albañil, que en contexto de accidente laboral (caida de 2 metros) presenta contusión en cara lateral de pierna derecha con diagnóstico de fractura de 1/3 medio de perone de pierna derecha, Paciente presenta buen curso clinico con consolidación completa de la fractura a los 3 meses de evolución, pero persistiendo dolor y aumento de volumen en cara anterior de la pierna. Se solicita resonancia magnética de pierna que es informada como normal. A la exploración en reposo nada a destacar, en bipedestación (Fig. 1) se observa masa palpable de 2 cm aprox en cara anteromedial de 1/3 medio de tibia de pierna derecha, que se reduce al pasar a decúbito supino. Se realiza ecografia dinámica con paciente en bipedestación y forzando dorsiflexión del pie, confirmándose hernia de músculo tibial anterior con disrupción parcia de su fascia, hernia de 11,7 mm de tamaño con 3 cm de extensión (Fig 2). Se realiza tratamiento conservador mediante tratamiento rehabilitador antiinflamatorio (magnetoterapia) + vendajes compresivos locales. RESULTADOS: Paciente presenta buena evolución clinica presentando a los 4 meses de iniciado el tratamiento disminución de dolor y refiriendo ausencia de hernia, que se confirma a la exploración clinica. Paciente retorna a su actividad laboral sin incidencias. COMENTARIOS Y CONCLUSIONES: Las hernias musculares son raras, su localización mas habitual es en extremidades inferiores. Son un diagnóstico de exclusión, que muchas veces pasa desapercibido (1) y pueden ser causa de dolor y aumento de volumen crónico unilateral en extremidad inferior


Asunto(s)
Humanos , Masculino , Adulto , Hernia/diagnóstico por imagen , Músculo Esquelético/diagnóstico por imagen , Pierna , Terapia de Campo Magnético/métodos , Dolor/etiología , Músculo Esquelético/patología , Accidentes de Trabajo , Ultrasonografía , Terapia de Campo Magnético/instrumentación , Vendajes de Compresión
10.
Acta Cir Bras ; 35(10): e202001007, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33237178

RESUMEN

PURPOSE: Previous studies have questioned whether the triceps brachii muscle tendon (TBMT) has a double or single insertion on the ulna. Aiming to provide an answer, we describe the anatomy of the TBMT and review a magnetic resonance imaging (MRI) series of the elbow. METHODS: Forty-one elbows were dissected to assess the details of the triceps brachii insertion. Elbow plastination slices were analyzed to determine whether there was a space on the TBMT. Magnetic resonance imaging from the records of the authors were also obtained to demonstrate the appearance of the pre-tricipital space on MRI. RESULTS: A virtual space on the medial aspect near the TBTM insertion site in the olecranon was consistently found on anatomic dissections. It was a distal pre-tricipital space. Magnetic resonance imaging demonstrated the appearance of the pre-tricipital space on MRI, and its extension was measured longitudinally either in elbow flexion or extension. There was no statistically significant difference between the measurements of this space in the right and left elbows or between flexion and extension (p > 0.05). The coefficient of variation was <10% for all measurements. CONCLUSION: Knowledge of this structure may be essential to avoid incorrect diagnosis and unnecessary therapeutic interventions.


Asunto(s)
Articulación del Codo , Músculo Esquelético , Codo , Articulación del Codo/diagnóstico por imagen , Imagen por Resonancia Magnética , Músculo Esquelético/diagnóstico por imagen , Tendones/diagnóstico por imagen
11.
Medicine (Baltimore) ; 99(41): e22318, 2020 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-33031270

RESUMEN

INTRODUCTION: The market for dietary supplements in the sports sector has been growing rapidly for several years, though there is still lacking evidence regarding their claimed benefits. One group is that of nitric oxide increasing supplements, so-called "NO-boosters," which are claimed to improve the supply of oxygen and nutrients to the muscle by enhancing vasodilation.The aim of this study was to investigate 3 of these supplements in healthy male athletes for their muscle perfusion-enhancing potential using contrast-enhanced ultrasound (CEUS). METHODS: This placebo-controlled, double-blind, randomized cross-over trial will be carried out at the Center for Orthopedics, Trauma Surgery and Spinal Cord Injury of the University Hospital Heidelberg. Three commercial NO enhancing products including 300 mg of the specific green tea extract VASO6 and a combination of 8 g L-citrulline malate and 3 g L-arginine hydrochloride will be examined for their potential to increase muscular perfusion in 30-male athletes between 18 and 40 years and will be compared with a placebo. On each of the 3 appointments CEUS of the dominant biceps muscle will be performed at rest and after a standardized resistance training. Every athlete receives each of the 3 supplements once after a wash-out period of at least 1 week. Perfusion will be quantified via VueBox quantification software. The results of CEUS perfusion measurements will be compared intra- and interindividually and correlated with clinical parameters. DISCUSSION: The results of this study may help to establish CEUS as a suitable imaging modality for the evaluation of potentially vasodilatory drugs in the field of sports. Other supplements could also be evaluated in this way to verify the content of their advertising claims. TRIAL REGISTRATION: German Clinical Trials Register (DRKS), ID: DRKS00016972, registered on 25.03.2019.


Asunto(s)
Arginina/administración & dosificación , Citrulina/administración & dosificación , Músculo Esquelético/irrigación sanguínea , Músculo Esquelético/diagnóstico por imagen , , Ultrasonografía/métodos , Adolescente , Adulto , Medios de Contraste , Estudios Cruzados , Suplementos Dietéticos , Método Doble Ciego , Humanos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Vasodilatación
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2113-2116, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-33018423

RESUMEN

The purpose of this study was to develop an automatic method for the segmentation of muscle cross-sectional area on transverse B-mode ultrasound images of gastrocnemius medialis using a convolutional neural network(CNN). In the provided dataset images with both normal and increased echogenicity are present. The manually annotated dataset consisted of 591 images, from 200 subjects, 400 relative to subjects with normal echogenicity and 191 to subjects with augmented echogenicity. From the DICOM files, the image has been extracted and processed using the CNN, then the output has been post-processed to obtain a finer segmentation. Final results have been compared to the manual segmentations. Precision and Recall scores as mean ± standard deviation for training, validation, and test sets are 0.96 ± 0.05, 0.90 ± 0.18, 0.89 ± 0.15 and 0.97 ±0.03, 0.89± 0.17, 0.90 ± 0.14 respectively. The CNN approach has also been compared to another automatic algorithm, showing better performances. The proposed automatic method provides an accurate estimation of muscle cross-sectional area in muscles with different echogenicity levels.


Asunto(s)
Procesamiento de Imagen Asistido por Computador , Redes Neurales de la Computación , Algoritmos , Humanos , Músculo Esquelético/diagnóstico por imagen , Ultrasonografía
13.
Plast Reconstr Surg ; 146(4): 778-781, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32969999

RESUMEN

Mortality after gluteal augmentation with fat transfer techniques is extremely high. Placement of fat subcutaneously versus in the gluteal musculature, or both, is considerably debated. The purpose of this study was to radiographically show the anatomical difference in live subjects in different procedural positions: the flexed or "jackknife" versus prone position. A total of 10 women underwent computed tomographic scanning of the pelvis with venous phase run-off in both the jackknife and prone positions. A computed tomography-specialized radiologist then reviewed images and measured distances from the inferior and superior gluteal veins to the skin and muscle. Three-dimensional imaging and analysis were also performed. Measurements were significantly shorter with respect to distance from skin to muscle, skin to vessel, and vessel to muscle observed from inferior and superior gluteal veins in the jackknife versus the prone position. Three-dimensional modeling showed a significant reduction in the volume and inferior and superior gluteal vein diameters when in the jackknife position. When placed in the jackknife position for gluteal augmentation with fat transfer, extreme caution should be taken with the injecting cannula, as the underlying muscle is only 2 to 3 cm deep. Three-dimensional analysis showed narrowed and reduced volume of gluteal vasculature when in the jackknife position; this is a possible indication of torsion or stretch on the vessel around the pelvic rim that could cause vein avulsion injury from the pressurized fat within the piriform space.


Asunto(s)
Nalgas/irrigación sanguínea , Nalgas/diagnóstico por imagen , Músculo Esquelético/irrigación sanguínea , Músculo Esquelético/diagnóstico por imagen , Posicionamiento del Paciente/métodos , Tomografía Computarizada por Rayos X , Adulto , Nalgas/cirugía , Femenino , Humanos , Persona de Mediana Edad , Músculo Esquelético/cirugía , Posición Prona , Estudios Prospectivos , Procedimientos Quirúrgicos Reconstructivos , Adulto Joven
14.
J Sports Med Phys Fitness ; 60(8): 1057-1064, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32955831

RESUMEN

BACKGROUND: Rock climbers are characterized by enhanced forearm fatigue resistance. This study compared the forearm isometric force of rock climbers (RC), strength-matched power lifters (PL) and aerobically trained (AT) athletes to determine the contribution of muscle oxygen desaturation during ischemia. METHODS: Aerobically trained athletes (N.=6, 23±1 years, 77±1 kg), power lifters (N.=7, 24±1 years, 80±3 kg) and rock climbers (N.=8, 25±2 years, 74±2 kg) took part in a controlled forearm ischemic occlusion (5 min) assessment using near infrared spectroscopy. In addition, three fatigue protocols were completed: protocol 1, sustained maximal voluntary contraction (MVC) until exhaustion; protocol 2, sustained 40% MVC for 3 mins duration; protocol 3, an intermittent 40% MVC (5-s contraction, 5-s recovery) for a duration of 3 mins. Forearm contractile fatigue was quantified as the reduction in MVC. RESULTS: MVC was equivalent between groups (P>0.05). Sustained MVC force (time to decline 50% MVC) was longer in the RC versus AT (AT: 35±5, PL: 46±6, RC: 54±4 s, P<0.05) and both AT and PL for sustained 40% MVC (AT: 56±9, RT: 62±8, RC: 87±7 s, P<0.05). Reduction in MVC was less in RC post intermittent 40% contractions (P<0.05). Oxygen desaturation half-time was longer in the RC versus AT (AT: 65±9, RT: 86±7, RC: 99±7 s, P<0.05) and this was associated with time to 50% MVC (P<0.05, r2=0.53) and time to 40% MVC task failure (P<0.05, r2=0.32). CONCLUSIONS: Rock climbers' enhanced isometric fatigue-resistance and ability to maintain MVC was associated with a lower oxygen consumption of the forearm flexors during the ischemic state. This suggests a training adaptation involving intracellular oxygen consumption.


Asunto(s)
Antebrazo/fisiología , Montañismo/fisiología , Fatiga Muscular/fisiología , Músculo Esquelético/fisiología , Adaptación Fisiológica , Adulto , Dedos/fisiología , Antebrazo/irrigación sanguínea , Antebrazo/diagnóstico por imagen , Humanos , Contracción Isométrica/fisiología , Masculino , Músculo Esquelético/irrigación sanguínea , Músculo Esquelético/diagnóstico por imagen , Consumo de Oxígeno , Acondicionamiento Físico Humano/fisiología , Espectroscopía Infrarroja Corta , Levantamiento de Peso/fisiología , Adulto Joven
15.
PLoS One ; 15(8): e0236497, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32785230

RESUMEN

When human movement is assisted or controlled with a muscle actuator, such as electrical muscle stimulation, a critical issue is the integration of such induced movement with the person's motion intention and how this movement then affects their motor control. Towards achieving optimal integration and reducing feelings of artificiality and enforcement, we explored perceptual simultaneity through electrical muscle stimulation, which involved changing the interval between intentional and induced movements. We report on two experiments in which we evaluated the ranges between detection and stimulus for perceptual simultaneity achievable with an electromyography-triggered electrical muscle stimulation system. We found that the peak range was approximately 80-160 ms, with the timing of perceptual simultaneity shifting according to different adaptation states. Our results indicate that perceptual simultaneity is controllable using this adaptation strategy.


Asunto(s)
Electromiografía , Corteza Motora/fisiología , Movimiento/fisiología , Músculo Esquelético/fisiología , Adulto , Estimulación Eléctrica , Mano/fisiología , Humanos , Masculino , Corteza Motora/diagnóstico por imagen , Músculo Esquelético/diagnóstico por imagen , Visión Ocular/fisiología , Adulto Joven
16.
Muscle Nerve ; 62(4): 541-549, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32654203

RESUMEN

MRI is a helpful tool for monitoring disease progression in late-onset Pompe disease (LOPD). Our study aimed to evaluate if muscle diffusion tensor imaging (mDTI) shows alterations in muscles of LOPD patients with <10% fat-fraction. We evaluated 6 thigh and 7 calf muscles (both legs) of 18 LOPD and 29 healthy controls (HC) with muscle diffusion tensor imaging (mDTI), T1w, and mDixonquant sequences in a 3T MRI scanner. The quantitative mDTI-values axial diffusivity (λ1 ), mean diffusivity (MD), radial diffusivity (RD), and fractional anisotropy (FA) as well as fat-fraction were analyzed. 6-Minute Walk Test (6-MWT) data were correlated to diffusion metrics. We found that mDTI showed significant differences between LOPD and HC in diffusion parameters (P < .05). Thigh muscles with <10% fat-fraction showed significant differences in MD, RD, and λ1-3 . MD positively correlated with 6-MWT (P = .06). To conclude, mDTI reveals diffusion restrictions in muscles of LOPD with and without fat-infiltration and reflects structural changes prior to fatty degeneration.


Asunto(s)
Enfermedad del Almacenamiento de Glucógeno Tipo II/diagnóstico por imagen , Pierna/diagnóstico por imagen , Músculo Esquelético/diagnóstico por imagen , Muslo/diagnóstico por imagen , Adolescente , Adulto , Anciano , Imagen de Difusión Tensora , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
17.
Int J Mol Sci ; 21(13)2020 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-32630032

RESUMEN

Obesity is a characteristic of COVID-19 patients and the risk of malnutrition can be underestimated due to excess of fat: a paradoxical danger. Long ICU hospitalization exposes patients to a high risk of wasting and loss of lean body mass. The complex management precludes the detection of anthropometric parameters for the definition and monitoring of the nutritional status. The use of imaging diagnostics for body composition could help to recognize and treat patients at increased risk of wasting with targeted pathways. COVID-19 patients admitted to the ICU underwent computed tomography within 24 hours and about 20 days later, to evaluate the parameters of the body and liver composition. The main results were the loss of the lean mass index and a greater increase in liver attenuation in obese subjects. These could be co-caused by COVID-19, prolonged bed rest, the complex medical nutritional therapy, and the starting condition of low-grade inflammation of the obese. The assessment of nutritional status, with body composition applied to imaging diagnostics and metabolic profiles in COVID-19, will assist in prescribing appropriate medical nutritional therapy. This will reduce recovery times and complications caused by frailty.


Asunto(s)
Caquexia , Infecciones por Coronavirus/patología , Obesidad/patología , Neumonía Viral/patología , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , Composición Corporal , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico por imagen , Femenino , Humanos , Hígado/diagnóstico por imagen , Hígado/metabolismo , Masculino , Persona de Mediana Edad , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/metabolismo , Estado Nutricional , Obesidad/complicaciones , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico por imagen , Estudios Prospectivos , Factores de Riesgo , Tomografía Computarizada por Rayos X
18.
Clin Interv Aging ; 15: 889-895, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32606630

RESUMEN

Background: The study aimed to investigate the potential association of trunk skeletal muscle mass (tSM) and phase angle measured by bioelectrical impedance analysis (BIA) with the chance of femoral neck fractures in very elderly people. Patients and Methods: This case-control study enrolled 78 femoral neck fracture patients aged over 75 years (29 males) and 1:2 matched healthy controls. All participants were subjected to BIA examination by specialists. tSM, the corrected values by height squared of tSM (tSMI) and phase angle were compared between fracture patients and controls. Multivariate logistic regression was performed to explore the strength of association of femoral neck fracture with tSM, tSMI, and phase angle. Results: tSM (kg) of fracture patients was significantly lower than those of controls in all participants (women: 13.49±0.42 vs 15.44±0.39, p<0.05; men: 15.30±0.71 vs 17.54±0.78, p<0.05). In the sarcopenic subgroup, fracture patients also got a lower tSM than controls (women: 12.58±0.21 vs 13.62±0.16, p<0.05; men:14.41±0.29 vs 16.07±0.21, p<0.05). The comparison of tSMI between the two groups was similar to that of tSM. Phase angle (°) at 50 kHz in fracture patients was significantly lower than that of controls in women and men (women: 3.70±0.32 vs 4.61±0.21, p<0.05; men: 3.50±0.20 vs 3.84±0.22, p<0.05). Multivariate logistic regression analysis demonstrated higher fracture chance with significantly associated decreased tSM [women: OR (95% CI): 0.78(0.67-0.91); men: 0.74(0.64-0.86)] and tSMI [women: OR (95% CI): 0.72(0.61-0.85); men: 0.69 (0.59-0.81)]. In addition, per 1° increase of phase angle in the trunk could decrease the fracture risk by 14% for women [OR (95% CI): 0.86 0.79-0.94)] and 29% for men [OR (95% CI): 0.71 (0.64-0.79)]. Conclusion: This study indicates a decrease in tSM, tSMI, and phase angle measured by BIA is significantly related to the increased chance of femoral neck fracture in people aged over 75 years. Strengthening the mass and strength of trunk skeletal muscles may help reduce the risk of femoral neck fracture in elderly patients.


Asunto(s)
Fracturas del Cuello Femoral/diagnóstico por imagen , Anciano Frágil/estadística & datos numéricos , Músculo Esquelético/patología , Sarcopenia/patología , Anciano de 80 o más Años , Estudios de Casos y Controles , Impedancia Eléctrica , Femenino , Fracturas del Cuello Femoral/prevención & control , Humanos , Masculino , Músculo Esquelético/diagnóstico por imagen , Factores de Riesgo , Sarcopenia/diagnóstico por imagen
19.
Neurology ; 95(9): e1211-e1221, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32611642

RESUMEN

OBJECTIVE: We followed up patients with facioscapulohumeral muscular dystrophy (FSHD) with sequential examinations over 2 years to investigate whether inflammatory lesions always precede fat replacement, if inflammation can be resolved without muscle degeneration, and if inflammatory lesions in muscle are always followed by fat replacement. METHODS: In this longitudinal study of 10 sequential MRI assessments over 2.5 years, we included 10 patients with FSHD. We used MRI with short TI inversion recovery to identify regions of interest (ROIs) with hyperintensities indicating muscle inflammation. Muscle T2 relaxation time mapping was used as a quantitative marker of muscle inflammation. Dixon sequences quantified muscle fat replacement. Ten healthy controls were examined with a magnetic resonance scan once for determination of normal values of T2 relaxation time. RESULTS: We identified 68 ROIs with T2 elevation in the patients with FSHD. New ROIs with T2 elevation arising during the study had muscle fat content of 6.4% to 33.0% (n = 8) and 47.0% to 78.0% lesions that resolved (n = 6). ROIs with T2 elevation had a higher increase in muscle fat content from visits 1 to 10 (7.9 ± 7.9%) compared to ROIs with normal muscle T2 relaxation times (1.7 ± 2.6%; p < 0.0001). Severe T2 elevations were always followed by an accelerated replacement of muscle by fat. CONCLUSIONS: Our results suggest that muscle inflammation starts in mildly affected muscles in FSHD, is related to a faster muscle degradation, and continues until the muscles are completely fat replaced. CLINICALTRIALSGOV IDENTIFIER: NCT02159612.


Asunto(s)
Tejido Adiposo/diagnóstico por imagen , Inflamación/diagnóstico por imagen , Músculo Esquelético/diagnóstico por imagen , Distrofia Muscular Facioescapulohumeral/diagnóstico por imagen , Adulto , Progresión de la Enfermedad , Femenino , Humanos , Pierna , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Fuerza Muscular , Dinamómetro de Fuerza Muscular , Distrofia Muscular Facioescapulohumeral/fisiopatología , Muslo , Prueba de Paso
20.
Muscle Nerve ; 62(4): 516-521, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32710682

RESUMEN

INTRODUCTION: We evaluated the association between muscle ultrasound, number of motor units, and clinical parameters, and assessed their utility for distinguishing amyotrophic lateral scleorisis (ALS) patients from healthy individuals. METHODS: Three muscle pairs (abductor pollicis brevis, abductor digiti minimi, and tibialis anterior) of 18 ALS patients and 18 controls underwent muscle ultrasound (echointensity and thickness) and assessment of motor unit number index (MUNIX). The clinical and functional status of participants were also assessed. RESULTS: Mean age of the patients was 53.8 ± 12.1 years, and score on the ALS Functional Rating Scale-Revised was 38.9 ± 4.1. Echointensity of all tested muscles of ALS participants was significantly higher than that of controls, but there was no significant difference in muscle thickness. Muscle echointensity correlated significantly with clinical and electrophysiological parameters. CONCLUSION: Echointensity of muscles was highly associated with clinical scales and MUNIX, confirming its relevance as an ancillary diagnostic test in ALS patients.


Asunto(s)
Esclerosis Amiotrófica Lateral/diagnóstico por imagen , Neuronas Motoras/fisiología , Músculo Esquelético/diagnóstico por imagen , Adulto , Anciano , Esclerosis Amiotrófica Lateral/fisiopatología , Estudios Transversales , Electromiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Músculo Esquelético/fisiopatología , Ultrasonografía
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...