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1.
Adv Exp Med Biol ; 1232: 201-207, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893411

RESUMO

Our previous research confirmed that patients with malignant hematopoietic disease already had a low hemoglobin level before allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, no study has determined whether a correlation exists between exercise load, hemoglobin level, and muscle oxygen saturation (SmO2), during exercise. Therefore, the purpose of this study was to investigate whether near-infrared spectroscopy (NIRS)-derived SmO2 is associated with exercise load, as determined by a dynamometer, before allo-HSCT. This study included 19 male patients who received allo-HSCT in Hyogo College of Medicine Hospital (Japan) between November 2009 and October 2012. Patients performed isometric repeated dorsiflexion at 50% maximum voluntary contraction for 180 s to determine exercise load, and SmO2 was evaluated during exercise at the same time using NIRS (BOM-L1TRW, Omega Wave, Inc., Japan). The hemoglobin level was also evaluated before allo-HSCT. Patients with hematopoietic disease before allo-HSCT already had a low hemoglobin level. There was a significant correlation between exercise load and ∆SmO2; however, the hemoglobin level was not correlated with exercise load. In these patients, exercise load might be affected by muscle oxygen consumption rather than by the hemoglobin level. This finding shows that NIRS can used to assess fatigue in patients with malignant hematopoietic disease.


Assuntos
Exercício , Doenças Hematológicas , Neoplasias Hematológicas , Hemoglobinas , Músculo Esquelético , Consumo de Oxigênio , Doenças Hematológicas/metabolismo , Doenças Hematológicas/fisiopatologia , Neoplasias Hematológicas/metabolismo , Neoplasias Hematológicas/fisiopatologia , Hemoglobinas/metabolismo , Humanos , Japão , Masculino , Músculo Esquelético/metabolismo , Oxigênio/metabolismo
2.
Adv Exp Med Biol ; 1232: 215-221, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893413

RESUMO

Patients with hematological malignancy might already have decreased muscle oxygen saturation at rest and exercise capacity before undergoing hematopoietic stem cell transplantation (HSCT). However, to date, no studies have investigated the relationship between exercise capacity and muscle oxygen saturation at rest in these patients. Therefore, purpose of this study was to investigate the relationship between exercise capacity and muscle oxygen-hemoglobin (O2Hb) saturation (SmO2) at rest and patients' hemoglobin level before undergoing HSCT. METHODS: This study included 60 men with hematologic disease who underwent allo-HSCT. Patients performed a 6-minute walk test (6MWT) to determine exercise capacity, and muscle O2Hb saturation at rest was evaluatabed using near-infrared spectroscopy (BOM-L1TRW, Omegawave Inc., Japan); hemoglobin levels in hematological malignancy patients before undergoing HSCT were also evaluated. RESULTS: There was a significant correlation between the 6MWT and muscle O2Hb saturation at rest in hematological malignancy patients (p < 0.05). Additionally, the 6MWT was significantly correlated to the hemoglobin level (p < 0.05). Furthermore, muscle O2Hb saturation at rest was significantly related to hemoglobin level (p < 0.05). CONCLUSION: In patients with hematological malignancy, a relationship exists between exercise capacity, muscle O2Hb saturation, and hemoglobin level before they undergo HSCT. Therefore, rehabilitation staff, nurses, and physicians should recognize these relationships in patients who undergo allo-HSCT. Moreover, physiotherapists may need to promote muscle oxidative metabolism through exercise to increase exercise capacity in these patients.


Assuntos
Tolerância ao Exercício , Transplante de Células-Tronco Hematopoéticas , Hemoglobinas , Músculo Esquelético , Adolescente , Adulto , Hemoglobinas/metabolismo , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/metabolismo , Adulto Jovem
3.
Adv Exp Med Biol ; 1072: 287-291, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30178360

RESUMO

Impaired oxygen utilization in skeletal muscle potentially contributes to muscle weakness in patients with malignant hematopoietic disease and may explain altered hemodynamic responses to exercise in these patients. We investigated whether changes in hemoglobin parameters in the tibialis anterior muscle in patients with malignant hematopoietic diseases were different from those in age-matched healthy controls and whether these results were associated with a decline in muscle strength. Near-infrared spectroscopy was used during and after a repeated isometric contraction task at 50% of maximal voluntary contraction in 16 patients and 21 age- and sex-matched healthy controls. In the healthy control group, there was a correlation between muscle strength and hemoglobin dynamics, (ΔtHbmean: r = 0.42, p < 0.05; ΔtHbmax: r = 0.575, p < 0.01, respectively) but not in patients with malignant hematopoietic disease. The results of this study may suggest that haemoglobin dynamics during and following exercise were different between patients with malignant hematopoietic disease and healthy controls.


Assuntos
Neoplasias Hematológicas/metabolismo , Hemoglobinas/metabolismo , Músculo Esquelético/metabolismo , Adulto , Humanos , Masculino , Contração Muscular/fisiologia , Força Muscular/fisiologia
4.
Adv Exp Med Biol ; 1072: 293-298, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30178361

RESUMO

The purpose of this study was to compare the differences in fatigue to those in muscle oxygen consumption and blood flow to the skeletal muscles before and after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study included 25 male patients who had received allo-HSCT between November 2009 and August 2012. Fatigue was assessed by using the Piper fatigue scale. Muscle oxygen consumption, shown by the change in deoxyhemoglobin (ΔHHb), and blood flow to the skeletal muscle, shown by the change in total hemoglobin (ΔtHb), were measured non-invasively in the tibialis anterior muscle during endurance exercise using near-infrared spectroscopy. ΔHHb and ΔtHb were significantly lower following allo-HSCT than before it (p < 0.05). Before allo-HSCT, no relationship was observed between fatigue and either ΔHHb or ΔtHb. However, after allo-HSCT, a significant relationship was found between fatigue and ΔHHb (p < 0.05). Patients experience decreased muscle oxygen consumption and blood flow to skeletal muscles after allo-HSCT. Furthermore, fatigue may have a relationship with decreased muscle oxygen consumption in patients after allo-HSCT. Rehabilitation staff, nurses, and physicians should recognise both decreases in muscle oxygen consumption and blood flow in patients who have undergone allo-HSCT, and physiotherapists may need to promote muscle oxidative metabolism through exercise in order to maintain muscle strength.


Assuntos
Fadiga/etiologia , Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/metabolismo , Adulto , Hemoglobinas/análise , Humanos , Masculino , Consumo de Oxigênio/fisiologia , Transplante Homólogo
5.
Support Care Cancer ; 26(7): 2149-2160, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29372395

RESUMO

INTRODUCTION: Impaired skeletal muscle oxygenation potentially contributes to reduced exercise capacity in allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients during early recovery and may explain altered hemoglobin responses to exercise following allo-HSCT. We investigated whether skeletal muscle oxygenation parameters and hemoglobin parameters in the tibialis anterior decreased following allo-HSCT, and whether these results were associated with declines in exercise capacity. METHODS: We used near-infrared spectroscopy during and following a repeated isometric contraction task at 50% of maximal voluntary contraction in 18 patients before and after allo-HSCT. RESULTS: The rate of decrease in the muscle oxy-hemoglobin saturation (SmO2; an index of skeletal muscle oxygenation) was significantly lower after allo-HSCT (P < 0.01). In contrast, total hemoglobin (an index of hemoglobin) was not different after allo-HSCT. Furthermore, SmO2 during and following exercise was associated with exercise capacity (r = 0.648; P = 0.004 vs. r = 0.632; P = 0.005). CONCLUSION: The results of this study reveal that although the peripheral hemoglobin response was not altered by allo-HSCT, skeletal muscle oxygenation was decreased following allo-HSCT. Furthermore, the decrease in skeletal muscle oxygenation was associated with a reduction in exercise capacity.


Assuntos
Exercício/fisiologia , Transplante de Células-Tronco Hematopoéticas/métodos , Hemoglobinas/análise , Músculo Esquelético/metabolismo , Consumo de Oxigênio/fisiologia , Adolescente , Adulto , Tolerância ao Exercício/fisiologia , Humanos , Pulmão/fisiologia , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Oxigênio/metabolismo , Estudos Prospectivos , Transplante Homólogo , Adulto Jovem
6.
Support Care Cancer ; 25(8): 2569-2575, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28293731

RESUMO

INTRODUCTION: Malignant pleural mesothelioma (MPM) is a rare cancer that affects the thin cell wall lining of internal organs and structures. Studies have shown that patients with lung cancer have decreased pulmonary function and exercise capacity after pneumonectomy. However, to date, physical function and health-related quality of life (HRQOL) in surgically treated MPM patients have not been evaluated in detail. The aim of this study was to assess physical function and HRQOL of MPM patients following pleurectomy/decortication (P/D). METHODS: The subjects were 22 MPM patients (20 men and 2 women) who completed P/D between December 2013 and March 2015. Physical function was assessed using handgrip strength and knee extensor strength tests, the 6-min walk distance (6MWD), and pulmonary function tests, including forced expiratory vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). HRQOL was assessed using the Medical Outcome Study 36-item Short Form Health Survey (SF-36). RESULTS: The handgrip strength (P < 0.05), 6MWD, FVC, and FEV1 values following P/D decreased significantly compared to baseline (P < 0.001 for each comparison). Additionally, scores of three of the eight SF-36 domains were significantly lower following P/D: physical functioning (P < 0.001), body pain (P = 0.002), and vitality (P = 0.005). 6MWD correlated role physical (P < 0.05) and vitality (P < 0.01). Significant correlations were also observed between FEV1 and physical functioning (P < 0.05) and social functioning (P < 0.05). CONCLUSION: Patients with MPM who completed P/D have decreased physical function and HRQOL. Following surgery, exercise capacity and pulmonary function decreased more than limb muscle strength. Physicians, nurses, and rehabilitation staff should note these findings, which may provide insight into the development of customized rehabilitation strategies for patients with MPM who completed P/D.


Assuntos
Neoplasias Pulmonares/reabilitação , Mesotelioma/reabilitação , Neoplasias Pleurais/reabilitação , Pneumonectomia/métodos , Qualidade de Vida/psicologia , Procedimentos Cirúrgicos Torácicos/métodos , Idoso , Feminino , Força da Mão , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Mesotelioma/patologia , Mesotelioma/cirurgia , Pessoa de Meia-Idade , Neoplasias Pleurais/patologia , Neoplasias Pleurais/cirurgia , Pneumonectomia/psicologia
7.
Intern Med ; 54(2): 133-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25743003

RESUMO

OBJECTIVE: We examined the effects of intervention performed by a multidisciplinary cardiac rehabilitation (CR) team on the social rehabilitation of patients with cardiogenic out-of-hospital cardiopulmonary arrest (OHCA) in the acute phase. METHODS: This study included 122 patients who were resuscitated after cardiogenic OHCA during a 10-year period. They were divided into two groups: including a non-CR group of patients (n=58) who were admitted before the CR team started performing systematic intervention and a CR group (n=64) who were admitted after the intervention was initiated. The following items were examined for each group: treatment condition at onset, contents of treatment, primary disease, presence or absence of underlying disease, presence or absence of complications, general physical and neurological outcome, duration of hospital stay, and status of social rehabilitation. RESULTS: Although the number of patients with cardiogenic OHCA did not markedly change, the number of bystanders participating in cardiopulmonary resuscitation (CPR) was significantly higher in the CR group versus the non-CR group (p<0.01). The effect of bystanders participating in CPR also significantly reduced the mortality outcome (p<0.05 versus the group without CPR), and patients in the CR group were more likely to achieve social rehabilitation (p<0.05 versus the group without CPR). Moreover, the number of patients who returned to society one year later was increased in the CR group versus the non-CR group (p<0.05). The incidence of respiratory complications was also significantly lower in the CR group versus the non-CR group (p<0.05). CONCLUSION: Along with the usefulness of rapid pre-hospital aid, our results suggest that systemic intervention performed by the CR team administered while the patient was in the acute phase may have promoted social rehabilitation of patients resuscitated after cardiogenic OHCA.


Assuntos
Reanimação Cardiopulmonar/psicologia , Parada Cardíaca Extra-Hospitalar/psicologia , Parada Cardíaca Extra-Hospitalar/reabilitação , Equipe de Assistência ao Paciente/organização & administração , Doença Aguda , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Participação Social
8.
J Cardiol Cases ; 11(6): 160-163, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30546555

RESUMO

A 39-year-old man developed fulminant myocarditis and was transferred on mechanical ventilation and a ventricular-assist device to our hospital. On Hospital Day 10, he was weaned from all medical engineering devices, and bedside rehabilitation was initiated. Although a multidisciplinary cardiac rehabilitation team had intervened since Hospital Day 3, he could not be encouraged to begin ambulation because of hypotension and tachycardia. Moreover, he complained of loss of self-confidence and anxiety regarding physical strength, and expansion of activities was difficult. Exercises reflecting his immediate desires and daily activities were used as activity goals, and we developed an individualized exercise program with stepwise increase in load to motivate him to perform rehabilitation. At the time of discharge, his cardiac function recovered to nearly normal levels; however, muscle strength and respiratory function had not recovered. While the intervention was continued at the cardiac rehabilitation outpatient unit, improvement was observed in physical health and mental health-related scale scores. The patient returned to work 4 months after onset of his myocarditis. Moreover, the cardiac rehabilitation team provided support to him for his long-term overseas assignment in the fifth year after myocarditis onset. Long-term comprehensive support by the cardiac rehabilitation team was feasible and useful. .

9.
Support Care Cancer ; 20(12): 3161-8, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22526152

RESUMO

PURPOSE: Cachexia in patients with hematological malignancies is often related to sarcopenia. We believe that allogeneic hematopoietic stem cell transplant (allo-HSCT) patients often exhibit sarcopenia prior to transplantation. Here, we aimed to investigate the prevalence of sarcopenia and its relationship with body composition, physiological function, nutrition, fatigue, and health-related quality of life (QOL) in patients before allo-HSCT. We further investigated the confounding factors associated with sarcopenia. METHODS: We included 164 patients with allo-HSCT in this study. Body composition, handgrip, knee extensor strength, and 6-min walk test were evaluated. Furthermore, fatigue, nutritional status, and health-related QOL were also evaluated. RESULTS: Eighty-three patients (50.6 %) enrolled in our study had sarcopenia prior to allo-HSCT. Patients with sarcopenia experienced decreased muscular strength and increased fatigue compared with patients without sarcopenia (p < 0.05). Patients with sarcopenia showed significantly lower scores in physical functioning, bodily pain, and vitality in health-related QOL than those without sarcopenia. Multivariate regression analysis revealed that only gender and body mass index were significantly related to sarcopenia (gender, odds ratio, 3.09; body mass index, odds ratio, 0.70; p < 0.01). CONCLUSIONS: Sarcopenia is common in patients before allo-HSCT and related to low muscle strength, fatigue, and health-related QOL. Male patients may be more susceptible to sarcopenia than female patients before allo-HSCT. Further study of rehabilitation with gender insight is warranted for patients receiving allo-HSCT.


Assuntos
Fadiga/epidemiologia , Doenças Hematológicas , Transplante de Células-Tronco Hematopoéticas , Força Muscular , Estado Nutricional , Qualidade de Vida , Sarcopenia/epidemiologia , Adolescente , Adulto , Idoso , Composição Corporal , Índice de Massa Corporal , Caquexia/epidemiologia , Tolerância ao Exercício , Feminino , Força da Mão , Doenças Hematológicas/epidemiologia , Doenças Hematológicas/terapia , Neoplasias Hematológicas/epidemiologia , Neoplasias Hematológicas/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Análise de Regressão , Fatores Sexuais , Transplante Homólogo
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