[Tensor fascia lata unilateral hypertrophy: A case report]. / Hipertrofia unilateral del músculo tensor de la fascia lata, a propósito de un caso.

Hypertrophy of the tensor fascia lata muscle is an uncommon clinical entity, which can simulate a soft tissue tumour. In most patients, it presents as a palpable proximal anterior thigh mass. The characteristic appearance on CT or MRI allows a confident diagnosis of muscle hypertrophy to be made, avoiding unnecessary diagnostic biopsy or surgical intervention. In cases with suspected radiculopathy, electromyography is also useful. We present an illustrative case of hypertrophy of the tensor fascia lata muscle and its outcome after rehabilitation treatment.

The effects of unilateral and bilateral eccentric overload training on hypertrophy, muscle power and COD performance, and its determinants, in team sport players.

The study aimed to compare the chronic eccentric-overload training effects of unilateral (lateral lunge) vs bilateral (half-squat) using an inertial device, on hypertrophy and physical performance. Twenty-seven young team sports male players performed a 4 sets of 7 repetitions of inertial eccentric overload training, biweekly for 6 weeks, distributed in unilateral lunge group (UG: age: 22.8 ± 2.9 years; body mass: 75.3 ± 8.8 kg; height: 177.3 ± 3.7 cm) and bilateral squat group (BG: age: 22.6 ± 2.7 years; body mass: 79.5 ± 12.8 kg; height: 164.2 ± 7 cm). Lower limb muscle volume, counter movement jump (CMJ), power with both (POWER), dominant (POWERd) and no-dominant leg (POWERnd), change of direction turn of 90° with dominant (COD90d) and no-dominant leg (COD90nd) and 180° (COD180d and COD180nd), and 10m sprint time (T-10m) were measured pre and post-intervention. The UG obtained an increase of adductor major (+11.1%) and vastus medialis (+12.6%) higher than BG. The BG obtained an increase of vastus lateralis (+9.9%) and lateral gastrocnemius (+9.1%) higher than UG. Both groups improved CMJ, POWER, POWERd, POWERnd, COD90 and DEC-COD90, without changes in T-10m. The UG decrease DEC-COD90nd (-21.1%) and BG increase POWER (+38.6%) substantially more than the other group. Six-weeks of unilateral / bilateral EO training induce substantial improvements in lower limbs muscle volume and functional performance, although unilateral training seems to be more effective in improving COD90 performance.

[Rehabilitation of phonosurgically treated patients with edematous-hypertrophic changes of larynx]. / Rehabilitacja pacjentów leczonych fonochirurgicznie z powodu zmian obrzekowo-przerostowych krtani.

UNLABELLED: Advanced change of organic dysphonia are an indication for phonosurgery. Edematous-hypertrophic changes are cause of serious disturbances of voice. High-speed digital imaging (HSDI) technique is the unique method, allowing for assessment the effects of therapy and rehabilitation. AIM: The aim of the study is evaluation the usefulness of vibratory method in voice rehabilitation of patients with edematous-hypertrophic changes treated phonosurgically. MATERIALS AND METHODS: The group I contained 40 patients with edematous-hypertrophical changes phonosurgically treated. Type of clinical dysphonia was diagnosed with HSDI technique. Glottal closure was evaluated according to Committee on Phoniatrics of the European Laryngological Society (ELS) classification, postoperative material was pathomorphologically verified by Transmission Electron Microscopy (TEM). Patients with hyperfunction of larynx were rehabilitated for 21 days using massage device and after that visualization of larynx by HSDI technique was made again. Control group contains people with physiological voice. RESULTS: Severe dysphonia with oedematous-hypertrophic changes was found by HSDI technique in group I. Postoperative material was evaluated histopathological by TEM and confirmed the existing clinical morphological changes of larynx. Hyperfunction of phonation organ were diagnosed in 30 patients (75%). After 21 days of rehabilitation using massage device, hyperfunction was reduced as confirmed by HSDI. Normalization of amplitude, regularity, synchrony of vibration and physiological glottal closure were found at 67% cases. CONCLUSIONS: HSDI technique in digital sequence is useful in the diagnosis of edematous-hypertrophic changes of the larynx and monitoring the effects of the rehabilitation. Pathomorphological evaluation of postoperative material made by TEM confirmed the rightness of clinical diagnosis of the edematous-hypertrophic changes by HSDI. The consequence of phonosurgical procedures in edematous-hypertrophic changes of larynx is hyperfunction of larynx, confirmed objectively by HSDI technique. The use of massage device causes relaxation of laryngeal structures, normalizing parameters of visualizing evaluation.

[Neuromuscular system and aging: involutions and implications]. / Système neuromusculaire et vieillissement : involutions et implications.

In aged human, the number of muscle fibers and motor units decreases. The remaining motor units lose their functionality (decrease of the discharge frequency, greater fluctuation of the discharge) particularly those which contain type II fibers. The renewal of intracellular proteins declines which creates a negative balance between the daily protein losses and the capacities to renew them. The activity of the protein kinase (Akt) that stimulates the synthesis of regulation proteins (mTOR, p70S6, IGFBP-5) declines whereas the factors of degradation of proteins (NF-kappa B) are activated. Besides, the process of activation and proliferation of satellite cells is affected and the production of anabolic hormones and local factors is decreased. After a strength training program, muscle hypertrophy is linked to the protein synthesis at the level of myosin heavy chain (MHC) isoforms in older subjects. However, the transcription of the genes that code the MHC-I (slow form) increases and the transcription of the genes that code the MHC-II (fast form) decreases. Thus, the transition of the phenotype towards a slower form cannot be inverted by strength training during the advanced in age. Moreover, strength training enables to decrease the proportion of fibers containing MHC of hybrid form in the process of evolution. Hence, strength training can engender a stabilization of the muscular phenotype i.e. different isoforms of MHC. In addition, strength training counteracts the noxious effects mentioned above by generating muscular hypertrophy thanks to a reactive increase in the production of anabolic hormones. A program of aerobic training can induce an increase in the synthesis of ARN messengers coding isoforms related to the oxidative metabolism (MHC-I and to a lesser extent MHC-IIa) while the transcribed for the type MHC-IIx decrease.

A intervenção fonoaudiológica no pós-operatório da hipertrofia benigna do músculo masseter / The miofunctional oral intervention in the surgery treatment for the masseter muscle hipertrophy

OBJETIVO: descrever a abordagem fonoaudiológica no pós-operatório de pacientes que realizaram correção cirúrgica da hipertrofia do músculo masseter. METODOLOGIA: foram coletados dados referentes à avaliação e ao tratamento fonoaudiológico de 4 prontuários de sujeitos de ambos os gêneros, com faixa etária entre 16 e 24 anos, com hipertrofia benigna do músculo masseter, tratados cirurgicamente. RESULTADOS: as principais queixas pós-cirúrgicas estiveram relacionadas à limitação da abertura da boca, à dor na região da cirurgia, à rigidez muscular e a estalo em região da ATM. A terapia fonoaudiológica baseou-se em orientação quanto à retirada de hábitos deletérios; termoterapia na região do músculo masseter; manipulação da musculatura envolvida extra e intrabucais; alongamento da musculatura facial e cervical; alavanca de abertura forçada de boca e exercícios de órgãos fonoarticulatórios. CONCLUSÕES: a terapia fonoaudiológica apresenta-se como uma possibilidade de complementação ao tratamento cirúrgico, na adequação da amplitude dos movimentos mandibulares, assim como na eliminação dos sintomas presentes no pós-cirúrgico e na conscientização dos hábitos deletérios, que são apontados pela literatura como possíveis fatores desencadeantes.

Síndrome de Klippel-Trénaunay: a propósito de un caso / Klippel-Trénaunay syndrome: based on one case

El síndrome de Klippel-Trénaunay se caracteriza por una tríada de manifestaciones clínicas: angiomatosis cutánea, hipertrofia y venas varicosas, que afectan, por lo general, a una extremidad. Presentamos el caso de una niña de 13 años de edad con un angioma plano unilateral desde el pie derecho hasta la región mamilar derecha, varicosidades e hipotrofia del miembro inferior derecho, que ha precisado tratamiento de rehabilitación por linfedema y después de una intervención ortopédica para el alargamiento de dicho miembro. Con ello queremos recordar la existencia de este síndrome, que hoy por hoy tiene una etiopatogenia no aclarada, y conocer sus principales manifestaciones clínicas, que nos proporcionan el diagnóstico, y su tratamiento, sintomático, donde la rehabilitación desempeña un papel primordial dentro del abordaje multidisciplinar (AU)

Hipertrofia de ninfas / Nympha hypertrophy

Embora de ocorrência nåo muito freqüente, a hipertrofia dos pequenos lábios vulvares pode trazer desconforto e embaraço para suas portadoras. O desconhecimento sobre a possibilidade de correçåo cirúrgica faz com que muitas pacientes nem cheguem a conversar com seus ginecologistas sobre o problema, que é, no entanto, de soluçåo simples e eficaz. Os autores descrevem a técnica, alguns casos e tecem consideraçöes sobre o assunto