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1.
Medicine (Baltimore) ; 99(41): e22318, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031270

RESUMO

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.


Assuntos
Arginina/administração & dosagem , Citrulina/administração & dosagem , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Chá , Ultrassonografia/métodos , Adolescente , Adulto , Meios de Contraste , Estudos Cross-Over , Suplementos Nutricionais , Método Duplo-Cego , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Vasodilatação
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2113-2116, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018423

RESUMO

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.


Assuntos
Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Algoritmos , Humanos , Músculo Esquelético/diagnóstico por imagem , Ultrassonografia
3.
J Sports Med Phys Fitness ; 60(8): 1057-1064, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32955831

RESUMO

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.


Assuntos
Antebraço/fisiologia , Montanhismo/fisiologia , Fadiga Muscular/fisiologia , Músculo Esquelético/fisiologia , Adaptação Fisiológica , Adulto , Dedos/fisiologia , Antebraço/irrigação sanguínea , Antebraço/diagnóstico por imagem , Humanos , Contração Isométrica/fisiologia , Masculino , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Consumo de Oxigênio , Condicionamento Físico Humano/fisiologia , Espectroscopia de Luz Próxima ao Infravermelho , Levantamento de Peso/fisiologia , Adulto Jovem
4.
Plast Reconstr Surg ; 146(4): 778-781, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32969999

RESUMO

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.


Assuntos
Nádegas/irrigação sanguínea , Nádegas/diagnóstico por imagem , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Posicionamento do Paciente/métodos , Tomografia Computadorizada por Raios X , Adulto , Nádegas/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/cirurgia , Decúbito Ventral , Estudos Prospectivos , Procedimentos Cirúrgicos Reconstrutivos , Adulto Jovem
5.
PLoS One ; 15(8): e0236497, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785230

RESUMO

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.


Assuntos
Eletromiografia , Córtex Motor/fisiologia , Movimento/fisiologia , Músculo Esquelético/fisiologia , Adulto , Estimulação Elétrica , Mãos/fisiologia , Humanos , Masculino , Córtex Motor/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Visão Ocular/fisiologia , Adulto Jovem
6.
Neurol Clin ; 38(3): 493-504, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32703463

RESUMO

The limb girdle muscular dystrophies (LGMDs) are genetic muscle diseases with primary skeletal muscle involvement in persons with the ability to walk independently at some point in the disease course. They usually have increased creatine kinase levels along with patterns of fatty and fibrous deposition on muscle imaging and/or dystrophic features on muscle biopsy. Distinctive clinical features provide valuable diagnostic clues to the diagnosis and sometimes treatment of these disorders. The advent of gene and cell-based therapies; gene replacement, editing, and modulation; along with stem cell and small molecule therapies may significantly ameliorate clinical severity in the LGMDs.


Assuntos
Músculo Esquelético/diagnóstico por imagem , Distrofia Muscular do Cíngulo dos Membros/diagnóstico por imagem , Distrofia Muscular do Cíngulo dos Membros/genética , Adulto , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distrofia Muscular do Cíngulo dos Membros/terapia
7.
Neurol Clin ; 38(3): 697-710, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32703477

RESUMO

Inclusion body myositis is a slowly progressive myopathy, characteristically affecting quadriceps and long finger flexors. Atypical presentations do occur, however, and there is overlap with other myopathies, including inflammatory and hereditary etiologies. This article discusses atypical cases and differential diagnoses and considers the role of imaging and histopathology in differentiating inclusion body myositis.


Assuntos
Músculo Esquelético/diagnóstico por imagem , Miosite de Corpos de Inclusão/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Distrofias Musculares/diagnóstico por imagem , Miosite/diagnóstico por imagem , Miosite/patologia , Miosite de Corpos de Inclusão/patologia
8.
Clin Interv Aging ; 15: 889-895, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32606630

RESUMO

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.


Assuntos
Fraturas do Colo Femoral/diagnóstico por imagem , Idoso Fragilizado/estatística & dados numéricos , Músculo Esquelético/patologia , Sarcopenia/patologia , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Impedância Elétrica , Feminino , Fraturas do Colo Femoral/prevenção & controle , Humanos , Masculino , Músculo Esquelético/diagnóstico por imagem , Fatores de Risco , Sarcopenia/diagnóstico por imagem
9.
PLoS One ; 15(7): e0235836, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649730

RESUMO

Muscle ultrasound density (MUD) is a non-invasive parameter to indicate neuromuscular integrity in both children and adults. In healthy fetuses and infants, physiologic MUD values during development are still lacking. We therefore aimed to determine the physiologic, age-related MUD trend of biceps, quadriceps, tibialis anterior, hamstrings, gluteal and calf muscles, from pre- to the first year of postnatal life. To avoid a bias by pregnancy-related signal disturbances, we expressed fetal MUD as a ratio against bone ultrasound density. We used the full-term prenatal MUD ratio and the newborn postnatal MUD value as reference points, so that MUD development could be quantified from early pre- into postnatal life. Results: During the prenatal period, the total muscle group revealed a developmental MUD trend concerning a fetal increase in MUD-ratio from the 2nd trimester up to the end of the 3rd trimester [median increase: 27% (range 16-45), p < .001]. After birth, MUD-values increased up to the sixth month [median increase: 11% (range -7-27), p = 0.025] and stabilized thereafter. Additionally, there were also individual MUD characteristics per muscle group and developmental stage, such as relatively low MUD values of fetal hamstrings and high values of the paediatric gluteus muscles. These MUD trends are likely to concur with analogous developmentally, maturation-related alterations in the muscle water to peptide content ratios.


Assuntos
Feto/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Animais , Animais Recém-Nascidos , Bovinos , Feminino , Humanos , Recém-Nascido , Doenças Neuromusculares/diagnóstico por imagem , Gravidez , Ultrassonografia , Ultrassonografia Pré-Natal
10.
Int Heart J ; 61(4): 787-794, 2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32684602

RESUMO

Advanced age, obesity, and muscle weakness are independent factors in the onset of deep vein thrombosis (DVT). Recently, an association between sarcopenia and DVT has been reported. We hypothesized that sarcopenia related factors, observed by ultrasonography, are associated with the regression effect on the thrombus following anticoagulation therapy. The present study focused on gastrocnemius muscle (GCM) thickness and the GCM's internal echogenic brightness. We examined the association with DVT regression following direct oral anticoagulants (DOACs) treatment.The prospective cohort study period was between October 2017 and August 2018. We enrolled 46 patients diagnosed with DVT by ultrasonography, who were aged >60 years old and treated with DOACs. Sarcopenia was evaluated using the Asian Working Group for Sarcopenia flowchart. The average DOACs treatment period was 94 days, and 29 patients exhibited thrombus regression. On univariate logistic regression analysis, sarcopenia, average GCM diameter index, and gastrocnemius integrated backscatter index were significantly associated with thrombus regression. In a multivariate model, only the average GCM diameter index correlated with thrombus regression.The average GCM diameter index is associated with DVT regression treated with DOACs. Considering the GCM diameter during DVT treatment can be a marker to make a decision for the treatment of DVT.


Assuntos
Inibidores do Fator Xa/uso terapêutico , Músculo Esquelético/diagnóstico por imagem , Sarcopenia/diagnóstico por imagem , Trombose Venosa/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ultrassonografia , Trombose Venosa/diagnóstico por imagem
11.
Int J Mol Sci ; 21(13)2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32630032

RESUMO

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.


Assuntos
Caquexia , Infecções por Coronavirus/patologia , Obesidade/patologia , Pneumonia Viral/patologia , Adulto , Idoso , Betacoronavirus/isolamento & purificação , Composição Corporal , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico por imagem , Feminino , Humanos , Fígado/diagnóstico por imagem , Fígado/metabolismo , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/metabolismo , Estado Nutricional , Obesidade/complicações , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Estudos Prospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X
12.
Neurology ; 95(9): e1211-e1221, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32611642

RESUMO

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.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Inflamação/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Distrofia Muscular Facioescapuloumeral/diagnóstico por imagem , Adulto , Progressão da Doença , Feminino , Humanos , Perna (Membro) , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Força Muscular , Dinamômetro de Força Muscular , Distrofia Muscular Facioescapuloumeral/fisiopatologia , Coxa da Perna , Teste de Caminhada
13.
PLoS One ; 15(7): e0235924, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649705

RESUMO

Spatial frequency analysis (SFA) is a quantitative ultrasound (US) method originally developed to assess intratendinous tissue structure. This method may also be advantageous in assessing other musculoskeletal tissues. Although SFA has been shown to be a reliable assessment strategy in tendon tissue, its reliability in muscle has not been investigated. The purpose of this study was to examine the reliability of spatial frequency parameter measurement for a large muscle group within a healthy population. Ten participants with no history of lower extremity surgery or hamstring strain injury volunteered. Longitudinal B-mode images were collected in three different locations across the hamstring muscles. Following a short rest, the entire imaging procedure was repeated. B-mode images were processed by manually drawing a region of interest (ROI) about the entire muscle thickness. Four spatial frequency parameters of interest were extracted from the image ROIs. Intra- and inter-rater reliabilities of extracted SFA parameters were performed. Test-retest reliability of the image acquisition procedure was assessed between repeat trials. Intraclass correlation coefficients showed high intra- and inter-rater reliability (ICC(3,1) > 0.9 for all parameters) and good to moderate test-retest reliability (ICC(3,1) > 0.50) between trials. No differences in parameter values were observed between trials across all muscles and locations (p > 0.05). The high reliability metrics suggest that SFA will be useful for future studies assessing muscle tissue structure, and may have value in assessing muscular adaptations following injury and during recovery.


Assuntos
Músculo Esquelético/fisiologia , Ultrassonografia/métodos , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Músculo Esquelético/diagnóstico por imagem , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Adulto Jovem
14.
Artigo em Inglês | MEDLINE | ID: mdl-32570845

RESUMO

Ultrasound imaging allows the evaluation of musculoskeletal morphology and function. Ultrasound elastography can also offer semi-quantitative and/or quantitative assessment of tissue stiffness providing relevant information about adaptations of skeletal muscle mechanical properties. In this study we aimed to explore the feasibility of elastography ultrasound imaging in assessing the effect of strength training on vastus lateralis stiffness. Twenty-eight young male adults were separated in a control (n = 9) and strength-training (n = 20) groups. The strength-training group completed 15 weeks of either concentric (n = 10) or eccentric (n = 10) isokinetic training of the knee extensors. Ultrasound scans of the vastus lateralis for quasi-static elastography were collected. All image acquisitions and measurements were done by the same experienced sonographer. After 15 weeks, knee maximal extension isometric torque increased in the strength-training groups. After strength training, there was a decrease in the amount of red pixels in vastus lateralis region of interest [F(1,18) = 25.490; p < 0.001; η2 = 0.586], whereas the amount of green and blue pixels increased F(1,18) = 17.179; p < 0.01; η2 = 0.488; F(1,18) = 6.522; p < 0.05; η2 = 0.266], suggesting higher vastus lateralis stiffness. We conclude that concentric and eccentric strength training increases skeletal muscle stiffness, which can be evaluated by quasi-static elastography. Ultrasound elastography is suitable for non-invasive evaluation of skeletal muscle functional adaptations, which can be of importance for sports medicine and in designing optimal training and rehabilitation programs.


Assuntos
Técnicas de Imagem por Elasticidade , Treinamento de Resistência , Adulto , Humanos , Joelho , Masculino , Força Muscular , Músculo Esquelético/diagnóstico por imagem , Músculo Quadríceps/diagnóstico por imagem , Torque , Adulto Jovem
15.
PLoS One ; 15(6): e0234552, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32525949

RESUMO

INTRODUCTION: Digital tools like 3D laser-based photonic scanners, which can assess external anthropometric measurements for population based studies, and predict body composition, are gaining in importance. Here we focus on a) systematic deviation between manually determined and scanned standard measurements, b) differences regarding the strength of association between these standard measurements and body composition, and c) improving these predictions of body composition by considering additional scan measurements. METHODS: We analysed 104 men aged 19-23. Bioelectrical Impedance Analysis was used to estimate whole body fat mass, visceral fat mass and skeletal muscle mass (SMM). For the 3D body scans, an Anthroscan VITUSbodyscan was used to automatically obtain 90 body shape measurements. Manual anthropometric measurements (height, weight, waist circumference) were also taken. RESULTS: Scanned and manually measured height, waist circumference, waist-to-height-ratio, and BMI were strongly correlated (Spearman Rho>0.96), however we also found systematic differences. When these variables were used to predict body fat or muscle mass, explained variation and prediction standard errors were similar between scanned and manual measurements. The univariable predictions performed well for both visceral fat (r2 up to 0.92) and absolute fat mass (AFM, r2 up to 0.87) but not for SMM (r2 up to 0.54). Of the 90 body scanner measures used in the multivariable prediction models, belly circumference and middle hip circumference were the most important predictors of body fat content. Stepwise forward model selection using the AIC criterion showed that the best predictive power (r2 up to 0.99) was achieved with models including 49 scanner measurements. CONCLUSION: The use of a 3D full body scanner produced results that strongly correlate to manually measured anthropometric measures. Predictions were improved substantially by including multiple measurements, which can only be obtained with a 3D body scanner, in the models.


Assuntos
Adiposidade , Imageamento Tridimensional/normas , Músculo Esquelético/diagnóstico por imagem , Imagem Óptica/normas , Gordura Abdominal/diagnóstico por imagem , Gordura Abdominal/crescimento & desenvolvimento , Tamanho Corporal , Impedância Elétrica , Humanos , Masculino , Militares/estatística & dados numéricos , Músculo Esquelético/crescimento & desenvolvimento , Reprodutibilidade dos Testes , Suíça , Adulto Jovem
16.
Jpn J Clin Oncol ; 50(10): 1168-1174, 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-32533175

RESUMO

BACKGROUND: It is unknown whether sarcopenia influences treatment outcome in patients with soft tissue sarcoma. Herein, we aimed to elucidate the impact of sarcopenia on sarcoma treatment. METHODS: A total of 163 soft tissue sarcoma patients were included. Skeletal muscle measures were calculated using computed tomography images. Skeletal muscle area (SMA) and density (SMD) at the L3 level were extracted, and SMA was normalized by height as skeletal muscle index (SMI). The skeletal muscle gauge (SMG) was calculated by multiplying SMD × SMI. The relationship of skeletal muscle measures and clinical factors to wound complications and prognosis was evaluated, and classification and regression tree (CART) analysis was used to develop classification models for risk groups of surgical wound complications. RESULTS: Thirty-three patients developed wound complications. In univariate analysis, age (P = 0.0022), tumour location of adductor compartment of the thigh (P = 0.0019), operating time (P = 0.010), blood loss (P = 0.030), SMD (P = 0.0004) and SMG (P = 0.0001) were significantly correlated with complications. In multivariate analysis, lower SMG was an independent risk factor (P = 0.031, OR = 3.27). CART analysis classified three risk groups of surgical wound complications by SMG, age, tumour location and operating time, and area under the receiver operating characteristic curve (AUROCC) was 0.75. SMG was not associated with prognosis in univariate analysis (P = 0.15). CONCLUSIONS: The SMG does not affect overall survival but predicts surgical wound complications.


Assuntos
Músculo Esquelético/patologia , Sarcoma/patologia , Sarcoma/cirurgia , Ferida Cirúrgica/complicações , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Prognóstico , Fatores de Risco , Sarcoma/diagnóstico por imagem , Ferida Cirúrgica/diagnóstico por imagem , Ferida Cirúrgica/patologia , Análise de Sobrevida , Tomografia Computadorizada por Raios X , Resultado do Tratamento
17.
Am Heart J ; 224: 171-181, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32416332

RESUMO

BACKGROUND: Skeletal muscle wasting, or sarcopenia, affects a significant proportion of patients undergoing transcatheter aortic valve replacement (TAVR). However, its influence on post-TAVR recovery and 1-year health-related quality of life (HR-QOL) remains unknown. We examined the relationship between skeletal muscle index (SMI), post-TAVR length of hospital stay (LOS), and 1-year QOL. METHODS: The study sample consisted of 300 consecutive patients undergoing TAVR from 2012 to 2018 who had pre-TAVR computed tomographic scans suitable for analysis of body composition. Skeletal muscle mass was quantified as cm2 of skeletal mass per m2 of body surface area from the cross-sectional computed tomographic image at the third lumbar vertebra. Sarcopenia was defined using established sex-specific cutoffs (women: SMI < 39 cm2/m2; men: < 55 cm2/m2). Multivariable linear regression analysis was used to determine the relationship between SMI, LOS, and HR-QOL using the Kansas City Cardiomyopathy Questionnaire. RESULTS: Sarcopenia was present in most (59%) patients and associated with older age (82 vs 76 years; P < .001) and lower body mass index (27 vs 33 kg/m2; P < .001). There were no other differences in baseline clinical or echocardiographic characteristics among the 4 quartiles of SMI. SMI was positively correlated with LOS and 1-year QOL. After adjusting for age, gender, race, and body mass index, SMI remained a significant predictor of both LOS (P = .01) and 1-year QOL (P = .012). For every 10 cm2/m2 higher SMI, there was an 8-point increase in Kansas City Cardiomyopathy Questionnaire score, a difference that is clinically meaningful. CONCLUSIONS: Sarcopenia is prevalent in TAVR patients. Higher SMI is associated with shorter LOS and better 1-year HR-QOL. To achieve optimal TAVR benefits, further study into how body composition influences post-TAVR recovery and durable improvement in QOL is warranted.


Assuntos
Estenose da Valva Aórtica/cirurgia , Nível de Saúde , Qualidade de Vida , Medição de Risco/métodos , Sarcopenia/epidemiologia , Substituição da Valva Aórtica Transcateter , Idoso , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/complicações , Estudos Transversais , Feminino , Florida/epidemiologia , Seguimentos , Humanos , Masculino , Músculo Esquelético/diagnóstico por imagem , Período Pós-Operatório , Prevalência , Estudos Retrospectivos , Fatores de Risco , Sarcopenia/diagnóstico , Sarcopenia/etiologia , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia Computadorizada por Raios X
18.
Am J Gastroenterol ; 115(8): 1210-1216, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32467506

RESUMO

INTRODUCTION: There is increasing recognition of the central role of muscle mass in predicting clinical outcomes in patients with liver disease. Muscle size can be extracted from computed tomography (CT) scans, but clinical implementation will require increased automation. We hypothesize that we can achieve this by using artificial intelligence. METHODS: Using deep convolutional neural networks, we trained an algorithm on the Reference Analytic Morphomics Population (n = 5,268) and validated the automated methodology in an external cohort of adult kidney donors with a noncontrast CT scan (n = 1,655). To test the clinical usefulness, we examined its ability to predict clinical outcomes in a prospectively followed cohort of patients with clinically diagnosed cirrhosis (n = 254). RESULTS: Between the manual and automated methodologies, we found excellent inter-rater agreement with an intraclass correlation coefficient of 0.957 (confidence interval 0.953-0.961, P < 0.0001) in the adult kidney donor cohort. The calculated dice similarity coefficient was 0.932 ± 0.042, suggesting excellent spatial overlap between manual and automated methodologies. To assess the clinical usefulness, we examined its ability to predict clinical outcomes in a cirrhosis cohort and found that automated psoas muscle index was independently associated with mortality after adjusting for age, gender, and child's classification (P < 0.001). DISCUSSION: We demonstrated that deep learning techniques can allow for automation of muscle measurements on clinical CT scans in a diseased cohort. These automated psoas size measurements were predictive of mortality in patients with cirrhosis showing proof of principal that this methodology may allow for wider implementation in the clinical arena.


Assuntos
Aprendizado Profundo , Fibrose/mortalidade , Músculo Esquelético/diagnóstico por imagem , Adolescente , Adulto , Idoso , Algoritmos , Estudos de Coortes , Feminino , Humanos , Masculino , Michigan , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
19.
Am J Hum Genet ; 106(6): 793-804, 2020 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-32413282

RESUMO

Oculopharyngodistal myopathy (OPDM) is an adult-onset inherited neuromuscular disorder characterized by progressive ptosis, external ophthalmoplegia, and weakness of the masseter, facial, pharyngeal, and distal limb muscles. The myopathological features are presence of rimmed vacuoles (RVs) in the muscle fibers and myopathic changes of differing severity. Inheritance is variable, with either putative autosomal-dominant or autosomal-recessive pattern. Here, using a comprehensive strategy combining whole-genome sequencing (WGS), long-read whole-genome sequencing (LRS), linkage analysis, repeat-primed polymerase chain reaction (RP-PCR), and fluorescence amplicon length analysis polymerase chain reaction (AL-PCR), we identified an abnormal GGC repeat expansion in the 5' UTR of GIPC1 in one out of four families and three sporadic case subjects from a Chinese OPDM cohort. Expanded GGC repeats were further confirmed as the cause of OPDM in an additional 2 out of 4 families and 6 out of 13 sporadic Chinese individuals with OPDM, as well as 7 out of 194 unrelated Japanese individuals with OPDM. Methylation, qRT-PCR, and western blot analysis indicated that GIPC1 mRNA levels were increased while protein levels were unaltered in OPDM-affected individuals. RNA sequencing indicated p53 signaling, vascular smooth muscle contraction, ubiquitin-mediated proteolysis, and ribosome pathways were involved in the pathogenic mechanisms of OPDM-affected individuals with GGC repeat expansion in GIPC1. This study provides further evidence that OPDM is associated with GGC repeat expansions in distinct genes and highly suggests that expanded GGC repeat units are essential in the pathogenesis of OPDM, regardless of the genes in which the expanded repeats are located.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Distrofias Musculares/genética , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/genética , Cromossomos Humanos Par 19/genética , Metilação de DNA , Feminino , Humanos , Escore Lod , Masculino , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Distrofias Musculares/patologia , Distrofias Musculares/fisiopatologia , Linhagem , RNA-Seq , Expansão das Repetições de Trinucleotídeos/genética , Proteína Supressora de Tumor p53/metabolismo , Adulto Jovem
20.
Nutr Metab Cardiovasc Dis ; 30(7): 1161-1168, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32448718

RESUMO

BACKGROUND AND AIMS: The metabolic syndrome has been reported by cross-sectional studies to have an association with skeletal muscle quality and quantity. Using a longitudinal study design, this study aimed to explicate the association between muscle characteristics assessed with computed tomography (CT) and the incidence and progression of metabolic syndrome. METHODS AND RESULTS: In this retrospective study on a cohort of employees undergoing annual physical examinations, we evaluated data from 554 participants without metabolic syndrome. The cross-sectional skeletal muscle area was determined based on CT data at the level of the third lumbar vertebra, and the skeletal muscle density (SMD) and skeletal muscle index (SMI) were measured. The participants were divided into four study groups according to the sex-specific median values for SMI and SMD. We followed the participants for a mean period of 3.1 years. In the sex- and age-adjusted model, SMI and SMD had an interaction effect on the longitudinal change in number of metabolic syndrome components (ß = -0.074, p = 0.0727). Multiple regression analyses revealed that both low SMI and SMD was significantly associated with the change (ß = 0.131, p = 0.0281), whereas the low SMI and high SMD, and high SMI and low SMD were not. Both low SMI and SMD (hazard ratio (HR), 2.42; 95% confidence interval, 1.28-4.78) showed an increased adjusted HR for incident metabolic syndrome. CONCLUSION: The participants with both low quality and quantity of skeletal muscles were associated with the incidence and progression of metabolic syndrome, whereas those with only low quantity or quality of skeletal muscles were not.


Assuntos
Composição Corporal , Síndrome Metabólica/epidemiologia , Músculo Esquelético/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Progressão da Doença , Feminino , Nível de Saúde , Humanos , Incidência , Japão/epidemiologia , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Tronco
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