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1.
Orthopade ; 48(12): 992-997, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31659422

RESUMO

BACKGROUND: The need for effective training methods for positive adaptations in muscle strength and bone mineralization, suitable for all groups of patients, arises in both rehabilitation and pre-habilitation. In addition to mechanical stress, an increased metabolic stress, by means of reduced blood supply of the muscle, seems to induce positive adaptations as well. OBJECTIVES: Description of the effects of resistance training and opportunities of blood-flow restriction training in a clinical setting. METHODS: Key and specialized literature RESULTS: Regularly applied high mechanical loads are suitable to induce increases in muscle strength and mass as well as bone mineralization. In principle, the trainability of these tissues is given over the entire life span, although the adaptation of the muscle mass is reduced in the prepubertal and later stages of life. Classic strength training is particularly suitable as a training method to apply this stimulus quality (mechanical stress). For some years now, however, there has been increasing evidence that even low-intensity resistance training associated with metabolic stress is capable of producing hypertrophic effects and increasing muscle strength. This observation is particularly interesting for target groups whose mechanical capacity of the musculoskeletal system is reduced. Blood-flow-restriction training is particularly suitable as a training method for the application of this stimulus quality (metabolic stress). The data available on the effectiveness of low-intensity stress protocols on bone structure is still insufficient. Further research is needed to make evidence-based recommendations.


Assuntos
Adaptação Fisiológica/fisiologia , Força Muscular/fisiologia , Músculo Esquelético/irrigação sanguínea , Treinamento de Resistência/métodos , Estresse Mecânico , Metabolismo Energético/fisiologia , Humanos , Músculo Esquelético/fisiologia
2.
Curr Sports Med Rep ; 18(6): 224-228, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31385838

RESUMO

Blood flow restriction (BFR) training is commonly used to induce muscle hypertrophy and strength and is gaining popularity as a modality for treatment of musculoskeletal conditions and postoperative rehabilitation. This article reviews the current literature on BFR as a rehabilitative tool, identifies gaps in the literature, and reports the authors experience using BFR in the postoperative environment.


Assuntos
Traumatismos em Atletas/reabilitação , Constrição , Músculo Esquelético/irrigação sanguínea , Cuidados Pós-Operatórios/métodos , Humanos , Sistema Musculoesquelético/lesões , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Int J Sports Med ; 40(7): 434-439, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31189188

RESUMO

This study investigated aerobic metabolism responses in trunk muscles during a prolonged trunk extension exercise in athletes and untrained young men. The aim was to analyze the adaptations induced by 2 types of sports: one involving intensive use of trunk muscles (i. e., judo), and one known to induce high aerobic capacity in the whole body (i. e., cycling). Eleven judokas, 10 cyclists and 9 healthy untrained young men performed trunk extension exercises on an isokinetic dynamometer. During the first session, muscle strength was assessed during maximal trunk extension. During a second session, a 5-min exercise was performed to investigate aerobic responses with regard to trunk muscles. The near infrared spectroscopy technique and a gas exchange analyzer were used continuously to evaluate mechanical efficiency, V̇O2 on-set kinetics, trunk muscle deoxygenation and blood volume. Judokas showed greater trunk strength and mechanical efficiency (p<0.05). Cyclists presented faster V̇O2 on-set kinetics (p<0.05) and greater muscle deoxygenation and blood volume compared to untrained men (p<0.001). These results suggest that practicing judo improves trunk extension efficiency whereas cycling accelerates aerobic pathways and enhances microvascular responses to trunk extension exercise. Sport practice improves aerobic metabolism responses in trunk extensor muscles differently, according to the training specificities.


Assuntos
Ciclismo/fisiologia , Artes Marciais/fisiologia , Músculo Esquelético/metabolismo , Resistência Física/fisiologia , Aptidão Física/fisiologia , Adolescente , Adulto , Volume Sanguíneo , Humanos , Masculino , Microcirculação , Força Muscular , Músculo Esquelético/irrigação sanguínea , Consumo de Oxigênio , Condicionamento Físico Humano , Troca Gasosa Pulmonar , Espectroscopia de Luz Próxima ao Infravermelho , Torque , Tronco/fisiologia , Adulto Jovem
4.
Life Sci ; 231: 116533, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31173783

RESUMO

AIM: The aim of this study was to investigate the protective effect of chronic intermittent hypobaric hypoxia (CIHH) against skeletal muscle ischemia-reperfusion (IR) injury and to determine the underlying mechanism. MAIN METHODS: C57BL/6 mice were randomly divided into 3 groups: skeletal muscle IR injury group (IR), CIHH pretreatment following IR group (IR + CIHH), and sham operation group (Sham). The skeletal muscle IR injury model was induced by the unilateral application of a tourniquet on a hind limb for 3 h and then releasing it for 24 h. CIHH pretreatment simulating a 5000-m altitude was applied 6 h per day for 28 days. The functional and morphological performance of IR-injured gastrocnemius muscle was evaluated using contraction force, H&E staining, and transmission electron microscopy. IR injury-induced CD68+ macrophage infiltration was assessed by immunofluorescence. TNFα levels in serum and muscle were measured by ELISA and western blotting, respectively. Apoptosis was examined by TUNEL staining and Cleaved Caspase-3 protein expression. KEY FINDINGS: Acute IR injury resulted in reduced contraction tension, morphological destruction, macrophage infiltration, increased TNFα levels, and apoptosis in gastrocnemius muscle. CIHH pretreatment significantly ameliorated contraction function and morphological performance in IR-injured skeletal muscle. In addition, CIHH pretreatment resulted in marked decreases in CD68+ macrophage infiltration, TNFα levels, and apoptosis. SIGNIFICANCE: These data demonstrated that CIHH has a protective effect against acute IR injury in skeletal muscle via inhibition of inflammation and apoptosis.


Assuntos
Hipóxia/patologia , Músculo Esquelético/irrigação sanguínea , Traumatismo por Reperfusão/prevenção & controle , Animais , Apoptose/efeitos dos fármacos , Hipóxia/metabolismo , Inflamação/metabolismo , Inflamação/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/patologia , Fator de Necrose Tumoral alfa/metabolismo
5.
Infect Immun ; 87(8)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31138614

RESUMO

Gas gangrene, or clostridial myonecrosis, is usually caused by Clostridium perfringens and may occur spontaneously in association with diabetes mellitus, peripheral vascular disease, or some malignancies but more often after contamination of a deep surgical or traumatic lesion. If not controlled, clostridial myonecrosis results in multiorgan failure, shock, and death, but very little is known about the muscle regeneration process that follows myonecrosis when the infection is controlled. In this study, we characterized the muscle regeneration process after myonecrosis caused in a murine experimental infection with a sublethal inoculum of C. perfringens vegetative cells. The results show that myonecrosis occurs concomitantly with significant vascular injury, which limits the migration of inflammatory cells. A significant increase in cytokines that promote inflammation explains the presence of an inflammatory infiltrate; however, impaired interferon gamma (IFN-γ) expression, a reduced number of M1 macrophages, deficient phagocytic activity, and a prolongation of the permanence of inflammatory cells lead to deficient muscle regeneration. The expression of transforming growth factor ß1 (TGF-ß1) agrees with the consequent accumulation of collagen in the muscle, i.e., fibrosis observed 30 days after infection. These results provide new information on the pathogenesis of gas gangrene caused by C. perfringens, shed light on the basis of the deficient muscle regenerative activity, and may open new perspectives for the development of novel therapies for patients suffering from this disease.


Assuntos
Clostridium perfringens/patogenicidade , Gangrena Gasosa/fisiopatologia , Músculo Esquelético/fisiologia , Regeneração , Animais , Citocinas/metabolismo , Fibrose , Gangrena Gasosa/etiologia , Gangrena Gasosa/imunologia , Camundongos , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/patologia , Necrose , Infiltração de Neutrófilos
6.
Eur J Vasc Endovasc Surg ; 57(5): 702-707, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31003934

RESUMO

BACKGROUND: For the currently used compression therapy, the applied compression pressure is usually inadequate to exert an effective impact on the veins in different body positions. The aim was to assess the venous ejection fraction achieved by a new compression device which automatically adjusts the interface pressure to body position in an acute experimental setting. METHODS: A new portable, battery driven compression device providing pressure adjusted to allow for body position, and connected to a less or very stiff calf cuff wrap was tested. In patients with superficial venous incompetence, the ejection fraction (EF) of the calf pump was measured by strain gauge plethysmography. Applied in a random sequence, values achieved without compression, with the two cuffs, and with compression stockings exerting 23-32 mmHg, were compared. The applied compression pressures were simultaneously recorded in the supine and standing positions, and during walking. Comfort was assessed by a visual analogue scale (VAS) with 0 corresponding to very low comfort and 10 to very comfortable. RESULTS: In 16 patients with CEAP clinical stage C3-C6, EF without compression was 37%, increasing to 46.9% with stockings, to 64.8% (p < .001) by less stiff and to 75.5% (p < .001) by stiffer wraps. The median interface pressure (supine/standing) was 31/56 mmHg for the less stiff device, 32/68 mmHg for the stiffer device, and 23/26 mmHg for the stockings. The static stiffness index and the walking pressure amplitudes were significantly higher than those generated by the stocking, and the highest values were found with the stiffer wrap material. The device comfort was high both in the supine and standing positions (VAS 8 ± 2). CONCLUSIONS: The tested devices were comfortable at rest and haemodynamically effective during walking by automatically adjusting compression pressures to body position. They are significantly more effective than elastic stockings in improving EF. The system is able to overcome the problems of fast pressure loss by continuously re-adjusting the compression pressure.


Assuntos
Bandagens Compressivas , Músculo Esquelético/fisiopatologia , Posição Ortostática , Decúbito Dorsal , Insuficiência Venosa/fisiopatologia , Insuficiência Venosa/terapia , Dispositivos Eletrônicos Vestíveis , Adulto , Idoso , Desenho de Equipamento , Feminino , Hemodinâmica , Humanos , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/irrigação sanguínea , Caminhada
7.
Med Sci Sports Exerc ; 51(5): 1022-1031, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30986813

RESUMO

PURPOSE: Resistance exercise increases blood flow, induces osmotic and hydrostatic fluid shifts during and immediately after exercise, and may trigger inflammatory responses for several days in the working muscle. The resultant muscle swelling can subsequently affect muscle size and quality assessments. However, the effects of muscle swelling on x-ray attenuation of adipose estimate errors are unknown. METHODS: Peripheral quantitative computed tomography (pQCT) and ultrasonography were used to assess muscle and adipose tissue properties of both upper arms before, 24, 48, and 72 h after unilateral resistance exercise. Recreationally active participants (n = 17) completed the exercise while their contralateral limb served as a control. RESULTS: Resistance exercise resulted in a significant increase in pQCT-derived muscle cross-sectional area (includes intermuscular adipose tissue [IMAT] area), muscle area (excludes IMAT area) and IMAT area, and ultrasound-derived muscle thickness at 24, 48, and 72 h. A significant decrease in pQCT-derived muscle density was also detected as well as an increase in ultrasound-derived echo intensity at 48 and 72 h. The changes in muscle area, IMAT area, and muscle density were significantly correlated with changes in echo intensity, whereas the changes in muscle cross-sectional area and IMAT area were significantly correlated with changes in muscle thickness. CONCLUSION: Unaccustomed resistance exercise can cause errors in pQCT- and ultrasound-based muscle and adipose estimates for at least 72 h. These errors are the result of muscle swelling likely caused by muscle blood flow and inflammation-dependent fluid shifts in muscle. These findings may have implications for measurements in other inflammatory conditions.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Treinamento de Resistência , Adulto , Braço , Erros de Diagnóstico , Humanos , Masculino , Músculo Esquelético/irrigação sanguínea , Fluxo Sanguíneo Regional , Tomografia Computadorizada por Raios X , Ultrassonografia , Adulto Jovem
8.
Eur J Appl Physiol ; 119(6): 1439-1449, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30949807

RESUMO

PURPOSE: Whole-body vibration (WBV) training is frequently applied in sports and rehabilitation with the aim of inducing beneficial functional and structural adaptations. In the past decades, blood flow restriction (BFR) training has received increasing attention by enhancing the effectiveness of several low-load exercise regimens. The objective of this study was to evaluate the additional effect of BFR on myoelectric activity and metabolic accumulation during WBV training. METHODS: Fifteen active men performed three sessions in a counterbalanced order on three different days: whole-body vibration exercise (WBV), whole-body vibration exercise with blood flow restriction (WBV + BFR), and a control session (CON) with neither WBV nor BFR. Electromyographic (EMG) activity was measured in six lower limb muscles throughout each exercise session; lactate and reactive oxygen species (ROS) concentrations were determined prior to, immediately after and 15 min after the exercise sessions. RESULTS: EMG amplitudes increased from CON (29 ± 13% MVC) to WBV (45 ± 20% MVC) to WBV + BFR (71 ± 37% MVC) conditions (p < 0.05). Likewise, lactate concentrations increased in a similar manner, demonstrating significantly higher increases in the WBV + BFR session compared to WBV and CON. Furthermore, significant correlations between lactate concentration and EMG amplitude were detected. ROS concentration did not change significantly between the conditions. CONCLUSIONS: The findings of the present study emphasize that the addition of BFR increases the acute effects beyond WBV treatment alone which becomes manifested in both neuromuscular and metabolic adaptations. Further research is needed to identify potential long-term effects of the combination of these two training regimens.


Assuntos
Precondicionamento Isquêmico/métodos , Contração Isométrica , Músculo Esquelético/fisiologia , Consumo de Oxigênio , Vibração , Adulto , Humanos , Ácido Láctico/sangue , Masculino , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/metabolismo , Distribuição Aleatória , Espécies Reativas de Oxigênio/sangue
9.
Aerosp Med Hum Perform ; 90(5): 440-446, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31023403

RESUMO

INTRODUCTION: Microgravity leads to a progressive loss in muscular strength, endurance, and aerobic capacity (Vo2peak). Blood flow restricted (BFR) exercise has been shown to elicit rapid gains in muscular strength and Vo2peak. Rowing exercise combined with BFR could be a supplemental countermeasure to maintain preflight muscle function and Vo2peak, especially within future space vehicles with restricted physical volume.METHODS: There were 20 men who completed 19 min of rowing exercise during CON or BFR in a randomized order. Exercise intensity for all sets was 30% of peak work load achieved during a separate incremental maximal exercise test. Kaatsu training cuffs were inflated around each leg during BFR. Muscle oxygen saturation (Smo2) and heart rate (HR) were measured throughout exercise and rest. Rate of perceived exertion (RPE) and muscle activation, using surface electromyography (sEMG), were measured during the last 30 s of each exercise set. Blood pressure (BP) and whole blood lactate ([La-]b) were measured at rest and postexercise.RESULTS: Smo2 declined significantly in BFR during exercise and rest by 13% and 14%, respectively. HR and RPE showed significant increases during BFR (120.5 ± 5.53 vs. 128.9 ± 9.86 bts · min-1) (9.8 ± 1.85 vs. 11.8 ± 1.88 arbitrary units). No differences were observed for BP, [La-]b, and sEMG.DISCUSSION: Findings indicate exercise intensity and cuff pressure elicited acute muscular, cardiovascular, and perceptual responses. BFR rowing exercise could be advantageous as an adjunct for future exercise countermeasures where aerobic and anaerobic exercise may be performed on one device or in limited physical space.Mahoney SJ, Dicks ND, Lyman KJ, Christensen BK, Hackney KJ. Acute cardiovascular, metabolic, and muscular responses to blood flow restricted rowing exercise. Aerosp Med Hum Perform. 2019; 90(5):440-446.


Assuntos
Músculo Esquelético/fisiologia , Atrofia Muscular/prevenção & controle , Treinamento de Resistência/métodos , Voo Espacial , Ausência de Peso/efeitos adversos , Adulto , Eletromiografia , Voluntários Saudáveis , Humanos , Masculino , Força Muscular/fisiologia , Músculo Esquelético/irrigação sanguínea , Atrofia Muscular/diagnóstico , Atrofia Muscular/etiologia , Atrofia Muscular/fisiopatologia , Resistência Física/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Fatores de Tempo , Esportes Aquáticos/fisiologia , Adulto Jovem
10.
J Sports Sci ; 37(16): 1865-1873, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30945606

RESUMO

The purpose was to determine if the muscle swelling, echo intensity, and fatigue responses to blood flow restriction differs based on cuff width (Experiment 1), applied pressure (Experiment 2), and sex. Ultrasound of muscle was taken before and after exercise. In Experiment 1 (n = 96), men swelled more than women and more with a narrow cuff than a wide cuff (0.60 cm vs. 0.52 cm). Expressed as a percentage change, there were no longer differences between cuffs (Narrow: 15% vs. Wide: 14%) or sex (Men: 14% vs. Women: 15%). Echo intensity remained unchanged. Women required more repetitions to reach task failure in sets 2, 3, and 4. In Experiment 2 (n = 87), men swelled more than women (Men: 0.46 cm vs. Women: 0.31 cm). Expressed as a percentage change, there were no differences. Echo intensity decreased in both conditions and to a greater extent with a higher applied pressure. If the acute muscle swelling response is important for initiating long term adaptation, then our results indicate that neither cuff width, sex, nor applied pressure will differentially impact the adaptation observed via this mechanism. Changes in echo intensity were inconsistent and the utility of this measurement may need to be reconsidered.


Assuntos
Líquidos Corporais/fisiologia , Fadiga Muscular/fisiologia , Músculo Esquelético/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Treinamento de Resistência/instrumentação , Treinamento de Resistência/métodos , Adaptação Fisiológica , Adolescente , Adulto , Braço/anatomia & histologia , Braço/irrigação sanguínea , Braço/diagnóstico por imagem , Braço/fisiologia , Estudos Cross-Over , Desenho de Equipamento , Feminino , Humanos , Masculino , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Fatores Sexuais , Ultrassonografia , Adulto Jovem
11.
J Sports Sci ; 37(16): 1857-1864, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30961440

RESUMO

The purpose was to examine changes in the perceptual responses to lifting a very low load (15% one repetition maximum (1RM)) with and without (15/0) different pressures [40% (15/40) and 80% (15/80) arterial occlusion pressure] and compare that to traditional high load (70/0) resistance exercise. Ratings of perceived exertion (RPE) and discomfort were measured following each set of exercise. In addition, resting arterial occlusion pressure was measured prior to exercise. Assessments were made in training sessions 1, 9, and 16 for the upper and lower body. Data are presented as means and 95% CI. There were changes in RPE in the upper body with condition 15/40 [-2.1 (-3.4, -0.850)] and 15/80 [-2.4 (-3.6, -1.1)] decreasing by the end of training. In the lower body, RPE decreased in condition 15/40 [-1.4 (-2.3, -0.431)] by the end of the training study. There was a main effect of time in the upper body with all conditions decreasing discomfort. In the lower body, all conditions decreased except for 15/80. For arterial occlusion pressure, there were differences across time in the 15/40 condition and the 15/80 condition in the upper body. Repeated exposure to blood flow restriction may dampen the perceptual responses over time.


Assuntos
Braço/irrigação sanguínea , Percepção/fisiologia , Esforço Físico/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Treinamento de Resistência/métodos , Coxa da Perna/irrigação sanguínea , Adaptação Fisiológica , Adolescente , Adulto , Artérias/fisiologia , Feminino , Humanos , Masculino , Músculo Esquelético/irrigação sanguínea , Adulto Jovem
12.
Eur J Appl Physiol ; 119(7): 1533-1545, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31011807

RESUMO

PURPOSE: This study aimed to determine the effects of hypoxia and/or blood flow restriction (BFR) on an arm-cycling repeated sprint ability test (aRSA) and its impact on elbow flexor neuromuscular function. METHODS: Fourteen volunteers performed an aRSA (10 s sprint/20 s recovery) to exhaustion in four randomized conditions: normoxia (NOR), normoxia plus BFR (NBFR), hypoxia (FiO2 = 0.13, HYP) and hypoxia plus BFR (HBFR). Maximal voluntary contraction (MVC), resting twitch force (Db10), and electromyographic responses from the elbow flexors [biceps brachii (BB)] to electrical and transcranial magnetic stimulation were obtained to assess neuromuscular function. Main effects of hypoxia, BFR, and interaction were analyzed on delta values from pre- to post-exercise. RESULTS: BFR and hypoxia decreased the number of sprints during aRSA with no significant cumulative effect (NOR 16 ± 8; NBFR 12 ± 4; HYP 10 ± 3 and HBFR 8 ± 3; P < 0.01). MVC decrease from pre- to post-exercise was comparable whatever the condition. M-wave amplitude (- 9.4 ± 1.9% vs. + 0.8 ± 2.0%, P < 0.01) and Db10 force (- 41.8 ± 4.7% vs. - 27.9 ± 4.5%, P < 0.01) were more altered after aRSA with BFR compared to without BFR. The exercise-induced increase in corticospinal excitability was significantly lower in hypoxic vs. normoxic conditions (e.g., BB motor evoked potential at 75% of MVC: - 2.4 ± 4.2% vs. + 16.0 ± 5.9%, respectively, P = 0.03). CONCLUSION: BFR and hypoxia led to comparable aRSA performance impairments but with distinct fatigue etiology. BFR impaired the muscle excitation-contraction coupling whereas hypoxia predominantly affected corticospinal excitability indicating incapacity of the corticospinal pathway to adapt to fatigue as in normoxia.


Assuntos
Exercício , Hipóxia/fisiopatologia , Isquemia/fisiopatologia , Contração Muscular , Fadiga Muscular , Adulto , Braço/irrigação sanguínea , Braço/fisiopatologia , Feminino , Humanos , Masculino , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/inervação , Músculo Esquelético/fisiopatologia , Tratos Piramidais/fisiopatologia , Distribuição Aleatória
13.
Medicine (Baltimore) ; 98(13): e14678, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30921180

RESUMO

RATIONALE: Intermuscular hemangioma (IH) usually occurs in the muscles of the limbs and trunk, but can rarely occur in the occipital region. IH in the occipital region is easily misdiagnosed as arteriovenous malformation (AVM). PATIENT CONCERNS: A 31-year-old woman had a right occipital mass for 5 months without pulsation. DIAGNOSIS: Head computered tomography angiography (CTA) and digital substraction angiography (DSA) examinations showed that the lesion was mainly vascular, approximately 3 × 5 cm in size, and supplied by occipital arteries and the muscular branches of vertebral arteries. The venous drainage of the lesions communicated with the suboccipital vein plexus and the paravertebral vein in the venous phase, indicating AVM. Postoperative histological investigation showed the lesion was a hemangioma. INTERVENTIONS: It was recommended for surgical removal. The surgery was carried out under general anesthesia. The lesion showed a clear boundary. The occipital artery touched the anterior margin of the lesion, was exposed and ligated, and was removed around the lesion. The lesion consisted of massive blood vessels, and the surrounding muscles were swollen, indicating IH.After the lesion was removed, the normal muscle tissue around the lesion was also removed. OUTCOMES: The patient achieved a good recovery after surgery, and pathology confirmed IH. A postoperative 1-year CTA review was performed and showed partial residual, then the radiotherapy was recommended. She refused further radiotherapy, follow-up 2 years later showed no enlargement of the lesion. LESSONS: Although IH rarely occurs in the occipital region, this can occur. Due to the complexity of the drainage veins in the occipital region, these IH are prone to misdiagnosis as AVM.


Assuntos
Hemangioma/patologia , Malformações Arteriovenosas Intracranianas/patologia , Músculo Esquelético/patologia , Lobo Occipital/patologia , Adulto , Angiografia por Tomografia Computadorizada/métodos , Erros de Diagnóstico , Feminino , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Lobo Occipital/irrigação sanguínea , Lobo Occipital/diagnóstico por imagem , Resultado do Tratamento , Veias/anormalidades , Veias/patologia
14.
Eur J Appl Physiol ; 119(6): 1289-1303, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30915538

RESUMO

PURPOSE: During exercise in supine posture or under microgravity in space, the gravity-dependent component of local blood pressure in leg muscles at upright posture can be simulated by lower body negative pressure (LBNP). We hypothesized that during resistive exercise LBNP favors oxygen availability in lower extremities, benefiting energy levels and performance of working muscles. METHODS: In permutated crossover design, nine subjects performed a series of fifteen slow-paced concentric (4 s) and eccentric contractions (4 s) without or with 40 mmHg LBNP and 4 s pause between repetitions. The force at knee flexion was 6% of the one repetition maximum (1-RM) and gradually increased to 60% 1RM in the first half of the individual range of motion, subsequently remaining constant until full extension. RESULTS: During the low force periods of continuous exercise, LBNP enhanced the refill of capillary blood measured by near infrared spectroscopy, amplifying the increase of total haemoglobin by about 20 µmol/l (p < 0.01) and oxyhaemoglobin by about 10 µmol/l (p < 0.01). During continuous exercise, LBNP induced a trend towards a lower EMG increment. This LBNP effect was not found when the periods of low forces at knee flexion were extended by 4 s pauses. Increased respiratory oxygen uptake (+ 0.1 l/min, p < 0.05) indicated overall enhanced muscle energy turn-over. CONCLUSIONS: Our results suggest stimulation of oxidative metabolism through LBNP enables working muscles to meet the energy demands of intense exercise. Further research is needed on the consequences for energy metabolism and the molecular control of growth and differentiation.


Assuntos
Treinamento Intervalado de Alta Intensidade/métodos , Músculo Esquelético/fisiologia , Consumo de Oxigênio , Decúbito Dorsal , Adulto , Pressão Sanguínea , Humanos , Joelho/fisiologia , Masculino , Contração Muscular , Músculo Esquelético/irrigação sanguínea , Ausência de Peso/efeitos adversos
15.
Angiology ; 70(8): 747-755, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30913894

RESUMO

We determined whether calf muscle oxygen saturation (StO2) and vascular biomarkers of inflammation and oxidative stress were associated with an exercise pressor response during treadmill walking in 179 patients with symptomatic peripheral artery disease (PAD). The exercise pressor response was measured as the change in blood pressure from rest to the end of the first 2-minute treadmill stage (2 mph, 0% grade). There was a wide range in the change in systolic blood pressure (-46 to 50 mm Hg) and in diastolic blood pressure (-23 to 38 mm Hg), with mean increases of 4.3 and 1.4 mm Hg, respectively. In multiple regression analyses, significant predictors of systolic pressure included glucose (P < .001) and insulin (P = .039). Significant predictors of diastolic pressure included cultured endothelial cell apoptosis (P = .019), the percentage drop in exercise calf muscle (StO2; P = .023), high-sensitivity C-reactive protein (P = .032), and glucose (P = .033). Higher levels in pro-inflammatory vascular biomarkers, impaired calf muscle StO2 during exercise, and elevated blood glucose were independently associated with greater exercise pressor response in patients with symptomatic PAD. The clinical implication is that exercise and nutritional interventions designed to improve inflammation, microcirculation, and glucose metabolism may also lower blood pressure during exercise in patients with symptomatic PAD.


Assuntos
Glicemia/metabolismo , Exercício/fisiologia , Inflamação/sangue , Oxigênio/sangue , Doença Arterial Periférica/sangue , Adulto , Idoso , Biomarcadores/sangue , Tolerância ao Exercício/fisiologia , Feminino , Humanos , Claudicação Intermitente/fisiopatologia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/irrigação sanguínea , Estresse Oxidativo/fisiologia , Consumo de Oxigênio/fisiologia , Doença Arterial Periférica/fisiopatologia
16.
PLoS One ; 14(3): e0212512, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30865641

RESUMO

BACKGROUND: Whole body vibration exercise (WBVE) has been shown to improve muscular strength and power, and increase peripheral blood flow. The aim of this study was to evaluate the behavior of the skin temperature (Tsk) on regions of the lower limbs from an acute bout of WBVE. METHODS AND FINDINGS: Cross-sectional study approved by local ethics committee (Certificado de Apresentação para Apreciação Ética-CAAE-19826413.8.0000.5259) and Trial registration (Registro Brasileiro de Ensaios Clínicos-REBEC-RBR-738wng). Using Infrared thermography (IRT), Tsk and thermal symmetry of the posterior lower extremities (thigh, knee, calf and heel) were examined in 19 healthy participants. IRT was assessed during 60-second WBVE exposures of 0, 30 and 50 Hz. From the adjusted linear mixed effects model, vibration frequency, time and regions of the lower extremity were significant (p<0.001). However, the variable laterality was not significant (p = 0.067) and was excluded from the adjusted statistical model. The adjusted model was significant (p<0.00001) and all variables in the model were significant (p<0.01) indicating that Tsk decreases with time, independently of the vibration frequency. The value of the Pseudo-R-Squared for the model was 0.8376. The presented mathematical model of the current study may be useful to justify the patterns observed for all vibration frequencies between and 0 and 50 Hz. The main limitations of the study were the reduced time of the intervention and not having evaluated other regions of the body. CONCLUSIONS: The acute exposure of 60-second mechanical vibration has effect on the behavior of Tsk of the posterior region of the lower limbs, which is likely to be associated with a decrease on the blood flow due to WBVE. It is speculated that during WBVE a greater supply of blood is required where the body responds by shunting blood flow from the skin to working muscle in the first seconds of exercise. Further investigative work is required to verify this hypothesis.


Assuntos
Extremidade Inferior , Modelos Biológicos , Temperatura Cutânea , Termografia , Vibração , Adulto , Velocidade do Fluxo Sanguíneo , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Músculo Esquelético/irrigação sanguínea
17.
BMC Surg ; 19(1): 24, 2019 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-30786888

RESUMO

BACKGROUND: Monobloc resection of soft tissue sarcomas (STSs) has a major impact on overall survival and local recurrence. Anatomical boundaries, such as the sciatic notch, increase the risk of fragmentation of the lesion. To date there are few papers describing the optimal surgical technique to remove such STSs. The objective of this study is to describe a simultaneous anterior and posterior approach for resection of sciatic notch dumbbell tumours. CASE PRESENTATION: We present the surgical management of two patients diagnosed with well-differentiated liposarcomas of the sciatic notch with a retroperitoneal and gluteal extension in the two cases. Pre-operative diagnosis was made with a percutaneous biopsy including molecular analysis which demonstrated MDM2 amplification. We describe a simultaneous anterior and posterior approach, including the ligation of the posterior trunk of the internal iliac artery, to reduce intra-operative blood loss and devascularise the tumour. The anterior approach allows the evaluation of the tumour's retroperitoneal extension, release from its pelvic attachments and control of the surrounding neurovascular structures. During the posterior approach, bleeding is reduced by the devascularisation of the gluteal musculature achieved with internal iliac artery ligation. Clear margins were achieved in both cases. No vascular, skeletal or soft tissue reconstructions were required. CONCLUSIONS: Simultaneous combined anterior and posterior approaches to remove a malignant sciatic notch tumour optimises the chance of complete en bloc resection. This surgical strategy allows oncologic en bloc resection with minimal blood loss.


Assuntos
Lipossarcoma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Adulto , Nádegas , Feminino , Humanos , Artéria Ilíaca/cirurgia , Ílio , Lipossarcoma/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem
18.
Ulus Travma Acil Cerrahi Derg ; 25(1): 7-11, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30742297

RESUMO

BACKGROUND: The aim of the present study was to investigate the effects of curcumin on lung damage following ischemia/reperfusion (I/R) injury after hind limb ligation. METHODS: Forty Wistar rats were divided into four groups: sham (G1), I/R (G2), curcumin plus sham (G3), and curcumin plus I/R (G4). Curcumin was administered (200 mg/kg) daily for 2 weeks before the study. I/R was induced by placement of rubber tourniquets at the greater trochanters for 2 h, followed by reperfusion for 4 h. RESULTS: Curcumin pretreatment had significantly lower level of malondialdehydes and higher level of superoxide dismutase in the lung tissues (p<0.05) than the I/R group. Glutathione peroxidase activity was not significantly different among the groups (p>0.05). I/R caused severe histopathological injury (p<0.05), including inflammatory cell infiltration and intra-alveolar hemorrhage. CONCLUSION: These results suggest that curcumin pretreatment has protective effects against lung injury induced by muscle I/R.


Assuntos
Curcumina/farmacologia , Lesão Pulmonar , Pulmão/efeitos dos fármacos , Músculo Esquelético , Substâncias Protetoras/farmacologia , Traumatismo por Reperfusão/complicações , Animais , Modelos Animais de Doenças , Pulmão/fisiopatologia , Lesão Pulmonar/etiologia , Lesão Pulmonar/fisiopatologia , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/fisiopatologia , Ratos , Ratos Wistar
19.
Cell Mol Life Sci ; 76(8): 1507-1528, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30770952

RESUMO

Duchenne muscular dystrophy (DMD) represents one of the most devastating types of muscular dystrophies which affect boys already at early childhood. Despite the fact that the primary cause of the disease, namely the lack of functional dystrophin is known already for more than 30 years, DMD still remains an incurable disease. Thus, an enormous effort has been made during recent years to reveal novel mechanisms that could provide therapeutic targets for DMD, especially because glucocorticoids treatment acts mostly symptomatic and exerts many side effects, whereas the effectiveness of genetic approaches aiming at the restoration of functional dystrophin is under the constant debate. Taking into account that dystrophin expression is not restricted to muscle cells, but is present also in, e.g., endothelial cells, alterations in angiogenesis process have been proposed to have a significant impact on DMD progression. Indeed, already before the discovery of dystrophin, several abnormalities in blood vessels structure and function have been revealed, suggesting that targeting angiogenesis could be beneficial in DMD. In this review, we will summarize current knowledge about the angiogenesis status both in animal models of DMD as well as in DMD patients, focusing on different organs as well as age- and sex-dependent effects. Moreover, we will critically discuss some approaches such as modulation of vascular endothelial growth factor or nitric oxide related pathways, to enhance angiogenesis and attenuate the dystrophic phenotype. Additionally, we will suggest the potential role of other mediators, such as heme oxygenase-1 or statins in those processes.


Assuntos
Heme Oxigenase-1/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Distrofia Muscular de Duchenne/terapia , Neovascularização Patológica/terapia , Óxido Nítrico/metabolismo , Fator A de Crescimento do Endotélio Vascular/uso terapêutico , Fatores Etários , Animais , Modelos Animais de Doenças , Progressão da Doença , Distrofina/deficiência , Humanos , Masculino , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/patologia , Distrofia Muscular de Duchenne/patologia , Neovascularização Patológica/patologia , Fatores Sexuais
20.
J Therm Biol ; 80: 94-105, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30784494

RESUMO

The one-dimensional steady Pennes (bioheat) equation was applied to analyze heat conduction inside a combined layer of human muscle and fat, under Fanger thermal comfort conditions. The bioheat equation was solved subject to two boundary conditions at the skin surface: a prescribed skin temperature satisfying the Fanger comfort criterion, and a prescribed heat flux obtained from the overall energy balance for the system. In addition to a fixed body core temperature, an adiabatic condition was imposed as an auxiliary condition at the core of the body, and a pair of equations were derived, relating the blood perfusion and the volumetric heat generation rate for a given activity level and environmental conditions. By solving the two equations, we determined the functional dependence of blood perfusion and metabolic heat generation on the human activity level. For convenience, we presented simple explicit expressions for the key relations, with the aid of asymptotic analyses. Additional results include the temperature distribution inside the muscle layer, and the effects of muscle and fat layer thickness on the heat transfer processes.


Assuntos
Tecido Adiposo/fisiologia , Algoritmos , Temperatura Corporal , Metabolismo Energético , Músculo Esquelético/fisiologia , Fluxo Sanguíneo Regional , Tecido Adiposo/irrigação sanguínea , Humanos , Modelos Biológicos , Músculo Esquelético/irrigação sanguínea , Sensação Térmica
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