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1.
Pan Afr Med J ; 37: 48, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33209175

RESUMO

In the COVID-19's crisis, elective surgery and non-emergent cases were postponed; all other procedures have to be minimized. A 17-year male patient with severe crush and degloving injury over the thigh, gluteal, sacral, and perineum areas was admitted to our Department on the 16th of March 2020. The patient presented soft tissue skin and muscle loss. A double Latissimus Dorsi and Anterolateral Thigh free flaps were indicated. However, due to the particular circumstance of the COVID-19 crisis, we applied domestic negative wound therapy (NPWT) using gauzes and wall suction. We obtained suitable granulation tissue after 17 consecutive days with this treatment. The raw area was then covered with an expanded split-thickness skin graft. The wound healed at 95%, and the patient was discharged on 25th of April 2020. He was followed up in an outpatient setting with wound care and physiotherapy. This case showed that in a limited-resource setting, with available wall suction, the domestic NPWT is a versatile tool to promote granulation tissue.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Lesões por Esmagamento/cirurgia , Desenluvamentos Cutâneos/cirurgia , Tratamento de Ferimentos com Pressão Negativa/métodos , Pneumonia Viral/epidemiologia , Retalhos Cirúrgicos/transplante , Acidentes de Trânsito , Adolescente , Bandagens , Nádegas/lesões , Desbridamento , Humanos , Masculino , Músculo Esquelético/lesões , Pandemias , Períneo/lesões , Coxa da Perna/lesões , Cicatrização , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia
2.
Inflamm Res ; 69(12): 1235-1244, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32909096

RESUMO

OBJECTIVE: The inflammatory response and the presence of macrophages are reported to be necessary for proper muscle regeneration. However, our understanding of the molecular mechanisms governing how macrophages signal to promote muscle regeneration is incomplete. METHODS AND RESULTS: Here we conditionally deleted Wls, which is required for Wnt secretion, from macrophages and examined the impact on endothelial permeability following muscle injury. The expression of Wnt ligands and Wls was increased in the tibialis anterior (TA) of mice 2 days following BaCl2 injury. Loss of macrophage Wls inhibited the loss of endothelial barrier function, as measured by transendothelial resistance and Evans blue dye permeability assays. Interestingly, the blockade in endothelial permeability correlated with reduced VEGF levels and pretreatment of wild type endothelial cells with a VEGFR2 blocking antibody was sufficient to reduce endothelial permeability induced by stimulated macrophage supernatant. We also found that macrophage Wls-null TAs had myocytes with reduced cross-sectional area 7 day post-injury suggesting a delay in muscle regeneration. CONCLUSION: Our results indicate that macrophage-derived Wnt signaling increases endothelial permeability in a VEGF-dependent fashion following muscle injury. Our findings implicate macrophages as a primary source of Wnt ligands following muscle injury and highlight the Wnt pathway as a therapeutic target following injury.


Assuntos
Endotélio/patologia , Macrófagos/patologia , Músculo Esquelético/lesões , Músculo Esquelético/patologia , Via de Sinalização Wnt , Animais , Anticorpos Bloqueadores/farmacologia , Células Cultivadas , Células Endoteliais/patologia , Humanos , Camundongos , Camundongos Knockout , Permeabilidade , Regeneração , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Cicatrização
3.
Nat Commun ; 11(1): 4167, 2020 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-32820177

RESUMO

Muscle regeneration depends on a robust albeit transient inflammatory response. Persistent inflammation is a feature of age-related regenerative deficits, yet the underlying mechanisms are poorly understood. Here, we find inflammatory-related CC-chemokine-receptor 2 (Ccr2) expression in non-hematopoietic myogenic progenitors (MPs) during regeneration. After injury, the expression of Ccr2 in MPs corresponds to the levels of its ligands, the chemokines Ccl2, 7, and 8. We find stimulation of Ccr2-activity inhibits MP fusion and contribution to myofibers. This occurs in association with increases in MAPKp38δ/γ signaling, MyoD phosphorylation, and repression of the terminal myogenic commitment factor Myogenin. High levels of Ccr2-chemokines are a feature of regenerating aged muscle. Correspondingly, deletion of Ccr2 in MPs is necessary for proper fusion into regenerating aged muscle. Finally, opportune Ccr2 inhibition after injury enhances aged regeneration and functional recovery. These results demonstrate that inflammatory-induced activation of Ccr2 signaling in myogenic cells contributes to aged muscle regenerative decline.


Assuntos
Mediadores da Inflamação/metabolismo , Músculo Esquelético/fisiopatologia , Receptores CCR2/metabolismo , Regeneração/fisiologia , Transdução de Sinais/fisiologia , Fatores Etários , Animais , Transplante de Células/métodos , Quimiocina CCL2/metabolismo , Quimiocina CCL7/metabolismo , Quimiocina CCL8/metabolismo , Camundongos Endogâmicos C57BL , Camundongos Knockout , Desenvolvimento Muscular/genética , Músculo Esquelético/lesões , Músculo Esquelético/metabolismo , Miogenina/genética , Miogenina/metabolismo , Receptores CCR2/genética , Regeneração/genética , Células Satélites de Músculo Esquelético/citologia , Células Satélites de Músculo Esquelético/metabolismo , Células Satélites de Músculo Esquelético/transplante , Transdução de Sinais/genética , Ferimentos e Lesões/genética , Ferimentos e Lesões/fisiopatologia , Ferimentos e Lesões/terapia
4.
Am J Sports Med ; 48(10): 2489-2498, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32692936

RESUMO

BACKGROUND: Gastrocnemius injuries are a common lower extremity injury in elite baseball players. There are no current epidemiological studies focused on gastrocnemius injuries in professional baseball players that provide information on the timing, distribution, and characteristics of such injuries. HYPOTHESIS: Gastrocnemius injury in professional baseball players is a common injury that is influenced by factors such as age, player position, and time of season. STUDY DESIGN: Descriptive epidemiological study. METHODS: Based on Major League Baseball's (MLB's) Health and Injury Tracking System (HITS) database, gastrocnemius injuries that caused time out of play for MLB and Minor League Baseball (MiLB) players during the 2011-2016 seasons were identified. Player characteristics, including age, level of play, and position at time of injury, were collected. Injury-specific factors analyzed included date of injury, time of season, days missed, and activity leading to injury. RESULTS: A total of 402 gastrocnemius injuries (n = 145, MLB; n = 257, MiLB) occurred during the 2011-2016 seasons. MLB players were significantly older at the time of injury (30.1 years, MLB; 23.9 years, MiLB; P < .001). Base running (36.1%) was the most common activity causing the injury, followed by fielding (23.6%), with 50.3% of base-running injuries sustained on the way to first base. In MLB players, gastrocnemius injuries were most common in infielders (48.3%), followed by pitchers (27.6%) and then outfielders (17.9%), while for MiLB players the injuries were more evenly distributed (33.5%, 28.8%, and 30.7%, respectively). The frequency of injuries in MLB players dropped off after the start of the regular season, whereas MiLB players had a consistent injury rate throughout the year. CONCLUSION: Gastrocnemius injuries are a common cause of lower extremity injury in professional baseball players, resulting in significant time out of play. Base running, particularly to first base, was the most common activity during injury. Outfielders had the fewest injuries; however, they required the longest time to recover. This study provides the first investigation to date with the HITS database to examine the characteristics and distribution of gastrocnemius injuries in professional baseball players, offering insight into risk factors, injury prevention, and recovery expectations.


Assuntos
Traumatismos em Atletas , Beisebol/lesões , Músculo Esquelético/lesões , Atletas , Traumatismos em Atletas/epidemiologia , Humanos , Corrida/lesões
5.
Am J Pathol ; 190(10): 2039-2055, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32650005

RESUMO

This study investigated intercellular adhesion molecule-1 (ICAM-1), a membrane protein that mediates cell-to-cell adhesion and communication, as a mechanism through which the inflammatory response facilitates muscle regeneration after injury. Toxin-induced muscle injury to tibialis anterior muscles of wild-type mice caused ICAM-1 to be expressed by a population of satellite cells/myoblasts and myofibers. Myogenic cell expression of ICAM-1 contributed to the restoration of muscle structure after injury, as regenerating myofibers were more abundant and myofiber size was larger for wild-type compared with Icam1-/- mice during 28 days of recovery. Contrastingly, restoration of muscle function after injury was similar between the genotypes. ICAM-1 facilitated the restoration of muscle structure after injury through mechanisms involving the regulation of myofiber branching, protein synthesis, and the organization of nuclei within myofibers after myogenic cell fusion. These findings provide support for a paradigm in which ICAM-1 expressed by myogenic cells after muscle injury augments their adhesive and fusogenic properties, which, in turn, facilitates regenerative and hypertrophic processes that restore structure to injured muscle.


Assuntos
Adesão Celular/fisiologia , Molécula 1 de Adesão Intercelular/metabolismo , Desenvolvimento Muscular/fisiologia , Células Satélites de Músculo Esquelético/metabolismo , Animais , Comunicação Celular/fisiologia , Feminino , Hipertrofia/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Fibras Musculares Esqueléticas/metabolismo , Músculo Esquelético/lesões , Músculo Esquelético/metabolismo , Regeneração/genética
6.
Exerc Sport Sci Rev ; 48(4): 163-169, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32658042

RESUMO

The prolonged impairment in muscle strength, power, and fatigue resistance after eccentric exercise has been ascribed to a plethora of mechanisms, including delayed muscle refueling and microvascular and mitochondrial dysfunction. This review explores the hypothesis that local heat therapy hastens functional recovery after strenuous eccentric exercise by facilitating glycogen resynthesis, reversing vascular derangements, augmenting mitochondrial function, and stimulating muscle protein synthesis.


Assuntos
Exercício Físico/fisiologia , Temperatura Alta/uso terapêutico , Músculo Esquelético/lesões , Mialgia/terapia , Adaptação Fisiológica , Animais , Glicogênio/biossíntese , Humanos , Microcirculação , Mitocôndrias Musculares/fisiologia , Fadiga Muscular/fisiologia , Proteínas Musculares/biossíntese , Força Muscular/fisiologia , Músculo Esquelético/irrigação sanguínea , Mialgia/etiologia
7.
Wilderness Environ Med ; 31(3): 327-331, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32709490

RESUMO

The case of a 42-y-old rock climber who sustained a complete, isolated rupture of the short head of the biceps brachii muscle after falling onto his upper arm while bouldering is presented. This is the first description of this rare injury after a climbing accident. Moreover, there is no definitive consensus on whether and when surgical intervention is necessary in such a case. We performed a direct end-to-end suture of the muscle belly through an open surgical approach. Postoperatively, we performed a detailed follow-up, including clinical examinations and sonography and magnetic resonance imaging to check the integrity of the suture. After 6 mo, our patient had regained a full range of motion without functional complaints or pain. Concerning the sports-specific outcome, we only found a slight decrease in rock-climbing abilities (Union Internationale des Associations d'Alpinisme Scale of Difficulty grade VII+ postsurgery compared to VIII preinjury). In conclusion, we suggest that early surgical reapproximation of the muscle belly might be the best treatment option for this severe but rare injury in athletes.


Assuntos
Acidentes por Quedas , Montanhismo , Músculo Esquelético/lesões , Ruptura/terapia , Adulto , Humanos , Masculino , Volta ao Esporte , Ruptura/etiologia , Resultado do Tratamento
8.
J Sports Sci ; 38(21): 2423-2429, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32614675

RESUMO

ACE I/D polymorphism has been recently associated with the susceptibility to inflammation and muscle damage after exercise. The aim of this study was to understand the association between the ACE I/D polymorphism and muscle injuries in a large cohort of elite football players from two different countries. Seven hundred and ten male elite football players from Italy (n = 341) and Japan (n = 369) were recruited for the study. Genomic DNA was extracted from either the buccal epithelium or saliva using a standard protocol. Structural-mechanical injuries and functional muscle disorders were recorded from 2009 to 2018. A meta-analysis was performed using Review Manager 5.3.5. In the Japanese cohort, the ACE I/D polymorphism was significantly associated with muscle injury using the D-dominant model (OR: 0.48, 95% CI: 0.24-0.97, P = 0.040). The meta-analysis showed that in the pooled model (Italian and Japanese populations), the frequencies of the DD+ID genotypes were significantly lower in the injured groups than in non-injured groups (OR: 0.61, 95% CI: 0.38-0.98, P = 0.04) with a low degree of heterogeneity (I2  = 0%). Our findings suggest that the ACE I/D polymorphism could influence the susceptibility to developing muscle injuries among football players.


Assuntos
Músculo Esquelético/lesões , Peptidil Dipeptidase A/genética , Polimorfismo Genético , Futebol/lesões , Predisposição Genética para Doença , Genótipo , Humanos , Itália , Japão , Masculino , Adulto Jovem
9.
Orthopade ; 49(8): 737-748, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32710138

RESUMO

Gluteal insufficiency or hip abductor mechanism deficiency mainly following (revision) total hip replacement is associated with highly painful complaints and severe suffering of patients. It represents a great diagnostic and therapeutic challenge. Differentiated conservative treatment pathways, open surgical and endoscopic anatomic repair techniques with intact gluteal musculature and muscle transfer are available as salvage procedures for chronic not anatomically reconstructable mass ruptures. A stepwise diagnostic and therapeutic approach is required for restoration of the quality of life and painless or almost painless mobility of affected patients in occupation and daily life.


Assuntos
Artralgia/etiologia , Artroplastia de Quadril/métodos , Artroplastia de Quadril/psicologia , Nádegas/lesões , Músculo Esquelético/lesões , Músculo Esquelético/cirurgia , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos/métodos , Traumatismos dos Tendões/etiologia , Artralgia/diagnóstico , Artralgia/cirurgia , Nádegas/cirurgia , Endoscopia , Humanos , Traumatismos dos Nervos Periféricos/diagnóstico , Traumatismos dos Nervos Periféricos/epidemiologia , Traumatismos dos Nervos Periféricos/etiologia , Traumatismos dos Nervos Periféricos/terapia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Reoperação , Ruptura , Traumatismos dos Tendões/diagnóstico , Traumatismos dos Tendões/epidemiologia , Traumatismos dos Tendões/terapia , Resultado do Tratamento
10.
Arch. med. deporte ; 37(197): 183-190, mayo-jun. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-195230

RESUMO

INTRODUCCIÓN: Tanto la inmersión en agua fría como las prendas de compresión han sido usadas rutinariamente para acelerar la recuperación después del ejercicio, sin embargo, hay una falta de conocimiento del uso de ambas técnicas de forma simultánea. Pressurice Compressport, es una herramienta simple, no farmacológica y carente de efectos secundarios que permite aplicar la crioterapia compresiva (CC). OBJETIVO: Investigar el efecto crónico del Pressurice Compressport, tras cada partido, y sesión de entrenamiento, sobre los marcadores de daño muscular, la fuerza muscular y la fatiga. MÉTODOS: Un diseño de cohorte prospectivo. En 24 jugadores de baloncesto masculinos divididos en dos grupos, recuperación (RP) (n = 12) y control (GC) (n = 12). Los marcadores séricos del metabolismo muscular, la fuerza de cuádriceps (FC) y los valores de esfuerzo percibido (RPE) por escala de Borg CR10, se midieron en 3 momentos del estudio: a) día 1, (T1); b) día 28 (T2) y c) día 56 (T3). La CC se aplicó inmediatamente después de cada partido y entrenamiento. RESULTADOS: Se observó una disminución progresiva de todos los marcadores de daño muscular al final de la pretemporada en el grupo RP. Por el contrario, en el GC aumentaron y fueron significativas para la creatina quinasa (CK) (T1 vs. T3 p < 0,05). El curso temporal de la mioglobina (Mb) en el grupo RP (p > 0,05), siguió un patrón diferente al GC (p < 0,05). En RP los RPE disminuyeron significativamente (p < 0,05) en todos los puntos del estudio. La FC fue mayor en el RP que en el GC, además se obtuvieron ganancias a lo largo de la pretemporada en RP y una disminución en GC. CONCLUSIÓN: La CC es potencialmente capaz de promover la recuperación del daño muscular asociada con la competición y el entrenamiento, con reducciones en los marcadores del daño muscular, mejoras de la fuerza muscular y disminución significativa RPE


INTRODUCTION: Both cold water immersion and compression garments have been routinely used to speed recovery after exercise, however, there is a lack of knowledge of applying both techniques simultaneously. Pressurice Compressport, which is a simple tool, non-pharmacological and free of side effects that allows the application of compressive cryotherapy (CC). OBJECTIVE: To investigate the chronic effect of Pressurice Compressport, after each match and training session, on the markers of muscle damage, muscle strength and fatigue. METHODS: A prospective cohort design. In 24 male basketball players divided into two groups, recovery (RP) (n = 12) and control (GC) (n = 12). Serum markers of muscle metabolism, quadriceps strength (FC) and perceived effort values (RPE) by Borg CR10 scale were measured at 3 times in the study: a) day 1, (T1); b) day 28 (T2) and c) day 56 (T3). The CC was applied immediately after each match and training. Results: A progressive decrease in all markers of muscle damage was observed at the end of the pre-season in the RP group. On the contrary, in the GC they increased significantly for creatine kinase (CK) (T1 vs. T3 p < 0.05). The time course of myoglobin (Mb) in the RP group (p > 0.05) followed a pattern different from that of GC (p < 0.05). In RP, the RPE significantly decreased (p < 0.05) in all points of the study. The HR was higher in the RPE than in the GC, in addition gains were obtained throughout the pre-season in RPE and a decrease in GC. CONCLUSION: CC is potentially capable of promoting recovery from muscle damage associated with competition and training, with reductions in markers of muscle damage, improvements in muscle strength and significant decrease in RPE


Assuntos
Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Crioterapia/métodos , Traumatismos em Atletas/prevenção & controle , Músculo Esquelético/lesões , Basquetebol/fisiologia , Recuperação de Função Fisiológica/fisiologia , Estudos Prospectivos , Fadiga Muscular/fisiologia , Força Muscular/fisiologia , Bandagens Compressivas , Mioglobina/sangue , Valores de Referência , Fatores de Tempo , Reprodutibilidade dos Testes
11.
Jt Dis Relat Surg ; 31(2): 312-319, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584731

RESUMO

OBJECTIVES: This study aims to assess the functional outcomes, static-dynamic postural stability of patients and evaluate electromyographic activity of gluteus medius (GMed) muscle during gait and spatiotemporal parameters of gait in patients after antegrade intramedullary nailing (IMN) of femoral shaft fractures with trochanter tip entry. PATIENTS AND METHODS: Sixteen patients (15 males, 1 female; mean age 34.8±15.2 years; range, 18 to 58 years) who were treated with an antegrade trochanteric IMN between January 2009 and July 2013 and eight healthy male controls (mean age 39.3±9.8 years; range, 27 to 57 years) were included in this retrospective study. Muscle strength, static and dynamic postural stability and fall risk were evaluated. In addition, spatiotemporal parameters of gait were assessed using a validated wireless inertial sensing device and a wireless electromyography (EMG) device was used to measure electromyographic activity of GMed muscle in both groups. RESULTS: There were significant differences in muscle strength, functional and dynamic balance test scores between operated and intact sides (one-leg hop test score p=0.009, balance test scores p<0.001-0.033). There were significant differences in functional and quality of life physical function test scores between groups (one-leg hop test score p=0.014). However, no significant differences were found in EMG results, dynamics balance, and statics postural stability test scores between groups (p>0.05). CONCLUSION: After isolated femur fracture, patients treated with antegrade trochanteric IMN demonstrated good static and dynamic stability and poor functional outcomes compared to controls. In conclusion, patients with antegrade trochanteric IMN have good balance but poor functional performance; however, further studies are needed to find out the primary reason for these results.


Assuntos
Pinos Ortopédicos/efeitos adversos , Nádegas , Fixação Intramedular de Fraturas/efeitos adversos , Fraturas do Quadril/cirurgia , Músculo Esquelético , Complicações Pós-Operatórias , Adulto , Nádegas/diagnóstico por imagem , Nádegas/lesões , Eletromiografia/métodos , Feminino , Fixação Intramedular de Fraturas/instrumentação , Fixação Intramedular de Fraturas/métodos , Marcha , Humanos , Masculino , Força Muscular , Músculo Esquelético/lesões , Músculo Esquelético/fisiopatologia , Avaliação de Resultados em Cuidados de Saúde , Desempenho Físico Funcional , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Equilíbrio Postural , Estudos Retrospectivos , Análise Espaço-Temporal
12.
Am J Sports Med ; 48(9): 2287-2294, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32485114

RESUMO

BACKGROUND: Lower extremity injuries are the most common injuries in professional sports and carry a high burden to players and teams in the National Football League (NFL). Injury prevention strategies can be refined by a foundational understanding of the occurrence and effect of these injuries on NFL players. PURPOSE: To determine the incidence of specific lower extremity injuries sustained by NFL players across 4 NFL seasons. STUDY DESIGN: Descriptive epidemiology study. METHODS: This retrospective, observational study included all time-loss lower extremity injuries that occurred during football-related activities during the 2015 through 2018 seasons. Injury data were collected prospectively through a leaguewide electronic health record (EHR) system and linked with NFL game statistics and player participation to calculate injury incidence per season and per 10,000 player-plays for lower extremity injuries overall and for specific injuries. Days lost due to injury were estimated through 2018 for injuries occurring in the 2015 to 2017 seasons. RESULTS: An average of 2006 time-loss lower extremity injuries were reported each season over this 4-year study, representing a 1-season risk of 41% for an NFL player. Incidence was stable from 2015 to 2018, with an estimated total missed time burden each NFL season of approximately 56,700 player-days lost. Most (58.7%) of these injuries occurred during games, with an overall higher rate of injuries observed in preseason compared with regular season (11.5 vs 9.4 injuries per 10,000 player-plays in games). The knee was the most commonly injured lower extremity region (29.3% of lower body injuries), followed by the ankle (22.4%), thigh (17.2%), and foot (9.1%). Hamstring strains were the most common lower extremity injury, followed by lateral ankle sprains, adductor strains, high ankle sprains, and medial collateral ligament tears. CONCLUSION: Lower extremity injuries affect a high number of NFL players, and the incidence did not decrease over the 4 seasons studied. Prevention and rehabilitation protocols for these injuries should continue to be prioritized.


Assuntos
Traumatismos em Atletas/epidemiologia , Futebol Americano/lesões , Extremidade Inferior/lesões , Humanos , Incidência , Ligamentos/lesões , Músculo Esquelético/lesões , Estudos Retrospectivos , Ruptura/epidemiologia , Entorses e Distensões/epidemiologia
13.
Am J Sports Med ; 48(9): 2277-2286, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32543878

RESUMO

BACKGROUND: Clinical use of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) has gained momentum as treatment for muscle injuries. Exosomes, or small cell-derived vesicles, could be helpful if they could deliver the same or better physiological effect without cell transplantation into the muscle. HYPOTHESIS: Local delivery of exosomes derived from PRP (PRP-exos) or MSCs (MSC-exos) to injured muscles hastens recovery of contractile function. STUDY DESIGN: Controlled laboratory study. METHODS: In a rat model, platelets were isolated from blood, and MSCs were isolated from bone marrow and expanded in culture; exosomes from both were isolated through ultracentrifugation. The tibialis anterior muscles were injured in vivo using maximal lengthening contractions. Muscles were injected with PRP-exos or MSC-exos (immediately after injury and 5 and 10 days after injury); controls received an equal volume of saline. Histological and biochemical analysis was performed on tissues for all groups. RESULTS: Injury resulted in a significant loss of maximal isometric torque (66% ± 3%) that gradually recovered over 2 weeks. Both PRP-exos and MSC-exos accelerated recovery, with similar faster recovery of contractile function over the saline-treated group at 5, 10, and 15 days after injury (P < .001). A significant increase in centrally nucleated fibers was seen with both types of exosome groups by day 15 (P < .01). Genes involved in skeletal muscle regeneration were modulated by different exosomes. Muscles treated with PRP-exos had increased expression of Myogenin gene (P < .05), whereas muscles treated with MSC-exos had reduced expression of TGF-ß (P < .05) at 10 days after muscle injury. CONCLUSION: Exosomes derived from PRP or MSCs can facilitate recovery after a muscle strain injury in a small-animal model likely because of factors that can modulate inflammation, fibrosis, and myogenesis. CLINICAL RELEVANCE: Given their small size, low immunogenicity, and ease with which they can be obtained, exosomes could represent a novel therapy for many orthopaedic ailments.


Assuntos
Exossomos/transplante , Células-Tronco Mesenquimais , Músculo Esquelético/lesões , Plasma Rico em Plaquetas , Animais , Ratos , Recuperação de Função Fisiológica , Regeneração
15.
Plast Reconstr Surg ; 146(1): 43e-53e, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32590650

RESUMO

BACKGROUND: Skeletal muscle trauma can produce grave functional deficits, but therapeutic options remain limited. The authors studied whether a decellularized skeletal muscle scaffold would provide benefits in inducing skeletal muscle regeneration over acellular dermal matrices. METHODS: Eighty-two rat muscle defects were surgically created and assigned to no intervention or implantation of AlloDerm, Strattice, decellularized rat muscle, or decellularized rat dermis to 30 or 60 days. Decellularized rat muscle and dermis were prepared using a negative pressure-assisted protocol. Assessment for cellularity, neovascularization, myogenesis, inflammation and fibrosis were done histologically and by polymerase chain reaction. RESULTS: Histology showed relative hypercellularity of AlloDerm (p < 0.003); Strattice appeared encapsulated. Immunofluorescence for CD31 and myosin heavy chain in decellularized rat muscle revealed dense microvasculature and peripheral islands of myogenesis. MyoD expression in muscle scaffolds was 23-fold higher than in controls (p < 0.01). Decellularized rat muscle showed no up-regulation of COX-2 (p < 0.05), with less expression than decellularized rat dermis and Strattice (p < 0.002). Decellularized rat muscle scaffolds expressed tumor necrosis factor-α less than Strattice, AlloDerm, and decellularized rat dermis (p < 0.01); collagen-1a less than decellularized rat dermis and Strattice (p < 0.04); α-smooth muscle actin 7-fold less than AlloDerm (p = 0.04); and connective tissue growth factor less than Strattice, AlloDerm, and decellularized rat dermis (p < 0.02). CONCLUSION: Decellularized muscle matrix appears to reduce inflammation and fibrosis in an animal muscle defect as compared with dermal matrices and promotes greater expression of myocyte differentiation-inducing genes.


Assuntos
Derme Acelular , Músculo Esquelético , Engenharia Tecidual/métodos , Tecidos Suporte , Animais , Modelos Animais de Doenças , Masculino , Músculo Esquelético/citologia , Músculo Esquelético/lesões , Ratos , Ratos Sprague-Dawley , Cicatrização
16.
Int J Sports Med ; 41(11): 751-758, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32485778

RESUMO

We investigated early effects of Whole-Body Electromyostimulation added to hypocaloric diet on metabolic syndrome features in sedentary middle-aged individuals. We randomly assigned 25 patients to Whole-Body Electromyostimulation plus caloric restriction or caloric restriction alone for 26 weeks. Anthropometrics, blood pressure, fasting glucose and insulin, HOMA-IR, glycated hemoglobin, lipids, uric acid, creatinphosphokynase, C-reactive protein were assessed. Body composition was evaluated with direct-segmental, multi-frequency Bioelectrical Impedance Analysis. Both groups lost approximately 10% of weight, with similar effects on waist circumference and fat mass. Change in free-fat mass was significantly different between groups (caloric restriction -1.5±0.2 vs. Whole-Body Electromyostimulation plus caloric restriction +1.1±0.4 kg, p=0.03). Whole-Body Electromyostimulation plus caloric restriction group experienced greater percent reductions in insulin (-45.5±4.4 vs. -28.2±3.6%, p=0.002), HOMA-IR (-51.3±3.2 vs. -25.1±1.8%, p=0.001), triglycerides (-22.5±2.9 vs. -4.1±1.6%, p=0.004) and triglycerides/HDL (p=0.028). Subjects trained with Whole-Body Electromyostimulation had also significant improvement in systolic pressure (138±4 vs. 126±7 mmHg, p=0.038). No discontinuations for adverse events occurred. In middle-aged sedentary subjects with the metabolic syndrome, Whole-Body Electromyostimulation with caloric restriction for 26 weeks can improve insulin-resistance and lipid profile compared to diet alone. Further studies are needed to ascertain long-term efficacy and feasibility of this approach in individuals with the metabolic syndrome.


Assuntos
Restrição Calórica , Terapia por Estimulação Elétrica/métodos , Síndrome Metabólica/terapia , Antropometria , Biomarcadores/sangue , Glicemia/metabolismo , Colesterol/sangue , HDL-Colesterol/sangue , Creatina Quinase/sangue , Dieta Redutora , Terapia por Estimulação Elétrica/efeitos adversos , Feminino , Humanos , Insulina/sangue , Resistência à Insulina , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/dietoterapia , Pessoa de Meia-Idade , Músculo Esquelético/enzimologia , Músculo Esquelético/lesões , Estudo de Prova de Conceito , Triglicerídeos/sangue , Perda de Peso
17.
Int. j. morphol ; 38(3): 804-810, June 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1098323

RESUMO

Honey is a natural antioxidant that its protective effects have been proven against ischemia-reperfusion (IR) injury. The aim of this study was to evaluate the ameliorative effect of Persian Honey, Apis mellifera meda skorikov, on gastrocnemius muscle IR injury. Eighty adult male Sprague-Dawley rats weighing 250-300 g were used. They were divided into ten groups (N=8 per group). The ischemia was conducted with a silk suture 6-0 using the slipknot technique. All groups were rendered in ischemic for 3 h, and reperfused for various times of 3 days (3-day reperfusion), 7 days (7-day reperfusion), 14 days (14-day reperfusion), and 28 days (28-day reperfusion). Half of the groups had experimental honey (5 %) treatment immediately after ischemia. After reperfusion, the rats, based on the grouping, were killed with high doses of anesthetic, and the gastrocnemius muscles were removed and fixed. After the tissue processing, the evaluation of edema and mast cells infiltration was performed with hematoxylin-eosin and toluidine blue staining, respectively. TNF-α was detected with immunohistochemistry method. The amount of TNF-α as an index of acute inflammatory except the 3rd day significantly decreased on the other day of reperfusion (7th, 147th and 287th days). The mast cells infiltration was significantly decreased on 77th and 147th days. The tissue edema was decreased significantly in honey administrated group in the comparison with placebo groups. Honey administration can reduce damage caused by ischemia-reperfusion in the rat gastrocnemius muscle.


La miel es un antioxidante natural; sus efectos protectores han sido probados contra la lesión por isquemiareperfusión (IR). El objetivo de este estudio fue evaluar el efecto de mejora de la miel persa Apis mellifera meda skorikov, en la lesión por IR del músculo gastrocnemio. Se utilizaron 80 ratas Sprague-Dawley macho adultas con un peso entre 250 y 300 g divididas en diez grupos (N = 8 por grupo). La isquemia se realizó con una sutura de seda 6-0 utilizando la técnica slipknot permaneciendo isquémicos durante 3 h. La reperfusión se realizó durante varios tiempos de 3 días, 7 días (reperfusión de 7 días), 14 días (reperfusión de 14 días) y 28 días (28 días reperfusión). La mitad de los grupos recibió tratamiento experimental con miel (5 %) inmediatamente después de la isquemia. Después de la reperfusión, las ratas, fueron sacrificadas con altas dosis de anestésico, y los músculos gastrocnemios fueron removidos y fijados. Después de procesar el tejido, se realizó la evaluación del edema y la infiltración de mastocitos se realizó con tinción de hematoxilina-eosina y azul de toluidina, respectivamente. TNF-α se detectó con el método de inmunohistoquímica. La cantidad de TNF-α como índice de inflamación inflamatoria aguda, excepto en el tercer día, disminuyó significativamente al día siguiente de la reperfusión (7, 14 y 28 días). La infiltración de mastocitos disminuyó significativamente a los 7 y 14 días. El edema tisular disminuyó significativamente en el grupo administrado con miel en comparación con los grupos placebo. El tratamiento con miel puede reducir el daño causado por la isquemia-reperfusión en el músculo gastrocnemio de la rata.


Assuntos
Animais , Masculino , Ratos , Traumatismo por Reperfusão/complicações , Apis mellifica/administração & dosagem , Músculo Esquelético/lesões , Mel , Imuno-Histoquímica , Traumatismo por Reperfusão/tratamento farmacológico , Apis mellifica/farmacologia , Ratos Sprague-Dawley , Músculo Esquelético/efeitos dos fármacos , Substâncias Protetoras
18.
Salud trab. (Maracay) ; 28(1): 35-45, jun. 2020. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1104332

RESUMO

El presente artículo identificó la prevalencia de síntomas de trastornos músculo esquelético relacionados al trabajo en extremidades superiores y su relación con algunos factores de riesgo vinculados al desempeño de las tareas, factores psicosociales, sexo, edad y antigüedad laboral. Utilizando un diseño exploratorio, correlacional y una muestra por conveniencia de 45 trabajadores (hombres/mujeres). Se exploró la presencia de síntomas mediante el cuestionario nórdico estandarizado para población chilena; la repetitividad, postura forzada, fuerza y algunos factores ambientales mediante la norma técnica para identificación y evaluación de factores de riesgo de Trastornos Musculo esqueléticos relacionados con el trabajo del Ministerio de Salud chileno, los factores psicosociales mediante el cuestionario de SUSESO-ISTAS 21 versión breve, y la edad, sexo y antigüedad laboral mediante una ficha propuesta por los autores. Los resultados (año 2017) muestran que el 8 % de los trabajadores no manifestó síntomas en extremidad superior y espalda. Que 48.9% de trabajadores sintomáticos son hombres y menores de 45 años (55.6%) de antigüedad laboral inferior de 5 años (73.4%). No se observó diferencias estadísticas entre exigencia psicosocial y presencia de síntomas de Trastornos Musculo esqueléticos. No obstante el 51.6% de los trabajadores sintomáticos de Trastornos Musculo esqueléticos, tenía nivel alto de riesgo psicosocial para la dimensión doble presencia. Se concluye que para el control y la prevención Trastornos Musculo esqueléticos en el trabajo es imprescindible el conocimiento de la población laboral a proteger y adoptar un enfoque biopsicosocial amplio que genere información para actuar racionalmente y con expectativas de solución(AU)


This study measured the prevalence of musculoskeletal symptoms related to work using the upper extremities and their relationship to risk factors linked to task performance, psychosocial risk factors, sex, age and length of employment. The study design was exploratory and correlational, conducted in a convenience sample of 45 workers. The presence of symptoms was explored using the Nordic Musculoskeletal Questionnaire for a Chilean population, along with repetitiveness, forced posture, strength. Environmental factors were explored using the standard identification and evaluation of risk factors based on the Work-related Musculoskeletal Disorders inventory (TMERT in Spanish) of the Chilean Ministry of Health. Psychosocial factors were explored using the short version (21 items) of the Psychosocial Risk of the Workplace (SUSESOISTAS in Spanish) questionnaire, which explores age, sex and length of employment. Results in 2017 show that 8% of workers reported no symptoms in the upper extremity or back. In addition, 48.9% of symptomatic workers were men under 45 years of age (55.6%), with less than 5 years of employment (73.4%). No statistically significant differences were observed between psychosocial demands and presence of musculoskeletal symptoms. However, 51.6% of workers with musculoskeletal symptoms had high levels of psychosocial risk for the dual presence. We conclude that specific knowledge of the working population is essential in order to protect them and to control and prevent musculoskeletal disorders at work. In addition, a comprehensive biopsychosocial approach that generates information to act rationally and with expectations of finding solutions must be adopted(AU)


Assuntos
Humanos , Dorso , Riscos Ocupacionais , Fatores de Risco , Músculo Esquelético/lesões , Extremidade Superior , Análise e Desempenho de Tarefas , Inquéritos e Questionários , Categorias de Trabalhadores
19.
Plast Reconstr Surg ; 146(3): 552-562, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32459729

RESUMO

BACKGROUND: Traumatic muscle loss often results in poor functional restoration. Skeletal muscle injuries cannot be repaired without substantial fibrosis and loss of muscle function. Given its regenerative properties, the authors evaluated outcomes of fetal tissue-derived decellularized matrix for skeletal muscle regeneration. The authors hypothesized that fetal matrix would lead to enhanced myogenesis and suppress inflammation and fibrosis. METHODS: Composite tissue composed of dermis, subcutaneous tissue, and panniculus carnosus was harvested from the trunk of New Zealand White rabbit fetuses on gestational day 24 and from Sprague-Dawley rats on gestational day 18 and neonatal day 3, and decellularized using a sodium dodecyl sulfate-based negative-pressure protocol. Six, 10-mm-diameter, full-thickness rat latissimus dorsi wounds were created for each treatment, matrix was implanted (excluding the defect groups), and the wounds were allowed to heal for 60 days. Analyses were performed to characterize myogenesis, neovascularization, inflammation, and fibrosis at harvest. RESULTS: Significant myocyte ingrowth was visualized in both allogeneic and xenogeneic fetal matrix groups compared to neonatal and defect groups based on myosin heavy chain immunofluorescence staining. Microvascular networks were appreciated within all implanted matrices. At day 60, expression of Ccn2, Col1a1, and Ptgs2 were decreased in fetal matrix groups compared to defect. Neonatal matrix-implanted wounds failed to show decreased expression of Col1a1 or Ptgs2, and demonstrated increased expression of Tnf, but also demonstrated a significant reduction in Ccn2 expression. CONCLUSIONS: Initial studies of fetal matrices demonstrate promise for muscle regeneration in a rat latissimus dorsi model. Further research is necessary to evaluate fetal matrix for future translational use and better understand its effects.


Assuntos
Matriz Extracelular/genética , Regulação da Expressão Gênica , Desenvolvimento Muscular/genética , Músculo Esquelético/lesões , Prenhez , Engenharia Tecidual/métodos , Tecidos Suporte , Animais , Animais Recém-Nascidos , Western Blotting , Matriz Extracelular/metabolismo , Feminino , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Gravidez , RNA/genética , Coelhos , Ratos , Ratos Sprague-Dawley
20.
Int J Sports Med ; 41(9): 582-588, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32353882

RESUMO

Acute prolonged endurance running has been shown to alter muscle-specific circulating microRNA (miRNA) levels. Here, eighteen participants completed an 8 km run. We assessed the levels of hsa-miR-1-3p, -133a-3p, -133b, and -206 and their correlation with conventional biomarkers following exercise. Compared to before exercise (Pre), 8 km run significantly increased the lactate level immediately after exercise (0 h). Myoglobin (Mb) level increased at 0 h while creatine kinase (CK) level increased 24 h after exercise (24 h). The levels of creatine kinase MB isoenzyme (CK-MB) and cardiac troponin I (cTnI) were all elevated at 24 h and within the normal physiological range; The levels of hsa-miR-1-3p, -133a-3p, -133b significantly increased at 0 h but only hsa-miR-133a-3p still elevated at 24 h. Only hsa-miR-206 level decreased at 24 h; Additionally, the changes of hsa-miR-1-3p and hsa-miR-133a-3p were correlated with Mb at 24 h. These findings suggest that muscle-specific miRNA elevation in plasma is likely physiological and that these miRNA may be used as potential biomarkers for load monitoring in individuals.


Assuntos
MicroRNA Circulante/sangue , Músculo Esquelético/metabolismo , Resistência Física/fisiologia , Corrida/fisiologia , Adaptação Fisiológica , Biomarcadores/sangue , Frequência Cardíaca/fisiologia , Humanos , Ácido Láctico/sangue , Masculino , Músculo Esquelético/lesões , Consumo de Oxigênio/fisiologia , Condicionamento Físico Humano/fisiologia , Mecânica Respiratória/fisiologia , Corrida/lesões , Adulto Jovem
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