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1.
Medicine (Baltimore) ; 100(21): e25947, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032704

RESUMO

ABSTRACT: To compare the speed of propagation of ultrasound (US) waves (SoS) of the lower leg with the clinical reference standard computed tomography (CT) at the level of lumbar vertebra 3 (L3) for muscle loss assessment. Both calf muscles of 50 patients scheduled for an abdominal CT were prospectively examined with ultrasound. A plexiglas-reflector located on the opposite side of the probe with the calf in between was used as a timing reference for SoS (m/s). CT measurements were performed at the level of L3 and included area (cm2) and attenuation (HU) of the psoas muscle, abdominal muscles, subcutaneous fat, visceral fat and abdominal area. Correlations between SoS, body mass index (BMI) and CT were determined using Pearson's correlation coefficient. Based on reported CT sarcopenia threshold values, receiver operating characteristic (ROC) analysis was performed for SoS. Inter-examiner agreement was assessed with the median difference, inter-quartile range (IQR) and intraclass correlation coefficients. SoS of the calf correlated moderately with abdominal muscle attenuation (r = 0.48; P < .001), psoas muscle attenuation (r = 0.40; P < .01), abdominal area (r = -0.44; P < .01) and weakly with subcutaneous fat area (r = -0.37; P < .01). BMI correlated weakly with psoas attenuation (r = -0.28; P < .05) and non-significantly with abdominal muscle attenuation. Normalization with abdominal area resulted in moderate correlations with abdominal muscle area for SoS (r = 0.43; P < .01) and BMI (r = -0.46; P < .001). Based on sarcopenia threshold values for skeletal muscle attenuation (SMRA), area under curve (AUC) for SoS was 0.724. Median difference between both examiners was -3.4 m/s with IQR = 15.1 m/s and intraclass correlation coefficient = 0.794. SoS measurements of the calf are moderately accurate based on CT sarcopenia threshold values, thus showing potential for muscle loss quantification.


Assuntos
Perna (Membro)/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Sarcopenia/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/fisiopatologia , Perna (Membro)/fisiopatologia , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Estudos Prospectivos , Curva ROC , Valores de Referência , Sarcopenia/fisiopatologia , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/fisiopatologia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Ultrassonografia
2.
Ugeskr Laeger ; 183(18)2021 05 03.
Artigo em Dinamarquês | MEDLINE | ID: mdl-33998443

RESUMO

Diabetic muscle infarction (DMI) is a rare microvascular complication with spontaneous necrosis of skeletal musculature, most often localised to the thigh. DMI presents as an acute onset of pain in a muscle or muscle group. DMI is probably underdiagnosed because of its rareness and many differential diagnoses, why patients often undergo unnecessary and invasive diagnostic testing. The condition can be diagnosed with magnetic resonance imaging and the treatment is supportive with analgesics, bedrest and glycaemic control. We present two cases of DMI in patients with long-standing Type 1 diabetes.


Assuntos
Diabetes Mellitus Tipo 1 , Perna (Membro) , Diabetes Mellitus Tipo 1/complicações , Humanos , Infarto/diagnóstico por imagem , Infarto/etiologia , Perna (Membro)/diagnóstico por imagem , Imageamento por Ressonância Magnética , Músculo Esquelético/diagnóstico por imagem , Coxa da Perna/diagnóstico por imagem
3.
Am J Case Rep ; 22: e930889, 2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33879760

RESUMO

BACKGROUND Clostridial myonecrosis, also known as gas gangrene, is a highly lethal necrotizing soft tissue infection. While commonly associated with trauma, clostridial myonecrosis may be the result of parenteral injection of medications. Epinephrine is the most commonly reported medication leading to gas gangrene. CASE REPORT A 60-year-old man presented to the Emergency Department (ED) with "the worst pain in his life" to the right thigh near the site at which he auto-injected epinephrine after multiple bee stings 10-11 h prior to arrival. Initial heart rate was 112 beats/min but all other vital signs were unremarkable at presentation. Due to extreme pain, a computed tomography (CT) scan was ordered, revealing prominent gas within the anterior compartment of the right thigh, mostly involving the vastus lateralis and rectus femoris, suggesting necrotizing fasciitis. Antimicrobials were initiated immediately and the patient was taken for surgical debridement within 70 min after obtaining the CT results. Clostridium perfringens was cultured from the patient's tissue. After several surgical debridement's, appropriate antimicrobial therapy, supportive care, and wound care, the patient's limb remained intact and he was discharged after 11 days. CONCLUSIONS With millions of epinephrine auto-injectors prescribed yearly in the United States, awareness of clostridial gas gangrene following epinephrine auto-injection for the provider may help guide decision-making in patients presenting with extreme pain, redness, or swelling near the injection site after epinephrine injection.


Assuntos
Desbridamento , Epinefrina/administração & dosagem , Gangrena Gasosa/etiologia , Hipersensibilidade , Mordeduras e Picadas de Insetos/terapia , Perna (Membro)/diagnóstico por imagem , Animais , Antibacterianos/uso terapêutico , Abelhas , Clostridium perfringens/isolamento & purificação , Epinefrina/efeitos adversos , Gangrena Gasosa/terapia , Humanos , Injeções Subcutâneas , Masculino , Tomografia Computadorizada por Raios X
4.
Medicina (Kaunas) ; 57(4)2021 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-33800568

RESUMO

Background and Objectives: The aim of this study was to assess if there are structural and functional changes of hands and legs already in early rheumatoid arthritis (ERA), compared with the population-based control group. Additionally, we aimed to identify if the changes are symmetrical in hands and legs and if there are factors that are associated with these changes. The study was conducted, and, thus far, the results have been controversial. Materials and Methods: The study group consisted of 83 consecutive patients with ERA and 321 control subjects. Dual-Energy X-Ray Absorptiometry (DXA) machine was used to measure bone, lean and fat mass. Inflammation and bone markers, smoking and nutritional habits were assessed, to evaluate the effects of different factors. The 30-Second Chair Stand Test (30-CST) and the Handgrip Strength Test (HST) were used to estimate muscle strength. Results: The presence of ERA was associated with lower arm, leg lean mass and higher fat mass of arm, compared with control subjects. ERA was also associated with lower mean handgrip in HST and worse muscle strength of legs in the 30-CST. Bone mass changes were not so evident both in arms and legs. Smoking habits did not seem to have relevant effect on bone mass, muscle structural and functional changes, both on hands and legs. In ERA, lean mass of arm and leg was negatively associated with C-reactive protein (CRP). The intake of proteins in ERA was not associated with lean mass changes both in hands and legs. Conclusions: Structural and functional changes of hands and legs are different in ERA. ERA patients had higher fat mass of arm, lower lean mass of arm and leg and, accordingly, decreased muscle function. The lowering of lean mass of arm and leg in ERA was associated with the elevation of CRP.


Assuntos
Artrite Reumatoide , Perna (Membro) , Absorciometria de Fóton , Artrite Reumatoide/complicações , Força da Mão , Humanos , Perna (Membro)/diagnóstico por imagem , Força Muscular , Músculo Esquelético/diagnóstico por imagem
5.
Mayo Clin Proc ; 96(5): 1184-1192, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33840522

RESUMO

OBJECTIVE: To compare outcomes among patients with calf deep vein thrombosis (DVT) stratified by management strategy because distal or calf DVT is said to have low rates of propagation, embolization, and recurrence and, as such, guideline recommendations include provisions for serial imaging without treatment. PATIENTS AND METHODS: Consecutive patients with ultrasound-confirmed acute DVT involving the calf veins (January 1, 2016, to August 1, 2018) were identified by scrutinizing the Gonda Vascular Center Ultrasound database. Patients were segregated into 2 categories depending on management strategy; anticoagulation vs serial surveillance ultrasound without anticoagulation. Outcomes including venous thromboembolism (VTE) recurrence, bleeding, death, and net clinical benefit were compared by treatment strategy. RESULTS: There were 483 patients with calf DVT identified; 399 were treated with anticoagulation therapy and 84 were managed with surveillance ultrasound. Patients in the surveillance group were older (70.0±13.9 vs 63.0±14.9 years; P<.001) and more likely to have had a recent hospitalization (76.2% [64/84] vs 45.4% [181/399]; P<.001). Common reasons for choosing ultrasound surveillance included guideline prescriptive (58.3% [49/84]), active bleeding (21.4% [18/84]), and recent surgery (17.9% [15/84]). The VTE recurrence composite was lower for patients treated with anticoagulants (7.3% [29/399]) compared with surveillance (14.3% [12/84]; P=.04). The DVT propagation was less frequent in the treated group (2.8% [11/399] vs 8.3% [7/84]; P=.01). There was no difference in bleeding or mortality outcomes by management strategy. Net clinical benefit (VTE recurrence plus major bleeding) favored anticoagulant therapy (9.8% [39/399] vs 20.2% [17/84]; P<.01). CONCLUSION: Patients with calf DVT treated with anticoagulants had significantly better outcomes compared with those managed by a strategy of serial ultrasound surveillance without increasing bleeding outcomes.


Assuntos
Anticoagulantes/uso terapêutico , Perna (Membro)/irrigação sanguínea , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/tratamento farmacológico , Conduta Expectante/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Seguimentos , Hemorragia/induzido quimicamente , Hemorragia/epidemiologia , Humanos , Perna (Membro)/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Recidiva , Análise de Sobrevida , Resultado do Tratamento , Ultrassonografia , Trombose Venosa/mortalidade
6.
Medicine (Baltimore) ; 100(11): e23576, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33725923

RESUMO

ABSTRACT: Short-term immobilization leads to fatty muscular degeneration, which is associated with various negative health effects. Based on literature showing very high correlations between MRI Dixon fat fraction and Speed-of-Sound (SoS), we hypothesized that we can detect short-term-immobilization-induced differences in SoS.Both calves of 10 patients with a calf cast on one side for a mean duration of 41 ±â€Š26 days were examined in relaxed position using a standard ultrasound machine. Calf perimeters were measured for both sides. A flat Plexiglas-reflector, placed vertically on the opposite side of the probe with the calf in-between, was used as a timing reference for SoS. SoS was both manually annotated by two readers and assessed by an automatic annotation algorithm. The thickness values of the subcutaneous fat and muscle layers were manually read from the B-mode images. Differences between the cast and non-cast calves were calculated with a paired t test. Correlation analysis of SoS and calf perimeter was performed using Pearson's correlation coefficient.Paired t test showed significant differences between the cast and non-cast side for both SoS (P < .01) and leg perimeter (P < .001). SoS was reduced with the number of days after cast installment (r = -0.553, P = .097). No significant differences were found for muscle layer thickness, subcutaneous fat layer thickness, mean fat echo intensity, or mean muscle echo intensity.Short-term-immobilization led to a significant reduction in SoS in the cast calf compared to the healthy calf, indicating a potential role of SoS as a biomarker in detecting immobilization-induced fatty muscular degeneration not visible on B-mode ultrasound.


Assuntos
Traumatismos da Perna/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Atrofia Muscular/diagnóstico por imagem , Restrição Física/efeitos adversos , Ultrassonografia/métodos , Adulto , Idoso , Moldes Cirúrgicos/efeitos adversos , Feminino , Humanos , Perna (Membro)/diagnóstico por imagem , Perna (Membro)/fisiopatologia , Traumatismos da Perna/fisiopatologia , Traumatismos da Perna/terapia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Atrofia Muscular/etiologia , Projetos Piloto , Estudos Prospectivos , Reprodutibilidade dos Testes , Som , Adulto Jovem
7.
Magn Reson Med ; 86(1): 115-130, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33565187

RESUMO

PURPOSE: To evaluate the repeatability of multinuclear interleaved 1 H/31 P NMR dynamic acquisitions in skeletal muscle and the impact of nuclear Overhauser enhancement (nOe) on the 31 P results at 3T in exercise-recovery and ischemia-hyperemia paradigms. METHODS: A 1 H/31 P interleaved pulse sequence was used to measure every 2.5 s a perfusion-weighted image, a T 2 ∗ map, a 31 P spectrum and 32 1 H spectra sensitive to deoxymyoglobin. 21 subjects performed a plantar flexion exercise and after recovery underwent an 8-min lower leg ischemia. The procedure was repeated in visit 2 with 12 subjects. An additional exercise bout without 1 H excitation was appended to visit 1. Individual 1 H RF pulse nOe was measured at rest in every visit. RESULTS: Repeatability scores (coefficient of variation, Bland-Altman analysis) were similar to those found in the literature using similar mono-nuclear acquisitions. |Pi]/[PCr], pH drop, creatine rephosphorylation rate (τPCr ), maximum perfusion, time to peak perfusion, and blood flow post-exercise showed high reliability (intraclass correlation coefficient > 0.7), whereas hemodynamic results from reactive hyperemia showed higher repeatability. After accounting for nOe, which increased Pi and PCr signal-to-noise ratio by 30%, no differences in 31 P results were observed between interleaved and 31 P MRS-only acquisitions. τPCr was unaffected by nOe. CONCLUSION: The method shows good repeatability for both paradigms while simultaneously providing multiple dynamic data sets on a clinical scanner. The nOe effects were accounted for on a per-subject and per-visit basis using a short 31 P reference scan. This multiparametric approach has a multitude of applications for the study of oxygen utilization and ATP turnover in the muscle.


Assuntos
Perna (Membro) , Músculo Esquelético , Exercício Físico , Humanos , Perna (Membro)/diagnóstico por imagem , Espectroscopia de Ressonância Magnética , Músculo Esquelético/diagnóstico por imagem , Reprodutibilidade dos Testes
8.
Clin Imaging ; 75: 1-4, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33477081

RESUMO

We describe a 40-year-old man with severe COVID-19 requiring mechanical ventilation who developed aorto-bi-iliac arterial, right lower extremity arterial, intracardiac, pulmonary arterial and ilio-caval venous thromboses and required right lower extremity amputation for acute limb ischemia. This unique case illustrates COVID-19-associated thrombotic complications occurring at multiple, different sites in the cardiovascular system of a single infected patient.


Assuntos
Hipertensão Pulmonar , Trombose , Trombose Venosa , Adulto , Amputação , Humanos , Perna (Membro)/diagnóstico por imagem , Perna (Membro)/cirurgia , Extremidade Inferior/diagnóstico por imagem , Extremidade Inferior/cirurgia , Masculino , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/cirurgia , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/cirurgia
11.
Muscle Nerve ; 62(4): 541-549, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32654203

RESUMO

MRI is a helpful tool for monitoring disease progression in late-onset Pompe disease (LOPD). Our study aimed to evaluate if muscle diffusion tensor imaging (mDTI) shows alterations in muscles of LOPD patients with <10% fat-fraction. We evaluated 6 thigh and 7 calf muscles (both legs) of 18 LOPD and 29 healthy controls (HC) with muscle diffusion tensor imaging (mDTI), T1w, and mDixonquant sequences in a 3T MRI scanner. The quantitative mDTI-values axial diffusivity (λ1 ), mean diffusivity (MD), radial diffusivity (RD), and fractional anisotropy (FA) as well as fat-fraction were analyzed. 6-Minute Walk Test (6-MWT) data were correlated to diffusion metrics. We found that mDTI showed significant differences between LOPD and HC in diffusion parameters (P < .05). Thigh muscles with <10% fat-fraction showed significant differences in MD, RD, and λ1-3 . MD positively correlated with 6-MWT (P = .06). To conclude, mDTI reveals diffusion restrictions in muscles of LOPD with and without fat-infiltration and reflects structural changes prior to fatty degeneration.


Assuntos
Doença de Depósito de Glicogênio Tipo II/diagnóstico por imagem , Perna (Membro)/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Coxa da Perna/diagnóstico por imagem , Adolescente , Adulto , Idoso , Imagem de Tensor de Difusão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
12.
Proc Natl Acad Sci U S A ; 117(26): 14645-14656, 2020 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-32522873

RESUMO

Focusing waves inside inhomogeneous media is a fundamental problem for imaging. Spatial variations of wave velocity can strongly distort propagating wave fronts and degrade image quality. Adaptive focusing can compensate for such aberration but is only effective over a restricted field of view. Here, we introduce a full-field approach to wave imaging based on the concept of the distortion matrix. This operator essentially connects any focal point inside the medium with the distortion that a wave front, emitted from that point, experiences due to heterogeneities. A time-reversal analysis of the distortion matrix enables the estimation of the transmission matrix that links each sensor and image voxel. Phase aberrations can then be unscrambled for any point, providing a full-field image of the medium with diffraction-limited resolution. Importantly, this process is particularly efficient in random scattering media, where traditional approaches such as adaptive focusing fail. Here, we first present an experimental proof of concept on a tissue-mimicking phantom and then, apply the method to in vivo imaging of human soft tissues. While introduced here in the context of acoustics, this approach can also be extended to optical microscopy, radar, or seismic imaging.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Ultrassonografia/métodos , Acústica , Análise de Fourier , Humanos , Perna (Membro)/diagnóstico por imagem , Imagens de Fantasmas , Espalhamento de Radiação
15.
Radiology ; 295(3): 616-625, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32286193

RESUMO

Background Upper extremity MRI and proton MR spectroscopy are increasingly considered to be outcome measures in Duchenne muscular dystrophy (DMD) clinical trials. Purpose To demonstrate the feasibility of acquiring upper extremity MRI and proton (1H) MR spectroscopy measures of T2 and fat fraction in a large, multicenter cohort (ImagingDMD) of ambulatory and nonambulatory individuals with DMD; compare upper and lower extremity muscles by using MRI and 1H MR spectroscopy; and correlate upper extremity MRI and 1H MR spectroscopy measures to function. Materials and Methods In this prospective cross-sectional study, MRI and 1H MR spectroscopy and functional assessment data were acquired from participants with DMD and unaffected control participants at three centers (from January 28, 2016, to April 24, 2018). T2 maps of the shoulder, upper arm, forearm, thigh, and calf were generated from a spin-echo sequence (repetition time msec/echo time msec, 3000/20-320). Fat fraction maps were generated from chemical shift-encoded imaging (eight echo times). Fat fraction and 1H2O T2 in the deltoid and biceps brachii were measured from single-voxel 1H MR spectroscopy (9000/11-243). Groups were compared by using Mann-Whitney test, and relationships between MRI and 1H MR spectroscopy and arm function were assessed by using Spearman correlation. Results This study evaluated 119 male participants with DMD (mean age, 12 years ± 3 [standard deviation]) and 38 unaffected male control participants (mean age, 12 years ± 3). Deltoid and biceps brachii muscles were different in participants with DMD versus control participants in all age groups by using quantitative T2 MRI (P < .001) and 1H MR spectroscopy fat fraction (P < .05). The deltoid, biceps brachii, and triceps brachii were affected to the same extent (P > .05) as the soleus and medial gastrocnemius. Negative correlations were observed between arm function and MRI (T2: range among muscles, ρ = -0.53 to -0.73 [P < .01]; fat fraction, ρ = -0.49 to -0.70 [P < .01]) and 1H MR spectroscopy fat fraction (ρ = -0.64 to -0.71; P < .01). Conclusion This multicenter study demonstrated early and progressive involvement of upper extremity muscles in Duchenne muscular dystrophy (DMD) and showed the feasibility of MRI and 1H MR spectroscopy to track disease progression over a wide range of ages in participants with DMD. © RSNA, 2020 Online supplemental material is available for this article.


Assuntos
Braço/diagnóstico por imagem , Perna (Membro)/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Músculo Esquelético/diagnóstico por imagem , Distrofia Muscular de Duchenne/diagnóstico por imagem , Espectroscopia de Prótons por Ressonância Magnética/métodos , Adolescente , Estudos de Casos e Controles , Criança , Estudos de Coortes , Estudos Transversais , Progressão da Doença , Estudos de Viabilidade , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos
16.
J Plast Reconstr Aesthet Surg ; 73(6): 1025-1030, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32115379

RESUMO

BACKGROUND: Sometimes, injecting indocyanine green (ICG) or isotope at distal limbs is insufficient especially in cases with low lymphatic function. The purpose of this study was to elucidate the usefulness of multi-lymphosome injection ICG lymphography. METHODS: Two hundred and six lower limbs of 103 patients were included. ICG lymphography was performed by injecting ICG in three lymphosomes per limb: dorsum of foot (saphenous lymphatics), the proximal side of the lateral condyle (lateral calf lymphatics), and the lateral side of the superior edge of the knee (lateral thigh lymphatics). We observed the presence or absence of a linear pattern at each injection site with a near-infrared camera. Lymphoscintigraphy was performed by injecting an isotope in the first web space, conventionally. Whole body scintigrams were taken 60 min after injection. RESULTS: In multi-lymphosome ICG lymphography, the lateral thigh lymphatics were observed as a linear pattern in 75.2% of patients, the lateral calf lymphatics in 72.8%, and the saphenous lymphatics in 84.5% of patients. There was not a significant difference between secondary and primary lymphedema (p = 0.57, 0.77, and 0.56 in the lateral thigh, the lateral calf, and the saphenous lymphatics, respectively). Among the 12 limbs classified as Type 5, at least one linear pattern was found in 10 limbs (83.3%). CONCLUSIONS: We observed a linear pattern in 83.3% of the limbs that were lymphoscintigraphic Type 5 by using multi-lymphosome ICG lymphography. There is a possibility that the results of this study can increase the number of patients eligible for lymphatico-venous anastomosis (LVA) and increase the success rate of LVA.


Assuntos
Corantes , Verde de Indocianina , Perna (Membro)/diagnóstico por imagem , Vasos Linfáticos/diagnóstico por imagem , Linfedema/diagnóstico por imagem , Linfografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Corantes/administração & dosagem , Feminino , Humanos , Verde de Indocianina/administração & dosagem , Injeções Intralinfáticas , Perna (Membro)/patologia , Vasos Linfáticos/patologia , Linfedema/patologia , Linfocintigrafia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
Radiol Med ; 125(5): 474-480, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32166719

RESUMO

PURPOSE: The purpose of this study was to evaluate the change in capillary blood volume in the muscles of the lower limbs, before and after exercise, using intravoxel incoherent motion (IVIM). MATERIALS AND METHODS: Diffusion-weighted images were obtained (with 16 b values) from the thigh and leg muscles of 11 subjects. The imaging was obtained before and immediately exercise; additionally, imaging was performed at 3 h, 6 h, and 24 h after exercise, and an IVIM index was calculated. The exercise involved walking up and down a flight of stairs (140 steps) ten times. The IVIM of each time course-before and after the exercise-was compared. In addition, we examined the correlation of IVIM measurements with the degree of the muscle ache that occurred at 24 h following the exercise. RESULTS: The IVIM index significantly increased after exercise compared with that before exercise (P < 0.01). IVIM decreased at 3 h following exercise, but increased again at 24 h. A correlation was found between the IVIM index at 24 h after exercise and the degree of the muscle ache (r = 0.80) CONCLUSIONS: The capillary blood volume significantly increased after exercise when compared to before exercise. The capillary blood volume decreased after exercise at 3 h and 6 h following exercise, but it increased again at 24 h. There was a correlation between the degree of muscle ache and the amount of capillary blood volume measured from the femoral muscle at 24 h after exercise.


Assuntos
Volume Sanguíneo , Capilares/fisiologia , Extremidade Inferior/irrigação sanguínea , Músculo Esquelético/irrigação sanguínea , Subida de Escada/fisiologia , Adulto , Capilares/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Perna (Membro)/irrigação sanguínea , Perna (Membro)/diagnóstico por imagem , Extremidade Inferior/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Mialgia/fisiopatologia , Estudos Prospectivos , Coxa da Perna/irrigação sanguínea , Coxa da Perna/diagnóstico por imagem , Fatores de Tempo , Adulto Jovem
18.
Ann Afr Med ; 19(1): 8-14, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32174609

RESUMO

Background: Deep-venous thrombosis (DVT) of lower limbs is one of the most common causes of death caused by pulmonary embolism. Many medical and surgical disorders are complicated by DVT. B-mode and color Doppler imaging are needed for the early diagnosis of DVT to prevent complications and sequalae of DVT. Objectives: The objectives of this study are to evaluate the role of Doppler ultrasound in diagnosing DVT of lower limbs and to study the spectrum of findings in patients with DVT in Zaria. Methodology: A retrospective study was carried out on patients who had Venous Doppler Scan in the Department of Radiology ABUTH, Zaria, Nigeria, for suspected DVT over a period of 4 years from February 2014 to January 2018. Scans were done using DC-3 and DC-6 Mindray Ultrasound machines (2009 and 2013 Models, respectively, Shantou, China) coupled with high-frequency (7.5-12 MHz) linear and low-frequency curvilinear (2-5 MHz) transducers. Analysis of cases of DVT was performed in terms of age, sex, clinical features, predisposing conditions, anatomic distribution, stage, and pattern of thrombus involvement in the veins. Data were analyzed using the SPSS version 20.0 and value of P < 0.005 was considered as statistically significant. Results: A total of 252 patients' results were reviewed which consisted of 122 males (48.4%) and 130 females (51.6%). The patients' ages ranged from 11 to 80 years, averaging 45.5 ± 9.56 years. The most common indication for Doppler request was leg swellings. The most common risk factor for DVT was malignancy (36%), cardiac disorders (18%), and traumas (14%). Sixty-six (61%) cases showed left-sided and 26 (24%) right-sided, whereas 16 (15%) cases showed bilateral lower limb involvement. Predominant thrombus was above-knee region with 54% in the superficial femoral vein. Chronic stage was seen in 46 (42%) cases, subacute in 44 (41%) cases, and acute in 18 (17%) cases. Conclusion: Middle-aged females, left-sided leg, and above-knee segment were predominantly affected with DVT; hence, this buttresses the need for Doppler ultrasound in the diagnosis of DVT in all patients.


Assuntos
Perna (Membro)/irrigação sanguínea , Perna (Membro)/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Trombose Venosa/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
20.
Gait Posture ; 77: 89-94, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32004951

RESUMO

BACKGROUND: Reduced push-off intensity during walking is thought to play an important role in age-related mobility impairment. We posit that an age-related shift toward shorter plantarflexor operating lengths during walking functionally limits force generation, and thereby the ability of those muscles to respond to increased propulsive demands during walking. RESEARCH QUESTION: To determine whether gastrocnemius muscle fascicle lengths during normal walking: (1) are shorter in older than young adults, and (2) correlate with one's capacity to increase the propulsive demands of walking to their maximum. METHODS: We used in vivo cine B-mode ultrasound to measure gastrocnemius fascicle lengths in 9 older and 9 young adults walking at their preferred speed, their maximum speed, and with horizontal impeding forces that increased in a ramped design at 1%BW/s to their maximum. A repeated measures ANOVA tested for effects of age and walking condition, and Pearson correlations assessed the relation between fascicle outcomes and condition performance. RESULTS: A tendency toward shorter medial gastrocnemius muscle fascicle lengths in older versus young adults was not statistically significant. However, older adults walked with reduced peak fascicle shortening during all conditions compared to young adults - an outcome not explained by reduced muscle-tendon unit shortening and exacerbated during tasks with greater than normal propulsive demand. As hypothesized, we found a strong and significant positive correlation in older subjects between gastrocnemius fascicle lengths during normal walking and performance on the ramped impeding force condition (p = 0.005, r²â€¯= 0.704), even after controlling for isometric strength (p = 0.011, r²â€¯= 0.792) and subject stature (p = 0.010, r²â€¯= 0.700). SIGNIFICANCE: Our findings provide muscle-level insight to develop more effective rehabilitation techniques to improve push-off intensity in older adults and assistive technologies designed to steer plantarflexor muscle fascicle operating behavior during functional tasks.


Assuntos
Marcha/fisiologia , Perna (Membro)/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Adulto , Fatores Etários , Idoso , Fenômenos Biomecânicos , Feminino , Humanos , Perna (Membro)/fisiologia , Perna (Membro)/fisiopatologia , Masculino , Músculo Esquelético/fisiologia , Músculo Esquelético/fisiopatologia , Equipamentos de Autoajuda , Tendões/fisiologia , Ultrassonografia , Caminhada/fisiologia , Adulto Jovem
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