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2.
Anal Chem ; 94(48): 16667-16674, 2022 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-36417314

RESUMO

The physicochemical properties of active pharmaceutical ingredients (APIs) can depend on their solid-state forms. Therefore, characterization of API forms is crucial for upholding the performance of pharmaceutical products. Solid-state nuclear magnetic resonance (SSNMR) spectroscopy is a powerful technique for API quantification due to its selectivity. However, quantitative SSNMR experiments can be time consuming, sometimes requiring days to perform. Sensitivity can be considerably improved using 1H SSNMR spectroscopy. Nonetheless, quantification via 1H can be a challenging task due to low spectral resolution. Here, we offer a novel 1H SSNMR method for rapid API quantification, termed CRAMPS-MAR. The technique is based on combined rotation and multiple-pulse spectroscopy (CRAMPS) and mixture analysis using references (MAR). CRAMPS-MAR can provide high 1H spectral resolution with standard equipment, and data analysis can be accomplished with ease, even for structurally complex APIs. Using several API species as model systems, we show that CRAMPS-MAR can provide a lower quantitation limit than standard approaches such as fast MAS with peak integration. Furthermore, CRAMPS-MAR was found to be robust for cases that are inapproachable by conventional ultra-fast (i.e., 100 kHz) MAS methods even when state-of-the-art SSNMR equipment was employed. Our results demonstrate CRAMPS-MAR as an alternative quantification technique that can generate new opportunities for analytical research.


Assuntos
Cãibra Muscular , Humanos , Espectroscopia de Ressonância Magnética/métodos , Preparações Farmacêuticas
4.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 53(6): 1090-1092, 2022 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-36443057

RESUMO

Here, we reported two cases with hyperthyroidism who complained of myalgia and muscle cramps during treatment with methimazole tablets (or Thyrozol, the brand name). One case experienced muscle cramps after taking Thyrozol for 6 months, and by this time the patient's thyroid function had returned to normal. In the other case, pain caused by muscular cramps began after the patient took Thyrozol for two weeks and the patient's thyroid function had not returned to normal yet at the time. In both cases, pain caused by muscle cramps appeared while the patients were taking Thyrozol. The myalgia persisted in spite of a reduction in the Thyrozol dose, but was significantly relieved with the discontinuation of Thyrozol. Myalgia and muscle cramps did not recur after the patients were switched to methimazole ointment. There was a strong temporal association between oral administration of Thyrozol and pain caused by muscle cramps, which may indicate that myalgia and muscle cramps are adverse reactions of Thyrozol. Looking into the relevant literature on the topic, we explored in this report the possible mechanisms of the onset of muscle cramps associated with Thyrozol, and compared the adverse reactions of two different formulations of methimazole, intending to provide more clinical experience for the treatment of hyperthyroidism and the management of rare adverse reactions related to antithyroid drugs.


Assuntos
Hipertireoidismo , Metimazol , Humanos , Metimazol/efeitos adversos , Cãibra Muscular/induzido quimicamente , Mialgia , Hipertireoidismo/tratamento farmacológico , Comprimidos
5.
Medicine (Baltimore) ; 101(41): e31145, 2022 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-36254085

RESUMO

Muscle cramps are frequently overlooked and worsen the quality of life in patients with chronic liver disease (CLD). Therefore, a valuable biomarker for predicting muscle cramps is required in the clinical setting. This study aimed to investigate whether the serum Mac-2-binding protein glycosylation isomer (M2BPGi) levels, a reliable liver fibrosis marker, could predict muscle cramps in patients with CLD. This retrospective study included 80 patients with CLD. Muscle cramps were assessed using a questionnaire regarding their presence, frequency, pain severity, and duration. The associated predictors were analyzed using logistic regression analysis. The diagnostic accuracy and optimal cutoff values were evaluated using receiver operating characteristic curves. Of the 80 patients, 55% had muscle cramps and showed significantly higher serum M2BPGi levels than those without them (4.54 cutoff index [COI] vs 2.20; P = .001). Multivariate analysis revealed that M2BPGi (odds ratio [ORs], 1.19; 95% confidence interval, 1.003-1.42; P = .046) was independently associated with the presence of muscle cramps. The optimal COI value for predicting muscle cramps was 3.95, and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 61.4%, 80.6%, 79.4%, 63.0%, and 70.0%, respectively. Patients with a COI value ≥3.95 had a 2-fold higher incidence of muscle cramps than patients with a COI value <3.95 (79% vs 37%; P < .001). M2BPGi levels were also associated with the duration of muscle cramps. Serum M2BPGi appears useful as a biomarker for predicting muscle cramps in patients with CLD.


Assuntos
Cãibra Muscular , Qualidade de Vida , Antígenos de Neoplasias , Glicosilação , Humanos , Cirrose Hepática , Glicoproteínas de Membrana , Cãibra Muscular/complicações , Estudos Retrospectivos
6.
Trials ; 23(1): 873, 2022 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-36242050

RESUMO

BACKGROUND: Neuromuscular electrical stimulation (NMES) is an established therapy that has been widely used for many decades to improve circulation in the legs. However, studies using NMES devices in an elderly, ambulant, and otherwise apparently healthy population are lacking; this is despite the use of such devices being indicated for lower leg symptoms (such as aches, pain, and cramps) that are frequently seen in older individuals. The main purpose of this study is to evaluate the effect of non-invasive foot NMES (administered using Revitive Medic©) on such symptoms compared to a sham in a 12-week period. METHODS: This is a single-center, single (participant)-blind, parallel-group, randomized, placebo-controlled (sham group), interventional study. Participants will be randomized to 1 of 3 groups (1:1:1) with each study group receiving a different type of foot NMES: Revitive sham; Revitive Medic© Program 1; or Revitive® Program 2. Each participant will be instructed to self-administer the foot NMES device for 30 min twice daily for 8 weeks. During the study, all participants will continue with their normal life, activities, medications, and diet with no restrictions. Following the 8-week NMES treatment program participants will be assessed for Canadian Occupational Performance Measure performance (COPM-P) and satisfaction (COPM-S) scores, lower leg pain, lower leg symptoms (heaviness, tiredness, aching and cramps), and blood flow volume and intensity. DISCUSSION: Revitive® foot NMES has been proven to increase blood circulation in the legs during use, which may help to relieve symptoms such as pain, heaviness, cramps, and tiredness. When NMES is applied to the plantar surface of the feet it indirectly induces contraction of the calf muscle, activating the musculo-venous pump and thus improving circulation. This study aims to provide data informing on the applicability of foot NMES for the management of leg symptoms that are likely to be indicative of poor circulation in an elderly (> 65 years) community population. TRIAL REGISTRATION: ISRCTN10576209.


Assuntos
Terapia por Estimulação Elétrica , Perna (Membro) , Idoso , Canadá , Terapia por Estimulação Elétrica/efeitos adversos , Humanos , Vida Independente , Perna (Membro)/irrigação sanguínea , Cãibra Muscular , Dor/diagnóstico , Dor/etiologia , Dor/prevenção & controle
7.
MMW Fortschr Med ; 164(15): 29, 2022 09.
Artigo em Alemão | MEDLINE | ID: mdl-36064910
8.
Rev. neurol. (Ed. impr.) ; 75(6): 129-136, Sep 16, 2022. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-209610

RESUMO

Introducción: La enfermedad de McArdle está causada por una mutación en el gen PYGM y déficit de miofosforilasa muscular, resultando alterada la liberación de glucosa-1-P a partir del glucógeno. Suele manifestarse en la infancia con cansancio precoz y excesivo, mialgias, calambres y contracturas o rabdomiólisis, aunque no suele diagnosticarse hasta la etapa adulta. La creatincinasa se incrementa durante el ejercicio. Se presentan cuatro pacientes pediátricos, se resume la fisiopatología y se propone un algoritmo diagnóstico. Pacientes y métodos: Pacientes con edades entre 6 y 14 años. Se describe la anamnesis, la exploración física, la bioquímica, el electromiograma, el test de isquemia y el estudio genético, con biopsia muscular a un solo paciente. Se elabora un algoritmo a partir del test de isquemia. Resultados: En los tres varones, las mialgias aparecieron tras finalizar cada sesión deportiva, con un fenómeno second wind en un caso. Se apreció un test de isquemia sin elevación del lactato y marcada elevación del amonio en todos, una biopsia muscular con depósitos de glucógeno y ausencia de miofosforilasa, y gen PYGM con mutaciones homocigotas en todos. El tratamiento dietético les atenuó la sintomatología durante los ejercicios aeróbicos. Conclusiones: El test de isquemia resultó muy útil para demostrar una disfunción en la glucólisis anaeróbica. Se destaca que el suplemento oral de glucosa es muy útil para la enfermedad de McArdle, pero está contraindicado en los seis defectos de la glucólisis anaeróbica. El algoritmo también permite orientar el defecto de 20 miopatías metabólicas o estructurales, que se resumen.(AU)


INTRODUCTION: McArdle’s disease is caused by a mutation in the PYGM gene, causing a muscle myophosphorylase deficiency, altering the release of glucose-1-P from glycogen. It usually manifests itself in childhood with early and excessive tiredness, myalgias, cramps and contractures or rhabdomyolysis, although it is not usually diagnosed until adulthood. Creatine kinase increases sharply during exercise. Four pediatric patients are presented, the pathophysiology is summarized, and a diagnostic algorithm is proposed. PATIENTS AND METHODS: Ages between 6 and 14 years, the anamnesis, physical examination, biochemistry, elec­tro­myogram, ischemia test and genetic study are described. Muscle biopsy in a single patient. The algorithm was developed from the ischemia test. RESULTS: In the three men, myalgias appeared after finishing each sports session. Phenomenon ‘second wind’ in one case. Ischemia test without lactate elevation and marked ammonia elevation in all. Only one muscle biopsy with glycogen deposits and absence of myophosphorylase. PYGM gene with homozygous mutations in all. Dietary treatment attenuated their symptoms during aerobic exercises. CONCLUSIONS:The ischemia test was very useful to demonstrate a dysfunction in anaerobic glycolysis. It is worth noting that oral glucose supplementation is very useful in McArdle disease, but is contraindicated in all six defects of anaerobic glycolysis. The algorithm also allows targeting the defect of 20 metabolic or structural myopathies, which are summarized.(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Doença de Depósito de Glicogênio Tipo V/complicações , Doença de Depósito de Glicogênio Tipo V/diagnóstico , Glicogênio Fosforilase Muscular , Exercício Físico , Tolerância ao Exercício , Pacientes Internados , Exame Físico , Avaliação de Sintomas , Cãibra Muscular , Glicogênio/metabolismo , Neurologia , Mialgia , Rabdomiólise , Algoritmos
9.
PLoS One ; 17(7): e0271307, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35834513

RESUMO

BACKGROUND: Dialysis patients have been shown to have low serum carnitine due to poor nutrition, deprivation of endogenous synthesis from kidneys, and removal by hemodialysis. Carnitine deficiency leads to impaired cardiac function and dialysis-related hypotension which are associated with increased mortality. Supplementing with levocarnitine among hemodialysis patients may diminish incidence of intradialytic hypotension. Data on this topic, however, lacks consensus. METHODS: We conducted electronic searches in PubMed, Embase and Cochrane Central Register of Controlled Trials from January 1960 to 19th November 2021 to identify randomized controlled studies (RCTs), which examined the effects of oral or intravenous levocarnitine (L-carnitine) on dialysis-related hypotension among hemodialysis patients. The secondary outcome was muscle cramps. Study results were pooled and analyzed utilizing the random-effects model. Trial sequential analysis (TSA) was performed to assess the strength of current evidence. RESULTS: Eight trials with 224 participants were included in our meta-analysis. Compared to control group, L-carnitine reduced the incidence of dialysis-related hypotension among hemodialysis patients (pooled OR = 0.26, 95% CI [0.10-0.72], p = 0.01, I2 = 76.0%). TSA demonstrated that the evidence was sufficient to conclude the finding. Five studies with 147 participants showed a reduction in the incidence of muscle cramps with L-carnitine group (pooled OR = 0.22, 95% CI [0.06-0.81], p = 0.02, I2 = 74.7%). However, TSA suggested that further high-quality studies were required. Subgroup analysis on the route of supplementation revealed that only oral but not intravenous L-carnitine significantly reduced dialysis-related hypotension. Regarding dose and duration of L-carnitine supplementation, the dose > 4,200 mg/week and duration of at least 12 weeks appeared to prevent dialysis-related hypotension. CONCLUSION: Supplementing oral L-carnitine for at least three months above 4,200 mg/week helps prevent dialysis-related hypotension. L-carnitine supplementation may ameliorate muscle cramps. Further well-powered studies are required to conclude this benefit.


Assuntos
Hipotensão , Diálise Renal , Carnitina , Suplementos Nutricionais , Humanos , Hipotensão/tratamento farmacológico , Hipotensão/etiologia , Hipotensão/prevenção & controle , Cãibra Muscular/tratamento farmacológico , Cãibra Muscular/etiologia , Diálise Renal/efeitos adversos , Diálise Renal/métodos
10.
Transplant Cell Ther ; 28(9): 608.e1-608.e9, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35718343

RESUMO

Although autologous and allogeneic hematopoietic cell transplantation are used to treat hematologic diseases, they are associated with high morbidity and mortality. The goal of this cross-sectional study was to describe the incidence, characteristics, severity and clinical correlates of neuropathy and muscle cramps, as self-reported by hematopoietic cell transplantation survivors. We included all respondents to a survey conducted July 1, 2020, to June 30, 2021. Surveys were completed online or on-paper according to participants' preferences; they received one reminder if no survey was received 1 month after distribution. Statistics are primarily descriptive comparing subgroups of patients. Of 4641 potentially eligible patients, 1745 responded and are included in the analysis. Participants (615 [35%] autologous, 1130 [65%] allogeneic) were a median age of 64.1 years (interquartile range [IQR] 55.2-70.8) and surveyed at a median of 11 years (IQR 4-21) after their most recent transplantation. Neuropathy symptoms were reported by 65% of autologous recipients, 66% of allogeneic transplant recipients with current chronic graft versus host disease (GVHD), and 45% of allogeneic recipients who never developed chronic GVHD. Muscle cramps were reported by 56% of autologous recipients, and 52% of allogeneic recipients and were rated as "very painful" by nearly half of patients who experienced them. These results suggest that neuropathy symptoms and muscle cramps are much more prevalent among survivors after hematopoietic cell transplantation than previously recognized. Better approaches for prevention and treatment of these bothersome complications are needed.


Assuntos
Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Idoso , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Cãibra Muscular , Sobreviventes , Transplante Homólogo
11.
Acta Neurol Belg ; 122(5): 1305-1312, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35767146

RESUMO

INTRODUCTION: Autosomal recessive axonal neuropathy with neuromyotonia (ARAN-NM) is a rare disease entity linked to mutations in the histidine triad nucleotide binding protein 1 (HINT1) gene. The diagnosis and treatment of ARAN-NM are challenging. There have been few reports of ARAN-NM in East Asia. METHODS: A 15-year-old Chinese ARAN-NM patient developed muscle weakness, cramps and atrophy in the lower limbs at the age of 12. Electromyography (EMG) showed motor axonal degeneration and neuromyotonic discharges. Whole exome sequencing was performed. Bioinformatic methods and computational 3D structure modeling were used to analyze the identified variant. According to literature review, carbamazepine was prescribed to the patient. RESULTS: Genetic tests identified a homozygous mutation c.356G > T (p.R119L) in the HINT1 gene, which has never been reported before according to HGMD database. Several bioinformatic approaches predicted the variant was damaging. Computational 3D modeling indicated the variant changed the structure of HINT1 protein. Notably, we demonstrated the positive effects of carbamazepine in treating muscle stiffness and cramps of ARAN-NM. DISCUSSION: 22 variants have been reported in the HINT1 gene, and we identified a novel c.356G > T (p.R119L) variant. Our study expands the genetic spectrum of ARAN-NM. Moreover, large clinical trials are required to further demonstrate the role of carbamazepine in ARAN-NM.


Assuntos
Doença de Charcot-Marie-Tooth , Síndrome de Isaacs , Doenças do Sistema Nervoso Periférico , Adolescente , Carbamazepina/uso terapêutico , Doença de Charcot-Marie-Tooth/genética , Histidina/genética , Humanos , Síndrome de Isaacs/tratamento farmacológico , Síndrome de Isaacs/genética , Cãibra Muscular , Mutação/genética , Proteínas do Tecido Nervoso/genética , Nucleotídeos , Doenças do Sistema Nervoso Periférico/genética
12.
Anatol J Cardiol ; 26(5): 401-406, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35552177

RESUMO

BACKGROUND: Venous diseases encompass a large spectrum of abnormalities in the venous system with complaints, such as aching and swelling. Enhanced external counterpulsa-tion, proven safe and effective in patients with coronary artery disease and chronic heart failure, is a technique that increases venous return and augments diastolic blood pres-sure. This study assessed the effects of enhanced external counterpulsation on symp-toms of venous disease using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaire. METHODS: This study was designed prospectively for evaluating venous symptoms before and after enhanced external counterpulsation treatment. The study population con-sisted of 30 consecutive patients who were admitted to the cardiology clinic. The Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms ques-tionnaire was applied to assess venous symptoms one day before and after enhanced external counterpulsation treatment. RESULTS: The mean age of the patients was 64.62 ± 9.67 years. After 35 hours of enhanced external counterpulsation, 28 patients (93%) had at least 1 New York Heart Association functional class reduction compared with baseline and 43% of patients had 2 New York Heart Association functional classes improvement. The New York Heart Association class significantly decreased after enhanced external counterpulsation treatment (P<.001). There was a significant improvement in their swelling and night cramps symptoms compared with baseline (P< .001 and P = .05, respectively). Also, The left ventricular ejec-tion fraction significantly increased after the enhanced external counterpulsation treat- ment (P = .02). CONCLUSIONS: The findings obtained in the present study suggested that patients treated with enhanced external counterpulsation showed a significant reduction in swelling and night cramps symptoms. Although the total VEIN score did not change after the enhanced external counterpulsation procedure, improvement in swelling and night cramps under-lines the beneficial effects of enhanced external counterpulsation through the venousvascular territory.


Assuntos
Contrapulsação , Insuficiência Venosa , Idoso , Contrapulsação/efeitos adversos , Contrapulsação/métodos , Humanos , Perna (Membro) , Pessoa de Meia-Idade , Cãibra Muscular/etiologia , Qualidade de Vida , Resultado do Tratamento , Insuficiência Venosa/etiologia
13.
Eur J Neurol ; 29(9): 2744-2753, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35590453

RESUMO

BACKGROUND AND PURPOSE: Nabiximols is a therapeutic option for patients with multiple sclerosis (MS) spasticity whose symptoms are poorly controlled by conventional oral first-line medications. This study aimed to assess the relationship between changes in spasticity severity (measured on the 0-10 numeric rating scale [NRS]) and the presence of associated symptoms in patients treated with nabiximols, and to investigate the presence of the newly described 'spasticity-plus syndrome'. METHODS: We analyzed real-world data from the Italian Medicines Agency e-Registry on 1138 patients with MS spasticity who began treatment with nabiximols. Evaluation time points were baseline, 4 weeks, and 3, 6, 12 and 18 months after treatment start. RESULTS: Common symptoms associated with MS spasticity in this cohort were pain (38.4% at baseline), sleep disturbances (32.7%), and spasms/cramps (28.5%). Pain was frequently clustered with sleep disturbances (57.2% of pain cases) and spasms/cramps (43.9%). Approximately one-third of patients with data at all evaluation time points maintained treatment at 18 months. Nabiximols reduced the baseline mean spasticity 0-10 NRS score by 24.6% at Week 4, and by 33.9% at 18 months in treatment continuers. Nabiximols resolved a range of MS spasticity-associated symptoms at Week 4, and after 18 months in treatment continuers. CONCLUSION: This real-world analysis supports the concept of a spasticity-plus syndrome and suggests that nabiximols can favorably impact a range of spasticity-associated symptoms.


Assuntos
Doenças do Sistema Nervoso Central , Esclerose Múltipla , Canabidiol , Dronabinol , Combinação de Medicamentos , Humanos , Esclerose Múltipla/complicações , Esclerose Múltipla/tratamento farmacológico , Cãibra Muscular , Espasticidade Muscular/complicações , Espasticidade Muscular/etiologia , Dor/complicações , Espasmo/complicações , Resultado do Tratamento
14.
Rev Med Suisse ; 18(779): 785-788, 2022 Apr 27.
Artigo em Francês | MEDLINE | ID: mdl-35481501

RESUMO

Muscle cramps are very common and can reduce quality of life. There are multiple causes, including some physiological conditions, metabolic, endocrine, vascular disorders or neuromuscular diseases. Adequate management first requires differentiating cramps from other muscular phenomena. In most cases, the investigations are limited to a comprehensive history and clinical examination, but a biological, radiological and/or electrophysiological work-up may be useful. Treatment, when needed, is most often symptomatic and is unfortunately based on little evidence.


Les crampes musculaires sont fréquentes dans la population générale avec, dans certains cas, une altération importante de la qualité de vie. Leur cause est très variée, pouvant être en lien avec certaines conditions physiologiques ou avec des troubles métaboliques, endocriniens, vasculaires ou neuromusculaires. Une prise en charge adéquate nécessite dans un premier temps de différencier les crampes d'autres phénomènes musculaires. Dans la plupart des cas, les investigations se limitent à une anamnèse et un examen clinique, mais un bilan biologique, radiologique et/ou électrophysiologique peut être parfois indiqué. Le traitement, si nécessaire, est le plus souvent symptomatique et repose malheureusement sur peu d'évidences scientifiques.


Assuntos
Cãibra Muscular , Doenças Vasculares , Humanos , Cãibra Muscular/diagnóstico , Cãibra Muscular/etiologia , Cãibra Muscular/terapia , Qualidade de Vida , Doenças Vasculares/complicações
15.
Rev Med Suisse ; 18(779): 790-793, 2022 Apr 27.
Artigo em Francês | MEDLINE | ID: mdl-35481502

RESUMO

Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease of the adult age. It is an aggressive condition with a mean disease duration of only 3 to 5 years, characterized by progressive weakness and atrophy of limb, bulbar, and respiratory muscles. In general, death is caused by chronic hypoventilation due to respiratory insufficiency. No causal treatment is known today, but the two therapeutic agents authorized in Switzerland for the treatment of ALS can slow disease progression significantly. Other important therapeutic strategies include invasive/non-invasive ventilation, pain therapy, as well as physio-, ergo- and speech therapy on a regular basis.


La sclérose latérale amyotrophique (SLA) est la maladie du motoneurone la plus fréquente de l'adulte. C'est une maladie sévère (la survie moyenne est d'environ 3 à 5 ans), caractérisée par une dégénérescence des premier et deuxième motoneurones. Elle se manifeste par un déficit moteur amyotrophiant progressif des membres, de la langue, des muscles bulbaires et respiratoires. En général, le décès est causé par une hypoventilation chronique. Il n'existe actuellement aucun traitement curatif. Les deux médicaments autorisés en Suisse peuvent ralentir significativement la progression de la maladie et plusieurs nouvelles molécules sont à l'essai. Les traitements non médicamenteux/symptomatiques constituent le deuxième pilier de la prise en charge : ventilation non invasive, traitement des symptômes bulbaires, stabilisation du poids, physio et ergothérapie.


Assuntos
Esclerose Amiotrófica Lateral , Insuficiência Respiratória , Adulto , Esclerose Amiotrófica Lateral/diagnóstico , Esclerose Amiotrófica Lateral/terapia , Fasciculação/diagnóstico , Fasciculação/etiologia , Fasciculação/terapia , Humanos , Cãibra Muscular , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Suíça
16.
J Strength Cond Res ; 36(5): 1171-1176, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35482541

RESUMO

ABSTRACT: Szymanski, M, Miller, KC, O'Connor, P, Hildebrandt, L, and Umberger, L. Sweat characteristics in individuals with varying susceptibilities of exercise-associated muscle cramps. J Strength Cond Res 36(5): 1171-1176, 2022-Many medical professionals believe dehydration and electrolyte losses cause exercise-associated muscle cramping (EAMC). Unlike prior field studies, we compared sweat characteristics in crampers and noncrampers but accounted for numerous factors that affect sweat characteristics including initial hydration status, diet and fluid intake, exercise conditions, and environmental conditions. Sixteen women and 14 men (mean ± SD; age = 21 ± 2 year, body mass = 69.1 ± 11.6 kg, height = 171.4 ± 9.9 cm) self-reported either no EAMC history (n = 8), low EAMC history (n = 10), or high EAMC history (n = 12). We measured V̇o2max, and subjects recorded their diet. At least 3 days later, subjects ran at 70% of their V̇o2max for 30 minutes in the heat (39.9 ± 0.6° C, 36 ± 2% relative humidity). Dorsal forearm sweat was collected and analyzed for sweat sodium concentration ([Na+]sw), sweat potassium concentration ([K+]sw), and sweat chloride concentration ([Cl-]sw). Sweat rate (SWR) was estimated from body mass and normalized using body surface area (BSA). Dietary fluid, Na+, and K+ ingestion was estimated from a 3-day diet log. We observed no differences for any variable among the original 3 groups (p = 0.05-p = 0.73). Thus, we combined the high and low cramp groups and reanalyzed the data against the noncramping group. Again, there were no differences for [Na+]sw (p = 0.68), [K+]sw (p = 0.86), [Cl-]sw, (p = 0.69), SWR/BSA (p = 0.11), dietary Na+ (p = 0.14), dietary K+ (p = 0.66), and fluid intake (p = 0.28). Fluid and electrolyte losses may play a more minor role in EAMC genesis than previously thought.


Assuntos
Cãibra Muscular , Suor , Adulto , Eletrólitos , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Cãibra Muscular/etiologia , Sódio , Sudorese , Adulto Jovem
17.
Acta Myol ; 41(1): 37-40, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35465342

RESUMO

McArdle's disease is an autosomal recessive glycogenosis due to mutation in the myophosphorylase gene (PYGM) resulting in a pure myopathy. The clinical onset typically occurs in childhood with cramps, myalgia, and intolerance to physical exercise, although late onset forms are also reported. We describe a case of a 17-year-old male complaining of cramps and myalgia following brief and intense exercise. The patient reported marked improvement in muscle fatigability few minutes after starting aerobic exercise. When he was a child, he had experienced few episodes of vomiting, nausea, and black colored urine following physical activity. Laboratory testings revealed high creatine kinase serum levels. Genetic testings for metabolic myopathies demonstrated a compound heterozygous for two PYGM mutations (p.R570Q and p.K754Nfs*49) allowing the diagnosis of McArdle's disease. To date, 183 mutations in the PYGM gene are listed in Human Gene Mutation Database Professional 2021.2, but this novel compound heterozygosis has never been reported before.


Assuntos
Glicogênio Fosforilase Muscular , Doença de Depósito de Glicogênio Tipo V , Adolescente , Glicogênio Fosforilase Muscular/genética , Doença de Depósito de Glicogênio Tipo V/diagnóstico , Doença de Depósito de Glicogênio Tipo V/genética , Humanos , Masculino , Cãibra Muscular/genética , Mutação , Mialgia
18.
Muscle Nerve ; 66(1): 71-75, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35466411

RESUMO

INTRODUCTION/AIMS: Neuronal hyperexcitability (manifested by cramps) plays a pathological role in amyotrophic lateral sclerosis (ALS), and drugs affecting it may help symptomatic management and slow disease progression. We aimed to determine safety and tolerability of two doses of ranolazine in patients with ALS and evaluate for preliminary evidence of drug-target engagement by assessing muscle cramp characteristics. METHODS: We performed an open-label dose-ascending study of ranolazine in 14 individuals with ALS in two sequential cohorts: 500 mg (cohort 1) and 1000 mg (cohort 2) orally twice daily. Each had a 2-week run-in period, 4-week drug administration, and 6-week safety follow-up. Primary outcome was safety and tolerability. Exploratory measures included cramp frequency and severity, fasciculation frequency, cramp potential duration, ALS Functional Rating Scale---Revised score, and forced vital capacity. RESULTS: Six and eight participants were enrolled in cohorts 1 and 2, respectively. There were no serious adverse events. Two subjects in cohort 2 discontinued the drug due to constipation. The most frequent drug-related adverse event was gastrointestinal (40%). Cramp frequency decreased by 54.8% (95% confidence interval [CI], 39%-70.8%) and severity decreased by 46.3% (95% CI, 29.5-63.3%), which appeared to be dose-dependent, with decreased awakening due to cramps. Other outcomes showed no change. DISCUSSION: Ranolazine was well tolerated in ALS up to 2000 mg/day, with gastrointestinal side effects being the most frequent. Ranolazine reduced cramp frequency and severity, supporting its investigation for muscle cramps in a future placebo-controlled trial.


Assuntos
Esclerose Amiotrófica Lateral , Cãibra Muscular , Esclerose Amiotrófica Lateral/complicações , Esclerose Amiotrófica Lateral/tratamento farmacológico , Humanos , Cãibra Muscular/tratamento farmacológico , Cãibra Muscular/etiologia , Projetos Piloto , Ranolazina/uso terapêutico
19.
Am J Gastroenterol ; 117(6): 895-901, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35416793

RESUMO

INTRODUCTION: Muscle cramps are common among persons with cirrhosis and associated with poor health-related quality of life. Treatment options are limited. We sought to determine whether pickle juice can improve muscle cramp severity. METHODS: We enrolled 82 patients with cirrhosis and a history of >4 muscle cramps in the previous month from December 2020 to December 2021. Patients were randomized 1:1 to sips of pickle juice vs tap water at cramp onset. Our primary outcome assessed at 28 days was the change in cramp severity measured by the visual analog scale for cramps (VAS-cramps, scaled 0-10). Cramps were assessed 10 times over 28 days using interactive text messages. Secondary outcomes included the proportion of days with VAS-cramps <5, change in sleep quality, and global health-related quality of life measured using the EQ-5D. RESULTS: Overall, 74 patients completed the trial, aged 56.6 ± 11.5 years, 54% male, 41% with ascites, 38% with encephalopathy, and model for end-stage liver disease-sodium score 11.2 ± 4.9. Many patients were receiving other cramp therapies at baseline. The baseline VAS for cramps was 4.2 ± 3.4, the EQ-5D was 0.80 ± 0.10, and 43% rated sleep as poor. At trial completion, the respective values for the pickle juice and control arms were -2.25 ± 3.61 points on the VAS for cramps, compared with control tap water (-0.36 ± 2.87), P = 0.03; a proportion of cramp-days with VAS-cramps <5 were 46% vs 35% (P = 0.2); and the change in sleep quality was not different (P = 0.1). The end-of-trial EQ-5D was 0.78 ± 0.10 vs 0.80 ± 0.10 (P = 0.3). No differences in weight change were observed for those with and without ascites. DISCUSSION: In a randomized trial, sips of pickle brine consumed at cramp onset improve cramp severity without adverse events.


Assuntos
Doença Hepática Terminal , Alimentos Fermentados , Ascite , Feminino , Humanos , Cirrose Hepática/complicações , Masculino , Cãibra Muscular/etiologia , Cãibra Muscular/terapia , Qualidade de Vida , Índice de Gravidade de Doença , Água
20.
BMJ Case Rep ; 15(4)2022 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-35410943

RESUMO

A 45-year-old woman was evaluated for right-sided hemicorporal scar-like skin lesions on her arm and thoracic and inguinal areas that appeared shortly after reduction mammoplasty. Five years later, she developed spontaneous cramps and involuntary abnormal, painful, twitching movements in the same areas. With time, the cramps worsened and disabled the patient. The use of her right arm triggered contractures of muscles and abnormal movements. A diagnosis of neuromyotonia (NMT) was established on the basis of clinical findings and on electromyographic findings of a burst of high-frequency motor unit potentials recorded in the right triceps in the area of skin lesions. The results of medullary, encephalic MRI as well as a comprehensive metabolic panel were normal. She was positive for antinuclear antibodies without specificity. Neither antineural antibodies nor antivoltage-gated potassium channel complex antibodies (specifically, leucine-rich glioma inactivated protein 1 and contactin-associated protein-like-2) were detected. Her skin lesions were diagnosed as morphea. Two combined strategies of treatment were initiated: antiepileptic drugs for NMT and corticosteroids and methotrexate for morphea. NMT is a rare, debilitating neurological complication of morphea.


Assuntos
Síndrome de Isaacs , Esclerodermia Localizada , Anticorpos , Feminino , Humanos , Síndrome de Isaacs/complicações , Síndrome de Isaacs/diagnóstico , Leucina , Pessoa de Meia-Idade , Cãibra Muscular , Esclerodermia Localizada/complicações
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