Stimulus electrodiagnosis and motor and functional evaluations during ulnar nerve recovery

BACKGROUND: Distal ulnar nerve injury leads to impairment of hand function due to motor and sensorial changes. Stimulus electrodiagnosis (SE) is a method of assessing and monitoring the development of this type of injury. OBJECTIVE: To identify the most sensitive electrodiagnostic parameters to evaluate ulnar nerve recovery and to correlate these parameters (Rheobase, Chronaxie, and Accommodation) with motor function evaluations. METHOD: A prospective cohort study of ten patients submitted to ulnar neurorrhaphy and evaluated using electrodiagnosis and motor assessment at two moments of neural recovery. A functional evaluation using the DASH questionnaire (Disability of the Arm, Shoulder, and Hand) was conducted at the end to establish the functional status of the upper limb. RESULTS: There was significant reduction only in the Chronaxie values in relation to time of injury and side (with and without lesion), as well as significant correlation of Chronaxie with the motor domain score. CONCLUSION: Chronaxie was the most sensitive SE parameter for detecting differences in neuromuscular responses during the ulnar nerve recovery process and it was the only parameter correlated with the motor assessment.

Efeitos agudos da ventilação mecânica com hiperoxia na morfometria do diafragma de ratos / Acute effects of mechanical ventilation with hyperoxia on the morphometry of the rat diaphragm

CONTEXTUALIZAÇÃO: A asssistência ventilória mecânica (AVM) prolongada associada a altas frações de oxigênio produz impacto negativo na função diafragmática. No entanto, não são claros os efeitos agudos da AVM associada a altas frações de oxigênio em pulmões aparentemente sadios. OBJETIVO: Analisar os efeitos agudos da ventilação mecânica com hiperóxia na morfometria do diafragma de ratos. Métodos: Estudo experimental prospectivo, com nove ratos Wistar, com peso de 400±20 g, randomizados em dois grupos: controle (n=4), anestesiados, traqueostomizados e mantidos em respiração espontânea em ar ambiente por 90 minutos e experimental (n=5), também anestesiados, curarizados, traqueostomizados e mantidos em ventilação mecânica controlada pelo mesmo tempo. Foram submetidos à toracotomia mediana para coleta da amostra das fibras costais do diafragma que foram seccionadas a cada 5 μm e coradas pela hematoxilina e eosina para o estudo morfométrico. Para a análise estatística, foi utilizado o teste t de Student não pareado, com nível de significância de p<0,05. RESULTADOS: Não foram encontrados sinais indicativos de lesão muscular aguda, porém observou-se dilatação dos capilares sanguíneos no grupo experimental. Os dados morfométricos do diâmetro transverso máximo da fibra muscular costal foram em média de 61,78±17,79 µm e de 70,75±9,93 µm (p=0,045) nos grupos controle e experimental respectivamente. CONCLUSÃO: A ventilação mecânica de curta duração com elevada concentração de O2 produziu marcantes alterações microvasculares e musculares, podendo refletir o início do processo inflamatório.

BACKGROUND: Prolonged mechanical ventilatory support (MVS) combined with high oxygen concentrations has a negative impact on diaphragm function. However, the acute effects of MVS with hyperoxia have not been elucidated. Objective: To analyze the acute effects of mechanical ventilation with hyperoxia on the morphometry of the rat diaphragm. METHODS: An experimental, prospective study was conducted with Wistar rats (weight: 400±20 g), which were randomly allocated to two groups. The control group (n=4) was anesthetized, tracheostomized and kept spontaneously breathing room air for 90 minutes. The experimental group (n=5) was also anesthetized, curarized, tracheostomized and kept in controlled mechanical ventilation for the same amount of time. Both groups were submitted to median thoracotomy for sample collection of costal fibers from the diaphragm muscle, which were sectioned every 5 μm and stained with hematoxylin and eosin for the morphometric study. Independent Student's t tests were employed to investigate differences between groups, with a significance level of p<0.05. RESULTS: There were no signs of acute muscle lesions, however the blood capillaries became dilated in the experimental group. The mean morphometric data related to the maximum cross-sectional diameter of the diaphragm costal fibers were 61.78 ±17.79 µm and 70.75±9.93 µm (p=0.045) for the control and experimental groups, respectively. CONCLUSIONS: Short-term mechanical ventilation with hyperoxia led to significant microvascular and muscle changes, which may reflect the onset of an inflammatory process.

Atuação dos esteróides anabolizantes na regeneração músculo-esquelética / Performance of the anabolic steroids in the skeletal muscle regeneration

A capacidade regenerativa das fibras musculares depende da presença de células satélites, ocorrendo por mecanismos fisiológicos que compõem sua cito-arquitetura. Os esteróides anabolizantes apresentam efeitos de manutenção protéica, anticatabolismo e modulação do cálcio, e associados à regeneração muscular, proporcionam um auxílio na velocidade de recuperação de fibras lesadas, além do aumento do diâmetro da fibra. Assim sendo, o presente trabalho tem por objetivo atualizar informações e reunir descobertas sobre regeneração músculo-esquelética associada aos esteróides anabolizantes por levantamento bibliográfico em banco de dados Medline, Lilacs e Scielo, bem como a utilização de livros, monografias e dissertações da área. Para busca deste material foram utilizados os seguintes descritores: músculo esquelético, células satélite, regeneração muscular, esteróides anabolizantes, consultados em 2006. Analisando as informações obtidas, sugere-se que os esteróides anabolizantes atuam na preservação da integridade da fibra muscular diante do processo regenerativo, sendo necessários fundamentos mais precisos em modelos experimentais humanos.

The regeneration capacity of skeletal muscle fibers is largely mediated by satellite cells and occurs by means of physiological mechanisms involving their cytoarchitecture. The anabolic steroids are effective in increasing protein synthesis and promoting anti-catabolism and calcium modeling in skeletal muscles. As a result, the use of these drugs led to an increased fiber diameter as well as to an enhanced rate of regeneration of injured muscle fibers. The current study aimed to update information and collect findings about musculoskeletal regeneration associated with the use of anabolic steroids. To do so, a bibliographic survey was carried out in the database of Medline, Lilacs and Scielo, as well as in scientific books, monographs, dissertations and theses. The descriptors used in the survey were: musculoskeletal, satellite cells, muscle regeneration and anabolic steroids. The analysis of the collected information suggests that the anabolic steroids play a rolein the maintenance of the integrity of muscle fibers during the regenerative process. However, further foundations should be built for human experimental models.