Effect of M-wave Amplitude on Inter-evaluator Concordance and Number of Detected Innervation Zones in the Medial Gastrocnemius Using Multichannel Electromyography / Efecto de la Amplitud de la Onda M sobre la Concordancia entre Evaluadores y el Número de Zonas de Inervación Detectadas en el Gastrocnemio Medial Mediante Electromiografía Multicanal

SUMMARY: The Innervation Zones (IZ) correspond to clusters of neuromuscular junctions. The traditional method of locating IZs through voluntary muscle contractions may not be feasible in individuals with motor disorders. Imposed contractions by electrostimulation are an alternative. However, there is limited evidence regarding the factors that affect inter-evaluator concordance and the number of localized IZs when using imposed contraction. The main objective of this research was to determine the effect of the amplitude of compound motor action potentials (CMAPs) containing the M-wave on inter-evaluator agreement. As a secondary objective, was investigate the effect on the number of detected IZs. Twenty-four healthy volunteers (age: 21.2 ± 1.5years, weight: 67.4 ± 13.2kg, height: 1.68 ± 0.80m) participated in the study. Electrostimulation was applied to the tibial nerve to induce contraction of the medial gastrocnemius. The IZ were identified based on the M-wave recorded through multichannel electromyography. A receiver operating characteristic (ROC) analysis was conducted to assess sensitivity and specificity in detecting the IZs. Inter-rater agreement was evaluated using a two-way mixed effects test to determine the intraclass correlation coefficients (ICC). A p-value less than 0.05 was considered statistically significant. The ROC analysis revealed that for both evaluators, a specificity of 95% was achieved with an amplitude ≥30 %. The area under the ROC curve was 0.980 [0.964, 0.996], indicating a strong influence of CMAP amplitude on detection of IZs. The highest level of agreement (ICC = 0.788 [0.713, 0.844]) among the evaluators was observed with CMAP amplitudes equal to or greater than 80 % of the maximum M-wave. The findings of this study demonstrate that both the number and the inter-evaluator concordance for detecting IZs using imposed contractions are strongly influenced by the amplitude of the M-wave. Higher M-wave amplitudes were associated with improved concordance and increased IZ detection, making it crucial to standardize amplitude settings for reliable outcomes.

Las Zonas de Inervación (IZ) corresponden a grupos de uniones neuromusculares. El método tradicional para localizar IZs mediante contracciones musculares voluntarias puede no ser factible en personas con trastornos motores. Las contracciones impuestas mediante electro estimulación son una alternativa. Sin embargo, existe poca evidencia sobre los factores que afectan la concordancia entre evaluadores y el número de IZs localizadas al usar este tipo de contracciones. El objetivo de esta investigación fue determinar el efecto de la amplitud de los potenciales de acción motores compuestos (PAMCs) que contienen la onda M sobre la concordancia entre evaluadores. Como objetivo secundario, se investigó el efecto sobre el número de IZs detectadas. Veinticuatro voluntarios sanos (edad: 21.2 ± 1.5 años, peso: 67.4 ± 13.2 kg, altura: 1.68 ± 0.80 m) participaron en el estudio. Se aplicó electroestimulación al nervio tibial para inducir la contracción del gastrocnemio medial. Las IZs se identificaron según la onda M registrada mediante electromiografía multicanal. Se realizó un análisis de curva de las característica del receptor (ROC) para evaluar la sensibilidad y especificidad en la detección de las IZs. La concordancia entre evaluadores se evaluó utilizando una prueba de efectos mixtos de dos vías para determinar los coeficientes de correlación intraclase (ICC). Se consideró un valor de p menor que 0.05 como estadísticamente significativo. El análisis ROC reveló que para ambos evaluadores se logró una especificidad del 95% con una amplitud ≥30 %. El área bajo la curva ROC fue de 0.980 [0.964, 0.996], lo que indica una fuerte influencia de la amplitud del CMAP en la detección de las IZs. El nivel más alto de concordancia (ICC = 0.788 [0.713, 0.844]) entre los evaluadores se observó con amplitudes de CMAP iguales o mayores al 80 % de la onda M máxima. Los hallazgos de este estudio demuestran que tanto el número como la concordancia entre evaluadores para detectar IZs mediante contracciones impuestas están fuertemente influenciados por la amplitud de la onda M. Las amplitudes más altas de la onda M se asociaron con una concordancia mejorada y un aumento en la detección de IZs, lo que hace crucial estandarizar los ajustes de amplitud para obtener resultados confiables.

Deep infiltrating endometriosis: cine magnetic resonance imaging in the evaluation of uterine contractility / Endometriose infiltrativa profunda: cine ressonância magnética na avaliação da contratilidade uterina

Abstract Objective: To evaluate uterine function by using cine magnetic resonance imaging to visualize the contractile movements of the uterus in patients with and without deep infiltrating endometriosis (with or without associated adenomyosis). Materials and Methods: This was a prospective case-control study. The study sample comprised 43 women: 18 in the case group and 25 in the control group. We performed cine magnetic resonance imaging in a 3.0 T scanner, focusing on the presence, direction, and frequency of uterine peristalsis. Results: The frequency of uterine peristalsis was higher in the case group than in the control group, in the periovulatory phase (3.83 vs. 2.44 peristaltic waves in two minutes) and luteal phase (1.20 vs. 0.91 peristaltic waves in two minutes). However, those differences were not statistically significant. There was a significant difference between the patients with adenomyosis and those without in terms of the frequency of peristalsis during the late follicular/periovulatory phase (0.8 vs. 3.18 peristaltic waves in two minutes; p < 0.05). Conclusion: The frequency of uterine peristalsis appears to be higher during the periovulatory and luteal phases in patients with deep infiltrating endometriosis, whereas it appears to be significantly lower during the late follicular/periovulatory phase in patients with adenomyosis. Both of those effects could have a negative impact on sperm transport and on the early stages of fertilization.

Resumo Objetivo: Avaliar a função uterina mediante visualização dos movimentos contráteis do útero por meio de cine-ressonância magnética em pacientes com e sem endometriose infiltrativa profunda (com ou sem adenomiose associada). Materiais e Métodos: Estudo caso-controle prospectivo. A amostra foi composta por 43 mulheres, sendo 18 mulheres no grupo caso e 25 mulheres no grupo controle. A cine-ressonância magnética foi realizada com magneto 3.0 T, com foco na presença, direção e frequência do peristaltismo uterino. Resultados: O peristaltismo uterino foi mais frequente nas pacientes do grupo endometriose do que no grupo controle na fase periovulatória (3,83 × 2,44 peristalses em dois minutos) e lútea (1,20 × 0,91 peristalse em dois minutos). No entanto, esses resultados não foram estatisticamente significantes. Nas pacientes com adenomiose, observou-se redução significativa na frequência de peristaltismo durante a primeira fase do ciclo menstrual (3,18 × 0,8 peristalses; p < 0,05). Conclusão: A frequência de peristaltismo uterino parece estar aumentada durante a fase periovulatória e lútea em pacientes com endometriose infiltrativa profunda e significativamente reduzida em pacientes com adenomiose durante a primeira fase do ciclo menstrual. Ambos os efeitos têm potencial de interferir negativamente no transporte de espermatozoides e nos primeiros estágios de fecundação.

A Novel Dual-wavelength, Dual-function Laser System for Presbyopia and Glaucoma Treatments

To update the accommodation mechanisms and propose a dual-wavelength, dual-function laser system for presbyopia and glaucoma treatments.Study Design: Laser sclera softening (LSS) for increased accommodation of presbyopic eyes.Place and Duration of Study: New Taipei City, Taiwan, between Jan., 2023 and Feb., 2023.Methodology: Accommodation gain (AG) can be improved by: (i) thermal shrinkage of the scleral stroma and ciliary body, or (ii) softening of the scleral stroma (with temperature range of 700C to 900C), such that the the lens front and back curvature change (or lens thickening), leading to the thickening of ciliary body and its apex, and the increase of the space of ciliary body and lens equation (SCL), and the length of the posterior vitreal zonules (PVZ) increases.Results: A novel dual-color laser system having wavelength A and B, acting on the front-zone and back-zone of the sclera, respectively, where laser-A has a deep thermal penetration the sclera and ciliary body (CB) (0.5 to 1.0 mm); and laser-B has a shallow penetration depth in the sclera (0.3 to 0.5 mm), based on the optical property of the sclera. Laser-A (having a wavelength about0.8 to 0.98 um) leads to thermal shrinkage of the ciliary body such that the CLS is increased for accommodation gain which is much more effective than the prior art.Conclusion: The increase of AG can be achieved by scleral softening and ciliary body shrinkage which increase the SCL. A proposed novel dual-color laser system acting on the front-zone and back-zone of the sclera, respectively, could provide higher AG than that of single wavelength, or prior arts using scleral ablation. However, further clinical studies are required to justified the proposed novel system with predicted advantages and efficacy based on the optical properties of sclera.

Preparation of static training animal models and research status analysis / 针灸推拿医学（英文版）

As a form of Tuina(Chinese therapeutic massage)Qigong exercises and an essential part of exercise therapy,static training has proven clinical efficacy.However,further evidence is required to reveal its mechanism of action provided by animal experiments.There are four major ways to establish static training animal models:pole climbing,hind-limb suspension,isometric-contraction weight bearing,and electrical stimulation.These models have been used to study diseases of the motor,circulatory,and endocrine systems,etc.,and the mechanism has got extensive exploration.It reviewed static training animal models and the research progress to provide theoretical evidence for static training's experimental research and mechanism exploration.

Correlation between Elbow Flexor Muscle Strength and Needle Electromyography Parameters after Musculocutaneous Nerve Injury / 法医学杂志

OBJECTIVES@#To explore the changes of elbow flexor muscle strength after musculocutaneous nerve injury and its correlation with needle electromyography (nEMG) parameters.@*METHODS@#Thirty cases of elbow flexor weakness caused by unilateral brachial plexus injury (involving musculocutaneous nerve) were collected. The elbow flexor muscle strength was evaluated by manual muscle test (MMT) based on Lovett Scale. All subjects were divided into Group A (grade 1 and grade 2, 16 cases) and Group B (grade 3 and grade 4, 14 cases) according to their elbow flexor muscle strength of injured side. The biceps brachii of the injured side and the healthy side were examined by nEMG. The latency and amplitude of the compound muscle action potential (CMAP) were recorded. The type of recruitment response, the mean number of turns and the mean amplitude of recruitment potential were recorded when the subjects performed maximal voluntary contraction. The quantitative elbow flexor muscle strength was measured by portable microFET 2 Manual Muscle Tester. The percentage of residual elbow flexor muscle strength (the ratio of quantitative muscle strength of the injured side to the healthy side) was calculated. The differences of nEMG parameters, quantitative muscle strength and residual elbow flexor muscle strength between the two groups and between the injured side and the healthy side were compared. The correlation between elbow flexor manual muscle strength classification, quantitative muscle strength and nEMG parameters was analyzed.@*RESULTS@#After musculocutaneous nerve injury, the percentage of residual elbow flexor muscle strength in Group B was 23.43% and that in Group A was 4.13%. Elbow flexor manual muscle strength classification was significantly correlated with the type of recruitment response, and the correlation coefficient was 0.886 (P<0.05). The quantitative elbow flexor muscle strength was correlated with the latency and amplitude of CMAP, the mean number of turns and the mean amplitude of recruitment potential, and the correlation coefficients were -0.528, 0.588, 0.465 and 0.426 (P<0.05), respectively.@*CONCLUSIONS@#The percentage of residual elbow flexor muscle strength can be used as the basis of muscle strength classification, and the comprehensive application of nEMG parameters can be used to infer quantitative elbow flexor muscle strength.

The role of muscle relaxation in badminton players / O papel do relaxamento muscular em jogadores de badminton / El papel de la relajación muscular en jugadores de bádminton

ABSTRACT Introduction: In training, fatigue and recovery are antagonistic factors. Physical rehabilitation of athletes and elimination of sports fatigue have gradually become essential factors in improving competitiveness. Muscle relaxation exercises can reduce badminton players' physical effort, allowing them to recover quickly. Objective: Analyze muscle relaxation's effect on fatigue relief until the normalization of physical strength in badminton players. Methods: Twelve badminton players were grouped in cross-sectional tests. During the three weeks of physical training, players performed two training methods: muscle relaxation and complete rest. Laboratory analysis encompassed blood biomarkers such as urea and creatine kinase. Data were collected before and after the interventions, confronted, and studied mathematically and statistically. Results: The proportions of leukocytes and lymphocytes in the muscle relaxation group after resistance exercise were lower than before. The decrease of morning leukocytes in the muscle relaxation group on the second day was less than in the resting group. The recovery effect of the lymphocyte ratio was also better. After special strength training, the value of creatine kinase was significantly higher than before exercise in both the muscle relaxation group and the complete rest group. Conclusion: Muscle relaxation can reduce exercise fatigue in badminton players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: No treinamento, fadiga e recuperação são fatores antagônicos. A reabilitação física dos atletas e a eliminação da fadiga esportiva tornaram-se gradualmente fatores essenciais para melhorar a competitividade. O exercício de relaxamento muscular pode reduzir o esforço físico dos jogadores de badminton, permitindo ao jogador recuperar-se rapidamente. Objetivo: Analisar o efeito do relaxamento muscular sobre o alívio da fadiga até a normalização da força física nos jogadores de badminton. Métodos: Foram agrupados 12 jogadores de badminton em testes transversais. Durante as três semanas de treinamento físico, os jogadores realizaram dois métodos de treinamento: relaxamento muscular e repouso completo. A análise laboratorial englobou biomarcadores sanguíneos, como ureia e creatina cinase. Os dados foram coletados antes e após as intervenções, confrontados e estudados de forma matemática e estatística. Resultados: As proporções de leucócitos e linfócitos no grupo de relaxamento muscular após o exercício de resistência foram menores do que antes. A diminuição dos leucócitos matinais no grupo de relaxamento muscular no segundo dia foi menor do que no grupo de repouso, e o efeito de recuperação da relação de linfócitos também foi melhor. Após o treinamento especial de força, o valor da creatina quinase foi significativamente maior do que antes do exercício tanto no grupo de relaxamento muscular quanto no grupo de repouso completo. Conclusão: O relaxamento muscular pode reduzir a fadiga do exercício nos jogadores de badminton. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: En el entrenamiento, la fatiga y la recuperación son factores antagónicos. La rehabilitación física de los atletas y la eliminación de la fatiga deportiva se han convertido gradualmente en factores esenciales para mejorar la competitividad. El ejercicio de relajación muscular puede reducir el esfuerzo físico de los jugadores de bádminton, permitiendo que el jugador se recupere rápidamente. Objetivo: Analizar el efecto de la relajación muscular en el alivio de la fatiga hasta la normalización de la fuerza física en jugadores de bádminton. Métodos: Se agruparon doce jugadores de bádminton en pruebas transversales. Durante las tres semanas de entrenamiento físico, los jugadores realizaron dos métodos de entrenamiento: la relajación muscular y el descanso completo. Los análisis de laboratorio incluían biomarcadores sanguíneos como la urea y la creatina quinasa. Los datos se recogieron antes y después de las intervenciones, se confrontaron y se estudiaron matemática y estadísticamente. Resultados: Las proporciones de leucocitos y linfocitos en el grupo de relajación muscular tras el ejercicio de resistencia fueron menores que antes. La disminución de los leucocitos matinales en el grupo de relajación muscular en el segundo día fue menor que en el grupo de reposo, y el efecto de recuperación de la proporción de linfocitos también fue mejor. Después del entrenamiento especial de fuerza, el valor de la creatina quinasa fue significativamente mayor que antes del ejercicio tanto en el grupo de relajación muscular como en el de reposo completo. Conclusión: La relajación muscular puede reducir la fatiga del ejercicio en los jugadores de bádminton. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Strain Magnitude Assessed at Rest and During Stress Echocardiography in Patients with Normal Coronary Flow Reserve

Abstract Background Coronary flow and myocardial contractile performance assessed by strain magnitude increase during a dobutamine stress echocardiogram (DSE). Normal coronary flow reserve (CFR) can be attained upon completion of a DSE at age-predicted maximum heart rate (HR) (HRmax = 220 - age)] or submaximal HR [(0.85) HRmax] or before completion (early CFR). Objective To ascertain the association between delta strain and HR in patients with early normal CFR. Methods This prospective study included patients whose normal CFR was obtained before the DSE was completed. Percentage of resting HR (%HRrest) = [(HRrest ÷ HRmax) 100]% and %HR CFR = [(HR at the time of CFR attainment) ÷ (HRmax) 100]% were recorded. Strain was assessed in the left ventricular region of interest, and delta strain was calculated as the difference between the measures obtained at HRrest and after the DSE was completed. Strain agreement analysis for HRrest, %HRrest, and %HR CFR was performed using the kappa coefficient. The Shapiro-Wilk test was used to assess data normality, and the Mann-Whitney test was used to compare the groups. A p-value < 0.05 was considered statistically significant. Results Strain measured -23.3% ± 4.3% at baseline and -31.1% ± 4.9% during the DSE. In delta strain > 8 absolute points, the ROC curves showed an area under the curve of 0.874 ± 0.07 for %HRrest (p = 0.001) and an area under the curve of 0.862 ± 0.07 for %HR CFR (p = 0.001). In delta strain > 8 points, %HRrest ≤ 42.6% of HRmax and %HR CFR ≤ 62.5% of HRmax showed an accuracy of 82.9% and 79.8%, respectively. Conclusion In this study, lower HRrest and HR at the time of CFR attainment had a good association with better myocardial contractile performance, according to the change in strain magnitude.

Exercise fatigue injury under sport resistance / Lesão de fadiga causada por exercício sob resistência esportiva / Lesión por fatiga causada por ejercicio bajo resistencia deportiva

ABSTRACT Introduction Athletes are prone to local muscle fatigue due to high-intensity training and to long-term accumulation of musculoskeletal injuries. Musculoskeletal complications represent a large proportion of occupational health problems and, for this reason, have received increased attention from the sports industry. In this sense, studies on muscle fatigue should be intensified. Objective Verify muscle fatigue and injury involving the strain characteristics of lower limb joints in the eccentric and centripetal contraction of the jump. Methods A total of 691 individuals aged 20 to 40 years were selected. Fatigue was caused by active muscle contraction. The characteristic curves of active muscle contraction in different isometric, isotonic, and isokinetic training were analyzed. The degree of fatigue caused by three different sports states was tested by experimentation. The corresponding active muscle contraction characteristics were also analyzed. The potential for homeostasis at different ages was compared. Results The delay in recovery to fatigue is directly proportional to the athlete's age. The return to post-exercise relief proportion from fatigue gradually decreases. Conclusion The experimental results showed that active muscle contraction could reduce exercise fatigue to some extent. This beneficial biochemical property of active muscle contraction is not found in people with advanced age. The findings have a guiding potential for the relief of sports fatigue. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMO Introdução Os esportistas estão propensos à fadiga muscular local devido ao treinamento de alta intensidade, e ao acúmulo de lesões musculoesqueléticas a longo prazo. As complicações musculoesqueléticas representam uma grande fatia dos problemas de saúde ocupacional e por isso têm recebido maior atenção da indústria esportiva. Nesse sentido, os estudos sobre a fadiga muscular devem ser aprofundados. Objetivo Verificar a fadiga e lesão muscular envolvendo as características de esforço das articulações dos membros inferiores na contração excêntrica e contração centrípeta do salto. Métodos Foram selecionados 691 indivíduos com idade entre 20 a 40 anos. A fadiga foi ocasionada por contração muscular ativa. Foram analisadas as curvas características da contração muscular ativa em diferentes estados nos treinos isométrico, isotônico e isocinético. O grau de fadiga causado por três estados esportivos diferentes foi testado através de experimentos. Também foram analisadas as características de contração muscular ativa correspondentes. O potencial de homeostase em diferentes idades foi comparado. Resultados O retardo na recuperação à fadiga é diretamente proporcional a idade do esportista. A proporção de retorno ao alívio pós-exercício sobre a fadiga diminui gradualmente. Conclusão Os resultados experimentais mostram que a contração muscular ativa pode reduzir até certo ponto a fadiga ao exercício. Os efeitos dessas propriedades bioquímicas benéficas da contração muscular ativa não são encontrados em pessoas com idade avançada. Os achados tem um potencial orientador para o alívio da fadiga esportiva. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción Los deportistas son propensos a la fatiga muscular local debido al entrenamiento de alta intensidad, y a la acumulación de lesiones musculoesqueléticas a largo plazo. Las complicaciones musculoesqueléticas representan una gran parte de los problemas de salud laboral y por ello han recibido una mayor atención por parte de la industria del deporte. En este sentido, hay que profundizar en los estudios sobre la fatiga muscular. Objetivo Verificar la fatiga muscular y las lesiones que implican las características de esfuerzo de las articulaciones de los miembros inferiores en la contracción excéntrica y centrípeta del salto. Métodos Se seleccionaron 691 individuos de entre 20 y 40 años. La fatiga fue causada por la contracción muscular activa. Fueron analizadas las curvas características de la contracción muscular activa en diferentes estados en el entrenamiento isométrico, isotónico e isocinético. El grado de fatiga provocado por tres estados deportivos diferentes se comprobó mediante experimentos. También se analizaron las correspondientes características de la contracción muscular activa. Se comparó el potencial de homeostasis a diferentes edades. Resultados El retraso en la recuperación a la fatiga es directamente proporcional a la edad del deportista. La proporción de retorno al alivio de la fatiga después del ejercicio disminuye gradualmente. Conclusión Los resultados experimentales muestran que la contracción muscular activa puede reducir la fatiga del ejercicio en cierta medida. Los efectos de estas propiedades bioquímicas beneficiosas de la contracción muscular activa no se encuentran en las personas mayores. Los hallazgos tienen un potencial orientador para el alivio de la fatiga deportiva. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Strength of scapular elevation in women with TMD and asymptomatic women - a cross-sectional study

Temporomandibular disorder (TMD) is recognized for its high prevalence, presenting characteristic signs and symptoms. Cervical spine pain is present in 70% of diagnosed TMD cases. Aim To verify if women with TMD present changes in isometric muscle strength in the scapula elevation. Methods This is an observational, cross-sectional study. Thirty-five women, aged 22.89±2.04 years, were divided into the TMD group (TMDG), diagnosed with TMD according to the DC/TMD, and control group (CG), with asymptomatic individuals. The volunteers accessed a online link by the smartphone in order to answer questions on personal data, the Fonseca Anamnestic Index (FAI), Neck Disability Index (NDI), and Masticatory preference. In all participants, evaluation of the force of the scapula elevation muscles was performed, using a load cell model MM-100 (Kratos® SP, Brazil). Data were analyzed descriptively using the maximum, mean, and standard deviation and a two-way ANCOVA test was applied for all variables. A significance level of 5% was considered. Results There were no statistically significant differences between the TMDG and CG for the maximal and mean muscle strength of scapular elevation. There were statistically significant differences in FAI (p <0.001*) between the CG and the TMDG. Conclusion Based on the results, it was not possible to confirm the hypothesis that women diagnosed with TMD present lower isometric strength during scapular elevation (right/left).

An Experimental Evaluation of humboldtia vahliana wight., a Folk Medicinal Plant on Wound Healing Action in Wistar Albino Rats-an in-vivo Study

A wound is a break in the integrity of the skin or tissues often which may be associated with disruption of the structure and function. Globally, the magnitude of acute wounds as a healthcare problem is sharply rising mainly due to industrialization. There is still a need to revisit the ancient healing methods by using traditional medicine aiming to discover a wound healing drug with better protection, rapid granulation changes, least side effects, good bio-availability and low cost. A folk medicinal plant Humboldtia vahliana Wight. belongs to the family Fabaceae, is a medium sized tree with rough, dark brown bark mottled with white. Its stem bark is used for wound healing among the tribes. Aims and objectives: The study aims to evaluate the in-vivo wound healing action of Humboldtia vahliana Wight. through excision and incision animal wound models. Methodology: 36 male Wistar albino rats weighing 150-250gm. were selected and made into 3 groups each for both incision and excision wounds, i.e., control, standard and trial group -each containing 6 rats. The trial drug Humboldtia vahliana Wight. was applied over the wound area in the form of ‘Kalka’. In excision wound model, percentage of wound contraction was the parameter for the study and was achieved by using Planimetry. In incision wound model, tensile strength was the parameter and was achieved by Local Tensiometer. Results: In case of both Incision as well as Excision wound contraction study, the data shows a statistically non-significant increase in percentage wound contraction of Trial group when compared to Control and Standard groups. Interpretation and Conclusion: The stem bark of Humboldtia vahliana Wight. showed better wound healing action in Wistar albino rats when percentage of efficacy or mean values were compared

Reserva contráctil por fracción de eyección sola, o con elastancia. ¿Cuál es el mejor predictor de eventos luego de un Eco Estrés sin isquemia? / Contractile Reserve by Left Ventricular Ejection Fraction Alone, o Considering Elastance. ¿Which is the Best Predictor of Events After a Stress Echo Without Ischemia?

RESUMEN Introducción: El comportamiento de la fracción de eyección del ventrículo izquierdo (FEVI) durante el ejercicio se utiliza para medir la reserva contráctil (RC). La RC medida por elastancia podría tener mayor valor pronóstico. Objetivo: Establecer si la medición de la RC por elastancia añade valor pronóstico a largo plazo en relación al comportamiento aislado de la FEVI en pacientes con un Eco Estrés sin isquemia miocárdica. Material y métodos: Estudio retrospectivo, realizado en 904 pacientes con Eco Estrés con ejercicio sin isquemia. Se valoró la RC por FEVI y por elastancia. Se dividieron en 2 grupos: Grupo 1: RC por FEVI presente (a su vez este grupo se dividió en 2 subgrupos: Grupo 1 A, RC con elastancia presente y Grupo 1B: ausencia de RC por elastancia), y Grupo 2: pacientes con ausencia de RC por FEVI. El seguimiento fue de 17,7 ± 5,4 meses. Se consideraron como eventos: muerte, infarto agudo de miocardio (IAM), accidente cerebrovascular (ACV) y/o internación de causa cardiovascular. Resultados: Del total del Grupo 1 (536 pacientes), 200 (37,3%) se incluyeron en el Grupo 1A y 336 (62,7%) en el Grupo 1B. En el Grupo 2, se incluyeron 368 pacientes. En el seguimiento, los pacientes del Grupo 2 tuvieron más eventos, 30 (8,1%) vs. 22 (2,6%) (HR 3,14, IC95% 1,95-5,9, log rank test p<0,001). Dentro del G1, los pacientes del Grupo 1B presentaron más eventos: 18 (5,3%) vs 4 eventos (2%) (HR 2,46 IC95% 1,06-7,3, log rank test p<0,05). En el modelo de regresión, la elastancia fue la única variable predictora de eventos (HR 3,2, IC95% 1,83-5,6, p<0,001). Conclusiones: En el Eco Estrés ejercicio negativo para isquemia, el comportamiento de la RC evaluada por elastancia permitió identificar un subgrupo de peor pronóstico a largo plazo en pacientes con comportamiento normal de la FEVI.

ABSTRACT Background: The behavior of left ventricular ejection fraction (LVEF) during exercise is used to measure contractile reserve (CR). CR measured by elastance could have greater prognostic value. Objective: To establish whether the measurement of CR by elastance adds long-term prognostic value to CR measured by LVEF in patients with a Stress Echo without myocardial ischemia. Material and methods: Retrospective study, carried out in 904 patients with an exercise Stress Echo without ischemia. CR was assessed by LVEF and by elastance. Patients were divided into 2 groups: Group 1: presence of CR by LVEF (in turn this group was divided into 2 subgroups: Group 1A, CR with elastance present, and Group 1B: absence of CR by elastance), and Group 2: patients with absence of CR by LVEF. The follow-up was 17,7 ± 5,4 months. Outcomes considered were death, acute myocardial infarction (AMI), stroke, and cardiovascular hospitalization. Results: 536 patients were included in Group 1, 200 (37,3 %) in Group 1A and 336 (62,7%) in Group 1B. In Group 2, 368 patients were included. At follow-up, patients in Group 2 had more events, 30 (8.1%) vs. 22 (2.6%) (HR 3.14, 95% CI 1.95-5.9, log rank test p <0.001). Within G1, patients in Group 1B presented more events: 18(5.3%) vs 4 (2%) (HR 2.46 CI 95% 1.06-7.3, log rank test p <0.05). In the regression model, CR assessed by LVEF and additionally by elastance was the only significant outcome predictor (HR 3.2, 95% CI 1.83-5.6, p <0.001). Conclusions: In an exercise Stress Echo negative for ischemia, CR behavior evaluated by elastance allowed us to identify a subgroup with a worse long-term prognosis in patients with normal LVEF response.

Two devices to facilitate the perception of pelvic floor muscle contraction in the sitting position in women with urinary incontinence: comparative analysis / Dois dispositivos facilitadores de percepção da contração do assoalho pélvico na posição sentada em mulheres com incontinência urinária: análise comparativa / Dos herramientas que facilitan la percepción de la contracción del suelo pélvico en posición sentada de mujeres con incontinencia urinaria: un análisis comparativo

ABSTRACT The use of support devices may facilitate the perception of pelvic floor muscle (PFM) contraction, which is difficult to be performed. Therefore, this study aimed to compare the perception of PFM contraction in the sitting position during the use of two different support devices on women with PFM dysfunction. This is a cross-sectional study performed with 37 women with stress or mixed urinary incontinence (UI). All women performed three free PFM contractions sitting on a chair, followed by three contractions using each support device (sand pads and a cylindrical foam, which provide sciatic and perineal support, respectively). Women scored the perception of PFM contraction from 1 to 5, as well as the perception of facilitation of contraction (higher grades show better results) and discomfort (higher grades show more discomfort) when compared with free contraction. The cylindrical foam presented similar results to sand pads for the perception of PFM contraction (2.84±1.61 vs. 3.19±1.43; p=0.34) and facilitation of contraction (3.38±1.34 vs. 3.19±1.54; p=0.61), as well as for their discomfort (1.83±1.23 vs. 1.5±1.16; p=0.20). Of all women, 57% preferred sand pads. Thus, both sand pads (sciatic support) and the cylindrical foam (perineal support) improved the perception of PFM contraction and facilitation of contraction in the sitting position of women with PFM dysfunction when compared with sitting with no device. The two devices presented no difference between them.

RESUMO O uso de dispositivos de suporte pode auxiliar na percepção da contração dos músculos do assoalho pélvico (AP). O objetivo deste estudo foi, comparar na posição sentada, a percepção da contração dos músculos do AP durante o uso de dois tipos diferentes de dispositivos, em mulheres com disfunção dos músculos do AP. Para tanto, foi realizado um estudo transversal com 37 mulheres com incontinência urinária (IU) de esforço ou mista. Primeiro as participantes faziam três contrações livres dos músculos do AP sem o uso de dispositivos, sentadas em uma cadeira. Em seguida, faziam três contrações utilizando cada um dos dois dispositivos: almofadas de areia e uma espuma cilíndrica, que forneciam apoio isquiático e perineal, respectivamente. As pacientes atribuíram nota de 1 a 5 para a percepção que tiveram da contração dos músculos do AP, da facilitação da contração (quanto maior a nota, melhor o resultado) e do desconforto com o dispositivo (quanto maior a nota, maior o desconforto) em comparação às contrações livres. Como resultados principais, verificou-se que o uso da almofada cilíndrica foi similar ao das almofadas de areia para a percepção da contração dos músculos do AP (2,84±1,61 vs. 3,19±1,43; p=0,34), e da facilitação da contração (3,38±1,34 vs. 3,19±1,54; p=0,61), assim como do desconforto (1,83±1,23 vs. 1,5±1,16; p=0,20). Entre as participantes, 57% relataram preferir as almofadas de areia. Concluiu-se que em mulheres com incontinência urinária, tanto as almofadas de areia (apoio isquiático) quanto a espuma cilíndrica (apoio perineal) melhoraram a percepção da contração e facilitaram a contração dos músculos do assoalho pélvico na posição sentada, não havendo, no entanto, diferença entre os dispositivos.

RESUMEN Las herramientas de apoyo pueden ayudar en la percepción de la contracción de los músculos del suelo pélvico (SP), que no siempre es fácil de obtener su medición. El objetivo de este estudio fue comparar si dos tipos diferentes de herramientas ayudan a las mujeres con disfunción muscular del SP a contraer estos músculos en posición sentada. Para ello, se realizó un estudio transversal con 37 mujeres con incontinencia urinaria (IU) de esfuerzo o mixta. Primero, las participantes realizaron tres contracciones libres de los músculos del SP sentadas en una silla, sin el uso de herramientas de apoyo. Luego, realizaron tres contracciones utilizando cada uno de los dos dispositivos de apoyo: almohadillas de arena y espuma cilíndrica, que brindan apoyo isquiático y perineal, respectivamente. Las participantes deberían asignar una puntuación de 1 a 5 cuanto a su percepción de la contracción muscular del SP, de la facilitación de la contracción (cuanto mayor sea la puntuación, mejor será el resultado) y la incomodidad con la herramienta (cuanto mayor sea la puntuación, mayor será la incomodidad) en comparación con las contracciones libres. Los principales resultados encontrados apuntan que el uso de la almohadilla cilíndrica fue similar al de las almohadillas de arena en cuanto a su percepción de la contracción de los músculos del SP (2,84±1,61 vs. 3,19±1,43; p=0,34), y la facilitación de la contracción (3,38±1,34 vs. 3,19±1,54; p=0,61), así como la incomodidad (1,83±1,23 vs. 1,5±1,16; p=0,20). El 57% de las participantes informó preferir las almohadillas de arena. Se concluyó que tanto las almohadillas de arena (apoyo isquiático) como la espuma cilíndrica (apoyo perineal) mejoraron la percepción y la facilitación de la contracción muscular del SP en posición sentada de mujeres con disfunción muscular del SP en comparación con la ausencia de la herramienta, sin embargo, hay no hubo diferencia entre las herramientas.

Effects of Hyperthyroidism on Contractility and Na+/Ca2+ Exchanger Activity in the Isolated Papillary Muscle of Rats

Abstract Background: Hyperthyroidism (Hy) is an endocrine disorder, in which the thyroid hormones markedly alter the cardiac function. Increased myocardial contractility and cardiac output, improvement in diastolic relaxation, changes in electrical activity, increments in ventricular mass, and arrhythmias have been reported. However, the influences of thyroid hormones upon molecular mechanisms of cardiac functions have not yet been fully understood. Objectives: To evaluate changes in cardiac contractile parameters and the Na+/Ca2+ exchanger (NCX) function in induced hyperthyroid rats. Methods: Hy was induced by intraperitoneal injections of T3 (15 μg/100 g) for 10 days. Contractile parameters and NCX function were evaluated in the isolated papillary muscle. Data normality was confirmed by the Shapiro-Wilk test. The comparison between groups was performed through an unpaired Student's t-test. Results are expressed as mean ± SD. The accepted significance level was p < 0.05. Results: Our data revealed, in the Hy group, an increase of 30.98% in the maximum speed of diastolic relaxation (-284.64 ± 70.70 vs. -217.31 ± 40.30 mN/mm2/sec (p = 0.027)) and a boost of 149% in the NCX function in late phase of relaxation (20.17 ± 7.90 vs. 50.22 ± 11.94 minutes (p = 0.002)), with no changes in the maximum twitch force (p = 0.605) or maximum speed of systolic contraction (p = 0.208) when compared to the control. Conclusion: The improvement in relaxation parameters is hypothetically attributed to an increase in Sarco-Endoplasmic Reticulum Ca2+ATPase isoform 2 (SERCA2) expression and an increased calcium flow through L-type channels that boosted the NCX function.

Gender-based Variations in Trunk Motion and Isometric Strength in Young Adults with Low Back Pain: A Prospective Case-control Study / Variações baseadas em gênero no movimento e na força isométrica do tronco em jovens adultos com dor lombar: Um estudo de caso-controle prospectivo

Abstract Objective To determine gender-based variations in trunk range of motion (RoM) and isometric strength (IS) in symptomatic and asymptomatic young adults. Methods In this prospective case-control study, 73 subjects with low back pain (LBP) and 80 asymptomatic subjects were analyzed. Dynamometer-based device trunk RoM and IS measurements in extension, flexion, and rotation were compared in both groups and gender-based subgroups. Multivariate analysis was used to determine factors influencing trunk RoM and IS. Results Symptomatic males had significantly less extension RoM and extension, flexion, and rotation isometric trunk strength (ITS) (p < 0.0001) compared with asymptomatic males, whereas no significant difference was found between asymptomatic and symptomatic females. However, the mean extension-flexion RoM and mean extension-flexion ITS ratios were significantly lower (p = 0.04) in asymptomatic females compared with symptomatic females. Female gender was significantly associated with less extension and flexion ITS in both asymptomatic and symptomatic subjects. Conclusion Males with LBP had significant global ITS weakness when compared with asymptomatic males. Despite no significant ITS difference in symptomatic versus asymptomatic females, LBP caused significant extension-flexion RoM and ITS imbalance in females. These gender-based variations in trunk RoM and IS, especially the extensor-flexor IS imbalance in females, must be considered while designing rehabilitation treatment protocols for LBP.

Resumo Objetivo Determinar as variações na amplitude de movimento (ADM) do tronco e na força isométrica do tronco (FIT) em jovens adultos sintomáticos e assintomáticos baseadas no gênero dos indivíduos. Métodos Neste estudo caso-controle prospectivo, 73 indivíduos com dor lombar (DL) e 80 indivíduos assintomáticos foram analisados. As medidas de ADM do tronco e FIT de extensão, flexão e rotação foram comparadas em ambos os grupos e em subgrupos organizados por gênero. A análise multivariada foi usada para determinar os fatores que influenciam a ADM do tronco e a FIT. Results Symptomatic males had significantly less extension RoM and extension, flexion, and rotation isometric trunk strength (ITS) (p < 0.0001) compared with asymptomatic males, whereas no significant difference was found between asymptomatic and symptomatic females. However, the mean extension-flexion RoM and mean extension-flexion ITS ratios were significantly lower (p = 0.04) in asymptomatic females compared with symptomatic females. Female gender was significantly associated with less extension and flexion ITS in both asymptomatic and symptomatic subjects. Conclusão Indivíduos do sexo masculino com DL apresentaram significativa fraqueza global relacionada à FIT quando comparados com indivíduos do sexo masculino assintomáticos. Apesar de não haver diferença significativa de FIT em indivíduos do sexo feminino sintomáticos versus assintomáticos, a DL impactou a ADM e a FIT de extensão-flexão em indivíduos do sexo feminino. Essas variações de ADM do tronco e FIT baseadas no sexo, especialmente o desequilíbrio extensor-flexor de força isométrica em indivíduos do sexo feminino, devem ser consideradas ao projetar-se protocolos de tratamento de reabilitação para lombalgia.

Efectos de un protocolo de entrenamiento excéntrico sobre el rendimiento de velocidad en adolescentes de Chile / Effects of an Eccentric Training Protocol on Speed Performance in Chilean Adolescents

Resumen Introducción: Los beneficios del entrenamiento de fuerza sobre la velocidad de carrera han sido descritos en la bibliografía especializada, sin embargo, la evidencia sobre la influencia de estímulos específicos, basados en contracciones excéntricas sobre la musculatura extensora de cadera, no han sido demostrados. Objetivo: Determinar los efectos de un protocolo de entrenamiento basado en contracciones excéntricas (curl nórdico) sobre la velocidad de carrera en 20 metros en adolescentes de la región de Ñuble, Chile. Metodología: 42 individuos escolares fueron divididos en grupo experimental (n=22) y grupo control (n=20). El entrenamiento se desarrolló durante 6 semanas, con una frecuencia de 2 sesiones/semana, pasando de un volumen de 8 a 32 repeticiones de curl nórdico por sesión para el grupo experimental. El rendimiento de velocidad fue evaluado en 20 metros. La prueba T de Student fue utilizada para comparar los resultados pre y post intervención y se calculó el tamaño del efecto (TE). Resultados: Se encontraron diferencias estadísticamente significativas (p<0,05) a partir de la intervención en el grupo experimental (pre= 3,43 s. vs post= 3,15 s.), y un TE grande (1,04). Conclusión: Se concluye que el entrenamiento excéntrico basado en la aplicación de Curl nórdico, mejora el rendimiento de la velocidad de carrera.

Abstract Introduction: The specialized literature has described the benefits of strength training on running speed. In the same way, stimulation of training based on eccentric contractions has been shown to be effective in improving this quality. Objective: To determine the effects of a training protocol based on the stretch-shortening cycle (SSC) and another on eccentric contractions (Nordic curl) on the running speed in 20 meters in adolescents from the Ñuble Region, Chile. Methodology: 42 school subjects were divided into experimental group (n = 22) and control group (n = 20). The training was developed for 6 weeks, with a frequency of 2 sessions/week, going from a volume of 8 to 32 repetitions of Nordic curl per session for the experimental group. The speed performance was evaluated in 20 meters. With photocells, the T Student's was applied to compare the pre- and post-intervention results, and the effect size (ES) was calculated. Results: Statistically significant differences were found (p <0.05) from the intervention in the experimental group (pre= 3,43 s. vs post= 3,15 s.), and a large ES (1,04). Conclusion: It is concluded that the eccentric training based on the application of Nordic Curl improves the performance of the running speed.

Resumo Introdução: Os benefícios do treinamento de força na velocidade de corrida foram descritos na literatura especializada, no entanto, não foram demonstradas evidências sobre a influência de estímulos específicos, baseados em contrações excêntricas na musculatura extensora do quadril. Objetivo: Determinar os efeitos de um protocolo de treinamento baseado em contrações excêntricas (cacho nórdico) em velocidade de corrida de 20 m em adolescentes da região do Ñuble, Chile. Metodologia: 42 escolares foram divididos em um grupo experimental (n=22) e um grupo controle (n=20). O treino foi desenvolvido durante 6 semanas, com uma frequência de 2 sessões/semana, passando de um volume de 8 para 32 repetições de ondulação nórdica por sessão para o grupo experimental. O desempenho da velocidade foi avaliado acima de 20 metros. O teste T de Student foi usado para comparar os resultados pré e pós-intervenção e o tamanho do efeito (TE) foi calculado. Resultados: Foram encontradas diferenças estatisticamente significativas (p<0,05) da intervenção no grupo experimental (pré= 3,43 s. vs pós= 3,15 s.), e um TE grande (1,04). Conclusão: Conclui-se que o treinamento excêntrico baseado na aplicação do Curl nórdico melhora o desempenho da velocidade de corrida.

Efecto contráctil del extracto acuoso de Artemisia absinthium (ajenjo) frente a oxitocina en útero aislado de ratas / Contractile effect of aqueous extract of Artemisia absinthium (ajenjo) against oxytocin in isolated uterus of rats

RESUMEN Introducción. El uso de Artemisia absinthium (ajenjo) en el trabajo de parto es ampliamente empleado en países de la región; sin embargo, no hay evidencia científica suficiente de su eficacia y seguridad, lo que representa un alto riesgo maternofetal. Objetivo. El propósito fue evaluar el efecto contractil de la Artemisia absinthium (ajenjo) en comparación a la oxitocina en útero aislado de ratas. Métodos. Se separaron 8 ratas Holtzman en i) Grupo experimental: Artemisia dosis 5, 10, 20, 30, 40 y 50 mg y ii) Grupo control: oxitocina 10-6 M. Se montaron los úteros en un baño de órganos aislados y se registraron contracciones por 5 minutos. Resultados. La frecuencia de contracciones con ajenjo 40 y 50 mg fueron comparables con oxitocina (p>0,05). Asimismo, dosis de 20 y 30 mg de Artemisia provocaron contracciones significativamente más duraderas que la oxitocina. La intensidad resultó ser comparable con oxitocina con dosis de 20, 40 y 50 mg de Artemisia. Conclusión. El extracto acuoso de Artemisia absinthium presentó efecto contráctil similar a la oxitocina y dependiente de la dosis en útero aislado de ratas.

ABSTRACT Introduction. The use of Artemisia absinthium (wormwood) in labour is widely used in countries in the region; however, there is no enough scientific evidence of its efficacy and safety, which represents a high maternalfetal risk. Objective. The purpose was to assess the contractile effect of Artemisia absinthium (wormwood) compared to oxytocin in utero isolated from rats. Methods. Eight Holtzman rats were separated into i) Experimental group: Artemisia dose 5, 10, 20, 30, 40, and 50 mg and ii) Control group: oxytocin 10-6 M. The uteruses were mounted in an isolated organ bath, and contractions were recorded for 5 minutes. Results. The frequency of contractions with wormwood 40 and 50 mg were comparable with oxytocin (p>0.05). Likewise, doses of 20 and 30 mg of Artemisia caused significantly longer-lasting contractions than oxytocin. The intensity was found to be comparable with oxytocin at doses of 20, 40, and 50 mg of Artemisia. Conclusion. The aqueous extract of Artemisia absinthium has a contractile effect similar to oxytocin and is dose dependent in utero isolated from rats.

Blood glucose kinetics during concentric and eccentric muscle contractions

Studies comparing the two classes of stimuli (concentric and eccentric) have shown differences in the improvement of cardiovascular, metabolic, and muscle strength gain. This is an experimental, quantitative, and prospective study that aimed to verify the effect of eccentric exercise on glycolytic consumption and kinetics. The blood glucose kinetics of 17 male subjects was evaluated during a treadmill exercise with a 10% declined floor and velocity that required a 60% metabolic activity of VO2max, for 30 minutes. Seventy-two hours later, the same subjects exercised on the treadmill with a 10% inclined floor and 60% VO2max, for 30 minutes. To quantify glucose, blood samples were collected before the exercise, every three minutes along the 30 minutes of physical activity, and five and 10 minutes after finishing the exercise. For the downward slope, there was a homogeneous group behavior for blood glucose dynamics during the exercise, which was characterized by a monotonic decrease of glucose levels until reaching a minimum value at experimental times between 20 and 30 min, followed by a progressive recovery toward initial values. For the acclivity condition, blood glucose dynamics did not follow such a homogeneous behavior. A set of different types of dynamics could be identified. Experimental data showed that the type of dynamics could be predicted, to some extent, by the basal blood glucose level of subjects. The type of floor slope (upward or downward) directly affected glycolytic consumption and kinetics for the individuals analyzed.

Padrões de contração muscular e suas associações no terço superior da face: um estudo clínico e epidemiológico / Muscle contraction patterns and their associations in the upper third of the face: a clinical and epidemiological study

Introdução: o uso da toxina botulínica tornou-se um dos procedimentos cosméticos mais importantes realizados no mundo. Objetivo: identificar padrões de contração muscular da fronte, complexo glabelar e músculo orbicular dos olhos em pacientes do sul do Brasil, estabelecendo sua epidemiologia e possíveis associações entre eles. Métodos: foram incluídos 101 pacientes que buscaram tratamento com toxina botulínica para fronte, glabela e linhas perioculares entre 2012 e 2016. Análises foram feitas por meio de fotografias digitais tiradas durante consulta médica, antes da aplicação dos produtos. Os pacientes foram tratados com diferentes marcas de toxina botulínica, de acordo com suas preferências ou com as do médico. Resultados: os padrões de contração mais comuns foram frontal completo, glabelar em setas convergentes e periocular completo. Mulheres representaram 94,1% dos pacientes. A maioria tinha idade entre 31 e 50 anos, com média de 44,57 anos. Padrões mais frequentes em cada área individual foram mais frequentemente associados. Conclusões: o estudo mostra os principais padrões de contração muscular do terço superior da face em 101 pacientes, bem como suas características clínicas, e os compara com artigos publicados anteriormente. Estudos sobre padrões de contração muscular podem auxiliar no uso mais seguro e racional dos produtos disponíveis, evitando desperdícios e complicações.

Introduction: The use of botulinum toxin has become one the essential cosmetic procedures performed in the world. Objective: To identify patterns of muscle contraction of the forehead, glabellar complex, and orbicularis oculi muscle in patients from southern Brazil, establishing their epidemiology and possible associations between them. Methods: One hundred and one patients who sought treatment with botulinum toxin for the forehead, glabella, and periocular lines between 2012 and 2016 were included. Analyzes were made using digital photographs taken during a medical consultation before applying the products., The subjects received with different brands of botulinum toxin, according to the patients' or the doctors' preference Results: The most common contraction patterns were complete frontal, glabellar in converging arrows, and complete periocular. Women represented 94.1% of patients. Most patients were between 31 and 50 years old, with an average of 44.57 years. More frequent patterns in each area were more frequently associated. Conclusions: The study shows the main muscle contraction patterns of the upper third of the face in 101 patients, as well as their clinical characteristics, comparing them with previously published articles. Studies on muscle contraction patterns can assist in the safer and more rational use of the products available, avoiding waste and complications.