Changes of thickness and elasticity of skeletal muscles in diabetic patients and relative impact factors / 中国医学影像技术

Objective To observe changes of thickness and elasticity of skeletal muscles in patients with type 2 diabetes mellitus(T2DM)and relative impact factors.Methods Totally 62 T2DM patients(T2DM group)and 60 healthy adults(HC group)were prospectively recruited.Shear wave elastography(SWE)technology was used to measure the maximum Young's modulus(Emax)of the rectus abdominis and gastrocnemius muscles under relaxed and contracted states in both groups.The thickness and elasticity modulus of the skeletal muscles under the two states were compared between groups.Multiple linear regression analysis was performed to screen impact factors of the elasticity modulus of the rectus abdominis and gastrocnemius muscles.Results No significant difference of muscle thicknesses of rectus abdominis,nor of gastrocnemius muscle was found between groups under relaxed and contracted states(all P＞0.05).Under both relaxed and contracted states,the Emax of the rectus abdominis and gastrocnemius muscle in T2DM group were all lower than those in HC group(all P＜0.05).Multiple linear regression analysis showed that in T2DM group,the elasticity modulus of the rectus abdominis and gastrocnemius muscle under both relaxed and contracted states decreased linearly with disease duration,fasting blood glucose(FBG)and glycosylated hemoglobin(HbA1c)(all P＜0.05).Conclusion The elasticity modulus of skeletal muscle decreased in T2DM patients,and the reducing scales linearly related to disease duration,FBG and HbA1c.

Clinical analysis and literature review of juvenile idiopathic inflammatory myopathy with positive anti-NXP2 antibody / 中华风湿病学杂志

Objective:To investigate the clinical characteristics, muscle pathological features and treatment in patients with Juvenile idiopathic inflammatory myopathy (JIIM) with positive anti-nuclear matrix protein 2 (NXP2) antibody.Methods:The clinical data of 8 IMM patients with positive anti-NXP2 antibody were collected and the clinical manifestations, auxiliary examinations, muscle pathological changes and therapeutic effects were retrospectively analyzed.Results:The ratio of male to female was 1:3. The median age of disease onset was (6.1±3.8) years. Eight cases had proximal muscle weakness, 7 had dermatomyositis-like rash, 5 had myalgia,4 had calcinosis,3 had skin ulcer, 2 had edema and 1 had abdominal pain. Five cases had elevated serum creatine kinase. Eight cases with lower limb muscle MRI showed abnormal signals in muscle, space between muscles and fat tissue, 3 cases with chest high-resolution CT (HRCT) showed interstitial lung disease. Abdominal CT of 1 case showed irregular thickening, edema and peripheral inflammatory exudation in ascending colon and proximal transverse colon. Pathological biopsy of skeletal muscle showed perifascicular atrophy, inflammatory cell infiltration in fascicular membrane and around small vessels and muscle fiber space. Edema, hyperplasia could be seen in interstitium; but dissolved necrosis, and regenerated muscle fibers were rarely seen. Treatments included glucocorticoids, immunosuppressive agents and biological agents (1 case). After 6 months of follow-up, 5 cases had good outcomes and 3 cases had poor outcomes.Conclusion:Dermatomyositis is the major clinical manifestation of idiopathic inflammatory myopathy with positive anti-NXP2 antibody.It is associated with myasthenia, calcinosis, skin ulcers and intestinal vasculitis. The pathological changes in skeletal muscle are relatively slightmild. Glucocorticoids combined with immunosuppressive agents are effective in most cases.

Value of skeletal muscle index combined with interleukin-6 and activin A in predicting early-stage pancreatic cancer cachexia / 临床肝胆病杂志

ObjectiveTo investigate the value of L3 skeletal muscle index （L3-SMI） combined with interleukin-6 （IL-6） and activin A in predicting early-stage pancreatic cancer cachexia. MethodsA total of 74 patients with pancreatic cancer who were diagnosed in Hebei Medical University Forth Hospital from July 2020 to July 2023 were enrolled， and according to the presence or absence of cachexia after admission， the patient were divided into cachexia group with 58 patients and non-cachexia group with 16 patients. The levels of L3-SMI， IL-6， and activin A were observed within 48 hours after admission. The independent-samples t test was used for comparison of normally distributed continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. A multivariate Logistic regression analysis was used to investigate the influencing factors for pancreatic cancer cachexia； the receiver operating characteristic （ROC） curve was used to analyze the value of L3-SMI， IL-6， and activin A alone or in combination in predicting pancreatic cancer cachexia， and the Z test was used for comparison of the area under the ROC curve （AUC）. ResultsCompared with the non-cachexia group， the cachexia group had a significantly higher level of L3-SMI and significantly lower serum levels of IL-6 and activin A （t=8.649， 3.049， and 8.100， all P<0.05）. The multivariate logistic analysis showed that L3-SMI （odds ratio ［OR］=0.266， 95% confidence interval ［CI］： 0.103‍ ‍—‍ ‍0.683， P<0.05）， serum IL-6 （OR=4.158， 95%CI： 1.368‍ ‍—‍ ‍12.333， P<0.05）， and activin A （OR=5.124， 95%CI： 1.550‍ ‍—‍ ‍16.939， P<0.05） were influencing factors for pancreatic cancer cachexia. L3-SMI， IL-6， and activin A alone had a significantly lower AUC than the combination of the three indicators in predicting pancreatic cancer cachexia （0.851/0.752/0.791 vs 0.946， Z=-2.841， -2.552， and -2.647， all P<0.001）， and the combination of the three indicators had the highest sensitivity （90.9%）， specificity （87.8%） and Youden index （0.788）. ConclusionL3-SMI combined with serum IL-6 and activin A has a good value in predicting early-stage pancreatic cancer cachexia.

Study on thoracic skeletal muscle characteristics of Danon disease and hypertrophic cardiomyopathy based on cardiovascular magnetic resonance imaging / 中国医师杂志

Objective:To apply cardiovascular magnetic resonance (CMR) to quantitatively evaluate the morphology and tissue characteristics of thoracic skeletal muscle (TSM) in patients with Danon disease and hypertrophic cardiomyopathy (HCM), in order to provide auxiliary differential diagnostic information.Methods:A retrospective study was conducted on 15 Danon disease patients (Danon disease group) who completed CMR examination, and 15 HCM patients (HCM group) and 15 healthy volunteers (control group) who were matched by gender and age were compared. TSM (pectoralis major, pectoralis minor, erector spinae, and subscapularis) area index (TSMAi), T1 relaxation time of four groups, and extracellular volume (ECV) of skeletal muscles of two groups (pectoralis major and subscapularis) were measured for all subjects. Single factor analysis of variance and KruskalWallis test were used to compare three sets of values.Results:The total TSMAi of the Danon disease group was lower than that of the HCM group and the control group [(15.37±3.28)cm 2/m 2 vs (23.02±3.88)cm 2/m 2 vs (22.33±4.67)cm 2/m 2, P<0.001], and the TSMAi of each TSM was also lower than that of the HCM group and the control group (all P<0.05). There was no statistically significant difference in TSMAi between the HCM group and the control group (all P>0.05). The native T1 values of the pectoralis major muscle in the Danon disease group and HCM group were higher than those in the control group (all P<0.05). The ECV of the pectoralis major muscle and subscapularis muscle in the Danon disease group were higher than those in the HCM group and control group, and the enhanced T1 values were lower than those in the HCM group and control group (all P<0.05); There was no statistically significant difference in ECV and the enhanced T1 values between the HCM group and the control group ( P>0.05). Conclusions:The application of CMR can effectively evaluate the changes in TSM morphology and tissue characteristics in Danon disease patients. Compared with HCM patients, Danon disease patients showed significant atrophy of TSM with increased extracellular volume. CMR provides a quantitative reference for TSM in the differential diagnosis of the two.

Hepatic and skeletal muscle tissue immunometabolism in trained rats / Inmunometabolismo del tejido hepático y muscular esquelético de ratas entrenadas / Imunometabolismo tecidual hepático e muscular esquelético de ratos treinados

ABSTRACT Introduction: Physical exercise can be an alternative for preventing and treating the harmful effects of obesity, mainly inflammatory effects on skeletal muscle and liver tissues. However, no consensus exists regarding this purpose's best physical training model. Objective: Evaluate morphological, metabolic, and inflammatory alterations in rats' skeletal and hepatic muscle tissues caused by aerobic and resistance training. Methods: 24 Wistar rats were divided into sedentary (S), aerobic (AE), and resistance training (R) groups. Blood glucose, total cholesterol, and serum triglycerides were measured periodically. After euthanasia, body mass was measured to calculate the total mass gain during the experiment. High-density lipoprotein (HDL) was measured. Adipose tissue was extracted to calculate its percentage relative to body mass and the liver, soleus, and gastrocnemius muscles for morphological analyses and concentrations of glycogen, lipids, and Tumor Necrosis Factor α (TNF-α). The Kruskall-Wallis test and Dunn's post-test were performed for statistical analysis, adopting p<0.05. Results: Both training models reduced the percentage of adipose tissue, body mass gain, and hepatic TNF-α concentration (p<0.05). AE increased serum HDL, gastrocnemius fiber diameter and reduced the fractal dimension in the soleus (p<0.05). R reduced blood glucose and serum and liver lipids, increased liver and soleus glycogen concentrations, increased gastrocnemius fiber diameter, and decreased TNF-α (p<0.05). Conclusion: Both training models reduced body mass, relative visceral adipose tissue, serum total cholesterol concentration, and liver inflammation. However, resistance training was more effective in promoting metabolic effects in the liver and skeletal muscle and reducing muscle inflammation in rats. Level of Evidence V; Expert Opinion.

RESUMEN Introducción: El ejercicio físico puede ser una alternativa para prevenir y tratar los efectos nocivos de la obesidad, principalmente los efectos inflamatorios sobre los tejidos del músculo esquelético y del hígado. Sin embargo, no existe consenso sobre cuál es el mejor modelo de entrenamiento físico para este fin. Objetivo: Evaluar las alteraciones morfológicas, metabólicas e inflamatorias del entrenamiento aeróbico y de resistencia en sobre los tejidos músculo esqueléticos y hepáticos de ratas. Métodos: 24 ratas Wistar se dividieron en grupos sedentarios (S), aeróbicos (AE) y de entrenamiento de resistencia (R). Se midieron periódicamente glucosa en sangre, colesterol total y triglicéridos. Después de la eutanasia, se midió la masa corporal para calcular la ganancia de masa total durante el experimento. Se midió la lipoproteína de alta densidad (HDL). Se extrajo tejido adiposo para calcular su porcentaje relativo a la masa corporal, así como hígado, músculos sóleo y gastrocnemio para análisis morfológicos y concentraciones de glucógeno, lípidos y Factor de Necrosis Tumoral α (TNF-α). Para el análisis estadístico fueron utilizados Kruskall-Wallis y el post-test de Dunn, adoptando p<0,05. Resultados: Ambos entrenamientos redujeron el porcentaje de tejido adiposo, masa corporal y la concentración de TNF-α hepático (p<0,05). AE aumentó el HDL sérico, el diámetro de la fibra del gastrocnemio y redujo la dimensión fractal en el sóleo (p<0,05). R redujo la glucosa en sangre y los lípidos séricos y hepáticos, aumentó las concentraciones de glucógeno hepático y sóleo, aumentó el diámetro de la fibra del gastrocnemio y disminuyó el TNF-α (p<0,05). Conclusión: Ambos modelos de entrenamiento redujeron la masa corporal, el tejido adiposo visceral relativo, la concentración sérica de colesterol total y la inflamación hepática. El entrenamiento de resistencia demostró ser más eficaz para promover los efectos metabólicos en el hígado y el músculo esquelético, además de reducir la inflamación muscular en ratas. Nivel de Evidencia V; Opinión del Especialista.

RESUMO Introdução: O exercício físico pode se apresentar como uma alternativa para prevenção e tratamento de efeitos deletérios da obesidade, principalmente efeitos inflamatórios sobre os tecidos muscular esquelético e hepático. No entanto, não há consenso quanto ao melhor modelo de treinamento físico para tal finalidade. Objetivos: Avaliar alterações morfológicas, metabólicas e inflamatórias dos treinamentos aeróbico e resistido sobre os tecidos muscular esquelético e hepático de ratos. Métodos: 24 ratos Wistar foram divididos nos grupos sedentário (S), treinamento aeróbico (AE) e resistido (R). Glicemia, colesterol total e triglicerídeos séricos foram mensurados periodicamente. Após a eutanásia, a massa corporal foi mensurada para calcular o ganho total de massa durante o experimento. A lipoproteína de alta densidade (HDL) foi dosada. O tecido adiposo foi extraído para cálculo de sua porcentagem relativa à massa corporal assim como o fígado e os músculos sóleo e gastrocnêmio para as análises morfológicas e das concentrações de glicogênio, lipídios e Fator de Necrose Tumoral α (TNF-α). Para análise estatística, foram utilizados o teste de Kruskall-Wallis e o pós-teste de Dunn, adotando-se p<0,05. Resultados: Ambos os modelos de treinamento reduziram o percentual de tecido adiposo, ganho de massa corporal e concentração hepática de TNF-α (p<0,05). AE aumentou o HDL sérico, o diâmetro das fibras do gastrocnêmio e reduziu a dimensão fractal no sóleo (p<0,05). R reduziu a glicemia e os lipídios séricos e hepáticos, aumentou a concentração de glicogênio hepático e sóleo, aumentou o diâmetro das fibras gastrocnêmicas e diminuiu o TNF-α (p<0,05). Conclusão: Ambos os modelos de treinamento reduziram a massa corporal, o tecido adiposo visceral relativo, a concentração sérica de colesterol total e a inflamação hepática. No entanto, o treinamento resistido mostrou-se mais eficaz em promover efeitos metabólicos no fígado e no músculo esquelético, além de reduzir a inflamação muscular em ratos. Nível de Evidência V; Opinião do Especialista.

Changes related to muscle autophagy after exhaustive exercise and blunt trauma / Cambios relacionados con la autofagia muscular tras ejercicio exhaustivo y traumatismo contuso / Alterações relacionadas à autofagia muscular após exercício exaustivo e trauma contuso

ABSTRACT Objective: To study the temporal changes of autophagy related factors in skeletal muscle of rats after exhaustive exercise and blunt trauma. Methods: Forty-two male SD rats were divided into 7 groups with 6 rats in each group: Quiet control group (C), immediately after exhaustive exercise (E0), 24 hours after exhaustive exercise (E24), 48 hours after exhaustive exercise (E48), immediately after blunt trauma (D0), 24 hours after blunt trauma (D24), 48 hours after blunt trauma (D48). All groups of rats were killed and samped respectively at different time points specified above, and the right gastrocnemius muscle was taken, which was divided into two parts, one for mRNAs of, Lamp-2, BNIP3 and NIX by real-time fluorescent quantitative PCR, and the other for p62 protein by Western blotting. Results: (1) Compared with group C, mRNA levels of p62, Lamp-2 and NIX in group E48 were significantly increased after exhaustive exercise(P<0.05), suggesting that autophagy increased in 48h after exhaustive exercise. (2) Compared with group C, p62mRNA and Lamp-2 mRNA levels were significantly increased immediately after blunt trauma(P<0.05) and decreased significantly in 48h after blunt trauma(P<0.05), suggesting that autophagy activity was enhanced immediately after blunt trauma and decreased in 48h after injury. Conclusions: Generally, there were differences at each recovery phase between blunt trauma and exhausted exercise models, and the basal autophagy factors and mitochondrial autophagy factors were also inconsistent. Basal autophagy factors p62 and Lamp-2 increased significantly 48 hours after eccentric exhaustive exercise and immediately after blunt trauma. Mitochondrial autophagy factor BNIP3 did not increase after exhaustive exercise and blunt trauma, but NIX only increased after exhaustive exercise. Its molecular mechanism needs to be further studied. Level of Evidence III; Therapeutic Studies Investigating the Results of Treatment.

RESUMEN Objetivo: Estudiar los cambios temporales de los factores relacionados con la autofagia en el músculo esquelético de ratas tras el ejercicio exhaustivo y el traumatismo contuso. Métodos: Se dividieron 42 ratas SD macho en 7 grupos con 6 ratas en cada grupo: grupo de control silencioso (C), inmediatamente después del ejercicio exhaustivo (E0), 24 horas después del ejercicio exhaustivo (E24), 48 horas después del ejercicio exhaustivo (E48), inmediatamente después de un traumatismo contuso (D0), 24 horas después de un traumatismo contuso (D24), 48 horas después de un traumatismo contuso (D48). Todos los grupos de ratas fueron sacrificados y rotulados, respectivamente, en diferentes momentos especificados anteriormente, y se extrajo el músculo gastrocnemio derecho, dividido en dos partes, una para los ARNm Lamp-2, BNIP3 y NIX mediante PCR cuantitativa fluorescente en tiempo real, y la otra para la proteína p62 mediante Western blotting. Resultados: (1) En comparación con el grupo C, los niveles de ARNm de p62, Lamp-2 y NIX en el grupo E48 aumentaron significativamente tras el ejercicio exhaustivo (P<0,05), lo que sugiere que la autofagia aumentó en las 48 horas posteriores al ejercicio exhaustivo. (2) En comparación con el grupo C, los niveles de ARNm de p62 ARNm y Lamp-2 aumentaron significativamente inmediatamente después del traumatismo contuso (P<0,05) y disminuyeron significativamente a las 48 horas después del traumatismo contuso (P<0,05), lo que sugiere que la actividad de autofagia aumentó inmediatamente después del traumatismo contuso y disminuyó a las 48 horas después de la lesión. Conclusión: En general, hubo diferencias en cada fase de recuperación entre los modelos de traumatismo contuso y ejercicio exhaustivo, y los factores de autofagia basal y los factores de autofagia mitocondrial también fueron inconsistentes. Los factores de autofagia basal p62 y Lamp-2 aumentaron significativamente 48 horas después del ejercicio excéntrico exhaustivo e inmediatamente después del traumatismo contuso. El factor de autofagia mitocondrial BNIP3 no aumentó tras el ejercicio exhaustivo y el traumatismo contuso, pero NIX sólo aumentó tras el ejercicio exhaustivo. Su mecanismo molecular debe investigarse con más detalle. Nivel de Evidencia III; Estudios Terapéuticos que Investigan los Resultados del Tratamiento.

RESUMO Objetivo: Estudar as alterações temporais dos fatores relacionados à autofagia no músculo esquelético de ratos após exercício exaustivo e trauma contuso. Métodos: Quarenta e dois ratos machos SD foram divididos em 7 grupos com 6 ratos em cada grupo: Grupo de controle silencioso (C), imediatamente após o exercício exaustivo (E0), 24 horas após o exercício exaustivo (E24), 48 horas após o exercício exaustivo (E48), imediatamente após o trauma contuso (D0), 24 horas após o trauma contuso (D24), 48 horas após o trauma contuso (D48). Todos os grupos de ratos foram mortos e rotulados, respectivamente, em diferentes momentos especificados acima, e o músculo gastrocnêmio direito foi retirado, dividido em duas partes, uma para mRNAs de Lamp-2, BNIP3 e NIX por PCR quantitativo fluorescente em tempo real, e a outra para a proteína p62 por imunotransferência. Resultados: (1) Em comparação com o grupo C, os níveis de mRNA de p62, Lamp-2 e NIX no grupo E48 aumentaram significativamente após o exercício exaustivo (P<0,05), sugerindo que a autofagia aumentou em 48 horas após o exercício exaustivo. (2) Em comparação com o grupo C, os níveis de mRNA de p62mRNA e Lamp-2 foram significativamente aumentados imediatamente após o trauma contuso (P<0,05) e diminuíram significativamente em 48 horas após o trauma contuso (P<0,05), sugerindo que a atividade de autofagia foi aumentada imediatamente após o trauma contuso e diminuiu em 48 horas após a lesão. Conclusão: Houve, via de regra, diferenças em cada fase de recuperação entre os modelos de trauma contuso e de exercício exaustivo, sendo que os fatores de autofagia basal e os fatores de autofagia mitocondrial também foram inconsistentes. Os fatores de autofagia basal p62 e Lamp-2 aumentaram significativamente 48 horas após o exercício excêntrico exaustivo e imediatamente após o trauma contuso. O fator de autofagia mitocondrial BNIP3 não aumentou após o exercício exaustivo e o trauma contuso, mas o NIX aumentou somente após o exercício exaustivo. Seu mecanismo molecular precisa ser investigado com mais detalhes. Nível de Evidência III; Estudos Terapêuticos que Investigam os Resultados do Tratamento.

The Influence of High Physical Demand on the Occurrence of Major Muscle and Ligament Injuries in Professional Soccer Athletes: A Systematic Review / A influência da alta demanda física na ocorrência das principais lesões musculares e ligamentares em atletas profissionais de futebol: Uma revisão sistemática

Abstract Objective The present systematic review aimed to investigate the influence of high physical demand on the increase in muscle and ligament injuries in professional soccer athletes. Methods We analyzed scientific publications to determine the incidences of the main injuries, their causes and mechanisms, and their association with high physical demand. We compared amateur and professional players and assessed the effectiveness of FIFA11+ as a prevention alternative. Searches occurred on Scielo, Pubmed, and Google Scholar databases. The filters were the topic, publication date (last 5 years), and study relevance. The indexing terms were the following: Overuse, Calendar, Injuries, Muscular, Ligament, Athletes, Soccer, Football. We described the main data obtained to compare and analyze the results. This study complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Results The query resulted in 24 articles published from 2019 to 2023. The high physical demand increased the risk of injuries. Most injuries occurred in the lower limbs. The most common injuries were strains, sprains, contractures, and ligament ruptures. FIFA11+ presented itself as a viable prevention alternative. Conclusion We concluded that high physical demand increases the most frequent muscle and ligament injuries in professional soccer players, that is, strains, sprains, contractures, and ligament rupture, suggesting the FIFA11+ program as a prevention alternative.

Resumo Objetivo Esta é uma revisão sistemática que objetivou investigar a influência da alta demanda física no aumento de lesões musculares e ligamentares em atletas profissionais de futebol. Métodos Tratou-se de buscar, por meio da análise de publicações em meios científicos, as incidências das principais lesões, abordando suas causas e mecanismos bem como sua relação com a alta demanda física. Comparamos jogadores amadores (categorias de base) com jogadores profissionais e avaliamos a eficácia do FIFA11+ como alternativa de prevenção. As buscas foram realizadas nas plataformas Scielo, Pubmed e Google Scholar. Os filtros foram de acordo com o tema, data de publicação (últimos 5 anos) e relevância para o estudo. Foram utilizados os seguintes termos de indexação: Overuse, Calendar, Injuries, Muscular, Ligament, Athletes, Soccer, Football. Os principais dados obtidos foram descritos, objetivando a comparação e análise dos resultados. Foram aderidas as recomendações da declaração de Principais Itens para Relatar Revisões Sistemáticas e Metanálises (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA). Resultados A pesquisa resultou em 24 artigos, publicados entre 2019 e 2023. Quanto à influência da alta demanda física, observou-se o aumento do risco de lesões. Em relação à incidência, constatou-se a prevalência de lesões nos membros inferiores. Quanto aos tipos de lesões, nota-se que as mais comuns são estiramento, entorse, contratura e rompimento ligamentar. Quanto ao FIFA11 + , apresentou-se como alternativa viável de prevenção. Conclusão Concluiu-se que a alta demanda física aumenta a ocorrência das lesões musculares e ligamentares mais frequentes em futebolistas profissionais, que são estiramento, entorse, contratura e rompimento ligamentar, sugerindo-se o programa FIFA11+ como prevenção.

Relationship between ultrasound measurement of quadriceps muscle and nutritional status in ICU patients in a high-complexity trauma care hospital / Relação entre medida do músculo quadríceps pelo ultrassom e estado nutricional em pacientes internados em UTI de um hospital de alta complexidade de atendimento ao trauma

ABSTRACT Objective The present study aimed to investigate the association of quadriceps muscle thickness, measured by ultrasound, with the nutritional status of critically ill patients in a referral high-complexity trauma care hospital. Methods A cross-sectional observational study was conducted in the intensive care units in a tertiary hospital in Brazil. The sample comprised 30 critically ill trauma patients admitted between February and March 2022. The methodology involved evaluating muscle mass and comparing nutritional status through mid-upper arm circumference measurements and ultrasound assessments. Specifically, the quadriceps muscle thickness was quantified using ultrasound at a predefined site between the iliac crest and the proximal border of the patella. Results: The Kruskal-Wallis test indicated variability in quadriceps muscle thickness between the nutritional status groups, with statistical significance reached after excluding the overweight group (H(2) = 7.532, p=0.023). The moderate malnutrition group exhibited notably lower quadriceps muscle thickness. A positive correlation was found between quadriceps muscle thickness and mid-upper arm circumference adequacy (p<0.05), demonstrating fair to moderately strong correlation (rs=0.531). Conclusion Significant changes in quadriceps muscle thickness were detected by ultrasound assessment in moderate malnutrition patients compared to patients of other nutritional statuses. Ultrasound may be a valuable technique for monitoring muscle integrity in critically ill patients.

RESUMO Objetivo O presente estudo teve como objetivo investigar a associação da espessura do músculo quadríceps, medida por ultrassom, com o estado nutricional de pacientes críticos em um hospital de referência de alta complexidade para o cuidado de traumas. Métodos Um estudo observacional transversal foi conduzido nas unidades de terapia intensiva de um hospital terciário no Brasil. A amostra compreendeu 30 pacientes críticos de trauma admitidos entre fevereiro e março de 2022. A metodologia envolveu a avaliação da massa muscular e a comparação do estado nutricional por meio de medições da circunferência do braço e avaliações por ultrassom. Especificamente, a espessura do músculo quadríceps foi quantificada usando ultrassom em um local pré-definido entre a crista ilíaca e a borda proximal da patela. Resultados O teste de Kruskal-Wallis indicou variabilidade na espessura do músculo quadríceps entre os grupos de estado nutricional, com significância estatística alcançada após a exclusão do grupo com sobrepeso (H(2)=7.532, p=0,023). O grupo com desnutrição moderada exibiu um resultado menor em espessura do músculo quadríceps. Foi encontrada uma correlação positiva entre a espessura do músculo quadríceps e a adequação da circunferência do braço médio-superior (p<0,05), demonstrando uma correlação de razoável a moderadamente forte (rs=0,531). Conclusão Mudanças significativas na espessura do músculo quadríceps foram detectadas pela avaliação de ultrassom em pacientes com desnutrição moderada em comparação com pacientes de outros estados nutricionais. O ultrassom pode ser uma técnica valiosa para monitorar a integridade muscular em pacientes críticos.

Effect of dexmedetomidine on tourniquet-induced skeletal muscle injury

SUMMARY OBJECTIVE: The aim of this study was to investigate whether dexmedetomidine could reduce tourniquet-induced skeletal muscle injury. METHODS: C57BL6 male mice were randomly assigned to sham, ischemia/reperfusion, and dexmedetomidine groups. Mice in the ischemia/reperfusion and dexmedetomidine groups received normal saline solution and dexmedetomidine intraperitoneally, respectively. The sham group underwent the same procedure as the ischemia/reperfusion group, with the exception of tourniquet application. Subsequently, the ultrastructure of the gastrocnemius muscle was observed, and its contractile force was examined. In addition, Toll-like receptor 4 and nuclear factor-κB expression within muscles was detected by Western blot. RESULTS: Dexmedetomidine alleviated myocyte damage and increased the contractility of skeletal muscles. Moreover, dexmedetomidine significantly inhibited the expression of Toll-like receptor 4/nuclear factor-κB in the gastrocnemius muscle. CONCLUSION: Taken together, these results demonstrate that dexmedetomidine administration attenuated tourniquet-induced structural and functional impairment of the skeletal muscle, partly through inactivation of the Toll-like receptor 4/nuclear factor-κB pathway.

Systematic evaluation of the effects of resistance training on the treatment and prevention of sarcopenia in the elderly / 中华老年医学杂志

Objective:To evaluate the effects of different types of resistance training on the treatment and prevention of sarcopenia in the elderly.Methods:A computer search was conducted in seven databases including PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, and Wanfang, to identify randomized controlled trials published from the inception of the databases to March 2023, for the assessment of the preventive effects of resistance training on sarcopenia in older adults.Two reviewers independently performed the literature search, selection, and quality assessment of the included studies.A Meta-analysis was conducted using RevMan 5.3.Results:A total of 12 studies with 1018 participants were included.Compared with the control group, resistance training significantly improved the skeletal muscle mass index( MD=0.34, 95% CI: 0.24~0.44, P<0.01), grip strength( MD=1.63, 95% CI: 0.73~2.53, P<0.01), and 5 times sit-to-stand test performance( MD=-1.99, 95% CI: -2.48--1.51, P<0.01).However, there was no significant improvement observed in muscle mass( MD=1.28, 95% CI: -0.38-2.94, P>0.05), knee extensor strength( SMD=1.71, 95% CI: -0.51-3.93, P>0.05), or gait speed( MD=0.03, 95% CI: -0.03-0.08, P>0.05). Conclusions:Resistance training improves the skeletal muscle mass index, grip strength and the time taken to perform the 5 times sit-to-stand test in the elderly, thus delaying degenerative skeletal muscle changes in older adults with sarcopenia and offering a preventive effect on sarcopenia in healthy senior adults.

Irisin and skeletal muscle mitochondrial function and sarcopenia / 中华老年医学杂志

Irisin is a muscle factor that plays a crucial role in exercise-induced metabolic responses.Recent studies have revealed that it can boost the metabolic rate of both myocytes and adipocytes, while also enhancing mitochondrial content and dynamics.This ultimately helps to safeguard skeletal muscle, promote muscle growth, and maintain optimal muscle function.Therefore, irisin has the potential to serve as both a predictor and a biomarker for sarcopenia.In this paper, we delve into the impact of irisin on skeletal muscle, specifically exploring the synergistic relationship between irisin and mitochondria.Additionally, we investigate the effectiveness of irisin in reversing and restoring muscle atrophy, ultimately establishing irisin as a valuable target for treating sarcopenia.

Relationship and associated mechanism of serum fibroblast growth factor 21 and sarcopenia in hemodialysis patients / 中华肾脏病杂志

Objective:To investigate the relationship between serum fibroblast growth factor 21 (FGF21) and sarcopenia in hemodialysis (HD) patients, and to explore the relationship between FGF21 and signal pathways related to skeletal muscle metabolism in uremic state at the cellular level.Methods:The data of the HD patients from the blood purification center of the Third Affiliated Hospital of Soochow University were collected in this prospective observational study between January 2018 and December 2019. Serum FGF21 concentration was detected by enzyme-linked immunosorbent assay (ELISA). Meanwhile, the skeletal muscle indexes (SMI) at the fourth thoracic vertebra (T4) and the first lumbar vertebra (L1) were assessed by chest CT. According to the T4 SMI and L1 SMI, the patients were divided into sarcopenia group and non-sarcopenia group. The relationship between serum FGF21 and sarcopenia was analyzed. The C2C12 mouse myoblasts were cultured in vitro, which were intervened with healthy human serum, healthy human serum+different concentrations of FGF21, uremic serum, uremic serum+different concentrations of FGF21. The expressions of muscle ring finger protein-1 (MURF1), muscle atrophy F-box (Atrogin-1), myogenic differentiation (MyoD) and myogenin (MyoG) were detected by Western blotting. Results:A total of 118 HD patients with age of (52.64±15.29) years were enrolled in the study, including 64 males (54.2%) and 54 females (45.8%). The images at T4 and L1 level assessed by chest CT could be acquired from 118 patients and 82 patients, respectively. According to the lowest sex-specific quartile ( P25) of T4 SMI (male < 59.92 cm 2/m 2, female < 46.75 cm 2/m 2) and the lowest sex-specific quartile ( P25) of L1 SMI (male < 29.02 cm 2/m 2, female < 24.50 cm 2/m 2), patients were divided into sarcopenia group and non-sarcopenia group, and there were 29(24.58%) and 20(24.39%) patients in the sarcopenia group, respectively. When the patients were divided into two groups according to the sex-specific lowest quartile of T4 SMI, although the serum FGF21 level in the sarcopenia group was higher than that in the non-sarcopenia group, there was no statistical significance between the two groups [448.52(183.96, 1 684.08) ng/L vs. 273.65 (152.83, 535.54) ng/L, Z=-1.741, P=0.082]. When the patients were divided into two groups according to the sex-specific lowest quartile of L1 SMI, the serum FGF21 level in the sarcopenia group was significantly higher than that in the non-sarcopenia group [460.95(188.91, 1 276.38) ng/L vs. 239.10(133.25, 466.36) ng/L, Z=-2.170, P=0.030]. Binary logistic regression analysis showed that higher serum FGF21 was an independent influencing factor for sarcopenia in HD patients regardless of whether the patients were divided into two groups according to the sex-specific lowest quartile of T4 SMI or the sex-specific lowest quartile of L1 SMI (T4 SMI grouping: OR=4.085, 95% CI 1.778-9.388, P=0.001; L1 SMI grouping: OR=7.327, 95% CI 1.841-29.160, P=0.005). At T4 and L1 levels, the area under the receiver operating characteristic curve of FGF21 in predicting sarcopenia in HD patients was 0.636(95% CI 0.494-0.779, P=0.036) and 0.684(95% CI 0.535-0.833, P=0.018), respectively. Cell experiment showed that compared with the uremic serum group, the expressions of MURF1 and Atrogin-1 in myotube cells were increased, while the expressions of MyoD and MyoG were significantly decreased in uremic serum+FGF21 group (both P < 0.05). Conclusions:Higher serum FGF21 is associated with an increased risk of sarcopenia in HD patients. FGF21 may increase the expression of ubiquitin proteasome system, reduce the synthesis and differentiation of skeletal muscle protein, and promote the occurrence of muscle atrophy in uremic patients

Evaluation of functional parameters of the foot and ankle in elderly with sarcopenia

SUMMARY OBJECTIVE: With population aging, the prevalence of sarcopenia has increased. It is a pathology often neglected, with the potential to cause great damage if not diagnosed and treated. The objective of this study was to identify sarcopenic elderly people through the SARC-F score and palm grip test and to evaluate foot and ankle functionality parameters: gait speed, plantar sensitivity, and baropodometry. METHODS: This is a descriptive and cross-sectional study. The sample consisted of 20 sarcopenic elderly diagnosed through the SARC-F score and the handgrip strength test, from which demographic data were obtained, and the three functional tests related to the foot and ankle were performed. RESULTS: No individual was aware of the term sarcopenia. Regarding gait speed, 20 (100%) presented values compatible with sarcopenia (average of 0.52 m/s). Regarding plantar sensitivity, five (25%) of the patients showed changes in the exam with the detection of insensitivity. Regarding baropodometry, higher pressure values were observed in the right foot (average of 52.9±7.01%) compared to the left (average of 47.10±7.01%) and in the hindfoot (average of 55.85±16.21%) compared to the forefoot (mean 44.15±15.35%). When correlating the analyzed variables with the SARC-F scores, the only association that showed statistical significance (p<0.05) was the dynamometry on the right. CONCLUSION: The SARC-F score and the handgrip strength test are easy to apply in the screening of sarcopenia, and the functional parameters of the foot and ankle were shown to be altered in the studied group.

Heteropterys tomentosa and Interactions with the Musculoskeletal System: Systematic Review / Heteropterys tomentosa e Interações com o Sistema Musculoesquelético: Revisão Sistemática

Abstract Although Brazil is a country with the greatest plant biodiversity, there are still shortcomings regarding phytotherapy studies and their practical application. In Brazil alone there are 65 plants with psychoactive principles, and Heteropterys tomentosa, from the ethnobotanical point of view, is one of the most famous plants in the Midwest region, it is known for its aphrodisiac, physical and mental invigorating and depurative properties. The objective of this review was to point out the number of scientific articles published about the benefits of using the plant H. aphrodisiac in interactions with the musculoskeletal system. A consultation was performed in 10 databases: Embase, Scopus, Pubmed, Livivo, Science Direct, Web of science, Cochrane, Koreamed, Lilacs and Clinical trials for the elaboration of a systematic review, for this there was no limitation of time, language or type of study. Results: the search described found 111 articles, all primary studies; of these only 5 original studies (4.5%) were included in the review. Positive adaptations were observed in bones, tendons, muscles and hormone release, which resulted in improvements in exercise time and load, delaying fatigue and increasing functional capacity. However, the scarcity of studies, pointed out several gaps, opening space for other works. (AU)

Resumo Embora o Brasil seja um país com a maior biodiversidade vegetal, ainda existem carências com relação a estudos fitoterápicos e sua aplicação prática. Só no Brasil existem 65 plantas com princípios psicoativos, e a Heteropterys tomentosa, no ponto de vista etnobotânico, é uma das plantas mais famosas da região Centro-Oeste, ela é conhecida por propriedades afrodisíacas, de revigorante físico e mental, e depurativa. O objetivo desta revisão foi apontar a quantidade de artigos científicos publicados sobre os benefícios da utilização da planta H. aphrodisiaca em interações com o sistema musculoesquelético. Foi realizada uma consulta em 10 bases de dados, sendo elas: Embase, Scopus, Pubmed, Livivo, Science Direct, Web of science, Cochrane, Koreamed, Lilacs e Clinical trials para a elaboração de uma revisão sistemática, para isso não houve limitação de tempo, de língua ou tipo de estudo. A busca descrita encontrou 111 artigos, sendo todos estudos primários; destes apenas 5 estudos originais (4,5%) foram incluídos na revisão. Foram observadas adaptações positivas em ossos, tendões, músculos e liberação hormonal, que acarretaram melhorias no tempo e carga de exercício, retardando a fadiga e aumentando a capacidade funcional. Contudo, a escassez de estudos, apontou diversas lacunas, abrindo espaço para outros trabalhos. (AU)

Effect of different ischemia preconditioning modes on ischemia-reperfusion injury of skeletal muscle in rats / 中华创伤杂志

Objective:To investigate the effect of different ischemic preconditioning (IPC) modes on ischemia-reperfusion (IR) injury of skeletal muscle in rats.Methods:Forty male SD rats were selected to construct the model of IR injury of skeletal muscle by clamping one side of the femoral artery. In the IPC mode, the right femoral artery was clipped for 10 minutes, and reperfusion ensued for 10 minutes after the release of artery clamp. Such preconditioning procedure was repeated 3 times. The rats were divided into conventional IR group, IPC immediate group, IPC24-hour group, IPC48-hour group and sham operation group according to the random number table method, with 8 rats in each group.In conventional IR group, the right femoral artery was clipped for 3 hours and then the artery clamp was released to allow reperfusion for 3 hours. In IPC immediate group, the same treatment as conventional IR group was performed immediately after preconditioning. In IPC24-hour group, the rats received skin suturing after preconditioning and then fed in a cage for 24 hours before the same treatment as conventional IR group. In IPC48-hour group, the rats received skin suturing after preconditioning and then fed in a cage for 48 hours before the same treatment as conventional IR group. In sham operation group, the right femoral artery was bluntly separated but not clipped. At the end of reperfusion, the tibialis anterior muscle tissue, gastrocnemius muscle tissue and serum were collected. The ratio of wet weight to dry weight (W/D) of the tibialis anterior muscle tissue was calculated to evaluate tissue edema. After HE staining, histopathological changes of gastrocnemius muscle were observed and the injury severity of gastrocnemius tissue was scored. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and malondialdehyde (MDA) were determined by ELISA. Expressions of hypoxia receptor (EGLN1) and hypoxia-inducible factor-1α (HIF-1α) in the gastrocnemius tissue were detected by real-time fluorescence quantitative PCR (qRT-PCR).Results:The degree of tissue edema was reduced under different IPC modes when compared with conventional IR group (all P<0.01). The W/D in conventional IR group, IPC immediate group, IPC24-hour group and IPC48-hour group were 6.05±0.19, 5.70±0.12, 5.25±0.13 and 5.50±0.08, higher than 3.80±0.08 in sham operation group (all P<0.01). IPC24-hour group had the least degree of edema when compared with IPC immediate group and IPC48-hour group ( P<0.05 or 0.01). The muscle fibers in sham operation group were neatly arranged with clear structure, and the muscle fibers in other groups showed different degrees of injury and inflammatory infiltration. The total scores for tissue injury severity in IPC immediate group, IPC24-hour group and IPC48-hour group were (8.15±0.15)points, (6.15±0.38)points and (6.90±0.19)points, lower than (9.60±0.50)points in conventional IR group and higher than (0.16±0.16)points in sham operation group (all P<0.01). The total scores for tissue injury severity in IPC24-hour group and IPC48-hour group were not significantly different ( P>0.05), but both decreased when compared with IPC immediate group ( P<0.05 or 0.01). ELISA showed that the levels of TNF-α, IL-1β and MDA under different IPC modes were higher than those in sham operation group (all P<0.01), and the order from high to low was conventional IR group, IPC immediate group, IPC48-hour group, IPC24-hour group and sham operation group. Levels of IL-1β, TNF-α and MDA in IPC24-hour group were decreased when compared with IPC immediate group and IPC48-hour group (all P<0.05). qRT-PCR showed that the expression of EGLN1 mRNA from high to low was conventional IR group, IPC48-hour group, sham operation group, IPC immediate group and IPC24-hour group and that the expression of EGLN1 mRNA in IPC24-hour group decreased when compared with conventional IR group, IPC immediate group and IPC48-hour group (all P<0.01). The expression of HIF-1α mRNA increased under different IPC modes when compared with sham operation group (all P<0.01), and the order from high to low was IPC24-hour group, IPC immediate group, IPC48-hour group, conventional IR group and sham operation group. The expression of HIF-1α mRNA in IPC24-hour group increased when compared with conventional IR group, IPC immediate group and IPC48-hour group ( P<0.05 or 0.01), but there was no significant difference between IPC immediate group and IPC48-hour group ( P>0.05). Conclusions:Different ischemic preconditioning modes can reduce IR injury of skeletal muscle in rats by reducing tissue edema, inflammatory symptoms and oxidative stress response, among which reperfusion 24 hours after IPC has the best effect on IR injury. EGLN1 and HIF-1α may be involved in IPC to alleviate IR injury of skeletal muscle in rats.

Correlation between phase angle and loss of muscle mass in elderly diabetic patients / 中华老年医学杂志

Objective:To investigate the correlation between phase angle and muscle mass reduction in elderly diabetic patients.Methods:This paper retrospectively collected and analyzed the data of human composition and laboratory index in elderly patients with diabetes(n=106)and non-diabetic(n=153)patients in the Nutrition Department of Beijing Hospital, compared the differences between two groups, and explored the correlation between phase angle and muscle mass reduction in elderly diabetic patients.Phase angle was detected by bioelectrical impedance which was calculated as reactance/resistance× 180/π.Results:Phase angle was lower in elderly diabetic patients(5.17±0.65)°than in non-diabetic elderly patients(5.37±0.76)°( t=-2.075. P<0.05); age and fasting blood glucose were higher in elderly diabetic patients than in non-diabetic elderly patients(all P<0.05).There was no significant difference between the two groups in body mass index, fat, body fat percentage, visceral fat area, skeletal muscle index, body cell mass, total protein, albumin, and hemoglobin(all P>0.05).Correlation analysis results showed that in elderly diabetic patients, the phase angle was negatively correlated with body mass index( r=0.288, P<0.01), age( r=-0.680, P<0.01), was positively correlated with skeletal muscle( r=0.477, P<0.01), skeletal muscle index( r=0.505, P<0.01)and hemoglobin( r=0.382, P<0.01); and in the elderly non-diabetic group, phase angle was negatively correlated with age( r=-0.666, P<0.01)and positively correlated with body mass index( r=0.296, P<0.01), skeletal muscle( r=0.504, P<0.01), fat free mass( r=0.161, P<0.05), skeletal muscle index( r=0.441, P<0.01), body cell volume( r=0.496, P<0.01), and hemoglobin( r=0.420, P<0.01).The bioelectrical impedance apectroscopy detected skeletal muscle mass index<7.0 kg/m 2 for male and<5.7 kg/m 2 for female were used as the diagnosis standard for reduced muscle mass.The detection rate of muscle mass reduction was higher in elderly diabetic patients(17 cases, 16.04%)than in elderly non-diabetic patients(12 cases, 7.84%, χ2=4.229, P<0.05).The results of multiple regression analysis showed that the decrease of muscle mass in elderly diabetic patients was related to low phase angle( OR=0.413, 95% CI: 0.280-0.973, P<0.05)and aging( OR=2.174, 95% CI: 1.574-3.003, P<0.01). Conclusions:The phase angle is lower in diabetic elderly patients than in non-diabetic elderly patients, and the incidence of muscle mass reduction is higher in diabetic elderly patients than in non-diabetic elderly people.Decreased phase angle and increased age are related to the decrease of muscle mass in elderly diabetic patients.

Release of gastrocnemius aponeurosis and suture of the Achilles tendon end scar tissue managing the chronic Achilles tendon rupture / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of scar tissue suture at the broken end of Achilles tendon after gastrocnemius aponeurosis release in the treatment of chronic Achilles tendon rupture.@*METHODS@#The clinical data of 17 patients with old achilles tendon rupture treated from January 2017 to December 2019 were analyzed retrospectively, including 15 males and 2 females, aged 26 to 53 years with an average of (35.2±11.6) years old, and the time from injury to operation was 37 to 92 days with an average of (49.3±13.3) days. Myerson's classification included 6 cases of typeⅡ and 11 cases of typeⅢ. The defect of the broken end of Achilles tendon was 2 to 5 cm with an average of(4.1±1.5) cm after partial scar tissue was removed. All patients were treated with gastrocnemius aponeurosis, appropriate excision of scar tissue at the broken end of Achilles tendon and direct suture. The continuity and healing of Achilles tendon were evaluated by color Doppler ultrasound 3 months after operation. The ankle plantar flexor strength was measured by ankle plantar flexor strength tester before operation and 1 year after operation. American Orthopaedic Foot and Ankle Society ankle hindfoot score (AOFAS) and Achilles tendon rupture score were used before operation and 1 year after operation Achilles tendon total fracture score (ATRS) was used to evaluate the clinical rehabilitation of Achilles tendon rupture.@*RESULTS@#All patients were followed up for 12 to 18 months with an average of(13.6±1.8) months. The surgical incision healed in stageⅠ. Color Doppler ultrasound showed good continuity of Achilles tendon, local Achilles tendon slightly thickened and irregular fiber direction. The ankle plantar flexor force (92.2±3.9) N at 1 year after operation was significantly higher than that before operation (29.5±4.2) N (P<0.05);One year after operation, the AOFAS(91.20±3.30) was significantly higher than that before operation (42.20±4.40)(P<0.05);the ATRS (90.70±3.00) was significantly higher than that before operation(40.00±2.90)(P<0.05).@*CONCLUSION@#The gastrocnemius aponeurosis release combined with scar suture of Achilles tendon end is an effective technique for the treatment of chronic Achilles tendon rupture, avoid injury to hallux flexor longus or flexor digitorum longus, with the plantar flexor muscle strength of the ankle was recovered well, is an effective method to treat chronic Achilles tendon rupture.

Effect of SmO 2 goal-directed hemodynamic management on postoperative renal function in hypertensive patients undergoing laparoscopic radical gastrectomy for gastrointestinal tumors / 中华麻醉学杂志

Objective:To evaluate the effect of goal-directed hemodynamic management of muscle oxygen saturation (SmO 2) on the postoperative renal function in hypertensive patients undergoing laparoscopic radical gastrectomy for gastrointestinal tumors. Methods:Eighty-six essential hypertension patients, aged 18-64 yr, with body mass index ≤ 30 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective laparoscopic radical gastrectomy for gastrointestinal tumors under general anesthesia, were divided into 2 groups ( n=43 each) using a random number table method: routine group (group C) and SmO 2 goal-directed group (group S). The fluctuation of mean arterial pressure (MAP) and heart rate (HR) were maintained < 20% of the preoperative baseline value by adjusting infusion speed and vasoactive drugs in group C. SmO 2 was maintained not less than 70% or not less than the baseline value by evaluating cardiac output (CO), HR, stroke volume, stroke volume variation, systemic vascular resistance index and MAP and by adjusting infusion rate and vasoactive drugs in group S. SmO 2, HR, MAP, CO, cardiac index (CI), stroke volume variation and systemic vascular resistance index were recorded before anesthesia induction (T 0, baseline value), at the beginning of surgery (T 1), at 40 min after the start of pneumoperitoneum (T 2), at 5 min after the end of pneumoperitoneum (T 3), and at the end of surgery (T 4). The glomerular filtration rate was measured before surgery and at 24 h after surgery, and the occurrence of decline in postoperative acute renal function was recorded.Intraoperative hypotension, fluid input and output, postoperative tracheal extubation time, length of hospital stay, occurrence of acute kidney injury and transfer to ICU, and the Quality of Recovery-15 scale score at 24 h after operation were recorded. Results:Compared with group C, SmO 2 at T 1-3 and CO and CI at T 3 were significantly increased, SVRI at T 2-4 was decreased, the intraoperative infusion volume and urine volume were increased, the glomerular filtration rate and Quality of Recovery-15 scale score were increased at 24 h after surgery, the incidence of decline in acute renal function was decreased ( P<0.05), and no significant change was found in the incidence of intraoperative hypotension, blood loss, postoperative extubation time, length of hospital stay, incidence of acute kidney injury and rate of transfer to ICU in group S ( P>0.05). Conclusions:SmO 2 goal-directed hemodynamic management can reduce the development of decline in postoperative acute renal function and improve the quality of postoperative recovery of hypertensive patients undergoing laparoscopic radical gastrectomy for gastrointestinal tumors.

Dores musculares cervicais em pacientes com DTM e suas correlações / Cervical muscle pain in patients with TMD and its correlations

Introdução: As disfunções temporomandibulares apresentam uma variedade de sinais e sintomas que afetam a articulação temporomandibular, músculos da mastigação e estruturas relacionadas e muitos pacientes apresentam queixas cervicais. Objetivo: Verificar a correlação de dor à palpação dos músculos da mastigação (masseter, temporal anterior, pterigoideos lateral e medial) e digástrico, com a queixa de dor no pescoço; verificar a correlação de dor à palpação nos músculos da mastigação e digástrico, com dor à palpação no esternocleidomastoideo e trapézio, e se a força de correlação é diferente entre eles. Material e método: Foram avaliados 232 prontuários da clínica odontológica das Disfunções Temporomandibulares da Faculdade de Odontologia de Araçatuba, do período de 2011 a 2013. Os dados coletados foram submetidos à análise estatística, com alfa (α) = 0.01 para todos os casos, exceto digástrico quando associado ao trapézio (α) = 0.05. Resultado: A maioria dos pacientes era do sexo feminino. Houve correlação positiva entre dor à palpação nos músculos temporal, masseter, pterigoideo lateral, esternocleidomastoideo e trapézio, e queixa de dor no pescoço. Também houve correlação positiva entre a dor em todos os músculos da mastigação (masseter, temporal, pterigoideo lateral e medial) e digástrico e a dor no esternocleidomastoideo. Bem como a correlação de presença de dor nos músculos masseter, temporal, pterigoideo lateral e digástrico com dor no trapézio. A correlação de dor foi mais forte para o músculo esternocleidomastoideo, exceto para o pterigoideo lateral. Conclusão: Existe correlação positiva entre a queixa de dor à palpação nos músculos da mastigação, exceto pterigiodeo medial, e os músculos cervicais (esternocleidomastoideo e trapézio). A força de correlação entre a dor do masseter e temporal anterior com o esternocleidomastoideo é mais forte do que com o trapézio.

Introduction: Temporomandibular disorders present a variety of signs and symptoms that affect the temporomandibular joint, masticatory muscles and related structures, and many patients have cervical complaints. Objective: To verify the correlation of pain on palpation of the mastication muscles (masseter, anterior temporal, lateral and medial pterygoid), and digastric muscles with the complaint of neck pain; to verify the correlation of pain on palpation in the masticatory and digastric muscles with pain on palpation in the sternocleidomastoid and trapezius and if the correlation strength is different between them. Material and method: From 2011 to 2013, 232 medical records from the dental clinic of Temporomandibular Disorders of the Faculty of Dentistry of Araçatuba were evaluated. The data collected were submitted to statistical analysis, with alpha (α) = 0.01 for all cases, except digastric when associated with the trapezoid (α) = 0.05. Result Most patients were female. There was a positive correlation between pain on palpation in the temporal, masseter, lateral pterygoid, sternocleidomastoid and trapezius muscles, and complaints of neck pain. There was also a positive correlation between pain in all muscles of mastication (masseter, temporal, lateral and medial pterygoid), and digastric and sternocleidomastoid pain. As well as the correlation of the presence of pain in the masseter, temporal, lateral pterygoid and digastric muscles with pain in the trapezius. Pain correlation was strongest for the sternocleidomastoid muscle, except for the lateral pterygoid. Conclusion There is a positive correlation between the complaint of pain on palpation in the masticatory muscles, except Medial pterygoid, with the cervical muscles (sternocleidomastoid and trapezius). The strength of correlation between masseter and anterior temporal pain with the sternocleidomastoid is stronger than with the trapezius.

Síntomas osteomusculares en galponeros de granjas avícolas asociados a condiciones del trabajo / Osteomuscular symptoms in poultry farm workers associated with working conditions

INTRODUCCIÓN. Según datos de la Organización Mundial de Salud los trastornos musculoesqueléticos son la principal causa de discapacidad en el mundo; retrasar su diagnóstico provocaría una discapacidad prevenible. OBJETIVO. Determinar la prevalencia de síntomas osteomusculares en galponeros de granjas avícolas asociados a condiciones del trabajo. MATERIALES Y MÉTODOS. Estudio descriptivo transversal. Muestra aleatoria estratificada de 223 trabajadores, divididos en 106 galponeros y 117 personal administrativo de granjas avícolas de la provincia de Manabí. Criterios de inclusión: trabajadores mayores de 18 años de edad con al menos un año en la misma actividad. Para el análisis de datos, se utilizó Epi Info versión 7. RESULTADOS. La prevalencia de síntomas osteomusculares en los últimos 12 meses fue mayor en los galponeros en: hombro 81,69% y columna lumbar 56,96%. Mediante un análisis a través de regresión logística se determinó que los galponeros que trabajan por más de 10 años y que realizan movimientos repetitivos en menos de un minuto, tienen mayor riesgo de presentar dolor en el hombro (IC del 95% 1,26 ­ 4,98) e (IC del 95% 1,65 ­ 5,29). CONCLUSIÓN. Se registró la prevalencia de síntomas osteomusculares en galponeros de granjas avícolas asociados a condiciones del trabajo. RECOMENDACIÓN. Es necesario contar con sistemas de vigilancia a fin de proponer estrategias públicas en la industria avícola del Ecuador

INTRODUCTION. According to data from the World Health Organization musculoskeletal disorders are the leading cause of disability in the world; delaying their diagnosis would result in preventable disability. OBJECTIVE. To determine the prevalence of musculoskeletal symptoms in poultry farm workers associated with working conditions. MATERIALS AND METHODS. Cross-sectional descriptive study. Stratified random sample of 223 workers, divided into 106 poultry sheds workers and 117 administrative personnel of poultry farms in the province of Manabí. Inclusion criteria: Workers over 18 years of age with at least 1 year in the same activity. Fort he data analysis, Epi Info version 7 was used. RESULTS. The prevalence of musculoskeletal symptoms in the last 12 months was higher in sheds workers in: shoulder 81,69% and lumbar spine 56,96%. Using logistic regression analysis, it was determined that the sheds workers who have been working for more than 10 years and who perform repetitive movements in less than one minute have a greater risk of presenting shoulder pain (95% CI 1,26 ­ 4,98) and (95% CI 1,65 ­ 5,29). CONCLUSION. The prevalence of osteomuscular symptoms in poultry farm workers associated with working conditions was recorded. RECOMMENDATION. It is necessary to have surveillance systems in order to propose public strategies in the Ecuadorian poultry industry