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Sample records for bloqueio neuromuscular produzido

  1. Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia

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    Angélica de Fátima de Assunção Braga

    2013-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os efeitos farmacodinâmicos dos bloqueadores neuromusculares (BNM podem ser influenciados por diferentes drogas, entre elas os hipnóticos. O objetivo deste estudo foi avaliar a influência do propofol e do etomidato sobre o bloqueio neuromuscular produzido pelo cisatracúrio. MÉTODO: Foram incluídos 60 pacientes, ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos de acordo com o hipnótico empregado: GI (propofol e GII (etomidato. As pacientes receberam midazolam (0,1 mg.kg-1 por via muscular como medicação pré-anestésica, a indução foi com propofol (2,5 mg.kg-1 ou etomidato (0,3 mg.kg-1 precedido de fentanil (250 µg e seguido de cisatracúrio (0,1 mg.kg-1. Os pacientes foram ventilados com oxigênio a 100% até a obtenção de redução de 95% ou mais na amplitude da resposta do adutor do polegar, quando foi feita a laringoscopia e a intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Avaliaram-se o início de ação do cisatracúrio, as condições de intubação traqueal e as repercussões hemodinâmicas. RESULTADOS: Os tempos médios e os desvios padrão para o início de ação do cisatracúrio foram: GI (86,6 ± 14,3" e GII (116,9 ± 11,6", com diferença significativa (p < 0,0001. As condições de intubação traqueal foram aceitáveis em 100% dos pacientes do GI e em 53,3% no GII (p < 0,0001. CONCLUSÕES: A instalação do bloqueio neuromuscular com o cisatracúrio foi mais rápida e as condições de intubação traqueal foram melhores nos pacientes que receberam propofol em relação ao grupo que recebeu etomidato, sem repercussões hemodinâmicas.

  2. Influência da procainamida sobre o bloqueio neuromuscular produzido pelo rocurônio e investigação sobre o mecanismo de ação da procainamida na junção neuromuscular Influencia de la procainamida sobre el bloqueo neuromuscular producido por el rocuronio e investigación sobre el mecanismo de acción de la procainamida en la junción neuromuscular Influence of procainamide on the neuromuscular blockade caused by rocuronium and investigation on the mechanism of action of procainamide on the neuromuscular junction

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    Thalita Duque Martins; Yolanda Christina S. Loyola; Angélica de Fátima de Assunção Braga

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: A potencialização da procainamida sobre o bloqueio neuromuscular produzido pela d-tubocurarina já está comprovada, porém o mecanismo é controverso. O objetivo do estudo foi avaliar a influência da procainamida no bloqueio neuromuscular produzido pelo rocurônio e investigar os mecanismos desta interação. MÉTODO: Foram utilizados 15 ratos (250 a 300 g) em preparação descrita por Bülbring. Formaram-se os seguintes grupos (n = 5 cada): procainamida - 20 µg.mL-1 (G...

  3. Influência de anestésicos locais sobre o bloqueio neuromuscular produzido pelo rocurônio: ação da lidocaína e da mistura enantiomérica em excesso de 50% de bupivacaína na junção neuromuscular Influencia de anestésicos locales sobre el bloqueo neuromuscular producido por el rocuronio: acción de la lidocaína y de la mezcla enantiomérica en exceso de 50% de bupivacaína en la junción neuromuscular Influence of local anesthetics on the neuromuscular blockade produced by rocuronium: effects of lidocaine and 50% enantiomeric excess bupivacaine on the neuromuscular junction

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    Angélica de Fátima de Assunção Braga; Vanessa Henriques Carvalho; Franklin Sarmento da Silva Braga; Léa Rodrigues-Simioni; Yolanda Christina S Loyola; Glória Braga Potério

    2009-01-01

    JUSTIFICATIVA E OBJETIVOS: Os efeitos dos anestésicos locais (AL) na transmissão neuromuscular e sua influência no bloqueio neuromuscular produzido por bloqueadores neuromusculares competitivos são ainda alvo de pouca investigação. O objetivo do estudo foi avaliar in vitro os efeitos da lidocaína e da mistura enantiomérica em excesso de 50% de bupivacaína (S75-R25) no bloqueio neuromuscular produzido pelo rocurônio. MÉTODOS: Ratos foram distribuídos em cinco grupos (n = 5) de acordo com o fár...

  4. Influência do sevoflurano e do isoflurano na recuperação do bloqueio neuromuscular produzido pelo cisatracúrio Influencia del sevoflurano y del isoflurano en la recuperación del bloqueo neuromuscular producido por el cisatracúrio The influence of sevoflurane and isoflurane on the recovery from cisatracurium-induced neuromuscular block

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    Angélica de Fátima de Assunção Braga

    2002-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os efeitos dos agentes bloqueadores neuromusculares sobre a junção neuromuscular são aumentados pelos anestésicos voláteis. O objetivo deste estudo foi avaliar a influência do sevoflurano e do isoflurano na recuperação do bloqueio neuromuscular produzido pelo cisatracúrio. MÉTODO: Foram estudados 90 pacientes, estado físico ASA I e II, submetidos à cirurgias eletivas sob anestesia geral, distribuídos em três grupos: Grupo I (sevoflurano, Grupo II (isoflurano e Grupo III (propofol. Todos os pacientes receberam como medicação pré-anestésica, midazolam (0,1 mg.kg-1 por via muscular, 30 minutos antes da cirurgia. A indução anestésica foi obtida com alfentanil (50 µg.kg-1, propofol (2,5 mg.kg-1 e cisatracúrio (0,15 mg.kg-1. Os pacientes foram ventilados com oxigênio a 100% sob máscara até o desaparecimento das quatro respostas a SQE, quando foram realizadas as manobras de laringoscopia e intubação traqueal. Os agente voláteis para a manutenção da anestesia foram introduzidos logo após a intubação traqueal e empregados nas concentrações de 2% e 1%, respectivamente para o sevoflurano e isoflurano, e o propofol em infusão contínua (7 a 10 mg.kg-1.h-1. Em todos os pacientes empregou-se a mistura de oxigênio e óxido nitroso a 50%. A função neuromuscular foi monitorizada por aceleromiografia do músculo adutor do polegar, empregando-se a SQE a cada 15 segundos. Foram avaliados: a duração clínica do bloqueio neuromuscular (T1(25% e o índice de recuperação (IR= T1(25-75%. RESULTADOS: Os tempos médios e desvios padrão para a duração clínica (T1(25% e índice de recuperação (IR = T1(25-75% foram respectivamente: Grupo I (66,2 ± 13,42 min e 23,6 ± 5,02 min, Grupo II (54,4 ± 6,58 min e 14,9 ± 3,82 min e Grupo III (47,2 ± 7,43 min e 16,2 ± 2,93 min. Em relação à duração clínica houve diferença significante entre os grupos I e II, I e III, e II e III. Para o índice de

  5. The influence of lidocaine and racemic bupivacaine on neuromuscular blockade produced by rocuronium: a study in rat phrenic nerve-diaphragm preparation Influência da lidocaína e da bupivacaína racêmica no bloqueio neuromuscular produzido pelo rocurônio: estudo em preparação nervo frênico-diafragma de rato

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    Vanessa Henriques Carvalho

    2009-06-01

    Full Text Available PURPOSE: To evaluate in vitro lidocaine and racemic bupivacaine effects in neuromuscular transmission and in neuromuscular blockade produced by rocuronium. METHODS: Rats were distributed in 5 groups (n = 5 in agreement with the studied drugs: lidocaine, racemic bupivacaine, rocuronium, separately (Groups I, II, III; rocuronium in preparations exposed to local anesthetics (Groups IV, V. The concentrations used were: 20 µg/mL, 5 µg/mL and 4 µg/mL, for lidocaine, bupivacaine and rocuronium, respectively. It was evaluated: 1 amplitude of diaphragm muscle response to indirect stimulation, before and 60 minutes after separately addition of lidocaine, racemic bupivacaine and rocuronium and the association of local anesthetics - rocuronium; 2 membrane potentials (MP and miniature end-plate potentials (MEPP. RESULTS: Lidocaine and bupivacaine separately didn't alter the amplitude of muscle response and MP. In preparations previously exposed to lidocaine and racemic bupivacaine, the rocuronium blockade was significantly larger (90.10 ± 9.15% and 100%, respectively, in relation to the produced by rocuronium separately (73.12 ± 9.89%. Lidocaine caused an increase in the frequency of MEPP, being followed by blockade; racemic bupivacaine produced decrease being followed by blockade. CONCLUSIONS: Local anesthetics potentiated the blockade caused by rocuronium. The alterations of MEPP identify presynaptic action.OBJETIVO: Avaliar in vitro os efeitos da lidocaína e bupivacaína racêmica na transmissão neuromuscular e no bloqueio neuromuscular produzido pelo rocurônio. MÉTODOS: Ratos foram distribuídos em 5 grupos (n = 5 de acordo com a droga estudada: lidocaina, bupivacaína racêmica, rocurônio, isoladamente (Grupos I, II, III; rocurõnio em preparações expostas aos anestésicos locais (Grupos IV, V. As concentrações utilizadas foram: 20 µg/mL, 5 µg/mL e 4 µg/mL, para lidocaína, bupivacaína e rocurônio, respectivamente. Avaliou-se: 1

  6. Influência da procainamida sobre o bloqueio neuromuscular produzido pelo rocurônio e investigação sobre o mecanismo de ação da procainamida na junção neuromuscular Influencia de la procainamida sobre el bloqueo neuromuscular producido por el rocuronio e investigación sobre el mecanismo de acción de la procainamida en la junción neuromuscular Influence of procainamide on the neuromuscular blockade caused by rocuronium and investigation on the mechanism of action of procainamide on the neuromuscular junction

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    Thalita Duque Martins

    2007-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A potencialização da procainamida sobre o bloqueio neuromuscular produzido pela d-tubocurarina já está comprovada, porém o mecanismo é controverso. O objetivo do estudo foi avaliar a influência da procainamida no bloqueio neuromuscular produzido pelo rocurônio e investigar os mecanismos desta interação. MÉTODO: Foram utilizados 15 ratos (250 a 300 g em preparação descrita por Bülbring. Formaram-se os seguintes grupos (n = 5 cada: procainamida - 20 µg.mL-1 (Grupo I; rocurônio - 4 µg.mL-1 (Grupo II e rocurônio - 4 µg.mL-1 e procainamida - 20 µg.mL-1 (Grupo III. Avaliaram-se: 1 a amplitude das contrações musculares sob estimulação indireta em cada grupo, antes e após a adição dos fármacos; 2 os potenciais de placa terminal em miniatura (PPTM; 3 a eficácia da 4-aminopiridina na reversão do bloqueio neuromuscular. O mecanismo da interação foi estudado em Biventer cervicis (n = 5 e diafragma de rato desnervado (n = 5, observando-se a influência da procainamida na resposta à acetilcolina antes e após a adição da procainamida. RESULTADOS: A procainamida isoladamente não alterou as respostas neuromusculares. O bloqueio produzido com o Grupo III foi de 68,6% ± 7,1%, com diferença significativa (p = 0,0067 em relação ao Grupo II (10,4% ± 4,5%, revertido pela 4-aminopiridina. A procainamida ocasionou aumento na freqüência dos PPTM, seguido de bloqueio revertido pela 4-aminopiridina. Em Biventer cervicis a procainamida aumentou a resposta à ação de contração da acetilcolina, resultado não observado com o diafragma desnervado. CONCLUSÕES: A procainamida potencializou o bloqueio produzido pelo rocurônio. As alterações observadas com PPTM e Biventer cervicis identificaram ação pré-sináptica. O antagonismo da 4-aminopiridina sobre o bloqueio dos PPTM sugeriu dessensibilização dos receptores pela procainamida.JUSTIFICATIVA Y OBJETIVOS: La potenciación de la procainamida sobre

  7. Influência do propofol e do etomidato no bloqueio neuromuscular produzido pelo rocurônio: avaliação pela aceleromiografia Influencia del propofol y del etomidato en el bloqueo neuromuscular producido por el rocuronio: evaluación por la aceleromiografia Influence of propofol and etomidate on rocuronium-induced euromuscular block: evaluation with acceleromyography

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    Derli Conceição Munhoz

    2002-11-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Alguns hipnóticos podem interagir com os bloqueadores neuromusculares (BNM potencializando seus efeitos. O objetivo deste estudo foi avaliar a influência do propofol e do etomidato sobre o bloqueio neuromuscular produzido pelo rocurônio. MÉTODO: Foram incluídos no estudo 60 pacientes, estado físico ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos de acordo com o hipnótico empregado: Grupo I (propofol e Grupo II (etomidato. Todos os pacientes receberam midazolam (0,1 mg.kg-1 por via muscular como medicação pré-anestésica, 30 minutos antes da cirurgia. A indução anestésica foi obtida com propofol (2,5 mg.kg-1 ou etomidato (0,3 mg.kg-1 precedido de alfentanil (50 µg.kg-1 e seguido de rocurônio (0,6 mg.kg-1. Os pacientes foram ventilados sob máscara com oxigênio a 100% até a obtenção de redução de 75% ou mais na amplitude da resposta do músculo adutor do polegar, quando foram realizadas as manobras de laringoscopia e intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Foram avaliados: tempo de início de ação do rocurônio (T1 JUSTIFICATIVA Y OBJETIVOS: Algunos hipnóticos pueden interactuar con los bloqueadores neuromusculares (BNM potencializando sus efectos. El objetivo de este estudio fue evaluar la influencia del propofol y del etomidato sobre el bloqueo neuromuscular producido por el rocuronio. MÉTODO: Fueron incluidos en el estudio 60 pacientes, estado físico ASA I y II, sometidos a cirugías electivas bajo anestesia general, distribuidos aleatoriamente en dos grupos de acuerdo con el hipnótico empleado: Grupo I (propofol y Grupo II (etomidato. Todos los pacientes recibieron midazolam (0,1 mg.kg-1 por vía muscular como medicación pré-anestésica, 30 minutos antes de la cirugía. La inducción anestésica fue obtenida con propofol (2,5 mg.kg-1 o etomidato (0,3 mg.kg-1 precedido de alfentanil

  8. Influência do lítio no bloqueio neuromuscular produzido pelo atracúrio e pelo cisatracúrio: estudo em preparações nervo frênico-diafragma de rato Influencia del litio en el bloqueo neuromuscular producido por el atracurio y por el cisatracurio: estudio en preparo nervio frénico-diafragma del ratón Influence of lithium on the neuromuscular blockade produced by atracurium and cisatracurium: study on rat phrenic nerve-diaphragm preparations

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    Samanta Cristina Antoniassi Fernandes

    2007-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O lítio, fármaco amplamente utilizado nos distúrbios bipolares, pode interagir com os bloqueadores neuromusculares. Os mecanismos para explicar os seus efeitos na transmissão neuromuscular e a interação com bloqueadores neuromusculares são controversos. O objetivo deste trabalho foi avaliar, em diafragma de rato, os efeitos do lítio sobre a resposta muscular à estimulação indireta e a possível interação com os bloqueadores neuromusculares. MÉTODO: Utilizaram-se ratos com peso entre 250g e 300g, sacrificados sob anestesia com uretana. A preparação nervo frênico-diafragma foi montada de acordo com a técnica descrita por Bulbring. O diafragma foi mantido sob tensão, ligado a um transdutor isométrico e submetido à estimulação indireta de 0,1 Hz de freqüência. As contrações do diafragma foram registradas em fisiógrafo. Da análise da amplitude das respostas musculares avaliaram-se: os efeitos dos fármacos: lítio (1,5 mg.mL-1; atracúrio (20 µg.mL-1 e cisatracúrio (3 µg.mL-1 empregados isoladamente; da associação lítio-bloqueadores neuromusculares; e do lítio no bloqueio neuromuscular produzido pelo atracúrio (35 µg.mL-1 e cisatracúrio (5 µg.mL-1. Os efeitos foram avaliados antes e 45 minutos após a adição dos fármacos. Também foram estudados os efeitos do lítio nos potenciais de membrana (PM e potenciais de placa terminal em miniatura (PPTM. RESULTADOS: O lítio isoladamente não alterou a amplitude das respostas musculares, mas diminuiu significativamente o bloqueio neuromuscular produzido pelo atracúrio e cisatracúrio. Não alterou o PM e ocasionou aumento inicial da freqüência dos PPTM. CONCLUSÕES: O lítio empregado isoladamente não comprometeu a transmissão neuromuscular e aumentou a resistência ao efeito do atracúrio e cisatracúrio. Não mostrou ação sobre a fibra muscular, sendo que as alterações nos potenciais de placa terminal em miniatura evidenciaram a

  9. Influência da freqüência de estímulos na instalação do bloqueio neuromuscular produzido pelo rocurônio e pancurônio: avaliação pelo método acelerográfico Influencia de la frecuencia de estímulos en la instalación del bloqueo neuromuscular producido por el rocuronio y pancuronio: evaluación por el método acelerográfico Influence of stimulation frequency on rocuronium and pancuronium-induced neuromuscular block onset: acceleromyography evaluation

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    Derli da Conceição Munhóz

    2004-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Fatores relacionados ao paciente e ao bloqueador neuromuscular (BNM, assim como outros inerentes à monitorização da função neuromuscular podem influenciar na instalação do bloqueio neuromuscular. O objetivo deste estudo foi avaliar a influência de duas diferentes freqüências de estímulos sobre o tempo de instalação do bloqueio produzido pelo pancurônio e pelo rocurônio. MÉTODO: Foram incluídos no estudo 120 pacientes, estado físico ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos, de acordo com a freqüência de estímulo empregada, para a monitorização do bloqueio neuromuscular: Grupo I - 0,1 Hz (n = 60 e Grupo II - 1 Hz (n = 60. Em cada grupo formaram-se dois subgrupos (n = 30 de acordo com o bloqueador neuromuscular empregado: Subgrupo P (pancurônio e Subgrupo R (rocurônio. A medicação pré-anestésica consistiu de midazolam (0,1 mg.kg-1 por via muscular, 30 minutos antes da cirurgia. A indução anestésica foi obtida com propofol (2,5 mg.kg-1 precedido de alfentanil (50 µg.kg-1 e seguido de pancurônio ou rocurônio. Os pacientes foram ventilados sob máscara com oxigênio a 100% até a obtenção de redução de 75% ou mais na amplitude da resposta do músculo adutor do polegar, quando foram realizadas as manobras de laringoscopia e intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Foram avaliados: tempo de início de ação do pancurônio e do rocurônio; tempo para instalação do bloqueio total e condições de intubação traqueal. RESULTADOS: Os tempos médios (segundos para o início de ação e instalação de bloqueio neuromuscular total produzido pelo pancurônio foram: Grupo I (159,33 ± 35,22 e 222 ± 46,56 e Grupo II (77,83 ± 9,52 e 105,96 ± 15,58; para o rocurônio: Grupo I (83 ± 17,25 e 125,33 ± 20,12 e Grupo II (48,96 ± 10,16 e 59,83 ± 10,36 com diferença significativa

  10. Influência de anestésicos locais sobre o bloqueio neuromuscular produzido pelo rocurônio: ação da lidocaína e da mistura enantiomérica em excesso de 50% de bupivacaína na junção neuromuscular Influencia de anestésicos locales sobre el bloqueo neuromuscular producido por el rocuronio: acción de la lidocaína y de la mezcla enantiomérica en exceso de 50% de bupivacaína en la junción neuromuscular Influence of local anesthetics on the neuromuscular blockade produced by rocuronium: effects of lidocaine and 50% enantiomeric excess bupivacaine on the neuromuscular junction

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    Angélica de Fátima de Assunção Braga

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os efeitos dos anestésicos locais (AL na transmissão neuromuscular e sua influência no bloqueio neuromuscular produzido por bloqueadores neuromusculares competitivos são ainda alvo de pouca investigação. O objetivo do estudo foi avaliar in vitro os efeitos da lidocaína e da mistura enantiomérica em excesso de 50% de bupivacaína (S75-R25 no bloqueio neuromuscular produzido pelo rocurônio. MÉTODOS: Ratos foram distribuídos em cinco grupos (n = 5 de acordo com o fármaco estudado: lidocaína, bupivacaína (S75-R25, rocurônio, isoladamente (grupos I, II e III; rocurônio em preparações previamente expostas aos AL (grupos IV e V. As concentrações utilizadas foram: 20 µg.mL-1, 5 µg.mL-1 e 4 µg.mL¹ para lidocaína, bupivacaína (S75-R25 e rocurônio, respectivamente. Avaliaram-se: 1 a força de contração muscular do diafragma à estimulação elétrica indireta, antes e 60 minutos após a adição dos AL e do rocurônio isoladamente, e a associação AL-rocurônio; 2 os efeitos dos AL sobre o potencial de membrana (PM e potenciais de placa terminal em miniatura (PPTM. Em preparação biventer cérvicis de pintainho, foi avaliado o efeito do AL na resposta contraturante à acetilcolina. RESULTADOS: A lidocaína e a bupivacaína (S75-R25 isoladamente não alteraram as respostas musculares e os valores do PM. Nas preparações expostas aos AL, o bloqueio pelo rocurônio foi significativamente maior em relação ao produzido pelo rocurônio isoladamente. Em preparação biventer cervicis de pintainho, a lidocaína e a bupivacaína (S75-R25 diminuíram a resposta de contração à acetilcolina. A lidocaína aumentou a frequência dos PPTM, seguido de bloqueio; a bupivacaína (S75-R25 produziu diminuição seguida de bloqueio. CONCLUSÕES: Os anestésicos locais potencializaram o bloqueio neuromuscular causado pelo rocurônio. Os resultados mostraram ação pré-sináptica e póssináptica.JUSTIFICATIVA Y

  11. Influência do lítio no bloqueio neuromuscular produzido pelo atracúrio e pelo cisatracúrio: estudo em preparações nervo frênico-diafragma de rato Influencia del litio en el bloqueo neuromuscular producido por el atracurio y por el cisatracurio: estudio en preparo nervio frénico-diafragma del ratón Influence of lithium on the neuromuscular blockade produced by atracurium and cisatracurium: study on rat phrenic nerve-diaphragm preparations

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    Samanta Cristina Antoniassi Fernandes; Angélica de Fátima de Assunção Braga; Franklin Sarmento da Silva Braga; Yolanda Christina S. Loyola; Silmara Rodrigues de Souza; Caroline Coutinho de Barcelos

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: O lítio, fármaco amplamente utilizado nos distúrbios bipolares, pode interagir com os bloqueadores neuromusculares. Os mecanismos para explicar os seus efeitos na transmissão neuromuscular e a interação com bloqueadores neuromusculares são controversos. O objetivo deste trabalho foi avaliar, em diafragma de rato, os efeitos do lítio sobre a resposta muscular à estimulação indireta e a possível interação com os bloqueadores neuromusculares. MÉTODO: Utilizaram-se rato...

  12. Síndrome de Tako-Tsubo em decorrência de bloqueio neuromuscular residual: relato de caso Síndrome de Tako-Tsubo como consecuencia de bloqueo neuromuscular residual: relato de caso Tako-Tsubo syndrome secondary to residual neuromuscular blockade: case report

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    Marcos Guilherme Cunha Cruvinel; Fabiano Soares Carneiro; Roberto Cardoso Bessa Junior; Yerkes Pereira e Silva; Mirna Bastos Marques

    2008-01-01

    JUSTIFICATIVA E OBJETIVOS: A síndrome de Tako-Tsubo é uma complicação pós-operatória rara, com mortalidade em torno de 5%. O objetivo deste relato é apresentar o bloqueio neuromuscular residual como fator desencadeante da referida síndrome, discutir sobre a mesma e alertar sobre o bloqueio neuromuscular residual. RELATO DO CASO: Paciente do sexo feminino, 61 anos, estado físico ASA I, submetida à anestesia geral associada a bloqueio paravertebral cervical para reparo artroscópico de lesão de ...

  13. Anestesia peribulbar com ropivacaína como alternativa ao bloqueio neuromuscular para facectomia em cães Peribulbar anesthesia with ropivacaine as an alternative to neuromuscular blocking agents for cataract surgery in dogs

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    V.N.L.S. Oliva

    2010-06-01

    Full Text Available Desenvolveu-se uma técnica de bloqueio peribulbar comparando-a à técnica de anestesia oftálmica com bloqueio neuromuscular parcial em cães submetidos à facectomia extracapsular. Doze cães, de diferentes raças, foram alocados em dois grupos (G1 e G2 e anestesiados com acepromazina (0,05mg/kg, IV e propofol (5mg/kg, IV e mantidos com isofluorano sob ventilação espontânea. Os cães do G1 receberam o bloqueio peribulbar com ropivacaína 0,75%, e os do G2 o bloqueio neuromuscular parcial com brometo de pancurônio (0,01mg/kg, IV. Utilizaram-se, como parâmetros comparativos, escores de posicionamento do globo ocular, controle do reflexo oculocardíaco e pressão intraocular (mmHg. Foi possível propor uma técnica eficaz para cães baseando-se na técnica de bloqueio peribulbar posterior realizada no homem. Em ambos os grupos, o globo ocular permaneceu centralizado. Não ocorreram alterações eletrocardiográficas atribuídas ao reflexo oculocardíaco. Houve redução significativa da pressão intraocular em G1 após o bloqueio (10,7±0,6 e 14,7±0,6. Conclui-se que o bloqueio peribulbar proporcionou condições cirúrgicas apropriadas para a realização da facectomia, com a vantagem de promover bloqueio sensitivo do olho.A peribulbar block technique was developed and its clinical efficacy was compared with neuromuscular blockade in dogs undergoing cataract surgery. Twelve dogs of different breeds were randomly and equally allocated in two groups. After given acepromazine (0.05mg/kg, IV, anesthesia was induced with propofol (5mg/kg, IV and maintained with isoflurane in oxygen during spontaneous breathing. A peribulbar block with 0.75% ropivacaine was performed in G1 dogs while partial neuromuscular blockade with pancuronium (0.01mg/kg IV was provided in G2 dogs. Globe position scores, oculocardiac reflex, and intra-ocular pressure (mmHg were evaluated at pre-defined intervals during surgery. Peribulbar blocks were successful performed

  14. Síndrome de Tako-Tsubo em decorrência de bloqueio neuromuscular residual: relato de caso Síndrome de Tako-Tsubo como consecuencia de bloqueo neuromuscular residual: relato de caso Tako-Tsubo syndrome secondary to residual neuromuscular blockade: case report

    Directory of Open Access Journals (Sweden)

    Marcos Guilherme Cunha Cruvinel

    2008-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A síndrome de Tako-Tsubo é uma complicação pós-operatória rara, com mortalidade em torno de 5%. O objetivo deste relato é apresentar o bloqueio neuromuscular residual como fator desencadeante da referida síndrome, discutir sobre a mesma e alertar sobre o bloqueio neuromuscular residual. RELATO DO CASO: Paciente do sexo feminino, 61 anos, estado físico ASA I, submetida à anestesia geral associada a bloqueio paravertebral cervical para reparo artroscópico de lesão de manguito rotator. Após extubação foi evidenciado bloqueio neuromuscular residual por meio do exame clínico. Na sala de recuperação pós-anestésica evoluiu com sonolência, taquicardia, hipertensão arterial e acidose respiratória grave. Após a reintubação, evoluiu com parada cardíaca em atividade elétrica sem pulso, revertida com adrenalina e massagem cardíaca externa. Apresentou no pós-operatório elevação de segmento ST, aumento de troponina e acinesia de segmento médio-apical de ventrículo esquerdo com fração de ejeção estimada em 30%. A cineangiocoronariografia mostrou coronárias isentas de ateromatose significativa e grave comprometimento da função sistólica com acinesia inferior e ântero-septo-apical com hipercontratilidade compensatória de suas porções basais. Com o tratamento instituído houve recuperação funcional completa. CONCLUSÕES: O bloqueio neuromuscular residual associado à paralisia diafragmática e possível atelectasia pulmonar levando a insuficiência respiratória, hipercapnia e descarga adrenérgica foram os fatores desencadeantes da síndrome de Tako-Tsubo com sua grave repercussão clínica.JUSTIFICATIVA Y OBJETIVOS: El Síndrome de Tako-Tsubo es una complicación postoperatoria rara con una mortalidad en torno de un 5%. El objetivo de este relato es presentar el bloqueo neuromuscular residual como factor desencadenante del referido síndrome, discutir sobre él y alertar sobre el bloqueo

  15. Avaliação do bloqueio neuromuscular residual e da recurarização tardia na sala de recuperação pós-anestésica Evaluación del bloqueo neuromuscular residual y de la recurarización tardia en la sala de recuperación pós-anestésica Evaluation of residual neuromuscular block and late recurarization in the post-anesthetic care unit

    Directory of Open Access Journals (Sweden)

    Maria Cristina Simões de Almeida

    2004-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio neuromuscular residual altera a patência das vias aéreas aumentando o risco de graves complicações no pós-operatório. Nos pacientes que recebem o anticolinesterásico, a transmissão neuromuscular é incrementada pelo acúmulo de acetilcolina na placa motora, mas que, findo o efeito da neostigmina, teoricamente é possível uma "recurarização", visto que o agente antagonista não desloca o bloqueador neuromuscular do seu local de ação. Foi objetivo deste trabalho quantificar o grau de paralisia residual em Sala de Recuperação Pós-Anestésica (SRPA e averiguar se os pacientes que receberam neostigmina apresentam fenômeno de "recurarização" tardia. MÉTODO: Foram estudados na SRPA 119 pacientes adultos que receberam bloqueadores neuromusculares para diferentes tipos de procedimentos. Ao chegarem na SRPA, a transmissão neuromuscular foi quantificada através de um monitor por método acelerográfico. Os eletrodos estimuladores foram instalados no trajeto do nervo ulnar no punho, e empregou-se a seqüência de 4 estímulos, com correntes de 30 mA, na periodicidade de 15 até 120 minutos. Nesta pesquisa considerou-se como resíduo de bloqueio neuromuscular uma relação T4/T1 abaixo de 0,9. No tempo de permanência da SRPA foram igualmente registrados os sintomas clínicos sugestivos de bloqueio neuromuscular residual e aferidos os sinais vitais. Para análise estatística foram empregadas medidas descritivas tais como média e freqüência absoluta. RESULTADOS: Os pacientes que receberam pancurônio apresentaram maior incidência de resíduo de bloqueio neuromuscular, principalmente os idosos. Nos pacientes que receberam neostigmina houve expressivo percentual de bloqueio neuromuscular residual. Em nenhum grupo observou-se o fenômeno de "recurarização" tardia. CONCLUSÕES: Constatou-se expressivo número de pacientes com resíduo de bloqueio neuromuscular, quando utilizado o pancurônio. A

  16. Efeito da administração do atracúrio sobre a recuperação do bloqueio neuromuscular induzido pelo pancurônio Efecto de la administración del atracúrio sobre la recuperación del bloqueo neuromuscular inducido por el pancuronio Effect of atracurium on pancuronium-induced neuromuscular block recovery

    Directory of Open Access Journals (Sweden)

    Luís Fernando Rodrigues Maria

    2004-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Freqüentemente em cirurgias abdominais, na fase de fechamento da parede, há necessidade de doses adicionais de bloqueador neuromuscular. O objetivo deste estudo foi analisar, na vigência de recuperação parcial do bloqueio neuromuscular induzido pelo pancurônio, o efeito da administração de dose complementar de atracúrio sobre a recuperação espontânea do bloqueio neuromuscular. MÉTODO: Foram estudados 30 pacientes, divididos em dois grupos, 14 pacientes formaram o grupo pancurônio e 16 pacientes, o grupo atracúrio. A função neuromuscular foi monitorizada de forma contínua por acelerometria do músculo adutor do polegar, utilizando a seqüência de quatro estímulos (SQE, através da estimulação supramáxima do nervo ulnar. A indução da anestesia foi feita com propofol, fentanil, pancurônio 0,08 mg.kg-1 e a manutenção com N2O 60% em oxigênio e isoflurano na concentração expirada de 0,5%. Quando a primeira contração da seqüência de quatro estímulos (T1 recuperou 25%, o grupo pancurônio recebeu pancurônio 0,025 mg.kg-1 e o grupo atracúrio, 0,20 mg.kg-1 de atracúrio. Após a dose complementar foram anotados os tempos para recuperação espontânea de T1 igual a 10%, 25%, 75%, do índice de recuperação (IR25-75% e da relação T4/T1 igual a 0,8. RESULTADOS: Os tempos de recuperação espontânea após dose complementar de pancurônio ou atracúrio não diferiram quando avaliados pela recuperação de T1 em 10% (45,00 ± 15,50 vs 49,69 ± 9,41, 25% (61,64 ± 18,58 vs 64,25 ± 12,51 e 75% (94,00 ± 28,52 vs 84,69 ± 16,50. O IR25-75% (32,36 ± 13,76 vs 20,44 ± 9,24 e o tempo de recuperação da relação T4/T1 = 0,8 (176,86 ± 29,57 vs 141,50 ± 29,57 foram menores no grupo do atracúrio. CONCLUSÕES: Nas condições deste estudo, a complementação com atracúrio não promoveu alteração na recuperação espontânea inicial do bloqueio neuromuscular induzido pelo pancurônio e promoveu

  17. Complete atrioventricular block on isolated guinea pig heart induced by an aqueous fraction obtained from Psidium guajava L. leaf Bloqueio atrioventricular completo em coração isolado de cobaia produzido por uma fração aquosa obtida das folhas de Psidium guajava L

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    Antonio N.S. Gondim

    2006-09-01

    Full Text Available This paper aimed to study the electrocardiographic effect produced by the aqueous fraction (AqF obtained from the acetic extract of Psidium guajava L. leaf on the isolated guinea pig heart. Electrocardiographic records (ECG were obtained on isolated hearts beating spontaneously or under regular electrical stimulation. The hearts were mounted in a constant flow Langendorff perfusion system. Until 20 mg/mL, AqF did not change the spontaneous cardiac rate (control: 180 ± 9 bpm, test: 182 ± 10 bpm; N = 3; p > 0.05. Concentrations equal or greater then 20 mg/mL induced complete atrioventricular block (AVB. However, this effect promptly disappeared when AqF was removed from the perfusion fluid (N = 3 hearts. The AVB induced by AqF involves heart muscarinic receptors because atropine sulfate (1.5 mM could prevent the appearance of such disturbance.O presente trabalho visou estudar o efeito eletrocardiográfico produzido pela fração aquosa (AqF obtida do extrato acético das folhas de Psidium guajava L. em coração isolado de cobaia. Os traçados eletrocardiográficos foram obtidos em corações batendo espontaneamente ou então sob estimulação elétrica. Os corações foram montados em uma sistema de perfusão do tipo Langendoff de fluxo constante. A AqF, usada em concentrações menores que 20 mg/mL, não alterou a freqüência espontânea do coração (controle: 180 ± 9 bpm, teste: 182 ± 10 bpm; N = 3; p > 0,05. Todavia, concentrações iguais ou maiores que 20 mg/mL produziram bloqueio atrioventricular completo (BAV. Este efeito, contudo, desapareceu prontamente quando se removeu a AqF do fluido de perfusão coronariana (N = 3 corações. O BAV promovido pela AqF se faz mediado pelos receptores muscarínicos porque o sulfato de atropina (1,5 mM impediu o aparecimento deste efeito.

  18. Genetics and Neuromuscular Diseases

    Science.gov (United States)

    ... Dermatomyositis Inclusion-body myositis Diseases of Neuromuscular Junction Myasthenia gravis Lambert-Eaton (myasthenic) syndrome Congenital myasthenic syndromes Diseases of Peripheral Nerve Charcot-Marie- ...

  19. Doenças neuromusculares Neuromuscular disorders

    OpenAIRE

    Umbertina C. Reed

    2002-01-01

    Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo). Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de h...

  20. O uso de bloqueadores neuromusculares no Brasil El uso de bloqueadores neuromusculares en Brasil Neuromuscular blockers in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Cristina Simões de Almeida

    2004-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Dados estatísticos referentes ao uso de bloqueadores neuromusculares no Brasil são desconhecidos. Este trabalho se propõe a análise estatística desse tópico. MÉTODO: Foram compiladas 831 respostas de um questionário preenchido em parte por anestesiologistas presentes ao 48º Congresso Brasileiro de Anestesiologia em Recife, 2001 e em parte via Internet, por anestesiologistas cujos endereços eletrônicos constam na página da Sociedade Brasileira de Anestesiologia (www.sba.com.br. Foram analisados os seguintes dados: tempo de contato com a especialidade, região onde atuam os anestesiologistas, uso de bloqueadores neuromusculares (BNM em ordem de preferência, indicações do uso de succinilcolina, uso do monitor da transmissão neuromuscular, critérios para se considerar o paciente descurarizado, uso de neostigmina, forma de administração dos BNM e descrição de complicações observadas. RESULTADOS: A maioria dos anestesiologistas em questão exerce a profissão há mais de 11 anos e o maior número de respostas foi proveniente da região sudeste do Brasil. O BNM mais empregado é o atracúrio, seguido de pancurônio e succinilcolina. A succinilcolina é mais empregada na indução rápida e em crianças (80% e 25% respectivamente. Monitores da transmissão neuromuscular, 53% dos anestesiologistas nunca usam, e como critério de recuperação, 92% consideram o paciente descurarizado mediante sinais clínicos. Em 45% das vezes os profissionais empregam a neostigmina de forma rotineira, e 94% administra os BNM sob forma de bolus. Cerca de 30% registra ter havido complicação decorrente do uso de BNM. As complicações mais apontadas foram o bloqueio prolongado, o broncoespasmo grave e a curarização residual. CONCLUSÕES: O atracúrio é o bloqueador neuromuscular mais empregado no Brasil, há percentual alto de uso da succinilcolina em situações não emergenciais, o uso de monitores da transmiss

  1. Bloqueio seletivo dos nervos supraescapular e axilar promove analgesia satisfatória e menor grau de bloqueio motor: comparação com o bloqueio interescalênico

    Directory of Open Access Journals (Sweden)

    Patrícia Falcão Pitombo

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: Cirurgias artroscópicas do ombro cursam com intensa dor pós-operatória. Diversas técnicas analgésicas têm sido preconizadas. O objetivo deste estudo foi comparar o bloqueio dos nervos supraescapular e axilar nas cirurgias artroscópicas de ombro com a abordagem interescalênica do plexo braquial. MÉTODO: Sessenta e oito pacientes foram alocados em dois grupos de 34, de acordo com a técnica utilizada: grupo interescalênico (GI e grupo seletivo (GS, sendo ambas as abordagens realizadas com neuroestimulador. No GI, após resposta motora adequada foram injetados 30 mL de levopubivacaína em excesso enantiomérico de 50% a 0,33% com adrenalina 1:200.000. No GS, após resposta motora do nervo supraescapular e axilar, foram injetados 15 mL da mesma substância em cada nervo. Em seguida, realizada anestesia geral. Variáveis avaliadas: tempo para realização dos bloqueios, analgesia, consumo de opioide, bloqueio motor, estabilidade cardiocirculatória, satisfação e aceitabilidade pelo paciente. RESULTADOS: Tempo para execução do bloqueio interescalênico foi significativamente menor que para realização do bloqueio seletivo. Analgesia foi significativamente maior no pós-operatório imediato no GI e no pós-operatório tardio no GS. Consumo de morfina foi significativamente maior na primeira hora no GS. Bloqueio motor foi significativamente menor no GS. Estabilidade cardiocirculatória, satisfação e aceitabilidade da técnica pelo paciente não diferiram entre os grupos. Ocorreu uma falha no GI e duas no GS. CONCLUSÕES: Ambas as técnicas são seguras, eficazes com mesmo grau de satisfação e aceitabilidade. O bloqueio seletivo de ambos os nervos apresentou analgesia satisfatória, com a vantagem de proporcionar bloqueio motor restrito ao ombro.

  2. Doenças neuromusculares Neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Umbertina C. Reed

    2002-08-01

    Full Text Available Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo. Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de hipotonia muscular secundária ao comprometimento do sistema nervoso central ou a doenças sistêmicas não-neurológicas, são enfatizados, com base na experiência clínica vinda do atendimento a crianças com doenças neuromusculares durante os últimos 12 anos, no ambulatório de doenças neuromusculares do Hospital das Clínicas da Faculdade de Medicina, da Universidade de São Paulo. A revisão bibliográfica foi efetuada através do Medline e do periódico Neuromuscular Disorders, publicação oficial da World Muscle Society. Síntese dos dados: nas crianças, a maior parte destas afecções é geneticamente determinada, sendo as mais comuns a distrofia muscular progressiva ligada ao sexo, de Duchenne, a amiotrofia espinal infantil, a distrofia muscular congênita, a distrofia miotônica de Steinert, e as miopatias congênitas, estruturais e não estruturais. Polineuropatias hereditárias, síndrome miastênica congênita e miopatias metabólicas são menos comuns, porém mostram correlação geno-fenotípica cada vez mais precisa. Conclusões: na década passada, inúmeros avanços da genética molecular facilitaram imensamente o diagnóstico e o aconselhamento genético das doenças neuromusculares mais comuns das crianças, inclusive possibilitando diagnóstico fetal e, adicionalmente, vieram permitir melhor caracterização fenotípica e classificação mais objetiva.Objective: to discuss the most important aspects for performing a

  3. Neuromuscular complications in cancer.

    Science.gov (United States)

    Grisold, W; Grisold, A; Löscher, W N

    2016-08-15

    Cancer is becoming a treatable and even often curable disease. The neuromuscular system can be affected by direct tumor invasion or metastasis, neuroendocrine, metabolic, dysimmune/inflammatory, infections and toxic as well as paraneoplastic conditions. Due to the nature of cancer treatment, which frequently is based on a DNA damaging mechanism, treatment related toxic side effects are frequent and the correct identification of the causative mechanism is necessary to initiate the proper treatment. The peripheral nervous system is conventionally divided into nerve roots, the proximal nerves and plexus, the peripheral nerves (mono- and polyneuropathies), the site of neuromuscular transmission and muscle. This review is based on the anatomic distribution of the peripheral nervous system, divided into cranial nerves (CN), motor neuron (MND), nerve roots, plexus, peripheral nerve, the neuromuscular junction and muscle. The various etiologies of neuromuscular complications - neoplastic, surgical and mechanic, toxic, metabolic, endocrine, and paraneoplastic/immune - are discussed separately for each part of the peripheral nervous system. PMID:27423586

  4. Bloqueio do plexo braquial por via infraclavicular: abordagem ântero-posterior

    OpenAIRE

    Luiz Eduardo Imbelloni; Lúcia Beato; M. A Gouveia

    2001-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial é a técnica preferida pelos anestesiologistas para cirurgias nos membros superiores. Embora o acesso infraclavicular seja menos utilizado, ele pode oferecer algumas vantagens. O objetivo deste estudo prospectivo é mostrar os resultados observados em 50 pacientes submetidos a bloqueio do plexo braquial pela via infraclavicular, usando estimulador de nervo periférico e abordagem ântero-posterior. MÉTODO: Cinqüenta pacientes, com idades ent...

  5. Pneumotórax pós-bloqueio de plexo braquial guiado por ultrassonografia: relato de caso

    OpenAIRE

    Beatriz L. S. Mandim; Alves, Rodrigo R; Rodrigo de Almeida; João Paulo J. Pontes; Lorena J. Arantes; Fabíola P. Morais

    2012-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial é usado para anestesia nos membros superiores. O uso da ultrassonografia (USG) como técnica de bloqueio vem se popularizando nos últimos anos, facilitando a realização do bloqueio por fornecer imagens em tempo real do plexo e das estruturas circunjacentes, além de minimizar as complicações. O objetivo deste relato foi descrever um caso de pneumotórax após bloqueio interescalênico guiado por ultrassonografia. RELATO DE CASO: Paciente masc...

  6. Hereditary neuromuscular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Oezsarlak, O. E-mail: ozkan.ozsarlak@uza.be; Schepens, E.; Parizel, P.M.; Goethem, J.W. van; Vanhoenacker, F.; Schepper, A.M. de; Martin, J.J

    2001-12-01

    This article presents the actual classification of neuromuscular diseases based on present expansion of our knowledge and understanding due to genetic developments. It summarizes the genetic and clinical presentations of each disorder together with CT findings, which we studied in a large group of patients with neuromuscular diseases. The muscular dystrophies as the largest and most common group of hereditary muscle diseases will be highlighted by giving detailed information about the role of CT and MRI in the differential diagnosis. The radiological features of neuromuscular diseases are atrophy, hypertrophy, pseudohypertrophy and fatty infiltration of muscles on a selective basis. Although the patterns and distribution of involvement are characteristic in some of the diseases, the definition of the type of disease based on CT scan only is not always possible.

  7. Electrodiagnosis in neuromuscular disease.

    Science.gov (United States)

    Lipa, Bethany M; Han, Jay J

    2012-08-01

    Electromyography (EMG) is an important diagnostic tool for the assessment of individuals with various neuromuscular diseases. It should be an extension of a thorough history and physical examination. Some prototypical characteristics and findings of EMG and nerve conduction studies are discussed; however, a more thorough discussion can be found in the textbooks and resources sited in the article. With an increase in molecular genetic diagnostics, EMG continues to play an important role in the diagnosis and management of patients with neuromuscular diseases and also provides a cost-effective diagnostic workup before ordering a battery of costly genetic tests. PMID:22938876

  8. Electrodiagnosis in neuromuscular disease.

    Science.gov (United States)

    Lipa, Bethany M; Han, Jay J

    2012-08-01

    Electromyography (EMG) is an important diagnostic tool for the assessment of individuals with various neuromuscular diseases. It should be an extension of a thorough history and physical examination. Some prototypical characteristics and findings of EMG and nerve conduction studies are discussed; however, a more thorough discussion can be found in the textbooks and resources sited in the article. With an increase in molecular genetic diagnostics, EMG continues to play an important role in the diagnosis and management of patients with neuromuscular diseases and also provides a cost-effective diagnostic workup before ordering a battery of costly genetic tests.

  9. [Fatigue in neuromuscular disease].

    Science.gov (United States)

    Van Engelen, B G M; Kalkman, J S; Schillings, M L; Van Der Werf, S P; Bleijenberg, G; Zwarts, M J

    2004-07-01

    Chronic fatigue is a symptom of diseases such as cancer, multiple sclerosis, Parkinson's and cerebrovascular disease. Fatigue can also be present in people with no demonstrable somatic disease. If certain criteria are met, chronic-fatigue syndrome may be diagnosed in these cases. Fatigue is a multi-dimensional concept with physiological and psychological dimensions. The 'Short Fatigue Questionnaire' consisting of 4 questions is a tool to measure fatigue with a high degree of reliability and validity. Within the group of neuromuscular disorders, fatigue has been reported by patients with post-polio syndrome, myasthenia gravis, and Guillain-Barré syndrome. The percentage of neuromuscular patients suffering from severe fatigue (64%) is comparable with that of patients with multiple sclerosis, a disease in which fatigue is an acknowledged symptom. Now that reliable psychological and clinical neurophysiological techniques are available, a multidisciplinary approach to fatigue in patients with well-defined neuromuscular disorders may contribute towards the elucidation of the pathophysiological mechanisms of chronic fatigue, with the ultimate goal being to develop methods of treatment for fatigue in neuromuscular patients. PMID:15283024

  10. Purinoceptors in neuromuscular transmission

    NARCIS (Netherlands)

    Henning, RH

    1997-01-01

    At the neuromuscular junction, P-2-purinoceptors mediate the actions of the co-transmitter ATP and P-1-purinoceptors, those of its degradation product adenosine. The classification of the subtypes of P-1- and P-2-purinoceptors and their signal transduction routes is presented. Purinoceptor mediated

  11. Neuromuscular junctional disorders.

    Science.gov (United States)

    Girija, A S; Ashraf, V V

    2008-07-01

    Neuromuscular junctional disorders (NMJ) in children are distinct entity. They may be acquired or hereditary. They pose problem in diagnosis because of the higher occurrence of sero negative Myasthenia Gravis (MG) cases in children. The identity of MusK antibody positivity in a good percentage of sero negative cases further adds to problems in diagnosis. The Congenital Myasthenic Syndrome (CMS) which are rare disorders of hereditary neuromuscular transmission (NMT) has to be differentiated because immunotherapy has no benefit in this group. Molecular genetic studies of these diseases helps to identify specific type of CMS which is important as other drugs like Fluoxetine, Quinidine are found to be effective in some. In infancy, all can manifest as floppy infant syndrome. The important key to diagnosis is by detailed electrophysiological studies including repetitive nerve stimulation at slow and high rates and its response to anticholinesterases and estimation of Acetyl choline receptor antibodies. Other causes of neuromuscular transmission defects viz. snake venom poisoning and that due to drugs are discussed. PMID:18716738

  12. Bloqueio do plexo braquial por via infraclavicular: abordagem ântero-posterior

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2001-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial é a técnica preferida pelos anestesiologistas para cirurgias nos membros superiores. Embora o acesso infraclavicular seja menos utilizado, ele pode oferecer algumas vantagens. O objetivo deste estudo prospectivo é mostrar os resultados observados em 50 pacientes submetidos a bloqueio do plexo braquial pela via infraclavicular, usando estimulador de nervo periférico e abordagem ântero-posterior. MÉTODO: Cinqüenta pacientes, com idades entre 17 e 87 anos, estado físico ASA I e II, escalados para cirurgias ortopédicas da extremidade superior foram anestesiados com bloqueio do plexo braquial pela via infraclavicular. Todos os bloqueios foram realizados com estimulador de nervo periférico, a partir de 1 mA. Quando se obtinha uma adequada contração muscular na mão, no antebraço ou músculos do braço, a amperagem era diminuída até desaparecimento da resposta. Se a resposta desaparecesse com estímulo superior a 0,6 mA, a agulha poderia ser movimentada a procura de melhor resposta. Se a resposta não desaparecesse com estímulo menor que 0,5 mA, injetavam-se 50 ml de lidocaína a 1,6% com epinefrina 1:200.000. Foram avaliados o tempo de latência, duração da cirurgia, tolerância ao uso do torniquete, duração dos bloqueios sensitivo e motor, complicações e efeitos adversos. RESULTADOS: O bloqueio foi efetivo em 94% dos pacientes, o tempo médio da latência foi de 8,78 min, a duração média da cirurgia foi de 65,52 min e a tolerância ao torniquete foi observada em todos os pacientes. A média de duração do bloqueio sensitivo foi de 195,56 min e do bloqueio motor de 198,86 min. Ocorreu uma punção vascular. Não foram observados sinais e sintomas clínicos de toxicidade do anestésico local ou do vasoconstritor. Nenhum paciente apresentou efeitos adversos do bloqueio. CONCLUSÕES: O bloqueio infraclavicular do plexo braquial proporciona uma anestesia efetiva para

  13. Neuromuscular complications of acromegaly.

    Science.gov (United States)

    Pickett, J B; Layzer, R B; Levin, S R; Scheider, V; Campbell, M J; Sumner, A J

    1975-07-01

    Seventeen consecutive acromegalic patients were evaluated for evidence of neuromuscular dysfunction and followed for 1 year after hypophysectomy. Before treatment, four patients had both a myopathy and the carpal tunnel syndrome, five had myopathy alone, four had carpal tunnel syndrome alone, and four had neither. The myopathy was caracterized by mild, strictly promixal weakness and flabbiness of muscles; electromyography revealed typical myopathic abnormalities, but serum enzymes and muscle biopsy usually were normal. The presence of myopathy or the carpal tunnel syndrrome could not be correlated with the magnitude of growth hormone elevation or any secondary endocrine derangement, but myopathy was associated with a longer duration of acromegaly. Carpal tunnel symptoms usually improved in the first 6 weeks after hypophysectomy, while myopathy improved more slowly and sometimes was detectable 1 year later.

  14. Bloqueio Contínuo do Plexo Braquial em Contexto de Urgência

    OpenAIRE

    Mondim, V; Poeira, R; Pinhal, F; Tomé, I; Casteleira, M

    2011-01-01

    O bloqueio contínuo do plexo braquial constitui uma técnica anestésica potencialmente vantajosa em situações de trauma grave do membro superior e, particularmente, em cirurgia microvascular. Contribui para a reabilitação precoce, recuperação da função do membro e analgesia no pós-operatório.

  15. Bloqueio do nervo supraescapular: procedimento importante na prática clínica

    Directory of Open Access Journals (Sweden)

    Marcos Rassi Fernandes

    2012-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A dor no ombro é uma queixa frequente que ocasiona grande incapacidade funcional no membro acometido, assim como redução na qualidade de vida dos pacientes. O bloqueio do nervo supraescapular é um método terapêutico eficaz e vem sendo cada vez mais utilizado pelos anestesiologistas tanto para anestesia regional quanto para analgesia pós-operatória de cirurgias realizadas nesta articulação, o que justifica a presente revisão, cujo objetivo principal é descrever a técnica aplicada e as indicações clínicas. CONTEÚDO: Apresenta-se a anatomia do nervo supraescapular, desde a sua origem do plexo braquial até os seus ramos terminais, assim como as características gerais e a técnica empregada na execução do bloqueio deste nervo, as principais drogas utilizadas e o volume e as situações em que se faz jus a sua aplicação. CONCLUSÕES: O bloqueio do nervo supraescapular é um procedimento seguro e extremamente eficaz na terapia da dor no ombro. Também de fácil reprodutibilidade, está sendo muito utilizado por profissionais de várias especialidades médicas. Quando bem indicado, este método deve ser considerado

  16. Bloqueio contínuo do plexo lombar via posterior bilateral com bomba de infusão descartável: relato de caso

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2011-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O número de artroplastia total de quadril (ATQ bilateral tem aumentado a cada ano. Analgesia pós-operatória pela infusão contínua perineural com anestésico local tem se mostrado favorável quando comparada com analgesia sistêmica. O uso de bombas elastoméricas tem aumentado a satisfação do paciente quando em comparação com os modelos eletrônicos. O objetivo deste relato foi descrever um caso de analgesia contínua bilateral do plexo lombar via posterior, com infusão contínua através de bomba elastomérica, em paciente submetido à uma artroplastia bilateral de quadril. RELATO DO CASO: Paciente feminina, 46 anos, 65 kg, 162 cm, com artrite reumatoide e hipertensão arterial, estado físico ASA II, escalada para ser submetida a ATQ bilateral em um único estágio. Uso de corticosteroide por 13 anos. Hemoglobina = 10,1 g.dL-1, hematócrito = 32,7%. Monitoração de rotina. Raquianestesia com 15 mg de bupivacaína 0,5% isobárica. Anestesia geral com propofol (PFS e remifentanil e intubação sem bloqueadores neuromusculares. ATQ direita e no final, bloqueio plexo lombar com estimulador e conjunto agulha 150 mm e injeção de 20 mL bupivacaína 0,2% e passagem de cateter. ATQ esquerda e, no final, mesmo procedimento. Estudado dispersão do anestésico e contraste. Instalado bomba elastomérica com bupivacaína 0,1% (400 mL em velocidade de 14 mL.h-1. Transferida para Unidade de Cuidados Intensivos (UCI. Vinte e quatro horas após, nova bomba com a mesma solução. Nenhum bolus durante 50 horas. Após remoção de cateter, dor controlada por via oral com cetoprofeno e dipirona. CONCLUSÕES: O bloqueio bilateral contínuo periférico com infusão de bupivacaína a 0,1% com bombas elastoméricas é um procedimento seguro e efetivo em adultos.

  17. Neuromuscular disease classification system.

    Science.gov (United States)

    Sáez, Aurora; Acha, Begoña; Montero-Sánchez, Adoración; Rivas, Eloy; Escudero, Luis M; Serrano, Carmen

    2013-06-01

    Diagnosis of neuromuscular diseases is based on subjective visual assessment of biopsies from patients by the pathologist specialist. A system for objective analysis and classification of muscular dystrophies and neurogenic atrophies through muscle biopsy images of fluorescence microscopy is presented. The procedure starts with an accurate segmentation of the muscle fibers using mathematical morphology and a watershed transform. A feature extraction step is carried out in two parts: 24 features that pathologists take into account to diagnose the diseases and 58 structural features that the human eye cannot see, based on the assumption that the biopsy is considered as a graph, where the nodes are represented by each fiber, and two nodes are connected if two fibers are adjacent. A feature selection using sequential forward selection and sequential backward selection methods, a classification using a Fuzzy ARTMAP neural network, and a study of grading the severity are performed on these two sets of features. A database consisting of 91 images was used: 71 images for the training step and 20 as the test. A classification error of 0% was obtained. It is concluded that the addition of features undetectable by the human visual inspection improves the categorization of atrophic patterns. PMID:23804164

  18. Bloqueios nervosos guiados por ultra-som Bloqueos nerviosos guiados por ultrasonido Ultrasound-guided nerve blocks

    OpenAIRE

    Pablo Escovedo Helayel; Diogo Brüggemann da Conceição; Getúlio Rodrigues de Oliveira Filho

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios nervosos guiados por ultra-som são baseadas na visualização direta das estruturas nervosas, da agulha de bloqueio e das estruturas anatômicas adjacentes. Desta maneira, é possível depositar a solução de anestésico local precisamente em torno dos nervos e acompanhar a sua dispersão em tempo real, obtendo-se, assim, um bloqueio mais eficaz, de menor latência, menor dependência de referências anatômicas, menor volume de solução anestésica e mai...

  19. Neuromuscular ultrasound of cranial nerves.

    Science.gov (United States)

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

    2015-04-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  20. Bloqueio do nervo supraescapular: procedimento importante na prática clínica

    OpenAIRE

    Marcos Rassi Fernandes; Maria Alves Barbosa; Ana Luiza Lima Sousa; Gilson Cassem Ramos

    2012-01-01

    JUSTIFICATIVA E OBJETIVOS: A dor no ombro é uma queixa frequente que ocasiona grande incapacidade funcional no membro acometido, assim como redução na qualidade de vida dos pacientes. O bloqueio do nervo supraescapular é um método terapêutico eficaz e vem sendo cada vez mais utilizado pelos anestesiologistas tanto para anestesia regional quanto para analgesia pós-operatória de cirurgias realizadas nesta articulação, o que justifica a presente revisão, cujo objetivo principal é descrever a téc...

  1. Tests of gastric neuromuscular function.

    Science.gov (United States)

    Parkman, Henry P; Jones, Michael P

    2009-05-01

    Tests of gastric neuromuscular function are used to evaluate patients with symptoms referable to the upper digestive tract. These symptoms can be associated with alterations in the rates of gastric emptying, impaired accommodation, heightened gastric sensation, or alterations in gastric myoelectrical function and contractility. Management of gastric neuromuscular disorders requires an understanding of pathophysiology and treatment options as well as the appropriate use and interpretation of diagnostic tests. These tests include measures of gastric emptying; contractility; electrical activity; regional gastric motility of the fundus, antrum, and pylorus; and tests of sensation and compliance. Tests are also being developed to improve our understanding of the afferent sensory pathways from the stomach to the central nervous system that mediate gastric sensation in health and gastric disorders. This article reviews tests of gastric function and provides a basic description of the tests, the methodologies behind them, descriptions of the physiology that they assess, and their clinical utility. PMID:19293005

  2. Dengue-associated neuromuscular complications

    OpenAIRE

    Ravindra Kumar Garg; Hardeep Singh Malhotra; Amita Jain; Kiran Preet Malhotra

    2015-01-01

    Dengue is associated with many neurological dysfunctions. Up to 4% of dengue patients may develop neuromuscular complications. Muscle involvement can manifest with myalgias, myositis, rhabdomyolysis and hypokalemic paralysis. Diffuse myalgia is the most characteristic neurological symptom of dengue fever. Dengue-associated myositis can be of varying severity ranging from self-limiting muscle involvement to severe dengue myositis. Dengue-associated hypokalemic paralysis often has a rapidly evo...

  3. The undesirable effects of neuromuscular blocking drugs

    DEFF Research Database (Denmark)

    Claudius, C; Garvey, L H; Viby-Mogensen, J

    2009-01-01

    Neuromuscular blocking drugs are designed to bind to the nicotinic receptor at the neuromuscular junction. However, they also interact with other acetylcholine receptors in the body. Binding to these receptors causes adverse effects that vary with the specificity for the cholinergic receptor...... in question. Moreover, all neuromuscular blocking drugs may cause hypersensitivity reactions. Often the symptoms are mild and self-limiting but massive histamine release can cause systematic reactions with circulatory and respiratory symptoms and signs. At the end of anaesthesia, no residual effect...... of a neuromuscular blocking drug should be present. However, the huge variability in response to neuromuscular blocking drugs makes it impossible to predict which patient will suffer postoperative residual curarization. This article discusses the undesirable effects of the currently available neuromuscular blocking...

  4. Bloqueio simpático esquerdo por videotoracoscopia no tratamento da cardiomiopatia dilatada

    Directory of Open Access Journals (Sweden)

    Paulo M. Pêgo-Fernandes

    2010-12-01

    Full Text Available FUNDAMENTO: O nível da atividade nervosa simpática é um dos mais importantes determinantes prognósticos em pacientes com insuficiência cardíaca. OBJETIVO: O propósito dessa investigação foi realizar um estudo de viabilidade do emprego do bloqueio simpático esquerdo por toracoscopia em pacientes com insuficiência cardíaca (IC para avaliar a segurança e os efeitos imediatos. MÉTODOS: Quinze pacientes com cardiomiopatia dilatada e fração de ejeção do ventrículo esquerdo (FEVE 65 bpm, a despeito do uso adequado de beta-bloqueadores ou intolerantes a eles, forma selecionados. Dez pacientes foram submetidos à clipagem do espaço inter-espinhal em nível de T3-T4 e da porção inferior dos gânglios estrelados esquerdos através de videotoracocopia, enquanto outros cinco pacientes foram randomizados para um grupo controle. RESULTADOS: Nenhum dos pacientes operados apresentou qualquer evento cardiovascular adverso relacionado ao procedimento cirúrgico no período perioperatório. Dois pacientes do grupo cirúrgico morreram devido a tromboembolismo pulmonar ou infarto do miocárdio nos 6 meses de seguimento inicial, enquanto três pacientes do grupo controle apresentaram progressão da IC e morreram ou desenvolveram choque cardiogênico no mesmo período. Nos pacientes tratados, houve melhora na qualidade de vida, nível de atividade física e FEVE (de 25 ± 9% para 32 ± 8%, p=0,024 aos 6 meses de seguimento, enquanto esses parâmetros não se alteraram nos pacientes do grupo controle. CONCLUSÃO: O bloqueio simpático esquerdo via toracoscopia é factível e parece ser seguro em pacientes com IC grave. Esse estudo inicial sugere que esse procedimento pode ser uma abordagem alternativa eficaz para o bloqueio simpático no tratamento de cardiomiopatias dilatadas.

  5. The clinical examination for neuromuscular disease.

    Science.gov (United States)

    Glass, Eric N; Kent, Marc

    2002-01-01

    Neuromuscular disease can present even the most astute clinician with a challenging diagnostic dilemma. This article focuses on the neuroanatomy and the historical, physical, and neurologic examination findings observed in many of the neuromuscular disorders affecting dogs and cats. In addition, some common laboratory tests and imaging modalities used in the diagnosis of neuromuscular disease, including routine radiography, computed tomography, and magnetic resonance imaging, are discussed. A brief discussion of sensory nerve disorders is also presented. PMID:11785724

  6. Musculoskeletal complications of neuromuscular disease in children.

    Science.gov (United States)

    Driscoll, Sherilyn W; Skinner, Joline

    2008-02-01

    A wide variety of neuromuscular diseases affect children, including central nervous system disorders such as cerebral palsy and spinal cord injury; motor neuron disorders such as spinal muscular atrophy; peripheral nerve disorders such as Charcot-Marie-Tooth disease; neuromuscular junction disorders such as congenital myasthenia gravis; and muscle fiber disorders such as Duchenne's muscular dystrophy. Although the origins and clinical syndromes vary significantly, outcomes related to musculoskeletal complications are often shared. The most frequently encountered musculoskeletal complications of neuromuscular disorders in children are scoliosis, bony rotational deformities, and hip dysplasia. Management is often challenging to those who work with children who have neuromuscular disorders. PMID:18194756

  7. Electrophysiological study in neuromuscular junction disorders

    OpenAIRE

    Cherian, Ajith; Baheti, Neeraj N.; Iype, Thomas

    2013-01-01

    This review is on ultrastructure and subcellular physiology at normal and abnormal neuromuscular junctions. The clinical and electrophysiological findings in myasthenia gravis, Lambert-Eaton myasthenic syndrome (LEMS), congenital myasthenic syndromes, and botulinum intoxication are discussed. Single fiber electromyography (SFEMG) helps to explain the basis of testing neuromuscular junction function by repetitive nerve stimulation (RNS). SFEMG requires skill and patience and its availability i...

  8. Diagnostic NGS for Severe Neuromuscular Disorders

    OpenAIRE

    Radhika Dhamija; Chelsea Chambers

    2015-01-01

    Investigators from the University of Western Australia report the diagnostic yield of performing next generation sequencing (NGS; whole exome and targeted capture of 277 neuromuscular genes) in a heterogenous cohort of patients with neuromuscular disorders (NMD) presenting at or before birth.

  9. Common complications of pediatric neuromuscular disorders.

    Science.gov (United States)

    Skalsky, Andrew J; Dalal, Pritha B

    2015-02-01

    Children with pediatric neuromuscular disorders experience common complications, primarily due to immobility and weakness. Musculoskeletal complications include hip dysplasia with associated hip subluxation or dislocation, neuromuscular scoliosis, and osteoporosis and resulting fractures. Constipation, gastroesophageal reflux, and obesity and malnutrition are commonly experienced gastrointestinal complications. Disordered sleep also is frequently observed, which affects both patients and caregivers. PMID:25479776

  10. Bloqueio do nervo frênico após realização de bloqueio do plexo braquial pela via interescalênica: relato de caso A bloqueo del nervio frénico después de la realización de bloqueo del plexo braquial por la vía interescalénica: relato de caso Phrenic nerve block after interscalene brachial plexus block: case report

    OpenAIRE

    Luis Henrique Cangiani; Luis Augusto Edwards Rezende; Armando Giancoli Neto

    2008-01-01

    JUSTIFICATIVA E OBJETIVOS: Bloqueio do nervo frênico é um evento adverso do bloqueio do plexo braquial; entretanto, na sua maioria, sem repercussões clínicas importantes. O objetivo deste relato foi apresentar um caso em que ocorreu bloqueio do nervo frênico, com comprometimento ventilatório, em paciente com insuficiência renal crônica submetido a instalação de fístula arteriovenosa extensa, sob bloqueio do plexo braquial pela via perivascular interescalênica. RELATO DO CASO: Paciente do sexo...

  11. Efeito perioperatório do índice de massa corporal elevado no bloqueio do nervo periférico: uma análise de 528 bloqueios interescalênicos guiados por ultrassom

    Directory of Open Access Journals (Sweden)

    Kristopher Schroeder

    2012-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os pacientes obesos podem representar um desafio anestésico perioperatório único, tornando as técnicas anestésicas regionais um meio desafiador de oferecer analgesia para esta população. A orientação por ultrassom foi recentemente elogiada como sendo benéfica para esta população na qual os limites anatômicos de superfície podem ser obscurecidos. Neste estudo, é investigado o efeito do Índice de Massa Corporal (IMC elevado no bloqueio interescalênico do nervo periférico guiado por ultrassom. MATERIAL E MÉTODOS: Este estudo é uma análise retrospectiva de 528 pacientes consecutivos que receberam bloqueios nervosos interescalênicos pré-operatórios guiados por ultrassom no Hospital e Clínica da University of Wisconsin. Examinamos a associação entre IMC e os parâmetros: tempo exigido para localização do bloqueio; presença de náuseas e vômitos pós-operatórios (NVPO; pontuações de dor pós-operatória na sala de recuperação pós-anestésica (SRPA; volume de anestésico local injetado; complicações agudas; e administração de opioides antes, durante e depois da cirurgia. Foram utilizadas regressões univariada e multivariada com estimativa dos mínimos quadrados e logística. RESULTADOS: Um IMC elevado foi associado a maiores: tempo exigido para localização do bloqueio (p = 0,025, administração de fentanil durante a cirurgia (p < 0,001, pico de pontuações de dor em SRPA (p < 0,001, administração de opioide na SRPA (p < 0,001, administração oral de opioide na SRPA (p < 0,001, administração total de opioide na SRPA (p < 0,001 e incidência de náusea em SRPA (p = 0,025. CONCLUSÕES: Os bloqueios nervosos interescalênicos guiados por ultrassom para analgesia perioperatória podem ser executados de forma segura e efetiva em pacientes obesos, mas o procedimento pode ser mais difícil e a analgesia talvez não seja completa

  12. Tracheal intubation without neuromuscular block in children

    OpenAIRE

    Shaikh, Safiya I; Bellagali, Vijayalaxmi P

    2010-01-01

    Endotracheal intubation has been performed during the administration of Propofol anaesthesia without neuromuscular blockade. In the study, we have assessed tracheal intubating conditions and haemodynamic responses in children aged 4 to12 years by using combination of either Fentanyl and Propofol; or Propofol and a neuromuscular blocker, suxamethonium. Intubating conditions were assessed on a 1-4 scale based on ease of laryngoscopy, position of vocal cords, degree of coughing and jaw relaxatio...

  13. Pelvic fixation for neuromuscular scoliosis deformity correction

    OpenAIRE

    Dayer, Romain; Ouellet, Jean Albert; Saran, Neil

    2012-01-01

    Pelvic fixation is most frequently indicated in the pediatric population for the treatment of neuromuscular scoliosis with significant pelvic obliquity. Neuromuscular scoliosis surgery is associated with a high risk of complications, and this is further increased by extension of fusion to the sacrum. Numerous techniques have been described for pelvic fixation associated with a long spine fusion each with its own set of specific benefits and risks. This article reviews the contemporary surgica...

  14. Sugammadex: A Review of Neuromuscular Blockade Reversal.

    Science.gov (United States)

    Keating, Gillian M

    2016-07-01

    Sugammadex (Bridion(®)) is a modified γ-cyclodextrin that reverses the effect of the steroidal nondepolarizing neuromuscular blocking agents rocuronium and vecuronium. Intravenous sugammadex resulted in rapid, predictable recovery from moderate and deep neuromuscular blockade in patients undergoing surgery who received rocuronium or vecuronium. Recovery from moderate neuromuscular blockade was significantly faster with sugammadex 2 mg/kg than with neostigmine, and recovery from deep neuromuscular blockade was significantly faster with sugammadex 4 mg/kg than with neostigmine or spontaneous recovery. In addition, recovery from neuromuscular blockade was significantly faster when sugammadex 16 mg/kg was administered 3 min after rocuronium than when patients spontaneously recovered from succinylcholine. Sugammadex also demonstrated efficacy in various special patient populations, including patients with pulmonary disease, cardiac disease, hepatic dysfunction or myasthenia gravis and morbidly obese patients. Intravenous sugammadex was generally well tolerated. In conclusion, sugammadex is an important option for the rapid reversal of rocuronium- or vecuronium-induced neuromuscular blockade. PMID:27324403

  15. Neuromuscular Adaptations to Reduced Use

    Science.gov (United States)

    Ploutz-Snyder, Lori

    2009-01-01

    This viewgraph presentation reviews the studies done to reduce neuromuscular strength loss during unilateral lower limb suspension (ULLS). Since there are animals that undergo fairly long periods of muscular disuse without any or minimal muscular atrophy, there is an answer to that might be applicable to human in situations that require no muscular use to diminish the effects of muscular atrophy. Three sets of ULLS studies were reviewed indicated that muscle strength decreased more than the muscle mass. The study reviewed exercise countermeasures to combat the atrophy, including: ischemia maintained during Compound muscle action potential (CMAP), ischemia and low load exercise, Japanese kaatsu, and the potential for rehabilitation or situations where heavy loading is undesirable. Two forms of countermeasures to unloading have been successful, (1) high-load resistance training has maintained muscle mass and strength, and low load resistance training with blood flow restriction (LL(sub BFR)). The LL(sub BFR) has been shown to increase muscle mass and strength. There has been significant interest in Tourniquet training. An increase in Growth Hormone(GH) has been noted for LL(sub BFR) exercise. An experimental study with 16 subjects 8 of whom performed ULLS, and 8 of whom performed ULLS and LL(sub BFR) exercise three times per week during the ULLS. Charts show the results of the two groups, showing that performing LL(sub BFR) exercise during 30 days of ULLS can maintain muscle size and strength and even improve muscular endurance.

  16. Splicing therapy for neuromuscular disease.

    Science.gov (United States)

    Douglas, Andrew G L; Wood, Matthew J A

    2013-09-01

    Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA) are two of the most common inherited neuromuscular diseases in humans. Both conditions are fatal and no clinically available treatments are able to significantly alter disease course in either case. However, by manipulation of pre-mRNA splicing using antisense oligonucleotides, defective transcripts from the DMD gene and from the SMN2 gene in SMA can be modified to once again produce protein and restore function. A large number of in vitro and in vivo studies have validated the applicability of this approach and an increasing number of preliminary clinical trials have either been completed or are under way. Several different oligonucleotide chemistries can be used for this purpose and various strategies are being developed to facilitate increased delivery efficiency and prolonged therapeutic effect. As these novel therapeutic compounds start to enter the clinical arena, attention must also be drawn to the question of how best to facilitate the clinical development of such personalised genetic therapies and how best to implement their provision. PMID:23631896

  17. Bloqueio do plexo braquial, por via infraclavicular vertical, em paciente com doença pulmonar obstrutiva crônica: relato de caso

    OpenAIRE

    Conceição Diogo Brüggemann da; Helayel Pablo Escovedo; Cecato Fernanda

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: Os pacientes com doença pulmonar obstrutiva crônica (DPOC) têm risco aumentado de complicações pós-operatórias, sobretudo quando submetidos à anestesia geral. O bloqueio do plexo braquial representa uma alternativa para estes pacientes em intervenções cirúrgicas de membros superiores. O objetivo deste relato foi apresentar um caso de bloqueio do plexo braquial, por via infraclavicular vertical em paciente com DPOC com fratura de cotovelo. RELATO DO CASO: Paciente do...

  18. Bloqueio do plexo braquial por via axilar com neuroestimulador: verificação da latência e da eficácia

    OpenAIRE

    Itagyba Martins Miranda Chaves; Leandro Fellet Miranda Chaves; Clodoaldo Lopes Dias

    2001-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial por via axilar, embora bastante difundido por ter menor incidência de complicações, apresenta três inconvenientes que limitam seu uso: índice de falhas, latência longa e restrição a cirurgias de antebraço e mão. O objetivo deste estudo foi verificar o tempo de latência e a eficácia do bloqueio do plexo braquial por via axilar empregando-se um estimulador de nervo. MÉTODO: Participaram do estudo, aberto, prospectivo, 38 pacientes, estado ...

  19. Bloqueio do plano transverso abdominal contínuo bilateral em doente com cirurgia abdominal prévia

    Directory of Open Access Journals (Sweden)

    Isabel Flor de Lima

    2013-10-01

    Full Text Available Os autores apresentam um caso clínico em que foi realizado um bloqueio do plano do músculo transverso abdominal, com colocação de cateter bilateral, para analgesia pós-operatória de laparotomia exploradora, em doente com cirurgia abdominal prévia, insuficiência cardíaca, renal e hepática, em opção à analgesia epidural e aos opioides endovenosos em perfusão.

  20. Employment profiles in neuromuscular diseases.

    Science.gov (United States)

    Fowler, W M; Abresch, R T; Koch, T R; Brewer, M L; Bowden, R K; Wanlass, R L

    1997-01-01

    Consumer and rehabilitation provider factors that might limit employment opportunities for 154 individuals with six slowly progressive neuromuscular diseases (NMD) were investigated. The NMDs were spinal muscular atrophy (SMA), hereditary motor sensory neuropathy (HMSN), Becker's muscular dystrophy (BMD), facioscapulohumeral muscular dystrophy (FSHD), myotonic muscular dystrophy (MMD), and limb-girdle syndrome (LGS). Forty percent were employed in the competitive labor market at the time of the study, 50% had been employed in the past, and 10% had never been employed. The major consumer barrier to employment was education. Other important factors were type of occupation, intellectual capacity, psychosocial adjustment, and the belief by most individuals that their physical disability was the only or major barrier to obtaining a job. Psychological characteristics were associated with level of unemployment. However, physical impairment and disability were not associated with level of unemployment. There also were differences among the types of NMDs. Compared with the SMA, HMSN, BMD, and FSHD groups, the MMD and LGS groups had significantly higher levels of unemployment, lower educational levels, and fewer employed professional, management, and technical workers. Nonphysical impairment factors such as a low percentage of college graduates, impaired intellectual function in some individuals, and poor psychological adjustment were correlated with higher unemployment levels in the MMD group. Unemployment in the LGS group was correlated with a failure to complete high school. Major provider barriers to employment were the low level of referrals to Department of Rehabilitation by physicians and the low percentage of acceptance into the State Department of Rehabilitation. The low rate of acceptance was primarily attributable to the low number of referrals compounded by a lack of counselor experience with individuals with NMD. Both consumer and provider barriers may

  1. Protein defects in neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Vainzof M.

    2003-01-01

    Full Text Available Muscular dystrophies are a heterogeneous group of genetically determined progressive disorders of the muscle with a primary or predominant involvement of the pelvic or shoulder girdle musculature. The clinical course is highly variable, ranging from severe congenital forms with rapid progression to milder forms with later onset and a slower course. In recent years, several proteins from the sarcolemmal muscle membrane (dystrophin, sarcoglycans, dysferlin, caveolin-3, from the extracellular matrix (alpha2-laminin, collagen VI, from the sarcomere (telethonin, myotilin, titin, nebulin, from the muscle cytosol (calpain 3, TRIM32, from the nucleus (emerin, lamin A/C, survival motor neuron protein, and from the glycosylation pathway (fukutin, fukutin-related protein have been identified. Mutations in their respective genes are responsible for different forms of neuromuscular diseases. Protein analysis using Western blotting or immunohistochemistry with specific antibodies is of the utmost importance for the differential diagnosis and elucidation of the physiopathology of each genetic disorder involved. Recent molecular studies have shown clinical inter- and intra-familial variability in several genetic disorders highlighting the importance of other factors in determining phenotypic expression and the role of possible modifying genes and protein interactions. Developmental studies can help elucidate the mechanism of normal muscle formation and thus muscle regeneration. In the last fifteen years, our research has focused on muscle protein expression, localization and possible interactions in patients affected by different forms of muscular dystrophies. The main objective of this review is to summarize the most recent findings in the field and our own contribution.

  2. Tracheal intubation without neuromuscular block in children

    Directory of Open Access Journals (Sweden)

    Safiya I Shaikh

    2010-01-01

    Full Text Available Endotracheal intubation has been performed during the administration of Propofol anaesthesia without neuromuscular blockade. In the study, we have assessed tracheal intubating conditions and haemodynamic responses in children aged 4 to12 years by using combination of either Fentanyl and Propofol; or Propofol and a neuromuscular blocker, suxamethonium. Intubating conditions were assessed on a 1-4 scale based on ease of laryngoscopy, position of vocal cords, degree of coughing and jaw relaxation. Tracheal intubation was successful in 95% of patients receiving Fentanyl-Propofol and 100% of patients receiving Propofol-suxamethonium. Fentanyl-Propofol provided better haemodynamic stability than Propofol-suxamethonium. We conclude that Propofol-Fentanyl combination could be a useful alternative technique for tracheal intubation when neuromuscular blocking drugs are contraindicated or need to be avoided.

  3. Scoliosis and the impact in neuromuscular disease.

    Science.gov (United States)

    Mayer, Oscar Henry

    2015-01-01

    Scoliosis can alter respiratory mechanics by changing the orientation of the muscles and joints of the respiratory system and in severe forms can put a patient at risk of severe respiratory morbidity or respiratory failure. However, perhaps the most important factor in determining the pulmonary morbidity in scoliosis is the balance between the "load" or altered respiratory mechanics and the "pump" or the respiratory muscle strength. Therefore, scoliosis in patients with neuromuscular disease will both lead to increased "load" and a weakened "pump", an exceptionally unfortunate combination. While progressive neuromuscular disease by its nature does not respond favorably to attempts to improve respiratory muscle strength, the natural approach of early proactive management of the "load" and in the case of scoliosis a variety of different strategies have been tried with variable short term and long term results. Figuring this out requires both an understanding of the underlying pathophysiology of a particular neuromuscular condition and the available options for and timing of surgical intervention.

  4. Research highlights of partial neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Cheng ZHANG

    2014-05-01

    Full Text Available In order to understand the latest progression on neuromuscular disorders for clinicians, this review screened and systemized the papers on neuromuscular disorders which were collected by PubMed from January 2013 to February 2014. This review also introduced the clinical diagnosis and treatment hightlights on glycogen storage disease type Ⅱ (GSD Ⅱ, Duchenne muscular dystrophy (DMD, amyotrophic lateral sclerosis (ALS and spinal muscular atrophy (SMA. The important references will be useful for clinicians. doi: 10.3969/j.issn.1672-6731.2014.05.004

  5. Bloqueios nervosos guiados por ultra-som Bloqueos nerviosos guiados por ultrasonido Ultrasound-guided nerve blocks

    Directory of Open Access Journals (Sweden)

    Pablo Escovedo Helayel

    2007-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios nervosos guiados por ultra-som são baseadas na visualização direta das estruturas nervosas, da agulha de bloqueio e das estruturas anatômicas adjacentes. Desta maneira, é possível depositar a solução de anestésico local precisamente em torno dos nervos e acompanhar a sua dispersão em tempo real, obtendo-se, assim, um bloqueio mais eficaz, de menor latência, menor dependência de referências anatômicas, menor volume de solução anestésica e maior segurança. CONTEÚDO: O artigo revisa os aspectos relativos aos mecanismos físicos para formação de imagens, a anatomia ultra-sonográfica do neuroeixo e dos plexos braquial e lombossacral, os equipamentos e materiais empregados nos bloqueios, os ajustes do aparelho de ultra-som para melhorar as imagens, os planos de visualização das agulhas de bloqueio e as técnicas e o treinamento em bloqueios guiados por ultra-som. CONCLUSÕES: Os passos para se obter sucesso em anestesia regional incluem a identificação exata da posição dos nervos, a localização precisa da agulha, sem lesões nas estruturas adjacentes e, finalmente, a injeção cuidadosa de anestésico local junto aos nervos. Embora a neuroestimulação forneça grande auxílio na identificação dos nervos, esta não consegue, isoladamente, preencher todas essas exigências. Por isso, acredita-se que os bloqueios guiados por ultra-som serão a técnica de eleição para anestesia regional num futuro não muito distante.JUSTIFICATIVA Y OBJETIVOS: Las técnicas de bloqueos nerviosos guiados por ultrasonido se basan en la visualización directa de las estructuras nerviosas, de la aguja de bloqueo y de las estructuras anatómicas adyacentes. De esa manera, se puede depositar la solución de anestésico local precisamente en torno de los nervios y acompañar su dispersión en tiempo real, obteniéndose así, un bloqueo más eficaz, de menor latencia, menor dependencia de

  6. Neuromuscular hamartoma arising in the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Lai, P.H.; Chen, C.; Yeh, L.R.; Pan, H.B. [Department of Radiology, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813, Kaohsiung (Taiwan); Ho, J.T.; Hsu, S.S. [Department of Neurosurgery, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813, Kaosiung (Taiwan); Lin, S.L. [Department of Pathology, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813, Kaohsiung (Taiwan)

    2004-03-01

    We report a case brachial plexus neuromuscular hamartoma (choristoma) in a 28-year-old man who complained of numbness of the left hand and forearm for several years. MRI revealed a circumscribed, rounded mass in the left brachial plexus. The patient is well 2 years after surgery, with no neurological deficit. (orig.)

  7. Pregnancy and Childbirth with Neuromuscular Disease

    Science.gov (United States)

    ... to get a little bit Teamwork makes the difference weaker during Coordination and communication Having a neuromuscular disease can pose special anesthesia-related risks. the pregnancy and, unfortu- among the pregnant woman, her neurologist and a team experienced — local anesthesia. ( ...

  8. Electrodiagnosis of disorders of neuromuscular transmission.

    Science.gov (United States)

    Howard, James F

    2013-02-01

    This article reviews the use of electrodiagnostic testing in disorders of neuromuscular transmission and discusses the differences between various presynaptic and postsynaptic disorders. Attention is paid to quality control issues that influence the sensitivity of repetitive nerve stimulation and single fiber electromyography. Electrodiagnostic testing, when used as an extension of the clinician's history and physical examination, will provide appropriate direction in establishing the diagnosis.

  9. Neuromuscular function in different stages of sarcopenia.

    Science.gov (United States)

    Morat, Tobias; Gilmore, Kevin J; Rice, Charles L

    2016-08-01

    This study applied the screening tool developed by the European Working Group on Sarcopenia in Older People (EWGSOP) on seniors aged over 65years and concurrently tested various laboratory-based indices of neuromuscular function. Twenty-four healthy and independent living older adults (9 men, 15 women) with a mean age of 79.1±5.8years participated. Based on gait speed, handgrip strength and muscle mass all subjects were categorized into one of the three conceptual sarcopenia stages (pre-sarcopenia, sarcopenia, severe sarcopenia). Maximal strength of dorsiflexors in the left leg was measured and voluntary activation was assessed by the interpolated twitch technique. In addition, isometric evoked contractile properties were recorded. Skeletal muscle mass was assessed by ultrasound from nine sites. There were roughly equal number of subjects in each sarcopenic category, and age was not different among the 3 groups. There were no differences in handgrip strength and skeletal muscle mass index among the 3 groups. Gait speed was significantly slower (psarcopenia group, and 51% slower (p=0.03) compared with the pre-sarcopenia group, but when normalized to peak torques there were no statistical differences. The laboratory tests found neuromuscular differences among the 3 groups which generally supported the classification scheme and helped to illustrate some key factors that could explain differences in functional capacities. These initial findings support the assumption that this categorization is relevant for identifying older adults with different neuromuscular properties. However, further studies are needed to provide more insight into the specific neuromuscular changes in the three sarcopenia stages, and how these changes relate to functional capacity. Such studies could ultimately contribute to identifying optimal interventions to improve neuromuscular functioning. PMID:27108183

  10. Neuromuscular blockade in children Bloqueadores neuromusculares em crianças

    Directory of Open Access Journals (Sweden)

    João Fernando Lourenço de Almeida

    2000-06-01

    Full Text Available Neuromuscular blocking agents (NMBAs have been widely used to control patients who need to be immobilized for some kind of medical intervention, such as an invasive procedure or synchronism with mechanical ventilation. The purpose of this monograph is to review the pharmacology of the NMBAs, to compare the main differences between the neuromuscular junction in neonates, infants, toddlers and adults, and moreover to discuss their indications in critically ill pediatric patients. Continuous improvement of knowledge about NMBAs pharmacology, adverse effects, and the many other remaining unanswered questions about neuromuscular junction and neuromuscular blockade in children is essential for the correct use of these drugs. Therefore, the indication of these agents in pediatrics is determined with extreme judiciousness. Computorized (Medline 1990-2000 and active search of articles were the mechanisms used in this review.Os bloqueadores neuromusculares têm sido amplamente utilizados para controlar pacientes que necessitem imobilidade para algum tipo de intervenção médica, desde a realização de procedimentos invasivos até a obtenção de sincronismo com a ventilação mecânica. O objetivo básico desta monografia é revisar a farmacologia dos principais bloqueadores neuromusculares, analisar as diferenças existentes na junção neuromuscular de neonatos, lactentes, pré-escolares e adultos, além de discutir suas indicações em pacientes criticamente enfermos internados em unidade de terapia intensiva pediátrica. Revisão computadorizada da literatura (Medline 1990-2000 associado a busca ativa de artigos compuseram o mecanismo de busca dos dados desta revisão.

  11. Benzo(apireno em óleos de milho produzidos e comercializados no Brasil

    Directory of Open Access Journals (Sweden)

    TOLEDO M. Cecilia de F.

    1998-01-01

    Full Text Available Óleos de milho de diferentes marcas, produzidos e comercializados no Brasil, foram analisados quanto à presença de benzo(apireno (B(aP. A metodologia utilizada envolveu extração com ciclohexano, purificação em coluna de silica gel e determinação por cromatografia líquida de alta eficiência com detector de fluorescência. Todas amostras analisadas mostraram-se contaminadas por B(aP e os níveis determinados variaram entre as diferentes marcas analisadas e entre diferentes lotes de mesma marca, dentro da faixa de 0,85 a 25,17 µg/kg. Entre 49 amostras analisadas no período de dois anos, apenas uma apresentou nível de contaminação por B(aP abaixo do limite referencial de 1 µg/kg.

  12. Desarrollo neuromuscular en la atrofia muscular espinal

    OpenAIRE

    Martínez Hernàndez, Rebeca

    2012-01-01

    BACKGROUND: Spinal muscular atrophy (SMA) is a neuromuscular disease characterized by degeneration and loss of spinal cord motor neurons leading to denervation and muscular atrophy. It is caused by defects in the Survival Motor Neuron 1 gene (SMN1) and it is classified by age of onset and motor milestones into three main types which strongly correlate with the copy number of its homologous gene, SMN2. SMN2 expresses markedly less full‐length protein than SMN1, provoking disease manifestations...

  13. Splicing therapy for neuromuscular disease ☆

    OpenAIRE

    Andrew G. L. Douglas; Wood, Matthew J. A.

    2013-01-01

    Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA) are two of the most common inherited neuromuscular diseases in humans. Both conditions are fatal and no clinically available treatments are able to significantly alter disease course in either case. However, by manipulation of pre-mRNA splicing using antisense oligonucleotides, defective transcripts from the DMD gene and from the SMN2 gene in SMA can be modified to once again produce protein and restore function. A large numb...

  14. The emerging diversity of neuromuscular junction disorders

    OpenAIRE

    Newsom-Davis, J

    2007-01-01

    Research advances over the last 30 years have shown that key transmembrane proteins at the neuromuscular junction are vulnerable to antibody-mediated autoimmune attack These targets are acetylcholine receptors (AChRs) and muscle specific kinase (MuSK) in myasthenia gravis, voltage-gated calcium channels (VGCCs) in the Lambert-Eaton myasthenic syndrome (LEMS), and voltage-gated potassium channels (VGKCs) in neuromyotonia. In parallel with these immunological advances, mutations identified in g...

  15. Acute neuromuscular responses to car racing

    OpenAIRE

    Backman, Jani

    2005-01-01

    Purpose: The primary purpose of this study was to determine racing car drivers’ acute neuromuscular responses to race driving. The secondary purpose was to compare the cardiovascular loading of driving to that of maximal rowing action. Methods: The subjects of the present cross-sectional study (n = 9) were international level karting drivers. The study was performed in two parts; the laboratory tests and driving test. All subjects took part to the laboratory tests and five of the subjects per...

  16. Nova técnica de bloqueio do plexo braquial em cães New technique of brachial plexus block in dogs

    OpenAIRE

    Fábio Futema; Denise Tabacchi Fantoni; José Otávio Costa Auler Junior; Silvia Renata Gaido Cortopassi; Andrea Acaui; Angelo João Stopiglia

    1999-01-01

    O objetivo do presente estudo foi analisar a viabilidade e a eficácia de uma nova técnica para o bloqueio do plexo braquial em cães. Para tanto, foram utilizados 11 cães, machos e fêmeas, idade e peso variáveis e mestiços. Os animais foram pré-tratados com acepromazina e a indução da anestesia foi realizada com propofol. Posteriormente, os animais foram submetidos ao bloqueio do plexo braquial que constou da associação da técnica de múltiplas injeções com o emprego do estimulador de nervos e ...

  17. Influence of intense neuromuscular blockade on surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Donatsky, Anders Meller; Jensen, Bente Rona;

    2015-01-01

    neuromuscular block on surgical conditions with a subjective rating scale, force needed to close the fascia, incidences of abdominal contractions while suctioning the lungs, width of the wound diastase and operating time as outcome parameters. RESULTS: In all six pigs no abdominal contractions occurred while...... neuromuscular block suctioning the lungs elicited brief periods of abdominal EMG activity. No difference was found in the force needed to close the fascia when comparing no neuromuscular block with intense neuromuscular block. Furthermore, no significant differences were found in the width of the diastase...... not influence the force needed to close the fascia....

  18. O uso de bloqueadores neuromusculares no Brasil El uso de bloqueadores neuromusculares en Brasil Neuromuscular blockers in Brazil

    OpenAIRE

    Maria Cristina Simões de Almeida

    2004-01-01

    JUSTIFICATIVA E OBJETIVOS: Dados estatísticos referentes ao uso de bloqueadores neuromusculares no Brasil são desconhecidos. Este trabalho se propõe a análise estatística desse tópico. MÉTODO: Foram compiladas 831 respostas de um questionário preenchido em parte por anestesiologistas presentes ao 48º Congresso Brasileiro de Anestesiologia em Recife, 2001 e em parte via Internet, por anestesiologistas cujos endereços eletrônicos constam na página da Sociedade Brasileira de Anestesiologia (www....

  19. Bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno intravenoso melhora a analgesia após histerectomia abdominal

    Directory of Open Access Journals (Sweden)

    Evren Yucel

    2013-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: O objetivo deste estudo foi avaliar os efeitos da aplicação intravenosa(IV de dexcetoprofeno trometamol em bloqueio dos nervos ilioinguinal e ílio-hipogástrico na qualidade analgésica e no consumo de morfina após histerectomia abdominal total. MÉTODO: Estudo clínico controlado e randomizado conduzido com 61 pacientes. O estudo foi feito em sala de operação, sala de recuperação pós-anestésica e ambulatório. Os 61 pacientes foram randomicamente alocados em três grupos: grupo controle (Grupo C, grupo bloqueio (Grupo B e grupo bloqueio com dexcetoprofeno (Grupo BD. Antes da incisão cirúrgica feita após a indução da anestesia, fizemos o bloqueio dos nervos ilioinguinal e ilio-hipogástrico (Grupo C recebeu solução salina e grupos B e BD receberam levobupivacaína. Em contraste com os grupos C e B, o Grupo BD recebeu dexcetoprofeno. Administramos morfina a todos os pacientes para analgesia, com o uso do método de analgesia controlada pelo paciente (ACP durante o pós-operatório de 24 horas. Registramos os escores para dor pela escala visual analógica (EVA, os índices de satisfação, o consumo de morfina e os efeitos colaterais durante o pós-operatório de 24 horas. RESULTADOS: Os escores EVA do Grupo BD foram menores do que os dos grupos C e B no pós-operatório (p < 0,05 nos intervalos de 1, 2, 6 e 12 horas. Os escores EVA do Grupo C foram maiores do que os do Grupo B nas primeiras 2 horas de pós-operatório. O tempo até a primeira demanda de ACP foi mais longo, os valores de consumo de morfina mais baixos e os índices de satisfação maiores no Grupo BD do que nos outros dois grupos (p < 0,05. CONCLUSÃO: O bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno IV aumenta a satisfação do paciente e diminui o consumo de opioides e sugere que dexcetoprofeno trometamol é um analgésico anti-inflamatório não esteroide eficaz em analgesia pós-operatória.

  20. QUALIDADE DE LEITE PRODUZIDO POR RAÇAS BOVINAS NO MUNICÍPIO DE ITUVERAVA

    Directory of Open Access Journals (Sweden)

    Maria Amalia Brunini

    2015-06-01

    Full Text Available : This study aims to evaluate the quality of raw milk produced by the cattle breeds Holstein, Girolando, Gir and Brown Swiss, in Ituverava city, São Paulo state. There were collected five milk samples of each cattle breed, which were analyzed for the following parameters: total solids, solids nonfat, fat, protein, casein, lactose, acidity, pH, and the minerals calcium, potassium and phosphorus. The results obtained in this study, based on total solids, solids non fat, protein, casein, lactose, acidity, pH, and minerals (calcium, potassium and phosphorus indicate that the raw milk samples are evaluated in the standards established by the legislation. Considering the fat and protein, it can be concluded that milk produced by animals of the bovine breeds Gir and Brown Swiss is best suited to supply the agribusiness industry that manufactures dairy. O presente trabalho tem como objetivo avaliar a qualidade do leite cru produzido por bovinos das raças: Holandês, Girolando, Gir e Pardo-Suíço, no município de Ituverava/SP. Foram coletadas, de cada raça bovina, cinco amostras de leite, que foram analisadas quanto aos parâmetros sólidos totais, extrato seco desengordurado, gordura, proteína, caseína, lactose, acidez, pH e os minerais cálcio (Ca, potássio (K e fósforo (P. Os resultados obtidos neste estudo, com base nos teores de sólidos totais, extrato seco desengordurado, proteína, caseína, lactose, acidez, pH e minerais (cálcio, potássio e fósforo indicam que as amostras de leite cru aqui avaliadas estão em conformidade com os padrões estabelecidos pela legislação. Ao se considerar os teores de gordura e proteína, pode se concluir que o leite produzido por animais das raças bovina gir e pardo suíço é o mais adequado ao abastecimento da agroindústria que fabrica derivados de leite.

  1. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V;

    2015-01-01

    : An assessor-blinded, randomised controlled trial including people aged 30-50 years with no to mild pain following medial arthroscopic partial meniscectomy was conducted. Participants were randomly allocated to either a 12-week neuromuscular exercise program that targeted neutral lower limb alignment...... outcomes included additional measures of knee joint load distribution, patient-reported outcomes, maximal knee and hip muscle strength, and physical function measures. RESULTS: 60 out of 62 randomized participants (97%) completed the trial. There were no significant between-group differences in the change...

  2. 21 CFR 882.5810 - External functional neuromuscular stimulator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External functional neuromuscular stimulator. 882.5810 Section 882.5810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... External functional neuromuscular stimulator. (a) Identification. An external functional...

  3. Motoneuron and sensory neuron plasticity to varying neuromuscular activity levels

    Science.gov (United States)

    Ishihara, Akihiko; Roy, Roland R.; Ohira, Yoshinobu; Edgerton, V. Reggie

    2002-01-01

    The size and phenotypic properties of the neural and muscular elements of the neuromuscular unit are matched under normal conditions. When subjected to chronic decreases or increases in neuromuscular activity, however, the adaptations in these properties are much more limited in the neural compared with the muscular elements.

  4. Stress in Families of Children With Neuromuscular Disease.

    Science.gov (United States)

    Holroyd, Jean; Guthrie, Donald

    1979-01-01

    This study compared parents of children with neuromuscular diseases to parents of children with psychiatric diagnoses, using the Questionnaire on Resources and Stress. The groups showed different patterns of stress relating to child care. Within the neuromuscular group, parental stress increased with the severity of the child's illness.…

  5. Recent achievements in restorative neurology: Progressive neuromuscular diseases

    International Nuclear Information System (INIS)

    This book contains 27 chapters. Some of the chapter titles are: Computed Tomography of Muscles in Neuromuscular Disease; Mapping the Genes for Muscular Dystrophy; Trophic Factors and Motor Neuron Development; Size of Motor Units and Firing Rate in Muscular Dystrophy; Restorative Possibilities in Relation to the Pathology of Progressive Neuromuscular Disease; and An Approach to the Pathogenesis of some Congenital Myopathies

  6. Electrophysiological study in neuromuscular junction disorders

    Directory of Open Access Journals (Sweden)

    Ajith Cherian

    2013-01-01

    Full Text Available This review is on ultrastructure and subcellular physiology at normal and abnormal neuromuscular junctions. The clinical and electrophysiological findings in myasthenia gravis, Lambert-Eaton myasthenic syndrome (LEMS, congenital myasthenic syndromes, and botulinum intoxication are discussed. Single fiber electromyography (SFEMG helps to explain the basis of testing neuromuscular junction function by repetitive nerve stimulation (RNS. SFEMG requires skill and patience and its availability is limited to a few centers. For RNS supramaximal stimulation is essential and so is display of the whole waveform of each muscle response at maximum amplitude. The amplitudes of the negative phase of the first and fourth responses are measured from baseline to negative peak, and the percent change of the fourth response compared with the first represents the decrement or increment. A decrement greater than 10% is accepted as abnormal and smooth progression of response amplitude train and reproducibility form the crux. In suspected LEMS the effect of fast rates of stimulation should be determined after RNS response to slow rates of stimulation. Caution is required to avoid misinterpretation of potentiation and pseudofacilitation.

  7. Neuromuscular disruption with ultrashort electrical pulses

    Science.gov (United States)

    Pakhomov, Andrei; Kolb, Juergen F.; Joshi, Ravindra P.; Schoenbach, Karl H.; Dayton, Thomas; Comeaux, James; Ashmore, John; Beason, Charles

    2006-05-01

    Experimental studies on single cells have shown that application of pulsed voltages, with submicrosecond pulse duration and an electric field on the order of 10 kV/cm, causes sudden alterations in the intracellular free calcium concentration, followed by immobilization of the cell. In order to examine electrical stimulation and incapacitation with such ultrashort pulses, experiments on anesthetized rats have been performed. The effect of single, 450 nanosecond monopolar pulses have been compared with that of single pulses with multi-microsecond duration (TASER pulses). Two conditions were explored: 1. the ability to elicit a muscle twitch, and, 2. the ability to suppress voluntary movement by using nanosecond pulses. The second condition is relevant for neuromuscular incapacitation. The preliminary results indicate that for stimulation microsecond pulses are advantageous over nanosecond pulses, whereas for incapacitation, the opposite seems to apply. The stimulation effects seem to scale with electrical charge, whereas the disruption effects don't follow a simple scaling law. The increase in intensity (time of incapacitation) for a given pulse duration, is increasing with electrical energy, but is more efficient for nanosecond than for microsecond pulses. This indicates different cellular mechanisms for incapacitation, most likely subcellular processes, which have been shown to become increasingly important when the pulse duration is shortened into the nanosecond range. If further studies can confirm these initial results, consequences of reduced pulse duration are a reduction in weight and volume of the pulse delivery system, and likely, because of the lower required energy for neuromuscular incapacitation, reduced safety risks.

  8. Neuromuscular Dysfunction in Experimental Sepsis and Glutamine

    Science.gov (United States)

    Çankayalı, İlkin; Boyacılar, Özden; Demirağ, Kubilay; Uyar, Mehmet; Moral, Ali Reşat

    2016-01-01

    Background: Electrophysiological studies show that critical illness polyneuromyopathy appears in the early stage of sepsis before the manifestation of clinical findings. The metabolic response observed during sepsis causes glutamine to become a relative essential amino acid. Aims: We aimed to assess the changes in neuromuscular transmission in the early stage of sepsis after glutamine supplementation. Study Design: Animal experimentation. Methods: Twenty male Sprague-Dawley rats were randomized into two groups. Rats in both groups were given normal feeding for one week. In the study group, 1 g/kg/day glutamine was added to normal feeding by feeding tube for one week. Cecal ligation and perforation (CLP) surgery was performed at the end of one week. Before and 24 hours after CLP, compound muscle action potentials were recorded from the gastrocnemius muscle. Results: Latency measurements before and 24 hours after CLP were 0.68±0.05 ms and 0.80±0.09 ms in the control group and 0.69±0.07 ms and 0.73±0.07 ms in the study group (p<0.05). Conclusion: Since enteral glutamine prevented compound muscle action potentials (CMAP) latency prolongation in the early phase of sepsis, it was concluded that enteral glutamine replacement might be promising in the prevention of neuromuscular dysfunction in sepsis; however, further studies are required. PMID:27308070

  9. Electrophysiological study in neuromuscular junction disorders.

    Science.gov (United States)

    Cherian, Ajith; Baheti, Neeraj N; Iype, Thomas

    2013-01-01

    This review is on ultrastructure and subcellular physiology at normal and abnormal neuromuscular junctions. The clinical and electrophysiological findings in myasthenia gravis, Lambert-Eaton myasthenic syndrome (LEMS), congenital myasthenic syndromes, and botulinum intoxication are discussed. Single fiber electromyography (SFEMG) helps to explain the basis of testing neuromuscular junction function by repetitive nerve stimulation (RNS). SFEMG requires skill and patience and its availability is limited to a few centers. For RNS supramaximal stimulation is essential and so is display of the whole waveform of each muscle response at maximum amplitude. The amplitudes of the negative phase of the first and fourth responses are measured from baseline to negative peak, and the percent change of the fourth response compared with the first represents the decrement or increment. A decrement greater than 10% is accepted as abnormal and smooth progression of response amplitude train and reproducibility form the crux. In suspected LEMS the effect of fast rates of stimulation should be determined after RNS response to slow rates of stimulation. Caution is required to avoid misinterpretation of potentiation and pseudofacilitation. PMID:23661960

  10. Neuromuscular dressing effects: a literature review

    Directory of Open Access Journals (Sweden)

    Calero PA

    2012-05-01

    Full Text Available The kinesio taping is a technique that was created in 1979 by Doctor Kenzo Kase I’m looking through it that could generate a new therapeutic option to control pain, improve athletic performance and reduce the impact of musculoskeletal disorders. From the Sydney 2000 Olympic Games, this technique as a therapeutic alternative PTO and is composed of health professionals in the field of sport and physical rehabilitation.Objetive: This article aims to identify theoretical approaches on the bandage neuromuscular. Material and methods: held today, for which conducted a literature search of databases such as como Proquest, Ovid, Cochraine, PEDro, Journal of Orthopedic and Sports Physical, Sciencedirect, Pubmed y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs.The paper proposes a scheme of contextualization of the current landscape of the use and effects of kinesio taping in the management of different pathologies of the musculo-skeletal system in sports. Conclusion: it is concluded that currently many health professionals, and take the neuromuscular bandage a good therapeutic option in the management of diseases affecting the human body is investigated and every day more about the subject, which makes these new therapeutic methods to acquire a scientific value and transcends knowledge.

  11. Prevalence of complications in neuromuscular scoliosis surgery

    DEFF Research Database (Denmark)

    Sharma, Shallu; Wu, Chunsen; Andersen, Thomas;

    2013-01-01

    PURPOSE: Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. METHODS: PubMed and Em......PURPOSE: Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. METHODS: Pub......Med and Embase databases were searched for studies reporting the outcomes and complications of NMS surgery, published from 1997 to May 2011. We focused on NMS as defined by the Scoliosis Research Society's classification. We measured the pooled estimate of the overall complication rates (PR) using a random....... In regard to surgical complications affiliated with various surgical techniques in NMS, the level of evidence of published literature ranges between 2+ to 2-; the subsequent recommendations are level C. CONCLUSION: NMS patients have diverse and high complication rates after scoliosis surgery. High PRs...

  12. Neuromuscular blockade in cardiac surgery: An update for clinicians

    Directory of Open Access Journals (Sweden)

    Hemmerling Thomas

    2008-01-01

    Full Text Available There have been great advancements in cardiac surgery over the last two decades; the widespread use of off-pump aortocoronary bypass surgery, minimally invasive cardiac surgery, and robotic surgery have also changed the face of cardiac anaesthesia. The concept of "Fast-track anaesthesia" demands the use of nondepolarising neuromuscular blocking drugs with short duration of action, combining the ability to provide (if necessary sufficiently profound neuromuscular blockade during surgery and immediate re-establishment of normal neuromuscular transmission at the end of surgery. Postoperative residual muscle paralysis is one of the major hurdles for immediate or early extubation after cardiac surgery. Nondepolarising neuromuscular blocking drugs for cardiac surgery should therefore be easy to titrate, of rapid onset and short duration of action with a pathway of elimination independent from hepatic or renal dysfunction, and should equally not affect haemodynamic stability. The difference between repetitive bolus application and continuous infusion is outlined in this review, with the pharmacodynamic and pharmacokinetic characteristics of vecuronium, pancuronium, rocuronium, and cisatracurium. Kinemyography and acceleromyography are the most important currently used neuromuscular monitoring methods. Whereas monitoring at the adductor pollicis muscle is appropriate at the end of surgery, monitoring of the corrugator supercilii muscle better reflects neuromuscular blockade at more central, profound muscles, such as the diaphragm, larynx, or thoraco-abdominal muscles. In conclusion, cisatracurium or rocuronium is recommended for neuromuscular blockade in modern cardiac surgery.

  13. Nova técnica de bloqueio do plexo braquial em cães New technique of brachial plexus block in dogs

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    Fábio Futema

    1999-03-01

    Full Text Available O objetivo do presente estudo foi analisar a viabilidade e a eficácia de uma nova técnica para o bloqueio do plexo braquial em cães. Para tanto, foram utilizados 11 cães, machos e fêmeas, idade e peso variáveis e mestiços. Os animais foram pré-tratados com acepromazina e a indução da anestesia foi realizada com propofol. Posteriormente, os animais foram submetidos ao bloqueio do plexo braquial que constou da associação da técnica de múltiplas injeções com o emprego do estimulador de nervos e a técnica da palpação arterial como ponto de referência para a localização dos nervos. Utilizou-se como anestésico local, a bupivacaína com vasoconstritor administrado na dose total de 4mg/kg a 0,375% . O volume total foi dividido em 4 partes iguais, administradas na velocidade de 30 segundos cada, com o objetivo de se atingir a maior quantidade de nervos. O tempo necessário para realização da técnica foi de 11,30 ± 4,54 minutos; o período de latência para o bloqueio motor foi de 9,70 ± 5,52 minutos e para o bloqueio sensitivo foi de 26,20 ± 8,86 min. , sendo a duração da analgesia de 11:00 ± 0:45 horas. Em 90% dos animais, o bloqueio foi efetivo, constatado através da anestesia de todo membro torácico distal à articulação escápulo-umeral. A única complicação observada foi a hipotensão arterial desenvolvida em um animal. Mediante os resultados obtidos, pode-se pressupor que as cirurgias envolvendo o membro torácico distal à articulação escápulo-umeral poderão ser utilizadas com auxílio desta nova técnica do bloqueio do plexo braquial, bem como na analgesia pós-operatória de longa duração.The aim of this study was to evaluate the viability and efficacy of a new technique of brachial plexus block in dogs. Eleven mongrel dogs of different ages and weight, both male and female were used. Animals were pre-medicated with acepromazine and induction of anesthesia was performed with propofol. The brachial

  14. Bloqueio combinado raquiperidural versus bloqueio peridural contínuo para analgesia de parto em primigestas: resultados maternos e perinatais Combined spinal-epidural block versus continuous epidural block in labor analgesia for primiparous women: newborns and women outcomes

    Directory of Open Access Journals (Sweden)

    Márcio Antonio de Souza

    2009-10-01

    Full Text Available OBJETIVOS: comparar a evolução materna e perinatal após a utilização da analgesia peridural contínua versus analgesia combinada raqui-peridural em parturientes primigestas. MÉTODOS: foi realizado ensaio clínico aleatorizado com 128 gestantes primigestas em trabalho de parto, divididas em dois grupos: analgesia peridural (APC com 65 mulheres e grupo analgesia combinada raqui-peridural (ACRP com 63, admitidas no pré-parto de duas maternidades na cidade de Jundiaí - SP. Foram estudadas as variáveis: tempo de latência de instalação da analgesia, intensidade da dor e tempo total decorrido até a dilatação completa, índice de Apgar no primeiro e quinto minutos, tempo de resolução do parto, grau de bloqueio motor, efeitos adversos como náuseas, vômitos, prurido, hipotensão arterial, e grau de satisfação materna. Foram critérios de inclusão: primigestas, estado físico ASA 1 e 2, feto único, apresentação cefálica, de termo, dilatação cervical de 3 a 6 cm e solicitação de analgesia pelo obstetra. Foram excluídas mulheres com morbidades, ruptura de membranas, anormalidades fetais e uso de opioides até quatro horas antes. Para a análise estatística utilizou-se o teste de Mann-Whitney para as variáveis contínuas não paramétricas e os testes exato de Fisher e χ2 de Pearson, para variáveis categóricas. RESULTADOS: não houve diferença entre os grupos para velocidade de dilatação cervical, tempo para resolução do parto, parâmetros hemodinâmicos maternos, vitalidade do recém-nascido, complementações analgésicas durante o trabalho de parto e modo de parto. Houve maior rapidez de instalação da analgesia no grupo da ACRP e menor bloqueio motor no grupo de APC. Não foram observadas diferenças em relação aos efeitos adversos como náuseas, vômitos, prurido e hipotensão, sendo hipotensão mais frequente no grupo APC (16,9 versus 6,3% e náusea no grupo ACRP (6,3 versus 3,1%. CONCLUSÕES: as duas t

  15. Anormalidades neuromuscular no desuso, senilidade e caquexia

    OpenAIRE

    João Aris Kouyoumdjian

    1993-01-01

    É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso) deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural;...

  16. Neuromuscular synaptogenesis: coordinating partners with multiple functions.

    Science.gov (United States)

    Darabid, Houssam; Perez-Gonzalez, Anna P; Robitaille, Richard

    2014-11-01

    The formation of highly efficient and reliable synapses at the neuromuscular junction (NMJ) relies on dynamic molecular interactions. Studies of the development and maturation of the NMJ have focused on events that are dependent on synaptic activity and that require the coordinated actions of nerve- and muscle-derived molecules with different targets and effects. More recently, perisynaptic Schwann cells--the glial cells at NMJs--have become an important focus of research. These glia concomitantly contribute to pre- and postsynaptic maturation while undergoing maturation themselves. Thus, an intricate 'danse à trois’'regulates the maturation of the NMJ to form a highly efficient communication unit, in which fine glial processes lie in close proximity to a highly concentrated population of postsynaptic receptors and perfectly aligned presynaptic release sites. PMID:25493308

  17. Visual and tactile assessment of neuromuscular fade.

    Science.gov (United States)

    Brull, S J; Silverman, D G

    1993-08-01

    The accuracy of visual and tactile assessment of the neuromuscular fade in response to train-of-four (TOF) and double-burst stimulation (DBS) were compared to assess their relative utility in the clinical setting. For each of 74 data sets with a mechanographic TOF ratio less than 0.70, an observer (blinded to the presence or degree of fade) performed visual and tactile assessments of fade in response to TOF, DBS3,3, and DBS3,2 stimuli at low current (20 and 30 mA) and high current (50 and 60 mA). For the range of mechanographic TOF ratios between 0.41 and 0.70, visual assessment failed to identify TOF, DBS3,3, and DBS3,2 fade in 46%, 18%, and 14% of cases at high current and in 23%, 5%, and 0% of cases at low current, respectively. Tactile assessments failed to identify fade in 55%, 23%, and 14% of cases at high current and in 23%, 14%, and 14% of cases at low current. Overall, the ability to detect fade was comparable for visual and tactile assessments regardless of the method of neurostimulation (P = NS with paired t-test). However, the degree of overestimation of the fade ratio (i.e., quantitative assessment) tended to be less when using tactile means; the difference achieved significance for TOF at low current and DBS3,3 at both low and high currents. We conclude that the differences between the visual and tactile means of assessment are relatively small compared to the differences among the TOF and DBS patterns of neurostimulation. Both subjective techniques are often inadequate in settings in which assurance of full recovery of neuromuscular function is critical.

  18. Determinação do volume mínimo efetivo de bupivacaína 0,5% para bloqueio do plexo braquial por via axilar guiado por ultrassom

    OpenAIRE

    Leonardo Henrique Cunha Ferraro; Alexandre Takeda; Luiz Fernando dos Reis Falcão; André Hosoi Rezende; Eduardo Jun Sadatsune; Maria Angela Tardelli

    2014-01-01

    Justificativa e objetivo: o uso do ultrassom para acompanhar o correto posicionamento da agulha e a dispersão do anestésico local permitiu a redução do volume de anestésico local necessário para o bloqueio de nervos periféricos. Existem poucos trabalhos sobre o volume mínimo efetivo de anestésico local para o bloqueio do plexo braquial via axilar (BPVA). Este estudo foi conduzido com o objetivo de determinar o volume mínimo efetivo (VE90) de bupivacaína 0,5% comadrenalina (1:200.000) para o ...

  19. Eficácia analgésica pós-operatória de diferentes volumes e massas de ropivacaína no bloqueio de plexo braquial pela via posterior

    OpenAIRE

    Bruno Salome de Morais; Marcos Guilherme Cunha Cruvinel; Fabiano Soares Carneiro; Flavio Lago; Yerkes Pereira Silva

    2012-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial pela via posterior tem sua eficácia para cirurgias de ombro demonstrada por diferentes autores. Entretanto, não há um consenso sobre a massa e o volume ideal de anestésico local a ser empregado. O objetivo deste estudo é com parar diferentes volumes e massas de ropivacaína no bloqueio do plexo braquial pela via posterior em cirurgias artroscópicas de ombro. MÉTODO: Sessenta pacientes com idade > 18 anos, estado físico ASA I e II, escalad...

  20. A dissincronia mecânica é semelhante em diferentes padrões do bloqueio de ramo esquerdo

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    Rodrigo Bellio de Mattos Barretto

    2013-11-01

    Full Text Available FUNDAMENTOS: O bloqueio do ramo esquerdo (BRE e a presença de disfunção sistólica são as principais indicações de terapia de ressincronização cardíaca (TRC. A dissincronia ventricular mecânica pela ecocardiografia pode ajudar a identificar pacientes responsivos à TRC. O BRE pode mostrar diferentes padrões em sua morfologia. OBJETIVO: Comparar a prevalência de dissincronia mecânica em diferentes padrões de BRE em pacientes com disfunção sistólica esquerda. MÉTODOS: Analisaram-se 48 pacientes com fração de ejeção (FE 150 ms. RESULTADOS: Eram 24 homens, com idade 60 ± 11 anos e FEVE de 29 ± 7%. Trinta e dois apresentavam QRS > 150 ms, e 22, ECG eixo entre -30º e +90º. A dissincronia interventricular foi identificada em 73% dos pacientes e a intraventricular em valores entre 37-98%. Portadores de QRS > 150 ms apresentaram maiores dimensões do átrio e ventrículo esquerdos, e menor FE (p < 0,05, e o desvio esquerdo do eixo associou-se a pior função diastólica e maior diâmetro atrial. A presença de dissincronia mecânica interventricular e intraventricular (10 métodos foi semelhante entre os diferentes padrões de BRE (p = ns. CONCLUSÃO: Nos dois diferentes padrões eletrocardiográficos de BRE analisados, não foram observadas diferenças em relação à presença de dissincronia mecânica.

  1. The potential of disease management for neuromuscular hereditary disorders.

    Science.gov (United States)

    Chouinard, Maud-Christine; Gagnon, Cynthia; Laberge, Luc; Tremblay, Carmen; Côté, Charlotte; Leclerc, Nadine; Mathieu, Jean

    2009-01-01

    Neuromuscular hereditary disorders require long-term multidisciplinary rehabilitation management. Although the need for coordinated healthcare management has long been recognized, most neuromuscular disorders are still lacking clinical guidelines about their long-term management and structured evaluation plan with associated services. One of the most prevalent adult-onset neuromuscular disorders, myotonic dystrophy type 1, generally presents several comorbidities and a variable clinical picture, making management a constant challenge. This article presents a healthcare follow-up plan and proposes a nursing case management within a disease management program as an innovative and promising approach. This disease management program and model consists of eight components including population identification processes, evidence-based practice guidelines, collaborative practice, patient self-management education, and process outcomes evaluation (Disease Management Association of America, 2004). It is believed to have the potential to significantly improve healthcare management for neuromuscular hereditary disorders and will prove useful to nurses delivering and organizing services for this population.

  2. Genetics of Pediatric-Onset Motor Neuron and Neuromuscular Diseases

    Science.gov (United States)

    2015-08-24

    Spinal Muscular Atrophy; Charcot-Marie-Tooth Disease; Muscular Dystrophy; Spinal Muscular Atrophy With Respiratory Distress 1; Amyotrophic Lateral Sclerosis; Motor Neuron Disease; Neuromuscular Disease; Peroneal Muscular Atrophy; Fragile X Syndrome

  3. Effect of nimodipine and flunarizine on neuromuscular function in mice

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    Swapnil B. Kaikade

    2016-08-01

    Conclusions: Nimodipine has significant dose dependent depressant action on neuromuscular function while flunarizine has no effect on the above mentioned parameter. [Int J Basic Clin Pharmacol 2016; 5(4.000: 1524-1527

  4. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade

    DEFF Research Database (Denmark)

    Brueckmann, B; Sasaki, N; Grobara, P;

    2015-01-01

    BACKGROUND: This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. METHODS: Adult patients undergoing abdominal surgery received rocuronium, follow...

  5. Bloqueio seletivo dos nervos supraescapular e axilar promove analgesia satisfatória e menor grau de bloqueio motor: comparação com o bloqueio interescalênico El bloqueo selectivo de los nervios supraescapular y axilar promueve una analgesia satisfactoria y un menor grado de bloqueo motor: comparación con el bloqueo interescalénico Selective suprascapular and axillary nerve block provides adequate analgesia and minimal motor block: comparison with interscalene block

    Directory of Open Access Journals (Sweden)

    Patrícia Falcão Pitombo

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: Cirurgias artroscópicas do ombro cursam com intensa dor pós-operatória. Diversas técnicas analgésicas têm sido preconizadas. O objetivo deste estudo foi comparar o bloqueio dos nervos supraescapular e axilar nas cirurgias artroscópicas de ombro com a abordagem interescalênica do plexo braquial. MÉTODO: Sessenta e oito pacientes foram alocados em dois grupos de 34, de acordo com a técnica utilizada: grupo interescalênico (GI e grupo seletivo (GS, sendo ambas as abordagens realizadas com neuroestimulador. No GI, após resposta motora adequada foram injetados 30 mL de levopubivacaína em excesso enantiomérico de 50% a 0,33% com adrenalina 1:200.000. No GS, após resposta motora do nervo supraescapular e axilar, foram injetados 15 mL da mesma substância em cada nervo. Em seguida, realizada anestesia geral. Variáveis avaliadas: tempo para realização dos bloqueios, analgesia, consumo de opioide, bloqueio motor, estabilidade cardiocirculatória, satisfação e aceitabilidade pelo paciente. RESULTADOS: Tempo para execução do bloqueio interescalênico foi significativamente menor que para realização do bloqueio seletivo. Analgesia foi significativamente maior no pós-operatório imediato no GI e no pós-operatório tardio no GS. Consumo de morfina foi significativamente maior na primeira hora no GS. Bloqueio motor foi significativamente menor no GS. Estabilidade cardiocirculatória, satisfação e aceitabilidade da técnica pelo paciente não diferiram entre os grupos. Ocorreu uma falha no GI e duas no GS. CONCLUSÕES: Ambas as técnicas são seguras, eficazes com mesmo grau de satisfação e aceitabilidade. O bloqueio seletivo de ambos os nervos apresentou analgesia satisfatória, com a vantagem de proporcionar bloqueio motor restrito ao ombro.JUSTIFICATIVA Y OBJETIVOS: Las cirugías artroscópicas del hombro cursan con un intenso dolor postoperatorio. Diversas técnicas analgésicas han sido preconizadas

  6. Neuromuscular blockade in cardiac surgery: An update for clinicians

    OpenAIRE

    Hemmerling Thomas; Russo Gianluca; Bracco David

    2008-01-01

    There have been great advancements in cardiac surgery over the last two decades; the widespread use of off-pump aortocoronary bypass surgery, minimally invasive cardiac surgery, and robotic surgery have also changed the face of cardiac anaesthesia. The concept of "Fast-track anaesthesia" demands the use of nondepolarising neuromuscular blocking drugs with short duration of action, combining the ability to provide (if necessary) sufficiently profound neuromuscular blockade during surgery and i...

  7. Neuromuscular blockade: what was, is and will be.

    Science.gov (United States)

    Schepens, Tom; Cammu, Guy

    2014-01-01

    Non-depolarizing neuromuscular blocking agents (NMBAs) produce neuromuscular blockade by competing with acetylcholine at the neuromuscular junction, whereas depolarizing NMBAs open receptor channels in a manner similar to that of acetylcholine. Problems with NMBAs include malignant hyperthermia caused by succinylcholine, anaphylaxis with the highest incidence for succinylcholine and rocuronium, and residual neuromuscular blockade. To reverse these blocks, anticholinesterases can act indirectly by increasing the amount of acetylcholine in the neuromuscular junction; sugammadex is the only selective relaxant binding agent (SRBA) in clinical use. At all levels of blockade, recovery after sugammadex is faster than after neostigmine. Sugammadex potentially also has some other advantages over neostigmine that are related to neostigmine's increase in the amount of acetylcholine and the necessity of co-administering anticholinergics. However, hypersensitivity reactions, including anaphylaxis, have occurred in some patients and healthy volunteers after sugammadex and remain an issue for the FDA. In the near future, we may see the emergence of new SRBAs and of easier-to-use technologies that can routinely monitor neuromuscular transmissions in daily practice. The nature of the effect of sugammadex on freeing nicotinic acetylcholine receptors located outside the neuromuscular junction from NMBAs is unknown. Moreover, it is uncertain whether the full removal of the competing antagonists (by SRBAs) at the neuromuscular junction impacts the efficiency of acetylcholine transmission. In a recent pilot study in healthy volunteers, we demonstrated increased electromyographic diaphragm activity after sugammadex, compared to neostigmine. Further research is needed to elucidate the role of NMBAs and their reversal agents in the central control of breathing, respiratory muscle activity, and respiratory outcomes. PMID:25622380

  8. Degeneration of Neuromuscular Junction in Age and Dystrophy

    OpenAIRE

    Rüdiger eRudolf; Muzamil Majid Khan; Siegfried eLabeit; Deschenes, Michael R.

    2014-01-01

    Functional denervation is a hallmark of aging sarcopenia as well as of muscular dystrophy. It is thought to be a major factor reducing skeletal muscle mass, particularly in the case of sarcopenia. Neuromuscular junctions serve as the interface between the nervous and skeletal muscular systems, and thus they may receive pathophysiological input of both pre- and postsynaptic origin. Consequently, neuromuscular junctions are good indicators of motor health on a systemic level. Indeed, upon sarco...

  9. Agenesia de cava superior associada a bloqueio atrioventricular de 3º grau Agenesis of the right superior vena cava associated with total heart block

    Directory of Open Access Journals (Sweden)

    Gustavo J. Ventura Couto

    2008-03-01

    Full Text Available A persistência de veia cava superior esquerda com ausência da veia cava superior é uma anomalia rara, principalmente quando associada a bloqueio atrioventricular de 3º grau. Relatamos o caso de uma paciente, na qual durante implante de marca-passo definitivo, para a correção de bloqueio atrioventricular total, foi detectada presença de veia cava superior esquerda com suspeição de ausência de veia cava superior, o que levou ao emprego de técnica diferenciada para fixação do eletrodo ventricular. Para confirmação da provável agenesia, foram realizados diversos exames complementares de imagem, demonstrando-se a dificuldade no diagnóstico da síndrome aqui descrita.The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.

  10. Ventriculo-auriculostomia nos bloqueios ao trânsito do líquido cefalorraqueano na cisticercose encefálica

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    Gilberto M. Almeida

    1966-09-01

    Full Text Available São apresentados 16 casos de cisticercose encefálica com bloqueio ao trânsito do líquido cefalorraqueano, nos quais foi feita ventrículo-auriculostomia com válvula de Holter. Dos 16 pacientes, 5 faleceram, 10 estão vivos e sem sinais de hipertensão intracraniana e um não foi seguido. Considerando-se o prognóstico reservado da doença, principalmente quando existe hipertensão intracraniana, os resultados podem ser considerados bons. A derivação ventriculovenosa constitui, portanto, valioso método no tratamento da neurocisticercose com dilatação ventricular, causada por bloqueio ao trânsito do LCR. Algumas vêzes a má evolução do caso está relacionada à progressão da própria doença e não à falha no contrôle da hipertensão intracraniana.

  11. Animal models for genetic neuromuscular diseases.

    Science.gov (United States)

    Vainzof, Mariz; Ayub-Guerrieri, Danielle; Onofre, Paula C G; Martins, Poliana C M; Lopes, Vanessa F; Zilberztajn, Dinorah; Maia, Lucas S; Sell, Karen; Yamamoto, Lydia U

    2008-03-01

    The neuromuscular disorders are a heterogeneous group of genetic diseases, caused by mutations in genes coding sarcolemmal, sarcomeric, and citosolic muscle proteins. Deficiencies or loss of function of these proteins leads to variable degree of progressive loss of motor ability. Several animal models, manifesting phenotypes observed in neuromuscular diseases, have been identified in nature or generated in laboratory. These models generally present physiological alterations observed in human patients and can be used as important tools for genetic, clinic, and histopathological studies. The mdx mouse is the most widely used animal model for Duchenne muscular dystrophy (DMD). Although it is a good genetic and biochemical model, presenting total deficiency of the protein dystrophin in the muscle, this mouse is not useful for clinical trials because of its very mild phenotype. The canine golden retriever MD model represents a more clinically similar model of DMD due to its larger size and significant muscle weakness. Autosomal recessive limb-girdle MD forms models include the SJL/J mice, which develop a spontaneous myopathy resulting from a mutation in the Dysferlin gene, being a model for LGMD2B. For the human sarcoglycanopahties (SG), the BIO14.6 hamster is the spontaneous animal model for delta-SG deficiency, whereas some canine models with deficiency of SG proteins have also been identified. More recently, using the homologous recombination technique in embryonic stem cell, several mouse models have been developed with null mutations in each one of the four SG genes. All sarcoglycan-null animals display a progressive muscular dystrophy of variable severity and share the property of a significant secondary reduction in the expression of the other members of the sarcoglycan subcomplex and other components of the Dystrophin-glycoprotein complex. Mouse models for congenital MD include the dy/dy (dystrophia-muscularis) mouse and the allelic mutant dy(2J)/dy(2J) mouse

  12. Diagnostic Certified Assay: Neuromuscular and Cardiac Assessments

    Directory of Open Access Journals (Sweden)

    Rea Valaperta

    2013-01-01

    Full Text Available The expansion of the specific trinucleotide sequence, [CTG], is the molecular pathological mechanism responsible for the clinical manifestations of DM1. Many studies have described different molecular genetic techniques to detect DM1, but as yet there is no data on the analytical performances of techniques used so far in this disease. We therefore developed and validated a molecular method, “Myotonic Dystrophy SB kit,” to better characterize our DM1 population. 113 patients were examined: 20 DM1-positive, 11 DM1/DM2-negative, and13 DM1-negative/DM2-positive, who had a previous molecular diagnosis, while 69 were new cases. This assay correctly identified 113/113 patients, and all were confirmed by different homemade assays. Comparative analysis revealed that the sensitivity and the specificity of the new kit were very high (>99%. Same results were obtained using several extraction procedures and different concentrations of DNA. The distribution of pathologic alleles showed a prevalence of the “classical” form, while of the 96 nonexpanded alleles 19 different allelic types were observed. Cardiac and neuromuscular parameters were used to clinically characterize our patients and support the new genetic analysis. Our findings suggest that this assay appears to be a very robust and reliable molecular test, showing high reproducibility and giving an unambiguous interpretation of results.

  13. Electrophysiology of autonomic neuromuscular transmission involving ATP.

    Science.gov (United States)

    Sneddon, P

    2000-07-01

    Electrophysiological investigations of autonomic neuromuscular transmission have provided great insights into the role of ATP as a neurotransmitter. Burnstock and Holman made the first recordings of excitatory junction potentials (e.j.p.s) produced by sympathetic nerves innervating the smooth muscle of the guinea-pig vas deferens. This led to the identification of ATP as the mediator of e.j.p.s in this tissue, where ATP acts as a cotransmitter with noradrenaline. The e.j.p.s are mediated solely by ATP acting on P2X(1) receptors leading to action potentials and a rapid phasic contraction, whilst noradrenaline mediates a slower, tonic contraction which is not dependent on membrane depolarisation. Subsequent electrophysiological studies of the autonomic innervation of smooth muscles of the urogenital, gastrointestinal and cardiovascular systems have revealed a similar pattern of response, where ATP mediates a fast electrical and mechanical response, whilst another transmitter such as noradrenaline, acetylcholine, nitric oxide or a peptide mediates a slower response. The modulation of junction potentials by a variety of pre-junctional receptors and the mechanism of inactivation of ATP as a neurotransmitter will also be described.

  14. Neuromuscular Fatigue During 200 M Breaststroke

    Directory of Open Access Journals (Sweden)

    Ana Conceição

    2014-03-01

    Full Text Available The aims of this study were: i to analyze activation patterns of four upper limb muscles (duration of the active and non-active phase in each lap of 200m breaststroke, ii quantify neuromuscular fatigue, with kinematics and physiologic assessment. Surface electromyogram was collected for the biceps brachii, deltoid anterior, pectoralis major and triceps brachii of nine male swimmers performing a maximal 200m breaststroke trial. Swimming speed, SL, SR, SI decreased from the 1st to the 3rd lap. SR increased on the 4th lap (35.91 ± 2.99 stroke·min-1. Peak blood lactate was 13.02 ± 1.72 mmol·l-1 three minutes after the maximal trial. The EMG average rectified value (ARV increased at the end of the race for all selected muscles, but the deltoid anterior and pectoralis major in the 1st lap and for biceps brachii, deltoid anterior and triceps brachii in the 4th lap. The mean frequency of the power spectral density (MNF decreased at the 4th lap for all muscles. These findings suggest the occurrence of fatigue at the beginning of the 2nd lap in the 200m breaststroke trial, characterized by changes in kinematic parameters and selective changes in upper limb muscle action. There was a trend towards a non-linear fatigue state.

  15. Neuromuscular disorders in chronic alcohol intoxication

    Directory of Open Access Journals (Sweden)

    A. Yu. Emelyanova

    2015-01-01

    Full Text Available The paper reviews the present-day Russian and foreign literature on neuromuscular disorders in chronic alcohol intoxication. The most common manifestations of alcohol disease include alcoholic polyneuropathy (PNP and alcohol-induced skeletal muscle injury. The clinical polymorphism of alcoholic PNP is discussed. The paper considers a chronic sensory automatic form due to the direct toxic effects of ethanol and its metabolites during long-term alcohol intoxication, as well as acute/subacute sensorimotor neuropathy, the basis for the pathogenesis of which is B group vitamins, predominantly thiamine, deficiency that develops in the presence of drinking bouts concurrent with malnutrition and/or alcohol-related gastrointestinal tract diseases. In addition to nonuse of alcohol and a properly balanced diet, antioxidant therapy with alphalipoic acid and neurotropic B group vitamins is considered to be pathogenetic therapy for neuropathy. The most common and least studied clinicalform of alcohol-induced musculoskeletal injury is chronic alcoholic myopathy (AM, the diagnostic standard for which is morphometricand immunohistochemical examination of a muscle biopsy specimen. The morphological base for this form of myopathy is predominantly type 2 muscle fiber atrophy caused by impaired protein synthesis and a decreased regenerative potential of muscle fiber. The efficacy of antioxidants and leucine-containing amino acid mixtures in the treatment of chronic AM is discussed.

  16. Bloqueio completo do ramo esquerdo esforço-induzido: prevalência e prognóstico

    Directory of Open Access Journals (Sweden)

    Ricardo Stein

    2011-07-01

    Full Text Available FUNDAMENTO: O bloqueio completo do ramo esquerdo esforço-induzido (BCRE E-I é um achado infrequente ao teste de exercício e sua prevalência e significado prognóstico não são claros. OBJETIVO: Avaliar de forma longitudinal a prevalência e o significado prognóstico do BCRE E-I em homens americanos veteranos de guerra. MÉTODOS: Avaliamos 9.623 pacientes que realizaram ergometria em esteira (TE entre 1987 e 2007. Os desfechos foram comparados entre aqueles com TE NL, os com BCRE E-I e os que apresentaram Dep ST anormal. A mortalidade e a causa das mortes foram identificadas de forma cega para os resultados do TE. RESULTADOS: Nesta coorte prospectiva, 6922 indivíduos apresentaram TE NL (57,2 ± 11,4 anos, 1.739 apresentaram Dep ST anormal (62,7 ± 9,8 anos e 38 casos de BCRE E-I foram identificados (65,2 ± 11,9 anos. A prevalência do BCRE E-I foi 0,38%. Após 8,8 anos, ocorreram 1.699 mortes por todas as causas e 610 mortes cardiovasculares (CV. Doença arterial coronária e insuficiência cardíaca foram mais prevalentes nos pacientes com BCRE E-I. Pacientes com BCRE E-I tiveram razão de azar de 2,37 (p = 0,002 para mortalidade por todas as causas, mas a mesma não foi significativa quando ajustada para idade ou quando a mortalidade cardiovascular foi o desfecho avaliado. CONCLUSÃO: BCRE E-I é um achado raro. Indivíduos com BCRE E-I apresentam maior mortalidade por todas as causas quando comparados aqueles com TE NL. No entanto, tal fato é explicado por esses pacientes serem significativamente mais velhos e por apresentarem mais enfermidades cardiovasculares associadas.

  17. Bloqueio peridural caudal: técnica anestésica de uso exclusivo em crianças? É possível sua realização em adultos? Qual o papel do ultrassom nesse contexto?

    Directory of Open Access Journals (Sweden)

    Ilana Esquenazi Najman

    2011-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio peridural caudal é a mais popular entre todas as técnicas de anestesia regional em crianças. Com o avanço da idade, apenas a relativa dificuldade em localizar o hiato sacral limita seu uso. Entretanto, em adultos a técnica vem sendo largamente utilizada para controle de dor crônica com o auxílio da fluoroscopia. Assim, a habilidade em localizar o hiato e definir as variações anatômicas é o principal fator determinante do sucesso e segurança na execução do bloqueio peridural pela via caudal. Nesse contexto, o ultrassom vem ganhando espaço como guia para a realização do bloqueio caudal. O objetivo desta revisão foi elucidar o papel do ultrassom na anestesia caudal, além de demonstrar que o bloqueio caudal, muito utilizado em crianças, também é útil e pode ser usado em adultos. CONTEÚDO: Uma revisão literária sobre a anatomia da região sacral e da técnica anestésica necessária para a realização adequada do bloqueio caudal foi promovida. Além disso, artigos recentes sobre estudos realizados com bloqueios peridurais caudais guiados por ultrassom tanto em crianças quanto em adultos também foram incluídos. CONCLUSÕES: O ultrassom, apesar de suas limitações, pode ser útil como ferramenta adjuvante no posicionamento da agulha no espaço caudal. Permite a fácil identificação da anatomia sacral, além de visualização da injeção, em tempo real. Sua natureza portátil, não invasiva e livre de exposição à radiação faz dele uma tecnologia atrativa na sala operatória, principalmente na emergência de casos difíceis. Entretanto, como seu uso em bloqueios centrais do neuroeixo ainda é muito primitivo, é necessário que mais pesquisas sejam feitas para se consagre como técnica de rotina na prática anestésica.

  18. Determinação do volume mínimo efetivo de bupivacaína 0,5% para bloqueio do plexo braquial por via axilar guiado por ultrassom

    Directory of Open Access Journals (Sweden)

    Leonardo Henrique Cunha Ferraro

    2014-01-01

    Full Text Available Justificativa e objetivo: o uso do ultrassom para acompanhar o correto posicionamento da agulha e a dispersão do anestésico local permitiu a redução do volume de anestésico local necessário para o bloqueio de nervos periféricos. Existem poucos trabalhos sobre o volume mínimo efetivo de anestésico local para o bloqueio do plexo braquial via axilar (BPVA. Este estudo foi conduzido com o objetivo de determinar o volume mínimo efetivo (VE90 de bupivacaína 0,5% comadrenalina (1:200.000 para o BPVA guiado por ultrassom. Método: o método up-and-down proposto por Massey e Dixon foi usado para o cálculo do volume mínimo efetivo. A dose inicial foi de 5 ml por nervo (radial, mediano, ulnar e musculocutâneo. No caso de falha do bloqueio, o volume era aumentado em 0,5 mL por nervo. O sucesso do bloqueio resultava na diminuição do volume em 0,5 mL por nervo para o paciente subsequente. O sucesso do bloqueio foi definido como bloqueio da função motora ≤ 2 segundo a escala de Bromage modificada, ausência de sensibilidade térmica e de resposta ao pinprick. Foi definido como critério para término do estudo a obtenção de cinco casos de falha seguidos de casos de sucesso. Resultados: foram incluídos 19 pacientes no estudo. O volume mínimo efetivo (VE90 de bupi-vacaína 0,5% com 1:200.000 de adrenalina foi de 1,56 ml (IC 95% 0,99-3,5 por nervo. Conclusão: este trabalho corrobora alguns estudos que mostram que é possível obter anestesia cirúrgica com baixos volumes de anestésico local para bloqueios de nervo periférico guiados por ultrassom.

  19. Bloqueio dos nervos femoral e isquiático guiados por ultrassom em paciente anticoagulado: case reports Bloqueo de los nervios femoral e isquiático guiados por ultrasonido en paciente anticoagulado Ultrasound-guided femoral and sciatic nerve blocks in an anticoagulated patient: relato de casos

    OpenAIRE

    Leonardo Henrique Cunha Ferraro; Maria Angela Tardelli; Américo Masafuni Yamashita; José Daniel Braz Cardone; Juliana Midori Kishi

    2010-01-01

    JUSTIFICATIVA E OBJETIVOS: O uso de ultrassom para guiar a punção em bloqueios de nervos periféricos tem-se tornado cada vez mais frequente. Com a menor probabilidade de promover lesões vasculares, o ultrassom torna-se uma ferramenta interessante na realização de bloqueios periféricos, especialmente nos pacientes em uso de anticoagulantes ou com distúrbios da coagulação. O objetivo foi relatar dois casos em que se realizaram os bloqueios isquiático e femoral guiados por ultrassom em pacientes...

  20. Lumbopelvic flexibility modulates neuromuscular responses during trunk flexion-extension.

    Science.gov (United States)

    Sánchez-Zuriaga, Daniel; Artacho-Pérez, Carla; Biviá-Roig, Gemma

    2016-06-01

    Various stimuli such as the flexibility of lumbopelvic structures influence the neuromuscular responses of the trunk musculature, leading to different load sharing strategies and reflex muscle responses from the afferents of lumbopelvic mechanoreceptors. This link between flexibility and neuromuscular response has been poorly studied. The aim of this study was to investigate the relationship between lumbopelvic flexibility and neuromuscular responses of the erector spinae, hamstring and abdominal muscles during trunk flexion-extension. Lumbopelvic movement patterns were measured in 29 healthy women, who were separated into two groups according to their flexibility during trunk flexion-extension. The electromyographic responses of erector spinae, rectus abdominis and biceps femoris were also recorded. Subjects with greater lumbar flexibility had significantly less pelvic flexibility and vice versa. Subjects with greater pelvic flexibility had a higher rate of relaxation and lower levels of hamstring activation during maximal trunk flexion. The neuromuscular response patterns of the hamstrings seem partially modulated by pelvic flexibility. Not so with the lumbar erector spinae and lumbar flexibility, despite the assertions of some previous studies. The results of this study improve our knowledge of the relationships between trunk joint flexibility and neuromuscular responses, a relationship which may play a role in low back pain. PMID:27155332

  1. Using mouse cranial muscles to investigate neuromuscular pathology in vivo.

    Science.gov (United States)

    Murray, L M; Gillingwater, T H; Parson, S H

    2010-11-01

    Neuromuscular pathology is a classic hallmark of many diseases such as muscular dystrophy, myasthenia gravis, amyotrophic lateral sclerosis and spinal muscular atrophy. It is also a feature of many congenital and acquired myopathies and neuropathies such as diabetic neuropathy and toxin-exposure. The availability of experimentally accessible nerve-muscle preparations from rodent models in which pathological events can be studied in nerve and muscle, as well as at the neuromuscular junction, is therefore of fundamental importance for investigating neuromuscular disease. The group of small cranial muscles, which move the ear in the mouse provide ideal experimental preparations for the study of neuromuscular disease in vivo, but information regarding their anatomical and functional characteristics is currently lacking. Here, we provide a detailed description of the levator auris longus, auricularis superior, abductor auris longus and interscutularis muscles. In addition, we briefly review their differential fibre type and developmental characteristics, which can be exploited to aid our understanding of neuromuscular vulnerability and to provide preferable alternatives to more traditional muscle preparations such as gastrocnemius, soleus and diaphragm. PMID:20637618

  2. Outcome measures in neuromuscular disease: is the world still flat?

    Science.gov (United States)

    Lunn, Michael P; Van den Bergh, Peter Y K

    2015-09-01

    Valid, responsive, and meaningful outcome measures for the measurement of the impairment, activity limitations, and quality of life in patients with neuromuscular disease are crucial to identify the natural history of disease and benefits of therapy in clinical practice and trials. Although understanding of many aspects of neuromuscular diseases has advanced dramatically, the development of outcome measures has received less attention. The scales developed from Rasch theory by the PeriNomS Group represent the biggest significant shift in thought in neuromuscular outcome measures for decades. There remain problems with many of them, and further developments are required. However, incorporating them into our outcome sets for daily use and in clinical trials will lead to the more efficient capture of meaningful change and will result in better assessment of individuals and groups of patients in both clinical trials and neurological practice. PMID:26114965

  3. Neuromuscular exercise as treatment of degenerative knee disease

    DEFF Research Database (Denmark)

    Ageberg, Eva; Roos, Ewa M.

    2015-01-01

    Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional instabil......Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional...... instability associated with the degenerative knee disease than traditionally used training methods.SUMMARY FOR TABLE OF CONTENTS PAGECurrent data suggests that the effect from neuromuscular exercise on pain and function is comparable to the effects seen from other forms of exercise....

  4. Train-of-four fade during onset of neuromuscular block with nondepolarising neuromuscular blocking agents.

    Science.gov (United States)

    Gibson, F M; Mirakhur, R K

    1989-04-01

    Fade in the train-of-four (TOF) responses during onset of neuromuscular block was studied following administration of atracurium (225 or 450 micrograms/kg), vecuronium (40 or 80 micrograms/kg), pancuronium (60 or 120 micrograms/kg) and tubocurarine (450 micrograms/kg). TOF ratios were measured at approximate heights of T1 (first response in the TOF) of 75, 50 and 25%. Fade in TOF increased as the height of T1 decreased, with maximum fade being observed at T1 of 25%. The greatest difference between relaxants was observed at T1 of 25%, vecuronium showing the least fade and pancuronium, atracurium and tubocurarine showing increasing fade, in that order. The difference between atracurium and tubocurarine or between vecuronium and pancuronium was not significant, but the degree of TOF fade was significantly greater with atracurium and tubocurarine in comparison to vecuronium or pancuronium.

  5. Anormalidades neuromuscular no desuso, senilidade e caquexia Neuromuscular abnormalities in disuse, cachexia and ageing

    OpenAIRE

    João Aris Kouyoumdjian

    1993-01-01

    É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso) deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural;...

  6. Urgencias en patología neuromuscular Emergencies in neuromuscular pathology

    Directory of Open Access Journals (Sweden)

    T. Ayuso

    2008-01-01

    Full Text Available La debilidad muscular aguda (DMA es el síntoma predominante de las urgencias neuromusculares, especialmente si afecta a la musculatura respiratoria u orofaríngea. La DMA es un síndrome plurietiológico y con distintos niveles lesionales en la unidad motora. Dentro del amplio grupo de enfermedades neuromusculares, las que con mayor frecuencia provocan DMA e insuficiencia respiratoria son el síndrome de Guillain-Barré (SGB y la miastenia gravis (MG. El SGB constituye la causa más frecuente de parálisis flácida aguda; puede ocasionar fallo respiratorio en un tercio de los casos precisando ventilación mecánica. El diagnóstico preciso de este síndrome permitirá iniciar tratamiento inmunomodulador, que ha demostrado que modifica el curso de la enfermedad. Además, la valoración clínica de los pacientes y el conocimiento de sencillos tests neurofisiológicos y de función respiratoria guiarán la decisión de ventilación mecánica evitando la intubación de urgencia. La urgencia más frecuente que ocasiona la MG es la crisis miasténica, definida por el deterioro en la función bulbar con insuficiencia respiratoria aguda y riesgo de parada respiratoria. Ocurre en un 15-20% de pacientes miasténicos y puede desencadenarse por múltiples factores. Además del diagnóstico preciso de la crisis es importante la supresión de los factores desencadenantes y medidas de soporte ventilatorio. Entre las medidas farmacológicas son la plasmaféresis y las inmunoglobulinas intravenosas los instrumentos más útiles en la actualidad; estos tratamientos no sustituyen la vigilancia intensiva y el reconocimiento de los signos inminentes de fallo respiratorio que implican soporte ventilatorio invasivo o no invasivo.Acute muscle weakness (AMW is the predominant symptom of neuromuscular emergencies, especially if it affects the respiratory or oropharyngeal musculature . AMW is a multi-etiological syndrome, with different lesion levels in the motor unit

  7. Neuromuscular activity and knee kinematics in adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin; Olesen, Jens L.;

    2013-01-01

    This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS).......This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS)....

  8. New techniques in the tissue diagnosis of gastrointestinal neuromuscular diseases

    Institute of Scientific and Technical Information of China (English)

    Charles H Knowles; Joanne E Martin

    2009-01-01

    Gastrointestinal neuromuscular diseases are a clinically heterogeneous group of disorders of children and adults in which symptoms are presumed or proven to arise as a result of neuromuscular (including interstitial cell of Cajal) dysfunction. Common to most of these diseases are symptoms of impaired motor activity which manifest as slowed or obstructed transit with or without evidence of transient or persistent radiological visceral dilatation. A variety of histopathological techniques and allied investigations are being increasingly applied to tissue biopsies from such patients. This review outlines some of the more recent advances in this field, particularly in the most contentious area of small bowel disease manifesting as intestinal pseudo-obstruction.

  9. Hematoma neuroaxial após bloqueio peridural. É possível prevenir ou detectar? Relato de dois casos

    Directory of Open Access Journals (Sweden)

    Rodrigo de Lima e Souza

    2011-04-01

    ós-operatória nos pacientes submetidos aos bloqueios de neuroeixo, podem contribuir para a prevenção de sequelas neurológicas graves.

  10. Anticoagulantes e bloqueios espinhais

    Directory of Open Access Journals (Sweden)

    Itagyba Martins Miranda Chaves

    2001-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Com o uso de anticoagulantes para tromboprofilaxia, a incidência de hematomas em anestesias espinhais aumentou. O objetivo desta revisão é verificar a ocorrência de casos de hematomas espinhais e sua correlação com o uso de drogas utilizadas na tromboprofilaxia. CONTEÚDO: São feitas algumas considerações clínicas e farmacológicas sobre as drogas utilizadas em tromboprofilaxia (cumarínicos, aspirina e heparina. São ressaltados os fatores de risco, particularmente aos relatos de casos de pacientes que desenvolveram hematoma peridural decorrente do uso simultâneo de heparina de baixo peso molecular e anestesia peridural. CONCLUSÕES: Existe importante associação entre hematoma peridural e distúrbios hemorrágicos, principalmente em pacientes em tratamento com anticoagulantes. O reconhecimento do aumento do risco da associação da anestesia peridural, da anestesia subaracnóidea, a continuada vigilância e a educação são fundamentais para evitar futuros casos.

  11. Anormalidades neuromuscular no desuso, senilidade e caquexia

    Directory of Open Access Journals (Sweden)

    João Aris Kouyoumdjian

    1993-09-01

    Full Text Available É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural; em geral são afetadas preferencialmente fibras II, que podem assumir forma angular. Existe um processo contínuo intrínseco de envelhecimento de nervos e músculos, com desnervação e reinervação lenta e progressiva; o número de unidades motoras se reduz após 60 anos, sem ocorrência de atividade elétrica desnervatória; a quantidade de acetilcolina liberada nos neurônios terminais e a capacidade máxima de utilização de oxigênio estão diminuídas; a redução da capacidade oxidativa mitocondrial pode explicar o aumento de fibras I, mantendo-se o equilíbrio energético. Após poucas semanas de caquexia as fibras musculares podem ter o diâmetro reduzido em 30%, essa redução ocorre em ordem decrescente nos músculos dos membros inferiores, superiores e tronco; existe atrofia II preferencial com fibras angulares ocasionais, redução de RNA/síntese proteica, mantendo-se DNA normal.

  12. Degeneration of Neuromuscular Junction in Age and Dystrophy

    Directory of Open Access Journals (Sweden)

    Rüdiger eRudolf

    2014-05-01

    Full Text Available Functional denervation is a hallmark of aging sarcopenia as well as of muscular dystrophy. It is thought to be a major factor reducing skeletal muscle mass, particularly in the case of sarcopenia. Neuromuscular junctions serve as the interface between the nervous and skeletal muscular systems, and thus they may receive pathophysiological input of both pre- and postsynaptic origin. Consequently, neuromuscular junctions are good indicators of motor health on a systemic level. Indeed, upon sarcopenia and dystrophy, neuromuscular junctions morphologically deteriorate and exhibit altered characteristics of primary signaling molecules, such as nicotinic acetylcholine receptor and agrin. Since a remarkable reversibility of these changes can be observed by exercise, there is significant interest in understanding the molecular mechanisms underlying synaptic deterioration upon aging and dystrophy and how synapses are reset by the aforementioned treatments. Here, we review the literature that describes the phenomena observed at the neuromuscular junction in sarcopenic and dystrophic muscle as well as to how these alterations can be reversed and to what extent. In a second part, the current information about molecular machineries underlying these processes is reported.

  13. Mainstreaming Children with a Neuromuscular Disease: A Map of Concerns.

    Science.gov (United States)

    Strong, Kristine; Sandoval, Jonathan

    1999-01-01

    Four focus groups (n=21) were conducted to gather information about coping issues and teacher attitudes related to the education of children with a neuromuscular disease. Results indicate a need for better home/school communication, a need to establish children's sense of competence, and a need for improved peer relationships. (Author/CR)

  14. Exercise Therapy in Spinobulbar Muscular Atrophy and Other Neuromuscular Disorders

    DEFF Research Database (Denmark)

    Dahlqvist, Julia Rebecka; Vissing, John

    2016-01-01

    with muscle wasting due to neuromuscular conditions, however, a common belief has been that physical activity could accelerate degeneration of the diseased muscle and a careful approach to training has therefore been suggested. In this review, we describe the current knowledge about physical training...

  15. Get Ready to Wnt: Prepatterning in Neuromuscular Junction Formation

    OpenAIRE

    Zhang, Bin; Xiong, Wen C.; Mei, Lin

    2009-01-01

    Clustering of acetylcholine receptors (AChR) in muscle fibers prior to innervation by motor neurons is thought to be involved in neuromuscular junction formation. Jing et al. now report in Neuron that this prepatterning of AChRs, via a novel MuSK-dependent Wnt pathway, may guide motor axons to the central region of muscle fibers for synapse formation in zebrafish.

  16. Volume of the effect compartment in simulations of neuromuscular block

    NARCIS (Netherlands)

    Nigrovic, Vladimir; Proost, Johannes H.; Amann, Anton; Bhatt, Shashi B.

    2005-01-01

    Background: The study examines the role of the volume of the effect compartment in simulations of neuromuscular block (NMB) produced by nondepolarizing muscle relaxants. Methods: The molar amount of the postsynaptic receptors at the motor end plates in muscle was assumed constant; the apparent recep

  17. Facial rehabilitation: a neuromuscular reeducation, patient-centered approach.

    Science.gov (United States)

    Vanswearingen, Jessie

    2008-05-01

    Individuals with facial paralysis and distorted facial expressions and movements secondary to a facial neuromotor disorder experience substantial physical, psychological, and social disability. Previously, facial rehabilitation has not been widely available or considered to be of much benefit. An emerging rehabilitation science of neuromuscular reeducation and evidence for the efficacy of facial neuromuscular reeducation, a process of facilitating the return of intended facial movement patterns and eliminating unwanted patterns of facial movement and expression, may provide patients with disorders of facial paralysis or facial movement control opportunity for the recovery of facial movement and function. We provide a brief overview of the scientific rationale for facial neuromuscular reeducation in the structure and function of the facial neuromotor system, the neuropsychology of facial expression, and relations among expressions, movement, and emotion. The primary purpose is to describe principles of neuromuscular reeducation, assessment and outcome measures, approach to treatment, the process, including surface-electromyographic biofeedback as an adjunct to reeducation, and the goal of enhancing the recovery of facial expression and function in a patient-centered approach to facial rehabilitation.

  18. Bloqueio do nervo isquiático por abordagem posterior simplificada no ponto médio do sulco glúteo-femoral: estudo com diferentes volumes de lidocaína a 1%

    OpenAIRE

    Neuber Martins Fonseca; Beatriz Lemos Mandim; Roberto Araújo Ruzi; Fabiana Rosa Tavares

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do nervo isquiático por via subglútea foi descrito com sucesso em estudo anterior, sendo mais uma opção entre as várias abordagens possíveis. O nervo isquiático torna-se superficial na borda inferior do músculo glúteo máximo, permitindo seu acesso com fácil localização, pouco desconforto e baixo risco de punção acidental de grandes vasos. O objetivo deste estudo foi avaliar o bloqueio do nervo isquiático por esta abordagem simplificada com diferentes volu...

  19. Estudo comparativo entre bupivacaína (S75-R25) e ropivacaína para avaliar a segurança cardiovascular em bloqueio do plexo braquial

    OpenAIRE

    Adilson Hamaji; Marcelo Rosa Rezende; Rames Mattar Jr; Joaquim Edson Vieira; José Otávio Costa Auler Jr

    2013-01-01

    JUSTIFICATIVA E OBJETIVOS: Bupivacaína é o fármaco de escolha para anestesia regional por causa da eficácia, longa duração e do bloqueio motor menos intenso. Bupivacaína (S75-R25) é uma mistura de isômeros ópticos que contém 75% de levobupivacaína (S-) e 25% de dextrobupivacaína (R+) e foi criada por uma companhia farmacêutica brasileira. Este estudo comparou a eficácia e segurança de bupivacaína S75-R25 com vasoconstritor e ropivacaína para o sistema cardiovascular em bloqueio do plexo braqu...

  20. PICU EXTUBATION FAILURE: THE ROLE OF NEUROMUSCULAR DISORDERS

    Directory of Open Access Journals (Sweden)

    N. Billan MD

    2009-01-01

    Full Text Available ObjectiveNeuromuscular disorders (diseases of the motor unit, can cause respiratory problems such as impaired cough reflex, chest deformity, recurrent pneumonia and acute respiratory failure; these are the worst most common complications of these diseases and the leading cause of death in such patients (1, 2. Their management hence, very often, entails admission to the Pediatric Intensive Care Unit (PICU (3,4 and during this phase, endotracheal intubation is almost always necessary, to maintain the patency of airways and to apply Positive Pressure Ventilation (PPV. However, endotracheal intubation is always temporary, and its success or failure depends on the timely decision of its termination to restore the normal respiration or to avoid the risk of recurring respiratory failure (5, 6. We designed this study to evaluate the role of neuromuscular disorders in causing extubation failure as compared to that of other risk factors.Materials & MethodsIn an analytical cross-sectional study, the risk factors of reintubation and duration of mechanical ventilation in two groups of 30 patients each, was compared, the first successful extubation and the second with extubation failure.ResultsNeuromuscular disorders (including Spinal Muscular Atrophy, Guillain- Barre' Syndrome, Congenital Myopathies and Muscular Dystrophies were the main underlying diseases in extubation-failure group (P= 0.0002. Hypercapnia (PaCO2>50mmHg was shown to be the most common cause of both the first intubation (P=0.001 and reintubation (P=0.004 in the group of patients who failed extubation. The mean duration of intubation and mechanical ventilation was longer in patients with neuromuscular disorders who had extubation failure (P= 0.01.ConclusionThis study showed that, as underlying problems, neuromuscular disorders are the most common causes of prolonged intubation which defeat weaning from the ventilator and result in reintubation by inducing hypercapnia. Therefore the weaning

  1. Histochemical and immunohistological approach to comparative neuromuscular diseases.

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    Serenella Papparella

    2009-12-01

    Full Text Available The broad category of neuromuscular diseases covers conditions that involve the weakness or wasting of the body muscles. These problems may occur in the spinal cord, the peripheral nerves or the muscle fibers. Some may be hereditary, while others are acquired. Commonly recognized conditions fall into the categories of myopathies, which are diseases of the muscle like muscular dystrophy, disorders of the junction where the nerve impulses are transmitted to the muscle like myasthenia gravis, and neuropathies, which are diseases of the peripheral nervous system. The diagnosis of most neuromuscular diseases rest on careful clinical evaluation of the patient, electromyography, the muscle biopsy, and in some instances, molecular genetic studies. Muscle biopsy, associated to histochemical and immunohistological techniques, plays a key role in diagnosis of many neuromuscular disorders. A number of morphological abnormalities of muscle can be recognized on histological stains such as haematoxylin and eosin and Engel trichrome. Histochemical techniques are essential for the study of muscle biopsies for four main reasons. First, they demonstrate the non-uniform nature of the muscle highlighting the different biochemical properties of specific fibre type and their selective involvement in certain disease processes. Second, they may show an absences of a particular enzyme. Third, an excess of a particular substrate can be demonstrated. Fourth, they may show structural changes in the muscle which would not be apparent with routine histological stains, such as the enzyme-deficient cores in central core disease "mouth-eaten" fibers, and abnormalities in the distribution of mitochondria. In some neuromuscular disorders there could be only non-specific myopathological features. However, a number of proteins, including sarcolemmal, sarcomeric, and nuclear proteins as well as enzymes with defects responsible for neuromuscular disorders, have been identified during

  2. Efectos del vendaje neuromuscular sobre la flexibilidad del raquis lumbar

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    A.M. Labrador-Cerrato

    2015-03-01

    Full Text Available Introducción: El vendaje neuromuscular es una técnica que produce una estimulación muy selectiva sobre la piel a través de la aplicación de unas vendas elásticas especiales con el fin de lograr cambios propioceptivos, aumento o inhibición del tono muscular y mitigación de algias, entre otros. Objetivos: Comprobar si la aplicación del vendaje neuromuscular permite aumentar la flexión del raquis lumbar comparándola con otras técnicas de vendaje placebo (esparadrapo rígido convencional; Omniplaste®-E; observar la concordancia entre la prueba sit-and-reach y el test de Schober en la valoración de la ganancia de flexión lumbar. Material y métodos: Estudio piloto experimental a triple ciego. Se distribuyeron aleatoriamente 45 sujetos sanos de 20-55 años en tres grupos: 1 esparadrapo convencional; 2 Omniplaste®-E; 3 vendaje neuromuscular. En todos los participantes se evaluó la flexión del raquis lumbar mediante la prueba sit-and-reach y el test de Schober antes y después de la intervención siguiendo el mismo protocolo. Resultados: Considerado un intervalo de confianza del 95% y grado de significación estadística p<0,05 en todos los casos, se obtuvo un incremento estadísticamente significativo de la flexión lumbar en todos los grupos según la prueba sit-and-reach, que fue mayor en el grupo del vendaje neuromuscular (1,5 cm de mediana; p=0,011. Según el test de Schober, solamente el vendaje neuromuscular se mostró eficiente (p<0,001, incrementándose el valor basal en un 6,25% (1 cm de mediana. Conclusiones: La aplicación del vendaje neuromuscular sobre la columna lumbar mejora la flexión lumbar respecto a técnicas placebo a partir de los resultados obtenidos mediante el test de Schober, así como una mayor flexión global del tronco que estas técnicas según la prueba sit-and-reach. El test de Schober parece ser más fiable y preciso que la prueba sit-and-reach para estudios de este tipo.

  3. Bloqueio do nervo supraescapular: procedimento importante na prática clínica. Parte II Suprascapular nerve block: important procedure in clinical practice. Part II

    Directory of Open Access Journals (Sweden)

    Marcos Rassi Fernandes

    2012-08-01

    Full Text Available O bloqueio do nervo supraescapular é um método de tratamento reprodutível, confiável e extremamente efetivo no controle da dor no ombro. Esse método tem sido amplamente utilizado por profissionais na prática clínica, como reumatologistas, ortopedistas, neurologistas e especialistas em dor, na terapêutica de enfermidades crônicas, como lesão irreparável do manguito rotador, artrite reumatoide, sequelas de AVC e capsulite adesiva, o que justifica a presente revisão (Parte II. O objetivo deste estudo foi descrever as técnicas do procedimento e suas complicações descritas na literatura, já que a primeira parte reportou as indicações clínicas, drogas e volumes utilizados em aplicação única ou múltipla. Apresentamse, detalhadamente, os acessos para a realização do procedimento tanto direto como indireto, anterior e posterior, lateral e medial, e superior e inferior. Diversas são as opções para se realizar o bloqueio do nervo supraescapular. Apesar de raras, as complicações podem ocorrer. Quando bem indicado, este método deve ser considerado.The suprascapular nerve block is a reproducible, reliable, and extremely effective treatment method in shoulder pain control. This method has been widely used by professionals in clinical practice such as rheumatologists, orthopedists, neurologists, and pain specialists in the treatment of chronic diseases such as irreparable rotator cuff injury, rheumatoid arthritis, stroke sequelae, and adhesive capsulitis, which justifies the present review (Part II. The objective of this study was to describe the techniques and complications of the procedure described in the literature, as the first part reported the clinical indications, drugs, and volumes used in single or multiple procedures. We present in details the accesses used in the procedure: direct and indirect, anterior and posterior, lateral and medial, upper and lower. There are several options to perform suprascapular nerve block

  4. Análise retrospectiva de fatores de risco e preditores de complicações intraoperatórias dos bloqueios do neuroeixo realizados na Faculdade de Medicina de Botucatu-UNESP

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    Ivan Dias Fernandes Pereira

    2011-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: As alterações cardiovasculares associadas aos bloqueios do neuroeixo apresentam interesse pela frequência com que ocorrem e porque algumas delas podem ser consideradas efeitos fisiológicos desencadeados pelo bloqueio do sistema nervoso simpático. O objetivo desta pesquisa foi avaliar as complicações cardiovasculares intraoperatórias e os fatores preditores associados aos bloqueios do neuroeixo em pacientes com idades > 18 anos submetidos a procedimentos não obstétricos, em um período de 18 anos, em hospital universitário de atendimento terciário-HCFMB-UNESP. MÉTODO: Foi realizada análise retrospectiva das seguintes complicações: hipertensão arterial, hipotensão arterial, bradicardia sinusal e taquicardia sinusal. Tais complicações foram correlacionadas com técnica anestésica, estado físico (ASA, idade, sexo e comorbidades pré-operatórias. Para a análise estatística, foram utilizadas o teste de Tukey para comparações entre proporções e regressão logística. RESULTADOS: Foram avaliados 32.554 pacientes submetidos a bloqueios do neuroeixo e houve 4.109 citações de hipotensão arterial, 1.107 de bradicardia sinusal, 601 de taquicardia sinusal e 466 de hipertensão arterial no período intraoperatório. Hipotensão foi mais frequente nos pacientes submetidos à anestesia subaracnoidea contínua (29,4%, OR = 2,39, com idades > 61 anos e do sexo feminino (OR = 1,27. CONCLUSÕES: Hipotensão e bradicardia intraoperatórias foram complicações mais frequentes, sendo que a hipotensão arterial esteve relacionada à técnica anestésica (ASC, faixa etária elevada e sexo feminino. Taquicardia e hipertensão arterial podem não ter sido diretamente relacionadas aos bloqueios do neuroeixo.

  5. Estudo comparativo entre bupivacaína (S75-R25 e ropivacaína para avaliar a segurança cardiovascular em bloqueio do plexo braquial

    Directory of Open Access Journals (Sweden)

    Adilson Hamaji

    2013-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Bupivacaína é o fármaco de escolha para anestesia regional por causa da eficácia, longa duração e do bloqueio motor menos intenso. Bupivacaína (S75-R25 é uma mistura de isômeros ópticos que contém 75% de levobupivacaína (S- e 25% de dextrobupivacaína (R+ e foi criada por uma companhia farmacêutica brasileira. Este estudo comparou a eficácia e segurança de bupivacaína S75-R25 com vasoconstritor e ropivacaína para o sistema cardiovascular em bloqueio do plexo braquial. MÉTODOS: Pacientes foram randomizados para receber bloqueio do plexo braquial com bupivacaína S75-R25 (Grupo B com epinefrina 1:200.000 ou ropivacaína (Grupo R, ambos os fármacos a 0,50%, em 30 mL ECG contínuo (Holter foi registrado durante todo o procedimento, bem como a escala de força de Lovett, além de monitoramento (frequência cardíaca, oximetria de pulso e pressão arterial não invasiva. A incidência de eventos adversos foi comparada com os testes do qui-quadrado ou exato de Fisher. RESULTADOS: Quarenta e quatro pacientes foram estudados. Não houve diferença significativa em relação à idade, peso, altura, gênero e tempo cirúrgico. Não houve diferença entre arritmias supraventriculares antes ou depois do bloqueio do plexo braquial, independentemente do anestésico local escolhido. A perda de sensibilidade foi mais rápida no Grupo B (23,1 ± 11,7 min em comparação com o Grupo R (26,8 ± 11,5 min, embora não significativa (p = 0,205, teste t de Student. Houve uma redução da frequência cardíaca, observada durante a monitoração contínua de 24 horas (Holter. CONCLUSÃO: Este estudo demonstrou eficácia semelhante entre bupivacaína S75-R25 e ropivacaína para bloqueio do plexo braquial, com incidências semelhantes de arritmias supraventriculares.

  6. Bloqueio do nervo isquiático por abordagem posterior simplificada no ponto médio do sulco glúteo-femoral: estudo com diferentes volumes de lidocaína a 1%

    Directory of Open Access Journals (Sweden)

    Fonseca Neuber Martins

    2006-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do nervo isquiático por via subglútea foi descrito com sucesso em estudo anterior, sendo mais uma opção entre as várias abordagens possíveis. O nervo isquiático torna-se superficial na borda inferior do músculo glúteo máximo, permitindo seu acesso com fácil localização, pouco desconforto e baixo risco de punção acidental de grandes vasos. O objetivo deste estudo foi avaliar o bloqueio do nervo isquiático por esta abordagem simplificada com diferentes volumes de lidocaína a 1%. MÉTODO: Foram estudados 40 pacientes com intervenções cirúrgicas na perna ou no pé distribuídos em dois grupos. Após monitorização, eles foram posicionados em decúbito ventral e realizado bloqueio no ponto médio do sulco glúteo-femoral, com auxílio de neuroestimulador e agulha de 5 cm eletricamente isolada, utilizando 300 mg (G1 ou 200 mg (G2 de lidocaína a 1% sem adrenalina. RESULTADOS: Obteve-se anestesia adequada em todos os casos com o volume e a concentração usados. O tempo de execução do bloqueio foi de 8,6 ? 5,7 min (G1 e 5,6 ? 5,7 min (G2. A latência foi de 5,98 ? 1,4 min (G1 e 6,7 ? 2,9 min (G2. A duração sensitiva e motora do bloqueio foi de 243 ? 37 min e 152 ? 30 min (G1 e 235 ? 39 min e 149 ? 59 min (G2, respectivamente. Não foram observadas diferenças estatísticas significativas entre os grupos estudados. CONCLUSÕES: Essa abordagem é eficaz e de fácil execução, podendo a dose total de anestésico ser reduzida sem comprometimento da qualidade.

  7. Theory of multichannel magnetic stimulation: toward functional neuromuscular rehabilitation.

    Science.gov (United States)

    Ruohonen, J; Ravazzani, P; Grandori, F; Ilmoniemi, R J

    1999-06-01

    Human excitable cells can be stimulated noninvasively with externally applied time-varying electromagnetic fields. The stimulation can be achieved either by directly driving current into the tissue (electrical stimulation) or by means of electro-magnetic induction (magnetic stimulation). While the electrical stimulation of the peripheral neuromuscular system has many beneficial applications, peripheral magnetic stimulation has so far only a few. This paper analyzes theoretically the use of multiple magnetic stimulation coils to better control the excitation and also to eventually mimic electrical stimulation. Multiple coils allow electronic spatial adjustment of the shape and location of the stimulus without moving the coils. The new properties may enable unforeseen uses for peripheral magnetic stimulation, e.g., in rehabilitation of patients with neuromuscular impairment. PMID:10356871

  8. Early appearance and possible roles of non-neuromuscular cholinesterases.

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    Carla eFalugi

    2012-04-01

    Full Text Available The biological function of the cholinesterase (ChE enzymes is well known and has been studied since the beginning of the XXth century; in particular, acetylcholinesterase (AChE, E.C. 3.1.1.7 is an enzyme playing a key role in the modulation of neuromuscular impulse transmission. However, in the past decades, there has been increasing interest concerning its role in regulating non-neuromuscular cell-to-cell interactions mediated by intracellular ion concentration changes, like the ones occurring during gamete interaction and embryonic development. An understanding of the mechanisms of the cholinergic regulation of these events can help us foresee the possible impact on environmental and human health, including gamete efficiency and possible teratogenic effects on different models, and help elucidate the extent to which exposure to ChE inhibitors may affect human health.

  9. Estudo comparativo entre clonidina associada à bupivacaína e bupivacaína isolada em bloqueio de plexo cervical para endarterectomia de carótida Estudio comparativo entre la clonidina asociada a la bupivacaína y la bupivacaína aislada en bloqueo de plexo cervical para endarterectomía de carótida A comparative study between bupivacaine and clonidine associated with bupivacaine in cervical plexus block for carotid endarterectomy

    OpenAIRE

    Walter Pinto Neto; Adriana Machado Issy; Rioko Kimiko Sakata

    2009-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio de plexo cervical permite avaliação neurológica durante a endarterctomia, além de manter analgesia pós-operatória. A clonidina é agonista alfa2 com efeito analgésico em diferentes bloqueios. O objetivo deste estudo foi comparar o efeito analgésico da clonidina com bupivacaína em relação à bupivacaína isolada em bloqueio de plexo cervical. MÉTODO: Foram avaliados 30 pacientes de forma aleatória e duplamente-encoberta divididos em dois grupos: G1 recebeu 1,...

  10. Estudo radiológico da dispersão de diferentes volumes de anestésico local no bloqueio de plexo braquial pela via posterior Estudio radiológico de la dispersión de diferentes volúmenes de anestésico local en el bloqueo de plexo braquial por vía posterior Radiological evaluation of the spread of different local anesthetic volumes during posterior brachial plexus block

    OpenAIRE

    Marcos Guilherme Cunha Cruvinel; Carlos Henrique Viana de Castro; Yerkes Pereira Silva; Flávio de Oliveira França; Flávio Lago

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A dispersão do anestésico local no bloqueio interescalênico foi bem estudada, porém no bloqueio pela via posterior são poucos os estudos. O objetivo deste estudo foi determinar a dispersão de diferentes volumes de anestésico local nesta técnica através de exame radiológico contrastado. MÉTODO: Dezesseis pacientes submetidos a bloqueio do plexo braquial pela via posterior, 15 foram divididos aleatoriamente em três grupos de cinco: Grupo 1: volume de 20 mL; Grupo 2: v...

  11. Anormalidades neuromuscular no desuso, senilidade e caquexia Neuromuscular abnormalities in disuse, cachexia and ageing

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    João Aris Kouyoumdjian

    1993-09-01

    Full Text Available É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural; em geral são afetadas preferencialmente fibras II, que podem assumir forma angular. Existe um processo contínuo intrínseco de envelhecimento de nervos e músculos, com desnervação e reinervação lenta e progressiva; o número de unidades motoras se reduz após 60 anos, sem ocorrência de atividade elétrica desnervatória; a quantidade de acetilcolina liberada nos neurônios terminais e a capacidade máxima de utilização de oxigênio estão diminuídas; a redução da capacidade oxidativa mitocondrial pode explicar o aumento de fibras I, mantendo-se o equilíbrio energético. Após poucas semanas de caquexia as fibras musculares podem ter o diâmetro reduzido em 30%, essa redução ocorre em ordem decrescente nos músculos dos membros inferiores, superiores e tronco; existe atrofia II preferencial com fibras angulares ocasionais, redução de RNA/síntese proteica, mantendo-se DNA normal.Cachexia, ageing and disuse and their effects on the human and animals neuromuscular system are reviewed. Disuse induces reduction of muscle fibers (mainly II diameter with peripheral myofibrils lost; there is no core-targetoid or even reduction on myophosphorilase activity, both typical of denervation; the acetylcholine spontaneous release and trophic factors on myoneural junction are maintained; muscle fibers could change to angular shape. Ageing affects nerve and muscle by a continuous and progressive process of denervation and reinner

  12. Degeneration of Neuromuscular Junction in Age and Dystrophy

    OpenAIRE

    Rudolf, Rüdiger; Khan, Muzamil Majid; Labeit, Siegfried; Deschenes, Michael R.

    2014-01-01

    Functional denervation is a hallmark of aging sarcopenia as well as of muscular dystrophy. It is thought to be a major factor reducing skeletal muscle mass, particularly in the case of sarcopenia. Neuromuscular junctions (NMJs) serve as the interface between the nervous and skeletal muscular systems, and thus they may receive pathophysiological input of both pre- and post-synaptic origin. Consequently, NMJs are good indicators of motor health on a systemic level. Indeed, upon sarcopenia and d...

  13. Neuromuscular control and rehabilitation of the unstable ankle

    OpenAIRE

    Hung, You-jou

    2015-01-01

    Lateral ankle sprain is a common orthopedic injury with a very high recurrence rate in athletes. After decades of research, it is still unclear what contributes to the high recurrence rate of ankle sprain, and what is the most effective intervention to reduce the incident of initial and recurrent injuries. In addition, clinicians often implement balance training as part of the rehabilitation protocol in hopes of enhancing the neuromuscular control and proprioception of the ankle joint. Howeve...

  14. Ultrastructural muscle and neuro-muscular junction alterations in polymyositis

    Directory of Open Access Journals (Sweden)

    L. L. Babakova

    2015-02-01

    Full Text Available Ultrastructural analysis of 7 biopsies from m.palmaris longus and m.deltoideus in patients with confirmed polymyositis revealed alterationand degeneration of muscle fibers and anomalies of neuro-muscular junction (NMJ. The NMJ abnormalities and following denervation ofmuscle fibers in polymyositis start with subsynaptic damages. The occurance of regeneration features in muscle fibers at any stage is characteristic for PM.

  15. Computed tomography of skeletal muscles in neuromuscular disease

    Energy Technology Data Exchange (ETDEWEB)

    Rodiek, S.O.; Kuether, G.

    1985-06-01

    CT-documentation of skeletal muscular lesions caused by neuromuscular diseases implies an essential contribution to conventional techniques in the macroscopic field. Size, distribution and degree of lesions as well as compensatory mechanisms are proved thereby. We report about the different effects on muscle appearance referring to 106 patients of our own experience in amyotrophic lateral sclerosis, spinal muscular atrophy, poliomyelitis, polyradiculitis, polyneuropathy as well as peripheral traumatic nerve lesions.

  16. Progress in therapeutic antisense applications for neuromuscular disorders

    OpenAIRE

    Aartsma-Rus, Annemieke; van Ommen, Gert-Jan B.

    2009-01-01

    Neuromuscular disorders are a frequent cause of chronic disability in man. They often result from mutations in single genes and are thus, in principle, well suited for gene therapy. However, the tissues involved (muscle and the central nervous system) are post-mitotic, which poses a challenge for most viral vectors. In some cases, alternative approaches may use small molecules, for example, antisense oligonucleotides (AONs). These do not deliver a new gene, but rather modulate existing gene p...

  17. LRP4 Is Critical for Neuromuscular Junction Maintenance

    OpenAIRE

    Barik, Arnab; Lu, Yisheng; Sathyamurthy, Anupama; Bowman, Andrew; Shen, Chengyong; Li, Lei(Beijing Institute of Petrochemical Technology, Beijing, 102617, People's Republic of China); Xiong, Wen-Cheng; Mei, Lin

    2014-01-01

    The neuromuscular junction (NMJ) is a synapse between motor neurons and skeletal muscle fibers, and is critical for control of muscle contraction. Its formation requires neuronal agrin that acts by binding to LRP4 to stimulate MuSK. Mutations have been identified in agrin, MuSK, and LRP4 in patients with congenital myasthenic syndrome, and patients with myasthenia gravis develop antibodies against agrin, LRP4, and MuSK. However, it remains unclear whether the agrin signaling pathway is critic...

  18. Myasthenia and related disorders of the neuromuscular junction

    OpenAIRE

    Spillane, Jennifer; Beeson, David J; Kullmann, Dimitri M.

    2010-01-01

    Abstract Our understanding of transmission at the neuromuscular junction has increased greatly in recent years. We now recognise a wide variety of autoimmune and genetic diseases that affect this specialised synapse, causing muscle weakness and fatigue. These disorders greatly affect quality of life and rarely can be fatal. Myasthenia Gravis is the most common disorder and is most commonly caused by auto-antibodies targeting postsynaptic acetylcholine receptors (AChRs). Antibodie...

  19. Report on Adaptive Force, a specific neuromuscular function

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    Marko Hoff

    2015-08-01

    Full Text Available In real life motions, as well as in sports, the adaptation of the neuromuscular systems to externally applied forces plays an important role. The term Adaptive Force (AF shall characterize the ability of the nerve-muscle-system to adapt to impacting external forces during isometric and eccentric muscle action. The focus in this paper is on the concept of this neuromuscular action, which is not yet described in this way. A measuring system was constructed and evaluated for this specific neuromuscular function, but only the main information of the evaluation of the measuring system and the preliminary reference values are mentioned here, while an article with detailed description will be published separately. This paper concentrates on the three following points: 1 What is the peculiarity of this neuromuscular function, introduced as AF? 2 Is the measuring system able to capture its specific characteristics and which phases of measurement occur? 3 It seems reasonable to discuss if AF can be distinguished and classified among the known force concepts. The article describes the measuring system and how it is able to capture special features of real life motions like submaximal intensities and the subjects’ option to react adequately on external varying forces. Furthermore, within one measurement the system records three different force qualities: the isometric submaximal Adaptive Force (AFiso, the maximal isometric Adaptive Force (AFisomax and the maximal eccentric Adaptive Force (AFeccmax. Each of these phases provide different and unique information on the nerve-muscle-system that are discussed in detail. Important, in terms of the Adaptive Force, seems to be the combination of conditional and coordinative abilities.

  20. Cardiac involvement in children with neuro-muscular disorders

    OpenAIRE

    E. N. Arkhipova

    2015-01-01

    Many inherited neuromuscular disorders include cardiac involvement as a typical clinical feature. Among the most common of them is the group of muscular dystrophies. Dilated cardiomyopathy, ventricular arrhythmias, atrial fibrillations, atrioventricular and intraventricular conduction abnormalities, and sudden cardiac death are well known pathological findings in Duchenne muscular dystrophies, myotonic dystrophy type I and 2, Emery-Dreifuss muscular dystrophies and different types of limb-gir...

  1. Aggravated neuromuscular symptoms of mercury exposure from dental amalgam fillings.

    Science.gov (United States)

    Akbal, Ayla; Yılmaz, Hınç; Tutkun, Engin; Köş, Durdu Mehmet

    2014-01-01

    Dental amalgam fillings are widely used all over the world. However, their mercury content can lead to various side effects and clinical problems. Acute or chronic mercury exposure can cause several side effects on the central nerve system, renal and hepatic functions, immune system, fetal development and it can play a role on exacerbation of neuromuscular diseases. In this case, we will present a patient with vacuolar myopathy whose symptoms were started and aggravated with her dental amalgam fillings.

  2. Altered neuromuscular control mechanisms of the trapezius muscle in fibromyalgia

    Directory of Open Access Journals (Sweden)

    Karlsson Stefan J

    2010-03-01

    Full Text Available Abstract Background fibromyalgia is a relatively common condition with widespread pain and pressure allodynia, but unknown aetiology. For decades, the association between motor control strategies and chronic pain has been a topic for debate. One long held functional neuromuscular control mechanism is differential activation between regions within a single muscle. The aim of this study was to investigate differences in neuromuscular control, i.e. differential activation, between myalgic trapezius in fibromyalgia patients and healthy controls. Methods 27 fibromyalgia patients and 30 healthy controls performed 3 minutes bilateral shoulder elevations with different loads (0-4 Kg with a high-density surface electromyographical (EMG grid placed above the upper trapezius. Differential activation was quantified by the power spectral median frequency of the difference in EMG amplitude between the cranial and caudal parts of the upper trapezius. The average duration of the differential activation was described by the inverse of the median frequency of the differential activations. Results the median frequency of the differential activations was significantly lower, and the average duration of the differential activations significantly longer in fibromyalgia compared with controls at the two lowest load levels (0-1 Kg (p Conclusion these findings illustrate a different neuromuscular control between fibromyalgia patients and healthy controls during a low load functional task, either sustaining or resulting from the chronic painful condition. The findings may have clinical relevance for rehabilitation strategies for fibromyalgia.

  3. Defective membrane remodeling in neuromuscular diseases: insights from animal models.

    Directory of Open Access Journals (Sweden)

    Belinda S Cowling

    Full Text Available Proteins involved in membrane remodeling play an essential role in a plethora of cell functions including endocytosis and intracellular transport. Defects in several of them lead to human diseases. Myotubularins, amphiphysins, and dynamins are all proteins implicated in membrane trafficking and/or remodeling. Mutations in myotubularin, amphiphysin 2 (BIN1, and dynamin 2 lead to different forms of centronuclear myopathy, while mutations in myotubularin-related proteins cause Charcot-Marie-Tooth neuropathies. In addition to centronuclear myopathy, dynamin 2 is also mutated in a dominant form of Charcot-Marie-Tooth neuropathy. While several proteins from these different families are implicated in similar diseases, mutations in close homologues or in the same protein in the case of dynamin 2 lead to diseases affecting different tissues. This suggests (1 a common molecular pathway underlying these different neuromuscular diseases, and (2 tissue-specific regulation of these proteins. This review discusses the pathophysiology of the related neuromuscular diseases on the basis of animal models developed for proteins of the myotubularin, amphiphysin, and dynamin families. A better understanding of the common mechanisms between these neuromuscular disorders will lead to more specific health care and therapeutic approaches.

  4. Neuromuscular responses to simulated brazilian jiu-jitsu fights.

    Science.gov (United States)

    da Silva, Bruno Victor Corrêa; Ide, Bernardo Neme; de Moura Simim, Mário Antônio; Marocolo, Moacir; da Mota, Gustavo Ribeiro

    2014-12-01

    The aim of this study was to investigate the neuromuscular performance responses following successive Brazilian Jiu-Jitsu (BJJ) fights. Twenty-three BJJ athletes (age: 26.3 ± 6.3 years; body mass: 79.4 ± 9.7 kg; body height: 1.80 ± 0.1 m) undertook 3 simulated BJJ fights (10 min duration each separated by 15 min of rest). Neuromuscular performance was measured by the bench press throw (BPT) and vertical counter movement jump (VCMJ) tests, assessed before the 1st fight (Pre) and after the last one (Post). Blood lactate (LA) was measured at Pre, 1 min Post, and 15 min Post fights. Paired t-tests were employed in order to compare the BPT and VCMJ results. One-way ANOVA with Bonferroni post hoc tests were utilized to compare LA responses. The results revealed a significant (p BJJ fights demanded considerable anaerobic contribution of ATP supply, reinforcing the high-intensity intermittent nature of the sport. Nevertheless, no negative impact on acute neuromuscular performance (power) was observed.

  5. Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hader, H.; Gadoth, N.; Heifetz, H.

    1983-11-01

    The physiologic replacement of the lower paraspinal muscles by fat was evaluated in 157 patients undergoing computed tomography for reasons unrelated to abnormalities of the locomotor system. Five patients with neuromuscular disorders were similarly evaluated. The changes were graded according to severity at three spinal levels: lower thoracic-upper lumbar, midlumbar, and lumbosacral. The results were analyzed in relation to age and gender. It was found that fatty replacement of paraspinal muscles is a normal age-progressive phenomenon most prominent in females. It progresses down the spine, being most advanced in the lumbosacral region. The severest changes in the five patients with neuromuscular disorders (three with poliomyelitis and two with progressive muscular dystrophy) consisted of complete muscle group replacement by fat. In postpoliomyelitis atrophy, the distribution was typically asymmetric and sometimes lacked clinical correlation. In muscular dystrophy, fatty replacement was symmetric, showing relative sparing of the psoas and multifidus muscles. In patients with neuromuscular diseases, computed tomography of muscles may be helpful in planning a better rehabilitation regimen.

  6. Neuromuscular conditions for physicians - what you need to know.

    Science.gov (United States)

    Edwards, Laura; Phillips, Margaret

    2016-06-01

    The Royal College of Physicians (RCP) and the British Society of Rehabilitation Medicine co-hosted a meeting entitled 'Neuromuscular conditions for physicians - what you need to know' at the RCP on 30 November 2015. There was a series of talks, ranging from in-depth genetic and molecular descriptions of pathology to multidisciplinary management of chronic neuromuscular conditions, which stimulated lively debate and discussion. Some overarching themes emerged from the day, most notably: i) the changing expectations and survival rates in Duchenne muscular dystrophy (DMD), which are transforming this disorder into an adult as much as a paediatric condition; ii) the need for integrated management and good communication -between services - whether primary, secondary and tertiary care, medical teams and intensivists, or the multiple teams involved in providing treatment to neuromuscular patients; and iii) in line with the above, the essential need for streamlining care such that patients can avoid spending most of their time attending outpatient appointments, and instead concentrate on living full lives and exploring educational, occupational, leisure and social opportunities. PMID:27251916

  7. [Molecular mechanisms underlying the formation of neuromuscular junction].

    Science.gov (United States)

    Higuchi, Osamu; Yamanashi, Yuji

    2011-07-01

    The neuromuscular junction (NMJ) is a synapse between a motor neuron and skeletal muscle. The contraction of skeletal muscle is controlled by the neurotransmitter acetylcholine (ACh), which is released from the motor nerve terminal. To achieve efficient neuromuscular transmission, acetylcholine receptors (AChRs) must be densely clustered on the muscle membrane of the NMJ. Failure of AChR clustering is associated with disorders of neuromuscular transmission such as congenital myasthenic syndromes (CMS) and myasthenia gravis (MG). Motoneuronal agrin and muscle-specific receptor tyrosine kinase (MuSK) are known to play essential roles in the formation and maintenance of NMJs in the central region of each muscle. However, it had been unclear how agrin activates MuSK. Recent studies have elucidated the roles of several key molecules, including the cytoplasmic adaptor protein Dok-7 and LDL receptor-related protein 4 (Lrp4), in agrin-induced MuSK activation. Moreover, new evidence indicates that cyclin-dependent kinase 5 (Cdk5) regulates postsynaptic differentiation. In this review, we summarize the latest developments in molecular mechanisms underlying NMJ formation in vertebrates. PMID:21747134

  8. Adiposity, physical activity and neuromuscular performance in children.

    Science.gov (United States)

    Haapala, Eero A; Väistö, Juuso; Lintu, Niina; Tompuri, Tuomo; Brage, Soren; Westgate, Kate; Ekelund, Ulf; Lampinen, Eeva-Kaarina; Sääkslahti, Arja; Lindi, Virpi; Lakka, Timo A

    2016-09-01

    We investigated the associations of body fat percentage (BF%), objectively assessed moderate-to-vigorous physical activity (MVPA) and different types of physical activity assessed by a questionnaire with neuromuscular performance. The participants were 404 children aged 6-8 years. BF% was assessed using dual-energy x-ray absorptiometry and physical activity by combined heart rate and movement sensing and a questionnaire. The results of 50-m shuttle run, 15-m sprint run, hand grip strength, standing long jump, sit-up, modified flamingo balance, box-and-block and sit-and-reach tests were used as measures of neuromuscular performance. Children who had a combination of higher BF% and lower levels of physical activity had the poorest performance in 50-m shuttle run, 15-m sprint run and standing long jump tests. Higher BF% was associated with slower 50-m shuttle run and 15-m sprint times, shorter distance jumped in standing long jump test, fewer sit-ups, more errors in balance test and less cubes moved in box-and-block test. Higher levels of physical activity and particularly MVPA assessed objectively by combined accelerometer and heart rate monitor were related to shorter 50-m shuttle run and 15-m sprint times. In conclusion, higher BF% and lower levels of physical activity and particularly the combination of these two factors were associated with worse neuromuscular performance. PMID:26734777

  9. The effect of cognitive fatigue on prefrontal cortex correlates of neuromuscular fatigue in older women

    OpenAIRE

    Shortz, Ashley E.; Pickens, Adam; Zheng, Qi; Mehta, Ranjana K.

    2015-01-01

    Background As the population of adults aged 65 and above is rapidly growing, it is crucial to identify physical and cognitive limitations pertaining to daily living. Cognitive fatigue has shown to adversely impact neuromuscular function in younger adults, however its impact on neuromuscular fatigue, and associated brain function changes, in older adults is not well understood. The aim of the study was to examine the impact of cognitive fatigue on neuromuscular fatigue and associated prefronta...

  10. PICU EXTUBATION FAILURE: THE ROLE OF NEUROMUSCULAR DISORDERS

    Directory of Open Access Journals (Sweden)

    N. Billan MD,

    2007-02-01

    Full Text Available ObjectiveNeuromuscular disorders (diseases of the motor unit, can cause respiratory problems such as impaired cough reflex, chest deformity, recurrent pneumonia and acute respiratory failure; these are the worst most common complications of these diseases and the leading cause of death in such patients (1, 2. Their management hence, very often, entails admission to the Pediatric Intensive Care Unit (PICU (3,4 and during this phase, endotracheal intubation is almost always necessary, to maintain the patency of airways and to apply Positive Pressure Ventilation (PPV. However, endotracheal intubation is always temporary, and its success or failure depends on the timely decision of its termination to restore the normal respiration or to avoid the risk of recurring respiratory failure (5, 6. We designed this study to evaluate the role of neuromuscular disorders in causing extubation failure as compared to that of other risk factors.Materials & MethodsIn an analytical cross-sectional study, the risk factors of reintubation and duration of mechanical ventilation in two groups of 30 patients each, was compared, the first successful extubation and the second with extubation failure.ResultsNeuromuscular disorders (including Spinal Muscular Atrophy, Guillain- Barre' Syndrome, Congenital Myopathies and Muscular Dystrophies were the main underlying diseases in extubation-failure group (P= 0.0002. Hypercapnia (PaCO2>50mmHg was shown to be the most common cause of both the first intubation (P=0.001 and reintubation (P=0.004 in the group of patients who failed extubation. The mean duration of intubation and mechanical ventilation was longer in patients with neuromuscular disorders who had extubation failure (P= 0.01.ConclusionThis study showed that, as underlying problems, neuromuscular disorders are the most common causes of prolonged intubation which defeat weaning from the ventilator and result in reintubation by inducing hypercapnia. Therefore the weaning

  11. Arraste via fecal de nutrientes da ingestão produzido por bagaço de mandioca hidrolisado

    Directory of Open Access Journals (Sweden)

    Raupp Dorivaldo da Silva

    2002-01-01

    Full Text Available A ingestão de fibras alimentares pode resultar em arraste de outros nutrientes para as fezes. Bagaço de mandioca produzido por polvilheira foi submetido à hidrólise enzimática para obtenção de um produto mais concentrado em fibra alimentar insolúvel denominado de bagaço de mandioca hidrolisado (BMH. O BMH foi avaliado em ensaios biológicos com ratos Wistar quanto a sua habilidade de arrastar os nutrientes da ingestão para as fezes, tendo como padrão de fibra o farelo de trigo (FT. Acréscimo à dieta base, substituindo igual quantidade de amido, de dose de 5%, 15% ou 25% de BMH promoveu arraste significativo de minerais (globalidade ou proteína; dose de 15% ou 25% promoveu arraste significativo de lipídeo; e, dose de 25% promoveu arraste significativo de carboidrato digestível. Dose de 25% de FT produziu arraste significativo de minerais (globalidade, proteína ou carboidrato digestível, mas, o lipídeo não foi arrastado. BMH produziu efeito mais pronunciado que FT em arrastar minerais (globalidade ou proteína para a dose de 5% ou 15%; no entanto, para a dose alta, de 25%, as fontes produziram efeitos semelhantes em arrastar a proteína, mas o FT promoveu maior arraste de minerais (globalidade. Não houve diferença entre fontes, BMH e FT, em arrastar lipídeo ou carboidrato digestível para as fezes. Na dose alta (25% o BMH promoveu efeitos, no máximo, semelhantes ao FT, em arrastar para as fezes os nutrientes da ingestão; assim, é recomendado como fonte alternativa de fibra alimentar insolúvel para a formulação de alimentos funcionais-digestivos.

  12. Bloqueio do plexo braquial por via interescalênica: efeitos sobre a função pulmonar Bloqueo del plexo braquial por vía interescalénica: efectos sobre la función pulmonar Interscalene brachial plexus block: effects on pulmonary function

    OpenAIRE

    Alexandre Hortense; Marcelo Vaz Perez; Jose Luis Gomes do Amaral; Ana Cristina Martins de Vasconcelos Oshiro; Heloisa Baccaro Rossetti

    2010-01-01

    JUSTIFICATIVA E OBJETIVOS: A via interescalênica é um dos acessos mais comumente utilizados no bloqueio do plexo braquial. Todavia, tem-se demonstrado associação dessa técnica com o bloqueio do nervo frênico ipsilateral. A disfunção diafragmática daí resultante provoca alterações na mecânica pulmonar, potencialmente deletérias em pacientes com limitação da reserva ventilatória. O objetivo do estudo foi avaliar a repercussão do bloqueio interescalênico sobre a função pulmonar por meio da medid...

  13. Clinical use of creatine in neuromuscular and neurometabolic disorders.

    Science.gov (United States)

    Tarnopolsky, Mark A

    2007-01-01

    Many of the neuromuscular (e.g., muscular dystrophy) and neurometabolic (e.g., mitochondrial cytopathies) disorders share similar final common pathways of cellular dysfunction that may be favorably influenced by creatine monohydrate (CrM) supplementation. Studies using the mdx model of Duchenne muscular dystrophy have found evidence of enhanced mitochondrial function, reduced intra-cellular calcium and improved performance with CrM supplementation. Clinical trials in patients with Duchenne and Becker's muscular dystrophy have shown improved function, fat-free mass, and some evidence of improved bone health with CrM supplementation. In contrast, the improvements in function in myotonic dystrophy and inherited neuropathies (e.g., Charcot-Marie-Tooth) have not been significant. Some studies in patients with mitochondrial cytopathies have shown improved muscle endurance and body composition, yet other studies did not find significant improvements in patients with mitochondrial cytopathy. Lower-dose CrM supplementation in patients with McArdle's disease (myophosphorylase deficiency) improved exercise capacity, yet higher doses actually showed some indication of worsened function. Based upon known cellular pathologies, there are potential benefits from CrM supplementation in patients with steroid myopathy, inflammatory myopathy, myoadenylate deaminase deficiency, and fatty acid oxidation defects. Larger randomized control trials (RCT) using homogeneous patient groups and objective and clinically relevant outcome variables are needed to determine whether creatine supplementation will be of therapeutic benefit to patients with neuromuscular or neurometabolic disorders. Given the relatively low prevalence of some of the neuromuscular and neurometabolic disorders, it will be necessary to use surrogate markers of potential clinical efficacy including markers of oxidative stress, cellular energy charge, and gene expression patterns. PMID:18652078

  14. Neuromuscular Responses to Simulated Brazilian Jiu-Jitsu Fights

    Directory of Open Access Journals (Sweden)

    Corrêa da Silva Bruno Victor

    2014-12-01

    Full Text Available The aim of this study was to investigate the neuromuscular performance responses following successive Brazilian Jiu-Jitsu (BJJ fights. Twenty-three BJJ athletes (age: 26.3 ± 6.3 years; body mass: 79.4 ± 9.7 kg; body height: 1.80 ± 0.1 m undertook 3 simulated BJJ fights (10 min duration each separated by 15 min of rest. Neuromuscular performance was measured by the bench press throw (BPT and vertical counter movement jump (VCMJ tests, assessed before the 1st fight (Pre and after the last one (Post. Blood lactate (LA was measured at Pre, 1 min Post, and 15 min Post fights. Paired t-tests were employed in order to compare the BPT and VCMJ results. One-way ANOVA with Bonferroni post hoc tests were utilized to compare LA responses. The results revealed a significant (p < 0.05 increase in VCMJ performance (40.8 ± 5.5 cm Pre vs. 42.0 ± 5.8 cm Post, but no significant changes in the BPT (814 ± 167 W Pre vs. 835 ± 213 W Post were observed. LA concentration increased significantly (p < 0.05 at Post, both in the 1st min and the 15th min of recovery. We concluded that successive simulated BJJ fights demanded considerable anaerobic contribution of ATP supply, reinforcing the high-intensity intermittent nature of the sport. Nevertheless, no negative impact on acute neuromuscular performance (power was observed.

  15. Quality of life after surgery for neuromuscular scoliosis

    Directory of Open Access Journals (Sweden)

    Peter Obid

    2013-02-01

    Full Text Available Surgery in patients with neuromuscular scoliosis is associated with a higher rate of complications. It is still controversially discussed whether the patients truly benefit from deformity correction. The purpose of this study is to investigate if the quality of life has been improved and if the patients and their caregivers are satisfied with the results of surgery. This is a retrospective clinical outcome study of 46 patients with neuromuscular scoliosis which were treated with primary stable posterior pedicle screw instrumentation and correction. To achieve fusion only autologous bone was used. Follow up was minimum 2 years and maximum 5 years with an average of 36 months. The patients and/or their caregivers received a questionnaire based on the PEDI (pediatric disability inventory and the GMFS (gross motor function score. The patients (and their caregivers were also asked if the quality of life has improved after surgery. Only 32 of 46 patients answered the questionnaire. The answers showed a high approval-rate regarding the patients satisfaction with the surgery and the improvement of quality of life. The questionnaire could be answered from 1 (I do not agree to 4 (I completely agree. The average agreement to the following statements was: i the quality of life has improved: 3.35; ii I am satisfied with surgery: 3.95; iii the operation has fulfilled my expectations: 3.76. The average age at surgery was 12.7 years. The mean pre-operative cobb-angle of the main curve was 83.1° with a correction post-operatively to a mean of 36.9° and 42.6° at final follow-up. That is an average correction of 56.9%. Although spinal fusion in neuromuscular scoliosis is associated with a higher rate of complications our results show that the patients and their caregivers are satisfied with the operation and the quality of life has improved after surgery.

  16. Selective activation of neuromuscular compartments within the human trapezius muscle

    DEFF Research Database (Denmark)

    Holtermann, A; Roeleveld, K; Mork, P J;

    2009-01-01

    Task-dependent differences in relative activity between "functional" subdivisions within human muscles are well documented. Contrary, independent voluntary control of anatomical subdivisions, termed neuromuscular compartments is not observed in human muscles. Therefore, the main aim of this study...... was to investigate whether subdivisions within the human trapezius can be independently activated by voluntary command using biofeedback guidance. Bipolar electromyographical electrodes were situated on four subdivisions of the trapezius muscle. The threshold for "active" and "rest" for each subdivision was set...... to >12% and subdivisions, 11 of 15 subjects learned selective activation of at least one of the four anatomical subdivisions of the trapezius...

  17. MRI in neuromuscular disorders; MRT bei neuromuskulaeren Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Fischmann, Arne [Klinik St. Anna, Luzern (Switzerland). Inst. fuer Radiologie und Nuklearmedizin; Fischer, Dirk [Kantonsspital Bruderholz (Switzerland)

    2014-03-15

    Neuromuscular disorders are caused by damage of the skeletal muscles or supplying nerves, in many cases due to a genetic defect, resulting in progressive disability, loss of ambulation and often a reduced life expectancy. Previously only supportive care and steroids were available as treatments, but several novel therapies are under development or in clinical trial phase. Muscle imaging can detect specific patterns of involvement and facilitate diagnosis and guide genetic testing. Quantitative MRT can be used to monitor disease progression either to monitor treatment or as a surrogate parameter for clinical trails. Novel imaging sequences can provide insights into disease pathology and muscle metabolism. (orig.)

  18. Cardiac involvement in children with neuro-muscular disorders

    Directory of Open Access Journals (Sweden)

    E. N. Arkhipova

    2015-01-01

    Full Text Available Many inherited neuromuscular disorders include cardiac involvement as a typical clinical feature. Among the most common of them is the group of muscular dystrophies. Dilated cardiomyopathy, ventricular arrhythmias, atrial fibrillations, atrioventricular and intraventricular conduction abnormalities, and sudden cardiac death are well known pathological findings in Duchenne muscular dystrophies, myotonic dystrophy type I and 2, Emery-Dreifuss muscular dystrophies and different types of limb-girdle muscular dystrophies and other disorders. Detection of cardiac pathology in patients with different muscular dystrophies is possible with ECG, echocardiography and cardiovascular magnetic resonance imaging, which are recommended for screening and early cardioprotective treatment.

  19. Tissue engineering for neuromuscular disorders of the gastrointestinal tract

    Institute of Scientific and Technical Information of China (English)

    Kenneth L Koch; Khalil N Bitar; John E Fortunato

    2012-01-01

    The digestive tract is designed for the optimal processing of food that nourishes all organ systems.The esophagus,stomach,small bowel,and colon are sophisticated neuromuscular tubes with specialized sphincters that transport ingested food-stuffs from one region to another.Peristaltic contractions move ingested solids and liquids from the esophagus into the stomach; the stomach mixes the ingested nutrients into chyme and empties chyme from the stomach into the duodenum.The to-and-fro movement of the small bowel maximizes absorption of fat,protein,and carbohydrates.Peristaltic contractions are necessary for colon function and defecation.

  20. The prejunctional inhibitory effect of suramin on neuromuscular transmission in vitro

    NARCIS (Netherlands)

    Henning, RH; Rowan, EG; Braga, MFM; Nelemans, A; Harvey, AL

    1996-01-01

    The P-2 purinoceptor antagonist suramin reverses skeletal muscle paralysis evoked by non-depolarizing neuromuscular blocking agents in vitro and in vivo. To further study the action of suramin on neuromuscular transmission, (miniature) endplate potentials ((m.)e.p.ps), motor nerve terminal currents

  1. Identification of the Feedback Component of the Neuromuscular System in a Pitch Control Task

    NARCIS (Netherlands)

    Damveld, H.J.; Abbink, D.A.; Mulder, M.; Mulder, Mark; Van Paassen, M.M.; Van der Helm, F.C.T.; Hosman, R.J.A.W.

    2010-01-01

    This goal of this study is to understand which parts of the the neuromuscular system contribute during a pitch control task. A novel method developed at the Delft University of Technology allows us to determine the contribution of the neuromuscular feedback system by identifying the admittance, whic

  2. Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes

    NARCIS (Netherlands)

    Zech, Astrid; Klahn, Philipp; Hoeft, Jon; Eulenburg, Christine Zu; Steib, Simon

    2014-01-01

    Purpose Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular traini

  3. Pharmacokinetic studies of neuromuscular blocking agents : Good Clinical Research Practice (GCRP)

    NARCIS (Netherlands)

    Viby-Mogensen, J; Ostergaard, D; Donati, F; Fisher, D; Hunter, J; Kampmann, JP; Kopman, A; Proost, JH; Rasmussen, SN; Skovgaard, LT; Varin, F; Wright, PMC

    2000-01-01

    In September 1997, an international consensus conference on standardization of studies of neuromuscular blocking agents was held in Copenhagen, Denmark. Based on the conference, a set of guidelines fur good clinical research practice (GCRT) in pharmacokinetic studies of neuromuscular blocking agents

  4. Sugammadex, a new reversal agent for neuromuscular block induced by rocuronium in the anaesthetized Rhesus monkey.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Pol, F. van de; Bom, A.; Booij, L.H.D.J.

    2006-01-01

    BACKGROUND: Binding of the steroidal molecule of rocuronium by a cyclodextrin is a new concept for reversal of neuromuscular block. The present study evaluated the ability of Sugammadex Org 25969, a synthetic gamma-cyclodextrin derivative, to reverse constant neuromuscular block of about 90% induced

  5. Plantar flexor neuromuscular adjustments following match-play football in hot and cool conditions

    DEFF Research Database (Denmark)

    Girard, O; Nybo, Lars; Mohr, Magni;

    2015-01-01

    We assessed neuromuscular fatigue and recovery of the plantar flexors after playing football with or without severe heat stress. Neuromuscular characteristics of the plantar flexors were assessed in 17 male players at baseline and ∼30 min, 24, and 48 h after two 90-min football matches in tempera...

  6. Bloqueio do plexo braquial por via supraclavicular: estudo clínico comparativo entre bupivacaína e levobupivacaína Bloqueo del plexo braquial por vía supraclavicular: estudio clínico comparativo entre bupivacaína y levobupivacaína Supraclavicular brachial plexus block: a comparative clinical study between bupivacaine and levobupivacaine

    OpenAIRE

    José Ricardo Pinotti Pedro; Lígia Andrade Silva Telles Mathias; Judymara Lauzi Gozzani; Flavia Salles de Souza Pinotti Pedro; José Carlos Rittes

    2009-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio de plexo braquial é técnica anestésica utilizada para procedimentos em membros superiores. O plexo braquial é território potencial para absorção de anestésicos locais. Estudos dos estereoisômeros da bupivacaína vêm demonstrando menor potencial de toxicidade da fração levógira (levobupivacaína) sobre o sistema cardiovascular. Porém, é discutida a eficácia anestésica (bloqueio sensitivo e motor) da levobupivacaína em anestesia do neuroeixo. Este estudo visa...

  7. Bloqueio do plexo braquial, por via infraclavicular vertical, em paciente com doença pulmonar obstrutiva crônica: relato de caso Bloqueo del plexo braquial, por vía infraclavicular vertical, en paciente con enfermedad pulmonar obstructiva crónica: relato de caso Infraclavicular vertical brachial plexus blockade in patients with chronic obstructive pulmonary disease: case report

    OpenAIRE

    Diogo Brüggemann da Conceição; Pablo Escovedo Helayel; Fernanda Cecato

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: Os pacientes com doença pulmonar obstrutiva crônica (DPOC) têm risco aumentado de complicações pós-operatórias, sobretudo quando submetidos à anestesia geral. O bloqueio do plexo braquial representa uma alternativa para estes pacientes em intervenções cirúrgicas de membros superiores. O objetivo deste relato foi apresentar um caso de bloqueio do plexo braquial, por via infraclavicular vertical em paciente com DPOC com fratura de cotovelo. RELATO DO CASO: Paciente do...

  8. Bloqueio do plexo braquial pela via posterior com uso de neuroestimulador e ropivacaína a 0,5% Bloqueo del plexo braquial por la vía posterior con el uso de neuroestimulador y ropivacaína a 0,5% Posterior brachial plexus block with nerve stimulator and 0.5% ropivacaine

    OpenAIRE

    Lúcia Beato; Gustavo Camocardi; Luiz Eduardo Imbelloni

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: Existem várias maneiras de abordar o plexo braquial dependendo da experiência do anestesiologista e da região a ser operada. O bloqueio do plexo braquial pela via posterior pode representar uma alternativa para cirurgias de ombro, clavícula e úmero proximal. O objetivo deste estudo foi mostrar os resultados observados em pacientes submetidos a bloqueio do plexo braquial pela via posterior com uso de neuroestimulador e ropivacaína a 0,5%. MÉTODO: Vinte e dois pacient...

  9. Prevalência de paralisia diafragmática após bloqueio de plexo braquial pela via posterior com ropivacaína a 0,2%

    OpenAIRE

    Cruvinel Marcos Guilherme Cunha; Castro Carlos Henrique Viana de; Silva Yerkes Pereira; Bessa Júnior Roberto Cardoso; França Flávio de Oliveira; Lago Flávio

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio de plexo braquial pela via interescalênica descrita por Winnie é uma das técnicas mais eficazes para promover analgesia pós-operatória de intervenções cirúrgicas no ombro. Uma de suas conseqüências é a paralisia diafragmática. Esta paralisia pode levar, em pacientes com algum grau de disfunção pulmonar prévia, à insuficiência respiratória. A abordagem do plexo braquial por via posterior tem conquistado espaço. O objetivo deste estudo foi determinar a prev...

  10. Eficácia analgésica pós-operatória de diferentes volumes e massas de ropivacaína no bloqueio de plexo braquial pela via posterior

    Directory of Open Access Journals (Sweden)

    Bruno Salome de Morais

    2012-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial pela via posterior tem sua eficácia para cirurgias de ombro demonstrada por diferentes autores. Entretanto, não há um consenso sobre a massa e o volume ideal de anestésico local a ser empregado. O objetivo deste estudo é com parar diferentes volumes e massas de ropivacaína no bloqueio do plexo braquial pela via posterior em cirurgias artroscópicas de ombro. MÉTODO: Sessenta pacientes com idade > 18 anos, estado físico ASA I e II, escalados para cirurgias artroscópicas de ombro unilateral foram alocados aleatoriamente em três grupos: A (10 mL a 0,5%, B (20 mL a 0,5%, C (5 mL a 1%. O bloqueio foi realizado com agulha 22G de 100 mm conectada ao neuroestimulador, em um ponto 3 cm lateral ao ponto médio do interespaço de C6 e C7, sendo injetada a solução correspondente a cada grupo. A dor pós-operatória foi avaliada na SRPA e nas primeiras 24 horas do pós-operatório. Os grupos foram comparados quanto ao tempo para primeira queixa de dor, à pontuação na ENV e ao consumo de morfina nas primeiras 24 horas. RESULTADOS: Não houve diferença estatisticamente significativa entre os três grupos em relação a idade, peso e altura. Não houve diferença no tempo até a primeira queixa de dor, ENV superior a três e consumo de morfina no pós-operatório entre os grupos. CONCLUSÕES: O presente estudo concluiu que 5 mL de ropivacaína 1% promoveu eficácia analgésica similar a 10 mL ou 20 mL de ropivacaína 0,5% no bloqueio do plexo braquial pela via posterior com o uso do neuroestimulador

  11. The Wnt and BMP Families of Signaling Morphogens at the Vertebrate Neuromuscular Junction

    Directory of Open Access Journals (Sweden)

    Juan P. Henríquez

    2011-12-01

    Full Text Available The neuromuscular junction has been extensively employed in order to identify crucial determinants of synaptogenesis. At the vertebrate neuromuscular synapse, extracellular matrix and signaling proteins play stimulatory and inhibitory roles on the assembly of functional synapses. Studies in invertebrate species have revealed crucial functions of early morphogens during the assembly and maturation of the neuromuscular junction. Here, we discuss growing evidence addressing the function of Wnt and Bone morphogenetic protein (BMP signaling pathways at the vertebrate neuromuscular synapse. We focus on the emerging role of Wnt proteins as positive and negative regulators of postsynaptic differentiation. We also address the possible involvement of BMP pathways on motor neuron behavior for the assembly and/or regeneration of the neuromuscular junction.

  12. Riscos cardiovasculares do bloqueio androgênico Riesgos cardiovasculares del bloqueo androgénico Cardiovascular risks of androgen deprivation therapy

    Directory of Open Access Journals (Sweden)

    Adriano Freitas Ribeiro

    2010-09-01

    Full Text Available O adenocarcinoma de próstata é o câncer mais comum no sexo masculino após o câncer de pele. Entre as várias formas de tratamento do câncer de próstata, a terapia de bloqueio androgênico é uma modalidade consagrada nos pacientes com doença metastática ou localmente avançada, que provavelmente resulta em aumento de sobrevida. No entanto, o bloqueio androgênico é causador de uma série de consequências adversas. Complicações como osteoporose, disfunção sexual, ginecomastia, anemia e alterações na composição corporal são bem conhecidas. Recentemente, uma série de complicações metabólicas foi descrita como aumento da circunferência abdominal, resistência à insulina, hiperglicemia, diabete, dislipidemia e síndrome metabólica com consequente aumento do risco de eventos coronarianos e mortalidade cardiovascular nessa população específica. Este artigo de atualização apresenta uma revisão bibliográfica realizada no MEDLINE de toda literatura publicada em inglês no período de 1966 até junho de 2009, com as seguintes palavras-chave: androgen deprivation therapy, androgen supression therapy, hormone treatment, prostate cancer, metabolic syndrome e cardiovascular disease, no intuito de analisar quais seriam os reais riscos cardiovasculares da terapia de deprivação androgênica, também chamada bloqueio androgênico, nos pacientes com câncer de próstata.El adenocarcinoma de próstata es el cáncer más común en el sexo masculino después del cáncer de piel. Entre las varias formas de tratamiento del cáncer de próstata, la terapia de bloqueo androgénico es una modalidad consagrada en los pacientes con enfermedad metastásica o localmente avanzada, que probablemente resulta en aumento de sobrevida. Mientras tanto, el bloqueo androgénico es causante de una serie de consecuencias adversas. Complicaciones como osteoporosis, disfunción sexual, ginecomastia, anemia y alteraciones en la composición corporal son

  13. Caracterização físico-química e perfil lipídico de queijos produzidos com leite ovino

    OpenAIRE

    Luiz Gustavo de Pellegrini; Ana Paula Gusso; Daniela Buzatti Cassanego; Paula Mattanna; Neila Silvia Pereira dos Santos Richards

    2013-01-01

    Este trabalho teve por objetivo caracterizar os queijos Pecorino Toscano, Feta e Labneh produzidos com leite ovino quanto aos aspectos físico-químicos e perfil lipídico. Foram adquiridos e analisados queijos tipo Pecorino Toscano Fresco, com 90, 180 e 270 dias de maturação, Feta e Labneh elaborados com leite de ovelha, comercializados no estado do Rio Grande do Sul, Brasil. As análises realizadas foram: pH, acidez titulável, proteína, gordura, umidade, cinzas e perfil de ácidos graxos. O maio...

  14. Nitrato e nitrito em leite produzido em sistemas convencional e orgânico Nitrate and nitrite in milk produced by conventional and organic systems

    OpenAIRE

    Joice S. dos Santos; Lígia Beck; Melissa Walter; Marines Sobczak; Clair J. Olivo; Ijoni Costabeber; Tatiana Emanuelli

    2005-01-01

    Nitratos e nitritos podem estar presentes naturalmente em diversos alimentos, entre eles o leite. Devido a sua toxicidade, são estabelecidos limites para a presença destes compostos nos alimentos. Assim, investigou-se os níveis de nitratos e nitritos em amostras de leite in natura, produzido por vacas submetidas aos sistemas de manejo convencional e orgânico. As amostras foram coletadas em propriedades da Região da Depressão Central do Rio Grande do Sul, Brasil. Os teores médios de nitrato e ...

  15. A neuromuscular monitoring system based on a personal computer.

    Science.gov (United States)

    White, D A; Hull, M

    1992-07-01

    We have developed a computerized neuromuscular monitoring system (NMMS) using commercially available subsystems, i.e., computer equipment, clinical nerve stimulator, force transducer, and strip-chart recorder. This NMMS was developed for acquisition and analysis of data for research and teaching purposes. Computer analysis of the muscle response to stimulation allows graphic and numeric presentation of the twitch response and calculated ratios. Since the system can store and recall data, research data can be accessed for analysis and graphic presentation. An IBM PC/AT computer is used as the central controller and data processor. The computer controls timing of the nerve stimulator output, initiates data acquisition, and adjusts the paper speed of the strip chart recorder. The data processing functions include establishing control response values (when no neuromuscular blockade is present), displaying force versus time and calculated data graphically and numerically, and storing these data for further analysis. The general purpose nature of the computer and strip chart recording equipment allow modification of the system primarily by changes in software. For example, new patterns of nerve stimulation, such as the posttetanic count, can be programmed into the computer system along with appropriate data display and analysis routines. The NMMS has functioned well in the operating room environment. We have had no episodes of electrocautery interference with the computer functions. The automated features have enhanced the utility of the NMMS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1322977

  16. Myasthenia and related disorders of the neuromuscular junction.

    Science.gov (United States)

    Spillane, Jennifer; Beeson, David J; Kullmann, Dimitri M

    2010-08-01

    Our understanding of transmission at the neuromuscular junction has increased greatly in recent years. We now recognise a wide variety of autoimmune and genetic diseases that affect this specialised synapse, causing muscle weakness and fatigue. These disorders greatly affect quality of life and rarely can be fatal. Myasthenia gravis is the most common disorder and is most commonly caused by autoantibodies targeting postsynaptic acetylcholine receptors. Antibodies to muscle-specific kinase (MuSK) are detected in a variable proportion of the remainder. Treatment is symptomatic and immunomodulatory. Lambert-Eaton myasthenic syndrome is caused by antibodies to presynaptic calcium channels, and approximately 50% of cases are paraneoplastic, most often related to small cell carcinoma of the lung. Botulism is an acquired disorder caused by neurotoxins produced by Clostridium botulinum, impairing acetylcholine release into the synaptic cleft. In addition, several rare congenital myasthenic syndromes have been identified, caused by inherited defects in presynaptic, synaptic basal lamina and postsynaptic proteins necessary for neuromuscular transmission. This review focuses on recent advances in the diagnosis and treatment of these disorders. PMID:20547629

  17. Efeito do estradiol e da progesterona no desenvolvimento e na qualidade de embriões bovinos produzidos in vitro

    Directory of Open Access Journals (Sweden)

    A.N Reis

    2010-12-01

    Full Text Available Avaliaram-se o desenvolvimento e a qualidade de embriões bovinos, cocultivados com células epiteliais do oviduto bovino (CEOBs expostas ou não ao estradiol e à progesterona. Os ovócitos foram maturados in vitro por 24h e, então, fertilizados utilizando-se sêmen congelado, em estufa de CO2 a 5% e 38,5ºC. As CEOBs foram cultivadas em TCM-199 com ou sem estradiol (E2 (24 horas, nas mesmas condições da maturação e fertilização in vitro (MIV e FIV, e, em seguida, adicionadas aos diferentes grupos em CR2 com ou sem progesterona (P4 (G1=P4+E2; (G2=E2; (G3=P4 e (G4=controle. Após 18h da FIV, as células foram cultivadas nos diferentes sistemas. Nenhuma diferença (P>0,05 foi observada nas taxas de clivagem entre G1, G2 e G4 (53,5%; 56,3%; 51,7% e nos padrões de blastocistos (BLs (29,3%; 31,2%, 28,7%. Índices menores (P<0,05 foram obtidos no G3 para ambas as variáveis (34,5%; 16,4%. G1 e G2 apresentaram taxas de eclosão maiores (P<0,05 que os outros grupos (23,3%; 23,2%, sendo G4 (19,3% diferente de G3 (16,1%. Em G1, G2 e G3, o número de células nos BLs aumentou 125,9; 128,4 e 123,6, respectivamente (P<0,05, em relação ao G4 (112,5. Conclui-se que o tratamento das CEOBs com o E2, nas primeiras 24 horas de cultivo, pode ser usado isoladamente ou em combinação com a progesterona, a fim de melhorar a qualidade de embriões bovinos produzidos in vitro

  18. MODELAGEM MATEMÁTICA DOS IMPACTOS EXTRAMUROS DO RUÍDO PRODUZIDO POR UMA UNIVERSIDADE EM MOSSORÓ-RN

    Directory of Open Access Journals (Sweden)

    Carlos Enrique Jeronimo

    2015-04-01

    Full Text Available Neste trabalho, desenvolveu-se um estudo para quantificação do ruído produzido por uma universidade em Mossoró-RN, bem como, estimando-se os níveis de atenuação deste ruído com distanciamento, por meio da modelagem matemática. As medições do ruído ambiental foram realizadas por meio de um analisador de Ruído no período noturno no campus da instituição, variando de 0 a 100 m de distância em cada vértice. Aplicaram-se os modelos matemáticos para encontrar relações entre o nível de ruído e a distância de leitura dos dados. Após análise dos resultados, encontrou-se uma relação entre a atenuação pela distância em apenas dois vértices e que os níveis de ruídos estão acima do permitido. Foi possível a determinação do parâmetro K, para a atenuação dos níveis de ruído em dois vértices do prédio, obtendo-se valores de 5,94 e 8.44 dB(A.m-1 nos vértices 3 e 4, respectivamente. Por fim, espera-se que os resultados obtidos neste mapeamento acústico e modelagem de parâmetros matemáticos possam auxiliar no planejamento da implantação de empreendimentos e edificações futuras ao redor do campus da universidade, especialmente, pois é possível fazer a previsibilidade de certas zonas e orientar na indicação dos locais mais silenciosos e os locais mais ruidosos no seu entorno.

  19. Pellets de trigo e soja produzidos por extrusão Wheat and soybean pellets produced by extrusion-cooking

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    Sin Huei Wang

    2008-09-01

    Full Text Available A mistura de trigo e soja representa uma importante fonte calórico-protéica com proteínas de boa qualidade. Apesar disso, a utilização da soja como ingrediente tem sido limitada pelo seu sabor de feijão cru (beany flavor, o qual é melhorado pelo processo de extrusão. Foram estudados os efeitos de umidade da mistura, Temperatura de Barril (TB e Velocidade de Rotação de Parafuso (VRP, Nº 5 do extrusor no Índice de Expansão (IE, no Índice de Solubilidade em Água (ISA e nas características sensoriais de pellets produzidos com mistura de trigo e soja (90:10, objetivando a otimização deste processo para a obtenção de pellets fritos com melhores qualidades sensoriais. A farinha mista crua foi extrusada em 2 umidades (32 e 35%, 4 TB (60 a 90 °C e 4 VRP (60 a 150 rpm, totalizando 32 tratamentos. O pellet frito, preparado com a farinha mista com 32% de umidade e extrusada em 60 rpm a 80 °C, apresentou o maior IE e as melhores qualidades sensoriais (aparência, sabor e textura, sendo preferido pela equipe de provadores não treinados, tanto com sabor de bacon como com sabor de queijo.The mixture of wheat with soybean represents an important calorie-protein source with good protein quality. In spite of this, the use of soybeans as an ingredient has been limited by their beany flavor, which is improved by the extrusion process. Effects of mixture moisture, Barrel Temperature (BT and Screw-Speed (SS, Nº 5 on Expansion Index (EI, Water Solubility Index (WSI and sensory characteristics of pellets produced with a wheat-soybean (90:10 mixture were studied, in order to optimize this process for obtaining fried pellets with better sensory qualities. Raw mixed flour was extruded at two moisture contents (32 and 35%, four BT (60 to 90 °C and four SS (60 to 150 rpm, totalizing 32 treatments. The fried pellets, prepared with the mixed flour with 32% moisture and extruded at 60 rpm and 80 °C, presented the greatest EI and the best sensory

  20. INCIDENCE OF RESIDUAL NEUROMUSCULAR BLOCKADE AT TRACHEAL EXTUBATION: COMPARISON OF ATRACURIUM WITH VECURONIUM

    Directory of Open Access Journals (Sweden)

    Shwetha S

    2015-11-01

    Full Text Available BACKGROUND: Occurrence of undetected residual neuromuscular blockade is a common event in the post anaesthesia care unit. AIM: To compare the incidence and degree of residual neuromuscular blockade with the use of intermediate acting neuromuscular blocking agents Atracurium and Vecuronium. METHODS: 360 patients satisfying the inclusion and exclusion criteria were enrolled in the study and randomly allocated into one of the two study groups of 180 each to receive either Atracurium or Vecuronium intraoperatively. The anaesthesiologist blinded from the study extubated the patient based on the standard clinical criteria and the corresponding Train of Four(TOF ratios were noted by a blinded research assistant using a TOF watch (TOF- Watch® SX Organon, Ireland Ltd., Dublin, Ireland. Residual neuromuscular blockade was defined as a TOF ratio of 0.9 thirty minutes after tracheal extubation. CONCLUSION: We conclude from our study that significant post-operative residual curarization (TOF < 0.9 exists in majority of patients at the time of tracheal extubation (54.4% incidence despite the use of intermediate acting neuromuscular blocking drugs. The incidence and degree of post-operative residual curarization is significantly greater with Vecuronium compared to Atracurium. Thus we suggest that quantitative neuromuscular monitoring is required to assure complete neuromuscular recovery.

  1. Zebrafish calls for reinterpretation for the roles of P/Q calcium channels in neuromuscular transmission

    OpenAIRE

    Hua WEN; Linhoff, Michael W.; Hubbard, Jeffrey M; Nelson, Nathan R.; Stensland, Donald; Dallman, Julia; Mandel, Gail; Brehm, Paul

    2013-01-01

    A long-held tenet of neuromuscular transmission is that calcium-dependent neurotransmitter release is mediated by N-type calcium channels in frog but P/Q-type channels in mammals. The N-type assignment in frog is based principally on pharmacological sensitivity to ω-conotoxin GVIA. Our studies show that zebrafish neuromuscular transmission is also sensitive to ω-conotoxin GVIA. However, positional cloning of a mutant line with compromised neuromuscular function identified a mutation in a P/Q-...

  2. Neuromuscular medicine competency in physical medicine and rehabilitation residents: a method of development and assessment.

    Science.gov (United States)

    Lin, Lei; Cuccurullo, Sara J; Innerfield, Caitlin E; Strax, Thomas E; Petagna, Anne

    2013-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with neuromuscular disorders. It further sought to verify acquired competencies in neuromuscular rehabilitation through objective evaluation methodology. An American Association of Neuromuscular and Electrodiagnostic Medicine board-certified physician with 10 yrs of clinical experience in neuromuscular and general rehabilitation trained 19 residents using a standardized competency-based module. The residents were trained through clinical training, lectures, and review of self-assessment examination concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill proficiency were measured in (1) completion of neuromuscular history and physical examination satisfactorily, (2) diagnosis and ability to design a patient care management plan via chart stimulated recall examinations, (3) physician-patient interaction via patient surveys, (4) physician-staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient care report and to document a patient care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data were collected on an ongoing basis. The objective measures compared resident self-assessment examination scores in neuromuscular rehabilitation before and after the institution of the comprehensive neuromuscular competency module in the residency program. Nineteen (100%) of 19 residents successfully demonstrated proficiency in every segment of the

  3. Neuromuscular medicine competency in physical medicine and rehabilitation residents: a method of development and assessment.

    Science.gov (United States)

    Lin, Lei; Cuccurullo, Sara J; Innerfield, Caitlin E; Strax, Thomas E; Petagna, Anne

    2013-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with neuromuscular disorders. It further sought to verify acquired competencies in neuromuscular rehabilitation through objective evaluation methodology. An American Association of Neuromuscular and Electrodiagnostic Medicine board-certified physician with 10 yrs of clinical experience in neuromuscular and general rehabilitation trained 19 residents using a standardized competency-based module. The residents were trained through clinical training, lectures, and review of self-assessment examination concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill proficiency were measured in (1) completion of neuromuscular history and physical examination satisfactorily, (2) diagnosis and ability to design a patient care management plan via chart stimulated recall examinations, (3) physician-patient interaction via patient surveys, (4) physician-staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient care report and to document a patient care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data were collected on an ongoing basis. The objective measures compared resident self-assessment examination scores in neuromuscular rehabilitation before and after the institution of the comprehensive neuromuscular competency module in the residency program. Nineteen (100%) of 19 residents successfully demonstrated proficiency in every segment of the

  4. Deep neuromuscular blockade leads to a larger intraabdominal volume during laparoscopy

    DEFF Research Database (Denmark)

    Lindekaer, Astrid Listov; Halvor Springborg, Henrik; Istre, Olav

    2013-01-01

    for measuring the intra-abdominal space available to the surgeon during laproscopy, in order to examine whether the relaxation produced by deep neuromuscular blockade can increase the working surgical space sufficiently to permit a reduction in the CO2 insufflation pressure. Using the laproscopic grasper...... patients shows that the intra-abdominal space at 8 mm Hg with blockade is comparable to the intra-abdominal space measured at 12 mm Hg without blockade. The impact of neuromuscular blockade was not correlated with patient height, weight, BMI, and age. Thus, using neuromuscular blockade to maintain a steady...

  5. Controle da dor pós-operatória da artroplastia total do joelho: é necessário associar o bloqueio do nervo isquiático ao bloqueio do nervo femoral? Control del dolor postoperatorio de la artroplastia total de la rodilla: ¿es necesario asociar el bloqueo del nervio isquiático al bloqueo del nervio femoral? Control of postoperative pain following total knee arthroplasty: is it necessary to associate sciatic nerve block to femoral nerve block?

    Directory of Open Access Journals (Sweden)

    Affonso H. Zugliani

    2007-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A artroplastia total do joelho (ATJ promove grande trauma tecidual, produzindo intensa dor no pós-operatório. A analgesia pós-operatória de boa qualidade é fundamental, devendo-se considerar que a mobilização articular precoce é um importante aspecto para obtenção de bons resultados. Há controvérsias na literatura sobre a eficácia do bloqueio isolado do nervo femoral. O objetivo deste estudo foi avaliar a analgesia pós-operatória com a associação do bloqueio dos nervos isquiático e femoral. MÉTODO: Foram estudados 17 pacientes submetidos à ATJ sob raquianestesia, divididos em dois grupos: A e B. No Grupo A (n = 9 foi realizado bloqueio do nervo femoral e no Grupo B (n = 8, bloqueio dos nervos femoral e isquiático. Os bloqueios foram realizados no pós-operatório imediato utilizando-se 20 mL de ropivacaína a 0,5% em cada um. A dor foi aferida nas primeiras 24 horas pela Escala Analógica Visual e escala verbal. Foi observado o tempo decorrido entre os bloqueios e a primeira queixa de dor (M1. RESULTADOS: A mediana do tempo de analgesia (M1 no Grupo A foi de 110 min. e no Grupo B de 1.285 min. (p = 0,0001. Não foram observadas complicações atribuíveis às técnicas utilizadas. CONCLUSÃO: O bloqueio do nervo isquiático, quando associado ao bloqueio do nervo femoral, nas condições deste estudo, melhorou de maneira significativa a qualidade da analgesia pós-operatória da ATJ.JUSTIFICATIVA Y OBJETIVOS: La artroplastia total de la rodilla (ATR promueve gran trauma del tejido produciendo un intenso dolor en el postoperatorio. La analgesia de postoperatorio de buena calidad es fundamental, debiendo considerar que la movilización articular precoz es un importante aspecto para la obtención de buenos resultados. Existen controversias en la literatura sobre la eficacia del bloqueo aislado del nervio femoral. El objetivo de este estudio fue evaluar la analgesia en postoperatorio con la asociaci

  6. Regional neuromuscular regulation within human rectus femoris muscle during gait.

    Science.gov (United States)

    Watanabe, Kohei; Kouzaki, Motoki; Moritani, Toshio

    2014-11-01

    The spatial distribution pattern of neuromuscular activation within the human rectus femoris (RF) muscle was investigated during gait by multi-channel surface electromyography (surface EMG). Eleven healthy men walked on a treadmill with three gait speeds (4, 5, and 6 km/h) and gradients (0°, 12.5°, and 25°). The spatial distribution of surface EMG was tested by central locus activation (CLA), which is calculated from 2-D multi-channel surface EMG with 46 surface electrodes. For all conditions, CLA was around the middle regions during the swing-to-stance transition and moved in a proximal direction during the stance phase and stance-to-swing transition (pphase significantly moved to proximal site with increasing gait speed (pphases, with increasing grade, CLA significantly moved distally (pgait cycle and is non-uniformly regulated longitudinally.

  7. Presynaptic elements involved in the maintenance of the neuromuscular junction

    Science.gov (United States)

    Burrows, G. H.

    1984-01-01

    Alterations in the neuromuscular junction were observed in rats preceding loss of muscle mass. In view of the possibility that these alterations involve changes in the secretion of myotrophic agents by presynaptic motor neurons, an investigation was undertaken to characterize a neuronall factor which is thought to be involved in the initiation and maintenance of cholinergic synapses. This factor, which is secreted into the incubation medium by NG108-15 neuroblastoma x glioma hybrid cells, induces the aggregation of nicotinic acetylcholine receptors on primary cultures of rat hindlimb myotubes. Previous attempts to purify this factor failed. Extensive washing of the NG108-15 cells with hepes-buffered salt solution followed by short (4 hour) collection times resulted in the collection of incubation medium containing maximal aggregation activity with as little as 5 ug secreted protein per ml of fresh medium. A three-fold increase in specific activity was obtained after anion exchange chromatography.

  8. Active zone stability:insights from fly neuromuscular junction

    Institute of Scientific and Technical Information of China (English)

    Xiaolin Tian; Chunlai Wu

    2015-01-01

    The presynaptic active zone is a dynamic structure that orchestrates regulated release of neurotrans-mitters. Developmental and aging processes, and changes in neuronal network activity can all modulate the number, size and composition of active zone and thereby synaptic efifcacy. However, very little is known about the mechanism that controls the structural stability of active zone. By study-ing a model synapse, theDrosophila neuromuscular junction, our recent work shed light on how two scaffolding proteins at the active zone regulate active zone stability by promoting a localized dephos-phorylation event at the nerve terminal. Here we discuss the major insights from our ifndings and their implications for future research.

  9. Alterations in neuromuscular function in girls with generalized joint hypermobility

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Melcher, Jesper Sandfeld; Melcher, Pia Grethe Sandfeld;

    2016-01-01

    BACKGROUND: Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. METHODS: Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions...... (90°) at 20 % Maximum Voluntary Contraction, and explosive isometric knee flexions while sitting. EMG was recorded from knee flexor and extensor muscles. RESULTS: Early rate of torque development was 53 % faster for GJH. Reduced hamstring muscle activation in girls with GJH was found while knee...... adaptation to compensate for hypermobility. Higher medial muscle activation indicated higher levels of medial knee joint compression in girls with GJH. Increased flexion-extension co-activation ratios in GJH were explained by decreased agonist drive to the hamstrings....

  10. Resúmenes de los trabajos sobre las Enfermedades Neuromusculares

    Directory of Open Access Journals (Sweden)

    Congreso Nacional de Neurología

    2010-03-01

    Full Text Available Las enfermedades neuromusculares constituyen un conjunto de afectaciones que afectan las neuronas motoras periférica, las vías motoras eferentes o los efectores (músculos esqueléticos. Sus manifestaciones clínicas son muy variadas y dependen de la causa y de los niveles de afectación. En este acápite se pueden encontrar los resúmenes de trabajos relacionados con el síndrome de Guillain Barre, polineuropatía diabética, Atrofia Muscular Espinal, Distrofia miotónica y otros todos presentados en el salón que abordó estas enfermedades.

  11. Abdominal compartment syndrome successfully treated with neuromuscular blockade

    Directory of Open Access Journals (Sweden)

    Kris T Chiles

    2011-01-01

    Full Text Available A 48 year old male admitted to the intensive care unit after a cardiac arrest complicated by a stroke intra-operatively during automatic implantable cardioverter defibrillator placement. He post-operatively developed a rigid abdomen, elevated peak and plateau pressures, hypoxia and renal insufficiency. He was diagnosed with abdominal compartment syndrome with an intra-abdominal compartment pressure of 40mmHg. The patient was administered 10 mg of intravenous cisatracuriumbesylate in preparation for bedside surgical abdominal decompression. Cisatracurium eliminated the patients need for surgical intervention by reducing his abdominal compartment pressures to normal and improving his hypoxia and renal function. This case illustrates that neuromuscular blockade should be attempted in patients with abdominal compartment syndrome prior to surgical intervention.

  12. Diverticular Disease of the Colon: Neuromuscular Function Abnormalities.

    Science.gov (United States)

    Bassotti, Gabrio; Villanacci, Vincenzo; Bernardini, Nunzia; Dore, Maria P

    2016-10-01

    Colonic diverticular disease is a frequent finding in daily clinical practice. However, its pathophysiological mechanisms are largely unknown. This condition is likely the result of several concomitant factors occurring together to cause anatomic and functional abnormalities, leading as a result to the outpouching of the colonic mucosa. A pivotal role seems to be played by an abnormal colonic neuromuscular function, as shown repeatedly in these patients, and by an altered visceral perception. There is recent evidence that these abnormalities might be related to the derangement of the enteric innervation, to an abnormal distribution of mucosal neuropeptides, and to low-grade mucosal inflammation. The latter might be responsible for the development of visceral hypersensitivity, often causing abdominal pain in a subset of these patients. PMID:27622368

  13. LRP4 is critical for neuromuscular junction maintenance.

    Science.gov (United States)

    Barik, Arnab; Lu, Yisheng; Sathyamurthy, Anupama; Bowman, Andrew; Shen, Chengyong; Li, Lei; Xiong, Wen-cheng; Mei, Lin

    2014-10-15

    The neuromuscular junction (NMJ) is a synapse between motor neurons and skeletal muscle fibers, and is critical for control of muscle contraction. Its formation requires neuronal agrin that acts by binding to LRP4 to stimulate MuSK. Mutations have been identified in agrin, MuSK, and LRP4 in patients with congenital myasthenic syndrome, and patients with myasthenia gravis develop antibodies against agrin, LRP4, and MuSK. However, it remains unclear whether the agrin signaling pathway is critical for NMJ maintenance because null mutation of any of the three genes is perinatal lethal. In this study, we generated imKO mice, a mutant strain whose LRP4 gene can be deleted in muscles by doxycycline (Dox) treatment. Ablation of the LRP4 gene in adult muscle enabled studies of its role in NMJ maintenance. We demonstrate that Dox treatment of P30 mice reduced muscle strength and compound muscle action potentials. AChR clusters became fragmented with diminished junctional folds and synaptic vesicles. The amplitude and frequency of miniature endplate potentials were reduced, indicating impaired neuromuscular transmission and providing cellular mechanisms of adult LRP4 deficiency. We showed that LRP4 ablation led to the loss of synaptic agrin and the 90 kDa fragments, which occurred ahead of other prejunctional and postjunctional components, suggesting that LRP4 may regulate the stability of synaptic agrin. These observations demonstrate that LRP4 is essential for maintaining the structural and functional integrity of the NMJ and that loss of muscle LRP4 in adulthood alone is sufficient to cause myasthenic symptoms. PMID:25319686

  14. [Genetic defects and disorders at the neuromuscular junction].

    Science.gov (United States)

    Ohno, Kinji

    2011-07-01

    Genetic defects in molecules expressed at the neuromuscular junction (NMJ) cause congenital myasthenic syndromes (CMSs), which are characterized by muscle weakness, abnormal fatigability, amyotrophy, and minor facial anomalies. Muscle weakness mostly develops under 2 years but is also sometimes seen in adults. Mutations identified to date include (i) muscle nicotinic acetylcholine receptor (AChR) subunits, (ii) rapsyn that anchors and clusters AChRs at the neuromuscular junction, (iii) agrin that is released from the nerve terminal and induces AChR clustering by stimulating the downstream LRP4/MuSK/Dok-7/rapsyn/AChR pathway, (iv) muscle-specific kinase (MuSK) that transmits the AChR-clustering signal from agrin/LRP4 to rapsyn/AChR, (v) Dok-7 that transmits the AChR-clustering signal from agrin/LRP4/MuSK to rapsyn/AChR, (vi) skeletal muscle sodium channel type 1.4 (Nav1.4) that spreads the depolarization potential from the endplate throughout muscle fibers, (vii) collagen Q that anchors acetylcholinesterase to the synaptic basal lamina, and (viii) choline acetyltransferase that resynthesizes acetylcholine from recycled choline at the nerve terminal. In addition, mutations in the heparin sulfate proteoglycan perlecan, which binds to many molecules including collagen Q and dystroglycan, causes Schwartz-Jampel syndrome. Interestingly, mutations in LRP4 cause Cenani-Lenz syndactyly syndrome but not CMS. AChR, MuSK, and LRP4 are also targets of auto-antibodies in myasthenia gravis. In addition, molecules at the NMJ are targets of many other disease states AChRs are blocked by the snake toxin alpha-bungarotoxin and the plant poison curare. The presynaptic SNARE complex is attacked by botulinum toxin. Acetylcholinesterase is inhibited by the nerve gas sarin and by organophosphate pesticides. This review focuses on the molecular bases underlying defects of AChR, rapsyn, Nav1.4, collagen Q, and choline acetyltransferase. PMID:21747136

  15. Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome

    Science.gov (United States)

    Rowe, Peter C.; Fontaine, Kevin R.; Lauver, Megan; Jasion, Samantha E.; Marden, Colleen L.; Moni, Malini; Thompson, Carol B.; Violand, Richard L.

    2016-01-01

    Chronic fatigue syndrome (CFS) is a complex, multisystem disorder that can be disabling. CFS symptoms can be provoked by increased physical or cognitive activity, and by orthostatic stress. In preliminary work, we noted that CFS symptoms also could be provoked by application of longitudinal neural and soft tissue strain to the limbs and spine of affected individuals. In this study we measured the responses to a straight leg raise neuromuscular strain maneuver in individuals with CFS and healthy controls. We randomly assigned 60 individuals with CFS and 20 healthy controls to either a 15 minute period of passive supine straight leg raise (true neuromuscular strain) or a sham straight leg raise. The primary outcome measure was the symptom intensity difference between the scores during and 24 hours after the study maneuver compared to baseline. Fatigue, body pain, lightheadedness, concentration difficulties, and headache scores were measured individually on a 0–10 scale, and summed to create a composite symptom score. Compared to individuals with CFS in the sham strain group, those with CFS in the true strain group reported significantly increased body pain (P = 0.04) and concentration difficulties (P = 0.02) as well as increased composite symptom scores (all P = 0.03) during the maneuver. After 24 hours, the symptom intensity differences were significantly greater for the CFS true strain group for the individual symptom of lightheadedness (P = 0.001) and for the composite symptom score (P = 0.005). During and 24 hours after the exposure to the true strain maneuver, those with CFS had significantly higher individual and composite symptom intensity changes compared to the healthy controls. We conclude that a longitudinal strain applied to the nerves and soft tissues of the lower limb is capable of increasing symptom intensity in individuals with CFS for up to 24 hours. These findings support our preliminary observations that increased mechanical sensitivity may be a

  16. Exercise therapy and other types of physical therapy for patients with neuromuscular diseases: a systematic review.

    NARCIS (Netherlands)

    Cup, E.H.C.; Pieterse, A.J.; Broek-Pastoor, J.M. Ten; Munneke, M.; Engelen, B.G.M. van; Hendricks, H.T.; Wilt, G.J. van der; Oostendorp, R.A.B.

    2007-01-01

    OBJECTIVE: To summarize and critically appraise the available evidence on exercise therapy and other types of physical therapies for patients with neuromuscular diseases (NMD). DATA SOURCES: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, Medline, CINAHL,

  17. Nitrato e nitrito em leite produzido em sistemas convencional e orgânico Nitrate and nitrite in milk produced by conventional and organic systems

    Directory of Open Access Journals (Sweden)

    Joice S. dos Santos

    2005-06-01

    Full Text Available Nitratos e nitritos podem estar presentes naturalmente em diversos alimentos, entre eles o leite. Devido a sua toxicidade, são estabelecidos limites para a presença destes compostos nos alimentos. Assim, investigou-se os níveis de nitratos e nitritos em amostras de leite in natura, produzido por vacas submetidas aos sistemas de manejo convencional e orgânico. As amostras foram coletadas em propriedades da Região da Depressão Central do Rio Grande do Sul, Brasil. Os teores médios de nitrato e nitrito encontrados nas amostras (n=45 foram de 6,65±0,84mg/L e 1,76±0,17mg/L, respectivamente. O leite produzido no sistema orgânico apresentou 7,08mg/L de nitrato e 1,61mg/L de nitrito, enquanto o produzido no sistema convencional apresentou 6,36 e 1,87mg/L, respectivamente. Não foi observada diferença significativa entre os teores de nitrato e nitrito encontrados nas amostras de leite em função do sistema de produção avaliado, época de coleta, turno de ordenha ou local de origem, isto é, propriedade produtora.Nitrates and nitrites can be naturally found in many foods, including milk. Due to their toxicity there is a maximum level allowed for these compounds in foods. In the present study, nitrate and nitrite levels were evaluated in raw milk samples produced in conventional and organic systems. Samples were collected from farms of the Depressão Central of Rio Grande do Sul, Brazil. The average levels of nitrate and nitrite in samples (n=45 were 6.65±0.84mg/L and 1.76±0.17mg/L, respectively. Milk produced in the organic system exhibited 7.08mg/L nitrate and 1.61mg/L nitrite, while milk produced in the conventional system exhibited 6.36 and 1.87mg/L, respectively. Nitrate and nitrite levels in raw milk were not affected by the production system, the period of collection, milking shift or the site of production (farm.

  18. Physical complications in anorexia nervosa. Haematological and neuromuscular changes in 12 patients.

    Science.gov (United States)

    Alloway, R; Shur, E; Obrecht, R; Russell, G F

    1988-07-01

    Of twelve patients consecutively admitted to the Maudsley Hospital Eating Disorders Unit, four had neuromuscular abnormality, eight haematological abnormality, and four no abnormality. All those having neuromuscular signs had concomitant haematological dysfunction. Vomiting, and food restriction with vegetarianism, appeared more likely to lead to complications than either food restriction alone or laxative abuse. The physical status of severely underweight patients admitted for refeeding needs to be carefully monitored. PMID:3224253

  19. Neuromuscular activity of Bothrops alcatraz snake venom in chick biventer cervicis preparations.

    Science.gov (United States)

    de Moraes, Delkia Seabra; Aparecido de Abreu, Valdemir; Rostelato-Ferreira, Sandro; Leite, Gildo B; Alice da Cruz-Höfling, Maria; Travaglia-Cardoso, Silvia R; Hyslop, Stephen; Rodrigues-Simioni, Léa

    2012-02-01

    Venom (10-100 μg/ml) from Bothrops alcatraz, a pitviper from the Alcatrazes Archipelago off the coast of southeastern Brazil, caused progressive, irreversible neuromuscular blockade in chick isolated biventer cervicis preparations. The venom also inhibited contractures to exogenous ACh (110 μM) and KCl (20 mM), caused myofiber damage and increased creatine kinase release. Commercial bothropic antivenom raised against mainland Bothrops species neutralized the neuromuscular activity, depending on the venom concentration. PMID:22155137

  20. Can hyperbaric oxygen be used to prevent deep infections in neuro-muscular scoliosis surgery?

    OpenAIRE

    Inanmaz, Mustafa Erkan; Kose, Kamil Cagri; Isik, Cengiz; Atmaca, Halil; Basar, Hakan

    2014-01-01

    Background The prevalence of postoperative wound infection in patients with neuromuscular scoliosis surgery is significantly higher than that in patients with other spinal surgery. Hyperbaric oxygen has been used as a supplement to treat postsurgical infections. Our aim was to determine beneficiary effects of hyperbaric oxygen treatment in terms of prevention of postoperative deep infection in this specific group of patients in a retrospective study. Methods Forty two neuromuscular scoliosis ...

  1. Development of a Neuromuscular Junction Model on Surfaces Modified by Plasma Polymerization

    OpenAIRE

    E. Zuñiga-Aguilar; R. Godínez; O. Ramírez-Fernández; Morales, J.; R. Olayo

    2013-01-01

    The aim of this work is to implement a biological model of neuromuscular junctions to study the mechanisms involved in intra and inter cellular processes using cell co-cultures. To optimize growth and development of the neuromuscular junction, cells were seeded on plasma polymerized pyrrole which has proven suitable for other types of cell cultures. The cell lines used were motor neuron NG108-15 and skeletal muscle C2C12. Cells were evaluated according to their morphology and elect...

  2. Premature awakening and underuse of neuromuscular monitoring in a registry of patients with butyrylcholinesterase deficiency

    DEFF Research Database (Denmark)

    Thomsen, J L; Nielsen, C V; Palmqvist, D F;

    2015-01-01

    , neuromuscular monitoring, and postoperative respiratory complications, defined as arterial oxygen desaturation prematurely awakened if anaesthesia had been terminated while the patient was still...... paralysed. RESULTS: We included 123 patients. Neuromuscular monitoring was applied before awakening in 48 (39%) patients. A nerve stimulator was never used or only after attempted awakening in the remaining 75 (61%) patients. Premature awakening occurred in 75 (100%) and 14 (29%) of the unmonitored...

  3. Update on the approach of respiratory therapy in patients with neuromuscular diseases

    OpenAIRE

    Priscilla Barreto Paula; Laura Maria de Lima Belizário Facury Lasmar; Maria Teresa Mohallem Fonseca; Marina Belisário Carvalhais; Maria da Glória Rodrigues Machado

    2010-01-01

    Objective: To assess the role of physiotherapy in approaching neuromuscular disease (NMD), with emphasis on preventive and therapeutic aspects of respiratory therapy. Methods: A nonsystematic literature review covering the past twenty years, using the databases MEDLINE and LILACS through the following descriptors: neuromuscular diseases, physical therapy, vital capacity and respiratory failure. Results: The studies reviewed show the need to establish a routine periodic evaluation of respirato...

  4. The Immediate Effect of Lumbar Spine Patterns of Neuromuscular Joint Facilitation in Young Amateur Baseball Players

    OpenAIRE

    Huo, Ming; Maruyama, Hitoshi; Kaneko, Takasumi; Naito, Daiki; Koiso, Yuta

    2014-01-01

    [Purpose] The aim of the study was to investigate the changes in baseball pitching velocity, the functional reach test (FR) and the simple reaction times (SRT) in young amateur baseball players after lumbar spine patterns of neuromuscular joint facilitation (NJF) treatment. [Subjects] The subjects were 11 young amateur baseball players. An NJF intervention and a proprioceptive neuromuscular facilitation (PNF) intervention were performed. The interventions were performed one after the other wi...

  5. Reduced gap junctional coupling leads to uncorrelated motor neuron firing and precocious neuromuscular synapse elimination

    OpenAIRE

    Personius, Kirkwood E.; Chang, Qiang; Mentis, George Z.; O'Donovan, Michael J.; Rita J Balice-Gordon

    2007-01-01

    During late embryonic and early postnatal life, neuromuscular junctions undergo synapse elimination that is modulated by patterns of motor neuron activity. Here, we test the hypothesis that reduced spinal neuron gap junctional coupling decreases temporally correlated motor neuron activity that, in turn, modulates neuromuscular synapse elimination, by using mutant mice lacking connexin 40 (Cx40), a developmentally regulated gap junction protein expressed in motor and other spinal neurons. In C...

  6. Effect of the neuromuscular activation of knee extensors on vertical jump by using electrostimulation method

    OpenAIRE

    Bílý, Jiří; Cacek, Jan

    2014-01-01

    Neuromuscular electrical stimulation is one of the methods of strength development during which there is no voluntary muscle contraction. The aim of this study was to investigate the influence of the neuromuscular activation of knee extensors on vertical jump by using electrostimulation method. Ten healthy trained male students in sports-sciences, aged 21-25 years, perform Sargent jump test. They perform two kinds of jump - squat jump and drop jump (42 cm heigh bench) immediately after electr...

  7. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    OpenAIRE

    O'Driscoll Jeremiah; Kerin Fearghal; Delahunt Eamonn

    2011-01-01

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joi...

  8. Update on neuromuscular disorders in pediatric orthopaedics: Duchenne muscular dystrophy, myelomeningocele, and cerebral palsy.

    Science.gov (United States)

    Chambers, Henry G

    2014-01-01

    The purpose of this seminar was to review a large range of lower extremity and neuromuscular disorders. Because of the diversity of the topics covered, including clubfoot and vertical talus treatment, management of Legg-Calve-Perthes disease, and limb lengthening in dwarfism, this review will focus on the neuromuscular subsection reviewing the current management of the muscular dystrophies, myelomeningocele, and cerebral palsy. PMID:25207736

  9. Routine and specialized laboratory testing for the diagnosis of neuromuscular diseases in dogs and cats.

    Science.gov (United States)

    Shelton, G Diane

    2010-09-01

    The diagnosis of neuromuscular diseases can be challenging. The first step is recognition that the disease involves the neuromuscular system (muscle, neuromuscular junction, peripheral nerve, and ventral horn cells of the spinal cord). Many neuromuscular diseases share clinical signs and cannot be distinguished based on clinical examination. Routine laboratory screening, including a CBC, biochemical profile, and urinalysis, can identify some of the most common systemic abnormalities that cause muscle weakness and myalgia, such as hypo- and hyperglycemia, electrolyte disorders, or thyroid abnormalities, and may suggest a specific diagnosis, such as diabetes mellitus, hypo- or hyperadrenocorticism, renal failure, or hypothyroidism. Increased creatine kinase activity, increased cardiac troponin I concentration, and myoglobinuria are useful in detecting skeletal and cardiac muscle damage. Identification of acetylcholine receptor antibodies is diagnostic for acquired myasthenia gravis. For primary muscle or peripheral nerve diseases, tissue biopsy is the most direct way to determine specific pathology, correctly classify the disease, and determine the course of additional laboratory testing. For example, inflammatory, necrotizing, dystrophic, metabolic, or congenital myopathies require different laboratory testing procedures for further characterization. Many neuromuscular diseases are inherited or breed-associated, and DNA-based tests may already be established or may be feasible to develop after the disorder has been accurately characterized. This review focuses on both routine and specialized laboratory testing necessary to reach a definitive diagnosis and determine an accurate prognosis for neuromuscular diseases. PMID:20726955

  10. Evaluation of neuromuscular activity in patients with obstructive sleep apnea using chin surface electromyography of polysomnography

    Institute of Scientific and Technical Information of China (English)

    YIN Guo-ping; YE Jing-ying; HAN De-min; WANG Xiao-yi; ZHANG Yu-huan; LI Yan-ru

    2013-01-01

    Background It is believed that defects in upper airway neuromuscular control play a role in sleep apnea pathogenesis.Currently,there is no simple and non-invasive method for evaluating neuromuscular activity for the purpose of screening in patients with obstructive sleep apnea.This study was designed to assess the validity of chin surface electromyography of routine polysomnography in evaluating the neuromuscular activity of obstructive sleep apnea subjects and probe the neuromuscular contribution in the pathogenesis of the condition.Methods The chin surface electromyography of routine polysomnography during normal breathing and obstructive apnea were quantified in 36 male patients with obstructive sleep apnea.The change of chin surface electromyography from normal breathing to obstructive apnea was expressed as the percent compensated electromyography value,where the percent compensated electromyography value =(normal breath surface electromyography-apnea surface electromyography)/normal breath surface electromyography,and the percent compensated electromyography values among subjects were compared.The relationship between sleep apnea related parameters and the percent compensated electromyography value was examined.Results The percent compensated electromyography value of the subjects varied from 1% to 90% and had a significant positive correlation with apnea hypopnea index (R2=0.382,P <0.001).Conclusions Recording and analyzing chin surface electromyography by routine polysomnography is a valid way of screening the neuromuscular activity in patients with obstructive sleep apnea.The neuromuscular contribution is different among subjects with obstructive sleep apnea.

  11. ANÁLISE SENSORIAL E MICROBIOLÓGICA DE KEFIR ARTESANAL PRODUZIDO A PARTIR DE LEITE DE CABRA E DE LEITE DE VACA

    Directory of Open Access Journals (Sweden)

    Felipe Alves de Almeida

    2011-02-01

    Full Text Available O kefir vem sendo considerado como um alimento funcional, produzido através da fermentação lática e alcoólica do leite por bactérias e leveduras, possuindo consistência semelhante à de um iogurte, mas de valor nutricional e terapêutico muito maior. É originário das montanhas dos Cáucaso e da Ásia Central tendo sido consumido por milhares de anos pela população das montanhas que relacionam seu uso diário com a longevidade e saúde. O objetivo deste trabalho foi elaborar um kefir a base de leite de vaca e outro a base de leite de cabra e avaliar suas características microbiológicas e a aceitabilidade de cada um dos produtos.

  12. Análise da qualidade do composto produzido na unidade de tratamento mecânico e biológico da GESAMB

    OpenAIRE

    Barradas, Helena Isabel Rodrigues

    2015-01-01

    O objectivo deste trabalho consiste na análise preliminar da qualidade do composto produzido na fase de testes da unidade de TMB da GESAMB. Efectuaram-se recolhas ao composto já maturado (a matéria orgânica foi degradada) e realizaram-se análises laboratoriais às propriedades físico-químicas. Os resultados obtidos revelam que a compostagem ainda não é totalmente eficiente, pois o composto ainda não se encontra estabilizado (a matéria orgânica ainda é susceptível à degradação) apesar de ...

  13. Propriedades físicas de painéis aglomerados de madeira produzidos com adição de película de polipropileno biorientado

    Directory of Open Access Journals (Sweden)

    Laurenn B. de Macedo

    2015-07-01

    Full Text Available No Brasil, as últimas décadas foram marcadas pela crescente produção de paineis de madeira seguida pelo aumento do consumo nacional; isto descreve o quão promissora é a área devido à sua grande potencialidade quanto ao desenvolvimento de novos produtos e tecnologias; como exemplo disto existe a possibilidade de mistura entre materiais lignocelulósicos e os diversos resíduos produzidos pela sociedade. Entre tais resíduos o plástico é o que apresenta maior abundância nos descartes domésticos. Neste contexto, o presente trabalho objetivou determinar propriedades físicas de paineis aglomerados homogêneos confeccionados com partículas de madeira de Eucalyptus sp e Pinus sp e de embalagens de película de polipropileno biorientado tendo, como adesivo, a resina poliuretana à base de óleo de mamona. Foram avaliadas as propriedades: inchamento em espessura e absorção de água, com corpo de prova com e sem impermeabilização, e massa específica. Concluiu-se que, dos fatores investigados, apenas o uso do impermeabilizante foi significativo. De acordo com a ANSI A208.1 (ANS, 1999 os paineis produzidos são classificados como de alta massa específica (H. Relativamente ao inchamento em espessura por 2 h, os paineis atenderam ao exigido pela NBR 14810 (ABNT, 2013 para espessura de 8 a 13 mm.

  14. Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study

    OpenAIRE

    Marine Garguilo; Michèle Lejaille; Isabelle Vaugier; David Orlikowski; Nicolas Terzi; Frédéric Lofaso; Hélène Prigent

    2016-01-01

    Background Respiratory involvement in neuromuscular disorders may contribute to impaired breathing-swallowing interactions, swallowing disorders and malnutrition. We investigated whether the use of non-invasive ventilation (NIV) controlled by the patient could improve swallowing performances in a population of neuromuscular patients requiring daytime NIV. Methods Ten neuromuscular patients with severe respiratory failure requiring extensive NIV use were studied while swallowing without and wi...

  15. Tetanic fade following administration of nondepolarizing neuromuscular blocking drugs.

    Science.gov (United States)

    Gibson, F M; Mirakhur, R K

    1989-06-01

    Fade in response to tetanic stimulation was studied following administration of atracurium 120 or 225 micrograms/kg, vecuronium 23 or 40 micrograms/kg, pancuronium 30 or 60 micrograms/kg, or d-tubocurarine 185 or 450 micrograms/kg. Ten patients received each dose and tetanic fade was measured at maximum block in the patients, who received the lower doses of the relaxants or at 10% recovery in those who received the higher doses. Fade during tetanic stimulation was generally similar in all the groups with the exception of the higher dose of pancuronium which showed a significantly greater fade in comparison with the higher doses of atracurium and d-tubocurarine. If fade in response to tetanic stimulation represents a prejunctional effect, the results from the present study suggest that neuromuscular blocking drugs cannot be differentiated with respect to their relative prejunctional effects by measurement of tetanic fade during established block after administration of clinically useful doses as used in the present study.

  16. Applications of Shape Memory Alloys for Neurology and Neuromuscular Rehabilitation

    Directory of Open Access Journals (Sweden)

    Simone Pittaccio

    2015-05-01

    Full Text Available Shape memory alloys (SMAs are a very promising class of metallic materials that display interesting nonlinear properties, such as pseudoelasticity (PE, shape memory effect (SME and damping capacity, due to high mechanical hysteresis and internal friction. Our group has applied SMA in the field of neuromuscular rehabilitation, designing some new devices based on the mentioned SMA properties: in particular, a new type of orthosis for spastic limb repositioning, which allows residual voluntary movement of the impaired limb and has no predetermined final target position, but follows and supports muscular elongation in a dynamic and compliant way. Considering patients in the sub-acute phase after a neurological lesion, and possibly bedridden, the paper presents a mobiliser for the ankle joint, which is designed exploiting the SME to provide passive exercise to the paretic lower limb. Two different SMA-based applications in the field of neuroscience are then presented, a guide and a limb mobiliser specially designed to be compatible with diagnostic instrumentations that impose rigid constraints in terms of electromagnetic compatibility and noise distortion. Finally, the paper discusses possible uses of these materials in the treatment of movement disorders, such as dystonia or hyperkinesia, where their dynamic characteristics can be advantageous.

  17. Neuromuscular disorders: genes, genetic counseling and therapeutic trials.

    Science.gov (United States)

    Zatz, Mayana; Passos-Bueno, Maria Rita; Vainzof, Mariz

    2016-01-01

    Neuromuscular disorders (NMD) are a heterogeneous group of genetic conditions, with autosomal dominant, recessive, or X-linked inheritance. They are characterized by progressive muscle degeneration and weakness. Here, we are presenting our major contributions to the field during the past 30 years. We have mapped and identified several novel genes responsible for NMD. Genotype-phenotype correlations studies enhanced our comprehension on the effect of gene mutations on related proteins and their impact on clinical findings. The search for modifier factors allowed the identification of a novel "protective"; variant which may have important implication on therapeutic developments. Molecular diagnosis was introduced in the 1980s and new technologies have been incorporated since then. Next generation sequencing greatly improved our capacity to identify disease-causing mutations with important benefits for research and prevention through genetic counseling of patients' families. Stem cells researches, from and for patients, have been used as tools to study human genetic diseases mechanisms and for therapies development. The clinical effect of preclinical trials in mice and canine models for muscular dystrophies are under investigation. Finally, the integration of our researches and genetic services with our post-graduation program resulted in a significant output of new geneticists, spreading out this expertise to our large country. PMID:27575431

  18. Degeneration of neuromuscular junction in age and dystrophy.

    Science.gov (United States)

    Rudolf, Rüdiger; Khan, Muzamil Majid; Labeit, Siegfried; Deschenes, Michael R

    2014-01-01

    Functional denervation is a hallmark of aging sarcopenia as well as of muscular dystrophy. It is thought to be a major factor reducing skeletal muscle mass, particularly in the case of sarcopenia. Neuromuscular junctions (NMJs) serve as the interface between the nervous and skeletal muscular systems, and thus they may receive pathophysiological input of both pre- and post-synaptic origin. Consequently, NMJs are good indicators of motor health on a systemic level. Indeed, upon sarcopenia and dystrophy, NMJs morphologically deteriorate and exhibit altered characteristics of primary signaling molecules, such as nicotinic acetylcholine receptor and agrin. Since a remarkable reversibility of these changes can be observed by exercise, there is significant interest in understanding the molecular mechanisms underlying synaptic deterioration upon aging and dystrophy and how synapses are reset by the aforementioned treatments. Here, we review the literature that describes the phenomena observed at the NMJ in sarcopenic and dystrophic muscle as well as to how these alterations can be reversed and to what extent. In a second part, the current information about molecular machineries underlying these processes is reported. PMID:24904412

  19. Verifax: Biometric instruments measuring neuromuscular disorders/performance impairments

    Science.gov (United States)

    Morgenthaler, George W.; Shrairman, Ruth; Landau, Alexander

    1998-01-01

    VeriFax, founded in 1990 by Dr. Ruth Shrairman and Mr. Alex Landau, began operations with the aim of developing a biometric tool for the verification of signatures from a distance. In the course of developing this VeriFax Autograph technology, two other related applications for the technologies under development at VeriFax became apparent. The first application was in the use of biometric measurements as clinical monitoring tools for physicians investigating neuromuscular diseases (embodied in VeriFax's Neuroskill technology). The second application was to evaluate persons with critical skills (e.g., airline pilots, bus drivers) for physical and mental performance impairments caused by stress, physiological disorders, alcohol, drug abuse, etc. (represented by VeriFax's Impairoscope prototype instrument). This last application raised the possibility of using a space-qualified Impairoscope variant to evaluate astronaut performance with respect to the impacts of stress, fatigue, excessive workload, build-up of toxic chemicals within the space habitat, etc. The three applications of VeriFax's patented technology are accomplished by application-specific modifications of the customized VeriFax software. Strong commercial market potentials exist for all three VeriFax technology applications, and market progress will be presented in more detail below.

  20. Development of neuromuscular organization in the ctenophore Pleurobrachia bachei.

    Science.gov (United States)

    Norekian, Tigran P; Moroz, Leonid L

    2016-01-01

    The phylogenetic position of the phylum Ctenophora and the nature of ctenphore nervous systems are highly debated topics in modern evolutionary biology. However, very little is known about the organization of ctenophore neural and muscular systems, and virtually nothing has been reported about their embryogenesis. Here we have characterized the neural and muscular development of the sea gooseberry, Pleurobrachia bachei, starting from the cleavage stages to posthatching larvae. Scanning electron microscopy and immunochemistry were used to describe the formation of the embryonic mouth, tentacles, combs, aboral organ, and putative sensory cells. The muscles started their specification at the end of the first day of Pleurobrachia development. In contrast, neurons appeared 2 days after myogenesis, just before the hatching of fully formed cydippid larvae. The first tubulin-immunoreactive neurons, a small group of four to six cells with neuronal processes, was initially recognized at the aboral pole during the third day of development. Surprisingly, this observed neurogenesis occurred after the emergence of distinct behavioral patterns in the embryos. Thus, the embryonic behavior associated with comb cilia beatings and initial muscle organization does not require morphologically defined neurons and their elongated neurites. This study provides the first description of neuromuscular development in the enigmatic ctenophores and establishes the foundation for future research using emerging genomic tools and resources.

  1. Neuromuscular characteristics and fatigue during 10 km running.

    Science.gov (United States)

    Paavolainen, L; Nummela, A; Rusko, H; Häkkinen, K

    1999-11-01

    This study investigated neuromuscular characteristics and fatigue during 10 km running (10 K) performance in well-trained endurance athletes with different distance running capability. Nine high (HC) and ten low (LC) caliber endurance athletes performed the 10 K on a 200 m indoor track, constant velocity lap (CVL, 4.5 m x s(-1)) 5 times during the course of the 10 K and maximal 20 m speed test before (20 m(b)) and after (20 m(a)) the 10 K. Running velocity (V), ground contact times (CT), ground reaction forces (F) and electromyographic activity (EMG) of the leg muscles (vastus lateralis; VL, biceps femoris; BF, gastrocnemius; GA) were measured during 20 m(b), 20 m(a), and CVLs. The 10 K times differed (pactivity of GA in relation to the IEMG of the total contact phase during the CVLs was higher (prun did not differentiate endurance athletes with different V10K. However, a capability to produce force rapidly throughout the 10 K accompanied with optimal preactivation and contact phase activation seem to be important for 10 km running performance in well trained endurance athletes.

  2. Nocturnal hypoxaemia and hypercapnia in children with neuromuscular disorders.

    Science.gov (United States)

    Bersanini, Chiara; Khirani, Sonia; Ramirez, Adriana; Lofaso, Frédéric; Aubertin, Guillaume; Beydon, Nicole; Mayer, Michèle; Maincent, Kim; Boulé, Michèle; Fauroux, Brigitte

    2012-05-01

    The aim of the study was to identify daytime predictors of nocturnal gas exchange anomalies in children with neuromuscular disease (NMD) and normal daytime gas exchange. Lung function tests, respiratory muscle evaluation and nocturnal gas exchange were obtained as part of routine evaluation. We included 52 consecutive children with Duchenne muscular dystrophy (n = 20), spinal muscular atrophy (n = 10) and other NMD (n = 22). 20 patients had nocturnal hypoxaemia, defined as minimal arterial oxygen saturation measured by pulse oximetry (S(p,O(2))) carbon dioxide tension (P(tc,CO(2))) >50 mmHg for ≥ 2% of night time. Forced vital capacity and helium functional residual capacity correlated with minimal nocturnal S(p,O(2)) (p = 0.009 and p = 0.01, respectively). Daytime pH correlated negatively with maximal nocturnal P(tc,CO(2)) (p=0.005) and daytime arterial carbon dioxide tension (P(a,CO(2))) correlated with the percentage of time with a P(tc,CO(2)) >50 mmHg (p = 0.02). Sniff nasal inspiratory pressure correlated with minimal nocturnal S(p,O(2)) (p = 0.02). Daytime P(a,CO(2)) was a weak predictor of nocturnal hypercapnia (sensitivity 80%; specificity 57%). Daytime lung function and respiratory muscle parameters correlate poorly with nocturnal hypoxaemia and hypercapnia in children with NMD and normal daytime gas exchange, which necessitates more systematic sleep studies in these children. PMID:22135279

  3. Neuromuscular factors related to success in Olympic wrestling

    Directory of Open Access Journals (Sweden)

    Alfonso Martínez-Moreno

    2011-03-01

    Full Text Available AbstractThis study was undertaken to determine the relationship between maximum dynamic and isometric strength and success in male and female Olympic wrestling. Thirty-five female and thirty-seven male wrestlers were assigned into 4 groups according to their gender and competitive level: men elite (♂ ET, n = 18 and amateur (AT ♂, n = 19 and female elite (♀ ET n = 13 and amateur (AT ♀, n = 22. All subjects underwent assessments of body composition, countermovement jump, maximum dynamic strength test in full squat and bench press exercises and maximum isometric strength test of grip and hip extension. All the neuromuscular markers studied showed significantly higher values in the two elite groups compared to their respective amateur groups results, except the jump height between ♀ET y ♀AT, where no significant differences were detected. The present results suggest that the higher maximum isometric and dynamic strength values, explained in part by the differences in lean mass, will give elite wrestlers a clear advantage during the most frequently used techniques in Olympic wrestling. Key  Words: bench press; squat; maximum dynamic strength; maximum isometric strength; combat.

  4. Pseudoephedrine and circadian rhythm interaction on neuromuscular performance.

    Science.gov (United States)

    Pallarés, J G; López-Samanes, Á; Fernández-Elías, V E; Aguado-Jiménez, R; Ortega, J F; Gómez, C; Ventura, R; Segura, J; Mora-Rodríguez, R

    2015-12-01

    This study analyzed the effects of pseudoephedrine (PSE) provided at different time of day on neuromuscular performance, side effects, and violation of the current doping cut-off threshold [World Anti-Doping Agency (WADA)]. Nine resistance-trained males carried out bench press and full squat exercises against four incremental loads (25%, 50%, 75%, and 90% one repetition maximum [1RM]), in a randomized, double-blind, cross-over design. Participants ingested either 180 mg of PSE (supra-therapeutic dose) or placebo in the morning (7:00 h; AM(PLAC) and AM(PSE)) and in the afternoon (17:00 h; PM(PLAC) and PM(PSE)). PSE enhanced muscle contraction velocity against 25% and 50% 1RM loads, only when it was ingested in the mornings, and only in the full squat exercise (4.4-8.7%; P < 0.05). PSE ingestion raised urine and plasma PSE concentrations (P < 0.05) regardless of time of day; however, cathine only increased in the urine samples. PSE ingestion resulted in positive tests occurring in 11% of samples, and it rose some adverse side effects such us tachycardia and heart palpitations. Ingestion of a single dose of 180 mg of PSE results in enhanced lower body muscle contraction velocity against low and moderate loads only in the mornings. These mild performance improvements are accompanied by undesirable side effects and an 11% risk of surpassing the doping threshold.

  5. Neuromuscular adjustments of the quadriceps muscle after repeated cycling sprints.

    Directory of Open Access Journals (Sweden)

    Olivier Girard

    Full Text Available PURPOSE: This study investigated the supraspinal processes of fatigue of the quadriceps muscle in response to repeated cycling sprints. METHODS: Twelve active individuals performed 10 × 6-s "all-out" sprints on a cycle ergometer (recovery = 30 s, followed 6 min later by 5 × 6-s sprints (recovery = 30 s. Transcranial magnetic and electrical femoral nerve stimulations during brief (5-s and sustained (30-s isometric contractions of the knee extensors were performed before and 3 min post-exercise. RESULTS: Maximal strength of the knee extensors decreased during brief and sustained contractions (~11% and 9%, respectively; P0.05. While cortical voluntary activation declined (P 40% reduced (P<0.001 following exercise. CONCLUSION: The capacity of the motor cortex to optimally drive the knee extensors following a repeated-sprint test was shown in sustained, but not brief, maximal isometric contractions. Additionally, peripheral factors were largely involved in the exercise-induced impairment in neuromuscular function, while corticospinal excitability was well-preserved.

  6. An examination of neuromuscular and metabolic fatigue thresholds

    International Nuclear Information System (INIS)

    This study examined the relationships among the physical working capacity at the fatigue threshold (PWCFT), the power outputs associated with the gas exchange threshold (PGET) and the respiratory compensation point (PRCP), and critical power (CP) to identify possible physiological mechanisms underlying the onset of neuromuscular fatigue. Ten participants (mean ± SD age: 20 ± 1 years) performed a maximal incremental cycle ergometer test to determine the PWCFT, PGET, and PRCP. CP was determined from the 3 min all-out test. The PWCFT (197 ± 55 W), PRCP (212 ± 50 W), and CP (208 ± 63 W) were significantly greater than the PGET (168 ± 40 W), but there were no significant differences among the PWCFT, PRCP, and CP. All thresholds were significantly inter-4 (r = 0.794–0.958). The 17% greater estimates for the PWCFT than PGET were likely related to differences in the physiological mechanisms that underlie these fatigue thresholds, while the non-significant difference and high correlation between the PWCFT and the PRCP suggested that hyperkalemia may underlie both thresholds. Furthermore, it is possible that the 5% lower estimate of the PWCFT than CP could more accurately reflect the demarcation of the heavy from severe exercise intensity domains. (paper)

  7. Safe neuromuscular electrical stimulator designed for the elderly.

    Science.gov (United States)

    Krenn, Matthias; Haller, Michael; Bijak, Manfred; Unger, Ewald; Hofer, Christian; Kern, Helmut; Mayr, Winfried

    2011-03-01

    A stimulator for neuromuscular electrical stimulation (NMES) was designed, especially suiting the requirements of elderly people with reduced cognitive abilities and diminished fine motor skills. The aging of skeletal muscle is characterized by a progressive decline in muscle mass, force, and condition. Muscle training with NMES reduces the degradation process. The discussed system is intended for evoked muscle training of the anterior and posterior thigh. The core of the stimulator is based on a microcontroller with two modular output stages. The system has two charge-balanced biphasic voltage-controlled stimulation channels. Additionally, the evoked myoelectric signal (M-wave) and the myokinematic signal (surface acceleration) are measured. A central controller unit allows using the stimulator as a stand-alone device. To set up the training sequences and to evaluate the compliance data, a personal computer is connected to the stimulator via a universal serial bus. To help elderly people handle the stimulator by themselves, the user interface is kept very simple. For safety reasons, the electrode impedance is monitored during stimulation. A comprehensive compliance management with included measurements of muscle activity and stimulation intensity enables a scientific use of the stimulator in clinical trials.

  8. [Critical study of radiculomedullary and neuromuscular complications of ankylosing spondylitis].

    Science.gov (United States)

    Serratrice, G; Acquaviva, P; Pouget, J; Guerra, L

    1987-03-01

    Medullo-radicular and neuro-muscular involvements of ankylosing spondylarthritis, often reported in an analytic fashion in the literature, deserve to be the subject of a critical study. Various neurological manifestations secondary to exceptional atlo-occipital and sometimes axis-atlas subluxations and medullary lesions as well as syndromes of the cauda equina. The medullary lesions have an epidural origin (3 cases in the literature, 2 cases from the authors) or are secondary to a spondylodiscitis (4 cases in the literature) or secondary to both (1 case reported by the authors). As for syndromes of the cauda equina the authors report 3 cases to be added to the 55 published previously. It concerns always old spondylarthritis. The lesions combine posterior diverticula and lesions of the lamina. The treatment is usually ineffective. A special case is represented by forms with trophic disorders. More debatable are the radicular lesions, which, except for intercostal pain, should be linked to local pain. Electromyographic abnormalities are of no significance. Alterations of the paravertebral muscles viewed on the scanner X have, for now, an uncertain significance. Finally, various associations, without significance such as multiple sclerosis, diffuse muscular lesions and the classic spondylotic pseudo-tabes, should be rejected.

  9. [Cellular therapy and gene therapy: perspectives in neuromuscular pathology].

    Science.gov (United States)

    Fardeau, M

    1993-10-01

    Identification of the gene coding for the protein (dystrophin) which is lacking or abnormal in Duchenne or Becker type human muscular dystrophies was a decisive turning point in neuro-muscular pathology. Since that time, a considerable number of gene abnormalities have been identified or at least localized. The severity of these diseases, their steady evolution and the absence of any efficient drug therapy, have lead to the development of new therapeutic approaches based on restoring the genetic capacities of the muscle cell. There are two possibilities for therapy. The first is based on the transfer of myogenic cells derived from the 'satellite' cells normally present at the periphery of muscle fibers. The results obtained from a murine model of Duchenne dystrophy ('mdx' mouse) were very promising. However, the results from application of the same techniques to the canine model (GRMDX) or to affected children are, at the present time, disappointing. A number of biological questions remain to be solved before this technique can be more extensively applied to humans. The second possibility is based on gene transfer, through a viral vector. The adenovirus is presently a possible vector. The first experimental results, on 'mdx' mice, are again very encouraging. Extension of these studies to the canine model is a necessary prerequisite for any human application. It should be noted that these two approaches are complementary. Their future applications may depend on the diffuse or selective nature of the skeletal muscle atrophy, and on whether cardiac and respiratory muscles are involved. PMID:8290312

  10. Bloqueio do nervo frênico após realização de bloqueio do plexo braquial pela via interescalênica: relato de caso A bloqueo del nervio frénico después de la realización de bloqueo del plexo braquial por la vía interescalénica: relato de caso Phrenic nerve block after interscalene brachial plexus block: case report

    Directory of Open Access Journals (Sweden)

    Luis Henrique Cangiani

    2008-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Bloqueio do nervo frênico é um evento adverso do bloqueio do plexo braquial; entretanto, na sua maioria, sem repercussões clínicas importantes. O objetivo deste relato foi apresentar um caso em que ocorreu bloqueio do nervo frênico, com comprometimento ventilatório, em paciente com insuficiência renal crônica submetido a instalação de fístula arteriovenosa extensa, sob bloqueio do plexo braquial pela via perivascular interescalênica. RELATO DO CASO: Paciente do sexo masculino, 50 anos, tabagista, portador de insuficiência renal crônica em regime de hemodiálise, hipertensão arterial, hepatite C, diabetes mellitus, doença pulmonar obstrutiva crônica, a ser submetido à instalação de fístula arteriovenosa extensa no membro superior direito sob bloqueio de plexo braquial pela via interescalênica. O plexo braquial foi localizado com utilização do estimulador de nervo periférico. Foram injetados 35 mL de uma solução de anestésico local, constituída de uma mistura de lidocaína a 2% com epinefrina a 1:200.000 e ropivacaína a 0,75% em partes iguais. Ao final da injeção o paciente apresentava-se lúcido, porém com dispnéia e predomínio de incursão respiratória intercostal ipsilateral ao bloqueio. Não havia murmúrio vesicular na base do hemitórax direito. A SpO2 manteve-se em 95%, com cateter nasal de oxigênio. Não foi necessária instalação de métodos de auxílio ventilatório invasivo. Radiografia do tórax revelou que o hemidiafragma direito ocupava o 5° espaço intercostal. O quadro clínico foi revertido em três horas. CONCLUSÕES: O caso mostrou que houve paralisia total do nervo frênico com sintomas respiratórios. Apesar de não ter sido necessária terapêutica invasiva para o tratamento, fica o alerta para a restrição da indicação da técnica nesses casos.JUSTIFICATIVA Y OBJETIVOS: El bloqueo del nervio frénico es un evento adverso del bloqueo del plexo braquial, sin

  11. Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward

    Directory of Open Access Journals (Sweden)

    de Araújo Carlos José Soares

    2012-11-01

    Full Text Available Abstract Background Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. Methods This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failure treatment in a tertiary cardiology hospital. Patients in the intervention group performed a conventional rehabilitation and neuromuscular electrostimulation. Patients underwent 60 minutes of electrostimulation (wave frequency was 20 Hz, pulse duration of 20 us two times a day for consecutive days until hospital discharge. Results The walked distance in the six-minute walking test improved 75% in the electrostimulation group (from 379.7 ± 43.5 to 372.9 ± 46.9 meters to controls and from 372.9 ± 62.4 to 500 ± 68 meters to electrostimulation, p Conclusion The neuromuscular electrostimulation group showed greater improvement in the walked distance in the six-minute walking test in patients admitted to ward for compensation of heart failure.

  12. A Dutch guideline for the treatment of scoliosis in neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Titarsolej PJ

    2008-09-01

    Full Text Available Abstract Background Children with neuromuscular disorders with a progressive muscle weakness such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy frequently develop a progressive scoliosis. A severe scoliosis compromises respiratory function and makes sitting more difficult. Spinal surgery is considered the primary treatment option for correcting severe scoliosis in neuromuscular disorders. Surgery in this population requires a multidisciplinary approach, careful planning, dedicated surgical procedures, and specialized after care. Methods The guideline is based on scientific evidence and expert opinions. A multidisciplinary working group representing experts from all relevant specialties performed the research. A literature search was conducted to collect scientific evidence in answer to specific questions posed by the working group. Literature was classified according to the level of evidence. Results For most aspects of the treatment scientific evidence is scarce and only low level cohort studies were found. Nevertheless, a high degree of consensus was reached about the management of patients with scoliosis in neuromuscular disorders. This was translated into a set of recommendations, which are now officially accepted as a general guideline in the Netherlands. Conclusion In order to optimize the treatment for scoliosis in neuromuscular disorders a Dutch guideline has been composed. This evidence-based, multidisciplinary guideline addresses conservative treatment, the preoperative, perioperative, and postoperative care of scoliosis in neuromuscular disorders.

  13. RANDOMIZED CLINICAL TRIAL TO COMPARE THE INCIDENCE OF RESIDUAL NEUROMUSCULAR BLOCK FOLLOWING PANCURONIUM AND ATRACURIUM USING TRAIN OF FOUR RATIO

    Directory of Open Access Journals (Sweden)

    Nagesha

    2014-04-01

    Full Text Available BACKGROUND: Several clinical studies have reported that significant number of patients receiving non depolarizing muscle relaxants during general anesthesia show postoperative residual neuromuscular block when assessed by neuromuscular monitor in the recovery room. The degree of residual neuromuscular block produced by non-depolarizing muscle relaxants can be evaluated by clinical tests as well as by neuromuscular monitoring y neuromuscular monitor in the recovery room. A randomized double blind clinical trial to determine and compare the incidence of postoperative residual neuromuscular block in patients receiving pancuronium and atracurium applying Train of Four ratio using Train of Four- Guard neuromuscular monitor. AIMS AND OBJECTIVES: To compare the incidence of postoperative residual neuromuscular block following pancuronium and atracurium using Train of Four Ratio in the recovery room. MATERIALS AND METHODS: Comparative randomized study done using 100 patients of age between 15-60 years belonging to either sex, ASA grade 1 and 2 with GROUP ‘P’ – Pancuronium was employed as the muscle relaxant, GROUP ‘A’ – Atracurium was employed as the muscle relaxant. Statistical analysis done using student “t” test. RESULTS: The mean duration required to attain Train of Four Ratio of 0.80 in patients with initial Train of four ratio <0.80 in group ‘P’ was 9.65±5.4413 min and in group ‘A’ was 2.8± 1.4832 min. CONCLUSION: 1. Our study concludes that the incidence of residual neuromuscular block in patients receiving pancuronium and atracurium were 40% and 10% respectively. Thus residual neuromuscular block can be a significant problem in recovery room, during the postoperative period. 2. The use of intermediate acting non depolarizing muscle relaxant like atracurium lowers the incidence of residual neuromuscular block but does not eliminate it.

  14. Jornalismo em segunda tela. Webjornal produzido com dispositivos móveis em redação virtual

    Directory of Open Access Journals (Sweden)

    Zanei Ramos Barcellos

    2014-12-01

    Full Text Available Este artigo inicialmente aborda o uso de dispositivos móveis pessoais, portáteis, interativos e multimídias nas várias etapas da produção, distribuição e consumo de produtos e conteúdos jornalísticos. Discute a possibilidade de o trabalho jornalístico ser feito totalmente no ciberespaço de forma remota. Também propõe o uso dos termos “redação virtual” e “jornalismo em segunda tela” amparado pela narrativa transmidiática. Num segundo momento, o trabalho relata a experiência de produção, formatação e distribuição de conteúdos jornalísticos multimídia em segunda tela, usando dispositivos móveis e em redação virtual. O objetivo é produzir matérias direcionada a mídias que sejam mais adequadas à cada notícia, tendo um telejornal de grande audiência como primeira tela. A transmissão paralela ao Jornal Nacional, da Rede Globo de Televisão, levantou antecipadamente suas pautas e produziu matérias sobre os mesmos temas, mas com foco local. Esse jornal, o #Tela2, foi produzido por alunos do curso de Jornalismo da Pontifícia Universidade Católica do Paraná (PUCPR. O artigo expõe também o processo de criação e de planejamento, e detalha todas as etapas da produção realizada pelos alunos, acompanhadas de avaliações críticas. As turmas mesclaram-se e dividiram-se em equipes para desempenhar diferentes tarefas: conselho editorial, rádio-escuta, redes sociais, reportagem de televisão, reportagem de rádio, reportagem de jornal (texto e foto, reportagem com texto coletivo em tempo real. Também foram designadas equipes para a realização de três entradas ao vivo: câmera fixa para televisão, matéria de televisão ao vivo (câmara viva e entrevista de rádio. Os resultados apontam que a experimentação foi satisfatória ao demonstrar ser possível realizar jornalismo integralmente em redações virtuais, usando apenas dispositivos móveis comuns na atualidade em todas as etapas do fazer jornal

  15. Bonfils Fiberscope: Intubating Conditions and Hemodynamic Changes without Neuromuscular Blockade

    Directory of Open Access Journals (Sweden)

    Atabak Najafi

    2011-04-01

    Full Text Available To compare intubating conditions and hemodynamic changes between Bonfils Intubation Fiberscope and Macintosh laryngoscopy without administering neuromuscular blocking drugs (NMBDs. METHODS: In this randomized controlled trial,80 male and female patients, scheduled for elective surgery, aged 15 to 60 years, ASA class II or I, non-obese, non smokers, without anticipated difficult intubation; were randomly allocated into two groups of 40: Bonfils and Macintosh. Following adequate hydration and preoxygenation, midazolam 0.03 mg.kg-1 was administered, followed by intravenous alfentanil 20 µg.kg-1, lidocaine 1.0 mg.kg-1, and propofol 2 mg.kg-1 sequentially. Trachea was then intubated using Bonfils Intubation Fiberscope in the Bonfils group and conventional Macintosh laryngoscopy in the Macintosh group. Intubating condition, mean arterial blood pressure, heart rate, pulse oximetry, and success rate were measured. RESULTS: Clinically acceptable intubating condition scores did not differ significantly between the groups (P=0.465. Compared to the baseline values, heart rate rose significantly after intubation only in the Macintosh group (P<0.001. Although mean arterial blood pressure increased immediately after intubation in the Macintosh group (P=0.022, its post-intubation values were significantly less than baseline in both groups (P<0.001. Intubation time took much longer in the Bonfils group (40 s than the Macintosh group (11 s, P<0.001. In the absence of NMBDs, Bonfils Intubation Fiberscope compares well with Macintosh laryngoscopy in terms of success rate and intubating conditions, but with less mechanical stress and hemodynamic compromise and longer intubation time.

  16. Lower Limb Neuromuscular Asymmetry in Volleyball and Basketball Players

    Directory of Open Access Journals (Sweden)

    Fort-Vanmeerhaeghe Azahara

    2016-04-01

    Full Text Available The primary objective of the present study was to evaluate the agreement between the dominant leg (DL (determined subjectively and the stronger leg (SL (determined via a functional test in a group of basketball and volleyball players. The secondary objective was to calculate lower limb neuromuscular asymmetry when comparing the DL vs the non-dominant leg (NDL and the SL vs the weaker (WL leg in the whole group and when differentiating by sex. Seventy-nine male and female volleyball and basketball players (age: 23.7 ± 4.5 years performed three single-leg vertical countermovement jumps (SLVCJ on a contact mat. Vertical jump height and an inter-limb asymmetry index (ASI were determined. Only 32 (40% of the subjects had a concordance between the perception of their dominant leg and the limb reaching the highest jump height. Using the DL as the discriminating variable, significant (p<0.05 inter-limb differences were found in the total group of players. When comparing between sexes, significant differences (p<0.05 arose in the female group only. With regard to the WL vs. the SL, significant (p<0.05 differences were noted in the whole group and when stratified into males and females. The mean ASI ranged from 9.31% (males to 12.84% (females and from 10.49% (males to 14.26% (females, when comparing the DL vs. the NDL and the SL vs. the WL, respectively. Subjective expression of leg dominance cannot be used as a predictor of limb jump performance. Vertical jump asymmetry of 10-15% exists and this can be considered as a reference value for male and female basketball and volleyball players.

  17. Efeitos neuromusculares e cardiovasculares do pipecurônio: estudo comparativo entre diferentes doses Efectos neuromusculares y cardiovasculares del pipecuronio: estudio comparativo entre diferentes dosis Neuromuscular and cardiovascular effects of pipecuronium: a comparative study between different dose

    OpenAIRE

    Angélica de Fátima de Assunção Braga; Leandro Yoshioka; Franklin Sarmento da Silva Braga; Gloria Maria Braga Potério; José Aristeu F Frias; Rita de Cássia Rodrigues

    2008-01-01

    JUSTIFICATIVA E OBJETIVOS: O pipecurônio é um bloqueador neuromuscular não-despolarizante, com propriedades similares as do pancurônio, mas desprovido de efeitos cardiovasculares. Foram avaliados os efeitos neuromusculares, as condições de intubação traqueal e as repercussões hemodinâmicas de duas diferentes doses de pipecurônio. MÉTODO: Pacientes foram distribuídos em dois grupos de acordo com a dose de pipecurônio: Grupo I (0,04 mg.kg-1) e Grupo II (0,05 mg.kg-1). A medicação pré-anestésica...

  18. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study

    DEFF Research Database (Denmark)

    Sorgenfrei, Iben F; Norrild, Kathrine; Larsen, Per Bo;

    2006-01-01

    Sugammadex (Org 25969) forms a complex with steroidal neuromuscular blocking agents, thereby reversing neuromuscular block. This study investigated the dose-response relation, safety, and pharmacokinetics of sugammadex to reverse rocuronium-induced block....

  19. Use of neuromuscular monitoring to detect prolonged effect of succinylcholine or mivacurium

    DEFF Research Database (Denmark)

    Cassel, J; Staehr-Rye, A K; Nielsen, C V;

    2014-01-01

    Mutations in the butyrylcholinesterase gene can lead to a prolonged effect of the neuromuscular blocking agents, succinylcholine and mivacurium. If the anaesthesiologist is not aware of this condition, it may result in insufficient respiration after tracheal extubation. However, this can be avoided...... effect of the neuromuscular blocking agent was not discovered until after extubation. In the third patient, the lack of response to nerve stimulation was interpreted as a technical failure and the prolonged effect of succinylcholine was discovered when general anaesthesia was terminated. Both patients...... had insufficient respiration. They were therefore re-sedated, transferred to the intensive care unit and the tracheas were extubated after full recovery from neuromuscular blockade. We recommend the use of monitoring every time these agents are used, even with short-acting drugs like succinylcholine...

  20. Effect of exercise therapy on neuromuscular activity and knee strength in female adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S.; Samani, Afshin; Olesen, Jens L.;

    2016-01-01

    BACKGROUND: Female adolescents with patellofemoral pain are characterized by altered neuromuscular knee control and reduced maximal quadriceps torque. The purpose of this study is to investigate whether exercise therapy and patient education are associated with larger improvements in neuromuscular...... knee control and maximal quadriceps torque compared with patient education alone. METHODS: This is an ancillary analysis of a cluster randomized controlled trial investigating the effect of patient education and exercise therapy on self-reported recovery in 121 adolescents with patellofemoral pain...... flexion/extension kinematics and maximal quadriceps torque. FINDINGS: There was an 8-15% greater decrease in the complexity of surface electromyography suggesting an improvement in neuromuscular knee control among those randomized to exercise therapy (0.08

  1. Sympathetic innervation controls homeostasis of neuromuscular junctions in health and disease.

    Science.gov (United States)

    Khan, Muzamil Majid; Lustrino, Danilo; Silveira, Willian A; Wild, Franziska; Straka, Tatjana; Issop, Yasmin; O'Connor, Emily; Cox, Dan; Reischl, Markus; Marquardt, Till; Labeit, Dittmar; Labeit, Siegfried; Benoit, Evelyne; Molgó, Jordi; Lochmüller, Hanns; Witzemann, Veit; Kettelhut, Isis C; Navegantes, Luiz C C; Pozzan, Tullio; Rudolf, Rüdiger

    2016-01-19

    The distribution and function of sympathetic innervation in skeletal muscle have largely remained elusive. Here we demonstrate that sympathetic neurons make close contact with neuromuscular junctions and form a network in skeletal muscle that may functionally couple different targets including blood vessels, motor neurons, and muscle fibers. Direct stimulation of sympathetic neurons led to activation of muscle postsynaptic β2-adrenoreceptor (ADRB2), cAMP production, and import of the transcriptional coactivator peroxisome proliferator-activated receptor γ-coactivator 1α (PPARGC1A) into myonuclei. Electrophysiological and morphological deficits of neuromuscular junctions upon sympathectomy and in myasthenic mice were rescued by sympathicomimetic treatment. In conclusion, this study identifies the neuromuscular junction as a target of the sympathetic nervous system and shows that sympathetic input is crucial for synapse maintenance and function. PMID:26733679

  2. Local identifiability and sensitivity analysis of neuromuscular blockade and depth of hypnosis models.

    Science.gov (United States)

    Silva, M M; Lemos, J M; Coito, A; Costa, B A; Wigren, T; Mendonça, T

    2014-01-01

    This paper addresses the local identifiability and sensitivity properties of two classes of Wiener models for the neuromuscular blockade and depth of hypnosis, when drug dose profiles like the ones commonly administered in the clinical practice are used as model inputs. The local parameter identifiability was assessed based on the singular value decomposition of the normalized sensitivity matrix. For the given input signal excitation, the results show an over-parameterization of the standard pharmacokinetic/pharmacodynamic models. The same identifiability assessment was performed on recently proposed minimally parameterized parsimonious models for both the neuromuscular blockade and the depth of hypnosis. The results show that the majority of the model parameters are identifiable from the available input-output data. This indicates that any identification strategy based on the minimally parameterized parsimonious Wiener models for the neuromuscular blockade and for the depth of hypnosis is likely to be more successful than if standard models are used.

  3. Naturally occurring plant polyphenols as potential therapies for inherited neuromuscular diseases.

    Science.gov (United States)

    Fuller, Heidi R; Humphrey, Emma L; Morris, Glenn E

    2013-11-01

    There are several lines of laboratory-based evidence emerging to suggest that purified polyphenol compounds such as resveratrol, found naturally in red grapes, epigallocatechin galate from green tea and curcumin from turmeric, might be useful for the treatment of various inherited neuromuscular diseases, including spinal muscular atrophy, Duchenne muscular dystrophy and Charcot-Marie-Tooth disease. Here, we critically examine the scientific evidence related to the known molecular effects that these polyphenols have on different models of inherited neuromuscular disease, with particular attention to problems with the validity of in vitro evidence. We also present proteomic evidence that polyphenols have in vitro effects on cells related to metal ion chelation in cell-culture media. Although their precise mechanisms of action remain somewhat elusive, polyphenols could be an attractive approach to therapy for inherited neuromuscular disease, especially since they may be safer to use on young children, compared with some of the other drug candidates.

  4. [Prolonged neuromuscular block induced by mivacurium in a patient treated with cyclophosphamide].

    Science.gov (United States)

    Vigouroux, D; Voltaire, L

    1995-01-01

    A case is reported of prolonged neuromuscular block after mivacurium chloride for laparoscopic cholecystectomy, in a 45 years old patient, treated with cyclophosphamide for a Wegener's granulomatosis. The neuromuscular function monitoring by train-of-four showed a duration of action of 75 min after an intubation dose of 0.20 mg.kg-1. Additional bolus of 1 mg, corresponding to 25% of usual doses, every 10 or 15 min, were sufficient for maintaining muscle relaxation. Spontaneous recovery, without any antagonization, lasted 40 min for a TOF ratio (T4/T1) > or = 70%. Recovery index from 25 to 75% were 13 min. Plasma butyrilcholinesterases activity were reduced to a level of 50%. With reference to literature about succinylcholine, the responsibility of cyclophosphamide is likely, and discussed. This observation shows the value of monitoring the neuromuscular transmission. PMID:8745976

  5. Update on the approach of respiratory therapy in patients with neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Priscilla Barreto Paula

    2010-03-01

    Full Text Available Objective: To assess the role of physiotherapy in approaching neuromuscular disease (NMD, with emphasis on preventive and therapeutic aspects of respiratory therapy. Methods: A nonsystematic literature review covering the past twenty years, using the databases MEDLINE and LILACS through the following descriptors: neuromuscular diseases, physical therapy, vital capacity and respiratory failure. Results: The studies reviewed show the need to establish a routine periodic evaluation of respiratory function in order to introduce physical therapy measures relevant to each stage of the disease. The monitoring should include pulmonary function tests and specific techniques of chest physiotherapy, in order to avoid complications such as respiratory failure. Conclusion: The introduction of regular monitoring and preventive physiotherapy measures have helped to increase survival and improve quality of life of patients with neuromuscular diseases.

  6. Analgesia, sedation, and neuromuscular blockade during targeted temperature management after cardiac arrest.

    Science.gov (United States)

    Riker, Richard R; Gagnon, David J; May, Teresa; Seder, David B; Fraser, Gilles L

    2015-12-01

    The approach to sedation, analgesia, and neuromuscular blockade during targeted temperature management (TTM) remains largely unstudied, forcing clinicians to adapt previous research from other patient environments. During TTM, very little data guide drug selection, doses, and specific therapeutic goals. Sedation should be deep enough to prevent awareness during neuromuscular blockade, but titration is complex as metabolism and clearance are delayed for almost all drugs during hypothermia. Deeper sedation is associated with prolonged intensive care unit (ICU) and ventilator therapy, increased delirium and infection, and delayed wakening which can confound early critical neurological assessments, potentially resulting in erroneous prognostication and inappropriate withdrawal of life support. We review the potential therapeutic goals for sedation, analgesia, and neuromuscular blockade during TTM; the adverse events associated with that treatment; data suggesting that TTM and organ dysfunction impair drug metabolism; and controversies and potential benefits of specific monitoring. We also highlight the areas needing better research to guide our therapy. PMID:26670815

  7. Interpretation of electroneuromyographic studies in diseases of neuromuscular junction and myopathies

    Directory of Open Access Journals (Sweden)

    Mansukhani Khushnuma

    2008-01-01

    Full Text Available Electroneuromyography (ENMG also called electrodiagnosis or at times simply (and erroneously electromyography (EMG, has been used for the diagnosis of neuromuscular and muscle diseases. It consists of tests done serially and assessed collectively, to arrive at a diagnosis of neuromuscular weakness. The test should be treated as an extension of the clinical examination and not a replacement. When done adequately ENMG is the only test which gives information about the function of the peripheral nervous system and hence co-relates well with the clinical signs. This article reviews the role of ENMG in the evaluation of neuromuscular and muscle disease. We hope this will meet the requirements of both practicing neurologists and dedicated electromyographers.

  8. The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players

    DEFF Research Database (Denmark)

    Zebis, Mette K; Bencke, Jesper; Andersen, Lars;

    2008-01-01

    and 8 female elite team handball players aged 26 +/- 3 years at the start of the study. INTERVENTION: The subjects participated in a specific neuromuscular training program previously shown to reduce non-contact ACL injury. METHODS: Neuromuscular activity at the knee joint, joint angles at the hip and...

  9. Caracterização físico-química e perfil lipídico de queijos produzidos com leite ovino

    Directory of Open Access Journals (Sweden)

    Luiz Gustavo de Pellegrini

    2013-10-01

    Full Text Available Este trabalho teve por objetivo caracterizar os queijos Pecorino Toscano, Feta e Labneh produzidos com leite ovino quanto aos aspectos físico-químicos e perfil lipídico. Foram adquiridos e analisados queijos tipo Pecorino Toscano Fresco, com 90, 180 e 270 dias de maturação, Feta e Labneh elaborados com leite de ovelha, comercializados no estado do Rio Grande do Sul, Brasil. As análises realizadas foram: pH, acidez titulável, proteína, gordura, umidade, cinzas e perfil de ácidos graxos. O maior pH ocorreu nos queijos tipo Pecorino Toscano com 180 dias de maturação e Feta. Em relação à acidez titulável estes apresentaram comportamento contrário ao do pH. Os valores de proteína oscilaram entre 15,98 e 28,29% m/m, sendo os maiores valores para os queijos com maior tempo de maturação. A gordura apresentou variação idêntica à proteína, onde os queijos tipo Pecorino Toscano com 180 e 270 dias de maturação apresentaram maior valor. Os valores de umidade apresentaram-se inversos ao tempo de maturação, sendo que os queijos com 270, 180 e 90 dias de maturação apresentaram valores de 25,14, 25,95 e 30,26% m/m respectivamente. As cinzas também se demonstraram maiores para os queijos maturados. Em relação ao perfil lipídico, foram identificados 23 ácidos graxos, ocorrendo diferença significativa na maioria dos resultados, inclusive no somatório dos ácidos graxos saturados, monoinsaturados, poliinsaturados e na relação entre insaturados e saturados. Portanto, devido à escassez de informações sobre a composição de queijos produzidos com leite ovino, outras pesquisas devem ser realizadas para caracterizar de forma consistente estes produtos.

  10. Neuromuscular factors related to success in Olympic wrestling FACTORES NEUROMUSCULARES RELACIONADOS CON EL RENDIMIENTO EN LUCHA OLÍMPICA

    Directory of Open Access Journals (Sweden)

    Francisco Borrego

    2011-03-01

    Full Text Available AbstractThis study was undertaken to determine the relationship between maximum dynamic and isometric strength and success in male and female Olympic wrestling. Thirty-five female and thirty-seven male wrestlers were assigned into 4 groups according to their gender and competitive level: men elite (♂ ET, n = 18 and amateur (AT ♂, n = 19 and female elite (♀ ET n = 13 and amateur (AT ♀, n = 22. All subjects underwent assessments of body composition, countermovement jump, maximum dynamic strength test in full squat and bench press exercises and maximum isometric strength test of grip and hip extension. All the neuromuscular markers studied showed significantly higher values in the two elite groups compared to their respective amateur groups results, except the jump height between ♀ET y ♀AT, where no significant differences were detected. The present results suggest that the higher maximum isometric and dynamic strength values, explained in part by the differences in lean mass, will give elite wrestlers a clear advantage during the most frequently used techniques in Olympic wrestling. Key  Words: bench press; squat; maximum dynamic strength; maximum isometric strength; combat.ResumenEste estudio se llevó a cabo para determinar la relación entre la fuerza dinámica e isométrica máxima con el éxito en Lucha Olímpica masculina y femenina. Treinta cinco mujeres y treinta y siete varones luchadores fueron divididos en 4 grupos de acuerdo a su género y nivel competitivo: hombres élite (♂ET, n = 18 y amateur (♂AT, n = 19 y mujeres élite (♀ET, n = 13 y amateur (♀AT, n = 22. Todos los sujetos fueron sometidos a valoraciones de la composición corporal, salto con contramovimiento, test de fuerza dinámica máxima en los ejercicios de sentadilla completa y press banca así como test de fuerza isométrica máxima de agarre y de extensión de cadera. Todas las variables neuromusculares estudiadas presentaron valores

  11. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-06-09

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed\\/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  12. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

    Full Text Available Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT scores, 2 Star Excursion Balance Test (SEBT reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  13. Propiocepción y control neuromuscular en el fútblo infantil

    OpenAIRE

    Zarza, Cristían

    2014-01-01

    En el fútbol profesional la escasa utilización de la pierna no hábil hace que muchas situaciones de juego no se resuelvan eficazmente, además de predisponer a la aparición de lesiones. El presente estudio se concentró en determinar la influencia del entrenamiento propioceptivo y del control neuromuscular en las cualidades físicas y técnicas del miembro no hábil. Objetivo: Indagar el nivel propioceptivo y de control neuromuscular del miembro inferior no hábil en chicos que re...

  14. Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Lund, Hans; Juul-Kristensen, Birgit;

    2014-01-01

    a voluntary arm movement task and 2) selective activation tasks during sessions with and without on-line biofeedback, in a general population consisting of 16 SIS patients and 15 controls (No-SIS). Furthermore, 3) a systematic review was conducted of all available clinical scapular assessment methods...... in neuromuscular activity of scapular stabilising muscles were observed, 2) and when provided with visual EMG feedback, the SIS group performed equally well as the No-SIS group, However, when assessing the neuromuscular function with and without the use of biofeedback, the findings show that without biofeedback...

  15. Conservação pos-colheita e caracterização de frutos de physalis (Physalis angulata L.) produzidos na Região Metropolitana de Curitiba - Paraná

    OpenAIRE

    Bolzan, Renata Padilha

    2013-01-01

    Resumo: Frutos de Physalis angulata L. produzidos na Região Metropolitana de Curitiba - Paraná, foram caracterizados quanto às características químicas e físicas e a capacidade antioxidante e seu desempenho quanto a diferentes condições de armazenamento e embalagens. Quanto a caracterização física e química dos frutos de Physalis angulata L. produzidos na Região Metropolitana de Curitiba - Paraná, os resultados encontrados foram: peso médio de 2,16 g e diâmetro de 1,06 cm, relação SS/AT de 18...

  16. Analgesia para a sutura artroscópica do manguito rotador: estudo comparativo entre o bloqueio interescalênico do plexo braquial e o bloqueio da bursa subacromial contínuo Management of pain after the rotator cuff arthroscopic suture: comparative study among the interescalenic blockade and the continuous intrabursal infusion

    Directory of Open Access Journals (Sweden)

    Alexandre Almeida

    2007-10-01

    Full Text Available OBJETIVO: Comparar o nível de dor pós-operatória de pacientes submetidos à sutura artroscópica da lesão do manguito rotador (MR que receberam protocolos diferentes de analgesia pós-operatória. Demonstrar a relação entre dor e o sexo do paciente, a dimensão da lesão suturada e a utilização da capsulotomia interna. Verificar a prevalência dos efeitos colaterais. MÉTODO: Foram analisados três grupos de pacientes operados entre 1º de junho de 2004 e 31 de maio de 2007. O grupo I foi composto pelos pacientes que receberam bloqueio interescalênico com ropivacaína a 0,75%. No grupo II, o mesmo bloqueio foi acrescido de 150µg de clonidina. No grupo III foi administrado um bolus de 30ml de ropivacaína a 0,75% para infiltração dos portais artroscópicos e diretamente no espaço subacromial, seguido de infusão contínua de ropivacaína a 0,2% em bomba de infusão. Os pacientes foram submetidos à medição da escala analógica visual (EAV com 24 horas após o procedimento. As variáveis estudadas foram: EAV, sexo, tamanho da lesão, necessidade de capsulotomia interna e prevalência dos efeitos colaterais. O estudo avaliou 196 pacientes, dos quais foram excluídos 51, totalizando n = 145 pacientes. O total de pacientes no grupo I foi de 65; no grupo II, de 19; e no grupo III, de 61. RESULTADOS: O índice da EAV médio encontrado no grupo I foi de 3,88 ± 1,737 (3; no grupo II, de 3,8 ± 1,6 (3; e no grupo III, de 1,95 ± 1,6 (2. Houve diferença significativa ao comparar os grupos I e III (p OBJECTIVE: To compare the level of postoperative pain in patients submitted to arthroscopic suture of a rotator cuff lesion who had different analgesia protocols. To demonstrate the relationship between pain and the gender of the patient, the dimension of the lesion sutured, and the use of internal capsulotomy. To check the prevalence of side effects. METHODS: Three groups of patients operated on between June 01, 2004 and May 31, 2007 were

  17. Neuromuscular Electrical Stimulation for Mobility Support of Elderly.

    Science.gov (United States)

    Mayr, Winfried

    2015-08-24

    The stimulator for neuromuscular electrical stimulation for mobility support of elderly is not very complicated, but for application within "MOBIL" we have some additional demands to fulfill. First we have specific safety issues for this user group. A powerful compliance management system is crucial not only to guide daily application, but for creating hard data for the scientific outcome. We also need to assure easy handling of the stimulator, because the subjects are generally not able to cope with too difficult and complex motor skills. So, we developed five generations of stimulators and optimizing solutions after field tests. We are already planning the sixth generation with wireless control of the stimulation units by the central main handheld control unit. In a prototype, we have implemented a newly available high capacity memory, a breakthrough in "compliance data storage" as they offer the necessary high storage capacity and fast data handling for an affordable prize. The circuit also contains a 3D accelerometer sensor which acts as a further important safety features: if the control unit drops, this event is detected automatically by the sensor and activates an emergency switch-off that disables the stimulation to avoid associated risks. Further, we have implemented a hardware emergence shutdown and other safety measures. Finally, in the last example muscle torque measurements are referenced with compliance data. In the study normalized maximum voluntary contraction (MVC) and maximum stimulation induced contraction (MSC) were assessed in regular check-ups along the training period. With additional consideration of adjusted stimulation intensity for training out of the compliance data records we are able to estimate the induced contraction strength, which turned out to amount in average 11% of MVC. This value may seem on a first sight rather low, and ought to be considered in relation to the results at the end of the training period. Therefore the

  18. Genetic and evolutionary analysis of the Drosophila larval neuromuscular junction

    Science.gov (United States)

    Campbell, Megan

    Although evolution of brains and behaviors is of fundamental biological importance, we lack comprehensive understanding of the general principles governing these processes or the specific mechanisms and molecules through which the evolutionary changes are effected. Because synapses are the basic structural and functional units of nervous systems, one way to address these problems is to dissect the genetic and molecular pathways responsible for morphological evolution of a defined synapse. I have undertaken such an analysis by examining morphology of the larval neuromuscular junction (NMJ) in wild caught D. melanogaster as well as in over 20 other species of Drosophila. Whereas variation in NMJ morphology within a species is limited, I discovered a surprisingly extensive variation among different species. Compared with evolution of other morphological traits, NMJ morphology appears to be evolving very rapidly. Moreover, my data indicate that natural selection rather than genetic drift is primarily responsible for evolution of NMJ morphology. To dissect underlying molecular mechanisms that may govern NMJ growth and evolutionary divergence, I focused on a naturally occurring variant in D. melanogaster that causes NMJ overgrowth. I discovered that the variant mapped to Mob2, a gene encoding a kinase adapter protein originally described in yeast as a member of the Mitotic Exit Network (MEN). I have subsequently examined mutations in the Drosophila orthologs of all the core components of the yeast MEN and found that all of them function as part of a common pathway that acts presynaptically to negatively regulate NMJ growth. As in the regulation of yeast cytokinesis, these components of the MEN appear to act ultimately by regulating actin dynamics during the process of bouton growth and division. These studies have thus led to the discovery of an entirely new role for the MEN---regulation of synaptic growth---that is separate from its function in cell division. This work

  19. Neuromuscular electrical stimulation for mobility support of elderly

    Directory of Open Access Journals (Sweden)

    Winfried Mayr

    2015-10-01

    Full Text Available The stimulator for neuromuscular electrical stimulation for mobility support of elderly is not very complicated, but for application within "MOBIL" we have some additional demands to fulfill. First we have specific safety issues for this user group. A powerful compliance management system is crucial not only to guide daily application, but for creating hard data for the scientific outcome. We also need to assure easy handling of the stimulator, because the subjects are generally not able to cope with too difficult and complex motor skills. So, we developed five generations of stimulators and optimizing solutions after field tests. We are already planning the sixth generation with wireless control of the stimulation units by the central main handheld control unit. In a prototype, we have implemented a newly available high capacity memory, a breakthrough in “compliance data storage” as they offer the necessary high storage capacity and fast data handling for an affordable prize. The circuit also contains a 3D accelerometer sensor which acts as a further important safety features: if the control unit drops, this event is detected automatically by the sensor and activates an emergency switch-off that disables the stimulation to avoid associated risks. Further, we have implemented a hardware emergence shutdown and other safety measures. Finally, in the last example muscle torque measurements are referenced with compliance data. In the study normalized maximum voluntary contraction (MVC and maximum stimulation induced contraction (MSC were assessed in regular check-ups along the training period. With additional consideration of adjusted stimulation intensity for training out of the compliance data records we are able to estimate the induced contraction strength, which turned out to amount in average 11% of MVC. This value may seem on a first sight rather low, and ought to be considered in relation to the results at the end of the training period

  20. AVALIAÇÃO DA QUALIDADE MICROBIOLÓGICA DO QUEIJO MINAS FRESCAL PRODUZIDO POR LATICÍNIOS DO ESTADO DE MINAS GERAIS

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    Thaís Conceição Custódio Apolinário

    2015-01-01

    Full Text Available Este trabalho avaliou a presença de coliformes totais e termotolerantes, Salmonella spp., estafilococos coagulase positiva e Listeria monocytogenes em queijos Minas Frescal, produzidos por diferentes indústrias da região da Zona da Mata Mineira fiscalizadas por Serviços de Inspeção Federal, Estadual ou Municipal, num total de 31 amostras de queijos Minas Frescal. Foram encontradas 77,4% das amostras com contagens superiores ao preconizado pela legislação para coliformes totais, 54,8% para coliformes termotolerantes, 16,12% para estafilococos coagulase positiva e 9,6% para Listeria monocytogenes. Nenhuma das amostras apresentou contaminação por Salmonella spp. Diante disso, 80,6% das amostras analisadas encontravam-se imprópria para o consumo, por apresentar contagem de pelo menos um dos microrganismos analisados fora dos limites especificados pela legislação. Conclui-se que os queijos Minas Frescais não apresentam qualidade microbiológica satisfatória, o que compromete a segurança do alimento para o consumidor.

  1. Bloqueio por clipagem de gânglios simpáticos torácicos no tratamento da hiper-hidrose Thoracic sympathetic block by clamping for treatment of hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Wilson de Souza Stori Jr.

    2006-10-01

    Full Text Available FUNDAMENTOS: Bloqueio simpático videotoracoscópico no tratamento da hiper-hidrose é realizado por clipagem do tronco simpático, com possibilidade de reversão em casos de sudorese compensatória intensa. OBJETIVO: Avaliar sucesso terapêutico, satisfação e sudorese compensatória nos pacientes submetidos a essa técnica. MÉTODO: Estudo prospectivo em que 45 pacientes foram divididos em dois grupos. Grupo I: um paciente com hiper-hidrose palmar e 20 com hiper-hidrose palmar e plantar submetidos a bloqueio de T3; Grupo II: quatro pacientes com hiper-hidrose axilar , dois com hiper-hidrose axilar e palmar, dois com hiper-hidrose axilar e plantar e 16 com hiperidrose axilar, palmar e plantar submetidos a bloqueio de T3 e T4. RESULTADOS: No grupo I 95,2% dos pacientes tinham hiper-hidrose palmar e plantar, e no grupo II 66,7% tinham hiperidrose axilar, palmar e plantar. Na região palmar, resultados excelentes ou bons ocorreram em 95,3% do grupo I e em 94,4% do grupo II; na região plantar 40% do grupo I e 44,5% do grupo II apresentaram bons resultados; e na região axilar, 95,8% relataram resultados excelentes ou bons. Em seis meses, havia sudorese compensatória em 76,2% do grupo I e 91,7% do grupo II, mas a sudorese compensatória intensa ocorreu em apenas três pacientes do grupo II. CONCLUSÕES: Esse tratamento foi eficiente para o tratamento da hiper-hidrose. Ao final de seis meses, todos os pacientes do grupo I e 95,9% dos pacientes do grupo II estavam satisfeitos com os resultados.BACKGROUND: Videothoracoscopic for the treatment of hyperhidrosis is carried out by clamping of the sympathetic trunk, with a possibility for reversal in cases of intense compensatory sweating. OBJECTIVE: To evaluate therapeutic success, satisfaction, and compensatory sweating in patients submitted to this technique. METHOD: Prospective study in which 45 patients were divided into two groups. Group I: one patient with palmar hyperhidrosis and 20 patients with

  2. Oclusão artério-venosa da retina após bloqueio retrobulbar: relato de dois casos Combined central retinal vein and artery occlusion after retrobulbar anesthesia: report of two cases

    Directory of Open Access Journals (Sweden)

    Rogil José de Almeida Torres

    2005-04-01

    Full Text Available São descritos dois casos de oclusão artério-venosa da retina após cirurgia intra-ocular. As duas pacientes foram submetidas à anestesia peribulbar. Devido à sensação dolorosa e à mobilidade ocular foi necessário a realização de bloqueio retrobulbar. Ao final da cirurgia, ambas receberam injeção subconjuntival de gentamicina associada à dexametasona. No primeiro dia pós-cirúrgico as pacientes apresentaram arreflexia pupilar e acuidade visual de percepção luminosa, sendo referidas para nosso serviço. A confirmação do diagnóstico de oclusão vascular retiniana mista foi feito por meio do exame de retinografia fluorescente. As pacientes não manifestaram, em nenhum momento, alterações neurológicas, porém a perda visual foi grave e permanente. Por meio da descrição cirúrgica, da história clínica e dos achados oftalmoscópicos e angiográficos discutem-se as possíveis causas desta grave lesão vascular retiniana, dando ênfase à presumida injeção de anestésico na bainha do nervo óptico durante o bloqueio retrobulbar. Ao mesmo tempo, abordam-se medidas preventivas para evitar tal complicação.Two cases of combined central retinal artery and vein occlusion after intraocular surgery are described. Both patients were submitted to peribulbar anesthesia. Due to the painful sensation and ocular mobility retrobulbar anesthesia was necessary. At the end of the surgery both patients received a subconjunctival injection of gentamicin associated with dexamethasone. On the very first day after the surgery the two patients showed pupillary areflexia and visual acuity of luminous perception when they were referred to our service. The confirmation of the diagnosis of combined vascular occlusion of the retina was obtained by fluorescein angiography test. The two patients never showed, any neurological alteration. However visual loss was severe and permanent. By means of surgical description, clinical history, fundus photography

  3. Proprioceptive Neuromuscular Facilitation Flexibility Techniques: Acute Effects on Arterial Blood Pressure.

    Science.gov (United States)

    Cornelius, William L.; Craft-Hamm, Kelley

    1988-01-01

    The effects of stretching techniques on arterial blood pressure (ABP) were studied in three groups of 20 men each. Each group performed one of three proprioceptive neuromuscular facilitation (PNF) techniques. Results are presented. The study indicates that the benefits of stretching may outweigh the risk of elevated ABP. (JL)

  4. Synaptic defects in the spinal and neuromuscular circuitry in a mouse model of spinal muscular atrophy.

    Directory of Open Access Journals (Sweden)

    Karen K Y Ling

    Full Text Available Spinal muscular atrophy (SMA is a major genetic cause of death in childhood characterized by marked muscle weakness. To investigate mechanisms underlying motor impairment in SMA, we examined the spinal and neuromuscular circuitry governing hindlimb ambulatory behavior in SMA model mice (SMNΔ7. In the neuromuscular circuitry, we found that nearly all neuromuscular junctions (NMJs in hindlimb muscles of SMNΔ7 mice remained fully innervated at the disease end stage and were capable of eliciting muscle contraction, despite a modest reduction in quantal content. In the spinal circuitry, we observed a ∼28% loss of synapses onto spinal motoneurons in the lateral column of lumbar segments 3-5, and a significant reduction in proprioceptive sensory neurons, which may contribute to the 50% reduction in vesicular glutamate transporter 1(VGLUT1-positive synapses onto SMNΔ7 motoneurons. In addition, there was an increase in the association of activated microglia with SMNΔ7 motoneurons. Together, our results present a novel concept that synaptic defects occur at multiple levels of the spinal and neuromuscular circuitry in SMNΔ7 mice, and that proprioceptive spinal synapses could be a potential target for SMA therapy.

  5. The assisted 6-minute cycling test to assess endurance in children with a neuromuscular disorder

    NARCIS (Netherlands)

    Jansen, M.; Jong, M. de; Coes, H.M.; Eggermont, F.; Alfen, N. van; Groot, I.J. de

    2012-01-01

    Introduction: For late- or non-ambulant children with a neuromuscular disorder no suitable endurance tests are currently available. We developed the assisted 6-minute cycling test (A6MCT) for the legs and arms and investigated its psychometric properties in healthy boys and boys with Duchenne muscul

  6. Reversal of profound neuromuscular blockade with sugammadex in an infant after bronchial foreign body removal.

    Science.gov (United States)

    Azizoglu, Mustafa; Birbicer, Handan; Memis, Suleyman; Taşkınlar, Hakan

    2016-09-01

    Sugammadex is a selective chemical agent that can reverse neuromuscular blockade induced by vecuronium and rocuronium. The aim of this report is to discuss the effectiveness of sugammadex in the reversal of neuromuscular blockade in children younger than 2 years. A 16-month-old boy, weighing 10 kg, was admitted to the pediatric emergency department due to choking, cyanosis, and severe respiratory distress that occurred while he was eating peanuts. In the emergency department, the patient's condition deteriorated, and he went into respiratory arrest. He was immediately intubated and taken to the operating room. A rigid bronchoscopy was performed under general anesthesia, with administration of intravenous pentothal (5 mg/kg), rocuronium (0.6 mg/kg), and fentanyl (0.5 μg/kg) in the operating room. The foreign body was removed within 6 minutes, and the profound neuromuscular blockade was reversed with a dose of 2 mg/kg sugammadex. He was extubated successfully after obtaining the spontaneous respiratory activity, and adequate breathing was restored. Clinical use of sugammadex in children younger than 2 years is not recommended because of the lack of clinical studies. In this case report, the profound neuromuscular blockade was successfully reversed with a dose of 2 mg/kg sugammadex in a 16-month-old boy. However, more prospective clinical studies are required for the safe use of this agent in children. PMID:27555184

  7. Metabolic, cardiorespiratory, and neuromuscular fitness performance in children with cerebral palsy: A comparison with healthy youth.

    Science.gov (United States)

    García, Claudia Cardona; Alcocer-Gamboa, Alberto; Ruiz, Margarita Pérez; Caballero, Ignacio Martínez; Faigenbaum, Avery D; Esteve-Lanao, Jonathan; Saiz, Beatriz Moral; Lorenzo, Teresa Martín; Lara, Sergio Lerma

    2016-04-01

    The aim of this study was to assess metabolic, cardiorespiratory, and neuromuscular fitness parameters in children with spastic cerebral palsy (CP) and to compare these findings with typically developing children. 40 children with CP (21 males, 19 females; mean age, 11.0±3.3 yr; range, 6.5-17.1 yr; Gross Motor Function Classification System levels 1 or 2) and 40 healthy, age- and sex-matched children completed a test battery that consisted of 8 tests and 28 measures that assessed cardio-respiratory fitness, energy expenditure, anaerobic endurance, muscle strength, agility, stability and flexibility. Children with CP had significantly lower performance (Pmetabolic tests than those of healthy children, Differences in neuromuscular measures of muscular strength, speed, agility, anaerobic endurance, and flexibility between groups were most apparent. Grouped differences in cardiorespiratory variables revealed a 25% difference in performance, whereas grouped differences in metabolic and neuromuscular measures were 43% and 60%, respectively. The physical fitness of contemporary children with CP is significantly less than healthy, age-matched children. Significant differences in neuromuscular measures between groups can aid in the identification of specific fitness abilities in need of improvement in this population. PMID:27162775

  8. Effect of intravenous anesthetic propofol on synaptic vesicle exocytosis at the frog neuromuscular junction

    Institute of Scientific and Technical Information of China (English)

    Luciana Ferreira LEITE; Renato Santiago GOMEZ; Matheus de Castro FONSECA; Marcus Vinicius GOMEZ; Cristina GUATIMOSIM

    2011-01-01

    Aim: To investigate the presynaptic effects of propofol, a short-acting intravenous anesthetic, in the frog neuromuscular junction. Methods: Frog cutaneous pectoris nerve muscle preparations were prepared. A fluorescent tool (FM1-43) was used to visualize the effect of propofol on synaptic vesicle exocytosos in the frog neuromuscular junction. Results: Low concentrations of propofol, ranging from 10 to 25 μmol/L, enhanced spontaneous vesicle exocytosis monitored by FM1-43 in a Ca2+-dependent and Na+-independent fashion. Higher concentrations of propofol (50, 100, and 200 μmol/L) had no effect on spontaneous exocytosis. By contrast, higher concentrations of propofol inhibited the Na+-dependent exocytosis evoked by 4-aminopyri-dine but did not affect the Na+-independent exocytosis evoked by KCI. This action was similar and non-additive with that observed by tetrodotoxin, a Na+ channel blocker.Conclusion: Our data suggest that propofol has a dose-dependent presynaptic effect at the neuromuscular transmission which mayhelp to understand some of the clinical effects of this agent on neuromuscular function.

  9. Metabolic, cardiorespiratory, and neuromuscular fitness performance in children with cerebral palsy: A comparison with healthy youth

    Science.gov (United States)

    García, Claudia Cardona; Alcocer-Gamboa, Alberto; Ruiz, Margarita Pérez; Caballero, Ignacio Martínez; Faigenbaum, Avery D.; Esteve-Lanao, Jonathan; Saiz, Beatriz Moral; Lorenzo, Teresa Martín; Lara, Sergio Lerma

    2016-01-01

    The aim of this study was to assess metabolic, cardiorespiratory, and neuromuscular fitness parameters in children with spastic cerebral palsy (CP) and to compare these findings with typically developing children. 40 children with CP (21 males, 19 females; mean age, 11.0±3.3 yr; range, 6.5–17.1 yr; Gross Motor Function Classification System levels 1 or 2) and 40 healthy, age- and sex-matched children completed a test battery that consisted of 8 tests and 28 measures that assessed cardio-respiratory fitness, energy expenditure, anaerobic endurance, muscle strength, agility, stability and flexibility. Children with CP had significantly lower performance (P<0.05) on most cardiorespiratory and metabolic tests than those of healthy children, Differences in neuromuscular measures of muscular strength, speed, agility, anaerobic endurance, and flexibility between groups were most apparent. Grouped differences in cardiorespiratory variables revealed a 25% difference in performance, whereas grouped differences in metabolic and neuromuscular measures were 43% and 60%, respectively. The physical fitness of contemporary children with CP is significantly less than healthy, age-matched children. Significant differences in neuromuscular measures between groups can aid in the identification of specific fitness abilities in need of improvement in this population. PMID:27162775

  10. Neuromuscular control of scapula muscles during a voluntary task in subjects with Subacromial Impingement Syndrome

    DEFF Research Database (Denmark)

    Larsen, C M; Søgaard, Karen; Chreiteh, S S;

    2013-01-01

    Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population with and w...

  11. The effect of neuromuscular blockade on canine laparoscopic ovariectomy: A double-blinded, prospective clinical trial

    NARCIS (Netherlands)

    van Goethem, B.; van Nimwegen, S.A.; Akkerdaas, L.C.; Murrell, J.C.; Kirpensteijn, J.

    2012-01-01

    The Effect of Neuromuscular Blockade on Canine Laparoscopic Ovariectomy: A Double-Blinded, Prospective Clinical Trial Bart Van Goethem, Diplomate ECVS, Sebastiaan Alexander van Nimwegen, PhD, Ies Akkerdaas, DVM, Joanna Claire Murrell, BVSc., PhD, Diplomate ECVAA, and Jolle Kirpensteijn, PhD, Diploma

  12. Use of neuromuscular electrostimulation in the treatment of dysphagia in patients with multiple sclerosis

    NARCIS (Netherlands)

    H. Bogaardt; D. van Dam; N.M. Wever; C.E. Bruggeman; J. Koops; W.J. Fokkens

    2009-01-01

    OBJECTIVES: We explored the possible effects of neuromuscular electrostimulation on the swallowing function of patients with multiple sclerosis and swallowing problems. METHODS: Twenty-five patients (average age, 53.1 years; SD, 9.8 years) with multiple sclerosis and swallowing problems were treated

  13. A survey of the current use of neuromuscular blocking drugs among the Middle Eastern anesthesiologists

    Directory of Open Access Journals (Sweden)

    Abdelazeem Eldawlatly

    2013-01-01

    Full Text Available Background: This survey aimed to assess the extent of practice of the Middle Eastern anesthesiologists in the use of neuromuscular blocking agents (NMB in 2012. Methods: We distributed an electronic survey among 577 members of the Triple-M Middle Eastern Yahoo anesthesia group, enquiring about their practice in the use of neuromuscular blocking agents. Questions concerned the routine "first choice" use of NMB, choice for tracheal intubation, the use of neuromuscular monitoring (NMT, type of NMB used in difficult airway, frequency of using suxamethonium, cisatracurium, rocuronium and sugammadex, observed side effects of rocuronium, residual curarization, and the reversal of residual curarization of rocuronium. Results: A total of 71 responses from 22 Middle Eastern institutions were collected. Most of the Middle Eastern anesthesiologists were using cisatracurium and rocuronium frequently for tracheal intubation (39% and 35%, respectively. From the respondents, 2/3 were using suxamethonium for tracheal intubation in difficult airway, 1/3 were using rocuronium routinely and 17% have observed hypersensitivity reactions to rocuronium, 54% reported residual curarization from rocuronium, 78% were routinely using neostigmine to reverse the rocuronium, 21% used sugammadex occasionally, and 35% were using NMT routinely during the use of NMB. Conclusions: We believe that more could be done to increase the awareness of the Middle Eastern anesthesiologists about the high incidence of PROC (>20% and the need for routine monitoring of neuromuscular function. This could be accomplished with by developing formal training programs and providing official guidelines.

  14. The influence of gender on neuromuscular pre-activity during side-cutting

    DEFF Research Database (Denmark)

    Bencke, Jesper; Zebis, Mette K

    2011-01-01

    investigated. This cross-sectional study aimed to examine gender differences in neuromuscular pre-activity during a maneuver that mimics a movement associated with the incidence of ACL injuries. Twenty-four team handball players (12 male and 12 female) with no history of ACL injury were tested for EMG pre...

  15. Pharyngeal neuromuscular dysfunction associated with bilateral guttural pouch tympany in a foal.

    Science.gov (United States)

    Bell, Chris

    2007-02-01

    A 2-month-old warmblood filly was presented for a 1-week history of a large, nonpainful, fluctuant swelling of the parotid and laryngeal area. Bilateral guttural pouch tympany was diagnosed. Surgical correction resolved the guttural pouch tympany; however, postoperative pharyngeal neuromuscular dysfunction developed. PMID:17334035

  16. Pharyngeal neuromuscular dysfunction associated with bilateral guttural pouch tympany in a foal

    OpenAIRE

    Bell, Chris

    2007-01-01

    A 2-month-old warmblood filly was presented for a 1-week history of a large, nonpainful, fluctuant swelling of the parotid and laryngeal area. Bilateral guttural pouch tympany was diagnosed. Surgical correction resolved the guttural pouch tympany; however, postoperative pharyngeal neuromuscular dysfunction developed.

  17. Postoperative effects of neuromuscular exercise prior to hip or knee arthroplasty

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders;

    2014-01-01

    supervised neuromuscular exercise prior to total joint arthroplasty (TJA) of the hip or knee did not confer additional benefits 3 months postoperatively compared with TJA alone. However, the intervention group experienced a statistically significant short-term benefit in ADL and pain, suggesting an earlier...

  18. Neurophysiological Strategies for the Diagnosis of Disorders of the Neuromuscular Junction in Children

    Science.gov (United States)

    Pitt, Matthew

    2008-01-01

    The disorders of the neuromuscular junction seen in children, the congenital myasthenic syndromes and autoimmune myasthenia gravis, are very rare. Their clinical symptoms and signs may be variable, most notably in the neonate and infant. They should enter the differential diagnosis of many different clinical presentations, such as "floppy infant"…

  19. Monozygous twins with neuromuscular transmission defects at opposite sides of the motor endplate.

    Science.gov (United States)

    Punga, A R; Nygren, I; Askmark, H; Stålberg, E V

    2009-03-01

    Disorders affecting the postsynaptic side of the neuromuscular junction include autoimmune myasthenia gravis (MG) as well as some of the congenital myasthenic syndromes (CMS). Lambert-Eaton myasthenic syndrome (LEMS) is an acquired autoimmune neuromuscular disorder in which autoantibodies are directed against the presynaptic calcium channels. Here we describe two monozygous twin brothers: case 1 was diagnosed with an indeterminate form of acquired postsynaptic neuromuscular junction defect at age 32 and case 2 with LEMS at age 47. Case 1 presented clinically with mild generalized myasthenic weakness, neurophysiological examination revealed disturbed neuromuscular transmission along with probable myositis and serum analysis regarding antibodies against the acetylcholine receptor and muscle-specific tyrosine kinase was negative. Case 2 presented with proximal muscle fatigue accompanied by areflexia at rest and antibodies against the P/Q-type voltage-gated calcium channels were present. Neurophysiologically, case 2 had reduced baseline compound motor action potential amplitudes on neurography, decrement on low-frequency repetitive nerve stimulation (RNS) and pathological increment on high frequency RNS. To our knowledge this is the first case report of its kind and adds an intriguing contrast to the more common diagnosis of CMS in monozygous twins. PMID:18684214

  20. Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

    Science.gov (United States)

    Clark, Heather; Lazarus, Cathy; Arvedson, Joan; Schooling, Tracy; Frymark, Tobi

    2009-01-01

    Purpose: To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method: A systematic search was conducted to…

  1. Man-machine interface system for neuromuscular training and evaluation based on EMG and MMG signals.

    Science.gov (United States)

    de la Rosa, Ramon; Alonso, Alonso; Carrera, Albano; Durán, Ramon; Fernández, Patricia

    2010-01-01

    This paper presents the UVa-NTS (University of Valladolid Neuromuscular Training System), a multifunction and portable Neuromuscular Training System. The UVa-NTS is designed to analyze the voluntary control of severe neuromotor handicapped patients, their interactive response, and their adaptation to neuromuscular interface systems, such as neural prostheses or domotic applications. Thus, it is an excellent tool to evaluate the residual muscle capabilities in the handicapped. The UVa-NTS is composed of a custom signal conditioning front-end and a computer. The front-end electronics is described thoroughly as well as the overall features of the custom software implementation. The software system is composed of a set of graphical training tools and a processing core. The UVa-NTS works with two classes of neuromuscular signals: the classic myoelectric signals (MES) and, as a novelty, the myomechanic signals (MMS). In order to evaluate the performance of the processing core, a complete analysis has been done to classify its efficiency and to check that it fulfils with the real-time constraints. Tests were performed both with healthy and selected impaired subjects. The adaptation was achieved rapidly, applying a predefined protocol for the UVa-NTS set of training tools. Fine voluntary control was demonstrated to be reached with the myoelectric signals. And the UVa-NTS demonstrated to provide a satisfactory voluntary control when applying the myomechanic signals.

  2. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Schaller SJ

    2013-09-01

    Full Text Available Stefan Josef Schaller,1,2 Heidrun Fink11Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; 2Department of Anesthesia, Massachusetts General Hospital, Boston, MA, USAAbstract: Sugammadex is the first clinical representative of a new class of drugs called selective relaxant binding agents. It has revolutionized the way anesthesiologists think about drug reversal. Sugammadex selectively binds rocuronium or vecuronium, thereby reversing their neuromuscular blocking action. Due to its 1:1 binding of rocuronium or vecuronium, it is able to reverse any depth of neuromuscular block. So far, it has been approved for use in adult patients and for pediatric patients over 2 years. Since its approval in Europe, Japan, and Australia, further insight on its use in special patient populations and specific diseases have become available. Due to its pharmacodynamic profile, sugammadex, in combination with rocuronium, may have the potential to displace succinylcholine as the "gold standard" muscle relaxant for rapid sequence induction. The use of rocuronium or vecuronium, with the potential of reverse of their action with sugammadex, seems to be safe in patients with impaired neuromuscular transmission, ie, neuromuscular diseases, including myasthenia gravis. Data from long-term use of sugammadex is not yet available. Evidence suggesting an economic advantage of using sugammadex and justifying its relatively high cost for an anesthesia-related drug, is missing. Keywords: reversal agent, cyclodextrin, PORC, SRBAs

  3. Optimized surgical space during low-pressure laparoscopy with deep neuromuscular blockade

    DEFF Research Database (Denmark)

    Staehr-Rye, Anne K; Rasmussen, Lars S; Rosenberg, Jacob;

    2013-01-01

    Laparoscopic cholecystectomy (LC) can be performed using low intra-abdominal pressure (space conditions using either deep, continuous muscle relaxation or moderate blockade during low-pressure (8 mm......Hg) LC. We hypothesized that a deep neuromuscular block would be associated with a higher proportion of optimal surgical space conditions....

  4. How persons with a neuromuscular disease perceive employment participation: a qualitative study

    NARCIS (Netherlands)

    Minis, M.A.H; Satink, T.J.; Kinebanian, A.; Engels, J.A.; Heerkens, Y.F.; Engelen, B.G.M. van; Nijhuis-Van der Sanden, M.W.G.

    2014-01-01

    Introduction A qualitative study was carried out to understand how people with a slow progressive adult type neuromuscular disease (NMD) perceive employment participation. Methods 16 paid employed persons with NMD were interviewed in open, in-depth interviews. Data were analyzed using the constant c

  5. Man-Machine Interface System for Neuromuscular Training and Evaluation Based on EMG and MMG Signals

    Directory of Open Access Journals (Sweden)

    Patricia Fernández

    2010-12-01

    Full Text Available This paper presents the UVa-NTS (University of Valladolid Neuromuscular Training System, a multifunction and portable Neuromuscular Training System. The UVa-NTS is designed to analyze the voluntary control of severe neuromotor handicapped patients, their interactive response, and their adaptation to neuromuscular interface systems, such as neural prostheses or domotic applications. Thus, it is an excellent tool to evaluate the residual muscle capabilities in the handicapped. The UVa-NTS is composed of a custom signal conditioning front-end and a computer. The front-end electronics is described thoroughly as well as the overall features of the custom software implementation. The software system is composed of a set of graphical training tools and a processing core. The UVa-NTS works with two classes of neuromuscular signals: the classic myoelectric signals (MES and, as a novelty, the myomechanic signals (MMS. In order to evaluate the performance of the processing core, a complete analysis has been done to classify its efficiency and to check that it fulfils with the real-time constraints. Tests were performed both with healthy and selected impaired subjects. The adaptation was achieved rapidly, applying a predefined protocol for the UVa-NTS set of training tools. Fine voluntary control was demonstrated to be reached with the myoelectric signals. And the UVa-NTS demonstrated to provide a satisfactory voluntary control when applying the myomechanic signals.

  6. Invasive home mechanical ventilation, mainly focused on neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Börger, Sandra

    2010-01-01

    Full Text Available Introduction and background: Invasive home mechanical ventilation is used for patients with chronic respiratory insufficiency. This elaborate and technology-dependent ventilation is carried out via an artificial airway (tracheal cannula to the trachea. Exact numbers about the incidence of home mechanical ventilation are not available. Patients with neuromuscular diseases represent a large portion of it. Research questions: Specific research questions are formulated and answered concerning the dimensions of medicine/nursing, economics, social, ethical and legal aspects. Beyond the technical aspect of the invasive home, mechanical ventilation, medical questions also deal with the patient’s symptoms and clinical signs as well as the frequency of complications. Economic questions pertain to the composition of costs and the differences to other ways of homecare concerning costs and quality of care. Questions regarding social aspects consider the health-related quality of life of patients and caregivers. Additionally, the ethical aspects connected to the decision of home mechanical ventilation are viewed. Finally, legal aspects of financing invasive home mechanical ventilation are discussed. Methods: Based on a systematic literature search in 2008 in a total of 31 relevant databases current literature is viewed and selected by means of fixed criteria. Randomized controlled studies, systematic reviews and HTA reports (health technology assessment, clinical studies with patient numbers above ten, health-economic evaluations, primary studies with particular cost analyses and quality-of-life studies related to the research questions are included in the analysis. Results and discussion: Invasive mechanical ventilation may improve symptoms of hypoventilation, as the analysis of the literature shows. An increase in life expectancy is likely, but for ethical reasons it is not confirmed by premium-quality studies. Complications (e. g. pneumonia are rare

  7. Fatiguing exercise intensity influences the relationship between parameters reflecting neuromuscular function and postural control variables.

    Directory of Open Access Journals (Sweden)

    Sébastien Boyas

    Full Text Available The purpose of this study was to investigate the influence of fatiguing exercise intensity on the nature and extent of fatigue-induced changes in neuromuscular function and postural stability in quiet standing. We also explored the contribution of selected neuromuscular mechanisms involved in force production to postural stability impairment observed following fatigue using an approach based on multivariate regressions. Eighteen young subjects performed 30-s postural trials on one leg with their eyes closed. Postural trials were performed before and after fatiguing exercises of different intensities: 25, 50 and 75% of maximal isometric plantarflexor torque. Fatiguing exercises consisted of sustaining a plantarflexor isometric contraction at the target intensity until task failure. Maximal isometric plantarflexor torque, electromyographic activity of plantarflexor and dorsiflexor muscles, activation level (twitch interpolation technique and twitch contractile properties of plantarflexors were used to characterize neuromuscular function. The 25% exercise was associated with greater central fatigue whereas the 50 and 75% exercises involved mostly peripheral fatigue. However, all fatiguing exercises induced similar alterations in postural stability, which was unexpected considering previous literature. Stepwise multiple regression analyses showed that fatigue-related changes in selected parameters related to neuromuscular function could explain more than half (0.51≤R(2≤0.82 of the changes in postural variables for the 25% exercise. On the other hand, regression models were less predictive (0.17≤R(2≤0.73 for the 50 and 75% exercises. This study suggests that fatiguing exercise intensity does not influence the extent of postural stability impairment, but does influence the type of fatigue induced and the neuromuscular function predictors explaining changes in postural variables.

  8. Estudo qualiquantitativo do biogás produzido por substratos em biodigestores tipo batelada Qualiquantitatve study of biogas produced by substrates in batch biodigestors

    Directory of Open Access Journals (Sweden)

    João A. Galbiatti

    2010-04-01

    Full Text Available A presente pesquisa foi desenvolvida no Departamento de Engenharia Rural da FCAV/UNESP, SP, Brasil, com o objetivo de se estudar, qualiquantitativamente, o biogás produzido por 5 substratos que, após utilizados na digestão anaeróbia, foram caracterizados como: 1 - Esterco de aves de corte com cama de capim napier (EACN; 2 - Esterco de aves de corte com cama de capim napier triturado (EACNT; 3 - Esterco suíno (ES; 4 - Esterco bovino (EB e 5 - Esterco de bovino misturado com 50% de bagaço de cana-de-açúcar (EB50C. Dos dados levantados concluiu-se que: o substrato EACN e o ES produziram volumes maiores e menores de biogás, respectivamente, comparados com os demais; a mistura de bagaço de cana-de-açúcar no substrato EB prejudica a produção acumulada de biogás e sua qualidade; a partir dos 57 dias após o enchimento dos biodigestores todos os substratos já produziam biogás com teor de metano superior a 48%, com exceção do substrato ES; o substrato triturado (EACNT não apresentou características muito distintas do substrato não triturado (EACN; a qualidade do biogás na fase de produção máxima é semelhante para todos os substratos estudados; o biogás que mostrou maior valor de metano na sua composição foi o produzido com EB, superior em até 17,7% à produção do EACNT.Aiming to study the biogas produced by 5 substrates from both quality and quantity point of view, this research was conducted at the Rural Engineering Department of FCAV/UNESP - Brazil, State of São Paulo. The substractes that were used in the anaerobic digestion were characterized as: 1 - Slaughter fowls' manure with napier grass bed (MFNG; 2 - Slaughter fowls' manure with triturate napier grass bed (MFNGT; 3 - Suine manure (SM; 4 - Bovine manure (BM and 5 - Bovine manure mixed with 50% of sugarcane bagasse (BM50S. From the data colIected it was concluded that: the substract (MFNG and the substract containing SM produced higher and lower volumes of biogas

  9. Propriedades emulsificantes e estabilidade do biossurfactante produzido por Bacillus subtilis em manipueira Studies of emulsifying properties and stability of the biosurfactant produced by Bacillus subtilis in cassava wastewater

    Directory of Open Access Journals (Sweden)

    Francisco Fábio Cavalcante Barros

    2008-12-01

    Full Text Available Devido ao elevado poder tensoativo, baixa toxidez e biodegradabilidade, os lipopeptídios produzidos por bactérias do gênero Bacillus estão entre os biossurfactantes mais conhecidos e estudados. Estes compostos são apontados como potenciais insumos para diversos setores industriais, inclusive o de alimentos. Para que seja possível sua aplicação industrial, no entanto, é necessário que estes compostos apresentem estabilidade e manutenção de suas propriedades em condições extremas, que estão freqüentemente associadas a esses processos. O objetivo deste trabalho foi estudar a estabilidade do biossurfactante produzido pela linhagem LB5a de Bacillus subtilis, cultivado em manipueira (resíduo da industrialização da mandioca em um processo piloto. Os estudos de estabilidade foram realizados em função da variação de temperatura, pH e concentração salina. Foram realizadas avaliações da sua capacidade emulsificante em misturas de água com hidrocarbonetos e óleos vegetais, bem como a estabilidade das emulsões formadas. Os resultados mostraram que o biossurfactante foi estável à temperatura de 100 °C por 140 minutos e a 121 °C por até 60 minutos, à concentração de 2,5 a 20% de NaCl e na faixa de pH de 6 a 10. Em relação ao índice de emulsão com 24 horas (IE24, o biossurfactante mostrou elevados valores para diversos hidrocarbonetos cíclicos e alifáticos, além de óleos vegetais com diferentes perfis de ácidos graxos. Todos os resultados obtidos demonstraram a importância do biossurfactante para potenciais aplicações em diversos ramos industriais.Due to the high surface activity, low toxicity, and biodegradability lipopeptides produced by bacteria of the genus Bacillus are among the best biosurfactants known and studied. These compounds are mentioned as potential inputs for various industrial sectors. However, to allow their implementation in industrial processes, it is necessary stability under extreme

  10. Qualidade de processamento de tubérculos de batata produzidos sob diferentes disponibilidades de nitrogênio Potato processing quality of tubers grown under different nitrogen availabilities

    Directory of Open Access Journals (Sweden)

    Viviani Ruffo de Oliveira

    2006-04-01

    Full Text Available O objetivo do trabalho foi determinar o teor de matéria seca e a coloração de chips de batata da cultivar Asterix produzidos sob cinco níveis de nitrogênio. O plantio foi feito em 02/09/2003, na UFSM, em sacolas com 4,4dm³ de substrato comercial. Os tratamentos foram constituídos por cinco soluções nutritivas com doses de N de 5,0 (T1, 8,3 (T2, 11,3 (T3, 14,3 (T4 e 16,3mmol L-1 (T5. Os tubérculos foram colhidos em 17/12/2003, aos 104 dias após o plantio, e após 15 dias na temperatura de 20°C foram determinados o teor de matéria seca e a coloração dos chips. O teor de matéria seca dos tubérculos aumentou da primeira até a terceira dose, decrescendo a seguir segundo um modelo polinomial. Os valores foram de 19,5; 20,5; 20,8; 18,6 e 18,4g 100g-1 nas doses de T1 a T5, respectivamente. Somente os tubérculos produzidos com as doses T2 e T3 atingiriam o teor mínimo de matéria seca preconizado pela literatura, que é de 20g 100g-1. Não houve relação entre a coloração dos chips e as doses de N fornecidas. Concluiu-se que o N pode reduzir o teor de matéria seca dos tubérculos e que critérios específicos de manejo da adubação nitrogenada devem ser observados para a produção de tubérculos destinados ao processamento industrial.The goal of the work was to determine dry matter content and chip color of potato tubers, cultivar Asterix, grown under five N levels. Tubers were planted in bags with 4.4dm-3 of a commercial substrate, on September 2nd, 2003, at UFSM, RS, Brazil. Treatments consisted of five nutrient solutions with N concentrations of 5.0 (T1, 8.3 (T2, 11.3 (T3, 14.3 (T4 and 6.3mmol L-1 (T5. Tubers were harvested on December 17th, 2003, at 104 days after planting. Tubers were stored during 15 days before determinations of dry matter and chip color. Dry matter content increased in tubers from T1 to T3 and decreased thereafter, following a polynomial model. Dry matter content was 19.5; 20.5; 20.8; 18.6 and 18.4g 100g

  11. Avaliação comparativa entre o besilato de atracúrio e o cloreto de alcurônio sobre a frequência cardíaca e a ventilometria de cães anestesiados com halotano Comparative evaluation between atracurium besylate and alcuronium chloride on heart rate and ventilometry of the dogs anesthetized with halothane

    Directory of Open Access Journals (Sweden)

    Alexandre da Silva Polydoro

    1996-08-01

    Full Text Available Vinte cães provenientes da rotina anestésico-cirúrgica do Hospital de Clínicas Veterinárias da Universidade Federal de Santa Maria (UFSM, foram divididos em 2 grupos, I e II. e submetidos ao bloqueio neuromuscular com besilato de atracúrio 0,5mg/kg IV ou cloreto de alcurônio 0,1mg/kg IV consecutivamente. Foram monitorados a ventilometria, a freqüência cardíaca e o tempo de bloqueio neuromuscular dos animais que receberam besilato de atracúrio, submetidos à reversão espontânea, enquanto que a reversão do bloqueio produzido com cloreto de alcurônio foi realizada aos 60 minutos após instalação deste pela administração de neostigmina precedida de sulfato de atropina. Os resultados obtidos demonstraram diminuição do volume corrente pulmonar para ambos os grupos à partir da reversão do bloqueio, com diminuição significativa para o grupo que recebeu cloreto de alcurônio até vinte minutos após reversão e diferença estatisticamente significativa entre os grupos aos 20 minutos após reversão. Houve diminuição nos valores de frequência cardíaca à partir dos 10 minutos após indução anestésica até 30 minutos decorridos do bloqueio para ambos os grupos, com significando estatística no grupo que recebeu besilato de atracúrio. O tempo médio de bloqueio com besilato de atracúrio foi de 49,07 ± 12,67 minutos.Twenty dogs for the surgical-anaesthetic routine of the Veterinary Hospital of Federal University of Santa Maria - Brazil were divided in two groups, I and II, and submitted to neuromuscular block with atracurium besylate 0.5mg/kg (I or alcuronium chloride 0.1mg/kg (II. Ventilometry. heart rate and the time for reversion of the blockage were evaluated in group I. Reversal of relaxation in group II was carried with neostigmine preceded by atropine. The results demonstrated a reduction in tidal volume for both groups in the reversion of the blockage, with statistical significance between the groups 20 minutes

  12. Architectural properties of the neuromuscular compartments in selected forearm skeletal muscles.

    Science.gov (United States)

    Liu, An-Tang; Liu, Ben-Li; Lu, Li-Xuan; Chen, Gang; Yu, Da-Zhi; Zhu, Lie; Guo, Rong; Dang, Rui-Shan; Jiang, Hua

    2014-07-01

    The purposes f this study were to (i) explore the possibility of splitting the selected forearm muscles into separate compartments in human subjects; (ii) quantify the architectural properties of each neuromuscular compartment; and (iii) discuss the implication of these properties in split tendon transfer procedures. Twenty upper limbs from 10 fresh human cadavers were used in this study. Ten limbs of five cadavers were used for intramuscular nerve study by modified Sihler's staining technique, which confirmed the neuromuscular compartments. The other 10 limbs were included for architectural analysis of neuromuscular compartments. The architectural features of the compartments including muscle weight, muscle length, fiber length, pennation angle, and sarcomere length were determined. Physiological cross-sectional area and fiber length/muscle length ratio were calculated. Five of the selected forearm muscles were ideal candidates for splitting, including flexor carpi ulnaris, flexor carpi radials, extensor carpi radialis brevis, extensor carpi ulnaris and pronator teres. The humeral head of pronator teres contained the longest fiber length (6.23 ± 0.31 cm), and the radial compartment of extensor carpi ulnaris contained the shortest (2.90 ± 0.28 cm). The ulnar compartment of flexor carpi ulnaris had the largest physiological cross-sectional area (5.17 ± 0.59 cm(2)), and the ulnar head of pronator teres had the smallest (0.67 ± 0.06 cm(2)). Fiber length/muscle length ratios of the neuromuscular compartments were relatively low (average 0.27 ± 0.09, range 0.18-0.39) except for the ulnar head of pronator teres, which had the highest one (0.72 ± 0.05). Using modified Sihler's technique, this research demonstrated that each compartment of these selected forearm muscles has its own neurovascular supply after being split along its central tendon. Data of the architectural properties of each neuromuscular compartment provide insight into the 'design' of their

  13. Decreased Variability of the 6-Minute Walk Test by Heart Rate Correction in Patients with Neuromuscular Disease

    DEFF Research Database (Denmark)

    Prahm, Kira Philipsen; Witting, Nanna; Vissing, John

    2014-01-01

    by heart rate correction. METHODS: Sixteen patients with neuromuscular diseases, including Facioscapulohumeral muscular dystrophy, Limb-girdle muscular dystrophy, Charcot-Marie-Tooths, Dystrophia Myotonica and Congenital Myopathy and 12 healthy subjects were studied. Patients were excluded if they had...

  14. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific.

    Science.gov (United States)

    Astephen Wilson, Janie L; Dunbar, Michael J; Hubley-Kozey, Cheryl L

    2015-01-01

    The future of total knee arthroplasty (TKA) surgery will involve planning that incorporates more patient-specific characteristics. Despite known biological, morphological, and functional differences between men and women, there has been little investigation into knee joint biomechanical and neuromuscular differences between men and women with osteoarthritis, and none that have examined sex-specific biomechanical and neuromuscular responses to TKA surgery. The objective of this study was to examine sex-associated differences in knee kinematics, kinetics and neuromuscular patterns during gait before and after TKA. Fifty-two patients with end-stage knee OA (28 women, 24 men) underwent gait and neuromuscular analysis within the week prior to and one year after surgery. A number of sex-specific differences were identified which suggest a different manifestation of end-stage knee OA between the sexes.

  15. Tratamiento farmacológico de las alteraciones neuromusculares en el paciente crítico Pharmacological treatment neuromuscular impairments in critically ill patients

    OpenAIRE

    C. Ortiz Leyba

    2006-01-01

    El empleo de fármacos para tratamiento de las alteraciones neuromusculares que se presentan en el enfermo ingresado en una Unidad de Cuidados Intensivos es prácticamente inexistente. El empleo de inmunoglobulinas por vía venosa para el tratamiento de la polineuropatía del paciente crítico (PPC) no aporta ninguna evidencia para su uso. Más importancia tiene el tratamiento profiláctico, como es el caso de la administración de una perfusión de insulina para prevenir la hiperglucemias que seasoci...

  16. Tratamiento farmacológico de las alteraciones neuromusculares en el paciente crítico Pharmacological treatment neuromuscular impairments in critically ill patients

    Directory of Open Access Journals (Sweden)

    C. Ortiz Leyba

    2006-05-01

    Full Text Available El empleo de fármacos para tratamiento de las alteraciones neuromusculares que se presentan en el enfermo ingresado en una Unidad de Cuidados Intensivos es prácticamente inexistente. El empleo de inmunoglobulinas por vía venosa para el tratamiento de la polineuropatía del paciente crítico (PPC no aporta ninguna evidencia para su uso. Más importancia tiene el tratamiento profiláctico, como es el caso de la administración de una perfusión de insulina para prevenir la hiperglucemias que seasocian a un mayor desarrollo de la PPC. Nuevos datos inducen a pensar que el mecanismo protector de esta perfusión, normalizando los niveles de glucosa se hacen modulando una disfunción endotelial y a unos menores niveles de dimetilarginina asimétrica (ADMA. Con respecto a la miopatía del paciente crítico o a los cuadros de bloqueo neuromuscular prolongado, el tratamiento consiste en evitar el empleo de diversos fármacos que se sabe se asocian al desarrollo de estas entidades como son los corticoides, los relajantes musculares y los aminoglucósidos. Por lo que respecta a la parálisis aguda flácida -infección por el virus del oeste del nilo se han comunicado casos anecdóticos de mejoría con el empleo de corticoides o de interferón, pero su tratamiento rutinario queda aún por establecer.The use of drugs for treating neuromuscular impairments that present in the patient admitted to the Intensive Care Unit is virtually inexistent. The use of intravenous immunoglobulins for managing polyneuropathy of the critically ill patient (PCIP is supported by no evidence. More important is prophylactic therapy, as is the administration of insulin perfusion to prevent hyperglycemia that is associated to increased development of PCIP. New data suggest that the protective mechanism of this perfusion, which normalizes glucose levels, is achieved through the modulation of endothelial dysfunction and lowering levels of asymmetrical di-methyl arginine (ADMA. As

  17. EFFECT OF NEUROMUSCULAR REEDUCATION IN BILATERAL FACIAL PALSY ON PATIENT WITH GBS

    Directory of Open Access Journals (Sweden)

    Sanjiv Kumar, MPT, PhD

    2014-04-01

    Full Text Available Background: Bilateral facial palsy is a rare entity and remains to be a challenging case to diagnose and manage which has the major impact on the physical and social aspect of the affected individual. Objective: The aim of the report is to determine the role of neuromuscular reeducation in restoration of function in person with Guillain Barre Syndrome present with facial diplegia. Case report: We report the case of 23 year male presenting with history of deviation of mouth to the right side, followed by bilateral facial involvement and latter distal symmetrical involvement of bilateral upper and lower limb. The facial diplegia was managed by PNF and Electrical stimulation. Conclusions: Neuromuscular reeducation is an effective intervention for restoration of function after facial diplegia.

  18. Enhancement of neuromuscular activity by natural specimens and cultured mycelia of Cordyceps Sinensis in mice

    Directory of Open Access Journals (Sweden)

    K P Singh

    2014-01-01

    Full Text Available The present study was aimed to evaluate the effect of natural specimen and laboratory cultured mycelia of Cordyceps sinensis on neuromuscular activity in mice. The powder of natural specimen and laboratory cultured Cordyceps sinensis was orally administered at the dose rate of 100, 300 and 500 mg/kg for 30 days. Natural specimen and in vitro propagated Cordyceps sinensis showed significant (P<0.05 enhancement in neuromuscular endurance and antidepressant activity at 300 and 500 mg/kg as compared to the control group. However, the fungus did not proved to be as effective as fluoxetine in exhibiting antidepressant action. Muscular endurance was determined on a Rota rod apparatus while antidepressant (mood elevating activity was measured on a photoactometer in Swiss albino mice. The effects produced by both natural specimens and laboratory cultured Cordyceps sinensis were comparable and showed almost equal potency.

  19. Effects of mescaline and some of its analogs on cholinergic neuromuscular transmission.

    Science.gov (United States)

    Ghansah, E; Kopsombut, P; Malleque, M A; Brossi, A

    1993-02-01

    Mescaline (3,4,5-trimethoxyphenylethylamine; MES) and its analogs, anhalinine (ANH) and methylenemescaline trimer (MMT) were investigated, using sciatic-sartorius preparations of the frog and cortical tissue from the rat. The effects of MES and its analogs were examined with respect to muscle twitch, resting membrane potential and nicotinic receptor binding. Mescaline and its analogs (10-100 microM) blocked both directly and neurally evoked twitches but their effects on neurally evoked twitches were greater than those on directly evoked twitches. Mescaline, ANH and MMT decreased amplitude of the miniature endplate and endplate potentials, decreased acetylcholine (ACh) quantal content, hyperpolarized the resting membrane potential and prolonged duration of the action potential. They did not significantly displace the binding of [125I]-alpha-bungarotoxin (alpha-BTX) to nicotinic receptors, at concentrations which blocked neuromuscular transmission. These results suggest that MES and its analogs inhibit cholinergic neuromuscular transmission by blocking release of ACh; they also affect K+ conductance.

  20. Split-dose atropine versus glycopyrrolate with neostigmine for reversal of gallamine-induced neuromuscular blockade

    DEFF Research Database (Denmark)

    Wetterslev, J; Jarnvig, I; Jørgensen, L N;

    1991-01-01

    The effects of a split-dose of atropine sulphate versus a single dose of glycopyrrolate given with neostigmine for the reversal of gallamine-induced neuromuscular blockade were studied in 55 patients undergoing gynaecological surgery. The patients were randomized to receive either a single dose of......, whereas none occurred in the glycopyrrolate group (P less than 0.05). It is concluded that a split-dose of atropine has similar chronotropic effects to a single dose of glycopyrrolate for the reversal of gallamine-induced neuromuscular blockade. However, the finding of a higher incidence of cardiac...... arrhythmias in the atropine group suggests that this reversal regime should be reserved for patients without cardiac disease....

  1. Acceleromyography and mechanomyography for establishing potency of neuromuscular blocking agents: a randomized-controlled trial

    DEFF Research Database (Denmark)

    Claudius, C; Viby-Mogensen, J; Skovgaard, Lene Theil

    2009-01-01

    BACKGROUND: Acceleromyography (AMG) is increasingly being used in neuromuscular research, including in studies establishing the potency of neuromuscular blocking and reversal agents. However, AMG is insufficiently validated for use interchangeably with the gold standard, mechanomyography (MMG) for...... this purpose. The aim of this study was to compare AMG and MMG for establishing dose-response relationship and potency, using rocuronium as an example. METHODS: We included 40 adult patients in this randomized-controlled single-dose response study. Anaesthesia was induced and maintained with propofol......-response relationships were determined for both recording methods using log (dose) against probit (maximum block). The obtained slopes of the regression lines, ED(50), ED(95) and the maximum block were compared. RESULTS: The ED(50) and ED(95) [95% confidence interval (CI)] for AMG were 185 microg/kg(167-205 microg...

  2. [Neuromuscular dynamic scapular winging: Clinical, electromyographic and magnetic resonance imaging diagnosis].

    Science.gov (United States)

    Nguyen, Christelle; Guérini, Henri; Roren, Alexandra; Zauderer, Jennifer; Vuillemin, Valérie; Seror, Paul; Ouaknine, Michaël; Palazzo, Clémence; Bourdet, Christopher; Pluot, Étienne; Roby-Brami, Agnès; Drapé, Jean-Luc; Rannou, François; Poiraudeau, Serge; Lefèvre-Colau, Marie-Martine

    2015-12-01

    Dyskinesia of the scapula is a clinical diagnosis and includes all disorders affecting scapula positioning and movement whatever its etiology. Scapular winging is a subtype of scapular dyskinesia due to a dynamic prominence of the medial border of the scapula (DSW) secondary to neuromuscular imbalance in the scapulothoracic stabilizer muscles. The two most common causes of DSW are microtraumatic or idiopathic lesions of the long thoracic nerve (that innerves the serratus anterior) or the accessory nerve (that innerves the trapezius). Diagnosis of DSW is clinical and electromyographic. Use of magnetic resonance imaging (MRI) could be of interest to distinguish lesion secondary to a long thoracic nerve from accessory nerve and to rule out scapular dyskinesia related to other shoulder disorders. Causal neuromuscular lesion diagnosis in DSW is challenging. Clinical examinations, combined with scapular MRI, could help to their specific diagnosis, determining their stage, ruling out differential diagnosis and thus give raise to more targeted treatment. PMID:26433832

  3. Maximum likelihood q-estimator reveals nonextensivity regulated by extracellular potassium in the mammalian neuromuscular junction

    CERN Document Server

    da Silva, A J; Santos, D O C; Lima, R F

    2013-01-01

    Recently, we demonstrated the existence of nonextensivity in neuromuscular transmission [Phys. Rev. E 84, 041925 (2011)]. In the present letter, we propose a general criterion based on the q-calculus foundations and nonextensive statistics to estimate the values for both scale factor and q-index using the maximum likelihood q-estimation method (MLqE). We next applied our theoretical findings to electrophysiological recordings from neuromuscular junction (NMJ) where spontaneous miniature end plate potentials (MEPP) were analyzed. These calculations were performed in both normal and high extracellular potassium concentration, [K+]o. This protocol was assumed to test the validity of the q-index in electrophysiological conditions closely resembling physiological stimuli. Surprisingly, the analysis showed a significant difference between the q-index in high and normal [K+]o, where the magnitude of nonextensivity was increased. Our letter provides a general way to obtain the best q-index from the q-Gaussian distrib...

  4. Respiratory motor training and neuromuscular plasticity in patients with chronic obstructive pulmonary disease: A pilot study.

    Science.gov (United States)

    Ovechkin, Alexander V; Sayenko, Dimitry G; Ovechkina, Elena N; Aslan, Sevda C; Pitts, Teresa; Folz, Rodney J

    2016-07-15

    The objective of this study was to examine the feasibility of a full-scale investigation of the neurophysiological mechanisms of COPD-induced respiratory neuromuscular control deficits. Characterization of respiratory single- and multi-muscle activation patterns using surface electromyography (sEMG) were assessed along with functional measures at baseline and following 21±2 (mean±SD) sessions of respiratory motor training (RMT) performed during a one-month period in four patients with GOLD stage II or III COPD. Pre-training, the individuals with COPD showed significantly increased (prespiratory muscle activity and disorganized multi-muscle activation patterns in association with lowered spirometrical measures and decreased fast- and slow-twitch fiber activity as compared to healthy controls (N=4). Following RMT, functional and respiratory sEMG activation outcomes during quite breathing and forced expiratory efforts were improved suggesting that functional improvements, induced by task-specific RMT, are evidence respiratory neuromuscular networks re-organization.

  5. Surgical Space Conditions During Low-Pressure Laparoscopic Cholecystectomy with Deep Versus Moderate Neuromuscular Blockade

    DEFF Research Database (Denmark)

    Staehr-Rye, Anne K; Rasmussen, Lars S.; Rosenberg, Jacob;

    2014-01-01

    described, but deep neuromuscular blockade may be beneficial. We investigated if deep muscle relaxation would be associated with a higher proportion of procedures with "optimal" surgical space conditions compared with moderate relaxation during low-pressure (8 mm Hg) laparoscopic cholecystectomy. METHODS......). RESULTS: Optimal surgical space conditions during the entire procedure were observed in 7 of 25 patients allocated to deep neuromuscular blockade and in 1 of 23 patients allocated to moderate blockade (P = 0.05) with an absolute difference of 24% between the groups (95% confidence interval, 4......%-43%). Laparoscopic cholecystectomy was completed at pneumoperitoneum 8 mm Hg in 15 of 25 and 8 of 23 patients in the deep and moderate group, respectively (95% confidence interval, -2% to 53%; P = 0.08). Surgical space conditions during dissection of the gallbladder assessed by use of the numeric rating scale were...

  6. Analgesia pós-operatória para procedimentos cirúrgicos ortopédicos de quadril e fêmur: comparação entre bloqueio do compartimento do psoas e bloqueio perivascular inguinal Analgesia postoperatoria para procedimientos quirúrgicos ortopédicos de cadera y fémur: comparación entre bloqueo del compartimiento del psoas y bloqueo perivascular inguinal Postoperative analgesia for orthopedic surgeries of the hip and femur: a comparison between psoas compartment and inguinal paravascular blocks

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2006-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Este estudo avaliou a eficácia da injeção única de bupivacaína a 0,25% no compartimento do psoas ou perivascular inguinal por meio do estimulador de nervos periféricos para analgesia pós-operatória em pacientes submetidos a intervenções cirúrgicas ortopédicas. MÉTODO: Cem pacientes receberam bloqueio do plexo lombar através do compartimento do psoas e foram comparados com 100 pacientes que receberam bloqueio do plexo lombar via perivascular inguinal, identificados pelo estimulador de nervos periféricos com a injeção de 40 mL bupivacaína a 0,25% sem epinefrina. A analgesia nos nervos ilioinguinal, genitofemoral, cutâneo femoral lateral, femoral e obturatório foi avaliada 4, 8, 12, 16, 20 e 24 horas após o final da intervenção cirúrgica. A intensidade da dor foi também avaliada no mesmo período. A quantidade de opióides administrada no pós-operatório foi anotada. Em cinco pacientes de cada grupo, estudo radiográfico com contraste não-iônico foi realizado para avaliar a dispersão da solução anestésica. RESULTADOS: Os nervos ilioinguinal, genitofemoral, cutâneo femoral lateral, femoral e obturatório foram bloqueados em 92% dos pacientes no compartimento do psoas versus 62% no bloqueio perivascular inguinal. O bloqueio do plexo lombar reduziu a necessidade de opióides e 42% dos pacientes submetidos ao bloqueio do compartimento do psoas e 36% dos pacientes no bloqueio inguinal não necessitaram de analgésico adicional no pós-operatório. A duração da analgesia foi em torno de 21 horas com bloqueio do compartimento do psoas e 15 horas com bloqueio perivascular inguinal. CONCLUSÕES: O bloqueio do compartimento do psoas e perivascular inguinal é uma excelente técnica para analgesia pós-operatória em intervenções cirúrgicas ortopédicas reduzindo a necessidade de opióides. Este estudo mostrou que a injeção no compartimento do psoas foi mais fácil e mais efetiva no bloqueio

  7. Bloqueio extraconal para facectomia com implante de lente intra-ocular: influência do fentanil associado ao anestésico local na qualidade do bloqueio e na analgesia pós-operatória Bloqueo extraconal para facectomia con implantación de lente intra-ocular: influencia del fentanil asociado al anestésico local en la calidad del bloqueo y en la analgesia pos-operatoria Extraconal block for cataract extraction surgery with implantation of intraocular lens: contribution of fentanyl associated to local anesthetics for quality of block and postoperative analgesia

    Directory of Open Access Journals (Sweden)

    Daniel Espada Lahoz

    2003-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A anestesia locorregional para cirurgias oftalmológicas oferece vantagens, como: mínimas alterações fisiológicas, anestesia completa, bloqueio dos reflexos oculares, pequena incidência de náuseas e vômitos, menor tempo de recuperação e analgesia pós-operatória. A preocupação constante com a qualidade do bloqueio, assim como da abordagem da analgesia pós-operatória deve ficar sob a responsabilidade do anestesiologista. O objetivo deste estudo foi avaliar se o fentanil contribui na qualidade do bloqueio extraconal e na analgesia pós-operatória de facectomias com implante de lente intra-ocular. MÉTODO: Estudou-se a associação do fentanil e bupivacaína a 0,75% na qualidade do bloqueio ocular e na analgesia pós-operatória em 164 pacientes submetidos a facectomia com implante de lente intra-ocular (técnica extracapsular, de ambos os sexos com homogeneidade de parâmetros antropométricos, olho operado, classificação do estado físico (ASA e índice de risco cardíaco de Goldman. Os pacientes foram distribuídos em dois grupos (82 pacientes em cada grupo por sorteio de forma aleatória, com e sem fentanil. Avaliou-se a qualidade do bloqueio por: aparecimento da dor no per-operatório, manutenção de movimentação das pálpebras ou do globo ocular, persistência do reflexo de Bell, número de bloqueios realizados para a obtenção de condições cirúrgicas e avaliação do bloqueio pelo cirurgião. A analgesia pós-operatória foi avaliada pela necessidade de complementação analgésica pelo paciente. RESULTADOS: Fentanil associado à solução anestésica no bloqueio extraconal aumentou significativamente o bloqueio do músculo reto medial (com fentanil - 17,1%, sem fentanil - 32,9% e diminuiu o consumo de analgésicos no período pós-operatório (uso de analgésicos com fentanil - 20,7%, não uso de analgésicos com fentanil - 41,5%. CONCLUSÕES: Nas condições deste estudo o fentanil

  8. Long Term Follow-up of Ventilated Patients with Thoracic Restriction and Neuromuscular Disease

    Directory of Open Access Journals (Sweden)

    Dina Brooks

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate the long term effects of home mechanical ventilation (HMV on pulmonary function, nighttime gas exchange, daytime arterial blood gases, sleep architecture and functional exercise capacity (6 min walk. Patients with respiratory failure attributable to thoracic restrictive disease (TRD (kyphoscoliosis or neuromuscular disease (NMD were assessed, ventilated, trained and followed in a dedicated unit for the care of patients requiring long term ventilation.

  9. Transcription Factors in Muscle Atrophy Caused by Blocked Neuromuscular Transmission and Muscle Unloading In Rats

    OpenAIRE

    Nordquist, Jenny; Höglund, Anna-Stina; Norman, Holly; Tang, Xiaorui; Dworkin, Barry; Larsson, Lars

    2007-01-01

    The muscle wasting associated with long-term intensive care unit (ICU) treatment has a negative effect on muscle function resulting in prolonged periods of rehabilitation and a decreased quality of life. To identify mechanisms behind this form of muscle wasting, we have used a rat model designed to mimic the conditions in an ICU. Rats were pharmacologically paralyzed with a postsynaptic blocker of neuromuscular transmission, and mechanically ventilated for one to two weeks, thereby unloading ...

  10. EFFECT OF TRAINING WITH NEUROMUSCULAR ELECTRICAL STIMULATION ON ELBOW FLEXION STRENGTH

    OpenAIRE

    Holcomb, William R.

    2006-01-01

    Neuromuscular electrical stimulation (NMES) may be used to prevent strength loss associated with post-surgical immobilization. Most studies testing the effectiveness of NMES have trained the knee extensors. The purpose of this investigation was to test the effectiveness of NMES when training the elbow flexors. Twenty-four students were randomly assigned to one of three groups: NMES training, isometric training or control. Testing and training were completed using a Biodex™ dynamometer. After ...

  11. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training

    OpenAIRE

    BEHRENS, Martin; Weippert, Matthias; Wassermann, Franziska; Bader, Rainer; Bruhn, Sven; Mau-Moeller, Anett

    2015-01-01

    Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals ...

  12. The BMP signaling pathway at the Drosophila neuromuscular junction and its links to neurodegenerative diseases

    OpenAIRE

    Bayat, Vafa; Jaiswal, Manish; Bellen, Hugo J

    2010-01-01

    The Drosophila neuromuscular junction (NMJ) has recently provided new insights into the roles of various proteins in neurodegenerative diseases including Amyotrophic Lateral Sclerosis (ALS), Spinal Muscular Atrophy (SMA), Multiple Sclerosis (MS) Hereditary Spastic Paraplegia (HSP), and Huntington’s Disease (HD). Several developmental signaling pathways including WNT, MAPK and BMP/TGF-β signaling play important roles in the formation and growth of the Drosophila NMJ. Studies of the fly homolog...

  13. Neuromuscular adaptations in football athletes with prior history of hamstring strain injury

    OpenAIRE

    Areia, Carlos Morgado

    2015-01-01

    Background: Hamstring strain injuries (HSI) are one of the most common injuries in a wide variety of running-sports, resulting in a considerable loss of competition and training time. One of the most problematic consequences regarding HSI is the recurrence rate and its non-decrease over the past decades, despite increasing evidence. Recent studies also found several maladaptations post-HSI probably due to neuromuscular inhibition and it has been proposed that these adaptations post-injury may...

  14. Effectiveness of neuromuscular electrical stimulation in the functional knee rehabilitation in soldiers

    OpenAIRE

    R. Castillo-Lozano

    2015-01-01

    Background: The versatility of military physical therapist practice enables them not only to diagnose knee injuries but also to provide a wide range of definitive care and rehabilitation, reducing the need for costly evacuation. The aim this study was to evaluate the effectiveness of interventions by Neuromuscular Electrical Stimulation (NMES) in the functional knee rehabilitation in soldiers and describe the main predictors and determinants in each intervention. Methods: A systematic search ...

  15. Haemodynamic performance of neuromuscular electrical stimulation (NMES) during recovery from total hip arthroplasty

    OpenAIRE

    Broderick, Barry J.; Breathnach, Oisin; Condon, Finbarr; Masterson, Eric; ÓLaighin, Gearóid

    2013-01-01

    Background Patients post total hip arthroplasty (THA) remain at high risk of developing Deep Vein Thrombosis (DVT) during the recovery period following surgery despite the availability of effective pharmacological and mechanical prophylactic methods. The use of calf muscle neuromuscular electrical stimulation (NMES) during the hospitalised recovery period on this patient group may be effective at preventing DVT. However, the haemodynamic effectiveness and comfort characteristics of NMES in po...

  16. The Effects on the Pulmonary Function of Normal Adults Proprioceptive Neuromuscular Facilitation Respiration Pattern Exercise

    OpenAIRE

    Seo, KyoChul; Cho, Misuk

    2014-01-01

    [Purpose] The purpose of this study was to determine whether proprioceptive neuromuscular facilitation (PNF) respiration exercise increases the pulmonary function of normal adults. [Subjects and Methods] Twenty-eight normal adults in their 20s were randomly assigned to an experimental group (n=14) or control group (n=14). Over the course of four weeks, the experimental group participated in PNF respiration pattern exercises for 30 minutes three times per week. Subjects were assessed pre-test ...

  17. Neuromuscular exercise improves functional performance in patients with severe hip osteoarthritis

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Larsen, Anders Holsgaard;

    Purpose. Exercise is regarded a cornerstone in the treatment of mild to moderate osteoarthritis (OA). However, little is known of the effects in patients with advanced and end-stage OA. The purpose was to evaluate the effect of neuromuscular exercise in patients with severe hip OA. Methods. Desig...... to the NEMEX-TJR program improves functional performance and leg extension power in patients with severe OA of the hip joint....

  18. Comparison of Apical Axial Derotation between Adolescent Idiopathic and Neuromuscular Scoliosis with Pedicle Screw Instrumentation

    OpenAIRE

    Modi, Hitesh N.; Suh, Seung-Woo; Srinivasalu, S.; Mehta, Satyen; Yang, Jae-Hyuk

    2008-01-01

    Study Design A retrospective study. Purpose To compare outcomes of apical derotation with pedicle screws in idiopathic and neuromuscular scoliosis (NMS). Overview of Literature No information about apical derotation in NMS with pedicle screws is available. Methods We performed deformity correcting surgery using pedicle screw constructs on 12 adolescent idiopathic scoliosis (AIS) patients (mean age 14.1 years) and 16 NMS patients (mean age 16.5 years). Preoperative, postoperative, and final fo...

  19. Neuromuscular induced phonation in a human ex vivo perfused larynx preparation

    OpenAIRE

    Berke, Gerald; Mendelsohn, Abie H; Scott Howard, Nelson; Zhang, Zhaoyan

    2013-01-01

    Considering differences in laryngeal anatomy, degree of control, and range of voice qualities between animals and humans, investigations of the neuromuscular process of voice control are better conducted using a living human larynx in which parametric stimulation of individual laryngeal muscles is possible. Due to difficulties in access and monitoring of laryngeal muscle activities, such investigations are impossible in living human subject experiments. This study reports the recent success i...

  20. Descripción histológica del huso neuromuscular

    Directory of Open Access Journals (Sweden)

    Freddy Moreno

    2015-05-01

    Full Text Available Esta nota de clase tiene como propósito realizar la descripción morfológica del huso neuromuscular en una preparación histológica de músculo estriado esquelético dentro del contexto de la asignatura Sistema Locomotor, la cual forma parte del núcleo fundamental del programa académico de medicina de la Pontificia Universidad Javeriana Cali.

  1. Changes in Hyolaryngeal Movement and Swallowing Function After Neuromuscular Electrical Stimulation in Patients With Dysphagia

    OpenAIRE

    Lee, Hoo Young; Hong, Ji Seong; Lee, Kil Chan; Shin, Yoon-Kyum; Cho, Sung-Rae

    2015-01-01

    Objective To investigate immediate changes in hyolaryngeal movement and swallowing function after a cycle of neuromuscular electrical stimulation (NMES) on both submental and throat regions and submental placement alone in patients with dysphagia. Methods Fifteen patients with dysphagia were recruited. First, videofluoroscopic swallowing study (VFSS) was performed before NMES. All patients thereafter received a cycle of NMES by 2 methods of electrode placement: 1) both submental and throat re...

  2. Attenuation of age-related changes in mouse neuromuscular synapses by caloric restriction and exercise

    OpenAIRE

    Valdez, G; Tapia, J; Kang, H; Clemenson, G.D.; Gage, F.H.; Lichtman, Jeff; Sanes, Joshua R.

    2010-01-01

    The cellular basis of age-related behavioral decline remains obscure but alterations in synapses are likely candidates. Accordingly, the beneficial effects on neural function of caloric restriction and exercise, which are among the most effective anti-aging treatments known, might also be mediated by synapses. As a starting point in testing these ideas, we studied the skeletal neuromuscular junction (NMJ), a large, accessible peripheral synapse. Comparison of NMJs in young adult and aged mice...

  3. Performances in cerebellar and neuromuscular transmission tests are correlated in migraine with aura

    OpenAIRE

    Ambrosini, A; Sándor, P S; De Pasqua, V; Pierelli, F; Schoenen, J.

    2008-01-01

    In previous studies, we described subclinical abnormalities of neuromuscular transmission and cerebellar functions in migraineurs. The aim of this study was to search if these two functions are correlated in the same patient. Thirteen migraineurs [five without aura (MO) and eight with aura (MA)] underwent both stimulation-SFEMG and 3D-movement analysis. Single fiber EMG (SFEMG) results were expressed as the "mean value of consecutive differences" (mean MCD). Precision of arm-reaching movement...

  4. GA-Binding Protein Is Dispensable for Neuromuscular Synapse Formation and Synapse-Specific Gene Expression▿

    OpenAIRE

    Jaworski, Alexander; Smith, Cynthia L.; Burden, Steven J.

    2007-01-01

    The mRNAs encoding postsynaptic components at the neuromuscular junction are concentrated in the synaptic region of muscle fibers. Accumulation of these RNAs in the synaptic region is mediated, at least in part, by selective transcription of the corresponding genes in synaptic myofiber nuclei. The transcriptional mechanisms that are responsible for synapse-specific gene expression are largely unknown, but an Ets site in the promoter regions of acetylcholine receptor (AChR) subunit genes and o...

  5. Induction of multiple signaling loops by MuSK during neuromuscular synapse formation

    OpenAIRE

    Moore, Chris; Leu, Marco; Müller, Ulrich; Brenner, Hans Rudolf

    2001-01-01

    At the neuromuscular junction, two motor neuron-derived signals have been implicated in the regulation of synaptogenesis. Neuregulin-1 is thought to induce transcription of acetylcholine receptor (AChR) genes in subsynaptic muscle nuclei by activating ErbB receptors. Neural agrin aggregates AChRs by activating the receptor tyrosine kinase MuSK. Here, we show that these two signals act sequentially. Agrin, by activating MuSK, induces the synthesis and aggregation of...

  6. Visualizing the Live Drosophila Glial-neuromuscular Junction with Fluorescent Dyes

    OpenAIRE

    Brink, Dee; Gilbert, Mary; Auld, Vanessa

    2009-01-01

    Our project identified GFP labeled glial structures at the developing larval fly neuromuscular synapse. To look at development of live glial-nerve-muscle synapses, we developed a larval tissue preparation that had features of live intact larvae, but also had good optical properties. This new preparation also allowed for access of perfusates to the synapse. We used fly larvae, immersed them in artificial hemolymph, and relaxed their normal rhythmic body contractions by chilling them. Next we d...

  7. The Role of MuSK in Synapse Formation and Neuromuscular Disease

    OpenAIRE

    Burden, Steven J.; Yumoto, Norihiro; Zhang, Wei

    2013-01-01

    Muscle-specific kinase (MuSK) is essential for each step in neuromuscular synapse formation. Before innervation, MuSK initiates postsynaptic differentiation, priming the muscle for synapse formation. Approaching motor axons recognize the primed, or prepatterned, region of muscle, causing motor axons to stop growing and differentiate into specialized nerve terminals. MuSK controls presynaptic differentiation by causing the clustering of Lrp4, which functions as a direct retrograde signal for p...

  8. Prolonged mental exertion does not alter neuromuscular function of the knee extensors

    OpenAIRE

    Pageaux, Benjamin; Marcora, Samuele; Lepers, Romuald

    2013-01-01

    International audience; Purpose: The aim of this study was to test the hypotheses that prolonged mental exertion i) reduces maximal muscle activation and ii) increases the extent of central fatigue induced by subsequent endurance exercise. Methods: Neuromuscular function of the knee extensor muscles was assessed in 10 male subjects in two different conditions: i) before and after prolonged mental exertion leading to mental fatigue; ii) before and after an easy cognitive task (control). Both c...

  9. Comparative investigation of the pharmacology of fish and mammalian neuromuscular systems

    Energy Technology Data Exchange (ETDEWEB)

    Gant, D.B.

    1985-01-01

    Neuromuscular pharmacology has been extensively studied in mammals but there have been few investigations examining the neuromuscular systems of fish. In situ experiments have shown that the basic cholinergic characteristics of fish neuromuscular junctions are different from those of mammals. In order to further understand the nature of these differences, the nicotinic acetylcholine receptors (AChR) of rat and buffalo sculpin (Enophrys bison) neuromuscular junctions and the AChR of electric ray (Torpedo california) electroplax, were investigated using receptor binding analysis. A rapid filtration assay was utilized to measure (/sup 125/I)..cap alpha..-BGT binding to tissue membranes. Scatchard analysis of (/sup 175/I)..cap alpha..-BGT binding was performed on sculpin pectoral muscle rat gastrocnemius, rat denervated gastrocnemius, and Torpedo electroplax. The affinity constant was similar for all tissues studied. In competition studies, d-tubocurarine had the highest affinity for the (/sup 125/I)-..cap alpha..-BGT binding site in all tissues, illustrating the nicotinic nature of the binding sites. Acetylcholine had high affinity for the rat gastrocnemius binding site and low affinity for the sculpin pectoral muscle and Torpedo electroplax binding site. Atropine had high affinity for the sculpin pectoral muscle binding site when compared to the rate gastrocnemius and Torpedo electroplax binding site, indicating that the sculpin pectoral site may have some mixed muscarinic-nicitinic characteristics. These results indicate that there are definite qualitative as well as quantitative differences between the fish skeletal muscle nicotinic receptor and the nicotinic receptor of fish electroplax and rat skeletal muscle.

  10. Bone density and neuromuscular function in older competitive athletes depend on running distance

    OpenAIRE

    Gast, Ulf; Belavy, Daniel; Armbrecht, Gabriele; Kusy, Krzysztof; Lexy, H; Rawer, R; Rittweger, Jörn; Winwood, Keith; Zielinski, Jacek; Felsenberg, Dieter

    2013-01-01

    Summary Individuals who are involved in explosive sport types, such as 100-m sprints and long jump, have greater bone density, leg muscle size, jumping height and grip strength than individuals involved in long-distance running. Introduction The purpose of this study is to examine the relationship between different types of physical activity with bone, lean mass and neuromuscular performance in older individuals. Methods We examined short- (n050), middle- (n019) and lo...

  11. Neuromuscular adaptations to 4 weeks of intensive drop jump training in well-trained athletes

    DEFF Research Database (Denmark)

    Alkjær, Tine; Meyland, Jacob; Raffalt, Peter C;

    2013-01-01

    This study examined the effects of 4 weeks of intensive drop jump training in well-trained athletes on jumping performance and underlying changes in biomechanics and neuromuscular adaptations. Nine well-trained athletes at high national competition level within sprinting and jumping disciplines...... performance also in well-trained athletes without concomitant changes in muscle strength. It is suggested that the behavioral improvement is primarily due to neural factors regulating the activation pattern controlling the drop jump movement....

  12. Surface neuromuscular electrical stimulation for quadriceps strengthening pre and post total knee replacement.

    LENUS (Irish Health Repository)

    Monaghan, Brenda

    2010-01-01

    Total knee replacement has been demonstrated to be one of the most successful procedures in the treatment of osteoarthritis. However quadriceps weakness and reductions in function are commonly reported following surgery. Recently Neuromuscular Electrical Stimulation (NMES) has been used as an adjunct to traditional strengthening programmes. This review considers the effectiveness of NMES as a means of increasing quadriceps strength in patients before and after total knee replacement.

  13. Studies on neuromuscular blockade by boldine in the mouse phrenic nerve-diaphragm.

    Science.gov (United States)

    Kang, J J; Cheng, Y W; Fu, W M

    1998-02-01

    The effects of boldine [(S)-2,9-dihydroxyl-1,10-dimethoxy-aporphine], a major alkaloid in the leaves and bark of Boldo (Peumus boldus Mol.), on neuromuscular transmission were studied using a muscle phrenic-nerve diaphragm preparation. Boldine at concentrations lower than 200 microM preferentially inhibited, after an initial period of twitch augmentation, the nerve-evoked twitches of the mouse diaphragm and left the muscle-evoked twitches unaffected. The twitch inhibition could be restored by neostigmine or washout with Krebs solution. The twitches evoked indirectly and directly were both augmented initially, suggesting that the twitch augmentation induced by boldine was myogenic. Boldine inhibited the acetylcholine-induced contraction of denervated diaphragm dose-dependently with an IC50 value of 13.5 microM. At 50 microM, boldine specifically inhibited the amplitude of the miniature end plate potential. In addition, boldine was similar to d-tubocurarine in its action to reverse the neuromuscular blocking action of alpha-bungarotoxin. These results showed that the neuromuscular blockade by boldine on isolated mouse phrenic-nerve diaphragm might be due to its direct interaction with the postsynaptic nicotinic acetylcholine receptor. PMID:9541284

  14. Cardiorespiratory and neuromuscular responses during water aerobics exercise performed with and without equipment.

    Science.gov (United States)

    Pinto, S S; Cadore, E L; Alberton, C L; Silva, E M; Kanitz, A C; Tartaruga, M P; Kruel, L F M

    2011-12-01

    The aim of the study was to compare the cardiorespiratory and neuromuscular responses to water aerobics exercise performed with and without equipment. 15 women performed stationary jogging combined with elbow flexion/extension without equipment, with water-drag forces equipment and with water-floating equipment, at 2 submaximal cadences and at maximal cadence. Heart rate, oxygen uptake and electromyographic signal from biceps brachii, triceps brachii, biceps femoris and rectus femoris were collected during the exercise. The heart rate and oxygen uptake showed significantly higher values during the execution of the water aerobics exercise with either equipment compared to the execution without equipment. In addition, significant difference was found between submaximal cadences. For neuromuscular responses, no significant differences were found between the submaximal cadences for all muscles analyzed; however, significant differences were found between these submaximal cadences and the maximal cadence. Similarly, the results showed no significant differences between the execution of the exercise with or without equipment, except in the muscle activation of triceps brachii and biceps femoris, which was higher when using water-floating and water-drag forces equipment, respectively. In conclusion, the water aerobics exercise presented higher cardiorespiratory responses with equipment and also increased the cadence of execution. Nevertheless, neuromuscular responses were higher only at maximal cadence. PMID:22052026

  15. Sex alters impact of repeated bouts of sprint exercise on neuromuscular activity in trained athletes.

    Science.gov (United States)

    Billaut, François; Smith, Kurt

    2009-08-01

    This study characterized the effect of sex on neuromuscular activity during repeated bouts of sprint exercise. Thirty-three healthy male and female athletes performed twenty 5-s cycle sprints separated by 25 s of rest. Mechanical work and integrated electromyograhs (iEMG) of 4 muscles of the dominant lower limb were calculated in every sprint. The iEMG signals from individual muscles were summed to represent overall electrical activity of these muscles (sum-iEMG). Neuromuscular efficiency (NME) was calculated as the ratio of mechanical work and sum-iEMG for every sprint. Arterial oxygen saturation was estimated (SpO2) with pulse oximetry throughout the protocol. The sprint-induced work decrement (18.9% vs. 29.6%; p women than for the men. However, the sprints decreased NME (10.1%; p men, R2 = 0.87; women, R2 = 0.91; all p sprint exercise is not likely to be explained by a difference in muscle contractility impairment in men and women, but may be due to a sex difference in muscle recruitment strategy. We speculate that women would be less sensitive to arterial O2 desaturation than men, which may trigger lower neuromuscular adjustments to exhaustive exercise.

  16. Comparison of electromyography and kinemyography during recovery from non-depolarising neuromuscular blockade.

    Science.gov (United States)

    Stewart, P A; Freelander, N; Liang, S; Heller, G; Phillips, S

    2014-05-01

    In this study, two commercially available quantitative neuromuscular function monitoring techniques, electromyography (EMG) and kinemyography (KMG), were compared with respect to repeatability and accuracy during late recovery from neuromuscular blockade. Train-of-four (TOF) ratios were recorded in 30 patients using KMG and EMG at the adductor pollicis muscle. Measurements were taken on the same hand using the Datex-Ohmeda NeuroMuscular Transmission monitor (GE Healthcare, Helsinki, Finland). Instrumental precision was evaluated using the coefficient of repeatability, while accuracy was assessed using the bias and limits of agreement. The coefficients of repeatability were similar for both techniques (0.035 for KMG and 0.043 for EMG), indicating a similar level of precision. KMG overestimated the TOF ratios measured with EMG with a bias of 0.11 (95% limits of agreement: -0.13 to 0.35). At a TOF ratio of 0.90 the bias was 0.08 (95% limits of agreement: -0.08 to 0.25). This means that at a TOF ratio of 0.90 measured with KMG will be approximately equivalent to a TOF ratio of 0.80 measured with EMG at the adductor pollicis muscle, but it may indeed be as low as 0.65 or as high as 1.00. Therefore, TOF ratios measured by KMG and EMG cannot be used interchangeably.

  17. Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis

    Science.gov (United States)

    Sarwahi, Vishal; Amaral, Terry; Wendolowski, Stephen; Gecelter, Rachel; Gambassi, Melanie; Plakas, Christos; Liao, Benita; Kalantre, Sarika; Katyal, Chhavi

    2015-01-01

    Minimally invasive surgery (MIS) has been described in the treatment of adolescent idiopathic scoliosis (AIS) and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations. PMID:26649305

  18. Exercise-induced dehydration does not alter time trial or neuromuscular performance.

    Science.gov (United States)

    Stewart, C J; Whyte, D G; Cannon, J; Wickham, J; Marino, F E

    2014-08-01

    This study examined the effect of exercise-induced dehydration by ~4% body mass loss on 5-km cycling time trial (TT) performance and neuromuscular drive, independent of hyperthermia. 7 active males were dehydrated on 2 occasions, separated by 7 d. Participants remained dehydrated (DEH, -3.8±0.5%) or were rehydrated (REH, 0.2±0.6%) over 2 h before completing the TT at 18-25 °C, 20-30% relative humidity. Neuromuscular function was determined before dehydration and immediately prior the TT. The TT started at the same core temperature (DEH, 37.3±0.3°C; REH, 37.0±0.2 °C (P>0.05). Neither TT performance (DEH, 7.31±1.5 min; REH, 7.10±1.3 min (P>0.05)) or % voluntary activation were affected by dehydration (DEH, 88.7±6.4%; REH, 90.6±6.1% (P>0.05)). Quadriceps peak torque was significantly elevated in both trials prior to the TT (Pperformance and neuromuscular function are not reduced by dehydration, independent of hyperthermia.

  19. Comparison of the Capacity of Different Jump and Sprint Field Tests to Detect Neuromuscular Fatigue.

    Science.gov (United States)

    Gathercole, Rob J; Sporer, Ben C; Stellingwerff, Trent; Sleivert, Gord G

    2015-09-01

    Different jump and sprint tests have been used to assess neuromuscular fatigue, but the test with optimal validity remains to be established. The current investigation examined the suitability of vertical jump (countermovement jump [CMJ], squat jump [SJ], drop jump [DJ]) and 20-m sprint (SPRINT) testing for neuromuscular fatigue detection. On 6 separate occasions, 11 male team-sport athletes performed 6 CMJ, SJ, DJ, and 3 SPRINT trials. Repeatability was determined on the first 3 visits, with subsequent 3 visits (0-, 24-, and 72-hour postexercise) following a fatiguing Yo-Yo running protocol. SPRINT performance was most repeatable (mean coefficient of variation ≤2%), whereas DJ testing (4.8%) was significantly less repeatable than CMJ (3.0%) and SJ (3.5%). Each test displayed large decreases at 0-hour (33 of 49 total variables; mean effect size = 1.82), with fewer and smaller decreases at 24-hour postexercise (13 variables; 0.75), and 72-hour postexercise (19 variables; 0.78). SPRINT displayed the largest decreases at 0-hour (3.65) but was subsequently unchanged, whereas SJ performance recovered by 72-hour postexercise. In contrast, CMJ and DJ performance displayed moderate (12 variables; 1.18) and small (6 variables; 0.53) reductions at 72-hour postexercise, respectively. Consequently, the high repeatability and immediate and prolonged fatigue-induced changes indicated CMJ testing as most suitable for neuromuscular fatigue monitoring.

  20. Neuromuscular onset succession of high level gymnasts during dynamic leg acceleration phases on high bar.

    Science.gov (United States)

    von Laßberg, Christoph; Rapp, Walter; Mohler, Betty; Krug, Jürgen

    2013-10-01

    In several athletic disciplines there is evidence that for generating the most effective acceleration of a specific body part the transfer of momentum should run in a "whip-like" consecutive succession of body parts towards the segment which shall be accelerated most effectively (e.g. the arm in throwing disciplines). This study investigated the question how this relates to the succession of neuromuscular activation to induce such "whip like" leg acceleration in sports like gymnastics with changed conditions concerning the body position and momentary rotational axis of movements (e.g. performing giant swings on high bar). The study demonstrates that during different long hang elements, performed by 12 high level gymnasts, the succession of the neuromuscular activation runs primarily from the bar (punctum fixum) towards the legs (punctum mobile). This demonstrates that the frequently used teaching instruction, first to accelerate the legs for a successful realization of such movements, according to a high level kinematic output, is contradictory to the neuromuscular input patterns, being used in high level athletes, realizing these skills with high efficiency. Based on these findings new approaches could be developed for more direct and more adequate teaching methods regarding to an earlier optimization and facilitation of fundamental movement requirements.

  1. Nonmuscle Myosin II helps regulate synaptic vesicle mobility at the Drosophila neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Qiu Xinping

    2010-03-01

    Full Text Available Abstract Background Although the mechanistic details of the vesicle transport process from the cell body to the nerve terminal are well described, the mechanisms underlying vesicle traffic within nerve terminal boutons is relatively unknown. The actin cytoskeleton has been implicated but exactly how actin or actin-binding proteins participate in vesicle movement is not clear. Results In the present study we have identified Nonmuscle Myosin II as a candidate molecule important for synaptic vesicle traffic within Drosophila larval neuromuscular boutons. Nonmuscle Myosin II was found to be localized at the Drosophila larval neuromuscular junction; genetics and pharmacology combined with the time-lapse imaging technique FRAP were used to reveal a contribution of Nonmuscle Myosin II to synaptic vesicle movement. FRAP analysis showed that vesicle dynamics were highly dependent on the expression level of Nonmuscle Myosin II. Conclusion Our results provide evidence that Nonmuscle Myosin II is present presynaptically, is important for synaptic vesicle mobility and suggests a role for Nonmuscle Myosin II in shuttling vesicles at the Drosophila neuromuscular junction. This work begins to reveal the process by which synaptic vesicles traverse within the bouton.

  2. Comparison of the Capacity of Different Jump and Sprint Field Tests to Detect Neuromuscular Fatigue.

    Science.gov (United States)

    Gathercole, Rob J; Sporer, Ben C; Stellingwerff, Trent; Sleivert, Gord G

    2015-09-01

    Different jump and sprint tests have been used to assess neuromuscular fatigue, but the test with optimal validity remains to be established. The current investigation examined the suitability of vertical jump (countermovement jump [CMJ], squat jump [SJ], drop jump [DJ]) and 20-m sprint (SPRINT) testing for neuromuscular fatigue detection. On 6 separate occasions, 11 male team-sport athletes performed 6 CMJ, SJ, DJ, and 3 SPRINT trials. Repeatability was determined on the first 3 visits, with subsequent 3 visits (0-, 24-, and 72-hour postexercise) following a fatiguing Yo-Yo running protocol. SPRINT performance was most repeatable (mean coefficient of variation ≤2%), whereas DJ testing (4.8%) was significantly less repeatable than CMJ (3.0%) and SJ (3.5%). Each test displayed large decreases at 0-hour (33 of 49 total variables; mean effect size = 1.82), with fewer and smaller decreases at 24-hour postexercise (13 variables; 0.75), and 72-hour postexercise (19 variables; 0.78). SPRINT displayed the largest decreases at 0-hour (3.65) but was subsequently unchanged, whereas SJ performance recovered by 72-hour postexercise. In contrast, CMJ and DJ performance displayed moderate (12 variables; 1.18) and small (6 variables; 0.53) reductions at 72-hour postexercise, respectively. Consequently, the high repeatability and immediate and prolonged fatigue-induced changes indicated CMJ testing as most suitable for neuromuscular fatigue monitoring. PMID:26308829

  3. Conservative treatment of neuromuscular scoliosis in adult tetraplegia: a case report.

    Science.gov (United States)

    Hastings, Jennifer D; Dickson, Julie; Tracy, Linsey; Baniewich, Christine; Levine, Cedar

    2014-12-01

    We report successful correction of new onset neuromuscular scoliosis without spinal surgery in a man who is 30-years post-American Spinal Injury Association Impairment Scale grade A C6 injury with new onset of left neuromuscular scoliosis (Cobb angle 45°) after a motor vehicle collision. Interventions included nightly low-load prolonged stretching (LLPS) (4h left side lying over bolster), a series of 6 botulinum toxin injections (BTIs) at 3-month intervals, and progressive seating adjustments to counteract the spinal curvature. Monthly seating adjustments included rear quadrant wedging, lateral supports, and hip blocking to promote erect and symmetrical posture. A normative Cobb angle (5°) was achieved after 8 months of treatment. Improvements in alignment were demonstrated in physical examination outcome measures at the final session and follow-up. LLPS, seating adjustments, and paraspinal BTI are nonsurgical options for treating neuromuscular scoliosis in adults with tetraplegia. Further studies are necessary to determine optimum protocols and examine generalizability of these treatment methods.

  4. Reversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis.

    LENUS (Irish Health Repository)

    Weekes, G

    2012-02-01

    A 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg\\/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg\\/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.

  5. Reversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis.

    LENUS (Irish Health Repository)

    Weekes, G

    2010-07-01

    A 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg\\/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg\\/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.

  6. Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis

    Directory of Open Access Journals (Sweden)

    Vishal Sarwahi

    2015-01-01

    Full Text Available Minimally invasive surgery (MIS has been described in the treatment of adolescent idiopathic scoliosis (AIS and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.

  7. CARACTERÍSTICAS FÍSICO-QUÍMICAS E SENSORIAS DO TOMATE (Lycopersicon esculentum PRODUZIDO POR CULTIVO ORGÂNICO EM COMPARAÇÃO AO CONVENCIONAL*

    Directory of Open Access Journals (Sweden)

    R. G. BORGUINI

    2009-03-01

    Full Text Available

    A pesquisa descreve as características físicoquímicas e sensoriais do tomate orgânico em comparação ao convencional. Amostras de tomate cultivares Carmem e Débora produzidos por cultivo orgânico e convencional foram avaliadas fisicamente, considerando-se a textura e cor, e quimicamente com relação ao pH, sólidos solúveis totais e acidez total titulável. As amostras foram também avaliadas sensorialmente quanto ao aroma, sabor, cor e aspecto geral. Os frutos de tomate cultivar Débora e Carmem não apresentaram diferenças com relação à tonalidade de vermelho dos frutos provenientes do cultivo orgânico quando comparado ao convencional. Quanto à textura, os resultados se mostraram similares, entre o lote orgânico (8,85 N x 105 e convencional (8,47 N x 105 do cultivar Carmem. Para o cultivar Débora foram observados valores de 10,28 N x 105 e 9,38 N x 105 para o cultivo orgânico e convencional, respectivamente. Quanto aos valores de pH, sólidos solúveis totais e acidez total titulável, foram observadas diferenças entre os dois tipos de cultivo. A análise sensorial dos frutos, revelou diferenças significativas (p<0,05 entre os cultivos orgânico e convencional apenas para os atributos de sabor e aspecto geral. PALAVRAS-CHAVE: Tomate; análise sensorial; alimentos orgânicos.

  8. Modelo experimental de trauma medular agudo produzido por aparelho estereotáxico modificado Experimental model of acute spinal cord injury produced by modified steriotaxic equipment

    Directory of Open Access Journals (Sweden)

    B.B.J. Torres

    2010-02-01

    Full Text Available Foram utilizados 55 ratos machos da espécie Rattus novergicus, variedade Wistar, com o objetivo de propor um modelo experimental de trauma medular produzido por aparelho estereotáxico modificado, capaz de reproduzir clinicamente lesões medulares padronizadas. Após realização de laminectomia dorsal de T13, utilizou-se peso compressivo de 50,5g (25 animais - grupo I ou 70,5g (30 animais - grupo II, durante cinco minutos, comprimindo a medula espinhal. Os animais foram assistidos durante oito dias, por meio de testes comportamentais para avaliar a sensibilidade dolorosa, a capacidade motora, o posicionamento tátil e proprioceptivo e a capacidade de manter-se em plano inclinado. No grupo I, observaram-se déficits neurológicos moderados e transitórios, que variaram entre os animais. No grupo II, foi possível obter um trauma padronizado, caracterizado por paraplegia bilateral e simétrica dos membros posteriores, perda de propriocepção e da sensibilidade dolorosa de todos os animais. A utilização do aparelho estereotáxico desenvolvido permite reproduzir clinicamente trauma medular padronizado em ratos, de maneira simples, econômica e satisfatória, o que poderá proporcionar avanços nas investigações terapêuticas, abrangendo doenças neurodegenerativas, como é o caso do trauma medular agudo.Fifty-five male rats (Rattus novergicus, Wistar variety, were used with the purpose of suggesting an experimental model of spinal cord trauma performed by using a modified stereotaxic equipment capable to reproduce clinically (standardized pattern spinal cord injury. After dorsal laminectomy of T13, a compression was performed with 50.5g (25 animals - group I or 70.5g (30 animals - group II during five minutes on spinal cord. The animals were assisted during eight days by behavioral tests to evaluate painful sensibility, motor capacity, proprioceptive and tactil placing, and stability on inclined plan. In the group I, moderate and transitory

  9. Estimativas das propriedades de compostos LVL produzidos com paricá (Schizolobium amazonicum Huber ex Ducke por meio de stress wave

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    Rafael Rodolfo Melo

    2014-12-01

    Full Text Available Foram avaliadas as propriedades físicas e mecânicas de compósitos LVL produzidos com a madeira de paricá (Schizolobium amazonicum Huber ex. Ducke, por meio de Stress Wave Timer. Os compósitos foram confeccionados em laboratório, dos quais foram retiradas amostras, que foram inicialmente destinadas à realização dos ensaios não destrutivos. Todas as amostras, com dimensões de 2,2 × 2,2 × 40 cm, foram ensaiadas, não destrutivamente, com a propagação de ondas nos sentidos flatwise e edgewise. Em sequência, as mesmas amostras foram destinadas à confecção de subamostras, para realização dos ensaios destrutivos, físicos (absorção de água, inchamento em espessura e inchamento residual e mecânicos (resistência e rigidez à flexão estática flatwise; resistência e rigidez à flexão estática edgewise; resistência à compressão paralela e resistência ao cisalhamento paralelo e perpendicular. A velocidade de propagação das ondas (V0 e o módulo de elasticidade dinâmico (Emd, obtidos com o auxílio do Stress Wave, foram utilizados para elaboração de modelos de predição das propriedades avaliadas. Os resultados indicaram que o Stress Wave Timer apresenta resultados satisfatórios para predição das propriedades mecânicas de compósitos LVL. Com relação às propriedades físicas, embora tenham sido verificados modelos com ajustes significativos, constatou-se limitação dessa ferramenta para predição desses parâmetros. Contudo, considerando ambas as propriedades, físicas e mecânicas, os melhores ajustes foram observados em amostras ensaiadas com a propagação de ondas no sentido edgewise e com o uso da variável independente Emd.

  10. Efeitos de farelo alimentar fibroso produzido a partir da linhaça em indivíduos com constipação intestinal

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    Fernanda S. Lopes

    2015-08-01

    Full Text Available A preocupação com o bem estar e a melhora da qualidade de vida tem levado as pessoas a consumirem alimentos mais saudáveis os chamados alimentos funcionais, no qual se destaca os que contêm fibra alimentar. Devido às propriedades fibrosas que a linhaça constitui, o presente trabalho teve por objetivo avaliar a eficácia da ingestão de um farelo alimentar rico em fibras, em indivíduos sedentários e não sedentários com constipação intestinal. O presente estudo apresentou caráter laboratorial e experimental com abordagem quantitativa utilizando-se o método da estatística descritiva. O farelo foi produzido à base da semente de linhaça, com adição de outros ingredientes fibrosos, foi embalado e rotulado, e em seguida distribuído para o consumo. De acordo com os dados obtidos, na análise da composição nutricional do farelo fibroso evidenciou-se um teor apreciável de fibra alimentar. Para a avaliação das características organolépticas do farelo foi observado uma maior aprovação para o sabor, textura e aroma. Quanto à avaliação da função intestinal dos indivíduos após consumir o farelo fibroso foi observado uma melhora significativa em todas as características observadas antes de consumir o farelo, sendo relatado um aumento no número das evacuações. Em relação aos indivíduos sedentários e não sedentários observou-se que independente da prática ou não de atividade física o mesmo foi bastante eficaz em ambos os casos, não sendo relatado nenhum tipo de reação adversa. Diante dos dados concluímos que o farelo fibroso foi bastante eficaz na melhora da constipação intestinal na maioria dos casos estudados.

  11. Comparação das técnicas transarterial e de estimulação de múltiplos nervos para bloqueio do plexo braquial por via axilar usando lidocaína com epinefrina Comparación de las técnicas transarterial y de estimulación de múltiples nervios para bloqueo del plexo braquial por vía axilar usando lidocaína con epinefrina Comparison of transarterial and multiple nerve stimulation techniques for axillary block using lidocaine with epinephrine

    OpenAIRE

    Luiz Eduardo Imbelloni; Lúcia Beato; José Antônio Cordeiro

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A técnica transarterial com grandes doses de anestésico local resulta em alta efetividade para o bloqueio axilar do plexo braquial. A técnica utilizando múltiplos estímulos exige mais tempo e maior experiência. Este estudo prospectivo compara a latência e o índice de sucesso do bloqueio do plexo braquial usando duas técnicas de localização: transarterial ou múltipla estimulação dos nervos. MÉTODO: A lidocaína com epinefrina, 800 mg, foi usada inicialmente para o blo...

  12. Estudo comparativo da eficácia analgésica pós-operatória de 20, 30 ou 40 mL de ropivacaína no bloqueio de plexo braquial pela via posterior Estudio comparativo de la eficacia analgésica postoperatoria de 20, 30 o 40 mL de ropivacaína en el bloqueo de plexo braquial por la vía posterior A comparative study on the postoperative analgesic efficacy of 20, 30, or 40 mL of ropivacaine in posterior brachial plexus block

    OpenAIRE

    Marcos Guilherme Cunha Cruvinel; Carlos Henrique Viana de Castro; Yerkes Pereira Silva; Gustavo Prosperi Bicalho; Flávio de Oliveira França; Flávio Lago

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: As intervenções cirúrgicas por via artroscópica no ombro estão relacionadas com a dor pós-operatória de grande intensidade. Dentre as técnicas de analgesia, o bloqueio do plexo braquial é a que oferece os melhores resultados. O objetivo deste estudo foi determinar qual volume de anestésico local no bloqueio de plexo braquial pela via posterior propicia analgesia pós-operatória para essas operações de maneira mais eficiente. MÉTODO: Noventa pacientes submetidos a blo...

  13. Estudo comparativo da eficácia analgésica pós-operatória de 20 mL de ropivacaína a 0,5, 0,75 ou 1% no bloqueio de plexo braquial pela via posterior Estudio comparativo de la eficacia analgésica postoperatoria de 20 mL de ropivacaina a 0,5, 0,75 ó 1% en el bloqueo de plexo braquial por la vía posterior Comparative study for the postoperative analgesic efficacy of 20 mL at 0.5, 0.75, and 1% ropivacaine in posterior brachial plexus block

    OpenAIRE

    Marcos Guilherme Cunha Cruvinel; Carlos Henrique Viana de Castro; Yerkes Pereira Silva; Bruno Salomé Morais; Flávio de Oliveira França; Flávio Lago

    2008-01-01

    JUSTIFICATIVA E OBJETIVOS: As intervenções cirúrgicas por via artroscópica no ombro estão relacionadas com a dor pós-operatória de grande intensidade. Dentre as técnicas de analgesia, o bloqueio do plexo braquial é a que oferece os melhores resultados. O objetivo deste estudo foi determinar qual concentração de anestésico local no bloqueio de plexo braquial pela via posterior propicia analgesia pós-operatória mais prolongada para essas operações. MÉTODO: Noventa pacientes submetidos ao bloque...

  14. Bases anatômicas para o bloqueio anestésico do plexo braquial por via infraclavicular Bases anatómicas para el bloqueo anestésico del plexo braquial por vía infraclavicular Anatomical basis for infraclavicular brachial plexus block

    OpenAIRE

    Luiz Carlos Buarque Gusmão; Jacqueline Silva Brito Lima; José Carlos Prates

    2002-01-01

    JUSTIFICATIVA E OBJETIVOS: Procuramos demonstrar neste estudo a presença constante da fossa infraclavicular, com a finalidade de sua utilização como via de acesso para o bloqueio anestésico do plexo braquial por via infraclavicular. Visando solucionar o ponto onde os fascículos do plexo braquial podem ser localizados no interior da fossa, propusemos medidas a partir da face anterior da clavícula e do ângulo formado pelo encontro do músculo deltóide com a clavícula (ângulo deltoclavicular). A ...

  15. Bloqueio bilateral do nervo pudendo para hemorroidectomia em paciente acondroplásico: relato de caso Bloqueo bilateral del nervio pudendo para hemorroidectomía en paciente acondroplásico: relato de caso Bilateral blockade of the pudend nerve to hemorrhoidectomy in achondroplasic patient: case report

    OpenAIRE

    Bruno Salomé de Morais; Marcos Guilherme Cunha Cruvinel; Yerkes Pereira Silva; Dener Augusto Diniz; Carlos Henrique Viana de Castro

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O nanismo acondroplásico ou acondroplasia é a forma mais comum de nanismo e ocorre na maioria dos casos por alteração genética espontânea. A anestesia desses pacientes apresenta várias particularidades. O objetivo do presente relato foi descrever um caso de paciente acondroplásico, com história prévia de intervenção cirúrgica da coluna para descompressão medular, submetido a hemorroidectomia através de bloqueio bilateral dos nervos pudendos. RELATO DO CASO: Paciente...

  16. Bracing superior to neuromuscular training for the prevention of self-reported recurrent ankle sprains: a three-arm randomised controlled trial

    OpenAIRE

    Janssen, Kasper W.; van Mechelen, Willem; Verhagen, Evert A L M

    2014-01-01

    Background Ankle sprain is the most common sports-related injury with a high rate of recurrence and associated costs. Recent studies have emphasised the effectiveness of both neuromuscular training and bracing for the secondary prevention of ankle sprains. Aim To evaluate the effectiveness of combined bracing and neuromuscular training, or bracing alone, against the use of neuromuscular training on recurrences of ankle sprain after usual care. Methods 384 athletes, aged 18–70, who had sustain...

  17. Distribuição do nervo fibular comum em fetos de equinos e descrição anatômica de pontos para bloqueio anestésico

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    Luciana P. Iglesias

    2012-07-01

    Full Text Available Analisou-se a distribuição do nervo fibular comum em 30 fetos de equinos, sem raça definida, provenientes do acervo do Laboratório de Anatomia Animal da Faculdade de Medicina Veterinária da Universidade Federal de Uberlândia, que foram injetados e conservados em solução aquosa de formaldeído a 10%. Contatou-se que o referido nervo deriva do isquiático, divide-se em nervos fibulares superficial e profundo, distribuindo-se para os músculos extensores lateral e longo do dedo, fibular terceiro e tibial cranial. Traçando-se uma linha imaginária na região médio-lateral da tuberosidade do osso tíbia, o nervo fibular comum pode ser bloqueado em sua parte proximal, no terço caudal, entre o tendão de inserção do músculo bíceps femoral e a face lateral do músculo gastrocnêmio lateral (terço médio; e o nervo fibular profundo, na parte proximal da tíbia, crânio-distalmente ao fibular comum. O bloqueio do nervo fibular superficial pode ser realizado em duas regiões da tíbia: na proximal, considerando-se a linha imaginária, distalmente ao ponto citado para o fibular comum e caudalmente ao descrito para o fibular profundo; e na distal, na face lateral da articulação tíbio-társica, entre os tendões de inserção dos músculos extensores lateral e longo do dedo.

  18. Caffeine ingestion reverses the circadian rhythm effects on neuromuscular performance in highly resistance-trained men.

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    Ricardo Mora-Rodríguez

    Full Text Available PURPOSE: To investigate whether caffeine ingestion counteracts the morning reduction in neuromuscular performance associated with the circadian rhythm pattern. METHODS: Twelve highly resistance-trained men underwent a battery of neuromuscular tests under three different conditions; i morning (10:00 a.m. with caffeine ingestion (i.e., 3 mg kg(-1; AM(CAFF trial; ii morning (10:00 a.m. with placebo ingestion (AM(PLAC trial; and iii afternoon (18:00 p.m. with placebo ingestion (PM(PLAC trial. A randomized, double-blind, crossover, placebo controlled experimental design was used, with all subjects serving as their own controls. The neuromuscular test battery consisted in the measurement of bar displacement velocity during free-weight full-squat (SQ and bench press (BP exercises against loads that elicit maximum strength (75% 1RM load and muscle power adaptations (1 m s(-1 load. Isometric maximum voluntary contraction (MVC(LEG and isometric electrically evoked strength of the right knee (EVOK(LEG were measured to identify caffeine's action mechanisms. Steroid hormone levels (serum testosterone, cortisol and growth hormone were evaluated at the beginning of each trial (PRE. In addition, plasma norepinephrine (NE and epinephrine were measured PRE and at the end of each trial following a standardized intense (85% 1RM 6 repetitions bout of SQ (POST. RESULTS: In the PM(PLAC trial, dynamic muscle strength and power output were significantly enhanced compared with AM(PLAC treatment (3.0%-7.5%; p≤0.05. During AM(CAFF trial, muscle strength and power output increased above AM(PLAC levels (4.6%-5.7%; p≤0.05 except for BP velocity with 1 m s(-1 load (p = 0.06. During AM(CAFF, EVOK(LEG and NE (a surrogate of maximal muscle sympathetic nerve activation were increased above AM(PLAC trial (14.6% and 96.8% respectively; p≤0.05. CONCLUSIONS: These results indicate that caffeine ingestion reverses the morning neuromuscular declines in highly resistance

  19. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report

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    Parker Stephen W

    2005-02-01

    Full Text Available Abstract Background Vestibular rehabilitation (VR is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC, have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. Methods We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width, lower extremity sagittal plane mechanical energy expenditures (MEE, and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity, were measured. Results Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. Conclusion Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster

  20. Efeitos neuromusculares e cardiovasculares do pipecurônio: estudo comparativo entre diferentes doses Efectos neuromusculares y cardiovasculares del pipecuronio: estudio comparativo entre diferentes dosis Neuromuscular and cardiovascular effects of pipecuronium: a comparative study between different dose

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    Angélica de Fátima de Assunção Braga

    2008-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O pipecurônio é um bloqueador neuromuscular não-despolarizante, com propriedades similares as do pancurônio, mas desprovido de efeitos cardiovasculares. Foram avaliados os efeitos neuromusculares, as condições de intubação traqueal e as repercussões hemodinâmicas de duas diferentes doses de pipecurônio. MÉTODO: Pacientes foram distribuídos em dois grupos de acordo com a dose de pipecurônio: Grupo I (0,04 mg.kg-1 e Grupo II (0,05 mg.kg-1. A medicação pré-anestésica consistiu em midazolam (0,1 mg.kg-1 por via muscular, 30 minutos antes da operação. A indução anestésica foi obtida com propofol (2,5 mg.kg-1 precedido de fentanil (5 µg.kg-1 e pipecurônio nas doses de 0,04 e 0,05 mg.kg-1 para os Grupos I e II, respectivamente. Os pacientes foram ventilados com O2 a 100% sob máscara até a redução de 75% da amplitude da resposta a estímulo isolado (1 Hz, quando foram realizadas a laringoscopia e intubação traqueal. O isoflurano (0,5 a 1% em mistura de O2 e N(20 a 50% para a manutenção da anestesia, foi introduzido logo após a intubação traqueal. Os pacientes foram ventilados mecanicamente para manter P ET CO2 entre 32 e 36 mmHg. A farmacodinâmica do pipecurônio foi avaliada por aceleromiografia. RESULTADOS: Os tempos médios e desvios-padrão para o início de ação, duração clínica (T1(25% e índice de recuperação (T1(25-75% foram: Grupo I (122,10 ± 4,18 s, 49,63 ± 9,54 min e 48,21 ± 6,72 min e Grupo II (95,78 ± 8,91 s, 64,84 ± 13,13 min e 48,52 ± 4,95 min. O início de ação, a duração clínica e as condições de intubação traqueal foram significativamente diferentes entre os grupos. CONCLUSÕES: O pipecurônio na dose 0,05 mg.kg-1 pode ser usado em procedimentos de longa duração, nos quais é desejável evitar alterações cardiocirculatórias.JUSTIFICATIVA Y OBJETIVOS: El pipecuronio es un bloqueador neuromuscular no despolarizador, con propiedades similares a las

  1. Analgesia pós-operatória em correção cirúrgica de pé torto congênito: comparação entre bloqueio nervoso periférico e bloqueio peridural caudal Analgesia postoperatoria en corrección quirúrgica de pie jorobado congénito: comparación entre bloqueo nervioso periférico y bloqueo epidural caudal Postoperative analgesia for the surgical correction of congenital clubfoot: comparison between peripheral nerve block and caudal epidural block

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    Monica Rossi Rodrigues

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O procedimento de correção de pé torto congênito (PTC cursa com dor pós-operatória intensa. A técnica mais utilizada em crianças é a peridural caudal associada à anestesia geral. Tem como limitação a curta duração da analgesia pós-operatória. Os bloqueios de nervos periféricos têm sido apontados como procedimentos com baixa incidência de complicações e tempo prolongado de analgesia. O objetivo do estudo foi comparar o tempo de analgesia dos bloqueios nervosos periféricos e bloqueio caudal e o consumo de morfina nas primeiras 24 horas após a correção de PTC em crianças. MÉTODO: Estudo randômico, encoberto, em crianças submetidas à intervenção cirúrgica para liberação póstero-medial de PTC, alocadas em 4 grupos conforme a técnica anestésica: Caudal (ACa; Bloqueios isquiático e femoral (IF; Bloqueios isquiático e safeno (IS; Bloqueio isquiático e anestesia local (IL, associados à anestesia geral. Nas primeiras 24 horas os pacientes receberam dipirona e paracetamol via oral e foram avaliados por anestesiologista que desconhecia a técnica empregada. Conforme escores da escala CHIPPS (Children's and infants postoperative pain scale era administrada morfina via oral (0,19 mg.kg-1 por dia. RESULTADOS: Foram estudadas 118 crianças distribuídas nos grupos ACa (30, IF (32, IS (28 IL (28. O tempo médio entre o bloqueio e a primeira dose de morfina foi 6,16 horas no grupo ACa, 7,05 horas no IF, 7,58 horas no IS e 8,18 horas no IL. O consumo de morfina foi 0,3 mg.kg-1 por dia nos quatro grupos. Não houve diferença significativa entre os grupos. CONCLUSÕES: Os bloqueios nervosos periféricos não promoveram maior tempo de analgesia, tampouco redução no consumo de morfina nas primeiras 24 horas em crianças submetidas à correção de PTC quando comparados ao bloqueio peridural caudal.JUSTIFICATIVA Y OBJETIVOS: El procedimiento de corrección de pie jorobado congénito (PJC, debuta

  2. Consecuencias clínicas de las alteraciones neuromusculares en el paciente crítico Clinical consequences of neuromuscular impairments in critically ill patients

    OpenAIRE

    A. Mesejo; E. Pérez-Sancho; Moreno, E.

    2006-01-01

    La patología neuromuscular en el paciente crítico se desarrolla en dos contextos: enfermedades neurológicas primarias que requieren su ingreso en Medicina Intensiva por necesitar vigilancia estricta o ventilación mecánica y manifestaciones del sistema nervioso periférico secundarias a enfermedades sistémicas críticas. En el primer grupo son las más frecuentes el Síndrome de Guillain-Barré y la Miastenia Gravis y en el segundo la Polineuropatía y la Miopatía del paciente crítico. El patrón clí...

  3. Manejo de longo prazo em crianças com transtornos neuromusculares Long-term management of children with neuromuscular disorders

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    Eugen-Matthias Strehle

    2009-10-01

    Full Text Available OBJETIVO: A distrofia muscular de Duchenne é o tipo mais comum de miopatia genética. Contudo, existe um grande número de doenças neuromusculares hereditárias que são individualmente muito raras e sobre as quais não há muita informação clínica disponível. Este artigo de revisão baseia-se na experiência do autor em uma clínica pediátrica para tratamento de doenças musculares e apresenta orientação prática e planos terapêuticos para os problemas frequentemente encontrados. FONTES DE DADOS: O banco de dados da MEDLINE foi pesquisado com o objetivo de localizar artigos recentes e relevantes para o manejo de crianças com miopatias e neuropatias hereditárias. Uma coorte de 200 pacientes foi avaliada através de análise estatística descritiva. SÍNTESE DOS DADOS: A distrofia muscular de Duchenne representou quase metade dos diagnósticos, seguida da atrofia muscular espinhal (12%, da distrofia muscular de Becker e da distrofia miotônica (7% cada. Dezesseis pacientes (9% apresentaram miopatia de origem desconhecida. CONCLUSÕES: Assim como ocorre com outras doenças crônicas, esses pacientes devem passar por acompanhamento periódico realizado por profissionais de saúde desde cedo para aumentar sua expectativa de vida e melhorar sua qualidade de vida. É útil para os médicos adotarem uma abordagem estruturada ao atender crianças com transtornos neuromusculares e monitorar todos os sistemas de órgãos afetados.OBJECTIVE: Duchenne muscular dystrophy is the commonest genetic myopathy but there exist a large number of inherited neuromuscular diseases which individually are very rare and where clinical information is not widely available. This review is based on the author's experience in a pediatric muscle clinic and provides practical guidance and treatment plans for frequently encountered problems. SOURCES: A MEDLINE search was conducted to retrieve recent articles relevant to the management of children with

  4. Biomechanical and neuromuscular characteristics of male athletes: implications for the development of anterior cruciate ligament injury prevention programs.

    Science.gov (United States)

    Sugimoto, Dai; Alentorn-Geli, Eduard; Mendiguchía, Jurdan; Samuelsson, Kristian; Karlsson, Jon; Myer, Gregory D

    2015-06-01

    Prevention of anterior cruciate ligament (ACL) injury is likely the most effective strategy to reduce undesired health consequences including reconstruction surgery, long-term rehabilitation, and pre-mature osteoarthritis occurrence. A thorough understanding of mechanisms and risk factors of ACL injury is crucial to develop effective prevention programs, especially for biomechanical and neuromuscular modifiable risk factors. Historically, the available evidence regarding ACL risk factors has mainly involved female athletes or has compared male and female athletes without an intra-group comparison for male athletes. Therefore, the principal purpose of this article was to review existing evidence regarding the investigation of biomechanical and neuromuscular characteristics that may imply aberrant knee kinematics and kinetics that would place the male athlete at risk of ACL injury. Biomechanical evidence related to knee kinematics and kinetics was reviewed by different planes (sagittal and frontal/coronal), tasks (single-leg landing and cutting), situation (anticipated and unanticipated), foot positioning, playing surface, and fatigued status. Neuromuscular evidence potentially related to ACL injury was reviewed. Recommendations for prevention programs for ACL injuries in male athletes were developed based on the synthesis of the biomechanical and neuromuscular characteristics. The recommendations suggest performing exercises with multi-plane biomechanical components including single-leg maneuvers in dynamic movements, reaction to and decision making in unexpected situations, appropriate foot positioning, and consideration of playing surface condition, as well as enhancing neuromuscular aspects such as fatigue, proprioception, muscle activation, and inter-joint coordination.

  5. What Is the Evidence for Harm of Neuromuscular Blockade and Corticosteroid Use in the Intensive Care Unit?

    Science.gov (United States)

    Annane, Djillali

    2016-02-01

    Neuromuscular blocking agents and corticosteroids are widely used in medicine and in particular in the intensive care unit (ICU). Neuromuscular blockade is commonly used to ease tracheal intubation, to optimize mechanical ventilation and oxygenation in acute respiratory disorders such as status asthmaticus and acute respiratory distress syndrome (ARDS), to prevent shivering during therapeutic hypothermia, and also in patients with elevated intracranial pressure. In the ICU, patients with sepsis, ARDS, community-acquired pneumonia, exacerbation of chronic obstructive pulmonary disease, severe asthma, or trauma may receive corticosteroids. It is not rare that ICU patients receive concomitantly neuromuscular blocking drugs and corticosteroids. Among the various serious adverse reactions to these drugs, secondary infection and ICU-acquired weakness may place a burden to the health-care system by resulting in substantial cost and long-term morbidity. Both superinfections and ICU-acquired paresis are more likely when high doses of fluorinated corticosteroids are combined with prolonged treatment with a long-acting non-depolarizing neuromuscular blocker. Modern ICU practices favor lower dose of corticosteroids and very short course of short-acting curare for the management of sepsis or ARDS. Recent trials provided no evidence for increased risk of secondary infections or critical illness neuromyopathy in patients with sepsis or ARDS with the use of corticosteroids or neuromuscular blockers. PMID:26820274

  6. The effects of Duvernoy's gland secretion from the xenodontine colubrid Philodryas olfersii on striated muscle and the neuromuscular junction: partial characterization of a neuromuscular fraction.

    Science.gov (United States)

    Prado-Franceschi, J; Hyslop, S; Cogo, J C; Andrade, A L; Assakura, M; Cruz-Höfling, M A; Rodrigues-Simioni, L

    1996-04-01

    The effect of Philodryas olfersii Duvernoy's secretion was studied in vivo in mice and chicks as well as in the mouse phrenic nerve-diaphragm and the chick biventer cervicis preparations. The whole secretion (20-40 micrograms/ml) increased the creatine kinase (CK) levels in mice but had no effect on the mouse phrenic nerve-diaphragm preparation. In the chick, the secretion caused head drop and paresia as well as irreversible blockade of the twitch-tension evoked by indirect stimulation in the chick biventer cervicis preparation (50% paralysis in 34.5 +/- 2.7 min, n = 4). The secretion also caused muscle contracture (30% of the maximal twitch-tension generated) after a latency of nearly 9 min. Following fractionation on a Superose 12 FPLC column, the neuromuscular activity was recovered in the high mol. wt fraction (Peak I). At a concentration of 10 micrograms/ml in the chick biventer cervicis preparation, Peak I caused 50% paralysis within 18.5 +/- 3.0 min (n = 4), and evoked a strong contracture (70% of the maximal twitch-tension generated). The contractile responses of the chick preparation to ACh and KCL were partially blocked (90%) by the whole secretion and totally blocked by Peak I. CK release was increased by the whole secretion but not by Peak I. The whole secretion also produced various degrees of muscle cell lysis and extensive widening of the intercellular spaces. The latter showed a loosely arranged membranous network. In general, Peak I caused only minor morphological alterations compared with the whole secretion, although these were still significantly different from those observed in the control preparations. The changes principally involved hypercontraction of the muscle fibers. Based on the above results, we conclude that Peak I contains the factor(s) responsible for the in vitro effects on neuromuscular transmission, whereas the direct myotoxic effect is apparently caused by at least one other component of the Duvernoy's secretion. PMID:8735245

  7. Atividade alelopática do filtrado de cultura produzido por Fusarium solani Allelopathic activity of culture filtrate produced by Fusarium solani

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    A.P.S. Souza Filho

    2007-03-01

    Full Text Available As plantas daninhas se constituem no principal problema a impor limitação à exploração da agropecuária nas áreas tropicais. Entretanto, o controle químico dessas plantas tem gerado insatisfações de ordem social, quer porque contaminam as fontes de recursos naturais ou por comprometerem a qualidade dos alimentos da dieta dos animais, em geral, e dos humanos, em particular. Os objetivos deste trabalho foram identificar e caracterizar a atividade alelopática do filtrado de cultura produzido pelo fungo Fusarium solani f. sp. pipers. Foram avaliados os efeitos das toxinas, nas concentrações de 1,0 e 4,0%, sobre a germinação de sementes e o desenvolvimento da radícula e do hipocótilo das plantas daninhas malícia (Mimosa pudica e mata-pasto (Senna obtusifolia. Os resultados mostraram presença de atividade alelopática inibitória, com variações de acordo com a concentração e a planta receptora. A intensidade dos efeitos inibitórios induzidos pelo extrato esteve positivamente associada à concentração, com efeitos mais intensos verificados a 4,0%. Independentemente da concentração e do bioensaio, a espécie malícia se mostrou mais sensível aos efeitos do filtrado da cultura. O desenvolvimento da radícula foi o fator da planta mais intensamente inibido. Os resultados indicam a existência de potencial de utilização da toxina produzida pelo fungo, como fonte alternativa no controle de plantas daninhas, o que justifica estudos mais avançados.Weeds are a major problem limiting agriculture and cattle raising activities in the tropics. Current chemical control measures have raised environmental concerns due to their potential of contaminating natural resources and compromising the quality of animal feed. The objective of this paper was to identify and characterize the potential allelopathic activity of Fusarium solani f. sp. pipers culture filtrate. The effects of the toxin were analyzed at 1% and 4% concentration, on seed

  8. Bloqueio do plexo braquial pela via posterior com uso de neuroestimulador e ropivacaína a 0,5% Bloqueo del plexo braquial por la vía posterior con el uso de neuroestimulador y ropivacaína a 0,5% Posterior brachial plexus block with nerve stimulator and 0.5% ropivacaine

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    Lúcia Beato

    2005-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Existem várias maneiras de abordar o plexo braquial dependendo da experiência do anestesiologista e da região a ser operada. O bloqueio do plexo braquial pela via posterior pode representar uma alternativa para cirurgias de ombro, clavícula e úmero proximal. O objetivo deste estudo foi mostrar os resultados observados em pacientes submetidos a bloqueio do plexo braquial pela via posterior com uso de neuroestimulador e ropivacaína a 0,5%. MÉTODO: Vinte e dois pacientes com idade entre 17 e 76 anos, estado físico ASA I e II, submetidos a cirurgias ortopédicas envolvendo o ombro, clavícula e úmero proximal foram anestesiados com bloqueio de plexo braquial pela via posterior utilizando neuroestimulador a partir de 1 mA. Obtida a contração desejada, a corrente foi diminuída para 0,5 mA e, permanecendo a resposta contrátil, foram injetados 40 mL de ropivacaína a 0,5%. Foram avaliados os seguintes parâmetros: latência, analgesia, duração da cirurgia, duração da analgesia e do bloqueio motor, complicações e efeitos colaterais. RESULTADOS: O bloqueio foi efetivo em 20 dos 22 pacientes; a latência média foi de 15,52 min; a duração média da cirurgia foi de 1,61 hora. A média de duração da analgesia foi de 15,85 horas e do bloqueio motor 11,16 horas. Não foram observados sinais e sintomas clínicos de toxicidade do anestésico local e nenhum paciente apresentou efeitos adversos do bloqueio. CONCLUSÕES: Nas condições deste estudo o bloqueio de plexo braquial pela via posterior com o uso do neuroestimulador e ropivacaína a 0,5% demonstrou ser uma técnica efetiva, confortável para o paciente e de fácil realização.JUSTIFICATIVA Y OBJETIVOS: Existen varios modos de abordar el plexo braquial dependiendo de la experiencia del anestesiologista y de la región que será operada. El bloqueo del plexo braquial por la vía posterior puede representar una alternativa para cirugías de hombro, clav

  9. Bloqueio do nervo maxilar para redução de fraturas do osso zigomático e assoalho da órbita Bloqueo del nervio maxilar para reducción de fracturas del hueso zigomático y suelo de la órbita Maxillary nerve block for zygoma and orbital floor fractures reduction

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    Karl Otto Geier

    2003-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Poucos relatos existem sobre redução de fraturas da órbita zigomática e do arco zigomático sob anestesia regional. O objetivo deste estudo é verificar a qualidade do bloqueio do nervo maxilar por via extraoral, para redução de fraturas do osso zigomático e do assoalho da órbita. MÉTODO: Quinze pacientes foram submetidos à bloqueio do nervo maxilar pela técnica de Moore (abordagem infrazigomática para redução de fraturas isoladas do arco zigomático (oito pacientes e associadas ao assoalho da órbita (sete pacientes. Nenhum paciente recebeu medicação pré-anestésica. Após sedação e anestesia local com 2 ml de lidocaína a 1,5% com adrenalina a 1:300.000, o nervo maxilar foi abordado com 8 ml da mesma solução anestésica através de uma agulha 22G, 10 cm de comprimento de ponta romba. Foram avaliados: o tempo de bloqueio, a latência, o tempo de analgesia, a incidência de falhas, a necessidade de anestesia geral e as complicações. RESULTADOS: Os primeiros três bloqueios foram difíceis, resultando em dois bloqueios parciais e uma falha. Os restantes foram efetivos e os pacientes não referiram nenhum desconforto ou dor durante o bloqueio e a cirurgia. O tempo para a realização do bloqueio variou de 5 a 20 minutos, enquanto a latência anestésica ficou entre 3 e 10 minutos. Foram registradas 7 ocorrências de punção vascular, porém sem relatos de formação de hematomas. CONCLUSÕES: Redução de fraturas zigomáticas são factíveis sob bloqueio do nervo maxilar, quando realizadas na fossa ptérigo palatina, permitindo anestesia de seus dois ramos distais, nervo zigomático-temporal e nervo zigomático-frontal.JUSTIFICATIVA Y OBJETIVOS: Pocos relatos existen sobre reducción de fracturas de la órbita zigomática y del arco zigomático bajo anestesia regional. El objetivo de este estudio es confirmar la calidad del bloqueo del nervio maxilar por vía extraoral, para reducción de

  10. Bupivacaine 0,25% versus ropivacaine 0,25% in brachial plexus block in dogs of beagle breedBupivacaína 0,25% versus ropivacaína 0,25% no bloqueio do plexo braquial em cães da raça beagle

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    Thiago Ignácio Wakoff

    2013-06-01

    Full Text Available The brachial plexus block (BPB is a regional anesthesia technique which enables the attainment of surgical procedures distal scapulohumeral articulation. This study aimed to compare the efficacy of ropivacaine and bupivacaine 0.25% without vasoconstrictor in BPB guided by electrical stimulation in dogs. Thirteen male and female beagle dogs underwent a BPB using bupivacaine and ropivacaine 0.25% (4mg/kg, both alone and in different times. The anesthesic block was performed in the right forelimb and as control group the block proceeded in the left forelimb using a solution of sodium chloride 0.9% in volume corresponding to the drug in the contralateral limb. The block was performed after the localization of the radial nerve with the aid of eletrical stimulation, which was infiltrated half the volume of anesthetic calculated and subsequently the remaining solution was administered on the median nerve. We evaluated sensitive and motor latencies and sensitive and motor block total time by clamping technique. In the present study, a technique for electrical stimulation was effective in 100% of animals. Bupivacaine had lower motor latency period, however, the sensitive latency between the two groups showed no statistically significant differences. In the block total time, bupivacaine obtained time significantly higher. Clinical signs characteristic of Horner’s syndrome were present in 15% of animals treated with bupivacaine. Furthermore, two animals presented signs of cardiotoxicity in bupivacaine group. The use of bupivacaine (4mg/kg without vasoconstrictor in dogs brachial plexus block provided longer analgesia and motor blockade, however, ropivacaine at the same dose and concentration was found to be free of deleterious effects associated of cardiovascular instability, hemodynamic and respiratory. O bloqueio do plexo braquial (BPB é uma técnica de anestesia regional que possibilita a realização de procedimentos cirúrgicos distais a articula

  11. Evaluation of two regional anesthetic methods on the front limb of dogs using hyperbaric bupivacaine Avaliação de dois métodos de bloqueios anestésicos regionais no membro anterior em cães usando bupivacaína hiperbárica

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    Gustavo Guerino Macedo

    2010-06-01

    Full Text Available PURPOSE: To evaluate the effects of bupivacaine 0.5 and 0.25% in intravenous regional anesthesia (IVRA and brachial plexus block (BPB, respectively, on anesthesia, motor block and cardiovascular parameters in dogs. METHODS: Fourteen healthy adult dogs averaging 10 kilograms (kg of body weight. Animals were randomly assigned to receive one of the two treatments IVRA (n=7 or BPB (n=7. All the animals were sedated with acepromazine (0.1 mg/kg intramuscular. To execute the BPB was used an electrical nerve stimulation. Anesthesia, motor block, sedation, cardiovascular and respiratory effects were measured as effect of the treatment. RESULTS: BPA showed superior efficiency and duration of anesthesia (BPB - 456 ± 94 minutes vs IVRA - 138 ± 44 as well as motor block. There only physiologic parameter which change were the systolic pressure in BPB and respiratory rate for both treatments. CONCLUSION: In dogs the 0.25 % hyperbaric bupivacaine in BPB produces a front limb anesthesia about three times more than the 0.5 % in IVRA, with ptosis of the limb blocked and little interference in the cardiovascular system but with decrease in respiratory rate.OBJETIVO: Avaliar os efeitos da bupivacaína 0,5 e 0,25 % na anestesia regional endovenosa (IVRA e no bloqueio do plexo braquial (BPB respectivamente, na anestesia, bloqueio motor e parâmetros cardiovasculares em cães. MÉTODOS: Foram utilizados 14 cães sadios adultos pesando em média 10 kilos. Animais foram aleatoriamente designados a um de dois tratamentos IVRA (n = 7 ou BPB (n = 7. Todos os animais foram sedados com acepromazina (0,1 mg/kg intramuscular. Para realizar o BPB foi usado um estimulador elétrico nervoso. Anestesia, bloqueio motor, sedação, efeitos cardiovascular e respiratório foram mensurados como efeitos dos respectivos bloqueios. RESULTADOS: O bloqueio BPB demonstrou eficiência superior e maior duração da anestesia (BPB - 456 ± 94 minutos vs IVRA - 138 ± 44 minutos bem como maior

  12. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training.

    Science.gov (United States)

    Behrens, Martin; Weippert, Matthias; Wassermann, Franziska; Bader, Rainer; Bruhn, Sven; Mau-Moeller, Anett

    2015-01-01

    Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after 8 weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms) and iMVC of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave), peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that cycling endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue resistance. PMID:26029114

  13. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training

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    Martin eBehrens

    2015-05-01

    Full Text Available Previously published studies on the effect of short-term endurance training on the neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after eight weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms and isometric maximum voluntary contraction of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave, peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that the endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue

  14. Assessment of ventilatory neuromuscular drive in patients with obstructive sleep apnea

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    L.R.A. Bittencourt

    1998-04-01

    Full Text Available The presence of abnormalities of the respiratory center in obstructive sleep apnea (OSA patients and their correlation with polysomnographic data are still a matter of controversy. Moderately obese, sleep-deprived OSA patients presenting daytime hypersomnolence, with normocapnia and no clinical or spirometric evidence of pulmonary disease, were selected. We assessed the ventilatory control and correlated it with polysomnographic data. Ventilatory neuromuscular drive was evaluated in these patients by measuring the ventilatory response (VE, the inspiratory occlusion pressure (P.1 and the ventilatory pattern (VT/TI, TI/TTOT at rest and during submaximal exercise, breathing room air. These analyses were also performed after inhalation of a hypercapnic mixture of CO2 (DP.1/DPETCO2, DVE/DPETCO2. Average rest and exercise ventilatory response (VE: 12.2 and 32.6 l/min, respectively, inspiratory occlusion pressure (P.1: 1.5 and 4.7 cmH2O, respectively, and ventilatory pattern (VT/TI: 0.42 and 1.09 l/s; TI/TTOT: 0.47 and 0.46 l/s, respectively were within the normal range. In response to hypercapnia, the values of ventilatory response (DVE/DPETCO2: 1.51 l min-1 mmHg-1 and inspiratory occlusion pressure (DP.1/DPETCO2: 0.22 cmH2O were normal or slightly reduced in the normocapnic OSA patients. No association or correlation between ventilatory neuromuscular drive and ventilatory pattern, hypersomnolence score and polysomnographic data was found; however a significant positive correlation was observed between P.1 and weight. Our results indicate the existence of a group of normocapnic OSA patients who have a normal awake neuromuscular ventilatory drive at rest or during exercise that is partially influenced by obesity

  15. Direct and indirect measurement of neuromuscular fatigue in Canadian football players.

    Science.gov (United States)

    Clarke, Nick; Farthing, Jonathan P; Lanovaz, Joel L; Krentz, Joel R

    2015-05-01

    This study assessed the effects of a fatiguing game simulation (G-Sim) on the balance of collegiate Canadian football players. The purpose of the study was to evaluate postural control as a potential tool for monitoring neuromuscular fatigue (NMF) in collision-based team sports. Fifteen male Canadian football players were recruited (mean±SD: age 21.8±1.6 years, weight 97.6±14.7 kg). Indirect NMF measures (postural sway and countermovement jump (CMJ)) were performed 24 h before (TBase), immediately before (TPre) and after (TPost), and 24 h (T24) and 48 h after (T48) a Canadian football G-Sim. Peak isometric knee extensor torque of a maximal voluntary contraction (MVC) and electrically evoked tetani at 20 Hz (P20) and 80 Hz (P80) were also recorded as direct NMF measures at TBase, TPre, TPost, and T48. At TPost, we observed significant declines in MVC, P20, and the MVC/P80 ratio (-15.3%, -15.7%, and -12.1%, respectively; n=12) along with reductions in CMJ takeoff velocity and peak power (-6.9% and -6.5%, respectively; n=12) and larger area of the center of pressure trajectory (95.2%; n=10) during a 60-s postural sway task. All variables were no longer different than baseline by T48. Acute neuromuscular impairment in this cohort is likely attributable to alterations in excitation-contraction coupling due to structural damage and central activation failure. Congruency between the direct and indirect measures of NMF suggests monitoring postural sway has the potential to identify both neuromuscular and somatosensory alterations induced by acute game-induced fatigue in collision-based team sports players.

  16. Effect of jumping interval training on neuromuscular and physiological parameters: a randomized controlled study.

    Science.gov (United States)

    Ache-Dias, Jonathan; Dellagrana, Rodolfo A; Teixeira, Anderson S; Dal Pupo, Juliano; Moro, Antônio R P

    2016-01-01

    This study analyzed the effect of 4 weeks of jumping interval training (JIT), included in endurance training, on neuromuscular and physiological parameters. Eighteen recreational runners, randomized in control and experimental groups, performed 40 min of running at 70% of velocity at peak oxygen uptake, for 3 times per week. Additionally, the experimental group performed the JIT twice per week, which consisted of 4 to 6 bouts of continuous vertical jumps (30 s) with 5-min intervals. Three days before and after the training period, the countermovement (CMJ) and continuous jump (CJ30), isokinetic and isometric evaluation of knee extensors/flexors, progressive maximal exercise, and submaximal constant-load exercise were performed. The JIT provoked improvement in neuromuscular performance, indicated by (i) increased jump height (4.7%; effect size (ES) = 0.99) and power output (≈ 3.7%; ES ≈ 0.82) of CMJ and rate of torque development of knee extensors in isometric contraction (29.5%; ES = 1.02); (ii) anaerobic power and capacity, represented by the mean of jump height (7.4%; ES = 0.8), and peak power output (PPO) (5.6%; ES = 0.73) of the first jumps of CJ30 and the mean of jump height (10.2%, ES = 1.04) and PPO (9.5%, ES = 1.1), considering all jumps of CJ30; and (iii) aerobic power and capacity, represented by peak oxygen uptake (9.1%, ES = 1.28), velocity at peak oxygen uptake (2.7%, ES = 1.11), and velocity corresponding to the onset of blood lactate accumulation (9.7%, ES = 1.23). These results suggest that the JIT included in traditional endurance training induces moderate to large effects on neuromuscular and physiological parameters.

  17. The punctum fixum-punctum mobile model: a neuromuscular principle for efficient movement generation?

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    Christoph von Laßberg

    Full Text Available According to the "punctum fixum-punctum mobile model" that was introduced in prior studies, for generation of the most effective intentional acceleration of a body part the intersegmental neuromuscular onset succession has to spread successively from the rotation axis (punctum fixum toward the body part that shall be accelerated (punctum mobile. The aim of the present study was to investigate whether this principle is, indeed, fundamental for any kind of efficient rotational accelerations in general, independent of the kind of movements, type of rotational axis, the current body position, or movement direction. Neuromuscular onset succession was captured by surface electromyography of relevant muscles of the anterior and posterior muscle chain in 16 high-level gymnasts during intentional accelerating movement phases while performing 18 different gymnastics elements (in various body positions to forward and backward, performed on high bar, parallel bars, rings and trampoline, as well as during non-sport specific pivot movements around the longitudinal axis. The succession patterns to generate the acceleration phases during these movements were described and statistically evaluated based on the onset time difference between the muscles of the corresponding muscle chain. In all the analyzed movement phases, the results clearly support the hypothesized succession pattern from punctum fixum to punctum mobile. This principle was further underlined by the finding that the succession patterns do change their direction running through the body when the rotational axis (punctum fixum has been changed (e.g., high bar or rings [hands] vs. floor or trampoline [feet]. The findings improve our understanding of intersegmental neuromuscular coordination patterns to generate intentional movements most efficiently. This could help to develop more specific methods to facilitate such patterns in particular contexts, thus allowing for shorter motor learning

  18. Contribución del soporte nutricional al tratamiento de las alteraciones neuro-musculares del paciente crítico Contribution of nutritional support to treatment neuromuscular impairments of critically ill patients

    OpenAIRE

    J. C. Montejo González

    2006-01-01

    Las alteraciones neuromusculares que tienen lugar en el paciente crítico han sido atribuidas a factores como la situación séptica, la liberación de mediadores inflamatorioso el empleo de fármacos que afectan desfavorablemente a la función neuro-muscular. El papel de factores metabólicos y nutricionales en el desarrollo de esta patología ha recibido poca atención. En la actualidad, el empleo de protocolos de control intensivo de la glucemia podría tener gran interés en la prevención de las alt...

  19. Vendaje Neuromuscular y su aplicación en la mejora del rendimiento muscular

    OpenAIRE

    Rodrigo Rodríguez, Jorge

    2015-01-01

    El Vendaje Neuro-Muscular (VNM) es una técnica que utiliza vendajes blandos muy elásticos, por sus efectos, entre otros, sobre la fisiología de los músculos vendados. En el mundo del deporte esta técnica es usada con finalidad preventiva, terapéutica en fase aguda, y favorecedora de la recuperación en la fase post-lesión. Diversos autores han encontrado resultados contradictorios en cuanto a su posible utilidad en el aumento del rendimiento deportivo (Tieh-Cheng et al.2008; Li-Chun Yu et al. ...

  20. Same-day physical therapy consults in an outpatient neuromuscular disease physician clinic

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    Pucillo EM

    2016-10-01

    Full Text Available Evan M Pucillo,1 Nancy Christensen-Mayer,2 Shelly D Poole,2 Denise M Whitten,2 Danielle Freeman,3 Blake R Bohe,4 Brandon R Swensen,3 A Gordon Smith,1 Nicholas E Johnson1 1Department of Neurology, School of Medicine, 2Department of Physical Medicine & Rehabilitation, 3Outpatient Neurology, University of Utah Hospitals and Clinics, 4Business Support, University of Utah Information Technology, Salt Lake City, UT, USA Background: Team-based care has been shown to offer more comprehensive benefits to patients when compared to standard physician-based care alone in clinics for chronic conditions. However, apart from grant-funded multidisciplinary clinics, there are no reports on the usage of same-day physical therapy (PT consults within a daily outpatient neuromuscular disease (NMD physician clinic.Objective: To determine the impact of same-day PT consults at the University of Utah’s outpatient Clinical Neurosciences Center.Design: A qualitative assessment and survey of patient satisfaction.Methods: An eight question Health Insurance Portability and Accountability Act-compliant patient satisfaction survey using a 5-point Likert scale was administered. Demographic data and Press-Ganey Provider Satisfaction surveys were retrospectively collected from electronic medical records for patients receiving same-day PT encounters in the neuromuscular division over 1 year.Results: Mean (standard deviation age was 54.22 (19.81 years for 134 patient encounters, median age was 60 years, with 76 male (57% and 58 female (43% patients. Mean Likert score for 61 self-reported patient satisfaction surveys for same-day PT consults was 4.87 (97.4%. Press-Ganey Provider Satisfaction scores improved from 89.9% (N=287 for the year prior to 90.8% (N=320 for the corresponding year (P=0.427. A total of 46 (75.4% patients have either never before received PT care or never before received PT care for their NMD, 67.4% of whom were male.Conclusion: Same-day PT consults in an

  1. Growth differentiation factor 6 as a putative risk factor in neuromuscular degeneration.

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    Michèle G DuVal

    Full Text Available Mutation of Glass bottom boat, the Drosophila homologue of the bone morphogenetic protein or growth/differentiation factor (BMP/GDF family of genes in vertebrates, has been shown to disrupt development of neuromuscular junctions (NMJ. Here we tested whether this same conclusion can be broadened to vertebrate BMP/GDF genes. This analysis was also extended to consider whether such genes are required for NMJ maintenance in post-larval stages, as this would argue that BMP genes are viable candidates for analysis in progressive neuromuscular disease. Zebrafish mutants harboring homozygous null mutations in the BMP-family gene gdf6a were raised to adulthood and assessed for neuromuscular deficits. Fish lacking gdf6a exhibited decreased endurance (∼ 50%, p = 0.005 compared to wild type, and this deficit progressively worsened with age. These fish also presented with significantly disrupted NMJ morphology (p = 0.009, and a lower abundance of spinal motor neurons (∼ 50%, p<0.001 compared to wild type. Noting the similarity of these symptoms to those of Amyotrophic Lateral Sclerosis (ALS model mice and fish, we asked if mutations in gdf6a would enhance the phenotypes observed in the latter, i.e. in zebrafish over-expressing mutant Superoxide Dismutase 1 (SOD1. Amongst younger adult fish only bigenic fish harboring both the SOD1 transgene and gdf6a mutations, but not siblings with other combinations of these gene modifications, displayed significantly reduced endurance (75%, p<0.05 and strength/power (75%, p<0.05, as well as disrupted NMJ morphology (p<0.001 compared to wild type siblings. Bigenic fish also had lower survival rates compared to other genotypes. Thus conclusions regarding a role for BMP ligands in effecting NMJ can be extended to vertebrates, supporting conservation of mechanisms relevant to neuromuscular degenerative diseases. These conclusions synergize with past findings to argue for further analysis of GDF6 and other BMP genes as

  2. EFEITO DO TREINO NEUROMUSCULAR NA ROTAÇÃO DO JOELHO DURANTE A ATERRISSAGEM EM MULHERES

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    Narayana Vianna Spanó

    2016-04-01

    Full Text Available Introdução: O grande índice de lesões do ligamento cruzado anterior sem envolver contato em mulheres é motivo de curiosidade entre os cientistas, pois avaliações de aterrissagem podem sugerir a predisposição ao risco dessa lesão. Neste sentido, vários protocolos de treinamento foram utilizados como intervenção e obtiveram resultados diversificados na alteração desse fator de risco. Objetivo: O objetivo deste projeto foi avaliar as possíveis alterações de rotação do joelho na aterrissagem unipodal após a intervenção de um programa de treinamento neuromuscular. Métodos: Participaram do estudo 18 mulheres com idade entre 18 e 51 anos, que foram distribuídas em dois grupos: grupo de treinamento neuromuscular de oito semanas (GTN (n = 11 e grupo controle (GC (n = 7. Além disso, não apresentavam lesão musculoesquelética ou dores nos membros inferiores. Cada participante realizou cinco aterrissagens unipodais válidas de uma plataforma de 40 cm de altura. O processo de captura de movimento foi realizado com 12 câmeras infravermelho do sistema OptiTrack(tm para obter as coordenadas tridimensionais de marcadores fixados nos pontos anatômicos de interesse. Os sistemas de coordenadas locais da coxa e da perna foram definidos por meio dos respectivos marcadores fixados nos pontos anatômicos. Dessa forma, foram calculados os ângulos de rotação do joelho nos planos sagital, frontal e transverso através das sequências dos ângulos de Euler e as velocidades angulares através das formulações dos quatérnions. Resultados: Os resultados mostraram que houve um aumento na velocidade de rotação do joelho após o treinamento neuromuscular. Conclusão: Conclui-se que o treinamento neuromuscular resultou em maior velocidade de rotação no joelho nos 40 milissegundos que sucedem a aterrissagem unipodal.

  3. L- and DL-carnitine induce tetanic fade in rat neuromuscular preparation

    OpenAIRE

    Lopes G.; Bazotte R.B.; Curi R.; Alves-Do-Prado W.

    2003-01-01

    Carnitine, a structurally choline-like metabolite, has been used to increase athletic performance, although its effects on neuromuscular transmission have not been investigated. It is present in skeletal muscle and its plasma levels are about 30 to 90 µM. Using rat phrenic nerve diaphragm preparations indirectly and directly stimulated with high rate pulses, D-carnitine (30 and 60 µM), L-carnitine (60 µM) and DL-carnitine (60 µM) were shown to induce tetanic fade (D-carnitine = 19.7 ± 3.1%, N...

  4. Preventing Ischial Pressure Ulcers: III. Clinical Pilot Study of Chronic Neuromuscular Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Hilton M. Kaplan

    2011-01-01

    Full Text Available Objective: BIONs™ (BIOnic Neurons are injectable, wireless microstimulators that make chronic BION Active Seating (BAS possible for pressure ulcer prevention (PUP. Neuromuscular electrical stimulation (NMES produces skeletal motion and activates trophic factors, counteracting three major etiological mechanisms leading to pressure ulcers (PUs: immobility, soft-tissue atrophy, and ischemia. Companion papers I and II reviewed prior experience with NMES for PUP, and analyzed the biomechanical considerations, respectively. This paper presents a treatment strategy derived from this analysis, and the clinical results of the first three cases.

  5. [Anesthetic Management of a Patient with Facioscapulohumeral Muscular Dystrophy: Importance of Monitoring Neuromuscular Function at Multiple Sites].

    Science.gov (United States)

    Matsui, Shuhei; Tanaka, Satoshi; Kiyosawa, Kenkichi; Tanaka, Toshiyuki; Kawamata, Mikito

    2015-12-01

    A 39-year-old female with facioscapulohumeral muscular dystrophy (FSHD) was scheduled for thoracoscopic resection of an anterior mediastinal tumor. She had slowly progressive weakness and atrophy in the fascial and shoulder girdle muscles. General anesthesia was induced and maintained with propofol, remifentanil, and fentanyl combined with thoracic paravertebral block. Rocuronium-induced neuromuscular blockade was evaluated with acceleromyography at the corrugator supercilii, masseter, and adductor pollicis muscles. There was no reaction at the atrophic corrugator supercilii muscle in response to train-of-four (TOF) stimulation even before rocuronium administration. In contrast twitch responses at the masseter and adductor pollicis muscles to TOF stimulation could be evoked and the duration of action of rocuronium was found to be similar to that of the normal population. The perioperative course was uneventful. Neuromuscular monitoring sites should be carefully selected in FSHD patients because of possible inability to monitor neuromuscular function at the atrophic muscles. PMID:26790332

  6. Bloqueio do plexo braquial por via supraclavicular: estudo clínico comparativo entre bupivacaína e levobupivacaína Bloqueo del plexo braquial por vía supraclavicular: estudio clínico comparativo entre bupivacaína y levobupivacaína Supraclavicular brachial plexus block: a comparative clinical study between bupivacaine and levobupivacaine

    Directory of Open Access Journals (Sweden)

    José Ricardo Pinotti Pedro

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio de plexo braquial é técnica anestésica utilizada para procedimentos em membros superiores. O plexo braquial é território potencial para absorção de anestésicos locais. Estudos dos estereoisômeros da bupivacaína vêm demonstrando menor potencial de toxicidade da fração levógira (levobupivacaína sobre o sistema cardiovascular. Porém, é discutida a eficácia anestésica (bloqueio sensitivo e motor da levobupivacaína em anestesia do neuroeixo. Este estudo visa demonstrar a eficácia anestésica da levobupivacaína, comparandoa com a bupivacaína racêmica em bloqueio de plexo braquial, via perivascular subclávia. MÉTODO: Cinquenta pacientes adultos de ambos os sexos, ASA I e II, foram submetidos à anestesia de plexo braquial via perivascular subclávia para procedimentos ortopédicos de membros superiores, com auxílio de neuroestimulador. Foram divididos de modo aleatório em dois grupos: G BUPI - bupivacaína racêmica e G LEVO - levobupivacaína, num volume de 30 mL a 0,5%. O bloqueio sensitivo foi avaliado pelo método de "picada de agulha" nos metâmeros de C5 a C8; e o bloqueio motor, nos intervalos em minutos 1, 2, 5, 10, 15, 20, 25, 30 ou até instalação do bloqueio em movimentos dos dedos, mão, antebraço e braço. RESULTADOS: Não houve diferença estatística entre os dois grupos quanto à latência, incidência de falhas e grau do bloqueio motor, bem como incidência de falhas do bloqueio sensitivo, mas verificou-se diferença estatística da latência do bloqueio sensitivo em todos os metâmeros analisados. Não houve efeitos adversos inerentes à aplicação do anestésico local. CONCLUSÕES: A levobupivacaína demonstrou eficácia anestésica em bloqueio de plexo braquial, equiparável à solução racêmica usualmente empregada.JUSTIFICATIVA Y OBJETIVOS: El bloqueo de plexo braquial es la técnica anestésica utilizada para procedimientos en miembros superiores. El plexo

  7. Increased pain sensitivity but normal function of exercise induced analgesia in hip and knee osteoarthritis - treatment effects of neuromuscular exercise and total joint replacement

    DEFF Research Database (Denmark)

    Kosek, E; Roos, Ewa M.; Ageberg, E;

    2013-01-01

    To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters.......To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters....

  8. Neuromuscular electrical stimulation improves exercise tolerance in chronic obstructive pulmonary disease patients with better preserved fat-free mass

    Directory of Open Access Journals (Sweden)

    Lara Maris Nápolis

    2011-01-01

    Full Text Available BACKGROUND: High-frequency neuromuscular electrical stimulation increases exercise tolerance in patients with advanced chronic obstructive pulmonary disease (COPD patients. However, it is conceivable that its benefits are more prominent in patients with better-preserved peripheral muscle function and structure. OBJECTIVE: To investigate the effects of high-frequency neuromuscular electrical stimulation in COPD patients with better-preserved peripheral muscle function. Design: Prospective and cross-over study. METHODS: Thirty COPD patients were randomly assigned to either home-based, high-frequency neuromuscular electrical stimulation or sham stimulation for six weeks. The training intensity was adjusted according to each subject's tolerance. Fat-free mass, isometric strength, six-minute walking distance and time to exercise intolerance (Tlim were assessed. RESULTS: Thirteen (46.4% patients responded to high-frequency neuromuscular electrical stimulation; that is, they had a post/pre Δ Tlim >10% after stimulation (unimproved after sham stimulation. Responders had a higher baseline fat-free mass and six-minute walking distance than their seventeen (53.6% non-responding counterparts. Responders trained at higher stimulation intensities; their mean amplitude of stimulation during training was significantly related to their fat-free mass (r = 0.65; p<0.01. Logistic regression revealed that fat-free mass was the single independent predictor of Tlim improvement (odds ratio [95% CI] = 1.15 [1.04-1.26]; p<0.05. CONCLUSIONS: We conclude that high-frequency neuromuscular electrical stimulation improved the exercise capacity of COPD patients with better-preserved fat-free mass because they tolerated higher training stimulus levels. These data suggest that early training with high-frequency neuromuscular electrical stimulation before tissue wasting begins might enhance exercise tolerance in patients with less advanced COPD.

  9. A Markov computer simulation model of the economics of neuromuscular blockade in patients with acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Chow John L

    2006-03-01

    Full Text Available Abstract Background Management of acute respiratory distress syndrome (ARDS in the intensive care unit (ICU is clinically challenging and costly. Neuromuscular blocking agents may facilitate mechanical ventilation and improve oxygenation, but may result in prolonged recovery of neuromuscular function and acute quadriplegic myopathy syndrome (AQMS. The goal of this study was to address a hypothetical question via computer modeling: Would a reduction in intubation time of 6 hours and/or a reduction in the incidence of AQMS from 25% to 21%, provide enough benefit to justify a drug with an additional expenditure of $267 (the difference in acquisition cost between a generic and brand name neuromuscular blocker? Methods The base case was a 55 year-old man in the ICU with ARDS who receives neuromuscular blockade for 3.5 days. A Markov model was designed with hypothetical patients in 1 of 6 mutually exclusive health states: ICU-intubated, ICU-extubated, hospital ward, long-term care, home, or death, over a period of 6 months. The net monetary benefit was computed. Results Our computer simulation modeling predicted the mean cost for ARDS patients receiving standard care for 6 months to be $62,238 (5% – 95% percentiles $42,259 – $83,766, with an overall 6-month mortality of 39%. Assuming a ceiling ratio of $35,000, even if a drug (that cost $267 more hypothetically reduced AQMS from 25% to 21% and decreased intubation time by 6 hours, the net monetary benefit would only equal $137. Conclusion ARDS patients receiving a neuromuscular blocker have a high mortality, and unpredictable outcome, which results in large variability in costs per case. If a patient dies, there is no benefit to any drug that reduces ventilation time or AQMS incidence. A prospective, randomized pharmacoeconomic study of neuromuscular blockers in the ICU to asses AQMS or intubation times is impractical because of the highly variable clinical course of patients with ARDS.

  10. A randomized, dose-response study of sugammadex given for the reversal of deep rocuronium- or vecuronium-induced neuromuscular blockade under sevoflurane anesthesia

    DEFF Research Database (Denmark)

    Duvaldestin, Philippe; Kuizenga, Karel; Saldien, Vera;

    2010-01-01

    Sugammadex is the first of a new class of selective muscle relaxant binding drugs developed for the rapid and complete reversal of neuromuscular blockade induced by rocuronium and vecuronium. Many studies have demonstrated a dose-response relationship with sugammadex for reversal of neuromuscular...... blockade in patients induced and maintained under propofol anesthesia. However, sevoflurane anesthesia, unlike propofol, can prolong the effect of neuromuscular blocking drugs (NMBDs) such as rocuronium and vecuronium.......Sugammadex is the first of a new class of selective muscle relaxant binding drugs developed for the rapid and complete reversal of neuromuscular blockade induced by rocuronium and vecuronium. Many studies have demonstrated a dose-response relationship with sugammadex for reversal of neuromuscular...

  11. Neuromuscular electrical stimulation and dietary interventions to reduce oxidative stress in a secondary progressive multiple sclerosis patient leads to marked gains in function: a case report.

    Science.gov (United States)

    Reese, David; Shivapour, Ezzatolah T; Wahls, Terry L; Dudley-Javoroski, Shauna D; Shields, Richard

    2009-01-01

    Neuromuscular electrical stimulation has been used to aid musculoskeletal recovery. Excessive oxidative stress and excitoxicity are implicated in secondary progressive multiple sclerosis. A 52-year-old white female with SPMS had been scooter- and cane-dependent for 4 years. She requested and received a trial of neuromuscular electrical stimulation. Two months after initiating NMES the patient adopted several nutritional interventions to lower oxidative stress and excito-toxicity. During the first 2 months of neuromuscular electrical stimulation, the therapist observed modest gait improvements. Following the addition of nutritional interventions, more rapids gains in strength and endurance, including muscle groups not receiving neuromuscular electrical stimulation were observed by both the therapist and the patient. After 8 months of neuromuscular electrical stimulation (6 months of nutritional intervention) the patient's function had improved sufficiently that she no longer used a scooter or cane and rode her bicycle routinely 8 miles, including hills. PMID:19918474

  12. Does perioperative tactile evaluation of the train-of-four response influence the frequency of postoperative residual neuromuscular blockade?

    DEFF Research Database (Denmark)

    Pedersen, T; Viby-Mogensen, J; Bang, U;

    1990-01-01

    The authors conducted a randomized controlled clinical trial to evaluate the usefulness of perioperative manual evaluation of the response to train-of-four (TOF) nerve stimulation. A total of 80 patients were divided into four groups of 20 each. For two groups (one given vecuronium and one...... pancuronium), the anesthetists assessed the degree of neuromuscular blockade during operation and during recovery from neuromuscular blockade by manual evaluation of the response to TOF nerve stimulation. In the other two groups, one of which received vecuronium and the other pancuronium, the anesthetists...

  13. Increased rate of force development and neuromuscular activity after high-load resistance training in patients undergoing dialysis

    DEFF Research Database (Denmark)

    Molsted, Stig; Andersen, Jesper L.; Eidemak, Inge;

    2013-01-01

    development was tested using the Good Strength dynamometer chair. Muscle strength and neuromuscular function in the m. Vastus lateralis was estimated using electromyography in a one repetition maximum test during dynamic knee extension and during a 20s isometric knee extension with 50% of the one repetition......AimThe aim of this study was to investigate the effects of high-load resistance training on the rate of force development and neuromuscular function in patients undergoing dialysis. MethodsTwenty-nine patients were tested before and after 16 weeks of resistance training. The rate of force...

  14. Neuromuscular exercise prior to joint arthroplasty in patients with osteoarthritis of the hip or knee.

    Science.gov (United States)

    Villadsen, Allan

    2016-04-01

    Osteoarthritis (OA) is a degenerative joint disease affecting the whole joint and peri-articular structures like the muscles. The hallmark of OA is cartilage loss. The main symptoms are pain and decreased physical function leading to a reduced quality of life. OA ranks eight in leading causes of disability worldwide and it generates a heavy economic burden for society. The prevalence of OA increases with age and 10-18% aged above 60 years are affected. Currently there is no cure for OA and the various treatment modalities aim at addressing symptoms, i.e. reducing pain, improving physical function and preventing further progression of the disease. Exercise has proven to be a viable treatment option with regard to reducing pain and improving physical function in patients with mild to moderate knee OA and is today regarded a cornerstone in the treatment. The documentation is less clear for hip OA. Patients with severe OA of the hip or knee are treated with total joint arthroplasty (TJA). Although, in general, it is a very successful procedure, there are still challenges to overcome in this patient group, as approximately 10% of those having hip arthroplasty and 20% of those having knee arthroplasty have persistent symptoms. The evidence on the efficacy of exercise prior to TJA is sparse. It is based on insufficiently powered trials and with interventions of questionable validity. Two recent systematic reviews and meta-analyses reach conflicting conclusions and highlight the need for high quality trials with sufficient sample sizes. In this dissertation, I wanted to evaluate the effects of an individualised neuromuscular exercise programme (NEMEX-TJR) when administered prior to joint arthroplasty in patients with severe OA of the hip or knee joint. This intervention was previously found to be feasible with regard to pain level during exercise and it was possible to progress the training level in this patient group. The main question asked was: Does the addition of

  15. A training program to improve neuromuscular and performance indices in female high school basketball players.

    Science.gov (United States)

    Noyes, Frank R; Barber-Westin, Sue D; Smith, Stephanie T; Campbell, Thomas; Garrison, Tiina T

    2012-03-01

    The purpose of this study was to determine if a sports-specific training program could improve neuromuscular and performance indices in female high school basketball players. We combined components from a published anterior cruciate ligament injury prevention program for jump and strength training with other exercises and drills to improve speed, agility, overall strength, and aerobic conditioning. We hypothesized that this sports-specific training program would lead to significant improvements in neuromuscular and performance indices in high school female basketball players. Fifty-seven female athletes aged 14-17 years participated in the supervised 6-week program, 3 d·wk(-1) for approximately 90-120 minutes per session. The program was conducted on the basketball court and in weight room facilities in high schools. The athletes underwent a video drop-jump test, multistage fitness test, vertical jump test, and an 18-m sprint test before and upon completion of the training program. All the subjects attended at least 14 training sessions. After training, a significant increase was found in the mean estimated VO2max (p basketball players. PMID:22289699

  16. Antagonism by hemoglobin of effects induced by L-arginine in neuromuscular preparations from rats

    Directory of Open Access Journals (Sweden)

    C.R. Ambiel

    2001-04-01

    Full Text Available Nitric oxide (NO-synthase is present in diaphragm, phrenic nerve and vascular smooth muscle. It has been shown that the NO precursor L-arginine (L-Arg at the presynaptic level increases the amplitude of muscular contraction (AMC and induces tetanic fade when the muscle is indirectly stimulated at low and high frequencies, respectively. However, the precursor in muscle reduces AMC and maximal tetanic fade when the preparations are stimulated directly. In the present study the importance of NO synthesized in different tissues for the L-Arg-induced neuromuscular effects was investigated. Hemoglobin (50 nM did not produce any neuromuscular effect, but antagonized the increase in AMC and tetanic fade induced by L-Arg (9.4 mM in rat phrenic nerve-diaphragm preparations. D-Arg (9.4 mM did not produce any effect when preparations were stimulated indirectly at low or high frequency. Hemoglobin did not inhibit the decrease of AMC or the reduction in maximal tetanic tension induced by L-Arg in preparations previously paralyzed with d-tubocurarine and directly stimulated. Since only the presynaptic effects induced by L-Arg were antagonized by hemoglobin, the present results suggest that NO synthesized in muscle acts on nerve and skeletal muscle. Nevertheless, NO produced in nerve and vascular smooth muscle does not seem to act on skeletal muscle.

  17. [Screening for hereditary neuromuscular disorders with molecular genetic methods in the Roma population of Hungary].

    Science.gov (United States)

    Herczegfalvi, Agnes; Pikó, Henriett; Karcagi, Veronika

    2008-11-30

    Recent medical genetic research has identified a number of novel, or previously known, but rare conditions, caused by private founder mutations. The Finnish and Ashkenazi Jew populations provide the best examples for identifying genes in unique genetic disorders. In these populations, research efforts and high-level medical services resulted in intense improvements of medical care and in organization of population-based screening programs. Hereditary disorders of the Roma populations are known for a long time. The genetic background of these diseases has been established by extensive molecular genetic studies. The Romas represent 6% of the Hungarian population and live under extremely bad health conditions. Therefore, our aim was to map the incidence of the hereditary neuromuscular disorders among the Hungarian Roma population. Moreover, we intended to provide proper information, genetic counseling and possible prevention strategies for the families at risk, which should represent a primer task in public health. Because of our experience in neuromuscular disorders, we choose six, frequent, autosomal recessive disorders for these clinical and genetic studies: hereditary motor and sensory neuropathy type Lom (HMSNL), hereditary motor and sensory neuropathy type Russe (HMSNR), congenital cataracts facial dysmorphism syndrome (CCFDN), limb-girdle muscular dystrophy 2C (LGMD2C), congenital myasthenic syndrome (CMS) and spinal muscular atrophy (SMA). Following identification of the founder mutations, the possibility of prenatal diagnosis and carrier screening for family members will contribute to the decrease of the recurrence risk for these severe, mostly untreatable disorders. PMID:19070320

  18. Sport-specific functional movement can simulate aspects of neuromuscular fatigue occurring in team sports.

    Science.gov (United States)

    Wilke, Jan; Fleckenstein, Johannes; Krause, Frieder; Vogt, Lutz; Banzer, Winfried

    2016-06-01

    Fatigue protocols have been used over the years to examine muscular exhaustion. As an alternative to approaches in laboratory settings, functional agility protocols claiming to mimic the multifaceted loads of athletic activity have been proposed. This study aimed to examine the effects of a functional agility short-term fatigue protocol (FAST-FP) on neuromuscular function. Twenty-eight healthy sports students (15 males, aged 24.3 ± 2.4 years) completed the FAST-FP, which consists of four components: three counter-movement jumps (90% of individual maximum), a 20-s bout of step-ups, three bodyweight squats and an agility run. Tasks were repeated until the participants no longer achieved the required jump height in two consecutive sets. Outcomes (pre-post) encompassed subjective exhaustion (visual analogue scale [VAS]), maximum isometric voluntary force of the knee extensors (MIVF), reactive strength index (RSI), mean power frequency (MPF, measured using surface electromyography) and maximum knee range of motion (ROM). Post-intervention, VAS (+54 mm) increased significantly, while MIVF (-6.1%), RSI (-10.7%) and MPF (-4.1%) were reduced (p  0.05). The FAST-FP induces small-to-moderate impairments in neuromuscular function and considerable self-perceived fatigue. Current evidence on exhaustion developing in team sports suggests that this magnitude of fatigue is similar. The protocol might thus be valuable in the evaluation of treatments counteracting post-match fatigue in team sports.

  19. Quisqualate-activated single channel currents in neuromuscular preparations of small and large crayfish.

    Science.gov (United States)

    Finger, W; Martin, C; Pareto, A

    1988-06-01

    Single channel currents elicited by 1-5 mumol/l quisqualate in neuromuscular preparations in large (greater than 16 month old) and small (1-3 month old) crayfish were recorded by means of the patch-clamp technique. In preparations from large crayfish single channel currents of variable amplitude (-1 to -12 pA) were induced by quisqualate. The mean burst lengths of these currents were tau approximately equal to 1-2 ms. In the opener muscle of the first walking leg and the contractor epimeralis muscle of small crayfish the mean burst lengths of single channel currents evoked by quisqualate were prolonged by a factor of about 4 (tau approximately equal to 5 ms). Moreover, in the opener muscle of the first walking leg of small crayfish single channel currents of small amplitude (-0.5 to -2.5 pA) were preferentially evoked by quisqualate. By contrast, in the contractor epimeralis muscle of small crayfish mainly single channel currents of large amplitude (-10 to -12 pA) were elicited by quisqualate. The results suggest that at the stage of neuromuscular development characterizing the small crayfish, gating properties of excitatory postsynaptic channels are different from those in adult crayfish. Furthermore, the results obtained in the opener muscle of the first walking leg of small crayfish are consistent with those obtained previously by means of the noise analysis technique.

  20. Estimating neuromuscular stimulation within the human torso with Taser (registered) stimulus

    Energy Technology Data Exchange (ETDEWEB)

    Sun Hongyu [Department of Electrical and Computer Engineering, University of Wisconsin, Madison, WI 53706 (United States); Webster, John G [Department of Biomedical Engineering, University of Wisconsin, Madison, WI 53706 (United States)

    2007-11-07

    Designers of electromuscular incapacitation devices need to know efficacy. Which areas of nerve and muscle are stimulated and are these areas adequate to cause incapacitation? This paper focuses on efficacy, which used a torso-sized finite element model with a mesh of about 5 mm. To estimate the neuromuscular regions stimulated by the Taser (registered) X26, calculations of electric current density and field strength values with 1 A inserted into the torso using the Utah 3D mesh were made. Field-times-duration values for given Taser stimulation were calculated. Then the region where the motor nerve was stimulated by the Taser was estimated by using a field-times-duration threshold from Reilly (1998 Applied Bioelectricity: From Electrical Stimulation to Electropathology (New York: Springer)). Neuromuscular stimulation occurred up to about 19 cm away from the darts and included the spinal cord. The current density at the heart for dart separation less than 10 cm was smaller than for larger dart separation. Users of finite element computer models will find information for torso models and their creation, meshing and operation.

  1. Estimating neuromuscular stimulation within the human torso with Taser (registered) stimulus

    International Nuclear Information System (INIS)

    Designers of electromuscular incapacitation devices need to know efficacy. Which areas of nerve and muscle are stimulated and are these areas adequate to cause incapacitation? This paper focuses on efficacy, which used a torso-sized finite element model with a mesh of about 5 mm. To estimate the neuromuscular regions stimulated by the Taser (registered) X26, calculations of electric current density and field strength values with 1 A inserted into the torso using the Utah 3D mesh were made. Field-times-duration values for given Taser stimulation were calculated. Then the region where the motor nerve was stimulated by the Taser was estimated by using a field-times-duration threshold from Reilly (1998 Applied Bioelectricity: From Electrical Stimulation to Electropathology (New York: Springer)). Neuromuscular stimulation occurred up to about 19 cm away from the darts and included the spinal cord. The current density at the heart for dart separation less than 10 cm was smaller than for larger dart separation. Users of finite element computer models will find information for torso models and their creation, meshing and operation

  2. Neuromuscular Junction Protection for the Potential Treatment of Amyotrophic Lateral Sclerosis

    Directory of Open Access Journals (Sweden)

    Dan Krakora

    2012-01-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is a neuromuscular disease characterized by the progressive degeneration of upper and lower motor neurons (MNs, leading to muscular atrophy and eventual respiratory failure. ALS research has primarily focused on mechanisms regarding MN cell death; however, degenerative processes in the skeletal muscle, particularly involving neuromuscular junctions (NMJs, are observed in the early stages of and throughout disease progression. According to the “dying-back” hypothesis, NMJ degeneration may not only precede, but actively cause upper and lower MN loss. The importance of NMJ pathology has relatively received little attention in ALS, possibly because compensatory mechanisms mask NMJ loss for prolonged periods. Many mechanisms explaining NMJ degeneration have been proposed such as the disruption of anterograde/retrograde axonal transport, irregular cellular metabolism, and changes in muscle gene and protein expression. Neurotrophic factors, which are known to have neuroprotective and regenerative properties, have been intensely investigated for their therapeutic potential in both the preclinical and clinical setting. Additional research should focus on the potential of preserving NMJs in order to delay or prevent disease progression

  3. Electromyographic stages of denervation/reinnervation process in neuromuscular diseases: need for revision

    Directory of Open Access Journals (Sweden)

    S. S. Nikitin

    2015-01-01

    Full Text Available Analysis of motor unit potentials (MUPs parameters registered by needle EMG electrodes is the key for understanding changes of the motor units in different neuromuscular disorders. The classification of MUPs changes known as electromyographic stages (EMGS of the denervation/reinnervation process (DRP is based on the analysis of myogenic, synaptic neurogenic and neuronal disorders. Current article focuses on pathogenesis of typical and atypical MUPs of low duration, decreased and increased amplitude, additionally muscle biopsy data and neurophysiological assessment of muscle fiber density, and мacro-EMG. The absence of primary neurogenic disturbances in inflammatory and non-inflammatory muscle diseases, as well as in neuro-muscular junction disorders, confirmed by single fiber EMG and мacro-EMG makes it impossible to discuss the concept of EMG stages in patients with these levels of pathology. The EMG stages concept can be applied for peripheral nerve and motor neuron disturbances only, reflecting the volume but not the efficiency of reinnervation.

  4. Estimating neuromuscular stimulation within the human torso with Taser® stimulus

    Science.gov (United States)

    Sun, Hongyu; Webster, John G.

    2007-11-01

    Designers of electromuscular incapacitation devices need to know efficacy. Which areas of nerve and muscle are stimulated and are these areas adequate to cause incapacitation? This paper focuses on efficacy, which used a torso-sized finite element model with a mesh of about 5 mm. To estimate the neuromuscular regions stimulated by the Taser® X26, calculations of electric current density and field strength values with 1 A inserted into the torso using the Utah 3D mesh were made. Field-times-duration values for given Taser stimulation were calculated. Then the region where the motor nerve was stimulated by the Taser was estimated by using a field-times-duration threshold from Reilly (1998 Applied Bioelectricity: From Electrical Stimulation to Electropathology (New York: Springer)). Neuromuscular stimulation occurred up to about 19 cm away from the darts and included the spinal cord. The current density at the heart for dart separation less than 10 cm was smaller than for larger dart separation. Users of finite element computer models will find information for torso models and their creation, meshing and operation.

  5. Intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: present status and practical therapeutic guidelines.

    Science.gov (United States)

    Dalakas, M C

    1999-11-01

    This review summarizes the current status of intravenous immunoglobulin (IVIg) in the treatment of autoimmune neuromuscular disorders and the possible mechanisms of action of the drug based on work in vivo, in vitro, and in animal models. Supply of idiotypic antibodies, suppression of antibody production, or acceleration of catabolism of immunoglobulin G (IgG) are relevant in explaining the efficacy of IVIg in myasthenia gravis (MG), Lambert-Eaton myasthenic syndrome (LEMS), and antibody-mediated neuropathies. Suppression of pathogenic cytokines has putative relevance in inflammatory myopathies and demyelinating neuropathies. Inhibition of complement binding and prevention of membranolytic attack complex (MAC) formation are relevant in dermatomyositis (DM), Guillain-Barré syndrome (GBS), and MG. Modulation of Fc receptors or T-cell function is relevant in chronic inflammatory demyelinating polyneuropathy (CIDP), GBS, and inflammatory myopathies. The clinical efficacy of IVIg, based on controlled clinical trials conducted in patients with GBS, CIDP, multifocal motor neuropathy (MMN), DM, MG, LEMS, paraproteinemic IgM anti-myelin-associated glycoprotein (anti-MAG) demyelinating polyneuropathies, and inclusion body myositis is summarized and practical issues related to each disorder are addressed. The present role of IVIg therapy in other disorders based on small controlled or uncontrolled trials is also summarized. Finally, safety issues, risk factors, adverse reactions, spurious results or serological tests, and practical guidelines associated with the administration of IVIg in the treatment of neuromuscular disorders are presented.

  6. Alternative NF-κB Isoforms in the Drosophila Neuromuscular Junction and Brain.

    Directory of Open Access Journals (Sweden)

    Bo Zhou

    Full Text Available The Drosophila NF-κB protein Dorsal is expressed at the larval neuromuscular junction, where its expression appears unrelated to known Dorsal functions in embryonic patterning and innate immunity. Using confocal microscopy with domain-specific antisera, we demonstrate that larval muscle expresses only the B isoform of Dorsal, which arises by intron retention. We find that Dorsal B interacts with and stabilizes Cactus at the neuromuscular junction, but exhibits Cactus independent localization and an absence of detectable nuclear translocation. We further find that the Dorsal-related immune factor Dif encodes a B isoform, reflecting a conservation of B domains across a range of insect NF-κB proteins. Carrying out mutagenesis of the Dif locus via a site-specific recombineering approach, we demonstrate that Dif B is the major, if not sole, Dif isoform in the mushroom bodies of the larval brain. The Dorsal and Dif B isoforms thus share a specific association with nervous system tissues as well as an alternative protein structure.

  7. INFLUENCE OF ALLOFERIN ON NEUROMUSCULAR FUNCTION IN MYASTHENIA PATIENTS UNDERGOING THYMECTOMY

    Institute of Scientific and Technical Information of China (English)

    罗霞; 叶铁虎; 罗爱伦; 任洪智; 金永芳

    1994-01-01

    Myasthenia gravis patients are hypersensitive to nondepolarizing relaxants,such as alcuronium,an intermedi-ate-long nondepolarizing agent. This study observed the effects of alcuronium treatment in myasthenia gravis pa-tients as compared with non-MG patients during operation.Ten MG patients (Ossermann class Ⅰ-Ⅳ,scheduled for thymectomy)and 10non-MG patients(ASA class Ⅰ-Ⅱ,scheduled for operation)were selected.An induc-tion dose of alcuronium 0.2 mg/kg and thiopental 4-6 mg/kg was given,followed by intubation and ventilation with 50% nitrous oxide in oxygen and 0.5-1.5% ethrane.Neuromuscular transmission was monitored using an accelerogragh and degrees of neuromuscular function at different depths were recorded.There were statistically significant differences between the tow groups.The effect of alloferin in the MG group was quicker and deeper.This study also found a relation between MG class and the recovery of respiration: Respiratory recovery was quicker in classes Ⅰ-Ⅱ than in classes Ⅲ-Ⅳ.

  8. Bayesian analysis of the kinetics of quantal transmitter secretion at the neuromuscular junction.

    Science.gov (United States)

    Saveliev, Anatoly; Khuzakhmetova, Venera; Samigullin, Dmitry; Skorinkin, Andrey; Kovyazina, Irina; Nikolsky, Eugeny; Bukharaeva, Ellya

    2015-10-01

    The timing of transmitter release from nerve endings is considered nowadays as one of the factors determining the plasticity and efficacy of synaptic transmission. In the neuromuscular junction, the moments of release of individual acetylcholine quanta are related to the synaptic delays of uniquantal endplate currents recorded under conditions of lowered extracellular calcium. Using Bayesian modelling, we performed a statistical analysis of synaptic delays in mouse neuromuscular junction with different patterns of rhythmic nerve stimulation and when the entry of calcium ions into the nerve terminal was modified. We have obtained a statistical model of the release timing which is represented as the summation of two independent statistical distributions. The first of these is the exponentially modified Gaussian distribution. The mixture of normal and exponential components in this distribution can be interpreted as a two-stage mechanism of early and late periods of phasic synchronous secretion. The parameters of this distribution depend on both the stimulation frequency of the motor nerve and the calcium ions' entry conditions. The second distribution was modelled as quasi-uniform, with parameters independent of nerve stimulation frequency and calcium entry. Two different probability density functions for the distribution of synaptic delays suggest at least two independent processes controlling the time course of secretion, one of them potentially involving two stages. The relative contribution of these processes to the total number of mediator quanta released depends differently on the motor nerve stimulation pattern and on calcium ion entry into nerve endings. PMID:26129670

  9. Enteric neuromuscular junctions: comparison of ultrastructural features in different phylogenetic groups.

    Science.gov (United States)

    Halasy, K; Benedeczky, I; Fekete, E; Tóth, L; Gábriel, R

    1988-04-01

    The enteric neuromuscular junctions of snail (Helix pomatia), locust (Locusta migratoria migratorioides), cockroach (Periplaneta americana), carp (Cyprinus carpio) and tench (Tinca tinca) were studied by means of different light and electron microscopic methods. The nitroblue tetrazolium staining revealed that the myenteric plexuses of the above species are composed of nerve cells, a network of varicose nerves and nerve bundles. Instead of highly organized ganglia, single neurons or small groups of 2-4 cells are characteristic of the invertebrates and fish studied. Catecholaminergic fluorescence induced by glyoxylic acid was detected in the muscular layer of the entire alimentary tract in snail and the hindgut of tench. Fluorescent nerves and perikarya were frequent in the snail gut, while only nerves and no perikarya were found in tench. A close contact between enteric muscles and nerves is the most common form of enteric neuromuscular junction in both the smooth (i.e. the molluscan and fish gut) and the striated (i.e. the insect gut) musculature. The striated musculature (i.e. the insect gut, the oesophagus of carp, and the oesophagus, stomach and the midgut of tench) also receives a synaptic input. Cytochemical evidence is provided of the cholinergic character of fish motor endplates. The ultrastructural appearance and vesicle population of certain nerve terminals suggest a universal role of aminergic and peptidergic control in gut motility. PMID:3393275

  10. Effectiveness of neuromuscular electrical stimulation in the functional knee rehabilitation in soldiers

    Directory of Open Access Journals (Sweden)

    R. Castillo-Lozano

    2015-12-01

    Full Text Available Background: The versatility of military physical therapist practice enables them not only to diagnose knee injuries but also to provide a wide range of definitive care and rehabilitation, reducing the need for costly evacuation. The aim this study was to evaluate the effectiveness of interventions by Neuromuscular Electrical Stimulation (NMES in the functional knee rehabilitation in soldiers and describe the main predictors and determinants in each intervention. Methods: A systematic search of the literature about NMES in physiotherapy was performed using the following electronic databases: Web of Science, PubMed, Cochrane, Physiotherapy Evidence Database (PEDro and CINAHL. The search strategy was: "neuromuscular electrical stimulation" and "physical therapy" and "strengthening" and "knee". Inclusion criteria were: original articles published and peer reviewed between 2004-2015, focusing on physiotherapy interventions by NMES on subjects older than 18 years. A total resulting from 46 studies was included in the study. Results: The results show the evidence on the effectiveness of NMES therapeutic/preventive purposes in the muscular system; and the importance of physical therapy in the army. Conclusion: As a method of functional knee rehabilitation, NMES proves effective in achieving the therapeutic/preventive objectives in soldiers. Level of Evidence: II. Systematic review of randomized clinical trials with homogeneity.

  11. Neuromuscular characteristics and fatigue in endurance and sprint athletes during a new anaerobic power test.

    Science.gov (United States)

    Paavolainen, L; Häkkinen, K; Nummela, A; Rusko, H

    1994-01-01

    The purpose of this study was to investigate neuromuscular and energy performance characteristics of anaerobic power and capacity and the development of fatigue. Ten endurance and ten sprint athletes performed a new maximal anaerobic running power test (MARP), which consisted of n x 20-s runs on a treadmill with 100-s recovery between the runs. Blood lactate concentration [la-]b was measured after each run to determine submaximal and maximal indices of anaerobic power (P3 mmol.l-1, P5 mmol.l-1, P10 mmol.l-1 and Pmax) which was expressed as the oxygen demand of the runs according to the American College of Sports Medicine equation: the oxygen uptake (ml.kg-1.min-1) = 0.2 x velocity (m.min-1) + 0.9 x slope of treadmill (frac) x velocity (m.min-1) + 3.5. The height of rise of the centre of gravity of the counter movement jumps before (CMJrest) and during (CMJ) the MARP test, as well as the time of force production (tF) and electromyographic (EMG) activity of the leg muscles of CMJ performed after each run were used to describe the neuromuscular performance characteristics. The maximal oxygen uptake (VO2max), anaerobic and aerobic thresholds were determined in the VO2max test, which consisted of n x 3-min runs on the treadmill.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Chronic respiratory failure in patients with neuromuscular diseases: diagnosis and treatment.

    Science.gov (United States)

    Paschoal, Ilma Aparecida; Villalba, Wander de Oliveira; Pereira, Mônica Corso

    2007-01-01

    Neuromuscular diseases affect alveolar air exchange and therefore cause chronic respiratory failure. The onset of respiratory failure can be acute, as in traumas, or progressive (slow or rapid), as in amyotrophic lateral sclerosis, muscular dystrophies, diseases of the myoneural junction, etc. Respiratory muscle impairment also affects cough efficiency and, according to the current knowledge regarding the type of treatment available in Brazil to these patients, it can be said that the high rates of morbidity and mortality in these individuals are more often related to the fact that they cough inefficiently rather than to the fact that they ventilate poorly. In this review, with the objective of presenting the options of devices available to support and substitute for natural ventilation in patients with neuromuscular diseases, we have compiled a brief history of the evolution of orthopedic braces and prostheses used to aid respiration since the end of the 19th century. In addition, we highlight the elements that are fundamental to the diagnosis of alveolar hypoventilation and of failure of the protective cough mechanism: taking of a clinical history; determination of peak cough flow; measurement of maximal inspiratory and expiratory pressures; spirometry in two positions (sitting and supine); pulse oximetry; capnography; and polysomnography. Furthermore, the threshold values available in the literature for the use of nocturnal ventilatory support and for the extension of this support through the daytime period are presented. Moreover, the maneuvers used to increase cough efficiency, as well as the proper timing of their introduction, are discussed.

  13. Multiscale entropy-based approach to automated surface EMG classification of neuromuscular disorders.

    Science.gov (United States)

    Istenic, Rok; Kaplanis, Prodromos A; Pattichis, Constantinos S; Zazula, Damjan

    2010-08-01

    We introduce a novel method for an automatic classification of subjects to those with or without neuromuscular disorders. This method is based on multiscale entropy of recorded surface electromyograms (sEMGs) and support vector classification. The method was evaluated on a single-channel experimental sEMGs recorded from biceps brachii muscle of nine healthy subjects, nine subjects with muscular and nine subjects with neuronal disorders, at 10%, 30%, 50%, 70% and 100% of maximal voluntary contraction force. Leave-one-out cross-validation was performed, deploying binary (healthy/patient) and three-class classification (healthy/myopathic/neuropathic). In the case of binary classification, subjects were distinguished with 81.5% accuracy (77.8% sensitivity at 83.3% specificity). At three-class classification, the accuracy decreased to 70.4% (myopathies were recognized with a sensitivity of 55.6% at specificity 88.9%, neuropathies with a sensitivity of 66.7% at specificity 83.3%). The proposed method is suitable for fast and non-invasive discrimination of healthy and neuromuscular patient groups, but it fails to recognize the type of pathology. PMID:20490940

  14. Respiratory motor training and neuromuscular plasticity in patients with chronic obstructive pulmonary disease: A pilot study.

    Science.gov (United States)

    Ovechkin, Alexander V; Sayenko, Dimitry G; Ovechkina, Elena N; Aslan, Sevda C; Pitts, Teresa; Folz, Rodney J

    2016-07-15

    The objective of this study was to examine the feasibility of a full-scale investigation of the neurophysiological mechanisms of COPD-induced respiratory neuromuscular control deficits. Characterization of respiratory single- and multi-muscle activation patterns using surface electromyography (sEMG) were assessed along with functional measures at baseline and following 21±2 (mean±SD) sessions of respiratory motor training (RMT) performed during a one-month period in four patients with GOLD stage II or III COPD. Pre-training, the individuals with COPD showed significantly increased (p<0.05) overall respiratory muscle activity and disorganized multi-muscle activation patterns in association with lowered spirometrical measures and decreased fast- and slow-twitch fiber activity as compared to healthy controls (N=4). Following RMT, functional and respiratory sEMG activation outcomes during quite breathing and forced expiratory efforts were improved suggesting that functional improvements, induced by task-specific RMT, are evidence respiratory neuromuscular networks re-organization. PMID:27137413

  15. Severe neuromuscular denervation of clinically relevant muscles in a mouse model of spinal muscular atrophy.

    Science.gov (United States)

    Ling, Karen K Y; Gibbs, Rebecca M; Feng, Zhihua; Ko, Chien-Ping

    2012-01-01

    Spinal muscular atrophy (SMA), a motoneuron disease caused by a deficiency of the survival of motor neuron (SMN) protein, is characterized by motoneuron loss and muscle weakness. It remains unclear whether widespread loss of neuromuscular junctions (NMJs) is involved in SMA pathogenesis. We undertook a systematic examination of NMJ innervation patterns in >20 muscles in the SMNΔ7 SMA mouse model. We found that severe denervation (<50% fully innervated endplates) occurs selectively in many vulnerable axial muscles and several appendicular muscles at the disease end stage. Since these vulnerable muscles were located throughout the body and were comprised of varying muscle fiber types, it is unlikely that muscle location or fiber type determines susceptibility to denervation. Furthermore, we found a similar extent of neurofilament accumulation at NMJs in both vulnerable and resistant muscles before the onset of denervation, suggesting that neurofilament accumulation does not predict subsequent NMJ denervation. Since vulnerable muscles were initially innervated, but later denervated, loss of innervation in SMA may be attributed to defects in synapse maintenance. Finally, we found that denervation was amendable by trichostatin A (TSA) treatment, which increased innervation in clinically relevant muscles in TSA-treated SMNΔ7 mice. Our findings suggest that neuromuscular denervation in vulnerable muscles is a widespread pathology in SMA, and can serve as a preparation for elucidating the biological basis of synapse loss, and for evaluating therapeutic efficacy.

  16. Distinct neural and neuromuscular strategies underlie independent evolution of simplified advertisement calls.

    Science.gov (United States)

    Leininger, Elizabeth C; Kelley, Darcy B

    2013-04-01

    Independent or convergent evolution can underlie phenotypic similarity of derived behavioural characters. Determining the underlying neural and neuromuscular mechanisms sheds light on how these characters arose. One example of evolutionarily derived characters is a temporally simple advertisement call of male African clawed frogs (Xenopus) that arose at least twice independently from a more complex ancestral pattern. How did simplification occur in the vocal circuit? To distinguish shared from divergent mechanisms, we examined activity from the calling brain and vocal organ (larynx) in two species that independently evolved simplified calls. We find that each species uses distinct neural and neuromuscular strategies to produce the simplified calls. Isolated Xenopus borealis brains produce fictive vocal patterns that match temporal patterns of actual male calls; the larynx converts nerve activity faithfully into muscle contractions and single clicks. In contrast, fictive patterns from isolated Xenopus boumbaensis brains are short bursts of nerve activity; the isolated larynx requires stimulus bursts to produce a single click of sound. Thus, unlike X. borealis, the output of the X. boumbaensis hindbrain vocal pattern generator is an ancestral burst-type pattern, transformed by the larynx into single clicks. Temporally simple advertisement calls in genetically distant species of Xenopus have thus arisen independently via reconfigurations of central and peripheral vocal neuroeffectors. PMID:23407829

  17. Controle on-line da taxa média de defeitos por item produzido numa produção finita on-line process control of the average number of defects per item in a short run production

    Directory of Open Access Journals (Sweden)

    Carla Simone de Lima Teixeira

    2013-01-01

    Full Text Available Este trabalho propõe uma abordagem para monitoramento da taxa média de defeitos por item produzido numa produção finita ou encomenda de N itens. A cada ciclo de m itens produzidos, inspecionam-se os últimos r itens. Em cada item inspecionado conta-se o número de defeitos e cada item é classificado como aprovado se o número de defeitos satisfizer o critério do limite de controle. Se todos os r itens forem aprovados, a produção continua, caso contrário interrompe-se a produção à procura de causas especiais. Os itens inspecionados são descartados somente quando há parada no processo. Após a produção de N itens, um lote adicional será produzido para completar a quantia encomendada, mas esses não passarão por inspeção. Será utilizada uma cadeia de Markov finita de estados discretos para determinar as probabilidades de mudança de estado. Elas são utilizadas nas expressões de custo para determinar a estratégia ótima de monitoração, que será obtida através da otimização de três parâmetros: intervalo amostral (m, tamanho da amostra retrospectiva (r e o limite de controle (LC. Os parâmetros serão obtidos através de busca direta, de forma que se minimize a expressão do custo médio por item produzido. Um exemplo numérico ilustra a proposta.This paper proposes an approach for monitoring the average number of non-conformities per items in short-run productions of N items. After every m produced items, the last r items are inspected. For each inspected item, the number of defects is counted; each inspected item is classified as approved if it meets the control limit criterion. If all r inspected items are approved, then the production goes on, otherwise it is stopped for adjustment. The inspected items are all discarded in case of production stoppage. After a production of N items, an additional lot is produced to complete the size ordered, but this additional lot does suffer inspection. A finite discrete state

  18. Armazenamento sob condições ambiente e aceitabilidade do melão 'F1 Jangada' produzido em sistema hidropônico Storage under atmosphere conditions and acceptability of the melon 'F1 Jangada' croped in hydroponic system

    Directory of Open Access Journals (Sweden)

    Maria M. Rinaldi

    2006-12-01

    Full Text Available O objetivo deste trabalho foi determinar o período de armazenamento pós-colheita e a aceitabilidade pelo consumidor de melão híbrido 'F1 Jangada' (Cucumis melo L., produzido em sistema hidropônico, mantido em condições ambiente (22 ± 2 ºC e umidade relativa de 40 ± 5%. O experimento compreendeu o período de 21-6-2005 a 2-8-2005. Foi utilizado o esquema fatorial 5 x 2, em delineamento experimental inteiramente casualizado, com cinco períodos de armazenamento (0; 7; 21; 28 e 42 dias e dois tipos de substrato (areia e fibra de coco, com três repetições, em que cada repetição consistiu em cinco frutos de meloeiro. Foram avaliados o pH, a acidez titulável, os sólidos solúveis, a perda de massa fresca, a análise sensorial e a decisão de compra dos melões. Foram verificados efeitos do tipo de substrato e tempo de armazenamento sobre os valores de pH dos melões. A acidez titulável dos melões diminuiu significativamente nos primeiros sete dias de armazenamento, em ambos os substratos. Não foram verificados efeitos do tipo de substrato e tempo de armazenamento nos sólidos solúveis dos melões durante o armazenamento. Não houve diferença de perda de massa fresca dos frutos produzidos nos dois substratos, sendo de 7,1 ± 0,2%, durante os 42 dias de armazenamento. O tipo de substrato não interferiu na aparência geral, cor, textura e sabor dos melões. Aos 42 dias de armazenamento, os melões produzidos nos dois tipos de substrato apresentaram-se aceitáveis pelo consumidor. No entanto, os produzidos no substrato com areia apresentaram melhor aceitabilidade e decisão de compra ao longo do armazenamento.The objective of this work was to evaluate the storage period postharvest and acceptability by consumer of hybrid melon 'F1 Jangada' (Cucumis melo L., produced in hydroponic system, stored in atmosphere conditions (22 ± 2 ºC and 40 ± 5% relative humidity. The research was carried from June 21st to August 2nd, 2005. It was

  19. Caracterização de biopolímeros produzidos por Beijerinckia sp. 7070 em diferentes tempos de cultivo Characterization of biopolymers produced by Beijerinckia sp 7070 at different culture times

    Directory of Open Access Journals (Sweden)

    Caroline Dellinghausen Borges

    2004-09-01

    Full Text Available Biopolímeros são polissacarídeos microbianos. O biopolímero produzido por Beijerinckia sp. 7070 possui comportamento pseudoplástico e apresenta alta viscosidade em baixas velocidades de deformação, conferindo ao polímero excelentes características de suspensão. O objetivo desse trabalho foi caracterizar o biopolímero produzido por Beijerinckia sp. 7070 em diferentes tempos de cultivo, quanto à produção total, produção de polímeros de fibra longa e curta, produtividade, viscosidade e composição química. Os polímeros produzidos em meio YM líquido foram recuperados em diferentes tempos de cultivo, secos e pesados para determinação da produção e produtividade. O tipo de fibra produzido durante o cultivo foi avaliado microscopicamente. Viscosidades aparentes de solução aquosa 1% foram determinadas a 6, 12, 30 e 60rpm, a 25º C, em um viscosímetro Brookfield. A composição do biopolímero foi determinada por cromatografia em camada delgada comparativa. As maiores produções totais encontradas foram em 30 e 72h, a maior produtividade em 48h e a maior viscosidade em 72h. Os polímeros de fibra longa apresentaram uma tendência de tornarem-se mais longos com o tempo. A viscosidade do polímero de fibra longa foi maior que a do de fibra curta. Todos os biopolímeros apresentaram os mesmos componentes (glucose, galactose, fucose e ácido glucurônico mas em concentrações diferentes.Biopolymers are microbial polysaccharides. The biopolymer produced by Beijerinckia sp 7070 has pseudoplastic behaviour and shows high viscosity at low deformation rates, giving to polymer excellent suspension characteristics. The objective of this work was to characterize the biopolymer produced at different culture times by Beijerinckia sp 7070 in relation to total production, production of short and long fiber polymers, productivity, viscosity and chemical composition. The polymers produced in liquid YM medium were recovered at different

  20. Conhecimentos produzidos acerca do crack: uma incursão nas dissertações e teses brasileiras Knowledge derived from studies on crack: an incursion into Brazilian dissertations and theses

    OpenAIRE

    Diego Schaurich Rodrigues; Dirce Stein Backes; Hilda Maria Barbosa de Freitas; Claudia Zamberlan; Maria Helena Gelhen; Juliana Silveira Colomé

    2012-01-01

    Trata-se de um estudo do tipo revisão sistemática, com base na modalidade revisão integrativa, que objetivou analisar as características do conhecimento produzido sobre o crack pelos cursos de mestrado e doutorado brasileiros. O corpus de investigação foi composto por 33 trabalhos (18 dissertações e 15 teses), sendo que 51,5% dos estudos pertencem à área das Ciências da Saúde, com destaque para o Programa de Pós-Graduação de Psiquiatria (e Psicologia Médica) que produziu cinco dissertações/te...

  1. Métodos inovadores para a bio-secagem do CDR produzido na linha de processo da unidade de Tratamento Mecânico e Biológico (TMB) – Caso de estudo na VALNOR SA

    OpenAIRE

    Mendes, Cláudia Rodrigues

    2014-01-01

    A presente dissertação foca-se em métodos inovadores para a bio-secagem do Combustível Derivado de Resíduos (CDR) produzido na linha de Tratamento Mecânico de Biológico (TMB), na VALNOR SA. O CDR representa 25 a 35% dos resíduos indiferenciados tratados numa unidade de TMB e que resulta do refugo e rejeitados retirados na linha de triagem mecânica e no processo de afinação do composto orgânico. O CDR pode ser utilizado como combustível alternativo ao combustível fóssil em centrais de co-ge...

  2. Consecuencias clínicas de las alteraciones neuromusculares en el paciente crítico Clinical consequences of neuromuscular impairments in critically ill patients

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    A. Mesejo

    2006-05-01

    Full Text Available La patología neuromuscular en el paciente crítico se desarrolla en dos contextos: enfermedades neurológicas primarias que requieren su ingreso en Medicina Intensiva por necesitar vigilancia estricta o ventilación mecánica y manifestaciones del sistema nervioso periférico secundarias a enfermedades sistémicas críticas. En el primer grupo son las más frecuentes el Síndrome de Guillain-Barré y la Miastenia Gravis y en el segundo la Polineuropatía y la Miopatía del paciente crítico. El patrón clínico común más frecuente consiste en el desarrollo de un cuadro de acusada debilidad y cuadriparesia cuya manifestación más típica es la necesidad de respiración asistida o la dificultad/imposibilidad para su retirada. Se consideran factores desencadenantes el fracaso multiorgánico y la sepsis en la polineuropatía y los esteroides y bloqueantes neuromusculares en la miopatía, actuando como coadyuvantes en ambos casos la malnutrición, particularmente la hipoalbimunemia, y la hiperglucemia. Considerando que la afectación neuropática y miopática coexisten con frecuencia, se ha acuñado el término polineuromiopatía del paciente crítico. Tanto el Síndrome de Guillain-Barré como la polineuropatía del paciente crítico se localizan a nivel del nervio periférico, por lo que debe efectuarse un diagnóstico diferencial entre ambos. La forma de presentación es diferente ya que el primero es una patología aguda que motiva su ingreso en UCI, mientras que la polineuropatía se adquiere durante la hospitalización. En el primero es frecuente la afectación del sistema nervioso autónomo y la disociación albúmino-citológica en el LCR, lo que no se da en la polineuropatía. Los estudios electrofisiológicos muestran signos de desmelinización con disminución de la velocidad de conducción y normalidad en la amplitud de potenciales motores en el Síndrome de Guillain- Barré frente a velocidad de conducción normal y amplitud reducida

  3. Bloqueio inadvertido do neuroeixo durante artroplastia vertebral: relato de caso Bloqueo no percibido del neuroeje durante la artroplastia vertebral: relato de caso Accidental spinal block during vertebral artroplasty: case report

    Directory of Open Access Journals (Sweden)

    Michelle Nacur Lorentz

    2006-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A cirurgia de artroplastia vertebral com uso do cimento ósseo tem suas particularidades e complicações. Na maioria das vezes o procedimento é realizado sob anestesia local com sedação, mas algumas vezes é realizado bloqueio subaracnóideo ou peridural com morfina com o intuito de fornecer analgesia pós-operatória. O objetivo deste relato foi discutir as possíveis complicações em cirurgias de artroplastia vertebral. RELATO DO CASO: Paciente do sexo masculino, 76 anos, apresentando fratura patológica em T12, foi admitido para cirurgia de artroplastia vertebral e biopsia óssea. Foi realizada sedação com midazolam e fentanil, o paciente foi colocado em decúbito ventral e o cirurgião infiltrou anestésico local desde a pele até o corpo vertebral de T12 a seguir biopsiou a vértebra e injetou 6 mL de cimento ósseo em T12. Ao final do procedimento o paciente apresentava paralisia dos membros inferiores. CONCLUSÕES: A intervenção cirúrgica na coluna vertebral não é procedimento isento de complicações. Quando se associa bloqueio espinal pode-se retardar o diagnóstico de complicação cirúrgica; além disto corre-se o risco de se imputar à anestesia um problema proveniente do procedimento cirúrgico.JUSTIFICATIVA Y OBJETIVOS: A cirugía de artroplastia vertebral con uso del cimiento óseo tiene sus particularidades y complicaciones. En la mayoría de las veces el procedimiento se realiza bajo anestesia local con sedación, pero en algunos casos se realiza el bloqueo subaracnoideo o peridural con morfina con el interés de suministrar analgesia postoperatoria. El objetivo de este relato fue el de discutir las posibles complicaciones en cirugías de artroplastia vertebral. RELATO DEL CASO: Paciente del sexo masculino, 76 años, presentando fractura patológica en T12, fue admitido para cirugía de artroplastia vertebral y biopsia ósea. Se realizó sedación con midazolam y fentanil, el paciente fue

  4. Efeitos dentoesqueléticos produzidos pelo aparelho de Herbst na dentadura mista Dentoskeletal treatment effects produced by the Herbst appliance in the mixed dentition

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    Marcio Rodrigues de Almeida

    2006-10-01

    Full Text Available OBJETIVO: o objetivo desta pesquisa clínica prospectiva foi avaliar as alterações cefalométricas dentárias e esqueléticas produzidas pelo aparelho de Herbst em jovens com má oclusão de Classe II, 1ª divisão durante a dentadura mista. METODOLOGIA: trinta jovens (15 do gênero masculino e 15 do feminino com idade média inicial de 9 anos e 10 meses foram tratados com o aparelho de Herbst por um período de 12 meses. Para a comparação dos grupos utilizou-se uma amostra controle de 30 jovens (15 do gênero masculino e 15 do feminino Classe II, 1ª divisão, com idade média inicial de 9 anos e 8 meses, que foram mantidos sem tratamento durante 12 meses. Para cada jovem foram utilizadas duas telerradiografias em norma lateral, obtidas ao início e no final do período de acompanhamento. Utilizou-se um método convencional de avaliação cefalométrica e o método proposto por Pancherz. RESULTADOS E CONCLUSÕES: os resultados deste estudo demonstraram que os efeitos do aparelho de Herbst produzidos na dentadura mista foram primariamente de natureza dentoalveolar. Os incisivos inferiores foram inclinados para vestibular e os superiores foram retruídos; também houve uma extrusão significante dos molares inferiores, enquanto os superiores sofreram restrição de desenvolvimento no sentido vertical. Não houve diferença significante de restrição do crescimento anterior da maxila entre os dois grupos. No sentido vertical da face, a altura facial ântero-inferior se comportou de forma similar, não demonstrando alteração significante entre os grupos. O tratamento com o aparelho de Herbst produziu um aumento modesto, porém, significante no comprimento da mandíbula comparado ao grupo controle. Este aumento, entretanto, foi de menor magnitude que aquele observado em pacientes adolescentes utilizando o mesmo protocolo de tratamento. A correção do overjet (Herbst ocorreu devido a 22% de alterações esqueléticas e 78% de altera

  5. Quality of raw milk produced in agreste region of Pernambuco, Brazil / Qualidade do leite cru produzido na região do agreste de Pernambuco, Brasil

    Directory of Open Access Journals (Sweden)

    Márcia de Aguiar Ferreira Barros

    2010-04-01

    negativamente na produção e rendimento de derivados. No Estado de Pernambuco, não é diferente. Sendo o segundo maior produtor do Nordeste, Pernambuco tem sua maior produção de leite localizada na Região Agreste do estado, que fica entre a Zona da Mata e o Sertão. A produção de leite no Agreste, cresceu 23% nos últimos dois anos, chegando a 980 mil litros/dia. Com o objetivo de avaliar a qualidade microbiológica e físico-química do leite cru produzido nesta região, foram coletadas amostras em 53 propriedades rurais, nos municípios de Saloa, Águas Belas, São Bento do Una e Bom Conselho. Enumeraram-se aeróbios mesófilos, coliformes totais, Escherichia coli e estafilococos em placas de Petrifilm™ especificas (3M do Brasil Ltda.. A detecção de Listeria monocytogenes e Salmonella ssp foi realizada utilizando o sistema VIDAS (BioMeriex®. Organofosforados e carbamatos foram pesquisados pela técnica de Cromatografia em Camada Delgada. O teor de gordura, sólidos totais, sólidos não gordurosos, densidade, proteína e lactose foram obtidos por espectroscopia de em analisador ultra-sônico (US. Realizou-se ainda crioscopia, California Mastite Teste (CMT, peroxidase, acidez Dornic e Ring-test para monitoramento da presença de Brucelose nas propriedades. Nas análises microbiológicas, as amostras apresentaram altas contagens de microrganismos aeróbios mesófilos, coliformes totais, Escherichia coli, psicrotróficos e estafilococos coagulase positiva. A média de aeróbios mesófilos foi de 1,68% X 107, sendo 83% acima de 106. Listeria monocytogenes e Salmonella sp não foram detectadas, 47% das amostras foram positivas para carbamatos, organofosforados ou ambos. No CMT 67,9% das amostras foram positivas, e no Ring test 26,4% das propriedades foram positivas. Assim, apenas 2 (3,77% das amostras estariam dentro dos padrões estabelecidos pela IN 51.

  6. Muscles in a mouse model of spinal muscular atrophy show profound defects in neuromuscular development even in the absence of failure in neuromuscular transmission or loss of motor neurons.

    Science.gov (United States)

    Lee, Young Il; Mikesh, Michelle; Smith, Ian; Rimer, Mendell; Thompson, Wesley

    2011-08-15

    A mouse model of the devastating human disease "spinal muscular atrophy" (SMA) was used to investigate the severe muscle weakness and spasticity that precede the death of these animals near the end of the 2nd postnatal week. Counts of motor units to the soleus muscle as well as of axons in the soleus muscle nerve showed no loss of motor neurons. Similarly, neither immunostaining of neuromuscular junctions nor the measurement of the tension generated by nerve stimulation gave evidence of any significant impairment in neuromuscular transmission, even when animals were maintained up to 5days longer via a supplementary diet. However, the muscles were clearly weaker, generating less than half their normal tension. Weakness in 3 muscles examined in the study appears due to a severe but uniform reduction in muscle fiber size. The size reduction results from a failure of muscle fibers to grow during early postnatal development and, in soleus, to a reduction in number of fibers generated. Neuromuscular development is severely delayed in these mutant animals: expression of myosin heavy chain isoforms, the elimination of polyneuronal innervation, the maturation in the shape of the AChR plaque, the arrival of SCs at the junctions and their coverage of the nerve terminal, the development of junctional folds. Thus, if SMA in this particular mouse is a disease of motor neurons, it can act in a manner that does not result in their death or disconnection from their targets but nonetheless alters many aspects of neuromuscular development.

  7. Processing quality of potato tubers produced during autumn and spring and stored at different temperatures Qualidade de processamento de tubérculos de batata produzidos no outono e na primavera e armazenados em diferentes temperaturas

    Directory of Open Access Journals (Sweden)

    Sergio T de Freitas

    2012-03-01

    Full Text Available The objective of this work was to access processing quality of potato clones (Solanum tuberosum Asterix, SMINIA793101-3, and Missaukee cultivated during spring and autumn growing seasons and stored at 4, 8, 12, or 25ºC. Clones grown in spring had shorter dormancy than clones grown in autumn. Potato tubers grown in spring and autumn and stored at 4ºC, as well as tubers grown in autumn and stored at 8ºC had no sprouting for six months. Among clones grown in autumn, the longest dormancy period during storage at 12ºC was observed in the clone SMINIA793101-3, and at 25ºC was in the clone Asterix. In potato tubers grown in spring, the longest dormancy period during storage at 8ºC was observed in the clones SMINIA793101-3 and Missaukee, at 12ºC was in the clone SMINIA793101-3, and at 25ºC was in the clones Asterix and Missaukee. Potato tubers grown in spring had higher dry matter, starch content, and respiration rates, and lower reducing sugar, and total polyphenol content. The only exception was the Missaukee that had similar dry matter content in both growing seasons. In general, storage at 4ºC and 8ºC were more effective in reducing respiration rates and maintaining higher dry mater content of potato tubers. Chip darkening, reducing sugars, and total polyphenol content increased during storage of potato tubers. Darker chip color, higher reducing sugars and polyphenol content were obtained during storage at temperatures of 4ºC and 8ºC. These results suggest that the best storage temperature depends on genotype, tuber physiological age, and growing conditions.O objetivo deste trabalho foi determinar a qualidade de processamento dos clones de batata (Solanum tuberosum Asterix, SMINIA793101-3, e Missaukee cultivados durante outono e primavera e armazenados a 4, 8, 12, ou 25ºC. Clones produzidos na primavera tiveram menor período de dormência que clones produzidos no outono. Tubérculos produzidos na primavera e outono e armazenados a 4º

  8. Neuromuscular Scoliosis

    Science.gov (United States)

    ... About SRS العَرَبِية 中文 فارسی français deutsche Ελληνικά Italiano 日本語 한국어 português español Türkçe Member Login Become ... SRS Türkçe español português 한국어 日本語 Ελληνικά deutsche Italiano français فارسی 中文 العَرَبِية Patients and Families Find ...

  9. Acute effect of scapular proprioceptive neuromuscular facilitation (PNF) techniques and classic exercises in adhesive capsulitis: a randomized controlled trial.

    Science.gov (United States)

    Balcı, Nilay Comuk; Yuruk, Zeliha Ozlem; Zeybek, Aslican; Gulsen, Mustafa; Tekindal, Mustafa Agah

    2016-04-01

    [Purpose] The aim of our study was to compare the initial effects of scapular proprioceptive neuromuscular facilitation techniques and classic exercise interventions with physiotherapy modalities on pain, scapular dyskinesis, range of motion, and function in adhesive capsulitis. [Subjects and Methods] Fifty-three subjects were allocated to 3 groups: scapular proprioceptive neuromuscular facilitation exercies and physiotherapy modalities, classic exercise and physiotherapy modalities, and only physiotherapy modalities. The intervention was applied in a single session. The Visual Analog Scale, Lateral Scapular Slide Test, range of motion and Simple Shoulder Test were evaluated before and just after the one-hour intervention in the same session (all in one session). [Results] All of the groups showed significant differences in shoulder flexion and abduction range of motion and Simple Shoulder Test scores. There were statistically significant differences in Visual Analog Scale scores in the proprioceptive neuromuscular facilitation and control groups, and no treatment method had significant effect on the Lateral Scapular Slide Test results. There were no statistically significant differences between the groups before and after the intervention. [Conclusion] Proprioceptive neuromuscular facilitation, classic exercise, and physiotherapy modalities had immediate effects on adhesive capsulitis in our study. However, there was no additional benefit of exercises in one session over physiotherapy modalities. Also, an effective treatment regimen for shoulder rehabilitation of adhesive capsulitis patients should include scapular exercises.

  10. Referral of patients with neuromuscular disease to occupational therapy, physical therapy and speech therapy: usual practice versus multidisciplinary advice.

    NARCIS (Netherlands)

    Cup, E.H.C.; Pieterse, A.J.; Knuijt, S.; Hendricks, H.T.; Engelen, B.G.M. van; Oostendorp, R.A.B.; Wilt, G.J. van der

    2007-01-01

    PURPOSE To compare the volume of occupational therapy (OT), physical therapy (PT) and speech therapy (ST) as currently received by patients with neuromuscular diseases with the volume of OT, PT and ST recommended by a multidisciplinary team. METHOD: The use of OT, PT and ST was studied retrospective

  11. Reducing knee and anterior cruciate ligament injuries among female athletes: a systematic review of neuromuscular training interventions.

    Science.gov (United States)

    Hewett, Timothy E; Myer, Gregory D; Ford, Kevin R

    2005-01-01

    There is evidence that neuromuscular training not only decreases the potential biomechanical risk factors for ACL injury, but also decreases knee and, specifically, ACL injury incidence in female athletes. Five of the six interventions in this systematic review demonstrated significant effects on overall knee or ACL injury rates. It appears that plyometric power, biomechanics and technique, strength, balance, and core stability training can induce neuromuscular changes and potential injury prevention effects in female athletes. However, it is unknown which of these components is most effective or whether the effects are combinatorial. Future research should assess the relative efficacy of these interventions alone and in combination to achieve the optimal effect in the most efficient manner possible. Selective combination of neuromuscular training components may provide additive effects, further reducing the risk of ACL injuries in female athletes. Additional research directions include the assessment of relative injury risk using mass neuromuscular screening, the development of more specific injury prevention protocols targeted toward high-risk athletes, and the determination of when these interventions should be implemented. It may be that prepubertal or early pubertal female athletes may have the potential to achieve optimal biomechanical changes and the greatest chance of injury-free sports participation throughout their careers. PMID:15742602

  12. Effects of preoperative neuromuscular electrical stimulation on quadriceps strength and functional recovery in total knee arthroplasty. A pilot study.

    LENUS (Irish Health Repository)

    Walls, Raymond J

    2010-01-01

    Supervised preoperative muscle strengthening programmes (prehabilitation) can improve recovery after total joint arthroplasty but are considered resource intensive. Neuromuscular electrical stimulation (NMES) has been shown to improve quadriceps femoris muscle (QFM) strength and clinical function in subjects with knee osteoarthritis (OA) however it has not been previously investigated as a prehabilitation modality.

  13. Neuromuscular control of scapula muscles during a voluntary task in subjects with Subacromial Impingement Syndrome. A case-control study

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Søgaard, Karen; Chreiteh, S S;

    2013-01-01

    Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population with and w...

  14. Proactive and reactive neuromuscular control in subjects with chronic ankle instability: evidence from a pilot study on landing

    NARCIS (Netherlands)

    Levin, O.; Vanwanseele, B.; Thijsen, J.R.; Helsen, W.F.; Staes, F.F.; Duysens, J.E.J.

    2015-01-01

    To understand why subjects with chronic ankle instability (CAI) have frequent sprains, one must study the preparation/reactions of these subjects to situations related to ankle inversion in real life. In the present pilot study, we examined whether subjects with CAI altered their neuromuscular contr

  15. A METHOD FOR STUDYING THE PHARMACODYNAMIC PROFILE OF NEUROMUSCULAR BLOCKING-AGENTS ON VOCAL CORD MOVEMENTS IN ANESTHETIZED CATS

    NARCIS (Netherlands)

    VANDENBROM, RHG; HOUWERTJES, MC; AGOSTON, S

    1991-01-01

    1 A new in vivo experimental method is described whereby the neuromuscular blocking effects of muscle relaxants can be investigated on the intrinsic laryngeal muscles of anaesthetized cats. The peripheral tibialis anterior muscle preparation is employed in the same animal to compare the blocking eff

  16. Employment status of patients with neuromuscular diseases in relation to personal factors, fatigue and health status : A secondary analysis

    NARCIS (Netherlands)

    Minis, Marie-Antoinette; Kalkman, Joke; Akkermans, Reinier; Engels, Josephine; Huijbregts, Peter; Bleijenberg, Gijs; Oostendorp, Rob; Engelen, Baziel

    2010-01-01

    To determine the number of employed people in a group of patients with neuromuscular diseases and in 3 separate subgroups (facioscapulo-humeral dystrophy, hereditary motor and sensory neuropathy, and myotonic dystrophy) to investigate any differences in employment status between the patient groups,

  17. Employment status of patients with neuromuscular diseases in relation to personal factors, fatigue and health status: a secondary analysis.

    NARCIS (Netherlands)

    Minis, M.A.; Kalkman, J.S.; Akkermans, R.P.; Engels, J.A.; Huijbregts, P.A.; Bleijenberg, G.; Oostendorp, R.A.B.; Engelen, B.G.M. van

    2010-01-01

    OBJECTIVE: To determine the number of employed people in a group of patients with neuromuscular diseases and in 3 separate subgroups (facioscapulo-humeral dystrophy, hereditary motor and sensory neuropathy, and myotonic dystrophy) to investigate any differences in employment status between the patie

  18. ALS as a distal axonopathy : molecular mechanisms affecting neuromuscular junction stability in the presymptomatic stages of the disease

    NARCIS (Netherlands)

    Moloney, Elizabeth B; de Winter, Fred; Verhaagen, J.

    2014-01-01

    Amyotrophic Lateral Sclerosis (ALS) is being redefined as a distal axonopathy, in that many molecular changes influencing motor neuron degeneration occur at the neuromuscular junction (NMJ) at very early stages of the disease prior to symptom onset. A huge variety of genetic and environmental causes

  19. Utrophin abundance is reduced at neuromuscular junctions of patients with both inherited and acquired acetylcholine receptor deficiencies

    NARCIS (Netherlands)

    Slater, CR; Young, C; Wood, SJ; Bewick, GS; Anderson, LVB; Baxter, P; Fawcett, PRW; Roberts, M; Jacobson, L; Kuks, J; Vincent, A; NewsomDavis, J

    1997-01-01

    Congenital myasthenic syndromes are a heterogenous group of conditions in which muscle weakness resulting from impaired neuromuscular transmission is often present from infancy. One form of congenital myasthenic syndrome is due to a reduction of the number of acetylcholine receptors (AChRs) at the n

  20. Neuromuscular training improves knee kinematics, in particular in valgus aligned adolescent team handball players of both sexes.

    NARCIS (Netherlands)

    Barendrecht, M.; Lezeman, H.C.; Duysens, J.E.J.; Smits-Engelsman, B.C.M.

    2011-01-01

    The purpose of this study was to investigate the effects of added neuromuscular training (NMT), as compared to just regular training (RT), on lower extremity kinematics and single leg stability in adolescent team handball players of both sexes and to investigate whether these effects are more eviden

  1. Reversal of rocuronium-induced neuromuscular block by sugammadex is independent of renal perfusion in anesthetized cats

    NARCIS (Netherlands)

    Staals, L.M.; Boer, H.D. de; Egmond, J. van; Hope, F.; Pol, F.M. van de; Bom, A.H.; Driessen, J.J.; Booij, L.H.D.J.

    2011-01-01

    PURPOSE: Sugammadex is a selective relaxant binding agent designed to encapsulate the aminosteroidal neuromuscular blocking agent rocuronium, thereby reversing its effect. Both sugammadex and the sugammadex-rocuronium complex are eliminated by the kidneys. This study investigated the effect of sugam

  2. DEVELOPMENT AND TESTING PSYCHOMETRIC PROPERTIES OF AN ICF-BASED HEALTH MEASURE : THE NEUROMUSCULAR DISEASE IMPACT PROFILE

    NARCIS (Netherlands)

    Bos, Isaac; Kuks, Jan B. M.; Wynia, Klaske

    2015-01-01

    Objectives: To develop a measure that is based on the International Classification of Functioning, Disability and Health (ICF) and reflects the prevalence and severity of disabilities related to neuromuscular disorders, and to evaluate the psychometric properties of this measure. Methods: A prelimin

  3. Bloqueio atrioventricular de 2° grau do tipo I Mobitz após aplicação de penicilina benzatina: relato de caso Bloqueo atrioventricular de 2º grado tipo Mobitz I después de la aplicación de penicilina benzatina: relato de caso Second degree atrioventricular block Mobitz type I after administration of benzathine penicillin: case report

    Directory of Open Access Journals (Sweden)

    Lúcia de Sousa Belém

    2009-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio atrioventricular de 2° grau do tipo I de Mobitz é observado como alteração transitória na presença de infarto de parede inferior ou de intoxicação medicamentosa. O objetivo desse relato foi apresentar caso de bloqueio atrioventricular de 2° grau tipo I de Mobitz após aplicação de penicilina benzatina. RELATO DO CASO: Paciente apresentou síncope e sudorese após aplicação de penicilina benzatina. Ao exame físico apresentava-se sudoreico, bradicárdico e com ritmo irregular. Foi realizado eletrocardiograma (ECG que mostrava bloqueio atrioventricular de 2° grau do tipo I de Mobitz. Administrou-se atropina 0,5 mg por via venosa. Após uma hora foi repetido o ECG que apresentava traçado normal. Paciente permaneceu seis horas assintomático e então recebeu alta. CONCLUSÕES: O bloqueio atrioventricular de 2° grau do tipo I de Mobitz surgiu após aplicação de penicilina benzatina.JUSTIFICATIVA Y OBJETIVOS: El bloqueo atrioventricular de 2° grado del tipo I de Mobitz es observado como una alteración transitoria en la presencia de infarto de la pared inferior o de intoxicación medicamentosa. El objetivo de este relato fue presentar un caso de bloqueo atrioventricular de 2° grado tipo I de Mobitz después de la aplicación de penicilina benzatina. RELATO DEL CASO: Paciente que presentó síncope y sudoración después de la aplicación de penicilina benzatina. En el examen físico sudaba, estaba bradicárdico y con ritmo irregular. Fue realizado el electrocardiograma (ECG que mostraba un bloqueo atrioventricular de 2° del tipo I de Mobitz. Se le administró atropina 0,5 mg por vía venosa. Después de una hora, fue repetido el ECG que presentaba un trazado normal. El paciente permaneció seis horas asintomático y entonces recibió el alta. CONCLUSIONES: El bloqueo atrioventricular de 2° grado del tipo I de Mobitz surgió después de la aplicación de la penicilina benzatina.BACKGROUND AND

  4. Cateterismo posterior do plexo braquial em cão: estudo radiológico e avaliação de três protocolos anestésicos na duração do bloqueio motor e sensitivo

    OpenAIRE

    A.N. Teixeira; P.O.B. Jesus; F. Antunes; B.A. Mota

    2013-01-01

    Avaliou-se a eficiência do cateterismo posterior do plexo braquial em cães para promover bloqueio motor e sensitivo, por meio de três protocolos anestésicos. Foram utilizados nove cães, machos e fêmeas, sem distinção de raça e idade, com peso variando de 6 a 15kg, distribuídos em três grupos de três animais por grupo. Após a confirmação do correto posicionamento do cateter pela via posterior do plexo braquial por meio do exame radiográfico, foram aplicadas as medicações de acordo com os grupo...

  5. Estudo comparativo entre ultrassom e neuroestimulação no bloqueio do plexo braquial pela via axilar Estudio comparativo entre ultrasonido y neuroestimulación en el bloqueo del plexo braquial por la vía axilar A comparative study between ultrasound and neurostimulation guided axillary brachial plexus block

    OpenAIRE

    Diogo Brüggemann da Conceição; Pablo Escovedo Helayel; Getúlio Rodrigues de Oliveira Filho

    2009-01-01

    JUSTIFICATIVA E OBJETIVOS: O uso do ultrassom em Anestesia Regional vem crescendo. Existem poucos estudos comparando o uso do ultrassom com a neuroestimulação. O objetivo deste estudo foi comparar a execução do bloqueio do plexo braquial pela via axilar guiado por neuroestimulação com dupla injeção e guiado por ultrassonografia em procedimentos cirúrgicos na mão. Para isto, foram comparados o tempo de realização, a taxa de sucesso e complicações. MÉTODO: Após a aprovação do Comitê de Ética em...

  6. Contribución del soporte nutricional al tratamiento de las alteraciones neuro-musculares del paciente crítico Contribution of nutritional support to treatment neuromuscular impairments of critically ill patients

    Directory of Open Access Journals (Sweden)

    J. C. Montejo González

    2006-05-01

    Full Text Available Las alteraciones neuromusculares que tienen lugar en el paciente crítico han sido atribuidas a factores como la situación séptica, la liberación de mediadores inflamatorioso el empleo de fármacos que afectan desfavorablemente a la función neuro-muscular. El papel de factores metabólicos y nutricionales en el desarrollo de esta patología ha recibido poca atención. En la actualidad, el empleo de protocolos de control intensivo de la glucemia podría tener gran interés en la prevención de las alteraciones neuro-musculares de los pacientes críticos. Los mecanismos exactos de la implicación de la hiperglucemia en esta patología son, todavía, desconocidos, aunque la evidencia de los datos procedentes de la investigación es importante. La miopatía caquectizante (atrofia muscular tiene lugar de manera habitual como consecuencia de los cambios obligados por la respuesta metabólica al estrés. El efecto del aporte de nutrientes sobre la ganancia de masa muscular es muy limitado, por lo que deben estudiarse otras acciones dirigidas a recuperar, de manera más rápida, la masa muscular perdida. Deben evitarse pautas agresivas de renutrición con objeto de prevenir el síndrome de realimentación y el consiguiente mayor deterioro de la función muscular. El aporte de substratos específicos, como la glutamina, podría tener un efecto beneficioso en la recuperación de las alteraciones neuro-musculares del paciente crítico. No obstante, no existen aún datos para justificar su empleo si el único objetivo es la recuperación de la función neuro-muscular.Neuromuscular impairments occurring in the critically ill patient have been attributed to factors such as sepsis, release of inflammatory mediators, or the use of drugs unfavorably affecting neuromuscular function. The role of metabolic and nutritional factors in the development of this condition has received little attention. Currently, the use of protocols of intensive glycemia monitoring

  7. The Neuromuscular Junction (NMJ: aging at the crossroad between nerves and muscle

    Directory of Open Access Journals (Sweden)

    Marta eGonzalez-Freire

    2014-08-01

    Full Text Available Aging is associated with a progressive loss of muscle mass and strength and a decline in neurophysiological functions. Age-related neuromuscular junction (NMJ plays a key role in musculoskeletal impairment that occurs with aging. However, whether changes in the NMJ precede or follow the decline of muscle mass and strength remains unresolved. Many factors such as mitochondrial dysfunction, oxidative stress, inflammation, changes in the innervation of muscle fibers and mechanical properties of the motor units probably perform an important role in NMJ degeneration and muscle mass and strength decline in late life. This review addresses the primary events that might lead to NMJ dysfunction with aging, including studies on biomarkers, signaling pathways and animal models. Interventions such as caloric restriction (CR and exercise may positively affect the NMJ through this mechanism and attenuate the age-related progressive impairment in motor function.

  8. Kismet positively regulates glutamate receptor localization and synaptic transmission at the Drosophila neuromuscular junction.

    Directory of Open Access Journals (Sweden)

    Rupa Ghosh

    Full Text Available The Drosophila neuromuscular junction (NMJ is a glutamatergic synapse that is structurally and functionally similar to mammalian glutamatergic synapses. These synapses can, as a result of changes in activity, alter the strength of their connections via processes that require chromatin remodeling and changes in gene expression. The chromodomain helicase DNA binding (CHD protein, Kismet (Kis, is expressed in both motor neuron nuclei and postsynaptic muscle nuclei of the Drosophila larvae. Here, we show that Kis is important for motor neuron synaptic morphology, the localization and clustering of postsynaptic glutamate receptors, larval motor behavior, and synaptic transmission. Our data suggest that Kis is part of the machinery that modulates the development and function of the NMJ. Kis is the homolog to human CHD7, which is mutated in CHARGE syndrome. Thus, our data suggest novel avenues of investigation for synaptic defects associated with CHARGE syndrome.

  9. Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie

    2014-01-01

    Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics Larsen CM1, Juul-Kristensen B1,2 Holtermann A3, Lund H1,2, Søgaard K1 1University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics, DK 2Institute...... patient sample with SIS, and to assess the clinimetric properties of clinical assessment methods of scapular kinematics as important aspects for optimising effect measures of treatment in order to improve clinical guidelines in this area. METHODS: Scapular muscle activity was examined, 1) during......, the SIS group had a lower scapular muscle control, 3) When addressing the possibility for measuring scapular kinematics clinically, the findings show a substantially larger number of clinical assessment methods for scapular position and function than previously reported. None of the included clinical...

  10. Brain-Controlled Neuromuscular Stimulation to Drive Neural Plasticity and Functional Recovery

    Science.gov (United States)

    Ethier, C.; Gallego, J.A.; Miller, L.E.

    2015-01-01

    There is mounting evidence that appropriately timed neuromuscular stimulation can induce neural plasticity and generate functional recovery from motor disorders. This review addresses the idea that coordinating stimulation with a patient’s voluntary effort might further enhance neurorehabilitation. Studies in cell cultures and behaving animals have delineated the rules underlying neural plasticity when single neurons are used as triggers. However, the rules governing more complex stimuli and larger networks are less well understood. We argue that functional recovery might be optimized if stimulation were modulated by a brain machine interface, to matched the details of the patient’s voluntary intent. The potential of this novel approach highlights the need for a better understanding of the complex rules underlying this form of plasticity. PMID:25827275

  11. Effects of intensive physical rehabilitation on neuromuscular adaptations in adults with poststroke hemiparesis

    DEFF Research Database (Denmark)

    Andersen, Lars L; Zeeman, Peter; Jørgensen, Jørgen R;

    2011-01-01

    Hemiparesis-disability and muscle weakness of 1 side of the body-is a common consequence of stroke. High-intensity strength training may be beneficial to regain function, but strength coaches in the field of rehabilitation need evidence-based guidelines. The purpose of this study was to evaluate...... the effect of intensive physical rehabilitation on neuromuscular and functional adaptations in outpatients suffering from hemiparesis after stroke. A within-subject repeated-measures design with the paretic leg as the experimental leg and the nonparetic leg as the control leg was used. Eleven outpatients...... with hemiparesis after stroke participated in 12 weeks of intensive physical rehabilitation comprising unilateral high-intensity strength training with near-maximal loads (4-12 repetition maximum) and body weight supported treadmill training. At baseline and 12-week follow-up, the patients went through testing...

  12. Neuromuscular adaptations to different modes of combined strength and endurance training.

    Science.gov (United States)

    Eklund, D; Pulverenti, T; Bankers, S; Avela, J; Newton, R; Schumann, M; Häkkinen, K

    2015-02-01

    The present study investigated neuromuscular adaptations between same-session combined strength and endurance training with 2 loading orders and different day combined training over 24 weeks. 56 subjects were divided into different day (DD) combined strength and endurance training (4-6 d·wk(-1)) and same-session combined training: endurance preceding strength (E+S) or vice versa (S+E) (2-3 d·wk(-1)). Dynamic and isometric strength, EMG, voluntary activation, muscle cross-sectional area and endurance performance were measured. All groups increased dynamic one-repetition maximum (pmuscle cross-sectional area (ptraining (pmuscle actions. A high correlation (padaptations showed indications of being compromised and highly individual relating to changes in isometric strength when E+S-training was performed, while gains in one-repetition maximum, endurance performance and hypertrophy did not differ between the training modes.

  13. Feasibility of neuromuscular training in patients with severe hip or knee OA

    DEFF Research Database (Denmark)

    Ageberg, Eva; Link, Anne; Roos, Ewa M

    2010-01-01

    knee injuries, to older patients with severe hip or knee OA. We hypothesized that the training program was feasible, determined as: 1) at most acceptable self-reported pain following training; 2) decreased or unchanged pain during the training period; 3) few joint specific adverse events related to...... training, and 4) achieved progression of training level during the training period. METHODS: Seventy-six patients, between 60 and 77 years, with severe hip (n = 38, 55% women) or knee OA (n = 38, 61% women) underwent an individualized, goal-based neuromuscular training program (NEMEX-TJR) in groups for a...... were: not attending or ceasing training because of increased pain/problems in the index joint related to training, and self-reported pain > 5 after training. The level of difficulty of training was registered. RESULTS: Patients with severe OA of the hip or knee reported safe pain (median 2 cm) after...

  14. [Mechanism of the development of neuromuscular disorders in Itsenko-Cushing disease].

    Science.gov (United States)

    Agafonov, B V; Lahutina, T S; Deianova, A F

    1982-01-01

    The results of electromyographic studies indicate that the affection of the neuromuscular system is seen in all the patients with Icenko-Cushing's disease. Changes in different indices of the electromyogram (EMG), i.e. denervation activity, a character of the summary EMG alteration, mean duration of the motor unit action potentials (MUAP), the number of polyphase action potentials, their amplitude and the MUAP synchronization in different spheres indicate a neurogenic character of this affection. It was shown that both denervation and reinnervation processes are more pronounced in the foot muscles than in the hand ones. The denervation process is seemed to be primarily developed in the foot muscles, followed by the hand musculature injury. Therefore, the changes in several EMG parameters may be seen during several stages of the disease in some muscles and not to be observed in the others. PMID:7156070

  15. Cholinergic neuromuscular junctions in Brachionus calyciflorus and Lecane quadridentata (Rotifera:Monogononta)

    Institute of Scientific and Technical Information of China (English)

    Ignacio Alejandro Prez-Legaspi; Alma Lilin Guerrero-Barrera; Ivn Jos Galvn-Mendoza; Jos Luis Quintanar; Roberto Rico-Martnez

    2014-01-01

    Objective:To identify the presence of joint muscular and cholinergic systems in two freshwater rotifer species, Brachionus calyciflorus and Lecane quadridentata. Methods: The muscle actin fibers were stained with phalloidin-linked fluorescent dye, and acetylcholine was detected with Amplex Red Acetylcholine/Acetylcholinesterase Assay Kit, and then confocal scanning laser microscopy was used. Results:The musculature of Brachionus calyciflorus showed a pattern similar to other species of the same genus, while that of Lecane quadridentata was different from other rotifer genera described previously. The cholinergic system was determined by co-localization of both muscles and acetylcholine labels in the whole rotifer, suggesting the presence of neuromuscular junctions. Conclusions: The distribution pattern of muscular and acetylcholine systems showed considerable differences between the two species that might be related to different adaptations to particular ecological niches. The confirmation of a cholinergic system in rotifers contributes to the development of potential neuro-pharmacological and toxicological studies using rotifers as model organism.

  16. Coordinated motor neuron axon growth and neuromuscular synaptogenesis are promoted by CPG15 in vivo.

    Science.gov (United States)

    Javaherian, Ashkan; Cline, Hollis T

    2005-02-17

    We have used in vivo time-lapse two-photon imaging of single motor neuron axons labeled with GFP combined with labeling of presynaptic vesicle clusters and postsynaptic acetylcholine receptors in Xenopus laevis tadpoles to determine the dynamic rearrangement of individual axon branches and synaptogenesis during motor axon arbor development. Control GFP-labeled axons are highly dynamic during the period when axon arbors are elaborating. Axon branches emerge from sites of synaptic vesicle clusters. These data indicate that motor neuron axon elaboration and synaptogenesis are concurrent and iterative. We tested the role of Candidate Plasticity Gene 15 (CPG15, also known as Neuritin), an activity-regulated gene that is expressed in the developing motor neurons in this process. CPG15 expression enhances the development of motor neuron axon arbors by promoting neuromuscular synaptogenesis and by increasing the addition of new axon branches. PMID:15721237

  17. Autoantibodies to neurotransmitter receptors and ion channels: from neuromuscular to neuropsychiatric disorders

    Directory of Open Access Journals (Sweden)

    Pilar eMartinez-Martinez

    2013-09-01

    Full Text Available Changes of voltage-gated ion channels and ligand-gated receptor channels caused by mutation or autoimmune attack are the cause of so-called channelopathies in the central and peripheral nervous system. We present the pathophysiology of channelopathies of the neuromuscular junction in terms of loss-of-function and gain-of-function principles. Autoantibodies generally have reduced access to the CNS, but in some cases this is enough to cause disease. A review is provided of recent findings implicating autoantibodies against ligand–activated receptor channels and potassium channels in psychiatric and neurological disorders, including schizophrenia and limbic encephalitis. The emergence of channelopathy-related neuropsychiatric disorders has implications for research and practice.

  18. The neuro-muscular system in fresh-water furcocercaria from Belarus. I Schistosomatidae.

    Science.gov (United States)

    Tolstenkov, Oleg O; Akimova, Ludmila N; Chrisanfova, Galina G; Terenina, Nadezhda B; Gustafsson, Margaretha K S

    2012-01-01

    The neuro-muscular system (NMS) in cercariae of the family Schistosomatidae from Belarus was studied with immunocytochemical methods and confocal scanning laser microscopy. The specimens of Bilharziella polonica were compared with Trichobilharzia szidati and Trichobilharzia franki. The patterns of F-actin in the musculature, 5-HT-immunoreactive (IR), FMRFamide-IR neuronal elements and α-tubulin-IR in sensory receptors and nerves were investigated. No indications of structural differences in the musculature, the 5-HT-IR, FMRF-IR neuronal elements and the general distribution of sensory receptors were noticed between cercariae of Trichobilharzia spp. The number of 5-HT-IR neurons in the cercarial bodies is 16. In cercaria B. polonica, the tail musculature is weaker than in Trichobilharzia spp. A detailed schematic picture of the NMS in the tail of Trichobilharzia spp. cercaria is given. The function of NMS elements in the tail is discussed.

  19. The neuro-muscular system in continuously swimming cercariae from Belarus. I Xiphidiocercariae.

    Science.gov (United States)

    Tolstenkov, Oleg O; Akimova, Ludmila N; Terenina, Nadezhda B; Gustafsson, Margaretha K S

    2012-11-01

    The neuromuscular system (NMS) in cercariae of Neoastiotrema trituri, Plagiorchis elegans, Omphalometra flexuosa, Skrjabinoeces similis and Prosthogonimus ovatus was studied with immunocytochemical methods and confocal scanning laser microscopy. The patterns of F-actin in the musculature, 5-HT immunoreactive (IR), FMRFamide-IR neuronal elements and α-tubulin-IR sensory receptors were investigated, and they were found to be rather similar in all the cercariae studied. Four species have seven paired 5-HT-IR neurons in the body, and P. elegans has eight. N. trituri has three 5-HT-IR neurons in each brain ganglion, while the other species have four. A high degree of conformity in the structure of the NMS was observed, probably reflecting the close phylogenetic relationship and the similar strategy of host finding.

  20. Pharmacotherapy to protect the neuromuscular junction after acute organophosphorus pesticide poisoning.

    Science.gov (United States)

    Bird, Steven B; Krajacic, Predrag; Sawamoto, Keigo; Bunya, Naofumi; Loro, Emanuele; Khurana, Tejvir S

    2016-06-01

    Organophosphorus (OP) pesticide poisoning is a leading cause of morbidity and mortality in the developing world, affecting an estimated three million people annually. Much of the morbidity is directly related to muscle weakness, which develops 1-4 days after poisoning. This muscle weakness, termed the intermediate syndrome (IMS), leads to respiratory, bulbar, and proximal limb weakness and frequently necessitates the use of mechanical ventilation. While not entirely understood, the IMS is most likely due to persistently elevated acetylcholine (ACh), which activates nicotinic ACh receptors at the neuromuscular junction (NMJ). Thus, the NMJ is potentially a target-rich area for the development of new therapies for acute OP poisoning. In this manuscript, we discuss what is known about the IMS and studies investigating the use of nicotinic ACh receptor antagonists to prevent or mitigate NMJ dysfunction after acute OP poisoning. PMID:27258847

  1. Neuromuscular Risk Factors for Knee and Ankle Ligament Injuries in Male Youth Soccer Players.

    Science.gov (United States)

    Read, Paul J; Oliver, Jon L; De Ste Croix, Mark B A; Myer, Gregory D; Lloyd, Rhodri S

    2016-08-01

    Injuries reported in male youth soccer players most commonly occur in the lower extremities, and include a high proportion of ligament sprains at the ankle and knee with a lower proportion of overuse injuries. There is currently a paucity of available literature that examines age- and sex-specific injury risk factors for such injuries within youth soccer players. Epidemiological data have reported movements that lead to non-contact ligament injury include running, twisting and turning, over-reaching and landing. Altered neuromuscular control during these actions has been suggested as a key mechanism in females and adult populations; however, data available in male soccer players is sparse. The focus of this article is to review the available literature and elucidate prevalent risk factors pertaining to male youth soccer players which may contribute to their relative risk of injury. PMID:26856339

  2. Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders;

    2014-01-01

    muscle power. RESULTS: Included were 165 patients, 56% female, average age 67 years (SD ± 8), and a body mass index of 30 (SD ± 5), who were scheduled for primary hip or knee replacement. The postintervention difference between mean changes in ADL was 7.2 points (95% CI 3.5 to 10.9, p = 0.0002) in favor......OBJECTIVE: Knowledge about the effects of exercise in severe and endstage osteoarthritis (OA) is limited. The aim was to evaluate the efficacy of a neuromuscular exercise program in patients with clinically severe hip or knee OA. METHODS: This was a randomized controlled assessor-blinded trial...... and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb...

  3. Same-day physical therapy consults in an outpatient neuromuscular disease physician clinic

    Science.gov (United States)

    Pucillo, Evan M; Christensen-Mayer, Nancy; Poole, Shelly D; Whitten, Denise M; Freeman, Danielle; Bohe, Blake R; Swensen, Brandon R; Smith, A Gordon; Johnson, Nicholas E

    2016-01-01

    Background Team-based care has been shown to offer more comprehensive benefits to patients when compared to standard physician-based care alone in clinics for chronic conditions. However, apart from grant-funded multidisciplinary clinics, there are no reports on the usage of same-day physical therapy (PT) consults within a daily outpatient neuromuscular disease (NMD) physician clinic. Objective To determine the impact of same-day PT consults at the University of Utah’s outpatient Clinical Neurosciences Center. Design A qualitative assessment and survey of patient satisfaction. Methods An eight question Health Insurance Portability and Accountability Act-compliant patient satisfaction survey using a 5-point Likert scale was administered. Demographic data and Press-Ganey Provider Satisfaction surveys were retrospectively collected from electronic medical records for patients receiving same-day PT encounters in the neuromuscular division over 1 year. Results Mean (standard deviation) age was 54.22 (19.81) years for 134 patient encounters, median age was 60 years, with 76 male (57%) and 58 female (43%) patients. Mean Likert score for 61 self-reported patient satisfaction surveys for same-day PT consults was 4.87 (97.4%). Press-Ganey Provider Satisfaction scores improved from 89.9% (N=287) for the year prior to 90.8% (N=320) for the corresponding year (P=0.427). A total of 46 (75.4%) patients have either never before received PT care or never before received PT care for their NMD, 67.4% of whom were male. Conclusion Same-day PT consults in an outpatient NMD physician clinic demonstrated excellent patient satisfaction and improved access to specialty care. This model could potentially be implemented in other academic medical centers to improve access to rehabilitation services for patients with NMD. PMID:27757040

  4. A comparison of assisted and unassisted proprioceptive neuromuscular facilitation techniques and static stretching.

    Science.gov (United States)

    Maddigan, Meaghan E; Peach, Ashley A; Behm, David G

    2012-05-01

    A comparison of assisted and unassisted proprioceptive neuromuscular facilitation techniques and static stretching. J Strength Cond Res 26(5): 1238-1244, 2012-Proprioceptive neuromuscular facilitation (PNF) stretching often requires a partner. Straps are available allowing an individual to perform PNF stretching alone. It is not known if a strap provides similar improvements in the range of motion (ROM) as partner-assisted PNF or static stretching. The purpose of this study was to compare assisted and unassisted (with a strap) PNF stretching and static stretching. Hip joint ROM, reaction time (RT), and movement time (MT) were measured prestretching and poststretching. Thirteen recreationally active adults participated in this study. The participants were subjected to 5 different stretch interventions in a random order on separate days. Stretch conditions included unassisted PNF stretching using (a) isometric, (b) concentric, and (c) eccentric contractions with a stretch strap, (d) partner-assisted isometric PNF, and (e) static stretching. The RT, MT, dynamic, active, passive hip flexion angle, and angular velocity with dynamic hip flexion were measured before and after the intervention. The ROM improved (p < 0.05) 2.6, 2.7, and 5.4%, respectively, with dynamic, active static, and passive static ROM, but there was no significant difference between the stretching protocols. There was a main effect for time (p < 0.05) with all stretching conditions negatively impacting dynamic angular velocity (9.2%). Although there was no significant effect on RT, MT showed a negative main effect for time (p < 0.05) slowing 3.4%. In conclusion, it was found that all 3 forms of active stretching provided similar improvements in the ROM and poststretching performance decrements in MT and angular velocity. Thus, individuals can implement PNF stretching techniques with a partner or alone with a strap to improve ROM, but athletes should not use these techniques before important

  5. Assembly, plasticity and selective vulnerability to disease of mouse neuromuscular junctions.

    Science.gov (United States)

    Santos, Alexandre Ferrão; Caroni, Pico

    2003-01-01

    Although physiological differences among neuromuscular junctions (NMJs) have long been known, NMJs have usually been considered as one type of synapse, restricting their potential value as model systems to investigate mechanisms controlling synapse assembly and plasticity. Here we discuss recent evidence that skeletal muscles in the mouse can be subdivided into two previously unrecognized subtypes, designated FaSyn and DeSyn muscles. These muscles differ in the pattern of neuromuscular synaptogenesis during embryonic development. Differences between classes are intrinsic to the muscles, and manifest in the absence of innervation or agrin. The distinct rates of synaptogenesis in the periphery may influence processes of circuit maturation through retrograde signals. While NMJs on FaSyn and DeSyn muscles exhibit a comparable anatomical organization in postnatal mice, treatments that challenge synaptic stability result in nerve sprouting, NMJ remodeling, and ectopic synaptogenesis selectively on DeSyn muscles. This anatomical plasticity of NMJs diminishes greatly between 2 and 6 months postnatally. NMJs lacking this plasticity are lost selectively and very early on in mouse models of motoneuron disease, suggesting that disease-associated motoneuron dysfunction may fail to initiate maintenance processes at "non-plastic" NMJs. Transgenic mice overexpressing growth-promoting proteins in motoneurons exhibit greatly enhanced stimulus-induced sprouting restricted to DeSyn muscles, supporting the notion that anatomical plasticity at the NMJ is primarily controlled by processes in the postsynaptic muscle. The discovery that entire muscles in the mouse differ substantially in the anatomical plasticity of their synapses establishes NMJs as a uniquely advantageous experimental system to investigate mechanisms controlling synaptic rearrangements at defined synapses in vivo.

  6. Effect of resistance training on neuromuscular junctions of young and aged muscles featuring different recruitment patterns.

    Science.gov (United States)

    Deschenes, Michael R; Sherman, E Grace; Roby, Mackenzie A; Glass, Emily K; Harris, M Brennan

    2015-03-01

    To examine the effects of aging on neuromuscular adaptations to resistance training (i.e., weight lifting), young (9 months of age) and aged (20 months of age) male rats either participated in a 7-week ladder climbing protocol with additional weight attached to their tails or served as controls (n = 10/group). At the conclusion, rats were euthanized and hindlimb muscles were quickly removed and frozen for later analysis. Longitudinal sections of the soleus and plantaris muscles were collected, and pre- and postsynaptic features of neuromuscular junctions (NMJs) were visualized with immunofluorescence staining procedures. Cross-sections of the same muscles were histochemically stained to determine myofiber profiles (fiber type and size). Statistical analysis was by two-way ANOVA (main effects of age and treatment) with significance set at P ≤ 0.05. Results revealed that training-induced remodeling of NMJs was evident only at the postsynaptic endplate region of soleus fast-twitch myofibers. In contrast, aging was associated with pre- and postsynaptic remodeling in fast- and slow-twitch myofibers of the plantaris. Although both the soleus and the plantaris muscles failed to display either training or aging-related alterations in myofiber size, aged plantaris muscles exhibited an increased expression of type I (slow-twitch) myofibers in conjunction with a reduced percentage of type II (fast-twitch) myofibers, suggesting early stages of sarcopenia. These data demonstrate the high degree of specificity of synaptic modifications made in response to exercise and aging and that the sparsely recruited plantaris is more vulnerable to the effects of aging than the more frequently recruited soleus muscle.

  7. Combined effect of heat stress, dehydration and exercise on neuromuscular function in humans.

    Science.gov (United States)

    Ftaiti, F; Grélot, L; Coudreuse, J M; Nicol, C

    2001-01-01

    This study examined the combined effect of exercise induced hyperthermia and dehydration on neuromuscular function in human subjects. Six trained male runners ran for 40 min on a treadmill at 65% of their maximal aerobic velocity while wearing a tracksuit covered with an impermeable jacket and pants to impair the evaporation of sweat. These stressful experimental running conditions led the runners to a physiological status close to exhaustion. On average, the 40 min run ended at a heart rate of 196 (SD 8) beats.min-1, a tympanic temperature of 40 (SD 0.3) degrees C and with a loss of body mass of 2 (SD 0.5)%. Pre- and post-running strength tests included measurements of maximal knee extension and flexion torques in both isometric and isokinetic (at 60 and 240 degrees.s-1) conditions. A 20 s endurance test at 240 degrees.s-1 was also performed. Surface electromyographic (EMG) activity was recorded from six knee extensor and flexor muscles during the entire protocol. The treadmill run led to clear decrements in maximal extension torque and EMG activity both in isometric and at the slowest isokinetic velocity (60 degrees.s-1). However, no differences in these parameters were observed at 240 degrees.s-1. Furthermore, the EMG patterns of the major knee extensor and flexor muscles remained remarkably stable during the treadmill run. These results demonstrate that the exercise-induced hyperthermia and dehydration in the present experiments had only minor effects on the neuromuscular performance. However, it is also suggested that high internal body temperature per se could limit the production of high force levels.

  8. Electromyographic monitoring of facial nerve under different levels of neuromuscular blockade during middle ear microsurgery

    Institute of Scientific and Technical Information of China (English)

    CAI Yi-rong; XU Jing; CHEN Lian-hua; CHI Fang-lu

    2009-01-01

    Background The evoked electromyography (EMG) is frequently used to identify facial nerve in order to prevent its damage during surgeries. Partial neuromuscular blockade (NMB) has been suggested to favor EMG activity and insure patients' safety. The aim of this study was to determine an adequate level of NMB correspondent to sensible facial nerve identification by evaluating the relationship between facial EMG responses and peripheral NMB levels during the middle ear surgeries.Methods Facial nerve evoked EMG and NMB monitoring were performed simultaneously in 40 patients who underwent tympanoplasty. Facial electromyographic responses were recorded by insertion of needle electrodes into the orbicularis oris and orbicularis oculi muscles after electrical stimulation on facial nerve. The NMB was observed objectively with the hypothenar muscle's twitching after electrical stimulation of ulnar nerve, and the intensity of blockade was adjusted at levels of 0, 25%, 50%, 75%, 90%, and 100% respectively with increased intravenous infusion of Rocuronium (muscle relaxant).Results All of the patients had detectable EMG responses at the levels of NMB ≤50%. Four out of forty patients had no EMG response at the levels of NMB ≥75%. A significant linear positive correlation was present between stimulation thresholds and NMB levels while a linear negative correlation was present between EMG amplitudes and NMB levels.Conclusions The facial nerve monitoring via facial electromyographic responses can be obtained when an intraoperative partial neuromuscular blockade is induced to provide an adequate immobilization of the patient. The 50% NMB should be considered as the choice of anesthetic management for facial nerve monitoring in otologic microsurgery based on the relationship of correlation.

  9. Carbohydrate vs protein supplementation for recovery of neuromuscular function following prolonged load carriage

    Directory of Open Access Journals (Sweden)

    Fallowfield Joanne L

    2010-01-01

    Full Text Available Abstract Background This study examined the effect of carbohydrate and whey protein supplements on recovery of neuromuscular function after prolonged load carriage. Methods Ten male participants (body mass: 81.5 ± 10.5 kg, age: 28 ± 9 years, O2max: 55.0 ± 5.5 ml·kg-1·min-1 completed three treadmill walking tests (2 hr, 6.5 km·h-1, carrying a 25 kg backpack consuming 500 ml of either: (1 Placebo (flavoured water [PLA], (2 6.4% Carbohydrate Solution [CHO] or (3 7.0% Whey Protein Solution [PRO]. For three days after load carriage, participants consumed two 500 ml supplement boluses. Muscle performance was measured before and at 0, 24, 48 and 72 h after load carriage, during voluntary and electrically stimulated contractions. Results Isometric knee extension force decreased immediately after load carriage with no difference between conditions. During recovery, isometric force returned to pre-exercise values at 48 h for CHO and PRO but at 72 h for PLA. Voluntary activation decreased immediately after load carriage and returned to pre-exercise values at 24 h in all conditions (P = 0.086. During recovery, there were no differences between conditions for the change in isokinetic peak torque. Following reductions immediately after load carriage, knee extensor and flexor peak torque (60°·s-1 recovered to pre-exercise values at 72 h. Trunk extensor and flexor peak torque (15°·s-1 recovered to pre-exercise values at 24 h (P = 0.091 and 48 h (P = 0.177, respectively. Conclusion Recovery of neuromuscular function after prolonged load carriage is improved with either carbohydrate or whey protein supplementation for isometric contractions but not for isokinetic contractions.

  10. Neuromuscular Fatigue and Physiological Responses After Five Dynamic Squat Exercise Protocols.

    Science.gov (United States)

    Raeder, Christian; Wiewelhove, Thimo; Westphal-Martinez, Marc P; Fernandez-Fernandez, Jaime; de Paula Simola, Rauno A; Kellmann, Michael; Meyer, Tim; Pfeiffer, Mark; Ferrauti, Alexander

    2016-04-01

    This aimed to analyze neuromuscular, physiological and perceptual responses to a single bout of 5 different dynamic squat exercise protocols. In a randomized and counterbalanced order, 15 male resistance-trained athletes (mean ± SD; age: 23.1 ± 1.9 years, body mass: 77.4 ± 8.0 kg) completed traditional multiple sets (MS: 4 × 6, 85% 1 repetition maximum [RM]), drop sets (DS: 1 × 6, 85% 1RM + 3 drop sets), eccentric overload (EO: 4 × 6, 70% 1RM concentric, 100% 1RM eccentric), flywheel YoYo squat (FW: 4 × 6, all-out), and a plyometric jump protocol (PJ: 4 × 15, all-out). Blood lactate (La), ratings of perceived exertion (RPE), counter movement jump height (CMJ), multiple rebound jump (MRJ) performance, maximal voluntary isometric contraction force, serum creatine kinase (CK) and delayed onset muscle soreness were measured. Immediately post exercise, La was significantly (p protocols. There was a significant time × protocol interaction (p ≤ 0.05) in MRJ with a significant lower performance in DS, EO, and FW compared with PJ (0.5 hours post exercise), and in EO compared with all other protocols (24 hours post exercise). A significant main time effect with peak values 24 hours post exercise was observed in CK serum concentrations (p protocol interaction. In conclusion, (a) metabolic and perceptual demands were higher in FW and EO compared with MS, DS and PJ, (b) neuromuscular fatigue was consistent up to 48 hours post exercise in all protocols, and PMID:26349042

  11. Surgical complications in neuromuscular scoliosis operated with posterior- only approach using pedicle screw fixation

    Directory of Open Access Journals (Sweden)

    Singh Surya Udai

    2009-05-01

    Full Text Available Abstract Background There are no reports describing complications with posterior spinal fusion (PSF with segmental spinal instrumentation (SSI using pedicle screw fixation in patients with neuromuscular scoliosis. Methods Fifty neuromuscular patients (18 cerebral palsy, 18 Duchenne muscular dystrophy, 8 spinal muscular atrophy and 6 others were divided in two groups according to severity of curves; group I ( 90°. All underwent PSF and SSI with pedicle screw fixation. There were no anterior procedures. Perioperative (within three months of surgery and postoperative (after three months of surgery complications were retrospectively reviewed. Results There were fifty (37 perioperative, 13 postoperative complications. Hemo/pneumothorax, pleural effusion, pulmonary edema requiring ICU care, complete spinal cord injury, deep wound infection and death were major complications; while atelectesis, pneumonia, mild pleural effusion, UTI, ileus, vomiting, gastritis, tingling sensation or radiating pain in lower limb, superficial infection and wound dehiscence were minor complications. Regarding perioperative complications, 34(68% patients had at least one major or one minor complication. There were 16 patients with pulmonary, 14 with abdominal, 3 with wound related, 2 with neurological and 1 cardiovascular complications, respectively. There were two deaths, one due to cardiac arrest and other due to hypovolemic shock. Regarding postoperative complications 7 patients had coccygodynia, 3 had screw head prominence, 2 had bed sore and 1 had implant loosening, respectively. There was a significant relationship between age and increased intraoperative blood loss (p = 0.024. However it did not increased complications or need for ICU care. Similarly intraoperative blood loss > 3500 ml, severity of curve or need of pelvic fixation did not increase the complication rate or need for ICU. DMD patients had higher chances of coccygodynia postoperatively. Conclusion

  12. Effects of organophosphate,carbamate and pyrethroid insecticides and their mixtures on neuromuscular junction transmission

    Institute of Scientific and Technical Information of China (English)

    HeFS; XiaoC

    2002-01-01

    To investigate the effects of organophosphorus (OP),carbamate (Carb),pyrehroid (Pyr) insecticides and their mixtures on neuromuscular junction transmission (NMJT),dimethoate(D) and phoxim(P),methomyl(M),and fenvalerate(F) were selected.Rats were intraperitoneally intoxicated by D,P,M,F,D+M,D+F,P+M,or P+F with the dosage of each LD50 respectively.The function of the NMJT was assessed with the mean consecutive differences (MCD) of the latencies of single fiber action potentials detected by stimulation single fiber electromyography(SSFEMG) at the stimulus frequency of 20 Hz.The SSFEMG was also applied to detect the function of NMJT in 40 patients with OPs and their mixtures poisoning in this study.The results showed that (1)the myasthenia occurred only in rats with OPs and their mixtures poisoning,but not in F,M intoxicated rats.The increase of MCD shown by SSFEMG and induced by OP and their mixtures indicating a post-synaptic block was well correlated with the occurrence of myasthenia both in rats and patients(P<0.001);(2)the increase of MCD in rats of OP poisoning was significant in comparison with the control and F,M intoxicated rats;but was not significantly different from those in rats intoxicated by OP mixtures;(3)the MCDs were significantly increased in IMS patients of both acute OP poisoning and OP mixtures poisoning,but showing no significant difference between the two groups of patients.It is concluded that OP is the only responsible agent for the dysfunction of neuromuscular transmission induced by single OP and OP mixture insecticides which could be sensitively detected by SSFEMG.

  13. Impaired Axonal Na(+) Current by Hindlimb Unloading: Implication for Disuse Neuromuscular Atrophy.

    Science.gov (United States)

    Banzrai, Chimeglkham; Nodera, Hiroyuki; Kawarai, Toshitaka; Higashi, Saki; Okada, Ryo; Mori, Atsuko; Shimatani, Yoshimitsu; Osaki, Yusuke; Kaji, Ryuji

    2016-01-01

    This study aimed to characterize the excitability changes in peripheral motor axons caused by hindlimb unloading (HLU), which is a model of disuse neuromuscular atrophy. HLU was performed in normal 8-week-old male mice by fixing the proximal tail by a clip connected to the top of the animal's cage for 3 weeks. Axonal excitability studies were performed by stimulating the sciatic nerve at the ankle and recording the compound muscle action potential (CMAP) from the foot. The amplitudes of the motor responses of the unloading group were 51% of the control amplitudes [2.2 ± 1.3 mV (HLU) vs. 4.3 ± 1.2 mV (Control), P = 0.03]. Multiple axonal excitability analysis showed that the unloading group had a smaller strength-duration time constant (SDTC) and late subexcitability (recovery cycle) than the controls [0.075 ± 0.01 (HLU) vs. 0.12 ± 0.01 (Control), P < 0.01; 5.4 ± 1.0 (HLU) vs. 10.0 ± 1.3 % (Control), P = 0.01, respectively]. Three weeks after releasing from HLU, the SDTC became comparable to the control range. Using a modeling study, the observed differences in the waveforms could be explained by reduced persistent Na(+) currents along with parameters related to current leakage. Quantification of RNA of a SCA1A gene coding a voltage-gated Na(+) channel tended to be decreased in the sciatic nerve in HLU. The present study suggested that axonal ion currents are altered in vivo by HLU. It is still undetermined whether the dysfunctional axonal ion currents have any pathogenicity on neuromuscular atrophy or are the results of neural plasticity by atrophy. PMID:26909041

  14. Bloqueio do plexo braquial por via interescalênica: efeitos sobre a função pulmonar Bloqueo del plexo braquial por vía interescalénica: efectos sobre la función pulmonar Interscalene brachial plexus block: effects on pulmonary function

    Directory of Open Access Journals (Sweden)

    Alexandre Hortense

    2010-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A via interescalênica é um dos acessos mais comumente utilizados no bloqueio do plexo braquial. Todavia, tem-se demonstrado associação dessa técnica com o bloqueio do nervo frênico ipsilateral. A disfunção diafragmática daí resultante provoca alterações na mecânica pulmonar, potencialmente deletérias em pacientes com limitação da reserva ventilatória. O objetivo do estudo foi avaliar a repercussão do bloqueio interescalênico sobre a função pulmonar por meio da medida da capacidade vital forçada (CVF. MÉTODO: Estudo duplamente encoberto com 30 pacientes, estado físico I ou II (ASA, distribuídos aleatoriamente em dois grupos de15. Foi administrada solução a 0,5% de ropivacaína (Grupo Ropi ou bupivacaína a 0,5% com epinefrina (Grupo Bupi. O bloqueio foi realizado utilizando estimulador de nervo periférico e sendo injetados 30 mL de anestésico local. Quatro espirometrias foram realizadas em cada paciente: antes do bloqueio, 30 minutos, 4 e 6 horas após. Os pacientes não receberam sedação. RESULTADOS: Um paciente do Grupo Ropi e três pacientes do Grupo Bupi foram excluídos do estudo por falha de bloqueio. A redução da CVF no Grupo Ropi foi máxima aos 30 minutos (25,1% e a partir de então houve tendência progressiva à recuperação. Já com bupivacaína, a redução da CVF pareceu ser menos acentuada nos diversos momentos estudados; observou-se redução adicional entre 30 minutos (15,8% e 4 horas (17,3%, sendo esta sem diferença estatística. A partir de 4 horas, notou-se tendência à recuperação. Em ambos os grupos, após 6 horas de bloqueio a CVF encontra-se ainda abaixo dos valores prévios. CONCLUSÕES: O bloqueio interescalênico reduz a CVF na maioria dos casos; as alterações foram mais acentuadas no Grupo Ropivacaína.JUSTIFICATIVA Y OBJETIVOS: La vía interescalénica es uno de los accesos más a menudo utilizados en el bloqueo del plexo braquial. Sin embargo, se ha

  15. Estudo comparativo dos bloqueios intercostal e interpleural para analgesia pós-operatória em colecistectomias abertas Estudio comparativo de los bloqueos intercostal e interpleural para analgesia pós-operatoria en colecistectomias abiertas Comparative study of intercostal and interpleural block for post-cholecystectomy analgesia

    Directory of Open Access Journals (Sweden)

    Antonio Mauro Vieira

    2003-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A analgesia no pós-operatório é desejada pelos pacientes e tem sido praticada pela maioria dos anestesiologistas. Além dos opióides, os anestésicos locais têm sido utilizados nos bloqueios periféricos e centrais para se obter a analgesia pós-operatória. O objetivo deste estudo foi comparar duas técnicas de bloqueio dos nervos intercostais para analgesia pós-operatória em colecistectomias abertas. MÉTODO: Sessenta pacientes foram submetidos a colecistectomias abertas com incisão subcostal e receberam bloqueio intercostal (Grupo IC, n=30 ou bloqueio interpleural (Grupo IP, n=30, ambos com 100 mg de bupivacaína a 0,5% com adrenalina, para analgesia pós-operatória. Foram avaliados os tempos de analgesia e as queixas relatadas pelos pacientes. RESULTADOS: A qualidade da analgesia foi considerada boa para ambas as técnicas. A duração média de analgesia foi de 505 minutos no grupo IP e 620 minutos no grupo IC, não havendo diferença estatística entre eles. Náuseas, vômitos e dor abdominal leve foram as queixas pós-operatórias mais freqüentes. Não se constatou qualquer complicação pós-operatória associada exclusivamente aos bloqueios, assim como não foi evidenciado nenhum caso de pneumotórax. CONCLUSÕES: Concluiu-se que as técnicas promoveram analgesia satisfatória após colecistectomia, sendo que o bloqueio interpleural apresentou maior facilidade de execução.JUSTIFICATIVA Y OBJETIVOS: La analgesia en el pós-operatorio es deseada por los pacientes y ha sido practicada por la mayoría de los anestesiologistas. Además de los opioides, los anestésicos locales han sido utilizados en los bloqueos periféricos y centrales para obtenerse la analgesia pós-operatoria. El objetivo de este estudio fue comparar dos técnicas de bloqueo de los nervios intercostales para analgesia pós-operatoria en colecistectomias abiertas. MÉTODO: Sesenta pacientes fueron sometidos a colecistectomias

  16. Fisiopatología de las alteraciones neuromusculares en el paciente crítico Pathophysiology of neuromuscular impairments in the critically ill patients

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    A. García de Lorenzo

    2006-05-01

    Full Text Available Objetivo: Analizar las causas y manifestaciones de la debilidad muscular que desarrollan los pacientes críticos durante su estancia en la UCI y revisar la bibliografía. Desarrollo: A principios de los años 80 se describió en pacientes críticos sépticos una polineuropatía axonal mixta que clínicamente se caracterizaba por una debilidad muscular de intensidad variable que en su vertiente más grave producía tetraplejia y/o dependencia del ventilador. Casi paralelamente se describió la miopatía aguda de los cuidados intensivos en pacientes asmáticos que eran ingresados en la UCI por exacerbación de su enfermedad. Con posterioridad se observó que esta miopatía se presentaba también en pacientes trasplantados, sépticos o quemados. Hay autores que consideran a la miopatía aguda de los cuidados intensivos como la primera causa de debilidad muscular en la UCI. Conclusiones: En este artículo se describen la clínica, etiopatogenia, diagnóstico y tratamiento de la polineuropatía del paciente crítico y de la miopatía aguda de los cuidados intensivos. Los dos cuadros clínicos son diferenciables en muchas ocasiones, siendo de gran ayuda los estudios neurofisiológicos y eventualmente la biopsia muscular. Aunque algunos autores prefieren englobar estas entidades bajo el nombre de polineuromiopatía, proponemos la denominación general de Síndrome Neuromuscular Agudo en el paciente crítico término más descriptivo, que no presupone un mecanismo ni una etiología única.Objective: to analyze the causes and manifestations of muscle weakness that critically ill patients develop during their staying at the ICU, and literature review. Development: in the early 1980s, a mixed axonal polyneuropathy was described in septic critically ill patients, which clinically manifested by muscle weakness of variable severity, leading to quadriplegia and/or ventilator dependency in its most severe presentation. Almost at the same time, an acute

  17. Estimulação elétrica neuromuscular em cães com atrofia muscular induzida Neuromuscular electric stimulation in dogs with induced muscle atrophy

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    C. Pelizzari

    2008-02-01

    Full Text Available Empregou-se a estimulação elétrica neuromuscular (EENM de baixa freqüência no músculo quadríceps femoral de cães com atrofia induzida e avaliou-se a ocorrência de ganho de massa nessa musculatura. Foram utilizados oito cães com pesos entre 15 e 30kg, distribuídos aleatoriamente em dois grupos denominados de I ou controle e II ou tratado. A articulação femorotibiopatelar esquerda foi imobilizada por 30 dias pelo método de transfixação percutânea tipo II, com retirada de aparelho de imobilização após esse período. Decorridas 48 horas da remoção, foi realizada a EENM nos cães do grupo II, cinco vezes por semana, com intervalo de 24 horas cada sessão, pelo período de 60 dias. Foram avaliadas a circunferência da coxa, a goniometria do joelho, a análise clínica da marcha, as enzimas creatina-quinase (CK e aspartato-amino-transferase (AST e a morfometria das fibras musculares em cortes transversais do músculo vasto lateral colhido mediante biópsia muscular. A EENM foi empregada no músculo quadríceps femoral na freqüência de 50Hz, duração de pulso de 300 milisegundos e relação de tempo on/off de 1:2. Quanto à morfometria das fibras do músculo vasto lateral, no grupo tratado houve aumento significativo (PLow frequency neuromuscular electrical stimulation (NMES was used on the femoral quadriceps of dogs with induced muscular atrophy and the occurrence of gain in mass in these muscles was evaluated. Eight dogs from 15 to 30kg were randomly distributed in two groups named I, or control; and II, or treated. For the induction of muscular atrophy, the left femoral-tibial-patellar joint was immobilized for 30 days by percutaneous transfixation type II. After 30 days, the immobilization device was removed. The NMES treatment began 48 hours after the removal of the immobilization device of the dogs of group II, and it was carried out five times per week with an interval of 24 hours between each session, for 60 days. The

  18. Bloqueio isquiático-femoral guiado por ultra-som para revisão de coto de amputação: relato de caso Bloqueo isquiático-femoral guiado por ultrasonido para revisión de muñón de amputación: relato de caso Ultrasound-guided sciatic-femoral block for revision of the amputation stump: case report

    OpenAIRE

    Pablo Escovedo Helayel; Diogo Bruggemann da Conceição; Carla Feix; Gustavo Luchi Boos; Bruno Schroder Nascimento; Getúlio Rodrigues de Oliveira Filho

    2008-01-01

    JUSTIFICATIVA E OBJETIVOS: O emprego da ultra-sonografia na anestesia regional vem se tornando cada vez mais difundido pelo seu papel facilitador e pela sua eficácia. A visualização direta por meio da ultra-sonografia permite que se identifiquem os nervos periféricos, independentemente da capacidade de se obter estimulação sensitiva ou motora. RELATO DO CASO: Paciente submetido à revisão de coto de amputação no nível do joelho sob bloqueio isquiático-femoral guiado por ultra-som com 40 mL de ...

  19. Prevalência de paralisia diafragmática após bloqueio de plexo braquial pela via posterior com ropivacaína a 0,2% Prevalencia de parálisis diafragmática después del bloqueo del plexo braquial por la vía posterior con ropivacaína a 0,2% Prevalence of diaphragmatic paralysis after brachial plexus blockade by the posterior approach with 0.2% ropivacaine

    OpenAIRE

    Marcos Guilherme Cunha Cruvinel; Carlos Henrique Viana de Castro; Yerkes Pereira Silva; Roberto Cardoso Bessa Júnior; Flávio de Oliveira França; Flávio Lago

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio de plexo braquial pela via interescalênica descrita por Winnie é uma das técnicas mais eficazes para promover analgesia pós-operatória de intervenções cirúrgicas no ombro. Uma de suas conseqüências é a paralisia diafragmática. Esta paralisia pode levar, em pacientes com algum grau de disfunção pulmonar prévia, à insuficiência respiratória. A abordagem do plexo braquial por via posterior tem conquistado espaço. O objetivo deste estudo foi determinar a prev...

  20. Antifungal compound produced by the cassava endophyte Bacillus pumilus MAIIIM4a Composto antifúngico produzido pelo endófito de mandioca Bacillus pumilus MAIIIM4a

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    Flávia Mandolesi Pereira de Melo

    2009-10-01

    Full Text Available In the search for new organisms and new secondary metabolites, a study was conducted to evaluate the diversity of endophytic bacteria from ethnovarieties of cassava cultivated by Brazilian Amazon Indian tribes and also to study the secondary metabolites produced by a Bacillus pumilus strain. Sixty seven cassava endophytic bacteria were subjected to 16S rRNA sequencing and FAME analysis. The bacterial profile revealed that 25% of all endophytic isolates belonged to the genus Bacillus. The isolate B. pumilus MAIIIM4a showed a strong inhibitory activity against the fungi Rhizoctonia solani, Pythium aphanidermatum and Sclerotium rolfsii. Secondary metabolites of this strain were extracted using hexane, dichloromethane and ethyl acetate. Extracts were subjected to bioautography and LC/MS analysis, which allowed the identification of pumilacidin, an antifungal compound produced by B. pumilus MAIIIM4a. The bacterial endophytic localization was confirmed by cassava cell tissue examination using scanning electron microscopy.Na busca de novos organismos e novos metabólitos secundários, um estudo foi conduzido visando avaliar a diversidade de bactérias endofíticas de etnovariedades de mandioca cultivadas por tribos indígenas da Amazônia brasileira e também para estudar metabólitos secundários produzidos por Bacillus pumilus. Sessenta e sete bactérias endofíticas de mandioca foram identificadas através do seqüenciamento do gene 16S rRNA e por meio da análise de ácidos graxos (FAME. Essas análises revelaram que 25% de todos os endofíticos pertenciam ao gênero Bacillus. O isolado Bacillus pumilus MAIIIM4a apresentou forte ação inibitória contra os fitopatógenos Rhizoctonia solani, Pythium aphanidermatum e Sclerotium rolfsii. Os metabólitos secundários deste isolado foram extraídos do sobrenadante usando-se hexano, diclorometano e acetato de etila. Esses extratos foram utilizados nas análises de bioautografia e LC-MS, as quais